Insulin Apidra (Epidera): nā loiloi, nā ʻōlelo e pili ana i ka hoʻohana ʻana o ka glulisin

"Apidra", "Epidera", insulin-glulisin - ke kumu nui o ka lāʻau lapaʻau ka mea kanu o ka insulle kūloko o ke kanaka, i loaʻa e ka ʻenehana genetic.

Ma ka ikaika o kāna hana, ua like ia me ka hoʻokaʻawale i ka insulin kanaka. Akā e hoʻomaka ʻo Apidra e hana wikiwiki, ʻoiai ka lōʻihi o ka lōʻihi o ka lāʻau lapaʻau.

ʻO nā hiʻohiʻona Pharmacological

Lapaʻau lāʻau ʻO ka hana nui o ka insulin a me nā mea āpau āpau (ʻaʻole i pau ʻole ka insulin-glulisin) ke ʻano maʻamau o ke kaila koko.

Mahalo i ka insulin gluzulin, ka hoʻoneʻe ʻana o ka glucose i ka kahe koko e hoʻoneʻe ai a me kona hoʻoulu ʻia ʻana e hoʻoulu ʻia e nā kino peripheral, ʻoi loa ka momona, ʻoka a me ka muscular. ʻO ke ʻano, insulin:

• pale i ka hana o ka glucose i loko o ka ate;
• hoʻonui i nā synthesis protein;
• pale i ka proteolysis;
• kāhea ana i ka lipolysis i ka adipocytes.

Ua hōʻike ʻia nā haʻawina e pili ana i nā limahana olakino a me nā mea maʻi me ka maʻi mellitus no ka hoʻokaʻawale ʻana i ke kaʻina o ka subcutaneous o ka insulin-glulisin ʻaʻole e hōʻemi wale i ka manawa e kali ai no ka hoʻolaha ʻana, akā e hōʻemi ana i ka lōʻihi o ka hoʻolahaʻana i ka lāʻau. Hoʻohālikelike kēia iā ia mai i ka insulin soluble kanaka.

Me ka hoʻokolohua subcutaneous, ka hopena o ke kōpae haʻahaʻa o ka insulin-glulisin i ke koko e hoʻomaka ana ma hope o 15-20 mau minuke. Me nā inikini intravenous, ka hopena o ka insulle kūloko o ke kanaka a me nā hopena o ka insulin-glulisin e pili ana i ka glucose o ke koko.

ʻO ka hui Apidra i like ka hana hypoglycemic like me ke ʻano o ka insulin soluble kanaka. I nā hoʻokolohua lapaʻau i nā mea maʻi me ka maʻi type 1, ua loiloi ʻia nā hopena hypoglycemic o ka soluble insulin o ke kanaka a me Apidra.

Ua hoʻolako ʻia lāua ʻelua ma kahi wai o 0.15 U / kg subcutaneously ma nā manawa like e pili ana i ka pāʻina 15-minuke, ʻo ia ka mea i manaʻo ʻia.

Ua hōʻike ʻia nā hopena o nā noi ʻana i ka insulin-glulisin, mālama i 2 mau minuke ma mua o ka ʻai, ka hāʻawi ʻana i ka mālama glycemic pololei ma hope o ka ʻai ʻana me ka insulin soluble kanaka, ka mea i helu ʻia ma 30 mau minuke ma mua o ka ʻai.

Inā mālama ʻia ka insulin-glulisin i 2 mau minuke ma mua o kahi pāʻina, hāʻawi ka lāʻau lapaʻau i ka nānā glycemic maikaʻi ma hope o kahi pāʻina. ʻOi aku ka maikaʻi ma mua o ka lawelawe ʻana i ka insulin soluble kanaka 2 mau minuke ma mua o ka papaʻaina.

Insulin-glulisin, i lawelawe ʻia i nā minuke 15 ma hope o ka hoʻomaka ʻana o ka ʻai, hāʻawi ʻia ka ʻike glycemic ma hope o ka papaʻaina e like me ka hoʻolalelale ʻana e ka wai o ka soluble kanaka, ka hoʻomaka ʻana o ka mea 2 mau minuke ma mua o ka hoʻomaka ʻana o ka ʻai.

ʻO kahi hōʻike o ka hana mua, i hana pū me Apidra, insulin soluble kanaka a me insulin-lyspro i ka hui o nā mea maʻi me ka momona a me ka maʻi maʻi, i hōʻike ʻia i kēia mau maʻi ka maʻi ole-glulisin ʻaʻole e pau i kāna mau hana wikiwiki.

