Hypoglycemic mankhwala a insulin Lantus: mankhwala ndi malangizo ogwiritsira ntchito

Zisonyezero zamatenda a mankhwalawa a mankhwala "Lantus" amawonetsa mawonekedwe ake apamwamba poyerekeza ndi mitundu ina ya insulin, popeza imafanana kwambiri ndi anthu. Zotsatira zoyipa sizinalembedwe. Kuyang'aniridwa kuyenera kulipidwa pokhapokha kukonza kwa mankhwalawa komanso njira yoyendetsera mankhwalawa mogwirizana ndi malangizo ogwiritsira ntchito.

Kuphatikizika, mawonekedwe omasulira ndi ma CD

Amapezeka mu mawonekedwe osavuta popanda mtundu wa jakisoni pansi pa khungu.

• 1 ml Insulin glargine 3.6378 mg (wofanana ndi 100 IU wa insulin ya anthu)
• zinthu zina (zinc chloride, hydrochloric acid, metacresol, glycerol (85%), madzi a jakisoni, sodium hydroxide).

Kutulutsa Fomu:

• Mbale 10 ml, bokosi limodzi,
• 3 ml ma cartridge, ma cartridge 5 ali ndi ma bokosi ojambula ma ma cell,
• Makilogalamu atatu a 3 ml mu dongosolo la OptiKlik, machitidwe 5 mu phukusi la makatoni.

Pharmacokinetics

Kupenda koyerekeza kuchuluka kwa magazi a glargine ndi isofan kunawonetsa kuti glargine imawonetsa kuyamwa kwa nthawi yayitali, ndipo palibe chiwonetsero chazovuta. Ndi subcutaneous makonzedwe kamodzi patsiku, inshuwaransi yolimbitsa thupi imatheka mkati mwa masiku 4 kuyambira jekeseni woyamba.

Kutulutsa nthawi kumatheka chifukwa chobweretsa mafuta onenepa. Chifukwa cha kunyowa kwambiri, ndikokwanira kugwiritsa ntchito mankhwalawa kamodzi patsiku. Kutalika kwa zochita kumafika maola 29, kutengera mawonekedwe a thupi la wodwalayo.

Chidachi chapangidwira zochizira matenda a shuga mwa akulu ndi ana opitilira zaka 6.

Malangizo ogwiritsira ntchito (mlingo)

"Lantus" imalowetsedwa pansi pakhungu pakhungu, phewa kapena pamimba kamodzi patsiku nthawi yomweyo. Komwe kuli jekeseni ndikulimbikitsidwa kusinthana pamwezi.

Jekeseni wa mtsempha wa jekeseni wokhazikitsidwa pakhungu limakhala pachiwopsezo cha kukhala ndi vuto la hypoglycemia.

Mlingo komanso nthawi yoyenera jekeseni iyenera kutsimikiziridwa ndi dokotala. Odwala omwe ali ndi matenda amtundu wachiwiri a II amapatsidwa mankhwala a monotherapy kapena othandizira ndi Lantus, limodzi ndi othandizira ena a hypoglycemic.

Onse cholinga choyambirira ndikusinthidwa kwa gawo lina la insulini yofunika ikasamutsidwa kupita ku mankhwalawa limachitika palokha.

Zofunika! Ndi zoletsedwa kusakaniza ndi insulin ina kapena kukonzanso mankhwala, izi zidzapangitsa kusintha kwa mbiri ya nthawi ya ola limodzi!

Pakumayambiriro kogwiritsa ntchito glargine, kuyankha kwa thupi kumajambulidwa. Masabata oyamba, kuyang'anira bwino gawo la glucose ndikulimbikitsidwa. Ndikofunikira kusintha mlingo wa mankhwalawa ndikusintha kwa thupi, maonekedwe owonjezera a masewera olimbitsa thupi.

Zotsatira zoyipa

Mavuto ambiri amthupi:

1. Kutsitsa kuchuluka kwa shuga m'magazi. Pezani ngati mulingo wawonjezera. Matenda a pafupipafupi a hypoglycemic amakhudza dongosolo lamanjenje ndipo amafunika thandizo ladzidzidzi, chifukwa amayamba kukomoka. Zizindikiro zakuchepetsa gawo la shuga ndi tachycardia, njala yokhazikika, thukuta.
2. Zowonongeka pazida zowoneka (kuchepa kwakanthawi kawonedwe ndipo, monga chotulukapo chake, kupezeka kwa matenda ashuga a retinopathy mpaka khungu).
3. Lipodystrophy yachilengedwe (kuchepa kwa mayamwa kwa mankhwalawa). Kusintha mwadongosolo kwa malo obisalako a subcutaneous kumachepetsa vuto.
4. Thupi lawo siligwirizana (kuyabwa, redness, kutupa, kawirikawiri urticaria). Osowa kwambiri - edema ya Quincke, brasmchial spasm kapena anaphylactic kugwedezeka ndikuwopseza kuti adzafa.
5. Myalgia - kuchokera musculoskeletal system.
6. Kupangidwe kwa ma antibodies ku insulin inayake (kusintha mwa kusintha kwa mankhwala).

Bongo

Kupitilira muyeso womwe udakhazikitsidwa ndi dokotala kumabweretsa kudandaula kwa hypoglycemic, komwe kumawopseza moyo wa wodwalayo.

Hypoglycemia imakhala yocheperako komanso yolimbitsa thupi chifukwa chomwa nthawi yambiri chakudya. Ngati vuto la hypoglycemic limachitika pafupipafupi, njira ya glucagon kapena dextrose imayendetsedwa.

Kuyanjana kwa mankhwala osokoneza bongo

Kuphatikiza Lantus ndi mankhwala ena kumafuna kusintha kwa insulin.

Hypoglycemic zotsatira zimathandizira kuchuluka kwa:

• sulfonamide antimicrobial agents,
• mankhwala osokoneza bongo a shuga
• disopyramide
• fluoxetine
• pentoxifylline
• mafupa
• Mao zoletsa
• salicylates,
• propoxyphene.

Glucagon, danazole, isoniazid, diazoxide, estrogens, okodzetsa, ma gestagens, kukula kwamagulu, adrenaline, terbutaline, salbutamol, proteinase inhibitors komanso antipsychotic pang'ono akhoza kuchepetsa mphamvu ya hypoglycemic ya glargine.

Kukonzekera komwe kumatchinga beta-adrenergic receptors mumtima, clonidine, mchere wa lithiamu ungathe kuchepetsa ndikuwonjezera mphamvu ya mankhwalawa.

Malangizo apadera

Insulin glargine sagwiritsidwa ntchito pochiza matenda osiyanasiyana a metabolic acid omwe amakwiya chifukwa chophwanya kagayidwe kazakudya chifukwa cha kuchepa kwa insulin. Matendawa amatenga jakisoni wambiri wa insulin yochepa.

Chitetezo cha odwala omwe ali ndi vuto la impso kapena chiwindi sichinaphunzire.

Kuunikira moyenera shuga wanu wamagazi kumaphatikizapo:

• kutsatira njira yeniyeni yochizira,
• kusinthana kwa malo a jakisoni,
• kuphunzira kwa luso la jakisoni waluso.

Mukatenga Lantus, chiwopsezo cha hypoglycemia chimachepetsa usiku ndikuwonjezeka m'mawa. Odwala omwe ali ndi matenda a episodic hypoglycemia (omwe ali ndi stenosis, proliferative retinopathy) amalimbikitsidwa kuti azitha kuyang'anira kuchuluka kwa glucose mosamala.

Pali magulu omwe ali pachiwopsezo chomwe zizindikiro za hypoglycemia mwa odwala zimachepetsedwa kapena palibe. Gawoli limaphatikizapo anthu okalamba, omwe ali ndi neuropathy, omwe amapezeka pang'onopang'ono kwa hypoglycemia, omwe ali ndi vuto la kusokonezeka kwa malingaliro, okhala ndi mawonekedwe a shuga, kulandira chithandizo cha nthawi imodzi ndi mankhwala ena.

Zofunika! Khalidwe losazindikira nthawi zambiri limabweretsa zovuta zowopsa - vuto la hypoglycemic!

Malamulo oyambira azikhalidwe kwa odwala omwe ali ndi gulu loyambira la shuga:

• Nthawi zonse mumatha kudya zakudya zam'madzi, ngakhale ndimatsuko ndi m'mimba,
• osayimitsa kwathunthu makonzedwe a insulin.

Teknoloji ya Kutsata Magazi a Magazi:

• pafupipafupi musanadye
• mutadya pambuyo pa maola awiri,
• kuyang'ana kumbuyo,
• kuyesa zomwe zimapangitsa kuchita masewera olimbitsa thupi komanso / kapena kupsinjika,
• mkati mwa hypoglycemia.

