Iningi lamalungiselelo e-insulin eRussia avela kwamanye amazwe. Phakathi kokufana kwesikhathi kwe-insulin, iLantus, eyenziwe enye yezinkampane ezinkulu zemithi iSanofi, isetshenziswa kabanzi.
Naphezu kweqiniso lokuthi lesi sidakamizwa sibiza kakhulu kune-NPH-insulin, isabelo sayo semakethe siyaqhubeka sikhula. Lokhu kuchazwa ngumphumela wokwehlisa ushukela isikhathi eside futhi obushelelezi. Kungenzeka prick Lantus kanye ngosuku. Umuthi ukuvumela ukuthi ulawule kangcono zombili izinhlobo zesifo sikashukela, gwema i-hypoglycemia, futhi uvuse kakhulu ukungalingani kwe-allergic.
Ibhuku lokufundisa
I-Insulin Lantus yaqala ukusetshenziswa ngo-2000, yabhaliswa eRussia eminyakeni emithathu kamuva. Esikhathini esedlule, umuthi ukufakazele ukuphepha kwawo kanye nokusebenza kwawo, ufakiwe ohlwini lwe-Vital and Essential Drug, ngakho-ke isifo sikashukela singasithola mahhala.
| Ukwakheka | Isithako esisebenzayo yi-insulin glargine. Uma kuqhathaniswa ne-hormone yomuntu, i-molecule ye-glargine iguqulwa kancane: i-acid eyodwa ifakwa esikhundleni, kufakwe ezimbili. Ngemuva kokuphatha, i-insulin enjalo kalula yenza izakhi eziyinkimbinkimbi ngaphansi kwesikhumba - ama-hexamers. Isixazululo sine-pH ene-acidic (cishe i-4), ukuze izinga lokuwohloka kwama-hexamers liphansi futhi lingabikezelwa. Ngaphezu kwe-glargine, i-Lantus insulin iqukethe amanzi, izinto ezingama-antiseptic m-cresol ne-zinc chloride, kanye ne-glycerol stabilizer. I-acidity edingekayo yesisombululo itholakala ngokungeza i-sodium hydroxide noma i-hydrochloric acid. |
| Khipha ifomu | Njengamanje, i-insulin yeLantus itholakala kuphela esibayeni seSoloStar. Kubekwa ikhareji le-3 ml epeni ngalinye. Ebhokisini lekhadibhodi amasirinji emi-5 nemiyalo. Kumakhemisi amaningi, ungawathenga ngawodwana. |
| Ukubukeka | Isixazululo sivele ngokuphelele futhi singenamibala, asinamqondo ngisho nalapho kugcinwe isikhathi eside. Akudingekile ukuxuba ngaphambi kokwethulwa. Ukuvela kwanoma yikuphi ukufakwa, i-turbidity kuwuphawu lomonakalo. Ukuqoqwa kwento esebenzayo ngamayunithi ayi-100 nge-millilita (U100). |
| Isenzo se-Pharmacological | Naphezu kokungafani kwesimo se-molecule, i-glargine iyakwazi ukubopha kuma-cell receptors ngendlela efanayo ne-insulin yabantu, ngakho-ke umgomo wesenzo uyefana kubo. I-Lantus ikuvumela ukuthi ulawule umzimba we-glucose metabolism uma kwenzeka kushoda i-insulin yakho: uvuselela izicubu zomzimba nezicubu ze-adipose ukumunca ushukela, futhi kuvimbela nokwakheka koshukela ngesibindi. Njengoba iLantus iyi-hormone esebenza isikhathi eside, kufakwa esikhungweni sokugcina ushukela osheshayo. Njengomthetho, onesifo sikashukela i-mellitus, kanye neLantus, kufakwa ama-insulin amafushane - I-Insuman yomenzi ofanayo, ama-analogues noma i-ultrashort Novorapid neHumalog. |
| Ububanzi bokusetshenziswa | Kungenzeka usebenzise kuzo zonke izazi zesifo sikashukela esidala kuneminyaka emi-2 ezidinga ukwelashwa kwe-insulin. Ukusebenza kahle kweLantus akuthintwa ubulili nobudala beziguli, isisindo esithe xaxa nokubhema. Akunandaba ukuthi usifaka kuphi lesi sidakamizwa. Ngokusho kwemiyalo, ukwethulwa esiswini, ethangeni nasehlombe kuholela ezingeni elifanayo le-insulin egazini. |
