Apidra - cov lus qhia ua ntej rau kev siv

Daim ntawv tshuaj ntawm Apidra yog kev daws teeb meem rau subcutaneous (sc) kev tswj hwm: ib qho yuav luag tsis muaj xim lossis tsis muaj xim pob tshab kua (10 ml hauv lub raj mis, 1 lub raj mis rau hauv cov thawv ntawv thawv, 3 ml hauv cartridges, hauv ib qho paug: 5 cartridges rau ib rab koob xaum xim) “OptiPen” lossis 5 daim laub ntsia rau hauv rab koob uas siv pov tseg “OptiSet”, lossis 5 lub laub “OptiClick”).

Hauv 1 ml ntawm kev daws muaj:

• cov tshuaj nquag: insulin glulisin - 3.49 mg (sib npaug rau 100 IU ntawm tib neeg cov tshuaj insulin),
• Cov khoom siv pabcuam: trometamol, m-cresol, polysorbate 20, sodium chloride, muaj cov hydrochloric acid, sodium hydroxide, dej rau kev txhaj tshuaj.

Cov Yuav Tsum Muaj

• ntshav qab zib,
• cov menyuam yaus hnub nyoog txog 6 xyoo (cov ntaub ntawv hais txog kev siv tsuas siv tsawg),
• muaj tshuaj tiv thaiv tsis haum rau cov tshuaj insulin glulisin lossis lwm yam tshuaj ntawm cov tshuaj.

Nrog kev ceev faj, Apidra pom zoo rau siv thaum cev xeeb tub.

Cov neeg mob uas muaj daim siab tsis txaus siab yuav xav tau cov tshuaj insulin tsawg dua vim qhov txo qis ntawm gluconeogenesis thiab qeeb hauv cov tshuaj insulin metabolism.

Txo cov xav tau cov tshuaj insulin kuj muaj peev xwm ua tau rau lub raum tsis ua haujlwm thiab hauv lub hnub nyoog laus (vim yog lub raum tsis ua haujlwm).

Tsuas tshuaj thiab tswj hwm

Apidra insulin yog siv tam sim ua ntej noj mov (rau 0-15 feeb) lossis tam sim ntawd tom qab noj mov los ntawm s.c. txhaj tshuaj lossis txuas ntxiv mus rau hauv cov rog subcutaneous siv lub twj tso kua mis-ua haujlwm.

Cov koob tshuaj thiab cov txheej txheem ntawm kev tswj hwm cov tshuaj tau xaiv ib tus zuj zus.

Kev siv tshuaj Apidra yog siv rau hauv kev kho txoj kev nyuaj nrog kev siv tshuaj nruab nrab lossis los ntawm insulin / kev ua yeeb yam ntev ntev ntawm cov tshuaj insulin; ua ke siv nrog cov tshuaj hypoglycemic hauv qhov ncauj tau tso cai.

Pom zoo rau cov chaw ntawm lub cev rau kev tswj hwm tshuaj:

• s / c txhaj tshuaj - tsim hauv lub xub pwg, ncej puab lossis lub plab, thaum qhov kev taw qhia rau hauv lub plab phab ntsa muab qhov nrawm sai dua,
• Txoj kev lis ntshav tas mus li - ua nyob rau hauv roj subcutaneous rog hauv plab.

Koj yuav tsum hloov lwm qhov chaw ntawm Txoj kev lis ntshav thiab txhaj tshuaj nrog txhua tus tom qab ua haujlwm ntawm cov tshuaj.

Vim tias daim ntawv ntau npaum li cas ntawm Apidra yog qhov kev daws teeb meem, kev rov qab kho dua tsis tas yuav tsum tau ua ntej siv nws.

Tus nqi ntawm kev nqus thiab, raws li, qhov pib thiab sijhawm ntawm cov tshuaj yuav txawv nyob ntawm tus yam ntxwv ntawm lub cev, nyob ntawm qhov chaw txhaj tshuaj ntawm cov tshuaj thiab lwm yam kev hloov pauv.

Kev saib xyuas yuav tsum tau ua thaum saib xyuas cov tshuaj kom thim cov feem ntau ntawm nws nkag mus ncaj qha rau hauv cov hlab ntshav. Tom qab cov txheej txheem, qhov chaw txhaj tshuaj yuav tsum tsis txhob zaws.

Cov neeg mob yuav tsum tau qhia kev qhia txhaj tshuaj.

Thaum tswj hwm cov tshuaj uas siv lub tshuab nqus dej rau cov tshuaj insulin infusion, cov tshuaj yuav tsis tov nrog lwm cov tshuaj / cov neeg sawv cev.

Cov tshuaj Apidra tsis tov nrog lwm yam tshuaj tsuas yog tib neeg isofan-insulin. Hauv qhov no, Apidra tau kos rau hauv lub koob txhaj tshuaj ua ntej, thiab kev txhaj tshuaj yog nqa tawm tam sim ntawd tom qab sib tov. Cov ntaub ntawv hais txog kev siv cov kev daws teebmeem ntev ua ntej kev txhaj tshuaj tsis muaj.

Daim cartridges yuav tsum siv nrog OptiPen Pro1 insulin syringe cwj mem los yog cov khoom siv sib xws hauv cov khoom nruj me ntsis raws li cov khw muag cov lus qhia rau lub thauj lub laub, txuas rab koob, thiab txhaj tshuaj insulin. Ua ntej siv daim cartridge, koj yuav tsum ua qhov muag pom kev ntawm lub tshuaj. Rau kev txhaj tshuaj, tsuas yog ib qho tseeb, tsis muaj kob uas tsis muaj cov khoom pom tau yooj yim yog qhov tsim nyog. Ua ntej kev teeb tsa, daim cartridge yuav tsum xub khaws tseg rau 1-2 teev ntawm chav sov, thiab ua ntej qhia kev daws teeb meem, cov pa npuas yuav tsum tau muab tshem tawm ntawm daim cartridge.

Cov roj laub siv tsis tau rov qab. Siv tsis tau OptiPen Pro1 koob txhaj tshuaj tsis haum.

Thaum lub cev tsis ua haujlwm ntawm lub koob txhaj tshuaj, kev daws teeb meem tuaj yeem raug kos los ntawm daim cartridge rau hauv cov yas syringe uas tsim nyog rau cov tshuaj insulin ntawm qhov concentration ntawm 100 IU / ml, thiab tom qab ntawv siv rau tus neeg mob.

