Chimodzi mwazitsulo zomwe zimagwiritsidwa ntchito kukhazikitsa shuga m'magazi ndi Detemir. Kodi mankhwalawa ali ngati chiyani? Momwe mungagwiritsire ntchito ndi fanizo lomwe lingasinthidwe?
Kodi njira yanji?
Kugwiritsa ntchito matekinoloje amakono a DNA kumathandizanso asayansi kangapo kuwonjezera mphamvu ya othandizira omwe ali ndi insulin yokhazikika.
Njira yothetsera jekeseni ya Detemir imapangidwa pogwiritsa ntchito njira zama biotechnological processing a recombinant ma CD.
Detemir ndi yankho la pH yopanda mbali, ndiyowonekera ndipo ilibe mtundu. Wothandiziratu wa matenda ashuga ndi wa ma insulini angapo amene akhala akuchita kwakanthaŵi. Mumsika, insulin detemir imagulitsidwa pansi pa dzina la Levimir.
Kuyika mapaketi kumawoneka motere: M'mafakitala, amagulitsidwa mumapangidwe a cartridge, mu iliyonse ya 0.142 ml yonyansa. Pafupifupi, ma CD amatenga pafupifupi ma ruble 3,000. Monga mitundu ina ya mankhwala okhala ndi insulin, mankhwalawa amagulitsidwa ndi mankhwala.
Chinsinsi cha zochita za Detemir
Detemir imachita zambiri kuposa insulin glargine ndi isofan. Zotsatira zazitali za wothandizirazi zimachitika chifukwa chodziyanjana ndi ma cell maselo komanso kuphatikiza kwawo ndi mafuta amafuta am'magazi a ma albumin. Poyerekeza ndi ma insulini ena, detemir imabalalika pang'onopang'ono mthupi lonse. Njira yotereyi imagwiranso ntchito kwa mankhwala, ndikuwonjezera mayamwidwe.
Komanso, mosiyana ndi njira zina, insulin iyi imaneneratu, chifukwa chake zimakhala zosavuta kuyendetsa zotsatira zake.
Izi ndichifukwa cha zinthu zingapo:
- Detemir imakhalabe yamadzimadzi kuyambira pakukwanira kufikira pomwe wothandizirayo amalowetsedwa mu thupi;
- Tinthu tating'onoting'ono timakhala ndi ma cell mamolekyulu mu seramu yamagazi ndi njira yothandizira.
Chidacho chimalumikizana ndi ma receptors akunja omwe amapezeka pa cytoplasmic cell membrane. Kapangidwe ka insulini-receptor kamapangidwa kamene kamalimbitsa njira ya mkati mwake. Kuphatikiza kwamphamvu kwa syntlyase ya glycogen, hexokinase ndi pyruvate kinase enzymes kumachitika.
Kusakanikirana kwa glucose komwe kumachitika kumachepa chifukwa cha kuchuluka kwa mayendedwe a shuga mkati mwa maselo, kumayamba kulowa mu minofu. Glycogenogeneis ndi lipogeneis nawonso amakulitsidwa. Chiwindi chimayamba kutulutsa shuga pang'onopang'ono.
Kinetic katundu wothandizira
Pambuyo poyambitsa kununkhira m'thupi, kumalimbikitsidwa kwambiri m'madzi a plasma pambuyo maola 7. Wodwalayo akapatsidwa jakisoni kawiri pa tsiku, ndiye kuti matendawa amayamba kukhazikika patatha masiku ochepa akuchira. Pakadutsa 3 mg jakisoni mthupi, mawu oyambira kugwira ntchito amakhala pafupifupi maola 15 ndipo kugwira ntchito bwino kumachitika pambuyo pa maola awiri.
Popeza kununkha kumatha kugawika, kumazungulira m'magazi.
Zimapukusidwa pafupifupi kwathunthu, ndipo ma metabolites onse amakhala otetezeka kwathunthu kwa thupi. Hafu ya moyo wa mankhwalawa imasiyanasiyana malingana ndi mlingo womwe umaperekedwa kwa wodwala. Pafupifupi, ndi maola 6.
