I-Liraglutide yokulwa nokukhuluphala - imiyalo yokusebenzisa

ILiraglutide, kanye ne-analogue yayo ngomthamo ohlukile weViktoz, akuwona umuthi omusha. E-United States, Russia nakwamanye amazwe lapho umuthi uvunyelwe ngokusemthethweni, ubusetshenziselwa ukuphatha isifo sikashukela sohlobo 2 kusukela ngo-2009.

Lo muthi wesigaba se-incretin unamandla we-hypoglycemic. Inkampani yaseDenmark uNovo Nordisk ikhiqiza i-liraglutide ngaphansi kwegama lokuhweba iVictoza. Kusukela ngo-2015, ekhemisi likhemisi, ungathola i-generic Saxenda.

Zonke zibekwe njengezidakamizwa zokunciphisa isisindo kubantu abadala. Babekwa ngenkomba yomzimba engu-30, ekhombisa ukukhuluphala.

Kungenzeka ukusebenzisa umuthi nge-BMI yama-27I ngaphezulu uma isiguli sinezifo ezibangelwa ukucasuka ngokweqile - umfutho wegazi ophakeme, uhlobo 2 sikashukela.

Ngemuva kuka-2012, i-liraglutide umuthi wesine wokukhuluphala ogunyazwe eMelika. UNdunankulu wezokudla okunempilo uWilliam Troy Donahue waseDenver uchaza ukuthi lesi sidakamizwa sakhiwe njenge-analogue ye-GLP eyenziwe emathunjini, esithumela amasiginali we-satellite ebuchosheni. Lokhu kungomunye wemisebenzi yawo, inhloso esemqoka yehormone nomlingani wayo wokwenziwa ukusiza i-pancreatic b-cell ekuguqulweni kweglucose ibe amandla, hhayi emafutheni.

Ngabe umuthi usebenza kanjani?

ILiraglutide e-radar (irejista yemithi yaseRussia) ifakwa ngaphansi kwamagama okuhweba iViktoza nesiSaksenda. Umuthi uqukethe isakhi se-liraglutide esiyisisekelo, esifakwe ngezithako: i-sodium hydrogen phosphate dihydrate, phenol, sodium hydroxide, amanzi ne-propylene glycol.

Njenge-GLP-2 yemvelo, i-liraglutide ihlangana nama-receptors, ivuselela ukukhiqizwa kwe-insulin neglucagon. Izindlela zokwenziwa kwe-insulin yendabuko ziya ngokuya zijwayelekile. Le ndlela ikuvumela ukuba uguqule ngokuphelele i-glycemia.

Umuthi ulawula ukukhula kwamafutha omzimba usebenzisa izindlela zivimba indlala nokusetshenziswa kwamandla. Ukwehla kwesisindo okufika ku-3 kg kwaqoshwa ngesikhathi sokuvivinywa kwemitholampilo ngokusetshenziswa kweSaxenda ekwelashweni okuyinkimbinkimbi nge-metformin. Ukuphakama kwe-BMI ekuqaleni, ngokushesha iziguli kwehle emzimbeni.

Nge-monotherapy, umthamo okhalweni wehliswe ngo-3-3.6 cm unyaka wonke, futhi isisindo sehlile saba ngamazinga ahlukahlukene, kodwa kuzo zonke iziguli, kungakhathalekile ukuba khona kwemiphumela engathandeki. Ngemuva kokushintsha iphrofayili ye-glycemic, i-liraglutide imisa ukukhula kwamaseli e-b abhekene nokuhlanganiswa kwe-insulin yawo uqobo.

Ngemuva komjovo, umuthi udonswa kancane kancane. Inani eliphakeme lokuhlushwa kwalo libonakala ngemuva kwamahora angama-8-12. Kuma-pharmacokinetics wesidakamizwa, ubudala, ubulili noma umehluko wobuzwe awudlali indima ekhethekile, njengoba kwenza i-pathologies yesibindi nezinso.

