Insulin glargine

Insulin glargine bụ analogue nke insulin mmadụ, nke a na-enweta site na ntugharị nke DNA nke nje na ụdị nke Escherichia coli (nje K12). Insulin glargine, na-ejikọ ya na ndị na - anabata insulin kpọmkwem (ihe mgbochi nke yiri insulin mmadụ) na - eme ka mmetụta ndu sitere na insulin na - agbanwe agbanwe. Insulin glargine na-edozi metabolism nke glucose. Ọgwụ na -ebelata mkpụkọ nke glucose n'ọbara site na-akpali ya ike site na anụ ahụ (karịkwa adipose anụ ahụ na akwara ọkpụkpụ) na igbochi gluconeogenesis (usoro nke imeju glucose na imeju). Insulin na - akwalite njikọ protein, na - egbochi proteolysis na lipolysis na adipocytes. Mgbe etinyere n’abụ nke subcutaneous, a na - egbochi acid acid nke insulin glargine ma mepụta microprecipitate, site na ha enwere ịhapụ ọgwụ ọ bụla n’adịghị ala, nke a na - ewepụta ogologo oge nke ime ihe na ịkọwapụta, ezigbo profaịlụ nke usoro ịta ahụhụ oge. Mgbe ihe dị ka elekere 1 gasịrị, ihe a na-amalite na nchịkwa ọgwụ Subcutaneous. Ogologo oge a na-eme bụ 1 ụbọchị, ihe kachasị bụ awa 29. Mgbe ụbọchị abụọ ruo 4 ka mkpụrụ nke mbụ gasịrị n’ọbara, a na-enweta ngụkọ echiche kwụsiri ike. E jiri ya tụnyere insulin-isofan, insulin glargine nwere nwayọ nwayọ ma na-adị ogologo oge, insulin glargine enweghị ebe ịta ahụhụ kachasị elu. N’ime mmadụ n’ime abụba dị n’ime ala, insulin glargine sitere na njedebe carbonxyl nke agbụ nke B na-agbadata ma mekwaa metabolites na-arụ ọrụ: 21A-Gly-insulin (M1) na 21A-Gly-des-30B-Thr-insulin (M2). Glargine insulin na-agbanweghi agbanwe yana ngwaahịa ndị ọ na-emebi emebi dị na ọbara ọgbụgba ahụ. Nnyocha nke insulin glargine na nnwale maka chromosome aberration (na vivo na Chinese hamster, cytogenetic in vitro on V79 sel), n'ọtụtụ ule (nnwale na hypoxanthine-guanine phosphoribosyltransferase nke sel mammalian, ule Ames). Agụrụ carcinogenicity nke insulin glargine na oke na ụmụ oke, nke natara ihe dịka 0.455 mg / n'arọ (ihe dị ka ugboro 10 na 5 ugboro maka mmadụ mgbe ejiri subcutaneously na-achịkwa) ruo afọ abụọ. Nsonaazụ nke ọmụmụ ahụ enyeghị anyị ohere ka anyị ruo nkwubi okwu ikpeazụ banyere ụmụ oke n'ihi oke nwụrụ na ndị otu niile, n'agbanyeghị agbanyeghị. Achọpụtara histiocytomas na saịtị ịgba ọgwụ na ụmụ oke (ọ bụghị nke ọnụ ọgụgụ pụtara ìhè) na oke oke (ọnụ ọgụgụ pụtara maka) na mgbe ị na-eji ihe mgbaze acid. Achọpụtaghị etuto dị otú ahụ n’ime ụmụ nwanyị mgbe a na-agbaze insulin n’ime ihe ndị ọzọ ma ọ bụ mgbe a na-eji nchịkwa nnu. Maka ụmụ mmadụ, amabeghị ịdị mkpa nke ihe ndị a. Na omumu banyere omumu, na mgbe omumu ma na imu umu nwanyi na oke oke nwere ogwu ihe na udiri ihe nke ugboro asaa ka ekpughere n ’uzo ochichi n’ime mmadu, ekpughere oke mmuo nke nne, bu nke kpatara hypoglycemia, tinyere ọtụtụ ọnwụ.

Ọrịa shuga mellitus, nke chọrọ ọgwụgwọ insulin, na ndị ọrịa karịrị afọ 6.

Ngwakọta na ụdị ntọhapụ

n'ime karama dị milimita 10 (100 IU / ml), na mkpọ nke kaadiboodu 1 karama ma ọ bụ na katọn nke 3 ml, na ngwugwu nke blister pack 5 katrized, na mkpọ nke kaadiboodu 1 blister pack, ma ọ bụ 1 katrized nke 3 ml na sisti ugwo OptiKlik ", N'ime usoro nke kaadiboodu usoro sistemụ.

