Ngenxa yezifundo eziningi kanye nomkhakha wezemithi, njengamanje kunezidakamizwa ezisebenzayo ezilwa nesifo sikashukela. Ngosizo lwemithi ethile, ungagcina izinga le-insulin egazini.
Indawo ekhethekile phakathi kwezidakamizwa ihlalwa izidakamizwa zesimanje ukufaka esikhundleni se-insulin yangaphakathi. I-Insulin Glargin ingasetshenziswa njengethuluzi elizimele, kwesinye isikhathi likhona kwezinye izidakamizwa, ngokwesibonelo, iLantus noma iSolostar. Lesi sakamuva siqukethe cishe ama-70% we-insulin, iLantus - 80%.
Ucwaningo ngemiphumela yale mishanguzo ngesikhathi sokukhulelwa alwenzwanga, ngakho-ke, udokotela oholayo kuphela okufanele athathe isinqumo sokwamukelwa. Futhi, imali kufanele inikezwe ngokuqapha ezinganeni ezingaphansi kweminyaka eyisikhombisa.
Incazelo yesifo sikashukela
Isifo sikashukela yisifo se-pancreatic esibangelwa ukuntuleka kokuhlanganiswa kwe-insulin. Ngalesi sifo, umsebenzi wezitho eziningi nezinhlelo zomzimba kuyaphazamiseka, ngoba kwenzeka izinguquko ekulinganisweni kwe-metabolic.
Ezimweni ezingama-90%, lesi sifo asihlotshaniswa nokushoda kwe-insulin, njengomthetho, isifo sikashukela esinjalo sibhaliswa kubantu abakhuluphele. I-10% yamacala ahambisana nokungalingani kwe-glucose ne-insulin, okubangelwa yi-pathology ye-pancreas.
Kunezizathu eziningana ezingaba ngabasekeli besi sifo:
- isakhi sofuzo
- ukuphazamiseka kohlelo lwe-autoimmune,
- ukuphazamiseka okuhambisana nokukhuluphala nabanye.
Uhlelo lwe-autoimmune luvikela umzimba ezinhlobonhlobo zamagciwane angaphakathi nangaphandle, amagciwane namagciwane. Lokhu kufaka phakathi amaseli akho nawangaphandle angaphandle anezinkinga ezinkulu.
Umuthi wesimanje awazi ukuthi kungani ngasikhathi sinye uhlelo lwe-autoimmune luqala iphutha ukuthatha izicubu zomzimba namangqamuzana angaphandle, zizama ukuziqothula, zikhiqiza amasosha omzimba akhethekile.
Njengomthetho, ukubhujiswa okunjalo kwenziwa ngempumelelo, futhi amaseli aphunyukile ekuqothulweni aqala ukukhiqiza ama-hormone, kufaka phakathi i-insulin, ngendlela esheshayo. Le nqubo ithatha isikhathi, bese kuba nomzuzwana lapho umthamo we-insulin uqala ukwehla, okusho ukuthi izinga likashukela likhuphuka, elingenakudilizwa.
Izimpawu zesifo sikashukela sesibili:
- Izifo ze-pancreatic, ezifana ne-pancreatitis,
- ukuphazamiseka kwe-hormonal, kuvame ukuphazamisa i-goiter,
- ukusetshenziswa njalo kwezidakamizwa ze-hormonal noma ezinobuthi ukwelapha ezinye izifo.
Noma ngabe yini imbangela yesifo sikashukela, indlela yokusebenza kwalesi sifo ihlala ingashintshiwe. Ngenxa yokuntuleka kwe-insulin, umzimba awudli i-glucose futhi awukwazi ukuwuqoqoda emisipha nasesibindi. Kuvela ushukela omkhulu wamahhala, uthuthwa ngegazi futhi kuhlanza zonke izitho zomzimba, kuzilimaze kakhulu.
I-glucose ingesinye sabanikezeli bamandla, ngakho-ke ukungapheleli kwayo kuvame ukunxeshezelwa ngenye into. Kulokhu, umzimba uqala ukucubungula amafutha, ubabheka njengomthombo wamandla.
Lokhu “kugaya” kwamafutha kunamanani amaningi ama-enzyme okudla, angenayo indlela yokuphuma emzimbeni.
Ama-enzymes enzelwe ukudaya ukudla agaya ekugcineni ama-pancreas, aphumele ezinhlotsheni zokuvuvukala, ezihambisana nezimpawu eziningi.
Izici zezidakamizwa
Umgomo wokusebenza kwe-insulin, umsebenzi wayo osemqoka, kufaka phakathi i-Glargin, ukulawula i-glucose metabolism. I-Insulin Lantus isheshisa ukungena kwe-glucose ngemisipha nangama-adipose izicubu, ngenxa yalokho, izinga loshukela we-plasma liyancipha. Lesi sidakamizwa futhi sehlisela izinga lokukhiqizwa koshukela esibindini.
