Syringe pen Baeta > He hoʻomaʻemaʻe a me ke pale aku

ʻO ia ka hopena no ka hoʻokele subcutaneous. I loko o ka syringe peni hiki ke 1,2 a me ka 2.4 ml o ka waiwai hana. ʻO ka pā i ka pā penehina hoʻokahi.

Aia i ka pūhui kekahi:

exenatide -250 mcg,
sodium acetate trihydrate,
huehue acacial acae,
mannitol
metacresol
wai no ka uliaa.

ʻO "Baeta Long" kahi lōpiopio no ka hoʻomākaukau no ka hoʻokuʻuʻana, kūʻai ʻia me ka uku kūpaʻa. ʻOi aku ke kiʻekiʻe o ke ʻano o kēia ʻano lāʻau lapaʻau, hoʻohana pinepine ʻia ʻo ia mau manawa. Hoʻohana wale ia ma ka subcutaneously wale nō.

Ka hana lāʻau lapaʻau

Loaʻa i kahi hopena hypoglycemic. Hoʻonui koʻikoʻi nui i ka kaohi koko glucose, ka hoʻolālā i ka hana o nā cell beta pancreatic, pani i ka huna nui ʻana o ka glucagon, hoʻomaikaʻi i ka huna ʻana o ka glucose i ka glucose a e hoʻohiolo i ka gastric waʻa.

ʻOkoʻa nā Exenatide i ka hoʻopili ʻana mai ka insulin, sulfonylurea a me nā mea ʻē aʻe, no laila ʻaʻole hiki ke lilo iā lākou ke loli i ka mālama ʻana.

ʻO ka poʻe maʻi e lawe ana i ka lāʻau lapaʻau Bayeta e hoʻohaʻahaʻa i ko lākou makemake, kāpae ka loaʻa ʻana o ke kaumaha, a me ka manaʻo o ka maikaʻi loa.

Lapaʻau lāʻau

Hoʻololi koke ʻia ia, ke kūwaho kiʻekiʻe - ma hope o 2 mau hola. ʻAʻole pili ʻia ka hopena e ka pūnaewele wili. Hoʻomau ia i ka gastrointestinal tract, pancreas. Hoʻokuʻu ʻia ia e nā pūpū ma hope o 10 mau hola.

ʻO ka maʻi diabetes mellitus type 2, a e hoʻohana ʻia nā mea monotherapy a hui pū ʻia me nā lāʻau lapaʻau hypoglycemic ʻē aʻe.

Nā Hoʻohui

Hypersensitivity o nā māhele,
ʻO nā maʻi koʻikoʻi o ka papa gastrointestinal me ka gastroparesis concomitant,
ʻO ka mōʻaukala maʻi ketoacidosis,
ʻOi aku ka hopena o ka pilikia.
ʻAno maʻi type 1
ʻŌpū a me ka lactation
Aia ma lalo o ka makahiki 18 i lalo iho.

Nā ʻōkuhi no ka hoʻohana (ʻano a me ke ʻano)

Hoʻohana ʻia ka lāʻau lapaʻau ma ka ʻōpū, ka poʻohiwi, ke kihi a me nā ʻokiʻoki. Pono e hoʻololi ʻia ka pūnaewele injection. E hoʻomaka me ka helu ʻana o 5 mcg ʻelua mau manawa ʻelua ma mua o ka papaʻaina. Hiki iā ʻoe ke hoʻonui i ka nui i ka 10 mcg ʻelua mau manawa i kahi lā ma hope o 4 mau pule, inā e hōʻike ʻia. Me ka hopena hui, pono ʻia ka hoʻoponopono ʻana o ka sulfonylurea a me nā derivatives i ka insulin.

Nā palapala ʻano:

Aia i hoʻokahi papa (ma kahi hoʻokahi):
Kauoha:
Mea waiwai: exenatide 2,0 mg
Nā mea hoʻoweliweli: polymer 50:50 DL 4AP (copoly-D, L-lactide-glycolide) 37.2 mg, sucrose 0.8 mg Māhele:
ʻO ka sodium Carmellose 19 mg (ʻokoʻa paha ka nui o ka hiki ke pane aku), ʻo ka sodium klorila 4.1 mg, polysorbate 20 0.63 mg, sodium dihydrogen phosphate monohidate 0.61 mg, sodium hydrogen phosphate heptahydrate 0.51 mg, wai no ka hōʻemi iā 0. 63 g

Hoʻokahi ka penikala syringe (ma kahi hoʻokahi):
Kauoha:
Mea waiwai: exenatide 2,0 mg
Nā mea hoʻoweliweli: polymer 50:50 DL 4AP (copoly-D, L-lactide-glycolide) 37.2 mg, sucrose 0.8 mg Māhele:
ʻO ka sodium Carmellose 19 mg (ka nui o ka nui e hiki ke hoʻokō ʻia ka hopena), ʻo ka sodium chloride 4.1 mg, polysorbate 20 0.63 mg, sodium dihydrogen fosfat monohate 0.61 mg, sodium hydrogen phosphate heptahydrate 0.51 mg, 1 M sodium hydroxide solution 0 , 36 mg, wai no ka inake 604 mg

ʻO nā waiwai Pharmacological

Hoʻonui nā glucose-hilinaʻi i ka glucose i ka huna ʻana o ka insulin e nā beta beta o ka pancreas. Me kahi hoʻohaʻahaʻa o ka glucose i loko o ke koko, e hoʻoemi ʻia kahi hōʻemi i ka neʻe ʻana i ka insulin. I ka hihia i hoʻohana ʻia ai ka exenatide me ka metformin a / a i ʻole thiazolidinedione, ʻo ka nui o nā mahele hypoglycemia ʻaʻole iʻoi aku i ka nui o ka ʻike ma ka pūʻulu plasebo me nā metformin a / a i ʻole thiazolidinedione, ka mea paha i ka hopena o ka glucose i kūmole i ka insulinotropic hana o ka hana (e ʻike i ka ʻāpana "Nā Manaʻo Kūlana" ").

Hoʻopili ʻo Exenatide i ka mea huna o ka glucoseagon, ka ʻike i ʻike ʻia e hiki ke hoʻonui ʻia i loko o nā mea maʻi me ka maʻi diabetes mellitus type 2 (T2DM). ʻO ka emi ʻana o ke kaʻe o ka glucagon i loko o ke koko, e alakaʻi i ka kaho o ka nui o ka hoʻokuʻu ʻana o ka glucose e ka ate. ʻAʻohe o Exenatide me ka hoʻokaʻawale mau i nā mea huna o ka glukagon a me nā mea ʻē aʻe i pane aku ai i ka emi ʻana o ka kaila o ka glucose o ke koko. Ke hoʻolōʻihi nei ʻo Exenatide i ke kaʻina hana o ke kau ʻana i ka ʻōpū, a laila e hoʻemi ana i ka nui o ka glucose mai ka meaʻai i ke kahe koko.

Hōʻike ʻia ʻo Exenatide e hōʻemi i ka nui o ka meaʻai i hoʻopau ʻia ma muli o ke kaemi ʻana i ka makemake a me ka hoʻonui haʻahaʻa.

ʻO nā hopena Pharmacodynamic
Hoʻonui ka Exenatide i ka mālama glycemic ma muli o ka hōʻemi lōʻihi o ka wikiwiki wikiwiki i ka glucose wā postprandial a me ka wikiwiki o ka hoʻokahe koko koko i nā maʻi me nā maʻi maʻi type 2. ʻAʻole i like me endogenous GLP-1, nā lāʻau lapaʻau pharmacokinetic a me ka pharmacodynamic o Bayeta Long e hāʻawi i ka hiki ke hoʻohana ʻia i hoʻokahi manawa i ka hebedoma.

Ma kahi noiʻi pharmacodynamic o exenatide i nā mea maʻi me ka maʻi type 2 (n = 13), hoʻihoʻi hou i ka hana mua i ka huna ʻia o ka insulin a me ka hoʻomaikaʻi ʻana i ka lua o ka hana o ka huna ʻia o ka insulin i ka pane ʻana i ka hoʻokele bolus intravenous.

He mākaukau me ka palekana
1628 nā mea maʻi i komo pū i nā hoʻokolohua kūloko o ka lāʻau lapaʻau Bayeta Long (804 nā maʻi i loaʻa i ka lāʻau ʻo Bayeta Long), he 54% ka poʻe, 46% he mau wahine, ʻo 281 nā mea maʻi (he 141 nā mea maʻi i loaʻa iā Bayeta Long) he 65 mau makahiki.

ʻO ka control glycemic
I loko o nā haʻawina ʻelua (ʻoi aku ka 24 a me 30 mau pule), ua hoʻohālikelike ʻia ka hoʻomākaukau ʻana o Bayeta ® Long 2 mg hoʻokahi manawa i ka hebedoma me exenatide 2 mau manawa i ka lā. I nā haʻawina ʻelua, ʻo ka uku mua o ka ʻike ʻana o ka hemoglobin glycosylated (HbA_1c) i loko o ke koko (ma hope o 4 a 6 paha mau pule) ua emi ka hopena o kēia hōʻailona. Ua hoʻolako ʻia ka hoʻohana ʻana o Bayeta Long i kahi kaona nui nui i ka ʻike ʻo HbA_1c ka hoʻohālikelike ʻana me nā mea maʻi e loaʻa exenatide 2 mau manawa i kahi lā. Nā hopena koʻikoʻi maʻi o Bayeta Long me ka mahalo i ka nānā ʻana o HbA_1c kiaʻi kūʻokoʻa o ka baseline hypoglycemic therapy ma nā papa ʻelua ʻelua. I nā hui ʻelua (Bayeta Long ® ka hoʻomākaukau a me ka exenatide 2 mau manawa i kahi lā (mākaukau ʻo Bayeta)) ka hoʻemi ʻana o ka paona kino i ʻike ʻia i nā helu ʻimi mua, ʻoiai ka ʻokoʻa ma waena o nā hui hoʻomaʻamaʻa ʻaʻole i koʻikoʻi.

ʻO ka hōʻemi hou aʻe i ka uka o HbA_1c a me ka emi mau ʻana o ke kaumaha o ke kino i nānā ʻia ma kahi o 52 mau hebedoma i nā mea maʻi e hoʻopau ana i ka hoʻomaka o 30-pule ka pule a me ka manawa o 22-pule i hoʻomoʻa ʻole ʻia o ka hoʻopaʻa ʻana. I ka poʻe maʻi i mālama ʻia me Bayeta Long, kahi i emi ai ka hoʻokaʻina o ka HbA i ʻike ʻia ma ka hopena o ka hoʻomaka ʻana o nā haʻawina._1c 2.0% hoʻohālikelike ʻia i lalo.

I loko o kahi hōʻike pule 26 pule, ʻo ka hoʻomākaukau ʻana o ka manawa 2-mg Bayeta Long i hāʻawi hou ʻia i ka hōʻoki ʻia o ka neʻe ʻana o HbA_1c, ka emi nui o ka statistically i ka nui o ke kaupaona kino a me kahi hanana ʻoi aku ka loaʻa ʻole o nā hanana o ka hypoglycemia e hoʻohālikelike ʻia me ka gehu o ka insulin i hoʻokahi lā. Loaʻa nā ʻike i loaʻa ma ka manawa lōʻihi o kēia noiʻi (156 hebedoma) me nā hualoaʻa i loaʻa ma hope o 26 wiki o ka mālama ʻana.

I loko o kahi aʻo he ʻelua makapō 26-pule, ua hoʻohālikelike ʻia ʻo Bayeta Long me sitagliptin a me ka pioglitazone ma nā lā nui no nā lā maʻi i nā maʻi e loaʻa pū ana ka metformin. Hōʻike ka Baeta ® Long i ka ʻoi aku ka nui ma ka sitagliptin a me ka pioglitazone ma ka hoʻemi ʻana o ka neʻe o ka HbA_1c pili i nā waiwai kumu. Ua maikaʻi loa ka hoʻomākaukau ʻana o ka Baeta ® Long lōʻihi ma mua o ka sitagliptin, e hāʻawi ana i ka hoʻemi ʻana o ke kaumaha o ke kino, ʻoiai ka hoʻonui i ke kaumaha o ke kino i ʻike ʻia i ka hui pioglitazone.

Kau ka paona
Ma nā noiʻi āpau o Bayeta Long, kahi i ʻike ʻia ke emi ʻana o ke kino kino pili i nā waiwai kumu.ʻO ka emi ʻana o ke kaumaha o ke kino me ka hoʻohana ʻana iā Bayeta Long i mālama ʻia no nā mea maʻi a ʻike paha o ka maʻi maʻi a i ʻole, inā paha ka ʻike nui ʻana o ka hoʻemi ʻana o ke kaupaona kino i ʻike ʻia i loko o ka hui o nā poʻe maʻi i hoʻomau i ka maʻi (a hoʻemi ʻia ka awelika o 2.9-5.2 kg i nā mea maʻi me ka maʻi pākaukau, hoʻohālikelike me ka hoʻohaʻahaʻa o ka 2.2-2.9 kg i nā mea maʻi me ka hōʻai ʻole).

ʻO ka pākuʻi o nā mea maʻi i loaʻa i ka emi ʻana o ke kaumaha o ke kino a me ka hoʻohaʻahaʻa ʻana i ka ʻike o HbA_1c, mai 70 a 79% (ka hapa o nā mea maʻi i hōʻemi i ka ʻōpū o ka HbA_1co 88-96%).

Hoʻomoʻa Plasma / serum glucose
Hāʻawi ke kauka ʻo Bayeta Long i ka hōʻemi nui ʻana o ka hoʻokeʻa ʻana i ka plasma plasma / serum glucose i ʻike ʻia. Ua mālama ʻia kēia emi ma hope o 4 mau wiki o ka maʻi. ʻO ka emi ʻana o ke kūpaʻa postprandial i ʻike ʻia. Kēlā ka hoʻomaikaʻi ʻana i ka hoʻokeo ʻana i ka hoʻokahe koko glucose i paʻa ma luna o 52 mau wiki o ka lapaʻau.

Koiā hana Beta
Ua hōʻike ʻia nā haʻawina haukaʻi i kahi hoʻomaikaʻi ʻana i ka hana cell cell, kahi i loiloi ʻia me ka hoʻohana ʻana i ka ʻōnaehana loiloi homeostatic (HOMA-B). Hoʻomaʻamaʻa ka hopena ma ka hana cell beta i ka 52 mau lā o ka lapaʻau.

Paʻai koko
Ma nā noiʻi o Bayeta Long, kahi i ʻike ʻia ai kahi emi o ke koko systolic (SBP) e 2.9-4.7 mm RT. ʻAniā. I loko o kahi hōʻike 30 wiki o Bayeta Long a me Exenatide 2 mau manawa i kahi lā (hoʻomākaukau ʻana ʻo Bayeta ®), ʻelua mau hana lapaʻau i hāʻawi i ka emi nui o ka SBP pili i nā waiwai kumu pono (4.7 ± 1.1 mm Hg a me 3.4 ± 1.1 mmHg, kahi like) me ka loaʻa ʻole o kahi hōʻailona koʻikoʻi ma waena o nā hui mālama. Loaʻa ka hoʻomaikaʻi ʻana i ka pae o SBP no 52 mau lā o ka mālama ʻana.

Lipid ʻaoʻao
ʻAʻole i pōʻino ʻo Bayeta Long i ka ʻōlelo lipid.

Lapaʻau lāʻau
Hoʻomaʻamaʻa nā ʻōkuhi molihope o Exenatide i ka hiki ke hoʻohana i ka lāʻau Bayeta Long no ka hana lōʻihi loa. Ma hope o ke komo ʻana i ke kahe koko, ua kahele ʻia ka exenatide a hoʻohālikelike ʻia e like me nā waiwai pharmacokinetic i ʻike ʻia (i wehewehe ʻia ma kēia ʻāpana).

Kapehu
I ka wā o ka hoʻohana ʻana o Bayeta Long® i kahi awelika o 2 mg hoʻokahi i hoʻokahi pule, ʻoi aku ka nui o ka neʻe ʻana o ka exenatide ma mua o ka hoʻouluulu ʻana (ʻoi aku ka haʻahaʻa)

ʻO 50 pg / ml) ma hope o 2 mau hebedoma o ka lapaʻau, e ukali ʻia e ka piʻi ʻana o ka ʻenekenui kūʻokoʻa o ka exenatide i loko o ke koko koko no nā lā 6-7 mau pule. I nā pule aʻe, hiki i ka neʻe o ka exenatide i ka pae o 300 pg / ml, e hōʻike ana i ka loaʻa ʻana o kahi kūlana ekilibrium. Ma ka hoʻokele e kaulike ai ʻo ka exenatide kaulike ma luna o ka hoʻokele me ka pinepine o hoʻokahi manawa ma ka hebedoma me ka liʻiliʻi o ka ʻike ʻana ma waena o ka nui a me ka liʻiliʻi.

Kahele
ʻO ka nui ākea ka ʻike o ka hoʻoili ʻana o ka exenatide ma hope o ke kaona o ka subcutaneous o hoʻokahi pākahi he 28 lita.

Metabolism a me ka hoʻopā ʻana
Ua hōʻike ʻia nā haʻawina preclinical ua hoʻopili ʻia ka exenatide mua e nā ʻōpū ma ka wā o ka filtration glomerular, i ukali ʻia e ka pale ʻana o proteolytic. ʻO ka awelika ʻike ākea o exenatide ʻo 9 l / h. ʻO kēia mau hiʻohiʻona pharmacokinetic ʻaʻole hilinaʻi i ka maʻa o ka exenatide. ʻO ka awelika o ka exenatide i loko o ke koko koko e hoʻohaʻahaʻa i lalo o ka neʻe ka ʻike ma kahi o 10 mau wiki ma hope o ka hoʻokuʻu ʻana o ka maʻi me Bayeta Long.

ʻO ka pharmacokinetics i nā kūlana kulekele kūikawā
ʻO ka maʻi me ka hana renal impaired
Ua hōʻike ʻia ka lapaʻau Pharmacokinetic i ka nui o nā mea maʻi me ka hana ʻole o ka renal i loaʻa i ka Bayeta Long ma kahi o ka 2 mg i hōʻike ʻia me ka hana ʻole o ka maʻi papaha (n = 10) a me ka maʻalahi (n = 56) o ka hōʻeha, ka nui o ka pae ʻana o ka mahele o ka exenatide hiki ke mālama ʻia. e ka 74% a me 23% hoʻohālikelike ʻia me nā mea maʻi me ka hana maʻamau maʻamau (n = 84).

ʻO nā mea maʻi me ka hana pūlima hemahema
ʻAʻole i mālama ʻia kahi noiʻi pharmacokinetic i nā maʻi me ka hana maʻi lēwa. ʻO ka Exenatide i hoʻopili nui ʻia e nā keiki, no laila, he hana hemahema hemahema, ʻaʻole paha e hoʻopilikia i ka neʻe o ka exenatide i ke koko.

ʻO ka wahine, nā lāhui a me ke kaumaha
ʻAʻole loaʻa ka hopena o ke kāne me ka lāhui a me ke kaumaha a me ke kino i ka hopena o ka lāʻau pharmacokinetic o exenatide.

ʻO nā maʻi maʻi
Hoʻololi ʻia ka ʻikepili i nā poʻe maʻi ʻelemakule, akā ʻaʻole i hōʻike nā ʻikepili i loaʻa i nā loli nui i ka pae o ka hoʻolaha ʻana o ka exenatide me ka hoʻonui ʻana o ka makahiki i 75 mau makahiki.

Me ka hoʻomakaʻana o ka exenatide ma kahi o 10 μg 2 mau manawa i ka lā, ʻo nā mea maʻi me ka maʻi type type 2 nona 75-85 mau makahiki i hōʻike i ka hoʻonui ʻana o AUC (ma lalo o ka pāpaʻi pharmacokinetic) ma ka awelika o 36% hoʻohālikelike ʻia me nā mea maʻi i nā makahiki 45-65 mau makahiki, ka mea ia e ola ana. , pili me ka hoʻohaʻahaʻa ʻana i ka hana o ka keiki i ka poʻe ʻelemakule (e ʻike i ka ʻāpana "Dosage a me ka hoʻokele").

