I-Baeta Long ingeyeqembu lama-hypoglycemic agents wokuphatha kwabazali. Ukufakwa kufakwa ngaphansi kwesikhumba. Indlela yokusebenza isebenza ngokuma kwezakhiwo zamakhemikhali ze-exenatide, ezisebenza kuma-receptors e-glucagon-like peptide-1. Ingxenye esebenzayo ingathuthukisa ukukhiqizwa kwe-insulin ngaphambi kokudla kwe-glucose kusuka ekudleni. Ngaso leso sikhathi, umsebenzi we-hormonal wamaseli we-pancreatic beta uyancipha lapho kufinyelelwa ushukela ojwayelekile wegazi.
Igama Lezwe elingafanele
I-Exenatide.
I-Baeta Long ingeyeqembu lama-hypoglycemic agents wokuphatha kwabazali.
I-ATX
A10BJ01.
Khipha amafomu nokwakheka
Umuthi wenziwa ngesimo sempuphu emhlophe yokwenziwa kwemijovo engaphansi. Umuthi unomphumela owenzeka isikhathi eside. I-Powder ithengiswa iphelele nge-solvent. Lesi sakamuva siwuketshezi olucacile olune-tint ephuzi noma nsundu. I-powder iqukethe i-2 mg yento esebenzayo - i-exenatide, efakwe nge-sucrose ne-polymer njengezakhi ezisizayo.
I-solvent iqukethe:
- i-croscarmellose sodium;
- i-sodium chloride;
- sodium dihydrogen phosphate ngesimo se-monohydrate;
- oyinyumba amanzi wokujova.
Isenzo se-Pharmacological
Umuthi ungoweqembu le-incretin mimetics - GLP-1. Lapho i-glucagon-like peptide-1 icushiwe, i-extenatide ithuthukisa ukugcinwa kwe-hormone kwe-insulin ngamaseli e-pancreatic beta ngaphambi kokudla okuhlosiwe. Umuthi wehlisela phansi ukungabikho kwesisu lapho ungena egazini. Isakhiwo esisebenzayo se-Baeta sithuthukisa ukuzwela kwezicubu esenzweni se-insulin, ngaleyo ndlela sithuthukise ukulawulwa kwe-glycemic ngokumelene nesizinda sikashukela esingancikeli i-insulin. Ukukhiqizwa kwe-insulin kuyeka lapho izinga kashukela wegazi lehla liye kwelejwayelekile.
Izifundo zemitholampilo zikhombisile ukuthi ukuphathwa kwe-exenatide kunciphisa isifiso sokudla futhi kunciphisa ukudliwa kokudla.
I-Exenatide ekwakhiweni kwamakhemikhali ihluka ngesakhiwo samangqamuzana se-insulin, okuphuma ku-D-phenylalanine ne-sulfonylurea, i-alpha-glucosidase blockers kanye naku-thiazolidinediones. Umuthi wezidakamizwa wenza ngcono ukusebenza kweziqhingi zeLangerhans zamanyikwe. Kulokhu, i-exenatide inhibes secretion of glucagon.
Ezifundweni zemitholampilo, kwatholakala ukuthi ukuphathwa kwe-exenatide kunciphisa isifiso sokudla futhi kunciphisa ukungena kokudla, kuvimbela ukuhamba kwesisu. Into esebenzayo ithuthukisa umphumela we-hypoglycemic wamanye ama-antidiabetesic agents.
I-Pharmacokinetics
Ngokuphathwa kwe-subcutaneous, umuthi unqwabelana egazini ngaphandle kokuthola i-biotransformation kumaseli wesibindi. Umthamo omaphakathi wokusatshalaliswa kwe-exenatide ungamalitha angama-28. Into esebenzayo ishiya umzimba usebenzisa i-glomerular filtration ngokusebenzisa izinso, bese ilandelwa yi-proteinolytic cleavage. Umuthi ukhishwa ngokuphelele emavikini ayishumi kuphela ngemuva kokuphela kokwelashwa.
I-ejog ye-hypoglycemic iyadingeka ukunciphisa i-serum yokuxineka kashukela egazini ngohlobo 2 sikashukela.
