Insulin Apidra Solostar: cov lus qhia rau kev siv

Cov tshuaj nquag: insulin glulisin - 100 PIECES (3.49 mg),
kev zam: metacresol (m-cresol) 3.15 mg, trometamol (tromethamine) 6.0 mg, sodium chloride 5.0 mg, polysorbate 20 0.01 mg, sodium hydroxide rau pH 7.3, hydrochloric acid rau pH 7 3, dej rau kev txhaj tshuaj txog 1.0 ml.

Kev piav qhia Pob tshab tsis muaj xim ua kua.

Cov yam ntxwv Pharmacological:

Cov Tshuaj Hauv Tshuaj Cov tshuaj insulin glulisin yog qhov sib xyaw ua ke ntawm tib neeg cov tshuaj insulin, uas yog sib npaug hauv lub zog rau insulin tib neeg.
Qhov kev txiav txim tseem ceeb tshaj plaws ntawm insulin thiab insulin analogues, suav nrog insulin glulisin, yog kev cai ntawm cov metabolism hauv cov piam thaj. Cov tshuaj insulin txo cov concentration ntawm cov piam thaj hauv cov ntshav, txhawb kev nqus ntawm cov piam thaj los ntawm cov ntaub so ntswg, tshwj xeeb tshaj yog cov leeg pob txha thiab cov nqaij mos adipose, nrog rau inhibiting kev tsim cov piam thaj hauv lub siab. Cov tshuaj Insulin muab cov lipolysis hauv adipocytes, inhibits proteolysis thiab nce cov synthesis protein. Cov kev tshawb fawb hauv cov neeg tuaj yeem noj qab haus huv thiab cov neeg mob ntshav qab zib mellitus pom tias nrog subcutaneous tswj hwm ntawm cov tshuaj insulin, glulisin pib ua haujlwm sai dua thiab muaj lub sijhawm luv luv ntawm kev nqis tes ua dua li kev tiv thaiv tib neeg cov kua dej. Nrog txoj kev tswj hwm subcutaneous, cov nyhuv ntawm insulin glulisin, uas txo cov concentration ntawm cov piam thaj hauv cov ntshav, pib tom qab 10-20 feeb. Thaum muab cov tshuaj pleev ib ce, qhov tshwm sim ntawm kev txo qis ntshav qabzib hauv cov ntshav ntawm insulin glulisin thiab solulin tib neeg cov kua dej ua kom sib luag hauv lub zog. Ib chav ntawm insulin glulisin muaj tib yam hypoglycemic yam li ib chav ntawm solulin tib neeg cov kua dej.
Hauv ib theem kuv qhov kev sim hauv cov neeg mob uas muaj hom 1 mob ntshav qab zib mellitus, hypoglycemic profiles ntawm insulin glulisin thiab soluble tib neeg insulin tau raug saib xyuas subcutaneously ntawm koob tshuaj ntawm 0.15 U / kg ntawm lub sijhawm sib txawv ntawm tus qauv noj haus 15 feeb. Cov txiaj ntsig ntawm txoj kev tshawb pom pom tias insulin glulisin, siv 2 feeb ua ntej noj mov, tau muab tib txoj kev tswj glycemic tom qab noj mov ib yam li soluble tib neeg cov tshuaj insulin, siv 30 feeb ua ntej noj mov. Thaum muab 2 feeb ua ntej noj mov, insulin glulisin muab glycemic tswj tau zoo tom qab noj mov dua soluble tib neeg cov tshuaj insulin muab 2 feeb ua ntej noj mov. Glulisin insulin, muab 15 feeb tom qab pib noj mov, muab tib yam glycemic tswj tom qab noj mov ib yam li soluble tib neeg insulin, muab 2 feeb ua ntej noj mov.
Ib theem kuv kawm ua nrog insulin glulisin, insulin lispro thiab solulin tib neeg cov kua dej hauv ib pawg neeg mob ntshav qab zib mellitus thiab rog rog tau qhia tias hauv cov neeg mob no insulin glulisin khaws nws txoj kev coj cwj pwm sai. Hauv qhov kev tshawb nrhiav no, lub sijhawm mus txog 20% ntawm tag nrho AUC (thaj chaw hauv qab qhov ntsuas-sijhawm nkhaus) yog 114 feeb rau insulin glulisin, 121 feeb rau insulin lispro thiab 150 feeb rau solulin tib neeg, thiab AUC (0-2 teev), ua rau muaj kev cuam tshuam. kuj tseem ntxov hypoglycemic kev ua si, feem, yog 427 mg / kg rau insulin glulisin, 354 mg / kg rau insulin lispro, thiab 197 mg / kg rau solulin tib neeg cov kua dej.
Cov kev tshawb fawb soj ntsuam ntawm hom 1.
Hauv 26-lub lis piam kev soj ntsuam ntawm theem III, uas piv rau insulin glulisin nrog insulin lispro, muab subcutaneously sai ua ntej noj mov (0-15 feeb), cov neeg mob uas muaj ntshav qab zib hom 1 siv insulin glargine li basal insulin, insulin glulisin yog piv nrog insulin lispro nyob rau hauv kev sib piv nrog glycemic tswj, uas tau soj ntsuam los ntawm kev hloov pauv hauv kev xav ntawm glycosylated hemoglobin (Lb1c) thaum lub sijhawm kawm txog qhov kawg piv nrog thawj zaug. Tau saib xyuas cov ntshav qabzib nyob rau ntawm kev ntsuas tus kheej. Nrog kev tswj hwm ntawm insulin glulisin, hauv kev sib piv rau kev kho mob nrog insulin, lyspro tsis xav tau nce ntxiv ntawm cov koob tshuaj insulin basal.
Lub sijhawm 12 lub lis piam mus rau kev soj ntsuam hauv cov neeg mob uas muaj ntshav qab zib hom 1 uas tau txais insulin glargine ua kev kho mob tau qhia tias cov tshuaj insulin glulisin tswj tau tam sim ntawd tom qab noj mov tau muab piv rau qhov ntawm insulin glulisin tam sim ntawd ua ntej noj mov (rau 0-15 feeb) lossis soluble tib neeg cov insulin (30-45 feeb ua ntej noj mov).
Hauv cov neeg ntawm cov neeg mob uas ua tiav txoj kev tshawb no, nyob rau hauv pab pawg ntawm cov neeg mob uas tau txais insulin glulisin ua ntej noj mov, tau pom qhov txo qis hauv HL1C ntau dua piv rau cov pab pawg ntawm cov neeg mob uas tau txais insulin tib neeg.

