Cov tshuaj Onglisa - taw qhia thiab cov lus qhia rau kev siv

"Onglisa" yog muag hauv cov qauv ntawm cov ntsiav tshuaj uas muaj xim, uas tej zaum yuav muaj 2.5 lossis 5 mg thiab raug muab tshuaj raws li cov koob tshuaj kws kho mob.

Cov ntsiav tshuaj tau ntim hauv pob ntawm 30 hauv ib qho.

Pharmacodynamics thiab pharmacokinetics

Kev kho mob ntshav qab zib suav nrog kev kho mob pharmacological, uas tau sau tseg los ntawm tus kws kho mob endocrinologist raws li kev ua haujlwm ntawm tus kab mob thiab tus neeg mob lub cev, nrog rau kev tsis siv tshuaj kho mob, uas yog, kev noj haus thiab kev tawm dag zog yog ib feem tseem ceeb ntawm kev kho mob, yam uas tsis muaj peev xwm ua tiav kev them nyiaj. Onglisa yog ib qho tshuaj hypoglycemic rau tshuaj tiv thaiv ntshav qab zib hom 2. Cov tshuaj no tuaj yeem raug kho raws li kev kho mob monotherapy, lossis hauv kev sib xyaw nrog lwm cov tshuaj hypoglycemic. Nws muaj cov npe meej ntawm kev cim, contraindications thiab cov lus qhia tshwj xeeb.

Cov txheej txheem ntawm kev txiav txim ntawm "onglises" yog ua raws cov kev thaiv ntawm ib qho tshwj xeeb enzyme, uas nyob rau hauv lub cev ua haujlwm ntawm kev ua haujlwm ntawm cov nqaijrog sib cais. Qhov enzyme no, dipeptidyl peptidase-4, ntxiv rau ntau lub zog, txhawm rau cov protein uas ua rau cov kua ntshav tawm los ntawm cov hlwb pancreatic, zoo li thaiv cov zais ntawm glucagon rau nws thiab nce lub cev ntawm cov tshuaj insulin-zais cia rau cov ntshav qabzib.

Dipeptidyl peptidase-4 lossis sau DPP-4 rhuav tshem glucagon-zoo li peptide-1 (GLP-1) thiab glucose-nyob rau insulinotropic polypeptide (HIP). Saxagliptin hauv kev sib xyaw ntawm "onglise" thaiv DPP-4, uas ua rau cov ntshav nce ntxiv ntawm GLP-1 thiab HIP.

Yog li, cov tshuaj ua rau:

• Txo cov ntshav glucagon concentration,
• Nce insulin ntau ntau,
• Ntxiv teb ntawm beta hlwb rau qabzib.

Cov chaw soj ntsuam tau tshawb pom uas ua rau pom kev cuam tshuam ntawm "onglise" nyob rau theem ntawm glycosylated hemoglobin thiab cov kua nplaum sai thiab tom qab noj mov.

Tseem Ceeb! Cov tshuaj tuaj yeem ua ke nrog lwm tus neeg mob hypoglycemic lossis insulin.

"Onglisa" zoo nqus mus rau hauv cov ntshav, los ntawm kwv yees li 75% thiab nce mus txog nws qhov siab tshaj plaws hauv cov ntshav 1-4 teev tom qab kev tswj hwm. Cov nyhuv ntawm cov zaub mov ntawm kev nqus tau tsis pom qhov chaw kuaj mob. Nws yog metabolized los ntawm daim siab thiab lub raum. Tsuas yog lub raum tsis ua haujlwm loj yuav tsum tau txhaj tshuaj kho, vim nws tuaj yeem cuam tshuam kev lim thiab zoo siab ntawm cov tshuaj. Hepatic tsis ua hauj lwm ntawm qhov mob hnyav thiab lub raum tsis ua haujlwm ntawm me me mus rau qib degrees tsis ua rau muaj kev hloov pauv tseem ceeb hauv qhov kev cia siab ntawm "onglise".