Ib rab koob rov qab siv tau yog siv rau kev txhaj tshuaj nkaus xwb rau ib tus neeg mob (kom tsis txhob muaj mob).

Tag nrho cov lus pom zoo saum toj no thiab cov cai yuav tsum raug pom thaum siv lub kaw lus cartridge thiab OptiKlik koob txhaj tshuaj rau kev tswj hwm Apidra daws teeb meem, uas yog lub khob ntim nrog cov twj tso kua mis txuas, tsau rau hauv cov thawv ntim pob tshab thiab muaj 3 ml ntawm glulisin insulin kua.

Sab sij huam

Feem ntau qhov tsis xav tau txoj kev xav ntawm kev kho tshuaj insulin yog hypoglycemia, uas feem ntau tshwm sim thaum siv cov tshuaj insulin nyob rau hauv cov koob tshuaj ntau dua qhov xav tau.

Cov kev mob tshwm sim tsis zoo cuam tshuam nrog kev tswj hwm tshuaj los ntawm cov plab hnyuv siab raum thiab cov kab mob ntawm cov neeg mob tau sau npe thaum lub sijhawm kuaj mob (cov npe tau muab los ntawm kev siv cov hauv qab cov lej ntawm qhov tshwm sim: ntau dua 10% - ntau zaus, ntau dua 1%, tab sis tsawg dua 10% - feem ntau, ntau 0.1%, tab sis tsawg dua 1% - qee zaum, ntau dua 0.01%, tab sis tsawg dua 0.1% - tsis tshua muaj, tsawg dua 0.01% - tsis tshua muaj tsawg):

• cov metabolism: feem ntau heev - ua rau lub ntsej muag ntshav siab, nrog rau cov hauv qab no tshwm sim sai li sai tau: cov hws txias, pallor ntawm daim tawv nqaij, qaug zog, ntxhov siab, tshee tshee, poob siab, poob siab, tsis meej pem, tsaug zog, nyuaj mloog, pom kev tsis txaus siab, xeev siab, nqhis dej heev, mob taub hau, mob taub hau heev, qhov tshwm sim ntawm qhov nce ntawm hypoglycemia tuaj yeem yog: tsis nco qab thiab / lossis qaug dab peg, ib ntus lossis tas mus li ua rau lub hlwb ua haujlwm, hauv cov xwm txheej loj, tuag taus tshwm sim
• daim tawv nqaij thiab cov nqaij mos subcutaneous: feem ntau - ua rau pom kev tsis haum, xws li o, hyperemia, khaus ntawm qhov chaw txhaj tshuaj, feem ntau txuas ntxiv ntawm lawv tus kheej nrog kev kho mob txuas ntxiv, tsis tshua muaj lipodystrophy, feem ntau yog vim qhov kev ua txhaum ntawm kev hloov chaw ntawm cov tshuaj insulin hauv ib qho ntawm thaj chaw / rov tswjfwm ntawm cov tshuaj mus rau qhov qub chaw
• Kev siv tshuaj tiv thaiv qhov mob tsis haum: qee lub sijhawm - ua tsis taus pa, lub hauv siab nruj, khaus, khaus, ua pob khaus, nyob rau hauv cov mob loj heev ntawm kev tsis haum tshuaj (suav nrog anaphylactic), lub neej muaj peev xwm ua tau.

Tsis muaj cov ntaub ntawv tshwj xeeb ntawm cov tsos mob ntawm insulin ntau dhau ntawm glulisin, tab sis vim yog siv sijhawm ntev ntawm Apidra, qhov sib txawv ntawm qhov ntau ntawm cov ntshav qog ntshav qis yog qhov ua tau.

Kev kho mob ntawm tus mob yog nyob ntawm qhov ntau ntawm cov kab mob:

• Kev mob ntshav qab zib tsawg - nres ntawm kev siv cov piam thaj lossis cov khoom muaj suab thaj, hauv kev sib txuas nrog cov neeg mob ntshav qab zib tau pom zoo kom ib txwm muaj cov ncuav qab zib, khoom qab zib, tej yam ua kom qab zib, kua txiv qab zib,
• kev mob ntshav qog ntshav siab (nrog rau kev tsis nco qab) - nres intramuscularly (intramuscularly) lossis sc los ntawm kev tswj hwm ntawm 0.5-1 mg ntawm glucagon, lossis iv (tso ntshav tshuaj) cov ntshav qabzib (dextrose) thaum tsis muaj lus teb rau glucagon tswj rau li ntawm 10-15 feeb Tom qab nws rov qab nco qab, tus neeg mob tau qhia kom muab cov carbohydrates nyob rau hauv sab hauv kom tiv thaiv tau qhov kev rov ua rau cov ntshav qog ntshav, tom qab ntawd, txhawm rau txhawm rau tsim qhov ua rau muaj ntshav nce siab ntau, thiab tseem yuav tiv thaiv kev txhim kho ntawm cov mob ntu ntawd ntawm tus neeg mob, nws yog qhov yuav tsum tau soj ntsuam rau qee lub sijhawm hauv tsev kho mob.

Cov lus qhia tshwj xeeb

Nyob rau hauv kev hloov pauv ntawm tus neeg mob mus rau insulin los ntawm lwm lub chaw tsim khoom lossis ib hom tshiab ntawm cov tshuaj insulin, kev saib xyuas kev kho mob nruj yog qhov tsim nyog, vim kev kho ntawm txoj kev kho tag nrho yuav tsum tau ua.

Noj cov tshuaj insulin tsis tsim nyog lossis txiav kev kho mob tsis tsim nyog, tshwj xeeb tshaj yog nyob rau cov neeg mob ntshav qab zib hom 1, tuaj yeem ua rau hyperglycemia thiab ntshav qab zib ketoacidosis - muaj feem yuav ua rau tuag taus. Lub sijhawm ntawm qhov yuav tshwm sim ntawm kev kho ntshav qog ntshav ncaj qha nyob ntawm qhov ceev ntawm qhov kev txiav txim ntawm kev siv cov tshuaj insulin thiab yog li yuav hloov nrog txoj kev kho qhov tseeb ntawm kev kho mob.

