Yini i-Dapagliflozin: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

I-Dapagliflozin iyimithi kadokotela esiza ukulawula amazinga kashukela egazini kubantu abanesifo sikashukela sohlobo 2. Le mithi ingeyeqembu lezidakamizwa ezibizwa ngokuthi ama-SGLT2 inhibitors, asebenza ngokusiza izinso zakho ukususa i-glucose eyeqile emzimbeni wakho ngomchamo. Ngaphandle kokuphathwa kwesifo sikashukela, odokotela baphinda babhale i-dapagliflozin ukwelapha ukuhluleka kwenhliziyo kanye nesifo sezinso esingamahlalakhona ezigulini ezithile.

Yini i-Dapagliflozin?

I-Dapagliflozin iyimithi yomlomo evimba iphrotheni ethile ezinso zakho ebizwa nge-SGLT2 (i-sodium-glucose cotransporter 2). Le phrotheni ngokuvamile isiza izinso zakho ukumunca kabusha i-glucose igcinele ngaphakathi emgudwini wakho wegazi. Uma i-dapagliflozin ivimba le phrotheni, izinso zakho zikhipha i-glucose eningi ngomchamo wakho esikhundleni sokuyigcina egazini lakho.

Ungase uyibone le mithi ngegama layo lomkhiqizo, i-Farxiga. Le mithi yaqala ukugunyazwa yi-FDA ngo-2014 futhi selokhu yaba yithuluzi elibalulekile ekuphatheni izimo eziningana. Iza njengamaphilisi owathatha ngomlomo kanye ngosuku, okwenza kube lula kubantu abaningi ukuyifaka emsebenzini wabo wansuku zonke.

Yini i-Dapagliflozin Esetshenziselwa Yona?

I-Dapagliflozin isebenza ngezinhloso ezintathu ezinkulu emithini yesimanje. Okokuqala futhi okuvame kakhulu, isiza abantu abadala abanesifo sikashukela sohlobo 2 ukulawula amazinga kashukela egazini labo uma ukudla nokuzivocavoca kuphela kunganele. Odokotela abaningi bayayibhala kanye neminye imithi yesifo sikashukela efana ne-metformin ukuhlinzeka ngokuqapha okungcono ushukela wegazi.

Okwesibili, le mithi ingasiza abantu abadala abanokuhluleka kwenhliziyo, ikakhulukazi labo abanokuncipha kwe-ejection fraction. I-ejection fraction yenhliziyo yakho ilinganisa ukuthi inhliziyo yakho iphampa kahle kangakanani igazi ngokuqina ngakunye. Uma lo msebenzi ukhubazekile, i-dapagliflozin ingasiza ukunciphisa ingozi yokulaliswa esibhedlela nokufa kwenhliziyo.

Okwesithathu, odokotela bangase banikeze i-dapagliflozin kubantu abadala abanezifo ezingamahlalakhona ezinso ukuze banciphise ukuqhubeka komonakalo wezinso. Lokhu kusetshenziswa kubaluleke kakhulu ngoba izifo ezinso zivame ukuthuthuka kanye nesifo sikashukela nezimo zenhliziyo. Umuthi usiza ukuvikela izinso zakho ekulimaleni okuqhubekayo ngenkathi usekela impilo yakho yonke.

Isebenza Kanjani I-Dapagliflozin?

I-Dapagliflozin isebenza ngendlela ehlukile kuneminye imithi eminingi yesifo sikashukela. Esikhundleni sokucindezela amanyikwe akho ukuthi akhiqize i-insulin eningi noma ukwenza amaseli akho azwele kakhulu ku-insulin, ithatha indlela eyingqayizivele ngezinso zakho. Cabanga ngezinso zakho njengezihlungi eziyinkimbinkimbi eziqhelelanisa ushukela futhi ziwubuyisele emsingeni wakho wegazi.

Uma uthatha i-dapagliflozin, ivimba amaprotheni e-SGLT2 ezinso zakho okungajwayelekile ukuthi abuyisele ushukela. Lokhu kusho ukuthi ushukela omningi uyahlelwa ngaphandle kwegazi lakho futhi uqedwe ngomchamo wakho. Ngenxa yalokho, amazinga kashukela egazini lakho ancipha ngokwemvelo ngaphandle kokubeka ingcindezi eyengeziwe emanyikweni akho.

