Yam ntshav qab zib hom 2 ua 90% ntawm txhua hom ntshav qab zib. Ntawm ib sab tes, cov tshuaj tiv thaiv insulin txwv tsis pub cov cell ua ke los ntawm insulin. Ntawm qhov tod tes, muaj dys-cell ua haujlwm: los ntawm kev ua txhaum ntawm cov khoom yas los ua kom tiav kev tuag, thiab hauv cov neeg mob ntshav qab zib lawv qhov ntim tau txo 63% (hauv cov tawv nyias - los ntawm ib nrab tsawg dua). Tag nrho cov no tsis tso cai rau lub cev sau cov tshuaj hormones xav tau tag nrho kom kov yeej cov tshuaj insulin.
Txhawm rau ua txhaum lub voj voos no, ntau cov tshuaj tau tsim los tswj kev glycemic. Biguanides thiab thiazolidinediones tawm tsam nrog insulin tsis kam, sulfonylureas thiab av nplaum ua kom lub zog sib txuas ntawm cov tshuaj insulin endogenous, Acarbose thiab Glucobay thaiv kev nqus ntawm cov piam thaj hauv cov hnyuv, tab sis ntxiv rau qhov kev ua tau zoo, kuj tseem muaj teeb meem kev nyab xeeb. Hauv qee, ntau ntawm lawv cuam tshuam tsis zoo rau lub cev qhov hnyav, thaum rog yog qhov tseem ceeb ua rau mob ntshav qab zib hom 2.
Kev tsim tshuaj tshiab tam sim no yog tshuaj ntau zuj zus. Tus neeg saib xyuas DPP-4 Januvia (lub npe thoob ntiaj teb - Sitagliptin, Januvia, Sitagliptin) yog qhov nruab nrab hauv qhov no - nws txo qhov qab los noj mov, thiab dhau sijhawm - thiab qhov hnyav, thiab qhov no tsis yog nws tau txais txiaj ntsig nkaus xwb.
Tshaj 10 xyoo dhau los ntawm kev soj ntsuam mob, ib qho pov thawj tsim nyog ntawm nws cov hauj lwm tau raug tsim ntau ntxiv.
Dosage daim ntawv thiab muaj pes tsawg leeg
Janucius incretin mimetic, daim duab uas tau nthuav tawm hauv ntu no, yog tsim nyob rau hauv lub hauv paus ntawm sitagliptin, nthuav tawm nyob rau hauv daim ntawv ntawm phosphate monohydrate. Siv rau hauv cov ntsiav tshuaj ntawm ntau cov tshuaj noj thiab chaw sau: magnesium, microcrystalline cellulose, sodium, calcium hydrogen phosphate.
Cov kws kho ntshav qab zib tuaj yeem sib txawv qhov ntau npaum li cas ntawm cov tshuaj hauv cov xim: nrog qhov koob tshuaj tsawg kawg nkaus - paj yeeb, nrog qhov siab tshaj plaws - beige. Nyob ntawm qhov hnyav, cov ntsiav tshuaj tau cim: "221" - koob tshuaj 25 mg, "112" - 50 mg, "277" - 100 mg. Cov tshuaj tau ntim rau hauv cov hlwv pob. Yuav muaj ob peb lub hlwv nyob rau hauv txhua lub thawv.
Thaum lub ntsuas kub txog li 30 ° C, cov tshuaj tuaj yeem khaws cia hauv lub sijhawm lav (txog li ib xyoos).
Yuav ua li cas Januvia ua haujlwm
Cov tshuaj hluavtaws hypoglycemic nyob nrog pab pawg ntawm cov tsiaj txhu ntau zuj zus uas inhibit DPP-4. Kev siv li niaj zaus ntawm Januvia tsub kom ntau ntxiv ntawm cov khoom plig, txhawb lawv cov kev ua ub no. Kev tsim cov tshuaj endogenous insulin nce, qhov sib txuas ntawm glucagon hauv lub siab yog suppressed.
Kev tswj hwm ntawm qhov ncauj txwv tsis pub cov piam thaj ntawm glucagon-zoo li peptide GLP-1, uas ua lub luag haujlwm zoo tshaj plaws hauv kev ua tiav ntawm kev paub txog cov piam thaj hauv insulin, thiab rov kho nws lub zog ntawm kev xav. Cov teeb ntsuas no ua rau muaj qhov hloov pauv ntawm glycemia.
Sitagliptin pab txo glycated hemoglobin, yoo qabzib, thiab lub cev yuag. Txij ntawm lub plab zom mov, cov tshuaj tau nqus mus rau hauv cov hlab ntshav hauv 1-4 teev. Lub sijhawm ntawm kev noj thiab lub caloric tus nqi ntawm cov zaub mov tsis cuam tshuam rau pharmacokinetics ntawm qhov inhibitor.
