Zonse zokhudza Insulin Apidra kuyambira A mpaka Z

Apidra ali m'gulu la zophatikizanso za insulin yaumunthu, yomwe imagwirizana ndi izi mwamphamvu yogwira ntchito, koma imathamanga kwambiri komanso osati yokhalitsa. Kuti mukwaniritse zotsatira zomwe mukufuna, chinthucho chikuyenera kutumizidwa ndi dokotala.

Zomwe zimapangidwira

Mankhwala amapezeka mu mawonekedwe a yankho omwe amayenera kuperekedwa mosavuta. Chipangizocho ndi madzi osakhala kopanda utoto wowonekera. Chidebe chilichonse chimakhala ndi 10 ml ya chinthucho. Makatoni amakhala ndi 3 ml ya chinthu.

M'mililita iliyonse ya chinthu, zosakaniza zotsatirazi zilipo:

• 3,49 mg wa yogwira pophika - insulin glulisin, yomwe ili yofanana ndi 100 IU ya insulin ya anthu;
• Zowonjezera zina - trometamol, sodium chloride, madzi, ndi zina.

Mfundo yogwira ntchito

Chithandizo chophatikizika mu mankhwala ndi insulin glulisin. Chidachi ndi njira ina ya insulin, yomwe imapangidwa m'thupi la munthu. Komabe, molekyuluyo imasinthidwa ndikuzikonzanso. Mphamvu ya chigawochi imafanana ndi insulin yaumunthu. Zochita zake zimatheka mwachangu. Komabe, kutalika kwa zotsatirazi ndi kwakufupikitsa.

Insulin glulisin imayambitsa zoletsa shuga zomwe zimachitika m'chiwindi. Chifukwa chogwiritsa ntchito apidra, lipolysis m'maselo am'madzi imalepheretseka, njira zopangira mapuloteni apangidwe zimalimbikitsidwa, ndipo kuwonongeka kwa mapuloteni a protein kumayimitsidwa.

Mothandizidwa ndi mankhwalawa mobisa, kutsika kwa glucose kumachitika makamaka pambuyo pa mphindi 10-20. Mukamagwiritsa ntchito mankhwala a bongo, chinthucho chimagwira limodzi ndi insulin. 1 unit ya mankhwala omwe ali ofanana ndi gawo limodzi la insulin ya munthu.

Panthawi ya mayesero azachipatala, zidapezeka kuti kugwiritsa ntchito apidra 2 mphindi musanadye chakudya kumakulolani kuti muthane ndi kuchuluka kwa glucose m'magazi mutatha kudya. Mankhwalawa amathandizanso shuga kuposa kugwiritsa ntchito insulin ya munthu mphindi 30 asanadye.

Zizindikiro ndi zoletsa kugwiritsa ntchito

Malangizo ogwiritsira ntchito apidra akuwonetsa kuti mankhwalawa amagwiritsidwa ntchito polimbana ndi chiwonetsero cha matenda a shuga a mellitus, omwe amafunikira chithandizo cha insulin. Vutoli litha kutumizidwa kwa achikulire, odwala ndi achinyamata atatha zaka 6.

Kutsutsana kwakukulu pakugwiritsira ntchito chinthu kumaphatikizapo izi:

1. Zaka zosakwana zaka 6 - izi zimachitika chifukwa cha kuchepetsedwa kwa chidziwitso chachipatala chokhudza kugwiritsidwa ntchito kwa chinthu
2. Ana aang'ono;
3. Kukhalapo kwa hypoglycemia;
4. Kuzindikira kwakukulu kwa chophatikizira kapena zina za mankhwala.

Mosamala kwambiri, apidra iyenera kugwiritsidwa ntchito panthawi yobala mwana. Anthu omwe ali ndi vuto la chiwindi angafunike kuchepa kwa insulin. Izi zimachitika chifukwa cha kuchepa kwa gluconeogeneis komanso kuchepa kwa kagayidwe kazinthu ka insulin.

Kutsika kwa kuchuluka kwa yogwira ntchito kungawonedwe ndi kulephera kwa impso. Zilinso chimodzimodzi kwa odwala okalamba, chifukwa cha kuwonongeka kwa impso.

Mawonekedwe akugwiritsidwa ntchito

Kuti mukwaniritse zotsatira zofunika, thunthu liyenera kutumizidwa musanadye chakudya - kwa mphindi 0 mpaka 15. Izi zitha kuchitika pambuyo chakudya. Chidachi chimagwiritsidwa ntchito munjira zomwe zimaphatikizapo insulin ya kukhudzana kwapakatikati kapena nthawi yayitali kapena njira ina ya zinthu zoyambira - lantus. Mankhwalawa amayenera kuphatikizidwa ndi mankhwala osokoneza bongo monga mapiritsi, omwe amachepetsa shuga la magazi.

Mlingo umasankhidwa payekha. Apidra akulimbikitsidwa kuti azithandizidwa mosavuta. Kulowetsedwa kwanthawi yayitali, komwe kumachitika kudzera pampu ya insulini, amathanso kugwiritsidwa ntchito.

Mankhwalawa amalowetsedwa m'matumbo a subcutaneous, omwe amapezeka m'chiuno, pamimba, pamapewa. Ndi kulowetsedwa kwanthawi yayitali, mankhwalawa amatha kuikidwa kokha m'matumbo am'mimba. Masamba oyambira amafunika kusinthidwa.

Mlingo wa kutengeka, nthawi ya zochitika komanso kutalika kwa zochita zimatsimikiziridwa ndi dera la jakisoni, mulingo wakuchita zolimbitsa thupi ndi zina. Jekeseni wokhazikika mkati mwa khoma lam'mimba imayambitsa kukwezeka kwa kutengeka, poyerekeza ndi madera ena.

Thupi lomwe lili m'matotolo liyenera kugwiritsidwa ntchito ndi cholembera cha insulin kapena zida zina. Ndikofunika kwambiri kuti mutsatire malangizo omwe mungatengere katiriji, kukhazikitsa singano, ndikugawa mankhwalawo. Musanagwiritse ntchito katemera, ndikofunikira kupenda mankhwalawa. Pakupakidwa jakisoni, madzi wamba osasinthika amatha kugwiritsidwa ntchito. Palibe zinthu zolimba ziyenera kukhalapo.

Asanagwiritse ntchito, cartridge imasiyidwa kwa maola angapo kutentha kwa firiji. Musanagwiritse ntchito chidebe, ndikofunikira kuchotsa thovu lonse. Pambuyo pa mankhwala, makatiriji sangathe kudzazidwanso.

Ngati syringe ya cholembera yawonongeka, nzoletsedwa kuzigwiritsanso ntchito. Ngati chipangizocho sichingayende bwino, njira yothetsera cartridge ingayikidwe mu syringe yaying'ono, yoyenera kugwiritsa ntchito insulini mu 100 IU / ml.

Kenako mankhwalawa amatumizidwa. Phata la syringe lomwe ndiloyenera kugwiritsidwanso ntchito lingagwiritsidwe ntchito jakisoni kwa wodwala m'modzi yekha. Izi zithandiza kuti matenda asalowe mthupi.

Zofunikira pa kulumikizana ndi insulin sizipezeka. Chifukwa chake, mankhwalawa sayenera kuphatikizidwa ndi mankhwala ena. Chokha chomwe chimasokoneza ndi insulin ya anthu.

Mankhwala a insulin nthawi zambiri amasungidwa mwa anthu omwe ali ndi vuto la impso. Koma kufunika kwa chinthu ichi kumatha kuchepa ndi vuto la impso.
Mphamvu za mankhwalawa mwa anthu omwe ali ndi mavuto pachiwindi sanaphunzire. Odwala omwe ali ndi vuto la chiwindi, vuto la mankhwalawa limatha kuchepa. Izi zimachitika chifukwa cha kuchepa kwa mphamvu ya gluconeogenesis. Komanso, njirayi imakhudzidwa ndi kuchepetsedwa kwa kagayidwe kachakudya.

