Exenatide: nqe thiab analogues ntawm Bayeta
Cov cim ntawm cov tshuaj byte, sib hloov tau nyob rau hauv cov nqe lus ntawm cov nyhuv hauv lub cev, kev npaj muaj ib lossis ntau yam zoo tib yam tshuaj rau lub cev. Thaum xaiv cov lus txhais, xav txog tsis yog lawv cov nqi nkaus xwb, tab sis kuj yog lub teb chaws ntawm kev tsim khoom thiab lub koob npe ntawm cov neeg tsim khoom.
- Qhia txog ntawm cov tshuaj
- Sau cov analogues thiab cov nqi
- Xyuas
Qhia txog ntawm cov tshuaj
Baeta - Exenatide (Exendin-4) yog glucagon zoo li polypeptide receptor agonist thiab yog 39-amino acid amidopeptide. Cov tshuaj tsis sib xws, xws li glucagon-zoo li peptide-1 (GLP-1), txhim kho cov kua dej tsis txaus rau cov insulin secretion, txhim kho β-cell muaj nuj nqi, txwv tsis pub muaj ntshav qabzib ntau thiab ua rau lub plab zom mov tom qab lawv nkag mus rau hauv cov ntshav tawm ntawm txoj hnyuv.
Exenatide yog lub zog loj zuj zus uas ua rau cov ntshav qabzib-insulin muaj peev xwm ua rau muaj cov ntshav qabzib ntau yam thiab muaj lwm yam teebmeem ntshav qabzib ntau ntxiv rau cov neeg mob ntshav qab zib hom 2.
Cov amino acid sib lawv liag ntawm exenatide ib nrab sib raug rau ntu ntawm tib neeg GLP-1, los ntawm qhov uas nws khi thiab ua rau GLP-1 cov neeg txais kev pabcuam hauv tib neeg, uas ua rau muaj kev sib txuas ntxiv rau cov piam thaj thiab kev tso pa ntawm insulin los ntawm pancreatic cells-hlwb nrog kev koom tes ntawm cyclic AMP thiab / lossis lwm yam kev cuam tshuam ntawm cov ntshav. txoj kev. Exenatide txhawb kev tso tawm ntawm insulin los ntawm β-hlwb lub xub ntiag ntawm cov ntshav siab ntau.
Exenatide sib txawv hauv cov qauv tshuaj thiab cov tshuaj pharmacological los ntawm insulin, sulfonylurea derivatives, D-phenylalanine derivatives thiab meglitinides, biguanides, thiazolidinediones thiab alpha-glucosidase inhibitors.
Exenatide txhim kho glycemic tswj nyob rau hauv cov neeg mob uas muaj ntshav qab zib hom 2 vim yog cov haujlwm hauv qab no.
Cov kua nplaum-cov kua nyeem cov kua nplaum: nyob hauv hyperglycemic tej yam kev mob, exenatide ua rau cov piam thaj tsis muaj piam thaj cov insulin secretion los ntawm pancreatic cells-hlwb. Qhov insulin secretion tso tseg thaum cov concentration ntawm cov piam thaj hauv cov ntshav txo qis thiab nws nce mus rau qhov qub, yog li txo cov kev pheej hmoo ntawm cov ntshav qog ntshav qab zib.
Thawj theem ntawm cov tshuaj insulin: muab cov tshuaj insulin rau thawj 10 feeb, hu ua "thawj theem ntawm cov tshuaj insulin", tshwj xeeb tshaj yog tsis tuaj rau cov neeg mob ntshav qab zib hom 2. Tsis tas li ntawd, qhov poob ntawm thawj theem ntawm cov tshuaj insulin yog ib qho kev ua haujlwm thaum ntxov ntawm function-cell ua haujlwm ntawm hom ntshav qab zib 2.
Kev tswj hwm ntawm exenatide rov qab los yog hloov kho tau zoo ntau theem ntawm thawj thiab theem ob ntawm cov tshuaj insulin hauv cov neeg mob uas muaj ntshav qab zib hom 2.
Glucagon tso pa tawm: nyob rau hauv cov neeg mob uas muaj hom 2 mob ntshav qab zib mellitus tawm tsam keeb kwm ntawm hyperglycemia, kev tswj hwm ntawm exenatide suppresses ntau dhau hwv ntawm glucagon. Txawm li cas los xij, exenatide tsis cuam tshuam rau lub cev glucagon teb li cas rau kev mob ntshav qab zib.
Kev ua zaub mov noj: kev tswj hwm ntawm exenatide ua rau lub cev txo qis thiab ua kom tsawg dua ntawm qhov khoom noj, inhibits lub plab zom mov, uas ua rau nws qeeb.
Gastric emptying: Exenatide tau pom tias inhibit plab hnyuv, uas ua rau qeeb plab zom mov. Hauv cov neeg mob uas muaj hom 2 mob ntshav qab zib mellitus, kev kho mob exenatide ua ke nrog metformin, thiazolidinedione thiab / los yog sulfonylurea kev npaj ua rau txo qis rau cov ntshav qabzib, ntshav qabzib tom qab, nrog rau HbA 1c, yog li txhim kho glycemic tswj hauv cov neeg mob no.
Sau cov analogues
Daim ntawv tso tawm (los ntawm qhov nrov) | Nqe, tshiav. |
Baeta | |
250mcg / ml 2.4ml N1 (Eli Lilly & Tuam Txhab (Tebchaws Asmeskas) | 11408.20 |
Baeta Ntev | |
0.002 Zauv 4 lub thawv ntawm cov koob txhaj tshuaj - kov (AstraZeneca Pharmaceuticals LP (USA) | 13829.90 |
Sab nraub qaum * (Exenatide *) |
Ob tus qhua tuaj yeem qhia ntau zaus tauj ib hnub
Kuv yuav tsum tau noj Byet ntau npaum li cas?Cov neeg teb feem ntau yuav tau haus cov tshuaj no 1 zaug nyob rau ib hnub. Daim ntawv tshaj tawm qhia tias pes tsawg tus neeg teb ntxiv siv cov tshuaj no.
Cov Tswv Cuab | % | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Ib hnub | 2 | Kaum ob tus neeg qhua qhia txog lub hnub nyoog mob
| 41.7% | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
30-45 xyoo | 4 | 33.3% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
> 60 xyoo lawm | 3 | Cov khoom txaus nyiamYuav ua li cas xaiv txoj cai piv rau Qhov sib txawv ntawm cov kis thiab kab mob Kev ua xua yog qhov ua rau mob khaub thuas Txoj hlab zis: kho mob chlamydial urethritis Cov lus qhia rau kev siv tshuajTsuas yog cov tshuaj uas muaj exenatide yog Baeta. Ntxiv rau cov ntsiab lus tseem ceeb, muaj cov ntsiab lus me me ntawm cov tshuaj ntxiv: sodium acetate trihydrate, mannitol, metacresol, acetic acid thiab dej distilled. Nws yog tsim los ntawm ob lub tuam txhab Swedish - AstraZeneca thiab Bristol-Myers Squibb Co (BMS). Baeta tsuas muaj ib daim ntawv tshuaj - 250 mg ampoules uas muaj cov tshuaj ntshiab, rau txhua qhov muaj cov cwj mem tshwj xeeb nrog lub ntim ntawm 1.2 lossis 2.4 ml. Cov tshuaj yog muag los ntawm cov tshuaj, yog li tsuas yog tus kws kho mob koom nrog tuaj yeem sau nws rau tus neeg mob. Tom qab tus neeg mob kis tau ampoules, nws yuav tsum ua tib zoo nyeem cov lus qhia rau kev siv. Cov tshuaj no siv ob qho tib si nrog monotherapy thiab nrog kev kho ntxiv ntawm hom 2 mob ntshav qab zib mellitus, thaum nws tsis tuaj yeem tswj hwm qhov theem ntawm glycemia. Cov kev qhia muaj ib daim ntawv teev cov tshuaj uas koj tuaj yeem sib xyaw ua ke hauv Bayeta:
Qhov ntau npaum ntawm cov tshuaj yog 5 mcg ib hnub 1 teev ua ntej noj mov loj. Nws yog txhaj rau hauv qab daim tawv nqaij mus rau hauv plab, forearm lossis ncej puab. Yog tias qhov kev kho mob ua tiav, tom qab 30 hnub cov koob tshuaj tau nce rau 10 mcg ob zaug ib hnub. Kev sib txuas ntawm cov tshuaj nrog sulfonylurea derivatives, qhov koob tshuaj ntawm tom kawg yuav tsum raug txo kom tsis txhob txo sai sai hauv cov piam thaj. Thaum lub sij hawm qhia txog kev daws teeb meem, yuav tsum ua raws li cov cai hauv qab no:
Cov tshuaj yuav tsum nyob rau hauv qhov chaw tsaus tsaus kom deb ntawm cov menyuam yaus ntawm qhov kub ntawm 2-8C.