| Umthamo | Umthamo we-insulin ubalwa ngesisekelo sokufundwa okusheshayo kwe-glucometer izinsuku eziningana. Kukholelwa ukuthi uLantus uthola amandla aphelele kungakapheli izinsuku ezi-3, ngakho-ke ukulungiswa komthamo kungenzeka kuphela ngemuva kwalesi sikhathi. Uma isilinganiso sansuku zonke sokuzila ukudla kwe-glycemia siku> 5.6, umthamo weLantus unyuswa ngamayunithi ama-2. Umthamo uthathwa njengokhethwe kahle uma kungekho-hypoglycemia, kanye ne-glycated hemoglobin (HG) ngemuva kwezinyanga ezi-3 zokusebenzisa <7%. Njengomthetho, onesifo sikashukela sohlobo 2, umthamo uphakeme kakhulu kunohlobo 1, ngoba iziguli zingamelana ne-insulin. |
| Shintsha kuzidingo ze-insulin | Umthamo odingekayo we-insulin ungakhula ngesikhathi sokugula. Ithonya elikhulu kunawo wonke lifakwa izifo kanye nokuvuvukala, kuhambisana nomkhuhlane. I-Insulin Lantus idingeka kakhulu ngokucindezelwa ngokweqile kwemizwelo, ukuguqula indlela yokuphila kube ukusebenza ngokomzimba okusebenzayo, okude. Ukusetshenziswa kotshwala nge-insulin therapy kungahle kubangele i-hypoglycemia enzima. |
| Contraindication |
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| Ukuhlanganiswa neminye imithi | Ezinye izinto zingathinta umphumela weLantus, ngakho-ke yonke imishanguzo ethathwe kwisifo sikashukela kufanele ivumelane nodokotela. Isenzo se-insulin sincishisiwe:
Umphumela we-Lantus insulin uthuthukiswa ngu:
I-Sympatholytics (Raunatin, Reserpine) inganciphisa ukuzwela ku-hypoglycemia, okwenza kube nzima ukuyazi. |
| Umphumela wecala | Uhlu lwemiphumela emibi yeLantus aluhlukile kwamanye ama-insulin anamuhla:
Eminyakeni eminingana edlule, bekukhona ubufakazi bokuthi uLantus uyandisa ubungozi be-oncology. Ucwaningo olulandelayo luveze noma yikuphi ukuhlangana phakathi komdlavuza kanye ne-insulin analogues. |
| Ukukhulelwa | I-Lantus ayithinti inkambo yokukhulelwa nempilo yengane. Emiyalweni yokusetshenziswa, kunconywa ukusebenzisa umuthi ngokuqapha ngokweqile ngalesi sikhathi. Lokhu kungenxa yesidingo esishintsha njalo sehomoni. Ukuthola isinxephezelo esimeme sesifo sikashukela, kuzofanela uvakashele udokotela njalo ushintshe umthamo we-insulin. |
| Ubudala bezingane | Phambilini, uLantus SoloStar uvunyelwe izingane kusuka eminyakeni eyi-6. Ngokuqala kocwaningo olusha, iminyaka yehlisiwe yaba yiminyaka emi-2. Kuyavela ukuthi iLantus yenza ezinganeni ngendlela efanayo neyabantu abadala, ayithinti ukukhula kwayo. Umehluko kuphela otholakele imvamisa ephakeme yokungezwani komzimba ezinganeni, iningi lazo elanyamalala ngemuva kwamasonto amabili. |
| Isitoreji | Ngemuva kokuqala kokusebenza, ipeni lesirinji lingagcinwa amasonto amane ekushiseni kwegumbi. Amapeni amasha wesirinji agcinwa esiqandisini, impilo yeshalofu iyiminyaka emithathu. Izici zomuthi zingonakala uma zivezwa imisebe ye-ultraviolet, amazinga aphansi kakhulu angama-30 (C). |
Ngokuthengiswa ungathola izinketho ezi-2 ze-insulin Lantus. Eyokuqala yenziwa eJalimane, igcwele eRussia. Umjikelezo wesibili wokukhiqizwa ogcwele wenzekile eRussia kwisitshalo iSanofi esifundeni sase-Oryol. Ngokusho kweziguli, ikhwalithi yezidakamizwa iyafana, ukushintshwa kusuka kokunye kuya kwesinye akubangeli zinkinga.