Mob ntshav qab zib Hom 2
26-lub lis piam theem kev soj ntsuam zaum ua raws 26-lub limtiam rov qab soj ntsuam kev nyab xeeb los ua piv rau insulin glulisin (0-15 feeb ua ntej noj mov) nrog soluble tib neeg insulin (30-45 feeb ua ntej noj mov), uas tau muab tshuaj subcutaneously rau cov neeg mob ntshav qab zib hom 2 mob ntshav qab zib, ntxiv rau siv tshuaj insulin-isofan ua cov tshuaj insulin. Qhov nruab nrab ntawm tus neeg mob lub cev qhov nruab nrab ntsuas yog 34.55 kg / m2. Cov tshuaj insulin glulisin qhia nws tus kheej piv rau soluble tib neeg insulin nrog kev hloov pauv hauv HL1C ntau tom qab 6 lub hlis kev kho mob piv nrog tus nqi pib (-0.46% rau insulin glulisin thiab -0.30% rau solulin tib neeg cov kua dej, p = 0.0029) thiab tom qab 12 lub hlis ntawm kev kho mob piv nrog thawj zaug tus nqi (-0.23% rau insulin glulisin thiab -0.13% rau soluble tib neeg insulin, qhov sib txawv tsis tseem ceeb). Hauv qhov kev tshawb fawb no, feem ntau cov neeg mob (79%) tau sib xyaw luv luv ntawm insulin nrog insulin-isophan tam sim ntawd ua ntej txhaj tshuaj. 58 cov neeg mob thaum lub sij hawm ntawm randomization siv cov tshuaj hypoglycemic hauv qhov ncauj thiab tau txais cov lus qhia los txuas ntxiv noj lawv hauv tib (tsis hloov pauv) koob tshuaj.

Haiv neeg thiab tub los ntxhais
Hauv kev tswj cov chaw kho mob hauv cov neeg laus, qhov sib txawv ntawm kev nyab xeeb thiab kev ua tau zoo ntawm insulin glulisin tsis pom nyob rau hauv kev soj ntsuam ntawm pab pawg sib txawv los ntawm haiv neeg thiab poj niam txiv neej.

Cov Tshuaj Pharmacokinetics Hauv cov tshuaj insulin glulisin, kev hloov ntawm cov amino acid asparagine ntawm tib neeg insulin ntawm txoj haujlwm B3 nrog lysine thiab lysine ntawm txoj haujlwm B29 nrog glutamic acid txhawb nqa kom sai dua.

Kev Tsis Xiam thiab Bioavailability
Pharmacokinetic concentration-sijhawm nkhaus hauv cov neeg ua haujlwm zoo thiab cov neeg mob uas muaj hom 1 thiab hom 2 mob ntshav qab zib mellitus qhia tau tias kev nqus ntawm insulin glulisin piv rau soluble tib neeg insulin yog kwv yees li 2 zaug sai dua, thiab qhov siab tshaj plaws ntshav pliav tiav (Stax) yog kwv yees li 2 ntau zaus ntxiv.
Hauv txoj kev tshawb nrhiav ua rau cov neeg mob uas muaj ntshav qab zib hom 1, tom qab ua haujlwm subulinaneous ntawm insulin glulisin ntawm koob tshuaj ntawm 0.15 U / kg, Tmax (lub sijhawm ntawm qhov pib ntawm qhov ntshav siab tshaj plaws) yog 55 feeb, thiab Stm yog 82 ± 1.3 mcU / ml piv nrog Tmax ntawm 82 feeb thiab Cmax ntawm 46 ± 1.3 μU / ml rau solulin tib neeg cov kua dej. Lub sijhawm nyob hauv lub nruab nrab nyob rau hauv cov kab ke rau cov kua dej insulin glulisin tau luv dua (98 feeb) dua rau soluble tib neeg cov kua dej (161 feeb).
Hauv kev tshawb nrhiav nyob rau hauv cov neeg mob uas muaj hom 2 mob ntshav qab zib mellitus tom qab subcutaneous tswj hwm ntawm insulin glulisin ntawm koob tshuaj ntawm 0.2 U / kg, Stax yog 91 mkU / ml nrog interquartile latitude ntawm 78 txog 104 mkU / ml.
Nrog kev tswj hwm subcutaneous ntawm insulin glulisin nyob hauv thaj av ntawm sab xub ntiag phab ntsa, ncej puab, lossis xub pwg (hauv thaj av deltoid leeg), kev nqus tau sai dua thaum qhia rau thaj av ntawm sab xub ntiag phab ntsa piv nrog kev tswj hwm tshuaj nyob hauv thaj av ntawm tus ncej puab. Tus nqi ntawm kev nqus ntawm thaj av deltoid yog nruab nrab.
Qhov kev txiav txim siab tsis txaus ntseeg ntawm insulin glulisin tom qab kev tswj hwm subcutaneous yog kwv yees li 70% (73% los ntawm anterior plab phab ntsa, 71 los ntawm deltoid cov leeg thiab 68% los ntawm thaj chaw muaj pojniam) thiab muaj qhov tsis tshua pom kev hauv cov neeg mob txawv

Kev xa Khoom
Kev faib tawm thiab kev tawm ntawm insulin glulisin thiab soluble tib neeg insulin tom qab kev tswj hwm zoo ib yam, nrog cov faib tawm ntawm 13 litres thiab 21 litres thiab ib nrab ntawm lub neej ntawm 13 thiab 17 feeb, feem.

