Tujeo Solostar - inshuwaransi yatsopano yogwira ntchito yayitali yozama

Insulin imagwiritsidwa ntchito pochiza odwala omwe ali ndi mtundu woyamba 1 komanso mtundu wa 2 matenda a shuga, mawonekedwe a matendawa komanso matenda a shuga. Kugwiritsa ntchito moyenera kumatha kuchepetsa kuchuluka kwa shuga ndikuchepetsa kukula kwa zovuta zomwe zimayenderana ndi matendawa. Kuchulukana ndi malo a kaperekedwe ka mankhwala zimatengera nthawi yomwe achitapo kanthu.

Kuchita bwino ndi chitetezo cha Tujeo Solostar

Pakati pa Tujeo Solostar ndi Lantus, kusiyana ndikuwonekeratu. Kugwiritsa ntchito Tujeo kumalumikizidwa ndi chiopsezo chochepa kwambiri cha kukhala ndi hypoglycemia mwa odwala matenda a shuga. Mankhwala atsopanowa atsimikizira kukhazikika kwokhazikika komanso kwanthawi yayitali poyerekeza ndi Lantus kwa tsiku limodzi kapena kupitilira apo. Muli malo ena atatu a yogwira 1 ml yankho, lomwe limasintha kwambiri malo.

Kutulutsa kwa insulin kumayamba pang'onopang'ono, kenako kumalowa m'magazi, nthawi yayitali imayendetsa kuchuluka kwa shuga m'magazi masana.

Kuti mupeze insulin yomweyo, Tujeo amafunikira katatu kuposa Lantus. Jakisoni sadzakhala wowawa kwambiri chifukwa chakuchepa kwa dera la mpweya. Kuphatikiza apo, mankhwalawa ocheperako amathandizira kuwunika bwino momwe amalowera m'magazi.

Kusintha kwapadera pa mayankho a insulin mutatenga Tujeo Solostar kumaonekera mwa iwo omwe amatenga Mlingo wambiri wa insulin chifukwa cha mankhwala omwe amapezeka ndi insulin.

Ndani angagwiritse ntchito insulin Tujeo

Kugwiritsa ntchito mankhwalawa kumaloledwa kwa okalamba omwe ali ndi zaka zopitilira 65, komanso odwala matenda ashuga omwe ali ndi aimpso kapena chiwindi.

Mukakalamba, ntchito ya impso imatha kuwonongeka kwambiri, zomwe zimapangitsa kuchepa kwa kufunika kwa insulin. Ndi kulephera kwa aimpso, kufunika kwa insulini kumachepa chifukwa kuchepa kwa insulin metabolism. Ndi kulephera kwa chiwindi, kufunika kumachepa chifukwa kuchepa kwa kuthekera kwa gluconeogeneis ndi insulin metabolism.

Sitikulimbikitsidwa kugwiritsa ntchito Tujeo Solostar panthawi yoyembekezera komanso mkaka wa m'mawere, ndibwino kusinthana ndi zakudya zabwino.

Malangizo ogwiritsira ntchito Tujeo Solostar

Insulin ya Tujeo imapezeka ngati jakisoni, woperekedwa kamodzi pa nthawi yoyenera patsiku, koma tsiku lililonse nthawi yomweyo. Kusiyanitsa kwakukulu mu nthawi yoyendetsera kuyenera kukhala maola 3 isanachitike kapena itatha nthawi yokhazikika.

Odwala omwe akusowa mlingo amayenera kuyang'anitsitsa magazi awo kuti athe kuyamwa kwambiri, ndipo abwerere mwakale kamodzi. Palibe vuto, mutatha kudumpha, simungathe kulowa muyezo wapawiri kuti mupange zomwe zayiwalika!

Kwa odwala omwe ali ndi matenda a shuga 1, Tujeo insulin iyenera kuperekedwa mwachangu ndi insulin panthawi yachakudya kuti ithetsere kufunika kwake.

Odwala a Tujeo insulin 2 omwe ali ndi matenda ashuga ayenera kuphatikizidwa ndi mankhwala ena a hypoglycemic. Poyamba, ndikulimbikitsidwa kuyambitsa 0.2 U / kg kwa masiku angapo.

KUMBUKIRANI. Tujeo Solostar imayang'aniridwa mosasamala! Simungathe kulowa nawo kudzera m'mitsempha! Kupanda kutero, pamakhala chiopsezo cha hypoglycemia.

Gawo 1 Chotsani cholembera ku firiji ola limodzi musanagwiritse ntchito, chokani kutentha. Mutha kulowa mankhwala ozizira, koma zimakhala zowawa kwambiri. Onetsetsani kuti mwapeza dzina la insulin ndi nthawi yomwe nthawi yake yakwana. Chotsatira, muyenera kuchotsa chipewa ndikuyang'anitsitsa ngati insulini ikuwonekera. Osagwiritsa ntchito ngati wapangika utoto. Opaka chingamu pang'ono ndi ubweya wa thonje kapena nsalu yothira ndi mowa wa ethyl.

Gawo 2 Chotsani chophimba chotchingira mu singano yatsopanoyo, ndikukulungani pa cholembera kufikira chitayima, koma osagwiritsa ntchito mphamvu. Chotsani kapu yakunja ndi singano, koma osataya. Chotsani chophimba chamkati ndi kutaya nthawi yomweyo.

Gawo 3. Pali zenera loletsa kumwa pa syringe yomwe ikuwonetsa kuti ndi ma unit angati omwe adzalowe. Chifukwa cha zatsopanozi, kusanthula pamiyeso sikofunikira. Mphamvu imawonetsedwa mumagulu amodzi a mankhwalawo, osofanana ndi ma analogu ena.

Choyamba yesetsani mayeso okhudza chitetezo. Mukamaliza kuyesa, dzazani syringe ndi 3 PIECES, kwinaku mukutembenuza chosankha cha mankhwalawo mpaka cholembacho chiri pakati pa manambala 2 ndi 4. Kanikizani batani loyang'anira mlingo mpaka litayima. Ngati dontho lamadzi lituluka, ndiye kuti cholembera cha syringe ndi choyenera kugwiritsidwa ntchito. Kupanda kutero, muyenera kubwereza chilichonse mpaka gawo 3. Ngati zotsatira sizinasinthe, ndiye kuti singano ndiyolakwika ndipo iyenera kusintha.

Gawo 4 Pambuyo pokhazikitsa singano, mutha kuyimba mankhwalawo ndikudina batani la metering. Ngati batani silikuyenda bwino, musagwiritse ntchito mphamvu kuti mupewe kuwonongeka. Poyamba, mlingo umakhala w zero, wosankha uyenera kuzunguliridwa mpaka polemba pamzere ndi mlingo womwe ukufunidwa. Ngati mwayi wosankhidwa atembenukira kutali kuposa momwe ungafunire, mutha kuubweza. Ngati mulibe ED yokwanira, mutha kulowa mankhwalawa 2 jakisoni, koma ndi singano yatsopano.

Zowonetsera zenera lotsogolera: ngakhale manambala amawonetsedwa moyang'anizana ndi cholembera, ndipo manambala osamvetseka amawonetsedwa pamzere pakati pa manambala. Mutha kuyimba ma PIERES 450 mu cholembera. Mlingo wa 1 mpaka 80 mayunitsi umadzazidwa ndi cholembera ndipo umaperekedwa mu kuwonjezeka kwa mlingo wa 1 unit.

Mlingo ndi nthawi yogwiritsira ntchito zimasinthidwa malinga ndi momwe thupi la wodwala aliyense limachitikira.

Gawo 5 Insulin iyenera kuyikiridwa ndi singano m'matumbo a subcutaneous a ntchafu, phewa kapena pamimba popanda kukhudza batani la dosing. Kenako ikani chala chanu batani, ndikukankhira mbali yonseyo (osati patali) ndikuigwira mpaka "0" iwonekere pazenera. Pang'onopang'ono kuwerenga mpaka asanu, kenako amasulidwe. Chifukwa chake mlingo wathunthu udzalandiridwa. Chotsani singano pakhungu. Malo omwe ali ndi thupi ayenera kusinthidwa ndikumayambitsa jakisoni watsopano aliyense.

Gawo 6 Chotsani singano: tengani nsonga ya kapu yakunja ndi zala zanu, gwiritsani singanoyo ndikuyiyika mu kapu yakunja, ndikulimba mwamphamvu, kenako tembenuzani cholembera ndi dzanja lanu lina kuti muchotsere singano. Yesaniso mpaka singano ichotsedwe. Tayetsani mu chidebe cholimba chomwe chimatayidwa ndi dokotala. Tsekani cholembera ndi cholembera ndipo musachiyimitsenso mufiriji.

