Matenda a shuga ndi matenda oopsa omwe amatha kudalira insulini (mtundu 1) kapena osadalira insulini (mtundu 2). Potsirizira pake, matendawa amathandizidwa bwino mothandizidwa ndi othandizira a hypoglycemic komanso zakudya zapadera. Koma ndi mtundu woyamba wa matenda komanso matenda amtundu 2 atayamba, chithandizo cha insulin sichingagawidwe nawo.
Nthawi zambiri, odwala omwe ali ndi shuga wambiri mumagazi amapatsidwa insulin Glulizin. Ili ndi yankho loyera la jakisoni, chinthu chachikulu chomwe ndi analogue ya sungunuka wa insulin yaumunthu, chopangidwa pogwiritsa ntchito genetic engineering.
Mankhwala ali ndi kufupikitsa komwe kumapangitsa kutsika kwa shuga m'magazi. Apidra SoloStar ndi Apidra ndi omwe ali ndi njira, zomwe zimaphatikizira insulini Glulisin.
Pharmacological zotsatira ndi pharmacokinetics
Njira yothetsera vutoli imakhala ndi kufupikitsa kwakanthawi. Kuphatikiza apo, imayendetsa njira ya kuyamwa kwa glucose mwa zotumphukira (mafuta, minofu yamatumbo), kulepheretsa kupanga kwa shuga mu chiwindi.
Komanso, mankhwalawa amathandizira kaphatikizidwe ka mapuloteni, amalepheretsa mapuloteni ndi lipolysis mu adipocytes. Pambuyo pothandizidwa ndi subcutaneous, kutsika kwa shuga kumachitika pambuyo pa mphindi 10-20.
Pankhani ya kayendetsedwe ka iv, mphamvu ya hypoglycemic ikufanana ndi zochita za insulin ya anthu. Chifukwa chake, pankhani yothandiza, 1 IU ya insulini Glulisin ndi wofanana ndi 1 IU ya insulle ya anthu sungunuka.
Poyerekeza ndi insulin yaumunthu, Glulisin amalowetsedwa mwachangu kwambiri. Izi zimachitika chifukwa cholowa m'malo mwa asparagine amino acid (3B) ndi lysine, komanso lysine (malo 29B) ndi glutamic acid.
Mafuta pambuyo pa sc makonzedwe:
- pa ntchafu - sing'anga;
- m'mimba khoma - mwachangu;
- mapewa - apakatikati.
Mtheradi bioavailability ndi 70%. Tikayambitsidwa m'malo osiyanasiyana, zimakhala zofanana ndipo zimakhala ndi kusiyana kochepa pakati pa odwala (kusiyanasiyana kwa 11%).
Mukamayendetsedwera pang'onopang'ono ndi matenda a shuga 1, 015 U / kg TCmax ndi 55 min., Ndipo kg Cmax ndi 80.7-83.3 μU / ml. Mu mtundu wachiwiri wa matenda, pambuyo poti mankhwalawa amapezeka pa 0,2 PESCES / kg, Cmax ndi 91 mcU / ml.
Pakufalikira kwazinthu, nthawi yokwanira yowonekera ndi 98 min. Ndi on / kumayambiriro, voliyumu yogawa ndi 13 malita, T1 / 2 - 13 Mphindi. AUC - 641 mg x h / dl.
Ma pharmacokinetics mu odwala matenda ashuga osakwana zaka 16 okhala ndi mtundu woyamba wa matenda ali chimodzimodzi ngati akulu. Ndi sc management T1 / 2 ndi kuyambira 37 mpaka 75 mphindi.
Malangizo ogwiritsira ntchito mankhwalawa
Insulin Glulisin imayang'aniridwa mosiyanasiyana, mlingo umasankhidwa payekha kwa wodwala aliyense. Kuvulala kumachitika mu mphindi 0 mpaka 15. musanadye kapena mutamaliza kudya.
Glulisin amagwiritsidwa ntchito pochiritsa regimens, kuphatikizapo kugwiritsa ntchito insulin yapakatikati kapena yayitali, kapena mawonekedwe awo. Komanso, mankhwalawa amatha kugwiritsidwa ntchito limodzi ndi mankhwala omwe ali ndi vuto la hypoglycemic, omwe amagwiritsidwa ntchito pakamwa.