Chaw Sau Ntawv
Tom qab ua haujlwm subulinaneous ntawm insulin, glulisin yog tawm sai dua soluble tib neeg insulin, muaj qhov pom meej ib nrab-lub neej ntawm 42 feeb, piv nrog pom meej ib nrab-lub neej ntawm soluble tib neeg insulin ntawm 86 feeb. Hauv kev soj ntsuam ib ntu ntawm insulin glulisin kev tshawb fawb hauv cov tib neeg muaj kev noj qab haus huv thiab cov neeg muaj ntshav qab zib hom 1 thiab ntshav qab zib hom 2, pom meej txog ib nrab lub neej nyob ntawm 37 txog 75 feeb.

Pab Pawg Neeg Tshwj Xeeb

Cov neeg mob raum tsis ua haujlwm
Hauv qhov kev tshawb fawb soj ntsuam hauv cov tib neeg tsis muaj ntau yam kev ua haujlwm hauv lub raum (kev tsim lub peev xwm (cleinine clearance (CC)> 80 ml / min, 30¬50 ml / feeb, 1/10, hom:> 1/100, 1/1000, 1 / 10000, Ntawm qhov muaj pes tsawg leeg thiab daim ntawv tso tawm

Yog li, Apidra yog cov tshuaj insulin luv luv. Los ntawm qhov pom ntawm lub xeev kev sib sau - qhov no yog kev daws teeb meem. Nws yog tsim tshwj xeeb rau kev cog pob zeb tawg subcutaneous thiab yog pob tshab, nrog rau xim tsis muaj xim (nyob hauv qee kis, qee qhov ntxoov ntxoo me me tseem nyob hauv).

Nws lub ntsiab feem, uas yog tam sim no hauv qhov sib piv me me hauv, yuav tsum tau txiav txim siab insulin hu ua glyzulin, uas yog tus cwj pwm los ntawm nws cov yeeb yam sai thiab cov txiaj ntsig ntev ntev. Cov muaj mob:

cresol
trometamol,
sodium tshuaj dawb
polysorbate thiab ntau lwm tus, kuj muaj nyob ntawm.

Txhua tus sib koom ua ke ua ib hom tsis muaj ib qho tsis txaus ntseeg tshwj xeeb cov tshuaj tuaj yeem tau nrog txhua hom ntshav qab zib: ob qho tib si thawj thiab zaum thib ob. Apidra insulin yog tsim nyob rau hauv daim ntawv ntawm cov ntawv tshwj xeeb ua los ntawm cov iav tsis muaj xim.

Txog ntawm qhov cuam tshuam pharmacological

Apidra cuam tshuam cov piam thaj li cas?

Glulin insulin yog qhov ua kom rov ua rau tib neeg lub cev cia siab. Raws li koj paub, nws tuaj yeem piv tau hauv lub zog rau kev tiv thaiv tib neeg cov kua dej, tab sis nws yog tus yam ntxwv ua rau nws pib "ua haujlwm" ntau dua sai dua thiab muaj lub sijhawm luv luv ntawm cov pa tshuaj tiv thaiv. qhov no pab tau zoo tshaj.

Qhov tshwj xeeb tshaj plaws thiab siv tau ua haujlwm tsis yog rau cov tshuaj insulin, tab sis kuj rau nws cov analogues, yuav tsum tau txiav txim siab tas li kev cai nyob rau hauv cov lus pauv ntawm qabzib hloov. Cov tshuaj hormones uas hais tawm txo cov ntsiab lus ntawm cov piam thaj hauv cov ntshav, uas txhawb kev siv cov kua nplaum nrog kev pab ntawm cov ntaub so ntswg, ib yam li. Qhov no yog qhov tseeb tshwj xeeb tshaj yog rau cov pob txha pob txha thiab cov nqaij qog adipose. Apidra insulin kuj ua rau kev tsim cov piam thaj hauv lub siab. Ntxiv rau, nws suppresses txhua tus txheej txheem cuam tshuam nrog lipolysis hauv adipocytes, proteolysis thiab nrawm cuam tshuam protein sib cuam tshuam.

Raws li kev soj ntsuam ntawm ntau cov kev tshawb fawb, nws tau ua pov thawj tias glulisin, yog qhov tseem ceeb thiab tau qhia ob feeb ua ntej noj zaub mov, tuaj yeem muab tib txoj kev tswj cov kua nplaum tom qab noj raws li tib neeg-hom insulin haum rau kev rhuav tshem. Txawm li cas los xij, nws yuav tsum tau muab 30 feeb ua ntej noj mov.

Txog ntau npaum

Cov ntsiab lus tseem ceeb tshaj plaws hauv cov txheej txheem ntawm kev siv ib qho yeeb tshuaj, suav nrog cov tshuaj insulin, yuav tsum tau txiav txim siab ntau npaum cov tshuaj. Apidra raug nquahu kom ua luv luv (tsawg kawg ntawm xoom thiab qhov siab tshaj 15 feeb) ua ntej lossis noj mov tam sim ntawd.

Cov tshuaj tuaj yeem siv ua ke nrog cov tshwj xeeb hypoglycemic hom kab mob.

Yuav xaiv cov koob tshuaj Apidra li cas?

Lub Apidra insulin dosing algorithm yuav tsum tau xaiv ib tus zuj zus txhua zaus. Yog tias muaj kev kuaj pom lub raum tsis ua haujlwm lawm, kev txo qis hauv qhov xav tau cov tshuaj no yog qhov ua tau.

Hauv cov neeg mob ntshav qab zib nrog lub cev tsis ua haujlwm ntawm lub cev xws li lub siab, xav tau cov tshuaj insulin ntau dua yog qhov yuav txo qis. Qhov no yog vim muaj peev xwm txo qis cov ntshav qabzib neogenesis thiab qeeb hauv metabolism hauv nqe lus ntawm cov tshuaj insulin. Txhua yam no ua rau cov ntsiab lus meej meej thiab, tsis muaj ib qho tseem ceeb dua, ua raws li cov koob tshuaj qhia, qhov tseem ceeb tshaj plaws hauv kev kho mob ntshav qab zib.

