Tus kab mob no cuam tshuam txog 9% ntawm cov neeg hauv ntiaj teb. Cov chaw lag luam kws tshuaj thiab kev kho mob ntawm cov thawj coj hauv ntiaj teb tau nqis peev nyiaj ntau lab daus las, thiab cov ntshav qab zib tau sib kis ib puag ncig ntawm lub ntiaj teb, ua rau cov yau dua, ua rau muaj kev ntxhov siab.
Kev mob kis tau rau ntawm lub teev uas tsis tau xav tias: los ntawm 2020, ib nrab lab tus neeg mob uas muaj ntshav qab zib hom 2 tau kwv yees, thiab cov kws kho mob tsis tau kawm paub txog kev tswj hwm tus kabmob no tau li cas.
Yog tias muaj ntshav qab zib hom 1, uas cuam tshuam tsawg dua 10% ntawm txhua tus neeg mob ntshav qab zib, txhua yam yog yooj yim: txo qhov hnoos ntshav qabzib hauv cov ntshav los ntawm kev txhaj tshuaj insulin (tsis muaj dab tsi ntxiv tau muab rau ntawd) thiab txhua yam yuav zoo (hnub no, rau cov neeg mob no, lawv kuj tau tsim cov qog cuav) ), tom qab ntawd nrog hom ntshav qab zib hom 2, thev naus laus zis siab tsis ua haujlwm.
Los ntawm cov piv txwv, rau hom ntshav qab zib hom 2, piam thaj tau tshaj tawm tias yog tus yeeb ncuab tseem ceeb, txhawm rau ua lag luam nrog cov tshuaj txo cov ntshav qab zibCov. Kev kho mob ntshav qab zib nrog kev pab los ntawm kev ua kom pyramids yog qhov muaj zog heev, thaum lwm cov tshuaj tau siv rau ib hom tshuaj, tom qab ntawv thib peb cov tshuaj ntxiv rau hauv cov txheej txheem no kom txog thaum tig los ntawm insulin.
Tau 20 lub xyoo dhau los, cov kws kho mob tau tawm tsam nrog kev noj qab zib, tab sis cov txiaj ntsig yog qis dua xoom, vim tias cov kev mob tshwm sim thiab cov teeb meem ntawm cov tshuaj feem ntau tshaj li lawv qhov kev ua tau zoo, tshwj xeeb yog tias koj tsis ua raws li cov tshuaj noj, tsis txhob coj mus rau cov tshuaj uas siv rau thiab leej twg tsis yog.
Ib ntawm cov phiajcim kabmob no yog lub plawv thiab cov hlab ntshav. Nws yog qhov tseeb hais tias kev kho mob ntshav qab zib ntau dhau ua rau lub txiaj ntsig thiab ua rau vascular tuag. Qab Zib tsuas yog cov cim ntawm hom ntshav qab zib hom 2; tus kab mob yog ua raws li mob metabolic.
Cov tshuaj ntawm lub cim tshiab Onglisa, tsim los ntawm cov kws tshawb fawb British thiab Italian, tsis tsuas yog muaj antidiabetic, tab sis kuj muaj peev xwm cardioprotective. Cov tshuaj ntawm cov incretin koob, uas suav nrog Onglisa, yog qhov kev hloov kho tshiab tshaj plaws hauv thaj chaw ntawm kev mob ntshav qab zib. Lawv ua hauj lwm kom txo tau qhov qab los noj mov thiab kom poob ceeb thawj - ib qho ntawm cov laj thawj tseem ceeb ntawm kev txhim kho mob ntshav qab zib hom 2.
Tsis tas li ntawd, muaj ntau zuj zus ntxiv tsis ua rau kev mob ntshav siab, pab txo ntshav siab, thiab tiv thaiv cov leeg hlwb. Tus nqi siab thiab tsis muaj kev kuaj mob vim lub sijhawm luv luv ntawm kev siv tshuaj yeeb tuaj yeem raug ntaus nqi rau qhov tsis zoo ntawm Onglisa, tab sis qhov no tseem yog lub sijhawm.
