Saxagliptin no nā maʻi maʻi - mau manaʻo e hoʻohana

He mea paʻakikī e noʻonoʻo paha i kekahi mau makahiki he 100 i hala iho nei ʻaʻohe insulin, a ua hōʻoia ʻia e ka maʻi maʻi me ka make koke ʻO nā lāʻau lapaʻau hoʻohaʻahaʻa ʻia no nā maʻi maʻi type 2 ua ʻike wale ʻia i ka waenakonu o nā kenekulia hope, a ma mua o ka hiki ʻana o kēia mau mea maʻi, ʻoiai ʻaʻole wikiwiki loa.

I kēia lā ma ka Pūnaewele ua nui ka ʻike e pili ana i nā lāʻau hou, nā lāʻau lapaʻau, nā mea hoʻomalu no ka mālama ʻana a me kā lākou iho pono i ka glycemia i hiki ke loaʻa i kēlā me kēia maʻi maʻi, aia wale nō ka mea palaualelo a mālama ole wale nō iā ia iho e haʻalele i nā mea āpau, e kali ana no nā hoʻopiʻi.

ʻO kekahi o nā papa hou o nā lāʻau antidiabetic o ka incretinomimetics (exenatide, liraglutide, sitagliptin, vildagliptin, saxagliptin). ^ E Ha yM. He aha nā pono o ka maʻi diabetes?

Nā hana hana o ka incretins

ʻO ka incretins he hormone kanaka. Hoʻokumu kā lākou gastrointestinal ma hope o ka hoʻokomo ʻana i ka meaʻai, ka neʻe ʻana o ka insulin i kēia manawa e hoʻonui ʻia ana e 80%. Ua hōʻike ʻia ʻelua mau ʻano o lākou i ke kino - GLP-1 (like me peptide-1 ka glucone-1) a me HIP (insulinotropic polypeptide). Aia nā mea i loaʻa o nā hope ma nā b-cell, a ma GLP-1 hiki ke loaʻa i nā ʻokoʻa ʻē aʻe, no laila ke multivariate ka hopena o kāna hana.

1. Hoʻonui ka GLP-1 i ka hana o ka insulin endogenous e nā b-cell;
2. Mālama ka ʻona i ka hana huna o ka glucagon e nā b-cell;
3. Hoʻopōpili ʻo Incretin i kahi momona palu;
4. He hōʻemi ia i ka momona a hana i kahi ʻano o ka piha piha;
5. Ka hopena maikaʻi i ka pūnaehana neʻe o ka naʻau, ka puʻuwai, nā kīʻaha koko.

ʻO Glucagon, ka mea i hoʻoili ʻia i loko o nā palu o nā b-cell, ka kūlike ʻokoʻa i ka insulin. Hoʻonui ia i ke kao o ka glucose i loko o ke kahe koko e ka hoʻokuʻu ʻana iā ia mai ka ate.

Pono ka ʻūhā i ka glucose e hoʻopou i nā kumuwaiwai o nā ikehu, kahi i loaʻa ai i loko o ke ʻano o ka glycogen. Ma ka hoʻokaʻawale ʻana i ka synthesis o ka glucagon, ua hākō ka mau hormones i ka hoʻokuʻu i nā glucose mai ka ate, e hoʻonui pinepine i ka hoʻokuʻu o ka insulin.

He aha nā pono he hoʻopale waʻa piha ʻana no ka maʻi maʻi? Hoʻopili ke kino i ka hapa nui o ka glucose i loko o nā pahu. Inā e hāʻawi ia ma laila i nā liʻiliʻi liʻiliʻi, ʻaʻole he nui nā kulu o ka neʻe koko. Kōkua kēia i ka hoʻoponopono ʻana i ka pilikia o ka glycemia postprandial (ahiahi). ʻAʻole hiki ke hoʻonāukiuki i ka mālama ʻana i ka makemake maʻamau o ka maʻi maʻamau i ka lā 2: GLP-1 pili pololei i ke kikowaena o ka pōloli i ka hypothalamus.

Loaʻa i ka pono o ka incretins no ka puʻuwai a me ke koko ke aʻo ʻia i kēia manawa. I loko o ka keʻena noiʻi, ua ʻike ʻia ua loaʻa ka GLP-1 i ka hoʻihoʻi hou ʻana i nā pū me ka pancreatic a pale i nā ʻoi o nā sel mai ka luku.He aha ka mea e pale ai i ka hoʻohana ʻana o nā hormones kūlohelohe ma mua o nā lāʻau lapaʻau? Ua hoʻopau ʻia ʻo GLP-1 e DPP-4 (type 4 dipeptidyl peptidase) i 2 mau minuke, a me HIP - i nā minuke 6.

Ua hiki mai nā kānaka ʻepekema me 2 mau pūʻulu o nā lāʻau lapaʻau e like me ka incretins:

• Hoʻopiʻi i ka hana o ka hana o ka GLP-1;
• Ke kāohi nei i ka hana o nā enzyme DPP-4 a hoʻolōʻihi i ke ola o nā hormones.