Kev taw qhia thiab contraindications

Cov tshuaj tsuas yog rau cov neeg mob ntshav qab zib hom 2, tab sis muaj ib hom mob twg, thiab muaj ib hom foos insulin. Ua ke nrog kev noj haus thiab kev tawm dag zog ua rau muaj kev hloov pauv sai ntawm kev saib xyuas cov piam thaj hauv lub cev.

Ntawm cov contraindications yog:

• Tus kheej lub cev tsis haum rau ib qho ntawm cov khoom siv, nrog rau kev poob siab anaphylactic thiab lwm yam kev txhaum fab hnyav nyob rau hauv keeb kwm, vim qhov tshuaj tiv thaiv rau cov tshuaj ntawm pawg no,
• Nws yog suav tias yog contraindicated ua yeeb tshuaj rau hom ntshav qab zib hom 1, vim tias tsis muaj cov ntaub ntawv ntawm nws cov hauj lwm zoo,
• Cov ketone tso zis rau lub cev ntau, ketoacidosis thiab mob ntshav qab zib tsis xeev,
• Vim tias lub lactose nyob rau hauv muaj pes tsawg leeg, nws yog contraindicated nyob rau hauv cov neeg nrog lactose malabsorption thiab nrog lactase deficiency,
• Cov me nyuam qis dua 18 xyoo
• Tus poj niam thaum lub sijhawm cev xeeb tub thiab lactation vim tias tsis muaj kev tshawb fawb txog qhov tshwm sim ntawm cov tshuaj ntawm qhov mob ntawm lub cev xeeb tub thiab tus menyuam hauv lub sijhawm neonatal.

Tus txheeb ze contraindications los yog tej yam kev mob uas nws yog tsim nyog los sau cov tshuaj nrog kev saib xyuas zoo yog lub raum lossis daim siab tsis txaus, lub hnub nyoog tshaj 65 xyoo, mob txhaws qog nrog exocrine thiab endocrine insufficiency tsis txaus soj ntsuam kuaj mob los yog keeb kwm.

Sab sij huam

"Onglisa", cov lus qhia rau kev siv tshuaj muaj cov npe ntawm cov tsos mob tsis zoo uas yuav tshwm sim thaum noj cov tshuaj.

• Cov kab mob kis tau ntawm lub nruab pa sab saud, mob txeeb zig, mob plab, mob plab (mob kis yooj yim heev)
• Dyspeptic tsos mob (xeev siab, ntuav),
• Mob taub hau
• Kev ua xua tsis haum (kuj ib txwm muaj, tab sis tsis tas yuav tsum txiav kev kho ntxiv)
• Kev sib xyaw ua ke yuav nyuaj los ntawm mob taub hau, nasopharyngitis, edema ntawm qis qis,
• Kev mob ntshav qab zib nrog kev kho mob ntshav qab zib, thiab nrog kev kho mob tshwm sim nrog tib lub zog thiab xav tau kev ntsuas nrawm los nce cov ntshav qabzib.

Thaum hais txog cov tsos mob zoo li mob taub hau, tshee tshee hauv qhov kawg, lub qhov ncauj qhuav, tawm hws, tshaib plab, nws yog qhov yuav tsum tau ua tam sim ntawd ntsuas kom nce qib ntawm cov suab thaj.

Tsuas tshuaj thiab tshaj

Kev siv cov tshuaj los ntawm cov ntshav qab zib tau tso cai lub sijhawm twg los tau nruab hnub, ib zaug ib hnub, thawj zaug koob tshuaj yog 5 mg.

Cov koob tshuaj tsis hloov thaum ua ke nrog lwm cov tshuaj. Ua ntej pib lub sij hawm teem tseg, koj yuav tsum sab laj nrog tus kws kho mob-endocrinologist, uas, tom qab kuaj xyuas, nug thiab kuaj hauv chav kuaj, yuav txheeb xyuas qhov xav tau thiab chav kho mob kom raug.

