ʻO ka mea pōʻino, ʻaʻole mau loa ka hiki ke hoʻokele i nā pae gula i nā hana lapaʻau a me ka hoʻōla kūpono. A laila ʻoe e hoʻohana ai, no ka laʻana, ʻo Galvus, nā kikowaena kūloko, ke kumukūʻai o ka mea nui o ka mea i ʻoi aku ma mua o nā mea i lawe mai i nā lāʻau lapaʻau, kahi e pili pū ana me ka hoʻemi ʻana i ke kumukūʻai o ka halihali, ʻokoʻa, ka ukana.
Ma muli o kāna kumukūʻai nui, hiki i nā mea maʻi me nā hōʻemi haʻahaʻa a me nā kumukūʻai i hoʻololi i ka mālama i ka analogues. Akā he aha ke maikaʻi e koho ai? E kūkākūkā hou ʻia kēia, akā, ʻo ka mea mua, pono ʻoe e hoʻomaʻamaʻa iā ʻoe iho i ka lāʻau lapaʻau Galvus.
ʻO ka mea hana a ka lawena hypoglycemic pānaʻi vildagliptinum, akā aia kahi koho no ka hui pū me ka metformin. Ke kūʻai aku nei i ka lāʻau lapaʻau ma kahi lāʻau kūʻai, hāʻawi ka mea lapaʻau i kekahi mau ʻano - 50 mg, like pū me ka metformin 50/500 mg, 50/850 mg a 50/1000 mg.
ʻO Vildagliptin kahi hui o nā mea e hoʻomaikaʻi ai i ka hana ʻana o nā alpha a me nā selela beta i hana i nā mokupuni o Langerhans ma ka pancreas a hoʻoneʻe i ka hana a dipeptidyl peptidase-4. Hoʻopau kēia enzyme kūikawā i ka pona o ka glucagon-like 1 ka peptide (GLP-1) a me ka glucose-dependotine insulin -ropypide (HIP).
ʻO nā hiʻohiʻona maʻamau o ka lāʻau
Mahalo i ka vildagliptin, ua hoʻonui ʻia nā hopena maikaʻi o dipeptidyl peptidase-4, a ke hoʻolōʻihi nei ka hana o ka GLP-1 a me HIP, ma kahi ʻē aʻe, hoʻonui ʻia. Ke ala ka pae o ka waihona o kēia mau mea i loko o ke koko, hoʻomaikaʻi ka vildagliptin i ka hoʻokaʻā i nā cell beta i ka glucose i hana ʻia, a laila e hoʻonui ai i ka hana o ke kōloli. Pono e hoʻomaopopo ʻia ka waiwai o ka hoʻonuiʻana i ka hana o nā poli beta ma ka pae o ko lākou luku ʻia. No laila, i nā poʻe me nā pae o ke kō maʻamau, ʻaʻole pili ke vildagliptin i ka hana o ka insulin a, ʻoiaʻiʻo, ka pae ʻana o ka glucose.
Hoʻonui ka mea hana i ka helu o GLP-1 a hoʻonui koke i ka ʻike ʻana i nā sela alpha o ka ʻanuʻu islete i ka glucose. ʻO ka hopena, hoʻonui ka hana o ka hoʻālaʻai aagonia. ʻO ka emi ʻana o kona hoʻonui i ka wā o ka ʻai e hoʻonāukiuki i ka nui o ka naʻau o nā kelepona peripheral i kahi hormone hoʻohaʻahaʻa i ka suka.
I ka hoʻonui wikiwiki ʻana i ka nui o ka kō, ka māhuahua o ka glucose me ka pae o ka insulin, ka mea e hilinaʻi nui ʻia ana i ka hoʻonui ʻia ʻana o ka GLP-1 a me HIP, a me ka hoʻōla o ka hana glucose i loko o ka puʻuwai e lohi i ka wā o ka ʻina a ma hope o ia mea, e hoʻonāukiuki i ka hōʻemi o ka hōʻiliʻili o ka glucose i loko o ke koko. Pono e hoʻomaopopo ʻia he hiki ke hoʻonui i kahi kikoʻī o ka maʻi o GLP-1 hiki i ka lohi i ke kaʻina hana o ka gastric, ʻoiai ʻo ka hoʻomaʻamaʻa ʻana i ka lāʻau i ʻole ka hoʻonāukiuki i ka hoʻomohala ʻana i kahi ʻano like.
ʻO ka hoʻohana pinepine ʻana o nā ʻāpana ʻelua - metformin a me vildagliptin, ʻoi aku ka maikaʻi o ka kaohi o ka glycemia i kahi maʻi maʻi no 24 mau hola.
