Izici kanye nemithetho yokusetshenziswa kwe-insulin Apidra SoloStar

I-Apidra SoloStar iyisisombululo sokwenza imijovo engaphansi. Isakhi esihola phambili salo muthi yiGlulisin, esebenza njenge-analogue ye-insulin yabantu.

Le hormone itholakala kusetshenziswa izindlela zobunjiniyela bezakhi zofuzo. Umphumela wokusetshenziswa kwaso ulingana namandla esenzo se-insulin yomuntu, ngakho-ke i-Apidra isetshenziswa ngempumelelo ekwenzeni i-glycemia ibe nse kubantu abanesifo sikashukela.

Imininingwane ejwayelekile

I-Apidra, noma ibhekwa njenge-analogue ephindaphindayo yehomoni yomuntu, ibonakala ngomphumela osheshayo futhi ongapheli kangako uma uqhathaniswa nawo. Umuthi we-pharmacological uvezwa ohlelweni lwe-radar (irejista yezidakamizwa) njenge-insulin emfushane.

I-Apidra yisisombululo esisetshenziselwa imijovo engabonakali.

Ngaphezu kwento esebenzayo (i-glulisin), umuthi uqukethe ezinye izinto ezinjengalezi:

• i-polysorbate 20 (i-monolaurate);
• i-sodium hydroxide;
• i-trometamol (yemukela proton);
• i-sodium chloride;
• i-cresol;
• i-acid (kugxiliwe) i-hydrochloric.

Isixazululo somuthi sibekwa kumakhadibhokisi aqukethe ama-3 ml, afakwe esibayeni sentambo futhi awakwazi ukushintshwa. Kunconywa ukugcina umuthi esiqandisini ngaphandle kokuwubeka ekuqandeni nasekufeni kwelanga. Ipeni lesirinji 2 amahora ngaphambi kokuba umjovo wokuqala ube segumbini elinokushisa kwegumbi.

Intengo yamapeni ama-5 lesi sidakamizwa cishe ama-ruble angama-2000. Intengo enconywe ngumenzi ingahluka kumanani uqobo.

Izici ze-Pharmacological

I-Apidra inqunyelwe abanesifo sikashukela ukuguqula glycemia. Ngenxa yokuba khona kwengxenye yama-hormone ekwakhiweni kwayo, inani lesikhombi se-glucose egazini liyancipha.

Ukwehla kwezinga likashukela kuqala engxenyeni yehora ngemuva kokujova ngenkani. Imijovo ye-intravenous ye-insulin yemvelaphi yabantu nesixazululo se-Apidra cishe inomphumela ofanayo kumanani we-glycemia.

Ngemuva komjovo, izinqubo ezilandelayo zethulwa emzimbeni:

• ukukhiqizwa kweglucose kuvinjelwe isibindi;
• i-lipolysis iyacindezelwa emangqamuzaneni enza izicubu ze-adipose;
• kukhona ubuhle bokuhlanganiswa kwamaprotheni;
• ukuthathwa kwe-glucose kwezicubu ezithambile kuyashukunyiswa;
• ukuwohloka kwamaprotheni kuyacindezelwa.

Ngokwemiphumela yocwaningo olwenziwe phakathi kwabantu abaphilile neziguli ezinesifo sikashukela, ukujova okufakwayo kwe-hormone Apidra akugcini nje ukunciphisa isikhathi sokulinda somphumela owufunayo, kodwa futhi kunciphise nesikhathi somphumela. Lesi sici sehlukanisa le hormone nge-insulin yomuntu.

Umsebenzi we-hypoglycemic uyefana ku-hormone Apidra naku-insulin yomuntu. Kwenziwe izivivinyo zemitholampilo ezahlukahlukene zokuhlola imiphumela yale mishanguzo. Babandakanya iziguli ezinesifo sohlobo lokuqala. Imiphumela etholakele iholele esiphethweni sokuthi isixazululo seGlulisin ngenani le-0,15 U / kg, esilawulwa imizuzu emi-2 ngaphambi kokudla, senza ukuthi sikwazi ukubheka izinga le-glucose ngemuva kwamahora ama-2 ngendlela efanayo nangemva kokuba imijovo yabantu i-insulin yenziwe engxenyeni yehora.

I-Apidra igcina izakhiwo zokuthatha isinyathelo ngokushesha kwiziguli ezinokukhuluphala okukhona.