Hais Txog Kev Txhaj Tshuaj

Cov tshuaj yuav tsum tau muab tshuaj los ntawm txhaj tshuaj subcutaneous, nrog rau los ntawm kev ua kom tsis tu ncua. Nws raug nquahu kom ua qhov no tshwj xeeb tshaj tawm nyob rau hauv subcutaneous thiab rog cov ntaub so ntswg uas siv cov txheej txheem tshwj xeeb-lub zog.

Kev txhaj tshuaj subcutaneous yuav tsum tau nqa tawm hauv:

Cov lus qhia ntawm Apidra insulin siv qhov kev txuas ntxiv mus rau hauv subcutaneous lossis cov nqaij rog yuav tsum tau nqa tawm ntawm lub plab. Cov cheeb tsam ntawm tsis yog tsuas yog txhaj tshuaj, tab sis kuj tseem infusions hauv thaj chaw dhau los, cov kws tshaj lij pom zoo sib hloov rau ib leeg rau ib qho kev siv tshiab ntawm kev tivthaiv. Cov yam ua rau thaj chaw cog, lub cev qoj ib ce, thiab lwm yam "ntab dej" tuaj yeem muaj qhov cuam tshuam ntawm qhov ntsuas ntawm kev nrawm ntawm kev nqus thiab, vim li ntawd, ntawm lub community launch thiab qhov cuam tshuam.

Yuav muab tshuaj li cas?

Kev phais pob zeb me me rau hauv cov phab ntsa ntawm thaj tsam mob plab dhau los ua ib qho kev lees paub ntawm ntau yam nrawm nrawm dua li rho tawm mus rau lwm thaj chaw ntawm tib neeg lub cev. Nco ntsoov ua raws li cov kev cai txwv tsis pub cais tawm ntawm cov tshuaj mus rau cov ntshav ntawm cov ntshav.

Tom qab qhia txog cov tshuaj insulin "Apidra" nws raug txwv tsis pub zaws qhov chaw txhaj tshuaj. Tus mob ntshav qab zib yuav tsum tau qhia rau cov txheej txheem txhaj tshuaj kom yog. Qhov no yuav yog tus yuam sij rau 100% kev kho mob tau zoo.

Txog kev mob thiab kev siv lus

Rau cov txiaj ntsig siab tshaj plaws hauv kev siv cov tshuaj siv tshuaj, ib qho yuav tsum nco qab txog cov xwm txheej thiab txee lub neej. Yog li, daim cartridges thiab cov kab ke ntawm cov hom no yuav tsum tau muab cia rau hauv qhov chaw me ntsis rau cov menyuam yaus, uas yuav tsum tau pom los ntawm kev tiv thaiv tseem ceeb ntawm lub teeb.

Hauv qhov no, tus txheej txheem kub yuav tsum tau ua, uas yuav tsum yog los ntawm ob txog yim degrees.

Lub ntsiab lus yuav tsum tsis khov.

Tom qab siv cov roj cartridges thiab daim cartridge tau pib, lawv kuj yuav tsum tau tseg rau hauv qhov chaw uas tsis muaj kev nkag tau rau cov menyuam yaus uas muaj kev tiv thaiv txhim khu kev ntseeg tsis yog los ntawm kev nkag mus ntawm lub teeb, tab sis kuj los ntawm kev tshav ntuj. Tib lub sijhawm, qhov ntsuas kub yuav tsum tsis tshaj 25 degrees ntawm tshav kub, txwv tsis pub qhov no tuaj yeem qhia txog qhov zoo ntawm Apidra insulin.

Txhawm rau kom muaj kev tiv thaiv zoo dua los ntawm tus ntawm lub teeb, nws yog ib qho tsim nyog yuav tsum tsis txhob tuaj yeem yog daim cartridges, tab sis cov kws tshaj lij pom zoo xws li cov kab ke hauv lawv tus kheej cov pob, uas tau ua los ntawm cov duab los qhia tshwj xeeb. Lub txee lub neej ntawm cov khoom tau piav qhia yog ob xyoos.

Tag nrho txog kev tas sij hawm

Lub txee lub neej ntawm cov tshuaj uas nyob hauv daim cartridge lossis qhov system no tom qab siv thawj plaub lub lis piam. Nws raug nquahu kom nco ntsoov tias tus lej ntawm thawj zaug cov tshuaj insulin raug coj los cim rau ntawm lub pob. Nov yuav yog ib qho kev lees paub ntxiv rau cov kev kho mob ua tiav rau txhua yam ntshav qab zib.

Txog kev phiv

Cov kev mob tshwm sim uas ua cim los ntawm Apidra insulin yuav tsum tau muab sau tseg cais. Ua ntej tshaj plaws, peb tab tom tham txog cov khoom zoo li hypoglycemia. Nws yog tsim vim kev siv cov kev txiav txim ntau dhau ntawm cov tshuaj insulin, uas yog, cov uas tig tawm los ua ntau dua li qhov xav tau tiag tiag rau nws.

Ntawm ib feem ntawm cov kab mob muaj nuj nqi ua haujlwm ntawm cov metabolism, ua rau lub qog ntshav ntshav kuj tseem nyob. Tag nrho cov cim ntawm nws tsim yog tsiag ntawv los ntawm kev cia li nco dheev: muaj suab npe txias txias, tshee tshee thiab ntau ntxiv. Kev phom sij hauv qhov teeb meem tshwj xeeb no yog qhov kev nce ntshav siab nce siab, qhov no tuaj yeem ua rau tus neeg tuag.

Cov kev tawm tsam hauv zos tseem muaj peev xwm ua tau, uas yog:

hyperemia,
puffiness,
qhov khaus tseem ceeb (ntawm qhov chaw txhaj tshuaj).

