ʻO ka maʻi Hypoglycemic Januvia (nā ʻōlelo a me nā kūkā o ka maʻi maʻi)

ʻO Jasonvia ka lāʻau antidiabetic mua e pili ana i kahi hui kālā hou o nā lāʻau lapaʻau, nā DPP-4 inhibitors. I ka hoʻomaka ʻana o ka hana o Januvia, kahi hoʻomaka o ka manawa nui i ka mālama ʻana i ka maʻi maʻi. Wahi a nā kānaka ʻepekema, ʻaʻole emi iki kēia mea ʻike ʻia ma mua o ka loaʻa ʻana o ka metformin a i ʻole ka hoʻokumu ʻana o ka insulin like ʻole. ʻO ka lāʻau hou e hōʻemi ana i ka huki me ka maikaʻi e like me ka hoʻomākaukau ʻana o ka sulfonylurea (PSM), akā i ka manawa hoʻokahi ʻaʻole ia e alakaʻi i ka hypoglycemia, maʻalahi iki ka ʻae a me ke kōkua i ka hoʻihoʻi ʻana i nā cell beta.

Wahi a nā ʻōlelo kuhikuhi, hiki ke lawe ʻia ʻo Iāvia me nā mea hoʻohana hypoglycemic ʻē aʻe, me ka hoʻohui pū ʻana me ka insulin.

Nā hōʻailona no ka hoʻohana ʻana

Wahi a nā loiloi o nā hui maʻi maʻi maʻi, ʻo ka lāʻau mua-kaʻa mua, ʻo ia hoʻi, i kuhikuhi koke ʻia ma hope o ka hoʻomaka ʻana o ke ʻano maʻi maʻi maʻamau, he metformin. Me kona nele o ka hana pono, ua hoʻohui ʻia nā lāʻau lapaʻau laina lua. No ka manawa lōʻihi, ua hāʻawi ʻia ka uku maikaʻi i ka hoʻomākaukau o ka sulfonylurea, no ka mea e pili ana i ka kōʻai koko ma mua o ka mau lāʻau hou. I kēia manawa, ʻoi aku ka nui o nā kauka e kau nei i nā lāʻau hou - GLP-1 mimetics a me DPP-4 inhibitors.

Ma ke ʻano he kānāwai maʻamau, ʻo Lavvia kahi lāʻau lapaʻau no ka mellitus maʻi diabetes, i hoʻohui ʻia i ka metformin i ke keena ʻo ka 2 o ka mālama ʻana no ka maʻi maʻi maʻi. ʻO kahi hōʻailona o ka pono o ka lāʻau hōʻemi i ka kōkōleka lua he glycated hemoglobin> 6.5%, hoʻolako ʻia ua lawe ʻia ka metformin ma ke ʻano kokoke loa i ka nui, ʻike ʻia kaʻai ʻai haʻahaʻa, a mālama ʻia ka hana pilikino maʻamau.

Ke koho nei i nā mea e kuhikuhi ai i kahi maʻi: ʻoiʻi ka hoʻomākaukau ʻana o ka sulfonylurea a i ʻole ʻoviavia, e mālama pono i ka pōʻino o ka hypoglycemia no ka mea maʻi.

ʻO ka maʻi maʻi a me nā hoʻohaʻahaʻa manaʻo e hana ia i ka wā ma mua

• Ka hana maʻamau o ke kō -95%
• Hoʻokuʻuina o ka pua thrombosis - 70%
• Hoʻopau i kahi puʻuwai ikaika -90%
• Hoʻopau i ke kiʻekiʻe o ke koko - 92%
• ʻO ka hoʻonuiʻana i ka ikehu i ka wā, hoʻomaikaʻi i ka hiamoe i ka pō -97%

Nā manaʻo no ka hoʻokipa ʻana iā Januvia a me nā mea hoʻohālike:

1. ʻO nā maʻi me ka hoʻohaʻahaʻa ʻana i ka hypoglycemia ma muli o ka neuropathy a i ʻole nā ​​kumu ʻē aʻe.
2. ʻO ka maʻi maʻi predisposed i ka hypoglycemia nocturnal.
3. ʻO nā maʻi maʻi, nā maʻi maʻi.
4. Hoʻomaopopo i ka poʻe maʻi maʻi e koi nui i ka nānā ʻana i ka wā o ka lawe ʻana i kahi kaʻa, hana ma nā kiʻekiʻe, me nā mea paʻakikī.
5. ʻO nā maʻi me ka hypoglycemia pinepine e lawe i ka sulfonylurea.