Cov tshuaj tiv thaiv thiab kev tsis haumZoo li lwm yam tshuaj, Cov tshuaj Bayeta muaj qee qhov contraindications:
Rau ib qho laj thawj twg, piv txwv li, nrog kev siv tshuaj tsis raug, cov kev mob tshwm sim tuaj yeem tshwm sim:
Hauv cov xwm txheej zoo li no, tus neeg mob yuav tsum sab laj nrog tus kws kho mob uas yuav kho cov kev kho mob.
Nqi, tshuaj xyuas thiab analogues tshuajCov tshuaj Baeta tuaj yeem yuav tom chaw muag tshuaj lossis ua ib qho xaj hauv Is Taws Nem. Txij li thaum cov tshuaj ntshuam tuaj, tus nqi rau nws yog, raws li, siab heev. Yog li ntawd, tsis yog txhua tus muaj peev xwm yuav nws. Tus nqi nws txawv nyob ntawm seb qhov ntim ntawm qhov kev daws teeb meem, cov nqi thauj khoom thiab cov npoo ntawm cov muag khoom:
Coob tus neeg mob uas tau txais Bayet cov tshuaj tau txaus siab rau cov tshuaj no. Firstly, nws tsuas yog siv ib zaug ib hnub, thiab qhov thib ob, nws yeej txo qis qis ntawm cov piam thaj thiab lub cev qhov hnyav hauv cov neeg rog. Txawm li cas los xij, tom qab tso tawm cov tshuaj, cov tuam ntxhab ua txoj kev tshawb fawb los ntawm kev lag luam hauv kev xaiv cov neeg mob xaiv. Cov txiaj ntsig ntawm txoj kev tshawb pom pom tias feem ntau ntawm cov neeg siv tshuaj muaj cov kev xav tsis zoo hauv qab no:
Raws li rau cov analogues uas muaj tib lub tshuaj nquag, lawv tsis muaj nyob. Hauv Lavxias pharmacological ua lag luam, koj tuaj yeem tsuas pom cov tshuaj uas muaj cov tshuaj zoo sib xws. Cov no suav nrog incretin mimetics - Viktoza thiab Januvius. Cov ntsiab lus ntxaws ntxaws txog lawv tuaj yeem nrhiav hauv Is Taws Nem lossis nug koj tus kws kho mob. Thiab yog li, exenatide, uas muaj nyob hauv kev npaj Bayeta, txo qis ntshav qabzib hauv cov ntshav thiab tsis ua rau cov ntshav qis. Tus kws kho mob sau cov tshuaj no, tshem tawm qhov ua tau contraindications, phiv tshuaj thiab coj mus rau hauv tus account tus yam ntxwv ntawm tus neeg mob. Thov cov kev kho kom zoo, koj tuaj yeem tshem tawm cov tsos mob ntshav qab zib kom ntev. Noj qab nyob zoo! Yuav kom tau txais cov nyiaj them tuaj ncua, kev kho mob ntshav qab zib hom 2 yuav tsum muaj txhij txhua. Yuav kho tus kab mob li cas yuav qhia tus kws tshaj lij hauv video hauv kab lus no. Baeta | Lavxias analogues ntawm cov tshuaj nrog cov nqi thiab tshuaj xyuas| Lavxias analogues ntawm cov tshuaj nrog cov nqi thiab tshuaj xyuasNtshav qab zib mellitus yog ib yam mob uas pauv tau ntau tus neeg lub neej. Vim tias nws, koj yuav tsum tau ua raws li kev noj haus nruj thiab qoj ib ce, tab sis nws tshwm sim tias qhov no tsis txaus. Hauv cov xwm txheej zoo li no, xav tau kev pab kho mob. Baeta yog yeeb tshuaj tsim los ua kom cov ntshav qabzib hauv qib siab. ThovBaeta - cov tshuaj uas ua lub ntsej muag hypoglycemic. Nws muaj cov tshuaj nquag exenatide, uas yog hluavtaws. Nrog nws, qhov txo qis hauv cov qib ntawm cov piam thaj hauv cov ntshav ncig tuaj yeem tshwm sim. Baeta txhawb kev ua kom zoo ntawm GLP-1 (qhov no tshwm sim nrog cov tshuaj nquag exenatide, uas yog ib qho muaj zog zuj zus). Cov tshuaj tso cai rau pancreatic beta hlwb kom normalize insulin ntau lawm. Yog hais tias tus neeg mob mob siab dhau los ntawm hyperglycemia, ces Byeta txo qis kev zais ntawm glucagon. Nws yog ib qho tseem ceeb tias cov tshuaj tsis cuam tshuam rau cov lus teb glucagon. Byeta txo tus nqi ntawm qhov tsis pom kev ntawm lub ntsiab lus ntawm lub pais plab. Qhov no thiaj li ua kom tsis qab los thiab qhov hnyav ntawm tus neeg mob. Cov tshuaj yeeb yaj kiab tuaj yeem siv rau kev kho mob sib koom nrog metformin thiab insulin. Nrog kev pab ntawm no, cov ntshav qab zib hauv cov ntshav hauv cov neeg mob tau txo qis thiab ib theem ntawm glycemic tswj tau tiav. Cov lus qhia tau taw qhia cov pov thawj hauv qab no rau kev siv tshuaj rau hom 2 ntshav qab zib mellitus:
Cov tshuaj yog txhaj rau hauv daim tawv nqaij, tom qab ntawd cov tshuaj nquag nqus sai sai. Qhov ua tau zoo tshaj plaws ntawm kev siv tshuaj yog tau tiav ob peb teev tom qab kev tswj hwm. Cov tshuaj nquag ua tiav los ntawm cov raum. Kev tshem tawm zaum kawg ib nrab-lub neej yog kwv yees li 2 teev. Cov haiv neeg, tub los ntxhais, thiab muaj hnub nyoog (nrog lub raum ua haujlwm nyob rau theem txaus) tsis muaj kev cuam tshuam rau kev siv tshuaj.
