I-Apidra ingeyolesigaba sokuphindaphinda okubandakanya i-insulin yomuntu, esebenzisana nayo ngamandla esenzo, kepha inomphumela osheshayo futhi ongapheli. Ukuthola imiphumela oyifunayo, into kufanele inqunywe ngudokotela.
Izici zokwakheka
Umuthi uyatholakala ngesimo sesixazululo okufanele siphathwe ngokungaziphathi. Ithuluzi liwuketshezi cishe olungenamibala lokuvumelana okusobala. Isitsha ngasinye siqukethe u-10 ml wento. Ama-cartridge aqukethe i-3 ml yento.
Kuwo wonke amamililitha wezinto, izithako ezilandelayo zikhona:
- I-3.49 mg yesithako esisebenzayo - i-insulin glulisin, efana ne-100 IU ye-insulin yabantu;
- Izithako ezingeziwe - i-trometamol, i-sodium chloride, amanzi, njll.
Isimiso sokusebenza
Isithako esisebenzayo kulo muthi yi-insulin glulisin. Ithuluzi ngenye indlela ye-insulin, ekhiqizwa emzimbeni womuntu. Kodwa-ke, i-molecule iguqulwa kabusha. Amandla ale ngxenye afana ne-insulin yabantu. Isenzo saso sitholakala ngokushesha. Kodwa-ke, isikhathi somphumela sifushane.
I-insulin glulisin iholela ekuvinjelweni kwezinqubo zokwenziwa kweglucose ezenzeka esibindini. Ngenxa yokusetshenziswa kwe-apidra, i-lipolysis kumaseli wamafutha ivinjelwe, izinqubo zokwenziwa ezibhekele ukuhlanganiswa kwamaprotheni ziyaqiniswa, futhi ukubola kwezakhi zamaprotheni kuyamiswa.
Ngokufakwa kwesidakamizwa ngokungazelele, ukwehla kokuxineka koshukela kwenzeka ngokoqobo ngemuva kwemizuzu eyi-10-20. Lapho usebenzisa umuthi umuthi, isakhi esisebenzayo sihambisana nomphumela waso ne-insulin yomuntu. Iyunithi eli-1 lengxenye yezidakamizwa lifana neyunithi elilodwa le-insulin yomuntu.
Ngesikhathi sokuhlolwa kwempilo yomtholampilo, kwatholakala ukuthi ukusetshenziswa kwe-apidra imizuzu emi-2 ngaphambi kokudla kukuvumela ukuthi ulawule inani leglucose egazini ngemuva kokudla. Umuthi ulawula kangcono ushukela kunokusebenzisa i-insulin yomuntu imizuzu engama-30 ngaphambi kokudla.
Izinkomba nemikhawulo yokusetshenziswa
Imiyalo yokusetshenziswa kwe-apidra ikhombisa ukuthi into isetshenziselwa ukulwa nokubonakaliswa kwesifo sikashukela i-mellitus, esidinga ukwelashwa kwe-insulin. Umuthi ungabekelwa abantu abadala, iziguli zentsha nezingane ngemuva kweminyaka engu-6 yobudala.
Ukwephulwa okungukhiye kokusetshenziswa kwento kufaka okulandelayo:
- Iminyaka engaphansi kweminyaka engu-6 - lokhu kungenxa yemikhawulo yolwazi lomtholampilo mayelana nokusetshenziswa kwento kuyo
- Bantwanyana;
- Ukuba khona kwe-hypoglycemia;
- Ukuzwela ngokweqile kwesithako esisebenzayo noma ezinye izinto zomuthi.
Ngokucophelela kakhulu, i-apidra kufanele isetshenziswe ngesikhathi sokuzala. Abantu abanokwehluleka kwesibindi bangadinga ukuncishiswa kumthamo we-insulin. Lokhu kungenxa yokwehla kwe-gluconeogeneis kanye nokwehla kwenqubo ye-insulin.
