Liraglutide - mankhwala ochizira matenda a shuga a 2: malangizo ndi kuwunika

Kodi liraglutide ndi chiyani?

Liraglutide ndi analogue yabwinobwino yamahomoni ake - glucagon-ngati peptide-1 (GLP-1), yomwe imapangidwa m'mimba yamagetsi poyankha chakudya ndipo imayambitsa kuphatikiza kwa insulin. Natural GLP-1 imawonongeka m'thupi pakangotha ​​mphindi zochepa, kapangidwe kameneka kamasiyanasiyana mu izi mwa ma 2 amino acid omwe amapangidwira mankhwala. Mosiyana ndi munthu (wobadwira) GLP-1, liraglutide imasunga ndende nthawi yayitali, yomwe imalola kuti iperekedwe kamodzi kokha mu maola 24.

Amapezeka mu mawonekedwe a yankho lomveka bwino, amagwiritsidwa ntchito popangira jakisoni wa 6 mg / ml (gawo lathunthu la 18 mg mwathunthu). Kampani yoyamba yopanga inali kampani ya ku Denmark Novo Nordisk. Mankhwalawa amaperekedwa ku pharmacies monga mawonekedwe a cartridge, odzaza ndi cholembera, momwe jakisoni tsiku lililonse limapangidwira. Mulingo uliwonse umakhala ndi 3 ml ya yankho, phukusi la zidutswa ziwiri kapena zisanu.

Pharmacological zochita za mankhwala

Mothandizidwa ndi yogwira - liraglutide, yolimbikitsanso kupanga insulin yake, ntchito ya β-cell imakhala bwino. Pamodzi ndi izi, kuchuluka kwambiri kwa mahomoni omwe amadalira shuga - glucagon - amaponderezedwa.

Izi zikutanthauza kuti ndi shuga wambiri wowonjezera magazi, kupanganso insulini yake kumalimbikitsidwa ndipo katemera wa glucagon amakakamizidwa. Zotsutsana ndi izi, kuchuluka kwa glucose kumakhala kotsika, chinsinsi cha insulin chimachepa, koma kaphatikizidwe ka glucagon kamatsalira pamlingo womwewo.

Mphamvu yosangalatsa ya liraglutide ndi kuchepa thupi komanso kuchepa kwa minofu ya adipose, yomwe imakhudzana mwachindunji ndi limagwirira lomwe limathetsa njala komanso kuchepetsa mphamvu.

Kafukufuku kunja kwa thupi awonetsa kuti mankhwalawa amatha kupereka mphamvu mwamphamvu m'maselo a β, ndikuchulukitsa kuchuluka kwawo.

Zizindikiro zogwiritsidwa ntchito

Liraglutide amangopangidwira anthu azaka zopitilira 18 omwe amakhala ndi matenda a shuga a 2. Chofunikira ndi kudya bwino komanso kuchita masewera olimbitsa thupi.

Itha kugwiritsidwa ntchito ngati:

1. Mankhwala okhawo ochizira matenda a shuga 2.
2. Kuphatikiza mitundu ya mapiritsi (metformin, ndi zina) pazochitika zomwe munthu sangathe kukwaniritsa kuyenera kwa glycemic mothandizidwa ndi mankhwala ena.
3. Kuphatikiza ndi insulin, pomwe kuphatikiza kwa liraglutide ndi metformin sikunapereke zotsatira zomwe mukufuna.

Contraindication ndi zoyipa

Mndandanda wamikhalidwe pamene liraglutide ndi yoletsedwa kapena kuletsa kugwiritsa ntchito:

• tsankho;
• chotupa chodalira m'matumbo a chithokomiro, ngakhale ngati chimapezeka kamodzi mwa abale apamtima;
• neoplasms yokhudza ziwalo ziwiri za endocrine;
• Mtundu woyamba wa shuga;
• kuthamanga kwa magazi ndi matupi a ketone;
• gawo lotsiriza la kulephera kwa impso;
• kulephera kwa mtima;
• kuchedwa kutulutsa m'mimba;
• matenda amatumbo;
• kulephera kwambiri kwa chiwindi;
• nthawi ya pakati ndi yoyamwitsa;
• wazaka 18.