Sing na-egbu insulin glargine na usoro onunu ogwu

Insulin glargine ka abanye n'ime subcutaneous abụba nke ubu, afọ ma ọ bụ apata ụkwụ, otu oge kwa ụbọchị n'otu oge. Site na nchịkwa ọhụụ ọ bụla, saịtị ịgba ntụtụ kwesịrị ịme ọzọ na mpaghara akwadoro. A na-edobe oge ehihie na ọgwụ a na-elekọta ya n’otu n’otu. N'ime ndị ọrịa nwere ụdị ọrịa shuga abụọ nke mellitus, a ga-eji ọgwụ ahụ mee ihe n'ụdị monotherapy, yana yana ọgwụ hypoglycemic ndị ọzọ.
Nlekọta intravenous nke ọgwụ a na-emebu, nke ezubere maka nchịkwa subcutaneous, nwere ike ibute oke hypoglycemia. Ekwesighi inye insulin glargine intravenia, ebe oge ihe ga-abụ site na ntinye ya na anụ ahụ dị n'okpuru ala.
Mgbe ị na-eji insulin nke glargine insulin na-eji insulin emegharị obere oge ma ọ bụ ogologo oge, ị nwere ike ịgbanwe ọgwụ kwa ụbọchị nke insal insal basal na usoro ọgwụgwọ antidiabetic (nchịkwa nchịkwa na ojiji nke insulins dị mkpụmkpụ ma ọ bụ usoro nke hypoglycemic na-ahụ maka nchịkwa ọnụ). Mgbe ị na-ebufe ndị ọrịa site na nchịkwa insulin-isofan ugboro abụọ kwa ụbọchị na nchịkwa nke insulin glargine otu ugboro kwa ụbọchị, iji belata ihe egwu abalị na ụtụtụ hypoglycemia, ọ dị mkpa iji belata ọgwụ mbụ nke insulin basal site na 20-30% na izu mbụ nke ọgwụgwọ. O nwere ike ịbawanye usoro nke insulin na-eme ihe n'oge oge mbelata dose, mgbe ahụ, a ga-edozigharị usoro usoro usoro ahụ n'otu n'otu. Mgbe ị na-agbanye insulin glargine yana n'izu ndị mbụ mgbe ọ nwụsịrị, ọ dị mkpa iji nlezianya nyochaa ọkwa nke glucose dị n'ọbara.
Site na usoro nhazi metabolic ka mma yana mmụba nke insulin na-abawanye, enwere ike ịchọ ndozi ọzọ. Enwere ike ịchọ nhazi mgbanwe nke dose, dịka ọmụmaatụ, mgbe ị na-agbanwe ụdị ndụ onye ọrịa, oke ahụ, oge nke nchịkwa ọgwụ, yana ọnọdụ ndị ọzọ na-abawanye n'ihe ize ndụ nke ịmalite hypoglycemia.
Insulin glargine abụghị ọgwụ ịhọrọ maka ịgwọ ọrịa ketoacidosis na-arịa ọrịa shuga (na nke a, a na-atụ aro itinye insulin nke na-adị obere oge).
Ahụmịhe nke iji ọgwụ ahụ nwere oke, yabụ ọ nweghị ụzọ ị ga-esi nyochaa nchekwa ya na arụmọrụ ya na ọgwụgwọ ndị ọrịa nwere ezumike arụ ọrụ ezumike ma ọ bụ ọrụ hepatic. N'ime ndị ọrịa nwere nsogbu akụrụngwa ezumike, mkpa insulin nwere ike belata n'ihi ike ọgwụgwụ nke usoro ezumike ya. N'ime ndị ọrịa agadi, ịbawanye njọ na ọrụ akụrụ nwere ike ime ka mbelata insulin chọrọ. N'ime ndị ọrịa nwere nnukwu mmeju nke ọnọdụ imeju, enwere ike belata mkpa nke insulin n'ihi mbelata ikike biotransformation nke insulin na gluconeogenesis. Ọ bụrụ na ọkwa glucose ọbara adịghị arụ ọrụ, ọ bụrụ na enwere ọchịchọ ịmalite hyper- ma ọ bụ hypoglycemia, tupu ịhazighaa usoro ọgwụ ọ dị, ọ dị mkpa ịlele usoro nke injections subcutaneous n'ụzọ ziri ezi, izu oke nke ntinye na usoro ọgwụgwọ edepụtara na ebe nchịkwa ọgwụ, na-eburu n'uche ihe niile dabara na nsogbu ahụ.
Profaịlụ nke insulin etinyere nwere mmetụta na oge mmepe nke hypoglycemia, yabụ enwere ike ịgbanwe ya na mgbanwe na usoro ọgwụgwọ. N'ihi mmụba nke oge ọ na-ewe maka nchịkwa nke insulin na-eme ogologo oge mgbe ị na-eji Lantus, ihe ize ndụ nke ịmalite ịrịa hypoglycemia n'abalị na-ebelata, ebe n'ụtụtụ a, ihe egwu a nwere ike ịba ụba. Ndị ọrịa nwere hypoglycemia nwere ike dị mkpa (nnwale siri ike nke akwara ụbụrụ ma ọ bụ akwara akwara, protinerative retinopathy) chọrọ usoro nchekwa pụrụ iche, a na-atụ aro ka ọ gbasie ike ịchịkwa ọkwa glucose ọbara. Ndị ọrịa kwesịrị ịma banyere ọnọdụ nke ike hypoglycemia nwere ike belata akpọ, mgbanwe ma ọ bụ anọghị, gụnyere ndị ọrịa nwere usoro iwu nchịkwa glucose ọbara, ndị ọrịa agadi, ndị ọrịa hypoglycemia ji nwayọọ nwayọọ na-etolite, ndị ọrịa nwere ogologo oge nke ọrịa shuga mellitus, ndị ọrịa nwere neuropathy, ndị ọrịa nwere nsogbu uche, ndị ọrịa na - enweta ọgwụ concomitant na ọgwụ ndị ọzọ. Ọnọdụ ndị a nwere ike ibute ọrịa hypoglycemia (ya na enweghị mmụọ) tupu onye ọrịa achọpụta na ọ na-etolite hypoglycemia.
Ọ dị mkpa iburu n'uche ohere a na-enwekarị hypoglycemia (ọkachasị n'abalị) mgbe ị na-achọpụta mbelata ma ọ bụ usoro glycosylated hemoglobin.
Nrube isi na nri ndị ọrịa, nri, usoro ị doụ mmiri, iji ọgwụ kwesịrị ekwesị, ịchịkwa ihe ịrịba ama nke hypoglycemia na-atụnye ụtụ dị ukwuu n'ihe ize ndụ nke hypoglycemia. Ihe ndị na - eme ka ịbawanye ụba nke hypoglycemia chọrọ nlezianya nlezianya, n'ihi na ha nwere ike iduga ịchọrọ ịmegharị ọgwụ ahụ. Ihe ndị a gụnyere: mmụba na mmetụta insulin (ebe ọ na - ewepụ ihe ndị na - akpata nrụgide), mgbanwe n'ọnọdụ insulin nchịkwa, ihe a na - ahụkarị, ogologo oge ma ọ bụ ịba ụba nke mmega ahụ, imebi nri na nri, ọrịa ndị na - esonyere afọ ọsịsa, vomiting, nri nri, skul, endocrine ọgba aghara (ezughi oke nke adrenal cortex ma ọ bụ adenohypophysis, hypothyroidism), ị alcoholụ mmanya, ojiji ihe ụfọdụ ọgwụ ndị ọzọ.
A chọkwuru nchịkwa nke ịba ụba nke glucose n'ọbara maka ọrịa ndị dị n'ọbara. N'ọtụtụ ọnọdụ ndị dị otú ahụ, nyocha urinal maka ọnụnọ nke ozu ketone na imeziwanye usoro usoro usoro ị theụ ọgwụ ahụ dị mkpa. Oge ụfọdụ na-abawanye mkpa insulin. Ndị ọrịa nwere ụdị 1 nke ọrịa shuga kwesịrị ịga n'ihu na-a regularụ carbohydrates obere obere, n'agbanyeghị eziokwu na ha enweghị ike iri nri ma ọ bụ nwee ike iri nri naanị obere obere (yana ọgbụgbọ na ihe yiri ya). Ndị ọrịa dị otú a agaghị akwụsị ikwusi insulin kpamkpam.

