The zikuchokera mankhwala "NovoMix 30 Flexpen", kumasulidwa mawonekedwe, zikuonetsa, contraindication, limagwirira, mtengo, analogues ndi ndemanga

NovoMix 30 FlexPen ndi mankhwala ophatikiza omwe amagwiritsidwa ntchito popanga matenda a shuga mellitus osiyanasiyana a etiology. Munkhaniyi tiunika "NovoMix Penfill" - malangizo ogwiritsira ntchito.

Yang'anani! Mu gulu la anatomical-Therapeutic-kemikali (ATX), "NovoMix 30" akuwonetsedwa ndi code A10AD05. Dzinalo Lopanda tanthauzo Lonse (INN): Insulin aspart biphasic.

Zothandiza pazitsulo:

• Soluble (30%) insulin aspart ndi ma protein a protamine (70%).

Mankhwalawa amakhalanso ndi zokutengani.

Pharmacodynamics ndi pharmacokinetics

NovoMix ndi analogue othamanga omwe amakhala ndi insulin okhala nthawi yayitali pafupifupi 3 mpaka 5 maola. Novomix amayamba kuchita zinthu nthawi yomweyo atangoyendetsa (pakadutsa mphindi 10). Mankhwalawa amayeserera kuyankha kwa kapamba wabwino ndi chakudya. Pakadali pano, kugwiritsa ntchito insulin yocheperako-pang'onopang'ono nthawi zambiri kumakhala kofunika kugwiritsa ntchito mankhwala osakhalitsa, chifukwa imatha kuperekedwa mwachangu musanadye (kapena ngakhale nthawi ya kapena itatha). Insulin imachepetsa shuga ndipo motero shuga. Insulin imalepheretsa gluconeogeneis ndi glycogenolysis mu chiwindi.

Chachikulu pharmacological zotsatira za mankhwala:

• Kupititsa patsogolo mayamwidwe am'magazi m'misempha ndi mafuta,
• Kupititsa patsogolo kwa kapangidwe ka glycogen m'maselo am'mimba ndi chiwindi,
• Kupititsa patsogolo kwamafuta acid,
• Kuphatikiza kwamphamvu mapuloteni, mwachitsanzo, mu minofu minofu.

Mankhwalawa ali ndi zovuta zotsutsana ndi glucagon, adrenaline, cortisol ndi mahomoni ena omwe amalimbikitsa glycemia.

Novomix 30 imaposa yomwe idakhazikitsira (NovoRapid) molingana ndi kuthamanga kwa kuchitapo kanthu, koma imathandizanso kukhala ndi hypoglycemia yowopsa pamitundu yosadalira insulin. Kafukufuku waposachedwa wa Phase III wotsogozedwa ndi Dr. Keith Boehring awonetsa kuti mankhwalawa amatha kuwonjezera hypoglycemia.

Omwe anali nawo anali 689 odwala matenda a shuga a mtundu wachiwiri omwe ali ndi monosaccharides omwe samalamuliridwa bwino, omwe anapitiliza kumwa mankhwala a insulin komanso amkamwa motsutsana ndi mankhwalawo. Mukamagwiritsa ntchito NovoMix, kutsekemera kwa shuga m'magazi kunatsitsidwa ola limodzi mutatha kudya kuposa kumwa insulin. Nthawi zambiri, odwala adakumana ndi hypoglycemia maola awiri atatha kudya, ngati amamwa mankhwalawa.

Izi zitha kukhumudwitsa kampani komanso mwina madokotala ena. Mapeto ake, ambiri amayembekeza kuti apeze mwayi wothandizira mwachangu zinthu zomwe zitha kupezeka m'mizere 4, yomwe ili pafupifupi mphindi 5 m'mbuyomu kuposa pamene amatenga NovoRapid.

Zizindikiro ndi contraindication

• Posachedwa wapezeka ndi matenda a shuga a glycemia a 16.7 mmol / L ndi mawonetsedwe ena othandizira,
• Mimba
• Myocardial infarction (mankhwala osachepera miyezi itatu itatha matenda a mtima),
• Dziwitsani matenda a LADA (matenda a shuga a autoimmune)
• HbA1c (glycated hemoglobin) woposa 7%,
• Kukhumba kwa wodwala.

Chizindikiro chodziwika bwino ndi shuga wodalira insulin. Chomwe chimayambitsa matenda a shuga 1 sichidziwikabe. Zonse zokhudzana ndi chilengedwe komanso chibadwa zimathandizira nawo kumayambiriro kwa matendawa.

Mu matenda a shuga amtundu wachiwiri, thupi limatha kutulutsa mahomoni, koma limasiya kugwira ntchito pama cell. Matenda a shuga omwe samadalira insulin nthawi zambiri amakula kwakanthawi. Zingatenge zaka zingapo kuti zitheke kwambiri insulin. Poyamba, thupi limatha kulipira chidwi chochepetsedwa cha maselo kuti apange insulini pakukulitsa kapangidwe kake. Ngati matenda ashuga samalandiridwa, zimabweretsa kufooka kwathunthu kwa insulin. Kwa odwala matenda a shuga omwe amadalira insulin, NovoMix imangokhazikitsidwa pokhapokha kusintha kwamachitidwe ndi zinthu zomwe zimagwira pakamwa sizigwira ntchito.

