Isixazululo somjovo I-Insulin Glulisin ithengwa iziguli ezinesifo sikashukela i-mellitus. Lesi sidakamizwa siyadingeka ukwehlisa ushukela wegazi, kanye nokwelashwa kwalesi sifo. Le insulin emfushane. Kuyingxenye yeminye imishanguzo yesifo sikashukela. I-Glulisin inomphumela obizwa ngokuthi yi-hypoglycemic.
Ukusebenza kahle kanye nendlela yokusebenza
Le yi-analogue ye-insulin yabantu, enezici ezifanayo. Ngesikhathi esifanayo, umenzeli usebenza ngokushesha emzimbeni (kungakapheli imizuzu eyi-10 ukuya kwengama-20 ngemuva kokuphatha), kepha unesikhathi esifushane sethonya.
Umsebenzi osemqoka womuthi ukwehlisa izinga le-glucose, okwenzeka ngenxa yokuvuswa kwenqubo yokufakelwa yizicubu zayo eziwuzungezile.
Imisipha yesikhumba namathambo we-adipose ibamba ushukela ongcono kakhulu, ngaphandle kokwenza izinqolobane zayo esibindini. Ukusebenza kahle kwomuthi akuxhomekile ebulilini noma kuhlangeni lwesiguli.
Izakhiwo ze-Pharmacokinetic
Ukufakwa kwalesi sidakamizwa emzimbeni womuntu kushesha kakhulu (cishe izikhathi ezi-2). Ucwaningo olunjalo lwenziwe ezigulini ezazigula ngohlobo 1 nesifo sikashukela.
Uma sibheka ukuphathwa kwe-subcutaneous, isikhathi sokuhlushwa esigulini esinohlobo lokugula siyimizuzu engama-55, kodwa ngasikhathi sinye, i-hormone yomuntu ejwayelekile isesimweni sokujikeleza esimaphakathi semizuzu engama-62 isikhathi eside.
Ngemuva kwezifundo eziningi, kwatholakala ukuthi umuthi usebenza kakhulu lapho ujojwe ngokuqondile odongeni lwangaphakathi lwesisu, futhi umphumela omncane ungatholakala endaweni ye-hip.
Iziguli ezinokungalingani kwe-renal ziyozwa ukusebenza okufana nezinye izigaba zeziguli, kepha ezinye zazo zinganciphisa isidingo se-insulin. Ukuphakama okuphezulu nobude besikhathi somuthi lapho uhanjiswa enganeni noma ebusheni bayoba yalingana nepharamitha efanayo yomuntu omdala.
Amagama wezohwebo
I-Insulin Glulisin inamagama amanye amabili okuhweba: i-Apidra ne-Apidra SoloStar. Inketho yokuqala isetshenziselwa ukwelapha ushukela ezinganeni kusuka eminyakeni eyi-6, futhi futhi isetshenziselwa abantu abadala abadinga i-insulin. I-Apidra iqukethe u-3.49 mg wento esemqoka (insulin glulisin). Le nto ingaqhathaniswa ne-100 IU ye-hormone yomuntu.
Lesi sidakamizwa sithengiswa ebhodleleni eliyi-10 ml noma emigqonyeni ekhethekile yama-3 ml. Inketho yokuqala igcwele ebhokisini le-cathodic, bese elesibili - lifakwe emgqeni onamakhompiyutha. Enguqulweni yakamuva, kunama-cartridge angu-5 anjalo afakwa esibayeni esikhethekile (isirinji) "OptiPen" noma "OptiSet" (ipeni elilahlayo).
Umenzi futhi wenza uhlelo oluhlukile lwe-cartridge "OptiKlik". Zonke iziqukathi ziqukethe uketshezi olucacile, olungenamibala.
Enye i-analogue yesidakamizwa i-Apidra SoloStar. Into esebenzayo ekuyo isesilinganisweni esifanayo njengasekuqaleni
Izinkomba Nokusetshenziswa
Umuthi ucishe ufane nomuntu ngaphandle kwesikhathi sokuvezwa, okuyinto esifushane. Kwanele ukunikeza isiguli umjovo owodwa womuthi, futhi ngemuva kwemizuzu engu-15 uzozizwa ephumule kakhulu.
