I-Hypoglycemic drug invokana - umphumela emzimbeni, imiyalo esetshenzisiwe

I-Attokana igama lokuhweba lomuthi othathwe ukwehlisa ushukela wegazi.

Leli thuluzi lenzelwe iziguli ezinesifo sikashukela sohlobo II. Umuthi uyasebenza zombili ohlakeni lwe-monotherapy, futhi ngokuhambisana nezinye izindlela zokwelapha isifo sikashukela.

Imininingwane ejwayelekile, ukwakheka kanye nendlela yokukhululwa

I-Invocana isidakamizwa esinomphumela we-hypoglycemic. Umkhiqizo wenzelwe ukuphathwa ngomlomo. I-Attokana isetshenziswe ngempumelelo ezigulini ezinesifo sikashukela sohlobo II.

Umuthi lo unempilo yeminyaka emashalofini yeminyaka emibili. Gcina umuthi endaweni yokushisa engeqi kuma-30⁰C.

Umkhiqizi walo muthi nguJanssen-Ortho, inkampani esePuerto Rico. Ukupakisha kwenziwa yinkampani iJanssen-Silag ese-Italy. Obambe amalungelo alo muthi nguJohnson noJohnson.

Isakhi esiyinhloko salo muthi yi-Kanagliflozin hemihydrate. Kwithebhulethi elilodwa le-Attokana, kukhona cishe ama-306 mg ale nto esebenzayo.

Ngaphezu kwalokho, i-18 mg ye-hyprolose ne-anactrous lactose (cishe i-117.78 mg) ikhona ekubunjweni kwamacwecwe emithi. Ngaphakathi komgogodla wethebhulethi kukhona ne-magnesium stearate (4.44 mg), i-microcrystalline cellulose (117.78 mg) ne-croscarmellose sodium (mayelana ne-36 mg).

Igobolondo lomkhiqizo liqukethe ifilimu, equkethe:

• i-macrogol;
• i-talc;
• utshwala be-polyvinyl;
• titanium dioxide.

I-Attokana itholakala ngohlobo lwezibhebhe ze-100 nezingama-300 mg. Ezibhebheni ze-300 mg, igobolondo elinombala omhlophe likhona; ezibhebheni ze-100 mg, igobolondo liphuzi. Kuzo zombili izinhlobo zamathebhulethi, ngakolunye uhlangothi kune-“CFZ” eqoshwe, kanti emuva kukhona izinombolo eziyi-100 noma ezingama-300 ngokuya ngesisindo sethebhulethi.

Umuthi uyatholakala ngesimo samakhaza. Iqhubu elilodwa liqukethe amaphilisi ayi-10. Ipakethe elilodwa lingaqukatha ama-1, 3, 9, 10 ama-blisters.

Isenzo se-Pharmacological

I-Kanagliflozin njengengxenye eyinhloko yomuthi inciphisa ukubuyiselwa emuva (i-reabsorption) ye-glucose. Ngenxa yalokhu, ukumbiwa kwayo ngezinso kuyanda.

Ngenxa yokubuyiselwa emuva, ukwehla okuphikelelayo kwenani le-glucose egazini lesiguli kwenzeka. Ngokukhishwa kwe-glucose, kuvela umphumela wokugaya. Ngenxa yalokhu, umfutho wegazi we-systolic uyancipha.

I-Kanagliflozin inomthelela ekulahlekelweni kwekhalori. I-invokana ingasetjenziswa njengesidakamizwa esilahlekelwa isisindo. Ngomthamo we-300 mg, kunomthelela ekwehlisweni okungcono kwesibalo se-glucose egazini kunokutholakala komthamo we-100 mg. Ukusetshenziswa kweKaragliflozin akubangeli ukuthathwa kabi kwe-glucose.

Umuthi usiza ukwehlisa umkhawulo wezinso weglucose. Lapho uthatha umuthi, ukuphuma kweglucose yizinso kuyathuthukiswa. Ngesikhathi sokudla isikhathi eside i-Attokana, kuyehla ukwehla kwesibalo se-glucose egazini.

