NovoRapid Flekspen - malangizo * ogwiritsidwa ntchito

Munkhaniyi, mutha kuwerengera malangizo ogwiritsira ntchito mankhwalawa NovoRapid. Amapereka ndemanga kuchokera kwa alendo omwe amabwera patsamba lino - ogwiritsa ntchito mankhwalawa, komanso malingaliro a akatswiri azachipatala pakugwiritsa ntchito NovoRapid machitidwe awo. Chopempha chachikulu ndikuti muwonjezere ndemanga zanu za mankhwalawa: mankhwalawo adathandizira kapena sanathandizire kuchotsa matendawa, ndizovuta ziti zomwe zimawoneka ndi zotsatirapo zake, zomwe mwina sizinalengezedwe ndi wopanga. Ma Analogs a NovoRapida pamakhala ma analogues omwe amapezeka. Gwiritsani ntchito pochiza matenda a shuga a mellitus insulin amadalira mtundu wa 1 komanso osadalira insulin 2 mwa akuluakulu, ana, komanso pa nthawi yobereka. The zikuchokera mankhwala.

NovoRapid - Analogue a insulin ya anthu a nthawi yayitali. Mu kapangidwe ka maselo a insulini iyi, proline amino acid pamalo a B28 m'malo mwake ndi aspartic acid, omwe amachepetsa chizolowezi cha mamolekyulu kupanga hexamers, omwe amawonedwa mu njira ya insulin wamba.

Imalumikizana ndi cholandirira chapadera pa cytoplasmic membrane wa maselo ndikupanga insulini-receptor zovuta zomwe zimapangitsa njira zamkati, kuphatikiza kapangidwe kazinthu zingapo za enzymes (hexokinase, pyruvate kinase, glycogen synthetase). Mphamvu ya hypoglycemic imalumikizidwa ndi kuchuluka kwa kayendedwe kazinthu zamagetsi ndikuwonjezera kuyamwa kwa glucose ndi minofu, kukondoweza kwa lipogenesis, glycogenogeneis, ndi kuchepa kwa kuchuluka kwa kupanga kwa chiwindi ndi chiwindi.

Insulin aspart (mankhwala a Novorapid) ndi insulin yaumunthu ali ndi zochitika zofanana molar ofanana.

Insulin aspart imatengeka kuchokera ku subcutaneous adipose minofu mwachangu komanso mwachangu kuposa zochita za sungunuka wa munthu.

Kutalika kwa insulin aspart pambuyo subcutaneous makonzedwe ndi ochepera kuposa sungunuka munthu insulin.

Kupanga

Insulin aspart + Excipients.

Pharmacokinetics

Pambuyo subcutaneous makonzedwe a insulini, nthawi yafika pazipita ndende (Tmax) mu madzi am`magazi ndi pafupifupi 2 zina zosakwana pambuyo makonzedwe a sungunuka munthu insulin. The pazipita kuchuluka kwa madzi am`magazi (Cmax) zimatheka pafupifupi mphindi 40 pambuyo subcutaneous makonzedwe a 0,15 IU pa 1 makilogalamu kulemera kwa odwala omwe ali ndi matenda a 1 shuga. The kuchuluka kwa insulin kubwerera ku chiyambi chake pambuyo maola 4-6 pambuyo makonzedwe a mankhwala. Kuchuluka kwa mayamwa kumacheperachepera odwala omwe ali ndi matenda a shuga a 2, omwe amachititsa kuti Cmax achepetse kenako Tmax (mphindi 60).

Zizindikiro

• lembani matenda a shuga 1 mellitus (wodalira insulin),
• lembani matenda a shuga a 2 a mellitus (osadalira insulini): gawo la kukana kwa othandizira a hypoglycemic, osagwirizana ndi mankhwalawa (panthawi yophatikiza mankhwalawa), matenda ogwirizana.

Kutulutsa Mafomu

Yothetsera subcutaneous ndi mtsempha wa magazi makonzedwe a 100 PIECES mu 1 ml katiriji 3 ml (Penfill).

Yothetsera subcutaneous ndi mtsempha wa magazi makonzedwe a 100 PIECES mu 1 ml katoni mu 3 ml syringe cholembera (Flexpen).

Malangizo ogwiritsira ntchito ndi mtundu wa mankhwala

NovoRapid (Flexpen and Penfill) ndi mndandanda wofulumira wa insulin. Mlingo wa NovoRapid umatsimikiziridwa ndi dokotala aliyense payekha malinga ndi zosowa za wodwala. Nthawi zambiri, mankhwalawa amagwiritsidwa ntchito limodzi ndi nthawi yayitali kapena kukonzekera kwa insulini, omwe amaperekedwa kamodzi pa tsiku.

Kuti mukwaniritse bwino kwambiri glycemic control, tikulimbikitsidwa kuyeza kuchuluka kwa shuga m'magazi ndikusintha mlingo wa insulin.

Nthawi zambiri, zofunika tsiku ndi tsiku la insulin mwa akulu ndi ana zimachokera ku 0,5 mpaka 1 IU pa 1 makilogalamu amalemu. Pogwiritsa ntchito mankhwala musanadye, kufunikira kwa insulin kungaperekedwe ndi NovoRapid ndi 50-70%, kufunika kwa insulini kumaperekedwa ndi insulin yayitali.