Kev Sau ua ke thiab daim ntawv ntawm kev tso tawm
Txhua ntsiav tshuaj Onglisa, cov duab uas tau nthuav tawm hauv ntu no, muaj 2.5 lossis 5 mg ntawm saxagliptin hydrochloride hauv lub plhaub. Cov mis tau ntxiv nrog cov ntsaws: cellulose, lactose monohydrate, croscarmellose sodium, magnesium stearate thiab Opadrai dyes (dawb, daj thiab xiav rau 2.5 mg ntsiav tshuaj thiab dawb, paj yeeb thiab xiav rau ntau npaum li 5 mg).
Cov tshuaj tuaj yeem tuaj yeem paub tau los ntawm cov duab (cov ntsiav tshuaj biconvex nrog lub ntsej muag daj thiab kos cim 2.5 / 4214 thiab pinkish nrog engraving 5/4215). Cov ntawv luam yuav tau ntaus thwj rau ntawm ib sab nrog tus cwj mem xiav.
Koj tuaj yeem yuav cov tshuaj kws kho mob ua kom yuav. Rau Ongliz ntsiav tshuaj, tus nqi tsis yog los ntawm qeb pob nyiaj siv: rau 30 pcs. 5 mg hauv Moscow koj yuav tsum them 1700 rubles. Cov neeg tsim khoom tau txiav txim siab lub neej txee ntawm cov tshuaj nyob rau hauv 3 xyoos. Cov kev mob cia ntawm cov tshuaj yog tus qauv.
Cov yam ntxwv ntawm Pharmacological
Lub ntsiab tseem ceeb ntawm Onglisa yog saxagliptin. Hauv ib hnub tom qab nkag rau hauv txoj hnyuv, nws cuam tshuam kev ua si ntawm DPP-4 peptide. Thaum muaj kev sib cuag nrog cov piam thaj, qhov kev tshem ntawm cov enzyme hloov zuj zus (2-3 zaug) txhim kho kev zais ntawm glucagon-zoo li peptide-1 (GLP-1) thiab piam thaj-insulinotropic polypeptide (HIP).
Nyob rau tib lub sijhawm, qib ntawm glucagon hauv b cell poob, kev ua haujlwm ntawm b hlwb lub luag haujlwm rau kev tsim cov tshuaj endogenous insulin nce. Yog li ntawd, qhov ntsuas ntawm kev yoo mov thiab postprandial glycemia yog txo qis.
Qhov kev nyab xeeb thiab ua haujlwm ntawm cov tshuaj tau kawm hauv 6 qhov kev sim, hauv 4148 cov neeg ua haujlwm pab dawb uas muaj hom 2 tau koom nrog. Txhua tus neeg tuaj koom qhia tau qhov zoo ntawm glycated hemoglobin, qab zib tsis muaj suab thaj thiab glycemia tom qab kev ua kom tsis pub muaj cov tshuaj carbohydrate. Cov neeg koom nrog qhov uas tsis ua tiav 100% glycemic tswj tau muab tshuaj ntxiv - thiazolidinediones, metformin, glibenclamide.
Cov neeg mob noj tshuaj ntxiv tiv thaiv kab mob tau pom zoo sib xws. Qhov hnyav ntawm txhua tus neeg tuaj koom rau hauv cov kev sim kawm tseem nyob ruaj khov.
Thaum Saxagliptin tshuaj
Tus mob ntshav qab zib nrog hom 2 Tus kab mob Ongliz tau sau tseg:
- Raws li monotherapy, ua ke nrog kev ua neej hloov kho;
- Hauv kev sib xyaw ua ke, nrog ntxiv ntawm cov kev xaiv dhau los nrog metformin, yog tias monotherapy tsis muab kev tswj tiav ntawm glycemia;
- Ua ke nrog cov peev txheej ntawm sulfanylurea series thiab thiazolidinediones, yog tias kev sib xyaw dhau los siv tsis tau txaus.
Rau leej twg Onglisa yog contraindicated
Txij li thaum saxagliptin yog qhov muaj lub zog loj uas ua rau kom muaj kev tiv thaiv zoo ntawm b cell thiab txwv tsis pub ua haujlwm ntawm b cell, nws tuaj yeem siv nrog qee qhov kev txwv, tshwj xeeb, cov tshuaj tsis qhia:
- Cov poj niam cev xeeb tub thiab lactating;
- Hauv thaum yau;
- Tus mob ntshav qab zib nrog hom 1;
- Nrog rau cov tshuaj insulin-tiv thaiv cov kab mob ntshav qab zib hom 2;
- Cuam tshuam los ntawm cov kab mob ntshav qab zib ketoacidosis;
- Yog tias tus neeg mob tsis mob siab rau galactose;
- Nrog hypersensitivity rau cov khoom xyaw ntawm cov mis.