Cov mob tseem ceeb uas tuaj yeem hloov lossis ua kom cov tsos mob ntawm kev txhim kho hypoglycemia tsis tshua hais tawm:

• lub caij ntev muaj ntshav qab zib hauv tus neeg mob,
• uas mob ntshav qab zib neuropathy
• intensification ntawm insulin txoj kev kho,
• siv qee cov tshuaj, piv txwv li, β-blockers,
• hloov dua siab tshiab rau tib neeg cov kua dej los ntawm insulin ntawm tsiaj keeb kwm.

Kev kho cov tshuaj insulin kuj tseem ceeb yog tias muaj kev hloov pauv hauv cov cai ntawm lub cev muaj zog lossis khoom noj khoom haus. Kev ua kom lub cev ua si muaj zog ntau ntxiv tom qab noj mov tuaj yeem nce qhov feem ntau ntawm kev txhim kho hypoglycemia. Piv nrog rau kev ua kom tiav ntawm tib neeg cov tshuaj insulin, hypoglycemia tuaj yeem txhim kho sai sai tom qab tswj hwm kev ua haujlwm sai ntawm insulin analogues.

Qhov tsis pom txog hypo- lossis hyperglycemic tshua tuaj yeem ua rau tsis nco qab, tsis nco qab, lossis tuag.

Cov mob tsis haum lossis cov kev xav ntau dhau kuj tuaj yeem hloov tus neeg mob xav tau cov tshuaj insulin.

Yeeb tshuaj sib cuam tshuam

Tsis muaj kev tshawb fawb txog kev sib raug zoo ntawm cov tshuaj pharmacokinetic ntawm Apidra, tab sis raws li cov ntaub ntawv muaj nyob rau cov tshuaj zoo sib xws, nws tuaj yeem xaus lus tias muaj kev sib txuam ntawm cov chaw muag tshuaj muaj peev xwm tsis zoo li.

Qee cov tshuaj / yeeb tshuaj tuaj yeem cuam tshuam rau cov metabolism hauv cov piam thaj, uas yuav xav tau kho cov tshuaj insulin glulisin ntau dua thiab tau saib xyuas cov kev kho kom zoo thiab tus neeg mob lub neej.

Yog li thaum siv ua ke nrog kev daws Apidra:

• qhov ncauj hypoglycemic tshuaj, angiotensin hloov enzyme inhibitors, disopyramides, fluoxetine, fibrates, monoamine oxidase inhibitors, propoxyphene, pentoxifylline, sulfonamide antimicrobials, salicylates - tuaj yeem txhim kho hypoglycemic nyhuv ntawm insulin thiab nce hypoglycemia,
• glucocorticosteroids, diuretics, danazol, diazoxide, isoniazid, somatropin, phenothiazine derivatives, sympathomimetics (epinephrine / adrenaline, terbutaline, salbutamol), estrogens, thyroid hormones, progestins (tshuaj tiv thaiv hauv qhov ncauj), antipsychotin, antipsynchotin muaj peev xwm txo cov nyhuv hypoglycemic ntawm insulin,
• clonidine, β-blockers, ethanol, ntsev ntsev lithium - potentiate lossis ua kom cov nyhuv tsis muaj zog ntawm insulin,
• pentamidine - tuaj yeem ua rau hypoglycemia, tom qab los ntawm hyperglycemia,
• cov tshuaj nrog kev ua si sympatholytic (β-blockers, guanethidine, clonidine, reserpine) - nrog hypoglycemia, lawv tuaj yeem txo qhov mob hnyav lossis npog qhov tsos mob ntawm reflex adrenergic kev ua kom mob.

Kev tshawb fawb ntawm kev sib raug zoo ntawm insulin glulisin tsis tau ua, yog li ntawd, Apidra yuav tsum tsis txhob sib xyaw nrog lwm cov tshuaj, qhov tshwj tsis yog muaj isofan-insulin.

Nyob rau hauv cov ntaub ntawv ntawm kev qhia ntawm kev daws teeb meem siv infusion twj tso kua mis, Apidra yuav tsum tsis txhob tov nrog lwm cov tshuaj.

Cov qauv ntawm Apidra yog: Vozulim-R, Actrapid (NM, MS), Gensulin R, Biosulin R, Insuman Rapid GT, Insulin MK, Insulin-Fereyn CR, Gansulin R, Humalog, Pensulin (SR, CR), Monosuinsulin (MK, MP ), Humulin Tsis Txaus, NovoRapid (Penfill, FlexPen), Humodar R, Monoinsulin CR, Insuran R, Rinsulin R, Rosinsulin R.

Cov lus thiab cov xwm txheej ntawm kev cia

Khaws rau hauv lawv tus kheej daim ntawv ntim khoom, tsis pub nkag mus rau lub teeb, ntawm qhov kub ntawm 2-8 ° C. Tsis khov. Khaws tsis ncav cuag ntawm cov menyuam yaus!

Tom qab qhib lub pob, muab cia rau hauv ib qho chaw tiv thaiv los ntawm lub teeb ntawm kub txog 25 ° C. Lub txee lub neej ntawm cov tshuaj tom qab nws siv thawj zaug yog 4 lub lis piam (nws raug pom zoo rau hnub tim ntawm qhov tau txais thawj cov tshuaj ntawm cov tshuaj nyob rau ntawm daim ntawv lo).

Cov chaw muag tshuaj

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 tau ua nyob rau hauv cov neeg tuaj yeem noj qab haus huv thiab cov neeg mob ntshav qab zib mellitus tau qhia tias nrog sc tswj hwm cov tshuaj insulin glulisin pib ua haujlwm sai dua thiab muaj lub sijhawm luv luv ntawm kev ua dua li soluble tib neeg cov kua dej. Nrog txoj kev tswj hwm subcutaneous, qhov qis qis ntawm cov piam thaj hauv cov ntshav, kev nqis tes ntawm insulin glulisin pib hauv 10-20 feeb. Thaum muab cov tshuaj rau lub ntsej muag, qhov ntxim li hypoglycemic ntawm insulin glulisin thiab soluble tib neeg insulin yog sib npaug hauv lub zog. Ib chav ntawm insulin glulisin muaj tib yam qabzib-txo qis kev ua haujlwm raws li ib chav ntawm solulin tib neeg cov kua dej.

Hauv ib theem kuv kawm nyob hauv cov neeg mob ntshav qab zib hom 1, ntshav qabzib-txo cov ncauj lus ntawm cov tshuaj insulin glulisin thiab solulin tib neeg cov tshuaj insulin tau raug tso tshuaj subcutaneously ntawm koob tshuaj ntawm 0.15 U / kg ntawm lub sijhawm sib txawv raws li qauv noj haus 15 feeb. Cov txiaj ntsig ntawm txoj kev tshawb pom pom tias insulin glulisin siv sijhawm li 2 feeb ua ntej ib pluas noj tau muab tib txoj kev tswj glycemic tom qab noj mov ib yam li soluble tib neeg cov tshuaj insulin tau 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 tau muab tib yam glycemic tswj tom qab noj mov tas li tib neeg solulin 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 rog rog pom tias hauv cov neeg mob no, insulin glulisin khaws nws cov yeeb yam sai. Hauv qhov kev tshawb nrhiav no, lub sijhawm nce mus txog 20% ​​ntawm tag nrho AUC yog 114 min rau insulin glulisin, 121 min rau insulin lispro thiab 150 min rau solulin tib neeg cov kua dej, thiab AUQ_{(0-2 h) |}kuj tseem pom kev txo qis ntshav qabzib thaum ua haujlwm, ntsig txog, yog 427 mg / kg rau insulin glulisin, 354 mg / kg rau insulin lispro, thiab 197 mg / kg rau solulin tib neeg cov tshuaj.

Cov chaw tshawb fawb
Yam 1 ntshav qab zib.
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 ntshav qab zib hom 1 siv insulin glargine li insulin glulisin yog qhov sib piv. nrog lispro insulin rau kev tswj glycemic, uas tau soj ntsuam los ntawm kev hloov pauv hauv kev xav ntawm glycated hemoglobin (HbA_1s) thaum lub sijhawm kawg ntawm qhov xaus ntawm txoj kev tshawb pom hauv qhov sib piv nrog tus nqi pib. Thaum cov tshuaj insulin raug muab, glulisin, tsis zoo li kev kho mob nrog lyspro insulin, tsis tas yuav nce ntxiv ntawm cov koob tshuaj insal basal.

Kev soj ntsuam 12 lub lis piam III hauv cov neeg mob uas muaj ntshav qab zib hom 1 uas tau txais insulin glargine raws li kev kho mob qhia qhov tseeb pom tias cov txiaj ntsig ntawm insulin glulisin tswj hwm tam sim ntawd tom qab noj mov tau piv rau qhov ntawm insulin glulisin tam sim ntawd ua ntej noj mov (rau 0 -15 min) lossis solulin tib neeg cov kua dej (30-45 feeb ua ntej noj mov).

Hauv cov pab pawg ntawm cov neeg mob uas tau txais insulin glulisin ua ntej noj mov, tau pom qhov txo qis HbA ntau dua_1s piv nrog rau pab pawg neeg ntawm cov neeg mob tau txais soluble tib neeg cov kua dej.

Mob ntshav qab zib Hom 2
Ib lub sijhawm 26 lub lis piam mus soj ntsuam tom qab 26-lub lis piam rov qab los ntawm kev soj ntsuam kev nyab xeeb los ua piv rau insulin glulisin (0-15 feeb ua ntej noj mov) nrog solulin tib neeg cov insulin (30-45 feeb ua ntej noj mov), uas tau txhaj tshuaj subcutaneously nyob rau hauv cov neeg mob uas muaj hom 2 mob ntshav qab zib mellitus, ntxiv rau siv insulin-isophan ua insulin basal. Insulin glulisin tau pom tias piv rau soluble tib neeg insulin nrog kev hloov pauv hauv HbA ntau_1s tom qab 6 lub hlis thiab tom qab 12 lub hlis ntawm kev kho mob piv nrog thawj tus nqi.

Thaum lub sijhawm txuas ntxiv sc infusion ntawm insulin siv hom twj tso kua mis (rau hom 1 mob ntshav qab zib mellitus) hauv 59 cov neeg mob kho nrog Apidra ® lossis insulin aspart hauv ob pawg kho mob, qhov tsawg tshwm sim ntawm catheter occlusion tau pom (0.08 occlusions ib hlis thaum siv tshuaj Apidra ® thiab 0.15 occlusions ib lub hlis thaum siv cov tshuaj insulin aspart), zoo ib yam li muaj kev cuam tshuam zoo ib yam ntawm qhov chaw txhaj tshuaj (10.3% thaum siv Apidra ® thiab 13.3% thaum siv insulin aspart).

Hauv cov menyuam yaus thiab cov hluas muaj mob ntshav qab zib hom 1 mob ntshav qab zib, leej twg tau txais tshuaj insulin ib zaug ib hnub ib zaug thaum yav tsaus ntuj, insulin glargine, lossis ob zaug ib hnub thaum sawv ntxov thiab yav tsaus ntuj, isulin insulin, thaum piv rau kev ua tau zoo thiab kev nyab xeeb ntawm kev kho mob nrog insulin glulisin thiab insulin lispro nrog rau kev tswj hwm 15 feeb ua ntej noj mov, nws tau qhia tias kev tswj glycemic, qhov tshwm sim ntawm kev mob ntshav qab zib, uas yuav tsum muaj kev cuam tshuam ntawm cov neeg thib peb, nrog rau qhov tshwm sim ntawm qhov mob ntshav qab zib hnyav tau sib piv hauv ob pawg kho mob. Ntxiv mus, tom qab 26 lub lim tiam ntawm kev kho mob, cov neeg mob tau txais kev kho mob insulin nrog glulisin kom ua tiav kev tswj glycemic piv rau lispro insulin yuav tsum muaj qhov nce ntawm cov tshuaj insulin txhua hnub, sai insulin thiab tag nrho cov tshuaj insulin.

