UJanuvia ungomunye wemithi ephumelela kakhulu nephephe kakhulu esetshenziswa kwezokwelapha ukwelapha isifo sikashukela.
Umuthi esakhiweni sawo umuthi owenziwe eqenjini lama -retretin.
Ama-incretin ngokwawo angama-hormone abandakanyeka ngqo ekwakhekeni kwe-insulin nasekusetshenzisweni kweglucose egazini.
Izidakamizwa ezivela kuleli qembu zinemiphumela elandelayo emzimbeni womuntu:
- ukukhuthaza ukukhiqizwa kwe-insulin ye-hormone ngamaseli we-beta wamanyikwe;
- vimbela ukukhiqizwa kwe-glucagon ngamaseli we-pancreatic alpha;
- yehlisa ijubane inqubo yokuthulula isisu;
- ukufaka isandla ekwehleni kwesifiso sokudla;
Ngaphezu kwalokho, zithinta ngokunenzuzo ukusebenza kwezinhlelo zenhliziyo nezinzwa.
Yini i-ejenti ye-hypoglycemic?
Umuthi wesifo sikashukela weJanuvia uthola ukuthandwa phakathi kochwepheshe bezokwelapha kanye neziguli ezinalokhu kutholwa.
Ukulungiswa kwethebhulethi kunomphumela obonakalayo we-hypoglycemic futhi kungokwesigaba se-DPP-4 inhibitors.
Ukusetshenziswa kwesidakamizwa kukhuthaza ukukhula kwama-incretin asebenzayo futhi kuvuse isenzo sabo. Ngesikhathi sokusebenza okujwayelekile komzimba, ama-incretin akhiqizwa emathunjini, futhi izinga lawo likhuphuka kakhulu ngemuva kokudla.
Njengomphumela wentuthuko yesifo sikashukela, ukwehluleka kwenzeka enkambweni yale nqubo, futhi ngenxa yalokho, ochwepheshe bezokwelapha bathola ukubuyiselwa kwayo ngokunquma iziguli umuthi uJanuvia.
Ama-incretin anesibopho sokuqhakambisa ukukhiqizwa kwe-insulin ngamanyikwe.
Ezinye zezinto zokwelapha ezisetshenziswayo zokwelapha yilezi:
- Kwehliswe ukuhla kwe-hemoglobin ye-glycated.
- Ukuqedwa kwezimpawu ze-hyperglycemia (kufaka phakathi ushukela wegazi osheshisiwe).
- I-Normalization yesisindo somzimba.
Umuthi uyatholakala ngesimo sethebulethi ngendlela amaphilisi ajikeleze ngayo, anemibala ye-beige.
Isithako esikhulu esisebenzayo yi-sitagliptin (mnn), njengoba izakhi ezisizayo ziyi-calcium hydrogen phosphate, i-microcrystalline cellulose, i-magnesium stearate, i-croscarmellose ne-sodium stearyl fumarate, nayo eyingxenye yomuthi. Izwe lendabuko uJanuvia - Netherlands, inkampani yemithi "MERCK SHARP & DOHME".
Amacwecwe anengxenye esebenzayo ye-sitagliptin, njengomthetho, asetshenziswa ezimweni:
- ekwelashweni okuyinkimbinkimbi kokwelashwa kwezifo ezinjengohlobo 2 lwesifo sikashukela, ukukhulisa umphumela we-hypoglycemic ngokuhlangana nabaphikisi noma i-metformin hydrochloride;
- njenge-monotherapy ekwakhiweni kwe-insulin-ezimele yesifo sikashukela ngokuhlanganiswa nama-regimens okungezona izidakamizwa - ukwelashwa kokudla kanye nomsebenzi womzimba.
Kumele kuqashelwe ukuthi ukwelashwa okuyinkimbinkimbi ukusetshenziswa kwemithi yala maqembu alandelayo:
- ISitagliptin ivame ukusetshenziswa ngokubambisana ne-metformin (Siafor, Glucofage, Formmetin).
