Insulin Apidra Solostar: malangizo ogwiritsira ntchito

Zothandiza: insulin glulisin - 100 PIECES (3.49 mg),
zotuluka: metacresol (m-cresol) 3.15 mg, trometamol (tromethamine) 6.0 mg, sodium kolorayidi 5.0 mg, polysorbate 20 0,01 mg, sodium hydroxide kuti pH 7.3, hydrochloric acid mpaka pH 7 , 3, madzi a jakisoni mpaka 1.0 ml.

Kufotokozera Transparent colorless madzi.

Katundu

Mankhwala Insulin glulisin ndi analogue yobwerezabwereza ya insulin ya anthu, yofanana ndi mphamvu kwa insulin wamba ya anthu.
Chofunikira kwambiri cha insulin ndi insulin analogues, kuphatikizapo insulin glulisin, ndikuwongolera kwa kagayidwe ka glucose. Insulin imachepetsa kuchuluka kwa shuga m'magazi, ndikulimbikitsa kufatsa kwa glucose mwa zotumphukira, makamaka minofu yamatumbo ndi minyewa ya adipose, komanso kuletsa mapangidwe a shuga mu chiwindi. Insulin imachepetsa lipolysis mu adipocytes, linalake ndipo tikulephera kuphatikiza mapuloteni. Kafukufuku wodzipereka kwa odwala omwe ali ndi thanzi labwino komanso odwala omwe ali ndi matenda osokoneza bongo adawonetsa kuti ndi subulinaneous insulin, glulisin amayamba kuchita zinthu mwachangu komanso amakhala ndi nthawi yofupikirapo kuposa kusungunuka kwa insulin yamunthu. Ndi subcutaneous makonzedwe, momwe insulin glulisin, yomwe imachepetsa kuchuluka kwa shuga m'magazi, imayamba pambuyo pa mphindi 10-20. Mothandizidwa ndi mtsempha wa magazi, zotsatira za kuchepetsa kuchuluka kwa shuga m'magazi a insulin glulisin ndi insulle ya insulin yamunthu ndizofanana mu mphamvu. Gawo limodzi la insulin glulisin limakhala ndi zochitika zofanana za hypoglycemic monga gawo limodzi la insulin yaumunthu.
Mu gawo ine kuyesa kwa odwala omwe ali ndi mtundu 1 wa matenda a shuga, mapangidwe a hypoglycemic a insulin glulisin ndi insulle ya insulin yaanthu amaperekedwa mosagwirizana ndi 0,15 U / kg panthawi zosiyanasiyana pokhudzana ndi chakudya chokwanira cha mphindi 15. Zotsatira za phunziroli zidawonetsa kuti insulin glulisin, yomwe idapangidwira mphindi 2 asanadye chakudya, idapereka chiwonetsero chofananira cha glycemic pambuyo chakudya monga insulin ya munthu wosungunuka, kutumikiridwa mphindi 30 asanadye. Pakaperekedwa mphindi ziwiri asanadye, insulin glulisin imapereka chiwongolero chabwinoko pambuyo pa chakudya kuposa chakudya chosungunuka chomwe munthu amakhala nacho pakadutsa mphindi 2 asanadye. Glulisin insulin, yoyendetsedwa pakadutsa mphindi 15 chakudya chitayambika, idaperekanso chiwonetsero chofananira cha glycemic pambuyo paphwando monga chakudya chosungunuka cha anthu, choperekedwa mphindi ziwiri asanadye.
Phunziro lachigawo chomwe ndimachita ndi insulin glulisin, insulin lispro ndi insulle ya insulin yaumunthu pagulu la odwala omwe ali ndi matenda osokoneza bongo komanso kunenepa kwambiri adawonetsa kuti mwa odwala insulin glulisin amakhalanso ndi machitidwe omwe amathandizira. Phunziroli, nthawi yoti ifike 20% ya AUC yonse (dera lomwe linali pansi pa nthawi yopondera) inali mphindi 114 za insulin glulisin, mphindi 121 za insulin lispro ndi mphindi 150 zokhala ndi insulin yaumunthu, ndi AUC (0-2 maola), kuwonetsera komanso ntchito yoyambirira ya hypoglycemic, motero, inali 427 mg / kg ya insulin glulisin, 354 mg / kg kwa insulin lispro, ndi 197 mg / kg ya insulle ya anthu.
Maphunziro azachipatala a mtundu 1.
M'masabata makumi awiri ndi awiri oyesa gawo lachitatu la III, lomwe limayerekezera ndi insulin glulisin ndi insulin lispro, yomwe imayendetsedwa mosakhalitsa asanadye (0¬15 mphindi), odwala omwe ali ndi matenda a shuga 1 omwe amagwiritsa ntchito insulin glargine monga basulin insulin, insulin glulisin anali kufananizidwa ndi insulin lispro pokhudzana ndi kayendedwe ka glycemic, komwe kunayesedwa ndi kusintha kwa kuchuluka kwa glycosylated hemoglobin (Lb1c) panthawi yophunzira poyerekeza ndi koyambirira. Miyezo yamtengo wapatali yamagazi inawonedwa, yodziwunikira. Ndi makonzedwe a insulin glulisin, mosiyana ndi mankhwala a insulin, lyspro sanafune kuwonjezeka kwa mlingo wa basal insulin.
Chiyeso cha milungu iwiri cha gawo lachitatu chomwe chimachitika kwa odwala omwe ali ndi matenda a shuga 1 omwe adalandira insulin glargine monga chithandizo choyambira cha basal chinawonetsa kuti mphamvu ya insulin glulisin yoyang'anira mukangomaliza kudya inali yofanana ndi ya insulin glulisin musanadye chakudya 0-15 mphindi) kapena sungunuka wa munthu (30-45 mphindi musanadye).
Mwa kuchuluka kwa odwala omwe anamaliza phunziroli, pagulu la odwala omwe adalandira insulin glulisin asanadye, kuchepa kwakukulu kwa HL1C kumawonetsedwa poyerekeza ndi gulu la odwala omwe adalandira insulin yaumunthu yosungunuka.

