NovoMix 30 flexpen: ndemanga pakugwiritsa ntchito, malangizo

Analogue ya insulin ya anthu a nthawi yayitali.
Kukonzekera: NOVOMIX® 30 FlexPen ®
The yogwira mankhwala: insulin
ATX Encoding: A10AD05
KFG: Pakati-nthawi ya insulin yaumunthu yogwirizana ndi kuyamba mwachangu
Nambala yolembetsa: P. 015640/01
Tsiku lolembetsa: 04/29/04
Mwini reg. acc: NOVO NORDISK A / S

Kutulutsa mawonekedwe a Novomiks 30 flekspen, ma CD ndikuphatikizira ndi mankhwala.

Kuyimitsidwa kwa khungu loyera, likaphatikizika, limapanga choyera komanso chopanda utoto kapena chopanda utoto, poyambitsa mosamala, kuyimitsidwa kopepuka kuyenera.

1 ml
insulin aspart biphasic
100 PISITES *

Omwe amathandizira: mannitol, phenol, metacresol, zinc chloride, sodium chloride, sodium hydrogen phosphate dihydrate, protamine sulfate, sodium hydroxide, hydrochloric acid, madzi d / ndi.

* 1 unit imafanana ndi 35 mcg wa mankhwala osokoneza bongo a insulin.

3 ml - ma syringe ambiri omwe ali ndi mulingo wambiri (5) - ma CD.

Kufotokozera kwa mankhwalawa kumatengera malangizo ovomerezeka omwe angagwiritsidwe ntchito.

Zotsatira za pharmacological Novomix 30 flekspen

Analogue ya insulin ya anthu a nthawi yayitali. Imalumikizana ndi cholandirira chapadera pa cell ya cytoplasmic maselo ndikupanga insulini-receptor zovuta zomwe zimapangitsanso njira zina, kuphatikizapo kaphatikizidwe angapo ofunikira a michere (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.

NovoMix 30 Flexpen ndi kuyimitsidwa kwamitundu iwiri komwe kumakhala soluble insulin aspart (30%) ndi crystalline insulin aspart protamine (70%). Insulin aspart yomwe imapezeka ndi biotechnology (mu maselo a insulini, amino acid proline yomwe ili m'malo B28 imasinthidwa ndi aspartic acid.

Ikagwiritsidwa ntchito kwa odwala omwe ali ndi mtundu wa 1 komanso mtundu wa 2 matenda a shuga, NovoMix 30 FlexPen imathandizanso pamlingo wa glycosylated hemoglobin monga biphasic insulin yamunthu 30. Insulin aspart ndi insulin yaumunthu imachita zofananazo molar ofanana.

Mu insulin aspart, kulowetsedwa kwa amino acid proline pamalo B28 kwa aspartic acid kumachepetsa chizolowezi chopanga mamolekyulu kupanga hexamers m'chigawo chosungunuka cha NovoMix 30 FlexPen, chomwe chimawonedwa mu insulin ya anthu. Motere, insulin aspart imatengedwa kuchokera subcutaneous mafuta mwachangu kuposa sungunuka insulin yomwe ili ndi biphasic insulin ya munthu. Insulin aspart protamine, monga insulin ya munthu, imatengedwa nthawi yayitali.

Poyerekeza ndi insulin ya insulle ya anthu, insulin aspart (yolimbitsa thupi ya insulin ya anthu) imayamba kuchita zinthu mwachangu, kotero imatha kutumikiridwa musanadye (kuyambira 0 mpaka 10 mphindi musanadye). Zotsatira za crystalline insulin propart protamine (njira yapakatikati ya insulin yaumunthu) imafanana ndi ya insulin ya munthu. Pambuyo s / c makonzedwe a mankhwala a NovoMix 30 Flexpen, zotsatira zimayambika pambuyo 10 mphindi. Kuchuluka kwake kumawonedwa patatha maola 1-4 mutabayidwa. Kutalika kwa mankhwalawa kumafika maola 24.

Pharmacokinetics wa mankhwala.

Mukamagwiritsa ntchito NovoMix 30 FlexPen, Cmax ya insulini mu seramu imakhala yokwera 50% kuposa momwe mumagwiritsira ntchito insulin 30 ya anthu, pomwe nthawi yakufika ku Cmax imakhala yocheperako kawiri. Mankhwalawa akaperekedwa kwa odzipereka athanzi pamlingo wa thupi la 0.2 U / kg, pafupifupi Cmax anali 140 ± 32 pmol / L ndipo adafikiridwa pambuyo pa mphindi 60.

T1 / 2 yapakatikati, yowonetsa kufupika kwa kachigawo koyendetsedwa ndi protamine, ndi maola 8- 9. Ndende ya insulini yotsalira imabwelera ku chiyambi chake maola 15-18 patatha jekeseni wa s / c.

Odwala omwe ali ndi matenda a shuga a 2 mtundu, Cmax amafikiridwa pambuyo pa mphindi 95 ndipo amasungidwa kwambiri kuposa 0 maola osachepera 14 pambuyo pa kutsogozedwa kwa sc.

Kudalira kwa mayamwidwe a NovoMix 30 FlexPen pa tsamba la jakisoni sikunaphunzire.

Mlingo ndi njira ya mankhwala.

Mankhwalawa adapangira sc. Mankhwala a NovoMix 30 FlexPen sangathe kulowa / kulowa!

Mlingo umayikidwa payekha malinga ndi zomwe zimapangitsa shuga. Wapakati tsiku lililonse mlingo kuyambira 0,5 kuti 1 U / kg thupi. Ndi kukana kwa insulin (mwachitsanzo, odwala onenepa kwambiri), kufunikira kwa insulin tsiku ndi tsiku kumatha kuwonjezereka, ndipo odwala omwe ali ndi chinsinsi cha insulin yotulutsa, amatha kuchepetsedwa.

NovoMix 30 FlexPen ikhoza kugwiritsidwa ntchito mwa odwala omwe ali ndi mtundu wa 2 shuga mellitus mwina ngati monotherapy kapena kuphatikiza ndi metformin pokhapokha kuchuluka kwa glucose sikumayendetsedwa mokwanira ndi metformin yokha. Mlingo woyamba wa NovoMix 30 wophatikizidwa ndi metformin ndi 0,2 U / kg / tsiku. Mlingo uyenera kusinthidwa malinga ndi kufunika kwa insulin, kutengera zomwe zili m'magazi.

NovoMix 30 FlexPen iyenera kutumikiridwa musanadye, ngati n`kofunika mukangomaliza kudya. Kutentha kwa mankhwala omwe amaperekedwa kuyenera kukhala kutentha kwambiri.

Jekeseni imagwiritsidwa ntchito mu ntchafu kapena khoma lamkati, ngati mukufuna - paphewa kapena m'manja. Ndikofunikira kusintha malo a jekeseni mkati mwa anatomical dera kuti muchepetse kukula kwa lipodystrophy.

Monga kukonzekera kwina konse kwa insulin, kutalika kwa nthawi ya NovoMix 30 FlexPen kumatengera mlingo, malo oyendetsera, kutsika kwa magazi, kutentha ndi mulingo wa zolimbitsa thupi. Kudalira kwa mayamwidwe a NovoMix 30 FlexPen pa tsamba la jakisoni sikunaphunzire.

Malangizo ogwiritsira ntchito mankhwalawa NovoMix® 30 FlexPen ®

Flexpen ndi cholembera chopangira kupangira insulin. Flexpen imagwiritsidwa ntchito ndi singano zazifupi za NovoFayn. Kukhazikitsa kwa singano zazifupi za NovoFine kwalembedwa kuti S.

Simungagwiritse ntchito NovoMix 30 FlexPen ngati, mutagwedezeka, kuyimitsidwa sikusintha kukhala koyera komanso kwamitambo.

Mankhwalawa sayenera kugwiritsidwa ntchito ngati zotupa zoyera zikupezekamo kapena ngati tinthu tating'onoting'ono timamatira pansi kapena kukhoma la cartridge, ndikuwapatsa mawonekedwe owoneka ngati achisanu.

FlexPen Syringe cholembera ndiyoti azigwiritsa ntchito payekha ndipo sangakwaniritsidwe.

Malangizo atsatanetsatane ogwiritsira ntchito cholembera cha syringe ya FlexPen amaperekedwa mu malangizo azachipatala a NovoMix 30 FlexPen omwe amaikidwa phukusi lililonse.

Zotsatira zoyipa za Novomix 30 flekspen:

Zotsatira zoyipa zomwe zimakhudzana ndi kagayidwe kazachilengedwe: nthawi zambiri hypoglycemia, Zizindikiro zomwe zingaphatikizidwe ndi khungu, kuzizira thukuta, mantha, kunjenjemera, nkhawa, kutopa kapena zachilendo. kusokonezeka kwakanthawi kwakanthawi, mutu, nseru, tachycardia. Hypoglycemia ikhoza kuchititsa kuti musataye chikumbumtima, kusokonezeka kwakanthawi kapena kusasinthika kwa ubongo ndi kufa.

Zotsatira za matupi awo: kutulutsa kwakanthawi (komwe kumakhala kwakanthawi ndipo kumapita chithandizo chikapitirira) - redness, kutupa, kuyabwa pamalo opangira jakisoni, kuphatikiza (kupha moyo) - zotupa pakhungu, kuyabwa pakhungu, kuchuluka thukuta, kusokonezeka m'matumbo, angioedema, zovuta kupuma, tachycardia, kutsika magazi.

Zina: edema, kuphwanya kukhudzidwa (nthawi zambiri kumawonedwa kumayambiriro kwa chithandizo cha insulin ndipo ndikanthawi yochepa), kukula kwa lipodystrophy pamalo a jekeseni.

Zotsatira zamankhwala:

- kuchuluka kwa chidwi cha insulin kapena ziwalo zina za mankhwala.

