Insulin Apidra (Epidera): nyocha, ntuziaka maka ojiji glulisin

"Apidra", "Epidera", insulin-glulisin - isi ihe na - arụ ọrụ nke ọgwụ ahụ bụ nnwale insulin nke mmadụ na - enweta, nke enwetara site na inyocha mkpụrụ ndụ ihe nketa.

Site n'ike nke ihe o mere, o buru na insulin na-egbu mmadu. Mana Apidra malitere ime ihe ngwa ngwa, n’agbanyeghi na oge ogwu ya di obere.

Njirimara nke ogwu

Mlọ ọgwụ Ihe bụ ọrụ insulin na ọgwụ analogues ya niile (insulin-glulisin enweghị isị) bụ ịhazi shuga ọbara.

N'ihi insulin gluzulin, ịba ụba nke glucose na n'ọbara ọbara na-ebelata ma a na-adọta ya site na anụ ahụ dị n'akụkụ, ọkachasị abụba, akwara na akwara. Na mgbakwunye, insulin:

• na-egbochi mmepụta glucose na imeju;
• na-abawanye njikọta protein;
• na-egbochi proteinolysis;
• na-egbochi lipolysis na adipocytes.

Nnyocha emere na ndị ọrụ afọ ofufo nwere ahụike na ndị ọrịa nwere ọrịa mellitus gosipụtara n'ụzọ doro anya na nchịkwa subcutaneous nke insulin-glulisin abụghị naanị na-ebelata oge ị na-ekpughe, kama ọ na-ebelata oge ikpughe ọgwụ ahụ. Nke a na-eme ka ọdịiche dị n'etiti ya na insulin na-agbari mmadụ.

Site na nchịkwa subcutaneous, mmetụta na-ebelata shuga nke insulin-glulisin n'ime ọbara na-amalite mgbe nkeji 15-20 gachara. Site na inje intravenous, nsonaazụ nke insulin-soluble mmadụ na nsonaazụ insulin-glulisin nwere glucose ọbara dị ihe ha bụ.

Ngalaba Apidra nwere otu ọrụ ahụ ike hypoglycemic dị ka otu nke insulin na-arụ ọrụ nke mmadụ. N'ime ule nke ụlọ ọgwụ na ndị ọrịa nwere ọrịa shuga 1, a na-enyocha mmetụta hypoglycemic nke insulin na-arịa ọrịa mmadụ na Apidra.

Ejiri ha abụọ mee ihe na 0.15 U / kg subcutaneously n'oge dị iche iche na nri nkeji iri na ise, nke a na-ahụta ka ọ bụrụ ọkọlọtọ.

Nsonaazụ nke ọmụmụ gosipụtara na insulin-glulisin na-achịkwa nkeji 2 tupu nri nyere otu nyocha ahụ glycemic kpọmkwem mgbe nri dị ka insulin mmadụ si arụ ọrụ, nke a gbanyere nkeji 30 tupu nri.

Ọ bụrụ na a na - enye insulin-glulisin minit 2 tupu nri, ọgwụ na-enye nlekọta nke ukwuu glycemic nlegharị anya mgbe nri gasịrị. Ọ dị mma karịa inye gị insulin mmiri ọgwụ mmadụ nkeji 2 tupu nri.

Insulin-glulisin, nke a na-ahụ maka nkeji iri na ise ka ebido ebido nri ahụ, nyere nlekọta nke glycemic mgbe nri dị ka nke insulin na-asọpụta mmadụ na-ewepụta, iwebata nke na-apụta nkeji 2 tupu mmalite nri.

Nnyocha nke usoro nke mbụ, nke a na-eme na Apidra, insulin-lyspro nke mmadụ na insulin-lyspro n’etiti ndị ọrịa nwere oke ibu na ọrịa shuga mellitus, gosipụtara na n’ime ndị ọrịa a insulin-glulisin anaghị enwecha ọrụ ime ngwa ngwa.

N'ime omumu a, ọnụego ruru 20% nke mpaghara niile n'okpuru usoro oge (AUC) maka insulin-glulisin bụ nkeji 114, maka insulin-lispro -121 nkeji na maka insulin nke na-arịa mmadụ.

Na AUC (0-2 awa), na-egosipụtakwa ọrụ hypoglycemic n'oge, bụ 427 mg / kg maka insulin-glulisin, 354 mg / kg maka insulin-lyspro na 197 mg / n'arọ maka insulin na-akụ afọ.

Ọrịa shuga 1dị 1

Ọmụmụ nyocha ahụike. Na ụdị 1 mellitus ọrịa shuga, insulin-lispro na insulin-glulisin tụnyere ha.

N’ime usoro nyocha nke atọ nke izu ụka iri abụọ na isii, a na-enye ndị nwere ụdị ọrịa shuga 1 ụdị insulin glulisin obere oge tupu nri (insulin glargine dị ka insulin basal n’ime ndị ọrịa a).

