ʻO ka piha piha o ke kino o ke kanaka he mea hiki ʻole ke nānā i ka insulin. He hormon kupono ia no ka hoʻouluʻana o ka glucose, ka mea hele mai me ka meaʻai, i ka ikehu.
I nā kumu like, loaʻa kekahi poʻe i ka insulin. I kēia hihia, pono nā manaʻo no ka hoʻomaka ʻana o ka hormone hoʻokalakupua i ke kino. No kēia hana, hoʻohana pinepine ʻia ka insulin Degludek.
ʻO ka lāʻau lapaʻau ka insulin kanaka e loaʻa kekahi hopena lōʻihi loa. Hoʻohana ʻia ka huahana ma o ka biotechnology DNA recombinant e hoʻohana ana i ke kumuʻo Saccharomyces cerevisiae.
Lapaʻau
ʻO ke kumuhana o ka hana o Degludek insulin ka mea like me ka humā o ke kanaka. Hoʻokumu ka hopena o ka hoʻohaʻa ʻana i ke kō me ka hoʻoulu ʻana i ke kaʻina hana o ke kō e hoʻohana ai i nā kinipona ma hope o ka hoʻopaʻa ʻana i nā momona a me nā hāmeʻa o nā hāmeʻa a i nā manawa a me ka manawa o ka hoʻohaʻahaʻa i ka pae o ka hana glucose i ka ate.
Ma hope o ke kū hoʻokahi i ka hopena i loko o 24 mau hola, loaʻa iā ia ka hopena like. ʻO ka lōʻihi o ka hopena ma mua o nā hola 42 i loko o ka nui o ka palena therapeutic. He mea kūpono ia e hoʻokau ʻia kahi pilina linear ma waena o ka hoʻonui ʻana i ka nui o ka lāʻau a me kona hopena hypoglycemic holoʻokoʻa.
ʻAʻohe kūhai koʻikoʻi ʻole o ka maʻi i ka pharmacodynamics o Degludec insulin ma waena o nā mea maʻi ʻōpio a me nā mākua. Eia nō hoʻi, ʻaʻole i ʻike ʻia ka wehe ʻana o nā antibodies i ka insulin ma hope o ka mālama ʻana me Deglyudec no ka manawa lōʻihi.
ʻO ka hopena lōʻihi o ka lāʻau lapaʻau ma muli o ke hoʻonohonoho kūikawā o kāna kinona. Ma hope o ka hoʻomalu sc, kū i nā mutihexamers soluble, kahi ka ʻano o ka "depot" no ka insulin i ka kiko adipose subcutaneous.
Hoʻololi hūnā ʻia ka Multihexamers, ka hopena o ka hoʻokuʻu ʻana o nā monemors hormone. No laila, he kahe lōlō a hoʻolōʻihi i ka hopena o ke kahe i loko o ke kahawai, e hōʻoia ai i kahi pālahalaha pālahalaha a lōʻihi ka lōʻihi a me ka hopena paʻa.
I loko o nā plasma, ua loaʻa ke CSS i ʻelua a ʻekolu paha lā ma hope o ka paʻi ʻana. ʻO ka kohoʻana o ka lāʻau lapaʻau penei: kahi pilina o Degludek me albumin -> 99%. Inā mālama ʻia ka lāʻau lapaʻau ma ka subcutaneously, a laila hoʻohālikelike ʻia kona nui o ke koko i ka hana i loko i loko o nā pupu therapeutic.
ʻO ka holo ʻana o ka lāʻau lapaʻau ka mea like me ka hihia o ka insulin o ke kanaka. ʻAʻole ikaika nā metabolites a pau ma loko o ke kaʻina.
Ma hope o ka nānā ʻana o ka hoʻokele sc o T1 / 2 i ka manawa o kona lawe ʻana mai i ka ʻupepili aine, aia ma kahi o 25 mau hola, he ʻokoʻa ka dosage.
ʻAʻole pili ka kāne o nā mea maʻi i ka pharmacokinetics o ke kilanana ʻo insulin Degludec. Eia kekahi, ʻaʻohe mea ʻē aʻe o ka haukapila i ka therapy insulin i ka wā ʻōpio, nā maʻi kuʻuna a me nā maʻi maʻi me ka pale ʻana o ka ate a me ka hana ʻana.
