Galvus - nā ʻōlelo aʻoaʻo no ka hoʻohana ʻana, nā loiloi, nā mea hoʻohālike a me nā ʻano dosis (papa 50 mg, me ka metformin 50 500, 50 850, 50 1000 Met) o kahi lāʻau lapaʻau no ka mālama ʻana i ka maʻi type 2 i ka pākeke, nā keiki a me ka hānau ʻana

I kēiaʻatikala, hiki iā ʻoe ke heluhelu i nā ʻōkuhi no ka hoʻohana ʻana i ka lāʻau lapaʻau Galvus. ^ E Ha yM. Hāʻawi i ka hoihoi mai ka poʻe kipa i ka pūnaewele - nā mea kūʻai o kēia lāʻau lapaʻau, a me nā manaʻo o nā loea lapaʻau e pili ana i ka hoʻohana ʻana iā Galvus i kā lākou hoʻomaʻamaʻa. ʻO kahi noi nui, ʻo ia ke hoʻoikaika ikaika i kāu mau loiloi e pili ana i ka lāʻau lapaʻau: kōkua ka lāʻau lapaʻau a ʻaʻole hoʻi i kōkua i ka hoʻopiʻi ʻana i ka maʻi, nā mea hoʻopiʻi a me nā hopena ʻaoʻao, ua ʻike ʻia, ʻaʻole i hoʻolaha ʻia e ka mea hana ma ka annotation. Nā kikowaena o Galvus ma ke alo o nā mea hoʻokolohua kiko loaʻa. Hoʻohana no ka mālama ʻana i ka maʻi type 2 i ka pākeke, nā keiki, ʻoiai ʻo ka wā hapai a me ka lactation. ʻO ka hiʻohiʻona o ka lāʻau lapaʻau.

Galvus - ka lāʻau hypoglycemic waha. ʻO Vildagliptin (ka hana ikaika o ka lāʻau Galvus) he ʻelele o ka papa o ka hoʻoulu ʻana o ka insular apparatus o ka pancreas, sellyly pale i ka enzyme dipeptidyl peptidase-4 (DPP-4). ʻO ka hana wikiwiki a hoʻopau i ka hana DPP-4 (ʻoi aku ma mua o 90%) e hoʻoulu ai i ka hoʻowalewale ʻelua a me ka hoʻōla ʻana o ka meaʻai me ka peptide type 1 e like me GLP-1) a me ka glucose ka hilinaʻi i ka insulinotropic polypeptide (HIP) mai ka ʻōpū i loko o ka ʻōnaehana ma waena o ke ao.

Ke hoʻonui nei i nā kikowaena o ka GLP-1 a me HIP, ʻo vildagliptin e hoʻonui i ka naʻau o ka naʻau o nā selela pancreatic i ka glucose, e alakaʻi ai i kahi hoʻomaikaʻi ʻana i ka huna ʻana i ka glucose o ka glucose.

Ke koi nei i ka vildagliptin ma kahi o 50-100 mg i kēlā me kēia lā i nā mea maʻi me ka diabetes mellitus type 2, kahi hoʻomaikaʻi ʻana i ka hana o nā pancreatic β-cells ua ʻike ʻia. ʻO ka pae o ka holomua o ka hana o nā pū beta ke hilinaʻi i ka pae o ko lākou hōʻeha mua ʻia, no laila i loko o ka poʻe i hōʻino ʻia mai ka mellitus maʻi diabetes (me kahi pae kūlohelohe plasma maʻamau), ʻaʻole hoʻopiʻi ka vildagliptin i ka huna ʻana i ka insulin a ʻaʻole e hōʻemi i ka pae glucose.

I ka hoʻonui ʻana i ka kao o ka endogenous GLP-1, hoʻonui ka vildagliptin i ka hoʻololi ʻana o nā seleka o ka glucose i ka glucose, e alakaʻi ai i kahi holomua o ka hoʻoponopono o ka glucose i kālai ʻia ʻana o ka paleona. ʻO ka emi ʻana o ke kiʻekiʻe o ka glucagon i ka wā o ka pāʻina, ma ka huli ʻana, e hoʻolohi i ka hōʻemi i ka pale ʻana i ka insulin.

ʻO ka hoʻonui ʻana o ka pāʻana o ka insulin / glucagon e kū'ē ana i ke kua o ka hyperglycemia, ma muli o ka hoʻonui ʻana o ka ʻike ʻana o ka GLP-1 a me ka HIP, ke hoʻolilo nei i ka emi ʻana o ka hana o ka glucose i ka ate ma ka lua o ka wā prandial a ma hope o kaʻai ʻana, ka mea e hiolo ai i ka hoʻoliʻiliʻi o ka glucose i plasma koko.

Eia kekahi, e kū'ē i ka hope o ka hoʻohana o vildagliptin, kahi i hoʻohaʻahaʻa i ka pae o lipids i ka plasma koko, akā naʻe, ʻaʻole pili kēia hopena me kona hopena i ka GLP-1 a i ka HIP a me kahi hoʻomaikaʻi i ka hana o nā kōlena beta pancreatic.

Ua ʻike ʻia he piʻi nui ʻana o ka GLP-1 hiki ke hoʻolōʻihi i ka ʻōpū o ka gastric, akā ʻaʻole i nānā ʻia kēia hopena me ka hoʻohana ʻana o vildagliptin.

