Apidra - nā ʻōlelo aʻoaʻo no ka hoʻohana

ʻO ka ʻōnaehana kahe o Apidra he hopena no ka ʻāhui subcutaneous (sc): ka wai ʻala a ʻula ʻole a i ʻole nā ​​kala (10 ml i loko o nā haki, 1 pahu i loko o kahi pahu pahu, 3 ml i loko o nā pahu pahu, i kahi pā kuhihe: 5 mau kāleka no ka peni ʻili. "OptiPen" a i ʻole 5 mau pahu kāwili i kau ʻia ma ka peni penikala maʻa "OptiSet", a i ʻole nā ​​5 mau pahu kāwili "OptiClick").

I ka 1 ml o ka hoʻonā i loaʻa:

• mea hana ikaika: insulin glulisin - 3.49 mg (like me 100 IU o ka inina manuahi),
• ʻO nā mea kōkua: trometamol, m-cresol, polysorbate 20, sodium chloride, concentrated hydrochloric acid, sodium hydroxide, wai no ka hōʻemi.

Nā Hoʻohui

• huahuʻi,
• makahiki o nā keiki a hiki i 6 mau makahiki (he palena wale nō ka ʻike pili kino no ka hoʻohana ʻana).
• hypersensitivity o insulin glulisin a i ʻole kekahi mea ʻē aʻe o ka lāʻau.

Me ka mālama aka, ua ʻōlelo ʻia ʻo Apidra no ka hoʻohana ʻana i ka wā hāpai.

ʻO nā mea maʻi me ka maʻi hepatic e koi paha i kahi haʻahaʻa o ka insulin ma muli o kahi emi o ka glucoseoneogenesis a me kahi hoʻolohi i ka metabolism insulin.

ʻO ka hōʻemi i ka pono o ka insulin ka mea hiki pū me ka maikaʻi ʻole o ka renal a i ka wā kahiko (ma muli o ka hana renal impaired).

ʻLoe a me ke kākele

Hoʻolima koke ʻia ka insulin Apidra ma mua o kahi ʻai (no ka 0-15 mau minuke) a i ʻole ma hope o ka ʻai ʻana i ka maʻi ʻo s.c. a i ʻole ka hoʻomau ʻana o ka infusion i ka momona subcutaneous me ka ʻoki ʻana i kahi kaohi-hana.

ʻO ke ʻano o ke ʻano a me ke ʻano o ka hoʻokele ʻana o ka lālani ke koho ʻia ʻana

Hoʻohana ʻia ka hopena ʻo Apidra i ka hoʻoponopono lāʻau paʻa ʻana me ka insulin medium-acting a i ʻole ia me ka lālani insulin / lōʻihi-hana i ka analogue; hoʻohui ʻia me ka maʻi hypoglycemic waha.

Ua hoʻolako ʻia nā wahi kino no ke alakaʻi ʻana i nā lāʻau lapaʻau:

• s / c injection - hana ʻia ma ka poʻohiwi, ʻūhā a me nā ʻōpū paha, aʻo ka hoʻokomo ʻana i loko o ka ʻōpū o ka ʻōpū e hāʻawi i kahi wikiwiki o ka wikiwiki.
• ka infusion mau - hana i ka momona subcutaneous ma loko o ka ʻōpū.

Pono ʻoe e hoʻololi i nā wahi o ka infusion a me ka inake me kēlā me kēia kaila o ka lāʻau lapaʻau.

ʻOiai ka hoʻonā ʻai ʻana o ka mana ma Apidra, ʻaʻole pono ka resuspension ma mua o ka hoʻohana ʻana iā ia.

Ka like o ka helu o ke kīhāpai a, ma muli, ʻano ka hoʻomaka a me ka lōʻihi o ka lāʻau lapaʻau ma lalo o ke ʻano o ka hoʻoikaika kino, ke ʻano o ka hōʻina o ka hopena a me nā ʻano ʻē aʻe e hoʻololi ai.

Pono e mālama pono i ka wā e hoʻokele ana i ka lāʻau lapaʻau e haʻalele i ka hiki ke komo pololei i loko o nā moku koko. Ma hope o ke kaʻina hana, ʻaʻole e hoʻonui ʻia ka wahi o ka injection.

Pono e aʻo ʻia nā maʻi i nā ʻōkuhi injection.

Ke lawelawe nei i ka lāʻau lapaʻau me ka hoʻohana ʻana i kahi ʻōnaehana pump no ka infusion insulin, ʻaʻole hiki ke hui ʻia ke hoʻonā me nā mea lapaʻau / lāʻau lapaʻau ʻē aʻe.

ʻAʻole i hui pū ʻia ka hopena ʻo Apidra me kekahi mau lāʻau ʻē aʻe ke koe o ka isofan-insulin manu. I kēia hihia, ua huki mua ʻo Apidra i ka syringe mua, a lawe ʻia ʻo ia ka maʻi ʻaila ma hope o ke kāwili ʻana. ʻO ka ʻikepili i ka hoʻohana ʻia ʻana o nā hāmeʻa i hui ʻia ma mua o ka loaʻa ʻole o ka inikua.

Pono e hoʻohana ʻia nā cartridges me ka penalike penehina ʻo OptiPen Pro1 a i ʻole nā ​​mea like e like me ka ʻōlelo a ka mea hana no ka laka ʻana i ka pahu pahu, hoʻopono i ka pū, a hoʻonā i ka insulin. Ma mua o ka hoʻohana ʻana i ka pahu pahu, pono ʻoe e hana i kahi loiloi ʻike ʻike o ka lāʻau lapaʻau. No ka injection ana, ʻoi aku kahi kūpono o ke kala i loko o kahi kūpono ʻole ʻikea ʻole. Ma mua o ka hoʻonoho ʻana, pono e mālama mua i ka pahu kaʻa no nā hola 1-2 i ka mahana o ka lumi, a ma mua o ke kau ʻana i ka hoʻonā, pono e hoʻoneʻe i nā ʻōpū o ka ea mai ka pahu pahu.

ʻAʻole hiki ke hoʻonui hou ʻia nā pahu i hoʻohana ʻia. ʻAʻole hiki ke hoʻohana i ka peni ʻo OpringPen Pro1 i poino ʻia.

Ma ka hihia kahi kuhihewa ʻo ka syringe pen, hiki ke huki i ka hopena mai ka pahu pahu i loko o kahi syringe palani kūpono i kūpono no ka insulin i ka hoʻokalakupua o 100 IU / ml, a laila hāʻawi ʻia i ka mea maʻi.

Hoʻohana ʻia kahi penikala syringe hou no ka hōʻeha ʻana i ka mea maʻi hoʻokahi (e pale i ka maʻi maʻi).

Pono e nānā ʻia nā ʻōkuhi a me nā lula a pau i ke wā e hoʻohana ana i ka ʻōnaehana kīkē a me nā peni ʻike ʻo OptiKlik no ka lawelawe ʻana i ka ʻōnaehana ʻo Apidra, he pahu kīʻaha me kahi pūlona hoʻopili i hoʻopili ʻia, paʻa i loko o kahi ipu wai polū a me ka piha o 3 ml o ka mea hoʻonā insulin glulisin.