Haiv neeg thiab tub los ntxhais
Hauv kev tswj xyuas cov kev kho mob hauv cov neeg laus, qhov sib txawv ntawm kev nyab xeeb thiab kev ua tau zoo ntawm insulin glulisin tsis tau pom nyob hauv kev txheeb xyuas ntawm pab pawg sib txawv los ntawm qhov sib txawv 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 insulin nqus ntawm glulisin piv rau soluble tib neeg insulin yog kwv yees li 2 zaug sai dua thiab ntau qhov ntshav siab tshaj plaws tau tiav (Cmax) kwv yees li 2 ntau zaus ntxiv.

Hauv kev tshawb nrhiav rau cov neeg mob uas muaj mob ntshav qab zib hom 1, tom qab sc tswj hwm ntawm insulin glulisin ntawm ib koob ntawm 0.15 U / kg, T_max (lub sijhawm ntawm qhov pib ntawm cov ntshav siab tshaj plaws) yog 55 feeb, thiab C_max yog 82 ± 1.3 μU / ml piv rau T_maxconstituting 82 feeb, thiab C_maxntawm 46 ± 1.3 mcU / ml rau soluble 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 hauv cov neeg mob uas muaj mob ntshav qab zib hom 2 tom qab sc tswj hwm ntawm insulin glulisin ntawm koob tshuaj 0.2 PIECES / kg C_max yog 91 μED / ml nrog interquartile latitude ntawm 78 txog 104 μED / ml.

Thaum s / c ntawm cov tshuaj insulin raug tswj hwm, glulisin 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 lub plab ua ntej phab ntsa piv nrog kev tswj hwm ntawm cov tshuaj hauv thaj av ncej puab. Tus nqi ntawm kev nqus ntawm thaj av deltoid yog nruab nrab. Qhov tshwj xeeb tshaj plaws bioavailability ntawm insulin glulisin tom qab kev tswj hwm sc yog kwv yees li 70% (73% los ntawm anterior plab phab ntsa, 71 los ntawm deltoid leeg thiab 68% los ntawm lub ntsag) thiab muaj qhov tsis tshua pom kev hauv cov neeg mob sib txawv.

Kev faib khoom thiab tshem tawm
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. Tom qab sc tswj hwm cov tshuaj 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 hom 2, qhov pom tseeb tshem tawm ib nrab ntawm lub neej nyob ntawm 37 txog 75 feeb.

Cov chaw muag tshuaj hauv cov pab pawg neeg tshwj xeeb
Cov neeg mob raum tsis ua haujlwm
Hauv qhov kev tshawb fawb soj ntsuam ua rau cov neeg mob tsis muaj ntshav qab zib nrog rau ntau yam kev ua haujlwm ntawm lub raum (kev tsim lub peev xwm tshem tawm (CC)> 80 ml / min, 30-50 ml / min, ® hauv cov poj niam cev xeeb tub. Cov poj niam cev xeeb tub (tsawg dua 300 cov txiaj ntsig kev cev xeeb tub tau tshaj tawm) tsis qhia tias nws muaj txiaj ntsig tsis zoo rau kev xeeb tub, kev loj hlob hauv tus menyuam lossis tus menyuam tshiab. lichy ntawm insulin glulisine thiab tib neeg insulin nrog hwm rau cev xeeb tub, embryonic / me nyuam hauv plab kev loj hlob, yug menyuam thiab post-Natal txoj kev loj hlob.

Kev siv Apidra ® rau cov poj niam cev xeeb tub yuav tsum muaj kev tiv thaiv ceev faj. Ua tib zoo saib xyuas ntawm cov concentration ntawm cov piam thaj hauv cov ntshav thiab tswj cov glycemic txaus tsim nyog.

Cov neeg mob uas cev xeeb tub ua ntej los yog mob ntshav qab zib hauv lub cev yuav tsum muaj kev tiv thaiv glycemic txaus ua ntej xeeb tub thiab thoob plaws hauv lawv lub cev xeeb tub. Nyob rau thawj peb lub hlis thaum cev xeeb tub, qhov xav tau rau cov tshuaj insulin yuav tsawg dua, thiab nyob rau zaum ob thiab thib peb feem ntau, feem ntau nws tuaj yeem nce ntxiv. Tam sim ntawd tom qab yug los, xav tau insulin tsawg dua.

Cov neeg mob ntshav qab zib yuav tsum qhia lawv tus kws kho mob yog tias lawv cev xeeb tub los yog npaj yuav cev xeeb tub.

Lub sijhawm pub mis niam
Nws tsis paub meej tias insulin glulisin hla mus rau leej niam cov kua mis tau li cas, tab sis, feem ntau, cov tshuaj insulin tsis kis mus rau niam mis thiab tsis yog nqus los ntawm qhov ncauj tswj hwm.

Rau cov poj niam thaum lub sijhawm pub niam mis, yuav tsum muaj kev kho mob ntawm cov tshuaj insulin kom zoo thiab kev noj zaub mov kom zoo.

Tsuas tshuaj thiab tswj hwm

Apidra ® yuav tsum tau siv rau hauv kev kho mob uas suav nrog nruab nrab insulin nruab nrab, lossis insulin ntev ntev, lossis ntev ntev rau cov tshuaj insulin. Tsis tas li ntawd, Apidra ® tuaj yeem siv ua ke nrog tshuaj ntawm qhov ncauj hypoglycemic (PHGP).

Kev noj tshuaj ntxiv ntawm Apidra ® raug xaiv ib qho zuj zus raws li cov lus pom zoo ntawm tus kws kho mob raws li kev xav tau ntawm tus neeg mob. Txhua tus neeg mob ntshav qab zib tau raug qhia kom tswj xyuas lawv cov ntshav ntsuas ntshav qab zib.

Siv rau hauv pab pawg neeg mob tshwj xeeb
Menyuam yaus thiab tub ntxhais hluas
Apidra ® tuaj yeem siv rau hauv cov menyuam yaus hnub nyoog dhau 6 xyoo thiab cov hluas. Cov ntaub ntawv kev soj ntsuam txog kev siv cov tshuaj rau cov menyuam yaus hnub nyoog qis dua 6 xyoo yog txwv.

Cov neeg laus cov neeg mob
Muaj cov ntaub ntawv pharmacokinetics hauv cov neeg laus uas muaj ntshav qab zib mellitus yog qhov tsis txaus.
Lub raum khiav tsis zoo hauv lub hnub nyoog laus tuaj yeem ua rau txo qis hauv insulin.