Thayipha isifo sikashukela sokuqala

Ukuvivinywa kwemitholampilo okwenziwe phakathi kwabantu abanhlobo lokuqala lwesifo kwakususelwa ekuqhathaniselweni kwezakhiwo zikaGlulisin neLizpro. Emavikini angama-26, ama-hormone aqukethe lezi zinto anikezwa iziguli. I-Glargin yasetshenziswa njengokulungiselela kwe-basal. Ngemuva kokuphothulwa kwesikhathi sokucwaninga, kwaguqulwa ukuguqulwa kwe-glycosylated hemoglobin.

Iziguli ezingamaviki angama-26 zibuye zilinganise izinga le-glycemia zisebenzisa i-glucometer. Ukuqapha kukhombisa ukuthi ukwelashwa kwe-insulin ne-Glulisin kuqhathaniswa nokwelashwa nomuthi oqukethe i-Lizpro kwakungadingi ukwenyuswa komthamo we-hormone eyinhloko.

Isigaba sokuhlolwa sesithathu sithathe amaviki ayi-12. Kubandakanya izisebenzi zokuzithandela ezivela kubantu abanesifo sikashukela abajova uGargin.

Imiphumela yakhombisa ukuthi ukusetshenziswa kwekhambi nengxenye kaGlulisin ngemuva kokuqeda ukudla kwakusebenza kahle njengalapho kufakwe ngaphambi kokudla.

Ngendlela efanayo, ukucabanga kokusebenzisa i-Apidra (kanye nama-hormone afanayo) kwaqinisekiswa uma kuqhathaniswa ne-insulin yabantu, enikezwe isigamu sehora ngaphambi kokudla okuhleliwe.

Iziguli ezibamba iqhaza esivivinyweni zahlukaniswa zaba ngamaqembu ama-2:

• ababambiqhaza abalawula i-Apidra;
• iziguli ezinesifo sikashukela, zenza ukwelashwa kwe-insulin ngemijovo ye-hormone yomuntu.

Imiphumela yezilingo zomtholampilo yaholela esiphethweni sokuthi umphumela wokwehlisa i-glycated hemoglobin wawuphezulu eqenjini lokuqala lababambe iqhaza.

Thayipha isifo sikashukela sesi-2

Izifundo zeSigaba 3 ezibonisa umphumela wezidakamizwa ku-glycemia ezigulini ezinesifo sikashukela sohlobo 2 zenziwa amasonto angama-26. Ngemuva kokuphothulwa kwabo, kuye kwenziwa ezinye izivivinyo zokwelashwa, ezathatha isikhathi esifanayo ngesikhathi sabo.

Umsebenzi wabo bekuwukuthola ukuphepha ekusetshenzisweni kwemijovo ye-Apidra, enikezwe kungakapheli nemizuzu eyi-15 ngaphambi kokudla, nokuncibilikisa i-insulin yabantu, enikezwe iziguli imizuzu engama-30 noma engama-45.

I-insulin eyinhloko kubo bonke ababambe iqhaza kwakungu-Isofan. Inkomba yomzimba evamile yababambe iqhaza yayingama-34,55 kg / m². Ezinye iziguli zithatha ezinye izidakamizwa ngomlomo, ngenkathi zisaqhubeka nokuphatha i-hormone ngendlela engashintshiwe.

I-hormone i-Apidra yaqhathaniswa ne-insulin yomsuka womuntu ekuhlolweni kwezinga le-hemoglobin yezinyanga eziyisithupha nezinyanga eziyi-12 elihlobene nenani lokuqala.

Inkomba isishintshile ezinyangeni eziyisithupha zokuqala kanje:

• ezigulini zisebenzisa i-insulin yabantu - 0,30%;
• ezigulini ezathola ukwelashwa nge-insulin equkethe i-Glulizin - 0,46%.

Guqula inkomba ngemuva konyaka wokuhlola:

• ezigulini zisebenzisa i-insulin yabantu - 0,13%;
• ezigulini ezathola ukwelashwa nge-insulin equkethe i-Glulisin - 0,23%.

Ukusebenza kahle, kanye nokuphepha kokusetshenziswa kwezidakamizwa okususelwa ku-Glulisin, akuzange kuguquke kubantu bezinhlanga ezahlukene nobulili obuhlukile.

Amaqembu Eziguli Akhethekile

Isenzo se-Apidra singashintsha uma iziguli zinezindlela ezihlobene noshukela ezihlobene:

1. Ukwehluleka kwangempela Ezimweni ezinjalo, kukhona ukuncipha kwesidingo sehomoni.
2. I-Pathology yesibindi. Umphumela wabaphatheli beGlulisin aqukethe iziguli ezinokuphazamiseka okunjalo awucwaningwanga.

