INSULIN GLARGIN - IMIYALO YOKUSEBENZISA, INTENGO KANYE NEZIBUYEKEZO

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Isifo sikashukela isifo esibangelwa ukumpontshelwa yisifo okuyisona sokwephula ukukhiqizwa kwe-insulin. Lokhu kuholela eqinisweni lokuthi izinga likashukela likhuphuka kakhulu noma lehle kumanani we-pathological. Ukudla okwenziwe ngokudla kanye nokuhambisana neminye imithetho akuhlali kunikeze umphumela olindelekile, ngakho-ke odokotela bavame ukunikeza izidakamizwa ezifaka esikhundleni se-hormone into efanayo.

IGlulin insulin iyi-analogue ye-insulin yemvelo ekhiqizwa umzimba womuntu. Inqunyelwe ushukela i-mellitus ngokukhiqizwa okunganele kwale hormone.

Ukwakheka kanye nenqubo yokusebenza

Isithako esiyisisekelo esisebenzayo somuthi yi-insulin Glargin. Le yingxenye yokwenziwa etholwe yindlela yokuguqulwa. Ngenqubo yokudala kwayo, izinto ezi-3 ezibalulekile zithathelwa indawo. I-amino acid Asparagine ithathelwa indawo yiGlycine ku-A chain, kanti ama-Arginines amabili anamathele ku-B chain. Umphumela walokhu kuhlanganiswa kabusha yisisombululo sekhwalithi ephezulu kakhulu somjovo, onomphumela onenzuzo okungenani amahora angama-24.

Umuthi osebenzayo, ohlanganiswe nezinto ezisizayo, unomphumela omuhle emzimbeni wesiguli. Ngokusebenzisa kahle i-insulin Glargin:

Ithinta ama-insulin receptors atholwe emafutheni omzimba angaphansi kanye nezicubu zomsipha. Ngenxa yalokhu, umphumela ofana nalowo we-insulin yemvelo uyavuselelwa.
ejwayelekile izinqubo ze-metabolic: i-carbohydrate metabolism kanye nokukhiqizwa kweglue.
Ivuselela ukuthathwa kwe-glucose ngamafutha angaphansi, izicubu zemisipha kanye nomsipha wamathambo.
Yehlisa ukwenziwa kweglucose ngokweqile esibindini.
Ishukumisa ukwakheka kweprotheni elahlekile.

Umuthi ungena emashalofini ekhemisi ngesimo sesisombululo: emabhodleleni ayi-10 ml noma kuma-cartridge ama-3 ml. Kuqala ukusebenza ngemuva kwehora ngemuva kokuphatha.

Isikhathi esiphezulu sokusebenza amahora angama-29.

I-Carcinogenicity kanye nomphumela ekhweni lokukhulelwa kwengane

Ngaphambi kokuthi uthengiswe, umuthi uhlolwe i-carcinogenicity - ikhono lezinto ezithile ukwandisa amathuba amathumba abuhlungu nokunye okuguqukayo. Umthamo owandisiwe we-insulin wabelwa amagundane namagundane. Lokhu kuholele ku-:

Ukufa okuphezulu eqenjini ngalinye lezilwane zokuhlola;
Ama-tumic ayingozi kwabesifazane (emkhakheni wemijovo);
Ukungabikho kwezimila lapho kuncibilikiswa kuma-sol sol non-acid.

Ukuhlolwa kwembula ubuthi obuphakeme obudalwa ukuncika kwe-insulin.

Amandla okuzala nokubeletha umntwana ophile kahle akhubazekile.

Contraindication

I-Glargin ayinconywa ukuthi isetshenziswe nge-hypersensitivity kanye nokungabekezeleli komuntu ngamunye kwizakhi. Eminyakeni engu-6, lesi sidakamizwa sihlanganiswa futhi ngenxa yokuntuleka kwezifundo zokwelashwa. Sebenzisa umuthi ngokuqapha ezimweni ezilandelayo:

Ukulimazeka okuqinile noma okulinganiselayo kwezinso;
Ushintsho lwe-pathological esibindini;
Ukuguga okusebenza njalo kwanda kwezinso.

Ngesikhathi sokulashwa, gada njalo ushukela, ubheke ukunemba lapho ujova i-insulin emafutheni angaphansi kwenhliziyo. Naka izici zomzimba wesiguli - kwezinye izimo, umthamo womuthi kufanele uguqulwe.