Le mishanguzo i-analogues ye-insulin yomuntu, etholakala ngokunconywa kwe-Escherichia coli bacteria bacteria. Kubonakaliswa yi-solubility ephansi endaweni engathathi hlangothi.
Ibopha kuma-insulin receptors futhi ixhumanise i-bioeffect efana ne-insulin yangaphakathi (endo native).
Kukhona ukulungiswa kwe-glucose metabolism. Umuthi kanye nama-analogue awo kwehlisa ushukela wegazi, kusebenze ukuthathwa kwe-glucose ngezicubu ze-peripheral (ikakhulukazi i-adipose izicubu nemisipha), futhi kuvimbela ukwakheka kwe-glucose esibindini. I-insulin ivimbela i-proteinolysis ne-lipolysis, ngenkathi ithuthukisa ukwakheka kwamaprotheni.
Ngemuva kokuphathwa kobuhlakani besidakamizwa, umphumela uyabonakala ngemuva kwemizuzu engama-40-60. Njengomthetho, isenzo sibhekwa amahora angama-24, isilinganiso samahora angama-29. Ngomjovo owodwa onqenqemeni, ukuqina kokuqina kwento esegazini kuyabonakala ngemuva kwezinsuku ezingama-2-4.
Umuthi we-Insulin Glargin Lantus uqothulwe ngokuphelele ngenxa yendawo ekhethekile ene-acidic, futhi ngokuphatha ngendlela, i-acid ayithathi hlangothi futhi kwakheka imicroprecipitate, lapho umuthi ukhishwa khona ngamanani amancane ngokuhamba kwesikhathi.
Ku-plasma yegazi, akukho ukuguquguquka okubukhali kwevolumu ye-insulin, konke kwenzeka kahle. Izinto ezikhethekile zinikeza indlela yesenzo eside.
I-Insulin Glargin 300 inemiphumela emihle ye-pharmacokinetic ne-pharmacodynamic. Lokhu kungatuswa njenge-insal insulin kwiziguli ezinesifo sohlobo 1 nohlobo 2.
Uma usebenzisa i-Insulin Glargin 300 IU / ml, lokhu kuvula amathuba amahle wokwelashwa okwanele kwabantu abanesifo sikashukela.
Imiyalo yokusebenzisa umuthi
Imithamo yomuthi inqunywa ngokuhlukile. Umuthi uphathwa ngendlela engafani nezinye izikhathi ezi-1 ngosuku ngasikhathi sinye. Izindawo zokwazisa zingaba:
- izicubu ezinamafutha zesisu,
- ithanga
- ehlombe.
M
Ukudla imijovo kufanele kuhlanganiswe njalo nokwazisa ngakunye komuthi.
Ngohlobo 1 sikashukela, umuthi ubekwa njenge-insulin eyinhloko. Ngohlobo 2 sikashukela, sisetshenziswa njenge-monotherapy noma ngokuhlangana namanye ama-hypoglycemic agents.
Uma isiguli sesidlulisile sisuka ku-insulin esezingeni eliphakathi nendawo noma eside sayiswa ku-Insulin Glargin, khona-ke kuyadingeka ukulungiswa komthamo wansuku zonke we-insulin eyisisekelo noma ushintsho ekwelashweni okwenzeka ngokufana.
Lapho isiguli sidluliswa sisuka ku-insulin-isophan singena komunye umjovo owodwa womuthi, kuyadingeka ukwehlisa umthamo wansuku zonke we-basal insulin ngomunye kokuthathu emasontweni okuqala okwelashwa. Lokhu kuyadingeka ukunciphisa amathuba okuba ne-hypoglycemia ebusuku. Ngalesi sikhathi, ukuncipha komthamo kungasuswa ngokwanda kwenani le-insulin elisebenza ngokufushane.
Imiphumela emibi
I-Hypoglycemia ingumphumela omubi ojwayelekile wenqubo, njengokwelashwa kwe-insulin, kubonakala sengathi imithamo ye-insulin iphakeme ngokweqile uma kuqhathaniswa nesidingo sangempela. Ngenxa yokusebenzisa kabi umuthi, umuntu angaqala ukuba nokuhlaselwa kwe-hypoglycemia, okuvame ukuholela kokungasebenzi kahle kohlelo lwezinzwa.
Ukuphazamiseka kwe-Neuropsychiatric ngenxa ye-hypoglycemia, njengomthetho, kwandulelwa yizimpawu zokuphikisa kwe-adrenergic:
- indlala
- ukungaphatheki kahle
- tachycardia.
