Ngeshwa, akwenzeki njalo ukulawula amazinga kashukela ngokuzivocavoca umzimba kanye nokudla okufanele. Ngemuva kwalokho kuzofanele usebenzise, ngokwesibonelo, i-Galvus, i-analogues yasekhaya, izindleko zazo eziphansi kakhulu kunezidakamizwa ezingenisiwe, ezihambisana nokwehliswa kwezindleko zokuhamba, umshuwalense, nokupakisha.
Ngenxa yezindleko zayo eziphakeme, imvamisa iziguli ezinemali ephansi naphakathi nendawo kufanele zishintshele ekwelashweni ngama-analogues. Kepha yikuphi okungcono ukukhetha? Lokhu kuzoxoxwa kabanzi ngakho, kodwa okokuqala, kufanele uzijwayeze nomuthi weGalvus.
Ingxenye esebenzayo yomenzeli we-hypoglycemic yi-vildagliptinum, kepha kunezinketho zokuhlanganiswa ne-metformin. Lapho uthenga umuthi ekhemisi, usokhemisi unikeza imithamo ehlukahlukene - 50 mg, kanye nokuhlanganiswa ne-metformin 50/500 mg, 50/850 mg no-50/1000 mg.
I-Vildagliptin yiqembu lezinto ezithuthukisa ukusebenza kwamaseli we-alpha ne-beta akha iziqobana zeLangerhans emanyikweni futhi zivimbele isenzo se-dipeptidyl peptidase-4. Le enzyme ethile ibhubhisa uhlobo lwe-glucagon-uhlobo 1 i-peptide (i-GLP-1) kanye ne-insulinotropic polypeptide (HIP) ye-glucose.
Izici ezijwayelekile zomuthi
Ngenxa ye-vildagliptin, imiphumela emibi ye-dipeptidyl peptidase-4 iyancishiswa, futhi ukukhiqizwa kwe-GLP-1 ne-HIP, okuphambene nalokho, kuyathuthukiswa. Lapho izinga lalezi zinto ezisegazini likhuphuka, i-vildagliptin ithuthukisa ukutholakala kwamaseli we-beta kushukela okhiqizwayo, ngaleyo ndlela ikhuthaze ukwenziwa kwehomoni ekwehlisa ushukela. Kumele kwaziwe ukuthi inani lokuqhakambisa ukusebenza kwamaseli we-beta lincike ezingeni lokubhujiswa kwabo. Ngakho-ke, kubantu abanamazinga ashukela ajwayelekile, i-vildagliptin ayithinti ukukhiqizwa kwe-insulin futhi, futhi, ukukhiqizwa kweglue.
Ingxenye esebenzayo inyusa inani le-GLP-1 futhi ngokushesha yandise ukuzwela kwamangqamuzana we-alpha we-islet apparatus ku-glucose. Njengomphumela, ukukhiqizwa kwe-glucagon kuyanda. Ukwehla kwezinga layo elikhulayo ngesikhathi sokudla kuvusa ukwanda kokuzwela kwamaseli we-peripheral kwi-hormone enciphisa ushukela.
Ngesikhathi sokukhula okusheshayo kwamazinga kashukela, ama-glucagon kanye namazinga e-insulin akhuphuka, okuncike ngqo ekukhiqizweni okwenyukayo kwe-GLP-1 ne-HIP, futhi inqubo yokukhiqiza ushukela esibindini yehlisa ijubane zombili ngesikhathi sokudla nangemva kwayo, okuvusa ukwehla kwenqwabelana kwe-glucose egazini. Kufanele kuqashelwe ukuthi okuqukethwe okukhuliswe ngokomqondo kwe-GLP-1 kunganciphisa inqubo yokuqeda isisu, yize ukwenza lo muthi akuzange kuvuse ukuthuthuka komcimbi onjalo.
Ukusetshenziswa okuyinkimbinkimbi kwezakhi ezimbili - i-metformin ne-vildagliptin, kulawula kangcono izinga le-glycemia kwisifo sikashukela amahora angama-24.
