Apidra SoloStar

Insulin glulisin, chomwe ndi chophatikizika ku Apidra, ndichotsimikizika chogwirizana insulin yamunthu, mwa mphamvu ya ntchito yake yofanana ndi anthu obadwa nawo insulin. Poyerekeza sungunuka wa munthu insulin machitidwe a analogue amakula mwachangu, ndipo nthawi yokhala ndi mphamvu ndiyofupikitsa.

Zoyambira insulin, komanso ma analogues ake, kuphatikizapo insulin glulisinmalamulo shuga kagayidwe. Zotsatira za gululi la mankhwalawa ndizolinga zochepetsera ndende glucose wa plasmakutsegula kwa mayamwidwe ndi zotumphukira zimakhala (makamaka adipose minofu ndi mafupa minofu), komanso kukaniza mapangidwe shugam'matumbo a chiwindi. Mu adipocytesmankhwalawa amachepetsa lipolysisImachepetsa njirayi mapulotenindi kuwuka mapuloteni kaphatikizidwe. Kafukufuku wokhudza odwala matenda ashuga ndipo odzipereka ogwira ntchito zathanzi adatsimikizira kusintha kwapadera kwa Apidra ndi kayendetsedwe ka sc, komanso nthawi yayifupi, poyerekeza ndi yayifupi sungunuka wa munthu insulin. Ndi s / c njira yoyendetsera hypoglycemic Mphamvu ya mankhwalawa imawonedwa pakatha mphindi 10 mpaka 20. Poyerekeza jekeseni wa iv sungunuka wa munthu insulin ndi insulin glulisin Zotsatira zake za mankhwalawa zimakhalabe chimodzimodzi. Kuchepetsa shuga kwa gawo limodzi la mankhwala onsewa kumagwirizana.

Mu gawo loyamba la maphunziro omwe akupitiliza okhudza odwala omwe ali nawo insulin wodalira matenda a shuga glucose-kuchepetsa mphamvu kuwunika sungunuka wa munthu insulin ndi insulin glulisin ndi jakisoni wa s / c pa mlingo wa 0,15 U / kg, kutumikiridwa nthawi zosiyanasiyana poyerekeza ndi mphindi 15 ya chakudya. Malinga ndi zotsatira za kafukufuku, zidapezeka kuti kuyambitsa kwa Epidra mphindi ziwiri asanadye chakudya kumakhala ndi zomwezi glycemic kwenikwenimonga mawu oyamba insulin yamunthu theka la ola musanadye. Pankhani ya kukhazikitsidwa kwa onse a mankhwalawa 2 mphindi musanadye, zizindikiro zabwino kwambiri glycemic control zikuwonetsedwa insulin glulisin. Jakisoni wa apidra wopatsidwa mphindi 15 chakudya chidayambika zotsatira zamatendakuti kuyambitsa kwa mnzake 2 Mphindi asanadye.

Gawo loyamba la kafukufuku wopitiliza pakati lyspro insulin, insulin glulisin ndi sungunuka wa munthu insulin kuphatikizapo odwala onenepa Zawonetsedwa kuti kugwira ntchito mwachangu kwa Apidra kwasungidwa. Pakati pa kafukufukuyu, nthawi yofikira 20% ya AUC yathunthu, ya insulin glulisin/insulin lispro/insulin yamunthu inali 114/121/150 mphindi, AUC (maola 0-2), ndikuwonetsanso koyambirira shuga kutsika mchitidwewo anali 427 mg / kg / 354 mg / kg / 197mg / kg motsatana.

Gawo lachitatu la mayesero azachipatala a masabata 26 pakati insulin glulisin ndi lyspro insulinomwe amaperekedwa s / c posachedwa (mphindi 0-15) musanadye chakudya kwa odwala shuga achinyamatakugwiritsa ntchito ngati mankhwala osokoneza bongo - insulin glargine, zidapezeka kuti zotsatira za mankhwalawa onse anali ofanana poyerekeza glycemic controlyolumikizidwa ndi kusintha kwamitundu Hba1c(glycosylated hemoglobin) mgawo lomaliza la kafukufukuyu, poyerekeza ndi gawo loyamba. Magawo oyeserera adadziwika glucose wa plasmaokhazikika ndi kudziletsa. Pankhani ya jakisoni insulin glulisinpoyerekeza ndi mawu oyamba insulin lispro, kuchuluka kwamankhwala osokoneza bongo sikunafunikire.

Gawo lachitatu la mayesero azachipatala a milungu 12 odwala insulin wodalira matenda a shugaakulandira chithandizo cham'mbuyo insulin glarginekutsimikizika kogwira ntchito insulin glulisin, kutumikiridwa mukangomaliza kudya, osati chotsika ndi chomwe chinaperekedwa chisanachitike (mphindi 0 mpaka 15) chakudya kapena jakisoni sungunuka wa munthu insulinanali 30-305 mphindi asanadye.

Mu gulu la odwala omwe adalandira insulin glulisin pamaso chakudya, kuchepa kwakukulu kunadziwika Hba1cpoyerekeza ndi odwala omwe ali mgulu la ogwiritsa ntchito analogue aumunthu.

Gawo lachitatu la mayesero azachipatala a sabata la 26 omwe amatsatiridwa ndi mayeso a chitetezo cha masabata 26, poyerekeza insulin glulisinkutumikiridwa s / 0 0-15 mphindi asanadye ndi sungunuka wa munthu insulinkutumikiridwa / mphindi 30-55 asanadye, kuphatikizapo odwala shuga wosadalira insulinkulandira monga mankhwala akumbuyo - insulin isophane. Mloza wodwala wamba anali 34,55 kg / m2. Kuchepetsa kwakukulu Hba1c(-0.46%) adawonedwa mwa odwala ochokera pagululi glulisin insulinpoyerekeza gulu insulin yamunthu (-0.30%). Phunziroli, odwala ambiri (79%) nthawi yomweyo asadakhazikitsidwe amaphatikiza mankhwalawa isophane insulin. Anthu 58 omwe adaphunzira nthawi ya chisankho adatenga m`kamwa hypoglycemic wothandizira ndipo adapitiliza kumwa nawo mosasintha.

Pankhani ya kulowetsedwa kosatha sc insulinndikugwiritsa ntchito chipangizo cha pampu (chofanana ndi matenda a shuga ana) mwa odwala 59 omwe amagwiritsa ntchito mankhwala a Apidra kapena Aspart, pafupipafupi adadziwika chathet, kwa mankhwala Apidra - 0,08 kupendapa masiku 30, mankhwala Aspart - 0,15 kupendaNthawi imodzimodzi, komanso pafupipafupi zomwe zimachitika pakubaya jakisoni, 10,3% ndi 13.3%.

M'magulu azaka za ana ndi matenda a shuga a insulin, poyerekeza chitetezo ndi chidziwitso cha mawu oyamba ngati mankhwala akumbuyo - insulin glargine(kamodzi pa ma 24 maawa) kapena isulin insulin (kawiri pa tsiku, m'mawa ndi madzulo) ndi sc management insulin lispro ndi insulin glulisin (Mphindi 15 asanadye), m'magulu onse awiri zowunikira zikuwululidwa glycemic controlmayendedwe akulu magawo a hypoglycemic ndi mapangidwe pafupipafupi hypoglycemiaKufuna kulowererapo kwakunja. Komanso, nditatha kupanga chithandizo kwa milungu 26, mu gulu la Apidra, kuti muthe glycemic control kuchuluka kochepa kwambiri kwa tsiku ndi tsiku kunafunikira kudya insulinmankhwala osokoneza bongo ndi okwana mlingo wa insulin, poyerekeza ndi gulu lomwe likugwiritsa ntchito insulin lispro.

Panthawi ya mayesero azachipatala odwala akulu, palibe kusiyana kulikonse pakugwiritsa ntchito Apidra kwa odwala azikhalidwe zosiyanasiyana komanso mitundu yosiyanasiyana.

Mukamagwiritsa ntchito Apidra, m'malo mwake amino acid katsitsumzukwainsulin yamunthu pa lysinepa udindo wa OT, komanso lysinepa glutamic acid pa udindo B29, amathandizira kuti azamwa mwachangu mankhwala.

AUC ya mankhwalawa m'magulu onse odwala (odzipereka athanzi labwino komanso odwala omwe ali ndi vuto la 1 ndi 2) matenda ashuga) adawonetsa kuyamwa kwapamwamba kawiri konse komanso Cmax Apidra poyerekeza ndisungunuka wa munthu insulin.

Mukamachititsa maphunziro okhudza odwala omwe ali ndi shuga achinyamata, pambuyo pa jakisoni wa s / c wa 0.15 U / kg Apidra, Cmax yake idafikiridwa kwa mphindi 55 ndipo inali 82 ± 1.3 μED / ml, pomwe magawo awa a analogi yaumunthu anali 46 ± 1.3 μED / ml ndi mphindi 82. Kutalika Kwambiri insulin glulisin mu kayendedwe kazachilengedwe kunali kocheperako (98 min) kuposa insulin yamunthu(161 min).

Mukamachititsa maphunziro okhudza odwala omwe ali ndi shuga wosadalira insulin, pambuyo pa jekeseni wa scid wa 02 U / kg Apidra, Cmax yapakati pazomwe amagwiritsa ntchito anali 91 mcU / ml (m'gulu la 78-104 mcd / ml).

Kuthira kwa mankhwalawa, pankhani ya jakisoni wa scid wa Apidra, wochitika m'chigawo cha ntchafu anali wotsika kwambiri ndikuwonjezereka ndikuyambitsa kwa mankhwalawa m'dera la phewa. Chotupa chachikulu kwambiri chidawonedwa ndikulowetsedwa m'boma lakhomopo lamkati. Ndi subcutaneous makonzedwe, a bioavailability mtheradi wa Apidra anali pafupifupi 70% (m'chiuno - 68%, phewa - 71%, khoma lam'mimba - 73%) ndipo amadziwika ndi kusinthasintha kochepa kwa odwala osiyanasiyana.

Ndi on / pogawa insulin glulisin ndi kutulutsa kwake kotsatira kuli chimodzimodzi ndi kwa sungunuka wa munthu insulin ndipo motero: Vd - 13 malita ndi malita 22, T1 / 2 - 13 maminiti ndi mphindi 18. Ndi jakisoni wa s / c insulin glulisin zimachitika mwachangu (ndi T1 / 2 - 42 mphindi) poyerekeza ndi mnzake (ndi T1 / 2 - mphindi 86). Mukamachita kafukufuku wosanthula ndi kuyesa insulin glulisinkuphatikiza odzipereka athanzi komanso odwala omwe ali ndi mtundu 1 ndi 2 matenda ashuga, T1 / 2 ya mankhwalawa yomwe idapezeka inali yofanana ndi mphindi 37-75.

Phunziro lomwe limakhudza anthu opanda matenda ashugakoma kukhala matenda a impso madigiri osiyanasiyana azovuta (omwe ali ndi CC yoposa 80 ml / mphindi, 30-50 ml / mphindi ndi ochepera 30 ml / min) adawonetsa kusungidwa kwa gawo lalikulu la kuthamanga kwa ntchito ya Apidra. Komabe, liti matenda a impso lolani kuchepetsedwa kufunika kwa ntchito insulin.

At matenda a chiwindi Kafukufuku wa Apidra sanachitike.

Zotsatira za wodwala wokalamba pazamankhwala a Apidra sizimamveka bwino.

Ma pharmacodynamics ndi pharmacokinetics a Apidra amaphunziridwa m'magulu azaka za odwala omwe ali nawo matenda a shuga a insulin Wazaka 7-11 ndi zaka 12-16. Kutupa, Tmax ndi Cmax zamankhwala zomwe zili m'magulu onsewa zinali zofanana ndi zomwe zimachitika kwa anthu akuluakulu. Mukamaba jakisoni wa Apidra musanayesedwe ndi chakudya, zabwino koposaplasma glucose control mutatha kudya motsutsana insulin yamunthu. Kuchuluka kwa zinthu glucose wa plasma pambuyo chakudya (AUC0-6 maola) anali ofanana Apidra - 641 mg / h × dl, chifukwa sungunuka wa munthu insulin - 801 mg / h × dl.

Zotsatira zoyipa

Kuwonetsera koyipa komwe kumadziwika pogwiritsa ntchito mankhwalawa Apidra kunali machitidwe a gulu lamankhwala awa, chifukwa chake onse omwe analipo insulin.

Mawonekedwe oyipa kwambiri mankhwala a insulinzimawonedwa ndi kagayidwe kachakudya dongosolo hypoglycemia, zomwe nthawi zambiri zimachitika ndi kugwiritsidwa ntchito mosaganizira kwa mankhwala ochuluka insulin.

Zizindikiro hypoglycemianthawi zambiri zimawoneka mwadzidzidzi. Komabe, kuphwanya neuropsychiatricmachitidwe omwe amapangidwa kumbuyo neuroglycopenia(zachilendo kufookakapena kutopa, mutukumverera kutopakuchepa ndende zosokoneza zowoneka, kugona, wodwala matenda opatsirananseru chisokonezo/kulephera kudziwa) bwerani chiwonetserocho adrenergic kutsutsana (kusakhazikikanjala chisangalalo chamanjenjekukopa kwa pakhungu kunjenjemera,thukuta lozizirankhawa tachycardiawamphamvu kugunda kwa mtima) Kukula kwa chizindikiro ichi kumatengera kuthamanga komanso kutha kwa kukula hypoglycemia.

Kubwereza ndima zoopsa hypoglycemiazingayambitse kuwonongeka kapena kusokonezeka dongosolo lamanjenje. Kulengezedwa ndi kupitilira hypoglycemiaikhoza kukhala yowopsa kwa odwala, chifukwa kuwonjezeka kwa zizindikiro zake kungayambitse zakupha.

Zochita chitetezo cha mthupi zitha kuwonetsera zochitika zakumaloko Hypersensitivityto Apidra (kuphatikiza kugulukakumverera kuyabwa ndi kutupa pamalo opangira jekeseni). Izi, monga lamulo, zikudziwonekera pakapita masiku angapo jekeseni. Nthawi zina, izi sizimawoneka kuti zimayambitsa chidwi insulin, komanso chifukwa chokhumudwitsa khungu, chifukwa cha kubayidwa kale antiseptickukonza, komanso chifukwa cha jakisoni wosayenera wa SC.

Mawonekedwe amachitidwe ake HypersensitivityApidra akhoza kutsagana ndi zotupa (mwina ndi kuyaka) mthupi lonse chifuwa cholimba, kutsitsa magazi, zidzakwanirakugunda kwa mtima kapena hyperhidrosis. Zolemba zolemetsa chifuwa chachikulukuphatikiza zochitika za anaphylacticzitha kukhala zowopsa m'moyo.

Zotsatira zoyipa kuchokera pakhungu nthawi zambiri zimakhala zochepa. lipodystrophyKutha, komabe, kuchepetsa mayamwidwe insulin glulisin. Kupanga lipodystrophyimatha kubweretsa jakisoni pafupipafupi kumalo omwewo, popanda kusintha magawo a mankhwalawa. lipodystrophy.

Apidra, malangizo ogwiritsira ntchito

Insulin Apidra SoloStar idapangidwa kuti iyang'anire sc, yomwe inachitika pasanadutse (0-15 mphindi) kapena itangotha ​​chakudya.

Mankhwala ayenera kugwiritsidwa ntchito mu regimens achire, kuphatikizapo kugawana insulin yayitali (mwina analog) kapena lalitali magwiridwe antchito, komanso ofanana ndi m`kamwa hypoglycemic mankhwala machitidwe.

Malangizo a Apidra mlingo amatsimikiziridwa payekhapayekha.

Kukhazikitsidwa kwa Apidra SoloStar kumachitika pogwiritsa ntchito jakisoni wa sc, kapenakulowetsedwa kosalekezaanachita subcutaneous mafuta ntchito dongosolo la pampu.

Kuwongolera sc kumachitika paphewa, khoma lam'mimba (kutsogolo) kapena ntchafu. Kulowetsedwa amachitika mu subcutaneous mafuta m'dera khoma lamimba (kutsogolo). Malo a subcutaneous makina (ntchafu, khoma lam'mimba, phewa) ayenera kusinthidwa ndi jekeseni lililonse lotsatira. Pothamanga mayamwidwe Kutalika kwa mankhwalawa kungapangitse zinthu zomwe zimachitika zolimbitsa thupi, kusintha kwina, komanso malo oyang'anira. Kulowetsa khoma la m'mimba kumathamanga mayamwidwepoyerekeza ndi kuyambitsa ndi ntchafu kapena phewa.

Popanga jakisoni, njira zonse zofunika kuzisamala ziyenera kuonedwa kuti musatenge mankhwala oyambitsidwa mwachindunji mitsempha yamagazi. Pambuyo jekeseni oletsedwa kutikita minofum'malo oyambitsa. Odwala onse omwe akugwiritsa ntchito Apidra SoloStar amayenera kufunsidwa njira yoyenera yoyendetsera. insulin.

Kuphatikiza Apidra SoloStar kumaloledwa kokha ndi isophane insulin. Mukasakaniza mankhwalawa, Apidra iyenera kuyimiriridwa kaye syringe. Kuwongolera kwa SC kuyenera kuchitika pokhapokha atasakanikirana. Mu / jakisoni wa mankhwala osakanikirana sangathe kuchitika.

Ngati ndi kotheka, yankho la mankhwalawa limatha kuchotsedwa mu cartridge yomwe ikuphatikizidwa ndi cholembera ndikugwiritsidwa ntchito chipangizo pampulakonzedwa kuti lipitirire kulowetsedwa. Pankhani yakukhazikitsa kwa Apidra SoloStar ndi dongosolo kulowetsedwa, kusakaniza kwake ndi mankhwala ena onse saloledwa.

Mukamagwiritsa ntchito kulowetsedwa ndi thanki yomwe imagwiritsidwa ntchito ndi Apidra, iyenera kusinthidwa pambuyo osachepera maola 48 kutsatira malamulo onse mapa. Malangizowo atha kukhala osiyana ndi omwe adafotokozedwera zida zapampukomabe, kuphedwa kwawo ndikofunikira kwambiri kuti achite zinthu moyenera kulowetsedwandi kupewa mapangidwe oyipa.

Odwala omwe akupitilira kulowetsedwa kwa apidra s / d ayenera kukhala ndi njira zina zopangira jakisoni, komanso kuphunzitsidwa njira zoyenera zogwiritsira ntchito (kuwonongekachipangizo pampu).

Nthawi kulowetsedwa kosalekeza Apidra, kulakwitsa kwa kulowetsedwa pampu idayamba, kuphwanya ntchito yake, komanso zolakwitsa pamankhwala nawo, zimatha kukhala chifukwa cha hyperglycemia, matenda ashuga ketoacidosis ndi ketosis. Pothana ndi mawonekedwe awa, ndikofunikira kukhazikitsa chifukwa cha chitukuko ndikuchithetsa.

Kugwiritsa ntchito cholembera cha SoloStar Syringe ndi Apidra

Musanagwiritse ntchito koyamba, cholembera cha SoloStar chimayenera kuchitidwa kwa maola awiri firiji.

Musanagwiritse ntchito cholembera, muyenera kuwunika mosamala cartridge yomwe ili mmenemo, zomwe ziyenera kukhala wopanda utoto, chowonekeraosaphatikizira zowoneka nkhani yakunja yakunja (akumbutse kusasinthika kwamadzi).

Ntchito Zogwiritsa ntchito SoloStar Syringe sizingagwiritsenso ntchito ndipo ziyenera kutayidwa.

Pofuna kupewa matendaMunthu m'modzi yekha ndi yemwe angagwiritse ntchito cholembera chimodzi popanda kuchisintha kwa munthu wina.

Pogwiritsa ntchito cholembera chatsopano chilichonse, sinthanitsani mosamala ndi singano yatsopano (yogwirizana ndi SoloStar) ndikugwirira kuyesa chitetezo.

Pochita ndi singano, chisamaliro chachikulu chiyenera kuthandizidwa kupewa kuvulalandi mwayi zopatsirana kusamutsa.

Kugwiritsira ntchito zolembera za syringe kuyenera kupewedwa ngati kuwonongeka, komanso ngati osatsimikizika pantchito yawo moyenera.

Ndikofunikira nthawi zonse kukhala ndi cholembera chopanda chilichonse mu katundu, ngati chitha kapena kuwonongeka koyambirira.

Cholembera cha syringe chimayenera kutetezedwa ku dothi ndi fumbi, ndizovomerezeka kupukusa kunja kwake nsalu yonyowa. Sitikulimbikitsidwa kumiza cholembera madzimadzi, kuchapakapena mafutapopeza izi zitha kuyipitsa.

Syringe cholembera SoloStar yotetezeka imagwira ntchito, mosiyana dosing yeniyeni yankho ndipo imafunikira kuisamalira mosamala. Mukamachita manambala onse ndi cholembera, ndikofunikira kupewa chilichonse chomwe chitha kuwononga. Ngati mukukayikira kuti ikhoza kugwira ntchito, gwiritsani ntchito cholembera china.

Nthawi yomweyo jekeseni isanachitike, onetsetsani kuti analimbikitsa insulinpoyang'ana cholembera pa cholembera cholembera. Mukachotsa chipewa mu syringe cholembera, muyenera kutero kuyang'ana kowoneka Zomwe zili mkati mwake, ndikukhazikitsa singano. Chololedwa kokha wopanda utoto, chowonekerachofanana ndi madzi mokhazikika komanso kuphatikiza ina zolowa zakunja yankho insulin. Pakhungu lililonse lomwe latuluka, ayenera kugwiritsa ntchito singano yatsopano, yomwe imayenera kukhala yosabala komanso yoyenera cholembera.

Pamaso jakisoni, onetsetsani kuyesa chitetezo, yang'anani ntchito yoyenera ya cholembera ndi singano yomwe idayikidwapo, ndikuchotsanso yankho thovu (ngati alipo).

Pachifukwa ichi, pomwe zingwe zamkati ndi zamkati za singano zimachotsedwa, muyeso wa yankho lofanana ndi 2 PIECES umayesedwa. Kuloza singano ya cholembera kuti isungunuke molunjika, ikani pang'ono pakatoni ndi chala chanu, kuyesera kuti musunthe chilichonse thovu ku singano yoikika. Kanikizani batani lomwe limakonzekera makonzedwe a mankhwala. Ngati iwoneka kumapeto kwa singano, titha kuganiza kuti cholembera chimagwira monga momwe timayembekezera.Ngati izi sizingachitike, bwerezani zomwe zidatchulidwa pamwambapa mpaka zotsatira zomwe mukufuna zitheke.

Pambuyo kuyesapachitetezo, zenera la dengalo liyenera kuwonetsa mtengo "0", kenako mlingo womwe ungafunike ukhoza kukhazikitsidwa. Mlingo wothandizidwa ndi mankhwalawa uyenera kuyesedwa ndi kulondola kwa 1 UNIT, pamlingo kuchokera 1 UNIT (osachepera) mpaka 80 UNITS (pazambiri). Ngati ndi kotheka, mlingo wopitilira 80 amayiti umachitika jekeseni awiri kapena kuposa.

Mukabayidwa, singano yomwe imayikidwapo cholembera iyenera kuyikiridwa mosamalapansi pa khungu. Chingwe cha cholembera chomwe chimayikidwa pakukhazikitsa njira yothetsera vutoli chiyenera kukanikizidwa kwathunthu ndikukhala m'malo ano kwa masekondi 10 mpaka singano itachotsedwa, zomwe zimatsimikizira kukonzekera kwathunthu kwa mankhwala.

Pambuyo pa jekeseni, singano imayenera kuchotsedwa ndikuchotsedwa. Mwanjira imeneyi, chenjezo la kuperekedwa limaperekedwa. matendandi / kapena kuipitsama cholembera a syringe, komanso mankhwala opatsirana ndi mpweya ndikulowa mu cartridge. Mukachotsa singano yomwe imagwiritsidwa ntchito, cholembera cha SoloStar chizikhala chotseka ndi chipewa.

Pochotsa ndi kutaya singano, ndikofunikira kutsogoleredwa ndi malamulo ndi njira zapadera (mwachitsanzo, njira yokhazikitsa chipewa cha singano ndi dzanja limodzi), kuti muchepetse chiopsezo cha ngozikomanso kupewa matenda.

Bongo

Pankhani yamaulamuliro ochuluka insulinzitha kuchitika hypoglycemia.

Ndi kuwala hypoglycemia, mawonekedwe ake oyipa amatha kuyimitsidwa ndi chakudya shuga wokhalaZogulitsakapena shuga. Odwala ndi matenda ashuganthawi zonse amalimbikitsa kunyamula makeke, maswitizidutswa shugakapena msuzi wokoma.

Zizindikiro zazikulu hypoglycemia(kuphatikizazovuta zamitsempha, kukokana, kulephera kudziwa, kwa ndani) iyenera kuyimitsidwa ndi anthu achiwiri (ophunzitsidwa mwapadera) pochita jakisoni wa v / m kapena s / c glucagon kapena jakisoni Dextrose. Ngati ntchito glucagonsanapereke chifukwa kwa mphindi 10-15, sinthani ku iv dextrose.

Wodwala yemwe adabwera kuzindikiraamalimbikitsa kudya kwambiri chakudyaimani pamapeto kuti mubwereze hypoglycemia.

Kuti mudziwe zomwe zimayambitsa kwambiri hypoglycemiandi kupewa kukula kwake mtsogolo, ndikofunikira kuyang'ana wodwalayo mkati chipatala.

Kuchita

Kafukufuku wotsogola wogwirizana insulin glulisin osati kuchitidwa. Popeza kuchuluka kwachidziwitso komwe kumapangidwira pakagwiritsidwe ntchito ka mankhwala ena ofananawa, kupangika kwina kulikonse kwakukhudzana ndi mankhwala ndikosatheka. Pali zinthu zomwe zingakhudze shuga kagayidwe ndipo amafunika kusintha kwamankhwala insulin glulisin, komanso kuyang'ananso kwakanthawi kwamankhwala.

Kwa zinthu zomwe zimachuluka hypoglycemickulondola insulinndi kukulira chiwopsezo cha hypoglycemiaphatikizani: mafupaACE zoletsa m`kamwa hypoglycemic mankhwalasalicylates Ma discopyramid, Fluoxetine, Pentoxifyllinemonoamine oxidase zoletsa Propoxyphene, sulfonamides.

Zinthu zomwe zimachepetsa hypoglycemiczotulukapo insulinphatikizani: glucocorticoids, Diazoxide, Danazol, okodzetsa, otumphukira Phenothiazine, Isoniazid, Somatropin, mahomoni chithokomiro EnglandSalbutamol, Epinephrine, Terbutaline,, progestins (kulera kwamlomo), mankhwala a antipsychotic (Clozapine, Olanzapine), estrogensproteinase zoletsa.

Mchere wa Lithium, oletsa beta, Mowa, Clonidine zingasinthe hypoglycemiczochita za Apidra mbali iliyonse. Kugwiritsa ntchito panthawi imodzi Pentamidinezingayambitse hypoglycemia, komanso kupitiliza ku hyperglycemia.

Mothandizidwa ndi mankhwala ndi chisoni ntchito (Clonidine, Reserpinebeta blockers, Guanethidine), mawonetseredwe adrenergickutsegulira (Reflex) kumatha kuwonetsedwa pang'ono kapena kusakhalapo kwathunthu.

Chifukwa chakuchepa kwa maphunziro, Apidra sayenera kusakanikirana ndi mankhwala ena onse kupatula isulin insulin (munthu).

Mukamagwiritsa ntchito kulowetsedwa pampu kusakaniza Apidra ndi mankhwala ena saloledwa.

Malangizo apadera

Wodwala insulinchomera china chopangira kapena njira ina insulin ziyenera kuchitika moyang'aniridwa ndi ogwira ntchito zachipatala, pokhudzana ndi kufunika kosintha mtengo, chifukwa cha kupatuka insulin ndendemtundu wake (insulin isophane, sungunukaetc.), mawonekedwe (munthu, chinyama) ndi / kapena njira yopangira. Kusintha kungakhale kofunikira limodzi hypoglycemicChithandizo cha pakamwa. Kusiya mankhwala kapena mlingo wokwanira insulinmakamaka odwala shuga achinyamatazingayambitse matenda ashuga ketoacidosisndi hyperglycemiakuyimira chiopsezo ku moyo wa wodwalayo.

Nthawi yatha hypoglycemiachifukwa cha kuchuluka kwa mapangidwe insulin kwenikweni ogwiritsa ntchito mankhwala, ndipo chifukwa cha izi, amatha kusintha posintha njira zochizira. Kusintha kwazomwe zimapangidwa hypoglycemiakapena kuwapangitsa kuti asatchulidwe, kuphatikiza: kulimbitsa insulin mankhwalakupezeka kwa nthawi yayitali matenda ashugakukhalapo matenda ashuga a m'mimbazisinthe insulinkumwa mankhwala ena (i.e.opanga beta).

Kusintha insulinMlingo ungakhale wofunikira mukachulukitsa wodwala zolimbitsa thupi kapena kusintha zakudya zanu zatsiku ndi tsiku. Kuchita masewera olimbitsa thupi mukangodya kumene kumakulitsa vuto lanu hypoglycemia. Mukamagwiritsa ntchito kuthamanga insulin chitukuko hypoglycemiazikuyenda mwachangu.

Zosalipidwa Hyper- kapena hypoglycemicmawonetsedwe angayambitse chitukuko chikomokerekulephera kuzindikira kapena ngakhale kufa.

Kufunika kofunsira insulinzitha kusintha pa kutengeka mtima kapena matenda.

Wodwala akamagwira ntchito zolondola, zowopsa, komanso magalimoto oyendetsa, mwayi woti apange Hyper- kapena hypoglycemiandipo khalani osamala.

• Khalid (NM, MS),
• Vozulim R,
• Biosulin P,
• Gensulin r,
• Insulin MK,
• Gansulin r,
• Insulin-Ferein CR,
• Monosuinsulin(MK, MP),
• Insuman Rapid GT,
• NovoRapid(Penfill, FlexPen),
• Insuran P,
• Pensulin(SR, Czech Republic),
• Chichewa,
• Rinsulin P,
• Humodar R,
• Rosinsulin P,
• Humulin Wokhazikika,
• Monoinsulin CR.

Apidra imatha kutumizidwa kwa ana pokhapokha zaka 6.

Mimba (ndi mkaka wa m'mawere)

Maphunziro azachipatala a ntchito a Apidra ndi mimba palibe Zambiri zochepa za izi insulin pakati azimayi samawonetsera zoyipa zake mapangidwe intrauterine wa mwana wosabadwayo, kuthama mimbakapena mwana wakhanda.

Kuyesa kobereka nyama komwe kunachitidwa sikunawonetse kusiyana kulikonse insulin yamunthu ndi insulin glulisin mogwirizana fetal/fetalchitukuko, kumene mimba, ntchito yoyang'anira ndi pambuyochitukuko.

Gawirani Apidra woyembekezeraAzimayi ayenera kusamala ndikuwonetsetsa kuti plasma ikuwayang'anira kuchuluka kwa shuga ndi kuwongolera glycemia.

Amimbaazimayi okhala ndi matenda ashuga ayenera kudziwa kuchepetsedwa kwa kufunika kwa insulinkupyola Ine trimester wa mimbaonjezerani II ndi III trimesterkomanso kuchepa msanga pambuyo kubala mwana.

Kusankha insulin glulisin mkaka wa mayi woyamwitsa suukhazikika. Mukamagwiritsa ntchito yoyamwitsapangafunike kusintha njira.

Ndemanga za Apidra ya mankhwala, komanso za ena onse insulin, bwerani ndi chinthu chimodzi, kaya mankhwalawa abwera kwa munthu wina kapena wina. Panthawi yomwe mankhwala a Apidra ali oyenera kwa wodwalayo, palibe zodandaula zilizonse pakuyenda kwake komanso chitetezo. Kusavuta kugwiritsa ntchito zolembera za SoloStar ndi kulondola kwa dosing mwa izo zimawonekeranso. insulin.

Kutulutsa mawonekedwe ndi kapangidwe kake

Fomu ya Mlingo - njira yothetsera makina a subcutaneous (subcutaneous): yowoneka bwino, yopanda utoto kapena yopaka utoto (mukatoni mwa makatoni 5 a galasi 3 osawoneka bwino a 3 ml, atayikidwa mu zolembera zotayika, ndi malangizo ogwiritsira ntchito Apidra SoloStar).

Muli 1 ml ya yankho:

• yogwira mankhwala: insulin glulisin - 100 IU (mayunitsi) (3.49 mg),
• othandizira: hydrochloric acid, m-cresol (metacresol), sodium hydroxide, polysorbate 20, tromethamine (trometamol), sodium chloride, madzi a jekeseni.

Pharmacokinetics

Kuyamwa mwachangu kumathandizidwa ndi kulowetsedwa kwa insulin glulisin ya amino acid asparagine ya insulin yaumunthu pamalo B3 yokhala ndi lysine ndi lysine pamalo a B29 ndi glutamic acid.

Pharmacokinetic AUC yoletsa odwala omwe ali ndi mtundu woyamba wa 2 ndi mtundu wa 2 wodwala komanso odzipereka athanzi adawonetsa kuti mayamwidwe a insulini ngati glulisin poyerekeza ndi insulle ya insulin yamunthu anali pafupifupi nthawi ziwiri, mpaka kufika kawiri kuposa C_max (pazambiri pazinthu).

Malinga ndi zotsatira za kafukufuku wokhudza odwala omwe ali ndi matenda a shuga 1, T_max (nthawi yokwanira kudziwa kuchuluka kwa zinthu) pambuyo pa kupangika kwa insulin glulisin pa mlingo wa 0,15 U / kg s / c ndi insulin ya insulin ya anthu inali 55 ndi mphindi 82, motero, ndipo_max m'magazi am'magazi - 82 ± 1.3 ndi 46 ± 1.3 μED / ml. Mu insulin glulisin, nthawi yayitali yokhala munthawi yamagazi imafupikika kuposa momwe munthu amapangira insulin (98 ndi 161 mphindi, motero).

Odwala ndi mtundu 2 shuga pambuyo makonzedwe a 025 U / kg wa insulin glulisin sc_max zimapangitsa 91 μED / ml ndi malo amtundu wocheperako pamtunda wa 78-104 μED / ml.

Kuthamanga mwachangu kumadziwika pambuyo pokhazikitsa Apidra SoloStar khoma lamkati lakumbuyo, poyerekeza ndi kuyambitsa kwa mankhwalawa mu ntchafu. Mtheradi wa bioavailability wa insulin glulisin ndi pafupifupi 70% (kuchokera kukhoma lamkati lam'mimba - 73%, kuchokera ku minofu yolumikizana - 71%, kuchokera pa ntchafu - 68%), chizindikirochi chimakhala ndi kusiyana kocheperako.

Pambuyo pokonzekera intravenous, kufalitsa ndi kutulutsa kwa insulin glulisin ndi sungunuka wa insulin ya anthu ndi ofanana ndipo ndi chimodzimodzi: V_d (voliyumu yogawa) - 13 ndi 22 l, T_1/2 (kuchotsedwa hafu ya moyo) - 13 ndi mphindi 18.

Poyerekeza ndi insulin ya anthu osungunuka, insulin glulisin pambuyo pa s / c makonzedwe amachotsedwa mwachangu (zikuwoneka kuti T_1/2 ndi 86 ndi mphindi makumi asanu ndi limodzi motsatana). Mwa anthu athanzi komanso odwala omwe ali ndi matenda amtundu woyamba 1, 2_1/2 glulisin insulin pakuwunika kwapadera kwamaphunziro anali pamtunda wa mphindi 37-75.

Odwala omwe ali ndi vuto la impso, kufunika kwa insulin kumatha kuchepetsedwa. Pankhani ya chiwopsezo cha hepatic ntchito, magawo a pharmacokinetic sanaphunzire.

Pali zambiri zochepa pa pharmacokinetics of insulin glulisin mwa okalamba odwala matenda ashuga.

Mu ana omwe ali ndi matenda a shuga 1, ma pharmacokinetics ndi pharmacodynamics a insulin glulisin amaphunziridwa m'magulu awiri azaka - 7-11 ndi zaka 12-16.M'magulu onse awiri, kuyamwa kwazinthu kumadziwika_max ndi T_max anali ofanana ndi akulu. Monga mwa achikulire odwala, insulin glulisin ikagwiritsidwa ntchito musanayesedwe ndi chakudya imapereka chiwongolero chamagazi pambuyo podya, poyerekeza ndi insulin yaumunthu.

Zithunzi za 3D

Mimba komanso kuyamwa

Palibe chidziwitso chokwanira pakugwiritsa ntchito Apidra ® SoloStar ® mwa amayi apakati.

Zambiri zomwe zimapezeka pakugwiritsa ntchito insulin glulisin mwa amayi apakati (zotsatira zosakwana 300 zapakati) sizikuwonetsa zoyipa zake pakukula kwa kubereka, kukulira kwa mwana wosabadwa, kapena mwana wakhanda. Kafukufuku wolera nyama sanawonetse kusiyana kulikonse pakati pa insulin glulisin ndi insulin yaumunthu pokhudzana ndi pakati, kukula kwa embryonic / fetal, kubala kwa mwana ndi kubereka.

Kugwiritsa ntchito Apidra ® SoloStar ® mwa amayi apakati kuyenera kuchitika mosamala. Kusamala mosamala za kuchuluka kwa shuga m'magazi ndikusungabe glycemic control ndikofunikira.

Odwala omwe ali ndi pakati asanakhale ndi pakati kapena matenda ashuga ayenera kusamalitsa pakulimbana kwawo konse. Munthawi yoyamba kubereka, kufunika kwa insulini kumatha kuchepa, ndipo panthawi yachiwiri komanso yachitatu, imatha kuchuluka. Pambuyo pobadwa, insulini imafuna kuchepa mwachangu.

Sizikudziwika ngati insulin glulisin yachotsedwa mkaka wa m'mawere kapena ayi. Kwa amayi mukamayamwitsa, pangafunike kusintha njira ya insulin ndi zakudya.

Mlingo ndi makonzedwe

S / c posachedwa (0-15 mphindi) musanadye kapena mutangodya kumene.

Apidra ® SoloStar ® iyenera kugwiritsidwa ntchito pazinthu zamankhwala zomwe zimaphatikizapo insulin kapena sing'anga wa insulin wa nthawi yayitali kapena analogue wa insulin wa nthawi yayitali. Kuphatikiza apo, Apidra ® SoloStar ® ikhoza kugwiritsidwa ntchito limodzi ndi othandizira pakamwa a hypoglycemic.

Mlingo wa mankhwala Apidra ® SoloStar ® amasankhidwa payekha.

Mankhwala Apidra ® SoloStar ® amathandizidwa ndi jakisoni wa sc, kapena mwa kulowetsedwa kosalekeza m'mafuta oyambira pogwiritsa ntchito pampu.

Jekeseni wa subcutaneous wa Apidra ® SoloStar ® iyenera kuchitidwa m'chigawo cha khomo lamkati lakumbuyo, phewa kapena ntchafu, ndipo mankhwalawa amathandizidwa ndi kulowetsedwa kosalekeza mu mafuta osunthika a m'chigawo cha khoma lakunja kwam'mimba. Masamba obayira ndi kulowetsedwa m'malo omwe ali pamwambapa (khoma lakunja lam'mimba, ntchafu kapena phewa) ziyenera kusinthana ndi kukonzekera kulikonse kwatsopano kwa mankhwalawa. Kuchuluka kwa mayamwidwe, motero, kuyambira ndi kutalika kwa zochita zingakhudzidwe ndi: malo oyang'anira, zochitika zolimbitsa thupi ndi zina zosintha. Kuwongolera kwa khoma lam'mimba kumapereka khunyu mwachangu kuposa kayendetsedwe kazinthu zina zatchulidwazi (onani gawo la "Pharmacokinetics").

Chenjezo liyenera kuonedwa kuti mankhwalawo asalowe mwachindunji m'mitsempha ya magazi. Pambuyo pa kukonzekera mankhwalawa, ndizosatheka kutikita minyewa yoyang'anira. Odwala ayenera kuphunzitsidwa njira yolondola ya jakisoni.

Kusakaniza kwa insulin

Apidra ® SoloStar ® ikhoza kusakanikirana ndi insulin-isophan yaumunthu.

Mukasakaniza Apidra ® SoloStar ® ndi insulin-isophan ya anthu, Apidra ® SoloStar ® iyenera kukokedwa mu syringe yoyamba. Kubayidwa kwa SC kuyenera kuchitidwa mukangosakaniza. Osakaniza ma insulin omwe ali pamwambapa sangathe kulowa / kulowa.

Kupukuta kachipangizo kopitiliza kosalekeza

Mukamagwiritsa ntchito Apidra ® SoloStar ® yokhala ndi pampu yolumikizira insulini, singathe kusakanikirana ndi mankhwala ena.

Apidra ® itha kuperekedwanso ntchito pogwiritsa ntchito chipompo chopitilira kulowetsedwa kwa insulin. Ngati ndi kotheka, kukonzekera kwa Apidra ® kumatha kuchotsedwa mu katoni ya Apidra ® SoloStar ® syringe ndipo ikhoza kugwiritsidwa ntchito ngati makina poponya insulin mosalekeza.

Nthawi yomweyo, kulowetsedwa ndi chosungira chogwiritsidwa ntchito ndi Apidra ® ziyenera kulowedwa m'malo ndi malamulo aseptic pafupifupi maola 48. Malangizo awa akhoza kusiyanasiyana ndi malangizo onse omwe ali mumabuku azida zopopera. Ndikofunika kuti odwala azitsatira malangizo apadera omwe ali pamwambawa kuti agwiritse ntchito Apidra ®. Kulephera kutsatira malangizo apaderawa ogwiritsidwa ntchito ndi Apidra ® kungapangitse kuti pakhale zochitika zovuta kwambiri.

Mukamagwiritsa ntchito Apidra ® ndi chipangizo chothandizira kupomeleza insulini mosalekeza, singathe kusakanikirana ndi ma insulin ena kapena ma sol sol.

Odwala omwe amalandiridwa ndi Apidra ® ndi kulowetsedwa kosatha kwa sc ayenera kukhala ndi njira zina zoperekera insulin ndipo ayenera kuphunzitsidwa kuperekera insulin ndi jakisoni wa sc (pakavulazidwa chipangizo chomwe chimagwiritsidwa ntchito).

Mukamagwiritsa ntchito Apidra ® pogwiritsa ntchito zida zamapampu zothandizira kulowetsedwa kwa insulin, kusokonezeka kwa chipangizo, kugwiritsa ntchito molakwika kulowetsedwa kapena zolakwika pakugwiritsa ntchito kungayambitse kukula kwa hyperglycemia, ketosis ndi matenda ashuga a ketoacidosis. Pankhani ya chitukuko cha hyperglycemia kapena ketosis kapena matenda ashuga ketoacidosis, kuzindikiritsa mwachangu ndi kuchotsera zomwe zimayambitsa chitukuko.

Tsatirani malangizo oyenera kugwiritsa ntchito ma syringe amadzaza (onani gawo "Malangizo ogwiritsira ntchito ndi kusamalira").

Malangizo ogwiritsira ntchito ndi kusamalira cholembera chodzaza ndi SoloStar ®

Asanayambe kugwiritsa ntchito, cholembera cha syringe chimasungidwa kutentha kwa firiji kwa maola 1-2.

Musanagwiritse ntchito, yang'anani cartridge mkati mwa cholembera. Iyenera kugwiritsidwa ntchito pokhapokha yankho likakhala lowonekera, lopanda utoto, lilibe tinthu tolimba tomwe timayimira, ndikufanana, madzi.

Empty SoloStar ® Syringe Pens siyenera kugwiritsidwanso ntchito ndipo iyenera kutayidwa.

Popewa matenda, cholembera chodzaza chisanachitike chizingogwiritsidwa ntchito ndi wodwala m'modzi ndipo sayenera kusamutsidwira wina.

Kugwira SoloStar ® Syringe chole

Musanagwiritse ntchito cholembera cha SoloStar ®, muyenera kuwerenga mosamala malangizo ogwiritsa ntchito.

Zambiri zofunikira pogwiritsa ntchito SoloStar ® Syringe pen

Musanagwiritse ntchito, gwiritsani ntchito singano yatsopano ndi cholembera chonde ndikuyesani mosamala. Ma singano okha omwe amagwirizana ndi SoloStar ® ndi omwe ayenera kugwiritsidwa ntchito.

Malangizo apadera amayenera kuchitika popewa ngozi zokhudzana ndi kugwiritsa ntchito singano komanso mwayi wopatsira matenda.

Musagwiritse ntchito cholembera cha SoloStar ® ngati chawonongeka kapena ngati mulibe chitsimikizo kuti chidzagwira ntchito moyenera.

Nthawi zonse khalani ndi cholembera cha SoloStar ® syringe m'manja kuti itayike kapena kuwonongeka kwa fanizo lomwe limagwiritsidwa ntchito.

Malangizo osungira

Ngati cholembera cha SoloStar ® chikusungidwa mufiriji, chikuyenera kuchotsedwa pamenepo maola 1-2 musanabale jakisoni kuti njira ithe kutentha. Makamaka insulini yodziwika bwino imapweteka kwambiri.

Cholembera cha SoloStar ® chogwiritsidwa ntchito chimayenera kuwonongeka.

SoloStar ® syringe cholembera iyenera kutetezedwa kufumbi ndi dothi.

Kunja kwa SoloStar ® Syringe cholembera kumatha kutsukidwa ndikumupukuta ndi nsalu yonyowa.

Osamiza m'madzi, kutsuka ndikuphika cholembera cha SoloStar ®, chifukwa izi zitha kuwononga.

SoloStar ® Syringe pen imapereka moyenera insulini ndipo ndiotetezeka kugwiritsa ntchito. Zimafunikanso kusamala mosamala. Pewani zochitika zomwe zingawononge cholembera cha SoloStar ® Ngati mukukayikira kuti cholembera cha SoloStar ® syringe chitha kuwonongeka, cholembera chatsopanocho chikuyenera kugwiritsidwa ntchito.

Gawo 1. Kuwongolera kwa insulin

Ndikofunikira kuyang'ana cholembera pa cholembera cha SoloStar ® kuti mutsimikizire kuti ili ndi insulin yoyenera. Pambuyo pochotsa kapu ya cholembera, ma insulini omwe ali momwemo amawongolera: yankho la insulini liyenera kukhala lowonekera, lopanda utoto, losakhala ndi tinthu tolimba tomwe timakhala ngati madzi.

Gawo 2. Kulumikiza singano

Ma singano okha omwe amagwirizana ndi cholembera cha SoloStar ® ndi omwe ayenera kugwiritsidwa ntchito.

Pa jakisoni wotsatira, gwiritsani ntchito singano yatsopano yosabala. Pambuyo pochotsa chipewa, singano iyenera kuyikiridwa mosamala pa cholembera.

Gawo 3. Kuyesa Kwachitetezo

Pamaso pa jekeseni iliyonse, ndikofunikira kuyeserera chitetezo ndikuonetsetsa kuti cholembera ndi singano zimagwira bwino komanso thovu lakum air limachotsedwa.

Pimani mlingo wofanana ndi 2 PIERES.

Zingano zakunja ndi zamkati zimayenera kuchotsedwa.

Ikani cholembera ndi singano kumtunda, ikani pang'onopang'ono katiriji ndi chala chanu cha insulin kuti thovu lonse la mpweya lithe kuloza ndi singano.

Kanikizani (kwathunthu) batani la jakisoni.

Ngati insulini ikuwonekera pachimake pa singano, izi zikutanthauza kuti cholembera ndi singano zikugwira ntchito moyenera.

Ngati insulini siziwoneka pamphepete mwa singano, ndiye kuti gawo 3 limabwerezedwa mpaka insulini ikawonekere kumapeto kwa singano.

Gawo 4. Kusankha Mafuta

Mlingo ukhoza kukhazikitsidwa ndikulondola kwa 1 UNIT, kuyambira pa mlingo wocheperako (1 UNIT) kufikira wambiri (80 UNIT). Ngati kuli kofunikira kukhazikitsa mlingo wowonjezera wa PISCES 80, jakisoni wa 2 kapena kupitilira uyenera kuperekedwa.

Zenera la dosing likuyenera kuwonetsa "0" mukamaliza kuyesa kwa chitetezo. Pambuyo pake, mlingo wofunikira ukhoza kukhazikitsidwa.

Gawo 5. Mlingo

Wodwala ayenera kudziwitsidwa za njira ya jakisoni ndi katswiri wazachipatala.

Singano iyenera kuyikiridwa pansi pa khungu.

Batani la jakisoni liyenera kukanikizidwa kwathunthu. Imasungidwa m'malo ano kwa 10 s mpaka singano itachotsedwa. Izi zimathandizira kuyambitsa mtundu wa insulin kwathunthu.

Gawo 6. Kuchotsa ndi kutaya singano

Nthawi zonse, jekeseni aliyense atavulala, singano imayenera kuchotsedwa ndikuchotsedwa. Izi zimathandizira kupewa kuipitsidwa ndi / kapena kutenga kachilomboka, kulowa mu chidebe cha insulin ndi kutulutsa insulin.

Pochotsa ndi kutaya singano, muyenera kusamala mosamala. Malangizo otetezedwa oyenera kuchotsa ndi kuponyera singano (mwachitsanzo, njira yovalira chipewa ndi dzanja limodzi) amayenera kuonedwa kuti athetse ngozi za ngozi zogwiritsidwa ntchito ndi singano komanso kupewa matenda.

Mukachotsa singano, tsekani cholembera cha SoloStar ® ndi cap.

Magulu apadera a odwala

Matenda aimpso. Kufunika kwa insulini pakukanika kwa impso kumatha kuchepa.

Kuwonongeka kwa chiwindi. Odwala omwe ali ndi vuto la chiwindi, vuto la insulin lingathe kuchepa chifukwa cha kuchepetsedwa kwa gluconeogeneis komanso kuchepa kwa insulin metabolism.

Odwala okalamba. Zambiri zomwe zimapezeka mu pharmacokinetics mu odwala okalamba omwe ali ndi matenda osokoneza bongo ndi osakwanira. Kugwedezeka kwa impso muukalamba kungachititse kuchepa kwa insulin.

Ana ndi achinyamata. Apidra ® ikhoza kugwiritsidwa ntchito mwa ana opitirira zaka 6 ndi achinyamata. Zambiri zamankhwala pazokhudza kugwiritsa ntchito mankhwalawa kwa ana osakwana zaka 6 ndizochepa.

Wopanga

1. Sanofi-Aventis Deutschland GmbH, Germany.

2. CJSC Sanofi-Aventis Vostok, Russia. 302516, Russia, Dera la Oryol, Chigawo cha Oryol, s / n Bolshekulikovskoye, ul. Livenskaya, 1.

Zodandaula za ogula ziyenera kutumizidwa ku adilesi yoyimilira kampaniyo ku Russia: 125009, Moscow, ul. Tverskaya, 22.

Tele. ((495) 721-14-00, fakisi: (495) 721-14-11.

Pankhani yopanga mankhwalawa ku Sanofi-Aventis Vostok CJSC, Russia, madandaulo a ogula ayenera kutumizidwa ku adilesi iyi: 302516, Russia, Oryol Region, Oryol District, s / n Bolshekulikovskoye, Livenskaya, 1.

Tele./fax: +7 (486) 244-00-55.

Momwe mungagwiritsire ntchito: Mlingo ndi njira ya chithandizo

S / c pamimba, phewa kapena ntchafu, kapena mwa kulowetsedwa kosalekeza kwa Apidra SoloStar mu mafuta obisalira a m'mimba. Mankhwalawa amaperekedwa 0,5 mphindi asanadye kapena atangomaliza kudya. Maselo obayira ndi kulowetsamo ayenera kusinthana ndi jakisoni aliyense. Simungathe kufinya jakisoni wa malo (kupatula mankhwala kuti alowe m'mitsempha yamagazi). Zotsatira za mankhwalawa zimafotokozedwa m'magawo omwe amangokhala ndi insulini glulisin ndipo amasiyana ndi INE kapena magawo ena a zochitika za insulin zina. Mlingo amasankhidwa payekha.

Zotsatira za pharmacological

Hypoglycemic wothandizira, wosakhalitsa insulin. Chidziwitso chowonjezera cha insulin yaumunthu. Kugwiritsa ntchito Apidra SoloStar kumachepetsa kuchuluka kwa shuga m'magazi, kumathandizira kuyamwa kwa glucose ndi zotumphukira (minofu yamatumbo, minofu ya adipose), ndipo kumalepheretsa kupanga kwa shuga chiwindi. Imaphatikizira lipolysis mu adipocytes, proteinol, imawonjezera kaphatikizidwe kazakudya.

Ndi / v makonzedwe a Apidra SoloStar, kuchepa kwa shuga m'magazi kumayamba pambuyo pa mphindi 10-20, ndikuwongolera kwa / v, zotsatira za kuchepa kwa glucose zikufanana ndi insulle yamunthu. Mothandizidwa ndi mphamvu ya hypoglycemic, 1 IU ya insulini glulisin ndi wofanana ndi 1 IU ya insulle ya munthu sungunuka.

Zambiri

Apidra, ngakhale imawerengedwa ngati njira yowonjezera ya mahomoni amunthu, imadziwika ndi zotsatira zachangu komanso zosatenga nthawi yayitali poyerekeza ndi izo. Mankhwala a pharmacological amaperekedwa mu radar system (registry ya mankhwala) ngati insulin yochepa.

Apidra ndi yankho lomwe limagwiritsidwa ntchito popanga jakisoni wa subcutaneous.

Kuphatikiza pazomwe zimagwira (glulisin), mankhwalawa ali ndi zina monga:

• polysorbate 20 (monolaurate),
• sodium hydroxide
• trometamol (ovomereza proton),
• sodium kolorayidi
• kresol
• asidi (wozama) hydrochloric.

Njira yothetsera mankhwalawa imayikidwa m'makalata okhala ndi 3 ml, omwe amaikidwa mu cholembera ndipo sangathe kusintha. Ndikulimbikitsidwa kusunga mankhwalawo mufiriji popanda kuwuwonetsa kuzizira ndi kulowa kwa dzuwa. Ripeni wa syringe 2 maola jekeseni woyamba asanakhale m'chipinda ndi kutentha kwa chipinda.

Mtengo wa zolembera 5 zamankhwala ndi pafupifupi rubles 2000. Mtengo womwe umalimbikitsa wopanga ukhoza kusiyana ndi mitengo yeniyeni.

Makhalidwe

Apidra adalembedwa kuti odwala matenda ashuga azisintha glycemia. Chifukwa cha kukhalapo kwa gawo la mahomoni mu kapangidwe kake, kufunika kwa chidziwitso cha glucose m'magazi kumatsika.

Kutsika kwa shuga kumayamba mkati mwa ola limodzi pambuyo povulala. Jakisoni wambiri wa insulin yakuchokera kwa anthu ndi yankho la Apidra ali ndi zotsatira zofanana pazikhalidwe za glycemia.

Pambuyo jekeseni, njira zotsatirazi zimakhazikitsidwa m'thupi:

• kupanga shuga kumalepheretsa chiwindi,
• lipolysis imapanikizika m'maselo omwe amapanga minofu ya adipose,
• pali kukhathamiritsa kwa mapuloteni,
• kupezeka kwa glucose mu zotumphukira zimakhala.
• kuwonongeka kwa mapuloteni kumaponderezedwa.

Malinga ndi zotsatira za kafukufuku wochitidwa pakati pa anthu athanzi komanso odwala matenda ashuga, jakisoni wokhazikika wa mahomoni Apidra samangochepetsa nthawi yodikirira zotsatira, komanso kufupikitsa masikuwo. Ichi chimasiyanitsa timadzi tambiri ndi insulin yaumunthu.

Ntchito ya hypoglycemic ndiyofanana onse mu hormone Apidra komanso insulin ya anthu. Mayesero osiyanasiyana azachipatala adachitidwa kuti awonetsetse momwe mankhwalawa amathandizira. Amakhudzanso odwala omwe ali ndi matenda a mtundu woyamba. Zotsatira zomwe tidapeza zidatilola kuganiza kuti yankho la Glulisin mu 0,15 U / kg, yolumikizidwa mphindi ziwiri asanadye chakudya, zimapangitsa kuwunika kwa glucose pambuyo pa maola awiri ndendende ndi monga jakisoni wa insulin waumunthu adachitira theka la ola.

Apidra imasungiranso zomwe zimachitika mwachangu kwa odwala omwe ali ndi kunenepa kwambiri.

Mtundu woyamba wa shuga

Zoyesa zamankhwala zomwe zimachitika pakati pa anthu omwe ali ndi mtundu woyamba wa matenda zimadalira poyerekeza katundu wa Glulisin ndi Lizpro. Kwa milungu 26, mahomoni okhala ndi zinthuzi amaperekedwa kwa odwala. Glargin adagwiritsidwa ntchito ngati maziko oyambira. Nthawi yomaliza maphunziro ikatha, kusintha kwa hemoglobin ya glycosylated kunayesedwa.

Odwala pasanathe sabata 26 anayeza mulingo wa glycemia wogwiritsa ntchito glucometer. Kuwunikira kunawonetsa kuti chithandizo cha insulin ndi Glulisin poyerekeza ndi mankhwala omwe ali ndi Lizpro sanafune kuwonjezeka kwa kuchuluka kwa mahomoni akuluakulu.

Gawo lachitatu loyesa lidatenga milungu 12. Zimakhudza odzipereka ochokera kwa anthu odwala matenda a shuga omwe adabayira Glargin.

Zotsatira zake zinawonetsa kuti kugwiritsa ntchito yankho ndi gawo la Glulisin mutamaliza kudya kunali kothandiza monga momwe munabayirira musanadye.

Momwemonso, mwanzeru kugwiritsa ntchito Apidra (ndi mahomoni ofanana) adatsimikiziridwa poyerekeza ndi insulin yaumunthu, yoyendetsedwa theka la ola lisanakhazikitsidwe.

Odwala omwe adatenga nawo mayesowo adagawika m'magulu awiri:

• omwe akutsogolera Apidra
• odwala matenda ashuga, kuchititsa insulin mankhwala kudzera jakisoni wa munthu mahomoni.

Zotsatira za mayeso azachipatala zidabweretsa kuti zotsatira zakuchepetsa glycated hemoglobin zinali zokulirapo pagulu loyamba la otenga nawo mbali.

Type 2 shuga

Kafukufuku wachitatu 3 akuwonetsa kuchuluka kwa mankhwalawa glycemia mwa odwala omwe ali ndi matenda a shuga a 2 adachitika kwa milungu 26. Atamaliza, mayesero ena azachipatala adatsata, omwe adatenga nthawi imodzimodzi nthawi yawo yayitali.

Ntchito yawo inali kudziwa chitetezo kuchokera kugwiritsa ntchito jakisoni wa Apidra, yomwe idapangidwa pakadutsa mphindi 15 asanadye chakudya, ndikupatsa insulini yamunthu, yoperekedwa kwa odwala mphindi 30 kapena 45.

Insulin yayikulu mwa onse omwe anali nawo anali Isofan. Mlozera wapakati wa otenga nawo mbali anali 34,55 kg / m². Odwala ena adamwa mankhwala ena pakamwa, kwinaku akupitiliza kuperekera mahomoni muyezo wosasinthika.

Hormid Apidra idafanana ndi insulin yakuwonekera kwa munthu pakuwunika mphamvu ya hemoglobin ya glycated kwa miyezi isanu ndi umodzi ndi miyezi 12 yofanana ndi mtengo woyambira.

Chizindikirocho chasintha m'miyezi isanu ndi umodzi yoyambirira motere:

• Odwala kugwiritsa ntchito insulin ya anthu - 0,30%,
• Odwala omwe amathandizidwa ndi insulini yokhala ndi Glulisin - 0,46%.