Sikulimbikitsidwa kugwiritsa ntchito mankhwalawa mu ana ndi achinyamata ochepera zaka 18, chifukwa maphunziro azachipatala pakugwiritsa ntchito NovoMix 30 Flexpen mwa odwala a m'badwo uno sanachitike.

Gwiritsani ntchito pa nthawi yoyembekezera

Zochitika zamankhwala ndi insulin aspart panthawi yoyembekezera ndizochepa.

Munthawi ya kuyambika komanso nthawi yonse yomwe muli ndi pakati, kuwunika mosamala mkhalidwe wa odwala omwe ali ndi matenda osokoneza bongo ndikuwunika kuchuluka kwa shuga m'magazi a m'magazi ndikofunikira. Kufunika kwa insulini, monga lamulo, kumachepa mu trimester yoyamba ndipo pang'onopang'ono kumawonjezeka muyezo wachiwiri komanso wachitatu wamapazi oyembekezera. 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.

Panthawi yoyamwitsa, mankhwalawa amatha kugwiritsidwa ntchito popanda zoletsa. Kukhazikitsidwa kwa insulin kwa mayi woyamwitsa sikuopseza mwana. Komabe, zingakhale zofunikira kusintha mlingo wa NovoMix 30 FlexPen.

M'maphunziro oyesera nyama, palibe kusiyana komwe kunapezeka pakati pa embryotoxic ndi teratogenic zotsatira za insulin aspart ndi insulin ya munthu.

Malangizo apadera ogwiritsa ntchito Novomix 30 flekspen.

Mlingo wosakwanira kapena kusiya kulandira chithandizo, makamaka mtundu wa matenda a shuga 1 (wodwala-insulin), kungayambitse kukula kwa hyperglycemia kapena matenda ashuga a ketoacidosis.

Zizindikiro za hyperglycemia nthawi zambiri zimayamba pang'onopang'ono kwa maola angapo kapena masiku angapo ndipo zimaphatikizanso nseru, kusanza, kugona, kuyanika komanso khungu kuuma, pakamwa pouma, kutuluka kwamkodzo, ludzu komanso kusowa kwa chakudya, komanso mawonekedwe a fungo la acetone mu mpweya wotuluka. Popanda chithandizo choyenera, hyperglycemia imatha kupha.

Pambuyo kulipirira kagayidwe kazakudya, mwachitsanzo, ndi mankhwala olimbitsa kwambiri a insulin, odwala amatha kukumana ndi zisonyezo zam'mbuyomu za hypoglycemia, zomwe odwala ayenera kudziwitsidwa. 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.

NovoMix 30 FlexPen iyenera kugwiritsidwa ntchito molumikizana ndi kudya kwambiri. Muyenera kuganizira kuthamanga kwambiri kwa kuyambika kwa mphamvu ya mankhwalawa pochiza odwala omwe ali ndi matenda oyanjana kapena kumwa mankhwala omwe amachepetsa kuyamwa kwa chakudya. Pamaso pa matenda othandizira, makamaka a matenda opatsirana, kufunikira kwa insulin kumakulirakulira. Kuchepa kwa impso kapena hepatic kungayambitse kuchepa kwa insulin.

Kudumpha chakudya kapena masewera osakonzekera kungayambitse kukula kwa hypoglycemia. Poyerekeza ndi insulin yaumunthu ya biphasic, makonzedwe a NovoMix 30 FlexPen ali ndi mphamvu kwambiri pa hypoglycemic yoyamba maora 6 atatha. Pankhani imeneyi, nthawi zina, pangafunike kusintha mtundu wa insulin komanso / kapena mtundu wa zakudya.

Kusamutsa wodwala 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. Odwala omwe amasinthira ku NovoMix 30 FlexPen angafunike kusintha kwa mlingo poyerekeza ndi insulin yomwe kale idagwiritsidwa ntchito. Ngati ndi kotheka, kusintha kwa mlingo, mutha kupanga kale jakisoni woyamba wa mankhwalawa kapena mkati mwa milungu yoyamba kapena miyezi ya chithandizo. Kuphatikiza apo, kusintha kwa muyezo wa mankhwalawo kungafunike ndikusintha kwa zakudya komanso kuwonjezera mphamvu ya thupi. Kuchita masewera olimbitsa thupi ochitidwa mukangodya chakudya kumawonjezera chiopsezo cha hypoglycemia.

Osagwiritsa ntchito NovoMix 30 FlexPen pamapampu a insulin.

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.

Mankhwala osokoneza bongo:

Zizindikiro: hypoglycemia imayamba.

Chithandizo: wodwalayo amatha kuyimitsa hypoglycemia pakumeza shuga, shuga kapena zakudya zopatsa mphamvu. Chifukwa chake, odwala matenda a shuga amalangizidwa kuti azinyamula shuga, maswiti, makeke kapena mandimu okoma zipatso. Milandu yayikulu, ikasokonekera, 40% dextrose solution imalowetsedwa kudzera m'mitsempha, glucagon (0.5-1 mg) intramuscularly kapena subcutaneally. Pambuyo pakupezanso chikumbumtima, wodwalayo akulimbikitsidwa kudya zakudya zamafuta ambiri kuti aletse kukonzanso kwa hypoglycemia.

Mogwirizana wa Novomix 30 flekspen ndi mankhwala ena.

kanthu Hypoglycemic mankhwala patsogolo mankhwala m'kamwa hypoglycemic, Mao zoletsa, zoletsa Ace, carbonic zoletsa anhydrase, kusankha beta-blockers, bromocriptine, octreotide, sulfonamides, anabolic mankhwala, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, kukonzekera lifiyamu Muli okonzekera ethanol.

Mphamvu ya hypoglycemic ya mankhwalawa imachepetsedwa ndi kulera kwapakamwa, GCS, kukonzekera kwa mahomoni a chithokomiro, thiazide diuretics, heparin, tridclic antidepressants, sympathomimetics, danazole, clonidine, calcium blockers, diazoxide, morphine, phenytoin, nikotini.

Mothandizidwa ndi reserpine ndi salicylates, onse ofooketsa ndikulimbikitsa machitidwe a mankhwala a NovoMix 30 FlexPen ndi otheka.

Migwirizano yosungirako ya mankhwala Novomix 30 flekspen.

Mndandanda B. Osagwiritsidwa ntchito NovoMix 30 FlexPen iyenera kusungidwa mufiriji kutentha 2 2 mpaka 8 ° C (osayandikira kwambiri mufiriji), osazizira. Moyo wa alumali ndi zaka 2.

NovoMix 30 FlexPen Yogwiritsidwa ntchito iyenera kusungidwa kutentha osapitirira 30 ° C kwa milungu 4. Kuti muteteze kuchokera ku kuwala, NovoMix 30 FlexPen iyenera kutseka ndi chipewa.

Zizindikiro ndi contraindication kugwiritsa ntchito mankhwalawa

Flevoen ya NovoMix 30 imawonetsedwa kwa matenda ashuga. Pharmacokinetics sichinaphunzire m'magulu a odwala:

• okalamba
• ana
• odwala matenda a chiwindi ndi impso.

Mwapadera, mankhwalawa sayenera kugwiritsidwa ntchito kwa hypoglycemia, kuzindikira kwambiri kwa chinthu cha aspart kapena gawo lina la mankhwala.

Malangizo apadera ndi kuchenjeza kuti mugwiritse ntchito

Ngati mulingo woyenera wagwiritsidwa ntchito kapena mankhwalawo atha mwadzidzidzi (makamaka ndi matenda a shuga 1), zotsatirazi zingachitike:

Zonsezi ndi zowopsa pa thanzi ndipo zimatha kupha.

NovoMix 30 FlexPen kapena cholowa m'malo mwake ziyenera kuperekedwa mwachangu musanadye. Ndikofunikira kuganizira kumayambiriro kwa mankhwalawa pochiza odwala omwe ali ndi matendawa kapena kumwa mankhwala omwe angachedwetse kuyamwa kwa chakudya cham'mimba thirakiti.

Matenda onga (makamaka opatsirana komanso achichepere) amawonjezera kufunika kwa insulini yowonjezera.

Malinga ndi kusamutsa wodwala kupita ku mitundu yatsopano ya insulin, zomwe zimayambira kukhazikitsidwa kwa chikumbumtima zimatha kusintha ndikusiyana ndi zomwe zimachitika chifukwa chogwiritsa ntchito mankhwala a shuga a insulin. Poganizira izi, ndikofunikira kwambiri kusamutsa wodwala kupita ku mankhwala ena moyang'aniridwa ndi dokotala.

Kusintha kulikonse kumaphatikizapo kusintha kwa mlingo womwe umafunikira. Tikulankhula za mikhalidwe yotere:

• kusintha kwa mankhwala
• kusintha kwa mitundu kapena wopanga,
• Kusintha kochokera ku insulin (ya munthu, nyama kapena analogue ya munthu),
• njira yoyendetsera kapena kupanga.

Mukusintha kuti mupeze jakisoni wa NovoMix 30 FlexPen insulin kapena jakisoni wa analog, odwala matenda ashuga amafunika kuthandizidwa ndi dokotala posankha mlingo woyambira wa mankhwala atsopano. Ndizofunikanso mkati mwa masabata oyamba ndi miyezi mutasintha.

Poyerekeza ndi insulin yachilendo ya insulin yamunthu, jakisoni wa NovoMix 30 FlexPen ikhoza kuyambitsa kwambiri zotsatira za hypoglycemic. Itha kukhala mpaka maola 6, zomwe zimaphatikizapo kuwunika kwa Mlingo wofunika wa insulin kapena zakudya.

Kuyimitsidwa kwa insulini sikungagwiritsidwe ntchito pamapampu a insulin kuti muperekenso mankhwalawa pansi pa khungu.

Kutha kuyendetsa zinthu

Ngati, pazifukwa zosiyanasiyana, hypoglycemia imayamba kumwa mankhwala, wodwalayo sangathe kuyang'ana mokwanira komanso kuyankha moyenera pazomwe zimamuchitikira. Chifukwa chake, kuyendetsa galimoto kapena makina kuyenera kukhala ochepa. Wodwala aliyense ayenera kudziwa njira zoyenera zopewera kuthana ndi shuga m'magazi, makamaka ngati muyenera kuyendetsa.

M'malo omwe FlexPen kapena penipill yake ya analog idagwiritsidwa ntchito, ndikofunikira kuyeza chitetezo ndi kufunikira koyendetsa, makamaka ngati zizindikiro za hypoglycemia zimafooka kwambiri kapena palibe.

Kodi mankhwalawo amagwirizana bwanji ndi mankhwala ena?

Pali mitundu ingapo ya mankhwala omwe angakhudze kagayidwe kachakudya ka shuga m'thupi, kamayenera kuganiziridwanso mukamawerengera mlingo womwe umafunikira.

Njira zomwe zimachepetsa kufunika kwa insulin ya mahomoni ndi:

• matenda amkamwa,
• Mao zoletsa
• octreotide
• ACE zoletsa
• salicylates,
• anabolics
• sulfonamides,
• mowa wokhala
• blockers osasankha.

Palinso zida zomwe zimawonjezera kufunikira kwa kugwiritsidwa ntchito kwa NovoMix 30 FlexPen insulin kapena zosintha zina za penfill:

1. kulera kwamlomo
2. danazol
3. mowa
4. thiazides,
5. GSK,
6. mahomoni a chithokomiro.

Momwe mungagwiritsire ntchito ndi kumwa?

Mlingo wa NovoMix 30 Flexpen ndi munthu payekha ndipo amasankha dokotala, kutengera zosowa za wodwalayo. Chifukwa cha kuthamanga kwa mankhwalawa, ayenera kuperekedwa asanadye. Ngati ndi kotheka, insulin, komanso penfill, iyenera kuperekedwa pambuyo chakudya.

Ngati tizingolankhula za maulalo apakati, ndiye kuti NovoMix 30 FlexPen iyenera kuyikidwa kutengera kulemera kwa wodwalayo ndipo imachokera ku 0.5 mpaka 1 UNIT pa kilogalamu iliyonse patsiku. Kufunika kwake kungawonjezeke mwa omwe ali ndi matenda ashuga omwe ali ndi insulin kukana, ndikuchepa kwa zobisika zotsalira za mahomoni awo.

Flexpen nthawi zambiri imayendetsedwa mwachangu mu ntchafu. Jekeseni ndizothekanso mu:

• malo am'mimba (khoma lakunja lamkati),
• matako
• minyewa yotsekemera ya phewa.

Lipodystrophy imatha kupewedwa pokhapokha malo omwe akuwonetsedwa atabayira.

Kutsatira chitsanzo cha mankhwala ena, kutalika kwa mankhwalawa kumatha kusintha. Izi zimatengera:

1. Mlingo
2. masamba a jekeseni
3. kuthamanga kwa magazi
4. mulingo wakuchita zolimbitsa thupi
5. kutentha kwa thupi.

Kudalira kwazomwe zimayamwa pa jakisoni sindinakufufuze.

Odwala omwe ali ndi matenda a shuga a mtundu wa 2, NovoMix 30 FlexPen (ndi penfill analog) akhoza kuyesedwa ngati chithandizo chachikulu, komanso kuphatikiza ndi metformin. Zotsirizirazi ndizofunikira pamikhalidwe yomwe sizotheka kuchepetsa kuchuluka kwa shuga mwa njira zina.

Mlingo woyenera wovomerezeka wa mankhwalawa ndi metformin adzakhala magawo 0,2 pa kilogalamu ya kulemera kwa odwala patsiku. Kuchuluka kwa mankhwalawa kuyenera kusinthidwa malinga ndi zosowa munthawi iliyonse.

Ndikofunikanso kulabadira kuchuluka kwa shuga mu seramu yamagazi. Ntchito iliyonse yovuta yaimpso kapena kwa chiwindi imatha kuchepetsa kufunika kwa mahomoni.

NovoMix 30 Flexpen silingagwiritsidwe ntchito pochiza ana.

Mankhwala omwe akufunsawa angagwiritsidwe ntchito pothandilitsa pang'onopang'ono. Sitha kupangika m'matumbo kapena m'mitsempha.

Kuwonetsedwa kwa zoyipa

Zotsatira zoyipa zogwiritsa ntchito mankhwalawa zitha kudziwika pokhapokha ngati munthu akusintha kuchokera ku insulin ina kapena mukasintha mlingo. NovoMix 30 FlexPen (kapena mawonekedwe ake analog) ikhoza kukhudza thanzi la thanzi.

Monga lamulo, hypoglycemia imakhala chiwonetsero chambiri cha zotsatira zoyipa. Imatha kuchitika pamene muyezo upambana kwambiri pazofunikira zenizeni za mahomoni, ndiye kuti, insulin yambiri.

Kusowa kwambiri kungachititse kuti musakhale ndi chikumbumtima kapenanso kukokana, kenako ndikuwonongeka kwakanthawi kapena kwakanthawi kwa ubongo kapena ngakhale kufa.

Malinga ndi zotsatira za kafukufuku wazachipatala komanso kuchuluka kwa zomwe zidalembedwa pa NovoMix 30 pamsika, zitha kunenedwa kuti ziwopsezo za hypoglycemia m'magulu osiyanasiyana a odwala zimasiyana kwambiri.

Malinga ndi pafupipafupi zomwe zimachitika, zovuta zomwe zimachitika zimatha kugawidwa m'magulu:

• Kuchokera ku chitetezo chathupi: anaphylactic reaction (kawirikawiri), urticaria, totupa pakhungu (nthawi zina),
• zimachitika kawirikawiri: kuyabwa, kumva kwambiri, thukuta, kusokoneza kwam'mimba, kuchepa kwa kuthamanga kwa magazi, kugunda kwamtima, angioedema (nthawi zina),
• kuchokera ku dongosolo lamanjenje: zotumphukira ma neuropathies. Kusintha koyambirira kwamphamvu pakuwongolera shuga kungayambitse matenda owopsa a neuropathy, osakhalitsa (kawirikawiri),
• Mavuto am'maso: kukhumudwitsa (nthawi zina). Amakhala osakhalitsa m'chilengedwe ndipo amapezeka kumayambiriro kwenikweni kwa mankhwala a insulin,
• diabetesic retinopathy (nthawi zina). Ndiulamuliro wabwino kwambiri wa glycemic, mwayi wopitilira muyeso uwu udzachepetsedwa. Ngati machitidwe othandizira kwambiri agwiritsidwa ntchito, izi zingayambitse kukokoloka kwa retinopathy,
• kuchokera pamatumbo amkati ndi khungu, lipid dystrophy imatha kuchitika (nthawi zina). Amayamba m'malo omwe majekesedwe amapangidwa nthawi zambiri. Madokotala amalimbikitsa kuti asinthe jakisoni wa NovoMix 30 FlexPen (kapena mawonekedwe ake). Kuphatikiza apo, kumverera kwambiri kumatha kuyamba. Ndi kuyambitsa kwa mankhwala, kukula kwa hypersensitivity kwanuko ndikotheka: kufiyanso, kuyabwa pakhungu, kutupa m'malo a jakisoni. Izi zimachitika mosakhalitsa mwachilengedwe ndipo zimazimiririka ndi mankhwala omwe akupitilira,
• zovuta zina komanso zimachitika (nthawi zina). Kukula kumayambiriro kwa insulin. Zizindikiro zake ndizakanthawi.

Milandu yambiri

Mothandizidwa ndi mankhwalawa mopitirira muyeso, kukhazikika kwa chikhalidwe cha hypoglycemic ndikotheka.

Ngati magazi a shuga atsika pang'ono, ndiye kuti hypoglycemia imatha kuyimitsidwa pakudya zakudya zotsekemera kapena shuga. Ichi ndichifukwa chake munthu aliyense wodwala matenda ashuga amafunika kunyamula maswiti ochepa, mwachitsanzo, maswiti osapatsa shuga kapena zakumwa.

Pankhani ya kusowa kwambiri kwa shuga wamagazi, pomwe wodwalayo adagona, ndikofunikira kuti amupatse mankhwala osokoneza bongo kapena a subcutaneous makonzedwe a glucagon pakuwonekera kwa 0,5 mpaka 1 mg. Malangizo pazinthu izi ayenera kudziwika kwa iwo omwe ali ndi matenda ashuga.

Munthu wodwala matenda ashuga akangotuluka kukomoka, amafunika kudya pang'ono mafuta mkati. Izi zimapereka mwayi wopewa kuyambiranso.

Kodi NovoMix 30 Flexpen iyenera kusungidwa bwanji?

Moyo wa alumali wokhazikika ndi zaka 2 kuyambira tsiku lomwe adapanga. Bukuli likuti cholembera chomwe chingagwiritsidwe ntchito ndi NovoMix 30 FlexPen (kapena cholembera) sichingasungidwe mufiriji. Iyenera kutengedwa ndi inu mosungiramo ndi kusungidwa kwa milungu yopitilira 4 pamtunda osapitirira 30 digiri.

Cholembera chosindikizidwa chimasungidwa pamadigiri 2 mpaka 8. Mwatsatanetsatane simungathe kumasula mankhwalawo!

Fomu ya Mlingo:

Kufotokozera
Homogeneous yoyera yopanda chopanda kuyimitsidwa. Mphezi zimawonekera pamiyeso.
Mukayimirira, kuyimitsidwa kumakoma, ndikupanga choyera chamtendere komanso chopanda utoto kapena chopanda utoto.
Mukasakaniza zomwe zili mu cholembera mogwirizana ndi momwe zafotokozedwera m'Malangizo azomwe mungagwiritsire ntchito, kuyimitsidwa koyenera kuyenera kupanga.

