Isifo sikashukela i-mellitus yisifo esiyingozi esingathembela i-insulin (uhlobo 1) noma esingathembi i-insulin (uhlobo 2). Esimweni sokugcina, lesi sifo selashwa ngempumelelo ngosizo lwabenzeli be-hypoglycemic kanye nokudla okukhethekile. Kepha uma kuqala uhlobo lwesifo kanye nohlobo 2 lwesifo sikashukela, ukwelashwa kwe-insulin ngeke kusatshalaliswe ngakho.
Imvamisa, iziguli ezinokuhlushwa ushukela osegazini zinikezwa i-insulin Glulizin. Lesi yisixazululo esimhlophe somjovo, into esemqoka kuyo yi-analogue ye-insulin yomuntu encibilikisiwe, ithuthukiswe kusetshenziswa i-genetic engineering.
Umuthi unomphumela omfishane ohlose ukwehla ngokushesha kokuxineka koshukela egazini. I-Apidra SoloStar ne-Apidra zingezindlela, ezifaka i-insulin Glulisin.
Umphumela we-Pharmacological kanye ne-pharmacokinetics
Isixazululo sinomphumela omfushane we-hypoglycemic. Ngaphezu kwalokho, isebenzisa inqubo yokufakwa kweglucose izicubu ezithambile (okunamafutha, izicubu zamathambo), ukuvimbela inqubo yokukhiqiza ushukela esibindini.
Futhi, umuthi uvuselela ukwakheka kwamaprotheni, kuvimbela i-proteinolysis ne-lipolysis kuma-adipocytes. Ngemuva kokuphathwa kwe-subcutaneous, ukwehla kwezinga leshukela kwenzeka ngemuva kwemizuzu eyi-10-20.
Esimweni sokuphathwa kwe-iv, umphumela we-hypoglycemic uqhathaniswa nesenzo se-insulin yomuntu. Ngakho-ke, ngokuya kokusebenza kahle, i-1 IU ye-insulin Glulisin ilingana ne-1 IU ye-insulin yabantu encibilikayo.
Uma kuqhathaniswa ne-insulin yomuntu, uGlulisin umunca kabili ngokushesha okusheshayo. Lokhu kungenxa yokufakwa esikhundleni kwe-asparagine amino acid (isikhundla 3B) ne-lysine, kanye ne-lysine (isikhundla 29B) nge-glutamic acid.
Ukuqothuka ngemuva kokuphathwa kwe-sc:
- ethangeni - phakathi;
- odongeni lwesisu - okusheshayo;
- ehlombe - phakathi.
I-bioavailability eyi-70%. Uma wethulwa ezindaweni ezahlukahlukene, kuyafana futhi kunokuhluka okungaphansi phakathi kweziguli (izinga lokuhluka okungama-11%).
Lapho ihanjiswa ngokungaziphathi kahle ngohlobo 1 sikashukela, i-0.15 U / kg TCmax ingama-55 amaminithi., Kanye no-kg uCmax ngu-80.7-83.3 μU / ml. Ohlelweni lwesibili lwesifo, ngemuva kokuphathwa kwesidakamizwa ngomuthi we-0,2 PIECES / kg, i-Cmax ingu-91 mcU / ml.
Ekujikelezweni kwe-systemic, isikhathi sokuvezwa okulinganiselwe singama-98 min. Ngokuvula / kwesingeniso, umthamo wokusatshalaliswa ngamalitha ayi-13, T1 / 2 - imizuzu engu-13. I-AUC - 641 mg x h / dl.
I-pharmacokinetics in diabetesics engaphansi kweminyaka engu-16 ubudala enohlobo lokuqala lwesifo iyafana nakwabantu abadala. Nge-sc management T1 / 2 isuka emaminithini angama-37 kuye kwangama-75.
Imiyalo yokusebenzisa umuthi
I-Insulin Glulisin ilawulwa ngokungaziphathi, umthamo ukhethwa ngawodwa esigulini ngasinye. Ukulimala kwenziwa ngemizuzu engu-0-15. ngaphambi noma ngemuva kokudla.
I-Glulisin isetshenziswa kuma-regimens okwelapha, okubandakanya ukusetshenziswa kwe-insulin esezingeni eliphakathi noma ende, noma i-analogues yabo. Futhi, isidakamizwa singasetshenziswa sihlanganiswe nezidakamizwa ezinomphumela we-hypoglycemic, ezisetshenziswa ngomlomo.
Isixazululo sikhishwa ngesimo somjovo we-subcutaneous noma ukumnika usebenzisa iphampu ye-insulin. Ukufakwa kwenziwa endaweni ehlombe, ethangeni, odongeni lwesisu sangasemuva. Futhi ukwethulwa kwezimali ngokufakwa okuqhubekayo kwenziwa kwi-peritoneum.
Izindawo zemijovo kanye ne-infusions kumele zishintshwe ngaso sonke isikhathi. Ijubane lokufaka, ukuqala kanye nesikhathi somphumela kunqunywa yizinto ezahlukahlukene (umsebenzi womzimba, indawo yokuphatha). Ukuze uthole ukushesha, umuthi kumele ufakwe endaweni engaphambili kodonga lwesisu.
Kubalulekile ukuqaphela ukuthi i-insulin Glulisin ayingeni emithanjeni yegazi. Ngakho-ke, wonke umuntu onesifo sikashukela kufanele abe nobuciko ekuphathweni kwe-insulin. Ngemuva komjovo, indawo yomjovo ayenqatshelwe ukuba i-massage.
IGlulisin ivunyelwe ukuxutshwa ne-Isofan (insulin yomuntu), kepha uGlulisin kufanele adonswe kwisirinji kuqala. Ukuphathwa kwe-SC kufanele kwenziwe ngokushesha ngemuva kokuxuba izindlela. Kulokhu, ingxube ye-Isofan ne-Glulisin ayenqatshelwa ukuphathwa ngokuhlinzwa.
Uma i-insulin Glulisin ilawulwa kusetshenziswa ipompo, khona-ke ikhithi kufanele lishintshwe njalo ngamahora ama-4, linamathela emithethweni ebulala amagciwane. Ngendlela yokufakwa kokulawula, umuthi akufanele uhlanganiswe nezinye izixazululo noma ama-insulin.
Endabeni yokusetshenziswa ngokungafanele kwepompo noma ukwephula umsebenzi wayo, isifo sikashukela se-ketoacidosis, i-hyperglycemia noma i-ketosis singakhula. Ukuvikela ukwenzeka kwalezi zimo, ngaphambi kokwenza inqubo, kufanele ufunde ngokucophelela imithetho yokusebenzisa uhlelo bese ubala umthamo ngokucophelela.
Ngaphambi kokusebenzisa ikhambi, udinga ukubheka ukuvumelana kwalo, umbala kanye nokuqiniseka ukuthi azikho izinhlayiya ezingaphandle kulo. Uma umkhiqizo unamafu, unemibala noma ungcoliswa, khona-ke kwenqatshelwe ukuwusebenzisa.
Contraindication, imiphumela emibi, i-overdose
I-Insulin Glulizin ayisetshenziselwa ukwelapha izingane ezingaphansi kweminyaka engu-6 ubudala, nge-hypoglycemia kanye ne-hypersensitivity kuzakhi zayo. Umphumela wecala ovame kakhulu yi-hypoglycemia. Ukubonakaliswa kwesikhumba okwenziwa isikhumba nokuphazamiseka kwe-metabolic nakho kungenzeka.
Kwesinye isikhathi kuvela izimpawu ze-neuropsychiatric, ezinjengokukhathala, ukukhathala okuthe xaxa, ubuthakathaka obuphikelelayo, ukugoba, kanye nokuba nomfutho. Ubuhlungu bekhanda, ukuntuleka kokuxineka, ukwaziwa nokudideka nokuphazamiseka okubukwayo nako kuvela.
Imvamisa, ngaphambi kokuphazamiseka kwemizwa ye-neuropsychiatric, kuvela izimpawu zokuphikisana kwe-adrenergic. Lokhu yindlala, ukungaphatheki kahle, i-tachycardia, isasasa lezinzwa, izithukuthuku ezibandayo, ukukhathazeka, ukucwilisa isikhumba nokuthuthumela.
Kuyaqapheleka ukuthi ukuhlaselwa okunamandla kwe-hypoglycemia, okuvame ukuphindwaphindwa, kuholela kumonakalo kwi-NS. Ngaphezu kwalokho, kwezinye izimo, lokhu kungaholela ekufeni.
Ngaphezu kokwehla okubukhali kwamazinga kashukela, ukusabela okubi kwendawo kungenzeka ezindaweni lapho kwenziwa umjovo. Lokhu kufaka phakathi i-hyperemia, ukuvuvukala nokulunywa, imvamisa le mibono inyamalala ngokwayo ngesikhathi sokwelashwa okwengeziwe. Ngesinye isikhathi, ngenxa yokungahambisani nokushintshwa kwendawo yokulawulwa kwe-insulin, umuntu onesifo sikashukela angaba ne-lipodystrophy.
Izimpawu zesistimu zehypersensitivity nazo zingenzeka:
- ukulunywa
- i-urticaria;
- i-dermatitis ye-allergic;
- ukuqina kwesifuba;
- ukujaha.
Imikhuba ejwayelekile ingabulala.
Uma kwenzeka kweqa ngokweqile, i-hypoglycemia yamandla ahlukahlukene avela. Ukwehla kancane ushukela wegazi, isiguli kufanele siphuze iziphuzo noma imikhiqizo equkethe ushukela.
Kwisimo esibi kakhulu nokulahlekelwa ukwazi, s / c noma ku / m kuhanjiswa iDextrose noma iGlucagon. Lapho isiguli siphaphama, kudingeka sisebenzise ama-carbohydrate, okuzogwema ukuphinde kubuye.
Ukuxhumana neminye imithi nemiyalo ekhethekile
Lapho i-insulin Glulisin ihlanganiswa ne-ACE / MAO inhibitors, Disopyramide, fibrate, sulfonamides, salicylates nePropoxyphene, umphumela we-hypoglycemic uyathuthuka futhi amathuba we-hypoglycemia anda.
Inhlanganisela ye-insulin ene-proteinase inhibitors, iDanazole, antipsychotic, Salbutamol, Terbutaline, isoniazids, Epinephrine, Diazoxide, diuretics, Somatropin kanye ne-phenothiazine derivatives kuzokwenza umphumela we-hypoglycemic ubalulwe. I-Clonidine, i-beta-blockers, i-ethanol ne-lithium usawoti yenza buthaka ukusebenza kwe-insulin Glulisin. Futhi ukusetshenziswa komuthi okuhlangene nePentamidine kungavusa kokubili i-hypoglycemia ne-hyperglycemia.
Ukubuyekezwa kwabanesifo sikashukela bathi uma usebenzisa ama-ejenti akhombisa umsebenzi wozwela, izinkomba zokusebenzisa amandla kwe-adrenergic Reflex zingavalwa. Izidakamizwa ezinjalo zibandakanya i-clonidine ne-guanethidine.
Uma isiguli sidluliselwa kolunye uhlobo lwe-insulin noma umuthi kusuka kumenzi omusha, khona-ke lokhu kufanele kwenziwe ngaphansi kokuqashwa ngudokotela. Kuhle ukukhumbula ukuthi umthamo noma i-insulin engalunganga yokwelapha ingakhulisa i-ketoacidosis yesifo sikashukela kanye ne-hypoglycemia.
Ngaphezu kwalokho, ezinye izimo zingashintsha noma zenze izimpawu ze-hypoglycemia ephinyiselwe kancane. Izimo ezinjalo zifaka:
- inkambo ende yesifo sikashukela;
- ukuqinisa ukwelashwa nge-insulin;
- ukudluliselwa kwesiguli kusuka esilwaneni kuya kwi-hormone yomuntu;
- ukuthatha izidakamizwa ezithile;
- isifo sikashukela se-neuropathy.
Lapho ushintsha ukudla noma ukuzivocavoca kuyadingeka ukuze ushintshe umthamo we-insulin. Kodwa-ke, uma umuthi uphathwa ngokushesha ngemuva kwemidlalo, khona-ke amathuba we-hypoglycemia aphezulu.
Ngokuphathelene nokusetshenziswa kwe-insulin Glulisin ngesikhathi sokukhulelwa, inqubo yokwelashwa kumele isondele ngokuqapha ngokweqile, ngoba i-glycemia ingahle ikhule ngohlobo 2 sikashukela neyokuqala. Ngaphezu kwalokho, ezinyangeni zokuqala ezintathu zokukhulelwa nangemva kokubeletha, umthamo we-insulin uvame ukuncishiswa. Ngesikhathi sokuncelisa, ukulungiswa komthamo kungadingeka futhi.
Intengo yezixazululo zokulawulwa kwe-sc kususelwa ku-insulin Glulisin isukela ku-1720 kuya kuma-ruble angama-2100.
Ividiyo ekulesi sihloko ikhombisa ukuthi ungayijova kanjani i-insulin ngokungabonakali.
