Hoʻopilikia kēia maʻi i ka lā 9% o ka heluna o ka honua. ʻO nā ʻoihana lapaʻau a me nā ʻōnaehana olakino o nā ʻāina alakaʻi o ka honua e hoʻolilo ana i nā piliona kālā, a ua lanakila ka maʻi diabetes a me ka hakakā ʻana a puni ka honua, e lilo ana ka ʻōpio, a lilo i ka uluʻe ʻana.
Ke lawe nei ka maʻi maʻi ma kahi ʻano i manaʻo ʻole ʻia e: ma 2020, hapalua hapalua haneli nā maʻi maʻi me ka maʻi diabetes 2 ua wānana ʻia, a ʻaʻole i aʻo nā kauka pehea e hoʻomau pono ai i ka maʻi.
Inā me ka maʻi type 1, ka mea e pili ana i ka emi iho ma lalo o ka 10% o nā maʻi āpau, ua maʻalahi nā mea āpau: hoʻemi i ka kaila o ka glucose i ke kahe koko ma o ke kiʻi ʻana i ka insulin (ʻaʻohe mea ʻē aʻe e hāʻawi ʻia i laila) a maikaʻi nā mea āpau (i kēia lā, no kēlā mau mea maʻi, ua hana pū kekahi i kahi pancreas kūlohelohe. ), a laila me ka diabetes type 2, ʻaʻole holo maikaʻi ke ʻenehana kiʻekiʻe.
Ma ka hoʻohālikelike, no ke ʻano maʻi maʻi 2, ua haʻi ʻia ke kō i ka ʻenemi nui, e hoʻopiha ana i ka mākeke me nā lāʻau lapaʻau haʻahaʻa. ^ E Ha yM. Hoʻonui ʻia ka mālama ʻana o nā maʻi maʻi me ka kōkua o nā lāʻau lapaʻau, ʻoiai ke hoʻohana ʻia kekahi lāʻau lapaʻau hou i kekahi lāʻau lapaʻau, a laila hoʻohui ʻia kekahi lāʻau lapaʻau hou i kēia paʻakikī a hiki i ka huli ʻana o ka insulin.
No 20 mau makahiki i hala aku nei, ke hoʻoikaika ikaika nei nā kauka me ke kō, akā ʻo ka hopena i lalo o ke kīpē, ʻoiai ʻo nā hopena a me nā hoʻopiʻi o nā lāʻau lapaʻau pinepine pinepine i ko lākou mau hopena, ʻoiai inā ʻaʻole ʻoe e ʻimi i ka dosage, mai noʻonoʻo i ka mea no ka lāʻau lapaʻau ʻia a ʻo wai hoʻi ʻaʻole.
ʻO kekahi o kēia mau ʻāpana loiloi o nā pili ka puʻuwai a me ke koko. Ua hōʻike ʻia ʻo ia ka hana maalea loa o ka mālama ʻana i ka maʻi maʻi e hāʻawi i ka hopena kūlike a alakaʻi i ka make vascular. ʻO ka Sugar he hōʻailona wale nō ia o nā maʻi maʻi kaona 2, e kau ana ka maʻi ma ka metabolic syndrome.
ʻO ka lāʻau lapaʻau o ka hanauna hou o Onglisa, i hoʻomohala ʻia e nā kānaka ʻepekema Pelekānia a me Italia, ʻaʻole nā antidiabetic wale nō, akā nā kaha cardioprotective. ʻO nā lāʻau lapaʻau o ka laikini incrlet, e loaʻa iā Onglisa, nā mea hou i loko o ke kahua o ka maʻi maʻi. Hana lākou e hōʻemi i ka momona a me ka hāʻawi kaumaha - ʻo ia kekahi o nā kumu nui no ka hoʻomohala ʻana i ke ʻano maʻi type 2.
Eia kekahi, ʻaʻole ka hoʻonāukiuki o ka infletinomimetics i ka hypoglycemia, kōkua i ka hoʻohaʻahaʻa ʻana i ke koko, a pale i nā ʻoka pancreatic. ʻO ke kumu kūʻai kiʻekiʻe a me ka nele o ka ʻike lāʻau ma muli o ka manawa pōkole o ka hoʻohana ʻana i nā lāʻau hiki ke ʻike ʻia no nā hemahema o Onglisa, akā he mea kēia no kēia manawa.