Kuchuluka kwa zochita zolimbitsa thupi kwa wodwala, kusintha kwa zakudya zomwe timakonda, kapena matenda okhudzana ndi zina zitha kuchititsa kusintha kwa mlingo.

NovoRapid imayamba mwachangu komanso yofupika nthawi yochitapo kanthu kuposa insulin ya munthu wosungunuka. Chifukwa cha kuyambika mwachangu, NovoRapid iyenera kuperekedwa, ngati lamulo, chakudya chisanachitike, ngati kuli kotheka, chitha kuperekedweratu chakudya chisanafike. Chifukwa chakufupika kwakanthawi poyerekeza ndi insulin yaumunthu, chiopsezo chokhala ndi nocturnal hypoglycemia mwa odwala omwe amalandila NovoRapid ndi otsika.

NovoRapid jekeseni pang'onopang'ono m'chigawo cha anterior m'mimba khoma, ntchafu, phewa, deltoid kapena gluteal dera. Mawebusayiti omwe ali mkati mwa thupi limodzi amayenera kusinthidwa pafupipafupi kuti muchepetse chiwopsezo cha lipodystrophy. Monga kukonzekera konse kwa insulin, kuyika kwina kwa khoma lakunja kwam'mimba kumayamwa mwachangu poyerekeza ndi kayendetsedwe ka malo ena. Kutalika kwa zochita zimatengera mlingo, malo oyendetsera, kutsika kwa magazi, kutentha ndi kuchuluka kwa zochitika zolimbitsa thupi. Komabe, kuyambitsa mwachangu poyerekeza ndi insulin ya anthu sungunuka mosasamala malo omwe jakisoniyo anali.

NovoRapid itha kugwiritsidwa ntchito popanga subcutaneous insulin infusions (PPII) m'mapampu a insulin omwe amapangidwira insulin infusions. FDI iyenera kupangidwa khoma lakunja kwam'mimba. Malo olowetsedwa amayenera kusinthidwa nthawi ndi nthawi.

Mukamagwiritsa ntchito pampu ya insulini kulowetsedwa, NovoRapid sayenera kusakanikirana ndi mitundu ina ya insulin.

Odwala omwe akugwiritsa ntchito FDI ayenera kuphunzitsidwa bwino kugwiritsa ntchito pampu, chosungira choyenera, ndi dongosolo la ma pump pump. The kulowetsedwa set (chubu ndi catheter) ziyenera m'malo mwa wogwiritsa buku malangizo ophatikizidwa ndi kulowetsedwa.

Odwala omwe amalandila NovoRapid ndi FDI ayenera kukhala ndi insulin yowonjezera kuti ikwaniritse kulowetsedwa.

Ngati ndi kotheka, NovoRapid imatha kutumikiridwa kudzera m'mitsempha, koma ndi okhawo omwe ndi akatswiri azachipatala.

Pa kulowetsedwa kwa mtsempha, makina a kulowetsedwa ndi NovoRapid 100 IU mu 1 ml ndi kuchuluka kwa 0,05 IU mu 1 ml mpaka 1 IU mu 1 ml ya insulin aspart mu 0.9% sodium chloride solution, 5% dextrose solution kapena 10% dextrose solution munali 40 mmol / L potaziyamu potaziyamu pogwiritsa ntchito kulowetsedwa kwa polypropylene. Njira zoterezi ndizokhazikika pofunda kwa maola 24. Ngakhale kukhazikika kwakanthawi, kuchuluka kwa insulin kumayamba chifukwa cha zinthu zomwe zimayambitsa kulowetsedwa. Pa insulin infusions, ndikofunikira kuyang'anira kuchuluka kwa shuga m'magazi.

Zotsatira zoyipa

• hypoglycemia (kutulutsa thukuta kwambiri, khungu kapena mantha, kunjenjemera, kutopa kosazolowereka kapena kufooka, kusokonekera kwamaganizidwe, kusokonezeka kwa chidwi, chizungulire, kugona kwambiri, kusokonezeka kwakanthawi, mutu, nseru, tachycardia). Hypoglycemia yayikulu imapangitsa kuti mukhale osazindikira komanso / kapena kukhudzika, kusokonezeka kwakanthawi kapena kosasintha kwa ubongo ndi imfa,
• urticaria, zotupa pakhungu, kuyabwa,
• anaphylactic reaction,
• thukuta kwambiri
• kusokonezeka kwa m'mimba thirakiti (GIT),
• angioedema,
• kuvutika kupuma
• tachycardia (kuchuluka kwa mtima),
• kutsitsa magazi (BP),
• zimachitika kwanuko: matupi awo sagwirizana (redness, kutupa, kuyabwa kwa khungu m'malo a jakisoni), nthawi zambiri amakhala osakhalitsa komanso akudutsa pamene chithandizo chikupitirirabe,
• lipodystrophy,
• kuphwanya kuchotsa.

Contraindication

• achina,
• Hypersensitivity kuti insulini aspart.

Mimba komanso kuyamwa

Zochitika zamankhwala ndi NovoRapida pa nthawi yapakati ndizochepa.