Mimba komanso kuyamwa

Kafukufuku wazinyama sanawonetse momwe Lantus amakhudzira mluza. Komabe, kusamala kumalangizidwa kupaka glargine pa nthawi ya bere.

Trimester yoyamba, monga lamulo, imadziwika ndi kuchepa kwa kufunika kwa insulin, ndipo yachiwiri ndi yachitatu - ndi kuwonjezeka. Pambuyo pa kubereka komanso nthawi yoyamwitsa, kufunika kwake kumachepetsa kwambiri, chifukwa chake, kuyang'anira nthawi zonse kuchipatala ndikofunikira kuti musinthe.

Fananizani ndi fanizo

Ndemanga Zahudwala

Tanya: "Poyerekeza Lantus ndi Novorapid ndi zonse zomwe zimaganiziridwa, ndinazindikira kuti Novorapid imasunga nyumbayi kwa maola 4, ndipo Lantus ndiyabwino, zotsatira zake zimatha tsiku litayamba kubayidwa."

Svetlana: "Ndinasinthira kuchoka ku" Levemire "kupita ku" Lantus "monga momwemodzi - magawo 23 kamodzi patsiku madzulo. Ku chipatala, zonse zidali bwino kwa masiku awiri, ndidathamangitsidwa kunyumba. Mantha, kutsika mlungu uliwonse usiku uliwonse, ngakhale kumachepetsa mlingo wa magawo patsiku. Ndipo zidapezeka kuti kukhazikitsidwa kwa mlingo womwe ukufunikira kumachitika patadutsa masiku atatu itatha yoyamba, ndipo adokotala adakulangizani molondola, muyenera kuyamba ndi Mlingo wotsika. "

Alyona: "Ndikuganiza kuti si mankhwala ayi, koma momwe mungagwiritsire ntchito. Mlingo woyenera ndi maziko olondola ndikofunikira, kuchuluka kwa nthawi komanso nthawi yanji. Pokhapokha ngati ndizosatheka kukhazikitsa maziko, muyenera kusintha “Lantus” kukhala china, popeza ndikuwona kuti ndi mankhwala oyenera. ”

Tsatirani dongosolo la kudya, kuwongolera zakudya, musakhale pamavuto, khalani ndi moyo wogwira ntchito - zolemba za wodwala yemwe akufuna kukhala mosangalala kuyambira pamenepo.

Kutulutsa Fomu

Insulin Lantus ikupezeka mu mawonekedwe a yankho lomveka bwino, lopanda utoto (kapena wopanda mtundu) la jakisoni wofinya.

Pali mitundu itatu yamankhwala yotulutsira mankhwala:

• OptiClick Systems, zomwe zimaphatikizapo ma cartridge atatu osachita khungu. Chikwama chimodzi chokhala ndi makatoni asanu.
• OptiSet Syringe Mapensulo 3 ml kuthekera. Phukusi limodzi muli zolembera zisanu.
• Lantus SoloStar m'makalata Mlingo wa 3 ml, womwe umakwiririka ndi cholembera kuti ugwiritse ntchito kamodzi. Katirijiyo amakhala pansi mbali imodzi ndi choletsa cha brkidutyl ndikuwombedwa ndi chipewa cha aluminiyamu; kumbali inayo kuli kogumula wa brwaputyl. Mu bokosi limodzi lokhathamiritsa, mumakhala ma cholembera asanu opanda ma sindano.

Pharmacodynamics ndi pharmacokinetics

Yogwira pophika kwa Lantus insulin glargine ndi analog insulin yamunthu ntchito yayitali, yomwe imapangidwa ndi njira yotembenuzira DNA. Thupi limadziwika ndi kusungunuka kochepa kwambiri m'malo osaloledwa.

Komabe, popeza acidic sing'anga ilipo mu yankho (pH yake ndi 4), ili ndi insulin glargine kusungunuka popanda chotsalira.

Pambuyo jekeseni wa subcutaneous mafuta wosanjikiza, imalowa mu kulowererapo, chifukwa chomwe microprecipitate reagents amapangidwa.

Mwa microprecipitate, pang'ono, pang'ono pang'ono amatulutsidwainsulinglarginechifukwa chomwe kutsekeka kwa mawonekedwe apotolo "(opanda mfundo zapamwamba) kumatsimikizika"ndende - nthawi", Komanso Kutalika kwa kamwedwe kake ka mankhwala.

Magawo omwe amadziwika ndi zomangirainsulin glargine ndi insulin zolandilira thupi, zofanana ndi magawo a munthuinsulin.

Mu mankhwalawa amatha kupangika komanso mphamvu zake zachilengedwe insulinyemwe ndiwowongolera wofunikira kwambiri chakudya kagayidwe kachakudya ndi njira kagayidweshuga mthupi.

Insulin ndi zinthu ngati izi chakudya kagayidwe kachakudya chochita chotsatira:

• khazikitsani njira za biotransfform shuga mu glycogenmu chiwindi,
• thandizani kuchepetsedwa ndende shuga wamagazi,
• thandizirani kugwiranso ntchito shuga chigoba cham'mimba komanso minofu ya adipose,
• timalepheretsa kaphatikizidwe shuga kuchokera mafuta ndi mapuloteni m'chiwindi (gluconeogenesis).

Komanso insulin Amadziwikanso monga omwe amadzipangira mahomoni, chifukwa chakugwiritsa ntchito mphamvu yogwira mapuloteni komanso mafuta. Zotsatira zake:

• kuchuluka kwa mapuloteni (makamaka mu minofu),
• Njira ya enzymatic imatsekedwa kuwonongeka kwa mapuloteni, yomwe imapangidwa ndi michere ya proteinolytic ndi ma protein,
• kupanga kumawonjezeka lipids,
• njira yogawanikana imatsekedwa mafuta pa awo acid acid ma adipose minofu yama cell (adipocytes),

Maphunziro azachipatala oyerekeza anthu insulin ndi insulin glargine akuwonetsa kuti akaperekedwa kudzera mu milingo yofanana, zonse zimakwaniritsidwa yemweyo mankhwala.

Kutalika kwa chochita glarginekutalika kwa zochita za ena insulinzimadziwika ndi zolimbitsa thupi komanso zinthu zina zingapo.

Kafukufuku wopangidwa kuti azisamalira syntoglycemia pagulu la anthu athanzi komanso odwala omwe adapezeka kuti akudwala insulin matenda ashugantchito insulin glargine itayambitsidwa mafuta ochulukirapo, idayamba pang'ono pang'onopang'ono kuposa zochita za Hamineorn wosalowerera ndale.NPH insulin).

Kuphatikiza apo, zotsatira zake zinali zowonjezereka, zodziwika ndi nthawi yayitali ndipo sizimayenderana ndi kudumphadumpha.

Zotsatira izi insulin glargine mtima ndi kuchepetsedwa kuchuluka kwa mayamwidwe. Chifukwa cha iwo, mankhwalawa Lantus ndi okwanira kutenga osaposa kamodzi patsiku.

Komabe, ziyenera kukumbukiridwa kuti mawonekedwe a zomwe achite panthawiyo insulin (kuphatikiza insulin glargine) itha kukhala osiyana m'magulu osiyanasiyana komanso kwa munthu yemweyo, koma m'malo osiyanasiyana.

M'maphunziro azachipatala, zidatsimikiziridwa kuti mawonekedwe hypoglycemia (pathological mkhalidwe wochepetsedwa ndende shuga wamagazi) kapena yankho la kuyankha kwadzidzidzi kwakumadzi kwa hypoglycemia pagulu la odzipereka athanzi komanso odwala omwe ali ndi matenda insulin amadalira matenda a shuga pambuyo mtsempha wa magazi makonzedwe insulin glargine komanso munthu wamba insulin zinali zofanana kwathunthu.

Pofuna kuyesa momwe zimakhudzira insulin glargine pa chitukuko ndi kupita patsogolo matenda ashuga retinopathies kafukufuku wotseguka wazaka zisanu wa NPH wachitika mu gulu la anthu 1024 omwe ali ndi matenda osachiritsika omwe amadalira shuga.

Pa kafukufukuyu, kupitirira kwa chotupa retina lamaso masitepe atatu kapena kupitilira apo malinga ndi njira za ETDRS adapezeka pojambula fundus yamaso.

Nthawi yomweyo, bungwe limodzi limayenera kuchita masana insulin glargine ndikuwonetsa kawiri isofan insulin (NPH insulin).

Kafukufuku wofanizira adawonetsa kuti kusiyana pakupita patsogolo matenda ashuga retinopathies mankhwalawa matenda ashuga mankhwala isofan insulinndipo Lantus adavotera kuti ndi losafunika.