1. Pamaso jakisoni onse, muyenera kusintha singano kukhala yatsopano yosabala. Ngati singano imagwiritsidwa ntchito mobwerezabwereza, kubowoleka kumatha, chifukwa choti mankhwalawo atha kukhala osalondola,
2. Ngakhale posintha singano, syringe imodzi iyenera kugwiritsidwa ntchito ndi wodwala m'modzi osati kupatsira ena,
3. Osachotsa mankhwalawo mu syringe ku cartridge kuti muchepetse bongo wambiri,
4. Yesani mayeso a chitetezo pamaso pa jakisoni onse,
5. Tengani singano zapadera kuti zitha kapena kutha, komanso kutsuka mowa ndi chidebe cha zinthu zogwiritsidwa ntchito,
6. Ngati mukukumana ndi vuto loona, ndibwino kufunsa anthu ena kuti mulingo woyenera,
7. Osasakaniza ndikuchepetsa insulin ya Tujeo ndi mankhwala ena,
8. Gwiritsani ntchito cholembera uyenera kuyamba pambuyo powerenga malangizowo.

Kusintha kuchokera ku mitundu ina ya insulin kupita ku Tujeo Solostar

Mukasintha kuchokera ku Glargine Lantus 100 IU / ml kupita ku Tugeo Solostar 300 IU / ml, mlingo umayenera kusinthidwa, chifukwa zomwe zakonzedwazo sizili ndi bioequivalent ndipo sizisinthana. Mmodzi amatha kuwerengera gawo lililonse, koma kuti akwaniritse kuchuluka kwa shuga m'magazi, mlingo wa Tujo umafunika 10-18% kuposa mlingo wa Glargin.

Mukamasintha insulin yayikulu komanso yayitali, muyenera kusintha kusintha kwa mankhwalawo ndikusintha mankhwala a hypoglycemic, nthawi ya makonzedwe.

Ndikofunikira kuyang'anira kuwunika kwa metabolic pafupipafupi ndikuyankhulana ndi dokotala mkati mwamasabata awiri atatha kusintha insulin. Pambuyo pakukonzanso kwake, mlingo uyenera kusinthidwanso. Kuphatikiza apo, kusintha kumafunikira pakusintha kulemera, moyo, nthawi ya kayendetsedwe ka insulin kapena zochitika zina pofuna kupewa chitukuko cha hypo- kapena hyperglycemia.

Makhalidwe wamba

Sanofi amatulutsa antidiabetic othandizira kwambiri. "Tujeo" wa insulin ndi chitukuko chamakono, chomwe chimatengera njira ya glargine. Zomwe zimapangidwa ndi SoloStar zimakhala ndi mamolekyulu a glargine - m'badwo waposachedwa wa insulin. Chifukwa cha izi, chida ndichothandiza pa kukana insulin kwa digiri yotchulidwa.

Mankhwala ali ponseponse ndipo amalimbikitsidwa kuti agwiritsidwe ntchito mu mtundu 1 komanso matenda a shuga. Ndi mankhwala a Toujeo insulin, palibe chifukwa chogwiritsa ntchito kawirikawiri kulemera kwa thupi kapena kusiya kuukira kwa hypoglycemia.

Malonda ake ndi amadzimadzi omveka bwino. Amapezeka mu cartridge yamagalasi 1.5 ml. Ikukhazikidwa mu cholembera choyambirira cha Tujeo SoloStar. M'bokosi lamakalata 1, 3 kapena 5 syringe.

Mndandanda wa SoloStara malinga ndi kagwiritsidwe kake ndi kapangidwe kake ndi Tresiba, Peglizpro, Lantus, Levemir, Aylar.

Mankhwalawa ali contraindified mu matenda ashuga ketoacidosis, ana ndi achinyamata osakwana zaka 18, komanso anthu omwe ali ndi tsankho pazigawo zina.

Odwala omwe ali ndi matenda amtundu wa endocrine, omwe ali ndi zaka zoposa 60, ndi omwe amalephera kuwonongeka ndi odwala omwe ali ndi vuto la chiwindi.

Zotsatira za pharmacological

"SoloStar" ili ndi mbiri yopanda pake yolimba ya glycemic, yomwe imasunga chithandizochi kwa maola 24 mpaka 35. Kutha kwa theka-moyo ndi maola 19. "Tujeo" - mankhwala omwe amapezeka nthawi yayitali. Pang'onopang'ono zolowa, ndikugawa pang'onopang'ono.

Chochita chachikulu ndicho kukondoweza kwa kagayidwe. Mankhwala amathandizira kuyamwa kwa glucose mwa zotumphukira zimakhala - minofu ndi mafuta. Tujeo SoloStar imalepheretsa kupanga kwa shuga m'magazi a chiwindi. Ntchito yogwira glargine, analogue yopanga ya insulin yaumunthu, imalepheretsa lipolysis mu adipocytes. Nthawi yomweyo, imachepetsa kuchuluka kwa mapuloteni ndikuyambitsa kupanga mapuloteni, omwe amafunikira kuyamwa kwa glucose. Njira ya metabolic iyi imachitika mwachangu, chifukwa chake zotsatira zake zimadziwika pokhapokha pakukhazikitsa.

Chifukwa cha nthawi yayitali ya mankhwala, ngati kuli koyenera, mutha kusintha nthawi ya jakisoni ndikuwonjezera nthawi yayitali pakati pa njira. Mukamamwa Tujeo Solostar, kuchuluka kwa shuga m'magazi kumachepetsa pang'onopang'ono. Izi zimakuthandizani kusankha mlingo woyenera wa mankhwala a insulin popanda kudumpha mwadzidzidzi m'magazi a magazi.

Mankhwalawa amagwiranso ntchito mosasamala kanthu za jenda komanso zaka za wodwalayo. Insulin ikhoza kutumikiridwa nthawi yomweyo kapena pulogalamu yosinthika. Otetezeka kwa okalamba, opitilira 65, komanso odwala matendawo. Imathandizira mkhalidwe wabwinobwino wa wodwalayo, umaletsa kukula kwa zovuta.

Kusiyana pakati pa SoljoStar ndi Lantus

Sanofi adatulutsanso Apidra, Insumans, ndi Lantus insulin. SoloStar ndi analogue yapamwamba ya Lantus.

Pali zosiyana pakati pa SoloStar ndi Lantus. Choyamba, ndimakhudzidwa. SoloStar ili ndi 300 IU ya glargine, ndipo Lantus ali ndi 100 IU. Chifukwa cha izi, ndizovomerezeka kwanthawi yayitali.

Pochepetsa kukula kwa mpweya wotentha, Tujeo SoloStar pang'onopang'ono amatulutsa mahomoni. Izi zikufotokozera kuchepetsedwa kwa nocturnal kwambiri hypoglycemia kapena zovuta za matenda ashuga.

Zotsatira zamtundu wa 100 IU za glargine zimadziwika pambuyo pake pambuyo pa jekeseni wa 300 IU. Kuchita kwa nthawi yayitali kwa Lantus kumatha masiku opitilira 24.

Tujeo SoloStar imachepetsa mwayi wokhala ndi hypoglycemia wowopsa kapena wamadzulo pofika 21 mpaka 23%. Nthawi yomweyo, zisonyezo zochepetsera zomwe zili glycated hemoglobin ku SoloStar ndi Lantus ndi zofanana. "Glargin" pa mayunitsi 100 ndi 300 ndi otetezeka kuthandizira odwala matenda ashuga onenepa kwambiri.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mankhwala amapezeka mu mawonekedwe a yankho la subcutaneous (sc) makonzedwe: madzi osapaka utoto kapena wopanda utoto wokhala ndi mawonekedwe owoneka bwino (1.5 ml aliyense m'magalofu amtundu wamagalasi popanda mtundu, makatoni amaikidwa mu zolembera za SoloStar zotayidwa, mu cholembera 1, 3 kapena 3 Makatoni 5 ndi malangizo ogwiritsira ntchito Tujeo SoloStar).

Mu 1 ml yankho lili:

• yogwira mankhwala: insulin glargine - 10,91 mg, yomwe ikufanana ndi 300 PIECES (gawo la zochita),
• othandizira: glycerol 85%, zinc chloride, hydrochloric acid, metacresol (m-cresol), sodium hydroxide, madzi a jekeseni.

Mankhwala

Limagwirira ntchito yogwira ntchito Tujeo SoloStar, insulin glargine, umalimbana kuyang'anira kagayidwe kachakudya kagayidwe kachakudya mu magazi mwa kuletsa mapangidwe a shuga mu chiwindi ndikuwonjezera mayamwidwe ake ndi minofu yamatumbo, adipose ndi zina zotumphukira. Insulin glargine, kupondereza lipolysis mu adipocytes komanso zoletsa proteinol, kumawonjezera kaphatikizidwe kakapuloteni.