Kev tshawb fawb txog kev siv cov tshuaj rau cov menyuam yaus hnub nyoog qis dua 18 xyoo tsis tau ua. Hauv cov xwm txheej zoo li no, tshuaj insulin lossis lwm yam tshuaj nrog cov txheej txheem sib luag ntawm cov haujlwm raug siv. Sab sij huamXav txog cov kev mob tshwm sim thaum tuaj yeem siv tshuaj:
Yog tias koj siv cov tshuaj rau ntev, tom qab ntawd cov tsos ntawm cov tshuaj tiv thaiv mus rau nws yog ua tau. Qhov no ua rau kev kho ntxiv rau tsis muaj nqi. Nws yog ib qho tsim nyog kom tso tseg cov tshuaj, hloov nws nrog ib qho zoo sib xws, thiab cov tshuaj tiv thaiv yuav ploj mus. Baeta tsis muaj kev tiv thaiv kab mob. Kev kho mob rau cov kev mob tshwm sim nyob ntawm cov tsos mob. Tus nqi yog nyob ntawm qhov ntau npaum:
Hauv cov khw muag tshuaj sib txawv, tus nqi hloov pauv. Yog li, piv txwv li, ib qho kev daws teeb meem ntawm 1.2 ml tau pom rau 5590 rubles, thiab 2.4 ml - 8570 rubles. Xav txog qhov sib npaug ntawm Bayeta:
Txoj kev zoo tshaj plaws los thov los ntawm txhua qhov analogues no? Nws nyob ntawm kev ntsuas ntawm tus neeg mob. Nws tsis raug tso cai kom hloov los ntawm ib qho yeeb tshuaj mus rau lwm tus ntawm koj tus kheej, ua ntej siv nws yog qhov yuav tsum tau sab laj tus kws tshaj lij. Xav txog cov kev tshuaj xyuas uas tib neeg tawm txog cov tshuaj Bayeta: Galina sau (//med-otzyv.ru/lekarstva/144-b/35082-baeta #scomments) tias cov tshuaj tsis haum nws txhua: kev ntaus suab thaj thiab txhaj tshuaj tsis xis nyob kiag li. Tus poj niam tsuas hloov cov tshuaj, tom qab ntawd nws tus mob rov zoo li qub. Nws sau hais tias qhov tseem ceeb tshaj plaws yog kom muaj kev yoo mov noj. Dmitry hais tias (// med-otzyv.ru/lekarstva/144-b/35082-baeta #scomments) tau hais tias nws tau siv cov tshuaj nyob hauv ib xyoo tag nrho. Qab zib cia nyob rau theem zoo, tab sis lub ntsiab, raws li tus txiv neej, yog qhov txo qis hauv lub cev hnyav los ntawm 28 kg. Ntawm cov kev mob tshwm sim, nws ua xeev siab. Dmitry hais tias qhov no yog yam tshuaj zoo. Konstantin hais tias (//med-otzyv.ru/lekarstva/144-b/35082-baeta#scomments) tias qhov tshuaj zoo, tab sis cov kev txhaj tshuaj tsis zoo txaus. Nws cia siab tias nws yuav muaj peev xwm nrhiav tau ib qho analogue ntawm cov tshuaj, muaj nyob hauv ntsiav tshuaj daim ntawv. Kev txheeb xyuas hais tias cov tshuaj yuav pab tsis tau txhua tus. Ib qho ntawm nws cov teeb meem tseem ceeb yog daim ntawv ntawm kev tso tawm. Qhov no tsis yooj yim rau txhua tus neeg mob. Baeta - ib qho tshuaj uas tso cai rau koj kom cov dej qab zib hauv cov kab mob mus ntev. Nws yog tus nqi kim heev, tab sis qee kis nws raug xaj cia dawb hauv tsev kho mob. Yog tias koj them sai sai rau kev tshuaj xyuas cov neeg mob, cov tshuaj yog deb ntawm kev siv thoob ntiaj teb. Txuag lossis sib qhia: Hais txog yeeb tshuajBaeta cov tshuaj yog tsim los ntawm lub tuam txhab nto moo nyob hauv UK. Cov neeg ua haujlwm rau cov antagonists ntawm glucose-zoo li peptide, yog ib qho kev ua noj ua haus ntawm cov nce zuj zus. Cov nyhuv pharmacological yog vim muaj ntau ntxiv ntawm cov beta hlwb, ua cov lus teb rau cov khoom noj thiab qab zib hauv lub cev. Tom qab noj mov, Baeta thaiv kev hloov pauv ntawm glucagon thiab nws tso tawm rau qhov khoom plig. Cov tshuaj yeeb dej caw tam sim no muaj pes tsawg leeg tshuaj sib xyaw rau cov ntshav qab zib ua ke:
Cov tshuaj siv los ua monotherapy, zoo li nyob rau hauv kev sib koom tes tswj tshuaj ntawm hypoglycemic ntawm cov nyhuv hauv zos. Tso cov tshuaj insulin neutralizes cov piam thaj, tiv thaiv nws cov kev txuam nrog hauv cov hlab ntshav, plab hnyuv siab raum thiab cov ntaub so ntswg. Kev siv tshuaj rau kev kho mob ntshav qab zib yog nrov ntawm cov neeg mob rau ntau qhov laj thawj. Cov kev kho mob zoo vim yog kev tswj hwm subcutaneous ntawm cov tshuaj, txij li muaj qhov ua tiav kev nqus ntawm cov khoom siv, thiab tom qab ob peb teev cov suab thaj theem rov zoo li qub. Cov nyhuv yog lub sijhawm ntev thiab yog qhov tsawg kawg ib hnub. Nws yog tawm hauv lub cev nrog zis tsis hloov cov khoom ntawm lub cev ua tau ntawm cov zis. Tso tawm daim ntawv thiab muaj pes tsawg leegDaim ntawv ntau npaum li cas ntawm cov tshuaj tiv thaiv kab mob ua kom haum yog koob txhaj tshuaj nrog lub taub hau uas tsis hloov pauv. Hais txog cov txhais tau tias ntawm ib tiam neeg tshiab. Nws raug siv los tswj cov tshuaj hormone incretin subcutaneously (kev txhaj tshuaj koob tsis suav nrog). Cov xim tsis muaj xim Baeta daws tsis muaj ntxhiab tsw. Kev ua haujlwm ntawm cov tshuaj yog Exenatide ntawm kev saib xyuas ntawm 250 mg. Lub caij no yog cais los ntawm cov qaub ncaug ntawm ib tug nabqa, qhov tsis txawv ntawm kev dag uas nyob hauv lub caij nyoog tsis muaj zaub mov zoo. Thaum lub sij hawm muaj kev tshaib plab, lub txiav ntawm lub cev ntawm tus tsiaj reptile ceev synthesizes insulin. Raws li qhov tshwm sim no, cov nyhuv ntawm exenatide rau cov kab mob ntshav qab zib tau tsim tau. Ntxiv nrog rau cov tshuaj nquag, cov khoom pab sib txuam muaj nyob rau hauv qhov muaj pes tsawg leeg noj tshuaj: Ntshav qab zib yog ib txwm 3.8 mmol / L Yuav ua li cas kom muaj suab thaj nyob hauv 2019
Txoj kev ua kom tshem tawm zoo thiab cov khoom ua si nquag ua rau cov tshuaj kho mob, ua rau cov neeg mob ntshav qab zib ua lub neej zoo. Cov lus qhia tshwj xeebCov tshuaj yog xav kho hom mob ntshav qab zib hom 2. Nws yuav tsum tsis txhob pub siv Byet rau cov neeg mob uas muaj mob ntshav qab zib hom 1, zoo li yog tias tus kab mob loj zuj zus thiab kev vam khom rau kev noj qab haus huv ntawm pancreatic. Byeta tsis hloov pauv kev kho tshuaj insulin. Nws yog siv rau hauv cov ntshav qab zib hauv qhov tsis muaj qhov kho tau cov tshuaj thaum siv Metformin. Tsis pub siv tshuaj thaum muab hloov los ntawm ib hom tshuaj insulin mus rau lwm qhov. Txog kev kho mob ntshav qab zib tau zoo hauv tsev, cov kws tshaj lij qhia DiaLifeCov. Nov yog qhov cuab yeej tshwj xeeb:
Cov neeg tsim khoom tau txais tag nrho cov ntawv tso cai tsim nyog thiab cov ntawv pov thawj zoo muaj nyob rau hauv Russia thiab hauv cov tebchaws nyob sib ze. Peb muab cov luv nqi rau cov nyeem ntawm peb lub xaib! Yuav ntawm lub vev xaib raug cai Cov neeg mob coj mus rau hauv tus account qhov tseem ceeb ntawm qhov kev poob phaus vim yog qhov ua kom yuag tsawg dua. Kev ntsuas ntshav cov kev txwv yog nqa tawm txhua hnub, yog li kom tsis txhob nco qab txog cov ntshav piam thaj hauv qab qis dua qhov tsim nyog. Nws yog ib qho tseem ceeb thaum kev noj zaub mov nrog Exenatide thiab tswj kev ua lub neej nquag. Ua ke nrog lwm cov tshuajRaws li ib feem ntawm txoj kev kho mob nyuaj, kev txo cov tshuaj muaj piam thaj yog tshuaj nrog kev ceev faj, vim nws cuam tshuam rau cov tshuaj ntawm lwm pawg pharmacological:
Yeeb-tshuaj ntsiav tshuaj thiab tsiav tshuaj, kev nqus sai ntawm cov uas tshwm sim hauv lub plab zom mov, yuav tsum tau noj ua ntej subcutaneous thawj coj ntawm Baeta. Tsim muaj dyspeptic syndrome cuam tshuam tsis zoo rau qhov chaw muag tshuaj ntawm cov tshuaj thiab lub xeev ntawm lub plab zom mov. Baeta: cov lus qhia rau kev siv, nqi, xyuas, analoguesNtshav qab zib mellitus yog ib yam mob uas pauv tau ntau tus neeg lub neej. Vim tias nws, koj yuav tsum tau ua raws li kev noj haus nruj thiab qoj ib ce, tab sis nws tshwm sim tias qhov no tsis txaus. Hauv cov xwm txheej zoo li no, xav tau kev pab kho mob. Baeta yog yeeb tshuaj tsim los ua kom cov ntshav qabzib hauv qib siab. Cov khoom siv nquag: muaj exenatide 250 mcg. Cov muaj mob: sodium acetate trihydrate, glacial acetic acid, mannitol, metacresol, dej d / i. Kev taw qhia BayetaKev Kho Mob Ntshav Qab Zib: Hom 2 mob ntshav qab zib mellitus raws li kev kho mob monotherapy ntxiv rau kev noj haus thiab kev tawm dag zog kom ua tiav kev tswj glycemic. Hom 2 mob ntshav qab zib mellitus raws li kev kho mob ntxiv rau thaum tsis ua tiav kom tau glycemic tswj kom txaus:
Cov Tshuaj Tiv Thaiv BayetaHom 1 mob ntshav qab zib mellitus lossis qhov muaj ntshav qab zib ketoacidosis. Mob raum tsis ua hauj lwm (kev tshem tawm creatinine tsawg dua 30 ml / min). Lub xub ntiag ntawm kev mob plab hnyuv ntau nrog concomitant gastroparesis. Cev xeeb tub Lactation (noj niam mis). Cov menyuam yaus hnub nyoog qis dua 18 xyoo (kev nyab xeeb thiab kev ua tau zoo ntawm cov tshuaj hauv cov menyuam yaus tseem tsis tau tsim). Hypersensitivity rau exenatide lossis excipients uas ua cov tshuaj. Kev pom zoo rau kev siv Cov tshuaj yog muab sc rau tus ncej puab, plab / hauv plab. Qhov tshuaj thawj zaug yog 5 mcg, uas tau txhaj tshuaj 2 zaug ib hnub nyob rau txhua lub sijhawm rau 60-feeb sijhawm ua ntej noj thaum sawv ntxov thiab yav tsaus ntuj. Tsis txhob noj cov tshuaj tom qab noj mov. Yog tias kev txhaj tshuaj tsis tiav, kev kho mob mus txuas ntxiv yam tsis hloov pauv koob tshuaj. 1 lub hlis tom qab pib txoj kev kho mob, cov koob tshuaj yuav raug nce ntxiv rau 10 mcg 2 zaug hauv ib hnub. Thaum ua ke nrog metformin, thiazolidinedione, lossis nrog kev sib xyaw ntawm cov tshuaj no, cov koob tshuaj thawj zaug ntawm metformin thiab / lossis thiazolidinedione tsis tuaj yeem hloov pauv. Thaum muaj kev sib xyaw ntawm Bayeta ® nrog sulfonylurea derivatives, yuav tsum tau txo koob tshuaj sulfonylurea derivative kom txo qis kev pheej hmoo ntawm hypoglycemia. Siv rau lub raum tsis zoo muaj nuj nqi Cov tshuaj yog contraindicated nyob rau hauv kev mob raum tsis zoo (creatinine tshem tawm tsawg dua 30 ml / min). Phiv Rov Los Ntawm BaetaCov kev tsis zoo uas tshwm sim ntau tshaj li ntawm qhov teeb meem raug cais tawm tau teev npe raws li cov ntawv pov thawj hauv qab no: ntau heev - ≥10%, feem ntau - ≥1%, tab sis Los ntawm lub plab zom mov: feem ntau - xeev siab, ntuav, raws plab, ntau zaus - tsis qab los noj mov, dyspepsia, mob plab zom mov, qee zaum - mob plab, tsam plab, thiav, cem quav, ua txhaum cai ntawm saj tsis hnov qab, flatulence. Los ntawm sab hauv nruab nrab ntawm lub hauv nruab nrab lub paj hlwb: feem ntau - kiv taub hau, mob taub hau, tsis tshua muaj - tsaug zog. Los ntawm cov kab mob endocrine: feem ntau - hypoglycemia (hauv kev sib xyaw nrog sulfonylurea derivatives), feem ntau - zoo nkaus li tshee tshee, tsis muaj zog, hyperhidrosis.
Lwm yam: feem ntau - hnov mob ntawm daim tawv nqaij ntawm qhov chaw txhaj tshuaj, tsis tshua muaj - lub cev qhuav dej (cuam tshuam nrog xeev siab, ntuav thiab / lossis zawv plab). Ntau qhov xwm txheej ntawm cov ntshav coagulation sijhawm (INR) tau tshaj tawm nrog kev siv tib lub sij hawm ntawm warfarin thiab exenatide, uas qee zaum nrog los ntshav. Vim yog qhov tseeb tias qhov zaus ntawm hypoglycemia nce nrog kev sib koom tes ntawm cov tshuaj Baeta nrog sulfonylurea derivatives, nws yog qhov yuav tsum txiav txim siab txo qhov koob tshuaj sulfonylurea derivatives nrog kev pheej hmoo ntawm hypoglycemia. Feem ntau qhov tshwm sim ntawm cov ntshav qog nqaij hlav hauv qhov sib luag tau mob me me los yog mob nyhav thiab raug tso tseg los ntawm kev noj zaub mov hauv qhov ncauj. Feem ntau, cov kev mob tshwm sim tau mob sib khuav me me los sis mob hnyav thiab tsis ua rau txo kev kho mob. Feem ntau, tau sau npe ntawm xeev siab txog qhov mob sib khuav xwb los yog siv yoog tau siv tshuaj ntau thiab tsawg zuj zus, tsis muaj cuam tshuam nrog kev ua si txhua hnub. Nws tsis pom zoo hauv / hauv lossis hauv / m tswj hwm ntawm cov tshuaj. Bayeta® yuav tsum tsis txhob siv yog tias cov tshuaj tiv thaiv tau pom hauv kev daws teeb meem lossis yog hais tias daws tau pos huab lossis muaj qhov stain. Tshuaj tua kab mob rau exenatide tuaj yeem tshwm sim thaum kev kho mob nrog Bayeta®. Txawm li cas los xij, qhov no tsis cuam tshuam qhov nquag thiab hom ntawm cov kev mob tshwm sim. Cov neeg mob yuav tsum tau paub tias kev kho mob nrog Bayeta® tuaj yeem ua rau tsis qab los noj mov thiab / lossis lub cev qhov hnyav thiab tias vim los ntawm cov teebmeem no tsis tas yuav hloov pauv kev noj tshuaj. Cov neeg mob ua ntej pib kev kho mob nrog Bayeta® yuav tsum paub lawv tus kheej nrog Phau Ntawv Qhia kom siv cov koob txhaj tshuaj txuas nrog rau cov tshuaj. Cov txiaj ntsig ntawm kev sim sim Hauv kev tshawb fawb preclinical hauv cov nas thiab nas, tsis muaj cov teebmeem carcinogenic ntawm exenatide pom. Thaum cov nas tau muab koob tshuaj 128 zaug rau hauv tib neeg, ntau qhov nce hauv C-cell cov thyroid adenomas tau sau tseg tsis muaj cov cim tsis zoo, uas cuam tshuam nrog kev nce hauv lub neej ntawm kev sim cov tsiaj uas tau txais exenatide. Cov tsos mob: xeev siab thiab ntuav, nrog rau kev txhim kho sai ntawm hypoglycemia (thaum noj ib zaug 10 zaug ntau dua qhov siab tshaj qhov pom zoo).