Imvamisa, umuthi ungena egazini ngomjovo, ukhulisa inani lama-peptides, ubuyisela ama-pancreas. Ukudla kudonswa kangcono, Izimpawu zohlobo 2 sikashukela azijwayelekile.

Izivivinyo zokwelashwa zomuthi zenziwa phakathi nonyaka, futhi akukho mpendulo engalingani embuzweni mayelana nesikhathi sokulashwa. I-FDA incoma ukuthi kuhlolwe iziguli njalo ezinyangeni ezi-4 ukulungisa irejimeni.

Uma phakathi nalesi sikhathi ukwehla kwesisindo kungaphansi kwe-4%, khona-ke umuthi awulungele lesi siguli, futhi kufanele kuthathwe okunye esikhundleni saso.

Ungayelapha kanjani ukukhuluphala nge-liraglutide - imiyalo

Uhlobo lomthamo wesidakamizwa ngesimo se-pen-syringe senza lula ukusetshenziswa kwaso. I-syringe inokumaka okukuvumela ukuthi uthole umthamo odingekayo - kusuka ku-0.6 kuye ku-3 mg ngokuphumula kwe-0,6 mg.

Isilinganiso esiphakeme nsuku zonke se-liraglutide ngokuya ngemiyalo yokusetshenziswa yi-3 mg. Ngesikhathi esithile, ukuphuza umuthi noma ukudla, umjovo awuboshiwe. Umthamo wokuqala weviki lokuqala ubuncane (0.6 mg).

Ngemuva kwesonto, ungaguqula okujwayelekile ekukhuphukeni kwe-0.6 mg. Kusuka enyangeni yesibili, lapho inani lemithi elithathiwe lifinyelela ku-3 mg / ngosuku. Futhi kuze kube sekupheleni kwenkambo yokwelashwa, i-dont titration ayenziwa phezulu.

Umuthi uphathwa kanye nganoma yisiphi isikhathi sosuku, izindawo ezifanele zomzimba zokujova yisisu, amahlombe okhalweni. Isikhathi nendawo yomjovo kungashintshwa, into esemqoka ukugcina ngokunembile umthamo.

Noma ngubani ongenawo isipiliyoni sokusebenzisa amapeni we-syringe ngokwawo angasebenzisa izincomo zezinyathelo ngezinyathelo.

1. Ukulungiselela. Geza izandla, hlola zonke izesekeli (ipeni eligcwele i-liraglutide, inaliti notshwala busule).
2. Kuhlola umuthi esibayeni. Kufanele ibe nokushisa kwekamelo, uketshezi luhlala lubonakala.
3. Ukubeka inaliti. Susa isicucu esibambweni, susa ilebula ngaphandle kwenaliti, uyibambe ngesixha, uyifake esicelweni. Ukuyiguqula ngentambo, lungisa inaliti endaweni ephephile.
4. Ukuqedwa kwamabhamuza. Uma kunomoya ophathwayo, kufanele uwubeke kumayunithi angama-25, susa izixazululo ngenaliti bese uvula isibambo siphele. Nyakazisa isirinji ukukhipha umoya. Cindezela inkinobho ukuze iconsi lomuthi liphume ekugcineni kwenalithi. Uma kungekho ketshezi, ungaphinda inqubo, kodwa kube kanye kuphela.
5. Ukulungiswa kwedosi. Guqula inkinobho yomjovo ileveli oyifunayo elihambisana nomthamo wezokwelapha obekwe udokotela wakho. Ungazungeza kunoma iyiphi indlela. Lapho ujikeleza, ungacindezeli inkinobho bese uyikhipha. Inombolo efasiteleni kufanele ihlolwe ngaso sonke isikhathi ngethamo elibekwe udokotela.
6. Ukungena Indawo yomjovo kufanele ikhethwe kanye nodokotela, kepha uma kungekho khona okungcono kungcono ukuyishintsha ngaso sonke isikhathi. Hlanza isiza somjovo ngesitshi noma ngendwangu efakwe otshwaleni, vumela ukuthi ome. Ngesandla esisodwa, bamba isirinji, nangesinye - yenza isibaya esikhungweni somjovo ohlosiwe. Faka inaliti esikhunjeni bese ukhulula i-crease. Cindezela inkinobho esibambo bese ulinda imizuzwana eyi-10. Inaliti ihlala esikhunjeni. Bese ususa inaliti ngenkathi ubamba inkinobho.
7. Ukuhlola idosi. Hlanganisa indawo yokujova nge-napkin, qiniseka ukuthi ithamo lifakwe ngokuphelele (uphawu luka "0" kufanele luvele efasiteleni). Uma kunesibalo esihlukile, khona-ke isimo esejwayelekile asingeniswanga ngokugcwele. Umthamo olahlekile uphathwa ngokufanayo.
8. Ngemuva komjovo. Nqamula inalithi esetshenzisiwe. Bamba isibambo ngokuqinile bese ubeka cap. Ngokuyiguqula, khipha inaliti bese ulahla. Beka ipeni lokubeka endaweni.
9. Gcina ipeni lesirinji emaphaketheni alo okuqala. Ungashiyi inaliti emzimbeni, uyisebenzise kabili, noma usebenzise inalithi efanayo nabanye abantu.