Hoʻohana i ka wā hāpai a i ka wā o ka umauma

Kahawai
Hoʻohālikelike nā ʻikepili e pili ana i ka hoʻohana ʻana o Bayeta Long i nā wahine hāpai. Ua hōʻike nā haʻawina holoholona i ka hele ʻana o nā pono o ka reproduction. Ua hoʻohana ʻia ka hoʻohana ʻana i ka lāʻau lapaʻau Bayeta Long i ka wā hāpai.

Haumakua
ʻAʻohe mea ʻike i ka mea hiki ke Bayeta Long ke komo i ka waiū umauma. ʻAʻole pono e hoʻohana ʻo Bayeta ® I ka wā o ka hoʻoulu ʻana.

ʻLoe a me ke kākele

I ka manawa e hoʻohuli ʻia ka poʻe maʻi me ka exenatide therapy i ka manawa 2 i ka lā (mākaukau ʻo Bayeta ®) i ka lāʻau ʻo Bayeta Long, hiki ke nānā ʻia kahi hoʻonui pōkole o ka piʻi ʻana o ke koko glucose, e hoʻomaʻamaʻa, pinepine loa i loko o ʻelua mau pule ma hope o ka hoʻomaka ʻana o ka hopena.

Me ka hui pū ʻana o ka hoʻomākaukau mākaukau ʻo Bayeta Long me ka metformin, thiazolidinedione, a i ʻole pū me ka hoʻohui pū ʻana o nā lāʻau lapaʻau, hiki i ka loli mua ʻana o ka metformin a / a i ʻole thiazolidinedione i loli. I ka hihia o ka hui pū ʻana o Bayeta Long me kahi derive o ka sulfonylurea, hiki ke koi ʻia ka hoʻohaʻahaʻa ʻana i ka derivative sulfonylurea i mea e hoʻemi ai i ka hopena o ka hypoglycemia (e nānā i ka ʻāpana "Kūlana Kūlana").

Hoʻohana ʻia ʻo Baeta ® Long i hoʻokahi manawa i ka hebedoma ma ka lā hoʻokahi o ka pule. Inā kūpono, hiki ke hoʻololi ʻia ka lā o ka hebedoma, aʻo ke ʻano o ka maʻi hou e mālama ʻia ma mua o 24 mau hola ma hope o ka hopena mua. Hiki ke hoʻohana ʻia ka lāʻau lapaʻau Baeta ® Lā i kekahi manawa o ka lā, me ka mālama ʻole o ka meaʻai.

Inā hala kahi dosis, pono e lawelawe koke ʻia i ka mea hiki. A laila hiki i nā mea maʻi ke hoʻi mai i ka papa hana hoʻohana wiki. ʻElua ʻelua mau kaha inikua o Bayeta Long e hana i hoʻokahi lā.

ʻAʻole pono ka hoʻohana ʻana o Bayeta ® Long i kahi kao kūʻokoʻa kūʻokoʻa o ka neʻe o ka glucose i ke koko. ʻO ka nānā ponoʻī ʻana i ke kaʻe o ka glucose koko e koi pono e hoʻoponopono i ka nui o ka sulfonylurea.

Inā paha, ma hope o ka pau ʻana o ka therapy me Bayeta Long, e hoʻomaka ʻia ka hoʻohana ʻana o nā lāʻau lapaʻau hypoglycemic ʻē aʻe, e pono e noʻonoʻo ʻia ka hopena lōʻihi o Bayeta Long (e ʻike i ka paukū Pharmacokinetics).

Hoʻohana ma nā pūʻulu hoʻomanawanui kūikawā
ʻO nā maʻi maʻi
ʻAʻole koi ʻia ka hoʻoponopono ʻana ma ka maʻi ma muli o ka makahiki, akā i ka manawa e kuhikuhi ai i ka lāʻau lapaʻau i nā mea maʻi ma waena o ka poʻe maʻi, pono ke noʻonoʻo ʻia ka hopena o ka hōʻemi ʻana i ka hana me ka makahiki (ʻike hou ma ka pauku - "ʻO nā mea maʻi me ka hana renal impaired"). ʻO ka ʻike lapaʻau me ka lāʻau lapaʻau i nā mea maʻi ma mua o 75 mau makahiki he palena iki loa (e ʻike i ka ʻāpana "Pharmacokinetics").

ʻO ka maʻi me ka hana renal impaired
ʻO nā mea maʻi me ka hana renal impaired o ke koʻikoʻi iki (ʻo ka hana creinine 50-80 ml / min) ʻaʻole i koi ʻia ka hoʻoponopono ʻana. ʻAʻole hoʻolako ʻia ka hoʻohana ʻana o Bayeta Long i nā maʻi me ka maʻi hōʻeha o ka hakahaka hou (ʻo ka cleinine clearance o 30-50 ml / min) ʻaʻole i ʻōlelo ʻia ma muli o ka ʻike pilikino makemakika loa (e nānāpauku "Pharmacokinetics"). Bayeta ® Long ua contraindicated i ka poʻe maʻi me ka pau ʻole o ka hope kōpula a i ʻole ka hopena o ka ʻōpū (ʻo ka hana ʻana ʻo creatinine ® ke kūkaʻi lōʻihi i nā keiki a me nā ʻōpio i lalo o 18 makahiki o nā makahiki ʻaʻole i hoʻokumu ʻia.

Ke ʻano o ka noi
Hana ʻia ka Bayeta ® Long no ka hoʻohana kūʻokoʻa e nā maʻi. Pono nā pahu injection a peni paha e hoʻokahi mea maʻi a hoʻokahi wale nō.

Ma mua o ka hoʻomākaukau ʻana i ka hoʻopiʻi ʻana, e hōʻoia i ka leʻaleʻa hāleʻa a ʻaʻohe i nā mea kikoʻī. Pono e hoʻohana koke ʻia ka ʻaina mākaukau no ka maʻi maʻi, ʻaʻole i mālama.

Inā maloʻo ka lāʻau, ʻaʻole hiki ke hoʻohana.

Ke manaʻo ʻia nei e loaʻa i ka mea maʻi a i ʻole kona hoahānau / kahu mālama o ka mea maʻi i loaʻa ʻole ka hoʻonaʻauao olakino e loaʻa i ke aʻo ʻana i nā rula no ka pale ʻana i ka pono o ka lāʻau. Pono e hahai pono i nā loiloi o nā Kuleana no ka hoʻohana ʻana i ka penikala syringe ʻo Bayeta Long a i nā Kūlana no ka hoʻohana ʻana o ka lāʻau lapaʻau ʻo Bayeta Long i hoʻopuni ʻia ma kahi pahu pepa.

E hoʻolako ʻia ka lāʻau lapaʻau ma ka ʻōpū o ka ʻōpū, ʻāha a i ʻole poʻohiwi ma hope o ke kāwili ʻana i ka pauma me kahi kala.

Ua hōʻike ʻia nā ʻōkuhi no ka hoʻomākaukau ʻana o ka hana lāʻau lapaʻau i nā Kānāwai no ka hoʻohana ʻana i ka penina syilee ʻo Bayeta Long a i nā Kūlana no ka hoʻohana ʻana i ka pahu lāʻau lapaʻau ʻo Bayeta Long.

Loaʻa ka hopena

Me ka hoʻohana kau inoa o ka exenatide 2 mau manawa i ka lā, ua loaʻa nā lono lili e pili ana i ka hoʻomohala ʻana o ka maʻi pancreatitis a me ka hana ʻole ʻana o ka renal (ʻike i ka ʻāpana "Kūlana Kūlana").

ʻO ka huli aʻe nā ʻike ma ka ʻaoʻao ʻaoʻao o Bayeta Long i loaʻa i nā hoʻokolohua lapaʻau a me nā noi ma hope. Hōʻike ʻia nā hōʻike ʻino ʻana me ka hoʻohana ʻana i nā huaʻōlelo i makemake ʻia ma nā ʻōlelo o nā papa o ka organ-system a hōʻike i ke alapine kū loa Hōʻike ʻia ka ʻike i ka hōʻike ʻana i nā hanana e like me ka pae o ka makahiki: ʻ often pinepine (≥ 1/10), pinepine (≥ 1/100, 1).

Mai ka ʻaoʻao o ka metabolism a me kaʻaiʻai: pinepine pinepine - hypoglycemia 1 (i ka hihia o ka hui pū ʻana me kahi māla sulfonylurea), pinepine - lilo ʻole i ka makemake 1, ka hema - ka hakahaka 1.

Mai ka ʻōnaehana hoʻonāukiuki: pinepine - ʻehaʻeha 1, dizziness 1, luhi ʻole dysgeusia 1, nā ʻūlū 1.

Mai ka palaki kuʻekuʻe: pinepine pinepine - hanilau 1, maʻi ʻaʻa 1, pinepine ka lua ʻO ka pancreatitis 2 (e nānā i ka ʻāpana "Hoʻonohonoho Kūʻai kūikawā").

Ma ka ʻāpana o ka ʻili a me ka kiko. ka pinepine - heching a me / a urticaria 1 paha, pinepine hyperhidrosis 1, alopecia 1, ka ʻole i unuhi ʻia - macular a me papular rash 2, angioedema 2, abscesses at the injection site and cellulitis 2.

Mai nā pūpū a me ka maʻi urinary: pinepine - hana i ka hana renal, me ka nui o ka ole o ka renal ka nui, hoʻonui i ke ole pilikia papaha, renal ka ole, hoʻonui i ka serum creatinine kālele 1 (e nānā i ka ʻāpana "Nā loea kūikawā")

ʻO nā maʻi ākea a me nā hoʻopiʻi ma ka pūnaewele injection: pinepine - ʻeha i ka ʻōlelo injection 1, hōʻeha luhi 1, erythema i ka wahi hōʻeha 1, asthenia 1, pinepine - he rash ma ka wahi o ka injection 1, luhi - he ʻeha o ka hopohopo 1.

ʻO nā hoʻololi i loko o nā hōʻailona ʻōkuhi: ka kikoʻī i ʻike ʻole ʻia - hiki ke hoʻonui i ka ratio maʻamau maʻamau (INR).
1 Hoʻoholo ka pinepine o nā kelepona ma nā kumu o ka ʻike mai ka hoʻopaʻa ʻana i ka lōʻihi o ka hoʻopaʻa ʻana i ka pono a me ka palekana o ka exenatide lōʻihi mau loa, ʻo ka huina o nā mea maʻi he 2868 (me 1002 nā mea maʻi e lawe ana i ka sulfonylurea).
2 Hooholo i ke alapine e kau i nā hōʻike pili i ka wā e hoʻohana ʻia ai ka exenatide ka lōʻihi i ka nui o nā ʻano i ʻike ʻole ʻia.

Ka hōʻike ʻana o nā hopena kūlike o kēlā me kēia
Hypoglycemia
I ka hihia o ka hoʻohana ʻana i ka mākaukau Bay Bay Long i hui pū me ka hoʻomākaukau ʻana i ka sulfonylurea, ua ʻike ʻia kahi piʻi kiʻekiʻe o ka hypoglycemia (24.0% hoʻohālikelike ʻia me 5.4%) (e ʻike i ka ʻāpana "Kūlana Kūlana"). No ka hōʻemi i ka hopena o ka hypoglycemia i ka wā hui hoʻohui, pono paha i kahi hoʻoponopono ʻana o ka sulfonylurea (e ʻike i nā ʻāpana "Dosage and Administration" a me nā "Kūlana Kūlana").

Ua pili pū ka lāʻau ʻo Bayeta Long me ka hoʻohaʻahaʻa nui o ka hypoglycemia i hoʻohālikelike ʻia me ka insulin glargine therapy i nā mea maʻi e loaʻa ana i ka metformin (3% kū'ē i ka 19%) a i nā mea maʻi e loaʻa pū ana ka metformin a me ka sulfonylurea (20% hoʻohālikelike ʻia. me 42%). ʻO ka hapa nui o nā hopena o ka hypoglycemia i hōʻike i nā hoʻokolohua lapaʻau exenatide lohi (99.9%, n = 649) i hōʻoluʻolu a hoʻoholo ʻia ma hope o ka hoʻokomo o ka paʻalepa o ka lolo. Ua loaʻa iā kekahi mea maʻi kahi maʻi hypoglycemia koʻikoʻi, no ka mea, he haʻahaʻa haʻahaʻa o ka glucose i loko o ke koko (2.2 mmol / L), a pono ke kōkua i waho e lawe ai i ka hāleʻomaʻi e hoʻōki i ka hypoglycemia.

Kahula
ʻO ka hopena maʻamau ka maʻi maʻamau. Ma ka holoʻokoʻa, ma ka liʻiliʻi o kahi maʻi nausea i hoʻomaopopo ʻia i 20% o nā maʻi e loaʻa ana i ka Bayeta Long. ʻO ka hapa nui o ka maʻi he māmā a maʻalahi paha. I ka hapa nui o nā poʻe maʻi i loaʻa ke kaʻa ma ke ʻano mua o ka mālama ʻana, ua hoʻoliihoi ka ulu ʻana o ke ʻano maʻi i ka wā o ka mālama ʻana. ʻO ka ulu ʻana o ka hoʻokuʻu ʻana i ka hopena ma muli o nā hōʻino i loko o ke aʻo ʻana i hoʻokele ʻia he 30-wiki he 6% i nā mea maʻi e loaʻa ana iā Bayeta Long. ʻO nā hanana kaulana loa e koi ai i ka hoʻopau ʻana o ka maʻi lapaʻau i kekahi o nā pūʻulu o nā maʻi lapaʻau he nausea a me ka luaʻi. ʻO ka hōʻemi ʻana o ka maʻi ma muli o ke kaila a i ʻole ka luaʻi paha i hele i loko o ® ® Long.

Nā wahi hoʻolālā pūnaewele
I mau haʻawina ʻelima me ka hoʻomau mau ʻana i nā wiki he 24-30 mau loa, ua nānā ʻia ka hopena ma ka wahi maʻi i ka maʻi 17,1% o nā maʻi e loaʻa ana iā Bayeta Long.

Ma ka laulā, ua mau ʻoluʻolu nā hopena a, maʻa pinepine, ʻaʻole i alakaʻi i ka hoʻopau ʻana i ka lāʻau lapaʻau. Hiki i ka poʻe maʻi ke loaʻa ka hōʻailona maʻi ma ka hoʻomau ʻana i ka lāʻau me Bayeta Long. Pono ʻoe e koho i nā wahi hou no ka hoʻolaha ʻana i ka lāʻau lapaʻau ma kēlā me kēia maʻi hou.

I nā haʻawina haʻawina, ʻike pinepine ʻia ka hana ʻana o nā sila i nā subcutaneous liʻiliʻi i nā pūnaewele injection, he hopena ia o ka neʻe ʻana o nā polyospheres polymer ma ka hana o ka mākaukau, aia nā 50:50 DL 4AP polymer (copoly-D, L-lactide-glycolide). ʻO ka hapa nui o nā sila e pili ana i ka asymptomatic, ʻaʻole i hoʻopili i ke komo ʻana i ka noiʻi ʻana, a nalowale ma hope o 4-8 mau pule.

Hōʻailona Antibody
ʻO nā lāʻau lapaʻau e pili ana i nā protein a me nā peptides paha i nā waiwai immunogenic, no laila, ma hope o ka hoʻokele ʻana o Bayeta Long, hiki i ka antibodies i exenatide. I ka hapa nui o nā poʻe maʻi i ʻike ʻia nā antibodies, ua ʻemi ko lākou titerena i kēlā me kēia manawa.

ʻO ka heleʻana o nā antibodies (kiʻekiʻe a haʻahaʻa haʻahaʻa) ʻaʻole i hoʻoponopono me ka pae o ka mana glycemic. I nā hoʻokolike kulekele o Bayeta Long, ma kahi o 45% o nā maʻi e hōʻike ana i kahi haʻahaʻa haʻahaʻa haʻahaʻa o nā exenatide antibodies ma ka hopena o ka hōʻike. ʻO ka holoʻokoʻa, ua like ka nui o ka maʻi o nā maʻi me nā antibodies i nā hoʻokolohua āpau. I ka awelika, ma nā hoʻokolohua hoʻokolohua ma ka hōʻike 3, 12% o nā mea maʻi i loaʻa kahi titī antibody kiʻekiʻe. I kekahi o kēia mau mea maʻi, ua paʻa ka pane ʻana mai o ka glycemic at Bayeta Long therapy ma ka hopena o ka manawa hoʻokele i hoʻopaʻa ʻia ai, ma ka 2,6% o nā maʻi me ka titel kiʻekiʻe o nā antibodies, ʻaʻole maikaʻi ka ea glycemic i hoʻomaikaʻi, a ma 1,6% o nā mea maʻi ʻaʻole i hoʻomaikaʻi hou ʻia ka hemahema o nā antibodies.

ʻO nā mea maʻi me nā antibodies e exenatide i hōʻike hou i nā hopena hou aku ma ka wahi i hiki aku ai ka maʻi (no ka laʻana, ka ʻulaʻula o ka ʻili a me ka ʻeha), akā i ka manawa like, ʻo ka pinepine a me ke ʻano o nā hanana ʻino i loko o kēia mau maʻi e like like me nā maʻi nā mea ʻaʻole i loaʻa nā antibodies e exenatide . ^ E Ha yM.

I nā mea maʻi e loaʻa ana i ka Bayeta Long, ka lōʻihi o nā maʻi he mau immunogenic ma ka wahi o ka maʻi (ʻoi loa ka manawa, ʻeha me ka erythema a i ʻole ʻo ia) ma ka hana 30-pule a ʻelua pule 26-pule he 9%. Ua hele pinepine kēia mau ʻōiwi i nā mea maʻi me ka hopena maikaʻi ʻole i nā antibodies (4%) i hoʻohālikelike ʻia me nā mea maʻi me ka hopena maikaʻi (13%), me ka kiʻekiʻe o ka maʻi maʻi ma ka maʻi me nā titilo antibody kiʻekiʻe.

ʻAʻole i hōʻike ʻia nā hoʻohālikelike o ka antibody i ka nui o ka cross-reactivity me nā peptides endogenous like (glucagon a i ʻole GLP-1).

ʻO ka wikiwiki wikiwiki
I loko o kahi hōʻike 30-pule, aneane 3% o nā mea maʻi (n = 4/148) i mālama ʻia me Bayeta Long ma kahi o ka manawa ka manawa o ka wikiwiki o ka hoʻolilo nui ʻana (hōʻemi i ke kau ʻana o ke kino ma waena o nā kipa he ʻelua ma mua o ʻelua mau kipa. 5 kg i hoʻokahi pule).

Hoʻonui ka nui o ka puʻuwai
I loko o ka wai i waiho ʻia o nā mea maʻi me ka Bayeta Long i loko o nā hoʻokolohua lapaʻau, ke piʻi ʻana me ka piʻi ʻana o ka puʻuwai ma muli o 2.6 mau kuʻekuʻe i hoʻokahi minuke he mau mea e pili ana i ke kumu pae (74 mau beats i hoʻokahi minuke). Ma 15% o nā maʻi o ka hui ʻo Bayeta Long, ka nui o ka puʻuwai naʻau e piʻi e ≥ 10 mau beats i kēlā me kēia minamina, ke piʻi nei ka nui o ka puʻuwai haʻahaʻa e ≥ 10 mau beats i hoʻokahi minuke i nā hui lapaʻau ʻē aʻe i nānā ʻia ma nā 5-10% o nā maʻi.

