Ua tsaug rau ntau cov kev tshawb fawb thiab cov kws kev lag luam, tam sim no muaj cov tshuaj zoo tiv thaiv ntshav qab zib. Nrog kev pab ntawm qee yam tshuaj, koj tuaj yeem tswj cov qib insulin hauv cov ntshav.
Ib qho chaw tshwj xeeb ntawm cov tshuaj yog nyob ntawm cov tshuaj niaj hnub los hloov cov tshuaj insulin sab hauv. Insulin Glargin tuaj yeem siv ua cov cuab yeej ywj pheej, qee zaum nws muaj nyob hauv lwm cov tshuaj, piv txwv li, Lantus lossis Solostar. Cov tom kawg muaj txog 70% cov tshuaj insulin, Lantus - 80%.
Kev kawm txog qhov tshwm sim ntawm cov tshuaj no thaum cev xeeb tub tsis tau ua, yog li ntawd, tsuas yog tus kws kho mob uas tuaj koom yuav tsum txiav txim siab txog kev pub nkag mus. Tsis tas li, yuav tsum tau muab cov nyiaj pab nrog ceev faj rau cov menyuam yaus hnub nyoog qis dua xya xyoo.
Cov ntsiab lus ntawm ntshav qab zib
Mob ntshav qab zib yog ib qho kab mob pancreatic los ntawm qhov uas tsis muaj cov tshuaj lom neeg insulin. Nrog tus kab mob no, kev ua haujlwm ntawm ntau cov kabmob thiab cov kabmob ntawm lub cev tau cuam tshuam, vim tias muaj kev hloov pauv hauv kev muaj nyiaj hauv metabolic.
Hauv 90% ntawm cov neeg mob, tus kabmob tsis cuam tshuam nrog cov insulin deficiency, raws li txoj cai, cov ntshav qabzib no yog rau npe rau cov neeg rog. 10% ntawm cov neeg muaj mob cuam tshuam nrog cov qog ntawm cov piam thaj thiab insulin, uas yog vim yog pathology ntawm tus txiav
Muaj ntau yam laj thawj uas tuaj yeem dhau los ua tus kab mob:
- kev tshuaj ntsuam genetic predisposition
- kev cuam tshuam ntawm lub kaw lus autoimmune,
- kev tsis zoo uas cuam tshuam nrog kev rog dhau thiab lwm tus.
Lub kaw lus autoimmune tiv thaiv lub cev los ntawm ntau yam kabmob sab hauv thiab sab nraud, kab mob thiab kabmob sib kis. Qhov no suav nrog ob lub hlwb thiab tus kheej txawv teb chaws uas muaj teeb meem loj.
Cov tshuaj niaj hnub tsis paub yog vim li cas qee lub sijhawm cov kab mob autoimmune yog qhov yuam kev thiab pib noj cov leeg nqaij thiab cov hlwb rau lub teb chaws, sim tua lawv, ua rau cov tshuaj tiv thaiv tshwj xeeb.
Raws li txoj cai, qhov kev rhuav tshem no tau ua tiav, thiab cov cell uas tau dim ntawm kev tshem tawm pib tsim cov tshuaj hormones, suav nrog insulin, hauv hom nrawm. Tus txheej txheem no yuav siv qee lub sijhawm, tom qab ntawd muaj lub sijhawm thaum lub ntim ntawm cov tshuaj insulin pib poob, uas txhais tau hais tias theem ntawm cov piam thaj nce, uas tsis tuaj yeem tawg.
Cov cim qhia thib ob ntawm ntshav qab zib:
- pancreatic kab mob, xws li pancreatitis,
- kev ntshaus siab, feem ntau diffuse goiter,
- kev siv cov tshuaj hormonal lossis cov tshuaj lom kho tsis tu ncua los kho lwm yam kab mob.
Txawm qhov twg ua kom mob ntshav qab zib, cov tshuab ntawm cov kabmob tseem tsis hloov pauv. Vim tias tsis muaj cov tshuaj insulin, lub cev tsis nqus cov piam thaj thiab tsis tuaj yeem sau nws hauv cov nqaij thiab lub siab. Qhov ntau ntawm cov piam thaj dawb pom, nws yog thauj nrog ntshav thiab ntxuav tag nrho cov plab hnyuv siab raum, ua rau muaj mob loj rau lawv.