Izinkomba Baeta Long
I-ejog ye-hypoglycemic iyadingeka ukunciphisa i-serum yokuxineka kashukela egazini ngohlobo 2 sikashukela. Kuyenqatshelwe ngokuphelele ukuphatha umuthi wesifo sikashukela sohlobo 1. Umuthi usetshenziswa ngokusebenza okuphansi kwezinyathelo zokunciphisa isisindo ngokweqile: ukuzikhandla ngokwengeziwe komzimba, ukondleka okhethekile.
Contraindication
Umuthi uphulwe kubantu abane:
- isifo sikashukela esincike ku-insulin;
- i-hypersensitivity ngayinye ezintweni ezengeziwe nezisebenzayo zomuthi;
- ukwehluleka okunzima kwezinso;
- ulwelwesi olunamandla olcerative izilonda zokuguguleka komgudu wokugaya ukudla;
- isifo sikashukela sikashukela;
- izingane ezingaphansi kweminyaka engu-18;
- abakhulelwe futhi abancelile abesifazane.
Ungamthatha kanjani u-Baetu Long
Umuthi lo uphathwa ngokungajwayelekile emathangeni, odongeni lwesibeletho sangaphansi nangaphansi kwesikhumba ngenhla komsipha odabukisayo noma engalweni.
Umthamo osesigabeni sokuqala sokwelashwa ufinyelela ku-5 mg, imvamisa yokuphatha ngosuku - amahlandla ama-2. Umuthi kumele usetshenziswe kungakapheli imizuzu engama-60 ngaphambi kokuqala isidlo sokuzila. Kunconywa ukuthi unikeze imijovo ngaphambi kokudla kwasekuseni nangaphambi kokudla. Ngemuva kwenyanga ngemuva kokuqala kokwelashwa kwezidakamizwa ngokubekezelela okuhle, ukukhuphuka komthamo okufika ku-10 mg kuvunyelwe ukuphathwa izikhathi ezi-2 ngosuku.
Imiphumela emibi Baeta Long
Imiphumela emibi evela ekusetshenzisweni komuthi ingadalwa ukusetshenziswa kabi kwemithi noma ukusebenzisana okungalungile nesinye isidakamizwa. Imiphumela emibi kufanele ibikwe kudokotela wakho.
Amapheshana wesisu
Uma usebenzisa i-Byeta njenge-monotherapy, ukuthuthukiswa kwe:
- isicanucanu
- ukuhlanza
- ukuqunjelwa
- isifo sohudo isikhathi eside;
- ukwehla kwesifiso sokudla, i-anorexia;
- dyspepsia.
Ekwelashweni okuhlanganisiwe, ukusabela okuphambene okuchaziwe kuhambisana nengozi ekhulayo yezilonda zokulimala zesisu ne-duodenum, ukuvuvukala kwamanyikwe, ukuqunjelwa kokunambitheka okucasukile, ukubukeka kobuhlungu nokuqhakaza, ukuthopha, ukubopha.
Izitho zeHematopoietic
Ngokuvinjelwa kohlelo lwe-hematopoietic, inani lamaseli egazi liyancipha.
Isistimu yezinzwa ephakathi
Ukwephulwa kohlelo lwezinzwa kuvezwa ngesimo sokuba nesiyezi, ikhanda, ubuthakathaka kanye nokubonakala kokuqina. Ezimweni ezingavamile, kuvela amabhulashi aqhaqhazelayo.
Kusuka ohlelweni lomchamo
Ngokusetshenziswa kanye kanye nezinye izidakamizwa, ukuthuthukiswa kokuhluleka kwezinso noma ukwanda kwaso kungenzeka. Ukwanda okungenzeka kwe-serum creatinine okuhlushwa.
Uhlelo lwe-Endocrine
Ngokuhlukumeza umuthi, i-hypoglycemia ingaqala ukukhula. Ikakhulu ukusetshenziswa okufanayo kwe-sulfonylureas.
Ngokuhlukumeza umuthi, i-hypoglycemia ingaqala ukukhula.
Allergies
Ukuphendula kwe-allergic kubonakaliswa ukuthuthukiswa kokuqhuma kwesikhumba, ukulunywa, i-angioedema, i-urticaria, ukulahleka kwezinwele, ukushaqeka kwe-anaphylactic.
