Kugwira kwathunthu kwa thupi la munthu ndikosatheka popanda insulini. Ndi mahomoni ofunikira pokonza shuga, yemwe amabwera ndi chakudya, mu mphamvu.
Pazifukwa zosiyanasiyana, anthu ena ali ndi vuto la insulin. Poterepa, pali zofunika zakukhazikitsa mahomoni opanga thupi. Chifukwa chaichi, insulin Degludek imagwiritsidwa ntchito nthawi zambiri.
Mankhwala ndi insulin yaumunthu yomwe imakhala ndi zotsatira zowonjezera zazitali. Chogulitsachi chimapangidwa kudzera mu mitundu iwiri ya michere ya DNA pogwiritsa ntchito Saccharomyces cerevisiae.
Pharmacology
Mfundo za zomwe Degludek insulin imachita ndi zofanana ndi zomwe zimachitika m'thupi la munthu. Kutsitsa kwa shuga kumachitika chifukwa cholimbikitsa njira yogwiritsira ntchito shuga pogwiritsa ntchito minofu pambuyo pomangiriza ku mafuta ndi ma cell cell receptors ndipo nthawi yomweyo kutsitsa kuchuluka kwa shuga ndi chiwindi.
Pambuyo pobayira limodzi yankho mkati mwa maola 24, imakhala ndi zotsatira zofananira. Kutalika kwa zotsatirazi ndi maola opitilira 42 mkati mwa njira yothandizira. Ndizofunikira kudziwa kuti ubale wotsogola unakhazikitsidwa pakati pakuwonjezeka kwa kuchuluka kwa mankhwalawo komanso zotsatira zake zonse za hypoglycemic.
Panalibe kusiyana kwakukulu mwachipatala mu pharmacodynamics ya Degludec insulin pakati pa odwala ndi achinyamata okalamba. Komanso, kupanga ma antibodies kupita ku insulin sikunapezeke pambuyo pothandizidwa ndi Deglyudec kwa nthawi yayitali.
Kukhalitsa kwa mankhwala kumachitika chifukwa cha kapangidwe kake ka molekyu. Pambuyo pazoyang'anira sc, mankhwala osokoneza bongo osungunuka amapangidwa, omwe amapanga mtundu wa "depot" wa insulin m'matumbo a subipaneous adipose.
Ma Multihexamers amadzipatula pang'onopang'ono, zomwe zimapangitsa kuti amasulidwe a ma monmors apangidwe. Chifukwa chake, kuyenda pang'onopang'ono komanso kotenga nthawi yayitali kulowa mumtsinje wamagazi kumachitika, komwe kumatsimikizira zochitika zazitali komanso zosasinthika zokhala ndi shuga.
Mu plasma, CSS imatheka patadutsa masiku awiri kapena atatu jekeseni. Kugawidwa kwa mankhwalawa ndi motere: ubale wa Degludek ndi albin -> 99%. Ngati mankhwalawa amaperekedwa pang'onopang'ono, ndiye kuti magazi ake onse amakhala olingana ndi Mlingo womwe umaperekedwa pakachiritsi.
Kusweka kwa mankhwalawo ndikofanana ndi zomwe zimapangitsa insulin ya anthu. Ma metabolites onse omwe adapangidwa munjira imeneyi sagwira ntchito.
Pambuyo pa sc makonzedwe a T1 / 2 amatsimikiza ndi nthawi ya mayamwidwe kuchokera subcutaneous minofu, yomwe ili pafupifupi maola 25, mosasamala kanthu.
Gender ya odwala sichikhudza pharmacokinetics ya insulin Degludec. Kuphatikiza apo, palibe kusiyana kwakanthawi kachipatala kamankhwala othandizira odwala, odwala okalamba komanso odwala matenda ashuga omwe ali ndi vuto la chiwindi ndi impso.
Ponena za ana (azaka 6 mpaka 11) ndi achinyamata (azaka 12-18) omwe ali ndi matenda a shuga 1, ma pharmacokinetics a insulin Degludec ndiwofanana ndi odwala achikulire. Komabe, ngati jakisoni imodzi ya mankhwalawa odwala omwe ali ndi matenda a shuga 1, kuchuluka kwa mankhwalawa kwa odwala omwe ali ndi zaka zosaposa 18 ndi akulu kuposa a odwala matenda ashuga okalamba.
Ndizofunikira kudziwa kuti kugwiritsidwa ntchito mosalekeza kwa Degludek insulini sikukhudza ntchito yobereka komanso sikukuwononga thupi.
Ndipo chiŵerengero cha mitogenic ndi metabolic zochita za Degludek ndi insulin ya anthu ndizofanana.
Malangizo ogwiritsira ntchito mankhwalawa
Njira yothetsera vutoli iyenera kuperekedwa kokha pakhungu, ndipo iv ikaperekedwa ikuphatikizidwa. Komanso, kupereka khola la hypoglycemic, jekeseni imodzi patsiku ndikokwanira.
Ndizachilendo kuti Degludec insulin imagwirizana ndi mapiritsi onse ochepetsa shuga ndi mitundu ina ya insulin. Chifukwa chake, chida chingagwiritsidwe ntchito ngati monotherapy kapena ngati gawo la chithandizo chophatikiza.
Mlingo woyambirira wa mankhwalawa ndi magawo khumi. Pambuyo pang'onopang'ono kusintha kwa mankhwalawa kumachitika molingana ndi umunthu wa wodwalayo (kulemera, jenda, zaka, mtundu ndi njira ya matendawa, kupezeka kwa zovuta).
