UGalvus umuthi wezokwelapha isenzo sakhe okuhloswe ngaso ukwelapha isifo sikashukela sohlobo 2. Isithako esisebenzayo somuthi yi-Vildagliptin. Lo muthi uyatholakala ngesimo samathebulethi. Lesi sidakamizwa sinokubuyekezwa okuhle okuvela kubo bobabili odokotela kanye neziguli.
Isenzo se-vildagliptin sisuselwa ekuvuseleleni kwamanyikwe, okuyi-islet apparatus yayo. Lokhu kuholela ekunciphiseni okukhethiwe ekukhiqizweni kwe-enzyme dipeptidyl peptidase-4.
Ukwehla okusheshayo kwale enzyme kugqugquzela ukwanda kokufihlakala kohlobo lwe-peptide olu-glucagon kanye ne-insulinotropic polypeptide esekelwa glucose.
Izinkomba zokusetshenziswa
Umuthi usetshenziswa ekwelapheni isifo sikashukela sohlobo 2:
- njengoba umuthi okuwukuphela kwawo ohlangana nokudla nokuzivocavoca komzimba Ukubuyekezwa kukhombisa ukuthi ukwelashwa okunjalo kunikeza umphumela ohlala njalo;
- ngokuhlanganiswa ne-metformin ekuqaleni kokwelashwa kwezidakamizwa, kanye nemiphumela enganele yokudla nokudla okwandisiwe komzimba;
- yabantu abasebenzisa i-analogues equkethe i-vildagliptin ne-metformin, isibonelo i-Galvus Met.
- ngokusetshenziswa okuyinkimbinkimbi kwamalungiselelo aqukethe i-vildagliptin ne-metformin, kanye nokufakwa kwezidakamizwa nge-sulfonylureas, thiazolidinedione, noma nge-insulin. Kusetshenziswa ezimweni zokwehluleka ukwelashwa nge-monotherapy, kanye nokudla kanye nokuzivocavoca komzimba;
- njengezindlela zokwelapha eziphindwe kathathu kungabikho mphumela wokusetshenziswa kwemithi equkethe i-sulfonylurea derivatives kanye ne-metformin, eyayisetshenziswa ngaphambilini ngesimo sokuthi ukudla nokudla okwandayo komzimba;
- njengendlela yokwelapha kathathu ngokungatholakali komphumela wokusetshenziswa kwezidakamizwa eziqukethe i-insulin ne-metformin, eyayisetshenziswa ngaphambili, kuncike ekudleni nasekunyuseni umsebenzi womzimba.
Imithamo nezindlela zokusebenzisa umuthi
Umthamo walesi sidakamizwa ukhethiwe ngokulandelana esigulini ngasinye ngokubhekela kobunzima besifo kanye nokubekezelelana komuthi ngamunye. Ukwemukelwa kweGalvus phakathi nosuku akuxhomekile ekudleni kokudla. Ngokusho kokubuyekezwa, lapho wenza ukuxilongwa, lesi sidakamizwa sinqunywa ngokushesha.
Lo muthi one-monotherapy noma uhlanganiswa ne-metformin, i-thiazolidinedione noma i-insulin uthathwa kusuka ku-50 uye ku-100 mg ngosuku. Uma isimo sesiguli sibonakaliswa njengesihluku futhi i-insulin isetshenziselwa ukuqinisa izinga kashukela emzimbeni, khona-ke umthamo wansuku zonke ngu-100 mg.
Lapho usebenzisa izidakamizwa ezintathu, ngokwesibonelo, i-vildagliptin, i-sulfonylurea derivatives ne-metformin, isilinganiso sansuku zonke singu-100 mg.
Kunconywa ukuthi kuthathwe umthamo we-50 mg ukuthi uphuzwe kuthamo elilodwa ekuseni, umthamo we-100 mg kufanele uhlukaniswe ngemithamo emibili: 50 mg ekuseni kanye nenani elifanayo kusihlwa. Uma ngesizathu esithile umuthi uphuthelwe, kufanele uphuzwe ngokushesha, ngenkathi ungeqi isilinganiso somuthi sansuku zonke.
