Ungasisebenzisa kanjani isidakamizwa i-Saksenda? > Ukwelashwa nokuvimbelaUmuthi - uSaksenda - wokunciphisa umzimbaI-drug Saxenda yi-ejenti ye-hypoglycemic yokwelapha ukukhuluphala ezigulini ezinenkomba yesisindo somzimba ngenhla amayunithi angama-27. Izinkomba ezingeziwe zokusebenzisa kukhona uhlobo lwesifo sikashukela sohlobo 2 (olungaxhomekeki kwe-insulin), ukungasebenzi kahle kwe-lipoprotein metabolism kanye ne-cholesterol ephakeme yegazi.Umuthi lo ukhiqizwe kusukela ngo-2015 eDenmark nguNovo Nordisk. Ifomu lokukhishwa limelelwa yisisombululo (3 mg) sokuphatha ngokungena, lifakwe esibayeni sesirinji. Ukuze kube lula ukusetshenziswa, ithuluzi linesilinganiso sokuhlukaniswa, okukuvumela ukuthi uhlukanise ithuluzi libe izinhlelo eziningi. Iphakethe elilodwa liqukethe amasirinji ama-5.Isakhi esiyinhloko somkhiqizo wezemithi yi-liraglutide. Umuthi u-analogue wokwenziwa we-hormone GLP-1 noma i-glucagon-like peptide-1 (ukuhlangana ngokubambisana nemvelo prototype 97%), ekhiqizwa ngamathumbu futhi inomphumela kumanyikwe, kuvuselela ukukhululeka kwe-insulin. Izithako ezisizayo yilezi:i-sodium hydrogen phosphate dihydrate,amanzi ngomjovo.Kutholakala ngesimo sesisombululo esikhanyayo sokuphatha okungaphansi. Esiphaketheni samapeni ama-syringe ayi-3 ml.i-liraglutide (6 mg / ml),i-hydrochloric acid / sodium hydroxide,Umphumela oyinhloko ukunciphisa umzimba. Ukwengeza kunomphumela we-hypoglycemic. Lapho uthatha ama-3 mg we-liraglutide ngosuku, ukulandela ukudla nokuzivocavoca umzimba, cishe abantu abangama-80% banciphisa isisindo.I-Liraglutide iyi-analogue ye-peptide-1 yabantu (i-GLP-1), etholakala ngokubuyiselwa kwe-DNA. Ibopha futhi isebenze i-receptor ethile, ngenxa yalokho ukumunca kokudla okuvela esiswini kwehle kancane, izicubu ze-adipose ziyancipha, isifiso sokudla siyalawulwa, amasimba enza buthaka mayelana nendlala. Umuthi uvusa ukukhululeka kwe-insulin, unciphise ukucasha okukhulayo kwe-glucagon. Ngasikhathi sinye, kukhona ukuthuthukiswa kokusebenza kwamaseli we-beta kumanyikwe.Ukumunca kuhamba kancane, ukuqoqwa okukhulu kungamahora ayi-11 ngemuva kokuphatha. I-Bioavailability ingama-55%.Okwenziwe ngamabomu ngokweqile, akukho ndlela ethile yokuphuma. Ezinye izinto ziphuma ngomchamo nezindunduma. Ukuqedwa kwesigamu sempilo kusuka ezintweni eziphilayo kwenza cishe amahora angama-12-13.Ukukhuluphala (inkomba yomzimba ngaphezulu kwe-30), i-incl. okubangelwa ukungabekezelelwa kwe-glucose,Thayipha isifo sikashukela esingu-2 ngenzuzo yesisindo,Umfutho wegazi ophezulu we-Arterial,I-dyslipidemia eyeqile,I-apnea syndrome evimbela ukulala (ukukhuluphala njengomphumela wecala).Hypersensitivity kuzakhi,Ukulimazeka okukhulu noma ukuthikamezeka kwe-hepatic,Multiple endocrine neoplasia 2 izinhlobo,Ukwehluleka kwenhliziyo kwe-III-IV isigaba sokusebenza,Umlando womdlavuza we-medullary yegilo (umndeni noma umuntu ngamunye),Ukusetshenziswa kanyekanye kwezinye izidakamizwa ukulungisa isisindo somzimba,Ukukhuluphala kwesibili ngenxa yezinkinga zokudla, izifo ze-endocrine, nokusetshenziswa kwezidakamizwa eziholela ekuzuzeni isisindo,Ukusetshenziswa okufanayo ne-insulinIzingane ezingaphansi kweminyaka engu-18Ukukhulelwa nokukhulelwa,Ukudangala okukhulu, umlando wokuziphatha ngokuzibulala.Ilawulwa kuphela ngokungaxhunyiwe, ezinye izindlela zinqatshelwe. Umthamo ukhethwa ngudokotela ohambelayo.Kusetshenziswa kanye ngosuku, umjovo wenziwa ngaphandle kokudla. Umjovo ungenziwa esiswini, okhalweni, emahlombe noma emaqhingeni. Indawo yomjovo kufanele iguqulwe njalo. Kungcono ukunikeza umjovo ngasikhathi sinye sosuku.Umthamo wokuqala ngu-0.6 mg ngosuku. Kancane kancane, kuvunyelwe ukukhuphukela kuma-3 mg phakathi nesonto. Uma "imiphumela emibi" ivela futhi lapho umthamo ukhuphuka, ungasuswa, kufanele uyeke ukuthatha umuthi.Uhlu lwemiphumela engadingeki lukhulu kakhulu:ukusabela kwe-anaphylactic,ukusabela esakhiweni somjovoi-asthenia, ukukhathala,cholecystitis, cholelithiasis,ukwehluleka kwezinso okwenzekile, umsebenzi wezinso okhubazekile,Ubuhlungu esiswini sangaphezulu,I-hypoglycemia ezigulini ezinesifo sikashukela zisebenzisa amanye ama-hypoglycemic agents.Kungadala i-overdose uma kutholakala umthamo omkhulu ngokweqile. Kulokhu, kuboniswa lezi zimpawu ezilandelayo:isifo sohudo, kwesinye isikhathi esinzima kakhulu.Kunikezwa ukwelashwa okufanele ukudambisa izimpawu. Qiniseka ukuthi uthintana nodokotela.KUBALULEKILE! Azange kube namacala we-hypoglycemia ngenxa ye-overdose.USaksenda uxhumana kabi nezinye izindlela. Ngenxa yokulibaziseka kokukhipha i-gastric, kungathinta ukufakwa kwezinye izidakamizwa ezisetshenzisiwe, ngakho-ke sebenzisa ngokuqapha ekwelashweni okuhlanganisiwe.Ngenxa yokuntuleka kwemininingwane efanelekile yokuhambisana nezinye izidakamizwa, i-liraglutide ayikwazi ukuhlanganiswa.Labo abasebenzisa i-warfarin kanye nezinye izinto eziphuma ku-coumarin kufanele bavame ukuqapha i-INR ekuqaleni konyango lweSaxenda.Iziguli ezinesifo sikashukela akufanele zisetshenziswe nge-insulin. Futhi ayifanele i-monotherapy esikhundleni se-insulin.Ayisetshenziswa njengento esikhundleni se-insulin ekwelapheni isifo sikashukela.Sebenzisa ngokuqapha kubantu abanokwehluleka kwenhliziyo. Kukhona ubungozi bokuthola i-pancreatitis ebaluleke kakhulu, mayelana nokuthi isiguli kumele sizazi kanjani izimpawu zayo futhi ihlolwe njalo. Uma kwenzeka kube nezimpawu, ukulaliswa esibhedlela nokuhoxa kwezidakamizwa kuyadingeka.Isiguli kufanele siqaphele ubungozi bokuthola lezi zifo ezilandelayo:cholecystitis kanye cholelithiasis,isifo se-yegilo (kuze kube ukukhula komdlavuza),I-hypoglycemia in diabetesics,ukudangala nokuthambekela kokuzibulala,umdlavuza webele (akukho datha eqondile ekuxhumaneni nokuphathwa kwe-liraglutide, kepha kunezimo zokwelashwa),ukuphazanyiswa kwenhliziyo.Ayisetshenziswa uma ubuqotho bephakethe buphukile noma isisombululo sibukeka sihlukile kunoketshezi olucacile nolungenamibala.Kancane kuthinta ikhono lokushayela imoto. Iziguli ezisebenzisa i-Saxenda kwinhlanganisela yokwelapha ne-sulfonylurea amalungiselelo akhulisa ubungozi be-hypoglycemia, ngakho-ke azinconywa ukushayela imoto noma ukusebenzisa ezinye izindlela eziyingozi ngesikhathi sokwelashwa.Ikhishwa kuphela ngencwadi kadokotela!Isici sezidakamizwaIsithako esikhulu esisebenzayo somuthi waseDenmark uSaksenda yi-liraglutide. Kuyafana nengxenye ekhiqizwa amathumbu.ILiraglutide ibambezela inqubo yokuhambisa ukudla isuka esiswini iye ohlelweni lokugaya olungezansi. Ngenxa yalokhu, umuzwa wokudinwa ngemuva kokudla uqhubeka isikhathi eside, futhi isifiso sokudla siyancipha.Ukulahlekelwa isisindo ngaphandle kobuhlungu kunciphisa inani lokudla elichithwayo, elisiza ukunciphisa isisindo ngokushesha."I-Saksenda" ayenzi ukulungiswa okungenamsebenzi kokudla, ukudla okune-khalori ephansi kusadingeka. Kepha sibonga umuthi, awuhambisani nokuhlaselwa kabuhlungu yindlala. Lokhu kwenza inqubo yokunciphisa isisindo ingagcini nje ngokushesha, kodwa futhi ikhululeke, ingacasuli uhlelo lwezinzwa.Sincoma ukufunda ngama-burners amafutha ukuze wehlise isisindo. Uzofunda ngemvelo (i-oatmeal, izithelo, i-nokunye okufana nokolweni, i-ginger nabanye) kanye nokwenziwa (amaphilisi, izitika, ama-cocktails) abashisi bamafutha.Futhi nakhu okunye mayelana ne-L-carnitine yokulahleka kwesisindo.Ngubani ofaneleUmuthi awukwazi ukusetshenziswa ngokunqumela, ufuna ukwenza lula inqubo yokunciphisa isisindo. Uqokwa ngochwepheshe ngemuva kokuhlolwa kweziguli ngokuphelele.Isibonakaliso sokusetshenziswa yinkomba yesisindo somzimba engaphezu kwamayunithi angama-27 kuye kwangama-30.Izizathu ezingeziwe zokuphuza umuthi zingcindezi yegazi, i-cholesterol ingaphezulu kokujwayelekile, kanye nesifo sikashukela sohlobo 2, esingasebenzisi i-insulin.Ukuphepha kanye nokusebenza ngempumeleloNgaphambi kokungena emakethe yezokwelapha, uSaksenda wadlula uchungechunge lokuhlolwa kwelebhu nokwelashwa. Kwenziwe izifundo ezi-4. Kuma-3 kubo, iqembu elilawulayo lisebenzise umuthi amaviki angama-56. Esigulini sokuqala kuthathe isikhathi esingaphezu kwezinyanga ezi-2. Amaqembu abantu ahlukaniswe ngokwezimpawu zezinkinga ezazikhona, kepha zonke zazikhuluphele.Leyo ngxenye yezifundo ezasebenzisa umuthi yazuza impumelelo enkulu kakhulu ekunciphiseni isisindo kunaleyo ethatha i-placebo. Amaviki ayi-12, bakwazile ukunciphisa isisindo ngama-5% wesisindo somzimba.Ngaphezu kwalokho, amazinga abo kashukela egazi athuthukile, umfutho wegazi labo kanye namazinga e-cholesterol azinza. Kwabuye kwavezwa ukuthi uSaksenda akayona into enobuthi, ayivuseleli ukuthuthuka kwamathumba futhi awuthinti umsebenzi wokuzala.Kepha ngosizo lwayo kungenzeka ukuthuthukisa isimo samanyikwe.Izinguquko zesisindo somzimba weziguli ezinamandla ashukumisayo lapho uthatha isidakamizwa "Saksenda" ne-placeboKodwa-ke, ngazo zonke izinzuzo zako, umuthi ungadala imiphumela emibi. Okuphawulwe kaningi:isicanucanu nokuhlanza, isifo sohudo,Ubuhlungu esiswini noma amathumbu, i-belching, flatulence,ubuthakathaka ngenxa yokwehla kushukela wegazi, ukukhathala,Ezimweni ezingandile, kukhona:ukubonakaliswa komzimba endaweni yokujova noma okujwayelekile,i-hypoglycemia kuma-diabetes anesifo sohlobo 2.Zonke izimpawu ezingemnandi kufanele zibikwe kudokotela wakho. Kufanele anqume ukuthi ayeke ukusebenzisa umuthi noma alungise umthamo ngokwanele.Ukwethulwa kwe- "Saksenda"Umuthi ukhona ngendlela yesisombululo, obekwe esibayeni sesirinji. Ngakho-ke, kufakwa emzimbeni. Ukufakwa kwenziwa nsuku zonke ngaphansi kwesikhumba ezindaweni zesisu, ehlombe noma ethangeni, ngaphandle kokufakwa emzimbeni noma emthanjeni. Kungcono ukusebenzisa umuthi emahoreni afanayo, ungakhohlwa ukuguqula inaliti ngaso sonke isikhathi nesitsha.Umthamo ubalwa udokotela. Isikimu esijwayelekile ukuthi baqala ukwelashwa nge-0.6 mg ngosuku, engeza u-0.6 mg njalo ngeviki. Umthamo owodwa owodwa we-Saksenda akufanele udlule i-3 