M'maphunziro oyesera nyama, palibe kusiyana komwe kunapezeka pakati pa embryotoxicity ndi teratogenicity ya insulin aspart ndi insulin ya anthu. Munthawi yamatenda oyamba komanso nthawi yonse yomwe akukhala, ndikofunikira kuyang'anitsitsa momwe odwala omwe ali ndi matenda osokoneza bongo amayang'anira ndi kuchuluka kwa shuga m'magazi. Kufunika kwa insulini, monga lamulo, kumachepera mu trimester ya 1 ndipo pang'onopang'ono kumawonjezeka mu 2nd ndi 3 trimesters ya mimba. Nthawi yobadwa pambuyo pokhapokha ndipo mwayamba kubadwa, zofunika za insulin zimatha kugwa kwambiri. Pambuyo pobadwa, kufunikira kwa insulin kumabwereranso msanga momwe kunaliri asanakhale ndi pakati.

Insulin aspart ingagwiritsidwe ntchito pa mkaka wa m'mawere (yoyamwitsa), komanso kusintha kwa insulin kungafunike.

Gwiritsani ntchito ana

Osavomerezeka kuti azigwiritsidwa ntchito mwa ana ochepera zaka 6.

Gwiritsani ntchito odwala okalamba

Monga momwe amagwiritsidwira ntchito pokonzekera insulin ina, odwala okalamba ayenera kuyang'anitsitsa kuchuluka kwa shuga m'magazi ndikusintha mlingo wa NovoRapid payekha.

Malangizo apadera

Mlingo wosakwanira wa insulini kapena kusiya chithandizo, makamaka ndi matenda a shuga 1, angayambitse kukula kwa hyperglycemia kapena matenda ashuga ketoacidosis. Zizindikiro za hyperglycemia nthawi zambiri zimawonekera pang'onopang'ono pakupita kwa maola angapo kapena masiku. Zizindikiro za hyperglycemia ndi mseru, kusanza, kugona, kuwuma ndi khungu, pakamwa pouma, kutuluka kwamkodzo, ludzu komanso kusowa chilimbikitso, komanso mawonekedwe a fungo la acetone m'mlengalenga. Popanda chithandizo choyenera, hyperglycemia imatha kupha. Pambuyo kulipira kagayidwe kazakudya, mwachitsanzo, ndi insulin yokwanira, odwala amatha kuona zizindikiro zapadera za hypoglycemia.

Odwala omwe ali ndi matenda ashuga omwe ali ndi vuto lalikulu la kagayidwe, zovuta za matenda a shuga zimachitika pambuyo pake ndikupita patsogolo pang'onopang'ono. Pankhaniyi, tikulimbikitsidwa kuti tichite zinthu zomwe zimapangitsa kuti kagayidwe ka magazi kagwiritsidwe ntchito, kuphatikizapo kuwunika kuchuluka kwa shuga m'magazi.

Zotsatira za pharmacodynamic zokhala ndi ma insulin analoquer osakhalitsa ndikuti kupanga kwa hypoglycemia akagwiritsidwa ntchito kumayambira kale kuposa kugwiritsa ntchito insulle yamunthu.

Iyenera kuganizira kuchuluka kwakukula kwa zotsatira za hypoglycemic pochiza odwala omwe ali ndi matenda oyanjana kapena kumwa mankhwala omwe amachepetsa kuyamwa kwa chakudya. Pamaso pa matenda ophatikizana, makamaka ochokera kumayambiriro opatsirana, kufunika kwa insulin, monga lamulo, kumawonjezeka. Kuchepa kwa impso kapena hepatic kungayambitse kuchepa kwa insulin.

Mukasamutsa wodwala ku mitundu ina ya insulini, zizindikiro zoyambirira za hypoglycemia zimatha kusintha kapena kuchepa pang'ono poyerekeza ndi omwe amagwiritsa ntchito mtundu wa insulin kale.

Kusamutsa wodwala kuchokera ku NovoRapid kupita ku mtundu wina wa insulin kapena kukonzekera kwa insulin kwa wopanga wina kuyenera kuchitika moyang'aniridwa ndi achipatala. Mukasintha ndende, mtundu, wopanga ndi mtundu wa anthu (insulin ya anthu, insulin ya anthu, analogue ya insulini) ya kukonzekera kwa insulin ndi / kapena njira yopangira, kusintha kwa mlingo kungafunike.

Kusintha kwa muyezo wa insulin kungafunike ndi kusintha kwa zakudya komanso kuwonjezera mphamvu ya thupi. Kuchita masewera olimbitsa thupi mutangotha ​​kudya kumakulitsa chiopsezo cha hypoglycemia. Kudumpha chakudya kapena masewera osakonzekera kungayambitse kukula kwa hypoglycemia.

Kusintha kwakukulu mu boma la chiphuphu cha carbohydrate metabolism kumatha kubweretsa mkhalidwe wa ululu wammbuyo wammimba, womwe nthawi zambiri umasinthidwa.