Umthamo wansuku zonke weGalvus ekwelashweni kwezidakamizwa ezimbili noma ngaphezulu ngu-50 mg ngosuku. Njengoba izidakamizwa ezisetshenziswe ekwelashweni okuyinkimbinkimbi ndawonye neGalvus zithuthukisa umphumela wazo, umthamo wansuku zonke wama-50 mg uhambelana ne-100 mg ngosuku nge-monotherapy nalesi sidakamizwa.
Uma umphumela wokwelashwa ungatholakali, kunconyelwa ukwandisa umthamo wesidakamizwa kuya ku-100 mg ngosuku, futhi unikeze nemeta, i-sulfonylureas, i-thiazolidinedione, noma i-insulin.
Ezigulini ezinokuphazamiseka ekusebenzeni kwezitho zangaphakathi, njengezinso nesibindi, umthamo omkhulu kaGalvus akufanele udlule ku-100 mg ngosuku. Uma kwenzeka kube nokushoda okukhulu emsebenzini wezinso, umthamo wansuku zonke wesidakamizwa akufanele ube ngaphezu kwama-50 mg.
Ama-analoggs alesi sidakamizwa, nomdlalo wezinga lekhodi le-ATX-4: Onglisa, Januvia. Ama-analogues aphambili anento efanayo esebenzayo yiGalvus Met neVildaglipmin.
Ukubuyekezwa kweziguli ngalezi zidakamizwa, kanye nezifundo kusikisela ukuguquguquka kwazo ekwelashweni kwesifo sikashukela.
Incazelo yesidakamizwa Galvus Met
IGalvus Met ithathwa ngomlomo, igezwe ngamanzi amaningi. Umthamo wansuku zonke wezidakamizwa ukhethiwe ngokuqondene nomuntu ngamunye, noma kunjalo, uma unikezwe ukuthi umthamo omkhulu wesidakamizwa akufanele udlule i-100 mg.
Esigabeni sokuqala, inani lomuthi ophuziwe libekiwe kucatshangelwa imithamo ye-vildagliptin ethathwe ngaphambili kanye / noma i-metformin. Ukuze kuqedwe imiphumela emibi engenzeka ohlelweni lokugaya ukudla, isidakamizwa sithathwa ngokudla.
Uma ukwelashwa nge-vildagliptin kunganikeli umphumela oyifunayo, khona-ke ukwelashwa kweGalvus Metom kungabekwa. Okokuqala, kuthathwa umthamo ka-50 mg kabili ngosuku, ngemuva kwalokho ungangezela umthamo kuze kube yilapho umphumela utholakala.
Uma ukwelashwa nge-metformin kungaphumeleli, kuya ngethamo elivele selinqunyelwe, iGalvus Met iyanconywa ukuba ithathwe ngokulingana ne-metformin ngokwesilinganiso se-50 mg / 500 mg, 50 mg / 850 mg, 50 mg / 1000 mg. Umthamo wesidakamizwa kufanele uhlukaniswe kabili.
Uma i-vildagliptin ne-metformin zichazwe, ngalinye ngesimo samathebhulethi ahlukile, khona-ke i-Galvus Met ingabekwa ngokungezelela kubo, njengokwelashwa okwengeziwe ngesilinganiso sama-50 mg ngosuku.
Ngokuhlanganiswa kwezokwelapha nezidakamizwa eziqukethe i-sulfonylurea derivatives noma i-insulin, inani lomuthi libalwa ngale ndlela elandelayo: 50 mg izikhathi ezi-2 ngosuku njenge-analog ye-vildagliptin noma i-metformin, esilinganisweni lapho lo muthi uthathwe khona.
IGalvus Met is contraindication ezigulini ezikhubazekile ukusebenza kwethambo noma ezinokwehluleka kwezinso. Lokhu kungenxa yokuthi iGalvus Met nezinto zayo ezisebenzayo zikhishwe emzimbeni zisebenzisa izinso. Kubantu abaneminyaka yobudala, ukusebenza kwalezi zitho kuncipha kancane kancane.
Lokhu kuvame ukubonakala ezigulini ezineminyaka engaphezu kwengama-65. Iziguli zalo nyaka zibekelwa iGalvus Met ngenani elincane ukuze kulondolozwe izinga likashukela egazini ngokwejwayelekile.
