Chifukwa cha maphunziro ambiri komanso makampani opanga mankhwala, pakadali pano pali mankhwala othandiza kupewa matenda ashuga. Mothandizidwa ndi mankhwala ena, mutha kusungabe kuchuluka kwa insulin m'magazi.
Malo apadera pakati pa mankhwala omwe amakhalapo ndimankhwala amakono kuti alowe m'malo mwa insulin. Insulin Glargin ikhoza kugwiritsidwa ntchito ngati chida chodziyimira pawokha, nthawi zina imakhalapo m'mankhwala ena, mwachitsanzo, Lantus kapena Solostar. Zotsirizirazi zimakhala ndi 70% ya insulin, Lantus - 80%.
Kafukufuku wokhudzana ndi zovuta za mankhwalawa panthawi yomwe ali ndi pakati sanachitidwe, chifukwa chake, ndi dokotala wokhayo yemwe ayenera kusankha zochita. Komanso ndalama ziyenera kuperekedwa mosamala kwa ana osaposa zaka zisanu ndi ziwiri.
Tanthauzo la shuga
Matenda a shuga ndi matenda a pancreatic omwe amayamba chifukwa chosowa insulin. Ndi matendawa, ntchito ya ziwalo zambiri zamthupi ndi machitidwe amthupi zimasokonekera, popeza kusintha kwa kagayidwe kazachilengedwe kumachitika.
Mu 90% ya milandu, matendawa sagwirizana ndi kuchepa kwa insulin, monga lamulo, matenda ashuga oterewa amalembetsedwa mwa anthu onenepa kwambiri. 10% ya milandu imakhudzana ndi kusokonezeka kwa shuga ndi insulin, zomwe zimachitika chifukwa cha matenda a kapamba.
Pali zifukwa zingapo zomwe zimatha kukhala zoteteza matendawa:
- chibadwa
- kusokonekera kwa dongosolo la autoimmune,
- zovuta zomwe zimalumikizidwa ndi kunenepa kwambiri komanso zina.
Dongosolo la autoimmune limateteza thupi ku tizilombo toyambitsa matenda amkati ndi akunja, mabakiteriya komanso matenda. Izi zimaphatikizapo awiri ndi eni maselo omwe ali ndi vuto lalikulu.
Mankhwala amakono samadziwa chifukwa chake nthawi ina dongosolo la autoimmune limalakwika ndipo amayamba kutenga zikondamoyo ndi maselo akunja, kuyesera kuziletsa, ndikupanga ma antibodies apadera.
Monga lamulo, chiwonongeko chotere chimachitika bwino, ndipo maselo omwe atha kuthawa amayamba kupanga mahomoni, kuphatikiza insulin, mumachitidwe othamanga. Njirayi imatenga nthawi, ndiye kumadza mphindi pomwe kuchuluka kwa insulin kumayamba kutsika, zomwe zikutanthauza kuti mulingo wa shuga umakwera, womwe sungathe kuthyoledwa.
Zizindikiro zachiwiri za matenda ashuga:
- matenda a kapamba, monga kapamba,
- Matenda a mahomoni, omwe nthawi zambiri amasokoneza goiter,
- Kugwiritsa ntchito mankhwala a mahomoni nthawi zonse kapena poizoni kuchitira matenda ena.
Chilichonse chomwe chimayambitsa matenda ashuga, makina a matendawa amakhalabe osasinthika. Chifukwa chosowa insulini, thupi silitenga glucose ndipo silitha kudziunjikira m'misempha ndi m'chiwindi. Shuga wambiri waulere amawoneka, amatengedwa ndi magazi ndipo amatsuka ziwalo zonse, ndikuwapweteketsa iwo.
Glucose ndi m'modzi mwa omwe amapereka mphamvu, kotero kusowa kwake nthawi zambiri kumalipidwa ndi china. Poterepa, thupi limayamba kupanga mafuta, kuwaganizira ngati mphamvu.
"Chimbudzi" ichi cha mafuta chimakhala ndi ma enzyme ambiri a chakudya, omwe alibe njira yochotsera m'thupi.
Ma Enzym omwe amapangidwira kuti azigaya chakudya kumapeto kwake amapukusa kapamba, ndipo amayamba kutupuka, komwe kumayendera limodzi ndi zizindikilo zambiri.
Makhalidwe a mankhwala osokoneza bongo
Mfundo zoyenera kuchita ndi insulin, ntchito yake yofunika, kuphatikizapo Glargin, ndikukhazikitsa kagayidwe ka glucose. Insulin Lantus imathandizira kudya kwa shuga ndi minofu ndi minyewa ya adipose, motero, shuga ya plasma imachepa. Mankhwalawa amathandizanso kuchepetsa kuchuluka kwa shuga m'magazi.
