Apidra SoloStar

Insulin glulisin, wanda shine sashi mai aiki a cikin Apidra, ainihin ma ana analog ne na sakewa jikin mutum, ta hanyar karfin aikinta daidai yake da mutumtaka insulin. Idan aka kwatanta da insulin ɗan adam aikin wannan analog yana haɓaka cikin sauri, kuma tsawon lokacin tasirinsa ya ɗan guntu.

Aiki na asali insulin, kamar yadda ake amfani da alamun analogues, ciki har da insulin glulisintsari ne metabolism din glucose. Sakamakon wannan rukuni na kwayoyi suna nufin rage girman hankali plasma glucose, kunna kamuwa da shi ta hanyar kasusuwa (musamman tsopose nama da kasusuwa), kazalika don hana samuwar glucosea cikin hanta hanta. A karasocytesda miyagun ƙwayoyi depress lipolysisrage gudu tsari kariyakuma ya tayar sunadaran gina jiki. Nazarin da ya shafi marasa lafiya ciwon sukari da masu sa kai masu lafiya sun tabbatar da saurin farawa na tasirin abubuwan Apidra tare da gudanarwa ta sc, da kuma takaitaccen lokacin shi, idan aka kwatanta da insulin ɗan adam. Lokacin da s / zuwa hanyar gudanarwa hypoglycemic Ana lura da tasirin wannan magani bayan minti 10-20. Lokacin gwada iv injections insulin ɗan adam da insulin glulisin Sakamakon magungunan duka ya kasance daidai da matakin. Ayyukan glucose na rukunin kashi biyu na magunguna gaba daya sun hadu.

A cikin kashi na farko na karatun mai gudana wanda ya shafi marasa lafiya tare da mellitus-insulin-da ke fama da ciwon sukari ƙimar ƙarfin glucose insulin ɗan adam da insulin glulisin tare da s / c injections a kashi na 0.15 U / kg, ana gudanar dashi a lokuta daban-daban dangane da daidaitaccen abinci na mintina 15. Dangane da sakamakon binciken, an gano cewa gabatarwar Apidra mintuna 2 kafin cin abinci ya sami daidai tasirin glycemickamar yadda gabatarwar jikin mutum rabin awa kafin cin abinci. Game da gabatarwar duka waɗannan magunguna 2 mintuna 2 kafin abinci, mafi kyawun alamun kulawar glycemic lura dangane da insulin glulisin. Yin allurar apidra da aka ba mintina 15 bayan fara abincin ya ba iri ɗaya sakamakon glycemiccewa gabatarwar dan uwan ​​dan Adam mintina 2 kafin cin abinci.

A cikin kashi na farko na ci gaba da bincike tsakanin lyspro insulin, insulin glulisin da insulin ɗan adam hade da marasa lafiya tare da kiba an nuna cewa an kiyaye saurin ingancin Apidra. Yayin aiwatar da wannan binciken, lokacin da za'a kai ga kusan cikar 20% na cikakken kungiyar AUC, bi da bi, domin insulin glulisin/insulin lispro/jikin mutum ya kasance mintuna 114/121/150, wani AUC (0-2 hours), shima yana nuna da wuri karancin glucose matakin ya kasance 427 mg / kg / 354 mg / kg / 197mg / kg bi da bi.

A cikin kashi na 3 na gwajin asibiti na makonni 26 tsakanin insulin glulisin da lyspro insulinda aka gudanar s / c jim kaɗan (0-15 mintuna) kafin abinci ga marasa lafiya tare da cutar samariamfani da matsayin bango magani - insulin glargine, an gano cewa tasirin waɗannan magungunan biyu sun yi daidai da dangane da kulawar glycemicgraded da bambancin abun ciki Hba1c(glycosylated haemoglobin) a matakin karshe na karatun, idan aka kwatanta da matakin farko. Anyi la’akari da sigogi plasma glucosegyarawa ta hanyar kame kai. Game da allura insulin glulisinidan aka kwatanta da gabatarwar insulin lispro, karuwa a sashi na asalin magani ba'a buƙatarsa ​​ba.

A cikin kashi na 3 na gwajin asibiti na makonni 12 a cikin marasa lafiya tare da mellitus-insulin-da ke fama da ciwon sukariana jin magani na baya insulin glarginetabbatar da inganci insulin glulisin, Ana sarrafa shi nan da nan bayan cin abinci, ba ƙasa da wancan lokacin da aka sarrafa shi kafin (0-15 mintuna) abincin ko allura insulin ɗan adaman gudanar da mintuna 30-45 kafin cin abinci.

A cikin rukuni na binciken marasa lafiya da suka karba insulin glulisin Kafin abinci, mafi yawan raguwa ya lura Hba1ca kwatancen da marasa lafiya a rukuni na amfani analog na mutum.

A cikin kashi na 3 na gwajin asibiti na makonni 26 wanda ya biyo bayan gwajin aminci na makonni 26, idan aka kwatanta insulin glulisinan gudanar da s / c 0-15 mintuna kafin abinci da insulin ɗan adaman gudanar da s / c 30-45 mintuna kafin cin abinci, wanda ya shafi marasa lafiya tare da rashin wadatar insulinkarɓar ƙari a matsayin magani na asali - insulin isophane. Matsakaicin ma'aunin nauyin haƙuri shine 34.55 kg / m2. Significantarin rage raguwa Hba1c(-0.46%) an lura dashi a cikin marasa lafiya daga rukunin glulisin insulinidan aka kwatanta da kungiyar jikin mutum (-0.30%). A cikin wannan binciken, yawancin marasa lafiya (79%) nan da nan kafin gudanarwa sun haɗu da magungunan gajeriyar amfani da su karancin insulin. 58 sunyi karatu mutane a lokacin bazuwar na baki hypoglycemic jamiái kuma ya ci gaba da shan su cikin kashi mara canzawa.

A cikin yanayin ci gaba da sc jiko jiko insulintare da yin amfani da na'urar injin famfo (dangane da cutar sankara na yara) a cikin marasa lafiya 59 da ke amfani da magungunan Apidra ko Aspart, an lura da ƙarancin mitar. katuwar catheter, ga miyagun ƙwayoyi Apidra - 0.08 gushewaa kwanaki 30, don miyagun ƙwayoyi Aspart - 0.15 gushewadon daidai wannan lokacin, kazalika da nau'in mummunar halayen da ba daidai ba a wurin allurar, daidai da 10.3% da 13.3%.

A cikin ƙungiyar shekarun yara tare da insulin dogara da ciwon sukari, lokacin gwada aminci da tasiri na gabatarwar azaman maganin asalin - insulin glargine(sau ɗaya a 24 da yamma) ko isulin insulin (sau biyu a rana, safe da maraice) tare da sc gudanarwa insulin lispro da insulin glulisin (Minti 15 kafin abinci), a cikin rukunin biyun an nuna alamun masu nuna alama kulawar glycemicmummunan hanzari sassan jiki na hypoglycemic kuma samuwar tazara yawan hailaana buƙatar sa bakin waje. Haka kuma, bayan gudanar da aikin jiyya na makwanni 26, a cikin kungiyar Apidra, don samarwa kulawar glycemic an buƙatar ƙara yawan sashi na yau da kullun cikin sauri insulinasalin magani da kuma duka kashi insulin, idan aka kwatanta da rukuni ta amfani insulin lispro.

A lokacin gwaji na asibiti a cikin marasa lafiyar manya, babu bambance-bambance a cikin inganci da amincin yin amfani da Apidra ta marasa lafiya na jinsi daban-daban da jinsi daban-daban.

Lokacin amfani da hanyoyin maye gurbin Apidra amino acid bishiyar asparaginejikin mutum a kunne lysinea cikin matsayin OT, kazalika lysinea kunne acid din gilwa a cikin matsayi B29, ba da gudummawa ga saurin ƙwayoyi.

AUC na miyagun ƙwayoyi a cikin duk rukuni na marasa lafiya (masu ba da agaji da lafiya da marasa lafiya da ke fama da nau'in 1 da 2) ciwon sukari mellitus) ya nuna sau biyu na amfani da Cmax Apidra idan aka kwatanta dainsulin ɗan adam.

Lokacin gudanar da karatun da ya shafi marasa lafiya tare da cutar samari, bayan allurar s / c na 0.15 U / kg Apidra, an sami Cmax akan mintuna 55 kuma shine 82 ± 1.3 μED / ml, amma waɗannan sigogi na analog na mutum sun kasance daidai da 46 ± 1.3 μED / ml da minti 82. Matsakaicin Matsayi insulin glulisin a cikin na wurare dabam dabam wurare dabam dabam (98 min) fiye da in jikin mutum(161 min).

Lokacin gudanar da karatun da ya shafi marasa lafiya tare da rashin wadatar insulin, bayan allurar scram na 0.2 U / kg Apidra, matsakaicin Cmax na kayan aikinsa shine 91 mcU / ml (a cikin kewayon 78-104 mcd / ml).

Cutar da miyagun ƙwayoyi, a cikin yanayin allurar s / c na Apidra, wanda aka gudanar a yankin hip shine mafi ƙanƙanta da haɓaka tare da gabatarwar miyagun ƙwayoyi a cikin kafada. An lura mafi girman abu lokacin da aka allura shi zuwa ga bangon ciki na ciki. Tare da gudanarwa na subcutaneous, cikakken cikakken bioavailability na Apidra ya kusan 70% (hip - 68%, kafada - 71%, bangon ciki - 73%) kuma an nuna shi da ƙananan bambanci a cikin marasa lafiya daban-daban.

Tare da kunnawa / rarraba insulin glulisin kuma tushenta na baya yayi kama da na na insulin ɗan adam kuma yana bi da bi: Vd - lita 13 da lita 22, T1 / 2 - mintuna 13 da mintuna 18. Tare da allurar s / c insulin glulisin yana faruwa da sauri (tare da T1 / 2 - 42 mintuna) a kwatancen da abokin ɗan adam (tare da T1 / 2 - minti 86). Lokacin gudanar da bincike-bincike na bincike da gwaji insulin glulisinciki har da masu ba da agaji lafiya da marasa lafiya da nau'in 1 da 2 ciwon sukari, T1 / 2 na fili na wannan maganin yana cikin kewayon minti 37-75.

Nazarin ya shafi mutane ba tare da ciwon sukari mellitusamma da ilimin koda matakan digiri daban-daban na tsananin ƙarfi (tare da CC mafi girma daga 80 ml / min, 30-50 ml / min da ƙasa da 30 ml / min) ya nuna adana matsakaicin sigogi na matakan aiwatar da Apidra. Koyaya, yaushe cututtukan koda ba da damar rage buƙata don aikace-aikacen insulin.

A cututtukan hanta Ba a gudanar da nazarin tsarin suturar magunguna na Apidra ba.

Ba a fahimci tasirin tsofaffi mai haƙuri a kan sifofin magunguna na Apidra ba.

An yi nazarin Pharmododynamics da pharmacokinetics na Apidra a cikin shekarun yara na yara na marasa lafiya da insulin dogara da ciwon sukari 7-11 shekara da shekara 12-16. Ptionaukar ƙwayar cuta, Tmax da Cmax na miyagun ƙwayoyi a cikin waɗannan rukunoni biyu sun kasance daidai da na marasa lafiyar manya. Lokacin yin allurar Apidra nan da nan kafin gwada tare da abinci, mafi kyausarrafawar glucose na jini bayan cin abinci gaban jikin mutum. Haɓaka abun ciki plasma glucose bayan abinci (awanni na AUC0-6) daidai yake da Apidra - 641 mg / h × dl, don insulin ɗan adam - 801 mg / h × dl.