ʻO Galvus Met kahi lāʻau lapaʻau hypoglycemic waha hui pū ʻia. ʻO ka pūnāwai o ka lāʻau Galvus Met ka mea komo ʻelua mau pūmole hypoglycemic me nā ʻano hana like ʻole: vildagliptin, no ka papa o ka dipeptidyl peptidase-4 inhibitors, a me metformin (ma ke ʻano o ka hydrochloride), he mākaukau o ka papa biguanide. ʻO ka hoʻohui ʻana o kēia mau mea e hiki ai iā ʻoe ke hoʻomaikaʻi maikaʻi i ka piʻi ʻana o ka glucose i ke koko i loko o nā mea maʻi me ka maʻi type 2 i loko o 24 mau hola.

Hōʻike

ʻO Vildagliptin + poʻe keu (Galvus).

ʻO Vildagliptin + Metformin hydrochloride + nā mea waiwai (Galvus Met).

Lapaʻau lāʻau

A lawe ma luna o kahi ʻōpū ʻole, lawe koke ʻia ka vildagliptin. Me ka inu manawa like ʻole me ka meaʻai, a emi iki ka helu o ka ʻike ʻana o ka vildagliptin, akā naʻe, ʻaʻole pili ka ʻai i ka ʻaina o ka eʻa a me ka AUC. Kālaha ʻia ka lāʻau lapaʻau ma waena o ka plasma a me nā wahi hoʻoliʻiliʻi koko. ʻO Biotransformation ke ala nui o ka excretion o vildagliptin. I ke kino o ke kanaka, ua hoʻohuli ʻia ka 70% o ka nui o ka lāʻau. Ma hope o ka helu ʻana i ka lāʻau, ua pili ka 85% o ka nui ma ka ʻōpū a me 15% ma o ka ʻōpū, ʻo ka renal excretion o vildagliptin i loli ʻole he 23%.

Hoʻopilikia, ʻo ka hoʻomaʻamaʻa ʻana o ke ʻano hui kino, a me ka moʻomeheu i ka hopena o ka pharmacokinetics o vildagliptin.

ʻAʻole i hoʻokū ʻia nā hiʻohiʻona ʻo ka pharmacokinetic o vildagliptin i loko o nā keiki a me nā ʻōpio ma lalo o 18 makahiki o kona mau makahiki.

E kūlike i ka papaʻaina o ka ʻai, ke emi ʻana o ka nui a me ka helu o ka ʻike ʻana o ka metformin. ʻAʻole pono ka lāʻau lapaʻau e nakinaki i nā protein plasma, aʻo ka pilina o ka sulfonylurea e hoʻopaʻa ʻia iā lākou ma mua o ka 90%. Hoʻomoʻa ka Metformin i nā ʻāpana koko ʻokoʻa (ʻoi paha ka ikaika o kēia kaʻina ma mua o ka manawa). Me kahi hoʻokele intravenous hoʻokahi i nā limahana olakino, hoʻopili ʻia ka metformin e nā loli. ʻAʻole ia i hoʻokaʻawale ʻia i ka puʻu (ʻaʻole i ʻike ʻia nā metabolites i nā kānaka) a ʻaʻole i hoʻopā ʻia i ka bile. Ke hoʻoluhi ʻia, ma kahi o 90% o ka nui o ka lāʻau i hoʻoulu ʻia ma ke keiki i ka wā 24 mau hola mua.

ʻAʻole pili ka kāne o nā mea maʻi i ka pharmacokinetics o metformin.

ʻAʻole paʻa i nā hiʻohiʻona pharmacokinetic o metformin i loko o nā keiki a me nā'ōpio ma lalo o 18 makahiki o kona mau makahiki.

ʻAʻole i like ka hopena o ka meaʻai ma ka pharmacokinetics o vildagliptin a me ka metformin i ka hoʻohui ʻana o ka lāʻau lapaʻau ʻo Galvus Met.

Nā Hōʻike

Kauka 2 diabetes mellitus:

e like me ka monotherapy i ka hui ʻana me ka lāʻauʻai a me ka hoʻomaʻamaʻa ʻana,
i ka poʻe maʻi ma mua e loaʻa ana ka hopena me ka vildagliptin a me ka metformin i ke ʻano o nā lāʻau lapaʻau hoʻokahi (no Galvus Met),
i ka hui pū me metformin ma mua o kahi lāʻau lapaʻau mua me ka lawa ʻole o ka hoʻokō ʻana o ka mālama ʻana i ka meaʻai a me ka hoʻomaʻamaʻa ʻana;
ma ke ʻano he hui ʻelua o ka hui pū ʻana me ka metformin, derivatives sulfonylurea, thiazolidinedione a i ʻole insulin i ka hopena o ka hoʻoulu ʻia ʻana o ka meaʻai kūpono, hoʻomaʻamaʻa a me ka monotherapy me kēia mau lāʻau ʻana,
ma ke ʻāpana o kahi hui triple: i hui pū ʻia me nā derivatives sulfonylurea a me ka metformin i nā mea maʻi i mālama mua ʻia me nā derogative sulfonylurea a me ka metformin e pili ana i kahi keʻakeʻa o ka meaʻai a me ka hoʻōla ʻana a me ka loaʻa ʻole i kahi kūpono glycemic control.
ma ke ʻano he hui triple: i hui pū me ka insulin a me ka metformin i nā maʻi i loaʻa mua i ka insulin a me ka metformin ma ke keʻena o ka meaʻai a me ka hoʻomaʻamaʻa ʻana a ʻaʻole i hoʻokō i ka pono glycemic control.