Hoʻopili me nā hua lāʻau ʻē aʻe a me nā ʻano lāʻau ʻē aʻe o ka launa ʻana

Ke lawe nei i nā papa paracetamol ma ke ʻano o 1000 mg ma kahi ʻōpū ʻole a i ʻole hoʻi ma hope o ka ʻai ʻana, ma hope o nā hebedoma 14 o ka lapaʻau me Bayeta Long, ʻaʻohe ʻano nui o ka AUC o ka paracetamol i hoʻohālikelike ʻia i ka wā kāohi. ʻO Cmax (ka uʻi nui) o ka paracetamol i emi e 16% (ma kahi ʻōpū ʻole) a ma ka 5% (ma hope o ka ʻai), a me ka tmax (ka manawa e hiki ai i ka nui o ke kau) ua hoʻonui mai kahi 1 hola i ka manawa o ka kāohi i ka 1,4 hola (ma kahi ʻōpū ʻole) a me 1. 3 mau hola (ma hope o ka ʻai).

Hoʻomākaukau Sulfonylurea
Ma muli o ka hoʻonui nui o ka hypoglycemia i ka wā o ka maʻi me ka hoʻomākaukau ʻana o ka sulfonylurea, pono ke koi ʻia i ka hoʻoponopono ʻana i ka lāʻau sulfonylurea (e ʻike i nā ʻāpana "Dosage a me ka hoʻokele" a "ʻōlelo aʻoaʻo kūikawā").
Loaʻa nā hopena o nā hōʻike pili i hana ʻia ma lalo iho me ka hoʻohana ʻana i ka exenatide ma kahi pākeke o 10 gg 2 mau manawa i ka lā.

ʻO nā kahe waio Hydroxymethylglutaryl CoA reductase inhibitors
Ua hōʻemi ʻia ʻo AUC a me Cmax o ka lovastatin e ka 40% a me 28%, pākahi, a nui ka tmax i ka nui o 4 mau hola i ka wā i hoʻohana ʻia ai ka exenatide pākahi manawa i hoʻokahi lā me kahi mahele o lovastatin (40 mg) hoʻohālikelike ʻia me nā waiwai i ʻike ʻia me lovastatin wale nō. Ma nā 30 mau pule o ka papa hoʻokele plasebo pule o ka exenatide 2 mau manawa i ka lā, ʻo ka hoʻohana ʻana i ka papa HMG-CoA reductase inhibitors ʻaʻole ia i hoʻokō i ka loli mau o ka lipid profile (ʻike i ka ʻāpana "Pharmacodynamics"). ʻAʻole koi ʻia kahi hoʻoponopono hoʻoponopono mua, inā e pono, inā e ʻike ʻia ka ʻike lipid.

Warfarin
Inā i lawe ʻia ʻo warfarin i 35 mau minuke ma hope o ka hoʻokele ʻana o exenatide (2 mau manawa i ka lā), ua ʻike ʻia kahi hoʻonui tmax ma kahi o 2 mau hola. ʻAʻole i ʻike ʻia nā loli koʻikoʻi i ka Cmax a i ʻole AUC. Aia kahi hōʻike e pili ana i ka hoʻonui i INR i ka wā e hoʻohana nei i ke warfarin a me ka exenatide. I nā mea maʻi e lawe ana i nā warfarin a / a i ʻole derivatives Coumarin, pono ia e hoʻokele i ka INR i ka pae mua o ka maʻi me ka Bayeta Long (e nānā i ka ʻāpana "ʻaoʻao effects").

Digoxin a me lisinopril
Ma nā haʻawina o ke ʻano ʻoihana lapaʻau, ʻaʻole i loaʻa ka hopena o exenatide (2 mau manawa i ka lā) i ka hopena nui o ka Cmax a i AUC o ke digoxin a me ka lisinopril, akā naʻe, he nui ka tmax ma kahi o 2 mau hola i hōʻike ʻia.

Ethinyl estradiol a me levonorgestrel
Ma hope o ka hoʻohana ʻana i ka mea hoʻomalu kūleʻa i hui ʻia (30 μg o ka ethinyl estradiol a me 150 μg o levonorgestrel) hoʻokahi hola ma mua o ka hoʻokele ʻana o exenatide (ʻelua mau manawa i kahi lā), ʻaʻohe loli ma AUC, Cmax a i Cmin (hōʻemi haʻahaʻa) o ka ethinyl estradiol a me levonorgestrel. Ke hoʻohana nei i kahi hui i loko o kahi waha he 32 mau minuke ma hope o ka lawe ʻana iā Exenatide (ʻelua mau manawa i ka lā), ʻaʻole i loli ka AUC, akā naʻe, hemo ka Cmax o ka ethinyl estradiol ma kahi o 45% a me Cmax o ka levonorgestrel e 2741%, a me ka hoʻonui ʻana i ka tmax ma ka 2-4 hola ma muli o ka lohi ʻana o ka ʻōpū. . ^ E Ha yM. ʻAʻole emi iki ka emi ʻana o Cmax, no laila ʻaʻole koi ʻia ka hoʻoponopono ʻana o ka maʻi waha.

Nā ʻōlelo kikoʻī

ʻAʻole ia e kuhikuhi ʻia ʻo Baeta ® Long e like me ka lālani mua o ka mālama ʻana no ka maʻi mellitus type 2 i nā mea maʻi me nā mana glycemic hemahema ma ke kīhina o ka meaʻai a me ka hana kino.

ʻAʻole koho ʻo Bayeta ® Long i ka pono no ka insulin, ua hoʻohui pū ʻia ka hoʻohana ʻana me ka insulin (e ʻike i ka ʻāpana "Contraindications").

ʻAʻole pono ke hoʻokele ʻia ʻo Bayeta Long ma ka intravenously a i ʻole intramuscularly.

ʻO hoʻokahi pākahi o kēia huahana lapaʻau nā mea liʻiliʻi loa ma lalo o 1 mmol o ka sodium (23 mg), i.e. Hoʻomaʻawi ʻole ka hoʻomākaukau ʻana no ka sodium.

I ka hopena o ka Tumiki thyroid C-cell
ʻO ka hana ʻana o ka exenatide hoʻomohala hana i nā holoholona ʻonika (nā kiʻina) ma nā maʻi nui nui i pili ʻia me ka hoʻonui ʻana i ka ulu ʻana o ka Tumā C-cell kaomi me ka hui pū. Wahi a nā hopena o nā preclinical a me nā haʻawina ʻoihana, ʻaʻole hiki ke hoʻokaʻawale i kahi mea like o ka mau kaaka C-cell (me ka maʻi ʻolika medullary) o ka keleko thyroid. Kau ʻia ka lāʻau i loko o nā mea maʻi me ka maʻi o ka maʻi pakano medullary i loko o kahi pilikino pilikino a pilikino paha, a me ke ʻano nōʻehā type 2 MEN.

ʻO Serum calcitonin kahi hōʻailona olakino o ka maʻi thyroid thyle medullary. ʻO ka uluʻana o ka mālama maʻamau ʻana i ka ʻike serum calcitonin a i ʻole ka nānā ʻana i ka ultrasound o ka gland thyroid no ka ʻike mua ʻana i ka maʻi medullary i nā maʻi e loaʻa ana i ka Bayeta ® Long ʻaʻole i hoʻokumu. Hiki i ke kāohi ka hoʻonui ʻana i ka hopena o nā mea pono ʻole ma muli o ka liʻiliʻi o ka hoʻoholo no ka serium calcitonin no ka hōʻike ʻana i ke kanesa medullary a me kahi kiʻekiʻe kiʻekiʻe o nā maʻi o ka thyroid. Hiki i nā mea nui ke hoʻohuihui i ka ʻōlaʻi o ka serum calcitonin ke hōʻike nei i ke kanikau medullary, a ʻo ka poʻe maʻi me ka maʻi ʻolika medullary i mau pinepine ʻia nā mea> 50 ng / L. Inā hoʻoholo ʻia ka paʻa o ka calcitonin serum a hoʻonui ʻia, hoʻomanawanui hou ka mea maʻi. ʻO nā mea maʻi me nā nodules o ka glam thyroid i hoʻokumu ʻia i ka wā o kahi hōʻike kino a i ka tomography o ka ʻāʻī e nānā hou. Pono e hoʻomaopopo ʻia nā mea maʻi e pili ana i ka hiki ʻana o nā maʻi thyroid a me kā lākou mau hōʻailona (e ʻike i ka ʻāpana "Contraindications").

Hola paʻa kino hana
I nā mea maʻi me ka hopena o ka renal stage holomua e hele ai i ka hemodialysis, ʻo ka hoʻohana ʻana i ka exenatide 2 mau manawa i ka lā i hele pū ʻia me ka nui o nā hopena maikaʻi loa mai ka ʻeha o ka gastrointestinal, no laila, ka lāʻau lapaʻau Bayeta Long e hoʻohālikelike ʻia i nā mea maʻi me ka maikaʻi ʻole o ka hopena renal ʻole i ʻole hōʻaihewa maikaʻi ʻole (clearance creatinine ® loa i nā mea maʻi me ka hana renal impaired o ke kāʻei nui o ka maʻi (clearance clearance 30-50 ml / min) ʻaʻole i'ōlelo ʻia ma muli o ka liʻiliʻi ʻike hoʻokūkū.

Ua hōʻike ʻia nā hihia o ka renal dysfunction me ka hoʻohana ʻana i ke kau inoa ma hope o ka hoʻohana ʻana i ka lāʻau lapaʻau, me ka hoʻonui ʻana o ka konsumine serum creatinine, hoʻomohala ʻana o ka pilikia ʻole, hoʻopiʻi o ka papa o ka hana ʻole i ka hopena, a me ka hana ʻole ʻana o ka maʻi renal.I kekahi mau hihia, pono hemodialysis. ʻO kekahi o kēia mau pilikia i hiki ke dairdration ma muli o ka nausea, ka luaʻi, a me / a i ʻole nā maʻi a i ʻole, a i ʻole mau lāʻau lapaʻau me ka ʻike ʻike i ka hana ʻana i ka hana renal / metabolism wai. ʻO nā lāʻau hoʻohui i komo me ka angiotensin-hoʻohuli i ka paʻa o ka enzyme, non-steroidal anti-inflammatory drug, diuretics. Ke koho ʻana i ka maʻi hōʻailona a me ka hoʻokuʻu ʻana i ka lāʻau, hiki paha i ke kumu o nā loli pathological, me ka exenatide, hana hou ʻole i ka hana hou. E like me nā hopena o nā noi ʻo clinical a me preclinical, ʻaʻole i hōʻoia ka nephrotoxicity o ka exenatide.

ʻO nā maʻi maʻi o ka papa gastrointestinal
ʻAʻole i aʻo ʻia ʻo Bayeta Long i nā maʻi me nā maʻi koʻikoʻi o ka papa gastrointestinal, me ka paresis o ka ʻōpū. ʻO ka hoʻohana ʻana o Bayeta ® Long e hana pinepine i nā hopena ʻino mai ke kumu gastrointestinal e like me ka nausea, ka luaʻi a me ke ahulau, no laila ke hoʻohana nei i kēia lāʻau lapaʻau i nā maʻi me nā maʻi koʻikoʻi o ka pākīpona gastrointestinal ua contraindicated.

ʻO ka pancreatitis acute
Ua hōʻike ʻia nā hihia pālua o ka pancreatitis koʻikoʻi me ka hoʻohana ʻana iā Bayeta Long. I ka koho ʻana i ka mālama mālama ʻana, ua hoʻoholo ʻia ka pancreatitis, eia naʻe, ma nā hihia koʻikoʻi loa, ua ʻike ʻia ka hoʻomohala ʻana o ka pancreatitis necrotic a hemorrhagic a / a i ʻole ka make. Pono e hoʻomaopopo ʻia nā mea maʻi e pili ana i nā hiʻohiʻona hōʻailona o ka pancreatitis maʻa: mau loa ka maʻi kaumaha ma loko o ka ʻōpū. Inā kānalua ka pancreatitis, e hoʻokuʻu ʻia ka lāʻau exenatide. Inā hōʻike ka mea maʻi i ka pancreatitis maha, ʻaʻole pono ke kuhikuhi hou ʻia ka lāʻau Bayeta Long®. ʻO ka lāʻau lapaʻau Baeta ® Long kahi contraindicated i nā maʻi me ka mōʻaukala pancreatitis.

Nā lāʻau lapaʻau hoʻohuli
ʻO ka hoʻohana like ʻana o Bayeta Long me insulin, D-phenylalanine derivatives (meglitinides), alpha-glucosidase inhibitors, dipeptidyl peptidase-4 inhibitor and other GLP-1 reseptor agonists i aʻo ʻole ʻia. ʻO ka hoʻohana like ʻana o Bayeta® Long a me Exenatide 2 mau manawa i kahi lā (Bayeta ®) ʻaʻole i aʻo ʻia a ʻaʻole ʻae ʻia.

Hypoglycemia
Ma ke kumu o ka hoʻohana ʻana o ka mākaukau Bay Bay Long i hui pū me ka hoʻomākaukau ʻana i ka sulfonylurea, ua ʻike ʻia kahi kiʻekiʻe kiʻekiʻe o ka hypoglycemia. Ua hōʻike ʻia nō ma nā haʻawina ʻoihana maʻi nā maʻi me ka maʻi hānai maʻi i loaʻa i ke ʻano hui me ka sulfonylurea i kahi kiʻekiʻe kiʻekiʻe o nā hanana hypoglycemic hoʻohālikelike ʻia me nā mea maʻi me ka hana maʻamau maʻamau. No ka hōʻemi i ka hopena o ka hypoglycemia i pili me ka hoʻohana ʻana i ka lāʻau sulfonylurea, e noʻonoʻo e hōʻemi i ka nui o kēia lāʻau lapaʻau.

ʻO ka wikiwiki wikiwiki
ʻO ka wikiwiki wikiwiki wikiwiki e hōʻike ʻia ma ka huina o> 1.5 kg i kēlā me kēia pule i nā maʻi e loaʻa ana i ka exenatide. Hiki i ke kaupaona hopena ke loaʻa nā hopena maikaʻi loa. Me ka hoʻohaʻahaʻa wikiwiki ʻana i ka paona kino i nā maʻi, pono pono e kāohi i nā hōʻailona o ka cholelithiasis.

ʻO nā pilina me Warfarin
ʻO nā hihia o ka hoʻonui o INR, i kekahi mau mea e pili ana i ke koko, ua hōʻike ʻia me ka hoʻohui hoʻohui ʻana o ka warfarin a me ka exenatide (e nānā i ka ʻāpana "Hoʻohālikelike me nā lāʻau ʻē aʻe a me nā ʻano like ʻole o ka hoʻopili o ka lāʻau").

Ke hoʻihoʻi nei o ka maʻi
ʻO ka hopena o Bayeta ® ʻO ka lōʻihi ma hope o ka haʻalele ʻana o kāna ʻoihana e hoʻomau i ka manawa lōʻihi, ʻoiai ka hoʻoliʻiliʻi o ka exenatide i loko o ke koko koko no nā hebedoma 10. Wahi a ia, i ke koho ʻana i nā lāʻau lapaʻau ʻē aʻe a koho i kā lākou dosages, pono kēia ʻano e mālama pono i ka ʻoiaʻiʻo, no ka mea, i ka wā e hiki mai ana nā hopena ʻino a me nā hopena i hoʻopiʻi ʻia, ma ka liʻiliʻi loa, ma muli o ka hiki ʻana o exenatide i ke koko koko.

Hōʻailona Antibody
I nā mea maʻi e loaʻa ana i ka Bayeta Long, hiki i nā mea hui ke exenatide.
Ua hoʻoholo ʻia nā Exodatide antibodies i nā maʻi āpau i mālama ʻia me Bayeta Long i ka lāʻau hoʻokolohua 5 i hoʻopaʻa ʻia me ka lāʻau hoʻokolohua e kū mau ana i ka wiki 24-30. I 6% o nā mea maʻi i mālama ʻia me Bayeta Long, ua hui pū ʻia ka nohona antibody me kahi pane o glycemic emi. Inā loli ke ʻano o ka glycemic a inā ʻaʻole i loaʻa ka pae kūpono o ka kontrol glycemic, pono e loiloi ʻia ka ʻaha kūpono o ka maʻi hypoglycemic (e nānā i ka ʻāpana "ʻaoʻao effects").

Hypersensitivity hopena
Me ka hoʻohana kau inoa ʻana o ka exenatide, ua hōʻike ʻia nā hihia o nā hopena hypersensitivity koʻikoʻi (e like me ka hopena anaphylactic a me ka angioedema). Inā ulu nā hopena hypersensitivity, e ho'ōki ʻoe i ka hoʻohana ʻana i ka lāʻau Bayeta Long a me nā lāʻau lapaʻau ʻē aʻe, ʻo ka hoʻohana ʻana iā ia e hiki ai i ke ʻano hypersensitivity, e ʻimi koke i ke kōkua lāʻau lapaʻau (e ʻike i ka ʻāpana "ʻaoʻao effects").

Nā wahi hōʻike ma ka wahi ʻōlelo
Me ka hoʻohana ʻana o ka hoʻopaʻa inoa ʻana o Bayeta Long, ua hōʻike ʻia nā hihia o ka hanana koʻikoʻi ma ka wahi i hōʻike ʻia (e like me ka abscesses, cellulitis a me ka necrosis), me ka hoʻopili ʻana o nā hōʻailona koloi subcutaneous. I kekahi mau hihia, ua noi ʻia ka hoʻopiʻi ʻana (e ʻike i ka ʻāpana "ʻaoʻao hopena").

Pūnaewele
ʻAʻole i hana ʻia nā haʻawina no ka hopena o Bayeta ® Long ma ka hānai i loko o nā kānaka.

Packer (ka pale mua)

Amilin Ohio Electric, USA
8814 Trade Port Drive, West Chester, Ohio 45071, USA
Amylin Ohio LLC, USA
8814 Trade Port Drive, West Chester, Ohio 45071, USA

Vetter Pharma-Fertigun GmbH & Co. KG, Kelemānia (solvent i loko o ka pahu kī)
Eisenbahnstrasse 2-4, 88085 Langenargen, Kelemānia
Vetter Pharma-Fertigung GmbH & Co. KG, Kelemānia Eisenbahnstrasse 2-4, 88085 Langenargen, Kelemānia

Packer (kekaki (laʻa) helu)

Amilin Ohio ELC, USA (pen)
8814 Trade Port Drive, West Chester, Ohio 45071, USA
Amylin Ohio LLC, USA
8814 Trade Port Drive, West Chester, Ohio 45071, USA

Enestia Belgium NV, Belgium (hoʻonohonoho)
Kloknerstraat 1, Hamont-Ahel, B-3930, Pelekane
Enestia Belgium NV, Belgium
Klocknerstraat 1, Hamont-Achel, B-3930, Belgium

Ke hoʻopuka ʻana i ka mana kūpono

AstraZeneca UK Limited, UK
Pūnaewele ʻo Silk Road, Mcclesfield, Cheshire, SK10 2NA, UK
AstraZeneca UK Limited, United Kingdom
ʻO Silk Road Business Park, Macclesfield, Cheshire, SK10 2NA, United Kingdom

Amilin Ohio ELC, USA (pen)
8814 Trade Port Drive, West Chester, Ohio 45071, USA
Amylin Ohio LLC, USA
8814 Trade Port Drive, West Chester, Ohio 45071, USA

Loaʻa nā ʻike hou aʻe ma ke noi:
ʻO ka hui o AstraZeneca UK Limited, UK, ma Moscow a
LLC AstraZeneca Pharmaceutical 125284 Moscow, ul. Kauahi, 3, p 1

E hoʻokuʻu i ke ʻano a me ka ʻano

Hoʻokuʻu ʻia ʻo Baeta Long ma ke ʻano o ka pauka no ka hoʻomākaukau no ka hoʻokuʻu ʻana mai no ka ʻāwanana (s / c) ka hoʻokō ʻana i ka hana lōʻihi: kokoke i ke keʻokeʻo a i ʻole keʻokeʻo paha, ka ʻōpala ke ʻano ʻoniʻulu a ʻulaʻula / brown wai kūmole (hoʻonoho - pauku i ka huina e pili ana i ka 2 mg o ka exenatide, ma he 3 ml aniani wai palahalaha, pani ʻia me ka pahu pani pahu chlorobutyl a me kahi pōpō alumini me kahi pōpoki polypropylene, a he 0.65 ml pelalelo i loko o ka syringe i ʻike ʻia i 1.5 ml me ka piston polypropylene me kahi me kahi plunger hāmeʻa rhombutyl a me kahi mea hoʻopihapiha ʻo Luer, i kahi pā koki i hoʻopaʻa ʻia 1 set, me ka pahu 1 me ka pauna, 1 syringe me nā hāmeʻone, 1 pālule, a me nā paila he 2, i loko o ka pahu pahu me kahi paʻa mua o ka pā 4 blister packs, syringe pen - i ka puka o mua o ka peni mauʻu he mau pauka ma ka nui e like me 2 mg o ka exenatide, i ka lumi hope o ke aniani o ke aniani i hoʻohui ʻia i loko o ka ʻāpana syringe - 0.65 ml solvent, i loko o kahi pā kuhi i hoʻopaʻa ʻia 1 syringe pen me 1 mau lehelehe pono, i ka pōpoki kāleka me ka wehe mua i ka pūpū 4 kihapiha a me 1 mau pulupulu pelekula.Aia pū i kēlā me kēia pū ka pahuhopu no ka hoʻohana ʻana o Bayeta Long).