M'mayeso olamulidwa mwachisawawa omwe amachitika mu gulu la odwala 349 aubwana ndi unyamata (wazaka zisanu ndi chimodzi mpaka khumi ndi zisanu) ndi insulin amadalira mawonekedwe a shuga, ana adathandizidwa kwa masabata 28 mwanjira ya maziko a bolus insulin mankhwala.

Mwanjira ina, adathandizidwa ndi jakisoni wambiri, zomwe zimakhudza kuyambitsidwa kwa insulin wamba yamunthu musanadye.

Lantus anali kutumizidwa kamodzi masana (madzulo asanagone), munthu wabwinobwino NPH insulin - kamodzi kapena kawiri masana.

Kuphatikiza apo, mgulu lirilonse, pafupifupi pafupipafupi kwa chizindikiro hypoglycemia (mkhalidwe womwe umakhazikika ndi zizindikiro zake hypoglycemia, ndipo ndende ya shuga imatsikira pansipa magawo 70) ndi zotsatira zofananira glycogemoglobin, womwe ndi chizindikiro chachikulu cha magazi ndipo umawonetsa shuga wa magazi kwa nthawi yayitali.

Komabe, chizindikirocho plasma shuga ndende pamimba yopanda kanthu pagulu la maphunziro omwe adatenga insulin glargine, idachepetsedwa kwambiri poyerekeza ndi zoyambira kuposa momwe gulu limalandirira isophan insulin.

Kuphatikiza apo, pagulu lothandizira la Lantus, hypoglycemia limodzi ndi zizindikiro zoyipa kwambiri.

Pafupifupi theka la maphunziro - anthu 143 - omwe adalandira ngati gawo la kafukufukuyu insulin glargine, adapitilizabe mankhwala pogwiritsa ntchito mankhwalawa mu kafukufuku wina wotsatira, wophatikizira kuyang'anira odwala kwa zaka ziwiri.

Munthawi yonse yomwe odwala amatenga insulin glargine, palibe zododometsa zatsopano zomwe zidapezeka pokhudzana ndi chitetezo chake.

Komanso pagulu la odwala 26 azaka khumi ndi ziwiri mpaka khumi ndi zisanu ndi zitatu ndi matenda a shuga a insulin kafukufuku wopangidwa pamtunda unachitika omwe amafananizira kuyipa kwa kuphatikizainsulin "glargine + lispro" ndi kuphatikiza bwinoisophan-insulin + wamba insulin”.

Kutalika kwa kuyesako kunali masabata khumi ndi zisanu ndi chimodzi, ndipo njira zochizira zinaperekedwa kwa odwala motsatizana.

Monga kuyeserera kwa ana, kuchepa kwa ndende shuga magazi osala kudya poyerekeza ndi zoyambira adatchulidwaponso komanso ndiwofunika kwambiri m'gululi lomwe odwala adatenga insulin glargine.

Kusintha Kwa Zinthu glycogemoglobin pagululi insulin glargine ndi gulu isofan insulin anali ofanana.

Koma nthawi imodzimodzi, zizindikiritso zojambulidwa usiku shuga m'magazi omwe gululo limachitikira pogwiritsa ntchito kuphatikiza insulin "glargine + lispro"anali dongosolo lamphamvu kwambiri kuposa gulu lomwe mankhwalawo adachitika isofan insulin komanso munthu wamba insulin.

Otsika pang'ono anali 5.4 ndipo, motero, 4.1 mmol / L.

Zowopsa hypoglycemia Mu nthawi yausiku mugona paguluinsulin "glargine + lispro" anali 32%, ndipo pagulu "isophan-insulin + wamba insulin” — 52%.

Kupenda koyerekeza zizindikiro za zomwe zili insulin glargine ndi isofan insulin museramu yamagazi odzipereka athanzi ndi odwala matenda ashuga pambuyo makonzedwe a mankhwala mu subcutaneous minofu anawonetsa kuti insulin glargine pang'onopang'ono komanso motalika kuchokera kwa iwo.

Nthawi yomweyo, kuchuluka kwa plasma wozungulira insulin glargine poyerekeza ndi isofan insulin sanakhaleko.

Pambuyo subcutaneous jakisoni insulin glargine Kamodzi patsiku, plasma equilibrium concentration imatheka pafupifupi masiku awiri kapena anayi pambuyo pobayidwa jakisoni woyamba.

Pambuyo makonzedwe a mankhwala mtsempha wamagazi, theka moyo (theka moyo) insulin glargine ndi mahomonizopangidwa bwino kapambandi mfundo zofananira.

Pambuyo subcutaneous jakisoni wa mankhwala insulin glargine imayamba kupangika mwachangu kumapeto kwa polypeptide beta unyolo wokhala ndi amino acid wokhala ndi gulu la carboxyl laulere.

Zotsatira zake, izi zimapangidwa:

• M1 - 21A-Gly-insulin,
• M2 - 21A-Gly-des-30B-Thr-insulin.

Zazikulu zomwe zikuzungulira magazi a m'magazi Mulingo wa wodwala ndi metabolite M1, kumasulidwa kwake komwe kumawonjezeka molingana ndi kuchuluka kwa mankhwalawa a Lantus.

Zotsatira za Pharmacodynamic ndi pharmacokinetic zikuwonetsa kuti achire zotsatira za subcutaneous makonzedwe a mankhwalawa zimatengera makamaka kutulutsidwa kwa metabolite ya M1.

Insulin glargine mu mawonekedwe ake oyera ndi metabolite M2 sanapezeke mwa odwala ambiri. Pamene anali atapezeka, kutsimikizika kwawo sikudalira kuchuluka kwa Lantus.

Kafukufuku wazachipatala komanso kusanthula kwamagulu omwe adapangidwa motsatira zaka komanso jenda la odwala sizidawonetse kusiyana kulikonse pakuwoneka bwino komanso chitetezo pakati pa odwala omwe adachitidwa ndi Lantus ndi kuchuluka kwawerengero.

Madokotala aacacokinetic m'gulu la odwala kuyambira zaka ziwiri mpaka zisanu ndi chimodzi insulin wodalira matenda a shuga, zomwe zidawunikidwa mu umodzi mwazophunzirazi, zinawonetsa kuti kuchuluka kosachepera insulin glargine ndipo metabolites M1 ndi M2 wopangidwa munthawi ya biotransformation yake mwa ana ali ofanana ndi achikulire.

Umboni womwe ungapereke umboni wa kukhoza insulin glargine kapena zinthu zake zama metabolic zimadziunjikira m'thupi mothandizidwa ndi mankhwala nthawi yayitali, sizipezeka.

Makhalidwe

Lantus insulin ili ndi mtundu wapadera: mgwirizano wa insulin zolandilira, womwe ndi wofanana ndi zinthu zomwe zimagwirizana ndi insulin ya anthu.

Cholinga chachikulu cha mtundu uliwonse wa insulin ndikuwongolera kagayidwe kazakudwala (carbohydrate metabolism). Ntchito ya Lantus SoloStar insulin ndikuthandizira kudya shuga ndi minofu: minofu ndi mafuta, zomwe zimapangitsa kutsika kwa shuga m'magazi. Kuphatikiza apo, mankhwalawa amalepheretsa glucosynthesis m'chiwindi.

Insulin imatha kuyambitsa kuphatikiza mapuloteni, nthawi yomweyo, imalepheretsa njira zamapuloteni ndi lipolysis m'thupi.

Kutalika kwa zochita za insulin ya Lantus zimatengera zinthu zosiyanasiyana, komanso kuchuluka kwa zochita zolimbitsa thupi za munthu.

Mankhwala amatha kuyamwa pang'onopang'ono, pomwe, umapereka mphamvu yayitali chifukwa cha zochita zake. Pazifukwa izi, jakisoni imodzi ya mankhwala masana ndi yokwanira. Ndikofunikira kudziwa kuti malonda ake amakhala osakhazikika ndipo amachitapo kanthu malinga ndi nthawi yake.

Kugwiritsa ntchito mankhwala a Lantus insulin paubwana ndi unyamata kumayambitsa kuchuluka kwa hypoglycemia usiku kwambiri kuposa kugwiritsidwa ntchito kwa NPH-insulin m'gulu lino la odwala.

Chifukwa chogwira ntchito nthawi yayitali komanso kukomoka pang'onopang'ono panthawi yolamulidwa, insulin glargine siyambitsa kutsika kwa shuga m'magazi, uwu ndi mwayi wake waukulu poyerekeza ndi NPH-insulin. Hafu ya moyo wa insulin ya anthu ndi insulin glargine ndi yemweyo akapatsidwa mtsempha wa magazi. Awa ndiwo mphamvu ya insulin Lantus.

Momwe mungagwiritsire ntchito mankhwalawa?