Ukwemukelwa ngesikhathi sokukhulelwa nokukhulelwa

Abesifazane abazala ingane, umuthi ubekwa kuphela ngemuva kokubonisana kwangaphambili. Umuthi ubekelwa ezimweni lapho inzuzo engaba khona kumama iphakeme kunobungozi enganeni. Uma owesifazane okhulelwe enesifo sikashukela sokuthambisa, kunconywa ukuthi kuqashwe njalo izinqubo ze-metabolic.

Kwi-trimester yesi-2 ne-3 yokukhulelwa, isidingo se-insulin siyanda. Ngemuva kokubeletha, isidingo somuthi sehla kakhulu.

Ngesikhathi sokudla ingane, ungakhohlwa ukulawula nokulungisa umthamo uma kunesidingo

Kunoma iyiphi inyanga yokukhulelwa, udinga ukuqaphela ushukela wegazi futhi uqaphe njalo izinga layo.

Okunye ukuhambisana kwezidakamizwa

Izidakamizwa eziningi zithinta kabi i-carbohydrate metabolism. Kulezi zimo, umthamo we-insulin udinga ukushintshwa. Izidakamizwa ezinciphisa ushukela ngendlela emangalisayo zihlanganisa:

I-ACE ne-mao inhibitors;
Ama-Disopyramid;
Ama-salicylates nama-sulfanide agents maqondana namagciwane;
I-Fluoxetine;
Imicu ehlukahlukene.

Ezinye izidakamizwa zinganciphisa umphumela we-hypoglycemic we-hormone: i-glucocorticosteroids, i-diuretics, i-danazol, i-glucagon, isoniazid, i-diazoxide, i-estrogens, i-gestagens, njll. Uhlu oluphelele lwemithi engahambelani, bona imiyalo yokufaka.

I-insulin ayinconywa ukuba ihlanganiswe notshwala - lokhu kwandisa amathuba okuba ne-hypoglycemia.

Imiphumela emibi engenzeka

I-Insulin Glargin isidakamizwa esisehlelweni esidlula kuwo wonke umzimba, sithinta amazinga kashukela nezinqubo ze-metabolic. Ngokusetshenziswa okungafanele, amasosha omzimba angenamandla nezinye izici zomzimba, umuthi ungadala imiphumela engafuneki.

I-Hypoglycemia

Lesi yisimo se-pathological lapho amazinga kashukela wegazi ancishiswa kakhulu (ngaphansi kuka-3.3 mmol / l). Kwenzeka ezimweni lapho ipilisi le-insulin ngokweqile lanikwa isiguli, ladlula kakhulu izidingo zalo. Uma i-hypoglycemia inzima futhi iqhubeka ngokuhamba kwesikhathi, isongela impilo yomuntu. Ukuhlaselwa okuphindaphindwayo kuthinta uhlelo lwezinzwa. Ukwazi komuntu kuyaxaka futhi kudideke; kunzima esigulini ukugxila.

Ezimweni ezisezingeni eliphakeme, umuntu ulahlekelwa ngokuphelele ukwazi. Nge-hypoglycemia elinganiselayo, izandla zomuntu ziyaqhaqhazela, uhlala efuna ukudla, ucasuke kalula futhi unesifo senhliziyo eshesha. Ezinye iziguli zikhuphumele umjuluko.

Imiphumela emibi evela ohlelweni olubonakalayo

Ngomthethonqubo we-glucose egazini, izicubu ziba zimbi futhi zingaphansi kwengcindezi. Ukuphinda ku-lens yeso kuyashintsha futhi, okuholela ekuphazamisweni okubukwayo, okubuye kubuyele kokujwayelekile ngaphandle kokuphazanyiswa kwangaphandle.

Nge-diabetesic retinopathy (ukulimala kwe-retinal), inkambo yesifo inganda kakhulu ngenxa yokuguquguquka okukhulu kwamazinga kashukela egazini. Nge-retinopathy ekhulayo, kunconyelwa ukuthi njalo wenze i-Photocoagulation. Ngaphandle kwalokho, umphumela oseceleni ngendlela ye-hypoglycemia ungaholela ekulahlekelweni kombono.

I-Lipodystrophy

Lokhu kungukubhujiswa kolwelwesi olunamafutha olwakha ezindaweni zomjovo we-insulin. Ukufakwa kanye nokumuncwa kukhubazekile. Ukuvimbela ukusabela okunjalo, kunconywa ukuthi ushintshe / ushintshe izindawo zokujova insulin njalo.