Ulwazi olubalulekile lwe-Lantus
I-Insulin Lantus isidakamizwa eside. Kucishe kungenanamba futhi kusebenza ngokwesilinganiso samahora angama-24, amahora angama-29 aphezulu. Isikhathi, amandla esenzo, isidingo se-insulin sincike ezimweni zaso nohlobo lwesifo, ngakho-ke, irejimeni yokwelashwa nomthamo kukhethiwe esigulini ngasinye ngawodwana.
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%
Imiyalo yokusebenzisa itusa ukujova iLantus kanye ngosuku, ngasikhathi sinye. Ngokusho kwabanesifo sikashukela, ukuphathwa kabili kusebenza kangcono, ngoba kuvumela ukusetshenziswa kwemithamo ehlukahlukene yemini nobusuku.
Ukubalwa kwedosi
Inani leLantus elidingekayo ukwenza i-glycemia ifane nokujwayelekile, kuncike ebukhona be-insulin engaphakathi, ukumelana ne-insulin, izici zokuxoshwa kwe-hormone kusuka ezicutshini ezingaphansi, kanye nezinga lomsebenzi wesifo sikashukela. Uhlobo lokwelashwa lwendawo yonke lukhona. Ngokwesilinganiso, inani eliphelele lesidingo se-insulin lisuka ku-0,3 liye kwiyunithi eyi-1. ngekhilogremu eyodwa, isabelo seLantus kuleli cala sinama-30-50%.
Indlela elula ukubala umthamo weLantus ngesisindo, usebenzisa ifomula eyisisekelo: isisindo esingu-0,2 in kg = umthamo owodwa weLantus ngomjovo owodwa. Isibalo esinjalo alungile futhi cishe njalo kudinga ukulungiswa.
Ukubalwa kwe-insulin ngokuya nge-glycemia kunikeza, njengomthetho, ngomphumela omuhle kakhulu. Okokuqala, thola umthamo womjovo wakusihlwa, ukuze unikeze isizinda se-insulin ngisho nasebusuku ubusuku bonke. Amathuba we-hypoglycemia ezigulini eziseLantus angaphansi kune-NPH-insulin. Kodwa-ke, ngenxa yezizathu zokuphepha, zidinga ukuqashwa ngezikhathi ezithile koshukela ngesikhathi esiyingozi kunazo zonke - ekuseni kakhulu, lapho kukhiqizwa ama-insulin antonon hormone.
Ekuseni, uLantus uthunyelwa ukugcina ushukela esiswini esingenalutho usuku lonke. Umthamo wayo awuncike enanini lama-carbohydrate ekudleni. Ngaphambi kwesidlo sasekuseni, kuzodingeka ugwaze bobabili iLantus ne-insulin efushane. Ngaphezu kwalokho, akunakwenzeka ukwengeza imithamo bese wethula uhlobo olulodwa kuphela lwe-insulin, ngoba inqubo yabo yokusebenza ihlukile kakhulu. Uma udinga ukujova i-hormone ende ngaphambi kokulala, futhi ushukela ukhuphuke, yenza imijovo emi-2 ngasikhathi sinye: I-Lantus ngendlela evamile ne-insulin emfushane. Umthamo ngqo wehomoni emfushane ungabalwa usebenzisa ifomula yeForsham, okulinganiselwa ukuthi kusekelwe ekutheni i-1 unit of insulin izonciphisa ushukela cishe ngo-2 mmol / L.
Isingeniso Isikhathi
Uma kunqunywe ukuthi kufakwe uLantus SoloStar ngokwemiyalo, okungukuthi, kanye ngosuku, kungcono ukukwenza lokhu cishe ihora ngaphambi kokulala. Ngalesi sikhathi, izingxenye zokuqala ze-insulin zinesikhathi sokungena egazini. Umthamo ukhethiwe ngendlela yokuqinisekisa i-glycemia ejwayelekile ebusuku nasekuseni.
Lapho kukhishwa kabili, umjovo wokuqala wenziwa ngemuva kokuvuka, owesibili - ngaphambi kokulala. Uma ushukela ujwayelekile ebusuku futhi uphakanyiswe kancane ekuseni, ungazama ukuhambisa isidlo sakusihlwa ngaphambi kwesikhathi, cishe amahora angama-4 ngaphambi kokulala.
Ukuhlanganiswa namathebhulethi we-hypoglycemic
Ukudlanga kwesifo sikashukela sohlobo 2, ubunzima ekulandelweni kokudla okuphansi kwe-carb, kanye nemiphumela eminingana yokusetshenziswa kwezidakamizwa ezinciphisa ushukela kuholele ekutheni kuqhamuke izindlela ezintsha zokwelashwa kwayo.
