Uhlobo lwesifo sikashukela sohlobo 2 yisifo se-metabolic esakha ngenxa yokuxhumana okungahambi kahle kwe-insulin namaseli.
Abantu abanalolu hlobo lwe-malaise abakwazi ukuhlala balondoloze amazinga afanele kashukela ngokudla nangezinqubo ezikhethekile. Odokotela banquma iVildagliptin, esehlisa futhi igcine ushukela ngaphakathi kwemikhawulo eyamukelekayo.
Imininingwane ejwayelekile, ukwakheka kanye nendlela yokukhululwa
IVildagliptin imele isigaba esisha sezidakamizwa ezisetshenziswa ngentshiseko ekwelapheni isifo sikashukela sohlobo 2. Ivuselela ama-isanc we-pancreatic futhi ivimbela umsebenzi we-dipeptidyl peptidase-4. Inomphumela we-hypoglycemic.
Umuthi ungabekwa njengendlela yokwelapha ebalulekile, futhi uhlanganiswe neminye imithi. Kuhlanganiswe nokukhipha i-sulfonylurea, ne-thiazolidinedione, nge-metformin ne-insulin.
IVildagliptin yigama lomhlaba wonke lesithako esisebenzayo. Izidakamizwa ezimbili ezinalesi zinto zivezwa emakethe yamakhemikhali, amagama abo okuhweba yiVildagliptin neGalvus. Esokuqala siqukethe iVildagliptin kuphela, esesibili - inhlanganisela yeVildagliptin neMetformin.
Ukukhishwa ifomu: amaphilisi ngomthamo ka-50 mg, ukupakisha - izingcezu ezingama-28.
I-Pharmacodynamics ne-pharmacokinetics
I-Vildagliptin iyinto evimbela i-dipeptidyl peptidase ngenkuthalo ebonakalayo ye-GLP ne-HIP. Ama-hormone adonswa emathunjini kungakapheli amahora angama-24 futhi anda ngokuphendula ukudla. Umuthi uthuthukisa umbono wamaseli we-betta we-glucose. Lokhu kuqinisekisa ukwenziwa okujwayelekile kokusebenza kokuphepha kokuxhomekeka kweglucose kwe-insulin.
Ngokukhuphuka kwe-GLP, kukhona ukukhuphuka kokuqonda kwamaseli we-alpha ushukela, okuqinisekisa ukwenzeka kwejwayelekile kokulawulwa kwe-insulin. Kunokwehla kwenani lama-lipid egazini ngesikhathi sokwelashwa. Ngokuncipha kwe-glucagon, ukwehla kokumelana ne-insulin kwenzeka.
Umuthi osebenzayo umunwa ngokushesha, ukhuphula izinga lamahomoni egazini ngemuva kwamahora ama-2. Ukubopha amaprotheni aphansi kuyaphawulwa - akukho ngaphezu kwe-10%. IVildagliptin isatshalaliswa ngokufanayo phakathi kwamangqamuzana abomvu egazi ne-plasma. Umphumela omkhulu kwenzeka ngemuva kwamahora ayi-6. Umuthi udonswa kangcono esiswini esingenalutho, kanye nokudla, ukusabela kokumunca kuncipha ngezinga elincane - ngo-19%.
Akusebenzi futhi akubambezeli isoenzymes, akuyona indawo ephansi. Itholakala ku-plasma yegazi ngemuva kwamahora ama-2. Ingxenye yempilo yomzimba ingamahora ama-3, noma ngabe ithini. Biotransformation kuyindlela main of ukumbumbuluzwa. I-15% yezidakamizwa ikhishwa emafutheni, 85% - izinso (ezingashintshiwe ezingama-22.9%). Ukuqoqwa okuphezulu kakhulu kwento kutholakala kuphela ngemuva kwemizuzu engu-120.
Izinkomba kanye ne-contraindication
Inkomba enkulu yokuqokwa uhlobo lwesifo sikashukela sohlobo 2. I-Vildagliptin ichazwa njengokwelashwa okuyinhloko, ukwelashwa okuyinkimbinkimbi yezakhi ezimbili (ngokubandakanya umuthi owengeziwe), ukwelashwa okwenziwa izingxenye ezintathu (ngokubandakanya izidakamizwa ezimbili).
Esimweni sokuqala, ukwelashwa kwenziwa kanye nokuzivocavoca umzimba kanye nokudla okukhethwe ngokukhethekile. Uma i-monotherapy ingaphumeleli, kusetshenziswa inkimbinkimbi ngokuhlanganiswa kwale mithi elandelayo: i-sulfonylurea derivatives, thiazolidinedione, metformin, insulin.
