Upangiri wa akatswiri pakugwiritsa ntchito kusakaniza kwa Humalog Remix 50 pothandizira odwala omwe ali ndi matenda ashuga a 2

Msonkhano wa bungwe la akatswiri pakugwiritsa ntchito mankhwala osakanikirana a insulin Humalog Mix 50 mothandizidwa ndi mtundu 2 wa matenda a shuga (T2DM) unachitika. Mwa dongosolo la msonkhano wa bungwe la akatswiri, zovuta zakwaniritsa kuyendetsa bwino kwa glycemic kwa odwala omwe ali ndi matenda a shuga a 2 ndi zovuta zamankhwala ndi ma aligorivimu ogwiritsira ntchito kusakaniza kwa insulin komwe anakonzekera. Monga gawo la zokambiranazo, mwayi wakwaniritsa zolinga zakuchiritsa odwala matenda a shuga a 2 mothandizidwa ndi Humalog Remix 50 insulini, kuwonetsa mwatsatanetsatane ndi kuphwanya, komanso kukhathamiritsa kwa ma protocol a odwala omwe amalandila mankhwala a insulin ndi osakanizidwa a Humalog Remix 50 insulin.

Mawu osakira: mtundu 2 shuga mellitus, insulin, zosakaniza zopangidwa kale, lispro, Humalog Remix 50.

Msonkhano wa akatswiri odziwa kugwiritsa ntchito mankhwala osakanikirana a insulin 50

Gulu la akatswiri lakhala ndi zokambirana pazakuwongolera ndi njira zamagulu olamulira glycemic mwa insulin yosakanikirana yomwe inakonzedwa mu T2DM. Chisamaliro chapadera chidalipira pamagawo a mankhwalawa ndi Humalog Remix 50, kuphatikizapo zodziwikiratu ndi zotsutsana, zomwe zingatheke kuti zitheke kukwaniritsa zolinga zakuchiritsa ndi kuthandizira kuyang'anira odwala.

Mawu osakira: shuga mellitus mtundu 2, insulini, chisakanizo, lispro, Humalog Remix 50

Mwa dongosolo la khonsolo ya akatswiri, malipoti a Membala Wofanana wa Russian Academy of Medical Sayansi M.V. Shestakova wokhudza zovuta zakwaniritsa kuyendetsa bwino kwa glycemic kwa odwala omwe ali ndi T2DM ndi S.V. Elizarova ("Eli Lilly") pakuwunika kwachipatala pakugwiritsa ntchito mankhwala osakanizidwa a insulin Humalog Remix 50 ndi algorithm pakugwiritsa ntchito.

Zokambiranazi zidangoganizira zakufunika kwachipatala komanso kuthekera kukwaniritsa zolinga zakuchiritsira odwala omwe ali ndi matenda amtundu wa 2 mothandizidwa ndi Humalog Remix 50 insulin, mbiri ya odwala omwe adawonetsedwa mankhwalawa ndi osakaniza a Humalog Remix 50, ndi algorithm yachipatala.

Mu lipoti lake, M.V. Shestakova adatinso chaka chilichonse kuchuluka kwa odwala omwe ali ndi T2DM komanso kumwa insulini kumakulirakulira, komabe, pakuwunika kwakukulu, zizindikiro za glycemic sizikwaniritsidwa. Chimodzi mwazinthu izi ndi kuyamba kwadzidzidzi kwa insulin. Chifukwa chake, malinga ndi kafukufuku wa CREDIT, kuyamba kwa mankhwala a insulin kunachitika pa HbA1c ya 9,7%. Kafukufuku wa ACHIEVE (A1chieve Program ku Russia: kafukufuku wambiri wowunika wowunika bwino komanso otetezeka poyambitsa ndikuwonjezera insulin mankhwala omwe ali ndi matenda a insulin odwala omwe ali ndi matenda amtundu wa 2 omwe sanalandire insulin m'machitidwe azachipatala a tsiku ndi tsiku) adawonetsa kuti mwa odwala kuyambira ndi basal insulini, mulingo wa HbA1c anali 9,7%, ndipo kuchokera pazosakanikirana zopangidwa - 10,1%, ndi basic bolus therapy (BBT) - 10.4%. Mwanjira zonse, izi zili chifukwa ma endocrinologists ali ndi lingaliro lamphamvu kuti chithandizo cha insulin chiyenera kuyambitsidwa pa HbA1c pamwambapa 9%.

Pamodzi ndi izi, nthawi zambiri, kuyamba kwamphamvu kwa insulin ndi zotsatira za malingaliro oyipa a odwala omwe amathandizira insulin pokhapokha komanso kutanthauzira kwawo molakwika tanthauzo la insulin. Nthawi yomweyo, madokotala nthawi zambiri amakhala ndi nkhawa poganiza za zovuta za insulin, monga chiwopsezo cha hypoglycemia ndi kuchuluka kwa odwala. Tiyenera kudziwa kuti zotchinga zomwe zimayamba mwa odwala zimasintha ndikayamba insulin. Chifukwa chake, kafukufuku wolemba F.J. Snoek et al. , adawonetsa kuti mwa odwala omwe akulandira kale insulini, malingaliro olakwika a insulin mankhwala amachepetsa poyerekeza ndi odwala a insulin-naive. Izi zimadzutsa funso loti pakufunika kochita bwino pophunzitsa odwala omwe ali ndi matenda ashuga, popeza powonjezera luso la odwala, kuphatikiza ndi kudziwa mwakuya za matenda awo, ndizotheka kuchepetsa zopinga zachipatala pakanthawi koyenera komanso ka insulin.

Kufunika kwa kuwongolera kwambiri glycemic sikumangoyambitsa nthawi ya insulini kokha, komanso kusankha kwa insulin yokwanira komanso yothandiza, yokwaniritsa zolinga za glycemia.

Pali njira zambiri zoyambira ndi zolimbitsa insulin. Malinga ndi malingaliro a ADA / EASD, odwala omwe sanalandire chindapusa cha mankhwala a pakamwa hypoglycemic nthawi zambiri amapatsidwa mankhwala a basal insulin. Ngati magwiridwe olamulira a glycemic sakwaniritsidwa kapena sangathe kukhalabe ndi njira yomwe ilipo masiku ano, onjezerani prandial insulin. Therapy yokhala ndi zophatikizika zopangidwa mokonzekera imawerengedwa ngati njira ina pakuyambitsa ndi kukulitsa kwa insulin. Mu malingaliro aku Russia, mosiyana ndi malingaliro a ADA / EASD, zosakanikirana zopangidwa zimagwiritsidwa ntchito zonse poyambira insulin, pamodzi ndi insulin, komanso kukulira limodzi ndi prandial insulin. Kusankha kwa mankhwala a insulin mankhwala kumatengera, choyambirira, pamlingo wa glycemia, kutsatira machitidwe omwe amakhazikitsidwa komanso moyo wa wodwalayo.

Pofotokoza zofunikira pakuchita bwino polimbana ndi matenda a shuga, akatswiri adatsimikiza kuti lingaliro lomwe lingakhalepo la endocrinologists kuyamba mankhwala a insulin pamlingo wa HbA1c 9% akhoza kukhala kuti limagwirizanitsidwa ndi algorithm yomwe imayika chizindikiro ichi kwa odwala omwe ali ndi T2DM panjira yotsitsa shuga, pomwe insulin ndi mankhwala oyambira. Akatswiri adanenanso za kufunika kwa matanthawuzo omveka bwino a misempha ya glycemic, chifukwa ndizotheka kuti kusintha kwawokha kumapangitsa zolinga zakuchipatala kuzikwaniritsidwa. Kuphatikiza apo, pakufunika mtundu wina wosavuta wa ma algorithms opangira njira zochizira odwala omwe ali ndi T2DM. Ponena za zovuta zakwaniritsa zolinga zamankhwala mu cohort ya odwala omwe alandila kale mankhwala a insulin, akatswiri akuganiza kuti chithandizo cha insulini chomwe chimafunikira chimafuna chithandizo chothandizira, monga kudziwunikira kwa glycemia, kuwerengera kwa chakudya chamagulu omwe amadya zakudya komanso kukonza insulin Mlingo womwe umaperekedwa, apo ayi, sagwira ntchito.

Njira imodzi yokwaniritsira kagayidwe kachakudya mu T2DM ndikuyambitsa njira zamankhwala zamasiku ano za insulin ndi kusintha kwamachitidwe a pharmacokinetic ndi pharmacodynamic, kukuthandizani kusankha njira yabwino kwambiri ya insulini poganizira zomwe wodwalayo ali nazo. Ma insulini osakanikirana ndi omwe amakhala ndi insulin yochepa komanso yayitali, omwe ali oyenera kwambiri komanso ovomerezeka kwa odwala omwe amafunikira njira yovomerezeka ya insulin, amagwiritsidwa ntchito kwambiri pochiza odwala omwe ali ndi matenda a shuga a 2.

Humalog Mix 50 ndi chatsopano ku Russia chosakanizira chopangidwa ndi insulin analogue chokhala ndi insulin lispro ndi kuyimitsidwa kwake kwa protamine mu chiyerekezo cha 50:50. Nthawi yayitali yochitapo kanthu imaperekedwa ndi kuyimitsidwa kovomerezeka kwa lispro insulin (50%), yomwe imatsutsana ndi secaltion ya basal, ndi insulin lispro (50%) yomwe imagwira gashcemia itatha kudya. Mankhwalawa amaphatikiza kugwiritsa ntchito mosavuta komanso mawonekedwe apadera a ultrashort a mankhwala a Humalog.

