Zokonzekera zambiri za insulin ku Russia ndizoyambira kunja. Mwa mitundu yayitali ya insulin, Lantus, yopangidwa ndi imodzi mwa mabungwe akuluakulu azachipatala Sanofi, imagwiritsidwa ntchito kwambiri.
Ngakhale kuti mankhwalawa ndi okwera mtengo kwambiri kuposa NPH-insulin, gawo lawo la msika likukulabe. Izi zikufotokozedwa ndi kutalika komanso kosavuta kwa kuchepetsa shuga. Ndizotheka kumalipira Lantus kamodzi patsiku. Mankhwala amakupatsani mwayi kuwongolera mitundu yonse ya matenda a shuga, kupewa hypoglycemia, komanso kumayambitsa zosokoneza kawirikawiri.
Buku lamalangizo
Insulin Lantus idayamba kugwiritsidwa ntchito mu 2000, idalembetsedwa ku Russia zaka 3 pambuyo pake. Pazaka zapitazi, mankhwalawa adatsimikizira chitetezo chake ndikuchita bwino, adaphatikizidwa m'ndandanda wa Vital and Essential Drug, kotero odwala matenda ashuga amatha kupeza kwaulere.
| Kupanga | Chothandizira chophatikizika ndi insulin glargine. Poyerekeza ndi mahomoni amunthu, molekyu ya glargine imasinthidwa pang'ono: asidi limodzi limasinthidwa, awiri amawonjezeredwa. Pambuyo pa makonzedwe, insulin yotere imapanga mosavuta zovuta pansi pa khungu - hexamers. Njira yothetsera vutoli ili ndi pH ya acidic (pafupifupi 4), kotero kuti kuwonongeka kwa hexamers kumakhala kotsika komanso kolosera. Kuphatikiza pa glargine, Lantus insulin imakhala ndi madzi, antiseptic zinthu m-cresol ndi zinc chloride, ndi glycerol stabilizer. Acidity yofunikira ya yankho imatheka poonjezera sodium hydroxide kapena hydrochloric acid. |
| Kutulutsa Fomu | Pakadali pano, Lantus insulin ikupezeka mu zolembera za syringe za SoloStar zokha. Kathumba katali katatu kamayikidwa paliponse. M'bokosi lamakadi 5 syringe zolembera ndi malangizo. M'mafakitala ambiri, mutha kugula chilichonse pachokha. |
| Mawonekedwe | Njira yothetsera vutoli ndi yowonekera komanso yopanda utoto, ilibe ngakhale nthawi yayitali yosungirako. Sikoyenera kusakaniza musanayambe. Mawonekedwe a inclusions aliwonse, chinyezi ndi chizindikiro cha kuwonongeka. Ndende ya yogwira ntchito ndi magawo zana pa millilita (U100). |
| Zotsatira za pharmacological | Ngakhale ma molekyulu achilendo, glargine amatha kumangiriza ma cell receptor chimodzimodzi monga insulin ya anthu, chifukwa chake machitidwewo ndi ofanana kwa iwo. Lantus imakulolani kuyang'anira kagayidwe ka glucose ngati vuto la insulin yanu: imalimbikitsa minofu ndi minyewa ya adipose kuti itenge shuga, ndipo imalepheretsa kuphatikizika kwa shuga ndi chiwindi. Popeza Lantus ndi mahomoni ogwira ntchito kwa nthawi yayitali, amadzipaka kuti apitirize kudya shuga. Monga lamulo, ndi matenda a shuga a mellitus, limodzi ndi Lantus, ma insulin amafupika - Insuman ya wopanga yemweyo, analogues ake kapena ultrashort Novorapid ndi Humalog. |
| Mulingo wogwiritsa ntchito | Ndizotheka kugwiritsa ntchito onse odwala matenda ashuga kuposa zaka 2 omwe amafunikira mankhwala a insulin. Kuchita bwino kwa Lantus sikukhudzidwa ndi jenda komanso zaka za odwala, kunenepa kwambiri komanso kusuta. Zilibe kanthu kuti mupaka jakisoni mankhwala. Malinga ndi malangizo, kuyambitsidwa m'mimba, ntchafu ndi phewa kumabweretsa gawo lomweli la insulin m'magazi. |
| Mlingo | Mlingo wa insulini amawerengedwa pamaziko a kusala kudya kwa glucometer masiku angapo. Amakhulupirira kuti Lantus akupeza nyonga yayitali mkati mwa masiku atatu, kotero kusintha kwa mankhwalawa kumatheka pokhapokha nthawi iyi. Ngati glycemia yosambira tsiku lililonse ndi> 5.6, mulingo wa Lantus ukuwonjezeka ndi magawo awiri. Mlingo amawerengedwa moyenera ngati palibe hypoglycemia, ndi glycated hemoglobin (HG) pambuyo pa miyezi itatu yogwiritsidwa ntchito <7%. Monga lamulo, ndi matenda a shuga a 2, mankhwalawa ndi apamwamba kuposa mtundu 1, popeza odwala ali ndi insulin. |
| Sinthani mu insulin zofunika | Mlingo wofunika wa insulin ukhoza kuchuluka panthawi ya matenda. Mphamvu yayikulu imachitika ndi matenda ndi kutupa, limodzi ndi malungo. Insulin Lantus imafunikira kwambiri ndi kupsinjika kwakatundu, kusintha moyo kuti ukhale wolimbikira, ntchito yayitali. Mowa kugwiritsa ntchito mankhwala a insulin zimayambitsa kwambiri hypoglycemia. |
| Contraindication |
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| Kuphatikiza ndi mankhwala ena | Zinthu zina zimatha kuthana ndi zotsatira za Lantus, chifukwa chake onse omwe amamwa mankhwala a shuga ayenera kuvomerezedwa ndi dokotala. Machitidwe a insulin amachepetsa:
Lantus insulin zotsatira zimatheka ndi:
Sympatholytics (Raunatin, Reserpine) amatha kuchepetsa kukhudzika kwa hypoglycemia, zomwe zimapangitsa kuti zikhale zovuta kuzindikira. |
| Zotsatira zoyipa | Mndandanda wazotsatira za Lantus sizosiyana ndi ma insulini ena amakono:
Zaka zingapo zapitazo, panali umboni kuti Lantus amawonjezera chiopsezo cha oncology. Kafukufuku wotsatira watsutsa kuyanjana kulikonse pakati pa khansa ndi insulin. |
| Mimba | Lantus sichikhudza mayiyo ndi thanzi la mwana. Mu malangizo ogwiritsa ntchito, tikulimbikitsidwa kugwiritsa ntchito mankhwalawa mosamala kwambiri panthawiyi. Izi ndichifukwa chakufunika kosintha kwa mahomoni ambiri. Kuti mukwaniritse chindapusa cha matenda ashuga, muyenera kupita kwa dokotala pafupipafupi ndikusintha Mlingo wa insulin. |
| Ana m'badwo | M'mbuyomu, Lantus SoloStar adaloledwa kukhala ndi ana kuyambira zaka 6. Pakubwera kwa kafukufuku watsopano, zaka zachepa kukhala zaka ziwiri. Zimadziwika kuti Lantus amachita ana chimodzimodzi ndi akulu, sizikhudza kukula kwawo. Kusiyana komwe kumapezeka ndi kuchuluka kwa ziwopsezo zapakati pa ana, zomwe zambiri zimatha pambuyo pa masabata awiri. |
| Kusunga | Pambuyo pakuyamba ntchito, cholembera cha syringe chimatha kusungidwa kwa masabata anayi kutentha kutentha. Zolemba zatsopano za syringe zimasungidwa mufiriji, moyo wa alumali ndi zaka zitatu. Mphamvu za mankhwalawa zimatha kuwonongeka tikayatsidwa ma radiation ya ultraviolet, kutentha kwambiri (30 ° C). |
Pogulitsa mungapeze mitundu iwiri ya insulin Lantus. Yoyamba imapangidwa ku Germany, yodzaza ndi Russia. Kuzungulira kwachiwiri komwe kunachitika ku Russia ku chomera cha Sanofi kudera la Oryol. Malinga ndi odwala, kuchuluka kwa mankhwalawo ndikofanana, kusintha kuchoka pamtundu wina kupita kwina sikumabweretsa mavuto.
Chidziwitso Chofunikira Cha Lantus
Insulin Lantus ndi mankhwala osokoneza bongo. Ilibe pafupifupi pachimake ndipo imagwira ntchito pafupifupi maola 24, pazenera maola 29. Kutalika, mphamvu ya kuchitapo kanthu, kufunika kwa insulini kumatengera umunthu wake ndi mtundu wa matendawa, motero, dongosolo la mankhwalawa ndi Mlingo amasankhidwa kwa wodwala aliyense payekhapayekha.
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%
Malangizo ogwiritsira ntchito amalimbikitsa jekeseni wa Lantus kamodzi patsiku, nthawi imodzi. Malinga ndi odwala matenda ashuga, kuwongolera kawiri kumakhala koyenera, chifukwa kumathandizira kugwiritsa ntchito mitundu yosiyanasiyana masana ndi usiku.
Kuwerengera Mlingo
Kuchuluka kwa Lantus komwe kumafunikira kusintha glycemia kutengera kuchuluka kwa insulin, kutsutsana ndi insulini, mawonekedwe a mayamwidwe am'mimba, komanso kuchuluka kwa odwala matenda ashuga. Mtundu wa mankhwala ponseponse mulibe. Pafupifupi, kufunika kwathunthu kwa insulin kumachokera ku 0,3 mpaka 1 unit. pa kilogalamu, gawo la Lantus pamilandu iyi ndi 30-50%.
Njira yosavuta ndiyo kuwerengera mulingo wa Lantus ndi kulemera, pogwiritsa ntchito kakhazikidwe koyamba: 0,2 x kulemera kwa kg = mlingo umodzi wa Lantus ndi jekeseni imodzi. Kuwerengera kotero zosayenera ndipo pafupifupi nthawi zonse pamafunika kusintha.
Kuwerengera kwa insulin malinga ndi glycemia imapereka, monga lamulo, zotsatira zabwino kwambiri. Choyamba, pezani mlingo wa jakisoni wamadzulo, kuti apatsidwe insulini m'magazi usiku wonse. Kuwona kwa hypoglycemia mwa odwala ku Lantus kumakhala kotsika kuposa pa NPH-insulin. Komabe, pazifukwa zotetezeka, amafunika kuwunika shuga nthawi yayitali kwambiri - m'mamawa kwambiri, kupanga kwa ma insulin antagonist kumatheka.
M'mawa, Lantus amatumizidwa kuti azikhala ndi shuga pamimba yopanda kanthu tsiku lonse. Mlingo wake sukutengera kuchuluka kwa chakudya chamagulu muzakudya. Asanadye chakudya cham'mawa, muyenera kusuta onse a Lantus ndi insulin yochepa. Kuphatikiza apo, ndizosatheka kuwonjezera kuchuluka kwa mankhwalawo ndikuyambitsa mtundu umodzi wa insulin, popeza momwe amagwirira ntchito mosiyana kwambiri. Ngati mukufunikira jakisoni wa nthawi yayitali asanagone, ndipo glucose akuchuluka, chitani jakisoni 2 nthawi imodzi: Lantus muyezo komanso insulin yochepa. Mlingo wofanana wa mahomoni afupiafupi amatha kuwerengeka pogwiritsa ntchito fomula ya Forsham, yoyeneranso kutengera kuti 1 unit ya insulin idzachepetsa shuga ndi pafupifupi 2 mmol / L.
Nthawi yoyambira
Ngati wasankha kubayitsa Lantus SoloStar molingana ndi malangizo, ndiye kuti, kamodzi patsiku, ndibwino kuchita izi pafupifupi ola limodzi asanagone. Munthawi imeneyi, magawo oyamba a insulin ali ndi nthawi yolowa m'magazi. Mlingo amasankhidwa mwanjira yoti azitsimikizira glycemia wabwino usiku ndi m'mawa.
Pakaperekedwa kawiri, jakisoni woyamba amachitika mutadzuka, chachiwiri - asanagone. Ngati shuga ndiwabwinobwino usiku komanso kukwezedwa pang'ono m'mawa, mutha kuyesa kusunthira chakudya chamadzulo nthawi isanakwane, pafupifupi maola 4 musanagone.
Kuphatikiza ndi mapiritsi a hypoglycemic
Kukula kwa matenda ashuga amtundu wa 2, kuvuta kutsatira zakudya zamafuta ochepa, komanso zovuta zingapo zomwe zimagwiritsidwa ntchito pakugwiritsa ntchito mankhwala ochepetsa shuga zapangitsa kuti njira zatsopano zamankhwala zithandizire.