E hoʻokuʻu i nā palapala

Nā Papahana 50 mg (Galvus).

Nā papa hana 50 + 500 mg, 50 + 850 mg, 50 + 1000 mg (Galvus Met).

Nā ʻōkuhi no ka hoʻohana a me ka regimen dosage

Lawe ʻia ʻo Galvus i kahi ʻōlelo maʻamau, me he mea la o ka komo ʻana i ka meaʻai.

Pono ke koho ʻia o ka hoʻoponopono ʻia o ka lāʻau lapaʻau kūʻokoʻa e pili ana i ka hopena a me ka hikiʻole.

ʻO ke ʻano o ka lāʻau i manaʻo ʻia i ka wā o ka monotherapy a i ʻole ka mahele o ke ʻano hui ʻelua ʻelua me ka metformin, thiazolidinedione a i ʻole insulin (i ka hui pū me ka metformin a i ʻole metformin) he 50 mg a 100 mg o kēlā me kēia lā. I ka poʻe maʻi me ka maʻi maʻi ʻoi aku ka maʻi maʻamau 2 e loaʻa ana ka mālama me ka insulin, ua ʻōlelo ʻia ʻo Galvus i kahi maʻi o 100 mg i kēlā me kēia lā.

ʻO ka papa ʻōlelo ʻo Galvus i ʻōlelo ʻia ma ke ʻano he triple hui hoʻohui (vildagliptin + sulfonylurea derivatives + metformin) ka 100 mg i kēlā me kēia lā.

ʻO kahi paona o 50 mg i kēlā me kēia lā e pono e kuhikuhi i 1 mau wai i kakahiaka. Pono kahi wai o 100 mg no kēlā me kēia lā e 50 mg 2 mau manawa i ka lā ma ke kakahiaka a i ke ahiahi.

I ka manawa e lilo ai ma ke ʻāpana o ka hui pūnaehana ʻelua o nā mea me ka derony o ka sulfonylurea, e pili ana i ka pualapaʻa ʻia o Galvus he 50 mg 1 mau manawa i kēlā me kēia lā i ke kakahiaka. I ka hoʻohālikelike ʻia ʻana me ka derivatives o sulfonylurea, ʻo ka maikaʻi o ka lāʻau lapaʻau ma ka maʻa o 100 mg i kēlā me kēia lā ka like o ia ma ka hāleʻa 50 mg i kēlā me kēia lā. Me ka hopena ʻole o ka lāʻau lapaʻau e kūʻē i ka hope o ka hoʻohana ʻana o ka nui o ka lā i hāpai ʻia e mālama ʻia ai i kēlā me kēia lā o 100 mg, no ka mālama pono i ka glycemia, hiki ke loaʻa ka hopena hou aku i nā lāʻau maʻi hypoglycemic: metformin, sulfonylurea derivatives, thiazolidinedione a i ʻole insulin.

I nā maʻi me nā maʻi holi a me nā hana hepatic, ʻaʻole pono ka hoʻoponopono ʻana. I nā mea maʻi me ka hana ʻole a ʻoi paha ka hopena o ka renal (e komo pū ana me ka papa hana o ka hopena ʻole ʻana i ka maʻi hemodialysis), pono e hoʻohana ʻia ka lāʻau lapaʻau ma kahi o ka 50 mg hoʻokahi i hoʻokahi lā.

I nā poʻe maʻi maʻi (ʻoi aku ma mua o 65 mau makahiki), ʻaʻole pono ke hoʻoponopono ʻana.

No ka mea ʻaʻohe ʻike a me ka hoʻohana ʻana i ka lāʻau lapaʻau i nā keiki a me nā ʻōpio i lalo o 18 makahiki o kona mau makahiki, ʻaʻole ia e noi ʻia e hoʻohana i ka lāʻau i loko o kēia ʻano o nā maʻi.

Hoʻohana ʻia ka lāʻau. ʻO ka nui o ka noho ʻai ʻia ka lāʻau Galvus Met e pono ke koho ponoʻī ʻia e pili ana i ka hopena a me ka hikiʻole. Ke hoʻohana nei iā Galvus Met, ʻaʻole iʻoi aku ma kahi o ka nui o ka lā i ʻōlelo ʻia no ka vildagliptin (100 mg).

A pono e koho ʻia i ka inika hoʻomaka ʻia o ka lāʻau Galvus Met, me ka noʻonoʻo ʻana i nā regimens o ka mea maʻi me vildagliptin a me / a metformin paha. No ka hoʻēmiʻana i ka paʻakikī o nā hopena ʻaoʻao mai ka digestive system characteristic o metformin, lawe ʻia ʻo Galvus Met me ka meaʻai.

ʻO ka hopena kumu mua o Galvus Met me ka hiki ʻole o ka monotherapy me vildagliptin: hiki ke hoʻomaka ʻia ke mālama ʻana me Galvus Honey me kahi papa hoʻokahi me kahi maʻi o 50 mg / 500 mg 2 mau manawa i kahi lā, a ma hope o ka loiloi ʻana i ka hopena therapeutic, hiki ke hoʻonui pinepine ʻia ka lāʻau.

