Insulin Tresiba: kuwunika, kuwunika, kugwiritsa ntchito malangizo

Tresiba FlexTouch ndi insulin yokhala nthawi yayitali yomwe imagwiritsidwa ntchito pochiza matenda a shuga omwe amadalira insulin. Munkhaniyi tiona malangizo omwe angagwiritsidwe ntchito ngati mankhwala a "Tresiba".

Yang'anani! Mu gulu la anatomical-achire-kemikali (ATX), "Tresiba" akuwonetsedwa ndi code A10AE06. Dzina Lopanda Malire Padziko Lonse (Treshiba INN): Insulin Degludec.

Chofunikira chachikulu:

Tresiba ilinso ndi zotuluka.

Pharmacodynamics ndi pharmacokinetics: malongosoledwe amchitidwewo

Malinga ndi kafukufuku wa in vitro, ID ndi yogwiritsa ntchito ma insulin receptors, koma imafanana kwambiri ndi ma receptor a insulin ngati kukula kwa chinthu. Ma cell a insulin amapezeka pafupifupi maselo onse mosiyanasiyana. Maselo ofiira ali ndi ma receptor mazana ochepa, pomwe ma cell a chiwindi ndi maselo amafuta amawonetsa mazana angapo. Ma insulin receptors amapezeka mkati mwa membrane wa khungu motero, ndi a gulu la transmembrane receptors.

Ma pharmacokinetics a ID amafanizidwa, makamaka, ndi insulin glargine (IG). Pafupifupi theka la moyo ndi maola 25 (insulin glargine: maola 12). Kutalika kwa ID ndi maola osachepera 42. Popeza ID imagwirizanitsidwa kwambiri ndi albumin, kuchuluka kwa plasma sikungaphatikizidwe mwachindunji ndi insulin glargine. Komabe, zochitika za insulin ziwiri zimatha kuyesedwa pamlingo wa kulowetsedwa kwa glucose. Malinga ndi kafukufukuyu, odwala omwe ali ndi matenda a shuga 1, ID amachepetsa kwambiri kuchuluka kwa shuga m'magazi.

Zizindikiro ndi ma contraindication ogwiritsa ntchito mankhwalawa

Tresiba adayerekezedwa nthawi zambiri ndi glargine. Posachedwa, ena mwa maphunziro awa adasindikizidwa. Chimodzi mwaziphunzitso zambiri zamtunduwu zidachitika mwa anthu omwe adathandizidwa ndi insulin chaka chimodzi. Mwa otenga nawo 629, 472 adalandira ID ndipo 157 adalandira IG. M'magulu onsewa, HbA1c idatsika pafupifupi ndi 0,4% pachaka chimodzi, ndipo m'magulu onsewo mtengo wa HbA1c wotsika pansi 7% umatheka.

Kafukufuku wofanana adachitika mwa anthu omwe ali ndi matenda osokoneza bongo omwe amadalira insulin. Odwala adapatsidwa Treshiba kwa zaka 2 ndipo kuchuluka kwa monosaccharides m'magazi kumayezedwa pafupipafupi. Asayansi adazindikira kuti mankhwalawa bwino komanso kwa nthawi yayitali amachepetsa glycemia kuposa IG.

Kafukufuku wamkulu kwambiri mpaka pano mu pulogalamu ya BEGIN adaphatikizapo anthu 1,030 omwe ali ndi matenda a shuga a 2 omwe sanalandire insulini isanachitike mayeso. Anthu a 773 adalandira ID, 257 - IG, onsewa adatenganso metformin. Pambuyo pa chaka chimodzi chamankhwala, HbA1c inali yotsika ndi 1.06% mu gulu la ID. Zotsatira zoyipa zinali zofanana m'magulu onse awiriwa, koma nocturnal hypoglycemia idapezeka mwa odwala omwe amatenga Tresiba.

M'maphunziro awiri a sabata 26, anthu 927 omwe ali ndi matenda a shuga a 2 adatenga nawo gawo. Gulu 1 lidalandira ID (m'mawa kapena madzulo), ndipo yachiwiri - IG. Mankhwalawa anachepetsa glycemia ndikuwongoletsa mkhalidwe wa odwala.

Kafukufuku wowonjezeranso adawonetsa kuti ID imatha kuperekedwa mosiyanasiyana mosiyanasiyana mulingo yaying'ono (200 U / ml). Ngakhale kusintha kwakukulu pakubweza (kuyambira maola 8 mpaka 40), ID imatha kufikira mfundo za HbA1c, zomwe sizisiyana kwenikweni ndi chikhalidwe chomwe chimapatsidwa IG.