Lo muthi ubhekwa njengosebenza kahle ngokulinganisela ekulawuleni ushukela wegazi. Ngenkathi kungenzeka ukuthi ngeke wehlise i-A1C yakho (isilinganiso sikashukela wegazi esijwayelekile ezinyangeni ezi-2-3) ngendlela emangalisayo njenge-insulin noma eminye imithi, inikeza izinzuzo eziyingqayizivele. Abantu abaningi bathola ukuncipha kwesisindo esilinganiselwe nokuncipha kwengcindezi yegazi njengemiphumela emihle yokwanda kokuqedwa kukashukela.

Kufanele Ngiyithathe Kanjani I-Dapagliflozin?

Thatha i-dapagliflozin ngendlela enembile njengoba udokotela wakho ekunqumela ngayo, ngokuvamile kanye ngosuku ekuseni. Ungayithatha nokuthi ngaphandle kokudla, okwenza kube lula ohlelweni lwakho lwansuku zonke. Gwinya ithebhulethi yonke ngamanzi kunokuyichoboza, ukuyihlafuna, noma ukuyiqhekeza.

Ukunatha lo muthi ekuseni kuvame ukunconywa ngoba kwandisa ukuchama usuku lonke. Lesi sikhathi sikusiza ukuthi ugweme ukuvakashela endlini yangasese ebusuku njalo okungase kuphazamise ukulala kwakho. Uma uqala lo muthi, ungase uqaphele ukwanda kokuchama ezinsukwini ezimbalwa zokuqala njengoba umzimba wakho uzivumela.

Hlala unamanzi amaningi ngenkathi uthatha i-dapagliflozin, ikakhulukazi ngesikhathi sezulu esishisayo noma uma uzivocavoca. Umuthi ukwenza ulahlekelwe uketshezi oluningi ngokuchama okwanda, ngakho ukuphuza amanzi amaningi kusiza ukuvimbela ukoma. Zama okungenani izinkomishi zamanzi eziyi-8 nsuku zonke ngaphandle uma udokotela wakho ekweluleka ngenye indlela.

Uma unezinkinga zezinso, udokotela wakho cishe uzoqala ngomthamo ophansi futhi aqaphe ukusebenza kwezinso zakho njalo. Bangase futhi balungise umthamo wakho ngokusekelwe ekutheni izinso zakho zisebenza kahle kangakanani nokuthi usabela kanjani emuthini.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Dapagliflozin?

I-Dapagliflozin ngokuvamile iyimithi yesikhathi eside ozoqhubeka uyithatha uma nje isiza isimo sakho futhi uyayibekezelela kahle. Ngohlobo 2 lukashukela, lokhu kuvame ukusho ukuyithatha unomphela ngoba isifo sikashukela siyisimo esingapheli esidinga ukuphathwa okuqhubekayo.

Udokotela wakho uzoqapha intuthuko yakho ngokuhlolwa kwegazi njalo kanye nokuhlolwa ukuze aqinisekise ukuthi umuthi uyaqhubeka usebenza ngempumelelo. Bazobheka amazinga kashukela egazini lakho, ukusebenza kwezinso, nempilo yonke ukuze banqume ukuthi kufanele uqhubeke yini nokuthatha i-dapagliflozin. Abanye abantu bangase badinge ukulungiswa komthamo ngokuhamba kwesikhathi ngokuya ngokuthi umzimba wabo usabela kanjani.

Uma uthatha i-dapagliflozin ngenhliziyo ehlulekayo noma isifo sezinso esingapheli, ubude bokwelashwa busekelwe esimweni sakho esithile nokuthi usabela kahle kangakanani. Udokotela wakho uzosebenza nawe ukudala uhlelo lokwelapha olubhekana nezidingo zakho zomuntu ngamunye kanye nemigomo yezempilo.

