U-Onglisa ungomunye wabamele iqembu elisha lama-hypoglycemic agents, ama-DPP-4 inhibitors. Umuthi unendlela yokusebenza ehlukile evela kwamanye amaphilisi we-antidiabetes. Mayelana nokusebenza kahle, u-Ongliza uqhathaniswa nezindlela zendabuko; ngokuphepha kokusetshenziswa, udlula kakhulu kuzo. Ngaphezu kwalokho, umuthi unomphumela omuhle ezintweni ezihlobene, unciphisa ukuhamba kwesifo sikashukela kanye nokuthuthukiswa kwezinkinga.
Ososayensi bakholelwa ukuthi ukudalwa kwalezi zivimbelazi kuyisinyathelo esibi phambili ekwelashweni kwesifo sikashukela. Kucatshangwa ukuthi ukutholwa okulandelayo kuzoba izidakamizwa ezingabuyisela isikhathi eside umsebenzi we-pancreatic.
Ngabe umuthi u-Onglisa uhloselwe ini?
Isifo sikashukela sohlobo 2 sibonakaliswa umuzwa onciphile wamaseli we-pancreatic kuya ku-glucose, ukubambezeleka esigabeni sokuqala sokuhlanganiswa kwe-insulin (ngokuphendula ukudla kwe-carbohydrate). Ngokwanda kwesifo, isigaba sesibili sokukhiqizwa kwama-hormone siyalahleka kancane. Kukholelwa ukuthi imbangela enkulu yokungasebenzi kahle kwamaseli we-beta akhiqiza i-insulin ukuntuleka kwama-insretin. Lawa ama-peptides akhuthaza ukukhululeka kwe-hormone, akhiqizwa ukuphendula ukungena kweglucose egazini.
U-Onglisa ubambezela isenzo se-enzyme ye-DPP-4, edingekayo ekuqhekekeni kwama-insretin. Ngenxa yalokhu, ahlala egazini isikhathi eside, okusho ukuthi i-insulin ikhiqizwa ngevolumu enkulu kunokwejwayelekile. Lo mphumela usiza ukulungisa i-glycemia nasesiswini esingenalutho, kuthi ngemuva kokudla, usondeze ama-pancreas angaphili kahle emzimbeni. Ngemuva kokuqokwa kwe-Onglisa, i-glycated hemoglobin ezigulini incishiswa ngo-1.7%.
Isenzo se-Onglises sisuselwa ekunwetshweni komsebenzi wamahomoni akhe uqobo, umuthi ukhulisa ukuqina kwabo egazini ngokungaphansi kwezikhathi ezi-2. Njengoba i-glycemia isondela ngendlela ejwayelekile, ama-insretin ayeka ukuthonya ukwakheka kwe-insulin. Kulokhu, akukho bungozi be-hypoglycemia kuma-diabetes abaphuza umuthi. Futhi, inzuzo engenakuphikwa ye-Onglisa ukungabikhona komphumela wayo kwesisindo kanye namathuba okuthatha namanye amaphilisi okwehlisa ushukela.
Isifo sikashukela nokucindezela kuzoba yinto yesikhathi esedlule
- Ukwehlela ushukela -95%
- Ukuqedwa kwe-vein thrombosis - 70%
- Ukuqedwa kokushaya kwenhliziyo okuqinile -90%
- Ukuqeda umfutho wegazi ophakeme - 92%
- Ukwanda kwamandla ngesikhathi sosuku, ngcono ukulala ebusuku -97%
Ngaphezu kwesenzo esikhulu, u-Onglisa unenye futhi imiphumela emihle emzimbeni:
- Umuthi wehlisela inani likashukela lisuka emathunjini lingene egazini, ngaleyo ndlela libe nomthelela ekwehlelweni kokuphikisana nesifo sikashukela noshukela ngemuva kokudla.
- Ihlanganyela emthethweni wokuziphatha kokudla. Ngokusho kweziguli, u-Onglisa usheshisa umuzwa wokugcwala, okubaluleke kakhulu kwabanesifo sikashukela abanokukhuluphala.