Manje kunesincomo sokuqala ukujova i-insulin uma i-glycated hemoglobin ingaphezulu kwe-9%. Ucwaningo oluningi lubonise ukuthi ukuqala kwangaphambi kokuhlinzwa kwe-insulin nokudluliselwa ngokushesha kwirejimeni ebanzi kunikeza imiphumela engcono kunokwelashwa "kokuma" nabaphathelo be-hypoglycemic. Le ndlela inganciphisa kakhulu ingozi yezinkinga zesifo sikashukela sohlobo 2: inani lokunqunywa lehliswa ngo-40%, iso ne-izinyo ezinsipha yezinso lincishiswe ngo-37%, isibalo sabantu abashonile sincishiswe ngama-21%.
Uhlobo lonyango olusebenzayo olufakazelwe:
- Ngemuva kokuxilongwa - ukudla, ezemidlalo, iMetformin.
- Lapho lokhu kwelashwa kunganele, kunezelwa amalungiselelo e-sulfonylurea.
- Ngokuqhubeka okuqhubekayo - ushintsho endleleni yokuphila, i-metformin ne-insulin ende.
- Ngemuva kwalokho i-insulin emfushane yengezwe ku-insulin ende, kusetshenziswa irekhodi elinamandla lokwelapha i-insulin.
Emabangeni 3 no 4, uLantus angafakwa ngempumelelo. Ngenxa yesenzo eside nesifo sikashukela sohlobo 2, umjovo owodwa ngosuku unanele, ukungabikho kwesiqongo kusiza ukugcina i-insal insulin esezingeni elifanayo ngaso sonke isikhathi. Kwatholakala ukuthi ngemuva kokushintshela eLantus kuma-diabetes amaningi nge-GH> 10% ngemuva kwezinyanga ezi-3, izinga layo liyancipha ngo-2%, ngemuva kwezinyanga eziyisithupha lifinyelela okujwayelekile.
Ama-Analog
Ama-insulin asebenza isikhathi eside akhiqizwa abakhiqizi abangama-2 kuphela - uNovo Nordisk (Levemir noTresiba izidakamizwa) noSanofi (Lantus noTujeo).
Izici zokuqhathanisa zezidakamizwa ezisezintanjeni zesirinji:
| Igama | Into esebenzayo | Isikhathi sokwenza, amahora | Inani ngepakethe ngalinye, hlikihla. | Inani lentengo eyi-1, rub. |
| ILantus SoloStar | ubukhazikhazi | 24 | 3700 | 2,47 |
| I-Levemir FlexPen | ihlazo | 24 | 2900 | 1,93 |
| Tujo SoloStar | ubukhazikhazi | 36 | 3200 | 2,37 |
| ITresiba FlexTouch | degludec | 42 | 7600 | 5,07 |
I-Lantus noma i-Levemir - okungcono?
I-insulin esezingeni eliphakeme enephrofayli ecishe ifane nesenzo ingabizwa ngokuthi bobabili uLantus noLevemir. Uma usebenzisa noma iyiphi yazo, ungaqiniseka ukuthi namuhla izokwenza ngokufana nezolo. Ngomthamo ofanele we-insulin ende, ungalala ngokuthula ubusuku bonke ngaphandle kokwesaba i-hypoglycemia.
Umehluko wezidakamizwa:
- Isenzo sikaLevemir sibushelelezi. Igrafu, lo mehluko ubonakala ngokusobala, empilweni yangempela, cishe ngokungabonakali. Ngokusho kokubuyekezwa, umphumela wazo zombili izinambuzane ziyefana, lapho ushintsha usuka kwelinye uye kwesinye kaningi akudingeki nokuthi uguqule umthamo.
- ILantus isebenza isikhathi eside kunoLevemir. Emiyalweni yokusetshenziswa, kunconyelwa ukuyikokotela isikhathi esingu-1, i-Levemir - kuze kube izikhathi ezi-2. Ekusebenzeni, zombili lezi zidakamizwa zisebenza kangcono uma zidluliswa kabili.
- I-Levemir ithandiwe kwabanesifo sikashukela ngesidingo esiphansi se-insulin. Ingathengwa kuma-cartridges futhi ifakwe esibayeni sesirinji ngeyunithi yomthamo wamayunithi angama-0.5. ILantus ithengiswa ngamapeni aqediwe kuphela ezikhuphukeni zeyunithi eli-1.
