Matenda a shuga ndi matenda omwe chizindikiro chake chachikulu ndikuphwanya kupanga kwa insulin. Zotsirizirazi zimatsogolera ku mfundo yoti kuchuluka kwa shuga kumakwera kwambiri kapena kutsika kuzinthu zamagulu. Zakudya zopatsa thanzi komanso kutsatira malamulo ena sizimapereka zotsatira zomwe zimayembekezeredwa, chifukwa chake madokotala nthawi zambiri amapereka mankhwala omwe amaloza mahomoni ndi chinthu chofanana.
Glulin insulin ndi chithunzi cha insulin yachilengedwe yopangidwa ndi thupi la munthu. Amasankhidwa kuti akhale ndi shuga komanso kusakwanira kupanga mahomoni awa.
Kapangidwe ndi mfundo zoyenera kuchitapo
Chofunikira chachikulu pa mankhwalawa ndi insulin Glargin. Ichi ndi chipangizo chopangidwa chokhazikitsidwa ndi njira yosinthira. Pakupanga kwake, zinthu zitatu zofunika zimasinthidwa. Amino acid Asparagine imasinthidwa ndi Glycine mu A unyolo, ndipo ma Arginine awiri amaphatikizidwa ndi B chain. Zotsatira za kuyambiridwaku ndi njira yapamwamba yothandizira jakisoni, yomwe imakhala ndi phindu kwa maola osachepera 24.
Zinthu zomwe zimagwira, zophatikizidwa ndi zida zothandizira, zimakhala ndi phindu lothandiza m'thupi la wodwalayo. Kugwiritsa ntchito bwino insulin Glargin:
- Zimakhudza ma insulin receptors omwe amapezeka mu mafuta ochepa komanso minofu yam'mimba. Chifukwa cha izi, mphamvu yofanana ndi ya insulin yachilengedwe imapangidwira.
- normalization kagayidwe kachakudya njira: chakudya kagayidwe kazakudya ndi shuga.
- Imathandizira kukoka kwa glucose ndi subcutaneous mafuta, minofu minofu ndi chigoba minofu.
- Amachepetsa kupanga shuga owonjezera m'chiwindi.
- Zimayambitsa kapangidwe kazakudya zomanga thupi.
Mankhwala amalowa m'mashelefu ammadzi mu mawonekedwe a yankho: mu 10 ml mabotolo kapena ma 3 ml cartridge. Zimachitika ola limodzi pambuyo pa utsogoleri.
Kutalika kwakukulu kwa kuchitapo kanthu ndi maola 29.
Carcinogenicity komanso zimapangitsa kuti mwana akhale ndi pakati
Asanagulitsidwe, mankhwalawa adayesedwa a carcinogenicity - kuthekera kwa zinthu zina kukulitsa mwayi wa zotupa zoyipa ndi kusinthika kwina. Mlingo wowonjezera wa insulin unaperekedwa kwa mbewa ndi makoswe. Izi zidabweretsa:
- Kufa kwakukulu pagulu lililonse la nyama zoyesedwa;
- Zotupa zoyipa mu akazi (m'munda wa jakisoni);
- Kusakhalapo kwa zotupa pakasungunuka m'magulu osagwirizana ndi asidi.
Mayesowo adawonetsa kawopsedwe kakakulu chifukwa chodalira insulin.
Kutha kubereka ndi kubereka mwana wathanzi kumadwaladwala.
Contraindication
Glargin siyikulimbikitsidwa kuti mugwiritse ntchito ndi hypersensitivity ndi tsankho laumwini pazigawo zake. Pazaka 6, mankhwalawa amapangidwanso chifukwa cha kusowa kwa maphunziro azachipatala. Gwiritsani ntchito mankhwalawa mosamala pazotsatirazi:
- Zowopsa kapena zolimbitsa thupi.
- Kusintha kwachilombo mu chiwindi;
- Ukalamba wokhala ndi vuto la impso kuwipira.
Munthawi yamankhwala, penyani kuchuluka kwa shuga, onetsetsani kuti mukubayidwa ndi insulini mu mafuta obwera. Ganizirani mawonekedwe a thupi la wodwalayo - nthawi zina, mlingo wa mankhwalawa umayenera kusinthidwa.
Kulandila pa mimba ndi mkaka wa m`mawere
Amayi obereka mwana, mankhwala amaperekedwa pokhapokha atakambilana. Mankhwalawa amawonetsedwa pokhapokha ngati phindu lomwe lingachitike kwa mayi ndilokwera kuposa chiwopsezo kwa mwana wosabadwayo. Ngati mayi woyembekezera ali ndi matenda osokoneza bongo, ndikulimbikitsidwa kuwunika momwe metabolic amapangira.
Mu nyengo ya 2 ndi 3 ya kubereka, kufunika kwa insulin kumawonjezeka. Pambuyo pobereka, kufunika kwa mankhwalawa kumatsika kwambiri.
Mwezi uliwonse wam'mimba, muyenera kusamala ndi shuga yamagazi ndikuwonetsetsa nthawi zonse.
Zina zomwe zimagwirizana ndi mankhwala
Mankhwala angapo amawononga kagayidwe kazakudya. Muzochitika izi, mlingo wa insulin umayenera kusinthidwa. Mankhwala omwe amachepetsa kwambiri shuga akuphatikizapo:
- ACE ndi Mao zoletsa;
- Disopyramids;
- Ma salicylates ndi othandizira a sulufide motsutsana ndi ma virus;
- Fluoxetine;
- Maulalo osiyanasiyana.
Mankhwala ena amatha kuchepetsa kuthamanga kwa mahomoni: glucocorticosteroids, diuretics, danazol, glucagon, isoniazid, diazoxide, estrogens, gestagens, ndi zina.
Zotsatira zoyipa
Insulin Glargin ndi mankhwala achilengedwe omwe amadutsa thupi lonse, amakhudza kuchuluka kwa glucose ndi njira ya metabolic. Pogwiritsa ntchito molakwika, chitetezo chazofooka komanso mawonekedwe ena a thupi, mankhwalawa amatha kuyambitsa zotsatira zosafunikira.
Hypoglycemia
Umu ndi m'mene zimakhalira kuti shuga ya magazi imachepetsedwa kwambiri (osakwana 3.3 mmol / l). Zimachitika ngati wodwala anapatsidwa mankhwala ambiri a insulin, ndipo amapitilira zosowa zake. Ngati hypoglycemia imakhala yayikulu ndipo imachitika pakapita nthawi, imawopseza moyo wa munthu. Zobwerezedwa mobwerezabwereza zimakhudza dongosolo lamanjenje. Kuzindikira kwamunthu kumayamba kusokonekera ndikusokonezeka; ndizovuta kuti wodwalayo azingoyang'ana.
Zinthu zikuluzikulu, munthu amadzichotsera chidziwitso. Ndi hypoglycemia wolimbitsa, manja aanthu amanjenjemera, amafunafuna kudya nthawi zonse, amakwiya mosavuta komanso amakhala ndi vuto la mtima wothamanga. Odwala ena awonjezera thukuta.
Zotsatira zoyipa kuchokera pakawonedwe
Ndi malamulo a shuga m'magazi, minofu imakhala yovuta komanso yopsinjika. Kukonzanso kwa mandala a diso kumasinthanso, komwe kumayambitsa zosokoneza zowoneka, zomwe pambuyo pake zimabwereranso kwina popanda zosokoneza zakunja.
Ndi matenda a shuga a retinopathy (kuwonongeka kwa retinopathy), matendawa amatha kukula chifukwa cha kusinthasintha kwakukali m'magazi a shuga. Ndi prinifositosis yowonjezereka, tikulimbikitsidwa kuti muzichita ma photos pafupipafupi. Kupanda kutero, zotsatira zoyipa za hypoglycemia zingayambitse kuwonongeka.
Lipodystrophy
Uku ndikuwonongeka kwa membrane wamafuta omwe amapezeka m'malo a jakisoni. Kubzala ndi mayamwidwe kumalephera. Kuti mupewe izi, tikulimbikitsidwa kusinthasintha malo osabayira a insulin.
Thupi lawo siligwirizana
Izi makamaka zimachitika mderalo: urticaria, zotupa zosiyanasiyana, redness ndi kuyabwa, kupweteka kwa malo a jekeseni. Hypersensitivity insulin ikukula: kutikita kwa khungu (pafupifupi khungu lonse limakhudzidwa), bronchospasm, angioedema, kugwedezeka, kapena matenda oopsa. Izi zimachitika nthawi yomweyo ndipo zimawopseza wodwala.
Nthawi zina, kuyambitsidwa kwa timadzi timatulutsa kumapangitsa kuti zina zisinthe - kusintha kwa sodium, kupanga mapangidwe a edema ndi mapangidwe a chitetezo cha chitetezo ku insulin. Muzochitika izi, mlingo wa mankhwalawa umayenera kusinthidwa.
Njira zopewera kupewa ngozi
Insulin Glargin sinafotokozeredwe matenda ashuga a ketoacidosis, chifukwa ndiwothandiza kwa nthawi yayitali. Ndi hypoglycemia, wodwalayo amatulutsa zizindikiro zomwe zimathandizira kuzindikira kuchepa kwambiri kwa shuga ngakhale izi zisanachitike. Komabe, atha kukhala osatchulika kapena kupezeka kwathunthu kwa odwala a magulu otsatirawa:
- Ndi yokhazikika yokonza magazi;
- Odwala omwe amathandizidwa ndi mankhwala ena;
- Ndi zosokoneza mu ntchito ya psyche;
- Ndi pang'onopang'ono, ulesi chitukuko cha hypoglycemia;
- Anthu achikulire;
- Ndi neuropathy komanso njira yayitali ya matenda a shuga.
Momwe zimapangitsa mwayi wa hypoglycemia ukuwonjezeka
Mukamatsatira njira yomwe mwayikirayo, yang'anirani kuchuluka kwa shuga m'magazi ndikudya bwino, mwayi wa hypoglycemia umachepetsedwa. Ngati pali zina zowonjezera, sinthani mlingo.
Zomwe zimayambitsa kutsika kwa glucose ndizophatikiza:
- Hypersensitivity kuti insulin;
- Kusintha kwa dera komwe mankhwalawo amayamba;
- Matenda omwe amaphatikizidwa ndi chopondapo chopondapo (kutsekula m'mimba) ndi kusanza, kupangitsa matenda a shuga;
- Zochita zolimbitsa thupi zachilendo kwa thupi la wodwalayo;
- Kuledzera;
- Kuphwanya zakudya ndi kugwiritsa ntchito zakudya zoletsedwa;
- Kulephera mu chithokomiro cha chithokomiro;
- Mankhwala ophatikizana ndi mankhwala osagwirizana.
Ndi matenda obwera ndi matenda, kayendedwe ka glucose wamagazi kakuyenera kukhala kokwanira kwambiri.
Patsani magazi ndi mkodzo pafupipafupi kuti mudziwe mayeso ambiri. Ngati ndi kotheka, sinthani mlingo wa insulin (makamaka mtundu 1 wa shuga).
Thandizo loyamba la bongo
Kuchepa kwambiri kwa shuga ndi zovuta komanso kuyambitsa kuchuluka kwa mankhwalawa. Wodwala amatha kuthandizidwa motere:
- Mupatseni chakudya cham'mimba chambiri (mwachitsanzo, confectionery);
- Yambitsani glucacon mu subcutaneous mafuta kapena intramuscularly;
- Lowetsani yankho la dextrose (kudzera m'mitsempha).
Zochita zolimbitsa thupi tikulimbikitsidwa kuti muchepetse. Mlingo, komanso zakudya, zimayenera kusintha.
Insulin Glargin: malangizo ogwiritsira ntchito
Chidacho chimayambitsidwa mosamala mu thupi pamimba, dera la m'chiuno ndi mapewa. Mlingaliro wa mahomoni umagwiritsidwa ntchito 1 nthawi patsiku panthawi inayake. Masamba ena obayira Kukhazikitsa mankhwala mu mtsempha ndi zoletsedwa.
Dzina lamalonda, mtengo wake, malo osungira
Mankhwalawa akupezeka pansi pa mayina otsatirawa:
- Lantus - 3700 rubles;
- Lantus SoloStar - ma ruble 3500;
- Insulin Glargin - ma 35 rubles.
Sungani mufiriji kutentha kwa madigiri 2 mpaka 8. Mukatsegulira, sungani pamalo amdima ndipo ana sangathe kuwapeza, kutentha mpaka madigiri 25 (osati mufiriji).
Insulin Glargin: analogues
Ngati mtengo wa Insulin glargine sugwirizana ndi inu kapena ngati zotsatira zoyipa zambiri zakumwa chifukwa cha mankhwalawo, sinthani mankhwalawo ndi imodzi mwanjira zofananira:
- Humalog (Lizpro) ndi mankhwala ofanana ndi insulin yachilengedwe. Humalog imatengedwa mwachangu kulowa m'magazi. Ngati mumagwiritsa ntchito mankhwalawa nthawi yokhayo komanso muyezo womwewo, Humalog imakhala yolowerera kawiri mofulumira ndipo imafikira magawo ofunikira mu 2 hours. Chipangizocho chikugwira ntchito mpaka maola 12. Mtengo wa Humalogue umachokera ku ma ruble 1600.
- Aspart (Novorapid Penfill) ndi mankhwala omwe amatsutsa kuyankha kwa insulin pakudya. Imakhala yofooka komanso yochepa, zomwe zimapangitsa kuti magazi azikhala ochepa. Mtengo wa malonda umachokera ku ruble 1800.
- Glulisin (Apidra) ndiye mndandanda waufupi kwambiri wa mankhwala osokoneza bongo. Mwa mankhwala a pharmacological sizimasiyana ndi Humalog, komanso mwa zochita za metabolic - kuchokera ku insulin yachilengedwe yopangidwa ndi thupi la munthu. Mtengo - 1908 ma ruble.
Mukamasankha mankhwala oyenera, lingalirani za mtundu wa matenda ashuga, matenda opatsirana ndi machitidwe a thupi.