Ngemuva kokuvela kokufana kwama-insulin analogue amafushane, ukwelashwa kwesifo sikashukela kufinyelele ezingeni elisha ngokuyisisekelo: ukulawulwa okuzinzile kwe-glycemia kwiziguli eziningi kwenzeka, ingozi yokuphazamiseka kwe-microvascular, hypoglycemic coma yancishiswa kakhulu.
I-Apidra ingummeleli omncane kunabo bonke baleli qembu, amalungelo alesi sidakamizwa angawokukhathazeka okuvela eFrance iSanofi, enamagatsha amaningi, elinye lawo eliseRussia. I-Apidra isibonakalise izinzuzo ngaphezulu kokufaka okufushane komuntu: iqala futhi ime ngokushesha, ifinyelela inani eliphakeme. Ngenxa yalokhu, abanesifo sikashukela bangenqaba ukudla okulula, abanamatheliswa isikhathi sokudla, futhi bayasindiswa ekuthini balinde kuze kuqale isenzo se-hormone. Ngamafuphi, izidakamizwa ezintsha zadlula lendabuko ngazo zonke izindlela. Yingakho isilinganiso seziguli ezisebenzisa i-insulin analogues sikhula ngokuqinile.
Imiyalo yokusebenzisa
| Ukwakheka | Into esebenzayo yi-glulisin, i-molecule yayo ihlukile kune-endo native (synthesised emzimbeni) i-insulin ngama-amino acid amabili. Ngenxa yalokhu kufakwa esikhundleni, i-glulisin ayithambekele ekwakheni izinto eziyinkimbinkimbi ku-vial nangaphansi kwesikhumba, ngakho-ke ingena ngokushesha kwegazi ngokushesha ngemuva komjovo. Izithako ezisizayo zifaka i-m-cresol, chloride ne-sodium hydroxide, i-sulfuric acid, i-tromethamine. Ukuqina kwesisombululo kunikezwa ngokufakwa kwe-polysorbate. Ngokungafani namanye amalungiselelo amafushane, i-insulin Apidra ayiqukethe i-zinc. Isixazululo sine-pH engathathi hlangothi (7.3), ngakho-ke ingafakwelwa lapho kudingeka imithamo emincane kakhulu. |
| I-Pharmacodynamics | Ngokomgomo namandla esenzo, i-glulisin ifana ne-insulin yomuntu, idlula ngokushesha nangesikhathi somsebenzi. I-Apidra inciphisa ukugcwala koshukela emithanjeni yegazi ngokuvuselela ukumuncwa kwayo yimisipha nezicubu ze-adipose, futhi kuvimbela nokwakheka koshukela isibindi. |
| Izinkomba | Isetshenziselwa ushukela ukwehlisa ushukela ngemuva kokudla. Ngosizo lomuthi, i-hyperglycemia ingalungiswa ngokushesha, kubandakanya nezinkinga ezinkulu zesifo sikashukela. Ingasetshenziswa kuzo zonke iziguli kusuka eminyakeni eyi-6 ubudala, noma ngabe ubulili nesisindo. Ngokwemiyalo, i-insulin Apidra ivunyelwe ezigulini esezikhulile ezine-hepatic kanye ne-renal and insufficiency. |
| Contraindication | Ayikwazi ukusetshenziselwa i-hypoglycemia.. Uma ushukela uphansi ngaphambi kokudla, kuphephile ukusebenzisa i-Apidra isikhashana lapho i-glycemia ivamile. I-Hypersensitivity to gilluzin noma izingxenye ezisizayo zekhambi. |
| Imiyalo ekhethekile |
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| Umthamo | Umthamo ofunwayo unqunywa ngokusekelwe enanini lama-carbohydrate ekudleni kanye nokuguqulwa komuntu ngamunye kwezingxenye zesinkwa zibe amayunithi we-insulin. |