Kusintha kwa nthawi yayitali mu glycemic control kumachepetsa chiopsezo cha kupitirira kwa matenda ashuga retinopathy. Komabe, kukulitsa kwa insulin mankhwala osinthika kwambiri pakulamulira kwa glycemic kungakhale limodzi ndi kuwonongeka kwakanthawi kwa matenda ashuga retinopathy.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Kuthekera kwa odwala kulolera komanso kuchuluka kwa momwe angachitire amatha kusokonezeka panthawi ya hypoglycemia ndi hyperglycemia, zomwe zimakhala zowopsa nthawi zomwe maluso amenewa amafunikira makamaka (mwachitsanzo, poyendetsa galimoto kapena kugwira ntchito ndi makina ndi makina). Odwala ayenera kulangizidwa kuti achitepo kanthu popewa kukulitsa kwa hypoglycemia ndi hyperglycemia poyendetsa galimoto ndikugwiritsa ntchito njira. Izi ndizofunikira kwambiri kwa odwala omwe alibe kapena kuchepetsedwa Zizindikiro zakutsogolo kwa hypoglycemia kapena akuvutika ndi zochitika zapafupipafupi za hypoglycemia. Muzochitika izi, kuthekera kwa ntchito yotereyi kuyenera kuganiziridwa.

Kuyanjana kwa mankhwala osokoneza bongo

kanthu Hypoglycemic Novorapid patsogolo m'kamwa wothandizila hypoglycemic, zoletsa wa monoamine oxidase (Mao) zoletsa, angiotensin akatembenuka enzyme (Ace) zoletsa, carbonic anhydrase zoletsa, kusankha beta-blockers, bromocriptine, octreotide, sulfonamides, anabolic mankhwala, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, kukonzekera kwa lithiamu, kukonzekera komwe kumakhala ndi ethanol.

Mphamvu ya hypoglycemic ya NovoRapid imafooka ndi njira zakulera zam'mlomo, glucocorticosteroids (GCS), mahomoni a chithokomiro, thiazide diuretics, heparin, tricyclic antidepressants, sympathomimetics, danazole, clonidine, calcium blockers, diazoxide, morphine, pheny.

Mothandizidwa ndi reserpine ndi salicylates, onse kufooka ndikuwonjezera zochita za mankhwala ndikotheka.

Mankhwala okhala ndi thiol kapena sulfite, akaphatikizidwa ndi insulin, amachititsa kuti awonongeke.

Mndandanda wa mankhwala NovoRapid

Zofanana muzochitika zamagulu:

• Insulin aspart,
• Rosinsulin Aspart.

Mndandanda wa mankhwala a NovoRapid wolemba gulu la mankhwala (ma insulins):

• Khalid
• Apidra
• Berlinsulin,
• Biosulin
• Brinsulmidi
• Brinsulrapi
• Tileke,
• Gensulin
• Depot insulin C,
• Isofan Insulin World Cup,
• Iletin
• Insulinaspart
• Insulin glargine,
• Insulin glulisin,
• Insulin Isofanicum,
• Tepi ya insulin,
• Lyspro insulin
• Insulin maxirapid,
• Insulin sungunuka
• Insulin c
• Nkhumba ya insulin yoyeretsedwa kwambiri,
• Insulinnt
• Insulin Ultrante
• Insulin yamunthu
• Insulin ya chibadwa cha anthu,
• Insulin yopanga anthu insulin
• Insulin yobwerezabwereza ya anthu
• Insulin yayitali,
• Insulin Ultralong,
• Insulong
• Insulrap
• Insuman
• Insuran
• Pakati
• Lantus
• Levemir,
• Mikstard
• Monoinsulin
• Monotard
• NovoMix,
• Pensulin,
• Protamine insulin
• Protafan
• Rinsulin
• Rosinsulin,
• Solikva SoloStar,
• Sultofay,
• Tresiba FlexTouch,
• Tujeo SoloStar,
• Ultratard
• Kunyumba
• Homorap
• Humalog,
• Humodar
• Humulin.

Maganizo a Endocrinologist

Mankhwala abwino a hypoglycemic. Ndikulembera Novorapid kwa odwala omwe ali ndi mitundu iwiri ya matenda ashuga.Ndi mlingo woyenera, umasunga shuga wovomerezeka m'magazi. Mankhwalawa ndi osavuta kugwiritsa ntchito, ngakhale ana a sukulu amawadziba okha. Novorapid imalekerera bwino. Thupi lawo siligwirizana pa malo jakisoni ndilosowa kwambiri. Koma lipodystrophy, komabe, pochiza ndi ma insulin ena, zimachitika nthawi zambiri. Pakhala zochitika za kukhazikika kwa hypoglycemia machitidwe anga.

Katundu

Imalumikizana ndi cholandilira chapadera pa cell ya cytoplasmic cell ndipo imapanga insulini-receptor zovuta zomwe zimapangitsa njira zamkati, kuphatikiza kapangidwe kazinthu zingapo za enzymes (hexokinase, pyruvate kinase, glycogen synthase, ndi zina). Kutsika kwa glucose m'magazi kumachitika chifukwa cha kuchuluka kwa kayendedwe ka intracellular, kuchuluka kwa zotupa, kukondoweza kwa lipogenesis, glycogenogeneis, kuchepa kwa kuchuluka kwa shuga ndi chiwindi, ndi zina zambiri.