Phakathi kokuphambana kukhona:
- ukungabekezelelwa kwezidakamizwa;
- umsebenzi wezinso ongonakalisiwe;
- ukukhulelwa
- ukuntuleka kwe-lactase;
- ukungasebenzi kahle kwesibindi;
- abantu abangaphansi kweminyaka eyi-18;
- ukwehluleka kwenhliziyo;
- inkathi yokuhlanza;
- ukungabekezelelani kwe-galactose.
Imiyalo yokusebenzisa
Ithebhulethi zithathwa ngomlomo ngaphandle kokubhekelwa ekudleni kokudla. Uhlobo lomthamo lunqunywa ngudokotela, kucatshangelwa isimo sesiguli kanye nokubekezelela umuthi.
Umthamo onconyiwe ngu-50-100 mg. Ngohlobo olubi lwesifo sikashukela 2, umuthi unqunywa i-100 mg ngosuku. Ngokuhlanganiswa neminye imithi (esimweni sokwelashwa okwenziwa izingxenye ezimbili), ukuthathwa nsuku zonke kungama-50 mg (i-1 ithebhulethi). Ngomthelela onganele ngesikhathi sokwelashwa okuyinkimbinkimbi, umthamo unyuka ufike ku-100 mg.
Akukho mininingwane eqondile ngokusetshenziswa kwesidakamizwa ngesikhathi sokukhulelwa nokukhulelwa. Ngakho-ke, lesi sigaba asivumelekile ukuthatha umuthi owethulwe. Ngokuqapha ngokweqile kufanele kuthathwe ezigulini ezinesifo sesibindi / sezinso.
Abantu abangaphansi kweminyaka engu-18 ubudala abanconywa ukuthi basebenzise umuthi. Akukalulekanga ukushayela izimoto ngenkathi uthatha umuthi.
Ngokusebenzisa i-vildagliptin, kunganda ukubalwa kwesibindi. Ngesikhathi sokwelashwa isikhathi eside, kunconywa ukuthatha ukuhlaziywa kwe-biochemical ukuqapha isimo kanye nokulungiswa okungenzeka kokwelashwa.
Ngokwanda kwama-aminotransferases, kuyadingeka ukuphinda ulicele igazi. Uma izinkomba zanda ngaphezu kwezikhathi ezi-3, umuthi uyamiswa.
Imiphumela emibi kanye ne-overdose
Phakathi kwemicimbi engemihle ebonwa:
- i-asthenia;
- ukuthuthumela, isiyezi, ubuthakathaka, ikhanda;
- isicanucanu, ukuhlanza, ukubonakaliswa kwe-Reflux esophagitis, i-flatulence;
- i-edema yangaphandle;
- i-pancreatitis
- isisindo somzimba;
- i-hepatitis;
- i-pruritus, urticaria;
- okunye ukusabela komzimba.
Umuthi ubekezelelwa kahle yiziguli, umthamo wansuku zonke ovumelekile ufinyelela ku-200 mg ngosuku. Lapho usebenzisa ngaphezu kwe-400 ml, lokhu okulandelayo kungenzeka: izinga lokushisa, ukuvuvukala, ukufiphala kwamaphethelo, isicanucanu, ukufiphala. Uma kwenzeka kuvela izimpawu, kuyadingeka ukuhlanza isisu futhi ufune usizo lodokotela.
Kungenzeka futhi ukwandisa amaprotheni e-C-reactive, i-myoglobin, i-creatine phosphokinase. I-Angioedema ivame ukubonwa lapho ihlanganiswa ne-ACE inhibitors. Ngokuhoxiswa komuthi, imiphumela emibi iyanyamalala.
Ukusebenzisana kwezidakamizwa kanye nama-analog
Amandla wokuxhumana kwe-vildagliptin nezinye izidakamizwa aphansi. Impendulo yemithi ejwayele ukusetshenziswa ekwelapheni isifo sikashukela sohlobo 2 (Metformin, Pioglitazone nabanye) nezidakamizwa ezincanyana (i-Amlodipine, Simvastatin) ayisungulwa.
Umuthi ungaba negama lokuhweba noma igama elifanayo ngento esebenzayo. Emakhemisi ungathola iVildagliptin, Galvus. Ngokuphathelene ne-contraindication, udokotela unquma izidakamizwa ezifanayo ezibonisa umphumela ofanayo wokwelapha.