Type 2 shuga
Kuyesedwa kwamankhwala kwa gawo la 26 kwa milungu 26 yotsatiridwa ndi kafukufuku wotsatira wotsatira wa sabata la 26 kunachitika kuti afananize ndi insulin glulisin (0-15 mphindi musanadye) ndi insulin ya insulle ya anthu (30-45 mphindi musanadye), anali kutumikiridwa subcutaneous odwala ndi mtundu 2 matenda a shuga, kuwonjezera ntchito insulin-isofan ngati basal insulin. Mtundu wa odwala wodwalayo unali 34,55 kg / m2. Insulin glulisin adadziwonetsa kuti ali ngati fanizo la insulin yaumunthu poyerekeza ndi kusintha kwa kuwunika kwa HL1C pambuyo pa miyezi 6 ya chithandizo poyerekeza ndi mtengo woyambira (-0.46% wa insulin glulisin ndi -0.30% wa insulle ya insulle ya anthu, p = 0.0029) ndi Pambuyo pa miyezi 12 ya chithandizo poyerekeza ndi mtengo woyambira (-0.23% wa insulini glulisin ndi -0.13% wa insulle yaum sungunuka ya anthu, kusiyana sikofunikira). Phunziroli, odwala ambiri (79%) anasakaniza insulin yochepa ndi insulin-isophan nthawi yomweyo isanalowe. Odwala a 58 panthawi ya kuchepa kwa mankhwalawa amagwiritsidwa ntchito pakamwa hypoglycemic othandizira ndipo adalandira malangizo kuti apitilize kumwa iwo omwewo (osasinthika) mlingo.

Mtundu ndi jenda
M'mayeso azachipatala olamulidwa mwa achikulire, kusiyana pakubwera ndi chitetezo cha insulin glulisin sikunawonetsedwe mukuwunika kwamagulu omwe amasiyana ndi mtundu ndi jenda.

Pharmacokinetics Mu insulin glulisine, kulowetsedwa kwa amino acid asparagine wa insulin yaumunthu pamalo B3 ndi lysine ndi lysine pamalo B29 ndi glutamic acid amalimbikitsa kuyamwa mwachangu.

Mayamwidwe ndi Bioavailability
Pharmacokinetic nthawi yokhazikika pama odzipereka athanzi komanso odwala omwe ali ndi mtundu woyamba wa 2 komanso mtundu wa matenda ashuga 2 amawonetsa kuti mayamwidwe a insulini glulisin poyerekeza ndi insulle ya insulin yamunthu anali pafupifupi nthawi 2, ndipo kuchuluka kwakukulu kwa plasma (Stax) kunali pafupifupi 2 nthawi zina.
Mu kafukufuku yemwe wachitika kwa odwala omwe ali ndi matenda a shuga 1, atatha kulowetsedwa kwa insulin glulisin pa mlingo wa 0,15 U / kg, Tmax (nthawi yoyambira ndende ya plasma) anali mphindi 55, ndipo Stm anali 82 ± 1.3 mcU / ml poyerekeza ndi Tmax yamphindi 82 ndi Cmax ya 46 ± 1.3 μU / ml ya insulin yaumunthu. Nthawi yomwe amakhala munthawi yogwiritsira ntchito insulin glulisin inali yocheperako (mphindi 98) kusiyana ndi insulle ya munthu (161 mphindi).
Pakufufuza kwa odwala omwe ali ndi mtundu wa 2 shuga mellitus atatha kulowetsedwa kwa insulin glulisin pamtunda wa 0,2 U / kg, Stax anali 91 mkU / ml wokhala ndi masentimita 78 mpaka 104 mkU / ml.
Ndi subcutaneous makonzedwe a insulin glulisin m'chigawo cha anterior m'mimba khoma, ntchafu, kapena phewa (mu deltoid minofu dera), mayamwidwe anali mwachangu pamene adalowetsedwa m'chigawo cha khomo lamkati lakumbuyo poyerekeza ndi kuyamwa kwa mankhwala m'chigawo cha ntchafu. Kuchuluka kwa mayamwidwe kudera lotetemera kunali kwapakatikati.
Mtheradi bioavailability wa insulin glulisin pambuyo subcutaneous makonzedwe anali pafupifupi 70% (73% kuchokera khoma lamkati lakumbuyo, 71 kuchokera ku minofu ya deltoid ndi 68% kuchokera kudera lachikazi) ndipo anali ndi kusiyana kochepa kwa odwala osiyanasiyana.

