Zovuta za Novorapid ndi flekspen kusiyana kwake

Anthu. Ndiuzeni kusiyana kwa NovoRapid-Flexpen ndi NovoRapid-Penfill.

posable9905 Disembala 07, 2014 00:24

Wosunthira m'mapensulo, penfil m'matumba. Ndipo ndiye insulin yomweyo.

asher199404 Disembala 07, 2014 00:26

asher199404 Disembala 07, 2014 00:28

Zowona kuti cholembera ndi makatiriji ndi zomveka.

posable9905 Disembala 07, 2014 00:30

asher199404, ndidalemba zomwezi. Zimapanga kusiyana kotani ngati chimodzi ndi chimodzi chimatsanulidwa.

asher199404 Disembala 07, 2014 00:33

Ndinapatsidwa Penfill. Ngakhale izi zisanachitike, amapatsidwa zolembera. Ndidapatsa amayi anga zomwe akupeza, lero ndabwera ndipo ndadabwa.

posable9905 Disembala 07, 2014 00:38

asher199404, bwanji mukuchita mantha pamenepo?!

asher199404 Disembala 07, 2014 00:40

Chifukwa chomwe adalemba zolakwika kapena zopatsa

goose December 07, 2014 00:40

Ndimagwira komwe ndingayikemo cartridge ndikunyambita palibe chtoli?

asher199404 Disembala 07, 2014 00:45

Zoti ndimamvetsetsa makatakitala cholembera .. Koma kuyambira pachiyambi pomwe, palibe amene adandipatsa cholembera. Ndipo adakonza. Ndingatani tsopano?

goose Disembala 07, 2014 01:04

asher199404, pezani chogwirira. Kutha-mpaka-insulin kupsya? Ngati sichoncho, ndiye kuti mutha kufunsa endocrinologist, koma ngati mwachangu, ndiye kuti mugule, muma pharmacies ayenera

_7tragic81 Disembala 07, 2014 01:04

asher199404, ku Moscow? Bwera mawa, ndikupereka cholembera

posable9905 Disembala 07, 2014 01:11

asher199404, vuto sizomwe mukuchita, sangalalani kuti mwapereka))) ndipo muyenera kufunsa kapena kugula cholembera kumapeto

asher199404 Disembala 07, 2014 01:18

Inde, kuyambira pa chiyambi pomwe ndidatumizidwa zolembera. insulin itamaliza kutulutsa cholembera .nthawi iyi kupita kwa endocrinologist adafunsa zomwe Kolya ndidanena kuti cholembera cha Novorapid ndi Forori.

asher199404 Disembala 07, 2014 01:29

Anati adalemba bwino, nawonso sukalemba zomwezo. Lachinayi, mankhwalawo sanatigwiritse ntchito, komwe amapereka mankhwala. Ndisiyira Chinsinsi choti amayi alandire.

asher199404 Disembala 07, 2014 01:30

Lero sindinawone zolembera koma makatoni.

posable9905 Disembala 07, 2014 01:48

asher199404, tidamvetsetsa izi) koma zili bwino tangofunika cholembera! Kotero kuperekera nthawi imodzi kunatha

marseilles December 07, 2014 10:21

Mochulukitsa, mutha kugwiritsa ntchito syringe yotayika kuchokera m'botolo!

anastomosis December 07, 2014 11:46

Insulin ndi yomweyo, mawonekedwe a kumasulidwa ndi osiyana. Komanso m'mitsuko pamenepo

antipathy December 07, 2014 12:07

Mwambiri, zimawoneka kuti kuchuluka kwa zolembera zotayika sikolondola kwenikweni. m'malingaliro anga, ndibwino kufupikitsa insulini yonse mu makatoni omwe ali ndi cholembera chabwino bwino kuposa izi zotayidwa pulasitiki, ndazindikira nthawi zambiri kuti china chake chikugundana pamenepo ndipo chimaliziro sichinamalize " ndipo nthawi yotsatira insulin iyi "yolumikizidwa" ikabayidwa .. ndipo zimapezeka kuti kwakanthawi kochepa ndikupuma kwachiwiri ndikugwira matumbo .. ndipo iyemwini sanamvetse chifukwa.