| Isenzo esingafunwa | Ukuphendula okuhlukile kwe-Apidra kuvamile kuzo zonke izinhlobo ze-insulin. Imiyalo yokusebenzisa isetshenziswa ngemininingwane mayelana nazo zonke izenzo ezingathandeki. Imvamisa, i-hypoglycemia ehambisana nomuthi omningi wesidakamizwa iyabonakala. Zihambisana nokuthuthumela, ubuthakathaka, ukuguguleka. Isilinganiso senhliziyo esikhulayo sibonisa ubulukhuni be-hypoglycemia. Ukuphendula kwe-Hypersensitivity ngesimo se-edema, ukuqubuka, ubomvu kungenzeka kusayithi lomjovo. Imvamisa banyamalala ngemuva kwamasonto amabili basebenzise i-Apidra. Ukuphendula okubucayi kwesistimu akuvamile, kudinga ukufakwa esikhundleni esiphuthumayo kwe-insulin. Ukwehluleka ukuhambisana nenqubo yokuphatha kanye nezimpawu zomuntu ngamunye zezicubu ezi-subcutaneous kungaholela ku-lipodystrophy. |
| Ukukhulelwa kanye ne-GV | I-Insulin Apidra ayiphazamisi ukukhulelwa okunempilo, ayithinti ukuthuthukiswa kwe-intrauterine. Umuthi uvunyelwe ukusetshenziswa kwabesifazane abakhulelwe abanezinhlobo 1 no-2 sikashukela nesifo sikashukela sokukhulelwa. Ucwaningo lokuthi kungenzeka i-Apidra idlulele kubisi lwebele alwenziwe. Njengomthetho, ama-insulin angena ebisini ngobuncane obuncane, ngemuva kwalokho agaywa endaweni yokugaya yengane. Amathuba okuthi i-insulin ingene egazini lengane ikhishwe ngaphandle, ngakho-ke ushukela wakhe ngeke wehlise. Kodwa-ke, kunobungozi obuncane bokusabela komzimba enganeni kuya ku-glulisin nezinye izingxenye zesisombululo. |
| Ukusebenzelana kwezidakamizwa | Umphumela we-insulin buthaka: UDanazol, u-Isoniazid, uClozapine, u-Olanzapine, uSalbutamol, uSomatropin, iTerbutaline, i-Epinephrine. Gcizelela: I-Disopyramide, i-Pentoxifylline, i-Fluoxetine. I-Clonidine ne-reserpine - ingavala uphawu lokuqalwa kwe-hypoglycemia. I-Alcohol ikhulisa isinxephezelo sikashukela i-mellitus futhi ingavusa kakhulu i-hypoglycemia, ngakho-ke ukusetshenziswa kwayo kufanele kuncishiswe. |
| Khipha amafomu | Amakhemisi ikakhulukazi anikela nge-Apidra eSeniStar syringe pens. I-cartridge enesixazululo esingu-3 ml kanye nenqwaba ejwayelekile ye-U100 ibekwe kubo; ukufakwa kwe-cartridge akunikezwe. Isinyathelo sokuhambisa sepeni - 1 iyunithi. Ephaketheni lamapeni ama-5, ama-insulin ayi-15 ml noma ama-1500 kuphela we-insulin. I-Apidra iyatholakala nasezimvini eziyi-10 ml. Imvamisa zisetshenziswa ezikhungweni zezokwelapha, kepha zingasetshenziswa futhi ukugcwalisa indawo yokugcina iphampu ye-insulin. |
| Intengo | Ukufakwa ngamapeni wesirinji we-Apidra SoloStar kubiza cishe ama-ruble angama-2100, aqhathaniswa ne-analogues esiseduzane - iNovoRapid neHumalog. |
| Isitoreji | Impilo yamashalofu e-Apidra yiminyaka emi-2, inqobo nje uma sonke lesi sikhathi ibigcinwe esiqandisini. Ukuze unciphise ubungozi be-lipodystrophy kanye nobuhlungu bemijovo, i-insulin ifudunyezwa ekushiseni kwegumbi ngaphambi kokuyisebenzisa. Ngaphandle kokuthola ilanga, emazingeni okushisa aze afike ku-25 ° C, isidakamizwa esibayeni sesirinji sigcina impahla yaso emavikini ama-4. |
Masihlale imininingwane eminingi ngezimpawu zokusetshenziswa kwe-Apidra, ezingafakwanga emiyalweni yokusetshenziswa.