- I-Levemir ine-pH engathathi hlangothi, ngakho-ke ingahlanjululwa, okubalulekile ezinganeni ezincane nakwabanesifo sikashukela ngokuzwela okuphezulu kwe-hormone. I-Insulin Lantus ilahlekelwa izakhiwo zayo lapho ihlanjululwe.
- I-Levemir esefomini elivulekile igcinwa izikhathi ezingama-1.5 isikhathi eside (amaviki ayisithupha uma kuqhathaniswa ne-4 eLantus).
- Umenzi uthi ngesifo sikashukela sohlobo 2, i-Levemir ibangela ukukhuluphala kwesisindo. Empeleni, umehluko neLantus awunakwa.
Ngokuvamile, zombili lezi zidakamizwa ziyefana kakhulu, ngakho-ke onesifo sikashukela asikho isizathu sokushintsha esinye ngaphandle kwesizathu esanele: ukulawulwa kwe-allergy noma i-glycemic.
ILantus noma iTujeo - okufanele ukhethe?
Inkampani ye-insulin iTujeo ikhishwa yinkampani efanayo neLantus. Umehluko kuphela phakathi kweTujeo ukugcwala okukhuphukayo okungama-3-insulin solution (i-U300 esikhundleni se-U100). Okunye ukwakheka kuyafana.
Umehluko phakathi kukaLantus noTujeo:
- UTujeo usebenza amahora angama-36, ngakho-ke iphrofayili yakhe yesenzo iyathambile, kanti futhi nengozi ye-hypoglycemia yangebusuku incane;
- kuma-milliliters, umthamo weTujeo ucishe ube yingxenye yesithathu yomthamo weLantus insulin;
- amayunithi - iTujeo idinga cishe ama-20% ngaphezulu;
- I-Tujeo isidakamizwa esisha, ngakho-ke umphumela wayo emzimbeni wezingane awukaphenywa. Umyalo wenqatshelwe ukuwusebenzisa kwabanesifo sikashukela esingaphansi kweminyaka engu-18;
- ngokusho kokubuyekezwa, iTujeo ithambekele kakhulu ekukhetheni inaliti, ngakho-ke kuzodingeka ukuthi ithathelwe indawo njalo.
Ukushintshwa kusuka eLantus kuye eTujeo kulula impela: sifaka amayunithi amaningi njengangaphambili, futhi sibheka i-glycemia izinsuku ezintathu. Kungenzeka kakhulu, umthamo kuzodingeka ulungiswe kancane phezulu.
ILantus noma iTresiba
UTresiba ukuphela kwelungu elivunyiwe leqembu elisha le-insulin. Isebenza kuze kube ngamahora angama-42. Njengamanje, sekuqinisekisiwe ukuthi ngesifo sohlobo 2, ukwelashwa kwe-TGX kwehlisa i-GH ngo-0.5%, i-hypoglycemia ngo-20%, ushukela wehla ngo-30% ngaphansi ebusuku.
Ngokwesifo sikashukela sohlobo 1, imiphumela ayikhuthazi: I-GH incishiswa ngamaphesenti angama-0,2, i-hypoglycemia yasebusuku incipha ngo-15%, kepha ntambama, ushukela uwe kaningi nge-10%.Ngokuthi inani lentengo leTreshiba liphakeme kakhulu, kuze kube manje kunganconywa kuphela kwabanesifo sikashukela ngesifo sohlobo 2 nokuthambekela kwe-hypoglycemia. Uma isifo sikashukela singakhokhelwa ngeLantus insulin, ukuyiguqula akunangqondo.
Ukubuyekezwa kweLantus
ILantus yi-insulin ekhetheke kakhulu eRussia. Bangaphezu kuka-90% abanesifo sikashukela abajabule ngakho futhi bangayincoma abanye. Iziguli zisho izinzuzo zalo ezingabazeki zokutholakala komphumo wazo omude, obushelelezi, ozinzile nobonakalayo, ukukhululeka kokukhethwa komthamo, ukusetshenziswa kalula, nomjovo ongenabuhlungu.
Impendulo eqondile ifanelwe yikhono leLantus lokususa ukukhuphuka kokusa ushukela, ukungabi bikho komphumela kwesisindo. Umthamo wayo uvame ukungaphansi kwe-NPH-insulin.
Phakathi kokushiyeka, iziguli ezinesifo sikashukela i-mellitus ziphawula ukungabikho kwama-cartridgege ngaphandle kwamapeni wesirinji athengiswayo, isinyathelo esikhulu kakhulu somthamo, nephunga elingathandeki le-insulin.
