Diabetology yog ib thaj chaw muaj tshuaj kho nyob hauv tshuaj. Nyob rau hauv xyoo tas los no, ntau cov kev siv tshuaj tshiab tau tsim tawm uas pab txhawb kev tswj hwm cov ntshav qab zib hom 2. Qhov tshwm sim hauv kev vam meej ntawm lub xyoo caum dhau los no hu ua incretin mimetics, uas txo glycated hemoglobin los ntawm 1%Cov. Hauv qhov xwm txheej no, cov ntshav qab zib lub cev qhov hnyav tseem maj mam txo qis dua; cov tshuaj ntau ntxiv tsis ua rau muaj kev rau txim loj xws li mob ntshav qab zib.
Tag nrho cov yam ntxwv no (kev tsis haum xeeb ntawm lub cev qhov hnyav, tsis muaj qhov tsis zoo txaus ntshai, kev ua tau zoo ntxiv nrog rau tus nqi pheej yig) kuj tseem siv rau cov tshuaj tua kab mob tshuaj tua kab mob Metformin, uas tau ua tus coj txoj hauv kev kho mob hom 2 ntshav qab zib rau ib nrab xyoo.
Tshuaj tiv thaiv Asmeskas Combogliz Prolong ua ke zoo ntawm metformin thiab incretinomimetics, thiab daim ntawv ntev ntev muab kev yooj yim ntawm kev siv thiab kev nyab xeeb ntxiv.
Pharmacological cov yam ntxwv ntawm cov tshuaj
Combogliz Prolong yog kev sib xyaw ua ke ntawm saxagliptin thiab metformin, muab cov kws kho mob thiab cov ntshav qab zib nrog lub sijhawm tshiab los tswj lawv cov glycemic profile.
Saxagliptin
Saxagliptin yog ib tus neeg sawv cev ntawm cov tshuaj incretin. Cov hnyuv tsim tawm los ntawm cov hnyuv thaum carbohydrates nkag mus rau nws. Nws muaj 2 hom ntawm cov tshuaj hormones ntuj: GLP-1 (glucagon-zoo li peptide) thiab HIP (glucose-nyob insulinotropic polypeptide).
Nkag mus rau hauv cov ntshav, lawv 70% txhawb kev tsim tawm ntawm cov tshuaj insulin endogenous los ntawm the-hlwb lub luag haujlwm rau tus txheej txheem no.
Nyob rau hauv parallel, ncetins inhibit glucagon synthesis thiab inhibit qhov kev tso tawm ntawm cov ntsiab lus ntawm lub plab, tsim kom muaj kev ua haujlwm ntxiv.
Nws tau tsim tsa uas nyob rau hauv cov neeg mob ntshav qab zib nrog hom 2 tus kab mob, kev tsim cov tshuaj endogenous nce qis dua vim qhov tseeb tias cov tshuaj hormones tau yooj yim los ntawm cov enzyme DPP-4 (dipeptidyl peptidase). Cov agonists ntau dua inhibit cov kev ua ntawm DPP-4, thaum tswj kev ua haujlwm ntawm endogenous incretins. Khoom cua analogues ntawm GLP-1 tsis muaj qhov nkag siab zoo rau qhov kev txhoj puab heev enzyme.
Saxagliptin tsis tsuas yog ua kom ntev rau lub neej ntawm incretins, tab sis kuj tseem pab txhawb kev loj hlob ntawm lawv cov lej hauv lub cev kev xav (ntau kawg yog 2 zaug). Noj nce ntau ntxiv txo qhov ntsuas ntawm ob qho kev yoo mov thiab postprandial glycemia. Cov cwj pwm ntawm cov tshuaj muaj peev xwm tshem tawm cov kev mob hypoglycemic.
Metformin
Cov tshuaj antihyperglycemic metformin, tsuas yog tus sawv cev ntawm pawg loj loj, tsis cuam tshuam rau cov hlwb b, vim li ntawd, nws tsis txhawb cov tshuaj insulin thiab tsis ua haujlwm ntau dhau ntawm kev txiav tawm ntawm lub cev.
