U-Onglisa ungumuthi wesifo sikashukela, isithako esisebenzayo se-saxagliptin. I-Saxagliptin umuthi obekelwe ukwelashwa kwesifo sikashukela sohlobo 2.
Kungakapheli amahora angama-24 ngemuva kokuphatha, kuvimbela isenzo se-enzyme DPP-4. Ukuvinjelwa kwe-enzyme lapho kusebenzisana ne-glucose kukhuphuka izikhathi ezingama-2 kuya ku-2 izinga le-glucagon-like peptide-1 (engezansi kwe-GLP-1) ne-insulinotropic polypeptide (HIP) encike kushukela.
Ngenxa yalokho, okuqukethwe i-insulin ne-C-peptide emzimbeni kuyakhuphuka. Ngemuva kokuthi i-insulin ikhishwe amaseli we-beta we-pancreas ne-glucagon kusuka kumaseli we-alpha, i-glycemia esheshayo ne-postprandial glycemia incishiswa kakhulu.
Ukuphepha nokusebenzisa kahle kwe-saxagliptin emithanjeni ehlukene kufundwe ngokucophelela ezifundweni eziyisithupha ezilawulwa yi-placebo, ezibandakanya iziguli ezingama-4148 ezitholakala zinhlobo lwe-2 isifo sikashukela.
Ngesikhathi sokufunda, ukuthuthuka okukhulu ku-glycated hemoglobin, glucose osheshayo we-plasma ne-postprandial glucose kwaphawulwa. Iziguli lapho i-saxagliptin monopoly ingakhange ikhiqize imiphumela ebilindelwe yangezelelwa ngemithi efana ne-metformin, glibenclamide ne-thiazolidinediones.
Ubufakazi obuvela ezigulini nakwabodokotela: amasonto ama-4 ngemuva kokuqala kokwelashwa, kuphela i-saxagliptin, izinga le-hemoglobin ye-glycated lehle, futhi izinga le-glucose le-glucose lezila ngokushesha lehla ngemuva kwamasonto ama-2.
Izinkomba ezifanayo zaqoshwa eqenjini leziguli ezazinqunywe ukwelashwa ngokuhlanganiswa kwe-metformin, glibenclamide ne-thiazolidinedione, ama-analogues asebenza ngesigqi esifanayo.
Kuzo zonke izimo, ukwanda kwesisindo somzimba weziguli akubhekwanga.
Uma usebenzisa i-ongliza
Umuthi unqunyelwe iziguli ezinenkinga yesifo sikashukela sohlobo 2 ezimeni ezinjalo:
- Nge-monotherapy nalesi sidakamizwa ngokuhambisana nomsebenzi womzimba nokwelashwa kokudla;
- Ngokwelashwa okuhlanganiswa ngokuhlanganiswa ne-metformin;
- Uma kungekho ukusebenza kahle kwe-monotherapy ene-metformin, i-sulfonylurea derivatives, thiazolidinediones njengesidakamizwa esingeziwe.
Naphezu kweqiniso lokuthi umuthi ongaziwa ubhekane nezifundo eziningi kanye nezivivinyo, ukubukeza ngakho kunempilo kakhulu, ukwelashwa kungaqalwa kuphela ngaphansi kokuqondisa udokotela.
Contraindication nokusetshenziswa kwe-onglise
Njengoba umuthi uthinta ngempumelelo ukusebenza kwamaseli we-beta ne-alpha, uvuselela kakhulu umsebenzi wawo, awukwazi ukusetshenziswa njalo. Umuthi uphuliwe:
- Ngesikhathi sokukhulelwa, ukuzalwa kwengane nokukhulelwa.
- Intsha engaphansi kweminyaka eyi-18.
- Iziguli ezinomhlobo 1 wesifo sikashukela (isenzo esingafundiswanga).
- Ngokulashwa kwe-insulin.
- Nge-siketoicid ketoacidosis.
- Iziguli ezine-galactose engabekezelelani.
- Ngokuzwela ngakunye kunoma yiziphi izingxenye zomuthi.
Akunakusho ukuthi imiyalo yezidakamizwa ayinakwa. Uma kunokungabaza ngokuphepha kokusetshenziswa kwayo, kufanele kukhethwe i-analog inhibitors noma enye indlela yokwelashwa.
Umthamo onconyiwe kanye nokuphatha
U-Onglisa usetshenziswa ngomlomo, ngaphandle kokubhekiselwa ekudleni. Umthamo ophakanyisiwe wansuku zonke wesidakamizwa ngu-5 mg.
Uma ukwelashwa okwenziwa ngokuhlanganiswa kwenziwa, umthamo wansuku zonke we-saxagliptin uhlala ungashintshiwe, umthamo we-metformin ne-sulfonylurea derivatives unqunywa ngokuhlukile.
Ekuqaleni kokwelashwa okuhlanganiswa usebenzisa i-metformin, umthamo wezidakamizwa uzoba ngale ndlela elandelayo:
- Onglisa - 5 mg ngosuku;
- I-Metformin - 500 mg ngosuku.
Uma ukusabela okunganele kuphawulwe, umthamo we-metformin kufanele ulungiswe, uyanda.
Uma, ngasiphi isizathu, isikhathi sokuphuza umuthi siphuthelwe, isiguli kufanele siphuze iphilisi ngokushesha okukhulu. Akufanele ukuphinda kabili umthamo wansuku zonke kabili.
Ezigulini ezinokwehluleka okuncane kwe-renal njengesifo esijwayelekile, akudingekile ukulungisa umthamo wokungabonakali. Ngokungasebenzi kahle kwezinso kwezinhlobo ezilinganiselayo neziqinile ze-onglis kufanele kuthathwe ngamanani amancane - ama-2,5 mg kanye ngosuku.