Thaum xaiv cov txheej txheem kho mob, tus kws kho mob tsom tsis tau tsuas yog nyob rau ntawm cov npe contraindications, tab sis kuj ntawm kev sib raug zoo nrog saxagliptin ntawm cov tshuaj uas cov ntshav qab zib siv los ntawm cov kab mob concomitant. Yog li, txhua cov tshuaj uas cov mob ntshav qab zib noj nyob rau hauv parallel, tus kws kho mob yuav tsum tau qhia kom raws sijhawm.
Kev pom zoo rau kev siv
Tus kws kho mob txiav txim siab ntau npaum li cas ntawm cov tshuaj ib leeg, noj mus rau hauv qhov txiaj ntsig ntawm kev tshuaj xyuas, hnub nyoog, theem ntawm tus kab mob, cov tshuaj tiv thaiv ntawm lub cev. Txog Onglisa, cov lus qhia rau kev siv pom zoo kom noj cov ntsiav tshuaj ntawm qhov ncauj, tsis tas khi rau lub sijhawm noj mov. Tus txheej txheem pib siv tshuaj yog 5 mg / hnub.
Thaum pib ntawm cov chav kawm ntawm kev kho, tus qauv coj ua zoo li qhov no:
- Saksagliptin - 5 mg / hnub .;
- Metformin - 500 mg / hnub.
Tom qab 10-15 hnub, kev kho mob ntawm cov tshuaj uas raug xaiv tau raug ntsuas thiab, yog tias tsim nyog, cov koob tshuaj metformin raug hloov kho, ua raws li tus qauv ntawm Onglisa tsis hloov pauv.
Yog tias lub sijhawm thaum noj cov tshuaj ploj, nws raug coj mus nyob rau ib lub sijhawm ib zaug thaum thawj zaug. Koj tsis tuaj yeem muab ob npaug rau qhov ua tau, vim tias lub cev xav tau sijhawm los ua nws.
Yog tias muaj keeb kwm muaj mob raum, tsis tas yuav muaj koob tshuaj feem tsawg. Nrog cov ntawv sau rau mob hnyav thiab mob hnyav, cov cai yog txo los ntawm 2 zaug - 2.5 mg / hnub. (ib-zaug).
Thaum lub caij hemodialysis, ib lub ntsiav tshuaj yuav qaug cawv ntawm tus txheej txheem tom qab. Cov nyhuv ntawm Onglisa rau cov neeg mob uas mob peritoneal lim ntshav tsis tau kawm. Ua ntej sau ntawv muab tshuaj thiab thoob plaws chav kawm, nws yog qhov yuav tsum tau ntsuas qee qhov kev ua haujlwm ntawm lub raum.
Nrog rau cov kab mob siab (hepatic pathologies), cov tshuaj yog tawm hauv cov tshuaj 5 mg / hnub. Rau cov ntshav qab zib ntawm lub hnub nyoog loj, tsis tas yuav tsum tau txhaj ib feem kaum, tab sis kev mob raum yuav tsum txiav txim siab.
Cov koob tshuaj ntawm incretins yog halved nyob rau hauv txoj kev kho mob nrog inhibitors:
- Atazanavir;
- Ketoconazole;
- Igraconazole;
- Nelfinavir;
- Clarithromycin;
- Ritonavir;
- Saquinavir;
- Indinavir;
- Telithromycin.
Tsis muaj ntaub ntawv raug cai ntawm kev paub meej ntawm kev siv tshuaj rau cov poj niam cev xeeb tub thiab menyuam yaus hnub nyoog qis dua 18 xyoo, yog li ntawd cov tshuaj analogues raug xaiv rau hom mob ntshav qab zib no.
Undesirable zoo thiab overdose
Cov tshuaj ntawm cov pab pawg incretin ntawm cov tub ntxhais tiam tam sim no yog ib qho kev nyab xeeb tshaj plaws. Nrog rau txhua qhov kev pom zoo ntawm tus kws kho mob, Ongliz muaj kev zam rau txhua tus neeg mob ntshav qab zib.