Akatswiri adafufuza zotsatira za kafukufuku wamankhwala oyerekezera Humalog Mix 50 insulin ndi kachitidwe: insulin glargine kamodzi patsiku ndi jakisoni atatu a lyspro insulin musanadye kwambiri odwala omwe ali ndi T2DM, osagwirizana ndi glycemic panthawi ya mankhwala omwe ali ndi insulin glargine komanso mankhwala a hypoglycemic. Cholinga chachikulu cha phunziroli chinali kuwonetsa momwe insulin lyspro imasinthira 50 poyerekeza ndi mankhwala oyambira. Mu nthawi ya kafukufukuyu, malire sanafikire omwe amatsimikizira kuchuluka kwa mawonekedwe a Humalog Remix 50 okonzeka opangidwa ndi insulin poyerekeza ndi njira yoyambira ya bolus, koma luso lapamwamba la regimenyi linawonetsedwa pamaziko a data yomwe idapezedwa yochepetsa hemoglobin ya glycated, yomwe imafikira gulu 1 , 87% ya mtengo woyambira, pomwe HbA1c pagulu lonselo inali 6.95% yokhala ndi HbA1c ya 7.0%. Nthawi yomweyo, pagulu la odwala omwe amalandira insulin glargine osakanikirana ndi katatu la lyspro insulin asanadye kwambiri, kuchepa kwa hemoglobin ya glycated kunali 2.09% ndikufika pafupifupi 6.78% pagululi. Zinadziwika kuti odwala oposa 80% m'magulu onse awiriwa adapeza HbA1c ya 7.5%. Gawo la odwala omwe adakwaniritsa HbA1c ya 7.0% anali 69% m'gululi-bolus gulu ndi 54% mu gulu la Humalog Mix 50.

Pokambirana pafupipafupi zomwe zimachitika mu hypoglycemic, zidadziwika kuti mitundu yonse iwiri ya insulin imakhala yotetezeka chimodzimodzi. Ma pafupipafupi onse a hypoglycemia komanso pafupipafupi a nocturnal komanso hypoglycemia yayikulu sanali osiyana m'magulu.

Zotsatira zoyesedwa zakuchipatala zomwe zikuwonetsa kuyendetsa bwino komanso chitetezo chakugwiritsa ntchito Humalog Remix 50 ngati njira ina ya BBT, akatswiri adazindikira kuti ndiwofunikira kwambiri ndipo adaganiza kuti mankhwala a Humalog Mix 50 akhoza kukhala osowa pamsika waku Russia, kukulitsa mwayi wa endocrinologist posankha njira yabwino kwambiri ya insulin chithandizo.

Akatswiri adalimbikitsa kugwiritsa ntchito mankhwalawa ngati njira imodzi yazowerengera zochizira odwala omwe ali ndi matenda a shuga omwe amafunikira insulin.

Pokambirana, akatswiriwo adayang'ana mitundu yambiri ya odwala omwe ali ndi matenda a shuga a 2, omwe kusankha kwa insulin Humalog Remix 50 ndikofunikira kwambiri:

- monga njira ina yoyambira ya basal-bolus ya insulin yothandizira odwala omwe ali ovuta kupanga jakisoni angapo amitundu iwiri ya insulini ndipo sangathe kuyang'ananso pafupipafupi kwa glycemia, yofunikira pakukonzekera kwa chithandizo choyambira-bolus,
- Kwa odwala omwe amafunikira mankhwala a insulin kuti akonzetse kusala komanso kudya kwa postprandial glycemia, koma osakhala okhazikika pazolinga zamankhwala - HbA1c 7.5% kapena kupitilira,
- kwa odwala omwe salipiridwa chifukwa cha zosakanikirana zosakanikirana za insulin (30/70 ndi 25/75) mu regimen ya 2-fold (m'mawa ndi asanakadye chakudya chamadzulo), chifukwa cha postprandial glycemia (BCP), yomwe imafunanso jakisoni wowonjezera wa insulin yochita posachedwa kuti alamulire BCP pambuyo pa nkhomaliro. Kwa odwala oterowo, Humalog Mix 50 pakulamulira kwa jakisoni 3 patsiku idzakhala yophweka komanso yosavuta popanda kufunika koonjezera mtundu wa insulin,
- kwa odwala omwe salipiridwa insulin ya basal, omwe ali ndi vuto lalikulu la BCP chifukwa chogwiritsa ntchito zakudya zomwe zili ndi mafuta ochulukirapo, osakhala okonzeka kusintha zizolowezi zawo,
- kwa odwala omwe amalandira pulogalamu ya insulin-basel yokhala ndi mankhwalawa 50% ya gawo loyambira ndi 50% ya chinthu choyambirira, komabe, amafunika kuchepetsa njira ya insulin, mwachitsanzo, odwala akamachotsedwa kuchipatala kupita kuchipatala chopita kuchipatala.

Humalog Remix ya 50 ya insulin yoyambira ndi regimen ya titration idawonedwanso ngati gawo la bungwe la akatswiri .. Mulingo wambiri watsiku ndi tsiku komanso kuchuluka kwa jakisoni wa mtunduwu wa insulin kumatsimikiziridwa ndi zosowa za wodwala, momwe amakhalira, zakudya ndi glycemia. Ngati Humalog Remix 50 ndi njira yina yochiritsira wa basal-bolus ndipo ikakhala gawo lotsatira pambuyo pa insulin ya basal, ndiye kuti muyezo wa insulin wa tsiku ndi tsiku womwe wodwalayo adalandira kale wagawidwa magawo atatu ofanana ndikuyambitsa ngati Humalog Remix 50 asanadye kwakukulu . Komabe, chithandizo cha insulin chitha kuyambitsidwa zonse ndi jakisoni imodzi pachakudya chachikulu, komanso jekeseni awiri ndi atatu patsiku. Pambuyo pake, kutumikiridwa kwa mlingo wa jakisoni iliyonseyo kumakhala kofunika komwe kumatsimikizira kukwaniritsidwa kwa zolinga zochizira glycemic control. M'mawu othandiza, ndikofunikira kuzindikira kuti Humalog Mix 50 imasunga zonse zomwe zimapangidwa ndi Humalog insulin, ndipo kugwiritsa ntchito kotheka kumatheka pokhapokha musanadye, komanso panthawi yakudya komanso pambuyo pake, zomwe zimapangitsa kuti wodwalayo akhale ndi moyo wabwino.

Zotsatira Zoyembekeza za Insulin Humalog

Ma hormone a insulin omwe amagwiritsidwa ntchito:

Kutalika kwa zochita zawo - yayitali, yapakatikati, yayifupi, ya ultrashort, yayitali komanso yophatikiza,
komwe kumachokera zinthu zogwira ntchito - nkhumba ndi zotumphukira zochokera ku semisynthetic, zomwe zimapangidwa mwabanja laumunthu ndi mawonekedwe ake osinthika.

Insulin Humalog ndi dzina lodziwika bwino la mtundu wa French wokhala ndi mankhwala Lizpro (Insulin lispro) - ma gene-recombinant analogue a mahomoni opangidwa ndi maselo a beta am'mapapo a anthu. Kusiyana kwake kokha kuchokera ku mahomoni a insulin yaumunthu ndi kusintha kwakubwezeretsa kwa proline (No. 28) ndi lysine (No. 29) amino acid zotsalira mu mamolekyulu ake.

Kusiyana koteroko kunapangidwa mwadala. Tithokoze iye, Insulin Humalog ndi masanjidwe ake amatha kugwiritsidwa ntchito ndi odwala omwe ali ndi matenda amtundu wa 1, ndikudzaza kuchepa kwa mahomoni oyendera, komanso odwala omwe ali ndi matenda a shuga a 2, omwe ma cell awo amapanga insulin kukana (chitetezo chokwanira) kwa mahomoni awo a insulin.

Insulin - mahomoni oyendera "omwe amatsegula" membrane wam'magazi a glucose

Kuchulukitsa kwa mankhwala ndi gene-recombinant Lizpro ndi am'thupi la insulin. Nthawi yomwe ikuyembekezeka kugwa kwa glucose m'madzi am'magazi ndi 10-20 pambuyo pa kuperekedwa pansi pa khungu. Chiwonetsero chachikulu kwambiri chikuwonekera mkati mwa maola 1 mpaka 3, ndipo kutalika kwa nthawi ya hypoglycemic ndi maola 3-5.

Zambiri. "Odziwa" odwala matenda a shuga omwe amadalira insulin amadziwa, ndipo "oyamba" ayenera kukumbukira kuti jakisoni wa mahashoni a ultrashort amakhudza munthu wamkulu komanso mwana - pakatha mphindi 10, mukalowetsa pakhungu pamimba, ndipo patatha mphindi 20, ngati jakisoni ali wopangidwa paphewa. Komabe, kutalika kwa zotsatirapozi kumangokhala kwaokha, ndipo kumatha kusintha pakapita nthawi.

Njira yayikulu yogwiritsira ntchito ndikukhazikitsidwa kwa kagayidwe kazakudya zam'mimba ndikuthandizira pakugwiritsa ntchito shuga m'magazi, chifukwa chobwezeretsanso kuchuluka kwa insulin yam'madzi, popanda izi gwero lamphamvu (glucose) silingathe kudutsa mkati mwake.

Kuphatikiza pa mayamwidwe a shuga ndikuchepetsa kuchuluka kwake m'madzi am'magazi, Insulin Humalog ili ndi zotsatirazi:

amachulukitsa kuchuluka kwamafuta acid, glycerol ndi glycogen m'maselo a mafupa aminyewa.
zimawonjezera kupanga kwa mapuloteni ena,
imathandizira kugwiritsa ntchito ma amino acid,
amachepetsa kuchuluka kwa glycogenolysis ndi gluconeogeneis.