ʻO ka mea kūlohelohe, hiki i kekahi me ka maʻi maʻi maʻi ke hele i Januvia ma kahi. ʻO ka hōʻailona o ka hopena o Iovia kahi emi ʻana o ka hemoglobin glycated e 0.5 pakeneka a ʻoi aku paha ma hope o ʻeono mau mahina o ka mālama ʻana. Inā ʻaʻole i loaʻa kēia mau hopena, pono i ka mea maʻi ke koho i kekahi lāʻau lapaʻau hou. Inā ua emi iho ka GH, akā, ʻaʻole i hoʻokō i ke kumu maʻamau, ua hoʻohui ʻia kahi ʻauhue hypoglycemic kolu i ka regimen mālama.

Pehea e hana ai ka lāʻau lapaʻau?

ʻO nā inccrecins he mau gastrointestinal hormones i hana ma hope o ka ʻai a ke kū nei i ka hoʻokuʻu o ka insulin mai ka pancreas. Ma hope o ka pau ʻana o kā lākou hana, ua hoʻopili koke ʻia lākou e nā kaila ʻokoʻa - type 4 dipeptidyl peptidase, a i ʻole DPP-4. Ua pale ʻole i ka paleomaʻi, noho ʻole i kēia huehu. ʻO ka hopena, aia ka nui o ka incretins i ke koko, ʻo ia ka mea e hoʻonui pū ʻia ai ka synthesis o ka insulin, a me ka emi ʻana o ka glucose.

ʻO nā hiʻohiʻona maʻamau o nā mea hoʻohana DPP-4 i hoʻohana ʻia i ka mellitus maʻi diabetes:

• Ua lawe ʻia ʻo Januvia a me nā analogue ma ke alo, ua loaʻa i nā palapala papa;
• hoʻonui lākou i ka kao o ka incretins, akā ʻaʻole iʻoi aku ma mua o 2 mau manawa o ka physiological;
• aneane ʻaʻohe hopena kūpono ʻole i ka digestive tract;
• Mai hana ʻino i ka paona;
• ʻO ka hypoglycemia ma ka maʻi diabetes he ʻoi aku ka liʻiliʻi ma mua o ka hoʻomākaukau ʻana o ka sulfonylurea;
• hoʻemi i ka hemoglobin glycated e ka 0.5-1.8%;
• pili i ka wikiwiki a me ka glycemia postprandial. Hoʻemi ka glucose i ka momona, me ka hoʻopiʻi ʻana ma ke ʻano o ka hakahaka ʻana e ke kahikaha;
• hoʻonui i ka nui o nā cell beta i ka pancreas;
• ʻaʻole e hoʻopilikia i ka mea huna o ka glucoseagon i ka pane i ka hypoglycemia, ʻaʻole e hōʻemi i kona mau kumu huna i ka ate.

ʻO nā ʻōlelo aʻoaʻo no ka hoʻohana ʻana e wehewehe kikoʻī i ka pharmacokinetics o sitagliptin, ka mea ikaika o Januvia. Loaʻa kahi bioavailability kiʻekiʻe (ma kahi o 90%), mai kahi mai gastrointestinal i loko o 4 mau hola. Hoʻomaka ka hana i ka hapalua hola ma hope o ka hoʻokele ʻana, ʻoi aku ka hopena ma mua o kahi lā. Ma ke kino, ʻaʻole i hoʻohālikelike ʻia ka sitagliptin, 80% ka hoʻopili ʻia ʻana i ka urine ma ka ʻano like.

ʻO ka mea hana ʻo Januvia ʻo ʻAmelika Hui Pū ʻAmelika. ʻO ka lāʻau lapaʻau e komo ana i ka mākeke Lūkia ma ka Netherlands. I kēia manawa, ua hoʻomaka ka hana ʻana o kahi sitagliptin e ka hui Lūkini Akrikhin. Hōʻike ʻia kona helehelena ma nā pale o nā lāʻau lapaʻau i ka hapalua o 2018.