Cov piam thaj yog ib qho ntawm cov neeg xa khoom ntawm lub zog, yog li nws qhov tsis muaj peev xwm feem ntau them los ntawm lwm yam. Hauv qhov no, lub cev pib ua cov rog, xav tias lawv yog qhov chaw ntawm lub zog.
Qhov "zom plab zom mov" no ntawm cov rog yog muaj cov paib ntau hauv cov zaub mov, uas tsis muaj txoj hauv kev tshem tawm ntawm lub cev.
Cov enzymes uas tsim los zom cov zaub mov thaum kawg zom cov txiav, ua rau muaj mob ntawm cov mob, uas nrog cov tsos mob heev.
Cov yam ntxwv ntawm cov tshuaj
Lub hauv paus ntsiab lus ntawm kev ua ntawm insulin, nws txoj haujlwm tseem ceeb, suav nrog Glargin, yog tswj hwm kev ntshav qabzib. Cov Insulin Lantus ua kom nrawm ntxiv rau cov piam thaj los ntawm cov leeg nqaij thiab adipose cov nqaij, yog li ntawd, ntshav plasma suab thaj txo tsawg. Cov tshuaj no kuj tseem ua rau cov neeg ntshav qab zib qis hauv lub siab.
Cov tshuaj no yog cov tshuaj analogues ntawm tib neeg insulin, uas tau txais los ntawm kev pom zoo ntawm Escherichia coli kab mob DNA. Nws yog tus cwj pwm los ntawm kev qis qis hauv qhov nruab nrab tsis sib xws.
Nws khi rau cov kab mob insulin thiab kho kom zoo ib qho bioeffect zoo ib yam li sab hauv (endogenous) insulin.
Muaj kev hloov kho ntawm cov metabolism hauv qabzib. Cov tshuaj thiab nws cov analogues txo cov ntshav qab zib, ua kom cov ntshav qabzib los ntawm cov ntaub so ntswg (tshwj xeeb tshaj yog cov ntaub so ntswg adipose thiab cov leeg), thiab tseem muaj kev cuam tshuam rau kev tsim cov piam thaj hauv lub siab. Cov tshuaj Insulin inhibits proteolysis thiab lipolysis, thaum ua kom cov protein synthesis zoo.
Tom qab subcutaneous tswj hwm ntawm cov tshuaj, cov nyhuv yuav pom tau tom qab kwv yees li 40-60 feeb. Raws li txoj cai, qhov kev ua yog pom nyob rau 24 teev, qhov siab tshaj plaws ntawm 29 teev. Nrog txoj kev txhaj tshuaj ib zaug subcutaneous, cov tshuaj nyob rau hauv cov ntshav yog pom tom qab 2-4 hnub.
Cov tshuaj Insulin Glargin Lantus tshuaj yaj tag yog vim qhov nruab nrab acidic tshwj xeeb, thiab nrog kev tswj hwm subcutaneous, cov kua qaub yog neutralized thiab microprecipitate yog tsim, los ntawm cov tshuaj no tso tawm me me hauv lub sijhawm.
Hauv cov ntshav plasma, tsis muaj qhov txawv txav ntawm lub ntim ntawm cov tshuaj insulin, txhua yam tshwm sim ntseeg tau. Cov yeeb tshuaj tshwj xeeb muab txhais tau tias ua lub sijhawm ntev.
Insulin Glargin 300 muaj cov teebmeem zoo ntawm cov tshuaj pharmacokinetic thiab pharmacodynamic. Qhov hloov pauv no tuaj yeem pom zoo raws li basal insulin hauv cov neeg mob uas muaj hom 1 thiab ntshav qab zib hom 2.
Yog tias koj siv Insulin Glargin 300 IU / ml, qhov no qhib lub sijhawm zoo rau kev kho mob txaus rau cov neeg muaj ntshav qab zib.