Kwa mawu. Mwa njira, poyerekeza ndi ma genulin a insulin yamadzi a insulin, kuchuluka kwa kuchepa kwa hyperglycemia mutatha kudya ndi Lizpro Insulin kumanenedweratu.

Zokonzekera zonse za insulin zimagwiritsidwa ntchito motsutsana ndi maziko azakudya ndi malire ake 1700-3000 kcal

Zizindikiro, contraindication, mavuto ndi zina zina

Malangizo a mankhwala a Insulin Humalog ali ndi zinthu izi:

Zizindikiro - T1DM, T2DM, matenda ashuga, pachimake subcutaneous insulin kukana, chosavomerezeka postprandial hyperglycemia, mwangozi adalowa matenda omwe amapangitsa maphunziro a shuga, komanso opaleshoni kwa odwala matenda ashuga.
Contraindication - machitidwe a hyperglycemic, kuchuluka kwa chidwi cha munthu payekha.
Zotsatira zoyipa - ma insulin lens osakhalitsa, zotupa za insulin ndi zizindikiro za hypoglycemic:
1. mutu
2. khungu losakhala lachilengedwe
3. thukuta, thukuta lochulukirapo.
4. kugunda kwa mtima ndi kugunda kwa mtima
5. kunjenjemera kwa miyendo, kukokana kwa minofu, zopindika myoclonic, paresthesias ndi mitundu yosiyanasiyana ya maresi,
6. kuchepa kwa luntha.
7. zosokoneza tulo
8. nkhawa.

Glucagon jakisoni ayenera kukhala munthu woyamba thandizo matenda ashuga

Bongo - hypoglycemic precoma ndi chikomokere. Izi zimayimitsidwa ndi subcutaneous kapena mu mnofu makonzedwe a glucagon. Ngati palibe mankhwala oterowo kapena chifukwa chogwiritsa ntchito zotsatira zomwe mumafunazo sanapeze, jakisoni wadzidzidzi wa yankho la glucose wamitsempha.
Chenjezo. Odwala omwe ali ndi vuto la impso ndi chiwindi, panthawi yolimba kwambiri, osagwiritsa ntchito chakudya, komanso mankhwala a beta-blockers, sulfonamides kapena mao inhibitors, mukamamwa mankhwala osokoneza bongo omwe ali ndi zakumwa zoledzeretsa, kufunika kwa mankhwalawa kumatha kuchepetsedwa. Kuchulukitsa kwa mankhwalawa kungafunike pa matenda opatsirana, pakukhudzana ndimaganizo, pakuphwanya zakudya, munthawi ya chithandizo cha thiazide diuretics, kulera kwapakamwa, tricyclo-antidepressants ndi glucocorticosteroids.
Mlingo Lizpro (Humalog) prick pansi pa khungu, kuyambira 4 mpaka 6 pa tsiku. Mlingo umodzi, kuchuluka ndi nthawi ya jakisoni aliyense amasankhidwa ndi endocrinologist. Jakisoni imodzi yokhala ndi mlingo pamwamba pa PISCES 40 imavomerezeka pokhapokha. Mukasinthira ku Lizpro monotherapy ndi analogi yankhumba yomwe imathamanga, mungafunike kusintha. Pakupereka komanso pambuyo pake, mlingo wa mankhwalawa umalimbikitsidwa kuti achepetse kwambiri. Mayi wakhanda woyamwitsa yemwe ali ndi matenda ashuga angathenso kusintha mawonekedwe ndi / kapena zakudya.
Zinthu zosungira ndi kugwiritsa ntchito. Kukonzekera kwa insulin kuyenera kusungidwa pansipa ya firiji. Asanayambe kuyendetsa, mankhwalawo "amawotha", ndikugudubuza pakati pa kanjedza kakhumi mpaka ka 20. Tiyeneranso kusamalanso kuti jakisoni asalowe mumtsempha wamagazi.

Chenjezo! Ndikamayambitsa kukonzekera kuzizira, ngati mowa udzafika pakhungu, kapena chifukwa cha mphamvu yake yakubinoli komweko, vuto lodzikongoletsa (lipohypertrophy) lingapangike, lomwe limachepetsa kuyamwa kwa mankhwalawo. Chifukwa chake, mukabayidwa, muyenera kusintha nthawi zonse komwe jakisoni, ndipo pobowola pamalo amodzi, mwachitsanzo, pamimba, siyani mtunda wa 1 cm pakati pawo.

Kusiyana Humalog Remix 50 ndi Sakanizani 25 kuchokera ku ultrashort Humalog

M'makonzedwe ophatikizidwa Humalog amaphatikizanso 6 obwera

Insulin Humalog Remix 50 ndi Insulin Humalog Remix 25 ndi oimira gulu lophatikizana la insulin. Ndiwosakanikirana ndi yankho la ultrashort Lizpro ndi kuyimitsidwa kwa protamine ya Lizpro, komwe kumatanthauza mahomoni a nthawi yayitali. Kuwerengera kwa zinthu izi ku Mix ndi 50 - 1 mpaka 1, ndipo mu Kusakaniza 25 - 1 mpaka 3.

Kuthamanga kwa kuchitapo kanthu kwa Humalogs onse ndi ofanana, koma kutalika kwa msambo (kuchuluka kwa kuchuluka mu seramu yamagazi) ndikosiyana, ndipo chifukwa cha gawo la protamine Lizpro, zochitika za insulin zimapitilira. Chifukwa cha izi, jakisoni 3-2 patsiku la MIX50 kapena 2-1 jakisoni wa MIX25 akwanira odwala ena.

Zomwe mungagwiritse ntchito pokonzekera Humalog

Cartridge ndi amodzi mwa mitundu ya Quick Pen-injector

Anthu odwala matenda ashuga omwe amaphatikiza mitundu ya Insulin Humalog, chifukwa chakuti protiz Lizpro ili mwa kuyimitsidwa, ndipo pali okakamiza pakukonzekera, osangofunika kuti mankhwalawo adziwitsidwe musanabaye jekeseni, koma njira zotsatirazi ziyenera kuyang'aniridwa mosamala:

bwezeretsani madziwo ndikakusintha cartridge kapena syringe cholembera madigiri 180,
kuchuluka kwa nthawi - 10-12,
kuthamanga ndi mawonekedwe a mayendedwe ake ndi osalala, pafupifupi kutembenukira kumphindi imodzi,
samalani ndi mawonekedwe a chithovu, chomwe chidzawonetsedwa pakuchepetsa mlingo.
ngati mumva phokoso mukamayenda, musachite mantha ndipo musagwedeze mankhwalawo chifukwa cha chidwi - cartridge iliyonse kapena cholembera mwachangu chili ndi mpira wocheperako womwe umathandiza kusakaniza zigawo zonse za mankhwalawo.

Zofunika! Ngati, mutatha kusuntha, kuphatikiza kophatikizako sikunakhale koyenera kofanana ndi mkaka, koma ziphuphu zimawonekera, ndizoletsedwa kugwiritsa ntchito kukonzekera.

Malamulo ogwiritsa ntchito zolembera za QuickPen Syringe

Ngati batani lipanikizidwa mwamphamvu kutsatira malamulo onse a njira yoyambira, sinthani cholembera ndi chatsopano

Pakadali pano, onse omwe ndi oyera a insulin Humalog oyera komanso ophatikizika ndi Humalog Remix-25, akupezeka m'mapensulo oyenera.

Pogwiritsa ntchito zida zosavuta zotere, malamulo ndi njira zotsatirazi ziyenera kuonedwa:

osapitiliza zolembera zanu za asitomala ena,
pa jekeseni aliyense wotsatira, ingotengani singano yatsopano ya Becton Dickinson & C,
osagwiritsa ntchito cholembera chowonongeka, ndipo nthawi zonse muzikhala ndi chida chachiwiri, chomwe chingakhale chothandiza paziwoneka mwadzidzidzi pang'onopang'ono pakapezeka jakisoni imodzi,
anthu odwala matenda ashuga owoneka bwino kuti apakidwe jekeseni ndi cholembera amafunikira thandizo la anthu omwe amatha kuwona bwino, omwe angagwiritse ntchito,
musachotse cholembera chachikuda kuchokera ku cholembera cha syringe cholembera, chitha kukhala chofunikira pazochitika zadzidzidzi, kumuuza dokotala wa ambulansi yemwe ndi mankhwala omwe amapangitsa kuti mukhale ndi hypoglycemic precoma kapena chikomokere,
miyambo yachizolowezi isanachitike jakisoni aliyense amayenera kuwunika moyo wa alumali ndikuyang'ana kukonzekera kwa cholembera kuti agwiritsidwe ntchito (kumasula madzi pang'ono mumtsinje woonda), ndipo njirayi itatha, kuwunikira kwa mankhwala omwe atsalira
Kuuma kwa kubaya kwa mbewa yolumikizira mlingo kumakhudzidwa ndi kupindika kwa singano ndi kuphwanya kwa chonde chake, kuthamanga kwambiri komanso mwachangu, fumbi kapena tinthu tina tating'onoting'ono tomwe timalowa mu chipangizocho,
sungani zolembera ndi singano padera, kusungirako ndi singano yophatikizika kumapangitsa kuti mpweya ulowe mankhwalawa, zomwe zingapangitse kuchepa kwapadera kwa mlingo woperekedwa.
nyengo yotentha, mukamagwiritsa ntchito cholembera kunja kwa nyumba, gwiritsani ntchito chivundikiro chapadera kuti musunge,
Pezani upangiri kuchokera kwa endocrinologist wa momwe mungataye ndi singano, zolembera, ndi zojambula zotayira.

