INSULIN LANTUS: TUS NQI, TSHUAJ XYUAS, COV LUS QHIA RAU KEV SIV

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Lantus yog qhov yuav npaj cov insulin-txos qis dua. Qhov nquag ua haujlwm ntawm lub lantus yog cov tshuaj insulin glargine - ib qho khoom sib piv ntawm tib neeg cov tshuaj insulin, tsis zoo rau hauv ib puag ncig nruab nrab.

Hauv qhov kev npaj ua Lantus, cov tshuaj yeeb yaj kiab raug tshem tawm tag vim yog qhov tshwj xeeb acidic nruab nrab, thiab nrog kev tswj hwm subcutaneous, cov kua qaub yog neutralized thiab microprecipitates yog tsim, ntawm uas insulin glargine maj mam tso tawm hauv cov khoom me me. Yog li, yeej tsis muaj qhov txawv txav ntawm cov tshuaj insulin nyob rau hauv cov ntshav ntshav, tab sis pom qhov muaj qhov sib luag ntawm qhov xav txog lub sijhawm nkhaus nyob rau hauv. Micro precipitates muab cov tshuaj nrog lub sijhawm ntev dhau los.

Pharmacological kev ua

Qhov nquag ua haujlwm ntawm lub lantus muaj qhov sib txuam rau insulin receptors zoo ib yam li kev sib raug zoo rau tib neeg cov insulin. Nrog rau cov tshuaj insulin IGF-1, glargine khi 5-8 zaug muaj zog dua li cov neeg insulin, thiab nws cov metabolites tsis muaj zog.

Kev kho kom haum siab ntawm kev sib koom ua ke ntawm cov nquag muaj feem ua haujlwm ntawm insulin thiab nws cov metabolites hauv cov ntshav ntawm cov neeg mob ntshav qab zib hom ntshav qab zib mellitus qis dua qhov tsim nyog kom ntseeg tau tias ib nrab-qhov siab tshaj qhov txuas nrog IGF-1 receptors thiab txuas ntxiv ua rau cov kab mob mitogenic-proliferative catalyzed los ntawm cov receptor no.

Cov txheej txheem no ib txwm ua haujlwm los ntawm endogenous IGF-1, tab sis kev siv tshuaj tua kab mob ntawm cov tshuaj insulin uas siv hauv kev kho mob insulin muaj qis dua qhov kev siv tshuaj pharmacological uas tsim nyog los ua rau lub tshuab los ntawm IGF-1.

Lub luag haujlwm tseem ceeb ntawm ib qho insulin, suav nrog glargine, yog kev cai ntawm cov piam thaj glucose (carbohydrate metabolism). Cov tshuaj insulin lantus ua kom nrawm nrawm rau cov piam thaj los ntawm adipose thiab cov leeg nqaij, ua rau lub plasma ntshav qab zib tsawg dua. Tsis tas li, cov tshuaj no inhibits qhov ua haujlwm ntawm cov piam thaj hauv lub siab.

Cov tshuaj Insulin ua kom lub zog ntawm cov protein nyob hauv lub cev, thaum tab tom ua cov txheej txheem ntawm cov txheej txheem ntawm cov leeg (protein) thiab lipolysis hauv adipocytes.

Cov kev tshawb fawb soj ntsuam thiab chaw muag tshuaj tau qhia tias thaum muab tshuaj rau tib leeg, koob tshuaj insulin glargine thiab tib neeg cov tshuaj insulin sib npaug. Qhov kev ua ntawm insulin glargine hauv lub sijhawm, zoo li lwm tus neeg sawv cev ntawm qhov koob no, nyob ntawm kev ua haujlwm ntawm lub cev thiab ntau lwm yam.