Cov tshuaj no haum rau kev tswj hwm thaum lub sijhawm yooj yim: ua ntej, tom qab thiab thaum noj mov. Txog li 80% ntawm cov nquag ua hauj yog tawm los ntawm ob lub raum. Cov tshuaj yuav siv tau ob qho tib si nyob rau hauv monotherapy thiab nyob rau hauv txoj kev kho mob ntawm cov ntshav qab zib hom 2, tshwj xeeb tshaj yog nrog nce ntau ntawm hypoglycemic tawm tsam.
Hauv cov qauv txheej txheem, Januvia tau ntxiv los ntawm Metformin, kev noj zaub mov kom tsawg thiab ua rau lub cev qoj ib ce.
Koj tuaj yeem pom tus txheej txheem ntawm cov nyhuv ntawm cov tshuaj ntawm cov yees duab no:
Leej twg yuav qhia rau cov tshuaj
Januvia raug tshuaj rau hom 2 mob ntshav qab zib ntawm ntau theem ntawm kev tswj hwm tus kab mob.
Thaum ua ke nrog lwm cov tshuaj hypoglycemic, Januvia yog tshuaj:
- Ntxiv rau Metformin, yog tias kev hloov kho lub neej tsis coj cov kev cia siab tshwm sim;
- Ua ke nrog kev sib txuas ntawm pawg sulfonylurea - Euglucan, Daonil, Diabeton, Amaril, yog tias kev kho dhau los ua tsis tau zoo txaus lossis tus neeg mob tsis zam Metformin;
- Nyob rau hauv parallel nrog thiazolidinediones - Pioglitazan, Rosiglitazone, yog tias kev sib txuas ua ke yog tsim nyog.
Hauv kev kho peb zaug, Januvius ua ke:
- Nrog metformin, sulfonylurea derivatives, noj zaub mov kom tsawg thiab ua kom ib ce muaj zog, yog tias tsis muaj Januvia tsis tuaj yeem ua tiav 100% glycemic tswj;
- Tib lub sijhawm xws li Metformin thiab thiazolidinediones, PPARy kev tawm tsam, yog tias lwm yam kev tswj xyuas kab mob tsis tau ua kom zoo txaus.
Nws yog qhov ua tau los siv Januvia ntxiv rau kev kho mob insulin yog tias cov tshuaj kho tau cov teeb meem ntawm kev tiv thaiv insulin.
Leej twg yuav tsum tsis txhob ua cov tshuaj sitagliptin
Nrog hom 1 ntshav qab zib thiab ua xua rau cov khoom xyaw ntawm mis, Januvia yog contraindicated. Tsis txhob xaj tshuaj rau: 
- Cov poj niam cev xeeb tub thiab lactating;
- Nrog cov ketoacidosis uas mob ntshav qab zib;
- Hauv thaum yau.
Cov neeg mob raum uas muaj lub raum nrog lub sij hawm teem tseg ntawm Januvia yuav tsum tau nce siab mloog. Hauv cov ntawv loj, nws yog qhov zoo dua los xaiv analogues rau kev kho. Cov neeg mob ntawm hemodialysis tseem muaj kev saib xyuas tas mus li.
Yuav muaj teeb meem
Thaum muaj kev noj tshuaj ntau dhau lawm, kev ua haujlwm tsis haum, kev xaiv kab mob tsis zoo, qhov tsis zoo qhov xav tau yuav tshwm sim los ntawm kev ua kom zoo ntxiv ntawm cov kabmob uas twb muaj lawm lossis kev tsim kho tshiab. Cov kev tshwm sim zoo li no tseem muaj peev xwm ua tau los ntawm kev sib cuam tshuam ntawm kev cuam tshuam ntawm cov tshuaj uas kws kho mob ntshav qab zib tau txais.
Ntawm cov teeb meem mob ntshav qab zib, muaj cov mob hnyav (mob ntshav qab zib ketoacidosis, precoma thiab glycemic coma) thiab mob ntev - mob hlwb, neuropathy, retinopathy, nephropathy, encephalopathy, etc. Retinopathy yog qhov ua rau dig muag ntawm cov neeg mob ntshav qab zib: hauv Tebchaws Meskas - 24 txhiab tus neeg mob tshiab txhua xyoo. Nees ntshav yog qhov tseem ceeb ua rau lub raum khiav tsis zoo - 44% ntawm cov neeg mob ib xyoos, mob neuropathy yog qhov tseem ceeb uas tsis mob qhov ua rau mob siab tshaj plaws (60% ntawm cov mob tshiab ib xyoos).