Ime na lactation

Emegoro Teratogenicity na ọmụmụ omumu na Himalayan rabbits na oke nwere insulin subkianeous (insulin glargine nkịtị nke mmadụ). Enyere insulin n'ime insulin n'oge organogenesis na usoro nke 0.072 mg / kg kwa ụbọchị (ihe dị ka ugboro abụọ a na-atụ aro ịmalite ụmụ mmadụ na nchịkwa subcutaneous). Enyere ụmụ oke iji insulin tupu oge na mgbe etolite, n'oge ime ime nwere nke ruru 0.36 mg / n'arọ kwa ụbọchị (ihe dị ka ugboro asaa ka akwadoro ịmalite maka ụmụ mmadụ nwere njikwa subcutaneous). Na mkpokọta, nsonaazụ insulin na insulin glargine nkịtị na anụmanụ ndị a adịghị iche. Onweghi mmebi nke etolite etolite n’oge ọmụmụ ka amarapụtara.
Maka ndị ọrịa nwere ọrịa shuga ma ọ bụ nwee ọrịa shuga na mbụ, ọ dị mkpa ịhazi usoro metabolic nke ọma n'oge afọ ime. N’ime oge izizi nke ịtụrụ ime, mkpa insulin nwere ike belata ma mụbaa n’ime oge nke abụọ na nke atọ. Mkpa insulin ozugbo a mụsịrị nwa na-agbada ngwa ngwa (ihe ize ndụ nke hypoglycemia na-abawanye). Ya mere, n’oge a, ọ dị mkpa iji nlezianya nyochaa oke nke glucose na ọbara.
N'oge afọ ime, ọ dị mkpa iji nlezianya jiri ọgwụ ahụ (n'ime ụmụ nwanyị dị ime, edubeghị nnyocha ụlọ ọgwụ na-achịkwa nke ọma).
Jiri ogwu jiri anya na-a breastụ ara (a maghị ma insulin glargine dị na mmiri ara nke ụmụ nwanyị). Enwere ike ịchọ mmezi nke nri na insulin dolle regimen na ụmụ nwanyị nọọsụ.