Side effects

Bayyanannun bayyanannun bayyanannun lokacin amfani da miyagun ƙwayoyi Apidra sun kasance halayen halayen wannan rukuni na magunguna, sabili da haka don duk abubuwan da ke gudana insulin.

Mafi mahimmancin bayyanar mara kyau maganin insulinlura da tsarin na rayuwa shine yawan haila, wanda mafi yawan lokuta yakan faru ne tare da amfani da rashin hankali na yawan wuce haddi insulin.

Symptomatology yawan hailayakan bayyana kwatsam. Koyaya, take hakki ƙwaƙwalwar ƙwayar cutaHarafin aiki a bango neuroglycopenia(sabon abu rauniko gajiya, ciwon kaiji gajiyarage taro rikicewar gani, nutsuwa, cututtukan zuciyatashin zuciya rikicewa/asarar sani) bayyana bayyana adrenergic counterregulation (haushiyunwa juyayi mai juyayipallor na fata rawar jiki,gumi mai sanyidamuwa samarinmai karfi bugun zuciya) Zurfin wannan cutar ya dogara da hanzari da tsananin girmanwa yawan haila.

Maimaitawa mai tsanani aukuwa yawan hailana iya haifar da lalacewa ko rikicewa tsarin juyayi. Sanarwa da tsawaitawa yawan hailana iya zama barazanar rayuwa ga marasa lafiya, saboda karuwar alamomin sa na iya haifar da hakan m.

Yanayin aiki tsarin rigakafi na iya bayyana abubuwan mamaki na gida yawan tashin hankaliga Apidra (gami da flushingji itching da kumburi a wurin allura). Wadannan abubuwan mamaki, a matsayin mai mulkin, suna yin girman kai bayan 'yan kwanaki bayan allura. A wasu halaye, wannan alamar cutar ba ta bayyana ba daga tasirin insulin, kuma daga haushi na fata, saboda allurar riga-kafi maganin rigakafiaiki, kazalika saboda mummunan allurar SC.

Bayyanar tushen tsarin sirri yawan tashin hankaliApidra na iya kasancewa tare da rash (wataƙila tare da itchy) ko'ina cikin jiki, abin mamaki kirji, rage karfin jini, zai sha kansabugun zuciya ko hyperhidrosis. Abubuwa masu nauyi game da rashin lafiyar jikigami da abubuwan anaphylacticna iya zama barazanar rayuwa.

Abubuwan da ba su dace ba daga fata sukan iyakance. lipodystrophyiya yin duk da haka rage sha insulin glulisin. Zuwa samuwar lipodystrophyna iya haifar da injections akai-akai zuwa wuri guda, ba tare da canza wuraren sarrafa magunguna ba, don haka ana ba da shawarar cewa a canza wuraren allurar akai-akai (cinya, bango na ciki, kafada) domin hana ci gaba lipodystrophy.

Apidra, umarnin don amfani

Insulin Apidra SoloStar an yi shi ne don gudanarwar sc, wanda za'ayi a ɗan lokaci kaɗan (minti 0-15) ko kuma nan da nan bayan cin abinci.

Ya kamata a yi amfani da wannan magani a cikin hanyoyin maganin warkewa, gami da rabawa tsawan insulin (yiwu analog) ko matsakaici tsayi inganci, kuma a layi daya tare da na baka hypoglycemic kwayoyi aiki.

An tsara tsarin aikin allura na Apidra da akayi daban-daban.

Gabatar da Apidra SoloStar ana aiwatar dashi ta allurar sc, ko taci gaba jikoan yi shi da kitsen mai cutarwa tsarin famfo.

Ana gudanar da allurar sc all a cikin kafada, bangon ciki (gaban) ko cinya. Ana yin jiko a cikin kitse na subcutaneous a cikin yankin bango na ciki (gaban). Wajibi ne a sauya wuraren da ke ƙarƙashin ikon sarrafawa (cinya, bango na ciki, kafada) tare da kowane allura mai zuwa. Don sauri sha kuma tsawon lokacin bayyanuwa da miyagun ƙwayoyi na iya yin tasiri ga abubuwan da aka yi aiki na jiki, sauran yanayin canzawa, kazalika da wurin gudanarwa. Allura da bangon ciki na sauri shaidan aka kwatanta da gabatarwar zuwa cinya ko kafada.

Lokacin gudanar da allura, duk matakan da suka dace dole ne a kiyaye su don fitar da shigarwar miyagun ƙwayoyi kai tsaye jini. Bayan allura an haramta tausaa bangarorin gabatarwa. Dukkanin marasa lafiya da ke amfani da Apidra SoloStar ana buƙatar su yi shawara kan dabarun gudanarwa na kwarai. insulin.

An yarda da haɗaɗa Apidra SoloStar tare da insulin kwayoyin halittar mutum "insulin". A kan aiwatar da hada waɗannan magungunan, dole ne a shigar da Apidra cikin sirinji da farko. Ya kamata a gudanar da aikin SC nan da nan bayan tsarin hada abubuwa. Ba a aiwatar da allurar rigakafin magunguna ba.

Idan ya cancanta, za'a iya cire maganin maganin daga cikin katun da aka haɗa a cikin alkairin sirinji kuma anyi amfani dashi a ciki na'urar yin famfotsara don ci gaba sc jiko. Game da gabatarwar Apidra SoloStar tare da tsarin famfo, ba a yarda da hadawa da wasu magunguna ba.

Lokacin amfani jiko sa da tanki da aka yi amfani da shi tare da Apidra, ya kamata a canza su bayan akalla awanni 48 a cikin bin duk ka'idodi maganin asepsis. Waɗannan shawarwarin na iya bambanta da waɗanda aka ayyana a cikin umarnin guud don na'urorin yin famfoduk da haka, aiwatar da kisa yana da matukar muhimmanci ga halayen da suka dace jikoda hana samuwar mummunan sakamako mara kyau.

Marasa lafiya da ke ci gaba da kasancewa ta hanyar apidra s / d jiko ya kamata su sami madadin tsarin allura don gudanar da maganin, kuma a horar da su a cikin hanyoyin da ake amfani da su (idan ana lalacewa.na'urar yin famfo).

A lokacin ci gaba jiko Apidra, malfunction na jiko an saita famfo, cin zarafin aikinsa, da kuma kurakurai a cikin magudi tare da su, na iya zama cikin hanzari ya zama sanadin hawan jini, mai fama da ciwon sukari ketoacidosis da ketosis. Game da gano wadannan alamun, yana da gaggawa a tabbatar da dalilin ci gaban su kuma cire shi.

Amfani da SoloStar Syringe Pen tare da Apidra

Kafin amfani na farko, dole ne a riƙe alkairin sirinjin SoloStar na awanni 1-2 a zazzabi a daki.

Nan da nan kafin amfani da alkairin sirinji, yakamata a bincika kwalliyar da aka sanya a ciki, abubuwan da yakamata su kasance mara launi, mkuma ba sun hada da bayyane ba m batun kasashen waje (tunatar da daidaito ruwa).

Abubuwan SoloStar Syringe da aka yi amfani da shi baza'a iya sake amfani dasu ba kuma dole ne a zubar dasu.

Don hana yiwu kamuwa da cutaMutun ɗaya ne kawai zai iya amfani da alkalami ɗaya ɗaya ba tare da canja wurin shi ga wani mutum ba.

Tare da kowane sabon amfani da alkairin sirinji, a haɗa da sabon allura a kai (ya haɗa ta da SoloStar) ka riƙe gwajin aminci.

Lokacin kulawa da allura, yakamata a kula sosai raunin da ya faruda kuma dama na ciwon maɗamfari canja wuri.

Ya kamata a guji amfani da almarar sirinji idan sun lalace, haka kuma a yanayin rashin tabbas a aikinsu da kyau.

Ya zama koyaushe ya zama dole a sami alkalami mai sifiɗa na hannun jari, idan akwai asara ko lalacewar farkon.

Dole a kiyaye alkairin sirinji daga datti da ƙura, yana halatta a goge sassan jikinta rigar rigar. Ba'a ba da shawarar a nutsar da alkairin sirinji cikin ruwa, yin wankako man shafawasaboda wannan na iya haifar da lalacewar shi.

Mai aiki sirinji mai sulɓi SoloStar amintacce a cikin aiki, daban ainihin dosing na maganin kuma yana buƙatar kulawa da hankali. Lokacin aiwatar da dukkan jan kafa ta sirinji, ya wajaba don guje wa duk wani yanayi da zai haifar da lalacewarsa. Idan akwai wani tabbaci game da rashin aiki, yi amfani da alkalami na dabam.

Nan da nan kafin allurar, tabbata cewa shawarar shawarar insulinta hanyar bincika lakabin a kan alamar sirinji. Bayan an cire hula daga alkairin sirinji, kuna buƙatar aiwatarwa dubawa na gani abin da ke ciki, bayan wanda shigar allura. An yarda kawai mara launi, mkama da ruwa daidai da ba tare da wani ba kasashen waje daskararru mafita insulin. Don kowane allurar da ta biyo baya, ya kamata a yi amfani da sabon allura, wanda zai zama bakararre kuma ya dace da alkalami.

Kafin allurar dole ne a aiwatar gwajin aminci, bincika aikin da ya dace na alkairin sirinji da allura da aka sanya akan sa, sannan kuma cire shi daga maganin iska (idan akwai).

A saboda wannan, lokacin da aka cire ƙofofin ciki da na ciki na allura, ana auna kashi na maganin daidai yake da 2 PIECES. Yana nuna allura na alkairin madaidaiciya, a hankali, a matatar da katun a yatsan ku, kuna ƙoƙarin canza komai iska zuwa allurar da aka shigar. Latsa maɓallin da aka yi niyya don gudanar da magani. Idan ya bayyana a saman allura, zamu iya ɗauka cewa alkairin sirinji yana aiki kamar yadda aka zata.Idan hakan ba ta faruwa ba, maimaita wannan amfani na sama har sai an sami sakamako da ake so.

Bayan gwajiDon aminci, taga allurai na alkairin ya kamata ya nuna darajar “0”, bayan haka zaku iya saita sigar da ake buƙata. Ya kamata a auna yawan maganin da aka sarrafa tare da daidaito na 1 UNIT, a cikin adadin sashi daga 1 UNIT (mafi ƙaranci) zuwa 80 UNITS (mafi yawa). Idan ya cancanta, ana yin kashi daya akan raka'a 80 a cikin alluran biyu ko fiye.

Lokacin yin allura, dole ne a saka allura da aka ɗora a kan alkairin sirinji a hankalikarkashin fata. Maballin alkalami na syringe wanda aka shirya don gabatarwar mafita dole ne a matse shi sosai kuma ya kasance a cikin wannan matsayi na 10 seconds har sai an cire allurar, wanda ke tabbatar da cikakken ikon sarrafa maganin.

Bayan allurar, ya kamata a cire allura kuma a watsar da shi. Ta wannan hanyar, ana ba da gargaɗin ajiya. cututtukada / ko gurbata yanayialkalanin sirinji, da kuma yalwar miyagun ƙwayoyi da iska suna shiga cikin kicin. Bayan cire allura da aka yi amfani da shi, yakamata a rufe alkairin satarwar SoloStar tare da hula.

Lokacin cirewa da zubar da allura, ya zama dole a bi shi ta hanyar dokoki da hanyoyi na musamman (alal misali, dabarar shigar da madaukin allura da hannu ɗaya), don rage haɗarin hatsarorikazalika da hanawa kamuwa da cuta.