Zotsatira zoyipa zomwe zingachitike pogwiritsa ntchito mankhwalawa:

1. Matumbo. Kusanza, kusanza, kusokonezeka kwanyumba, kupweteka kwam'mimba, kumatulutsa.
2. Chiwonetsero cha khungu. Kuyabwa, zotupa, urticaria. Thupi lawo siligwirizana pa malo jakisoni.
3. Kupenda. Kuperewera kwa chakudya, kudya magazi, hypoglycemia, kusowa kwamadzi.
4. STS. Kuchuluka kwa mtima.
5. Machitidwe amanjenje. Mutu ndi chizungulire.

Ngati chimodzi mwazovuta za liraglutide chikuchitika, muyenera kudziwitsa dokotala wanu nthawi yomweyo. Mwinanso uku ndikumaganizirana kwakanthawi kochepa kwa thupi, kapena mwina kuwopseza thanzi.

Malangizo ogwiritsira ntchito

Liraglutide imayendetsedwa kokha pakhungu. Ndikoletsedwa kugwiritsa ntchito intramuscularly makamaka makamaka mtsempha! Njira yothetsera vutoli imagwiritsidwa ntchito nthawi imodzi kamodzi patsiku, ngakhale chakudya. Masamba omwe amafunidwa ndi jekete, ntchafu ndi pamimba.

Mlingo woyambira wocheperako ndi 0,6 mg wa patsiku, uyenera kudulidwa osachepera sabata, pambuyo pake ndikuwonjezera kuchuluka kwa 1,2 mg. Kuti mukwaniritse zotsatira zabwino, mankhwalawa amatha kuikidwa muyezo wa 1,8 mg. Mlingo wothandiza kwambiri ndi 1.8 mg (pankhani ya Victoza). Ngati Saksenda imagwiritsidwa ntchito, ndiye kuti mlingo waukulu ndi 3 mg tsiku lililonse.

Ngati mukuphonya mlingo wotsatira, muyenera kulowa mankhwalawo posachedwa maola 12 otsatira. Zapitirira nthawi yino, ndiye kuti mlingo umadulidwa ndipo tsiku lililonse mawa limayambitsidwa. Kukhazikitsa kawiri sikupereka zotsatira zabwino.

Zinthu zomwe zimagwiritsidwa ntchito zili mu cartridge yapadera, yomwe imapangidwa mu cholembera. Musanagwiritse ntchito, onetsetsani kuti yankho ndi lomveka komanso lopanda utoto. Popanga mankhwala, ndibwino kugwiritsa ntchito singano osakwana 8 mm kutalika mpaka 32G.

Liraglutide amaletsedwa kuzizira! Iyenera kusungidwa mufiriji ngati cholembera chake chatsopano. Pambuyo pakugwiritsa ntchito amatha kusungidwa kutentha mpaka 30 ° C, koma ndizotheka kuzisiyira mufiriji. Katoniyo amayenera kugwiritsidwa ntchito mwezi umodzi atatsegulidwa.

Zochita Zamankhwala

Analogue ya GLP-1 ili ndi mphamvu yotsika kwambiri yolumikizana ndi mankhwala ena, omwe amafotokozedwa ndi kagayidwe kapadera mu chiwindi ndikumangiriza mapuloteni a plasma.

Chifukwa cha kuchepa kwa m'mimba, mitundu ina ya pakamwa imamwetsedwa ndi kuchedwa, koma kusintha kwa mankhwalawa sikufunika.

Liraglutide amachepetsa kuchuluka kwa mankhwala ena, koma kusintha kwa mankhwalanso sikofunikira.

Liraglutide nthawi yapakati

Palibe maphunziro apadera omwe adachitidwa pagululi la odwala, chifukwa chake mankhwalawo ndi oletsedwa kuti azigwiritsidwa ntchito. Kafukufuku wokhudza nyama yamulembedwe wasonyeza kuti mankhwalawo ndi oopsa kwa mwana wosabadwayo. Pogwiritsa ntchito mankhwalawa, mayi ayenera kugwiritsa ntchito njira zakulera zokwanira, ndipo ngati akufuna kubereka, ayenera kudziwitsa adokotala za lingaliro ili kuti amupereketse ku mankhwala otetezeka.