N'ime ndị a, insulin-glulisin n'ihe metụtara njikwa glycemic ka e jiri ya tụnyere insulin-lyspro wee tụọ ya site na ịgbanwe ntụgharị ọbara glycosylated hemoglobin (L1L1c) na njedebe nke ọmụmụ ahụ na mmalite.

N'ime ndị ọrịa, a hụrụ ọkwa nke glucose n'ọbara, nke kpebiri onwe ya. Ihe dị iche n'etiti insulin-glulisin na nkwadebe insulin-lyspro bụ na mgbe enyere onye nke izizi ozi, ọ dịghị mkpa ịbawanye ọgwụ insulin bụ isi.

Ọnwụnwa nlere anya nke agba nke atọ, dị izu iri na abụọ, (ụdị 1 ọrịa shuga mellitus na-eji insulin-glargine dịka a kpọrọ ndị ọrụ afọ ofufo) dị ka ndị ọrụ afọ ofufo) gosipụtara na ebumnuche nke ịkụnye insulin-glulisin ozugbo nri riri ka nke ịbanye insulin-glisin. ozugbo tupu nri (nkeji 0-15). Ma ọ bụ nkeji iri atọ ruo iri anọ na ise tupu iri nri insulin nke mmadụ.

E kee ndị ọrịa gafere ule abụọ dị iche iche:

1. Otu mbu buru insidra insulin tupu nri.
2. Ejiri insulin nke abụọ na-agwọ mmadụ.

Ihe ọmụmụ nke ndị otu mbụ gosipụtara mbelata nke ukwuu na HL1C karịa ndị ọrụ afọ ofufo nke otu nke abụọ.

Ọrịa shuga 2dị 2

Nke mbu, nnwale nke ulo ogwu nke agba nke atọ mere ihe karịrị izu iri abụọ na isii. Ihe ọmụmụ 26 maka izu, ihe ndị dị mkpa iji tụnyere ihe omume Apidra (nkeji 0-15 tupu nri) yana insulin mmadụ na -akpata (nkeji iri anọ na anọ ruo iri ise tupu nri).

E nyere ọgwụ ndị a ọgwụ nye ndị ọrịa nwere ọria mamịrị shuga n'ụdị nke abụọ (ndị a ji insulin-isofan dị ka insulin isi). Gburugburu ọnụ ọgụgụ ahụ dị arọ nke isiokwu ha bụ 34.55 kg / m².

N'ihe banyere mgbanwe na mkpokọ HL1C, mgbe ọnwa isii nke ọgwụgwọ gasịrị, insulin-glulisin gosipụtara mmekorita ya na insulin na-arịa mmadụ site na uru mbụ n'ụzọ dị otú a:

• nke insulin na-arịa mmadụ, 0.30%;
• maka insulin-glulisin-0.46%.

Ma mgbe otu afọ ọgwụgwọ gasịrị, foto a gbanwere dịka:

1. maka insulin na-arịa mmadụ - 0.13%;
2. maka insulin-glulisin - 0.23%.

Ọtụtụ n'ime ndị ọrịa na-esonye n'ọmụmụ ihe a, ozugbo ịgba ntụtụ, jikọtara insulin-isophan na insulin na-eme obere oge. N'oge usoro ịgba, 58% nke ndị ọrịa jiri ọgwụ hypoglycemic wee tinye ntuziaka ka ha gaa n'ihu were ha otu usoro.

N'ime ule ụlọ ọgwụ a na-achịkwa na ndị okenye, enweghị ọdịiche na arụmọrụ yana nchekwa nke insulin-glulisin mgbe ị na-enyocha ìgwè dị iche iche mata na okike na agbụrụ.

Na Apidra, dochie anya amino acid asparagine n'ọnọdụ B3 nke insulin mmadụ nwere na lysine, na mgbakwunye, lysine nọ n'ọnọdụ B29 nwere acid glutamic, na-akwalite mmịpụta ngwa ngwa.