Nsonaazụ insulin glargine dị

Hypoglycemia bụ ihe na-akachasị akpata n'ihi ị insụ insulin, o nwere ike ime mgbe ị na-eji insulin dị elu karịa nke a chọrọ ya. Ọrịa hypoglycemia siri ike (nke na-agbadakarị) nwere ike ibute mmebi nke sistemụ ụjọ. Ọrịa hypoglycemia ogologo oge na nke siri ike nwere ike itinye ndụ ndị ọrịa n'ihe ize ndụ. Ihe mgbaàmà nke usoro nchịkwa adrenergic (na nzaghachi hypoglycemia, ịgbalite sistemu nke usoro ụjọ) na-apụtakarị tupu nsogbu nke sistem na psyche n'oge hypoglycemia (ọrịa nkwarụ, ọnwụ nke mmụọ ma ọ bụ nke nwere mgbede): iwe, agụụ, tachycardia, ọsụsọ oyi (ha na-ekwupụta ya karịa hypoglycemia dị mkpa ma na-eto ngwa ngwa).
Dịka ọ dị na nhazi insulin ndị ọzọ, igbu oge n’ime mkpụkọ insulin na lipodystrophy nwere ike ịmalite n’ebe a na-agba ya. N'oge ọnwụnwa nke ụlọ ọgwụ na iji insulin glargine dị na 1 - 2% nke ndị ọrịa, achọpụtara lipodystrophy, na lipoatrophy bụ ihe a na-ahụghị. Mgbanwe nke oge ọ bụla na-abanye n'ime ahụ nke akwadoro maka nchịkwa ọgwụ subcutaneous nwere ike belata ogo nke mmetụta a na-emetụta ma ọ bụ gbochie ihe omume ya.
Ngosipụta akara nke usoro glucose dị n'ọbara nwere ike ibute nkwarụ nwa oge n'ihi mgbanwe na ntanye anya na oghere anya na anụ ahụ. Alizationhazi oge ịba ụba nke glucose ọbara na -ewepụta ihe ọghọm nke inwe ọrịa mamịrị retinopathy. Ojiji nke insulin, nke na-esokwa mgbanwe dị ukwuu na ọkwa glucose ọbara, nwere ike ime ka mbibi nwa oge na-arịa ọrịa retinopathy. N'ime ndị ọrịa nwere ọrịa retinopathy na-abawanye uru, ọkachasị ndị na-anaghị anata ọgwụgwọ photocoagulation, nnukwu hypoglycemia nwere ike ibute ọhụụ na-adịghị adị.
N'oge nnwale ụlọ ọgwụ na iji insulin glargine dị na 3 ruo 4% nke ndị ọrịa, a hụrụ mmeghachi omume na saịtị ahụ (ncha ọbara ọbara, itching, mgbu, urticaria, mbufụt, edema). Ọtụtụ obere mmeghachi omume na-edozikarị n'ime ụbọchị ole na ole - ọtụtụ izu. N’oge na-adịbeghị anya, insulin (gụnyere insulin glargine) ma ọ bụ ndị na-arịa ọrịa na-etolite mmeghachi ahụ nfụkasị ngwa ngwa (mmeghachi ahụ anụ ahụ, bronchospasm, angioedema, hypotension art ma ọ bụ ujo), nke na-eyi ndụ onye ọrịa egwu.
Iji insulin eme ihe nwere ike ime ka e guzobe ọgwụ mgbochi ya. N'oge omumu ihe omumu nke otutu ndi oria natara insulin glargine na insulin-isophan, a huru otiti ndi mmadu n’agha megharia insulin nke mmadu n’otu oge. Mgbe ụfọdụ, ka ọnụnọ ọgwụ na-egbochi insulin, ọ dị mkpa imeghari usoro iji wepu mmụba nke ịmalite hyper - ma ọ bụ hypoglycemia. N'ọnọdụ ụfọdụ, insulin nwere ike ibute oge na mwepu sodium na ọzịza, ọkachasị ma ọ bụrụ na ị insụ insulin na-eduga n'ịhazi usoro metabolic nke ọma, bụ nke ezughi oke.