Nā ʻōkuhi no ka hoʻohana ʻana i nā papa
ʻAʻole pili ka ʻai i ka hoʻohana ʻana i ka lāʻau lapaʻau Galvus a i ʻole Galvus Met.
Ma mua o ka hoʻohana ʻana i ka lāʻau lapaʻau, pono e ʻimi i ke kōkua o ke loea e hoʻoholo i ka ʻāpana pūpū.
I nā ʻōlelo hoʻopili no ka lāʻau Galvus 50 mg, hōʻike ʻia nā hoʻohālikelike hiki ke hoʻoponopono ʻia e ke kauka hele ʻana:
- Me ka monotherapy a i hui pū pū ai me ka therapy insulin, thiazolidinedione, metformin - 50-100 mg.
- ʻO nā mea hoʻohālikelike o ke ʻano maʻi ʻoi aku ka lōʻihi o ka 100 mg i kēlā me kēia lā.
- Hoʻomaopopo ka vildagliptin, kahi honu o ka sulfonylurea a me nā metformin - 100 mg i kēlā me kēia lā.
- ʻO ka hoʻohana pinepineʻana o ka sulfonylurea a me nā dervus Galvus e hōʻike i kahi kao o 50 mg pākahi i kēlā me kēia lā.
- Inā loli ka maʻi a me ka kiʻekiʻe o ka lolo, ʻo ka nui o kēlā me kēia lā he 50 mg.
Hoʻokomo ʻia ka mea i hoʻokomo ʻia i ka ʻike e lawe ʻia aku ai ka nui o ka make ma 50 mg i ka manawa kakahiaka, a ʻo ka 100 mg pono e hoʻokaʻawale ʻia i ʻelua mau wai - i ke kakahiaka a i ke ahiahi
ʻO ka ʻike o ka lāʻau Galvus Met e hoʻoholo ʻia e ke kauka, i ka nānā ʻana i ka nui o ka huka a me ke kāhea ʻana o nā māhele o ka lāʻau i ka mea maʻi. Nānā ka haʻawina i kēia mau haʻahaʻa helu e pili ana:
- me ka hoʻohana ʻole o vildagliptin, e manaʻo ʻia e lawe i ka 50/500 mg papalua i hoʻokahi lā;
- inā ʻaʻole pono ka hoʻohana ʻana o ka metformin, lawe iā 50/500 mg, 50/850 mg a i ka 50/1000 mg ʻelua o ka lā, e like me ka metformin i hoʻohana mua;
- me ka hui ʻole o ka vildagliptin a me ka metformin, 50/500 mg, 50/850 mg a i ʻole 50/1000 mg ʻelua o ka lā e hoʻohana ʻia, e pili ana i nā mea i hoʻohana ʻia;
- i ka wā o ka mālama mua ʻana me ka lāʻau lapaʻau ma muli o ka hiki ʻole o kaʻai ʻana a me ka hoʻomaʻamaʻa ʻana i ke kino, lawe i ka 50/500 mg i hoʻokahi lā;
- i ka hui pū ʻana me ka maʻi hana insulin a me nā derivatives o ka olonylurea, ʻo 50 ka nui o ka nui o ka vildagliptin i kēlā me kēia lā, a ʻo ke ʻano metformin e like me ka monotherapy.
Hoʻokui ʻia ka hoʻohana ʻana i ka lāʻau lapaʻau no nā poʻe maʻi maʻi e loaʻa nei i ka hana ʻole ʻana a me nā ala ʻē aʻe o kēia ʻano. Eia kekahi, ua kuhikuhi ʻia ka mālama kūikawā i nā poʻe maʻi o ka ʻoihana o ka makahiki kahiko (ma mua o 65 mau makahiki), ʻoiai lākou i ka hōʻemi ma ka hana o nā keiki.
Hiki i ke kauka ke hoʻonui i ka hewa o ka lāʻau lapaʻau, eia naʻe, ʻaʻole ia i pāpā ʻia i ka mālama ʻana i kāu iho ponoʻi, hiki i kēia ke alakaʻi i nā hopena kūpono ʻole ʻole.
ʻO nā maʻi a me nā hōʻeha
Ua loaʻa i ka lāʻau lapaʻau nā contraindications, a me nā lāʻau ʻē aʻe.
ʻO ka kumu, pili nā contraindications me ka hiki o kekahi mau kino o ke kanaka e hemo i nā mea ikaika mai ke kino.
Ua papa ʻia ia e hoʻohana i nā ʻano o Galvus a me Galvus Met no nā maʻi maʻi e ʻeha ana a i ʻole i ka maʻi i kekahi mau maʻi.