Imiyalo yevidiyo yokusebenzisa ipeni lesirinji neVictoza - kule vidiyo

Elinye iphuzu elibalulekile: i-liraglutide yokunciphisa umzimba akuyona indawo ye-insulin, kwesinye isikhathi esetshenziswa ngabanesifo sikashukela abanesifo sohlobo 2. Ukusebenza kwezidakamizwa zalo mkhakha weziguli akufundwanga.

I-Liraglutide ihlanganiswe ngokuphelele nezidakamizwa ezinciphisa ushukela ngokususelwa ku-metformin futhi, enguqulweni ehlangene, i-metformin + thiazolidinediones.

Ngubani omiselwe i-liraglutide

I-Liraglutide ingumuthi ongathi sína, futhi kuyadingeka ukuwuthola kuphela ngemuva kokuqokwa kondli noma i-endocrinologist. Njengomthetho, umuthi unikezwa abasebenza isifo sikashukela abanesifo sohlobo lwe-2, ikakhulukazi lapho kukhona ukukhuluphala, uma ukuguqulwa kwendlela yokuphila kungavumeli ukwenziwa kwesisindo kube nokwakheka koshukela egazini ngaphandle kwezidakamizwa.

Umuthi ukuthinta kanjani ukusebenza kwemitha? Uma isiguli sinesifo sikashukela esinesifo sohlobo 2, ikakhulukazi uma sidla eminye imishanguzo ye-hypoglycemic, iphrofayili ye-glycemic iya ngokuya ivama. Ezigulini ezinempilo, akukho songo se-hypoglycemia.

Ukulimala okungase kube okuvela kulo muthi

I-Liraglutide i-contraindication uma kungenzeka uzwela okuphezulu kwizithako zefomula. Ngaphezu kwalokho, umuthi awunqunyelwe:

1. Isifo sikashukela esinesifo sohlobo 1;
2. Nge-pathologies enzima yesibindi nezinso;
3. Iziguli ezinokwehluleka kwenhliziyo zohlobo 3 no-4;
4. Uma umlando wokuvuvukala kwamathumbu;
5. Omama abakhulelwe futhi abancelile;
6. Ngama-neoplasms we-yegilo yegilo;
7. Esimweni se-ketoacidosis yesifo sikashukela;
8. Iziguli ezine-endocrine neoplasia syndrome eziningi.

Umyalo awukhuthazi ukuthatha i-liraglutide ngokuhambisana nemijovo ye-insulin noma ezinye iziphikisi ze-GLP-1. Kunemikhawulo yobudala: umuthi awubekelwe izingane nabantu abavuthiwe (ngemuva kweminyaka engama-75) ubudala, ngoba izifundo ezikhethekile zalo mkhakha weziguli azenziwanga.

Uma kunomlando we-pancreatitis, umuthi nawo awuchaziwe, ngoba akukho okuhlangenwe nakho komtholampilo maqondana nokuphepha kwawo kwalesi sigaba seziguli.