Nrog rau kev tswj hwm subcutaneous, cov tshuaj Lantus yog maj mam nqus, kom nws siv tau ib hnub ib zaug. Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias muaj cov kev paub cuam tshuam kev hloov pauv txawv hauv qhov xwm ntawm kev ua ntawm insulin lub sijhawm. Cov kev tshawb fawb pom tau tias qhov kev hloov pauv ntawm cov ntshav qab zib ua kom tsis muaj qhov sib txawv loj thaum siv insulin glargine thiab insulin NPH.

Thaum siv Lantus hauv cov menyuam yaus thiab cov hluas, kev txhim kho ntawm nocturnal hypoglycemia pom muaj tsawg dua li ib pawg ntawm cov neeg mob tau txais NPH insulin.

Tsis zoo li insulin NPH, glargine vim kev nqus sai tsis ua rau lub ncov tom qab kev tswj hwm subcutaneous. Kev sib luag ntawm cov tshuaj hauv cov ntshav ntshav tau pom nyob rau ntawm 2 - 4 hnub ntawm kev kho nrog ib leeg ib leeg saib xyuas ib leeg. Ib nrab-lub neej ntawm insulin glargine thaum muab cov tshuaj sib haum rau tib lub sijhawm ntawm tib neeg cov tshuaj insulin.

Nrog cov metabolism hauv cov insulin glargine, ob lub tebchaw nquag M1 thiab M2 yog tsim. Kev txhaj tshuaj Subantaneous ntawm Lantus muaj lawv cov txiaj ntsig tseem ceeb vim yog raug rau M1, thiab M2 thiab insulin glargine tsis tau kuaj pom nyob hauv feem ntau ntawm cov ncauj lus.

Qhov ua tau zoo ntawm cov tshuaj Lantus yog ib yam hauv pawg sib txawv ntawm cov neeg mob. Hauv chav kawm ntawm cov kev tshawb fawb, pab pawg tau tsim los ntawm hnub nyoog thiab poj niam txiv neej, thiab cov nyhuv ntawm cov tshuaj insulin hauv lawv yog tib yam li cov pej xeem tseem ceeb (raws li kev ua tau zoo thiab kev nyab xeeb). Hauv cov menyuam yaus thiab tub ntxhais hluas, kev tshawb fawb pharmacokinetics tsis tau ua.

Kev ntsuas rau siv

Lantus yog tsim rau kev kho kab mob ntshav qab zib-insulin nyob rau cov neeg laus thiab menyuam yaus hnub nyoog tshaj li 6 xyoo.

Txoj kev ntawm daim ntawv thov.

Cov tshuaj yog siv rau kev coj ua subcutaneous, nws yog txwv tsis pub muab tso rau hauv txoj leeg ntshav. Cov txiaj ntsig ntev ntawm cov roj lantus yog txuam nrog nws cov lus qhia rau hauv cov rog subcutaneous.

Nws yog ib qho tseem ceeb kom tsis txhob hnov qab tias nrog kev tswj hwm ntawm cov tshuaj kho mob ib txwm muaj rau cov tshuaj, mob ntshav qab zib siab ntau tuaj yeem tsim kho. Thaum siv cov tshuaj no, yuav tsum muaj ntau txoj cai:

Thaum lub sijhawm kho mob, koj yuav tsum ua raws li qee yam kev ua neej thiab muab qhov hno kom raug.
Koj tuaj yeem nkag mus rau cov tshuaj hauv plab plab, ntxiv rau hauv tus ncej lossis cov leeg txhaws. Tsis muaj qhov sib txawv hauv qhov chaw kho mob nrog cov hau kev ntawm cov thawj coj.
Txhua qhov kev txhaj tshuaj yog zoo tshaj plaws nyob rau qhov chaw tshiab hauv thaj chaw pom zoo.
Koj tsis tuaj yeem yug Lantus lossis sib tov nws nrog lwm yam tshuaj.

Tsuas tshuaj

Lantus yog qhov ua yeeb yam ntev ntev, yog li nws yuav tsum tau txhaj tshuaj ib hnub ib zaug, zoo dua rau tib lub sijhawm. Kev muab tshuaj rau txhua tus neeg yuav tau xaiv ib tus zuj zus, ib yam li koob tshuaj thiab lub sijhawm siv.