ʻO ka hopena kumu mua o Galvus Met me ka maikaʻi ʻole o ka monotherapy metformin: ʻoiai ke ʻano o ka hopena o ka metformin i lawe ʻia, ʻimi ʻia me Galvus Met e hoʻomaka me kahi papa hoʻokahi me kahi maʻi o 50 mg / 500 mg, 50 mg / 850 mg a i ʻole 50 mg / 1000 mg 2 mau manawa i ka lā.

ʻO ka maʻi kumu mua o Galvus Met i loko o nā mea i loaʻa i ka hopena hui me ka vildagliptin a me ka metformin e like me nā papa hoʻokaʻawale: e pili ana i nā ʻano o ka vildagliptin a i loaʻa ka metformin i lawe ʻia, mālama ʻia me Galvus Met me kahi papa e like me ka mea e like me ka mea e hiki ai i ka mālama ʻana i ka 50 mg / 500 mg , 50 mg / 850 mg a i 50 mg / 1000 mg, a me ka titrated ma ka hopena.

ʻO ka maʻi kumu mua o Galvus Met ma ke ʻano he hana mua i ka poʻe maʻi me ka diabetes mellitus type 2 me ka ʻike ʻole o ka hoʻomaʻamaʻa ʻana o ka papa ʻaina a me ka hoʻomaʻamaʻa ʻana: ma ke ʻano he hoʻomaka ʻana, ʻo Galvus Met e pono e kuhikuhi ʻia i loko o kahi kinohi o 50 mg / 500 mg hoʻokahi manawa i ka lā a me ka wā ma hope aʻe o ka loiloi ʻana i ka hopena therapeutic ʻO ka hapakō i kahi momona a hiki i 50 mg / 100 mg 2 mau manawa i ka lā.

ʻO ka hui hoʻohui me Galvus Met hui pū me ka derogatives sulfonylurea a i ʻole insulin: ka helu ʻana o ka haʻawina o Galvus Met mai kahi wai o vildagliptin 50 mg 2 mau manawa i kahi lā (100 mg i kēlā me kēia lā) a me ka metformin i loko o kahi pane e like me ka mea i lawe mua ʻia ma ke ʻano lāʻau hoʻokahi.

ʻO ka hoʻohana ʻana o Galvus Met he contraindicated i loko o nā mea maʻi me ka hana ʻole o ka renal a i ʻole ka hopena ʻole.

Hoʻokuʻu ʻia ka Metformin e nā keiki. No ka mea pinepine ka poʻe maʻi ma mua o 65 mau makahiki i ka emi ʻana o ke kumu hana ʻole, ua kuhikuhi ʻia ʻo Galvus Met i kēia ʻano o nā mea maʻi ma ka liʻiliʻi liʻiliʻi loa e hōʻoia i ka normalization o ka glucose kukuna ma hope o ka hoʻoholo ʻana i ka QC e hōʻoia i ka hana maoli. Ke hoʻohana nei i ka lāʻau lapaʻau i nā mea maʻi ma mua o 65 mau makahiki he mea pono ia, e nānā mau i ka hana renal.

No ka ʻike ʻole ʻia o ka palekana a me ka hana ʻana o Galvus Met i nā keiki a me nā ʻōpio ma lalo o ka makahiki 18, ʻaʻole i aʻo ʻia ka hoʻohana ʻana i ka lāʻau i loko o kēia ʻano o nā maʻi.

Loaʻa ka hopena

lie kanikela
āhāhuʻe
hāpau
mea ʻalaʻawa
paila, mamaila,
gastroesophageal reflux,
ʻeha ka ʻōpū
nā ʻeha, hoʻohemo ʻana,
he ʻano hūnā
huahuʻi,
hipehuxikisis
mea momona
ʻili ka ʻili
urticaria
huu
huhuhu,
peripheral edema,
hepatitis (hiki ke hoʻihoʻi ʻia ma ka hoʻokuʻu ʻana o ka lāʻau),
lōkohu
ʻili ʻōwili o ka ʻili,
mākaʻi
kaomi ʻana i ke kō o ka vitamin B12,
lactic acidosis
ʻākōwili ka naʻau i loko o ka waha.

Nā Hoʻohui

hana ʻole a hana ʻole paha i ka hana renal: me ka pae serum creatinine i ʻoi aku ma mua o 1,5 mg% (ʻoi aku ma mua o ka 135 μmol / l) no nā kāne a ʻoi aku ka 1,4 mg% (ʻoi aku ma mua o 110 110mol / l) no nā wahine,
nā hana ʻoi me ka pilikia o ka hoʻomohala ʻana i ka hana renal: dehydration (me ka maʻi ʻaʻa, ka luaʻi), ke ʻano, ka maʻi maʻi o ka maʻi maʻi, nā maʻi o ka hypoxia (haʻalulu, sepsis, maʻi maʻi, nā maʻi bronchopulmonary).
ʻoi a ka hopena puʻuwai a me ka palaualopiko o ka wīkō, kaʻai o ka myocardial infarction, ka maʻi cardiovascular failed (kūwī),
pauna aho hanu
lawelawe aho ʻaia,
ka huaka a ʻo ka metabolic acidosis ʻoiʻi (me ka ketoacidosis maʻi i hui pū ʻia a i ʻole coma). Pono ke hoʻoponopono i ka ketoacidosis Diabetic e nā lāʻau insulin,
lactic acidosis (me ka mōʻaukala),
ʻAʻole i kuhikuhi ʻia ka lāʻau lapaʻau i 2 mau lā ma mua o ka hoʻokō ʻana, ka radioisotope, nā haʻawina x-ray me ka hoʻomaka ʻana o nā mea hoʻohālikelike a i loko o 2 mau lā ma hope o ke hoʻokō ʻana,
hapai
lactation
maʻi diabetes type 1
humuhinu maoli, huakino makehewa
ka adherence i ka meaʻai haʻahaʻa-emi (emi iho ma mua o 1000 kcal i kēlā me kēia lā),
nā keiki ma lalo o 18 mau makahiki o ka (a me ka palekana a me ka palekana o ka hoʻohana ʻaʻole i hoʻopaʻa ʻia),
hypersensitivity i vildagliptin a i metformin a i ʻole kekahi mea like o ka lāʻau.