Izindlela zokuphatha zingahluka: ngobuqili endaweni ethile yomzimba ngosizo lwepompo le-insulin. Inketho yokugcina yenziwa ngesimo sokufakwa (ngaphandle kwekhefu) kwizicubu ezinamafutha ngaphansi kwesikhumba.
Le nqubo kufanele yenziwe ngaphambi kokudla, noma ngemuva kwayo, kodwa ngokushesha. Ukujova okungama-subcutaneous kwenziwa kahle kakhulu esiswini sesisu, kepha futhi kungaba semahlombe, ethangeni. Kodwa ukumnika kuvunyelwe esiswini kuphela.
Udokotela ohambelayo kuphela onganquma uhlobo lonyango. Ngakho-ke, lesi sidakamizwa sisetshenziswa lapho kudingeka ukuphatha i-insulin esigulini isikhathi eside noma esiphakathi.
Kwamukelekile ukuhlanganisa ukwethulwa kwezidakamizwa namathebulethi (izidakamizwa ze-hypoglycemic). Umthamo nokukhethwa kwalo muthi kunqunywa udokotela ohambelayo, ngoba isiguli asinalo ilungelo lokuzikhethela ngokwaso. Lokhu kugcwele imiphumela emibi.
Phakathi kwemiyalo ekhethekile yokusetshenziswa, ungathola futhi inkomba yendawo yokuphatha umuthi. Ngakho-ke, kuyadingeka ukuvimbela ukulimala kwemithambo yegazi.
Ngaphezu kwalokho, kwenqatshelwe ukufaka indawo lapho kwenziwa umjovo khona.
Imiphumela emibi engaba khona
Uma i-Insulin Glulizin ikhethiwe, imiyalo yokusebenzisa kumele ixwayise umsebenzisi ngemiphumela emibi engaba khona. Uma umuntu enikezwe umuthi owedlu lomuthi, kepha engakufuni lokhu, isiguli singaba ne-hypoglycemia. Lokhu kungumphumela omubi kakhulu ojwayelekile wokusebenzisa lesi sidakamizwa.
Lapho kukhona umphumela omubi onjalo wokufakwa komuthi, isiguli sivame ukuba nezimpawu zesifo ngokushesha. Uphonswa izithukuthuku ezibandayo, umuntu azizwe ediniwe, omile futhi edidekile. Ngasikhathi sinye, uneziqubu ezinwebekile zomzimba kanye nesifiso esinamandla.
Izimpawu ezengeziwe: isicanucanu, ukucanuzelelwa kwemizwa, nokukhathazeka kwezinzwa. Izimpawu zalesi sifo sizokhula, uma zingamiswa, umuntu angalahlekelwa ukwazi. Isiguli sitholakala sinemizwa yokuqaqanjelwa, ukusebenza kwengqondo kukhubazekile, kanti esimweni esibi kakhulu, kuyoholela ekufeni.
Ngokuvamile, iziguli ziqaphela ukuphazamiseka okuvamile ekusebenzeni komzimba wazo. Isibonelo, kwesinye isikhathi isiguli singakhula ukulunywa, okhalweni, noma i-dermatitis ye-allergic. Lezi zimpawu zingakhula ngokuhambisana nomuzwa wokuqina esifubeni noma asphyxiation. Uma imiphumela emibi kuleli fomu ikhula kakhulu ngenkuthalo, ngenxa yalokho kuba nokungezwani okujwayelekile, ukushaqeka kwe-anaphylactic, leso simo kungaholela ekufeni.
Kwesinye isikhathi endaweni yokujova esikhumbeni, kusabela ukuqaphela kwe-hypersensitivity. Kungenziwa kuvezwe njengendawo emangazayo lapho kuthanda khona. Ngokuhamba kwesikhathi, lesi simo sifana ngokwaso, futhi ngemuva kwezinqubo ezimbalwa sinyamalala ngokuphelele. Ezinye iziguli zingaba ne-lipodystrophy.