Hauv qee kis, cov hauv qab no raug sau tseg:
- Dyspeptic cuam tshuam;
- Mob taub hau;
- Kev mob caj dab
- Kab mob ua pa;
- Urogenital kab mob ntawm qhov kis tau.
Yog tias ib qho ntawm cov tsos mob tshwm sim lossis lwm yam kev txawv txav tsis zoo tshwm sim, koj yuav tsum tsis txhob siv cov tshuaj thiab sab laj nrog koj tus kws kho mob.
Rau cov hom phiaj kev tshawb fawb, cov tshuaj tau muab rau cov neeg tuaj yeem pab hauv cov koob tshuaj ntau dua qhov suav txog 80 zaug. Cov cim ntawm intoxication tsis tsau. Tshaj saxagliptin tuaj yeem raug tshem tawm uas siv hemodialysis.
Cov lus pom zoo ntxiv
Saxagliptin tsis raug sau cia hauv txoj cai tswjfwm 3 zaug hauv kev txhaj tshuaj insulin yog ua ke nrog metformin thiab thiazolidinediones, vim tias qhov cuam tshuam ntawm kev cuam tshuam no tsis tau kawm. Kev tswj raum yog nqa tawm ntawm txhua theem ntawm kev kho mob nrog Onglisa, tab sis nrog rau daim ntawv me me, kev noj tshuaj tsis hloov, hauv lwm yam nws yog halved.
Saxagliptin nrog kev hwm txog hypoglycemic muaj kev nyab xeeb kiag li, tab sis hauv kev sib xyaw nrog sulfonylurea tshuaj tuaj yeem ua rau mob hypoglycemic. Yog li no, nrog txoj kev kho mob nyuaj, kev them ib feem kaum ntawm cov koob txhaj tshuaj ntawm qhov kawg hauv qhov kev taw qhia ntawm qhov txo qis yog qhov yuav tsum ua.
Thaum muaj kev tsis txaus ntseeg rau cov tshuaj ntawm cov yeeb yaj kiab ntxiv - DPP-4 inhibitors, Ongliza kuj tseem tsis yog kws kho mob, vim qee kis muaj kev tsis haum tshuaj tau sau los ntawm cov tawv nqaij zoo ib yam rau tus mob anaphylactic ceeb thiab angioedema, xav tau kev tshem tawm tshuaj tam sim ntawd.
Txij li thaum cov tshuaj muaj lactose, nws tsis yog kws kho mob rau cov neeg mob ntshav qab zib nrog ib tus neeg kam, lactose tsis txaus, qabzib-galactose malabsorption.
Hauv kev siv tshuaj xyuas cov neeg mob ntshav qab zib tom qab kho mob Onglisa, tau muaj tus mob ntawm kev loj hlob ntawm tus mob leeg qhuav. Thaum sau tshuaj ib chav ntawm saxagliptin, tus neeg mob yuav tsum paub txog cov yam ntxwv ntawm tus yam ntxwv: qhov mob tas mus li thiab mob hnyav ntawm lub epigastrium.
Yog tias muaj qhov tsis xis nyob hauv plab, koj yuav tsum tsum tsis txhob noj tshuaj thiab qhia qhov mob siab rau koj tus kws kho mob. Qhov kev tshwm sim yog ib ntus thiab thim rov qab, hla lawv tus kheej tom qab tsis txiav yeeb tshuaj.
Hauv raum tsis ua hauj lwm hauv kev tsim mob hnyav thiab mob hnyav, ib qho tshuaj feem pua ib zaug. Hauv cov mob hnyav, Onglizu siv nrog ceev faj; ntawm lub davhlau ya nyob twg theem, thaum tus neeg mob tsis tuaj yeem tsis muaj hemodialysis, tsis txhob siv txhua. Kev tswj hwm kev mob ntawm ob lub raum hauv cov xwm txheej zoo li no tau ua ua ntej pib kev pib kho thiab txhua txhua rau lub hlis nrog kev siv Ogliza tas li.