No ka mea, ua mālama ʻia nā maʻi me ka poli o ka puʻuwai i kekahi mau hihia, ua hōʻike ʻia ka acidosis lactic, ʻo ia paha kekahi o nā hopena ʻaoʻao o ka metformin, ʻaʻole pono ʻo Galvus Met i ka poʻe maʻi me nā maʻi o ka maʻi a i ʻole nā mea maʻi hepatic biochemical hepatic.

Me ka mālama aka, ua aʻo ʻia e hoʻohana i nā lāʻau lāʻau e pili ana i ka metformin i nā mea maʻi ma luna o 60 mau makahiki o ka makahiki, a i ka wā e hoʻokō ai i ka hana kino koʻikoʻi ma muli o ka piʻi nui o ka lolo lactic.

ʻŌpū a me ka lactation

No ka mea ʻaʻole i lawa nā hōʻike a nā wahine hāpai i ka hoʻohana ʻana i ka lāʻau Galvus a i ʻole Galvus Met, hoʻohana i ka lāʻau lapaʻau i ka wā hapai.

I loko o nā hihia o ka metabolism glucose impaired i nā wahine hāpai, loaʻa ka nui o ka hoʻouluʻana o ka anomalies congenital, a me ka pinepine o ka neonatal morbidity a me ka make. E hoʻolaʻa i ka hoʻoliʻiliʻi o ke koko i ka wā hapai, ua hōʻike ʻia ka insulin monotherapy.

I nā hoʻokolohua hoʻokolohua, i ka wā e kuhikuhi ana i vildagliptin i nā inakē he 200 mau manawa i ʻoi aku i ko ke ake ʻana, ʻaʻole i kau ka lāʻau i ka hoʻomōmaʻomaʻo a me ka hoʻomohala mua ʻana o ka embryo a ʻaʻole i kau i ka hopena teratogenic ma ka pūpū. I ka lawe ʻana i ka vildagliptin i hui pū me ka metformin ma kahi hapa o 1:10, ʻaʻohe pū kekahi hopena teratogenic o ka maʻi fetus.

No ka mea ʻaʻole i ʻike ʻia e hoʻopili ʻia ana ka vildagliptin a i mua paha i ka metformin i ka waiū kanaka, ua hoʻohana ʻia ka hoʻohana ʻana i ka lāʻau ʻo Galvus i ka wā o ka hoʻoulu ʻana.

Hoʻohana i nā keiki

Contraindicated i nā keiki a me nā ʻōpio ma lalo o nā makahiki he 18 (ʻo ka maikaʻi a me ka palekana o ka hoʻohana ʻana, ʻaʻole i hoʻokū ʻia).

Hoʻohana i nā mea maʻi maʻi

Me ka mālama aka, ua aʻo ʻia e hoʻohana i nā lāʻau lapaʻau e pili ana i ka metformin i nā maʻi ke ʻoi aku ma mua o 60 mau makahiki.

Nā ʻōlelo kikoʻī

I nā poʻe maʻi e loaʻa ana i ka insulin, ʻaʻole hiki iā Galvus a Galvus Met ke hoʻololi i ka insulin.

Mai ka wā e hoʻohana ai i ka vildagliptin, he piʻi nui ka hana o aminotransferases (maʻa mau me ka hōʻike ʻole ʻana i nā mea lapaʻau) i ʻike pinepine ʻia i ka hui kaohi, ma mua o ke kuhikuhi ʻana i ka lāʻau lapaʻau ʻo Galvus a me Galvus Met, ʻo ia hoʻi i ka wā o ka mālama ʻana me ka lāʻau lapaʻau, e ʻōlelo ʻia no ka hoʻoholo ʻana i nā palena biochemical o ka hana ate. Inā he hana nui ka mea maʻi o nā aminotransferases, pono e hōʻoia ʻia kēia hopena e kahi noiʻi lua, a laila e hoʻoholo pinepine i nā ʻōhua biochemical o ka ate hana a hiki i ko lākou hoʻomaʻamaʻa ʻana. Inā heʻoi aku ka nui o ka hana a AST a i ʻole ALT e piʻi a ʻoi aku paha iʻoi aku ma mua o VGN i hoʻopaʻa ʻia e ka noiʻi hou ʻana, pono ia e kāpae i ka lāʻau lapaʻau.

