Comboglizzen, nrhiav, yuav

Pauv lub npe ntawm qhov kev npaj: Komboglize Prolong

Lub npe txawv tebchaws tsis raws cai: Metformin (metformin) + Saxagliptin (saxagliptin)

Daim ntawv noj tshuaj: Zaj duab xis-coated ntsiav tshuaj

Yam tshuaj muaj sia: Metformin hydrochloride + saxagliptin

Pab pawg kws tshuaj: Kev siv tshuaj hypoglycemic rau kev tswj hwm ntawm qhov ncauj (dipeptidyl peptidase 4 inhibitor + biguanide).

Cov yam ntxwv Pharmacological:

Combogliz Prolong muab ob lub tshuaj hypoglycemic nrog sib xyaw ua ke ntawm kev nqis tes ua txhawm rau txhim kho glycemic tswj nyob rau hauv cov neeg mob uas muaj hom 2 mob ntshav qab zib mellitus (DM2): saxagliptin, dipeptidyl peptidase 4 inhibitor (DPP-4), thiab metformin, tus sawv cev ntawm chav kawm biguanide.

Hauv kev teb rau kev noj zaub mov los ntawm cov hnyuv me, cov tshuaj hormones ntau ntxiv tso rau hauv cov ntshav, xws li glucagon-zoo li peptide-1 (GLP-1) thiab glucose-dependant insulinotropic polypeptide (HIP). Cov tshuaj hormones no txhawb lub cev tawm ntawm insulin los ntawm pancreatic beta hlwb, nyob ntawm seb cov concentration ntawm cov piam thaj hauv cov ntshav, tab sis tsis ua li cas los ntawm enzyme DPP-4 rau ob peb feeb. GLP-1 kuj tseem qis qis kev zais cia ntawm glucagon hauv alpha cell, txo lub siab ua haujlwm rau lub ntsej muag. Hauv cov neeg mob uas muaj ntshav qab zib hom 2, qhov kev tso tawm ntawm GLP-1 tsawg dua, tab sis qhov tshuaj insulin rau GLP-1 tseem nyob. Saxagliptin, yog qhov muaj kev sib tw txhim kho ntawm DPP-4, txo qhov tsis muaj txiaj ntsig ntawm cov tshuaj hormones incretin, yog li ua rau lawv cov kev nkag siab hauv cov hlab ntshav thiab ua rau txo qis ntawm cov piam thaj tom qab noj mov.

Metformin yog ib hom tshuaj hypoglycemic uas txhim kho cov kua nplaum ua haujlwm rau cov neeg mob ntshav qab zib hom 2, txo qis qis thiab tom qab cov ntshav qabzib feem ntau. Metformin txo qhov tsim tawm ntawm cov piam thaj los ntawm lub siab, txo qis kev nqus ntawm cov piam thaj hauv cov hnyuv thiab nce insulin rhiab heev, ua kom muaj qhov nqus ntau ntxiv thiab kev siv cov kua nplaum nyob. Tsis zoo li sulfonylurea kev npaj, metformin tsis ua rau cov ntshav qog ntshav qab zib hauv cov neeg mob ntshav qab zib hom 2 lossis cov neeg muaj mob noj qab haus huv (tshwj tsis yog muaj xwm txheej tshwj xeeb, saib rau cov nqe lus "Kev Ceeb Toom" thiab "Cov Lus Qhia Tshwj Xeeb"), thiab hyperinsulinemia. Thaum lub sij hawm siv cov tshuaj metformin kho, cov kua dej hauv cov kua dej tseem tsis hloov, txawm hais tias yoo insulin ceev thiab cov lus teb rau cov pluas noj thaum nruab hnub yuav tsawg zuj zus.

Kev taw qhia rau kev siv:

Hom 2 mob ntshav qab zib mellitus ua ke nrog kev noj haus thiab qoj ib ce kom txhim kho glycemic tswj.

