I-Saxenda (Saxenda) yiqembu lezimali esenzo salo sihlose ukunciphisa isisindo sesiguli. Kubonakala ngobubanzi obuncane, inani elikhulu lemiphumela emibi nemikhawulo yokusetshenziswa.
Igama Lezwe elingafanele
ILiraglutide
I-Saxenda (Saxenda) yiqembu lezimali esenzo salo sihlose ukunciphisa isisindo sesiguli.
I-ATX
A10BJ02
Khipha amafomu nokwakheka
Umuthi wenzelwe ukuphatha okungaqondakali. Inikezwa njengesisombululo semijovo. Umuthi uyingxenye eyodwa. Lokhu kusho ukuthi ukwakheka kufaka i-1 into esebenzayo - i-liraglutide. Ukuhlushwa kwayo ku-1 ml yesidakamizwa ngu-6 mg. Umuthi ukhiqizwa kumasirinji akhethekile. Umthamo ngamunye ngu-3 ml. Inani eliphelele lezinto ezisebenzayo kwisirinji enjalo yi-18 mg.
Ukuqanjwa kuhlanganisa nezinto ezingathinti inqubo yokulahlekelwa isisindo:
- phenol;
- i-sodium hydrogen phosphate dihydrate;
- propylene glycol;
- i-hydrochloric acid / sodium hydroxide;
- amanzi ngomjovo.
Umuthi unikezwa kwiphakeji equkethe amasirinji ama-5.
Umuthi wenzelwe ukuphatha okungaqondakali.
Isenzo se-Pharmacological
Ithuluzi libonisa iqembu lezidakamizwa ze-hypoglycemic, liyinhlangano ye-analogue yokwenziwa ye-peptide-1 noma i-GLP-1 ye-synthetic yomuntu. Itholakala ngokusebenzisa i-biotechnology ngokususelwa kwinhlanganisela ye-DNA ephindaphindayo kanye nohlu lwesigaba se-yeast fungi, umehluko okuyisilinganiso esiphakeme sokufana ngokulandelana kwe-amino acid kwe-GLP-1 (97% yabantu).
Umsebenzi oyinhloko weSaxenda ubopha ama-receptors e-GLP-1 ngokusebenza kwawo okwengeziwe. Lokhu kunciphisa isidingo sokudla. Lo mphumela kungenxa yokwanda kwesiginali mayelana nokugcwala komzimba. Ngasikhathi sinye, kube nokuncipha kokuqina kwezimpawu zendlala. Ngenxa yalokhu, kukhona ukwehla kwesisindo somzimba, ngoba umuntu akasizwa isidingo sokudla, isifiso sokudla asibuthakathaka.
Okokuqala, isisindo sezicubu ze-adipose siyancishiswa. Isici salo muthi ukungabi namandla okukhulisa ukusetshenziswa nsuku zonke kwamandla. Into esebenzayo ekwakhiweni ibandakanyeka ezinqubweni eziningi ze-biochemical. Isibonelo, sibonga kuye, ukuqina kokukhiqizwa kwe-insulin kuyanda. Kodwa-ke, kukhona ukwehla kokukhiqizwa kwe-glucagon ngendlela encike kushukela.
Umsebenzi oyinhloko weSaxenda ubopha ama-receptors e-GLP-1 ngokusebenza kwawo okwengeziwe. Lokhu kunciphisa isidingo sokudla.
Amanyikwe futhi ayathuthuka, ngenxa yokujwayelekile komsebenzi we-beta-cell. Umphumela wale nqubo ukwehla kokuzila kwe-glucose nangemva kokudla. Ngenxa yalokhu, ukuthulula kwe-gastric kubambezeleka kancane, okunomthelela ekwandeni kobude besikhathi, kuhambisana nomuzwa wokugcwala.
Kuyaphawuleka ukuthi umuthi okukhulunywa ngawo uwukuphela kokufana kwezimpawu ezinikeza ukwehliswa okukhulu kwesisindo somzimba (9%). Imiphumela enjalo iqinisekiswa izifundo zomtholampilo ezenziwa isikhathi eside ezibandakanya iziguli ezahlukahlukene ezinokukhuluphala ngokweqile noma ngokweqile. Umphumela odingekile watholakala ngokuhambisana nokudla (empeleni okuyi-hypocaloric) kanye nokuzivocavoca okulinganiselayo.