Kugawa
Kugawika ndi kutulutsa kwa insulin glulisin ndi madzi osungunuka pakhungu pambuyo pamitsempha yama cell ndi ofanana, ndikugawa mavitamini 13 malita ndi malita 21 ndi theka la moyo wamphindi 13 ndi 17, motsatana.

Kuswana
Pambuyo pothandizidwa ndi insulin, glulisin imapukusidwa mwachangu kuposa insulin yaumunthu, ndikumakhala ndi moyo wamphindi 42, poyerekeza ndi theka la moyo wosasungunuka wamunthu wamphindi 86. Pakufufuza kwapadera kwamaphunziro a insulin glulisin mwa onse athanzi komanso omwe ali ndi matenda amtundu wa 1 komanso mtundu wa 2, theka la moyo limachokera pamphindi 37 mpaka 75.

Magulu Opatsa Odwala

Odwala omwe ali ndi vuto la impso
Mu kafukufuku wazachipatala wochitidwa mwa anthu omwe alibe magwiridwe antchito osiyanasiyana a impso (creatinine clearance (CC)> 80 ml / min, 30¬50 ml / min, 1/10, wamba:> 1/100, 1/1000, 1 / 10000, Pa kapangidwe ndi mawonekedwe a kumasulidwa

Chifukwa chake, Apidra ndi insulin yochepa. Kuchokera pakuwona mkhalidwe wakuphatikiza - iyi ndi yankho. Amapangidwira kuphatikizira amkati ndipo amaonekera pang'onopang'ono, komanso wopanda utoto (nthawi zina, mthunzi wina ukupezekabe).

Gawo lake lalikulu, lomwe limapezeka mulingo wocheperako, liyenera kutengedwa kuti ndi insulini yotchedwa glyzulin, yomwe imadziwika ndi zochita zake zachangu komanso nthawi yayitali. Othandizira ndi:

kresol
trometamol,
sodium kolorayidi
polysorbate ndi ena ambiri, amapezekanso pa.

Onsewa amaphatikizika pamodzi amapanga popanda kukayikira mankhwala apadera omwe angapezeke ndi mtundu uliwonse wa matenda ashuga: oyambayo ndi achiwiri. Apidra insulin imapangidwa mwa ma cartridge apadera opangidwa ndi galasi lopanda utoto.

Zokhudza zotsatira zamankhwala

Kodi Apidra amakhudza bwanji shuga?

Glulin insulin ndi analogue yowonjezera ya anthu. Monga mukudziwa, ikhoza kufananizidwa ndi mphamvu kuti isungunuke insulin yaumunthu, koma ndizodziwika kuti imayamba "kugwira ntchito" mwachangu kwambiri komanso imakhala nthawi yayifupi. Izi ndizothandiza kwambiri.

Chofunika kwambiri komanso chofunikira kwambiri osati pa insulin zokha, komanso pa analogues yake, imayenera kuganiziridwa nthawi zonse malinga ndi kusintha kwa shuga. Ma mahomoni operekedwa amachepetsa kuchuluka kwa shuga m'magazi, omwe amachititsa kuti shuga agwiritsidwe ntchito mothandizidwa ndi zotumphukira. Izi ndizowona makamaka kwa minofu yamafupa ndi minofu ya adipose. Apidra insulin imalepheretsanso kupanga shuga m'magazi. Kuphatikiza apo, imachepetsa njira zonse zomwe zimagwirizanitsidwa ndi lipolysis mu adipocytes, proteinolysis komanso imathandizira kuyenderana kwa mapuloteni.

Malinga ndi zotsatira za kafukufuku wambiri, zidatsimikiziridwa kuti glulisin, chomwe chimakhala gawo lalikulu ndikulowetsedwa mphindi ziwiri asanadye chakudya, imatha kuperekanso chiwonetsero chofananira cha kuchuluka kwa shuga atatha kudya monga insulin yaumunthu yoyenera kusungunuka. Komabe, iyenera kuperekedwa kwa mphindi 30 chakudya chisanafike.

Zokhudza mlingo

Mfundo yofunikira kwambiri pakugwiritsa ntchito mankhwala aliwonse, kuphatikiza mayankho a insulin, iyenera kutengedwa ngati kumvetsetsa kwa mlingo. Apidra tikulimbikitsidwa kuti ibweretsedwe posachedwa (kwa zero kochepa komanso kupitirira mphindi 15) musanadye kapena mutangodya.

Mankhwala angagwiritsidwe ntchito limodzi ndi enieni a mtundu wa hypoglycemic.

Momwe mungasankhire mlingo wa Apidra?

