Tresiba insulin - momwe mungagwiritsire ntchito mankhwalawa, mtengo

Choyamba, kugwiritsa ntchito insulin, muyenera kusankha mlingo wofanana. Izi zitha kutenga nthawi.

Tresiba ndi insulin. Ngati dotolo asankha mlingo woyenera, ndiye kuti m'masiku 5 ayende bwino, zomwe zimapatsanso ufulu wogwiritsa ntchito Tresib.

Opanga amati mankhwalawa amatha kugwiritsidwa ntchito nthawi iliyonse masana. Koma madotolo amalimbikitsabe kutsatira mtundu wa mankhwalawo, kuti asapeputse "bwino".

Tresiba ikhoza kugwiritsidwa ntchito mobisa, koma ndizoletsedwa kulowa m'mitsempha, chifukwa cha izi kutsika kwamphamvu m'magazi kumayamba.

Sizoletsedwa kulowa mu minofu, chifukwa nthawi ndi kuchuluka kwa zochulukirapo zimasiyana. Ndikofunikira kulowa kamodzi patsiku nthawi imodzi, makamaka m'mawa.

Mlingo woyamba wa insulini: mtundu wachiwiri wa matenda ashuga - mtundu woyamba wa magawo 15 ndipo kenako kusankhidwa kwa mlingo wake, lembani shuga imodzi - kuti iperekedwe kamodzi patsiku ndi insulin yotsalira, yomwe ndimatenga ndi chakudya ndipo pambuyo pake kusankha kwanga.

Malo oyambira: ntchafu ya m'mbali, pamapewa. Onetsetsani kuti mwasintha jakisoni, monga chifukwa cha kukulira kwa milomo.

Wodwala yemwe sanamwe insulin m'mbuyomu, mogwirizana ndi malangizo ogwiritsira ntchito Tresib, ayenera kutumikiridwa kamodzi patsiku m'magawo 10.

Ngati munthu wasamutsidwa kuchokera ku mankhwala ena kupita ku Teshiba, ndiye kuti ndimasanthula kuchuluka kwa shuga m'magazi ndikusintha komanso masabata oyambilira kumwa mankhwala atsopano. Pangakhale kofunikira kusintha nthawi ya makonzedwe, muyeso wa kukonzekera kwa insulin.

Mukasinthira ku Tresiba, munthu ayenera kukumbukira kuti insulin yomwe wodwalayo anali ndi njira yoyambira, ndiye posankha kuchuluka kwake, mfundo ya "unit to unit" iyenera kuonedwa ndikusankhidwa koyimira pawokha.

Mukasinthira ku insulin yokhala ndi matenda a shuga 1, mfundo ya "unit to unit" imagwiritsidwanso ntchito. Ngati wodwalayo ali ndi makonzedwe awiri, ndiye kuti insulini imasankhidwa payokha, ndikotheka kuti muchepetse mulingo ndi zotsatirazi za shuga.

Ndikofunikira kumangodula kamodzi kamodzi patsiku, makamaka nthawi imodzi. Anthu omwe ali ndi mtundu wachiwiri wa matenda ashuga amafunika kuphatikiza kugwiritsa ntchito mankhwala a hypoglycemic, ndipo odwala omwe ali ndi mtundu woyamba wa shuga ali ndi fomu yayitali yophatikizidwa ndi yochepa. Kutengera ndi momwe wodwalayo alili, dokotala amasankha mlingo woyenera wa mankhwalawo.

Pa nthawi yoyembekezera komanso yoyamwitsa

Amayi oyembekezera komanso oyembekezera amayamwa mankhwalawa moyenera.

Contraindication ndi Kusamala

Kusalolera kapena Hypersensitivity payekha.