Nā ʻōkuhi no ka hoʻohana

Loaʻa ka lāʻau lapaʻau o Hoavia i loko o kahi waihona o 25, 50, 100 mg. Loaʻa nā papa papa i kahi membrane kiʻi a ua waihoʻoluʻu ʻia ma ke ʻano: 25 mg - pale pink, 50 mg - waiū, 100 mg - beige.

Pono ka lāʻau no nā ʻoi aku he 24 mau hola. Lawe ʻia kekahi manawa i kēlā me kēia manawa, me ke ʻano ʻole o ka manawa o ka meaʻai a me kona ʻano. Wahi a nā loiloi, hiki iā ʻoe ke hoʻololi i ka manawa o ka lawe ʻana iā Januvia i 2 mau hola me ka ʻole ke mōhai aku i ka glycemia.

ʻO nā ʻōlelo ʻōlelo mai ke ʻōkuhi koho pākiha:

1. ʻO ka hopena kiʻekiʻe loa he 100 mg. Ua kuhikuhi ʻia ia no nā maʻi maʻi āpau ʻaʻole i loaʻa nā contraindications. Hoʻomaka me nā wahi liʻiliʻi me ka hoʻonui nui ʻana, ʻaʻole pono ia, ʻoiai ua hoʻomanawanui maikaʻi ʻia ʻo Januvia e ke kino.
2. Hoʻokomo ka kauka i ka hoʻopau ʻana o ka sitagliptin, no laila, me ka nele o ka renal, hiki i ka lāʻau lapaʻau ke hōʻili i loko o ke koko. I mea e pale ʻole ai i ka make, ua hoʻoponopono ʻia ka lāʻau o Januvia ma muli o ke ʻano o ka lawa ʻole. Inā GFR> 50, maʻa mau ka 100 mg maʻamau. Me GFR <50 - 50 mg, GFR <30 - 30 mg.
3. No ka mea maʻi me ka maʻi hepatic, ʻaʻole pono ka hoʻoponopono ʻana o ka nui o Hoavia, no ka mea, ʻaʻole i hoʻonā ʻia ka sitagliptin i loko o nā kuli.
4. I nā poʻe maʻi maʻi maʻi kahiko, ʻo ke kahe o ka sitagliptin i loko o ke koko he 20% kiʻekiʻe ma mua o ka poʻe ʻōpio. ʻO kēlā like ʻole like ʻole e pili i ka glycemia a ʻaʻole hiki ke alakaʻi iā ʻoe i ka overdose, ʻaʻohe mea pono e hoʻololi i ka hewa o Januvia.

ʻO ka hopena hoʻohaʻahaʻa i ka Sugar:

Nā hopena hopena

Ua hoʻāʻo ʻia nā noiʻi hoʻāʻo ʻana i ka ʻae ʻana o Januvia i kēia lāʻau lapaʻau, ka mea hoʻokahi wale nō a me ka hoʻohui pū ʻana me nā papa antidiabetic ʻē aʻe, ʻaʻohe hopena o ka hopena. ʻAʻohe kūlike koʻikoʻi statistically i ka pono o ka pono o nā poʻe maʻi me ka maʻi maʻi mai ka hui mana a me ka poʻe e lawe ana iā Januvia. Eia nō naʻe, ke kuhikuhi nei nā ʻōkuhi no ka hoʻohana ʻana i nā pilikia olakino āpau i loaʻa i nā maʻi: nā maʻi ʻeha, ke poʻo, ka ʻolua, etc.

Wahi a nā maʻi maʻi, ʻaʻole nā ​​kumu o nā papa o Arizonavia i ka hypoglycemia. ʻO kēia no ka mea e hana i ka pane wale ʻana o ke kaila i loko o ke koko. Hiki i ka Sugar ke hāʻule wale i ka wā e hoʻohana ai iā Januvia me ka hoʻomākaukau o ka sulfonylurea. I mea e pale aku ai i kēia, pono ʻoe e hōʻemi i ka nui o PSM.