Ka hoʻonohonoho ʻana a me ke ʻano o ka hoʻokuʻu ʻana
ʻO kēlā me kēia papa Onglisa, ke kiʻi o ia ka mea i hōʻike ʻia ma kēia ʻāpana, aia kahi 2.5 a 5 mg mg o ka saxagliptin hydrochloride i loko o ka ua. Hoʻopili ʻia ka ʻōlepa me nā hoʻopiha: cellulose, lactose monohidate, sodium croscarmellose, magnesium stearate a me nā ʻāpana Opadrai (keʻokeʻo, ʻāpana a me nā aniani no ka papa he 2,5 mg a me ke keʻokeʻo, ʻulaʻula a me ka uliuli no ka inu ʻana o 5 mg).
Hiki ke hoʻomaopopo i ka lāʻau lapaʻau ma ke ʻano (nā biconvex papa me kahi kaila melemele a ʻo ka māka 2,5 / 4214 a pinkish me ka kahakaha 5/4215). Hoʻopili ʻia ka ʻōlelo ma kēlā me kēia ʻaoʻao me ke aniani uliuli.
Oe ke kuai i ka lāʻau lapaʻau lapaʻau. No nā papa Ongliz, ʻaʻole mai ke kumukūʻai mai ke kumukūʻai ʻoihana: no nā 30 mau pcs. 5 mg ma Moscow e pono ʻoe e uku i ka 1700 rubles. Ua hoʻoholo ka mea hana i ka noho papa o ka lāʻau lapaʻau i loko o 3 mau makahiki. Mālama nā kūlana o ka lāʻau lapaʻau.
Nā hiʻohiʻona Pharmacological
ʻO ka papa hana nui o Onglisa he saxagliptin. I loko o hoʻokahi lā ma hope o ka komo ʻana i ke kao ʻōpala, ke kāohi nei i ka hana o ka peptide DPP-4. Ma ka hoʻopili me ka glucose, ʻo ke kaohi o ka enzyme me ka nui (2-3 mau manawa) e hoʻonui i ka ʻike ʻana i ka pona o ka ponaide e like me peptide-1 (GLP-1) a me ka glucose-e hilinaʻi i ka insulinotropic polypeptide (HIP).
I ka manawa like, emi ka nui o ka glucagon i loko o nā sel e b, nā hana o nā kelepona kuleana no ka hoʻouka ʻana o ka insulin endogenous. I ke hopena, ua hoʻemi nui ʻia nā hōʻailona o ka wikiwiki a me ka glycemia postprandial.
ʻO ke palekana a me ka kūleʻa o ka lāʻau lapaʻau ua aʻo ʻia i nā hoʻokolohua 6, ma ka hana he 4148 mau mea paahana me ka maʻi type 2. Ua hōʻike nā mea komo a pau i ka dinamics maikaʻi o ka gogemobly glycated, kaona pololi a me ka glycemia ma hope o kahi ukana. ʻO nā poʻe i hōʻino ʻole i hoʻokō ʻia 100% glycemic control ua kau ʻia nā lāʻau lapaʻau hou - thiazolidinediones, metformin, glibenclamide.
ʻO nā mea maʻi e lawe ana i nā lāʻau antidiabetic hou i hōʻike i nā hopena like. Ua kūpaʻa ka paona o nā mea a pau i nā hoʻokolohua.
Ma kahi i kauoha ʻia ai ʻo Saxagliptin
ʻO ka maʻi maʻi maʻi me ka maʻi ʻānō o Ongliz i kauoha ʻia:
- E like me ka monotherapy, i hui pūʻia me nā loli hoʻololi;
- I ka hui aku, me ka hoʻohui o ka koho ma mua me ka metformin, inā ʻaʻole hāʻawi ʻo monotherapy i ka mana piha o ka glycemia;
- Me nā hua derivatives o ka lālani sulfanylurea a me thiazolidinediones, inā ʻaʻole i lawa nā hui mua.
Ia Onglisa e hui aku ana
No ka mea he ikaika stimulant ka saxagliptin e hoʻonui ana i ka hana o nā b nā a me ke pale aku i ka hana o nā huina b, hiki ke hoʻohana pū me kekahi mau kaupalena, ʻoi, ʻaʻole i hōʻike ʻia ka lāʻau lapaʻau.