Sebenzisa ngesikhathi sokuzala nezingane
Uma uGlulisin ebekelwe owesifazane ngalesi sikhathi esijabulisayo, kodwa esinzima, imiyalo ichaza izici zokusetshenziswa kwalesi sidakamizwa njengento ehlukile. Le ndawo ayifundiswanga kahle, ngakho-ke alukho ulwazi olwanele.
Umuthi uhlolwe ezilwaneni. Ucwaningo aluvezi mehluko ngemuva kokwethulwa kwaleli thuluzi nokwehluka komuntu ngesikhathi sokukhulelwa. Ngemuva kokwethulwa, akukho shintsho ekwakhiweni kwesibeletho ngesikhathi sokubeletha kanye nangemva kwayo.
Kepha ngasikhathi sinye, iziguli ezinje kufanele ziqaphele ikakhulukazi ekuphatheni umuthi. Le nqubo kumele yenziwe ngaphansi kokugadwa kweglucose yegazi. Endabeni yesifo sikashukela sokukhulelwa, owesifazane kufanele aqaphe njalo imetabolism yakhe.
Imvamisa, odokotela baxwayisa iziguli ngokushintsha imithamo ngezikhathi ezihlukile zokuthinta. Ngakho-ke, banganciphisa umthamo ku-trimester yokuqala, bese banda phakathi kwama-trimesters amabili alandelayo. Ngemuva kokuthi owesifazane abelethe, uzobona ukwehla kwezidingo ze-insulin.
Umuthi awungeni ubisi lwebele futhi alungenwa ngesikhathi sokuqunjelwa. Kepha udokotela ohambelayo angalungisa umthamo womuthi ngalesi sikhathi futhi anikeze nokudla okukhethekile kowesifazane.
Ukuxhumana nezinye izidakamizwa
I-Insulin Glulisin lapho ithathwa ndawonye ne-guanethidine ingavusa ukukhula kwe-hypoglycemia, okuyizimpawu zayo ezingeke zikhanye kangako.
Amaqembu alandelayo wezidakamizwa angaba ngabameli bokuthuthuka kwemiphumela emibi:
- Ama-Disopyramid;
- I-MAO noma i-PAF inhibitors;
- Ama-Sulfonamides;
- Izicucu;
- Ama-salicylates;
- I-Propoxyphene.
Ukwehla kwezimpawu ze-hypoglycemic kubonakala kanye nokusetshenziswa okuhlangene kwesidakamizwa nama-ejenti anjalo:
- I-Diuretics;
- UDanazole;
- Ama-Protocol inhibitors;
- I-Diazoxide;
- Imithi ye-antipsychotic;
- U-Epinephrine et al.
Imikhakha elandelayo yezidakamizwa yenza buthaka izakhiwo ze-Insulin:
- Clonidine;
- Usawoti weLithium;
- I-Ethanol;
- Ama-blocker e-Beta.
Awukwazi ukukhansela ngokunganqikazi, ukunciphisa noma ukwandisa umthamo wesidakamizwa, kanye nokuwuhlanganisa nezinye izidakamizwa. Ukushintshela kolunye uhlobo lwe-insulin kwenziwa kuphela ngudokotela ohambelayo, futhi le nqubo yenzeka ngaphansi kokuqashwa okuqinile kwezokwelapha.
Ngalesi sikhathi, kungenzeka kulungiswe ukulungiswa komthamo okufika ngesikhathi. Uma unganamatheli kulezi zincomo noma ungafaki kahle isidakamizwa esidingekayo, ungavusa ukukhula ngokushesha kwe-hypoglycemia, kanye nesinye isimo esingaba yingozi.
Ngaphezu kwalokho, udokotela angawashintsha umthamo uma isiguli sishintsha ekudleni, kanye nezinguquko zomzimba. Masinyane ngemuva kokudla, isiguli sinqatshelwe ukuthi singashukuthi sisebenze, ngoba lokhu kungadala ukuqala kwe-hypoglycemia.