Ma kēia noiʻi ʻana, ʻo ka pae o ka hōʻea ma waena o 20% o ka huina ma lalo o ka pihi kiʻekiʻe-manawa (AUC) no ka insulin-glulisin i mau minuke 114, no ka insulin-lispro -121 mau minuke a no ka insulin solulle kanaka - 150 mau minuke.

A AUC (0-2 mau hola), e hōʻike ana nō hoʻi i ka hana hypoglycemic i ke ʻano, ʻo kēlā me kēia 427 mg / kg no ka insulin-glulisin, 354 mg / kg no ka insulin-lyspro a me 197 mg / kg no ka soluble insulin o ke kanaka.

ʻAno maʻi type 1

ʻĀina haʻawina. I ke ʻano type diabetes mellitus, ua hoʻohālikelike ʻia ka insulin-lispro a me ka insulin-glulisin.

I ka hoʻokolohua lapaʻau hopena-3 mau i nā wiki he 26, ua hāʻawi ka poʻe me ka diabetes type 1 i ka glulisin insulin i ka manawa ma mua o ka ʻai (ʻo ka insulin glargine e hana ana he basal insulin i kēia mau maʻi).

I kēia poʻe kānaka, ʻo ka insulin-glulisin e pili ana i ka mana glycemic i hoʻohālikelike ʻia me ka insulin-lyspro a ua loiloi ʻia e ka hoʻololi ʻana i ka neʻe o ka hemoglobin glycosylated (L1L1c) i ka hopena o ka noi me ka hoʻomaka ʻana.

I ka poʻe maʻi, nā mea hoʻohālikelike o ka glucose i loko o ke kahawai, ua hoʻoholo ʻia e ka mālama pono ʻana, ua nānā ʻia. ʻO ka ʻokoʻa ma waena o ka insulin-glulisin a me ka hoʻomākaukau ʻana o ka insulin-lyspro, i ka wā i mālama ʻia ai ka mea mua, ʻaʻohe mea e pono e hoʻonui i ka dosis o ka insulin maʻamau.

ʻO nā hoʻokolohua haukapila o ke kolu o ka lā, mau loa he 12 mau hebedoma, (type type 1 diabetes mellitus e hoʻohana ana i ka insulin-glargine e like me ke ʻano nui no ka hāpai ʻana i ke ʻano o nā mea haʻipiʻi) hōʻike ʻia nā ʻano o ke kaha injecting insulin-glulisin ma hope o ka ʻai i hoʻohālikelike ʻia i ka injecting insulin-glisin koke koke ma mua o ka ʻai (0-15 mau minuke). A i ʻole 30-45 mau minuke ma mua o ka ʻai ʻana i ka insulin soluble kanaka.

Ua hoʻokaʻawale ʻia nā mea maʻi i hala i nā hoʻokolohua ʻelua.

1. Ua lawe ʻia ka hui mua i ka apidra insulin ma mua o ka papaʻaina.
2. ʻO ka hui ʻelua i mālama ʻia i ka insulin soluble kanaka.

ʻO nā kumuhana o ka hui mua i hōʻike i kahi emi nui o ka HL1C ma mua o nā mea hana o ka hui lua.

ʻAno maʻi type 2

ʻO ka mua, ua hoʻomaka ʻia nā hoʻokolohua lapaʻau o ke kolu ma mua o 26 mau pule. Ua ukali ʻia lākou e nā kula palekana 26-pule, he pono e hoʻohālikelike i ka hana a Apidra (0-15 mau minuke ma mua o ka ʻai) me ka insulin soluble kanaka (30-45 mau minuke ma mua o ka ʻai).

Ua hoʻokaʻawale ʻia kēia mau lāʻau ʻelua i nā mea maʻi me ka diabetes type type 2 (ʻo kēia mau kānaka i hoʻohana i ka insulin-isofan ma ke ʻano nui o ka insulin). ʻO ka awelika o ke kaupaona kino kino o nā kumuhana he 34.55 kg / m².

No ka mahalo i ka loli ʻana o ka ʻike ʻana o ka HL1C, ma hope o ʻeono mau malama o ka mālama ʻana, ua hōʻike mai ka insulin-glulisin i kona ʻano me ka hoʻololi kūlohelohe o ke kanaka i ka hoʻohālikelike ʻana me ka waiwai mua o kēia ʻano:

• no ka soluble kōlea o kanaka, 0.30%;
• no ka insulin-glulisin-0.46%.

A ma hope o ka 1 makahiki o ka mālama ʻana, ua loli ke kiʻi e like me kēia:

1. no nā lālani hāmeʻa kūloko kanaka - 0.13%;
2. no ka insulin-glulisin - 0.23%.

ʻO ka hapa nui o nā mea maʻi e komo nei i kēia noiʻi ʻana, ma mua o ka hiki ʻana o ka maʻi Injection, hoʻāla ʻia me ka insulin-isophan me ka hana pōkole hana. I ka manawa o ka randomization, 58% o nā mea maʻi i hoʻohana i nā lāʻau hypoglycemic a ua kākau ʻia i nā kauoha e hoʻomau i ka lawe iā lākou ma ka papa like.

I ka hoʻokolohua ʻana i nā lāʻau lapaʻau i ʻike ʻia i nā pākeke, ʻaʻohe ʻokoʻa ʻole ka hopena a me ka palekana o ka insulin-glulisin i ka hoʻopaʻa ʻana i nā ʻōpala i hōʻike ʻia e ka wahine a me ka lāhui.

Ma Apidra, ka hoʻohuli ʻana i ka asparagine waikawa amino ma ke kūlana B3 o ke kanaka i ka insulin me ka lysine, a me ka hoʻohui, ʻo ka lysine i ka manawa B29 me ka waikawa glutamic, hāpai i ka hoʻopili koke ʻana.

Nā Pūnaewele Pōkoki kūikawā

• ʻO nā mea maʻi me ka hoʻonāʻau pū kekahi. Ma kahi noiʻi haumanu i hana ʻia i nā kānaka olakino me ke ʻano he nui o ka kūlana hana ʻole (cleince clearance (CC)> 80 ml / min, 30¬50 ml / min, <30 ml / min), ka nui o ka hoʻomaka ʻana o ka hana o ka insulin-glulisin i mālama ʻia. Eia nō naʻe, i ka mua o ka hikiʻole o ka renal ka mea, pono ke hōʻemi i ka insulin.
• ʻO nā maʻi me nā ala poloka o ka hana ate. Ma kēia pūʻulu o nā mea maʻi, ʻaʻole i aʻo ʻia nā ʻikena pharmacokinetic.
• E nā ʻōpio. No kēia pūʻulu o nā mea maʻi, ua ʻohi ʻia nā ʻikepili pharmacokinetic i nā hopena o ka insulin-glulisin.
• Na keiki a ʻōpio. Ua mālama ʻia ka lāʻau lapaʻau me nā mea laila ʻo ka insulin-glulisin i nā ʻōpio (12-16 mau makahiki) a i nā keiki (7–11 mau makahiki) me ke ʻano maʻi type 1. Hoʻonui koke ka lāʻau insulin-glulisin i nā makahiki ʻelua me Stax a me Tmax e like pū me ka poʻe i nā maʻi pākeke me nā maʻi maʻi 1 a me nā mea kōkua olakino. Ke hoʻolako koke ʻia ma mua o ka hoʻāʻo me ka meaʻai, ʻo ka insulin-glulisin, e like me ka hui pākē a ʻo nā pākeke, hoʻolako i ka kaohi o ke kō o ke koko ma hope o ka ʻai ʻana i ka hoʻohālikelike ʻana i ka insulin soluble kanaka. ʻO ka hoʻonuiʻana i ka hoʻoliʻiliʻi koko ma hope o ka ʻai ʻana (AUC 0-6 hola - ʻo ka wahi ma lalo o ke kaʻe "koko gula - manawa" 0-6 hola) ʻo 641 mg / (hdl) no Apidra a me 801 mg / (h ' d) no ka inehu soluble kanaka.

Nā ʻōhua a me nā kaha

Insulin-hilinaʻi i ke ʻano maʻi diabetes i nā keiki ma hope o 6 mau makahiki o nā makahiki, nā ʻōpio a me nā pākeke.

Pono e hoʻokuʻi ʻia nā Insulin-glulisin i kahi manawa koke a i ʻole kahi pāʻina. Pono e hoʻohana ʻia ʻo Apidra i nā hoʻoponopono hoʻoponopono i hoʻoili ʻia ai nā insulins lōʻihi, nā mea hana a nā mea hou a i ʻole nā ​​analogues.