Malangizo ogwiritsira ntchito
Mlingo wofunikira wodwala umasankhidwa payekha. Detemir imatha kutumikiridwa katatu patsiku. Ngati khungu limayamwa kuti iwongoletse glycemia, mankhwalawa amagwiritsidwa ntchito kawiri. Mlingo umodzi umaperekedwa m'mawa, ndipo 2 madzulo asanagone kapena atatha maola 12 jekeseni wam'mawa.
Odwala omwe ali ndi zaka zopitilira 50 ndipo akuvutika ndi vuto la chiwindi kapena impso amafunika kusankha mosamala kwambiri. Kuphatikiza apo, amafunika kuyang'aniridwa pafupipafupi ndi shuga wamagazi.
Jakisoni wa Detemir amaika insulin mosapindika, phewa, kapena dera la khoma lamkati lakumbuyo. Kukula kwa zochita (mayamwidwe) a mankhwalawa zimatengera tsamba la jekeseni. Ngati jakisoni wapangidwa m'dera limodzi, malo oyika ndi singano ayenera kusinthidwa nthawi iliyonse. Izi ndichifukwa choti lipodystrophy imatha kuchitika - awa ndi ma cone achilendo, omwe amakhala ovuta kuwachotsa.
Chonde dziwani: ngati insulin idalowetsedwa m'mimba, ndiye kuti muyenera kubweza masentimita 5 kuchokera ku navel ndikugwera mozungulira.
Komanso, zonse zimachitika molingana ndi algorithm:
- Malowa amathandizidwa ndi antiseptic, zotsalira zake zimayenera kupuma pakhungu;
- Khungu limagwidwa ndimadzi;
- Singano imayikidwa pakona. Palibe kukankha mwamphamvu komwe kumapangidwa, pambuyo pake piston amatambasula pang'ono. Ngati mungalowe mchombo, ndiye kuti muyenera kusintha tsamba la jakisoni.
- Madzimadzi amayamba pang'onopang'ono komanso moyenera. Ngati pisitoni siyikuyenda bwino, khungu pamwamba pa singano limatupa ndikuwuma - muyenera kukankhira singano mozama.
- Pambuyo pakubaya insulin, muyenera kusiya singano pansi pa khungu kwa masekondi 4-6. Zitatha izi, singano imachotsedwa ndikusunthika lakuthwa, tsamba la jakisalo limapukusidwanso ndi antiseptic.
Kuti jakisoni asakhale wowawa momwe mungathere, sankhani singano yofupikitsa komanso yocheperako, mukasungunuka, osafinya khungu mwamphamvu, ndikulankhula ndi dzanja molimba mtima.
Zoyang'ana musanalowe ndalama?
Musanagwiritse jakisoni, muyenera:
- Onaninso mtundu wa malonda;
- Tetezani mankhwala kupukusira kwa mphira ndi mowa kapena antiseptic wina;
- Onjezani kukhulupirika kwa cartridge. Ngati ndiowonongeka kunja kapena gawo lowoneka bwino lomwe limakulirakulira m'lifupi mwake, siligwiritsidwa ntchito ndipo liyenera kubwezeredwa ku pharmacy.
Chonde dziwani kuti insulini yozizira kapena yosungika bwino, makatoni okhala ndi madzi amtambo komanso achikuda, sayenera kugwiritsidwa ntchito. Detemir siyenera kugwiritsidwa ntchito kumapampu a insulin.
Mukabayidwa, muyenera kutsatira malamulowa:
- Mankhwalawa amaperekedwa pokhapokha.
- Pambuyo pa jekeseni aliyense, sinthani singano (ngati insulin imagwiritsidwa ntchito mu ampoule), chifukwa mankhwalawo amatha kutuluka chifukwa cha kutentha.
- Makatoni sangadzazidwe. Izi zimatheka pokhapokha ndi ma syrable osinthika.
Mankhwala osokoneza bongo
Mankhwala, lingaliro la insulin mopitirira muyeso silimapangidwa. Nthawi yomweyo, wodwala akamadya mlingo waukulu kuposa womwe adasankhidwa, amayamba kukhala ndi chithunzi cha matenda a hypoglycemia (otsika kwambiri a shuga).