Umthelela ekhonweni lokulawula izindlela
Umuthi we-hypoglycemic awuthinti ukusebenza kwengqondo, amakhono emoto amahle nohlelo lwezinzwa. Ngakho-ke, ngesikhathi sokwelashwa kuvunyelwe ukusebenza ngamasu ayinkimbinkimbi, ukushayela neminye imisebenzi edinga isivinini esikhulu sokuphendula ngokomzimba nangokwengqondo, ukugxila.
Imiyalo ekhethekile
I-Exenatide ayinconywa ngemuva kokudla. Kwenqatshelwe ukufaka imijovo ye-intravenous and intramuscular.
Izinto zokwelapha zinamandla okuba yi-immunogenicity, ngenxa yokuthi umzimba wesiguli, lapho kukhona i-hypersensitivity, ungakhiqiza amasosha omzimba ngokumelene nezinto ezisebenzayo. Ezimweni eziningi, i-titer of antibodies yayincane kakhulu futhi ayizange iholele ekuthuthukiseni ukusabela kwe-anaphylactic. Emavikini angama-82 ekwelashweni kwezidakamizwa, ukwehla kancane kancane kokuphendula komzimba kwabonwa, ngakho-ke, umuthi awuzange ubeke engcupheni impilo maqondana nokukhula okungenzeka kwe-anaphylactic shock.
Kwenqatshelwe ukufaka imijovo ye-intravenous and intramuscular.
Ezimweni ezingavamile, i-exenatide inganciphisa i-peristalsis yemisipha ebushelelezi yepheshana lesisu. Ngakho-ke, ukusetshenziswa okufanayo kwezidakamizwa ezivimbela ukuhamba kwamathumbu noma ezidinga ukumukelwa ngokushesha okugaywa ukudla akunconyelwanga.
Ngemuva kokuyekiswa kokwelashwa kwezidakamizwa, umphumela we-hypotensive ungaqhubeka isikhathi eside, ngoba izinga le-plasma liyancipha amasonto ayi-10. Uma, ngemuva kokuyeka umuthi, udokotela ebeka enye yokwelapha izidakamizwa, kubalulekile ukuxwayisa uchwepheshe ngokuphathwa kwangaphambilini kwe-Baeta. Lokhu kuyadingeka ukugwema ukuvela kokungaphenduki okuhle.
Ekwenzeni komtholampilo, bekunezimo zokuncipha kwesisindo esisheshayo (cishe ama-1.5 kg ngesonto) ngesikhathi sokwelashwa nge-exenatide. Ukwehla okunamandla kwesisindo somzimba kungadala imiphumela emibi: ukuguquguquka kwesizinda se-hormonal, ingozi eyandayo ye-pathologies ye-inhliziyo, ukukhathala, ukuthuthukiswa kokudangala, mhlawumbe ukulahla izinso. Ngokuncipha kwesisindo, kuyadingeka ukulawula izimpawu ze-cholelithiasis.
Sebenzisa ebudaleni
Abantu abaneminyaka engaphezu kwengu-60 ubudala abadingi ukuguqula kabusha uhlobo lokwelashwa.
Abantu abaneminyaka engaphezu kwengu-60 ubudala abadingi ukuguqula kabusha uhlobo lokwelashwa.
Isabelo sezingane
Ukusetshenziswa kwalesi sidakamizwa ebuntwaneni akuvunyelwe ngenxa yokuntuleka kolwazi ngomphumela womuthi ekwakhiweni komzimba womuntu kuze kube yilapho uneminyaka eyi-18.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Ngesikhathi sokuhlolwa kwezidakamizwa kwezilwane, kutholakale imiphumela enobuthi ezithweni zangasese zikamama nemiphumela ye-teratogenic ku-fetus. Lapho usebenzisa umuthi ngabesifazane abakhulelwe, ukuhlukunyezwa kwe-intrauterine, ukuphazamiseka ekwakhiweni kwezitho nezicubu ngesikhathi se-embyogenesis kungenzeka. Ngakho-ke, ukusetshenziswa kwe-Baeta kwabesifazane ngesikhathi sokukhulelwa kuvinjelwe.
Ngesikhathi sokulashwa ngomuthi we-hypoglycemic, kunconyelwa ukukhansela ukuncelisa ibele ngenxa yamathuba we-hypoglycemia enganeni.
