Hom Ntshav Qab Zib 2 mellitus yog kab mob metabolic uas tshwm sim los ntawm kev ua kom muaj kev cuam tshuam ntawm cov insulin nrog cov cell.
Cov tib neeg muaj qhov ua tsis tau zoo no yuav tsis tuaj yeem tswj cov suab thaj kom zoo los ntawm kev noj zaub mov noj thiab cov txheej txheem tshwj xeeb. Cov kws kho mob sau ntawv rau Vildagliptin, uas ua kom qis thiab ua kom cov piam thaj tsis pub dhau.
Cov ntaub ntawv dav dav, muaj pes tsawg leeg thiab daim ntawv tso tawm
Vildagliptin yog tus sawv cev ntawm chav kawm tshiab ntawm cov tshuaj uas nquag siv hauv kev kho mob ntshav qab zib hom 2. Nws stimulates pancreatic islets thiab inhibits kev ua si ntawm dipeptidyl peptidase-4. Nws muaj cov nyhuv hypoglycemic.
Cov tshuaj muaj peev xwm ua tau raws li kev kho mob tseem ceeb, thiab ua ke nrog lwm cov tshuaj. Nws ua ke nrog sulfonylurea derivatives, nrog thiazolidinedione, nrog metformin thiab insulin.
Vildagliptin yog lub npe thoob ntiaj teb rau cov khoom xyaw nquag. Ob lub tshuaj nrog cov tshuaj no tau nthuav tawm ntawm lub khw muag tshuaj, lawv cov npe lag luam yog Vildagliptin thiab Galvus. Thawj zaug tsuas yog Vildagliptin, qhov thib ob - kev sib xyaw ntawm Vildagliptin thiab Metformin.
Daim ntawv tso tawm: cov ntsiav tshuaj nrog qhov ntau npaum ntawm 50 mg, ntim - 28 daim.
Pharmacodynamics thiab pharmacokinetics
Vildagliptin yog ib yam tshuaj uas cuam tshuam nrog dipeptidyl peptidase nrog kev pom tseeb hauv GLP thiab HIP. Cov tshuaj hormones yog txaws mus rau hauv cov hnyuv li ntawm 24 teev thiab nce ntxiv hauv kev teb rau kev noj zaub mov. Cov tshuaj ntxiv txhim kho kev nkag siab ntawm cov hlwb betta rau qabzib. Qhov no ua rau muaj lub luag haujlwm ntawm kev ua haujlwm ntawm cov piam thaj hauv cov piam thaj ntawm insulin.
Nrog rau kev nce hauv GLP, muaj qhov nce ntxiv hauv kev pom ntawm alpha hlwb rau qab zib, uas ua kom muaj kev ua haujlwm ntawm cov piam thaj hauv kev ua haujlwm ntawm insulin. Muaj ib qho txo qis hauv cov lipids hauv cov ntshav thaum kho. Nrog rau qhov txo hauv glucagon, qhov txo qis hauv insulin kuj tshwm sim.
Cov tshuaj ua kom muaj zog sai sai, nce qib hauv cov tshuaj hormones hauv cov ntshav tom qab 2 teev .Txoj kab mob protein tsawg tau sau tseg - tsis pub dhau 10%. Vildagliptin yog sib npaug faib ntawm cov qe ntshav liab thiab ntshav ntshav. Qhov siab tshaj plaws tshwm sim tom qab 6 teev. Cov tshuaj zoo dua nqus rau ntawm lub plab khoob, nrog rau cov zaub mov, qhov kev tawm tsam poob qis rau qee yam me me - los ntawm 19%.
Nws tsis ua kom muaj zog thiab tsis ncua isoenzymes, nws tsis yog qhov substrate. Nws muaj nyob hauv ntshav ntshav tom qab 2 teev. Ib nrab-lub neej los ntawm lub cev yog 3 teev, tsis hais noj ntau npaum li cas. Biotransformation yog qhov tseem ceeb ntawm kev nthuav dav. 15% ntawm cov tshuaj tawm hauv cov quav, 85% - los ntawm ob lub raum (hloov pauv 22,9%). Qhov kev xav ntau tshaj plaws ntawm cov tshuaj tau tiav tsuas yog tom qab 120 feeb.
Kev taw qhia thiab contraindications
Qhov tseem ceeb qhia rau kev teem caij yog hom ntshav qab zib 2. Vildagliptin yog qhov kev kho mob tseem ceeb, kev kho ob yam sib xyaw ua ke (nrog kev koom nrog tshuaj ntxiv), peb-txoj kev kho (nrog rau ob qhov tshuaj).
Hauv thawj kis, kev kho mob yog nqa tawm ua ke nrog kev tawm dag zog lub cev thiab tshwj xeeb xaiv kev noj haus. Nrog kev tsis ua tiav ntawm kev kho mob monotherapy, ib qho nyuaj siv nrog kev sib txuam ntawm cov tshuaj hauv qab no: sulfonylurea derivatives, thiazolidinedione, metformin, insulin.