Bayeta® yuav tsum tau siv nrog ceev faj hauv cov neeg mob noj tshuaj ntawm qhov ncauj uas yuav tsum nqus sai los ntawm kev mob plab, vim tias Byeta® yuav ncua kev mob plab zom mov. Cov neeg mob yuav tsum raug qhia kom noj cov tshuaj hauv qhov ncauj, cov nyhuv ntawm nws nyob ntawm lawv lub luag haujlwm tseem ceeb (piv txwv li tshuaj tua kab mob), tsawg kawg 1 teev ua ntej kev tswj hwm ntawm exenatide. Yog tias cov tshuaj no yuav tsum tau noj nrog zaub mov, tom qab ntawd lawv yuav tsum noj thaum cov zaub mov noj thaum cov tshuaj exenatide tsis tau txais. Nrog rau kev tswj hwm tib lub sijhawm ntawm digoxin (ntawm koob tshuaj 0.25 mg 1 zaug / hnub) nrog kev npaj Bayeta max, qhov kawg ntawm digoxin poob qis txog 17%, thiab T max nce li 2.5 teev. Txawm li cas los xij, tag nrho cov tshuaj pharmacokinetic ntawm qhov sib npaug ntawm lub xeev tsis hloov. Nrog cov lus qhia ntawm Bayeta®, AUC thiab Cmax ntawm lovastatin txo los ntawm kwv yees li 40 thiab 28%, thiab Tmax tau nce li ntawm 4 teev li. Kev sib koom tes ntawm Bayeta® nrog HMG-CoA reductase inhibitors tsis nrog kev hloov pauv hauv cov ntshav lipid (HDL cholesterol), Cov roj (LDL), cov roj (cholesterol tag nrho thiab triglycerides). Hauv cov neeg mob uas tsis tshua mob me me los sis mob ntshav qis los ntawm lisinopril (5-20 mg / hnub), Bayeta® tsis hloov pauv ntawm AUC thiab Cmax ntawm lisinopril ntawm kev sib npaug. Tmax ntawm lisinopril ntawm qhov sib npaug nce los ntawm 2 teev .Tsis tsis muaj kev hloov pauv ntawm qhov ntsuas ntawm nruab nrab txhua hnub SBP thiab DBP. Nws tau sau tseg tias nrog kev qhia txog warfarin 30 feeb tom qab kev npaj ntawm Bayeta® Tmax tau nce li ntawm 2 teev. Tsis pom muaj kev hloov pauv hauv Cmax thiab AUC. Kev siv Bayeta® txuam nrog insulin, D-phenylalanine derivatives, meglitinides lossis alpha-glucosidase inhibitors tsis tau kawm. Khaws ntawm qhov kub ntawm 2 txog 8 ° C. Txee lub neej: 2 xyoos. Analogs hauv kev muaj pes tsawg leeg thiab qhia txog kev siv
Cov npe saum toj no ntawm cov yeeb tshuaj analogues, uas qhia Baeta hloov chaw, yog qhov tsim nyog tshaj plaws vim tias lawv muaj tib cov tshuaj sib luag thiab sib luag ua ke raws li kev taw qhia rau kev siv Analogs los ntawm qhov taw qhia thiab cov qauv ntawm kev siv
Sib txawv muaj pes tsawg leeg, tuaj yeem ua ke nyob rau hauv kev taw qhia thiab cov qauv ntawm daim ntawv thov
Yuav ua li cas thiaj nrhiav tau qhov pheej yig tshuaj ntawm cov tshuaj kim?Txhawm rau kom pom qhov pheej yig cov khoom sib piv rau cov tshuaj, cov dav dav lossis cov lus sau, ua ntej txhua yam peb pom zoo kom them sai sai rau qhov muaj pes tsawg leeg, uas yog rau tib cov tshuaj nquag thiab qhia tau rau kev siv. Cov tshuaj sib xyaw zoo ib yam ntawm cov tshuaj yuav qhia tau tias cov tshuaj cuam tshuam nrog cov tshuaj, kws tshuaj sib npaug lossis chaw muag tshuaj. Txawm li cas los xij, tsis txhob hnov qab txog qhov ua tsis muaj zog ntawm cov tshuaj uas zoo sib xws, uas tuaj yeem cuam tshuam kev nyab xeeb thiab ua haujlwm. Tsis txhob hnov qab txog cov lus qhia ntawm cov kws kho mob, kev noj tshuaj rau nws tus kheej tuaj yeem tsim kev puas tsuaj rau koj kev noj qab haus huv, yog li nco ntsoov sab laj nrog koj tus kws kho mob ua ntej siv cov tshuaj. Glibenclamide4 muab pib los ntawm 100.00 ua ntej 135.00 tshiav 4 muab pib los ntawm 112.00 ua ntej 126.00 tshiav 19 muaj pib ntawm 339.00 ua ntej 615.00 tshiav 34 muab pib los ntawm 55.00 ua ntej 11,650.00 tshiav 27 muab pib los ntawm 48.00 ua ntej 178.00 tshiav 2 muab pib los ntawm 227.00 ua ntej 246.00 tshiav Glimepiride Cov Kws Muag Tshuaj1 muab pib los ntawm 180.00 ua ntej 180.00 tshiav 13 muab pib los ntawm 147.00 ua ntej 376.00 tshiav 18 muab pib los ntawm 290.00 ua ntej 436.00 tshiav 29 muab pib los ntawm 154.00 ua ntej 805.00 tshiav 11 muaj pib ntawm 97.00 ua ntej 345.00 tshiav 45 muab pib los ntawm 1,250.00 ua ntej 4,044.00 tshiav Combogliz Prolong18 muab pib los ntawm 3,090.00 ua ntej 3,899.00 tshiav 10 muab pib los ntawm 1,425.00 ua ntej 1,959.00 tshiav 17 muab pib los ntawm 1,469.00 ua ntej 1,767.00 tshiav 63 muab pib los ntawm 667.00 ua ntej 1,904.00 tshiav 19 muaj pib ntawm 1,749.00 ua ntej 2,189.00 tshiav 25 muab pib los ntawm 689.00 ua ntej 1,369.00 tshiav 16 muab pib los ntawm 1,648.00 ua ntej 1,959.00 tshiav Txhua qhov tsis zoo ntawm Baeta raug nthuav tawm rau kev tshaj tawm xov xwm nkaus xwb thiab tsis yog lub laj thawj ntawm kev txiav txim siab ywj pheej ntawm kev hloov tshuaj. Ua ntej siv cov tshuaj, sab laj rau koj tus kws kho mob thiab nyeem cov lus qhia rau kev siv. SELF-TSHUAJ TUA TUAJ YEEM HAIS TIAS KOJ HEALTH Kev siv tshuaj Hypoglycemic Tshuaj Baeta: cov lus qhia rau kev siv, nqe, tshuaj xyuas thiab analoguesBaeta yog kev npaj ua hluavtaws raws li cov tshuaj yeeb exenatide, uas muaj cov nyhuv hypoglycemic. Cov nyhuv no tau ua tiav los ntawm kev ua kom cov glucagon-zoo li peptide-1 receptors thiab ua kom lub zog ntawm cov tshuaj insulin los ntawm beta-hlwb ntawm lub pancreatic caj pas, uas pab txo qis cov ntshav qabzib. Ntawm cov kev kho mob ntawm Beat yog:
Cov tshuaj Beata yog qhia rau kev siv tshwj xeeb rau cov neeg mob kev mob ntshav qab zib hom 2. Nws yog tshuaj txhawm rau tswj theem ntawm glycemia hauv cov neeg mob uas tau txais kev kho mob tiv thaiv nrog sulfonylurea derivatives thiab metformin. Daim ntawv thov ntaCov tshuaj yog muab tshuaj subcutaneously nyob rau sab sauv los yog nruab nrab thib peb ntawm lub xub pwg, ncej puab, thiab tseem nyob hauv plabCov. Raws li txoj cai, nws raug nquahu kom hloov rau cov chaw no kom tsis txhob muaj kev tsim cov khoom lag luam subcutaneous. Kev txhaj tshuaj yuav tsum tau ua kom raug raws li txhua txoj cai siv rau kev xaum xim. Cov tshuaj yuav tsum tau siv sijhawm ib teev ua ntej cov zaub mov tseem ceeb ntawm lub sijhawm tsawg kawg 6 teev. Exenatide tsis tuaj yeem tov nrog lwm cov ntaub ntawv tshuaj, uas yuav zam qhov kev txhim kho ntawm cov kev tsis haum siab. Tsuas yog tus kws kho mob yuav tsum noj cov tshuaj, raws li kev ntsuas xws li ntshav qabzib, qhov koob tshuaj ntawm cov tshuaj hypoglycemic tseem ceeb, muaj cov kab mob concomitant ailments, thiab cov zoo li. Feem ntau thawj koob tshuaj Baeta yog 5 mcg ob zaug ib hnub rau plaub lub lis piam. Ntxiv mus, qhov nyiaj ntawm cov tshuaj tswj tau tuaj yeem muab nce ntxiv mus rau 10 μg ib hnub (yog tias tsim nyog). Nws tsis pom zoo kom ntau tshaj qhov noj ntau dua 10 mcg. Cov tsos mob ntawm kev siv yeeb tshuaj ntau dhau los kuaj tau pom tias kev siv ntau dua 100 μg ntawm cov tshuaj ib hnub thiab ua rau pom tias ntuav hnyav tawm tsam keeb kwm ntawm kev nce qib sai sai hypoglycemia. Exenatide: nqe thiab analogues ntawm BayetaCov tshuaj Baeta, uas nws cov tshuaj nquag yog exenatide, yog suav tias yog qhov tshuaj tsis muaj zog hypoglycemic. Lub cuab yeej yog siv rau hauv kev kho mob ntshav qab zib hom 2, tshwj xeeb yog lub nra hnyav nrog kev rog. Qhov ua tau zoo ntawm cov tshuaj no cuam tshuam nrog kev ua haujlwm ntawm cov haujlwm tseem ceeb tshaj plaws, uas txo qis cov piam thaj hauv ntshav. Nws tsub kom cov kua dej tso tawm tsis zais, thiab tseem, kev ua kom lub zog nce zuj zus ntxiv, muaj lwm cov txiaj ntsig hauv qab zib:
Qhov txiaj ntsig tseem ceeb ntawm ib yam khoom xws li exenatide yog tias nws nce tsim tawm ntawm cov tshuaj insulin los ntawm parenchyma, thiab tom qab ntawd nres nws txoj kev tso cia thaum cov ntshav qabzib rov qab mus rau qub. Yog li, qhov tshwm sim ntawm qhov pib ntawm hypoglycemic lub xeev nyob rau hauv tib neeg yog yuav luag xoom. Tom qab cov tshuaj nkag mus rau hauv tib neeg lub cev, nws tam sim ntawd pib ua thiab ncav lub ncov hauv nws cov kev ua hauv ob teev. Lub sijhawm ntawm exenatide yog 24 teev, yog li qhov kev taw qhia ntawm nws ib hnub ib zaug muab txo qis hauv qab zib cov ntsiab lus hauv tib 24 teev. Ntxiv rau, exenatide txo qhov qab los noj mov uas yog ntshav qab zib, vim li ntawd, nws tau noj tsawg dua, lub plab zom mov qis, thiab nws tsis plam tawm sai li sai tau. Yog li, xws li cov khoom tsis tsuas yog tswj kom ntshav qab zib cov ntshav, tab sis kuj tseem pab kom tshem tau cov khoom hnyav ntxiv 4-5 kilo. Exenatide 2 mgKev txiav txim los ntawm tus me nyuam nyob rau hauv lub thermo-tub yees rau Moscow lossis Russia. Them nyiaj - nyiaj ntsuab ntawm qhov xa! Tus nqi yog taw qhia saum toj no. Hla lub txee! Daim ntawv yog cov lus qhia txog kev siv thiab daim ntawv pov thawj zoo los ntawm lub tuam txhab tsim khoom. Peb cov khoom yog tsim raws li cov cai ntawm European GMP EU thiab German Tshooj 13 AMG txoj cai lij choj lees tias qhov zoo thiab kev nyab xeeb ntawm cov tshuaj. Pom zoo los ntawm Asmeskas FDA thiab European Medical Agency. Cov lus qhia ntau dhauCov lus piav qhia yog ua raws cov lus qhia rau kev siv, kev tshuaj xyuas tus neeg mob thiab cov txiaj ntsig ntawm kev sim tshuaj. Bidureon yog ib cov tshuaj rau kev ua rau cov ntshav qab zib hauv cov neeg laus uas muaj ntshav qab zib hom 2 ntau. Nws yuav tsum tau siv nrog rau kev noj haus thiab kev tawm dag zog, nrog rau cov tshuaj noj hauv qhov ncauj uas koj tau noj tam sim no. Tsis pom zoo siv los ua kev kho mob ntshav qab zib. Cov tshuaj no tej zaum:
Cov Kev Tshawb Nrhiav Chaw Kawm ExenatideCov neeg mob ntshav qab zib hom 2 koom nrog txoj kev tshawb no ntawm kev ua tau zoo thiab kev nyab xeeb ntawm cov tshuaj. Tom qab 24-lub lim tiam ntawm txoj kev kho mob uas lawv siv Bidureon ntawm kev noj tshuaj ntawm 2 mg ib hnub:
Nws yog ib qho tseem ceeb kom nco ntsoov tias cov tshuaj no tsis yog tsim rau kom yuag! Mechanism ntawm kev uaBidureon yog qhov tshuaj qeeb qeeb tas mus li. Qhov kev txiav txim ntawm ib zaug txhaj tshuaj yuav kav 7 hnub. Cov tshuaj no pab koj lub cev tso tawm cov insulin thaum nws xav tau kom txo qis hauv cov ntshav qab zib, ua haujlwm thoob ib asthiv. Txhua koob tshuaj muaj microspheres (cov khoom me me) uas muaj cov khoom ua kom nquag plias - exenatide, Cov tshuaj no maj mam zom, maj mam tso tawm cov tshuaj hauv koj lub cev rau ib lim tiam los pab tswj koj cov ntshav qab zib. Tsis tas li ntawd, thaum noj tshuaj, qhov ntsuas ntawm kev zom thiab qab los noj mov tau nce siab me ntsis, uas ua rau nws tuaj yeem txo qhov hnyav me ntsis. Txij li nws yuav siv li 6 rau 7 lub lis piam kom mus txog qhov zoo tshaj plaws ntawm cov tshuaj hauv cov ntshav, nws yog ib qho tseem ceeb kom noj cov tshuaj ntxiv raws li koj tus kws kho mob tau qhia. Yuav ua li cas thiaj yuav siv cov tshuaj. Cov kauj ruam los ntawm kauj ruam cov lus qhia:
Tseem Ceeb! Txij ntawm no, koj yuav muab cov tshuaj sib tov thiab ntim cov kua tshuaj. Tom qab koj sib tov cov tshuaj, koj yuav tsum tau txhaj tshuaj. Koj tsis tuaj yeem khaws cov tshuaj sib xyaw rau kev tswj hwm nyob rau lwm lub sijhawm tom qab.