Nā hopena hopena

ʻO ka hopena ʻokoʻa ʻoi loa ka hopena o ka inika insulin o ka hypoglycemia, maʻamau e kū ana i ka wā e hoʻohana ai i ka insulin i nā inapoʻa kiʻekiʻe loa ʻoi aku ka kiʻekiʻe.

ʻO nā hopena ʻinoʻino e pili ana me ka hoʻomoka ʻana o ka lāʻau lapaʻau e nā kino a me nā ʻōnaehana o nā maʻi i hoʻopaʻa ʻia i ka wā o nā hoʻokolohua lapaʻau (hāʻawi ʻia ka papa inoa ma ka hoʻohana ʻana i kēia maʻa ʻia o ka piʻi ʻana o ka hopena: ʻoi aku ma mua o 10% - pinepine pinepine, ʻoi aku ma mua o 1%, akā he emi ma lalo o 10% - pinepine, ʻoi aku ka nui 0.1%, akā emi iki ma ka 1% - i kekahi manawa, ʻoi aku hoʻi ma mua o 0,01%, akā emi iki ma lalo o 0.1% - loaʻa ʻole, emi ʻole ma mua o 0,01% - ʻano liʻiliʻi loa):

• metabolism: pinepine pinepine - hypoglycemia, hui pū me nā mea i ʻike koke ʻia i nā hōʻailona: ka hoʻoilo maloʻo, ka palu o ka ʻili, ka luhi, nā hopohopo, nā hopohopo, ke kuʻi ʻana, nāwaliwali, ka hilahila, ka hiamoe, paʻakikī i ka hoʻoikaika ʻana, nā kuʻuna kuʻuna, ke kaumaha, ka pōloli nui. hōʻeha ka maʻi ʻeha, nā palpitations koʻikoʻi, kahi hopena o ka piʻi i ka hypoglycemia hiki i: ka nalowale o ka ʻike a me / a me ka hopu ʻana, i ka wā pōkole a mau loa paha o ka hana o ka lolo, i nā hihia koʻikoʻi, hopena hopena
• ʻili a me ka ʻili o ka subcutaneous: pinepine - i hōʻike ʻia nā maʻi kūloko, e like me ka ʻōpū, ka hyperemia, ka hōʻeha ʻana i ka wahi ʻomaʻi kahi, maʻamau ka hoʻomau ʻana ma o lākou iho me ka hoʻomau ʻia ʻana, hiki i ka lipodystrophy, ka mea nui loa no ka hana hewa ʻana o nā wahi o ka hoʻokele i ka insulin i kekahi o nā wahi / ka hana hou ʻana i ka lāʻau lapaʻau. ma kahi hookahi
• nā hopena hypersensitivity: i kekahi manawa - ka ʻeha, ka ʻāʻī ʻana o ka umauma, nā hives, ka ʻeha, dermatitis allergic, i nā hihia koʻikoʻi o nā hanana alerine he nui (me ka anaphylactic), hiki i ka hoʻoweliweli ʻana.

ʻAʻohe data kikoʻī i ka hōʻailona o ka insulin overdose o glulisin, akā ma muli o ka hoʻohana mau ʻana o nā koina kiʻekiʻe o Apidra, hiki i nā ʻano ke kaumaha o ka hypoglycemia ke hiki.

ʻO ka Therapy o ke kūlana e hilinaʻi ana i ka pae o ka maʻi.

• nā ʻōpū o ka hypoglycemia mālie - e pani me ka hoʻohana ʻana i nā huahana a i ʻole nā ​​mea i loaʻa i ke kō, e pili ana i nā mea maʻi me ka maʻi maʻi e hoʻomau i nā kuki, nā ʻuʻu, nā ʻāpana o ka honi i hoʻonaninani ʻia, ka wai momona huaʻai.
• nā ʻōpū o ka hypoglycemia koʻikoʻi (me ka nalowale o ka ʻike) - e hana i ka intramuscularly (intramuscularly) a i ʻole e sc o ka neʻe ʻana o ka 0.5-1 mg o glucagon, a i ka iv (intravenous) ka hoʻokele o ka glucose (dextrose) i ka ʻole o ka pane ʻana o ka hoʻokele glucagon e no 10-15 mau minuke Ma hope o ka ʻike hou ʻana, ʻōlelo ʻia ka mea maʻi e hāʻawi i nā mea kanu i loko i mea e pale ai i ka hoʻoulu hou ʻana o ka hypoglycemia, ma hope o ia mea, i mea e hoʻokū ai i ke kumu o ka hypoglycemia koʻikoʻi, a pale pū hoʻi i ka hoʻomohala ʻana o kēlā me kēia kīpē o ka maʻi, pono ia e kiaʻi no kekahi manawa i ka haukapila.

Nā ʻōlelo kikoʻī

I ka hihia o ka hoʻoneʻe ʻana i ka mea maʻi i ka insulin mai kahi mea hana hou a i ʻole kahi ʻano o ka insulin hou, pono ke nānā ʻia ʻana o ka maʻi lapaʻau, ʻoiai ke koi ʻana o ka ʻoma e like me ke koina.

ʻO nā hemahema o ka insulin a i ʻole hiki ke hoʻopau ʻia ka hōʻola ʻana, ma ka mea nui i nā mea maʻi me ka maʻi diabetes type 1, hiki ke hōʻeha i ka maʻi hyperglycemia a me ka ketoacidosis maʻi - hiki i nā kūlana hoʻoweliweli. ʻO ka manawa o ka hoʻomohala ʻana o ka hypoglycemia pololei i hilinaʻi i ka wikiwiki o ka hana o ka insulin i hoʻohana ʻia a no laila hiki ke hoʻololi me ka hoʻoponopono ʻana o ka noho hoʻoponopono.

ʻO nā kūlana nui e hiki ke hoʻololi a hoʻolilo paha i nā hōʻailona o ka hoʻolālā hypoglycemia liʻiliʻi i ʻōlelo ʻia:

• ka lōʻihi o ke alo o ka maʻi maʻi ma ka mea maʻi
• neuropathy maʻi maʻi
• ka ulu ʻana o ka inamina insulin,
• ka hoʻohanaʻana i kekahi mau lāʻau lapaʻau, no ka laʻana, β-blockers,
• ka hoʻololi ʻana i ka insulin o ke kanaka mai ka insulin o ka holoholona hihiu.

Hiki ke pono ke hoʻoponopono ʻia i nā dosis insulin e pono ai ke hoʻololi i ka hoʻoponopono ʻana i nā hana kaʻa a i ʻole ʻano kaiʻai. Hoʻonui ka nui o ke kino kino i loaʻa koke ma hope o ka ʻai e hiki ai ke hoʻonui i ka ulu ʻana o ka hypoglycemia. Hoʻohālikelike ʻia me ka hana o ka hoʻonaninani ʻia o ka insulin kanaka, hiki i ka hypoglycemia ke hoʻomohala koke i ka wā o ka hoʻokele o ka analogue wikiwiki e wikiwiki i ka hana.

ʻO nā maʻi hypcompensated hyp- a i ʻole ka hyperglycemic hopena e hopena i ka nalo, ka maikaʻi ʻana, a me ka make.

ʻO nā maʻi kūleʻa a i ʻole nā ​​mea kaumaha e hiki ai ke hoʻololi hou i ka pono o ka mea maʻi i ka insulin.

