Insulin glargine

Abincin abinci, abinci na jiki da kuma yarda da wasu shawarwari na likitoci ba koyaushe ke ba da sakamakon da ake tsammanin ba. Saboda haka, masu ciwon sukari galibi ana rubanya magungunan maye gurbin insulin. Ofayansu shine Insulin Glargin. Wannan kwatankwacin kwatancen kwayar halitta ce ta jikin mutum. Menene alamu na amfani da maganin?

Formaddamar da tsari da abun da ke ciki

Ana amfani da miyagun ƙwayoyi a cikin hanyar samar da mafita ga gudanarwar subcutaneous (sc): tsabtataccen ruwa mai laushi (3 ml kowane a cikin gilashin gilashin gilashi ba tare da launi ba, 1 ko harsashi 1 a cikin blisters, fakitin 1 a cikin kwali na kwali, 10 ml a gilashin m kwalabe ba tare da launi ba, a cikin kwali na kwali 1 kwalban da umarnin don amfani da Insulin glargin).

1 ml na bayani ya ƙunshi:

• abu mai aiki: glargine insulin - 100 PIECES (ɓangaren aiki), wanda yake daidai da 3.64 MG,
• abubuwa masu taimako: zinc chloride, metacresol, glycerol, sodium hydroxide, hydrochloric acid, ruwa don allura.

Pharmacodynamics

Insulin glargine magani ne na hypoglycemic, analog na aikin insulin tsawon lokaci.

Abubuwan da ke aiki da miyagun ƙwayoyi shine insulin glargine, analog na insulin ɗan adam wanda aka samu ta hanyar sake haɗuwa da kwayoyin halittar DNA (deoxyribonucleic acid) na ƙwayoyin K12 na nau'in Escherichia coli.

Ana amfani da insulin glargine ta hanyar rashin isasshen yanayin a cikin tsaka tsaki yanayi. Cikakken solubility na abu mai aiki a cikin abun da ke cikin miyagun ƙwayoyi an cimma shi ne saboda abubuwan da ke cikin hydrochloric acid da sodium hydroxide. Adadinsu yana ba da mafita tare da amsawar acid - pH (acidity) 4, wanda, bayan an gabatar da miyagun ƙwayoyi a cikin mai mai subcutaneous, an lalata shi. Sakamakon haka, ana kirkiro microprecipitate, daga cikinsu akwai kullun sakin ƙananan adadin insulin glargine, wanda ke ba da ƙwayar magani tare da tsawaita aiki da kyakkyawan yanayin da ake iya faɗi wanda ya dace da jujjuyar lokaci.

Abubuwan da ke ɗaure nauyin insulin glargine da aiki na metabolites na M1 da M2 ga takamaiman masu karɓar insulin yana kusa da na insulin na ɗan adam, wanda ke ƙayyade ƙarfin insulin glargine don samun tasirin halitta kamar insulin halittar jini.

Babban aikin insulin glargine shine tsari na metabolism metabolism. Ta hanyar hana kwayar glucose a cikin hanta da kuma karfafa shanyewar glucose ta hanyar tsopose nama, kasusuwa da sauran kasusuwa na jiki, yana taimakawa rage yawan glucose a cikin jini. Yana haɓakar lipolysis a cikin adipocytes kuma yana jinkirta proteolysis, yayin da yake haɓaka samuwar furotin.

Tsawan aikin insulin glargine yana faruwa ne sakamakon rage yawan shanshi. Matsakaicin tsawon insulin glargine bayan gudanarwar subcutaneous shine sa'o'i 24, matsakaicin shine 29 hours. Tasirin maganin yana faruwa kimanin awa 1 bayan gudanarwa. Ya kamata a ɗauka a cikin zuciya cewa tsawon lokacin aikin insulin glargine a cikin marasa lafiya daban-daban ko a cikin haƙuri ɗaya na iya bambanta sosai.

An tabbatar da ingancin maganin a cikin yara masu fama da nau'in 1 na ciwon sukari na shekaru fiye da 2 shekaru. Lokacin amfani da gulingine na insulin, akwai ƙananan abin da ya faru na bayyanar cututtuka na hypoglycemia yayin rana da dare a cikin yara 2-6 shekara idan aka kwatanta da insulin-isofan.

Sakamakon binciken da ya dawwama na shekaru 5 ya nuna cewa a cikin marasa lafiya da ke dauke da nau'in ciwon sukari na 2 na sukari, yin amfani da insulin glargine ko insulin-isophan yana da sakamako iri ɗaya kan ci gaban cututtukan cututtukan zuciya.

Idan aka kwatanta da insulin ɗan adam, kusancin insulin glargine don mai karɓar IGF-1 (insulin-kamar haɓaka factor 1) ya ninka sau 5-8, kuma metabolites mai aiki M1 da M2 sun ɗan yi ƙasa kaɗan.

A cikin marasa lafiya da ke cikin nau'in 1 na ciwon sukari na mellitus, yawan tattara insulin glargine da metabolites yana da ƙasa ƙasa da matakin da ake buƙata na rabin-iyakar dauri ga masu karɓar IGF-1, biye da kunna hanyar haɓakar mitogenic, wanda aka haifar ta hanyar masu karɓar IGF-1. Ya bambanta da ilimin kimiyyar lissafi na IGF-1 mai cike da damuwa, maida hankali na insulin maida hankali wanda aka samu tare da aikin insulin na glargine yana da matukar ƙanƙantar da hankali fiye da maida hankali kan magunguna wanda ya isa ya kunna hanyar haɓaka mitogenic.

Sakamakon bincike na asibiti ya nuna cewa yayin amfani da insulin glargine a cikin marasa lafiya da babban haɗarin haɓaka cutar zuciya da rashin haƙuri na rashin ƙarfi, ƙarancin azumin glycemia ko nau'in ciwon sukari na 2, yiwuwar haɓaka rikitar cututtukan zuciya ko mutuwar jijiyoyin jini. tare da wannan daidaitaccen maganin cututtukan zuciya. Ba a sami bambance-bambance ba a cikin adadin kowane bangare wanda yake ƙunshe da ƙarshen ƙarshen, mai hadewar alamomin sakamakon microvascular, da kuma mace-mace daga duk abubuwan.

Pharmacokinetics

Idan aka kwatanta da insulin-isophan, bayan subcutaneous management na insulin glargine, ya zama ya fi tsayi kuma ya fi tsayi a kula, kuma babu wani fifiko a cikin taro.

A kan asalin tsarin kwayar halitta ta insulin glargine na yau da kullun, daidaituwa game da abu mai aiki a cikin jini ya kai bayan kwanaki 2-4.

Rabin rayuwa (T_1/2a) glargine insulin bayan gudanarwar cikin jijiyoyi yana daidai da T_1/2 jikin mutum.

Lokacin da aka shigar da maganin a cikin ciki, cinya, ko kafada, ba a sami bambance-bambance masu mahimmanci ba a cikin yawan tattara insulin.

Insulin glargine yana nuna ƙananan ƙananan bambancin bayanan furotin a cikin mai haƙuri ɗaya ko a cikin marasa lafiya daban-daban idan aka kwatanta da insulin na ɗan adam-matsakaici na ɗan adam.

Bayan an shigar da insulin glargine a cikin kitse na subcutaneous, sharewar β-sarkar (beta-sarkar) daga carbonxyl (C-terminus) yana faruwa tare da samuwar metabolites masu aiki guda biyu: M1 (21 A -Gly-insulin) da M2 (21 A - Gly-des-30 B-Thr-insulin). Hanyoyin metabolite M1 galibi suna kewaya a cikin jini, yanayin aikinsa yana ƙaruwa tare da ƙara yawan ƙwayoyi. Ayyukan insulin glargine an gano shi musamman saboda ƙaddamar da tsarin na metabolite M1. A cikin mafi yawan lokuta, ana iya gano insulin glargine da metabolite M2 a cikin keɓaɓɓiyar kewaya. A cikin lokuta mafi ƙarancin gano insulin glargine da M2 metabolite a cikin jini, maida hankali ne kowannensu bai dogara da maganin da aka sarrafa ba.