mg. Ivolumu yesidakamizwa ilawulwa ngumuntu oqondisayo kwisirinji. Ngemuva kokufaka inaliti esikhunjeni, udinga ukucindezela inkinobho futhi ungayikhiphi kuze kube yilapho ikhawunta yedosi ibuyela ku-zero.Yini engcono - "Saksenda" noma "Viktoza"ILiraglutide, esiza ukwehlisa inani lokudla okudliwayo, ayikhona kuphela ekwakhiweni kweSaksenda.Ingxenye eyinhloko yesidakamizwa "iVictoza", ekhiqizwa yinkampani efanayo yemithi. Kepha kuleli thuluzi, ukuqoqwa kwe-liraglutide kuphezulu.Ngakho-ke, umthamo wansuku zonke weVictoza akufanele udlule i-1.8 mg. Futhi ungayisebenzisi ukunciphisa umzimba, kodwa ukuthuthukisa isimo sohlobo 2 sikashukela.Uma inhloso ukulungisa isisindo somzimba, kufanele uthathe uSaxenda. Yakhelwe ngqo isisindo, futhi ayisetshenziswa ekwelapheni isifo sikashukela.Sincoma ukufunda ngezidakamizwa ezokwehlisa i-lipid. Uzofunda ngezinkomba zokuthatha izidakamizwa, ngezigaba, izidakamizwa zakamuva ezinomphumela wokunciphisa i-lipid.Futhi nakhu okunye mayelana nomuthi i-Reduxin wokunciphisa umzimba.Inzuzo enkulu yeSaxenda ukuthi ngokuphela kokuphuza kwayo, isisindo asiqali ukukhula futhi. Ngesikhathi sokusetshenziswa komkhiqizo, isisu sibuyela kusayizi waso ojwayelekile.Isiguli asizwa isidingo sokudla ngaphezu kokulashwa.Kuzodingeka ulawule kuphela okuqukethwe kwekhalori kokudla.ISaksenda: imiyalo esetshenziswayo, intengo, ukubuyekezwa kanye nama-analoguesUkukhuluphala yinkinga engahle ivele kunoma yimuphi umuntu. Isisindo esithe xaxa sithinta kabi wonke umzimba womuntu, ikakhulukazi uma enezifo ezimbi. Kunemithi yokwelapha lesi sifo. Enye yazo iSaxenda. Bheka imiyalo yokusebenzisa lo muthi ngemininingwane eminingi.Qhathanisa ama-analoguesISaksenda ine-analogues kokubumbeka nangokufana kwezakhiwo nomphumela. Kunconywa ukuthi uzijwayeze nabo ukuze uqhathanise.IVictoza (liraglutide). Umuthi nawo ukhiqizwa yiNovo Nordisk, kepha izindleko zawo ziphansi - kusuka kuma-ruble ayi-9000. Isenzo nokwakheka kuyafana ne-Saxend. Umehluko ubhekene nokuhlushwa kuphela (kunezinhlobo ezahlukahlukene) kwelinye igama lokuhweba. Khipha ifomu - 3 ml syringe pens."Baeta" (exenatide). Iphinde yehlise ukuphuma kwe-gastric futhi inciphise iphango. Intengo ingafika kuma-ruble ayi-10,000. Futhi kuyatholakala ngohlobo lwamapeni wesirinji. Umkhiqizi - "Inkampani ye-Eli Lilly". Ilungele ukwelashwa kwesifo sikashukela, ngoba inomphumela we-hypoglycemic, lo ngumphumela wayo oyinhloko, ukuncipha kwesisindo kuyangezelelwa. Kuyenqatshelwa kwabesifazane abakhulelwe nezingane.I-Forsiga (dapagliflozin). Ivimbela ukumuncwa kwe-glucose ngemuva kokudla, kwehlisa ukuqina kwayo emzimbeni. Izindleko ezivela kuma-ruble ayi-1800. Inkampani ekhiqiza lo muthi yiBristol Myers, ePuerto Rico. Kuyatholakala ngesimo sethebhulethi. Ungasebenzisi ukwelashwa kwezingane ezingaphansi kweminyaka engu-18, abesifazane abakhulelwe nabafaka i-lactating, asebekhulile.I-NovoNorm (repaglinide). Umuthi wesifo sikashukela. Ukuqina kwesisindo kuyinzuzo eyengeziwe. Intengo - kusuka kuma-ruble ayi-180. Ifomu ngamathebulethi. Khiqiza inkampani ethi "Novo Nordisk", eDenmark. Isebenza ngokushesha nangendlela efanele. Imiphumela emibi eminingi."Reduxin" (sibutramine). Amakhebhulethi enzelwe ukwelapha ukukhuluphala. Izindleko zokufakwa ngama-ruble ayi-1600. Ukunciphisa isisindo ngempumelelo, ngenkathi ukwelashwa kungahlala izinyanga ezintathu kuya eminyakeni emibili. Izinto eziningi eziphikisayo: ungasebenzisi ukwelapha abesifazane abakhulelwe, abantu abangaphansi kweminyaka engu-18 nangaphezulu kweminyaka engama-65."Diagninid" (repaglinide). Amacwecwe asetshenziswa njenge-hypoglycemic kubantu abanesifo sikashukela sohlobo 2. Intengo cishe ngama-ruble angama-200 wamathebulethi angama-30. Uhlu lwe-contraindication lungezingane kanye nokuguga, ukukhulelwa nokukhishwa komzimba. Kubizwa njengethuluzi elingeziwe ekudleni kanye nesethi yokuvivinya umzimba.USIZO. Noma yikuphi ukusetshenziswa kwe-analogue kunqunywe ngudokotela. Ukuzelapha ngokwakho kwenqatshelwe!Iningi labantu lithi ukwehla kwesisindo kwenzeka, kodwa kuphela uma kulandelwa ukudla okuqinile futhi kunomzimba womzimba.U-Andrei: “Nginezinkinga ngoshukela wegazi nesisindo. Udokotela unqume uSaksenda. Umuthi ubiza kakhulu, kepha, njengoba kwenzeka, uyasebenza. Kwaphela inyanga, ushukela ume ku-6.2 mmol / L, futhi isisindo sehlile ngo-3 kg. Lo ngumphumela omuhle kakhulu kimi. Futhi impilo yami isiba ngcono kakhulu. "Ukusinda kwesibindi kuphelile, angitholanga umphumela ohlukile wokuthi imfundo iyangethusa."UGalina: “Ngemuva kokukhulelwa, waba nesisindo esiningi ngokumelene nesifo sikashukela. Udokotela unqume ukwelashwa kukaSaxenda. Kwakunemiphumela emibi ngendlela yesiyezi nenausea, kodwa kancane kancane umzimba ngokusobala wawusetshenziswa kuyo, ngakho bahamba. Isisindo sihamba ngokuqinile, cishe amakhilogremu amahlanu ngenyanga, bengilusebenzisa izinyanga ezimbili manje. Ngijabule kakhulu ukuthi ngizizwa ngiphilile ngokujwayelekile. "IVictoria: “Ngemuva kwenyanga ngithathe lo muthi, ushukela ugcinwa ku-5.9 mmol / L. Phambilini bekuze kufike ku-12. Ngaphezu kwalokho, isisindo sehlile ngo-3 kg. Akusekho buhlungu kumanyikwe. Ngilandela ukudla okuqinile, ngakho-ke kuyasiza ukuzwa umphumela wekhambi. Njengakho konke ngaphandle kwentengo ephezulu. Kodwa kuyasiza. ”Inhloso yeSaksenda yokwelashwa kwesifo sikashukela kanye nokukhuluphala yisinqumo sikadokotela ozoba khona. Kepha ezimweni eziningi kulungisiswa umphumela ozinzile.Abantu bayabona ukuthi banelisekile ngomuthi, kuyilapho ukuba khona kwemiphumela emibi akubucayi. Ngakho-ke, lesi sidakamizwa sinedumela elihle emakethe yezidakamizwa.Kuphela ngokukhuluphala kakhulu, kunikeza imiphumela emibi.Isidakamizwa sikhonjiswa ukunciphisa umzimba ngesisindo esinzima ngokweqile. Kaningi kuchazwa kubantu abanesifo sikashukela sohlobo 2. Imijovo ihloselwe ukuphathwa kobuhlakani kuphela. Umkhiqizo ufakwa esibayeni esikhethekile sesirinji, okulula ukusifaka ngokwakho.Ngiqale ukuphatha umthamo we-0.6 mg, kancane kancane nganda ngaya ku-1 mg. Ngenxa yalokho, ngaba nemiphumela emibi evela emgodini wesisu. Imiyalo ikhombisa ukusabela okunjalo. Ngemuva kwalokho wayeka ukusebenzisa umkhiqizo. Isisindo (3.6 kg), esedlule emavikini ayi-1.5, sabuya zingakapheli izinsuku ezimbalwa.Ngifuna ukuqaphela ukuthi imiphumela emibi ingenzeka cishe kuzo zonke izitho nezinhlelo. Lesi sidakamizwa esibucayi, esingaphephile.Isithako esisebenzayo yi-liraglutide.Umphumela omncane kakhuluUmuthi ubukeka unesimanje kakhulu futhi ubukeka. Ephaketheni amapeni ama-5 syringe anoketshezi, umthamo we-3 ml. Ukusetshenziswa kulula. Ngenza imijovo esiswini. Akulimazi, inaliti imfushane futhi mncane. Ungqimba olunamafutha esiswini lufafaze lobuhlungu obuvela ngomjovo.Kulokhu, konke kuyenzeka futhi akunabuhlungu. Ngenze imijovo yokuqala ka-0,5 ml. Ngabuka umzimba ukuthi luzosabela kanjani. Ngaphambi kwalokhu, kunjalo, wabonisana nodokotela. Ngathola izeluleko zokwelashwa ngokusetshenziswa kwalesi sidakamizwa. Ngemuva kwesonto ngikhulise umthamo womuthi, kepha hhayi omkhulu.Futhi waqala ukunciphisa umsoco wakhe. Kwakunomuzwa ongaqondakali wendlala encane, kodwa kwakungabonakali kimi ukuthi umuthi ngandlela thile ungisizile ukulwa nayo. Kusetshenziswe izinyanga ezingaba ngu-2. Ngazincenga ukuthi ngingayeki ukwelashwa, kodwa umphumela waba ngesizotha kakhulu. Ezinyangeni ezimbili alahlekelwe ngu-1.5 kg.Lokhu akwanele ngesisindo sami.Ngisho nokulahleka kwamakhilogremu ayi-10 ngenxa yokusebenzisa le-serum akangijabulisi - ngithole imiphumela emibi eminingi kakhulu ngemuva kwayo. Nokho angizange ngizihlukumeze futhi ngithathe isifundo esinqunyiwe sezinyanga ezi-3, kepha ngiyeke, angafinyeleli enyangeni yokuqala.Okokuqala, kunzima impela ukwenza imijovo ngokwakho, ngaphandle kwamakhono akhethekile. Umuthi kufanele uphathwe ngokungaziphathi. Imijovo emi-2 yokuqala engingakwazanga ukuyibeka kahle - okuqukethwe ipeni lesirinji kungena emsipha, amagquma ayekhuphuka, okwakungaxazululwa isikhathi eside.Yebo, futhi lapho ihanjiswa ngokungaziphathi kahle, cishe amahora amabili, ukuvuvukala okubuhlungu kwabonwa ngisho nasendaweni yomjovo, ngoba phela, umuthi ongu-6 ml wawumningi kakhulu ukuwujova ngaphansi kwesikhumba. Ukuphazamiseka okukhulu ukuthi i-serum idinga ukuphathwa ngokuqinile ngesikhathi, ngaphandle kwesikhathi esilahlekile, kepha lokhu akusebenzi njalo.Ngemuva kwesonto ngisetshenzisiwe, ngaqala ukuba nezinkinga ngepheshana lesisu, ukukhuphuka kovalo kanye nokuqwasha. Futhi lapho kuphela inyanga wabe esesimweni sokudangala - ubunzima obunjalo, ngendlela, buboniswa kwimiyalo. Isifiso sanyamalala ngokuphelele, sasigula kusuka kuhlobo lemikhiqizo kuphela.Ngokuvamile, kugcwele kakhulu umuthi, okuyinto, ngicabanga, ofanele kuphela njengendawo yokugcina yokulwa nokukhuluphala.Umuthi ungene esimweni sokudangala okukhuluNgazihlekisa ngami, ngijove ngeSaxenda, ngomjovo, inyanga eyodwa. Futhi yize inkambo enconyiwe izinyanga ezintathu, ngashiya le ndlela yokunciphisa umzimba. Kuqale ngenani elilinganiselwe le-0,6 mg, bese lenyuka laya ku-1.2 mg.Kwakungemnandi ukwenza le mijovo, kepha ayilethi zinhlungu eziningi. Ngiqhubeke nokudla, ngaqala ukugijima ekuseni, ukuthuthukisa umphumela. Ngemuva kwamasonto amabili, ngaba nesimo sokukhathazeka. Nginethemba empilweni, futhi nakhu okuncane - kwezinye izinyembezi - noma ikuphi ukuphazamiseka okuncane ukucindezela. Kwafika eqophelweni lokuthi ngithole imibono ekhathazayo.Ngale micabango ngazilethela i-hysteria.Ngemuva kwenyanga, kwavela imiphumela yokuqala, kwaba sobala ukuthi lesi sidakamizwa siyasebenza. Futhi nokho ngayeka. Ngakusasa ekuseni ngavuka njengomuntu ojabulayo, yonke imicabango emibi yahlakazeka futhi akukho okunye okungahambanga kahle ekhanda lami.I-Saxenda 6 mg / mlI-Saksenda (liraglutide) i-3 mg - isidakamizwa esisesimweni sesisombululo sokunciphisa isisindo. Kunqunyelwe