Umuthi i-Baeta unempahla ye-hypoglycemic futhi isetshenziswa ekwelapheni uhlobo 2 lwesifo sikashukela. Leli thuluzi yi-exenatide, ebhekwa njenge-amino acid amidopeptide.
Umuthi uthuthukisa ukukhululeka kwe-hormone enciphisa ushukela futhi kusiza ukulawula i-glycemia. Ngasikhathi sinye, kunciphisa ukungasebenzi kwesisu futhi kuvuselele umsebenzi wamaseli we-beta wamanyikwe.
Le ndatshana izokusiza ukuthi uqonde ukuthi yikuphi lapho udinga khona ukuthi uphuze umuthi futhi lapho kungalimaza khona isiguli esinesifo sikashukela.
Izici ezijwayelekile zomuthi
Umuthi weBaeta yisisombululo esingaqokiwe sokufakwa ngaphakathi. Into esebenzayo yesidakamizwa yi-exenatide, futhi iqukethe inani elincane le-sodium acetate trihydrate, metacresol, mannitol, acetic acid, amanzi ancitshisiwe. Badedela umuthi ngesimo sama-ampoules (250 mg), ngalinye linepeni yesirinji ekhethekile enomthamo we-1,2 no-2.4 ml.
Iziguli ezithatha lo muthi zibona ukwehla koshukela wegazi ngenxa yale ndlela yokusebenza:
- I-Byeta ithuthukisa ukukhishwa kwe-insulin kusuka ku-parenchyma nge-glucose ekhuphukayo egazini lomuntu.
- I-insulin secretion iyema lapho kunokwehla kwamazinga kashukela.
- Isinyathelo sokugcina ukuqinisa ushukela wegazi lakho.
Kubantu abahlushwa uhlobo lwesibili sikashukela, ukusetshenziswa kwomuthi kuholela kulezi zinguquko:
- Ukuvimbela ukukhiqizwa kwe-glucagon okweqile, okucindezela i-insulin.
- Ukuvinjwa kokuhamba kwesisu.
- Yehlise iphango.
Lapho umuthi uphathwa ngokungaziphathi, into esebenzayo iqala ukusebenza ngokushesha futhi ifinyelele ekusebenzeni kwayo okuphezulu kakhulu ngemuva kwamahora amabili.
Umphumela wesidakamizwa umiswa ngokuphelele kuphela emva kosuku.
Imiyalo yokusebenzisa umuthi
Udokotela okhona kuphela ongakunikeza umuthi, noma ngabe yikuphi uma kufanele uzindle. Ngemuva kokuthola umuthi weBaeta, imiyalo yokusebenzisa kufanele ifundwe ngokucophelela.
Inkomba yokusetshenziswa kwalesi sidakamizwa uhlobo 2 sikashukela nge-mono- noma ukwelashwa okwengeziwe. Isetshenziswa lapho kungenakwenzeka ukulawula ngokwanele izinga le-glycemia. Umuthi lo ungasetjenziswa hlangana neendlela ezinjalo:
- I-Metformin;
- I-Thiazolidinedione;
- izinto ezithathwe kuma-sulfonylurea;
- inhlanganisela ye-metformin, i-sulfonylurea;
- inhlanganisela ye-metformin ne-thiazolidinedione.
Umthamo wekhambi ngu-5 μg kabili ngosuku ngehora ngaphambi kokuthatha isidlo esikhulu. Kufakelwa ujwayelekile engxenyeni engaphambili, ethangeni noma esiswini. Ngemuva kwenyanga yokwelashwa okuphumelelayo, umthamo uyandiswa ube ngu-10 mcg kabili ngosuku. Uma umuthi usetshenziswa uhlangana nezinsizakalo ze-sulfonylurea, umthamo wokugcina kumele wehliswe ukugwema isimo sesiguli.
Le mithetho elandelayo yokuphatha umuthi nayo kufanele ibonwe:
- ayikwazi ukuphathwa ngemuva kokudla;
- Kuyinto engathandeki ukujova nge-intramuscularly noma ngaphakathi kwegazi;
- uma isixazululo sinamafu futhi sishintshiwe umbala, kungcono ukusisebenzisa;
- uma izinhlayiya zitholakala kusisombululo, ukuphathwa kwezidakamizwa kumele kukhanselwe;
- phakathi nokwelashwa kweBayeta, ukukhiqizwa kwe-antibody kungenzeka.