Insulin "Lantus" akuwonetsedwa kwa subcutaneous makonzedwe. Mothandizidwa ndi mtsempha wa magazi amaletsedwa, chifukwa ngakhale mlingo umodzi umabweretsa kukula kwambiri kwa hypoglycemia.

Kuphunzitsa kugwiritsa ntchito mankhwalawa:

• Ndikofunika kuyang'ana moyo wina munthawi ya mankhwalawa ndikutsatira malamulo ndi njira yothandizira jekeseni.
• Pali zosankha zingapo zamasamba oyendetsera mankhwala odwala: m'chiuno, m'misempha yovunda komanso m'mimba.
• Kubayira kulikonse kuyenera kuchitika paliponse momwe mungathere munzvimbo yatsopano malinga ndi malire.
• Sizoletsedwa kusakaniza Lantus ndi mankhwala ena, komanso kuthira ndi madzi kapena zakumwa zina.

Mlingo wa insulin "Lantus SoloStar" umatsimikiziridwa payekhapayekha. Mlingo komanso nthawi amasankhidwa. Chongolimbikitsira chokha ndi jakisoni imodzi ya mankhwalawa patsiku, ndipo ndikofunikira kuti majakisoni aperekedwe nthawi yomweyo.

Mankhwalawa akhoza kuphatikizidwa ndi mankhwala a shuga a m'mlomo wamtundu wachiwiri.

Odwala okalamba amafuna kusintha kwa mlingo, chifukwa nthawi zambiri amakhala ndi matenda a impso, chifukwa chomwe kufunikira kwa insulin kumachepetsedwa. Izi zimagwiranso ntchito kwa odwala okalamba omwe ali ndi vuto la chiwindi. Njira za insulin kagayidwe zimachepetsedwa, kuphatikiza pali kuchepa kwa gluconeogenesis.

Izi zimatsimikizira malangizo a insulin "Lantus" ogwiritsira ntchito.

Kusamutsa odwala kumankhwala

Ngati m'mbuyomu wodwalayo amathandizidwa ndimankhwala ena omwe akhala akuchita kwa nthawi yayitali kapena ngati ali nawo pafupi, ndiye kuti angasinthidwe kupita ku Lantus, ndikotheka kuti kusintha kwa mlingo waukulu wa insulin kungakhale kofunikira, ndipo izi zikuphatikizanso kuwunika kwa njira zonse zochizira.

Pakakhala kusintha kuchokera ku insulini yachiwiri ya insulin NPH kupita jekeseni imodzi ya Lantus insulin, ndikofunikira kuchita mosinthika. Choyamba, mlingo wa NPH-insulin umachepetsedwa ndi wachitatu m'masiku 20 oyambirira a gawo latsopano la mankhwala. Mlingo wa insulin womwe umathandizidwa pakudya umachulukitsidwa pang'ono. Pambuyo pa masabata awiri ndi atatu, ndikofunikira kuti musankhe wodwala payekha.

Ngati wodwala ali ndi mankhwala othandizira kupangira insulin, kayendedwe ka thupi pakuwongolera kwa a Lantus, komwe, kungafunike kusintha kwa mlingo. Komanso, kudziwa kuchuluka kwa mankhwala omwe angagwiritsidwe ntchito kungafunike ngati zinthu zina zakhudza kagayidwe ka mankhwala m'thupi, mwachitsanzo, kusintha kwa thupi kapena kakhalidwe kogwira ntchito kwambiri kapena, mosiyana, pang'ono.

Kodi Lantus insulin imayendetsedwa bwanji?

Kupereka mankhwala

Mankhwalawa amaperekedwa pogwiritsa ntchito syringes yapadera "OptiPen", "SoloStar", "Pro1" ndi "ClickStar".

Mapensulo amaperekedwa ndi malangizo. Pansipa pali mfundo zina za momwe mungagwiritsire ntchito zolembera:

1. Zolembera zowonongeka ndi zosweka sizingagwiritsidwe ntchito jakisoni.
2. Ngati ndi kotheka, kumayambiriro kwa mankhwalawa kuchokera ku cartridge kungachitike pogwiritsa ntchito syringe yapadera, yomwe imakhala ndi magulu a 100 ml.
3. Asanayike katiriji mu syringe cholembera, iyenera kusungidwa kwa maola angapo kutentha kwa firiji.
4. Musanagwiritse ntchito cartridge, onetsetsani kuti yankho mkati mwake lili ndi mawonekedwe abwinobwino: palibe kusintha kwa utoto, chinyezi ndipo kulibe.
5. Ndikofunikira kuti muzichotsa thovu mu katiriji (izi zimanenedwa m'malangizo am'manja).
6. Makatoni ndi ogwiritsa ntchito kamodzi kokha.
7. Ndikofunikira kuti zilembedwe zolembetsa zama cartridge kuti mupewe kulakwitsa kwa mankhwala ena m'malo mwa Lantus insulin.

Malinga ndi ndemanga, chimodzi mwazinthu zoyipa zomwe zimachitika ndikamayambitsa mankhwalawa ndi hypoglycemia. Izi zimachitika ngati kusankha kwa mankhwalawa kwa mankhwalawo kwatipanga molakwika. Poterepa, kuwerengetsa kwa mlingo kumafunikira kuti muchepetse.

Zotsatira zoyipa zimawonedwanso monga:

• lipohypertrophy ndi lipoatrophy,
• dysgeusia,
• kutsika kwamawonedwe owoneka,
• retinopathies
• mawonetseredwe a thupi lawo wamba komanso wamba,
• kupweteka kwa minyewa ndi kusungidwa kwa sodium ion mthupi.

Izi zikuwonetsedwa ndi malangizo omwe aphatikizidwa ndi Lantus insulin.

Hypoglycemia monga zotsatira zoyipa zimachitika nthawi zambiri. Izi, zimayambitsa kusokonezeka kwamanjenje. Kutalika kwa nthawi yayitali kwa hypoglycemia ndi kowopsa pamoyo komanso thanzi la wodwala.

Kupanga kwa ma antibodies ku insulin.

Mwa ana, kupezeka kwa zotsatirazi pamakhala kumaonekeranso.

Lantus ndi pakati

Palibe zambiri zachipatala pazokhudzana ndi mankhwalawa panthawi yomwe muli ndi pakati, popeza sipanakhale mayesero azachipatala kwa amayi apakati. Komabe, malinga ndi kafukufuku wotsatsa pambuyo pa malonda, mankhwalawa alibe vuto lililonse pakukula kwa mwana wosabadwayo komanso nthawi yomwe ali ndi pakati.

Kuyesa kwa kanyama mu nyama kwatsimikizira kusapezeka kwa poizoni ndi zovuta za insulin glargine pa mwana wosabadwayo.

Ngati ndi kotheka, n`zotheka kupereka mankhwala pa nthawi ya bere, kutengera kuyang'aniridwa kwa zasayansi mayeso a shuga ndi zina zomwe zidzachitike mtsogolo mwa mayi ndi mwana wosabadwayo.

Contraindication

• achina,
• tsankho pamagawo othandizika ndi mankhwala
• Mankhwala a Lantus samapangidwira matenda ashuga a ketoacidosis,
• ana osakwana zaka 6,
• mosamala kwambiri, mankhwalawa amaperekedwa kwa odwala omwe amapita patsogolo retinopathy komanso kuchepetsedwa kwa ziwongo ndi matenda a mtima.
• mosamalitsa chimodzimodzi, mankhwalawa amalembedwa kwa odwala omwe ali ndi vuto la neuronomic, matenda amisala, kupita patsogolo kwapang'onopang'ono kwa hypoglycemia, komanso omwe adapezeka ndi matenda a shuga kwa nthawi yayitali.
• mosamala kwambiri, mankhwalawa amaperekedwa kwa odwala omwe adalandira insulin ya nyama asanasinthe ku insulin ya anthu.

Chiwopsezo cha hypoglycemia chitha kuchulukana pazinthu zotsatirazi zomwe sizimagwirizanitsidwa ndi njira yatsatanetsatane ya matenda:

• mavuto a dyspeptic limodzi ndi matenda am'mimba komanso kusanza,
• zolimbitsa thupi,
• kuchuluka kwa chidwi ndi ma insulin pomwe akuchotsa zomwe zimayambitsa zovuta.
• kuperewera ndi kusowa kwa chakudya,
• uchidakwa
• kugwiritsa ntchito mankhwala ena.