ngaphezu kokudla nokuzivocavoca. Akusizi kuphela ukwehlisa isisindo, kepha futhi konga umphumela ngokuzayo.Umuthi uvunyelwe e-United States ukwelashwa kwabantu:ngomugqa wesisindo somzimba ongaphezu kwama-30 (ukukhuluphala),enenkomba yesisindo somzimba engaphezu kwama-27 (okhuluphele) kanye nenye yezimpawu ezilandelayo: umfutho wegazi ophakeme, uhlobo 2 sikashukela, cholesterol ephezulu.Ukunaka! Ngokusho kwewebhusayithi yomkhiqizi (https://www.saxenda.com) ISaxenda ayihloselwe ukusetshenziswa ngokuhlanganyela neVictoza noma ne-insulin! Futhi akuhloselwe ukwelapha isifo sikashukela sohlobo 2.ISaxenda inento efanayo esebenzayo neViktoza - liraglutid (liraglutid). Ngakho-ke, ukusetshenziswa kwabo okuhlangene kuzoholela ekuqotheni ngokweqile kwalokhu.Imiphumela yolingo yomtholampiloNgokuthatha i-Saxenda (kanye nokudla nokuzivocavoca), iziguli zilahlekelwe cishe amakhilogremu angaphezu kuka-2,5 uma kuqhathaniswa ne-placebo: ngokwesilinganiso, i-7.8 ne-3 kg, ngokulandelana.Ngenxa yokwelashwa, ama-62% eziguli ezithatha umuthi alahlekelwe ngaphezulu kwe-5% yesisindo sokuqala, kuthi u-34% - ngaphezulu kwe-10%.Umphumela omkhulu kakhulu wokuthatha i-Saxenda uzibonakalisa kumaviki awu-8 okuqala ukwelashwa.Ngokusho kolunye ucwaningo, ama-80% eziguli ezilahlekelwe ngaphezu kwesilinganiso esingu-5% wesisindo sazo emasontweni okuqala okwelashwa abagcinanga nje ngomphumela, kepha balahlekelwa ngomunye u-6.8%.Isixazululo Esingasasebenzi 1 mli-liraglutide 6 mg(kwipeni elilodwa le-syringe eligcwaliswe ngaphambi kwesikhathi liqukethe i-3 ml yesisombululo, elihambelana ne-18 mg ye-liraglutide)ababukeli: i-sodium hydrogen phosphate dihydrate - 1,42 mg, phenol - 5.5 mg, propylene glycol - 14 mg, hydrochloric acid / sodium hydroxide (yokulungiswa kwe-pH), amanzi okujova - kufika ku-1 mlInto esebenzayo yesidakamizwa i-Saksenda ® - liraglutide - iyi-analog ye-glucagon-like peptide-1 (GLP-1), ekhiqizwa indlela yokuphinda i-biotechnology ye-DNA isebenzise ubunzima Ama-Saccharomyces cerevisiaekokuba ne-97% Homology yokulandelana kwe-amino acid ekupheleleni kwe-GLP-1 yabantu. I-Liraglutide ibopha futhi isebenze i-GLP-1 receptor (GLP-1P). ILiraglutide imelana nokuqhekeka kwe-metabolic, i-T yayo1/2 kusuka ku-plasma emva kokuphathwa kwe-s / c kungamahora ayi-13. Iphrofayili ye-pharmacokinetic ye-liraglutide, evumela iziguli ukuthi ziyiphathe kanye ngosuku, ziwumphumela wokuzihlanganisa, okuholela ekufambiseni ngokushesha umuthi, ukubopha amaprotheni e-plasma, kanye nokumelana ne-dipeptidyl peptidase-4 (DPP) -4) ne-endopeptidase engathathi hlangothi (NEP).I-GLP-1 isilawuli somzimba sokudla kanye nokudla. I-GLP-1P yatholakala ezindaweni eziningana zobuchopho ezihilelekile ekulawuleni isifiso sokudla. Ezifundweni zezilwane, ukuphathwa kwe-liraglutide kuholele ekubanjweni kwakhe ezindaweni ezithile zobuchopho, kufaka phakathi i-hypothalamus, lapho i-liraglutide, ngokusebenzisa kusebenze okuthile kwe-GLP-1P, ukwanda kwezimpawu zokugcwala kanye nokwenza buthaka amasimba endlala, ngaleyo ndlela kuholele ekwehleni kwesisindo somzimba.I-Liraglutide yehlisa isisindo somzimba womuntu ngokunciphisa isisindo se-adipose izicubu. Ukwehla kwesisindo kwenzeka ngokunciphisa ukudla. I-Liraglutide ayikhuphi ukusetshenziswa kwamandla kwamandla kwamahora angama-24. I-Liraglutide ilawula iphango ngokuthuthukisa umuzwa wokugcwala kwesisu nokuthamba, ngenkathi yenze buthaka umuzwa wendlala futhi inciphise ukusetshenziswa okulindelekile kokudla. I-Liraglutide ivuselela ukugcinwa kwe-insulin futhi inciphise ukucasha okuphezulu ngokungenangqondo kwesimo se-glucose, futhi futhi kuthuthukisa umsebenzi wamaseli we-pancreatic beta, okuholela ekunciphiseni kokuzila kwe-glucose ngemuva kokudla. Indlela yokunciphisa ukugxila kwe-glucose ifaka nokubambezeleka okuncane kokukhipha i-gastric.Ekuvivinyweni komtholampilo okuhlala isikhathi eside okubandakanya iziguli ezikhuluphele ngokweqile noma ukukhuluphala ngokweqile, ukusetshenziswa kweSaksenda ® kuhlangene nokudla kilojoule ephansi kanye nokwenyuka komzimba okuholele ekunciphiseni okukhulu kwesisindo somzimba.Imiphumela yokudla, ukudla ikhalori, ukusetshenziswa kwamandla, ukuphuma kwe-gastric, nokuzila ukudla okusheshayo noshukela we-glucose we-postprandialImiphumela yemithi ese-pharmacodynamic ye-liraglutide yafundwa ocwaningweni lwamasonto ayisi-5 olubandakanya iziguli ezikhuluphele ezingama-49 (BMI - 30- 40 kg / m 2) ngaphandle kwesifo sikashukela.Isifiso sokudla, ukudla kwekhalori nokusetshenziswa kwamandlaKukholelwa ukuthi ukwehliswa kwesisindo ngokusetshenziswa kweSaksenda ® kuhlotshaniswa nokulawulwa kokudla kanye nenani lama-kilojoule adliwayo. Isifiso sokudla sahlolwa ngaphambi nangemva kwamahora ayisi-5 ngemuva kokudla kwasekuseni okujwayelekile, ukudla okungenamkhawulo kwahlolwa ngesikhathi sasemini esalandela. ISaksenda ® ikhuphule umuzwa wokugcwala nokugcwala kwesisu ngemuva kokudla futhi yanciphisa umuzwa wendlala kanye nenani elilinganiselwe lokudla okulinganiselwe, kanye nokwehliswa kokudla okungenamkhawulo okuqhathaniswa nokuqhathaniswa ne-placebo. Lapho kuhlolwa kusetshenziswa igumbi lokuphefumula, akubangakho ukwanda kokusetshenziswa kwamandla kwamahora angama-24 okuhambisana nokwelashwa.Ukusetshenziswa kwesidakamizwa i-Saksenda ® kuholele ekubambezelweni okuncane kokukhipha i-gastric ngesikhathi sehora lokuqala ngemuva kokudla, okuholele ekwehlekeni kwezinga lokukhuphuka kokuhlushwa, kanye nokuqoqeka kweglucose yegazi ngemuva kokudla.I-glucose, i-insulin neglucagon esiswini esingenalutho nangemva kokudlaI-glucose, i-insulin ne-glucagon esiswini esingenalutho nangemva kokudla kwahlolwa ngaphambi nangemva kwamahora ayi-5 ngemuva kokudla okujwayelekile. Uma kuqhathaniswa ne-placebo, i-Saxenda ® inciphise ukuzila nokugxila kwe-glucose ye-postprandial (AUC0-60 imizuzu) phakathi nehora lokuqala ngemuva kokudla, futhi futhi kunciphise i-Auc eglue engama-5 kanye nokwandisa ushukela we-glucose (AUC0-300 imizuzu) Ngaphezu kwalokho, iSaxenda ® inciphise ukugxila kwe-postprandial glucagon (AUC0-300 imizuzu ) kanye ne-insulin (AUC0-60 imizuzu) kanye nokwanda kwe-insulin okuhlushwa0-60 imizuzu) ngemuva kokudla kuqhathaniswa ne-placebo.Ukugxila nokwanda kwe-glucose nokugxila kwe-insulin nakho kwahlolwa ngesikhathi sokuhlolwa kokuguliswa kwe-glucose yomlomo (i-PTTG) ngo-75 g ushukela ngaphambi nangemva konyaka wokuqala wokwelashwa ezigulini ezingama-3731 ezinokukhuluphala kanye nokungabekezelelwa kwe-glucose. Uma kuqhathaniswa ne-placebo, iSaxenda ® inciphise ukuzila nokukhuphuka kweglucose. Umphumela wawubonakaliswa kakhulu ezigulini ezinokulimazeka kwe-glucose. Ngaphezu kwalokho, i-Saksenda ® inciphise ukugxila kokuzila futhi yandise ukuqina kwe-insulin ngokuqhathaniswa ne-placebo.Umphumela wokuzila futhi ukwandisa ukugxila kwe-glucose ezigulini ezinesifo sikashukela sohlobo 2 noma ngokweqileI-Saxenda ® inciphise i-glucose yokuzila kanye ne-glucose ekhulayo ye-postprandial glucose (imizuzu engama-90 ngemuva kokudla, inani eliphansi lokudla okungu-3 ngosuku) kuqhathaniswa ne-placebo.Umsebenzi we-pancreatic beta cellEkuvivinyweni kwemitholampilo okufika unyaka owodwa usebenzisa iSaxenda ® ezigulini ezinokweqile noma ukukhuluphala ngokweqile kanye noma ngaphandle kwesifo sikashukela, ukuthuthukiswa nokulungiswa kokusebenza kweseli le-pancreatic beta kuboniswe kusetshenziswa izindlela zokulinganisa ezifana nemodeli yokuhlola umsebenzi we-homeostatic beta -Izinsimbi (NOMA-B) kanye nesilinganiso sokugxila kwe-proinsulin ne-insulin.Ukusebenza kahle Kwemitholampilo NokuphephaUkusebenza nokuphepha kweSaxenda ® ngokulungiswa kwesisindo komzimba isikhathi eside kuhlanganiswe nokudla okune-calories ephansi futhi kwandise ukusebenza ngokomzimba kwafundwa ezihlangwini ezi-4 ezingakhethwe, ezingaboni kabili, ezilawulwa yi-placebo (izivivinyo ezi-3 zamaviki angama-56 novivinyo olungu-1 lwamasonto angama-32). Izifundo zifake phakathi kweziguli ezingama-5358 ezigabeni ezi-4 ezahlukahlukene: 1) iziguli ezinenkinga yokukhuluphala ngokweqile noma eyeqile ngokweqile, kanye nenye yalezi zimo / izifo ezilandelayo: ukubekezelelwa kwe-glucose, i-hypertension ye-arterial, i-dyslipidemia, i-2) yeziguli ezikhuluphele ngokweqile noma ezikhuluphele kakhulu. ngohlobo lwe-2 yesifo sikashukela esingalawulwa ngokungapheleli (inani le-HbA1c ebangeni le-7-10%), ngaphambi kokuqala kocwaningo lokulungiswa kwe-HbA1c lezi ziguli ezisetshenzisiwe: ukudla nokuzivocavoca, i-metformin, i-sulfonylureas, i-glitazone yodwa noma kunoma iyiphi inhlanganisela, iziguli ezi-3) ezinokukhuluphala okune-apnea evimbayo yesilinganiso esilinganiselwe noma esinzima, 4) iziguli ezinokukhuluphala ngokweqile noma ngokweqile kanye ne-hypertension ye-arterial eyejwayelekile noma i-dyslipidemia, eye yathola ukwehla kwesisindo somzimba okungenani sika-5% ngokudla okuphansi kwekhalori.Ukwehla okwengeziwe kwesisindo somzimba kutholakale ezigulini ezinokukhuluphala / ngokweqile ezithola i-Saksenda ® ngokuqhathaniswa neziguli ezithola i-placebo kuwo wonke amaqembu afundwayo, kufaka phakathi ngokuba khona noma ukungabikhona kokubekezela kokukhubazeka kwe-glucose, thayipha isifo sikashukela esingu-2 kanye ne-apnea esemaphakathi noma enzima.Esifundweni soku-1 (iziguli ezikhuluphele ngokweqile futhi zikhuluphele, ngokubekezelelwa kwe-glucose noma ngaphandle kokulimala), ukuncipha kwesisindo kwakungu-8% ezigulini ezaziphathwa nge-Saksenda ® ngokuqhathaniswa ne-2.6% eqenjini le-placebo.Ocwaningweni 2 (iziguli ezikhuluphele nezikhuluphele ngokweqile ezinesifo sikashukela sohlobo 2), ukuncipha kwesisindo kwakungu-5.9% ezigulini eziphathwe ngeSaksenda ®, uma kuqhathaniswa ne-2% eqenjini le-placebo.Ku-Study 3 (iziguli ezikhuluphele nezikhuluphele ngokweqile ezine-apnea enqabayo), ukwehla kwesisindo kwakungu-5.7% ezigulini eziphathwe ngeSaksenda ®, uma kuqhathaniswa ne-1,6% eqenjini