Yog tias tus kws kho mob cov lus pom zoo hais txog qhov ntau npaum li cas thiab lub sijhawm ntawm kev pub nkag yog tsis ua raws, kev ua haujlwm dyspeptic thiab lub ntsej muag tsis zoo ntawm lub plab nyhuv.
Ntawm lwm qhov kev mob tshwm sim, kev ua kom lub cev tsis muaj zog feem ntau tshwm sim, nrog rau cov hlab ntsws ua pa.
Txog cov tshuaj Januvia hauv kev txheeb xyuas, cov neeg mob ntshav qab zib yws yws mob taub hau thiab tso tawm ntshav ntxiv. Hauv kev tshuaj ntsuam xyuas, kab leukocyte yuav nce me ntsis ntxiv, tab sis cov kws kho mob tsis suav tias theem no tseem ceeb. Tsis muaj kev sib txuas ua ke ntawm kev noj cov tshuaj thiab kev txhim kho ntawm kev mob pancreatitis.
- lub siab ua ntxhov
- ua pa tau kab mob
- dyspepsia
- dyspeptic mob
Nrog lub sijhawm ntev ntawm kev siv cov sitagliptin, kev ntxhov siab los ntawm lub siab, cov hlab ntsha, thiab ntshav tsim tau. Tus mob ntshav qab zib yuav tsum tau qhia txog qhov yuav tsum tau mus ntsib kws kho mob yog tias muaj kev hloov pauv hauv ntshav siab lossis ntshav siab thaum noj Januvia.
Tsis muaj ib qho mob ntawm kev quav tshuaj rau hauv cov kev siv tshuaj; nrog kev hloov kho tsis txaus ntawm kev ua neej, tsuas yog nws cov txiaj ntsig tsawg yog ua tau.
Ntau tus neeg mob
Januvia yog cov tshuaj kho mob hnyav, thiab nruj me ntsis rau cov lus pom zoo ntawm tus neeg endocrinologist yog qhov tseem ceeb rau nws cov hauj lwm zoo. Kev pib nyab xeeb ntawm sitagliptin yog 80 mg.
Cov kev tshawb fawb txog qhov cuam tshuam ntawm kev haus luam yeeb ntau tau ua nrog kev nce kaum npaug hauv cov tshuaj no.
Yog hais tias kev mob hypoglycemic tsim, tus neeg mob yws mob taub hau, tsis muaj zog, mob plab tsis zoo, ua rau muaj qhov tsis zoo, nws yog qhov tsim nyog los yaug lub plab, muab cov neeg mob nqus cov tshuaj. Kev kho mob uas muaj tsos mob yuav nqa tawm hauv tsev kho mob ntshav qab zib.
Cov rooj sib hais ntawm kev haus dej ntau dhau tau sau tseg tsis tshua muaj. Qhov no feem ntau cuam tshuam nrog ib tus neeg tsis kam txais lossis cov teebmeem ntawm lwm cov tshuaj siv hauv kev kho mob nyuaj.
Hemodialysis ntawm Januvia yog qhov tsis muaj txiaj ntsig. Rau 4 teev, thaum cov txheej txheem tau dhau mus, tom qab noj ib koob, tsuas yog 13% ntawm cov tshuaj tau tso tawm.
Lub peev xwm ntawm Januvia nrog txoj kev kho mob
Sitagliptin tsis inhibit qhov kev ua ntawm Simvastatin, Warfarin, Metformin, Rosiglitazone. Januvia tuaj yeem siv los ntawm cov poj niam uas niaj hnub siv cov kev tiv thaiv kev tiv thaiv. Concurrent coj nrog Dioxin me ntsis ntxiv qhov muaj peev xwm ntawm qhov tom kawg, tab sis cov kev hloov pauv no tsis tas yuav hloov kho koob.
Januvia tuaj yeem siv ua ke nrog cyclosporine lossis inhibitors (xws li ketoconazole). Cov nyhuv ntawm sitagliptin hauv cov rooj plaub no tsis yog qhov tseem ceeb thiab tsis hloov pauv qhov xwm txheej rau kev noj tshuaj.
Kev pom zoo rau kev siv
Rau Januvia cov tshuaj, cov lus qhia txog kev siv raug kos kom paub meej txaus, thiab nws yuav tsum kawm ua ntej pib kev kho mob.