Sakamakon shekarun mai haƙuri da jinsi a kan magunguna na insulin glargine ba a kafa su ba.

Binciken sakamakon gwaji na asibiti ta hanyar rukunin ƙungiyoyi ya nuna rashi bambance-bambance a cikin aminci da tasirin insulin glargine ga masu shan sigari idan aka kwatanta da yawan jama'a.

A cikin marasa lafiya tare da kiba, aminci da tasiri na miyagun ƙwayoyi ba su da illa.

Magungunan ƙwayar insulin glargine a cikin yara masu shekaru 2 zuwa 6 tare da nau'in ciwon sukari na 1 suna kama da waɗanda ke cikin manya.

Tare da mummunan mataki na gazawar hanta, yanayin biotransformation na insulin yana raguwa saboda raguwa a cikin ikon hanta zuwa gluconeogenesis.

Contraindications

• shekaru har zuwa shekaru 2
• rashin hankali ga abubuwan da ke cikin miyagun ƙwayoyi.

Tare da taka tsantsan, ya kamata a yi amfani da insulin glargine a cikin marasa lafiya da ke dauke da farfadowa na ƙwayar cuta, ƙarancin jijiya na jijiya ko jijiyoyin ƙwayar ƙwayar cuta, yayin ciki da shayarwa.

Glulin insulin, umarnin don amfani: hanyar da sashi

Ba dole ne a gudanar da insulin glargine ta hanyar intravenously (iv) ba!

Maganin shine maganin sc a cikin kitse mai zurfi na ciki, cinya ko kafadu. Ya kamata a sauya wuraren allurar cikin ɗayan wuraren da aka bada shawarar.

Ba a sake yin amfani da maganin kafin amfani da ake bukata ba.

Idan ya cancanta, ana iya cire gulingine insulin daga cikin kicin a cikin sirinji mai ƙima wanda ya dace da insulin kuma ana iya gudanar da maganin da ake so.

Za'a iya amfani da katako tare da sirinji-alkalami.

Kada a cakuda miyagun ƙwayoyi tare da sauran insulins!

Matsakaici, lokacin gudanar da maganin shawo kan jiki da kuma ƙimar manufar maida hankali a cikin jini ana ƙaddara shi kuma an daidaita shi daban-daban ta likita.

Sakamakon canje-canje a cikin yanayin haƙuri, ciki har da aikin jiki, a kan matakin sha, farawa da tsawon lokacin aikin miyagun ƙwayoyi ya kamata a yi la’akari.

Ya kamata a gudanar da insulin glargine s / c 1 sau ɗaya kowace rana koyaushe a lokaci guda, dace ga mai haƙuri.

Dukkanin marasa lafiya da ke dauke da cutar siga yakamata suyi sa ido a kai a kai yayin tattara yawan glucose din jini.

A cikin marasa lafiya da nau'in ciwon sukari na 2 na sukari, ana iya amfani da insulin glargine azaman maganin monotherapy kuma a hade tare da sauran wakilai na hypoglycemic.

Ya kamata a dauki matakan insulin cikin kulawa tare da taka tsantsan kuma a karkashin kulawar likita. Canji a kashi na iya buƙata idan an rage nauyin jikin mai haƙuri ko rage shi, lokacin gudanar da maganin, yanayin rayuwarsa da sauran yanayi yana ƙara tsinkaye zuwa haɓakar hauhawar jini ko hypoglycemia.

Insulin glargine ba magani bane na zazzabin ketoacidosis na masu ciwon sukari, magani wanda ya shafi gabatarwar insulin gajeriyar aiki.

Idan tsarin kulawa ya hada da injections na basal da prandial insulin, to kashi na insulin glargine, gamsar da bukatar insulin basal, yakamata ya kasance cikin kashi 40-60% na yawan insulin na yau da kullun.

A cikin marasa lafiya da masu ciwon sukari na nau'in 2 waɗanda ke yin jiyya tare da nau'ikan maganganu na wakilai na hypoglycemic, ya kamata a fara amfani da magani tare da kashi insulin 10 IU 1 a kowace rana tare da daidaitattun daidaitattun hanyoyin maganin.

Idan tsarin kulawa na baya ya haɗa da matsakaiciyar matsakaici ko insulin aiki mai tsawo, lokacin canja mai haƙuri zuwa yin amfani da insulin glargine, yana iya zama dole don sauya sashi da lokacin gudanarwar insulin gajeriyar magana (ko analog ɗin sa) a cikin rana ko don daidaita sakin ƙwayar maganganu na baki.

Lokacin canja wurin mai haƙuri daga gudanar da nau'in sashi na insulin glargine, wanda ya ƙunshi 300 IU a cikin 1 ml, don gudanar da insulin glargine, kashi na farko na miyagun ƙwayoyi ya kamata ya zama 80% na kashi na maganin da ya gabata, amfani da wanda aka yanke, kuma ana gudanar dashi sau ɗaya a rana. Wannan zai rage haɗarin hauhawar jini.

Lokacin yin sauyawa daga aikin insulin-isophan 1 sau ɗaya kowace rana, kashi na farko na insulin glargine yawanci ba a canza shi kuma ana gudanar dashi sau 1 a rana.

Lokacin canzawa daga gudanar da insulin-isofan sau 2 a rana zuwa guda gudanarwar insulin glargine a lokacin bacci, ana ba da shawarar rage ƙwayar maganin yau da kullun ta 20% daga kashi na yau da kullun na insulin-isofan. Mai zuwa yana nuna gyararsa gwargwadon aikin mutum.

Bayan farawar farko tare da insulin mutum, yakamata a fara amfani da insulin glargine kawai a karkashin kulawa ta likitanci, gami da lura da yadda ake tattara glucose a cikin jini. A cikin makonni na farko, in ya cancanta, ana daidaita tsarin aikin sashi. Gaskiya ne gaskiyar ga marasa lafiya waɗanda ke cikin rigakafi ga insulin na mutum waɗanda ke buƙatar a ba su babban insulin na mutum. Amfani da insulin glargine, analog na insulin na mutum, na iya haifar da babban ci gaba a cikin martanin insulin.

Tare da haɓakar jijiyar ƙwayar ƙwayar jiki zuwa insulin saboda ingantaccen kulawa na rayuwa, gyaran hanyoyin sarrafawa yana yiwuwa.

A cikin marasa lafiya da masu ciwon sukari mellitus a cikin tsofaffi, an bada shawarar yin amfani da farkon matsakaici da matakan kulawa da insulin glargine kuma a hankali ƙara haɓaka su. Ya kamata a ɗauka a cikin zuciya cewa cikin tsufa amincewa da haɓakar haɓakawar jini yana da wahala.

Alamu da nau'in sakin

Babban kayan aiki na miyagun ƙwayoyi shine insulin na Glargin roba. Samun shi ta hanyar gyaran DNA na ƙwayoyin cuta na Escherichia coli (iri K12). Nunin don amfani shine mellitus na sukari-wanda ke dogara da yara a cikin yara sama da shekaru 6, matasa da manya.

Lokacin da aka yi amfani da shi daidai, magani yana bayar da:

• normalization na rayuwa tafiyar matakai - samar da sukari da kuma carbohydrate metabolism,
• masu karɓa na insulin masu karɓa a cikin ƙwayar tsoka da mai mai kitse,
• kamshi a jiki da kasusuwa, kashin tsoka da mai kitse,
• kunnawa daga kwayar sunadarai,
• raguwa a cikin samar da sukari mai yawa a cikin hanta.