le-placebo.Esifundweni se-4 (iziguli ezikhuluphele ngokweqile kanye nokukhuluphala ngokweqile ngemuva kokuncipha kwesisindo esedlule okungenani i-5%), ukwehla okuqhubekayo kwesisindo somzimba kwakungu-6.3% ezigulini eziphathwe ngeSaksenda ®, uma kuqhathaniswa ne-0,2% eqenjini le-placebo. Esifundweni 4, inani elikhulu leziguli laligcina ukwehliswa kwesisindo okutholwe ngaphambi kokulashwa ngeSaksenda ® ngokuqhathaniswa ne-placebo (81.4% no-48.9%, ngokulandelana).Ngaphezu kwalokho, kubo bonke abantu abafundile, iningi leziguli ezithola iSaxenda ® lithole ukwehla kwesisindo somzimba esingekho ngaphansi kwama-5% nangaphezulu kwe-10% uma kuqhathaniswa neziguli ezithola i-placebo.Esifundweni soku-1 (iziguli ezinenkinga yokukhuluphala ngokweqile kanye nokukhuluphala ngokweqile ngokubakhona noma ukungabi bikho kokubekelwa phansi kwe-glucose), ukwehla kwesisindo somzimba okungenani esingu-5% ngeviki lama-56 lokwelashwa kwabonwa ku-63,5% weziguli ezithola i-Saxenda ®, uma kuqhathaniswa I-26.6% eqenjini le-placebo. Isilinganiso seziguli lapho ukwehla kwesisindo evikini lama-56 lokwelashwa kufinyelele ngaphezu kwe-10% kungama-32.8% eqenjini leziguli ezithola iSaksenda ®, uma kuqhathaniswa ne-10.1% eqenjini le-placebo. Sekukonke, ukwehla kwesisindo somzimba kwenzeka cishe kuma-92% eziguli ezithola iSaksenda ®, uma kuqhathaniswa cishe ne-65% eqenjini le-placebo.Umdwebo 1. Ukushintsha kwesisindo somzimba (%) ku-dynamics kuqhathaniswa nenani lokuqala ezigulini ezinokukhuluphala noma ngokweqile ngokweqile noma ngaphandle kokulimala kwe-glucose.Ukwehla kwesisindo ngemuva kwamasonto ayi-12 ekwelashwa ngeSaxenda ®Iziguli ezinempendulo yokuqala yokwelashwa zachazwa njengeziguli ezathola ukwehla kwesisindo somzimba okungenani sama-5% ngemuva kwamaviki e-12 ezokwelashwa (amasonto ama-4 wokukhushulwa komthamo kanye namasonto ayi-12 ekwelashweni komthamo we-3 mg).Ezifundweni ezimbili (iziguli ezinenkinga yokukhuluphala noma okhuluphele ngaphandle nange-Type 2 sikashukela mellitus), ama-67.5 no-50.4% weziguli athola ukwehla kwesisindo somzimba okungenani sika-5% ngemuva kwamaviki ayi-12 elashwa.Ngokuqhubeka nokwelashwa ngeSaksenda ® (kuze kube unyaka owodwa), ama-86.2% alezi ziguli athola ukwehla kwesisindo somzimba okungenani esingu-5% no-51% - okungenani ama-10%. Ukwehla kwesisindo somzimba kulezi ziguli eziqede isifundo bekungu-11.2% uma kuqhathaniswa nenani lokuqala. Ezigulini ezithole ukwehla kwesisindo somzimba esingaphansi kwama-5% ngemuva kwamasonto angama-12 wokwelashwa ngethamo le-3 mg futhi zaqeda isifundo (unyaka 1), ukwehla okujwayelekile kwesisindo somzimba kwakungu-3.8%.Ukwelashwa nge-Saksenda ® kuthuthukise kakhulu ama-glycemic indices ku-subpopulations nge-standardoglycemia, ukubekezelelwa kwe-glucose engasebenzi kahle (isilinganiso sokwehla kwe-HbA1s - 0.3%) nohlobo 2 sikashukela mellitus (ukwehla okuphakathi ku-HbA1c - 1,3%) ngokuqhathaniswa ne-placebo (ukwehla okuphakathi kwe-HbA1c - 0.1 no-0,4% ngokulandelana). Ocwaningweni oluthinta iziguli ezingabekezeleleki kahle i-glucose glucose, thayipha 2 isifo sikashukela esakhiwe ngenani elincane leziguli ezithola i-Saksenda ® ngokuqhathaniswa neqembu le-placebo (0,2 ne-1.1%, ngokulandelana). Ngokwesibalo esikhulu seziguli ezikhubazekile ukubekezelela i-glucose, ukuthuthukiswa okubucayi kwalesi simo kwabonwa kuqhathaniswa neqembu le-placebo (69,2 no-32.7%, ngokulandelana).Ocwaningweni oluthinta iziguli ezinesifo sikashukela sohlobo 2, ama-69.2 kanye nama-56,5% eziguli eziphathwe ngeSaksenda ® azuze umgomo wazo we-HbA.1s ® ukwehla okukhulu komfutho wegazi (ngamamaki angu-4,3 uma kuqhathaniswa namaphoyinti angu-1.5), ubaba (ngo-2.7 uma kuqhathaniswa namaphoyinti angu-1.8), ukujikeleza okhalweni (ngo-8,2 kuqhathaniswa no-4 cm) kanye noshintsho olukhulu ekuhliseni okusheshayo kwe-lipid (ukwehla okuphelele I-Chs nge-3,2 iphikisana ne-0.9%, ukwehla kwe-LDL ngo-3.1 uma kuqhathaniswa ne-0.7%, ukwanda kwe-HDL ngo-2,5 uma kuqhathaniswa no-0.5%, ukwehla kwe-triglycerides ngo-13.6 uma kuqhathaniswa no-4.8%) uma kuqhathaniswa ne- placebo.Lapho usebenzisa i-Saksenda ®, kube nokuncipha okukhulu uma kuqhathaniswa ne-placebo ekujuleni kobunzima be-apnea ethintekayo, okuye kwahlolwa ukuncipha kwenkomba ye-apnea-hypnoea index (YAG) ngamacala ayi-12,2 no-6.1 ngehora, ngokulandelana.Ngokunikezwa kwezindawo ezingaba khona ze-immunogenic zamaprotheni kanye ne-peptide izidakamizwa, iziguli zingakha amasosha omzimba ukuya ku-liraglutide ngemuva kokwelashwa ngeSaxenda ®. Ezifundweni zemitholampilo, i-2.5% yeziguli eziphathwe ngeSaksenda ® yathuthukisa amasosha omzimba ku-liraglutide. Ukwenziwa kwamasosha omzimba akuholelanga ekunciphiseni ukusebenza kweSaksenda ®.Ukuhlolwa KwenhliziyoImicimbi ebalulekile yenhliziyo nemithambo yegazi (MASE) kwahlolwa yiqembu labachwepheshe abazimele bangaphandle futhi lachazwa njenge-infyoction ye-myocardial engababulali, unhlangothi olungaboli nokufa ngenxa yesifo senhliziyo. Kuzo zonke izivivinyo zomtholampilo ezinde ezisebenzisa iSaxenda ®, 6 Mace ezigulini ezithola iSaksenda ®, no-10 Mace - labo abathola i-placebo. Isilinganiso sobungozi kanye ne-95% CI uma siqhathanisa iSaxenda ® ne-placebo kwakungu-0.31 0,1, 0,92. Ekuvivinyweni kwemitholampilo kwesigaba sesithathu, ukukhuphuka kwezinga lesifo senhliziyo ngesilinganiso sokushaywa / amaminithi ayi-2,5 (kusuka ku-1.6 kuye ku-3.6 beats / min ezifundweni ngazinye) kwabonwa ezigulini ezithola i-Saksenda ®. Ukwanda okukhulu kwesilinganiso senhliziyo kwabonwa ngemuva kwamaviki e-6 elashwa. Lokhu kunyuka kuguqulwe futhi kwanyamalala ngemuva kokuyekiswa kokulashwa kwe-liraglutide.Imiphumela Yokuhlola IziguliI-Saksenda ® iqhathaniswa nezikolo ezinqunyelwe ukubekezela zesiguli zezinkomba ngazinye. Ukuthuthuka okuphawuleka kwabonwa ekuhlolweni okuphelele kohlu lwemibuzo olwenziwe lula ngemiphumela yesisindo somzimba kwikhwalithi yempilo (IWQoL-Lite) nazo zonke izikali zohlu lwemibuzo lokuhlola ikhwalithi yempilo SF-36, okubonisa umthelela omuhle ezingxenyeni zomzimba nezengqondo zekhwalithi yempilo.Idatha Yokuphepha YangaphambiliIdatha eyingqayizivele esekwe ocwaningweni lokuphepha kwamakhemikhali, ubuthi obuphindaphindwe bokubeka ubuthi kanye ne-genotoxicity ayivezwanga ingozi ebantwini.Ocwaningweni we-carcinogenicity weminyaka emi-2 kumagundane namagundane, kutholakale isimila se-thyroid C-cell esingazange siholele ekufeni. Umthamo ongewona ubuthi (NOAEL) ayisungwanga kumagundane. Ezinkomeni zithola ukwelashwa izinyanga ezingama-20, ukuthuthukiswa kwalezi tumbu akuzange kubonwe. Imiphumela etholakele ezifundweni zamagundane yenzeka ngenxa yokuthi ama-rodent abucayi ikakhulukazi kumshini othile ongaqondile ubuhlanga oqondiswe yi-GLP-1 receptor. Ukubaluleka kwemininingwane etholakele abantu kuphansi, kepha akukwazi ukukhishwa ngokuphelele. Ukuvela kwamanye ama-neoplasms ahambisana nokwelapha akuzange kuphawulwe.Ucwaningo lwezilwane aluzange luveze imiphumela emibi yesidakamizwa ekuzaleni, kepha kube nokukhuphuka okumbalwa kwesifo sokufa kwangaphambi kokuzala lapho sisebenzisa imithamo ephezulu kakhulu yomuthi.Ukwethulwa kwe-liraglutide maphakathi nesikhathi sokuzivocavoca kudale ukwehla kwesisindo somzimba womama nokukhula kwe-fetus kube nomphumela ongaziwa ngokuphelele kwizimbambo kumagundane, nakunogwaja, ukuphambuka ekwakhekeni kwesikhumba. Ukukhula kwezingane ezisanda kuzalwa kumagundane kwehliswa ngesikhathi sokwelashwa nge-liraglutide, futhi lokhu kwehla kwaqhubeka ngemuva kokuncelisa ibele eqenjini liphathwe ngemithamo ephezulu yemithi. Akukaziwa ukuthi yini edale ukwehla okunjalo ekukhuleni kwamagundane asanda kuzalwa - ukwehla kokudla kwama-khalori ngabantu abakhulelwe noma umphumela oqondile we-GLP-1 kumntwana osanda kuzalwa / osanda kuzalwa.Izinkomba Saksenda ®Ngaphezu kokudla okunekhalori ephansi kanye nokuzivocavoca okwandisiwe kokusebenzisa isikhathi eside ukuze kulungiswe isisindo somzimba kwiziguli ezindala ezine-BMI: ≥30 kg / m 2 (ukukhuluphala) noma ≥27 kg / m 2 no-2 (ngokweqile) uma ikhona ukugula okukodwa okuhambisana nokukhuluphala (njengokulimazeka kwe-glucose, isifo sikashukela sohlobo 2, umfutho wegazi ophakeme, i-dyslipidemia, noma i-apnea evimbela ukulala).Imininingwane ekusetshenzisweni kweSaksenda ® kwabesifazane abakhulelwe ilinganiselwe. Izifundo zezilwane zikhombise ubuthi bokuzala (bheka Idatha Yokuphepha Yangaphambili) Ingozi engaba khona kubantu ayaziwa.Ukusetshenziswa kwesidakamizwa i-Saksenda ® ngesikhathi sokukhulelwa ku-contraindified. Lapho uhlela noma ukhulelwe, ukwelashwa ngeSaksenda ® kufanele kuyekwe.Akwaziwa ukuthi i-liraglutide idlulela obisini lwebele lomuntu. Izifundo zezilwane zikhombisile ukuthi ukungena kwe-liraglutide kanye nama-metabolites ahlobene nokwakheka kubisi lwebele kuphansi. Ucwaningo lwangaphambilini lubonise ukwehla okuhlobene nokwelashwa ekukhuleni kwamagundane asanda kuncelisa amabele (bheka Idatha Yokuphepha Yangaphambili) Ngenxa yokuntula okuhlangenwe nakho, i-Saksenda ® iphikisiwe ngesikhathi sokuncelisa.Ukuhlolwa kokusebenzelana kwezidakamizwa kwe-vitro. Amandla aphansi kakhulu we-liraglutide ukusebenzisana kwe-pharmacokinetic nezinye izinto ezisebenzayo, ngenxa yesifo se-metabolic ohlelweni lwe-cytochrome P450 (CYP) nokubopha amaprotheni e-plasma egazi.Ekuhlolweni kokusebenzelana kwezidakamizwa kwe-vivo. Ukulibaziseka okuncane kokukhipha i-gastric lapho usebenzisa i-liraglutide kungathinta ukumuncwa kwezidakamizwa ezisetshenziswa kanyekanye ukuphathwa komlomo.Izifundo zokuxhumana azikhombisanga noma yikuphi ukwehla kwezempilo okubonakalayo kokuncipha, ngakho-ke ukulungiswa komthamo akudingeki.Izifundo zokuxhumana zenziwa kusetshenziswa i-liraglutide ngethamo lika-1,8 mg. Umphumela wesilinganiso sokukhipha i-gastric wawunjalo lapho usebenzisa i-liraglutide ngethamo lika-1,8 mg no-3 mg (AUC0-300 imizuzu paracetamol). Iziguli eziningana