Cov neeg mob raum tsis ua haujlwm
Txoj kev xav tau cov tshuaj insulin hauv lub raum tsis ua haujlwm yuav poob qis.

Cov neeg mob mob siab tsis ua haujlwm
Hauv cov neeg mob uas muaj lub siab ua haujlwm tsis txaus siab, qhov xav tau rau insulin tuaj yeem txo vim muaj peev xwm txo qis gluconeogenesis thiab ua rau cov metabolism hauv insulin tsis ua haujlwm qeeb.

Kev Sib Sau thiab daim ntawv ntawm kev tso tawm

nyob rau hauv 10 ml fwj los yog hauv 3 ml cartridges, hauv ib pob ntawv los ntawm lub taub hau 1 lub raj mis lossis hauv cov hlwv ntim cov ntim 5 ntim rau OptiPen syringe cwj mem los yog daim cartridges mounted hauv OptiSet pov tseg cwj mem los yog nrog OptiClick cartridge system Cov.

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. Cov tshuaj insulin glulisin pib ua haujlwm sai dua thiab muaj lub sijhawm luv luv ntawm kev ua ntau dua li cov neeg ua kom tau cov tshuaj insulin. 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 inhibits adipocyte lipolysis thiab proteolysis thiab txhim kho cov protein synthesis. Cov kev tshawb fawb tau ua nyob rau hauv cov neeg tuaj yeem noj qab haus huv thiab cov neeg mob ntshav qab zib mellitus tau qhia tias nrog sc tswj hwm cov tshuaj insulin glulisin pib ua haujlwm sai dua thiab muaj lub sijhawm luv luv ntawm kev ua dua li soluble tib neeg cov kua dej. Thaum s / coj los qhia txog kev txo qis ntshav qabzib hauv cov ntshav, kev ua ntawm insulin glulisin pib hauv 10-20 feeb. Nrog kev tswj hwm iv, qhov tshwm sim ntawm kev txo qis cov ntshav qabzib cov insulin glulisin thiab soluble tib neeg insulin yog sib npaug hauv lub zog. Ib chav ntawm insulin glulisin muaj tib yam qabzib-txo qis kev ua haujlwm raws li ib chav ntawm solulin tib neeg cov kua dej.

Hauv ib theem kuv kawm hauv cov neeg mob uas muaj hom 1 mob ntshav qab zib mellitus, cov ntshav qabzib-txo qis ntawm cov tshuaj insulin glulisin thiab solulin tib neeg cov tshuaj insulin raug soj ntsuam, muab rau s.c. ntawm ib koob ntawm 0.15 units / kg hauv cov sij hawm sib txawv raws li 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 raws li cov tib neeg solulin, muab 2 feeb ua ntej noj mov.

Kev pham Ib theem kuv kawm ua nrog insulin glulisin, insulin lispro thiab solulin tib neeg cov kua dej hauv ib pawg neeg rog rog pom tias hauv cov neeg mob no, insulin glulisin khaws nws cov yeeb yam ua haujlwm sai. Hauv qhov kev tshawb nrhiav no, lub sijhawm mus txog 20% ​​ntawm tag nrho AUC yog 114 min rau insulin glulisin, 121 min rau insulin lispro thiab 150 min rau solulin tib neeg cov kua dej, thiab AUC (0-2 teev), uas tseem qhia txog kev txo qis ntshav qabzib thaum ntxov, yog 427 mg · kg -1 - rau insulin glulisin, 354 mg · kg -1 - rau insulin lispro thiab 197 mg · kg -1 - rau solulin tib neeg insulin, feem.

Yam 1 ntshav qab zib. Hauv 26-lub lis piam kev soj ntsuam ntawm theem III, nyob rau hauv uas insulin glulisin piv nrog lispro insulin, tswj s.c. tsis ntev ua ntej noj mov (0-15 feeb), cov neeg mob ntshav qab zib hom mellitus, siv insulin glargine, insulin glulisin li basal insulin. tau muab piv rau lyspro insulin nrog kev tswj hwm glycemic, uas tau soj ntsuam los ntawm kev hloov pauv hauv kev xav ntawm glycosylated hemoglobin (HbA_1C) thaum lub sijhawm kawg ntawm txoj kev tshawb no piv nrog qhov tshwm sim. 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.

Kev soj ntsuam 12 lub lis piam III hauv cov neeg mob uas muaj ntshav qab zib hom 1 uas tau txais insulin glargine raws li kev kho mob qhia tau 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 min) lossis solulin tib neeg cov kua dej (30–45 feeb ua ntej noj mov).

Hauv cov pejxeem 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 HbA ntau dua._1C piv nrog rau pab pawg neeg ntawm cov neeg mob tau txais soluble tib neeg cov kua dej.

Yam 2 ntshav qab zib mellitus. Lub sijhawm 26-lub lim tiam zaum 3 kev soj ntsuam tom qab 26-lub limtiam ua raws li kev soj ntsuam kev nyab xeeb tau ua los piv rau insulin glulisin (0-15 feeb ua ntej noj mov) nrog solulin tib neeg cov tshuaj insulin (30-45 min ua ntej noj mov) uas tau muab tshuaj sc rau hauv cov neeg mob uas muaj hom 2 mob ntshav qab zib mellitus, ntxiv rau kev siv tshuaj insulin-isophan ua basal. Qhov nruab nrab ntawm tus neeg mob lub cev qhov nruab nrab ntsuas yog 34.55 kg / m 2. Insulin glulisin tau pom tias piv rau soluble tib neeg insulin nrog kev hloov pauv hauv HbA ntau_1C tom qab 6 lub hlis ntawm kev kho mob piv nrog cov txiaj ntsig (-0.46% rau insulin glulisin thiab -0.30% rau kev kho tib neeg cov kua dej, p = 0.0029) thiab tom qab 12 lub hlis ntawm kev kho mob piv nrog cov txiaj ntsig (-0.23% - rau cov tshuaj insulin glulisin thiab -0.13% rau soluble tib neeg cov kua dej, qhov sib txawv tsis tseem ceeb). Hauv txoj kev tshawb fawb no, feem ntau cov neeg mob (79%) tau sib xyaw lawv cov tshuaj insulin luv luv nrog isulin insulin tam sim ua ntej txhaj tshuaj. Nyob rau lub sijhawm ntawm randomization, 58 cov neeg mob siv cov tshuaj hypoglycemic hauv qhov ncauj thiab tau txais cov lus qhia los txuas ntxiv siv lawv ntawm tib cov tshuaj.