Nws tswj hwm qhov chaw txhawm ntawm glycemia los ntawm inhibiting kev tso tawm ntawm glycogen hauv daim siab los ntawm 30%. Metformin txwv qhov nqus ntawm cov kua nplaum nyob rau hauv txoj hnyuv, txhim kho qhov rhiab ntawm cell receptors rau lawv tus kheej insulin. Los ntawm kev nrawm rau kev thauj khoom ntawm cov piam thaj mus rau cov leeg nqaij, nws nce lub zog siv nyiaj rau qhov kev xav tau ntawm lub cev thiab txo cov nqi ntawm kev hloov pauv ntawm cov piam thaj tsis ua haujlwm rau cov rog.
Metformin nrog kev tso tawm hloov kho tau muaj qhov ntxiv ntxiv - qhov tsawg kawg ntawm kev phiv los ntawm txoj hnyuv, qhov hnyav hnyav. Kev nqus cov kua txiv ua kua, cov qog ua kom yaj sai, cov tshuaj ntsiav yws thiab ua kom tiav nrog gel. Ua tsaug rau qhov gel gel matrix no, cov tshuaj tso tawm kom ncaj thoob plaws ib hnub, muab cov xwm txheej rau qhov siab tshaj plaws.
Kev sib xyaw ntawm kev ua kom nce ntxiv nrog metformin tau raug lees paub los ntawm cov kws kho mob pom tias zoo rau txhua ntu ntawm kev tswj hom ntshav qab zib hom 2. Ntxiv rau qhov yooj yim ntawm kev tau txais thiab ua siab ntev rau cov neeg mob rau cov kev kho mob zoo li cas, cov qauv tseem ceeb yog kev ua haujlwm siab thiab kev nyab xeeb. Rau cov neeg mob ntshav qab zib, qhov no yog qhov kev xaiv zoo tshaj plaws, vim tias cov tshuaj tsis pab txhawb rau qhov hnyav, kev txhim kho ntawm cov hlab plawv tsis ua haujlwm, txiav, thiab mob oncology.
Tso daim ntawv thiab muaj pes tsawg leeg Kombiglyze ntev
Lub tuam txhab Asmeskas chaw muag tshuaj Bristol-Myers Squibb ua rau cov tshuaj tiv thaiv kab mob ua rau cov tshuaj pleev xim rau xim dawb nrog kev hloov kho lub peev xwm.
Ib qho tshuaj ntsiav muaj 500 lossis 1,000 mg ntawm cov tshuaj ua kom muaj sia ntawm Metformin thiab 2.5 lossis 5 mg ntawm Saxagliptin. Ntxiv nrog rau cov khoom xyaw tseem ceeb, muaj pes tsawg leeg ntxiv nrog cov ntsaws: magnesium stearate, sodium carmellose, hypromellose. Cov xim ntawm lub plhaub tuaj yeem yog xim daj, liab dawb lossis daj ntseg, nyob ntawm seb ntau npaum li cas. Cov tshuaj ntsiav tau ntim hauv txhuas ntawv ci blister hlwb. Ib lub thawv ntawv thawv yuav muaj 4-8 daim hlau.
Tso cov tshuaj uas kws kho mob sau tseg. Ntawm Combogliz Ntev lub sijhawm nyob ntawm seb ntau npaum li cas: 1000 mg + 5 mg (28 ntsiav tshuaj) - txog 3250 rubles .; 1000 mg + 2.5 mg (56 ntsiav tshuaj rau ib pob) - txog 3130 rubles.
Lub txee lub neej ntawm cov tshuaj yog tsis pub ntau tshaj 3 xyoos. Cov tshuaj uas tas sij hawm yuav tsum tau muab pov tseg. Cov tshuaj tsis tas yuav tshwj xeeb rau kev cia khoom.
Combogliz Prolong: cov lus qhia rau kev siv
Tus kws kho mob xaiv cov sij hawm ntawm kev tswj hwm thiab noj ntau npaum li cas, noj mus rau hauv tus lej ntsuas ntawm glucometer, kev noj qab haus huv thoob plaws, hnub nyoog ntawm cov ntshav qab zib, cov tshuaj tiv thaiv ib leeg rau cov ntsiav tshuaj. Feem ntau, cov kev qhia muab cov lus qhia ntawd.