Kuchita mankhwala osokoneza bongo

Mankhwala omwe amawonjezera kufunika kwa insulin: mahomoni a chithokomiro, corticosteroids, mahomoni ogonana achikazi ngati gawo la njira zakulera za pakamwa komanso anabolic androgenic steroids. Zinthu zomwe zimachepetsa kufunika kwa mahomoni a pancreatic: mankhwala ochepetsa shuga m'magazi, monoamine oxidase inhibitors, beta-blockers, salicylates, sulfonamides.

Nthawi zambiri amawonetsedwa mawonekedwe a ziwengo, zizindikiro za hypoglycemia, nthawi zambiri - lipodystrophy.

Bongo

Contraindication

Wodwala wosakwana zaka 18.
Nthawi ya mimba yonse.
Nthawi yoyamwitsa.
Kusagwirizana ndi insulin yokha kapena zowonjezera zina mwa mankhwala a Tresib. Pambuyo pa kukhazikitsidwa kwa mankhwalawa, imayamba kuchita mphindi 30-60. Zotsatira za mankhwalawa zimatha maola 40, ngakhale sizikudziwika ngati zili zabwino kapena zoyipa, ngakhale opanga akunena kuti iyi ndi mwayi wabwino. Ndikulimbikitsidwa kulowa tsiku lililonse nthawi yomweyo. Koma ngati, komabe, wodwalayo amamwa tsiku lina lililonse, ayenera kudziwa kuti mankhwalawa omwe adapereka satha masiku awiri, ndipo akhoza kuiwalanso kapena kusokonezeka ngati adabaya jakisoni panthawi yoikika. Insulin imapezeka mu zolembera zotayika komanso makatiriji omwe amaikidwa mu cholembera. Mlingo wa mankhwalawa ndi magawo a 150 ndi 250 mu 3 ml, koma amatha kusiyanasiyana kutengera dziko ndi dera.

Chizindikiro chachikulu chogwiritsa ntchito mankhwalawa ndi shuga kwa akulu. Mankhwala ena amagwiritsidwa ntchito kwa ana.

Poyamba, Tresiba (dzina lamalonda Degludeka) adapangira mtundu wa 2 matenda ashuga, koma atatha kafukufuku adaloledwa kugwiritsa ntchito mtundu 1 tsiku lililonse.

Mankhwalawa amasiyana ndi mankhwala ena pakanthawi kochepa. Izi zimathandiza odwala kupewa chiopsezo cha hypoglycemia.

Izi zimachitika chifukwa chakuti tinthu tating'onoting'ono ta timadzi tomwe timalumikizidwa, tomwe timapangidwa ndi mankhwala omwe ali ofanana ndi insulin yaumunthu momwe tingathere, amaphatikizidwa kukhala molekyulu imodzi yayikulu. Mgwirizanowu umachitika pambuyo pa jakisoni pansi pa khungu la munthu.

Katundu wina amapangira wodwalayo. Mukamachita ntchito m'thupi mumakhala zinyalala zomwe zimachitika pang'onopang'ono.

Zotsatira zake, munthu amapatsidwa pafupipafupi izi mpaka jekeseni wotsatira.

Komanso, insulin Degludek (yotchedwa Tresiba) imakuthandizani kuti muchepetse kuchuluka kwa shuga patsiku. Imasunga magwiridwe antchito pafupifupi ofanana.

Ndi mankhwalawa, dokotala angakwaniritse shuga wochepa m'mankhwala anu. Izi zimakuthandizani kuti mukhale ndi moyo wabwino wa odwala komanso zotsatira zake zimatalikitsa moyo wawo.

Kupatula apo, shuga ochuluka m'magazi amakhudza ziwalo zonse zamkati mwa munthu.

Monga mankhwala aliwonse, insulin Degludec imakhala ndi zotsutsana. Mankhwala sangathe kugwiritsidwa ntchito pazotsatira zotsatirazi:

Ngati mayi atenga mwana kapena kumudyetsa, motere, mlingo ndi mankhwalawa amadziwitsidwa poganizira moyo wochepa wa madokotala angapo.
Ngati wodwalayo sanafike zaka 18. Mankhwala ena amagwiritsidwa ntchito kwa ana.
Ngati odwala ali ndi matupi awo sagwirizana ndi zinthu zomwe zimagwiritsidwa ntchito pena mankhwala ena owonjezera. Dokotala amapanga nthawi ina poganizira izi.