Isicelo sokusebenza kokulimala kwezinso
Lapho usebenzisa umuthi ezigulini ezihluleke kakhulu ngokwezifo, kwavela ukwanda kwezigameko zokusabela okungekuhle ezivela emgodini wesisu. Ikakhulu ngokuqalwa kwe-creatinine ngezansi kwe-30 ml / min. Kulokhu, ukuphathwa kwe-Baeta okufakwayo kubantu abanokungasebenzi kahle kwezinso kuvinjelwe.
Umuthi uphulwe ukuze usetshenziswe ngabantu abanezifo ezinzima zesibindi.
Sebenzisa umsebenzi wesibindi okhubazekile
Umuthi uphulwe ukuze usetshenziswe ngabantu abanezifo ezinzima zesibindi.
Ukweqisa
Emsebenzini wokuthengisa ngemuva, kuye kwaba nezimo zokusebenzisa ngokweqile, isithombe somtholampilo okwakungukuthuthuka kokuhlanza nokucanuzelelwa kwenhliziyo. Kulokhu, isiguli sinqunywe ukwelashwa okugxilwe ekususweni kwezimpawu. Ukwehlisa amathuba okuba ne-overdose, ungasisebenzisi kabi isidakamizwa. Uma kungekho isenzo se-hypoglycemic, kuyadingeka ukushintshela ekwelashweni esikhundleni, ukwanda okuzimele komthamo noma imvamisa yokuphathwa kweBayeta kuyaphulwa. Imvamisa ephezulu yokusebenzisa izikhathi 2 ngosuku.
Ukuxhumana nezinye izidakamizwa
I-Exenatide, uma inikezwa ngokubambisana ne-Digoxin, yehlisa inani eliphezulu le-serum lokugcina ngo-17%, isikhathi sokuyifinyelela lenyuka ngamahora ayi-2,5. Ngaphezu kwalokho, ukwelashwa okunjalo okuxubayo akukuthinti inhlala-kahle yesiguli futhi kuvunyelwe ukusetshenziswa.
Ngokuphathwa kanyekanye kweBaeta Long eneLovastatin, ukwehla kwamazinga weplasma aphezulu weLovastatin kubonwa ngama-28%, isikhathi sokufika kweCmax ngamahora ama-4. Ngokushintshwa okunjalo kwamapharamitha we-pharmacokinetic, ukulungiswa kwenqubo yomthamo yazo zombili izidakamizwa kuyadingeka.
I-Exenatide, uma inikezwa ngokubambisana ne-Digoxin, yehlisa inani eliphezulu le-serum lokugcina ngo-17%, isikhathi sokuyifinyelela lenyuka ngamahora ayi-2,5.
Ukuthatha i-HMG-CoA reductase inhibitors kungathinti i-fat metabolism. Akukho zinguquko ekuhlushweni kwe-Exenatide kuhlangene ne-Metformin, iTiazolidatedione.
Ezigulini ezithatha u-5-20 mg wethamo lansuku zonke leLisinopril ukwenza umfutho wegazi ube namandla, ngenkathi usebenzisa i-exantide, isikhathi sokufinyelela ezingeni eliphezulu leplasma le-lisinopril sanda. Izinguquko emingceleni yamakhemikhali
Lapho kuhlanganiswa ne-warfarin ezifundweni zangemuva kokumaketha, amacala okuthuthuka kokopha kwangaphakathi kanye nokwanda kwenkathi yokufika ekufakweni kwenqwaba ye-warfarin ngamahora ama-2 kwaqoshwa. Le nhlanganisela ayinconywa njengendlela yokwelapha yokuhlanganisa. Uma kunesidingo, esigabeni sokuqala sokwelashwa, isiguli sidinga ukulawula izinga le-coumarin ne-warfarin etholakala ku-plasma yegazi.
Ukuhambisana notshwala
Imithi ye-Hypoglycemic ayivunyelwe ukusetshenziswa nezimpawu zokuhoxisa. Ngesikhathi sokulashwa, kwenqatshelwe ngokuphelele ukuphuza utshwala. I-ethyl utshwala ingakhulisa amathuba okukhulisa i-hypoglycemia neminye imiphumela emibi. I-Ethanol inomphumela omubi kumaseli wesibindi, okwandisa ingozi yokuqothuka kwamafutha.