Ib lub sij hawm ntev noj feem ntau noj 1 r. / Hnub. tib lub sijhawm.
Haus ib ntsiav tshuaj thaum sawv ntxov lossis yav tsaus ntuj, tsis muaj kev sib tsoo. Rau cov khoos phis tawm cov qauv tsim tawm, lub plhaub kev ntseeg siab yog qhov tshwj xeeb.
Qhov ntau npaum li cas yog ib tug neeg, raws li kev pib kho mob nws tuaj yeem yog 1 ntsiav tshuaj (500 mg ntawm metformin + 2.5 mg ntawm saxagliptin), yog tias ua tiav glycemic tswj tsis tuaj yeem ua tiav, qhov koob tshuaj tau nce rau 2 ntsiav tshuaj (1000 mg ntawm metformin + 5 mg ntawm saxagliptin).
Nrog rau kev siv tshuaj ib txhij rau kev kho mob ntawm cov kab mob uas pom tseeb, cov txiaj ntsig ntawm lawv cov kev cuam tshuam yuav tsum ua tib zoo xav txog. Hauv tshwj xeeb, nrog kev tswj hwm tib lub sijhawm ntawm cov tshuaj tiv thaiv kab mob CYP3A4 / 5 isoenzymes (Indinavir, Ketoconazole, Nefazodon, Itraconazole, Atazanavir), koob tshuaj tsawg kawg ntawm saxagliptin yog tshuaj - 2.5 mg.
Cov tshuaj kho raws li cov tshuaj metformin nrog lub caij nyoog ntev ntawm qhov tsis nyiam qhov cuam tshuam rau hauv daim ntawv ntawm dyspeptic tsis zoo yog ntau tsawg dua li analogues nrog kev tso tawm sai. Yog li tias lub cev yoog rau cov kev mob tshiab, nws yog qhov tsis mob kiag li rau txoj hnyuv, koob tshuaj titration yuav tsum tau nqa tawm maj, txhua 2 lub lis piam.
Txhua yam kev hloov pauv hauv lub neej yuav tsum raug suav nrog thaum kho qhov kev cai noj tshuaj, yog li nws yog ib qho tseem ceeb kom qhia tus kws kho mob txog lawv kom raws sijhawm.
Cov Lus Cim Kombiglyce Prolong
Rau Combogliz Prolong, ib qho analogue nrog tib cov khoom xyaw nquag yuav yog Comboglis XR, uas yog tsim hauv Ltalis thiab UK. Tus nqi ntawm ib qho analogue yog los ntawm 1650 rubles. (28 ntsiav tshuaj ntawm 1000 mg ntawm metformin thiab 2.5 mg ntawm saxagliptin).
Cov tshuaj sib xyaw ua ke ntawm Avandamet, Yanumet, Glimecomb, GalvusMet thiab Bagomet ntxiv muaj cov kev ua kom zoo nkauj zoo sib xws.
Sau tshuaj rau ntawm cov tshuaj raws li ib yam muaj xws li Glyformin Prolong, Glucofage, Metadiene, Sofamet, Diaformin Od, Ongliza, Matospanin, Metfogamma, Siofora.
Leej twg muaj tshuaj
Combogliz prolong tau tawm rau hom 2 mob ntshav qab zib kom normalize glycemic tswj ntxiv rau kev noj haus kom tsawg thiab ua kom lub cev muaj zog txaus, yog tias txoj kev hloov hauv lub neej tsis muab cov txiaj ntsig uas xav tau thiab kev sib xyaw ntawm saxagliptin nrog metformin yog qhov tsim nyog rau tus neeg mob.
Kev tsis raug thiab tus txheeb ze contraindications
Txawm hais tias cov tshuaj noj nrog qhov siab ntawm kev nyab xeeb, uas yog Combogliz Prolong, tsis yog rau kev siv tshuaj rau ib leeg rau ib leeg thiab kev mob siab rau qhov sib xyaw ntawm cov mis.