Katundu

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

Kuchepa kwa kuchuluka kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa kayendedwe ka intracellular pambuyo pa kumangiriza kwa insulin receptors a minofu ndi minofu yamafuta komanso kuletsa kwa kupanga kwa shuga ndi chiwindi.

Pambuyo subcutaneous makonzedwe a NovoMix® 30 FlexPen ®, zotsatira zimachitika mkati mwa mphindi 10-20. Kuchuluka kwakukulu kumawonedwa pamtunda kuchokera kwa 1 mpaka maola 4 jekeseni. Kutalika kwa mankhwalawa kumafika maola 24.

Mu kafukufuku wotsatira miyezi itatu wokhudzana ndi odwala omwe ali ndi matenda amtundu wa 1 ndi mtundu wa 2 omwe amalandila NovoMix ® 30 FlexPen ® ndi biphasic insulin 30 kawiri tsiku lililonse asanadye chakudya cham'mawa komanso chakudya chamadzulo, NovoMix ® 30 FlexPen ® adawonetsedwa kuti amachepetsa kupsinjika kwa postprandial kwambiri shuga wamagazi (mutatha kadzutsa ndi chakudya chamadzulo).

Kuwunika kwa meta kuchokera ku mayeso asanu ndi anayi othandizira odwala omwe ali ndi mtundu woyamba wa 2 ndi matenda a 2 adawonetsa kuti NovoMix® 30 FlexPen ®, yomwe imayendetsedwa musanadye chakudya cham'mawa komanso chakudya chamadzulo, imayendetsa bwino ndende yama glucose a postprandial pambuyo pa chakudya cham'mawa, nkhomaliro komanso chakudya chamadzulo), poyerekeza ndi insulin ya anthu 30 .. Ngakhale kutsitsimuka kwa glucose kwa odwala omwe amagwiritsa ntchito NovoMix® 30 FlexPen ® anali apamwamba, ambiri, NovoMix® 30 FlexPen ® imapereka t Zomwe zimachitika pakukumana kwa glycosylated hemoglobin (HbA_1c,, ngati biphasic insulin ya anthu 30.

Mu kafukufuku wazachipatala wokhudzana ndi odwala 341 omwe ali ndi mtundu wa matenda a shuga 2, odwala adangosankhidwa mwanjira zamagulu othandizira a NovoMix® 30 FlexPen®, NovoMix® 30 FlexPen ® pophatikiza ndi metformin ndi metformin pophatikizana ndi zotumphukira za sulfonylurea. HbA_1c Pambuyo pa milungu 16 ya chithandizo sichinasiyane ndi odwala omwe amalandila NovoMix® 30 FlexPen ® limodzi ndi metformin komanso odwala omwe amalandila metformin osakanikirana ndi zotumphukira za sulfonylurea. Phunziroli, 57% ya odwala anali ndi basal HbA_1c anali apamwamba kuposa 9%, mu chithandizo ichi cha odwala omwe ali ndi NovoMix® 30 FlexPen ® pamodzi ndi metformin kunapangitsa kutsika kwakukulu kwa ndende ya HbA_1ckuposa odwala kulandira metformin osakanikirana ndi sulfonylurea.

Pakafukufuku wina, odwala omwe ali ndi matenda a shuga 2 omwe amakhala ndi vuto lodana ndi glycemic omwe adamwa mankhwala osokoneza bongo a hypoglycemic adasinthidwa mwachisawawa m'magulu otsatirawa: kulandira NovoMix® 30 kawiri pa tsiku (odwala 117) ndikulandila insulin glargine kamodzi patsiku (odwala 116). Pambuyo pa masabata 28 ogwiritsa ntchito mankhwalawa, kuchepa kwapakati pa ndende ya HbA_1c pagulu la NovoMix® 30 FlexPen ®, anali 2.8% (mtengo woyamba unali 9.7%). Mu 66% ndi 42% ya odwala omwe amagwiritsa ntchito NovoMix® 30 FlexPen®, kumapeto kwa kafukufukuyu, HbA imayikira_1c anali pansi pa 7% ndi 6.5%, motsatana. Kutanthauza kuti kusala kwam'magazi glucose kutsika ndi pafupifupi 7 mmol / L (kuyambira 14.0 mmol / L koyambirira kwa phunzirolo mpaka 7.1 mmol / L).

Zotsatira za kusanthula kwa meta kosuntha kwakupezeka m'mayesero azachipatala okhudzana ndi odwala omwe ali ndi mtundu wa 2 mellitus adawonetsa kuchepa kwa ziwonetsero zonse za nocturnal hypoglycemia ndi hypoglycemia yayikulu ya NovoMix ® 30 FlexPen ® poyerekeza ndi insulin yamunthu ya 30. Pali chiwopsezo cha anthu onse kupezeka kwa hypoglycemia masana mwa odwala omwe amalandila NovoMix® 30 FlexPen ® anali apamwamba.

Ana ndi achinyamata: Kuyesedwa kwamankhwala kwa milungu 16 kunachitika komwe kuyerekezera shuga wamagazi mukatha kudya ndi NovoMix ® 30 (musanadye chakudya), insulin / biphasic human insulin 30 (asanadye) komanso isofan-insulin (yoyesedwa kale gona). Phunziroli linakhudza odwala 167 azaka zapakati pa 10 mpaka 18. HbA pafupifupi_1c m'magulu onse awiriwa adakhalabe pafupi ndi zoyambirira m'maphunziro onse. Komanso, mukamagwiritsa ntchito NovoMix® 30 FlexPen ® kapena biphasic insulin 30 ya anthu, panalibe kusiyana pakachitika hypoglycemia.

Kafukufuku wokhudzana ndi khungu wamaso awiri adachitidwanso mwa odwala omwe ali ndi zaka 6 mpaka 12 (odwala okwana 54, masabata 12 pamtundu uliwonse wamankhwala). Zovuta za hypoglycemia komanso kuchuluka kwa shuga atatha kudya pagulu la odwala omwe amagwiritsa ntchito NovoMix® 30 FlexPen ® anali otsika kwambiri poyerekeza ndi zomwe zili mgulu la odwala omwe amagwiritsa ntchito insulin yamunthu inshuwaransi 30. HbA_1c kumapeto kwa kafukufukuyu, pagulu la anthu omwe amagwiritsa ntchito insulin 30 ya biphasic anali otsika kwambiri kuposa gulu la odwala omwe amagwiritsa ntchito NovoMix® 30 FlexPen ®.

Odwala okalamba: The pharmacodynamics of NovoMix® 30 FlexPen ® mu okalamba ndi odwala a senile sanafufuzidwe. Komabe, mu kafukufuku wosasinthika wamaso awiri wakhungu womwe udachitika kwa odwala 19 omwe ali ndi mtundu wa 2 matenda a shuga omwe ali ndi zaka 65-83 (kutanthauza zaka 70), pharmacodynamics ndi pharmacokinetics of insulin aspart ndi soluble insulin ya anthu. Kusiyana kwina mu pharmacodynamics (kuchuluka kwa kulowetsedwa kwa glucose - GIR_max ndi dera lomwe litapendekeka chifukwa cha kulowetsedwa kwa mphindi 120 pambuyo popanga insulin - AUC_Girgir, 0-120 min) pakati pa insulin aspart ndi insulin ya anthu odwala okalamba anali ofanana ndi odzipereka athanzi komanso odwala achinyamata omwe ali ndi matenda a shuga.

Pharmacokinetics
Mu insulin aspart, kulowetsedwa kwa amino acid proline pamalo B28 kwa aspartic acid kumachepetsa chizolowezi cha mamolekyulu kupanga hexamers m'chigawo chosungunuka cha NovoMix® 30 FlexPen ®, chomwe chimasungunuka mu insulin ya anthu. Pankhaniyi, insulin aspart (30%) imayamwa kuchokera ku mafuta a subcutaneous mwachangu kuposa insulle insulin yomwe ili mu biphasic insulin yamunthu. 70% yotsala imagwera mawonekedwe a crystalline a protamine-insulin aspart, omwe mayamwidwe omwe ali ofanana ndi a insulin NPH ya anthu.

Kuchuluka kwa insulini mu seramu yamagazi pambuyo pa makonzedwe a NovoMix ® 30 FlexPen ® ndi 50% kuposa omwe amapezeka ndi insulin 30 ya anthu, ndipo nthawi yakufikirako ndi theka la insulin 30 yaumunthu m'magulu odzipereka, mutatha kukonzekera kwa NovoMix® 30 kuchokera kuwerengetsa kwa 0,20 IU / kg kwa kulemera kwa thupi, kuchuluka kwakukulu kwa insulini mu seramu kunatheka pambuyo pa mphindi 60 ndipo panali 140 ± 32 pmol / L. Theka la moyo (t_1/2) ya NovoMix® 30, yomwe imawonetsa kuyatsidwa kwa kachigawo kogwirizana ndi protamine, anali maola 8-9. Magulu a insulin a insulini amabwerera ku maola 15-18 pambuyo pothandizidwa ndi mankhwalawa. Odwala omwe ali ndi matenda a shuga 2, amachepetsa kwambiri mphindi 95 pambuyo pa kukhazikika ndipo amakhala pamwamba maola 14.

Okalamba ndi odwala senile:
Kafukufuku wa pharmacokinetics a NovoMix® 30 mwa odwala okalamba ndi a senile sanachitike. Komabe, kusiyana kwakaphatikizidwe mu pharmacokinetics pakati pa insulin aspart ndi insulle insulin ya anthu okalamba omwe ali ndi matenda a shuga a 2 (azaka 65-83 zaka, zaka zapakati - zaka 70) 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 (Maminiti 82 (malo osiyanasiyana: 60-120 maminiti)), pomwe pazenera C_max zinali zofanana ndi zomwe zimawoneka m'magulu ang'onoang'ono omwe ali ndi matenda a shuga a 2, komanso ochepera pang'ono poyerekeza ndi odwala 1 a shuga.

