Imithi enesakhi esisebenzayo - i-saxagliptin isetshenziswa ngesikhathi sokwelapha uhlobo lwe-2 sikashukela mellitus. Zingahlanganiswa nezinye izidakamizwa ezinciphisa ushukela ukuthuthukisa umphumela wokwelapha. Le ndatshana izokusiza ukuthi ufunde ngezakhiwo eziphambili zento, izinkomba, ukuphikisana, ukusabela okungekuhle, umuthi oqukethe i-saxagliptin, ukubukeza kwabanesifo sikashukela nemithi efanayo.
Kuze kube manje, uhlobo 2 sikashukela selashwa ngenxa yezakhi eziningana: ukondleka okufanele, ukuvivinya umzimba, ukuqapha ushukela wegazi njalo. Indawo esemqoka ekwelashweni kwalesi sifo ukwelashwa ngezidakamizwa.
Ukusetshenziswa kwe-Onglisa noma i-Saxagliptin, iMetformin ngokubambisana inomphumela omuhle ezingeni le-glucose esigulini. Ukubuyekezwa mayelana nalezi zidakamizwa kuhle kakhulu.
Ukudonswa kuphela kwentengo ephakeme yesidakamizwa u-Ongliza nezimpawu zayo. Ukuqinisekisa umphumela ongcono kakhulu wokwelapha futhi uvikele izinkinga eziningi, izidakamizwa kumele zithathwe ngokuqinile ngaphansi kokuqondisa udokotela.
Izici zento esebenzayo
I-Saxagliptin is ahibitor ekhethiweyo eguquguqukayo yokuncintisana yedipididyl peptidase-4 (DPP-4). Ngesikhathi sokusetshenziswa kwento ezigulini ezinesifo sikashukela sohlobo 2, umsebenzi we-enzyme ye-DPP-4 uyancipha phakathi nosuku.
Ngemuva kokuthi isiguli sithathe ushukela, ukugcwala kwe-glucagon kuncishiswa kakhulu. Ngasikhathi sinye, kukhona ukukhishwa kwehomoni - i-insulin yi-pancreas, noma ngokunembile - amaseli wayo we-beta. Le nqubo isiza ukunciphisa ushukela wegazi esiswini esingenalutho kubantu.
Le nto ixhumana nezinto eziningi ze-hypoglycemic - metformin, glibenclamide, pioglitazone, ketoconazole, simvastatin noma dithiazem. Kepha ukusetshenziswa, kanye nama-inducers we-CYP3A4 / 5 isoenzymes, isibonelo, ketoconazole, itraconazole, indinavir nabanye, kunganciphisa ukusebenza komphumela wokwelapha we-saxagliptin.
Ocwaningweni oluningi, ososayensi abakwazanga ukuthola umphumela okhethekile we-saxagliptin kuphrofayela ye-lipid. Lapho usebenzisa le nto, akukho nzuzo yesisindo yabonwa kunoma yisiphi isiguli esihloliwe uhlobo lwe-2 mellitus yesifo sikashukela.
Kumele kuqashelwe ukuthi ososayensi abenzi izifundo ezihlobene nethonya lezinto ze-hypoglycemic zezinto ezinjengokubhema, utshwala, ukudla, kanye nokusetshenziswa kwemithi ye-herbal.
Ngakho-ke, abantu abanemikhuba emibi futhi badla izidakamizwa zemvelo kufanele bathathe into ngokuqapha ngokweqile.
Imiyalo yokusebenzisa umuthi
Umuthi owaziwa kakhulu oqukethe into esebenzayo - i-saxagliptin ngu-Onglisa.
Itholakala ngesimo samaphilisi ayi-5 mg. Iphakethe elilodwa liqukethe izingcezu ezingama-30.
Zithathwa ngokungakhathalekile isidlo, zigezwe ngenani elincane lamanzi.
Izinkomba eziphambili zokusebenzisa umuthi u-Onglisa, lapho i-saxagliptin iyinto ephambili ye-hypoglycemic, kucatshangelwa:
- Thayipha i-2 mellitus yesifo sikashukela, uma ukudla nokuvivinya umzimba kungathinti ukwehla kushukela wegazi, njenge-monotherapy.
- Njengethuluzi elingeziwe le-metformin esigabeni sokuqala sokwelashwa ukuthuthukisa inqubo ye-hypoglycemic.