Imiyalo yokusebenzisa amaphilisi
Ukudla akukuthinti ukusetshenziswa komuthi uGalvus noma iGalvus Met.
Ngaphambi kokusebenzisa umuthi, kubalulekile ukufuna usizo lochwepheshe ozocacisa umthamo ngamunye.
Emiyalweni enamathiselwe yesidakamizwa i-Galvus 50 mg, kukhonjiswa imithamo engalungiswa udokotela ohambelayo:
- Nge-monotherapy noma ngokuhlanganiswa ne-insulin therapy, thiazolidinedione, metformin - 50-100 mg.
- Abaphethwe yisifo sikashukela esezingeni eliphezulu bathatha i-100 mg ngosuku.
- Ukwemukelwa kwe-vildagliptin, okuphuma ku-sulfonylurea kanye ne-metformin - 100 mg ngosuku.
- Ukusetshenziswa okuyinkimbinkimbi kwe-sulfonylurea ne-Galvus derivatives kusikisela umthamo we-50 mg ngosuku.
- Uma umuntu onesifo sikashukela esene-dysfunction ephakathi nendawo futhi ephezulu, umthamo wansuku zonke ngu-50 mg.
Ukufakwa kuqukethe imininingwane yokuthi umthamo we-50 mg kufanele uthathwe ngasese ekuseni, bese kuthi u-100 mg uhlukaniswe ngemithamo emibili - ekuseni nakusihlwa.
Imithamo yomuthi i-Galvus Met nayo inqunywa ngudokotela, ngokubheka izinga ushukela kanye nokubekezelelana kwezakhi zomuthi ezigulini. Le ncwajana iphakamisa imithamo emaphakathi ejwayelekile:
- ngokungasebenzi kokusebenzisa i-vildagliptin, kunconywa ukuthatha u-50/500 mg kabili ngosuku;
- uma ukusetshenziswa kwe-metformin kungaphumeleli, thatha i-50/500 mg, 50/50 mg noma 50/1000 mg kabili ngosuku, kuya nge-metformin esetshenziswe ngaphambili;
- ngenhlanganisela engasebenzi ye-vildagliptin ne-metformin, 50/500 mg, 50/50 mg noma 50/1000 mg kabili ngosuku, kuye ngezingxenye ezisetshenzisiwe;
- ngesikhathi sokwelashwa kokuqala nomuthi ngenxa yokungasebenzi kahle kokudla nokuzivocavoca komzimba, thatha u-50/500 mg kanye ngosuku;
- ngokuhambisana nokwelashwa kwe-insulin nokuphuma kwe-sulfonylurea, umthamo we-vildagliptin ungama-50 mg kabili ngosuku, futhi i-metformin iyefana ne-monotherapy.
Ukusetshenziswa kwalesi sidakamizwa kuvinjelwe ngokuphelele kubantu abanesifo sikashukela abahlushwa ukwehluleka kwezinso nezinye izifo zalesi sitho. Ngaphezu kwalokho, ukunakekelwa okukhethekile kubekelwe iziguli zesigaba sebudala (ngaphezulu kweminyaka engama-65), ngoba zivame ukuba nokuncipha kokusebenza kwezinso.
Udokotela angakhulisa umthamo womuthi, noma kunjalo, kwenqatshelwe ukuzibandakanya ngokwakho ekwelashweni, lokhu kungaholela emiphumeleni engathandeki futhi engenakuphikwa.
Contraindication kanye nomonakalo ongaba khona
Umuthi lo unezinto eziningi eziphikisana, kanye nezinye izidakamizwa.
Ngokuyisisekelo, i-contraindication ihlangene nekhono lezitho ezithile zomuntu ukususa izinto ezisebenzayo emzimbeni.
Kwenqatshelwe ukusebenzisa izindlela zikaGalvus noGalvus Met kubantu abanesifo sikashukela abahlupheka noma abahlupheka izifo ezithile:
- Ukungasebenzi kahle kwe-renal noma ukuhluleka kwe-renal (okuqukethwe kwe-creatinine kungaphezu kwe-135 μmol / L kowesilisa, ngaphezu kwe-110 μmol / L kowesifazane).