E pili ana i nā kamaliʻi (6-11 mau makahiki) a me nā ʻōpio (12-18 mau makahiki) me ka maʻi type 1, ʻo nā pharmacokinetics o ka insulin Degludec e like like me nā mea maʻi. Eia naʻe, me ka maʻi hoʻokahi o ka lāʻau lapaʻau i nā mea maʻi me ka maʻi type 1, ʻo ka nui o ka nui o ka lāʻau i nā mea maʻi ma lalo o ka 18 mau makahiki he ʻoi aku ka nui ma mua o nā maʻi maʻi kahiko.
ʻAʻole ia he mea nui e pili ana i ka hoʻomau mau ʻana o ka insulin Degludek i ka hana i ka hana a ka hopena, ʻaʻohe hopena iʻa i ke kino o ke kanaka.
Aʻo ka māhele o ka hana mitogenic a me ka metabolic ka hana o Degludek a me ka insulin kanaka like.
Nā ʻōkuhi no ka hoʻohana ʻana i ka lāʻau lapaʻau
Pono e hoʻokō ʻia kēia hopena ma lalo o ka ʻili, a ua contraindicated ʻo ka lawelawe ʻana. Eia kekahi, e hoʻolako i kahi hopena hypoglycemic paʻa, hoʻokahi lawa ka lāʻau i kēlā me kēia lā.
He mea pono ia e kū pono ana ʻo Degludec insulin me nā papa ʻaina āpau a me nā ʻano like ʻole o ka insulin. No laila, hiki ke lilo i ka mea hana i ka monotherapy a i ʻole ka māhele o ka mālama hui.
ʻO ka inika mua o ka lāʻau lapaʻau he 10 mau ʻāpana. Ma hope o ka hoʻololi ʻia ʻana o ka inane hoʻoneʻe ʻana ma muli o nā ʻano pilikino o ka mea maʻi (ke kaumaha, ka wahine, ka makahiki, ke ʻano a me ka papa o ka maʻi, ke ʻano o nā hoʻopiʻi).
Inā loaʻa ka mea maʻi maʻi i kekahi ʻano ʻē aʻe o ka insulin a e hoʻokaʻawale ʻia paha i Degludek (Tresib), a laila e helu ʻia ka ʻimi mua e like me ke kumu 1: 1. No laila, ʻo ka nui o ka insulin basal e like me ka insulin Degludek.
Inā aia ka mea maʻi i ka lua o ka noho ʻana o ka ʻenehana no ka inikua a i ʻole ka mea maʻi i ka ʻikepili o ka hemoglobin glycated a emi mai ka 8%, a laila ke koho nei ka ʻaha maʻa. Pono pinepine e hōʻemi i ka dosage me kāna hoʻoponopono hou aʻe.
Holo nā loiloi o nā kauka i ka mea ʻoi aku ka maikaʻi o ka hoʻohana ʻana i nā dosis liʻiliʻi o ka insulin. Pono kēia no ka mea inā ʻoe e unuhi i ka leo i loko o nā analogue, a laila e kiʻi i ka glycemia i makemake ʻia, makemake ʻoe i kahi haʻahaʻa o ka lāʻau.
ʻO ka hoʻāʻo ʻia ka nui o nā insulin e hiki ke hana i hoʻokahi manawa i kēlā me kēia 7 mau lā.
Kūkulu ʻia ka Titration ma ka awelika ʻelua o mua o ka ana ʻana o ka ʻaihue wikiwiki.
ʻO nā kumulau, overdose, pili pili lāʻau
ʻAʻole lawe ʻia ka insulin Degludec i ka wā kamaliʻi, a me ka hoʻāʻo ʻana o kēlā me kēia mea i nā ʻāpana, i ka wā o ka lactation a me ka hapai.
ʻAʻohe hopena kūpono loa e hiki ai ke hoʻonāukiuki i ka hypoglycemia, akā hiki i kēia kūlana ke ulu mālie. Me kahi kaomi liʻiliʻi o ka kō, pono e inu ka mea maʻi e inu i kahi mea momona a ʻai ʻole i ka huahana e loaʻa ana i ka momona māmā.
Ma kahi o ka hypoglycemia koʻikoʻi, inā ʻike ʻole ka mea maʻi, ua huʻi ʻia ia me ka momonaagonona a i ʻole ka hopena glucose. Inā ma hope o ka hoʻohana ʻana i ka glucagon ka mea i ʻike ʻole ʻia ka mea maʻi, a laila hāʻawi ʻia ka dextrose, a hāʻawi ʻia ka hōʻaiʻē e ka ʻai o ka mea i kālai ʻia.