Mankhwalawa ndi fanizo la insulin yaumunthu, yomwe imapangidwa ndi kutsimikizira kwa Escherichia coli bacteria wa DNA. Amadziwika ndi solubility yotsika m'malo osagwirizana nawo.
Amamangirira ku insulin receptors ndikuyimira pakati bioeffect ofanana ndi mkati (amkati) insulin.
Pali kusintha kwa kagayidwe kakang'ono ka shuga. Mankhwala ndi fanizo amachepetsa shuga m'magazi, kuchititsa kuti shuga azipezeka ndi zotumphukira zake (makamaka minyewa ya adipose ndi minofu), komanso zimalepheretsa kupangika kwa shuga m'chiwindi. Insulin imalepheretsa mapuloteni ndi lipolysis, pamene imakulitsa kuphatikiza mapuloteni.
Pambuyo subcutaneous makonzedwe a mankhwala, zotsatira amadziwika pambuyo pafupifupi 40-60 Mphindi. Monga lamulo, chochitikacho chimawonedwa maola 24, nthawi yayitali ya maola 29. Ndi jakisoni wamkati limodzi, kuchuluka kwa zinthu zomwe zili m'magazi kumawonedwa patatha masiku 2-4.
Diso la Insulin Glargin Lantus limasungunuka kwathunthu chifukwa cha acidic yapakati, ndipo pambuyo pa kayendetsedwe ka subcutaneous, asidiyo samasankhidwa ndipo microprecipitate imapangidwa, pomwe mankhwalawo amamasulidwa pang'ono.
M'magazi am'magazi, palibe kusinthasintha kwakukuru kwa insulin, zonse zimachitika mosalala. Zinthu zapadera zimapereka njira yotalikira.
Insulin Glargin 300 ili ndi zotsatira zabwino za pharmacokinetic ndi pharmacodynamic. Izi zitha kukhala zovomerezeka monga insal insulin mwa odwala omwe ali ndi mtundu woyamba wa 2 ndi matenda a shuga.
Ngati mugwiritsa ntchito Insulin Glargin 300 IU / ml, izi zimatsegula mwayi wabwino wowerengera anthu omwe ali ndi matenda ashuga.
Malangizo ogwiritsira ntchito mankhwalawa
Mlingo wa mankhwalawa amatchulidwa payekhapayekha. Mankhwala kutumikiridwa subcutaneous 1 nthawi patsiku limodzi. Madera oyambitsa akhoza kukhala:
- minofu yamafuta am'mimba,
- ntchafu
- phewa.
M
Kudya jakisoni kumayenera kusinthidwa nthawi zonse ndikamayambitsa mankhwala.
Mtundu wa matenda a shuga 1, mankhwalawa amatchulidwa ngati insulin yayikulu. Mtundu wachiwiri wa shuga, umagwiritsidwa ntchito ngati monotherapy kapena kuphatikiza ndi othandizira ena a hypoglycemic.
Ngati wodwala wasintha kuchokera ku insulin kapena yolimba kwa nthawi yayitali kupita ku Insulin Glargin, ndiye kuti mufunika kusintha mankhwalawa tsiku lililonse chifukwa cha insulin yofunikira kapena kusintha kwa chithandizo chamankhwala.
Wodwala akachotsedwa kwa insulin-isophan kupita jekeseni limodzi la mankhwalawa, ndikofunikira kuchepetsa tsiku lililonse la basal insulin ndi gawo limodzi mwa magawo atatu mu milungu yoyamba ya mankhwalawa. Izi ndizofunikira kuti muchepetse kugona kwa hypoglycemia usiku. Munthawi imeneyi, kuchepetsedwa kwa mulingo wambiri kungathe kuthana ndi kuwonjezeka kwa insulin yochepa.
Zotsatira zoyipa
Hypoglycemia ndimavuto obwera chifukwa cha ndondomekoyi, monga mankhwala a insulin, zimawoneka ngati Mlingo wa insulin ndi wokwera kwambiri poyerekeza ndi chosowa chenicheni. Chifukwa chogwiritsa ntchito mosayenera mankhwalawa, munthu akhoza kuyamba kudwala matenda a hypoglycemia, omwe nthawi zambiri amachititsa kuti mitsempha iziyenda bwino.
Matenda a neuropsychiatric chifukwa cha hypoglycemia, monga lamulo, amatsogozedwa ndi zizindikiro za kukakamiza kwa adrenergic:
- njala
- kusakhazikika
- tachycardia.