Ungayeki ukuthatha i-dapagliflozin ngokuzumayo ngaphandle kokukhuluma nodokotela wakho kuqala. Ukuyeka kungazelelwe kungabangela amazinga akho kashukela egazi ukuthi anyuke ngokushesha, okungase kube yingozi. Uma udinga ukuyeka umuthi, udokotela wakho uzokusiza ukuthi wenze kanjalo ngokuphepha futhi angase acebise ngeminye imithi.

Yiziphi Izimo Ezingezinhle ze-Dapagliflozin?

Njengayo yonke imithi, i-dapagliflozin ingabangela imiphumela emibi, nakuba kungewona wonke umuntu oyitholayo. Ukuqonda ukuthi yini ongayilindela kungakusiza ukuthi uzizwe ulungile futhi wazi ukuthi ungaxhumana nini nomhlinzeki wakho wezempilo.

Imiphumela emibi evame kakhulu ivame ukuba mncane futhi ivame ukuthuthuka njengoba umzimba wakho ujwayela umuthi:

• Ukunyuka kokuchama nokoma (kuvame kakhulu emasontweni ambalwa okuqala)
• Ukutheleleka emgudwini womchamo, ikakhulukazi kwabesifazane
• Ukutheleleka ngemvubelo endaweni yamalunga obulili
• Isiyezi noma ukukhathala lapho usukuma
• Isicanucanu noma isisu esibuhlungu
• Ubuhlungu emhlane
• Ukuqunjelwa

Le miphumela emibi evamile ivame ukungabonakali kangako njengoba umzimba wakho ujwayela umuthi. Ukunyuka kokuchama, ngokwesibonelo, kuvame ukungabi nankinga ngemva kwamasonto ambalwa okuqala okwelashwa.

Imiphumela emibi engathi sína ayivamile kodwa idinga ukunakekelwa kwezokwelapha ngokushesha. Lokhu kufaka phakathi izimpawu zokuphelelwa amanzi emzimbeni njengokoma okukhulu, umlomo owomile, noma isiyezi esingathuthuki ngokuphumula. Kufanele futhi ubheke izimpawu ze-ketoacidosis, isimo esingaba yingozi esingenzeka ngisho nangamazinga kashukela egazi ajwayelekile.

Imiphumela emibi engavamile kodwa engathi sína edinga ukunakekelwa kwezokwelapha ngokushesha ihlanganisa:

• Ukuphelelwa amanzi emzimbeni okukhulu ngezimpawu ezinjengokudideka, ukushaya kwenhliziyo okusheshayo, noma ukuquleka
• I-Diabetic ketoacidosis (iphunga lomoya elinjengama-fruity, isicanucanu, ukuhlanza, ubuhlungu besisu)
• Izifo ezinzima zamathumbu zomchamo ezisabalalela ezinso
• I-Necrotizing fasciitis (ukutheleleka okukhulu kwesicubu esingaphansi kwesikhumba esizungeze izitho zangasese)
• Ukuphendula okukhulu komzimba okunezinkinga zokuphefumula noma ukuvuvukala kobuso nomphimbo

Uma uhlangabezana nanoma yiziphi lezi zimpawu ezinzima, funa usizo lwezokwelapha ngokushesha. Ngenkathi lezi zinkinga zingavamile, ukuzazi kuzokusiza ukuthi uthole ukwelashwa ngokushesha uma kudingeka.

Ubani Ongafanele Athathe I-Dapagliflozin?

I-Dapagliflozin ayifanele wonke umuntu, futhi udokotela wakho uzocabangela ngokucophelela umlando wakho wezokwelapha ngaphambi kokuyinika. Abantu abanesifo sikashukela sohlobo 1 akufanele bathathe lo muthi ngoba kungandisa ingozi yabo yokuthuthukisa i-ketoacidosis eyingozi.

Uma unesifo esinzima sezinso, udokotela wakho cishe ngeke anikeze i-dapagliflozin noma ayisebenzise ngokucophelela okukhulu. Umuthi usebenza ngezinso zakho, ngakho ukuncipha komsebenzi wezinso kungathinta kokubili ukusebenza kwawo nokuphepha kwawo. Udokotela wakho uzohlola ukusebenza kwezinso zakho ngokuhlolwa kwegazi ngaphambi kokuqala ukwelashwa.

