Umehluko omkhulu phakathi kweVictoza ukungabikho okuphelele kwezimpawu ezimakethe zamakhemikhali, okuthinta inqubomgomo yamanani entengo enjalo.
Umuthi uhlose ukunciphisa nokunciphisa i-glucose ejwayelekile, kepha uthole ukutholakala kwawo njengesidakamizwa ukwengeza isisindo ngokweqile.
Yiluphi ikhambi lokwelapha eliyinkimbinkimbi?
I-mellitus yesifo sikashukela enganciki i-insulin yisifo se-endocrine lapho amaseli omzimba enqaba i-insulin ekhiqizwa yi-pancreas.
Ngenxa yale nqubo, amangqamuzana alahlekelwa ukuzwela kwawo ku-hormone, ushukela awukwazi ukungena ngaphakathi kwezicubu, uqwabelana emzimbeni. Futhi, ukwenyuka kwamazinga e-insulin kuyabonakala futhi, ngoba amanyikwe aqala ukukhiqiza inani laleli hormone ngevolumu ekhuphukayo.
Ngesikhathi sokuthuthukiswa kwenqubo ye-pathological, kukhona ukwephulwa kwazo zonke izinqubo ze-metabolic emzimbeni, izitho eziningi eziningi zangaphakathi kanye nezinhlelo ziyahlupheka.
Ukwelashwa okuyinkimbinkimbi kwanamuhla kwe-pathology kusekelwe ezimisweni ezilandelayo:
- Ukuhambisana nokudla. Ukukhetha okulungile kwamamenyu nokudla okusetshenzisiwe ngeke kusize kuphela ukunciphisa amazinga kashukela, kodwa futhi kusiza ekuguquleni isisindo ngokwejwayelekile. Njengoba wazi, esinye sezizathu zokuthuthuka kwe-mellitus yesifo sikashukela esinga-insulin ukukhuluphala.
- Ukwelashwa ngokomzimba nakho kunomthelela omuhle ekujwayelweni kashukela wegazi. Kwesinye isikhathi kwanele ukuhola indlela yokuphila esebenzayo, ukuhamba nsuku zonke emoyeni omusha nokudla okufanele, ukuze isiguli sizizwe singcono.
- Ukwelashwa kwezidakamizwa. Ukubuyisa ushukela kokujwayelekile kuzosiza umuthi ofanele obekwe udokotela wakho.
Kuze kube manje, ukwelashwa kwe-mellitus yesifo sikashukela esinga-insulin kusetshenziswa elinye lamaqembu alandelayo amadivayisi wezokwelapha:
- izidakamizwa ezitholakala sulfonylurea. Umphumela we-pharmacological ukukhuthaza ukucasulwa kwe-insulin yangaphandle;
- imithi efakwe eqenjini lama-Biguanides. Imiphumela yabo ihlose ukwehlisa isidingo secretion ye-insulin;
- umuthi osuselwa ku-thiazolidinol usiza ukunciphisa ushukela wegazi futhi ube nomphumela omuhle ekuvumelaneni kwephrofayili ye-lipid;
- ama-incretins.
Uma umuthi ongenhla oshukela wegazi ophansi ungalethi umphumela omuhle, ukwelashwa kwe-insulin kungasetshenziswa.
Imiphumela emqoka yemithi
Umuthi i-Victoza, njengomthetho, unqunyelwa ezigulini ezitholwa nesifo sikashukela esinga-insulin, njengesidakamizwa sezokwelapha esisizayo. Inkambo yokwelapha yokusebenzisa umuthi onjalo kumele ihambisane nokudla okukhethekile nokuqeqeshwa ngokomzimba okusebenzayo. Kulesi simo kuphela, ungafinyelela umphumela omkhulu kusukela ekusebenziseni umuthi.
Umuthi weVictoza ukhiqizwa ngumenzi ngesimo sesixazululo somjovo we-subcutaneous. Kumatafula kanye nezinye izindlela zokwelapha, umuthi awethulwanga kuze kube manje.
I-Victoza yezidakamizwa iyi-analogue ye-glucagon-peptide yomuntu-ekhiqizwa indlela ye-biotechnological, futhi amaphesenti ayisishiyagalolunye nesikhombisa ahambisana nayo. Into ibopha kuma-receptors athile abhekiswe kwi-incretin ekhiqizwa ngumzimba. Futhi, i-incretin ye-hormone inesibopho sokukhuthaza ukukhiqizwa kwe-insulin uma kukhona ukwanda kweglucose yegazi.
Umphumela wesidakamizwa futhi usiza ukunciphisa ukukhiqizwa kwe-insulin uma isimo se-hypoglycemia sibhekwa. Ngakho-ke, ukwehla kwesisindo kanye nokujwayelekile, kwenzeka, inani lama-deposits lamafutha liyancipha, futhi ukukhula kokudla kuyanyamalala.