- Nā makuahine hāpai a me ka lactating;
- I ke wā kamaliʻi;
- Maʻa maʻi maʻi me nā maʻi ʻano ʻehā;
- Me kahi ʻano hilinaʻi-insulin e pili ana i ka lolo type 2;
- Hoʻokomo ʻia e ka maʻi ketoacidosis maʻi maʻi;
- Inā ʻaʻole hoʻomanawanui ka mea maʻi i ka galactose;
- Me ka hypersensitivity i nā mea kanu o ka pulu.
Ke koho ʻana i kahi hoʻoponopono mālama lapaʻau, ʻaʻole kau ka luna o ke kauka ma luna o nā contraindications i kakau ʻia, akā hiki pū nō hoʻi i ke ʻano me ka saxagliptin o nā lāʻau lapaʻau i lawe ʻia e ka maʻi maʻi mai nā maʻi concomitant. No laila, ʻo nā lāʻau āpau a pau i ka lolo e hoʻopau pono ai, pono e hoʻomaopopo ʻia ke kauka i ka manawa kūpono.
Nā manaʻo e hoʻohana
Hoʻoholo ke kauka i ka nui o ka lāʻau lapaʻau hoʻokahi, me ka mālama i nā hopena o ka hoʻokolokolo, ka makahiki, ka ʻano o ka maʻi, ka ʻano kū hoʻokahi o ke kino. No Onglisa, nā ʻōlelo aʻo no ka hoʻohana ʻana i ka papa ʻōlelo ma ke ʻano he maʻamau, me ka ʻole o ka nakinaki ʻia i ka manawa e ʻai ai. ʻO ka maʻa hoʻomaka hoʻomaka o ka lāʻau no 5 mg / lā.
I ka hoʻomakaʻana o ka papa e mālama ai, ke ʻano ka like me ka regimen maʻamau:
- Saksagliptin - 5 mg / lā .;
- Metformin - 500 mg / lā.
Ma hope o nā lā he 10-15, ka loiloi ʻia o ka hopena o ka lālia i koho ʻia a inā pono, ke hoʻoponopono ʻia nā ʻano o nā metformin, e mālama ana i ke ʻano o Onglisa i loli ʻole.
Inā pau ka manawa lawe i ka lāʻau lapaʻau, ua lawe ʻia ia ma ke ʻano maʻamau ma ka manawa mua. ʻAʻole hiki iā ʻoe ke pālua i ke kapu, no ka mea, pono ke kino i ka manawa e hoʻoiho ai ia mea.
Inā loaʻa kahi moʻaukala o kahi maʻi papalapa, ʻaʻohe pono o ka titration dosis. Me ke ʻano maʻalahi a paʻakikī, hoʻemi ʻia ka maʻamau ma ka manawa 2 - 2.5 mg / lā. (one-one).
I ka wā hemodialysis, inu ka papa ma ka hope o ke kaʻina. ʻO ka hopena o Onglisa i nā poʻe maʻi e pili ana i nā dialy peritoneal i aʻo ʻole ʻia. Ma mua o ke kuhikuhi ʻana i ka lāʻau lapaʻau a ma ke ʻano o ka papa holo, pono ia i ka nānā ʻana i kēlā me kēia manawa i ka hana o nā keiki.
Me nā ala hepatic, kuhikuhi ke lāʻau lapaʻau i ka mahele maʻamau o 5 mg / lā. No nā maʻi maʻi o ka pākeke, ʻaʻole pono ka nui o ka titration, akā pono e noʻonoʻo ʻia ke ʻano o nā keiki.
Kahi ʻia ka nui o nā incretins i loko o ka hoʻōla paʻakikī me nā inhibitors:
- Atazanavir;
- Ketoconazole;
- Igraconazole;
- Nelfinavir;
- Clarithromycin;
- Ritonavir;
- Saquinavir;
- Indinavir;
- ʻO Telithromycin.
ʻAʻohe mea ʻike pili pili i ka ʻōlelo aʻo o ka hoʻohana ʻana i ka lāʻau lapaʻau no nā wahine hāpai a me nā keiki ma lalo o ke 18 makahiki, no laila ua koho ʻia nā mea analogue no kēia ʻāpana o ka maʻi maʻi.