posable9905 Disembala 07, 2014 12:35

antipathy, ndipo amasinthasintha nthawi zina kumayenda! Komanso m'makalata omwe ndimakonda

Kusiyana kwa mankhwala osokoneza bongo

Polimbana ndi matenda ashuga, mitundu iwiri ya mankhwala imagwiritsidwa ntchito. NovoRapid Penfill imayimiriridwa ndi makatiriji (otha kusintha) opangidwa ndi galasi la hydrolytic la gulu loyambalo, zidutswa zisanu mu chithuza cholongedzedwa m'bokosi. NovoRapid Flexpen imapezeka mu zolembera 5 zotayika mu paketi imodzi. Ngakhale mawonekedwe osiyanasiyana, mankhwalawa ndi ofanana - amadzimadzi osakhala ndi utoto, mu 1 ml momwe insulin aspart imakhala ndi 100 PIECES. Chidebe chimodzi chaching'ono chimakhala ndi mayunitsi 300. (3 ml) madzi.

Zizindikiro ndi contraindication

Mankhwalawa amalembera odwala onse omwe amadalira insulin komanso osadalira insulin. Zifukwa zokanira kugwiritsa ntchito:

• achina,
• tsankho kwa insulin kapena ziwalo zina za mankhwala,
• ana osakwana zaka 2 (chifukwa cha kusowa kwa kafukufuku wofufuza yemwe angatsimikizire chitetezo cha NovoRapida cha gulu ili).

Bwererani ku tebulo la zamkati

Kugwiritsa

Kukhazikitsidwa kwa "Flexpen" ndi "Penfill" kumachitika pogwiritsa ntchito njira ziwiri - jekeseni wamkati ndi subcutaneous. Dokotala amasankha mtundu wa aliyense wa odwala matenda ashuga. Chifukwa chakuti NovoRapid ndi insulin yothamanga, imagwiritsidwa ntchito limodzi ndi wothandizira kwa nthawi yayitali. Mulimonsemo, ndikofunikira kuwongolera msinkhu wa shuga ndikusintha kuchuluka kwa mankhwalawa omwe amaperekedwa. Mlingo wa tsiku ndi tsiku ndi 0,5-1 magawo. pa kilogalamu imodzi yakulemera kwa thupi. Ngati muzibayira mankhwala musanadye, ndiye kuti insulini ingapatse thupi 50-70%, yonseyo imapangidwira ndi analogue yokhala nthawi yayitali.

Kufunika kosinthira kwa mankhwalawa kumachitika ngati mukuwonjezeka zolimbitsa thupi, ndikusintha kwa zakudya kapena matenda ena. "Flexspen" ndi "Penfill" amagwiritsidwa ntchito pang'onopang'ono, kusankha nthawi zambiri jakisoni m'dera la khoma lamkati lakumbuyo (m'malo ano, zigawo za mankhwala zimatengedwa mwachangu). Popewa kukula kwa lipodystrophy, kusintha kwa jakisoni ndikofunikira. Jakisoni wamkati amaloledwa kwa okhawo ophunzitsidwa bwino.

NovoRapid saloledwa kuperekedwa intramuscularly.

Munjira, ziyenera kukumbukiridwa kuti pansi pa khungu singano ikhale osachepera 6 masekondi. Sungani batani mpaka atachotsedwa. Izi ndizofunikira kuti mankhwalawo azilandira kwathunthu, komanso kuti magazi asalowe ndi singano kapena chidebe chokhala ndi mankhwalawo. Chidebe sichingadzazidwe ndi insulin.

Zosunga

Mankhwala "FlexPen" ndi "Penfill" ayenera kusungidwa ndi ana, kutali ndi malo omwe amatentha, kutentha kwa 2-8 ° C. Sungani mufiriji kutali ndi mufiriji, mankhwalawo sayenera kuzizira. Tetezani ku kuwala (mankhwalawa ayenera kukhala m'bokosi). Chipewa chikuyenera kuvalidwa pachikono. Moyo wa alumali ndi miyezi 30. Zotseguka zotsegulidwa ndi zolembera zomwe zimagwiritsidwa ntchito kale sizitha kuikidwanso mufiriji. Zitha kusungidwa mu mawonekedwe awa osaposa masiku 28 pa kutentha mpaka 30 ° C.

Zotsatira zoyipa

Kuthamanga insulini kungayambitse vuto, monga kupezeka kwa hypoglycemia. Mawonekedwe ake:

• kutuluka thukuta kwambiri
• chikopa,
• nkhawa zosafotokozedwa
• miyendo ndi mikono itanjenjemera
• zosokoneza
• kusayang'ana bwino malo,
• kufooka
• chizungulire
• nseru
• mutu
• kuwonongeka kwamawonekedwe,
• kukomoka mtima,
• kupezeka kwa chilakolako chambiri.

Ndi kuchepa kwambiri kwa shuga m'magazi, wodwalayo amatha kukomoka.

Glycemia imathandizidwanso ndi kukhudzidwa, kuiwala, kusokonezeka kwa ubongo ndipo imatha kupha. Mwinanso kupezeka kwalephera m'matumbo am'mimba komanso mawonetseredwe a thupi lawo. Nthawi zina pamakhala kuchepa kwa kukakamizidwa. Nthawi zina, pakhungu la jakisoni limakhala lofiira ndi kutupa, kuyamwa kumachitika. Mawonetsedwe onsewa ndi osagwirizana ndipo amakwiya chifukwa cha kuwonekera kwa mankhwalawa kwa odwala omwe akudwala matenda a shuga.

Kusankha chida

Anthu odwala matenda ashuga a Mtundu 1 amakonda kugwiritsa ntchito Penfill chifukwa mankhwalawa amachepetsa glucose panthawi yoyamba 4 kudya. Pankhani yoyambitsa mankhwalawa mwachindunji pakhungu, pakatha mphindi 10, chinthu chogwira ntchito chimayamba kugwira ntchito. Kwa maola ena awiri, mphamvu ya mankhwalawo imafika pachimake, ndipo patatha maola ena 4 muyenera kuyambiranso. Ngakhale zili zofanana, odwala ena amawonetsa kuti mankhwalawa omwe ali mu cartridgeges ndi osavuta kugwiritsa ntchito kuposa FlexPen, chipangizo cha ma syringe pensulo chomwe sichingakhale chodabwitsa panthawi yolakwika kwambiri. Kusankhidwa kwa chithandizo chimodzi kapena chimzake kumadalira zomwe anthu amakonda.

Ichi ndi mankhwala omwe ali ndi hypoglycemic effect, omwe ndi analogue ya insulin yochepa yaumunthu. Insulin yotchedwa Novulinide imapangidwa ndi njira yomwe imagwiritsidwanso ntchito DNA ya biotechnology yogwiritsa ntchito Saccharomyces cerevisiae strain, ndi proline (amino acid) pamalo a B28 m'malo mwake ndi aspartic acid.

Mankhwalawa amamangirira ku ma receptor ena omwe amakhala kunja kwa cytoplasmic membrane a maselo.

Zotsatira zake, insulin-receptor tata imapangidwa, yomwe imapangitsa njira zina mkati mwa maselo, kuphatikiza kuyambitsa kaphatikizidwe ka michere yofunika (glycogen synthetase, hexokinase, pyruvate kinase).

Kuchepa kwa kuchuluka kwa shuga m'magazi kumachitika chifukwa chakuwonjezeka kwa kayendedwe kake mkati mwa maselo, kutseguka kwa ziwalo za thupi, komanso chifukwa cha kukondoweza kwa magwiridwe a glulyse m'magazi.