Yuav ua li cas thiaj paub tseeb tias cov tshuaj raug tswj hwm zoo?Nias lub piston kom txog thaum koj hnov qhov pom tseeb. Tom qab ntawv, tos lwm 10 vib nas this. Tam sim no koj tuaj yeem ntseeg tau tias koj tau ua txhua yam zoo Thaum xaj ntau pob koj tau txais luv nqi: 2 pob ib: 400.00 € 3 pob ib: 395.00 € 4 pob ib: 390.00 € 5 pob ib: 385.00 € 10 pob ib: 375.00 € Pharmacological kev txiav tximKev siv tshuaj hypoglycemic. Exenatide (Exendin-4) yog qhov ua kom zoo ntxiv thiab yog 39-amino acid amidopeptide. Cov ntau zuj zus, xws li glucagon-zoo li peptide-1 (GLP-1), txhim kho cov kua dej tsis txaus rau cov kua dej, txhim kho beta ntawm tes ua haujlwm, txwv tsis pub muaj ntshav qabzib ntau thiab ua rau lub plab zom mov tom qab lawv nkag mus rau hauv cov ntshav tawm ntawm txoj hnyuv. Exenatide yog lub zog loj zuj zus uas ua rau cov ntshav qabzib-insulin muaj peev xwm ua rau muaj cov ntshav qabzib ntau yam thiab muaj lwm yam teebmeem ntshav qabzib ntau ntxiv rau cov neeg mob ntshav qab zib hom 2. Cov amino acid sib lawv liag ntawm exenatide ib feem sib raug rau ntu ntawm tib neeg GLP-1, los ntawm qhov uas nws khi thiab ua rau GLP-1 cov neeg txais kev pabcuam hauv tib neeg, uas ua rau muaj kev sib txuas ntxiv rau cov ntshav qabzib thiab kev tso ntshav ntawm insulin los ntawm pancreatic beta hlwb nrog kev koom tes ntawm cyclic AMP thiab / lossis lwm yam kev cuam tshuam ntawm lub cev. txoj kev. Exenatide txhawb kev tso tawm ntawm insulin los ntawm beta hlwb nyob ib puag ncig ntawm kev nce siab nyob hauv siab. Exenatide sib txawv hauv cov qauv tshuaj thiab cov tshuaj pharmacological los ntawm insulin, sulfonylurea derivatives, D-phenylalanine derivatives thiab meglitinides, biguanides, thiazolidinediones thiab alpha-glucosidase inhibitors. Exenatide txhim kho glycemic tswj nyob rau hauv cov neeg mob uas muaj ntshav qab zib hom 2 vim yog cov haujlwm hauv qab no. Hauv hyperglycemic tej yam kev mob, exenatide ua rau cov piam thaj tsis muaj peev xwm tso cov kua dej ntawm cov kua dej los ntawm pancreatic beta hlwb. Cov tshuaj insulin tsis ua haujlwm ntxiv vim tias cov ntshav qabzib ntau thiab tsawg mus rau qhov ib txwm ua, yog li txo qhov kev pheej hmoo ntawm cov ntshav qog ntshav qis. Insulin secretion rau thawj 10 feeb (teb rau kev nce ntxiv ntawm glycemia), hu ua "thawj theem ntawm cov tshuaj insulin", tshwj xeeb tshaj yog tsis tuaj. cov neeg mob ntshav qab zib hom 2. Tsis tas li ntawd xwb, qhov poob ntawm thawj theem ntawm cov tshuaj insulin yog ib qho kev ua haujlwm thaum ntxov ntawm beta cell ua haujlwm hauv hom 2 ntshav qab zib. Kev tswj hwm ntawm exenatide rov qab los yog hloov kho tau zoo ntau theem ntawm thawj thiab theem ob ntawm cov tshuaj insulin hauv cov neeg mob uas muaj ntshav qab zib hom 2. Hauv cov neeg mob uas muaj hom 2 mob ntshav qab zib mellitus tawm tsam keeb kwm ntawm hyperglycemia, kev coj noj coj ua ntawm exenatide txwv kev tso cia ntau dhau ntawm glucagon. Txawm li cas los xij, exenatide tsis cuam tshuam rau lub cev glucagon teb li cas rau kev mob ntshav qab zib. Nws tau pom tias kev coj noj coj ua ntawm exenatide ua rau kev poob qis thiab ua kom tsawg dua ntawm txoj kev noj zaub mov, inhibits lub cev muaj zog ntawm lub plab, uas ua rau lub qeeb ntawm nws qhov khoob. Hauv cov neeg mob uas muaj hom 2 mob ntshav qab zib mellitus, kev kho mob exenatide nrog kev sib xyaw nrog metformin, thiazolidinedione thiab / los yog sulfonylurea kev npaj ua rau txo qis ntshav qabzib, ntshav qabzib tom qab, nrog rau HbA1c, yog li txhim kho glycemic tswj hauv cov neeg mob no. Cov Tshuaj PharmacokineticsKev Zam Tom qab kev tswj hwm ntawm exenatide ntawm ib koob ntawm 10 μg rau cov neeg mob uas muaj hom 2 mob ntshav qab zib mellitus, exenatide nrawm nrawm thiab mus txog qhov txhais tau tias C max tom qab 2.1 teev, uas yog 211 pg / ml, AUCo-inf yog 1036 pg? h / ml Thaum tso tawm rau exenatide, AUC nce rau hauv kev faib ua feem rau cov koob tshuaj nce ntxiv ntawm 5 μg txog 10 μg, thaum tsis muaj qhov sib luag ntawm Cmax. Tib cov txiaj ntsig tau pom nrog kev coj ua subcutaneous ntawm exenatide hauv plab, ncej puab lossis caj npab. Kev faib tawm ntawm Vd exenatide tom qab sc tswj hwm yog 28.3 L. Kev tiv thaiv kab mob thiab kev nthuav tawm Exenatide feem ntau yog ua los ntawm glomerular pom tom qab los ntawm kev muaj cov khoom (proteolytic degradation). Exenatide tshem tawm yog 9.1 l / h. Qhov kawg T1 / 2 yog 2.4 teev. Cov ntsej muag pharmacokinetic ntawm exenatide yog koob tshuaj ywj siab. Ntsuas qhov ntau ntawm exenatide raug txiav txim kwv yees li 10 teev tom qab noj tshuaj. Pharmacokinetics hauv cov chaw kho mob tshwj xeeb Hauv cov neeg mob uas tsis tshua mob hlwb los yog mob raum (CC 30-80 ml / min), kev tshem tawm tsis yog qhov txawv ntawm kev tshem tawm hauv cov neeg mob uas lub raum tsis ua haujlwm, yog li ntawd, kev kho tshuaj tsis tas yuav tsum tau txhaj.