Yawan damuwa

Game da wuce kima mulki insulinna iya faruwa yawan haila.

Tare da haske yawan haila, za a iya dakatar da bayyanannun bayyanannun ta hanyar cin abinci sukari dauke dana samfuroriko glucose. Marasa lafiya tare da ciwon sukariko da yaushe bayar da shawarar dauke kuki, alewaguda sukariko ruwan 'ya'yan itace mai zaki.

Bayyanar cututtuka yawan haila(gami daraunin jijiyoyin jiki, katsewa, asarar sani, ga wa) ya kamata a dakatar da mutum na biyu (wanda aka horar da shi) na biyu ta hanyar yin allurar v / m ko s / c glucagon ko iv allura Dextrose. Idan aikace-aikace glucagonbai ba da sakamako ba na mintina 10-15, canza zuwa gwamnatin iv dextrose.

Haƙuri wanda ya zo sanibayar da shawarar cin abinci mai arziki carbohydratestsaya a kan ƙarshe don maimaitawa yawan haila.

Don sanin abubuwan da ke haifar da mai ƙarfi yawan hailada kuma rigakafin ci gabanta a nan gaba, wajibi ne a lura da mai haƙuri a ciki asibiti.

Haɗa kai

Nazarin hulɗa da kamfanonin harhada magunguna insulin glulisin ba za'ayi ba. Ganin irin ilimin da ake da shi na ilimin zamani wanda aka tara yayin amfani da wasu magunguna masu kama da haka, samar da duk wata hanyar cudanya da magani ba zata yuwu ba. Akwai abubuwa wadanda zasu iya shafar su metabolism din glucose da buƙatar gyare-gyare na sashi insulin glulisin, kazalika da kara sa ido sosai game da aikin tiyatar.

Zuwa ga abubuwa masu haɓaka hypoglycemicinganci insulinda kuma kara hadarin yawan hailasun hada da: fibratesACE masu hanawa na baka hypoglycemic kwayoyisalicylates Abubuwan cikin rashin kunya, Fluoxetine, Pentoxifyllinekwayoyin hana kwayoyi (monoamine oxidase inhibitors) Propoxyphene, sulfonamides.

Zuwa cikin abubuwanda suke ragewa hypoglycemictasirin insulinsun hada da: glucocorticoids, Diazoxide, Danazol, diuretics, abubuwan samo asali Phenothiazine, Isoniazid, Somatropin, kwayoyin thyroid gland shine yake, yakamata (Salbutamol, Epinephrine, Terbutaline), progestins (maganin hana haihuwa), magungunan ƙwayoyin cutaClozapine, Olanzapine), estrogensmasu hana masu kariya.

Salts na Lithium, beta-blockers, ethanol, Clonidine na iya canzawa hypoglycemicaikin Apidra a bangare daya ko wata. Amfani na lokaci daya Pentamidinena iya haifar da yawan haila, da gaba ga hawan jini.

A ƙarƙashin rinjayar kwayoyi tare da ayyukan tausayawa (Clonidine, Narkataccenbeta hanawa, Guanethidine), bayyana adrenergickunnawa (reflex) ana iya bayyana ƙasa ko ɓacewa gaba ɗaya.

Saboda rashin karatun karfin jituwa, Apidra bai kamata a hade shi da wasu magunguna ba sai dai isulin insulin (mutum).

Lokacin amfani jiko famfo ba a yarda da haɗuwa da Apidra da wasu kwayoyi ba.

Umarni na musamman

Alƙawarin haƙuri insulinwani masana'antar shuka ko madadin insulin yakamata a gudanar da shi karkashin tsananin sanya ido na ma’aikatan lafiya, dangane da yiwuwar sauya tsarin sashi, saboda karkacewar insulin taronau'insa (insulin isophane, mai narkewada sauransu), tsari (mutum, dabba) da / ko hanyar samarwa. Hakanan ana iya canza canje-canje a layi daya hypoglycemicfar tare da baka siffofin. Rage magani ko rashin isasshen magani insulinmusamman a cikin marasa lafiya tare da cutar samarina iya haifar da haifar da ciwon sukari ketoacidosisda hawan jiniwakiltar hatsari ga rayuwar mai haƙuri.

Rashin lokaci na ci gaba yawan hailasaboda yawan samuwar tasirin insulin amfani da kwayoyi, kuma saboda wannan, yana iya canzawa yayin daidaita tsarin kulawa da warkewa. A cikin yanayi canza yanayin halitta yawan hailako sanya su kasa da aka ambata, hada da: tsanani na insulin fardogon kasancewa ciwon sukari mellituskasancewar mai ciwon sukari mai ciwon sukaricanza kanta insulinshan wasu ƙwayoyi (misali.masu hana beta).

Daidaitawa insulindosages na iya zama dole lokacin da kara haƙuri aiki na jiki ko canza tsarin abincinku na yau da kullun. Yi motsa jiki daidai bayan cin abinci yana kara haɗarin ku yawan haila. Lokacin amfani da sauri insulin ci gaba yawan hailatafiya da sauri.

Ba tare da lissafi ba hyper- ko hypoglycemicbayyanai na iya haifar da ci gaba comaasarar sani ko ma mutuwa.

Bukatar aikace-aikace insulinna iya canzawa a yawan kwantar da hankali ko cututtuka.

Lokacin da mai haƙuri yayi aikin daidai, aiki mai haɗari, kazalika da tuki motocin, yiwuwar ƙirƙirar hyper- ko yawan hailakuma kuyi hankali.

• Aiki (NM, MS),
• Vozulim-R,
• Biosulin P,
• Gensulin r,
• Insulin MK,
• Gansulin r,
• Insulin-Ferein CR,
• Monosuinsulin(M, MP),
• Insuman Rapid GT,
• NovoRapid(Penfill, FlexPen),
• Insuran P,
• Pensulin(SR, Jamhuriyar Czech),
• Humalogue,
• Rinsulin P,
• Humodar R,
• Rosinsulin P,
• Humulin akai-akai,
• Monoinsulin CR.

Ana iya ba da maganin Apidra ga yara kawai bayan shekaru 6.

A cikin ciki (da lactation)

Nazarin asibiti na amfani da Apidra tare da ciki ba ya nan. Limitedarancin aikace-aikacen aikace-aikacen wannan insulin ciki mata ba su nuna mummunar tasirinsa ba ciki na ciki na tayin, gudana cikiko a kan jariri.

Gwajin dabbobi da aka yi bai nuna bambanci tsakanin su ba jikin mutum da insulin glulisin dangane da tayin/tayinci gaba, hanya ciki, aikin patrimonial da postnatalci gaba.

Sanya Apidra mai cikimata su yi hankali da kulawa tare da wajabta ci gaba da lura da cutar plasma matakin glucose da sarrafawa kamuwa da cuta.

Cikimata da ciwon sukari ya kamata sanin yiwuwar raguwar buƙatu na insulinko'ina Na watanni uku na cikikaruwa a Na biyu da na ukukazalika da saurin raguwa bayan haihuwa.

Zabi insulin glulisin tare da madara na mahaifiyar mai reno ba a kafa. Lokacin amfani dashi nonoyana iya zama dole a daidaita tsarin allurai.

Nunawa game da magungunan Apidra, da kuma game da duk sauran insulin, ka gangaro zuwa abu daya, shin wannan magani yazo ga mutum ko kuma wani. A cikin yanayin yayin da magungunan Apidra sun dace da mai haƙuri, kusan babu koke game da inganci da amincinsa. Hakanan an lura da dacewa da amfani da allonnnin murfin SoloStar da daidaituwar dosing a cikinsu. insulin.

Formaddamar da tsari da abun da ke ciki

Sigar tsari - mafita don gudanarwar subcutaneous (subcutaneous): m, kusan launi mara launi ko mara launi (a cikin kwali na kwali 5 na gilashin launuka marasa launi na 3 ml, an sanya su a allon alkalami, da umarnin don amfani da Apidra SoloStar).

Abun ciki na 1 ml na bayani:

• abu mai aiki: insulin glulisin - 100 IU (raka'a aiki) (3.49 mg),
• abubuwan taimako: hydrochloric acid, m-cresol (metacresol), sodium hydroxide, polysorbate 20, tromethamine (trometamol), sodium chloride, ruwa don allura.

Pharmacokinetics

An sauƙaƙe ɗaukar sauri ta hanyar canzawa cikin insulin glulisin na amino acid asparagine na ɗan adam insulin a matsayi B3 tare da lysine da lysine a matsayi B29 tare da glutamic acid.

Kamfanin AUC na Pharmacokinetic AUC a cikin marasa lafiya da ke da nau'in 1 da nau'in 2 na masu ciwon sukari da masu sa kai masu lafiya sun nuna cewa yawan ƙwayar insulin na glulisin idan aka kwatanta da insulin ɗan adam mai narkewa ya ninka sau biyu cikin sauri, har zuwa sau biyu mafi girma C_max (iyakar maida hankali ne akan abu).

Dangane da sakamakon binciken da ya shafi marasa lafiya da nau'in ciwon sukari na 1, T_max (lokaci don kaiwa ga mafi yawan maida hankali a cikin abu) bayan gudanarwar insulin glulisin a cikin kashi 0.15 U / kg s / c kuma insulin ɗan adam ya kasance minti 55 da minti 82, bi da bi, da_max a cikin jini na jini - 82 ± 1.3 da 46 ± 1.3 μED / ml. A cikin insulin glulisin, matsakaicin lokacin zama a cikin keɓaɓɓiyar keɓaɓɓen ya zama ƙasa da na insulin ɗan adam na yau da kullun (minti 98 da 161, bi da bi).

A cikin marasa lafiya masu fama da cutar sukari na 2 bayan 0 0 U / kg na insulin glulisin sc_max sa 91 μED / ml tare da matsakaiciyar nesa a cikin kewayon 78-104 μED / ml.

An lura da sauri sosai bayan gabatarwar Apidra SoloStar a cikin bangon ciki na ciki, idan aka kwatanta da gabatarwar miyagun ƙwayoyi a cinya. Cikakken bioavailability na insulin glulisin shine kusan 70% (daga bangon ciki na ciki - 73%, daga ƙwayar tsoka - 71%, daga cinya - 68%), wannan alamar yana da ƙananan bambancin mutum.

Bayan gudanarwar jijiya, rarrabawar da insulin glulisin da insulin jikin mutum yayi iri daya kuma suna bi da bi: V_d (ƙarar rarraba) - 13 da 22 l, T_1/2 (kawar da rabin rayuwar) - 13 da mintuna 18.

Idan aka kwatanta da insulin na ɗan adam mai narkewa, glulisin insulin bayan aikin s / c an keɓe shi da sauri (bayyane T_1/2 minti 86 da minti 42 kenan). A cikin mutane masu lafiya da marasa lafiya da nau'in 1 da nau'in ciwon sukari na 2, bayyanuwar T_1/2 Glulisin insulin a cikin bincike-binciken sashe na karatu ya kasance a cikin kewayon mintuna 37-75.

A cikin marasa lafiya da gazawar renal, ana iya rage buƙatar insulin. A cikin yanayin rashin aiki mai cutarwa, ba a yi nazarin sigogin magani ba.

Akwai iyakataccen bayani game da pharmacokinetics na insulin glulisin a cikin tsofaffi marasa lafiya da ciwon sukari.