Ukungezwani komzimba

Lokhu ikakhulukazi ukusikisela kwendawo: i-urticaria, imishayo ehlukahlukene, ubomvu nokulunywa, ubuhlungu endaweni yomjovo. I-Hypersensitivity to insulin eba khona: ukusabela okujwayelekile kwesikhumba (cishe sonke isikhumba kuthintekile), i-bronchospasm, i-angioedema, ukushaqeka, noma ukuqina komfutho we-arterial. Ukusabela okunjalo kuba khona manjalo futhi kubeka engcupheni impilo yesiguli.

Ezimweni ezingavamile, ukwethulwa kwe-hormone kunikeza imiphumela eyengeziwe - ukugcinwa kwe-sodium, ukwakheka kwe-edema kanye nokwakhiwa kwempendulo yokuzivikela komzimba ekuphathweni kwe-insulin. Kulezi zimo, umthamo wesidakamizwa kumele ulungiswe.

Ukuphepha kokuphepha

I-Insulin Glargin ayinqunyelwe i-ketoacidosis yesifo sikashukela, ngoba iyinhlangano esebenza isikhathi eside. Nge-hypoglycemia, isiguli sithuthukisa izimpawu ezisiza ukuqaphela ukwehla okunamandla kushukela ngisho nangaphambi kokuba lokhu kwenzeke. Kodwa-ke, zingancishiswa kancane noma zingekho ngokuphelele kwiziguli zamaqembu alandelayo:

Ngokulungiswa okujwayelekile kwe-glucose yegazi;
Iziguli eziphathwa ezinye izidakamizwa;
Ngokuphazamiseka emsebenzini we-psyche;
Ngokuthuthuka kancane kwamanje kwe-hypoglycemia;
Abantu abadala;
Nge-neuropathy kanye nenkambo ende yesifo sikashukela.

Uma uqaphela lesi simo sekwephuze kakhulu, kuzoba nzima, kuholele ekulahlekelweni kokungazi futhi, kwezinye izikhathi, ngisho nokufa.

Kulezo zimo lapho amathuba e-hypoglycemia enyuka khona

Uma ulandela uhlelo olunqunyiwe, hlola amazinga kashukela wegazi njalo udle ngakwesokudla, amathuba we-hypoglycemia ancishiswa. Uma kunezici ezengeziwe, shintsha umthamo.

Izizathu eziholela ekunciphiseni kwe-glucose zifaka:

I-Hypersensitivity kuya ku-insulin;
Ukuguqulwa kwendawo lapho umuthi ungeniswa kuwo;
Izifo ezihambisana ne-gobolimba (isisu) kanye nokugabha, okuyinkimbinkimbi yesifo sikashukela;
Ukusebenza ngokomzimba okungajwayelekile komzimba wesiguli;
Ukusetshenziswa kabi kotshwala;
Ukwephulwa kokudla kanye nokusetshenziswa kokudla okungavunyelwe;
Ukwehluleka ku-gland yegilo;
Ukwelashwa okuhlanganayo nezidakamizwa ezingahambisani.

Ngezifo ezihlangana kanye nokutheleleka, ukulawulwa kweglucose yegazi kufanele kube kucace ngokwengeziwe.

Nikeza igazi nomchamo njalo ukuze kuhlolwe okujwayelekile. Uma kunesidingo, lungisa umthamo we-insulin (ikakhulukazi uhlobo 1 sikashukela).

Usizo lokuqala lwe-overdose

Ukwehla okubukhali kweglucose kungumphumela ongemuhle ngokwethulwa komthamo owengeziwe womuthi. Isiguli singasizwa kanjena:

Mnike kalula ama-carbohydrate angagayeki (isibonelo, i-confectionery);
Yethula i-glucacon kumanqatha we-subcutaneous noma nge-intramuscularly;
Faka ikhambi le-dextrose (ngokungena ngaphakathi).

Ukusebenza komzimba kunconyelwa ukunciphisa. Uhlobo lomthamo, kanye nokudla, kudinga ukulungiswa.

Insulin Glargin: Imiyalo esetshenzisiwe

Ithuluzi lethulwa ngokucophelela emzimbeni esifundeni sesisu, indawo yezinkalo namahlombe. I-analogue ye-hormone isetshenziswa isikhathi esingu-1 ngosuku ngesikhathi esithile. Amanye amasayithi wokujova ukugwema uphawu kanye neminye imiphumela emibi. Ukwethula umuthi emthanjeni akuvunyelwe ngokuphelele.