Kuchita ndi mankhwala ena

Malangizowa akuyenera kuganiziridwa:

• kuphatikiza ndi mankhwala omwe amakhudza kagayidwe kazakudya kungafune kubwereza,
• kuphatikiza ndi mankhwala ena amkamwa a shuga amathandizira kuchuluka kwa insulin,
• kuphatikiza ndi mankhwala monga Danazol, Diazoxide, glucagon corticosteroid, estrogens ndi progestin, zotumphukira za phenothiazine, proteinase inhibitors, othandizira mahomoni a chithokomiro amathandizira kuchepetsa mphamvu ya hypoglycemic ya Lantus,
• kuphatikiza ndi mankhwala monga Clonidine, lithiamu, mankhwala opangidwa ndi ethanol ali ndi zotsatira zosayembekezereka: pakhoza kukhala kuwonjezeka kapena kuchepa kwa zotsatira za Lantus,
• munthawi yomweyo makonzedwe a Lantus ndi Pentamidine poyamba akhoza kukhala ndi vuto la hypoglycemic, ndipo zotsatira zake zimakhala za hyperglycemic.

Insulin "Lantus": analogues

Pakadali pano, zomwe zimafananizira kwambiri ndi insulin ya mahomoni amadziwika:

• pocheperapo pang'ono - Apidra, Humalog, Novorapid Penfill,
• ndikuchita kwanthawi yayitali - "Levemir Penfill", "Tresiba".

Kodi pali kusiyana kotani pakati pa Tujeo ndi Lantus insulin? Ndi insulin iti yomwe imagwira ntchito kwambiri? Yoyamba imapangidwa mu ma syringe omwe amagwiritsidwa ntchito. Iliyonse ili ndi mlingo umodzi. Kusiyana kwakukulu kuchokera ku Lantus ndi kuchuluka kwa insulin. Mankhwala atsopanowa ali ndi kuchuluka kwa 300 IU / ml. Chifukwa cha izi, mutha kuchita jakisoni ochepa patsiku.

Zowona, chifukwa chakuwonjezeka katatu, mankhwalawo asintha pang'ono. Ngati Lantus idaloledwa kugwiritsidwa ntchito ngati matenda ashuga mwa ana ndi achinyamata, ndiye kuti Tujeo sagwiritsa ntchito kwenikweni. Wopanga adalimbikitsa kuti ayambe kugwiritsa ntchito chida ichi kuyambira wazaka 18.

Odwala ambiri omwe ali ndi matenda opatsirana a shuga amasiya ndemanga zotsutsa za Lantus ndi mankhwala omwe ali ndi vutoli. Ndemanga zambiri zoyipa zimagwirizanitsidwa ndikupanga zotsatira zoyipa zosafunikira. Tiyenera kukumbukira kuti chinsinsi chokwanira chamankhwala ndi zotsatira zake ndikusankhidwa koyenera kwa mankhwalawa komanso mtundu wa mankhwalawa. Mwa odwala ambiri, malingaliro amveka kuti insulin siyothandiza konse kapena imayambitsa zovuta. Mwazi wa shuga utakhala wochepa kale, mankhwalawo amangowonjezera vutoli, ndikofunikira kuti mugwiritse ntchito poyambira chitukuko cha matenda pofuna kupewa kukula kwa zovuta zowopsa komanso zosasinthika.

Omanga a thupi amakhalanso amawunikira za mankhwalawa ndipo, kuweruza ndi iwo, mankhwalawa amagwiritsidwa ntchito mwangwiro ngati othandizira, omwe amathanso kukhala ndi vuto losadalirika paumoyo, chifukwa limagwiritsidwa ntchito pazinthu zina.

Malangizo ogwiritsira ntchito Lantus

Kuphatikizika kwa mankhwalawa kumaphatikizapo insulin glargine - analogue of human insulinyodziwika ndi nthawi yayitali.

Njira yothetsera vutoli idapangidwa kuti ayipatse mafuta osakanikira, amaletsedwa kupaka jakisoni wodwala kudzera m'mitsetse.

Ichi ndichifukwa choti njira yotalikirapo yochitira zinthu imatsimikiziridwa ndendende ndikuwongolera kwa mankhwalawa, koma ngati itaperekedwa kudzera m'mitsempha, imatha kupweteka hypoglycemic kuukira woopsa.

Kusiyana kulikonse kokulirapo kwa zisonyezo insulin kapena mulingo shuga palibe magazi omwe adapezeka m'magazi atabaya jekeseni wa m'mimba khoma, minofu yolimba, kapena minofu ya ntchafu.

Insulin Lantus SoloStar Ndi dongosolo lama cartridge lomwe limayikidwa mu cholembera, pomwepo lingagwiritsidwe ntchito. Liti insulin cartridge imatha, cholembera chimatayidwa ndikuchotsedwanso china.

OptiClick Systems Zapangidwa kuti zigwiritsenso ntchito. Liti insulin cholembera chimatha, wodwalayo ayenera kugula cartridge yatsopano ndikuyikhazikitsa m'malo opanda kanthu.

Asanayambe makonzedwe a mafuta osakanikirana, Lantus sayenera kuchepetsedwa kapena kuphatikizidwa ndi mankhwala ena insulin, popeza izi zimatha kubweretsa kuphwanya mbiri ya nthawi komanso zochita za mankhwala. Pambuyo posakanikirana ndi mankhwala ena, mpweya umathanso kuchitika.

Kufunika kwachipatala pakugwiritsidwa ntchito ndi Lantus kumawonetsedwa kamodzi ndi tsiku lililonse. Potere, mankhwalawa amatha kudulidwa nthawi iliyonse ya tsiku, koma nthawi zonse.

Mlingo wa mankhwalawa, komanso nthawi yomwe akukonzekera, amatsimikiziridwa ndi dokotala aliyense payekha.

Odwala adapezeka shuga wosadalira insulin, Lantus angagwiritsidwe ntchito limodzi ndi mankhwala antidiabetesic pakamwa pakamwa.

Kuchuluka kwa ntchito kwa mankhwala kumatsimikiziridwa m'magawo omwe ali ndi mawonekedwe a Lantus okha osafanana mayunitsi ndi INE, omwe amagwiritsidwa ntchito kuti azindikire mphamvu ya zochita za anthu ena insulin.

Odwala aukalamba (wopitilira zaka 65), pakhoza kuchepa mosalekeza pakufunika kwa tsiku ndi tsiku insulin chifukwa cha kuchepa kwapang'onopang'ono kwa ntchito impso.

Odwala ndi mkhutu aimpso ntchito, kufunika kwa mankhwala insulin akhoza kuchepetsedwa chifukwa chakuchepa kwa kagayidwe ka zinthu zomwe zimagwira.

Odwala kukanika kwa chiwindi pali kuchepa kwa kusowa kwa mankhwala insulin poganiza kuti kuthekera kwawo kuletsa kaphatikizidwe kumachepetsedwa kwambiri shuga kuchokera kumafuta ndi mapuloteni m'chiwindi, ndipo kagayidwe kamachepetsainsulin.

Pochita ana, mankhwalawa amagwiritsidwa ntchito pochiza ana azaka zopitilira zisanu ndi chimodzi ndi achinyamata. Kwa ana ochepera zaka zisanu ndi chimodzi, chitetezo ndi kuchita bwino kwa chithandizo cha mankhwala a Lantus sichinaphunzire.

Posamutsa odwala kuchokera ku mankhwala osokoneza bongo insulin, yomwe imadziwika ndi nthawi yayitali yochita, komanso posintha chithandizo ndi mankhwala ena insulin yaitali lantus, kusintha kwa mankhwalawa angalimbikitsidwe maziko (basal) insulin ndikupanga kusintha kwazomwezo.

Izi zikugwiritsidwa ntchito pa Mlingo ndi nthawi yoyang'anira mankhwala ena insulin kuchita mwachidule, mwachangu mahomoni kapena Mlingo wa mankhwala antidiabetesic pakamwa.

Kuti muchepetse kutukuka hypoglycemic kuukira usiku kapena m'mawa kwambiri, kwa odwala mukamawachotsa kuchikhalidwe chovomerezeka basal NPH insulin Ngati mwalandira limodzi Lantus mu milungu ingapo yoyambirira, ndikofunikira kuti muchepetse tsiku NPH insulin osachepera 20% (kwakukulu 20-30%).

Nthawi yomweyo, kuchepa kwa mlingo wa insulin kuyenera kulipidwa (osachepera gawo) pakukulitsa Mlingo wa insulin, womwe umadziwika ndi kanthawi kochepa. Pamapeto pa gawo ili la chithandizo, mankhwalawa amasinthidwa molingana ndi matupi a wodwalayo komanso momwe matendawo aliri.

Odwala omwe kumwa kwambiri Mlingo NPH insulin chifukwa cha kukhalapo kwa ma antibodies aanthu ku insulin ya anthu mwa iwo, kusintha poyankha kumatha kudziwidwa ndikasamutsidwa ku chithandizo cha Lantus.

Pa kusintha kwa mankhwalawa ndi Lantus, komanso masabata oyamba pambuyo pake, ndikofunikira kuyang'anitsitsa kuchuluka kwa kagayidwe kachakudya kwa wodwala.