Cov Tshuaj Tiv Thaiv:

- Kom ib tug neeg rhiab rau ib feem ntawm cov tshuaj,

- Cov kev tsis haum siab loj ntxiv (anaphylaxis lossis angioedema) rau DPP-4 cov tshuaj tiv thaiv kab mob,

- Hom 1 mob ntshav qab zib mellitus (siv tsis tau kawm),

- Siv nrog rau cov insulin (tsis kawm),

- Kev tsis haum ntshav hauv lub cev, kev lactase deficiency thiab glucose-galactose malabsorption,

- Muaj hnub nyoog txog 18 xyoo (kev nyab xeeb thiab tsis tau muaj kev kawm tau zoo),

- Kev ua haujlwm raum (cov ntshav creatinine ≥1.5 mg / dl rau cov txiv neej, ≥1.4 mg / dl rau cov poj niam lossis txo cov creatinine txo), suav nrog cov mob los ntawm kev mob plawv tsis ua haujlwm (poob siab), mob myocardial infarction thiab septicemia,

- Mob kab mob uas muaj qhov pheej hmoo ntawm lub raum ua haujlwm: lub cev qhuav dej (nrog rau ntuav, raws plab), kub taub hau, mob hnyav kis, mob ntawm hypoxia (poob siab, mob sepsis, mob raum, kab mob bronchopulmonary),

- Mob nyhav lossis mob ntsws metabolic acidosis, nrog rau ketoacidosis uas mob ntshav qab zib, nrog lossis tsis hnov ​​mob,

- Cov lus sib tw hais txog kev tshwm sim ntawm cov mob huam thiab mob ntev tuaj yeem ua rau kev tsim cov nqaij mos hypoxia (ua pa tsis ua haujlwm, lub plawv tsis ua haujlwm, mob myocardial infarction),

- Kev phais mob hnyav thiab raug mob (thaum kho mob insulin),

- Lub siab ua haujlwm tsis zoo,

- Mob qaug cawv ntev thiab qaug cawv lom,

- Cov kab mob lactic acidosis (suav nrog keeb kwm),

- Lub sijhawm tsawg kawg 48 teev ua ntej thiab nyob rau hauv 48 teev tom qab ua kev tshawb fawb radioisotope lossis xoo hluav taws xob nrog kev qhia ntawm iodine-muaj cov tshuaj tiv thaiv kev cuam tshuam,

- Ua raws li kev noj zaub mov hypocaloric (5% ntawm cov neeg mob tau txais kev hloov pauv metformin, thiab kev tsim kho ntau dua li hauv pawg placebo, yog mob raws plab thiab xeev siab / ntuav).

Cov kev mob tshwm sim hauv qab no tau tshaj tawm lub sijhawm tshaj tawm tom qab kev siv tshuaj saxagliptin: kev mob nrawm thiab mob lub cev tsis haum, suav nrog anaphylaxis, angioedema, xoo pob thiab urticaria. Nws tsis tuaj yeem ntseeg siab tau kwv yees ntau zaus ntawm kev nthuav dav ntawm cov xwm txheej no, txij li cov lus tau txais cov xwm txheej los ntawm cov pejxeem ntawm qhov tsis paub (saib tshooj "Contraindications" thiab "Cov Lus Qhia Tshwj Xeeb").