Tej zaum, ntxiv rau qhov no, kev txhim kho ntawm cov kev tsis haum tshuaj, qee kis peb tab tom tham txog urticaria lossis khaub thuas dermatitis. Txawm li cas los xij, qee zaum qhov no tsis zoo li cov teeb meem ntawm daim tawv nqaij, tab sis tsuas yog asphyxiation lossis lwm cov tsos mob ntawm lub cev. Nyob rau hauv txhua rooj plaub, txhua qhov kev mob tshwm sim tuaj yeem tsis muaj tseeb yuav zam tau los ntawm kev ua raws li cov lus pom zoo thiab nco ntsoov qhov raug thiab siv tau ntawm cov insulin li Apidra.

Txog contraindications

Cov tshuaj uas txuam nrog uas muaj rau ib qho yeeb tshuaj twg yuav tsum tau muab tshwj xeeb. Qhov no yuav yog qhov tseem ceeb ntawm qhov tseeb tias insulin yuav ua haujlwm ntawm 100%, yog qhov ua tau zoo ntawm kev txhim kho lub cev thiab tiv thaiv lub cev. Yog li, contraindications txwv tsis pub siv "Apidra" yuav tsum suav nrog kev ruaj khov ntawm qog ntshav qab zib thiab kev paub ntau ntxiv rau cov tshuaj insulin, gluzilin, thiab lwm yam tshuaj ntawm cov tshuaj.

Cov poj niam cev xeeb tub tuaj yeem siv Apidra?

Nrog rau kev saib xyuas tshwj xeeb, kev siv cov cuab yeej no yog qhov tsim nyog rau cov poj niam uas tab tom nyob rau theem twg cev xeeb tub lossis pub mis niam. Txij li thaum hom insulin nthuav tawm yog hom tshuaj muaj zog txaus, nws tuaj yeem tsim kev tsim kev puas tsuaj tsis yog rau tus pojniam nkaus xwb, tabsis kuj yuav ua rau tus menyuam hauv plab thiab. Txawm li cas los xij, qhov no yog nyob deb ntawm txhua kis mob cuam tshuam nrog ntshav qab zib. Hauv kev sib txuas no, nws raug pom zoo tias koj ua ntej sab laj tus kws tshaj lij uas yuav qhia txog qhov pom zoo rau kev siv tshuaj tua kab mob “Apidra”, thiab tseem sau ntawv yuav siv qhov xav tshuaj.

Txog qhov ntsuas tshwj xeeb

Nyob rau hauv tus txheej txheem ntawm kev siv ib qho yeeb tshuaj, nws yog ib qho tsim nyog yuav tsum txiav txim siab ib qho tseem ceeb ntawm ntau qhov sib txawv. Piv txwv li, qhov tseeb hais tias kev hloov pauv ntawm tus mob ntshav qab zib mus rau lub hom phiaj tshiab ntawm insulin lossis tshuaj los ntawm lwm qhov kev txhawj xeeb yuav tsum tau ua nyob rau hauv kev tswj xyuas nruj tshwj xeeb. Qhov no vim yog qhov tseeb tias nws tuaj yeem xav tau kev kho mob nrawm nrog kev kho kom zoo.

Kev siv cov tshuaj ntau tsis txaus ntawm kev tivthaiv lossis txiav kev kho mob, tshwj xeeb tshaj yog rau cov neeg muaj ntshav qab zib hom 1, tuaj yeem ua rau tsim muaj tsis tsuas hyperglycemia, tab sis kuj tseem meej ketoacidosis. Cov no yog cov xwm txheej uas muaj kev phom sij heev rau tib neeg lub neej.

Kev hloov pauv ntawm cov tshuaj insulin kuj yuav tsim nyog thaum muaj kev hloov pauv ntawm cov kev ua ub no hauv lub phiaj xwm lub cev muaj zog lossis thaum noj zaub mov.

Zaj lus no muaj txiaj ntsig zoo heev. Kuv xav hais tias coob leej neeg uas raug kev txom nyem los ntawm tus kab mob no yuav pab tau. Ua tsaug rau koj yuav piav qhia txog yuav khaws cov tshuaj no li cas. Tus kws kho mob nws tus kheej kuj tau sau tseg nws. Ntau yam zoo tau sau hauv kab lus, Kuv vam tias nws yuav pab kuv!

Qhov nquag ua haujlwm ntawm Apidra yog insulin glulisin. Nws yog ib qho piv txwv ntawm cov kua dej, uas tsim tawm hauv tib neeg lub cev, tab sis cov molecule raug hloov pauv los ntawm kev rov ua dua. Lub zog ntawm kev ua ntawm ib yam khoom yog sib npaug rau tib neeg insulin (soluble), tab sis, tsis zoo li tom kawg, qhov kev txiav txim tshwm sim sai dua, lub sijhawm ntawm cov nyhuv ntawm insulin glulisin yog luv dua.

Cov tshuaj nquag tswj hwm kev hloov pauv ntawm cov piam thaj hauv cov roj ntsha, txo lawv cov kev xav hauv cov hlab ntshav, txhim kho kev nqus ntawm cov kua nplaum los ntawm cov hlwb nyob rau hauv cov ntaub so ntswg ntawm qhov nqaj tawv (tshwj xeeb tshaj yog cov leeg pob txha, cov roj ua rau lub cev). Insulin glulisin tiv thaiv kev tsim cov piam thaj hauv lub siab. Apidra inhibits cov txheej txheem ntawm lipolysis nyob rau hauv adipose cov ntaub so ntswg hlwb, nres lub cev decomposition ntawm cov qauv protein, thiab txhim kho cov txheej txheem hluavtaws tsim cov khoom protein.

Thaum muab tshuaj subcutaneously, qhov kev txo qis hauv cov ntshav qabzib ntau yog pom tom qab 1 / 6–1 / 3 teev. Nyob rau hauv kev mob ntawm kev tswj hwm kev tso ntshav, lub zog ntawm insulin glulisin yog sib npaug rau lub zog ntawm tib neeg insulin. 1 pawg ntawm insulin glulisin yog sib npaug rau 1 chav ntawm insulin tib neeg.