Umuthi ungabekwa ngemuva kokuqinisekisa ukusebenza okujwayelekile kwezinso. Ukuqapha ukusebenza kwezinso ezigulini ezindala kufanele kwenziwe njalo.
Imiphumela emibi
Ukusetshenziswa kwezidakamizwa kanye neGalvus Met kungathinta umsebenzi wezitho zangaphakathi kanye nesimo somzimba wonke. Imiphumela emibi ebikwa kakhulu yilena:
- isiyezi kanye nekhanda;
- imilenze ethuthumela;
- umuzwa wokubanda;
- isicanucanu esihambisana nokuhlanza;
- i-gastroesophageal Reflux;
- ukuqaqamba nobuhlungu obukhulu esiswini;
- ukuqubuka kwesikhumba komzimba;
- ukuphazamiseka, ukuqunjelwa kanye nesifo sohudo;
- ukuvuvukala
- ukumelana komzimba omncane ezifweni kanye namagciwane;
- umthamo wokusebenza ophansi kanye nokukhathala okusheshayo;
- isifo sesibindi kanye namanyikwe, ngokwesibonelo, i-hepatitis kanye ne-pancreatitis;
- ukudonsa kanzima kwesikhumba;
- ukubonakala kwamaqhubu.
Contraindication ekusebenziseni isidakamizwa
Izici ezilandelayo nokubuyekezwa kungenzeka kube ukungqubuzana kokwelashwa ngalo muthi:
- ukungahambi kahle komzimba noma ukungabekezeleli komuntu ezintweni ezisebenzayo zomuthi;
- isifo sezinso, ukwehluleka kwezinso nomsebenzi okhubazekile;
- izimo ezingaholela ekusebenzeni kahle kwe-renal, njengokuhlanza, isifo sohudo, umkhuhlane kanye nezifo ezithathelanayo;
- izifo zesistimu yenhliziyo, ukuhluleka kwenhliziyo, ukufakwa kwe-myocardial;
- izifo zokuphefumula;
- i-ketoacidosis yesifo sikashukela ebangelwa yisifo, ukoma, noma isimo esimatasatasa, njengengxaki yesifo sikashukela. Ngaphezu kwalesi sidakamizwa, ukusetshenziswa kwe-insulin kuyadingeka;
- ukunqwabelana kwe-lactic acid emzimbeni, i-lactic acidosis;
- ukukhulelwa kanye nokuncelisa;
- uhlobo lokuqala lwesifo sikashukela;
- ukusetshenziswa kabi kotshwala noma ubuthi obunobuthi;
- ukunamathela ekudleni okuqinile, lapho kuthathwa khona ikhalori akukho ngaphezu kwe-1000 ngosuku;
- iminyaka yokubekezela. Ukuqokwa kwalo muthi akunconyelwe iziguli ezingaphansi kweminyaka engu-18. Kunconywe abantu abaneminyaka engaphezu kwengama-60 ubudala ukuba baphuze lo muthi ngaphansi kokuqondisa kodokotela;
- umuthi umisiwe ukuthatha izinsuku ezimbili ngaphambi kokuhlinzwa okunqunyelwe, izifundo ze-radiographic noma ukwethulwa kokungafani. Kunconywa futhi ukwenqaba ukusebenzisa umuthi izinsuku ezi-2 emva kwezinqubo.
Kusukela lapho uthatha i-Galvus noma i-Galvus Meta, enye yezinto eziphambana kakhulu yi-lactic acidosis, khona-ke iziguli ezihlushwa izifo zesibindi nezinso akufanele zisebenzise le mithi ukwelapha isifo sikashukela sohlobo 2.
Ezigulini ezineminyaka engaphezu kwengama-60 ubudala, ubungozi bezinkinga zesifo sikashukela bukhuphuka kaningana, ukuvela kwe-lactic acidosis okubangelwa umlutha engxenyeni yezidakamizwa - i-metformin. Ngakho-ke, kumele isetshenziswe ngokucophelela okukhulu.
Ukusetshenziswa kwomuthi ngesikhathi sokukhulelwa nokuncelisa ibele
Umphumela wesidakamizwa kubantu besifazane abakhulelwe awukafundwa namanje, ngakho-ke ukuphathwa kwawo akunconywa kwabesifazane abakhulelwe.
