I-Liraglutide - umuthi wokwelapha isifo sikashukela sohlobo 2: imiyalo nokubuyekezwa

Kuyini i-liraglutide?

ILiraglutide iyi-analogue ethuthukisiwe yehomoni yayo uqobo - i-glucagon-like peptide-1 (GLP-1), ekhiqizwa emgodini wokugaya ukudla ukuphendula ukuthathwa kokudla futhi ibangela ukuhlanganiswa kwe-insulin. Imvelo ye-GLP-1 ibhujiswa emzimbeni emizuzwini embalwa, eyakhiwe yenziwe yehlukile kuyo ngokufakwa kwama-amino acid ama-2 endaweni yokwakheka kwamakhemikhali. Ngokungafani nobuntu (bomdabu) i-GLP-1, i-liraglutide igcina ukugxila okuzinzile phakathi nosuku, okukuvumela ukuphathwa isikhathi esisodwa kuphela emahoreni angama-24.

Kutholakala ngesimo sesisombululo esikhanyayo, kusetshenziselwa imijovo engaphansi kwethamo le-6 mg / ml (inani eliphelele le-18 mg le nto ngokuphelele kwayo). Inkampani yokuqala yokukhiqiza kwakuyinkampani yaseDenmark uNovo Nordisk. Umuthi uhanjiswa emakhemisi ngesimo sebhokisana, ligcwele esibayeni, lapho kwenziwa imijovo yansuku zonke. Umthamo ngamunye uphatha 3 ml wesisombululo, kwiphakheji lezingcezu ezi-2 noma ezi-5.

Isenzo se-Pharmacological somuthi

Ngaphansi kwesenzo sento esebenzayo - i-liraglutide, ukukhiqizwa kabusha kwe-insulin yayo okwenzekayo, umsebenzi wama-β-cell uyathuthuka. Kanye nalokhu, ukuvela ngokweqile kwe-hormone encike kushukela - glucagon - kuyacindezelwa.

Lokhu kusho ukuthi ngokuqukethwe okunoshukela omningi wegazi, ukukhiqizwa kwe-insulin okwenyukayo kanye nokuvunduzelwa kweglucagon kuyacindezelwa. Esimweni esiphikisayo, lapho ukuqoqwa kwe-glucose kuphansi, ukugcinwa kwe-insulin kuyancipha, kepha ukuvela kwe-glucagon kuhlala kulelo zinga linye.

Umphumela omnandi we-liraglutide ukwehla kwesisindo kanye nokwehla kwezicubu ze-adipose, ezihlobene ngqo nomshini obangela indlala futhi unciphise ukusetshenziswa kwamandla.

Ucwaningo olungaphandle komzimba luye lwabonisa ukuthi umuthi uyakwazi ukufaka umfutho onamandla kuma-β-cell, anda inani lawo.

Izinkomba zokusetshenziswa

ILiraglutide yenzelwe kuphela abantu abangaphezu kweminyaka engu-18 ubudala abaphila nesifo sikashukela sohlobo 2. Isidingo sokuqala ngukudla okuhle komzimba kanye nokuzivocavoca umzimba.

Ingasetshenziswa njenge:

1. Umuthi okuwukuphela kwawo ekwelapheni isifo sikashukela sohlobo 2 (ukwelashwa okuyisisekelo).
2. Ngokuhlanganiswa namafomu wethebhulethi (i-metformin, njll.) Ezimweni lapho umuntu engakwazi ukufeza ukulawulwa kwe-glycemic oyifunayo ngosizo lwezinye izidakamizwa.
3. Ngokuhlanganiswa ne-insulin, lapho ukuhlanganiswa kwe-liraglutide ne-metformin kungazange kunikeze umphumela oyifunayo.

Contraindication kanye nemiphumela emibi

Uhlu lwezimo lapho i-liraglutide inqatshelwe noma inqunyelwe ukusebenzisa:

• ukungabekezelelani ngakunye;
• isimila esibuhlungu esivela emaholideni we-yegland gland, noma ngabe satholakala kanye kwezihlobo eziseduze;
• ama-neoplasms athinta izitho ezimbili zohlelo lwe-endocrine;
• Uhlobo 1 sikashukela;
• ushukela wegazi ophakeme nemizimba ye-ketone;
• isigaba sokugcina sokwehluleka kwezinso;
• ukwehluleka kwenhliziyo okungapheli;
• ukubambezela ukukhipha isisu;
• ukuvuvukala kwamathumbu isifo;
• ukwehluleka kwesibindi okunzima;
• isikhathi sokukhulelwa nokuncelisa;
• iminyaka engu-18.