Cov kev paub hauv kev kho tus mob ntshav qab zib rau cov laus (txij li 75 xyoo) tsis txaus, yog li no, cov neeg mob no xav tau kev saib xyuas ntau ntxiv.
Cov txiaj ntsig ntawm cawv ntawm Onglisa ntawm kev muaj peev xwm tswj hwm kev thauj khoom lossis cov txheej txheem nyuaj tsis tau tshaj tawm, yog li, cov neeg mob ntshav qab zib yuav tsum noj cov tshuaj nrog ceev faj, tshwj xeeb tshaj yog vim kiv taub hau tshwm sim ntawm cov kev mob tshwm sim. Kev saib xyuas tshwj xeeb hauv cov xwm txheej zoo li no yuav tsum muaj rau cov neeg mob siv Onglisa hauv kev kho mob nyuaj, vim tias qee cov tshuaj tiv thaiv kab mob tuaj yeem ua rau mob ntshav qab zib tsis txaus.
Cov kev paub ntawm kev siv cov tshuaj rau cov teeb meem plawv plawv pom tias cov tshuaj normalizes plawv. Hauv tebchaws Amelikas, txawm tias muaj kev txwv ntau tshaj ntawm thaj chaw qab zib, tus kws kho mob tau sau ntawv rau cov neeg mob ntshav qab zib nrog arrhythmia Onglizu txhawm rau txhim kho glycemic indices thiab rov qab ua lub plawv dhia.
Cov Tshuaj Yeeb Yeeb Tshuaj Tiv Thaiv nrog Onglisa thiab analogues
Ua raws li cov ntaub ntawv ntawm kev tshawb fawb, cov txiaj ntsig ntawm kev sib cuam tshuam ntawm Onglisa nrog lwm cov khoom siv thaum lub sijhawm ua cov txheej txheem kho mob tsis yog suav tias yog qhov tseem ceeb hauv chaw kho mob.
Qhov tshwm sim ntawm kev ua tau zoo ntawm kev kho rau kev siv dej cawv, luam yeeb, ntau yam zaub mov noj, tshuaj homeopathic tsis tau tsim.
Hauv cov ntawv sau ua ke, los ntawm cov xov tooj incretin, nrog rau Onglisa, Galvus thiab Januvia raug tso tawm, hauv cov xaum qhuav - Baetu thiab Viktoza.
Kws tshaj lij thiab cov neeg siv cov kev ntaus nqi
Ntawm cov ncauj lus thematic txog cov tshuaj Ongliza, cov kev txheeb xyuas zoo kawg nkaus, tej zaum qhov tsis zoo tsuas yog tus nqi sib raug rau nws cov European zoo.
Hmoov tsis zoo, cov kab mob, xws li lub hnub nyoog laus, yog qhov tsis hloov thiab tsis tuaj yeem, vim tias kev noj qab haus huv, raws li koj paub, tsis tuaj yeem yuav, thiab hom mob ntshav qab zib hom 2 tsis yog lam tau lam hu ua ib daim pib.
Tab sis tus txiav ua ntshav qab zib nrog tus mob ntshav qab zib hom 2 tsis tau mob siab rau, nws muaj qhov tshwj tseg rau nws rov qab ua nws txoj haujlwm, thiab tso nws xaus ua qhov tsis muaj zog (los ntawm qhov pom ntawm insulin secretion) hloov ua ntej.
Ua ntej tso Ongliza rau hauv kev ua lag luam, cov neeg tsim khoom siv nyiaj ntau lab nyiaj tsis yog los ua pov thawj qhov tsis muaj qhov cuam tshuam tsis zoo, tab sis tseem lees tias nws cov hauj lwm zoo. Yog tias cov tshuaj tsuas pab kho cov teeb meem ntev mus txog 10-20 xyoo, txawm hais tias lub sijhawm no puv ntoob (tsis muaj mob plawv, tsis nco qab, mob qog ntshav, dig muag, tsis muaj zog, mob raum tsis ua haujlwm), koj yuav tsum mob siab rau nws.
Cov lus hais txog qhov ua tau ntawm Onglisa thiab cov txiaj ntsig ntawm cov tshuaj mob ntshav qab zib rau kev noj qab haus huv ntawm endocrinologist Shmul Levit, lub taub hau. Lub koom haum ntawm Diabetology, saib cov yees duab:
