Lantus Solostar (cholembera) - cholembera wa insulin

Tikukupatsani kuti muwerenge nkhaniyi pamutuwu: "insulin lantus solostar" ndi ndemanga kuchokera kwa akatswiri. Ngati mukufuna kufunsa funso kapena kulemba ndemanga, mutha kuchita izi pansipa, nkhaniyo itatha. Katswiri wathu wamtundu wa endoprinologist adzakuyankhirani.

Lantus ndi imodzi mwazithunzi zopanda pake za insulin ya munthu. Kupezeka m'malo mwa amino acid katsitsumzukwa ndi glycine pa 21 malo A ndi unyolo ndikuwonjezera awiri arginine amino acid mu B unyolo ku terminal amino acid. Mankhwalawa amapangidwa ndi kampani yayikulu yopanga mankhwala ku France - Sanofi-Aventis. Popita maphunziro ambiri, zidatsimikiziridwa kuti insulin Lantus sikuti imangochepetsa chiopsezo cha hypoglycemia poyerekeza ndi mankhwala a NPH, komanso imathandizira kagayidwe kazachilengedwe. Pansipa pali malangizo achidule ogwiritsa ntchito ndi kuwunika kwa odwala matenda ashuga.

Chithandizo cha Lantus ndi insulin glargine. Amapezeka ndi majini obwezeretsanso pogwiritsa ntchito mtundu wa k-12 wa bakiteriya Escherichia coli. M'malo osaloŵerera, samasungunuka pang'ono, mu acid acid sing'anga imasungunuka ndikupanga microprecipitate, yomwe imatulutsa insulini pang'onopang'ono. Chifukwa cha izi, Lantus ali ndi mbiri yosavuta kuchitira mpaka maola 24.

Kupanga kwakukulu pa pharmacological:

• Ochepa adsorption ndi mbiri yopanda kanthu mkati maola 24.
• Kuponderezedwa kwa proteinolysis ndi lipolysis mu adipocytes.
• Gawo lolimbikira limamangirira ma insulin receptors maulendo 5-8 mwamphamvu.
• Kukuwongolera kagayidwe kachakudya kagayidwe kachakudya, kuletsa shuga kupangika kwa chiwindi.

Mu 1 ml Lantus Solostar muli:

• 3.6378 mg wa insulin glargine (malinga ndi 100 IU ya insulin ya anthu),
• 85% glycerol
• madzi a jakisoni
• hydrochloric wozama acid,
• m-cresol ndi sodium hydroxide.

Lantus - njira yowonekera yothandizira jakisoni wa sc, imapezeka mu:

• makatoni a dongosolo la OptiKlik (5pcs pa paketi iliyonse),
• Syringe zolembera Lantus Solostar,
• Syringe cholembera ya OptiSet mu phukusi limodzi 5 ma PC. (magawo 2),
• Mbale 10 ml (magawo 1000 mu vala imodzi).

1. Akuluakulu ndi ana ochokera zaka 2 zokhala ndi matenda amtundu wa 1.
2. Type 2 shuga mellitus (pankhani ya kusagwira kwa mapiritsi).

Mukunenepa kwambiri, kuphatikiza mankhwalawa ndikothandiza - Lantus Solostar ndi Metformin.

Pali mankhwala omwe amakhudza kagayidwe kazakudya, pomwe akuwonjezera kapena kuchepetsa kufunika kwa insulin.

Chepetsa shuga: pakamwa antidiabetesic othandizira, sulfonamides, ACE zoletsa, salicylates, angioprotectors, monoamine oxidase inhibitors, antiarrhythmic dysopyramides, narcotic analgesics.

Onjezani shuga: mahomoni a chithokomiro, diuretics, sympathomimetics, kulera kwapakamwa, zotumphukira za phenothiazine, proteinase inhibitors.

Zinthu zina zimakhala ndi mphamvu ya hypoglycemic komanso hyperglycemic. Izi zikuphatikiza:

• beta blockers ndi mchere wa lithiamu,
• mowa
• clonidine (antihypertensive mankhwala).

1. Ndi zoletsedwa kugwiritsa ntchito mwa odwala omwe ali ndi vuto la insulin glargine kapena othandizira.
2. Hypoglycemia.
3. Chithandizo cha matenda ashuga ketoacidosis.
4. Ana osakwana zaka 2.

Zotheka zimachitika kawirikawiri, malangizowo akuti mwina atha:

• lipoatrophy kapena lipohypertrophy,
• matupi awo sagwirizana (edema ya Quincke, mantha onse, bronchospasm),
• kupweteka kwa minyewa ndi kuchedwa mu thupi la ayodini,
• dysgeusia ndi kuwonongeka kwa mawonekedwe.

Ngati munthu wodwala matenda ashuga agwiritsa ntchito ma insulin apakatikati, ndiye kuti musinthana ndi Lantus, muyezo ndi mtundu wa mankhwalawo umasinthidwa. Kusintha kwa insulin kuyenera kuchitika kokha kuchipatala.

M'tsogolomu, dokotala amayang'ana shuga, njira yodwalayo, kulemera kwake ndikusintha kuchuluka kwa mayendedwe omwe amaperekedwa. Pakatha miyezi itatu, kugwiritsa ntchito bwino kwa mankhwalawa kungayang'anitsidwe ndikusanthula kwa hemoglobin ya glycated.

Malangizo pavidiyo:

Ku Russia, onse odwala matenda a shuga omwe amadalira insulin adasamutsidwa kuchoka ku Lantus kupita ku Tujeo. Malinga ndi kafukufuku, mankhwalawa ali ndi chiopsezo chochepa cha kukhala ndi hypoglycemia, koma machitidwe ambiri anthu amadandaula kuti atasinthira ku Tujeo shuga wawo adalumphira kwambiri, motero amakakamizidwa kugula okha Lantus Solostar insulin.

Levemir ndi mankhwala abwino kwambiri, koma ali ndi chinthu china chogwira ntchito, ngakhale nthawi yayitali ndi maola 24.

Aylar sanakumane ndi insulin, malangizo akuti uyu ndi Lantus yemweyo, koma wopanga ndi wotsika mtengo.

Maphunziro a zachipatala a Lantus omwe ali ndi amayi apakati sanachitike. Malinga ndi zomwe sizinalembedwera, mankhwalawa samakhudza kwambiri mayendedwe a mwana komanso iyemwini.

Kuyesera kunachitika pa zinyama, pomwepo zimatsimikiziridwa kuti insulin glargine ilibe vuto la kubereka.

Lantus Solostar woyembekezera atha kutumikiridwa pokhapokha insulin NPH isagwire ntchito. Amayi amtsogolo akuyenera kuwunika shuga wawo, chifukwa mu trimester yoyamba, kufunika kwa insulin kumatha kuchepa, komanso mu trimester yachiwiri ndi yachitatu.

Osawopa kuyamwitsa mwana; malangizo ake alibe zomwe Lantus imatha kudutsa mkaka wa m'mawere.

Tsiku lotha ntchito ya Lantus ndi zaka 3. Muyenera kusungira m'malo amdima otetezedwa ndi kuwala kwa dzuwa pa kutentha kwa madigiri 2 mpaka 8. Nthawi zambiri malo abwino kwambiri ndi firiji. Poterepa, onetsetsani kuti mwayang'ana kutentha, chifukwa kuzizira kwa insulin Lantus koletsedwa!

Kuyambira koyamba kugwiritsa ntchito, mankhwalawa amatha kusungidwa kwa mwezi umodzi m'malo opanda khungu pamtunda wa osaposa 25 digiri (osati mufiriji). Osagwiritsa ntchito insulin yomwe yatha.

Lantus Solostar amalembedwa mwaulere ndi mankhwala ndi endocrinologist. Komanso zimachitika kuti wodwala matenda ashuga ayenera kugula yekha mankhwala ku pharmacy. Mtengo wamba wa insulin ndi ma ruble 3300. Ku Ukraine, Lantus angagulidwe 1200 UAH.

Odwala matenda ashuga akuti ndi insulin yabwino kwambiri, kuti shuga yawo imasungidwa mwa malire. Nazi zomwe anthu akunena za Lantus:

Ambiri adangotsala ndemanga zabwino zokha. Anthu angapo adanena kuti Levemir kapena Tresiba ndiwofunikira.

Ndi matenda a shuga, anthu amakakamizidwa kubwereza kuchuluka kwa insulin mthupi kudzera jakisoni. Akatswiri apanga mankhwala omwe amapezeka ndi mawonekedwe a haibridi a DNA. Chifukwa cha izi, mankhwala a Lantus Solostar adakhala analogue othandiza a insulin yaumunthu. Mankhwalawa amakupatsani mwayi kusintha kuchuluka kwa shuga m'thupi la munthu kuti mutsimikizire ntchito zofunika.

Mankhwalawa ndi osavuta kugwiritsa ntchito, chifukwa amapezeka mu mawonekedwe a cholembera, omwe amakupangitsani kudzipangira nokha. Muyenera kupereka mankhwalawa pansi pakhungu m'mimba, ntchafu kapena phewa. Kubaya jekeseni ndikofunikira kamodzi patsiku. Pankhani ya kumwa mankhwalawa, ayenera kuuzidwa ndi adokotala, potengera zomwe akuwonetsa ndi matendawa.

Lantus Solostar amaphatikizidwanso ndi mankhwala ena omwe amathandizanso kuthamangitsa shuga mu mtundu 2 odwala matenda ashuga. Komabe, ndikofunikira kuti muphunzire mosamala za kusagwirizana kwa mankhwalawa ndi ena.

Mankhwala amakhala insulin glargine. Kuphatikiza apo: madzi, glycerol, asidi (hydrochloric), sodium hydroxide ndi m-cresol. Makatoni amodzi ali ndi 3 ml. yankho.

Mphamvu ndi mbiri ya insulin glargine ndi yofanana ndi anthu, chifukwa chake, pambuyo pa kayendetsedwe kake, kagayidwe ka glucose kamachitika, ndipo ndende yake imachepa. Komanso, mankhwalawa amathandizira kukonza kaphatikizidwe, mapuloteni komanso lipolysis mu ma adipocytes.

Kuchita kwa insulin yotere ndikutali, koma ngakhale kuti chitukuko chimachitika pang'onopang'ono. Komanso pa nthawi ya mankhwalawa imakhudzanso umunthu wa munthu, moyo wake.

Kafukufuku adazindikira kuti insulin glargine siyimayambitsa matenda ashuga.

M'malo osaloledwa, insulin imasungunuka pang'ono. Mu acidic, microprecipitate imawonekera, ndikuimasula, kotero nthawi ya mankhwalawa imapangidwa kwa maola 24. Ponena za zinthu zazikulu zamankhwala, ili ndi mbiri yopanda pake komanso yolekezera pang'onopang'ono.

Dziko lomwe adachokera mankhwalawa ndi France (Sanofi-Aventis Corporation). Komabe, makampani ambiri opanga mankhwala ku Russia amathanso kugulitsa ndi kupanga mankhwala kutengera zomwe zidawakomera.

Lantus Solostar iyenera kuyendetsedwa mosakakamiza. Ndikofunikira kudziwa nthawi yeniyeni kuti muzitha kupereka mankhwala nthawi yomweyo. Katswiriyu ayenera kuwerengetsa mlingo, kutengera kusanthula ndi mayeso. Mankhwalawa amachotsedwa pazinthu zomwe amagwira, mosiyana ndi mankhwala ena onse.

Mutha kugwiritsa ntchito mankhwalawa anthu omwe ali ndi mtundu wina wa matenda ashuga. Kugwiritsa ntchito kumaloledwa limodzi ndi zinthu za hypoglycemic.

Kusunthira ku mankhwalawa ndi omwe ali ndi zotsatira zapakati kapena zazitali, ndikofunikira kusintha mlingo ndi nthawi yogwiritsira ntchito. Kuti muchepetse chiopsezo cha hypoglycemia usiku, ndibwino kuti muchepetse mlingo panthawi ya kusintha kwa insulin iyi. Nthawi zina, munthu amatha kupanga ma antibodies, ndipo momwe mankhwalawo amacheperachepera. Kuti muchite izi, muyenera kusinthasintha mlingo ndikuwunika kuchuluka kwa shuga.

Malangizo okhudzana ndi mankhwala:

• Lowani mu minyewa yokhayo (pamimba, ntchafu, phewa).
• Ndikulimbikitsidwa kuti musinthe mawebusayiti a jekeseni kuti mupewe kuwoneka kwa hematomas kapena zowawa.
• Musati mupeze jakisoni.
• Komanso, akatswiri amaletsa kusakaniza mankhwalawa ndi mankhwala ena.
• Musanayambe jakisoni, chotsani thovu kuchokera mumchombocho ndikutenga singano yatsopano.

Popeza mankhwalawo amagulitsidwa ngati cholembera, ayenera kuwunikidwa kaye asanalowe jakisoni kuti pasapezeke mawanga mu yankho. Ngati pali chitayiko, ndiye kuti mankhwalawo amawoneka kuti ndi osayenera komanso osatetezeka kuti mugwiritse ntchito. Mukatha kugwiritsa ntchito cholembera, iyenera kutayidwa. Mukumbukiranso kuti mankhwalawa sangasamutsidwe kwa anthu ena.

Ponena za kuwerengera kwa mulingo, ndiye, monga tafotokozera kale, iyenera kuyikidwa ndi katswiri. Mankhwala pawokha amakulolani kupanga mlingo wa 1 mpaka 80 mayunitsi. Ngati jakisoni wokhala ndi muyeso wa magawo opitilira 80 ndiofunikira, jakisoni iwiri imachitika.

Pamaso pa jekeseni, muyenera kuyang'ananso cholembera. Kuti muchite izi, algorithm yotsatirayi ya zochita imachitidwa:

• Kutsimikiza
• Kuyesa maonekedwe.
• Kuchotsa kachipewa, kumangirira singano (yopanda zingwe).
• Ikani syringe ndi singano mmwamba (mutatha muyeso wa 2 U).
• Dinani pa cartridge, kanikizani batani lolembetsani njira yonse.
• Onani madontho a insulini kumapeto kwa singano.

Ngati mkati mwa mayeso a insulin yoyamba sikuwoneka, kuyesaku kumachitika mobwerezabwereza mpaka yankho litawonekera pambuyo kukanikiza batani.

Zotsatira zoyambirira zomwe zimayambitsidwa ndi Lantus Solostaom ndi mawonekedwe a hypoglycemia. Ndi mankhwala osokoneza bongo kapena kusintha kwa nthawi yakudya, kusintha kwa glucose kumachitika, zomwe zimabweretsa izi. Chifukwa cha hypoglycemia, munthu amatha kudwala matenda amitsempha.

Kuphatikiza apo, pamaziko ogwiritsa ntchito mankhwalawa, zizindikiro zotsatirazi zingaoneke:

• Mavuto ndi dongosolo lamanjenje (retinopathy, dysgeusia, kuwonongeka kwa mawonekedwe).
• Lipoatrophy, lipodystrophy.
• Allergy (anti-neurotic edema, bronchospasm).
• Bronchospasm.
• Edema wa Quincke.
• Zowawa.
• Kutupa ndi kutupa pambuyo pa jekeseni.

Ngati mankhwalawa awonjezereka, ndiye kuti glycemia sangapewe. Pankhaniyi, munthu akhoza kupeza zotsatirazi:

• Mutu.
• Kutopa
• Kutopa.
• Mavuto amawonedwe, kulumikizana, kuyika malo m'malo.

Zizindikiro zotsatirazi zitha kuchitika: njala, kusakwiya, kuda nkhawa, thukuta lakumwa, mtima.

Patsamba la jakisoni, lipodystrophy imatha kuonekera, yomwe imachepetsa kuyamwa kwa mankhwala. Kuti mupewe izi, ndikofunikira kusintha tsamba la jakisoni, kusinthanitsa ntchafu, phewa ndi pamimba. Kuphatikiza apo, madera a mano, redness, ndi zowawa zimatha kupezeka m'malo a khungu. Komabe, patangopita masiku ochepa mavutowa amatha.

Monga mankhwala aliwonse, insulin Lantus SoloStar imakhala ndi contraindication kuti agwiritse ntchito, malinga ndi momwe mankhwalawa sayenera kumwa:

• Anthu omwe ali ndi hypersensitivity ku mankhwalawa.
• Ndi tsankho lanu pazigawo za mankhwala.
• Pamavuto a chiwindi kapena impso.
• Ana osakwana zaka 6.
• Ndi ketoacidosis.
• Okalamba omwe asokoneza impso kapena chiwindi.
• Odwala ndi ubongo stenosis.

