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Semaglutideinonzi glucagon-like peptide-1 (GLP-1) receptor agonist inonyanya kushandiswa kudzora mazinga eglucose muropa kune varwere vane chirwere cheshuga chechipiri. GLP-1 inonzi endogenous hormone yakavanzwa neL-masero mudumbu mudiki mushure mekudya, achitamba akawanda physiological mabasa. Semaglutide inotevedzera zviito zvemuviri zveGLP-1 uye inogadzirisa shuga yeropa uye uremu munzira nhatu huru:

1. Kusimudzirwa kweInsulin Secretion: GLP-1 inokurudzira secretion ye insulin kubva papancreatic β-cell kana mazinga eglucose eropa akakwira, zvichibatsira kuderedza shuga yeropa. Semaglutide inosimudzira maitiro aya nekuita iyo GLP-1 receptor, kunyanya kutamba basa rakakosha mukugadzirisa postprandial hyperglycemia. Iyi nzira inoita kuti Semaglutide ibudirire kuderedza mushure mekudya kweropa glucose spikes, kuvandudza huwandu hweglycemic control kune varwere vane chirwere cheshuga 2.
2. Inhibition yeGlucagon Secretion: Glucagon ihomoni inovanzwa nepancreatic α-cells inosimudzira kuburitswa kweglucose kubva pachiropa kana mazinga eglucose eropa akaderera. Nekudaro, mune varwere vane Type 2 chirwere cheshuga, glucagon secretion inowanzowedzera zvisina kujairika, zvichiita kuti kukwidziridzwa kweglucose yeropa. Semaglutide inhibits yakawandisa secretion yeglucagon nekuita iyo GLP-1 receptor, ichiwedzera kubatsira kudzikisa mazinga eglucose eropa.
3. Kunonoka kweGastric Emptying: Semaglutide inoderedzawo chiyero chekubuda kwegastric, zvinoreva kuti kufamba kwechikafu kubva mudumbu kusvika kumatumbo maduku kunononoka, zvichiita kuti kuwedzera zvishoma nezvishoma mumashure ekudya kweglucose yeropa. Mhedzisiro iyi haingobatsiri chete kudzora postprandial yeropa glucose asi zvakare inowedzera kunzwa kwekuzara, kuderedza kudya kwese kwekudya uye kubatsira mukuremerwa.

Kunze kwemigumisiro yayo pakugadzirisa glucose yeropa, Semaglutide yakaratidza zvakakosha kurasikirwa kwemabhenefiti, zvichiita kuti ive mumiriri wehutano hwekufutisa. Kuderedza uremu kunobatsira kwete kuvarwere veshuga chete asiwo kune vasina chirwere cheshuga vane kufutisa.

Iyo yakasarudzika nzira uye kiriniki inoshanda yeSemaglutide inoita kuti ive mushonga unokosha mukutarisira chirwere cheshuga. Uyezve, sezvo tsvakurudzo inofambira mberi, zvingangoshandiswa zveSemaglutide mukudzivirira kwemwoyo uye kurapa kufutisa kuri kuwedzera. Zvisinei, mamwe migumisiro, yakadai sekurwadziwa kwepamuviri uye kushungurudza, inogona kuitika panguva yekushandiswa kweSemaglutide, saka inofanira kushandiswa pasi pekutarisirwa kwechiremba.

Liraglutideis glucagon-like peptide-1 (GLP-1) receptor agonist inonyanya kushandiswa mukurapa kwerudzi rwechipiri chirwere cheshuga uye kufutisa. GLP-1 ihomoni inovanzwa neL-masero mudumbu mudiki mushure mekudya, uye inoita mabasa akawanda mukudzora shuga yeropa. Liraglutide inoteedzera chiito cheGLP-1, ichiita akati wandei akakosha maitiro emuviri:

1. Kusimudzirwa kweInsulin Secretion: Kana mazinga eglucose eropa achikwira, GLP-1 inokurudzira insulin secretion kubva mupancreatic β-cell, ichibatsira kudzikisa mazinga eglucose muropa. Liraglutide inosimudzira kuita uku nekuita iyo GLP-1 receptor, kunyanya kuvandudza kudzora shuga yeropa panguva yepostprandial hyperglycemia. Izvi zvinoita kuti Liraglutide ishandiswe zvakanyanya mukugadzirisa post-kudya yeropa glucose mazinga mune varwere vane Type 2 chirwere cheshuga.
2. Inhibition yeGlucagon Secretion: Glucagon ihomoni inovanzwa nepancreatic α-masero ayo anowanzo kurudzira kuburitswa kweglucose kubva pachiropa kana mazinga eglucose eropa akaderera. Nekudaro, mune varwere vane Type 2 chirwere cheshuga, glucagon secretion inowanzokwirisa zvisina kujairika, zvichitungamira kumazinga eglucose eropa. Liraglutide inobatsira kudzora shuga yeropa nekudzivisa glucagon secretion, kuderedza kushanduka kweglucose yeropa muvarwere vane chirwere cheshuga.
3. Kunonoka Kubvisa Gastric: Liraglutide inononotsawo kubuda kwegastric, zvichireva kuti kufamba kwechikafu kubva mudumbu kuenda kudumbu diki kunonokerwa, zvichikonzera kukwira kunonoka kwemashure ekudya glucose yeropa. Izvi hazvingobatsiri chete mukudzora glucose yeropa asiwo zvinowedzera kunzwa kwekuzara, kuderedza kudya uye kubatsira varwere kubata huremu hwavo.
4. Weight Management: Pamusoro pemhedzisiro yayo pakutonga kweglucose yeropa, Liraglutide yakaratidza kuderera kwehuremu mabhenefiti. Izvi zvinonyanya kukonzerwa nemigumisiro yaro pakuderedza gastric kubuda uye kuwedzera satiety, zvichiita kuti kuderedza caloric kudya uye kuora muviri. Nekuda kwekuita kwayo mukuderedza uremu, Liraglutide inoshandiswawo mukurapa kufutisa, kunyanya muvarwere vane chirwere cheshuga vane kufutisa.
5. Cardiovascular Protection: Zvidzidzo zvenguva pfupi yapfuura zvakaratidza kuti Liraglutide zvakare ine moyo inodzivirira mhedzisiro, ichidzikisa njodzi yemoyo. Izvi zvakakonzera kuwedzera kwayo kushandiswa kwakapararira kune varwere vane chirwere cheshuga uye chirwere chemoyo.

Muchidimbu, Liraglutide inogadzirisa shuga yeropa uye huremu kuburikidza nemaitiro akati wandei, ichiita basa rakakosha mukutonga kwechirwere cheshuga uye kuratidza kugona mukurapa kufutisa uye kudzivirira kwemoyo. Nekudaro, mamwe mhedzisiro, senge kusvotwa, kurutsa, uye hypoglycemia, inogona kuitika panguva yekushandiswa kweLiraglutide, saka inofanirwa kushandiswa pasi pekutariswa kwechiremba kuve nechokwadi chekuchengetedza uye kushanda.

TirzepatideMushonga wekuita maviri-action peptide wakagadzirirwa panguva imwe chete kuita glucagon-like peptide-1 (GLP-1) receptors uye glucose-inotsamira insulinotropic polypeptide (GIP) receptors. Iyi mbiri mbiri receptor agonism inopa Tirzepatide yakasarudzika kiriniki mabhenefiti mukudzora rudzi rwechipiri chirwere cheshuga uye kutonga huremu.