Odwala ndi mkhutu aimpso ndi kwa chiwindi ntchito:
Kafukufuku wa pharmacokinetics a NovoMix® 30 FlexPen ® mu odwala omwe ali ndi vuto laimpso ndi kwa chiwindi sikuchitika. Komabe, ndi kuwonjezeka kwa mlingo wa mankhwalawa odwala omwe ali ndi vuto losiyanasiyana laimpso ndi kwa chiwindi, sizinasinthe mu pharmacokinetics ya soluble insulin aspart.

Ana ndi achinyamata:
Mankhwala a NovoMix® 30 FlexPen ® mu ana ndi achinyamata sanaphunzire. Komabe, mankhwala a pharmacokinetic ndi pharmacodynamic a soluble insulin aspart adawerengera ana (azaka 6 mpaka 12) komanso achinyamata (azaka 13 mpaka 17) omwe ali ndi matenda ashuga a mtundu woyamba. Kwa odwala azaka zonse ziwiri, insulin aspart imadziwika ndi mayamwidwe achangu ndi ma t_maxchimodzimodzi ndi akulu. Komabe, zofunikira za C_max m'magulu awiri azaka ziwiri anali osiyana, zomwe zikuwonetsa kufunikira kwa kusankha kwa mankhwala a insulin.

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

Mu mayeso a in vitro, omwe anaphatikiza kumangiriza insulin ndi ma IGF-1 zolandila ndi zotsatira za kukula kwa maselo, zidawonetsedwa kuti zofunikira za aspart insulin ndizofanana ndi insulin yaumunthu. Kafukufuku adawonetsanso kuti kudzipatula komwe kumangidwa kwa insulin aspart ku insulin receptors kuli kofanana ndi kwa insulin ya anthu.

Zoyipa:

Gwiritsani ntchito pa nthawi yoyembekezera komanso nthawi yoyamwitsa
Zochitika zamankhwala ndikugwiritsa ntchito NovoMix® 30 FlexPen ® pa nthawi yokhala ndi pakati ndizochepa.

Kafukufuku wokhudza kugwiritsa ntchito NovoMix® 30 FlexPen® mwa amayi apakati sanachitike. Komabe, zidziwitso kuchokera ku mayesero awiri azachipatala omwe adayang'aniridwa mosasinthika (motero, amayi apakati a 157 ndi 14 omwe adalandira insulin aspart mu basic basic borus regimen of medical) sizinawonetse zovuta zilizonse za insulin aspart pa mimba kapena thanzi la mwana wosabadwayo / wakhanda poyerekeza ndi insulin yaumunthu. Kuphatikiza apo, mayesero azachipatala a azimayi 27 omwe ali ndi vuto la matenda osokoneza bongo omwe amalumikizana ndi insulin komanso osungunuka anthu (14 azimayi amalandila insulin, 13 insulin yaumunthu) adawonetsa mbiri yofanana ya insulin.

Munthawi ya kuyambika kwa kutenga pakati komanso panthawi yonseyo, ndikofunikira kuyang'anitsitsa momwe odwala omwe ali ndi matenda osokoneza bongo amayang'anira ndikuwonetsetsa kuchuluka kwa shuga m'magazi. 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, NovoMix® 30 FlexPen ® ikhoza kugwiritsidwa ntchito popanda zoletsa. Kukhazikitsidwa kwa insulin kwa mayi woyamwitsa sikuopseza mwana. Komabe, zingakhale zofunikira kusintha mlingo wa NovoMix® 30 FlexPen ®.

Mlingo ndi makonzedwe:

Mlingo wa NovoMix® 30 FlexPen ® umatsimikiziridwa ndi dokotala aliyense payekha, mogwirizana ndi zosowa za wodwala. Kuti mukwaniritse bwino kwambiri matenda a glycemia, tikulimbikitsidwa kuwongolera kuchuluka kwa shuga m'magazi ndikusintha mlingo wa mankhwalawa.

Odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga a mellitus NovoMix ® 30 FlexPen ® amatha kuthandizidwa kuti azigwiritsidwa ntchito ngati mankhwalawa komanso kuphatikiza ndi mankhwala amkamwa a hypoglycemic milandu pomwe kuchuluka kwa shuga m'magazi kumangoyendetsedwa ndi mankhwala amkamwa a hypoglycemic.

Kukhazikitsa mankhwala
Kwa odwala omwe ali ndi matenda a shuga a mtundu woyamba 2 omwe amapatsidwa insulin yoyamba, mankhwalawa a NovoMix ® 30 FlexPen ® ndi magawo 6 musanadye chakudya cham'mawa komanso 6 gawo musanadye chakudya. Kukhazikitsidwa kwa magawo 12 a NovoMix® 30 Flexpen® kamodzi patsiku madzulo (musanadye chakudya chamadzulo) ndikololedwa.

Kusamutsa wodwala kuchokera kukonzekera kwina kwa insulin
Mukasamutsa wodwala kuchokera ku biphasic insulin ya anthu kupita ku NovoMix® 30 FlexPen ®, wina ayenera kuyamba ndi kumwa ndi mtundu womwewo wa makonzedwe. Kenako sinthani za mankhwalawa mogwirizana ndi zofunikira za wodwalayo (onani malingaliro otsatirawa okhudza kuchuluka kwa mankhwalawo). Monga nthawi zonse, posamutsa wodwala kupita ku mtundu wina wa insulin, kuyang'aniridwa mosamala kuchipatala ndikofunikira pakusintha kwa wodwalayo komanso m'masabata oyamba ogwiritsa ntchito mankhwalawa.

Kupititsa patsogolo mankhwala
Kulimbikitsanso chithandizo cha NovoMix® 30 FlexPen ® ndikutheka ndikusintha kuchokera ku mlingo umodzi wa tsiku lililonse kupita pawiri. Ndikulimbikitsidwa kuti mutatha kupeza mlingo wa magawo 30 a mankhwalawa kuti mugwiritse ntchito NovoMix® 30 FlexPen ® kawiri pa tsiku, mugawa mgawo magawo awiri ofanana - m'mawa ndi madzulo (musanadye chakudya cham'mawa komanso chamadzulo).

Kusinthika kwa kugwiritsidwa ntchito kwa NovoMix® 30 FlexPen ® katatu patsiku ndikotheka ndikugawa mlingo wam'mawa m'magawo awiri ofanana ndikuyambitsa magawo awiriwa m'mawa komanso pachakudya chamasana (katatu tsiku tsiku).

Kusintha kwa Mlingo
Kusintha mlingo wa NovoMix® 30 FlexPen ®, shuga wotsika kwambiri wa glucose yemwe amapezeka masiku atatu apitawa amagwiritsidwa ntchito.

Kuti muwone kukwana kwa mlingo wapitalo, gwiritsani ntchito phindu la kuchuluka kwa shuga m'magazi chakudya chotsatira.

Kusintha kwa dose kutha kuchitidwa kamodzi pa sabata mpaka phindu la HbA lithe._1c.

Musachulukitse mlingo wa mankhwalawa ngati hypoglycemia idawonedwa panthawiyi.

Kusintha kwa Mlingo kumakhala kofunikira pakulimbitsa thupi la wodwalayo, kusintha zakudya zake, kapena kukhala ndi vuto. Kusintha mlingo wa NovoMix® 30 FlexPen®, tikulimbikitsidwa kugwiritsa ntchito malangizo awa:

Magazi a shuga ndende musanadye

NovoMix® 30 mlingo kusintha 10 mmol / l> 180 mg / dl+ 6 magulu

Magulu apadera a odwala
Monga momwe amagwiritsidwira ntchito pokonzekera insulin, mwa odwala omwe ali m'magulu apadera, shuga wamagazi amayenera kuyang'aniridwa mosamala komanso mlingo wa aspart aspart payekha.

Okalamba ndi odwala senile:
NovoMix® 30 FlexPen ® ikhoza kugwiritsidwa ntchito mwa odwala okalamba, komabe, zomwe zimawagwiritsa ntchito limodzi ndi mankhwala am'mlomo a hypoglycemic odwala omwe ali ndi zaka zoposa 75 ndizochepa.

Odwala ndi mkhutu aimpso ndi kwa chiwindi ntchito:
Odwala omwe ali ndi vuto la impso kapena hepatic, kuchepa kwa insulin kumatha kuchepetsedwa.

Ana ndi achinyamata:
NovoMix® 30 FlexPen ® ikhoza kugwiritsidwa ntchito pochiza ana ndi achinyamata azaka zopitilira zaka 10 milandu ikakhala kuti amakonda kugwiritsa ntchito insulin yosakanizika kale. Zambiri zamankhwala zamankhwala zilipo kwa ana a zaka 6 - 9 (onani gawo la Pharmacodynamic Properties).

NovoMix® 30 FlexPen ® iyenera kuperekedwa mwachangu mu ntchafu kapena kunja kwamimba khoma. Ngati angafune, mankhwalawa amatha kuperekedwa kwa phewa kapena matako.

Ndikofunikira kusintha malo a jekeseni mkati mwa anatomical dera kuti muchepetse kukula kwa lipodystrophy.

Monga kukonzekera kwina konse kwa insulin, kutalika kwa nthawi ya NovoMix® 30 FlexPen ® kutengera mlingo, malo oyendetsera, kutsika kwa magazi, kutentha ndi mulingo wakuchita zolimbitsa thupi.

Poyerekeza ndi biphasic insulin ya anthu, NovoMix® 30 FlexPen® imayamba kuchita zinthu mwachangu, chifukwa chake imayenera kuperekedwa mwachangu musanadye. Ngati ndi kotheka, NovoMix® 30 FlexPen ® ikhoza kutumikiridwa patangotha ​​chakudya.

