Novorapid Flexpen > Chithandizo ndi kupewa

NovoRapid Flexpen ndi analogue yaifupi yogwira insulin yopangidwa ndi biotechnology (amino acid proline pa malo 28 a B unyolo amaloledwa ndi aspartic acid). Mphamvu ya hypoglycemic ya insulin aspart imakhala mukupanga kukhathamiritsa kwa glucose pomanga minyewa pambuyo pomanga insulin kuti minofu ndi mafuta cell receptors, komanso kuletsa kwa shuga kutulutsa chiwindi.
Mphamvu ya mankhwalawa NovoRapid Flexpen imachitika kale kuposa kukhazikika kwa insulin yamunthu, pomwe shuga ya m'magazi imatsika mkati mwa maola 4 atatha kudya. Ndi sc makonzedwe, nthawi ya zochita za NovoRapid Flexpen ndi yofupikirapo kuposa ya sungunuka wa munthu insulin ndipo imachitika 10-20 min pambuyo makonzedwe. Kuchuluka kwake kumachitika pakati pa 1 ndi 3 mawola jakisoni. Kutalika kwa kuchitapo kanthu - maola 3-5.
Akuluakulu Zotsatira za mayesero azachipatala a odwala omwe ali ndi mtundu wa matenda a shuga I amveketsa kuti pakukhazikitsa mankhwala a NovoRapid Flexpen, kuchuluka kwa shuga pambuyo podya ndi kotsika poyerekeza ndi kuyambitsa insulin.
Anthu achikulire ndi osawadziwa. Kafukufuku wosasinthika, wamaso awiri wazaka 19 za II odwala matenda ashuga azaka 65-83 zaka (amatanthauza zaka 70) akuyerekeza pharmacodynamics ndi pharmacokinetics ya insulin aspart ndi sungunuka wa anthu. Kusiyana kwazomwe zimachitika muyezo wa pharmacodynamic magawo (kuchuluka kwa mayamwidwe a shuga - GIRmax ndi AUC - kuchuluka kwake kwa kulowetsedwa kwa mphindi 120 pambuyo pa kukonzekera kwa insulin - AUC GIR 0-120 min) pakati pa insulin aspart ndi insulin yaumunthu inali yofanana mwa anthu odwala komanso odwala matenda ashuga osakwana zaka 65
Ana ndi achinyamata. Mu ana omwe amathandizidwa ndi NovoRapid Flexpen, mphamvu ya kuwunika kwakanthawi kwamagazi a shuga ndi chimodzimodzi ndi insulin yaumunthu. Mu kafukufuku wazachipatala wa ana a zaka zapakati pa 2-6, mphamvu ya glycemic control idayerekezeredwa ndi kayendetsedwe ka madzi osungunuka musanadye chakudya komanso katswiri wa chakudya atapatsidwa chakudya, ndipo pharmacokinetics ndi pharmacodynamics adatsimikiza mwa ana a zaka 6 mpaka 12 ndi achinyamata 13-16 wazaka. Mbiri ya pharmacodynamic ya insulin aspart mwa ana ndi akulu inali yomweyo. Zoyesa zamankhwala za odwala omwe ali ndi mtundu woyamba wa matenda a shuga I amellletus adawonetsa kuti mukamagwiritsa ntchito insulin aspart, chiwopsezo chokhala ndi hypoglycemia usiku chimachepa poyerekeza ndi insulin yaumunthu, ponena za pafupipafupi milandu ya hypoglycemia masana, panalibe kusiyana kwakukulu.
Nthawi yapakati. M'maphunziro azachipatala omwe amachitika mwa azimayi oyembekezera 322 omwe ali ndi matenda amtundu wa I, chitetezo ndi kufunikira kwa insulin aspart ndi insulin yaumunthu kuyerekezedwa. Anthu 157 analandila insulini, anthu 165. - insulin yaumunthu. Pankhaniyi, palibe zovuta zoyipa za insulin pa mayi wapakati, mwana wosabadwa, kapena mwana watsopano yemwe adawululidwa poyerekeza ndi insulin ya munthu. Kuphatikiza apo, mu kafukufuku yemwe anachitika mwa amayi 27 oyembekezera omwe ali ndi matenda ashuga, anthu 14. analandila insulin, anthu 13. - insulin yaumunthu. Malinga ndi zotsatira za kafukufukuyu, chitetezo chofanana cha kukonzekera kwa insulin kumeneku chikuwonetsedwa.
