ISitagliptin iyatholakala ngesimo se-phosphate monohydrate. Ukukhishwa kwifomu yithebhulethi ehlanganiswe nefilimu
Ithuluzi lihluke kakhulu ekwakhekeni kwalo kwamakhemikhali nakwisenzo se-pharmacological kusuka kuma-analogues kanye nokutholakala kwe-sulfonylureas, biguanides ne-alpha-glycosidase inhibitors.
Ukuvinjwa kwe-DPP 4 nge-Sitagliptin kuholela ekwandeni kokuxineka kwama-hormone amabili i-GLP-1 ne-HIP. La mahomoni angawomndeni wama-incretin. Ukuqedwa kwalawa mahomoni kwenziwa emathunjini.
Iqoqo lama-hormone landa ngenxa yokudla. Ama-incretin ayingxenye yohlelo lomzimba olawula ushukela homeostasis emzimbeni.
I-Pharmokinetics kanye nezinkomba zokusetshenziswa kwomuthi
Ngemuva kokuthatha umuthi, umuthi udonswa ngokushesha. Lesi sidakamizwa sine-bioavailability ephelele yama-87%. Ukudla ukudla okunamafutha akukuthinti kakhulu i-kinetics yezidakamizwa.
Ukuhoxiswa kwalo muthi kwenziwa ngokungashintshiwe ekwakhiweni komchamo. Ngemuva kokumisa lo muthi isonto lonke, ama-87% anomchamo no-13% onamachibi ayakhululwa.
Umuthi usetshenziswa njengendlela ye-monotherapy lapho kukhona uhlobo lwe-II yesifo sikashukela esigulini. Umuthi uvunyelwe ukuthathwa ngaphandle kokudla. I-Sitagliptin ene-Metformin ngokuhlanganiswa ingasetjenziswa njengezindlela eziyinkimbinkimbi lapho kukhona uhlobo 2 lwesifo sikashukela. Umthamo onconywayo wokuphuza umuthi uhlangana ne-Metformin ngu-100 mg kanye ngosuku.
Uma uphuthelwa isikhathi sokuthatha i-Sitagliptin, kufanele uyithathe ngokushesha. Lokhu kungenxa yokuthi ukuthatha umthamo ophindwe kabili womuthi akwamukeleki.
Kwenqatshelwe ukuthatha umuthi kaningi kunokunconywa yimiyalo yokusebenzisa.
Ithuluzi likuvumela ukuthi ulawule amazinga kashukela emzimbeni, kepha lo muthi awusilaphi isifo sikashukela.
Umuthi kufanele uphuzwe noma ngabe isiguli sizwa kahle, umuthi kufanele siwunqamule kuphela ngemuva kokubonisana nodokotela futhi ngokunconywa kwakhe.
Imiyalo yokusebenzisa umuthi
I-Sitagliptin yisidakamizwa esibekezelelwa kahle uma sithathwa yiziguli zombili ngesikhathi se-monotherapy, futhi njengengxenye yokwelapha okuyinkimbinkimbi nezinye izidakamizwa ezinendawo ye-hypoglycemic.
Ukuhoxiswa komthamo oyinhloko umuthi ngokusebenzisa izinso. Le ndlela yokususa into esebenzayo emzimbeni idinga udokotela ozohlola ukusebenza kwezinso lapho kukhona ukwehluleka kwezinso esigulini ngaphambi kokusebenzisa umuthi. Uma kunesidingo, kulungiswa umthamo womuthi. Lapho kukhona indlela ethambile yokwehluleka kwezinso, ukulungiswa komthamo umuthi othathwe akwenziwa.
Uma isiguli sinokuhluleka okulinganiselayo kwe-renal, umthamo wesidakamizwa akufanele udlule i-50 mg kanye ngosuku. Umuthi ungasetjenziswa ngasiphi isikhathi, ngaphandle kwenqubo yokudayela.
Lapho usebenzisa umuthi njengengxenye yokwelashwa okuyinkimbinkimbi, ukuze uvimbele ukuthuthukiswa kwe-hypoglycemia ye-sulfon emzimbeni, umthamo wokuphuma kwe-sulfonylurea osetshenziswayo kumele wehliswe.
Ukudonswa kwezidakamizwa ezisetshenziswayo kwenziwa ngudokotela oya khona ngemuva kokuhlolwa okuphelele komzimba wesiguli onenkinga yesifo sikashukela sohlobo 2.
Uma kukhona izinsolo zokuthuthuka emzimbeni wesiguli se-pancreatitis, kuyadingeka ukuyeka ukuthatha i-Sitagliptin kanye nezinye izidakamizwa ezinamandla okuphelisa ukwanda kwesifo.