Mmekọrịta nke insulin glargine na ihe ndị ọzọ

Insulin glargine nwere ọgwụ ọgwụ dabara na ọgwụ ndị ọzọ. Agaghị agwakọta insulin glargine na insulins ndị ọzọ ma ọ bụ dilis (ịgbaze ma ọ bụ ịgwakọta nwere ike ịgbanwe profaịlụ insulin glargine n'oge, yana ịgwakọta insulins ndị ọzọ nwere ike ibute mmiri).Drugsfọdụ ọgwụ na-arụ ọrụ na metabolism; nke a nwere ike ịchọ mgbanwe nke insulin glargine. Nkwadebe ndị na-eme ka mmetụta inspoglycemic dị na insulin na-eme ka a na-enwekwa atụmanya na mmepe nke hypoglycemia gụnyere angiotensin na-atụgharị enzyme inhibitors, hypoglycemic oral, fibrates, na-enupụ isi, fluoxetine, pentoxifylline, monoamine oxidase inhibitors, ọgwụ propoxyphene, sulfani. Ọwọrọ nke na - emebi ike hypoglycemic mmetụta nke insulin gụnyere Danazol, glucocorticoids, diazoxide, glucagon, diuretics, isoniazid, gestagens, estrogens, somatotropin, homonụ thyroid, sympathomimetics (salbutamol, epinephrine, terbutaline inhibido), ihe nchedo antiolazinase Clonidine, beta-igbochi, mmanya, lithium salts nwere ike ime ka ike gwụ ma welie mmetụta hypoglycemic nke insulin. Pentamidine nwere ike ibute hypoglycemia, mgbe ụfọdụ hyperglycemia na-esochi. N'okpuru mmetụta nke ọgwụ ọjọọ nwere mmetụta ọmịiko (clonidine, beta-blockers, reserpine, guanfacine), akara nke adrenergic counter-regulation nwere ike ghara ịdị ma ọ bụ belata.

Dodoụbiga ya ókè

N'ihi ịba insulin ókè, glargine na-amalite ịrịa hypoglycemia dị oké njọ na oge ụfọdụ, nke na-eyi ndụ onye ọrịa egwu. Ọgwụ: hypoglycemia na-adịkarị ala site na ingestion nke carbohydrates ngwa ngwa digestible, ọ nwere ike ịdị mkpa ịgbanwe usoro onunu ogwu nke ọgwụ ahụ, mmega ahụ, nri, hypoglycemia siri ike, nke na-esonyere coma, nsogbu akwara ozi, ọdịdọ, chọrọ subcutaneous ma ọ bụ intramuscular management nke glucagon, intravenous management of Solution Enwere ike ịchọ ọgwụ were ogologo oge na nlekọta ahụike, ebe ọ bụ na ụlọ ọgwụ a na-ahụ anya nlọghachi nke hypoglycemia ga-ekwe omume.

Ojiji nke insulin ọgwụ glargine na-eme

A na-edobere dose ahụ n’otu n’otu. A na-elekọta ha s / c otu ugboro kwa ụbọchị, n'otu oge ahụ. Ekwesịrị itinye insulin glargine n'ime abụba dị n'okpuru nke afọ, ubu ma ọ bụ n'apata ụkwụ. saịtị injection kwesịrị iji usoro ọgwụgwọ ọgwụ ọ bụla ọzọ mee ihe. Na shuga na-arịa insulin na-akpata insulin (ụdị nke m) eji ọgwụ eme ihe dika insulin. Na ọrịa mellitus na-abụghị insulin na-arụ ọrụ (ụdị II) enwere ike iji ọgwụ ahụ mee ihe dị ka monotherapy, yana yana ọgwụ hypoglycemic ndị ọzọ. Mgbe ị na-ebufe onye ọrịa site na insulin na ogologo oge ma ọ bụ nke ime ihe na insulin glargine, ọ nwere ike ịdị mkpa iji dozie ọgwụ kwa ụbọchị nke insulin ahụ ma ọ bụ gbanwee ọgwụgwọ antidiabetic (usoro na usoro nchịkwa nke insulins dị mkpụmkpụ ma ọ bụ analogues ha, yana ọgwụ mgbochi antidiabetic ọnụ). nchịkwa nke insulin-isofan maka otu ntụtụ insulin glargine kwesịrị belata insulin insulin kwa ụbọchị site na 20-30% n'izu ndị mbụ nke ọgwụgwọ mmiri ọ drinkingụ drinkingụ iji belata oke ọrịa hypoglycemia n'abalị na n'ụtụtụ ụtụtụ. N'oge a, mbelata insulin insulin ga-akwụghachi ya ụgwọ site na mmụba nke usoro insulin dị mkpụmkpụ.