Apidra insulin dosing algorithm iyenera kusankhidwa payekha nthawi iliyonse. Zikachitika kuti matenda a impso akundikana, kuchepa kwa kufunikira kwa timadzi timeneti ndi kotheka.

Pa anthu odwala matenda ashuga omwe ali ndi vuto la chiwindi, kusowa kwa mapangidwe a insulin ndiwotheka kuchepa. Izi zimachitika chifukwa cha kuchepa mphamvu kwa glucose neogeneis komanso kuchepa mphamvu kwa kagayidwe kazinthu ka insulin. Zonsezi zimapereka tanthauzo lomveka, komanso zosafunikira, kutsatira mankhwala omwe akuwonetsedwa, ofunikira kwambiri pakulimbana ndi matenda a shuga.

About Jekeseni

Mankhwala ayenera kuperekedwa ndi subcutaneous jakisoni, komanso kulowetsedwa mosalekeza. Ndikulimbikitsidwa kuti muchite izi mwapadera minofu yamafuta ochepa komanso mafuta pogwiritsa ntchito pulogalamu yapadera yopopera.

Jakisoni wotsekemera uyenera kuchitika mu:

Kubweretsa Apidra insulin pogwiritsa ntchito kulowetsedwa kosalekeza kapena minofu yamafuta kuyenera kuchitika m'mimba. Madera omwe samaba jakisoni wokha, komanso ma infusions omwe adapangidwa kale, akatswiri amalimbikitsa kusinthana wina ndi mnzake pakukhazikitsa kwatsopano kwa chinthucho. Zinthu monga dera lodzala, zochitika zolimbitsa thupi, ndi zina “zoyandama” zimatha kukhala ndi chiyambukiro pakukula kwa mayamwidwe ndipo, monga chotulukapo chake, pakubweretsa komanso kuchuluka kwake.

Momwe mungapangire jakisoni?

Kukhomeredwa pansi kwa khoma lam'mimba kumakhala chotsimikizika cha mayamwidwe ambiri kuposa kumizidwa m'malo ena a thupi. Onetsetsani kuti mwatsata malamulo osamala kuti musatenge mankhwala oikidwa m'mitsempha yamagazi.

Pambuyo pa kukhazikitsa kwa insulin "Apidra" ndizoletsedwa kutikita minofu jakisoni. Anthu odwala matenda ashuga ayenera kuphunzitsidwanso njira yolondola ya jakisoni. Ichi ndi chinsinsi cha chithandizo chokwanira cha 100%.

Zokhudza malo osungirako ndi mawu

Pakulimbikitsa kwakukulu pakugwiritsa ntchito mankhwala aliwonse, munthu ayenera kukumbukira momwe alili. Chifukwa chake, makatoni ndi makina amtunduwu amayenera kusungidwa m'malo ocheperako kwa ana, omwe akuyenera kudziwikanso ndi chitetezo chachikulu pakuwala.

Pankhaniyi, boma la kutentha liyeneranso kuonedwa, lomwe liyenera kuyambira madigiri awiri mpaka asanu ndi atatu.

Gawo silikhala louma.

Kugwiritsa ntchito makatiriji ndi makina a cartridge kuyambika, amafunikanso kusungidwa m'malo omwe ana sangathe kuwapeza omwe ali ndi chitetezo chodalirika osati kokha pakuwala kwa kuwala, komanso ku dzuwa. Nthawi yomweyo, zizindikiro za kutentha siziyenera kupitirira kutentha 25, apo ayi izi zitha kudziwa pa Apidra insulin.

Kuti mudziteteze modabwitsa ku mphamvu ya kuunika, ndikofunikira kuti musangopulumutsa makatiriji okha, koma akatswiri amalimbikitsa kachitidwe kameneka m'mapaketi awo, omwe amapangidwa ndi makatoni apadera. Alumali moyo wofotokozedwayo ndi zaka ziwiri.

Zonse zokhudza tsiku lotha ntchito

Moyo wa alumali wa mankhwala omwe amapezeka mu cartridge kapena dongosololi mutatha kugwiritsa ntchito masabata anayi. Ndikofunika kukumbukira kuti chiwerengero chomwe insulin yoyamba idatengedwa chidalembedwa paphukusili. Ichi chidzakhala chitsimikizo chowonjezereka pakuchiza bwino kwa mtundu uliwonse wa matenda ashuga.

Zotsatira zoyipa

Zotsatira zoyipa zomwe zili ndi Apidra insulin ziyenera kudziwidwa padera. Choyamba, tikulankhula za chinthu monga hypoglycemia. Amapangidwa chifukwa chogwiritsa ntchito kwambiri ma insulin, ndiye kuti, omwe amapezeka kuti ali ndizofunikira kwambiri kuposa kufunika kwake kwenikweni.

Pa gawo la chamoyo monga metabolism, hypoglycemia imapangidwanso kwambiri. Zizindikiro zonse za mapangidwe ake zimadziwika mwadzidzidzi: pali thukuta lotentha, kunjenjemera ndi zina zambiri. Kuopsa pankhaniyi ndikuti hypoglycemia ichuluke, ndipo izi zitha kuchititsa kuti munthu afe.