Hoʻohui nūhou

ʻAʻohe mea i noiʻi e pili ana i ka launa pūloko o ka pharmacokinetic o Apidra, akā e pili ana i ka ʻikepili i loaʻa no nā lāʻau like ʻole, hiki ke hoʻoholo ʻia i kahi kūpaʻa i ka maʻi lapaʻau.

Hiki i kekahi mau lāʻau lapaʻau ke hana aku i ka metabolism glucose, hiki iā ia ke hoʻoponopono pono i nā pona insulinulisulis a nānā i ke ʻano o ka maʻi a me ke kūlana o ka mea maʻi.

No laila ke hoʻohana pū ʻia me ka ʻōmole Apidra:

• Nā lāʻau lapaʻau hypoglycemic waha, angiotensin e hoʻohuli ana i ka hoʻoneʻe o ka enzyme, disopyramides, fluoxetine, fibrates, monoamine oxidase inhibitors, propoxyphene, pentoxifylline, sulfonamide antimicrobials, salicylates - hiki ke hoʻonui i ka hopena hypoglycemic o ka insulin a hoʻonui hypoglycemia,
• glucocorticosteroids, diuretics, danazol, diazoxide, isoniazid, somatropin, phenothiazine derivatives, sympathomimetics (epinephrine / adrenaline, terbutaline, salbutamol), estrogens, hormon tiroid, progestins (oral contraceptives), antipsyotin, antipsyotin, antipsyotin, hiki ke hōʻemi i ka hopena hypoglycemic insulin,
• clonidine, β-blockers, ethanol, lithium salts - potentiate a hoʻonāwaliwali paha i ka hopena hypoglycemic o ka insulin,
• pentamidine - hiki i kahi kumu hypoglycemia, ukali ʻia e hyperglycemia,
• nā mea kanu me ka hana sympatholytic (β-blockers, guanethidine, clonidine, reserpine) - me ka hypoglycemia, hiki iā lākou ke hōʻemi i ka palaki a i ʻole nā ​​hōʻailona o ka hoʻihoʻi adrenergic reflex.

ʻAʻole i lawelawe ʻia nā haʻawina e pili ana i ka like me ka insulin glulisin, no laila, ʻaʻole hui ʻia ʻo Apidra me nā lāʻau ʻē aʻe, ʻo ka mea ʻē aʻe ka isofan-insulin.

I ka hihia o ka hoʻolaha o ka hoʻonā ma ka hoʻohana ʻana i kahi pā infusion, ʻaʻole e hui ʻia ʻo Apidra me nā lāʻau lapaʻau ʻē aʻe.

The analogues of Apidra are: 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 maʻamau, NovoRapid (Penfill, FlexPen), Humodar R, Monoinsulin CR, Insuran R, Rinsulin R, Rosinsulin R.

Nā kuleana a me nā kūlana e waiho ai

E mālama i loko o kā lākou iho pahu pahu pepa, me ka ʻole o ka mālamalama, i ke wela o 2-8 ° C. Mai hoʻokaʻawale. E mālama i nā keiki.

Ma hope o ka wehe ʻana i ka pākauke, kūʻai aku i kahi e pale ʻia mai ka mālamalama i nā wela a hiki i 25 ° C. ʻO ke ola o ka lāʻau noho ka lāʻau ma hope o kona hoʻohana mua ʻana he mau hebedoma 4 (ua paipai ʻia e hōʻailona i ka lā o ka hoʻokomo mua o ka hoʻonā ma ka lepili).

ʻO nā waiwai Pharmacological

ʻO ka hana koʻikoʻi o ka insulin a me nā alapi o ka insulin, e komo pū ana me ka glulisin insulin, ʻo ia ka hoʻoponopono ʻana i nā kaila metabolism. ʻO ka insulin ka hōʻemi ʻana i ka hoʻoliʻi o ka glucose i loko o ke koko, e hoʻoulu ai i ka lilo ʻana o ka glucose i nā kiko peripheral, ʻoi aku ka nui o nā ʻiwi a me nā kiko o ka adipose, a me ka pale ʻana i ka hoʻokumu ʻana o ka glucose i loko o ka ate. Hoʻokomo ka insulin i ka lipolysis ma adipocytes, keʻae i ka proteolysis a hoʻonui i ka synthesis protein. Ua hōʻike ʻia nā haʻawina i hana ʻia i nā mea hana olakino a me nā poʻe maʻi me ka maʻi mellitus me ka mālama ʻana i ka insulin glulisin i hoʻomaka e holo wikiwiki a he lōʻihi ka hana ma mua o ka insulin kanaka. Me ka hoʻokūkū kūloko, ka hoʻohaʻahaʻa ʻana o ka glucose i ke koko, ka hoʻomaka ʻana o ka hana a ka glulisin insulin i loko o 10-20 mau minuke. Ke lawelawe ʻia intravenously, like ka hopena o ka hypoglycemic insulin glulisin a hoʻōla i ka insulin kanaka i ka ikaika. Hoʻokahi like me ka insulin glulisin i ka hana like like me ka hoʻokaʻawaleʻana o nā glucose i ka nui o ka insulin.

I kahi manawa aʻu e aʻo ai i nā maʻi me ka maʻi type 1, nā haʻahaʻa hoʻohiolo ʻana i ka glucose o ka glucose glulisin a me ka soluble o ke kanaka i lawelawe ʻia ma ka subcutaneously ma kahi pāʻala o 0.15 U / kg i nā manawa like ʻole e pili ana i ka pāʻina 15-mau minuke. Ua hōʻike ʻia nā hopena o ka noi ʻana i mālama ʻia e ka insulin glulisin i 2 mau minuke ma mua o kahi pāʻina i hāʻawi ʻia i ka mana glycemic like ma hope o kahi pāʻina e like me ka soluble kanaka e lawelawe ana i 30 mau minuke ma mua o kahi pāʻina. I ka manawa e hoʻolako ʻia i 2 mau minuke ma mua o kahi pāʻina, ua hāʻawi aku ka insulin glulisin i ka mana glycemic maikaʻi ma hope o kahi pāʻina ma mua o ka hoʻomehana ʻana i ka insulin kanaka i lawelawe ʻia 2 mau minuke ma mua o kahi pāʻina. Hoʻololi ʻo Glulisin insulin i nā minuke 15 ma hope o ka hoʻomaka ʻana o ka ʻai e hāʻawi i ka kahe like glycemic like ma hope o ka ʻaʻa ʻana e like me ka insulin soluble kanaka, lawelawe ʻia he 2 mau minuke ma mua o ka pāʻina.

Ma kahi haʻawina aʻu i hana me ka insulin glulisin, insulin lispro a soluble insuline kanaka i loko o kahi hui o nā maʻi luhi e hōʻike ana i kēia mau maʻi, ka hoʻomau ʻia ka insulin glulisin i kāna mau hana wikiwiki. Ma kēia noiʻi ʻana, ʻo ka manawa e hiki ai ke 20% o ka huina AUC he 114 min no ka insulin glulisin, 121 min no ka insulin lispro a me 150 min no ka hoʻomāneʻe ʻana i ka insulin o ke kanaka, a me AUQ_{(0-2 h)}e hoʻohālikelike ana i ka hana o ka hoʻohaʻahaʻa i ka glucose, ma kēlā me kēia, he 427 mg / kg no ka glulisin insulin, 354 mg / kg no ka lālani insulin, a me 197 mg / kg no ka hoʻōloli ʻana i ka insulin o ke kanaka.