Uma i-hemodialysis yenziwa, i-onglisa ithathwa ngemuva kokuphela kweseshini. Umphumela we-saxagliptin ezigulini ezihlelwe yi-peritoneal dialysis awukaphenywa. Ngakho-ke, ngaphambi kokuqala ukwelashwa nalesi sidakamizwa, kufanele kwenziwe ukuhlola okwanele kokusebenza kwezinso.
Ngokuhluleka kwesibindi, i-onglise ingabekwa ngokuphephile kumthamo omaphakathi obonisiwe - 5 mg ngosuku. Ukwelashwa kweziguli esezikhulile, i-onglise isetshenziswa kumthamo ofanayo. Kepha kufanele kukhunjulwe ukuthi ingozi yokuthola ukwehluleka kwezinso kulesi sigaba sikashukela iphezulu.
Akukho ukubuyekezwa noma izifundo ezisemthethweni zemiphumela yomuthi ezigulini ezingaphansi kweminyaka engu-18. Ngakho-ke, entsheni enesifo sikashukela sohlobo 2, kukhethwa ezinye izakhi ezisebenzayo.
Ukuqeda umthamo we -xplise kuyadingeka uma umuthi unqunywe ngasikhathi sinye nama-inhibitors anamandla. Lokhu:
- ketoconazole,
- klithithycin,
- atazanavir
- indinavir
- igraconazole
- nelfinavir
- ritonavir
- i-saquinavir ne-telithromycin.
Ngakho-ke, umthamo ophelele nsuku zonke ngu-2,5 mg.
Izici zokwelashwa kwabesifazane abakhulelwe nemiphumela emibi
Akukacwaningwanga ukuthi umuthi uthinta kanjani inkambo yokukhulelwa, nokuthi ngabe ungena yini ebisini lukamama, ngakho-ke, umuthi awubekelwe ngesikhathi sokuzala nokudla ingane. Kunconywa ukusebenzisa amanye ama-analogues noma ukuyeka ukuncelisa ibele.
Imvamisa, kulandela imithamo nezincomo zokwelapha okuhlanganisiwe, umuthi ubekezelelwa kahle, ezimweni ezingandile, njengoba izibuyekezo ziqinisekisa, lokhu okulandelayo kungabonakala:
- Ukuqhafaza
- I-Gastroenteritis;
- Ubuhlungu bekhanda;
- Ukwakheka kwezifo ezithathelwanayo zepheshana lokuphefumula elingaphezulu;
- Izifo ezithathelwanayo zohlelo lwe-genitourinary.
Uma kunezimpawu eyodwa noma eziningi, kufanele umise umuthi noma ulungise umthamo.
Ngokusho kokubuyekezwa, noma ngabe i-onglise yasetshenziswa isikhathi eside emithanjeni edlula izikhathi ezingama-80 ezinconyiwe, azikho izimpawu zobuthi ezinobuthi. Ukususa umuthi emzimbeni uma kungenzeka udakwe, kusetshenziswa indlela ye-geomdialysis.
Yini enye ukwazi
I-Onglis ayinqunyelwe nge-insulin noma ekwelashweni kathathu nge-metformin ne-thiazolididones, ngoba izifundo zokusebenzisana kwazo azenziwanga. Uma isiguli sinezinkinga eziphakathi kokulingana kuya kokuhluleka kakhulu kwezinso, umthamo wansuku zonke kufanele uncishiswe. Abantu abanesifo sikashukela abanokungasebenzi kahle kwezinso badinga ukubhekwa njalo kwesimo sezinso ngesikhathi sokwelashwa.
Kusungulwe ukuthi izinto ezithathwe kuma-sulfonylureas zingavusa i-hypoglycemia. Ukuvimbela ubungozi be-hypoglycemia, umthamo we-sulfonylurea ohambisana nokwelashwa okungajwayelekile kufanele ulungiswe. Lokho wukuthi, kuncishisiwe.
Uma isiguli sinomlando we-hypersensitivity kunoma iyiphi enye inhibitors efana ne-DPP-4, i-saxagliptin ayinqunyelwe. Ngokuqondene nokuphepha kanye nokusebenza kahle kokwelashwa ngalo muthi ezigulini esezikhulile (ezingaphezu kweminyaka engu-6 ubudala), azikho izixwayiso kuleli cala. U-Onglisa uyabekezelelwa futhi wenza ngendlela efanayo nasezigulini ezincane.
Njengoba umkhiqizo uqukethe i-lactose, ayifanele labo abanokungabekezeleleki ngokuzalwa kule nto, ukuntuleka kwe-lactose, glucose-galactose malabsorption.
Umphumela wesidakamizwa emandleni okushayela izimoto nezinye izinto ezidinga ukunakwa kakhulu awucwaningwanga ngokuphelele.
Akukho okuphikisana okuqondile nokushayela imoto, kodwa kufanele kukhunjulwe ukuthi phakathi kwemiphumela emibi isiyezi nobuhlungu bekhanda kuyaphawulwa.
Ukuxhumana nezinye izidakamizwa
Ngokwezivivinyo zomtholampilo, ubungozi bokuxhumana phakathi kwe-onglises nezinye izidakamizwa, uma zithathwe ngasikhathi sinye, zincane kakhulu.
Ososayensi abatholanga ukuthi ukubhema, utshwala, ukusetshenziswa kwemithi ye-homeopathic, noma ukudla kokudla kuyithinta kanjani imiphumela yomuthi, ngenxa yokushoda kocwaningo kule ndawo.