- Cov tshuaj tsis yog pom rau cov niam cev xeeb tub thiab lactating (lawv tau pauv mus rau insulin ib ntus), vim tias tsis muaj pov thawj txaus rau nws cov txiaj ntsig, lawv tsis raug sau tseg rau cov menyuam yaus.
- Cov tshuaj tsis haum rau cov neeg mob ntshav qab zib nrog hom 1.
- Hauv kev ua haujlwm ntawm lub raum, nrog rau cov xwm txheej uas ua rau lawv mob, cov tshuaj kuj tsis raug txwv.
- Tsis txhob siv cov tshuaj kho mob rau cov neeg mob pathologies uas ua rau oxygen oxygen tshaib plab ntawm cov ntaub so ntswg.
- Nrog ketoacidosis (mob ntshav qab zib) nrog lossis tsis nco qab, cov tshuaj yog tsis noj ib ntus.
- Cov tshuaj tua kab mob raug tso tseg thaum ua haujlwm, nrog raug mob hnyav, kub nyhiab. Kev kuaj mob xoo hluav taws xob nrog kab cim iodine uas muaj cov cim ntsuas hauv ntshav qab zib yuav ua rau lub raum puas tsuaj, yog li nws kuj hloov mus rau cov tshuaj insulin. Hauv tag nrho, kev kho mob insulin yog qhia rau 48 teev ua ntej thiab 48 teev tom qab cov txheej txheem, tshwj xeeb, nws txhua tus yog nyob ntawm qhov mob ntawm ob lub raum thiab kev noj qab nyob zoo ntawm tus neeg mob.
- Lub siab pathologies, lactic acidosis thiab cawv quav cawv kuj yog nyob rau hauv daim ntawv teev npe ntawm contraindications. Koj tsis tuaj yeem hais kom yuav cov tshuaj rau cov neeg mob uas mob caj ces galactose intolerance.
Kev saib xyuas tshwj xeeb yuav tsum tau them rau cov mob ntshav qab zib ntawm lub hnub nyoog laus, tshwj xeeb tshaj yog nrog kev noj zaub mov tsis txaus, mob rau leeg thiab tsis ua haujlwm txaus hauv lub cev uas tuaj yeem ua rau mob ntshav qab zib.
Muaj peev xwm tsis xav txog kev cuam tshuam thiab overdose
Saksagliptin nrog kev sib txawv ntawm qhov tshwm sim muaj peev xwm ua rau muaj mob:
- Kev mob pob txha
- Cov neeg phais ib ce
- Mob plab;
- Ntuav;
- Mob txeeb zig;
- Kev tsis txaus siab ntawm cov lus sib dhos ntawm txoj hnyuv;
- Thrombocytopenia;
- Nasopharyngitis;
- Kev Hypoglycemia;
- Mob plab zom mov;
- O rau lub ntsej muag;
- Kev mob caj dab
- Urticaria.
Cov kev tshawb fawb hauv lub tsev sim pom tau txo qis ntawm qhov nqus ntawm cov vitamin B12 nrog rau kev siv lub sijhawm ntev ntawm cov tshuaj, nrog rau kev txo qis ntawm cov lymphocytes. Cov mob ntawm kev noj ntau tshaj yog ib leeg, ntau zaus tshwm sim nrog kev siv saxagliptin ntev ntev. Cov tshuaj tsis ua rau qaug cawv, nrog ib qho dhau ntawm cov tshuaj, hemodialysis zoo. Nyob rau hauv parallel, kev tshwm sim kev kho mob yog ua.
Kev noj tshuaj ntau tshaj plaws ntawm metformin yog qhov ntau, qhov txaus ntshai tshaj plaws yog lactic acidosis.Cov. Koj tuaj yeem paub tus mob los ntawm cov cim hauv qab no:
- Puas;
- Ua tsis taus pa;
- Mob plab;
- Tsawg cov ntshav siab;
- Kev Ntshav Siab;
- Mob nqaij ntshiv;
- Lub plawv tuaj kev ntxhov siab.
