Pambuyo mawonekedwe a insulin analogues aposachedwa, chithandizo cha matenda a shuga chimafikira pamlingo wina watsopano: kuwongolera kwa glycemia mwa odwala ambiri kunakhala kotheka, chiopsezo cha kusokonezeka kwa microvascular, hypoglycemic coma idachepetsedwa kwambiri.
Apidra ndiye woimira wotsiriza wa gululi, ufulu wa mankhwalawo ndi wa French nkhawa Sanofi, yomwe ili ndi nthambi zambiri, yomwe ili ku Russia. Apidra yatsimikizira maubwino pazinthu zazifupi za anthu: zimayamba ndikuyima mwachangu, kufikira nsonga. Chifukwa cha izi, odwala matenda ashuga amatha kukana zokhwasula-khwasula, samangika nthawi yakudya, ndipo samapulumutsidwa mpaka kungodikira pomwe mahomoniwo ayamba. M'mawu ena, mankhwala atsopano amapitilira chikhalidwe chonse m'njira zonse. Ichi ndichifukwa chake kuchuluka kwa odwala omwe amagwiritsa ntchito insulin analogues kukukula pang'onopang'ono.
Malangizo ogwiritsira ntchito
| Kupanga | Zomwe zimagwiritsidwa ntchito ndi glulisin, mamolekyu ake amasiyana ndi amino acid amkati (ophatikizidwa m'thupi) ndi ma amino acid awiri. Chifukwa cha izi, glulisin sakonda kupanga mankhwala ophatikizira amkati komanso pansi pa khungu, kotero imalowa mwachangu m'magazi atangolowa jekeseni. Zothandizira zothandizira zimaphatikizapo m-cresol, chloride ndi sodium hydroxide, sulfuric acid, tromethamine. Kukhazikika kwa yankho kumaperekedwa ndi kuwonjezeredwa kwa polysorbate. Mosiyana ndi kukonzekera kwina kwapafupi, insulin Apidra ilibe zinc. Njira yothetsera vutoli imakhala ndi pH yosavomerezeka (7.3), choncho imatha kuchepetsedwa ngati mulingo wochepa kwambiri ukufunika. |
| Mankhwala | Malingana ndi mfundo komanso mphamvu yogwira, glulisin imafanana ndi insulin yaumunthu, imaposa liwiro ndi nthawi yogwira ntchito. Apidra amachepetsa kuchuluka kwa shuga m'mitsempha yamagazi ndikulimbikitsa mayamwidwe ndi minofu ndi minyewa ya adipose, komanso amalepheretsa kuphatikizika kwa shuga ndi chiwindi. |
| Zizindikiro | Ntchito shuga kuti muchepetse shuga pambuyo chakudya. Mothandizidwa ndi mankhwalawa, hyperglycemia imatha kuwongoleredwa mwachangu, kuphatikiza ndi zovuta za matenda ashuga. Itha kugwiritsidwa ntchito mwa odwala onse kuyambira wazaka 6, ngakhale atakhala kuti ndi amuna kapena akazi komanso kulemera. Malinga ndi malangizo, insulin Apidra imaloledwa kwa okalamba omwe ali ndi hepatic komanso aimpso komanso osakwanira. |
| Contraindication | Sangagwiritsidwe ntchito ngati hypoglycemia.. Ngati shuga ndi ochepa asanadye, ndi bwino kupatsa Apidra pang'ono pambuyo poti glycemia ikhale yachilendo. Hypersensitivity kuti gilluzin kapena othandiza mbali yankho. |
| Malangizo apadera |
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| Mlingo | Mlingo wofunikawo umatsimikizika potengera kuchuluka kwa chakudya mu chakudya komanso kusintha kwa zinthu m'magawo a insulin. |
| Zosafunika | Zotsatira zoyipa za Apidra ndizofala mitundu yonse ya insulin. Malangizo ogwiritsira ntchito adziwitsana tsatanetsatane wa zonse zomwe zingachitike osafunika. Nthawi zambiri, hypoglycemia yolumikizana ndi mankhwala osokoneza bongo amawonedwa. Amayenda ndi kunjenjemera, kufooka, kukwiya. Kuchuluka kwa mtima kwa mtima kumawonetsa kuopsa kwa hypoglycemia. Hypersensitivity zimachitika mu mawonekedwe a edema, zotupa, redness ndizotheka jekeseni malo. Nthawi zambiri zimatha pambuyo pa masabata awiri ogwiritsa ntchito Apidra. Zosiyanasiyana zokhudza zonse zimachitika kawirikawiri, zomwe zimafunikira kuti insulini isinthidwe mwachangu. Kulephera kutsatira njira zamakonzedwe ndi zinthu za munthu zomwe zimakhala ndi subcutaneous minofu kungayambitse lipodystrophy. |