Ukwehla kwevolumu yento esebenzayo kungabonakala ukwehluleka kwezinso. Kwenzeka okufanayo nasezigulini esezikhulile, ngenxa yokusebenza kwemithambo engasebenzi kahle.
Izici zokusebenzisa
Ukuthola imiphumela edingekayo, into kufanele iphathwe ngokushesha ngaphambi kokudla ukudla - imizuzu engu-0-15. Lokhu kungenziwa ngemuva kokudla. Ithuluzi lisetshenziswa kumamodi afaka i-insulin yokuvezwa okuphakathi noma okude noma enye into ye-basal - lantus. Umuthi kufanele uhlanganiswe nezidakamizwa ngendlela yamathebulethi, ezinganciphisa ushukela wegazi.
Umthamo ukhethiwe ngamunye. I-Apidra inconyelwa ukuphathwa ngokungaziphathi. I-infusion ende subcutaneous, eyenziwa ngepompo le-insulin, nayo ingasetshenziswa.
Umuthi ufakwa ezicutshini ezingaphansi, ezifakwa ekhaya okhalweni, esiswini, emahlombe. Ngokufakwa isikhathi eside, umuthi ungafakwa kuphela kwezicubu zesisu. Izindawo zokwazisa zidinga ukushintshwa.
Izinga lokutholwa, isikhathi sokwenzeka nesikhathi sokusebenza kunqunywa yindawo yomjovo, izinga lomsebenzi womzimba nezinye izinto. Imijovo esetshenziselwa ukungena odongeni lwesisu iholela ekujuleni kokuncipha, uma uyiqhathanisa nezinye izindawo.
Into esemagobolondweni kufanele isetshenziswe ngepeni ye-insulin noma ngamadivayisi afanayo. Kubaluleke kakhulu ukuthi ulandele imiyalo yokulayisha i-cartridge, unamathisele inaliti futhi uphathe umuthi. Ngaphambi kokusebenzisa i-cartridge, kubalulekile ukwenza isheke lomuthi obonakalayo. Ngemijovo, kusetshenziswa kuphela uketshezi olungenamibala wokungaguquguquki okucacile. Azikho izinto eziqinile okufanele zibe khona kuyo.
Ngaphambi kokusebenzisa, i-cartridge kuqala ishiywe amahora ambalwa ekushiseni kwegumbi. Ngaphambi kokusebenzisa isisetshenziswa esitsheni, kubalulekile ukususa wonke ama-bubble air. Ngemuva kokuphathwa umuthi, ama-cartridge angagcwaliswa.
Uma i-syringe yepeni ilimele, kwenqatshelwe ukuyisebenzisa futhi. Uma umshini ungasebenzi kahle, isixazululo esivela ku-cartridge singafakwa kwisirinji encane, efanelekile ukusetshenziswa kwe-insulin ngevolumu ye-100 IU / ml.
Ngemuva kwalokho umuthi uyabanjiswa. Ipeni lesirinji elungele ukusetshenziswa okuphindwayo lingasetshenziselwa imijovo esigulini esisodwa kuphela. Lokhu kuzosiza ukuvikela ukutheleleka ukungena emzimbeni.
Imininingwane edingekayo ekuxhumaneni ne-insulin ayitholakali. Ngakho-ke, lo muthi akufanele uhlanganiswe neminye imithi. Ukuphela kwento yi-insulin ye-NPH yomuntu.
Izici ze-chemacokinetic ze-insulin zivame ukugcinwa kubantu abahlushwa umsebenzi wezinso. Kepha isidingo sale nto singancipha ngokusebenza kwezinso okungasebenzi kahle.
Izici zesidakamizwa kubantu abanezinkinga esibindini azifundwanga. Ezigulini ezinenkinga yokusebenza kwesibindi, isidingo sale nto singancipha. Lokhu kungenxa yamandla ancishisiwe e-gluconeogeneis. Futhi, le nqubo ithintwa yi-metabolism encishisiwe yento esebenzayo.