Ngesikhathi sokwelashwa, imisebenzi eminingana yenziwa ngasikhathi sinye: isifiso sokudla kanye nokusetshenziswa kwamandla kuyancishiswa, isidingo samakhalori ongezekile siyancipha, kanti ukuphuma kwe-gastric kuhamba kancane. Kwakukholelwa ukuthi imiphumela enjalo iyatholakala ngokulungisa isifiso sokudla nesibalo sekhalori. Kodwa-ke, umuthi okukhulunywa ngawo usebenza kangcono kune-placebo.
Kuyaphawuleka ukuthi umuthi okukhulunywa ngawo uwukuphela kokufana kwezimpawu ezinikeza ukwehliswa okukhulu kwesisindo somzimba (9%).
I-Pharmacokinetics
Ukufakwa kwe-liraglutide kuhamba kancane. I-bioavailability yale nto ingama-55%. Umsebenzi wethamo lomuthi uvela emahoreni ayi-11 ngemuva komthamo womuthi. Amandla ayo okubopha kumaprotheni e-plasma (98%) ayaziwa. Njengomphumela wezifundo, kwatholakala ukuthi ngemuva kokuphatha, indawo yezidakamizwa iyaqhubeka nokuwukuphela kwento esebenzayo.
Lapho igxotshwa, i-liraglutide iyaguqulwa. Ngenxa yalokhu, kukhishwa ama-metabolites ama-2, abonakala ngomsebenzi ophansi. Ngakho-ke, ezinqubweni ezikhuthaza ukunciphisa umzimba, azibambiqhaza. Ngemuva kokuphela kwesenzo, into esemqoka ayisuswa emzimbeni ngesikhathi sokuhamba kwamathumbu noma ukuchama.
Izitho eziphambili ezibhekene nokuqedwa kwemikhiqizo yedoti (izinso, amathumbu) ngezinga elincane zibamba iqhaza kule nqubo.
Izinkomba zokusetshenziswa
Umuthi ubekelwa kuphela ngendlela yendlela yokusiza. Kuvame ukusetshenziswa kanye nokudla okuphansi kwekhalori, ezemidlalo (ngomthwalo olinganiselayo). Izinkomba ezisetshenziswayo ukukhuluphala (i-BMI ingaphezu kwama-30 kg / m²), ngokweqile (i-BMI ingaphezulu kwama-27 kg / m²). Esimweni sesibili, lesi sidakamizwa sisetshenziselwa ukwelapha iziguli okungaqinisekiswanga ukuthi kutholakala ukuthi ukukhuluphala kuphi, kepha inzuzo yesisindo iyabonakala.
Inkomba yokusebenzisa ukukhuluphala.
Kunconywa ukusebenzisa i-Saxenda uma okungenani kunesici esisodwa esingesihle esinegalelo ekwandeni kwesisindo somzimba kuqapheleka: umfutho wegazi ophezulu, i-cholesterol eyandayo, uhlobo 2 sikashukela.
Contraindication
Izimo eziningana zokugula lapho kwenqatshelwe ukusebenzisa umuthi okukhulunywa ngazo:
- ukusabela okungekuhle kwesimo esithile;
- umdlavuza we-yegilo (umlando kanye nowokukhula);
- izifo ze-endocrinological (uhlobo lwe-endocrine neoplasia II);
- isimo sokudangala, imicabango yokuzibulala;
- ukwehluleka kwenhliziyo (kuphela esigabeni sokuthuthukiswa kwezimo ze-pathological zesigaba se-III-IV);
- ukusetshenziswa, kanye nezinye izindlela ezithinta isisindo somzimba, akunandaba ukuthi angamakhemisi noma amele iqembu lezithasiselo zokudla;
- nge-Type 2 sikashukela mellitus, umuthi awusetshenziswa nge-insulin;
- izinqubo zokuvuvukala emgodini wokugaya ukudla, umsebenzi wezimoto ophazamisekile esiswini.
Ngokunakekela
Kunezifo eziningi lapho kungcono ukungasebenzisi i-Saxenda. Kodwa-ke, ayikho imikhawulo eqinile ekusetshenzisweni kwalesi sidakamizwa. Ukuphulwa okuhlobene:
- ukwehluleka kwenhliziyo kwamakilasi we-I-II;
- ubudala obuphambili (ngaphezulu kweminyaka engama-75);
- isifo se-yegilo;
- ukuthambekela kokuthuthukisa i-pancreatitis.