- Ngokungafani namalungiselelo we-sulfonylurea, nawo futhi akhulisa i-insulin synthesis, u-Onglisa akalimazi kumaseli we-beta. Ucwaningo luveze ukuthi aligcini nje ngokubhubhisa amaseli e-pancreatic, kodwa, kunalokho, livikela futhi lize likhuphule inani lazo.
Ukwakheka nefomu lokukhululwa
Umuthi ukhiqizwa e-United States yinkampani ye-Anglo-Sweden i-AstraZeneca. Amathebulethi eyenziwe ngomumo angafakwa e-Italy noma e-UK. Esiphambanweni sezilondolozi ezi-3 ezigcotshwe ngamathebulethi ayi-10 ngalinye kanye nemiyalo esetshenzisiwe.
Into esebenzayo yesidakamizwa yi-saxagliptin. Lesi yisibalo esisha kakhulu sama-inhibitors asetshenziswa njengamanje e-DPP-4; singene emakethe ngo-2009. Njengezitho ezisizayo, i-lactose, i-cellulose, i-magnesium stearate, i-croscarmellose sodium, amadayi asetshenziswa.
U-Onglisa unemithamo emi-2 - 2,5; 5 mg Ithebhulethi i-2.5 mg ephuzi, umuthi wokuqala ungahlukaniswa imibhalo 2,5 no-4214 ohlangothini ngalunye lwethebhulethi. I-Onglisa 5 mg inemibala epinki, imakwe nezinombolo 5 no-4215.
Umuthi kufanele utholakale ngokuthengiswa ngomuthi, kepha lesi simo asibonakali kuwo wonke amakhambi emithi. Intengo ye-Onglizu iphakeme impela - cishe ama-ruble ayi-1900. iphakethe ngalinye. Ngo-2015, i-saxagliptin yafakwa ohlwini lwezidakamizwa iVital and Essential, ngakho-ke labo abanesifo sikashukela ababhalisile bangazama ukuthola la maphilisi mahhala. U-Ongliza akasenayo i-generics, ngakho-ke kufanele akhiphe umuthi wokuqala.
Ungayithatha kanjani
U-Onglisa unqunyelwe isifo sikashukela sohlobo 2. Ukwelapha nakanjani kufanele kufake phakathi ukudla nokuzivocavoca. Ungakhohlwa ukuthi umuthi usebenza ngobumnene kakhulu. Ngokusebenzisa okungalawulwa kwama-carbohydrate kanye nendlela yokuphila engenzi lutho, akakwazi ukunikeza isinxephezelo esidingekayo sikashukela.
Ukwehluka kwe-bioavailability kwe-saxagliptin kungama-75%, ukuqina okuphelele kwento esegazini kubonwa ngemuva kwemizuzu engu-150. Umphumela womuthi uhlala okungenani amahora angama-24, ngakho-ke akudingekile ukuthatha ukudla kwawo ngokudla. Amathebulethi asogobolondo lwefilimu, awakwazi ukwephulwa futhi achotshozwe.
Umthamo wansuku zonke onconywayo ngu-5 mg. Ezigulini esezikhulile ezinobuthakathaka be-renal kanye nokungasebenzi kahle kwe-hepatic, ukulungiswa kwamthamo akudingeki.
Umthamo ophansi (2,5 mg) awukhonjelwe ukuthi:
- ngokwehluleka kwezinso nge-GFR <50. Uma kusolwa isifo sezinso, kunconywa ukuthi kuhlolwe umsebenzi wabo;
- Okwesikhashana, uma kunesidingo, ukuthathwa kwama-antibhayirasi athile, ama-antiviral, ama-antifungal agents, uhlu lwabo oluphelele luboniswa emiyalweni.
Ukuxhumana nokulimaza
Ongliz angaqokwa:
- Ngesikhathi sokukhulelwa, i-lactation. Umphumela womuthi ekukhuleni kwe-fetus, ukubakhona kokungena ubisi akukafundwa.
- Uma isiguli singaphansi kweminyaka engu-18. Ayikho imininingwane yezokuphepha ngenxa yokushoda kocwaningo olubandakanya izingane.