Sinthani chizindikiro patatha chaka choyesa:

• Odwala kugwiritsa ntchito insulin ya anthu - 0,13%,
• Odwala omwe amathandizidwa ndi insulini yokhala ndi Glulisin - 0,23%.

Kuchita bwino, komanso chitetezo cha kugwiritsa ntchito mankhwalawa zochokera ku Glulisin, sizinasinthe mwa anthu amitundu yosiyanasiyana komanso osiyana amuna.

Magulu Opatsa Odwala

Machitidwe a Apidra angasinthe ngati odwala ali ndi matenda osiyanasiyana okhudzana ndi matenda ashuga:

1. Kulephera kwina. Muzochitika zotere, pali kuchepa kwa kufunika kwa mahomoni.
2. Matenda a chiwindi. Zotsatira za othandizira okhala ndi Glulisin okhala ndi odwala omwe ali ndi zovuta zotere sizinaphunzire.

Palibe deta pakusintha kwa pharmacokinetic mwa okalamba odwala. Mu ana ndi achinyamata a zaka 7 mpaka 16, akudwala matenda amtundu 1, mankhwalawa amalowetsedwa msanga pambuyo povomerezeka.

Kupanga jakisoni wa Apidra musanadye kumakupatsani mwayi wokhala ndi glycemia wambiri pambuyo podyera poyerekeza ndi insulin ya anthu.

Zizindikiro ndi mlingo

Kugwiritsa ntchito njira ya mankhwala ndikofunikira kwa anthu omwe ali ndi matenda omwe amadalira insulin. Gulu la odwala omwe amamwa mankhwalawa nthawi zambiri amakhala ndi ana opitirira zaka 6.

Njira yokhala ndi Glulisin iyenera kutumikiridwa mukangodya chakudya kapena itangotsala pang'ono kale. Apidra amagwiritsidwa ntchito limodzi ndi insulin mankhwala kapena othandizira okhala ndi nthawi yayitali yolimbikitsira, komanso mawonekedwe awo. Kuphatikiza apo, amaloledwa kugwiritsa ntchito mankhwala ena a hypoglycemic pamodzi ndi jakisoni a mahomoni. Mlingo wa jekeseni wa Apidra uyenera kutumizidwa ndi adokotala okha.

Chithandizo cha matendawa chikuyenera kuchitika pokhapokha kuyang'aniridwa ndi katswiri. Sizoletsedwa popanda kusintha kwa mankhwala aliwonse, makamaka jakisoni wa insulin, komanso kuletsa chithandizo kapena kusinthana ndi mitundu ina ya mahomoni popanda kuvomerezedwa ndi endocrinologist.

Komabe, pali zitsanzo za insulini zochizira zamankhwala zazifupi. Amatanthawuza kuwerengera komwe kumawakakamira kuchuluka kwa mikate yomwe amadya patsiku (1 XE yofanana ndi 12 g yamafuta).

Chofunikira cha mahormoni:

• kuphimba 1 XE pakudya m'mawa, zigawo ziwiri ziyenera kudulidwa,
• mu nkhomaliro muyenera mayunitsi 1.5.,
• madzulo, kuchuluka kwa mahomoni ndi XE kumawerengedwa kuti ndiofanana, ndiye 1: 1, motsatana.

Kusunga shuga m'magawo olipidwa, ndi glycemia wabwinobwino ndikubwinobwino, ngati mumayang'anira shuga nthawi zonse. Izi zitha kuchitika mwa kutenga miyezo pa mita ndikuwerengera kuti pakufunika kuchuluka kwa mahomoni kuti apange jakisoni molingana ndi kuchuluka kwakukonzekera kwa XE yomwe ingatenge.

Njira Zoyang'anira

Apidra solution yothetsera jakisoni imalowetsedwa pakhungu ngati cholembera chagwiritsidwa ntchito. Muzochitika za odwala omwe akugwiritsa ntchito pampu ya insulin, wothandizirayo amalowa kudzera pamtunda wa mafuta onunkhira kudzera mwa kulowetsedwa kosatha.

Mfundo zofunika kuzidziwa musanabaye:

1. Njira yothetsera vutoli imalowetsedwa m'dera la ntchafu, phewa, koma nthawi zambiri m'malo ozungulira navel pamimba.
2. Mukakhazikitsa pampu, mankhwalawa amayenera kulowa m'matumbo amkati pamimba.
3. Masamba obayira ayenera kusintha.
4. Kuthamanga ndi kutalika kwa mayamwidwe, nthawi yamayendedwe azotsatira zimadalira dera loyang'anira yankho, komanso katundu amene wachitika.
5. Osamasefa gawo lomwe yankho lake idalowetsedwa kuti isalowe m'matumba.
6. Zingwe zopangidwa m'mimba zimatsimikizira kuyambika msanga kwa jakisoni kuposa jakisoni wamagawo ena.
7. Apidra ikhoza kuphatikizidwa ndi hormone Isofan.

Yankho la Apidra lomwe limagwiritsidwa ntchito pa pump pump sayenera kusakanikirana ndi mankhwala ena ofanana. Malangizo a chipangizochi ali ndi chidziwitso chokwanira pakugwiritsa ntchito chipangizochi.

Zambiri pazakanema zamapampu a insulin:

Zotsatira zoyipa

Pa chithandizo cha insulin, matenda opatsirana amatha kuchitika.Kukhazikika kwa zizindikiro za neuropsychiatric nthawi zambiri kumayambitsidwa ndi zizindikiro zomwe zimakhudzana ndi kuwonjezeka kwa magazi. M'malo mwake, mawonetseredwe oterewa ndi chikhalidwe cha hypoglycemia.

Vutoli limachitika makamaka chifukwa cha mlingo wosankhidwa mosayenera kapena chakudya cholakwika chomwe chimadyedwa ndi kuchuluka kwa mayunitsi.

Ngati hypoglycemia ikuchitika, wodwalayo sasintha ngati njira zoyenera sizitengedwa. Amagwiritsidwa ntchito popanga mafuta angapo.

Wodwalayo amatha kulumidwa, nthawi zambiri amakhala ndi mwayi wopumula kwa zizindikiro zomwe zili mdziko lino. Kupanda kutero, chikomokere chikhoza kuchitika, ndizosatheka kuti mutuluke popanda thandizo la kuchipatala. Odwala omwe ali ndi vutoli ayenera kuyamwa jakisoni.

Kusokonezeka kwa kagayidwe ndi khungu

M'madera a jakisoni, zimachitika monga:

Zizindikiro zomwe zimafotokozedwazo nthawi zambiri zimangokhala zokha ndipo sizikufuna kusiya kumwa mankhwala.

Mavuto okhudzana ndi metabolism akufotokozedwa pakupanga hypoglycemia, yomwe imayendera limodzi ndi zizindikiro zotsatirazi:

• kutopa
• kufooka ndi kumva kuti watopa,
• zosokoneza zowoneka
• kugona
• tachycardia
• kulumikizana
• kumverera kwa mutu
• thukuta lozizira
• maonekedwe osazindikirika, komanso kuwonongeka kwathunthu.

Kukhazikitsidwa kwa yankho popanda kusintha madera omwe amapangika kumatha kubweretsa lipodystrophy. Ndikukhudzidwa kwa minyewa yomwe imakumana ndi zoopsa ndipo zimafotokozedwera zotupa za atrophic.

Mavuto ambiri

Zovuta zamachitidwe munthawi yogwiritsira ntchito mankhwalawa ndizosowa.

Kupezeka kwawo kumayendera limodzi ndi zizindikiro zotsatirazi:

• mphumu,
• urticaria
• kumverera kwa kuyabwa
• dermatitis chifukwa cha chifuwa.

Nthawi zina, zovuta zina zomwe zimayikidwa pangozi zimatha kuyika moyo wa wodwala pangozi.

Odwala apadera

Zilimbikitso za yankho ziyenera kuperekedwa kwa amayi apakati mosamala kwambiri. Kuwongolera kwa glycemia mu chimango cha chithandizo chotere kuyenera kuchitika pafupipafupi.

Malangizo ofunikira a insulin kwa amayi oyembekezera:

1. Mtundu uliwonse wa matenda ashuga, kuphatikiza mawonekedwe a matendawa, umafunikira kuti pakhale glycemia wambiri panthawi yonse yovomerezeka.
2. Mlingo wa magawo a mankhwala omwe amaperekedwa amawonjezeka mu trimester yoyamba ndikuwonjezeka pang'onopang'ono, kuyambira kuyambira miyezi 4 ya mimba.
3. Pambuyo pobadwa, kufunikira kwa mahomoni, kuphatikizapo Apidra, kumachepetsedwa. Amayi omwe ali ndi matenda osokoneza bongo nthawi zambiri amafunikira kusiya mankhwala a insulin atabereka.

Ndizofunikira kudziwa kuti kafukufuku wokhudzana ndi kulowa kwa mahomoni ndi gawo la Glulisin mkaka wa m'mawere sanachitike. Kutengera ndi zomwe zili mu ndemanga za amayi oyamwitsa omwe ali ndi matenda ashuga, nthawi yonse ya mkaka wa m`mawere, muyenera kuyimilira kapena mothandizidwa ndi madokotala kuti musinthe mlingo wa insulin ndi zakudya.

Apidra sinafotokozeredwe ana osakwana zaka 6. Palibe chidziwitso chachipatala pakugwiritsa ntchito mankhwalawa pagulu la odwala.

Kupanga ndi mawonekedwe a kumasulidwa

Mu 1 millilita ya Apidra Solostar yankho lili ndi chokhacho chophatikizira - insulin glulisin mu gawo la 100 PIECES. Komanso, mankhwalawa ali ndi:

• Hydroskide ndi Sodium Chloride
• Madzi okonzedwa
• Metacresol
• Polysobat
• Trometamol
• Hydrochloric acid.

Njira yokhala ndi insulini ndi madzi omveka bwino, osasankhidwa, omwe amapezeka mumbale 3 ml. Paketiyi imaphatikizapo mabotolo amodzi kapena asanu okhala ndi zolembera.

Kuchiritsa katundu

Insulin glulisin yomwe ili mu Apidra ndi njira yofananira ndi ya insulin yomwe imapangidwa m'thupi la munthu. Glulisin amachita zinthu mwachangu kwambiri ndipo amadziwika ndi nthawi yochepa poyerekeza ndi insulin yachilengedwe.

Mothandizidwa ndi insulin glulisin, kusintha pang'onopang'ono kwa kagayidwe ka glucose kumawonedwa. Ndi kuchepa kwa shuga, kukondoweza kwa mayamwidwe ake mwachindunji ndi zotumphukira, kuphatikizira kwa kaphatikizidwe ka glucose m'maselo a chiwindi amalembedwa.

Insulin imalepheretsa njira ya lipolysis yomwe imachitika mu adipocytes, komanso proteinolysis. Nthawi yomweyo, kaphatikizidwe wamaproteni amakula kwambiri.

Chifukwa cha kafukufuku wambiri ndi kutenga nawo mbali anthu omwe ali ndi matenda ashuga, komanso odwala athanzi, zotsatira zotsatirazi zidapezeka: ndi subcutaneous makonzedwe a Apidra, kuchitapo kanthu mofulumira kwa insulin kumawonedwa ndi nthawi yovutikira kwambiri kuposa insulin yamadzimadzi yotentha.

Pambuyo pa kukhazikitsidwa kwa glulisin pansi pa khungu, zotsatira zake zimadziwika pambuyo pa mphindi 10-20. Koma pakubayidwa m'mitsempha, ndolo ya glucose imatsika chimodzimodzi ngati pambuyo pobweretsa insulin yachilengedwe. 1 unit ya insulin glulisin imadziwika ndi katundu wofanana ndi glucose wofanana ndi gawo limodzi la insulin yachilengedwe.

Odwala omwe ali ndi matenda a aimpso, kufunika kwa insulin nthawi zambiri kumachepetsedwa.

Apidra Solostar: malangizo ogwiritsira ntchito

Subcutaneous makonzedwe a Apidra ayenera kuchitika musanadye kapena pambuyo chakudya.

Mankhwala okhala ndi insulin ayenera kugwiritsidwa ntchito molingana ndi dongosolo la mankhwala antidiabetesic limodzi ndi insulin, yomwe imadziwika ndi kutalika kwakanthawi kapena insulin. Mwina mungagwiritse ntchito mankhwala ophatikizira a hypoglycemic pakamwa.

Kusankhidwa kwa regimen ya muyezo kumachitika ndi endocrinologist.

Mafala Akutoma

Kukhazikitsidwa kwa yankho la insulini kumachitika mosadukiza ndi jakisoni kapena kulowetsedwa pogwiritsa ntchito pulogalamu yapadera ya pampu.

Subcutaneous jakisoni imachitika m'mimba khoma (mwachindunji mbali yake yakumbuyo), m'chigawo chachikazi kapena phewa. Kulowetsedwa kwa mankhwala ikuchitika m'mimba khoma. Malo omwe kulowetsedwa ndi jekeseni ayenera kukhala akusintha mosalekeza.

Momwe mungagwiritsire ntchito cholembera

Apidra isanayambike, cholembera chimakhala chofunikira kuti chiwotche kutentha pang'ono (pafupifupi maola 1-2).

Singano yatsopano imalumikizana ndi cholembera cha insulin, ndiye kuti muyenera kuyesa mayeso otetezeka. Pambuyo pake, chizindikirocho "0" chidzawoneka pazenera la drr. Kenako mulingo woyenera umakhazikitsidwa. Mtengo wocheperako wa mlingo womwe waperekedwa ndi gawo limodzi, ndipo pazofunikira ndi magawo 80. Ngati pakufunika bongo wambiri, jakisoni zingapo zimachitika.

Nthawi ya jakisoni, singano, yomwe imayikidwapo cholembera, imayenera kuyikiridwa pang'onopang'ono pakhungu. Batani pa syringe cholembera lidzakanikizidwa, liyenera kukhalabe pomwepo mpaka mphindi yakucha. Izi zimathandizira kuyambitsidwa kwa mlingo woyenera wa mankhwala okhala ndi insulin.

Pambuyo jakisoni, singano imachotsedwa ndikuitaya. Chifukwa chake, zitha kuteteza matenda a insulin. M'tsogolomo, cholembera cha syringe iyenera kutsekedwa ndi chipewa.

Mankhwala atha kuperekedwa kwa amayi apakati komanso akakhanda.

Contraindication ndi Kusamala

Mtengo: kuchokera 421 mpaka 2532 rub.

Mankhwala okhala ndi insulin Apidra Solostar sagwiritsidwa ntchito kuwonetsa hypoglycemia ndikuwonjezereka kwa magawo a mankhwala.

Mukamagwiritsa ntchito mankhwala ena a insulin ochokera kwa wopanga wina, muyenera kuwongolera chithandizo chamankhwala omwe amachokera kwa dokotala yemwe akupezekapo, chifukwa kufunika koti mugwiritse ntchito mankhwalawa sikungatheke. Mungafunike kusintha chiwembu cha hypoglycemic mankhwalawa pakamwa.

Kutsiliza kwa mankhwala othandizira kapena kugwiritsa ntchito mankhwala osokoneza bongo okwanira, makamaka mwa anthu omwe ali ndi matenda ashuga, kumatha kuyambitsa matenda a shuga komanso matenda a hypoglycemia.

Nthawi yopezeka ya hypoglycemia ikukhudzana mwachindunji ndi kuchuluka kwa chitukuko cha hypoglycemic kuchokera ku mankhwala omwe amagwiritsidwa ntchito, amatha kusintha ndi kusintha kwa chithandizo cha antidiabetesic.

Zina zomwe zimatha kuchepetsa zovuta za hypoglycemia, zimaphatikizapo:

• Njira yayitali ya matenda a shuga
• Kwambiri insulin mankhwala
• Kukula kwa matenda a shuga
• Kugwiritsa ntchito mankhwala angapo (mwachitsanzo, β-blockers).

Kusintha kwa mlingo wa insulin Apidra Solostar kumachitika ndi kuwonjezeka kwa zochitika zolimbitsa thupi kapena kusintha kwa zakudya za tsiku ndi tsiku.

Pankhani ya kuchuluka zolimbitsa thupi mutatha kudya, mwayi wokhala ndi hypoglycemia ukuwonjezeka. Kuchita insulin mwachangu kungayambitse hypoglycemia.

Zizindikiro zosafupika za hypo- ndi hypoglycemic zimayambitsa kupezeka kwa matenda a shuga, chikomokere, kapena kutsogolo kwa imfa.

Ndi kusintha kwa mkhalidwe wamalingaliro, kukula kwa matenda ena, pangafunikire kusintha mlingo wa mankhwala okhala ndi insulin.

Mukamagwira ntchito mosamala, magalimoto oyendetsa, chiopsezo chokhala ndi hypo- ndi hyperglycemia chikuwonjezeka, choncho muyenera kusamalidwa mwapadera.

Kuchita mankhwala osokoneza bongo

Mukamamwa mankhwala ena, zimachitika kuti kagayidwe kazakudwala kajambulidwe, mogwirizana ndi izi, pakufunika kusintha Mlingo wa glulisin ndikuwongolera machitidwe a antidiabetesic mankhwala.

Mwa zina mwa mankhwala omwe amalimbikitsa kuchuluka kwa hypoglycemic a glulisin ndi:

• Zoletsa zina za angiotensin zotembenuza enzyme, monoamine oxidase
• Pentoxifylline
• Mankhwala othandizira
• Njira zochokera sulfonamide antimicrobial agents
• Ma discopyramid
• Hypoglycemic mankhwala opangira pakamwa
• Fluoxetine
• Salicylates
• Propoxyphene.

Mankhwala angapo amaperekedwa omwe amachepetsa kwambiri hypoglycemic zotsatira za yankho la insulin:

• Isoniazid
• Somatropin
• Danazol
• Ena achifundo
• Mankhwala a estrogen-progestin
• COC
• Diazoxide
• Mapuloteni oletsa
• Mahomoni a chithokomiro
• Mankhwala a antipsychotic
• GKS
• Phenothiazine Derivatives
• Mankhwala osokoneza bongo.

Ndizofunikira kudziwa kuti β-adrenergic blockers, mankhwala okhala ndi ethanol komanso ma lithiamu, clonidine amatha kuwonjezera ndikuchepetsa mphamvu ya hypoglycemic ya Apidra.

Pogwiritsa ntchito reserpine, β-adrenergic blockers othandizira, clonidine, ndi guanethidine, zizindikiro za hypoglycemia zitha kukhala zopanda mphamvu kapena zosakhalapo.

Popeza palibe chidziwitso pakudziwika kwa mankhwala a gluzilin, osasakanikirana ndi mankhwala ena, insulin isofan ndiyosiyana.

Pankhani yogwiritsa ntchito pampu kulowetsedwa kupatsa Apidra, kusakaniza njira yokhala ndi insulin ndi mankhwala ena sikuyenera kutero.

Zotsatira zoyipa ndi bongo

Nthawi zambiri, anthu odwala matenda ashuga amatha kukhala ndi vuto ngati hypoglycemia.

Nthawi zina, totupa pakhungu ndi mawonekedwe a kutupa kwanuko kumawonedwa.

Kupezeka kwa lipodystrophy ngati sikutsatira dongosolo lodziwika bwino la chithandizo chamankhwala sikulakwa.

Mawonetseredwe ena omwe amatsutsa ndi monga:

• Matenda a khungu lawo siligwirizana, mwachangu ndi mtundu wa uritisaria, kupindika
• Kumverera kwamphamvu m'chifuwa (m'malo osowa).

Ndikofunikira kudziwa kuti zomwe zimachitika pakhungu lathupi lathu (chiwonetsero cha thupi lawo) zimathandizidwanso tsiku lotsatira pambuyo pa jekeseni. Nthawi zina, zizindikiro zoyipa sizobwera chifukwa cha kuwonekera kwa insulin, koma chifukwa cha mkwiyo pakhungu chifukwa cha chithandizo chamankhwala chisanayambidwe ndi jakisoni kapena chifukwa cha jakisoni wosayenera.

Mukazindikira matenda amtundu wonse, chiopsezo cha kufa chimakhala chachikulu. Chifukwa chake, pakuwonetsedwa pang'ono kwa zovuta zammbali, muyenera kufunsa dokotala.

Ndi kukhazikitsidwa kwa mankhwala ochulukirapo a Apidra, hypoglycemia ikhoza kukhala yofatsa komanso yowopsa. Pankhaniyi, ndikofunikira kuchitira chithandizo:

• Ofatsa - Zakudya zokhala ndi shuga kapena zakumwa
• Mawonekedwe owopsa (osazindikira chikumbumtima) - pakuyimitsidwa, 1 ml ya mankhwala Glucagon amaperekedwa pansi pa khungu kapena minofu, osagwirizana ndi Glucagon, njira yolowerera shuga ndiyotheka.

Wodwala akayambanso kuzindikiridwa, zidzakhala zofunikira kumamupatsa chakudya chamafuta ambiri. Pambuyo pake, kuwunika momwe wodwalayo alili ndi dokotala wololedwa kumalimbikitsidwa.

Eli Lilly ndi Company, France

Mtengo kuyambira 1602 mpaka 2195 rub.

Humalogue ndi amodzi mwa othandizira omwe amawonetsa zotsatira za hypoglycemic. Humalog ili ndi insulin lyspro. Mothandizidwa ndi mankhwalawa, zidzatha kuyendetsa kagayidwe ka glucose ndikuwonjezera kwambiri mapuloteni. Mankhwala amapangidwa mwanjira yankho ndi kuyimitsidwa.

Ubwino:

• Kugwiritsa ntchito
• Kukhazikika kwa hypoglycemic kwambiri
• Zovuta zoyipa ndizokayikitsa.

Chuma:

• Musagwiritse ntchito ngati hypoglycemia ikukayikiridwa.
• Mtengo wokwera
• Zingayambitse thukuta.

Apidra SoloStar, malangizo ogwiritsira ntchito: njira ndi mlingo

Apidra SoloStar njira imayendetsedwa s.c. kwa mphindi 0-15 musanadye kapena mutangodya.

Mankhwalawa amadziwitsidwa pamankhwala azachipatala omwe amaphatikizapo insulin, kapena insulin, kapena wothandizira wa insulin yayitali. Apidra SoloStar itha kugwiritsidwa ntchito limodzi ndi othandizira pakamwa.

Mlingo wothandizila uyenera kusankhidwa payekha.

Kukhazikitsidwa kwa yankho la Apidra SoloStar kumatha kuchitika ngati jakisoni wa sc kapena kulowetsedwa kosalekeza m'mafuta oyenda mothandizidwa ndi dongosolo la pampu.

Malo operekera mankhwala:

• s / c jekeseni: m'dera la mpanda wam'mimba, ntchafu kapena phewa,
• kulowetsedwa kosalekeza: m'chigawo cha khomo lamkati lakumbuyo.

Ndi chithandizo chilichonse chatsopano cha mankhwalawa, omwe amawonetsera jakisoni / kulowetsedwa ayenera kusintha. Malo oyang'anira apidra SoloStar, zolimbitsa thupi ndi zina zotha kusintha zimatha kusokoneza mankhwalawa komanso nthawi ya mankhwalawa. Mukamayambitsa kukhoma kwa m'mimba, kunyowa pang'ono pang'onopang'ono kumadziwika kuposa momwe kumayambira mbali zina za thupi zomwe zafotokozedwa pamwambapa.

Pofuna kupewa kulowa kwa Apidra SoloStar mwachindunji m'mitsempha yamagazi, njira zopewera chitetezo ziyenera kuonedwa. N`zosatheka kutikita minofu dera mankhwala. Odwala ayenera kutsatira njira yolondola ya jakisoni.

Insulin glulisin imatha kusakanikirana ndi insulin ya anthu, pomwe Apidra SoloStar amakhala woyamba kukokedwa mu syringe. Jekeseni wa SC uyenera kuchitidwa mukangosakaniza. Ma insulin osakanikirana omwe ali mkati sangaperekedwe.

Panthawi yopitilira kulowetsedwa, Apidra SoloStar samasakanikirana ndi mankhwala ena, kuphatikizapo ma insulin kapena sol sol.

Ngati ndi kotheka, mankhwalawa amatha kuchotsedwa pa cartridge ya syringe cholembera ndikugwiritsira ntchito jakisoni pogwiritsa ntchito pompopompo kuti apitirize kulowetsedwa kwa insulin.

The kulowetsedwa ndi chosungira ntchito mankhwala ayenera m'malo osachepera 48 maola, kutsatira aseptic malamulo. Malangizowa atha kusiyanasiyana ndi malangizo omwe ali pamabukuwa ogwiritsira ntchito zida zapompo. Komabe, ngati malingaliro apaderawa samatsatiridwa, zochitika zovuta zimatha.

Ndikofunikira kulingalira kuthekera kwa kuthyoka kwa chipangizo chomwe chimagwiritsidwa ntchito, chifukwa chake ndikofunikira kukhala ndi njira zina zoperekera mankhwalawo ndikutha kuyendetsa bwino ntchito ya wothandizira wa SC.

Chifukwa chakuchita bwino kwa chipangizo, pampu yolakwika ya kulowetsedwa, kapena cholakwika pakuwathandiza, kukulitsa kwa hyperglycemia, matenda ashuga ketoacidosis ndi ketosis ndikotheka. Zikatero, chizindikiritso ndi kuthetseratu zomwe zimayambitsa zochitika zoyipazi ndizofunikira.

Tsatirani malangizo oyenera kugwiritsa ntchito ma syringe osadzaza.

Asanagwiritse ntchito, cholembera cha syringe chizisungidwa kutentha kwa fupi kwa maola 1-2 (kugwiritsa ntchito insulin yowawa kumapweteka kwambiri). Asanayambitsidwe, muyenera kuyang'ana cartridge yomwe ili mkati mwa cholembera. Pankhani ya tinthu tolimba towoneka, komanso kusintha kwa mtundu ndi kusasinthasintha, Apidro SoloStar sayenera kugwiritsidwa ntchito. Mukatha kugwiritsa ntchito, cholembera chopanda kanthu chimayenera kutayidwa (kugwiritsanso ntchito) koletsedwa.

Cholembera chodzaza sichingasamutsidwe kwa munthu wina, chikuyenera kugwiritsidwa ntchito ndi wodwala m'modzi yekha, zomwe zingachepetse mwayi wokhala ndi matenda.

Singano yatsopano iyenera kulumikizidwa ku cholembera isanafike ntchito iliyonse. Kuyesedwa kwachitetezo kuyenera kuchitika (chipangizo ndi singano zimagwira bwino, thovu zam'mlengalenga zichotsedwa). Kungogwiritsa ntchito singano zogwirizana basi.

Chipangizocho chimapereka insulini molondola ndipo ndi bwino kugwiritsa ntchito. Cholembera chimbale chiyenera kutetezedwa kufumbi ndi dothi. Mutha kuyeretsa kunja ndikupukuta ndi nsalu yonyowa. Osamiza cholembera chindapusa mumadzi, chotsani komanso muchotse.

Mukamayesa chitetezo, yeretsani mlingo womwe ungafanane ndi zigawo ziwiri (zoteteza mkati ndi kunja kwa singano ziyenera kuchotsedwa). Cholembera cha syringe chimayikidwa ndi singano ndikumakoka bwino ndi chala pa cartulin la insulin kuti thovu la mpweya lithe kulowera kwa singano. Ndiye akanikizire kwathunthu jakisoni wa mankhwala. Ngati chipangizocho chikugwira ntchito molondola, insulini imawoneka pamsonga pa singano.

Mukamaliza kuyesa chitetezo, zenera la dosing liyenera kuwonetsa "0". Pambuyo pake, mutha kukhazikitsa mlingo wofunikira.

Mlingo ukhoza kuyikidwa mulingo kuchokera 1 mpaka 80 mayunitsi molondola 1 unit. Ngati mukufuna kulowa muyezo waukulu, tengani jakisoni awiri kapena angapo.

Wodwala ayenera kudziwitsidwa ndi akatswiri azachipatala za njira yothandizira jakisoni. Singano iyenera kuyikiridwa pansi pa khungu. Batani la jakisoni liyenera kukanikizidwa kwathunthu. Imachitika pamalo amenewa kwa masekondi 10 mpaka singano itachotsedwa. Izi zimapangitsa kukhazikitsidwa kwa mtundu wonse wa insulin.

Singano pambuyo pa jekeseni iliyonse pamavuto onse amayenera kuchotsedwa ndikuthiridwa. Izi ndikuti tilewe kuipitsidwa komanso / kapena kachilomboka, mpweya womwe uli mu thanki ya insulin komanso kutulutsa insulin. Mukachotsa singano, tsekani cholembera ndi chipewa.

Kufunika kwa insulini motsutsana ndi vuto la chiwopsezo cha hepatic kungachepe, komwe kumalumikizidwa ndi kuchepa kwa gluconeogeneis komanso kutsika kwa insulin metabolism.

Ndi kulephera kwa aimpso, kufunika kwa insulin kumatha kuchepa.

Kwa odwala okalamba omwe ali ndi matenda ashuga, zambiri za pharmacokinetics ndizosakwanira. Ndi zaka, mwayi wa matenda aimpso umawonjezeka, womwe ungayambitse kuchepa kwa insulin.

Humulin NPH

Eli Lilly East S.A., Switzerland

Mtengo kuyambira 148 mpaka 1305 rub.

Humulin NPH - mankhwala omwe ali ndi yogwira insulin-isophan, amagwiritsidwa ntchito mu shuga kuwongoletsa glycemia. Humulin NPH imapangidwa mwa njira yothetsera mavitamini omwe amagwiritsidwa ntchito cholembera.

Ubwino:

• Atha kulembetsa kukhala ndi pakati
• Gwiritsani ntchito matenda oyamba a shuga
• Mankhwala aantidiabetic a nthawi yayitali amaloledwa.

Chuma:

• Zingayambitse kuyabwa kwadzaoneni.
• Pazotsatira zamankhwala, kugunda kwa mtima kumatha kupezeka
• Amangotulutsidwa ndi mankhwala okha.

Novo Nordic, Denmark

Mtengo kuchokera 344 mpaka 1116 rubles.

LS ili ndi insulin yochepa. Amalandira mankhwala a shuga osagwirizana ndi glycemic control ndi mankhwala ena. Mothandizidwa ndi Actrapid, njira ya intracellular njira imayendetsedwa chifukwa cha kusunthidwa kwacamP biosynthesis komanso kulowa mwachangu m'maselo a minofu. The yogwira thunthu ndi sungunuka insulin. Mankhwala amapangidwa mwanjira yothetsera.

Ubwino:

• Mtengo wotsika
• Kuchepetsa msanga kwa shuga m'magazi
• Itha kugwiritsidwa ntchito ndi insulin yayitali.

Chuma:

• Maonekedwe a zizindikiro za lipodystrophy samatsutsidwa
• Quincke edema imayamba
• Ndi zochulukirapo zolimbitsa thupi, kusintha kwa mlingo kumafunika.

Kukopa pa kuthekera koyendetsa magalimoto ndi njira zowerengeka

Panthawi yamankhwala, pamakhala chiwopsezo poyendetsa. Izi zimachitika chifukwa chakuchepa kwa hyperglycemia ndi hypoglycemia, komanso kusokonezeka kowoneka komwe kumachitika pakukhazikitsa izi. Izi ndizowopsa kwa odwala ofooka, komanso kwa odwala omwe alibe zizindikiro kapena omwe ali ndi ziwonetsero pafupipafupi za hypoglycemia. Kuti apange lingaliro la kuthekera / kusatheka kwa wodwala kuyendetsa magalimoto, zinthu izi ziyenera kuwunikiridwa munthawi iliyonse. Pofuna kupewa kuthekera kwa hypoglycemia, odwala amalangizidwa kuti azisamala poyendetsa galimoto.

Mimba komanso kuyamwa

Zomwe tikugwiritsa ntchito Apidra SoloStar mwa amayi apakati ndizosakwanira. Malinga ndi kuchuluka kwakanthawi kochepa (zotsatira zosakwana 300 pobala), mankhwalawa samakhudza kwambiri njira ya kubereka, kukula kwa mwana wosabadwa, kapena mwana wakhanda. M'maphunziro a kubala nyama, palibe kusiyana komwe kunapezeka pakati pa insulin glulisin ndi insulin yaumunthu pokhudzana ndi pakati, kukula kwa embryonic / fetal, kubala kwa mwana ndi kubereka.

Apidra SoloStar mu amayi apakati akuyenera kugwiritsidwa ntchito mosamala poyang'anira kuwunika kwa shuga wamagazi ndikuwongolera glycemic control.

Amayi omwe ali ndi pakati asanabadwe kapena matenda ashuga ayenera kusamalitsa nthawi yonse ya bere. Kufunika kwa insulin panthawi yoyamba ya mimba kumatha kuchepa, ndipo nthawi yachiwiri - trimesters yachitatu, imatha kuchuluka. Mukangobereka, mumakhala kuchepa msanga kwa zofunikira za insulin.

Palibe umboni wotsimikizira kapena kukana kuti insulin glulisin imachotsedwa mkaka wa m'mawere. Pa yoyamwitsa, pangafunike kusintha zakudya ndi insulin dosing regimen.

Kuyanjana kwa mankhwala osokoneza bongo

Kafukufuku wapadera wokhudzana ndi kukhudzana kwa pharmacokinetic sanachitike. Kutengera ndi chidziwitso cha mankhwala ena omwe akukwaniritsidwa, akukhulupirira kuti chitukuko cha zochitika zamankhwala ndizovuta kwambiri. Zinthu zina / kukonzekera kungakhudze kagayidwe ka glucose, muzochitika zotere kusintha kwa Apidra SoloStar makamaka kuwunika mosamala chithandizo kungafunike.

Mankhwala omwe amakhudza kuchuluka kwa insulin:

• kuchuluka (kuphatikizapo kuwonjezeka kwa kudziwikiratu kwa hypoglycemia): angiotensin kutembenuza ma enzyme zoletsa, propoxyphene, pakamwa hypoglycemic othandizira, disopyramide, fluoxetine, fibrate, pentoxifylline, monoamine oxidase inhibitors, sulfonamide antimicrobials, salicylates,
• kuchepa: somatropin, glucocorticosteroids, diazoxide, danazole, isoniazid, diuretics, phenothiazine zotumphukira, sympathomimetics, progestins, estrogens, mahomoni a chithokomiro, mankhwala a antipsychotic, proteinase inhibitors.

Zochitika zina:

• Clonidine, beta-blockers, mowa, mchere wa lithiamu: akaphatikizidwa, ndizotheka kuwerengetsa kapena kufooketsa zotsatira za insulin,
• pentamidine: hypoglycemia imatha kupezeka ndi chitukuko cha hyperglycemia,
• Clonidine, beta-blockers, reserpine, guanethidine: akaphatikizidwa ndi mankhwala osokoneza bongo, Zizindikiro za adrenergic activation zitha kutchulidwa kochepa kapena kusapezeka.

Osasakaniza insulin glulisin ndi mankhwala ena alionse kuphatikiza ndi insulin isofan.

Pankhani yoyendetsera mothandizidwa ndi pampu kulowetsedwa, Apidra SoloStar sayenera kusakanikirana ndi ma sol sol ndi kukonzekera kwina kwa insulin.

Ma Analogs a Apidra SoloStar ndi awa: Apidra, Insulin Lyspro, Humalog, Brinsulrapi MK 40 U / ml, Actrapid HM Penfill, etc.

Migwirizano ndi magwiritsidwe akusungidwa

Sungani pamalo amdima pa kutentha kwa 2-8 ° C. Osamawuma. Pewani kufikira ana.

Moyo wa alumali ndi zaka 2.

Mukatha kugwiritsa ntchito koyamba, moyo wa alumali wa Apidra SoloStar mu cholembera yotayika ndi masabata anayi. Zingwe zotayirira mutangoyamba kugwiritsa ntchito ziyenera kusungidwa pamatenthedwe mpaka 25 ° C pamalo otetezedwa ndi kuwala komanso kwa ana.