Ntchito yayikulu ya odwala matenda ashuga ndikutsanzira ntchito za kapamba momwe angathere. Insulin yomwe yapakidwa pang'onopang'ono insulin yamunthu imatengedwa pang'onopang'ono kuchokera ku minofu, chifukwa ma hexamers ayenera kuyamba kuwola ngati opanga kuti athe kulowa m'magazi.

Mu diabetes 1 mtundu, mankhwalawa adagwira mwachangu komanso mwamphamvu kuposa NovoRapid. Zotsatira zake, kuchuluka kwa shuga m'magazi kumatha kudya. Ngakhale sizinanenedwe mwatsatanetsatane ngati kuyendetsa bwino shuga wa postprandial kungakhale ndi zotsatira zabwino popewa zovuta za matenda ashuga. Komabe, kafukufuku wa 2000 omwe adafalitsidwa mu magazini yotchedwa Diabetes Care adawonetsa kuti chiopsezo cha zovuta za microvascular chikuwonjezeka kwambiri ndi shuga wamkulu wa postprandial.

Pakufufuza kwa Onset2, odwala 689 omwe ali ndi matenda a shuga a 2 adalandira NovoMix kapena NovoRapid kwa masabata 26 omwe amadya zakudya limodzi ndi metformin. Komanso mu kafukufukuyu, kuchepa kwa HBA1c kunali chimodzimodzi m'magulu onse awiri. Mankhwalawa adachepetsa kuchuluka kwa postprandial saccharides kwambiri pambuyo ola limodzi kapena awiri kuposa NovoRapid. M'maphunziro onse awiri, mankhwalawa sanawonjezere hypoglycemia.

• Hypersensitivity mankhwala
• Hypoglycemia.

Mlingo ndi bongo

Malinga ndi malangizo, jakisoni wa insulin nthawi zambiri amachitidwa ndi wodwalayo ndi cholembera. Kuti izi zitheke, othandizira amapanga ndandanda yolumikizirana ndi wodwala (yemwenso amatchedwa "regimen"). Ndandanda iyi ikuwonetsa mitundu ya insulin yomwe imagwiritsidwa ntchito komanso nthawi yomwe iyenera kuperekedwa. Mutha kupaka jakisoni (ndi singano) mutagwirizana pa mlingo wa chinthu.

Cholinga ndikuyerekeza kutulutsa kwa insulini kuchokera ku chithokomiro chathanzi, komanso kusintha mankhwalawo kukhala moyo wa wodwalayo. Pazomwezi, kuphatikiza kwa insulin yayitali kapena yapakatikati, komanso zinthu zazifupi kapena zazing'onoting'ono, zimagwiritsidwa ntchito nthawi zonse. Mankhwala omwe amagwiritsidwa ntchito kwa nthawi yayitali amathandizidwa kamodzi kapena kawiri patsiku: amathandiza kutsanzira basal ndikutulutsa kosalekeza kwa insulin. Kukonzekera kwa ultrashort kumayendetsedwa kangapo patsiku, nthawi zambiri asanadye, kuyerekeza kuchuluka kwa mahomoni a insulin atatha kudya.

Kupambana kwa chithandizo cha insulin kwa nthawi yayitali kumatengera osati mankhwala omwe asankhidwa, komanso pazinthu zina - kudzipereka kwa odwala pakudya ndi moyo wawo. Zotsatira za insulin zimabweretsa pokhapokha ngati wodwala (ambiri) ali ndi shuga ya magazi yomwe imagwera panthawi yomwe mukufuna. Mulingo wabwinobwino wa odwala matenda ashuga pamimba yopanda kanthu ndi 4 mmol / L, ndipo pambuyo chakudya - 10 mmol / L.

Kudzi kudziletsa kwa glycemia ndikofunikira kwambiri pakuthandizira matenda aliwonse a matenda ashuga. Kudziyang'anitsitsa kumachitika poyesa mulingo wa ma securgesides m'magazi. Izi nthawi zambiri zimachitika kamodzi kapena kangapo patsiku pogwiritsa ntchito glucometer. Dokotala amayeneranso kuyeza kuchuluka kwa HbA1c. Kutengera zomwe mumayesa, ndikofunikira kusintha makonzedwe a insulin.

Kudziyang'ananso ndikofunikira kuti insulini ichotsere hypoglycemia (shuga wochepa kwambiri wamagazi). Ndi chithandizo cha insulin choyenera, chiopsezo cha hypoglycemia chitha kuchepetsedwa mpaka zero. Hypoglycemia nthawi zambiri sikuti imangokwiyitsa anthu, komanso imakhala pangozi yoopsa.

Kuchita

Mankhwalawa amatha kuyanjana ndi zinthu zonse zomwe zimakhudza mwachindunji kapena m'njira zina glycemia.

Maganizo a adotolo komanso odwala.

Mankhwalawa angagwiritsidwe ntchito musanadye kadzutsa, nkhomaliro kapena chakudya chamadzulo. NovoMix, malinga ndi kafukufuku, amachepetsa kwambiri zomwe zimapezeka m'magazi m'magazi. Mlingo uyenera kuvomerezedwa ndi adokotala.

Boris Alexandrovich, katswiri wa matenda ashuga

Ndimalowetsa mankhwala musanadye. Monga momwe mita ikuwonekera, mankhwalawa amachepetsa shuga. Zotsatira zoyipa sizikudziwika.