Ndipo pomaliza, tikukulimbikitsani kuwona kanema kuchokera kwa endocrinologist pa malamulo ndi njira zoyendetsera kukonzekera kwa insulin, kutengera mtundu wa chipangizocho chomwe mankhwalawa a mahomoni amaperekedwa.

Mlingo

Kuyimitsidwa kwa makina oyang'anira.

1 ml muli:
ntchito: insulin lispro 100 IU,
zokopa: metacresol 2.2 mg. phenol madzi 1.0 mg, glycerol (glycerin) 16 mg, protamine sulfate 0,19 mg, sodium hydrogen phosphate heptahydrate 3,78 mg, zinc oxide qs kuti ipeze zinc ions 30,5 μg, madzi a jakisoni mpaka 1 ml, 10% yankho la hydrochloric acid ndi / kapena 10% sodium hydroxide yankho la pH ya 7.0-7.8.

Kuyimitsidwa koyera komwe kumachoka, ndikupanga koyera koyera komanso kowoneka bwino, kopanda mtundu kapena pafupifupi wamitundu. Mtengo umasinthidwa mosavuta ndikugwedezeka modekha.

Mankhwala

Mankhwala
Humalog Mix 50 ndi chopangidwa chopangidwa chopangidwa ndi yankho la insulin lispro 50% (analog yothamanga ya insulin yaumunthu) komanso kuyimitsidwa kwa protamine kuyimitsidwa kwa insulin lispro 50% (analog ya insulin ya anthu a nthawi yayitali).

Chochita chachikulu cha insulin lyspro ndi malamulo a kagayidwe ka glucose.

Kuphatikiza apo, imakhala ndi anabolic komanso anti-catabolic zotsatira zosiyanasiyana zamthupi. Mu minofu yamatenda mumakhala kuchuluka kwa glycogen, mafuta acid, glycerol. kuchuluka kwa mapuloteni komanso kuchuluka kwa ma amino acid, koma kuchepa kwa glycogenolysis, gluconeogeneis. ketogenesis. lipolysis. catabolism ya protein ndi amino acid kumasulidwa.

Lyspro insulin yawonetsedwa kuti ikufanana ndi insulin yaumunthu, koma zotulukapo zake zimathamanga ndipo zimatha kuchepera.

Kukwanira kwathunthu ndi kuyambika kwa mphamvu ya insulin kumadalira malo a jakisoni (m'mimba, ntchafu, matako), mlingo (kuchuluka kwa insulin), kuchuluka kwa magazi, kutentha kwa thupi ndi zochitika zolimbitsa thupi.

Pambuyo pobayira mankhwalawa a Humalog® Remix 50, kuyambiranso kuchitapo kanthu komanso kuyambiranso koyambirira kwa zochitika za insulin lispro zimawonedwa. Kukhazikika kwa mankhwalawa ndi pafupifupi mphindi 15, zomwe zimapangitsa kuti mankhwalawa aperekedwe musanadye (0-15 mphindi musanadye), poyerekeza ndi insulin yaumunthu wamba. Pambuyo pobayira mankhwalawa a Humalog® Remix 50, kuyambiranso kuchitapo kanthu komanso kuyambiranso koyambirira kwa zochitika za insulin lispro zimawonedwa. Mbiri ya insulin lyspro protamine imafanana ndi zochitika pachitetezo cha insulin-isophan chotalika pafupifupi maola 15.

Pharmacokinetics
The pharmacokinetics ya insulin lispro imadziwika ndi kuyamwa mwachangu ndikufika pazitali kwambiri m'magazi 30-70 patatha jekeseni wofikira. The pharmacokinetics ya kuyimitsidwa kwa insulin lysproprotamine ndi ofanana ndi sing'anga-insulin-isophan). Pharmacokinetics ya mankhwala Humalog Remix 50 imatsimikiziridwa ndi katundu wa pharmacokinetic pazigawo ziwiri za mankhwalawa.

Ndi makonzedwe a lyspro insulin, mayamwidwe msanga kuposa sungunuka anthu insulin odwala aimpso kulephera. Odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga, kupatsirana kwa mapiritsi pakati pa lyspro insulin ndi insulle ya insulin yaumunthu kumawonedwa mu ntchito zambiri za aimpso, mosasamala kanthu za ntchito yaimpso. Ndi makonzedwe a insulin lyspro, kuyamwa mwachangu ndikuchotsa mwachangu kumawonedwa poyerekeza ndikusungunuka kwa insulin ya anthu odwala omwe ali ndi vuto la chiwindi.

Ndi chisamaliro:

Nthawi yokhala ndi pakati komanso yoyamwitsa,
Ndi kulephera kwa aimpso, kuperewera kwa chiwindi, kupsinjika kwa mtima, kuchuluka kwa zochitika zolimbitsa thupi, kusintha kwa zakudya zamasiku onse, kufunika kwa insulin kungasinthe komanso kusintha kwa insulin kungafunike.
Ndi kuphunzira kwa nthawi yayitali matenda a shuga, matenda a shuga, kapena kugwiritsa ntchito mankhwala oletsa beta-adrenergic, zizindikiro zomwe zimaneneratu kuti hypoglycemia ingasinthe kapena kusalankhula pang'ono.

Gwiritsani ntchito panthawi yoyembekezera komanso poyamwitsa

Kafukufuku wazinyama sanawonetse chinsinsi chovuta kapena mphamvu ya insulin lyspro pa mwana wosabadwayo. Sipanakhalepo mayesero azachipatala ogwiritsira ntchito lyspro insulin mwa amayi apakati. Popeza kafukufuku wokhudzana ndi mphamvu ya mankhwala pakubala kwanyama nthawi zonse samalola kupitiliza kuchuluka kwa zomwe zimachitika mthupi la munthu, mankhwala a Humalog® Mix 50 pa nthawi yoyembekezera amayenera kugwiritsidwa ntchito pokhapokha ngati pakufunika kuthandizidwa kuchipatala.

Odwala omwe ali ndi matenda ashuga, ndikofunikira kuti adziwitse dokotala za zoyambira kapena pakati.

Pa nthawi ya pakati, ndikofunikira kuwunika momwe odwala alandirira chithandizo cha insulin. Kufunika kwa insulin nthawi zambiri kumachepetsa panthawi yoyambirira ndikuwonjezeka panthawi yachiwiri komanso yachitatu. Nthawi yobadwa pambuyo pokhapokha ndipo mwayamba kubadwa, zofunika za insulin zimatha kugwa kwambiri.

Odwala omwe ali ndi matenda a shuga mellitus nthawi yoyamwitsa angafunikire kusintha mlingo wa insulin, zakudya, kapena zonse ziwiri.

Mlingo ndi makonzedwe

Mlingo wa Humalog Mix 50 umatsimikiziridwa ndi dokotala payekha, kutengera kuchuluka kwa shuga wamagazi.

Ndondomeko ya insulin makonzedwe ali payekha.

Mankhwalawa amayenera kuperekedwa kokha. Kutsata kwa mtsempha wa mankhwalawa Humalog® Mix 50 sikovomerezeka.

Kutentha kwa mankhwala omwe amaperekedwa kuyenera kukhala kutentha kwambiri.

Jakisoni wotsekemera ayenera kuperekedwa kwa phewa, ntchafu, matako kapena pamimba. Masamba a jakisoni ayenera kusinthidwa kuti malo omwewo sawagwiritsanso ntchito mwina kamodzi pamwezi. Ndi subcutaneous makonzedwe a Humalog® Mix 50 kukonzekera, chisamaliro chiyenera kutengedwa kuti mankhwalawa asadutse mu mitsempha yamagazi. Pambuyo pa jakisoni, tsamba la jakisidwe siliyenera kutenthedwa.

Kuti mupeze malingaliro pakukhazikitsa cartridge mu chipangizo chothandizira kukonzekera kwa Humalog® Mix 50 ndikuyika singano yake musanapereke mankhwalawa, werengani malangizo a wopanga a chipangizocho popereka insulin. Tsatirani mosamalitsa malangizo owerengedwa.

Pambuyo pokonza makina a Humalog® Mix 50 kukonzekera, kuyambira mwachangu ndikuwonjezeka kwa zochitika za lyspro insulin kumawonedwa. Chifukwa cha izi, Humalog® Mix 50 ikhoza kutumikiridwa nthawi isanayambe kapena itatha. Kutalika kwa kanthu kuyimitsidwa insulin lysproprotamine. yomwe ndi gawo la Humalog Mix 50. Ndiwofanana ndi nthawi ya insulin-isophan.

Mbiri yakuchitidwa kwa insulini, mosasamala mtundu wake, imasinthasintha kwakukulu onse mwa odwala osiyanasiyana kutengera mawonekedwe awo, komanso mwa wodwala m'modzi malinga ndi nthawi yake. Monga kukonzekera kwina konse kwa insulin, kutalika kwa zochita za Humalog® Mix 50 zimatengera mlingo, malo a jakisoni, magazi, kutentha kwa thupi ndi zochitika zolimbitsa thupi.

Kukonzekera mawu oyamba
Asanagwiritse ntchito, cartridge ya Humalog® Mix 50 imayenera kukukhidwira pakati pama manja khumi ndikugwedezeka, kutembenuka kwa 180 ° komanso maulendo khumi kuti ipatsenso insulin mpaka itakhala yunifolomu yamadzi. Osagwedezeka mwamphamvu, chifukwa izi zingapangitse mawonekedwe a chithovu, omwe amatha kusokoneza mlingo woyenera. Kuti zithandizire kusakanikirana, mpira wawung'ono wagalasi uli mkati mwa cartridge.

Osagwiritsa ntchito Humalog® Remix 50. ngati ili ndi mapokoso pambuyo poti mwasakaniza.