Izinguquko ezibalulekile kumthethonqubo kashukela wegazi zivame ukudala ukungasebenzi kahle kokubonakalayo ngenxa yezinguquko ku-turgor yezicubu nokukhishwa kwelensi yeso. Ukuqina isikhathi eside ushukela wegazi kwehlisa ingozi yokuba nesifo sikashukela.
Ukuphendula kwasendaweni endaweni yomjovo nokuphendula okwenziwa yileli gciwane:
- ubomvu
- izinhlungu
- ukulunywa
- urticaria
- ukuvuvukala.
Ukuphazamiseka okuningi okuncane endaweni yokulawulwa kwe-insulin kuvame ukuhamba kumaviki ambalwa. Ukuphendula kwe-Hypersensitivity ekukhuleni kwe-insulin ezimweni ezingavamile.
Ukuphendula okunjalo kwe-insulin noma i-excipients kungavela ngendlela yokuthuthukiswa kokuphendula kwesikhumba okujwayelekile. Ngaphezu kwalokho, okulandelayo kungenzeka:
- i-angioedema,
- bronchospasm
- i-arterial hypotension noma ukushaqeka.
Konke lokhu kwephulwa kungasongela impilo yomuntu.
Kwesinye isikhathi ukuba khona kwama-antibodies kuma-insulin kudinga ushintsho kumthamo wokuqeda ukuthambekela kwe-hyper- noma hypoglycemia. Futhi, i-insulin ingadala ukubambezeleka kokuphuma kwe-sodium.
Ngenxa yalokhu, i-edema iyenzeka, ikakhulukazi uma ukwelashwa kwe-insulin okusebenzayo kuholela ekuqondisweni okungcono kwezinqubo ze-metabolic.
Ukusebenzelana kwezidakamizwa
Umuthi awuhambelani nezinye izixazululo. Akudingi ukuxutshwa neminye imikhiqizo noma kuhlanjululwe.
Izidakamizwa eziningi zithinta i-glucose metabolism, edinga ukuguqulwa komthamo. Izidakamizwa ezinjalo zibandakanya:
- ama-hypoglycemic agents
- Ama-inhibitors e-ACE
- ama-disopyramid
- imicu
- i-fluoxetine,
- Mao inhibitors
- pentoxifylline
- propoxyphene
- ama-salicylates,
- izidakamizwa ze-sulfa.
Izindlela ezinganciphisa umphumela we-insulin zihlanganisa:
- okokugcoba
- ama-estrogens
- isoniazid
- glucocorticoids,
- danazol
- diazoxide
- i-glucagon,
- i-clozapine.
- ama-gestagens
- ukukhula kwehomoni,
- ama-hormone egilo
- epinephrine
- salbutamol,
- terbutaline
- ama-proteinase inhibitors
- olanzapine.
Kwangathi kungaba buthaka futhi kwandise umphumela we-insog:
- ama-beta blockers,
- i-clonidine
- usawoti we-lithium
- utshwala
Ukukhetha kwe-insulin
Uma siqhathanisa ne-pharmacokinetics yezidakamizwa ezibhekwayo, khona-ke ukuqokwa kwabo njengodokotela kukhonjiswa kwisifo sikashukela sohlobo lokuqala nolwesibili. Ama-insulin anamuhla awanikeli ekuzuzeni isisindo ngenxa yokusebenzisa izidakamizwa. Inani lamaconsi asebusuku bokuhlushwa ushukela wegazi nalo lehliswa kakhulu.
Kunesidingo somjovo owodwa we-insulin usuku lonke. Ezigulini, kulula kakhulu. Ukusebenza okuphezulu okwaziwayo kwe-insulin analogue yomuntu ene-metformin yeziguli ezinesifo sikashukela sohlobo 2. Ucwaningo lwesayensi lukhombisa ukwehla okukhulu kokugxuma kobusuku ngobungako be-glucose. Ngakho-ke, i-normalization ye-glycemia yansuku zonke iyatholakala.
Kuyafuneka ukuthi uqaphele inhlanganisela ye-Insulin Glargin Lantus ngemithi yomlomo ukwehlisa ushukela wegazi kulezo ziguli ngokungakwazi ukunxephezela isifo sikashukela. Lezi ziguli kufanele zinqunywe i-Insulin Glargin ezigabeni zokuqala zesifo.
Lesi sidakamizwa singanconywa yi-endocrinologist noma udokotela ojwayelekile. Ukwelashwa okujulile usebenzisa iLantus kunikeza ithuba lokulawula i-glycemia kubantu abanesifo sikashukela sawo wonke amaqembu.
Izindleko
Ikhemisi linikeza amalungiselelo e-insulin ngezindleko ezahlukahlukene. Intengo incike kwifomu lapho kuvezwa khona ama-analogues omuthi we-Glargin Insulin. Izindleko zalo muthi ziqala kuma-ruble angama-2800 kuya kwangama-4100