Nws yog qhov tso cai muab tshuaj Lantus rau cov neeg mob uas kuaj pom tus mob ntshav qab zib hom 2 ua ke nrog cov tshuaj tiv thaiv kab mob rau kev tswj hwm qhov ncauj.

Nws yog ib qho tseem ceeb uas yuav tau txiav txim siab hais tias cov kev ntsuas ntawm kev ua ntawm cov tshuaj no yog txawv ntawm qhov kev ntsuas ntawm lwm cov tshuaj muaj cov tshuaj insulin.

Cov neeg laus cov laus yuav tsum tau hloov kho qhov koob tshuaj, vim tias lawv tuaj yeem txo qhov xav tau ntawm insulin vim tias muaj kev puas tsuaj hauv lub raum. Tsis tas li ntawd, nyob rau hauv cov neeg mob uas lub siab tsis ua haujlwm zoo, qhov xav tau ntawm insulin yuav poob qis. Qhov no yog vim qhov tseeb tias cov tshuaj insulin metabolism ua rau qeeb dua, thiab gluconeogenesis tseem txo qis.

Hloov mus rau Kab Ntsuas nrog lwm hom insulin

Yog tias ib tus neeg ua ntej siv tshuaj ntawm nruab nrab thiab siab ntev ntawm kev nqis tes ua, tom qab ntawd hloov mus rau Lantus, nws feem ntau yuav xav kho qhov tshuaj ntawm cov tshuaj inulin, nrog rau kev tshuaj xyuas cov kev kho mob.

Txo qhov kev pheej hmoo ntawm cov ntshav qog ntshav thaum sawv ntxov thiab thaum tsaus ntuj, thaum hloov pauv ob lub sijhawm ntawm kev siv tshuaj basal insulin (NPH) mus rau ib qho kev txhaj tshuaj (Lantus), qhov tshuaj ntawm cov tshuaj insal basal yuav tsum txo 20-30% thaum thawj nees nkaum hnub ntawm kev kho mob. Thiab cov koob tshuaj insulin muab nyob rau hauv kev txuas nrog ib pluas noj yuav tsum tau nce ntxiv me ntsis. Tom qab ob mus rau peb lub lis piam, kev hloov kho tshuaj yuav tsum tau nqa tawm ntawm tus kheej rau txhua tus neeg mob.

Yog tias tus neeg mob tau txais cov tshuaj tiv thaiv rau tib neeg cov tshuaj insulin, tom qab ntawd thaum siv Lantus, lub cev tau teb rau cov tshuaj insulin hloov pauv, uas tseem yuav xav tau kev tshuaj xyuas. Nws tseem yog qhov tsim nyog thaum hloov txoj kev ua neej, hloov lub cev qhov hnyav lossis lwm yam cuam tshuam rau xwm ntawm kev ua ntawm cov tshuaj.

Taw qhia

Cov tshuaj Lantus yuav tsum raug tswj hwm tsuas yog siv OptiPen Pro1 lossis ClickSTAR koob txhaj tshuaj. Ua ntej pib siv, koj yuav tsum ua tib zoo kawm cov lus qhia rau tus cwj mem thiab ua raws txhua qhov kev lag luam cov lus pom zoo. Qee qhov kev cai rau kev siv cov xaum xim:

Yog tias tus kov tawg, ces nws yuav tsum tau muab pov tseg thiab ib qho tshiab siv.
Yog tias tsim nyog, cov tshuaj los ntawm daim cartridge tuaj yeem raug tswj nrog cov tshuaj insulin tshwj xeeb nrog ib nplai ntawm 100 units hauv 1 ml.
Lub taub ntim yuav tsum khaws cia ntawm chav tsev qhov chaw nyob rau ob peb xuab moos ua ntej muab tso rau hauv cov xaum xaum.
Koj tuaj yeem siv cov kab ntawv ntawd nkaus xwb uas qhov pom ntawm txoj kev daws teeb meem tsis tau hloov pauv, nws cov xim thiab pob tshab, tsis muaj nag lossis daus tau tshwm sim.
Ua ntej qhia kev daws los ntawm daim cartridge, nws yog ib qho tsim nyog yuav tsum tshem tawm cov pa npuas (yuav ua li cas thiaj ua li no, nws tau sau rau hauv cov lus qhia rau tus cwj mem).
Refilling cartridges yog nruj me ntsis txwv tsis pub.
Txhawm rau tiv thaiv kev raug mob los ntawm lwm yam tshuaj insulin es tsis txhob siv cov glargine, koj yuav tsum kuaj cov ntawv ntawm txhua qhov kev txhaj tshuaj.

Sab sij huam

Feem ntau cov feem ntau, cov neeg mob uas tsis muaj qhov xav tau thaum siv cov tshuaj Lantus yog hypoglycemia. Nws muaj kev vam meej yog tias cov tshuaj tau muab tshuaj rau hauv ntau npaum li qhov tsim nyog rau tus neeg mob. Cov kev mob tshwm sim hauv qab no kuj yuav tshwm sim rau kev qhia ntawm Lantus:

nyob rau ib feem ntawm cov kev paub ntawm cov plab hnyuv siab raum thiab lub paj hlwb - dysgeusia, zuj zus pom tseeb tseeb, retinopathy;
ntawm ib feem ntawm daim tawv nqaij, nrog rau subcutaneous ntaub so ntswg - lipohypertrophy thiab lipoatrophy;
hypoglycemia (kev tsis txaus siab metabolic);
kev tsis haum tshuaj - edema thiab liab ntawm daim tawv nqaij ntawm qhov chaw txhaj tshuaj, urticaria, anaphylactic ceeb, bronchospasm, Quincke's edema;
kev ncua ntawm sodium ions hauv lub cev, mob leeg.

Nws yuav tsum tau yug los rau hauv lub siab tias yog qhov kev mob ntshav qab zib ntau dhau los, feem ntau qhov kev pheej hmoo ntawm kev txhim kho kev ntshaus siab hauv kev ua haujlwm ntawm lub paj hlwb yog qhov siab. Ntev ntshav siab thiab ntshav qis yog qhov txaus ntshai rau tus neeg mob lub neej.

Thaum kho cov tshuaj insulin, cov tshuaj tiv thaiv tuaj yeem tsim cov tshuaj.

Hauv cov menyuam yaus thiab tub ntxhais hluas, cov tshuaj Lantus tuaj yeem txhim kho qhov tsis xav zoo xws li mob leeg, mob tshwm sim, qhov mob ntawm qhov chaw txhaj tshuaj. Feem ntau, rau ob tus laus thiab menyuam yaus, kev nyab xeeb ntawm Lantus yog nyob rau tib theem.

Cov Yuav Tsum Muaj

Lantus yuav tsum tsis txhob raug rau cov neeg mob uas tsis txaus siab rau cov tshuaj nquag lossis cov khoom siv pabcuam hauv kev daws teebmeem, ntxiv rau cov neeg mob ntshav qab zib.

Hauv cov menyuam yaus, kab mob Lantus tuaj yeem raug kho yog tias lawv muaj hnub nyoog 6 xyoo thiab laus dua.

Raws li yeeb tshuaj ntawm kev xaiv rau kev kho mob ketoacidosis, cov tshuaj no tsis tau sau tseg.

Nws yog ib qho tsim nyog yuav tsum tau siv Lantus ua tib zoo siv rau hauv cov neeg mob uas muaj kev phom sij ntau ntxiv thaum lub sijhawm muaj ntshav qab zib tsawg, tshwj xeeb tshaj yog nyob rau cov neeg mob nqaim ntawm lub hlwb thiab cov hlab ntsha lossis cov hlab ntsha hlwb loj loj, cov lus qhia tau taw qhia txog qhov no.