1. GLP-1 Receptor Agonism: GLP-1 inonzi endogenous hormone yakavanzwa neL-cells muura mushure mekudya, inokurudzira insulin secretion, inhibiting glucagon kusunungurwa, uye kunonoka kubuda kwegastric. Tirzepatide inokwidziridza mhedzisiro iyi nekumisikidza GLP-1 receptors, zvichibatsira kudzikisa zvinobudirira mazinga eglucose eropa, kunyanya mu postprandial glucose management. Pamusoro pezvo, GLP-1 receptor activation inowedzera satiety, kuderedza kudya uye kubatsira mukurasikirwa.
2. GIP Receptor Agonism: GIP imwe incretin hormone yakavanzwa neK-masero mumatumbo, inokurudzira insulin secretion uye kugadzirisa mafuta metabolism. Tirzepatide inowedzera kuwedzera insulin secretion ne activating GIP receptors uye ine mhedzisiro pamafuta tishu metabolism. Iyi mbiri yekuita maitiro inopa Tirzepatide mukana wakakura mukuvandudza insulin sensivity, kudzikisa mazinga eglucose eropa, uye kutonga huremu.
3. Kunonoka Kubvisa Gastric: Tirzepatide inononokawo kubvisa gastric, zvinoreva kuti kufamba kwechikafu kubva mudumbu kusvika kumatumbo maduku kunononoka, zvichiita kuti kuwedzera zvishoma nezvishoma mumashure ekudya kweglucose yeropa. Izvi hazvingobatsiri kudzora glucose yeropa asiwo zvinowedzera kunzwa kwekuzara, zvichiwedzera kuderedza kudya kwekudya.
4. Weight Management: Nekuda kwekuita kwayo kuviri kweGLP-1 uye GIP receptors, Tirzepatide yakaratidza zvakakosha mhedzisiro mukuremerwa kwekutonga. Zvidzidzo zvekiriniki zvakaratidza kuti Tirzepatide inogona kuderedza huremu hwemuviri zvakanyanya, izvo zvinonyanya kubatsira kune Type 2 chirwere cheshuga vanoda kudzora huremu hwavo.

Iyo yakawanda nzira yeTirzepatide inopa hutsva hwekurapa sarudzo mukugadzirisa mhando ye2 chirwere cheshuga, kunyatso kudzora shuga yeropa ichibatsira varwere kuwana uremu, nekudaro vachivandudza hutano hwese. Pasinei nemigumisiro yaro inokosha yekiriniki, mamwe migumisiro, yakadai sekurwadziwa kwepamuviri, inogona kuitika panguva yekushandiswa kweTirzepatide, saka inofanira kushandiswa pasi pekutarisirwa kwechiremba.

Oxytocinihomoni yepeptide inowanzoitika mu hypothalamus uye inochengetwa uye yakasunungurwa ne posterior pituitary gland. Inobata basa rakakosha muchibereko chemunhukadzi, kunyanya panguva yekuzvara uye mushure mekusununguka. Basa guru reOxytocin nderekuita kuti uterine tsandanyama dzibatane nekusunga maoxytocin receptors pamasero akatsetseka emhasuru yechibereko. Ichi chiito chakakosha pakutanga uye kuchengetedza maitiro ebasa.

Panguva yekusununguka, apo mwana anofamba nemugero rekuzvara, kubuda kweOxytocin kunowedzera, zvichiita kuti pave nekugwinya kwakasimba uye kune rhythmic uterine inobatsira kusununguka mwana. Kana kufambira mberi kwemudumbu kuchinonoka kana kuti kwakamira, yekugadzira Oxytocin inogona kuiswa mutsinga nevarapi vehutano kuti iwedzere kudzvanya kwechibereko uye kukurumidzisa hurongwa hwekubara. Iyi nzira inozivikanwa seLabor induction.

Pamusoro pekukonzera kusununguka, Oxytocin inoshandiswa zvakanyanya kudzora kubuda kweropa mushure mekusununguka, dambudziko rinowanzoitika uye rinogona kuva nengozi mushure mekusununguka. Postpartum hemorrhage inowanzoitika apo chibereko chikatadza kubata zvakanaka mushure mekusununguka. Nekusimudzira kusimba kwechibereko, Oxytocin inobatsira kuderedza kurasikirwa neropa, zvichidzikisa njodzi kuutano hwaamai hunokonzerwa nekubuda ropa kwakanyanya.

Uyezve, Oxytocin inoita basa rinokosha mukuyamwisa. Kana mwana mucheche akayamwa zamu yaamai, Oxytocin inoburitswa, zvichiita kuti matumbu emukaka abatane uye asanda mukaka nemumadhamu, zvichiita kuti mukaka ubude. Iyi nzira yakakosha pakubudirira kuyamwisa, uye Oxytocin dzimwe nguva inoshandiswa kubatsira vanaamai vanosangana nematambudziko panguva yekuyamwisa.

Pakazere, Oxytocin mushonga unokosha mukuzvara, une kushandiswa kwakapararira mukufambisa basa, kudzora kubuda kweropa mushure mekusununguka, uye kutsigira kuyamwisa. Nepo Oxytocin kazhinji yakachengeteka kushandisa, kutonga kwayo kunofanirwa kugara ichitungamirwa nenyanzvi dzekurapa kuti ive nechokwadi chemhedzisiro yekurapa uye kuderedza zvingangoitika.