Imiphumela emibi engahle yenzeke ngenkathi kusetshenziswa umuthi:

1. Amapheshana wesisu. Isicanucanu, ukugabha, ukuphazamiseka kwesisu, ubuhlungu besisu, ukuqhakaza.
2. Inani lesikhumba. I-ukulunywa, i-rash, i-urticaria. Imiphumela yokungezwani komzimba endaweni yomjovo.
3. Ukukhohlisa umzimba. Ukuntuleka kwesifiso sokudla, i-anorexia, i-hypoglycemia, ukomisa.
4. STS. Ukwanda kwenhliziyo.
5. Uhlelo lwezinzwa. Ubuhlungu bekhanda nesiyezi.

Uma enye yezimpawu zemiphumela emibi ye-liraglutide yenzeka, kufanele wazise udokotela wakho ngokushesha. Mhlawumbe lokhu kusabela kwesikhashana komzimba, noma mhlawumbe usongo olukhulu empilweni.

Imiyalo yokusebenzisa

I-Liraglutide iphathwa kuphela ngaphansi kwesikhumba. Kwenqatshelwe ukuyisebenzisa ngendlela efanele futhi ikakhulukazi ngaphakathi! Isixazululo sisetshenziswa ngasikhathi sinye kanye ngosuku, ngaphandle kokudla. Izindawo zokujova ezithandwayo ihlombe, ithanga nesisu.

Umthamo omncane wokuqala wokuqala ngu-0,6 mg ngosuku, kufanele ukhishwe okungenani isonto, emva kwalokho kungenzeka ukuthi ukwandise umthamo ukuya ku-1,2 mg. Ukuthola umphumela omuhle kakhulu, umuthi ungabekwa kumthamo we-1.8 mg. Umthamo osebenza kahle kakhulu ngu-1.8 mg (esimweni seVictoza). Uma kusetshenziswa iSaksenda, khona-ke umthamo ophelele ngu-3 mg ngosuku.

Uma uphuthelwa umthamo olandelayo, kufanele ufake umuthi ngokushesha okukhulu ngaphakathi kwamahora ayi-12 alandelayo. Uma kudlule lesi sikhathi manje, khona-ke umthamo weqiwe bese kuthathwa umthamo ojwayelekile ngosuku olulandelayo. Ukwethulwa kwe-Double akunikezi umphumela omuhle.

Into esebenzayo ikukhosikhethi ekhethekile, eyakhelwe esibayeni sentambo. Ngaphambi kokuwusebenzisa, qiniseka ukuthi isixazululo sicacile futhi singenamibala. Ukulawulwa kwezidakamizwa, kungcono ukusebenzisa izinaliti ezingaphansi kuka-8 mm ubude kuze kufike ku-32G thick.

I-Liraglutide inqatshelwe ukuthi iqhwa! Kufanele igcinwe esiqandisini uma ipeni lesirinji lisha. Ngemuva kokusetshenziswa kokuqala, ingagcinwa emazingeni okushisa aze afike ku-30 ​​° C, kepha kungenzeka ukuyishiya esiqandisini. I-cartridge kumele isetshenziswe inyanga eyodwa ngemuva kokuvulwa.

Ukusebenzelana kwezidakamizwa

I-analogue ye-GLP-1 inekhono eliphansi kakhulu lokuxhumana nezinye izidakamizwa, ezichazwa yi-metabolism ekhethekile esibindini kanye nokubopha amaprotheni e-plasma.

Ngenxa yokuchithela kwe-gastric okubambezelekile, ezinye izindlela zomlomo zidonswa ngokubambezeleka, kepha ukulungiswa komthamo kuleli cala akudingeki.

I-Liraglutide yehlisa ukuqoqwa okuphezulu kwezidakamizwa ezithile, kepha ukulungiswa komthamo nakho akudingekile.

I-Liraglutide ngesikhathi sokukhulelwa

Akukho zifundo ezikhethekile ezenziwayo kuleli qembu leziguli, yingakho umuthi uvunyelwe ukusetshenziswa. Ucwaningo ezilwaneni zaselabhorathri luye lwabonisa ukuthi into inobuthi ku-fetus. Lapho usebenzisa umuthi, owesifazane kufanele asebenzise inzalo eyanele, futhi uma kwenzeka ehlela ukukhulelwa, kufanele azise udokotela oholayo ngalesi sinqumo ukuze asidlulisele ekwelashweni okuphephile.