Mankhwala osavomerezeka kuti agwiritsidwe ntchito ndi mwana wochepera zaka 6. Amaletsanso kumwa mankhwala okhala ndi hypersensitivity ku chinthu chogwira.

Zotsatira zoyipa

Malinga ndi kafukufuku wa US Food and Drug Administration (FDA), hypoglycemia imakonda kupezeka mwa odwala usiku. Ngati "usiku" umatanthauziridwa mosiyana (kuchokera 2 mpaka 6 maola kapena pakati pa ola limodzi mpaka maola 8), ndiye kuti palibe kusiyana kwakukulu.

Pazokhudzana ndi zochitika zamkati pamtima, kuwunika koyambirira sikunawonetse kusiyana kwakukulu pakati pa ID ndi mankhwala ena. Komabe, kuwunikanso kwina ndi FDA, momwe masoka amtima anali kufotokozedwa mosamalitsa, kuwonetsa chizolowezi pakati pa ma ID pazomwe zimachitika pafupipafupi kukomoka kwamtima, kumenya ndi kufa kwamtima. Ku Switzerland, chidziwitso chazomwe chimagwiritsidwa ntchito chamankhwala sichikupereka chisonyezo chilichonse chazovuta zomwe zingachitike.

Zotsatira zina zoyipa, monga zochita zakomweko jakisoni kapena lipodystrophy, ndizosowa.

Odwala amatha kudwala kwambiri hypoglycemia kapena hyperglycemia (osalondola kapena osakwanira pokonzekera mankhwalawa). Zinthu zonsezi zimatha kuwononga thupi kukula kwambiri kapena kucheperako kutengera kutalika kwa nthawi ya hypoglycemic kapena hyperglycemic. Hyperglycemia imasokoneza ziwalo zambiri zamthupi ndi machitidwe amthupi, komanso zimayambitsa zovuta zazikulu pakapita nthawi yayitali.

Zomwe zimapangitsa kuti insulin isakhale yovuta kwambiri chifukwa ndi insulin. Nthawi zambiri, sayanjana zimachitika zina magawo yankho, osati insulin yokha. Zizindikiro zimatha kupezekanso jakisoni. Izi zimaphatikizapo kuyabwa, kuwotcha komanso kufiyira khungu pakhungu. Odwala ena atha kukhala ndi chifuwa chowuma komanso zizindikiro za mphumu.

Kumayambiriro kwa mankhwala a insulin, kuonera kwambiri kumatha kuchitika, makamaka ngati msana wa glycemia unasintha. Zosokoneza zowonekera nthawi zambiri zimatha mkati mwa masabata awiri.

Mlingo ndi bongo

Mlingo uyenera kukhazikitsidwa payekhapayekha, monga ma insulini ena. Mtundu woyamba wa shuga, chithandizo chimathandizidwa ndi insulin yochepa. Mtundu wachiwiri wa matenda a shuga, mankhwalawa amatha kugwiritsidwa ntchito pawokha kapena kuphatikiza ndi am'magazi a hypoglycemic.

Sitikulimbikitsidwa kugwiritsa ntchito mankhwalawa mwa amayi apakati komanso munthawi yoyambira, popeza maphunziro a chitetezo sanachitidwe.

Kuchita

Tresiba insulin amalumikizana ndi mankhwala omwe amakhudza kagayidwe ka glucose. Ena angayambitse kuchepa kapena kuwonjezeka kwa kufunikira kwa insulin. Zitsanzo ndi mahomoni, opanga ma beta, mankhwala osiyanasiyana a psychotropic, mankhwala achifundo, mowa, ndi ena.

Zofanizira zazikulu za Tresiba:

Maganizo a dokotala wodziwa bwino komanso wodwala matenda ashuga.

Tresiba ndi mankhwala othandizira odwala othandizira omwe amagwira ntchito tsiku lonse. Komabe, musanagwiritse ntchito, muyenera kufunsa dokotala, chifukwa mankhwalawa angayambitse hypoglycemia.

Mikhail Mikhailovich, katswiri wa matenda ashuga

Ndili ndi matenda ashuga 1. Ndakhala ndikumwa mankhwalawo kwa zaka zingapo. Sindikumva zovuta zilizonse. Nthawi zina hypoglycemia imachitika, koma khungubwe la shuga limaletsa.