Kuphunzira mwalamulo kwa mankhwalawa

Kugwiritsa ntchito bwino kwa zinthu zogwira ntchito kunafufuzidwa ndi pulogalamu ya mayeso azaumoyo a LEAD. Anthu 4000 omwe ali ndi matenda a shuga a 2 adapereka phindu lawo kwambiri. Zotsatira zake zidawonetsa kuti mankhwalawa ndi othandiza komanso otetezeka monga chithandizo chachikulu, komanso mapiritsi ena ochepetsa shuga.

Zinadziwika kuti anthu omwe akhala akulandira liraglutide kwa nthawi yayitali amachepetsa thupi komanso kuthamanga kwa magazi. Kuchuluka kwa hypoglycemia kumachepera nthawi 6, ndikuyerekeza ndi glimepiride (Amaril).

Zotsatira za pulogalamuyi zidawonetsa kuti kuchuluka kwa hemoglobin komanso kulemera kwa thupi kumachepetsa kwambiri liraglutide kuposa insulin glargine yophatikizana ndi metformin ndi glimepiride. Kulembedwa kuti ziwerengero za kuthamanga kwa magazi zimachepa pambuyo pa sabata 1 logwiritsa ntchito mankhwalawa, zomwe sizimadalira kuchepa thupi.

Zotsatira zomaliza:

• kuonetsetsa phindu la hemoglobin;
• kutsitsa kuthamanga kwa magazi;
• kutayika kwa mapaundi owonjezera.

Ubwino ndi zoyipa zamagwiritsidwe

Malo abwino:

• Imatha kutha kudya komanso kuchepetsa thupi.
• Imachepetsa kuwopsa kwa zovuta zazikulu zomwe zimakhudzana ndi CVS.
• Imagwiritsidwa ntchito nthawi 1 patsiku.
• Malingana momwe mungathere, imasungirako ntchito ya β-cell.
• Imalimbikitsa kapangidwe ka insulin.

Zosayenera:

• Ntchito yolowerera.
• Anthu olumala owoneka bwino amatha kukumana ndi zovuta zina akamagwiritsa ntchito cholembera.
• Mndandanda waukulu wamakampani.
• Sitha kugwiritsidwa ntchito ndi amayi apakati, obooletsa komanso ana osakwana zaka 18.
• Mtengo wokwera wa mankhwala.

Kodi pali ma fanizo?

Mankhwala omwe amangokhala ndi liraglutide:

1. Victoza;
2. Saxenda.

Mankhwala ophatikizidwa, kuphatikiza pake ndi insulin degludec - Sultofay.

Zitha kusintha liraglutide

Ndemanga kanema wamankhwala ochepetsa thupi

Mtengo

Tilingalira za mankhwalawa Viktoza ndi Saksenda malinga ndi chuma, titha kunena kuti mankhwala oyamba atenga ndalama zochepa. Ndipo sikuti ngakhale ndizakuti zimangotenga ndalama zochepa, koma kuti mlingo wokwanira tsiku ndi tsiku ndi 1.8 mg, pomwe mankhwala ena ali ndi 3 mg. Izi zikutanthauza kuti 1 cartridge ya Victoza ndi yokwanira masiku 10, ndipo Saxend - kwa 6, ngati mutamwa mlingo waukulu.

Ndemanga Zahudwala

Marina Ndili kudwala matenda ashuga a 2 pafupifupi zaka 10, ndimamwa metformin ndipo ndimabaya insulin, shuga ndiwotsika 9-11 mmol / l. Kulemera kwanga ndi makilogalamu 105, adotolo adalimbikitsa kuyesa Viktoza ndi Lantus. Pakatha mwezi umodzi, adataya makilogalamu 4 ndipo shuga adasungidwa m'magawo 7-8 mmol / L.

Alexander Ndikhulupirira kuti ngati metformin ikuthandizira, ndibwino kumwa mapiritsi. Mukasinthira kale ku insulin, ndiye kuti mutha kuyesa liraglutide.