Zomwe zimachitika mdera lanu ndizothekanso, zomwe ndi:

Hyperemia,
kudzikuza,
kuyabwa kwakukulu (pamalo opangira jakisoni).

Mwinanso, kuwonjezera pa izi, kukulira kwa ziwopsezo zomwe sizigwirizana, nthawi zina tikulankhula za urticaria kapena chifuwa cha thupi. Komabe, nthawi zina izi sizifanana ndi mavuto a pakhungu, koma kungokhala phokoso kapena zizindikiro zina zathupi. Mulimonsemo, zovuta zonse zomwe zaperekedwa sizingapewere kukayikira kutsatira malangizowo ndikukumbukira kugwiritsa ntchito bwino insulin monga Apidra.

Zokhudza contraindication

Contraindations yomwe ilipo kwa mankhwala aliwonse ayenera kupatsidwa chidwi chapadera. Izi ndizofunikira kwambiri kuti insulini imagwira ntchito pa 100%, kukhala njira yothandiza kwambiri yobwezeretsanso ndi kuteteza thupi. Chifukwa chake, zotsutsana zomwe zimaletsa kugwiritsa ntchito "Apidra" ziyenera kuphatikizapo hypoglycemia yokhazikika komanso chiwopsezo chochulukirapo cha insulin, gluzilin, komanso gawo lina lililonse la mankhwalawa.

Kodi amayi oyembekezera amatha kugwiritsa ntchito Apidra?

Ndi chisamaliro chapadera, kugwiritsa ntchito chida ichi ndikofunikira kwa amayi omwe ali pa nthawi iliyonse yoyembekezera kapena yoyamwitsa. Popeza mtundu wa insulin woperekedwa ndi mankhwala amphamvu, ungathe kuvulaza mkaziyo komanso mwana wosabadwayo. Komabe, izi mwina zimakhala kutali ndi milandu yonse yokhudzana ndi matenda a shuga. Pankhaniyi, tikulimbikitsidwa kuti muyambe mwaonana ndi katswiri yemwe adzakuwonetsereni kuvomerezeka kwa kugwiritsa ntchito insulini "Apidra", ndikuti akupatseni muyeso womwe mukufuna.

Pazidziwitso zapadera

Mukamagwiritsa ntchito mankhwala aliwonse, ndikofunikira kuganizira zingapo zingapo zosiyanasiyana. Mwachitsanzo, kuti kusinthika kwa matenda ashuga kukhala mtundu watsopano wa insulin kapena chinthu china chochokera pakukhudzidwa kwina kuyenera kuchitika moyang'aniridwa mwaluso kwambiri. Izi ndichifukwa choti pakhoza kufunikira kusintha kwamankhwala kwathunthu.

Kugwiritsa ntchito mankhwala osakwanira kapena kumaletsa chithandizo, makamaka mwa anthu omwe ali ndi matenda a shuga 1, kungayambitse mapangidwe a hyperglycemia okha, komanso ketoacidosis yeniyeni. Awa ndi mikhalidwe yomwe mumakhala chiopsezo chenicheni ku moyo wa munthu.

Kusintha kwa Mlingo wa insulin kungakhale kofunikira kuti masinthidwe amtundu wa aligoriv mu dongosolo la mota kapena pakudya.

Nkhaniyi ndi yothandiza kwambiri. Ndikuganiza kuti anthu ambiri omwe akudwala matendawa athandiza. Zikomo posanthula momwe mungasungire mankhwalawa. Adotolo nayenso adalembera. Nkhaniyi idalembedwa zabwino zambiri, ndikhulupirira ndipo yandithandiza!

Gawo logwira ntchito la Apidra ndi insulin glulisin. Ndi analogue ya insulin, yomwe imapangidwa m'thupi la munthu, koma molekyuluyo imasinthidwa ndikuzikonzanso. Mphamvu ya chinthu ndi yofanana ndi insulin yaumunthu (sungunuka), koma, mosiyana ndi ichi, izi zimachitika mwachangu, kutalika kwa mphamvu ya insulin glulisin ndi kufupikitsika.

Chithandizo chogwira ntchito chimawongolera kuchuluka kwa mamolekyulu a glucose, kutsitsa kukhazikika kwake m'magazi, kumathandizira kuyamwa kwa mamolekyulu am'magazi a maselo mu minyewa yomwe imafikira pazowonjezera (makamaka mafupa am'mimba, maselo amafuta). Insulin glulisin imalepheretsa kupanga shuga m'magazi. Apidra linalake ndipo limalepheretsa kupangika kwa lipolysis mu minofu ya adipose, imayimitsa kuwonongeka kwa mapuloteni, ndikuwonjezera mapangidwe a mapuloteni.

Mothandizidwa ndi subcutaneally, kuchepa kwa kuchuluka kwa shuga kumachitika pambuyo pa maola 1 / 6-1 / 3. Pansi pa mkhalidwe wa intravenous management, mphamvu ya insulin glulisin ndiyofanana ndi mphamvu ya insulin ya anthu. 1 unit ya insulin glulisin ndi ofanana 1 unit ya insulin ya anthu.