Hanyar maganin shine mafita. Ana sayar da Glargin a cikin katako 3 ml ko a cikin 10 ml vials.

Aikin magunguna

Babban aikin insulin Glargin, kamar sauran insulin, shine tsari na metabolism metabolism. Magungunan yana rage glucose na jini ta hanyar motsa gulukos ta hanyar tsinkaye guda biyu (musamman tsoka da kasusuwa na tso adi), tare da hana samuwar glucose a cikin hanta. Insulin Glargin yana hana adipocyte lipolysis aiki, yana hana proteolysis kuma yana haɓaka aikin furotin.

An samo insulin Glargin ta hanyar gabatar da gyare-gyare guda biyu zuwa tsarin insulin ɗan adam na asali: maye gurbin asparagine na asalin tare da glycine na amino acid a matsayi na A21 na sarkar da kuma ƙara ƙwayoyin arginine guda biyu zuwa ƙarshen tashar NH2-jerin sarkar B.

Insulin Glargin shine tabbataccen bayani a pH na acidic (pH 4) kuma yana da ƙarancin ƙarfi a cikin ruwa a tsaka tsaki pH. Bayan subcutaneous gwamnatin, da acidic bayani shiga cikin neutralization dauki tare da samuwar microprecipitates, daga abin da adadi kaɗan na Glargin insulin a hankali fito, samar da wani m sanannu (ba tare da bayyane kololumai) bayanin martaba-lokaci maida hankali ga 24 hours. Tsawon lokacin aikin insulin na Glargin yana faruwa ne sakamakon rage girman abin da yake sha, wanda yake da alaƙa da ƙarancin saki. Saboda haka, miyagun ƙwayoyi suna iya kiyaye matakan insulin na basal a cikin marasa lafiya da masu ciwon sukari tare da gudanarwa na subcutaneous sau ɗaya a rana. Dangane da karatun asibiti da ilimin kimiyyar magunguna na ƙasashen waje, insulin Glargin kusan yana da alaƙa a cikin ayyukan halitta tare da insulin ɗan adam.

Umarnin don amfani

An zabi sashi na miyagun ƙwayoyi daban-daban ga kowane mai haƙuri. Ana magance maganin a ƙarƙashin 1 sau ɗaya kowace rana. Yana da kyau a yi hakan a lokaci guda. Yankunan don allura sune kasusuwa na cinya na cinya, cinya ko kafada. A kowane allura, ya kamata a canza wurin allurar.

A cikin nau'in 1 na ciwon sukari, an wajabta insulin Glargin a matsayin babba. Don nau'in cuta ta 2, ana amfani dashi azaman monotherapy ko a hade tare da sauran wakilai na hypoglycemic.

Wasu lokuta ana nuna marasa lafiya sauyawa daga matsakaici ko insulin aiki zuwa Glargin. A wannan yanayin, dole ne ku canza tsarin kulawa da daidaituwa ko daidaita adadin yau da kullun na insulin na asali.

Lokacin canzawa daga Isofan insulin zuwa allurar guda ɗaya na Glargin, kuna buƙatar rage kashi yau da kullun na insulin basal (ta 1/3 a farkon makonni na farji). Wannan yana taimakawa rage haɗarin haɓakar cutar rashin ƙwaƙwalwar ƙwayar maraice. Rage yawan sashi a kan wani lokaci da aka ƙayyade yana ƙaruwa ne ta hanyar ƙara yawan insulin gajeren aiki.

Side effects

Glargin magani ne wanda ke shafar tsarin tafiyar rayuwa da sukarin jini.Tare da tsarin rigakafi mai rauni, amfani mara kyau da wasu fasali na jiki, magani zai iya haifar da tasirin da ba'a so.

Lipodystrophy wani rikitarwa ne tare da lalata kitse mai kitse a wuraren allura na hormone. A wannan yanayin, sha da shan ƙwayoyi suna damuwa. Don hana wannan amsawa, yakamata a sauƙaƙa ɓangaren gudanar da insulin.

Hypoglycemia yanayi ne wanda ke tattare da hankali wanda yaduwar glucose a cikin jini ya ragu sosai (kasa da 3.3 mmol / l). Yana tasowa a cikin lokuta inda ake gudanar da aikin insulin mai yawa ga mai haƙuri. Hare-hare masu maimaitawa suna shafar tsarin juyayi na tsakiya. Mutumin ya koka da girgije da rikicewa, matsaloli tare da natsuwa. A lokuta masu rikitarwa, akwai cikakkiyar asarar hankali. Tare da matsakaici hypoglycemia, rawar jiki hannaye, kullun jin yunwa, saurin bugun zuciya da haushi. Wasu marasa lafiya suna da tsananin zufa.

Bayyanar bayyanar cututtuka. Waɗannan halayen gida ne galibi: jin zafi a wurin allura, cututtukan ciki, aljihun fata da ƙaiƙayi, rashes daban-daban. Tare da hypersensitivity ga hormone, bronchospasm, cikakkiyar halayen fata suna haɓaka (yawancin abin rufe jiki yana shafa), hauhawar jijiyoyin jini, angioedema, da rawar jiki. Amsar rigakafi ta tashi nan take.

Sakamakon sakamako na gefen gefen na'urar gani ba zai yanke hukunci ba. Tare da ka'idar glucose a cikin jini, kyallen takarda suna fuskantar matsin lamba kuma suna cikin tashin hankali. Abubuwan shakatawa a cikin ruwan tabarau na ido kuma suna canzawa, wanda ke haifar da rikicewar gani. A tsawon lokaci, suna ɓacewa ba tare da tsangwama daga waje ba.

Rashin ciwon sukari cuta ce mai wuyar kamuwa da cututtukan zuciya. Tare da lalacewar akan tantin ido. Sakamakon raguwar sukari na jini, hanya ta cutar na iya ƙaruwa. Akwai farfadowa daga retinopathy, wanda ke ɗauke da cutar basur da haɓaka sabbin tasoshin da aka kafa waɗanda ke rufe macula. Idan ba a kula dashi ba, haɗarin cikakkiyar hasarar hangen nesa yana ƙaruwa.

Taimako na farko don yawan shan ruwa

Ragewar sukarin jini yana faruwa lokacin da ake yin manyan allurai na Glargin. Don taimakawa mai haƙuri, bar shi ya ci samfurin da ya ƙunshi ƙwayoyin carbohydrates na narkewa (alal misali, samfurin kayan kwalliya).

Hakanan ana bada shawara don gabatar da glucacon intramuscularly ko cikin mai mai subcutaneous. Babu ƙarancin amfanin da ake amfani da allurar rigakafi ta hanyar maganin dextrose.

Dole ne a rage yawan motsa jiki. Likita yakamata ya daidaita tsarin maganin da rage cin abinci.

Hulɗa da ƙwayoyi

Glargin bai dace da hanyoyin maganin ba. Haramun ne a haxa shi da wasu kwayoyi ko kiwo.

Yawancin magunguna suna shafar metabolism. A wannan batun, kuna buƙatar canza kashi na insulin basal. Waɗannan sun haɗa da pentoxifylline, MAO inhibitors, na baka hypoglycemic formulations, salicylates, ACE inhibitors, fluoxetine, melopyramide, propoxyphene, fibrates, sulfonamide kwayoyi.

Hanyoyin da ke rage tasirin hypoglycemic na insulin sun hada da somatotropin, diuretics, danazole, estrogens, epinephrine, isoniazid, protease inhibitors, glucocorticoids, olanzapine, diazoxide, hormones thyroid, glucagon, salbutamol, clozapine, terbutagen, g.

Salts na lithium, beta-blockers, barasa, clonidine na iya haɓaka ko raunana sakamakon hypoglycemic na insulin.