Mlọ ọgwụ

Isoro ndị na - anabata insulin na - emekọrịta ihe: ihe jikọtara ọnụ na insinlar glargine a kapịrị ọnụ na ndị na - anabata insulin na - akpachi anya, ọ na - enwe ike ịgbagha mmetụta ndu sitere na insulin.

Ọrụ kachasị mkpa nke insulin, ya mere insulin glargine, bụ nhazi nke metabolism metabolism. Insulin na analorọ ya na - ebelata glucose ọbara site na ime ka glucose na - eme ka anụ ahụ dịkwuo elu (ọkachasị akwara na akwara anụ ahụ), yana igbochi nguzobe nke imeju (gluconeogenesis). Insulin na-egbochi lipolysis adipocyte na proteolysis, ebe ha na-akwalite njikọta protein.

Ogologo oge nke insulin glargine na-arụ ọrụ metụtara oke belata ihe ọ na-eme, nke na-enye ohere iji ọgwụ ahụ otu ugboro n'ụbọchị. Mgbe nchịkwa nke sc, usoro mmalite ga - ebilite, ná nkezi, mgbe elekere elekere 1. Oge nkezi nke ime ihe bụ awa 24, kacha kacha bụ awa 29.

Mlọ ọgwụ

Ihe omumu ihe omumu banyere insulin glargine na insulin-isofan na obara obara n’ime ndi mmadu nwere nsogbu na ndi nwere oria oria mamellitus mgbe sc nke ogwu gha ekpughere obara di nwayọ nke ukwu, ya na enweghi nnabata nke insulin glargine ma oburu na insulin-isofan. .

Site na otu nlekọta SC nke Lantus otu ugboro n’ụbọchị, ngụkọta insulin glargine dị n’ọbara na-enweta mkpụrụ ụbọchị 2-4 ka ọ gbasasịrị nke mbụ.

Site na nchịkwa iv, ọkara ndụ insulin glargine na insulin nke mmadụ yiri.

N'ime mmadụ nwere abụba dị n'okpuru ala, insulin glargine na-ekpochapu nke ọma site na nkwụsị carbonxyl (C-terminus) nke agbụ B ka ọ bụrụ 21--Gly-insulin na 21 A -Gly-des-30 B -Thr-insulin. Na plasma, ma insulin glargine na-agbanweghi agbanwe yana ngwaahịa iberibe ya dị.

Usoro onunu ogwu na nhazi

S / c na abụba dị n'okpuru nke afọ, ubu ma ọ bụ apata ụkwụ, n'otu oge ahụ 1 oge kwa ụbọchị. Ebe ndị irighiri ahụ kwesịrị iji usoro ọgwụ dịgasị iche iche dochie usoro ọgwụ ọ bụla.

Na / na ntinye nke usoro a na-emebu, ebumnuche maka nchịkwa sc, nwere ike ibute mmepe nke hypoglycemia siri ike.

Ọ bụ n’otu n’otu ka ahọrọ usoro Lantus na oge ụbọchị iwebata ya. N'ime ndị ọrịa nwere ụdị ọrịa mellitus nke 2, enwere ike iji Lantus mee ihe dịka monotherapy yana yana ọgwụ hypoglycemic ndị ọzọ.

Ntughari site na ọgwụgwọ na ọgwụ hypoglycemic ndị ọzọ na Lantus. Mgbe ị na-eji usoro ọgwụgwọ insanten dochie ogologo oge ma ọ bụ ogologo ọgwụ insanten, ọ nwere ike ịdị mkpa iji dozie ọgwụ kwa ụbọchị nke ọgwụ basal, yana ọ ga-adị mkpa ịgbanwe ọgwụ mkpịsị mkpịsị odee (usoro na nchịkwa nchịkwa nke insulins dị mkpụmkpụ nke na-eji obere oge ma ọ bụ ọgwụ nje ha ma ọ bụ nke onunu). ) Mgbe ị na-ebufe ndị ọrịa ka ha nye insulin-isophan ugboro abụọ n’ụbọchị gaa n’otu nlekọta nlekọta nke Lantus iji belata ọghọm hypoglycemia n’abalị na n’isi ụtụtụ, belata insulin insulin nke izizi belata ka 20-30% n’ime izu ndị mbụ nke ọgwụgwọ. N’ime oge ịbelata oke, ị nwere ike iwelie insulin ọgwụ dị mkpụmkpụ, mgbe ahụ usoro nhazi usoro onunu ogwu aghaghi idozigharị n’otu n’otu.

Agaghị agwakọta Lantus na nhazi insulin ndị ọzọ ma ọ bụ dil. Mgbe agwakọta ma ọ bụ dilze, profaịlụ nke omume ya nwere ike ịgbanwe ka oge na-aga, na mgbakwunye, ịgwakọta na insulins ndị ọzọ nwere ike ibute mmiri.

