Momwe mungagwiritsire ntchito NovoMix 30 Penfill Kuyimitsidwa

Mayina apadziko lonse lapansi - novomix 30 penfill

Kupanga ndi mawonekedwe a kumasulidwa.

Kuyimitsidwa kwa kayendetsedwe ka SC yoyera, yopanda pake (yopanda matumba, makangaza amatha kutuluka), ikalumikizidwa, imasunthika, ndikupanga choyera komanso chopanda utoto kapena chosawoneka bwino, posakaniza mosamala ndi kuyimitsidwa koyenera kuyenera. 1 ml ili ndi magawo awiri a insulin - 100 IU (3.5 mg), insulini ya insulin - 30%, crystalline insulin aspart protamine - 70%.

Othandizira: glycerol - 16 mg, phenol - 1.5 mg, metacresol - 1.72 mg, nthaka ya zinc. - 19.6 μg, sodium kolorayidi - 0,877 mg, sodium hydrogen phosphate dihydrate - 1,25 mg, protamine sulfate

0,33 mg wa sodium hydroxide

2.2 mg, hydrochloric acid

1,7 mg, madzi d / i - mpaka 1 ml.

Kuyimitsidwa d / p / kukhazikitsidwa kwa 100 PIECES / 1 ml: makatoni 3 ml 5 ma PC.

3 ml (300 PIECES) - makatoni (5) - matuza (1) - mapaketi a makatoni.

Zotsatira za pharmacological.

NovoMix 30 Penfill ndi kuyimitsidwa kwamitundu iwiri komwe kumakhala kusakanikirana kwa insulin analogues: soluble insulin aspart (30% yochepa-insulin analog) ndi makhiristo a aspart protamine insulin (70% yapakati-insulin analog).

Mankhwala a NovoMix 30 penfill ndi insulin aspart, omwe amapangidwa ndi njira ya DNA yogwiritsira ntchito biotechnology pogwiritsa ntchito Saccharomyces cerevisiae.

Insulin aspart ndi insipotential sungunuka wa munthu insulin yochokera molarity indices.

Kutsika kwa shuga m'magazi kumachitika chifukwa cha kuwonjezeka kwa mayendedwe ake amkati atatha kumangiriza insulin yolandilira minofu ndi minyewa yamafuta komanso kuletsa munthawi yomweyo kupanga shuga.

Pambuyo subcutaneous makonzedwe a NovoMix 30 Penfill, zotsatira zimachitika mkati 10-20 mphindi. Zolemba malire
momwe zimawonedwera mosiyanasiyana kuyambira maola 1 mpaka 4 jekeseni. Kutalika kwa mankhwalawa kumafika maola 24.

M'miyezi itatu yoyeserera yolimbana ndi odwala omwe ali ndi matenda amtundu wa 1 ndi mtundu wa 2 omwe alandila NovoMix 30 Penfill ndi biphasic insulin ya anthu 30 kawiri patsiku musanadye chakudya cham'mawa komanso chakudya chamadzulo, NovoMix 30 Penfill adawonetsedwa kuti amachepetsa glucose wa postprandial kwambiri (pambuyo kadzutsa ndi chakudya chamadzulo).

Kusanthula kwa meta kuchokera ku mayeso asanu ndi anayi azachipatala okhudzana ndi odwala omwe ali ndi matenda ashuga
Mitundu 1 ndi 2 adawonetsa kuti NovoMix 30 Penfill, pomwe idaperekedwa chakudya cham'mawa komanso chakudya chamadzulo, imapereka chiwongolero chabwino cha glucose wamagazi a postprandnal (kuchuluka kwapakati kwamankhwala a glucose pambuyo pa chakudya cham'mawa, masana ndi chakudya chamadzulo), poyerekeza ndi insulin 30 ya anthu.

Ngakhale glucose yofulumira idakwera kwambiri mwa odwala omwe amagwiritsa ntchito NovoMix 30 penfill, onse, NovoMix 30 Penfill ali ndi zotulukapo zofanana pakukumana kwa glycosylated hemoglobin (HbA_1c,, ngati biphasic insulin ya anthu 30.

Mu kafukufuku wazachipatala wokhudzana ndi odwala 341 omwe ali ndi matenda a shuga a mtundu wa 2, odwala adasinthidwa mosintha kuti akhale magulu a chithandizo cha NovoMix 30 Penfill, NovoMix 30 Penfill osakanikirana ndi metformin ndi metformin osakanikirana ndi sulfonylurea.

HbA_1c Pambuyo pa milungu 16 ya chithandizo sichinasinthe odwala omwe amalandila NovoMix 30 Penfill osakanikirana 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 cha odwala a novoMix 30 Penfill osakanikirana ndi metformin adayambitsa kuchepa kwakukulu kwa ndende
Hba_1ckuposa odwala kulandira metformin osakanikirana ndi sulfonylurea.

Pakafukufuku wina, odwala omwe ali ndi matenda a shuga a mtundu wachiwiri omwe amakhala ndi vuto lonyansa la glycemic omwe adamwa mankhwala 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 Penfill inakwana 2.8% (mtengo woyamba unali 9.7%). Mu 66% ndi 42% ya odwala omwe amagwiritsa ntchito NovoMix 30 Penfill kumapeto kwa kafukufukuyu, HbA imayikira_1c anali pansi 1% 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 panthawi ya mayeso azachipatala okhudzana ndi odwala omwe ali ndi matenda a shuga 2 amawonetsa kuchepa kwa ziwonetsero zonse za nocturnal hypoglycemia ndi hypoglycemia yayikulu ya NovoMix 30 Penfill poyerekeza ndi insulin ya anthu apakati a 30 nthawi yomweyo. Hypoglycemia mwa odwala omwe amalandila NovoMix 30 Penfill anali apamwamba.

Ana ndi achinyamata. Kafukufuku wazachipatala wa masabata 16 adachitidwa omwe anayerekezera magazi a glucose atatha kudya ndi NovoMix 30 (asanakadye chakudya), insulin / biphasic human insulin 30 (asanadye) komanso isofan-insulin (yoyendetsedwa asanagone). 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 Penfill kapena biphasic insulin 30 ya anthu, panalibe kusiyana kulikonse pamalingaliro a 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 ndi kuchuluka kwa shuga pambuyo chakudya pagulu la odwala omwe amagwiritsa ntchito NovoMix 30 Penfill anali otsika kwambiri poyerekeza ndi zomwe zimapezeka m'gulu la odwala omwe amagwiritsa ntchito insulin ya anthu a biphasic 30. HbA_1c kumapeto kwa kafukufukuyu, gulu la insulin 30 ya anthu omwe anali ochepa kwambiri anali otsika kwambiri kuposa gulu la odwala omwe amagwiritsa ntchito NovoMix 30 Penfill.

Odwala okalamba. Pharmacodynamics NovoMix 30 Malipiro a odwala okalamba ndi a senile sanaphunzire. 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_{GIR, 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 chopanga mamolekyulu kupanga hexamers m'chigawo chosungunuka cha NovoMix 30 Penfill, chomwe chimawonedwa 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 pa fomu ya kristalo, protamine-insulin aspart, muyeso wa mayamwidwe womwe uli wofanana ndi wa insulin NPH ya anthu.

Kuchuluka kwa insulin yambiri m'magazi pambuyo pa kutumikiridwa kwa NovoMix 30 Penfill ndi 50% kuposa kuposa kwa insulin 30 ya anthu, ndipo nthawi yomwe imakwaniritsidwa imakhala yochepa kwambiri kuposa momwe imaperekera insulin 30 ya anthu.

Odzipereka athanzi, pambuyo pa kukonzekera kwa NovoMix 30 pamlingo wa 0,20 U / kg thupi, kuchuluka kwakukulu kwa insulini mu seramu yamagazi kufikiridwa pambuyo pa mphindi 60 ndikufikira 140 ± 32 pmol / L. Kutalika kwa T_1/2NovoMix 30, yomwe ikuwonetsa 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 komanso odwala a senile. Kafukufuku wokhudza pharmacokinetics a NovoMix 30 odwala okalamba ndi a senile sanachitike. Komabe, kusiyana pakati pa pharmacokinetics pakati pa insulin aspart ndi soluble insulin ya anthu okalamba omwe ali ndi matenda a shuga 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 (magawo awiri othandiza: 60-120 mphindi)), pomwe ambiri ndende (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 Penfill kwa odwala omwe ali ndi vuto la Impso 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 Penfill mu ana ndi achinyamata sanaphunzire. Komabe

Mankhwala a pharmacokinetic ndi pharmacodynamic a soluble aspart insulin amaphunziridwa mwa ana (azaka 6 mpaka 12) komanso achinyamata (azaka 13 mpaka 17) omwe ali ndi matenda a shuga a mtundu woyamba.

Kwa odwala azaka zonse ziwiri, insulin aspart imadziwika ndi mayankho a T mwachangu_maxchimodzimodzi ndi akulu. Komabe, zofunikira za C_max m'magulu awiri azaka ziwiri anali osiyana, zomwe zikuwonetsa kufunikira kwa kusankha kwa mankhwala a insulin.

Chitetezo chakumtunda kwamtunda. M'maphunziro oyambira, palibe chowopsa kwa anthu, kutengera deta yomwe ambiri amavomereza.

maphunziro a chitetezo chamatsenga, kugwiritsanso ntchito poizoni, ma genotoxicity ndi poizoni wobereka.

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.

Mtundu woyamba wa matenda a shuga 1. Mellitus wa mtundu 2 wa matenda osokoneza bongo omwe amatsutsana ndi mankhwalawa.

Mlingo regimen ndi njira kugwiritsa ntchito osakaniza 30 penfill.

NovoMix 30 Penfill idapangidwa kuti ikwaniritse makatani. Simungathe kulowetsa NovoMix 30 Penfill kudzera m'mitsempha, chifukwa izi zimatha kuyambitsa hypoglycemia. NovoMix 30 iyeneranso kupewedwa intramuscularly. NovoMix 30 Penfill for subcutaneous insulin infusion (PPII) pamapampu a insulin sangathe kugwiritsidwa ntchito. Mlingo wa NovoMix 30 Penfill umatsimikiziridwa ndi dokotala aliyense payekha, mogwirizana ndi zosowa za wodwalayo. Kuti mukwaniritse bwino kwambiri matenda a glycemia, tikulimbikitsidwa kuwongolera kuchuluka kwa shuga m'magazi ndikusintha mlingo wa mankhwalawa.

Odwala omwe ali ndi matenda a shuga a mtundu wa 2, NovoMix 30 Penfill, amatha kuwerengeka ngati mankhwala a monotherapy komanso kuphatikiza ndi mankhwala amkamwa a hypoglycemic panthawi yomwe kuchuluka kwa shuga m'magazi kumangoyendetsedwa ndi mankhwala amkamwa a hypoglycemic.

Chiyambi cha zamankhwala. Kwa odwala omwe ali ndi matenda a shuga a mtundu woyamba omwe ayambitsidwa ndi insulin, muyezo wa NovoMix 30 Penfill ndi magawo 6 musanadye chakudya cham'mawa komanso magawo 6 musanadye chakudya chamadzulo. Kukhazikitsidwa kwa magawo khumi ndi awiri a NovoMix 30 Penfill kamodzi patsiku madzulo (musanadye chakudya chamadzulo) ndikololedwa.

Tumizani wodwala kuchokera kukonzekera kwina kwa insulin. Mukasamutsa wodwala kuchokera ku biphasic insulin ya anthu kupita ku NovoMix 30 Penfill iyenera kuyamba chimodzimodzi

Mlingo ndi makonzedwe a 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 kwachipatala ndikofunikira pakusintha kwa wodwalayo komanso m'milungu yoyamba yogwiritsa ntchito mankhwalawa.

Kulimbitsa chithandizo. Kulimbitsa mankhwala a NovoMix 30 Penfill ndikotheka kusintha kuchokera panjira imodzi tsiku lililonse kupita pawiri. Ndikulimbikitsidwa kuti mutatha kutenga magawo 30 a mankhwalawa kuti mugwiritse ntchito NovoMix 30 Penfill kawiri pa tsiku, ndikugawa mlingo mu magawo awiri ofanana - m'mawa ndi madzulo (musanadye kadzutsa ndi chakudya chamadzulo). Kusinthika kwa kugwiritsidwa ntchito kwa NovoMix 30 Penfill katatu patsiku ndikotheka ndikugawa mlingo wa m'mawa m'magawo awiri ofanana ndikupereka magawo awiriwa m'mawa komanso pakudya nkhomaliro (katatu katatu tsiku).

Kusintha kwa Mlingo. Kusintha mlingo wa NovoMix 30 Penfill, kutsika kwa glucose kotsika kwambiri komwe kumapezeka masiku atatu apitawa kumagwiritsidwa 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 Penfill, tikulimbikitsidwa kugwiritsa ntchito malingaliro otsatirawa a kumwa mankhwala:

Magulu apadera a odwala. Monga nthawi zonse, mukamagwiritsa ntchito mankhwala a insulin, odwala omwe ali m'magulu apadera, kuphatikiza shuga m'magazi kuyenera kuyang'aniridwa mosamala kwambiri ndipo mlingo wa aspart aspart payekha uyenera kusintha.

Okalamba komanso odwala a senile. NovoMix 30 Penfill imatha kugwiritsidwa ntchito mwa odwala okalamba, komabe, momwe amamugwiritsira ntchito limodzi ndi mankhwala am'mlomo a hypoglycemic odwala omwe ali ndi zaka zoposa 75 ali ndi malire.