- Ama-Pathologies akhulisa amathuba okukhula kokusebenza kwezinso. Lokhu kufaka phakathi ukomisa (ukugabha noma uhudo), umkhuhlane, izifo kanye nesimo se-hypoxia.
- Ukungasebenzi kwesibindi.
- Ukuqala kwe-lactic acidosis.
- Ukuthuthukiswa kokwehluleka ukuphefumula.
- Ukuthuthukiswa kokuhluleka kwenhliziyo kwifomu elibi nelingamahlalakhona, kanye ne-infarction ye-myocardial acute.
- I-Metabolic acidosis, kufaka phakathi ukuqala kwe-ketoacidosis, ikoma, i-precoma.
- Ngesikhathi sokuzala nengane.
- Isifo sikashukela esincike ku-insulin.
- Ukuhlinzwa.
- Awukwazi ukusebenzisa lesi sidakamizwa ezinsukwini ezimbili ngaphambi nangemuva kokuhlolwa kwe-radiological and radioisotope ngokwethulwa kwengxenye equkethe iodine.
- Intoxication ngotshwala noma ifomu layo elingamahlalakhona.
- Ukudla okunamakhalori aphansi (ngaphansi kuka-kcal we-1000 ngosuku).
- Hhayi ngaphansi kweminyaka eyi-18.
- Ukungabekezelelani komuntu ngamunye ku-vildagliptin, i-metformin nezinye izinto.
Uma umuthi usetshenziswa ngendlela engafanele noma ngenxa yezizathu ngaphezu kokulawulwa kwesiguli, kungaba nemiphumela emibi, ngokwesibonelo:
- ikhanda kanye nesiyezi;
- ukungavikeleki kwemisipha yokuqothuka (ukuthuthumela) nokubanda;
- i-gastroesophageal Reflux;
- ukuphefumula kwenhliziyo kanye nokuhlanza;
- isifo sohudo noma ukuqunjelwa;
- ukwanda kwerhasi emathunjini;
- shintsha ukunambitha
- i-hypoglycemia;
- ukukhathala;
- i-hyperhidrosis;
- imivimbo esikhumbeni, ukulunywa, i-urticaria;
- ukukhukhumala kwe-peripheral;
- i-arthralgia (izinhlungu ezihlangene);
- ukukhipha isikhumba;
- ukubonakala kwamaqhubu;
- i-lactic acidosis;
- ukuntuleka kwe-Vitamin B12;
- i-pancreatitis
Ngaphezu kwalokho, i-hepatitis ingakhula emzimbeni.
Izindleko, ukubuyekezwa kanye namagama afanayo
Umenzi wesidakamizwa yinkampani yezokwelapha yaseSwitzerland iNovartis, ekhiqiza umuthi nge-vildagliptin noma ngenhlanganisela ye-vildagliptin ene-metformin.
Izidakamizwa zinga-odolwa online online noma vele uye ekhemisi eliseduze. Intengo yomuthi incike ohlotsheni lwayo lokukhululwa. Ibanga lezindleko limi ngokulandelayo:
- I-Galvus 50 mg (amaphilisi angama-28) - ama-ruble ayi-765.
- UGalvus Met 50/500 mg (amaphilisi angama-30) - ama-ruble ayi-1298.
- UGalvus Met 50/850 mg (amaphilisi angama-30) - ama-ruble ayi-1380.
- UGalvus Met 50/1000 mg (amaphilisi angama-30) - ama-ruble ayi-1398.
Njengoba ubona, umuthi awubizi kangako. Akuwona wonke umuntu ozokwazi ukukhokhela ukwelashwa okujwayelekile ngalezi zidakamizwa, ngakho-ke kunesidingo sokukhetha izidakamizwa ezifanayo, ezizokhulunywa ngokuhamba kwesikhathi.