Inani elanele lemininingwane ephathelene nezakhiwo ze-pharmacokinetic zabantu asebekhulile abanesifo sikashukela azitholakali. Ngokukhubazeka ekusebenzeni kwezinso, ukwehla kwesidingo sokuphathwa kwe-insulin kungabonakala.
Ukuphendula okungafani
Umphumela omubi kakhulu futhi oyingozi kakhulu we-insulin therapy ukuthuthukiswa kwe-hypoglycemia. Imvamisa, lesi simo sibhekwa lapho usebenzisa i-insulin kumthamo ophakeme kakhulu kunalokho okudingekayo.
Imiphumela emibi ehambisana nokusetshenziswa komuthi ifaka lokhu okulandelayo:
- Ngokushintshwa kwezinqubo ze-metabolic, i-hypoglycemia ivame ukwenzeka, ehambisana nokubonakaliswa okungathandeki. Lokhu kufaka phakathi ukujuluka okupholile, ukufiphaza isikhumba, ukukhathala. Futhi, umuntu angaba nezimpawu zokukhathazeka, ukwethuka kwemikhawulo, ukukhuluphala ngokweqile, ukwazi ukungakwazi kahle, ukozela. Imvamisa i-hypoglycemia iboniswa ukushaya kwenhliziyo okunamandla, ikhanda elibi, kanye nenausea. Njengoba lesi simo sikhuphuka, kwenzeka izimo zokufikelwa amandla okugobeka kanye nokukhalaza. Kungenzeka futhi kube nokusebenza kwengqondo okulimaza unomphela noma okwesikhashana. Ezimweni ezinzima ikakhulukazi, kunengozi yokufa.
- Ngokulimala kwesikhumba kanye nokwakheka kwe-subcutaneous, kuvela izimpawu zokungezwani komzimba. Babonakala ngesimo sokudumba, ukulunywa, i-hyperemia endaweni yezokuphatha. Uma ukwelashwa kuqhubeka, lezi zimpawu ziyanyamalala. Ezimweni ezingavamile, i-lipodystrophy iyabonakala. Imvamisa, kungumphumela wokwephulwa kokushintshwa kwezindawo zokusetshenziswa kwe-insulin noma ukuphinda wethule umuthi endaweni efanayo.
- Ukuzwela kokuzwela ngokweqile kubonakaliswa ukwanela, umuzwa wokuqina esifubeni, nokulunywa. Imvamisa kuba khona i-urticaria kanye ne-allergic dermatitis. Ezimweni ezinzima, kwenzeka ukungalingani okujwayelekile komzimba, kufaka phakathi i-anaphylactic. Zibonisa ingozi yangempela yokuphila.
Ukweqisa
Akukho lwazi oluthile mayelana nokuhlaziywa kwezimpawu ze-apidra ye-apidra. Kodwa-ke, ngokusebenzisa isikhathi eside umthamo owengeziwe wezidakamizwa, kunobungozi be-hypoglycemia yobulukhuni obuhlukahlukene.
Ukwelashwa kwalezi zimo kunqunywa ubukhali bazo:
- I-hypoglycemia emnene ingamiswa ngokudla ushukela noma ukudla okuqukethe ushukela. Ngoba abantu abanesifo sikashukela kufanele ngaso sonke isikhathi babe noswidi, ushukela noma amakhukhi nabo. Ijusi yezithelo nayo yinhle.
- Amacala ayinkimbinkimbi we-hypoglycemia, ahambisana ne-swoon, aqedwa ngokufakwa kwe-0.5-1 mg ye-glucagon. Lo muthi ungahle usetshenziswe ngokungaxhunyiwe noma ngokungaqondakali. I-Intravenous glucose nayo ingasetshenziswa. Uma kungekho mpendulo, i-glucagon ingahanjiswa kungakapheli imizuzu eyi-10-15. Lapho umuntu ebuyela ezingqondweni, kudingeka anikeze ama-carbohydrate ngaphakathi. Lokhu kuzosiza ukuvikela ukubuyela emuva kwe-hypoglycemia. Ngemuva kwalokho isiguli kufanele silaliswe esibhedlela emnyangweni weziguli. Lokhu kusiza ukuthola izimbangela ze-hypoglycemia eyinkimbinkimbi futhi kuvimbele ukuvela kwalezo zimo ngokulandelayo.