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 Penfill amatha kugwiritsidwa ntchito pochiza ana ndi achinyamata azaka zopitilira zaka 10 ngati milandu ya insulin yosakaniza isanachitike. Zambiri zamankhwala zamankhwala zilipo kwa ana a zaka 6 - 9 (onani gawo la Pharmacodynamic Properties).

NovoMix 30 Penfill 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 zochita za NovoMix 30 Penfill zimatengera mlingo, malo oyendetsera, kutsika kwa magazi, kutentha ndi kuchuluka kwa zochitika zolimbitsa thupi.

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

Malangizo kwa odwala ogwiritsa ntchito NovoMix 30 Penfill.

Simungagwiritse ntchito NovoMix 30 Penfill:

Ngati mumadwala (hypersensitive) kuti mupeze insulin kapena chilichonse chomwe chimapanga NovoMix 30 Penfill.

Ngati mukumva kuti hypoglycemia ikuyandikira (shuga wamagazi ochepa).

Kwa subcutaneous insulin kulowetsedwa (PPII) mu mapampu a isisulin.

Ngati katiriji kapena zida zokumbira zomwe zili ndi cartridge zomwe zaikidwapo zatsitsidwa, kapena katirijiyo wawonongeka kapena waphwanyidwa.

Ngati machitidwe osunga mankhwalawo adaphwanyidwa kapena ndiuma.

Ngati insulin singakhale yoyera komanso yamtambo mutasakaniza.

Ngati zotupa zoyera zikukhalabe pokonzekera mukasakaniza kapena ngati tinthu tating'onoting'ono timamamatira pansi kapena makhoma a cartridge.

Musanagwiritse ntchito NovoMix 30 Penfill:

Chongani cholembera kuti muwonetsetse kuti mtundu woyenera wa insulini wasankhidwa.

Nthawi zonse muziyang'ana cartridge, kuphatikizapo pisitoni ya mphira. Osagwiritsa ntchito cartridge ngati ili ndi zowonongeka zowoneka, kapena ngati pali kusiyana pakati pa piston ndi Mzere Woyera pa cartridge. Kuti mupeze malangizo owonjezereka, onani malangizo ogwiritsira ntchito kachitidwe ka insulin.

Nthawi zonse gwiritsani ntchito singano yatsopano jekeseni iliyonse kuti mupewe matenda.

NovoMix 30 Malipiro ndi singano zimangopita kwa munthu payekha.

NovoMix 30 ndi ya jakisoni wofinya. Musamapereke insulini kudzera m'mitsempha kapena m'mitsempha.

Nthawi iliyonse, sinthani malo opangira jekeseni mkati mwa gawo la anatomical. Izi zikuthandizira kuchepetsa chiwopsezo cha zisindikizo ndi zilonda pamalo a jakisoni. Malo abwino kwambiri a jekeseni ndi khoma lakunja lam'mimba, matako, ntchafu kapena phewa. Insulin imachita zinthu mwachangu ngati itayambitsidwa khoma lakumbuyo lamkati. Nthawi zonse muziyang'anira ndende ya magazi anu.

Njira yophatikiza insulin.

Musanayike katiriji mu jakisoni kuti mupereke insulin, igwiritseni kutentha ndi firiji kenako kusakaniza monga tafotokozera pansipa:

Mukamagwiritsa ntchito NovoMix 30 Penfill kwa nthawi yoyamba, gudungani katiriji ndi manja anu maulendo 10 - ndikofunikira kuti cartridge ili m'malo owongoka. Kenako kwezani ndikutsitsa cartridge kangapo mmwamba ndi pansi kuti galasi la galasi mkati mwa cartridge lisunthe kuchokera mbali ina ya cartridge kupita mbali ina. Bwerezani izi pamanambala mpaka
mpaka madziwo azikhala oyera komanso mitambo. Njira zosakanikirana zimakhala zosavuta ngati pofika nthawi iyi insulin itayamba kutentha. Lowetsani nthawi yomweyo.

Jekeseni aliyense wotsatira, gwiritsani ntchito jakisoni ndi cartridge momwemo mpaka madzi atayamba kuyera ndi mitambo, koma osachepera 10. Lowetsani nthawi yomweyo.

Yang'anani kuti magawo 12 a insulini amakhalabe mu katiriji kuti atsimikizire kusakanikirana. Ngati magawo ochepera 12 atsala, gwiritsani ntchito NovoMix 30 Penfill.

Momwe mungapangire insulin.

Insulin iyenera kuyikiridwa pansi pa khungu. Gwiritsani ntchito njira ya jakisoni yomwe dokotala wanu kapena namwino mumatsatira, kutsatira malangizo opereka insulin monga afotokozedwera malangizo a chipangizo chanu chogwiritsira ntchito insulin.

Gwirani singano pansi pakhungu lanu kwa masekondi 6 osachepera. Sungani zomwe zimayesedwa mpaka singano itulutse pansi pakhungu. Izi zikuwonetsetsa kuti insulin yathunthu imasungidwa ndipo izitha kuteteza magazi kuti asalowe ndi singano kapena katoni ndi insulin.

Mukabaya jakisoni aliyense, onetsetsani kuti mukuchotsa ndi singano, osasunga NovoMix 30 Penfill ndi singano yomata. Kupanda kutero, madzi amatha kutuluka kuchokera ku cartridge, zomwe zingayambitse kuchuluka kwa insulin.

Musadzazenso katoniyo ndi insulin.

NovoMix 30 Penfill idapangidwa kuti igwiritsidwe ntchito ndi NOvo Nordisk insulin injection system ndi NovoFine kapena NovoTvist.

Ngati NovoMix 30 Penfill ndi insulini ina mu penfill cartridge imagwiritsidwa ntchito pochiza nthawi yomweyo, magawo awiri osiyana a insulin makonzedwe ayenera kugwiritsidwa ntchito, imodzi iliyonse ya insulin.

Monga chisamaliro, nthawi zonse muzikhala ndi inshuwaransi popereka insulin ngati NovoMix 30 Penfill itayika kapena yowonongeka.

Njira zopewera kugwiritsa ntchito kusakaniza kwatsopano 30 penfilla.

NovoMix 30 Malipiro ndi singano ndizothandiza nokha. Musadzazenso makatoni a Penfill. NovoMix 30 Penfill sangagwiritsidwe ntchito ngati mutasakaniza siyikhala yoyera komanso yamitambo. Iyenera kutsimikizika kwa wodwala kufunika kosakanikirana ndi NovoMix 30 Penfill kuyimitsidwa musanayambe kugwiritsidwa ntchito. Simungagwiritse ntchito NovoMix 30 Penfill ngati pali madzi oundana. Odwala ayenera kuchenjezedwa kuti ataye singano pambuyo jekeseni aliyense.

Zotsatira zoyipa.

Zotsatira zoyipa zomwe zimapezeka mwa odwala omwe amagwiritsa ntchito NovoMix 30 makamaka zimachitika chifukwa cha kupatsirana kwamatenda. Chochitika chovuta kwambiri chambiri ndi insulin ndi hypoglycemia. Zomwe zimachitika chifukwa chogwiritsa ntchito NovoMix 30 zimasiyana malinga ndi kuchuluka kwa odwala, kuchuluka kwa mankhwalawa, komanso kuwongolera glycemic.

Pa gawo loyambirira la insulin, zolakwika zotupa, edema ndi zimachitika zimapezeka m'malo a jakisoni
mankhwalawa (kuphatikizapo kupweteka, kufiyira, ming'oma, kutupa, hematoma, kutupa ndi kuyabwa pamalowo jakisoni. Zizindikirozi nthawi zambiri zimakhala zakanthawi. Kusintha msanga pakuwongolera glycemic kungayambitse mkhalidwe wa "ululu wammbuyo", womwe nthawi zambiri umatembenuka. 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. Zomwe zimayambitsa zovuta zimafotokozedwa ngati: pafupipafupi (≥1 / 10), nthawi zambiri (≥ 1/100 kwa mankhwala osokoneza bongo, kuchepetsa kuchepa kwa chakudya.

Matenda okhala ndi vuto limodzi, makamaka opatsirana komanso kutentha thupi, nthawi zambiri amalimbikitsa kufunika kwa insulin. Kusintha kwa magazi kungafunikenso ngati wodwala ali ndi matenda a impso, chiwindi, mkhutu wa adrenal ntchito, pituitary gland kapena chithokomiro cha chithokomiro.

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

Kusamutsa wodwala kuchokera kukonzekera kwina kwa insulin. 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 yaumunthu, analog ya insulin yaumunthu) pokonzekera insulin ndi / kapena njira yopangira, kusintha kwa mlingo kungafunike. Odwala omwe amasintha kuchokera ku insulin ina kukonzekera mankhwala a NovoMix 30 Penfill angafunikire kuwonjezera kuchuluka kwa jakisoni kapena kusintha mlingo poyerekeza ndi Mlingo wa kukonzekera kwa insulin kale. Ngati ndi kotheka, kusintha kwa mlingo, mutha kupanga kale jakisoni woyamba wa mankhwalawa kapena mkati mwa milungu yoyamba kapena miyezi ya chithandizo.

Zokhudza malo jakisoni. Monga mankhwala ena a insulin, zimachitika mu jakisoni wa jekeseni, yomwe imawonetsedwa ndi kupweteka, kufiyira, ming'oma, kutupa, hematomas, kutupa ndi kuyabwa. Kusintha pafupipafupi jakisoni wambiri m'dera limodzilimodzi kumatha kuchepetsa zizindikiro kapena kuteteza kukula kwa izi. Kuchitidwa nthawi zambiri kumatha patatha masiku angapo mpaka milungu ingapo. Nthawi zina, NovoMix 30 Penfill ingafunike kuchotsedwa chifukwa cha zomwe zimachitika jekeseni.

Kugwiritsa ntchito munthawi yomweyo mankhwala a gulu la thiazolidinedione komanso kukonzekera insulin.Milandu yokhudzana ndi matenda a mtima omwe amayamba chifukwa cha kulephera kwa mtima adanenedwa mothandizidwa ndi odwala omwe ali ndi thiazolidinediones kuphatikiza kukonzekera kwa insulin, makamaka ngati odwala oterewa ali pachiwopsezo chotukuka kwa mtima wosalephera. Izi zimayenera kukumbukiridwa popereka mankhwala ophatikiza ndi thiazolidatediones ndi insulin yokonzekera odwala. Ndi mankhwala osakanikirana oterowo, ndikofunikira kuchita mayeso azachipatala kwa odwala kuti azindikire zizindikiritso za mtima kulephera, kulemera kwa thupi ndi kupezeka kwa edema. Ngati zizindikiro za kulephera kwa mtima zikuchulukirachulukira kwa odwala, chithandizo ndi thiazolidatediones ziyenera kusiyidwa.

Kukopa pa kuyendetsa magalimoto ndi kugwira ntchito ndi njira.Kuthekera kwa odwala kulolera komanso kuchuluka kwa momwe angachitire amatha kusokonezeka panthawi ya hypoglycemia, zomwe zimatha kukhala zowopsa nthawi zomwe maluso amenewa amafunikira makamaka (mwachitsanzo, poyendetsa magalimoto kapena kugwira ntchito ndi makina ndi makina).

Odwala ayenera kulangizidwa kuti achitepo kanthu popewa kukula kwa hypoglycemia mukamayendetsa. Izi ndizofunikira kwambiri kwa odwala omwe alibe kapena kuchepetsedwa Zizindikiro zakutsogolo kwa hypoglycemia kapena akuvutika ndi zochitika zapafupipafupi za hypoglycemia. Muzochitika izi, kuyendetsa bwino ndikuchita ntchito yotereyi kuyenera kuganiziridwa.

Bongo.

Mlingo wa insulin wofunikira wowonjezera wa insulin sunakhazikitsidwe, koma hypoglycemia imatha kukula pang'onopang'ono ngati mulingo wambiri wa insulin umayendetsedwa molingana ndi zosowa za wodwala.

Wodwala amatha kuthetsa hypoglycemia wofatsa mwa kudya shuga kapena zakudya zomwe zili ndi shuga. Chifukwa chake, ndikulimbikitsidwa kwa odwala omwe ali ndi matenda ashuga kuti azisenza mankhwala okhala ndi shuga nthawi zonse.

Ngati hypoglycemia yavuta kwambiri, wodwalayo akapanda kudziwa, 0,5 mg mpaka 1 mg ya glucagon amayenera kuthandizidwa kudzera mu minyewa kapena modutsa (munthu wophunzitsidwa bwino angagwiritsidwe ntchito) kapena njira ya intravenous glucose (dextrose) (katswiri wazachipatala yekha amene angagwire ntchito). M'pofunikanso kuperekera dextrose m'mitsempha ngati wodwalayo asadzayambenso chikumbumtima mpaka mphindi 10-15 atatha kugwirira ntchito kwa glucagon. Pambuyo podzikanso, wodwalayo amalangizidwa kuti azidya zakudya zokhala ndi mchere wambiri kuti muchepetse kubwerezanso kwa hypoglycemia.

Kuchita ndi mankhwala ena.

Hypoglycemic zotsatira za insulin kuonjezera m'kamwa mankhwala hypoglycemic, Mao zoletsa, Ace zoletsa, carbonic anhydrase zoletsa, si kusankha beta-blockers, bromocriptine, octreotide, sulphonamides, anabolic mankhwala, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, mankhwala Li +, mankhwala a ethanol ndi ethanol. Kulera kwapakamwa, corticosteroids, mahomoni a chithokomiro, thiazide diuretics, heparin, tridclic antidepressants, sympathomimetics, danazole, clonidine, BMKK, diazoxide, morphine, phenytoin, nikotini kufooketsa mphamvu ya hypoglycemic. Mothandizidwa ndi reserpine ndi salicylates, kufooka komanso kuwonjezeka kwa machitidwe a mankhwalawa ndizotheka.