Ukuzila kusiza ukubambezela ukumuncwa kwe-glucose emathunjini. Ekuqhubekeni kwezifundo, kwavela ukuthi izinga likashukela wegazi lapho uthatha umuthi ngaphambi nangemva kokudla lihlukile. Ukuqinisa i-glycemia lapho kudliwa umuthi ongu-100 mg kuguqulwe ku-1,9 mmol / L, nalapho uthatha u-300 mg kuya ku--2.4 mmol / L.

Ngemuva kwamahora ama-2 ngemuva kokudla, izinga likashukela wegazi laguquka lisuka ku--2.7 mmol / L lapho lidla ama-100 mg futhi lisuka laya ku -3,5 mmol / L lapho lithatha umuthi ongu-300 mg.

Ukusetshenziswa kweKaragliflozin kuthuthukisa ukusebenza kwe-β-cell.

I-Pharmacokinetics

IKaragliflozin ibonakala ngokufakwa ngokushesha. I-pharmacokinetics yento ayinakho umehluko uma ithathwa ngumuntu onempilo, noma uma ithathwa ngumuntu onesifo sikashukela sohlobo II.

Izinga eliphezulu leKanagliflosin liphawulwa ngemuva kwehora eli-1 ngemuva kokuthatha i-Attokana. I-Half-life yesidakamizwa amahora angama-10.6 uma usebenzisa i-100 mg yesidakamizwa namahora angama-13.1 lapho uthatha umuthi ongu-300 mg.

I-bioavailability yesidakamizwa ingama-65%. Ingathathwa ngaphambi nangemva kokudla, kepha ngomphumela omuhle kakhulu, kunconywa ukuthatha umuthi ngaphambi kokudla kokuqala.

IKaragliflozin isatshalaliswa kakhulu kwezicubu. Umuthi uhlangana kahle namaprotheni egazi. Izinga lingama-99%. Umuthi usebenza kakhulu ekuhlanganisweni kwe-albhamuin.

I-Kanagliflosin inezinga eliphansi lokuhlanzwa kwezicubu zomzimba kuyo. Ukuhlanjululwa kwezinso kusukela kwento (imvume yezinso) ngu-1.55 ml / min. Isilinganiso senani eliphelele lokuhlanza umzimba kusuka eKhanagliflozin ngu-192 ml / min.

Izinkomba kanye ne-contraindication

Umuthi ubekelwe iziguli ezinesifo sikashukela sohlobo II.

Umuthi ungasetshenziswa:

• njengendlela ezimele neyodwa yokwelapha lesi sifo;
• ngokuhambisana neminye imithi enciphisa ushukela kanye ne-insulin.

Phakathi kokuphulwa kokusetshenziswa, abameli baveze:

• ukwehluleka okunzima kwezinso;
• ukungabekezeleleki komuntu I-Kanagliflozin nezinye izinto zomuthi;
• ukungabekezelelani kwe-lactose;
• iminyaka efinyelela eminyakeni eyi-18;
• ukwehluleka kwesibindi okunzima;
• thayipha isifo sikashukela;
• ukuhluleka kwenhliziyo okungamahlalakhona (amakilasi ama-3-4 wokusebenza);
• ukuncelisa;
• isifo sikashukela sikashukela;
• ukukhulelwa

Imiyalo yokusebenzisa

Emini, kuvunyelwe ithebhulethi engu-1 yesidakamizwa (100 noma 300 mg). Kunconywa ukuthatha umuthi ekuseni kanye nesisu esingenalutho.

Lapho usebenzisa umuthi kanye namanye ama-hypoglycemic agents kanye ne-insulin, kunconyelwa ukunciphisa umthamo wokugcina ukuze uvikele ukuvela kwe-hypoglycemia.

Njengoba i-canagliflozin inomphumela oqinile wokugaya, umthamo wezidakamizwa ezigulini ezinomsebenzi wezinso ongasebenzi kahle, kanye nabantu abangaphezu kweminyaka yobudala engama-75, kufanele babe ngu-100 mg kanye.

Iziguli ezibekezelela kahle i-canagliflozin zinconywa ukuthatha nomuthi ongu-300 mg kanye ngosuku.

Ukweqa umuthi akufiseleki. Uma kwenzeka lokhu, kufanele uphuze umuthi ngokushesha. Akuvunyelwe ukusebenzisa umthamo ophindwe kabili womuthi phakathi nosuku.