Ayikho imininingwane ekushintsheni kwe-pharmacokinetic ezigulini esezikhulile. Ezinganeni nasentsheni esukela eminyakeni engu-7 kuya kwengu-16 ubudala, ehlushwa isifo sikashukela sohlobo 1, umuthi udonswa ngokushesha ngemuva kokuphathwa kobuhlakani.

Ukwenza imijovo ye-Apidra ngaphambi kokudla kukuvumela ukuthi ulondoloze izinga elijwayelekile le-glycemia ngemuva kokudla ngokuqhathaniswa ne-insulin yomuntu.

Izinkomba nomthamo

Ukusetshenziswa kwekhambi lokwelapha kuyadingeka kubantu abanohlobo lwesifo oludinga i-insulin. Isigaba seziguli ezinqunywe umuthi uvame ukufaka izingane ezingaphezu kweminyaka eyi-6.

Isixazululo esine-Glulisin kufanele sikhishwe ngokushesha ngemuva kokudla noma ngaphambi nje kwangaphambi kwaso. I-Apidra isetshenziswa ngokuhambisana nokwelashwa kwe-insulin isikhathi eside noma ama-ejenti anethonya eliphakathi lethonya, kanye nezimpawu zawo. Ngaphezu kwalokho, kuvunyelwe ukusebenzisa ezinye izidakamizwa ze-hypoglycemic kanye nemijovo ye-hormone. Umthamo womjovo we-Apidra kufanele unqunywe ngudokotela kuphela.

Ukwelashwa kwesifo kufanele kwenziwe kuphela ngaphansi kokuqashwa kukachwepheshe. Kwenqatshelwe ngokuzimela ukushintsha umthamo wanoma imuphi umuthi, ikakhulukazi imijovo ye-insulin, kanye nokukhansela ukwelashwa noma ukushintshela kwezinye izinhlobo ze-hormone ngaphandle kwemvume yangaphambili evela ku-endocrinologist.

Kodwa-ke, kunohlobo oluthile lokuvikelwa kwe-insulin olusebenzisa ama-hormone asebambeni amafushane. Kusho ukubalwa kwemali okuphoqelekile kwenombolo yamayunithi esinkwa adliwe ngosuku (1 XE alingana nama-12 g wama-carbohydrate).

Isidingo seHormone:

• ukumboza i-1 XE ibhulakufesi, amayunithi ama-2 kufanele agxunyekwe .;
• kwasemini udinga amayunithi ayi-1.5 .;
• kusihlwa, inani le-hormone ne-XE libhekwa njengelilingana, okungukuthi, 1: 1, ngokulandelana.

Ukugcina isifo sikashukela esigabeni sesinxephezelo, ne-glycemia ejwayelekile kuyinto evamile, uma ubhekisisa njalo ushukela. Lokhu kungatholakala ngokuthatha izilinganiso kumamitha nokubala isidingo sehomoni yokwenza imijovo ngokuya ngenani elihleliwe le-XE elizothathwa.

Izindlela Zokuphatha

Isixazululo somuthi we-Apidra sifakwa ngaphansi kwesikhumba uma kusetshenziswa ipeni. Ezimweni lapho iziguli zisebenzisa iphampu ye-insulin, umenzeli ungena ngokungenisa okungapheli endaweni enamafutha angaphansi.

Amaphoyinti abalulekile okufanele wazi ngaphambi kokujova:

1. Isixazululo sifakwa endaweni ethangeni, ehlombe, kepha ikakhulukazi endaweni ezungeze inkaba esiswini.
2. Lapho ufaka iphampu, umuthi kufanele ungene ezingxenyeni ezingaphansi kwesisu.
3. Izindawo zomjovo kufanele zishintshe.
4. Ijubane kanye nesikhathi sokumuncwa, ukuqala komphumela kuncike endaweni yomjovo wekhambi, kanye nasemthwalweni owenziwe.
5. Musa ukuzilolonga izingxenye lapho ikhambi lafakwa khona ukuze lingangeni emikhunjini.
6. Ukufakwa okwenziwe esiswini kuqinisekisa ukuqala komphumela okusheshayo kunemijovo kwezinye izindawo.
7. I-Apidra ingahlanganiswa ne-hormone Isofan.

Isixazululo se-Apidra esisetshenziselwa uhlelo lwepompo akumele sihlanganiswe neminye imithi efanayo. Imiyalo yale divayisi iqukethe imininingwane ephelele ngokusebenza kwensiza.