Dose makonzedwe

1. Sambani m'manja.
2. Sankhani tsamba la jakisoni.
3. Konzani khungu lanu jakisoni monga momwe dokotala wanenera.
4. Chotsani kapu yodzitchinjiriza kunja kwa singano.
5. Konzani khungu, kuliphatikiza khola lalikulu.
6. Ikani singano mosazindikira mu khola lomwe mwasonkhanitsa ndikuchita jekeseni mogwirizana ndi malangizo ogwiritsa ntchito cholembera.
7. Chotsani singano ndikufinya pang'onopang'ono malo opaka jakisoni ndi swab ya thonje kwa masekondi angapo. Osatupa malo a jakisoni.
8. Pogwiritsa ntchito singano yoteteza kunja, inthanitsani singano ndikuitaya.
9. Ikani chipewa pa cholembera.

Kwa kukonzekera kwa Humalog ® Mix 50 mu cholembera cha syringe ya QuickPen.
Musanapereke insulini, ndikofunikira kuti muzidziwitsa cholembera cha QuickPen TM.

Zotsatira zoyipa

Hypoglycemia ndizotsatira zoyipa zomwe zimachitika ndikumayambitsa kukonzekera konse kwa insulin, kuphatikiza Humalog Remix 50. Hypoglycemia yayikulu imatha kutaya chikumbumtima ndipo. mwapadera, kufikira imfa.

Zotsatira zoyipa: Odwala amatha kudwala matendawa m'njira yofiyira, kutupa, kapena kuyabwa pamalowo. Izi zazing'ono zimakonda kutha patatha masiku angapo kapena milungu. Nthawi zina, izi zimachitika chifukwa cha zifukwa zosakhudzana ndi insulin, mwachitsanzo, mkwiyo pakhungu ndi wothandizira kuyeretsa kapena jakisoni wosayenera.

Zosagwirizana zimachitikachifukwa cha insulin zimachitika kangapo, koma ndizowopsa. Amatha kuwonetsedwa ndi kuyabwa kwakukulu, kupuma movutikira, kupuma movutikira, kutsika magazi, tachycardia, thukuta lochulukitsa. Milandu yambiri yokhudzana ndimomwe thupi limagwirira ntchito ikhoza kukhala pachiwopsezo cha moyo. Nthawi zina mankhwalawa amakhala osakanikirana kwambiri ndi Humalog® Remix 50, chithandizo chofunikira chimafunika. Mungafunike kusintha kwa insulin, kapena kutsimikiza mtima.

Ndi kugwiritsa ntchito nthawi yayitali - chitukuko ndichotheka lipodystrophy pamalo opangira jekeseni.

Mauthenga wamba:
Milandu ya chitukuko cha edema idawululidwa, makamaka, ndi kusintha kwachulukidwe ka shuga m'magazi motsutsana ndi maziko a insulini yolimbitsa thupi poyambirira yolimbana ndi glycemic.

Bongo

Mankhwala osokoneza bongo a insulin amachititsa hypoglycemia, limodzi ndi zizindikiro zotsatirazi: ulesi, kuchuluka thukuta, tachycardia, kufooka kwa khungu, kupweteka mutu, kunjenjemera, kusanza, chisokonezo. Mwachitsanzo, pazochitika zina, mwachitsanzo, ngati matendawo atenga nthawi yayitali kapena kuwunika kwambiri matenda ashuga, Zizindikiro zakutsogolo kwa hypoglycemia zimatha kusintha.

Hypoglycemia wofatsa nthawi zambiri imatha kuimitsidwa mwa kumeza shuga kapena shuga. Kusintha kwa mlingo wa insulin, zakudya, kapena zolimbitsa thupi kungafunike. Malangizo a hypoglycemia wolimbitsa amatha kuchitika pogwiritsa ntchito intramuscular kapena subcutaneous makonzedwe a glucagon. kenako kumeza chakudya. Zambiri za hypoglycemia, limodzi ndi chikomokere, kukomoka kapena kuchepa kwa mitsempha, zimayimitsidwa ndi kutsekeka kwa mtima kapena kupweteka kwamkati pogwiritsira ntchito njira ya dextrose (glucose). Pambuyo pozindikira, wodwalayo ayenera kupatsidwa chakudya chopatsa thanzi kuti alepheretse kukonzanso kwa hypoglycemia. Kudya zakudya zamagulu ochulukirapo komanso kuwunika wodwalayo kungafunike, chifukwa kuyambiranso kwa hypoglycemia ndikotheka.

Kuchita ndi mankhwala ena

Mphamvu ya hypoglycemic ya mankhwala a Humalog Remix 50 imachepetsedwa ngati imagwiritsidwa ntchito limodzi ndi mankhwala otsatirawa: kulera kwapakamwa, glucocorticosteroids, mahomoni a chithokomiro a iodine. beta₂adrenergic agonists (mwachitsanzo, ritodrin, salbutamol, terbutaline), thiazide diuretics, chlorprothixene, diazoxide. isoniazid, nikotini acid, zotumphukira za phenothiazine.

Mphamvu ya hypoglycemic ya Humalog® Mix 50 imapangitsidwa ndi: beta-blockers, ethanol ndi mankhwala okhala ndi ethanol, anabolic steroids, fenfluramine, guanethidine, tetracyclines, mankhwala a hypoglycemic. salicylates (mwachitsanzo acetylsalicylic acid), mankhwala a sulfonamide, ma antidepressants (monoamine oxidase inhibitors), angiotensin-akatembenuza enzyme inhibitors (Captopril, enapril), octreotide, angiotensin II receptor antagonists.

Beta blockers. clonidine, reserpine ikhoza kuphimba mawonetseredwe a zizindikiro za hypoglycemia.

Kuchita kwa Humalog® Mix 50 ndi kukonzekera kwina kwa insulin sikunaphunzire.

Ngati mukufunika kugwiritsa ntchito mankhwala ena, kuwonjezera pa insulin, funsani dokotala.

Kugwiritsa ntchito pamodzi kwa Humalog® Mix 50 ndi mankhwala a thiazolidatedione kungakulitse chiwopsezo cha edema ndi kulephera kwa mtima, makamaka kwa odwala omwe ali ndi matenda amtima.

Malangizo apadera

Kusamutsa wodwala kupita ku mtundu wina kapena kukonzekera kwa insulin ndi dzina lina lamalonda kuyenera kuchitika moyang'aniridwa ndi achipatala. Sinthani muzochita, chizindikiro (wopanga), mtundu (sungunuka insulin, insulin-isophan, ndi zina). mitundu (nyama, munthu, analogue of insulin ya anthu) ndi / kapena njira yopanga (DNA recombinant insulin kapena insulin ya chiyambi cha nyama) zitha kufuna kusintha kwa mlingo.

Mwa odwala ena, kusintha kwa mankhwalawa kungakhale kofunikira pakusintha kwa insulin yochokera ku nyama kupita ku insulin ya anthu. Izi zitha kuchitika kale poyambilira kukonzekera kwa insulin ya anthu kapena pang'onopang'ono pakangotha milungu ingapo kapena miyezi ingapo atasamutsidwa.

Matenda osasinthika a hypoglycemic kapena hyperglycemic amatha kupangitsa kuti musakhale ndi chikumbumtima, chikomokere, kapena kufa. Zizindikiro zakutsogolo kwa hypoglycemia zimatha kusintha kapena kusalankhula pang'ono ndi matenda a shuga, matenda ashuga, kapena chithandizo cha mankhwala monga beta-blockers.

Mlingo wosakwanira kapena kusiya kulandira chithandizo, makamaka kwa odwala omwe ali ndi vuto la matenda ashuga 1, kungayambitse matenda a hyperglycemia ndi matenda ashuga a ketoacidosis (mikhalidwe yomwe ikhoza kukhala yowopsa kwa wodwalayo).

Kufunika kwa insulin kumatha kuchepa ndi kulephera kwa aimpso, komanso ndi vuto la chiwindi chifukwa kuchepa kwa mphamvu ya gluconeogeneis, komanso kuchepa kwa insulin kagayidwe, komabe, mwa odwala omwe ali ndi vuto losatha la chiwindi, kukana kwa insulini kungayambitse kuchuluka kwa kufunika kwake.

Kufunika kwa insulini kumatha kuwonjezeka ndi matenda ena kapena kupsinjika mtima kwambiri.

Kuwongolera mlingo wa insulin kungafunike ndi kuwonjezeka kwa zochitika zolimbitsa thupi kapena kusintha kwa zakudya zomwe mumakonda. Kuchita masewera olimbitsa thupi kumatha kuyambitsa chiwopsezo cha hypoglycemia.

Mukamagwiritsa ntchito insulin pokonzekera limodzi ndi mankhwala a gulu la thiazolidinedione, chiopsezo chotenga matenda a edema ndi matenda a mtima omwe amalephera chikuwonjezereka, makamaka kwa odwala omwe ali ndi matenda amtima komanso kupezeka kwa zinthu zomwe zingayambitse matenda osalephera a mtima.

Popewa kufalitsa matenda opatsirana, cholembera / cholembera chilichonse chimayenera kugwiritsidwa ntchito ndi wodwala m'modzi, ngakhale singano isinthidwe. Makatoni okhala ndi Humalog® Mix 50 akuyenera kugwiritsidwa ntchito ndi zolembera zomwe zikuwonetsedwa ndi CE. malinga ndi malangizo a wopanga chipangizocho.

Zokhudza mphamvu pakutha kuyendetsa magalimoto ndimakina

Panthawi ya wodwala hypoglycemia, chidwi ndi kuthamanga kwa zochitika zama psychomotor zitha kuchepa. Izi zitha kukhala zowopsa nthawi zomwe maluso amenewa amafunikira makamaka (mwachitsanzo, kuyendetsa magalimoto kapena makina).

