I-Trulicity yi-ejenti ephumelela kakhulu ye-hypoglycemic, okuyi-agonist ye-glucagon-like polypeptide (GLP) receptors. Inika imiphumela emihle ku-mellitus engavikelekile kwe-insulin (uhlobo 2). Imijovo ingasetjenziswa bobabili nge-monotherapy, futhi njengesengezo emithini esele ibekiwe ye-antidiabetes.
Igama Lezwe elingafanele
Ihanjiswe ngaphansi kwegama elithi Dulaglutid.
I-ATX
Inekhodi i-A10BJ05 (ama-hypoglycemic agents).
Khipha amafomu nokwakheka
Isixazululo Esilungile ngaphandle kokufaka imibala. I-1 cm³ iqukethe u-1.5 mg noma u-0,75 mg we-ngumuglutida eyindilinga. Ipeni lesirinji ejwayelekile liqukethe i-0.5 ml yesisombululo. Kufakwa inaliti ye-hypodermic ne-syringe. Kunama-syringes ayi-4 kwiphakeji eyodwa.
Ipeni lesirinji ejwayelekile liqukethe i-0.5 ml yesisombululo.
Isenzo se-Pharmacological
Ukuba yi-agonist ye-GLP-1 receptors, umuthi unomphumela wehlisela ushukela ngenxa yokuba khona kwe-molecule ye-analogues ye-peptide eshintshiwe ye-glucagon. Ihlotshaniswa nesiza se-immunoglobulin IgG4 yomuntu olungiselelwe. I-molecule yento iye yenziwa ukuze kuncishiswe ukuqina kokuphendula komzimba.
Ngokukhuphuka kweglucose, umuthi usiza ukwenza ngokwejwayelekile ukukhiqizwa kwe-insulin. Ngasikhathi sinye, umuthi ucindezela ukukhiqizwa kwe-glucagon kubantu abanesifo sikashukela sohlobo 2. Kulokhu, ukugcinwa kwe-glucose ngamaseli wesibindi kuyancipha, ngenxa yokuthi kungenzeka ukulawula inani le-glucose yegazi.
Ezigulini ezinesifo sikashukela sohlobo 2 esitholakele, umuthi ophuma kumjovo wokuqala ongaqhekekile wejwayelekile glycemia. Ngokwenza njalo, kusiza ukwehlisa inani ngaphambi kokudla kwasekuseni ngaphambi, nangemva kokudla. Lesi simo sigcinelwa zonke izinsuku eziyi-7 ngaphambi kokunye ukuphathwa kwekhambi lezidakamizwa.
Ngokukhuphuka kweglucose, umuthi usiza ukwenza ngokwejwayelekile ukukhiqizwa kwe-insulin.
Ukuhlaziywa kwesenzo sento kukhombisa ukuthi umuthi usebenza zonke izigaba zokuhlanganiswa kwe-insulin kwezicubu zamanyikwe. Umjovo owodwa uvumela ukwandisa inqubo yokukhiqizwa kwe-insulin ibe sezingeni eliphakeme kubantu abanesifo sikashukela esinga-insulin.
I-Pharmacokinetics
Ngemuva kokuphathwa kwezidakamizwa, ukuqoqwa okuphezulu kwe-kuhlalaglutide kwaqoshwa ngemuva kwezinsuku ezi-2. Ingxenyenamba ephakathi ye-plasma yakhishwa ngamaviki angama-2-4 kusukela kuqale ukwelashwa. Lezi zinkomba azishintshanga ngaphandle kokuthi umuthi ulimale yiphi ingxenye yomzimba. Ingagwazwa ngokusebenza okulinganayo ngaphansi kwesikhumba sezindawo ezivunyelwe zomzimba ngokuya ngemiyalo, ekuvumela ukuthi uhlanganise amasayithi womjovo.
I-bioavailability lapho ibeka umthamo we-0,75 mg cishe u-65%, futhi nge-1.5 mg ingaphansi kwengxenye. Umuthi udilizwa abe ama-amino acid emzimbeni. Ubudala, ubulili, isintu asithinti ama-pharmacokinetics omuthi. Ngokusebenza okunganele kwe-renal, izinqubo zokusatshalaliswa kanye nokuqedwa kwesidakamizwa emzimbeni siguquka kancane.