Momwe mphamvu ya metabolic imayendera bwino ndipo, monga chotulukapo chake, kukhudzika kwa insulin kumawonjezereka, kusintha kwina muyezo wa mankhwalawa kungalimbikitsidwe.

Kusintha kwa Mlingo ndikofunikira:

• thupi la wodwalayo lisintha.
• moyo wa wodwalayo ukasintha kwambiri,
• ngati masinthidwe akukhudzana ndi nthawi yoyang'anira
• ngati m'mbuyomu sizinaoneke zomwe zingachitike zomwe zingayambitse kukula kwa hypo- kapena hyperglycemia.

Musanapange jakisoni woyamba, muyenera kuwerenga mosamala malangizo Lantus SoloStar. Cholembera sichingagwiritsidwe ntchito kamodzi kokha. Pankhaniyi, ndi thandizo lake, mutha kulowa muyezo insulin, omwe amasiyanasiyana kuchokera kumodzi mpaka makumi asanu ndi atatu (gawo ndilofanana gawo limodzi).

Musanagwiritse ntchito, yang'anani chogwirira. Njira yothetsera vutoli imaloledwa kulowetsedwa pokhapokha ngati ikuwonekera, yopanda utoto ndipo mulibe chodetsa chilichonse choonekera mwa iyo. Kunja, kusasinthika kwake kuyenera kufanana ndi kusasintha kwamadzi.

Popeza mankhwalawa ndi njira yothetsera vutoli, sikofunikira kuti musanganize musanayende.

Asanayambe kugwiritsa ntchito, cholembera cha syringe chimasiyidwa kwa ola limodzi kapena awiri. Kenako, ma thovu am'mlengalenga amachotsedwa mmalo mwake ndipo jakisoni amapangidwa.

Cholembacho chimapangidwa kuti chigwiritsidwe ntchito ndi munthu m'modzi yekha ndipo sayenera kugawana ndi ena. Ndikofunikira kuti mutetezere ku mvula ndikugwa kwamakina, chifukwa izi zimatha kuwononga dongosolo la cartridge ndipo, chifukwa chake, kugwira ntchito kwa cholembera.

Ngati zowonongeka sizitha kupewedwa, chigwacho sichitha kugwiritsidwa ntchito, chifukwa chake chimasinthidwa ndi china chogwira ntchito.

Asanayambitse Lantus, ayenera kuyika singano yatsopano. Pankhaniyi, amaloledwa kugwiritsa ntchito ngati singano zopangidwira makamaka syringe cholembera SoloStarndi singano zoyenera pamadongosolo ano.

Pambuyo pa jakisoni, singano imachotsedwa, saloledwa kuigwiritsanso ntchito. Ndikulimbikitsidwanso kuchotsa singano musanataye chida cha SoloStar.

Lantus SoloStar, malangizo ogwiritsira ntchito: njira ndi mlingo

Njira yothetsera vutoli ndi yokhayo yothandizidwa ndi kulowetsedwa ndi jekeseni wamafuta am'mimba, ntchafu kapena mapewa. Ndondomeko imachitidwa tsiku ndi tsiku, nthawi imodzi patsiku losavuta (koma nthawi yomweyo) kwa wodwala. Tsamba la jakisoni liyenera kusinthidwa pafupipafupi.

Simungathe kulowa Lantus SoloStar kudzera m'mitsempha!

Kuti mupewe njirayi moyenera, ndikofunikira kuti muphunzire mosamala momwe zinthu zimayendera ndikutsatira mosamalitsa.

Choyamba, nthawi yoyamba yomwe mugwiritsa ntchito cholembera, muyenera kuchotsa kaye mufiriji ndikuyisunga kutentha kwa maola 1-2. Panthawi imeneyi, yankho limawonjezera kutentha kwa chipinda, komwe kungapewe kusungunuka kwa insulin.

Pamaso pa njirayi, muyenera kuonetsetsa kuti insulin imagwirizana ndikusanthula chizindikiro cholembera. Tikachotsa kapu, kuwunika bwino bwino kwa zomwe zili m'bokosilo la cholembera kuyenera kuchitika. Mankhwalawa angagwiritsidwe ntchito ngati njira yothetsera vutoli ili ndi mawonekedwe owoneka bwino, opanda utoto wopanda tinthu tokhala ngati ma cell olimba.

Ngati kuwonongeka kwa milandu kwapezeka kapena kukayikira pakubwera pamtundu wa cholembera, ndizoletsedwa kugwiritsa ntchito. Pankhaniyi, tikulimbikitsidwa kuti muchepetse yankho kuchokera ku cartridge mu syringe yatsopano, yoyenera insulin 100 IU / ml, ndikupanga jakisoni.

Singano zogwirizana ndi SoloStar ziyenera kugwiritsidwa ntchito.

Jekeseni aliyense amapangidwa ndi singano yatsopano yosabala, yomwe imayikidwa patsogolo pa jekeseni yachindunji ya Lantus SoloStar.

Kuti tiwonetsetse kuti mulibe thovu la mpweya komanso cholembera chimbudzi ndi singano zimagwira ntchito bwino, kuyesedwa koyambirira koyenera ndikofunikira. Kuti muchite izi, ndikuchotsa zingano zakunja ndi zamkati za singano ndikuyeza muyeso wogwirizana ndi mayunitsi awiri, cholembera cha syringe chimayikidwa ndi singano. Kugulira chala chanu mokakamira pa insulin, makatani onse amlengalenga amaponyedwa ku singano ndikusindikiza batani jakisoni. Maonekedwe a insulin pamsonga pa singano akuwonetsa kugwira ntchito kwa cholembera ndi singano. Ngati kutulutsa kwa insulin sikunachitike, kuyesako kuyenera kubwerezedwa mpaka zotsatira zomwe mukufuna zitheke.

Cholembera cha syringe chili ndi ma PISCES a 80 a insulin ndipo amachiritsa moyenera. Kukhazikitsa mlingo wofunikira pogwiritsa ntchito sikelo yomwe imakuthandizani kuti mukhale osagwirizana ndi 1 unit. Pamapeto pa kuyesedwa kwa chitetezo, nambala 0 iyenera kukhala pazenera, mutatha kukhazikitsa muyeso wofunikira. Mochedwa pomwe kuchuluka kwa mankhwala mu syringe cholembera kuli kochepa kuposa momwe amafunikira pakukhazikitsa, jakisoni iwiri imachitika pogwiritsa ntchito chotsalira cholembera, ndi choperewera kuchokera ku cholembera chatsopano.

Wogwira ntchito zachipatala ayenera kudziwitsa wodwalayo za jakisoni ndi kuwonetsetsa kuti amachitidwa moyenera.

Kuti mupeze jakisoni, singano imayikidwa pansi pa khungu ndipo batani la jakisoni limakanikizidwa njira yonse, likuyimika pamasekondi 10. Izi ndizofunikira pakukonzekera kwathunthu kwa mlingo wosankhidwa, ndiye kuti ngodya imachotsedwa.

Pambuyo pa jakisoni, singano imachotsedwa mu cholembera ndikuchotsera, ndipo cartridge imatsekedwa ndi chipewa. Ngati malingaliro awa sanatsatidwe, chiwopsezo cha mpweya ndi / kapena matenda omwe amalowa mu cartridge, kuipitsidwa, komanso kutulutsa insulin.

Cholembacho chimapangidwa kuti chigwiritsidwe ntchito ndi wodwala m'modzi yekha! Iyenera kusungidwa m'malo osawoneka bwino, kupewa kufota ndi fumbi. Mutha kugwiritsa ntchito nsalu yonyowa pokonza kunja kwa cholembera. Osamizidwa m'madzimadzi, chotsani kapena mafuta!

Wodwala amayenera kukhala ndi cholembera chindapusa chida chilichonse chakuwonongeka kapena kutayika.

Chingwe chopanda kanthu kapena chilichonse chokhala ndi mankhwala omwe chatha ntchito chizitaya chilichonse.

Musaziziritse cholembera cholembera jakisoni.

Pambuyo pakutsegulira, zomwe zili mu cholembera cha syringe zitha kugwiritsidwa ntchito kwa masabata 4, ndikulimbikitsidwa kuti muwonetse tsiku lomwe jakisoni woyamba wa Lantus SoloStar adalemba.

Mlingo mankhwala kutumikiridwa aliyense payekha, poganizira matenda zikuwonetsa ndi concomitant mankhwala.

Munthawi yogwiritsira ntchito mankhwalawa, wodwalayo ayenera kuganizira kuti kusamba ndi nthawi ya zochita za insulin imatha kusintha motsogozedwa ndi zochitika zolimbitsa thupi komanso kusintha kwina m'thupi lake.

