Malangizo a NovoRapid Penfill > Chithandizo ndi kupewa

Insulin Aspart * (Insulin aspart *)

Matenda a shuga ndi achikulire, achinyamata ndi ana opitilira zaka 2.

Kuchulukitsa chidwi cha munthu payekha kwa insulini kapena chilichonse cha mankhwala.

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

Mimba komanso kuyamwa:

NovoRapid ® Penfill ® ikhoza kutumikiridwa panthawi yapakati. Zambiri kuchokera kwa mayeso awiri azachipatala omwe adayang'aniridwa mosasamala (157 + 14 amayi oyembekezera omwe adawunikidwa) sanawonetse zovuta zilizonse za insulin aspart pa mimba kapena thanzi la mwana wosabadwayo / wakhanda poyerekeza ndi insulin ya anthu (onani Pharmacodynamics).

Kuwunikira mosamala kuchuluka kwa shuga m'magazi ndikuwunika azimayi oyembekezera omwe ali ndi matenda osokoneza bongo a shuga (mtundu 1 shuga, mtundu wachiwiri wa shuga kapena matenda osokoneza bongo) amalimbikitsidwa panthawi yonse yomwe ali ndi pakati komanso panthawi yomwe ali ndi pakati. Kufunika kwa insulini, monga lamulo, kumachepera mu trimester yoyamba ndipo pang'onopang'ono kumawonjezeka pang'onopang'ono wachiwiri komanso wachitatu wokonzekera kutenga pakati. Pambuyo pobadwa, kufunikira kwa insulin kumabwereranso msanga momwe kunaliri asanakhale ndi pakati.

Panthawi yoyamwitsa, NovoRapid ® Penfill ® ikhoza kugwiritsidwa ntchito, chifukwa kuperekera insulin kwa mayi woyamwitsa sikuopseza mwana. Komabe, zingakhale zofunikira kusintha mlingo wa mankhwalawo.

Zotsatira zoyipa zomwe zimawoneka mwa odwala omwe amagwiritsa ntchito NovoRapid ® Penfill ® zimachitika makamaka chifukwa cha kupangika kwa mankhwala a insulin.

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.

Zoyipa zonse zomwe zafotokozedwa pansipa, kutengera mtundu wa mayeso azachipatala, zimayikidwa m'magulu molingana ndi kukula kwa chitukuko malinga ndi MedDRA ndi machitidwe a ziwalo. Zomwe zimachitika pakakhala zovuta zimafotokozedwa motere: kawirikawiri (? 1/10), kawirikawiri (? 1/100, Yothetsera subcutaneous ndi mtsempha wa magazi makonzedwe1 ml ntchito: insulinZIWANDA 100 (3.5 mg) excipients: glycerol - 16 mg, phenol - 1.5 mg, metacresol - 1.72 mg, zinc chloride - 19.6 μg, sodium kolorayidi - 0,58 mg, sodium hydrogen phosphate dihydrate - 1,25 mg, sodium hydroxide 2M - pafupifupi 2.2 mg, 2M hydrochloric acid - pafupifupi 1.7 mg, madzi a jakisoni - mpaka 1 ml Makatoni amodzi amakhala ndi 3 ml ya yankho, lofanana ndi 300 PIERES.
Mlingo ndi makonzedwe:

NovoRapid ® Penfill ® ndi analogue yolimba kwambiri ya insulin. Mlingo wa NovoRapid ® Penfill ® umatsimikiziridwa ndi dokotala payekha, mogwirizana 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.

Mwachizolowezi, chinthu chofunikira tsiku lililonse cha insulin mwa akulu ndi ana kuyambira 0,5 mpaka 1 U / kg thupi. Pogwiritsa ntchito mankhwala musanadye, kufunika kwa insulin kungaperekedwe ndi NovoRapid ® Penfill ® ndi 50-70%, kufunika kwa insulin kumaperekedwa ndi insulin yowonjezera. Kuchuluka kwa zochita zolimbitsa thupi kwa wodwala, kusintha kwa zakudya zomwe timakonda, kapena matenda okhudzana ndi zina zitha kuchititsa kusintha kwa mlingo.

NovoRapid ® Penfill ® imayamba mwachangu komanso yofupikitsa nthawi pochita kuposa insulin yamunthu yosungunuka. Chifukwa cha kuyambika mwachangu, NovoRapid ® Penfill ® iyenera kuyendetsedwa, 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 ® Penfill ® ndi yotsika.

Magulu apadera a odwala. Monga momwe amagwiritsidwira ntchito pokonzekera insulin ina, mwa okalamba odwala ndi odwala aimpso kapena a hepatic insuffidence, magazi a shuga ayenera kuyang'aniridwa mosamala kwambiri komanso mlingo wa aspart aspart payekha.

Ana ndi achinyamata. Kugwiritsa ntchito NovoRapid ® Penfill ® m'malo mwa insulin ya anthu sungunuka mwa ana ndikofunikira pakakhala koyenera kuti ayambe kuchitapo kanthu mwachangu, mwachitsanzo, ngati zimavuta kuti mwana azisunga nthawi yofunikira pakati pakubaya ndi chakudya.

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

NovoRapid ® Penfill ® ndi jakisoni sc 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 ® 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 kulowetsedwa kwa insulin, 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.

Mu / m'mawu oyamba. Ngati ndi kotheka, NovoRapid ® imatha kuperekedwera iv, koma kokha ndi akatswiri azachipatala oyenerera.

Pa makonzedwe amkati, makina a kulowetsedwa ndi NovoRapid ® 100 IU / ml omwe ali ndi ndende ya 0.05 mpaka 1 IU / ml insulin mu 0.9% sodium chloride solution, 5 kapena 10% dextrose solution yokhala ndi 40 mmol / l imagwiritsidwa ntchito potaziyamu mankhwala ena ogwiritsa ntchito polypropylene kulowetsedwa muli. Njira zoterezi ndizokhazikika pofunda kwa maola 24. Ngakhale kukhazikika kwakanthawi, chiwopsezo china cha insulin choyambirira chimatengedwa ndi zinthu zam'kati mwa kulowetsedwa. Pa insulin infusions, ndikofunikira kuyang'anira kuchuluka kwa shuga m'magazi.

NovoRapid ® Penfill ® ndi singano ndizongogwiritsa ntchito nokha. Musadzazenso cartridge ya Penfill ®.

NovoRapid ® Penfill ® silingagwiritsidwe ntchito ngati yasiya kuwoneka bwino komanso yopanda utoto kapena itaundana. Mupangitseni wodwala kutaya singano pambuyo povulala iliyonse.

NovoRapid ® ikhoza kugwiritsidwa ntchito pamapampu a insulin (onani. Mlingo ndi makonzedwe "). Ma Tubes, mkati mwake omwe amapangidwa ndi PE kapena polyolefin, adayesedwa ndikupezeka kuti ndi oyenera kugwiritsidwa ntchito pamapampu.

Milandu yofulumira (kuchipatala, kuvuta kwa chipangizocho chifukwa cha insulin management) NovoRapid ® yoyendetsera wodwala imatha kuchotsedwa mu katoni pogwiritsa ntchito syringe ya U100.