He hopena hoʻoneʻe a hikiʻole
ʻO nā lāʻau lapaʻau o ka pūʻulu hoʻohui o ka hanauna hou loa kekahi o kahi palekana. Me nā manaʻo āpau a ke kauka, i hoʻomanawanui ʻia ʻo Ongliz e ka hapa nui o nā maʻi maʻi.
I kekahi mau hihia, penei ke kau nei:
- Nā maʻi Dyspeptic;
- Ulo;
- ʻO ka pancreatitis
- Nā maʻi ʻeha;
- ʻO nā maʻi urogenital o kahi ʻanoʻeha.
Inā loaʻa i kahi o nā hōʻailona a i ʻole kahi hōʻoluʻolu ʻē aʻe paha, pono ʻoe e kāpae i ka hoʻohana ʻana i ka lāʻau lapaʻau a nīnau aku i kāu kauka.
No nā kumuʻepekema, ua hāʻawi ʻia ka lāʻau lapaʻau i nā mea hana ma nā hōkeo ma mua o ka 80 mau manawa. ʻAʻole paʻa nā hōʻailona o ka hoʻohālikelike. Hiki ke hoʻopau ʻia ka saxagliptin me ka hoʻohana ʻana i hemodialysis.
Nā ʻōlelo ʻokoʻa
ʻAʻole i kuhikuhi ʻia ʻo Saxagliptin i kahi regiple triple i hui pū ʻia i nā inikini insulin me metformin a me thiazolidinediones, no ka mea, ʻaʻole i aʻo ʻia nā hopena o kēia hoʻokele. Ke mālama ʻia ka mālama ʻana i nā pōpoki i nā manawa āpau o ka mālama me Onglisa, akā me kahi ʻano ʻoluʻolu, ʻaʻole i loli ka dosage, ma nā ʻaoʻao ʻē aʻe.
ʻO Saxagliptin e pili ana i nā hopena hypoglycemic palekana loa, akā i ka hoʻohui me nā lāʻau lapaʻau sulfonylurea hiki ke hoʻonāukiuki i nā kūlana hypoglycemic. No laila, me ka mālama paʻakikī, titration o nā pona o ka hopena i ke kuhikuhi o ka hōʻemi he kauoha.
I ka hihia no ka hoʻomaloka ʻana i nā lāʻau lapaʻau o ka series reslet - DPP-4 inhibitors, ʻaʻole hoʻi i kuhikuhi ʻia ʻo Ongliza, no kekahi mau mea ua hōʻike ʻia nā hopena aleremia mai nā rashes kaola maʻamau i ka pīhoihoi anaphylactic a me ka angioedema, e koi ana i ka hoʻoneʻe koke ʻana i nā lāʻau lapaʻau.
No ka mea ka nui o ka lāʻau lapaʻau i ka lactose, ʻaʻole ia i kuhikuhi no ka maʻi maʻi me ka intolerance pilikino, pilikia o ka lactose, ka malabsorption glucose-galactose.
Ma ke kaʻina o ka nānāʻana i nā maʻi maʻi maʻi ma hope o ka mālama ʻana me Onglisa, aia kahi mau mea e hiki ai ke hoʻomohala ana i ka maʻi pancreatitis hoʻonā. Ke koho ʻana i kahi papa o ka saxagliptin, pono e hoʻomaopopo ʻia ka mea maʻi e pili ana i kahi hōʻailona alohilohi: kū mau a me ka ʻeha nui i ka epigastrium.
Inā pilikia ʻoe i loko o ka ʻōpū, pono ʻoe e ʻae i ka lawe ʻana i ka lāʻau lapaʻau a hōʻike aku i ka malaise i kāu kauka. ʻO nā hopena he pōkole a hoʻihoʻi, kau ma luna o lākou iho ma hope o ka hoʻokuʻu ʻana i ka lāʻau.
I nā hana renal i ke ʻano maʻalahi a me ka hōʻeha ʻana, hoʻokahi titration pākahi. I nā kūlana koʻikoʻi, hoʻohana ʻia ʻo Onglizu me ka akahele; i ka manawa kahua, ke hiki ʻole i ka mea maʻi me ka hemodialysis, mai hoʻohana nui. ʻO ka nānā ʻana i ke kūlana o nā keiki i kēlā mau hihia e lawe ʻia ma mua o ka hoʻomaka ʻana o ka papa o ka mālama ʻana a me kēlā me kēia mahina ʻeono me ka hoʻohana mau ʻana o Ogliza.