Thaum muab sib xyaw nrog "metformin", feem ntau cov tshuaj pib ntawm "onglise" kuj yog 5 mg, thiab "metformin" yog 500 mg rau ib hnub. Yog tias kev kho mob zoo li no tsis ua kom tshwm sim, nws yuav muaj tseeb dua los tsa koob tshuaj "metformin".

Txog li 2.5 mg ib hnub twg, kev siv ntawm "onglise" raug txo qis hauv kev ua haujlwm raum tsis zoo. Nrog cov ntawv me dua, nrog rau daim siab ua kom lub siab thiab cov neeg nyob hauv hnub nyoog siab, tsis tas yuav txo koob tshuaj.

Kev sib txuam

Tom qab qee qhov kev tshawb fawb txog kev sib cuam tshuam yeeb tshuaj, tsis muaj kev cuam tshuam loj heev uas pom tias yuav cuam tshuam kev kho mob.

Rau feem ntau seem, kev hloov pauv ntawm cov tshuaj mus los ntawm daim siab, uas ua rau lub hauv paus ntawm qee yam enzymes. Kev sib xyaw nrog cov tshuaj ntawm tib yam hauv kev coj ua tsis tau ua rau muaj kev rau txim loj.

Tseem Ceeb! Cov kev cuam tshuam los ntawm kev haus luam yeeb, haus dej cawv, thiab muaj hnub nyoog ntawm kev kho "tsis ua pa" tsis tau kawm.

Ntawm cov analogues ntawm cov tshuaj muaj peev xwm pom ob qho tib si tuam ntxhab thiab txawv teb chaws. Lub Npe Tsis Txhim Kho Lub Npe International (INN) yog saxagliptin.

“Lydia, 60 xyoo. Kuv raug sau hais tias "onglyz" ua ke nrog "metformin," txij li kuv tus mob tsis ruaj khov, kuv cov ntshav qab zib tas li dhia, Kuv mloog zoo li nkees heev, nws nyuaj rau kev ua haujlwm. Tsuas yog ib txoj kev kho kom pab tau tshem txhua tus tsis mob tsis zoo thiab txo cov piam thaj kom 7 mmol / l. "

“Lolita, 53 xyoo. Kuv tau muab cov tshuaj no thaum tsis muaj lwm yam pab, nws yog kuv qhov kev cia siab kawg. Qhov kev txhim kho zoo yog kev txhim kho sai, thiab tsis muaj ib qho kev mob tshwm sim rau kuv. Ib yam tshuaj yog los hloov chaw rau cov uas tsis pab. ”

“Michael, 49 xyoo. Kuv tau noj "tsis yws" raws li kws kho mob tau sau los lawm ntau tshaj peb lub xyoos nrog rau "metformin". Qab zib tsis sawv yog tias kuv ua raws li kev noj zaub mov noj. Yog tias koj ua raws li tag nrho cov cai, kuaj xyuas koj cov ntshav tas li, tom qab ntawv ntshav qab zib tsis tuaj yeem nco qab. "

Ntau qhov chaw kho mob qhia tias lawv pom tus nqi ntawm cov tshuaj. Nws tuaj yeem xaj online lossis daim ntawv yuav tshuaj hauv lub khw muag tshuaj hauv nroog. Tus nqi feem ntau nyob ntawm 1900-2000 rubles rau pob ntawm 30 ntsiav tshuaj. Qhov no yog txaus rau ib lub hlis ntev-chav kev kawm. Cov tshuaj no yuav tsum raug qaug cawv yam tsis muaj kev cuam tshuam. Yog li, koj yuav tsum tau saib xyuas cov tshuaj uas yuav tsum tau muaj ua ntej.