Zotsatira zoyipa:

Pa gawo loyambirira la insulin, zolakwika zotupa, edema ndi zimachitika zimapezeka pamalo a jakisoni (kuphatikiza ululu, kufiyira, ming'oma, kutupa, kuphwanya, kutupa ndi kuyunkhira pamalo a jekeseni. Zizindikirozi nthawi zambiri zimakhala zakanthawi. 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.

Zotsatira zonse zoyipa zomwe zaperekedwa pansipa, kutengera za mayeso azachipatala, zimayikidwa m'magulu molingana ndi kukula kwa chitukuko malinga ndi MedDRA ndi kachitidwe ka ziwalo. Zotsatira zoyipa zimafotokozedwa ngati: pafupipafupi (≥ 1/10), nthawi zambiri (≥ 1/100 to * Onani “Kufotokozera kwamomwe zotsatira zoyipa”

Kufotokozera kwamomwe munthu amachitikira:
Machitidwe a anaphylactic
Zochitika kawirikawiri kwambiri zamagulu a hypersensitivity (kuphatikizapo kuphathamira pakhungu, kuyabwa, thukuta, kusokonezeka kwa m'mimba, angioedema, kupuma movutikira, kutsitsa kwamtima, kuchepa kwa magazi), zomwe zimatha kukhala pachiwopsezo cha moyo, zimadziwika.

Hypoglycemia
Hypoglycemia ndi njira yodziwika kwambiri yotsatirira. Zimatha kukhala ngati mlingo wa insulini ndiwokwera kwambiri poyerekeza ndi kufunika kwa insulin. Hypoglycemia yambiri ikhoza kuyambitsa kusokonezeka kwa chikumbumtima komanso / kapena kukhumudwa, kuwonongeka kwakanthawi kapena kosasinthika kwa ubongo kugwira ntchito mpaka pakufa. Zizindikiro za hypoglycemia, monga lamulo, zimayamba mwadzidzidzi. Izi zitha kuphatikizira "thukuta lozizira", khungu la thupi, kutopa kwambiri, mantha kapena kunjenjemera, nkhawa, kutopa kapena zachilendo, kusokonezeka, kuchepa msanga, tulo, kugona kwambiri, kusawona bwino, mutu, nseru, komanso kupweteka mtima. .

Kafukufuku wachipatala awonetsa kuti kuchuluka kwa hypoglycemia kumasiyana malinga ndi kuchuluka kwa odwala, dosing regimen, ndi kayendedwe ka glycemic. M'mayesero azachipatala, panalibe kusiyana kulikonse pazochitika za hypoglycemia pakati pa odwala omwe amalandila aspart insulin mankhwala ndi odwala omwe amagwiritsa ntchito kukonzekera kwa insulin.

Lipodystrophy
Nthawi zambiri za lipodystrophy zalembedwa. Lipodystrophy imatha kupezeka pamalo a jakisoni.

Bongo

- Wodwalayo amatha kuthetsa hypoglycemia wofatsa pogwiritsa ntchito shuga kapena shuga wokhala ndi shuga. Chifukwa chake, ndikulimbikitsidwa kwa odwala omwe ali ndi matenda ashuga kuti azisenza mankhwala okhala ndi shuga nthawi zonse.
- Pakachitika vuto lalikulu la hypoglycemia, pomwe wodwalayo sakudziwa, 0,5 mg mpaka 1 mg ya glucagon amayenera kuthandizidwa ndi intramuscularly kapena subcutaneously (munthu wophunzitsidwa bwino angagwiritsidwe ntchito) kapena njira ya intravenous glucose (dextrose) (katswiri wazachipatala yekha amene angayendetse). M'pofunikanso kuperekera dextrose m'mitsempha ngati wodwalayo asadzayambenso chikumbumtima mpaka mphindi 10-15 atatha kugwirira ntchito kwa glucagon. Pambuyo pozindikira, wodwalayo amalangizidwa kuti azilemba chakudya kuti alepheretse kuyambiranso kwa hypoglycemia.

Kuchita ndi mankhwala ena

Hypoglycemic zotsatira za insulin patsogolo m'kamwa wothandizila hypoglycemic, monoamine oxidase zoletsa, angiotensin akatembenuka zoletsa enzyme, carbonic zoletsa anhydrase, kusankha beta-blockers, bromocriptine, sulfonamides, anabolic mankhwala, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, mankhwala lifiyamu salicylates .

Hypoglycemic mphamvu ya insulin imafooketsedwa ndi kulera kwapakamwa, glucocorticosteroids, mahomoni a chithokomiro, thiazide diuretics, heparin, tridclic antidepressants, sympathomimetics, somatropin, danazole, clonidine, "wosakwiya" calcium blockers, diazhenotin, morphine.

Beta-blockers amatha kufinya zizindikiro za hypoglycemia.

Octreotide / lanreotide imatha kuwonjezeka ndikuchepetsa kufunikira kwa insulin.

Mowa ungapangitse kapena kuchepetsa mphamvu ya insogulin.

Kusagwirizana.
Popeza maphunziro ophatikizira sanachitike, NovoMix® 30 FlexPen ® sayenera kusakanikirana ndi mankhwala ena.

Pharmacological zimatha mankhwala Novomix 30 flekspen

NovoMix 30 FlexPen ndi kuyimitsidwa kwamitundu iwiri komwe kumakhala kusakanikirana kwa insulin analogen: insulin aspart (analog ya human insulin-insulin) ndi protamine-insulin aspart (analog ya insulin ya anthu omwe amakhala nthawi yayitali). Kutsika kwa shuga m'magazi mothandizidwa ndi insulin aspart kumachitika pambuyo povomerezana ndi insulin receptors, zomwe zimapangitsa kuti pakhale shuga ndi minyewa komanso mafupa am'magazi ndipo nthawi imodzi imalepheretsa kutulutsa shuga m'chiwindi. NovoMix 30 FlexPen ndi kuyimitsidwa kwamitundu iwiri komwe kumakhala 30% sungunuka wa insulini. Izi zimathandizira kuyambika mwachangu kuposa kusungunuka kwa insulin yaumunthu ndipo amalola kuti mankhwalawo aperekedwe nthawi yomweyo musanadye (kuyambira 0 mpaka 10). Gawo lachigiriki (70%) limakhala ndi protamine-insulin aspart, mawonekedwe a zochitika omwe ali ofanana ndi protamine-insulin Hagedorn (NPH) yotsutsana ndi anthu.NovoMix 30 FlexPen akuyamba kuchita mphindi 1020 pambuyo pobayira. Kuchuluka kwake kumatheka pambuyo maola 4 - 4 pambuyo pa kukhazikitsa. Kutalika kwa kuchitapo kanthu mpaka maola 24.
Mlingo wa hemoglobin wa glycosylated odwala omwe ali ndi mtundu woyamba 1 ndi mtundu wa 2 shuga, omwe amaperekedwa ndi NovoMix 30 kwa miyezi itatu, ndi chimodzimodzi ngati akuwonetsa insulin ya anthu. Mlingo wofanana wa molar ukaperekedwa, insulin imafanana ndi zochitika za insulin ya anthu. Pakafukufuku wazachipatala, odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga a mellitus (anthu 341), ogawika m'magulu malinga ndi mfundo zosasinthika, adangolandira NovoMix 30 FlexPen, kapena NovoMix 30 FlexPen kuphatikiza ndi metformin, kapena metformin palimodzi ndi sulfonylurea. Pambuyo pa chithandizo cha milungu 16, malingaliro a glycosylated hemoglobin НbА1с mulingo mwa odwala omwe amalandila NovoMix 30 osakanikirana ndi metformin kapena metformin osakanikirana ndi sulfonylurea anali omwewo. Phunziroli, mu 57% ya odwala, mulingo wa HbA1c ndiwokwera kuposa 9%. Mwa odwalawa, kuphatikiza kwa NovoMix 30 FlexPen ndi metformin kunapangitsa kuchepa kwambiri kwa HbA1c poyerekeza ndi kuphatikiza kwa metformin ndi sulfonylurea.
Pakufufuza kwa odwala matenda amtundu wa II omwe amawongolera
glycemia kudzera pakamwa hypoglycemic mankhwala
idatsika, ndipo imathandizira pakubwera kwa mankhwala
NovoMix 30 kawiri patsiku (odwala 117) kapena mwa makina
insulin glargine kamodzi patsiku (odwala 116). Pambuyo pa masabata 28
Chithandizo cha NovoMix 30, limodzi ndi
Kusankhidwa kwa Mlingo, mulingo wa HbA1c watsika ndi 2.8% (pafupifupi
Makhalidwe a HbA1c akaphatikizidwa mu kafukufuku = 9.7%). Munthawi ya chithandizo cha NovoMix 30, HbA1c yotsika ndi 7% idafika pa 66% ya odwala, ndipo ochepera 6.5% - 42% mwa odwala.
kuthamanga kwa plasma glucose kumeneku kunachepa
pafupifupi 7 mmol / l (kuyambira 14.0 mmol / l musanalandire chithandizo - mpaka 7.1
mmol / l).
Pharmacokinetics. Mu insulin, aspart, amino acid proline yomwe ili pa 28 ya B ya molekyulu ya insulin imalowedwa m'malo ndi spartic acid, yomwe imachepetsa mapangidwe a hexamers omwe amapangidwa pokonzekera insulin yaumunthu. Mu gawo losungunuka la NovoMix 30 FlexPen, gawo la insulin ndi 30% ya insulini yonse. Amatengedwa m'magazi kuchokera ku minyewa yothamanga mofulumira kuposa insulle insulin ya biphasic insulin yamunthu. 70% yotsalayo imawerengedwa ndi mtundu wa crystalline wa protamine-insulin aspart, womwe umayamwa nthawi yayitali ndendende ndi insulin NPH.
Kuchuluka kwa insulini mu seramu yamagazi pambuyo pa kutumikiridwa kwa NovoMix 30 Flexpen ndi 50%, ndipo nthawi yakufikirako ndi theka la mabapasic insulin 30. Mwa odzipereka athanzi, pambuyo pa sc makonzedwe a NovoMix 30 pamlingo wa 0,20 U / kg kuchuluka kwa thupi kuchuluka kwa insulini mu seramu kunatheka pambuyo mphindi 60 ndipo anali 140 ± 32 pmol / L. Hafu ya moyo wa NovoMix 30, yomwe imawonetsa kuyamwa kwa kachigawo kakang'ono ka protamine, anali maora 8-9. Mlingo wa insulin m'magazi seramu unabweleranso koyambirira kwa maola 15-18 pambuyo pa kuperekedwa kwa s / c. Odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga, amakhala ndi chidwi chofika mphindi 95 atakhazikitsa ndipo amakhala osachepera maola 14.
Ana ndi achinyamata.
The pharmacokinetics of NovoMix 30 FlexPen mwa ana ndi achinyamata sichinafufuzidwe. Komabe, mwa ana (azaka 6 mpaka 12) ndi achinyamata (azaka 13 mpaka 17) omwe ali ndi matenda amtundu woyamba 1, a pharmacokinetics ndi pharmacodynamics a soluble aspart insulin adaphunzira. Zinali zotengeka mwachangu kwa odwala a magulu onse awiriwa, pomwe zofunikira za nthawi kuti zitheke kuzunzidwa zinali zofanana ndi za akulu. Nthawi yomweyo, mitengo ya Cmax yamagulu osiyanasiyana inali yosiyana kwambiri, zomwe zikuwonetsa kufunikira kwa kusankha kwa mankhwala a insulin.
Ma pharmacokinetics a NovoMix 30 sanaphunziridwe payekha.
okalamba, ana ndi odwala omwe ali ndi vuto la ntchito
impso kapena chiwindi.