Carbetocininonzi synthetic oxytocin analog inonyanya kushandiswa kudzivirira kubuda kweropa mushure mekusununguka, kunyanya kutevera zvikamu zvecesarean. Postpartum hemorrhage idambudziko rakakomba rinogona kuitika mushure mekuzvara mwana, kazhinji nekuda kweiyo uterine atony, uko chibereko chinotadza kubata zvakanaka. Carbetocin inoshanda nekusunga kune oxytocin receptors pamusoro peiyo uterine yakatsetseka tsandanyama maseru, ichimisikidza aya ma receptors, uye kuitisa uterine contractions, nekudaro ichibatsira kuderedza kurasikirwa kweropa.

Kuenzaniswa neyakasikwa oxytocin, Carbetocin ine hafu yeupenyu hurefu, zvichireva kuti inoramba ichishanda mumuviri kwenguva yakareba. Ichi chiitiko chenguva refu chinobvumira Carbetocin kuti ipe kusimba kwechibereko, zvichiita kuti zvive zvakanyanya mukudzivirira kubuda kweropa mushure mekusununguka. Pamusoro pezvo, Carbetocin haidi kuramba ichiwedzerwa senge oxytocin asi inogona kubayiwa sejekiseni rimwe chete, kurerutsa nzira dzekiriniki uye kuderedza kudiwa kwezvinhu zvekurapa.

Zvidzidzo zvekiriniki zvakaratidza kuti Carbetocin inoshanda zvakanyanya mukudzivirira kubuda ropa kunotevera zvikamu zvecesarean, zvichideredza zvakanyanya kudiwa kwekuwedzera uterotonic mishonga. Sangano reWorld Health Organisation (WHO) rakasanganisira Carbetocin semushonga wakajairwa wekudzivirira kubuda kweropa mushure mekusununguka, kunyanya mune zvigadziriso-zvishoma zvigadziriso uko zvakanakira zvedosi rimwe chete kutonga zvinonyanya kubatsira.

Zvakakosha kuziva kuti nepo Carbetocin ichipa mabhenefiti akakosha mukudzivirira kubuda kweropa mushure mekusununguka, inogona kunge isingakodzeri mamiriro ese. Mune zvimwe zviitiko, zvakadai seuterine overdistension, abnormal placental attachment, kana detachment, mamwe maitiro ekurapa angave akakodzera. Naizvozvo, kushandiswa kweCarbetocin kunofanirwa kutariswa nevanoziva nezvehutano nyanzvi zvichienderana nemamiriro chaiwo.

Muchidimbu, Carbetocin, seanalogi yeoxytocin inoshanda kwenguva refu, inoita basa rakakosha mukudzivirira kubuda kweropa mushure mekusununguka kunotevera zvikamu zvese zvekubara uye kusununguka kwemukadzi. Nokusimudzira kuputika kwechibereko, zvinobudirira kuderedza dambudziko rekubuda ropa mushure mekusununguka, kupa kuchengetedzwa kwakakosha kwekusununguka kwakachengeteka.

Terlipressinis a synthetic analog ye antidiuretic hormone inonyanya kushandiswa kurapa acute kubuda ropa kusagadzikana kunokonzerwa nechiropa cirrhosis, senge esophageal variceal kubuda ropa uye hepatorenal syndrome. Esophageal variceal kubuda ropa chinhu chinowanzoitika uye chakakomba kune varwere vane chiropa cirrhosis, nepo hepatorenal syndrome rudzi rwekutadza kweitsvo kunokonzerwa nekusashanda kwechiropa kwakanyanya.

Terlipressin inoshanda nekutevedzera chiito che antidiuretic hormone (vasopressin), zvichiita kuti tsinga ye visceral yeropa, kunyanya mudumbu, zvichideredza kuyerera kweropa kune idzi nhengo. Iyi vasoconstriction inobatsira kuderedza portal vein pressure, kuderedza njodzi yekubuda ropa. Kusiyana neyakajairwa vasopressin, Terlipressin ine nguva yakareba yekuita uye mishoma mhedzisiro, ichiita kuti ishandiswe zvakanyanya mukurapa maitiro.