Malo opumulira ochokera ku malo ogulitsa mankhwala.

Migwirizano ndi magwiritsidwe akusungidwa.

Sungani pa kutentha kwa 2 ° C mpaka 8 ° C (mufiriji), koma osati pafupi ndi mufiriji. Osamawuma. Pa makatiriji otseguka: Osasunga mufiriji. Sungani ku kutentha kosaposa 30 ° C. Gwiritsani ntchito pakatha milungu 4.

Sungani makatoni makatoni kuti muteteze.

NovoMix 30 Penfill iyenera kutetezedwa ku kutentha kwakukulu ndi kuwala. Pewani kufikira ana.

Moyo wa alumali ndi zaka 2.

Kugwiritsa ntchito mankhwala a Novomix 30 penfill pokhapokha malinga ndi dokotala, malangizo ndi omwe amaperekedwa!

Njira yogwiritsira ntchito NovoMix 30 Penfill mu fomu yoyimitsidwa

NovoMix® 30 Penfill® idapangidwa kuti ikwaniritse makatani. Osamayendetsa NovoMix® 30 Penfill® kudzera m'mitsempha, chifukwa izi zimatha kuyambitsa hypoglycemia. Magulu oyendetsa makanema a NovoMix® 30 Penfill® ayeneranso kupewa. Osagwiritsa ntchito NovoMix® 30 Penfill® chifukwa cha subcutaneous insulin kulowetsedwa (PPII) pamapampu a insulin.

Mlingo wa NovoMix® 30 Penfill ® 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 Penfill ® akhoza kuthandizidwa onse ngati mankhwalawa komanso kuphatikiza ndi mankhwala amkamwa a hypoglycemic milandu pomwe kuchuluka kwa shuga m'magazi kumangoyendetsedwa ndi mankhwala amkamwa a hypoglycemic.

Kwa odwala omwe ali ndi matenda a shuga a mtundu woyamba 2 omwe amapatsidwa insulin yoyamba, mankhwalawa a NovoMix ® 30 Penfill ® ndi magawo 6 musanadye chakudya cham'mawa komanso magawo 6 musanadye chakudya chamadzulo. Kukhazikitsidwa kwa magawo 12 a NovoMix® 30 Penfill® 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, Penfill® iyenera kuyambitsidwa ndi mlingo womwewo ndi mawonekedwe ake. Kenako sinthani za mankhwalawa mogwirizana ndi zofunikira za wodwalayo (onani malingaliro otsatirawa okhudza kuchuluka kwa mankhwalawo). Monga nthawi zonse posamutsa wodwala ku mtundu watsopano wa insulin, kuyang'aniridwa kwamankhwala kofunikira kumafunikira pakusintha kwa wodwala komanso m'masabata oyamba ogwiritsa ntchito mankhwalawa.

Kulimbitsa mankhwala a NovoMix ® 30 a Penfill ® ndikutheka ndikusintha kwa mtundu umodzi wa tsiku ndi tsiku kupita pawiri. Ndikulimbikitsidwa kuti mutatha kulandira magawo 30 a mankhwalawa kuti mugwiritse ntchito NovoMix® 30 Penfill® kawiri pa tsiku, mugawanitse mlingowo m'magawo awiri ofanana - m'mawa ndi madzulo (musanadye chakudya cham'mawa komanso chamadzulo). Kusinthika kwa kugwiritsidwa ntchito kwa NovoMix® 30 Penfill® katatu patsiku ndikotheka ndikugawa mlingo wam'mawa m'magawo awiri ofanana ndikuyambitsa magawo awiriwa m'mawa komanso pachakudya chamasana (katatu tsiku tsiku).

Kusintha mlingo wa NovoMix® 30 Penfill ®, magazi ochepetsa magazi a shuga omwe 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 dozi kumachitika kamodzi pa sabata mpaka pomwe phindu la HbA1c lifika.

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 Penfill®, tikulimbikitsidwa kugwiritsa ntchito malangizo awa:

Magazi a shuga ndende musanadye

Magulu apadera a odwala

Monga nthawi zonse, mukamagwiritsa ntchito mankhwala a insulin, odwala omwe ali m'magulu apadera, kuphatikiza shuga m'magazi kuyenera kuyang'aniridwa mosamala kwambiri ndipo mlingo wa aspart aspart payekha uyenera kusintha.

Okalamba komanso odwala a senile

NovoMix® 30 Penfill ® ikhoza kugwiritsidwa ntchito mwa odwala okalamba, komabe, zomwe zimawagwiritsa ntchito limodzi ndi mankhwala amkamwa 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 Penfill ® ikhoza kugwiritsidwa ntchito pochiza ana ndi achinyamata azaka zopitilira zaka 10 ngati milandu ya insulin yosakaniza isanachitike. Zambiri zamankhwala zamankhwala zilipo kwa ana a zaka 6 - 9 (onani gawo la Pharmacodynamic Properties).

NovoMix® 30 Penfill® 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 zochita za NovoMix® 30 Penfill® kumadalira mlingo, malo oyendetsera, kutsika kwa magazi, kutentha ndi mulingo wa zolimbitsa thupi.

Poyerekeza ndi biphasic insulin yaumunthu, NovoMix® 30 Penfill® imachitapo kanthu mwachangu, kotero iyenera kuperekedwa mwachangu musanadye. Ngati ndi kotheka, NovoMix® 30 Penfill® imatha kutumikiridwa patangotha ​​chakudya.

Momwe mungagwiritsire ntchito: Mlingo ndi njira ya chithandizo

S / c mu ntchafu kapena khomo lam'mimba lakunja. Ngati ndi kotheka, mdera la phewa kapena matako. Ndikofunikira kusintha malo a jekeseni mkati mwa anatomical dera kuti muchepetse kukula kwa lipodystrophy. Mankhwalawa amaperekedwa nthawi yomweyo asanadye, ngati n`koyenera, atangodya. Kutentha kwa insulin yoyenera kuyenera kukhala kutentha kwambiri.

Mlingo wa mankhwalawa umatsimikiziridwa ndi dokotala aliyense payekhapayekha, potengera kuchuluka kwa shuga m'magazi. Pafupifupi, tsiku lililonse mlingo wa NovoMix 30 Penfill ndi 0.5-1 U / kg thupi. Odwala omwe ali ndi insulin kukaniza (kuphatikizapo chifukwa cha kunenepa kwambiri), kufunikira kwa insulin tsiku ndi tsiku kumatha kuwonjezereka, ndipo odwala omwe ali ndi chinsinsi cha insulin, amatha kuchepetsedwa.

Insulin NovoMiks: mlingo wa mankhwala makonzedwe, ndemanga

Insulin NovoMiks ndi mankhwala omwe ali ndi fanizo la timadzi timene timachepetsa shuga. Amayendetsa matenda a shuga mellitus, onse omwe amadalira insulin komanso osadalira insulin. Pakadutsa melon, matendawa amafalikira m'makona onse a dziko lapansi, pomwe 90% ya anthu odwala matenda ashuga akuvutika ndi mtundu wachiwiri wa matenda, otsala 10% - kuchokera ku fomu yoyamba.

Jakisoni wa insulini ndi wofunikira, osakwanira pakukonzekera, osasintha mu thupi ndipo ngakhale kufa kumachitika. Chifukwa chake, munthu aliyense yemwe ali ndi matenda a shuga, banja lake ndi abwenzi ayenera kukhala ndi "chida" chodziwa zamankhwala osokoneza bongo ndi insulin, komanso momwe angagwiritsidwire ntchito moyenera.

Insulin imapezeka ku Denmark mu mawonekedwe a kuyimitsidwa, omwe amakhala mu katoni 3 ml (NovoMix 30 Penfill) kapena cholembera cha 3 ml syringe (NovoMix 30 FlexPen). Kuyimitsidwa kwake ndi koyera, nthawi zina mapangidwe a flakes amatha. Ndikapangira oyera oyera komanso ma translucent amadzimadzi pamwamba pake, mumangofunika kuti mugwedezeke, monga akunenera malangizo omwe aphatikizidwa.

Zinthu zomwe zimagwiritsidwa ntchito ndi mankhwalawa zimasungunuka insulin (30%) ndi makhiristo, komanso insulin protart (70%). Kuphatikiza pazinthu izi, mankhwalawa amakhala ndi glycerol, metacresol, sodium hydrogen phosphate dihydrate, zinc chloride ndi zinthu zina.

Mphindi 10-20 pambuyo poti mankhwala ayambike pakhungu, amayamba mphamvu yake ya hypoglycemic. Insulin aspart imamangilira ma cell receptors, motero glucose amatengedwa ndi zotumphukira maselo ndikupanga kwake kuchokera ku chiwindi sikulepheretsa. Zotsatira zazikulu za insulin makonzedwe zimawonedwa pambuyo pa maola 1-4, ndipo zotsatira zake zimakhala kwa maola 24.

Maphunziro a pharmacological pophatikiza insulin ndi mankhwala ochepetsa shuga a mtundu II odwala matenda ashuga atsimikizira kuti NovoMix 30 yophatikiza ndi metformin imakhala ndi zotsatira zapamwamba za hypoglycemic kuposa kuphatikiza kwa sulfonylurea ndi metformin.

Komabe, asayansi sanayesere kuchuluka kwa mankhwalawa kwa ana aang'ono, anthu okalamba komanso akuvutika ndi matenda a chiwindi kapena impso.

Ndi dokotala yekhayo amene ali ndi ufulu wopereka mlingo woyenera wa insulin, poganizira kuchuluka kwa shuga m'magazi a wodwalayo. Tiyenera kukumbukira kuti mankhwalawa amaperekedwa limodzi ndi mtundu woyamba wa matenda komanso osagwira ntchito mwanjira yachiwiri.

Popeza mahomoni a biphasic amagwira ntchito mofulumira kwambiri kuposa mahomoni amunthu, nthawi zambiri amathandizidwa asanadye zakudya, ngakhale ndizotheka kuzipereka pambuyo poti zadzaza ndi chakudya.

Chizindikiro chapakati chakufunika kwa munthu wodwala matenda ashuga mu mahomoni, kutengera kulemera kwake (ma kilogalamu), ndi magawo a 0,5-1 patsiku. Mlingo wa tsiku ndi tsiku wa mankhwalawa ungathe kuwonjezeka ndi odwala omwe saganizira za mahomoni (mwachitsanzo, kunenepa kwambiri) kapena kuchepa pomwe wodwala ali ndi maselo ena opangidwa ndi insulin. Ndi bwino kupaka jekete m'ntchafu, koma ndizothekanso kumtunda kwamatumbo kapena phewa. Ndikosayenera kubaya pamalo amodzi, ngakhale m'deralo.

Insulin NovoMix 30 FlexPen ndi NovoMix 30 Penfill itha kugwiritsidwa ntchito ngati chida chachikulu kapena kuphatikiza ndi mankhwala ena a hypoglycemic. Akaphatikizidwa ndi metformin, mlingo woyamba wa timadzi ndi magawo 0,2 a kilogalamu patsiku. Dokotala azitha kuwerengetsa kuchuluka kwa mankhwalawa pogwiritsa ntchito chizindikiro cha shuga m'magazi komanso zomwe wodwalayo ali nazo. Tiyenera kudziwa kuti kukanika kwa aimpso kapena chiwindi kungapangitse kuchepa kwa kufunika kwa odwala matenda ashuga mu insulin.

NovoMix imangoperekedwa pokhapokha (zambiri za ma algorithm operekera insulin mosakwiya), ndizoletsedwa kupanga jakisoni mu minofu kapena m'mitsempha. Popewa kupangika komwe kumalowa, nthawi zambiri pamafunika kusintha malo a jakisoni. Zilonda zitha kupangidwa m'malo onse omwe tawonetsedwa kale, koma mphamvu ya mankhwalawo imachitika kale kwambiri mukamayambitsa m'chiuno.

Mankhwalawa amasungidwa mzimu wa zaka kuyambira tsiku lotulutsidwa. Njira yatsopano yosagwiritsidwa ntchito mu cartridge kapena syringe cholembera imasungidwa mufiriji kuyambira madigiri 2 mpaka 8, ndipo imagwiritsidwa ntchito kutentha kwa firiji kwa masiku osakwana 30.

Popewa dzuwa kuti lisalowe, chipewa choteteza chikuyenera kuvala cholembera.

NovoMix ilibe zotsutsana pokhapokha kuchepa msanga kwa shuga kapena chiwopsezo cha chilichonse chomwe chili.

Dziwani kuti panthawi ya kubala kwa mwana, palibe zotsatira zoyipa zomwe zimapezeka pa mayi woyembekezera ndi mwana wake.

Mukamayamwa, insulini imatha kuperekedwanso, chifukwa samaperekedwa kwa mwana ndi mkaka. Komabe, asanagwiritse ntchito NovoMix 30, mayi ayenera kufunsa dokotala yemwe adzakupatseni mankhwala oteteza.

Ponena za kuvulala kwa mankhwalawa, zimagwirizana makamaka ndi kukula kwa mlingo. Chifukwa chake, ndikofunikira kuperekera mankhwala osankhidwa, kutsatira malangizo onse a dokotala. Zotsatira zoyipa zingakhale ndi:

1. Mkhalidwe wa hypoglycemia (zambiri za zomwe hypoglycemia ili mu shuga mellitus), womwe umayendetsedwa ndi kusazindikira ndi kugwidwa.
2. Kuthamanga pakhungu, urticaria, kuyabwa, thukuta, anaphylactic zimachitika, angioedema, kuchuluka kwa mtima ndi kuchepetsa magazi.
3. Sinthani kukonzanso, nthawi zina - kukula kwa retinopathy (kusokonezeka kwa ziwiya za retina).
4. Lipid dystrophy pamalo opangira jakisoni, komanso redness ndi kutupa pamalo a jakisoni.

Mwapadera, chifukwa cha kusasamala kwa wodwala, mankhwala osokoneza bongo amatha kuchitika, zomwe zimasiyana, kutengera kuuma kwa vutolo. Zizindikiro za hypoglycemia ndi kugona, kusokonezeka, nseru, kusanza, tachycardia.

Ndi bongo wofatsa, wodwalayo ayenera kudya malonda okhala ndi shuga wambiri. Itha kukhala ma cookie, maswiti, msuzi wokoma, ndikofunika kukhala ndi china pamndandanda. Mankhwala osokoneza bongo oledzera amafunika kuperekera mphamvu ya glucagon mosadukiza, ngati thupi la wodwalayo silikuyankha jakisoni wa glucagon mwanjira iliyonse, woperekayo ayenera kuyamwa shuga.

Pambuyo pakuchiritsa matenda, wodwalayo ayenera kudya zakudya zopatsa mphamvu mosavuta kuti asadzabwerenso ku hypoglycemia.

Mukapereka jekeseni wa NovoMix 30 wa insulin, kufunikira kuyenera kuperekedwa kuti mankhwala ena amathandizira pakuchitika kwa hypoglycemic.

Mowa makamaka umawonjezera kuchepa kwa shuga kwa insulin, ndipo beta-adrenergic blockers maski zizindikiro za boma la hypoglycemic.

Kutengera mankhwala omwe amagwiritsidwa ntchito limodzi ndi insulin, ntchito zake zimatha kuwonjezeka komanso kuchepa.

Kuchepa kwa kuchuluka kwa mahomoni kumawonedwa mukamagwiritsa ntchito mankhwala otsatirawa:

• mankhwala a hypoglycemic amkati,
• monoamine oxidase inhibitors (MAO),
• angiotensin kutembenuza ma enzyme (ACE) zoletsa,
• osasankha beta-adrenergic blockers,
• octreotide
• anabolic steroids
• salicylates,
• sulfonamides,
• zakumwa zoledzeretsa.

Mankhwala ena amachepetsa ntchito ya insulin ndikuwonjezera kufunikira kwa wodwalayo. Izi zimachitika mukamagwiritsa ntchito:

1. mahomoni a chithokomiro
2. glucocorticoids,
3. amphanomachul
4. danazole ndi thiazides,
5. njira zakulera zotengera mkati.

Mankhwala ena nthawi zambiri sagwirizana ndi NovoMix insulin. Izi ndiye, zoyambirira, zopangidwa zokhala ndi thiols ndi sulfite. Mankhwalawa amaletsedwanso kuti awonjezere njira yothetsera. Kugwiritsa ntchito insulin ndi othandizawa kungayambitse zotsatira zoyipa kwambiri.

Popeza mankhwalawa amapangidwa kunja, mtengo wake umakhala wokwera kwambiri. Itha kugulidwa ndi mankhwala muchipatala kapena adayitanitsa pa intaneti patsamba laogulitsa. Mtengo wa mankhwalawa umatengera kuti yankho lake limakhala bwanji mu katoni kapena syringe ndi momwe amakhazikitsira. Mtengo umasiyanasiyana kwa NovoMix 30 Penfill (ma cartridge 5 pa paketi) - kuchokera ku 1670 mpaka 1800 ma ruble aku Russia, ndipo NovoMix 30 FlexPen (ma cholembera a syringe asanu pa paketi) ali ndi mtengo pamtunda kuchokera ku 1630 mpaka 2000 rubles aku Russia.

Ndemanga za anthu ambiri odwala matenda ashuga omwe adalowetsa m'magazi a biphasic ndiabwino. Ena amati adasinthira ku NovoMix 30 atatha kugwiritsa ntchito ma insulini ena opangira. Pankhani imeneyi, ndikotheka kuwunikira zabwino za mankhwalawa mosavuta ndikugwiritsa ntchito kuchepa kwa vuto la hypoglycemic.

Kuphatikiza apo, ngakhale mankhwalawo ali ndi mndandanda wazambiri wamavuto oyipa omwe amachitika, samachitika kawirikawiri. Chifukwa chake, NovoMix imatha kuonedwa ngati mankhwala opambana kwathunthu.

Zowonadi, panali ndemanga kuti nthawi zina iye sanali woyenera. Koma mankhwala aliwonse amakhala ndi zotsutsana.

Ngati mankhwalawa sakukwanira wodwala kapena amayambitsa mavuto ena, dokotala yemwe akupezekapo amatha kusintha njira yochiritsira. Kuti achite izi, amasintha mlingo wa mankhwalawo kapenanso kuletsa kugwiritsa ntchito mankhwalawo. Chifukwa chake, pakufunika kugwiritsa ntchito mankhwalawa omwe ali ndi vuto lofanana la hypoglycemic.

Tisaiwale kuti kukonzekera kwa NovoMix 30 FlexPen ndi NovoMix 30 Penfill kulibe lingaliro mu gawo lomwe limagwira - insulin aspart. Dokotala amatha kukupatsani mankhwala omwe ali ndi vuto lofananalo.

Mankhwalawa amagulitsidwa ndi mankhwala. Chifukwa chake, ngati ndi kotheka, mankhwala a insulin, wodwalayo ayenera kufunsa dokotala.

Mankhwala omwe ali ndi vuto lofananalo ndi awa:

1. Humalog Remix 25 ndi chithunzi chopanga cha mahomoni opangidwa ndi thupi la munthu. Chofunikira kwambiri ndi insulin lispro. Mankhwalawa amakhalanso ndi njira yochepa posankha kuchuluka kwa glucose komanso kagayidwe kake. Ndi kuyimitsidwa koyera, komwe kumasulidwa mu cholembera chotchedwa Quick Pen. Mtengo wapakati wamankhwala (masentimita 5 a syringe 3 ml iliyonse) ndi ma ruble 1860.
2. Himulin M3 ndi insulin yochita pakatikati yomwe imamasulidwa poyimitsidwa. Dziko lopanga mankhwalawa ndi France. Yogwira ntchito ya mankhwalawa ndi biosynthet insulin. Amachepetsa kwambiri kuchuluka kwa shuga m'magazi popanda kuyambitsa hypoglycemia. Mu msika wogulitsa mankhwala ku Russia, mitundu ingapo ya mankhwala ingagulidwe, monga Humulin M3, Humulin Regular, kapena Humulin NPH. Mtengo wapakati wa mankhwalawa (5 syringe pens 3 ml) ndi wofanana ndi ma ruble 1200.

Mankhwala amakono apita patsogolo, tsopano, kuti jakisoni wa insulin ayenera kuchitidwa kangapo patsiku. Ma cholembera abwino kwambiri amapangira njirayi nthawi zambiri. Msika wama pharmacological umapereka zosankha zingapo zopanga ma insulin. Chimodzi mwazomwe zimadziwika ndi mankhwala otchedwa NovoMix, omwe amachepetsa kuchuluka kwa shuga pamakhalidwe abwino ndipo samatsogolera hypoglycemia. Kugwiritsa ntchito moyenera, komanso kudya komanso kuchita masewera olimbitsa thupi kumawathandiza kukhala ndi moyo wautali komanso wopanda chisoni kwa odwala matenda ashuga.

• Chithandizo choyamba
• Ogulitsa pa intaneti
• Za kampani
• Zambiri

• Wofalitsa:
• +7 (495) 258-97-03
• +7 (495) 258-97-06
• Imelo: Imelo yotetezedwa
• Adilesi: Russia, 123007, Moscow, ul. 5 Thunthu, d.12.

Webusayiti yovomerezeka ya Radar Gulu la Makampani ®. Ensaikulopediya yayikulu ya mankhwala osokoneza bongo ndi katundu wa mankhwala omwe amapezeka ku Russia Internet. Ndondomeko yamankhwala Rlsnet.ru imapatsa ogwiritsa ntchito malangizo, mitengo ndi mafotokozedwe a mankhwala, zowonjezera pazakudya, zida zamankhwala, zida zamankhwala ndi zina. Maupangiri a pharmacological akuphatikiza chidziwitso cha kapangidwe ndi mawonekedwe amamasulidwe, zochitika zamankhwala, zisonyezo zogwiritsidwa ntchito, contraindication, zotsatira zoyipa, kugwiritsa ntchito mankhwala, njira yogwiritsira ntchito mankhwala, makampani opanga mankhwala. Ndondomeko ya mankhwala ili ndi mitengo yamankhwala ndi mankhwala ku Moscow ndi mizinda ina ya Russia.

Sizoletsedwa kufalitsa, kukopera, kufalitsa zambiri popanda chilolezo cha RLS-Patent LLC.
Mukamagwiritsa ntchito zidziwitso zofalitsidwa pamasamba a webusayiti ya www.rlsnet.ru, kulumikizana ndi gwero lachidziwitso ndikofunikira.

Tili pamawebusayiti:

Maumwini onse ndi otetezedwa.

Kugwiritsa ntchito malonda pazinthu sikuloledwa.

Zambiri zimapangidwira akatswiri azaumoyo.

INSULINUM ASPARTUM A10A D05

KUKHALA NDI ZOCHULUKA:

kukayikira d / mkati. 100 IU / ml cartridge 3 ml, chisa. mu cholembera, No. 1, Na. 5

No. UA / 4862/01/01 kuyambira pa 2/2/100 mpaka 2/2/155

hypoglycemia, hypersensitivity kwa insulin aspart kapena mankhwala ena alionse.

Zotsatira zoyipa zomwe zimachitika mwa odwala omwe amagwiritsa ntchito NovoMix 30 FlexPen zimagwirizana kwambiri ndi kuchuluka kwa mankhwalawa omwe amaperekedwa ndi mankhwalawa 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, 1/10 000,

• Tags: Novo Nordisk, NOVOMIX 30 FLEXPEN, NOVOMIX 30 FLEXPEN

Zotsatira za pharmacological

Hypoglycemic wothandizira, analogue ya insulin ya anthu a nthawi yayitali.

Imalumikizana ndi cholandirira kumtundu wakunja kwa maselo ndikupanga insulini-receptor zovuta zomwe zimapangitsanso ma processor, kuphatikizapo kaphatikizidwe angapo ofunikira a michere (hexokinase, pyruvate kinase, glycogen synthetase). Kuchepa kwa kuchuluka kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa mayendedwe ake, kuchuluka kwa zotupa, kukondoweza kwa lipogenesis, glycogenogeneis, ndi kuchepa kwa kuchuluka kwa shuga m'magazi.

Ilinso ndi zochitika zofanana ndi insulin yaumunthu mu molar ofanana. Kulowetsedwa kwa amino acid proline pamalo a B28 ndi aspicic acid kumachepetsa chizolowezi chopanga mamolekyulu kupanga hexamers m'chigawo chosungunuka cha mankhwalawa, chomwe chimawonedwa ndi insulin ya anthu. Motere, insulin aspart imatengedwa kuchokera subcutaneous mafuta mwachangu kuposa sungunuka insulin yomwe ili ndi biphasic insulin ya munthu. Insulin aspart protamine imamizidwa nthawi yayitali.

Pambuyo pa utsogoleri wa NovoMix 30 Penfill, zotsatira zimayambika pambuyo pa mphindi 10 mpaka 20, zotsatira zake ndizofunikira - maola 1 mpaka 4. Kutalika kwa nthawi ya NovoMix 30 Penfill imafika maola 24 (kutengera mlingo, malo oyendetsera, kuchuluka kwa magazi, kutentha kwa thupi ndi kuchuluka kwa zochitika zolimbitsa thupi )

Gulu la Nosological (ICD-10)

NOVOMIKS 30 flexpen - fomu yotulutsira, mawonekedwe ndi ma CD

Kuyimitsidwa kwa kayendetsedwe ka SC yoyera, yopanda pake, yopanda mapampu, masamba amatha kuoneka mwachitsanzo), ikajambulika, imasunthika, ndikupanga mbewa yoyera komanso yopanda utoto kapena yopanda utoto, poyambitsa mosakhalitsa kuyimitsidwa.

PRING glycerol, phenol, metacresol, zinc chloride, sodium chloride, sodium hydrogen phosphate dihydrate, protamine sulfate, sodium hydroxide, hydrochloric acid, madzi d / i.

* 1 unit ikufanana ndi 35 μg (kapena 6 nmol) wa anulinrous insulin.

3 ml (300 PIECES) - makatoni am'magalasi (1) - zolembera zowerengeka zamankhwala angapo a jakisoni angapo (5) - mapaketi a makatoni.

Analogue ya insulin ya anthu a nthawi yayitali ndikuyamba mwachangu zochita.

NovoMix 30 Flexpen ndi kuyimitsidwa kwamitundu iwiri komwe kumakhala ndi insulle insulin aspart (30% yochepa-insulin analog) ndi makhiristo a aspart protamine insulin (70%-insulin analog).

Insulin aspart yomwe imapangidwanso ndi biotechnology ya DNA yogwiritsidwanso ntchito pogwiritsa ntchito Saccharomyces cerevisiae.