Odwala ayenera kulangizidwa kuti azisamala kuti apewe hypoglycemia poyendetsa magalimoto ndi makina. Izi ndizofunikira kwambiri kwa odwala omwe ali ndi zofatsa kapena zosapezekapo zizindikiro, okhazikika a hypoglycemia kapena okhazikika a hypoglycemia. Zikatero, adotolo amayenera kuwunika kuthekera koyendetsa wodwalayo ndi magalimoto ndi njira zake.

Kutulutsa Fomu

Kuyimitsidwa kwa subcutaneous makonzedwe a 100 IU / ml.

Makatoni:
3 ml ya mankhwala pa cartridge. Makatiriji asanu pachimake. Chithuza chimodzi pamodzi ndi malangizo ogwiritsira ntchito pakatoni.

Syringe cholembera QuickPM TM:
3 ml ya mankhwalawa mu cartridge, omwe adamangidwa mu cholembera cha syringe ya Quick Pen. Ma syringe asanu a QuickPen TM, iliyonse ili ndi malangizo ogwiritsira ntchito ndi cholembera cha syringe ya QuickPEN TM, kuti mugwiritse ntchito phukusi la makatoni.

Dzina ndi adilesi yaopanga

Wopanga ndi wonyamula:
Lilly France, France
2 Ru du Colonel Lilly. 67640 Fegersheim, France

Packer ndikupereka mawonekedwe oyang'anira:
Lilly France, France
2 Ru du Colonel Lilly. 67640 Fegersheim
kapena
Eli Lilly ndi Company, USA (Quick Pen Syringe TM)
Indianapolis. Indiana 46285

Ndemanga za madotolo pakusintha kwa 50

Mulingo wa 5.0 / 5

Kugwiritsa ntchito bwino

Mtengo / ubora

Zotsatira zoyipa

Kuchepetsa kuchuluka kwa jakisoni kuyambira 5-6 mpaka 3 (insulin imagwiritsidwa ntchito katatu patsiku musanadye kwambiri). Cholembera chimodzi chokha m'malo awiri - palibe chisokonezo kwa okalamba komanso osawona odwala bwino. Imagwira bwino kwambiri matenda ashuga amtundu wa 2 pomwe kukonzanso kwa postprandial kumafunikira kuposa basal. Kwa odwala omwe ali ndi hypoglycemia pakati pa chakudya (chifukwa insulin ya basal ndiyochepa kuposa mitundu ina).

Kuphatikiza koyamba kwa 50 mpaka 50 - theka basal, hafu ultrashort. Zothandiza kwa odwala omwe ali ndi matenda a shuga a 2 omwe analandila kale mankhwala a insulin. Tsopano, odwala anga omwe ali ndi mbiri yayitali ya matenda a shuga, omwe ali ndi encephalopathy, sangasokoneze insulin "yayitali" ndi "yochepa"!

Mulingo 4.2 / 5

Kugwiritsa ntchito bwino

Mtengo / ubora

Zotsatira zoyipa

Kuchuluka kwa jakisoni 2 kawiri pa tsiku m'malo mwa 4-5.

Njira yofunikira kwambiri pakudya ndi zakudya ndizofunikira.

Kugwiritsa ntchito kuphatikiza ma insulin kumafunikira njira yosamala kwambiri yowerengera zakudya ndi zakudya, luso labwino kuwerengera ndikuwunika mtundu wa macronutrients. Mutha kuwona izi ngati chinthu chabwino, pamene kudzikhuthura kwa wodwala kumawonjezeka, zolakwa zaumoyo zimachotsedwa.

Chonde werengani malangizowa musanagwiritse ntchito.

Kuyamba
Quick Pen Syringe chole ndi yosavuta kugwiritsa ntchito. Ndi chida chothandizira kuperekera insulini ("insulini syringe cholembera") yokhala ndi 3 ml (magawo 300) ya kukonzekera kwa insulin ndi ntchito ya 100 IU / ml. Mutha kubaya kuchokera 1 mpaka 60 magawo a insulin pa jakisoni. Mutha kukhazikitsa mlingo molondola ndi umodzi. Ngati mwayika mayunitsi ambiri. Mutha kukonza mankhwalawa osataya insulin.

Musanagwiritse ntchito syPinge ya QuickPen, werengani bukuli ndikutsatira malangizo ake ndendende. Ngati simutsatira malangizowa, mutha kulandira inshuwaransi yotsika kwambiri kapena kwambiri.

Pulogalamu yanu ya insulin ya QuickPen iyenera kugwiritsidwa ntchito povulala panu. Osadutsa cholembera kapena singano kwa ena, chifukwa zimatha kufalitsa kachilomboka. Gwiritsani ntchito singano yatsopano jekeseni iliyonse.

Musagwiritse ntchito cholembera ngati gawo lake lina lawonongeka kapena lawonongeka. Nthawi zonse tengani cholembera chopanda kanthu ngati mungataye cholembera kapena chikaonongeka.

Sitikulimbikitsidwa kugwiritsa ntchito cholembera chindapusa kwa odwala omwe ataya kuwona kwathunthu kapena owona msanga popanda thandizo la anthu owona bwino omwe aphunzitsidwa kugwiritsa ntchito cholembera.

Kukonzekera Kwachangu kwa Syninge

Zolemba zofunikira

Werengani ndikutsatira malangizo ogwiritsira ntchito mankhwalawa.
Onani cholembera pa cholembera asanalowe jakisoni iliyonse kuti mutsimikizire kuti mankhwala sanathere ndipo mukugwiritsa ntchito mtundu woyenera wa insulini: musachotsere ilebuloyo pa cholembera.

Chidziwitso: Mtundu wa batani lothamanga la cholembera cha QuickPen umafanana ndi mtundu wa Mzere pa cholembera cholembera ndipo zimatengera mtundu wa insulin. Mbukuli, batani la imvi limadukaduka. Mtundu wa buluu wa cholembera cha syringe wa QuickPen umaonetsa kuti. kuti lakonzedwa kuti lizigwiritsidwa ntchito ndi zinthu za Humalog®.

Kufotokozera kwapfupi

Kusintha kwa humalog 50 - chisakanizo cha insulin yocheperako yokhala ndi insulin yochepa. Amachepetsa shuga. Imawonetsa anabolic kwenikweni, imalepheretsa ma catabolism zosiyanasiyana ziwalo ndi zimakhala. Imakhala ndi kuphatikizira komwe kumakhala ndi insulin yaumunthu, koma imayamba kuchita zinthu mwachangu. Pambuyo pakuyang'anirani, imayamba kuchita pakapita mphindi 15, yomwe imakupatsani jakisoni musanadye. Mankhwala a insulin okwanira m'magazi amadziwika kuti ndi mphindi 30-70 pambuyo pa kupangika. Malangizo ogwiritsa ntchito chipangizocho popereka mankhwalawo alembedwa papepala. Musanachite izi, ndikofunikira kuti mupeze mawonekedwe a insulin, momwe bokosi ndi mankhwala limakulungidwira kangapo pakati pama manja ndikukutembenuka. Kugwedeza mwamphamvu sikofunikira Pankhaniyi, thovu lingasokoneze dosing yolondola. Kuti athandizire kupumula kwamadzimadzi, galasi laling'ono limayikidwa mkati mwa cartridge. Kupezeka kwa ma flakes mutatha kusakaniza ndi chifukwa chokana kugwiritsa ntchito mankhwalawa. Sambani m'manja bwinobwino musanabaye. Jekeseni imagwiritsidwa ntchito pakhungu lomwe limakhazikika ndi zala zamanja zaulere. Pambuyo pochotsa singano, tsamba la jakisalo limakanikizidwa pang'ono kwa masekondi angapo ndi swab thonje. Pambuyo pa jakisoni, singanoyo imakonzanso, ndipo cholembera sichitha chimatsekeka ndi chotchingira. Pamaso makonzedwe, yankho liyenera kubweretsedwa kutentha kwa chipinda. Jekeseni wa subcutaneous amachitidwa mu minofu ya deltoid, quadriceps, khoma lamkati lakumbuyo, gluteus maximus. Chisamaliro chiyenera kuchitidwa kuti chisayambitse yankho mu mtsempha wamagazi. Kuwonongera jakisoni sikulimbikitsidwa. Pakati pazovuta zosagwirizana ndizogwiritsa ntchito Humalog mix 50, komanso kukonzekera kwa insulin, hypoglycemia ndiyotheka kwambiri. Muzochitika zazikulu kwambiri, kusiya chikumbumtima ndi zotsatira zakupha sikumachotsedwa.

Nthawi zina odwala amatha kudwala matendawa, kuwonetsedwa ndi hyperemia, kutupa, kuyabwa pamalo a jekeseni. Kuchita koteroko sikumakhala kofunika kwambiri m'chipatala ndipo nthawi zambiri kumadutsa kokha popanda kuchitapo kanthu. Zovuta kwambiri (koma zowopsa, kuphatikiza pangozi) ndizowonekera mwatsatanetsatane: kuyamwa kwathunthu, kulimbitsa thupi ndi kupumira msanga, hypotension yotsika mtima, palpitations mtima, hyperhidrosis. Zikatero, njira zochizira zofunikira zimafunikira. Pogwiritsa ntchito nthawi yayitali komanso kutsata pafupipafupi pamalo amodzi motsatizana, lipodystrophy yakudziko imayamba. Kugwiritsa ntchito bwino kwa mankhwalawa kumachepa ngati kumagwiritsidwa ntchito limodzi ndi kulera kwapiritsi, glucocorticosteroid mahomoni, mahomoni okhala ndi chithokomiro, mphamvu za beta-2 adrenoreceptor, thiazide diuretics, antipsychotic chlorprotixene, potaziyamu activator diazoxide, isotonic tuberculosis drug. Beta-adrenoreceptor blockers, mankhwala okhala ndi ethanol, anabolic steroids, chilangizo chowongolera fenfluramine, sympatholytic guanethidine, tetracycline ndi sulfonamide, mapiritsi a hypoglycemic, salicylic acid inhibitors, zoletsa zoletsa zotsatira za hypoglycemic. Beta-adrenergic blockers, clonidine, reserpine amatha kuphimba zizindikiro za hypoglycemia. Kugwiritsa ntchito mankhwala ena molumikizana ndi Humalog Remix 50 ndikotheka pokhapokha pokhapokha ngati mukugwirizana ndi adotolo. Kugwiritsa ntchito mankhwalawa limodzi ndi glitazones (rosiglitazone, pioglitazone) kungathandizire kukulitsa edema ndikuwonongeka kwa minofu yamtima.