Kupezedwa ndi kubwerezanso kwa mabakiteriya amtundu wa DNA (deoxyribonucleic acid) amtundu wa mtundu wa Escherichia coli (tizilombo ta K12) wogwiritsidwa ntchito ngati wopanga, insulin glargine imasungunuka pang'ono m'malo osaloledwa. Pa pH 4 (acid yapakatikati), insulin glargine imasungunuka kwathunthu. Kusagwirizana kwa asidi komwe kumachitika yankho atatha jakisoni kulowa m'mafuta amkati amachititsa kuti microprecipitate, yomwe imamasula pang'ono insulin glargine ikhale yokhazikika.

Poyerekeza ndi insulin isophan, insulin glargine (100 IU / ml) imadziwika ndi kuyambukira pang'onopang'ono kwa hypoglycemic zotsatira pambuyo poyang'anira sc, nthawi yayitali imadziwika ndi kusungidwa kwa yunifolomu ya kukhalapo.

Poyerekeza insulin Tujeo SoloStar ndi insulin glargine 100 IU / ml, zidapezeka kuti pambuyo poti mankhwala a sc awagwiritsa ntchito pamlingo wofunikira kwambiri, zotsatira zake za hypoglycemic zinali zowonjezereka ndipo zimatha maola 24 mpaka 36. Kuchitapo kanthu kwa nthawi yayitali kumalola odwala, ngati kuli kotheka, kusintha nthawi ya kapangidwe ka mankhwalawa, pochita njirayi pasanathe maola atatu musanayambe kapena mutatha nthawi yokhazikika.

Kusiyana pakati pa hypoglycemic action curve of insulin glargine 100 IU / ml ndi Tujeo SoloStar kumalumikizidwa ndi kusintha kumasulidwa kwa insulin glargine kuchokera ku precipitate. Pakukhazikitsa chiwerengero chomwecho cha insulin glargine, kuchuluka kwa mankhwalawa kumafunikira katatu kuposa momwe angapangire insulin glargine 100 IU / ml, izi zimathandizira kuchepetsa mawonekedwe a mpweya komanso kumasulidwa kwake kwapang'onopang'ono kuchokera ku kutsatsa kwa mankhwala, poyerekeza ndi insulin glargine 100 U / ml

Zotsatira za hypoglycemic ndi intravenous (iv) makulidwe ofanana a insulin glargine ndi insulin ya anthu ndi chimodzimodzi.

Chifukwa cha biotransfform ya insulin glargine, metabolites awiri omwe amapanga amapangika - M1 ndi M2. Malinga ndi zotsatira za kafukufuku wa mu vitro, kuyanjana kwa insulin glargine ndi metabolites yake yogwira zolandirira ma insulin zolandilira anthu ikufanana ndi insulin ya anthu.

Chiyanjano cha insulin glargine cha insulin-monga kukula chinthu 1 (IGF-1) cholandilira chimakhala champhamphwi mpaka 5-8 kuposa cha insulin ya anthu, koma pafupifupi 70-80 nthawi kutsika kuposa IGF-1. Ma metabolites M1 ndi M2 ndi otsika poyerekeza ndi insulin yaumunthu pakugwirizana kwa IGF-1 receptor.

Odwala omwe ali ndi matenda amtundu wa 1 shuga, kuchuluka kwathunthu kwa insulin glargine ndipo ma metabolites ndi otsika kwambiri kuposa gawo lofunikira kuti theka limangirizidwe kwa IGF-1 receptors komanso kuyambitsa kwotsatira kwa mitogenic proliferative. Itha kuthandizidwa ndi kuchuluka kwa mphamvu ya thupi ya endo native IGF-1, koma zochizira za insulin zomwe zimatsimikiziridwa munthawi ya chithandizo cha Tujo SoloStar ndizotsika kwambiri kuposa kutsika kwa zamankhwala zofunika pa izi.

Zotsatira zoyesa zamankhwala zamankhwala, zomwe zimakhudza odwala omwe ali ndi matenda a shuga 1 a mellitus (odwala 546) ndi mtundu wa 2 shuga mellitus (2474 odwala), adawonetsa kuti, poyerekeza ndi zoyambira za glycosylated hemoglobin (Hb_A1c, kuchepa kwa mfundo zake kumapeto kwa maphunziro sikunali kocheperako pogwiritsa ntchito insulin glargine 100 IU / ml.

Chiwerengero cha odwala omwe afikira chandamale Hb_A1c (pansipa 7%), m'magulu onse azithandizo anali ofanana.

Pakutha kwa phunziroli, kuchuluka kwa kuchepetsa shuga m'magazi pogwiritsa ntchito Tujeo SoloStar ndi insulin glargine 100 IU / ml inali chimodzimodzi. Nthawi yomweyo, kuchepa kwapang'onopang'ono kwa kuchuluka kwa shuga m'magazi a m'magazi kunadziwika panthawi ya kusankha kwa mankhwalawa panthawi ya mankhwala.

Poyerekeza zotsatira ndi makonzedwe a insulin glargine 300 IU / ml m'mawa kapena madzulo, tapeza kuti kuwongolera kwa glycemic, kuphatikizapo kusintha kwa Hb_A1czinali zofanana. Mankhwalawa akaperekedwa pakati pa maola atatu isanachitike kapena itatha nthawi yokhazikika, sunayende bwino.

Poyerekeza ndi kugwiritsa ntchito kwa Tujo SoloStar kwa miyezi isanu ndi umodzi, kuwonjezeka kwa kulemera kwa thupi kosachepera 1 kg ndikotheka.

Zinapezeka kuti kusintha kwa Hb_A1c jenda, fuko, zaka kapena kulemera kwa wodwalayo, kutalika kwa matenda a shuga (osakwana zaka 10, zaka 10 kapena kupitilira) komanso zoyambirira za chizindikiro izi sizikhala ndi vuto.

Zotsatira za mayesero azachipatala kwa odwala omwe ali ndi mtundu wa matenda a shuga 2 awonetsa kuchepa kwambiri komanso / kapena kutsimikizira hypoglycemia, komanso hypoglycemia yokhala ndi zizindikiro zamankhwala, kuposa momwe amathandizira ndi insulin glargine 100 IU / ml.

Pankhani yochepetsera chiopsezo chokhala ndi hypoglycemia yotsika komanso / kapena kutsimikizika, mwayi wa Tujeo SoloStar pa insulin glargine 100 IU / ml unawonetsedwa nthawi yoyambira mwezi wachitatu wamankhwala mpaka kumapeto kwa kafukufuku mu 23% ya odwala omwe adalandila othandizira a hypoglycemic othandizira komanso 21% ya odwala kumwa insulin ndi zakudya.

Kugwiritsidwa ntchito kwa Tujeo SoloStar kumayambitsa kuchepa kwa chiwopsezo cha hypoglycemia mwa odwala omwe adalandira chithandizo cha insulin kale, komanso mwa odwala omwe sanalandire insulin kale.

Odwala omwe ali ndi matenda a shuga 1 amisipirasi, kuchuluka kwa hypoglycemia pakugwiritsa ntchito Tujeo SoloStar ndikufanana ndi mankhwalawa ndi insulin glargine 100 IU / ml. Dziwani kuti nthawi yoyamba ya chithandizo, pafupipafupi kukula kwa mitundu yonse ya nocturnal hypoglycemia kumakhala kotsika ndi mankhwalawa kuposa ndi insulin glargine 100 IU / ml.

Zotsatira za kafukufukuyu sizinawonetse kukhalapo kwa kusiyana komwe kumakhudzana ndikupanga ma antibodies kupita ku insulin, komanso pakuwoneka bwino, chitetezo, ndi mlingo wa insal insulin poyerekeza odwala omwe amathandizidwa ndi Tujeo SoloStar ndi odwala omwe amathandizidwa ndi insulin glargine 100 IU / ml.

Kafukufuku wapadziko lonse, wamitundu yambiri, wosasankhidwa wa insulin glargine 100 IU / ml adachitidwa mwa odwala 12 537 omwe ali ndi vuto la glucose, kusala glycemia kapena gawo loyambirira la 2 matenda osokoneza bongo komanso kutsimikizira matenda a mtima. Hafu imodzi ya omwe adalandira nawo kafukufukuyu adalandira insulin glargine 100 IU / ml, mlingo wake womwe umatulutsidwa mpaka kutsukidwa kwa plasma glucose ya 5.3 mmol kapena kutsika kudapezeka, ndipo winayo adalandira chithandizo chokwanira. Phunziroli lidatenga zaka pafupifupi 6.2.

Median Hb_A1c, zotulukapo zake zinali 6.4%, panthawi ya chithandizo anali mu 5.9-6.4% mu gulu la insulin glargine ndi 6.2-6.6% mu gulu lachipatala lodziwika bwino.