| Mimba ndi GV | Insulin Apidra sichimasokoneza mimba yathanzi, sizikhudza chitukuko cha intrauterine. Mankhwalawa amaloledwa kugwiritsidwa ntchito mwa amayi apakati omwe ali ndi mitundu 1 ndi 2 shuga komanso matenda a shuga. Kafukufuku wazomwe angathe kuti Apidra adutse mkaka wa m'mawere sanachitike. Monga lamulo, ma insulini amalowera mkaka wochepa kwambiri, kenako amamugaya m'mimba mwa mwana. Kuthekera kwa insulini kulowa m'magazi a mwana kumathetsedwa, ndiye kuti shuga yake sidzatha. Komabe, pali chiopsezo chochepa cha mwana wosadwala yemwe angayambire glulisin ndi zina mwa yankho. |
| Kuyanjana kwa mankhwala osokoneza bongo | Mphamvu ya insulin imafooka: Danazol, Isoniazid, Clozapine, Olanzapine, Salbutamol, Somatropin, Terbutaline, Epinephrine. Tsindikani: Disopyramide, Pentoxifylline, Fluoxetine. Clonidine ndi reserpine - amatha kutsika chizindikiro cha kuyambika kwa hypoglycemia. Mowa umachulukitsa kubwezeretsanso kwa matenda a shuga komanso kumatha kupangitsa munthu kukhala ndi hypoglycemia, choncho kugwiritsidwa ntchito kwake kuyenera kuchepetsedwa. |
| Kutulutsa Mafomu | Mankhwala amapatsa makamaka Apidra mu zolembera za SoloStar syringe. Katiriji wokhala ndi 3 ml yankho ndikuyika muyezo wa U100; Syringe cholembera gawo - 1 unit. Mu phukusi la zolembera 5, ndi 15 ml kapena 1500 okha a insulin. Apidra imapezekanso mu Mbale 10 ml. Nthawi zambiri amagwiritsidwa ntchito m'malo azachipatala, koma amathanso kugwiritsidwa ntchito kudzaza chosungira pampu ya insulin. |
| Mtengo | Ma phukusi omwe ali ndi zolembera za syringe ya Apidra SoloStar amatenga ma ruble 2100, omwe amafananizidwa ndi analogues apafupi kwambiri - NovoRapid ndi Humalog. |
| Kusunga | Alumali moyo wa Apidra ndi zaka 2, bola nthawi yonseyi adasungidwa mufiriji. Kuchepetsa chiopsezo cha lipodystrophy ndi zilonda za jakisoni, insulini imawotha kutentha kwa chipinda isanayambe ntchito. Popanda kupeza dzuwa, kutentha mpaka 25 ° C, mankhwalawa amapezeka m'khola la syringe. |
Tikhazikike mwatsatanetsatane pazinthu zomwe zimagwiritsidwa ntchito ndi Apidra, zomwe sizinaphatikizidwe mu malangizo ogwiritsa ntchito.
Kuti mupeze chiphuphu chabwino cha matenda ashuga ku Apidra, muyenera:
- Kuchita insulin mphindi 15 musanadye. Malinga ndi malangizowo, yankho limatha kutumikiridwa panthawi ya chakudya komanso pambuyo pake, koma pamenepa muyenera kulimbana ndi shuga wokwanira kwakanthawi, zomwe zikutanthauza kuti akhoza kukhala ndi mavuto ambiri.
- Sungani ziwerengero za mkate, kupewa kuti musagwiritse ntchito chakudya chosavomerezeka.
- Pewani chakudya chochuluka chomwe chimakhala ndi index yayikulu ya glycemic. Pangani chakudya makamaka pama chakudya pang'ono, phatikizani mwachangu ndi mafuta komanso mapuloteni. Malinga ndi odwala, ndi zakudya zotere, ndizosavuta kusankha mlingo woyenera.
- Sungani cholemba ndipo, potengera zomwe zidasungidwa, sinthani nthawi yake muyezo wa Apidra insulin.
Mankhwalawa amatha kugwiritsidwa ntchito kwambiri kulipirira matenda a shuga kwa achinyamata. Gululi silili ndi chizolowezi chosadya, zakudya zapadera, moyo wokangalika. Mu unamwali, kufunika kwa insulini nthawi zambiri kumasinthika, chiopsezo cha hypoglycemia ndichopitirira, ndipo hyperglycemia imatha nthawi yayitali atatha kudya. Hemoglobin wapakati pa achinyamata ku Russia ndi 8.3%, omwe ali kutali kwambiri ndi omwe akufuna.
Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale
- Matenda a shuga -95%
- Kuthetsa kwa mitsempha thrombosis - 70%
- Kuthetsa kwa kugunda kwamtima kwamphamvu -90%
- Kuthana ndi kuthamanga kwa magazi - 92%
- Kuwonjezeka kwa mphamvu masana, kukonza kugona usiku -97%
Kafukufuku wogwiritsa ntchito Apidra mwa ana awonetsa kuti mankhwalawa, komanso Humalog ndi NovoRapid, amachepetsa shuga. Kuopsa kwa hypoglycemia kunalinso chimodzimodzi. Ubwino wambiri wa Apidra ndiyabwino kwambiri yolamulira glycemic mwa odwala omwe ali ndi shuga yayitali pakudya.