Haihuwa da lactation

Matan da ke haihuwar yara an wajabta su ne bayan tattaunawa da likitan masu halartar. Amfani da maganin yana da kyau idan amfanin mace mai ciki ya fi gaban hadarin da tayi. Idan mahaifiyar mai haihuwar tana fama da ciwon sukari, ana buƙatar ta sa idanu a kai a kai.

A cikin sati na 2 da na uku na ciki, da bukatar hodar iblis. Bayan haihuwar yara - saukad da sosai. Gyara kwatankwacin kashi yakamata ayi ta kwararru. Yayin shayarwa, ana buƙatar zaɓin kashi da sarrafawa.

A kowane mataki na ciki, yana da muhimmanci a yi la’akari da matakin glucose a cikin jini.

Kariya da aminci

Glargin, kasancewa magani ne na dogon lokaci, ba a amfani dashi don maganin ketoacidosis na masu ciwon sukari.

Tare da hypoglycemia, mai haƙuri yana da alamun da ke nuna raguwa mai yawa a cikin glucose jini koda kafin hakan ta faru. Koyaya, a cikin wasu marasa lafiya, ƙila ba za su iya bayyana kwatankwacinsu ba ko kuma a faɗi cikakke. Kungiyar hadarin ta hada da:

• mutane suna shan wasu magunguna
• tsofaffi
• marasa lafiya da jinin al'ada
• marasa lafiya da tsawan tsoka da kuma cututtukan zuciya,
• mutane masu tabin hankali,
• mutane masu rauni, ci gaba a hankali na hauhawar jini.

Idan ba a gano irin waɗannan yanayi a cikin lokaci ba, za su ɗauki tsari mai wahala. Mai haƙuri yana fuskantar rashi na rashin sani, kuma a wasu halaye har ma da mutuwa.

Kashe (NovoRapid Penfill). Simulates amsa insulin ga abinci ci. Yana aikata ɗan gajeren lokaci kuma mai rauni isa. Wannan yana ba shi sauƙin sarrafa sukarin jininka.

Humalogue (Lizpro). Abun da ke cikin miyagun ƙwayoyi yana kwafin insulin na halitta. Abubuwa masu aiki suna saurin shiga cikin jini. Idan kun gabatar da Humalog a sashi guda kuma a lokaci tsayayyen lokaci, za'a sha sau 2 cikin sauri. Bayan awa 2, alamu sun koma daidai. Ingantacce har zuwa 12 hours.

Glulisin (Apidra) - analogue na insulin tare da mafi karancin lokacin aiki. Ta hanyar aikin metabolism bai bambanta da aikin hormone na halitta ba, kuma ta hanyar kayan magunguna - daga Humalog.

Godiya ga bincike da ci gaba da yawa, akwai magunguna masu inganci da yawa ga masu ciwon suga. Ofayansu shine Insulin Glargin. Ana amfani dashi azaman kayan aiki mai zaman kanta a cikin monotherapy. Wani lokaci kayan aikinsa suna cikin wasu magunguna, alal misali, Solostar ko Lantus. Karshen ya ƙunshi kimanin kashi 80% na insulin, Solostar - 70%.

Pharmacology

Yana ɗaukar takamaiman ga masu karɓar insulin (sigogi masu ɗauri suna kusa da waɗanda insulin na mutum yake), yana yin tasiri akan tasirin halitta mai kama da insulin halittar jini. Yana daidaita metabolism. Insulin da analogues dinsu suna rage glucose jini ta hanyar karfafa glucose uptake ta kashin bayan gida (musamman kasusuwa da tsotse nama), tare da hana samuwar glucose a cikin hanta (gluconeogenesis). Insulin yana hana lipolysis adipocyte da proteolysis, yayin inganta haɓakar furotin.

Bayan gabatarwar cikin kitse na subcutaneous, maganin acidic an magance shi tare da ƙirƙirar microprecipitates, daga abin da ake ƙaddamar da ƙananan ƙwayar insulin glargine koyaushe, yana samar da tsinkaya, mai santsi (ba tare da kololuwa ba) bayanin tsarin lokaci-lokaci, har ma da tsawon lokacin aiki.

Bayan sc gwamnati, fara aikin yana faruwa, a matsakaici, bayan awa 1. Matsakaicin tsawon lokacin aikin shine awoyi 24, matsakaicin shine awoyi 29. Tare da gudanar da mulki guda daya a rana, daidaituwar yanayin yawan insulin glargine a cikin jini ya isa cikin kwanaki 2-4. bayan kashi na farko.

Nazarin kwatancen na insulin glargine da insulin-isofan a cikin jini a cikin mutane masu lafiya da marasa lafiya da ke fama da ciwon sukari bayan sc gudanar da kwayoyi sun bayyana a hankali wanda ya fi daukar hankali, da kuma rashin wadatuwa a cikin insulin glargine idan aka kwatanta da insulin-isofan .

A cikin kitse na ɗan adam, insulin glargine an rabu dashi daga ƙarshen carbonxyl na sarkar B don samar da metabolites mai aiki: M1 (21 A -Gly-insulin) da M2 (21 A -Gly-des-30 B -Thr-insulin). A cikin plasma, glargine insulin da ba ya canzawa da kayan aikin share fage suna nan.

Carcinogenicity, mutagenicity, tasirin tasirin haihuwa

An gudanar da binciken shekaru biyu na ƙwayar insulin glargine a cikin mice da berayen lokacin da aka yi amfani da su a allurai har zuwa 0.455 mg / kg (kimanin 5 da 10 sau mafi girma fiye da allurai ga mutane tare da s / c gwamnatin). Bayanan da aka samo bai bamu damar zartar da ƙarshen ƙarshe game da ƙoshin mata ba, saboda yawan mace-mace a cikin duka rukuni, ba tare da la'akari da kashi ba. An gano tarihin allurar rigakafi a cikin berayen maza (ƙididdigar mahimmanci) kuma a cikin berayen maza (ƙididdigar marasa ƙima) ta amfani da maganin acidic. Ba a gano waɗannan ciwukan cikin dabbobi mata ta amfani da sarrafa gishirin ko narke insulin a cikin sauran abubuwan daskarewa ba. Ba a san mahimmancin wannan lura a cikin mutane ba.

Ba a gano Mutulinicity na insulin glargine ba a cikin wasu gwaje-gwaje da yawa (gwajin Ames, gwaji tare da hypoxanthine-guanine phosphoribosyltransferase na sel mammalian), a gwaje-gwaje don lalata abubuwan kwayoyi na chromosomal (cytogenetic) a cikin vitro a kan sel V79, a cikin vivo a hamster na kasar Sin).

A cikin nazarin haihuwa, kazalika a cikin karatu na gaba da na bayan haihuwa a cikin berayen maza da mata a cikin s / c allurai na insulin kimanin 7 sau da shawarar farawa don s / c a cikin mutane, gubar mahaifa ta haifar da yawan zubar da jini, wanda ya hada da da yawa m lokuta.

Haihuwa da lactation

Tasirin Teratogenic. An yi nazarin farfadowa da karatun teratogenicity a cikin beraye da zomaye na Himalayan tare da kulawar insulin (insulin glargine da insulin na mutum). An gudanar da insulin ga berayen mata kafin dabbar ta hanyar dabbar, lokacin dabbar ta hanyar canjin ciki kuma a duk lokacin haihuwa a allurai har zuwa 0.36 mg / kg / day (kusan sau 7 sama da shawarar fara farawar s / c a cikin mutane). A cikin zomaye, an gudanar da insulin a yayin organogenesis a allurai na 0.072 mg / kg / rana (kusan sau 2 sama da shawarar farawa don s / c a cikin mutane). Sakamakon insulin glargine da na al'ada insulin a cikin waɗannan dabbobi ba su da bambanci. Babu isasshen haihuwa da ci gaban tayi.