ʻĀina haʻawina
ʻAno maʻi type 1.
Ma ka hōʻike he 26 ma ka hopena o ka maʻi III, kahi i hoʻohālikelike ai i ka glulisin insulin me ka lālani insulin, ka lawelawe ʻana i ka subcutaniously ma mua o ka ʻai (0-15 mau minuke), nā mea maʻi me ka maʻi maʻi mellitus type 1 me ka hoʻohana ʻana i ka gulin insulin ma ka basal insulin, ua hoʻohālikelike ʻia ka glulisin insulin me ka insulin licpro no ka mālama glycemic, i loiloi ʻia e ka loli o ka neʻe o ka hemoglobin glycated (HbA_1s) i ka manawa o ka hopena o ke aʻo e hoʻohālikelike me nā kumu mua. I ka wā e lawelawe ʻia ai ka insulin, ʻaʻole like me ka lapaʻau ka mea like me ka insulin lyspro, ʻaʻole i koi ʻia ka nui o ka insulin basal.

Kahi wikiō lapaʻau 12 12 mau wikiō i nā mea maʻi me ka maʻi type 1 ka mea i loaʻa i ka glargine insulin e like me ke kumu basal i hōʻike mai i ka maikaʻi o ke kulekele insulin glulisin koke ma hope o ka ʻai ʻana ka hoʻohālikelike ʻana i ka insulin glulisin koke ma mua o ka ʻai (no ka 0. -15 min) a hoʻoola paha i ka inika ke kanaka (30-45 min ma mua o ka ʻai).

I ka hui o nā mea maʻi i loaʻa i ka glulisin insulin ma mua o ka papaʻaina, ua ʻike ʻia kahi hōʻemi nui loa i ka HbA_1s ua hoʻohālikelike ʻia me kahi pūʻulu o nā maʻi e loaʻa ana i ka insulin kanaka hoʻāla.

ʻAno maʻi type 2
Ua hoʻokolohua ʻia ka haukapila o 26 mau pule he 26 mau me ka hahai ʻana o ka wiki he 26 me ke ʻano o kahi hōʻike palekana e hoʻohālikelike i ka glulisin insulin (0-15 mau minuke ma mua o ka ʻai) me ka soluble manuahi kanaka (30-45 mau minuke ma mua o ka ʻai). i ka mea i hoʻohālikelike subcutaneously ma nā mea maʻi me ka maʻi diabetes mellitus type 2, i ka hoʻohui ʻana me ka hoʻohana ʻana i ka insulin-isophan e like me ka basal insulin. Ua hōʻike ʻia ka Insulin glulisin e hoʻohālikelike ʻia e hoʻoponopono i ka insulin kanaka e pili ana i nā loli i ka nānā ʻana o ka HbA_1s ma hope o 6 mau mahina a ma hope o 12 mau mahina o ka mālama ʻana i hoʻohālikelike ʻia me ka waiwai mua.

I ka wā e hoʻomau ʻia ai ka maʻi infusion o ka insulin e hoʻohana ana i kahi mākaʻi o ka pauka (no ka maʻi mellitus type 1) i ka maʻi 59 i mālama ʻia me Apidra ® a i ʻole ka aspart o ka insulin i nā hui mālama ʻelua, i ʻike ʻia ka haʻahaʻa haʻahaʻa catheter (0,08 mau hana i kēlā me kēia mahina i ka wā e hoʻohana ai i ka lāʻau lapaʻau. ʻO Apidra ® a me 0.15 mau kala i ka mahina i ka wā e hoʻohana ai i ka insulin aspart), a me ke ʻano like o ka hopena ma ka wahi o ka maʻi maʻi (10,3% i ka wā e hoʻohana ai ʻo Apidra ® a me 13,3% i ka wā e hoʻohana ai ka insulin aspart).

I nā keiki a me nā ʻōpio me ka diabetes mellitus type 1, ka mea i loaʻa i ka insulin baseline hoʻokahi i ka lā i ke ahiahi, ka huehue i ka insulin, a ʻelua hoʻi i kēlā lā i ke kakahiaka a me ke ahiahi, ka insulin isulin, i ka wā e hoʻohālikelike ai i ka pono a me ka palekana o ka mālamaʻana me ka glulisin insulin a me ka laikini insulin me ka no ka hoʻomalu 15 mau minuke ma mua o kahi pāʻina, hōʻike ʻia ka mālama glycemic, ka mea i loaʻa i ka hypoglycemia, ka mea e koi ai i ke kikowaena o nā ʻaoʻao ʻekolu, a me ka hopena o nā maʻi hypoglycemic kino i hoʻohālikelike ʻia i nā hui mālama ʻelua. Eia kekahi, ma hope o 26 hebedoma no ka mālama ʻana, nā mea maʻi e loaʻa ana i ka mālamaʻana i ka insulin me ka glulisin e hoʻokō i kahi kāohi glycemic i hoʻohālikelike ʻia i ka insulin lispro e koi i ka nui o ka nui o nā lā i nā insulin basal, e hana wikiwiki ana ka insulin a me ka nui o ka mahele o ka insulin.

Kanikau a me ka wahine
I nā hoʻokolohua lapaʻau hoʻokele i ka pākeke, ʻaʻole i hōʻike ʻia nā ʻokoʻa i ka palekana a me ka hana pono ʻana o ka insulin glulisin i ka hōʻike ʻana o nā hui i hōʻike ʻia e ka lāhui a me ka wahine.

Lapaʻau lāʻau
In insulin, glulisin, the replacement of the amino acid asparagine of human insulin in position B3 with lysine and lysine at position B29 with glutamic acid Promuces the fastorporption.

Hoʻopau a me Bioavailability
ʻO nā pēpē Pharmacokinetic neʻe-manawa o ka poʻe hana ma ke olakino olakino a me nā mea maʻi me ka type 1 a me ka type 2 diabetes mellitus i hōʻike i ka hoʻoliʻi ʻana o ka insulin i ka glulisin e hoʻohālikelike ana i ka soluble kanaka e pili ana i ka manawa 2 mau wikiwiki a me ka nui o ka plasma kiʻekiʻe e loaʻa ana (Cmax) ma kahi o 2 mau manawa hou aku.

Ma kahi noiʻi i hana ʻia i nā mea maʻi me ka diabetes mellitus type 1, ma hope o ka hoʻomalu sc sceptin o ka insulin glulisin ma ke ʻano o 0.15 U / kg, T_max (ka manawa o ka hoʻomaka ʻana o ka uila plasma nui loa) he 55 mau minuke, a me C_max he 82 ± 1.3 μU / ml i hoʻohālikelike ʻia me T_maxhe mau minuke 82, a C_maxo 46 ± 1.3 mcU / ml no ka hoʻāʻo wai kōpaʻa kanaka. ʻO ka manawa noho ma ka systemic circulate no insulin glulisin ka pōkole (98 mau minuke) ma mua o ka soluble manuahi kanaka (161 mau minuke).