Mlingo ndi makonzedwe

P / c, mu / mu. NovoRapid Penfill imayamba mwachangu komanso yofupika nthawi yochitapo kanthu kuposa kusungunuka kwa insulin yamunthu. Chifukwa cha kuyambika mwachangu, NovoRapid Penfill iyenera kuperekedwa, ngati lamulo, nthawi yomweyo chakudya chisanachitike, ngati kuli koyenera, chitha kuperekedweratu chakudya chisanafike.

Mlingo wa mankhwalawa umatsimikiziridwa ndi dokotala aliyense payekha, malinga ndi kuchuluka kwa shuga m'magazi. Nthawi zambiri, NovoRapid ® Penfill ® imagwiritsidwa ntchito limodzi ndi insulini pakukonzekera kapena nthawi yayitali, yomwe imayendetsedwa kamodzi pa tsiku.

Nthawi zambiri, zokwanira tsiku ndi tsiku insulin ndi 0.5-1 magawo / kg thupi. Pogwiritsa ntchito mankhwala musanadye, kufunikira kwa insulin kungaperekedwe ndi NovoRapid penfill ndi 50-70%, kufunika kwa insulin kumachitika chifukwa chokhala ndi insulin.

Kutentha kwa insulin yoyenera kuyenera kukhala kutentha kwambiri. NovoRapid Penfill amalowa jekeseni pang'ono m'chigawo cha khomo lamkati, ntchafu, phewa kapena matako. Masamba obayira omwe ali mdera lomwelo la thupi amayenera kusinthidwa pafupipafupi.

Monga kukonzekera kwina konse kwa insulin, kutalika kwa zochita za NovoRapid Penfill zimatengera mlingo, malo a makonzedwe, kutsika kwa magazi, kutentha ndi kuchuluka kwa zochitika zolimbitsa thupi.

Kuwongolera kwa khoma lakhoma lam'mimba kumathandizira kuti lizichotsa mofulumira poyerekeza ndi kayendetsedwe ka malo ena. Komabe, kuyambitsa mwachangu poyerekeza ndi insulin ya anthu sungunuka mosasamala malo omwe jakisoniyo anali.

Ngati ndi kotheka, NovoRapid Penfill imatha kuperekedwera iv, koma okhawo odziwa ntchito zachipatala oyenerera. Pa kulowetsedwa kwa mtsempha, makina a kulowetsedwa ndi NovoRapid Penfill 100 IU / ml omwe ali ndi ndende ya 0.05 mpaka 1 IU / ml insulin mu 0.9% sodium chloride-5 kapena 10% dextrose solution yokhala ndi 40 mmol / l potaziyamu mankhwala ena ogwiritsa ntchito polypropylene kulowetsedwa muli. Njira zoterezi ndizokhazikika pakukhazikika kwa kutentha kwa maola 24. Pa insulin infusions, ndikofunikira kuyang'anitsitsa kuchuluka kwa shuga m'magazi.

NovoRapid Penfill itha kugwiritsidwanso ntchito popanga ma subulinane insulin infusions (PPII) m'mapampu a insulini omwe amapangidwira insulin infusions. FDI iyenera kupangidwa khoma lakunja kwam'mimba. Malo olowetsedwa amayenera kusinthidwa nthawi ndi nthawi. Mukamagwiritsa ntchito pampu ya insulin ya NovoRapid penfill insulin, musaphatikize ndi mitundu ina ya insulin. Odwala omwe akugwiritsa ntchito FDI ayenera kuphunzitsidwa kugwiritsa ntchito pampu, chosungira choyenera, komanso dongosolo la tubing pump. The kulowetsedwa set (chubu ndi catheter) ziyenera m'malo mwa wogwiritsa buku malangizo ophatikizidwa ndi kulowetsedwa. Odwala omwe amalandila NovoRapid Penfill ndi PPI ayenera kukhala ndi insulini yowonjezera yomwe ingagwiritsidwe ntchito pakavulala.

Bongo

Zizindikiro: Kukula kwa hypoglycemia (thukuta lozizira, palpitations, kunjenjemera, njala, kukwiya, kusakhazikika, pallor, kupweteka mutu, kugona, kusowa poyenda, kuyankhula komanso kuwonongeka kwamaso). Hypoglycemia ingayambitse matenda amisala ndi minyewa.

Chithandizo: shuga kapena shuga mkati mwake (ngati wodwalayo akudziwa), s / c, i / m - glucagon (pa mlingo wa 0.5-1 mg) kapena i / v - shuga. Kuphatikiza apo, iv yoyendetsedwa ndi shuga ndiyofunikira panthawiyo, pakatha mphindi 10-15 pambuyo pa kukhazikitsidwa kwa glucagon, wodwalayo samadzidwalanso. Pambuyo kupezanso mphamvu, pakamwa chakudya chamafuta kumalimbikitsidwa kuti musadzabwerenso ku hypoglycemia.

Njira zopewera kugwiritsa ntchito

Mlingo wosakwanira kapena kusokonezeka kwa mankhwalawa, makamaka odwala matenda a shuga a shuga (mtundu 1), amatha kutsogolera ku hyperglycemia ndi matenda ashuga a ketoacidosis.

Palibe zochitika zachipatala kwa ana ochepera zaka 6. NovoRapid iyenera kugwiritsidwa ntchito mwa ana m'malo mwa insulin yochepa yokhayo yokhayo pokhapokha ngati kuyambitsa mwachangu kumatha kukhala ndi zotsatira zabwino - mwachitsanzo, ngati zimakhala zovuta kuti mwana athe kupeza nthawi yayitali pakati pa jakisoni ndi zakudya.

Matenda obvuta, makamaka matenda, nthawi zambiri amachulukana, ndipo kuwonongeka kwa impso kapena chiwindi kumachepetsa kufunika kwa insulin. Kusamutsa wodwala kupita ku mtundu wina kapena mtundu wa insulin kuyenera kuchitika moyang'aniridwa ndi achipatala. Mukamagwiritsa ntchito NovoRapid Penfill, kuchuluka kwa jakisoni patsiku kapena kusintha kwa mankhwalawa kungafunike poyerekeza ndi omwe amagwiritsa ntchito insulin. Ngati pakufunika kusintha kwa mlingo, izi zitha kuchitika kale pakabayidwa koyamba kapena milungu ingapo kapena miyezi ingapo mutasinthira. Pambuyo kulipirira kagayidwe kazakudya kwa odwala, Zizindikiro zawo zakutsogolo kwa hypoglycemia zimatha kusintha, zomwe ayenera kudziwa. Kudumpha chakudya kapena masewera osakonzekera kungayambitse hypoglycemia. Gwiritsani ntchito mosamala makamaka mukamagwira ntchito yoyendetsa magalimoto ndi anthu omwe ntchito yawo imalumikizidwa ndi chidwi chochuluka, chifukwa hypoglycemia imatha kukhala, makamaka kwa odwala omwe ali ndi zofatsa kapena zosapezekapo, omwe ali patsogolo pa hypoglycemia kapena zochitika zake pafupipafupi. Zikatero, muyenera kuganizira mozama ngati kuli koyenera kuti wodwalayo ayendetse galimoto. Makatoni a Penfill ndi ogwiritsa ntchito nokha. Pambuyo jekeseni osachepera 6 s, singano imayenera kukhalabe pansi pa khungu pakumwa zonse.