Hōʻike ʻia ka ʻano mua ma ka mākeke home na Bayeta (e pili ana i ka exenatide) a me Viktoza (e pili ana i ka liraglutide) - nā analogues o GLP-1, e hoʻopiha piha i kona mau mana, akā me ka hopena lōʻihi. Hiki ke hoʻohuiʻia nā pono a me ke kaupaonaʻana o ka 4 kg noʻeono mau mahina a me ka emi ʻana o ka hemoglobin glycated e 1,8%.

Hōʻike ʻia ka ʻaoʻao ʻelua ma o nā lāʻau lapaʻau ʻekolu - Galvus (hoʻokumu ʻia ma vildagliptin), ʻo Yanuviya (e pili ana i ka sitagliptin), ʻo Onglisa (ma kona ʻano - saxagliptin). ʻO kā lākou hana nui o ka kaohi ʻana i ka DPP-4 enima, e hoʻopau ana i ka incretins. Hoʻonui ka hana o nā hormone i ka lōʻihi o 2 mau manawa, no laila, ʻaʻole i hoʻoweliweli ka glycemia i kahi kanaka. He liʻiliʻi nā hopena hoʻonani, no ka mea e ulu ka nui o nā hormones i ke kaila physiological.

ʻO ka hopena ma ko lākou paona ke kūlike, ʻo ka glycated hemoglobin e hōʻemi ʻia i ke ala like me ka hui mua.

Kuhi mea huahana

ʻO Saxagliptin ka lāʻau hou loa o ka papa o ka papa inoa DPP-4. ʻO kāna inoa kalepa ʻo Onglisa. Hoʻokuʻu lākou i ka lāʻau lapaʻau i nā helu 2 o 2.5 a me 5 mg, kūʻai aku i nā papa kaukau ʻana. ʻO ka nohoola o ka noho o ka lāʻau he 3 mau makahiki, he kūlike nā kūlana mālama.

ʻAʻole ia i hoʻokomo ʻia ʻo Saxagliptin i ka papa inoa o nā pilaleka makemake, ʻoiai naʻe i kekahi mau wahi i kuhikuhi ʻia i ke kumu o ke kākau inoa kikowaena mai ka waihona kālā kūloko. No ka mālamaʻana o Onglisa i nā kumukūʻai o nā lāʻau lapaʻau pūnaewele, pono ʻoe e hoʻohana i ka 1700 rubles. kēlā me kēia mahina (5 mg tablet). No ka hoʻohālikelike, ʻo ke kumukūʻai o ka mahina ʻo Januvia (maʻa o 100 mg) e kūʻai he 2,400 rubles, Galvus - 900 rubles.

Nā manaʻo e hoʻohana

Hoʻokomo ʻia nā ʻōlelo kuhikuhi Saksagliptin no ka hoʻohana ʻana i ka lawe ʻana i ka lā 1p. / Lā. Hiki iā ʻoe ke hoʻohana i ka pono no ka monotherapy a i ʻole i ka ʻano paʻakikī.

ʻO nā lāʻau lapaʻau e hoʻohui pū ana i ka saxagliptin a me nā metformin ʻaʻole i kūkulu ʻia, e like me nā analogues YanuMeta a me GalvusMeta.
No nā pilikia o nā keiki liʻiliʻi, ʻaʻole pono ʻoe e hoʻoponopono i ka ʻai ʻana; i nā hihia koʻikoʻi loa, ua hoʻemi ʻia ka nui ma o 2 mau manawa.

Ka mea i kuhikuhi iā Saxagliptin

ʻO nā lāʻau lapaʻau kai Saxagliptin (a synonym - Onglisa) hiki ke kuhikuhi ʻia a i ka wā o ka prediabetes o ke ʻano 2nd, i ka wā e hoʻololi ai ke ʻano o ke ʻano (ka ʻai haʻahaʻa-kaʻai ʻana, ka hana ʻona kūpono, ka mālama ʻana i ke kūlana ʻenehana) ʻaʻole i hāʻawi i ka kaulike o ka glucose i ke kahe koko.

He kūpono kūpono ʻo Saxagliptin no ka hoʻōla paʻakikī, pololei i ka nui o nā lāʻau lapaʻau e kau ʻia i ka manawa like ma hope o ke ʻano maʻi, e hilinaʻi ʻia i ka hana o ka hemoglobin glycated. He kuʻaloli like me Ongliza, ua hoʻohālikelike ʻia ka metformin, a me ka ʻole o ka lawa glycemic control, kuhikuhi i ka hoʻomākaukau ʻana o ka sulfonylurea a me ka thiazolidinediones.