Umuthi uyatholakala njengevolumu ye-syringe pen Victoza yamamililitha amathathu. Isithako esikhulu esisebenzayo kulo muthi yi-liraglutide. Umuthi udonswa ngaphakathi kwamahora ayisishiyagalombili kuya kwayishumi nambili, futhi kungalesi sikhathi kuphela lapho izinga laso eliphezulu egazini lingabhekwa.
Ipeni yesirinji i-Victoza ithengiswa emaphaketheni ekhethekile amakhadibhodi enani elilodwa, amabili noma amathathu umjovo. Ngaphezu kwalokho, iqukethe imiyalo esemthethweni enemininingwane yokusetshenziswa komkhiqizo wolwazi olunolwazi olulandelayo:
- Igayidi yesinyathelo ngesinyathelo sokuthi ungagwaza kanjani i-Victoza futhi kanjani.
- Imithamo enconyiwe.
- Ukusetshenziswa kwenaliti ngendlela efanele.
- Imiphumela emibi nokuphikisana.
Ukupakishwa ngezinaliti kufakwa ku-cartridge ekhethekile yengilazi, equkethe nepeni yesirinji enokuphinda isebenze. Isirinji ngayinye yanele imithamo engamashumi amathathu ka-0.6 mg. Uma udokotela enquma iziguli ezinkulu ezigulini, inani lemijovo liyancipha. Umjovo wenziwa kalula, into esemqoka ukuthola amakhono athile ukuze kufakwe inaliti ngaphansi kwesikhumba.
Izinkomba eziphambili zokujova ngohlobo lwe-2 yesifo sikashukela esuselwa kulesi sidakamizwa yile elandelayo:
- njengomuthi oyinhlokoꓼ
- kanye neminye imithi - iMetformin, iGlibenclamide, iDibetolongол
- kusetshenziswa ukwelashwa kwe-insulin.
Ngaphezu kwalokho, umuthi ungabekelwa iziguli ezinesifo sikashukela njengesidakamizwa sokunciphisa umzimba. Ukubuyekezwa kweziguli zeVictoza kukhombisa ukuthi lapho uthatha umuthi, ukwehla kwesifiso sokudla kuyabonakala, izinga le-glucose egazini lijwayelekile.
Ngaphezu kwalokho, ukujova njalo ngenyanga kusiza ekulinganiseni inani le-triglycerides.
Imiyalo yokusebenzisa umuthi
Imiyalo yeVictoza yokusetshenziswa ithi ukuqala kokwelashwa kufanele kwenziwe ngemithamo ephansi kakhulu yomuthi. Ngakho-ke, kulawulwa i-metabolic control efanelekile.
Ngesikhathi sokuthatha umuthi, isiguli kufanele siqaphe njalo amazinga kashukela egazini. Ukunikezwa komuthi, nokuthi mangaki imithamo efakiwe kulomjovo, kunqunywa kuphela ngudokotela ohambelayo. Kulokhu, ukuzelapha kunqatshelwe ngokuphelele.
Umuthi i-Viktoza uphathwa kanye ngosuku, kusukela lapho isenzo se-liraglutide esebenzayo iqala ukwenzeka ngemuva kwesikhathi esithile.
Umjovo nge-Victoza kufanele uphathwe ngaphansi kwesikhumba kwenye yezindawo ezilula kakhulu:
- Ihlombe.
- I-Thigh.
- Belly
Kulokhu, umjovo wenaliti wokujova awuncike ekudleni okuyinhloko. Njengesincomo, kubhekwa njengokulungile ukugcina izikhathi ezifanayo phakathi kwemijovo. Kumele kuqashelwe ukuthi umuthi i-Viktoza awuvunyelwe ukungena ngaphakathi noma ngokungena emzimbeni.
Isibalo semithamo enconyiwe sincike ekujuleni kwenhliziyo yesifo kanye nezimpawu zesiguli ngasinye. Esigabeni sokuqala sokwelashwa okucindezelwayo, kunconywa ukujova kanye ngosuku, okuzoba yi-0.6 mg ye-liraglutide. Kungekapheli ngisho neviki ngemuva kokuqala kokwelashwa, kukhuphuka imithamo efinyelela ku-1,2 mg wesidakamizwa ngosuku evunyelwe. Ukwanda ngakunye okwalandela komthamo kumele kwenzeke ngokuvalwa okungenani kwezinsuku eziyisikhombisa.
Isilinganiso esiphezulu se-liraglutide esikhishwe akufanele singeqi ku-1.8 mg.