Insulin aspart ndi insipotential sungunuka wa munthu insulin yochokera molarity indices.

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 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.

M'miyezi itatu yoyeserera yolimbana ndi odwala omwe ali ndi matenda amtundu wa 1 ndi mtundu wa 2 omwe adalandira NovoMix 30 Flex Pen ndi biphasic insulin ya anthu 30 2 nthawi / tsiku asanadye chakudya cham'mawa komanso chakudya chamadzulo, NovoMix 30 FlexPen adawonetsedwa kuti amachepetsa kuchuluka kwa glucose wa postprandial m'magazi ochulukirapo (mutatha kadzutsa ndi chakudya chamadzulo).

Kuwunika kwa meta komwe kumapezeka m'mayesero 9 azachipatala okhudzana ndi odwala omwe ali ndi mtundu woyamba 1 komanso mtundu wa 2 matenda a shuga adawonetsa kuti NovoMix 30 FlexPen, pomwe idaperekedwa kadzutsa chakudya cham'mawa komanso chakudya chamadzulo, imapereka chiwongolero chokwanira cha kuchuluka kwa shuga m'magazi (kuwonjezereka kwa prandial glucose pambuyo chakudya cham'mawa, nkhomaliro ndi chakudya chamadzulo), poyerekeza ndi insulin ya anthu 30 .. Ngakhale kuthamanga kwa glucose mwa odwala omwe amalandila Novo Remix 30 FlexPen anali apamwamba, ambiri NovoMix 30 FlexPen ali ndi zomwezi ystvie ndende wa hemoglobin glycosylated (HbA_1C,, ngati biphasic insulin ya anthu 30.

Mu kafukufuku wazachipatala wokhudzana ndi odwala omwe ali ndi mtundu wa 2 shuga mellitus (n = 341), odwala adasinthidwa mwachisawawa kumagulu azithandizo okha a NovoMix 30 FlexPen, NovoMix 30 FlexPen osakanikirana ndi metformin ndi metformin yophatikizidwa ndi sulfonylurea. HbA_1C Pambuyo pa milungu 16 ya chithandizo sichinasinthe odwala omwe amalandila NovoMix 30 Flexpen osakanikirana 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 osakanikirana ndi metformin adayambitsa kuchepa kwakukulu kwa ndende ya HbA_1Ckuposa odwala kulandira metformin osakanikirana ndi sulfonylurea.

Pakafukufuku wina, odwala omwe ali ndi matenda a shuga a 2 omwe amakhala ndi vuto lodana ndi glycemic osamwa bwino omwe amamwa mankhwala a hypoglycemic adasinthidwa mwachisawawa m'magulu otsatirawa: NovoMix 30 FlexPen 2 nthawi / tsiku (odwala 117) ndi insulin glargine 1 nthawi / tsiku (odwala 116). Pambuyo pa masabata 28 ogwiritsa ntchito mankhwalawa, kuchepa kwapakati pa HbA_1C mgulu la ogwiritsa ntchito la NovoMix, 30 Flexpen inali 2.8% (mtengo woyambirira unali 9.7%). 66% ndi 42% ya odwala omwe amagwiritsa ntchito NovoMix 30 Flexpen adadziwika ndi mfundo za HbA kumapeto kwa kafukufuku._1C pansipa 7% ndi 6.5% motsatana. Kutanthauza kuti kusala kwam'magazi glucose kutsika ndi pafupifupi 7 mmol / L (kuyambira 14 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 matenda a shuga 2 amawonetsa kuchepa kwa ziwonetsero zonse za nocturnal hypoglycemia ndi hypoglycemia yayikulu ya NovoMix 30 FlexPen poyerekeza ndi insulin yamunthu ya 30 nthawi yomweyo. Hypoglycemia mwa odwala omwe amalandila NovoMix 30 Flexpen anali apamwamba.

Kafukufuku wazachipatala wa masabata 16 adachitidwa mwa ana ndi achinyamata omwe amayerekezera shuga wamagazi atatha kudya ndi NovoMix 30 FlexPen (asanadye), insulin / biphasic human insulin 30 (asanadye) ndi insulin-isophan (yoyambirira isanakwane kugona). 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 kulikonse pamalingaliro a 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 mgululi omwe amathandizidwa ndi NovoMix 30 FlexPen anali otsika kwambiri poyerekeza ndi zomwe zimagwiritsidwa ntchito pagululi pogwiritsa ntchito insulin yamunthu inshuwaransi 30 HHA_1C kumapeto kwa kafukufukuyu, pagulu la insulin 30 ya anthu omwe anali ochepa kwambiri anali otsika kwambiri kuposa gulu la NovoMix 30 FlexPen.

The pharmacodynamics of NovoMix 30 FlexPen mwa okalamba ndi odwala senile sanaphunzire. 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_{GIR, 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.

Mu insulin aspart, m'malo mwa proline amino acid pamalo a B28 a aspartic acid amachepetsa chizolowezi chopanga ma molekyulu kupanga hexamers mumagawo a solvole NovoMix ® 30 FlexPen ®, omwe amawoneka osungunuka a insulin. Pankhaniyi, insulin aspart (30%) imayamwa kuchokera ku mafuta a subcutaneous mwachangu kuposa insulle insulin yomwe ili mu biphasic insulin yamunthu. 70% yotsala imagwera pa mawonekedwe a crystalline a protamine-ipsulin aspart, kuchuluka kwa mayamwa komwe kuli kofanana ndi komwe kumapangitsa insulin NPH.

Mukamagwiritsa ntchito NovoMix ® 30 FlexPen ® C_max seramu insulini ndi pafupifupi 50% kuposa pamene ntchito biphasic insulin 30, pomwe nthawi yofika C_max 2 nthawi zochepa pa avareji. Pamene s / c ya mankhwala kwa odzipereka athanzi pa 0,2 U / kg kulemera kwa thupi C_max insulin aspart inali 140 ± 32 pmol / L ndipo inatheka pambuyo pa mphindi 60.

Odwala ndi mtundu 2 matenda a shuga_max akwanitsa mphindi 95 pambuyo pa utsogoleri ndipo amakhalabe pamwamba pa maola osachepera 14

The serum insulin ndende imabweranso pamlingo woyambirira pambuyo pa maola 15-18 pambuyo pobayira.

T_1/2kuwonetsa kuyamwa kwa gawo lomwe limagwirizana ndi protamine ndi maola 8-9

Pharmacokinetics mu milandu yapadera yamankhwala

Kafukufuku wa pharmacokinetics a NovoMix ® 30 FlexPen ® mwa odwala okalamba 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 (82 min (interquartile range: 60-120 min)), at average 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.

Kafukufuku wa pharmacokinetics a NovoMix ® 30 FlexPen ® kwa odwala omwe ali ndi vuto la Impso 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.

Makhalidwe a pharmacokinetic a NovoMix ® 30 FlexPen ® mwa 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 amtundu 1.Kwa odwala azaka zonse ziwiri, insulin aspart imadziwika ndi mayankho a T mwachangu_maxchimodzimodzi ndi akulu. Komabe, zofunikira za C_max m'magulu awiri azaka ziwiri anali osiyana, zomwe zikuwonetsa kufunikira kwa kusankha kwa mankhwala a insulin.

NovoMix30 FlexPen lakonzedwa kuti sc sc. Mankhwala sangathe kutumizidwa iv. izi zimatha kuyambitsa kwambiri hypoglycemia. M'pofunikanso kupewa kutsekeka kwa NovoMix30 FlexPen. Osagwiritsa ntchito NovoMix 30 FlexPen pakuchepetsa kulowetsedwa kwa insulin m'mapampu a insulin.

Mlingo wa NovoMix 30 FlexPen umatsimikiziridwa ndi dokotala aliyense payekha komanso mogwirizana ndi zomwe wodwala akufuna. Kuti mupeze milingo yabwino kwambiri ya glycemia, tikulimbikitsidwa kuwunika kuchuluka kwa shuga m'magazi ndikusintha mlingo wa mankhwalawa.

Odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga a mellitus NovoMix 30 FlexPen atha kutumikiridwa monga mankhwala a monotherapy komanso osakanikirana ndi mankhwala amkamwa a hypoglycemic komanso muzochitika izi pomwe kuchuluka kwa shuga m'magazi sikungoyendetsedwa mokhazikika ndi mankhwala amkamwa a hypoglycemic.

Chifukwa lembani odwala matenda a shuga a 2 omwe amayamba kupatsidwa insulin, mlingo woyambirira wa NovoMix 30 FlexPen ndi 6 magawo asanadye chakudya cham'mawa ndi magawo 6 musanadye chakudya chamadzulo. Kukhazikitsidwa kwa magawo 12 a NovoMix 30 Flexpen ndikololedwa 1 nthawi / tsiku madzulo (musanadye chakudya chamadzulo).

Kusamutsa wodwala kuchokera kukonzekera kwina kwa insulin

At kusamutsa wodwala kuchokera ku biphasic insulin ya anthu kupita ku NovoMix 30 Flexpen Ayenera kuyamba ndi mlingo womwewo ndi regimen. Kenako sinthani za mankhwalawo mogwirizana ndi zofunikira za wodwalayo (onani tebulo kuti mupeze malingaliro pazomwe mungamwe mankhwalawo). Monga nthawi zonse posamutsa wodwala kupita ku mtundu wina wa insulin, kuyang'aniridwa mosamala kwachipatala ndikofunikira pakusintha kwa wodwalayo komanso m'milungu yoyamba yogwiritsa ntchito mankhwalawa.

Kupititsa patsogolo chithandizo cha NovoMix 30 FlexPen ndikotheka posintha kuchokera ku gawo limodzi la mankhwala tsiku ndi tsiku kupita pawiri. Ndikulimbikitsidwa kuti mutatha kutenga magawo 30 a mankhwalawa kuti mugwiritse ntchito NovoMix 30 Thirani 2 nthawi / tsiku, ndikugawa mlingo mu magawo awiri ofanana - m'mawa ndi madzulo (musanadye chakudya cham'mawa komanso chamadzulo).

Kusintha kwa kugwiritsa ntchito NovoMix 30 Flexpen 3 nthawi / tsiku ndikotheka ndikugawa mlingo wa m'mawa m'magawo awiri ofanana ndikupereka magawo awiriwa m'mawa komanso pachakudya (katatu katatu tsiku).

Kusintha mlingo wa NovoMix 30 FlexPen, kuthamanga kwa glucose kotsika komwe kamapezeka m'masiku atatu omaliza kumagwiritsidwa ntchito.

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

Kusintha kwa Mlingo ukhoza kuchitika 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 muyezo wa NovoMix 30 FlexPen, tikulimbikitsidwa kugwiritsa ntchito malangizo omwe alembedwa pagome:

Kuyimitsidwa koyenda, Novo Nordisk

NovoMix® 30 Penfill®

Kuyimitsidwa kwa subcutaneous makonzedwe a 1 ml yogwira mankhwala: insulin aspart - sungunuka insulini (30%) ndi makhiristo a insulini wa puloteni (70%) 100 IU (3.5 mg) ochokera: glycerol - 16 mg, phenol - 1.5 mg , metacresol - 1.72 mg, zinc (mwanjira ya zinc chloride) - 19.6 μg, sodium kolorayidi - 0,877 mg, sodium hydrogen phosphate dihydrate - 1,25 mg, protamine sulfate - pafupifupi 0,32 mg, sodium hydroxide - pafupi 2 , 2 mg, hydrochloric acid - pafupifupi 1.7 mg, madzi a jakisoni - mpaka 1 ml 1 makatoni (3 ml) ali ndi 300 PESCES

NovoMix® 30 FlexPen ®

Kuyimitsidwa kwa subcutaneous makonzedwe a 1 ml yogwira mankhwala: insulin aspart - sungunuka insulini (30%) ndi makhiristo a insulini wa puloteni (70%) 100 IU (3.5 mg) ochokera: glycerol - 16 mg, phenol - 1.5 mg , metacresol - 1.72 mg, zinc (mwanjira ya zinc chloride) - 19.6 μg, sodium kolorayidi - 0,877 mg, sodium hydrogen phosphate dihydrate - 1,25 mg, protamine sulfate - pafupifupi 0,32 mg, sodium hydroxide - pafupi 2 , 2 mg, hydrochloric acid - pafupifupi 1.7 mg,madzi a jakisoni - mpaka 1 ml 1 syringe cholembera chisanafike (3 ml) muli 300 PIECES

Homogeneous yoyera yopanda chopanda kuyimitsidwa. Mphezi zimawonekera pamiyeso.

Mukayimirira, kuyimitsidwa kumakoma, ndikupanga choyera chamtendere komanso chopanda utoto kapena chopanda utoto.

Mukasakaniza mpweya wokhazikika malinga ndi njira zomwe zafotokozedwera mu malangizo ogwiritsira ntchito mankhwalawa, kuyimitsidwa payekha kuyenera kupanga.

Mu insulin aspart, kulowetsedwa kwa amino acid proline pamalo a B28 kwa aspartic acid kumachepetsa chizolowezi chopanga ma molekyulu kupanga hexamers m'chigawo chosungunuka cha NovoMix® 30 Penfill® / FlexPen ®, chomwe chimawonedwa mu insulin yaumunthu. 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.

Serum Cmax wa insulin pambuyo pa NovoMix® 30 Penfill® / FlexPen® ndi 50% kuposa kuposa ya biphasic insulin 30, ndipo Tmax ndiyofupikirapo kuposa ya biphasic insulin 30.