Nws yog ib qho tsim nyog yuav tsum tau ceev faj nrog cov neeg mob uas qhov tshwm sim ntawm kev mob ntshav qab zib tuaj yeem ua npog ntsej muag, piv txwv li, nrog cov leeg hlwb tsis haum, kev puas siab puas ntsws, maj mam txhim kho hypoglycemia, thiab ntev ntawm cov ntshav qab zib. Nws tseem yog qhov yuav tsum tau ua tib zoo sau Lantus rau cov neeg laus thiab cov neeg mob uas tau hloov mus rau tib neeg cov kua dej los ntawm cov tshuaj ntawm tsiaj keeb kwm.

Thaum siv Lantus, koj yuav tsum tau ua tib zoo saib xyuas cov tshuaj hauv cov neeg uas muaj kev pheej hmoo siab ntawm kev mob ntshav qab zib siab ntau. Qhov no yuav tshwm sim thaum:

nce qhov rhiab heev ntawm cov hlwb mus rau insulin, piv txwv li, ntawm kev tshem tawm yam ua rau kev ntxhov siab;
kev tawm dag zog lub cev;
raws plab thiab ntuav;
kev noj tsis txaus, nrog rau kev noj zaub mov hla;
haus dej haus cawv;
kev tswj hwm ntawm qee cov tshuaj.

Hauv kev kho mob ntawm Lantus, nws zoo dua tsis koom rau hauv cov haujlwm uas xav tau kev saib xyuas, vim tias hypoglycemia (zoo li hyperglycemia) tuaj yeem ua rau txo qis ntawm qhov pom thiab pom tseeb.

Lantus thiab cev xeeb tub

Hauv cov poj niam cev xeeb tub, tsis tau tshawb nrhiav qhov kev tshawb fawb txog cov tshuaj no tau ua tiav. Cov ntaub ntawv tau tsuas yog nyob rau hauv kev tshawb fawb tom qab kev lag luam (kwv yees li 400 - 1000 tus neeg mob), thiab lawv tau qhia tias insulin glargine tsis muaj kev cuam tshuam zoo rau lub sijhawm cev xeeb tub thiab kev loj hlob ntawm tus menyuam.

Cov tsiaj sim tau pom tias cov tshuaj insulin glargine tsis muaj kev cuam tshuam ntawm lub cev xeeb tub thiab tsis cuam tshuam qhov kev ua haujlwm.

Cov poj niam cev xeeb tub Lantus tuaj yeem raug xaj los ntawm kws kho mob yog tias tsim nyog. Nws yog ib qho tseem ceeb nyob rau tib lub sijhawm los saib xyuas cov kua qab zib txhua lub sijhawm thiab ua txhua yam kom muaj cov ntshav qabzib nyob rau hauv cov poj niam cev xeeb tub, nrog rau kev saib xyuas cov kev mob ntawm leej niam lub cev thaum lub sijhawm xeeb tub. Hauv thawj peb lub hlis, xav tau cov tshuaj insulin yuav txo qis, thiab hauv qib thib ob thiab thib peb, nce ntxiv. Tam sim ntawd tom qab yug tus me nyuam, lub cev xav tau cov khoom no poob qis thiab cov ntshav qog ntshav yuav pib tau.

Nrog kev lactation, kev siv ntawm Lantus tseem ua tau nyob rau hauv kev soj ntsuam tas li ntawm qhov ntau thiab tsawg ntawm cov tshuaj. Thaum nqus tau rau hauv lub plab zom mov, insulin glargine raug faib ua cov amino acids thiab tsis muaj kev phom sij rau tus menyuam thaum lub sijhawm pub niam mis. Cov lus qhia uas glargine kis mus rau niam cov kua mis, cov lus qhia tsis muaj.