Zotsatira poyerekeza phunziroli zidawonetsa kuti poyerekeza ndi momwe mankhwalawo amathandizira ndi insulin glargine 100 IU / ml, mwayi wokhala ndi zovuta zamtima (zosagwirizana ndi kuphedwa kwa mtima ndi chifuwa cha mtima), njira yosinthira kapena kuchipatala chifukwa cha kukhazikika kwa mtima, kuperewera kwa mtima zovuta. Chizindikiro chophatikizira cha zovuta za microvascular chikuphatikiza laser Photocoagulation kapena vitlimomy, kutayika kwa chifukwa cha matenda ashuga, kuphatikizika kwa ndende ya cellininia, kupitilira kwa albuminuria, kapena kufunika kwa mankhwala a dialysis. Kugonana kwamtundu ndi mtundu sikukhudza magwiridwe ndi chitetezo cha Tujeo SoloStar.

Pazonse, palibe kusiyana pakukwaniritsidwa komanso chitetezo cha mankhwalawa pakati pa odwala omwe ali ndi mtundu 1 ndi mtundu wa 2 wodwala matenda ashuga a zaka 65 ndi odwala okalamba ndi achichepere. Popewa zochita za hypoglycemic, mu okalamba odwala, Mlingo woyambirira ndi wowonjezera uyenera kutsika kuposa masiku onse, kuchuluka kwa mankhwalawa kumalimbikitsidwa kuti kuchitike pang'onopang'ono. Mwa odwala okalamba, zimakhala zovuta kudziwa zizindikiro za hypoglycemia, chifukwa chake, ndikofunikira kuyang'anitsitsa kuchuluka kwa shuga m'magazi.

Palibe chidziwitso chokhudza chitetezo cha ana ndi kugwiritsa ntchito Tujeo SoloStar mwa ana.

Pharmacokinetics

Poyerekeza ndi insulin glargine, 100 PIECES / ml, pambuyo pa s / C ya Tujeo SoloStar, kuchuluka kwa insulini kumatheka chifukwa chothilira pang'onopang'ono komanso kwa nthawi yayitali, zomwe zimapangitsa kuti pakhale nthawi yochepetsetsa kwambiri ya ndende kwa maola 36. C_ss (kuchuluka kwa kuchuluka kwa mankhwalawa mu plasma) mkati mwa achire osiyanasiyana omwe amakhala atakwaniritsidwa pambuyo pa maola a 58-96 a ntchito pafupipafupi a Tujo SoloStar.

Wodwala yemweyo ali ndi kusiyana kocheperako pakudziwonetsera kwa insulin kwa maola makumi awiri ndi limodzi.

Insulin glargine imapangidwa mofulumira kuchokera mbali ya carboxyl (C-terminus) ya beta unyolo, chifukwa cha biotransformation iwiri yogwira metabolites M1 (21 A -Gly-insulin) ndi M2 (21 A -Gly-des-30 B -Thr-insulin . Metabolite M1 imapezeka makamaka m'madzi a m'magazi; kuwonekera kwake kwadongosolo kumawonjezeka molingana ndi kuchuluka kwa insulin glargine. Zinakhazikitsidwa kuti achire zotsatira za mankhwalawa makamaka chifukwa cha kuwonekera kwa zokhudza metabolite M1, popeza muzochitika zambiri odwala insulin glargine ndi metabolite M2 sazindikira mu kayendedwe ka magazi. Nthawi zina, kuchuluka kwa magazi a insulin glargine ndi M2 ya metabolite sikudalira kuchuluka kwa mlingo wa insulin glargine.

T_½ (theka-moyo) wa metabolite M1, ngakhale atakhala ndi insulin glargine, ali pamtunda wa maola 18 mpaka 19.

Zotsatira za mtundu wa wodwala kapena jenda pa pharmacokinetics ya Tujeo SoloStar sizinakhazikitsidwe.

Palibe chidziwitso pa zaka za mankhwala pa pharmacokinetics ya mankhwala. Kupewa magawo a hypoglycemic kwa odwala omwe ali ndi matenda osokoneza bongo okalamba, tikulimbikitsidwa kuti milingo yoyambirira ndi kukonza ipatsidwe pang'onopang'ono ndikuwonjezereka kwa pang'onopang'ono.

Ma pharmacokinetics a Tujo SoloStar mwa ana sanaphunzire.

Mukamachita maphunziro ndi insulin yaumunthu, kuwonjezeka kwa insulin kwa anthu omwe amapezeka ndi aimpso ndi hepatic. Zofananazo zimayembekezeredwa mukamagwiritsa ntchito insulin glargine, kotero ndikulimbikitsidwa kuti odwala omwe ali m'gulu ili azisamala kuchuluka kwa shuga wamagazi.

Contraindication

• wazaka zosakwana zaka 18 (popeza maphunziro azachipatala otsimikizira kutha ndi mankhwalawa kwa ana ndi achinyamata palibe),
• Hypersensitivity pamagawo a mankhwala.

Chenjezo liyenera kuperekedwa kwa insulin Tujeo SoloStar pa nthawi yomwe ali ndi pakati, odwala okalamba, omwe ali ndi vuto losagwirizana ndi endocrine (kuphatikizapo kuperewera kwa adrenal cortex ndi adenohypophysis, hypothyroidism), stenosis yayikulu ya mitsempha kapena mitsempha ya m'mimba, proliferative retinopathy (makamaka posakhala ndi mafupa) , kuperewera kwambiri kwa chiwindi, matenda omwe amayenda ndi matenda am'mimba kapena kusanza.

Tugeo SoloStar, malangizo ogwiritsira ntchito: njira ndi mlingo

Njira yothetsera vutoli idapangidwa kuti ayambe kuyambitsa mafuta am'mimba, mapewa kapena m'chiuno ndi jakisoni wa sc. Ndondomeko imachitika nthawi 1 patsiku panthawi yoikika. Pa jekeseni aliyense wotsatira, muyenera kusankha malo atsopano m'malo omwe akutsimikiziridwa kuti angawongolere.

Intravenous makonzedwe a njira yotsutsana!

Simungagwiritse ntchito pampu yolowetsa insulin kuti mupeze yankho.

Bokosi la syringe lili ndi magawo 80 a yankho lokonzekera kugwiritsa ntchito lomwe sayenera kuchotsanso syringe ina kapena kugwiritsidwa ntchito ndi odwala angapo, ngakhale singano itasinthidwa.

Cholembera cha syringe chimakhala ndi chida chotsitsa ndi kukweza kwa 1 unit. Zimawonetsa kuchuluka kwa magawo a insulin glargine omwe amayenera kuperekedwa.

Kuti muwongolere mankhwalawa, gwiritsani ntchito singano zapadera za BD Micro-Fine Plus za zolembera za SoloStar syringe. Singano ndizongogwiritsa ntchito kamodzi. Kugwiritsa ntchito singano mobwerezabwereza kumawonjezera chiopsezo cha kufinya ndi kusanja kosayenera kwa mankhwalawo, komanso kuipitsidwa ndi matenda.

Mukamagwiritsa ntchito cholembera kwa nthawi yoyamba, imachotsedwa mufiriji pasanathe ola limodzi jekeseni isanachitike kuti jakisoni azikhala pamalo otentha ndipo makina ake samapweteka kwambiri.

Pamaso pa jekeseni aliyense, muziwunika dzina la insulin ndi tsiku lotha ntchito polemba cholembera. Ndikulimbikitsidwa kuwonetsa tsiku lotsegulira.

Popeza tachotsa kapu mu cholembera, ndikofunikira kuti tiwone pang'onopang'ono insulin. Ngati zomwe zili mu cartridge ndizamtambo, zosasinthika kapena zophatikizira zinthu zakunja, zomwe zikuyenera kuyenera kutayidwa. Kupezeka kwa thovu m'madzi a insulin sikuvulaza.

Pambuyo powonetsetsa kuti yankho lake likuwoneka ngati madzi oyera, mutha kupitiriza njirayi. Choyamba, muyenera kupukuta nembanemba wa rabara pa cartridge ndi nsalu yoviikidwa mu mowa wa ethyl. Tengani singano yatsopano ndipo, mutachotsa zokutira, popanda kuyesetsa mopitirira muyeso, pezani njira yonse mpaka ku cholembera. Chotsani khungu lakunja kenako ndi kapu yamkati kuchokera singano.

Pamaso jekeseni aliyense, ndikofunikira kuchita mayeso a chitetezo, zotsatira zake ziyenera kutsimikizira kuyenera kwa cholembera, ndikuchotsa kusokoneza kwa singano kapena kukhazikitsa mlingo woyipa wa insulin.

Kuti muchite mayeso otetezedwa, muyenera kuyika cholembera pa chizindikiritso cha manambala 2 ndi 4, chomwe chikugwirizana ndi magulu atatu. Ngati dontho la insulin likuwoneka pachimake pa singano mutatha kukanikiza batani la mlingo wonse, amatanthauza kuti cholembera chikugwira ntchito moyenera. Izi ngati sizichitika, ndiye kuti mutha kubwereza kukanikiza batani lolemba. Ngati palibe dontho kumapeto kwa singano mutayesa kachitatu, ikani singano ndikubwereza mayesowo. Ngati kuchotsa singano sikunapange kanthu koma kuyesa kwachitetezo kulephera, cholembera cholowetsa m'malo mwake chimayenera kulocha china. Musagwiritse ntchito syringe kuti mupeze insulin kuchokera ku cholembera.