Malinga ndi kafukufuku wazachipatala, palibe zotsatira zoyipa mukamagwiritsa ntchito mankhwalawa panthawi yapakati. Mankhwalawa alibe mphamvu pa mayi ndi mwana.

Dokotala atha kukulemberani Lantus SoloStar ngati insulin ya NPH ilibe vuto. Ndikofunikira kuyang'anira kuchuluka kwa shuga kwa amayi apakati makamaka mosamala, popeza muzoyimira zosiyanasiyana zizindikiro zake zimatha kusintha. Mu zoyambilira, nthawi zambiri zimakhala zotsika kuposa zachiwiri ndi zachitatu. Komanso, ndi mankhwalawa, mumatha kuyamwitsa popanda kuwopa zovuta ndi zovuta zake.

Kuchita ndi mankhwala ena

Mankhwala Lantus Solostar amatha kusintha malinga ndi mankhwala omwe amaphatikizidwa nawo. Izi zikuphatikiza:

• angiotensin zoletsa,
• mankhwala antidiabetesic mankhwala
• monoamine oxidant zoletsa,
• sanjimpimamide,
• propoxyphene
• disopyramids
• Glarinin.

Kuphatikiza ndi mankhwala a corticosteroid, Lantus SoloStara ndizovomerezeka. Izi ndi monga: danazol, isoniazid, diazoxide, diuretics, estrogens.

Kuchepetsa kapena kuyambitsa mphamvu ya Lantus imatha kupanga lithiamu salt, mowa wa ethyl, pentamidine, clonidine.

Ngati bongo umachitika, ndikofunikira kusiya hypoglycemia mothandizidwa ndi zinthu zomwe zimakhala ndi chakudya chamagulu ambiri. Pakakhala mtundu woopsa wa hypoglycemia, glucagon amayenera kubayidwa m'matumbo kapena pansi pa khungu kapena glucose m'mitsempha.

Zomwe zimapangitsa kuti bongo lizidwala kwambiri. Pankhaniyi, ndikofunikira kukaonana ndi dokotala kuti apange mayeso obwereza ndikukhazikitsa mtundu watsopano wa mayamwidwe atsopano.

Mukayimitsa hypoglycemia, simungathe kusiya wodwalayo osakhudzidwa, chifukwa kuukira kumatha kubwerezedwa masana. Ndikofunika kwambiri kuwunikira mosamala mlingo, kuchita masewera olimbitsa thupi nthawi zonse, osadumpha chakudya, osadya zakudya zoletsedwa. Pankhani yopezeka ndi matenda ashuga, anthu ayenera kuyang'anitsitsa momwe aliri, kuti ngati kuli koyenera afunefune thandizo.

Kusungika kwa mankhwalawa kumatha zaka zitatu, malinga ndi kutentha kwa madigiri 8. Osayika chimbudzi m'malo omwe ana angakwere. Ndikwabwino kusunga mankhwalawo mufiriji kuti mukhale kutentha koyenera. Komabe, ndikofunikira kukumbukira kuti simungasunge insulini mufiriji.

Cholembera cha syringe chitha kugwiritsidwa ntchito jekeseni woyamba kwa masiku 28. Majekeseni atapangidwa, ndizosatheka kusunga mankhwalawo mufiriji. Ndikwabwino kuti boma lotentha lisapitirire 25 digiri. Kugwiritsa ntchito mankhwala omwe adatha sikuletsedwa.

Odwala ambiri omwe adatha kuyesa ndikugwiritsa ntchito mankhwalawa adakwaniritsidwa, chifukwa zimathandiza kuti shuga asakhale ndi malire.

Komabe, sikuti aliyense amakhala wopambana poyendetsa mankhwalawa mopweteka, chifukwa chake, jekeseni isanachitike, ndikofunikira kuti muphunzire mosamala malangizo onse omwe wopanga akupanga.

Odwala omwe ali ndi matenda a shuga Lantus SoloStar amaperekedwa kwaulere, monga endocrinologist amauza malinga ndi mankhwala. Nthawi zina, muyenera kugula mankhwala anu. Pankhaniyi, palibe mavuto, chifukwa amagulitsidwa ku pharmacy mu zolembera. Mtengo wapakati wa mankhwalawo ndi pafupifupi ruble 3,500, ndipo ku Ukraine pafupifupi 1300 hryvnia.

Pali ma analogu okwanira omwe ali ndi zinthu zofananira mu kapangidwe kake, koma nthawi yomweyo amakhudza thupi m'njira zosiyanasiyana. Lantus insulin analog ena ndi:

• Tujeo (insulin glargine). Dziko loyambirira Germany.
• Aylar (insulin glargine). Dziko loyambirira India.
• Levemir (insulin detemir). Dziko ochokera ku Denmark.

Analogue yotchuka kwambiri ndi Tujeo. Kusiyana kwakukulu pakati pa insulin lantus ndi tujeo ndikuti amachita mosiyana pa chinthu china. Ku Russia, odwala matenda ashuga omwe ali ndi nthenda yoyamba amasinthidwa kupita ku Tujeo, koma si aliyense amene ali ndi vuto ndipo amachepetsa shuga.

Ponena za Levemira, mankhwalawa amasiyanitsidwa ndizomwe zimagwira. Ndipo Aylar ndiosiyana kwambiri pamtengo, mosiyana ndi Lantus, koma nthawi yomweyo ali ndi malangizo komanso kapangidwe kofananira.

Pamaso pa jekeseni aliyense wa mankhwalawa, muyenera kuwonetsetsa mosamala. Popeza limapezeka pokhapokha ngati mwalandira mankhwala, kufunsira musanagwiritse ntchito kuli kofunikira mwachangu. Pakakhala vuto la bongo, muyenera kuchitapo kanthu kuti muchepetse kuopsa ndi zovuta za zovuta. Simungachedwe ndi kupumula kwa hypoglycemia, chifukwa kumatha kupweteka.

Ana aang'ono amaletsedwa jakisoni wa mankhwalawa. Kuti mudziwe zovuta zonse ndi zotsutsana, ndibwino kuphunzira malangizo musanayambe jakisoni.

Insulin Lantus Solostar: ndemanga ndi mtengo, malangizo ogwiritsira ntchito

Insulin Lantus SoloStar ndi analogue ya mahomoni omwe amakhala ndi nthawi yayitali, omwe cholinga chake ndikuthandizira matenda a shuga a mtundu 1 komanso a 2. Chithandizo chogwira mankhwalawa ndi insulin glargine, chinthu ichi chimapezeka ku Escherichiacoli DNA pogwiritsa ntchito njira yobwerezeranso.

Glargin amatha kumangiriza ma insulin zolandilira ngati insulin yaumunthu, kotero mankhwalawo ali ndi zofunikira zonse zachilengedwe zokhudzana ndi mahomoni.

Kamodzi mu subcutaneous mafuta, insulin glargine imalimbikitsa mapangidwe a microprecipitate, chifukwa chomwe kuchuluka kwa mahomoni kumatha kulowa m'mitsempha yamagazi a wodwala matenda ashuga. Njira imeneyi imapereka mbiri yabwino kwambiri ya glycemic.

Wopanga mankhwalawa ndi kampani yaku Germany ya Sanofi-Aventis Deutschland GmbH. Chofunikira chachikulu cha mankhwalawa ndi insulin glargine, kapangidwe kake kamaphatikizanso othandizira mu mawonekedwe a metacresol, zinc chloride, glycerol, sodium hydroxide, hydrochloric acid, madzi a jakisoni.

Lantus ndi madzi owoneka bwino, opanda khungu kapena pafupifupi khungu. Kuzindikira kwa yankho la subcutaneous makonzedwe ndi 100 U / ml.

Kathumba kalikonse kamakhala ndi 3 ml ya mankhwala; cartridge iyi imayikidwa mu cholembera cha syloge SoloStar. Ma cholembera asanu a insulin amagulitsidwa pabokosi la makatoni, setiyi imaphatikizapo buku la malangizo a chipangizocho.

• Mankhwala omwe ali ndi ndemanga zabwino kuchokera kwa madokotala ndi odwala angagulidwe ku pharmacy kokha ndi mankhwala othandizira.
• Insulin Lantus akuwonetsedwa chifukwa cha matenda a shuga omwe amadalira odwala ndi ana opitirira zaka zisanu ndi chimodzi.
• Fomu yapadera ya SoloStar imalola kuti ana azitha zaka zopitilira ziwiri azilandira.
• Mtengo wa phukusi la zolembera zisanu ndi mankhwala a 100 IU / ml ndi ma ruble 3,500.