Lactic acidosis ka hopena paʻakikī a maikaʻi loa akā ʻo ka hoʻopiʻi kūlohelohe e kū mai ana me ka hōʻemi o ka metformin i loko o ke kino. Lactacidosis me ka hoʻohana ʻana i ka metformin i nānā nui ʻia i nā mea maʻi me ka maʻi mellitus me ka maikaʻi ʻole o ka renal maikaʻi ʻole. Hoʻopili ʻia ka pilikia o ka hoʻomohala ʻana i ka acidosis lactic i nā mea maʻi me ka maʻi mellitus maʻi diabetes maikaʻi ʻole, me ka ketoacidosis, ka pōloli lōʻihi, ka nui o ka inu ʻana i ka waiʻona, ʻeha ʻole a me nā maʻi e hoʻoiho ai i ka hypoxia.

Me ka hoʻomohala ʻana o ka acidosis lactic, kahi pōkole o ka hanu, ka ʻeha ʻeha a me nā hypothermia i ʻike ʻia, ukali ʻia e ka coma. ʻO nā ʻōlima o ka papa hana i loaʻa ka waiwai diagnostic: kahi hōʻemi i ke koko pH, kahi serum lactate konsile ma luna o 5 nmol / l, a me kahi nui anionic interval a me ka hoʻonui nui o ka lactate / pyruvate. Inā kānalua ka metabolic acidose, pono e hoʻokuʻu ʻia ka lāʻau lapaʻau a hoʻomaha koke ka maʻi maʻi i ka haukapila.

No ka mea, ua hoʻopili ʻia ka metformin e nā keiki, ka ʻoi o ka hōʻemi ʻana o ka hōʻuluʻulu ʻana a me ka hoʻomohala ʻana o ka acidosis lactic, ʻoi aku ka nui o ka hana o ka renal. Ke hoʻohana nei i ka lāʻau lapaʻau, pono ʻo Galvus Met e loiloi pinepine i ka hana renal, ʻo ia hoʻi i loko o nā hopena e hiki mai ana i ka mea i hoʻopōʻino ʻia: ke ʻano mua o ka mālama ʻana me nā lāʻau antihypertensive, nā loea hypoglycemic, a i ʻole NSAIDs. ʻO ke kānāwai, pono e nānā ʻia ka hana ʻoi aku ma mua o ka hoʻomaka ʻana o ka mālama ʻana me Galvus Met, a laila liʻiliʻi ma kahi o 1 manawa i kēlā me kēia makahiki no ka poʻe maʻi me ka hana o ka renal maʻamau a ma kahi o 2 mau manawa i kēlā me kēia makahiki no ka poʻe maʻi me ka creatinine serum ma mua o VGN. I nā mea maʻi me ka pōmaikaʻi koʻikoʻi kahi hana kīnā ʻole, pono ia e nānā ʻia ma mua o 2 mau manawa i ka makahiki. Inā hele ʻole nā hōʻailona o ka hana a ke kīpoki, pono e hōʻoki ʻia ʻo Galvus Met.

Ke hoʻokō nei i nā haʻawina x-ray e koi ana i ka hoʻomoe ʻana o nā ihe i ka radiopaque iodine ka mea i hoʻopihapiha ʻia, ʻo Galvus Met e hoʻoleʻaleʻa a manawa (48 mau hola ma mua, a i loko o kahi mau hola 48 ma hope o ka hoʻopaʻa ʻana), ʻoiai ka hana hoʻokō o ka iodine e hoʻopihapiha ana i nā radiopaque e pili ana i ka hopena o ka mahiki i ka hana o ke keiki a hoʻonui i ka hopena o ka ka hoʻomohala ʻana o ka hoʻomehana lactic acidosis. Hiki iā ʻoe ke hoʻomau i ka lawe ʻana iā Galvus Met wale nō ma hope o ka loiloi lua o ka hana ʻōpili.

Ma ka hana ole cardiovascular kaulike (pīhoihoi), ʻoi aku ka hopena o ka puʻuwai, paʻa o ka myocardial infarction a me nā kūlana ʻē aʻe e hōʻike ʻia ana e ka hypoxia, ka hoʻomohala ʻia o ka acidosis lactic a me ka hoʻomaʻamaʻa ʻole a prerenal akō hiki. Inā hele mai nā kūlana i luna, e hoʻokuʻu koke ʻia ka lāʻau.

I ka wā o ke kaʻina holoʻokoʻa (me ka ʻokoʻa ʻole o nā hana liʻiliʻi i pili ʻole i ke kaupalena ʻia ʻana o ka ʻai a me ka waiʻai), pono o Galvus Met. Hiki iā ʻoe ke hoʻomau i ka lawe ʻana i ka lāʻau ma hope o ka mea hoʻomaka ke lawe i ka ʻai ma luna iho ona a hōʻike ʻia kēlā maʻi kīnā ʻole ʻoi ʻole.

Ua hoʻonohonoho ia e hoʻonui i ka eʻule (alkohol) ka hopena o ka metformin i ka metabolism lactate. Pono e hōʻike ʻia ka poʻe maʻi e pili ana i ka hiki ʻole o ka hōʻemi kino ʻana i ka wā o ka hoʻohana ʻana i ka lāʻau Galvus Met.

