Ngokuthuthuka kwesifo sikashukela esingancikeli i-insulin, iziguli azihlali zilawula izinga le-glycemia zisebenzisa ukudla okhethekile nokuzivocavoca umzimba. U-Onglisa umuthi onciphisa ushukela osetshenziswa ezimeni ezinjalo ukwenza uzinzo we-glucose egazini.
Njenganoma yisiphi isidakamizwa, u-Onglisa unokuphikisana okuthile, ukusabela okuphambene, kanye nezici zokusebenzisa. Ngakho-ke, ngaphambi kokusebenzisa umuthi, udinga ukuthola ulwazi olunemininingwane ngalo.
U-Onglisa (ngo-lat. Onglyza) isidakamizwa esidumile esisetshenziswa emhlabeni wonke ngesifo sikashukela sohlobo 2. Igama elingabambeki ezweni (i-INN) lomuthi yiSaxagliptin.
Umenzi walesi simiso se-hypoglycemic inkampani yaseMelika iBristol-Myers squibb. Ingxenye eyinhloko - i-saxagliptin ithathwa njengenye yamakhemikhali wokuphindisela anobuhlakani obunamandla kakhulu we-dipeptidyl peptidase-4 (DPP-4). Lokhu kusho ukuthi lapho umuthi uphuzwa ngomlomo, into esemqoka ivimbela isenzo se-enzyme ye-DPP-4 phakathi nosuku.
Ngaphezu kwe-saxagliptin, amaphilisi we-Ongliz aqukethe inani elincane lezingxenye ezengeziwe - i-lactose monohydrate, i-croscarmellose sodium, i-microcrystalline cellulose, i-macrogol, i-talc, i-titanium dioxide, i-magnesium stearate nezinye. Kuya ngesimo sokukhishwa, ithebhulethi eyodwa yesidakamizwa ingaqukatha u-2,5 noma 5 mg wento esebenzayo.
Ngabe i-ejenti yokuphikisana nesifo sikashukela u-Onglisa isebenza kanjani ngemuva kokungena emzimbeni womuntu? ISaxagliptin imunwa ngokushesha emgudwini wokugaya ukudla, okuqukethwe kwawo okuphezulu kakhulu ku-plasma yegazi kubonwa emahoreni angama-2-4 ngemuva kokufakwa. Umuthi unomphumela onjalo:
- Kwenyusa izinga le-ISU ne-GLP-1.
- Yehlisa okuqukethwe i-glucagon, futhi futhi ithuthukisa ukusabela kwamaseli we-beta, okubandakanya ukwanda kwezinga le-C-peptides ne-insulin.
- Kuthuthukisa ukukhishwa kwe-hormone enciphisa ushukela ngamaseli e-beta akhiwe kumanyikwe.
- Kuvimbela ukukhishwa kwe-glucagon kumaseli we-alpha weziqithi zeLangerhans.
Ngokukhombisa izinqubo ezingenhla emzimbeni, umuthi we-Onglis uthuthukisa amanani we-glycated hemoglobin (HbA1c), izinkomba zeglue esiswini esingenalutho nangemva kokudla. Odokotela bangase banikeze umuthi ngokuhlanganiswa namanye ama-hypoglycemic agents (metformin, glibenclamide noma thiazolidinediones).
Umuthi osebenzayo ukhishwa emzimbeni emzimbeni ngendlela engashintshiwe nangendlela ye-metabolite ene-bile nomchamo.
Ngokwesilinganiso, imvume yokuqina kwe-saxagliptin ingama-230 ml ngomzuzu, kanti isilinganiso se-glomerular filtration rate (GFR) singu-120 ml ngomzuzu.
Imiyalo yokusebenzisa amaphilisi
Ngaphambi kokuthatha umuthi, isiguli sidinga ukubonisana nodokotela waso wezempilo ozonquma umthamo ngamunye osuselwa kushukela likashukela. Lapho uthenga umuthi i-Onglisa, imiyalo yokusebenzisa kufanele ifundwe ngokucophelela futhi uma unemibuzo buza udokotela wabo.
Amacwecwe asetshenziswa kungakhathalekile isikhathi sokudla, ahlanzwa phansi ngengilazi yamanzi. Uma umuthi uthathwa njenge-monotherapy, khona-ke umthamo wansuku zonke ngu-5 mg. Uma udokotela enquma ukwelashwa okuhlangene, khona-ke kuvunyelwe ukusebenzisa i-Ongliza 5 mg nge-metformin, i-thiazolidinediones nezinye izidakamizwa ze-hypoglycemic ngosuku.
Ukuhlanganisa i-Onglisa ne-metformin, udinga ukunamathela kumthamo wokuqala we-5 mg no-500 mg, ngokulandelana. Kwenqatshelwe ngokuqinile ukuthatha imithamo ephindwe kabili ecaleni lapho isiguli ekhohlwa ukuphuza umuthi ngesikhathi. Ngokushesha lapho ekhumbula lokhu, kudingeka aphuze iphilisi elilodwa.