A cikin yara masu fama da ciwon sukari na 1, an yi nazarin Pharmokinetics da pharmacodynamics na insulin glulisin a cikin shekaru biyu - 7-1 da 12-16.A cikin bangarorin biyu, an lura da ɗaukar abu mai sauri, kuma dabi'un C_max da kuma T_max sun yi kama da waɗanda ke cikin manya. Kamar yadda yake a cikin tsofaffi marasa lafiya, insulin glulisin lokacin da aka shafa shi nan da nan a gaban gwajin tare da abinci ya samar da mafi kyawun sarrafa glucose na jini bayan cin abinci, idan aka kwatanta da insulin ɗan adam mai narkewa.

Hotunan 3D

Haihuwa da lactation

Babu isasshen bayani game da amfanin Apidra ® SoloStar ® a cikin mata masu juna biyu.

Limitedarancin adadin bayanan da aka samu akan amfani da glulisin insulin a cikin mata masu juna biyu (ƙasa da sakamako guda 300 da aka samu rahoton ciki) ba ya nuna illarsa ta hanyar ciki, ci gaban cikin mahaifa ko jariri. Karatuttukan dabbobi na dabbobi bai bayyana wani bambance-bambance tsakanin insulin glulisin da insulin dan adam dangane da ciki, ci gaban mahaifa / tayi, ci gaban haihuwa da kuma bayan haihuwa.

Yin amfani da Apidra ® SoloStar ® a cikin mata masu ciki ya kamata a aiwatar da shi da taka tsantsan. Ana buƙatar saka idanu sosai akan yawan haɗuwar glucose a cikin jini da kuma riƙe kulawar glycemic.

Marasa lafiya da ke da juna biyu kafin masu juna biyu ko cutar sankara ta hanji ya kamata su kula da karfin glycemic a duk lokacin da suke cikin ciki. A cikin lokacin farko na ciki, bukatar insulin na iya raguwa, kuma a lokacin karo na biyu da na uku, yawanci yana iya ƙaruwa. Nan da nan bayan haihuwa, bukatar insulin ya ragu da sauri.

Ba'a san ko yalwataccen insulin glulisin a cikin nono ba ko a'a. Ga mata yayin shayarwa, yana iya zama dole a daidaita tsarin rage yawan insulin da abinci.

Sashi da gudanarwa

S / c in an jima (0-15 mintuna) kafin ko jim kaɗan bayan cin abinci.

Apidra ® SoloStar ® ya kamata a yi amfani da su ta hanyoyin da suka haɗa da ko dai insulin na matsakaici ne ko insulin yin aiki mai tsayi ko kuma analog mai aiki na dogon lokaci. Bugu da kari, Apidra ® SoloStar ® za a iya amfani dashi a hade tare da wakilai na maganin hypoglycemic na bakin.

An zaɓi tsarin magani na magungunan Apidra ® SoloStar ® daban.

Magungunan Apidra ® SoloStar ® ana gudanar dashi ne ta hanyar allura ta sc, ko ta ci gaba da jiko cikin kitse mai amfani da injin famfo.

Ya kamata a yi allurar cikin ciki ta Apidra ® SoloStar ® a cikin yankin bangon gaban ciki, kafada ko cinya, kuma ana gudanar da maganin ta hanyar ci gaba da kitse a cikin yanki na bangon ciki. Wuraren allurar da wuraren jiko a wuraren da ke sama (bangon ciki na ciki, cinya ko kafada) ya kamata ya canza tare da kowane sabon magani na miyagun ƙwayoyi. Rage yawan sha kuma, saboda haka, farawa da tsawon lokacin aiwatarwa na iya shafar su: shafin gudanarwa, ayyukan jiki da sauran yanayin canzawa. Gudanar da ƙananan ƙwayoyin zuwa bango na ciki yana samar da ɗan sauri kadan fiye da gudanarwa zuwa sauran sassan da aka ambata a sama na jikin mutum (duba ɓangaren "Magunguna magunguna").

Dole ne a kiyaye yin rigakafin don hana kwayoyi shiga cikin hanyoyin jini kai tsaye. Bayan gudanar da maganin, ba shi yiwuwa a tausa yankin allurar. Yakamata a horar da marassa lafiya yadda ya kamata.

Hada insulin

Apidra ® SoloStar ® za a iya haɗe shi da insulin-isophan.

Lokacin da aka haɗa Apidra ® SoloStar ® da insulin-isophan, Apidra ® SoloStar ® ya kamata a jawo shi cikin sirinji da farko. Ya kamata a yi allurar SC kai tsaye bayan hadawa. Ba za a iya shiga cikin cakulan da aka haɗa abubuwan ciki na ciki ba / ciki.

Umpwararren na'urar don yin gaba da jiko

Lokacin amfani da Apidra ® SoloStar ® tare da tsarin famfo don jiko insulin, baza'a iya haɗuwa dashi da wasu kwayoyi ba.

Hakanan za'a iya gudanar da Apidra ® ta amfani da na'urar yin famfo don ci gaba da ƙarancin ins na insulin. Idan ya cancanta, za a iya cire shiri na Apidra from daga cikin kicin na allurar apidra ® SoloStar and kuma ana iya amfani dashi don gudanarwa ta hanyar yin amfani da na'urar yin fanfon don ci gaba da aikin sikari na insulin.

A lokaci guda, saita jiko da tafki da aka yi amfani da shi tare da Apidra ® ya kamata a maye gurbinsu da dokokin aseptic aƙalla a kowane sa'o'i 48. Waɗannan shawarwarin na iya bambanta da umarnin gaba ɗaya a cikin littattafan don na'urorin yin famfo. Yana da mahimmanci cewa marasa lafiya su bi umarnin na musamman na sama don amfanin Apidra ®. Rashin bin waɗannan umarni na musamman don amfanin Apidra ® na iya haifar da ci gaban mummunan lamari.

Lokacin amfani da Apidra ® tare da na'ura mai amfani da famfuna don ci gaba da karɓar insulin na insulin, baza'a iya haɗuwa da shi tare da wasu maganadisun abubuwa ba.

Marasa lafiya waɗanda ke kulawa da Apidra ® ta hanyar ci gaba da rikitar sc ya kamata su sami madadin tsarin don sarrafa insulin kuma ya kamata a horar da su don sarrafa insulin ta allura (idan fashewar na'urar yin amfani da shi).

Lokacin amfani da Apidra ® tare da na'urorin famfo don ci gaba da haɓaka insulin, rushewar na'urar famfo, lalata jiko na saiti ko kurakurai a cikin ma'amala na iya haifar da hanzari ga haɓakar hyperglycemia, ketosis da ketoacidosis na ciwon sukari. Game da haɓakar haɓakar hyperglycemia ko ketosis ko ketoacidosis mai ciwon sukari, ana buƙatar gano mai sauri da kuma kawar da abubuwan da ke haifar da ci gaban su.

Bi umarnin don dacewa da ingantaccen sirinji da aka riga aka cika (duba ɓangaren "Umarnin don amfani da shi").

Umarnin don amfani da shi na alƙalami mai cike da farashi SoloStar ®

Kafin amfani na farko, dole ne a kiyaye alƙalin sirinji a zafin jiki a cikin 1-2 na sa'o'i 1-2.

Kafin amfani, bincika katun cikin alkairin sirinji. Yakamata a yi amfani da shi idan mafita a zahiri, mara launi, ba ya ƙunshi abubuwan daskararren abubuwa kuma, cikin daidaito, yayi kama da ruwa.

Ptyarancin SoloStar e Syringe alkalami dole ne a sake amfani dasu kuma dole ne a zubar da su.

Don hana kamuwa da cuta, alƙalami guda ɗaya ya kamata yakamata ya yi amfani da shi kuma ba za a tura shi ga wani ba.

Karɓar SoloStar ® Syringe Pen

Kafin amfani da allon alkairin SoloStar ®, yakamata ka karanta umarnin don amfani.

Muhimmin bayani kan amfani da Syringe Pen

Kafin kowane amfani, a hankali haɗa sabon allura zuwa maɓallin sirinji kuma gudanar da gwajin lafiya. Kada a yi amfani da allura waɗanda suka dace da SoloStar ®.

Dole a yi taka tsantsan don kiyaye haɗari da ya shafi amfani da allura da kuma yiwuwar kamuwa da cuta.

Karka taɓa amfani da alkairin SoloStar ® idan ya lalace ko kuma ba ka tabbata cewa zai yi aiki yadda yakamata ba.

Koyaushe sanya takaddun sirinji na SoloStar ® na hannu a hannu ko asara ko lalacewar samfurin da aka yi amfani da su.

Koyarwar ajiya

Idan aka adana allurar siririn SoloStar ® a cikin firiji, za a cire shi daga can 1-2 sa'o'i kafin allurar da aka yi niyya don maganin zai sha zafin jiki a ɗakin. Gudanar da insulin mai narkewa shine mafi zafi.

Dole ne a lalata alkairin sirinji SoloStar ® da akayi amfani dashi.

Dole ne a kiyaye alkairin sirinjin SoloStar from ƙura da datti.

Za a iya tsabtace waje na SoloStar ® Syringe Pen ta hanyar goge shi da dattin rigar.

Kada a nutsar a cikin ruwa, a matse a sa mai ruwan allurar SoloStar ®, domin wannan na iya lalata shi.

SoloStar ® Syringe Pen daidai yana kwance insulin kuma yana da aminci don amfani. Hakanan yana buƙatar kulawa da hankali. Guji yanayi wanda lalacewar alƙawarin SoloStar ® na iya faruwa. Idan akwai shakkun cewa misalin SolomonStar ® syringe pen na iya lalacewa, dole ne a yi amfani da sabon alkairin sirinji.

Mataki na 1. Kula da insulin

Wajibi ne a bincika alamar akan allon alkairin SoloStar ® don tabbatar da cewa ya ƙunshi insulin da ya dace. Bayan an cire maƙarƙen siririn sirinji, bayyanar insulin da ke ciki ana sarrafa shi: maganin insulin dole ne ya zama mai ma'ana, mara launi, ba ya ƙunshi isassun barbashi mai bayyane mai kama da ruwa mai daidaituwa.

Mataki na 2. Haɗa allura

Dole ne kawai a yi amfani da allura waɗanda suka dace da alkairin SoloStar ® sirinji.

Don kowane allurar da ta biyo baya, koyaushe yi amfani da sabon allurar bakararre. Bayan cire hula, dole a saka allura a hankali akan almalin syringe.

Mataki na 3. Gwajin aminci

Kafin kowane allura, ya zama dole a gudanar da gwajin aminci kuma a tabbata cewa alƙalin sirinji da allura suna aiki sosai kuma an cire kumburin iska.

Auna kwatankwacin kashi biyu daidai.

Dole ne a cire ƙananan ƙofofin allura na ciki da ciki.

Sanya alƙalin sirinji tare da allura sama, a hankali a mato ƙirin tare da yatsan insulin ɗinka duk kumburin iska ya motsa zuwa allura.

Latsa (cikakke) maɓallin allura.

Idan insulin ya bayyana a saman allura, wannan yana nufin cewa alkalami mai kaɗa da allura suna aiki daidai.

Idan insulin bai bayyana ba a saman allura, to sai an sake maimaita mataki na 3 har sai insulin ta bayyana a saman allura.

Mataki 4. Yankan Sashi

Za'a iya saita kashi tare da daidaito na 1 UNIT, daga mafi ƙarancin (1 UNIT) zuwa matsakaicin (80 UNIT). Idan ya zama dole a gabatar da kashi sama da raka'a 80, ya kamata a ba da allura 2 ko fiye.