Pharmacology

Humalog Mix 50 ndi chopangidwa chopangidwa chopangidwa ndi yankho la insulin lispro 50% (analog yofulumira ya insulin yaumunthu) ndi kuyimitsidwa kwa protamine kwa insulin lispro 50% (analog ya insulin ya anthu a nthawi yayitali).

Chochita chachikulu cha insulin lyspro ndi malamulo a kagayidwe ka glucose.

Kuphatikiza apo, imakhala ndi anabolic komanso anti-catabolic zotsatira zosiyanasiyana zamthupi. Mu minofu ya minofu, pali kuchuluka kwa glycogen, mafuta acid, glycerol, kuchuluka kwa mapuloteni komanso kuwonjezereka kwa kumwa ma amino acid, koma nthawi yomweyo kumachepa mu glycogenolysis, gluconeogeneis, ketogenesis, lipolysis, proteinabolism ndi kutulutsidwa kwa ma amino acid.

Zinawonetsedwa kuti Lyspro insulin ndiyofanana ndi insulin yaumunthu, koma zotulukapo zake zimathamanga ndipo zimatha kuchepera. Pambuyo pobayira mankhwalawa a Humalog Remix 50, kuyambiranso kuchitapo kanthu komanso kumayambiriro kwa msambo pachimake cha lyspro insulin kumawonedwa. Kukhazikika kwa mankhwalawa ndi pafupifupi mphindi 15 pambuyo pake, komwe kumakupatsani mwayi woperekera mankhwalawa musanadye (0-15 mphindi musanadye), poyerekeza ndi insulin yaumunthu wamba. Pambuyo pobayira mankhwalawa a Humalog Remix 50, kuyambiranso kuchitapo kanthu komanso kumayambiriro kwa msambo pachimake cha lyspro insulin kumawonedwa. Mbiri ya insulin lyspro protamine imafanana ndi mbiri ya zochitika zamasiku onse a insulin-isophan ndi kutalika kwa maola pafupifupi 15.

Pharmacokinetics

Kukwanira kwathunthu ndi kuyambika kwa mphamvu ya insulin kumadalira malo a jakisoni (m'mimba, ntchafu, matako), mlingo (kuchuluka kwa insulin), kuchuluka kwa insulin, mankhwalawa. Amawonongedwa ndi insulinase makamaka m'chiwindi ndi impso. Amachotsa impso (30-80%).

Zotsatira zoyipa

Hypoglycemia ndimavuto ambiri omwe amapezeka ndi makonzedwe onse a insulin, kuphatikiza Humalog Remix 50. Hypoglycemia ikhoza kuchititsa kuti musataye chikumbumtima, makamaka, ndikamwalira.

Thupi lawo siligwirizana: Odwala amatha kuona matupi awo sagwirizana ndi mawonekedwe ofiira, kutupa, kapena kuyunkhira pamalo a jakisoni. Izi zazing'ono zimakonda kutha patatha masiku angapo kapena milungu. Nthawi zina, izi zimachitika chifukwa cha zifukwa zosakhudzana ndi insulin, mwachitsanzo, mkwiyo pakhungu ndi wothandizira kuyeretsa kapena jakisoni wosayenera.

Zotsatira zoyipa zamagetsi zomwe zimachitika chifukwa cha insulin zimachitika kangapo, koma zimakhala zazikulu kwambiri. Amatha kuwonetsedwa ndi kuyabwa kwakukulu, kupuma movutikira, kufupika, kuchepa kwa magazi, kuchuluka kwa mtima, komanso thukuta kwambiri. Milandu yambiri yokhudzana ndimomwe thupi limagwirira ntchito ikhoza kukhala pachiwopsezo cha moyo. Nthawi zina mankhwalawa amakumana kwambiri ndi Humalog Remix 50, chithandizo chofunikira chimafunika. Mungafunike kusintha kwa insulin, kapena kutsimikiza mtima.

Kugwiritsa ntchito nthawi yayitali - kukulitsa kwa lipodystrophy pamalo jakisoni ndikotheka.

Mimba komanso kuyamwa

Maphunziro okwanira komanso owongoleredwa moyenera mwa amayi apakati sanachitike. Odwala omwe ali ndi matenda osokoneza bongo amalangizidwa kuti adziwitse dokotala za mimba yomwe ikupitirirabe kapena yomwe yakonzekera. Pa nthawi ya pakati, ndikofunikira kuwunika momwe odwala alandirira chithandizo cha insulin. Kufunika kwa insulin nthawi zambiri kumachepetsa panthawi ya 1 trimester ndikuwonjezeka panthawi ya II ndi III trimesters. Nthawi yobadwa pambuyo pokhapokha ndipo mwayamba kubadwa, zofunika za insulin zimatha kugwa kwambiri.

Odwala omwe ali ndi matenda a shuga mellitus nthawi yoyamwitsa angafunikire kusintha mlingo wa insulin, zakudya, kapena zonse ziwiri.

Kukongoletsa Mtundu wa batani la Dose:

Dokotala wanu wakupangira mtundu wa insulin wabwino kwambiri. Kusintha kulikonse kwa mankhwala a insulin kuyenera kuchitidwa kokha moyang'aniridwa ndi dokotala.
QuickPen Syringe chole ikukulimbikitsidwa kuti mugwiritse ntchito ndi singano za Becton. Dickinson ndi Company (BD) yama cholembera ma syringe.
Musanagwiritse ntchito cholembera, onetsetsani kuti singanoyo imalumikizidwa kwathunthu ndi cholembera.
Tsatirani malangizo omwe aperekedwa apa.

Mafunso omwe amafunsidwa pafupipafupi okonzekera kukonzekera Penti ya QuickPen Syringe kuti mugwiritse ntchito

Kodi kukonzekera kwanga kwa insulin kuyenera kuwoneka bwanji? Kukonzekera kwina kwa insulin ndi kuyimitsidwa kogwiritsa, pomwe ena ndi mayankho omveka, onetsetsani kuti mukuwerenga malongosoledwe a insulin m'mawu omwe aikidwa kuti mugwiritse ntchito.
Ndichite chiyani ngati mlingo wanga waposa 60? Ngati mlingo womwe wakupatsani uli pamwamba pa 60 mayunitsi. Mufunika jekeseni wachiwiri, kapena mutha kulankhulana ndi dokotala za izi.
Chifukwa chiyani ndigwiritse ntchito singano yatsopano kubayira iliyonse? Ngati singano agwiritsidwanso ntchito, mutha kulandira mulingo wolakwika wa insulin, singano imatha kutsekeka, kapena cholembera chimatha, kapena mutha kutenga kachilomboka chifukwa chazovuta.
Ndichite chiyani ngati sinditsimikiza kuchuluka kwa insulini yanga? Kwezani chogwirira kuti nsonga ya singano ilowe pansi. Mulingo wapa cartridge wosonyeza bwino kuchuluka kwa insulini yotsalira. Manambalawa ASATHA kugwiritsidwa ntchito kukhazikitsa mlingo.
Ndichite chiyani ngati sindingathe kuchotsa kapu ku cholembera? Kuti muchotse chipewa, kokerani. Ngati zikukuvutani kuchotsa chipewa, sinthani mosamala kachiwotchiyo ndi kuyimitsa kuti muimasule. ndiye, kukoka, chotsani kapu.

Kuyang'ana cholembera cha SyPinge cha QuickPen cha Insulin

Zolemba zofunikira

Onani kuchuluka kwanu kwa insulin nthawi zonse. Chitsimikizo cha kutulutsidwa kwa insulini kuchokera ku cholembera kuti chichitike jekeseni iliyonse isanafike pang'onopang'ono mpaka inshuwaransi ikawonekere kuonetsetsa kuti cholembera chakonzeka.
Ngati simukuyang'ana insulin yanu musanayambe kudwala, mutha kulandira insulin yochepa kwambiri kapena yambiri.

Mafunso Omwe Amakonda Kufunsa za Kuchita Macheke a Insulin

Chifukwa chiyani ndiyenera kuwerengera insulin yanga isanadye jakisoni iliyonse?
1. Izi zikuwonetsetsa kuti cholembera chakonzekera kumwa.
2. Izi zikutsimikizira kuti chinyengo cha insulin chimatuluka mu singano mukakanikiza batani la mlingo.
3. Izi zimachotsa mpweya womwe ungatenge mu singano kapena katoni ya insulini pakagwiritsidwe ntchito.
Ndichite chiyani ngati sindingathe kukanikiza bwino batani la mlingo panthawi yachangu ya insulin?
1. Phatikizani singano yatsopano.
2. Yang'anani insulin kuchokera ku cholembera.
Kodi ndiyenera kuchita chiyani ndikawona makamu am'kati mwa katiriji?
Muyenera kufufuza insulin kuchokera ku cholembera.
Kumbukirani kuti simungasunge cholembera ndi singano yolumikizidwa, chifukwa izi zimatha kupangitsa kuti pakhale thovu. Khungu laling'ono la mpweya silikuwakhudza mankhwalawo, ndipo mutha kulowa muyezo wanu mwachizolowezi.