Kusankhidwa kwa mlingo wa NovoMix 30

141-180 mg / 100 ml

Muyenera kuyang'ana kwambiri kutsika kwa shuga m'masiku atatu apitawa. Ngati pakhala pali magawo a hypoglycemia panthawiyi, mlingo wa insulin suwonjezereka. Kusankha kwa dose kumachitika kamodzi pa sabata mpaka mulingo wa HbA1c ufike. Miyezo ya shuga ndende musanadye chakudya chimawonetsa kuyenera kwa zomwe zidaperekedwa kale.
Kuchepa kwa chiwindi kapena impso kungathandize kuchepetsa wodwala kufunika kwa insulin.
NovoMix 30 Flexpen itha kugwiritsidwa ntchito mwa ana ndi achinyamata azaka zapakati pa 10 ndi kupitirira, mukamayambitsa kuphatikizidwa kwa insulin. Zambiri kuchokera kuzipatala zakuchipatala pakugwiritsa ntchito mankhwalawa kwa ana azaka za 6-16 ndizochepa. Kafukufuku mu ana osaposa zaka 6 sanachitike.
NovoMix 30 FlexPen ikhoza kugwiritsidwa ntchito mwa odwala okalamba, komabe, momwe amagwiritsidwira ntchito palimodzi ndi PSS mwa anthu azaka zopitilira 75 ndi ochepa.
Palibe chifukwa choti NovoMix 30 FlexPen iperekedwe iv.
Malangizo Mankhwala NovoMiks 30
Thawitsani wodwala
Kufunika kophatikizidwa kwathunthu kuyenera kutsimikiziridwa.
kuyimitsidwa kwa insulin musanagwiritse ntchito. Pambuyo poyambitsa
Kuyimitsidwa kwake kuyenera kukhala kofanana ndi kofiyira ndi mitambo. NovoMix 30 FlexPen idapangidwa kuti igwiritsidwe ntchito payekha.
Musadzadzenso NovoMix 30 FlexPen.
NovoMix 30 FlexPen imagwiritsidwa ntchito ndi singano zazifupi za NovoFine®.
Musanagwiritse ntchito NovoMix 30
Flekspen: ndikofunikira kuyang'ana pa label kuti mupeze mtundu woyenera wa insulin yomwe imagwiritsidwa ntchito. Nthawi zonse gwiritsani ntchito singano yatsopano jekeseni iliyonse.
Osagwiritsa ntchito NovoMix 30 FlexPen:

• mapampu a insulin,
• ngati cholembera cha syringe cha FlexPen chatayika, ngati chawonongeka kapena chopunduka, monga pamenepa insulin ikhoza kutayikira,
• ngati cholembera sichinasungidwe bwino kapena ngati chikuwuma, ngati chitayambitsa kuyimitsidwa sichikhala choyera komanso chamtambo, ngati ziphuphu zoyera kapena tinthu tating'onoting'ono tating'ono tikuwoneka pokonzekera, kutsatira pansi kapena makoma a cartridge, ndikuwapatsa mawonekedwe owoneka ngati achisanu.

NovoMix 30 Flexpen idapangidwa jakisoni wa SC.
Mankhwalawa sangathe kulowa mkati / mkati kapena mwachindunji.
Popewa kulowetsedwa, malo opangira jakisoni amayenera kusinthidwa nthawi zonse. Malo abwino owongolera ndi khoma lakunja lam'mimba, matako, kunja kwa ntchafu kapena phewa. Kuchita kwa insulin kumachitika mwachangu mukabayidwa m'chiuno.

Zotsatira zoyipa za mankhwala Novomix 30 flekspen

Zotsatira zoyipa zomwe zimachitika mwa odwala omwe amagwiritsa ntchito NovoMix 30 FlexPen zimagwirizana kwambiri ndi kuchuluka kwa mankhwala omwe amaperekedwa ndipo ndikuwonetsedwa kwa insulin. Zotsatira zoyipa kwambiri za insulin mankhwala ndi hypoglycemia. Zimatha kuchitika ngati mlingo umakulirakulira wodwala amafuna insulin. Hypoglycemia yayikulu imatha kuyambitsa chikumbumtima ndi / kapena kukhudzidwa, kutsatiridwa ndi kuwonongeka kwakanthawi kapena kosatha kwa ntchito yaubongo ngakhale kufa. Malinga ndi zotsatira za kafukufuku wazachipatala, komanso kuchuluka kwa deta yomwe idayambitsidwa pamsika, chiwopsezo cha hypoglycemia chimasiyanasiyana m'magulu osiyanasiyana a odwala komanso ndi mitundu yosiyanasiyana ya mankhwala, kuchuluka kwa hypoglycemia mwa odwala omwe amalandira insulin aspart ndi chimodzimodzi kwa omwe amalandila anthu insulin
Otsatirawa ndi pafupipafupi pazomwe zimachitika zomwe, malinga ndi kafukufuku wazachipatala, zitha kuphatikizidwa ndikuyambitsa kwa mankhwala a NovoMix 30 Flexpen.
Malinga ndi kuchuluka kwa zomwe zimachitika, izi zimachitika nthawi zina (1/1000, ≤1 / 100) ndi sikawirikawiri (1/10 000, ≤1 / 1000). Zina mwadzidzidzi zimachitika kawirikawiri (≤1/10 000).
Kuchokera ku chitetezo chamthupi
Si kawirikawiri: anaphylactic zochita.
Nthawi zina: urticaria, kuyabwa, zotupa pakhungu.
Mitundu yambiri ya hypersensitivity imatha kuphatikizira zotupa pakhungu, kuyabwa, thukuta, kusokonezeka m'mimba, angioedema, kupuma movutikira, palpitations komanso kutsika kwa magazi. Izi ndi zoopsa pamoyo.
Kuchokera ku dongosolo lamanjenje
Zosowa: zotumphukira neuropathies. Kusintha kwamphamvu kwa kayendedwe ka shuga m'magazi kungayambitse ululu wammbuyo wammbuyo, womwe nthawi zambiri umakhala wosakhalitsa.
Kuphwanya gawo la masomphenyawo
Nthawi zina: Kusokonezeka kwa kukonzanso, kumatha kuchitika kumayambiriro kwa insulin mankhwala ndipo kumakhala kochepa m'chilengedwe.
Nthawi zina: matenda ashuga retinopathy. Kukonzanso kwanthawi yayitali glycemic kuchepetsa kumachepetsa chiwopsezo cha matenda ashuga a retinopathy. Komabe, kulimbitsa kwa insulin mankhwala kuti athe kukonza bwino glycemic control kungayambitse kuchepa kwakanthawi kwa matenda ashuga retinopathy.
Pa khungu ndi subcutaneous minofu
Nthawi zina: lipodystrophy, imatha kupezeka m'malo a jakisoni chifukwa chosagwirizana ndi malingaliro oti asinthe jakisoni m'dera lomwelo, hypersensitivity. Insulin ikabayidwa, hypersensitivity ya m'deralo imatha kuchitika (redness, kutupa, ndi kuyabwa pamalo opaka jekeseni). Izi zimachitika nthawi zambiri ndipo zimatha mosakhalitsa.
Matenda osakanikirana komanso zimachitika m'malo opezeka jakisoni
Nthawi zina: Edema yachilengedwe, imatha kuyamba kumayambiriro kwa insulin. Zizindikirozi nthawi zambiri zimakhala zosakhalitsa.