Simungathe kugwiritsa ntchito mankhwalawa intravenously, makina okhawo opanikizika ndi omwe amavomerezeka.

Malangizo ogwiritsira ntchito

Zotsatira za pharmacological

Monga mitundu ina ya insulin, Tciousba imamangiriza ma receptors, imapangitsa kuti maselo agwire glucose, imapangitsa kaphatikizidwe ka mapuloteni komanso kuchuluka kwa mafuta, ndikuletsa kuchepa kwa thupi. Jakisoni utatha, "zotupa" zimapangidwa pansi pa khungu, pomwe mamolekyulu a insludec amamasulidwa pang'ono ndi pang'ono. Chifukwa cha limagwirira ili, mphamvu ya jekeseni iliyonse imakhala mpaka maola 42.

Zizindikiro zogwiritsidwa ntchito

Type 1 ndi matenda ashuga 2, omwe amafunikira chithandizo cha insulin. Itha kulembedwa kwa ana azaka zoyambira 1. Kuti minofu yanu ikhale yolimba komanso yokhazikika, onani nkhani "Kuchiritsa matenda A shuga 1 kapena" Insulin ya Type 2 Diabetes ". Dziwani kuti ndi magawo angati a insulin omwe amayamba kulowetsedwa.

Mukabayidwa pokonzekera Trecib, monga mtundu wina wa insulin, muyenera kutsatira zakudya.

Contraindication	Degludec insulin tsankho. Thupi lawo siligwirizana kwa omwe amapeza jakisoni. Palibe zotsatira za maphunziro azachipatala a ana osakwana chaka chimodzi, komanso amayi apakati.
Malangizo apadera	Werengani nkhani yokhudza momwe kupsinjika, matenda opatsirana, zochitika zolimbitsa thupi, ndi zina zimakhudzira insulin. Werengani momwe mungaphatikizire shuga ndi insulin ndi mowa. Jakisoni wa Tresib akhoza kuphatikizidwa ndikumwa mapiritsi a metformin (Glucofage, Siofor), komanso mankhwala ena a matenda a shuga a 2.

Mlingo

Mlingo woyenera wa insulin, komanso ndandanda ya jakisoni, iyenera kusankha payokha. Momwe mungachite izi - werengani nkhani "Kuwerengera Mlingo wa insulin yayitali ma jakisoni usiku ndi m'mawa." Mwapadera, tikulimbikitsidwa kupatsa mankhwala Tresib kamodzi patsiku. Koma Dr. Bernstein adalangiza kuti agawe mwanjira ya tsiku ndi tsiku jekeseni awiri. Izi zimachepetsa shuga m'magazi.

Zotsatira zoyipa

Zotsatira zoyipa kwambiri komanso zoopsa ndi shuga m'magazi (hypoglycemia). Unikani zisonyezo zake, njira zopewera, chisamaliro chazangu zadzidzidzi. Tresiba insulin imakhala ndi chiopsezo chocheperako cha hypoglycemia kuposa Levemir, Lantus ndi Tujeo, ndipo makamaka, mankhwala osakhalitsa komanso a ultrashort. Kuyabwa ndi redness pa malo jakisoni ndizotheka. Zotsatira zoyipa za thupi sizimachitika. Lipodystrophy imatha kuchitika - chinthu chovuta chifukwa chophwanya kukhudzidwa kwa malo ena obayira.