Imvamisa ekwelashweni okuyinkimbinkimbi, isidakamizwa sisetshenziswa ngokubambisana ne-Metformin noma ezinye izidakamizwa ezisehlisa ushukela. Kulokhu, imithamo yezidakamizwa ezinjalo inqunywa ngudokotela ohambelayo.
Ngokwenkambiso yezokwelapha, ekwelashweni kwe-pathology asebekhulile, umthamo ophethwe umuthi awuzange uhlukane nalokhu okubalwe ngenhla.
Ukubuyekezwa mayelana neVictoza yongoti bezokwelapha kwehla iqiniso lokuthi ukusetshenziswa komuthi kufanele kwenziwe kuphela njengoba kuyalelwe udokotela. Kulokhu, ungakugwema ukutholakala kwemiphumela emibi bese ukhetha umthamo ofanele.
Kungcono ukugcina umuthi esiqandisini emazingeni okushisa amabili kuya kwayisishiyagalombili.
Kuvunyelwe futhi ukushiya umuthi ezindaweni lapho ukukhanya kwelanga kungangeni khona, inqobo nje uma izinga lokushisa lingangeqi ngamashumi amathathu.
Yikuphi ukuphambana kokusetshenziswa okukhona?
Njenganoma yisiphi esinye isidakamizwa, i-Victoza inezinombolo eziningi zokuphikisana ukuze isetshenziswe.
Yonke imibiko etholakalayo iboniswa kwimiyalo yokusebenzisa umuthi.
Ngenqubo yokwelashwa yokwelashwa neVictoza, konke ukubhekelana okungenzeka kusetshenziswe kwayo kumele kubhekwe.
I-Liraglutide akufanele isetshenziswe kumacala alandelayo:
- hypersensitivity engxenyeni eyodwa noma eziningi zomuthiꓼ
- iziguli ezinesifo sikashukela sohlobo lwesifo sikashukelaꓼ
- uma isiguli sine-ketoacidosisꓼ yesifo sikashukela
- Izinkinga zomsebenzi ojwayelekile wezinso, i-organ pathologiesꓼ enzima
- uma kunezinkinga ngokusebenza kwesibindiꓼ
- uma kungasebenzi kahle uhlelo lwe-genitourinaryꓼ
- uma kukhona izifo zezitho zesifo senhliziyo, ukwehluleka kwenhliziyoꓼ
- ukuthuthukiswa kwezinqubo zokuvuvukala emathunjini, kanye nezinye izifo zezitho zamapheshana emathunjini (kufaka phakathi i-paresis yesisu) ꓼ
- izingane ezingaphansi kweminyaka eyishumi nesishiyagalombili neziguli ngemuva kweminyaka engamashumi ayisikhombisa nanhlanuꓼ
- amantombazane ngesikhathi sokukhulelwa nokukhulelwa.
Izifundo zobudokotela zikhombisile ukuthi kuyaphulwa ukuthi abesifazane baphuze umuthi ngesikhathi sokukhulelwa. Kunobungozi obukhulu bomphumela omubi wento esebenzayo ekuthuthukisweni kwesibeletho nokuphila kwayo. Kufanele wenqabe ukusebenzisa umuthi ngisho nalapho uhlela ingane engakazalwa. Ngokuqondene nenkathi yokuqunjelwa, odokotela bathi iViktoza cishe ayingene ebisini lwebele. Kulokhu, noma uncelisa ibele, akunconywa ukuthatha umuthi ngalo.
Njengoba umuthi usetshenziselwa ukwelapha isifo sikashukela futhi unomphumela omuhle ekuthini isisindo sisejwayelekile ezigulini zalo mkhakha, abanye abantu abanempilo bayasisebenzisa njengendlela yokunciphisa isisindo.
Odokotela batusa ukugwema ukusetshenziswa kwezinyathelo ezinjengalezi, ngoba kunengozi enkulu yokuba nomdlavuza we-thyroid lapho uphuza umuthi kubantu abaphilile.
Imiphi imiphumela emibi engenzeka?
Lapho usebenzisa umuthi, imiphumela emibi ingavela.
Ukwehluleka ukuhambisana nezincomo zikadokotela oholayo, ukungawunaki ulwazi oluchazwe emiyalweni yokusebenzisa umuthi, kungaholela emiphumeleni emibi.
Ikakhulu kaningi, ukubonakaliswa okungalungile okunjalo kutholakala ezigabeni zokuqala zenkambo yokwelashwa.
Imiphumela emibi eyinhloko engaba khona ngenxa yokuphuza umuthi ukubonakaliswa kokusabela okulandelayo:
- Ukwephula izinqubo umzimba of umsoco. Okuyinhloko isicanucanu, ukugabha, ukuhudula noma ukuqunjelwa, izinhlungu esiswini, ukulahlekelwa ngokuphelele kwesifiso sokudla. Ezimweni ezingavamile, ukuphuma komzimba kuyabonakala.