Mukalowetsa amino acid proline m'chigawo B28 ndi spartic acid mu mankhwala a Novo Rapid Flexpen, chidwi cha ma molekyulu kupanga hexamers chimachepa, ndipo chizolowezichi chimasungidwa mu yankho la insulin wamba.

Pankhani imeneyi, mankhwalawa amaphatikizidwa bwino kwambiri ndi subcutaneous makonzedwe, ndipo machitidwe ake amapezeka kale kwambiri kuposa insulin ya anthu.

NovoRapid Flexpen ndiwothandiza kwambiri pakuchepetsa shuga m'magazi anayi oyambirira atatha kudya kuposa insulin yaumunthu. Mwa anthu omwe ali ndi matenda a shuga 1, akamagwiritsa ntchito wothandizirawa, mumakhala kuchepa kwa shuga m'misempha poyerekeza ndi insulin.

Novo Rapid Flexpen ali ndi nthawi yochepa pochita ndi subcutaneous makonzedwe kuposa sungunuka munthu insulin.

Ndi subcutaneous jakisoni, mankhwalawa amayamba kuchita mphindi khumi kapena makumi awiri, ndipo zotsatira zake zimakhala 1 mpaka 3 pambuyo pa kukhazikitsa. Kutalika kwa mankhwalawa ndi maola atatu kapena asanu.

Kugwiritsidwa ntchito kwa Novo Rapida Flexpen mu matenda ashuga omwe ali ndi matenda amtundu 1 amachepetsa mwayi wa zochitika za nocturnal hypoglycemia poyerekeza ndi insulin ya anthu osungunuka. Chiwopsezo chachikulu cha kuchuluka kwa hypoglycemia masana sichinawonekere.

Mankhwalawa mogwirizana ndi molarity ndiwofanana ndi insulin yaumunthu.

Zogulitsa

Ndi subulinane insulin, spart imakhala yofupika nthawi 2 kuti ifike pazambiri zamagazi kuposa kuyambitsa kwa insulin yaumunthu.

Zokwanira za plasma zimakhala pafupifupi 492 + 256 mmol / lita ndipo zimatheka ngati mankhwalawa amaperekedwa kwa odwala omwe ali ndi mtundu wa 1 shuga mellitus pa 0,15 U / kg thupi pambuyo pa mphindi makumi anayi. Kufikira koyamba, insulini imabwera pambuyo pa jakisoni.

Mu mtundu 2 shuga mellitus, kuchuluka kwa mayamwidwe kumachepa pang'ono ndipo izi zikufotokozera kuchuluka kwapamwamba kwambiri (352 + 240 mmol / lita) ndi nthawi yayitali yokwaniritsa (pafupifupi ola limodzi).

Nthawi yoti ifike pazambiri za insulin ndi yochepa kwambiri kuposa nthawi yogwiritsira ntchito insulin yaumunthu, pomwe kusinthasintha kwa ndende chifukwa kumakhala kwakukulu.

Pharmacokinetics mu milandu yapadera yamankhwala

Ntchito pa pharmacokinetics ya mankhwalawa sichinachitike mwa odwala okalamba komanso mwa anthu omwe ali ndi vuto la chiwindi kapena impso.

Mwa ana azaka zisanu ndi chimodzi mpaka khumi ndi ziwiri, komanso achinyamata azaka za 13 mpaka 17, omwe ali ndi matenda 1 amshuga, insulin aspart imatengedwa mwachangu pazaka zonse ziwiri, ndipo nthawi yofika pazovuta zambiri imakhala yofanana ndi akulu.

Koma pakati pa magulu a mibadwo iwiriyi pali kusiyana pakukhudzidwa, chifukwa chake ndikofunikira kuti aliyense asankhe kuchuluka kwa mankhwalawa kutengera mtundu womwe wodwala ali.