Panthawi ya mayeso azachipatala, zidapezeka kuti kuperekera kwa Apidra masekondi 120 isanakwane gawo la chakudya kumakupatsani mwayi wowongolera zomwe zili m'magazi m'mene chakudya chimatha. Kuchita kwa mankhwalawa kumakupatsani mwayi wowongolera kuchuluka kwa shuga kuposa kumayambiriro kwa insulin ya munthu kwa ola limodzi musanadye. Zochitika pambuyo pa kupangika kwa Apidra kudzera ¼ chakudya chikangolowa, chimafanana ndi zomwe zimapangitsa kuti munthu apange insulin, yomwe idalowetsedwa m'thupi masekondi 120 asanadye.

Mankhwalawa a kunenepa kwambiri, kafukufuku wa zomwe Apidra adachita akuwonetsa kuti nthawi ya chitukuko cha zotsatira zakezi imakhala kwa mphindi 114. AUC ya maola 0-2 anali 427 mg × kg.

Njira yogwiritsira ntchito

Kukhazikitsidwa kwa Apidra kuyenera kuchitika musanadye chakudya kapena kuchuluka kwa mphindi 15 isanachitike. Mankhwala amagwiritsidwa ntchito mankhwala regimens amene ali kale ndi insulin kukonzekera ndi nthawi yayitali yochita kapena kufananiza kwa nthawi yayitali yogwira insulin. Apidra ikhoza kuphatikizidwa mu mankhwalawa achire omwe ali ndi hypoglycemic mankhwala othandizira pakamwa. Mlingo wa mankhwalawa amasankhidwa mosiyanasiyana.

M'pofunika kupatula momwe mungathere mankhwala omwe amalowa pakama. Komanso, simungathe kufinya m'dera lomwe mankhwalawo adalowetsedwa. Wokondedwa ogwira ntchito ayenera kuphunzitsa wodwalayo momwe angapangire mankhwalawo.

Ndizosavomerezeka kuphatikiza Apidra ndi othandizira ena (kupatulapo anthu isofan-insulin). Mukamagwiritsa ntchito mankhwala a Apidra, omwe amaperekedwa ndi chipompo, ndizosavomerezeka kusakaniza yankho ndi mankhwala ena onse.

Malamulo ogwiritsira ntchito mankhwalawa

Osayambiranso yankho.
Ngati kuli kofunikira kusakaniza yankho la Apidra ndi insulin-insulin yaumunthu, ndiye kuti yankho la insulin glulisin limayamba kukokedwa mu syringe. Osasunga zosakaniza.

Makatoni okhala ndi yankho ndi oyenera ku zolembera za syringe za OptiPen Pro 1
Musanagwiritse ntchito, muyenera kuwerengera yankho mu katiriji wa utoto (liyenera kukhala lowonekera), chifukwa cha kusowa kwa tizinthu tina.
Siyani cartridge pamoto kutentha kwa mphindi 60-120 musanayikemo ndi cholembera chosakanizira.
Chotsani thovu lam'mlengalenga.
Makatoni sakusinthika.
Zingwe zowonongeka za syringe siziyenera kugwiritsidwa ntchito.
Syringe pulasitiki ingagwiritsidwe ntchito kuperekera mankhwala. Mwa izi, yankho limachotsedwa mu cartridge ndi syringe. Syringe iyenera kulembedwa kuti 100 IU / ml insulin.
Cholembera chosinthanso chitha kugwiritsidwa ntchito kuperekera mankhwalawa kwa wodwala m'modzi yekha.

Kugwiritsa ntchito makatiriji a optiClick dongosolo (ichi ndi makatoni okhala ndi 3 ml yankho la Apidra, lomwe limayikidwa mu chidebe cha pulasitiki chokhala ndi pistoni):

Makatoni amtunduwu okhala ndi chidebe ndi piston ayenera kugwiritsidwa ntchito ndi cholembera cha syringe ya OptiClick.
Malangizo ogwiritsira ntchito cholembera cha sytige ya OptiClick amaperekedwa pokonza chipangizochi.
Pakapanda kugwira bwino ntchito cholembera, sangathe kugwiritsa ntchito.
Onani dongosolo lama cartridge musanagwiritse ntchito yankho. Pasapezeke maginito pokonzekera, yankho liyenera kukhala loonekera, popanda kupaka utoto.
Chotsani thovu ku cartridge musanapereke yankho.
Simungagwiritse ntchito katiriji pakudzaza.
Kuchokera pa cartridge, mutha kujambula yankho mu syringe ya pulasitiki ndikuyika mankhwalawo.
Popewa matenda, ndizosavomerezeka kugwiritsa ntchito cholembera kwa odwala angapo.

Kukhazikitsa kwa mankhwalawa kumachitika chifukwa cha kubaya jekeseni wofikira. Mutha kuthana ndi yankho la Apidra mu njira yolowerera kulowetsedwa pogwiritsa ntchito pampu. Kuyambitsa kumachitika mu minofu ya adipose pansi pa khungu.