Kev cuam tshuam nrog lwm yam tshuaj

Nrog tib lub sijhawm siv cov tshuaj Lantus nrog qee lwm yam txhais tau tias muaj kev cuam tshuam cov metabolism carbohydrate, qhov kev hloov kho tshuaj yog tsim nyog.

Cov suab thaj txo qis ntawm cov tshuaj insulin yog txhim kho los ntawm cov tshuaj mob ntshav qab zib hauv qhov ncauj, angiotensin-hloov nyhuv tshuaj tiv thaiv, disopyramides, fibrates, monoamine oxidase inhibitors, fluoxetine, pentoxifylline, salicylates, propoxyphene, sulfonamides.

Cov nyhuv ntshav hypoglycemic ntawm Lantus yog txo qis los ntawm kev nqis tes ntawm danazol, diazoxide, corticosteroids, glucagon, diuretics, estrogens thiab progestins, somatotropin, sympathomimetics, isoniazid, phenothiazine derivatives, olanzapine, protease inhibitors, clozapine, thyroid hormones.

Qee cov tshuaj, xws li clonidine, beta-blockers, lithium thiab ethanol, tuaj yeem ob leeg txhim kho thiab ua kom lub zog ntawm Lantus.

Cov lus qhia rau kev siv ua ke nrog cov tshuaj no nrog pentamidine qhia tau tias kev muaj ntshav qab zib tsawg yuav tshwm sim ua ntej, uas tom qab ntawv dhau mus ua hyperglycemia.

Noj ntau dhau

Kev noj tshuaj ntau dhau ntawm cov yeeb yaj kiab Lantus tuaj yeem ua rau mob hnyav, ua kom ntev thiab mob ntshav qab zib tsawg, uas yog qhov txaus ntshai rau kev noj qab haus huv thiab lub neej ntawm tus neeg mob. Yog hais tias kev noj haus ntau dhau tsis zoo qhia, nws tuaj yeem nres los ntawm kev siv carbohydrates.

Thaum muaj kev txhim kho tsis tu ncua ntawm hypoglycemia, tus neeg mob yuav tsum hloov nws txoj kev ua neej thiab kho qhov koob tshuaj uas tau siv rau kev siv.

Yog hais tias hypoglycemia manifests nws tus kheej kom meej meej heev, nrog rau kev mob nriaj nrog, mob hlwb hloov, ces glucagon yuav tsum tau txhaj tshuaj subcutaneously lossis intramuscularly lossis txhaj tshuaj rau ntawm cov ntshav khov kho. los ntawm txoj kev, tus mob muaj qhov tshwm sim hnyav tshaj plaws, thiab cov cim ntawm hypoglycemic coma, thiab qhov no yog nws, koj yuav tsum paub.

Nws yuav tsum nco ntsoov tias cov tshuaj Lantus muaj qhov cuam tshuam ntev, yog li txawm tias tus neeg mob tus mob tau zoo dua, koj yuav tsum tau noj cov zaub mov ntxiv mus ntev thiab saib xyuas qhov mob ntawm lub cev.

Daim ntawv tso tawm

Lantus muaj nyob rau hauv daim ntawv ntawm kev daws rau kev txhaj tshuaj, ntim hauv 3 ml cartridges. 5 daim cartridges tau ntim rau hauv cov hlwv thiab ib lub blister ntim tau muab tso rau hauv cov thawv ntawv thawv.

Cia rau cov neeg mob

Lub txee lub neej ntawm Lantus yog 3 xyoos, lub sijhawm no nws haum rau kev siv, kev tswj hwm kub yuav tsum tswj tsis pub dhau 2 - 8 degrees Celsius. Nws yog txwv tsis pub khov rau cov tshuaj. Tom qab qhib lub laub yuav tsum khaws cia ntawm qhov kub li 15 - 25 degrees. Txee lub neej ntawm kev qhib tshuaj tsis yog ntau dua 1 hlis.