I-Tresiba Flextach isidakamizwa esinciphisa ushukela. Kuyi-analogue ye-insulin esebenza komuntu isikhathi eside. Ngenxa yezimpawu zayo zamakhemikhali, iTresiba isetshenziswa kaningi yiziguli ezinenkinga yesifo sikashukela esincike ku-insulin. Isetshenziswa njengesisekelo sokugcina amazinga e-insulin egazi.
Izimo ezahlukahlukene zingadala ukuncika kwe-insulin. Uhlobo 1 sikashukela i-mellitus, isimilo sabantu abasebasha, ekuqaleni belashwa nge-insulin. Njengoba ama-pancreas engakwazi ukudedela le hormone egazini ngenxa yokuphazamiseka kofuzo okuningi.
Uhlobo 2 sikashukela i-mellitus, esidalwa engxenyeni endala yabantu, senzeka ngokumelene nesizinda soshintsho lwe-pathological kumaseli we-pancreatic kanye nokuthuthukiswa kokumelana kwama-cell receptors ku-insulin. Ishukela elinjalo alidingi ukwelashwa ngokushesha ngamalungiselelo e-insulin. Ngokuhamba kwesikhathi kuphela lapho ukungakwaneli kwezigcawu zeLangerhans nokukhululwa kwe-hormone kukhula, ngokulandelana.
I-Tresiba Flextach inesakhiwo esiyingqayizivele esiza kakhulu impilo yabanesifo sikashukela. Umuthi uyatholakala ngesimo sepeni, okwenza ukuphathwa kwe-insulin kube lula futhi kungabi buhlungu futhi kusiza izindlela zokuwuthwala umuthi.
Kuthengiswe iTresiba kwiphakethe lamapeni ama-5. Intengo ephakathi yokufaka isuka kuma-ruble angama-7600 - 8840. Lokhu kusiza kakhulu, ngoba intengo ikhonjiswa ngokushesha ngamapeni ama-5.
Ukwakheka kanye nesimo somuthi
I-Tresiba Flextach yezidakamizwa iyatholakala ngesimo sepeni yesirinji ene-cartridge ehlanganisiwe. Umuthi utholakala kumithamo emi-2, elungele kakhulu iziguli ezinesisindo esikhulu somzimba kanye nenkambo yesifo sikashukela esiyinkimbinkimbi. I-cartridge ngayinye ye-3 ml. Ngokuvumelana nalokho, amapeni ama-300 nama-600 amayunithi we-insulin ayatholakala.
Ku-1 ml yesisombululo somjovo uqukethe i-insulin main insulin degludec 100 nama-200 amayunithi.
Izakhiwo ezifanayo zinakho:
- I-Glycerol - 19.6 / 19.6 mg;
- I-Metacresol - 1.72 / 1.72 mg;
- I-Phenol - 1.5 / 1.5 mg;
- IHydrochloric acid;
- I-Zinc - 32.7 / 71.9 mcg;
- I-Sodium hydroxide;
- Amanzi wokujova - kuze kufike ku-1/1 ml.
Umuthi ungalawulwa ngomuthi ongafika ku-80/60 U / kg. Kulokhu, isinyathelo sokulungiswa kwamthamo yiyunithi eli-1 noma elingu-2. Utho ngalunye lwe-insludec insulin luhambelana neyunithi efanayo ye-insulin yabantu.
Indlela yokusebenza
Indlela yokusebenza yesidakamizwa isuselwa ku-agonism ephelele ye-insulin degludec enomuntu endo native. Lapho igxilwe, ibopha ama-insulin receptors, ikakhulukazi izicubu namafutha. Ngenxa yalokho, inqubo yokufakwa kweglucose egazini iyasebenza. Kukhona futhi ukwehla kwe-Reflex ekukhiqizweni kwe-glucose ngamaseli wesibindi avela ku-glycogen.
I-recombinant insulin degludec ikhiqizwa kusetshenziswa i-genetic engineering, esiza ukwahlukanisa i-DNA yama-bacterium e-Saccharomyces cerevisiae. Ikhodi yabo yofuzo ifana kakhulu ne-insulin yabantu, esiza kakhulu futhi isheshise ukwenziwa kwezidakamizwa. Ingulube i-insulin yayikhona. Kepha wabangela ukusabela okuningi okuvela emasosheni omzimba.