I loko o 1 mauʻu no ka pauma (1 set a 1 mau syringe penʻi) he:

kaha waiwai: exenatide - 2 mg,
Nā kumuhana hou: sucrose, polymer 50:50 DL 4AP copoly- (D, L-lactide-glycolide).

Ka hana hoʻoponopono: polysorbate 20, sodium carmellose, sodium dihydrogen fosfat monohidate, sosa klorida, sosa hydrogen fosfate heptahydrate, wai no ka hōʻohu, no ka hoʻohui ʻana i kahi peni ʻiwikē - 1 M pākuʻi ʻia he sodium hidroksida.

Lapaʻau lāʻau

ʻO ka Exenatide kahi mea agonist o ka hopena o ka peptide-1 peptide-1 (GLP-1), e hōʻike ana i kekahi mau hopena antihyperglycemic i loaʻa i GLP-1. ʻO ka papa waikawa amino i loaʻa i ka exenatide kekahi hapa i hoʻopili me ka pilina o ke kanaka GLP-1. Ua hōʻike i nā haʻawina vitro ua paʻa ka waiwai hana a hoʻoulu i nā mea hoʻokipa GLP-1, a me nā cyclic adenosine monophosphate (cAMP) a / a i ʻole nā ala ʻē aʻe o ka hana uila intracellular e komo i kāna hana o ka hana.

Hoʻonui ka glucose o Exenatide i ka hana insulin e ka pancreatic β-cell. Hōʻike ka emi ʻana o ka hana hana i ka inika no kahi hōʻemi o nā kaila koko. Inā i hoʻohana pū ʻia ka mea hana me ka thiazolidinedione a me / a i ke metformin, ʻaʻole i oi aku ka lōʻihi o nā manawa o ka hypoglycemia i hoʻopaʻa ʻia ma ka hui pletebo me ka thiazolidinedione a me / a metformin. ʻO kēia paha ma muli o ka hopena glucose-hilinaʻi o ka hana insulinotropic o ka hana.

Hoʻopili ka Exenatide i ka hana o glucagon, ke kiʻekiʻe o ka nui o ka manawa i hoʻonui ʻia i nā mea maʻi me ka diabetes mellitus type 2. ʻO ka emi ʻana o ke kaena o ka glucagon i loko o ke koko e hoʻemi ana i ka wikiwiki o ke kaʻina o ka hōʻaiho o ka glucose e ka ate. Akā i ka manawa like, ʻaʻole he alakaʻi o exenatide i kahi palaki o ka hoʻokaʻamau maʻamau o ka glucoseagon a me nā hormone ʻē aʻe nā kumu o ka emi o ke kaila o ke koko. Kōkua ʻo Baeta Long e hoʻolohi i ka holoi ʻana i ka ʻōpū, kahi e hoʻemi ai i ka nui o ka glucose i ke kahe koko. Ke kōkua nei ka hoʻohana ʻana i ka huahana i ka hoʻēmi ʻana i ka nui o nā meaʻai i hoʻopau ʻia ma muli o ke kahe ʻana o ka makemake a me ka hoʻonui ʻana i ka manaʻo piha.

Hāʻawi ke Exenatide i ka mālama glycemic maikaʻi ma muli o ka hōʻemi lōʻihi o ka hoʻokeo ʻana i ka glucose koko a me ka glucose postprandial i loko o nā mea maʻi me ka maʻi maʻamau 2. Ma kahi hoʻohālikelike i ka endPous GLP-1, ʻokoʻa nā mea kanu a me ka mea paʻa pharmacokinetic o Baeta Long i ka hoʻohana ʻana i ka lāʻau i hoʻokahi manawa i kēlā me kēia 7 lā. Ma kahi noiʻi pharmacodynamic o exenatide i nā mea maʻi me ka maʻi diabetes type 2, hoʻihoʻi hou ʻia ka hapa I o ka huna ʻana o ka insulin a me ka hoʻomaikaʻi ʻana i ke ʻano II hōʻike i hōʻike ʻia ma ka pane ʻana i ka hoʻokele bolra intravenous (iv).

Ma ke ʻano o nā haʻawina ʻelua (ʻo ka lōʻihi o 24 a me 30 mau pule), ʻo Baeta Long ma kahi lāʻau o 2 mg 1 mau manawa i ka lā 7 i hoʻohālikelike ʻia me exenatide i lawe ʻia ma ka 2 o ka lā (ʻo ka lāʻau lapaʻau Bayeta). I nā haʻawina ʻelua, ʻo ka emi ʻana o ka hemoglobin glycated (HbA_1c) i ka koko ua hoʻopaʻa ʻia i ka wā mua o ke kau ʻana - 4 a i 6 mau pule ma hope o ka hoʻomaka ʻana o ka hoʻopaʻa ʻana. I ka poʻe maʻi e loaʻa ana i ka lāʻau lapaʻau, aia kahi hōʻemi nui nui a statistically i HbA_1s hoʻohālikelike ʻia me nā mea maʻi mai ka hui exenatide, lawe ʻia i 2 mau manawa i ka lā. I nā hui ʻelua, ua ʻike ʻia ka emi ʻana o ka paona kino i pili i ka pae ʻāina, akā ʻo ka ʻokoʻa ma waena o nā pūʻulu ʻaʻole ia he koʻikoʻi.

ʻO ka hōʻemi HbA hou_1c a me ka hoʻohaʻamau mau ʻana i ke kaumaha o ke kino i hoʻopaʻa ʻia ma ka liʻiliʻi he 52 mau maʻi i nā maʻi nā mea i hoʻopau i ka manawa o ka pule 30-pule a me ka manawa o 22-pule i hoʻomoʻa ʻole ʻia ma ka hōʻike ʻana.

I ke aʻo ʻana o 26 mau pule o Baeta Long ma kahi o ka nui o ka 2 mg i alakaʻi i kahiʻoi loa aku o ka neʻe ʻana o ka HbA_1c, ka nui o ka emi ʻana o ka nui o ke kaupaona kino a me kahi hanana ʻoi aku ka loaʻa ʻole o nā hanana hypoglycemia i hoʻohālikelike ʻia me ka glargine insulin, i loaʻa i hoʻokahi lā. Eia nō, hōʻike kekahi 26 mau pule ʻelua makapō i ka nui o Bayeta Long ma luna o ka pioglitazone a me sitagliptin, ka mea i lawe ʻia i ka nui o kēlā me kēia lā aʻo ka lawe ʻana i ka metformin, e hōʻemi i ka pae o HbA_1c pili i ka papa waiwai.

I ka hoʻomakaʻana o nā haʻawina a pau ka lāʻau Baeta Long, kahi i hōʻemi ʻia ke kaupaona kino e pili ana i nā waiwai kumu.

Ua alakaʻi pū ʻia ka lāʻau lapaʻau i ka emi nui o ka wikiwiki o ka plasma plasma / serum glucose. Ua hoʻomaopopo ʻia kēia emi i nā hebedoma 4 ma hope o ka hoʻomaka ʻana o ka mālama ʻana. I ka hoʻohui, ua hōʻemi ʻia ka liʻiliʻi o ka pae o ka glucose postprandial. Kūkākena ka hoʻomaikaʻi ʻana i ka ʻaihikihila ʻana i ke koko i ka wā 52 mau pule.

I loko o nā noi ʻana o ka lāʻau lapaʻau, ua ʻike ʻia kahi emi o ke koko systolic (SBP) o 2.9–4.7 mm Hg. ʻAniā. pili i nā waiwai kumu. ʻO ka holomua i loaʻa i ka mākaukau GARDEN ua nānā ʻia i ka 52 mau pule o ka lāʻau.

Nā hōʻailona no ka hoʻohana ʻana

Noi ʻia ke hoʻohana ʻana ʻo Baeta Long no ka maʻi maʻamau ʻo ka maʻi 2 no ka mālama ʻana i ka metformin, thiazolidinedione, sulfonylurea derivatives, kahi hui o metformin a me kahi derony sulfonylurea a me thiazolidinedione a me ka metformin ma lalo o ke ʻano o ka hoʻomohala ʻana i ka glycemic control (inā hoʻohana kēia mau mea āpau i nā hōkele i pau ʻole).

Baeta Long, nā ʻōlelo e hoʻohana ai: ke ʻano a me ke ʻano

ʻO ka lāʻau Baeta Long e mālama ʻia i ka subcutaniously i loko o ka ʻōpū, ka ʻūhā a mua ʻole paha i ka manawa o ka lā, me ka mālama ʻole i ka meaʻai.

ʻO ka paipai ʻia no ka lawaiʻa hypoglycemic a me 2 mg 1 manawa i ka 7 lā.

Ma ka hana o ka hoʻokaʻawale ʻana i kahi maʻi mai Exenatide 2 mau manawa i kahi lā (ʻo ke ʻano lāʻau lapaʻau Bayeta) i ka hōʻola ʻia ʻo Bayeta Long, hiki ke nānā ʻia he piʻi iki o ka nui o ke kaʻe koko ma ke ʻano, ka mea nui loa i loaʻa i loko o 14 mau lā ma hope o ka hoʻomaka ʻana o kahi lapaʻau.

Me ka hoʻohana pū ʻana o ka lāʻau me thiazolidinedione, metformin, i hui pū ʻia me kēia mau hui ʻana, ʻaʻole e hoʻoponopono ʻia ka maʻi mua o ka thiazolidinedione a me / a i ʻole metformin. Inā i kuhikuhi ʻia ʻo Baeta Long e hui pū me kahi derivative o ka sulfonylurea, hiki ke hoʻokaʻawale ʻia ka hopena o ka hopena o ka hopena e hoʻemi i ka hopena o ka hypoglycemia.

E hoʻokele ʻia ʻo Baeta Long i kēlā me kēia lā 7, i ka lā hoʻokahi o ka pule. Inā pono, hiki iā ʻoe ke hoʻololi i ka lā o ka hoʻokele o ka lāʻau lapaʻau, akā, ʻo ka hopena hou aʻe i kēia hihia e pono e lawelawe ʻia ma mua o 24 mau hola ma hope o ka maʻi mua.

Inā hele ʻoe i kahi maʻa iki, pono ʻoe e hoʻokomo iā ia i ka manawa pōkole loa, a laila hoʻohana iā Baeta Long e like me ka maʻamau. Pono e kāhea i ʻelua inikua o ka lāʻau i loko o ka lā hoʻokahi ʻaʻole pono.

ʻAʻole pono ka ʻoihana me ka lāʻau lapaʻau e nānā i ke kūʻokoʻa kūʻokoʻa o ka nui o ka glucose o ke koko, eia naʻe, pono ke ʻano o ia mana e hoʻololi i ka hopena o kahi derivative sulfonylurea.

I ka hoʻomaka ʻana o ka hoʻohana o nā ʻaina hypoglycemic ʻē aʻe ma hope o ka pau ʻana o ka papa o ka hoʻomaʻamaʻa ʻana o Bayeta Long, pono ia e noʻonoʻo i ka hopena lōʻihi o ka lāʻau.

ʻO ka ʻaihue hypoglycemic mākaʻi no ka hoʻohana kūʻokoʻa ʻana e nā maʻi. Hoʻohana ʻia kahi penikala peni a i loaʻa paha kahi pahu i hoʻokahi manawa hoʻokahi a hoʻokahi wale nō ka mea maʻi. Ma mua o ka hoʻomākaukau ʻana i ka hoʻopanee, e hōʻoia i ka leʻaleʻa o ka solvent a ʻaʻole i komo i nā māhele ʻike ʻia. ʻAʻole hiki ke mālama ʻia ka hoʻokuʻu ʻia ʻana mai ka pauku; pono e hoʻohana koke ʻia no ka hoʻokele.

Mai hoʻohana i kahi hoʻomākaukau hoʻomākaukau mua ʻana.

ʻO ka mea maʻi a i ʻole nā mea e mālama ana iā ia a ʻaʻole i aʻo ʻia ka lāʻau lapaʻau e hoʻomaʻamaʻa pono i nā lula no ka hōʻino ʻana iā ʻoe iho o ka lāʻau a e hahai pono i nā ʻōlelo i hāʻawi ʻia i loko o ka hana no ka hoʻohana ʻana i ka syringe pen / kit Baeta Long, i hoʻopili ʻia i ka lāʻau lapaʻau.

Nā hopena hopena

ʻO nā hanana ʻino loa i hōʻike ʻia i ka wā o ka mālama ʻana me ka lāʻau lapaʻau ka maʻi ʻuwala a me ka huʻi. ʻO ka maʻi wai, ʻo ia ka mea e loaʻa pinepine ai ka hopena, ua nānā ʻia i ka hapa nui o nā poʻe maʻi ma ka hoʻomaka ʻana o ke papa; ma hope, i ka wā o ke kaʻina hana, ua emi iki ka hopena o kēia hopena ʻO ka hapanui o nā maʻi i hāpai i ka wā o ka hoʻohana ʻana o ka lawehala hypoglycemic pili i ka ʻāʻī a i ʻole ka paʻakikī o ka paʻakikī.

I ka wā o ka lāʻau lapaʻau ʻo Baeta Long, ua hōʻike ʻia nā hanana pōʻino e like me kēia.

I ka wā o ka hana o ka hoʻopaʻa inoa ʻana o Baeta Long, aia nā lono o ka hana ʻole o ka palaka, e like me ka hoʻonui ʻana i ka bun serum, pilikia ʻole, hoʻopiʻi ʻana i ka hana ʻole o ka pilikia, a me ka hana ʻole ʻole o ka māla. I kekahi manawa i kēlā mau hanana, pono hemodialysis. Hiki ke hoʻoweliweli ka nui o kēia mau ʻōuli ma ka huehue ma muli o ka maʻi a me / a i ʻole a i ʻole a i ʻole a i ʻole a ma muli o ka hoʻohana ʻana i nā lāʻau e hōʻakei i ka metabolism wai a me ka hana ʻana paha, a laila e komo pū ai i nā diuretics, nā lāʻau anti-inflammatory non-steroidal (NSAID). Ke kuhikuhi nei i ka mālama ʻana i ka maʻi hōʻailona a me ka hoʻokuʻu ʻana i ka lāʻau lapaʻau i hopena i kēia mau hopena, ua hoʻihoʻi ʻia ka hana renal impaired. ʻO ka nephrotoxicity o ka exenatide e like me nā hopena o nā haʻawina ʻaʻole i hōʻoia ʻia.

E pale aku i ke ʻano o ka mālama ʻana me Bayeta Long, ma nā hihia līpiki, ka hoʻopaʻa ʻia ʻana o ka maʻi pancreatitis maʻa, ʻoi aku ka hala ma hope o ka koho ʻana o ka mālama mālama, mālama. Eia naʻe, ʻo ka nānā ʻana o ka hemorrhagic a i ʻole necrotic pancreatitis a / a i ʻole ka make ke make. ʻO nā hiʻohiʻona hiʻohiʻona o ka maʻi pancreatitis ka hoʻomau mau ʻana i ka ʻeha o ka ʻōpū. Inā kānalua ʻoe i ka hoʻomohala ʻana o kēia hoʻopiʻi ʻana, pono e hoʻokuʻu ʻia ka lāʻau lapaʻau.

Ke hoʻohana nei i ka exenatide, ua ʻike ʻia nā hihia o ka hoʻolilo ʻana o ka paona wikiwiki - ma ka nui o mua o 1.5 kg i hoʻokahi pule. Hiki i ke kaupaona ʻana ke alakaʻi i nā hopena maikaʻi ʻole, ma muli o kēia hopena, me kēia hopena ʻokoʻa, ka mālama pono ʻana i nā hōʻailona o ka cholelithiasis.

Hoʻokomo i ka hiki ke lawe i nā kaʻa a me nā mīkini paʻakikī

ʻAʻole i lawe ʻia ka noi ʻana o ka hopena o ka exenatide ma luna o ke kaʻa e lawe i nā kaʻa a me nā mīkini ʻē aʻe. I ka hoʻohana ʻana o Byeta Long i ka hui pū ʻana me ka mākaukau sulfonylurea i ka wā e ke kaʻa ana i ka kaʻa a hana pū paha me nā ʻoihana paʻakikī, ʻo ia ka mea e mālama ʻia e mālama pono i ka hopena o ka hypoglycemia.

ʻŌpū a me ka lactation

Pono nā wahine o nā makahiki hānau i ka wā e mālama ai i nā contraceptives kūpono.Ma muli o ka hana mau ʻana ʻo Baeta Long, ua hoʻopau pono i ka lāʻau lapaʻau ma mua o ʻekolu mau mahina ma mua o ka hoʻohālikelike ʻia.

Hoʻopili ʻia nā ʻikepili e pili ana i ka hoʻohana ʻana i nā lāʻau lapaʻau e nā wahine i ka wā hāpai. Ma nā noi preclinical i loko o nā holoholona, ua loaʻa nā mea maʻi pomo.

ʻAʻole ʻike ka ʻikepili e hōʻoia nei i ka hiki o ka exenatide e hoʻopā ʻia i ka waiū kanaka.

I ka wā hapai a me ka lactation, ua hoʻomaʻemaʻe ʻia ka mālama ʻana ʻo Bayeta Long.

I ka hihia o ka hana renal hemaʻa

Loaʻa ʻia i loko o nā mea maʻi i mālama ʻia me Baeta Long ma kahi o ka 2 mg, ma ka heleʻana o ka maʻi hōʻemi a me ke kaulike, he nui o ka pae ʻana o ka maʻi o ka exenatide e 23 a me 74%, kēlā me kēia, hiki ke mālama, hoʻohālikelike ʻia me nā poʻe me ka hana kūlohelohe maʻamau.

I ka loaʻa ʻana o kahi haʻahaʻa o ka hopena o ka hana o ka renal (CC 50-80 ml / min), ʻaʻole pono ke hoʻoponopono ʻia i ka hopena Bayeta Long; no ka maʻi maʻalahi (30-50 ml / min), ʻaʻole ia e ʻōlelo ʻia e hoʻohana i ka lāʻau lapaʻau ma muli o ka mea paʻa i ka maʻi lapaʻau, ma nā maʻi koʻikoʻi. nā maʻi (CC ma lalo o 30 ml / min) a i ʻole ka pau ʻana o ka lawelawe ʻole ʻana i ka papa hana ʻole me ka lāʻau i contraindicated.

Me ka hana pūpū hemahema

I loko o nā mea maʻi me ka hana aho kīnā ʻole, ʻaʻole i hoʻokō ʻia kahi noiʻi pharmacokinetic o ka lāʻau lapaʻau. No ka mea ua hoʻopau nui ʻia ʻo Baeta Long e nā keiki, nā maʻi hōʻeha i ke aʻeha e pili ʻole ana i nā pae o ka exenatide koko.