ezilashwa nge-liraglutide zazinesiqephu okungenani esisodwa sohudo olunzima.Isifo sohudo singathinta ukumuncwa kwemithi yomlomo ehlanganayo.I-Warfarin nezinye izinto eziphuma ku-coumarin. Azikho izifundo zokusebenzisana ezenziwayo. Ukuxhumana okubalulekile ngokwezinto ngezinto okusebenzayo nge-solubility ephansi noma ngenkomba emincane yokwelapha, efana ne-warfarin, ngeke kukhishwe. Ngemuva kokuqala ukwelashwa nge-Saxenda ® ezigulini ezithola i-warfarin noma ezinye izinto eziphuma ku-coumarin, kunconywa kakhulu ukubhekwa kwe-MHO.Paracetamol (acetaminophen). I-Liraglutide ayishintshanga ukuvezwa okuphelele kwe-paracetamol ngemuva komthamo owodwa we-1000 mg. Cmax i-paracetamol yehliswe ngo-31% kanye ne-Median Tmax lenyuke ngemizuzu engu-15 Ukulungiswa kwedose nokusetshenziswa okufanayo kwe-paracetamol akudingekile.Atorvastatin. U-Liraglutide akazange ashintshe ukuvezwa okuphelele kwe-atorvastatin ngemuva komthamo owodwa we-atorvastatin 40 mg. Ngakho-ke, ukulungiswa kwamthamo we-atorvastatin lapho kusetshenziswa ngokuhlanganiswa ne-liraglutide akudingekile. Cmax i-atorvastatin yehliswe ngo-38%, kwathi i-Median Tmax kukhuphuke kusuka emahoreni ayi-1 kuye kwangama-3 ngokusetshenziswa kwe-liraglutide.Griseofulvin. U-Liraglutide akazange akushintshe ukuvezwa okuphelele kwe-griseofulvin ngemuva kokusebenzisa umthamo owodwa we-griseofulvin 500 mg. Cmax i-griseofulvin inyuswe ngo-37%, kanti i-Median Tmax akashintshiwe. Ukulungiswa kwe-dose kwe-griseofulvin nezinye izinto ezihlanganisiwe nge-solubility ephansi kanye nokungena okuphezulu akudingeki.I-Digoxin. Ukusetshenziswa komthamo owodwa we-1 mg digoxin kuhlanganiswe ne-liraglutide kwaholela ekunciphiseni kwe-AUC ye-digoxin nge-16%, ukwehla ku-Cmax ngama-31%. I-Median Tmax inyuke ukusuka emahoreni ayi-1 kuye kwayi-1.5. Ngokusekelwe kulemiphumela, ukulungiswa komthamo kwe-digoxin akudingekile.Lisinopril. Ukusetshenziswa komthamo owodwa we-lisinopril 20 mg ngokuhlanganiswa ne-liraglutide kuholele ekwehleni kwe-15% ku-AUC ye-lisinopril, ukwehla ku-Cmax ngama-27%. I-Median Tmax I-lisinopril inyuke ukusuka emahoreni ayi-6 kuye kwayi-8. Ngokusekelwe kulemiphumela, ukulungiswa kwamthamo kwe-lisinopril akufuneki.Izindlela zokuvimbela inzalo zomlomo wesibeletho emlomo. ILiraglutide inciphise uCmax i-ethinyl estradiol ne-levonorgestrel ngo-12 no-13%, ngokulandelana, ngemuva kokusebenzisa idosi elilodwa lokuvimbela inzalo lomlomo kwehomoni yomlomo. Tmax yazo zombili lezi zidakamizwa nokusetshenziswa kwe-liraglutide zikhuphuke ngamahora ayi-1.5. Awukho umphumela obalulekile womtholampilo ekuvezweni kwe-ethinyl estradiol noma levonorgestrel. Ngakho-ke, umphumela kumthelela wokuvimbela inzalo awulindelekile lapho uhlanganiswa ne-liraglutide.Ukungafaneleki. Izinto zokwelapha ezingezwe ku-Saksenda ® zingadala ukubhujiswa kwe-liraglutide. Ngenxa yokuntuleka kwezifundo zokuhambisana, lesi sidakamizwa akufanele sixube nezinye izidakamizwa.P / c. Umuthi awukwazi ukungena ngaphakathi / ku noma / m.Isidakamizwa i-Saxenda ® siphathwa kanye ngosuku noma ngasiphi isikhathi, kungakhathalekile ukuthi kudliwani ukudla. Kufanele ihanjiswe esiswini, ethangeni, noma ehlombe. Indawo nesikhathi somjovo kungashintshwa ngaphandle kokulungiswa komthamo. Noma kunjalo, kungakuhle ukunikeza imijovo cishe ngasikhathi sinye sosuku ngemuva kokukhetha isikhathi esikahle kunazo zonke.Imithamo Umthamo wokuqala ngu-0.6 mg / ngosuku. Umthamo ukhuphuka ube ngu-3 mg / ngosuku, unezela i-0.6 mg ngezikhathi okungenani isonto eli-1 ukwenza ngcono ukubekezelelana kwesisu (bheka ithebula).Uma, ngemithamo ekhulayo, entsha ibekezelelwa kabi yisiguli amasonto ama-2 alandelanayo, ukunqanyulwa kokwelashwa kufanele kubhekwe. Ukusetshenziswa komuthi okwidosi yansuku zonke yama-3 mg akunconywa.Izinkomba Dose mg AmavikiUkunyuswa komdosi ngaphezulu kwamasonto amane 0,6 1st1,2 2nd1,8 Okwesithathu2,4 4thUmthamo wokwelapha 3Ukwelashwa kweSaxenda ® kufanele kunqanyulwe uma, ngemuva kwamasonto ayi-12 kokusebenzisa umuthi ngomuthi we-3 mg / ngosuku, ukulahleka kwesisindo somzimba kwakungaphansi kwe-5% yenani lokuqala. Isidingo sokwelashwa okuqhubekayo kufanele sibuyekezwe njalo ngonyaka.Umthamo olahlekile. Uma kudlule isikhathi esingaphansi kwamahora ayi-12 ngemuva komthamo ojwayelekile, isiguli kufanele siphathe esisha ngokushesha okukhulu. Uma kusele amahora angaphansi kwayi-12 ngaphambi kwesikhathi esivamile somthamo olandelayo, isiguli akufanele singene kumthamo ophuthelwe, kepha kufanele siqale kabusha umuthi kusuka kumthamo olandelayo obuhleliwe. Ungalethi umthamo owengeziwe noma owandisiwe wokunxephezela lowo olahlekile.Iziguli ezinesifo sikashukela sohlobo 2. I-Saksenda ® akufanele isetshenziswe ngokuhlanganiswa namanye ama-agonists we-GLP-1 receptor.Ekuqaleni kokwelashwa ngeSaksenda ®, kunconyelwa ukunciphisa umthamo we-insulin secretagogues (kanye ne-sulfonylureas) ukunciphisa ingozi ye-hypoglycemia.Iziguli esezikhulile (iminyaka engama-≥65 ubudala). Ukulungiswa kwedosi ngokususelwe eminyakeni yobudala akudingekile Ukuhlangenwe nakho kokusetshenziswa kwezidakamizwa ezigulini ezineminyaka engu-≥75 kunqunyelwe, kuyadingeka ukusebenzisa umuthi ezigulini ezinjalo ngokuqapha.Ukwehluleka kwangempela Ezigulini ezinokulimazeka okuncane noma okulinganiselayo kwe-renal (i-creatinine Cl ≥30 ml / min), ukulungiswa kwamthamo akudingeki. Kunokuhlangenwe nakho okulinganiselwe ngokusetshenziswa kweSaksenda ® ezigulini ezinokulimazeka okukhulu kwe-renal (Cl creatinine ® kulezi ziguli, kufaka phakathi iziguli ezihluleka ukuhluleka kwe-re-end-phase.Umsebenzi wesibindi okhubazekile. Ezigulini ezinenkinga yesibindi sokusebenza okubucayi noma okulinganiselayo, ukulungiswa kwamthamo akudingeki. Ezigulini ezinenkinga yesibindi ukusebenza kobunzima obukhulu noma obulinganiselayo, umuthi kufanele usetshenziswe ngokuqapha. Ukusetshenziswa kwesidakamizwa i-Saksenda ® ezigulini ezinenkinga yokuqina kwesibindi kuyaphulwa.Izingane. Ukusetshenziswa kwesidakamizwa i-Saksenda ® ezinganeni nasentsheni engaphansi kweminyaka engu-18 kufakwa emthethweni lapho kungekho datha yokuphepha nokusebenza kahle.Imiyalo yeziguli ekusetshenzisweni kwesidakamizwa i-Saksenda ® solution yokulawulwa kwe-sc ye-6 mg / ml kwipeni lesirinji eligcwaliswe kuqalaNgaphambi kokusebenzisa ipeni lesirinji eligcwaliswe ngaphambili ngeSaxenda ®, kufanele ufunde ngokucophelela le miyalo.Sebenzisa ipeni ngemuva kokuba isiguli sifunde ukulisebenzisa ngaphansi kokuqondisa kukadokotela noma umhlengikazi.Bheka ilebula kwelebuli yesirinji ukuze uqiniseke ukuthi iqukethe i-Saxenda ® 6 mg / ml, bese ufunda ngokucophelela imifanekiso engezansi, ekhombisa imininingwane yepeni yenaliti nenaliti.Uma isiguli sinenkinga yokubona noma sinezinkinga ezinkulu zokubona futhi singakwazi ukwahlukanisa izinombolo kwikhawunta yedosi, ungasebenzisi ipeni lesirinji ngaphandle kosizo. Umuntu ngaphandle kokulimazeka okubukwayo, oqeqeshelwe ukusetshenziswa kahle kwepeni lesirinji eligcwaliswe ngaphambili ngeSaksenda ®, angasiza.Ipeni lesirinji eligcwaliswe ngaphambili liqukethe i-18 mg ye-liraglutide futhi likuvumela ukuba ukhethe umthamo we-0.6 mg, 1,2 mg, 1.8 mg, 2.4 mg no-3.0 mg. Ipeni yesirinji yeSaxenda ® yenzelwe ukusetshenziswa ngezinaliti ezilahlayo i-NovoFayn ® noma iNovoTvist ® efinyelela ku-8 mm ubude. Izinaliti azifakiwe kuphakethe.Imininingwane ebalulekile. Naka imininingwane emakwe njenge kubalulekile, lokhu kuyadingeka ukuze kusetshenziswe ngokuphephile ipeni lesirinji.Ipeni lesirinji eligcwaliswe kuqala ngeSaxenda ® nenaliti (isibonelo).Mina.Ukulungiselela ipeni lesirinji ngenaliti yokusebenzisaBheka igama nekhodi yemibala kwilebula yepeni yesirinji ukuze uqiniseke ukuthi iqukethe iSaksenda ®.Lokhu kubaluleke kakhulu uma isiguli sisebenzisa imishanguzo ehlukile yokujova. Ukusetshenziswa kwesidakamizwa esingalungile kungaba yingozi empilweni yakhe.Susa isicucu esibayeni sesirinji (Fig. A).Qiniseka ukuthi isixazululo esibayeni se-syringe sinokusobala futhi singenamibala (Fig. B).Bheka efasiteleni esikalini esele. Uma umuthi unamafu, ipeni lesirinji alikwazi ukusetshenziswa.Thatha inaliti entsha yokulahla bese ususa isinamatheli sokuzivikela (Fig. C).Beka inaliti esibayeni sesirinji bese uyiguqula ukuze inalithi igcobhoze ipeni lesirinji (Fig. D).Susa isiciko sangaphandle senalithi, kodwa ungasilahli (Fig. E). Kuzodingeka ngemuva kokuqedwa komjovo ukususa inaliti ngokuphepha.Susa futhi ulahle inaliti yangaphakathi yenaliti (fig. F). Uma isiguli sizama ukubuyisa ingaphakathi kwinaliti, kungenzeka ukuthi sikhethiwe. Ithonsi lekhambi lingavela ekugcineni kwenalithi. Lokhu kwenzeka okwejwayelekile, noma kunjalo, isiguli kufanele sisabheke ukuthathwa kwemithi uma kusetshenziswa okokuqala ipeni yesirinji. Inaliti entsha akufanele ifakwe kuze kube yilapho isiguli sesilungele ukwenza umjovo.Imininingwane ebalulekile. Njalo sebenzisa inaliti entsha yomjovo ngamunye ukugwema ukuqhekeka kwenalithi, ukutheleleka, ukutheleleka kanye nokwethulwa komthamo ongalungile womuthi. Ungalokothi usebenzise inaliti uma igobile noma ilimele.II. Ihlola ukutholwa kwesidakamizwaNgaphambi komjovo wokuqala, sebenzisa ipeni elisha lesirinji ukubheka ukuhamba komuthi. Uma ipeni lesirinji selivele lisebenza, iya ku-Isinyathelo III “Ukusetha Idosi”.Guqula okhethiweyo wethamo kuze kufike uphawu lokuhlola izidakamizwa (i-vvw) esibonelweni senkomba sihambisane nenkomba yedosi (Fig. G).Bamba ipeni lesirinji ngenaliti phezulu.Cindezela inkinobho yokuqala bese uyibamba kulesi sikhundla kuze kube yilapho ikhawunta yedosi ibuyela ku-zero (Fig. H).U- "0" kufanele abe ngaphambi kwenkomba yedosi. Ithonsi lesisombululo kufanele libonakale ekugcineni kwenalithi. Ithonsi elincane lingahlala ekugcineni kwenaliti, kepha ngeke lifakwe.Uma ukuvela kwekhambi ekugcineni kwenalithi kungaveli, kubalulekile ukuphinda usebenze II “Kuhlola