Mtundu wachiwiri wa matenda a shuga, kugwiritsa ntchito mankhwala a Lantus SoloStar mu mawonekedwe a monotherapy komanso kuphatikiza othandizira ena a hypoglycemic.

Mlingo, nthawi ya insulin makonzedwe ndi hypoglycemic makonzedwe ayenera kutsimikizika payekhapayekha, poganizira zolinga za glucose mu magazi.

Kusintha kwa Mlingo kuyenera kupangidwa kuti muchepetse kukula kwa hypo- kapena hyperglycemia, mwachitsanzo, pakusintha nthawi ya makonzedwe a insulin, kulemera kwa thupi ndi / kapena moyo wa wodwalayo. Kusintha kulikonse kwa insulin kuyenera kuchitika pokhapokha poyang'aniridwa ndi achipatala komanso mosamala.

Lantus SoloStar sakhala wa chisankho cha insulin yochizira matenda ashuga ketoacidosis, mu nkhani iyi, kulowetsedwa kwa insulin kosakhalitsa kuyenera kukondedwa. Ngati njira yothandizira mankhwalawa imaphatikizapo jakisoni wa basal ndi prandial insulin, ndiye kuti insulin glargine pa mlingo womwe umagwirizana ndi 40-60% ya tsiku lililonse la insulini limasonyezedwa monga insal insulin.

Mankhwala oyamba tsiku lililonse a insulin glargine kwa odwala omwe ali ndi matenda a shuga 2 amaphatikizika ndi mankhwala a pakamwa a hypoglycemic ayenera kukhala magawo khumi. Kusintha kwina kwa mlingo kumachitika payekhapayekha.

Odwala onse, kulandira mankhwala ndi mankhwala kuyenera kutsagana ndi kuwunika kuchuluka kwa shuga m'magazi.

Wodwala akatembenukira ku regimen ya mankhwala ogwiritsira ntchito Lantus SoloStar pambuyo povomerezeka pochita mankhwalawa pakatikati kapena insulin yayitali, zingakhale zofunikira kusintha nthawi ndi nthawi ya uthandizire wa insulin kapena analogue yake ndikusintha Mlingo wa othandizira pakamwa.

Ngati wodwalayo anali pa chithandizo cham'mbuyomu cha Tujeo (magawo 300 a insulin glargine mu 1 ml), ndiye kuti kuchepetsa chiopsezo cha hypoglycemia mukasinthira ku Lantus SoloStar, mlingo woyambirira wa mankhwalawa suyenera kupitirira 80% ya mlingo wa Tujeo.

Mukasinthana ndi jekeseni imodzi ya isofan insulin masana, njira yoyamba ya insulin glargine imakonda kugwiritsidwa ntchito mu kuchuluka kwa mankhwala omwe amachotsedwa.

Ngati njira yotsogola yam'mbuyomu idaperekedwa jekeseni wa isofan insulin masana nthawi yomweyo, ndiye kuti posamutsa wodwalayo jekeseni imodzi ya Lantus SoloStar asanagone, kuti athetse mwayi wa hypoglycemia usiku ndi m'mawa kwambiri, mlingo wake woyamba umadalira kuchuluka kwa 80% ya mlingo wa tsiku ndi tsiku wa insulin. Pa mankhwala, mlingo umasinthidwa malinga ndi yankho la wodwalayo.

Kusintha kuchokera ku insulin yaumunthu kuyenera kuchitika moyang'aniridwa ndi achipatala. M'milungu yoyamba yogwiritsira ntchito insulin glargine, kuyang'anira kagayidwe kosamala ka shuga ndikuwongolera dongosolo la insulin dosing ngati kuli koyenera kumalimbikitsidwa. Makamaka ayenera kupatsidwa chidwi ndi odwala omwe ali ndi antibodies kwa insulin yaumunthu omwe amafunikira kwambiri insulin ya anthu. Mu gulu ili la odwala, motsutsana ndi kagwiritsidwe ntchito ka insulin glargine, kusintha kwakukulu pamayendedwe a insulin makonzedwe ndikotheka.

Momwe ma metabolic amathandizira ndikukhala ndi chidwi cha minofu kuti insulin iwonjezeke, gawo la kusintha limasinthidwa.

Kusakaniza ndi kuchepa kwa insulin glargine ndi ma insulin ena kumatsutsana.

Mukamapereka mankhwala a Lantus SoloStar, odwala okalamba amalimbikitsidwa kuti azigwiritsa ntchito Mlingo woyambira, kuwonjezeka kwawo kwa mankhwalawa kuyenera kuchepetsedwa. Tiyenera kukumbukira kuti muukalamba kuvomereza kukhala ndi hypoglycemia ndikovuta.

Mimba komanso kuyamwa

Kugwiritsidwa ntchito kwa Lantus SoloStar kumaloledwa panthawi yamatumbo molingana ndi mawonekedwe azachipatala.

Zotsatira za kafukufukuyu zikuwonetsa kusapezeka kwa zovuta zina zilizonse pa nthawi yoyembekezera, komanso mkhalidwe wa mwana wosabadwayo kapena thanzi la mwana wakhanda.

Mayi ayenera kudziwitsa dokotala yemwe wakupezekayo za kukhalapo kapena kukonzekera kutenga pakati.

Tiyenera kukumbukira kuti m'nthawi yoyambirira ya kubereka, kufunika kwa insulini kumatha kuchepa, ndipo muyezo wachiwiri ndi wachitatu ungathe kuchuluka.

Kuwunikira mosamala kuchuluka kwa shuga m'magazi kumafunikira mukangobadwa kumene chifukwa kuchepa msanga kwa zofunikira za insulin.

Pa mkaka wa m`mawere, ayenera kuwunikira kusintha mlingo wa insulin ndi zakudya.

Ndi kale kapena gestational matenda a shuga pa mimba, ndikofunikira kusamalira njira zoyenera zama metabolic panthawi yonse ya bere kuti tipewe kuwoneka kosayenera chifukwa cha hyperglycemia.

Gwiritsani ntchito paubwana

Kukhazikitsidwa kwa Lantus SoloStar kwa ana osaposa zaka 2 ndi zotsutsana.

Zambiri zamankhwala pazokhudza kugwiritsa ntchito insulin glargine mwa ana osaposa zaka 6 sizipezeka.

Odwala ochepera zaka 18, zimachitika jakisoni wambiri ndi njira zina zoyipa zomwe zimachitika nthawi yomweyo.

Gwiritsani ntchito mu ukalamba

Mukamapereka mankhwala a Lantus SoloStar, odwala okalamba amalimbikitsidwa kuti azigwiritsa ntchito Mlingo woyambira, kuwonjezeka kwawo kwa mankhwalawa kuyenera kuchepetsedwa. Tiyenera kukumbukira kuti muukalamba kuvomereza kukhala ndi hypoglycemia ndikovuta.

Kuwonongeka pang'onopang'ono kwa ntchito ya impso mwa okalamba kumathandizira kuchepa kwamphamvu kwa zofunikira za insulin.

Migwirizano ndi magwiritsidwe akusungidwa

Pewani kufikira ana.

Sungani pa 2-8 ° C m'malo opanda pake, osamakhazikika.

Cholembera chogwiritsidwa ntchito chimayenera kusungidwa pamatenthedwe mpaka 30 ° C pamalo amdima. Mukatsegula, zomwe zili mu cholembera cha syringe zitha kugwiritsidwa ntchito kwa milungu 4.

Moyo wa alumali ndi zaka zitatu.

Ndemanga za Lantus SoloStar

Ndemanga za Lantus SoloStar ndi zabwino. Odwala onse amadziwa kuthandizira kwamankhwala mosavuta, kugwiritsa ntchito mosavuta, zochitika zochepa zovuta. Sonyezani kufunikira kwakukwaniritsa mosamalitsa malangizo onse a dotolo. Izi ndichifukwa choti insulini yoyendetsedwera kumbuyo kwa vuto lakudya kapena zochitika zolimbitsa thupi kwambiri sizitha kuteteza wodwalayo kuti asalumphe shuga kapena magazi a hypoglycemia.

Malo osungira

Lantus yalembedwa pa B. Imasungidwa pamalo otetezedwa ndi kuwala kwa dzuwa, osavomerezeka ndi ana. Dongosolo lotenthetsera kutentha kwambiri kuyambira 2 mpaka 8 ° C (ndibwino kusungira zolembera ndi yankho mufiriji).

Kuzizira kwa mankhwalawa sikuloledwa. Komanso, chotengera sichiyenera kuloledwa kuyanjana ndi yankho ndi freezer ndi zakudya kapena zinthu oundana.

Pambuyo potsegula ma phukusi la cholembera, limaloledwa kuti lisungidwe kwa milungu inayi pa kutentha kosaposa 25 ° C pamalo otetezedwa bwino ndi dzuwa, koma osati mufiriji.