I kahi noiʻi i nā mea maʻi me ka diabetes mellitus type 2 ma hope o ka nānā ʻana i ka insulin glulisin ma kahi o ka helu o 0.2 PIECES / kg C_max ʻo 91 μED / ml me kahi latitu interquartile o 78 a 104 μED / ml.

I ka lawelawe ʻia ʻana o ka insulin i ka hana a glulisin ma ka wahi o ka paia o ka ʻōpū o ka ʻōpū, ka ʻūhā, a i ʻole ka poʻohiwi (ma ka wahi o ka puʻu deltoid), ʻoi aku ka wikiwiki o ka lilo ʻana i ka wā i hoʻokomo ʻia ai i ka pā o ka ʻōpū o ka ʻōpū kuʻuna i hoʻohālikelike ʻia me ka hoʻokolohua ʻana i ka lāʻau lapaʻau ma ka ʻāʻī o ka ʻōpū. Kahi waena o ka huina ʻana mai ka wahi deltoid. ʻO ke kūlohelohe kūloko o ka insulin glulisin ma hope o ka hoʻokele sc ma kahi o 70% (73% mai ka paia ʻōpū o ka ʻōpū, 71 mai ka musele deltoid a 68% mai ka hip) a he ʻano haʻahaʻa haʻahaʻa i nā mea maʻi like.

Ka ʻāpana a me ka haʻalele ʻana
Ka hoʻoili ʻia a me ka hoʻopuka ʻana o ka insulin glulisin a hoʻōla i ka insulin kanaka ma hope o ke kāʻei ʻana i ka intravenous e like, me ka paʻi ʻana o 13 lita a 21 mau lita a me ka hapalua ola o 13 a 17 mau minuke, kēlā me kēia. Ma hope o ka hoʻomalu ʻia ʻana o ka insulin, ua ulana wikiwiki ʻia ka glulisin ma mua o ka lolo o ke kanaka, e loaʻa ana ka hapalua-ola o nā minuke 42 mau makahiki, i hoʻohālikelike ʻia me ka hapalua manawa like ʻole o ka soluble manuahi kanaka he 86 mau minuke. Ma kahi hōʻike no ka hoʻāʻo ʻana i ka noi ʻana o ka insulin glulisin i nā mea olakino olakino a me nā mea me ka maʻi type type 1 a me ke ʻano 2, ʻo ka hoʻopau ʻia ʻana o ka hapalua-ola mai 37 a 75 mau minuke.

ʻO ka pharmacokinentics i nā hui maʻi maʻi kūikawā
ʻO nā mea maʻi me ka maikaʻi ʻole o ka pūpū
Ma kahi noiʻi haumanu i hana ʻia i nā mea maʻi me ka maʻi hānai me ka nui o kahi ʻano hana o ke akeʻa (ʻo ka creinine clearance (CC)> 80 ml / min, 30-50 ml / min, ® i nā wahine hāpai. He hapa o ka ʻikepili i loaʻa ma ka hoʻohana ʻana o insulin glulisin ma wahine i hāpai ʻia (ʻoi aku ka 300 mau hopena hualoaʻa i hōʻike ʻia), ʻaʻole ia e hōʻike i ka hopena maikaʻi loa i ka hāpai ʻana, hoʻomohala a i ʻole kahi keiki hou. lichy ma waena o insulina glulisine a me kanaka insulina me ka mahalo i ka hāpai keiki, embryonic / fetal kūpono 'ana, ka nahunahu hanau a me ka lāʻau kū-Natal ulu.

Ke hoʻohana nei ka hoʻohana ʻana o Apidra ® i nā wahine hāpai. Pono ka mālama ʻana i ka neʻe o ka glucose i ke koko a mālama i ka ʻike glycemic kūpono e pono ai.

ʻO nā mea maʻi me ka ma mua o ka wā a i ʻole ka maʻi gestational e pono ke loaʻa i ka glycemic control ma mua o ka ʻāʻī ʻana a i ko lākou wā o ko lākou ʻōpū. I ka wā o ka trimester mua o ka hānau ʻana, e hoʻēmi paha ka pono o ka insulin, a i ka wā o ka trimesters lua a me ke kolu, hiki iā ia ke hoʻonui. Ma hope iho o ka hānau ʻana, ua loli wikiwiki ka noi ʻana o ka insulin.

ʻO ka poʻe maʻi me ka maʻi maʻi maʻi e hoʻomaopopo i kā lākou kauka inā loaʻa iā lākou a hoʻolālā paha e lilo i ka manawa hānai.

Nā wā male
ʻAʻole ʻike ʻia inā hoʻokomo ʻia ka insulin glulisin i ka waiū umauma, akā i ka laulā, ʻaʻole i komo ka insulin i ka waiū umauma a ʻaʻole i huhū ʻia e ka lawelawe waha.

I nā wahine i ka wā o ka hānai ʻana, pono ke hoʻoponopono ʻia i ka insulin dosing regimen a me ka meaʻai.

ʻLoe a me ke kākele

Pono e hoʻohana ʻia ʻo Apidra ® i nā koikoi lāʻau e pili ana i ka insulin medium-acting, a i ʻole he hana līlī paha, a i ʻole he mea hana e hana i ka inanini. Eia kekahi, hiki ke hoʻohana pū iā Apidra ® i hui pū me nā huaʻala hypoglycemic waha (PHGP).

Hoʻokaʻawale ʻia ke kauā o ka dosage ʻo Apidra ® ma muli o nā ʻōlelo a ke kauka e like me nā pono o ka mea maʻi. Ua ʻōlelo ʻia nā maʻi āpau me ka maʻi maʻi e nānā i kā lākou koko kukuna.

Hoʻohana ma nā pūʻulu hoʻomanawanui kūikawā
Na keiki a ʻōpio
Hiki ke hoʻohana ʻia ʻo Apidra ® i nā keiki keu 6 mau makahiki a me nā ʻōpio. Hoʻohui ka ʻikepili maʻi ma ka hoʻohana ʻana i ka lāʻau i nā keiki ma lalo o 6 mau makahiki o ka makahiki.

ʻO nā maʻi maʻi
ʻAʻole loaʻa i nā ʻike pharmacokinetics i nā maʻi maʻi me nā maʻi mellitus me ka lawa ʻole.
Hiki i ka hana renal pale i ka wā ʻelemakule ke alakaʻi i ka emi ʻana o nā koi o ka insulin.

ʻO nā maʻi me ka hāʻule ʻole o ka pūpū
Pono ka emi ʻana o ka insulin i ka hana ʻole i kahi a me ka hōʻemi.

ʻO nā maʻi me ka palaualohi maʻa
I nā mea maʻi me ka hana o ka puʻuwai maʻi, hiki ke emi ka pono o ka insulin ma muli o ka hōʻemi i ka gluconeogenesis a me kahi haʻahaʻa o ka metabolism insulin.

Ka hoʻonohonoho ʻana a me ke ʻano o ka hoʻokuʻu ʻana

i loko o nā pahu he 10 ml a i loko o nā pahu pahu wai he 3 ml, i loko o ka pā pahu pepa 1 pahu a i ʻole i ka pahu kāwili pepa blister 5 mau kāwili ʻana no ka peni syringe peni a i nā pahu kāwili ʻole i hoʻokomo ʻia i loko o kahi ʻeke syringe penikala OptiSet a me ka ʻōnaehana OptiClick . ^ E Ha yM.