Kulowetsedwa kwa amino acid proline pamalo a B28 okhala ndi aspartic acid mu insulin aspart kumachepetsa chizolowezi cha mamolekyulu kupanga hexamers, yomwe imawonedwa mu yankho la insulin wamba. Motere, insulin aspart imatengedwa mwachangu kuchokera ku mafuta a subcutaneous ndipo imayamba kuchita zinthu mwachangu kuposa insulin yamunthu. Insulin aspart amachepetsa shuga m'magazi 4 koyamba pambuyo chakudya asanasungunuke munthu insulin. Kutalika kwa insulin aspart pambuyo pa subcutaneous makonzedwe afupikitsa kuposa sungunuka wa insulin. Pambuyo subcutaneous makonzedwe, mphamvu ya mankhwalawa imayamba pakadutsa mphindi 10-20 pambuyo pa kuperekera. Kuchuluka kwake kumawonedwa patatha maola atatu jekeseni. Kutalika kwa mankhwalawa ndi maola 3-5.

Zoyesa zamankhwala zokhudzana ndi odwala omwe ali ndi matenda amtundu wa 1 asonyeza kuti ali ndi vuto la kuchepa kwa mankhwalawa akamagwiritsa ntchito insulin aspart poyerekeza ndi insulin ya anthu. Chiwopsezo cha masana hypoglycemia sichinachuluke kwambiri.

Insulin aspart ndi equipotential sungunuka wa munthu insulin kutengera kuyamwa kwake.

Akuluakulu Zoyesa zamankhwala zokhudzana ndi odwala omwe ali ndi vuto la matenda ashuga 1 awonetsa kuchepa kwakumaso kwa glucose wamagazi ndi insulin aspart poyerekeza ndi insulin yaumunthu.

Okalamba: Kafukufuku wosasinthika, wakhungu lambiri, wopanga magawo a pharmacokinetics ndi pharmacodynamics (FC / PD) wa insulin aspart ndi sungunuka wa insulin wa anthu odwala okalamba omwe ali ndi mtundu wa 2 matenda a shuga (19 odwala zaka 65-83 zaka, amatanthauza zaka 70). Kusiyana kwazomwe zimachitika mu pharmacodynamic pakati pa insulin aspart ndi insulle ya insulin yaumunthu mwa odwala okalamba anali ofanana ndi odzipereka athanzi komanso odwala achinyamata omwe ali ndi matenda a shuga.

Ana ndi achinyamata. Kugwiritsa ntchito insulin aspart mwa ana kuwonetsa zotsatira zofananira pakulamulira kwa glycemic kwa nthawi yayitali mukayerekeza ndi insulin yaumunthu.
Kafukufuku wazachipatala yemwe amagwiritsa ntchito insulle ya anthu osungunuka musanadye chakudya komanso asipilini atatha kudya amapangidwa mwa ana aang'ono (odwala 26 azaka za pakati pa 2 mpaka 6), ndipo kafukufuku umodzi wa FC / PD unachitika mwa ana (6 Wazaka 12) ndi achinyamata (wazaka 13 mpaka 17). Mbiri ya pharmacodynamic ya insulin aspart mwa ana inali yofanana ndi ya akuluakulu.

Mimba Kafukufuku wachipatala wokhudzana ndi chitetezo chokwanira komanso mphamvu ya insulin aspart ndi insulin ya anthu pochiza amayi apakati omwe ali ndi vuto la matenda osokoneza bongo a mellitus (322 azimayi apakati omwe adawunika, 157 mwa iwo adalandira insulin aspart, 165 - insulin yaanthu / chatsopano.
Maphunziro owonjezera azachipatala mwa azimayi 27 omwe ali ndi gestational matenda a shuga omwe amalandila insulin aspart ndi insulin yaumunthu (insulin aspart analandila azimayi 14, insulin 13 ya anthu) amawonetsa kuyanjana kwa mbiri ya chitetezo komanso kusintha kwakukulu pakulamulira kwa glucose pambuyo pa chakudya.

Pharmacokinetics
Pambuyo subcutaneous makonzedwe a insulini, nthawi yofika pazipita ndende (t_max) mu madzi am`magazi pafupifupi 2 nthawi zosakwana pambuyo makonzedwe a sungunuka wa munthu insulin. The pazipita plasma ndende (Cmax) pafupifupi 492 ± 256 pmol / L ndipo 40 mphindi pambuyo subcutaneous makonzedwe a 0,15 U / kg thupi kulemera kwa odwala matenda amtundu 1 shuga. The kuchuluka kwa insulin kubwerera ku chiyambi chake pambuyo maola 4-6 pambuyo makonzedwe a mankhwala. Kuchuluka kwa mayamwa kumacheperachepera odwala omwe ali ndi matenda amtundu wa 2, omwe amachititsa kuti azikhala ndi mpweya wochepa (352 ± 240 pmol / L) komanso pambuyo pake t_max (Mphindi 60).

Kusiyanasiyana kwamunthu payekha mu t_max kutsika kwambiri mukamagwiritsa ntchito insulin aspart poyerekeza ndi insulin yamunthu, pomwe kusiyanasiyana kwa C_maxkwa aspart insulin yambiri.