- Renal dysfunction a ʻole renal failed (ʻo ka mea hana likinine ma mua o 135 135mol / L i ke kāne, ʻoi aku ma mua o 110 μmol / L i ka wahine).
- ʻO nā ala e hoʻonui ai i ka hopena o ka hoʻomohala ʻana i ka maʻi hana. Hoʻopili kēia me ka dehydration (pane a i ʻole ka maʻi), kahi maʻi keʻeha, nā maʻi maʻi, a me kahi kūlana o ka hypoxia.
- Polōpiopio.
- ʻO ka hoʻomakaʻana o ka acidosis lactic.
- ʻO ka hoʻomohala ʻana o ka hana hanu ʻole.
- ʻO ka hoʻomohala ʻana o ka puʻuwai naʻau i ka loiloi a me ke ʻano maʻamau, me ka halaʻi iʻa myocardial infarction.
- Metabolic acidosis, me ka hoʻomaka ʻana o ka ketoacidosis, coma, precoma.
- I ka wā e hānau ai kahi keiki a me ka umauma.
- ʻO ka maʻi maʻi kāpeka.
- Nā mea lawelawe.
- ʻAʻole hiki iā ʻoe ke hoʻohana i ka lāʻau lapaʻau i ʻelua mau lā ma hope a ma hope o ka hoʻokolokolo o ka radiological a me radioisotope me ka hoʻomaka ʻana o kahi māhele i loaʻa iodine.
- Hoʻohālikelike me ka waiʻona a i kona ʻano kumu.
- ʻO kaʻai haʻahaʻa-haʻahaʻa (emi iho ma lalo o 1000 kcal i kēlā me kēia lā).
- ʻAʻole ma lalo o ka makahiki 18.
- Ka pilina pilikino i vildagliptin, metformin a me nā mea like ʻē aʻe.
Inā hoʻohana maikaʻi ʻia ka lāʻau lapaʻau a i ʻole nā kumu ma waho o ka kaohi o ka mea maʻi, hiki mai paha nā hopena maikaʻi ʻole, no ka laʻana:
- nā kuʻuna a me ka maʻi lahilahi;
- hanaʻole (hōʻeha) a me ke kani ʻana;
- reflux gastroesophageal;
- pōkole o ka ulaula a me ka luaʻi;
- huʻi a i ʻole constipation;
- hoʻonui ka hoʻonui i ke kino i loko o ka ʻāpana;
- loli ma ka ʻono
- hypoglycemia;
- luhi;
- hyperhidrosis;
- rashes ma ka ʻili, kaʻili, urticaria;
- pulu;
- ʻohiʻuku (ʻōpū naʻau);
- ka hoʻohālikelike ʻana o ka ʻili;
- ke ʻano o nā blisters;
- lactic acidosis;
- kakela bitamina B12;
- lōkohu
Eia kekahi, hoʻomohala ka maʻi hepatitis i ke kino.
ʻO ke kumukūʻai, nā loiloi a me nā hōʻailona
ʻO ka mea hana i ka lāʻau lapaʻau ka hui ʻoihana olakino Swiss Novartis, e hana ana i kahi lāʻau lapaʻa me vildagliptin a i hui pū paha me vildagliptin me metformin.
Hiki ke kauoha ʻia nā lāʻau lapaʻau ma ka pūnaewele pūnaewele aiʻole e hele wale i ka māka kūʻai kokoke loa. ʻO ke kumu kūʻai o kahi lāʻau lapaʻau i hilinaʻi ʻia i kona ʻano hemo. Penei:
- Galvus 50 mg (28 papa) - 765 mau rubles.
- Galvus Met 50/500 mg (30 papa) - 1298 mau rubles.
- Galvus Met 50/850 mg (30 papa) - 1380 mau rubles.
- Galvus Met 50/1000 mg (30 papa) - 1398 mau rubles.
E like me kāu e ʻike ai, ʻaʻole maʻalahi ke kumukūʻai. ʻAʻole hiki i nā kānaka āpau ke hoʻolako i ke ʻano mau me kēia mau lāʻau lapaʻau, no laila aia ke koho i nā lāʻau like ʻole, e kūkākūkā ʻia ma hope aʻe.