Odzipereka athanzi, pambuyo pa kukonzedwa kwa NovoMix® 30 pamlingo wa 0,2 U / kg wa Cmax wa insulin aspart mu seramu idatheka pambuyo pa mphindi 60 ndikufika (140 ± 32) pmol / L. Kutalika kwa T1 / 2 kwa NovoMix ® 30, komwe kumawonetsera kuchuluka kwa kuyamwa kwa kachigawo kakumangiriridwa ka protamine, anali maola 8-9 Mlingo wa insulin m'magazi seramu unabweranso koyamba ma 15-18 mawola atatha s / c ya mankhwala. Odwala omwe ali ndi matenda a shuga 2, Cmax adawonetsedwa pambuyo pa 95 ndipo amakhala pamwamba pa maola 14 osachepera.

Okalamba komanso odwala a 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 mtundu wa 2 matenda a shuga (65-83 zaka, kutanthauza zaka 70) anali ofanana ndi odzipereka athanzi komanso odwala achinyamata omwe ali ndi matenda a shuga. Odwala okalamba, kuchepa kwa mayamwidwe kunawonedwa, komwe kunayambitsa kutsika kwa T1 / 2 (82 min-ququartile range - 60-120 min), pomwe Cmax wamba inali yofanana ndi yomwe imawonedwa mwa odwala ang'onoang'ono omwe ali ndi matenda a shuga 2, komanso ocheperako pang'ono kuposa Odwala a shuga a Type 1.

Odwala ndi mkhutu aimpso ndi kwa chiwindi ntchito. No pharmacokinetics of NovoMix® 30 Penfill® / FlexPen® adawerengera odwala omwe ali ndi vuto laimpso ndi kwa chiwindi. 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. Makhalidwe a pharmacokinetic a NovoMix® 30 Penfill® / FlexPen® sanaphunzitsidwe mwa ana ndi achinyamata. Komabe, mankhwala a pharmacokinetic ndi pharmacodynamic a soluble insulin aspart amaphunzitsidwa mwa ana (azaka 6 mpaka 12) komanso achinyamata (azaka 13 mpaka 17) ndi mtundu wa matenda a shuga 1. Mwa odwala a misinkhu yonse iwiri, insulin aspart imadziwika ndi kulowerera mwachangu ndi mfundo za Tmax zofanana ndi zomwe mwa akulu. Komabe, chikhalidwe cha Cmax m'magulu awiriwa chinali chosiyana, zomwe zikuwonetsa kufunikira kwa kusankha kwa mankhwala a insulin.

NovoMix® 30 Penfill® / FlexPen ® ndi kuyimitsidwa kwamitundu iwiri komwe kumapanga insulin anartuble (30% yochepa-insulin analog) ndi makhiristo a aspart protamine insulin (70%-insulin analog). Mankhwala othandizira a NovoMix® 30 Penfill® / FlexPen ® ndi insulin aspart, yomwe imapangidwa ndi njira yowonjezera ya DNA biotechnology pogwiritsa ntchito mtundu wa Saccharomyces cerevisiae.

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

Kutsika kwa shuga m'magazi kumachitika chifukwa cha kuwonjezeka kwa mayendedwe ake amkati atatha kumangiriza insulin yolandilira minofu ndi minyewa yamafuta komanso kuletsa munthawi yomweyo kupanga shuga. Pambuyo pa utsogoleri wa SC wa NovoMix® 30 Penfill® / FlexPen ®, zotsatira zimayamba mkati mwa mphindi 10 mpaka 20. Kuchuluka kwakukulu kumawonedwa pamtunda kuchokera pa 1 mpaka maola 4 jekeseni. Kutalika kwa mankhwalawa kumafika maola 24.

M'mayeso atatu othandizira odwala omwe ali ndi vuto la mtundu woyamba wa 1 ndi mtundu wa 2 omwe alandila NovoMix® 30 Penfill® / FlexPen ® ndi biphasic insulin 30, kawiri pa tsiku, asanadye chakudya cham'mawa komanso chakudya chamadzulo, NovoMix® 30 Penfill adawonetsedwa. ® / FlexPen ® imachepetsa kwambiri kuchuluka kwa shuga m'magazi (pambuyo pa chakudya cham'mawa komanso chamadzulo).

Kuwunikira kwamtundu wa zidziwitso zomwe zimapezeka m'maphunziro 9 azachipatala okhudzana ndi odwala omwe ali ndi mtundu woyamba wa 2 ndikuwonetsa kuti NovoMix® 30 Penfill® / FlexPen ® akamapereka kadzutsa asanafike chakudya chamadzulo amapereka moyenera milingo yama glucose a postprandial kuchuluka kwa glucose pambuyo pa chakudya cham'mawa, chakudya chamasana komanso chakudya chamadzulo) poyerekeza ndi ma insulini a biphasic a anthu 30. Ngakhale kusala kwa glucose m'magazi omwe amagwiritsa ntchito NovoMix® 30 Penfill® / FlexPen ® anali apamwamba, onse a NovoMix® 30 Penfill® / FlexPen® Ndi cholinga chofanana pa ndende ya glycated hemoglobin (HbA1c), komanso biphasic anthu insulin 30.

Mu kafukufuku wazachipatala wokhudzana ndi odwala 341 omwe ali ndi matenda a shuga a mtundu wa 2, odwala adasinthidwa mosiyanasiyana kumagulu azithandizo okha NovoMix® 30 Penfill® / FlexPen®, NovoMix® 30 Penfill® / FlexPen® kuphatikiza ndi metformin ndi metformin molumikizana ndi sulfonylurea. Kuchuluka kwa HbA1c pambuyo pa milungu 16 ya chithandizo sikunakhale kosiyana kwa odwala omwe amalandila NovoMix® 30 Penfill® / FlexPen ® mosakanikirana ndi metformin, komanso mwa odwala omwe amalandila metformin limodzi ndi zotumphukira za sulfonylurea. Phunziroli, mu 57% ya odwala, kuchuluka kwa HbA1c kunali kwakukulu kuposa 9%; mwa odwalawa, chithandizo ndi NovoMix® 30 Penfill® / FlexPen ® posakanikirana ndi metformin zidapangitsa kuchepa kwakukulu kwa kuchuluka kwa HbA1c kuposa kwa odwala omwe amachitidwa ndi metformin kuphatikizika ndi zotumphukira sulfonylureas.

Pakafukufuku wina, odwala omwe ali ndi matenda a shuga a 2 omwe amakhala ndi vuto lonyansa la glycemic omwe adamwa mankhwala osokoneza bongo a hypoglycemic adasinthidwa mwachisawawa m'magulu otsatirawa: kulandira NovoMix® 30 kawiri pa tsiku (odwala 117) ndikulandila insulin glargine 1 nthawi patsiku (odwala 116). Pambuyo pa masabata 28 operekera mankhwala, kuchepa kwapakati pa ndende ya HbA1c mu gulu la NovoMix® 30 Penfill® / FlexPen ® inali 2.8% (mtengo woyambirira unali 9,7%). Mu 66% ndi 42% ya odwala omwe amagwiritsa ntchito NovoMix® 30 Penfill® / FlexPen ®, kumapeto kwa kafukufukuyu, mfundo za HbA1c zinali pansi pa 7 ndi 6.5%, motsatana. Kutanthauza kuti kusala kwam'magazi glucose kutsika ndi pafupifupi 7 mmol / L (kuyambira 14 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 shuga 2 amawonetsa kuchepa kwa ziwonetsero zonse za nocturnal hypoglycemia ndi hypoglycemia yayikulu ya NovoMix® 30 Penfill® / FlexPen ® poyerekeza ndi biphasic insulin 30. chiopsezo chonse cha masana hypoglycemia mwa odwala omwe amalandila NovoMix® 30 Penfill® / FlexPen ® anali wamkulu.

Ana ndi achinyamata. Kuyesedwa kwamankhwala kwa milungu 16 kunachitika poyerekeza ndi shuga wamagazi pambuyo pa chakudya ndi NovoMix® 30 (musanadye chakudya), insulin / biphasic human insulin 30 (asanadye) komanso isofan-insulin (yoyendetsedwa asanagone). Phunziroli lidakhudza odwala 167 kuyambira zaka 10 mpaka 18. Miyezo yapakati ya HbA1c m'magulu onse awiriwa idatsala pafupi ndi zoyambirira mufukufuku wonse. Komanso, mukamagwiritsa ntchito NovoMix® 30 Penfill® / FlexPen ® kapena biphasic insulin 30 ya anthu, panalibe kusiyana kwakukulu pakuchitika kwa hypoglycemia.

Kafukufuku wokhudzana ndi khungu wamaso awiri adachitidwanso mwa anthu odwala kuyambira wazaka 6 mpaka 12 (odwala 54 kwathunthu, masabata 12 pa mtundu uliwonse wa chithandizo). Zovuta za hypoglycemia komanso kuchuluka kwa shuga pambuyo pa chakudya pagulu la odwala omwe amagwiritsa ntchito NovoMix® 30 Penfill® / FlexPen ® anali otsika kwambiri poyerekeza ndi zomwe zimapezeka mgulu la odwala omwe amagwiritsa ntchito insulin ya anthu a biphasic 30. HbA1c pamapeto pamaphunziro mu gulu la biphasic insulin 30 yamunthu inali yotsika kwambiri poyerekeza ndi gulu la odwala omwe amagwiritsa ntchito NovoMix® 30 Penfill® / FlexPen ®.

Odwala okalamba. Pharmacodynamics ya NovoMix® 30 Penfill® / FlexPen ® mu odwala okalamba sizinafufuzidwe. Komabe, mu kafukufuku wosasinthika wamaso awiri wakhungu womwe udachitika mwa odwala 19 omwe ali ndi matenda a shuga 2 - 65-83 zaka (zikutanthauza zaka 70), a pharmacodynamics ndi pharmacokinetics a insulin aspart ndi soluble insulin ya anthu. Kusiyana kwazotsatira zamapiritsi a pharmacodynamic - kuchuluka kwa kulowetsedwa kwa glucose - GIRmax ndi malo omwe amaponderezedwa chifukwa cha kulowetsedwa kwa mphindi 15 pambuyo pa kukonzekera kwa insulin - AUCGIR, 0-120 min) pakati pa insulini ndi insulin ya anthu odwala okalamba anali ofanana ndi odwala odwala athanzi odzipereka komanso odwala achichepere odwala matenda ashuga.

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.

1. 
   Itsenko-Cushing's syndrome: monograph. . - M: Mankhwala, 1988 .-- 224 p.
2. 
   Dobrov, A. Matenda a shuga - osati vuto / A. Dobrov. - M: Book House (Minsk), 2010 .-- 166 p.
3. 
   Efimov A.S. Matenda a shuga Moscow, yosindikiza nyumba "Mankhwala", 1989, 288 pp.
4. Melnichenko G. A., Peterkova V. A., Tyulpakov A. N., Maksimova N. V. Ma syndromes osadziwika mu endocrinology, Phunzirani - M., 2013. - 172 p.
5. Balabolkin M.I., Klebanova E.M., Kreminskaya V.M. Funderalal and clinical thyroidology, Medicine - M., 2013. - 816 p.

Ndiloleni ndidziwitse. Dzina langa ndi Elena. Ndakhala ndikugwira ntchito ya endocrinologist kwazaka 10. Ndikukhulupirira kuti pakadali pano ndili katswiri pantchito yanga ndipo ndikufuna kuthandiza alendo onse omwe amapezeka pamalowo kuti athetse zovuta osati ntchito. Zinthu zonse za tsambalo amazisonkhanitsa ndikuzikonza mosamala kuti athe kufotokoza zambiri zofunikira. Musanagwiritse ntchito zomwe zikufotokozedwa pa webusaitiyi, kufunsana ndi akatswiri ndizofunikira nthawi zonse.

Kufotokozera za mtundu wa kipimo

Homogeneous yoyera yopanda chopanda kuyimitsidwa. Mphezi zimawonekera pamiyeso.

Mukayimirira, kuyimitsidwa kumakoma, ndikupanga choyera chamtendere komanso chopanda utoto kapena chopanda utoto.

Mukasakaniza mpweya wabwino malinga ndi njira yofotokozedwera mu Instruction mayendedwe azachipatala, kuyimitsidwa koyenera kuyenera kupanga.

Mankhwala

NovoMix ® 30 Penfill ® ndi kuyimitsidwa kwamitundu iwiri komwe kumakhala soluble insulin aspart (30% yochepa-insulin analog) ndi makhiristo a aspart protamine insulin (70% yapakati-insulin analog). Mankhwala othandizira a NovoMix ® 30 Penfill ® ndi insulin aspart, yopangidwa ndi njira yobwerezeranso DNA biotechnology pogwiritsa ntchito kupsyinjika Saccharomyces cerevisiae.

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

Kutsika kwa shuga m'magazi kumachitika chifukwa cha kuwonjezeka kwa mayendedwe ake amkati atatha kumangiriza insulin yolandilira minofu ndi minyewa yamafuta komanso kuletsa munthawi yomweyo kupanga shuga. Pambuyo subcutaneous makonzedwe a NovoMix ® 30 Penfill ®, zimachitika mu mphindi 10-20. Kuchuluka kwakukulu kumawonedwa pamtunda kuchokera pa 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 adalandira NovoMix ® 30 Penfill ® ndi biphasic insulin ya anthu 30 2 pa tsiku musanadye chakudya cham'mawa komanso chakudya chamadzulo, adawonetsedwa kuti NovoMix ® 30 Penfill ® imachepetsa kuchuluka kwa postprandial kwambiri shuga wamagazi (mutatha kadzutsa ndi chakudya chamadzulo).