Musanagwiritse ntchito mankhwalawa, muyenera kufunsa dokotala, endocrinologist angakuthandizeni kusankha mlingo woyenera ndikupereka nthawi yeniyeni ya jekeseni. Insulin imalowetsedwa kamodzi kamodzi patsiku, pomwe jakisoni imachitidwa mosamalitsa panthawi inayake.

Mankhwala amalowetsedwa mu mafuta ochepa a ntchafu, phewa kapena pamimba. Nthawi iliyonse mukasinthana ndi tsamba la jakisoni kuti mkwiyo usaonekere pakhungu. Mankhwalawa amatha kugwiritsidwa ntchito ngati mankhwala odziimira pawokha, kapena kuphatikiza ndi mankhwala ena ochepetsa shuga.

Musanagwiritse ntchito Lantus SoloStar insulini mu cholembera kuti mupeze chithandizo, muyenera kudziwa momwe mungagwiritsire ntchito jakisoni. Ngati chithandizo cha insulin m'mbuyomu chinkachitika ndi chithandizo cha insulin yochita masewera olimbitsa thupi kapena yapakati, mlingo wa tsiku ndi tsiku wa basal insulin uyenera kusinthidwa.

1. Pankhani ya kusintha kwa jakisoni wa insulin-isophan wa nthawi ziwiri kupita kwa jekeseni mmodzi wa Lantus mkati mwa milungu iwiri yoyambirira, mlingo wa tsiku ndi tsiku wa mahomoni a basal uyenera kuchepetsedwa ndi 20-30 peresenti. Mlingo wochepetsedwa uyenera kulipidwa ndikuwonjezera kuchuluka kwa insulin yochepa.
2. Izi zimalepheretsa kukula kwa hypoglycemia usiku ndi m'mawa. Komanso, mukasinthana ndi mankhwala atsopano, kuyankha kowonjezereka kwa jakisoni wa mahomoni kumawonedwa nthawi zambiri. Chifukwa chake, poyamba, muyenera kuyang'anira kuchuluka kwa shuga m'magazi pogwiritsa ntchito glucometer ndipo ngati kuli koyenera, sinthani mawonekedwe a insulini.
3. Ndi kusintha kwa kagayidwe kakang'ono, nthawi zina kumva kukhudzidwa kwa mankhwalawa kumatha kuwonjezeka, motere, ndikofunikira kusintha regimen. Kusintha kwa mankhwalawa kumafunikanso pakusintha moyo wa anthu odwala matenda ashuga, kuchulukitsa kapena kuchepa thupi, kusintha nthawi ya jakisoni ndi zina zomwe zimapangitsa kuti hypo- kapena hyperglycemia isanayambike.
4. Mankhwala ndi oletsedwa kwa mtsempha wa magazi, izi zimapangitsa kuti matenda a hypoglycemia atukuke. Musanapange jakisoni, muyenera kuonetsetsa kuti cholembera sichikhala choyera komanso chosalala.

Monga lamulo, Lantus insulin imayendetsedwa usiku, mlingo woyambirira ungakhale magawo 8 kapena kupitirira. Mukasinthana ndi mankhwala atsopano, kuyambitsa mlingo waukulu nthawi yomweyo kumadzetsa moyo, chifukwa chake kukonzaku kumayenera kuchitika pang'onopang'ono.

Glargin amayamba kugwira ntchito mwachangu ola limodzi pambuyo pa jekeseni, pafupifupi, amachita kwa maola 24. Komabe, ndikofunikira kulingalira kuti ndi mlingo waukulu, nthawi yomwe mankhwalawa angagwire maola 29.

Insulin Lantus sayenera kusakanikirana ndi mankhwala ena.

Mothandizidwa ndi kuchuluka kwa insulin, wodwala matenda ashuga amatha kukhala ndi vuto la hypoglycemia. Zizindikiro za matendawa nthawi zambiri zimayamba kuoneka mwadzidzidzi ndipo zimayenda limodzi ndi kumva kutopa, kufooka, kufooka, kuchepa kwa tulo, kugona, kusokonezeka kwa maonekedwe, kupweteka mutu, nseru, chisokonezo, ndi kupsinjika.

Mawonetsedwe awa nthawi zambiri amatsogozedwa ndi zizindikiritso zamtundu wa njala, kusakwiya, kusangalala kwamanjenje kapena kugwedezeka, kuda nkhawa, khungu lotuwa, mawonekedwe a thukuta lozizira, tachycardia, palpitations. Hypoglycemia yayikulu imatha kuwononga mphamvu yamanjenje, motero ndikofunikira kuthandiza odwala matenda ashuga panthawi yake.

Nthawi zina, wodwalayo amakhala ndi vuto chifukwa cha mankhwalawo, omwe amaphatikizidwa ndi mawonekedwe amtundu wapakhungu, angioedema, bronchospasm, ochepa hypertension, mantha, komanso oopsa kwa anthu.

Pambuyo pa jakisoni wa insulin, ma antibodies omwe amagwira ntchito amatha kupanga. Pankhaniyi, ndikofunikira kusintha mtundu wa mankhwalawa kuti muchepetse chiopsezo chokhala ndi hypo- kapena hyperglycemia. Osowa kwambiri, mwa odwala matenda ashuga, kukoma kumatha kusintha, nthawi zina, ntchito zowoneka zimasokonezeka kwakanthawi chifukwa cha kusintha kwa magonedwe amaso.

Nthawi zambiri, m'malo a jakisoni, odwala matenda ashuga amakhala ndi lipodystrophy, yomwe imachedwetsa kuyamwa kwa mankhwalawa. Kuti mupewe izi, muyenera kusintha tsamba la jakisoni pafupipafupi. Komanso, kufiyanso, kuwonda, kuwawa kumawoneka pakhungu, matendawa ndi osakhalitsa ndipo nthawi zambiri amatha pambuyo masiku angapo ochizira.

• Insulin Lantus sayenera kugwiritsidwa ntchito ndi hypersensitivity kwa yogwira mankhwala glargine kapena zinthu zina zothandiza za mankhwalawa. Mankhwalawa amaletsedwa kuti azigwiritsidwa ntchito mwa ana ochepera zaka zisanu ndi chimodzi, koma adotolo atha kukulemberani mtundu wina wa SoloStar, wopangidwira mwana.
• Chenjezo liyenera kuchitidwa panthawi ya insulin. Ndikofunika tsiku lililonse kuyeza shuga wamagazi ndikuwongolera matendawa. Pambuyo pobereka, ndikofunikira kusintha mlingo wa mankhwalawa, chifukwa kufunika kwa insulin panthawi imeneyi kumachepetsedwa kwambiri.

Nthawi zambiri, madokotala amalimbikitsa pakapita nthawi yokhala ndi matenda ashuga kuti agwiritse ntchito njira ina ya insulin - mankhwala Levemir.

Ngati bongo wapamwamba kwambiri, hypoglycemia imayimitsidwa ndikutenga zinthu zomwe zimaphatikizapo chakudya cham'mimba chambiri. Kuphatikiza apo, mitundu ya mankhwalawa imasintha, zakudya zoyenera ndi zochitika zolimbitsa thupi zimasankhidwa.

Mu hypoglycemia yayikulu, glucagon imayendetsedwa kudzera m'mitsempha kapena pang'onopang'ono, ndipo jakisoni wofunsira wa njira yowonjezera shuga imaperekedwanso.

Kuphatikiza ndi adotolo angakulangireni kudya kwakutali kwa chakudya chambiri.

Musanapange jakisoni, muyenera kuwunika momwe bokosi lamatumba limayikidwa mu cholembera. Njira yothetsera vutoli iyenera kukhala yowonekera, yopanda utoto, yopanda chimbudzi kapena owoneka tinthu tina, osatikumbutsa madzi mokhazikika.

Cholembera cha syringe ndi chida chotayikira, chifukwa chake, jekeseni, ayenera kutaya, kugwiritsanso ntchito kungayambitse matenda. Kubayira kulikonse kuyenera kuchitidwa ndi singano yatsopano yosabala, chifukwa chaichi ndigwiritsa ntchito singano zapadera, zopangidwa ndi ma cholembera a syringe kuchokera kwa wopanga uyu.

Zipangizo zowonongeka ziyeneranso kutayidwa; ndikungokayikira pang'ono pakulakwitsa, jakisoni sangapange ndi cholembera ichi. Pachifukwa ichi, odwala matenda ashuga nthawi zonse ayenera kukhala ndi cholembera chowonjezerapo kuti chilowe m'malo mwake.