Mawonekedwe

Insulin Aspart - gawo lalikulu la mankhwalawa, lili ndi mphamvu ya hypoglycemic. Ichi ndi chiwonetsero cha insulin yochepa, yomwe imapangidwa m'thupi la munthu. Insulin Aspart imapangidwa ndi ukadaulo wa ma DNA a recombinant.

Mankhwalawa amalumikizana ndi ma cell amtundu wa cytoplasmic wama amino acid osiyanasiyana, amapanga mapangidwe ambiri a insulin, komanso amathandizira njira zamkati.

Pambuyo kuchepa kwa kuchuluka kwa shuga mthupi, kusintha kotere kumachitika:

kayendedwe kazinthu zatsatanetsatane,
kuchuluka kwa minofu kumachuluka
glycogeneis, lipogeneis.

Ndikotheka kukwaniritsa kuchepa kwa kuchuluka kwa shuga m'magazi. Novorapid imagwira bwino ntchito ndiminyewa yamafuta, koma nthawi yake yochita ndizochepa kuposa ya insulin yaumunthu.

Mankhwalawa adamulowetsa pambuyo pa mphindi 10-20 pambuyo pa jakisoni, amatha maola 3-5, kuchuluka kwakukulu kwa mahomoni kumawonedwa pambuyo pa maola 1-3.

Kugwiritsa ntchito mwadongosolo kwa Novorapid kumachepetsa kugona kwa hypoglycemia usiku kangapo. Milandu ya kuchepa kwakukulu kwa postprandial hypoglycemia imadziwika. Mankhwala tikulimbikitsidwa mtundu 1 ndi mitundu yachiwiri ya odwala matenda ashuga.

Zizindikiro zogwiritsidwa ntchito

mtundu 1 shuga
kugwiritsa ntchito mtundu wa 2, ngati njira zina zochiritsira sizothandiza,
mtundu wachiwiri pa nthawi yapakati.
ndi matenda a shuga.
ketoacidotic chikomokere, chofuna chithandizo chakanthawi ndi insulin, kapena zina zofanana.
mawonekedwe a steroid a shuga.

Endocrinologist amasankha nthawi yomwe wodwala angatenge Novorapid.

Kuzindikira kwa shuga - ingomwani tsiku lililonse.

Kutulutsa Fomu

Penorill wa Novorapid amapezeka m'mabotolo atatu a 3 ml otengera ma syringe. Pali ma cartridge 5 mu paketi imodzi. Novorapid Flekspen ndi cholembera chotupa china, chomwe chimakhala ndi 3 ml ya chinthucho, phukusi la zidutswa 5. Malangizowo akuwonetsa kuti mankhwalawa ndi ofanana pakapangidwe. Cholembera cha syringe ndi chosavuta kugwiritsa ntchito ngati mukufuna kulowa muyezo waung'ono wa mankhwalawo.

Malangizo ogwiritsira ntchito

Ndi metabolism yabwino, kukula kwamatenda kumachedwetsedwa, zizindikiro sizikutchulidwa. Chifukwa chake, ndikofunikira kukhazikika pakulamulira kwa metabolic, kuwunika kuchuluka kwa shuga mthupi.

Njira za Hypoglycemic zimakula msanga ngati wodwala matenda ashuga ali ndi matenda othandizirana, ndipo mankhwala omwe amachepetsa kuyamwa kwa chakudya amagwiritsidwa ntchito. Kufunika kwamankhwala kumawonjezeka ndi zovuta zamtundu umodzi. Thupi silifunikira insulin ngati wodwalayo ali ndi mavuto ndi ziwalo zamkati.

Pambuyo poti odwala asintha kupita ku mankhwala ena, zizindikiro za hypoglycemia zimasinthika kapena kuchepera. Madokotala nthawi zonse amawunika momwe wodwalayo akusinthira mtundu wina wa mahomoni. Mankhwala akasinthidwa, mlingo umasinthidwa. Kusintha kwa kuchuluka kwa mankhwala omwe mumagwiritsidwa ntchito kumafunikira mukamadya zakudya zina, mutachotsedwa kapena kuwonjezeka kwa zolimbitsa thupi.

Mlingowo umatsimikiziridwa ndi endocrinologist payekhapayekha kwa wodwala aliyense, poganizira zosowa zake. Novorapid amaphatikizidwa ndi insulin yayitali komanso yayitali osachepera 1 nthawi patsiku. Magazi a glucose, insulin yochulukirapo imayendetsedwa kuti ipeze njira yoyenera yothanirana ndi glycemia. Ana amapatsidwa 1.5 mpaka 1 unit. pa kilogalamu ya kulemera. Kusintha kadyedwe kanu kapena moyo wanu pamafunika kusintha kwa mlingo.

Novorapid imayendetsedwa asanadye, mwayi wa usiku wa hypoglycemia umachepetsedwa.

Wodwala matenda ashuga amatha kuperekera mankhwalawo payekha, jakisoni wokhazikika amapangidwa m'mimba, ntchafu, mu minofu yolimba. Tsamba la jakisoni limasintha kuti lipodystrophy isamere.

Mankhwala amagwiritsidwa ntchito PPII; mapampu a insulin amagwiritsidwa ntchito kulowetsedwa. Panthawi imeneyi, jakisoni amapangidwa kutsogolo kwa m'mimba. Nthawi zina, Novorapid amalowa jekeseni wamkati, akatswiri okhawo omwe amadziwa bwino amapanga jakisoni.

Zotsatira zoyipa

Zotsatira za insulin ya rDNA m'thupi nthawi zina zimadetsa nkhawa za odwala. Zotsatira zoyipa kwambiri ndi kutsika kwa shuga - hypoglycemia. Pafupipafupi mwadzidzidzi vutoli limapezeka m'magulu osiyanasiyana a odwala ndilosiyana, limatsimikiziridwa ndi Mlingo, mawonekedwe oyang'anira.

Timapereka kuchotsera kwa owerenga tsamba lathu!

Pa magawo oyambilira a maphunziro, kusintha kosinthika kumachitika, kupweteka, Hyperemia, kutupa, ndi kuyabwa kumachitika pamalo a jakisoni. Zizindikiro zotere zimazimiririka pakapita nthawi popanda chithandizo.

Kuchepetsa kwambiri glycemia kumayambitsa kuwonongeka kwa retinopathy.

Zina zoyipa zomwe zimawonedwa mu anthu odwala matenda ashuga zimatuluka mwanjira zosiyanasiyana zamatenda a ziwalo ndi machitidwe:

chitetezo chofooka
misempha imasokonekera,
masomphenya amawonongeka
Kutupa pa malo a jekeseni.

Hypoglycemia imayamba ndi kuchuluka kwa insulin, kuphwanya njira ya zamankhwala. Vuto lalikulu la matendawa ndi loopsa kwa munthu wodwala matenda ashuga. Pali mavuto ndi dongosolo lamagazi, ubongo umasokonekera, mwayi woti imfa umachulukitsidwa.