ukutholwa kwalo muthi”, kepha kungabi ngaphezu kwezi-6. Uma ukuvela kwesisombululo kungaveli, shintsha inaliti bese uphinda lo msebenzi. Uma ukuvela kwesixazululo seSaxenda ® kungaveli, kufanele ulahle ipeni usebenzise okusha.Imininingwane ebalulekile. Ngaphambi kokusebenzisa ipeni elisha okokuqala, qiniseka ukuthi ukwehla kwesisombululo kuvela ekugcineni kwenalithi. Lokhu kuqinisekisa ukutholwa kwalo muthi.Uma ukuvela kwesisombululo kungaveli, umuthi ngeke uphathwe, noma ngabe ikhambi lokulinganisa lihamba. Lokhu kungakhombisa ukuthi inaliti ivaliwe noma yonakele. Uma isiguli singabheki ukuthathwa kwezidakamizwa ngaphambi komjovo wokuqala ngepeni entsha yesirinji, angeke singene kumthamo odingekayo futhi umphumela olindelekile wokulungiselela kweSaxenda ® ngeke uzuze.I-III. Ukulungiswa kwedosiGuqula okhethiweyo wethamo ukuze ushayele umthamo odingekayo esigulini (0.6 mg, 1.2 mg, 1.8 mg, 2.4 mg noma 3 mg) (Fig. I).Uma umthamo ungasetwanga kahle, jikisa okhethiweyo wethamo phambili noma emuva emuva kuze kube yilapho kusele umthamo ofanele. Umthamo omkhulu ongabekwa ngu-3 mg. Isikhethi somthamo sikuvumela ukuthi ushintshe umthamo. Isikhombisi sokuthathwa komthamo kuphela nesikhombisi sedosi esizokhombisa inani le-mg lomuthi ku-umthamo okhethwe isiguli.Isiguli singathatha ukuya ku-3 mg wesidakamizwa ngomuthi ngamunye. Uma ipeni lesirinji elalisetshenzisiwe liqukethe ngaphansi kwe-3 mg, ikhawunta yedosi izoma ngaphambi kokuthi i-3 ibonakale ebhokisini.Njalo lapho okhethiweyo wethamo ejikelezwa, ukuchofoza kuzwakala, umsindo wokuqhafaza uncike ekutheni yiluphi uhlangothi olukhethiweyo lomthamo oluguqukayo (phambili, emuva, noma uma umuthi oqoqiwe wedlula inani lemishanguzo yesidakamizwa esisele epeni yesirinji). Lokhu kuchofoza akufanele kubalwe.Imininingwane ebalulekile. Ngaphambi komjovo ngamunye, hlola ukuthi isiguli sakha umaki ongakanani ku-imitha nenkomba yedosi. Musa ukubala ukuchofoza kwepeni lesirinji.Isikali esilinganiselwe sikhombisa inani elilinganayo lesisombululo esisele esibayeni sepeni, ngakho-ke ngeke isetshenziselwe ukukala umthamo womuthi. Ungazami ukukhetha eminye imithamo kunemithamo ye-0.6, 1.2, 1.8, 2.4 noma 3 mg.Izinombolo ezisewodini lezinkomba kufanele ziphambuke ngokuqondile Inkomba yemithamo - lesi sikhundla siqinisekisa ukuthi isiguli sithola umthamo ofanele womuthi.Mangaki umuthi osele?Isikali esisele sibonisa inani elilinganisiwe lomuthi osele esibayeni sesirinji (Fig. K).Ukunquma ukuthi singakanani isidakamizwa esisele, sebenzisa ikhawunta yomthamo (Fig. L)Guqula okhethiweyo wethamo kuze kube yilapho ikhawunta yomuthi iyeka. Uma ikhombisa "3", okungenani i-3 mg yomuthi ishiywe esibayeni sesirinji. Uma ikhawunta yedosi ikhombisa ngaphansi kwe- "3", khona-ke lokhu kusho ukuthi asikho isidakamizwa esanele esibayeni sokufaka ukuphatha umthamo ophelele we-3 mg.Uma udinga ukufaka inani elikhulu lomuthi kunokuba ushiywe esibayeni sesirinjiUma isiguli siqeqeshwa udokotela noma umhlengikazi kuphela lapho esihlukanisa khona isilinganiso somuthi phakathi kwamapeni amabili wesirinji. Sebenzisa umshini wokubala ukuhlela imithamo yakho njengoba kunconywe udokotela noma umhlengikazi wakho.Imininingwane ebalulekile. Kufanele uqaphele kakhulu ukubala umthamo ngendlela efanele. Uma ungaqiniseki ukuthi uhlukanisa kanjani umthamo ngendlela efanele lapho usebenzisa amapeni amabili wesirinji, kufanele usethe futhi uphathe umthamo ophelele usebenzisa ipeni lesirinji entsha.IV. Ukuphathwa kwezidakamizwaFaka inaliti ngaphansi kwesikhumba usebenzisa inqubo yokujova enconywe udokotela wakho noma umhlengikazi (Fig. M).Qinisekisa ukuthi ikhawunta yedosi isendimeni yombono wesiguli. Ungathinti ikhawunta yedosi ngeminwe yakho - lokhu kungaphazamisa umjovo.Cindezela inkinobho yokuqala yonke indlela futhi uyibambe kulesi sikhundla kuze kube yilapho ikhawunta yedosi ikhombisa u "0" (Fig. N).U- "0" kumele ahluke ngqo kwinkomba yomthamo. Kulokhu, isiguli singase sizwe noma sizwe ukuchofoza.Bamba inaliti ngaphansi kwesikhumba ngemuva kokuthi ikhawunta yedosi ibuyele ku-zero, bese ubala kancane ukuya ku-6 (Fig. O).Uma isiguli sisusa inaliti ngaphansi kwesikhumba phambilini, sizobona ukuthi umuthi uphuma kanjani ngenaliti. Kulokhu, kuzodingiswa umthamo ongapheleli womuthi.Susa inaliti ngaphansi kwesikhumba (Fig. P).Uma igazi livela endaweni yomjovo, cindezela ngobumnene uswidi wekotoni endaweni yomjovo. Musa ukwenza umthambo isayithi lomjovo.Ngemuva kokuthi umjovo usuqedile, ungabona ukwehla kwekhambi ekugcineni kwenaliti. Lokhu kuyinto ejwayelekile futhi ayithinti umthamo wesidakamizwa esikhishwe.Imininingwane ebalulekile. Hlala uhlola ikhawuntari yedosi ukuze wazi ukuthi ingakanani i-Saxenda ® ekhishwe.Bamba inkinobho yokuqalisa kuze kube yilapho ikhawunta yedosi ikhombisa "0".Ungakuthola kanjani ukuqhekeka noma ukulimala kwenaliti?Uma, ngemuva kokucindezela isikhathi eside inkinobho yokuqalisa, u- "0" angaveli kwikhawunta yedosi, lokhu kungakhombisa ukuqothuka noma ukulimala kwenaliti.Lokhu kusho ukuthi isiguli asitholile isidakamizwa, noma ngabe ikhawunta yedosi isishintshe isikhundla ukusuka kwithosi lokuqala elibekwe yisiguli.Ukuthi wenzeni ngenaliti evalekile?Susa inaliti njengoba kuchaziwe ekusebenzeni kweV “Ngemuva kokuqeda umjovo” bese uphinda zonke izinyathelo eziqala ukusebenza I “Ukulungisa ipeni nenaliti entsha”.Qiniseka ukuthi umthamo odingekayo ubekelwe isiguli.Ungalokothi uthinte ikhawunta yedosi ngenkathi uphatha umuthi. Lokhu kungaphazamisa umjovo.V. Ngemuva kokuqeda umjovoLapho inaliti yangaphandle iphumula endaweni eflethini, faka isiphelo senaliti ku-cap ngaphandle kokuyithinta noma inaliti (fig. R).Lapho inaliti ingena cap, ubeke ngokucophelela cap inaliti (Fig. S). Khipha inaliti bese uyilahla, uqaphela izinyathelo zokuya ngokuya ngemiyalo kadokotela noma umhlengikazi.Ngemuva komjovo ngamunye, faka isicucu esibayeni sesirinji ukuvikela ikhambi elikuyo ekuvezweni ukukhanya (i-Fig. T).Kuyadingeka njalo ukulahla inaliti ngemuva komjovo ngamunye ukuze uqinisekise umjovo onethezekile futhi uvikele ukuvinjwa kwezinaliti. Uma inaliti ivaliwe, isiguli ngeke sikwazi ukuphatha umuthi.Lahla ipeni lesirinji elingenalutho inaliti inqanyuliwe, ngokuya ngezincomo ezinikezwe udokotela wakho, umhlengikazi, usokhemisi noma ngokuhambisana nezidingo zasendaweni.Imininingwane ebalulekile. Ukuze ugweme ukuthathwa kwenaliti ngephutha, ungalokothi uzame ukubuyisa ingaphakathi kwinaliti. Susa njalo inaliti esibayeni sepayipi ngemuva komjovo ngamunye. Lokhu kuzogwema ukuvala inaliti, ukutheleleka, ukutheleleka, ukuvuza kwesisombululo kanye nokungenisa umthamo ongafanele womuthi.Gcina ipeni nezinaliti ungafinyeleleki kubo bonke, futhi ikakhulukazi ezinganeni.Ungalokothi udlulise ipeni lakho lesirinji nalesi sidakamizwa nezinaliti kuso.Abanakekeli kufanele basebenzise izinaliti ezisetshenzisiwe ngokunakekela okuthe xaxa ukugwema imijovo eyenzeka ngengozi nokutheleleka ngesifo.Ukunakekelwa kwepeni lesirinjiUngashiyi ipeni emotweni noma enye indawo lapho kungadalulwa khona amazinga okushisa aphezulu kakhulu noma aphansi kakhulu.Musa ukusebenzisa iSaksenda ® uma ngabe iqandisiwe. Kulokhu, umphumela olindelekile wokusetshenziswa kwomuthi ngeke utholakale.Vikela ipeni lesirinji othulini, ukungcola kanye nazo zonke izinhlobo zotshwala.Ungayigezi ipeni, ungayicwilisi kuketshezi noma uyigcobe. Uma kunesidingo, ipeni lesirinji lingahlanzwa ngendwangu emanzi encibilikisiwe ngesikhunta esincane.Musa ukulahla noma ukushaya ipeni endaweni enzima.Uma isiguli siphonsa ipeni lesirinji noma singabaza ukusebenza kwaso, kufanele unamathisele inalithi entsha bese ubheka ukuhamba komuthi ngaphambi kokwenza umjovo.Ukugcwalisa kabusha ipeni lesirinji akuvunyelwe. Ipeni lesirinji engenalutho ngokushesha.Ungazami ukulungisa ipeni yesirinji ngokwakho noma ukuhlukanise.I-GLP-1 isilawuli somzimba sokudla kanye nokudla. I-liraglutide yayo yokwenziwa yokwenziwa okucwaningisisiwe ihlolwe kaningi ezilwaneni, phakathi lapho kwembulwa umphumela wazo ku-hypothalamus. Kulapho umuthi wawuthuthukisa khona amasiginali wobuthakathaka kanye nezimpawu ezibuthakathaka zendlala. Endabeni yokwehliswa kwesisindo, i-liraglutide, ngakho-ke, isixazululo seSaxenda ngokwaso sisebenza ikakhulu ngokunciphisa izicubu ze-adipose, okungenzeka ngenxa yokwehliswa kwesilinganiso sokudla okudliwayo.Njengoba umzimba ungakwazi ukwahlukanisa phakathi kwama-hormone emvelo nawokufakelwa, ukuncipha kokudla kanye nokujwayelekile kokugaya ukudla lapho usebenzisa iSaxenda kuqinisekisiwe.Ngokungafani nezithasiselo zokudla ezinezithako kwesinye isikhathi ezingazi lutho kumuntu nakwisayensi, imishanguzo ene-liraglutide ifakazele ukusebenza ngokuphelele ngokuqondene nomphumela wokuncipha kwesisindo:shintsha amazinga kashukelabuyisela ukusebenza kwamanyikwe,asize umzimba ukuthi ugcwale ngokushesha, ngenkathi udonsa ngokuphelele izakhamzimba kokudla.Ukusebenza kweSaxenda kuqinisekiswa izibalo: cishe i-80% yabasebenzisi abagxile ekunciphiseni isisindo esilahlekelwe ngempela lapho bayisebenzisa. Futhi nokho, umuthi uqobo awusebenzi kahle njengoba besingathanda. Ochwepheshe batusa ukunciphisa umzimba ukuze ungezelele ukwelashwa ngemisebenzi yomzimba nokudla okuphansi kwekhalori. Ngenxa yokusetshenziswa kweSaxenda, ukunqunyelwa kokudla akunazinhlungu, okuguqula ukwehliswa kwesisindo kube uhlelo lwezinzwa olungacasuli.Siza Ngaphambi kokungena emakethe yezokwelapha, umuthi udlule uchungechunge lwezivivinyo zokwelashwa. Ezifundweni ezi-3 kwezi-4, iqembu elilawulayo lisebenzise lo muthi amasonto angama-56, kwelinye - ngaphezu kwezinyanga ezi-2. Bonke ababambiqhaza bokuhlolwa babenenkinga evamile - ukukhuluphala ngokweqile.Ezinye zezifundo ezisebenzisa iSaxenda zathola impumelelo enkulu ekunciphiseni isisindo kuneziguli ezathatha i-placebo. Ngaphezu kokunciphisa isisindo, ososayensi baphawula