Tsopano pali malingaliro kuti ayambe kubayitsa insulin ngati glycated hemoglobin imaposa 9%. Kafukufuku wambiri awonetsa kuti kuyambiranso kwa insulin mankhwala ndikusamutsidwa mwachangu kwa regimen yolimba kumapereka zotsatira zabwino kuposa chithandizo "chakuyimitsidwa" ndi othandizira a hypoglycemic. Njira imeneyi imachepetsa kwambiri vuto la matenda ashuga amtundu wa 2: kuchuluka kwa kuchepetsedwa kumachepetsedwa ndi 40%, michereopathy ya maso ndi impso imachepetsedwa ndi 37%, kuchuluka kwa kufera kumachepetsedwa ndi 21%.
Kutsimikizira kogwiritsa ntchito machitidwe:
- Pambuyo pozindikira - zakudya, masewera, Metformin.
- Ngati mankhwalawa sakukwanira, kukonzekera kwa sulfonylurea kumawonjezeredwa.
- Kupitanso patsogolo - kusintha kwa moyo, metformin ndi insulin yayitali.
- Kenako insulin yochepa imawonjezeredwa ndi insulin yayitali, regimen yovuta kwambiri ya insulin mankhwala imagwiritsidwa ntchito.
Pa magawo 3 ndi 4, Lantus angagwiritsidwe ntchito bwino. Chifukwa chachitali ndi matenda a shuga a 2, jakisoni imodzi patsiku ndi yokwanira, kusapezeka kwa nsonga kumathandizira kusunga insulini nthawi yomweyo. Zinapezeka kuti atasinthira ku Lantus m'magulu ambiri a anthu odwala matenda ashuga omwe ali ndi GH> 10% pambuyo pa miyezi itatu, mlingo wake umatsika ndi 2%, pambuyo miyezi isanu ndi umodzi wafika pachimodzimodzi.
Analogi
Ma insulin omwe amakhala nthawi yayitali amapangidwa ndi opanga awiri okha - Novo Nordisk (Levemir ndi mankhwala a Tresiba) ndi Sanofi (Lantus ndi Tujeo).
Poyerekeza mankhwala omwe amapezeka m'matumba a syringe:
| Dzinalo | Zogwira ntchito | Nthawi yogwira, maola | Mtengo pa paketi iliyonse, pakani. | Mtengo wa 1 unit, rub. |
| Lantus SoloStar | glargine | 24 | 3700 | 2,47 |
| Levemir FlexPen | chinyengo | 24 | 2900 | 1,93 |
| Tujo SoloStar | glargine | 36 | 3200 | 2,37 |
| Tresiba FlexTouch | degludec | 42 | 7600 | 5,07 |
Lantus kapena Levemir - ndibwino?
Insulin yapamwamba kwambiri yomwe imakhala ndi mbiri yochita zambiri imatha kutchedwa Lantus ndi Levemir. Mukamagwiritsa ntchito ina iliyonse yaiwo, musakayikire kuti masiku ano zichitanso chimodzimodzi dzulo. Ndi mlingo woyenera wa insulin yayitali, mutha kugona mwamtendere usiku wonse osawopa hypoglycemia.
Kusiyana kwa mankhwala:
- Zochita za Levemir ndizabwino. Pazithunzi, kusiyana kumeneku kumawonekera bwino, m'moyo weniweni, pafupifupi wosazindikira. Malinga ndi ndemanga, mphamvu ya ma insulini onse ndi ofanana, mukasintha kuchoka ku wina kupita kwina nthawi zambiri simusowa kusintha mlingo.
- Lantus amagwira ntchito nthawi yayitali kuposa Levemir. Malangizo ogwiritsira ntchito, tikulimbikitsidwa kuti tizililuma 1 nthawi, Levemir - mpaka katatu. Pochita, mankhwalawa onse amagwira bwino ntchito akaperekedwa kawiri.
- Levemir amasankhidwa kwa odwala matenda ashuga omwe amafunikira kwambiri insulin. Ikhoza kugulidwa m'makalata ndi kumaikidwa mu cholembera ndi gawo la dosing ya mayunitsi 0,5. Lantus amagulitsidwa kokha m'mapensulo akutha mu 1 unit.