Malangizo apadera

Mukamapita kumalo omwe muli ndi nthawi yosiyanasiyana, muyenera kudziwa kuchokera kwa dokotala momwe mungagwiritsire ntchito mankhwalawo moyenera. Ngati munthu waleka kubayidwa, hyperglycemia, ketoacidosis imayamba. Pa matenda 1 a matenda ashuga, matendawa amapezeka pafupipafupi. Zizindikiro zimawoneka pang'onopang'ono, kukulira nthawi.

Pali mseru, kusanza, kugona, khungu limawuma, hydrate a mucosa am'kamwa amachepa, kukodza kumayamba kumachitika pafupipafupi, ndimamva ludzu nthawi zonse, kusowa kudya. Imanunkhiza acetone kuchokera mkamwa mwanga. Ngati hyperglycemia ikukayikiridwa, chithandizo chamankhwala chimachitika nthawi yomweyo kuti apulumutse moyo wa wodwalayo. Kuchuluka kwa mankhwalawa kumasintha zizindikirazo, koma hypoglycemia imakhalabe.

Vutoli limachitika mlingo wa insulini ukadutsa. Kukula kwake sikungotengera kuchuluka kwa mankhwalawa, komanso kuchuluka kwamagwiritsidwe ntchito, momwe wodwalayo alili, kupezeka kwa zinthu zomwe zikukulitsa.

Zizindikiro za hypoglycemia zimakula motsatizana, zimavuta popanda kulamula kuchuluka kwa shuga. Ndi nthenda yofatsa yamatenda, odwala amalangizidwa kuti azidya shuga wambiri kapena zakudya zam'madzi, amwe madzi a zipatso kapena tiyi wokoma mankhwala.

Odwala nthawi zonse amafunika kunyamula maswiti kapena maswiti ena ndi iwo kuti azisinthasintha shuga awo akamva kuti sakukonda. M'mavuto akulu, odwala amasiya kuzindikira, madokotala kapena okondedwa omwe amadziwa zoyenera kuchita.

Kusintha kwa odwala matenda ashuga, amadzipaka ndi glucagon intramuscularly kapena subcutaneally. Ngati mankhwalawa sakulitsa, wodwalayo sayambiranso, gwiritsani ntchito njira ya dextrose, jekeseni kudzera m'mitsempha.

Chotsani kuchokera ku insulin ina

Kusamutsa odwala ku mtundu wina wa insulin kapena mankhwala kuchokera kwa wopanga wina kumachitika moyang'aniridwa ndi madokotala. Mukamayang'anira kuchuluka kwa mankhwalawa, njira yawo yopangira ndi zina, momwe mlingo umasinthira, pafupipafupi jakisoni amawonjezeka.

Pa mankhwala ndi mankhwala ena, zimachitika jakisoni malo, ululu, kuyamwa, zotupa, kutupa, kutupa, kutupa. Zizindikiro sizimawoneka kwambiri ndikusintha jakisoni, chithandizo chimalephera nthawi zina.

Endocrinologist amasankha analogue othandizira kuti asinthe Novorapid. Mlingo wofunikira wa insulin amawerengedwa, chiwembu cha jekeseni chimasankhidwa.

Mtengo wa Novorapid Penfil ndi ma ruble 1799 a majekiseni 5.

Insulin yaifupi Aspart imagwiritsidwa ntchito kwambiri pa mitundu 1 ya anthu ashuga.

Madokotala amamulembera Novorapid Penfil ngati kugwiritsidwa ntchito kwa mankhwala ena sikothandiza kapena wodwala sakukwanira mokwanira pazigawo zawo.

Mankhwalawa amagwiranso ntchito mwachangu, atachotsa zosakhudza zosiyanasiyana, koma thupi liyenera kusinthidwa ndi mtundu wina wa insulin.

Matenda a shuga nthawi zonse amayambitsa zovuta zakupha. Mwazi wamagazi ochulukirapo ndi woopsa kwambiri.

Aronova S.M. adafotokoza za chithandizo cha matenda ashuga. Werengani kwathunthu

Mapangidwe a odwala matenda ashuga

Mankhwala a NovoRapid diabetesic (insulin) amapangidwa m'njira ziwiri - awa ndi ma cartridge a Penfill osinthika ndi zolembera zopangidwa ndi FlexPen.

Kapangidwe ka cartridge ndi cholembera ndi chimodzimodzi - ndi madzi omveka bwino a jekeseni, pomwe 1 ml imakhala ndi insulin aspart mu 100 PISCES. Makatoni amodzi okhazikika, ngati cholembera chimodzi, ali ndi pafupifupi 3 ml ya yankho, yomwe ndi magawo 300.

Makatoni amapangidwa ndi galasi la hydrolytic la gulu la I. Wotsekedwa mbali imodzi ndi ma disisi a mphira am'madzi a polyisoprene ndi brkidutyl, mbali inayo ndi ma pisitoni apadera a rabara. Pali makatoni asanu ogwiritsidwanso ntchito pachimake cha aluminiyamu, ndipo chithuza chimodzi chimangiriridwa m'bokosi la makatoni. Momwemonso zolembera za syringe ya FlexPen zimapangidwa. Ndizotayidwa ndipo ndizopangidwira mitundu ingapo. M'bokosi lamakalata pali asanu mwa iwo.

Mankhwalawa amasungidwa m'malo ozizira kutentha kwa 2-8 ° C. Sichiyenera kuyikidwa pafupi ndi mufiriji, komanso siyenera kuzizira. Komanso makatoni omwe amatha kusintha ndi ma syringe ayenera kutetezedwa ndi dzuwa. Ngati NovoRapid insulin (katiriji) watsegulidwa, sangathe kusungidwa mufiriji, koma uyenera kugwiritsidwa ntchito pakatha milungu inayi. Kutentha kosungira sikuyenera kupitirira 30 ° C. Moyo wa alumali wa insulin wosatsimikizika ndi miyezi 30.

Pharmacology

Mankhwala a NovoRapid (insulin) amakhala ndi vuto la hypoglycemic, ndipo gawo lomwe limagwira, insulini aspart, ndi chida chofanizira cha timadzi tambiri tomwe timapanga. Katunduyu amapezeka pogwiritsa ntchito mitundu yapadera ya DNA. Vuto la Saccharomyces cerevisiae limawonjezeredwa pano, ndipo amino acid yotchedwa "proline" imasinthidwa kwakanthawi ndi wina wokhala ndi aspartic.

Mankhwalawa amakumana ndi zolandilira zam'mimba za cytoplasmic yama cell, pomwe amapanga zovuta zonse za insulin, amapangitsa njira zonse zomwe zimachitika mkati mwa maselo. Pambuyo pakuchepetsa kuchuluka kwa shuga m'magazi a plasma, kuchuluka kwa mayendedwe amkati, kuwonjezeka kwa kugaya kwa minofu yambiri, kuwonjezeka kwa glycogenogeneis ndi lipogenesis. Kuchuluka kwa shuga komwe kumachitika m'chiwindi kumachepa.

Kusintha amino acid proline ndi Aspartic acid mukakumana ndi insulin aspart kumachepetsa kuthekera kwa mamolekyulu kupanga hexamers. Homoni wamtunduwu umakakamizidwa bwino ndi mafuta osakanikirana, amakhudza thupi mwachangu kuposa mphamvu ya insulin yaumunthu.