Anthu ambiri odwala matenda ashuga omwe amathandizidwa ndi insulin sawona kuti ndizotheka kupewa kukhala ndi vuto la hypoglycemia. M'malo mwake, izi siziri choncho. Mutha kusunga shuga wokhazikika ngakhale ndi matenda oopsa a autoimmune. Ndipo makamaka, ndi matenda a shuga a 2 ochepa. Palibe chifukwa chakuwonjezera kuchuluka kwa shuga m'magazi anu kuti mudzilimbitse nokha motsutsana ndi hypoglycemia yoopsa. Onerani kanema pomwe Dr. Bernstein akufotokoza nkhaniyi. Phunzirani momwe mungasinthire zakudya zopatsa thanzi komanso mulingo wa insulin.

Mfundo ya Treshiba yogwira ntchito

Kwa odwala matenda ashuga amtundu 1, kubwezeretsanso insulin yosowa ndi jakisoni wa ma hormone ofunikira ndikofunikira. Ndi mtundu wa 2 wodwala matenda a shuga, chithandizo cha insulini ndiye chothandiza kwambiri, chovomerezeka komanso chodula. Chochitika chokhacho chofunikira kwambiri pakukonzekera insulin ndi chiopsezo cha hypoglycemia.

Kugwa kwa shuga ndizowopsa usiku, chifukwa zimatha kupezeka mochedwa kwambiri, kotero zofunika zachitetezo kwa ma insulin aatali zikupitilira kukula. Mu shuga mellitus, wokhazikika komanso wolimba, akapanda kusintha mphamvu ya mankhwalawo, amachepetsa chiopsezo cha hypoglycemia pambuyo pa kukhazikitsa.

Insulin Tresiba imakwaniritsa zolinga izi:

Mankhwalawa ndi a gulu latsopano lama insulini lalitali-lalitali, chifukwa limagwira ntchito motalikirapo kuposa ena onse, maola 42 kapena kupitilira apo. Izi ndichifukwa choti mamolekyulu osinthidwa "amamatira" pansi pa khungu ndipo amatuluka kulowa m'magazi pang'onopang'ono.
Maola 24 oyambilira, mankhwalawa amalowa m'magazi momwemonso, zotsatira zake zimachepa bwino. Peak kuchitapo sikikupezeka konse, mbiriyo ndiyotsika.
Majakisoni onse amachita chimodzimodzi. Mutha kukhala otsimikiza kuti mankhwalawa amagwiranso ntchito monga dzulo. Zotsatira za Mlingo wofanana ndizofanana kwa odwala azaka zosiyanasiyana. Kusintha kwa machitidwe ku Tresiba ndi kokwana kanayi kuposa kwa Lantus.
Tresiba imakhumudwitsa 36% hypoglycemia kuposa ma insulin anthawi yayitali kuyambira nthawi ya 0:00 mpaka 6:00 ndi mtundu wa 2 shuga. Ndi matenda amtundu 1, phindu silodziwikiratu, mankhwalawa amachepetsa chiwopsezo cha nocturnal hypoglycemia ndi 17%, koma amachulukitsa chiopsezo cha hypoglycemia masana ndi 10%.

Chosakaniza chophatikizika cha Tresiba ndi degludec (munjira zina - degludec, the English degludec). Uku ndikuchita kuphatikizanso kwa insulin, momwe ma molekyulu amasinthidwa. Monga mahomoni achilengedwe, imatha kumangiriza ma cell receptors, imalimbikitsa kudutsa kwa shuga kuchokera m'magazi kulowa m'magazi, ndikuchepetsa kupanga shuga m'chiwindi.

Chifukwa cha kapangidwe kake kosintha pang'ono, insuliniyi imapangika kuti ikhale yolimba mu cartridge. Pambuyo pakuyambitsa pansi pa khungu, imapanga mtundu wamtundu wa depot, womwe umakamizidwa pang'onopang'ono komanso mwachangu, womwe umatsimikizira kukhathamiritsa kwa mahomoni m'magazi.