Pharmacokinetics mu ana (wazaka 6-12) ndi achinyamata (wazaka 13 mpaka 17) wokhala ndi matenda amtundu 1. Kulowetsedwa kwa insulin aspart kumachitika mwachangu m'magulu onse azaka ndi t_maxchimodzimodzi ndi akulu. Komabe, pali zosiyana C_max m'magulu awiri azaka, zomwe zimagogomezera kufunika kwa kumwa kwa mankhwalawa. Okalamba: Kusiyana kwapakati pa pharmacokinetics pakati pa insulin aspart ndi soluble insulin ya anthu odwala okalamba (zaka 65-83, zaka zapakati pa 70 zaka) zamtundu wa 2 wodwala mellitus anali ofanana ndi odzipereka athanzi komanso odwala achinyamata omwe ali ndi matenda a shuga. Mwa odwala okalamba, kuchepa kwa mayamwidwe kunawonedwa, zomwe zidapangitsa kutsika kwa t_max (82 (kusiyanasiyana: mphindi 60-120), pomwe C_max zinali zofanana ndi zomwe zimawonedwa mwa odwala ang'onoang'ono omwe ali ndi matenda a shuga a 2 komanso ochepera pang'ono poyerekeza ndi odwala 1 a shuga. Kuperewera kwa chiwindi: Kafukufuku wa pharmacokinetics adachitika ndi mlingo umodzi wa aspart insulin mwa odwala 24 omwe chiwindi chawo chimagwira kuchokera pakulakwitsa kwambiri. Mwa anthu omwe ali ndi vuto la chiwindi, odwala, mayamwidwe a insulini amachepetsa komanso osakhazikika, zomwe zimapangitsa kuchepa kwa t_max kuchokera pafupifupi mphindi 50 mwa anthu omwe ali ndi chiwindi chokwanira mpaka mphindi 85 mwa anthu omwe ali ndi vuto la chiwindi chokwanira komanso mwamphamvu. Malo omwe akuponderezedwa nthawi yayitali, mapiritsi a plasma ambiri komanso chilolezo chokwanira (AUC, C_max ndi CL / F) inali misewu yofanana ndi kuchepa kwa chiwindi ndi ntchito yofananira. Kulephera kwamkati: Kafukufuku adachitika mu pharmacokinetics of insulin aspart mwa odwala 18 omwe ntchito yawo yaimpso imachokera pachizolowezi mpaka kuwonongeka kwambiri. Palibe zotsatira zochokera pachilolezo cha creatinine pa AUC, C_max, t_max insulin. Zambiri zinali zochepa kwa iwo omwe ali ndi vuto locheperako komanso lopweteka kwambiri. Anthu omwe ali ndi vuto la aimpso omwe amafunikira dialysis sanaphatikizidwe mu phunziroli.

Zambiri Zachitetezo Chachikulu:
Kafukufuku wammbuyo sanawonetse vuto lililonse kwa anthu, potengera kafukufuku wovomerezeka wazachipatala, kuwopsa kwa kugwiritsidwa ntchito mobwerezabwereza, genotoxicity komanso kubereka kawopsedwe. M'mayeso a in vitro, kuphatikizapo kumangiriza ma insulin receptors ndi insulin-grow grow-1, komanso momwe zimakhudzira kukula kwa maselo, machitidwe a insulin aspart amafanana kwambiri ndi insulin ya anthu. Kafukufuku adawonetsanso kuti kudzipatula kumangiriza kwa insulin receptor ndikofanana ndi insulin yaumunthu.

Zoyipa:

Sitikulimbikitsidwa kugwiritsa ntchito mankhwalawa NovoRapid® Flexpen® mwa ana osakwana zaka 2, chifukwa maphunziro azachipatala mwa ana osakwana zaka 2 sanachitidwe.

Gwiritsani ntchito pa nthawi yoyembekezera komanso nthawi yoyamwitsa
NovoRapid® Flexpen® imatha kulembedwera panthawi yapakati. Zambiri kuchokera kwa mayeso awiri azachipatala omwe adawerengedwa mosasamala (157 + 14 amayi oyembekezera omwe adawunikidwa) sizinawonetse vuto lililonse la insulini pa mimba kapena thanzi la mwana wosabadwayo / wakhanda poyerekeza ndi insulin ya anthu (onani gawo "

Mlingo ndi makonzedwe:

Kuti mukwaniritse bwino kwambiri glycemic control, tikulimbikitsidwa kuyeza kuchuluka kwa shuga m'magazi ndikusintha mlingo wa insulin.

Mwachizolowezi, chinthu chofunikira tsiku lililonse cha insulin mwa akulu ndi ana kuyambira 0,5 mpaka 1 U / kg thupi. Mankhwala akaperekedwa musanadye, kufunikira kwa insulin kungaperekedwe ndi NovoRapid® FlexPen® ndi 50-70%, kufunikira kwotsalira kwa insulin kumaperekedwa ndi insulin yayitali.

Kuchuluka kwa zochita zolimbitsa thupi kwa wodwala, kusintha kwa zakudya zomwe timakonda, kapena matenda okhudzana ndi zina zitha kuchititsa kusintha kwa mlingo.