Umuthi kumele ugcinwe endaweni evikelwe ukukhanya nezingane ezincane. Ukushisa kwesitoreji kufanele kubonwe kuhla kusuka ku-2 kuya ku-8 degrees, ngakho-ke kungcono ukugcina umuthi esiqandisini, kepha ungawuqandisi.
Impilo yeshalofu yomkhiqizo iyiminyaka emi-2, kanti isisombululo esibayeni sepayipi siyinyanga eyi-1 emazingeni okushisa angadluli kuma-25 degrees.
Izindleko zomuthi nokubuyekezwa
I-Baeta yezidakamizwa ingathengwa kunoma iyiphi ikhemisi noma ifake i-oda ekhemisi eliku-inthanethi. Kumele kuqashelwe ukuthi umuthi uthengiswa kuphela ngomuthi obhaliwe. Njengoba umenzi walo mkhiqizo eyiSweden, ngenxa yalokho intengo yawo iphakeme impela.
Ngakho-ke, akuyena wonke umuntu ojwayelekile onesifo sikashukela ongakwazi ukuthenga umuthi onjalo. Izindleko ziyehluka ngokuya ngesimo sokukhishwa kwezimali:
- I-1,2 ml ipeni lesirinji - kusuka kuma-ruble angama-4246 kuya kuma-6398;
- Ipeni yesirinji yesirinji - kusuka kuma-ruble angama-5301 kuya kwangama-8430.
Muva nje kwenziwe ucwaningo lokumaketha, oluhanjelwe iziguli ezikhethwe ngokuzithandela eziphuze lo muthi. Kubhekiswa kumuthi weBayeta, ukubuyekezwa kwawo kukhombisa ukuba khona kwale miphumela emibi elandelayo:
- Ukuphazamiseka kohlelo lwezinzwa: ukukhathala, ukuhlanekezela noma ukuntula ukunambitha.
- Shintsha kumetabolism nokudla: ukunciphisa isisindo, ukomisa umzimba ngenxa yokugabha.
- Isenzeko esingajwayelekile kakhulu sokuphendula kwe-anaphylactic.
- Ukuphazamiseka kanye ne-pathologies yendlela yokugaya ukudla: ukwanda kwegesi, ukuqunjelwa, i-pancreatitis eyingozi (kwesinye isikhathi).
- Izinguquko zokuchama: ukungasebenzi kahle kwezinso, ukukhuphuka kwamazinga e-creatinine, ukwehluleka kwezinso noma ukuqina kwaso.
- Ukuphendula kwesikhumba kwesikhumba: i-alopecia (ukulahleka kwezinwele), ukulunywa, i-urticaria, i-angioedema, imichilo ye-maculopapular.
Kuyiqiniso, iphuzu elingelona iqiniso izindleko eziphakeme zomuthi, kungenxa yalesi sizathu ukuthi iziguli eziningi ezinesifo sikashukela zishiya ukubuyekezwa kwazo kwi-Intanethi. Kepha, ngaphandle kwalokhu, umuthi wehlisa kahle izinga leshukela egazini lesiguli futhi usiza ekulweni nesisindo ngokweqile.
Ngaphezu kwalokho, ngenxa yobucayi bomphumela wayo wokwelapha, akubangeli ukuhlaselwa kwe-hypoglycemia.
Contraindication kanye nemiphumela emibi
Kwezinye izimo, ukuthatha umuthi kuba yinto engenakwenzeka ngenxa yokuba khona kwe-contraindication esigulini. Kungaba:
- i-ketoacidosis yesifo sikashukela - ukwephulwa ku-metabolism ye-carbohydrate;
- ifomu lesifo sikashukela esincike ku-insulin;
- ukwehluleka kwezinso nge-CC ngaphansi kwama-30 ml / min;
- i-pathology yendlela yokugaya ukudla ngaphandle kwe-gastroparesis;
- ukungabekezelelani komuntu ngamunye ezingxenyeni zomuthi;
- izingane nentsha engaphansi kweminyaka eyi-18;
- isikhathi sokuzala nengane.