- Njengokwengezwa kwe-monotherapy ene-metformin, i-sulfonylurea derivatives, thiazolidinediones, uma kungenakwenzeka ukulawula ngokwanele izinga leshukela.
Ngaphambi kokuqala ukwelashwa, imiyalo yokusebenzisa umuthi we-Ongliz kufanele ifundwe ngokucophelela. Udokotela oholayo kuphela ongakunikeza ukwelashwa ngalesi sidakamizwa, awukwazi ukusithenga ngaphandle kadokotela. Nge-monotherapy noma ukuhlanganiswa nezinye izindlela, isiguli asidli ngaphezu kwe-5 mg yomuthi u-Onglisa ngosuku. Esigabeni sokuqala sokwelashwa nge-saxagliptin, iMetformin ithathwa ngosuku ku-500 mg. Esimweni lapho isiguli sikhohliwe ukuthi kuyadingeka ukuphuza isibhebhe se-Onglisa, lokhu kumele kwenziwe ngokushesha. Kwamanye amaqembu eziguli, umthamo wansuku zonke ungancishiselwa ku-2,5 mg. Okokuqala, laba bantu abane-hemodialysis kanye nokwehluleka kwezinso. Ngesikhathi esifanayo, i-Ongliz kufanele ithathwe kuphela ngemuva kokudlula inqubo ye-hemodialysis.
Iithebhulethi zigcinwa lapho izingane zingafinyeleleki emazingeni okushisa asekamelweni. Impilo yeshalofu yesidakamizwa yiminyaka emi-3.
Contraindication kanye nemiphumela emibi
Njengezinye izidakamizwa eziningi, umuthi we-Ongliz ungavunyelwa.
Ngasikhathi sinye, u-Ongliza unqunywa ngudokotela ngokunakekela okukhethekile ezigulini ezihluleka yizinso, asebekhulile kanye neziguli abathatha okuphuma kusisu.
Uma isiguli sihlanganisa izidakamizwa ezimbili - i-Onglizu ne-Metformin, i-nasopharyngitis, ukuvuvukala kwe-nasopharynx okubangelwa yimvelo egulisayo. Qiniseka ukubuza udokotela wakho ukuthi uyisebenzisa kanjani iMetformin neminye imithi.
Awukwazi ukusebenzisa lesi sidakamizwa kubantu:
- ngaphansi kweminyaka eyi-18;
- thayipha i-1 isifo sikashukela;
- ukuphathwa i-insulin nokwelashwa kwezidakamizwa;
- ukungabekezelelwa kwe-galactose, ukuntuleka kwe-lactase, ukukhiqizwa kwe-glucose-galactose malabsorption;
- nge-ketoacidosis yesifo sikashukela;
- ngesikhathi sokukhulelwa nokuqunjelwa;
- nokungabekezeleli komuntu ngamunye ezingxenyeni zomuthi.
Ngesikhathi se-monotherapy, umuthi ungahle ubangele ukusabela okungekuhle kubantu, okufana:
- izifo zokuphefumula eziphezulu;
- ukuvuvukala kwephepha lomchamo;
- isicanucanu nokuhlanza
- ikhanda;
- i-sinusitis (ubunzima bokubethelwa kwe-rhinitis);
- i-gastroenteritis (ukuvuvukala kwesisu namathumbu amancane).
Imiyalo esetshenziswayo ayizivezi izimpawu ezingase zibe khona ezihambisana nehaba lomuthi. Kepha uma kwenzeka, kunconywa ukwelashwa okubonakalayo.
Ngaphezu kwalokho, i-saxagliptin yethi ingasuswa kusetshenziswa inqubo ye-hemodialysis.
Ukubuyekezwa kwezindleko nezidakamizwa
Umuthi u-Onglisa ungathengwa kunoma yiliphi ikhemisi ngencwadi kadokotela noma uyalwe ku-Intanethi. Ukuze wenze lokhu, iya kwi-inthanethi ekhemisi ye-inthanethi bese ulandela imiyalo ukubeka i-oda. Njengoba umuthi ukhiqizwa e-United States, izindleko zawo ziphakeme impela. Intengo yesidakamizwa esinciphisa ushukela isukela ku-1890 kuya ku-2045 ruble.