Loaʻa ʻia nā metformin i kahi kokoke o 7% o nā hihia e hoʻoiho i kahi emi o ka asymptomatic i ka serum bitamina B12 kāʻai. ʻO ke emi ʻana o nā hihia i loaʻa pinepine ʻole i ka ulu ʻana i ka anemia. Ka mea, ma hope o ka haʻalele ʻana o ka metformin a me / a i ʻole ke kūpaʻa o ka vitamin B12, ke mālama ʻana i ka serum o ka huaora B12. ʻO ka poʻe maʻi e loaʻa iā Galvus Met, ua hōʻike ʻia ma kahi o ka manawa 1 i kēlā me kēia makahiki e hana i kahi hōʻike koko ākea a inā e ʻike ʻia kahi hana kolohe, e hoʻoholo i ko lākou kumu a lawe i nā kūpono kūpono. Ka mea maʻamau, ʻo kekahi mau mea maʻi (no ka laʻana, nā mea maʻi me ka hoʻopiʻi ʻole ʻia a i ʻole malabsorption o ka vitamin B12 a i ʻole ka calcium) he predisposition e hoʻohaʻahaʻa i ka serum concentrations o ka vitamin B12. I ia mau hihia, hiki ke hoʻolako ʻia e hoʻoholo i ka serum konsentrate o ka vitamin B12 i kahi liʻiliʻi i 1 manawa i 2 mau makahiki.

Inā he mea maʻi me ka diabetes mellitus type 2, nāna i pane mua ma ke olakino, hōʻike i nā hōʻailona o ka ulu ʻana (kahi loli ma nā ʻāpana laboratorium a i ʻole nā hōʻike kulana), a ʻaʻole maopopo iki nā hōʻailona, pono e hana koke ʻia nā hoʻokolohua e ʻike i ke ketoacidosis a me / a i ʻole ka lactic acidosis. Inā hoʻopaʻa ʻia ka acidosis i kahi ʻano a i ʻole kekahi e hoʻopaʻa ʻia, pono ʻoe e kāpae koke i ka Galvus Met a lawe i nā ana kūpono.

ʻO ka maʻamau, ma nā maʻi e loaʻa wale nō iā Galvus Met, ʻaʻole ʻike ʻia ka hypoglycemia, akā naʻe hiki ke kūpaʻa ʻia i ke ʻano o ke kīʻaha haʻahaʻa (a inā ʻaʻole ke ʻano o ka hana kino olakino e ka mākaukau o ka ʻona o ka ʻai), a i ʻole ke kūpaʻa ʻana o ka inu ʻona. ʻO ka hypoglycemia ka mea maʻamau i ka poʻeʻelemakule, debilitated a hoʻohaʻahaʻa paha i nā maʻi, a he maikaʻi hoʻi i ke ʻano o ka hypopituitarism, ka ʻoluʻolu adrenal a i ʻole nā wai inu wai. I nā poʻe maʻi maʻi a i nā mea maʻi e loaʻa ana nā beta-blockers, hiki ke loaʻa ka maʻi o ka hypoglycemia.

Me ka luhi (ke maʻi, ke trauma, ka maʻi, ʻoihana) i hōʻea i kahi mea maʻi e loaʻa ana i nā ʻaihue hypoglycemic i ke ʻano paʻa, hiki ke hōʻemi i ka hopena o nā mea hope a i kekahi manawa. I kēia hihia, pono paha e kāpae iā Galvus Met a kuhikuhi i ka insulin. Hiki iā ʻoe ke hoʻomau hou i ka mālama ʻana me Galvus Met ma hope o ka hopena o ke ake o ka manawa.

Hoʻokomo i ka hiki ke lawe i nā kaʻa a kāohi i nā mīkini

ʻO ka hopena o ka lāʻau Galvus a i ʻole Galvus Met i ka hiki ke lawe i nā kaʻa a hana a me nā mīkini me nā mea i aʻo ʻole ʻia. Me ka hoʻolālā ʻana o ka dizziness i ka hope o ka hoʻohana ʻana i ka lāʻau lapaʻau, pono ka mea e pale i ka hoʻolele ʻana i nā kaʻa a hana pū me nā mīkini.

Hoʻohui nūhou

Me ka hoʻohana like ʻana o vildagliptin (100 mg 1 manawa i kēlā me kēia lā) a me ka metformin (1000 mg 1 manawa i kēlā me kēia lā), ʻaʻohe kikowaena pili lapaʻau koʻikoʻi ma waena o lākou. ʻAʻole hoʻi i loko o nā hoʻokolohua hoʻokolohua, ʻaʻole hoʻi i ka wā ākea o ka hoʻohana ʻana o Galvus Met i nā mea maʻi e loaʻa ana i nā lāʻau lapaʻau like ʻole.

He haʻahaʻa haʻahaʻa ʻo Vildagliptin no ka hoʻopili ʻana i nā lāʻau. No ka mea, he vildagliptin ka papahele o ka isoenzymes cytochrome P450, ʻaʻole ia e hoʻopili a hoʻowalewale i kēia mau isoenzymes, ʻo kona pilina me nā lāʻau lapaʻau nā mea hoʻohaumu, na mea paʻa, a i ʻole nā hanana ʻo P450 e hiki ʻole. Me ka hoʻohana ʻana o ka vildagliptin ʻaʻole i pili i ka helu metabola o nā lāʻau lapaʻau he poʻe hoʻohālikelike o nā enzyme: CYP1A2, CYP2C8, CYP2C9, CYP2C19, CYP2D6, CYP2E1 a me CYP3A4 / 5.