1. Chovala chotchinga chimachotsedwa pa chipangizocho, pambuyo pake chizindikirocho chizisungidwa ku insulin zitsimikiziridwa kuti zitsimikiziridwa kuti kukonzekera koyenera kulipo. Maonekedwe a yankho limawunikiranso, pakakhala matope, zigawo zakunja zakunja kapena kusasinthasintha kwa insulin, insulini iyenera kulowedwa ndi ina.
2. Chotchinga chitachotsedwa, singano yosalala imasungidwa mosamala ndi cholembera. Nthawi iliyonse muyenera kuyang'ana chipangacho musanapange jakisoni. Ndikofunikira kuwonetsetsa kuti cholembedwayo poyamba chinali pa 8, zomwe zikuwonetsa kuti syringe sigwiritsidwepo kale.
3. Kuti muyike mlingo womwe umafunikira, batani loyambira limatulutsidwa kwathunthu, ndipo pomwepo chosankha sangathe kuzungulira. Chovala chakunja ndi chamkati chikuyenera kuchotsedwa, chikuyenera kusungidwa mpaka njirayi itamalizidwa, kuti pambuyo pa jakisoni, chotsani singano yogwiritsidwa ntchito.
4. Cholembera cha syringe chimagwira ndi singano, pambuyo pake muyenera kupukusa zala zanu pakasungidwe ka insulini kuti mlengalenga mu thovu mutseguke kudutsa singano. Kenako, batani loyambira limakanikizidwa njira yonse. Ngati chipangizocho chili chokonzeka kugwiritsidwa ntchito, dontho laling'ono liyenera kuwonekera pamwamba pa singano. Pakapanda dontho, cholembera chimodzicho chimabwezedwanso.

Wodwala matenda ashuga amatha kusankha mtundu wake kuchokera 2 mpaka 40 mayunitsi, gawo limodzi pankhaniyi ndi magawo awiri. Ngati kuli kofunikira kuperekera kuchuluka kwa insulin, ma jakisoni awiri amapangidwa.

Pa mulingo wotsalira wa insulin, mutha kuwona kuchuluka kwa mankhwalawo omwe atsala mu chipangizocho. Piston wakuda ali pachigawo choyambirira cha mzere wachikuda, mankhwalawo ndi magawo 40, ngati piston iyikidwa kumapeto, mlingo ndi magawo makumi awiri. Wosankha mlingo watembenuzidwa mpaka cholemba cholimira chikhale mlingo womwe mukufuna.

Kuti mudzaze cholembera cha insulin, batani loyambira jakisoni limakokedwa mpaka pamapeto. Muyenera kuwonetsetsa kuti mankhwalawa amasankhidwa mu mlingo woyenera. Batani loyambira limasinthidwa kukhala kuchuluka kwamahomoni omwe atsalira mu tank.

Pogwiritsa ntchito batani loyambira, wodwala matenda ashuga amatha kudziwa kuchuluka kwa insulini. Panthawi yotsimikizira, batani limasungidwa mphamvu. Kuchuluka kwa mankhwalawa omwe atha kutumiziridwa akhoza kuweruzidwa ndi mzere womaliza wowonekera.

• Wodwalayo ayenera kuphunzira kugwiritsa ntchito zolembera za insulin pasadakhale, njira yolumikizira insulin iyenera kuphunzitsidwa ndi ogwira ntchito kuchipatala. Singano imakhala imayikidwa nthawi zonse, kenako batani loyambira limakanikizidwa mpaka pamapeto. Ngati batani lipanikizidwa njira yonse, kuwonekera kumveka kumveka.
• Batani loyambira limasungidwa kwa masekondi 10, kenako singano imatha kutulutsidwa. Njira ya jekeseni iyi imakupatsani mwayi kuti mupeze mlingo wonse wa mankhwalawo. Jakisoni utapangidwa, singano imachotsedwa mu cholembera ndikuitaya; simungathe kuyigwiritsanso ntchito. Chotetezera chimayikidwa pa cholembera.
• Cholembera chilichonse cha insulini chimatsagana ndi buku la malangizo, momwe mungadziwire momwe mungakhazikitsire cartridge, kulumikiza singano ndikupanga jakisoni. Musanayambe kuperekera insulin, katiriji ayenera kukhala osachepera maola awiri. Palibe chifukwa makatiriji opanda kanthu angagwiritsidwenso ntchito.

Ndikothekanso kusunga Lantus insulin pansi pamatenthedwe kuchokera ku 2 mpaka 8 madigiri m'malo amdima, kutali ndi dzuwa. Mankhwalawa amayenera kuperekedwa kwa ana.

Moyo wa alumali wa insulin ndi zaka zitatu, pomwe yankho lake lidzatayidwe, silingagwiritsidwe ntchito pazomwe zidakonzekera.

Mankhwala omwewo okhala ndi hypoglycemic effect akuphatikiza Levemir insulin, yomwe ili ndi ndemanga zabwino kwambiri. Mankhwala ndi oyambira sungunuka wa anthu omwe akhala akuchita insulin.

Timadzi timeneti timapangidwa kudzera mu michere ya DNA yogwiritsidwanso ntchito ngati mtundu wa Saccharomyces cerevisiae. Levemir imalowetsedwa m'thupi la odwala matenda ashuga kokha. Mlingo komanso kuchuluka kwa jakisoni ndi mankhwala kwa dokotala, potengera momwe wodwalayo alili.

Lantus amalankhula za insulin mwatsatanetsatane mu kanema munkhaniyi.

Insulin Lantus: malangizo, kuyerekezera ndi analogues, mtengo

Zokonzekera zambiri za insulin ku Russia ndizoyambira kunja. Mwa mitundu yayitali ya insulin, Lantus, yopangidwa ndi imodzi mwa mabungwe akuluakulu azachipatala Sanofi, imagwiritsidwa ntchito kwambiri.

Ngakhale kuti mankhwalawa ndi okwera mtengo kwambiri kuposa NPH-insulin, gawo lawo la msika likukulabe. Izi zikufotokozedwa ndi kutalika komanso kosalala kwa shuga. Ndizotheka kumalipira Lantus kamodzi patsiku. Mankhwala amakupatsani mwayi kuwongolera mitundu yonse ya matenda a shuga, kupewa hypoglycemia, komanso kumayambitsa zosokoneza kawirikawiri.

Insulin Lantus idayamba kugwiritsidwa ntchito mu 2000, idalembetsedwa ku Russia zaka 3 pambuyo pake. Pa nthawi yapita, mankhwalawa adatsimikizira chitetezo chake komanso kugwira ntchito kwake, adalembedwera m'ndandanda wa Vital and Essential Drug, kotero anthu odwala matenda ashuga amatha kupeza ufulu.

Chothandizira chophatikizika ndi insulin glargine. Poyerekeza ndi mahomoni amunthu, molekyu ya glargine imasinthidwa pang'ono: asidi limodzi limasinthidwa, awiri amawonjezeredwa. Pambuyo pa makonzedwe, insulin yotere imapanga mosavuta zovuta pansi pa khungu - hexamers. Njira yothetsera vutoli ili ndi pH ya acidic (pafupifupi 4), kotero kuti kuwonongeka kwa hexamers kumakhala kotsika komanso kolosera.

Kuphatikiza pa glargine, Lantus insulin imakhala ndi madzi, antiseptic zinthu m-cresol ndi zinc chloride, ndi glycerol stabilizer. Acidity yofunikira ya yankho imatheka poonjezera sodium hydroxide kapena hydrochloric acid.

Ngakhale ma molekyulu achilendo, glargine amatha kumangiriza ma cell receptor chimodzimodzi monga insulin ya anthu, chifukwa chake machitidwewo ndi ofanana kwa iwo. Lantus imakulolani kuyang'anira kagayidwe ka glucose ngati vuto la insulin yanu: imalimbikitsa minofu ndi minyewa ya adipose kuti itenge shuga, ndipo imalepheretsa kuphatikizika kwa shuga ndi chiwindi.

Popeza Lantus ndi mahomoni ogwira ntchito kwa nthawi yayitali, amadzipaka kuti apitirize kudya shuga. Monga lamulo, pankhani ya matenda a shuga a mellitus, limodzi ndi Lantus, ma insulin amafupika - Insuman ya wopanga yemweyo, ma analogues ake kapena ultrashort Novorapid ndi Humalog.