Nyob rau hauv qhov teeb meem nyuaj, hnov tsis nco qab, tsaus muag, hnov ntsej muag thiab coma tshwm sim. Tus neeg raug tsim txom xav tau kev mus pw hauv tsev kho mob sai, yam tsis muaj kev kho mob txaus, nws tuaj yeem tuag. Kev siv ntau tshaj metformin tseem raug tshem tawm los ntawm hemodialysis, nws yog ib qho tseem ceeb uas yuav tsum xav txog tias kev tshem tawm creatinine ncav cuag 170 ml / min.
Qhov ntau dua raws li cov ntshav qab zib ua tau raws li txhua tus kws kho mob pom zoo, qhov tsawg dua kev pheej hmoo ntawm kev mob nyhav. Yog hais tias siv sijhawm ntev los ntawm Combogliz, nws tsis yog qhov nyuaj ua raws li lub sijhawm teev tseg ntawm kev noj tshuaj.
Cov kev xaiv rau kev sib tham nrog lwm cov tshuaj
Thaum txhim kho txoj kev kho kab mob rau Combogliz Prolong, nws yog ib qho tseem ceeb ceeb toom rau endocrinologist txog txhua yam tshuaj uas tus mob ntshav qab zib siv los kho cov kab mob concomitant. Ib txhia ntawm lawv muaj peev xwm txhim kho cov suab thaj-txo cov peev xwm ntawm Comboglize, lwm tus txwv nws txoj haujlwm.
Rau lub tswv yim dav dav, koj tuaj yeem tshawb lub rooj.
Saxagliptin | Metformin |
Cov nyhuv hyperglycemic ntxiv | |
| Rifampicin, Pioglitazone, Magnesium thiab Aluminium Hydroxides / Simethicone | GCS, diuretics, nicotinic acid cov thyroid hormones, isoniazid, sympathomimetics, phenothiazines, estrogens, phenytoin, calcium channel blockers |
Provoke hypoglycemic tej yam kev mob | |
| Amprenavir, Diltiazem, Erythromycin, Fluconazole, Aprepitant, Verapamil, kua txiv kab ntxwv, Ketoconazole, tshuaj sulfonylurea, Glibenclamide, Ketoconazole, CYP3A 4/5 isoenzymes, Famotidine | Cov neeg sawv cev ua ke, Furosemide, tshuaj xws li ethanol, Nifedipine |
Amprenavir, Diltiazem, Erythromycin, Fluconazole, Aprepitant, Verapamil, kua txiv kab ntxwv, Ketoconazole, tshuaj sulfonylurea, Glibenclamide, Ketoconazole, CYP3A 4/5 isoenzymes, Famotidine
Cov neeg sawv cev ua ke, Furosemide, tshuaj xws li ethanol, Nifedipine
Nws pom tseeb tias kev sim tshuaj ntsuas tus kheej thiab kev noj tshuaj rau tus kheej nrog Combogliz Prolong tuaj yeem muaj kev phom sij loj rau kev noj qab haus huv.
Combogliz Prolong: txheeb xyuas cov ntshav qab zib
Cov kws kho mob soj ntsuam qhov ua tau zoo ntawm kev kho mob nrog Combogliz Prolong tshuaj nco ntsoov nws qhov tsis zoo, thiab cov ntshav qab zib kuj tsis muaj kev ntseeg nyob hauv nws lub peev xwm.
Ua kom tiav cov kev tswj ntshav qab zib yuav tsum muaj kev sib koom ua ke: kev noj zaub mov qis-carb fractional, soj ntsuam txhua hnub ntawm cov ntawv nyeem glucometer, kev tawm dag zog lub cev kom txaus thiab kev txhawb nqa kev kho mob. Tsuas yog hauv qhov kev sib xyaw ua ke no koj tuaj yeem suav rau 100% nyhuv ntawm Combogliz Prolong.
Hauv cov yeeb yaj kiab, kws tshaj lij-endocrinologist A.S. Ametov tham txog cov qauv tshiab ntawm kev tswj hwm tus mob ntshav qab zib hom 2.