Ucwaningo olusemthethweni ngomuthi

Ukusebenza kwento esebenzayo kuphenyiwe ngohlelo lwe-LEAD lokuhlolwa kwemitholampilo. Abantu abangama-4000 abanesifo sikashukela sohlobo lwe-2 benze umnikelo wabo obalulekile kukho. Imiphumela yakhombisa ukuthi umuthi uyasebenza futhi uphephile zombili njengezindlela zokwelapha eziphambili, futhi ngokuhambisana namanye amaphilisi anciphisa ushukela.

Kwaphawuleka ukuthi abantu abebekade bathola i-liraglutide isikhathi eside behlise isisindo somzimba kanye nomfutho wegazi. Ukwanda kwe-hypoglycemia kwehle izikhathi eziyisithupha, uma kuqhathaniswa ne-glimepiride (Amaril).

Imiphumela yohlelo ikhombisile ukuthi i-hemoglobin ye-glycated kanye nesisindo somzimba yehle kakhulu kwi-liraglutide kune-insulin glargine ehlanganiswa ne-metformin ne-glimepiride. Kubhalwe ukuthi izibalo zokucindezela kwegazi ziyancipha ngemuva kweviki elilodwa lokusebenzisa umuthi, okungaxhomekeki ekulahlekelweni kwesisindo.

Imiphumela yocwaningo lokugcina:

• qinisekisa inani eliqondisiwe le-hemoglobin ye-glycated;
• kwehlise amanani aphezulu omfutho wegazi;
• ukulahleka kwamakhilogremu angeziwe.

Izinzuzo nobubi bokusebenzisa

Izici ezinhle:

• Kunganciphisa isifiso sokudla futhi kunciphise isisindo somzimba.
• Yehlisa ukusongela okungaba khona kwezinkinga ezinkulu ezihambisana ne-CVS.
• Kusetshenziswa isikhathi esingu-1 ngosuku.
• Isikhathi eside ngangokunokwenzeka, sigcina umsebenzi wama-β-cell.
• Ikhuthaza ukuhlanganiswa kwe-insulin.

Okubi:

• Uhlelo lokusebenza lokungena.
• Abantu abangaboni kahle bangathola ubunzima lapho besebenzisa ipeni lesirinji.
• Uhlu olukhulu lwe-contraindication.
• Ayikwazi ukusetshenziswa ngabakhulelwe, abahlayo futhi izingane ezingaphansi kweminyaka engu-18.
• Izindleko eziphakeme zezidakamizwa.

Ingabe zikhona izichasiso?

Izidakamizwa eziqukethe i-liraglutide kuphela:

1. IVictoza;
2. Saxenda.

Umuthi ohlanganisiwe, kufaka phakathi wona ne-insulin degludec - Sultofay.

Yini engathatha isikhundla se-liraglutide

Ukubuyekezwa kwevidiyo yezidakamizwa ukuze unciphise isisindo

Intengo

Uma sibheka izidakamizwa uViktoza noSaksenda ngokubuka kwezomnotho, singaphetha ngokuthi umuthi wokuqala uzodla imali encane. Futhi iphuzu alikona ukuthi kuphela kubiza okungaphansi, kodwa ukuthi umthamo wansuku zonke ophelele ungama-1.8 mg kuphela, kanti esinye isidakamizwa sine-3 mg. Lokhu kusho ukuthi i-1 Victoza cartridge yanele izinsuku eziyi-10, namaSaxend - ama-6, uma uthatha umthamo omkhulu.

Ukubuyekezwa kwesifo sikashukela

UMarina Ngigula isifo sikashukela sohlobo 2 cishe iminyaka eyi-10, ngiphuza i-metformin ngigwaze i-insulin, ushukela uphezulu u-9-11 mmol / l. Isisindo sami singama-kg ayi-105, udokotela uncome ukuzama uViktoza noLantus. Ngemuva kwenyanga, alahlekelwe ama-4 kg noshukela agcinwe ebangeni le-7-8 mmol / L.

Alexander Ngikholelwa ukuthi uma i-metformin isiza, kungcono ukuphuza amaphilisi. Uma usuvele ushintshele ku-insulin, lapho ungazama i-liraglutide.