Mlingo wa insulini amawerengedwa pamaziko a kusala kudya kwa glucometer masiku angapo. Amakhulupirira kuti Lantus akupeza nyonga yayitali mkati mwa masiku atatu, kotero kusintha kwa mankhwalawa kumatheka pokhapokha nthawi iyi. Ngati glycemia yotsika tsiku lililonse ndi> 5.6, mulingo wa Lantus ukuwonjezeka ndi magawo awiri.

Mlingo umawerengeredwa moyenera ngati palibe hypoglycemia, ndi glycated hemoglobin (HG) pakatha miyezi itatu yogwiritsidwa ntchito pa kutentha kwa 30 ° C.

Pogulitsa mungapeze mitundu iwiri ya insulin Lantus. Yoyamba imapangidwa ku Germany, yodzaza ndi Russia. Kuzungulira kwachiwiri kumeneku kunachitika ku Russia pa chomera cha Sanofi mdera la Oryol. Malinga ndi odwala, kuchuluka kwa mankhwalawo ndikofanana, kusintha kuchoka pamtundu wina kupita kwina sikumabweretsa mavuto.

Insulin Lantus ndi mankhwala osokoneza bongo. Ilibe pafupifupi pachimake ndipo imagwira ntchito pafupifupi maola 24, pazenera maola 29. Kutalika, mphamvu ya kuchitapo kanthu, kufunika kwa insulini kumatengera umunthu wake ndi mtundu wa matendawa, motero, dongosolo la mankhwalawa ndi mlingo wake umasankhidwa kwa wodwala aliyense payekhapayekha.

Malangizo ogwiritsira ntchito amalimbikitsa jekeseni wa Lantus kamodzi patsiku, nthawi imodzi. Malinga ndi odwala matenda ashuga, kuwongolera kawiri kumakhala koyenera, chifukwa kumathandizira kugwiritsa ntchito mitundu yosiyanasiyana masana ndi usiku.

Kuchuluka kwa Lantus komwe kumafunikira kusintha glycemia kutengera kuchuluka kwa insulin, kutsutsana ndi insulin, kuchuluka kwa mayamwidwe am'mimba, komanso kuchuluka kwa ntchito ya odwala matenda ashuga. Mtundu wa mankhwala ponseponse mulibe. Pafupifupi, kufunika kwathunthu kwa insulin kumachokera ku 0,3 mpaka 1 unit. pa kilogalamu, gawo la Lantus pankhaniyi limakhala 30-50%.

Njira yosavuta ndiyo kuwerengera mulingo wa Lantus ndi kulemera, pogwiritsa ntchito kakhazikidwe koyamba: 0,2 x kulemera kwa kg = mlingo umodzi wa Lantus ndi jekeseni imodzi. Kuwerengera kotero zosayenera ndipo pafupifupi nthawi zonse pamafunika kusintha.

Kuwerengera kwa insulin malinga ndi glycemia imapatsa, monga lamulo, zotsatira zabwino kwambiri. Choyamba, pezani mlingo wa jakisoni wamadzulo, kuti apatsidwe insulini m'magazi usiku wonse. Kuwona kwa hypoglycemia mwa odwala ku Lantus kumakhala kotsika kuposa pa NPH-insulin. Komabe, pazifukwa zotetezeka, amafunikira kuyang'anira shuga nthawi yayitali kwambiri - m'mamawa kwambiri, kupanga kwa mahomoni-okana ndi insulin.

M'mawa, Lantus amatumizidwa kuti azikhala ndi shuga pamimba yopanda kanthu tsiku lonse. Mlingo wake sukutengera kuchuluka kwa chakudya chamagulu muzakudya. Asanadye chakudya cham'mawa, muyenera kusuta onse a Lantus ndi insulin yochepa. Kuphatikiza apo, ndizosatheka kuwonjezera kuchuluka kwa mankhwalawo ndikuyambitsa mtundu umodzi wa insulin, popeza momwe amagwirira ntchito mosiyana kwambiri. Ngati mukufunikira jakisoni wa nthawi yayitali asanagone, ndipo glucose akuchuluka, chitani jakisoni 2 nthawi imodzi: Lantus mwanjira yokhazikika komanso insulin yochepa. Mlingo wofanana wa mahomoni afupiafupi amatha kuwerengeka pogwiritsa ntchito fomula ya Forsham, yoyeneranso kutengera kuti 1 unit ya insulin idzachepetsa shuga ndi pafupifupi 2 mmol / L.

Ngati wasankha kubayitsa Lantus SoloStar molingana ndi malangizo, ndiye kuti, patsiku, ndibwino kuchita izi pafupifupi ola limodzi asanagone. Munthawi imeneyi, magawo oyamba a insulin ali ndi nthawi yolowa m'magazi. Mlingo amasankhidwa mwanjira yoti azitsimikizira glycemia wabwino usiku ndi m'mawa.

Ikaperekedwa kawiri, jakisoni woyamba amachitika mutadzuka, chachiwiri - asanagone. Ngati shuga ndiwabwinobwino usiku komanso kukwezeka pang'ono m'mawa, mutha kuyesa kusunthira chakudya chamadzulo nthawi isanakwane, pafupifupi maola 4 musanagone.

Kukula kwa matenda ashuga a mtundu 2, kuvuta kutsatira zakudya zamafuta ochepa, komanso zovuta zina zomwe zimagwiritsidwa ntchito pakugwiritsa ntchito mankhwala ochepetsa shuga zapangitsa kuti njira zatsopano zamankhwala zithandizire.

Tsopano pali malingaliro kuti ayambe kubayitsa insulin ngati glycated hemoglobin imaposa 9%. Kafukufuku wambiri awonetsa kuti kuyambiranso kwa insulin mankhwala ndikusamutsidwa mwachangu kwa regimen yolimba kumapereka zotsatira zabwino kuposa chithandizo "chakuyimitsidwa" ndi othandizira a hypoglycemic. Njira izi zitha kuchepetsa kwambiri vuto la matenda ashuga amtundu wa 2: kuchuluka kwamankhwala kumachepetsedwa ndi 40%, michereopathy ya maso ndi impso imachepetsedwa ndi 37%, chiwerengero chaimfa chimachepa ndi 21%.

Kutsimikizidwa kogwiritsa ntchito njira:

1. Pambuyo pozindikira - zakudya, masewera, Metformin.
2. Mankhwalawa akakwanira, kukonzekera kwa sulfonylurea kumawonjezeredwa.
3. Kupita patsogolo kwakukulu, kusintha kwa moyo, metformin ndi insulin yayitali.
4. Kenako insulin yochepa imawonjezeredwa ndi insulin yayitali, regimen yovuta kwambiri ya insulin mankhwala imagwiritsidwa ntchito.

Pa magawo 3 ndi 4, Lantus angagwiritsidwe ntchito bwino. Chifukwa chachitali ndi matenda a shuga a 2, jakisoni imodzi patsiku ndi yokwanira, kusapezeka kwa nsonga kumathandizira kuti insal insulin ikhale yomweyo nthawi zonse. Zinapezeka kuti atasinthira ku Lantus m'magulu ambiri a anthu odwala matenda ashuga omwe ali ndi GH> 10% pambuyo pa miyezi itatu, mulingo wake umatsika ndi 2%, patatha theka la chaka wafika pachimodzimodzi.

Ma insulin omwe amakhala nthawi yayitali amapangidwa ndi opanga awiri okha - Novo Nordisk (Levemir ndi mankhwala a Tresiba) ndi Sanofi (Lantus ndi Tujeo).

Poyerekeza mankhwala omwe amapezeka m'mleji:

1. 
   Filatova, M.V. masewera olimbitsa thupi a shuga mellitus / M.V. Filatova. - M.: AST, Sova, 2008 .-- 443 p.
2. 
   Tkachuk V. A. Kuyamba kwa maselo endocrinology: monograph. , Nyumba Yofalitsa Nyumba ya MSU - M., 2015. - 256 p.
3. 
   Matenda a Endocrine ndi mimba pamafunso ndi mayankho. Kuwongolera kwa madotolo, E-noto - M., 2015. - 272 c.

Ndiloleni ndidziwitse. Dzina langa ndi Elena. Ndakhala ndikugwira ntchito ya endocrinologist kwa zaka zoposa 10. Ndikukhulupirira kuti pakadali pano ndili katswiri pantchito yanga ndipo ndikufuna kuthandiza alendo onse omwe amapezeka pamalowo kuti athetse zovuta osati ntchito. Zinthu zonse za tsambalo amazisonkhanitsa ndikuzikonza mosamala kuti athe kufotokoza zambiri zofunikira. Musanagwiritse ntchito zomwe zikufotokozedwa pa webusaitiyi, kufunsana ndi akatswiri ndizofunikira nthawi zonse.