Ngokusebenzisa okungafanele noma ngenxa yezizathu ezithile, kuvela imiphumela engemihle, iveziwe:
- komzimba, okungukuthi i-urticaria, ukuqubuka kwesikhumba, ukulunywa;
- ukuphazamiseka kokugaya ukudla - isicanucanu, ukuhlanza, ukubhuqa, isisu, ukuqunjelwa, ukuncipha komzimba nokudla;
- ukuphazamiseka kohlelo lwezinzwa, okungukuthi ukozela, isiyezi, ikhanda;
- ukuhluleka kwe-renal / kwesibindi;
- ukwanda kwesikhathi sokuqina;
- ukuthuthukiswa kwe-hypoglycemia, i-pancreatitis, hyperhidrosis;
- ukwanda kwe-serum creatinine.
Ezimweni zokusabela ezingezinhle, uchwepheshe oholayo angalungisa irejimthi yokwelashwa nalesi sidakamizwa noma akhansele ukusetshenziswa kwawo ngokuvamile.
Ukufana kwezidakamizwa
Esimweni lapho isiguli singanikezwa izixazululo ezinjalo noma sizwa ukusabela okuhlukile, udokotela ohambayo angashintsha amaqhinga okwelashwa. Lokhu kwenzeka ngezindlela ezimbili eziphambili - ngokushintsha umthamo womuthi noma ngokuwushiya ngokuphelele. Esimweni sesibili, kuyadingeka ukuthi ukhethe izidakamizwa ze-analog ezizoba nomphumela ofanayo wokwelapha futhi ungalimazi umzimba onesifo sikashukela.
Kanjalo, i-Baeta ayinazo izindlela ezifanayo. Izinkampani ze-AstraZeneca neBristol-Myers squibb Co (BMS) kuphela ezikhiqiza ama-analogues angu-100 alo muthi (ama-generics). Kunezinhlobo ezimbili zezidakamizwa emakethe yezokwelapha yaseRussia, efana nomphumela wazo wokwelapha. Lokhu kufaka phakathi:
- I-Victoza ingumuthi, njengeBaeta, olulingisa i-incretin. Umuthi futhi ukhiqizwa ngohlobo lwamapeni wesirinji ama-infusions angaphansi kohlobo 2 sikashukela. Ukusetshenziswa njalo kwesidakamizwa kusiza ukwehlisa izinga le-hemoglobin ye-glycated ibe ngu-1.8% futhi yehle i-4-5 kg ngaphezulu ngonyaka wokwelapha. Kumele kuqashelwe ukuthi udokotela kuphela onganquma ukufaneleka komuthi othile. Izindleko ezijwayelekile (amapeni ama-2 syringe ka-3 ml) angama-ruble ayi-10 300.
- UJanuvia ungumlingisi we-incretin olwehlisa ushukela wegazi ekwelapheni isifo sikashukela sohlobo 2. Kuyatholakala ngesimo sethebhulethi. Intengo ejwayelekile yomuthi (amayunithi angama-28, i-100 mg) ngama-ruble ayi-1672, okuyishibhile phakathi kwezidakamizwa okukhulunywa ngazo. Kepha umbuzo wokuthi iliphi ikhambi okungcono ukuthatha kuwo uhlala kwikhono lodokotela.
Futhi-ke, isidakamizwa se-Bayeta yi-ejenti esebenzayo ye-hypoglycemic. Umphumela wayo wokwelapha unezici ezithile ezisiza ukufeza ukulawulwa okugcwele kwe-glycemic. Kodwa-ke, umuthi awukwazi ukusetshenziswa kwezinye izimo, futhi ungadala nemiphumela emibi.
Ngakho-ke, ukuzelapha ngokwakho akukufanele. Kuyadingeka ukuthatha uhambo lokuya kudokotela ohlola kahle isidingo somuthi, ecabanga ngezimpawu zomzimba wesiguli ngasinye. Ngemithamo efanele futhi ulandela yonke imithetho yokwenziwa kwekhambi, unganciphisa ushukela ube amazinga ajwayelekile bese ususa nezimpawu ze-hyperglycemia. Ividiyo ekulesi sihloko ikhuluma ngemithi yesifo sikashukela.