I mua o nā maʻi o ka ate, ʻaʻole pono ka hoʻoponopono ʻana o ka lāʻau.

Hoʻohana i ka wā kahiko

Hoʻolaha nā ʻikepili e pili ana i nā mea maʻi ʻelemakule, akā e like me nā ʻike i loaʻa, nā loli nui i ka pae o ka hōʻike o ka exenatide ʻaʻole i manaʻo ʻia me ka piʻi o ka makahiki a 75 mau makahiki.

Ke hoʻohana nei i ka exenatide 2 mau manawa i ka lā ma kahi o ka 0,01 mg, nā mea maʻi me ka maʻi diabetes type 2 nona 75-85 mau makahiki i hōʻike i ka nui o AUC (ʻo ia ka wahi ma lalo o ka pākeke pharmacokinetic) ma kahi o 36% i hoʻohālikelike ʻia me nā mea maʻi 45-65 mau makahiki he nui, ʻo ia ka mea , ma muli o ka nāwaliwali o ka hana palupalu i ka wā ʻelemakule.

ʻAʻole pono nā mea maʻi kahiko e hoʻohana ana i ka Bayeta Long, akā pono ka manaʻo e hōʻemi i ka hana o ke keiki me ka makahiki.

Hoʻohui nūhou

mau lāʻau lapaʻau (nā mea hōʻeha e hoʻokaʻawale i ka helu o ka hōʻeha ʻana o ka gastric): ʻaʻole i manaʻo ʻia kahi hōʻemi i loko o ka nui a me ka nui o ka lawe ʻana ʻana i kēia mau lāʻau, ʻaʻole ia e koi ʻia kahi hoʻololi i kā lākou mau pila.
paracetamol (ma ke ʻano o 1000 mg): ma hope o 14 mau wiki o ka mālama ʻana me Bayeta Long, ʻaʻohe loli nui i ka AUC o ka paracetamol i lawe ʻia ma kahi ʻoki ʻole a ma hope o ka ʻai ʻana, i ka wā e hoʻohālikelike ʻia me ka wā mālama, ka nui o ke koʻo (C_max) paracetamol ma hope o ka ʻai a ma ka ʻōpū ʻole i hoʻemi ʻia e 5 a 16%, pākahi, a me ka manawa e hiki ai ke kiʻekiʻe loa (T_max) hoʻonui mai kahi kokoke i 1 hola i ka manawa mālama i nā hola 1.3 (ma hope o ka ʻai) a me ka hola 1.4 (ma ka ʻōpū ʻole).
Nā mākaukau sulfonylurea: hoʻāliʻi ʻia ka hopena o ka hypoglycemia, pono e loli paha ka loli ʻana o kēia mau ʻāpana.

Nā hualoaʻa o nā noi ma ka launa pū i hoʻopaʻa ʻia me ka koho ʻana o Exenatide 2 mau manawa i ka lā ma kahi kiko o 0.01 mg:

warfarin: i ka wā e lawe ai i ke warfarin, ua hoʻonui ʻia ka T i nānā 35 mau minuke ma hope o ke kaha o ka exenatide injection_max ma kahi o 2 mau hola, loli hoʻololi nui ʻo C_max a i ʻole i ʻike ʻia ʻo AUC, aia he mau lono no ka hoʻonui ʻana i ka INR, i ka hoʻomaka mua o ka maʻi me ka ʻo Bayeta Long, inā i hoʻohana pū ʻia i ka warfarin a / a i ʻole derivatives Coumarin, pono ia e nānā i nā kuhikuhi INR.
hydroxymethylglutaryl-CoA reductase inhibitors (HMG-CoA reductase), me nā lovastatin i kahi kūmole o 40 mg 1 mau manawa i ka lā: kahi hōʻemi o C_max a me AUC o ka lovastatin e ka 28 a me 40%, kēlā me kēia, me ka hoʻonui pū ʻana o T_max ma ka awelika, a hiki i ka 4 hola hoʻohālikelike ʻia i nā palapala hōʻoia i ka wā e lawe ana i ka lovastatin wale nō, i ka manawa 30-pule nā papa hoʻokele plasebo me ka hoʻohana pū ʻana o nā mea exenatide a me ka HMG-CoA reductase inhibitors, ʻaʻohe hopena hoʻomau i ka metabolid lipid, ʻaʻole pono ka hoʻoponopono ʻana o nā lāʻau lapaʻau. akā inā pono, pono e nānā ʻia ka ʻike lipid.
levonorgestrel (0.15 mg) a me ethinyl estradiol (0.03 mg): ʻaʻohe loli i nā hōʻailona C i ʻike ʻia._max/ C_min a me AUC o kēia mau mea ma hope o ka lawe ʻana i kahi mea ulu waha, nā mea a lākou i kū ai, 1 hola ma mua o ka hoʻokele ʻana o exenatide, i ka wā e hoʻohana ai i ka hui i hoʻohui ʻia 35 mau minuke ma hope o ka hoʻokele ʻana o exenatide, ʻaʻole i hoʻopaʻa ʻia nā loli o AUC, akā naʻe, ua emi ka hōʻemi ma C i ʻike ʻia._max levonorgestrel e 27-41%, ethinyl estradiol ma 45%, a me ka hoʻonui ma T_max e nā hola he 2-4 ma muli o ka emi ʻana o ka hapa o ka weuweu o ka gastric, kahi waiho ʻana o C_max ʻAʻole he koʻikoʻi i ka maʻi maʻi, no laila ʻaʻole koi ʻia ka loli ma ka hopena o nā ʻāpana ʻawaʻawa.
lisinopril a me digoxin: ʻaʻohe hopena nui o ka klinikoma ma C i hoʻopaʻa ʻia_max a i ʻole AUC o kēia mau mea, akā, he piʻi ka T i ʻike ʻia_max no na hora 2 paha.

ʻO nā meaʻala o Baeta Long he Trulicity, Viktoza, Baeta, Lixumia, etc.

Nā kuleana a me nā kūlana e waiho ai

Store i loko o ka pauka i ka wahi i pale ʻia mai ka mālamalama, ma waho o ka hiki ʻana o nā keiki, i ka mahana o ka 2-8 ° C, ʻaʻole ka manuahi. Ma hope o ka wehe ʻana i ka pā, hiki ke mālama ʻia i ka lāʻau i loko o nā pā i hoʻopihapiha ʻia no nā minamina ʻehā mau manawa ʻaʻole iʻoi aku ma mua o 30 ° C.

ʻO 2 mau makahiki kona ola i ka noho pu ʻana me ka peni ʻo ka syringe he 2 mau makahiki.

Hoike no Baeta Long

ʻAʻole ʻike ʻia nā loiloi e pili ana iā Baeta Long mai nā poʻe maʻi ma nā pūnaewele olakino, ma muli o ke kuhi ʻia ʻana o ka lāʻau lapaʻau wale nō e ka Ministry of Health of Russia i ka 2017. ʻ speaklelo nā loea i ka exenatide ma ke ʻano he mālamalama antidiabetic maikaʻi loa no nā poʻe maʻi me ka diabetes type 2 a me kahi hui kikoʻī o ke kino ʻoi aku ma mua o 35 kg / m², ʻaʻole i hiki ke hoʻokō i nā pahuhopu glycemic wale nō ma hope o ka monotherapy me metformin / thiazolidinedione, a i ʻole me ka hoʻohui pū ʻana o kēia mau lāʻau a i ʻole ka hui ʻana o ka metformin me ka hoʻomākaukau ʻana o ka sulfonylurea (i ka wā e hoʻohana ai i kēia mau lāʻau i ka nui loa i kā ʻia ʻia). Loaʻa nā pōmaikaʻi o ka hana exenatide ka lōʻihi o ka hana ʻana i ka palekana cardiovascular i kūkulu ʻia i ka hoʻopaʻa ʻana i nā ʻoihana lapaʻau a me ka haʻahaʻa o ka lawelawe ʻana i nā inikini 4-5 i kēlā me kēia mahina. ʻO ka mea hope, e like me nā poʻe loea, hiki ke kōkua i ka hoʻonui ʻana i ka hana hoʻomanawanui i ka mālama ʻana.

ʻO ka wehewehe ʻana i ka lāʻau lapaʻau, hoʻokuʻu i ke ʻano a me nā ʻano

Hana ʻo Baeta e like me ka agonist receptor enteroglucagon (like me ka peptide like-gona like me ka pona). Kōkua ka lāʻau lapaʻau e hōʻemi i nā waiwai o ka glucose, hoʻomaikaʻi i ka hana ʻana o nā hua beta i ka pancreas.

ʻOiai nā mea e like ai me ka insulin, ʻokoʻa ʻo Baeta ma mua o ka hormone i loko o kāna pānaʻi a me nā waiwai pharmacological, ʻoiai ʻo kona kumukūʻai.

Loaʻa ka lāʻau lapaʻau i nā penikala syringe, ʻo ia kahi mea o ka syringes insulin e hoʻohana ʻia e nā maʻi he nui. ʻAʻole hoʻokomo ʻia nā pono no nā inikua i loko o ka pahu, no laila e kūʻai ʻia lākou. ʻO ka pā i ka mea he penikala syringe wale nō i kahi pahu koi i loaʻa iā ia ka lāʻau i ka nui o 1.2 a 2.4 ml.

ʻO ka mea nui ka Exenatide (250 mcg).
ʻO ka huika paʻakai acetic (1.59 mg) kahi mea kōkua.
ʻO Metacresol Component i ka nui o 2.2 mg.
ʻO ka wai a me nā mea waiwai'ē aʻe (noho i ka 1 ml).

ʻO Baeta kahi ʻōnaehana i ʻoluʻolu kala ʻole ka hona ʻole.

ʻO nā maʻi maʻi kūikawā

Loaʻa i nā poʻe me ka maʻi maʻi ʻaʻala āpau i nā maʻi maʻamau. I kēia hihia, pono ʻoe e akahele ma ka hoʻohana ʻana i ka lāʻau ʻo Bayeta.

ʻO ka pūpū o nā maʻi e koi ana i ka nānā kūikawā:

ʻO ka loaʻaʻole i ka hana o nā keikiʻehā. ʻO ka maʻi me ka hoʻohaʻahaʻa a me ke ʻano huki i ʻole ke kaulike i ʻole e pono ai ke hoʻoponopono i ka ʻōpū o Bayet.
ʻO ka loaʻaʻole o ka pepelu. ʻOiai ʻaʻole ʻike kēia mea i ka hoʻololi i ka neʻe o ka exenatide i ke koko, pono ke kūkākūkā ʻana me ke kauka loea.
E na keiki. ʻAʻole i aʻo ʻia ka hopena o ka lāʻau i loko o kahi ʻōpio ma lalo o 12 mau makahiki. I ka wā kamaliʻi 12-16 mau makahiki ma hope o ka hoʻopuka o ka hoʻonā (5 μg), ua like nā pālaki pharmacokinetic me ka ʻikepili i loaʻa i loko o kahi noiʻi o nā maʻi maʻi.
Kahihi Ma muli o ka hopena maikaʻi paha o ka lāʻau lapaʻau ma ka hoʻolālā ʻana o ka pūpū, ua contraindicated no ka hoʻohana ʻia e nā māmā wahine.

Overdose a me ke kamaʻilio pū me nā lāʻau ʻē aʻe

ʻO ke ʻano o nā hōʻailona e like me ka luaʻi koʻikoʻi, hōʻeha paʻa, a i ʻole ke hōʻemi ʻana i ke kahe o ke koko e hōʻike nei i kahi overdose o ka lāʻau (ʻoi aku ka nui o ka manawa i hāʻawi ʻia i nā hopena ma o 10 mau manawa).

ʻO ka Hoʻōla i kēia hihia ke hōʻoluʻolu i nā hōʻailona. Me nā hōʻike palupalu o hypoglycemia, lawa ia e hoʻopau i nā palaka, a inā i nā hōʻailona koʻikoʻi, pono paha ka lawelawe intravenous dextrose.

I ka wā o ka mālama ʻana me nā inikini Bayeta, me nā lāʻau ʻē aʻe, ʻo nā mea nui e noʻonoʻo e noʻonoʻo ai:

ʻO nā lāʻau lapaʻau e pono ai i ka hoʻowalewale wikiwiki ʻia i loko o ka puhihihi ʻana e pono e lawe ʻia i ka hola 1 ma mua o ka hoʻokele ʻana o Byet a i ʻole i kahi ʻano kīnā ʻole paha nā inikina.
Hoʻoulu ka hopena o Digoxin me ka hoʻomohala piha ʻana o Byet, a hoʻonui ʻia ka manawa o kona excretion ma 2.5 mau hola.
Inā pono e hoʻemi i ke kahe o ke koko me ka lāʻau Lisinopril, pono ia e nānā i ke ka manawa o ka manawa ma waena o ke lawe i nā papaʻaina a me nā hua ʻōlelo a Bayet.
Ke lawe nei ʻo Lovastatin, ua hoʻonui ʻia kona hapalua-ola e 4 hola.
ʻO ka manawa hoʻomaha no ke warfarin mai ke kino e hoʻonui i 2 mau hola.

Nā manaʻo e pili ana i ka lāʻau lapaʻau

Mai nā loiloi o nā mea maʻi, hiki ke hoʻoholo ʻia no ka hana a me ka maikaʻi ʻo Bajeta ma hope o kona hoʻohana ʻia ʻana, ʻoiai he nui nā mea e ʻike i ke kumukūʻai kiʻekiʻe o ka lāʻau lapaʻau.

Ua hōʻike aku kahi maʻi maʻi i ka hala ʻana o 2. I loko o kēia manawa, ʻo ka hoʻāʻo ʻana e hōʻemi i ke kō ma ka lawe ʻana i nā ʻano lāʻau like ʻole ʻaʻole i kūleʻa. I hoʻokahi mahina i hala aku nei, ua kuhikuhi mai ke kauka hele iaʻu i kahi maʻi ʻomaʻāina o ka lāʻau lapaʻau o Bayet. Ua heluhelu wau i nā loiloi ma ka Pūnaewele a ua hoʻoholo e noʻonoʻo. Pīhoihoi ka hopena o ka hopena. I loko o 9 mau lā o ka hoʻokele ʻana, ua hōʻemi ke kiʻekiʻe o ke kōpake mai 18 mmol / l i 7 mmol / l. Eia kekahi, ua hiki ke nalowale i ka 9 kg hou. I kēia manawa ʻaʻole wau e manaʻo i ka maloʻo maloʻo a me ka momona i koʻu waha. ʻO ke ʻano maikaʻi wale nō ka lāʻau lapaʻau ke kumukūʻai kiʻekiʻe.

Elena Petrovna

No hoʻokahi mahina i ʻoki ʻia ʻo Baeta. I ka hopena, ua hiki iaʻu ke hōʻemi i nā nui o ka puna i nā hui a hōʻemi nā paona i ka 4 kg. Ke hauʻoli nei wau i ka mea i hōʻemi ʻia ka momona. Kauka aku ke kauka e hoʻomau i ka lawelawe ʻana i ka lāʻau lapaʻau no kekahi mahina ʻē aʻe, akā i kēia manawa ua hoʻoholo wau e pili i kahi meaʻai ikaika a hoʻi hoʻi i nā papa i hala. ʻO ke kumukūʻai no ia mea ke kiʻekiʻe iaʻu, ʻaʻole hiki iaʻu ke kūʻai iā ia i kēlā me kēia mahina.

ʻO nā mea wikiō ma ka hoʻohana kūpono ʻana i ka peni ʻiwehi leo i ka lāʻau lapaʻau.

Hiki iaʻu ke hoʻololi i ka lāʻau lapaʻau?

ʻAʻohe mea kikoʻī i ka hopena no ka hoʻokele subutaneus o Bayet ma ka mākeke lāʻau lapaʻau. Aia wale nō "Baeta Long" - kahi pālapa no ka hoʻomākaukau o ka hoʻopanee ʻana i hoʻohana ʻia no ka maʻi.

ʻO nā huaʻala aʻe e loaʻa ana kahi hopena therapeutic like, e like me Baeta:

Victoza. ^ E Ha yM. Kuhi ʻia ka pono no ka hoʻokele subcutaneous a loaʻa i nā ʻano syringe penens. ʻO kona hoʻohana ʻana e nā mea maʻi me ka diabetes type 2 hiki ke hoʻemi i ke kō a hōʻemi i ka paona.
Januvia - e loaʻa i ka palapala papa.ʻO ia kekahi o nā ala a pau i ke ʻano like me ke kino.

Loaʻa ka lāʻau lapaʻau Baeta i nā lāʻau lapaʻau hoʻolālā. Hoʻololi ʻia kona kumukūʻai ma kahi o 5200 mau rubles.

Hoʻohana i ke wā ʻōpio a me nā makahiki kahiko

ʻAʻohe ʻikepili e pili ana i ka hopena o ka lāʻau lapaʻau ma ke kino o nā keiki ma lalo o ka 18 mau makahiki o laila, no laila, ʻaʻole i hoʻohana ʻia no kā lākou lāʻau. ʻOiai aia keʻike i ka hoʻohana ʻana i nā keiki mai nā makahiki 12, ua like nā hōʻailona like me nā mea pākeke. Akā e kuhikuhi pinepine ʻia nā ʻano ʻē aʻe.

Hiki ke hoʻohana e mālama i ka maʻi maʻi i nā maʻi maʻi maʻi. Eia nō naʻe, pono ʻoe e nānā i ke ʻano o ia poʻe i loaʻa ka mōʻaukala ketoacidosis a i ʻole he renal function renal. Hoʻomaopopo ʻia kēlā mau maʻi e hana pinepine i nā hoʻokolohua.

Hoʻohālikelike me nā lāʻau like ʻole

Loaʻa i kēia lāʻau lapaʻau nā analogues e hiki ke hoʻohana e mālama i ka maʻi maʻi. E noʻonoʻo pono i kā lākou mau waiwai i nā kikoʻī.

ʻAno inoa, ʻano waiwai	Mea hana	ʻO nā hoʻopiʻi a me ka hoʻohuihui	ʻO ke kumukūʻai, rub.
ʻO Victoza (liraglutide).	ʻO Novo Nordisk, Denemaka.	ʻOkoʻa: he mea hana pono e kōkua ʻaʻole wale e mālama i nā pae glucose maʻamau, akā e hōʻemi hoʻi i ka paona. Cons: kumukūʻai kiʻekiʻe a me ka pono e kauoha i loko o kahi lāʻau lapaʻau i mua.	Mai 9000 no nā pālapaʻa syringe ʻelua 3 ml
"Januvia" (sitagliptin).	Merck Sharp, Ka Netherlands.	E kuhikuhi i ka incretinomimetics. E like me nā waiwai i ka "Bayeta". ʻOi aku ka kūpono.	Mai 1600
"Guarem" (guar gum).	Orion, Kauka.	Kau: hoʻemi wikiwiki ka wikiwiki. ʻĀpana: Hiki i ka maʻi kanī.	Mai 500
"Invokana" (canagliflozin).	Janssen-Silag, Italia.	Hoʻohana ʻia i nā hihia kahi kūpono ʻole nā metformin. Hoʻolālā i nā pae gula. Hoʻomaka kaiʻai kauoha.	2600/200 pak.
Novonorm (repaglinide).	ʻO Novo Nordisk, Denemaka.	ʻOko: hoʻemi haʻahaʻa, hoʻemi i ke kaupaona - he hopena hou. Cons: ka nui o nā hopena ʻaoʻao.	Mai 180 rub.

Hiki wale ke hoʻohana ʻana i nā metala me ke ʻae a ke kauka komo. Ua papa ʻia ka lāʻau lapaʻau pilikino!

Nānā ka poʻe i hiki ke loaʻa ka hopena o ka ʻaoʻao, i ka nui o ka nui me nā koho kūpono ʻole. Ua haʻi ʻia ka hopena o ka lawe ʻana i ke kaupaona ʻana, ʻoiai ʻaʻole ma nā āpau. Ma ke kuʻuna nui, nā “Bayeta” loaʻa nā loiloi maikaʻi o ka maʻi maʻi me ka ʻike.