Ngokusebenza okunganele kwe-renal, izinqubo zokusatshalaliswa kanye nokuqedwa kwesidakamizwa emzimbeni siguquka kancane.
Izinkomba zokusetshenziswa
Umuthi ubekiwe:
- nge-monotherapy (ukwelashwa ngomuthi owodwa), lapho umsebenzi womzimba osezingeni elifanele nokudla okwenzelwe ngokukhethekile ngenani elinciphile lama-carbohydrate akwanele ukulawula okujwayelekile kwezinkomba zoshukela;
- uma ukwelashwa nge-Glucophage kanye nokufana kwayo kuphambane ngenxa yanoma yisiphi isizathu noma umuthi awubekezelelwa ngabantu;
- ekwelashweni okuhlanganisiwe kanye nokusetshenziswa kanyekanye kwezinye izinhlanganisela ezinciphisa ushukela, uma ukwelashwa okunjalo kungalethi umphumela wokwelapha odingekayo.
Umuthi awubekelwe ukunciphisa umzimba.
Ukwehlisa ukugcwala koshukela egazini, bathatha inkambo ye-Diaformin.
Imiyalo yokusebenzisa iMetformin-Teva.
Lapho ushintsha amazinga kashukela, kusetshenziswa amaphilisi e-Amaryl. Funda kabanzi ngalesi sidakamizwa lapha.
Contraindication
Kuyavumelaniswa ezimweni ezinjalo:
- ukuzwela okuphezulu kwento esebenzayo;
- isifo sikashukela esincike ku-insulin, lapho isiguli siphoqelelwa ukuthola imijovo ye-insulin;
- isifo sikashukela sikashukela;
- umsebenzi wokuphazamiseka wezinso, lapho izinkomba zomsebenzi wazo zijwayelekile ukuthi kudluliselwe esigulini ku-dialysis noma kufakelo;
- inhliziyo kakhulu nokuntuleka kwemithambo okubangelwa inkambo eyinkimbinkimbi yesifo sikashukela;
- Izifo ezinzima zesisu, ikakhulukazi, kuthiwa i-gastric paresis;
- ukuvuvukala okukhulu kwama-pancreas (iziguli ezinjengazo kamuva zidinga ukudluliselwa ku-insulin);
- ukuthinta;
- inkathi yokuhlanza;
- iminyaka efinyelela eminyakeni eyi-18 (izifundo zokwelapha ngokuphepha kokusetshenziswa ezinganeni zingaqhutshwa).
Ngokunakekela
I-Trulicity kufanele inikezwe ngokuqapha kubantu abasebenzisa izidakamizwa ezidinga ukumuncwa kakhulu esiswini namathumbu. Ngokukhathalela okukhulu, nikeza imali kubantu abangaphezu kweminyaka engu-75 ubudala.
Ungayithatha kanjani i-Trulicity
Ukuthatha umuthi wesifo sikashukela
Umuthi usetshenziswa kuphela ngokungaziphathi. Ungenza imijovo esiswini, ethangeni, ehlombe. Ukuphathwa kwe-Intramuscular noma intravenous akuvunyelwe. Ngokuzenzakalelayo angajova nganoma yisiphi isikhathi sosuku, noma ngabe ukudla kungakanani.
Nge-monotherapy, i-0.75 mg kufanele ilawulwe. Endabeni yokwelashwa okuhlangene, i-1.5 mg yesisombululo kufanele ihanjiswe. Ezigulini ezineminyaka yobudala engama-75 nangaphezulu, u-0.75 mg wesidakamizwa kufanele uphathwe, noma ngabe uluhlobo luphi lokwelashwa.
Uma umuthi ungezwa kuma-analog ama-Metformin neminye izidakamizwa esehlisa ushukela, khona-ke umthamo wawo awushintshiwe. Lapho welapha nge-analogues kanye nokususelwa kwe-sulfonylurea, i-prandial insulin, kubalulekile ukunciphisa umthamo wezidakamizwa ukuvimbela ubungozi be-hypoglycemia.
Uma umthamo olandelayo womuthi ulahlekile, khona-ke kufanele uphathwe ngokushesha, uma kunezinsuku ezingaphezu kwezintathu ngaphambi komjovo olandelayo. Uma kusasele izinsuku ezingekho ngaphansi kwezintathu ngaphambi komjovo ngokuya ngohlelo, ukuphathwa okulandelayo kuyaqhubeka ngokohlelo.