Hoʻohālikelike Kahumoku

Arkady Alexandrovich

Endocrinologist me kaʻike

E nīnau i ka mea loea

I kekahi mau makahiki i hala aku nei, ua ʻike ʻia ka ʻike koʻikoʻi ʻo Januvia i ka maʻi maʻamau i ka maʻi maʻi me nā maʻi puʻuwai. Ua hoʻōla ʻia ia ma 2015. Ua hōʻoia ʻia kahi hoʻokolokolo ʻekolu ʻekolu i ka mālama ʻana o ka hana o Januvia i ka hopena o ka hōʻeha o ka puʻuwai, hōʻeuʻeu ka naʻau, ka angina pectoris, a me nā maʻi ʻē aʻe.

ʻO ka hoʻokipa ʻia kahi e pili ana iā Januvia

ʻAʻole hiki ke lawe ʻia ka lāʻau lapaʻau i ka poʻe me ka hypersensitivity e sitagliptin a i ʻole nā ​​mea ʻē aʻe o ka paila. Ke lawe, he rash, angioedema, anaphylaxis hiki.

ʻAʻole i aʻo ʻia ka hopena o ka lāʻau i nā keiki, i ka wā hāpai a me ka lactation. Ma muli o ka nele o nā ʻike palekana, ua pāpā ka ʻōlelo i ka mālama ʻana iā Yanuvia no kēia mau poʻe maʻi o ka maʻi maʻi.

E like me nā paila haʻahaʻa e hoʻoheheʻe ʻia, ʻaʻole hoʻohana ʻia ʻo Januvia no ka hoʻopiʻi ʻana i nā maʻi o ka maʻi maʻi, i ka wā o ka hoʻihoʻi ʻana mai nā hōʻeha nui a me nā hana hōʻemi.

Ke keu

Wahi a nā ʻōlelo aʻo, ʻae maikaʻi loa ka hala ʻana o ka ʻewalu walu o Yanuvia. Inā lawe nui ʻia kahi nui nui, hiki i kahi mea maʻi me ka maʻi maʻi maʻi lapaʻau e pono ai ka mālama olakino: ka wehe ʻana i nā papa no undigested mai ka digestive tract, dialysis, mea kākoʻo.

He mea hiki ke hoʻololi

ʻO ka analogue piha o Januvia ʻo Kelemania Kselievia. ʻAʻole naʻe i hiki ke kūʻai aku iā ia ma Rūsia, i ka wā e kauoha aku ai i waho o ke kumukūʻai e pili ana i ka 80 euros ma kēlā me kēia mahina mālama mālama.

Hoʻomākaukau a me nā hana like (DPP-4) a me nā hana like (GLP-1 mimetics):

ʻAʻole loaʻa nā huahana analog kaua o ka lāʻauvia, kokoke ma ke kumu kūʻai no ka papa ma kēlā me kēia mahina - Galvus (ma kahi o 1500 rubles) a me Ongliza (1900 rubles).

ʻO Jasonvia a Galvus paha - ʻoi aku ka maikaʻi

Hōʻike nā loilo o nā kauka e pili kokoke ana ʻo Galvus a me ʻOviavia e like me ke kumumanaʻo o ka hana a me ka hopena o ka hoʻohaʻahaʻa i ke kō, ʻoiai nā ʻano hana like ʻole. Ua hōʻoia ʻia kēia e ka ʻike ʻikepili, kahi i hoʻohālikelike ai i nā lāʻau lapaʻau:

• 1 papa o Januvia 100 mg i like nā papa ʻelua o Galvus 50 mg;
• i nā poʻe me ka maʻi mellitus decompensated, glycated hemoglobin i hōʻemi i 7% i ka 59% o nā maʻi maʻi e lawe ana iā Januvia, ma 65% o nā mea maʻi ma Galvus;
• Ua mau ʻia ka hypoglycemia mālie i 3% o nā mea maʻi ma Januvia, ma 2% - ma Galvus. ʻO ka hypoglycemia koʻikoʻi ua hele i ka wā e lawe ai i kēia mau lāʻau.