Yog tias lub sijhawm ntawm nkag mus hauv sijhawm tsis tiav, qhov tshuaj yuav tsum quag cawv thaum thawj zaug. Nyob rau tib lub sijhawm, ob npaug txoj kev coj ua yog txaus ntshai, vim tias yuav tsum muaj ib lub sijhawm txhua hnub ntawm cov koob tshuaj.
Cov qauv tshuaj sib txawv ntawm Januvia yog 100 mg / hnub. Hauv lub raum pathologies ntawm qhov mob sib khuav ntawm qhov hnyav mus rau mob hnyav, 50 mg / hnub yog kho.Yog tus kab mob loj zuj zus thiab mob hnyav dua, cov kev cai tau kho rau 25 mg / hnub. Yog tias cov tshuaj no tau siv ua ke nrog lwm cov tshuaj uas muaj suab thaj, kev noj tshuaj insulin lossis ntsiav tshuaj yuav tsum raug txo kom tsis txhob mob ntshav qab zib.
Yog tias tsim nyog, lim ntshav yog nqa tawm, thaum muab tshuaj rau qhov tsawg kawg nkausCov. Lub sijhawm ntawm tau txais Januvia tsis khi rau lub sijhawm ntawm txheej txheem. Hauv cov laus (txij li 65 xyoo), cov neeg mob ntshav qab zib tuaj yeem siv cov tshuaj yam tsis muaj kev txwv ntxiv, yog tias tseem muaj teeb meem ntxiv los ntawm lub raum. Hauv rooj plaub tom kawg, yuav tsum tau txhaj tshuaj.
Cov lus pom zoo tshwj xeeb
Yanuvia tuaj yeem muas tau hauv lub khw muag tshuaj network tsuas yog muaj daim ntawv yuav tshuajCov. Kev mob hypoglycemia, raws li kev tshawb fawb, nrog kev kho hnyav tsis yog ib qho muaj ntau dua li siv cov placebo. Cov nyhuv ntawm lub cev ntawm Januvia tawm tsam keeb kwm ntawm kev tso siab ntawm cov tshuaj insulin tsis tau kawm, yog li cov neeg mob tsuas yog txwv nrog hypoglycemic tswj.
Qhov tshwm sim tsis zoo ntawm cov tshuaj ntawm lub peev xwm los tswj kev thauj lossis cov txheej txheem nyuaj tsis tau sau tseg, txij li cov kev ua haujlwm ntawm lub hauv nruab nrab cov hlab ntsha tsis cuam tshuam.
Hypersensitivity thaum noj Januvia tuaj yeem hais tawm tsis nco qab uas xav tau. Tus neeg mob lub ntsej muag o, ua pob ua pob ua paug tuaj. Hauv cov xwm txheej nyhav, Quincke's edema tau pom. Nrog rau cov tsos mob zoo li no, cov tshuaj raug nres tam sim ntawd thiab nrhiav kev pab kho mob.
Januvia hauv txoj kev kho nyuaj siv yog qhov tsis muaj qhov xav tau tom qab noj Metformin thiab kev hloov kho lub neej. Koj tseem tuaj yeem siv cov tshuaj thaum hloov mus rau insulin.
Xyuas txog Januvia
Nrog cov ntawv nce qib ntawm cov ntshav qab zib hom 2 uas tsis muaj piam thaj txo cov ntsiav tshuaj, ob peb tswj kom tsis txhob muaj cov piam thaj hauv tshuaj.
Nws kuj tseem ceeb kom pom koj cov tshuaj uas yuav pab tswj hwm tus kab mob ncua ntev tsis tas yuav ntxiv teeb meem tshiab rau tus kab mob ntshav qab zib.
Thaum xaiv cov tshuaj hypoglycemic uas tsim nyog rau kev cuam tshuam ntshav qab zib, cov kws tshwj xeeb tau saib xyuas glycemic thiab tsis-glycemic tau. Hauv thawj qhov xwm txheej, qhov no yog qhov txo qis ntawm glycated hemoglobin, qhov kev pheej hmoo ntawm hypoglycemia, insulin secretion, thiab muaj kev nyab xeeb. Hauv qhov thib ob - kev hloov pauv ntawm lub cev lub cev, HF muaj kev pheej hmoo txaus ntshai, ua siab ntev, muaj kev nyab xeeb ntawm tus kheej, pheej yig, nqe, yooj yim siv.