ʻO ka manaʻo ma ka lāʻau Galvus, he kūpono kūpono lākou. ʻO nā hōʻike o ka hapa nui o nā maʻi e lawe nei i ka lāʻau lapaʻau e hōʻike ma hope o 1-2 mau o ka lawe ʻana iā Galvus, hoʻihoʻi ka hōʻailona glucose i mea maʻamau. Eia kekahi, ʻo nā maʻi maʻi e like me ka wā e hoʻohana ai i ka lāʻau e hiki ke ʻai i ka meaʻai i kālai mua ʻia. ʻO Galvus Met, mahalo i kāna metformin, e kōkua ana e nalo i nā 3-4 mau paona keu i nā mea maʻi me ka momona. Eia nō naʻe, loaʻa i kahi hōʻike nui ka lāʻau lapaʻau - ʻo ia ke kumukūʻai kiʻekiʻe.
Inā pāpā ʻia ka mea maʻi mai ka hoʻohana ʻana iā Galvus ma muli o contraindications a i ʻole ka hopena, ke kauka ke kauka i kekahi lāʻau lapaʻau hou. Hiki i kēia mau hiʻohiʻona, ʻo ia hoʻi kēlā mau huahana e loaʻa ai ka waihona like, ʻokoʻa ka ʻokoʻa i nā ʻokoʻa hoʻohui. ʻO Galvus Met wale ka mea like no Galvus; ʻo kēia mau mākaukau ʻelua e pili ana i ka vildagliptin.
Eia nō naʻe, he nui kēia mau lāʻau lapaʻau e like me nā hopena lapaʻau like, e kūkākūkā ʻia ma hope aʻe.
Nā inoa o ka lāʻau Galvus
ʻO kēia pūʻulu o nā lāʻau lapaʻau e komo pū me nā mea ikaika - vildagliptin. Hoʻopili kēia ma ka Vipidia, Onglisa, Januvius a me nā kālā Trazent. Ma Lūkia, ʻaʻole i hoʻonohonoho ʻia nā hoʻomākaukau e pili ana vildagliptin, no laila e kamaʻilio mākou e pili ana i nā lāʻau lapaʻau i hoʻopuka ʻia.
ʻO Vipidia kahi lāʻau lapaʻau e hoʻemi ana i ke kō i makemake ʻia no ka monotherapy a i ʻole hui pū ʻana i ka mālama maʻi type 2. Hoʻokuʻu ʻia ia ma nā ʻano papa papa, ʻo ke ʻano kiʻekiʻe nui loa i kēlā me kēia lā he 25 mg a ʻaʻole hilinaʻi i ka pāʻina. ʻAʻole pono e lawe ʻia kahi lawelawe hypoglycemic e ka maʻi maʻi me ka renal, hepatic, heart heart, me ka ketoacidosis maʻi a me nā ʻano like ʻole o ka maʻi diabetes. ʻO nā hopena ʻaoʻao ke like me ka hopena maikaʻiʻole o ka lāʻau Galvus. Ma muli o ka nele o nā ikepili i ka hopena o ka lāʻau lapaʻau ma nā keiki ma lalo o 18 mau makahiki a me nā wahine hāpai, ʻaʻole i kuhikuhi ʻia no ia mau ʻano o nā maʻi. ʻO ke kumukūʻai kūpono o Vipidia (25 mg 28 mau papa) he 1239 mau rubles.
He mākaukau maikaʻi ʻo Onglisa no ka mālama ʻana i nā pae ʻai koko ma luna o ka ʻōpū ʻole a ma hope o ka ʻai ʻana. Mahalo i nā waiwai nui o ka saxagliptin, mālama pū ka lāʻau lapaʻau i nā mea o nā glucagon. Hiki ke lilo iā ia a he waiwai paʻa a hui pū ʻia me nā lāʻau lapaʻau ʻē aʻe. ʻO ka lāʻau lapaʻau Onglis i contraindicated ma ka inika insulin, type 1 i ka maʻi diabetes a me ka ketoacidosis. ʻO nā manaʻo nui ka mea nui ke poʻo, kuʻekuʻe, ʻeha ʻeha. Ka awelika kumukūʻai o ka lāʻau (5 mg 30 mau papa) ʻo 1936 mau rubles.
ʻO Januvia kahi mākaʻikaʻi hypoglycemic, kahi e loaʻa ai ka sitagliptin kaha. Hoʻohana ka hoʻohana ʻana i ka lāʻau lapaʻau e hoʻomaʻamaʻa i ka pae o ke glycemia a me ka glucagon. Hoʻoholo ʻia nā Dosages e ke kauka hele, e kau nei i ka ʻike o ke kō, ke ola laulima a me nā mea ʻē aʻe. Ke hoʻohālikelike ʻia ka lāʻau lapaʻau i ka hihia o ka diabetes-depend-dependence a me nā intolerance pilikino i nā ʻāpana. I ka wā o ka hoʻohana ʻana, ka ʻeha, ka pilikia o ke kaʻa ʻana, ka hōʻeha ʻana o nā ʻeha, a me nā maʻi ʻeha. I ka awelika, ʻo ka uku o kahi lāʻau lapaʻau (100 mg 28 mau papa) ʻo 1666 rubles.