Pambuyo poyeserera chitetezo, chizindikiro cha mlingo uyenera kukhala "0". Kuti muyike mlingo womwe waperekedwa, muyenera kukhazikitsa cholemba pamzere womwewo ndi mlingo womwe mukufuna. Ngati polemba litasinthidwa mwangozi kupitirira mlingo womwe umafunikira, muyenera kuubwezera.

Ngati zomwe zili mu cartridge ndizochepa poyerekeza ndi mankhwala, makonzedwe awiri ayenera kupangidwira: imodzi kuchokera ku cholembera yomwe ilipo, ina yomwe ili ndi insulin yochuluka ya cholembera chatsopano. Njira ina ndikupereka mlingo wonse wofunikira ndi cholembera chatsopano.

Ngakhale manambala (kuchuluka kwa mayunitsi) pawindo lodziwitsa anthu amawonetsedwa moyang'anizana ndi chizindikiro cha mankhwalawo, manambala osamveka amawonekera pamzere pakati pa manambala.

Pali magawo 450 a insulini mu katiriji, mlingo ukhoza kuyikidwa kuchokera ku 1 mpaka 80 mayunitsi mukukula kwa 1 unit. Cholembera chilichonse cha syringe chimakhala ndi mlingo woposa umodzi, kuchuluka kwake pa cartridge kumakupatsani mwayi wodziwa kuchuluka kwa insulin yomwe ilipo.

Kuti mupeze jakisoni, muyenera kusankha malo ndipo mutagwira cholembera ndi thupi, ndikuyika singano, kenako, ndikuyika chala chanu pa batani la mlingo, ndikukankhira njira yonse ndikuyigwira. Simungathe kukanikiza batani pakona, muyenera kuwonetsetsa kuti chala chake sichikuletsa kuzungulira kwa chosankha. Ndikofunika kuti batani likanikizidwe mpaka "0" iwonekere pazenera la mankhwalawo, pang'onopang'ono kuwerenga mpaka kasanu. Ndipokhapo pomwe batani lotulutsa lingathe kumasulidwa ndiku singano ichotsedwa.

Pakakhala zovuta ndi kugwiritsa ntchito batani la mlingo, mphamvuyo sayenera kuyigwiritsa ntchito kuti isawononge cholembera. Ndikofunikira kutsimikizira patency ya singano poyesanso chitetezo chachiwiri. Ngati batani lipitilirabe kugwira ntchito molakwika, sinthani cholembera.

Pambuyo pa jakisoni, singano imayenera kuchotsedwa pogwiritsa ntchito kapu yakunja ya singano. Kuti muchite izi, gwiritsani ntchito zala ziwiri kuti muthe kumapeto kwenikweni kwa kapu yakunja ndikuyika singano mkati mwake. Kanikizani chidacho mwamphamvu, ndikugwira gawo lalikulu lakunja kwa singano mwamphamvu, kutembenuzira cholembera kangapo ndi dzanja lina.

Singano yomwe imagwiritsidwa ntchito iyenera kutayidwa muchidebe chosagwira ndi punct.

Pambuyo pochotsa singano, cholembera cha syringe chimayenera kutsekedwa ndi chipewa ndikusungidwa pamalo otetezedwa ku kuwala ndi kutentha. Osayika cholembera chogwiritsidwa ntchito mufiriji.

Ngati pali chikaiko chilichonse chogwiritsira ntchito cholembera kapena ngati chawonongeka, sichiyenera kugwiritsidwa ntchito; musayesere kukonza. Ndikulimbikitsidwa kusamalira mosamala gawo la syringe: pewani kugwera pamalo olimba, mutetezeni kuti musakhudzane ndi malo okhala, fumbi kapena dothi, musapake mafuta. Mutha kugwiritsa ntchito nsalu yonyowa pokonza kunja.

Ndikulimbikitsidwa kuti nthawi zonse mumakhala ndi cholembera cha syringe ndi singano zopumira.

Dokotalayo ndi amene amawerengera mlingo ndi nthawi ya Tujo SoloStar, poganizira zolinga za kutsekeka kwa shuga m'magazi payekhapayekha.

Kusintha kwa mankhwala a insulin kumachitika mosamala kwambiri ndipo ndi dokotala yemwe amaganizira zomwe zimayambitsa kusakwanira kwa glycemic control, kuphatikizapo kusintha kwa kulemera kwa thupi, moyo wodwala, nthawi ya insulin.

Tujeo SoloStar si mankhwala osankha a matenda ashuga a ketoacidosis, chifukwa cha mankhwalawa ndikofunikira kugwiritsa ntchito iv pokhazikitsa insulin.

Odwala omwe ali ndi matenda ashuga amalangizidwa kuti aziyang'anira kuchuluka kwa shuga m'magazi.

Popereka mankhwala, wogwira ntchito zachipatala ayenera kulangiza wodwalayo mwatsatanetsatane za momwe angagwiritsire ntchito mankhwalawa, ndikuwonetsetsa momwe wodwalayo amathandizira.

Mankhwalawa a matenda amtundu wa 1 shuga, Tujeo SoloStar ndi mankhwala omwe amaperekedwa limodzi ndi insulin, omwe amaperekedwa pakudya ndipo amafunikira kusintha kwa mlingo.

Kwa odwala omwe ali ndi matenda a shuga 2, mankhwalawa oyambira tsiku lililonse a Tujeo SoloStar amalimbikitsidwa kuti aikidwe pamlingo wa 0,0 PESCES pa kilogalamu imodzi ya kulemera kwa wodwala, ndikutsatira kusintha kwa mlingo wa munthu aliyense.

Mukamasintha chithandizo kuchokera ku mankhwala a insulin glargine 100 IU / ml kupita ku Tujeo SoloStar, kapena mosinthanitsa, ziyenera kukumbukiridwa kuti mankhwala osokoneza bongo siwothandiza komanso sasinthika mwachindunji.

Pambuyo pa insulin glargine chithandizo cham'mbuyomu, 100 IU / ml, kusintha kwa Tujeo SoloStar kutha kuchitika pamlingo wa unit chilichonse. Komabe, kuti mukwaniritse chandamale cha glucose chandamale, mufunika kuti mupeze insulin glargine 300 U / ml.

Mukasintha kuchokera ku Tujo SoloStar kupita ku insulin glargine 100 IU / ml, mlingo wa insulini uyenera kuchepetsedwa pafupifupi 20%, ngati kuli kotheka, kusintha kwa mlingo kuyenera kupitilizidwa.

Pambuyo pakusintha imodzi mwa mankhwalawa kupita kwina, kuwunika mosamala metabolism kumalimbikitsidwa mkati mwa masabata awiri oyamba.

Mukasintha kuchokera ku insulin ya pakatikati kapena nthawi yayitali kukhala njira yothandizira mankhwalawa ndi Tujeo SoloStar, zingakhale zofunikira kusintha mlingo wa insal insulin ndikusintha Mlingo ndi nthawi yogwiritsira ntchito insulin yofulumira, othandizira insulin analogi kapena osagwiritsa ntchito insulin hypoglycemic.

Mukamasintha kuchokera pakukhazikitsidwa kwa insal 1 nthawi patsiku, mlingo wa Tujeo SoloStar ungathe kukhazikitsidwa pokhazikitsidwa ndi insulin yomwe kale idalowetsedwa.

Mukamasintha kuchokera pakukhazikitsa insulin 2 patsiku, mlingo woyambirira wa mankhwalawa uyenera kukhala 80% ya okwanira tsiku ndi tsiku a insulin.

Kukhalapo kwa ma antibodies a anthu ku insulin ya odwala omwe akupezeka ndi mankhwala omwe ali ndi Mlingo wambiri wa insulin, zimawongolera poyankha insulin glargine 300 IU / ml.

Kusintha kwa mankhwala othandizirana ndi mankhwalawa kuyenera kutsagana ndi kuwunika mozama kagayidwe kachakudya.

Kuwonjezeka kwa insulivivity pamtunda wa kusintha kwa kagayidwe kachakudya kungafune kuwonjezeredwa kwa regimen.

Kungoyendetsa kamodzi kwa Tujeo SoloStar masana kumathandizira wodwala kukhala ndi ndondomeko yosinthika ya jakisoni ndipo, ngati kuli kotheka, jekeseni maola 3 isanachitike nthawi yanthawi ya njirayo kapena maola atatu pambuyo pake.

Musachulukane ndi insulin glargine 300 PIECES / ml kapena kusakaniza ndi insulin ina.

Pochiza odwala okalamba, kuwunika mosamala kuchuluka kwa shuga m'magazi kumafunika. Posankha mlingo wa gulu ili la odwala, ndikofunikira kuganizira kuwonongeka kwapang'onopang'ono mu ntchito yawo yaimpso, zomwe zingayambitse kuchepa kwa insulin kosalekeza.