Ngokuphawuleka ikakhulukazi iziguli ezinenkinga yokwehluleka kwezinso. Ngefomu elincane lokungasebenzi kwezinso, akudingekile ukulungisa umthamo womuthi. Ezigulini ezinokwehluleka okulinganiselwe noma okunzima kwe-renal, kanye nalabo abahlangabezana ne-hemodialysis, umthamo wansuku zonke ngu-2,5 mg. Ngaphezu kwalokho, lapho usebenzisa i-CYP 3A4 / 5 inhibitors eqinile, umthamo wemithi ye-Onglis kufanele ube omncane (2,5 mg).
Umenzi ukhombisa kumaphakeji usuku lokuphelelwa isikhathi, okuvame ukuba yiminyaka emithathu. Umuthi ugcinwa kude nezingane ezincane kumazinga okushisa angabi ngaphezu kwama-30.
Contraindication kanye nokulimala okungenzeka
Njengoba umenzi engazange enze isibalo esanele sokuhlolwa maqondana nokusetshenziswa komuthi we-Ongliz wesifo sikashukela esincike ku-insulin, ukusetshenziswa okuyinkimbinkimbi kwe-insulin, kanye nasebuntwaneni nasebusheni, ezimweni ezinjalo, umuthi awunqatshelwe.
Ngaphezu kwalokho, ama-contraindication aqashelwa ngokusemthethweni okusetshenziselwa wona yi-ketoacidosis yesifo sikashukela, ukukhipha ilactation nokukhulelwa, i-hypersensitivity kuzakhi zomuthi, ukushoda kwe-lactase, i-glucose-galactose malabsorption kanye nokuzwela kokuzala kwe-galactose.
Udokotela ukala ubuhle nokulimala ngaphambi kokunquma umuthi we-Onglis kwiziguli esezikhulile ezinokungalingani okulinganiselwe nokuqina kwezinso ngokuhlanganiswa ne-sulfonylurea derivatives.
Kwesinye isikhathi lapho uphuza umuthi, kuvela imiphumela engathandeki. Umuthi u-Onglisa unezimbalwa zazo, noma kunjalo, isiguli singakhalaza:
- i-sinusitis (ukuvuvukala kwe-mucosa yamakhala);
- ukuqunjelwa;
- ikhanda
- izifo ezithinta umchamo;
- ukuthuthukiswa kwe-gastroenteritis (ukuvuvukala kwamathumbu amancane nesisu);
- izifo zokuphefumula eziphezulu;
- I-nasopharyngitis (ukusetshenziswa okuyinkimbinkimbi kwe-Onglisa ene-metformin).
Umenzi awakhombisi amacala okusebenzisa izidakamizwa ngokweqile. Kodwa-ke, lapho kuvela izimpawu ezingakhombisa ukweqisa, i-hemodialysis isetshenziswa ukususa i-saxagliptin nama-metabolites ayo emzimbeni.
Ukwelashwa okubonakalayo kuyenziwa futhi.
Izici zokusebenzisana nezinye izidakamizwa
Ngokungafani nezinye izidakamizwa ze-antidiabetic, ngokwesibonelo, umuthi weMetformin, umuthi we-Onglis ungasetshenziswa ngokuhlanganiswa cishe nazo zonke izindlela. Kodwa-ke, uma kuvela noma yiziphi izifo ezihlangene, onesifo sikashukela kufanele aye ehhovisi likadokotela ayovalelisa ukulimala okungase kube khona kuleyo mithi.
Ezinye izidakamizwa, ezinjengeCarbamazepine, Phenytoin, Phenobarbital, Dexamethasone, Rifampicin, okuyi-inducers ye-CYP 3A4 / 5 isoenzymes, zinganciphisa okuqukethwe kwama-metabolites ayisisekelo esakhi esisebenzayo. Ngakho-ke, ngenxa yokuthatha le mishanguzo kukhuphuka izinga le-glucose kushukela sikashukela.
Ngenxa yokuthi ukutholakala kwe-sulfonylurea kukhulisa amathuba ezimpawu ze-hypoglycemia, umthamo wabo uma usetshenziswa ngokuhlangana ne-Onglisa kufanele wehliswe ube mncane.
Emiyalweni enamathiselwe kunemiyalo yokuthatha u-Onglisa. Njengoba lolu khambi lubangela isiyezi kwezinye izimo, kunconyelwa ukuthi iziguli ezinomsebenzi wazo zihlobene nezimoto nokulawulwa kwemishini zincome ukuthi uzisuse kulowo msebenzi ngenkathi usebenzisa umuthi.
Lokhu kumcabango nje ngoba azikho izifundo ezenziwayo ngomuthi womuthi onaka isikhathi sokunakwa.