Izinto zevidiyo eziphathelene nezinzuzo zamaphampu we-insulin:

Ukuphendula okungafani

Ngesikhathi sokwelashwa kwe-insulin, i-convulsive syndrome kungenzeka. Ukuqala kwezimpawu ze-neuropsychiatric ezimweni eziningi kwandulelwa yizimpawu ezihambisana nokwanda kwamanani wegazi lomfutho. Eqinisweni, ukubonakaliswa okunjalo kuwuphawu lwe-hypoglycemia.

Lesi simo ikakhulukazi siwumphumela wedosi elikhethwe ngendlela engafanele noma ukuphathwa kabi kokudla okudliwayo ngenombolo efakiwe yamayunithi.

Uma i-hypoglycemia yenzeka, isimo sesiguli asenzi ngokwejwayelekile uma kungathathwanga zinyathelo ezifanele. Zisebenza ekusetshenzisweni kwama-carbohydrate amaningana.

Uma isiguli siluma ngokushesha, amathuba amaningi ayoba nawo okuthola impumuzo okusheshayo kwezimpawu ezikhona kulesimo. Ngaphandle kwalokho, i-coma kungenzeka, cishe akunakwenzeka ukuphuma kuyo ngaphandle kosizo lwezokwelashwa. Iziguli ezikulesi simo zidinga ukufakelwa ikhambi le-glucose.

Ukuphazamiseka kusuka emzimbeni kanye nesikhumba

Ezindaweni zomjovo, ukusabela okufana:

• ukulunywa
• hyperemia;
• ukuvuvukala.

Izimpawu ezisohlwini zivame ukuziphilela zodwa futhi azidingi ukuyekwa kokulashwa kwezidakamizwa.

Ukuphazamiseka mayelana nokudla emzimbeni kuvezwa ekwakhiweni kwe-hypoglycemia, ehambisana nalezi zimpawu ezilandelayo:

• ukukhathala
• ubuthakathaka nokuzizwa ukhathele;
• ukuphazamiseka okubukwayo;
• ukozela
• i-tachycardia;
• ukuphefumula kwenhliziyo;
• umuzwa wekhanda;
• umjuluko obandayo;
• ukubonakala kokucasha kokungazi, kanye nokulahlekelwa ngokuphelele.

Ukwethulwa kwesixazululo ngaphandle kokushintsha indawo yokubhoboza kungaholela ku-lipodystrophy. Ukusabela kwezicubu ebuhlungwini obungapheliyo futhi kuvezwe kwizilonda ze-atrophic.

Ukuphazamiseka okujwayelekile

Ukuphazamiseka kwesistimu ngesikhathi sokusebenzisa umuthi akuvamile.

Ukuvela kwabo kuhambisana nezimpawu ezilandelayo:

• ukuhlaselwa yisifuba somoya;
• i-urticaria;
• umuzwa wokulunywa;
• dermatitis okubangelwa komzimba.

Kwezinye izimo, ukungezwani okujwayelekile kungafaka impilo yeziguli engozini.

Iziguli ezikhethekile

Ukufakwa kwekhambi kufanele kunikezwe abakhulelwe ngokucophelela okukhulu. Ukulawulwa kwe-Glycemia ohlakeni lokwelashwa okunjalo kufanele kwenziwe njalo.

Amaphuzu abalulekile wokulashwa kwe-insulin komama abakhulelwe:

1. Noma yiluphi uhlobo lwesifo sikashukela, kufaka phakathi uhlobo lokugula lwesifo, kudinga ukugcinwa kwezinga le-glycemia ngaphakathi kwemikhawulo ejwayelekile kuyo yonke inkathi yokukhulelwa.
2. Umthamo wamayunithi wesidakamizwa esikhokhelwayo wehla ku-trimester yokuqala futhi ukhuphuka kancane, kusukela ezinyangeni ezi-4 zokukhulelwa.
3. Ngemuva kokubeletha, isidingo se-hormone, kufaka phakathi i-Apidra, siyancishiswa. Abesifazane abanesifo sikashukela sokukhulelwa ngokuvamile badinga ukuyekwa kokulashwa kwe-insulin ngemuva kokubeletha.

Kuyaqapheleka ukuthi izifundo ngokungena kwe-hormone enengxenye yeGlulisin kubisi lwebele azange kwenziwe. Ngokusekelwe olwazini oluqukethwe ekubuyekezweni komama abasebehlengikazi abanesifo sikashukela, kuyo yonke le nkathi yokuqunjelwa, kufanele ngokuzimela noma ngosizo lodokotela baguqule umthamo we-insulin nokudla.

I-Apidra ayinqunyelwe izingane ezingaphansi kweminyaka engu-6. Akukho mininingwane emtholampilo ngokusetshenziswa kwezidakamizwa kulesi sigaba seziguli.