Zochizira odwala aimpso kapena hepatic kuchepa, palibe malangizo apadera pa kukonza kwa regimen. Tiyenera kukumbukira kuti kuchepetsa kuchepa kwa insulin m'gulu lino la odwala kumatha kuchepetsa kufunika kwa insulin, chifukwa chake, amafunikira kuyang'anira kuchuluka kwa shuga m'magazi.

Zambiri

Mankhwala - insulin "Toujeo Solostar" ali ndi yogwira mankhwala glargine, omwe amakhala ndi mphamvu yayitali, cholinga chake ndicho kuphwanya kuchuluka kwa mamolekyulu a shuga m'magazi. Amapangidwa ndi kampani yodziwika bwino ya mankhwala Sanofi, yomwe imagwira ntchito yopanga insulin ya mitundu monga Insumans, Apidra.

Ubwino ndi kuipa

Mankhwalawa adadutsa mayesero azachipatala, ndi otetezeka kwathunthu ku thupi la munthu. Koma monga mankhwala ambiri, ili ndi zabwino komanso zoipa. Ubwino wa Tujeo SoloStar insulin ukuwonetsedwa mu zotsatirazi zochizira:

• Kutalika kwa mankhwalawa, komwe kumachitika kwa maola 32- 35 osafika pachimake pa chiwopsezo cha glycemic,
• choyenera kuchitira odwala omwe ali ndi mtundu 1 ndi mtundu 2 matenda a shuga,
• kuchuluka kwa yogwira pophika ndikwapamwamba kwambiri kuposa kufananizira ndipo kumafika magawo 300 pa 1 ml,
• kwa nthawi 1, mankhwala ochepa omwe amapezeka mu jakisoni wa jakisoni amaperekedwa,
• amachepetsa chiopsezo cha hypoglycemia usiku.
• Zoyipa zazikulu za mankhwalawa ndizopezeka pazinthu zotsatirazi zokhudzana ndi kufotokozera kwa insulin yamtunduwu:
• contraindicated pamaso pa matenda ashuga ketoacidosis,
• osayenera chithandizo cha odwala matenda ashuga omwe ali ndi vuto la impso ndi chiwindi.
• matupi awo sagwirizana ndi yogwira mankhwala akhoza kuchitika - glargine (wotchulidwa mawonekedwe a ofiira otupa pakhungu pamasaya, khosi, m'munsi, m'mimba, kuzungulira kwa jekeseni malo, kuyabwa, kutupa kwa nembanemba
• Palibe chidziwitso chachipatala chokhudza chitetezo cha mankhwalawa pochiza ana, komanso azimayi omwe ali ndi pakati.

Zotsalira zonse za insulin Tujeo SoloStar sizinanene chilichonse chotsutsana ndi zoperewera zomwe zimalepheretsa kugwiritsidwa ntchito kwake ngati chida chachikulu pothandizira matenda a shuga a mtundu 1. Amawonetsedwa kuti agwiritse ntchito odwala omwe ali ndi matenda ashuga omwe amakonda kuchita zovuta za hypoglycemic.

Kusiyana kwa insulin Lantus

Tujeo ali ndi kusiyana kwakukulu kokhudza insulin Lantus. Zimakhala kuti SoloStar imakhazikika kwambiri. Zomwe zimagwiritsidwa ntchito m'mankhwala awa ndizofanana - ndi glargine.

Mankhwala ena onse alibe kusiyana kwakukulu. Kupangidwa ndi kampani yomweyo ya Germany - Sanofi Aventis.

Mothandizidwa ndi adokotala, endocrinologist Tujeo akhoza m'malo ndi mankhwala omwe ali ndi katundu wofanana komanso mawonekedwe osiyanasiyana. Izi ndi zotungira za zinthu zotsatirazi:

1. Levemir yokhala ndi chinthu chophatikizira mawonekedwe ake. Ilinso ndi nthawi yayitali, koma osati yokhazikika.
2. Tresiba. The achire zotsatira zimatheka chifukwa cha dehydlude chigawo, chomwe chimakhazikitsa kuchuluka kwa glucose m'magazi munthawi yochepa.
3. Lantus. Analogue yomwe ili pafupi kwambiri ndi mankhwala oyambira Tujo SoloStar.

Mitundu ya insulin yofanana ndi mankhwala omwe angagwiritsidwe ntchito angagwiritsidwe ntchito ngati njira zina pothandizira matenda a shuga mellitus kupewa kuyambika kwa hypoglycemia.

Mimba komanso kuyamwa

Odwala omwe ali ndi matenda ashuga ayenera kudziwitsa dokotala za mimba yomwe ilipo kapena idakonzekera.

Panalibe mayeso azachipatala omwe amayesedwa mwachisawawa pakugwiritsa ntchito mankhwalawa Tujo SoloStar® mwa amayi apakati.

Chiwerengero chochulukirapo (zotsatira zopitilira 1000 za kubereka poyeserera ndikuyembekeza kutsatira) ndikutsatsa pambuyo pogulitsa insulin glargine 100 IU / ml adawonetsa kuti sanakhale ndi zotsatirapo zake pamaphunziro ndi zotsatira za kutenga pakati, mkhalidwe wa mwana wosabadwayo kapena thanzi la akhanda.

Kuphatikiza apo, pofuna kuyesa chitetezo cha insulin glargine ndi insulin isofan mwa amayi apakati omwe ali ndi matenda am'mbuyomu kapena a gestational matenda a shuga, kuwunika kwa meta-kuyesedwa kwa mayeso asanu ndi atatu a kuchipatala komwe kunachitika, kuphatikiza azimayi omwe amagwiritsa ntchito insulin glargine 100 IU / ml panthawi yapakati (n = 331) ndi isophan insulin (n = 371).

Kuwunika kwa meta kumeneku sikunawonetse kusiyana kwakukulu pokhudza chitetezo cha mayi kapena mwana wakhanda pogwiritsira ntchito insulin glargine ndi insulin isofan panthawi yapakati.

Mu maphunziro a zinyama, palibe deta yachindunji kapena yosalunjika yomwe idatengeka pa embryotoxic kapena fetotoxic of insulin glargine 100 IU / ml ikagwiritsidwa ntchito mu Mlingo wa 6 mpaka 40 nthawi yayikulu kuposa Mlingo woyenera mwa anthu.

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 yoletsa kubereka osawoneka ndi zotsatira zoyipa zomwe zimagwirizana ndi hyperglycemia.

Ngati ndi kotheka, kugwiritsa ntchito mankhwalawa Tujo SoloStar ® panthawi ya kubereka kungaganiziridwe.

Kufunika kwa insulin kumatha kuchepa mu trimester yoyamba ya kutenga pakati, komanso, kuwonjezeka panthawi yachiwiri komanso yachitatu. Pambuyo pobadwa, kufunika kwa insulini kumachepera msanga (chiopsezo cha hypoglycemia chikuwonjezeka). Pansi pa izi, kuwunikira mosamala kuchuluka kwa shuga m'magazi ndikofunikira.

Odwala nthawi yoyamwitsa angafunikire kusintha kwamomwe mulingo wa insulin ndi zakudya.

4 Njira zoperekera jakisoni

Njira yothetsera insulin imapezeka m'mbale, makatiriji, ngati gawo la zolembera zomalizidwa. Mankhwalawa amaperekedwa pogwiritsa ntchito zida zapadera. Njira yakhazikitsidwe ndi malamulo ogwiritsira ntchito ndizosiyana.

Pogwiritsa ntchito syringes zotayika, mutha kubayira insulini iliyonse, kupatula Tujeo. Amagwiritsidwanso ntchito kuyang'anira mahomoni amakula. Ndikofunikira kuonetsetsa kuti kuyika chizindikiro pa syringe "100 U / ml" chikufanana ndi kuchuluka kwa mankhwalawa. Chifukwa cha singano yayitali (12 mm), jakisoni m'matumbo ang'onoang'ono amachitika pakadutsa 45 madigiri.

Ma cholembera a syringe ndi othandiza kutulutsa (otakataka) komanso osinthika:

• Mtundu woyamba ndi chipangizo chokhala ndi cartridge yokhazikitsidwa yomwe ili ndi yankho la insulin. Sizingasinthidwe, cholembera chololedwa.
• Pazida zomwe zingagwiritsidwenso ntchito, katoni yatsopano ikhoza kuikidwapo yapita itatha. Pobayira, ma singano otayika amagwiritsidwa ntchito. Ngati kutalika kwawo sikuposa 5 mm, sikofunikira kuti mupukuteni khungu pamalo a jekeseni. Ngati kukula kwa singano ndi 6-8 mm, insulin imabayidwa pakona 90 madigiri.

Khola la syringe ndilokha. Musanagwiritse ntchito, onani tsiku lotha ntchito ndi dzina la mankhwalawo lomwe muli.