Ezinye izimo ezingakuvimbela ukuthi ungathathi i-dapagliflozin zihlanganisa:

• Isifo sesibindi esinzima
• Umlando we-diabetic ketoacidosis
• Ukwehluleka kwenhliziyo okukhulu okudinga ukulaliswa esibhedlela
• Umkhuhlane womchamo oqhubekayo noma umlando womdlavuza womchamo
• Ukukhulelwa noma ukuncelisa
• Ukuphelelwa amanzi emzimbeni okukhulu noma ukungalingani kwama-electrolyte

Abantu abadala bangase badinge ukucatshangelwa okukhethekile lapho bethatha i-dapagliflozin. Ushintsho oluhlobene nobudala ekusebenzeni kwezinso kanye nengozi eyengeziwe yokuphelelwa amanzi emzimbeni kusho ukuthi udokotela wakho uzokuqapha eduze futhi mhlawumbe aqale ngomthamo ophansi.

Xoxa nodokotela wakho ngayo yonke imithi oyithathayo, okuhlanganisa nemithi etholakala ngaphandle kwemvume kadokotela kanye nezithasiselo. Eminye imithi, ikakhulukazi leyo ethinta umfutho wegazi noma ushukela wegazi, ingase isebenzisane ne-dapagliflozin futhi idinge ukulungiswa komthamo.

Amagama Omkhiqizo we-Dapagliflozin

I-Dapagliflozin yaziwa kakhulu ngegama lomkhiqizo wayo elithi Farxiga, elikhiqizwa yi-AstraZeneca. Leli yigama ongase ulithole ebhodleleni lakho lemithi kanye nokupakishwa kwemithi. I-Farxiga itholakala ngamandla ahlukahlukene, ngokuvamile amaphilisi angu-5mg kanye nawangu-10mg.

Kwamanye amazwe, ungase uhlangane ne-dapagliflozin ngaphansi kwamanye amagama omkhiqizo, nakuba i-Farxiga isaqhubeka nokwaziwa kakhulu emhlabeni jikelele. Umuthi wakho wemithi angakusiza ukuthi uthole umuthi ofanele ngaphandle kokucatshangelwa igama lomkhiqizo, njengoba ezoqinisekisa ukuthi isithako esisebenzayo yi-dapagliflozin.

Eminye imithi ehlanganisiwe iqukethe i-dapagliflozin kanye neminye imithi yesifo sikashukela. Isibonelo, i-Xigduo XR ihlanganisa i-dapagliflozin ne-metformin, kuyilapho i-Qtern iyihlanganisa ne-saxagliptin. Lawa maphilisi ahlanganisiwe angaba lula uma uthatha imithi eminingi yesifo sikashukela.

Ezinye izindlela ze-Dapagliflozin

Uma i-dapagliflozin ingakulungele, ezinye izindlela ezingasiza ekuphatheni isimo sakho. Ezinye izithiyo ze-SGLT2 zisebenza ngendlela efanayo ne-dapagliflozin futhi zihlanganisa i-empagliflozin (Jardiance) kanye ne-canagliflozin (Invokana). Le mithi inezinzuzo nemiphumela emibi efanayo, nakuba izimpendulo zomuntu ngamunye zingahluka.

Ukuphathwa kwesifo sikashukela sohlobo 2, ezinye izindlela zihlanganisa amakilasi ahlukene emithi enezindlela ezihlukahlukene zokusebenza. I-Metformin isaqhubeka nokuba ukwelashwa kokuqala kubantu abaningi abanesifo sikashukela sohlobo 2. Ama-GLP-1 receptor agonists afana ne-semaglutide (Ozempic) noma i-liraglutide (Victoza) anikeza ukulawulwa okuhle koshukela wegazi ngenzuzo yokuncipha kwesisindo.