Eia kekahi, hiki ke hoʻohana pū iā Apidra e hui pū me nā lāʻau lapaʻau hypoglycemic waha. Ua koho mau ʻia ka hewa o ka lāʻau.

Pōʻalima ʻoihana

Hoʻohana ʻia ka lāʻau lapaʻau e ka subcutaneous injection a ma o ka hoʻomakeʻe ʻana i ka momona subcutaneous me ka hoʻohana ʻana i kahi pamu. Hoʻokomo ʻia nā huaʻōkole subcutaneous i ka ʻōpū, ka ʻūhā a me ke poʻohiwi paha. Hana ʻia ka ʻōpī pāleka i loko o ka ʻōpū.

ʻO nā wahi o ka infusion a me ka inikua me kēlā me kēia inikini insulin hou e hoʻololi pono ʻia. ʻO ka hoʻomaka ʻana o nā hana, ka lōʻihi a me ka manawa o ka adsorption e pili ʻia i ka hana kino a me kahi o ka hoʻokele. Hāʻawi ke subcutaneous ka ʻōpū i ka ʻōpū i nā adsorption wikiwiki aʻe ma mua o nā inikini i nā ʻaoʻao ʻē aʻe o ke kino.

I mea e pale aku ai i ka lāʻau lapaʻau ke kiʻi pololei i nā kīʻaha koko, pono e hoʻomaʻamaʻa nui loa. Ma hope koke o ka hoʻokō ʻana o ka lāʻau, ʻaʻole ke ʻānai ʻia ka pūnaewele i ka injection.

Ua ʻae ʻia ia e kāwili pū ʻo Apidra me nā insulin-isophan kanaka.

ʻO ka pākulu peni no ka infusion subcusioneous pinepine loa

Inā ka Apidra e hoʻohana ʻia e ka ʻōnaehana papahū no ka infusion mau o ka insulin, ua pāpā ʻia ʻo ia e kāwili ʻia me nā lāʻau lapaʻau ʻē aʻe.

E loaʻa ka ʻike hou aʻe e pili ana i ka hana o ka lāʻau lapaʻau, pono ia e aʻo i nā ʻōlelo e pili pū ana me ia. Me kēia, pono e ukali ʻia nā ʻōlelo aʻoaʻo a pau e pili ana i ka hoʻohana ʻana i nā peni ʻili piha piha.

ʻO nā hui kūikawā o nā maʻi e loaʻa i nā mea maʻi i loaʻa:

• hana renal maʻi ʻole (me kēlā mau maʻi, pono e hoʻēmi i ka inikini insulin);
• hana hepatic maʻi (e like me ka mea ma mua, ʻo ka pono o ka hoʻomākaukau ʻana i ka insulin e hoʻemi ana ma muli o ka emi ʻana o ka hiki i ka glucoseoneogenesis a me kahi hoʻohaʻahaʻa i ka metabolism insulin.

ʻAʻole lawa ka ʻikepili ma nā noiʻi pharmacokinetic o ka lāʻau lapaʻau i ka poʻe kahiko. Pono ka emi ʻana o ka insulin i nā poʻe maʻi maʻi ma muli o ka lawa ʻole o ka hana.

Hiki ke kuhikuhi ʻia ka lāʻau lapaʻau i nā keiki ma hope o 6 mau makahiki a me nā ʻōpio. ʻAʻole ʻike ka ʻike ma ka hopena o ka lāʻau lapaʻau ma nā keiki ma lalo o 6 mau makahiki o ka makahiki.

ʻO nā hopena ʻino

ʻO ka hopena hopena maʻamau e kū mai i ka wā o ka hoʻomehana insulin i ka wā i hoʻonui ʻia ai ka hopena he hypoglycemia.

Aia kekahi mau ʻano lino ʻē aʻe i pili i ka hoʻohana ʻana i ka lāʻau lapaʻau a ʻike ʻia i nā hoʻokolohua lapaʻau, ʻo kā lākou pinepine o ka hanana i ka papa.

Hoʻomaka mai ka metabolism a me ka ʻili

Hoʻokumu pinepine nā hypoglycemia i ulu. Hōʻike pinepine ʻia nā ʻano o kēia ʻano. ʻO nā hōʻike e hōʻike ʻia nei ma loko o nā ʻōnaehana neuropsychiatric:

1. ʻO ka palupalu, mālie, nāwaliwali.
2. Hoʻoholo i ka hiki ke kau.
3. ʻO nā haunaele ʻike.
4. ʻEhaʻeha.
5. Puka, kuʻi.
6. Ke kuhi nei i ka ʻike a i kona nalowale paha.
7. ʻ .lelo hoʻohālikelike.