Wahi a ka mea hana, me ka mālama ʻana me Galvus, hōʻemi a me ka triglycerides i ke koko, a laila e hōʻemi ana i ka hopena o nā maʻi vascular. Ma Januvia, ʻaʻohe mea i hana ʻia.

Uila

ʻO ke kumu kūʻai no kahi ʻaʻa o Januvia, i helu ʻia no 4 mau pule o ka hoʻokipa ʻana, mai 1489 a 1697 rubles. Kuhi ʻia aku ia ma ka lāʻau kūʻai wale nō i hoʻopuka ʻia e kahi endocrinologist a i ʻole mea lapaʻau. Loaʻa i nā poʻe maʻi maʻi hoʻopaʻa inoa e loaʻa iā Januvia no ka manuahi, ʻoiai ʻo sitagliptin aia ma ka papa inoa o nā lāʻau lapaʻau nui (Vital a me nā pono Drugs). Wahi a nā loiloi, ʻaʻole i loaʻa ka lāʻau i nā wahi a pau o Rūsia.

Nā Hōʻike Kokua

Ua hoʻohana wau e lawe i ka Diabeton MV a me Siofor, i kēia manawa ua hoʻohuli wau i ka lāʻau lapaʻau Iāvia. ʻO 100 mau hoʻoponopono o ka mālama ʻia he 100 mg o Januvia i kakahiaka, 3 mau manawa 500 mg o Siofor i ke ahiahi. He aha nā manaʻo e hiki ke kiʻi mai ka mahina o ka hoʻokele ʻana: ua hoʻonui iki ka nui o ke kō, i kēia manawa e pili ana i ka 5.7-6.7. Ma hope o ka ʻai ʻana, hoʻomaka nō hoʻi ʻo ia ma mua o ka pā maʻamau. Ua hoʻololi ka pane ʻana i ka ukana. Ma mua, ma hope o hoʻokahi hola, ua hōʻemi nā papa i ka hypoglycemia, ua hoʻokaʻawale ke kō i ke kō i ka manawa 3. I kēia manawa ke emi iki nei i ka 5.5, a laila ulu hou i kona pae maʻamau. Ma keʻano laulā, ua ulu iki ka glycated hemoglobin, a ua emi ka nui o ka huki i ke kō.

I Kelemānia, ua lawe ʻo Galvus, ma hope o ka neʻe ʻana i Lūkini, ua koi koʻu kauka iā Januvia. Hoʻemi lākou i ka hila me ka like o ka mea like, akā ua maikaʻi lākou i mua. He aha ke kumu, ʻaʻole maopopo iaʻu. Hāʻawi ʻia i kēlā me kēia manaʻo he kumu kumuhana, hoʻomaʻamaʻa maikaʻi ʻo Januvia i ka maʻi diabetes.

Ua hoʻohui a ua hana ʻo Januvia i ka lāʻau lapaʻau i ka paʻakikī Levemir + Humalog. Maikaʻi maikaʻi nā manaʻo mua - e pane wale ana ka lāʻau lapaʻau i ke kō, ʻo ka hoʻokaʻa haʻahaʻa, ʻaʻole i pā mai, hana lohi, hana ʻole. ʻO ka hapa o ka insulin e hoʻoemi ʻia e kahi hapaha. ʻO ka hopena maikaʻi i ʻike ʻole ʻia i nā ʻōkuhi he mea hōʻemi i nā mea momona e ka hapakolu. Manaʻo wau he lāʻau lapaʻau maoli maoli nō ia.

Maikaʻi loa ka lāʻau. Ka hoʻolaʻa ia i ke kō, kōkua i ka pohō o ke kaumaha, ʻaʻole ia e make i ka pōloli nui i ka wā e hemo ana i ka ʻai, e like me Gliclazide MV. ʻO nā pōʻino koʻikoʻi o Januvia kona kumukūʻai kiʻekiʻe. ʻAʻole naʻe lākou i hāʻawi i kahi papa manuahi, inā ʻaʻole hiki iaʻu ke loaʻa i nā lāʻau lapaʻau i ka lāʻau lapaʻau, ua haʻalele wau i nā noi. Pono wau e kūʻai iā ia iho.