Ezimweni zokwenyuka kwe-glucose egazini kwabesifazane abakhulelwe, kunengozi yokungalingani kokuzala enganeni, kanye nokuvela kwezifo ezahlukahlukene ngisho nokufa kwe-fetus. Ezimweni zeshukela elandayo, kunconyelwa ukusebenzisa i-insulin ukuze uyiqede.
Ehlelweni lokufunda umphumela wezidakamizwa emzimbeni wowesifazane okhulelwe, kwafakwa umthamo obedlula inani lama-200 ngezikhathi ezingama-200. Kulokhu, ukwephulwa kwentuthuko yesibeletho noma yikuphi ukukhubazeka okungakhange kutholakale. Ngokwazisa kwe-vildagliptin kuhlanganiswe ne-metformin esikalini sika-1: 10, ukwephulwa ekukhulisweni kwengane akuzange kubhalwe phansi.
Futhi, akukho datha ethembekile ezintweni eziyingxenye yesidakamizwa ngesikhathi sokuncelisa kanye nobisi. Kulokhu, omama abahlengikazi abaphakanyisiwe ukuthatha le mishanguzo.
Umphumela wokusetshenziswa kwalesi sidakamizwa ngabantu abangaphansi kweminyaka engu-18 awuchazwa okwamanje. Ukuphendula okuhlukile kokusetshenziswa kwomuthi ngeziguli zalo mkhakha wobudala nakho akwaziwa.
Ukusetshenziswa kwalesi sidakamizwa yiziguli ezingaphezu kweminyaka engama-60
Iziguli ezineminyaka engaphezu kwengama-60 ubudala ngenxa yobungozi bezinkinga noma imiphumela emibi ehambisana nokuphuza le mishanguzo kufanele ziqikelele ngokuqinile udosi lwazo futhi ziphuze umuthi ngaphansi kokuqondisa kukadokotela.
Izincomo ezikhethekile
Ngaphandle kokuthi le mishanguzo isetshenziselwa ukwengeza ushukela kuhlobo 2 lwesifo sikashukela, lezi akuzona izingqangi ze-insulin. Lapho ubasebenzisa, odokotela batusa ukuthola ukuthi imisebenzi yesibindi ihlukahlukene kangakanani.
Lokhu kungenxa yokuthi i-vildagliptin, okuyingxenye yesidakamizwa, iholela ekwandeni komsebenzi wama-aminotransferases. Leli qiniso alitholi ukubonakaliswa kunoma yiziphi izimpawu, kepha kuholela ekuphazamisweni kwesibindi. Lo mkhuba wabonwa ezigulini eziningi ezivela eqenjini lokulawula.
Iziguli eziphuza le mithi isikhathi eside futhi zingasebenzisi i-analogues zazo ziyanconywa ukuba ziye kohlola igazi okujwayelekile okungenani kanye ngonyaka. Inhloso yalolu cwaningo ukukhomba noma yikuphi ukuphambuka noma imiphumela emibi esiteji sokuqala kanye nokwamukelwa okufika ngesikhathi kwezinyathelo zokuziqeda.
Ngokushikashika kwezinzwa, ukucindezelwa, ukwehla, umphumela wezidakamizwa esigulini ungancishiswa kakhulu. Ukubuyekezwa kweziguli kukhombisa imiphumela emibi yesidakamizwa njenge-nausea nesiyezi. Ngezimpawu ezinjalo, kunconywa ukwenqaba ukushayela noma ukwenza umsebenzi wengozi eyandayo.
Kubalulekile! Amahora angama-48 ngaphambi kwanoma yiluphi uhlobo lokuxilonga kanye nokusetshenziswa komenzeli ohlukile, kunconywa ukuthi uyeke ngokuphelele ukuthatha le mishanguzo. Lokhu kungenxa yokuthi umehluko uqukethe iodine, kuhambisana nezakhi zomuthi, kungaholela ekuwohlokeni okukhulu kwemisebenzi yezinso nezinso. Ngokuphikisana nalokhu ngemuva, isiguli singakha i-lactic acidosis.