Ukuthola isinxephezelo sikashukela esihle ku-Apidra, udinga:
- Prick insulin imizuzu engu-15 ngaphambi kokudla. Ngokusho kwemiyalo, ikhambi lingalungiswa ngesikhathi sokudla nangemva kokudla, kepha kulokhu kuzodingeka ubekezelele ushukela ophezulu okwesikhashana, okusho ukuthi kungaba nengozi enkulu yezinkinga.
- Gcina ukubala okuqinile kwamayunithi wesinkwa, vimbela ukusetshenziswa kokudla okungabaliwe.
- Gwema amanani amaningi okudla anenkomba ephezulu ye-glycemic. Yakha ukudla ikakhulukazi kuma-carbohydrate ahamba kancane, hlanganisa ngokushesha ngamafutha namaprotheni. Ngokusho kweziguli, ngokudla okunjalo, kulula ukukhetha umthamo ofanele.
- Gcina idayari futhi, ngokususelwa kwidatha yayo, lungisa isilinganiso se-Apidra insulin.
Umuthi ungasetshenziswa kabanzi ukunxephezela abanesifo sikashukela eshumini nambili. Leli qembu alinayo imiyalo ekhethekile, imikhuba yokudla ekhethekile, indlela yokuphila esebenzayo. Ekukhuleni, isidingo se-insulin sivame ukuguquka, ubungozi be-hypoglycemia bungaphezulu, futhi i-hyperglycemia ihlala isikhathi eside ngemuva kokudla. I-hemoglobin esezingeni eliphakathi nendawo kwentsha eRussia ingu-8,3%, okude kakhulu nezinga okugxilwe kulo.
Isifo sikashukela nokucindezela kuzoba yinto yesikhathi esedlule
- Ukwehlela ushukela -95%
- Ukuqedwa kwe-vein thrombosis - 70%
- Ukuqedwa kokushaya kwenhliziyo okuqinile -90%
- Ukuqeda umfutho wegazi ophakeme - 92%
- Ukwanda kwamandla ngesikhathi sosuku, ngcono ukulala ebusuku -97%
Ucwaningo ngokusetshenziswa kwe-Apidra ezinganeni lukhombisile ukuthi lesi sidakamizwa, kanye neHumalog neNovoRapid, sinciphisa ushukela. Ingozi ye-hypoglycemia nayo beyifana. Inzuzo ebalulekile ye-Apidra ukulawula okuhle kwe-glycemic kwiziguli ezinoshukela obude obude ngemuva kokudla.
Imininingwane ewusizo mayelana ne-Apidra
I-Apidra isho i-insulin ye-ultrashort. Uma kuqhathaniswa ne-hormone emfishane yomuntu, umuthi ungena egazini izikhathi eziyi-2 ngokushesha, umphumela wokwehlisa ushukela ubonwa ikota yehora ngemuva kokuphathwa kobuhlakani. Isenzo siyaqina ngokushesha futhi ngemuva kwehora nesigamu sifinyelela inani eliphakeme. Isikhathi sokusebenza cishe amahora angama-4, ngemuva kwalokho inani elincane le-insulin lihlala egazini, elingakwazi ukuthinta i-glycemia.
Iziguli ezise-Apidra zinezinkomba ezingcono zikashukela, zingakwazi ukudla ukudla okuqinile okungaphansi kwabanesifo sikashukela esifushane. Umuthi unciphisa isikhathi kusuka ekuphathweni kuya ekudleni, awudingi ukubambelela ngokuqinile ekudleni nasekudla okulula okuphoqelekile.
Uma umuntu onesifo sikashukela enamathela ekudleni okuphansi kwe-carb, isenzo se-Apidra insulin singashesha kakhulu, ngoba ama-carbohydrate aphambili angenaso isikhathi sokuphakamisa ushukela wegazi ngesikhathi umuthi uqala ukusebenza. Kulokhu, kunconywa ama-insulin amafushane kodwa hhayi ama-ultrashort: I-Actrapid noma i-Humulin Regular.