Ngokuqondene nombono ngomuthi uGalvus, muhle kakhulu. Ukubuyekezwa kweziguli eziningi eziphuza lo muthi kukhombisa ukuthi ngemuva kwezinyanga eziyi-1-2 zokuthatha i-Galvus, izinkomba ze-glucose zibuyele kokujwayelekile. Ngaphezu kwalokho, abanesifo sikashukela abanjalo ngenkathi usebenzisa umuthi ungadla ukudla okuvinjelwe ngaphambili. IGalvus Met, sibonga i-metformin yayo, isiza ukulahlekelwa ngamakhilogremu angeziwe eziguli ezikhuluphele ngokweqile. Noma kunjalo, umuthi unamandla okubuyisa owodwa - kuyindleko yawo ephezulu.
Uma isiguli sinqatshelwe ukusebenzisa i-Galvus ngenxa ye-contraindication noma i-side effect, udokotela unquma esinye isidakamizwa. Lokhu kungaba ngamagama wokuvumelanisa, okungukuthi, leyo mikhiqizo equkethe into efanayo esebenzayo, umehluko usezingxenyeni ezingezekile kuphela. IGalvus Met ukuphela kwegama elifanayo neGalvus; lawa amalungiselelo amabili aqukethe i-vildagliptin.
Kodwa-ke, le mishanguzo inezidakamizwa eziningi ezifanayo ezinemiphumela efanayo yokwelapha, okuzoxoxwa ngayo ngokuhamba kwesikhathi.
Imidwebo yezidakamizwa uGalvus
Leli qembu lezidakamizwa lifaka isakhi esisebenzayo - i-vildagliptin. Lokhu kufaka phakathi u-Vipidia, u-Onglisa, u-Januvius kanye nezimali ze-Trazent. E-Russia, amalungiselelo aqukethe i-vildagliptin akhiqizwanga, ngakho-ke sizokhuluma ngezidakamizwa ezingenisiwe.
I-Vipidia isidakamizwa esinciphisa ushukela esenzelwe i-monotherapy noma ukwelashwa okuxubile kohlobo 2 sikashukela. Ikhishwa kwifomu lethebhulethi, umthamo wansuku zonke ophakeme kakhulu ungama-25 mg futhi ungaxhomekeki ekudleni. Umenzeli we-hypoglycemic angeke athathwe ngabanesifo sikashukela nge-renal, i-hepatic, ukuhluleka kwenhliziyo, nge-ketoacidosis yesifo sikashukela kanye nefomu lesifo sikashukela esincike kakhulu. Imiphumela emibi ifana nomphumela ongemuhle wesidakamizwa uGalvus. Ngenxa yokuntuleka kwemininingwane ngemiphumela yesidakamizwa ezinganeni ezingaphansi kweminyaka engu-18 nabesifazane abakhulelwe, ayinqunyelwe izigaba ezinjalo zeziguli. Izindleko ezijwayelekile ze-Vipidia (amaphilisi angama-25 mg 28) ngama-ruble ayi-1239.
U-Onglisa ulungiselela kahle ukugcina amazinga kashukela egazini esiswini esingenalutho nangemva kokudla. Ngenxa ye-saxagliptin ebalulekile yomuthi, umuthi futhi ulawula okuqukethwe i-glucagon. Ingasetshenziswa kokubili njengempahla elungisiwe futhi ihlanganiswe nezinye izidakamizwa. Umuthi we-Onglis ubethelwe ngendlela yokwelashwa kwe-insulin, uhlobo 1 sikashukela kanye ne-ketoacidosis. Ukuphendula okungathandeki okuyinhloko ikhanda, ukuvuvukala, umphimbo obuhlungu. Intengo ephakathi yesidakamizwa (amaphilisi ama-5 mg 30) angama-ruble ayi-1936.
UJanuvia ngumenzeli we-hypoglycemic, okubandakanya isakhi esisebenzayo i-sitagliptin. Ukusetshenziswa kwezidakamizwa kusiza ukwenza ngokwejwayelekile izinga le-glycemia ne-glucagon. Imithamo inqunywa ngudokotela ohambelayo, onaka okuqukethwe ushukela, impilo ejwayelekile nezinye izici. Umuthi uJanuvia ubekwa umthetho ophathelene nesifo sikashukela esincike ku-insulin kanye nokungabekezelelani komuntu ngamunye ezingxenyeni. Ngesikhathi sokusetshenziswa, ikhanda, izinkinga zokugaya ukudla, izinhlungu ezihlangene, kanye nezifo zokuphefumula zingavela. Ngokwesilinganiso, izindleko zomuthi (amaphilisi ayi-100 mg 28) angama-ruble ayi-1666.