Thaum kuaj mob hauv tsev kho mob, nws pom tias kev tswj hwm ntawm Apidra 120 lub vib nas this ua ntej ib feem ntawm cov zaub mov cia koj tswj cov piam thaj hauv cov ntshav tom qab kev noj mov tas. Qhov kev txiav txim ntawm cov tshuaj no tso cai rau koj kom zoo dua tswj qib ntshav qabzib dua nrog kev qhia ntawm cov tshuaj insulin rau ½ teev ua ntej noj mov. Qhov kev tshwm sim tom qab kev tswj hwm ntawm Apidra txog ¼ tom qab pib kev noj zaub mov txuam nrog kev nqis tes ua ntawm tib neeg insulin, nkag rau hauv lub cev 120 vib nas this ua ntej noj mov.

Hauv kev kho cov kev rog, kev tshawb fawb ntawm kev ua ntawm Apidra pom tias lub sijhawm txhim kho ntawm cov nyhuv hauv cov nquag ua haujlwm tau kav ntev li ntawm 114 feeb. AUC ntawm 0–2 teev tau 427 mg. Kg.

Txoj kev ntawm daim ntawv thov

Kev qhia ntawm Apidra yuav tsum tau nqa tawm tam sim ua ntej noj mov lossis ntau tshaj 15 feeb ua ntej nws. Cov tshuaj no yog siv rau hauv kev kho mob uas twb muaj cov tshuaj insulin npaj nrog lub sij hawm nruab nrab ntawm kev nqis tes ua los yog cov tshuaj ntawm cov tshuaj insulin-ntev ua yeeb yam. Apidra tuaj yeem ua ke hauv kev kho tshuaj nrog tshuaj hypoglycemic rau kev tswj hwm qhov ncauj. Qhov ntau thiab tsawg ntawm cov tshuaj yog xaiv nyob rau hauv txhua kis ntawm tus kheej.

Nws yog ib qho tsim nyog yuav tsum cais tawm ntau li ntau tau ntawm qhov ua tau ntawm cov tshuaj nkag mus rau hauv lub txaj vascular. Tsis tas li, koj tsis tuaj yeem zaws thaj chaw uas tau txhaj tshuaj. Zib ntab cov neeg ua haujlwm yuav tsum qhia tus neeg mob kom paub siv tshuaj.

Nws tsis tuaj yeem lees paub tov Apidra nrog lwm cov khoom siv kho mob (tshwj tsis yog muaj tib neeg isofan-insulin). Thaum siv cov tshuaj Apidra, uas yog muab nrog cov twj tso kua mis, nws tsis tuaj yeem lees txais tov qhov tshuaj uas muaj lwm yam tshuaj.

Cov cai tswj rau kev siv tshuaj

Tsis txhob thim qhov kev daws teeb meem.
Yog tias nws tsim nyog yuav tov cov tshuaj Apidra nrog isofan-tib neeg cov kua dej, ces cov tshuaj insulin glulisin yog cov xub tau los rau hauv cov phwj. Tsis txhob cia qhov sib tov sib xyaw.

Cov thawv ntim nrog cov tshuaj yog tsim nyog rau OptiPen Pro 1 koob txhaj tshuaj.
Ua ntej siv, koj yuav tsum ntsuas qhov kev daws teeb meem hauv daim cartridge rau xim (yuav tsum yog pob tshab), rau qhov tsis muaj cov khoom siv tshuab.
Tseg daim laub rau ntawm chav tsev qhov kub rau 60-120 feeb ua ntej ntxig nws mus rau hauv qhov rov siv tau kua mem.
Tshem tawm cov pa npuas los ntawm daim cartridge.
Cartridges tsis rov qab siv dua.
Lub koob txhaj tshuaj tsis huv yuav tsum tsis txhob siv.
Cov yas koob txhaj tshuaj tuaj yeem siv los tswj cov tshuaj. Txhawm rau ua qhov no, txoj kev daws teeb meem raug muab tshem tawm ntawm daim cartridge nrog daim duab dua. Cov koob txhaj tshuaj yuav tsum muaj npe rau 100 IU / ml tshuaj insulin.
Ib rab koob rov qab siv tau tuaj yeem siv los tswj cov tshuaj hauv tsuas yog ib tus neeg mob.

Siv cov ntawv cartridges ntawm OptiClick system (qhov no yog lub cartridge nrog 3 ml ntawm ib qho kev daws ntawm Apidra, uas tau muab tso rau hauv cov thawv ntim khoom nruab nrog lub twj piston):

Qhov no cartridge system nrog lub taub ntim thiab lub piston yuav tsum siv nrog OptiClick hom syringe mem.
Cov lus qhia rau kev siv OptiClick syringe cwj mem tau muab nyob rau hauv nqe lus ntawm qhov cuab yeej no.
Yog tias kev ua haujlwm tsis zoo ntawm lub koob txhaj tshuaj, nws siv tsis tau.
Tshawb xyuas daim cartridge system ua ntej thov kev daws teeb meem. Yuav tsum tsis muaj cov neeg kho tshuab hloov hauv kev npaj, qhov kev daws teeb meem yuav tsum yog pob tshab, tsis muaj xim.
Tshem tawm npuas ntawm daim cartridge ua ntej muab kev daws teeb meem.
Koj tsis tuaj yeem siv lub cartridge los ntawm sau rau.
Los ntawm daim cartridge, koj tuaj yeem kos qhov kev daws teeb meem rau hauv lub taub hau yas thiab tswj cov tshuaj.
Txhawm rau tiv thaiv kev kis kab mob, nws tsis tuaj yeem lees txais siv cov koob txhaj tshuaj rau ntau tus neeg mob.

Cov qhia ntawm cov tshuaj yog nqa tawm los ntawm staging ib subcutaneous txhaj tshuaj. Koj tuaj yeem nqa tawm txoj kev daws ntawm Apidra hauv daim ntawv ntawm txoj kev txuas ntxiv mus siv tus twj tso kua mis. Qhov kev qhia yog nqa tawm hauv daim ntaub adipose hauv qab daim tawv nqaij.