- Nge-sulfonylurea derivatives (Diabeteson noma i-Amaryl).
- Ngemithi eqenjini le-thiazolidinediones (Pioglitazole, Rosiglitazone).
Amathebhulethi aseJanuvia, afaka i-sitagliptin, adonswa ngokushesha ngemuva kokuthathwa futhi afinyelele ekuhlolweni kwe-plasma ephezulu ngemuva kwamahora amane.
Izinga le-bioavailability eliphelele likhulu impela futhi lifinyelela kumaphesenti angamashumi ayisishiyagalolunye.
Imiyalo yokusebenzisa umuthi
Umkhakha wezemithi usungule izindlela zokwenza umkhiqizo wokwelapha ngamanani ahlukahlukene efektri esebenzayo.
Ukunquma ukuthi imuphi umthamo ophathelene kakhulu nesiguli kunqunywa udokotela ohambelayo.
Ukukhetha komthamo wesidakamizwa kwenziwa kuphela emva kokuhlolwa kwesiguli.
Ukulungiswa kwethebhulethi kuvezwa emakethe yamakhemikhali kumithamo elandelayo:
- umuthi uqukethe i-25 mg yesithako esisebenzayo;
- inani lezinto ezisebenzayo ngu-50 mg;
- UJanuvia 100 mg - amaphilisi anomuthi omkhulu kakhulu.
Imiyalo kaJanuvia yokusebenzisa ikhombisa isidingo somuthi usebenzisa uhlelo olulandelayo:
- Amathebulethi athathwa ngomlomo ngenani elanele le-ketshezi, kungakhathalekile ukuthi kudliwani.
- Umthamo wansuku zonke wezidakamizwa kufanele ube amamililitha ayikhulu esakhi esisebenzayo.
- Uma uphuthelwa umthamo olandelayo, ungaphindi umthamo ophinda usetshenziswe olandelayo.
- Uma isiguli sinokungasebenzi kahle kwezinso ngendlela yokuhluleka kokulunga kwesitho, umthamo kufanele wehliswe ku-milligrams angamashumi amahlanu. Ngezinkinga ezinzima zokusebenza kwezinso, umthamo ovunyelwe akufanele udlule amamililitha angamashumi amabili nanhlanu ento esebenzayo.
Ukusetshenziswa kwe-sitagliptin kuvunyelwe kuphela njengoba kuyalelwe uchwepheshe wezokwelapha.
Uma kwenzeka kweqa izidakamizwa, izinguquko ezingxenyeni ye-QTc zingatholakala. Njengendlela yokwelapha, kusetshenziswa izindlela ezinjenge-gastric lavage, ukusetshenziswa kwemithi ye-enterosorbent kanye nokwelashwa okubonisa izimpawu.
Contraindication
UJanuvia umuthi ophephe kakhudlwana onesifo sikashukela.
Isici esihlukile somkhiqizo wokwelapha we-hypoglycemic Januvia kusuka kwezinye izidakamizwa ezinciphisa ushukela ukuphepha okuhlobene kokusetshenziswa kwaso.
Kulokhu, kunezimo lapho ukusetshenziswa komuthi kwenqatshelwe.
Ukulungiselela ithebhulethi akuvunyelwe ukuthatha amacala alandelayo:
- ngokwakhiwa kwesimo sokuncika kwesifo sikashukela;
- ebuntwaneni, njengoba izifundo zodokotela bezange zenziwa maqondana nomphumela womuthi emzimbeni wengane, umphumela wazo uhlala ungaziwa nanamuhla;
- umuthi awukwazi ukusetshenziswa uma isiguli sinokuzwela okukodwa kwengxenye eyodwa noma ngaphezulu kokuqanjwa;
- uma kukhona ukuthuthukiswa kwe-ketoacidosis yesifo sikashukela;
- ngesikhathi sokukhulelwa nangesikhathi uncelisa ibele.