Malo abwino a jakisoni wotsekemera ndi m'mimba, m'mbali mwa phewa, ndi ntchafu. Ngati ndi kotheka, kulowetsedwa kosalekeza ndiko kukhazikitsa minofu ya adipose pansi pa khungu pamimba. Kuyambitsa kulikonse kwa Apidra njira kuyenera kuchitika m'malo atsopano.

Kuchuluka kwa gawo logwira ntchito kumatha kusiyanasiyana malinga ndi jakisoni wa mankhwala, zochitika zolimbitsa thupi za wodwala, ndi zina. Kuthamanga mwachangu kwa zinthu zomwe zimayang'aniridwa kumawonedwa pamene jekeseni wamkati wamimba apangidwe.

Zotsatira zoyipa

Hypoglycemia - mankhwala osavomerezeka a insulin, omwe amatha kuchitika ngati mankhwalawa kwambiri a insulin amagwiritsidwa ntchito, kupitilira kufunika kwake.

Zotsatira zoyipa zomwe zimayesedwa kuchipatala zoyesedwa ndi kuperekera mankhwalawa zalembedwa pansipa malinga ndi machitidwe a ziwalo ndi dongosolo loti achepetse. Pofotokozera pafupipafupi zomwe zimachitika, njira zotsatirazi zimagwiritsidwa ntchito: nthawi zambiri (> 10%), nthawi zambiri (> 1% ndi 0,1% ndi 0,01% ndi

Mimba komanso kuyamwa

Palibe chidziwitso chokwanira pakugwiritsa ntchito insulin glulisin mwa amayi apakati.

Maphunziro a preclinical a kubala sanawonetse kusiyana pakati pa insulin glulisin ndi insulin ya anthu pazotsatira zawo pa kutenga pakati, fetal (fetal), kubala kwa mwana ndi chitukuko pambuyo pake pambuyo pake (onani Precinical Safety Kuyesa).

Popereka mankhwala kwa amayi apakati, muyenera kusamala. Kuonetsetsa bwino za shuga ndikofunikira.

Panthawi yonse yoyembekezera, ndikofunikira kukhalabe mkhalidwe wa metabolic ofanana kwa odwala omwe ali ndi matenda a preexisting kapena gestational matenda a shuga. Kufunika kwa insulin mu trimester yoyamba yam'mimba kumatha kuchepa, nthawi zambiri kumachulukirachulukanso komanso chachitatu. Pambuyo pobadwa, insulini imafuna kuchepa mwachangu.

Sizikudziwika ngati insulin glulisin imadutsa mkaka wa m'mawere, komabe, nthawi zambiri insulin siyidutsa mkaka wa m'mawere ndipo sichiyamwa pakapita mkamwa.

Amayi omwe akuyamwitsa angafunikire kusintha mlingo wa insulin ndi zakudya.

Zotsatira zoyipa

Hypoglycemia, njira yovuta kwambiri yokhudzana ndi insulin, imatha kukhala ngati mlingo wa insulin ndiwokwera kwambiri poyerekeza ndi kufunika kwa insulin.

Zotsatira zotsatirazi zomwe zimagwiritsidwa ntchito ndi mankhwalawa, zomwe zimawonedwa pakuyesa kwamankhwala, zimafotokozedwa pansipa pa magulu a ziwalo pochepetsa dongosolo la zomwe zimachitika (pafupipafupi:> 1/10, pafupipafupi> 1/100, 1/1000, 1/10000,

Bongo

Mwina chitukuko cha hypoglycemia chimachitika chifukwa cha kuchuluka kwa insulin poyerekeza ndi kudya komanso mphamvu zamagetsi.

Palibe chidziwitso chambiri cha mankhwala osokoneza bongo a insulin glulisin. Komabe, hypoglycemia imatha kukula m'magawo.

Magawo a hypoglycemia wofewa amatha kuthandizidwa ndi shuga wamlomo kapena maswiti. Chifukwa chake, tikulimbikitsidwa kuti odwala matenda ashuga azikhala ndi masamba angapo a shuga, maswiti, makeke kapena mandimu okoma zipatso nawo. Magawo a hypoglycemia woopsa, pomwe wodwalayo achoka, amatha kuthandizidwa ndi glucagon (0.5 - 1 mg), kutumikiridwa intramuscularly kapena subcutaneous ndi munthu yemwe adalandira malangizo oyenerera, kapena amathandizidwa ndi msana wa glucose wothandizidwa ndi adokotala. Glucose iyenera kuperekedwanso kudzera m'mitsempha ngati palibe yankho la wodwala kwa glucagon kwa mphindi 10-15. Pambuyo poyambiranso kudziwa, kudya zakumwa zamkamwa kumalimbikitsidwa kuti musayambenso.

Jekeseni wa glucagon atabaya, ndikofunikira kuyang'ana wodwalayo kuchipatala kuti adziwe zomwe zimayambitsa kwambiri hypoglycemia ndikuletsa kutulutsa kwa izi mtsogolo.