Izici Zokusebenzelana
Ucwaningo ngezinhlobo zokusebenzelana kwezidakamizwa ezidakamizweni alwenziwanga. Kodwa-ke, kungaphethwa ngokuthi ukusabela okukhulu kungenzeka.
Kuhle ukubheka izici ezilandelayo zokuxhumana:
- Ukuhlanganiswa kwezinto ezinomlomo we-hypoglycemic, i-fibrate, i-propoxyphene, i-ACE inhibitors kuthuthukisa umsebenzi we-hypoglycemic we-insulin, futhi futhi kwandisa ukuthambekela kokuthuthukisa i-hypoglycemia. Kungashiwo okufanayo ngokuhlanganiswa kwe-apidra nama-salicylates, sulfonamides, fluoxetine, pentoxifylline.
- Ukusetshenziswa okuhambisanayo nge-danazol, i-diuretics, i-sympathomimetics, ama-glucocorticosteroid mahormone, ama-estrogens kungaholela ekunciphiseni komphumela we-insogulin. Umphumela ofanayo ubonwa lapho umuthi uhlanganiswa nama-progestin, izinto ze-antipsychotic, izinto eziphuma ku-phenothiazine.
- Ama-ejenti anjenge-beta-blockers, usawoti we-lithium, i-ethanol ne-clonidine kuholela ekuthatheni amandla noma ekwenzeni buthaka izakhiwo ze-insogulin.
- Ngokuhlanganiswa komuthi ne-pentamidine, kunengozi ye-hypoglycemia ne-hyperglycemia elandelayo.
- Ukusetshenziswa kwesidakamizwa kuhlangene nezidakamizwa ezinemisebenzi enozwela kungavusa ukwehla kobunzima noma kube buthaka kwezimpawu zokusebenzisa amandla kwe-Reflex adrenergic. Lo mphumela ubonwa ngokuhlanganiswa komuthi nge-clonidine, i-guanethidine, i-reserpine.
Ukuhlaziywa kokuhambisana kwe-insulin glulisin akukaze kwenziwe. Ngakho-ke, akufanelekile ukuhlanganisa i-apidra nezinye izinto. Ohlukile kulokhu yi-isophane-insulin yomuntu. Uma usebenzisa into esebenzisa iphampu yokufaka, kwenqatshelwe ngokuphelele ukuyihlanganisa neminye imithi.
Ama-Analog
I-insulin apidra ine-analogue ethile:
- I-Humalogue;
- I-Actrapid;
- I-Novorapid;
- Insuran r.
Izici Zokugcina
Umuthi kufanele ugcinwe ebhokisini lekhadibhodi lapho ungafinyeleleki khona. Ukushisa kufanele kube ngama-2-8 degrees. Musa ukufriza umuthi. Kubaluleke kakhulu ukuyivikela ezinganeni. Ngemuva kokuvula iphakheji, umkhiqizo kufanele usetshenziswe emavikini ama-4. Isikhathi sokusebenzisa umuthi sokuqala kufanele siphawulwe kwiphakheji.
Ukubuyekezwa
Ukubuyekezwa mayelana ne-apidra kukhombisa ukusebenza kahle kwalo muthi:
I-Apidra isidakamizwa esisebenzayo esisiza ukubhekana nezimpawu zesifo sikashukela. Udokotela kufanele anikeze lesi sidakamizwa kuphela. Lokhu kuzosiza ukugwema imiphumela emibi eyingozi futhi uzuze imiphumela oyifunayo.