Zambiri zokwanira zokhudzana ndi kuchuluka kwa mankhwala a pharmacokinetic a okalamba omwe ali ndi matenda a shuga sapezeka. Ndi zovuta mu kugwira ntchito kwa impso, kuchepa kwa insulin kuyang'anira kungawonedwe.

Zotsatira zoyipa

Chovuta kwambiri komanso chowopsa cha insulin Therapy ndikukula kwa hypoglycemia. Mwachizolowezi, vutoli limawonedwa mukamagwiritsa ntchito insulini mu mlingo womwe ndi wokwera kwambiri kuposa momwe umafunikira.

Zotsatira zoyipa zomwe zimagwirizanitsidwa ndikugwiritsa ntchito mankhwalawa ndi izi:

1. Kusintha kwa kagayidwe kachakudya kagayidwe kachakudya, hypoglycemia imachitika nthawi zambiri, yomwe imayendera limodzi ndi mawonekedwe osasangalatsa. Izi zimaphatikizapo thukuta lozizira, kufinya kwa khungu, kutopa. Komanso, munthu amatha kukhala ndi zizindikiro za kuda nkhawa, kunjenjemera, kutopa kwambiri, kuda nkhawa, kugona. Nthawi zambiri hypoglycemia imadziwika ndi kugunda kwamtima, kupweteka mutu, komanso nseru. Izi zikamakula, kukomoka komanso kukomoka kumachitika. Pangakhalenso ntchito yabwinobwino kapena yosakhalitsa ya ubongo. M'mikhalidwe yovuta kwambiri, pamakhala chiopsezo cha kufa.
2. Chifukwa cha kuwonongeka kwa khungu komanso kapangidwe kazinthu zina, matupi a ziwengo zimachitika nthawi zambiri. Amawoneka ngati kutupa, kuyabwa, hyperemia m'dera loyang'anira. Ngati chithandizo chikupitilizidwa, zizindikirazi zimazimiririka. Nthawi zina, lipodystrophy imawonedwa. Nthawi zambiri, zimachitika chifukwa chophwanya kusintha kwa magawo a insulin kapena kugwiritsidwanso ntchito kwa mankhwalawo m'dera lomweli.
3. Mchitidwe wogwiritsa ntchito kwambiri umadziwika ndi kukhathamira, kumva zolimba pachifuwa, komanso kuyabwa. Nthawi zambiri pamakhala matenda a urticaria komanso khungu. Munthawi yovuta, thupi limakhala limasokoneza, kuphatikizira anaphylactic. Zikuyimira moyo weniweni.

Bongo

Palibe chidziwitso chokhudzana ndi kusanthula kwa chizindikiro cha bongo wa apidra. Komabe, ngati mugwiritsa ntchito nthawi yayitali kuchuluka kwa mankhwalawa, pamakhala chiopsezo cha hypoglycemia ya zovuta zosiyanasiyana.

Therapy ya mikhalidwe iyi imatsimikizika ndi kuwuma kwawo:

• Hypoglycemia yofatsa imatha kuyimitsidwa pakudya shuga kapena shuga wokhala ndi shuga. Chifukwa anthu omwe ali ndi matenda ashuga ayenera kukhala ndi maswiti, shuga kapena ma cookie nawo. Madzi a zipatso ndizabwino kwambiri.
• Milandu yovuta ya hypoglycemia, yomwe imatsatana ndi swoon, imachotsedwa ndikuyambitsa kwa 0.5-1 mg ya glucagon. Mankhwala angagwiritsidwe ntchito intramuscularly kapena subcutaneous. Glucose wamkati ungagwiritsidwenso ntchito. Popanda kuyankha, glucagon amatha kuperekedwa mkati mwa mphindi 10-15. Munthu akabwerera ku chikumbumtima, amayenera kupatsa chakudya chamafuta mkati. Izi zikuthandizira kupewa kuyambiranso kwa hypoglycemia. Kenako wodwala amayenera kugonekedwa m'chipatala. Izi zimathandiza kukhazikitsa zomwe zimayambitsa zovuta za hypoglycemia komanso kupewa zomwe zimachitika pambuyo pake.