- Isistimu yezinzwa ephakathi inganikeza amasignali ngendlela yezinhlungu ezinzima zekhanda.
- Ukuphendula okungalungile kwezitho zepheshana lesisu kuvame ukwenzeka, njengokuthuthuka noma ukwanda kwe-gastritis, i-gastroesophageal Reflux, i-belching, ukuqhakaza nokwanda ukwakheka kwegesi. Kuyaqabukela, iziguli zikhononda ngokukhula kwe-pancreatitis eyingozi.
- Ukuphazamiseka kusuka kumasosha omzimba kungabonakala njengokuphendula kwe-anaphylactic.
- Ngendlela yezinqubo ezithathelwanayo zepheshana lokuphefumula elingaphezulu.
- Ukuphendula okungalungile okuvela kumjovo.
- Ukukhathala komzimba okujwayelekile kanye nempilo ebuthakaꓼ
- Ngokwengxenye yohlelo lwezitho zofuzo, imiphumela emibi iziveza njengokwehluleka kwezinso okulimazayo, ukungasebenzi kahle kwezinso okujwayelekileꓼ
- Izinkinga ngesikhumba. Imvamisa, ukusabela okunjalo kuboniswa ngendlela yokuqunjaza esikhunjeni, i-urticaria, kanye nokulunywa.
Ngendlela ye-hypoglycemia, imiphumela emibi ezigulini ivezwa kaningi kakhulu. Umphumela onjalo ungavela lapho umthamo ungabonakali kahle, ikakhulukazi ekwelashweni okuhlanganayo nezinye izidakamizwa ezinciphisa ushukela. Emsebenzini wezokwelapha, i-hypoglycemia enzima yabonwa ku-mellitus yesifo sikashukela lapho kuhlanganiswa i-Viktoza nezidakamizwa ezivela eqenjini le-sulfonylurea derivatives.
Ngaphezu kwalokho, ukuphuza umuthi kwezinye izikhathi kungahle kuhambisane nokwakhiwa kokungezwani komzimba, okubonakalisa ngesimo se-urticaria, ukuqubuka, ukuphefumula kobunzima, kanye nokwanda kwemvamisa yokushaywa kwenhliziyo.
Ngokweqile komuthi izikhathi ezingaphezu kwamashumi amane, kwenqatshelwa ngendlela yokucanuzelelwa kwenhliziyo nokuhlanza kanzima. Ngasikhathi sinye, izinga le-glucose egazini alizange lehle emazingeni abucayi.
Uma kwenzeka kweqa ngokweqile, kunconywa ukulandela izincomo zikadokotela oholayo futhi wenze inkambo yokwelashwa okubonakalayo.
Kungenzeka yini ukuthi ungene esikhundleni seViktoza ngomkhiqizo onezakhiwo ezifanayo?
Kuze kube manje, imakethe yamakhemikhali ayinazo izifanekiselo eziphelele zesidakamizwa iViktoza.
Intengo yomuthi onjalo, okokuqala, kuya ngenani lamapeni wesirinji kwiphakeji.
Ungathenga umuthi emakhemisi asedolobheni kusuka kuma-ruble ayi-7 kuye kwangama-11,2.
Le mithi elandelayo iyafana emiphumeleni yayo yemithi, kepha ngesinye isithako esisebenzayo:
- I-Novonorm yisidakamizwa sethebhulethi esinomthelela wokwehlisa ushukela emzimbeni. Umenzi womuthi onjalo yiJalimane. Isithako esikhulu esisebenzayo i-repaglinide yento. Kuvame ukusetshenziselwa i-mellitus engavikelekile nge-insulin, njengethuluzi eliyinhloko noma ekuhlanganiseni i-metformin noma i-thiazolidinedione. Izindleko zomuthi, ngokuya ngomthamo, ziyahlukahluka kusuka kuma-ruble ayi-170 kuye kwangama-230.
- I-Baeta isidakamizwa esinqunywe njenge-adjuvant ekwelapheni okuyinkimbinkimbi ekwelapheni i-mellitus engavikelekile nge-insulin. Kutholakala ngesimo sesixazululo somjovo we-subcutaneous. Isithako esikhulu esisebenzayo yi-exenatide. Intengo evamile yomuthi onjalo kumakhemisi ngama-ruble ayizinkulungwane ezine.
Ngaphezu kwalokho, i-analogue yesidakamizwa iViktoza nguLuxumia
Udokotela okhona kuphela onganquma ngesidingo sokubuyisela umuthi phakathi nenkambo yokwelashwa.
I-video ekulesi sihloko ikhuluma ngezidakamizwa ezisehlisa ushukela wegazi.