1. Insulin-wodwala matenda a shuga a mellitus (mtundu woyamba).
2. Matenda a shuga osagwirizana ndi insulin (mtundu 2) mu gawo la kukana kwa othandizira a hypoglycemic kapena osagwirizana ndi mankhwalawa (monga gawo la zovuta mankhwala), komanso matenda omwe amagwirizana.

Novo Rapid Flexpen ali ndi njira yolowera komanso yolowerera. Mankhwalawa amayamba kuchita zinthu mwachangu ndipo amakhala ndi nthawi yofupika kuposa kusintha kwa insulin yamunthu.

Iyenera kuperekedwa nthawi yomweyo musanadye chakudya kapena mutangodya (chifukwa cha kuyamba kwachangu).

Kwa wodwala aliyense, dokotala amasankha mtundu wa insulin payokha, kutengera zomwe zili m'magazi. Novo Rapid Flexpen nthawi zambiri imaphatikizidwa ndi kukonzekera kwina kwa insulin (nthawi yayitali kapena nthawi yayitali), yomwe imayendetsedwa kamodzi pa tsiku.

Mwachilengedwe, kufunikira kwa insulin tsiku ndi tsiku kumakhala pakati pa 0,5 ndi 1 U / kg thupi. Kufunikira kumeneku ndi 50-70% kukhutitsidwa ndi kukhazikitsidwa kwa mankhwala a Novo Rapid Flexpen musanadye, ndipo ndalama zotsalazo zimatengedwa ndi insulin yayitali.

Ndi kukhazikitsidwa kwa kutentha kwa mankhwalawa kuyenera kufananizidwa ndi kutentha.

Cholembera chilichonse cha insulin chimagwiritsidwa ntchito ndi munthu payekha ndipo ndizoletsedwa kuzizitsanso.

Ngati Novo Rapid Flexpen imagwiritsidwa ntchito nthawi yomweyo ndi ma insulin ena mu Flexpen cholembera, ndiye kuti pakukhazikitsa mtundu uliwonse wa insulin ndikofunikira kugwiritsa ntchito njira zopangira jakisoni.

Asanayambitsidwe mankhwalawa, ndikofunikira kuyang'anitsa ma phukusi, kuwerenga dzina ndikuwonetsetsa kuti mtundu wa insulini umasankhidwa molondola.

Wodwala nthawi zonse amayenera kuyang'ana cartridge ndi mankhwalawo, kuphatikizapo pisitoni ya mphira. Malangizo onse amafotokozedwa mwatsatanetsatane mu malangizo a insulin management system. Ulusi wa mphira uyenera kuthandizidwa ndi thonje lomwe limanyowa mu mowa wa ethyl.

Ndi zoletsedwa kugwiritsa ntchito mankhwala a Novo Rapid Flexpen ngati:

• katoni kapena syringe idagwa,
• cartridge idaphwanyidwa kapena kuwonongeka, chifukwa izi zimapangitsa kuti insulin ipume,
• gawo lowoneka la pisitoni ya mphira ndiwakukula kuposa mzere wa code yoyera,
• insulin idasungidwa pansi pazinthu zomwe sizigwirizana ndi zomwe zidafotokozedwazo, kapena zouma,
• insulini yakhala utoto kapena yankho lake ndi mitambo.

Kuti mupeze jakisoni, singano iyenera kuyikiridwa pansi pa khungu ndikudina batani loyambira njira yonse. Pambuyo jakisoni, singano iyenera kusiyidwa pansi pakhungu kwa masekondi 6 osachepera. Chingwe cha syringe chiyenera kukanikizidwa mpaka singano itachotsedwa kwathunthu.

Pakupangiridwa jakisoni aliyense, singanoyo imayenera kuchotsedwa, chifukwa ngati izi sizinachitike, ndiye kuti madzi amachokera ku cartridge amatha kutuluka (chifukwa cha kusiyana kwa kutentha) ndi kuchuluka kwa insulini kumasintha.

Kubwezeretsanso katoni ndi insulin nkoletsedwa.