- Uma ukusabela kwe-hypersensitivity ku-saxagliptin kwenzeka ngaphambilini, ezinye izidakamizwa ezivela eqenjini elifanayo, izakhi ezisizayo zethebhulethi. Ngokusho komkhiqizi, ubungozi bokusabela okunjalo ngu-1.5%. Zonke bezingadingi ukufakwa kwesiguli esikhungweni sezokwelapha futhi bezingasongelanga impilo.
- Ngokubekezelela kwe-lactose.
- Iziguli ezime ngokuphelele ukwakheka kwe-insulin yazo (uhlobo 1 sikashukela, ukuhlinzwa kwe-pancreatic).
Okwesikhashana, umuthi uthathelwa indawo nge-insulin yokwelapha i-ketoacidosis enzima, ukuhlinzwa okukhulu nokulimala.
U-Onglisa unezinga eliphezulu lezokuphepha. Lesi esinye sezidakamizwa ezimbalwa ze-antidiabetesic ezingenawo imiphumela emibi. Ngokwemiphumela yocwaningo lokuphendula okuhlukile ezigulini ezine-saxagliptin, babebaningi njengaseqenjini elilawulayo elithatha i-placebo. Noma kunjalo, imiyalo esetshenzisiwe ibonakalisa zonke izinkinga ezihlangabezana nazo ezigulini: izifo zokuphefumula nezokuchama, isiyezi, isifo sohudo, ukugabha, Ubuhlungu besisu, ukuqubuka, ukulunywa, ukukhathala.
Imininingwane ebalulekile yeziguli ezinomlando wokuhluleka kwenhliziyo noma enobungozi obukhulu bokusebenza kwe-renal okhubazekile, kufaka phakathi isifo sikashukela: ucwaningo luye lwabonisa ukuthi kula maqembu esifo sikashukela, ukwelashwa nge-Onglisa kwandisa ingozi yokulaliswa esibhedlela ngenxa yokwehluleka kwenhliziyo (ngokwesilinganiso, 1%, kusuka ku-3 kuye ku-4%). I-FDA yakhishwa isexwayiso ngo-2016, ngenguqulo yakamuva yebhukwana esevele ikhombisa lolu lwazi.
Sebenzisa neminye imithi
Ukuvimbela izinkinga eziningi zesifo sikashukela ezigidini zeziguli, izidakamizwa ezintsha kanye nezinqubo zokwelashwa zethulwa njalo ekusebenzeni komtholampilo. Ukwelashwa okuyisisekelo njengamanje kubhekwa njengezinguquko ze-metformin + yokuphila. Uma le khithi alanele, qala inhlanganisela yokwelapha: engeza omunye wezidakamizwa ezivunyiwe ekwelashweni okukhona.
Ngeshwa, akubona bonke abaphephile nabasebenza ngokwanele:
| Iqembu | Amagama | Okubi |
| Sulfonylureas | I-Diabeteson, Amaryl, Glidiab, Diabefarm, Gliclazide, njll. | Bandisa ubungozi be-hypoglycemia, bathinta isisindo somzimba, futhi banomthelela ekubhujisweni okusheshayo kwamaseli we-beta. |
| I-Glitazones | I-Roglit, Avandia, iPioglar, i-Diab-ejwayelekile. | Ukuqina kwesisindo, i-edema, ukwenza buthaka kwezicubu zamathambo, ingozi yokuhluleka kwenhliziyo. |
| I-Glucosidase Inhibitors | I-Glucobay | Imiphumela emibi ejwayelekile ehambisana nohlelo lokugaya ukudla: ukungakhululeki, isifo sohudo, ukuthopha. |
I-Onglisa ngokuya ngokusebenza ilingana nale mithi engenhla, futhi ngokuya ngokuphepha kanye nobuncane be-contraindication, idlula kakhulu, ngakho-ke kucatshangwa ukuthi izokwandiswa kakhulu ezigulini.
Inhlangano yaseRussia Endocrinologists Association ivume ukusetshenziswa kwe-DPP-4 inhibitors kuhlanganiswe ne-metformin njengomugqa wokuqala wezokwelapha isifo sikashukela. Zombili lezi zidakamizwa azinegalelo ku-hypoglycemia, zithinta imbangela yoshukela ophezulu kusuka kuma-engeli ahlukene: zithinta ukungahambisani kahle kwe-insulin kanye nokungasebenzi kahle kwe-beta cell.
