Elinye lama-insulin asetshenziselwa ukuqinisa ushukela wegazi yi-Detemir. Unjani lo muthi? Ungayisebenzisa kanjani futhi yiziphi izithasiselo ezingashintshwa?
Liyini leli khambi?
Ukusetshenziswa kobuchwepheshe besimanje kwe-DNA recombination kusize ososayensi izikhathi eziningana ukukhuphula ukusebenza kwama-ejenti nge-insulin ejwayelekile.
Isixazululo somjovo we-Detemir sakhiwa kusetshenziswa indlela yokucutshungulwa kwezinto eziphilayo zamaketanga we-DNA.
I-Detemir yisisombululo esine-pH engathathi hlangothi, isobala futhi ayinayo imibala. Lesi simeli sokulwa nesifo sikashukela singama-insulin ambalwa asebenza isikhathi eside. Emakethe, i-insulin detemir ithengiswa ngaphansi kwegama uLevimir.
Ukupakisha kubukeka kanjena: Kumakhemisi, kuthengiswa ngefomethi yenqola, ngawunye wayo u-0,142 ml wesitha. Ngokwesilinganiso, ukupakisha kubiza cishe ama-ruble angama-3,000. Njengezinye izinhlobo zezidakamizwa eziqukethe i-insulin, lo muthi uthengiswa ngomuthi kadokotela.
Umnyombo wesenzo sikaDetemir
I-Detemir isebenza ebanzi kakhulu kune-insulin glargine ne-isofan. Umphumela wesikhathi eside walesi agent kungenxa yokuzihlanganisa okukhanyayo kwezinhlaka zamangqamuzana nokuhlangana kwabo ne -ide fatty acid chain nama-molecule e-albhamuin. Uma uqhathanisa namanye ama-insulin, i-detemir isabalalisa kancane emzimbeni wonke. Umshini onjalo womsebenzi wandisa isenzo somuthi, futhi uthuthukisa ukumuncwa kwawo.
Futhi, ngokungafani nezinye izindlela, le insulin ingabhekeka ngaphezulu, ngakho-ke kulula ukulawula umphumela wayo.
Lokhu kungenxa yezici eziningana:
- I-Detemir ihlala isesimweni se-liquid kusuka ekubeni sesimweni esiningi kuze kube yilapho i-ejenti ingeniswa emzimbeni;
- Izinhlayiya zalo ziboshelwe kuma-molekyuli e-albhamuin esegazini yegazi ngendlela yesiphuphu.
Ithuluzi lixhumana nama-receptors angaphandle akhiwe kulwelwesi lwesitho se-cytoplasmic. I-insulin-receptor tata iyakhiwa evusa inkambiso yezinqubo ze-intracellular process. Ukuhlanganiswa okwandisiwe kwe-glycogen synthetase, i-hexokinase ne-pyruvate kinase enzymes kwenzeka.
Ukuxutshwa kwamakhompiyutha kashukela kuyancipha ngenxa yokunyuka kokuhamba koshukela ngaphakathi kwamangqamuzana, kuqala ukungenelwa kangcono kwezicubu. I-Glycogenogenesis ne-lipogeneis nazo zithuthukisiwe. Isibindi siqala ukukhiqiza ushukela kancane.
Izici zeKinetic zomenzeli
Ngemuva kokwethulwa kwe-detemir emzimbeni, kugxiliswa kakhulu kumamanzi we-plasma ngemuva kwamahora ayi-7. Uma isiguli sinikezwa imijovo kabili ngosuku, khona-ke izimo ze-glycemic zizinza ngemuva kwezinsuku ezimbalwa zokwelashwa. Lapho ngaphezu kwe-3 mg kufakwe emzimbeni, isethulo sokusebenza singamahora ayi-15 futhi ukusebenza kahle kakhulu kutholakala ngemuva kwamahora ama-2.
Njengoba i-detemir inokusabalalisa okuhle, ijikeleza egazini kumthamo obalulekile.
It is metabolised cishe ngokuphelele, futhi wonke ama-metabolites aphephile ngokuphelele emzimbeni. Ukuphila kwesigamu umuthi kuyahluka ngokuya ngomthamo ophathiswe isiguli. Ngokwesilinganiso, kungamahora ayi-6.
Imiyalo yokusebenzisa
Umthamo odingekayo esigulini ukhethiwe ngamunye. I-Detemir ingahanjiswa izikhathi eziyi-1-2 ngosuku. Uma i-detemir ibekelwa ukwengeza ukulawulwa kwe-glycemia, umuthi usetshenziswa kabili. Umthamo owodwa uphuzwa ekuseni, kanti ama-2 kusihlwa ngaphambi kokulala noma ngemuva kwamahora ayi-12 ngemuva komjovo wasekuseni.