Cov lus qhia rau kev siv tshuaj
Cov koob tshuaj ntawm cov tshuaj tau sau tseg ib tus zuj zus. Cov tshuaj yog muab tshuaj subcutaneously 1 zaug hauv ib hnub nyob rau tib lub sijhawm. Cov cheeb tsam ntawm kev taw qhia tuaj yeem yog:
- subcutaneous rog lub cev ntawm lub plab mog,
- ncej puab
- xwb pwg.
M
Noj rau kev txhaj tshuaj yuav tsum muaj txoj kev hloov ua ke nrog txhua qhov kev qhia ntawm cov tshuaj.
Hauv ntshav qab zib hom 1, cov tshuaj yog kws kho muab cov tshuaj insulin tseem ceeb. Ntawm ntshav qab zib hom 2, nws yog siv los kho mob lossis siv nrog lwm tus neeg mob ntshav qab zib.
Yog hais tias tus neeg mob tau hloov los ntawm nruab nrab lossis ntev ua yeeb yam insulin rau Insulin Glargin, tom qab ntawd yuav tsum kho qhov tshuaj ntawm cov tshuaj insulin ib hnub lossis hloov pauv kev kho mob kom tsim nyog.
Thaum tus neeg mob hloov mus ntawm insulin-isophan mus rau ib qho kev txhaj tshuaj, nws yog qhov yuav tsum tau txo qis txhua hnub ntawm kev noj tshuaj basal insulin los ntawm ib feem peb hauv thawj lub lim tiam ntawm kev kho mob. Qhov no yog qhov tsim nyog los txo cov kev pheej hmoo ntawm thaum tsaus ntuj hypoglycemia. Nyob rau lub sijhawm no, kev txo qis rau hauv lub cev tuaj yeem txiav txim los ntawm qhov nce ntawm cov lej ntawm lub cev luv luv.
Sab sij huam
Kev mob ntshav qab zib yog ib qho kev tsis zoo ntau ntawm cov txheej txheem, xws li kev kho tshuaj insulin, nws zoo li yog tias cov koob tshuaj ntawm cov tshuaj insulin ntau dua qhov piv rau cov kev xav tau tiag tiag. Vim tias siv tshuaj tsis raug cai, ib tus neeg yuav pib muaj kev mob ntshav qab zib, uas feem ntau ua rau lub cev tsis ua haujlwm ntawm lub paj hlwb.
Neuropsychiatric ntshawv siab vim yog lub qog ntshav qab zib, raws li txoj cai, yog dhau los ntawm cov tsos mob ntawm adrenergic counterregulation:
- kev tshaib kev nqhis
- txob taus
- tachycardia.
Cov kev hloov pauv ntau nyob hauv kev tswj hwm ntawm cov ntshav qab zib feem ntau ua rau lub ntsej muag pom kev tsis zoo vim qhov hloov ntawm cov nqaij mos thiab qhov nruab nrab ntawm lub lens ntawm lub qhov muag. Lub caij nyoog ntev li ib txwm ua ntawm cov piam thaj hauv ntshav yuav txo qis qhov kev pheej hmoo ntawm kev tsim muaj ntshav qab zib retinopathy.
Cov tshuaj tiv thaiv hauv zos hauv thaj chaw txhaj tshuaj thiab kev fab tshuaj tsis haum tuaj yeem tshwm sim:
- liab
- kev mob
- khaus
- urticaria
- o tuaj.
Feem ntau cov kev tshwm sim me me hauv thaj tsam ntawm kev siv tshuaj insulin feem ntau ploj mus li ntawm ob peb lub lis piam feem ntau. Kev tsis haum lub cev tsis haum rau insulin tsim muaj qee yam.
Xws li cov tshuaj rau insulin lossis excipients tuaj yeem tshwm sim los ntawm kev txhim kho ntawm cov tawv nqaij kev tsis haum xeeb. Ntxiv rau, cov hauv qab no yog qhov yuav tshwm sim:
- angioedema,
- bronchospasm
- arterial hypotension lossis poob siab.
Txhua qhov kev ua txhaum no tuaj yeem tsim kev puas tsuaj rau tus neeg lub neej.