Alla: “Ua ʻelua makahiki wau i hoʻohana i ka lāʻau. I loko o kēia manawa, hoʻihoʻi ka gula i ka maʻamau, a ua hōʻemi ke kaumaha i ka 8 kg. Makemake wau e hana wikiwiki a ʻaʻohe ʻaoʻao. E kuhikuhi aku wau ia oe. "

Oksana: "Baeta" kahi lāʻau lapaʻau nui, akā kōkua ia i ka maʻi maʻi maʻi. Mālama ka Sugar i ka pae like, kahi aʻu e ʻoliʻoli nui ai. ʻAʻole hiki iaʻu ke ʻōlelo he nui ka hoʻemi ʻana i ke kaupaona, akā ma ka liʻiliʻi e oki wau i ka hoʻōla ʻana. Akā ʻoi aku ka ʻiʻo o ka ʻono. Makemake wau eʻai liʻiliʻi, a no laila ua lōʻihi ka paona ma ka pāʻina like. I ka laulā, ua ʻoluʻolu wau i kēia lāʻau lapaʻau. ”

Igor: “Ua kuhikuhi lākou i kēia lāʻau lapaʻau no ka mālama ʻana i ka wā i pau ai kaʻu mau lāʻau kahiko. Ma keʻano holoʻokoʻa, kūpono nā mea āpau, koe wale no ka uku kiʻekiʻe. ʻAʻole i loaʻa ka "Bayetu" i nā pōmaikaʻi, pono ʻoe e kauoha i mua. ʻO kēia wale nō ka pilikia. ʻAʻole wau makemake e hoʻohana i nā kikowaena, akā ʻo ka mea pono. ʻOiai hiki iaʻu ke hoʻomaopopo ua ʻike koke au i ka hopena - he mau minuke wale nō ma hope o ka hoʻomaka ʻana o ka pau. Pau ka momona, no laila ua nalo aku ke kaumaha ma ka manawa like. "

Hoʻohālikelike

ʻO "Baeta" kahi lāʻau lapaʻau maikaʻi e kaulana i waena o nā mea maʻi me ka maʻi maʻi. ʻOi ka hoʻohālikelike ʻia i ka wā e pau ai nā lāʻau i ka hana. A hoʻopau ʻia ke kumukūʻai kiʻekiʻe e nā hopena hou o ke kaupaona ʻana a me kahi hōʻike maʻamau o nā hopena ʻeha i nā maʻi e hoʻomaʻamaʻa ʻia. No laila, ʻokoʻa ka maikaʻi ʻo “Bayeta” mai nā mea e hoʻohana ana i ka lāʻau lapaʻau a me nā kauka.

Nā hiʻohiʻona o ka papa o nā maʻi diabetes type 2 i ka mea makua

ʻO ke ʻano o ke ʻano maʻi mellitus type 2 i ka poʻe i nā ʻelemakule he ʻokoʻa ia i nā maʻi maʻi ʻōpio. ʻO ka maʻi kēia mau ʻano aʻe:

ua hele ʻole nā hōʻailona waho o ke ʻano o ka maʻi maʻi - ʻaʻohe mau hōʻailona o ke urination, makewai, ka maloʻo maloʻo,
aia nā maʻi maʻamau, ʻike ʻole i ka maʻi - ka hemahema o ka hoʻomanaʻo, ka nāwaliwali ākea,
ʻike ʻia nā ʻano loli i nā paia o nā kahe koko.
kalepa kūpono holomua o nā hanana pili kino, e hoʻomohala ai,
i loko o nā maʻi āpau he nui, ʻaʻole ka hōʻike ʻo ka noiʻi ʻana i ka hoʻoliʻiliʻi koko wikiwiki.

Inā kūpono paha ka mālama ʻana i ka mea ʻelemakule ma nā kumu he nui:

kūlana maʻamau o ka mea maʻi
ka hele ʻana a i ʻole o ka holomua o ka puʻuwai hohonu,
ka hoʻomaopopo ʻana i nā mea maʻi a me ka hiki ke hana i nā hana i pono i kēlā me kēia lā - ka nānā ʻana i ke kō koko, lawe i nā paila, kaʻai ʻana,
ka pilikia o ka hypoglycemia - ke emi ʻana o ka hoʻokaʻa o ke koko ma lalo o ka pā maʻamau,
ka lula o ka hōʻemi kino ʻana ma ka maʻi - ka nalowale o ka hoʻomanaʻo, ka mālama ʻana i ke kumu, ka ʻōpū o ka noʻonoʻo.

ʻO ke kaumaha, haʻahaʻa haʻahaʻa, hoʻopoina, pilikia i ke aʻo ʻana i nā hana e pono ai no ka maʻi diabetes i ka pale ponoʻī o ka maʻi mai ka hopena i kahi pilikia i ka mālama ʻana i nā maʻi maʻi.

Nā maʻi maʻi maʻi 2 e hoʻemi i ke kō

Hoʻokaʻawale ʻia nā lāʻau lapaʻau hoʻokaʻa i loko o nā pūʻulu e like me ka hoʻolālā o ka hana. ʻO ka papa inoa o nā papa o nā lāʻau lapaʻau no ka maʻi maʻi ma lalo nei:

kel Luna nui (metformin),
Hoʻomākaukau kaʻaila
glinids (meglitinides),
hoʻomokuʻu ʻia (glitazones),
ʻO nā mea paʻa o ka glucosidase,
ʻO nā mea hoʻohālikelike o ka peptide receptor gluc-like -1 (aGPP-1),
dipeptidyl peptidase-4 inhibitors (IDPP-4, gliptins),
type 2 sodium glucose cotransporter inhibitors (INGLT-2, glyphlosins),
insulins.

No nā papa no ka mālama ʻana i ka maʻi hānai ma nā ʻano pākeke 2, pono nā noi kūikawā:

ka hōʻemi o ka hypoglycemia - ke hāʻule koke o ke kumu o ka hilo ma lalo o ka maʻamau, pono e hōʻemi ʻia
ka make ʻole o ka hoʻoulu ʻia ʻana o ka puʻuwai, nā ʻōpū, ka naʻau.
pono keʻaola pū me ka lāʻau ʻai,
pono e hoʻāla i nā paila.

No ka mālamaʻana i ka maʻi diabetes type 2 i nā mea maʻi ma waena, ʻo nā mea palekana e lawe ʻia i ka peptidase-4 inhibitors. Me ko lākou hoʻohanaʻana, ua hoʻemi ʻia ka hopena o ka hypoglycemia.

Ua ʻike ʻia ʻo Metformin i nā kānaka o nā ʻōpio a me ka wā ʻelemakule, inā ʻaʻohe maʻi a ka maʻi contraindications i kona ʻae ʻia.
Me ka mālama aka, pono nā maʻi maʻi e lawe i ka hoʻomākaukau o ka olonylurea, no ka mea me ka piʻi o ka hypoglycemia e piʻi me ka ʻōpua. Ma hope o 61 makahiki, ʻaʻole ia e manaʻo ʻia e lawe i ka gibenclamide - nā papa pili i kēia pūʻulu o nā lāʻau.

Hāʻawi ka mālama ʻia i ke ʻano o ka sodium glucose cotransporter inhibitors. ʻAʻole pono e hoʻohana pū me ka diuretics.
ʻAʻole i kuhikuhi ʻia ʻo Thiazolidinediones i kahi hopena no ka maʻi maʻi i nā pākeke.

Ua hoʻohana ʻia ʻo Biguanides no ka mālama ʻana i ka maʻi diabetes ma mua o 50 mau makahiki. ʻO nā mea nui o kēia hui o ka lāʻau metformin a me metformin. Eia naʻe, ua hoʻopau ʻia ka fenformin ma muli o ka nui o ka loaʻa o ka hoʻomoʻakai lactic acidosis i ka wā e lawe ai ia. ʻO ka acidact lactic (waiu coma) kahi hoʻopiʻi weliweli e pili ana i ka hoʻonāukiuki o ka pauna o ka paʻakai--kino o ke kino i kahi hoʻonui o ka acidity. Lactic acidosis i manaʻo ʻia e ka metformin he mea ʻemi loa ia. No laila, mai ka makahiki 2005, e like me nā ʻōlelo a nā hui āpau o ka maʻi maʻi, ke ʻano o ka metformin he lāʻau lapaʻau mua loa no ka mālama ʻana i ka maʻi type 2.

ʻO nā mākaukau mua o ka metformin he mau lāʻau ma lalo o nā inoa inoa ʻo Siofor (Berlin-Chemie AG, Kelemānia), Glucophage (Nycomed, Austria). He nui nā huaola - nā lāʻau lapaʻau.

ʻO ka Metformin kahi papa koko koko hoʻohaʻahaʻa i pinepine i nā ʻāina he nui. Hoʻohana ʻia ka lāʻau lapaʻau e mālama i nā ʻano maʻi mellitus type 2 no ka manawa lōʻihi, no laila ua maopopo ka hopena o kāna hana antihyperglycemic. Ua hoʻokumu ʻia ka mea hoʻonāukiuki i nā kumu:

kahe ʻana i ka ʻōpū o ka pale o ke akeola,
i hoʻonui i ka hoʻololi o ka glucose i ka lactate i ka gastrointestinal tract,
mahuahua i ka insulin i nā mea taliaina,
hoonui i ka laweʻana o glucose i ka membrane i loko o nā ʻōpū,
Ka hoʻemi ʻana i ke kōpaʻa koko, triglycerides a me nā lipoproteins haʻahaʻa haʻahaʻa,
nā hoʻonui kiʻekiʻe kiʻekiʻe o ka lipoproteins density.

Ua lanakila ʻo Metformin i ka pale ʻana, insensitivity (kū'ē) o nā kinipōpeka peripheral i insulin, a ʻo ka pūnaka a me nā puʻuwai. Ma muli o ke hoʻohana pono ʻana i ka lāʻau lapaʻau:

hoʻokaʻawale ka hana glucose i ka ʻāʻī,
Ka hoʻoliʻi ʻana o ka insulin a me ka piʻi ʻana o ka glucose hoʻāla
ʻāpili ʻia nā momona momona

ʻO ka emi ʻana o ke kūlohelohe o peripheral i lalo o ka hana a ka metformin e alakaʻi i ka hoʻomaikaʻi ʻana i ka hana o ka glucose i loko o ka ate, nā ʻuna a me nā kiko adipose. Ma muli o kēia, ʻaʻole ulu ke hyperglycemia, he mea weliweli no ka hoʻomohala ʻana i nā pilikia o ka maʻi.

I waena o nā hopena hopena o ka metformin ka maʻi ʻeha a me nā maʻi ʻē aʻe o ka ʻōpū: kahi māla metallic i loko o ka waha, nausea, anorexia, ka mea ma ka hoʻomaka ʻana i ka lapaʻau e mālama ʻia ma aneane 20% o nā maʻi, akā e hala ma hope o kekahi mau lā. Pili pū kēia mau maʻi me ka hoʻolohi o ka hoʻokaʻina o ka glucose i ka pā liʻiliʻi i ka metformin. ʻO ka hoʻopiʻi ʻana i ka hana o ka digestive, hōʻalo ai ka likela i ka fermentation a me ka lemulewa. ʻO ka hoʻololi mauʻana i ka mea maʻi e hālāwai me ka metformin e hōʻoia ʻia ma o ka koho ʻana o ka liʻiliʻi o nā lāʻau lapaʻau (500 mg), ma mua o ka wā e moe ai, a laila hui pū a i ʻole ma hope o ka ʻaina, me kahi kīʻaha wai. Hoʻonui ʻo Metformin i ka hoʻonuiʻana i ka lactate ma ke kiko o ka pūpiki liʻiliʻi a aneane pālua ia i kona ʻili i ke koko, e hoʻonui ai i ka hoʻōho o ka lactic acidosis.

Ua hōʻike ʻia nā haʻawina no ka mālama ʻana i ka maʻi maʻi, he metformin ka lāʻau lapaʻau e hoʻohaʻahaʻa ana i ke kōpaʻa koko ma ka hapa haʻahaʻa o ka ulu ʻana o ka hypoglycemia like me ka sulfonylurea a me ka insulin. ʻO Siofor kahi lāʻau lapaʻau maikaʻi e hōʻemi ana i ka hana o ka glucose e ka atepona, ʻo ia ka mea e hoʻopiʻi i ka hana nui no ka hoʻonui ʻana i ke kaila glucose koko.

ʻO kēia ke ʻano hoʻohālikelike nui ka metformin no ka mālama ʻana i ka maʻi maʻi 2. ʻAʻole hiki ke kapa ʻia ia i ka lāʻau lapaʻau hou, kahi hāmeʻa o ka hanauna hope loa, akā ʻaʻole e pau ka makemake o ka lāʻau lapaʻau. Ua nui ka noiʻi ʻana me ka lāʻau lapaʻau. Lākahi kēia lāʻau lapaʻau, e like me nā mea hou e hoʻohana ʻia ai.
Ua hoʻokumu ʻia ma ka hoʻohui o antihyperglycemic kekahi, aia nā hopena ʻē aʻe. Hoʻokomo ka lāʻau lapaʻau i nā mea alakaʻi e pili ana i ka holomua o ka atherosclerosis:

hoʻomaikaʻi i nā hana o ka endothelium - kahi kīwaha o nā ʻāpana e kau ana i ka naʻau o loko o ke koko a me nā kīʻaha lymph, nā pūpole puʻuwai,
hoʻōla ia maʻi ʻaʻa,
hōʻemi i ka nui o ke kaumaha oxidative - ke kaʻina o ka hōʻino kino o ka cell ma muli o ka maʻi oxidation,
hoʻopilikia maikaʻi i ka metabolism momona a me ke kaʻina o ka hōʻemi o nā māha koko i ke koko.

ʻAʻole maikaʻi wale ke ala ʻo Metformin no ka maʻi maʻamau ʻoi aku ka 2, akā he lāʻau lapaʻau ka hopena i ka hopena prophylactic e pili ana i ka maʻi naʻau. Hiki i ka lāʻau lapaʻau ke pale i ka ulu o nā kōpili o ke kinipona, me ka hoʻolōʻihi i ka kaʻina hana. Eia nō naʻe, pono nō nā noiʻi e hōʻoia i kēia mau hopena.

Dipeptidyl peptidase-4 inhibitors (gliptins) - lāʻau lapaʻau maʻi hou

ʻO nā inhibitor ʻo Dipeptidyl peptidase-4 he mau lāʻau hou e hoʻemi ana i ke kō koko. Ua kūkulu ʻia nā lāʻau lapaʻau e mālama i ka ʻike e pili ana i ka pona o nā incretins, nā mea hua i hana ʻia ma hope o ka ʻaina a hoʻoulu i ka huna ʻana i ka insulin, i ʻike ʻia ma ka kenekulia 21. Wahi a ke ʻano hana o kēia ʻano o nā lāʻau lapaʻau i ka wā e lawe ʻia ai:

hoʻonāukiuki i ka glucose glucose
kaohi ʻana i ka glucose glucose - ka uhi ʻana o ka glucoseagon - ka hormone pancreatic,
hōʻemi i ka hana o ka glucose e ka pepi.

ʻO kekahi o nā pono pono nui o ka papa hou o ka papa ʻaina i ka hoʻohaʻahaʻa ʻana i ka hemahema o ka hypoglycemia. I ka wā elemakule, hiki i nā kūlana hypoglycemic ke hoʻonāukiuki i ka hoʻomohala ʻana o ka pilikia hypertensive, spasm o nā moku coronary me ka hoʻomohala ʻana i ka infococose myocardial akō, ka hala koke o ka ʻike.
Hiki ke hoʻonohonoho ʻia nā Gliptins:

no ka malama ana i na maʻi me neia kahi mai;
me ka ʻae ʻole ʻana a i ʻole contraindications i ke koho ʻana i biguanides,
i ka hui pū ʻana me nā paila koko.

He liʻiliʻi nā hopena lāʻau lapaʻau, ʻaʻole e hoʻonui i ka paona kino, hoʻolohi lohi i ka gastric. ʻO ka ʻike ʻana i nā glyptins ʻaʻole i hui pū ʻia e ka hoʻomohala ʻana o ka edema. Hiki ke lawe ʻia kēia mau lāʻau lapaʻau type 2 i nā manawa āpau i hōʻike ʻia i nā maʻi o ka maʻi. ʻO Metformin, nā agonist receptor peptide like-pionide, a me nā inhibitor α-glucosidase e hōʻeha ana i ka hōʻeha o ka gastrointestinal, aʻo ka glyptins e hoʻomanawanui maikaʻi ʻia e nā mea maʻi.
Akā he maʻi koʻikoʻi ka lāʻau lapaʻau hou. Nani ka lāʻau lapaʻau.
Me ka makaʻala, nā lāʻau lapaʻau maʻi pili i ka pūʻulu "dipeptidyl peptidase-4 inhibitors" i kuhikuhi ʻia:

i nā hana heʻilihua nui (koe wale nō no Sākxiptin, linagliptin),
me ka puuwai hema ole.

ʻO nā papa no ka diabetes type 2 o ka papa o nā gliptins i contacticated i ka ketoacidosis, kahi hoʻohui o ka maʻi maʻi e ulu nei ma waena o ka nele o ka insulin i ka wā hāpai a me ka lactation.
Ma ka hana lapaʻau, ua hoʻohana ʻia nā dimeptidyl peptidase-4 i ka wā 2005. Ua hōʻike ʻia ka papa inoa o nā lāʻau lapaʻau e pili ana i ka pūʻulu IDPP-4 i hoʻopaʻa ʻia ma Lūkia ma ka Papa Helu 1.
Papa Hana 1

*ʻO ka inoa generic honua no ka lāʻau lapaʻau*	*Trade inoa o ka lāʻau lapaʻau*	*E hoʻokuʻu i ke ʻano*	*Kumukūʻai lāʻau lapaʻau*
sitagliptin	Januvia	100 mg papa, 28 ʻāpana	1565 ʻōpala.
vildagliptin	Galvus	50 mg papa, 28 ʻāpana	$ 85.50
saxagliptin	Onglisa	5 papa papa, 30 ʻāpana	1877 rub.
linagliptin	Trazenta	5 papa papa, 30 ʻāpana	1732 ʻōpala.
alogliptin	Vipidia	25 mg papa, 28 ʻāpana	1238 RUB

Ma waena o lākou iho, ʻokoʻa nā gliptins i ka lōʻihi o ka hana, ka hoʻoweliweli me nā lāʻau ʻē aʻe, ka hiki ʻana o ka hoʻohana i kekahi mau maʻi o nā maʻi. I nā ʻōlelo no ka hoʻohaʻahaʻa i ka nui o ke kō o ke koko, palekana a me ke ahonui, ua like kēia mau ʻano maʻi pākaʻi 2.

Ua kuhikuhi ʻia kēia mau lāʻau lapaʻau i hoʻohui pū me ka metformin. Hiki ke kuhikuhi ʻia Vildagliptin a me sitagliptin me ka hoʻomākaukau ʻana i ka insulin, e wehe ana i nā puka hou no ka hui pū ʻana i nā maʻi i nā maʻi me ke ala lōʻihi o ka maʻi.

Hoʻopili ʻia nā Dipeptidyl peptidase-4 mai ka manawa o ko lākou helehelena e lawe i kahi ikaika i waena o nā lāʻau lapaʻau no ka mālama ʻana i ka maʻi type 2. ʻO ka haʻahaʻa haʻahaʻa o ka hypoglycemia, ʻaʻohe hopena ma ke kaumaha o ke kino, a ʻaʻohe hopena hopena mai ka gastrointestinal tract e hoʻokaʻawale i kēia papa o nā lāʻau lapaʻau mai nā lāʻau ʻē aʻe no ka mālama ʻana i ka maʻi diabetes type 2.