Ukubuyekezwa mayelana nomuthi nezindleko zawo
Kwi-Intanethi ungathola ukuphawula okuningi okuhle mayelana nomenzeli we-hypoglycemic u-Onglisa. Lesi sidakamizwa esihle esinciphisa ngempumelelo amazinga kashukela kubantu abanesifo sikashukela abanesifo sohlobo 2. Phakathi kwezinzuzo zomuthi ukwelula ukusetshenziswa, ukwenzeka okuqabukela kakhulu kwemiphumela emibi kanye nokusebenza kwayo.
Ukubuyekezwa okungalungile kuhlobene kakhulu nezindleko zomuthi. Njengoba kukhiqizwa phesheya, izindleko zokuhamba, ukuthunyelwa kwamakhambi, njll. Ziyanda. Umgomo wamanani uhloswe kwiziguli ezinamazinga aphezulu okunotha. Ngakho-ke, intengo yephakethe elilodwa le-Onglisa, equkethe amaphilisi angama-30 ama-5 mg lilinye, isukela ku-1835 kuya kuma-2170 ama-ruble aseRussia. Ukonga imali ethile, iziguli zifaka i-oda lokuthenga umuthi online. Izindleko zomuthi othengwe nge-Intanethi zizokwehla kakhulu kunekhemisi ejwayelekile.
Ngaphandle komqondo omuhle weziguli nodokotela mayelana nomuthi olwa nesifo sikashukela, kwabanye akulungile. Kwi-Intanethi kwesinye isikhathi ungathola imibono yokuthi umuthi ubungenawo ukwehla kwamazinga kashukela ngokuphelele. Ngakho-ke, odokotela banquma umuthi u-Onglisa njengezengezo zokwelapha ngeSiofor noma iDiabetes.
Akumele sikhohlwe ukuthi izibhebhe ngokwazo ngeke zibe nomphumela ofanele wehlise izinga le-glycemia.
Ukwelashwa okuyinkimbinkimbi kokudla nemidlalo kuphela okuzosiza ukufeza umphumela oyifunayo.
Izidakamizwa ezifanayo
Kwezinye izimo, ukuthatha umuthi u-Onglisa kuba nzima.
Lapho-ke udokotela ubhekene nomsebenzi wokushintsha inqubo yokwelashwa yesiguli sakhe.
Uchwepheshe ukhetha umuthi oqukethe isithako esifanayo esisebenzayo, noma onomphumela ofanayo wokwelapha.
Ngezansi kwezifanekiso ezithandwa kakhulu zomuthi u-Onglisa.
- UGalvus - i-vildagliptin esebenzayo, ibiza ama-ruble angama-789.
- I-Vipidia - i-alogliptin esebenzayo, ibiza ama-ruble ayi-1241.
- UJanuvia - i-sitagliptin esebenzayo, izindleko ezingama-ruble ayi-1634.
- Ama-Glucovans - i-glibenclamide esebenzayo + ye-metformin hydrochloride, ibiza ama-ruble angama-270
- I-Trazhenta - i-linagliptin esebenzayo, izindleko zama-ruble ayi-1711.
Ukufana kwezidakamizwa u-Onglisa kuyabiza impela, ngaphandle kwamaGlucovans neGlucofage. Ngeshwa, umuthi awukhishwa mahhala ngokwemibandela yokukhetha. Kepha isiguli sinelungelo lokucela udokotela wakhe ukuthi afakele i-Ongliz enqunyiwe ngama-analogues akhishwa mahhala anikezwe umuthi ofanele. Kwabanesifo sikashukela, iMetformin, iGlibenclamide, iGliclazide, iGrimepiride nezinye izidakamizwa zinganikezwa ngendlela ekhethekile.
Udokotela ngamunye nesiguli ngasinye banquma ukuthi yikuphi okuhle kuye. Ngemuva kwakho konke, umuthi ungasebenza, kepha ubize kakhulu futhi, ngakolunye uhlangothi, ushibhile, kepha unganikeli umphumela ofanele we-hypoglycemic. Inketho enhle inani lemali.
Isifo sikashukela yisifo esibi esidinga ukunakwa ngokukhethekile. Ukuze izinga likashukela lingakhuphuki, awudingi nje kuphela ukuthatha amaphilisi ngokuya ngezincomo zikadokotela, kodwa futhi unamathela ekudleni okuqinile futhi uphile impilo esebenzayo.
Abanye bakholelwa ukuthi u-Onglisa umuthi omuhle kakhulu one-saxagliptin. Kodwa akufanele sikhohlwe ukuthi umuthi ngamunye ungaba nengozi ethile. Ngakho-ke, iziguli kufanele zifunde ngokucophelela incazelo yomuthi. Ukuphela kwendlela efanelekile yokulawulwa kwesifo sikashukela okuzoqinisa amazinga kashukela.
UDkt Gorchakov uzokhuluma ngemigomo yokwelashwa kwesifo sikashukela sohlobo 2 kuvidiyo ekulesi sihloko.