Ga marasa lafiya da ciwon sukari na baya ko na ciki, yana da muhimmanci a kula da kyakkyawan tsari na tafiyar matakai na rayuwa yayin daukar ciki. Bukatar insulin na iya raguwa a cikin farkon farkon ciki kuma ya karu yayin watanni na biyu da na uku. Nan da nan bayan haihuwa, buƙatar insulin ya ragu da sauri (haɗarin hauhawar jini yana ƙaruwa). A ƙarƙashin waɗannan yanayin, saka idanu a hankali game da glucose jini yana da mahimmanci.

Yi amfani da taka tsantsan a cikin ciki (ba a gudanar da nazarin binciken asibiti mai tsafta cikin mata masu juna biyu ba).

FDA rukuni na aiki akan tayin - C.

Yi amfani da hankali yayin shayarwa (ba a sani ba ko insulin glargine ya fito cikin ruwan nono na mata). A cikin mata masu shayarwa, ana buƙatar buƙatar sashin insulin da kuma daidaita yanayin abinci.

Side effects na kwayar insulin glargine

Hypoglycemia - Sakamakon mafi yawan abin da ba a ke so shi ba na maganin insulin na iya faruwa idan kashi na insulin yayi yawa idan aka kwatanta da buƙatarta. Hare-hare na mummunan hypoglycemia, musamman maimaituwa, na iya haifar da lalacewar tsarin juyayi. Abubuwa na tsawan lokaci da matsanancin rashin ƙarfi na iya haifar da barazanar rayuwar marasa lafiya. Bayyanar cututtuka ta tsarin adrenergic counter (kunnawa na tsarin juyayi a cikin mayar da martani ga hypoglycemia) yawanci yana haifar da rikicewar neuropsychiatric da ke haɗuwa da cututtukan hypoglycemia (faɗuwar rana ko asara, ciwo mai narkewa): yunwar, damuwa, gumi mai sanyi, tachycardia (saurin ci gaban hypoglycemia) kuma mafi mahimmancinsa, mafi bayyanannun alamomin adrenergic counter-regulation).

Abubuwa masu haɗari daga idanu. Canje-canje masu mahimmanci a cikin tsarin glucose a cikin jini na iya haifar da rauni na ɗan lokaci sakamakon canje-canje a cikin ƙwayar jijiya da ƙwayawar tabarau na ido. Tsawon lokaci na daidaituwa na glucose na jini yana rage haɗarin ci gaban cututtukan cututtukan zuciya. Harkokin insulin, tare da haɓaka mai ƙarfi a cikin glucose na jini, na iya haifar da haɓaka ɗan lokaci na hanya na maganin ciwon sukari. A cikin marasa lafiya da cututtukan fata na farfadowa, musamman waɗanda ba su karɓar magani na photocoagulation, abubuwan da ke tattare da mummunan rashin ƙarfi na iya haifar da ci gaban hasara na yau da kullun.

Lipodystrophy. Kamar yadda duk wani magani na insulin, lipodystrophy da jinkiri na gida cikin sha / ɗaukar insulin na iya haɓaka a wurin allurar. A cikin gwaje-gwaje na asibiti yayin aikin insulin ta amfani da insulin glargine lipodystrophy a cikin 1-2% na marasa lafiya, yayin da lipoatrophy ya kasance gaba daya uncharacteristic. Sauyawar wuraren allurar allura a cikin sassan jiki wanda aka ba da shawarar kula da insulin na insulin zai iya taimakawa rage zafin wannan yanayin ko hana haɓakawa.

Abubuwan da suka shafi gida a cikin aikin kulawa da halayen ƙwayar cuta. A cikin gwaji na asibiti yayin aikin insulin ta amfani da insulin, an lura da halayen glargine a wurin allurar a cikin 3-4% na marasa lafiya. Irin waɗannan halayen sun haɗa da jan, ciwo, ƙaiƙayi, amya, kumburi, ko kumburi. Yawancin ƙananan halayen a wurin aikin insulin yawanci suna warwarewa na tsawon kwanaki zuwa makonni da yawa. Allergic halayen da nan da nan irin rashin lafiyar zuwa insulin ne rare. Irin wannan halayen ga insulin (gami da insulin glargine) ko kuma tsofaffi na iya bayyana azaman ƙarawar fatar jiki, angioedema, bronchospasm, jijiyoyin jijiyoyin jiki ko rawar jiki, don haka suna iya zama barazana ga rayuwar mai haƙuri.

Sauran halayen. Yin amfani da insulin na iya haifar da samuwar ƙwayoyin cuta a ciki. A lokacin gwaji na asibiti a cikin rukunin marasa lafiya da aka bi da insulin-isofan da insulin glargine, an lura da samuwar ƙwayoyin cuta-insulin tare da insulin na mutum tare da mitar guda. A cikin halayen da ba a san su ba, kasancewar irin waɗannan ƙwayoyin rigakafi ga insulin na iya buƙatar daidaita yanayin don kawar da halayen haɓakar hauhawar jini. Da wuya, insulin na iya haifar da jinkiri a cikin ƙwayar sodium da haɓakar edema, musamman idan ingantaccen ilimin insulin yana haifar da ci gaba a cikin ƙarancin ƙarancin hanyoyin tafiyar matakai.

Haɗa kai

Magunguna ba tare da maganin wasu magunguna ba. Kada a hada shi da insulin glargine tare da sauran shirye-shiryen insulin ko kuma aka gurɓata (lokacin da aka gauraya ko an gurza shi, bayanan aikinsa na iya canzawa akan lokaci, ƙari, haɗawa da sauran insulins na iya haifar da hazo). Yawancin kwayoyi suna shafar metabolism metabolism, wanda na iya buƙatar daidaita sashi na insulin glargine. Magunguna waɗanda zasu iya haɓaka tasirin hypoglycemic na insulin kuma ƙara haɓakar tsinkayar ci gaban hypoglycemia sun haɗa da wakilai na bakin jini, masu hana ACE, rashin biyayya, fibrates, fluoxetine, MAO inhibitors, pentoxifylline, propoxyphene, salicylates da maganin antimicrobials.Magunguna waɗanda zasu iya raunana tasirin hypoglycemic na insulin sun hada da glucocorticoids, danazole, diazoxide, diuretics, glucagon, isoniazid, estrogens, progestogens, somatotropin, sympathomimetics kamar epinephrine, salbutamol, terbutaline da hormones sitor, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors clozapine.

Beta-blockers, clonidine, salts na lithium, barasa - zasu iya haɓakawa da kuma raunana tasirin hypoglycemic na insulin. Pentamidine na iya haifar da hypoglycemia, wanda wasu lokuta ana maye gurbinsu da hyperglycemia. A ƙarƙashin rinjayar magunguna na juyayi kamar beta-blockers, clonidine, guanfacine da reserpine, alamun adrenergic counter-regulation na iya rage ko ba su nan.

Babban bayani

Wannan magani yana cikin rukunin insulin. Sunan kasuwancinsa shine Lantus. Ana amfani da wakili don kula da ciwon sukari na mellitus na insulin. Akwai shi azaman allura. Ruwan ba shi da launi kuma kusan zai bayyana.

Insulin Glargin alama ce ta insulin ɗan adam ta hanyar sinadarai. Bambanta cikin dogon aiki. Magungunan yana taimakawa rage yawan glucose a cikin jinin mai haƙuri.

Babban abin da ke ciki shine insulin Glargin.

Baya ga shi, maganin ya hada da:

• glycerol
• zinc chloride
• metacresol
• hydrochloric acid,
• sodium hydroxide
• ruwa.

An ba da izinin amfani da maganin kawai tare da izinin gwani kuma a cikin sashi ɗin da aka wajabta masa, don hana rikitarwa.