Dị ka ọ dị na ọgwụ analogues ndị ọzọ nke insulin mmadụ, ndị ọrịa na-enweta ọgwụ ike dị ukwuu n'ihi ọnụnọ ọgwụ insulin na-ahụ maka mmadụ nwere ike ịnweta mmelite nke nzaghachi insulin mgbe ị na-agbanye Lantus.

Na usoro ịgbagharị na Lantus na izu mbụ ka emesịrị ya, a chọrọ nlezianya nyochaa glucose ọbara.

N'ihe banyere usoro mmezi nke metabolism yana mmụba na insulin na-esite na ya, ịgbatịkwu usoro usoro usoro onunu ogwu nwere ike ịdị mkpa. Enwere ike ịchọ nhazi mgbazinye, dịka ọmụmaatụ, mgbe ị na-agbanwe oke ahụ onye ọrịa, ụdị ndụ ya, oge ụbọchị maka nchịkwa ọgwụ, ma ọ bụ mgbe ọnọdụ ndị ọzọ bilitere na-eme ka atụmanya na mmepe hypo-ma ọ bụ hyperglycemia.

Ekwesighi iji ọgwụ a mee ya. Ogologo oge nke ihe nke Lantus bụ site na ntinye ya n’anụ arụ dị n’ime ala ahụ dị n’ime ala.

Ntụziaka pụrụ iche

Lantus abụghị ọgwụ ịhọrọ maka ọgwụgwọ nke ketoacidosis mamịrị. N'ụdị ndị a, a na-atụ aro maka nchịkwa insulin nke na-adị obere oge. N'ihi mmachi amamịghe Lantus, ọ gaghị enwe ike ịtụle arụmọrụ ya na nchekwa ọfụma n'ịgwọ ndị ọrịa nwere ọrụ imeju na-arụ ọrụ ma ọ bụ ndị ọrịa nwere nnukwu ọdịda ma ọ bụ nnukwu akụrụ. N'ime ndị ọrịa nwere nsogbu akụrụngwa ezumike, mkpa insulin nwere ike ibelata n'ihi ikelata usoro iwepụ ya. N'ime ndị ọrịa agadi, ịbawanye njọ na ọrụ akụrụ nwere ike ibute mbelata nke insulin chọrọ. N'ime ndị ọrịa nwere oke ịba ọcha n'anya, enwere ike belata mkpa nke insulin n'ihi mbelata ikike gluconeogenesis na biotransformation nke insulin. N'ihe banyere njikwa na-adịghị arụ ọrụ na ọkwa nke glucose n'ọbara, yana ọ bụrụ na enwere mmetụta nke mmepe hypo- ma ọ bụ hyperglycemia, tupu ịga n'ihu na ntụzi nke usoro usoro onunu ogwu, ọ dị mkpa ịlele izi ezi nke nrube isi na usoro ọgwụgwọ edepụtara, ebe nchịkwa nke ọgwụ na usoro nke nyocha nke ike. na-atụle ihe niile metụtara nsogbu ahụ.

Hypoglycemia. Oge mmepe nke hypoglycemia dabere na profaịlụ nke insulin ejiri mee ya, ya mere, nwere ike gbanwee site na mgbanwe na usoro ọgwụgwọ. N'ihi mmụba nke oge ọ na-ewe insulin na-eme ogologo oge ịbanye na ahụ mgbe ị na-eji Lantus, ohere nke ịmalite ịmịnye hypoglycemia na-ebelata, ebe n'ụtụtụ a, enwere ike ịmụba ihe a. Ndị ọrịa nwere ọrịa hypoglycemia nwere ike inwe nnukwu nsogbu gbasara ahụike, dịka ndị ọrịa nwere nnukwu akarị akwara akwara ma ọ bụ arịa ụbụrụ (ihe ọghọm nke ịmalite ọrịa obi na ọrịa ụbụrụ nke hypoglycemia), yana ndị ọrịa nwere ọrịa retinopathy na-abawanye uru, ọkachasị ma ọ bụrụ na ha anabataghị ọgwụgwọ photocoagulation (ihe egwu) ọhụhụ dị n’ọbara n’ihi hypoglycemia), a ga-akpachara anya maka iche, a na-atụkwa aro ka o mee ka nleba anya nke glucose ọbara. Ndị ọrịa kwesịrị ịma ọnọdụ nke ebumnuche hypoglycemia nwere ike gbanwee, kpọọlata okwu ma ọ bụ anọghị na ụfọdụ ndị dị ize ndụ. Otu ndị a gụnyere:

- ndị ọrịa amachasịla usoro nke glucose ọbara,

- ndi ọrịa nke hypoglycemia bidoro nwayọ,

- ndị agadi ọrịa,

- ndị ọrịa neuropathy,

- ndị ọrịa nwere ọria mamịrị ogologo oge,

- ndị ọrịa na - arịa ọrịa uche,

- ndị ọrịa na - anata ọgwụgwọ ọgwụ na ọgwụ ndị ọzọ (lee "Mmekọrịta").