NovoRapid® Flexpen ® imayamba mwachangu komanso yofupikitsa nthawi pochitapo kuposa insulin ya munthu wosungunuka. Chifukwa cha kuyambika mwachangu, NovoRapid® FlexPen ® iyenera kuperekedwa, monga lamulo, nthawi yomweyo chakudya chisanachitike, ndipo ngati kuli koyenera, chitha kuperekedweratu chakudya chisanafike. Chifukwa chakufupika kwakanthawi poyerekeza ndi insulin yaumunthu, chiopsezo chokhala ndi nocturnal hypoglycemia mwa odwala omwe amalandila NovoRapid® Flexpen® ndiwotsika.

Magulu apadera a odwala
Monga ndi ma insulin ena, mwa okalamba odwala ndi odwala aimpso kapena kwa chiwindi, magazi a shuga amayenera kuyang'aniridwa mosamala kwambiri ndi mlingo wa aspart wa aspart payekha.

Ana ndi achinyamata
Ndikofunika kugwiritsa ntchito NovoRapid® FlexPen ® m'malo mwa sungunuka waumunthu m'magazi pakakhala koyenera kuti ayambe kuchitapo kanthu, mwachitsanzo, ngati zimavuta kuti mwana asunge nthawi yoyenera pakati pakubayidwa ndi zakudya.

Chotsani kuchokera kukonzekera kwina kwa insulin
Mukasamutsa wodwala kuchokera ku kukonzekera kwa insulin ina ku NovoRapid® FlexPen ®, kusintha kwa NovoRapid® FlexPen ® ndi basulin insulin kungafunike.

NovoRapid Fle Flexpen ® jekeseni subcutaneally m'dera la anterior m'mimba khoma, ntchafu, phewa, deltoid kapena gluteal dera. Mawebusayiti omwe ali mkati mwa thupi limodzi amayenera kusinthidwa pafupipafupi kuti muchepetse chiwopsezo cha lipodystrophy. Monga kukonzekera konse kwa insulin, kuyika kwina kwa khoma lakunja kwam'mimba kumayamwa mwachangu poyerekeza ndi kayendetsedwe ka malo ena. Kutalika kwa zochita zimatengera mlingo, malo oyendetsera, kutsika kwa magazi, kutentha ndi kuchuluka kwa zochitika zolimbitsa thupi. Komabe, kuyambitsa mwachangu poyerekeza ndi insulin ya anthu sungunuka mosasamala malo omwe jakisoniyo anali.

NovoRapid ® ikhoza kugwiritsidwa ntchito popanga ma subulinane a insulin infusions (PPII) m'mapampu a insulin omwe amapangidwira insulin infusions. FDI iyenera kupangidwa khoma lakunja kwam'mimba. Malo olowetsedwa amayenera kusinthidwa nthawi ndi nthawi.

Mukamagwiritsa ntchito pampu ya insulini kulowetsedwa, NovoRapid® sayenera kusakanikirana ndi mitundu ina ya insulin.

Odwala omwe akugwiritsa ntchito FDI ayenera kuphunzitsidwa bwino kugwiritsa ntchito pampu, chosungira choyenera, ndi dongosolo la ma pump pump. The kulowetsedwa set (chubu ndi catheter) ziyenera m'malo mwa wogwiritsa buku malangizo ophatikizidwa ndi kulowetsedwa.

Odwala omwe amalandila NovoRapid ® ndi FDI ayenera kukhala ndi insulini yowonjezera kuti ikwaniritse kulowetsedwa.

Intravenous makonzedwe
Ngati ndi kotheka, NovoRapid® imatha kutumikiridwa kudzera m'mitsempha, koma okhawo omwe ndi akatswiri azachipatala.

Pa kulowetsedwa kwa mtsempha, makina a kulowetsedwa ndi NovoRapid® 100 IU / ml okhala ndi 0.05 IU / ml mpaka 1 IU / ml insulin katsitsidwe mu 0.9% sodium chloride solution, 5% dextrose solution kapena 10% dextrose solution yokhala ndi 40 mmol / L potaziyamu potaziyamu pogwiritsa ntchito kulowetsera kwa polypropylene. Njira zoterezi ndizokhazikika pofunda kwa maola 24. Ngakhale kukhazikika kwakanthawi, kuchuluka kwa insulin kumayamba chifukwa cha zinthu zomwe zimayambitsa kulowetsedwa. Pa insulin infusions, ndikofunikira kuyang'anira kuchuluka kwa shuga m'magazi.

Zotsatira zoyipa:

Chotsatira chovuta kwambiri ndi hypoglycemia. Zotsatira zoyipa zimasiyanasiyana malinga ndi kuchuluka kwa odwala, ma regimen regimen, ndi kayendedwe ka glycemic (onani gawo pansipa).

Pa gawo loyambirira la insulin, zolakwika zotupa, edema ndi zochita zake zimatha kupezeka pamalo a jakisoni (kupweteka, kufiyira, ming'oma, kutupa, hematoma, kutupa ndi kuyabwa pamalowo jakisoni. Zizindikirozi nthawi zambiri zimakhala zachilengedwe. Kusintha kwapang'onopang'ono pakuwongolera glycemic kumatha kubweretsa mkhalidwe wa "ululu wammbuyo wamitsempha," womwe umatha kusintha. Kulimbitsa kwa insulin mankhwala ndikusintha kolimba kwa mphamvu ya kagayidwe kazakudya kungayambitse kuwonongeka kwakanthawi mu matenda a shuga, pomwe kusintha kwakanthawi kwakanthawi ka glycemic kumachepetsa chiopsezo cha kupitirira kwa matenda ashuga retinopathy.