Kutulutsa Fomu

Mankhwala amapezeka m'mitundu itatu:

Tciousba Penfill - makatoni okhala ndi yankho, kugwiritsidwa ntchito kwa mahomoni mwa iwo ndi mulingo wanthawi zonse - U Insulin imatha kusindikizidwa ndi syringe kapena kumaikidwa makatiriji mu zolembera za NovoPen ndi zina zofanana.
Tresiba FlexTouch yokhala ndi ndende U100 - syringe zolembera momwe makilogalamu 3 ml amakwezedwa. Cholembera chitha kugwiritsidwa ntchito mpaka insulini momwemo itatha. Cartridge m'malo sichinaperekedwe. Mlingo wa gawo - 1 unit, mlingo waukulu kwambiri wa kuyambitsa 1 - 80 mayunitsi.
Tresiba FlexTouch U200 - omwe adapangidwa kuti akwaniritse chosowa chowonjezereka cha mahomoni, nthawi zambiri awa ndi odwala omwe ali ndi matenda osokoneza bongo omwe ali ndi vuto lalikulu la insulin. Kuchuluka kwa insulin kumachulukitsa, kotero kuchuluka kwa yankho lomwe limayambitsidwa pansi pa khungu ndilochepa. Ndi cholembera, mutha kulowa kamodzi mpaka mayunitsi 160. mahomoni mukuwonjezeka kwa 2 mayunitsi. Makatoni okhala ndi kuchuluka kwa Refludec Palibe chifukwa chomwe mungatulutsire ma cholembera oyambilira ndi kuyika enawo, chifukwa izi zidzapangitsa kuti pakhale mankhwala osokoneza bongo okwanira komanso hypoglycemia yayikulu.

Kutulutsa Fomu

The kuchuluka kwa insulin mu mayunitsi mu ml	Insulin mu 1 makatoni, unit
The kuchuluka kwa insulin mu mayunitsi mu ml	ml	mayunitsi
Chifwamba	100	3	300
FlexTouch	100	3	300
FlexTouch	200	3	600

Ku Russia, mitundu yonse itatu ya mankhwalawa amalembetsedwa, koma m'masitolo am'magazi amapereka kwambiri Tresib FlexTouch yokhazikika. Mtengo wa Treshiba ndiwokwera kuposa wazomera zina zazitali. Paketi yokhala ndi zolembera 5 za ma syringe (15 ml, ma unit 4500) imakhala ndalama kuchokera 7300 mpaka 8400 rubles.

Kuphatikiza pa degludec, Tresiba imakhala ndi glycerol, metacresol, phenol, zinc acetate. Acidity yothetsera imayandikira ndale chifukwa chowonjezera hydrochloric acid kapena sodium hydroxide.

Zisonyezo zakusankhidwa kwa Tresiba

Mankhwalawa amagwiritsidwa ntchito limodzi ndi ma insulin othamanga othandizira am'magazi a mitundu yonse ya matenda a shuga. Ndi matenda 2 a mtundu, ndi insulin yayitali yokha yomwe ingafotokozedwe gawo loyamba. Poyamba, malangizo a ku Russia omwe amagwiritsidwa ntchito adalola kugwiritsa ntchito Treshiba kokha kwa odwala akuluakulu. Pambuyo pa maphunziro omwe amatsimikizira chitetezo chake chamoyo chokula, zosintha zidapangidwa ku malangizowo, ndipo tsopano zimalola kuti mankhwalawa azigwiritsidwa ntchito mwa ana kuyambira chaka chimodzi.

Mphamvu ya degludec pa mimba komanso kukula kwa makanda mpaka chaka sichinaphunzirepo, chifukwa chake, Tresib insulin sinafotokozedwe m'magulu awa a odwala. Ngati wodwala matenda ashuga adanenanso kale kuti thupi lawo siligwirizana ndi Refludec kapena mbali zina za yankho, ndikofunikanso kukana chithandizo ndi Tresiba.