Tus txheej txheem ntawm kev ua ntawm saxagliptin ntawm lub cev nyob rau hauv cov ntshav qab zib

Kev kis tus kabmob ntshav qab zib hom 2 nyob hauv lub ntiaj teb tab tom loj hlob, qhov no los ntawm kev ua neej nyob ntawm tib neeg thiab kev noj zaub mov zoo. Txawm li cas los xij, chaw muag tshuaj tsis sawv tseem, tsim cov tshuaj tshiab rau kev kho mob ntshav qab zib.

Ib qho ntawm cov chav kawm tshiab ntawm cov tshuaj muaj yees yog incretin mimetics, uas suav nrog saxagliptin (saxagliptin).

Tus txheej txheem ntawm kev txiav txim ntawm incretins

Tus incretins yog tib neeg cov tshuaj hormones tsim tawm los ntawm kev mob plab thaum cov zaub mov nkag mus. Vim lawv cov kev nqis tes ua, kev tsim tawm ntawm cov tshuaj insulin ntau ntxiv, uas pab cov piam thaj rau kev nqus, uas tso tawm thaum lub plab zom mov.

Txog rau hnub tim, ob hom kev nce ntxiv tau tshawb pom:

• GLP-1 (zoo li glucone-zoo li peptide-1);
• ISU (insulinotropic polypeptide).

Cov receptors ntawm thawj yog nyob rau hauv txawv plab hnyuv siab raum, uas tso cai nws mus nthuav qhia dav dav. Qhov thib ob yog tswj los ntawm pancreatic β-cell receptors.

Ntawm cov txheej txheem tseem ceeb ntawm lawv cov kev txiav txim yog:

• nce tso pa ntawm cov tshuaj hormone insulin los ntawm pancreatic cells;
• ua kom qeeb hauv cov plab zom mov;
• txo nyob rau hauv glucagon ntau lawm;
• tsis qab los noj mov thiab zoo nkaus;
• txhim kho lub plawv thiab cov hlab ntsha, muaj qhov cuam tshuam zoo ntawm cov leeg hlwb.

Nrog rau kev nce hauv insulin ntau lawm, cov piam thaj tau zoo dua tuaj, tab sis yog tias nws yog qhov ib txwm, cov kev ua kom lub tso pa tawm nres thiab tus neeg tsis muaj kev pheej hmoo ntawm lub qog ntshav qab zib. Kev txo qis hauv lub ntim ntawm glucagon, tus insulin antagonist, ua rau txo qis kev noj haus ntawm daim siab glycogen thiab kev tso tawm ntawm cov piam thaj dawb, thaum lub sijhawm ua ke nrog kev nce ntxiv ntawm kev noj glycogen hauv cov leeg. Yog li ntawd, cov piam thaj siv tam sim ntawd ntawm qhov chaw tsim khoom, tsis tas nkag mus rau cov ntshav.

Thaum kev tso tawm ntawm lub plab tau qeeb, zaub mov nkag mus rau txoj hnyuv hauv ntu me me, uas txo cov piam thaj hauv cov ntshav thiab, vim li ntawd, nce ntxiv hauv nws cov concentration. Ua rau cov pas zes me me, nws yooj yim dua los ntawm lub cev. Hauv qhov no, qhov txo qis hauv qab los noj mov ntau dua li kev siv lub luag haujlwm.

Qhov cuam tshuam rau hauv kev ncig mus los tau tsuas yog sau tseg, tab sis tsis tau kawm. Nws tau pom tias incretins pab pancreatic cells-hlwb rov qab sai.

Nws tsis yooj yim sua kom tau txais cov tshuaj hormones hauv lawv daim ntawv dawb hauv qhov ntau txaus, yog li, cov kws tshawb fawb tau tsim cov qauv tshuaj (analogues) uas ua haujlwm zoo ib yam:

• rov ua dua cov nyhuv ntawm glucone-zoo li peptide-1;
• txo cov teebmeem ntawm kev puas tsuaj rau cov enzymes, yog li ua kom ntev lub neej ntawm cov tshuaj hormones.

Saxagliptin belongs rau pab pawg thib ob.

Tso Tawm Cov Ntawv

Saxagliptin yog ib feem ntawm cov tshuaj Onglisa, ua yeeb yam xws li inhibitor ntawm DPP-4. Cov cuab yeej no tsis yog nyob rau hauv tsoomfwv cov npe ntawm cov tshuaj tshwj xeeb, tab sis tuaj yeem muab rau cov neeg mob ntshav qab zib mellitus los ntawm kev pab nyiaj hauv peev nyiaj hauv cheeb tsam.

Cov tshuaj muaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj nrog lub plhaub daj, muaj 2.5 mg ntawm saxagliptin lossis 5 mg ntawm nws cov hydrochloride. Cov lus sib xyaw tseem muaj cov khoom sib xyaw uas ua kom muaj txiaj ntsig zoo tshaj tawm ntawm cov tshuaj nquag. Cov tshuaj ntsiav tau sau npe cim qhia lawv cov koob tshuaj.