ukuthuthuka kwe-glucose yegazi ne-cholesterol, kanye nokuqina kwengcindezi.Yize iqiniso lokuthi uSaksenda uzibonakalisile evela ohlangothini oluhle kakhulu, lo muthi udinga isimo esibambekayo. Ngaphambi kokuthi uqale ulahlekelwe isisindo ngomuthi, kungcono ukukala okuhle nokubi.Izinzuzo zokusebenzisa umkhiqizo wokwelapha nge-liraglutide imi ngale ndlela elandelayo:ukusebenza kahle okufakazelwe yisayensi (abanye baphatha ukulahleka okufika kuma-30 kg ngenyanga yokwelapha),ukungabikho kwezakhi ezingaziwa ekwakhiweni,amathuba okususa izifo ezihambisana nesisindo somzimba ngokweqile.Okubi kumelelwa uhlu olandelayo:izindleko eziphakeme zemithiimiphumela emibi emibiuhlu oluhlaba umxhwele lwe-contraindicationukuntuleka kwesicelo sokuncipha kwesisindo "sokungena"Imithetho nomthamoIsixazululo se-liraglutide siphathwa ngokungaziphathi kanye ngosuku ehlombe, ethangeni noma esiswini, mhlawumbe ngasikhathi sinye. Ukuphathwa kwe-Intramuscular noma intravenous kuvinjelwe! Izinga lokushisa lesisombululo ngesikhathi sokusetshenziswa kufanele libe lokushisa kwekamelo.Uhlobo olusezingeni elifanele lokufaka isicelo lubandakanya ukusetshenziswa kwe-0.6 mg yesisombululo ngosuku ngeviki lokuqala. Ngemuva kwalokho, umthamo ukhuphuka ngo-0.6 mg njalo ngeviki. Umthamo owodwa omkhulu yi-3 mg, elingana nesirinji eyodwa ye-Saxenda.Isikhathi sesifundo sokunciphisa umzimba kufanele sisungulwe ngokuhlukile. Kungcono ukuthi ubonwe ngudokotela onquma ukuqhubeka nokusebenzisa umuthi noma ukukhansele isifundo lapho kutholakala imiphumela edingekayo. Isikhathi esilinganiselwe sezifundo ziyizinyanga ezi-4, ubukhulu bungu-1 unyaka.Kubalulekile! Ukwelashwa nge-Saxenda kufanele kunqanyulwe uma, ngemuva kwamasonto ayi-12 wokulashwa komuthi umthamo we-3 mg ngosuku, ukuncipha kwesisindo kungaphansi kwe-5% yenani lokuqala.Ibuzwe yi-liraglut>I-Handle SyringeNjengoba kunikezwa imishanguzo engafani nedivaysi ethandekayo, kubalulekile ukwazi kahle izinto eziyinkimbinkimbi zokuphatha ipeni lesirinji.Isigaba sokuqala ukulungiselela, okuqukethe amaphuzu alandelayo:Ihlola impilo yeshelufu umuthi, igama layo nebhakhodi,ukususwa kwe-capUkuzihlola ngokwayo isixazululo uqobo: kufanele kungabi namabala futhi kube sobala, uma uketshezi lunamafu, akunakwenzeka ukusebenzisa,isusa isinamatheli esivikela kunaliti,kufakwa inaliti kwisirinji (kufanele ibambe ngokuqinile)ukususwa kwengquza yangaphandle,Ukususa ithumba elingaphakathiuhlola ukugeleza kwesixazululo: ngenkathi ubamba isirinji ngokuqondile, cindezela inkinobho yokuqala, ithonsi lesiphuzo kufanele livele ekugcineni kwenaliti, uma ithonsi lingabonakali, cindezela futhi, uma kungenakuphendulwa, isirinji kufanele ichithwe okwesibili, ngoba kuthathwa njengengathandeki.Kwenqatshelwe ngokuphelele ukunikeza umjovo uma inaliti igobile noma ilimele. Izinaliti ziyatholakala, ngakho-ke kufanele kusetshenziswe okusha ngomjovo ngamunye. Ngaphandle kwalokho, ukutheleleka kwesikhumba kungenzeka.Isigaba sesibili ukubeka umthamo wekhambi. Ukuze wenze lokhu, jikisa okhethiweyo kulolo olufunayo. Ngaphambi komjovo ngamunye, kubalulekile ukubheka inani lesisombululo esiqoqiwe yi-dispenser.Ngemuva kwalokho kulandela inqubo yokwethula ikhambi. Ngalesi sikhathi, ungathinti i-dispenser ngeminwe yakho, ngaphandle kwalokho umjovo ungaphazamiseka. Kungcono ukukhetha indawo yomjovo nodokotela, kodwa kunoma yikuphi, kufanelekile ukuyishintsha ngezikhathi ezithile. Ngaphambi kokwethulwa kwekhambi, isiza somjovo sihlanziwe ngohlobo lokusula utshwala. Lapho isikhumba soma, udinga ukwenza i-crease endaweni yomjovo ohlosiwe (ungakhipha i-crease kuphela ngemuva kokufakwa kwenaliti). Okulandelayo, udinga ukubamba inkinobho yokuqalisa kuze kube yilapho i-counter ikhombisa 0. Inaliti isuswe esikhunjeni ngemuva kokuthi isiguli sibaliwe saba ngu-6.Uma igazi liphume endaweni yomjovo, kufanele kufakwe i-swab yekotini, kepha akunakuphikwa ukuthi kufanele ihlanjululwe.Ukuze ugweme imiphumela engathandeki, ipeni lesirinji kufanele livikeleke othulini noketshezi, zama ukungalahli noma lishaye. Ukugcwalisa ithuluzi kabusha akunakwenzeka - ngemuva kokusebenzisa kokugcina, kufanele kuchithwe.Njengoba isakhi esisebenzayo somuthi we-Saxenda siphazamisa isizinda se-hormonal futhi siphoqa izitho eziningi ukuba zisebenze ngandlela thile, ngisho nangokubambelela ngqo kumthamo, akunakwenzeka ukugwema ukuthuthukiswa kwemiphumela emibi:ukusabela komzimbaukukhathala, ukusebenza okwehlisiwe, ubuvuvu nokudangala,ukwehluleka ukuphefumula kanye nokutheleleka kwepheyisi yokuphefumula,Izinkinga zamapheshana wesisu (phakathi kwazo isicanucanu, ukuqhakaza, ukuqunjelwa, isifo sohudo, i-dyspepsia, izinhlungu, ukugabha, i-belching ezinzima, i-gastroesophageal Reflux igqame kakhulu).Njengomthetho, imiphumela emibi iyatholakala emasontweni ambalwa okusebenzisa iSaxenda. Ngokuzayo, ukusabela okunjalo komzimba ekungenisweni kwe-liraglutide kancane kancane kuyanyamalala. Empeleni ngemuva kwamasonto amane, isimo sisejwayelekile impela. Uma izimpawu ziqhubeka, kungcono ukubonana nodokotela ngokushesha.Kuyaqabukela, kepha kwenzeka ukuthi ukwehlisa isisindo ngosizo lweSaxenda kubangela ukomisa, i-pancreatitis, cholecystitis, umsebenzi wezinso ophazamisekile.Ungayithenga kuphiUngathenga i-Saksenda rr kunethiwekhi yamakhemisi noma wenze i-oda ekhemisi le-inthanethi. Umuthi wokuthenga awudingekile. Izindleko zokufakwa kwamapeni ama-5 syringes-cishe ama-ruble angama-26,200. Ukuthenga amaphakethe emithi amaningi ngesikhathi esisodwa kungonga okuncane.Izinaliti zesirinji nazo zingathengwa ezindaweni zokuthengisa umkhiqizo uqobo. Intengo yezingcezu eziyikhulu ezingama-8 mm cishe ama-ruble angama-750. Inombolo efanayo yezinaliti ezingama-6 mm izobiza cishe ama-ruble angama-800.Kusetshenziselwa ukunciphisa inani lokudla okudliwayo, i-liraglutide ayitholakali eSaxend kuphela. Iyingxenye yesidakamizwa iVictoza, eyenziwe yinkampani efanayo. Ukukhiqizwa sekusungulwe kusukela ngonyaka we-2009. Ukukhishwa ifomu - ipeni lesirinji elinesixazululo se-liraglutide elinomthamo we-3 ml. Ukufakwa kweCatonon kunamasirinji ama-2. Izindleko - ama-ruble angama-9500.Abaningi abanciphisa isisindo bayazibuza - iVictoza noma iSaxenda yokunciphisa umzimba? Ochwepheshe bavikela ngokungathandabuzi ukhetho lwesibili, okubonisa umehluko omkhulu phakathi kwemithi: ISaksenda yisizukulwane esisha somuthi, okusho ukuthi sesithuthukile kakhulu. Emzabalazweni wokulwa nesisindo ngokweqile, kusebenza kakhulu kuneVictoza, okuthi, okokuqala, yathuthukiswa njengekhambi lesifo sikashukela. Ngaphezu kwalokho, i-syxinge yepeni yaseSaxenda yanele inani elisetshenzisiwe, futhi inani lemiphumela emibi engenzekayo kanye ne-contraindication yokwelashwa iyancishiswa.Intengo yezixazululo ngokususelwa ku-liraglutide ayibizi kumuntu wonke. Abaningi abanciphisa isisindo banentshisekelo kuma-analogues aseSaxenda, angasebenza ngempumelelo ngokulinganayo ekulweni nesisindo ngokweqile. Amakhemisi alungele ukunikela endaweni ekhombisa umphumela ofanayo wokwelapha:Belvik - amaphilisi okulawula iphango asebenza ama-receptors obuchopho abangela ukugcwala.I-Baeta iyi-amino acid amidopeptide esiza ukubambezela ukukhishwa esiswini futhi ngaleyo ndlela inciphise iphango. Kutholakala ngesimo sesisombululo esibekwe esibayeni sesirinji.I-Reduxin umuthi wokwelapha ukukhuluphala nge-sibutramine. Kutholakala kwifomu le-capsule.I-Orsoten ingumkhiqizo wezidakamizwa ngendlela yamaphilisi asuselwa ku-orlistat. Kubekelwe ukunciphisa ukumuncwa kwamafutha emzimbeni wamathumbu.I-Lixumia ingumuthi wokwelapha ukunciphisa i-hypoglycemia. Isebenza ngaphandle kokudla. Kutholakala ngesimo sesisombululo esibekwe esibayeni sesirinji.I-Forsiga ingumuthi we-hypoglycemic ngendlela yamathebulethi.INovonorm ingumuthi womlomo.Ukuqina kwesisindo kungumphumela wesibili.Ukubuyekezwa kanye nemiphumela yokunciphisa isisindoNgokwami ​​ujwayelene noSaksenda. Ngisebenzise ikhambi ekuncomeni kwe-endocrinologist (angikwazanga ukunciphisa umzimba isikhathi eside). Labo bantu ababiza umuthi ngokuthi “umlingo” mhlawumbe abakaze bawuthole. Eqinisweni, imijovo iyodwa ayiqinisekisi ukwehla kwesisindo esingu-100% - kuzofanela ulandele ukudla okune-calorie ephansi nokuvivinya umzimba. Lokhu kusho ukuthi lapho udla amakhekhe futhi uwageza ngosawoti, awudingi ukuba nethemba lokuncipha kwesisindo esinamandla ne-Saxenda. Kepha ngokuvamile, ithuluzi lihle kakhulu. I-normalizing ukugaya, isiza ukulahla izingxenye ezinkulu. Ukuphela kokuphazamiseka ukuthola imijovo. Uma ungakaze uzilimaze, kuzoba nzima.U-Anastasia, oneminyaka engama-32Ngiphawule umkhuba owodwa: lawo mantombazane adinga ukulahlekelwa amakhilogremu ambalwa avame ukuthakazelela izidakamizwa zokunciphisa umzimba. Vele, ababoni ubungozi. Kuze kube muva nje, nami bengiphakathi kwabo. Ngokuphakama okungama-169 cm, wayenesisindo esingu-65 kg futhi ezibheka njengamafutha. Ngifunde ukubuyekezwa mayelana nokunciphisa isisindo ngeSaksenda, ngiku-oda ekhemisi eliku-inthanethi. Kuqale ukugwaza. Isifiso sinciphile ngosuku lwesibili lokwelashwa. Angidlanga lutho, ngivele ngaphuza itiye namanzi. Lapho-ke isimo asizange sishintshe - ngemuva komjovo, umzimba wami wenqaba ngokwehlukana. Njengokulindelekile, imiphumela emibi ayizange ithathe isikhathi eside ukulinda: ikhanda, isicanucanu, uhlobo oluthile lwe- "cottonness", i-izinyembezi ... Ngemuva kwesonto nohhafu wokuhlolwa okunjalo, kwadingeka ngiye kudokotela. Ngenxa yalokho, ngakwazi ukunciphisa isisindo ngokufanele, kepha impilo yami yathuthumela. Ungalokothi uphinde uphinde wenze iphutha lami. Kuyingozi ukuthenga imishanguzo engaka ngaphandle kukadokotela!Sekuphele inyanga ngisebenzisa iSaksend. Ngayiqala le nkambo ngoba kwakufanele ngehlise ushukela wegazi lami. Kunqume udokotela. Angiboni imiphumela emibi engathi sína. Ngaphandle kokuthi kusihlwa kusiyezi kancane futhi kwesinye isikhathi