Ngaphambi kokusebenzisa lesi sidakamizwa, udokotela kumele azise isiguli ngezimpawu zokuqala zokuqina kwe-pancreatitis.
Contraindication kanye nemiphumela emibi
Ukusetshenziswa kwesidakamizwa kungavusa ukuvuvukala okungathi sína futhi okusongela impilo kwamanyikwe emzimbeni womuntu.
Ngokusebenzisa ngokungafanele umuthi, uyakwazi ukuvusa ukuvela kwenqwaba yemiphumela emibi emzimbeni. Lapho kuvela izimpawu zokuqala zokwephula, thintana nodokotela ngokushesha.
Lapho usebenzisa umuthi, imiyalo yemithamo enikezwe udokotela ohambelayo kufanele ilandelwe ngokuqinile.
Lapho usebenzisa umuthi, umuntu angathola inani elikhulu lemiphumela emibi. Imiphumela emibi eyinhloko yile:
- i-angioedema;
- anaphylaxis;
- ukuqhuma
- i-vasculitis yesikhumba;
- i-urticaria;
- izifo zesikhumba ezixakayo, iStevens-Johnson syndrome;
- i-pancreatitis eyingozi;
- ukonakala kwezinso, ukwehluleka okubabazekayo be-renal kudinga ukuguqulwa kwidayali;
- i-nasopharyngitis;
- izifo zokuphefumula zamapheshana;
- ukuhlanza
- ukuqunjelwa
- ikhanda
- i-myalgia;
- i-arthralgia;
- izinhlungu emuva
- Ubuhlungu emilenzeni;
- ukulunywa
Uma usebenzisa umuthi, kufanele kukhunjulwe ukuthi kukhona uhla oluphelele lokusetshenziswa kwalesi sidakamizwa.
I-contraindication eyinhloko yokuphuza umuthi yile elandelayo:
- hypersensitivity;
- ukuba khona kwesifo sikashukela sohlobo lokuqala;
- isifo sikashukela sikashukela;
- iminyaka yesiguli engaphansi kweminyaka eyi-18;
- inkathi yokuhlanza;
- isikhathi sokuzala ingane.
Lapho usebenzisa umuthi, zonke izincomo kufanele zilandelwe ngokuqinile; ikhambi akufanele lithathwe uma kukhona okukhona okuphikisana nalokho. Uma kwenzeka kusetshenziswa i-overdose noma ubuthi ngenxa yokuphuza umuthi, kufanele ushayele i-ambulensi ngokushesha.
Ukweqisa noma ubuthi bomzimba ngomuthi obekiwe kungavusa izinkinga ezinkulu zempilo kuze kube ngomphumela obulalayo.
Ama-analog, izindleko nokuxhumana nezinye izindlela
Ngesikhathi sokuvivinywa kwemitholampilo, amalungiselelo asuselwa ku-sitagliptin awazange abe nomphumela obalulekile futhi obalulekile kuma-chemetics kinetics wezidakamizwa ezifana ne-rosiglitazone, metformin, glibenclamide, warfarin, simvastatin, kanye nokuvimbela inzalo ngomlomo.
Uma usebenzisa ama-ejenti asuselwe ku-sitagliptin, inhibition ye-CYP2C8, CYP3A4, CYP2C9 isoenzymes akwenzeki. Ngaphezu kwalokho, izidakamizwa azivimbeli ama-enzyme CYP1A2, CYP2D6, CYP2B6, CYP2C19.
Ukusetshenziswa okuhlangene kwe-sitagliptin ne-metformin akunalo ushintsho olukhulu kuma-pharmacokinetics e-sitagliptin ku-mellitus yesifo sikashukela.
Isidakamizwa esivame kakhulu iJanuvia. I-analogue yesidakamizwa saseRussia uJanuvia yiYanumet, izindleko zayo eRussia cishe ama-ruble angama-2980.
Ukwahlulela ngokubuyekezwa kweziguli ezisebenzise lo muthi ukwelashwa, kunomthelela omkhulu ezingeni ushukela emzimbeni, kepha kudinga ukulawulwa okuqinile kwesimo somzimba ngenxa yokuvela kwenani elikhulu lemiphumela emibi.
Intengo yomuthi incike esifundeni sezwe kanye nokufakwa kwomuthi futhi isukela ku-1596 kuya ku-1724 ruble. Ividiyo ekulesi sihloko izokhuluma ngezindlela zokwelapha i-glycemia.