Cov ntsiav tshuaj tau ntim rau hauv cov hlwv ntim ntawm 10 daim thiab ib lub thawv ntawv.

Kev taw qhia thiab contraindications

Kev npaj ua Saxagliptin-based yog kev pom zoo rau kev siv nrog:

1. Kev ntsuas mob ntshav qab zib ua ntej, thaum kev coj ua ib txwm muaj, suav nrog kev noj zaub mov zoo, kev tawm dag zog thiab lwm yam lus pom zoo tsis pab. Lub cuab yeej tso cai rau koj kom tsis txhob muaj kev puas tsuaj ntawm β-hlwb thiab yog li inhibit kev txhim kho ntawm cov ntshav qab zib hom 2;
2. Lub xub ntiag ntawm tus kab mob kuaj pom. Hauv qhov no, lub cuab yeej tuaj yeem siv ua tshuaj ywj siab los yog ua ke nrog lwm cov tshuaj:
   • Metformin;
   • tshuaj insulin;
   • sulfonylurea derivatives;
   • thiazolidinediones.

Cov tshuaj tiv thaiv kev siv tshuaj yog:

• yam 1 mob ntshav qab zib mellitus;
• kev cuam tshuam ntau dhau ntawm ib qho ntawm cov tshuaj;
• siab rhiab heev rau DPP-4 inhibitors;
• muaj qhov tshwm sim ntawm cov ntshav qab zib ketoacidosis;
• indigestibility ntawm lactose thiab lactase tsis muaj peev xwm, mob ntshav qab zib-galactose malabsorption;
• lub sijhawm ntawm tes tsho thiab lactation;
• muaj hnub nyoog me.

Hauv cov rooj plaub no, cov tshuaj tiv thaiv analogues ntawm cov tshuaj tau siv lossis cov nyiaj nrog cov sib txawv sib txawv raug xaiv.

Qhov ua tau zoo ntawm kev pib kho kev kho mob saxagliptin + metformin

Cov lus qhia rau kev siv

Cov ntsiav tshuaj noj ntawm qhov ncauj tsis hais txog kev tau txais khoom noj. Cov tshuaj ntsiav tau nqos tag nrho thiab ntxuav nrog lub zog me me. Cov koob tshuaj yog nyob ntawm hom kev kho thiab tus neeg mob saib xyuas.

Nrog rau kev siv cais, saxagliptin raug pom zoo kom noj 5 mg ib hnub ib zaug.

Hauv kev sib xyaw ua ke nrog lwm cov tshuaj mob ntshav qab zib, kev noj tshuaj yog 5 mg rau ib hnub, tib yam siv rau qhov sib ntxiv ntawm cov kev siv tshuaj tiv thaiv hypoglycemic nrog saxagliptin.

Thaum pib thawj theem ntawm kev siv cov tshuaj nrog metformin, ntau npaum ntawm saxagliptin yog 5 milligrams, thiab metformin yog 500 milligrams ib hnub.

Rau cov neeg mob raum pathology, kev noj tshuaj raug txo kom tsawg dua 2.5 mg ib hnub. Yog tias siv cov tshuaj hemodialysis, cov tshuaj yuav qaug tom qab ua tiav. Cov nyhuv ntawm cov tshuaj thaum lub sijhawm peritoneal lim ntshav tsis tau tshawb xyuas qhov tseeb. Nyob rau hauv txhua rooj plaub, ua ntej sau ntawv yuav cov tshuaj, cov kws txawj qhia kom yauv mus soj ntsuam cov neeg mob ob lub raum.

Rau cov neeg mob siab ua lub siab pathologies, kev hloov kho koob tshuaj yog tsis tsim nyog. Txoj kev kho yog nqa tawm raws li kev pom zoo. Qhov no kuj siv rau cov neeg laus laus, qhia tias lawv tsis muaj teeb meem lub raum.

Ib txoj kev tshawb nrhiav txog cov nyhuv ntawm cov tshuaj rau ntawm tus me nyuam hauv plab hauv cov poj niam cev xeeb tub thiab cov menyuam yaus tseem tsis tau ua. Yog li, nws nyuaj rau twv seb nws yuav raug dab tsi. Rau cov neeg mob no, lwm cov neeg ua pov thawj feem ntau siv. Yog tias tus poj niam noj saxacgliptin thaum pub mis, nws yuav tsum tsis kam pub mis.

Nyob rau hauv cov ntaub ntawv ntawm kev coj ua ib txhij nrog kev ua haujlwm CYP3A4 / 5 inhibitors, qhov kev noj tshuaj txhua hnub yog halved.

Cov no yog cov tshuaj hauv qab no:

• Ketoconazole;
• Clarithromycin;
• Atazanavir;
• Indinavir;
• Nefazodon;
• Itraconazole;
• Ritonavir;
• Telithromycin;
• Nelfinavir;
• Saquinavir thiab lwm tus.