Kukhazikitsidwa kwa mlingo wofunikira

Zolemba zofunikira

Tsatirani malamulo a asepsis ndi antiseptics omwe adokotala amuuzani.
Onetsetsani kuti mwalowa muyezo wofunikira mwa kukanikiza ndikuyika batani la mlingo ndikuwerengera pang'onopang'ono mpaka 5 musanachotsere singano. Ngati insulin ikukoka kuchokera singano, mwina. Simunagwire singano pansi pa khungu lanu nthawi yayitali.
Kukhala ndi dontho la insulin pamsana pa singano ndikwabwinobwino. Izi sizingakhudze mlingo wanu.
Cholembera cha syringe sichingakulolezeni kujambula mlingo wopitilira muyeso wamagulu a insulin otsalira mu katoni.
Ngati mukukayika kuti mwapereka mlingo wonse, musamaperekenso mlingo wina. Imbani woimira wanu wa Lilly kapena dokotala wanu kuti akuthandizeni.
Ngati mlingo wanu uposa kuchuluka kwa magawo omwe atsalira mu cartridge. Mutha kulowetsa kuchuluka kwa insulini mu cholembera ichi ndipo mugwiritse ntchito cholembera chatsopano kuti mumalize pakufunika kwa mankhwalawo, KAPA kulowa gawo lonse lofunikira pogwiritsa ntchito cholembera chatsopano.
Osayesa kubaya insulin potembenuza batani la mlingo. Simulandila insulin ngati mutembenuza batani la mlingo. Muyenera kusinthitsa batani la mlingo molunjika kuti mulandire mlingo wa insulin.
Musayese kusintha mlingo wa insulin panthawi ya jakisoni.
Singano yomwe imagwiritsidwa ntchito iyenera kutayidwa malinga ndi zofunikira zotaya zinyalala zakuchipatala.
Chotsani singano pambuyo pa jekeseni iliyonse.

Mafunso Ofunsidwa Kawirikawiri

Chifukwa chiyani zimakhala zovuta kukanikiza batani la mlingo ndikayesa kubaya?
1. Singano yanu itha kumangidwa. Yesani kuphatikiza singano yatsopano. Mukangochita. Mutha kuwona momwe insulin imatuluka mu singano. Kenako yang'anani cholembera.
2. Makina osindikiza mwachangu pa batani la mlingo amatha kupangitsa batani kukanikiza. Kutsinikiza pang'onopang'ono batani la mlingo kungapangitse kukanikiza mosavuta.
3. Kugwiritsa ntchito singano yayikulu kukuthandizira kuti musakanize kubatani. Funsani othandizira anu azaumoyo za kukula kwaku singano kopambana.
4. Ngati kukanikiza batani pakati pa kayendetsedwe ka mlingo kumakhalabe wolimba pambuyo poti mfundo zonse pamwambazi zitha, ndiye kuti cholembera sichingasinthidwe.
Ndiyenera kuchita chiyani ngati syringe yachonde ya Peneni ikamagwiritsa ntchito?
Cholembera chako chidzakhala cholimba ngati nkovuta kuti ugwiritse kapena kubayira. Popewa cholembera kuti chisamatirire:
1. Phatikizani singano yatsopano. Mukangochita. Mutha kuwona momwe insulin imatuluka mu singano.
2. Chongani insulin.
3. Ikani mlingo wofunikira ndi jakisoni.
Musayesere kupaka cholembera, chifukwa izi zitha kuwononga gawo la cholembera.
Kukanikiza batani la mlingo kumatha kulowa ngati zinthu zakunja (dothi, fumbi, chakudya, insulini kapena zakumwa zilizonse) zikalowa mkatikati mwa syringe. Musalole zodetsa kuti zilowe mu cholembera.
Chifukwa chiyani insulini imatuluka mu singano nditamaliza kupereka mlingo wanga?
Mwinanso. Munachotsa singano mwachangu kwambiri pakhungu.
1. Onetsetsani kuti mukuwona nambala ya "O" pawindo la chizindikiro.
Kupereka mlingo wotsatira, kanikizani ndikuyika batani la mlingo ndikuyamba pang'ono pang'ono mpaka 5 musanachotsere singano.
Ndichite chiyani ngati mlingo wanga wakhazikika ndipo batani la muyeso limabweranso mwangozi popanda singano yomata ndi cholembera?
1. Sinthani batani la mlingo kukhala zero.
2. Phatikizani singano yatsopano.
3. Chitani insulin.
4. Ikani mlingo ndi jakisoni.
Ndingatani ngati nditayamwa mlingo woyenera (wotsika kwambiri kapena wotsika kwambiri)?
Sinthani batani la mlingo kumbuyo kapena kutsogolo kuti musinthe mlingo.
Kodi ndingatani ngati ndikuwona kuti insulini imatuluka mu cholembera pa nthawi yosankha kapena kusintha?
Musamapereke mlingo, chifukwa mwina simungalandire mlingo wathunthu. Khazikitsani cholembera ku nambala ya zero ndikuyang'ananso kuchuluka kwa insulini kuchokera ku cholembera (onani gawo "Kuyang'ana Pangongole Yotumizira Ya QuickPen Kuti Ipatsidwe Insulini"). Khazikitsani mlingo woyenera ndi jakisoni.
Kodi ndiyenera kuchita chiyani ngati mlingo wanga wonse ukhazikika?
Cholembera sichingakulorengenso kuti muike mankhwalawo mopitilira kuchuluka kwa kuchuluka kwa insulini yotsalira mukatoni. Mwachitsanzo, ngati mukufuna mayunitsi 31, ndipo magawo 25 okha atsala mu katoni, ndiye kuti simungathe kudutsa nambala 25 mukamayikiratu. Osayesa kukhazikitsa mlingowo podutsa nambala iyi. Ngati gawo loyenera latsala m'khola, mutha:
1. Lowetsani gawo ili pang'ono, kenako lembani mlingo wotsalira pogwiritsa ntchito cholembera chatsopano.
kapena
2. Lowetsani mlingo wathunthu kuchokera ku cholembera chatsopano.
Chifukwa chiyani sindingathe kukhazikitsa mlingo kuti mugwiritse ntchito insulin yaying'ono yomwe yasiyidwa mu katiriji yanga?
Cholembera chimbalecho chimapangidwa kuti chitha kupatsa. Magulu 300 a insulin. Chida cha cholembera sichitha kuteteza katiriji kuti lisatheretu, chifukwa kuchuluka kwa insulini komwe kumakhalabe ndi kathumba sikungavulazidwe ndikulondola.

Kusunga ndi kutaya

Zolemba zofunikira

Cholembera sichingagwiritsidwe ntchito ngati chakhala kunja kwa firiji kwa nthawi yopitilira nthawi yomwe idafotokozedwa mu Maupangiri Ogwiritsira Ntchito.
Osasunga cholembera ndi singano yake. Ngati singanoyo yatsala kuti ikanikizidwe, insulansi ingatuluke m'timalo, kapena insulin ikhoza kupukuta mkati mwa singano, potseka singano, kapena thovu la mpweya litha kupanga katiriji.
Zilembera zomwe sizikugwiritsidwa ntchito ziyenera kusungidwa mufiriji kutentha kwa 2 ° C mpaka 8 ° C. Osagwiritsa ntchito cholembera kuti chitauma.
Cholembera cha syringe chomwe mukugwiritsa ntchito pano chiyenera kusungidwa pa kutentha osaposa 30 ° C komanso pamalo otetezedwa kuti asatenthe ndi kutentha.
Fotokozerani Malangizowo kuti mugwiritse ntchito pozindikira bwino malo osungirako cholembera.
Sungani cholembera kuti chisafike kwa ana.
Tayetsani phula zing'onozing'ono zomwe zingagwiritse ntchito zopumira, zotengera zomwe zingagwiritsidwe ntchito (mwachitsanzo, muli pazipangizo za zinthu kapena zinyalala), kapena monga momwe katswiri wanu wazachipatala adakulimbikitsira.
Tayani chimbudzi chogwiritsa ntchito sindingagwiritse ntchito ndi singano molingana ndi malangizo a dokotala.
Osabwezanso zotengera zazitali.
Funsani dokotala wanu za momwe mungathere kutaya zotengera zotayidwa m'dera lanu.
Malangizo pakugwiritsira ntchito masingano sasintha m'malo mwa malangizo oyendetsera kutaya kwanu, malangizo omwe akutsimikiziridwa ndi akatswiri anu azaumoyo kapena zofunikira za dipatimenti.

Ngati muli ndi mafunso kapena mavuto okhudzana ndi kugwiritsa ntchito QuickPen Syringe pen, lemberani ndi dokotala.

Dzina ndi adilesi yaopanga:
Eli Lilly ndi Kampani. USA

"Eli Lilly ndi Company",
Indianapolis, MU 46285, USA.

Eli Lilly ndi Kampani.
Indianapolis. Indiana 46285. United States.

Zoyimira ku Russia:
"Eli Lilly Vostok S.A.", 123317. Moscow
Presnenskaya embankment, d. 10

Humalog®, Humalog ® in the QuickPen syringe pen Humalog® Mix 50 mu cholembera cha syringe ya QuickPen ™, Humalog® Mix 25 mu cholembera cha sypinge ya QuickPen ndi zizindikiro za Eli Lilly & Company.

Cholembera cha syringe cha QuickPen ™ chimakwaniritsa zenizeni za dosing ndi zofunikira za ISO 11608 1: 2000