ʻAʻole lawa ka ʻike i ka mālama ʻana i nā maʻi maʻi i ka makahiki ʻelemakule (mai 75 mau makahiki), no laila, lawa kēia ʻano o nā mea maʻi i ka mālama nui.
ʻAʻole i paʻi ʻia nā hopena o ka hopena o Onglisa i ka hiki ke kāohi i ka lawena a i ʻole paha i nā mea ʻenehana. No laila, ʻaʻole e paʻi ka poʻe maʻi maʻi maʻi i ka lāʻau me ka akahele, ʻoiai no ka mea ʻo ka huki ʻana i waena o nā hopena ʻaoʻao. Pono ke nānā pono i ia mau kūlana no nā maʻi e hoʻohana ana iā Onglisa i ka mālama ʻana i ka paʻakikī, ʻoiai ua loaʻa kekahi mau lāʻau antidiabetic e hoʻonāukiuki i ka hypoglycemia.
ʻO ka ʻike no ka hoʻohana ʻana i ka lāʻau lapaʻau no nā pilikia cardiovascular e hōʻike ana i ka lāʻau lapaʻau e hoʻomaʻamaʻa i ka puʻuwai naʻau. I ʻAmelika, ʻoiai me ka palena palena kiʻekiʻe o ke kō, ʻo ke kauka ke kau nei i nā maʻi maʻi me ka arrhythmia Onglizu e hoʻomaikaʻi i nā maʻi glycemic a hoʻihoʻi i ka helu naʻau.
Nā Pili i nā lāʻau lapaʻau me Onglisa a me nā kikowaena
E like me ka ʻikepili o ka noiʻi ʻepekema, ʻaʻole i helu ʻia nā hopena o ka maʻi o Onglisa me nā mea ʻē aʻe i ka wā o ka mālama ʻana.
ʻAʻole ka hopena i ka hopena i ka hopena o ka mālama ʻana no ka hoʻohanaʻana i ka waiʻona, nā mea inu ʻoki, nā ʻano meaʻai like ʻole, nā ʻano hanana homeopathic.
I loko o ka papa palapala, mai ka pūnāwai waihona, a me Onglisa, hoʻokuʻu ʻia ʻo Galvus lāua ʻo Januvia, i loko o ka ʻāpana syringe - Baetu a me Viktoza.
Nā loiloi a me nā loiloi hoʻohana
Ma nā papa kūkala nui e pili ana i ka lāʻau lapaʻau Ongliza, he mea kupaianaha nā loiloi, aʻo ka drawback wale nō ka mea e pili ana i kāna ʻano Europa.
Minamina, ʻaʻole e hiki ke hoʻōla ʻia nā maʻi, e like me ka wā kahiko, no ka mea, ʻaʻole e hiki ke kūʻai ʻia ke olakino, e like me kāu e ʻike ai, a me ka maʻi maʻamau kīnā 2 ʻaʻole i kapa ʻia ka tikina like ʻole.
Akā ʻaʻole ʻo ka pancreas i kahi maʻi maʻi me ka maʻi type 2 me ka atrophied, he mālama ia no ka hoʻihoʻi ʻana i kāna mau hana, a ua hoʻopau iā ia i mea ʻole ka hana (mai kahi ʻike nui o ka mea huna o ka insulin) o mua.
Ma mua o ka hoʻokuʻu ʻana iā Ongliza i ka mākeke, ua lilo ka mea hoʻomohala i mau miliona kālā ʻaʻole wale nō e hōʻoia i ka haʻalele ʻana o nā hopena maikaʻi ʻole, akā e hōʻoia pū i kona hōʻoia. Inā kōkua wale nō ka lāʻau lapaʻau i ka hoʻopiʻi ʻana i nā hoʻopiʻi no nā makahiki 10-20, ʻo ia hoʻi no kēia manawa o ka piha ʻana (me ka hōʻeha ʻole o ka naʻau, ka nalina, ka gangrene, ka makapō, ke hala ʻole, nā hana a ke kumu huna) ola, pono ʻoe e nānā pono iā ia.
ʻO nā manaʻo e pili ana i ka hiki o Onglisa a me ka hopena o nā lāʻau lapaʻau maʻi i ke olakino o ka endocrinologist Shmul Levit, poʻo. Institute of Diabetology, ʻike wikiō:
