Insulin - Tujeo Solostar

Mankhwala
Chochita chofunikira kwambiri cha insulini, kuphatikiza insulin glargine, ndiko kuyambiranso kwa kagayidwe kazakudwala. Insulin ndi kufananiza kwake kumachepetsa kuchuluka kwa glucose m'magazi, kumapangitsa kuti mayamwidwe azikhala ndi zotumphukira (makamaka mafupa am'mimba ndi adipose minofu) ndikuletsa kupangika kwa shuga mu chiwindi. Insulin imalepheretsa lipolysis mu adipocytes (mafuta m'magazi) ndipo imalepheretsa proteinol, pamene ikukula kaphatikizidwe ka mapuloteni.
Makhalidwe a Pharmacodynamic
Insulin glargine ndi chithunzi cha insulin yaumunthu yomwe imapangidwanso ndi mabakiteriya amtunduwu Escherichia coli (K12 strains) wogwiritsa ntchito ngati wopanga zovuta. Imakhala ndi madzi ochepa osaloŵerera m'ndale. Pa pH 4 (m'malo okhala acidic), insulin glargine imasungunuka kwathunthu. Pambuyo poyambitsa mafuta ochulukirapo, acidic yankho limaphatikizidwa, zomwe zimatsogolera pakupanga microprecipitate, komwe ma insulin glargine amatulutsidwa nthawi zonse.
Kukhazikika kwa zochita za insulin glargine ya 100ED / ml pang'onopang'ono kunayamba pang'onopang'ono kuyerekezera ndi insulin insulin, kupindika kwakeko kunali kosalala komanso kopanda mapikidwe, ndipo nthawi yayitali (idatha kuchokera ku maphunziro owerengeka a euglycemic inachitika mwa odzipereka athanzi komanso odwala omwe ali ndi shuga mtundu 1 shuga).
Zotsatira za hypoglycemic za kukonzekera kwa Tujeo SoloStar ® pambuyo pa kayendetsedwe kake kosasinthika, poyerekeza ndi kuphatikizika kwa insulin glargine 100 IU / ml, inali yowonjezereka komanso yayitali (deta kuchokera pakuwunika kwa maola 36 osachiritsika omwe amapangidwa mwa odwala 18 omwe ali ndi shuga mtundu 1 shuga). Kugwiritsa ntchito kwa mankhwalawa Tujeo SoloStar ® kumatha maola opitilira 24 (mpaka maola 36) ndi kayendetsedwe kake kosavomerezeka mu Mlingo wofunikira kwambiri (onani chithunzi pansipa).

Kukhalitsa kwa hypoglycemic kwa nthawi yayitali kukonzekera kwa Tujeo SoloStar ®, kupitilira maola opitilira 24, kumalola, ngati kuli kofunikira, kusintha nthawi yolamulidwa ndi mankhwalawa kwa maola 3 asanafike kapena maola atatu pambuyo pa nthawi yokhazikika yodwala (onani gawo "Njira ya kayendedwe ndi Mlingo").
Zosiyanasiyana mumajika a hypoglycemic zotsatira za Tujeo SoloStar ® ndi insulin glargine 100 IU / ml zimagwirizanitsidwa ndi kusintha kwa kutulutsidwa kwa insulin glargin kuchokera ku precipitate.
Kwa chiwerengero chomwecho cha insulin glargine, kuchuluka kwa Tujeo SoloStar ® kukonzekera ndi gawo limodzi mwa magawo atatu a insulin glargine 100 IU / ml. Izi zimabweretsa kuchepa kwapamwamba pamtunda wa mpweya wotere, womwe umapereka kutulutsa pang'onopang'ono kwa insulin glargine kuchokera ku kukonzekera kwa Tujeo SoloStar ®, poyerekeza ndi insulin precipitate glargine 100 IU / ml.
Momwe Mlingo wofanana wa insulin glargine ndi insulin ya anthu amathandizidwa ndi mitsempha, mphamvu yawo ya hypoglycemic inali chimodzimodzi.
Kuyankhulana ndi insulin receptors: insulin glargine imapukusidwa kwa metabolites awiri ogwira, Ml ndi M2 (onani gawo la Pharmacokinetics). Kafukufuku mu vitro idawonetsa kuti kuyanjana kwa insulin glargine ndi metabolites yake Ml ndi M2 pama reculin a insulin aanthu ndi ofanana ndi insulin yamunthu.
Kuyankhulana ndi insulin-grow factor 1 receptors (IGF-1):
chiyanjano cha insulin glargine ya IGF-1 receptor ndiyokwera nthawi 5-8 kuposa momwe munthu amapangira insulin (koma pafupifupi 70-80 nthawi yocheperako kuposa IFR-1), pomwe insulin metabolites ikufanizidwa ndi insulin yaumunthu glargine Ml ndi M2 ali ndi mgwirizano wotsika pang'ono wa IGF-1 receptor poyerekeza ndi insulin yaumunthu. Chiwonetsero chonse cha insulin (kuchuluka kwa insulin glargine ndi metabolites), yotsimikizika mwa odwala omwe ali ndi matenda a shuga 1, anali otsika kwambiri poyerekeza ndi kuchuluka kwa zomangiriza za IGF-1 receptors ndikutsatiridwa kwa njira yapamwamba ya IGO-1 receptors . Kuzungulira kwa thupi kwa endo native IGF-1 kumatha kuyendetsa njira ya matogenic proliferative, komabe, njira zochizira zotsekemera zomwe zimatsimikiziridwa panthawi ya insulin, kuphatikiza chithandizo ndi Tujeo SoloStar ®, ndizotsika kwambiri poyerekeza ndi ma pharmacological omwe amafunikira kuyambitsa njira ya mitogenic proliferative.
Zotsatira zomwe zimapezeka m'mayesero onse azachipatala a Tujeo SoloStar ® omwe anachitika ndi odwala 546 omwe ali ndi matenda amtundu wa 1 komanso odwala 2474 omwe ali ndi matenda amtundu wa 2 adawonetsa kuchepa kwa glycated hemoglobin (HbAlc) poyerekeza ndi zoyambira zawo zoyambirira Malangizo, pofika kumapeto kwa phunziroli sanali ocheperako pochizira ndi insulin glargine 100 IU / ml.
Peresenti ya odwala omwe adakwanitsa kuthana ndi HbAlc kufunika (pansipa 7%) anali ofanana m'magulu onse azachipatala.
Kutsika kwa kugundika kwa shuga m'magazi kumapeto kwa maphunzirowa ndi Tujeo SoloStar ® ndi insulin glargine 100 IU / ml inali yofanana, koma nthawi yomweyo, ndi chithandizo ndi Tujeo SoloStar ®, kuchepa kumeneku kunkachitika pang'onopang'ono panthawi yopanga mlingo.
Odwala omwe amathandizidwa ndi Tujeo SoloStar ®, pakutha kwa miyezi 6 ya chithandizo, pafupifupi kulemera kochepa kochepera 1 kg kunawonedwa.
Kusintha kwa HbAlc kunali kosadalira jenda, mtundu, zaka, kutalika kwa matenda a shuga, HbAlc, kapena body mass index (BMI).
Odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga, zotsatira za maphunziro azachipatala zawonetsa kuchepa kwakukulu komanso / kapena kutsimikizira hypoglycemia, komanso zolembedwa za hypoglycemia zokhala ndi zizindikiro zamankhwala, mukamathandizidwa ndi Tujeo SoloStar®, poyerekeza ndi insulin glargine 100 U / ml.
Ubwino wa Tujeo SoloStar ® pa insulin glargine 100 IU / ml pakuchepetsa kukhala ndi vuto lalikulu komanso / kapena kutsimikizika kwa hypoglycemia wa nocturnal kwawonetsedwa kwa odwala omwe adalandira kale mankhwala osokoneza bongo a hypoglycemic (23% yochepetsa chiopsezo) kapena insulin ndi chakudya (21% yochepetsa chiopsezo ) pakati pa sabata la 9 mpaka kumapeto kwa kafukufukuyu, poyerekeza ndi mankhwala a insulin glargine omwe ali ndi 100 PESCES / ml.
Mu gulu la odwala omwe amathandizidwa ndi Tujeo SoloStar®, poyerekeza ndi odwala omwe amathandizidwa ndi insulin glargine 100 U / ml, kuchepa kwa chiwopsezo cha hypoglycemia, onse mwa odwala omwe adalandira kale insulin mankhwala ndi odwala omwe sanalandire insulin kale, kuchepa chiwopsezo chinali chachikulu m'milungu isanu ndi itatu yamankhwala (nthawi yoyambirira yamankhwala) ndipo sizidalira zaka, jenda, mtundu, index index (IM G), komanso nthawi yayitali ya matenda a shuga (> zaka 10).
Odwala omwe ali ndi vuto la matenda a shuga a mtundu woyamba 1, kuchuluka kwa hypoglycemia pa chithandizo cha Tujeo SoloStar ® kunali kofanana ndi komwe odwala omwe ali ndi insulin glargine 100 U / ml. Komabe, chiwopsezo cha nocturnal hypoglycemia (m'magulu onse a hypoglycemia) panthawi yoyambira chithandizo chinali chochepa kwambiri kwa odwala omwe anali ndi Tujeo SoloStar ® poyerekeza ndi odwala omwe amathandizidwa ndi insulin glargine 100 U / ml.
M'mayesero azachipatala, kuyang'anira kamodzi kwa Tujeo SoloStar ® masana ndi dongosolo lokhazikika (nthawi yomweyo) kapena kusintha kosinthika kwa kayendetsedwe (osachepera 2 pa sabata, mankhwalawa adathandizidwa maola 3 isanakwane kapena maola atatu pambuyo pa nthawi yokhazikika makonzedwe, chifukwa chomwe magawo pakati pa magwiridwe adafupikitsidwira mpaka maola 18 ndikuwonjezeredwa mpaka maola 30) anali ndi vuto lofananalo pa index ya HbAlc, kusala kwa plasma glucose concentration (GPC) komanso kuchuluka kwa kumapeto kwa jekeseni kusintha kwa shuga m'magazi m'magazi pakudzisankha nokha. Kuphatikiza apo, mukamagwiritsa ntchito Tujeo SoloStar® ndi nthawi yokhazikika kapena yosinthika, panalibe kusiyana kulikonse pazochitika za hypoglycemia nthawi iliyonse masana kapena usiku hypoglycemia. Zotsatira za kafukufuku woyerekeza Tujeo SoloStar ® ndi insulin glargine 100 IU / ml sizinawonetse kukhalapo kwa kusiyana kulikonse pakuwoneka bwino, chitetezo kapena mlingo wa insulini ya basal yomwe imagwirizana ndi kupanga kwa antibodies kupita ku insulin pakati pa odwala omwe amathandizidwa ndi Tujeo SoloStar ® ndi insulin Glargine 100 PIECES / ml (onani gawo "Zotsatira zoyipa").
Mu kafukufuku wapadziko lonse lapansi, wama multicenter, osasinthika, ORIGIN (Outcome Reduction with Initial Glargine INtervention), ophatikiza odwala 12537 omwe ali ndi vuto la kusala kudya glycemia (HH), kulolerana kwa glucose (NTG) kapena gawo loyambirira la 2 matenda a shuga komanso kutsimikizira matenda a mtima. kuti mankhwala a insulin glargine omwe ali ndi 100 PIECES / ml, poyerekeza ndi chithandizo cha hypoglycemic, sichinasinthe chiopsezo chokhala ndi vuto la mtima (kufa ndi mtima, kupha kwa myocardial infarction kapena kusafa stroko, chiopsezo cha kusinthanso kwa mitsempha (coronary, carotid kapena zotumphukira mitsempha) kapena chiwopsezo chogonekedwa m'chipatala chifukwa cha chotupa cha mtima. Chiwopsezo cha zovuta zamtundu wa cellvas (kuphatikiza chizindikiro cha zovuta zamasamba: laser photocoagulation kapena vitibleomy, kutaya kwamaso chifukwa cha matenda ashuga. , kapena kuwirikiza kawiri kwa ndende ya creatinine m'magazi, kapena kupezeka kwa kufunika kwa mankhwala a dialysis.
Pakafukufuku wofufuza momwe insulin glargine 100 IU / ml ikuyambira pa matenda ashuga a zaka zisanu pakuwunika kwa odwala omwe ali ndi matenda a shuga a 2, panalibe kusiyana kwakukulu pakayesedwe ka matenda ashuga retinopathy pochiza insulin glargine 100 IU / ml, poyerekeza ndi insulin isofan.
Magulu apadera a odwala
Ghana ndi mtundu
Panalibe kusiyana pakukhazikika ndi chitetezo cha Tujeo SoloStar ® ndi insulin glargine 100 IU / ml kutengera mtundu ndi mtundu wa odwala.
Odwala okalamba
M'mayeso azachipatala olamulidwa, odwala 716 (23% yaanthu kuti awone ngati ali ndi chitetezo) okhala ndi matenda amtundu wa 1 ndi mtundu wa 2 anali ndi zaka> 65 ndi odwala 97 (3%) anali ndi zaka> 75 zaka. Pazonse, panalibe kusiyana pakukwaniritsidwa komanso chitetezo cha mankhwalawa pakati pa odwalawa ndi odwala aang'ono. Odwala okalamba omwe ali ndi matenda osokoneza bongo, kuti apewe kutengeka kwa hypoglycemic, mlingo woyambirira ndi kukonza ziyenera kutsika, ndikuwonjezera mlingo. Odwala okalamba angavutike kuzindikira hypoglycemia. Kuwunikira mosamala kuchuluka kwa shuga m'magazi kumalimbikitsidwa, ndipo mlingo wa insulin uyenera kusinthidwa payekhapayekha (onani gawo "Mlingo ndi Ulamuliro" ndi "Pharmacokinetics").
Odwala omwe ali ndi vuto la impso
M'mayeso azachipatala olamulidwa, kuwunikira kwa gulu la impso (komwe kumatsimikiziridwa ndi zotsatira za kusefukira kwa glomerular> 60 ml / mphindi / 1.73 m2 ya thupi) sikunawonetse kusiyana pakutetezeka ndi kuchita pakati pa Tujeo SoloStar ® ndi insulin glargine 100 U / ml Kuwunikira mosamala kuchuluka kwa shuga m'magazi kumalimbikitsidwa, ndipo mlingo wa insulin uyenera kusinthidwa payekhapayekha (onani "Mlingo ndi Administration" ndi "Pharmacokinetics").
Odwala onenepa
M'maphunziro azachipatala, kuwunika kwa gulu lozikidwa pamzera woloza thupi (BMI) (mpaka 63 kg / mita 2) sikunawonetse kusiyana kulikonse pakuwoneka bwino komanso chitetezo pakati pa Tujeo SoloStar ® ndi insulin glargine 100 IU / ml.
Odwala odwala
Palibe zambiri pakugwiritsa ntchito mankhwalawa Tujo SoloStar® mwa ana.
Pharmacokinetics
Madzi ndi kugawa
Pambuyo pobayira jakisoni wa Tujeo SoloStar ® kwa odzipereka odzipereka komanso odwala matenda ashuga, kuchuluka kwa insulini kumawonetsa kuchepa kwapang'onopang'ono komanso nthawi yayitali, komwe kumapangitsa kupindika kofatsa kwambiri kwa maola mpaka 36, ​​poyerekeza ndi insulin glargine 100 PIECES / ml. Kuphatikizika kwa nthawi ya Tujeo SoloStar ® kumachitika motsutsana ndi mapangidwe ake a pharmacodynamic. Chiyanjano chofananira mkati mwa zochiritsira zochiritsika chimatheka pambuyo pa masiku 3-4 ogwiritsira ntchito mankhwalawa tsiku lililonse Tujo SoloStar®.
Pambuyo pa subcutaneous jakisoni wa Tujeo SoloStar ®, kusinthasintha kwa wodwala yemweyo, kumatanthauzidwa kuti kuphatikiza kosinthika kwazomwe zimachitika pang'onopang'ono kwa insulin kwa maola 24 pachikhalidwe chofika ndende yofanana, inali yotsika (17.4%).
Kupenda
Mwa anthu, pambuyo pa subcutaneous makonzedwe a Tujeo SoloStar ®, insulin glargine imapangidwa mofulumira ndi carboxyl end (C-terminus) ya P-unyolo ndikupanga ma metabolites awiri ogwira Ml (21A-Gly-insulin) ndi M2 (21 A-Gly-des-30B- Thr-insulin). Nthawi zambiri metabolite Ml imazungulira m'madzi a m'magazi. Kuwonetsedwa mwadongosolo kwa Ml metabolite kumawonjezeka ndi kuwonjezeka kwa mankhwala a Tujeo SoloStar ® Kuyerekeza kwa pharmacokinetics ndi data ya pharmacodynamics kunawonetsa kuti zotsatira za mankhwalawa zimachitika makamaka chifukwa cha kuwonetsa kwa metabolite ya Ml. Mwa kuchuluka kwa odwala, insulin glargine ndi metabolite M2 sizikanakhoza kupezeka mu kayendedwe kazinthu. Muzochitika komwe kunali kotheka kudziwa insulin glargine ndi metabolite M2 m'magazi, kutsimikizika kwawo sikudalira mlingo womwe umayendetsedwa ndi mtundu wa insulin glargine.
Kuswana
Hafu ya moyo wa metabolite Ml, kuchuluka kwa metabolite wa mankhwala a Tujeo SoloStar ®, atabayira jakisoni wa mankhwalawa ndi maola 18 mpaka 19, mosaganizira kuchuluka kwake.
Omagulu odwala
Zaka ndi jenda
Palibe chidziwitso pazokhudza mtundu ndi jenda pa pharmacokinetics of insulin glargine (onani gawo la Pharmacodynamics).
Odwala okalamba
Zotsatira za ukalamba pa pharmacokinetics za Tujeo SoloStar ® sizinaphunzirepobe. Odwala okalamba omwe ali ndi matenda osokoneza bongo, kuti apewe kutengeka kwa hypoglycemic, mlingo woyambirira ndi kukonza ziyenera kutsikirako, ndipo kuchuluka kwa mankhwalawa kuyenera kuchepetsedwa (onani magawo "Pharmacodynamics" ndi "Njira yogwiritsira ntchito ndi Mlingo".
Ana
Mwa odwala, ana a pharmacokinetics a Tujeo SoloStar ® sanaphunzirepobe.
Odwala aimpso ndi kwa chiwindi kusakwanira
Zotsatira za kuperewera kwa impso ndi kwa hepatic pa pharmacokinetics ya mankhwala Tujo SoloStar ® sizinaphunziridwebe. Komabe, kafukufuku wina wokhala ndi insulin ya anthu awonetsa kuchuluka kwa insulin kwambiri mwa odwala omwe ali ndi impso komanso hepatic. Kuwunikira mosamala kuchuluka kwa shuga wamagazi ndikusintha kwa mlingo wa insulin ndikulimbikitsidwa (onani magawo "Mlingo ndi Ulangizi" ndi "Maupangiri Apadera").

Contraindication

Mwa amayi apakati (kuthekera kwa kusintha kwa insulin panthawi yomwe muli ndi pakati komanso pobereka), odwala okalamba (onanimagawo "Pharmacokinetics", "Pharmacodynamics", "Mlingo ndi Administration" komanso "Maupangiri Apadera"), odwala omwe ali ndi vuto losagwirizana ndi endocrine (monga hypothyroidism, kuperewera kwa adenohypophysis ndi adrenal cortex), omwe ali ndi matenda omwe amatsatiridwa ndi kusanza kapena kutsegula m'mimba, ndi stenosis yayikulu Mitsempha yamitsempha yamagazi kapena ziwiya zamkati, zokhala ndi proliferative retinopathy (makamaka ngati odwala sanajambulidwe), ndi kulephera kwa impso, ndi kulephera kwambiri kwa chiwindi (onani gawo "Lamulo Lapadera" Ania ")

Kutulutsa mawonekedwe, kapangidwe kake ndi ma CD

Wopezeka mu mawonekedwe a yankho lomveka bwino la jakisoni mu ma syringes 1.5 ml mu voliyumu (mpaka ma PC 5. Mu chikwama cha makatoni).

1 ml ya mankhwala ali:

• 300 PIECES za insulin glargine,
• metacresol
• nthaka ya chloride
• 85% glycerin,
• sodium hydroxide
• hydrochloric acid,
• madzi a jakisoni.

Zotsatira za pharmacological

Insulin yogwira ntchito kwa nthawi yayitali yomwe imayang'anira kagayidwe ka glucose. Ikadyedwa, minofu imakhudzidwa kuti igwire glucose, inhibitine mu chiwindi ndikuchepetsa chidwi chonse. Kuphatikiza apo, kuphatikiza mapuloteni kumalimbikitsidwa.

Glargin amagwiranso ntchito chimodzimodzi ndi insulin ya anthu. Nthawi yowonetsedwa kuchokera maola 24 mpaka 36 - zimatengera kukhalapo kwa zochitika zolimbitsa thupi ndi zinthu zina zokhudzana ndi izi. Pocheperako, zimayambitsa hypoglycemia poyerekeza ndi anzawo, kuphatikizapo usiku. Pafupifupi palibe phindu pakusintha kwa thupi, koma pamafunika zakudya zoyenera.

Pharmacokinetics

Pambuyo pakuyendetsa pang'onopang'ono, mayamwidwe amayamba pang'onopang'ono, nthawi yayitali, ndipo amafalikira mthupi lonse. Ndende yolingana ndi masiku 3-4 mutatha kugwiritsa ntchito tsiku lililonse.

Insulin yamtunduwu imapangidwa mofulumira mu thupi: theka la moyo wa maola 18-19.

Panalibe zovuta za msinkhu ndi jenda pakugwira bwino ntchito kwa glargine, koma mlingo woyambirira uyenera kuperekedwa kwa anthu achikulire wotsika ndikuwonjezereka pang'onopang'ono komanso molondola.

Lembani 1 ndipo lembani matenda ashuga a 2 mwa akulu.

Malangizo ogwiritsira ntchito (mlingo)

Amasankhidwa payekha ndi dotolo wothandizira. Zimatengera kufunikira kwa thupi kwa glucose. Funso la mlingo limasankhidwa pamaziko a kusanthula kwa data ya wodwala. Jakisoni amachitika kamodzi nthawi yomweyo.

Zofunika! Makungu a subcutaneous okha ndi omwe amaloledwa!

Ngati mankhwalawa adadulidwa, ndiye kuti mulibe chilichonse chomwe mungafotokozere izi ndi mlingo wapawiri! Muyenera kungoyang'ana magazi kuti musunthire shuga ndikubwerera ku boma mwachizolowezi ndikuwunika momwe zinthu ziliri.

Ndi matenda a shuga 1 amtunduwu, amagwiritsidwa ntchito molumikizana ndi insulin yothamanga kuti apeze zofunika pa chakudya.

Ndi matenda 2 a shuga, amaphatikizidwa ndi mankhwala ena a hypoglycemic.

Njira yothetsera vutoli ikhale ya kutentha kwa m'chipinda, malo opukutira - m'mimba, m'chiuno ndi mapewa. Malo omwe jakisoni amayenera kusinthidwa nthawi zonse kuti athetse chiwopsezo cha lipodystrophy.

Zotsatira zoyipa

1. Hypoglycemia.
2. Lipodystrophy.
3. Thupi lawo siligwirizana.
4. Zochita kupezeka m'malo a jakisoni (kuyabwa, redness, kutupa).
5. Retinopathy
6. Kutupa.
7. Myalgia.
8. Matenda am'mimba.

Zizindikiro zimatsitsimuka ndikusintha kwa mlingo kapena kusiya mankhwala.

Bongo

Ngati mlingo ndi waukulu kwambiri, hypoglycemia imayamba. Zizindikiro zake ndi kufooka, mseru komanso kusanza, kusokonezeka kwa chikumbumtima, mpaka kutha kwa chikumbumtima komanso kukula kwa chikomokere.

Hypoflycemia yofatsa imakhazikika chifukwa chodya zakudya zopatsa thanzi. Zapakati komanso zowonda zimachotsedwa ndi jakisoni wa glucagon kapena dextrose solution, ndikutsatira kuchipatala. Mulimonsemo, kusintha kwa insulin kumafunika.

Kuyanjana kwa mankhwala osokoneza bongo

Njira zomwe zimathandizira kutsata insulin glargine:

• m`kamwa hypoglycemic wothandizira
• ACE zoletsa ndi Mao,
• disopyramids
• mafupa
• fluoxetine
• pentoxifylline
• propoxyphene
• salicylates,
• mankhwala a sulfonamide.

Mankhwala omwe amachepetsa mphamvu yake:

• glucocorticosteroids,
• danazol
• diazoxide
• okodzetsa
• glucagon,
• isoniazid
• estrogens ndi progestogens,
• phenothiazine zotumphukira,
• somatropin,
• amphanomachul
• mahomoni a chithokomiro,
• atypical antipsychotic,
• proteinase zoletsa.

Zinthu zomwe zimapereka zotsatira zosiyanasiyana tikaphatira pamodzi:

Mankhwala omwe amachepetsa zizindikiro za hypoglycemia:

• beta blockers,
• clonidine
• ganethidine,
• yotsalira.

Malangizo apadera

Mosamalitsa amapatsidwa:

• amayi apakati ndi oyamwitsa
• anthu okalamba
• ndi chiwindi ndi kulephera kwa impso,
• akudwala matenda a endocrine komanso stenosis yamitsempha yama chotupa kapena ziwiya zaubongo,
• odwala retinopathy.

Osakhala bwino zochizira pachimake ketoacidosis ndi kuchotsedwa kwa hypoglycemic chikomokere.

Odwala omwe amafunikira insulini yocheperako sikuti nthawi zonse amakhala oyenera. Kusintha kwa Mlingo wofunikira.

Mukamayendetsa magalimoto, chisamaliro chiyenera kutengedwa, chifukwa pamakhala chiopsezo cha hypoglycemia. Ndikofunika kukana kuyendetsa galimoto nthawi yonse ya chithandizo.

Amangotulutsidwa ndi mankhwala okha.

Fananizani ndi fanizo

Tujeo Solostar amasiyana ndi ma insulin ena omwe amakonzekera. Kusiyanako ndi ma analogu omwe amagwiritsidwa ntchito kwambiri kukuwonetsedwa pagome.

Dzina, chinthu chogwira ntchito	Wopanga	Ubwino ndi zoyipa	Mtengo, pakani.
Lantus, insulin glargine	Sanofi-Aventis, Germany	Ubwino: ukhoza kuperekedwa kwa ana azaka zisanu ndi chimodzi. Kuchepetsa chidwi cha zomwe zimagwira, zotsatira zake zimatha mofulumira.	3700/5 syringe zolembera 3 ml
Levemir, insulin detemir	Novo Nordisk, Denmark.	Ubwino: Woyenera kugwiritsidwa ntchito ndi azimayi oyembekezera komanso ana kuyambira zaka 6, koma kusintha molondola kwa mankhwala. Zowonjezera: Zovomerezeka kwa zosaposa tsiku limodzi.	Kuchokera pa 2800/5 syringe zolembera 3 ml
Tresiba, degludec	Novo Nordisk, Denmark.	Ubwino: mpaka maola 42. Ndizotheka kwa ana kuyambira chaka chimodzi. Kugula: okwera mtengo kwambiri, osakhala nthawi zonse muma pharmacy.	Kuyambira 7600

Kugwiritsa ntchito mtundu wina wa insulin kuyenera kuyang'aniridwa ndi endocrinologist. Kudzichitira nokha mankhwala nkoletsedwa!

Mwambiri, chida ichi chimadziwika ndi mayankho abwino ochokera kwa odwala matenda ashuga omwe akudziwa zambiri, makamaka tikayerekeza ndi mankhwala ena.

Olga: “Kuyambira ndili ndi zaka 19 ndadwala matenda ashuga, ndayesa mankhwala osiyanasiyana osiyanasiyana. M'mbuyomu, Lantus adagwidwa, koma adasiya kumupatsa phindu. Asinthidwa kupita ku Tujeo. Sindingathe kuzizolowera, koma adokotala akukulangizani kuti muzitsatira zakudya zamafuta ochepa. Ndikhulupirira kuti zonse zikhala bwino. Mwa pluses, ndaona kuti kutalika kwake ndikosavuta. ”

A Victor: "" Tujeo "wa insulin ndi wokhazikika kuposa" Lantus ", choncho ndinazolowera kwa nthawi yayitali. Koma kwakukulu, ndimakonda khola la shuga, lopanda madontho. Ndimatsatira kadyedwe ndikukulangizani, ndiye kuti palibe mavuto. ”

Anastasia: “Ndimakonda kwambiri Tujeo kuposa Levemir, yomwe ndinakhalako pafupifupi chaka. Amagwiranso shuga yemwe adagona naye - ndimadzuka. Palibe nthawi yovutitsidwa ndi hypoglycemia. Ndipo koposa zonse - ndizosavuta kugwiritsa ntchito, ndipo zimaperekedwanso maubwino ku pharmacy. "

Anna: “Poyamba ndimakonda kugwiritsa ntchito Lantus. Nthawi yotsiriza yomwe adapatsa Tujeo kuzipatala, atakumana ndi dokotala, adaganiza zoyesa. Ndidakulitsa pang'ono koyamba mlingo woyamba, komanso mlingo wa Humalog, womwe ndimagwiritsa ntchito nawo. Pambuyo pa masiku atatu oyesedwa, Mlingo woyenera wapezeka, tsopano ndimatsatira. Ndimakonda insulin yabwinobwino, yopanda madandaulo. ”

Dmitry: “Ndili ndi zaka 23, ndinabayitsa jekeseni Lantus. Dokotalayo anasamukira ku Tujeo kwakanthawi, ndipo sindinkamukonda. Shuga adayamba kulumpha kwambiri, ndimayenera kugwiritsa ntchito Novorapid. Patatha mwezi wozunzidwa, adabwereranso ku Lantus. Mankhwalawa sanandigwirizire konse. ”

Pomaliza

Monga mukuwonera, Tujeo Solostar ili ndi zabwino komanso zoipa. Ndi kusankha moyenera mankhwalawa komanso mlingo wake, moyo wa anthu odwala matenda ashuga umakhala bwino. Chifukwa chake, akatswiri amalemekeza motengera nthawi yayitali ndipo amawalemba. Ndipo kuwunika kwa mankhwalawa kumawonetsa kuti ndizoyenera odwala ambiri omwe ali ndi matenda ashuga.

Mlingo ndi makonzedwe

Malangizo onse
Magawo a Tujeo SoloStar® (insulin glargine 300 IU / ml) amangotanthauza Tujeo SoloStar ® ndipo sofanana ndi ziwalo zina zomwe zikuonetsa mphamvu ya zochita za ena a insulin analogues. Tugeo SoloStar® iyenera kuyendetsedwa mosavomerezeka kamodzi patsiku nthawi iliyonse ya tsiku, makamaka nthawi yomweyo. Mankhwala Tujeo SoloStar ® omwe ali ndi jekeseni imodzi masana amakulolani kukhala ndi ndandanda yosinthika ya jakisoni: ngati kuli kotheka, odwala amatha kubaya jekeseni mkati mwa maola atatu musanayambe kapena ma 3 patatha nthawi yawo yokhazikika.
Zolinga zakukula kwa shuga m'magazi, muyezo wa nthawi ndi makonzedwe a mankhwala a hypoglycemic ziyenera kutsimikizika ndikusintha payekhapayekha.
Kusintha kwa magazi kungafunikenso, mwachitsanzo, pakusintha kulemera kwamthupi la wodwalayo, moyo wake, kusintha nthawi ya insulin, kapena zina zomwe zingakulitse chiwonetsero chakukula kwa hypo- kapena hyperglycemia (onani gawo "Malangizo Apadera"). Kusintha kulikonse kwa insulin kuyenera kuchitika mosamala komanso pokhapokha poyang'aniridwa ndi achipatala.
Tujeo SoloStar ® si insulin yosankha yochizira matenda ashuga a ketoacidosis. Pankhaniyi, makonda amayenera kuperekedwa kwa kulowetsedwa kwa insulin.
Odwala onse omwe ali ndi matenda ashuga, tikulimbikitsidwa kuwunika kuchuluka kwa shuga m'magazi.
Kuyamba kwa kugwiritsa ntchito mankhwalawa Tujo SoloStar ®
Odwala Awa Matenda Ati Ashuga
Tujeo SoloStar ® iyenera kugwiritsidwa ntchito kamodzi patsiku limodzi ndi insulin, kutumikiridwa pakudya, ndikufunika kusintha kwa mlingo wa munthu
Odwala a shuga a 2
Mlingo woyambirira woperekedwa ndi 0,2 U / kg ya kulemera kwa thupi kamodzi patsiku, ndikutsatira mlingo wa munthu payekha.
Kusintha kwa makonzedwe a insulin glargine 100 IU / ml kwa mankhwala a Tujeo SoloStar ® komanso, kuchokera ku mankhwala a Tujeo SoloStar ® kupita ku insulin glargin 100 IU / ml.
Insulin glargine 100 IU / ml ndi Tujeo SoloStar ® sofanana mu pharmacokinetic, machitidwe a pharmacodynamic ndi zotsatira zamankhwala. Pankhaniyi, kusintha kwa insulin glargine 100 PIECES / ml kupita ku mankhwala a Tujo SoloStar ® komanso mosiyanasiyana kumafunikira kuyang'aniridwa ndi dokotala, kusamala kwa kagayidwe kachakudya kosakanikirana ndi kusintha kwa mankhwalawo.

• Kusintha kuchokera ku insulin glargine 100 IU / ml kupita ku Tujeo SoloStar® kutha kuchitidwa pang'onopang'ono, koma mlingo waukulu wa Tujeo SoloStar ® ungafunikire kuti ukwaniritse zomwe mukufuna
• Mukasintha kugwiritsa ntchito mankhwalawa Tujo SoloStar ® insulin glargine 100 IU / ml kuti muchepetse chiopsezo cha hypoglycemia, mlingo uyenera kuchepetsedwa (pafupifupi 20%), ndikutsatira kusintha kwa mlingo ngati kuli kofunikira

Kusamalitsa mosamala kwa metabolic kumalimbikitsidwa panthawi komanso mkati mwa masabata angapo mutatha kuchoka pa imodzi mwazomwezi kupita ku zina.
Kusintha kuchokera ku insulin ina kupita ku Tujeo SoloStar ®

Mukamasintha njira yochiritsira yomwe ili ndi sing'anga yapakati komanso yautali kwa nthawi yayitali kukhala njira yothandizira mankhwalawa ndi Tujeo SoloStar ®, zingakhale zofunikira kusintha mlingo wa insal insulin ndikusintha munthawi yomweyo hypoglycemic therapy (kusintha Mlingo ndi nthawi ya makulidwe a insulin osakhalitsa kapena ma insulin ofana ndi insulin. mankhwala).

• Kusintha kuchokera kumodzi masana makonzedwe a basal insulin kupita ku kasitomala kamodzi patsiku la mankhwalawa Tujeo SoloStar® ukuchitika pang'onopang'ono pa gawo limodzi la mankhwala omwe amapezeka kale ndi insulin.
• Mukamasintha insulin kawiri tsiku lililonse ndikuyamba kukonzekera limodzi la Tujeo SoloStar ®, mlingo woyambira wa Tujeo SoloStar ® ndi 80% ya okwanira tsiku ndi tsiku a basal insulin, chithandizo chomwe chimatha.

Odwala omwe ali ndi Mlingo wambiri wa insulin, chifukwa cha kupezeka kwa ma antibodies a insulin ya anthu, atha kukhala ndi yankho labwino ku Tujo SoloStar ®.
Panthawi yosinthira ku mankhwalawa Tujo SoloStar ® ndipo patangopita milungu yochepa itatha, kuwunikira mosamala kagayidwe kake kamalimbikitsidwa.
Ndi kuyendetsa bwino kwa kagayidwe kazinthu komanso kuwonjezeka kwa insulin sensitivity, kusintha kwa Mlingo wowonjezera kungafunike. Kuwongolera kwa dosing regimen kungafunikenso, mwachitsanzo, pakusintha kulemera kwa thupi kapena moyo wa wodwalayo, nthawi ya makonzedwe a mlingo wa insulin ikasintha, kapena pachitika zinthu zina zomwe zimawonjezera kukonzekera kwa hypo- ndi hyperglycemia.
Kusintha kuchokera pakukhazikitsidwa kwa mankhwalawa Tujo SoloStar ® kupita ku ma insulin ena apansi