ʻO ka Trazhenta kahi lāʻau lapaʻau i hoʻoili ʻia i loko o ke ʻano o nā papa me ka lignagliptin ʻano ikaika. E hoʻonāwaliwali ia i ka gluconeogenesis a hoʻopaʻa i nā pae o ke kō. Koho ke kauka i nā dosages pakahi no kēlā me kēia maʻi.
ʻAʻole hiki ke hiki ke hoʻohana no ka ketoacidosis, type 1 lā i ka lolo a i ʻole e kūpaʻa i nā mea i loaʻa. ʻO ka kumukūʻai awelika (5 mg 30 mau papa) ʻo 1769 mau rubles.
Nā inoa o ka lāʻau Galvus Met
Ke lāʻau lapaʻau ʻo Galvus Met, ʻo Avandamet, Glimecomb, ʻo Combogliz Prolong o ka hana ʻana i Lūkini, loaʻa i nā mea nui ʻelua ka nui o ka hopena o ka hypoglycemic hopena.
ʻO Avandamet kahi hui kuʻi hypoglycemic hui i loaʻa i ʻelua māhele nui - rosiglitazone a me ka metformin. Hoʻohana ʻia ka lāʻau lapaʻau i ka mālama ʻana i ka maʻi diabetes-depend-non-insulin. Hoʻohana ʻia ka hana o ka rosiglitazone e hoʻonui i ka hoʻowalewale o ka ʻona o nā ʻenehana i nā ʻenekini, a me ka metformin - i ka nāwaliwali i ka hana ʻana o ka glucose ma o ka ate. ʻO ke kumukūʻai maʻamau o ka lāʻau (500/2 mg 56 papa) he 210 mau rubles, no laila he analogue kūpono loa ia.
ʻO Glimecomb kahi lāʻau lapaʻau maikaʻi hou e hoʻoponopono i ka pae glucose i kahi maʻi maʻi. Aia ia he ʻelua mau mea nui - gliclazide a me metformin. ʻO nā hoʻohālikelike i ka hoʻohana ʻana i kēia lāʻau lapaʻau ka maʻi kūloko o ka insulin, koma a me ka precoma, hypoglycemia, ka hapai, ka umauma a me nā ala ʻē aʻe. ʻO ke kumukūʻai awā (40/500 mg 60 papa) ʻo 440 mau rubles.
Hoʻopili ʻo Combogliz Prolong i nā mea maʻamau e like me ka metformin a me nā saxagliptin. Hoʻohana ʻia ia no ka maʻi maʻamau o ka lā 2, i ka hiki ʻana o ka hana kino a me ka meaʻai kūikawā i hiki ke hāʻawi i ka emi ʻana o ka glucose. Kōkua ka lāʻau lapaʻau i ka insulin e hoʻokuʻu ʻia mai nā beta beta a hoʻomaikaʻi i ka ʻāʻī o nā pona i laila. ʻO ka hoʻohālikelike i ka hoʻohana ʻana i ka lāʻau ka mea pono i nā mea like o ka lāʻau, ka maʻi kūlohelohe o ka insulin, ka wā kamaliʻi, ka hānau ʻana o ke keiki, ka lactation, maʻi kīnā, ʻōpū, metabolic acidosis a me nā mea'ē aʻe. ʻO ke kumukūʻai kūpono o ka lāʻau (1000/5 mg 28 mau papa) ʻo 2941 mau rubles.
Hoʻokumu i nā contraindications, ʻo ka hōʻeha a me ka uku kiʻekiʻe o ka lāʻau lapaʻau, hiki ke hoʻololi ʻia i kekahi. E like me kāu e ʻike ai, kokoke pau loa nā lāʻau lāʻau i kēia hana kuʻuna. I waena o lākou, hiki ke hoʻokaʻawale ke kikowaena ʻelua - Glimecomb a me Avandamet, ʻo ia ka mea ʻemi ma waena o nā lāʻau lapaʻau hypoglycemic ʻē aʻe. Ke koho ʻana i ke koho maikaʻi loa, ma ke ʻano ke kauka a me ka mea maʻi e noʻonoʻo i ʻelua mau mea koʻikoʻi - ke kumukūʻai a me ka hopena therapeutic o ka lāʻau.
Hāʻawi ʻia ka ʻikepili e pili ana i nā lāʻau lapaʻau maʻi maikaʻi loa i ke wikiō ma kēia ʻatikala.