Zochitika Pantchito

Kafukufuku wazomwe zimachitika pakukhudzana ndi mankhwala osokoneza bongo sikuchitika. Komabe, titha kunena kuti kusintha kwakukulu sikungachitike.

M'pofunika kuganizira zotsatirazi zomwe zikuchitika:

1. Kuphatikizika ndi zinthu zamkamwa za hypoglycemic, ma fibrate, propoxyphene, ACE inhibitors kumathandizira ntchito ya hypoglycemic ya insulin, komanso kumakulitsa chizolowezi chokhala ndi hypoglycemia. Zomwezi zitha kunenedwa za kuphatikiza kwa apidra ndi salicylates, sulfonamides, fluoxetine, pentoxifylline.
2. Kugwiritsidwa ntchito mosiyanasiyana ndi danazol, diuretics, sympathomimetics, glucocorticosteroid mahomoni, estrogens angayambitse kuchepa kwa mphamvu ya hypoglycemic ya insulin. Zotsatira zomwezo zimawonedwa pamene mankhwalawa amaphatikizidwa ndi ma progestin, zinthu za antipsychotic, zotumphukira za phenothiazine.
3. Magenge monga beta-blockers, mchere wa lithiamu, ethanol ndi clonidine amatsogolera pakupanga mphamvu kapena kufooka kwa zinthu za hypoglycemic za insulin.
4. Ndi kuphatikiza kwa mankhwala ndi pentamidine, pamakhala chiopsezo cha hypoglycemia ndi hyperglycemia yotsatira.
5. Kugwiritsa ntchito mankhwalawa kuphatikiza ndi mankhwala omwe ali ndi ntchito yachisoni kungapangitse kuchepa kwambiri kapena kufooka kwa zizindikiro za Refx adrenergic activation. Izi zimawonedwa ndi kuphatikiza kwa mankhwalawa ndi clonidine, guanethidine, reserpine.

Kuwunika kwa kufanana kwa insulin glulisin sikunachitike. Chifukwa chake, sikoyenera kuphatikiza apidra ndi zinthu zina. Chosiyana ndi ichi ndi isophane-insulin. Mukamagwiritsa ntchito chopopera kudzera pampu yolowetsa, ndizoletsedwa kuphatikiza ndi mankhwala ena.

Analogi

Insulin apidra ili ndi mitundu ingapo:

• Humalogue;
• Actrapid;
• Novorapid;
• Insuran r.

Zosunga

Mankhwalawa amayenera kusungidwa pabokosi lamakatoni kuti kuwala kungachitike. Kutentha kuyenera kukhala madigiri 2-8. Osamawumitsa mankhwalawo. Ndikofunika kwambiri kuziteteza kwa ana. Mukatsegula phukusi, mankhwalawo ayenera kugwiritsidwa ntchito pakatha milungu 4. Nthawi yoyamba kugwiritsa ntchito mankhwalawa iyenera kudziwidwa pa phukusi.

Ndemanga

Ndemanga za apidra zikuwonetsa kukhudzika kwakukulu kwa mankhwalawa:

Apidra ndi mankhwala othandiza omwe amathandizira kupirira Zizindikiro za matenda ashuga. Dokotala akuyenera kukupatsani mankhwala okhawo. Izi zikuthandizira kupewa zoyipa ndi kukwaniritsa zotsatira zomwe mukufuna.