Txhua yam tshuaj siv tshuaj kho mob tau ntev rau cov kab mob ntev tuaj yeem ua rau muaj kev mob tshwm sim thiab ua txhaum loj ntawm kev ua haujlwm ntawm cov nruab nrog cev thiab tshuab. Txhawm rau tiv thaiv qhov no, ntxiv rau kev saib xyuas tus kabmob tsis tu ncua nyob rau theem them, nws yog qhov yuav tsum tau qee zaus mus ntsib tus kws kho mob uas koom nrog. Lub sijhawm sib tham ntawd, tus kws kho mob yuav pom tias cov tshuaj tau siv los pab nws, puas yog tus neeg mob ua raws txhua cov lus qhia: seb nws puas noj zaub mov noj, txawm tias nws koom nrog kev ua kis las. Tom qab kuaj sim, nws yuav paub tseeb tias yuav hloov cov koob tshuaj, tshem tawm lossis ncua sijhawm.

"Onglisa" yog cov tshuaj txaus ntseeg nyob rau hauv kev kho mob ntshav qab zib, uas ua rau nws muaj peev xwm ua tiav kom muaj cov suab thaj hauv lub cev ib txwm muaj thiab nres tag nrho cov kab mob ntawm cov kab mob nrog rau cov kab mob tsis zoo thiab kev tiv thaiv kab mob sib kis, uas ua rau nws yog ib qho tseem ceeb ntawm kev kho mob ntshav qab zib 2 hom.

Cov Tshuaj Pharmacokinetics

Kev txwv tsis pub ntshav ntshav DPP-4 kev ua haujlwm tsawg kawg 24 teev tom qab kev saib xyuas ntawm saxagliptin yog vim nws muaj kev cuam tshuam zoo rau DPP-4 thiab lub caij nyoog khi rau nws. Qhov tseem ceeb tsub zuj zuj ntawm saxagliptin thiab nws cov metabolite tseem ceeb nrog kev siv tshuaj ntev 1 zaug / hnub tsis pom. Tsis muaj ib qho kev vam khom ntawm kev tshem tawm saxagliptin thiab nws cov metabolite tseem ceeb ntawm cov tshuaj ntawm lub sijhawm thiab lub sijhawm ntawm kev kho mob thaum noj saxagliptin 1 lub sijhawm / hnub hauv koob tshuaj ntawm 2.5 mg txog 400 mg rau 14 hnub.
Tom qab lub qhov ncauj tswj hwm, tsawg kawg 75% ntawm koob tshuaj saxagliptin yog nqus tau. Noj mov tsis muaj kev cuam tshuam loj heev rau pharmacokinetics ntawm saxagliptin hauv cov neeg tuaj noj qab haus huv zoo. Cov zaub mov ua rog ntau tsis cuam tshuam rau Cmax ntawm saxagliptin, thaum AUC nce 27% piv nrog kev yoo mov. Lub sijhawm nce mus txog Cmax rau saxagliptin ntau ntxiv kwv yees li 0.5 teev thaum noj tshuaj nrog zaub mov piv nrog kev yoo mov. Txawm li cas los xij, cov kev pauv hloov no tsis yog qhov tseem ceeb hauv tsev kho mob.
Kev khi ntawm saxagliptin thiab nws lub ntsiab metabolite rau cov ntshav cov protein tsis tseem ceeb, yog li, tuaj yeem xav tias kev faib tawm saxagliptin nrog kev hloov pauv ntawm cov protein sib xyaw ntawm cov ntshav pom nyob rau hauv hepatic lossis lub raum tsis ua haujlwm yuav tsis raug hloov pauv tseem ceeb.
Saxagliptin yog metabolized feem ntau nrog kev koom tes ntawm isoenzymes ntawm cytochrome P450 3A4 / 5 (CYP 3A4 / 5) nrog kev tsim cov nquag metabolite, cov nyhuv inhibitory uas tiv thaiv DPP-4 yog 2 lub sijhawm tsis muaj zog tshaj li ntawm saxagliptin.
Saxagliptin ua tawm hauv cov zis thiab cov kua tsib. Tom qab txhaj ib koob tshuaj 50 mg ntawm daim ntawv lo 14C-saxagliptin, 24% ntawm cov koob tshuaj tau raug tso tawm los ntawm lub raum ua qhov hloov pauv saxagliptin thiab 36% yog cov tshuaj metabolite ntawm saxagliptin. Cov tshuaj tiv thaiv kab mob tag nrho hauv cov zis ntsuas rau 75% ntawm kev noj tshuaj. Qhov nruab nrab lub raum tshem tawm ntawm saxagliptin yog kwv yees li 230 ml / min, qhov nqi nruab nrab ntawm glomerular pom tau yog li 120 ml / min. Rau lub ntsiab metabolite, lub raum tshem tawm tau sib piv nrog lub txiaj ntsig tseem ceeb ntawm glomerular pom.
Txog 22% ntawm tag nrho cov xov tooj cua tau pom nyob hauv cov quav.