Kayan magunguna

Babban tasirin wannan magani shine raguwar glucose. Wannan na faruwa ne ta hanyar haɗuwa tsakaninsa da masu karɓar insulin. Verya'idar aiki iri ɗaya mai kama da halin ɗan adam.

Ana inganta metabolism na glucose ta hanyar tasirin kwayoyi, kamar yadda ƙwararren mahaifa ya fara cinye shi sosai.

Bugu da ƙari, Glargin yana hana samar da glucose a cikin hanta. A karkashin tasirin sa, an samar da tsarin samar da furotin. Tsarin lipolysis, akasin haka, yana rage gudu.

Bayan shigar azzakari cikin farji na maganin ƙwaƙwalwa a cikin jiki, an keɓe shi, an kirkiro microprecipitate. Abubuwan da ke aiki suna mai da hankali sosai a cikin su, wanda a hankali aka sake shi. Wannan yana ba da gudummawa ga tsawon lokacin ƙwayoyi da kwanciyar hankali, ba tare da canje-canje masu ƙarfi ba.

Ayyukan Glargin yana farawa sa'a daya bayan allura. Ya ci gaba har tsawon kwana ɗaya.

Alamu, hanyar gudanarwa, allurai

Don ingantaccen magani, umarnin yakamata ayi amfani da samfurin. Dokokin shigar da likitan mata ne ke yin bayanin su.

An wajabta insulin Glargin ne kawai idan akwai dalili. Amfani da shi ya zama dole ga nau'in insulin-da ya dogara da ciwon sukari - wannan yana nuna cewa wannan cuta shine dalilin sanya shi.

Koyaya, wannan magani ba da shawarar kowa ba ne - gwani ya kamata yayi nazarin hoton asibiti na cutar a kowane yanayi.

An ba da izinin amfani dashi ga masu ciwon sukari na nau'in farko da na biyu. A cikin nau'in cutar ta farko, ana amfani da maganin a matsayin babban magani. A wani yanayin, za'a iya ba da Glargin duka biyu ta hanyar monotherapy kuma a hade tare da wasu kwayoyi.

Sashi koyaushe ana kirga daban. Wannan ya shafi nauyin mai haƙuri, shekarunsa, amma mafi mahimmanci al'amari shine halayen cutar. A yayin jiyya, ana yin gwaji na jini lokaci-lokaci don fahimtar yadda miyagun ƙwayoyi ke aiki, da kuma rage ko ƙara yawan a cikin lokaci.

Ana amfani da maganin a cikin hanyar injections, wanda yakamata a yi a ƙasa. Mitar allura tana sau daya a rana. Dangane da umarnin, yakamata ayi su a kusan lokaci guda - wannan yana tabbatar da inganci da rashin halayen halayen. An sanya allurar a kafaɗa, cinya ko cikin ƙoshin kitse na ciki. Don hana halayen masu illa, madadin wuraren gudanarwa.

Koyarwar bidiyo na Syringe-pen akan aikin insulin:

Side effects da yawan abin sama da ya kamata

Ko da lokacin rubuta likita da likita, ba za ku iya tabbata cewa amfani da shi zai yi ba tare da matsaloli ba. Duk da bin umarnin, wasu lokuta magunguna suna da tasirin da ba a iya faɗi, wanda ke alaƙa da halayen mutum na jiki. Saboda haka, sakamako masu illa suna faruwa.

Lokacin amfani da miyagun ƙwayoyi, matsaloli na iya tasowa kamar:

1. Hypoglycemia. Wannan sabon abu yana faruwa tare da wuce haddi na insulin a cikin jiki. Yawancin lokaci bayyanar tasa tana da alaƙa da zaɓin maganin da ba a zaɓa ba, amma wani lokacin dalilai sune halayen jiki. Irin wannan cin zarafi yana da haɗari sosai, tunda yana shafar aikin mai juyayi. Tare da mummunan hypoglycemia da rashin taimako, mai haƙuri na iya mutuwa. Wannan karkacewar ana nuna shi ta hanyar bayyanar cututtuka irin su asarar rai, sanyin bugun zuciya, amai, farin ciki.
2. Rashin gani. Tare da ilimin insulin, ana lura da tsauraran kwatsam a cikin adadin glucose, wani lokacin wanda zai haifar da retinopathy. Mai yiwuwa hangen nesa na mai haƙuri ya haifar da rauni, gami da makanta.
3. Lipodystrophy. Abin da ake kira take hakki a cikin aiwatar da rage amfani da kayan magani. Ana iya magance wannan cutar tare da taimakon canzawar kullun wuraren allurar.
4. Cutar Al'aura. Idan an gudanar da gwaje-gwajen da suka wajaba don maganin ƙwayar cutar kafin amfani da Glargin, irin waɗannan halayen suna faruwa da wuya kuma ba sa bambanta cikin ƙarfi. Mafi bayyanar halayyar a wannan yanayin: rashes na fata, jan launi na fata da itching a wurin allurar.

Idan kun sami irin waɗannan sifofin, ba tare da la'akari da ƙarfin su ba, kuna buƙatar tuntuɓi likita. A wasu halaye, zaku iya kawar da su ta hanyar sauya kashi na maganin. Kuma wani lokacin ana buƙatar canjin magani na gaggawa.

Yarda da takardar likita na hana mummunan tasirin da ke tattare da yawan sha. Amma wani lokacin wannan baya taimakawa. Idan akwai yawan abin sama da ya kamata, yawanci yawan jini yana faruwa. Wayar ta ya dogara da tsananin cutar. Wani lokacin dakatar da harin zai yuwu ta hanyar amfani da carbohydrates na narkewa. Tare da mummunan hari, taimakon likita ya zama dole.

Abun haɗin gwiwa da ka'idodin aiki

Babban sashi mai amfani da maganin shine insulin Glargin. Wannan kayan haɗin ne wanda aka samo ta hanyar canji. A cikin aiwatar da halittar sa, an maye gurbin abubuwa 3 masu mahimmanci. Amino acid Asparagine an maye gurbinsu da Glycine a cikin sarkar A, kuma an haɗa Arginines biyu a sarkar B. Sakamakon wannan sake haɗawa shine babban inganci don allura, wanda ke da amfani mai amfani aƙalla awanni 24.

Abubuwan da ke aiki, wanda aka haɗe tare da kayan taimako, suna da amfani mai amfani a jikin mai haƙuri. Tare da amfani da insulin Glargin ta hanyar da ta dace:

• Yana rinjayar masu karɓar insulin waɗanda suke cikin ƙwaƙwalwar ƙashi da ƙirar tsoka. Godiya ga wannan, tasiri mai kama da na insulin na halitta yana motsawa.
• normalizes metabolic tafiyar matakai: carbohydrate metabolism da glucose samar.
• Yana ƙarfafa ƙwayar glucose ta mai da ƙananan ƙwayar nama, ƙwayar tsoka da ƙashin ƙashi.
• Yana rage yawan samarda glucose mai yawa a cikin hanta.
• Yana ƙarfafa kwayar furotin da ya ɓace.

Magungunan sun shiga cikin shelf na kantin magani a cikin hanyar mafita: a cikin kwalabe 10 ml ko kuma kwandon shara 3 ml. Yana šaukar sa'a guda bayan gudanarwa.

Matsakaicin lokacin aiki shine awoyi 29.

Carcinogenicity da tasiri akan ikon ɗaukar ciki

Kafin a sayar da shi, an gwada maganin don maganin cututtukan fata - ikon wasu abubuwa don ƙara yiwuwar cutar ciwace-ciwacen daji da sauran maye gurbi. An gudanar da ƙarin insulin na insulin zuwa mice da berayen. Wannan ya haifar da:

• Babban mace-mace a cikin kowane rukuni na dabbobi masu gwaji,
• Muguwar cutuka a cikin mace (a fagen injections),
• Rashin ciwace-ciwacen tumbi lokacin da narkar da shi a cikin abubuwan narkewar acidic.