Ukufana kwezidakamizwa kufaka phakathi:
- I-Onglisa (isithako esisebenzayo se-saxagliptin);
- UJanuvia (into - sitagliptin);
- I-Trazenta (isakhi - i-linagliptin).
Izindleko zeVildagliptin zisukela kuma-ruble angama-760 kuya kwangama-880, kuya ngomqondo wekhemisi.
Umuthi kufanele ube lokushisa okungenani lama-25 degrees endaweni eyomile.
Imibono yongoti neziguli
Imibono yochwepheshe nokubuyekezwa kweziguli ngomuthi muhle kakhulu.
Ngokuphikisana nesizinda sokuphuza umuthi ezigulini ezinesifo sikashukela sohlobo 2, kutholakala umphumela olandelayo:
- ukwehla ngokushesha kweshukela;
- ukulungisa inkomba eyamukelekayo;
- ukusetshenziswa kalula;
- isisindo somzimba ngesikhathi se-monotherapy uhlala unjalo;
- ukwelashwa kuhambisana nomphumela we-antihypertensive;
- imiphumela emibi yenzeka ezimweni ezingavamile;
- ukuntuleka kwezimo ze-hypoglycemic ngenkathi uthatha umuthi;
- ukulungiswa kwe-lipid metabolism;
- izinga elihle lokuphepha;
- ukuthuthukiswa kwe-carbohydrate metabolism;
- ilungele iziguli eziningi ezinesifo sikashukela sohlobo 2.
IVildagliptin phakathi nocwaningo ifakazele ukusebenza kahle kanye nephrofayili yokubekezelela okuhle. Ngokusho kwezimpawu zomtholampilo nezinkomba zokuhlaziya, awekho amacala e-hypoglycemia abonwa ngenkathi kwelashwa izidakamizwa.
IVildagliptin ithathwa njengesidakamizwa esisebenza kahle se-hypoglycemic, esinqunyelwe uhlobo 2 sikashukela. Ifakiwe Kwirejista Yemithi (RLS). Kubekwe njenge-monotherapy futhi kuhlangene namanye ama-ejenti. Ngokuya ngokuqhubeka kwesifo, ukusebenza kahle kokwelashwa, umuthi ungafakwa ne-Metmorphine, i-sulfonylurea derivatives, insulin. Udokotela ohambelayo uzonquma umthamo ofanele futhi aqaphe isimo sesiguli. Imvamisa iziguli ezinesifo sikashukela sohlobo 2 zinezifo ezifanayo. Lokhu kuyinkimbinkimbi kakhulu ukukhethwa kokuncipha kwe-glucose efanele. Ezimweni ezinjalo, i-insulin iyindlela yemvelo yokunciphisa amazinga kashukela. Ukudla ngokweqile kungadala i-hypoglycemia, inzuzo yesisindo. Ngemuva kocwaningo, kutholakale ukuthi ukusetshenziswa kweVildagliptin kanye ne-insulin kungathola imiphumela emihle. Ingozi yokuba nezifo zenhliziyo, i-hypoglycemia iyancipha, i-lipid ne-carbohydrate metabolism ithuthukiswa ngaphandle kokuthola isisindo.
UFrolova N. M., udokotela wezifo ze-endocrinologist, udokotela wesigaba esiphakeme kunazo zonke
Bengilokhu ngithatha iVildagliptin isikhathi esingaphezu konyaka, udokotela wangibhalela yona ngokuhlanganiswa neMetformin. Kwakungikhathaza kakhulu ukuthi ngesikhathi selashwa isikhathi eside ngisazothola isisindo. Kepha ululame ngamakhilogremu angama-5 kuphela kuya kuma-85 wami. Phakathi kwemiphumela emibi, kwesinye isikhathi ngiye ngiqunjelwe futhi ngibe nomfutho. Ngokuvamile, ukwelashwa kunikeza umphumela oyifunayo futhi kudlula ngaphandle kwemiphumela engathandeki.
U-Olga, oneminyaka engama-44, uSaratov
Izinto zevidiyo ezivela kuDkt Malysheva mayelana nemikhiqizo engasetshenziswa njengengezwa kwezidakamizwa zesifo sikashukela:
I-Vildagliptin isidakamizwa esisebenzayo esehlisa amazinga kashukela futhi sithuthukisa umsebenzi we-pancreatic. Kuzosiza iziguli ezingakwazi ukuguqula amazinga kashukela ngokwenza izivivinyo ezikhethekile nokudla.