Ukuhlolwa kwezilwane kuqinisekisile ubuthi bokuzala we-metabolite, ngakho-ke, esigabeni sokuhlela ukukhulelwa, i-liraglutide kumele ithathelwe indawo nge-insal insulin. Ekwelashweni kwezilwane zesifazane, ukuhlangana komuthi obisini bekuphansi, kepha le mininingwane ayanele ukuthatha i-liraglutide ngesikhathi sokuqunjelwa.

Akunangqondo ngesidakamizwa nezinye izifaniso ezisetshenziselwa ukulungisa isisindo. Lokhu kusho ukuthi kuyingozi ukuhlola izindlela ezahlukahlukene zokunciphisa umzimba lapho welapha nge-liraglutide.

Imiphumela engathandeki

Imiphumela emibi evamile kakhulu ukuphazamiseka komgudu wokugaya ukudla. Cishe isigamu seziguli sikhononda nge-nausea, ukuhlanza, ubuhlungu be-epigastric. Njalo owesihlanu unokwephula isigqi sokuduka (kaningi - isifo sohudo ngokuphelelwa ngamanzi emzimbeni, kepha kungaqunjelwa). I-8% yokulahlekelwa iziguli ezisindayo izizwa ikhathala noma ukukhathala okungapheli.

Ukugxila kwabo ngesimo sabo ngale ndlela yokuncipha kwesisindo kufanele kukhokhwe kubantu abanesifo sikashukela abanesifo sohlobo 2, ngoba ama-30% alabo abathatha i-liraglutide isikhathi eside bathola imiphumela emibi kangako njenge-hypoglycemia.

Ukuphendula okulandelayo kujwayelekile ngemuva kokwelashwa nomuthi:

• Ubuhlungu bekhanda;
• I-Flatulence, ukuqhakaza;
• I-Belching, i-gastritis;
• Ukwehla kwesifiso sokudla kuze kufike ku-anorexia;
• Izifo ezithathelwanayo zohlelo lokuphefumula;
• I-Tachycardia;
• Ukwehluleka kwangempela
• Ukuvela komzimba wesimo sendawo (endaweni yomjovo).

Njengoba umuthi uvusa ubunzima ngokukhishwa kokuqukethwe esiswini, lesi sici singathinta kabi ukumuncwa kokugaya kwezinye izidakamizwa. Akukho mehluko obalulekile emtholampilo, ngakho-ke, asikho isidingo sokulungisa umthamo wezidakamizwa ezisetshenziswa ekwelashweni okuyinkimbinkimbi.

Ukweqisa

Izimpawu eziphambili ze-overdose ukuphazamiseka kwe-dyspeptic ngesimo sokucanuzelelwa kwenhliziyo, ukuhlanza, ubuthakathaka. Azange kube namacala okuthuthuka kwezimo ze-hypoglycemic, ngaphandle kokuthi ezinye izidakamizwa zithathwe ngokulinganayo ukunciphisa isisindo somzimba.

Imiyalo yokusetshenziswa kwe-liraglutide itusa ukukhishwa kwesisu okususelwa kwizinsalela zomuthi kanye nama-metabolites awo ngokusebenzisa ama-sorbents nokwelashwa okubonisa izimpawu.

Ngabe usebenza kangakanani umuthi wokunciphisa umzimba

Imithi esekwe kwisithako esisebenzayo se-liraglutide isiza ukunciphisa isisindo somzimba ngokunciphisa inani lokufakwa kokudla esiswini. Lokhu kusiza ukunciphisa isifiso sokudla ngo-15-20%.

Ukuze wandise ukusebenza ngempumelelo kwe-liraglutide ekwelapheni ukukhuluphala, kubalulekile ukuhlanganisa umuthi nokudla okwenziwe nge-hypocaloric. Akunakwenzeka ukufeza isibalo esiphelele ngomjovo owodwa nje. Kuzofanele sibuyekeze imikhuba yethu emibi, senze okuyinkimbinkimbi esilingana nesimo sempilo kanye nobudala bokuvivinya umzimba.