Malangizo apadera ogwiritsa ntchito mankhwalawa Novomix 30 flekspen

Mlingo wosakwanira kapena kusiya kulandira chithandizo (makamaka ndi mtundu wa matenda a shuga I) kungayambitse matenda a hyperglycemia ndi matenda ashuga a ketoacidosis, mikhalidwe imeneyi ikhoza kupha.
Odwala omwe atukula kwambiri kuchuluka kwa shuga m'magazi, mwachitsanzo chifukwa chodwala kwambiri, atha kuzindikira kusintha kwawo - zizindikilo za hypoglycemia, zomwe odwala ayenera kuchenjezedwa pasadakhale.
NovoMix 30 FlexPen iyenera kutumikiridwa musanadye. Kuyambika mwachangu kwa mankhwalawa kuyenera kuganiziridwa pochiza odwala omwe ali ndi matenda opatsirana kapena kumwa mankhwala omwe angachedwetse kuyamwa kwa chakudya m'mimba. Matenda obvuta, makamaka matenda ndi kutentha thupi, zimawonjezera kufunikira kwa insulin. Posamutsa wodwala ku mitundu ina ya insulini, zizindikiro zochenjeza zoyambirira zingasinthe kapena kusatchulika pang'ono poyerekeza ndi momwe zimakhalira pokonzekera insulin. Kusamutsa wodwala kupita ku mtundu wina kapena mtundu wa insulin kumachitika moyang'aniridwa ndi achipatala. Zosintha mu ndende, mtundu (wopanga), mtundu, magwero a insulin (nyama, munthu kapena insulin analogue) ndi / kapena njira yopangira ingapangitse kusintha kwa mlingo. Mukamasintha jakisoni wa NovoMix 30 FlexPen, odwala angafunikire kusintha mtundu wa insulin. Kufunika kosankha kwa mankhwalawa kumatha kuchitika pakukhazikitsa mankhwala atsopano, komanso pakubwera milungu ingapo kapena miyezi ingapo yogwiritsidwa ntchito.
Kudumpha chakudya, kusintha mwadzidzidzi zakudya, kapena kuchita masewera olimbitsa thupi mosayembekezereka kungayambitse hypoglycemia. Poyerekeza ndi biphasic insulin yaumunthu, jakisoni wa NovoMix 30 FlexPen imabweretsa zotsatira zambiri zotchulidwa za hypoglycemic, zomwe zimatha mpaka maola 6. Izi zitha kupangitsa kusankha kuchuluka kwa insulin komanso / kapena zakudya.
Kufunika kosankha kwamankhwala kumachitika ndi
kuchuluka kwa zolimbitsa thupi kapena kusintha kadyedwe. Kuchita masewera olimbitsa thupi mutangotha ​​kudya kumawonjezera chiopsezo cha hypoglycemia.
Kuyimitsidwa kwa insulin sikuyenera kugwiritsidwa ntchito pamapampu a insulin kuti mupitirize insulin.
Nthawi ya pakati ndi kuyamwa. Zochitika zamankhwala ndi insulin aspart panthawi yoyembekezera ndizochepa. Kafukufuku wazinyama adawonetsa kuti insulin, monga insulin ya munthu, ilibe mphamvu ya embryotoxic ndi teratogenic. Kuwongolera kowonjezereka kumalimbikitsidwa pochiza amayi apakati omwe ali ndi matenda ashuga nthawi yonse yomwe ali ndi pakati, komanso ngati akuyembekezeredwa kuti ali ndi pakati. Kufunika kwa insulin nthawi zambiri kumachepera mu trimester yoyamba ya kutenga pakati ndikuwonjezeka kwambiri mu yachiwiri ndi yachitatu trimester. Pambuyo pobadwa, kufunikira kwa insulin kumabweza msanga. Palibenso zoletsa zina pa mankhwalawa odwala matenda a shuga ndi insulin nthawi yoyamwitsa, chifukwa chithandizo cha mayi woyamwitsa sichikhala pachiwopsezo cha mwana. Komabe, zingakhale zofunikira kusintha mlingo wa NovoMix 30 FlexPen.
Kukopa pa luso loyendetsa magalimoto ndi zida. Kuyankha kwa wodwalayo komanso kuthekera kwake kochita chidwi kukhoza kukhala ndi vuto la hypoglycemia. Izi zitha kukhala zowopsa nthawi zomwe maluso amenewa ali ofunika kwambiri (mwachitsanzo, poyendetsa galimoto kapena pamakina owongolera).
Odwala ayenera kulangizidwa kuti azichita zinthu zoteteza hypoglycemia musanayendetse. Izi ndizofunikira kwambiri kwa iwo omwe afooka kapena kulibe zizindikiro - zotsogola za hypoglycemia kapena zochitika za hypoglycemia zimachitika pafupipafupi. Pazinthu zotere, kuyenera ndi chitetezo choyendetsa ziyenera kulemera.

Kugwiritsa ntchito mankhwala Novomix 30 flekspen

Mankhwala angapo amakhudza kagayidwe kazakudwala, kamene kamayenera kuganiziridwa posankha mtundu wa insulin.
Mankhwala omwe amachepetsa kufunika kwa insulin: othandizira a hypoglycemic othandizira, octreotide, Mao inhibitors, osasankha β-adrenergic receptor blockers, ACE inhibitors, salicylates, mowa, anabolic steroids ndi sulfonamides.
Mankhwala omwe amalimbikitsa kufunika kwa insulin: kulera kwamlomo, thiazides, corticosteroids, mahomoni a chithokomiro, sympathomimetics ndi danazole. Ma blockers a Β-adrenergic amatha kubweza zizindikiro za hypoglycemia, mowa umatha kupititsa patsogolo kuchuluka kwa hypoglycemic.
Kusagwirizana. Kuphatikizidwa kwa mankhwala ena ku insulin kungayambitse kuwonongeka kwake, mwachitsanzo, mankhwala okhala ndi thiols kapena sulfites. NovoMix 30 Flexpen silingathe kuwonjezeredwa ku mayankho a kulowetsedwa.

Bongo wa Novomix 30 flekspen, Zizindikiro ndi chithandizo

Ngakhale mulibe tanthauzo lenileni la mankhwala osokoneza bongo a insulin, hypoglycemia imatha kuchitika mothandizidwa ndi mankhwalawa.
Hypoglycemia yofatsa imayimitsidwa ndi kumeza kwa glucose kapena zakudya zotsekemera. Chifukwa chake, odwala matenda a shuga amalangizidwa kuti azinyamula masamba angapo a shuga, maswiti, makeke kapena mandimu okoma zipatso.
Mu hypoglycemia yayikulu, pomwe wodwalayo sakudziwa, ndikofunikira kuchita jekeseni wa v / m kapena s / c wa glucagon (kuyambira 0,5 mpaka 1 mg), ndi munthu yemwe adalandira malangizo oyenera. Katswiri wazachipatala amatha kuperekanso shuga m'magazi a wodwalayo ngati wodwala sayankha kukonzekera kwa glucagon mkati mwa mphindi 10-15.
Wodwalayo akadziwikanso, amayenera kudya zakudya zamagulu mkati kuti asayambenso matenda obwera chifukwa cha hypoglycemia.

Kusunga mankhwala a Novomix 30 flekspen

Moyo wa alumali ndi zaka 2.
Zogwiritsidwa ntchito cholembera cha NovoMix 30 FlexPen sichiyenera kusungidwa mufiriji. Cholembera cha syringe, chomwe chimagwiritsidwa ntchito kapena kunyamulidwa nanu, chizisungidwa osapitilira milungu 4 (kutentha osapitirira 30 ° C).
Zosagwiritsidwa ntchito cholembera cha syringe ndi NovoMix 30 FlexPen ziyenera kusungidwa mufiriji kutentha kwa 2-8 ° C (osayandikira kwambiri mufiriji). Osamawuma. Kuti muteteze ku zotsatira za kuwala, sungani cholembera ndi chovalacho.

Mndandanda wa malo ogulitsa mankhwala komwe mungagule Novomix 30 flekspen:

Wopanga:

Kuyimira
Novo Nordisk A / S
119330, Moscow,
Lomonosovsky Prospekt 38, ofesi 11

Malangizo kwa odwala pakugwiritsa ntchito NovoMix® 30 FlexPen® Chonde werengani malangizowa mosamala musanagwiritse ntchito NovoMix® 30 FlexPen®
NovoMix ® 30 FlexPen ® ndi cholembera china chokha cha insulini ndi chothandizira. Mlingo wa insulin womwe waperekedwa kuyambira 1 mpaka 60 mayunitsi, ungasinthidwe mu zowonjezera za 1 unit. NovoMix® 30 FlexPen ® idapangidwa kuti igwiritsidwe ntchito ndi singano zotayika NovoFayn® kapena NovoTvist® mpaka 8 mm kutalika. Monga kusamala, nthawi zonse tengani dongosolo la insulin m'malo mwanu NovoMix® 30 FlexPen ® itayika kapena itawonongeka.

Kukonzekera kwa NovoMix® 30 FlexPen ®
Chongani cholembera kuti muwonetsetse kuti FlexPen® ili ndi mtundu woyenera wa insulin. Pamaso jakisoni woyamba, sakanizani insulin:

A
Kuti muthandizire kusanganikirana, lolani kuti mankhwalawa atenthe ku kutentha kwa chipinda. Chotsani kapu ku cholembera.

Mu
Pindani cholembera pakati pa manja nthawi 10 - ndikofunikira kuti chikhale pamalo opingasa.

Ndi
Kwezani cholembera chotsika nthawi 10, monga zikuwonekera pa Chithunzi C, kotero kuti galasi lagalasi limasuntha kuchokera kumapeto kwenikweni kwa katiriji kupita mbali ina. Bwerezani zomwe zatchulidwa mu mfundo B ndi C mpaka zomwe zili mu cartridge zikhale zoyera komanso mitambo.
Jekeseni aliyense wotsatira, sakanizani zomwe zalembedwa mu Chithunzi C osachepera 10 mpaka zomwe zili mu cartridge zimakhala zoyera komanso kwamitambo. Pambuyo posakaniza, perekani jakisoni.

Nthawi zonse onetsetsani kuti magawo 12 a insulini amakhalabe mu katiriji kuonetsetsa kuti kusakanikirana kofanana. Ngati magawo ochepera 12 atsala, gwiritsani ntchito NovoMix® 30 FlexPen® yatsopano.

Singano ubwenzi

D
Chotsani chomata kuchotsekera mu singano yotaya. Yanikani singano mokoma komanso mwamphamvu pa NovoMix® 30 FlexPen ®.

E
Chotsani thumba lakunja la singano, koma osalitaya.

F
Chotsani ndikutaya kapu yamkati ya singano.