Iziguli Ezikhethekile Nezinkomba

I-Attokana ifakwa emzimbeni wabesifazane abakhulelwe nezingane ezingaphansi kweminyaka engu-18. Umuthi akufanele uphuzwe ngabesifazane abaphephayo, ngoba i-Kanagliflozin ingena ngokuqinile ubisi lwebele futhi ingathinta kabi impilo yosana olusanda kuzalwa.

Kusetshenziswa ngokuqapha ngabantu abangaphezulu kweminyaka engama-75. Babekelwa umthamo omncane womuthi.

Akunconywa ukunquma umuthi ezigulini:

• nokusebenza kokuphazamiseka kwezinso zezinga elikhulu;
• ngokuhluleka okungapheli kwe-renal esigabeni sokugcina;
• ngaphansi kokudayela.

Umuthi uthathwa ngokuqapha kubantu abanokwehluleka kwezinso okuncane. Kulokhu, umuthi uthathwa kumthamo omncane - 100 mg kanye ngosuku. Ngokuhluleka ngokwezinso okulinganiselayo, kuthathwa isilinganiso esincane somuthi.

Kwenqatshelwe ukuthatha lesi sidakamizwa ezigulini ezinesifo sikashukela sohlobo lwe-1 isifo sikashukela kanye nesifo sikashukela sikashukela. Umphumela odingekile wokwelashwa ngokuthatha umuthi osesigabeni sokugcina sokwehluleka ukwelapha izinso ngeke ubonwe.

I-Attokana ayinawo umphumela we-carcinogenic ne-mutagenic emzimbeni wesiguli. Akukho mininingwane ngemiphumela yesidakamizwa ekusebenzeni komuntu kokuzala.

Ngokwelashwa okuhlangene nemithi kanye namanye ama-hypoglycemic agents, kunconyelwa ukunciphisa umthamo wokugcina ukuze ugweme i-hypoglycemia.

Ukwehla komthamo we-intravascular kuvame ukwenzeka enyangeni yokuqala nesigamu sokuqala selashwa i-Invocana.

Ukukhishwa kwesidakamizwa kuyadingeka ngenxa yamacala angenzeka

• i-vulvovaginal candidiasis kwabesifazane;
• i-candida balanitis emadodeni.

Abesifazane abangaphezu kuka-2% no-0.9% wamadoda babenezifo eziphindaphindwayo lapho bethatha lo muthi. Izimo eziningi ze-vulvovaginitis zivele kwabesifazane emavikini okuqala ayi-16 kusukela kuqale ukwelashwa ne-Invocana.

Kunobufakazi bomphumela womuthi ekwakhiweni kwamaminerali kwamathambo kubantu abanesifo senhliziyo. Umuthi uyakwazi ukunciphisa ukuqina kwamathambo, okuholela engcupheni yokuqhekeka eqenjini elibekiwe leziguli. Kudingeka umuthi wokucophelela.

Ngenxa yengozi enkulu yokuthola i-hypoglycemia ngempatho ehlanganisiwe ye-Attokana ne-insulin, kunconyelwa ukugwema ukushayela.

Imiphumela emibi kanye ne-overdose

Eminye yemiphumela emibi yokuphuza umuthi yile:

• umuzwa wokoma;
• ukwehla kwethamo lomthamo wegazi ngendlela yesisi, ukomisa, ukwehlisa umfutho wegazi, ukuqothuka;
• i-vulvovaginal candidiasis kwabesifazane;
• ukuqunjelwa;
• i-polyuria;
• isicanucanu
• i-urticaria;
• umlomo owomile
• i-balanitis, i-balanoposthitis emadodeni;
• i-cystitis, ukutheleleka kwezinso;
• i-hypoglycemia ngokubambisana ngokubambisana ne-insulin;
• ukukhuphuka kwezinga le-hemoglobin;
• amazinga e-uric acid aphansi;
• isifo sikashukela sikashukela;
• ukuncipha kwamathambo;
• amazinga akhuphukayo e-serum potassium;
• ukukhuphuka kwe-cholesterol egazini.