Njira yothetsera vutoli imayendetsedwa ngati jakisoni wothandizidwa kapena kulowetsedwa pogwiritsa ntchito insulin. Jakisoni amachitika m'mbali mwa phewa, ntchafu, khomo lam'mimba lakunja. Ndipo kuyambitsa ndalama kudzera kulowetsedwa kosalekeza kumachitika mu peritoneum.
Ma zone a jakisoni ndi ma infusions ayenera kusinthidwa nthawi iliyonse. Kuthamanga kwa mayamwidwe, kuyambira ndi nthawi ya zotsatirazi kumatsimikiziridwa ndi zinthu zingapo (zolimbitsa thupi, malo oyang'anira). Ponyowa mwachangu, mankhwalawa amayenera kuponyedwa m'malo oyambira kukhoma pamimba.
Ndikofunika kusamala kuti insulin Glulisin isalowe m'mitsempha yamagazi. Chifukwa chake, aliyense wodwala matenda ashuga ayenera kukhala wodalirika popereka insulin. Pambuyo pa jekeseni, tsamba la jekeseni limaletsedwa kutikita minofu.
Glulisin amaloledwa kuphatikizidwa ndi Isofan (insulin yaumunthu), koma Glulisin ayenera kukokedwa mu syringe yoyamba. Kuwongolera kwa SC kuyenera kuchitidwa mukangosakaniza njira. Pankhaniyi, osakaniza a Isofan ndi Glulisin amaletsedwa kutumizidwa kudzera m'mitsetse.
Ngati insulin Glulisin imayendetsedwa pogwiritsa ntchito pampu, ndiye kuti kitacho chimayenera kusinthidwa maola 4 aliwonse, kutsatira malamulo a antiseptic. Ndi kulowetsedwa kwa kayendetsedwe ka mankhwala, mankhwalawa sayenera kukhala osakanikirana ndi mayankho ena kapena ma insulin.
Pankhani yogwiritsa ntchito pampu molakwika kapena kuphwanya ntchito yake, matenda ashuga a ketoacidosis, hyperglycemia kapena ketosis angayambike. Popewa kupezeka kwa zinthu ngati izi, musanachite njirayi, muyenera kuphunzira malamulo mosamala ndi kuwerengera.
Musanagwiritse ntchito yankho, muyenera kuyang'ana kusinthasintha kwake, utoto wake ndikuonetsetsa kuti mulibe tinthu tachilendo. Ngati mankhwalawo ndi amtambo, achikuda kapena osayera, ndiye kuti nzoletsedwa kugwiritsa ntchito.
Contraindication, mavuto, bongo
Insulin Glulizin sagwiritsidwa ntchito pochiza ana osaposa zaka 6, ndi hypoglycemia ndi hypersensitivity ku zigawo zake. Zotsatira zoyipa kwambiri ndizo hypoglycemia. Mawonekedwe amtundu wakhungu ndi kusokonezeka kwa metabolic ndizothekanso.
Nthawi zina zimakhala ndi vuto la neuropsychiatric, monga kugona, kukwiya kwambiri, kufooka kolimba, kukokana, komanso nseru. Mutu, kusowa kwa chidwi, kusokonezeka kwa malingaliro ndi kusokonezeka kowonekera kumawonekeranso.
Nthawi zambiri, musanafike vuto la neuropsychiatric, zizindikiro za kutsutsa kwa adrenergic zimachitika. Uku ndi njala, kusakwiya, tachycardia, chisangalalo chamanjenje, thukuta lozizira, nkhawa, kufinya khungu ndi kunjenjemera.
Ndizofunikira kudziwa kuti kuukira kwamphamvu kwa hypoglycemia, komwe kumachitika mobwerezabwereza, kumabweretsa kuwonongeka kwa NS. Komanso, nthawi zina, izi zitha kubweretsa imfa.
Kuphatikiza pa kutsika kwakukulu kwa shuga, zovuta zakomweko zimatha kupezeka m'malo omwe jekeseni adapangidwira. Izi zimaphatikizapo hyperemia, kutupa ndi kuyabwa, nthawi zambiri mawonetseredwe awa amazimiririka pawokha pakulandila chithandizo. Nthawi zina, chifukwa chosagwirizana ndi kusintha kwa malo a insulin, wodwala matenda ashuga amatha kukhala ndi lipodystrophy.