Kupezeka kwa thovu m'mbale. Kuyesedwa kwa chitetezo kumachitika pamaso pa jekeseni iliyonse.

Kuti muchite izi, magawo atatu a insulin amawaimbira, kenako batani loyendetsera mlingo likakanikizidwa njira yonse. Kumaoneka ngati dontho la yankho kumapeto kwa singano kumawonetsa thanzi la chogwirira.

Kupanda kutero, kuyesaku kungathe kubwerezedwa katatu. Ngati zotsatira zake ndi zoipa, sinthani singano kapena cholembera pokha.

Poyambitsa mlingo wofunikira pangani gawo lake pogwiritsa ntchito chosankhira. Chithunzi chofanana ndi kuchuluka kwa mayunitsi chiyenera kuwoneka m'bokosi la "pointer". Pambuyo pake, amapaka jekeseni ndi cholembera, ndikanikizani batani loyambira ndikuyamba pang'ono pang'ono mpaka asanu. Izi zimakuthandizani kuti muwonetsetse kuti yankho lonse lifika pamalowo.

Pampu ya insulin ndi chipangizo chonyamula ma insulin chomwe chimaperekedwa mu milingo yaying'ono tsiku lonse. Kugwiritsa ntchito kumakupatsani mwayi wokhala ndi shuga wokhazikika.

• chipangizo chowonetsera, mabatani olamulira ndi cartridge,
• kulowetsedwa: chubu momwe njira imaperekera, ndi cannula, yomwe imakhazikika pamimba,
• sensor ya kudziwa glucose wamagazi (mumitundu ina).

Kukonzekera kwa Ultrashort kumagwiritsidwa ntchito pampu. Mlingo ndi pafupipafupi mankhwala a insulin amatsimikiza ndi dokotala. Wodwalayo amaphunzitsidwanso kugwiritsa ntchito chipangizocho. Kuthekera kowonjezera kwa mankhwalawa kumaperekedwa.

Zoyipa za chipangizocho ndizokwera mtengo kwambiri, kufunika kobwezeretsa kulowetsedwa komwe kumakhala masiku atatu aliwonse.

Pomwe osagwiritsa ntchito

Toujeo imapezeka mu mawonekedwe a yankho lomveka bwino, lomwe lili ndi ma cartilges 1.5 galasi. Katirijiyo payokha amayikiramo cholembera kuti agwiritse ntchito kamodzi. M'mafakitala, mankhwala a Tujeo amagulitsidwa m'makatoni, omwe amakhala ndi zolembera 1,3 kapena 5.

Toujeo amangopangidwira kuti ingoikamo tinthu tating'onoting'ono tokhala m'mimba, ntchafu ndi mikono. Ndikofunika kusintha tsamba la jekeseni tsiku ndi tsiku kuti mupewe kupangika kwa zipsera ndi kukula kwa hyper- kapena hypotrophy ya minofu yolowerera.

Kukhazikitsidwa kwa inshuwaransi ya Tujeo mu mitsempha kuyenera kupewedwa, chifukwa izi zimatha kuyambitsa matenda oopsa a hypoglycemia. Kukula kwakanthawi kwa mankhwalawa kumangopezeka ndi jekeseni wa subcutaneous. Kuphatikiza apo, mankhwalawa Tujeo sangathe kulowetsedwa m'thupi ndi pampu ya insulin.

Kugwiritsa ntchito cholembera cha syringe imodzi, wodwalayo adzadzibaya yekha ndi kipimo cha 1 mpaka 80 mayunitsi. Kuphatikiza apo, pakugwiritsa ntchito, wodwala amakhala ndi mwayi wowonjezera mlingo wa insulin ndi 1 unit nthawi imodzi.

Mlingo wa insulin amawerengedwa m'magawo (magulu). Kuchuluka kwawo kumatha kukhazikika kapena kusiyanasiyana malinga ndi kuchuluka kwa shuga komanso kuchuluka kwa chakudya chamafuta omwe amaperekedwa ndi chakudya. Odwala onse omwe amalandira insulin ayenera kuphunzitsidwa ku Sukulu ya Matenda a shuga.

Amatanthawuza ndi nthawi yayitali yogwira ntchito, kukonzekera kwakutali komanso kopitilira muyeso kumakupatsani mwayi wokhala ndi shuga tsiku lonse (chigawo choyambira). Amagwiritsidwa ntchito kamodzi kapena kawiri pa tsiku.

Ma insulin afupia ndi a ultrashort amachepetsa shuga, omwe amadzuka chakudya pambuyo pake (chigawo cha bolus). Amapatsidwa chakudya musanadye kapena nthawi ya chakudya.

Ngati shuga ndi wamkulu, nthawi pakati pakukhazikitsa mankhwala ndi chakudya ndikulimbikitsidwa kuti iwonjezeke. Zosakaniza zokonzeka zimakhala ndi zonse ziwiri.

Amagwiritsidwa ntchito musanadye, nthawi zambiri kawiri patsiku.

Odwala omwe ali ndi vuto la matenda a shuga 1 komanso nthawi ya pakati, pakulimbikitsa mankhwala a insulini amagwiritsidwa ntchito, omwe amaphatikiza jakisoni 1 kapena 2 wa woyambira woyambira ndi kugwiritsa ntchito mitundu yochepa komanso ya ultrashort musanadye. Zowonjezera makonzedwe a mankhwalawo zimasonyezedwa chifukwa cha kuchuluka kwa shuga.

Mtundu wachiwiri wa matenda ashuga, insulin ya basal imatha kugwiritsidwa ntchito limodzi ndi mankhwala osokoneza bongo - jakisoni awiri atatu a msuzi womalizidwa, regimen yolimbikitsidwa, kapena jekeseni wa bolus musanadye. Mtundu wa mankhwalawa amasankhidwa ndi endocrinologist.

Toujeo Solostar amadziwikiritsa kwa anthu odwala matenda ashuga osakwana zaka 18 chifukwa cha kusowa kwa mayesero azaka zam'mbuyomu chifukwa chachitetezo cha mankhwalawa kapena chifukwa cha tsankho la munthu wa zigawo za Toujeo kapena insulin glargine.

Chenjezo limalangizidwa kupereka mankhwala:

• Amayi oyembekezera (pokhudzana ndi kuthekera kotheka kwa kuchuluka kwa mankhwalawa omwe amwedwa pambuyo pobadwa kwa mwana komanso panthawi yoyembekezera).
• Anthu okalamba (woposa zaka makumi asanu ndi awiri).
• Matenda a shuga pamaso pa endocrinological matenda.

Mukasintha kuchokera ku insulin imodzi kupita kwina, ndikofunikira kuti mulankhule ndi endocrinologists, okha ayenera kusankhidwa. M'mikhalidwe yomwe imayenderana ndi kutsegula m'mimba ndi kusanza, kupweteka kwambiri kwaimpso kapena chiwindi, kusamala kumafunikanso kugwiritsidwa ntchito.

Magawo a Tujeo SoloStar® (insulin glargin 300 IU / ml) amangotanthauza Tujeo SoloStar ® ndipo sangafanane ndi ziwalo zina zomwe zikuonetsa mphamvu ya zochita za ena a insulin analogues. Mankhwala Tujo SoloStar ® amayenera kuperekedwa nthawi / tsiku limodzi tsiku lililonse, 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 jakisoni kwa maola 3 isanakwane kapena ma 3 patatha nthawi yawo.

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 kuchuluka kwa thupi la wodwalayo, moyo wawo, kusintha nthawi ya kayendetsedwe ka insulin, kapena zina zomwe zingakulitse chiwonetsero chakukula kwa hypo- kapena hyperglycemia (onani.

"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, kukondera kuyenera kuperekedwa / pakubweretsa insulin yochepa.

Odwala onse omwe ali ndi matenda ashuga, tikulimbikitsidwa kuwunika kuchuluka kwa shuga m'magazi.

Kuyamba kwa kugwiritsa ntchito mankhwalawa Tujo SoloStar ®

Odwala omwe ali ndi vuto la matenda a shuga 1 Tujeo SoloStar ® azigwiritsidwa ntchito kamodzi patsiku limodzi ndi insulini yoyendetsedwa pakudya ndipo amafuna kuti munthu asinthe.

Odwala omwe ali ndi matenda a shuga a mtundu wa 2. Mankhwala oyambitsidwa koyambirira ndi 0,2 U / kg kamodzi patsiku, kenako ndikusintha kwa munthu.

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 ® sizomwe zili ndi bioequivaili komanso osasinthika mwachindunji.

- Kusintha kochokera ku insulin glargine 100 IU / ml kupita ku Tujeo SoloStar® kutha kuchitidwa pachilichonse, koma kuti tikwaniritse zomwe tikutsimikiza za plasma glucose, mlingo wapamwamba wa Tujeo SoloStar® ungafunike.