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

Cov Tshuaj Pharmacokinetics

Hauv cov tshuaj insulin, kev hloov pauv ntawm cov amino acid asparagine ntawm tib neeg insulin ntawm txoj hauj lwm B3 nrog lysine thiab lysine ntawm txoj haujlwm B29 nrog glutamic acid txhawb nqa kom sai dua.

Kev xiam thiab muaj peev xwm. Pharmacokinetic concentration-sijhawm nkhaus hauv cov neeg tuaj yeem noj qab haus huv thiab cov neeg mob uas muaj hom 1 thiab 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, nce mus txog ob zaug ntau dua C_max .

Hauv kev tshawb nrhiav rau cov neeg mob uas muaj mob ntshav qab zib hom 1, tom qab sc tswj hwm ntawm insulin glulisin ntawm ib koob ntawm 0.15 u / kg T_max (lub sijhawm ntawm qhov tshwm sim C_max ) yog 55 min thiab C_max hauv ntshav yog (82 ± 1.3) μed / ml piv rau T_max constituting 82 min thiab C_max tivthaiv (46 ± 1.3) μed / ml, rau soluble tib neeg cov kua dej. Lub sijhawm nyob hauv lub nruab nrab nyob rau hauv cov kab ke rau cov ntshav insulin glulisin tau luv dua (98 min) dua li cov tib neeg insulin (161 min).

Hauv kev tshawb nrhiav hauv cov neeg mob uas muaj mob ntshav qab zib hom 2 tom qab sc tswj hwm ntawm insulin glulisin ntawm koob tshuaj 0.2 u / kg C_max yog 91 μed / ml nrog interquartile latitude ntawm 78 txog 104 μed / ml.

Nrog rau kev tswj hwm ntawm subulinaneous ntawm insulin glulisin nyob rau sab xub ntiag phab ntsa, ncej puab lossis xub pwg (thaj tsam ntawm deltoid leeg), kev nqus tau sai dua thaum nkag mus rau hauv phab ntsa anterior plab piv nrog kev tswj hwm tshuaj nyob hauv tus ncej puab. Tus nqi ntawm kev nqus ntawm thaj av deltoid yog nruab nrab. Qhov tsis ncaj ncees ntawm bioavailability ntawm insulin glulisin (70%) ntawm qhov chaw txhaj tshuaj zoo ib yam thiab muaj qhov sib txawv ntawm cov neeg mob sib txawv. Qhov sib npaug ntawm kev sib txawv (CV) - 11%.

Kev faib khoom thiab rho tawm. Kev faib khoom thiab kev tawm ntawm cov insulin glulisin thiab soluble tib neeg cov kua dej tom qab iv kev tswj hwm zoo ib yam, nrog cov khoom faib ntawm 13 thiab 22 L, thiab T_1/2 constituting 13 thiab 18 min, ntsig txog.

Tom qab sc tswj hwm ntawm insulin, glulisin yog tawm sai dua soluble tib neeg cov kua dej, muaj kev pom tseeb T_1/2 42 feeb piv rau pom meej T_1/2 solulin tib neeg cov kua dej, muaj li ntawm 86 min. Hauv kev tshawb fawb qhov cuam tshuam ntu ntawm insulin glulisin kev tshawb fawb hauv cov tib neeg noj qab haus huv thiab cov neeg muaj ntshav qab zib hom 1 thiab ntshav qab zib hom 2, pom T_1/2 muaj li ntawm 37 mus rau 75 feeb.

Pab Pawg Neeg Tshwj Xeeb

Tsis hlauv. Hauv qhov kev tshawb fawb soj ntsuam ua rau cov tib neeg tsis muaj ntshav qab zib uas muaj ntau yam kev ua haujlwm hauv lub raum (creatinine Cl> 80 ml / min, 30-50 ml / min, T_max thiab C_max zoo ib yam li cov laus. Ib yam li cov neeg laus, thaum muab tshuaj tam sim ua ntej ntsuas zaub mov, insulin glulisin muab cov ntshav tswj cov ntshav qab zib zoo tom qab noj mov ntau dua li cov tib neeg cov kua dej. Qhov nce hauv cov ntshav qabzib concentration tom qab noj mov (AUC 0-6 h - thaj chaw hauv qab nkhaus rau cov ntshav qabzib concentration - lub sijhawm ntawm 0 txog 6 h) yog 641 mg · h · dl -1 - rau insulin glulisin thiab 801 mg · h · dl -1 - rau soluble tib neeg cov kua dej.

Cev xeeb tub thiab lactation

Cev xeeb tub Tsis muaj cov ntaub ntawv txaus qhia txog kev siv insulin glulisin hauv cov poj niam cev xeeb tub.

Cov kev tshawb fawb tsiaj yug me nyuam tseem tsis tau qhia txog qhov sib txawv ntawm insulin glulisin thiab tib neeg insulin nrog rau kev xeeb tub, kev loj hlob ntawm tus menyuam / tus menyuam hauv plab, kev yug menyuam thiab kev loj hlob tom qab.

Thaum muab tshuaj rau cov poj niam cev xeeb tub, yuav tsum saib xyuas kom zoo. Yuav tsum tau ua tib zoo soj ntsuam ntawm cov ntshav qabzib feem ntau.

Cov neeg mob ua ntej cev xeeb tub los yog mob ntshav qab zib hauv lub cev yuav tsum tau tswj hwm kev noj qab haus huv tshaj plaws hauv lawv cev xeeb tub. Nyob rau thawj peb lub hlis thaum cev xeeb tub, qhov xav tau rau cov tshuaj insulin yuav tsawg dua, thiab nyob rau zaum ob thiab thib peb feem ntau, feem ntau nws tuaj yeem nce ntxiv. Tam sim ntawd tom qab yug los, xav tau insulin tsawg dua.

Lactation. Nws tsis paub meej tias insulin glulisin hla mus rau leej niam cov kua mis tau li cas, tab sis feem ntau cov insulin tsis nkag rau hauv niam mis thiab tsis yog nqus los ntawm kev noj.