Wodwala ali ndi izi:
- Pallor;
- Kutentha;
- Tinnitus;
- Kuwonongeka kwa ndende;
- Kumva nseru;
- Dontho lakuthwa mu mtundu wamaso;
- Nkhawa ndi kusowa chidwi.
Nthawi zambiri munthu amadwala mwadzidzidzi. Mawonekedwe ofatsa amkhalidwewu amatha kutha mwa kutenga shuga pang'ono kapena china chilichonse cha shuga. Pali mapiritsi apadera omwe amathandiza kuthana osati hypoglycemia.
Vutoli limatsatiridwa ndi zizindikiro:
- Chikumbumtima;
- Chizungulire
- Kusokonekera kwa mawu;
- Kugwirizanitsa koyipa;
- Mantha olimba a mantha amkati.
Hypoglycemia yayikulu imathandizidwa ndi jakisoni wamitsempha kapena subcutaneous wa 1 mg ya glucagon. Ngati thupi la munthu silikuyankha jakisoniyo mwanjira iliyonse mkati mwa mphindi 20, yankho la shuga limayendetsedwa kudzera m'mitsempha. Nthawi zambiri wodwala amatha kufa kapena kusokonezeka bongo.
Zotsatira zoyipa
Maonekedwe awo mwachindunji zimatengera mlingo wa insulin yomwe inatengedwa. Mwa anthu, izi zimachitika ku Detemir.
- Kuphwanya kagayidwe kachakudya njira. Wodwalayo amatha kudwala matenda am'mimba komanso amachepetsa zinthu zosiyanasiyana m'magazi.
- Zomwe zimachitika kawirikawiri komanso kwanuko. Mukhoza kuyamba kufinya, kuyabwa, ndi kutupa. Mwina kukula kwa lipodystrophy ndi edema m'malo osiyanasiyana a thupi.
- Chitetezo cha mthupi. Odwala ena amakhala ndi ziwengo, urticaria. Kuchita koopsa kwambiri kwamomwe kumapangitsa kuti edema ya Quincke ikhale ndi zotsatira zina zomwe zimabweretsa imfa.
- Refraction chisokonezo. Mphezi zowala zimasinthidwa molakwika mu mandala, chifukwa chomwe chimawoneka chowonongeka ndi mawonekedwe amitundu.
- Rhinopathic matenda.
- Kuwonongeka kwa zotumphukira zamanjenje, chifukwa chomwe kumaphwanya chidwi cha khungu, minofu imakhala yofooka ndipo osamvetsera. Neuropathy imathanso kukhala yopweteka.
Ngati munthu ali ndi chidwi ndi zina mwazigawo za Detemir, izi zimachitika ngakhale mutamwa mankhwala ochepa. Amawonekera kwambiri kuposa odwala ena.
Monga tanena kale, kuwonongeka kumayambitsa hypoglycemia, komwe kumakhudza kwambiri ndende. Ndi vuto lotere, ndikulimbikitsidwa kuchepetsa kuyendetsa magalimoto, kuwongolera njira zovuta ndi mitundu ina ya ntchito, chifukwa imatha kukhala yowopsa kwa anthu.
Mwa odwala ena, hypoglycemia imatha kukula popanda zizindikiro kapena kuwonetsa kwambiri.. Ngati pali chiopsezo chakuti wodwalayo atha kudwala matendawa mosadukiza, ayenera kuchitapo kanthu kuti muchepetse kuchepa kwa shuga komanso kuthamangitsana kwa kuyendetsa ndikugwira ntchito yoopsa nthawi yayitali.
Kodi ndizotheka kubereka, amayi apakati ndi ana?
Palibe kusiyana kwa teratogenic kapena embryotoxic mukamagwiritsa ntchito insulin Detemir komanso munthu wamba. Pankhaniyi, amayi oyembekezera komanso omwe ali ndi nthawi yokhala ndi mkaka wa m'mawere, akamapereka mankhwala, ayenera kuyang'aniridwa ndi dokotala ndikuwonetsetsa kuchuluka kwa shuga.
Mwa amayi omwe ali ndi matenda a shuga, kuchuluka kwawo kwa glucose kumakhazikika pang'ono pama trimesters awiri a 2-3, motero kufunika kwa insulin kumachepa. Mkazi akamabereka ndikusiya kuyamwitsa, thupi limayambanso kusowa ndi insulin. Chifukwa chake simungachoke pamiyeso ya kumwa mankhwalawo chimodzimodzi, muyenera kusintha mankhwalawo.