- Mukayamba kugwiritsa ntchito Tujeo 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 ®

- Kusintha kuchokera ku jakisoni imodzi ya basal insulin masana kupita kumodzi wa Tujeo SoloStar ® masana kutha kuchitika pamaziko a gawo la mankhwala omwe amaperekedwa kale ndi insulin.

- Mukamasintha insulini ya basal insulin kawiri masana kupita kumakonzedwe a Tujeo SoloStar ®, mlingo woyambira wa Tujeo SoloStar ® kukonzekera 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.

Njira yogwiritsira ntchito mankhwalawa Tujo SoloStar ®

Tujeo SoloStar ® jekeseni wamafuta 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. Mu / kumayambiriro kwa chizolowezi cha sc sc chingayambitse 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.

- Kafukufuku wapaipi wa Tujeo SoloStar ® syringe cholembera akuwonetsa kuchuluka kwa magawo a Tujeo SoloStar ® omwe adzaperekedwe. Tujeo SoloStar ® Syringe cholembera yapangidwa mwapadera kukonzekera kwa Tujeo SoloStar ®,, kotero, palibe kutembenuka kwapadera kwa mlingo komwe kumafunikira,

Njira yogwiritsira ntchito

Insulin imayendetsedwa ndi jekeseni wa subcutaneous. "Tujeo SoloStar" itha kugwiritsidwa ntchito mosasamala zakudya. Kuti muchite bwino, tikulimbikitsidwa kupaka jekeseni nthawi yomweyo. Kulekerera - 3 maola. Wodwalayo amakhala ndi maola pafupifupi 6, omwe nthawi yomweyo amayenera kupereka insulin. Poterepa, simungawope kulumpha lakuthwa mu shuga.

Kusintha kwa Mlingo kungafunike kwa:

• kusintha zakudya
• kusinthana ndi mankhwala ena kapena wopanga,
• kukula kwa matenda kapena zovuta za matenda ashuga,
• Kusintha kwa moyo wakhazikika: Kupsinjika kwa thupi kapena kutengeka.

Mlingo ndi nthawi pakati pa njirazi zimatsimikiziridwa ndi kupezeka kwa endocrinologist. Musanayambe mankhwala a insulin, onetsetsani kuti mwawerengera malangizowo. "Tujeo SoloStar" imayambitsidwa kamodzi patsiku.

Insulin iyenera kuyikiridwa mu tinthu tating'onoting'ono tomwe tili m'chigawo cha khomo lamkati lam'mimba, ntchafu, kapena minyewa yapamwamba. Nthawi ndi nthawi, tsamba la jakisoni limasinthidwa. Pogwiritsa ntchito cholembera chimodzi, mutha kulowa muyezo 1 mpaka 80 mayunitsi nthawi imodzi. Chipangizocho chili ndi chida chapadera chomwe chimakupatsani mwayi kuti musankhe mtundu wa insulin wofunikira. Popewa matenda opatsirana, cholembera cha syringe chikulimbikitsidwa kugwiritsidwa ntchito pochiza wodwala m'modzi yekha.

Popewa kwambiri hypoglycemia, musatenge mankhwala omwe ali ndi syringe yokhazikika ku cartridge. Simungathe kudziwa kuchuluka kwamahomoni, chifukwa, zovuta zingachitike. Singano imagwiritsidwa ntchito nthawi imodzi yokha. Pambuyo jakisoni, amayenera kuchotsedwa ndikuisintha ndi yatsopano yosabala. Kugwiritsa ntchito singano mobwerezabwereza kumabweretsa totseguka. Izi zimawonjezera mwayi wopereka insulin yayikulu kapena yayikulu.

Pamaso pa njirayi, onetsetsani kuti yankho likuwonekera, palibe mabulamu amlengalenga. Chitani zoyeserera zaumoyo wa syringe ndi gawo la singano: kanikizani batani lolowera - yankho liyenera kuwoneka pamsonga pa singano. Pambuyo pake, mutha kuchita njirayi.

Tujeo SoloStar imagwiritsidwa ntchito ngati mtundu 1 wa matenda a shuga kuphatikiza ndi insulin yochepa. Mu matenda 2 amtunduwu amaikidwa ngati monotherapy kapena kuphatikiza ndi antidiabetesic oral. Mulingo wovomerezeka wa matenda a shuga a 2 ndi magawo 0,2 pa kilogalamu imodzi yakulemera kwa thupi.

Odwala ena a shuga asamukira ku Lantus kupita ku SoloStar. Choyamba, imwani mankhwalawa pamlingo wa 1: 1. M'tsogolomu, mlingo woyenera umasankhidwa. Mukasintha kuchoka ku Lantus kupita ku 100 PIECES ya glargine, mlingo umachepetsedwa ndi 20%.

Pakufunika kwenikweni, SoloStar imaloledwa kwa amayi apakati. Nthawi zambiri, mu trimester yoyamba, kufunikira kwa insulin kumachepetsedwa, mu trimesters yachiwiri ndi yachitatu imachulukirachulukira. Pa yoyamwitsa, kusintha kwa kuchuluka kwa mankhwalawa kungafunike. Mlingo wothandizila watsimikiza ndi dokotala.

Mankhwala a insulini, muyenera kuwunika mwadongosolo kuchuluka kwa shuga m'magazi.

Anthu odwala matenda ashuga amalangizidwa kuti azikhala nawo nthawi zonse - ngati chachikulu chikuwonongeka. Pambuyo jekeseni woyamba wa mlingo kuchokera mu cholembera, utha kugwiritsidwa ntchito osaposa mwezi umodzi. Sungani pamalo owuma otetezedwa ku dzuwa mwachindunji pa kutentha kwa +2 ... +8 о С.

Zotsatira zoyipa

Mwapadera, Tujeo SoloStar amatha kuyambitsa zosafunikira.

Pa mankhwala, mavuto ena amatha.

• Njira za metabolism: hypoglycemia - chikhalidwe chomwe chimachitika pakudya mlingo waukulu wa insulin kuposa momwe thupi limafunikira. Atha kukhala limodzi ndi kutopa, kugona, kupweteka mutu, kusokonezeka, kukokana.
• Organs: kuphwanya turgor ndi mandala Refractive index. Zizindikiro zake ndizakanthawi kochepa, safuna chithandizo. Kaŵirikaŵiri, kuwonongeka kwakanthawi kumachitika.
• Khungu ndi subcutaneous minofu: lipodystrophy ndi zochitika kwanuko m'dera loyang'anira. Amadziwika mu 1-2% yokha ya odwala. Popewa chizindikiro ichi, muyenera kusintha tsamba la jakisoni nthawi zambiri.
• Chitetezo chokwanira: zokhudza zonse ziwengo mu mawonekedwe a edema, bronchospasm, kutsitsa magazi, kugwedezeka.
• Machitidwe ena: kawirikawiri thupi limayamba kulolera insulin, ndikupanga ma antibodies ena.

Popewa zoyipa zilizonse, wodwalayo akulangizidwa kuti apimidwe. Nthawi zonse muzitsatira njira zomwe dokotala amakupatsani. Kudzichitira nokha mankhwala kungakhale pachiwopsezo cha moyo.

Kuyanjana kwa mankhwala osokoneza bongo

Magulu ena a mankhwalawa amakhudza kagayidwe ka glucose. Ngati ndi kotheka, kulumikizana molumikizana kwa mankhwala ndi Tujeo SoloStar deta kumafuna kusintha kwa insulin.

Oral hypoglycemic mankhwala, ACE inhibitors ndi MAO, salicylates, fluoxetine, pentoxifylline, propoxyphene, sulfonamides angakulitse kuchuluka kwa hypoglycemic ya insulin. Pankhaniyi, chiwopsezo cha kukhala ndi hypoglycemia chikukula.

Corticosteroids, danazole, diazoxide, diuretics, sympathomimetics, shuga

Beta-blockers, clonidine, mchere wa lithiamu ndi ethanol amatha kuwonjezera kapena kufooketsa mphamvu ya mankhwalawa.

Kuphatikiza ndi pentamidine, chiopsezo cha hypoglycemia chimakulanso, chomwe chimatha kukhala hyperglycemia.

Kuphatikiza ndi beta-blockers, clonidine, guanethidine ndi reserpine, zizindikiro kapena zizindikiro za yankho lamkati lazinthu zamkati pakukula kwa hypoglycemia mwina kapena sangakhalepo.

Akaphatikizidwa ndi pioglitazone, kulephera kwamtima nthawi zina kumayamba.

Tujeo SoloStar ndi kukonzekera bwino kwambiri kwa insulin komwe kwalandira ndemanga zambiri zabwino kuchokera kwa madokotala ndi odwala. Amachepetsa chiopsezo chamavuto amtima wam'matumbo, m'mimba thirakiti komanso pakati pama dongosolo amanjenje. Pa mankhwala, wodwala ayenera kuonedwa pafupipafupi ndi katswiri.