Wutar taga zata nuna “0” bayan kammala gwajin amincin. Bayan wannan, ana iya kafa kashi mai mahimmanci.

Mataki 5. Allura

Yakamata a sanar da mara lafiyar game da dabarar allura ta kwararrun likitoci.

Dole ne a saka allura a ƙarƙashin fata.

Ya kamata a matsi maɓallin allurar gabaɗaya. Ana riƙe shi a wannan matsayin don wani s 10 har sai an cire allura. Wannan yana tabbatar da gabatarwar kashi da aka zaɓa na insulin gabaɗaya.

Mataki 6. Ana cire da zubar da allura

A kowane hali, bayan kowane allura, ya kamata a cire allura kuma a watsar da shi. Wannan yana tabbatar da hana rigakafin cuta da / ko kamuwa da cuta, iska da ke shiga cikin akwati don insulin da yaduwar insulin.

Lokacin cirewa da zubar da allura, dole ne a yi taka-tsantsan taka tsan-tsan. Dole a kiyaye matakan kariya da aka ba da shawara don cirewa da jefa allura (alal misali, hanyar yin amfani da abin rufe hannu da hannu daya) domin rage haɗarin haɗari da ya shafi amfani da allura da kuma hana kamuwa da cuta.

Bayan cire allura, rufe allon alkairin SoloStar ® da hula.

Groupsungiyoyin haƙuri na musamman

Paarancin aiki na haya. Bukatar insulin a cikin maye na iya raguwa.

Rashin aikin hanta. A cikin marasa lafiya da ke fama da aikin hanta, buƙatar insulin na iya raguwa saboda rage ƙarfin gluconeogenesis da raguwa a cikin ƙwayar insulin.

Tsofaffi marasa lafiya. Ana samun bayanan pharmacokinetics a cikin tsofaffi marasa lafiya da masu ciwon sukari mellitus basu isa ba. Arancin aikin haya na tsufa na iya haifar da raguwar buƙatun insulin.

Yara da matasa. Ana iya amfani da Apidra ® a cikin yara sama da 6 da matasa. Bayanai na asibiti game da amfani da miyagun ƙwayoyi a cikin yara 'yan ƙasa da shekaru shida yana da iyaka.

Mai masana'anta

1. Sanofi-Aventis Deutschland GmbH, Jamus.

2. CJSC Sanofi-Aventis Vostok, Rasha. 302516, Rasha, Oryol Yankin, gundumar Oryol, s / n Bolshekulikovskoye, ul. Livenskaya, 1.

Ya kamata a aika da ikirarin mabukaci zuwa adireshin ofishin wakilin kamfanin a Rasha: 125009, Moscow, ul. Tverskaya, 22.

Waya: (495) 721-14-00, fax: (495) 721-14-11.

Dangane da batun samar da miyagun ƙwayoyi a Sanofi-Aventis Vostok CJSC, Rasha, ya kamata a aika da korafin mabukaci zuwa adireshin da ke gaba: 302516, Russia, Oryol Region, Oryol District, s / n Bolshekulikovskoye, ul. Livenskaya, 1.

Tel./fax: +7 (486) 244-00-55.

Yadda ake amfani: sashi da hanya na jiyya

S / c a cikin ciki, kafada ko cinya, ko ta hanyar ci gaba da jigilar Apidra SoloStar a cikin ƙashin ciki mai ciki na ciki. Ana gudanar da miyagun ƙwayoyi 0-15 mintuna kafin ko nan da nan bayan abinci. Kamfanonin da allurar ya kamata ya canza a kowane allurar. Ba za ku iya tausa yankin allura ba (don ware ƙwayar daga shiga cikin hanyoyin jini). An bayyana tasirin miyagun ƙwayoyi a cikin raka'a waɗanda keɓaɓɓun ne kawai ga insulin glulisin kuma ya bambanta da ME ko sauran raka'a ayyukan wasu insulins. An zabi kashi daban daban.

Aikin magunguna

Hypoglycemic wakili, insulin-gajeren aiki. Sakewa analog na insulin mutum. Yin amfani da Apidra SoloStar yana rage maida hankali na glucose a cikin jini, yana ƙarfafa shanyewar glucose ta gabobin mahaifa (tsokoki na kasusuwa, tsotse nama), kuma yana hana samuwar glucose a cikin hanta. Yana hana lipolysis a cikin adipocytes, proteolysis, yana haɓaka haɗarin furotin.

Tare da gudanarwar A / c na Apidra SoloStar, raguwar glucose jini yana farawa bayan mintina 10-20, tare da gudanarwa na iv, tasirin akan raguwar glucose yana daidai da insulin ɗan adam mai ƙarfi a cikin ƙarfi. Ta ƙarfin ƙarfin hypoglycemic, 1 IU na insulin glulisin shine 1 IU na insulin ɗan adam mai narkewa.

Babban bayani

Apidra, kodayake ana ɗaukarsa azaman analog ne na hormone na mutum, ana saninsa da sauri kuma ba mai daɗewa ba idan aka kwatanta shi. An gabatar da magani na pharmacological a cikin tsarin radar (rajista na miyagun ƙwayoyi) a matsayin gajeren insulin.

Apidra shine mafita wanda aka yi amfani dashi don injections na subcutaneous.

Baya ga abu mai aiki (glulisin), ƙwayar ta ƙunshi ƙarin ƙarin kayan aikin kamar:

• polysorbate 20 (monolaurate),
• sodium hydroxide
• wanda yake shine (proton na yarda),
• sinadarin sodium
• cresol
• acid (mai karfi) hydrochloric.

An sanya maganin maganin a cikin kwantena dauke da 3 ml, wanda aka sanya a cikin alkairin sirinji kuma ba za'a iya maye gurbinsa ba. Ana bada shawara don adana miyagun ƙwayoyi a cikin firiji ba tare da ɓoye shi zuwa daskarewa da shigar azzakari cikin rana ba. Alkalami mai sirinji 2 hours kafin allurar ta farko ya kamata ya kasance a cikin ɗaki mai zafin jiki.

Farashin 5 alkalami na miyagun ƙwayoyi ya kusan 2000 rubles. Farashin da mai samarwa ya ƙila na iya bambanta da ainihin farashin.

Halayen magunguna

An wajabta Apidra don masu ciwon sukari don daidaita yanayin glycemia. Sakamakon kasancewar kwayoyin halittar hormonal a cikin abin da ya kunsa, darajar ma'aunin glucose a cikin jini yana raguwa.

Ana sauke darajar sukari cikin kwata na awa daya bayan allurar subcutaneous. Maganin cikin ciki na insulin na asalin mutum da maganin Apidra suna da kusan iri guda iri guda akan dabi'un glycemia.

Bayan allura, ana aiwatar da hanyoyin da ke gaba a cikin jiki:

• hanta yana hana glucose,
• lipolysis yana cikin damuwa a cikin sel wanda suke yin tsotse nama,
• An inganta tsarin furotin,
• Tsarin glucose a cikin kasusuwa na gefe suna motsawa,
• An lalata furotin.

Dangane da sakamakon binciken da aka gudanar tsakanin mutane masu lafiya da marasa lafiya da masu cutar siga, allurar subcutaneous allurai na Apidra ba kawai rage lokacin jira bane don tasirin da ake so, amma kuma ya rage tsawon lokacin tasirin. Wannan fasalin yana bambanta wannan hormone daga insulin mutum.

Ayyukan hypoglycemic iri daya ne a cikin hormone Apidra da cikin insulin mutum. An gudanar da gwaje-gwaje na asibiti daban-daban don kimanta tasirin waɗannan kwayoyi. Sun haɗu da marasa lafiya waɗanda ke fama da cutar ta 1. Sakamakon da aka samu ya haifar da ƙarshen yanke shawara cewa maganin Glulisin a cikin adadin 0.15 U / kg, ana gudanar da 2 mintuna kafin cin abinci, ya sa ya yiwu a lura da matakin glucose bayan awanni 2 daidai gwargwado kamar bayan injections insulin na ɗan adam da aka yi a cikin rabin awa.

Apidra yana riƙe da kaddarorin kayan aiki cikin sauri a cikin marasa lafiya tare da ƙwayar kiba.

Type 1 ciwon sukari

Gwajin asibiti da aka gudanar a tsakanin mutane da nau'in cutar ta farko an samo su ne daga kwatancen abubuwan Glulisin da Lizpro. Makonni 26, ana ba da homon da ke ɗauke da waɗannan abubuwan haɗin ga marasa lafiya. Anyi amfani da Glargin azaman babban shiri. Bayan an kammala lokacin binciken, an kimanta canjin da ke cikin haemoglobin.

Marasa lafiya a cikin makonni 26 bugu da measuredari yana auna matakin ƙwayar cutar glycemia ta amfani da glucometer. Kulawa ya nuna cewa maganin insulin tare da Glulisin, idan aka kwatanta da magani tare da magani wanda ke dauke da Lizpro, baya buƙatar haɓaka yawan suturar hormone.

Matakin gwaji na uku ya kasance makonni 12. Ya ƙunshi masu ba da agaji daga mutanen da ke fama da ciwon sukari waɗanda suka allurar Glargin.

Sakamakon binciken ya nuna cewa yin amfani da maganin tare da kayan Glulisin bayan kammala cin abinci yana da tasiri kamar lokacin yin allura kafin abinci.

Ta wata hanyar, an tabbatar da dalilin amfani da Apidra (da kwayoyin halittu masu kama da juna) idan aka kwatanta da insulin ɗan adam, ana yin rabin sa'a kafin abincin da aka shirya.

An raba marasa lafiya da ke cikin gwajin zuwa rukuni biyu:

• mahalarta suna gudanar da Apidra
• marasa lafiya masu ciwon sukari, suna gudanar da ilimin insulin ta hanyar injections na jikin mutum.

Sakamakon gwaje-gwajen asibiti ya haifar da yanke hukuncin cewa sakamakon rage hawan jini mai narkewa ya kasance mafi girma a farkon mahalarta mahalarta.

Type 2 ciwon sukari

Nazarin 3 na zamani wanda ke nuna tasirin kwayoyi a cikin glycemia a cikin marasa lafiya da ke da nau'in ciwon sukari na 2 an gudanar da su tsawon makonni 26. Bayan sun kammala, sauran gwaji na asibiti sun biyo baya, wanda ya dauki lokaci guda a cikin tsawon lokacin su.

Aikin su shi ne tantance amincin daga amfani da injections na Apidra, ana gudanar da mintina 15 kafin abinci, da insulin mutum mai narkewa, ana gudanar da shi ga marasa lafiya 30 ko mintuna 45.

Babban insulin a cikin dukkanin mahalarta shine Isofan. Matsakaicin jigon jikin mahalarta shine 34.55 kg / m². Wasu marasa lafiya sun ɗauki ƙarin magunguna na baka, yayin da suke ci gaba da ba da maganin a cikin sashi mara canzawa.

Apidra na hormone ya zama mai daidaituwa da insulin na asalin ɗan adam lokacin da ake tantance kuzarin matakin gemoclobin na watanni 6 da watanni 12 dangane da darajar farawa.

Alamar ta canza a cikin watanni shida na farko kamar haka:

• a cikin marasa lafiya ta yin amfani da insulin na mutum - 0.30%,
• a cikin marasa lafiya waɗanda suka shiga jiyya tare da insulin wanda ke ɗauke da Glulisin - 0.46%.

Canza mai nuna alama bayan shekara ta gwaji:

• a cikin marasa lafiya ta yin amfani da insulin na mutum - 0.13%,
• a cikin marasa lafiya waɗanda suka shiga jiyya tare da insulin wanda ke ɗauke da Glulisin - 0.23%.