Kev ntsuas rau siv

Tshuaj Onglisa siv los kho cov ntshav qab zib hom 2 ntxiv rau kev noj haus thiab kev tawm dag zog kom txhim kho glycemic tswj raws li:
- tshuaj kho mob,
- pib kev sib txuas nrog kev kho mob nrog metformin,
- ntxiv rau kev kho mob monotherapy nrog metformin, thiazolidinediones, sulfonylurea derivatives, thaum tsis muaj glycemic tswj tau txaus hauv qhov kev kho no.

Txoj kev ntawm daim ntawv thov

Yog tias tsis teb rov qab, qhov tshuaj ntawm cov metformin yuav raug nce ntxiv.
Yog tias koj hla cov tshuaj Onglisa cov ntsiav tshuaj ploj yuav tsum tau noj sai li sai tau thaum tus neeg mob nco txog qhov no, txawm li cas los xij, ob zaug tshuaj ntawm cov tshuaj yuav tsum tsis txhob noj nyob rau hauv ib hnub.
Rau cov neeg mob uas tsis muaj lub raum tsis txaus (CC> 50 ml / min), tsis tas yuav txhaj tshuaj. Rau cov neeg mob uas mob raum lossis hnyav lub raum tsis ua haujlwm (CC ≤ 50 ml / min), ib yam li rau cov neeg mob hemodialysis, koob tshuaj Ongliz® yog 2,5 mg 1 zaug / hnub. Qhov tshuaj yuav tsum tau noj thaum kawg ntawm kev kho mob hemodialysis. Kev siv cov saxagliptin rau cov neeg mob ua mob rau txoj hlab ntshav peritoneal lim ntshav tsis tau kawm. Ua ntej pib kho nrog saxagliptin thiab thaum kho, nws raug nquahu kom kuaj xyuas lub raum kev ua haujlwm.
Yog tias daim siab ua haujlwm tsis zoo, hloov kho mob me, mob hnyav thiab hnyav tsis tas yuav ua haujlwm.
Koob tshuaj hloov kho hauv cov neeg mob laus tsis tas yuav. Txawm li cas los xij, thaum xaiv cov koob tshuaj, nws yuav tsum tau yug los rau hauv lub siab tias hauv pawg no ntawm cov neeg mob, qhov kev txo qis ntawm lub raum kev ua haujlwm yog qhov ntau dua.
Cov kev nyab xeeb thiab kev ua tau zoo ntawm cov tshuaj hauv cov neeg mob hnub nyoog qis dua 18 xyoo tsis tau kawm.
Thaum siv nrog cov muaj zog CYP 3A4 / 5 inhibitors, xws li ketoconazole, atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, ritonavir, saquinavir thiab telithromycin, koob tshuaj pom zoo ntawm Ongliza yog 2.5 mg 1 zaug / hnub.