Umuthi usetshenziswa kuphela ngokungaziphathi. Ungenza imijovo esiswini, ethangeni, ehlombe.
Isingeniso singenziwa kusetshenziswa isirinji. Lo ngumshini owodwa oqukethe u-0.5 ml wesidakamizwa onento esebenzayo engu-0,5 noma u-1.75 mg. Ipeni wethula umuthi ngokushesha ngemuva kokucindezela inkinobho, ngemuva kwalokho ikhishwe. Ukulandelana kwezenzo zomjovo kanje:
- khipha umuthi esiqandisini uqiniseke ukuthi ilebula liqinisekile;
- hlola ipeni;
- khetha indawo yomjovo (ungazifaka wena esiswini noma ethangeni, bese umsizi enze umjovo ehlombe);
- khipha cap futhi ungathinti inalithi oyinyumba;
- cindezela isisekelo esikhumbeni sendawo yomjovo, ujikeleze indandatho;
- cindezela ubambe inkinobho ekulesi sikhundla kuze kube yilapho ichofoza;
- qhubeka ucindezela isisekelo kuze kube ngokuchofoza kwesibili;
- khipha isibambo.
Ngokuzenzakalelayo, umuthi ungangenwa nganoma yisiphi isikhathi sosuku, kungakhathaleki ukuthi kudliwe kanjani.
Isikhathi esingakanani isifundo
Isikhathi sokwelashwa siyizinyanga ezi-3. Njengoba umuthi ulungele ukwelashwa isikhathi eside, udokotela angangeza isikhathi sokwamukelwa.
Imiphumela emibi Trulicity
Kaningi, iziguli zaziphawula ukuvela kwezimpawu zesisu nokukhathazeka kwamathumbu. Konke ukusabela kwaphawulwa njengokumnene nokulinganiselayo. Kwesinye isikhathi iziguli zazakha ibhulokhi ethambile yangaphakathi. Ukuthatha umuthi odlekeni olunconyelwayo kungadala ukwanda okuvamisile kokuvama kokuqothuka kwenhliziyo - ngezi-2 beats ngomzuzu. Kwakungenakubaluleka komtholampilo.
Ukwemukelwa kuhlotshaniswa nokwanda okuthile komsebenzi wama-enzyme e-pancreatic. Lokhu akubanga zimpawu ze-pancreatitis eyingozi.
Ngesikhathi sokwelashwa, iziguli zaphawula ukubonakala kwezimpawu zesisu nokukhathazeka kwamathumbu.
Amapheshana wesisu
Ezinswini zokugaya zeziguli, isicanucanu, isisu, nokuqunjelwa kwabonwa. Imvamisa kuke kwaba nezimo zokuncipha kwesifiso esifinyelela ku-anorexia, ukuqhakaza nesifo se-gastroesophageal. Ezimweni ezingavamile, ukwamukelwa kuholele ku-pancreatitis eyingozi, edinga ukungenelela okuphuthumayo kokuhlinzwa.
Ukuphazamiseka kwemetabolic nokudla
Isifo sikashukela kwesinye isikhathi saba nokuthuthuka kwe-hypoglycemia. Le nto ivele njengomphumela wokusetshenziswa kweMetformin noma ukulungiswa kwe-insulin okubandakanya Glargina. Imvamisa, iziguli zathola i-hypoglycemia njengempendulo ku-monotherapy nalesi sidakamizwa.
Isistimu yezinzwa ephakathi
Kuyaqabukela, ukwethulwa kwalesi sidakamizwa kuholele esiyezi, izicubu zomzimba.
Allergies
Kwakuqabukela, iziguli zibe nokuvela okufana ne-Quema ye-Quincke, i-urticaria enkulu, ukuqubuka okukhulu, ukuvuvukala kobuso, izindebe kanye nomphimbo. Kwesinye isikhathi kuye kuthi ukuvela kwe-anaphylactic. Kuzo zonke iziguli eziphuza umuthi, ama-antibodies athile kwisithako esisebenzayo, i-saglutide, awakhiwa.