Kuwunika kwa ma meta kuchokera ku mayeso 9 azachipatala okhudzana ndi odwala omwe ali ndi mtundu woyamba wa 2 ndi shuga 2 adawonetsa kuti NovoMix ® 30 Penfill ®, yomwe imayendetsedwa chakudya cham'mawa komanso chakudya chamadzulo, imapereka chiwongolero chokwanira cha glucose wamagazi a postprandial pambuyo pa chakudya cham'mawa, nkhomaliro ndi chakudya chamadzulo), poyerekeza ndi insulin ya biphasic ya anthu 30 Ngakhale kuthamanga kwa glucose odwala omwe amagwiritsa ntchito NovoMix ® 30 Penfill ® anali apamwamba, ambiri, NovoMix ® 30 Penfill ® imathandizanso chimodzimodzi glycosylated hemoglobin concentration (HbA _1c ,, ngati biphasic insulin ya anthu 30.

Mu kafukufuku wazachipatala wokhudzana ndi odwala 341 omwe ali ndi matenda a shuga a mtundu wa 2, odwala adasinthidwa mosiyanasiyana m'magulu othandizira a NovoMix ® 30 Penfill ®, NovoMix ® 30 Penfill ® kuphatikiza ndi metformin ndi metformin molumikizana ndi zotumphukira za sulfonylurea. HbA _1c Pambuyo pa milungu 16 ya chithandizo sichinasiyane ndi odwala omwe amalandila NovoMix ® 30 Penfill ® osakanikirana 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%; mwa odwala, chithandizo cha mankhwala a NovoMix ® 30 Penfill ® osakanikirana ndi metformin chinapangitsa kuchepa kwakukulu kwa ndende ya HLA _1s kuposa odwala kulandira metformin osakanikirana ndi sulfonylurea.

Pakafukufuku wina, odwala omwe ali ndi matenda a shuga a 2 omwe amakhala ndi vuto losagwirizana ndi glycemic omwe adamwa mankhwala a hypoglycemic adasinthidwa mwachisawawa m'magulu otsatirawa: kulandira NovoMix ® 30 kawiri pa tsiku (odwala 117) ndi kulandira insulin glargine 1 nthawi patsiku (odwala 116). Pambuyo pa masabata 28 ogwiritsa ntchito mankhwalawa, kuchepa kwapakati pa ndende ya HbA _1c pagulu la NovoMix ® 30, Penfill ® anali 2.8% (mtengo woyamba unali 9.7%). Mu 66% ndi 42% ya odwala omwe amagwiritsa ntchito NovoMix ® 30 Penfill ®, kumapeto kwa kafukufuku, mfundo za HbA _1c anali pansi pa 7 ndi 6.5%, motsatana. Kutanthauza kuti kusala kwam'magazi glucose kutsika ndi pafupifupi 7 mmol / L (kuyambira 14 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 Penfill ® poyerekeza ndi insulin ya insulin ya anthu a 30 nthawi yomweyo. kupezeka kwa hypoglycemia masana mwa odwala omwe amalandila NovoMix ® 30 Penfill ® anali wamkulu.

Ana ndi achinyamata. Kuyesedwa kwamankhwala kwa milungu 16 kunachitika poyerekeza ndi shuga wamagazi pambuyo pa chakudya ndi NovoMix® 30 (musanadye chakudya), insulin / biphasic human insulin 30 (asanadye) komanso isofan-insulin (yoyendetsedwa asanagone).Phunziroli linakhudza odwala 167 azaka zapakati pa 10 mpaka 18. HLA okwanira _1s m'magulu onse awiriwa adakhalabe pafupi ndi zoyambirira m'maphunziro onse. Komanso, mukamagwiritsa ntchito NovoMix ® 30 Penfill ® kapena biphasic insulin 30 ya anthu, panalibe kusiyana kulikonse pamalingaliro a 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). Zomwe zimachitika mu hypoglycemia komanso kuchuluka kwa glucose atatha kudya pagulu la odwala omwe amagwiritsa ntchito NovoMix ® 30 Penfill ® anali otsika kwambiri poyerekeza ndi zomwe zimapezeka m'gulu la odwala omwe amagwiritsa ntchito insulin 30 ya insulin. _1c kumapeto kwa kafukufukuyu, pagulu la insulin 30 ya anthu omwe anali ochepa kwambiri anali otsika kwambiri kuposa gulu la odwala omwe amagwiritsa ntchito NovoMix ® 30 Penfill ®.

Odwala okalamba. Pharmacodynamics ya NovoMix ® 30 Penfill ® mwa odwala okalamba sizinafufuzidwe. Komabe, mu kafukufuku wosasinthika wakhungu wamphongo wokhazikika womwe udapangidwa pa odwala 19 omwe ali ndi mtundu wa 2 mellitus wa 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 _{GIR, 0-120 mphindi} ) pakati pa insulin aspart ndi insulin ya anthu odwala okalamba anali ofanana ndi odzipereka athanzi komanso odwala achinyamata omwe ali ndi matenda a shuga.

Zambiri zam'mbuyo koma chitetezo

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

M'mayeso mu vitro Kuphatikiza kumangiriza ma insulin ndi ma IGF-1 receptors komanso momwe kukula kwa maselo, zidawonetsedwa kuti zofunikira za aspart insulin ndizofanana ndi insulin ya anthu. Kafukufuku adawonetsanso kuti kudzipatula komwe kumangidwa kwa insulin aspart ku insulin receptors kuli kofanana ndi kwa insulin ya anthu.

Pharmacokinetics

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 Penfill ®, 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% yotsalayo imawerengedwa ndi mtundu wa crystalline wa protamine-insulin aspart, kuchuluka kwa mayamwidwe komwe kuli kofanana ndi komwe kumapangitsa insulin NPH.

C _max seramu insulin pambuyo makonzedwe a NovoMix ® 30 Penfill ® ndi 50% kuposa kuposa a biphasic insulin 30 a T _max 2 nthawi yayifupi poyerekeza ndi biphasic insulin 30 ya anthu.

Ogwira ntchito zathanzi pambuyo pothandizidwa ndi mankhwalawa NovoMix ® 30 pamlingo wa 0,2 PIECES / kg C _max insulin aspart mu seramu idatheka pambuyo pa mphindi 60 ndipo anali (140 ± 32) pmol / L. Kutalika kwa T _1/2 NovoMix ® 30, yomwe imawonetsa kuyamwa kwa kachigawo kakumapeto kwa protamine, anali maora 8-9. Mlingo wa insulin m'magazi seramu wabwerera ku chiyambi cha maola 15-18 pambuyo povomerezeka pamankhwala. Odwala ndi mtundu 2 matenda a shuga _max adakwanitsa mphindi 95 atatha kuyang'anira ndipo adakhalabe pamwamba pazoyambira maola 14

Okalamba komanso odwala a senile. Kafukufuku wa pharmacokinetics a NovoMix ® 30 mwa odwala okalamba ndi a senile sanachitidwe. Komabe, kusiyana kwakaphatikizidwe mu pharmacokinetics pakati pa insulin aspart ndi insulle insulin ya anthu okalamba odwala mtundu wa 2 matenda a shuga (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 _1/2 (82 min (interquartile range - 60-120 min), pomwe ava 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 Penfill ® kwa odwala omwe ali ndi vuto la Impso 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 Penfill ® mu ana ndi achinyamata sanaphunzire. Komabe, mankhwala a pharmacokinetic ndi pharmacodynamic a soluble insulin aspart amaphunziridwa mwa ana (azaka 6 mpaka 12) komanso achinyamata (azaka 13 mpaka 17) ndi mtundu wa matenda a matenda a shuga 1. Kwa odwala azaka zonse ziwiri, insulin aspart imadziwika ndi kulowetsedwa mwachangu ndi ma T amagwira _max chimodzimodzi ndi akulu. Komabe, zofunikira za C _max m'magulu awiri azaka ziwiri anali osiyana, zomwe zikuwonetsa kufunikira kwa kusankha kwa mankhwala a insulin.

Mimba komanso kuyamwa

Zochitika zamankhwala ndikugwiritsa ntchito NovoMix ® 30 Penfill ® panthawi yokhala ndi pakati ndizochepa.

Komabe, zidziwitso kuchokera ku mayeso awiri azachipatala omwe adasankhidwa mosasamala (mwa azimayi 157 ndi amayi 14 omwe adalandira ma insulin aspim mu regimen yofunikira) sanawonetse mavuto aliwonse obwera ndi insulin aspart pa mimba kapena fetal / thanzi latsopanoli poyerekeza ndi insulin yamunthu yosungunuka. Kuphatikiza apo, mu kuyesedwa kwachipatala komwe kunakhudza azimayi 27 omwe ali ndi matenda osokoneza bongo omwe adalandira insulin aspart ndi solulle human insulin (insulin aspart analandira azimayi 14, insulin 13 ya anthu, mawonekedwe ofanana otetezedwa a mitundu yonse 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 Penfill ® ikhoza kugwiritsidwa ntchito popanda zoletsa. Kukhazikitsidwa kwa insulin kwa mayi woyamwitsa sikuopseza mwana. Komabe, zingakhale zofunikira kusintha mlingo wa NovoMix ® 30 Penfill ®.

Zotsatira zoyipa

Zotsatira zoyipa zomwe zimapezeka mwa odwala omwe amagwiritsidwa ntchito ndi mankhwala a NovoMiks ® 30, makamaka chifukwa cha kupatsirana kwa mankhwalawa. Chochitika chovuta kwambiri chambiri ndi insulin ndi hypoglycemia. Pafupipafupi mavuto obwera chifukwa chogwiritsa ntchito NovoMix ® 30 zimasiyana malinga ndi kuchuluka kwa odwala, kuchuluka kwa mankhwalawa, komanso kayendedwe ka glycemic.

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.

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: nthawi zambiri (≥1 / 10), nthawi zambiri (≥1 / 100, ® 30 Penfill ® sayenera kusakanikirana ndi mankhwala ena.

Mlingo ndi makonzedwe

NovoMix ® 30 Penfill ® idapangidwira s / c kuyambitsa. Osamayendetsa NovoMix ® 30 Penfill ® iv, as izi zimatha kuyambitsa kwambiri hypoglycemia. Makina a NovoMix ® 30 Penfill ® ayeneranso kupewa. Osagwiritsa ntchito NovoMix ® 30 Penfill ® pa sc / insulin kulowetsedwa (PPII) pamapampu a insulin.

Mlingo wa NovoMix ® 30 Penfill ® 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.

NovoMix ® 30 Penfill ® imatha kulembedwera odwala omwe ali ndi mtundu wa 2 shuga mellitus onse monga monotherapy komanso kuphatikiza ndi mankhwala a hypoglycemic omwe ali m'magazi pomwe kuchuluka kwa shuga m'magazi kumangoyendetsedwa ndi mankhwala amkamwa a hypoglycemic.

Kwa odwala omwe ali ndi matenda a shuga a mtundu woyamba omwe ayambitsidwa ndi insulin, muyezo wa NovoMix ® 30 Penfill ® ndi magawo 6 musanadye chakudya cham'mawa komanso magawo 6 musanadye chakudya chamadzulo. Kukhazikitsidwa kwa magawo 12 a NovoMix ® 30 Penfill ® kamodzi patsiku madzulo (asanadye chakudya chamadzulo) ndikololedwa.

Kusamutsa wodwala kuchokera kukonzekera kwina kwa insulin

Mukasamutsa wodwala kuchokera ku biphasic insulin ya anthu kupita ku NovoMix ® 30 Penfill ®, wina ayenera kuyamba ndi mlingo womwewo ndi mawonekedwe ake. 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 kwachipatala ndikofunikira pakusintha kwa wodwalayo komanso m'milungu yoyamba yogwiritsa ntchito mankhwalawa.

Kupititsa patsogolo chithandizo cha NovoMix ® 30 Penfill ® ndikotheka kusintha posintha kuchokera ku gawo limodzi tsiku lililonse kupita pawiri. Ndikulimbikitsidwa kuti mutatha kufikira kuchuluka kwa magawo 30 a mankhwalawa kuti mugwiritse ntchito NovoMix ® 30 Penfill ® 2 kawiri pa tsiku, ndikugawa mlingo mu magawo awiri ofanana - m'mawa ndi madzulo (musanadye chakudya cham'mawa ndi chakudya chamadzulo).

Kusinthika kwa kugwiritsidwa ntchito kwa NovoMix ® 30 Penfill ® katatu pa tsiku ndikotheka ndikugawa muyeso wa m'mawa m'magawo awiri ofanana ndikuyambitsa magawo awiriwa m'mawa komanso pachakudya chamasana (katatu tsiku tsiku).

Kusintha mlingo wa NovoMix ® 30 Penfill ®, kuthamanga kwambiri kwa glucose komwe kumachitika masiku atatu apitawa kumagwiritsidwa ntchito.

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

Kusintha kwa Mlingo ukhoza kuchitika 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 Penfill ®, pansipa ndi malingaliro pazomwe zimasinthidwa (onani tebulo).

Magulu apadera a odwala

Monga nthawi zonse, mukamagwiritsa ntchito mankhwala a insulin, odwala omwe ali m'magulu apadera, kuphatikiza shuga m'magazi kuyenera kuyang'aniridwa mosamala kwambiri ndipo mlingo wa aspart aspart payekha uyenera kusintha.