Tasirin, har da amincin amfani da kwayoyi dangane da Glulisin, bai canza a cikin mutane masu jinsi da jinsi dabam ba.

Rukunin Masu haƙuri na Musamman

Ayyukan Apidra na iya canzawa idan marasa lafiya suna da cututtukan da ke da alaƙa da cutar sankarau:

1. Rashin wahala. A irin waɗannan halayen, akwai raguwa a cikin buƙatar hormone.
2. Pathology na hanta. Ba a yi nazarin tasirin wakilan Glulisin a kan marasa lafiya da ke da irin wannan matsalar ba.

Babu bayanai game da canje-canje na kantin magani a cikin tsofaffi marasa lafiya. A cikin yara da matasa daga shekaru 7 zuwa 16, suna fama da ciwon sukari irin na 1, an sha magani sosai cikin hanzari bayan gudanar da aikin subcutaneous.

Yin injections na Apidra kafin cin abinci yana ba ku damar kula da matakin al'ada na glycemia bayan cin abinci idan aka kwatanta da insulin ɗan adam.

Alamu da magunguna

Yin amfani da maganin magani ya zama dole ga mutanen da ke dauke da nau'in cutar na insulin. Rukunin marasa lafiya waɗanda aka wajabta su ga miyagun ƙwayoyi yawancin lokuta sun haɗa da yara sama da shekaru 6.

Dole ne a gudanar da maganin da ke kunshe da Glulisin kai tsaye bayan abinci ko kuma a jima. Ana amfani da apidra a hade tare da dogon lokacin insulin ko kuma wakilai suna da matsakaicin tsawon lokacin tasiri, kazalika da analog ɗin su. Bugu da ƙari, an ba shi damar amfani da wasu magungunan hypoglycemic tare da injections na hormone. Dole ne a allurar da allurar Apidra ta likita kawai.

Ya kamata a gudanar da aikin tiyatar cutar kawai a ƙarƙashin kulawar kwararrun. Haramun ne a canza kai tsaye na kowane irin magunguna, musamman allurar insulin, kazalika da soke magani ko canzawa zuwa wasu nau'in hodar ba tare da izinin farko daga likitan ilimin endocrinologist ba.

Koyaya, akwai takaddun tsarin insulin na kwalliya wanda zai iya amfani da kwayoyin. Yana ɗaukar nauyin lissafin wajibi na adadin gurasar burodin da aka cinye kowace rana (1 XE daidai 12 g na carbohydrates).

Buƙatar Hoton:

• don rufe 1 XE don karin kumallo, raka'a 2 ya kamata a farashi,
• a cikin abincin rana kuna buƙatar raka'a 1.5.,,
• da maraice, ana ɗaukar adadin homon da XE daidai, watau 1: 1, bi da bi.

Kula da ciwon sukari a cikin lokaci na biyan diyya, da kuma glycemia na yau da kullun, idan kun lura da glucose koyaushe. Ana iya cimma wannan ta hanyar ɗaukar ma'auni akan mita da kuma ƙididdige buƙatar homon don yin injections daidai da adadin da aka tsara na XE.

Hanyar Gudanarwa

Maganin maganin na Apidra ana allurar ne da fata idan an yi amfani da alkalami. A cikin maganganun marasa lafiya ta amfani da famfon na insulin, wakili yana shiga ta hanyar mai mai subcutaneous mai ta hanyar jiko na dindindin.

Muhimman abubuwan da za ku sani kafin allurar:

1. Maganin shine allurar a cikin yankin cinya, kafada, amma mafi yawan lokuta a cikin yankin kusa da cibiya akan ciki.
2. Lokacin shigar da famfo, magani ya kamata ya shiga cikin shimfidar yadudduka a kan ciki.
3. Wuraren allurar ya kamata ya musanya.
4. Saurin gudu da tsawon lokacin sha, lokacin farawa ya dogara da yankin da za'a magance matsalar, harma da irin nauyin da akayi.
5. Kada a kewaya bangarorin da aka sa maganin don kada ya shiga tasoshin.
6. Abubuwan da aka yi a cikin ciki suna bada garantin saurin fara aiki fiye da allurar a wasu bangarorin.
7. Za a iya haɗuwa da Apidra tare da Isofan na hormone.

Maganin Apidra da aka yi amfani dashi don tsarin famfon ɗin ba dole ne a hade shi da wasu magunguna masu kama ba. Umarnin don wannan na'urar ya ƙunshi cikakken bayani game da aikin na'urar.

Abubuwan bidiyo game da fa'idodin matatun insulin:

M halayen

A lokacin maganin insulin, ciwon sanyin jiki na iya faruwa.Abubuwan da ke faruwa na bayyanar cututtukan ƙwaƙwalwar ƙwayar cuta a cikin mafi yawan lokuta ana gab da alamomi masu alaƙa da haɓaka ƙimar haɓaka jini. A zahiri, irin waɗannan bayyanannun halayen hypoglycemia ne.

Wannan halin shine mafi akasarin sakamakon zaɓin da bai dace ba ko kuma rashin daidaitaccen abinci wanda aka cinye tare da adadin raka'a.

Idan hypoglycemia ya faru, yanayin haƙuri ba ya daidaita idan ba a ɗauki matakan da suka dace ba. Sun ƙunshi amfani da carbohydrates da yawa.

Da sauri mai haƙuri zai iya yin cizo, da ƙarin damar da zai samu don sauƙin sauƙin alamun cutar halayyar wannan halin. In ba haka ba, laima na iya faruwa, kusan ba zai yiwu a fita daga ciki ba tare da taimakon likita ba. Marasa lafiya a cikin wannan yanayin suna buƙatar saka allurar glucose.

Rashin hankali daga metabolism da fata

A wuraren allura, halayen kamar:

Alamomin da aka jera akai-akai sukan tafi da kansu kuma basa buƙatar dakatar da ilimin magani.

Rashin hankali game da metabolism an bayyana shi a cikin ci gaban hypoglycemia, wanda ke hade da alamomin masu zuwa:

• gajiya
• rauni da gajiya,
• rikicewar gani
• nutsuwa
• samarin
• yawan tashin zuciya
• ciwon kai
• gumi mai sanyi
• bayyanar yanayin rashin sani, da kuma asararta gaba daya.

Gabatarwa da mafita ba tare da canza yankin naushi ba na haifar da lipodystrophy. Halin nama ne ga rauni na dindindin kuma an bayyana shi cikin rauni na atrophic.

Janar cuta

Rashin rikice-rikice na tsarin yayin amfani da miyagun ƙwayoyi suna da wuya.

Abin da ya faru yana haɗuwa da alamomin masu zuwa:

• fuka-fuka,
• cututtukan mahaifa
• abin mamaki na itching
• dermatitis lalacewa ta hanyar rashin lafiyan.

A wasu halayen, ƙaiƙayi na gaba ɗaya na iya yin illa ga rayuwar mai haƙuri.

Musamman marasa lafiya

Dole ne a sanya allurar maganin mafita ga mata masu juna biyu tare da taka tsantsan. Ya kamata a gudanar da kula da cutar ta hanji a cikin tsarin wannan jiyya koyaushe.

Mahimman mahimmancin maganin kwantar da hankali ga mata masu haihuwa:

1. Kowane irin nau'in ciwon sukari, ciki har da nau'in kwayar cutar ta cutar, yana buƙatar kula da matakin glycemia tsakanin iyakoki na al'ada a duk tsawon lokacin ciki.
2. Yawan sashi na magungunan da ake gudanarwa yana raguwa a cikin farkon farkon lokaci kuma yana ƙaruwa a hankali, yana farawa daga watanni 4 na ciki.
3. Bayan haihuwa, ana rage buƙatuwar ƙwayar cuta, ciki har da Apidra. Matan da ke fama da cutar sankarar mahaifa galibi suna bukatar katse aikin insulin bayan sun haihu.

Yana da mahimmanci a lura cewa binciken game da shigar azzakarin ciki tare da glulisin bangaren cikin nono ba a gudanar da shi ba. Dangane da bayanin da ke kunshe a cikin sake dubawa game da iyaye mata masu shayarwa da masu cutar siga, don duk tsawon lokacin lactation, ya kamata kaɗaita ko tare da taimakon likitoci don daidaita sashin insulin da abinci.

Ba a rubuta Apidra ga yara 'yan ƙasa da shekaru shida ba. Babu wani bayanin asibiti game da amfani da miyagun ƙwayoyi a cikin wannan rukuni na marasa lafiya.

Abun ciki da sakin siffofin

A cikin milliliter 1 na Apidra Solostar bayani yana ƙunshe da kayan aiki masu aiki kawai - insulin glulisin a cikin adadin 100 PIECES. Hakanan, ƙwayar ta ƙunshi:

• Hydroskide da Sodium Chloride
• Raba ruwa
• Metacresol
• Harshen Polysobat
• Karafarini
• Hydrochloric acid.

Maganin insulin wanda ke dauke da insulin ruwa bayyananne ne, wanda ba a shafa masa ba, ana iya samunsa a cikin kwalaben 3 ml. Kunshin ya hada da kwalabe 1 ko 5 tare da allon alkalami.

Hanyoyin warkarwa

Glulisin insulin wanda yake cikin Apidra wani kwatankwacin bayani ne na insulin na halitta wanda aka samar a jikin mutum. Glulisin yana yin saurin sauri kuma yana ɗan ɗanɗana lokacin ɗan gajeran lokaci idan ana kwatanta shi da insulin na halitta.

A karkashin aikin insulin glulisin, ana lura da matakan daidaita yanayin glucose a hankali. Tare da raguwa a cikin matakan sukari, haɓaka ɗaukar shi kai tsaye ta hanyar kyallen tsinkaye, ana yin rikodin abubuwan haɗin gulukos a cikin ƙwayoyin hanta.

Insulin yana hana aikin lipolysis wanda ke faruwa a cikin adipocytes, kazalika da proteolysis. A lokaci guda, haɗin furotin yana ƙaruwa sosai.

Sakamakon bincike da yawa tare da halartar mutanen da ke da ciwon sukari, da kuma marasa lafiya masu lafiya, an samo sakamako masu zuwa: tare da gudanar da aikin cikin ƙasa na Apidra, an lura da saurin aiwatar da insulin tare da ɗan gajeren lokacin bayyanuwa fiye da insulin na halitta na rayuwa.

Bayan gabatarwar glulisin a karkashin fata, an lura da tasirinsa bayan mintuna 10-20. Amma lokacin allurar cikin jijiya, ƙirar glucose ta ragu kamar yadda bayan gabatarwar insulin na halitta. Rukunin insulin glulisin yana ɗaukar kusan abubuwan guda ɗaya na rage yawan glucose kamar guda ɗaya na insulin na halitta.

A cikin marasa lafiya da ke dauke da cutar ta yara, bukatar insulin yawanci ana rage shi sosai.

Apidra Solostar: umarnin don amfani

Ya kamata a gudanar da aikin cikin Subidaneous na Apidra kafin abinci ko kuma bayan kai tsaye.

Ya kamata a yi amfani da kwayoyi waɗanda suke ɗauke da insulin bisa ga tsarin da aka tsara na maganin antidiabetic tare da insulin, wanda ke nuna matsakaicin tsawon lokacin fiddawa ko insulin aiki na tsawon lokaci. Zai yiwu a haɗe amfani da magungunan hypoglycemic don sarrafawa na baka.

Zaɓin tsarin kula da sashi ne ta hanyar endocrinologist.

Gabatarwa Apidra

Gabatar da maganin insulin wanda ke dauke da maganin yana gudana ne ta hanyar hanyar allura ta hanyar allura ko jiko ta amfani da tsarin famfo na musamman.

Ana aiwatar da allurar subcutaneous a cikin bango na ciki (kai tsaye sashin gabanta), a cikin yanki na femasin ko kafada. Jiko na miyagun ƙwayoyi ne da za'ayi a cikin bango na ciki. A wuraren jiko da allura ya kamata a canza koyaushe.

Yadda za a yi amfani da alkairin sirinji

Kafin gabatarwar Apidra, alkalami na syringe zai buƙaci a ɗan ɗanɗara ɗan zafin jiki a zazzabi a daki (kimanin awanni 1-2).

Sabuwar allura tana manne wa alkalami na insulin, to, kuna buƙatar gudanar da gwajin lafiya mai sauƙi. Bayan haka, alamar “0” za ta kasance a bayyane a jikin allurar sirinji na alkalami. Sannan ya zama dole sashi zai zama ingantacce. Mafi ƙarancin darajar da aka gudanar shine raka'a 1, kuma mafi girman shine raka'a 80. Idan akwai bukatar yawan zubar da ruwa, ana bayar da allura da yawa.

Yayin allurar, allurar, wacce aka sanya akan alƙalin syringe, zata buƙaci shigar da sannu a hankali a ƙarƙashin fata. Maballin da ke kan alƙalin syringe zai matse, ya kamata ya kasance cikin wannan matsayin nan da nan har zuwa lokacin hakar. Wannan yana tabbatar da gabatarwar adadin maganin da ake so wanda yake dauke da kwayar insulin.

Bayan allura, an cire allura kuma a zubar dashi. Don haka, zai yuwu a hana kamuwa da cutar sirinji ta insulin. Nan gaba, dole ne a rufe alkalami na syringe tare da hula.

Ana iya ba da magani ga mata masu juna biyu da masu shayarwa.

Contraindications da Kariya

Farashin: daga 421 zuwa 2532 rub.

Ba a amfani da kwayar insid-insulin mai ɗauke da ƙwayar cuta ta Apidra Solostar don bayyanuwar cututtukan hypoglycemia da haɓaka mai haɗari ga abubuwan da ke cikin maganin.

Lokacin amfani da kwayar insulin daga wani mai ƙira, za a buƙaci kulawa da kula da maganin antidiabetic ta likita mai halarta, tunda buƙatar daidaita matakan da aka ɗauka ba za'a yanke hukunci ba. Wataƙila kuna buƙatar canza makirci na maganin cututtukan jini na maganganu don maganin baka.

Kammala magani na maganin antidiabetic ko kuma yin amfani da yawan insulin, musamman a cikin mutanen da ke fama da cutar sanyin yara, na iya tsokani ketoacidosis mai ciwon sukari, da kuma ciwon suga, wanda ke haifar da hatsari ga rayuwa.

Matsakaicin lokaci don faruwar cututtukan hypoglycemia yana da alaƙa kai tsaye da ƙimar ci gaban tasirin hypoglycemic daga magungunan da aka yi amfani da shi, yana iya canzawa tare da gyaran maganin antidiabetic.

Wasu dalilai na iya rage zafin cutarwar cututtukan jini, sun haɗa da:

• Dogon fata na ciwon sukari
• M insulin magani
• Haɓaka cutar kansar ƙwayar cuta
• Amfani da adadin ƙwayoyi (misali, β-blockers).

Canji a cikin adadin insulin Apidra Solostar ana aiwatar dashi tare da karuwa a cikin aiki na jiki ko tare da canji a cikin abincin yau da kullun.

Game da haɓaka aiki na jiki nan da nan bayan cin abinci, da alama yiwuwar haɓakar haɓakar jini yana ƙaruwa. Magungunan insulin na ɗan gajeren lokaci na iya haifar da farawar hypoglycemia.

Rashin daidaituwa na hypo- da alamomin hypoglycemic suna haifar da faruwar cutar sankara, ko coma, ko kaiwa ga mutuwa.

Tare da canji a cikin yanayin motsin rai, haɓaka wasu cututtuka, yana iya zama dole don daidaita sashi na ƙwayar insulin.

Lokacin aiki tare da madaidaitan ƙirar, tuki motoci, haɗarin haɓaka hypo- da hyperglycemia yana ƙaruwa, don haka ana buƙatar kulawa ta musamman.

Hulɗa da miyagun ƙwayoyi

Lokacin ɗaukar wasu kwayoyi, za a iya rikodin sakamako akan metabolism na glucose, dangane da wannan, akwai buƙatar daidaita sashi na glulisin kuma a sarrafa sosai na maganin antidiabetic therapy.

Daga cikin magungunan da ke kara tasirin cutar glulisin sun hada da:

• Masu hana wata kwayar cutar angiotensin-mai canza enzyme, monoamine oxidase
• Pentoxifylline
• Ibwararrun Magunguna
• Yana nufin dangane da maganin antimicrobial na sulfonamide
• Abubuwan cikin rashin kunya
• Hypoglycemic magungunan da aka yi nufi don amfani da baki
• Fluoxetine
• Salicylates
• Propoxyphene.

An sanya magunguna da yawa waɗanda ke rage tasirin hypoglycemic sakamako na maganin insulin wanda ya ƙunshi:

• Isoniazid
• Somatropin
• Danazol
• Wasu masu juyayi
• Magungunan Estrogen-progestin
• COC
• Diazoxide
• Kare masu hana
• Kwayoyin cutar ta thyroid
• Magungunan ƙwayoyin cuta
• GKS
• Abubuwan Phenothiazine
• Magungunan diuretic.

Zai dace a lura cewa ckers-adrenergic blockers, ethanol-da ke dauke da kwayoyi masu dauke da lithium, clonidine sun sami damar haɓaka biyu da rage tasirin cutar ta Apidra.

Yayin amfani da reserpine, agents-adrenergic blocking jami'ai, clonidine, da guanethidine, alamun hypoglycemia na iya zama mai rauni ko ba ya nan.

Tunda babu wani bayani game da karfin maganin gluzilin, kada ku gauraya shi da wasu kwayoyi, toshe isulin din insulin shine na banda.

Game da yin amfani da famfon jiko don gudanar da Apidra, haɗawa da sinadarin insulin da wasu magunguna bai kamata ba.

Side effects da yawan abin sama da ya kamata

Kusan sau da yawa, mutane masu ciwon sukari na iya haɓaka irin wannan yanayin haɗarin kamar hypoglycemia.

A wasu halayen, ana lura da rashes akan fata da kuma bayyanar kumburin cikin gida.

Abunda ya faru da lipodystrophy idan ba'a bi ka'idojin magani na maganin antidi ba zai yanke hukunci ba.

Sauran bayyanar rashin lafiyan sun hada da:

• Fara'a na cututtukan ƙwayar cuta, ƙonewa ta hanyar nau'in urticaria, shaƙuwa
• Jin tafin a cikin yankin kirji (wajen da wuya).

Yana da kyau a lura cewa halayenda daga tsarin garkuwar jiki (bayyanar rashin lafiyan) za a iya yin jiyya a washegari bayan allura. A wasu halaye, bayyanar cututtuka marasa kyau ana haifar da su ta hanyar rashin insulin, amma ta fushin fata sakamakon maganin allurar riga-kafi tare da maganin maganin cututtukan ƙwayoyi ko saboda allurar da ba ta dace ba.

Lokacin da ake bincika ƙwayar cuta ta rashin lafiyar da ke tattare da cutar, haɗarin mutuwa yana da yawa. Sabili da haka, a mafi ƙarancin bayyanar cututtuka na gefe, kuna buƙatar tuntuɓi likita.

Tare da gabatarwar overdoses na Apidra, hypoglycemia na iya haɓaka ta duka mai laushi kuma mafi tsananin rauni. A wannan yanayin, wajibi ne don gudanar da magani:

• Matsakaici - Abinci ko abin sha mai ɗauke da sukari
• Wani mummunan yanayi (yanayin da bai sani ba) - don tsayawa, 1 ml na miyagun ƙwayoyi ana sarrafa Glucagon a ƙarƙashin fata ko tsoka, idan babu amsa ga Glucagon, maganin glucose na ciki yana yiwuwa.

Bayan mai haƙuri ya sake farfaɗo, zai zama tilas a samar masa abincin da ke da wadataccen ƙwayoyin carbohydrates. Bayan haka, ana ba da shawarar saka idanu akan yanayin haƙuri ta likitan halartar.

Ely Lilly da Kamfanin, Faransa

Farashi daga 1602 zuwa 2195 rub.

Humalogue yana daya daga cikin wakilan da ke nuna tasirin sakamako mai hauhawar jini. Humalog yana ɗauke da insulin lyspro. A ƙarƙashin tasirin miyagun ƙwayoyi, zai iya yiwuwa a tsara ma'anar glucose da kuma inganta haɓakar furotin. Ana samar da kwayoyi a cikin hanyar warwarewa da dakatarwa.

Ribobi:

• Amfani da shi
• A farko na m hypoglycemic sakamako
• Matsanancin halayen da ba a sani ba ana iya samarwa.

Yarda:

• Kada kayi amfani idan ana zargin hypoglycemia.
• Babban farashi
• Zai iya haifar da yawan ɗumi.

Apidra SoloStar, umarnin don amfani: hanyar da sashi

Ana gudanar da maganin Apidra SoloStar s.c. na mintuna 0-15 kafin abinci ko kuma jim kadan bayan abinci.

An sanya maganin a cikin tsarin kulawa wanda ya haɗa da ko dai insulin na matsakaici, ko insulin aiki a ciki, ko analog na yin aiki na dogon lokaci. Hakanan za'a iya amfani da Apidra SoloStar a hade tare da wakilai na bakin jini na jini.

Ya kamata a zaɓi jigilar magunguna daban daban.

Gabatarwa da maganin APidra SoloStar na iya faruwa azaman allura sc ko kuma kumburin ci gaba a cikin kitse na subcutaneous tare da taimakon tsarin inzali.

Wuraren da ake gudanar da magani:

• s / c allurar: a cikin yankin bangon baya na ciki, cinya ko kafaɗa,
• cigaban jiko: zuwa cikin yankin bangon baya na ciki.

Tare da kowane sabbin gudanarwa na miyagun ƙwayoyi, wuraren da ke nuna allura / jiko dole ne a canza su. Matsayin gudanar da Apidra SoloStar, aikin jiki da sauran yanayin canzawa na iya shafar farkon lokacin da miyagun ƙwayoyi. Lokacin da s / zuwa gabatarwar cikin bango na ciki, za'a lura da ɗan sauri kadan fiye da lokacin da aka gabatar da sauran sassan jikin da aka nuna a sama.

Don hana shigowar Apidra SoloStar kai tsaye cikin tasoshin jini, ya kamata a lura da kiyaye lafiya. Ba shi yiwuwa a tausa yankin gudanar da maganin. Dole ne mara lafiya su bi madaidaicin dabarar allurar.

Za a iya haɗu da insulin glulisin tare da isharar insulin na ɗan adam, tare da Apidra SoloStar sune farkon waɗanda za a zana su cikin sirinji. Ya kamata a yi allurar SC kai tsaye bayan hadawa. Ba za a iya gudanar da cakuda insulins hade da su ba.

Yayin ci gaban sc infused, Apidra SoloStar ba a cakuda shi da wasu kwayoyi, gami da insulins ko abubuwa masu ƙarfi.