Ezimweni ezingavamile, kuye kwaba nokuphendula kwendawo okuhambisana nokwaziswa kwekhambi ngaphansi kwesikhumba - ukuqubuka kanye nokuqubuka. Izimo ezinje zazibuthakathaka futhi zidlule ngokushesha.
Umthelela ekhonweni lokulawula izindlela
Kufanele inciphise umsebenzi ngezindlela eziyinkimbinkimbi nokushayela iziguli ngokuthambekela kwesiyezi nokuphonsa umfutho wegazi.
Uma kunenkambiso yokwehla komfutho wegazi, khona-ke isikhathi sokwelashwa kufanelekile ukuyeka ukushayela imoto.
Imiyalo ekhethekile
I-cell eseglutide isiza ukubambezela ukuphuma kokuqukethwe esiswini. Ngakho-ke, kuthinta futhi isilinganiso sokufakwa kwenombolo ethile yamalungiselelo omlomo.
Kwenqatshelwe ngokuphelele ukusebenzisa umuthi ekwelapheni iziguli ezinesifo sikashukela sohlobo 1. Akunasipiliyoni ngokusetshenziswa kwezidakamizwa ezinokwehluleka okukhulu kwenhliziyo.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Akunamininingwane mayelana nokunikezwa umuthi ngesikhathi sokukhulelwa. Ucwaningo lomsebenzi we-saglutide ezilwaneni usizile ukukhomba ukuthi unomphumela onobuthi ezinganeni. Kulokhu, ukusetshenziswa kwayo esikhathini sokumiswa kwenqatshelwe ngokuphelele.
Owesifazane othola ukwelashwa ngalo muthi angahlela ukukhulelwa. Kodwa-ke, lapho kuvela izibonakaliso zokuqala ezikhombisa ukuthi ukukhulelwa sekwenzekile, ikhambi kumele likhanseliwe bese kunqunyelwe i-analogue yalo ephephile. Akufanele uzibeke engcupheni yokuqhubeka nokuthatha lesi sikhathi ngesikhathi sokukhulelwa, ngoba izifundo zibonisa amathuba amakhulu okuthola ingane enesiphene. Umuthi ungaphazamisa ukwakheka kwamathambo.
Akukho mininingwane ngokufakwa kwe-yogglutide obisini lukamama. Noma kunjalo, ubungozi bemiphumela enobuthi enganeni ayibandakanywa, ngakho-ke, umuthi awunqatshiwe ngesikhathi sokuncelisa ibele. Uma kunesidingo sokuqhubeka nokuthatha umuthi, khona-ke ingane idluliselwa ekunikezeni ukudla okwenziwe ngethambo.
Akunamininingwane mayelana nokunikezwa umuthi ngesikhathi sokukhulelwa.
Ukunquma Trulicity ezinganeni
Ayabelwe.
Sebenzisa ebudaleni
Ngokuqapha, udinga ukufaka lomjovo ngemuva kweminyaka engama-75.
Ukweqisa Kweqiniso
Uma kwenzeka kuba ne-overdose, izimpawu zokungasebenzi kahle kwendlela yesisu nokuncipha kweshukela kungabonakala. Ukwelashwa kwalezi zimpawu kuyimpawu.
Ukuxhumana nezinye izidakamizwa
Amacala ajwayelekile kakhulu wokusebenzelana kwezidakamizwa kanje:
- I-Paracetamol - ukulungiswa kwedosi akudingeki, ukwehla kokufakwa kwe-compact akunalutho.
- I-Atorvastatin ayinalo ushintsho olubalulekile lokwelashwa lapho lusetshenziswa ngokuxhunyiwe.
- Ekwelashweni nge-kuhlalaglutide, ukwanda komthamo we-Digoxin akudingekile.
- Umuthi ungabekwa cishe nazo zonke izidakamizwa ze-antihypertensive.
- Izinguquko ekusetshenzisweni kwe-warfarin azidingeki.
Uma kwenzeka kweqa ngokweqile, izimpawu zokungasebenzi kahle kwendlela yesisu zingabonakala.
Ukuhambisana notshwala
Ayihambisani notshwala. Ukwehluleka ukuthobela lo mthetho kusongela ngezinkinga ezinkulu kanye nokuthuthukiswa kwe-hypoglycemia enzima.
Ama-Analog
Analogs yile:
- I-Dulaglutide;
- ILiraglutide;
- Saxenda;
- I-Exenatide;
- Victoza.