Tsiku lotha ntchito

Lantus ikugwiritsidwa ntchito kwa zaka 3 kuyambira tsiku lotuluka.

Mukatha kugwiritsa ntchito mankhwalawa, phula la syringe limaloledwa kugwiritsidwa ntchito kwa milungu yopitilira anayi. Pambuyo pokonzekera koyamba kwa yankho, tikulimbikitsidwa kuti tisonyeze tsiku lakelo.

Pambuyo pa kumaliza ntchito kolembedwa pa ma CD, sikuloledwa kugwiritsa ntchito mankhwalawa.

Lantus, ndemanga zamankhwala

Mabwalo ambiri a odwala matenda ashuga ali ndi mafunso ambiri: "Kodi mungasankhe chiyani - Lantus kapena Levemir?"

Mankhwalawa ndi ofanana wina ndi mnzake, chifukwa chilichonse ndi chosakanizira cha insulin ya munthu, chilichonse chimadziwika ndi zochita zazitali ndipo chilichonse chimamasulidwa ngati cholembera. Pachifukwa ichi, nkovuta kuti munthu wamba asankhe m'malo mwa aliyense wa iwo.

Mankhwala onse awiriwa ndi mitundu yatsopano ya insulin yomwe imapangidwira odwala matenda a shuga a insulin ndi mtundu wopanda insulin oyang'anira maola khumi ndi awiri kapena makumi awiri ndi anayi.

Mosiyana ndi insulin yaumunthu pamankhwala Levemire sikusoweka amino acid pa malo 30 a B-chain. M'malo mwake amino acid lysine pa udindo 29 wa B-chain wophatikizidwa ndi otsalira myristic acid. Chifukwa cha izi, zomwe zili pokonzekera insulin kumangirira ku plasma magazi mapuloteni 98-99%.

Monga kukonzekera kwa insulin kwa nthawi yayitali, mankhwalawa amagwiritsidwa ntchito mosiyanasiyana kusiyana ndi mitundu ya insulin yomwe imatengedwa musanadye. Cholinga chawo chachikulu ndikusunga shuga yokwanira kudya magazi.

Mankhwala otsekemera otsekemera amayambira pansi, kupanga insulin kapambapoletsa gluconeogenesis. Cholinga china chothandizira kuti musamasulidwe ndikuchotsa mbali kuti isafe. maselo otulutsa khunyu.

Ndemanga zomwe zimapezeka pamabungwewa zimatsimikizira kuti mankhwalawa onse ndi okhazikika komanso osiyanasiyana amtundu wa insulin, ochita chimodzimodzi odwala osiyanasiyana, komanso wodwala aliyense payekhapayekha, koma m'malo osiyanasiyana.

Ubwino wawo waukulu ndikuti amatsata zokhazokha za thupi zogwiritsira ntchito insulin ndipo amakhala ndi mbiri yokhazikika.

Kusiyana kwakukulu Levemira kuchokera Lantus SoloStar ndi:

• Tsiku lotha ntchito Levemira atatsegula phukusi ndi masabata asanu ndi limodzi, pomwe alumali ya Lantus ndi milungu inayi.
• Jakisoni wa lantus amalimbikitsidwa kamodzi patsiku, pomwe jakisoni Levemira Mulimonsemo, muyenera kubaya kawiri patsiku.

Mulimonsemo, lingaliro lomaliza laomwe mankhwalawa ndi oyenera kusankha limapangidwa ndi adotolo, yemwe ali ndi mbiri yonse yodwala komanso zotsatira zake zoyesedwa.

Kupanga ndi mawonekedwe a kumasulidwa

m'mabotolo a 10 ml (100 IU / ml), mu paketi ya makatoni 1 botolo kapena makatoni a 3 ml, mu paketi ya matuza 5 makatoni, mumapaketi a makatoni 1 a blister pack, kapena 1 cartridge of 3 ml mu system ya OptiKlik cartridge ", Mu phukusi la makatoni 5 a katoni

Mimba komanso kuyamwa

M'maphunziro a zinyama, palibe deta yachindunji kapena yosalunjika yomwe idapezeka pa embryotoxic kapena fetotoxic zotsatira za insulin glargine.

Mpaka pano, palibe ziwerengero zoyenera zogwiritsira ntchito mankhwalawa panthawi yapakati. Pali umboni wa kugwiritsa ntchito kwa Lantus mwa azimayi 100 oyembekezera omwe ali ndi matenda ashuga. Maphunziridwe ake ndi zotsatira za kutenga pakati pa odwalawa sizinasiyanane ndi zomwe zimachitika mwa amayi apakati omwe ali ndi matenda ashuga omwe amalandiranso kukonzekera kwina kwa insulin.

Kukhazikitsidwa kwa Lantus mwa amayi apakati kuyenera kuchitika mosamala. Kwa odwala omwe ali ndi matenda osokoneza bongo omwe alipo kale kapena a gestationalabetes mellitus, ndikofunikira kuti azitha kuyang'anira machitidwe a metabolic panthawi yonse yovomerezeka. Kufunika kwa insulin kumatha kuchepa mu trimester yoyamba ya kutenga pakati ndikuwonjezeka panthawi yachiwiri komanso yachitatu. Pambuyo pobadwa, kufunika kwa insulini kumachepera msanga (chiopsezo cha hypoglycemia chikuwonjezeka). Pansi pa izi, kuyang'anira shuga wamagazi ndikofunikira.

Mwa kuyamwa azimayi, mlingo wa insulini komanso kusintha kwa zakudya kungafunike.

Mlingo ndi makonzedwe

S / c mu mafuta opindika a pamimba, phewa kapena ntchafu, nthawi zonse nthawi imodzi 1 patsiku. Masamba a jakisoni amayenera kusinthana ndi jakisoni aliyense watsopano m'malo omwe akutsimikizidwira mankhwala a sc.

Mu / pakubweretsa njira yanthawi zonse, yolimbikitsidwa ndi sc, kungayambitse kukula kwa hypoglycemia.

Mlingo wa Lantus ndi nthawi yakatsiku lakukhazikitsidwa kwake amasankhidwa payekha. Odwala omwe ali ndi matenda a shuga a 2 mtundu, Lantus angagwiritsidwe ntchito ngati monotherapy komanso kuphatikiza mankhwala ena a hypoglycemic.

Kusintha kuchokera ku chithandizo ndi mankhwala ena a hypoglycemic kupita ku Lantus. Mukalowetsa pakati kapena pakakhala nthawi yayitali mankhwala a insulin, mungafunike kusintha tsiku ndi tsiku insulin, komanso mungafunike kusintha njira yothandizirana ndi antidiabetesic mankhwala (ma doses ndi makonzedwe a makina ogwiritsira ntchito mankhwala osokoneza bongo osakanikirana kapena kufananiza kwa mankhwala osokoneza bongo. ) Posamutsa odwala kuti ayambe kutumiza insulin-isophan kawiri masana kupita kuntchito imodzi ya Lantus kuti muchepetse chiopsezo cha hypoglycemia usiku ndi m'mawa kwambiri, mlingo woyambira wa insulin uyenera kuchepetsedwa ndi 20-30% m'milungu yoyamba yamankhwala. Munthawi yochepetsera mlingo, mutha kuwonjezera kuchuluka kwa insulin yochepa, kenako, mankhwalawa ayenera kusintha mosiyanasiyana.

Lantus sayenera kusakanikirana ndi insulin ina yokonzekera kapena kuchepetsedwa. Mukasakanikirana kapena kuchepetsedwa, mawonekedwe amachitidwe ake amatha kusintha pakapita nthawi, kuphatikiza, kusakanikirana ndi ma insulin ena kungayambitse mpweya.

Monga ma fanizo ena a insulin yaumunthu, odwala omwe amalandira Mlingo wambiri wa mankhwala chifukwa cha kupezeka kwa antibodies kwa insulin ya anthu amatha kupeza kusintha poyankha insulin pamene akusintha kupita ku Lantus.

Mukasinthira ku Lantus komanso milungu yoyamba itatha, kuyang'anira shuga wamagazi ndikofunikira.

Pofuna kusintha kwa kagayidwe kazinthu komanso kuwonjezereka kwa chidwi cha insulin, kuwongolera kwina kwa mankhwalawa kungakhale kofunikira. Kusintha kwa magazi kungafunikenso, mwachitsanzo, pakusintha kulemera kwamthupi la wodwala, moyo, nthawi ya tsiku yoperekera mankhwala, kapena pachitika zina zomwe zimawonjezera kukonzekera kwa hypo- kapena hyperglycemia.

Mankhwala sayenera kuperekedwa kwa iv. Kutalika kwa zochita za Lantus ndi chifukwa cha kukhazikitsidwa kwa minofu yaying'ono ya adipose.