Txog cov tshuaj Januvia kev xav zoo rau cov kws kho mob: Kev yoo glycemia yog ze rau qhov ib txwm, postprandial qab zib theem thaum kev noj zaub mov tsis ntau tshaj qhov txwv tau, kev tso ntshav qab zib kom tsis pom, cov tshuaj muaj kev nyab xeeb thiab ua tau zoo thiab ua tau raws li cov qauv. Tswv yim ntawm xibfwb A.S. Ametova, lub taub hau. Department of Endocrinology thiab Diabetology GBOU DPO RMAPE ntawm Ministry of Health ntawm Lavxias Lavxias, hais txog cov peev txheej ntawm sitagliptin, saib cov yeeb yaj kiab:
Kev tshuaj xyuas cov neeg mob noj Januvia tau sib xyaw.
A.I. Kuv tau nyob ntawm Metformin tau 3 xyoos lawm, tus kws kho mob tsis nyiam qhov kev sim zaum kawg, Kuv tau ntxiv Januvia ntxiv. Kuv tau haus ib ntsiav tshuaj rau ib lub hlis tam sim no. Tus kws kho mob tau hais tias koj tuaj yeem haus lub sijhawm twg los tau, tabsis kuv ib ce nyob kaj siab lug. Thiab cov tshuaj yuav tsum ua haujlwm, ua ntej txhua yam, thaum nruab hnub, thaum lub luag haujlwm ntawm lub cev yog siab tshaj plaws. Kuv tsis tau pom tias muaj cov tsos mob tshwm sim, thaum nws khaws qab zib.
T.O. Qhov kev sib cav tseem ceeb hauv kev sim rau kuv txoj kev noj qab haus huv yog tus nqi kho mob. Rau Januvia, tus nqi tsis yog qhov siv nyiaj ntau tshaj: Kuv tau yuav 28 ntsiav tshuaj ntawm 100 mg rau 1675 rubles. Kuv tau txaus ib qho khoom lag luam ntawd ib hlis. Cov tshuaj siv tau zoo, qab zib yog qhov qub, tab sis kuv xav yuav lwm yam tshuaj, yog li coj mus rau hauv tus account kuv nyiaj laus Kuv yuav nug tus kws kho mob kom hloov. Tej zaum ib tug neeg yuav qhia qhov pheej yig dua?
Sib piv cov yam ntxwv ntawm analogues ntawm Januvia
Yog tias peb piv cov tshuaj raws li ATX 4 code, tom qab ntawd hloov ntawm Januvia, koj tuaj yeem xaiv analogues:
- Txhab nrog cov tshuaj ua kom nquag plias saxagliptin;
- Galvus, tsim rau lub hauv paus ntawm vildagliptin;
- Galvus Met - vildagliptin txuam nrog metformin;
- Trazentu nrog cov tshuaj nquag linagliptin;
- Combogliz Prolong - raws li metformin thiab saxagliptin;
- Nesinu nrog cov nquag ua hauj alogliptin.
Lub tshuab ntawm cawv ntawm cov tshuaj yog zoo ib yam: lawv suppress qab los noj mov, tsis inhibit nruab nrab lub paj hlwb thiab cov hlab plawv system. Yog tias koj piv cov analogues nrog Yanuvia ntawm tus nqi, ces koj tuaj yeem nrhiav pheej yig dua: rau 30 ntsiav tshuaj ntawm Galvus Meta nrog tib lub tshuaj, koj yuav tsum them 1,448 rubles, rau 28 daim ntawm Galvus - 841 rubles. Onlisa yuav raug nqi ntau dua: 1978 rubles rau 30 pcs. Hauv tib nqe nqe thiab Trazhenta: 1866 rubles. rau 30 ntsiav tshuaj. Qhov uas kim tshaj plaws nyob rau hauv cov npe no yuav yog Combogliz Prolong: 2863 rubles. rau 30 pcs.
Yog tias nws tsis muaj peev xwm ua tiav qhov tsawg kawg yog ib nrab nyiaj them rau cov tshuaj tiv thaiv kab mob siab, koj tuaj yeem xaiv qhov kev xaiv txais tau nrog koj tus kws kho mob.
Niaj hnub no, ntshav qab zib hom 2 tsis yog ib qho kev khuam siab rau tag nrho lub neej. Tus neeg mob ntshav qab zib tau nkag mus siv cov tshuaj tshiab ntawm ntau hom kev sib kis, cov khoom siv kho mob nqa khoom rau kev tswj hwm tshuaj thiab kev tshuaj xyuas tus kheej glycemia. Cov tsev kawm ntawv ntawm cov neeg mob ntshav qab zib tau tsim nyob hauv tsev kho mob thiab chaw tu neeg mob, thiab muaj txhua yam ntaub ntawv keeb kwm tseem ceeb hauv Is Taws Nem.
Yog Januvius ua lub ntsej muag tshuaj tshiab rau kev kho mob ntshav qab zib hom 2 lossis keeb kwm xav tau yam xav tau.