Ezinye izinketho zihlanganisa:

• Ama-DPP-4 inhibitors afana ne-sitagliptin (Januvia) ekuphakameni okuncane ushukela wegazi
• Ama-Sulfonylureas afana ne-glyburide noma i-glipizide ekunciphiseni okukhulu ushukela wegazi
• Ukwelashwa nge-insulin kubantu abanesifo sikashukela esithuthuke kakhulu noma uma eminye imithi inganele
• Ama-Thiazolidinediones afana ne-pioglitazone ekumelaneni ne-insulin

Udokotela wakho uzocabangela izidingo zakho zempilo ezithile, ezinye izimo zezokwelapha, kanye nemigomo yokwelashwa lapho ekhetha elinye elingcono kakhulu. Ukukhetha kuncike ezintweni ezifana nokuthi amanyikwe akho asebenza kahle kangakanani, impilo yezinso zakho, kanye nengozi yakho yemiphumela emibi.

Ingabe i-Dapagliflozin ingcono kune-Metformin?

I-Dapagliflozin ne-metformin zisebenza ngendlela ehlukile futhi zisebenzela izindima ezihlukene ekuphathweni kwesifo sikashukela. I-Metformin ngokuvamile iyona yokuqala imithi odokotela abayinqumayo yesifo sikashukela sohlobo 2 ngoba isetshenziswe ngokuphepha amashumi eminyaka futhi inocwaningo oluningi olusekela ukusebenza kwayo.

I-Metformin ngokuyinhloko isebenza ngokunciphisa ukukhiqizwa kwe-glucose esibindini sakho futhi ithuthukise ukuzwela kwe-insulin emisipheni yakho nezinye izicubu. Ngokuvamile iyabekezeleleka kahle, ayibizi, futhi inezinzuzo eziqinisekisiwe zenhliziyo nemithambo yegazi. Abantu abaningi abanesifo sikashukela sohlobo 2 bazoqala nge-metformin ngaphambi kokucabangela eminye imithi.

I-Dapagliflozin inikeza izinzuzo eziyingqayizivele ezinganikezwa yi-metformin. Ingaqhubela phambili ukuncipha kwesisindo esincane, yehlise umfutho wegazi, futhi inikeze izinzuzo zokuvikela inhliziyo nemithambo yegazi nezinso. Lo muthi futhi usebenza ngokuzimela ku-insulin, okwenza usebenze ngisho nalapho amanyikwe akho engakhiqizi i-insulin eningi.

Esikhundleni sokuba ngcono noma ngembi kune-metformin, i-dapagliflozin ivame ukusetshenziswa kanye ne-metformin ukuze kuthuthukiswe ukulawulwa kukashukela wegazi. Abantu abaningi bathatha yomibili imithi ndawonye, njengoba isebenza ngezindlela ezihlukene futhi igcwalisana kahle. Udokotela wakho angase angeze i-dapagliflozin uma i-metformin yodwa ingafinyeleli imigomo yakho kashukela wegazi.

Imibuzo Evame Ukubuzwa Mayelana ne-Dapagliflozin

Ingabe i-Dapagliflozin iphephile ezigulini ezinokugula kwenhliziyo?

Yebo, i-dapagliflozin ngokuvamile iphephile kubantu abanezifo zenhliziyo futhi ingase inikeze nezinzuzo zenhliziyo nemithambo yegazi. Izifundo ezinkulu zomtholampilo zibonise ukuthi lo muthi unganciphisa ingozi yokufa ngenxa yezifo zenhliziyo nokulaliswa esibhedlela ngenxa yokuhluleka kwenhliziyo kubantu abanesifo sikashukela sohlobo 2.

Lo muthi uvunyelwe ngokuqondile ukwelapha ukuhluleka kwenhliziyo ngesilinganiso esincishisiwe sokukhipha igazi, ngisho nakubantu abangenaso isifo sikashukela. Lokhu kwenza kube yigugu ikakhulukazi ezigulini ezinombili isifo sikashukela nezinkinga zenhliziyo. Udokotela wakho wenhliziyo kanye nodokotela we-endocrinologist bangasebenzisana ukunquma ukuthi i-dapagliflozin ilungele yini isimo sakho senhliziyo esithile.

Ngingenzani uma ngiphuzile i-Dapagliflozin eningi ngengozi?