M'mahola anayi atatha kudya, insulin amachepetsa msempha wa plasma mwachangu kuposa mahomoni amtundu wa munthu. Koma zotsatira za NovoRapida ndi subcutaneous management ndizofupikirapo kuposa zomwe zimasungunuka ndi anthu.

Kodi NovoRapid amagwira ntchito nthawi yayitali bwanji? Funsoli limadetsa nkhawa anthu ambiri omwe ali ndi matenda ashuga. Chifukwa chake, mphamvu ya mankhwalawa imachitika pambuyo pa mphindi 10-20 pambuyo pa jekeseni. Kuphatikiza kwakukulu kwa mahomoni m'mwazi kumawonedwa patatha maola 1-3 mutatha kugwiritsa ntchito mankhwalawa. Chidacho chimakhudza thupi kwa maola 3-5.

Kafukufuku wa anthu omwe ali ndi matenda a shuga a I adawonetsa kuchepetsa zingapo pangozi ya nocturnal hypoglycemia pogwiritsa ntchito NovoRapida, makamaka poyerekeza ndi kuyamwa kwa insulin yamunthu. Kuphatikiza apo, panali kuchepa kwakukulu kwa gluprose wa postprandial mu plasma pamene adabayidwa ndi insulin aspart.

Zizindikiro ndi contraindication

Mankhwala NovoRapid (insulin) amapangidwira anthu omwe ali ndi matenda a shuga 1, omwe amadalira insulin, komanso odwala omwe ali ndi matenda a shuga 2 - osagwirizana ndi insulin omwe amadalira pakamwa motsutsana ndi hypoglycemic mankhwala omwe amatengedwa pakamwa, komanso matendawa. .

Contraindication kugwiritsa ntchito mankhwalawa ndi hypoglycemia ndi kudziwa kwambiri thupi insulin, amene amapatsidwa mankhwala.

Osagwiritsa ntchito NovoRapid wa ana ochepera zaka zisanu ndi chimodzi chifukwa chakusowa kwa maphunziro azachipatala.

Mankhwala "NovoRapid": malangizo ogwiritsira ntchito

Mankhwala NovoRapid ndi analogue a insulin. Imayamba kuchita nthawi yomweyo jekeseni. Mlingo wa wodwala aliyense ndiwawokha ndipo amasankhidwa ndi adokotala. Kuti mukwaniritse bwino, timadzi timeneti timaphatikizidwa ndi insulin ya nthawi yayitali kapena yapakati.

Pofuna kuthana ndi glycemia, kuchuluka kwa shuga m'magazi kumayeza nthawi zonse ndipo mlingo wa insulin umasankhidwa mosamala. Monga lamulo, mlingo wa tsiku ndi tsiku wa akulu ndi ana umachokera ku 0.5-1 U / kg.

Mukalandira jekeseni wa mankhwala a NovoRapid (malangizo omwe angagwiritsidwe ntchito amafotokozera mwatsatanetsatane dongosolo la mankhwalawa), kufunikira kwa insulin kumaperekedwa ndi 50-70%. Ena onse amakhutitsidwa ndi kuyendetsedwa kwa insulin yayitali (ya nthawi yayitali). Kuwonjezeka kwa zochita zolimbitsa thupi kwa wodwala komanso kusintha kwa zakudya, komanso zomwe zikuchitika kale, zimapangitsa kusintha kwa mlingo womwe waperekedwa.

Hormons NovoRapid, mosiyana ndi munthu wosungunuka, amayamba kuchita zinthu mwachangu, koma osapitirira. Pang'onopang'ono makonzedwe a insulini akusonyezedwa. Algorithm ya jakisoni imaphatikizapo kugwiritsa ntchito mankhwala musanadye chakudya, ndipo ngati pakufunika thandizo, mankhwalawa amagwiritsidwa ntchito mukangodya.

Chifukwa chakuti NovoRapid amachita thupi kwakanthawi kochepa, chiopsezo cha hypoglycemia usiku mwa odwala matenda a shuga amachepetsa kwambiri.

Odwala okalamba, komanso mwa anthu omwe ali ndi vuto la impso kapena hepatic, kuwunika kwa shuga wamagazi kumayenera kuchitika pafupipafupi, ndipo kuchuluka kwa insulini ya insulin kumasankhidwa payekha.

Ana "NovoRapid" amalowa m'malo mwa insulin ya anthu, koma pokhapokha ngati mukufuna mankhwala mwachangu. Amagwiritsidwa ntchito ngati mwana sasunga nthawi yomwe akufuna pakati pa jakisoni ndi chakudya. Ngati wodwala wasamutsidwa ku NovoRapid kuchokera ku mankhwala ena okhala ndi insulin, kusintha kwa mlingo, komanso basal insulin, kumafunika.

Subcutaneous makonzedwe a insulini (mahomoni a jekeseni algorithm akufotokozedwa mwatsatanetsatane mu malangizo ogwiritsira ntchito) amaphatikiza jekeseni wam'mimba, ntchafu, brachial and deltoid minofu, komanso matako. Malo omwe jakisoni amapangidwira amasinthidwe kupewa lipodystrophy.

Ndi kuyambitsa kwa mahomoni m'dera lakunja la peritoneum, mankhwalawa amalowetsedwa mwachangu kuposa jakisoni mbali zina za thupi. Kutalika kwa mphamvu ya timadzi timene timakhudzidwa ndi kuchuluka kwa malo, jakisoni, kuchuluka kwa magazi, kutentha kwa thupi, kuchuluka kwa zochita zolimbitsa thupi.

Njira "NovoRapid" imagwiritsidwa ntchito pa infusionsaneous infusions, yomwe imachitika ndi pampu yapadera. Mankhwalawa amalowetsedwa mu anterior peritoneum, koma malo amasinthidwa nthawi ndi nthawi. Ngati pampu ya insulin ikugwiritsidwa ntchito, NovoRapid sayenera kusakanikirana ndi mitundu ina ya insulin yomwe ilimo. Odwala omwe amalandila mahomoni ogwiritsira ntchito kulowetsedwa ayenera kukhala ndi chithandizo chamankhwala ngati chitha kuperewera.

NovoRapid itha kugwiritsidwa ntchito pakukonzekera intravenous, koma njirayi iyenera kuchitika ndi akatswiri odziwa zaumoyo. Kwa mtundu wamtunduwu, ma kulowetsedwa kulowetsedwa nthawi zina amagwiritsidwa ntchito, pomwe insulin imakhala ndi kuchuluka kwa 100 PIECES / ml, ndipo ndende yake ndi 0.05-1 PIECES / ml. Mankhwalawa amathandizira mu 0,9% sodium chloride, 5 ndi 10% dextrose yankho, lomwe limakhala ndi potaziyamu mankhwala ena mpaka 40 mmol / L. Ndalama zomwe zimanenedwa zimasungidwa kutentha kwawofunda osaposa tsiku limodzi. Ndi insulin infusions, muyenera kuperekera magazi pafupipafupi m'magazi.

Momwe mungawerengere kuchuluka kwa insulin?