Pogwiritsa ntchito insulin dongosolo la infusions wautali, malamulo awa akuyenera kuonedwa:

1. Mapiritsi okhala ndi polyolefin kapena polyethylene amayenera kupitilizidwa ndikuvomerezedwa kuti agwiritsidwe ntchito pakupopa mapampu.
2. Kuchuluka kwa insulin, ngakhale kuli kokhazikika, kumatha kutengeka ndi zinthu zomwe dongosolo limapangidwa.
3. Mukamagwiritsa ntchito pulogalamu ya Novo Rapid pump, singaphatikizidwe ndi mitundu ina ya insulin.
4. Malangizo onse a dotolo ndi malangizo ogwiritsira ntchito Novo Rapid mu pampu yamagetsi ayenera kuyang'aniridwa mosamala.
5. Musanayambe kugwiritsa ntchito njirayi, muyenera kuphunzira zambiri mosamala za zomwe ziyenera kutengedwa ngati mukudwala, kukweza kapena kutsitsa shuga wamagazi kapena dongosolo likasokonekera.
6. Musanaikemo singano, manja ndi khungu ziyenera kutsukidwa ndi sopo ndi madzi kuti mupewe matenda pamalowo.
7. Mukadzaza thanki, onetsetsani kuti mulibe mabulangete akuluakulu mu syringe kapena chubu.
8. Sinthani machubu ndi singano pokhapokha potsatira malangizo omwe abwera ndi kulowetsedwa uku.
9. Ndikofunikira kuyang'anitsitsa kuchuluka kwa glucose kuti azindikire mwachangu kuwonongeka kwa pampu ya insulin ndikuletsa kusokonezeka kwa kagayidwe kazakudya.
10. Ngati walephera dongosolo la insulin pampu, muyenera kusungitsa nthawi zonse ma insulini wothandizirana ndi mankhwalawa kuti muchepetse vuto la hyperglycemia.

Zotsatira zoyipa

Zotsatira zoyipa za mankhwala zomwe zimakhudzana ndi kagayidwe kazachilengedwe ndi hypoglycemia. Mawonekedwe ake:

• kutuluka thukuta kwambiri
• kukopa kwa pakhungu
• kunjenjemera, mantha, kumva kuda,
• kufooka kapena kutopa kwachilendo,
• kuphwanya kwa masanjidwe ndi malo
• chizungulire ndi mutu
• kumva kwamphamvu njala
• kuwonongeka kwakanthawi kowonekera,
• tachycardia, kukakamiza kutsika.

Hypoglycemia yamphamvu imatha kuyambitsa kukhumudwa komanso kusokonezeka kwamatumbo, matenda amisala a ubongo (osakhalitsa kapena osasinthika) ndi kufa.

Thupi lawo siligwirizana nthawi zambiri, ming'oma kapena totupa pakhungu limatha. Kugwedeza kwa anaphylactic ndikosowa kwambiri. A ziwengo zosakanikirana zimatha kuwonetsedwa ndi zotupa pakhungu, kuyabwa, kuchuluka thukuta, matenda am'mimba, angioedema, tachycardia komanso kuchepa kwa mavuto, kupuma movutikira.

Mawonetseredwe amtundu wakomweko (edema, redness, kuyabwa pamalo opaka jekeseni), monga lamulo, ndi osakhalitsa ndipo amangochitika pamene chithandizo chikuchitika.

Nthawi zambiri, lipodystrophy imatha kuchitika.

Zotsatira zina zoyipa zimaphatikizira kutupa (kawirikawiri) komanso kuphwanya Reflexion (pafupipafupi). Izi nthawi zambiri zimakhala zakanthawi.

Cork zochita za mankhwala Novo Rapid Flexpen nthawi zambiri amadalira kumwa ndipo zimachitika chifukwa cha pharmacological zochita za insulin.

Mimba komanso kuyamwa

Amayi oyembekezera alibe luso logwiritsa ntchito Novo Rapid Flexpen. Kuyesa kwa nyama zoyesera sikunawonetse kusiyana pakati pa insulin aspart ndi insulin yaumunthu mu embryotoxicity ndi teratogenicity.