kube nesicanucanu. Ngifunde izinto ezihlasimulisa umzimba kwi-Intanethi: abanye baba nomdlavuza wesikhumba, kanti abanye bayatyhafa. Emangele ngokweqiniso. ISaxenda yamukelwa kahle ngumzimba wami. Ngivivinya njalo, ngakho-ke nangenyanga yokwelashwa ushukela wehla usuka ku-12 uye ku-6 ngasikhathi sinye, ngakwazi ukwehla ngo-4 kg. Phambilini bekunesifiso se-wolfish, kepha manje yonke into isebangeni elamukelekayo, engijabule kakhulu ngalo. Into eyodwa iyakhathaza - inani. Isikhathi esingakanani iphakethe? Kuhlukile kuwo wonke umuntu, kepha noma kunjalo kuyabiza.Ukubuyekezwa kodokotela nochwephesheUMaria Anatolyevna, uchwepheshe-endocrinologistILiraglutide iyikhambi elisebenzayo lokukhuluphala. Umsebenzi wawo ukuthonya ama-pancreas, akhiqiza ama-hormone abhekele iqoqo lezikhilogremu - i-glucagon ne-insulin. Imakethe yanamuhla yemithi ayinikezeli izidakamizwa eziningi nge-liraglutide, ngakho-ke ezikhona zibaluleke kakhulu. Namuhla kwesinye isikhathi asisetshenziselwa izinkomba eziqondile, kepha futhi nokunciphisa isisindo. Umphumela kule ndawo ungatholakala impela, ngoba i-liraglutide isiza ukuzinzisa isifiso sokudla futhi ifukuza uhlelo lokugaya ukudla.ISaxenda ingumkhiqizo wezemithi owenziwe eDenmark. Thola kumakhemisi aseRussia kulula, ungathenga ngaphandle kadokotela. Kepha ukusetshenziswa kuyingozi ngaphandle kokucabanga. Uma uhlose ukunciphisa isisindo ngalo muthi, kufanele uqale uthintane nodokotela oyi-endocrinologist. Uma udokotela enquma ukuthi umuthi udingekile ngempela, bazonikezwa umthamo nesikhathi esifanele sesifundo. Kanye nokusetshenziswa kweSaxenda, ngincoma ukuthi kunganciphisa ukusetshenziswa kwamaswidi kanye nemikhiqizo kafulawa, kwandise ukusebenza komzimba futhi kuqede imikhuba emibi. Lapho-ke kuzophela kungalahli isisindo kuphela, kepha futhi nokuguqula isimo ngokujwayelekile.UKonstantin Igorevich, udokotela womndeniNamuhla, kuyimfashini ukusebenzisa izidakamizwa phakathi kwalabo abanciphisa isisindo esikhundleni sezinto zokudla ezinesikhathi sokukhathala.Akukho okumangazayo ukuthi: basho yonke indawo ukuthi, ngokungafani nezithako zokudla okunempilo, umuthi usiza kakhulu ukunciphisa isisindo. Kuyadabukisa, “ochwepheshe” bakhohlwa ngobungozi obuhambisana nokusetshenziswa kwemithi hhayi ngokuya izinkomba. Ngokukhethekile, iSaksenda umuthi ojwayelekile weVictoza, oklanyelwe ukwelapha isifo sikashukela sohlobo 2. Unganciphisa isisindo ngosizo lwayo uma ulisebenzisa ngokuya ngemiyalo futhi ngasikhathi sinye unamathela ekudleni okunempilo. Kepha noma yimuphi umuthi lapho i-liraglutide ikhona awunakusetshenziswa nje ukulahlekelwa yi-3-5 kg. Umphumela emzimbeni unamandla kakhulu futhi awunakuphikwa, ngoba sikhuluma ngamahomoni. Kubukeka kimi sengathi lolu lwazi kufanele lusatshalaliswe phakathi kweziguli odokotela uqobo. Futhi uma usukulungele ukuthatha ithuba, okungenani ube nentshisekelo kuhlu lwe-contraindication futhi utadishe ngokucophelela umthamo onconyiwe.Umuthi wenzelwe ukuphatha okungaqondakali. Inikezwa njengesisombululo semijovo. Umuthi uyingxenye eyodwa. Lokhu kusho ukuthi ukwakheka kufaka i-1 into esebenzayo - i-liraglutide. Ukuhlushwa kwayo ku-1 ml yesidakamizwa ngu-6 mg. Umuthi ukhiqizwa kumasirinji akhethekile. Umthamo ngamunye ngu-3 ml. Inani eliphelele lezinto ezisebenzayo kwisirinji enjalo yi-18 mg.Ukuqanjwa kuhlanganisa nezinto ezingathinti inqubo yokulahlekelwa isisindo:Umuthi unikezwa kwiphakeji equkethe amasirinji ama-5.Umuthi wenzelwe ukuphatha okungaqondakali.Ungamthatha kanjani uSaxendaI-Saxenda iyatholakala ngesimo sesisombululo se-subcutaneous (hhayi i-intramuscular!) Injection. Kuyadingeka ukwenza umjovo owodwa ngosuku, nganoma yisiphi isikhathi esikahle. Akunandaba ukudla.Umjovo wenziwa esiswini, ethangeni noma ehlombe. Kulokhu, kusetshenziswa izinaliti ezingasetshenziswa, ezibekwe phezu kwebhodlela nomuthi.Ngezansi ungabuka ividiyo enemiyalo enemininingwane yokuthi ungayithatha kanjani iSaxenda:Umuthi ubekelwe iziguli ezinesifo sikashukela i-mellitus yokulungiswa kwesisindo. ISaxendum imiselwe iziguli ezikhuluphele.Umuthi ungaphezu kokudla okufanele, okususelwa ekunciphiseni amakhalori, kanye nokukhulisa ukusebenza komzimba. Kusetshenziswa isikhathi eside kuze kube nemiphumela emihle.Umenzeli we-hypoglycemic ubekelwe iziguli ezinenkomba yesisindo somzimba ngenhla amayunithi angama-27.Kunezifo eziningi lapho kungcono ukungasebenzisi i-Saxenda. Kodwa-ke, ayikho imikhawulo eqinile ekusetshenzisweni kwalesi sidakamizwa. Ukuphulwa okuhlobene:izifundo zokuhluleka kwenhliziyo I-II,ukuguga (ngaphezulu kweminyaka engama-75),isifo se-yegiloukuthambekela kokuthuthukisa i-pancreatitis.Umuthi awusetshenziswanga ukungena emzimbeni noma ngomzimba. Ukuphatha ngokungasekelwa kwenziwa kanye ngosuku. Isikhathi sokubulawa komjovo singaba yisiphi, futhi akukho ukuncika kokudla.Izindawo ezinconyiwe zomzimba lapho umuthi uphathwa kangcono: ihlombe, ithanga, isisu.Qala inkambo yokwelashwa nge-0.6 mg yento esebenzayo. Ngemuva kwezinsuku eziyi-7, leli nani lenyuka ngomunye u-0.6 mg. Ngemuva kwalokho, umthamo uphinda ubonakale njalo ngesonto. Isikhathi ngasinye, kufanele kufakwe i-0.6 mg ye-liraglutide. Inani eliphezulu lomuthi nsuku zonke liyi-3 mg. Uma, ngokusetshenziswa isikhathi eside, kwaqashelwa ukuthi isisindo somzimba sehlile ngesisindo esingaphezu kwe-5% yesisindo sesiguli, inkambo yokwelashwa yaphazanyiswa ukuze kukhethwe i-analogue noma ukuphindaphinda umthamo.Ukuthatha umuthi wesifo sikashukelaKusetshenziswa irejimeni ejwayelekile yokwelapha, esetshenziswa kwezinye izimo. Ukugwema i-hypoglycemia, kunconywa ukunciphisa inani le-insulin.Ukugwema i-hypoglycemia, kunconywa ukunciphisa inani le-insulin.Ukulungiselela ipeni lesirinji ngenaliti yokusebenzisaUkukhwabanisa kwenziwa ngezigaba:susa isigaqa kwisirinji,kuvulwa inaliti elahliweyo (isinamatheli siyasuswa), ngemuva kwalokho singafakwa kwisirinji,masinyane ngaphambi kokuwusebenzisa, khipha ingaphakathi kwinaliti, elizofika lisebenziseka kamuva, ukuze ungakwazi ukulilahla,khona-ke cap yangaphakathi iyasuswa, ngeke isadingeka.Njalo lapho umuthi usetshenziswa, kusetshenziswa izinaliti ezingalahlwa.Ukuqhafaza phakathi kwenhliziyo nausea, izitulo ezikhululekile, noma ukuqunjelwa. Inqubo yokugaya iyaphazamiseka, ukoma emgodini womlomo kuya ngokuqina. Kwesinye isikhathi kuba nokunyakaza kokuqukethwe esiswini singene emgodini, kuqhume i-belching, ukwakheka kwegesi kuyaqina, nobuhlungu buvela esiswini esingenhla. I-pancreatitis ngezikhathi ezithile iba.Imiphumela emibi yesidakamizwa ingaba ukuhlanza imvelaphi yokucanuzelelwa kwenhliziyo.Iziguli ezingaphezu kweminyaka engama-65 zivunyelwe ukusebenzisa umuthi ukulungisa isisindo. Indlela yokufaka isicelo iyefana. Imvamisa, ukulungiswa komthamo akudingekile.Ezigulini ezinesifo sikashukela esidala kuneminyaka engama-75, umuthi awubekiwe, ezimeni ezihlukile, sisebenzisa ngokuqapha ngokulungiswa komthamo futhi ngaphansi kokuqondisa kukadokotela. Lokhu kuyasebenza nasezigulini ezinesifo sikashukela esiye satholakala ukuthi "sinokwehluleka kwezinso" noma "ukungasebenzi kahle kwesibindi."Ebuntwaneni, umuthi awunqunyelwe, ngoba akukho datha ekuphepheni nasekusebenzeni kwengane engaphansi kweminyaka eyi-18.Kwabesifazane abancelisa ibele, lo muthi uphethwe.ISaksenda noma iViktoza - okungconoKuwo womabili amalungiselelo, into eyodwa esebenzayo ikhona. I-Liraglutide isiza ukunciphisa inani lokudla okudliwayo, lo mphumela unikezwa isidakamizwa i-Saksenda. Imithi ikhiqizwa ngendlela efanayo yokukhishwa, kepha eViktoz, umthamo wengxenye esebenzayo uphakeme.Ngaphezu kwalokho, lokhu okusetshenziswayo akusetshenziselwa ukumelana nokukhuluphala kanye nokukhuluphala ngokweqile, kepha ukwenza ngcono isimo ngohlobo 2 sikashukela. I-Saxenda ayisetshenziselwa ukwelapha i-endocrine pathology.Okusho ukuthi, isidakamizwa ngasinye sihle emkhakheni waso wokufaka isicelo. Akunakuqhathaniswa, ngoba zisetshenziselwa izinhloso ezihlukile. ISaksenda - yehlisa isisindo futhi ayimvumeli ukuthi abuye, uViktoza - uphatha isifo sikashukela futhi asithinti isisindo somzimba.Engxenyeni yesibindi nepheshana elihlanganisiweUkwakheka kwe-calculi. Kukhona ushintsho lwezinkomba zelebhu ngesikhathi kuhlolwa isibindi.Ngokubonakaliswa kwayo okukhona, ezimweni eziningi, ukuthuthukiswa kwe-urticaria, ukushaqeka kwe-anaphylactic kuyaphawulwa. Amathuba okubonakala kokugcina kwezimpawu kungenxa yezimo eziningi ze-pathological: hypotension, arrhythmia, ukuphefumula komoya, ukuthambekela kwe-edema.Kokubonakaliswa okukhona komzimba lapho uthatha umuthi ezimweni eziningi, ukuthuthukiswa kwe-urticaria kuyaphawulwa.Umenzeli we-Hypoglycemic - i-glucagon-like receptor polypeptide antagonist(kwelinye ipeni lesirinji eligcwalisiwe ekuqaleni liqukethe i-3 ml yesisombululo, elihambelana ne-18 mg ye-liraglutide)Sebenzisa ebudaleniNgesikhathi sokulashwa, ukuthuthukiswa kokungaphenduki okuhle, ukuphazamiseka komzimba kungenzeki. Ngakho-ke, iminyaka yobudala ayithinti i-pharmacodynamics yomuthi. Ngalesi sizathu, ukubalwa kabusha komthamo akwenziwa.Ukufaka isicelo ebudaleni kungenzeka, ngoba ngesikhathi sokwelashwa akukho kuthuthukiswa kokungaphenduki okuhle, ukuphazamiseka komzimba.Kwenqatshelwe ukuhlanganisa iziphuzo eziqukethe utshwala kanye nomuthi okukhulunywa ngawo. Lokhu kungenxa yokwanda komthwalo esibindini, ongasiza ekunciphiseni ukumuncwa kwe-glucose.Kwenqatshelwe ukuhlanganisa iziphuzo eziqukethe utshwala kanye nomuthi okukhulunywa ngawo.Esikhundleni somuthi okukhulunywa ngawo, kusetshenziswa izindlela ezinjengalezi:Izimo zokugcina zomuthiIsirinji esingavulwanga kufanele sigcinwe esiqandisini ekushiseni kwe +2. + 8 ° C. Akunakwenzeka ukumisa iqulu okwelapha. Ngemuva kokuvula, isiponji singagcinwa emazingeni okushisa afinyelela ku- + 30 ° C noma esiqandisini. Kufanele ivalwe nge-cap yangaphandle. Izingane akufanele zithole umuthi.