Cov niam uas saib xyuas neeg mob yuav xav tau cov koob tshuaj insulin thiab kev noj zaub mov kom haum.

Noj ntau dhau

Cov tsos mob nrog rau kev tshaj tawm cov tshuaj insulin hauv kev sib piv rau qhov xav tau rau nws, uas yog txiav txim siab los ntawm kev noj zaub mov noj thiab lub zog noj, hypoglycemia tuaj yeem tsim kho.

Tsis muaj cov ntaub ntawv tshwj xeeb muaj txog kev noj cov tshuaj insulin glulisin ntau dhau. Txawm li cas los xij, nrog nws noj ntau dhau, hypoglycemia yuav tshwm sim ua mob me lossis mob hnyav.

Kev Kho Mob: Kev mob ntshav qog ntshav qab zib me me tuaj yeem nres nrog cov piam thaj lossis zaub mov muaj piam thaj. Yog li, nws tau pom zoo tias cov neeg mob ntshav qab zib ib txwm nqa tej qab zib, khaub noom, ncuav qab zib lossis kua txiv qab zib.

Kev mob ntshav qab zib tsis txaus, thaum lub sijhawm tus neeg mob poob siab, tuaj yeem nres los ntawm intramuscular lossis sc tswj ntawm 0.5-1 mg ntawm glucagon, uas yog ua los ntawm tus neeg uas tau txais cov lus qhia tsim nyog, lossis iv kev tswj hwm ntawm dextrose (qabzib) los ntawm tus kws kho mob. Yog tias tus neeg mob tsis teb rov qab rau hauv kev coj ntawm glucagon rau 10-15 feeb, nws kuj yog qhov tsim nyog los tswj hwm iv dextrose.

Tom qab nws rov qab nco qab, nws pom zoo tias tus neeg mob tau txais cov roj carbohydrates hauv sab hauv txhawm rau tiv thaiv kom tsis txhob rov qab ua dua ntawm tus mob ntshav qab zib tsawg.

Tom qab kev tswj hwm ntawm glucagon, tus neeg mob yuav tsum raug pom nyob hauv tsev kho mob los tsim kom muaj qhov ua rau cov ntshav qab zib no hnyav thiab tiv thaiv kev txhim kho ntawm lwm qhov xwm txheej zoo sib xws.

Muaj feem xyuam rau kev muaj peev xwm tsav tsheb thiab cov txheej txheem

Cov neeg mob yuav tsum tau qhia kom ceev faj thiab zam kev txhim kho hypoglycemia thaum tsav tsheb lossis tshuab. Qhov no yog qhov tshwj xeeb tshaj yog nyob rau hauv cov neeg mob uas tau txo qis lossis tsis tuaj yeem muaj peev xwm paub txog cov tsos mob uas qhia tias kev txhim kho hypoglycemia, lossis muaj kev pheej hmoo sai ntawm hypoglycemia. Hauv cov neeg mob zoo li no, lo lus nug ntawm kev muaj peev xwm tsav lawv nrog tsheb lossis lwm cov txheej txheem yuav tsum tau txiav txim siab ib leeg.

Cov lus qhia rau kev siv thiab tuav

Vials
Apidra ial vials yog npaj rau kev siv nrog cov tshuaj insulin nrog cov nplai tsim nyog thiab siv rau cov twj insulin.

Tshawb xyuas lub raj mis ua ntej siv. Nws yuav tsum tsuas yog siv yog tias cov tshuaj daws tau pom meej, xim thiab tsis muaj cov khoom pom.

Nruam sc infusion siv lub twj tso kua mis.

Apidra ® tuaj yeem siv rau kev txuas ntxiv sc infusion ntawm insulin (NPII) siv lub twj tso kua mis lub zog haum rau insulin infusion nrog lub ntsuas hluav taws xob thiab cov chaw ntim dej kom haum.

Txoj kev lis ntshav thiab teeb dej ntim dej yuav tsum tau hloov txhua 48 teev hauv kev ua kom tiav nrog cov cai aseptic.

Cov neeg mob uas tau txais Apidra ® dhau ntawm NPI yuav tsum muaj lwm yam tshuaj insulin hauv Tshuag thaum tsis ua haujlwm ntawm lub tshuab nqus dej.

Pob Cartridges
Daim cartridges yuav tsum tau siv ua ke nrog cov tshuaj insulin, AllStar, thiab raws li cov lus pom zoo hauv Cov Lus Qhia rau Kev Siv Lub Tuam Txhab ntawm cov khoom siv no. Lawv yuav tsum tsis txhob siv nrog lwm cov kua roj pleev xim rov qab, vim tias kev noj tshuaj yog tsim tau tsuas yog nrog cov xaum xaum hluav taws xob no.

Chaw tsim tshuaj cov lus qhia txog kev siv AllStar koob txhaj tshuaj hais txog kev thau lub thawv, txuas cov koob, thiab txhaj tshuaj insulin yuav tsum tau ua raws nraim. Tshawb xyuas daim cartridge ua ntej siv. Nws yuav tsum tsuas yog siv yog tias kev daws teeb meem pom tseeb, xim xim, tsis muaj cov khoom pom zoo. Ua ntej ntxig lub cartridge rau hauv daim ntaub nqus dej rov qab npuaj, lub taub ntim yuav tsum nyob ntawm chav sov li 1-2 teev. Ua ntej txhaj tshuaj, yuav tsum tshem cov pa npuas tawm ntawm daim cartridge (saib cov lus qhia rau kev siv koob txhaj tshuaj). Cov lus qhia siv kev siv koob txhaj tshuaj yuav tsum tau ua raws nraim. Lub laub ntim tsis tau ntim tsis tau. Yog tus cwj mem syringe "OlStar" (AllStar) puas ntsoog, nws siv tsis tau.

Yog tias tus cwj mem tsis ua haujlwm zoo, txoj kev daws teeb meem tuaj yeem kos tau los ntawm daim cartridge rau hauv lub koob txhaj tshuaj yas kom haum rau cov tshuaj insulin ntawm qhov siab ntawm 100 PIECES / ml thiab muab rau tus neeg mob.

Txhawm rau tiv thaiv tus kab mob, tus cwj mem uas siv tau rov qab yuav tsum tsuas yog siv rau tib tus neeg mob.