Isikhathi saso sokuchayeka emzimbeni kanye nokugcina isilinganiso se-insulin esingamahora angama-24 sicasulwa yizimpawu zaso zokucwaswa emafutheni angaphansi.
Lapho ilawulwa ngokungaziphathi kahle, i-insulin degludec yakha idepho yama-multihexamers encibilikayo. Amamolekyuli abopha ngokuqinile kumaseli wamafutha, aqinisekisa ukungena kancane kancane kancane kancane komuthi ungene egazini. Ngaphezu kwalokho, inqubo inezinga eliphansi. Lokhu kusho ukuthi i-insulin idonswa ngezinga elifanayo amahora angama-24 futhi ayinakho ukuguquguquka okushintshiwe.
Izinkomba kanye ne-contraindication
Isibonakaliso esiyinhloko nesisodwa sokusetshenziswa kwe-insulin esebenza isikhathi eside luhlobo 1 noma uhlobo 2 lwesifo sikashukela. I-Degludec insulin isetshenziselwa ukugcina izinga eliyisisekelo le-hormone esegazini ukwenza i-metabolism ibe sezingeni elifanele.
I-contraindication eyinhloko yile:
- Ukungabekezelelani komuntu ngamunye ezingxenyeni zomuthi;
- Ukukhulelwa nesikhathi sokudla;
- Izingane ezingaphansi konyaka ongu-1.
Imiyalo yokusebenzisa
Umthamo ukhethiwe esigulini ngasinye ngudokotela ohambelayo. Amavolumu ancike enkambweni ethile yesifo, isisindo sesiguli, indlela yokuphila esebenzayo, nokudla okuningiliziwe okufanele kulandelwe yiziguli.
Umuthi ungasetshenziswa njenge-monotherapy, kanye nengxenye yokwelashwa okuyinkimbinkimbi ukuze kugcinwe isisekelo se-insulin njalo. Sebenzisa njalo ngasikhathi sinye sosuku ukugwema ukuthuthukiswa kwe-hypoglycemia.
I-insulini ye-insulin engaphezulu kwesikhathi eside yenziwa kuphela ngaphandle kokucabanga, njengoba ezinye izindlela zokuphatha zingadala izinkinga. Izindawo ezifanele kunazo zonke zokujova okungama-subcutaneous: amathanga, amabhuzu, ihlombe, izicubu zomsipha odongeni olungaphambili lwesisu. Ngokushintshwa kwansuku zonke endaweni yokulawulwa kwezidakamizwa, ubungozi bokuqhamuka ne-lipodystrophy kanye nokusabela kwasendaweni kuncishisiwe.
Ngaphambi kokuthi uqale usebenzise ipeni lesirinji, udinga ukuthola imithetho yokusebenzisa le divayisi. Lokhu kuvame ukufundiswa udokotela ohambelayo. Noma isiguli siye emakilasini eqembu ukulungiselela impilo enesifo sikashukela. Kula makilasi, akhuluma ngamayunithi esinkwa ekudleni okunempilo, izimiso eziyisisekelo zokwelashwa ezincike esigulini, kanye nemithetho yokusebenzisa amaphampu, amapeni namanye amadivaysi okusebenzisa i-insulin.
Ngaphambi kokuqala inqubo, udinga ukuqinisekisa ubuqotho bepeni yesirinji. Kulokhu, kufanele unake i-cartridge, umbala wesisombululo, impilo yeshelufu nokusebenziseka kwama-valve. Isakhiwo se-syringe-pen Tresib sinje ngokulandelayo.
Bese uqala inqubo ngokwayo.
Kuyafaneleka ukunaka iqiniso lokuthi ukusetshenziswa okujwayelekile kuyadingeka ukusetshenziswa okuzimele. Isiguli kufanele sizibone ngokucacile izinombolo ezikhonjiswa kukhethi lapho ukhetha idosi. Uma lokhu kungenzeki, kufanelekile ukuthatha usizo olwengeziwe lomunye umuntu onombono ojwayelekile.