Ngale ndlela ebanzi yenkinga, ama-50% abo bonke abantu abaphilile asebeqedile izifundo ezigcwele kanye nekota yabanesifo sikashukela behlisa umzimba. Esigabeni sokuqala, ukuncipha kwesisindo kuqoshwe ngokwesilinganiso ngamaphesenti angama-5, kwesesibili - ngo-10%.

I-Liraglutide - i-analogues

Nge-liraglutide, intengo isukela kuma-ruble ayizinkulungwane eziyi-9 kuye kwangama-27, kuya ngomthamo. Kwisidakamizwa sokuqala, esibuye sithengiswe ngaphansi kwegama lokuhweba iViktoza neSaksenda, kunemithi enomphumela ofanayo wokwelapha.

1. I-Baeta - i-amino acid amidopeptide ebambezela ukungasebenzi kokuqukethwe esiswini, inciphise isifiso sokudla; izindleko zepeni yesirinji ngomuthi - kuze kufike kuma-ruble ayi-10,000.
2. I-Forsiga ing umuthi we-hypoglycemic womlomo, i-analog ye-liraglutide kumathebulethi ingathengwa ngentengo efinyelela kuma-ruble angama-280, isebenza ikakhulukazi ngemuva kokudla.
3. I-Liksumiya - umuthi okwehlisa i-hypoglycemia, kungakhathalekile isikhathi sokudla; intengo yepeni yesirinji ngomuthi - kuze kufike kuma-ruble angama-7 000.
4. I-NovoNorm - i-ejenti yomlomo ye-hypoglycemic enomphumela wesibili ngendlela yokuqina kwesisindo ngentengo efinyelela kuma-ruble angama-250.
5. I-Reduxin - imijovo yenziwa ezinyangeni ezintathu kuya eminyakeni emi-2. Intengo yokufaka isuka kuma-ruble ayi-1600.
6. I-Orsoten emaphaketheni ithathwa ngokudla. Izindleko - kusuka kuma-ruble angama-200.
7. I-Diagninide - amaphilisi athathwa ngaphambi kokudla. Intengo yalo muthi ivela kuma-ruble angama-200.

Amathebulethi afana ne-Liraglutide angahle awasebenzise, ​​kepha imijovo yepeni yesirinji iveze ukuthi isebenza kahle.. Imithi kadokotela iyatholakala. Intengo ephezulu yesidakamizwa esezingeni ihlala ivuselela ukubukeka kwezichibi ngamanani akhangayo emakethe.

Yikuphi i-analogue ezosebenza kangcono, ngudokotela kuphela onganquma. Ngaphandle kwalokho, umphumela wokwelapha nenani lemiphumela engathandeki akulindelekile.

Ukubuyekezwa nemiphumela yokwelashwa

Ngonyaka, amavolontiya angama-4800 abamba iqhaza ezivivinyweni zokwelapha zomuthi e-USA, ama-60% awo athatha ama-3 mg e-liraglutide ngosuku futhi alahlekelwa okungenani yi-5%. Ingxenye yesithathu yeziguli inciphise isisindo somzimba ngo-10%.

Ochwepheshe abaningi ababheki le miphumela njengebalulekile emtholampilo umuthi onemiphumela emibi eminingana. Ku-liraglutide, ukubuyekezwa kokuncipha kwesisindo ngokujwayelekile kuqinisekisa lezi zibalo.

Ehlelweni lokunciphisa isisindo ngeLyraglutide, umphumela omkhulu utholakala yilabo abaxazulula inkinga ku-tata:

• Kubona kudla lokune-calori yaphansi;
• Inqaba imikhuba emibi;
• Kwandisa umthwalo wemisipha;
• Kwakha isimo esihle sokukholwa ngemiphumela yokwelashwa.

E-Russian Federation, i-orlistat, i-sibutramine ne-liraglutide babhaliswa kusuka kwezidakamizwa ezi-slimming. USolwazi Endocrinologist u-E. Troshina wabeka i-liraglutide endaweni yokuqala ngokuya ngokusebenza kulolu hlu. Imininingwane kuvidiyo