Gwajin da aka yi ya nuna mai yawan guba da ke tattare da dogaron insulin.

Ikon haihuwar da haihuwar lafiya yana da illa.

Yawan abin sama da ya kamata

Kwayar cutar mai tsanani kuma wani lokacin tsawan hypoglycemia, yana barazanar rayuwar mai haƙuri.

Jiyya: Abubuwa na hypoglycemia na matsakaici yawanci ana tsayar da su ta hanyar haifar da ƙwayoyin carbohydrates mai sauƙin narkewa. Yana iya zama dole a canza tsarin magunguna, abinci ko aikin jiki. Abubuwan da ke tattare da rashin ƙarfi na jini, tare da coma, rashi ko raunin jijiyoyin jini, suna buƙatar sarrafawa na ciki ko guguwar glucagon, kazalika da gudanar da aikin kwantar da hankula game da maganin warware matsalar rashin ƙarfi. Ana buƙatar buƙatar ɗaukar carbohydrate na dogon lokaci da kulawa na ƙwararru, kamar hypoglycemia na iya dawowa bayan ingantawar asibiti.

Sashi da gudanarwa

Magungunan Glargin sun ƙunshi glargin insulin - analog wanda yake aiki da insulin na ɗan adam. Ya kamata a gudanar da miyagun ƙwayoyi 1 lokaci kowace rana koyaushe a lokaci guda.

An zabi adadin Glargin da lokacin rana don gudanarwarsa daban daban. A cikin marasa lafiya da ke fama da ciwon sukari na 2, za a iya amfani da Glargin duka a cikin tsarin monotherapy kuma a hade tare da sauran wakilai na hypoglycemic. An bayyana ayyukan wannan maganin a cikin raka'a (UNITS). Waɗannan raka'a suna amfani da Glargin ne kawai: wannan ba ɗaya bane da na rukunan da aka yi amfani da su don bayyana ayyukan sauran analogs na insulin.

Tsofaffi mara lafiya (fiye da 65 shekara)

A cikin tsofaffi marasa lafiya, rashi aiki na renal na iya haifar da raguwar hankali a cikin bukatun insulin.

Marasa lafiya tare da nakasa aiki na renal

A cikin marasa lafiya waɗanda ke fama da rauni na aikin ƙirar, ana iya rage buƙatar insulin saboda raguwar metabolism metabolism.

Ya kamata a gudanar da Glargin a ƙarƙashin ƙasa koyaushe a lokaci guda 1 lokaci ɗaya kowace rana. Zazzabi na insulin allurar ya dace da zazzabi dakin.

Babu wani bambanci na asibiti a cikin insulin insulin da matakan glucose bayan gudanarwar Glargine a cikin kitse na cikin ciki, kafada, ko cinya. A tsakanin yanki ɗaya na mulkin magani, yana da mahimmanci don canja wurin allurar kowane lokaci.

Lokacin gabatarwa, bi umarnin:

1. Maganin insulin na Glargin ya zama mai haske kuma mara launi. Kada kayi amfani da mafita idan tana da gajimare, mai kauri, ƙaramin launi ko kuma yana da barbashi mai kauri.

2. Lokacin amfani da gugar insulin, bi umarni don amfani tare da Fasahar Gangan ta Beijing da ta dace. Co. LTD., China.

3. Kafin subcutaneous gwamnatin, bi da wurin allura tare da maganin rigakafi. Yawancin lokaci ana yin maganin ne a cikin ciki, kafada ko cinya. Tare da kowane allura, ya wajaba don maye gurbin wurin allurar.

4. Formirƙira takalmin fata tare da yatsunsu, saka allura a cikin allurar kuma ka buɗe yatsunsu. Sannu a hankali danna kan piston na sirinji na sihiri yayin duk lokacin sarrafa magani. Bayan 'yan seconds bayan gudanar da insulin, cire allura kuma latsa wurin allura tare da swab na dan lokaci. Karka shafa wurin allurar don kazanta lalacewar kitsen subcutaneous ko ruwan lemo na miyagun ƙwayoyi.

Sauyawa daga jiyya tare da wasu magungunan cututtukan jini zuwa Glargin

Lokacin sauya maye gurbin magunguna tare da sauran insulins tare da tsarin kulawa da insulin na Glargin, yana iya zama dole don daidaita ma'aunin yau da kullun na Glargin, kuma yana iya zama dole don daidaita allurai na maganin antidiabetic consolitant (insulin cikin gaggawa, insalin insulin gajeren lokaci, magunguna na maganin antidiabetic).

Lokacin canja wurin marasa lafiya daga yanayin gudanar da insulin na mutum na matsakaicin tsawon lokacin aiki sau biyu a rana zuwa tsarin kulawa na insulin Glargin sau ɗaya a rana a cikin makon farko na jiyya, ya kamata a rage kashi na farko na insulin Glargin da kashi 20-30% idan aka kwatanta da jimlar yawan yau da kullun na insulin ɗan adam na matsakaici na tsawon lokaci. Game da sarrafa glucose na jini mara inganci, yakamata a daidaita sashi daidai da shawarar likita.

A cikin marasa lafiya da ke karɓar ƙwayar insulin na ɗan adam na matsakaiciyar matsakaici, saboda kasancewar ƙwayoyin rigakafi ga insulin na mutum yayin da aka canza shi zuwa Glargin, haɓakawa game da amsa yana yiwuwa.

Lokacin canzawa da kuma a farkon fewan makonni na farko na jiyya, ya zama dole don sarrafa matakin glucose a cikin jini kuma a hankali shirya yanayin sashi.

Game da ingantacciyar ƙa'idar aiki na metabolism da kuma sakamakon karuwar haɓakar ƙwaƙwalwar insulin, ƙarin gyaran hanyoyin yin magani zai iya zama dole. Hakanan ana iya buƙatar daidaita yanayin zafin, misali, lokacin canza nauyin haƙuri, yanayin rayuwa, lokacin rana don gudanar da magunguna, ko wasu yanayi waɗanda ke ba da gudummawa ga haɓakar tsinkayar ci gaban hauhawar jini ko hauhawar jini.

Side sakamako

Hypoglycemia: Hypoglycemia na iya lalacewa ta hanyar gabatar da nau'in insulin da ba daidai ba, yana ɗaukar nauyi na insulin da / ko abincin da bai dace ba tare da motsa jiki.

Lipodystrophy: Idan baku canza yankin insulin na sarrafawa ba, tofinan kitse na subcutaneous mai ko lipid hyperplasia na iya haɓaka.

Allergic halayen: Tare da maganin insulin, halayen rashin lafiyan gida na iya faruwa a cikin allura, kamar jan, ciwo, ƙaiƙayi, amya, kumburi da kumburi. Wadannan halayen ba koyaushe ba ne kuma yawanci suna ɓacewa tare da ci gaba da aikin likita. Tsarin halayen rashin lafiyan da ke da wuya. Tare da haɓakawarsu, barazanar ga rayuwar mai haƙuri na iya faruwa.

Abubuwa masu rauni daga gabobin hangen nesa: Canji mai mahimmanci a cikin tsarin glucose a cikin jini na iya haifar da rauni na gani na ɗan lokaci.

Inganta sarrafa glucose na jini tare da kara yawan insulin na iya haifar da lalacewa ta wani lokaci yayin maganin ciwon sukari. Tare da haɓakar hypoglycemia, asarar gajere na hangen nesa na ɗan lokaci na iya faruwa a cikin marasa lafiya tare da farfadowa na farfadowa (musamman a cikin marasa lafiya da ke karɓar maganin coagulation laser). Tsawon lokaci na daidaituwa na matakan glucose na jini yana rage hadarin kamuwa da cutar sikari.