Ukubuyekezwa kwabanesifo sikashukela abaningi kuyanelisa. Iziguli eziningi ezithatha inothi lomuthi zisebenza ngempumelelo yazo. Ngemuva kwenkambo yokuphuza amaphilisi, ukulandela ukudla nokuzivocavoca umzimba, ukujwayeza ushukela wegazi isikhathi eside kuyabonakala. Iziguli ezisebenzisa i-Ongliza zenelisekile ngokusetshenziswa okulula kwesidakamizwa. Ukuphendula okuhlukile kubonwe ezimweni ezingavamile. Okuwukuphela kwento edabukisayo yomuthi yizindleko zayo eziphakeme, ngenxa yokuthi kungumuthi ongenisiwe.
Ngasikhathi sinye, kube nokubuyekezwa kwabashayeli abashayela izimoto izimoto ezidalwe umuthi.
Ngakho-ke, abantu abahambisana nabaphathi bezokuthutha, kungakuhle ukuthi bayeke imisebenzi yabo ngesikhathi sokwelashwa ukuze bagweme imiphumela emibi.
Uhlu lwezidakamizwa ezifanayo
Uma isiguli senqatshelwe ukusebenzisa i-Ongliza noma sinemiphumela ethile emibi, udokotela ohambelayo angalungisa inkambo yokwelashwa ngokunikeza omunye umuthi ofanayo.
U-Onglisa akanazo iziphikiso kulokho okusebenzayo, kodwa ngokuya ngemiphumela emzimbeni womuntu, kunezidakamizwa ezinjalo:
- UJanuvia umuthi wethebhulethi wehlisela ukugcwala kweglucose egazini. Izwe elikhiqizayo yiNetherlands. Lesi sidakamizwa singasetshenziswa ne-monotherapy, futhi sihlanganiswe namanye ama-hypoglycemic agents njenge-Metformin ngokungasebenzi kahle kokudla kanye nomsebenzi womzimba. Ngokungafani ne-Onglisa, iJanuvia ine-contraindication ezimbalwa. Intengo emaphakathi ama-ruble ayi-1670.
- I-Trazenta iqukethe into i-linagliptin esebenzayo, evamisa amazinga kashukela egazi. Lesi sidakamizwa senziwa e-United States. I-Monotherapy kuleli cala ayisebenzi, umuthi usetshenziswa kanye nezinye izidakamizwa ezinciphisa ushukela (iMetformin, insulin, i-sulfonylurea derivatives, iPioglitazone, njll.). Noma kunjalo, lo muthi uthathwa njengephephe kakhulu, ngoba empeleni awubangeli ukusabela okubi. Izindleko ezijwayelekile ngama-ruble ayi-1790.
- INesina umuthi wokulawulwa kwesifo sikashukela sohlobo 2. Umenzi walesi sidakamizwa yinkampani yemithi yaseMelika iTakeda Pharmaceuticals. I-ejenti ye-hypoglycemic nayo isetshenziswa nge-monotherapy nangokunye ukwelashwa nezinye izidakamizwa. Imvamisa, imiphumela emibi ehambisana nokuphazamiseka kokugaya ukudla kwenzeka. Intengo ephakathi kumakhemisi ama-ruble ayi-965.
- IGalvus ingesinye isidakamizwa esisebenzayo se-antidiabetes. Ikhiqizwa yinkampani yezokwelapha yaseSwitzerland. Umuthi ungasetjenziswa ngokwelashwa kwe-insulin nezinye izidakamizwa ezinciphisa ushukela. Inenombolo enkulu impela yokuphikisana, kepha amacala okuvela kokungaphenduki kahle ancishiselwa ku-zero. Izindleko ezijwayelekile ngama-ruble angama-800.
Futhi, iziguli ezinesifo sikashukela zivame ukubekwa njengeMetformin 850 noma ngomthamo we-1000 mg.
Kumele kuqashelwe ukuthi asikho esinye sezidakamizwa ezingenhla esingasetshenziswa ebuntwaneni (kuze kube yiminyaka eyi-18), ngoba umphumela wazo wokwelapha kule minyaka emincane awuzange ufundwe. Yonke imishanguzo iyabiza futhi hhayi zonke iziguli ezingabiza.
Ividiyo ekulesi sihloko ikhuluma ngamaphilisi anciphisa ushukela.