Otu Ndị Ọrịa Pụrụ Iche Pụrụ Iche

• Ọrịa nwere nsogbu gbasara akụrụ. N'ime omumu ihe omumu nke emere na ndi mmadu nwere otutu onodu oru ha (nwechara okike (CC)> 80 ml / min, 30¬50 ml / min, <30 ml / min), emere ka onodu nke insulin-glulisin gharia. Agbanyeghị, na ọnụnọ nke akwara oke, enwere ike belata mkpa nke insulin.
• Ndị ọrịa nwere ọrịa imeju. N'ime ìgwè ndị ọrịa a, amụbeghị ọgwụ pharmacokinetic.
• Ndị okenye. Maka ìgwè ndị ọrịa a, data pharmacokinetic na nsonaazụ insulin-glulisin nwere oke oke.
• Childrenmụaka na ndị nọ n'afọ iri na ụma. Nchọpụta ọgwụ na ọgwụ nke insulin-glulisin dị na ndị nọ n'afọ iri na ụma (afọ iri na isii) na ụmụaka (afọ 7-1 ruo afọ asaa) nke nwere ụdị shuga 1. A na-etinye insulin-glulisin ọgwụ ngwa ngwa n'afọ ndụ abụọ na Stax na Tmax yiri nke ndị okenye okenye nwere ọrịa shuga nke 1 na ndị nwere ahụ ike. Mgbe etinyere insulin-glulisin ngwa ngwa tupu nnwale ahụ, ka insulin-glulisin, dị ka ọ dị n’etiti ndị okenye ọrịa, na-enye njikwa shuga ọbara ka ọ na-eri nri ma e jiri ya tụnyere insulin na-arịa mmadụ. Mmụba nke ịbawanye n'ọbara ọbara mgbe ị risịrị nri (AUC 0-6 awa - mpaghara dị n'okpuru usoro "shuga ọbara - oge" 0-6 awa) bụ 641 mg / (h'dl) maka Apidra na 801 mg / (h ' d) maka insulin soluble nke mmadụ.

Ihe ngosiputa na usoro onunu ogwu

Diabetesdị insulin na-adabere n'ụdị shuga 1 na ụmụaka mgbe afọ 6 gasị, ndị ntorobịa na ndị okenye.

Ekwesịrị inye insulin-glulisin obere oge ma ọ bụ ozugbo nri. A ga-eji Apidra mee ihe n'ụkpụrụ ọgwụgwọ nke gụnyere insulins na-arụ ọrụ ogologo oge, ma ọ bụ analogues ha.

Na mgbakwunye, Apidra nwere ike iji ya na ọgwụ ọnụ hypoglycemic. Usoro ogwu a na-ahọpụta mgbe niile n’otu n’otu.

Administrationzọ Nchịkwa

A na-ahụ ọgwụ ahụ site na ntụtụ subcutaneous ma ọ bụ site na infusion na abụba subcutaneous site na iji pọpụ insulin. A na-eme ọgwụ mgbochi Subcutaneous n'ime afọ, apata ma ọ bụ ubu. A na-arụkwa ọkpọkọ n’ime afọ.

Ọnọdụ infusion na injection na insulin ọhụụ nwere ike ịgbanwe ọzọ. Mmalite nke usoro, oge ọ ga-agbago na ọnụego adsorption nwere ike imetụta mmega ahụ na mpaghara nchịkwa. Nlekọta nke Subcutaneous nke afọ na-enye adsorption ngwa ngwa karịa inje n'ime akụkụ ahụ ndị ọzọ.

Iji gbochie ọgwụ ịbanye na arịa ọbara, ekwesịrị ịkpachara anya. Ozugbo nchịkwa ọgwụ ahụ gasịrị, ekwesighi ịhịa aka ntụtụ.

A na-ahapụ ya ka ịgwakọta Apidra na insulin-isophan mmadụ.

Ihe mgbapụta insulin maka infusionaneous infusion na-aga n'ihu

Ọ bụrụ na eji usoro mgbapụta ejiri Apidra mee ihe maka insulin insulin na-aga n'ihu, a machibidoro ịgwakọta ya na ọgwụ ndị ọzọ.

Iji nweta ihe omuma ndi ozo banyere ogwu nke ogwu a, odi nkpa itu ntuziaka nke a maka ya. Na nke a, ndụmọdụ niile gbasara iji pensụl pensụ jupụtara.

Otu ndị ọrịa pụrụ iche gụnyere ndị ọrịa nwere:

• arụ ọrụ ezumike n’akuku (ya na ọrịa ndị dị, mkpa injection insulin nwere ike ibelata);
• Ọrụ ịba ọcha n'anya (dị ka ọ dị na mbụ, mkpa maka nkwadebe insulin nwere ike ibelata n'ihi mbelata ikike gluconeogenesis na mbelata metabolism metabolism).

Ihe omuma banyere akwukwo banyere ogwu nke ogwu na ndi okenye ka ezughi ezu. Mkpa insulin n'ahụ ndị agadi nwere ike ibelata n'ihi ọrụ ezumike ezumike ezughi ezu.

Enwere ike inye ọgwụ ọgwụ ọgwụ ụmụaka ka afọ isii gachara. Ihe omuma banyere ihe omuma ogwu ahu n’ebe umuaka gbara afo 6 adighi adi.

Mmeghachi omume ọjọọ

Mmetụta dị njọ na-adịkarị na-apụta n'oge ọgwụgwọ insulin mgbe ọnụọgụ gafere bụ hypoglycemia.

Enwere mmeghachi omume ndị ọzọ na-adịghị mma na-ejikọta ya na iji ọgwụ ahụ ma hụ ya na ule ụlọ ọgwụ, ugboro ole ha na-eme na tebụl.

Ọrịa sitere na metabolism na anụ ahụ

Ọtụtụ mgbe hypoglycemia na-amalite. Ihe mgbaàmà nke ọnọdụ a na - abụkarị na mberede. Ihe ngosi ndi a bu ihe mgbaàmà nke akwara ọria:

1. Ike gwụrụ, ike gwụrụ m, adịghị ike.
2. Ikelatalata ilekwasị anya.
3. Ihe nlere Anya.
4. Rowsjọ.
5. Isi ọwụwa, ọgbụgbọ.
6. Mgbagha nke nsụhọ ma ọ bụ ọnwụ ya kpamkpam.
7. Ọrịa convulsive.

Mana ọtụtụ mgbe, ihe ịrịba ama nke neuropsychiatric na-ebu ụzọ nwee akara nke adrenergic counter-regulation (nzaghachi hypoglycemia nke sistemụ ọrịa ọmịiko):

1. Mkpirisi ụjọ, iwe.
2. Remjọ, ụjọ.
3. Mmetụta agụụ.
4. Pallor nke anụ ahụ.
5. Tachycardia.
6. Ọsụsọ oyi.

Dị Mkpa! Ugboro ugboro ugboro nke hypoglycemia nwere ike ibute mmebi nke sistem. Ọnọdụ ọrịa hypoglycemia siri ike ma na-adịte aka na-ebute ndụ onye ọrịa nnukwu nsogbu, ebe ọ bụ na nsonaazụ na-egbu egbu ga-ekwe omume na ọnọdụ na-abawanye.

N’ebe a na-agba ọgwụ ọjọọ, a na-ahụkarị ngosipụta mpaghara nke ịba ọcha n’anya:

• itching
• ọzịza;
• hyperemia.

N'ụzọ bụ isi, mmeghachi omume ndị a na-adịte aka ma na-apụkarị n'anya na usoro ọgwụgwọ ọzọ.

Mmeghachi omume dị otú ahụ sitere na anụ ahụ subcutaneous, dị ka lipodystrophy, dị ụkọ, mana enwere ike ịpụta n'ihi mmebi nke mgbanwe na saịtị ịgba ntụtụ (ị gaghị abanye insulin n'otu mpaghara).

Nsogbu izugbe

Ngosiputa sistemu nke huru na otutu ihe, ma oburu na ha aputa, ihe ndia bu akara ndi a.

1. urticaria;
2. gbua;
3. imechi obi;
4. itching
5. nfụkasị ahụ akpịrị.

Ọnọdụ ndị pụrụ iche nke allergies na-agbasa (nke a gụnyere ngosipụta anaphylactic) na-ebute ndụ onye ọrịa.

Ime

Ihe omuma banyere ojiji nke insulin-glulisin nke ndi nwanyi di ime adighi adi. Nnwale ụmụ anụmanụ egosipụtabeghị ọdịiche dị n'etiti insulin na -akasị mmadụ na insulin-glulisin n'ihe metụtara afọ ime, itu nwa n’afọ, na ịmụ nwa.

Agbanyeghị, ụmụ nwanyị dị ime kwesịrị iji nwayọ nye ọgwụ ahụ. N'oge ọgwụgwọ, a ga-enyocha nyocha nke shuga ọbara kwa ụbọchị.

Ndị ọrịa nwere ọrịa shuga tupu afọ ime ma ọ bụ ndị malitere ọrịa shuga n'ime ụmụ nwanyị dị ime kwesịrị ijide nchịkwa glycemic n'oge dum.

N’ime oge izizi nke ịtụrụ ime, mkpa onye insulin nwere ike belata. Mana, dịka iwu, n'oge mgbụsị akwụkwọ na-esote, ọ na-abawanye.

Mgbe ịmụchara nwa, mkpa ọ dị insulin na-ebelata ọzọ. Womenmụ nwanyị na-eme atụmatụ ịtụrụ ime kwesịrị ịgwa onye nlekọta ahụike banyere nke a.

Amabeghị ma insulin-glulisin nwere ike ịbanye na mmiri ara ara. Mụ nwanyị n’oge ha na-a breastụ ara nwere ike ịchọzigharị usoro nke ọgwụ na nri.

Childrenmụaka na ndị nọ n'afọ iri na ụma

Enwere ike iji insulin-glulisin na ụmụaka mgbe afọ 6 gachara na ndị ntorobịa. Maka ụmụaka na-erubeghị afọ isii, a naghị enye ọgwụ a ọgwụ, ebe ọ bụ na enweghị ozi banyere ụlọ ọgwụ.