Kuti mupeze kuchuluka kwa mankhwalawa, muyenera kudziwa kuti insulin imaphatikizidwa, yayitali (yowonjezera), yapakati, yochepa komanso ya ultrashort. Yoyamba matenda a shuga. Zimayambitsidwa pamimba yopanda kanthu. Amawonetsedwa kwa anthu omwe ali ndi matenda a shuga amtundu woyamba 1. Pali anthu omwe amagwiritsa ntchito mtundu umodzi wa insulini okha - wowonjezera. Anthu ena amagwiritsa ntchito NovoRapid pokhapokha kuti achulukane mwadzidzidzi m'magazi. Zovuta zazifupi, zazitali zimatha kugwiritsidwa ntchito nthawi imodzi pochiza matenda ashuga, koma zimaperekedwa nthawi zosiyanasiyana. Kwa odwala ena, kugwiritsa ntchito mankhwala palokha kumathandizira kuti akwaniritse zomwe mukufuna.

Mukamasankha insulin yayitali, zovuta zina ziyenera kukumbukiridwa. Mwachitsanzo, ndikofunikira kuti popanda kubaya joni yochepa komanso zakudya zoyambirira, shuga azikhala wofanana tsiku lonse lonse chifukwa cha insulin yayitali.

Kusankhidwa kwa mlingo wa insulin yayitali kwakhala motere:

M'mawa, popanda kadzutsa, yeretsani shuga.
Chakudya chamasana chimadyedwa, ndipo patatha maola atatu, shuga wa m'magazi amatsimikiza. Miyezo ina imachitika nthawi iliyonse musanagone. Patsiku loyamba la kusankha mankhwalawa, vumphani nkhomaliro, koma idyani chakudya chamadzulo.
Patsiku lachiwiri, chakudya cham'mawa ndi nkhomaliro amaloledwa, koma chakudya chamadzulo sichiloledwa. Shuga, komanso patsiku loyamba, amafunika kuwongoleredwa ola lililonse, kuphatikiza usiku.
Pa tsiku lachitatu, amapitilizabe miyeso, kudya pafupipafupi, koma osapereka insulin yayifupi.

Zizindikiro zoyenera m'mawa ndi:

tsiku la 1 - 5 mmol / l,
patsiku la 2 - 8 mmol / l,
pa tsiku la 3 - 12 mmol / l.

Zizindikiro za glucose zotere ziyenera kupezeka popanda mahomoni othamangitsa. Mwachitsanzo, ngati m'mawa shuga ali ndi 7 mmol / l, ndipo madzulo - 4 mmol / l, ndiye izi zikuwonetsa kufunikira kochepetsera muyeso wa mahomoni atali ndi 1 kapena 2 ma unit.

Nthawi zambiri, odwala amagwiritsa ntchito fomula ya Forsham kuti adziwe kuchuluka kwa tsiku lililonse. Ngati glycemia ikuchokera ku 150-216 mg /%, ndiye kuti 150 amatengedwa kuchokera pamlingo woyeserera wamagazi ndipo chiwerengero chotsalazo chimagawidwa ndi 5. Zotsatira zake, gawo limodzi la mahomoni ataliatali limapezeka. Ngati glycemia idutsa 216 mg /%, 200 imachotsedwa pa shuga woyezedwa, ndipo zotsatira zake zimagawidwa ndi 10.

Kuti mudziwe kuchuluka kwa insulin yayifupi, muyenera kuyeza kuchuluka kwa shuga sabata yonse. Ngati zinthu zonse zatsiku ndi tsiku zili zabwinobwino, kupatula madzulo, ndiye kuti insulin yochepa imangoperekedwa musanadye chakudya chamadzulo. Ngati shuga azidumphira chakudya chilichonse, ndiye kuti jakisoni amaperekedwa musanadye.

Kuti mudziwe nthawi yomwe mahomoni amayenera kuperekedwera, shuga ayenera kuyesedwa mphindi 45 asanadye. Kenako, muziwongolera shuga mphindi zisanu zilizonse kufikira mulingo wake wafika 0,3 mmol / l, mutatha kudya. Njirayi imalepheretsa kuyamba kwa hypoglycemia. Ngati pambuyo pa mphindi 45 shuga sichepa, muyenera kudikirira ndi chakudya mpaka glucose atatsikira pamlingo womwe mukufuna.

Kuti mudziwe kuchuluka kwa insulin ya ultrashort, anthu omwe ali ndi matenda amtundu wa 1 ndi mtundu wa 2 amalangizidwa kuti azitsatira zakudya sabata imodzi. Yang'anani kuchuluka kwa zakudya zomwe amadya. Musapitirire kuchuluka kwa chakudya chololedwa. Muyeneranso kuganizira zolimbitsa thupi za wodwalayo, mankhwala, kukhalapo kwa matenda osachiritsika.

Ultrashort insulin imayendetsedwa kwa mphindi 5-15 musanadye. Momwe mungawerengere mlingo wa NovoRapid insulin pamenepa? Tiyenera kukumbukira kuti mankhwalawa amachepetsa mphamvu ya glucose nthawi 1.5 mopitilira malo ake achidule. Chifukwa chake, kuchuluka kwa NovoRapid ndi 0,4 peresenti ya homoni yochepa. Muyezo ungadziwike makamaka pokhapokha poyesa.

Mukamasankha kuchuluka kwa insulini, kuchuluka kwa matendawa kuyenera kuganiziridwanso, komanso kuti kufunika kwa matenda ashuga aliwonse m'thupi la munthu sikupitirira 1 U / kg Kupanda kutero, bongo amatha kuchitika, zomwe zimayambitsa zovuta zingapo.

Malamulo oyenera kudziwa mtundu wa odwala matenda ashuga:

Kumayambiriro kwa matenda a shuga 1, mankhwalawa sayenera kupitirira 0,5 U / kg.
Mtundu woyamba wa shuga, womwe umayang'aniridwa ndimadwala kwa chaka chimodzi kapena kupitilira, kuchuluka kwa insulin komwe kumayendetsedwa ndi 0.6 U / kg.
Ngati matenda amtundu wa shuga 1 amaphatikizidwa ndi matenda oopsa angapo ndipo ali ndi zizindikiro zosakhazikika zamagulu am'magazi, kuchuluka kwa timadzi ndi 0.7 U / kg.
Mu matenda a shuga a mellitus, kuchuluka kwa insulin ndi 0,8 U / kg.
Ngati matenda a shuga ali ndi ketoacidosis, ndiye kuti pafupifupi 0,9 U / kg ya mahomoni amafunikira.
Pa nthawi yoyembekezera, mayi wachitatu trimester amafunika 1.0 U / kg.

Kuti muwerenge mlingo umodzi wa insulini, mlingo wa tsiku ndi tsiku uyenera kuchulukitsidwa ndi kulemera kwa thupi ndikugawidwa ndi awiri, ndipo chizindikiro chomaliza chikuyenera kuzunguliridwa.