Wasu halayen: Lokacin amfani da insulin, ana iya lura da samuwar ƙwayoyin cuta a jikinta. A cikin lura da matsakaitan lokacin insulin da insulin Glargin, samuwar ƙwayoyin cuta masu hulɗa da insulin ɗan adam da insulin Glargin an lura da su tare da iri ɗaya. A cikin halayen da ba kasafai ba, bayyanar rigakafin kwayoyin zuwa insulin na iya zama dole a daidaita sikelin insulin don kula da matakin glucose din da ake bukata a cikin jini.

A cikin mafi yawan lokuta, insulin, musamman tare da karuwar insulin, na iya haifar da riƙewar sodium da haɓakar edema.

Siffofin aikace-aikace

Yi amfani da yara

Ya kamata a kimanta aminci da tasiri na insulin Glargin a cikin yara masu ciwon sukari dangane da aikace-aikacensa na yau da kullun.

Yi amfani da tsofaffi

Za'a iya rage buƙatar insulin a cikin tsofaffi marasa lafiya da masu ciwon sukari a gaban gazawar koda.

Yarda da lokacin haila da lactation

Mata masu haihuwar yara, an sanya maganin ne kawai bayan shawarwarin farko. An tsara miyagun ƙwayoyi a cikin lokuta inda yiwuwar amfani ga uwa ta fi haɗari ga tayin. Idan mace mai ciki tana da ciwon sukari na ciki, ana bada shawara don kulawa da matakan tafiyar matakai na rayuwa.

A cikin kashi na biyu da na uku na ciki, bukatar insulin ya karu. Bayan haihuwa, bukatar maganin ta ragu sosai.

A kowane wata na ciki, kuna buƙatar yin hankali game da sukarin jini kuma ku kula da matakinsa koyaushe.

Sauran karfin jituwa

Yawancin kwayoyi suna shafar metabolism metabolism. A cikin waɗannan halayen, ana buƙatar canza sashin insulin. Magunguna waɗanda ke rage sukari sosai

• ACE da MAO hanawa,
• Yin watsi da su,
• Salicylates da wakilai na sulfanide da ƙwayoyin cuta,
• Fluoxetine,
• Dabanbannun fibrates.

Wasu kwayoyi za su iya rage tasirin cututtukan ƙwayar cuta: glucocorticosteroids, diuretics, danazol, glucagon, isoniazid, diazoxide, estrogens, gestagens, da dai sauransu Don cikakken jerin magunguna marasa jituwa, duba umarnin shirya kayan.

Hypoglycemia

Wannan yanayin yanayin rayuwa ne wanda rage yawan sukarin jini cikin jini (ƙasa da 3.3 mmol / l). Yana faruwa a lokuta inda aka gudanar da aikin wuce haddi na insulin ga mai haƙuri, matuƙar wuce buƙatarta. Idan hypoglycemia mai tsanani ne kuma yana faruwa tsawon lokaci, yana barazanar rayuwar mutum. Hare-hare masu maimaitawa suna shafar tsarin juyayi Tunanin mutum ya zama gajimare da rikicewa, kuma yana da wahala mai haƙuri ya mai da hankali.

A cikin maganganun ci gaba, mutum ya rasa hankali gaba daya. Tare da matsataccen matsakaitan jini, hannun mutum yakan yi rawar jiki, yana son cin abinci koyaushe, yana cikin fushi kuma yana fama da bugun zuciya. Wasu marasa lafiya sun kara yawan gumi.

Allergic halayen

Waɗannan halaye ne na gida da yawa: maganin urtikaria, rashes daban-daban, redness da itching, jin zafi a wurin allurar. Hypersensitivity ga insulin haɓakawa: haɓaka fata na fata (kusan dukkanin fatar ta shafa), bronchospasm, angioedema, shock, ko hauhawar jijiya. Irin waɗannan halayen suna haɓaka kai tsaye kuma suna haifar da barazana ga rayuwar mai haƙuri.

A cikin lokuta mafi wuya, gabatarwar hormone yana ba da ƙarin halayen - riƙewar sodium, samuwar edema da samuwar amsawar rigakafi ga aikin insulin. A cikin waɗannan halayen, dole ne a daidaita adadin maganin.

A cikin waɗannan lokuta yiwuwar hauhawar jini

Idan kun bi tsarin da aka tsara, akai-akai kula da matakan sukari na jini kuma ku ci daidai, da alama an rage girman yiwuwar cutar yawan kumburi. Idan akwai ƙarin dalilai, canza kashi.

Dalilan da ke haifar da raguwar glucose sun hada da:

• Rashin lafiyar jiki ga insulin,
• Canjin yanki wanda aka gabatar da miyagun ƙwayoyi,
• Cutar cututtukan da ke fama da matsananciyar zazzabi (zawo) da amai, rikitar da cutar siga,
• Aiki na al'ada ba sabon abu bane ga jikin mai haƙuri,
• Almubazzaranci
• Take hakkin abinci da kuma hana abinci,
• Rashin lafiyar thyroid
• Haɗin kai tare da kwayoyi masu jituwa.

Tare da cututtukan haɗaka da kamuwa da cuta, kulawar glucose jini ya kamata ya zama cikakke.

Sanya jini da fitsari akai-akai don gwaji na gaba daya. Idan ya cancanta, daidaita sashi na insulin (musamman ga nau'in ciwon sukari 1).

Insulin Glargin: umarnin don amfani

An saka samfurin a hankali a cikin jiki a cikin yankin, cinya da kafadu. Ana amfani da analog na hormone 1 sau ɗaya kowace rana a takamaiman lokaci. Madadin wuraren allurar don guje wa hatimin da sauran sakamako mara kyau. Haramunne haramun ne a saka allurar ta a jijiya.

Sunan kasuwanci, farashi, yanayin ajiya

Ana samun miyagun ƙwayoyi a ƙarƙashin sunayen kasuwancin da ke gaba:

• Lantus - 3700 rubles,
• Lantus SoloStar - 3500 rubles,
• Glargin Insulin - 3535 rubles.

Adana a cikin firiji a zazzabi na 2 zuwa 8. Bayan buɗewa, ajiye a wuri mai duhu da kuma daga isar yara, da zazzabi har zuwa digiri 25 (baya cikin firiji).

Insulin Glargin: analogues

Idan farashin magungunan insulin glargine bai dace da ku ba ko kuma idan abubuwan da ba a so da yawa suka taso daga karɓar ta, maye gurbin maganin tare da ɗayan analogues ɗin da ke ƙasa:

• Humalog (Lizpro) magani ne wanda ke kama da insulin na halitta. Humalog yana cikin sauri cikin jini. Idan kun sha magani ne kawai a lokacin da aka wajabta muku na rana kuma a irin maganin, Humalog zai sha sau biyu cikin sauri kuma zai kai matakan da ake so a cikin awa 2. Kayan aiki yana aiki har zuwa 12 hours. Kudin Humalog daga 1600 rubles ne.
• Aspart (Novorapid Penfill) magani ne wanda ke kwaikwayon amsawar insulin game da abincin. Yana yin aiki da ƙarfi sosai da gajeru, wanda ke ba shi sauƙin sarrafa matakin glucose a cikin jini. Kudin samfurin daga 1800 rubles.
• Glulisin (Apidra) shine mafi karancin maganin kwayoyi na insulin. Ta hanyar kaddarorin magunguna ba ya bambanta da Humalog, kuma ta hanyar aiki na rayuwa - daga insulin na halitta wanda jikin ɗan adam ya samar. Kudinsa - 1908 rubles.

Lokacin zabar maganin da ya dace, mai da hankali kan nau'in ciwon sukari, cututtukan haɗin kai da halaye na mutum.