Hoʻomākaukau Sulfonylurea

Wahi a ke ʻano o ka hana, no ka mea ʻoi a hoʻomākaukau ka sulfonylurea i nā mākaʻikaʻi e hoʻōla i ka huna ʻana i ka insulin (secretagogues). I nā mau makahiki, ʻo nā lāʻau lapaʻau o kēia papa ka mea nui i waena o nā lāʻau āpau e hoʻemi i ke kō o ke koko. Paipai ʻia nā pōpoki i ka hana ʻana o ka insulin i ke koko a he ala maikaʻi ia e mālama ai i nā pae o ka glucose koko.

Akā ʻo ka hoʻohana ʻana o ka hoʻomākaukau ʻana o ka sulfonylurea e pili ana i ka mahuahua o ke kaupaona ʻana i ke kaumaha o ke kino a me ka waihona o ka hypoglycemia, a me ke ʻano o ka pale ʻana i ke kino iā lākou. No laila, ʻo kēia pūʻulu o nā lāʻau lapaʻau e hoʻohālikelike ʻia i kahi lāʻau lapaʻau e hoʻemi i ke kō koko. Akā inā aia nā contraindications i ka hoʻohana ʻana o ka metformin, ʻonika ʻia ka sulfonylureas e like me nā papa nui.

I ka poʻe maʻi nā maʻi, ma muli o ka hoʻonui nui o ka hypoglycemia, ke kahakaha nei ka hoʻomākaukau ʻana o ka sulfonylurea e hoʻomaka i nā hapalua ma mua o ka wā o ka ʻōpio, a ʻo ka nui ka maʻi e hoʻonui lohi ai.

He lōʻihi loa ka papa inoa o nā lāʻau lapaʻau no kēia hui. Ua hoʻokaʻawale ʻia nā lāʻau lapaʻau i nā hanauna ʻelua. ʻO nā ʻelele maʻamau o ka lua o ka huahelu sulfonylurea derivatives he glimepiride, glibenkamide, glyclazide, glipizide, glycidone.ʻAʻole hoʻohana ʻia nā lāʻau lapaʻau mua i ka lāʻau lapaʻau.
Hāʻawi ʻia ka papa inoa o nā lāʻau lapaʻau kōmūlurea ma ka Papa 2.
Papaʻaʻina 2

*Inoa Kūʻai ʻole honua*	*ʻO nā inoa kalepa i hoʻopaʻa ʻia ma Rusia (hana maʻa, mg)*	*Puka Pōʻalima (mg)*	*Hoʻohui lehulehu*	*Ka lōʻihi o ka hana (mau hola)*
micibized glibenclamide	Maninyl 1.75 (1.75), Maninyl 3.5 (3,5), Glimidstad (3.5), Glibenclamide (1.75, 3.5)	1,75 – 14	Lawe iā 1 - 2 mau manawa i ka lā	16 – 24
glibenclamide non-micronized	Maninil 5 (5), Glibencamide (5), ʻO nā papa Glibenclamide 0,005 g (5)	2,5 – 20	Lawe iā 1 - 2 mau manawa i ka lā	16 – 24
gliclazide	Glidiab (80), Glyclazide-Akos (80), Diabefarm (80), Nā Diula (80), Diabinax (20, 40, 80)	80 – 320	Lawe iā 1 - 2 mau manawa i ka lā	16 – 24
hoʻololi ʻia gliclazide	Diabeton MV (30, 60), ʻO Glidiab MV (30), Diabefarm MV (30), Gliklada (30, 60, 90), Diabetalong (30, 60), Gliclazide MV (30, 60), Glyclazide MV Puka Laka (30, 60), Canon Keola (30, 60)	30 – 120	Lawe i ka lā hoʻokahi	24
glimepiride	Amaryl (1, 2, 3, 4), Glemaz (2, 4), Kakalula (2), Meglimide (1, 2, 3, 4, 6), Glimepiride (1, 2, 3, 4, 6), Glimepiride-Teva (1, 2, 3, 4), Diamerid (1,2, 3, 4), Glemauno (1, 2, 3, 4), Canon Glimepiride (1, 2, 3, 4), Kaumaka (1, 3, 4)	1 – 6	Lawe i ka lā hoʻokahi	24
glycidone	Kaikuaole (30)	30 – 180	Lawe iā 1-3 mau lā i ka lā	8 – 12
pili pili	Kaumakaiwa (5)	5 – 20	Lawe iā 1 - 2 mau manawa i ka lā	16 – 24
kelepona hoʻokele glipizide	ʻO ka lilo o Glibenez (5, 10)	5 – 20	Lawe i ka lā hoʻokahi	24

E ala ʻia kekahi mau pilikia, he mea ʻoi aku ka maikaʻi o nā lāʻauʻai no ka mea maʻi maʻa, ʻoi aku ka maikaʻi o nā lāʻau lapaʻau mai ka papa inoa. Ma waena o lākou iho, ʻokoʻa nā papa:

ka hoʻemi haʻahaʻa o ke koko,
lōʻihi o ka hana
regimen dosis
palekana.

Ua hōʻike ʻia nā haʻawina he nui nā lāʻau lapaʻau pono no ka maʻi maʻi o ka papa sulfonylurea i hōʻike ʻia no ka palekana. Eia nō naʻe, ʻo ka glibenclamide wale nō i hōʻike i ka World Health Organization a me ke Kuhina o ke Ola Health o Rūsia ma ke ʻano maikaʻi ʻoi e aʻo ʻia no ka hoʻohana ʻana i ka maʻi maʻi mai nā māka o nā ʻano o kēia papa lāʻau.

ʻO Glibenclamide kahi paila maʻi maikaʻi e hoʻopakele ai i nā ola o kahi nui o nā mea maʻi ma ka honua. He lāʻau kū hoʻokahi ka lāʻau lapaʻau i ka hana, a ʻo ia wale nō ka lāʻau lapaʻau i ʻike ʻia ka mea i hoʻāʻo ʻia e ka palekana i ka wā i hoʻohana ʻia ai i nā wahine hāpai. ʻO ka ʻoiaʻiʻo a me ka palekana o glibenclamide no ka mālamaʻana i nā maʻi diabetes type 2 ua hōʻoia ʻia ma o nā hōʻike lōʻihi o nā hōʻike hōʻike kiʻekiʻe. Hoʻomaopopo kahi hopena hou aʻe o ka lāʻau lapaʻau ma ka hōʻemi o nā hoʻopiʻi microvascular me kāna hoʻohana lōʻihi. ʻO ka mālama ʻia me ka glibenclamide hoʻokahi wale no nā makahiki he nui i manaʻo ʻia he mea nui i kekahi manawa, ʻo ke ʻano kekahi o ka hoʻomaʻamaʻa wale ʻana.

ʻOi aku ma mua o 10 mau makahiki i hala aku nei, ua hoʻokumu ʻia kahi ʻano micronized o glibenclamide, nona ka mea maikaʻi loa, kokoke i hoʻokahi haneli mau mea bioavailability, ka hopena o ka hoʻomaka koke o ka wikiwiki.

ʻAʻole i kuhikuhi ʻia nā poʻe ʻōpio e kuhikuhi i ka sulfonylureas lōʻihi e hana i ka pilikia o ka hypoglycemia. Maikaʻi, ʻoi aku ka maikaʻi o ka lawe i ka gliclazide, glycidone.

ʻO nā Glinids (meglitinides)

Hoʻokomo nā haukapila i ka mea huna insulin pancreatic. Ma ka hana lapaʻau, hoʻomaʻamaʻa iki nā papa o nā papa no ka maʻi type 2: ʻoi aku ka maikaʻi ma mua o nā lāʻau lapaʻau sulfonylurea, akā ʻoi aku ke keu aku. ʻO ka hapanui, ua kuhikuhi ʻia nā glinids i ka wā e piʻi ai ke kō o ke koko ma hope o ka ʻai ʻana (postprandial glycemia). ʻO nā lāʻau lapaʻau e hoʻoikaika pono i ka hoʻomaka mua o ka hana huna o ka insulin. Ma hope o ka lawe ʻana i nā papa, hopu koke ʻia lākou, hōʻea i ka pae kiʻekiʻe o ka plasma i loko o hoʻokahi hola.
ʻO nā hiʻohiʻona o ka lāʻau lapaʻau, kahi papa inoa o nā pono a me nā hemahema o ka hoʻohana ʻana i nā lāʻau papa pālolo e hōʻike ʻia ma ka Papa 3.
Papa Kiʻina 3

*Hoʻemi i ka hemoglobin glycated i ka wā monotherapy*	*Loaʻa nā pono*	*Mea nā hemahema*	*Nā Hōʻike*	*Nā Hoʻohui*
0,5 – 1,5 %	ʻO ka kaohi o ka hyperglycemia postprandial, ka wikiwiki wikiwiki o ka hana hiki ke hoʻohana ʻia i nā pānaʻi me kahi kahuʻai ʻole	ka hopena o ka hypoglycemia, loaʻa ka paona ʻaʻohe ʻike e pili ana i ka hana lōʻihi a me ka palekana. lawe i nā kau o ka ʻai nā kumukūʻai kiʻekiʻe	momo type diabetes mellitus: monotherapy i ka hui pū ʻana me ka hoʻomākaukau metformin	ʻAno maʻi type 1 coma a me nā kūlana precomatose o nā ʻano kumu, hapai a lactation Hāmeʻa (koe wale nō ka repaglinide), ka aho ʻole, hypersensitivity i kekahi o ka lāʻau

Itors-glucosidase inhibitors - nā lāʻau hou

Kuhi ʻia ka hana o nā lāʻau i ka papa o ka papa o ka inhibitor o α-glucosidase e kau ana i ka hoʻolamaka ʻana i ka hoʻokuʻu ʻana o ka glucose mai nā pākūkū paʻakikī. Hoʻemi kēia i ka hyperglycemia ma hope o ka ʻai ʻana. Ma ka hoʻoponopono ʻana i ka hoʻopili ʻana o ka glucose mai ka ʻōpū, ua hoʻemi ʻia nā alpha-glucosidase e hoʻomaʻemaʻe i kēlā me kēia lā i ka maʻamau o ka plasma koko.

ʻAʻole hōʻeuʻeu nā lāʻau lapaʻau o kēia pūʻulu i ka huna ʻana i ka insulin, no laila, ʻaʻole alakaʻi i ka hyperinsulinemia, mai hoʻonā i ka hypoglycemia. Ke hoʻolana nei i ka hoʻopihapiha ʻana o nā glucose i ke koko ma lalo o ka mana o nā lāʻau lapaʻau o ka papa o ka makahiki α-glucosidase e hoʻomaʻamaʻa i ka hana o ke pancreas a pale iā ia mai ka overstrain a me ka luhi.

Nā papa inoa α-glucosidase e pili ana i ka acarbose, miglitol, a me ka voglibosis. ʻO kahi lāʻau hou mai kēia pūʻulu he voglibosis. Wahi a nā hoʻokolohua lapaʻau, ʻo ka voglibosis ka mea kūpono loa i ka mālama ʻana o nā mea maʻi me ka maʻi diabetes type 2 me kahi ʻaihue wikiwiki wikiwiki (7.7 mmol / L) a me ka glycemia postprandial kiʻekiʻe (ma luna o 11.1 mmol / L). ʻO ka maikaʻi o ka lāʻau lapaʻau, ʻaʻohe nā hopena e pili ana i ka hypoglycemic, ka mea nui loa i nā mea maʻi maʻi.
I Lūkia, ua hoʻopaʻa wale ka acarbose mai nā lāʻau lapaʻau o kēia papa. ʻO ka inoa inoa kālepa o ka huahana me kēia mea ikaika ʻo Glucobay. Aia nā papa papaʻaina i loko o kahi waihona o 50 a me 100 mg, pono e lawe ʻia i ʻekolu mau manawa i ka lā.

ʻO nā hopena e pili ana ka maʻi maʻamau ke lawe ʻana i nā inhibitor α-glucosidase e piha ana i ka maʻi, flatulence a me nā maʻi maʻamau, ʻo ka hōʻeha o ka mea e kau ai i ka hopena o nā lāʻau a me ka nui o nā minamina. ʻAʻole hiki ke kapa ʻia kēia mau hopena he pōpilikia, akā he kumu maʻamau ia no ka haʻalele ʻana i nā lāʻau lapaʻau o kēia papa. Hoʻokumu nā hopena ʻaoʻao ma muli o ka nui o nā mea laʻa e hoʻonui ʻia i loko o ka ʻōpū nui. Hiki ke hoʻemi ʻia ka paʻakikī o nā hopena kūpono ʻole e ka hoʻomaka ʻana i ka mālama ʻana me nā ʻuʻuku liʻiliʻi a me ka hoʻonui iki ʻana i ka momona.

ʻO ka contraindication koʻikoʻi ma ka hoʻohanaʻana i nā lāʻau lapaʻau o ka papa o ka papa o ka makahiki o ka glucosidase, kahi maʻi o ka gastrointestinal tract.

ʻO Glonagon-like peptide receptor agonists -1 - nā hopena hope loa o nā huahana diabetes 2 mau hope loa

ʻO Glucagon-like peptide-1 agonist reseptor (AH) (GLP-1) ka lāʻau hou loa no ka mālama ʻana i ka maʻi maʻi.
ʻO ka hopena nui o ka hoʻohana ʻana i nā lāʻau lapaʻau o kēia papa ka hoʻoulu ʻana i ka mea huna o ka insulin e nā cell beta o ka pancreas. Ke hoʻolōʻihi nei nā lāʻau maʻi i ka piʻi o ka hanu. Hoʻopili kēia i ka loli o ka glycemia postprandial. Hoʻonui ka mea inu o kēia papa i ka manaʻo o ka piha a hoʻēmi i ka hoʻoulu ʻana i ka meaʻai, hoʻemi i ka hopena o ka hoʻomohala ʻana i nā maʻi cardiovascular.
Hōʻike ʻia ka papa inoa o nā lāʻau lapaʻau e like me nā peptide-1 receptor agonist receptor i hōʻike ʻia i ka Papa 4.
Papa Kiʻi 4

*Kaulana Nui ʻole o ke Aupuni AND*	*ʻO nā inoa kalepa i hoʻopaʻa ʻia ma Rusia (hana maʻa, mg)*	*Puka Pōʻalima (mg)*	*Hoʻohui lehulehu*	*Ka lōʻihi o ka hana (mau hola)*
exenatide	Bayeta (5, 10 mcg), no ka maʻi maʻi sc	10 - 20 mcg	Hoʻoponopono ʻia kahi palapala hōʻea i ka manawa 2 i ka lā	12
exenatide lōʻihi	Baeta Long (2,0) no ka maʻi ʻo SC	–	Hoʻoponopono ʻia kahi maʻi hou i hoʻokahi pule	168
liraglutide	Victoza (0.6, 1,2, 1,8), no ka injection sc	0,6 – 1,8	Hoʻoponopono ʻia kahi maʻi 1 manawa i kēlā me kēia lā	24
lixisenatide	Lycumum (10, 20 mcg), no ka sc inj	10 - 20 mcg	Hoʻoponopono ʻia kahi maʻi 1 manawa i kēlā me kēia lā	24
dulaglutide	Trulicity (0.75, 1.5) no ka maʻi sc sc	–	Hoʻoponopono ʻia kahi maʻi hou i hoʻokahi pule	168

ʻO AR GPP-1 kahi i koho ʻia i nā hopena lapaʻau ʻē aʻe.ʻO kekahi mau lāʻau lapaʻau prandial maʻamau - kāohi lākou i ka pae o ka glucose ma hope o ka papaʻaina, ʻoiai ʻo kekahi - ʻaʻole he lāʻau lapaʻau ʻole - hoʻemi i ke kōhi koko koko.

ʻO ka hana liʻiliʻi pōkole ARGP-1 ARs (exenatide a me lixisenatide) hoʻokaʻawale i ka hana huna ʻana i ka pale me ka hoʻēmi ʻana i ka ʻeha gastric a hoʻohenahe. Ke alakaʻi nei kēia i kahi lohi i ka hoʻopiliʻana o ka glucose i ka pā liʻiliʻi a hana pololei i ka hoʻokaʻawale ʻana i nā mea neʻe i ka hana postprandial.

Pono ka hana nonprandial GPP-1 ARs ma ka pancreas, hoʻōla i ka huna ʻana i ka insulin a me ka hoʻopaʻa ʻana i ka hana hana glucagon. Hāʻawi kēia i ka hōʻemi haʻahaʻa o ka glycemia postprandial a me kahi hoʻēmi nui i ka wikiwiki glycemia ma ke kāohi ʻana i ka mea huna o ka glucagon a hoʻemi ʻana i ka momona.

ʻAe ʻole AR AR-1 nonprandial me ka exenatide lohi, liraglutide, albiglutide, a me ka semaglutide. ʻO nā ʻano hana ʻē aʻe e hana ai i ka hoʻokaʻina ʻana o nā mea mai nā kiko o ka subcutaneous. ʻO ka hopena, hoʻonui ka lōʻihi o ka hana a nā lāʻau lapaʻau.
Loaʻa ma nā pono a me nā hemahema o ka papa kahi huahana A GLP-1 i ka Papa 5.
Pākaukau 5

*Hoʻemi i ka hemoglobin glycated i ka wā monotherapy*	*Loaʻa nā pono*	*Mea nā hemahema*	*Nā Nānā*
0,8 – 1,8 %	haʻahaʻa haʻahaʻa o hypoglycemia, mea kaumaha hoʻohaʻahaʻa i ke koko hōʻemi ma ka nui o ka make a me ka maʻi cardiovascular i ka poʻe me nā maʻi pūpū paʻa. hopena palekana pale i nā pupu ʻβ	ʻeha ka hopohopo, Ka hapanui o ka hoʻokolohua (ma ka lawe ʻana i ka exenatide), hiki i ka hopena o ka pancreatitis (ʻaʻole i hōʻoia ʻia) injection puka o ka hoʻokele nā kumukūʻai kiʻekiʻe	Contraindicated i ka uha kino a me ka piha o ka hepatic, ketoacidosis, hapai a me ka lactation.

Ke kuhikuhi nei i kēia papa hou o nā lāʻau lapaʻau no ka mālama ʻana i nā maʻi type 2 e like me kahi mea pili i ka metformin, sulfonylureas, a i ʻole hui pū kekahi o kēia mau mea e hoʻomaikaʻi i ka mana glycemic.

Hōʻike ʻia o nā papa i kahi lāʻau A GLP-1 ʻaʻole i hoʻoili ʻia e ka hypoglycemia, akā 30 - 45% o nā mea maʻi e hōʻike i nā hopena ʻoluʻolu mai ke kumu o ka gastrointestinal - nā maʻi hoʻi ma ke ʻano o ka maʻi maikaʻi, ka luaʻi a i ʻole ke hōʻemi, e hoʻemi ana i ka manawa.

ʻO ka sodium glucose cotransporter inhibitors (glyphlozines) - nā lāʻau hou o ka maʻi diabetes 2 hou

ʻO nā papa 2 sodium glucose cotransporter inhibitors (INGLT-2) nā papa hou e hoʻohaʻahaʻa ana i ke kō o ke koko. Me he ala la o ka hanauna hou, e hana ana ʻo INGLT-2 i kahi kumumanaʻo ʻē aʻe ma mua o nā ʻano lāʻau lapaʻau maʻi āpau 2 ʻē aʻe. Hoʻemi ka ka hana o nā lāʻau i kēia papa i ka pale ʻana i ka hoʻohiʻi ʻana o ka glucose i loko o nā keiki. Hoʻokuʻu kēia i ka glucose mai ke kino i ka pā ʻana. A ʻo kahi hopena, he nui ka hopena o ka mālama ʻana i ka dosis me ka hoʻoliʻi o ka glucose koko aʻo ka hoʻonui ʻana i ka huna ʻana i ka insulin a me ka hoʻohaʻahaʻa o ka pale ʻana i ka insulin.

