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:
- Ukwehluleka kwangempela Ezimweni ezinjalo, kukhona ukuncipha kwesidingo sehomoni.
- 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:
- Isixazululo sifakwa endaweni ethangeni, ehlombe, kepha ikakhulukazi endaweni ezungeze inkaba esiswini.
- Lapho ufaka iphampu, umuthi kufanele ungene ezingxenyeni ezingaphansi kwesisu.
- Izindawo zomjovo kufanele zishintshe.
- Ijubane kanye nesikhathi sokumuncwa, ukuqala komphumela kuncike endaweni yomjovo wekhambi, kanye nasemthwalweni owenziwe.
- Musa ukuzilolonga izingxenye lapho ikhambi lafakwa khona ukuze lingangeni emikhunjini.
- Ukufakwa okwenziwe esiswini kuqinisekisa ukuqala komphumela okusheshayo kunemijovo kwezinye izindawo.
- 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:
- Noma yiluphi uhlobo lwesifo sikashukela, kufaka phakathi uhlobo lokugula lwesifo, kudinga ukugcinwa kwezinga le-glycemia ngaphakathi kwemikhawulo ejwayelekile kuyo yonke inkathi yokukhulelwa.
- Umthamo wamayunithi wesidakamizwa esikhokhelwayo wehla ku-trimester yokuqala futhi ukhuphuka kancane, kusukela ezinyangeni ezi-4 zokukhulelwa.
- 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.