Kusintha kwakukuru mu kayendetsedwe ka shuga ka magazi kumayambitsa kuwonongeka kwa mawonekedwe chifukwa cha kusintha kwa minofu ya turgor ndi kutanthauzira kwa mandala amaso. Kukhalitsa kwa shuga kwa nthawi yayitali kumachepetsa chiopsezo chokhala ndi matenda a shuga.
Zomwe zimachitika mdera lanu momwe jakisoni amakhudzidwira komanso zimayambitsa matupi awo:
- redness
- kupweteka
- kuyabwa
- urticaria
- kutupa.
Nthawi zambiri zinthu zazing'ono zomwe zimachitika mdera la insulin nthawi zambiri zimatha patadutsa masabata ochepa. Hypersensitivity zimachitika kuti insulin ikuchitika kawirikawiri.
Zomwe zimachitika ndi insulin kapena zotuluka zimatha kuoneka ngati zikuchitika pakukhudza khungu. Kuphatikiza apo, awa ndi awa:
- angioedema,
- bronchospasm
- ochepa hypotension kapena mantha.
Zophwanya zonsezi zimatha kuwopseza moyo wa munthu.
Nthawi zina kukhalapo kwa ma antibodies ku insulin kumafunika kusintha kwa mlingo kuti athetse chizolowezi cha hyper- kapena hypoglycemia. Komanso, insulini imatha kuyambitsa kuchepa kwa mankhwala a sodium.
Zotsatira zake, edema imachitika, makamaka ngati yogwira insulin yotsatsira ikuwongolera bwino njira zama metabolic.
Zochita Zamankhwala
Mankhwalawa sagwirizana ndi njira zina. Sichiyenera kusakanikirana ndi zinthu zina kapena kuchepetsedwa.
Mankhwala ambiri amakhudza kagayidwe ka glucose, kamene kamasowa kusintha kwa mlingo. Mankhwalawa ndi monga:
- othandizira pakamwa
- ACE zoletsa
- disopyramids
- mafupa
- malamusi,
- Mao zoletsa
- pentoxifylline
- propoxyphene
- salicylates,
- mankhwala a sulfa.
Njira zomwe zingachepetse kuchepa kwa insulin ndi:
- okodzetsa
- estrogens
- isoniazid
- glucocorticoids,
- danazol
- diazoxide
- glucagon,
- clozapine.
- gestagens
- kukula kwamafuta,
- mahomoni a chithokomiro,
- epinephrine
- salbutamol,
- terbutaline
- proteinase zoletsa
- olanzapine.
Zitha kufooketsa ndikuwonjezera mphamvu ya insoglycemic:
- beta blockers,
- clonidine
- mchere wa lithiamu
- mowa
Kusankhidwa kwa insulin
Ngati tingayerekeze ndi ma pharmacokinetics a mankhwalawa omwe amawaganizira, ndiye kuti kuikidwa kwawo monga dokotala akuwonetsedwa kwa matenda a shuga a mtundu woyamba ndi wachiwiri. Ma insulin amakono samathandizira kuti thupi lizikula kwambiri chifukwa chogwiritsa ntchito mankhwala. Kuchuluka kwa madontho a usiku m'magazi a shuga ndimachepetsa kwambiri.
Pakufunika jakisoni imodzi yokha ya insulin tsiku lonse. Kwa odwala, ndizofunikira kwambiri. Odziwika kwambiri ogwira insulin analogue ndi metformin kwa odwala omwe ali ndi matenda a shuga a 2. Kafukufuku wasayansi akuwonetsa kuchepa kwakukulu kwa kudumpha kwamadzulo mu kuchuluka kwa shuga. Chifukwa chake, matenda a glycemia a tsiku ndi tsiku amakwaniritsidwa.
Ndikofunika kudziwa kuphatikiza kwa Insulin Glargin Lantus ndimankhwala apakamwa kuti muchepetse glucose wamagazi mwa odwala omwe sangathe kulipira shuga. Odwala otere ayenera kuikidwa Insulin Glargin mu magawo oyamba a matendawa.
Mankhwalawa akhoza kuvomerezedwa ndi endocrinologist kapena katswiri wamkulu. Kuchiza kwambiri pogwiritsa ntchito Lantus kumapereka mwayi wowongolera glycemia mwa anthu omwe ali ndi matenda a shuga a magulu onse.
Mtengo
Mankhwalawa amapereka insulin kukonzekera mosiyanasiyana. Mtengo umatengera mawonekedwe omwe amafananizira mankhwala a Glargin Insulin. Mtengo wa mankhwalawa umachokera ku 2800 mpaka 4100 rubles