Mndandanda wazotsatira zoyipa zimaperekedwa pagome.

Kusokonezeka Kwa Magazi

Kanthawi kochepa - Ming'oma, totupa pakhungu, zotupa pakhungu Osowa kwambiri - Anaphylactic reaction * Matenda a metabolism komanso zakudyaNthawi zambiri - Hypoglycemia * Kusokonezeka kwamanjenjeNthawi zambiri - zotumphukira neuropathy ("ululu wammbuyo"

Kuphwanya gawo la masomphenyawo

Nthawi zambiri - zolakwika zoyeserera Nthawi zambiri - matenda ashuga retinopathy Kusokonezeka kwa khungu ndi minofu yolowereraNthawi zambiri - lipodystrophy *

Zovuta ndi zovuta zina pamalo a jakisoni

Nthawi zambiri - zimachitika malo jakisoni Nthawi zambiri - edema

Zotsatira zonse zoyipa zomwe zaperekedwa pansipa, kutengera deta yomwe idatengeka kuchokera pazoyeserera zamankhwala, zimagawidwa m'magulu malinga ndi kufalikira kwa chitukuko motsatira ndondomeko ya MedDRA ndi ziwalo. Zomwe zimachitika pakakhala zovuta zimadziwika kuti: pafupipafupi (≥ 1/10), nthawi zambiri (≥ 1/100 to) Pakulipira kulikonse, gwiritsani ntchito singano yatsopano kuti mupewe matenda.
Samalani kuti musapinde kapena kuwononga singano musanagwiritse ntchito.
Popewa kubayidwa mwangozi, musabwezeretse cholowera chamkati pa singano.

Chingwe cha Insulin
Ngakhale mutagwiritsidwa ntchito moyenera cholembera, mpweya wochepa umatha kudzikundikira mukathumba lililonse.
Poletsa kulowa kwa kuwira kwa mpweya ndikuwonetsa kuyamwa kwa mtundu woyenera wa mankhwalawa:

E. Imbani 2 magawo a mankhwala ndikusintha chosankha.

F. Kugwira NovoRapid ® FlexPen ® ndi singano mmwamba, dinani katiriji kangapo ndi chala chanu kuti thovu lakumlengalenga lipite pamwamba pa cartridge.

G. Mukugwira NovoRapid® FlexPen ® ndi singano mmwamba, kanikizani batani loyambira njira yonse. Mlingo wosankha ubwerera ku zero.
Dontho la insulin liyenera kuonekera kumapeto kwa singano. Ngati izi sizingachitike, sinthani singano ndikubwereza njirayi, koma osapitirira 6.
Ngati insulini siyikuchokera singano, izi zikuwonetsa kuti cholembera sichili chosalongosoka ndipo sayenera kugwiritsanso ntchito.

Mlingo
Onetsetsani kuti chosankha cha mankhwalawo chikhala "O".

H. Dinani manambala ofunikira jakisoni. Mlingo umatha kusinthidwa ndikusinthanitsa ndi mtundu wosankhidwa mwanjira iliyonse mpaka mlingo woyenera wakhazikitsidwa kutsogolo kwa chizindikiro. Mukazungulira chosankha cha mankhwala, samalani kuti musakanize mwangozi batani loyambira kuti muchepetse kutulutsa kwa insulin. Sizotheka kukhazikitsa mlingo woposa kuchuluka kwa zigawo zomwe zatsalira mu cartridge.

Kusunga ndi chisamaliro
NovoRapid® Flexpen® idapangidwa kuti ikhale yogwira ntchito komanso yotetezeka ndipo imafunikira kuisamalira mosamala. Pakakhala dontho kapena makina mwamphamvu, cholembera cha syringe chimatha kuwonongeka ndipo insulin ikhoza kudontha.
Pamwamba pa NovoRapid® FlexPen ® amatha kutsukidwa ndi thonje swab choviikidwa mu mowa. Osamiza cholembera chindende, osachisambitsa kapena kumuthira mafuta, monga ikhoza kuwononga makina.
Kudzazidwa kwa NovoRapid® FlexPen ® sikuloledwa.

Makulidwe a insulin
Ikani singano pansi pa khungu. Gwiritsani ntchito njira jakisoni yomwe dokotala wanu wakupatsani.

Ine. Kuti mupeze jakisoni, dinani batani loyambira mpaka "0" akuwonekera kutsogolo kwa chizindikiro. Samalani: mukamapereka mankhwalawo, ingokanizani batani loyambira.
Mlingo wosankha ngati utasinthidwa, makonzedwe a mlingo sangachitike.

J. Mukachotsa singano pansi pa khungu, gwiritsani batani loyambira ndikukhumudwa kwathunthu.
Pambuyo pa jekeseni, siyani singano pansi pa khungu kwa masekondi 6 osachepera. Izi zikuthandizira kukhazikitsidwa kwa insulin yonse.

K. Lowetsani singano mumkono wakunja wa singano osakhudza cap. Pamene singano ilowa, valani chipewa ndikuvula singano.
Taya singano, samalira chitetezo, ndikutseka cholembera ndi chophimba.