Iziguli ezindala ezineminyaka engama-50 ubudala futhi ezihlushwa isibindi noma ukungasebenzi kwezinso zidinga ukukhetha idosi ngokucophelela. Ngaphezu kwalokho, kudingeka ziqashwe njalo nge-glucose yegazi.
Imijovo ye-Detemir insulin ifakwa ngokungagxili ehlombe, ethangeni, noma esifundeni sodonga lwesibeletho lwangaphandle. Ukuqina kwesenzo (ukumuncwa) kwemithi kuzoncika kusayithi lomjovo. Uma umjovo wenziwa endaweni eyodwa, indawo yokufaka inaliti kufanele ishintshwe phakathi nesikhathi ngasinye. Lokhu kungenxa yokuthi i-lipodystrophy ingenzeka - lezi yizigaxa ezingafani nalokhu, kanti okunzima ukuzisusa lapho.
Uyacelwa uqaphele: uma i-insulin ifakwe esiswini, lapho-ke udinga ukubuyisa u-5 cm kusuka enkabeni bese ugwaza embuthanweni.
Ngaphezu kwalokho, konke kwenziwa ngokuya nge-algorithm:
- Indawo iphathwa nge-antiseptic, izinsalela zayo kufanele zome esikhunjeni;
- Isikhumba sibanjwe ku-crease;
- Inaliti ifakwe ekhoneni. Akusenziwa i-push eqinile, ngemuva kwalokho i-piston yelula emuva kancane. Uma ungena esitsheni, kuzodingeka ushintshe isayithi lomjovo.
- Uketshezi lwethulwa kancane kancane futhi ngokulinganisa. Uma i-piston ingahambi kahle, isikhumba ngaphezulu kwenaliti siyakhukhumala futhi sikhathazeke - udinga ukucindezela inaliti ngokujulile.
- Ngemuva kokujova i-insulin, udinga ukushiya inaliti ngaphansi kwesikhumba imizuzwana engu-4-6. Ngemuva kwalokhu, inaliti isuswa ngokunyakaza okubukhali, isayithi lomjovo liphinda lisulwe nge-antiseptic.
Ukuze wenze umjovo ungabi zinhlungu ngangokunokwenzeka, khetha inaliti emfushane neyethambile, lapho uhlangana, ungasincengi isikhumba ngokuqinile, sinamathele ngesandla esinokuzithemba.
Yini okufanele uyibheke ngaphambi kokufaka imali?
Ngaphambi kokujova, kufanele:
- Phinda uhlole uhlobo lomkhiqizo;
- Khubaza ulwelwesi lwerabha ngotshwala noma ngenye i-antiseptic;
- Phinda ubuqotho be-cartridge. Uma ilinyazwe ngaphandle noma ingxenye ebonakalayo yolwelwesi idlula ububanzi behembe elimhlophe, ayinakusetshenziswa futhi kufanele ibuyiselwe ekhemisi.
Uyacelwa uqaphele ukuthi i-insulin eqandisiwe noma ebigcinwe ngendlela engafanele ngendlela efanele, ikhareji elinamanzi olunamafu futhi anemibala ngaphakathi, akufanele lisebenzise. I-Detemir akufanele isetshenziswe kumaphampu we-insulin.
Lapho ujova, kufanele ulandele le mithetho:
- Umuthi uphathwa kuphela ngaphandle kokuzenzela.
- Ngemuva komjovo ngamunye, shintsha inaliti (uma kusetshenziswa i-insulin ku-ampoule), ngoba umkhiqizo ungahle uvuze ngenxa yokuqhuma kokushisa.
- Ama-Cartridges awakwazi ukugcwaliswa kabusha. Le nqubo kungenzeka kuphela ngokuvumelanisa kabusha.
Ukweqisa izidakamizwa
Kwezokwelapha, umqondo we-insulin overdose kanjalo awakhiwa. Ngaso leso sikhathi, lapho isiguli sisebenzisa umthamo ophakeme kunaleso esikhethiwe, sakha isithombe somtholampilo se-hypoglycemia (ushukela ophansi kakhulu).
Isiguli sinezimpawu ezilandelayo:
- Pallor;
- I-Tremor;
- Tinnitus;
- Ukulahlekelwa kokuhlushwa;
- Umuzwa wesicanucanu;
- Ukwehla okukhulu kwekhwalithi yombono;
- Ukukhathazeka nokunganaki.