Kugwiritsa ntchito mankhwala "NovoRapid Flexpen"

Kukhazikitsidwa kwa hormone kumatha kuchitika pogwiritsa ntchito cholembera "NovoRapid Flexpen." Imakhala ndi zolembera zamtundu ndi chothandizira. Mlingo wa insulini womwe umayendetsedwa kuchokera ku 1 mpaka 60 mayunitsi, gawo limodzi la syringe ndi 1 unit. Mu mankhwalawa "NovoRapid" mankhwalawa amagwiritsidwa ntchito TM "Novotvist" kapena "Novofine" kutalika kwa 8 mm. Ngati mugwiritse ntchito cholembera, kumbukirani kuti: nthawi zonse muyenera kukhala ndi pulogalamu yopanda jakisoni wothandizirana ndi inu - kuti syringeyo itawonongeka kapena itayika.

Musanayendetse ma cell ndi cholembera, muyenera:

Werengani malembedwewo ndikuonetsetsa kuti NovoRapid ndiye insulini yomwe mukufuna.
Chotsani kapu ku cholembera.
Chotsani chomata chomwe chili pa singano yotayika.
Vulani singano m'manja. Pangofunika singano yatsopano pa jekeseni iliyonse kuti muchepetse kukula kwa mabakiteriya. Singano siyenera kuti ikhale yopindika kapena kuwonongeka.
Kuti mupewe jakisoni mwangozi pa singano mutatha kuperekera insulin, kapu sikuvalira.

Cholembera cha NovoRapid chingwe chitha kukhala ndi mpweya wochepa mkati. Kuti thovu la okosijeni lisadziunjike, ndipo mulingo woyamwa umaperekedwa molondola, malamulo ena ayenera kutsatiridwa:

Imbani 2 PESCES ya mahormone potembenuzira mlingo wosankha.
Ikani cholembera pakati ndi singano ndikukoka cartridge ndi chala chanu. Chifukwa chake ma thovu am'mlengalenga amasamukira kudera lapamwamba.
Mukugwira syringe ya FlexPen mozondoka ndi singano, kanikizani batani loyambira njira yonse. Osankha dosing panthawiyi abwerera ku "0" malo. Dontho limodzi la mahomoni limawonekera pa singano. Ngati izi sizingachitike, njirayi ikhoza kubwerezedwa kasanu ndi kamodzi. Ngati insulin singayende, ndiye kuti syringe ndi yopanda tanthauzo.

Musanakhazikitse mlingo, muyenera kuwonetsetsa kuti chosankha cha dosing chili mu "0". Chotsatira, muyenera kuyimba manambala omwe amafunikira, kuchuluka kwa mankhwalawo kumayendetsedwa ndi osankhidwa mbali zonse ziwiri. Mukakhazikitsa mlingo, muyenera kusamala ndikuyesera kuti musagunde mwangozi batani loyambira, apo ayi kutulutsidwa kwa mahomoni kumachitika. Ndikosatheka kukhazikitsa njira yoposa yomwe ili pokonzekera "NovoRapid". Komanso, musagwiritse ntchito muyeso wotsalira kuti mudziwe kuchuluka kwa mahomoni.

Panthawi ya insulin, njira yolimbikitsidwa ndi adotolo imatsatiridwa. Kuti mupeze jakisoni, dinani batani loyambira. Gwirani mpaka mlingo wosankha uli mu "0". Pa jakisoni, batani loyambira lokha limachitika. Munthawi yoyenera ya kuzungulira kwa chisonyezo, kuperekera kwa insulin sikuchitika.

Pambuyo pa jekeseni, singano pansi pa khungu iyenera kumenyedwa kwa masekondi ena asanu ndi limodzi, osatulutsa batani loyambira. Chifukwa chake mlingo wa insulin umayambitsidwa kwathunthu. Pambuyo pa jekeseni, singanoyo imatumizidwa kumtunda wakunja, ndipo ikalowa, imasulidwa ndikuitaya, ndikusamala. Kenako syringe imatsekedwa ndi chipewa. Singano imachotsedwa pakatha jekeseni iliyonse ndipo singathe kusungidwa ndi cholembera. Kupanda kutero, madzimadzi amatha kutayikira, zomwe zingayambitse kuyambitsa kwa cholakwika. Malangizo ogwiritsira ntchito akufotokozerani zambiri za momwe mungabayire insulin ya NovoRapid.

Mtengo wa mahormone

Mankhwala a NovoRapid amamasulidwa mosamala malinga ndi zomwe dokotala wanena. Mtengo wa makatiriji a Penfill asanu ndi pafupi 1800 rubles. Mtengo wa hormone Flexpen ndi ma ruble 2,000. Phukusi limodzi lili ndi zolembera zisanu za Novorapid insulin. Mtengo kutengera nambala yogawa ingasiyane pang'ono.

Ndemanga za Odwala

Ndi ndemanga ziti za NovoRapid? Anthu amati ndibwino insulin. Machitidwe mwachangu. Yoyenerera mankhwalawa a matenda amtundu wa 1 shuga, momwe shuga yamagazi ndi yovuta kuchepetsa. Odwala ambiri amagwiritsa ntchito mankhwalawa matenda a shuga amitundu iwiri. Ambiri mwa anthu odwala matenda ashuga amapeza syringes ya Flexpen yabwino kwambiri. Amathetsa kufunika kogulira ma syringe payokha.

Monga lamulo, odwala amagwiritsa ntchito mankhwala a NovoRapid motsutsana ndi maziko a insulin yayitali, omwe amathandiza kukhala ndi shuga nthawi zonse tsiku lonse. Zimathandizira kutsitsa shuga m'magazi mukatha kudya, zomwe zimapangitsa moyo kukhala wosavuta kwa anthu ambiri odwala matenda ashuga komanso amakulolani kudya kunja kwa nthawi ya sukulu. Anthu ena amalangizira poyambira matendawa kuti azigwiritsa ntchito timadzi timeneti tu.

Pali anthu omwe amati akaperekedwa kwa ana aang'ono, mankhwalawa amayambitsa kusintha kwadzidzidzi m'magazi a shuga, chifukwa chomwe ana amamva kuti sakukonda. Kuti izi zisachitike, makolo ambiri amakonda inshuwaransi yayitali ya NovoRapida.

Odwala ambiri amawona kuti mlingo wosankhidwa molakwika nthawi zambiri umakwiyitsa zimachitika za hypoglycemia ndipo umakula. Kuti mupewe zoterezi, musamadziderere, koma pemphani thandizo kwa akatswiri.

Gulu la Nosological (ICD-10)

Yothetsera subcutaneous ndi mtsempha wa magazi makonzedwe	1 ml
ntchito:
insulin	ZIWANDA 100 (3.5 mg)
zokopa: glycerol - 16 mg, phenol - 1.5 mg, metacresol - 1.72 mg, nthaka ya calcium - - 19.6 μg, sodium kolorayidi - 0.58 mg, sodium hydrogen phosphate diabetes - 1,25 mg, sodium hydroxide 2M - pafupifupi 2 , 2 mg, 2M hydrochloric acid - pafupifupi 1.7 mg, madzi a jakisoni - mpaka 1 ml
Makatoni amodzi amakhala ndi 3 ml ya yankho, lofanana ndi 300 PIERES.