Ama-Analog
I-Bayetu Long enomphumela ophansi noma ongekho wokulashwa ungathathelwa indawo omunye wumuthi olandelayo onomphumela ofanayo we-hypoglycemic:
- I-Baeta;
- I-Exenatide;
- IVictoza;
- I-Forsyga;
- I-NovoNorm.
Imibandela yekhefu lekhemisi
Ukuthengiswa kwamahhala kwalo muthi ngaphandle kweseluleko sikadokotela kwenqatshelwe.
Ngingakwazi ukuthenga ngaphandle kadokotela
Ngenxa yokuthuthuka okungenzeka kwe-hypoglycemia uma kuthathwe ngaphandle kwezinkomba eziqondile zezokwelapha, awukwazi ukuthenga umuthi ngaphandle kadokotela.
Intengo
Izindleko ezijwayelekile zomuthi ezimakethe zemithi ziyehluka kusuka kuma-ruble angama-5 322 kuya kwangama-11 000.
Izimo zokugcina zomuthi
Kunconywa ukuthi kuqukethe i-powder yokwelapha endaweni eqhelelene nokuchayeka ekukhanyiseni kwelanga, emazingeni okushisa we + 2 ... + 8 ° C. Ngemuva kokuvula iphakheji, isitoreji emazingeni okushisa afinyelela ku- + 30 ° C isikhathi esingaphezu kwamaviki ama-4 kuvunyelwe.
Isikhathi sokuphelelwa yisikhathi
Iminyaka emithathu
Umkhiqizi
I-Amilin Ohio Electric, e-USA.
Lapho kuhlanganiswa ne-warfarin, izifundo ezenziwa ngemuva kokuthengisa ziye zabhala ngamacala okopha kwangaphakathi.
Ukubuyekezwa
UMiroslav Belousov, oneminyaka engama-36, uRostov-on-Don
Nginesifo sikashukela esingancike e-insulin. Ngithatha iBayetu kanye nemijovo ye-insulin isikhathi esingangonyaka. Umuthi ubhekana ngokuphumelelayo nomsebenzi wawo - ushukela osuka ku-13 mmol uzinze ku-6-7 mmol. Kuneziphazamiso ekulethweni kwe-insulin edolobheni, ngafaka imijovo ye-Bayeta kuphela engabonakali. Ushukela wahlala uvamile. Nginesifo sesibindi ngasikhathi sinye, ngakho-ke ngaxhumana nodokotela wami ngaphambi kokusebenzisa umuthi. I-Baeta ayizange isibhebhethekise lesi sifo, ngakho-ke ngishiya isibuyekezo esihle.
U-Evstafy Trofimov, oneminyaka engama-44 ubudala, eSt
Ekuhlolweni okulandelayo kwembula ushukela wegazi ophakeme. Izinkomba ziphakame ngenxa yokuxineka kakhulu. Kwatholakala ukuthi sinesifo sikashukela sohlobo 2. Imijovo enikezwe i-Baeta Long. Kulula kakhulu ukubeka ngaphansi kwesikhumba ngepeni yesirinji. Sekuphele izinyanga eziyisithupha ngisebenzisa lo muthi. Umuthi uqobo awusebenzi. Lapho uthola ukwelashwa kwezidakamizwa, ukudla okhethekile kanye nokuzivocavoca kuyadingeka. Ngemuva kwalokho ushukela uncishiswa ube yinto evamile. Ngabona ukuthi ngesikhathi sokwelashwa ngiphelelwe ama-11 kg wesisindo ngokweqile, umfutho wegazi wehla. Kubalulekile ukunikeza imijovo ngokuqinile ngokwemiyalo.
U-Natya Solovyova, oneminyaka engama-34, iKrasnoyarsk
Nginesifo sikashukela sohlobo 2. Imijovo ye-Exenatide ibeka cishe unyaka. Isisindo sehle. Ngemuva komjovo wakusihlwa, isifiso sokudla sikhuphuka futhi ufuna ukudla okungayeki. Lokhu kungumphumela omubi onjalo. Uma uzilawula, ushukela uhlala uvamile.Ngincoma abantu abanenkinga efanayo ngokukhuphuka kwesifiso sokuhamba ngezinyawo ukuze basuse isilingo. Ekuseni, ushukela usebangeni le-6-7.2 mmol. Okuwukuphela kokudonsayo intengo ephezulu.