Ungamthatha kanjani uSaxenda
Umuthi awusetshenziswanga ukungena emzimbeni noma ngomzimba. Ukuphatha ngokungasekelwa kwenziwa kanye ngosuku. Isikhathi sokubulawa komjovo singaba yisiphi, ngenkathi kungekho ukuncika kokudla.
Izindawo ezinconyiwe zomzimba lapho umuthi uphathwa kangcono: ihlombe, ithanga, isisu.
Qala inkambo yokwelashwa nge-0.6 mg yento esebenzayo. Ngemuva kwezinsuku eziyi-7, leli nani lenyuka ngomunye u-0.6 mg. Ngemuva kwalokho, umthamo uphinda ubonakale njalo ngesonto. Isikhathi ngasinye, kufanele kufakwe i-0.6 mg ye-liraglutide. Inani eliphezulu lomuthi nsuku zonke liyi-3 mg. Uma, ngokusetshenziswa isikhathi eside, kwaqashelwa ukuthi isisindo somzimba sehlile ngesisindo esingaphezu kwe-5% yesisindo sesiguli, inkambo yokwelashwa yaphazanyiswa ukuze kukhethwe i-analogue noma ukuphindaphinda umthamo.
Ukuthatha umuthi wesifo sikashukela
Kusetshenziswa irejimeni ejwayelekile yokwelapha, isetshenziswe kwezinye izimo. Ukugwema i-hypoglycemia, kunconywa ukunciphisa inani le-insulin.
Ukugwema i-hypoglycemia, kunconywa ukunciphisa inani le-insulin.
Ukulungiselela ipeni lesirinji ngenaliti yokusebenzisa
Ukukhwabanisa kwenziwa ngezigaba:
- khipha isigaqa kwisirinji;
- kuvulwa inaliti elahliweyo (isinamatheli siyasuswa), ngemuva kwalokho singafakwa kwisirinji;
- ngokushesha ngaphambi kokusebenzisa, susa ikhebula elingaphandle inaliti, elizofika lisebenziseka kamuva, ukuze ungalilahli;
- khona-ke cap yangaphakathi iyasuswa, ngeke isadingeka.
Njalo lapho umuthi usetshenziswa, kusetshenziswa izinaliti ezingalahlwa.
Imiphumela emibi Iyakhuphuka
Umuthi uvusa ukubukeka kwenqwaba yokuphendula okungathandeki. Kodwa-ke, azenzeki ngokushesha. Imiphumela emibi ihlukile, ethintwa luhlobo lwe-pathology, ukuba khona kwezinye izifo, isimo esijwayelekile sesiguli, ukwanda kwaso.
Amapheshana wesisu
Ukuqhafaza phakathi kwenhliziyo nausea, izitulo ezikhululekile, noma ukuqunjelwa. Inqubo yokugaya iyaphazamiseka, ukoma emgodini womlomo kuya ngokuqina. Kwesinye isikhathi kuba nokunyakaza kokuqukethwe esiswini singene emgodini, kuqhume i-belching, ukwakheka kwegesi kuyaqina, nobuhlungu buvela esiswini esingenhla. I-pancreatitis ngezikhathi ezithile iba.
Imiphumela emibi yesidakamizwa ingaba ukuhlanza imvelaphi yokucanuzelelwa kwenhliziyo.
Kusuka emasosheni omzimba
Ezinye iziguli kutholakala ukuthi zine-anaphylactic reaction.
Isistimu yezinzwa ephakathi
Isiyezi, ukulala okunciphisile, ushintsho ekunambithekeni noma ekulahlekelweni kwalo okuphelele.
Kusuka ohlelweni lomchamo
Umsebenzi wezinso uyaphazamiseka. Kwesinye isikhathi ukwehluleka kokusebenza kwalesi sitho kuyakhula.
Engxenyeni yesikhumba nezicubu ezingaphansi
Ukusabela komzimba.
Kusuka ohlelweni lwezinhliziyo
Izinga lokushaya kwenhliziyo liguqulwa (kuboniswe yi-tachycardia).
Engxenyeni yesibindi ne-biliary
Ukwakheka kwe-calculi. Kukhona ushintsho lwezinkomba zelebhu ngesikhathi kuhlolwa isibindi.