Cov chaw zoo rau kev txhaj tshuaj subcutaneous yog lub plab, pwg thaj tsam, thiab ncej puab. Yog tias tsim nyog, Txoj kev lis ntshav tas mus li yog kev qhia txog adipose cov nqaij hauv qab daim tawv nqaij hauv plab. Txhua cov lus qhia tshiab ntawm Apidra daws yuav tsum tau nqa tawm hauv qhov chaw tshiab.

Qhov nqus ntawm cov tshuaj tiv thaiv nquag yuav sib txawv raws li qhov chaw txhaj tshuaj ntawm cov tshuaj, kev qoj ib ce ntawm tus neeg mob, thiab lwm yam mob. Kev nqus sai ntawm cov tshuaj nquag tau pom muaj thaum txhaj tshuaj rau hauv plab phab ntsa ua.

Sab sij huam

Kev ntshav siab - qhov kev xav tsis raug tshaj plaws ntawm kev siv tshuaj insulin, uas tuaj yeem tshwm sim yog tias muaj cov tshuaj insulin ntau dhau, siv ntau tshaj qhov xav tau.

Cov kev phiv tshuaj pom nyob rau hauv cov chaw soj ntsuam kuaj mob cuam tshuam nrog kev tswj hwm tshuaj tau teev hauv qab no raws li cov khoom hauv nruab nrog cev thiab hauv kev txiav txim siab txo cov xwm txheej. Hauv kev piav qhia qhov nquag muaj tshwm sim, cov txheej txheem hauv qab no yog siv: ntau heev (> 10%), feem ntau (> 1% thiab 0.1% thiab 0.01% thiab

Cev xeeb tub thiab lactation

Tsis muaj cov ntaub ntawv txaus ntawm kev siv tshuaj insulin glulisin rau cov poj niam cev xeeb tub.

Preclinical cov kev tshawb fawb ntawm kev rov ua dua tshiab tsis tau qhia qhov sib txawv ntawm insulin glulisin thiab tib neeg insulin hauv lawv qhov cuam tshuam rau kev xeeb tub, kev loj hlob ntawm tus menyuam (yug menyuam), kev yug menyuam thiab kev loj hlob hauv lub sijhawm tom qab yug menyuam (saib Preclinical Safety Tests).

Thaum muab tshuaj rau cov poj niam cev xeeb tub, kev ceev faj yuav tsum tau siv. Kev saib xyuas cov kua nplaum kom zoo yog qhov tsim nyog.

Thoob plaws hauv lub cev xeeb tub, nws yog ib qho tsim nyog los tswj lub xeev ntawm metabolic sib npaug hauv cov neeg mob preexisting los yog mob ntshav qab zib hauv lub cev. Qhov kev xav tau rau insulin hauv thawj lub hlis ntawm cev xeeb tub yuav txo qis, feem ntau nws nce hauv qib thib ob thiab thib peb. Tam sim ntawd tom qab yug los, xav tau insulin tsawg dua.

Nws tsis paub meej tias insulin glulisin hla mus rau leej niam cov kua mis li cas los xij, txawm li cas los xij, feem ntau cov insulin tsis kis mus rau niam mis thiab tsis nqus tom qab tswj hwm qhov ncauj.

Cov poj niam uas pub niam mis rau menyuam noj tej zaum yuav tau kho qhov koob tshuaj insulin thiab zaub mov noj kom ntau.

Sab sij huam

Kev mob ntshav qab zib tsawg, feem ntau cov kev phiv los ntawm kev kho insulin, tuaj yeem txhim kho yog tias cov koob tshuaj insulin ntau dhau piv rau qhov xav tau cov tshuaj insulin.

Cov kev mob tshwm sim hauv qab no cuam tshuam nrog kev siv yeeb tshuaj, pom thaum lub sijhawm sim kho mob, tau nthuav tawm hauv qab no ntawm cov chav kawm ntawm cov kabmob hauv kev txo qis ntawm lawv qhov tshwm sim (ntau zaus:> 1/10, nquag> 1/100, 1/1000, 1/10000,

Noj ntau dhau

Tej zaum qhov kev txhim kho hypoglycemia yog qhov txiaj ntsig dhau los ntawm kev ua dhau los ntawm insulin hauv kev sib piv rau kev noj zaub mov thiab lub zog ntawm tus neeg mob.

Tsis muaj cov ntaub ntawv qhia tshwj xeeb ntawm kev siv ntau dhau ntawm insulin glulisin. Txawm li cas los xij, hypoglycemia tuaj yeem tsim kho hauv theem.

Kev mob ntshav qab zib tsawg tsawg tuaj yeem kho tau los ntawm qhov ncauj lossis cov khoom qab zib. Yog li, nws tau pom zoo kom cov neeg mob ntshav qab zib muaj qee qhov piam thaj, qab zib, ncuav qab zib lossis kua txiv qab zib nrog lawv. Kev mob ntshav qog ntshav siab, thaum tus neeg mob lub siab, tuaj yeem kho nrog glucagon (0.5 - 1 mg), muab tshuaj intramuscularly lossis subcutaneously los ntawm tus neeg uas tau txais cov lus qhia cuam tshuam, lossis kho nrog cov ntshav qabzib tshuaj los ntawm tus kws kho mob. Cov kua nplaum yuav tsum tau muab tshuaj ntxiv yog tias tsis muaj tus neeg mob teb rau glucagon rau li 10-15 feeb. Tom qab rov nco qab, nco ntsoov noj haus hauv qhov ncauj kom zoo rau kev tiv thaiv kom rov huam mob.

Tom qab txhaj tshuaj rau glucagon txhaj tshuaj, nws yog ib qho tsim nyog yuav tau soj ntsuam tus neeg mob hauv tsev kho mob txhawm rau txhawm rau pom qhov ua rau muaj ntshav nce siab ntau thiab tiv thaiv kev txhim kho ntawm cov mob xws li yav tom ntej.