Ezimweni ezingavamile kakhulu, ukuthatha lo muthi kuholele ekwehlulekeni kwezinso, ukushaqeka kwe-anaphylactic ne-angioedema.

Akunazimo zokusebenzisa ngokweqile ngalo muthi. Umthamo we-1600 mg wabekezelelwa ngempumelelo ngabantu abanempilo kanye nomthamo wama-600 mg ngosuku kubantu abanesifo sikashukela sohlobo 2.

Uma kwenzeka kusetshenziswa i-overdose, i-gastric lavage iyenziwa, futhi isiguli siqashwe. Ukuxilongwa uma kwenzeka kwezeqisa akusebenzi.

Ukuxhumana neminye imithi kanye nama-analogues

Umuthi osebenzayo wesidakamizwa ungahlaselwa kalula yi-oxidative metabolism. Ngalesi sizathu, umphumela wezinye izidakamizwa esenzweni se-canagliflozin incane.

Umuthi uxhumana nezidakamizwa ezilandelayo:

• I-Phenobarbital, i-Rifampicin, i-Ritonavir - ukwehla kokusebenza kwe-Attokana, ukwanda komthamo kuyadingeka;
• I-Probenecid - ukungabi bikho komphumela obalulekile kumthelela womuthi;
• I-cyclosporin - ukungabi bikho komphumela obalulekile umuthi;
• I-Metformin, iWarfarin, iParacetamol - akukho mphumela obalulekile kuma-pharmacokinetics we-canagliflozin;
• I-Digoxin ukuxhumana okuncane okudinga ukuqapha isimo sesiguli.

Le mithi elandelayo inomphumela ofanayo ne-Attokana:

• Glucobay;
• I-NovoNorm;
• UJardins;
• I-Glibomet;
• I-Piroglar;
• I-Guarem;
• IVictoza;
• IGlucophage;
• Methamine;
• IFommetin;
• I-Glibenclamide;
• IGlurenorm;
• UGlidiab;
• I-Glykinorm;
• Ngikhanyisiwe;
• Trazenta;
• Galvus;
• I-Glutazone

Umbono wesineke

Ukusuka ekubuyekezweni kwesifo sikashukela nge-Invokan, singaphetha ngokuthi umuthi wehlisela ushukela wegazi kahle nemiphumela emibi ayivelakancane, kepha kunentengo ephezulu yomuthi, ephoqa abaningi ukuthi bashintshele kwimithi ye-analog.

Udokotela wami obonakalayo ungibhalele ukuthi ngibe ngummeli ngoba nginesifo sikashukela sohlobo 2. Umuthi omuhle osebenzayo. Imbalwa imiphumela emibi. Angikaze ngiqaphele noma yikuphi ukwenzeka ngalesi sikhathi sokulashwa. Kumaminithi, ngifuna ukuqaphela intengo ephezulu ngakho.

UTatyana, oneminyaka engama-52

Udokotela wancoma umuthi onesifo sikashukela se-Invokan. Ithuluzi lifakazelwe lisebenza. Ukuncipha okuqhubekayo kushukela wegazi kwaphawulwa. Kwakunemiphumela emibi ngesimo sokuqunjelwa okuncane, kepha ngemuva kokulungisa leli dosi, konke kwahamba. Ububi yintengo ephezulu kakhulu. Kukhona ezinye izifaniso eziningi ezitholakalayo.

U-Alexandra, oneminyaka engama-63

Sekuphele isikhathi eside ngihlaselwa yisifo sikashukela futhi nganquma ukushintshela ku-Invocana. Ithuluzi elibizayo, akuwona wonke umuntu okwazi ukulikhokhela. Ngokusebenza kahle akukubi. Ngijabule ngenani elincane le-contraindication nemiphumela emibi uma ngiqhathanisa nezinye izidakamizwa zesifo sikashukela.

U-Oleg, oneminyaka engama-48 ubudala

Izinto zevidiyo kuzinhlobo, izimpawu nokwelashwa kwesifo sikashukela:

Izindleko zomuthi emakhemisi zisukela kuma-ruble angama-2000-4900. Intengo ye-analogues yesidakamizwa ngama-ruble angama-50-4000.

Umkhiqizo usatshalaliswa kuphela ngokuya ngencwadi yengozi yokwelapha.