Imvamisa umuntu ugula ngokungazelele. Ukubonakaliswa okumnene kwalesi simo kungaqedwa ngokuthatha inani elincane loshukela noma omunye umkhiqizo weglucose. Kunamaphilisi akhethekile asiza ukunqoba i-hypoglycemia enkulu.
Lesi simo sihambisana nezimpawu:
- Ukungazi kahle;
- Isiyezi
- Ukulimazeka kwenkulumo;
- Ukuxhumana okumpofu;
- Umuzwa onamandla wokwesaba kwangaphakathi.
I-hypoglycemia enkulu iphathwa ngomjovo we-intramuscular noma subcutaneous we-1 mg we-glucagon. Uma umzimba womuntu ungaphenduli kulomjovo nganoma iyiphi indlela kungakapheli imizuzu engama-20, isixazululo soshukela siphathwa kahle. Ezimweni ezibucayi kakhulu, isiguli singafa noma sithola ukuphazamiseka kobuchopho.
Umphumela wecala
Ukubukeka kwabo ngqo kuncike kumthamo we-insulin othathwe. Ebantwini, ukusabela okunjalo ku-Detemir kungenzeka:
- Ukwephulwa kwezinqubo ze-metabolic. Isiguli singaba nesifo sokuphazamiseka kwamathumbu esiswini kanye nokungalingani kwezinto ezahlukahlukene egazini.
- Ukuphendula okujwayelekile nokwendawo komzimba. Sengathi blush, ukuluma, nokudumba. Mhlawumbe ukuthuthukiswa kwe-lipodystrophy ne-edema ezingxenyeni ezihlukene zomzimba.
- Amasosha omzimba. Ezinye iziguli zine-allergy, urticaria. Ukusabela okukhulu kwe-allergic kungadala i-edema kaQuincke nokunye ukusabela okuholela ekufeni.
- Isiphazamiso sokuphika. Imisebe ekhanyayo ibuyiselwe ngokungafanele ku-lens, ngenxa yokuthi kukhona ukungaboni kahle okubonakalayo okujwayelekile nombono wombala.
- Isifo se-Rhinopathic.
- Ukulimazeka ohlelweni lwezinzwa oluzungezile, ngenxa yokuthi kukhona ukwephulwa kokuzwela kwesikhumba, izicubu ziba buthaka zingalaleli. I-Neuropathy nayo ingaba buhlungu.
Uma umuntu ene-hypersensitive kwezinye izingxenye ze-Detemir, lokhu kusabela kungenzeka ngemuva kokuthatha imithamo emincane yomuthi. Bazoboniswa kakhulu ukwedlula kwezinye iziguli.
Njengoba sekushiwo, ukubulala kungadala i-hypoglycemia, okuthinta kabi ukugxila. Ngokuphazamiseka okunjalo, kunconywa ukunciphisa umkhawulo wokushayela imoto, ukulawula izindlela eziyinkimbinkimbi nezinhlobo ezithile zomsebenzi, ngoba zingaba yingozi kubantu.
Kwezinye iziguli, i-hypoglycemia ingakhula ngaphandle kwezimpawu noma ngokubonakala kwayo okungatheni amandla.. Uma kunobungozi bokuthi isiguli singayakha le nto ngokungathi sína, kufanele kuthathwe izinyathelo zokuvimbela ukwehla ushukela kanye nokushayela kokushayela nokwenza umsebenzi oyingozi esikhathini sokwelashwa nakho kufanele kucatshangwe.
Kungenzeka yini ukuba ngabahlengikazi, abesifazane abakhulelwe nezingane?
Akukho mehluko we-teratogenic noma we-embryotoxic uma usebenzisa i-insulin Detemir nomuntu ojwayelekile. Kulokhu, abesifazane abakhulelwe nalabo abasesikhathini sokuqunjelwa, lapho besenza ukwelashwa, kudingeka ukuthi babe ngaphansi kokuqashwa udokotela futhi babheke neshukela.
Kwabesifazane abanesifo sikashukela i-mellitus, amazinga abo eglucose azinza kancane kuma-trimesters angama-2-3, ngakho-ke isidingo se-insulin siyancipha. Lapho owesifazane ezala futhi eyeka ukuncelisa, umzimba uyaphinda futhi uqala ukuntula i-insulin. Ngakho-ke awukwazi ukushiya isigqi sokuphuza izidakamizwa ngokufanayo ezimeni ezinjalo, udinga ukulungisa umthamo.