Munthawi ya kusintha kwa makina a mankhwalawa Tujo SoloStar ® kugwiritsa ntchito insulin ina ndipo pakatha milungu ingapo itatha, kuyang'aniridwa kwa achipatala ndi kuyang'aniridwa mosamala kwa metabolism ndikulimbikitsidwa.
Ndikulimbikitsidwa kunena za malangizo ogwiritsira ntchito mankhwalawa omwe wodwala adawachotsa.
Kusakaniza ndi kuswana
Tujeo SoloStar® sayenera kusakanikirana ndi insulin ina iliyonse. Kusanganikirana kumabweretsa kusintha kwa mbiri ya zomwe Tujeo SoloStar® ikupita nthawi ndipo kumayambitsa mpweya.
Tujeo SoloStar® sayenera kuchepetsedwa. Kuwononga kungapangitse kusintha kwa mbiri yamomwe mankhwala a Tujo SoloStar ® angapangidwire.
Magulu apadera a odwala
Ana
Chitetezo ndi kufunikira kwa Tujeo SoloStar® mwa ana ndi achinyamata ochepera zaka 18 sizinakhazikitsidwebe (onani gawo la Pharmacokinetics).
Odwala okalamba
Tujeo SoloStar ® ikhoza kugwiritsidwa ntchito mwa odwala okalamba. Kupenda mosamala kuchuluka kwa shuga wamagazi ndikulimbikitsidwa, ndipo mlingo wa insulin uyenera kusankhidwa payekhapayekha. Mwa odwala okalamba, kuwonongeka pang'onopang'ono mu ntchito yaimpso kungapangitse kuchepa kwachilichonse pakufunika kwa insulin (onani magawo "Pharmacodynamics", "Pharmacokinetics" ndi "Maupangiri Apadera").
Odwala omwe ali ndi vuto la impso
Tujeo SoloStar ® ikhoza kugwiritsidwa ntchito mwa odwala omwe amalephera impso. Kupenda mosamala kuchuluka kwa shuga wamagazi ndikulimbikitsidwa, ndipo mlingo wa insulin uyenera kusankhidwa payekhapayekha. Odwala omwe ali ndi vuto la impso, kufunika kwa insulini kumatha kuchepa chifukwa cha kuchepa kwa insulin metabolism (onani magawo "Maupangiri Apadera", "Pharmacodynamics" ndi "Pharmacokinetics").
Odwala omwe ali ndi vuto la chiwindi
Tujeo SoloStar ® ikhoza kugwiritsidwa ntchito mwa odwala omwe ali ndi vuto la chiwindi. Kupenda mosamala kuchuluka kwa shuga wamagazi ndikulimbikitsidwa, ndipo mlingo wa insulin uyenera kusankhidwa payekhapayekha. Odwala omwe ali ndi hepatic insuffuffence, kufunika kwa insulini kumatha kuchepa chifukwa cha kuchepa kwa gluconeogeneis komanso kuchepa kwa insulin metabolism (onani magawo "Pharmacodynamics". "Pharmacokinetics" ndi "Maupangiri Apadera").
Njira yogwiritsira ntchito
Tujeo SoloStar ® imalowetsedwa m'mafuta othamanga am'mimba, mapewa kapena m'chiuno. Masamba a jakisoni amayenera kusinthana ndi jakisoni aliyense watsopano m'malo omwe analimbikitsidwa kuti apatsidwe mankhwala.
Tujeo SoloStar® silinapangidwe kuti likhale ndi intravenousous.
Kuchita kwa insulin glargine nthawi yayitali kumawonedwa pokhapokha ngati amayamba ndi mafuta. Mtsempha wa magazi a chizolowezi subcutaneous mlingo zingayambitse kwambiri hypoglycemia.Tujeo SoloStar® silinapangidwe kuti ligwiritsidwe ntchito ndi pampu yolowetsa insulin.
Tujeo SoloStar® ndi yankho lomveka bwino, osati kuyimitsidwa, kotero kupumulanso musanagwiritse ntchito sikufunika.
Kugwiritsa ntchito cholembera cha syringe cha Tujeo SoloStar oses, Mlingo wa 1 mpaka 80 pa jakisoni ungathe kutumikiridwa pakukula kwa mlingo umodzi.

• Tujeo SoloStar® Syringe pen Dose Counter ikuwonetsa kuchuluka kwa magawo a Tujeo SoloStar® omwe adzaperekedwe. Tujeo SoloStar ® Syringe cholembera yapangidwa mwapadera kukonzekera kwa Tujeo SoloStar ®, kotero kuti kusinthaku kwa mlingo wina sikofunikira.
• Tujeo SoloStar ® sayenera kuchotsedwa mu syringe cholembera ku syringe (onani "Malangizo Apadera").
• Osagwiritsanso ntchito singano. Pamaso pa jekeseni iliyonse, pang'onopang'ono singano yatsopano siyenera kulumikizidwa. Kugwiritsanso ntchito masingano kumawonjezera mwayi wotseka, womwe ungayambitse mlingo wochepa kapena mankhwala osokoneza bongo. Kuphatikiza apo, kugwiritsa ntchito singano yatsopano yosabala jekeseni iliyonse kumachepetsa chiopsezo cha kuipitsidwa ndi matenda.
• Ngati singano yatsekedwa, wodwalayo ayenera kutsatira malangizo omwe ali mu STEP 3 "Malangizo Ogwiritsa Ntchito Tujeo SoloStar® Syringe pen" (onani pansipa).

Popewa kufalikira kwamatenda obwera ndi magazi, cholembera cha insulin sichiyenera kugwiritsidwa ntchito ndi wodwala wopitilira m'modzi, ngakhale singano isinthidwe.
Kuti mugwiritse ntchito moyenera Tujeo SoloStar® Syringe pen, onani apa "Malangizo Ogwiritsa Ntchito Tujeo SoloStar® Syringe pen". Pofuna kusiyanitsa kuthekera kwa zolakwika (mwangozi) kayendetsedwe ka mtundu wina wa insulini m'malo mwa Tujeo SoloStar®, nthawi zonse muziyang'anitsitsa cholembera cholembera pamaso pa jekeseni aliyense (pazilembo za syringe ya Tujeo SoloStar ®, ndende ya "300 IU / ml" imasonyezedwa pazithunzi zokongola) .
Nthawi yogwiritsira ntchito mankhwalawa mu cholembera cha Tujeo SoloStar ® disposable itatha kugwiritsa ntchito ndi milungu 4 ikasungidwa m'malo amdima. Ndikulimbikitsidwa kuwonetsa tsiku lomwe linagwiritsidwa ntchito koyamba cholembera cholembera.