Buku lamalangizo

Insulin Lantus idayamba kugwiritsidwa ntchito mu 2000, idalembetsedwa ku Russia zaka 3 pambuyo pake. Pa nthawi yapita, mankhwalawa adatsimikizira chitetezo chake komanso kugwira ntchito kwake, adalembedwera m'ndandanda wa Vital and Essential Drug, kotero anthu odwala matenda ashuga amatha kupeza ufulu.

Chothandizira chophatikizika ndi insulin glargine. Poyerekeza ndi mahomoni amunthu, molekyu ya glargine imasinthidwa pang'ono: asidi limodzi limasinthidwa, awiri amawonjezeredwa. Pambuyo pa makonzedwe, insulin yotere imapanga mosavuta zovuta pansi pa khungu - hexamers. Njira yothetsera vutoli ili ndi pH ya acidic (pafupifupi 4), kotero kuti kuwonongeka kwa hexamers kumakhala kotsika komanso kolosera.

Kuphatikiza pa glargine, Lantus insulin imakhala ndi madzi, antiseptic zinthu m-cresol ndi zinc chloride, ndi glycerol stabilizer. Acidity yofunikira ya yankho imatheka poonjezera sodium hydroxide kapena hydrochloric acid.

Ngakhale ma molekyulu achilendo, glargine amatha kumangiriza ma cell receptor chimodzimodzi monga insulin ya anthu, chifukwa chake machitidwewo ndi ofanana kwa iwo. Lantus imakulolani kuyang'anira kagayidwe ka glucose ngati vuto la insulin yanu: imalimbikitsa minofu ndi minyewa ya adipose kuti itenge shuga, ndipo imalepheretsa kuphatikizika kwa shuga ndi chiwindi.

Popeza Lantus ndi mahomoni ogwira ntchito kwa nthawi yayitali, amadzipaka kuti apitirize kudya shuga. Monga lamulo, pankhani ya matenda a shuga a mellitus, limodzi ndi Lantus, ma insulin amafupika - Insuman ya wopanga yemweyo, ma analogues ake kapena ultrashort Novorapid ndi Humalog.

Mlingo wa insulini amawerengedwa pamaziko a kusala kudya kwa glucometer masiku angapo. Amakhulupirira kuti Lantus akupeza nyonga yayitali mkati mwa masiku atatu, kotero kusintha kwa mankhwalawa kumatheka pokhapokha nthawi iyi. Ngati glycemia yotsika tsiku lililonse ndi> 5.6, mulingo wa Lantus ukuwonjezeka ndi magawo awiri.

Mlingo umawerengeredwa moyenera ngati palibe hypoglycemia, ndi glycated hemoglobin (HG) pakatha miyezi itatu yogwiritsidwa ntchito pa kutentha kwa 30 ° C.

Pogulitsa mungapeze mitundu iwiri ya insulin Lantus. Yoyamba imapangidwa ku Germany, yodzaza ndi Russia. Kuzungulira kwachiwiri kumeneku kunachitika ku Russia pa chomera cha Sanofi mdera la Oryol. Malinga ndi odwala, kuchuluka kwa mankhwalawo ndikofanana, kusintha kuchoka pamtundu wina kupita kwina sikumabweretsa mavuto.

Chidziwitso chofunikira pakugwiritsa ntchito Lantus

Insulin Lantus ndi mankhwala osokoneza bongo. Ilibe pafupifupi pachimake ndipo imagwira ntchito pafupifupi maola 24, pazenera maola 29. Kutalika, mphamvu ya kuchitapo kanthu, kufunika kwa insulini kumatengera umunthu wake ndi mtundu wa matendawa, motero, dongosolo la mankhwalawa ndi mlingo wake umasankhidwa kwa wodwala aliyense payekhapayekha.

Malangizo ogwiritsira ntchito amalimbikitsa jekeseni wa Lantus kamodzi patsiku, nthawi imodzi. Malinga ndi odwala matenda ashuga, kuwongolera kawiri kumakhala koyenera, chifukwa kumathandizira kugwiritsa ntchito mitundu yosiyanasiyana masana ndi usiku.

Kuwerengera Mlingo

Kuchuluka kwa Lantus komwe kumafunikira kusintha glycemia kutengera kuchuluka kwa insulin, kutsutsana ndi insulin, kuchuluka kwa mayamwidwe am'mimba, komanso kuchuluka kwa ntchito ya odwala matenda ashuga. Mtundu wa mankhwala ponseponse mulibe. Pafupifupi, kufunika kwathunthu kwa insulin kumachokera ku 0,3 mpaka 1 unit. pa kilogalamu, gawo la Lantus pankhaniyi limakhala 30-50%.

Njira yosavuta ndiyo kuwerengera mulingo wa Lantus ndi kulemera, pogwiritsa ntchito kakhazikidwe koyamba: 0,2 x kulemera kwa kg = mlingo umodzi wa Lantus ndi jekeseni imodzi. Kuwerengera kumeneku sikolondola ndipo pafupifupi nthawi zonse pamafunika kusintha.

Kuwerengera kwa insulin malinga ndi glycemia imapatsa, monga lamulo, zotsatira zabwino kwambiri. Choyamba, pezani mlingo wa jakisoni wamadzulo, kuti apatsidwe insulini m'magazi usiku wonse. Kuwona kwa hypoglycemia mwa odwala ku Lantus kumakhala kotsika kuposa pa NPH-insulin. Komabe, pazifukwa zotetezeka, amafunikira kuyang'anira shuga nthawi yayitali kwambiri - m'mamawa kwambiri, kupanga kwa mahomoni-okana ndi insulin.

M'mawa, Lantus amatumizidwa kuti azikhala ndi shuga pamimba yopanda kanthu tsiku lonse. Mlingo wake sukutengera kuchuluka kwa chakudya chamagulu muzakudya. Asanadye chakudya cham'mawa, muyenera kusuta onse a Lantus ndi insulin yochepa. Kuphatikiza apo, ndizosatheka kuwonjezera kuchuluka kwa mankhwalawo ndikuyambitsa mtundu umodzi wa insulin, popeza momwe amagwirira ntchito mosiyana kwambiri. Ngati mukufunikira jakisoni wa nthawi yayitali asanagone, ndipo glucose akuchulukitsidwa, pangani jakisoni 2 nthawi imodzi: Lantus muyezo wamba ndi insulin yochepa. Mlingo wofanana wa mahomoni afupiafupi amatha kuwerengeka pogwiritsa ntchito fomula ya Forsham, yoyeneranso kutengera kuti 1 unit ya insulin idzachepetsa shuga ndi pafupifupi 2 mmol / L.

Nthawi yoyambira

Ngati wasankha kubayitsa Lantus SoloStar molingana ndi malangizo, ndiye kuti, patsiku, ndibwino kuchita izi pafupifupi ola limodzi asanagone. Munthawi imeneyi, magawo oyamba a insulin ali ndi nthawi yolowa m'magazi. Mlingo amasankhidwa mwanjira yoti azitsimikizira glycemia wabwino usiku ndi m'mawa.

Ikaperekedwa kawiri, jakisoni woyamba amachitika mutadzuka, chachiwiri - asanagone. Ngati shuga ndiwabwinobwino usiku komanso kukwezeka pang'ono m'mawa, mutha kuyesa kusunthira chakudya chamadzulo nthawi isanakwane, pafupifupi maola 4 musanagone.

Kuphatikiza ndi mapiritsi a hypoglycemic

Kukula kwa matenda ashuga a mtundu 2, kuvuta kutsatira zakudya zamafuta ochepa, komanso zovuta zina zomwe zimagwiritsidwa ntchito pakugwiritsa ntchito mankhwala ochepetsa shuga zapangitsa kuti njira zatsopano zamankhwala zithandizire.

Tsopano pali malingaliro kuti ayambe kubayitsa insulin ngati glycated hemoglobin imaposa 9%. Kafukufuku wambiri awonetsa kuti kuyambiranso kwa insulin mankhwala ndikusamutsidwa mwachangu kwa regimen yolimba kumapereka zotsatira zabwino kuposa chithandizo "chakuyimitsidwa" ndi othandizira a hypoglycemic. Njira izi zitha kuchepetsa kwambiri vuto la matenda ashuga amtundu wa 2: kuchuluka kwamankhwala kumachepetsedwa ndi 40%, michereopathy ya maso ndi impso imachepetsedwa ndi 37%, chiwerengero chaimfa chimachepa ndi 21%.