Lapaʻau lāʻau

ʻO ka Insulin glulisin kahi mea hoʻohālikelike o ka insulin o ke kanaka, kahi mea e kū like ai i ka ikaika o ka insulin kanaka maʻamau. Hoʻomaka ka insulin glulisin e holo wikiwiki me ka lōʻihi o ka hana ma mua o ke kūmole i ka insulin. ʻO ka hana koʻikoʻi o ka insulin a me nā alapi o ka insulin, e komo pū ana me ka glulisin insulin, ʻo ia ka hoʻoponopono ʻana i nā kaila metabolism. ʻO ka insulin ka hōʻemi ʻana i ka hoʻoliʻi o ka glucose i loko o ke koko, e hoʻoulu ai i ka lilo ʻana o ka glucose i nā kiko peripheral, ʻoi aku ka nui o nā ʻiwi a me nā kiko o ka adipose, a me ka pale ʻana i ka hoʻokumu ʻana o ka glucose i loko o ka ate. Hoʻopili ke Insulin i ka lipolysis adipocyte a me ka proteolysis a hoʻonui i ka synthesis protein. Ua hōʻike ʻia nā haʻawina i hana ʻia i nā mea hana olakino a me nā poʻe maʻi me ka maʻi mellitus me ka mālama ʻana i ka insulin glulisin i hoʻomaka e holo wikiwiki a he lōʻihi ka hana ma mua o ka insulin kanaka. I ka S / i ka hoʻolauna ʻana o ka haʻahaʻa o ka glucose i loko o ke koko, e hoʻomaka ana ka hana o ka insulin glulisin i 10-20 mau minuke. Me ka hoʻomehana iv, nā hopena o ka hoʻohaʻahaʻa i ka nui o ka glucose o ke koko o ka glucose glulisin a me ka hoʻomau i ka insulin kanaka i like me ka ikaika. Hoʻokahi like me ka insulin glulisin i ka hana like like me ka hoʻokaʻawaleʻana o nā glucose i ka nui o ka insulin.

Ma kahi hāleau aʻu e aʻo ai i nā maʻi me ka diabetes type type 1 mellitus, nā ʻōlelo hoʻoneʻe ʻana i ka glucose o ka glucose glulisin a me ka soluble o ke kanaka he loiloi ʻia, lawelawe ʻia s.c. ma kahi pākana o 0.15 mau ʻina / kg i nā manawa like ʻole e pili ana i ka pāʻina 15-mau minuke.

Ua hōʻike ʻia nā hopena o ka hōʻike ʻana i ka insulin glulisin, mālama i nā minuke 2 ma mua o ka pāʻina, ua hāʻawi ʻia kēlā like me ka glycemic control ma hope o kahi pāʻina e like me ka soluble kanaka kanaka, ka lawelawe ʻia 30 mau minuke ma mua o kahi pāʻina. I ka manawa e hoʻolako ʻia i 2 mau minuke ma mua o kahi pāʻina, ua hāʻawi aku ka insulin glulisin i ka mana glycemic maikaʻi ma hope o kahi pāʻina ma mua o ka hoʻomehana ʻana i ka insulin kanaka i lawelawe ʻia 2 mau minuke ma mua o kahi pāʻina. ʻO Glulisin insulin, e hoʻokele ʻia he mau minuke 15 ma hope o ka hoʻomaka ʻana o ka ʻai, hāʻawi i ka kahe like glycemic like ma hope o ka ʻaina e like me ka insulin soluble kanaka, lawelawe i ka mau minuke 2 ma mua o ka ʻaʻa.

Nā ʻilima Ma kahi haʻawina aʻu i hana ai me ka insulin glulisin, insulin lispro a hoʻōla i ka insulin kanaka i loko o kahi hui o nā maʻi luhi e hōʻike ana i loko o kēia mau maʻi, ke hoʻomau nei ka insulin glulisin i kāna mau hana wikiwiki. Ma kēia noiʻi ʻana, ʻo ka manawa e hiki ai i 20% o ka huina AUC he 114 min no ka insulin glulisin, 121 min no ka insulin lispro a me 150 min no ka hoʻomāneʻe ʻana i ka insulin o ke kanaka, a me AUC (0-2 mau hola), e hōʻike ana hoʻi i ka hana o ka hoʻohaʻahaʻa haʻahaʻa glucose, ʻo 427 mg · kg -1 - no ka glulisin insulin, 354 mg · kg -1 - no ka laikini insulin a me 197 mg · kg -1 - no ka solulle i ke ʻano o ka insulin kanaka, i kēlā me kēia.

ʻAno maʻi type 1. Ma ka hōʻike he 26 ma ka hopena ma hope o ka maʻi III, kahi i hoʻohālikelike ai ka insulin glulisin me ka insulin lispro, ua hoʻolako ʻia ka s.c. ma mua o ka ʻai (0-15 mau minuke), nā mea maʻi me ka maʻi laʻi mellitus type 1, e hoʻohana ana i ka glargine insulin, insulin glulisin like me ka basal insulin ua hoʻohālikelike ʻia me ka insulin lyspro e pili ana i ka mālama glycemic, i loiloi ʻia e ka loli ʻana o ka neʻe o ka hemoglobin glycosylated (HbA_1C) i ka manawa o ka hopena o ke aʻo e hoʻohālikelike ʻia me ka hopena. ʻO nā mea hoʻohālikelike o ke koko hoʻonaninani ʻia i nānā ʻia, hoʻoholo ʻia e ka nānā ponoʻī ʻana. Me ka hoʻokolohua o ka glulisin insulin, i kahi hoʻohālike i ka mālama ʻana me ka insulin, ʻaʻole i koi ʻia ka lyspro i ka nui o ka nui o ka insulin basal.

Kahi wikiō lapaʻau 12 12 mau wikiō i nā mea maʻi me ka maʻi type 1 ka mea i loaʻa i ka glargine insulin e like me ke kumu basal i hōʻike mai i ka hana o ka lawelawe ʻana o ka insulin glulisin ma hope o ka ʻai ʻana i ka like me ka insulin glulisin i mua o ka ʻai (no ka 0. –15 min) a hoʻoemi paha i ka inika ke kanaka (30-45 min i mua o ka ʻai).

I ka heluna o nā mea maʻi e hoʻopau i ka protocol aʻo, ma ka hui o nā mea maʻi i loaʻa i ka glulisin insulin ma mua o kaʻai ʻana, ua ʻike nui ʻia ka nui o ka HbA._1C ua hoʻohālikelike ʻia me kahi pūʻulu o nā maʻi e loaʻa ana i ka insulin kanaka hoʻāla.