Idan ya cancanta, za a iya cire maganin a cikin katun daga cikin alkairin sirinji kuma a yi amfani da allura ta amfani da na'urar yin famfo don ci gaba da ƙarancin ins insulin.

Ya kamata a sauya jiko da ajiyar da aka yi amfani da shi tare da ƙwayar aƙalla a kowane awanni 48, ana kiyaye ka'idojin aseptic. Waɗannan shawarwarin na iya bambanta da umarnin guud a cikin litattafai game da amfanin na'urorin yin famfo. Koyaya, idan ba'a bi waɗannan shawarwari na musamman ba, mummunan tashe-tashen hankula na iya haɓaka.

Wajibi ne a yi la’akari da yiwuwar rushewar na'urar yin amfani da shi, wanda ya isa ya zama akwai wasu hanyoyin dabam dabam na sarrafa ƙwayoyi kuma su sami damar gudanarda wakilin SC daidai.

Sakamakon rauni na na'urar yin famfo, ƙwayar jiko na saiti, ko kuskure a cikin riƙe su, haɓakar haɓakar bugun jini, ketoacidosis na ciwon sukari da ketosis mai yiwuwa ne. A irin waɗannan halayen, ana buƙatar ganowa da kuma kawar da sanadin abubuwan da ke haifar da waɗannan abubuwan haɗari.

Bi umarnin don dacewa sosai da abubuwan maye da aka riga aka cika.

Kafin amfani da shi, ya kamata a ajiye alkalami mai ƙima a zafin jiki a cikin awanni 1-2 (amfani da insulin mai sanyaya ya zama mai raɗaɗi). Kafin gabatarwar, kuna buƙatar bincika kicin ɗin da ke cikin alkairin sirinji. Game da abubuwan da ke bayyane tabbataccen barbashi, kazalika da canza launi da daidaito, bai kamata a yi amfani da Apidro SoloStar ba. Bayan an yi amfani da shi, dole ne a zubar da sirinjin mara wofi (sake amfani da shi).

Alkawarin da yake cikekken sirinji ba za'a iya tura shi ga wanin mutum ba, yakamata yai amfani da shi, wanda zai rage yiwuwar kamuwa da cuta.

Dole ne a haɗa sabon sabon allura da sirinji kafin kowane amfani. Dole ne a gudanar da gwajin aminci (na'urar da allura ta yi aiki sosai, an cire kumburin iska). Za'a iya amfani da allura masu dacewa.

Na'urar tana fitar da insulin daidai kuma yana da aminci don amfani. Ya kamata a kiyaye alkairin sirinji daga ƙura da datti. Zaku iya tsabtace waje ta hanyar goge shi da kayan rigar. Kada a nutsar da alkairin sirinji cikin ruwa, sa mai tsafta da ruwa.

Lokacin gudanar da gwajin aminci, auna sashin da ya yi daidai da raka'a 2 (dole ne a cire ƙulli na ciki da waje na allura). An sanya alkairin syringe tare da allura sama kuma a hankali a yatsa tare da yatsa a kan kayan insulin don kumburin iska ya motsa a cikin allurar. Sannan gabaɗaɗa maɓallin allurar miyagun ƙwayoyi. Idan na'urar tayi aiki daidai, insulin zai bayyana a saman allura.

Bayan kammala gwajin aminci, taga allurai ya kamata ya nuna “0”. Bayan haka, zaku iya saita adadin da ake buƙata.

Za'a iya saita kashi a cikin kewayon daga raka'a 1 zuwa 80 tare da daidaito na 1 naúrar. Idan kuna buƙatar shigar da babban kashi, gudanar da allura biyu ko fiye.

Yakamata a sanar da mara lafiyar kwararren likita game da dabarar allurar. Ya kamata a saka allura a ƙarƙashin fata. Dole a matse maɓallin allurar gabaɗaya. Ana riƙe shi a wannan matsayin na wani sakan 10 har sai an cire allura. Wannan yana tabbatar da gabatarwar cikakkiyar takaddar kashi na insulin.

Dole ne a cire allurar bayan kowane allura a duk lamura kuma a zubar dashi. Wannan don hana lalacewa da / ko kamuwa da cuta, iska a cikin tanki na insulin da yaduwar insulin. Bayan cire allura, rufe alƙawarin sirinji da hula.

Bukatar insulin a kan asalin aikin hepatic mai rauni yana iya raguwa, wanda ke da alaƙa da rage ƙarfin gluconeogenesis da raguwa cikin haɓakar insulin.

Tare da gazawar koda, buƙatar insulin na iya raguwa.

A cikin tsofaffi marasa lafiya da ciwon sukari, bayanai game da kantin magani bai isa ba. Tare da shekaru, da alama rashin aiki keɓaɓɓen aiki yana ƙaruwa, wanda zai iya haifar da raguwa cikin buƙatun insulin.

Humulin NPH

Eli Lilly Gabashin S.A., Switzerland

Farashi daga 148 zuwa 1305 rub.

Humulin NPH - magani ne tare da insulin-isophan mai aiki, ana amfani dashi a cikin ciwon sukari don sarrafa glycemia. Humulin NPH ana samar dashi ta hanyar mafita a cikin katukan katako wanda ake amfani dashi don alkalami mai siket.

Ribobi:

• Ana iya wajabta wa mai ciki
• Amfani da cutar sankara na farko
• An yarda da maganin antidiabetic na dogon lokaci.

Yarda:

• Zai iya haifar da itching na gaba daya.
• A bangon magani, ana iya gano ƙarancin zuciya
• Ana sake shi ne kawai ta takardar sayan magani.

Novo Nordic, Denmark

Farashi daga 344 zuwa 1116 rubles.

LS ya ƙunshi insulin gajere da aiki. An wajabta shi don ciwon sukari yayin rashin sarrafa glycemic da wasu kwayoyi. A ƙarƙashin tasirin Actrapid, an kunna hanyar hanyoyin cikin ciki saboda takamaiman ƙwarin csyP biosynthesis da saurin shiga cikin ƙwayoyin tsoka. Abunda yake aiki shine insulin abinci mai narkewa. Ana samar da kwayoyi a cikin hanyar warwarewa.

Ribobi:

• Pricearancin farashi
• Rage nauyi a cikin sukari na jini
• Ana iya amfani dashi tare da insulin aiki na dogon lokaci.

Yarda:

• Bayyanar alamun alamun lipodystrophy ba a yanke hukunci ba
• Quincke edema na iya haɓaka
• Tare da ƙara yawan motsa jiki, za a buƙaci daidaitawa kashi.

Tasiri a kan ikon tuka motoci da abubuwa masu rikitarwa

A lokacin jiyya, akwai haɗari lokacin tuki. Wannan ya faru ne saboda yiwuwar hauhawar jini da hauhawar jini, da kuma rikicewar gani da ake gani yayin ci gaban waɗannan yanayi. Wannan yana da haɗari musamman ga marasa lafiya da ke fama da rauni, da kuma marasa lafiya waɗanda ba su da alamun cututtuka ko kuma suna da maimaitawa na yawan haila. Don yanke shawara game da yiwuwar / ba zai yiwu ba ga mai haƙuri ya fitar da motocin, ya kamata a kimanta waɗannan abubuwan ta hanyar yanayin-kowanne hali. Don guje wa yiwuwar maganin cututtukan jini, an shawarci marasa lafiya su yi taka-tsantsan yayin tuki.

Haihuwa da lactation

Kwarewar amfani da Apidra SoloStar a cikin mata masu juna biyu bai isa ba. Dangane da karancin bayanai (kasa da sakamako 300 na ciki), kwayar ba ta yi tasiri ba ko ta hanyar daukar ciki, ci gaban tayin, ko jariri. A cikin nazarin nazarin dabbobi, ba a sami bambance-bambance tsakanin insulin glulisin da insulin mutum dangane da ciki, ci gaban tayi / tayi, ci gaban haihuwa da kuma bayan haihuwa.

Ya kamata a yi amfani da Apidra SoloStar a cikin mata masu juna biyu tare da taka tsantsan tare da yin taka tsantsan da lura da sanya ido kan haɓakar glucose da kuma kula da glycemic iko.

Matan da ke da juna biyu kafin masu juna biyu ko masu ciwon sukari suna buƙatar kula da glycemic iko a duk lokacin haihuwar. Bukatar insulin a lokacin farkon lokacin ciki na iya raguwa, kuma a lokacin karo na biyu - na uku, yana iya ƙaruwa. Nan da nan bayan bayarwa, akwai raguwa cikin sauri a cikin bukatun insulin.

Babu wata hujja da za ta tallafa ko musun cewa glulisin insulin yana cikin ruwan madara. Yayin shayarwa, yana iya zama dole don daidaita tsarin abinci da tsarin sarrafa allurar insulin.

Hulɗa da ƙwayoyi

Ba a gudanar da bincike na musamman kan hulɗa da magunguna ba. Dangane da ilimin da ke tattare da ilimin game da wasu magunguna masu kama, an yi imani cewa ci gaban hulɗa a magani ba shi yiwuwa. Wasu abubuwa / shirye-shirye na iya shafar metabolism na metabolism, a cikin irin waɗannan halayen daidaitawa na Apidra SoloStar kuma musamman ana buƙatar kulawa da kulawa.

Magungunan da ke shafar tasirin insulin:

• haɓaka (gami da haɓakar rigakafin cutar hypoglycemia): angiotensin tana juya mahaɗan enzyme, propoxyphene, oral hypoglycemic wakilai, rashin biyayya, fluoxetine, fibrates, pentoxifylline, monoamine oxidase inhibitors, sulfonamide antimicrobials, salicylates,
• raguwa: somatropin, glucocorticosteroids, diazoxide, danazole, isoniazid, diuretics, abubuwan tarihin phenothiazine, sympathomimetics, progestins, estrogens, hormones thyroid, magungunan antipsychotic, antihibchotic inhibitors.

Sauran hulɗa mai yiwuwa:

• Clonidine, beta-blockers, barasa, salts na litium: lokacin da aka haɗu, yana yiwuwa a ƙarfafa ko raunana sakamakon hypoglycemic na insulin,
• pentamidine: hypoglycemia na iya faruwa tare da ci gaban hyperglycemia,
• Clonidine, beta-blockers, reserpine, guanethidine: lokacin da aka haɗu da kwayoyi tare da aikin tausayawa, alamu na kunnawa adrenergic na iya zama ƙasa da sanarwa ko ba ya nan.

Kada a haɗu da glulisin insulin tare da wani magani banda isofan insulin na mutum.

Game da gudanar da mulki tare da taimakon famfon jiko, Apidra SoloStar bai kamata a hade shi da sauran abubuwa ba da sauran shirye-shiryen insulin.

Analogs na Apidra SoloStar sune: Apidra, Insulin Lyspro, Humalog, Brinsulrapi MK 40 U / ml, Actrapid HM Penfill, da sauransu.

Sharuɗɗan da yanayin ajiya

Adana a cikin duhu a zazzabi na 2-8 ° C. Kar a daskare. Ayi nesa da isar yara.

Rayuwar shelf shine shekaru 2.

Bayan amfani na farko, rayuwar shiryayye na Apidra SoloStar a cikin takaddar sirinji da za'a iya sasa shine 4 makonni. Allon da za'a iya zubar dashi bayan an fara amfani da shi yakamata a adana shi a yanayin zafi har zuwa 25 ° C a wani wuri da aka kiyaye shi daga haske da kuma ƙarshen isar da yara.