Ngaphezu kwalokho, ngokuqapha ngokweqile, kuyadingeka ukwenza inkambo yokwelashwa kweziguli ezinezinkinga ezinkulu ngokusebenza kwezinso. Kungakho, akufanele unqume ngokuzimela ngokusetshenziswa kwomuthi.
Ukwelashwa kufanele kuhanjiswe njengoba kuyalelwe nangaphansi kokuqondisa kukachwepheshe wezokwelapha.
Imiphumela emibi nemiphumela emibi engaba khona
Umuthi kaJanuvia unemiphumela emibi engemihle, ngokungafani nezinye izidakamizwa ezinciphisa ushukela.
Ingxenye esebenzayo ibekezelelwa kalula ngumzimba, empeleni ngaphandle kokubangela ukusabela okuphambene.
Ngaphezu kwalokho, kwezinye izimo, imiphumela emincane emincane evela ezinhlotsheni nasezinhlelweni zomzimba zingavela.
Njengomthetho, imiphumela emibi enjalo inyamalala ngemuva kokuhoxiswa kwezidakamizwa.
Ukuvela okungalungile kungenzeka engxenyeni yesistimu yokuphefumula ngendlela ye-nasopharyngitis noma izifo ezithathelwanayo zomgudu wokuphefumula.
Ngaphezu kwalokho, isiguli singakhalaza ngokuthuthukiswa kwezinqubo ezinjalo:
- Ubuhlungu bekhanda obukhulu.
- Ubuhlungu esiswini, buhambisana nokuphelelwa yisicanucanu, ukugabha, noma uhudo.
- Ukuboniswa kwe-hypoglycemia.
- Ngokwemiphumela yokuhlaziywa, kungenzeka ukuphambuka okulandelayo - izinga le-uric acid kanye ne-neutrophils lenyuka, inani le-alkaline phosphatase liyancipha.
Futhi, ukwanda kokushona kungahle kubalwe ngenombolo yokubonakaliswa okungalungile, ngenxa yalokho okunconyelwe ukushayela izimoto noma ukwenza imisebenzi ngamasu adinga ukwanda okukhulu kokunakwa.
Ukubuyekezwa kwabathengi nabachwepheshe bezokwelapha
Phakathi kweziguli eziningi ezisebenzise umuthi, ukubukeza ngakho ezimweni eziningi kuyakhanya.
Ukubuyekezwa okungalungile kuvame ukuhlotshaniswa nokuphulwa kwemiyalo yokusebenzisa umuthi.
Mayelana noJanuvia, ukubuyekezwa kukhombisa ukuthi umuthi unezinzuzo eziningana.
Izinzuzo ezibaluleke kakhulu zomenzeli we-hypoglycemic, uma kuqhathaniswa neminye imithi enciphisa ushukela, yile elandelayo:
- kukhona okwenziwe ngokwejwayelekile kwe-glucose yasekuseni egazini, isinxephezelo sithatha i-hue ephinyiselwe kancane;
- ngemuva kokudla, isidakamizwa sisebenza ngokushesha, silinganisa izinga le-glycemia;
- ushukela wegazi uyeka ukuba "yi-spasmodic" emvelweni, amaconsi abukhali noma ukukhuphuka kwawo akubonwa.
Kumele kuqashelwe ukuthi ngokuya ngemiyalo yokusetshenziswa komuthi, amaphilisi angaphuzwa nganoma yisiphi isikhathi sosuku, noma ngabe kuthathwa kanjani ukudla.
Ngasikhathi sinye, iziguli zithanda umuthi wasekuseni, zithi ngale ndlela kutholakala umphumela ozinzile futhi okhulunyiwe, ngoba umuthi kufanele unxephezele ukudla okufika phakathi nosuku.
Umbono wodokotela uthi akukho mehluko uma uphuza imishanguzo futhi umthetho omkhulu ukulandela irejimeni futhi ungaphuthelwa yisicelo esilandelayo. Kuyisikimu esinjalo esizovumela ukwelashwa kube nomphumela omuhle.