Ukwenza lula irejimeni yokwelashwa, umenzi ofanayo wadala i-Combogliz Prolong. Amacwecwe aqukethe i-500 noma i-1000 mg ye-metformin enwetshiwe kanye ne-2,5 noma i-5 mg ye-saxagliptin. Intengo yephakeji yanyanga zonke ingama-ruble angama-3300. I-analogue ephelele yesidakamizwa iyinhlanganisela ye-Ongliza ne-Glucofage Long, izobiza ama-ruble ayinkulungwane ashibhile.
Uma zombili izidakamizwa ezilinganisweni eziphakeme zinganikeli umphumela ofiselekayo wesifo sikashukela, kuvunyelwe ukungeza i-sulfonylureas, glitazones, insulin kwirejimeni yokwelashwa.
Kungenzeka yini ukubuyisela okuthile
U-Onglisa ungukuphela kwesidakamizwa se-saxagliptin kuze kube manje. Kusekuseni kakhulu ukukhuluma ngokuvela kwe-analogues engabizi kakhulu, ngoba ukuvikela amalungelo obunikazi kusebenza kwemithi emisha, evimbela ukukopisha okwangempela. Ngakho-ke, umenzi unikezwa ithuba lokuphinda enze ucwaningo olubizayo, ashukumise ukuthuthuka okuqhubekayo kwemithi yemithi. Ukulindela ukwehlisa intengo ye-Ongliza akukufanele.
Kumakhemisi aseRussia, ngaphezu kwe-Onglisa, ungathenga amaphilisi eqenjini elifanayo leGalvus neJanuvius. Le mishanguzo inomphumela ofanayo kwisifo sikashukela i-mellitus, ukuqhathanisa mayelana nokuphepha nokusebenza kahle akubonisanga umehluko omkhulu phakathi kwabo. Ngokusho kokubuyekezwa kwabanesifo sikashukela, ungabathola mahhala hhayi kuzo zonke izifunda, yize iqiniso ukuthi minyaka yonke lifakwa ohlwini lwezidakamizwa ezibalulekile.
Ukuthengwa okuzimele kwale mithi kuzobiza kakhulu:
| Izidakamizwa | Umthamo ophakanyisiwe mg | ~ Izindleko ngenyanga ukwelashwa, hlikihla. |
| Onglisa | 5 | 1900 |
| I-Combogliz Prolong (inhlanganisela ne-metformin) | 5+1000 | 3300 |
| UGalvus | 2x50 | 1500 |
| UGalvus Met (onama-metformin) | 2x (50 + 1000) | 3100 |
| UJanuvia | 100 | 1500 |
| I-Yanumet (ene-metformin) | 2x (50 + 1000) | 2800 |
Unga-oda la mapilisi ashibhile emakhemisi online. Esikhathini esikhulu kunazo zonke kubo kungenzeka ukuthi iveni yamahhala yesidakamizwa emakhemisi aseduze kwendlu.
Ngo-2017 kwamenyezelwa ukuthi kudalulwe isidakamizwa esihlanganisa i-saxagliptin ne-dapagliflozin ebizwa nge-Qtern. Kuhlanganisa izinzuzo zesinye sezidakamizwa eziphambili kakhulu zikashukela - u-Forsigi no-Onglisa. E-Russia, amaphilisi amasha awakabhaliswa.
Ukubuyekezwa
Ngenxa yalokho, ngesonto ushukela wami owamukelekayo waba ofanele. Usizo olubalulekile lwe-Ongliza ngicabanga ngekhono lakhe lokuqeda indlala yakhe. Ngeshwa, mina uqobo angikwazi ukubhekana nesifiso sami sokudla. Kulula kakhulu ukuthi bobabili i-Onglizu ne-Glucofage Long ithathwe kanye ngosuku. Ngiphuze kusihlwa - usuku lonke olulandelayo awukwazi ukucabanga ngemithi.