Uma ngengozi uphuze i-dapagliflozin eningi kunaleyo ebekiwe, xhumana nodokotela wakho noma isikhungo sokulawula ubuthi ngokushesha. Ukuphuza okuningi kungakhuphula ingozi yakho yokuphelelwa amanzi emzimbeni, umfutho wegazi ophansi, nokungalingani kwama-electrolyte. Ungalindi ukubona ukuthi ngabe izimpawu ziyavela yini.

Ziqaphelele izimpawu zemiphumela eminingi yemithi efana nokuchama okwandayo, ukoma okukhulu, isiyezi, noma ubuthakathaka. Phuza amanzi amaningi futhi ugweme imisebenzi eqinile kuze kube yilapho ungakhuluma nomhlinzeki wezempilo. Uma uzizwa ungazizwa kahle kakhulu noma uzoquleka, funa usizo lwezempilo oluphuthumayo ngokushesha.

Ngingenzani uma ngiphuthelwe umthamo we-Dapagliflozin?

Uma uphuthelwe umthamo we-dapagliflozin, uyithathe ngokushesha lapho ukhumbula, ngaphandle uma sekuseduze isikhathi somthamo wakho olandelayo ohleliwe. Kulokho, weqa umthamo ophuthelwe bese uqhubeka nohlelo lwakho lokulinganisa olujwayelekile. Ungalokothi uthathe imithamo emibili ngesikhathi esisodwa ukuze ulungise umthamo ophuthelwe.

Ukushoda umthamo ngezikhathi ezithile ngeke kubangele izinkinga ezinkulu, kodwa zama ukugcina ukuthatha imithi nsuku zonke ukuze uthole imiphumela engcono kakhulu. Cabangela ukusetha isikhumbuzi sansuku zonke ocingweni lwakho noma kumhleli wamaphilisi ukukusiza ukhumbule. Uma uvame ukukhohlwa imithamo, khuluma nodokotela wakho ngamasu okuthuthukisa ukunamathela emithini.

Ngingayeka nini ukuthatha i-Dapagliflozin?

Kufanele uyeke kuphela ukuthatha i-dapagliflozin ngaphansi kwesiqondiso sikadokotela wakho. Njengoba isifo sikashukela, ukuhluleka kwenhliziyo, nesifo sezinso esingamahlalakhona kuyizimo eziqhubekayo, cishe uzodinga ukuqhubeka nokuthatha imithi isikhathi eside ukuze ugcine izinzuzo zayo. Ukuyeka kungazelelwe kungabangela ukuthi ushukela wakho wegazi unyuke futhi kuqede imiphumela evikelayo enhliziyweni yakho nezinso zakho.

Udokotela wakho angase ayeke ukukunika i-dapagliflozin uma uba nemiphumela emibi engathi sína, uma ukusebenza kwezinso zakho kwehla kakhulu, noma uma ezinye izimo zezempilo zenza imithi ingafaneleki. Bazosebenza nawe ukuthola ezinye izindlela ezifanele futhi baqinisekise ukuguquka okuphephile ekwelashweni okuhlukene uma kudingeka.

Ngingayithatha i-Dapagliflozin ngesikhathi sokukhulelwa?

I-Dapagliflozin ayinconyelwe ngesikhathi sokukhulelwa, ikakhulukazi ngesikhathi sesibili nesithathu. Imithi ingase ilimaze izinso zomntwana osakhulayo futhi ibangele ezinye izinkinga. Uma uhlela ukukhulelwa noma uthola ukuthi ukhulelwe ngenkathi uthatha i-dapagliflozin, xhumana nodokotela wakho ngokushesha.

Udokotela wakho uzokusiza ukuthi uguqukele kwezinye izindlela eziphephile zokukhulelwa zokuphatha isifo sakho sikashukela noma ezinye izimo. I-Insulin ivame ukuba yindlela yokwelapha ekhethwayo yesifo sikashukela ngesikhathi sokukhulelwa, njengoba ingaweli ngaphesheya kwe-placenta futhi iphephile kumama nomntwana. Ngesiqondiso esifanele sezokwelapha, ungaqhubeka nokuba nempilo enhle ngesikhathi sokukhulelwa kwakho.