He mea hoʻonaninani ka papa inoa o nā lāʻau antidiabetic i loko o nā lāʻau lapaʻau (me ke ʻano o ka mea ʻai meaʻai, ka lāʻau lapaʻau, nā huaora), ʻelua a me ke ʻano lāʻau lapaʻau, ʻano mahalo. A eia hou, nā lāʻau lapaʻau hou, e like me nā hoʻokolohua, hōʻike i nā hopena hōʻoiaʻiʻo hou aku. ʻO kekahi o kēia mau lāʻau lapaʻau, kahi paʻa i ka maʻi maʻi maʻi, ʻo Forsiga e pili ana i ka dapagliflozin.
ʻO ka hoʻonohonohoʻana o ka lāʻau lapaʻau a me ke ʻano o ka hoʻokuʻu
I loko o ke keʻena lāʻau lapaʻau, kūʻai aku ʻo Dapagliflozin e like me nā papa melemele. Ma muli o ka nui, ua hūʻā ʻia lākou me ka hōʻailona ʻana i ka "5" ma ka mua a me "1427" ma ka ʻaoʻao, a me ke daimana paha me ka hōʻailona me "10" a me "1428".
Ma kekahi pā i loko o nā mea i hoʻonoho ʻia me 10 pcs. ʻO nā pōpō. I kēlā me kēia pahu kīpē he 3 a 9 paha o ia mau papa .. ʻAi nā bli a he 14 mau ʻāpana pākahi. I loko o kahi pahu o nā papa like i hiki ke loaʻa i ʻelua a ʻehā paha.
ʻO 3 mau makahiki kahi e noho ai ke ola o ka lāʻau. No dapagliflozin, ʻo ke kumukūʻai ma ke kaulahao kūʻai aku mai 2497 mau rubles.
ʻO ka mea hana nui o ka lāʻau dapagliflozin. Ma kahi o ia mea, ua hoʻohana ʻia nā hoʻopihapiha: cellulose, lactose maloʻo, silicon dioxide, crospovidone, magnesium stearate.
Lapaʻau
ʻO ka papa hana, dapagliflozin, he potent inhibitor (SGLT2) o ka sodium-depend type type 2 glucose transporter. Hōʻike ʻia i loko o nā aʻalolo, ʻaʻole ia i ʻike ʻia i kekahi mau mea kino a me nā ʻāpana (70 mau ʻano like me ka hoʻāʻo). ʻO SGLT2 ka mea nui e lawe ai i ka glucose reabsorption.
ʻAʻole kū kēia kaʻina me ka maʻi type 2, ke ʻano o ka hyperglycemia. Ma ka hoʻokaʻawale ʻana i ka hoʻoneʻe glucose, hoʻemi ʻia ka mea pale i kona reabsorption i loko o nā pūlū a ua hoʻokuʻu ʻia. Ma muli o kēia hopena, hōʻemi ka meli - ma ka ʻōpū ʻole a ma hope o ka hoʻomaʻamaʻa ʻana, hoʻomaikaʻi hou nā waiwai o ka hemoglobin glycosylated.
ʻO ka nui o nā glucose i lawe ʻia e pili ana i ka nui o ke kōpaʻa a me ka helu filtration glomerular rate. ʻAʻole pili ka mea pale kino i ka hana kūlohelohe o kona ake ponoʻī. Kūʻokoʻa kona mau hana i ka hana o ka insulin a me ka pae o ka ʻike ʻana iā ia.
ʻO nā hoʻokolohua me ka lāʻau lapaʻau ua hōʻoia i ka holomua o ka moku'āina o nā b-cell i kuleana no ka synthesis o ka hoʻomau i ka insulin.
Hoʻopau ke kulu ma kēia ala hoʻonāukiuki i ka hoʻohana ʻana i kaloli a me ka nalowale o ka momona nui, he liʻiliʻi diuretic ka hopena.
ʻAʻole hopena ka lāʻau lapaʻau i nā mea hoʻohele glucose hou e hoʻohele ʻia ma ke kino. Ke SGLT2, hōʻike ʻo dapagliflozin i kahi koho o 1,400 mau manawa i ʻoi aku i kona SGLT1, nona ke kuleana o ka hoʻopio o ka glucose i loko o ka ʻōpū.
Lapaʻau lāʻau
Me ka hoʻohana ʻana o Forsigi e ka maʻi maʻi maʻi a me nā poʻe ola olakino ma ka hoʻokolohua, ua ʻike ʻia kahi hoʻonui o ka hopena glucosuric. Ma nā helu kikoʻī, e like me kēia: no 12 mau hebedoma, lawe aku ka maʻi maʻi i ka lāʻau ma ka 10 gm / lā.
Hoʻopili pū ʻia ka lāʻau Dapagliflozin e ka diuresis osmotic. Me ka hoʻoponopono o ka lāʻau i wehewehe ʻia, ua loli ʻole ka hopena diuric no 12 mau hebedoma a lilo i 375 ml / lā. Ua ukali ʻia ke kaʻina hana me ka leʻo o ka liʻiliʻi o ka sodium, akā ʻaʻole ia e pili i kēia ʻike i kona ʻike i loko o ke koko.