Ngati wodwala matenda ashuga alandila mtundu wina wa insulini kapena wasamutsidwa ku Degludek (Tresib), ndiye kuti mlingo woyambirira amawerengedwa molingana ndi mfundo ya 1: 1. Chifukwa chake, kuchuluka kwa insulin ya basal iyenera kukhala yofanana ndi ya Degludek insulin.
Ngati munthu wodwala matenda ashuga ali mu machitidwe owerengeka a insulin kapena wodwala ali ndi glycated hemoglobin yochepera 8%, ndiye kuti mankhwalawa amasankhidwa payekhapayekha. Nthawi zambiri ndikofunikira kuti muchepetse muyezo komanso kukonza kwake.
Ndemanga za madotolo zimatsimikiza kuti ndibwino kugwiritsa ntchito insulin yaying'ono. Izi ndizofunikira chifukwa ngati mutanthauzira voliyumuyo mu analogues, ndiye kuti mupeze glycemia yomwe mukufuna, mumafunikiranso mlingo wotsika wa mankhwalawo.
Kuyesedwa kwotsatira kwa kuchuluka kwa insulin kumatha kuchitika kamodzi masiku 7.
Kutengeka kumatengera kuchuluka kwa miyeso iwiri yapitayi ya shuga.
Contraindication, bongo, kugwiritsa ntchito mankhwala
Degludec insulin satengedwa muubwana, komanso ndi tsankho la munthu pazigawo, panthawi ya mkaka wa m'mawere ndi pakati.
Palibe mlingo weniweni womwe ungayambitse hypoglycemia, koma matendawa amatha kukula pang'onopang'ono. Ndikangodonthetsa shuga pang'ono, wodwalayo ayenera kumwa chakumwa chokoma kapena kudya chinthu chomwe chili ndi chakudya chambiri.
Mu hypoglycemia yayikulu, ngati wodwalayo sakudziwa, amapaka jakisoni kapena shuga. Ngati wodwala atagwiritsa ntchito glucagon sayambiranso khungu, ndiye kuti amapatsidwa dextrose, ndipo ngongoleyo imaperekedwa kwa chakudya chokhala ndi chakudya.
Kufunika kwa insulin kumacheperachepera pamene:
- ARG ya peptide-1;
- mapiritsi a hypoglycemic;
- MAO / ACE zoletsa;
- osasankha beta blockers;
- sulfonamides;
- anabolic steroids;
- salicylates.
Liazide diuretics, njira yolerera ya mahomoni apakamwa, Danazol, GCS, Somatropin, sympathomimetics, mahomoni a chithokomiro amathandizira kukulira kufunikira kwa insulin. Kuwonetsedwa kwa hypoglycemia sikungatchulidwe pang'ono ngati Degludec atengedwa limodzi ndi a beta-blockers.
Lanreotide, Octreotide, ndi ethanol zimatha kuwonjezera kapena kuchepetsa kufunikira kwa insulin. Ndizofunikira kudziwa kuti ngati mankhwala ena awonjezeredwa ku yankho la insulin, izi zingayambitse kuwonongeka kwa wogwiritsa ntchito mahomoni.
Kuphatikiza apo, Degludec saloledwa kuti awonjezeredwe mayankho a kulowetsedwa.
Zotsatira zoyipa ndi malangizo apadera
Zotsatira zoyipa kwambiri ndizo hypoglycemia. Nthawi zambiri zizindikiro zake zimawonekera mwadzidzidzi. Mawonetsedwe oterowo akuphatikizira kuchepa kwa khungu, njala, mawonekedwe a thukuta lozizira, kugunda kwamtima kwamphamvu, kutopa, kunjenjemera, kupweteka mutu, mantha, nseru, kuda nkhawa, kugona, kugwirizanitsa bwino komanso kusasamala. Ndizothekanso kuwonongeka kwakanthawi mu shuga.
Allergies ndizothekanso, kuphatikizapo pangozi ya anaphylactic reaction. Nthawi zambiri chitetezo chamthupi chimatha, uritisaria kapena hypersensitivity. Vutoli limawonetsedwa ndi kuyabwa khungu, kutupa kwa milomo, lilime, kutopa ndi mseru.
Nthawi zina lipodystrophy imapezeka pamalo a jakisoni. Komabe, malinga ndi malamulo osintha jakisoni, mwayi wazowawa zotere ndizochepa.
M'malo oyendetsa, zovuta ndi zovuta zina zimatha kuchitika. Nthawi zina, edema yokhala ndi zotumphukira imayamba, nthawi zambiri pamalowa jakisoni:
- kuphatikizika;
- hematoma;
- mkwiyo
- kupweteka
- kuyabwa
- hemorrhage wamba;
- kusintha kwa khungu;
- erythema;
- kutupa
- minofu yolumikizana.
Ndemanga ya Deglyudeke insulin akuti mankhwalawa ndi osavuta komanso osavuta kugwiritsa ntchito, ndipo chifukwa chachitenga nthawi yayitali atakhazikitsa yankho, kuchuluka kwa glycemia kumakhalabe kwazonse kwa nthawi yayitali.
Mankhwala otchuka kwambiri otengera Degludek ndi chipangizo pansi pa dzina la malonda la Tresiba. Mankhwalawa amapezeka ngati zida zogwiritsira ntchito makatoni omwe amatha kugwiritsidwa ntchito mu zolembera za Novopen syringe kuti mugwiritse ntchito mobwerezabwereza.
Tresiba imapezekanso m'mapensulo otayika (FlexTouch). Mlingo ndi 100 kapena 200 magawo 3 ml.
Mtengo wa cholembera cha Treshiba Flex Touch umasiyana kuchokera ku 8000 mpaka 1000 rubles. Ndipo kanema yemwe ali munkhaniyi akungokuwuzani momwe mungagwiritsire ntchito insulin yowonjezera.