Mtengo (mu Russian Federation)

Mlingo wa tsiku ndi tsiku wa 30 U wa insulin pamwezi umatengera pafupifupi ma ruble 700 aku Russia. Mtengo wotsiriza umalimbikitsidwa kuti ukayang'ane ndi wogulitsa kapena wogulitsa mu pharmacy iliyonse.

Zofunika! Mankhwala amatha kumwedwa atakambirana ndi dokotala. Mankhwalawa amaperekedwera mosamalitsa malinga ndi zomwe akupatsani.

Zinthu ndi mfundo za mankhwalawa

Chofunikira chachikulu cha Tresib insulin ndi Insulin degludec (degludec). Chifukwa chake, monga Levemir, Lantus, Apidra ndi Novorapid, insulin ya Tresib ndi analogue ya mahomoni amunthu.

Asayansi amakono atha kupereka mankhwalawa mwapadera. Izi zidatheka chifukwa chakugwiritsanso ntchito ma biotechnology obwereza a DNA okhudza Saccharomyces cerevisiae mavuto ndi kusintha kwa maselo a maselo a insulin yaumunthu.

Palibe zoletsa kugwiritsa ntchito mankhwalawa, insulin ndiyabwino kwa onse odwala. Odwala omwe ali ndi mtundu woyamba komanso wachiwiri wa shuga amatha kugwiritsa ntchito mankhwalawa tsiku lililonse.

Poganizira za momwe mavuto a Tresib insulin amakhudzira thupi, ziyenera kudziwika kuti adzakhala motere:

1. mamolekyu a mankhwala amaphatikizidwa kukhala ma multicamera (ma mamolekyulu) atangolowa mankhwalawo. Chifukwa cha izi, insulin depot imapangidwa m'thupi,
2. Mlingo wawung'ono wa insulin umasiyanitsidwa ndi masheya, zomwe zimapangitsa kuti zitheke.

Zopindulitsa za Treshiba

Insulin yomwe imawerengedwa imakhala ndiubwino wambiri kuposa ma insulin ena komanso mawonekedwe ake. Malinga ndi ziwerengero zamankhwala zomwe zilipo, Tresiba insulin imatha kuyambitsa kuchuluka kwa hypoglycemia, mwa njira, ndipo ndemanga zimanenanso chimodzimodzi. Kuphatikiza apo, ngati muigwiritsa ntchito momveka bwino mogwirizana ndi malangizo omwe dokotala mwalandira, madontho m'magazi a shuga sakhazikitsidwa.

Ndikofunika kunena kuti zabwino zamankhwala zimanenedwanso:

• kusiyanasiyana pang'ono pamlingo wa glycemia mkati mwa maola 24. Mwanjira ina, mukamamwa mankhwala a dehydlude, shuga wamagazi amakhala m'magazi abwinobwino tsiku lonse,
• chifukwa cha mawonekedwe a mankhwala a Tresib, endocrinologist imatha kukhazikitsa mulingo woyenera wa wodwala aliyense.

Munthawi yomwe Tresib insulin Therapy ikuchitika, chindapusa chabwino cha matendawa chitha kupitilizidwa, zomwe zingathandize kukonza bwino thanzi la odwala. Ndipo malingaliro pa mankhwalawa samalola kukayikira kugwira ntchito kwake kwapamwamba.

Ndikounika kwa odwala omwe amagwiritsa ntchito mankhwalawo, ndipo samakumana ndi mavuto.

Contraindication

Monga mankhwala ena aliwonse, insulin ili ndi zotsutsana zomveka. Chifukwa chake, chida ichi sichingagwiritsidwe ntchito muzochitika zotere:

• Wodwala wosakwana zaka 18
• mimba
• mkaka wa m'mawere (yoyamwitsa),
• kusalolera kwa chimodzi mwazinthu zothandizira za mankhwala kapena chinthu chake chachikulu chogwira ntchito.

Kuphatikiza apo, insulin singagwiritsidwe ntchito jakisoni wovomerezeka. Njira yokhayo yoperekera inshuwaransi ya Tresib ndiyosazungulira!

Zotsatira zoyipa

Mankhwala ali ndi mavuto ake osiyanasiyana, mwachitsanzo:

• zovuta m'matenda a chitetezo cha mthupi (urticaria, sensitivity kwambiri),
• mavuto mu metabolic process (hypoglycemia),
• zovuta pakhungu ndi subcutaneous zimakhala (lipodystrophy),
• zovuta zonse (edema).