Zizindikiro zokhudzana ndi hypersensitivity ndizothekanso:
- kuyabwa
- urticaria;
- dermatitis;
- chifuwa cholimba;
- kutsutsika.
Matendawa:
Pankhani ya bongo, hypoglycemia yamphamvu zosiyanasiyana ikhoza kuchitika. Ndi kuchepa pang'ono kwa shuga m'magazi, wodwalayo ayenera kumwa zakumwa kapena zinthu zokhala ndi shuga.
M'mavuto akulu ndi kuwonongeka kwa chikumbumtima, s / c kapena mu / m amathandizidwa ndi Dextrose kapena Glucagon. Wodwala akayambanso kuzindikira, ayenera kudya zakudya zopatsa mphamvu, zomwe zingapewe kuyambiranso.
Kuchita ndi mankhwala ena ndi malangizo apadera
Pamene insulin Glulisin ikaphatikizidwa ndi ACE / MAO zoletsa, Disopyramide, fibrate, sulfonamides, salicylates ndi Propoxyphene, zotsatira za hypoglycemic zimakulitsidwa ndipo mwayi wa hypoglycemia umakulanso.
Kuphatikiza kwa insulin ndi proteinase inhibitors, Danazole, antipsychotic, Salbutamol, Terbutaline, isoniazids, Epinephrine, Diazoxide, diuretics, Somatropin ndi zotuluka mu phenothiazine zimapangitsa kuti zotsatira za hypoglycemic zithe. Clonidine, beta-blockers, Mafuta amchere ndi lifiyamu amachepetsa mphamvu ya insulin Glulisin. Ndipo kuphatikiza mankhwala pamodzi ndi Pentamidine kumatha kupangitsa onse kukhala hypoglycemia ndi hyperglycemia.
Ndemanga za anthu odwala matenda ashuga akuti mukamagwiritsa ntchito ntchito zomwe zikuwonetsa ntchito zomvera chisoni, zizindikiro za adrenergic Reflex activation zitha kutsitsidwa. Mankhwalawa amaphatikizapo clonidine ndi guanethidine.
Ngati wodwala wasamutsidwa kupita ku mtundu wina wa insulin kapena mankhwala kuchokera kwa wopanga watsopano, ndiye kuti izi ziyenera kuchitika moyang'aniridwa ndi achipatala. Ndikofunika kukumbukira kuti mulingo woyipa kapena kusiya kwa mankhwala a insulini amatha kukhala ndi matenda ashuga a ketoacidosis ndi hypoglycemia.
Komanso, mikhalidwe ina imatha kusintha kapena kupanga zizindikiro za hypoglycemia kutchulidwa kochepa. Zinthu ngati izi:
- kukhalitsa kwa shuga;
- kulimbitsa mankhwala ndi insulin;
- kusamutsa kwa wodwala kuchokera ku chinyama kupita ku hormone ya munthu;
- kumwa mankhwala ena;
- matenda ashuga a m'mimba.
Mukamasintha zakudya kapena kuchita masewera olimbitsa thupi ndikofunikira kusintha mlingo wa insulin. Komabe, ngati mankhwalawa amathandizidwa pambuyo pa masewera, ndiye kuti mwayi wa hypoglycemia ndi wokwera.
Pankhani yogwiritsa ntchito insulini Glulisin pa nthawi yoyembekezera, njira yothandizira mankhwalawa iyenera kufikiridwa mosamala kwambiri, chifukwa glycemia imatha kukhala mtundu 2 wa shuga komanso woyamba. Kuphatikiza apo, m'miyezi itatu yoyambirira ya kubereka komanso pambuyo pobereka, mlingo wa insulin nthawi zambiri umachepetsedwa. Panthawi yoyamwitsa, kusintha kwa mankhwalawa kungafunenso.
Mtengo wa mayankho a sc pofikira insulin Glulisin umachokera ku 1720 mpaka 2100 rubles.
Kanemayo munkhaniyi akuwonetsa momwe angabayire insulin mosakwiya.