ʻAno maʻi type 2. Ua hoʻokolohua ʻia ka hoʻokolohua lapaʻau 26 26 pule me ka ʻimi he 26 mau pule ma ke ʻano he mau palekana palekana e hoʻohālikelike i ka glulisin insulin (0-15 min ma mua o kaʻai) me ka soluble manuahi kanaka (30–45 min ma mua o ka ʻai) ʻo ia ka mea i lawelawe ʻia ma nā maʻi me nā maʻi diabetes type 2, ʻo ka hoʻohana ʻana i ka insulin-isophan e like me ka basal. ʻO ka awelika helu kino maʻi maʻi maʻi he 34.55 kg / m 2. Ua hōʻike ʻia ka Insulin glulisin e hoʻohālikelike ʻia e hoʻoponopono i ka insulin kanaka e pili ana i nā loli i ka nānā ʻana o ka HbA_1C ma hope o 6 mahina o ka mālama ʻana i hoʻohālikelike ʻia me ka hopena (-0.46% no ka glulisin insulin a me -0.30% no ka hoʻomālamalama ʻana o ke kanaka i ka insulin, p = 0.0029) a ma hope o 12 mau lapaʻau ka hoʻohālikelike ʻia me ka hopena (-0.23% - no ka mea e pili ana ka insulin glulisin a me -0.13% no ka soluble kanaka kanaka, ʻaʻole i koʻikoʻi ka ʻokoʻa. Ma kēia noiʻi ʻana, ʻo ka hapa nui o nā mea maʻi (79%) i hui pū i kā lākou insulin hana pōkole me ka insulin isulin ma mua koke o ka maʻi ʻana. I ka manawa o ka randomization, ua hoʻohana nā 58 mau maʻi i ka lāʻau hypoglycemic waha a ua kauoha ʻia e hoʻomau i ka hoʻohana ʻana iā lākou ma ka papa like.

Ke ʻano kanaka a me ka ʻano kāne. I ka hoʻokolohua ʻana i nā lāʻau lapaʻau i hoʻopaʻa ʻia i nā pākeke, nā ʻano ʻē ʻole i palekana a me ka pono o ka glulisin insulin i hōʻike ʻole ʻia i ka loiloi o nā hui i hōʻike ʻia e ka lāhui a me ka wahine.

Lapaʻau lāʻau

I loko o ka glulisine insulin, ka mea o ka hoʻoliʻi o ka amino acid asparagine o ke kanaka o ka insulin i ka wahi B3 me ka lysine a me ka lysine ma ke kūlana B29 me ka waikawa glutamic e hoʻolaha nui i ka hoʻopili ʻana.

Hoʻopau a me nā bioavailability. ʻO nā pēpē o ka pharmacokinetic i ka pale o ka manawa olakino me nā mea maʻi a me nā mea maʻi me ka maʻi diabetes type 1 a me 2 e hōʻike ana i ka hoʻoliʻi ʻana o ka insulin glulisin i hoʻohālikelike ʻia me ka soluble kanaka e pili ana i ka 2 mau wikiwiki, e piʻi ana i ʻelua manawa nui aku C_max .

Ma kahi noiʻi i hana ʻia i nā mea maʻi me ka diabetes mellitus type 1, ma hope o ka hoʻomalu sc sceptin o ka insulin glulisin ma ke ʻano o 0.15 u / kg T_max (ka manawa noho C_max ) he 55 min a me C_max i loko o nā plasma he (82 ± 1.3) μed / ml hoʻohālikelike ʻia me T_max ka wae ʻana 82 min a me C_max unhi (46 ± 1.3) μed / ml, no ka hoʻokaʻa sololi kanaka. ʻO ka manawa noho ma ka systemic circulate no insulin glulisin e ʻoi aku ka pōkole (98 min) ma mua o ke kanaka maʻamau (161 min).

I kahi noiʻi i nā mea maʻi me ka diabetes mellitus type 2 ma hope o ka hoʻomalu sc sceptin o ka insulin glulisin ma ke ʻano o ka nui o 0.2 u / kg C_max ʻo 91 μed / ml me kahi latitu interquartile o 78 a 104 μed / ml.

Me ka hoʻokolohua kūloko o ka insulin glulisin i ka paia o ka ʻōpū o ka ʻōpū, ʻāhae a i ʻole poʻohiwi (ʻtopili deltoid), ʻoi aku ka wikiwiki i ka wā e komo ai i loko o ka pā o ka ʻōpū kuʻuna i hoʻohālikelike ʻia me ka hoʻokolohua ʻana i ka lāʻau lapaʻau ma ka ʻāʻī. Kahi waena o ka huina ʻana mai ka wahi deltoid. ʻO ke kūlohelohe kūlohelohe o ka glulisin insulin (70%) ma nā wahi maʻi ʻokoʻa like like a like ʻole ia me ka loli haʻahaʻa ma waena o nā mea maʻi. Coefficient of variation (CV) - 11%.

Ka haʻalele a haʻalele. ʻO ka hoʻohālikelike a me ka hoʻopuka ʻana o ka insulin glulisin a hoʻōla i ka insulin kanaka ma hope o ka lawelawe ʻana iv, ua like nō, me ka helu kīpī o 13 a me 22 L, a me T_1/2 ke koho nei he 13 a me 18 min.

Ma hope o ka hoʻomalu sc scina o ka insulin, ua hoʻonui ʻia ka glulisin ma mua o ka hopena o ka insulin kanaka, ua ʻike ʻia ka T_1/2 42 mau minuke i ka ʻike ʻia T_1/2 soluble manuʻa kanaka, piha 86 min. Ma kahi hōʻike no ka ʻike ʻana i ka noi ʻana o ka insulin glulisin i nā mea olakino olakino a me nā mea me ka maʻi type 1 a me ke ʻano 2, ka mea ʻike T_1/2 hoʻomaka iā 37 ma 75 mau minuke.

Nā Pūnaewele Pōkoki kūikawā

ʻO Renal hiki ʻole. Ma kahi noiʻi haumanu i hana ʻia i loko o ka poʻe me ka maʻi ʻole me ka pae ākea o nā kūlana hana o nā keiki (creatinine Cl> 80 ml / min, 30-50 ml / min, T_max a C_max like me nā poʻeʻelemakule. E like me nā poʻe pākeke, ke hoʻokele koke ʻia ma mua o ka hoʻāʻo ʻana i ka ʻai, ʻo ka insulin glulisin e hāʻawi i ka kaohi glucose o ke koko ma hope o ka ʻai ʻana ma mua o ka hoʻomākeʻina i ka insulin o ke kanaka. ʻO ka hoʻonui ʻana i ka hoʻoliʻi glucose koko ma hope o ka ʻai ʻana (AUC 0-6 h - ka ʻāina ma lalo o ka lūlū no ke kaʻe o ka glucose o ke koko - ka manawa mai ka 0 i ka 6 h) ka 641 mg · h · dl -1 - no ka mea he nui ka insulin glulisin a me 801 mg · h · dl -1 - no ka hoʻāne me ka insulin.

ʻŌpū a me ka lactation

Kahawai ʻAʻole lawa ka ʻike ʻike i ka hoʻohana ʻana o ka insulin glulisin i nā wahine hāpai.

ʻAʻole hōʻike nā loiloi holoholona holoholona i kahi mau ʻokoʻa i waena o ka insulin glulisin a me ka insulin kanaka e pili ana i ka hapai, hoʻomohala a me ka hoʻomohala ʻana i ka male ʻana, hānau keiki a me ka hoʻomohala postnatal.

Ke koho nei i ka lāʻau lapaʻau i nā wahine hāpai, pono nō e mālama. Pono e nānā pono ana i nā pae momona o ke koko.