Mankhwala

Insulin aspart - analogue yafupi ya anthu omwe akuchita insulin yopangidwa ndi recombinant DNA biotechnology pogwiritsa ntchito kupsyinjika Saccharomyces cerevisiae momwe amino acid proline pa B28 imayimidwira ndi aspartic acid.

Imalumikizana ndi cholandirira chapadera pa cell ya cytoplasmic ya maselo ndikupanga insulin receptor zovuta zomwe zimapangitsanso zochitika zina, kuphatikizapo kaphatikizidwe angapo ofunikira a michere (kuphatikizapo hexokinase, pyruvate kinase, glycogen synthase). Kutsika kwa shuga m'magazi kumachitika chifukwa chophatikizira Kuchulukitsa kayendedwe kake kakang'ono kwambiri, kumathandizira kutulutsa minofu, zolimbikitsa lipogenesis, glycogenogeneis, ndikuchepetsa kuchuluka kwa shuga ndi chiwindi.

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 nthawi ya insulin aspart pambuyo pa sc makonzedwe amafupikirako kuposa omwe sungunuka wa insulin.

Pambuyo pa sc makonzedwe, mankhwalawa amayamba 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 a shuga 1 amawonetsa kuchepa kwam'magazi kwa glucose wama insulin poyerekeza ndi insulin yamunthu.

Okalamba. Kafukufuku wosasinthika, wakhungu lambiri, wophatikizidwa kwa pharmacokinetics ndi pharmacodynamics (FC / PD) wa insulin aspart ndi sungunuka wa insulin wa anthu odwala okalamba omwe ali ndi mtundu wa 2 shuga mellitus (19 odwala azaka 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 insulin yaumunthu yosungunuka musanadye chakudya komanso asipilini atatha kudya adachitidwa mwa ana aang'ono (odwala 26 azaka za 2 mpaka 6), ndipo kafukufuku umodzi wa FC / PD unachitika mwa ana (6- Wazaka 12) ndi achinyamata (wazaka 13-17). 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.

Mayeso ena azachipatala a azimayi 27 omwe ali ndi gestational matenda a shuga omwe amalandila insulin aspart ndi insulin ya anthu (insulin aspart analandila azimayi 14, insulin 13 ya anthu) adawonetsa kuyesana kwa mapulogalamu achitetezo komanso kusintha kwakukulu pakulamulira kwa glucose wa postprandial ndi chithandizo cha insulin.

Deta Yotetezera

Kafukufuku wammbuyo sanawonetse vuto lililonse kwa anthu, potengera kafukufuku wovomerezeka wazachipatala, kuwopsa kwa kugwiritsidwa ntchito mobwerezabwereza, genotoxicity komanso kubereka kawopsedwe.

M'mayeso mu vitro , kuphatikizapo kumangiriza ma insulin receptors ndi insulin-like grow factor-1, komanso momwe zimakhudzira kukula kwa maselo, machitidwe a insulini amafanana kwambiri ndi insulin ya anthu. Kafukufuku adawonetsanso kuti kudzipatula kumangiriza kwa insulin receptor ndikofanana ndi insulin yaumunthu.

Pharmacokinetics

Pambuyo sc makonzedwe a insulin zofunika T _max plasma, pafupifupi, 2 nthawi zosakwana pambuyo makonzedwe a sungunuka wa munthu insulin. Ndi _max mu plasma, pafupifupi (492 ± 256) pmol / l ndipo amakwaniritsidwa mphindi 40 pambuyo pa kuperekedwa kwa mlingo wa 0,15 U / kg kwa odwala omwe ali ndi matenda a shuga 1. mankhwala. Kuchuluka kwa mayamwa kumacheperachepera odwala omwe ali ndi matenda amtundu wa 2, omwe amachititsa kuti azikhala ndi chidwi chambiri - (352 ± 240) pmol / L - komanso T yayitali _max (60 min). Kusiyanasiyana kwa munthu payekha T _max Amatsika kwambiri akamagwiritsa ntchito insulin aspart poyerekeza ndi insulin yamunthu, pomwe kusiyanasiyana kwa C _max kwa aspart insulin yambiri.

Pharmacokinetics mu ana (wa zaka 6 mpaka 12) ndi achinyamata (wazaka 13 mpaka 17) wokhala ndi mtundu woyamba wa matenda a shuga. Kuyamwa kwa insulini kumachitika msanga m'magulu onse a T ndi T _max chimodzimodzi ndi akulu. Komabe, pali zosiyana C _max m'magulu awiri azaka, zomwe zimagogomezera kufunika kwa kuchuluka kwa mankhwala.

Okalamba. Kusiyana kwapakati pa pharmacokinetics pakati pa insulin aspart ndi solulin ya insulin ya anthu odwala okalamba (zaka 65-83, zaka zapakati zaka 70) zamtundu wa 2 wodwala matenda ashuga anali ofanana ndi odzipereka athanzi komanso odwala achinyamata omwe ali ndi matenda a shuga. Mwa odwala okalamba, kuchepa kwa kuchuluka kwa mayamwidwe kunawonedwa, zomwe zinayambitsa kuwonjezeka kwa T _max - 82 (kusiyanasiyana 60-120) mphindi, 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 matenda a shuga 1.

Kuperewera kwa chiwindi. Kafukufuku wa pharmacokinetics adachitika ndikukhazikitsa njira imodzi ya insulin aspart odwala 24 omwe chiwindi chake chimagwira ntchito kuchokera pakazoloweka mpaka kuwonongeka kwambiri. Odwala omwe ali ndi vuto la chiwindi, kuchuluka kwa mayamwidwe a insulini kunachepetsedwa komanso kusinthasintha, zomwe zimapangitsa kuchuluka 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. AUC, C _max mu plasma ndi chilolezo chokwanira (Cl / F) anali ofanana mwa anthu omwe amachepetsa komanso amakhala ngati chiwindi.

Kulephera kwina. Kafukufuku adachitika pa pharmacokinetics of insulin aspart mwa odwala 18 omwe ntchito yawo yaimpso imachokera pachizolowezi mpaka kuwonongeka kwambiri. Palibe zowoneka ngati Cl creatinine pa AUC, C adapezeka _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.

Mimba komanso kuyamwa

Zotsatira zoyipa

Zotsatira zoyipa zomwe zimawoneka mwa odwala omwe amagwiritsa ntchito NovoRapid ® Penfill ® zimachitika makamaka chifukwa cha kupangika kwa mankhwala a insulin.

Chotsatira chovuta kwambiri ndi hypoglycemia.

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

Mndandanda wazotsatira zoyipa zimaperekedwa pagome.

Zoyipa zonse zomwe zafotokozedwa pansipa, kutengera mtundu wa mayeso azachipatala, zimayikidwa m'magulu molingana ndi kukula kwa chitukuko malinga ndi MedDRA ndi machitidwe a ziwalo. Makulidwe azovuta amakumana ndi izi: kawirikawiri (≥1 / 10), nthawi zambiri (≥1 / 100, ® Penfill ® ikhoza kuyambitsa kuwonongeka kwa insulin. NovoRapid ® Penfill ® sayenera kusakanikirana ndi mankhwala ena. Kupatula ndi isofan-insulin ndi mayankho a kulowetsedwa ofotokozedwa mu gawo "Mlingo ndi Ulamuliro".