Thaum noj saxagliptin, tus neeg mob txuas ntxiv siv cov lus qhia dav dav rau lub koom haum kev noj haus, ua lub cev qoj ib ce thiab soj ntsuam cov kev xav hauv lub xeev.

Phiv thiab haus tshaj

Cov tshuaj muaj zoo tsis phiv. Nws lub ntsiab kom zoo dua yog qhov uas tsis muaj kev pheej hmoo ntawm lub qog ntshav qab zib.

Txawm li cas los xij, zoo li ib qho yeeb tshuaj hluavtaws, nws cuam tshuam rau cov txheej txheem ntawm lub cev hauv lub cev, ua rau lawv hloov pauv, uas tuaj yeem ua rau:

• kev txhim kho ntawm kev sib kis ntawm cov kab mob ntawm txoj hlab ua pa;
• mob dyspeptic;
• mob hlab ntsws
• cov tsos ntawm mob taub hau;
• mob plab zom mov;
• kev txhim kho ntawm kev mob hauv cov kab mob genitourinary.

Thaum soj ntsuam ib qho ntawm cov yam ntxwv no, koj yuav tsum yws rau tus kws kho mob uas tuaj koom nrog yuav xaiv qhov ntau dua qhov tsim nyog ntawm cov tshuaj lossis hloov nws mus rau lwm cov ntsiav tshuaj.

Kev noj tshuaj ntau dhau hauv kev sim tshuaj tsis pom, thaum lub siab ntawm 80 lub sijhawm siab tshaj qhov pom zoo tau siv. Yog tias muaj cov tsos mob overdose (xeev siab, ntuav, raws plab, mob taub hau, tsis muaj zog, thiab lwm yam), txoj kev kho mob yog ua tiav raws li cov tsos mob nrog kev tshem tawm sai ntawm cov tshuaj los ntawm lub cev, uas yog qhov yooj yim ua los ntawm hemodialysis.

Thaum ua ke nrog lwm cov tshuaj, hais tawm tsis tau pom. Txawm li cas los xij, kev siv txau nrog metformin thiab thiazolidinediones tsis tau kawm.

Video los ntawm cov kws tshaj lij:

Dab tsi tuaj yeem hloov saxagliptin?

Kev siv saxagliptin ua lub hauv paus tseem ceeb tsuas yog tsim hauv cov tshuaj Onglise, yog tias tus neeg mob muaj cov kev mob tshwm sim, nws yuav tsum tau siv cov tshuaj analogues, uas suav nrog lwm cov tshuaj tiv thaiv ntawm DPP-4 enzyme:

1. Januvia - Ib qho ntawm thawj cov cuab yeej ntawm hom no, tsim nyob hauv Tebchaws Asmeskas. Nws yog pom tseeb nyob rau hauv ib koob tshuaj ntawm 25, 50 thiab 100 mg. Txoj cai niaj hnub yog kwv yees li 100 mg. Cov nyhuv ntawm cov tshuaj tsuas kav ib hnub. Qee lub sij hawm nws tsim tawm nyob rau hauv cov npe YanuMet, uas ntxiv cov metformin.
2. Galvus - cov tshuaj uas tsim tawm hauv Switzerland, yog siv hauv qhov ntau npaum ntawm 50 mg rau ib hnub lossis ntau dua, feem ntau siv tshuaj pleev ib ce nrog insulin.
3. Nesina - tsim tawm hauv tebchaws Ireland, raws li apolgiptin benzoate nrog tshuaj ntau npaum 12,5 lossis 25 mg. 1 ntsiav tshuaj noj ib zaug ib hnub.
4. Vipidia - cov tshuaj tseem ceeb ntawm cov tshuaj alogliptin, uas muaj cov txiaj ntsig zoo ib yam, noj ib hnub ib zaug ntawm kev noj tshuaj ntawm 25 mg.
5. Trazhenta - ib qho khoom siv raws li linagliptin, tau pom zoo hauv daim ntawv ntawm 5 mg ntsiav tshuaj noj ntawm qhov ncauj.

Lwm cov analogues yog siv uas muaj cov sib txawv, tab sis cov txheej txheem zoo sib xws. Tus nqi ntawm cov tshuaj sib txawv raws li lub teb chaws kev tsim khoom thiab cov tshuaj sib tov.

Tus nqi ntawm cov tshuaj Onglisa, uas suav nrog saxagliptin, los ntawm 1700 txog 1900 rubles.

Lub sijhawm tsim tshuaj tshiab ua rau kom sai thiab daws tau cov teeb meem ntawm cov piam thaj hauv kev mob siab rau cov neeg mob ntshav qab zib mellitus.

Thaum lawv cov npe tseem tsis tau dav heev, tsuas yog ib cov tshuaj uas tsim tawm ntawm saxagliptin, uas muaj cov txiaj ntsig zoo hauv kev kho mob ntshav qab zib thiab tsis ua rau lub xeev ntawm cov ntshav qab zib tsis zoo. Nyob rau tib lub sijhawm, muaj cov analogues uas muaj cov tshuaj sib txawv, tab sis nrog cov txiaj ntsig kho zoo sib xws.