Umthamo we-insulin unqunywe ngokuhlukile. Awukwazi ukuxuba isidakamizwa nezinye izidakamizwa.

Isenzo esinjalo siholela ekushayeni kwezulu noshintsho esikhathini lapho i-Insulin Glargin ingasebenza khona.

Igama lokuhweba, izindleko, izimo zokugcina

Umuthi uyatholakala ngaphansi kwamagama alandelayo okuhweba:

I-Lantus - ama-ruble angama-3700;
I-Lantus SoloStar - ama-ruble angama-3500;
I-Insulin Glargin - ama-ruble angama-3535.

Gcina esiqandisini ekushiseni kwama-degree angama-2 kuye kwayi-8. Ngemuva kokuvula, gcina endaweni emnyama futhi ungafinyeleleki kuyo izingane, ngamazinga okushisa afinyelela kuma-25 degrees (hhayi esiqandisini).

I-Insulin Glargin: i-analogues

Uma intengo ye-Insulin glargine ingahambisani nawe noma uma imiphumela eminingi engathandeki ivela ekuyiphuzeni, thatha umuthi ngomunye wenkomba engezansi:

I-Humalog (Lizpro) isidakamizwa esifana ne-insulin yemvelo ekwakhiweni kwayo. I-Humalog ingena ngokushesha egazini. Uma uphatha umuthi kuphela ngesikhathi esinqunyelwe sosuku kanye nomthamo ofanayo, uHumalog uzodonswa ngokushesha izikhathi ezi-2 futhi uzofinyelela amazinga afunekayo emahoreni angama-2. Ithuluzi lisebenza kuze kube ngamahora ayi-12. Izindleko zeHumalogue zisuka kuma-ruble ayi-1600.
I-Aspart (i-Novorapid Penfill) iyisidakamizwa esilingisa impendulo ye-insulin ekudleni kokudla. Isebenza ngokubuthakathaka nangesikhashana, okwenza kube lula ukulawula izinga le-glucose egazini. Izindleko zomkhiqizo zivela kuma-ruble ayi-1800.
IGlulisin (Apidra) iyisidakamizwa esifushane kakhulu esisebenza ngezidakamizwa ze-insulin. Ngezakhiwo ze-pharmacological akuhlukile ku-Humalog, nangomsebenzi we-metabolic - kusuka ku-insulin yemvelo ekhiqizwa umzimba womuntu. Izindleko - ama-ruble ayi-1908.

Lapho ukhetha umuthi ofanele, gxila ohlotsheni lwesifo sikashukela, izifo ezihambisana nakho kanye nezimpawu zomzimba ngamunye.

Ukubuyekezwa

U-Irina, oneminyaka engama-37, uRyazan “Umuthi osebenzayo. Uma ulisebenzisa njalo futhi ngokuya ngemiyalo, ngeke uzizwe lushintsho empilweni yakho. Sebenzisa isirinji yokuphatha kulula, futhi isisombululo asidingi ukuthi sinyakaziswe. Amathuba okuthi ukhohlwe ukufaka i-insulin uphansi kakhulu - kwanele ukusebenzisa umuthi kanye kuphela ngosuku. Imiphumela emibi ayithandeki, kepha akufanele ukhuphule umthamo. Enye inzuzo ipeni elikhethekile elizokwazi ukusebenziseka kalula ngokwengeziwe ngomuthi. ”

U-Oleg, oneminyaka engama-44, uSamara “Sekuphele iminyaka ngihlaselwa isifo sikashukela. Ngazama izindlela ezahlukahlukene futhi ngangihlupheka kakhulu ngenxa yokuthi ushukela wehla kakhulu. Ngabekwa insulin glargine ngemuva kwezinkinga zempilo kanye nobunzima ekwelapheni isifo sikashukela. Kunemiphumela emibi, kepha kulezo zimo kuphela uma ithuluzi lisetshenziswe ngokungalungile. Landela ukudla, ungasebenzisi kabi utshwala futhi uphile impilo enempilo. Ngale ndlela uzogwema izinkinga eziningi ongahlangana nazo ngenkathi welashwa. Ngaphandle kwalokho, angitholanga amaphutha. Ukuphela kwento engadida abathengi abaningi izindleko ezinkulu. ”

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