Ntawm cov contraindications yog:
- tshuaj intolerance;
- lub raum tsis ua haujlwm;
- cev xeeb tub
- lactase tsis txaus;
- lub siab ua tsis taus haujlwm;
- cov hnub nyoog qis dua 18 xyoo;
- lub plawv tsis ua hauj lwm;
- lactation lub sijhawm;
- galactose intolerance.
Cov lus qhia rau kev siv
Cov ntsiav tshuaj noj ntawm qhov ncauj tsis hais txog kev noj zaub mov. Kev noj tshuaj ntau yog txiav txim los ntawm tus kws kho mob, suav txog tus neeg mob qhov mob thiab kam rau ua rau cov tshuaj.
Cov koob tshuaj pom zoo yog 50-100 mg. Hauv cov ntshav qab zib hom 2 hnyav tshaj plaws, cov tshuaj no tau muab sau 100 mg rau ib hnub. Ua ke nrog lwm cov tshuaj (Thaum muaj ob yam kev kho mob), qhov tshuaj txhua hnub yog 50 mg (1 ntsiav tshuaj). Nrog tsis muaj txiaj ntsig thaum lub sijhawm kho mob, cov koob nce siab txog 100 mg.
Tsis muaj cov ntaub ntawv qhia meej txog kev siv cov tshuaj thaum cev xeeb tub thiab lactation. Yog li no, pawg no yog qhov tsis xav noj raug tshuaj uas nthuav tawm. Nrog rau kev ceev faj yuav tsum tau siv rau hauv cov neeg mob mob siab / mob raum.
Cov tib neeg tsis tau muaj 18 xyoo tsis pom zoo siv cov tshuaj no. Nws tsis nquahu kom tsav tsheb thaum noj cov tshuaj.
Nrog rau kev siv vildagliptin, ib qho kev nce siab hauv lub siab ua haujlwm hauv lub siab. Lub sijhawm kho mob ntev, nws raug nquahu kom kuaj xyuas biochemical los saib xyuas qhov xwm txheej thiab kev hloov kho tau.
Nrog rau kev nce aminotransferases, nws yog ib qho tsim nyog yuav tau rov qab kuaj cov ntshav. Yog tias qhov ntsuas tau nce ntxiv ntau dua 3 zaug, kev noj tshuaj raug tso tseg.
Phiv thiab haus tshaj
Ntawm qhov ua tau cov kev tshwm sim tsis zoo yuav pom:
- asthenia;
- tshee hnyo, kiv taub hau, tsis muaj zog, mob taub hau;
- xeev siab ntuav, ntuav, tshwm sim ntawm reflux esophagitis, flatulence;
- cuab yeej peripheral edema;
- pancreatitis
- hnyav;
- kab mob siab;
- mob pruritus, urticaria;
- lwm cov kev tsis haum tshuaj.
Cov tshuaj muaj kev tiv thaiv zoo los ntawm cov neeg mob, cov tshuaj tiv thaiv ib hnub ib zaug yog txog 200 mg rau ib hnub. Thaum siv ntau tshaj 400 ml, cov hauv qab no yuav tshwm sim: kub, o, loog ntawm nqaj, xeev siab, tsaus muag. Yog hais tias cov tsos mob tshwm sim, nws yuav tsum tau yaug lub plab thiab mus nrhiav kev pab kho mob.
Nws tseem muaj peev xwm nce qib C-reactive protein, myoglobin, creatine phosphokinase. Angioedema feem ntau pom thaum ua ke nrog ACE inhibitors. Nrog kev tshem tawm ntawm cov tshuaj, phiv ploj.
Kev sib cuam tshuam txog Yeeb Tshuaj thiab Analogs
Lub peev xwm rau kev cuam tshuam ntawm vildagliptin nrog lwm cov tshuaj muaj tsawg. Kev teb rau cov tshuaj uas feem ntau siv rau hauv kev kho mob ntshav qab zib hom 2 (Metformin, Pioglitazone thiab lwm tus) thiab cov tshuaj nqaim tsawg (Amlodipine, Simvastatin) tsis tau tsim.
Cov tshuaj tuaj yeem muaj lub npe lag luam lossis tib lub npe nrog cov tshuaj nquag. Hauv cov khw muag tshuaj koj tuaj yeem nrhiav Vildagliptin, Galvus. Nyob rau hauv kev sib txuas nrog contraindications, tus kws kho mob sau cov tshuaj zoo sib xws uas pom muaj cov nyhuv kho zoo sib xws.
Cov tshuaj ntawm cov tshuaj suav nrog:
- Onglisa (nquag muaj tshuaj saxagliptin);
- Januvia (tshuaj - sitagliptin);
- Trazenta (tivthaiv - linagliptin).