Pamusoro pekushandiswa kwayo mukubuda ropa kwakanyanya, Terlipressin inoita basa rakakosha mukurapa hepatorenal syndrome. Hepatorenal syndrome inowanzoitika mumatanho epamusoro echiropa cirrhosis, inoratidzwa nekukurumidza kuderera mukushanda kweitsvo, ine yakaderera zvakanyanya yekurarama. Terlipressin inogona kuvandudza renal kuyerera kweropa, reverse itsvo kushanda kuderera, uye zvakanyanya kunatsiridza mhedzisiro yemurwere.

Zvakakosha kuziva kuti kunyange zvazvo Terlipressin inoshanda zvikuru mukurapa mamiriro ezvinhu akaoma aya, kushandiswa kwayo kunotakura dzimwe njodzi, dzakadai semigumisiro yemwoyo. Naizvozvo, Terlipressin inowanzoitwa muchipatara ichitariswa nenyanzvi dzehutano kuti ive nechokwadi chekuchengetedza uye kushanda kwekurapa.

Muchidimbu, Terlipressin, semushonga wepeptide, inoita basa risingadzoreki pakurapa kubuda ropa kwakanyanya uye hepatorenal syndrome inokonzerwa nechiropa cirrhosis. Haisi kungogadzirisa zvinobudirira kubuda kweropa asiwo inovandudza kushanda kwetsvo, kupa varwere mikana yakawanda yekuwedzera kurapwa.

Bivalirudinis a synthetic peptide drug inorongwa seyakananga thrombin inhibitor, inonyanya kushandiswa pakurapa anticoagulant, kunyanya muacute coronary syndromes (ACS) uye percutaneous coronary intervention (PCI). Thrombin inobata basa rakakosha mukuita kweropa coagulation nekushandura fibrinogen kuita fibrin, zvichitungamira mukuumbwa kwethrombus. Bivalirudin inoshanda nekusunga zvakananga kunzvimbo inoshanda yethrombin, inhibiting basa rayo, nokudaro kuwana anticoagulant mhedzisiro.

1. Direct Inhibition yeThrombin: Bivalirudin inosunga zvakananga kunzvimbo inoshanda ye thrombin, ichivharira kusangana kwayo ne fibrinogen. Kusunga uku kwakanangana zvakanyanya, zvichibvumira Bivalirudin kuvharira ese emahara thrombin uye thrombin yatosungwa kumagwamba. Nekuda kweizvozvo, Bivalirudin inonyatso kudzivirira kuumbwa kwezvivharo zvitsva uye kuwedzera kweiyo iripo.
2. Kurumidza Kutanga uye Kudzora: Bivalirudin ine kukurumidza kutanga kwechiito, nekukurumidza kuburitsa anticoagulant mhedzisiro pane intravenous administration. Zvichienzaniswa neyekare indirect thrombin inhibitors (yakadai seheparin), chiito cheBivalirudin chakazvimirira pane antithrombin III uye chinopa kudzoreka kuri nani. Izvi zvinoreva kuti anticoagulant mhedzisiro yacho inotarisika uye iri nyore kubata, kunyanya mumamiriro ekiriniki anoda kunyatso kudzora nguva yekubatana, senge PCI maitiro.
3. Pfupi Hafu yehupenyu: Bivalirudin ine hafu yehupenyu hupfupi, anenge maminetsi makumi maviri nemashanu, ichibvumira mhedzisiro yayo yeanticoagulant kuti iparare nekukurumidza mushure mekurega. Chimiro ichi chinonyanya kubatsira kune varwere vanoda pfupi asi yakanyanya anticoagulation, senge panguva yekupindira kwecoronary.
4. Ngozi Yekuderera Kweropa: Pamusana pezvinhu zvayo, Bivalirudin inopa anticoagulation inoshanda ine ngozi shoma yekubuda ropa. Zvidzidzo zvakaratidza kuti varwere vanorapwa neBivalirudin vane dambudziko rakaderera rekubuda ropa zvichienzaniswa nevaya vanogamuchira heparin yakasanganiswa neGP IIb/IIIa inhibitors. Izvi zvinoita kuti Bivalirudin ive yakachengeteka uye inoshanda anticoagulant sarudzo muACS uye PCI varwere.