Tus naj npawb tsis muaj ntawm lymphocytes

Thaum siv saxagliptin, ib koob tshuaj tiv thaiv qhov nruab nrab txo qis hauv tus naj npawb ntawm lymphocytes tau pom. Thaum txheeb xyuas cov ntaub ntawv sib xyaw ua ke ntawm tsib 24-lub lis piam, cov kev tshawb fawb tshuaj placebo, qhov nruab nrab txo ntawm kwv yees li 100 thiab 120 hlwb / ofl ntawm tus naj npawb ntawm lymphocytes los ntawm thawj tus lej nruab nrab ntawm 2200 hlwb / wasl tau pom nrog kev siv saxagliptin ntawm koob tshuaj 5 mg thiab 10 mg, feem, piv rau nrog cov placebo. Cov txiaj ntsig zoo sib xws tau pom thaum noj saxagliptin ntawm koob tshuaj 5 mg hauv kev pib ua ke nrog metformin piv nrog metformin monotherapy. Tsis muaj qhov sib txawv ntawm 2.5 mg saxagliptin thiab placebo. Qhov kev faib ua feem ntawm cov neeg mob uas tus naj npawb ntawm lymphocytes yog ≤ 750 hlwb / wasl yog 0.5%, 1.5%, 1.4%, thiab 0.4% hauv saxagliptin kho pawg mob ntawm koob tshuaj 2.5 mg, ntawm koob tshuaj 5 mg , ntawm ib koob ntawm 10 mg thiab placebo, ntsig txog. Hauv cov neeg mob feem ntau uas rov qab siv saxagliptin, tsis muaj qhov rov huam mob tau pom, txawm hais tias nyob hauv qee tus neeg mob cov lymphocytes poob qis dua nrog kev rov pib ntawm kev kho nrog saxagliptin, uas ua rau muaj kev tshem tawm saxagliptin. Qhov txo qis hauv cov lymphocytes tsis tau nrog cov kev ua kom pom.

Cov laj thawj rau txoj kev tsawg ntawm lymphocytes thaum lub sijhawm kev kho mob saxagliptin piv nrog cov placebo tsis paub. Yog tias muaj kev txawv txav lossis lub caij nyoog ntev, tus lej ntawm lymphocytes yuav tsum tau ntsuas. Cov nyhuv ntawm saxagliptin ntawm cov lymphocytes hauv cov neeg mob uas muaj qhov txawv txav hauv cov lymphocytes (piv txwv li, cov tshuaj tiv thaiv kab mob tib neeg) tsis paub.

Saxagliptin tsis muaj qhov tshwm sim hauv kev kho mob hauv platelet ntau hauv rau ob qhov dig muag, tswj qhov kev soj ntsuam kev nyab xeeb thiab ua tau zoo.

Vitamin B12 Concentration

Hauv kev tswj xyuas cov chaw kho mob ntawm cov tshuaj metformin kav ntev li 29 lub lim tiam, kwv yees li 7% ntawm cov neeg mob tau txo qis cov ntshav ua ntej cov lej ntawm cov vitamin B12 rau cov nqi tsis tseem ceeb yam tsis muaj kev soj ntsuam. Txawm li cas los xij, ib qho kev txo qis no tsis tshua muaj nrog los ntawm kev txhim kho ntawm lub cev tsis muaj zog thiab rov qab sai sai tom qab tsis siv tshuaj metformin lossis ntxiv cov vitamin B12 ntxiv.

Noj ntau dhau

Nrog lub sijhawm ntev ntawm kev siv cov tshuaj hauv cov koob tshuaj kom txog 80 zaug siab dua qhov kev pom zoo, cov tsos mob ntawm intoxication tsis tau piav qhia. Nyob rau hauv rooj plaub ntawm overdose, kev kho mob tsos mob yuav tsum tau siv. Saxagliptin thiab nws cov metabolite tseem ceeb yog kho los ntawm hemodialysis (kev kuaj mob ntxiv: 23% ntawm qhov hno hauv 4 teev).

Muaj qee tus neeg mob haus ntshav ntau tshaj ntawm cov tshuaj metformin, suav nrog kev noj ntau dua 50 g. Hauv 32% ntawm cov neeg haus tshuaj ntau tshaj ntawm metformin, cov neeg mob tau mob lactic acidosis. Metformin raug tawm hauv kev lim ntshav, thaum lub sijhawm meej txog 170 ml / min.

Hnub tas sij hawm: 3 xyoos

Cov mob uas faib tawm los ntawm cov khw muag tshuaj: Los ntawm tshuaj.

Chaw tsim tshuaj paus: Bristol Myers Squibb, Asmeskas