ʻO ka papa inoa o nā lāʻau lapaʻau glyphlozin i hoʻopaʻa ʻia ma Rūsia a me kā lākou mau inoa kalepa penei:

dapagliflozin (Forsig),
limahaima (jardins),
canagliflozin (Invocana).

Hoʻoulu nā papa papa Glyphlosin i ka hoʻonui ʻana o ka nui o ke kō i loko o ka pāʻai. Mai kēia, nā maʻi i hōʻemi i ka paona. I nā hana haʻawina, ʻo nā mea maʻi e lawe ana i dapagliflozin i hui pū me ka metformin no 24 mau wiki i ʻoi aku i ke kaumaha o ke kino ma mua o ka poʻe e lawe nei i ka metformin wale nō. Hoʻemi ke kaumaha o ke kino ʻaʻole ma ka wai wale nō, akā no ka momona. Eia naʻe, ʻaʻole hiki ke lawelawe ʻia ka lāʻau lapaʻau hou me he pale meaʻai. Hoʻemi ka emi ʻana o ke kaupaona kino me ke kiʻekiʻe o ke kō o ke koko ma nā mea kokoke i ka maʻamau.

Ua kuhikuhi ʻia nā lāʻau lapaʻau ʻo Glyphlosin i kēlā me kēia manawa o ka maʻi i hui pū ʻia me nā ʻano lāʻau ʻē aʻe. ʻO lākou ka palekana a me ka maikaʻi.
Eia nō naʻe, ua loaʻa i nā mea maʻi e lawe ana i ka dapagliflozin i ka hoʻomohala ʻana i nā maʻi ʻōiwi, ʻoi aku hoʻi i nā maʻi ʻoi.Eia kekahi, ʻo nā lāʻau lapaʻau o kēia papa e hoʻonui i ka pae o ka lipoproteins low low, he mea nui e noʻonoʻo ai, no ka mea, he nui nā maʻi me ka maʻi maʻi e pili ana i nā maʻi o ka maʻi maʻi.
Pākuʻi ka hopena i ka wā e lawe ai i nā papa papaʻa i ka type 2 sodium glucose cotransporter inhibitors:

huahuʻi,
huakaʻi renal function,
hopena diuretic
emi i ke kahe koko,
hoʻohaʻahaʻa i ke koko
nā kue ʻana o ka minela o ka minela.

Ua kuhikuhi ʻia nā lāʻau lapaʻau me ka mālama ʻana i ka wā ʻelemakule, me nā maʻi o ka maʻi o ka genitourinary tract, ʻoiai lawe ana i ka diuretics.
ʻO nā lāʻau lapaʻau o Glyphlosin kahi loaʻa koʻikoʻi nui. He mahal lākou.

Thiazolidinediones (glitazones) - nā lāʻau hou hou no ka maʻi maʻi type 2

ʻO Thiazolidinediones kahi hui kālā hou hou o nā lāʻau lapaʻau. Ua ʻae ʻia lākou no ka hoʻohana ʻana ma ke ʻano he lāʻau lapaʻau no ka mālama ʻana i nā maʻi maʻi type 2 i ka makahiki 1996. ʻO kā lākou hana o ka hana he hoʻonui i ka naʻau o ka insulin, ʻo ia hoʻi, ka kū ʻana o ka insulin, kekahi o nā kumu nui o ke kumu o ka maʻi diabetes.

Hoʻowalewale i ka hoʻohaʻahaʻa ʻana o nā cell i ka insulin, hoʻonui ʻia ka papa i ka hopena physiological o kā lākou iho iho o ka endogenous insulin a ma ka manawa like me ka hoʻohaʻahaʻa ʻana i ke kao o ke koko. Eia kekahi, loaʻa i ka glitazones ka mālama i ka hana hana o ka pancreas, ʻo ia hoʻi, hiki i ka hiki ke pale i ka diabetes type 2, kahi e kau ai iā lākou i kahi papa iʻoi aʻe ma mua o nā papa ʻē aʻe no ka mālama i ka maʻi maʻi.

I Lūkini, ʻelua mau lāʻau mai ka hui i manaʻo ʻia ua hoʻopaʻa inoa ʻia - rosiglitazone a me pioglitazone. Lawe nā mea maʻi i ka rosiglitazone ma ke ao holoʻokoʻa i nā makahiki he nui. Hoʻololi pinepine ʻia e hoʻokaʻawale ʻia no ka maʻi maʻi ma Rusia. Ua hōʻike ʻia ma mua o Rosiglitazone ka palekana o ka cardiovascular: ka nui o ka hoʻonui ʻia o ka myocardial infarction a me ka make cardiovascular. Akā, ua hoʻihoʻi hou ʻia ka lāʻau lapaʻau ma hope.

Ua hōʻike ʻia nā noiʻi inā inā mālama ʻia ka rosiglitazone me hoʻokahi mea lapaʻau no ka manawa lōʻihi, ʻaʻole pono ka pono e hoʻohui i ka lāʻau hou e like me ka wā e mālama ʻia me nā lāʻau lapaʻau (glyburide a metformin) i hoʻopaʻa ʻia nā lāʻau lapaʻau.

He nui nā pono o ka lāʻau Glitazone. Akā, ʻaʻole wikiwiki nā kauka e hoʻolilo i nā lāʻau lapaʻau o kēia papa i ka hoʻomaʻemaʻe pālahalaha. Ua hoʻokaʻawale ʻia nā manaʻo o ke kaiāulu olakino e pili ana i ka pono a me ka palekana o ka hoʻohana ʻana i ka thiazolidinedione. ʻO kahi mea e manaʻo nui ʻia ʻo ka hemahema o ka ʻikepili i ka palekana o ka hoʻohana lōʻihi o kēia mau lāʻau.
Nui nā ʻike i nā hopena ʻokoʻa ma ka mālama ʻana i nā glitazones i mea nui ia.

loaʻa ka momona (ma kahi o 3 - 6 kg),
hoʻomoʻi i ka wai me ka hoʻomohala ʻana i ka maʻi edematous a me ka palaualelo ʻana o ka naʻau,
hōʻemi i ka hoʻoliʻiliʻi ʻana o nā iwi.

Pono nā haʻawina hou i ka ʻike o ka hoʻohana ʻana i ka thiazolidinediones e pili ana i ka nui o ka ulu ʻana o ka hoʻomohala ʻana i nā neoplasms malignant, i ka maʻi tumehina kikoʻī, i hōʻoia ʻia e nā hoʻokolohua hoʻokolohua. Ua loaʻa ka piʻi nui e loaʻa i kahi kūhelu nui no ka rosiglitazone.
Ma mua o ka hoʻoluhi ʻana i nā lāʻau lapaʻau o ka papa thiazolidinedione, ʻokoʻa ke koʻikoʻi a ʻike i ka hopena e pili ana i ka ulu ʻana o ka puʻuwai naʻau. ʻO nā mea koʻikoʻi nui no kāna hoʻomohala ʻana:

puʻuwai paʻakikī
myocardial infarction a i ʻole coronary heart heart,
haehae maʻi
hema hypertrophy,
ua hōʻeha ʻia nā maʻi hōʻeha i nā ʻōpū puʻuwai,
ma mua o 70 mau makahiki
ʻoi aku ka nui o ka maʻi diabetes ma mua o 10 mau makahiki.
ka ʻōlaʻi a i ʻole ka mālama ʻia me ka diuretics loop
ka hoʻomohala ʻana o ka edema a i ka loaʻa ʻana o ka paona i ka wā e mālama ai me nā glitazones,
ʻōpū insulin
ka paʻaʻana o kahi hikiʻole i ka renal (ʻoi aku ma mua o 200 μmol / l).

E aʻo i nā ʻekepili pololei a me nā noi e hiki ke hoʻohana i nā lāʻau lapaʻau o kēia pūʻulu, nui nā noiʻi haumanu ua hoʻomau a hoʻomau.

Akā i kēia manawa, ʻaʻole hiki ke kuhikuhi ʻia nā lāʻau lapaʻau hou loa no ka maʻi maʻamau o ka papa o ka papa o ka thiazolidinediones. Pono e mālama ʻia nā hoʻokolohua hou aʻe e hōʻoia ai i ka palekana no ka hoʻohana mau ʻana.

ʻO ka maʻi lapaʻau i ka wā kahiko

Me kahi papa holomua o ka maʻi maʻi, hiki ke kuhikuhi i ka insulin i ka mea maʻi. ʻAʻole hiki ke lawe mau ʻia ka insulin ma ke ʻano me he mau papa, no ka mea, e ʻike ke wai ʻōpū i ka ʻōpū o ke ʻano e like me ka meaʻai a me ka huka nui ʻana ma mua o ka hana. No ka loaʻa ʻana o kahi inikini no ka insulin, pono ʻoe e loaʻa kahi maʻi. ʻAʻole ʻokoʻa loa ka hoʻoponopono koʻikoʻi o ka hoʻomākaukau ʻana o ka insulin i ka wā kahiko ma mua o nā papa kuhikuhi no nā maʻi ʻōpio.

Ua hoʻokaʻawale ʻia nā Insulins i nā lāʻau lapaʻau pōkole a lōʻihi. ʻO ka lōʻihi o ka hana o ka insulin i nā kānaka ʻē aʻe kekahi. No laila, koho ʻia ke koho ʻana i kahi regimen therapy insulin i lalo o ke kiaʻi o nā kauka. I loko o ka haukapila, mālama ʻia ka pae o ka glycemia, koho ʻia ke ʻano o ka insulin e like me nā hana metabola i loko o ke kino, kaʻai, ka ʻano kino.

Ma muli o ka mea maʻi e lawelawe ai i ka insulin ma luna o ia iho, hiki i ka hāmeʻe ʻana ma ka maʻi ma waena o nā poʻe maʻi hiki ke mālama wale ʻia inā mālama ʻia nā hana cognitive o ka mea maʻi maʻi, ua lawa ko lākou ʻike ʻana i ka honua ma hope o ka ʻike ʻana i nā loina kumu hoʻomehana o ka insulin a me ka mālama pono ʻana i ka glycemia.
Hāʻawi ʻia ka papa inoa o ka hoʻomākaukau ʻana o nā insulin i loko o Lūkini ma ka Papa 6.
Papa 6

*ʻAno insulin*	*Inoa Kūʻai ʻole honua*	*ʻO nā inoa kalepa i hoʻopaʻa ʻia ma Rusia*
Hoʻolaha ka hana hāmaki	ʻO ka inini Lyspro	Humawai
Hōʻikeʻike Insulin	NovoRapid
Insulin glulisin	Apidra
ʻO ka hana pōkole	Soluble kanaka genetically engineered insini	Actrapid NM, Humulin maʻamau, Insuman Rapid GT, Biosulin R, Insuran R, Gensulin R, Rinsulin R, Rosinsulin R, Humodar R 100 Rivers, Vozulim-R, Monoinsulin CR
ʻO kahi lōʻihi	Human Genetic Engineering Insulin Isophane	ʻO Protafan HM, Humulin NPH, Insuman Bazal GT, Biosulin N, Insuran NPH, Gensulin N, Rinsulin NPH, Rosinsulin S, Humodar B 100 Rīwī, Vozulim-N, nā pilikia o ka Protamine-insulin
Ka hana lōʻihi	Hoʻokomo ʻia ka insulin	Lantus, Tujeo
Insem detemir	Levemir
Hoʻolaha ka hana (super analogues insuran)	Insulin degludec	Tresiba
ʻO nā ʻano hana i hoʻomākaukau ʻia o ka insulin hana pōkole a me NPH-insulin	Insulin biphasic hoʻomehana ʻano kanaka	Humulin M3, Insuman Comb 25 GT, Biosulin 30/70, Gensulin M30, Rosinsulin M hui 30/70, Humodar K25 100 Kahewai, Vozulim-30/70
Kāwili piha mākaukau o nā ʻenehana hana pōkole hana ultra-pōkole a me nā analogamine ultra-pōkole e hana ana i nā kaila	ʻO ka bypasic insulin Lyspro	Humalog Mix 25, Humalog Mix 50
Insulin aspart lua ʻelua	NovoMix 30
Nā hui pūkaukau mākaukau o nā inikua hana ultra-pōkole a me nā analog analog e hana ʻoi pōkole e hana	70/30 insulin degludec + insulin aspart	Ryzodeg

ʻOi aku nā lāʻau maʻi diabetes ma mua: ʻoi paha hou

ʻAʻole ʻōlelo nā poʻe loea e pili ana i ka hoʻohana pono ʻana i nā lāʻau lapaʻau e hoʻolalelale me ka hoʻokomo ʻana o nā lāʻau lapaʻau hou hou i nā papa inoa no ka mālama ʻana. ʻO nā mea ʻē aʻe nā mea pili i ka lāʻau hou i huli ai i kahi maʻi. ʻO ka palekana piha o kahi lāʻau i hoʻoholo ʻia he 10 mau makahiki wale nō ma hope o kona hoʻohana nui ʻana i ka hana lapaʻau maoli.

Loaʻa nā papa maikaʻi maikaʻi no ka maʻi type 2 e ka World Health Organization i ʻike wale i ka metformin a me glibenclamide.No ka mea ʻo ia ka poʻe loaʻa nā hōʻike maikaʻi loa e maikaʻi a palekana ka pilila. ʻO nā lāʻau inoa kaulana ua hoʻokele maikaʻi loa i nā kūlana o ka "hoʻoikaika - palekana - kumukūʻai o ka mālama ʻana."
ʻO nā hopena nui loa a me nā manaʻo maikaʻi loa e pili ana i ka hiki ke hoʻomalu i ka papa o ke ʻano diabetes mellitus type 2 me ka hoʻohana ʻana o ka metformin a me nā papa glibenclamide. ʻO kahi noiʻi nui, ʻo ia ka mau makahiki 5, e loiloi i ka pono a me ka palekana o ka metformin, glibenclamide a me rosiglitazone ma ka mālama ʻana i nā maʻi maʻi me ka maʻi type 2, ʻo ia hoʻi ka hōʻike pū ʻana i ka ʻoi aku ka lāʻau "kahiko" i ʻoi aku ka maikaʻi. ʻOi aku ka maikaʻi o ka palekana ma ka hoʻohālikelike ʻana me ka "rosiglitazone" hou.
ʻO ka mea nui i ka wā e koho ana i ke ʻano o ka lāʻau lapaʻau no ka maʻi maʻi ʻokēkē 2 ka mea nui o ka hoʻokō maikaʻi ʻana i ka mana glycemic maikaʻi loa e ʻoi ai ka hoʻomaʻamaʻa ʻana a hoʻomalolo i ka holomua o ka micro-and komplication macrovascular.

Eia nō naʻe, ua ʻoi aku ka manaʻo nui loa: no ka "anti" anti-diabetes drug, ʻike maikaʻi ʻia nā hopena ʻino loa a kokoke i nā mea āpau a manaʻo ʻia. Loaʻa paha nā hopena i hoʻopau ʻia nā lāʻau "hou" i ka hiki ʻole a nānā koke ʻia. No laila, he mea nui loa ka noiʻi lōʻihi a me nā polokalamu nānā.

No ka laʻana, rosiglitazone, he māka o ka pūʻulu o thiazolidinediones, he nui nā koina o ka hoʻolaha ʻana, i hoʻohana pono no 8 mau makahiki, ʻo ia no ka manawa mua i loko o ke ʻano o nā haʻawina hauka lōʻihi, hōʻike ʻia kahi hopena hou - osteoporosis. Ma hope mai, ua ʻike ʻia ka hopena, ʻo ka ʻano o ka pioglitazone, pinepine i ka ulu ʻana i nā wahine, i pili pū me ka hoʻonui ʻana o ka mau puʻupuʻu. Ua hōʻike ʻia nā noiʻi hope ʻana i ka nui o ka hoʻouka ʻana o ka infococote myocardial i ka wā e mālama ai me ka rosiglitazone a me kahi pilikia o ka hoʻomohala ʻana i ka maʻi maʻi maʻi a me ka pioglitazone.

ʻO kekahi mau hopena hopena o nā lāʻau lapaʻau no ka maʻi maʻi hiki ke lilo i ka "luku" i ka maʻi maʻi maʻamau me nā maʻi. ʻOiai nā hopena like ʻole e like me ka hypoglycemia, loaʻa ka paona, ʻaʻole pono e haʻi i ka hoʻoweliweli o ka hoʻomohala ʻana i ka edema, osteoporosis, hōʻeha o ka puʻuwai, ʻaʻole maikaʻi loa no ka poʻe maʻi me ka maʻi laʻa type 2, nui loa ka hoʻopiʻi i ka hoʻokūkū.

Hoʻomaopopo i kēia mau hoʻopaʻapaʻa, ʻoi aku ka maikaʻi e hoʻomaka i ka mālama ʻana me nā lāʻau lapaʻau ʻikepili i aʻo ʻia. ʻAʻole wale lākou i ka maikaʻi palekana profile, akā ʻo ka maʻi kiʻekiʻe hypoglycemic kiʻekiʻe. ʻAʻole i loaʻa ka manawa "hou" i mea e hōʻoia ai i ko lākou palekana me ka hoʻohana lōʻihi. Eia kekahi, ʻaʻole lākou i hōʻike i kahi hopena hypoglycemic maikaʻi aʻe i hoʻohālikelike ʻia i nā mea maʻamau, "kahiko". Ua hoʻoholo ʻia kēia mau manaʻo ma hope o nā haʻawina lehulehu.

ʻO ka lāʻau hea e makemake ai? He aha ka hopena maikaʻi loa no ka maʻi diabetes type 2. Ua hōʻike ka Hui Hema e ka Pepa o nā Diabetes ke koho ʻana i kahi lāʻau lapaʻau e loaʻa ai nā hōʻike hōʻike (noiʻi) e hōʻoia i ka pono a me ka palekana o kekahi papa lāʻau no ka mālama ʻana i ka maʻi maʻi.

ʻO ka hanauna hou o nā lāʻau lapaʻau ka mea e ʻoi aku ka maikaʻi. Akā, ʻo ka hope o kā lākou hoʻohana ʻana e hoʻoholo ʻia ma hope o ka hōʻoia ʻana e ka hana ākea a lōʻihi. I ʻEulopa a me USA, ʻo ka hapa nui o nā mea maʻi e hoʻomau mau ʻia me nā lāʻau lapaʻau ʻia i hoʻopaʻa ʻia a hoʻopaʻa ʻia maoli.
ʻO ke ala kūpono ʻoi loa ma ka hana mua o ka mālama ʻana i ka diabetes mellitus type 2 he mau metformin, e noʻonoʻo ana i kona hopena maikaʻi, a me nā deralona sulfonylureas - kahi papa hana mua o nā lāʻau lapaʻau maʻi no ka pili ʻana o ka ikaika a me ka neʻe ʻana i hui pūnaʻi.

ʻO ka "lāʻau kahiko" lāʻau kuʻuna, nā lāʻau lapaʻau maʻamau - metformin a me nā kōlani sulfonylureas e noho mau i ka honua maʻamau i ka mālama ʻana i ka maʻi type 2. ʻO ke kumu no ke koho ʻana i ko lākou makemake a ʻo ia nā ʻōlelo penei:

ka palekana o ka mālamaʻana i nā maʻi
Loaʻa i nā hopena wā lōʻihi loa,
hopena i ka maikaʻi a me ka manaʻolana,
hiki i ka hoʻokele waiwai.

A e pono nui i kēia mau lāʻau lapaʻau i ka mālama ʻana i ka maʻi diabetes a hiki i ka ʻike hou aʻe e pili ana i nā lāʻau hou, a hiki i nā noiʻi nui e hōʻike i ko lākou ʻoi aku ka kiʻekiʻe ma mua o nā lāʻau lapaʻau.

ʻO nā hopena o nā hoʻokolohua lapaʻau lōʻihi a me keʻike nui i loaʻa i ka hana maʻamau ʻo ia ka ʻōlelo hilinaʻi a hilinaʻi loa paha no ka koho ʻana i nā lāʻau lapaʻau no ka mālama ʻana i ka maʻi mellitus.