Mukupfupisa, Bivalirudin, seyakananga thrombin inhibitor, inopa yakasarudzika nzira yekuita uye kliniki zvakanakira. Iyo haingodziviriri zvinobudirira thrombin kudzivirira kuumbwa kwevhavha asi zvakare ine mabhenefiti akadai sekukurumidza kutanga, pfupi hafu yehupenyu, uye yakaderera kubuda ropa. Nokudaro, Bivalirudin inoshandiswa zvakanyanya mukurapa kweacute coronary syndromes uye panguva yekupindira. Nekudaro, kunyangwe chimiro chayo chekuchengetedza chepamusoro, chinofanirwa kushandiswa pasi pekutungamirwa kwenyanzvi yehutano kuve nechokwadi chekuchengetedza kurapwa uye kushanda.

Octreotideis a synthetic octapeptide inotevedzera maitiro echisikigo somatostatin. Somatostatin ihomoni yakavanzwa ne hypothalamus uye mamwe matukisi anodzivisa kuvharwa kwehomoni dzakasiyana-siyana, kusanganisira kukura kwehomoni, insulini, glucagon, uye mahomoni emudumbu. Octreotide inoshandiswa zvakanyanya mumakiriniki ekurapa kweakasiyana mamiriro, kunyanya ayo anoda kudzora kwehomoni secretion uye zviratidzo zvine chekuita nebundu.

1. Kurapa kweAcromegaly: Acromegaly chirwere chinokonzerwa nekunyanya kuvharidzirwa kwekukura kwehomoni, kazhinji nekuda kwepituitary adenoma. Octreotide inobatsira kuderedza mazinga ekukura kwehomoni uye insulini-yakafanana nekukura-1 (IGF-1) muropa nekudzivisa kuvharidzirwa kwekukura kwehomoni, nokudaro kuderedza zviratidzo zveacromegaly, zvakadai sekuwedzera kwemaoko netsoka, kuchinja kwechimiro chechiso. , uye kurwadziwa kwemajoini.
2. Kurapa kweCarcinoid Syndrome: Carcinoid syndrome inokonzerwa nekunyanya kuvharwa kwe serotonin uye zvimwe bioactive zvinhu nemakumbo emudumbu carcinoid, zvichiita kuti zviratidzo zvakadai semanyoka, kuputika, uye chirwere chemwoyo. Octreotide inonyatso kudzora zviratidzo zvecarcinoid syndrome nekudzivisa kuvharwa kwehomoni idzi uye zvinhu, nokudaro zvichivandudza hupenyu hwevarwere.
3. Kurapa kweGastroenteropancreatic Neuroendocrine Tumors (GEP-NETs): GEP-NETs imhando isingawanzo yebundu rinowanzo tanga mudumbu remukati kana pancreas. Octreotide inoshandiswa kudzora kukura kwemamota aya uye zviratidzo zvavanokonzeresa, kunyanya mumamota anoshanda anoburitsa mahomoni akawanda. Nekuvharira mahormone akavanzwa nemamota, Octreotide inogona kuderedza kuitika kwezviratidzo uye, mune dzimwe nguva, inononoka bundu kukura.
4. Mamwe Maapplication: Pamusoro pekushandiswa kwekutanga kwataurwa pamusoro apa, Octreotide inoshandiswawo kurapa zvimwe zvisingawanzoitiki zvirwere zve endocrine, zvakadai se insulinomas, glucagonomas, uye VIPomas (mamota anobudisa vasoactive intestinal peptide). Uyezve, Octreotide inogona kushandiswa mukurapa kweacute hemorrhagic mamiriro, sekudzora kubuda kwepamusoro kwegumbo uye esophageal variceal kubuda ropa.

Pakazere, Octreotide inopa kurapa kunoshanda nekuvharisa kuburitswa kwemahomoni akasiyana, kunyanya mukugadzirisa zvirwere uye zviratidzo zvine chekuita nekubuda kwehomoni. Zvisinei, sezvo Octreotide inogona kukonzera mimwe migumisiro, yakadai sekurwadziwa kwepamuviri, gallstone formation, uye kuchinja kwemazinga eglucose yeropa, kunyatsocherechedza uye kurapwa pasi pekutungamirirwa kwechiremba zvakakosha.