Akā ʻo ka manawa pinepine, ʻo ka mua o nā hōʻailona neʻkaukau mua e ka hōʻailona o ka adrenergic counter-regulation (pane i ka hypoglycemia o ka systematatadad kūloko).

1. Nā huhū huhū, huhū.
2. Tremor, hopohopo.
3. Hōʻike i ka pōloli.
4. Pallor o ka ʻili.
5. Tachycardia.
6. ʻO ka huluhulu.

Nui! Hiki i nā pale hōʻeha ikaika o ka hypoglycemia ke hōʻeha i ka wahī. ʻO nā Episodes o ka hypoglycemia koʻikoʻi a lohi ka hopena i ka weliweli nui i ke ola o ka mea maʻi, ʻoiai hiki i kahi hopena hōʻeha ke hiki ke hoʻonui ʻia.

I nā pūnaewele injection o ka lāʻau lapaʻau, ʻike pinepine ʻia nā hōʻike kūloko o ka hypersensitivity:

• huu
• kuolo;
• mokaʻi maʻi.

He kumu maoli kēia o kēia mau kikooho a nalo pinepine i ka neʻe ʻana i ka lāʻau hou.

Kēia ʻano pane mai ka kiko kikoo, e like me ka lipodystrophy, he mea maʻamau ʻole ia, akā hiki ke kū mai ma muli o ka hōʻino o ka hoʻololi ʻana i ka pae injection (ʻaʻole hiki iā ʻoe ke komo i ka insulin ma ka wahi like).

ʻO nā maʻi maʻamau

Hōʻike pinepine ʻia nā ʻōnaehana ʻōnaehana o ka hypersensitivity, akā inā kūpaʻa ʻia, a laila ke ʻike nei kēia mau hōʻailona:

1. urticaria;
2. pīhoihoi;
3. humā nā ʻili;
4. huu
5. dermatitis allergic.

ʻO nā hihia kūikawā o nā maʻi āpau ākea (ua komo pū kēia me nā anaphylactic) e hoʻoweliweli i ka ola o ka mea maʻi.

Kahawai

ʻAʻole ʻike ka ʻike e pili ana i ka hoʻohana ʻana o ka insulin-glulisin e nā wahine hāpai. ʻAʻole i hōʻike i nā hoʻokolohua holoholona nui i kahi hoʻokaʻawale ma waena o ka insulin soluble kanaka a me ka insulin-glulisin e pili ana i ka hāpai ʻana, ka hoʻomohala ʻana i ka hanana ʻana o ka pūpū, hānau keiki a me ka hoʻomohala postpartum.

Eia naʻe, pono e hoʻomaopopo pono nā wahine hāpai i ka lāʻau lapaʻau. I ka wā o ka mālama ʻana, mālama pono ʻia ka nānā ʻana i ke kōʻai koko.

ʻO nā mea maʻi i loaʻa i ka maʻi diabetes ma mua o ka hāpai ʻana a i ʻole ka ulu ʻana i ka maʻi gestational i nā wahine hāpai e pono e mālama i ka mālama glycemic i ka manawa holoʻokoʻa.

I ka lāʻoma mua o ka hāpai ʻana, e hoʻemi paha ka mea maʻi no ka insulin. Akā, ma ke ʻano he lula, ma nā mea hana i hana ʻoi aku ka hoʻonui.

Ma hope o ka hānau keiki ʻana, pau ka pono i ka insulin. Pono nā wahine e hoʻolālā ana i ka hāpai hāpai i ka poʻe mālama olakino e pili ana i kēia.

ʻAʻole i ʻike ʻia inā hiki i ka insulin-glulisin ke komo i ka waiū umauma. Pono nā wahine i ka wā o ka hānai e hoʻoponopono i ke ʻano o ka lāʻau lapaʻau a me ka meaʻai.

Na keiki a ʻōpio

Hiki ke hoʻohana ʻia ka Insulin-glulisin i nā keiki ma hope o 6 mau makahiki a me nā ʻōpio. No nā keiki ma lalo o 6 mau makahiki o ka lāʻau, ʻaʻole i kuhikuhi ʻia ka lāʻau lapaʻau, no ka mea, ʻaʻohe ʻikepili ʻike.