Imodi Yokuphatha
Ngokusho kwemiyalo, i-insulin Apidra iphathwa ngaphambi kokudla ngakunye. Kuyinto efiselekayo ukuthi phakathi kokudla okungenani amahora angama-4. Kulokhu, umphumela wemijovo emibili awugqqi, ovumela ukulawula ngempumelelo kwesifo sikashukela. I-glucose idinga ukukalwa akukho ngaphambi kwamahora ama-4 emva komjovo, lapho umthamo olawulwa umuthi uphela umsebenzi wawo. Uma ngemuva kwalesi sikhathi ushukela ukhuphukile, ungenza okubizwa ngokuthi yi-ukulungisa poplite. Kuvunyelwe nganoma yisiphi isikhathi sosuku.
Ukuncika kwesenzo ngesikhathi sokuphatha:
| Isikhathi esiphakathi kokujova nesidlo | Isenzo | |
| I-Apidra SoloStar | I-insulin emfushane | |
| ikota yehora ngaphambi kokudla | isigamu sehora ngaphambi kokudla | I-Apidra ihlinzeka ngokulawula kahle sikashukela. |
| 2 amaminithi ngaphambi kokudla | isigamu sehora ngaphambi kokudla | Umphumela wehlisela ushukela womabili ama-insulin cishe uyafana, yize i-Apidra isebenza isikhathi esincane. |
| ikota yehora ngemuva kokudla | 2 amaminithi ngaphambi kokudla | |
I-Apidra noma iNovoRapid
Lezi zidakamizwa ziyafana ngezakhiwo, izici, intengo. Zombili i-Apidra neNovoRapid ziyimikhiqizo yabakhiqizi abaziwayo baseYurophu, ngakho-ke akukho kungabaza kukhwalithi yabo. Bobabili ama-insulin banabathandekayo babo phakathi kodokotela nabanesifo sikashukela.
Umehluko wezidakamizwa:
- I-Apidra ikhethwa ukuthi isetshenziswe kumaphampu we-insulin. Ingozi yokuvalwa kohlelo iphindwe izikhathi ezi-2 kuneNovoRapid. Kucatshangwa ukuthi umehluko onjalo uhlotshaniswa nokuba khona kwe-polysorbate kanye nokungabikho kwe-zinc.
- I-NovoRapid ingathengwa kuma-cartridges futhi isetshenziswe ngamapeni wesirinji ezikhuphukeni zamayunithi angama-0.5, okubalulekile kwabanesifo sikashukela abadinga imithamo emincane ye-hormone.
- Umthamo ophakathi nendawo we-insulin Apidra ongaphansi kwama-30%.
- I-NovoRapid ihamba kancane.
Ngaphandle kwalokhu mehluko, akunandaba ukuthi usebenzise ini - i-Apidra noma uNovoRapid. Ukushintshwa kwe-insulin eyodwa kuya kwenye kunconyelwe izizathu zokwelashwa kuphela, imvamisa lokhu kungukuthi ukusabela okukhulu komzimba.
I-Apidra noma i-Humalog
Lapho ukhetha phakathi kweHumalog ne-Apidra, kunzima nangokuthi ukusho ukuthi yikuphi okungcono, ngoba zombili lezi zidakamizwa cishe ziyafana ngesikhathi namandla esenzo. Ngokusho kwesifo sikashukela, ukushintshwa kusuka kwesinye i-insulin kuya kwesinye kwenzeka ngaphandle kobunzima, imvamisa ama-coefficients wokubala awashintshi.
Umehluko owatholakala:
- I-Apidra insulin ishesha ukwedlula uHumalog egxiliwe egazini ezigulini ezinokukhuluphala kwe-visceral;
- i-humalog ingathengwa ngaphandle kwamapeni wesirinji;
- kwezinye iziguli, imithamo yazo zombili amalungiselelo e-ultrashort ayalingana, kuyilapho ubude be-insulin ene-Apidra bungaphansi kuneHumalog.