Lapaʻau lāʻau
- Kapehu. Me ka hoʻohana waha, ua maloʻi ʻia ka lāʻau i ka digestive tract a aneane 100%. ʻAʻole pili ke komo i ka meaʻai i ka hopena o ka hoʻopili ʻana. ʻIke ʻia ka kiʻekiʻe o ka hōʻemi ʻana i ka lāʻau ma ke koko ma hope o 2 mau hola i ka wā i hoʻohana ʻia ma ka ʻōpū ʻole. ʻOi aku ka kiʻekiʻe o ka lāʻau o ka lāʻau lapaʻau, ʻoi aku ka kiʻekiʻe o ke kaila o ka plasma i kekahi mau manawa. Ma kahi kanu o 10 mg / lā. ʻo ka bioavailability kūpono piha ma kahi o 78%. I nā poʻe ola olakino ma ka hoʻokolohua, ʻaʻohe ʻai nui i ka ʻai i ka pharmacokinetics o ka lāʻau.
- Kahele. Hoʻopaʻa ka lāʻau lapaʻau i nā ʻōnaehana koko ma ka awelika o 91%. Me nā maʻi e koi ʻia, no ka laʻana, ka hemahema o ka renal, e hoʻomau ʻia ana kēia hōʻailona.
- Hāpai. ʻO TЅ i ka poʻe olakino he mau hola 12.0 ma hope o hoʻokahi pakahi no kahi papa pāpaona he 10 mg. Hoʻololi ʻia ka Dapagliflozin i loko o ka metabolite inert o dapagliflozin-3-O-glucuronide, ʻaʻohe ona hopena lapaʻau.
- ʻAno hānau. Ke puka pū nei ka lāʻau lapaʻau me nā metabolites me ke kōkua o nā keiki i kāna hana kumu. Ma kahi o 75% e hoʻopio ʻia i loko o ka pāʻai, ke koena ma o ka ʻōpū. Ma kahi o 15% o dapagliflozin e puka mai i ka mana kūpono.
Nā hihia kūikawā
ʻO ka nui o ka glucose i hoʻonā ʻia e nā paleha ma nā pilikia o kā lākou hana. Me nā ola olakino, ʻo kēia hōʻailona he 85 g, me kahi ʻano māmā - 52 g, me kahi awelika - 18 g, i nā pilikia koʻikoʻi - 11 g o glucose. Hoʻopili ka mea pale i nā protein i ka hopena like ma ka maʻi maʻi a me ka hui pū. ʻAʻole i aʻo ʻia nā hopena o ka hemodialysis i nā hopena hopena.
I nā hemahema a me ka maʻalahi o ka pīpī pēpē o ka pōpō, hoʻolaʻa ʻia ka pharmacokinetics o Cmax a me AUC ma o 12% a me 36%. ʻAʻole hewa kēlā hewa hewa i kahi mea lapaʻau, no laila, ʻaʻohe mea e pono ai e hōʻemi i ka nui o kēia ʻāpana o ka maʻi maʻi. Ma ke ʻano ikaika, hoʻohālikelike kēia mau kuhikuhi i ka 40% a me 67%.
I ka wā pākeke, ʻaʻole i mālama ʻia ka hoʻololi nui loa i ka hoʻolaha ʻana i ka lāʻau (inā ʻaʻohe kumu ʻē aʻe e hoʻomāinoino ana i ke kiʻi lāʻau lapaʻau). ʻO ka nāwaliwali nā kauā, ʻoi aku ka kiʻekiʻe o ka loaʻa ʻana o dapagliflozin.
I kahi kūlana paʻa, ma nā mea maʻi me ka diabetes type 2, ʻoi aku ka nui o ka Cmax a me AUC ma mua o nā kāne maʻi i ka 22%.
ʻO nā ʻokoʻa i nā hopena i hilinaʻi ʻia no ka lāhui o ʻEulopa, Negroid a i ʻole Mongoloid lāhui i loaʻa.
Me ka nui o ke kaupaona ʻana, ʻoi aku ka liʻiliʻi o nā hōʻailona o ka hopena o ka lāʻau lapaʻau, akā, ʻaʻole i ʻike nui ʻia nā hala, e koi ana i ka hoʻoponopono ʻia.
ʻO wai e pono no ka forsyga
Ke hoʻololi nei i kahi nohona (meaʻaiʻaiʻai haʻahaʻa, lawa ka hoʻoulu ʻana), i mea e hoʻoponopono ai i ka glycemia, hoʻohana ka lāʻau lapaʻau:
- Me ka monotherapy;
- Kūlike me ka metformin (inā ʻaʻole lawa ka hopena hypoglycemic);
- I ka paepae i hoʻonohonoho kū ʻia.