I-Trazhenta isidakamizwa ekhiqizwa ngesimo samathebulethi nge-lignagliptin esebenzayo. Yenza buthaka i-gluconeogeneis futhi iqinise amazinga kashukela. Udokotela ukhetha imithamo ngamunye esigulini ngasinye.
Ayikwazi ukusetshenziselwa i-ketoacidosis, thayipha isifo sikashukela esingu-1 nokungabekezeleli ezintweni eziqukethwe. Intengo ejwayelekile (amaphilisi ayi-5 mg 30) ngama-ruble ayi-1769.
Analogs of the drug Galvus Met
Umuthi weGalvus Met, ama-analogues yi-Avandamet, i-Glimecomb, ne-Combogliz Prolong yokukhiqizwa kwe-Russian, equkethe izinto ezimbili eziyimbangela ephumelelayo ye-hypoglycemic.
I-Avandamet yi-ejenti ehlanganisiwe ye-hypoglycemic equkethe izingxenye ezimbili eziyinhloko - i-rosiglitazone ne-metformin. Umuthi usetshenziswa ekwelapheni isifo sikashukela esinga-insulin. Isenzo se-rosiglitazone sihlose ukukhulisa ukuzwela kwama-cell receptors ku-insulin, kanye ne-metformin - ekwenze buthaka ukukhiqizwa kwe-glucose yisibindi. Izindleko ezijwayelekile zesidakamizwa (amaphilisi angu-500/25 mg angama-56) ngama-ruble angama-210, ngakho-ke yi-analogue engabizi kahle.
I-Glimecomb isinye isidakamizwa esisebenzayo esisimamisa izinga le-glucose yesifo sikashukela. Inezinto ezimbili eziyinhloko - i-gliclazide ne-metformin. Ukuxhumana kokusetshenziswa kwalesi sidakamizwa sikashukela-sincike ku-insulin, i-coma ne-precoma, i-hypoglycemia, ukukhulelwa, ukuncelisa ibele nezinye izifo. Intengo ephakathi (40/500 mg 60 amaphilisi) ngama-ruble angama-440.
ICombogliz Prolong ifaka izinto eziyisisekelo ezinjenge-metformin ne-saxagliptin. Kusetshenziselwa isifo sikashukela sohlobo 2, lapho umsebenzi ngokomzimba kanye nokudla okuyisipesheli kunganikezeli ukwehla kweglucose. Umuthi usiza ukuthi i-insulin ikhishwe kumaseli e-beta futhi ithuthukise ukwanda kwamaseli kuyo. Contraindication nokusetshenziswa komuthi umuzwa ngamunye wezinto zomuthi, ushukela othembele ku-insulin, ubuntwana, ukuzala kwengane, ukuqunjelwa, izinso ezingalimele, isibindi, i-metabolic acidosis nabanye. Izindleko ezijwayelekile zesidakamizwa (amaphilisi ayi-1000/5 mg 28) ngama-ruble angama-2941.
Ngokusekelwe kuma-contraindication, ukulimala okungaba khona kanye nezindleko eziphakeme zomuthi, zingathathelwa indawo ngomunye. Njengoba ubona, izidakamizwa kulolu chungechunge cishe ziyabiza impela. Phakathi kwazo, ama-analogues amabili angahlukaniswa - I-Glimecomb ne-Avandamet, okuyizinqolo ezishibhile phakathi kwezinye izidakamizwa ze-hypoglycemic. Lapho ukhetha indlela engcono kakhulu, bobabili udokotela kanye nesiguli bacabanga ngezinto ezimbili ezibalulekile - inani lentengo nomphumela wokwelapha umuthi.
Imininingwane ngemithi esebenza kahle kakhulu yesifo sikashukela inikezwe kuvidiyo kule ndatshana.