Munthawi yakukonzekera kutenga pakati komanso nthawi yonse ya bere, muyenera kuwunika momwe mayi ali ndi matenda ashuga, komanso kuyang'anira kuchuluka kwa shuga m'magazi.

Mu trimester yoyamba, kufunika kwa insulin nthawi zambiri kumachepetsedwa, ndipo chachiwiri komanso chachitatu, kuwonjezeka kwake pang'onopang'ono kumayamba.

Panthawi yobala mwana ndipo pambuyo pawo, kufunikira kungayambenso. Nthawi zambiri, atabereka mwana, amabwerera mwachangu ku gawo loyamba lomwe linali isanachitike mimba.

Nthawi yoyamwitsa, kugwiritsa ntchito Novo Rapid Flexpen kumaloledwa popanda zoletsa, chifukwa kukhazikitsidwa kwake kwa mayi woyamwitsa sikubweretsa ngozi kwa mwana. Koma nthawi zina ndikofunikira kuchita kusintha kwa mlingo.

Bongo

Chizindikiro chachikulu cha bongo ndi hypoglycemia, nthawi zina, chithandizo chamankhwala chongoopsa cha hypoglycemic chingafunike.

Ndi degree yofatsa, wodwalayo amatha kuthana ndi yekha mwa kudya shuga, glucose kapena zakudya zamafuta ambiri. Odwala nthawi zonse azikhala ndi maswiti, ma cookie kapena madzi a zipatso nawo.

Mu kwambiri hypoglycemia ndi kusazindikira, munthu ayenera jekeseni 40% shuga yankho mkati, subcutaneally kapena intramuscularly glucagon mu mlingo wa 0.5-1 mg

Pambuyo pozindikira, wodwalayo ayenera kudya zakudya zam'magazi kuti asayambenso hypoglycemia.

Zosungirako ndi moyo wa alumali

Mankhwala ndi a mndandanda B.

Ma phukusi osatsegulidwa ayenera kusungidwa mufiriji kutentha kwa madigiri 2-8. Musasungire insulin pafupi ndi mufiriji ndi kuzizira. Nthawi zonse muzivala kapu yoteteza kuti muteteze Novo Rapid Flexpen pakuwala.

Alumali moyo wa mankhwala 2 zaka.

Sitikulimbikitsidwa kusunga zolembera zoyambira mufiriji. Ndizoyenera kugwiritsidwa ntchito mkati mwa mwezi umodzi mutatha kutsegula ndikusunga pamtunda wa kutentha kosaposa 30 digiri.

Migwirizano ya Tchuthi

Novo Rapid Flexpen imagawidwa ku pharmacies kokha mwa mankhwala.

Mtengo wa 100 IU uli pa avareji pandalama zonse zamankhwala 1700-2000r

Mankhwala NovoRapid (insulin) ndi mankhwala atsopano. Kubwezeretsanso kuchepa kwa insulin yaumunthu ndipo ili ndi maubwino angapo kuphatikiza mitundu ina ya mahomoni. Zimapezeka mwachangu ndipo nthawi yomweyo zimachepetsa shuga. Itha kugwiritsidwa ntchito mosasamala chakudya. Amawerengedwa kuti ndi ultrashort insulin.

Mapangidwe a odwala matenda ashuga

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

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

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

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

Pharmacology

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

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

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

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

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

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

Mankhwala "NovoRapid": malangizo ogwiritsira ntchito

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

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

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

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

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

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

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

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

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

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

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

Momwe mungawerengere kuchuluka kwa insulin?

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

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

Kusankhidwa kwa mlingo wa insulin yayitali kwakhala motere:

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

Zizindikiro zoyenera m'mawa ndi:

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

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

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

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

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

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

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

Malamulo oyenera kudziwa mtundu wa odwala matenda ashuga:

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

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

Mtengo wa mahormone

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

Ndemanga za Odwala

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

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

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

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