Masinyane lungisa ipeni yesirinji ukuze isetshenziswe. Ukuze senze lokhu, sidinga ukususa i-cap epeni lesirinji futhi siqiniseke ukuthi kunesisombululo esikhanyayo, esingenamibala ewindini lebhokisi. Ngemuva kwalokho thatha inaliti yokulahla bese ususa ilebula kuyo. Ngemuva kwalokho cindezela inaliti ngesibambo futhi, ngokungathi kunjalo, usihlwithe.
Ngemuva kokuthi sikholwe ukuthi inaliti ibambe ngokuqinile esibayeni sesirinji, isuse ikhebula elingaphandle bese ulibeka eceleni. Inaliti ihlala inesibili elingaphakathi elincanyana elingaphakathi okufanele lilahlwe.
Lapho zonke izinto zomjovo sezilungile, sibheka ukungena kwe-insulin nempilo yohlelo. Kulokhu, umthamo wamayunithi ama-2 usethwe kwisikhethi. isibambo siphakamisa inaliti siboshwe. Ngomunwe wakho, thepha kancane ngomzimba ukuze wonke amabhamuza womoya abantantayo aqoqwe ngaphambi kwangaphakathi kwenalithi.
Ukucindezela i-piston yonke indlela, ukudayela kufanele kukhombise u-0. Lokhu kusho ukuthi umthamo odingekayo uphumile. Futhi ekugcineni kwangaphandle kwenaliti kufanele kwehle iconsi lesisombululo. Uma lokhu kungenzeki, phinda izinyathelo zokuqinisekisa ukuthi uhlelo luyasebenza. Lokhu kunikezwe imizamo eyi-6.
Ngemuva kokuthi amasheke aphumelele, siyaqhubeka nokufakwa komuthi emafutheni angaphansi kwenhliziyo. Ukuze wenze lokhu, qiniseka ukuthi okhethiwe ukhomba ku- "0". Bese ukhetha umthamo owuthandayo wokuphatha.
Faka inaliti ngaphansi kwesikhumba nganoma iyiphi indlela umhlengikazi ayikhombisile ngesikhathi sokuqeqeshwa. Khiya inaliti kulesi sikhundla. Ngaphandle kokuthinta okhethi noma ukuyihambisa nganoma iyiphi indlela, cindezela inkinobho yokuqala yonke indlela. Bamba inalithi ekuqineni kwesikhumba eminye imizuzwana emi-6, ukuze umuthi ukhiphe ipeni lesirinji ngokugcwele, bese ulikhipha. Indawo yomjovo akufanele ihlanganiswe noma ihlikihlwe.
Ngemuva kwalokho faka isicoco esingaphandle kwenalithi ukuze usisuse kwisibambo, bese usilahla. Vala ipeni lesirinji ne-cap yayo.
Ukunakekela ithuluzi akudingi mzamo. Ukuze wenze lokhu, udinga nje ukusula zonke izinto ezibonakalayo zepeni yesirinji ngogabha bekotoni ogcotshwe ngotshwala.
Ukuphendula okungafani
Ngesikhathi sokwelashwa, kungavela imiphumela emibi. Ukusabela okuvame kakhulu yi-hypoglycemia. Kubonwa, njengomthetho, kulezo ziguli ezedlula isilinganiso esikhonjisiwe, zilandele ngokunembile imiyalo, noma umthamo wakhethwa ngokungafanele.
I-Hypoglycemia ibonakaliswa yizimpawu ezahlukahlukene, okuthi ngokwezinga elithile noma kwesinye kuxhomeke ekusebenzeni kwengqondo okulimazayo noshukela wegazi. Indima ebalulekile nayo idlalwa yileyo naleyo nkinga ejwayelekile kashukela lapho umzimba wesiguli uyijwayele.
Ukubonakaliswa kwe-allergic kwenzeka kakhulu. Lo mphumela wecala uvame ukubonwa ngokuphendula kwe-anaphylactic kohlobo olusheshayo, okuvela ngenxa yokungabekezelelani kwengxenye ngayinye yezakhi zomuthi.
Imvamisa i-anaphylaxis iboniswa ngesimo se:
- I-Urticaria;
- Ukulunywa
- I-edema kaQuincke;
- I-Erythema;
- Ukwethuka kwe-Anaphylactic.