- Levemir ili ndi pH yosatenga mbali, kotero imatha kuchepetsedwa, ndikofunikira kwa ana aang'ono komanso odwala matenda ashuga omwe amakhala ndi chidwi chachikulu ndi mahomoni. Insulin Lantus imataya zinthu zake ikaphatikizidwa.
- Levemir poyera mawonekedwe amasungidwa nthawi 1.5 (masabata 6 motsutsana ndi 4 ku Lantus).
- Wopanga akuti ndi mtundu wa matenda ashuga a 2, Levemir amachititsa kuti achepetse thupi. Zochita, kusiyana ndi Lantus ndikosavomerezeka.
Pazonse, onse mankhwalawa ndi ofanana, kotero, ndi shuga palibe chifukwa chosinthira wina popanda chifukwa chokwanira: kuyanjana kapena kusayang'anira bwino glycemic.
Lantus kapena Tujeo - kusankha?
Kampani ya insulin Tujeo imamasulidwa ndi kampani yomweyo monga Lantus. Kusiyana pakati pa Tujeo ndikochulukitsa-katatu kwa insulin mu njira (U300 m'malo mwa U100). Zina zonse zikufanana.
Kusiyana pakati pa Lantus ndi Tujeo:
- Tujeo amagwira ntchito mpaka maola 36, kotero mbiri ya zomwe anachita ndi yosasangalatsa, ndipo chiopsezo cha nocturnal hypoglycemia ndi chochepa;
- M'mamililo, mlingo wa Tujeo uli pafupifupi gawo limodzi mwa magawo atatu a mankhwala a Lantus insulin;
- m'mayunitsi - Tujeo amafuna 20% ina;
- Tujeo ndi mankhwala atsopano, chifukwa chake zotsatira zake pa thupi la ana sizinafufuzidwebe. Malangizowa aletsedwa kugwiritsa ntchito odwala matenda ashuga osakwana zaka 18;
- Malinga ndi ndemanga, Tujeo amakonda kukwera ndi singano kwambiri, motero nthawi yake imayenera kusinthidwa nthawi iliyonse ndi yatsopano.
Kupita kuchokera ku Lantus kupita ku Tujeo ndikosavuta: timabayidwa mayunitsi ambiri ngati kale, ndipo timayang'anira glycemia kwa masiku atatu. Mokulira, mankhwalawa amayenera kusinthidwa pang'ono.
Lantus kapena Tresiba
Tresiba ndi yekhayo amene amavomerezedwa ndi gulu latsopano la insulin yayitali. Imagwira mpaka maola 42. Pakadali pano, zatsimikiziridwa kuti ndi matenda amtundu wa 2, chithandizo cha TGX chimachepetsa GH ndi 0.5%, hypoglycemia ndi 20%, shuga amatsika ndi 30% yochepera usiku.
Ndi matenda a shuga a mtundu woyamba, zotsatira zake sizolimbikitsa: GH imachepetsedwa ndi 0,2%, hypoglycemia usiku imachepa ndi 15%, koma masana, shuga imagwera nthawi zambiri ndi 10%.Popeza mtengo wa Treshiba ndiwokwera kwambiri, mpaka pano akhoza kungolimbikitsidwa odwala matenda ashuga omwe ali ndi matenda amtundu wa 2 komanso chizolowezi cha hypoglycemia. Ngati shuga ikhoza kulipiridwira ndi Lantus insulin, kusintha sizimveka.
Ndemanga za Lantus
Lantus ndiye insulin wokondedwa kwambiri ku Russia. Oposa 90% a odwala matenda ashuga amasangalala nazo ndipo amatha kuwalimbikitsa ena. Ubwino wosakayikika wa wodwala umaphatikizapo mphamvu yake yayitali, yosalala, yokhazikika komanso yomwe ikudziwikiratu, kusavuta kwa kusankha kwa mankhwalawa, kugwiritsa ntchito mosavuta, jekeseni wopanda ululu.
Kuyankha bwino kumayenera kuyenera kwa Lantus kuchotsa kutuluka kwa shuga m'mawa, kuchepa kwa mphamvu. Mlingo wake nthawi zambiri umakhala wochepera kuposa NPH-insulin.
Mwa zoperewera, odwala omwe ali ndi matenda a shuga amazindikira kusakhalapo kwama cartridge opanda syringe pena ogulitsa, gawo lalikulu kwambiri, komanso fungo losasangalatsa la insulin.