Imibandela yekhefu lekhemisi
Thengisa kuphela lapho wethulwa incwadi kadokotela.
Ngingakwazi ukuthenga ngaphandle kadokotela
Umuthi awunakuthengwa ngaphandle kwemithi. Kunengozi enkulu yokuthola inkohliso, engadala ukulimala okukhulu emzimbeni.
Inani lentengo
Izindleko zokufaka umuthi ezi-ampoules ezi-4 eRussia zivela kuma-ruble ayizinkulungwane eziyi-11.
Izimo zokugcina zomuthi
Ipeni lesirinji ligcinwa esiqandisini. Uma kungekho zimo ezinjalo, khona-ke zigcinwa isikhathi esingaphezu kwamaviki ayi-2. Ngemuva kwalesi sikhathi, ukusetshenziswa kwomuthi akuvunyelwe ngokuphelele, ngoba kuguqula izakhiwo futhi kube okubulalayo.
Umuthi awukwazi ukuhlanganiswa notshwala.
Isikhathi sokuphelelwa yisikhathi
Umkhiqizo ulungele ukusetshenziswa iminyaka emi-2 ukusuka ngosuku okwenziwe ngawo, inqobo nje uma ugcinwa esiqandisini. Lapho zigcinwa endaweni yokushisa yasekamelweni, impilo yeshalofu iyancishiswa ibe yizinsuku eziyi-14.
Umkhiqizi
Akhiqizwe e-Eli Lilly & Company, United States of America. I-Eli Lilly & Co, Isikhungo Sokukhiqiza ILilly, Indianapolis, e-USA.
Ukubuyekezwa kwe-Trulicity
Odokotela
U-Irina, udokotela wesifo sikashukela, oneminyaka engama-40, eMoscow: "Umuthi ukhombisa ukusebenza kahle kakhulu ekwelashweni kwesifo sikashukela sohlobo 2. Ngiwubeka njengokwengezwa kwezokwelapha ngeMetformin nezimpawu zayo. Njengoba umuthi udinga ukunikezwa isiguli kanye ngesonto, akubanga khona imiphumela emibi yokwelashwa. ilawula ukugxila kwe-glucose egazini ngemuva kokudla futhi ivimbele ukuthuthukiswa kwezinhlobo ezinzima ze-hyperglycemia. "
U-Oleg, i-endocrinologist, eneminyaka engama-55, uNaberezhnye Chelny: "Ngokusebenzisa leli thuluzi, kungenzeka ukuthi kulawulwe ngempumelelo isifo sikashukela esingancikeli i-insulin ezigabeni ezahlukahlukene zeziguli. Nginikeza umuthi uma umuthi wokwelapha weMetformin ungalethi imiphumela efunwayo futhi isiguli sihlala siphakamise ushukela ngemuva kwamaphilisi weGlucofage. izimpawu zesifo sikashukela futhi iqinisekisa amanani ajwayelekile. "
Iziguli
USvetlana, oneminyaka engama-45, uTambov: "Ngosizo lomkhiqizo, kungenzeka ukuthi kulondolozwe amanani ajwayelekile we-glucose. Uma ngithatha amaphilisi, ngangigcina amazinga kashukela aphezulu, ngizizwe ngikhathele, ngomile, kwesinye isikhathi ngiyisiyezi ngenxa yokwehla kakhulu ushukela. Umuthi uqede lezi zinkinga, manje ngiyazama gcina amazinga eglucose akho ejwayelekile. "
USergey, oneminyaka engama-50 ubudala, eMoscow: "Ithuluzi elisebenzayo lokulawula isifo sikashukela. Inzuzo yalo ukuthi udinga ukufaka imijovo kanye ngesonto. Uma usebenzisa umuthi kule modi, akukho miphumela emibi. Ngabona ukuthi ngemuva kwemijovo engezansi "Izinga le-glycemia selizinzile, impilo yathuthuka kakhulu. Phezu kwentengo ephakeme, ngihlela ukuqhubeka nokwelashwa."
U-Elena, oneminyaka engama-40 ubudala, eSt.Ngilawula izinkomba ze-glucose nsuku zonke. Ngithole ukuthi esiswini esingenalutho i-glucometer ayikhombisi ngenhla kuka-6 mmol / l. "