Ukuphendula kwendawo ekuphatheni izidakamizwa kuvame ukubonwa. Isiguli sikhononda ngokuvuvukala kwendawo, ukulunywa, ukuqunjelwa endaweni yomjovo. Ukusabela kokuvuvukala nobuhlungu bendawo kuyimpawu.
Izimo ze-lipodystrophy zivame ukubonwa lapho imiyalo yokusebenzisa ingalandelwa. Uma ulandela imithetho, futhi isikhathi ngasinye lapho ushintsha isayithi lomjovo, amathuba okukhula kwe-lipodystrophy azokwehla.
Ukweqisa
Isibonakaliso esivame kakhulu se-overdose yi-hypoglycemia. Lesi simo kungenxa yokwehla kwamazinga kashukela egazini ngokumelene nesizinda sokukhula kwe-insulin. I-Hypoglycemia ingabonakala ngezimpawu ezahlukahlukene, ezincike ebukhali balesi simo.
I-Hypoglycemia ingasolwa uma kuvela izimpawu ezimbalwa ezilandelayo:
- Isiyezi
- Umile;
- Indlala;
- Umlomo owomile;
- Ukujuluka okubandayo okunamathele;
- Izikhova
- Ukulunywa
- I-Tremor;
- Umuzwa we-palpitations;
- Umuzwa wokukhathazeka;
- Inkulumo engaboni kahle;
- Ukungazi okufiphele kuze kufinyelele ekhefini.
Usizo lokuqala lwe-hypoglycemia emnene lunganikezwa izihlobo noma isiguli. Ukwenza isimo sibe ngokwejwayelekile, udinga ukubuyisa izinga likashukela wegazi libuyele kokujwayelekile.
Uma isimo simbi kakhulu futhi sibangela ukuphulwa kokuqwashisa, kufanele ushayele i-ambulensi ngokushesha. Nge-hypoglycemia enzima, kuyalulekwa ukwethula i-insulin antidote - i-glucagon ku-umthamo we-0.5-1 mg intramuscularly noma ngokunqenqema. Uma i-glucagon engekho ngenxa yesizathu esithile, ingathathelwa indawo abanye abaphikisi be-insulin. Ama-hormone egilo, i-glucocorticoids, i-catecholamines, ikakhulukazi i-adrenaline, i-somatotropin ingasetshenziswa.
Ukwelashwa okuqhubekayo kuqukethe ukudonsa okubucayi kwesisombululo se-glucose nokubheka ngokuqhubekayo ushukela wegazi. Ngaphezu kwalokho lawula ama-electrolyte nokulinganisa kwamanzi.
Imigomo nemibandela yesitoreji
Gcina ipeni le-insulin lingatholakali ezinganeni. Ukushisa okulungile kokugcina kwama-cartridge angavaliwe angasebenzi ngu-+2 - +8 degrees. Kuvunyelwe ukugcina esiqandisini eshalofini lomnyango, elisekude neqhwa. Musa iqhwa umuthi!
Gwema ukuboniswa ukukhanya kwelanga kanye nokushisa ngokweqile. Ukuze wenze lokhu, gcina amakhadibhodi avaliwe ku-foil ekhethekile, enamathiselwe njengezinto zokuvikela.
Gcina ipeni lesirinji elivulekile endaweni yokushisa yegumbi endaweni emnyama. Izinga lokushisa eliphakeme kakhulu akufanele lidlule ama-degrees angu-30. Ukuvikela ngokumelene nemisebe yokukhanya, ngaso sonke isikhathi vula ibhokisi elivulekile nge-cap.
Impilo yamashalofu ephezulu yizinyanga ezingama-30. Ngemuva kosuku lokuphela kwesikhathi olukhonjiswe kwiphakheji, ukusetshenziswa komuthi kuyaphikiswa. I-cartridge evulekile enepeni yesirinji ingasetjenziswa amaviki ayi-8.
I-Tresiba insulin iyindlela enhle yokuthola ama-syringes, okwenza impilo ibe lula kakhulu ezicini eziningi zokwelashwa kwe-insulin.