Kuchita ndi mankhwala ena

Palibe kafukufuku wamakina omwe adachitika. Kutengera zomwe takumana nazo ndi mankhwala enanso, kuphatikizana kwa zamankhwala zamatenda ofunikira ndizokayikitsa.

Dziwitsani dokotala wanu za mankhwala onse omwe mumamwa, ngakhale atachitika mwanjira imodzi!

Zinthu zina zimakhudza kagayidwe ka glucose, kotero kusintha kwa insulin glulisin makamaka kuwunika mosamala kungafunike.

Zinthu zomwe zimathandizira kutsika kwa shuga m'magazi ndikuwonjezera chizolowezi cha hypoglycemia zimaphatikizira mankhwala a hypoglycemic apakhungu, angiotensin-kutembenuza enzyme zoletsa, disopyramides, fibrate, fluoxetine, MAO zoletsa, pentoxifylline, propoxyphene, salicylates ndi sulfibamide.

Zinthu zomwe zingachepetse magazi ochulukitsa m'magazi ndizophatikiza ma glucocorticosteroid mahomoni, danazole, diazoxide, diuretics, glucagon, isoniazid, zotupa za phenothiazine, somatropin, sympathomimetics (mwachitsanzo epinephrine adrenaline, salbutamol, mahomoni ecybutaline. , mu njira zakulera zam'mlomo), protease inhibitors ndi atypical antipsychotic mankhwala (mwachitsanzo, olanzapine ndi clozapine).

Beta-blockers, clonidine, mchere wa lithiamu ndi mowa zimatha kutsitsa ndikuchepetsa mphamvu ya shuga ya magazi. Pentamidine imatha kuyambitsa hypoglycemia, yomwe nthawi zina imalowa mu hyperglycemia.

Kuphatikiza apo, mothandizidwa ndi mankhwala achifundo ngati ß-blockers, clonidine, guanethidine ndi reserpine, zizindikiro za adrenergic antiregulation zitha kukhala zofatsa kapena zosakhalapo.

Maupangiri Ogwirizana

Chifukwa chosowa maphunziro othandizira, mankhwalawa sayenera kukhala osakanikirana ndi mankhwala ena kupatula insulin yaumunthu.

Zolemba zogwiritsira ntchito

Kusamutsa wodwala kupita ku mtundu wina kapena mtundu wa insulin kuyenera kuchitika moyang'aniridwa ndi achipatala. Sinthani mu mtundu wa kumasulidwa, mtundu (wopanga), mtundu (muyezo, NPH, zochedwa kuchita, ndi zina), chiyambi (mtundu wa nyama) ndi (kapena) ukadaulo wopanga ukhoza kukhala ndi kusintha kwa muyezo. Mlingo wowonjezera wa mankhwala amkamwa a hypoglycemic angafunike ndi munthawi yomweyo.

Kulephera kulandira dosing kapena kusiya kulandira chithandizo, makamaka odwala matenda a shuga omwe amadalira insulin, kungayambitse matenda a hyperglycemia ndi matenda ashuga ketoacidosis - moyo wowopsa.

Nthawi ya kukonzekera kwa hypoglycemia zimatengera limagwirira ake ntchito insulin, motero, angasinthe ndi kusintha kwa regimen mankhwala.

Mikhalidwe yomwe ingasinthe kapena kuchepetsa zizindikiro zoyambirira za hypoglycemia ndi monga: shuga wa nthawi yayitali, chisamaliro chokwanira ndi insulin, matenda ashuga a m'mimba, mankhwala monga ß-blockers, kapena kusintha kwa nyama kupita ku insulin ya anthu. Mlingo ungafunike ngati wodwalayo wawonjezera zochitika zake zolimbitsa thupi kapena wasintha dongosolo lazakudya. Kuchita masewera olimbitsa thupi mutangotha kudya kumatha kuwonjezera ngozi ya hypoglycemia.

Ngati hypoglycemia imayamba pambuyo pa jakisoni wa ma analogi othamanga, ndiye kuti imayamba kumayambika, poyerekeza ndi jakisoni wa insulle wa munthu.

Ngati zotupa za hypoglycemic ndi hyperglycemic sizikonzedwa, zingayambitse kuchepa kwa chikumbumtima, kwa ndani komanso kwa imfa ya wodwalayo.

Kufunika kwa wodwala insulin kungasinthe pa nthawi ya matenda kapena nkhawa.

Syringe Handle

Musanagwiritse ntchito cholembera cha SoloStar, muyenera kuwerenga mosamala malangizo ogwiritsira ntchito patsamba ili.

Kutulutsa Fomu

3 ml iliyonse pakabati katiriji komveka bwino (mtundu I). Katirijiyo amasindikizidwa mbali imodzi ndi choletsa cha brkidutyl ndikuwombedwa ndi chipewa cha aluminiyamu, kumbali ina ndi brwaputyl plunger.

Katirijiyo amaikika mu cholembera cha SoloStar. 5 SoloStar syringes imayikidwa pabokosi lamakatoni pamodzi ndi malangizo ogwiritsa ntchito.