Kutsimikizidwa kogwiritsa ntchito njira:

1. Pambuyo pozindikira - zakudya, masewera, Metformin.
2. Mankhwalawa akakwanira, kukonzekera kwa sulfonylurea kumawonjezeredwa.
3. Kupita patsogolo kwakukulu, kusintha kwa moyo, metformin ndi insulin yayitali.
4. Kenako insulin yochepa imawonjezeredwa ndi insulin yayitali, regimen yovuta kwambiri ya insulin mankhwala imagwiritsidwa ntchito.

Pa magawo 3 ndi 4, Lantus angagwiritsidwe ntchito bwino. Chifukwa chachitali ndi matenda a shuga a 2, jakisoni imodzi patsiku ndi yokwanira, kusapezeka kwa nsonga kumathandizira kuti insal insulin ikhale yomweyo nthawi zonse. Zinapezeka kuti atasinthira ku Lantus m'magulu ambiri a anthu odwala matenda ashuga omwe ali ndi GH> 10% pambuyo pa miyezi itatu, mlingo wake umatsika ndi 2%, pambuyo miyezi isanu ndi umodzi wafika pachimodzimodzi.

Ma insulin omwe amakhala nthawi yayitali amapangidwa ndi opanga awiri okha - Novo Nordisk (Levemir ndi mankhwala a Tresiba) ndi Sanofi (Lantus ndi Tujeo).

Poyerekeza mankhwala omwe amapezeka m'mleji:

Lantus kapena Levemir - ndibwino?

Ma insulin oyenera omwe ali ndi mbiri ya zochita amatha kutchedwa Lantus ndi Levemir (zambiri za Levemir). Mukamagwiritsa ntchito ina iliyonse yaiwo, musakayikire kuti masiku ano zichitanso chimodzimodzi dzulo. Ndi mlingo woyenera wa insulin yayitali, mutha kugona mwamtendere usiku wonse osawopa hypoglycemia.

Kusiyana kwa mankhwala:

Doctor of Medical Science, Mutu wa Institute of Diabetesology - Tatyana Yakovleva

Ndakhala ndikuphunzira matenda a shuga kwa zaka zambiri. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russia Academy of Medical Science idatha kupanga mankhwala omwe amachiritsiratu matenda ashuga. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipira mtengo wa mankhwalawo. Ku Russia, odwala matenda ashuga mpaka Meyi 18 (kuphatikiza) nditha kuipeza - Kwa ma ruble 147 okha!

1. Zochita za Levemir ndizabwino. Pazithunzi, kusiyana kumeneku kumawonekera bwino, m'moyo weniweni, pafupifupi wosazindikira. Malinga ndi ndemanga, mphamvu ya ma insulini onse ndi ofanana, mukasinthana kuchokera kumodzi kupita kwina, nthawi zambiri simusintha ngakhale pang'ono.
2. Lantus amagwira ntchito nthawi yayitali kuposa Levemir. Malangizo ogwiritsira ntchito, tikulimbikitsidwa kuti tizililuma 1 nthawi, Levemir - mpaka katatu. Pochita, mankhwalawa onse amagwira bwino ntchito akaperekedwa kawiri.
3. Levemir amasankhidwa kwa odwala matenda ashuga omwe amafunikira kwambiri insulin. Ikhoza kugulidwa m'makalata ndi kumaikidwa mu cholembera ndi gawo la dosing ya mayunitsi 0,5. Lantus amagulitsidwa kokha m'mapensulo akutha mu 1 unit.
4. Levemir ili ndi pH yosatenga mbali, kotero imatha kuchepetsedwa, ndikofunikira kwa ana aang'ono komanso odwala matenda ashuga omwe amakhala ndi chidwi chachikulu ndi mahomoni. Insulin Lantus imataya zinthu zake ikaphatikizidwa.
5. Levemir poyera mawonekedwe amasungidwa nthawi 1.5 (masabata 6 motsutsana ndi 4 ku Lantus).
6. Wopanga akuti ndi mtundu wa matenda ashuga a 2, Levemir amachititsa kuti achepetse thupi. Zochita, kusiyana ndi Lantus ndikosatheka.

Pazonse, onse mankhwalawa ndi ofanana, kotero, ngati munthu ali ndi matenda ashuga, palibe chifukwa chosinthira wina popanda chifukwa chokwanira.

Lantus kapena Tujeo - kusankha?

Insulin Tujeo imapangidwa ndi kampani yomweyo monga Lantus. Kusiyana pakati pa Tujeo ndikochulukitsa-katatu kwa insulini mu njira (U300 m'malo mwa U100). Zina zonse zikufanana.

Kusiyana pakati pa Lantus ndi Tujeo:

• Tujeo amagwira ntchito mpaka maola 36, ​​kotero mbiri ya zomwe anachita ndi yosasangalatsa, ndipo chiopsezo cha nocturnal hypoglycemia ndi chochepa
• mamililita, mlingo wa Tujeo uli pafupifupi gawo limodzi mwa magawo atatu a mankhwala a Lantus insulin,
• m'magawo - Tujeo amafuna 20% ochulukirapo
• Tujeo ndi mankhwala atsopano, chifukwa chake zotsatira zake pa thupi la ana sizinafufuzidwebe. Malangizowa amaletsa kugwiritsidwa ntchito mwa anthu odwala matenda ashuga osakwana zaka 18,
• Malinga ndi ndemanga, Tujeo amakonda kukwera kwambiri ndi singano, motero nthawi yake imayenera kusinthidwa ndi nthawi yatsopano.

Kupita kuchokera ku Lantus kupita ku Tujeo ndikosavuta: timabayidwa mayunitsi ambiri ngati kale, ndipo timayang'anira glycemia kwa masiku atatu. Mokulira, mankhwalawa amayenera kusinthidwa pang'ono.

Lantus kapena Tresiba - ndibwino?

Tresiba ndi yekhayo amene amavomerezedwa ndi gulu latsopano la insulin yayitali. Imagwira mpaka maola 42. Pakadali pano, zatsimikiziridwa kuti ndi matenda amtundu wa 2, chithandizo cha TGX chimachepetsa GH ndi 0,5%, hypoglycemia ndi 20%, shuga amatsika ndi 30% yochepa usiku.

Ndi matenda a shuga 1 amtundu, zotsatira zake sizolimbikitsa: GH imatsika ndi 0,2%, hypoglycemia usiku imachepa ndi 15%, koma masana, shuga imagwera nthawi zambiri ndi 10%. Popeza mtengo wa Treshiba ndiwokwera kwambiri, mpaka pano akhoza kungolimbikitsidwa odwala matenda ashuga omwe ali ndi matenda amtundu wa 2 komanso chizolowezi cha hypoglycemia. Ngati shuga ikhoza kulipiridwira ndi Lantus insulin, kusintha sizimveka.

Ndemanga za Lantus

Lantus ndiye insulin wokondedwa kwambiri ku Russia. Oposa 90% a odwala matenda ashuga amasangalala nazo ndipo amatha kuwalimbikitsa ena. Odwala amati zabwino zake zopanda kukayikira chifukwa chokhala ndi nthawi yayitali, yosalala, kukhazikika komanso kuwonekeratu, kugwiritsa ntchito njira yosavuta kwa mankhwalawa, kugwiritsa ntchito mosavuta, komanso jakisoni wopanda vuto.

Kuyankha bwino kumayenera kuyenera kwa Lantus kuchotsa kutuluka kwa shuga m'mawa, kuchepa kwa mphamvu. Mlingo wake nthawi zambiri umakhala wochepera kuposa NPH-insulin.

Mwa zoperewera, odwala omwe ali ndi matenda a shuga amazindikira kusakhalapo kwama cartridge opanda syringe peni ogulitsa, gawo lalikulu kwambiri, komanso fungo losasangalatsa la insulin.

Onetsetsani kuti mwaphunzira! Kodi mukuganiza kuti kuyamwa kwa mapiritsi ndi insulini kwa nthawi yonse yokhayo ndi njira yokhayo yosungira shuga m'manja? Sichowona! Mutha kutsimikizira izi nokha ndikuyamba kuzigwiritsa ntchito. werengani zambiri >>