Allergies
Ngokubonakaliswa kwayo okukhona, ezimweni eziningi, ukuthuthukiswa kwe-urticaria, ukushaqeka kwe-anaphylactic kuyaphawulwa. Amathuba okubonakala kokugcina kwezimpawu kungenxa yezimo eziningi ze-pathological: hypotension, arrhythmia, ukuphefumula, ukuthambekela kwe-edema.
Kuzibonakaliso ezikhona zokwaliwa lapho uthatha umuthi ezimweni eziningi, ukuthuthukiswa kwe-urticaria kuyaphawulwa.
Umthelela ekhonweni lokulawula izindlela
Ngokunikezwe ukuthi umuthi okukhulunywa ngawo unomphumela omncane enhliziyweni nenqubo yezinzwa, kuvunyelwe ukwenza izinto ezidinga ukunakwa okuthe xaxa, kubandakanya nokushayela izimoto. Kodwa-ke, kufanele kuqashelwe ngenkathi kubhekwa izimpawu.
Imiyalo ekhethekile
Kuyaphawuleka ukuthi kwabesifazane, imvume ngemuva kokuphathwa kwento esebenzayo ingaphansi kwabesilisa. Kodwa-ke, leli qiniso alithinti irejimeni yokwelashwa: ukubalwa kabusha komthamo akwenziwa.
Uma kunezimpawu ze-pancreatitis noma ukukhula kwesimo esifanayo esithombeni somtholampilo okulesi sifo, udinga ukuyeka inkambo yokwelashwa kuze kube yilapho sekuqinisekisiwe ukuthi isifo sitholakele.
Ukushintsha izinkinga zokudla nezokudla kungadala ukuthuthukiswa kwe-calculi.
Ngokuphikisana nesizinda sokuthatha lesi sidakamizwa ezigulini ezinesifo sohlobo lwe-2 isifo sikashukela, ubungozi bokuthuthuka kwezimo ezibangelwa ukungasebenzi kahle kwe-thyroid gland: ukukhula kwe-goiter, okuqukethwe kwe-calcitonin kwe-plasma, njll.
Nge-Saksenda therapy, amathuba okuphelelwa ngamanzi emzimbeni ayakhuphuka, ngakho-ke ukudotshwa kwamanzi nsuku zonke kufanele kukhuphuke.
Nge-Saksenda therapy, amathuba okuphelelwa ngamanzi emzimbeni ayakhuphuka, ngakho-ke ukudotshwa kwamanzi nsuku zonke kufanele kukhuphuke.
Ngokuphikisana nangemuva lokwelashwa ngale ndlela, inani elincane leziguli laba nomdlavuza webele, kwavela imicabango yokuzibulala.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Umuthi uvunyelwe ukusetshenziswa.
Ukuqokwa uSaksenda ezinganeni
Ngokucatshangelwa ukuthi ucwaningo lwethonya lomuthi emzimbeni wezingane alwenziwe, akunconywa ukuthi ulunikeze ukwelashwa kweziguli ezingaphansi kweminyaka engu-18.
Sebenzisa ebudaleni
Ngesikhathi sokulashwa, ukuthuthukiswa kokungaphenduki okuhle, ukuphazamiseka komzimba kungenzeki. Ngakho-ke, iminyaka yobudala ayithinti i-pharmacodynamics yomuthi. Ngalesi sizathu, ukubalwa kabusha komthamo akwenziwa.
Ukufaka isicelo ebudaleni kungenzeka, ngoba ngesikhathi sokwelashwa akukho ukuthuthukiswa kokuphazamiseka okungalungile, ukuphazamiseka komzimba.
Isicelo sokusebenza kokulimala kwezinso
Umuthi awubekelwe izifo zalesi sitho ngendlela ebucayi (ukucaciswa kwesidalwa esingaphansi kuka-30 ml ngomzuzu). Ngomsebenzi wezinso olinganiselwe futhi obuthakathaka, kuvunyelwe ukusebenzisa i-Saxend. Kodwa-ke, umthamo wesidakamizwa ungabalwa ngenxa yezinguquko ekuhlakazweni kwento esebenzayo.