ʻO nā maʻi me ka maʻi mua a me ka maʻi maʻi gestational pono e mālama pono i ka metabolic control ma o ko lākou wā'ōpiopio. I ka wā o ka trimester mua o ka hānau ʻana, e hoʻēmi paha ka pono o ka insulin, a i ka wā o ka trimesters lua a me ke kolu, hiki iā ia ke hoʻonui. Ma hope iho o ka hānau ʻana, ua loli wikiwiki ka noi ʻana o ka insulin.

Hoʻokaumana. ʻAʻole maopopo ʻia inā hoʻokomo ʻia ka insulin glulisin i ka waiū umauma, akā ma ka laulā nui o ka insulin, ʻaʻole ia e komo i loko o ka waiū umauma a ʻaʻole pāloi ʻia e ke ingestion.

Pono nā hānai kahu e pili ana i ka hoʻololi ʻana o ka insulin a me ka meaʻai.

Ke keu

Nā Hoʻomaka me ka hapa nui o ka insulin e pili ana i ka pono, ka mea i hoʻoholo ʻia e ka ʻai ʻana o ka meaʻai a me ka hoʻohana ʻana i ka ikehu, hiki i ka hypoglycemia ke ulu.

ʻAʻole loaʻa nā ʻike kikoʻī e pili ana i ka overdose o ka glulisin insulin. Eia nō naʻe, me kahi overdose, hypoglycemia e ulu i kahi akahai a paʻakikī paha.

Lāʻau: hiki ke hoʻopau ʻia nā ʻōpū o ka hypoglycemia maʻalahi me nā mea momona a me ke kō. No laila, ua ʻōlelo ʻia e lawe mau nā mea maʻi me ka lolo i nā ʻāpana o ke kō, kaʻaʻai, nā kuki a i ʻole nā ​​mea momona wai.

ʻO nā Episodes o ka hypoglycemia koʻikoʻi, kahi e nalowale ai ka mea maʻi, hiki ke kāpae ʻia e intramuscular a i ʻole ka hoʻokele sc o ka 0.5-1 mg o glucagon, hana ʻia e ka mea i loaʻa i nā ʻōlelo kūpono, a i ʻole ka hoʻomalu ʻana o ka dextrose (glucose) e ka poʻe lapaʻau. Inā ʻaʻole i pane mai ka mea maʻi i ka hoʻokele o ka maʻiagonona no nā minuke 10-15, pono nō hoʻi ia e hoʻokō i iv dextrose.

Ma hope o ka loaʻa hou ʻana i ka naʻau, e pono e hāʻawi ʻia ka mea maʻi i nā haʻalowa i loko e pale i ka hoʻi ʻana o ka hypoglycemia.

Ma hope o ka lawelawe ʻana o ka glucagon, pono e ʻike ʻia ka mea maʻi i ka haukapila e hoʻokumu i ke kumu o kēia hypoglycemia koʻikoʻi a pale aku i ka hoʻomohala ʻana i nā maʻi ʻē aʻe.

Hoʻopilikia i ka hiki ke hoʻokau i nā kaʻa a me nā māka

Pono e hoʻomaopopo ʻia nā mea maʻi e makaʻala a pale i ka hoʻomohala ʻana i ka hypoglycemia i ke kaʻa ʻana i nā kaʻa a i ʻole nā ​​mīkini. He mea koʻikoʻi loa kēia i nā mea maʻi i hōʻemi a i ʻole hoʻi i ka hiki ke hoʻomaopopo i nā hōʻailona e hōʻike ana i ka hoʻomohala ʻana o ka hypoglycemia, a i ʻole nā ​​manawa pinepine o hypoglycemia. I kēlā me kēia mau mea maʻi, pono ke hoʻoholo ʻia ka manaʻo o ka hiki ke hoʻokau iā lākou me nā kaʻa a i ʻole nā ​​ʻano ʻē aʻe paha.

Nā ʻōkuhi no ka hoʻohana a me ka lawe ʻana

ʻO nā ʻōnaʻi
Kuhi pono ʻia nā pahu a Apidra ® no ka hoʻohana ʻana me ka syringes insulin e like me ka pae ʻāpana kūpono a no ka hoʻohana ʻana me ka ʻōnaehana insulin.

E nānā i ka kīʻaha ma mua o ka hoʻohana ʻana. Pono e hoʻohana ʻia inā he maʻalahi ka hāmeʻa, ʻaʻohe ʻokoʻa a ʻaʻole ia e ʻike i ka lāʻau particulate ʻikea.

Hoʻonui ka infusion sc ka hoʻohana ʻana i ka ʻōnaehana pamu.

Hiki ke hoʻohana ʻia ʻo Apidra ® no ka infusion sc infusion o ka insulin (NPII) me ka hoʻohana ʻana i kahi polokalamu pā kolo kūpono no ka infusion insulin me nā catheters kūpono a me nā puna wai kūpono.

Pono e hoʻokomo ʻia nā infusion a me nā reservoir i nā hola 48 i ka hahai ʻana i nā rula aseptic.

ʻO ka poʻe maʻi e loaʻa iā Apidra ® ma o ka NPI e loaʻa i kahi inikini ʻē aʻe i loko o ka ʻoihana no ka pau ʻole o ka ʻōnaehana paila.

Nā ʻōpala
Pono e hoʻohana pū ʻia nā cartridges me ka peni insulin, AllStar, a e like me nā ʻōlelo i loko o nā Kuhina no ka hoʻohana ʻana o ka mea hana o kēia mea hana. ʻAʻole pono lākou e hoʻohana me nā penikala syringe hou hou, no ka mea, ua hoʻonohonoho pono ʻia ka dosing pololei me kēia peni syringe wale nō.

ʻO nā ʻōlelo a ka mea hana hana no ka hoʻohana ʻana i ka peni ʻo AllStar e pili ana i ke kau ʻana i ka pahu pahu, e hoʻopili ana i ka pono, a me ka ʻoa ʻana i ka insulin e pono e hahai ʻia. E nānā i ka pahu pahu ma mua o ka hoʻohana ʻana. Pono e hoʻohana wale inā he leʻalaha, ʻaʻole ʻili, ʻaʻole i ʻike ʻia nā papalapala ʻike. Ma mua o ke kau ʻana i ka pahu pahu i loko o nā ʻāpana syringe refillable, pono e noho ka pahu kaʻa i ka lumi lumi no 1-2 mau hola. Ma mua o ke kāhiko ʻana, pono e hoʻoneʻe ʻia nā lūlū ea mai ka pahu pahu (ʻike i nā ʻōlelo aʻoaʻo no ka hoʻohana ʻana i ka peni ʻo ke syringe). Pono e mālama pono ʻia nā ʻōlelo no ka hoʻohana ʻana i ka peni syringe. ʻAʻole hiki ke hoʻopau hou ʻia nā pahu kūwaho. Inā ua hōʻino ʻia ka syringe pen "OlStar" (AllStar), ʻaʻole hiki ke hoʻohana ʻia.

Inā ʻaʻole holo pono ka peni, hiki ke huki ʻia ka hopena mai ka pahu pahu i loko o kahi syringe palani kūpono i kūpono no ka insulin i ka paila o 100 PIECES / ml a lawelawe ʻia i ka mea maʻi.

No ka pale ʻana i ka maʻi, pono e hoʻohana ʻia ka peni reusable i loko o ka mea maʻi hoʻokahi.