Kwezinye izimo, abanesifo sikashukela babika ukuthi ngemuva kwesikhathi esithile, umphumela wokwelapha umuthi uqala ukuncipha futhi ugxume emazingeni e-glucose aqale phansi. Lesi simo sichazwa ngokuqhubeka kwenqubo ye-pathological.
Ngokusho kweziguli, ukubuyela emuva okuphambili kweJanuvia yinqubomgomo yamanani alesi sidakamizwa.
Intengo yesidakamizwa esine-dosage esiphezulu ihluka kusuka kuma-ruble ayi-1,500 kuye ku-1,700 ngephakethe ngalinye (amaphilisi angama-28).
Kwabanesifo sikashukela abaningi, izindleko ziye zingabekezeleleki, uma nje umuthi kufanele uphuzwe njalo, futhi iphakethe elinjalo lizohlala ngaphansi kwenyanga.
Kungakho, iziguli ziqala ukubheka imishanguzo engabizi kakhulu.
I-Hypoglycemic analog
UJanuvia kanye nama-analogues angathengwa emakhemisi uma unemithi kadokotela ebekwe ngudokotela wakho.
Namuhla, osokhemisi baseRussia abakwazi ukunikela ngama-analog aqondile ngengxenye efanayo esebenzayo kubathengi babo.
Uma siqhathanisa ikhodi ye-ATX-4 ngokuzenzakalela, ezinye izifanekiselo zeJanuvia zingasebenza njengezidakamizwa ezingezekayo.
U-Onglisa wumenzeli we-hypoglycemic osetshenziselwa ukwengeza amazinga kashukela egazi. Isithako esikhulu esisebenzayo yi-saxaglipin kwimithamo yemiligremu emibili nengxenye noma emihlanu. Umuthi ufakwa eqenjini lama-DPP-4 inhibitors. Okuvame ukusetshenziswa njengendlela yokwelapha yokuhlangana ngokuhlangana namathebulethi asuselwa ku-metformin. Izindleko zomuthi zingama-ruble ayi-1800.
IGalvus Met - iqukethe izinto ezimbili ezibalulekile - i-vildagliptin ne-metformin hydrochloride. Esokuqala singummeleli wesigaba sokuvuselela okokusebenza okungaphakathi kwama-pancreas futhi kusiza ukwandisa ukuzwela kwamangqamuzana e-beta ekungeneni ushukela njengoba ayelimele.
Kulokhu, i-metformin hydrochloride ivimbela inqubo ye-gluconeogeneis, ivuselela i-glycolysis, okuholela ekuthuthukisweni kangcono kwe-glucose ngamaseli nezicubu zomzimba. Ngaphezu kwalokho kunokwehla kokufakwa kweglue amaseli wamathumbu. Umuthi awuholeli ekuthuthukisweni kwe-hypoglycemia. Izindleko zethuluzi elinjalo zivela kuma-ruble ayi-1300 kuya kwangama-1500.
IGalvus ekusebenzeni kwayo iyafana neGalves Met, ngaphandle kokuthi iqukethe ingxenye eyodwa kuphela esebenzayo - i-vildagliptin. Intengo yesidakamizwa ivela kuma-ruble angama-800.
Isikhashana - ithebhulethi yezidakamizwa enomphumela obizwa ngokuthi yi-hypoglycemic. Isithako esikhulu esisebenzayo yi-linagliptin. Izici eziphambili zemithi yesidakamizwa zifaka phakathi amandla okunciphisa izinga le-glycemia, ukwanda kokuxineka kwama-incretins, ukwanda kokuphepha okuncike egazini le-insulin. Intengo yeTransgent icishe ibe ngama-ruble ayi-1700.
Yimuphi umuthi ozosiza ekunciphiseni izinga le-glucose eliphakeme futhi umise ukuthuthukiswa kwenqubo ye-pathological, udokotela okhona kuphela onganquma. Akunconyelwe ukuthi uzimele esikhundleni somuthi obekwe uchwepheshe wezokwelapha.
Ama-ejenti ephumelela we-hypoglycemic achazwe kuvidiyo kule ndatshana.