Sebenzisa umsebenzi wesibindi okhubazekile
Kuyenqatshelwa ukusebenzisa umuthi. Ngokulimazeka okuthambile noma okulinganiselwe kwe-hepatic, kuvunyelwe ukuyisebenzisa. Kodwa-ke, kulokhu, lesi sidakamizwa siyalandiswa. Lokhu kungenxa yoshintsho ekugxilweni kwalo ngokumelene nesizinda sokulimala kwesibindi somsebenzi.
Ukweqisa kwe-Saxend
Ngokukhula komthamo we-72 mg, imiphumela emibi iyanda: isicanucanu, ukuhlanza, ukuphazamiseka kwesitulo. Kodwa-ke, ingozi yokuba nezinkinga ezinzima isezingeni eliphansi. I-Hypoglycemia nayo ayitholakali.
Ngokukhuphuka komthamo we-72 mg, imiphumela emibi, njengokuphazamiseka kwesitulo, inyuka.
Ukuxhumana nezinye izidakamizwa
Ngokusetshenziswa ngasikhathi sinye kweSaksenda neWarfarin, kanye nezinye izinto ezithathwe njenge-coumarin, kunengozi yokuxhumana komtholampilo, kepha akukho datha eqinisekisiwe.
I-digoxin incishiswa kakhulu (nge-16%) ngaphansi kwethonya lomuthi okukhulunywa ngalo. Umphumela ofanayo uyatholakala ngokusetshenziswa kanyekanye kweSaxenda neLisinopril. Kulokhu, ukuqoqwa kokugcina kwezindlela kuyancipha.
Ngokuhlanganiswa kwesidakamizwa okukhulunywa ngaso kanye neParacetamol, azikho izinguquko emsebenzini noma ekusebenzeni kokuqala kwemithi. Umphumela ofanayo uyatholakala lapho usebenzisa i-Atorvastatin, Griseovulfine.
Ukuhambisana notshwala
Kwenqatshelwe ukuhlanganisa iziphuzo eziqukethe utshwala kanye nomuthi okukhulunywa ngawo. Lokhu kungenxa yokwanda komthwalo osesibindi, ongasiza ekunciphiseni ukumuncwa kwe-glucose.
Kwenqatshelwe ukuhlanganisa iziphuzo eziqukethe utshwala kanye nomuthi okukhulunywa ngawo.
Ama-Analog
Esikhundleni somuthi okukhulunywa ngawo, kusetshenziswa izindlela ezinjengalezi:
- IVictoza;
- I-Baeta;
- ILiraglutide.
Imibandela yekhefu lekhemisi
Umuthi ungathengwa kuphela ngokubhaliwe.
Ngingakwazi ukuthenga ngaphandle kadokotela
Alikho ithuba elinjalo.
Intengo yeSaxenda
Izindleko ezingama-ruble ayizinkulungwane ezingama-26 futhi zingahluka ngokuya ngesifunda.
Izindleko ezingama-ruble ayizinkulungwane ezingama-26 futhi zingahluka ngokuya ngesifunda.
Izimo zokugcina zomuthi
Isirinji esingavulwanga kufanele sigcinwe esiqandisini emazingeni okushisa + 2 ... + 8 ° C. Akunakwenzeka ukumisa iqulu okwelapha. Ngemuva kokuvula, isiponji singagcinwa emazingeni okushisa afinyelela ku- + 30 ° C noma esiqandisini. Kufanele ivalwe nge-cap yangaphandle. Izingane akufanele zithole umuthi.
Isikhathi sokuphelelwa yisikhathi
Isirinji engavulwanga ingagcinwa iminyaka emi-2 nezinyanga ezi-5 kusukela ngosuku lokukhululwa. Lapho ukwethembeka kwephakethe kwephulwa, impilo yeshelufu yento yezidakamizwa iyancishiswa ibe yinyanga eyi-1.
Umkhiqizi
INovo Nordisk A / S, eDenmark.
Yehlisa Ukubuyekezwa
UGalina, oneminyaka engama-33, uTver
Kwakufanele ngiphuze umuthi. Nginezisindo eziningi ngokweqile, kodwa angikakakhuli esigabeni seziguli ezikhuluphele. Angazi ukuthi kungani, kodwa umuthi awuzange usize ukususa amanoni. Yebo, bekunokwehla okuncane ngobuningi bayo, kepha kungenamandla ngokwanele.
U-Ana, oneminyaka engama-45EMoscow
Umuthi omuhle. Uma ulandela imiyalo yomkhiqizi, umphumela uzoba, yize utholakala kancane kancane.