Zambiri zothandiza za Apidra
Apidra amatanthauza insulin. Poyerekeza ndi mahomoni amfupi amunthu, mankhwalawa amalowa m'magazi ma 2 mwachangu, mphamvu yotsitsa shuga imawonedwa kotala la ola limodzi pambuyo pothandizidwa ndi subcutaneous. Kuchitapo kanthu kumakulirakulira ndipo pambuyo pa ola limodzi ndi theka ukufika pachimake. Kutalika kwa ntchito ndi pafupifupi maola 4, pambuyo pake insulin yaying'ono imatsalira m'magazi, omwe sangathe kukhudza glycemia.
Odwala ku Apidra ali ndi zofunikira zowonetsa shuga, sangakwanitse kudya zochepa okhwima kuposa odwala matenda ashuga omwe amakhala ndi insulin yochepa. Mankhwala amachepetsa nthawi kuchokera ku chakudya kupita ku chakudya, sikufuna kutsatira kwambiri zakudya komanso zokhwasula-khwasula.
Ngati wodwala matenda ashuga amatsatira zakudya zamafuta ochepa, njira ya Apidra insulin ikhoza kukhala yothamanga kwambiri, chifukwa chakudya pang'onopang'ono alibe nthawi yokweza shuga m'magazi nthawi yomwe mankhwalawa ayamba kugwira ntchito. Pankhaniyi, ma insulin afupiafupi koma osakhala a ultrashort amalimbikitsidwa: Actrapid kapena Humulin Regular.
Njira yoyendetsera
Malinga ndi malangizo, insulin Apidra imayendetsedwa musanadye chilichonse. Ndi zofunika kuti pakati chakudya anali pafupifupi 4 maola. Pankhaniyi, zotsatira za jakisoni awiri sizipitirira, zomwe zimapangitsa kuti matenda ashuga azitha. Ziphuphu zimayenera kuyesedwa palibe kale kuposa 4 maola pambuyo jekeseni, pamene kutumikiridwa mlingo wa mankhwala umatha ntchito. Ngati itatha nthawi imeneyi shuga atakulirakulira, mutha kupanga zotchedwa kukonza poplite. Zimaloledwa nthawi iliyonse masana.
Kudalira kwa chochitika pa nthawi yoyang'anira:
| Nthawi Pakati Pakulimira ndi Chakudya | Machitidwe | |
| Apidra SoloStar | Insulin yochepa | |
| kotala la ola limodzi asanadye | theka la ola musanadye | Apidra imapereka chiwongolero chabwino kwambiri cha matenda ashuga. |
| Mphindi 2 musanadye | theka la ola musanadye | Mphamvu yochepetsera shuga ya insulini zonsezi ndiyofanana, ngakhale Apidra amagwira ntchito nthawi yochepa. |
| kotala la ola mutatha kudya | Mphindi 2 musanadye | |
Apidra kapena NovoRapid
Mankhwalawa ndi ofanana mu katundu, mawonekedwe, mtengo. Apidra ndi NovoRapid onse ndi opanga odziwika ku Europe, chifukwa chake palibe kukayika pamtundu wawo. Onse a insulin ali ndi omwe amasilira pakati pa madokotala ndi odwala matenda ashuga.
Kusiyana kwa mankhwala:
- Apidra amasankhidwa kuti agwiritsidwe ntchito pamapampu a insulin. Chiwopsezo chobisa dongosolo ndi chochepa kwambiri poyerekeza ndi NovoRapid. Amaganiziridwa kuti kusiyana koteroko kumalumikizidwa ndi kukhalapo kwa polysorbate ndi kusapezeka kwa zinc.
- NovoRapid ikhoza kugulidwa m'makalateni ndikugwiritsira ntchito zolembera m'mitengo ya 0.5, zomwe ndizofunikira kwa odwala matenda ashuga omwe amafunika Mlingo wochepa wa mahomoni.
- Wapakati tsiku lililonse insulin Apidra ndi ochepera 30%.
- NovoRapid ndiyosachedwa pang'ono.
Kupatula zakusiyana kumeneku, zilibe kanthu kuti muzigwiritsa ntchito chiyani - Apidra kapena NovoRapid. Kusintha kwa insulin imodzi kupita kwina Chimalimbikitsidwa pazifukwa zamankhwala zokha, nthawi zambiri izi zimayambitsa mavuto ambiri.
Apidra kapena Humalog
Mukamasankha pakati pa Humalog ndi Apidra, ndizovuta kwambiri kunena zomwe zili bwino, chifukwa mankhwalawa onse ali ofanana nthawi ndi mphamvu yogwira. Malinga ndi akatswiri ashuga, kusintha kwa insulin imodzi kupita kwina kumachitika popanda zovuta zilizonse, nthawi zambiri ma coefficients powerengera sasintha.
Kusiyana komwe kunapezeka:
- Apidra insulin imathamanga kuposa Humalog yomwe imalowa m'magazi odwala omwe ali ndi kunenepa kwambiri kwa visceral;
- humalog ikhoza kugulidwa popanda zolembera;
- mwa odwala ena, Mlingo wa kukonzekera konse kwa ultrashort ndi ofanana, pomwe kutalika kwa insulin ndi Apidra sikungocheperako ndi Humalog.