Ua emi ka pono no ka insulin i ka wā i lawe ʻia ai me:
- ARG o peptide-1;
- nā papa hypoglycemic;
- MAO / ACE inhibitors;
- ʻaʻole nā mea koho beta koho ʻole;
- sulfonamides;
- anabolic steroid;
- paʻakai.
Thaizide diuretics, oralac contraceptives, Danazol, GCS, Somatropin, sympathomimetics, he nui nā hormones thyroid i ka hoʻonui i ka koi o ka insulin. Hōʻike ʻia ka hōʻike ʻana o ka hypoglycemia inā lawe ʻia ʻo Degludec me nā beta-blockers.
ʻO Lanreotide, Octreotide, a me ka ethanol hiki ke hoʻonui a hōʻemi paha i ka pono o ka insulin. ʻAʻole ia he mea kūpono inā inā hoʻohui kekahi mau lāʻau i ka hoʻonāʻana i ka insulin, hiki i kēia ke alakaʻi i ka luku ʻana i kahi mea hana.
Eia kekahi, ʻaʻole i ʻae ʻia ʻo Degludec e hoʻohui ʻia i nā hoʻonā infusion.
Nā hopena ʻaoʻao a me nā kauoha kūikawā
ʻO ka hopena maʻamau e hōʻike ai i ka hypoglycemia. Hōʻike pinepine ʻia kāna mau hōʻailona. ʻO kēlā mau hiʻohiʻona e pili ana i ka palau o ka ʻili, ka pōloli, ka hiʻohiʻona o kahi huluhulu maloʻo, kahi puʻuwai ikaika, luhi, ʻalā, ka ʻeha, ka hopohopo, ka nausea, ka hopohopo, keʻemoʻi, ka hoʻopulapula maikaʻi ʻole a me ka mālama ʻole. Hiki nō hoʻi ke kuʻi loiloi pōkole i ka maʻi diabetes.
Hiki i nā ʻōlani ke hiki i ka hopena me ke ʻano he anaphylactic hoʻoweliweli. Ma kahi ma ka ʻāpana o ka ʻōnaehana pale, urticaria a hypersensitivity hiki mai paha. Hōʻike ʻia kēia kūlana e ka ʻāʻī o ka ʻili, ka huhū o ka lehelehe, ka lehelehe, luhi a me ka ʻōpū.
I kekahi manawa hele ka lipodystrophy ma ka pūnaewele injection. Eia nō naʻe, ʻo ka nānā ʻana i nā lula no ka hoʻololi ʻana i ka wahi o ka injection, he mea liʻiliʻi loa ia.
Ma ka wahi o ka hoʻokele ʻana, hiki i nā maʻi maʻamau a me nā maʻi. Kūʻai kekahi, i ka edema peripheral, hele pinepine ʻia i ka wahi i hoʻouna ʻia:
- puʻohiʻu;
- hematoma;
- hoʻonāukiuki
- ʻeha
- huu
- hemorrhage kūloko;
- loli ka ʻili o ka ʻili;
- erythema;
- ka māla ʻana
- kūloko ʻaihue hui.
ʻ saylelo aku nā loiloi o Deglyudeke i ka maʻalahi o ka lāʻau e hoʻohana a maʻalahi i ka hoʻohana ʻana, a ma muli o ka hana lōʻihi ma hope o ka hoʻopuka ʻana o ka hopena, e hoʻomau ka pae o ka glycemia no ka manawa lōʻihi.
ʻO ka lāʻau lapaʻau kaulana loa e pili ana i Degludek kahi huahana ma ka inoa o ke kālepa Tresiba. Loaʻa ka lāʻau lapaʻau e like me kahi pahu me nā cartridges hiki ke hoʻohana wale i nā penikala syringe no Novopen no ka hoʻohana hou ʻia.
Loaʻa ʻia hoʻi ʻo Tresiba i nā peni hiki (FlexTouch). ʻO ka nui o ka lāʻau lapaʻau he 100 a 200 PIECES ma 3 ml.
ʻO ke kumukūʻai o kahi peni Treshiba Flex Touch e like me 8000 a 1000 mau rubles. A ʻo ke wikiō ma kēia ʻatikala e haʻi wale aku iā ʻoe pehea e hoʻohana ai i ka insulin palau.