Izi zimachitika kawirikawiri osati kwa odwala onse.

Chowonekera kwambiri komanso pafupipafupi cha kuchitidwa kovuta ndikubwezeretsanso malo a jekeseni.

Kutulutsa njira

Mankhwalawa amapezeka mu mawonekedwe a cartridgeges, omwe amatha kugwiritsidwa ntchito mu syopinge ya Novopen (Tresiba Penfill), yomwe imapangidwanso.

Kuphatikiza apo, ndizotheka kupanga Tresib mu mawonekedwe a zolembera zotayika (Tresib FlexTouch), yomwe imangopereka ntchito imodzi yokha. Iyenera kutayidwa pambuyo poyang'anira insulin yonse.

Mlingo wa mankhwalawa ndi 200 kapena 100 magawo 3 ml.

Malamulo oyambira kukhazikitsidwa kwa Tresib

Monga taonera kale, mankhwalawa amayenera kuperekedwa kamodzi patsiku.

Wopangayo akuti jakisoni wa Tresib insulin iyenera kuchitidwa nthawi yomweyo.

Ngati wodwala yemwe ali ndi matenda ashuga amagwiritsa ntchito kukonzekera kwa insulin koyamba, dokotala amupatsa mankhwala okwanira 10 mayeso kamodzi pa maola 24 aliwonse.

Mtsogolomo, malinga ndi zotsatira za kuyeza shuga wamagazi pamimba yopanda kanthu, ndikofunikira kuphatikiza kuchuluka kwa Tresib insulin modabwitsa.

Muzochitika zomwe chithandizo cha insulin chakhala chikuchitika kwa nthawi yayitali, endocrinologist akupereka mlingo wa mankhwalawo womwe ungafanane ndi mlingo wa basal hormone yomwe imagwiritsidwa ntchito kale.

Izi zitha kuchitika pokhapokha ngati mulingo wa hemoglobin wa glycated sunali wotsika kuposa 8, ndipo insulin ya basal idaperekedwa kamodzi masana.

Ngati mavutowa sanakwaniritsidwe mokwanira, ndiye kuti pakufunika mlingo wotsika wa Tresib.

Madokotala ali ndi lingaliro kuti idzagwiritsa ntchito muyeso yaying'ono. Izi ndizofunikira chifukwa ngati mutasinthanitsa ndi mankhwalawo, ndiye kuti mankhwala ocheperako amafunikira kuti akwaniritse glycemia wabwinobwino.

Kusanthula kwotsatira kwa kuchuluka kwa insulin kumatha kupangidwa nthawi imodzi pa sabata. Kusinthaku kumakhazikitsidwa pazotsatira zapakati pa miyeso iwiri yotsalira.

Tcherani khutu! Tresiba ikhoza kugwiritsidwa ntchito mosamala ndi:

Mbali zosungirako mankhwala

Tresiba iyenera kusungidwa pamalo abwino pa kutentha kwa madigiri 2 mpaka 8. Itha kukhala firiji, koma patali ndi mufiriji.

Sipadzayambiranso insulin!

Njira yosungiridwayo ikugwirizana ndi insulin yosindikizidwa. Ngati ili kale ndi cholembera chogwiritsidwa ntchito kapena pokhapokha, ndiye kuti chosungira chitha kuchitidwa kutentha, osayenera kupitirira 30 digiri. Alumali moyo wotseguka - miyezi iwiri (masabata 8).

Ndikofunikira kwambiri kuteteza cholembera ku dzuwa. Kuti muchite izi, gwiritsani ntchito kapu yapadera yomwe ingateteze kuwonongeka kwa Tresib insulin.

Ngakhale kuti mankhwalawa atha kugulidwa mu chipatala cha mankhwala osagwiritsa ntchito mankhwala, ndizosatheka kulemba nokha!

Milandu yambiri

Ngati pali mankhwala ochulukitsa a insulin (omwe sanalembetsedwe mpaka pano), wodwalayo angadzithandizire. Hypoglycemia imatha kuthetsedwa pogwiritsa ntchito zinthu zazing'ono zokhala ndi shuga:

• tiyi wokoma
• madzi a zipatso
• chokoleti chosakhala ndi matenda ashuga.

Popewa hypoglycemia, ndikofunikira kuti nthawi zonse muzikhala ndi kutsekemera kulikonse.