Okalamba komanso odwala a senile. NovoMix ® 30 Penfill ® ikhoza kugwiritsidwa ntchito mwa odwala okalamba, komabe, zomwe akumana nazo pophatikiza ndimankhwala a hypoglycemic omwe ali ndi odwala omwe ali ndi zaka zoposa 75 ndi ochepa.

Odwala ndi opuwala ntchito usiku ndi chiwindi. Odwala omwe ali ndi vuto la impso kapena hepatic, kuchepa kwa insulin kumatha kuchepetsedwa.

Ana ndi achinyamata. NovoMix ® 30 Penfill ® itha kugwiritsidwa ntchito pochiza ana ndi achinyamata azaka zopitilira 10 zaka milandu komwe kugwiritsa ntchito insulin yosakanikirana ndi yomwe imakondedwa. Zambiri zamankhwala azachipatala zimapezeka kwa ana azaka zapakati pa 6-9 (onani Pharmacodynamics).

NovoMix ® 30 Penfill ® iyenera kuthandizidwa mosadukiza 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 zochita za NovoMix ® 30 Penfill ® zimatengera mlingo, malo oyendetsera, kutsika kwa magazi, kutentha ndi kuchuluka kwa zochitika zolimbitsa thupi.

Poyerekeza ndi biphasic insulin ya anthu, NovoMix ® 30 Penfill ® imayamba kuchita zinthu mwachangu, chifukwa chake imayenera kuperekedwa mwachangu musanatenge wopemphayo. Ngati ndi kotheka, NovoMix ® 30 Penfill ® ikhoza kutumikiridwa posachedwa mutatenga wopemphayo.

Bongo

Zizindikiro Mulingo wofunikawo wa mankhwala osokoneza bongo ambiri a insulin sunakhazikitsidwe hypoglycemia imatha kukula pang'onopang'ono ngati Mlingo ndiwokwera kwambiri poyerekeza ndi zosowa za wodwala.

Chithandizo. Wodwala amatha kuthetsa hypoglycemia wofatsa mwa kudya shuga kapena zakudya zomwe zili ndi shuga. Chifukwa chake, ndikulimbikitsidwa kwa odwala omwe ali ndi matenda ashuga kuti azisenza mankhwala okhala ndi shuga nthawi zonse.

M'malo mwa kwambiri hypoglycemia, wodwala akakhala kuti alibe chikumbumtima, muyenera kulowa kuchokera ku 0,5 mg mpaka 1 mg ya glucagon mu / m kapena s / c (akhoza kuyendetsedwa ndi munthu wophunzitsidwa), kapena mu / yankho la glucose (dextrose) (katswiri wazachipatala yekha ndi amene angalowe). M'pofunikanso kuyang'anira dextrose iv ngati wodwalayo asadzayambenso chikumbumtima cha mphindi 10-15 atatha kugwiritsa ntchito shuga. Pambuyo podzikanso, wodwalayo amalangizidwa kuti azidya zakudya zokhala ndi mchere wambiri kuti muchepetse kubwerezanso kwa hypoglycemia.

Njira zopewera kupewa ngozi

NovoMix ® 30 Penfill ® ndi singano ndizongogwiritsa ntchito nokha. Musadzazenso cartridge ya Penfill ®.

NovoMix ® 30 Penfill ® sangagwiritsidwe ntchito ngati mutasakaniza siyikhala yoyera komanso yamitambo.

Iyenera kutsimikizika kwa wodwala kufunika kosakanikirana kuyimitsidwa kwa NovoMix® 30 Penfill® musanayambe kugwiritsidwa ntchito.

Musamagwiritse ntchito NovoMix ® 30 Penfill ® ngati yazizira. Odwala ayenera kuchenjezedwa kuti ataye singano pambuyo jekeseni aliyense.

Malangizo apadera

Asananyamuke ulendo wamtunda wophatikizapo kusintha kwa malo, wodwalayo ayenera kufunsa dokotala, chifukwa kusintha nthawi kumatanthauza kuti wodwalayo ayenera kudya ndi kupatsa insulin panthawi ina.

Hyperglycemia. Mlingo wosakwanira kapena kusiya kulandira chithandizo, makamaka mtundu wa matenda a shuga 1, kungayambitse kukula kwa hyperglycemia ndi matenda ashuga a ketoacidosis. Zizindikiro za hyperglycemia nthawi zambiri zimawonekera pang'onopang'ono pakupita kwa maola angapo kapena masiku. Zizindikiro za hyperglycemia ndi ludzu, kutuluka kwamkodzo, nseru, kusanza, kugona, kufooka ndi khungu, pakamwa pouma, kusowa chilimbikitso, komanso mawonekedwe a fungo la acetone m'mlengalenga.Popanda chithandizo choyenera, hyperglycemia odwala omwe ali ndi matenda amtundu wa 1 angayambitse matenda a shuga a ketoacidosis, vuto lomwe lingathe kupha.

Hypoglycemia. Kudumpha zakudya kapena kuchita masewera olimbitsa thupi mosakonzekera kungayambitse matenda a hypoglycemia. Hypoglycemia imatha kukhalanso ngati mlingo wa insulin ndiwokwera kwambiri poyerekeza ndi zosowa za wodwala (onani "Zotsatira zoyipa", "Mankhwala osokoneza bongo").

Poyerekeza ndi insulin yaumunthu ya biphasic, makonzedwe a NovoMix ® 30 Penfill ® ali ndi mphamvu yotchulidwa kwambiri mu maora 6 pambuyo pa kukhazikitsa. Pankhani imeneyi, nthawi zina, pangafunike kusintha mtundu wa insulin komanso / kapena mtundu wa zakudya. Pambuyo kulipirira kagayidwe kazakudya, mwachitsanzo, ndi insulin yokwanira, odwala amatha kukumana ndi zisonyezo zam'mbuyomu za hypoglycemia, zomwe odwala ayenera kudziwitsidwa. Zizindikiro zachilendo zimatha kutha ndi matenda a shuga. Kuwongolera mwamphamvu kwa glycemia mwa odwala kumatha kuwonjezera ngozi ya hypoglycemia, chifukwa chake, kuwonjezeka kwa mlingo wa NovoMix ® 30 Penfill ® uyenera kuchitika moyang'aniridwa ndi achipatala okhazikika (onani "Mlingo ndi Administration").

Popeza NovoMix ® 30 Penfill ® iyenera kugwiritsidwa ntchito molumikizana ndi kudya, munthu ayenera kuganizira kuchuluka kwa mankhwalawa momwe mankhwalawa amathandizira odwala omwe ali ndi matenda opatsirana kapena kumwa mankhwala omwe amachepetsa kuyamwa kwa chakudya.

Matenda okhala ndi vuto limodzi, makamaka opatsirana komanso kutentha thupi, nthawi zambiri amalimbikitsa kufunika kwa insulin. Kusintha kwa magazi kungafunikenso ngati wodwala ali ndi matenda a impso, chiwindi, mkhutu wa adrenal ntchito, pituitary gland kapena chithokomiro cha chithokomiro.

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

Kusamutsa wodwala kuchokera kukonzekera kwina kwa insulin. 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 yaumunthu, analog ya insulin yaumunthu) pokonzekera insulin ndi / kapena njira yopangira, kusintha kwa mlingo kungafunike. Odwala omwe amasintha kuchokera ku insulin ina kukonzekera mankhwala a NovoMix ® 30 Penfill ® angafunikire kuwonjezera kuchuluka kwa jakisoni kapena kusintha mlingo poyerekeza ndi Mlingo wa kukonzekera kwa insulin kale. Ngati ndi kotheka, kusintha kwa mlingo, mutha kupanga kale jakisoni woyamba wa mankhwalawa kapena mkati mwa milungu yoyamba kapena miyezi ya chithandizo.

Zokhudza malo jakisoni. Monga mankhwala ena a insulin, zimachitika mu jakisoni wa jekeseni, yomwe imawonetsedwa ndi kupweteka, kufiyira, ming'oma, kutupa, hematomas, kutupa ndi kuyabwa. Kusintha pafupipafupi jakisoni wambiri m'dera limodzilimodzi kumatha kuchepetsa zizindikiro kapena kuteteza kukula kwa izi. Kuchitidwa nthawi zambiri kumatha patatha masiku angapo mpaka milungu ingapo. Nthawi zina, NovoMix ® 30 Penfill ® ingafunike kuchotsedwa chifukwa cha zomwe zimachitika jekeseni.

Kugwiritsa ntchito munthawi yomweyo mankhwala a gulu la thiazolidinedione komanso kukonzekera insulin. Milandu yokhudzana ndi matenda a mtima omwe amayamba chifukwa cha kulephera kwa mtima adanenedwa mothandizidwa ndi odwala omwe ali ndi thiazolidinediones kuphatikiza kukonzekera kwa insulin, makamaka ngati odwala oterewa ali pachiwopsezo chotukuka kwa mtima wosalephera.Izi zimayenera kukumbukiridwa popereka mankhwala ophatikiza ndi thiazolidatediones ndi insulin yokonzekera odwala. Ndi mankhwala osakanikirana oterowo, ndikofunikira kuchita mayeso azachipatala kwa odwala kuti azindikire zizindikiritso za mtima kulephera, kulemera kwa thupi ndi kupezeka kwa edema. Ngati zizindikiro za kulephera kwa mtima zikuchulukirachulukira kwa odwala, chithandizo ndi thiazolidatediones ziyenera kusiyidwa.

Kukopa pa kuyendetsa magalimoto ndi kugwira ntchito ndi njira. Kuthekera kwa odwala kulolera komanso kuchuluka kwa momwe angachitire amatha kusokonezeka panthawi ya hypoglycemia, zomwe zimatha kukhala zowopsa nthawi zomwe maluso amenewa amafunikira makamaka (mwachitsanzo, poyendetsa magalimoto kapena kugwira ntchito ndi makina ndi makina).

Odwala ayenera kulangizidwa kuti achitepo kanthu popewa kukula kwa hypoglycemia mukamayendetsa. Izi ndizofunikira kwambiri kwa odwala omwe alibe kapena kuchepetsedwa Zizindikiro zakutsogolo kwa hypoglycemia kapena akuvutika ndi zochitika zapafupipafupi za hypoglycemia. Muzochitika izi, kuyendetsa bwino ndikuchita ntchito yotereyi kuyenera kuganiziridwa.

Kutulutsa Fomu

Kuyimitsidwa kwa makina oyang'anira, 100 PESCES / ml. Mu makatoni agalasi la hydrolytic kalasi yoyamba, yosindikizidwa ndi ma disc a rabara mbali imodzi ndi ma pisitoni a mphira kumbali ina, 3 ml iliyonse, mpira wamgalasi umayikidwa mu katiriji kuti uthandizire kusakanikirana kwa kuyimitsidwa, mu chithuza chamtundu wa makatoni 5, mumtundu wa makatoni 1.

Zotsatira zoyipa za Novomix 30:

Zotsatira zoyipa zomwe zimakhudzana ndi kagayidwe kazachilengedwe: hypoglycemia (kutuluka thukuta, khungu, mantha kapena kunjenjemera, kuda nkhawa, kufooka kapena kufooka, kusokonezeka, kusokonezeka, chizungulire, njala yayikulu, kusokonezeka kwakanthawi kwakanthawi, kupweteka kwa mutu. , nseru, tachycardia). Hypoglycemia yayikulu imatha kutha kwamtendere ndi / kapena kukokana, kusokonezeka kwakanthawi kapena kosasintha kwa ubongo ndi imfa.

Thupi lawo siligwirizana: zotheka - urticaria, zotupa pakhungu, kawirikawiri - anaphylactic zimachitika. Matenda ofala omwe amabwera chifukwa cha thupi amatha kuphatikizira zotupa pakhungu, khungu lanu

Zomwe zimachitika mdera: zimachitika mthupi (redness, kutupa, kuyabwa kwa khungu m'malo a jakisoni), nthawi zambiri zosakhalitsa komanso kudutsa pomwe chithandizo chikupitirirabe, lipodystrophy ndiyotheka.

Zina: kumayambiriro kwa mankhwalawa kawirikawiri - edema, mwina kuphwanya Refraction.

Gwiritsani ntchito pa nthawi yoyembekezera

Zochitika zamankhwala ndi insulin aspart pamimba ndizochepa.

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

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

Malangizo apadera ogwiritsa ntchito Novomix 30 penfill.

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

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

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

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

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

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

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

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

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

Osavomerezeka kuti azigwiritsidwa ntchito mwa ana ochepera zaka 6.

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.

Mogwirizana wa Novomix 30 penfill ndi mankhwala ena.

Hypoglycemic zotsatira za insulin 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 kukonzekera kokhala ndi Mowa.

Njira zakulera za pakamwa, GCS, mahomoni a chithokomiro, thiazide diuretics, heparin, tridclic antidepressants, sympathomimetics, danazole, Clonidine, calcium njira blockers, diazoxide, morphine, phenytoin, nikotini zimafooketsa mphamvu ya hypoglycemic.

Mothandizidwa ndi reserpine ndi salicylates, kufooka komanso kuwonjezeka kwa machitidwe a mankhwalawa ndizotheka.

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

Mafunso, mayankho, ndemanga pa mankhwala NovoMix 30 Penfill

Zomwe zimaperekedwa zimakonzekera akatswiri azamankhwala komanso zamankhwala. Chidziwitso chokwanira chokhudza mankhwalawa chili m'malangizo omwe amaphatikizidwa ndi zomwe amapanga ndi wopanga. Palibe chidziwitso chomwe chatumizidwa patsamba lino kapena tsamba lililonse la tsamba lathu chomwe chingagwire ntchito ngati cholowa m'malo mwapadera kwa katswiri.