Tus nqi ntawm Vildagliptin nyob ntawm 760 txog 880 rubles, nyob ntawm cov npoo ntawm lub tsev muag tshuaj.
Cov tshuaj yuav tsum nyob ntawm qhov kub li tsawg kawg 25 degrees hauv qhov chaw qhuav.
Kev xav ntawm cov kws tshaj lij thiab cov neeg mob
Lub tswv yim ntawm cov kws paub thiab tus neeg mob tshuaj txog cov tshuaj feem ntau zoo.
Tawm tsam keeb kwm yav dhau los ntawm kev noj tshuaj hauv cov neeg mob uas muaj ntshav qab zib hom 2, cov nyhuv hauv qab no yog sau tseg:
- ceev ceev hauv cov piam thaj hauv qab;
- kho kho qhov ntsuas pom;
- yooj yim ntawm kev siv;
- lub cev nyhav thaum lub sijhawm tshuaj monotherapy tseem zoo li qub;
- kev kho mob yog nrog los ntawm cov nyhuv antihypertensive;
- cov kev mob tshwm sim tshwm sim tsawg tsawg zaus;
- tsis muaj cov kev mob hypoglycemic thaum noj tshuaj;
- normalization ntawm lipid metabolism;
- theem zoo ntawm kev ruaj ntseg;
- txhim kho metabolism hauv cov metabolism;
- haum rau ntau tus neeg mob kev mob ntshav qab zib hom 2.
Vildagliptin nyob rau hauv chav kawm ntawm kev tshawb fawb tau ua pov thawj kev ua tau zoo thiab muaj qhov ua siab ntev zoo. Raws li kev soj ntsuam cov duab thiab tshuaj ntsuam pom, tsis muaj ib qho mob ntshav qab zib hauv lub cev tau pom thaum lub sijhawm hloov tshuaj.
Vildagliptin yog suav hais tias yog ib qho tshuaj tiv thaiv hypoglycemic zoo, uas tau muab tshuaj rau cov ntshav qab zib hom 2. Nws muaj nyob hauv Daim Ntawv Qhia Npe Tshuaj (RLS). Nws yog ntawv kho raws li kev kho mob monotherapy thiab hauv kev sib xyaw nrog lwm tus neeg sawv cev. Ua raws li cov chav kawm ntawm tus kabmob, cov txiaj ntsig ntawm kev kho mob, cov tshuaj muaj peev xwm ntxiv nrog Metmorphine, sulfonylurea derivatives, insulin. Tus kws kho mob uas tuaj koom yuav sau ntawv noj tshuaj kom yog thiab tshuaj xyuas tus neeg mob lub sijhawm. Feem ntau cov neeg mob ntshav qab zib hom 2 muaj kab mob concomitant. Qhov no ua rau ntau qhov kev xaiv ntawm kev pom cov ntshav zoo zoo-qab zib. Thaum zoo li no, insulin yog qhov feem ntau ntawm kev ua kom cov ntshav qab zib tsawg. Nws ntau dhau ntawm kev noj haus tuaj yeem ua rau lub ntsej muag ntshav qab zib, qhov hnyav nce. Tom qab txoj kev tshawb no, nws pom tias kev siv Vildagliptin nrog rau cov tshuaj insulin tuaj yeem ua tiav cov txiaj ntsig zoo. Txoj kev pheej hmoo ntawm kev tsim cov kab mob plawv, ntshav qab zib yog ua kom tsawg, lipid thiab carbohydrate metabolism zoo dua uas tsis muaj qhov hnyav ntxiv.
Frolova N. M., endocrinologist, kws kho mob ntawm qeb siab tshaj plaws
Kuv tau noj Vildagliptin rau ntau tshaj ib xyoos, nws tau sau ntawv rau kuv los ntawm tus kws kho mob ua ke nrog Metformin. Kuv txhawj xeeb heev tias thaum kho mob ntev kuv tseem tuaj yeem nce phaus. Tab sis nws rov zoo los ntawm tsuas yog 5 kg rau kuv 85. Ntawm cov kev mob tshwm sim, Kuv qee zaum muaj cem quav thiab xeev siab. Feem ntau, txoj kev kho muab cov nyhuv yam xav tau thiab dhau mus yam tsis muaj kev cuam tshuam dab tsi.
Olga, hnub nyoog 44 xyoo, Saratov
Cov khoom siv vis dis aus los ntawm Dr. Malysheva txog cov khoom lag luam uas tuaj yeem siv ua ntxiv rau tshuaj rau ntshav qab zib:
Vildagliptin yog cov tshuaj zoo uas txo qis dua cov piam thaj thiab kev ua haujlwm ntawm pancreatic. Nws yuav pab cov neeg mob uas tsis muaj peev xwm ua kom cov ntshav qab zib ib txwm ua los ntawm kev tawm dag zog tshwj xeeb thiab kev noj haus.