Nā Hoʻohui

Me ka

Papa helu holoʻokoʻa:

1. ʻO ka wā hāpai a me ka umauma;
2. Mua: ma mua o 18 a ma hope o 75 makahiki;
3. Me ka malabsorption glucose-galactose congenital;
4. ʻAno maʻi type 1;
5. Dioma ketoacidosis;
6. Me ka intolerance galactose, nele ka lactase;
7. Hypersensitivity i nā ʻāpana o ke ʻano.

Hoʻopili ʻia i nā contraindications i papa inoa, i ka wā e kahakaha ai i kahi regimen lapaʻau, mālama ka mea kauka i ka hōʻuluʻulu ʻana o ka saxagliptin me nā lāʻau ʻē aʻe e loaʻa ai e ka maʻi maʻi no nā maʻi concomitant. He mea nui e hōʻike i ka endocrinologist o nā koho hou aʻe i kahi manawa kūpono.

Nā hopena ʻaoʻao a me ka overdose

ʻO Saxagliptin ka mea e palekana ai ka hypoglycemic a ʻoi, no ka mea ʻaʻole ia e hoʻonāukiuki i ka hypoglycemia, akā, e like me kēlā lāʻau lapaʻau synthetic, hiki iā ia ke loaʻa nā hopena. Inā hele ʻia kēia mau ʻōuli a i ʻole kekahi mau pilikia ʻē aʻe, pono ʻoe e ʻimi i ke kauka: e hoʻoponopono ʻo ia i ka ʻona a koho paha i kahi mea hou.

I waena o nā hopena maʻamau pinepine ʻole:

• Nā maʻi hōʻeha;
• Hoʻopilikia nā hanana ʻehā o ka genitourinary system;
• Nā maʻi Dyspeptic;
• Ulo;
• Sinusitis
• Naihai Gastroenteritis

ʻAʻole i haʻi ʻia ke aʻo i nā hōʻailona o ka make nui loa, ʻo ka mea i hōʻike ʻia e ka lāʻau lapaʻau i hāʻawi ʻia i ka lāʻau lapaʻau i nā poʻe limahana olakino i nā peka ma mua o ka pākaukau e 80 mau manawa ʻaʻole i hōʻike i nā hōʻailona o ka hoʻohālikelike.

He aha hiki ke hoʻololi i ka saxagliptin

Me ka ʻoluʻolu ʻole a i ʻole contraindications, e koho ke kauka i nā analogues no ka saxagliptin. ʻAʻohe ala iki ma Onglise me ka like me ka mea pono e like me, akā, e like me ka pauna o ka hana, e pāpā ʻia ka hoʻonāukiuki ʻana o ka huakaʻi DPP-4:

1. ʻO Jasonvia ka lāʻau mua o kēia papa, i hoʻohana mua ʻia ma USA, a ma ʻEulopa. ʻO ka hapalua hola ma hope o ka ʻai ʻana, e kāohi ai ka lāʻau lapaʻau i ka enzyme no hoʻokahi lā. Hiki iā ʻoe ke kūʻai i nā papa ma 25.50 a me 100 mg. ʻO ka maʻa maʻamau ʻo 100 mg / lā. Hōʻike ʻia ka hopena i loko o hoʻokahi mahina. No ka hōʻoluʻolu o ka hoʻomaʻamaʻa paʻakikī, hana ʻia ka lāʻau lapaʻau me ka hui pū me ka metformin - YanuMet.
2. ʻO Galvus kahi lāʻau lapaʻau maikaʻi Switzerland, kūpono no ka mālama paʻakikī, e komo pū me ka insulin. Hoʻokuʻu ʻia ka lāʻau lapaʻau hoʻohui ʻo GalvusMet, hoʻohui ʻia kona ʻano me ka metformin. ʻO ka mea mua, lawe ʻia nā papa ma 50 mg / lā inā pono, e pālua ʻia ka helu, e hoʻohele ʻia ma nā lewa he 2.

ʻO ka hana pono a me ka palekana o nā lāʻau āpau ma kēia pūʻulu, he like, ʻo ka koho ʻana o kekahi lāʻau lapaʻau e hilinaʻi ʻia i ka hiki kālā o ka mea maʻi a me ka ʻike o ka endocrinologist me ka lāʻau lapaʻau. No saxagliptin, maikaʻi loa ke kumukūʻai i ka wā i hoʻohālikelike ʻia me nā mea hoʻohālike.

ʻO ka Saxagliptin e pili ana i onlagis, kahi hoʻomohala hou o nā lāʻau lapaʻau ʻEulopa ma ka papa o ka maʻi diabetes, ʻaʻole wale nō ka hypoglycemic, akā nani nō hoʻi nā hopena hou aku: e hōʻemi ana i ka momona a me ke kaumaha, mālama i ka pancreas, kōkua i ka mālama koko, a loaʻa nā kaha cardioprotective.

Hiki iā ʻoe ke aʻo hou e pili ana i ka incretins a me nā pono o nā lāʻau antidiabetic e pili ana iā lākou mai ka webinar o ka endocrinologist Dilyara Lebedeva ma kēia wikiō.