Ọnọdụ ndị dị otú a nwere ike iduga mmepe nke nnukwu hypoglycemia (ya na enwere ike mwepu nke mmụọ) tupu onye ọrịa ahụ achọpụta na ọ na-etolite hypoglycemia.

N'ọnọdụ na-ahụ ka ọkwa ọbara haemoglobin nkịtị kwesịrị ma ọ bụ belatara, ọ dị mkpa iburu n'uche ohere nke ịmalite ịmị mkpụrụ nke hypoglycemia ugboro ugboro (ọkachasị n'abalị).

Nrube isi nke ndị ọrịa na usoro dosing, nri na nri, ojiji nke insulin na ịchịkwa mmalite nke mgbaàmà hypoglycemia na-atụnye ụtụ dị ukwuu na ihe ize ndụ nke hypoglycemia. Ihe ndị na - eme ka ịbawanye ụba nke hypoglycemia chọrọ nlebara anya kachasị anya, dịka nwere ike ime ka nhazi insulin gbanwee. Ihe ndị a gụnyere:

- mgbanwe nke ochicho insulin.

- ịbawanye ụba na insulin (dịka ọmụmaatụ, mgbe ọ na - ewepụ ihe ndị na - akpata nchekasị),

- arụ ọrụ na-adịghị ahụkebe, ụba ma ọ bụ ogologo oge,

- ọrịa na - esonye na vomiting, afọ ọsịsa,

- imebi nri na nri,

- nri mịrị amị

- ụfọdụ nsogbu endocrine na - agbanweghi agbanwe (dịka hypothyroidism, ezughi oke nke adenohypophysis ma ọ bụ cortex adrenal),

- ịcomụkọta ọnya na ọgwụ ndị ọzọ.

Ọrịa. N'ime ọrịa ndị a na-eme n'ọbara, a na-achọkwu nlebara anya nke glucose ọbara. N'ọtụtụ ọnọdụ, a na-eme nyocha maka ọnụnọ nke ozu ketone na mmamịrị, a na-achọkarị insulin dosing. Mkpa insulin na-abawanye. Ndị ọrịa nwere ọrịa shuga nke 1 kwesịrị ịga n'ihu na-a atụ obere carbohydrates, ọ bụrụgodi na ha nwere ike iri naanị obere nri ma ọ bụ enweghị ike iri nri ma ọ bụrụ na ha nwere vomiting, wdg. Ndị ọrịa a ekwesịghị ikwusi insulin kpamkpam.

Nsonaazụ nke ọgwụ glargine ọgwụ

Esonyere nsonaazụ na metabolism metabolism: Ọnọdụ hypoglycemic (tachycardia, sweating ụba, pallor, agụụ, oke iwe, ọrịa ọgbụgba, ọgba aghara ma ọ bụ ọnwụ nke mmụọ). Mmeghachi omume mpaghara: lipodystrophy (1-2%), ịmịkpọ nke anụ ahụ, itching, ọzịza na ebe ịgba ahụ. Mmeghachi omume nfụkasị ahụ: urticaria, ụbụrụ Quincke, bronchospasm, hypotension art art, ujo. Ndị ọzọ: njehie dị n’ọria, na -anagide ọrịa shuga (na-enwe mgbanwe dị ala n’arụ ọbara), edema A na-edozi ọtụtụ mmeghachi omume n’ebe a na-agba ntụtụ n’ime ụbọchị ole na ole (ọtụtụ izu) site na mmalite ọgwụgwọ.

Mkparịta ụka ọgwụ ọjọọ insulin glargine

Mmetụta hypoglycemic nke insulin na-eme ka ọ dịkwuo mma site na MAO inhibitors, ọgwụ a na-akpọ hypoglycemic ọgwụ, ACE inhibitors, fibrates, biyayyapyramides, fluoxetine, pentoxifylline, propoxyphene, salicylates na sulfanilamides. A na-ebelata hypoglycemic mmetụta nke insulin site na Danazole, gluogens glucose, glucogens glucose, glucogens glucose, glucogens glucose, glucogens glucose, glucogens, glucose, glucose, glucose, glucose, mmụọ , somatotropin, sympathomimetics na homonụ thyroid. Clonidine, β-blockers, lithium salts na ethanol nwere ike ịkwalite ma mee ka ike gwụ hypoglycemic mmetụta nke insulin.Pentamidine nwere ike ibute hypoglycemia, nke n'ọnọdụ ụfọdụ na-ebute hyperglycemia. Undera n'okpuru ọgwụ nke ọgwụ ọmịiko, dịka β-blockers, clonidine, akara guanfacin na reserpup. enwere ike ibelata adrenergic counterregulation ma ọ bụ anọghị ya.