Nā Hoʻohui
- Hoʻonui kiʻekiʻe i nā mea o nā pulu;
- ʻAno maʻi type 1;
- Ketoacidosis;
- Maʻi nui o ka renal;
- Ka hoʻomauʻana i ka genetic i ka glucose a me ka lactase;
- ʻLelo a me ka lactation;
- ʻO nā keiki a me ʻōpio (ʻaʻohe data hilinaʻi);
- Ma hope o ka maʻi maʻi, i hele pū ʻia me ke koko;
- ʻO Senile makahiki (mai 75 mau makahiki) - e like me ka lāʻau mua.
Nā papahana hana maʻamau
ʻO ke algorithm no ka mālamaʻana o dapagliflozin i ke kauka, akā ke kuhikuhi ʻia nei nā ʻōnaehana maʻamau i nā ʻōlelo kuhikuhi no ka hoʻohana.
- Monotherapy. ʻAʻole paʻa ke kaʻaila i ka meaʻai, ʻo ka maʻamau o kēlā me kēia lā he 10 mg i ka manawa.
- ʻO ka hoʻolālā holoʻokoʻa. I ka hui me metformin - 10 mg / lā.
- ʻO ka papa hana mua. Ma kahi hoʻohālike o Metformin 500 mg / lā. Lawe ka Forsigu i 1 pā. (10g) i kēlā me kēia lā. Inā ʻaʻole i loaʻa ka hopena i makemake ʻia, e hoʻonui i ka hapa o Metformin.
- Me nā maʻi hepatic. ʻO ka maʻi maʻi me ka maʻi haʻahaʻa a me ka leʻaleʻa e pono ai i ka hoʻoponopono ʻana i ka wai. Ma ke ʻano ikaika, hoʻomaka lākou me 5 g / lā. Me ke ʻano maʻamau o ke kino, hiki ke hoʻonui ʻia ke ʻano i ka 10 mg / lā.
- Me nā mea hoʻohālikelike renal. I ke ʻano paʻakikī a paʻakikī, ʻaʻole i kuhikuhi ʻia ʻo Forsig (i ka wā hana cleince clearance (CC) <60 ml / min.);
- Mamua. I ka wā pākeke, ke koho ʻana i kahi regimen lapaʻau, alakaʻi ʻia lākou i ka nui o ke koko a me ke ʻano o nā maʻi.
Nā hopena hopena
ʻO nā haʻawina palekana o ka lāʻau lapaʻau e komo ai i nā mea hana 1,193 i hāʻawi ʻia iā Fortigu ma 10 mg / lā, a me 1393 nā poʻe i lawe i kahi pletebo. ʻO ka pinepine o nā hopena kūpono ʻole like me ka like.
I waena o nā hopena kūlike ʻole e koi ai i ka hoʻokuʻu ʻana o nā ʻoihana, ua ʻike ʻia nā mea penei:
- Hoʻonui i QC - 0.4%;
- Nā maʻi e pili ana i ka ʻōnaehana genitourinary - 0.3%;
- ʻO nā hōʻeha ma ka ʻili - 0.2%;
- ʻO nā maʻi pāpaʻi;
- Nā kipi o ka hoʻonohonoho paʻa - 0.2%.
Hōʻike ʻia nā kiko o nā noi ma ka papa ʻaina.
Nā Kūlana loiloi:
- Pā pinepine pinepine -> 0.1;
- Iā manawa -> 0,01, <0.1;
- Ke ʻano -> 0.001, <0.01.
ʻAno o nā ʻōnaehana a me nā ʻāpana | Pinepine pinepine | Pinepine | Ihiau |
Nā maʻi a me nā infestations | Vulvovaginitis, balanitis | Wehewehe genital | |
ʻO ka huʻihuʻi me ka meaʻaiʻaiʻai | Hypoglycemia (me ka hoʻohui ʻana o nā hana) | Kahuna | |
Nā maʻi Gastrointestinal | Nā huakaʻi hoʻi | ||
ʻIli kūloko | ʻOhua | ||
ʻŌnaehana musculoskeletal | ʻEha i ka pōpilikia | ||
ʻŌnaehana Genitourinary | Dysuria | Nocturia | |
ʻIkepili haipule | ʻO ka Dyslipidemia, hematocrit kiʻekiʻe | ʻO ka ulu o QC a me urea i ke koko |
Nā Hōʻike Manaʻo Dapagliflozin
Wahi a kahi noiʻi o nā malihini i nā kumuwaiwai papaʻa, ʻo ka hapa nui o nā maʻi maʻi maʻi ʻaʻohe huakaʻi, ua māʻona lākou me nā hopena lapaʻau. Nui ka mea i hoʻopau ʻia e ke kumukūʻai o ka pā, akā ke manaʻo pilikino e pili ana i nā makahiki, nā maʻi concomitant, ka nui o ka lehulehu i hiki ke lilo i alakaʻi no ka hoʻoholo ʻana ma ke koho ʻana iā Forsigi.
Hiki i kahi papa pilikino ke hana aku e ke kauka wale nō, e kāʻili ʻo ia i nā analogues no dapagliflozin (Jardins, Invokuan) inā ʻaʻole i lawa ka paʻakikī.
Ma ke wikiō - nā hiʻohiʻona o Dapagliflozin i kahi ʻano lapaʻau hou.