ʻAʻohe ʻanoʻike olakino koʻikoʻi o ka vildagliptin me nā lāʻau lapaʻau e hoʻohana pinepine ʻia i ka mālama ʻana o ka maʻi mellitus type type 2 (glibenclamide, pioglitazone, metformin) a me kahi hāpau olakino olakino (amlodipine, digoxin, ramipril, simvastatin, valsartan, warfarin).

Hoʻonui ka Furosemide i ka Cmax a me AUC o ka metformin, akā ʻaʻole i pili i ka hoʻomaʻemaʻe kino. Hoʻopau ka Metformin i ka Cmax a me AUC o ka furosemide a ʻaʻole i hoʻopilikia i ka hoʻomaʻemaʻe renal.

Hoʻonui ka Nifedipine i ka hoʻopili ʻana, Cmax a me AUC o ke metformin, i ka la pū, e hoʻonui i ka excretion i loko o ka urine. ʻAʻole hoʻomaʻamaʻa ʻo Metformin i nā hanana pharmacokinetic o ka nifedipine.

ʻAʻole hoʻopilikia ʻo Glibenclamide i nā mea laikini pharmacokinetic / pharmacodynamic o ka metformin. Hoʻopili maoli ka Metformin i ka Cmax a me AUC o ka glibenclamide, akā i ka nui o ka hopena ke ʻano nui. No kēia kumu, ʻaʻole maopopo ke ʻano o ka maʻi koʻikoʻi o kēiaʻoihana.

ʻO nā cial organic, no ka laʻa, amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, trimethoprim, vancomycin, a me nā mea ʻē aʻe, excreted e nā ʻuhane e ka neʻe tubularin, hiki i ka hui kūloko me ka metformin, no ka mea hoʻokūkū lākou no nā ʻōnaehana o ka tubule maʻamau. Hoʻonui ʻo Cimetidine i nā kaila o ka metformin i ka pulu / koko a me kona AUC ma o 60% a me 40%, kēlā. ʻAʻole pili ʻo Metformin i nā ʻāpana pharmacokinetic o ka cimetidine.

Pono e mālama pono i ka wā e hoʻohana ana iā Galvus Met me nā lāʻau lapaʻau e pili pū ana i ka hana kidney a i ʻole ka lawe ʻana i ka metformin i loko o ke kino.

Hiki i kekahi mau lāʻau ke hōʻeha i ka hyperglycemia a hōʻemi i ka hopena o nā mea kūmole hypoglycemic, ʻo ia mau lāʻau me ka thiazides a me nā diuretics, glucocorticosteroids (GCS), nā phenothiazines, ka hoʻomākaukau ʻana i ka hormone thyroid, estrogens, contraceptives waha, phenytoin, acid acid nicotinic, sympathomimetics, a me nā calcium antagonists. Ke koho ʻana i kēlā lāʻau lapaʻau hoʻohālikelike, a i ʻole, i ʻole ke hōʻea ʻia, e hāmama ʻia e nānā pono i ka hopena o ka metformin (ʻo kona hopena hypoglycemic hopena) a, inā pono, hoʻoponopono i ka hopena o ka lāʻau.

ʻAʻole kuhikuhi ʻia ka hoʻohana pinepine ʻana o danazolea e pale ai i ka hopena hyperglycemic o ka mea hope. Inā pono ke mālama me ka danazol a ma hope o ka hoʻokuʻu ʻana i ka hopena, pono ka hoʻoponopono ʻana o ka metformin i lalo o ka hoʻomalu o ka pae glucose.

ʻO Chlorpromazine i ka wā i lawe ʻia i nā inikini kiʻekiʻe (100 mg i kēlā me kēia lā) hoʻonui i ka glycemia, a hoʻoneʻe i ka hoʻokuʻu ʻana i ka insulin. I ka mālamaʻana i nā antipsychotics a ma hope o ka hoʻokuʻu ʻana i ka hopena, pono ke hoʻoponopono ʻia ma ke ʻano o ka pae o ka glucose.

ʻO kahi noiʻi radiological e hoʻohana ana i nā ʻenehana me ka iubine eodine e hoʻomoʻi i ka hoʻomohala ʻana o ka acidosis lactic i nā mea maʻi me ka maʻi mellitus me ka hana ʻole o ka hana.

Hoʻonohonoho ʻia e like me injections, beta2-sympathomimetics hoʻonui i ka glycemia ma muli o ka hoʻouluʻana o nā mea hoʻokele beta2-adrenergic. I kēia hihia, pono ka mana glycemic. Inā pono, ʻōlelo ʻia ka insulin.

Me ka hana like o ka metformin me nā derivatives sulfonylurea, insulin, acarbose, salicylates, hiki ke hoʻonui ʻia ka hopena hypoglycemic.

Mai ka hoʻohana ʻana o ka metformin i nā mea maʻi me ka hoʻohuihue ʻawaʻawa nui e hoʻonui ai i ka nui o ka lactic acidosis (ʻoi aku hoʻi i ka wā e pōloli ana, ʻalo ʻia, a i ʻole hōʻehaʻeha o ka ʻōpū), pono nā mea maʻi e hōʻole i ka inu ʻana i ka wai inu a me nā lāʻau ʻai e pili ana i ka ethanol (waʻa wai) i ka wā me ka Galvus Met.

Nā inoa o ka lāʻau Galvus

Hoʻololi nā kumu hoʻohālike o ka waiwai ikaika:

Nā huahana i loko o ka hui pharmacological (hypoglycemic agents):