Kev cuam tshuam nrog lwm yam tshuaj

Tsis muaj cov kev tshawb fawb txog kev sib txuam pharmacological tau ua tiav. Raws li cov kev tau dhau los nrog lwm cov tshuaj zoo sib xws, kev sib txuam ntawm pharmacological ntawm kev kho mob qhov tseem ceeb yog qhov tsis zoo.

Qhia rau koj tus kws kho mob txog TXHUA yam tshuaj uas koj noj, txawm tias nws tshwm sim ib qhov dhau ib ntawm!

Qee yam tshuaj cuam tshuam rau cov metabolism hauv qabzib, yog li kev txhaj tshuaj ntawm insulin glulisin thiab tshwj xeeb ua tib zoo saib xyuas yuav tsum tau.

Cov tshuaj uas tuaj yeem txhim kho cov piam thaj hauv kev kho ntshav hauv cov ntshav thiab ua rau cov ntshav qab zib tsawg nyob rau hauv qhov ncauj nrog rau cov tshuaj tiv thaiv ntshav qab zib, angiotensin-hloov enzyme inhibitors, disopyramides, fibrates, fluoxetine, MAO inhibitors, pentoxifylline, propoxyphene, salicylates thiab sulfibamide.

Cov yeeb tshuaj uas tuaj yeem txo cov ntshav qabzib-txo kev ua haujlwm suav nrog glucocorticosteroid cov tshuaj hormones, danazole, diazoxide, diuretics, glucagon, isoniazid, phenothiazine derivatives, somatropin, sympathomimetics (e.g. epinephrine adrenaline, salbutamol, terbutaline, hormones, e.g. cov tshuaj hormones , hauv qhov ncauj tiv thaiv kab mob), protease inhibitors thiab tshuaj atypical antipsychotic (piv txwv li, olanzapine thiab clozapine).

Beta-blockers, clonidine, lithium ntsev thiab dej cawv tuaj yeem txhim kho thiab ua kom cov ntshav qabzib-txo qis kev ua haujlwm ntawm cov kua dej hauv cov ntshav. Pentamidine tuaj yeem ua rau hypoglycemia, uas qee zaum nkag mus rau hauv hyperglycemia.

Tsis tas li ntawd, nyob rau hauv kev cuam tshuam ntawm cov tshuaj sympatholytic xws li ß-blockers, clonidine, guanethidine thiab reserpine, cov cim ntawm adrenergic antiregulation tej zaum yuav mob me lossis tsis tuaj.

Cov Lus Qhia Sib Tw

Vim tias tsis muaj kev kawm tshawb tau zoo, cov tshuaj no yuav tsum tsis txhob sib xyaw nrog cov tshuaj uas tsis yog tib neeg NPH insulin.

Daim ntawv thov nta

Kev hloov chaw ntawm tus neeg mob mus rau ib hom tshiab lossis hom tshuaj insulin yuav tsum tau ua nyob rau hauv kev saib xyuas mob nkeeg nruj me ntsis. Hloov pauv hauv daim ntawv tso tawm, hom (tsim tawm), hom (qauv, NPH, qeeb kev txiav txim siab, thiab lwm yam), keeb kwm (hom tsiaj) thiab (lossis) cov thev naus laus zis yuav ua rau muaj kev hloov pauv ntau npaum li cas. Dosage kev kho ntawm qhov ncauj hypoglycemic tej zaum yuav xav tau nrog kev kho mob tib lub sijhawm.

Kev noj tshuaj tsis txaus lossis tsis ua haujlwm ntawm kev kho mob, tshwj xeeb tshaj yog nyob rau hauv cov neeg mob ntshav qab zib insulin, tuaj yeem ua rau cov mob ntshav qab zib thiab ntshav qab zib ketoacidosis - ua rau muaj mob muaj sia.

Lub sijhawm ntawm kev txhim kho hypoglycemia yog nyob ntawm cov tshuab ntawm kev ua ntawm cov tshuaj insulin thiab, yog li ntawd, tuaj yeem hloov nrog kev hloov pauv ntawm kev kho mob.

Cov xwm txheej uas tuaj yeem hloov lossis txo qis cov kev mob ntshav qog ntshav thaum ntxov muaj xws li cov hauv qab no: mob ntshav qab zib mus ntev, kho mob hnyav nrog insulin, ntshav qab zib neuropathy, tshuaj xws li ß-blockers, lossis hloov los ntawm tsiaj mus rau tib neeg insulin. Koob tshuaj yuav tau noj yog tias tus neeg mob tau ua nws lub cev qoj ib ce los sis pauv noj mov lawm. Kev tawm dag zog tam sim ntawd tom qab noj mov tuaj yeem ua rau muaj kev pheej hmoo ntawm lub qog ntshav qab zib.

Yog tias hypoglycemia kev txhim kho tom qab kev txhaj tshuaj ntawm kev ua yeeb yam sai, tom qab ntawd nws yuav tshwm sim thaum ntxov, piv nrog kev txhaj tshuaj ntawm tib neeg cov kua dej.

Yog tias hypoglycemic thiab hyperglycemic tshua yog tsis kho, lawv tuaj yeem ua rau poob ntawm kev nco qab, rau leej twg thiab tus neeg mob tuag.

Tus neeg mob xav tau cov tshuaj insulin tuaj yeem hloov thaum mob los yog ntxhov siab ntxhov siab.

Kev siv tes taw

Ua ntej siv SoloStar koob txhaj tshuaj, koj yuav tsum ua tib zoo nyeem cov lus qhia rau kev siv muaj nyob hauv nplooj ntawv no.

Daim ntawv tso tawm

3 ml txhua qhov hauv ib qho ntshiab, iav iav cartridge (hom I). Lub pob txha taub tau ntim rau ntawm ib sab nrog lub bromobutyl nres thiab crimped nrog txhuas hau, ntawm qhov tod tes nrog bromobutyl plunger.

Lub cartridge yog ntsia rau hauv cov phwj uas pov tseg SoloStar. 5 SoloStar syringes muab tso rau hauv cov thawv thawv ntawv nrog cov lus qhia rau siv.