Qee zaum muaj cov tshuaj tiv thaiv rau cov tshuaj insulin xav tau ib qho kev hloov pauv hauv kev txiav tshuaj txhawm rau tshem tawm cov nyiam ntshav cag- lossis ntshav qog ntshav qab zib. Tsis tas li ntawd, cov tshuaj insulin tuaj yeem ua rau ncua sij hawm nyob hauv kev tshem tawm cov ntsev.
Raws li qhov tshwm sim, edema tshwm sim, tshwj xeeb tshaj yog yog hais tias cov tshuaj insulin ua rau cov kev cai zoo dua ntawm cov kev ua haujlwm ntawm cov metabolism.
Yeeb Tshuaj Sib Raug
Cov tshuaj tsis sib xws nrog lwm cov kev daws teeb meem. Nws tsis tas yuav tsum tau muab sib xyaw nrog lwm yam khoom los yog diluted.
Ntau yam tshuaj cuam tshuam rau cov metabolism hauv cov piam thaj, uas xav kom hloov koob. Cov tshuaj no suav nrog:
- cov tshuaj hypoglycemic qhov ncauj,
- ACE inhibitors
- disopyramids
- fibrates
- fluoxetine,
- MAO inhibitors
- pentoxifylline
- propoxyphene
- salicylates,
- tshuaj sulfa.
Txhais tau tias tuaj yeem txo qhov qis hypoglycemic nyhuv ntawm insulin suav nrog:
- tshuaj kho mob
- estrogens
- isoniazid
- glucocorticoids,
- danazol
- diazoxide
- glucagon,
- clozapine.
- txawj ntse
- kev loj hlob lawm,
- cov thyroid hormones,
- epinephrine
- salbutamol,
- terbutaline
- protease inhibitors
- olanzapine.
Yuav tuaj yeem ua kom tsis muaj zog thiab nce ntawm cov nyhuv hypoglycemic ntawm insulin:
- beta blockers,
- clonidine
- lithium ntsev
- cawv
Kev xaiv insulin
Yog tias peb piv rau pharmacokinetics ntawm cov tshuaj hauv cov kev xav, tom qab ntawd lawv cov kev teem caij ua kws kho mob tau qhia rau tus mob ntshav qab zib mellitus ntawm hom thawj thiab thib ob. Cov tshuaj insulins niaj hnub tsis pab txhawb rau qhov hnyav vim kev siv tshuaj. Tus naj npawb ntawm cov hnoos qeev ib zaug nyob hauv cov ntshav qab zib cov ntshav siab tseem ua kom tsawg.
Muaj qhov xav tau tsuas yog txhaj ib zaug ntawm cov tshuaj insulin txhua hnub. Rau cov neeg mob, nws yooj yim heev. Paub txog kev ua tau zoo ntawm tib neeg cov tshuaj insulin nrog metformin rau cov neeg mob ntshav qab zib hom 2. Kev tshawb fawb pom tau hais tias yuav txo qis qis thaum hmo ntuj hauv cov piam thaj. Yog li, normalization ntawm glycemia txhua hnub tau tiav.
Nws tsim nyog ceeb toom rau kev sib xyaw ua ke ntawm Insulin Glargin Lantus nrog qhov ncauj noj tshuaj kom txo cov ntshav qabzib hauv cov neeg mob uas tsis tuaj yeem them tus mob ntshav qab zib. Cov neeg mob zoo li no yuav tsum tau sau npe tshuaj Insulin Glargin hauv thawj theem mob.
Cov tshuaj no tuaj yeem pom zoo los ntawm endocrinologist lossis cov kws kho mob thoob ntiaj teb. Kev kho mob hnyav siv Lantus muab sijhawm los tswj glycemia rau cov neeg mob ntshav qab zib ntawm txhua pawg.
Nqi
Lub tsev muag tshuaj muaj cov tshuaj insulin npaj ntawm cov nqi sib txawv. Tus nqi nyob ntawm daim foos uas siv cov yeeb tshuaj Glargin Insulin tuaj. Tus nqi ntawm cov tshuaj yog los ntawm 2800 txog 4100 rubles