Yog li, cov neeg laus laus tsis tas yuav tsum ua qhov hloov kho koob tshuaj. Cov pharmacokinetics ntawm exenatide hauv cov menyuam hnub nyoog qis dua 12 xyoos tsis tau kawm. Hauv kev kawm pharmacokinetic nyob rau cov tub ntxhais hluas hnub nyoog 12 txog 16 xyoo nrog hom 2 mob ntshav qab zib mellitus, thaum exenatide tau raug tshaj tawm ntawm koob tshuaj 5 μg, pharmacokinetic tsis zoo ib yam li cov neeg laus. Tsis muaj qhov sib txawv ntau qhov sib txawv ntawm tus txiv neej thiab poj niam hauv pharmacokinetics ntawm exenatide. Cov chaw muag tshuaj ntawm exenatide hauv cov neeg sawv cev ntawm ntau haiv neeg sib txawv tsis hloov. Tsis tas yuav muab hloov kho los ntawm haiv neeg keeb kwm. Tsis muaj qhov tshwm sim pom tseeb ntawm kev ntsuas lub cev (BMI) thiab exenatide pharmacokinetics. Koob tshuaj hloov kho raws li BMI yog tsis xav tau. Cov mob tshwj xeebTsis txhob noj cov tshuaj tom qab noj mov. Nws tsis pom zoo hauv / hauv lossis hauv / m tswj hwm ntawm cov tshuaj. Bayeta® yuav tsum tsis txhob siv yog tias cov tshuaj tiv thaiv tau pom hauv qhov kev daws teeb meem lossis yog tias cov kua daws tau ua huab lossis muaj xim. Vim tias lub peev xwm tiv thaiv kab mob ntawm cov tshuaj muaj protein thiab peptides, kev txhim kho ntawm cov tshuaj tiv thaiv kom ua rau exenatide yog ua tau thaum kho nrog Bayeta®. Hauv feem ntau ntawm cov neeg mob hauv kev ua cov tshuaj tiv thaiv kab mob tau sau tseg, lawv cov titer txo qis raws li kev kho mob txuas ntxiv thiab tseem qis rau 82 lub lis piam. Lub xub ntiag ntawm cov tshuaj tiv thaiv tsis cuam tshuam qhov zaus thiab hom qhia txog kev phiv. Cov neeg mob yuav tsum tau paub tias kev kho mob nrog Bayeta® tuaj yeem ua rau kom qab los noj mov thiab / lossis lub cev hnyav, thiab tias vim muaj cov teebmeem no tsis tas yuav hloov pauv kev noj tshuaj. Hauv kev tshawb fawb preclinical hauv cov nas thiab nas, tsis muaj cov teebmeem carcinogenic ntawm exenatide pom. Thaum ib koob tshuaj tau siv nyob hauv nas 128 lub sij hawm koob tshuaj hauv tib neeg, kev nce lej ntawm C-cell cov thyroid adenomas tau sau tseg tsis muaj cov cim tsis zoo, uas cuam tshuam nrog kev nce hauv lub neej ntawm kev sim cov tsiaj tau txais exenatide. Cov mob raum tsis zoo ntawm lub raum kev ua haujlwm tau raug tshaj tawm, suav nrog kev nce ntxiv ntawm cov ntshav dej, kev txhim kho lub raum ua kom tsis zoo, ua rau lub siab mob mus rau lub raum thiab mob raum tsis ua haujlwm, thiab qee zaum hemodialysis xav tau. Qee qhov tshwm sim no tau pom nyob rau hauv cov neeg mob uas tau txais ib lossis ntau dua cov tshuaj pharmacological uas cuam tshuam rau lub raum kev ua haujlwm / dej metabolism thiab / lossis tawm tsam lwm cov xwm txheej tsis zoo uas ua rau lub cev tsis muaj zog, xws li xeev siab, ntuav thiab / lossis raws plab. Cov tshuaj tsis haum xeeb suav nrog ACE inhibitors, NSAIDs, thiab diuretics. Thaum sau tshuaj kho cov tsos mob thiab kev txiav tsis ua yeeb tshuaj, txawm tias yog vim li cas ntawm kev hloov pauv pathological, kev ua haujlwm tsis zoo hauv lub raum tau rov qab los. Thaum ua qhov kev npaj ua ntej thiab kev tshawb fawb ntawm exenatide, cov pov thawj ntawm cov nephrotoxicity ncaj tsis pom. Tsis tshua muaj neeg tau mob tshwm sim thaum uas siv Bayeta®. Cov neeg mob yuav tsum tau qhia paub txog cov yam ntxwv ntawm tus yam ntxwv ntawm tus mob pancreatitis: mob hnyav plab heev. Thaum kws kho mob muab tshuaj tua kab mob, kev daws teeb meem ntawm tus mob pancreatitis zoo. Cov neeg mob ua ntej pib kho nrog Bayeta® yuav tsum paub lawv tus kheej nrog Phau Ntawv Qhia kom siv rab koob txhaj tshuaj ntawm lub ntsej muag uas nyob nrog cov tshuaj.
Yeeb tshuaj sib cuam tshuamBayeta® yuav tsum tau siv nrog ceev faj hauv cov neeg mob noj lub qhov ncauj npaj uas yuav tsum nqus sai los ntawm kev mob plab, raws li Byeta® yuav ncua kev mob plab zom mov. Cov neeg mob yuav tsum raug qhia kom noj cov tshuaj hauv qhov ncauj, cov nyhuv ntawm nws nyob ntawm lawv lub luag haujlwm tseem ceeb (piv txwv, tshuaj tua kab mob), tsawg kawg 1 teev ua ntej kev tswj hwm ntawm exenatide. Yog tias cov tshuaj no yuav tsum tau noj nrog zaub mov, tom qab ntawd lawv yuav tsum noj thaum cov zaub mov noj thaum cov tshuaj exenatide tsis tau txais. Nrog kev tswj hwm tib lub sijhawm ntawm digoxin (0.25 mg 1 lub sijhawm /) nrog kev npaj Baeta®, qhov kawg ntawm digoxin tsawg dua 17%, thiab Tmax nce li ntawm 2.5 teev. Txawm li cas los xij, AUC hauv lub xeev qhov sib npaug tsis hloov. Tawm tsam keeb kwm yav dhau los ntawm kev tswj hwm ntawm Bayeta®, AUC thiab Cmax ntawm lovastatin txo los ntawm kwv yees li 40% thiab 28%, feem, thiab Tmax nce kwv yees li 4 teev. Co-administration ntawm Bayeta® nrog HMG-CoA reductase inhibitors tsis nrog kev hloov pauv hauv cov ntshav lipid muaj pes tsawg leeg Noj ntau dhauYog tias muaj kev noj ntau dhau (noj 10 zaug ntau kawg qhov pom zoo tshaj plaws), cov tsos mob hauv qab no tau pom tias: xeev siab thiab ntuav, nrog rau kev txo ntshav qabzib ntau hauv lub siab (hypoglycemia). Kev Kho Mob: Cov tsos mob, nrog rau kev tswj hwm ntawm dextrose daws teeb meem yog tias muaj ntshav qab zib tsawg. |