Kwa ana okulirapo, chithandizo cha insulini ndichotheka, pamene mwana ali ndi vuto la chiwindi, impso ndi ziwalo zina, muyenera kuyang'anira kuchuluka kwa shuga ndi momwe machitidwe amakhudzidwira.
Kugwirizana kwina ndi mankhwala ena
Mankhwala ena amatha kupititsa patsogolo zotsatira za Detemir:
- Othandizira kuchepetsa shuga pamlomo;
- Monoamine oxidase zoletsa mankhwala ndi angiotensin kutembenuza enzyme;
- Osasankha b-group adrenergic blockers.
Mowa umakhudzanso insulin chimodzimodzi. Zimathandizanso kutalika kwa zotsatira za hypoglycemic.
Zinthu zotsatirazi zimalepheretsa izi:
- Kukula kwamafuta osiyanasiyana;
- Glucocorticoids;
- Sympathomimetics yamagulu b;
- Mahomoni a chithokomiro;
- Mankhwala okhala ndi danazol.
Lancreotides ndi octreodites zimatha kukhudza zotsatira zapakati. Nthawi zina, amaziwikitsa kapena kuzichita. Ma sulfites ndi ma thiol sangathe kugwiritsidwa ntchito ndi insulin detemir, chifukwa amawononga kapangidwe ka insulin ndipo amachepetsa mphamvu yake. Chida ichi sichingawonjezeke ku kulowetsedwa kwa otsikira.
Sinthani ku Detemir ndi mitundu ina ya insulin
Njira zotere ziyenera kuchitika moyang'aniridwa ndi katswiri. Kusintha kwa ndende, kusintha kwa mtundu wa wothandizira (kuchokera kwa munthu kupita ku nyama / anthu a insulin analogues ndi mosemphanitsa) ndi zinthu zina kungafune kusintha kwa kayendedwe ka insulin.
PanjiraMukapita ku Detemir, muyenera kuyang'anitsitsa kuchuluka kwa odwala omwe ali ndi shuga. Kuwongolera kotereku kumachitika m'masabata angapo oyamba.
Mukamathandizira odwala matenda ashuga, muyenera kupuma pakati pa mankhwala osiyanasiyana. Zitha kuthana ndi mayamwidwe ndi wina ndi mnzake.
Zomwe zili ndi insulin
Dululir ya Detemir imakhala ndi mitundu iwiri yomwe fanizo la insulin limagwirira ntchito.
Nawa mayina awo ndi mitengo yake:
- Levemir Flekspen mu mawonekedwe a jakisoni - mtengo pa paketi 100 ml ndi ma ruble 4500.
- Levemir Penfil alinso mu mawonekedwe a yankho - kuchuluka komweko kumawononga ma ruble 5,000.
Gulu lomweli lamankhwala limaphatikizapo ndalama ndi insulin glargine. Mayina amalonda ndi mtengo wake:
- Yankho la jakisoni wa Aylar - ma ruble 3500;
- Latus Optiset ndi Latus Standard - ma ruble 2900;
- Latus Solostar - ma ruble 3000;
- Tozheo Solostar kuchokera ku ruble 1000 mpaka 2700.
Zofananira zina za detemir:
- Monodar Ultralong (kuyimitsidwa kwa jekeseni) - monga gawo la insulin ya nkhumba.
- Tresiba Flekstach - yankho la insuludec la insulin, limatengera rubles 5000.
Pomaliza
Detemir ndi imodzi mwamankhwala abwino kwambiri a insulin malinga ndi magawo a thupi ndi mankhwala. Ili pafupi kwambiri ndi insulin yaumunthu. Chochita sichimasiya chilichonse chogwira ntchito mthupi chomwe chitha kukhala ndi zotsutsana ndi thupi. Mtengo wake siwokwezeka kuposa mitundu ina ya insulini.
Chifukwa chake, mtengo wapakati wa izi ndi kusinthasintha kwake kumapangitsa kuti muzitha kugwiritsa ntchito magulu osiyanasiyana a odwala.