Ezinganeni esezikhulile, ukwelashwa kwe-insulin kungenzeka, kanti uma ingane inokuntuleka kwesibindi, izinso nezinye izitho zomzimba, udinga ukubheka njalo ukugxila kwe-glucose kanye nesimo sezinhlelo ezithintekile.
Ukuhambisana nezinye izidakamizwa
Ezinye izidakamizwa zingathuthukisa imiphumela ye-Detemir:
- Ama-ejenti okwehlisa ushukela ukuze asetshenziswe ngomlomo;
- I-Monoamine oxidase inhibiting izidakamizwa kanye ne-angiotensin yokuguqula i-enzyme;
- I-b-group adrenergic blockers engakhethi abanye.
Uphuzo oludakayo luthinta i-insulin ngendlela efanayo. Zibuye zivuse isikhathi somphumela we-hypoglycemic.
Izinto ezilandelayo zivimbela isenzo sale nto:
- Ama-hormone okukhula ahlukahlukene;
- Glucocorticoids;
- I-Sympathomimetics yeqembu b;
- Ama-hormone egilo;
- Izidakamizwa ezine-danazol.
Ama-lancreotides nama-octreodites angathinta umphumela ngokuhlangana. Ezimweni ezahlukahlukene, bayayivusa noma bayicishe. Ama-sulfites nama-thiols awakwazi ukusetshenziswa ne-insulin detemir, ngoba acekela phansi ukwakheka kwe-insulin futhi anciphise umphumela wawo. Leli thuluzi alikwazi ukungezwa kuzixazululo zokungenela kwabadonsi.
Shintshela ku-Detemir nezinye izinhlobo ze-insulin
Inqubo enjalo kufanele yenziwe ngaphansi kokuqashwa kukachwepheshe. Ukushintshwa kokuhlushwa, ushintsho ohlotsheni lwe-ejenti (kusuka kumuntu kuya esilwaneni / kubantu i-insulin analogues kanye okuphambene nalokho) nezinye izinto kungadinga ushintsho esigqini sokulashwa kwe-insulin.
Lapho umgwaqoLapho uya eDememir, udinga ukubheka njalo ushukela wegazi lesiguli. Ukulawulwa okunjalo kwenziwa emasontweni ambalwa okuqala.
Lapho wenza ukwelashwa okunesifo sikashukela okuyinkimbinkimbi, udinga ukuthatha ikhefu phakathi kwemithamo yezinhlobo ezahlukahlukene zemithi. Zingathinta ukumuncwa kanye nokumunyiswa komunye nomunye.
Okuqukethe i-insulin
I-Detemir insulin ine-analogues ezimbili eziyinhloko lapho into esebenza ngayo (insulin detemir) iyefana.
Nawa amagama abo kanye namanani alingwayo:
- I-Levemir Flekspen ngesimo semijovo - inani ngepakethe ngalinye nge-100 ml ngama-ruble angama-4500.
- I-Levemir Penfil nayo isesimweni sesisombululo - inani elifanayo libiza ama-ruble angama-5,000.
Iqembu elifanayo le-pharmacological lifaka imali nge-insulin glargine. Amagama wezohwebo nezindleko zokupakisha:
- Isixazululo somjovo we-Aylar - sifinyelela kuma-ruble angama-3500;
- I-Latus Optiset ne-Latus standard - ama-ruble angama-2900;
- I-Latus Solostar - ama-ruble ayi-3000;
- I-Tozheo Solostar kusuka kuma-ruble ayi-1000 kuya kwangama-2700.
Ezinye izifaniso zesikhalazo:
- IMonodar Ultralong (ukumiswa komjovo) - njengengxenye ye-insulin yengulube.
- I-Tresiba Flekstach - isixazululo nge-insulin degludec, ibiza cishe ama-ruble angama-5000.
Isiphetho
I-Detemir ingesinye sezidakamizwa ezinhle kakhulu ze-insulin ngokuya ngamapharamitha asemzimbeni nawamakhemikhali. Kusondelene kakhulu ne-insulin yomuntu yemvelo. Umkhiqizo awushiyi ngemuva kwezinto ezisebenzayo emzimbeni ezingaba nomthelela omubi emzimbeni. Intengo yayo ayiphezulu kunezinye izinhlobo ze-insulin.
Ngakho-ke, izindleko ezimaphakathi zalezi zindlela kanye nokusebenza okuhlukahlukene kwenza sikwazi ukuyisebenzisela izinhlobo ezahlukahlukene zeziguli.