Mukamawerengera mlingo (wa timadontho-timadontho), insulin yokwanira imaphatikizika kuti isungunuke insulin yaumunthu.
Mankhwala Kulowetsedwa kwa amino acid proline pamalo a B-28 a mamolekyulamu a insulin omwe ali ndi spartic acid mu mankhwala a NovoRapid Flexpen kumapangitsa kuchepa kwa mapangidwe a hexamers omwe amawonetsedwa ndikuyambitsa kwa insulin ya insulin yamunthu. Chifukwa chake, NovoRapid Flexpen imatengedwa mwachangu m'magazi kuchokera pamafuta ochulukirapo poyerekeza ndi insulin yamtundu wa munthu. Nthawi yoti ifike pazokwanira kuchuluka kwa insulini m'magazi ndi pafupifupi theka pomwe mukupaka insulin yaumunthu.
Kuchuluka kwa insulini m'magazi a odwala omwe ali ndi mtundu wa shuga I mellitus 492 ± 256 pmol / l kumatheka pambuyo pa 30 -40 pambuyo pa mankhwala a NovoRapid Flexpen pamlingo wa 0,15 U / kg thupi. Minyewa ya insulini ibwerera kumayambira maola 4-6 pambuyo pa kukhazikitsa. Kuchuluka kwa mayamwa kumacheperachepera odwala omwe ali ndi matenda amtundu II. Chifukwa chake, kuchuluka kwambiri kwa insulin mu odwala koteroko kumachepera - 352 ± 240 pmol / L ndipo kufikiridwa pambuyo pake - pafupifupi pambuyo pa mphindi 60 (50-90). Ndi kukhazikitsidwa kwa NovoRapid Flexpen, kusiyanasiyana kwakanthawi kokwanira kufikira wodwala yemweyo kumakhala kochepa kwambiri, ndipo kusiyanasiyana kwa kuchuluka kwa ndende kumakhala kwakukulu kuposa ndikuyambitsa insulin yaumunthu.
Ana ndi achinyamata.
Pharmacokinetics ndi pharmacodynamics a NovoRapid
Flexpen anaphunzitsidwa ana (2-6 wazaka 6-6 wazaka) komanso achinyamata (wazaka 13 mpaka 17) ndi matenda a shuga a mtundu wa I. Insulin aspart idalowetsedwa mwachangu m'magulu onse awiri, nthawi yofika Cmax m'magazi inali yofanana ndi akulu. Komabe, kukula kwa max kunali
osiyanasiyana mwa ana amisinkhu yosiyanasiyana, kuwonetsa kufunikira
aliyense kusankha Mlingo wa mankhwala NovoRapid Flexpen.
Anthu achikulire ndi osawadziwa.
Odwala omwe ali ndi matenda amtundu wa II omwe ali ndi zaka 65-83 zaka (zaka zapakati - 70 zaka)
kusiyanasiyana kwa mfundo zamankhwala
pakati pa insulin, aspart ndi insulin ya anthu anali ofanana mu anthu athanzi komanso odwala matenda ashuga osakwana zaka 65. Odwala achikulire omwe ali ndi mayamwidwe otsika, monga zimawonekera ndi nthawi yayitali kuti afikire insulin Cmax - 82 mphindi yokhala ndi mphindi 60-20 min, pomwe mitengo yake ya Cmax inali yofanana ndi odwala omwe ali ndi matenda amtundu wa II osakwana zaka 65, komanso kutsika pang'ono poyerekeza ndi odwala matenda amtundu wa I.
Kuwonongeka kwa chiwindi.
Mwa anthu 24 omwe ali ndi vuto losiyanasiyana la chiwindi (kuchokera kwazonse mpaka zowawa kwambiri), ma pharmacokinetics a insulin aspart atatsimikizika kamodzi kokha. Odwala omwe ali ndi kuchepa kwapakati komanso koopsa kwa hepatic, kuchepa kwa mayamwidwe kunachepa ndipo kunali kosinthika, monga zikuwonetsedwa ndi kuwonjezeka kwa nthawi kuti afike Cmax mpaka 85 min (mwa anthu omwe ali ndi chiwindi chokwanira, nthawi ino ndi mphindi 50). Makhalidwe a AUC, Cmax ndi CL / F mwa anthu ochepa othandizira chiwindi anali ofanana ndi omwe ali ndi chiwindi chokwanira.
Matenda aimpso. Mwa anthu 18 omwe ali ndi vuto losiyana ndi aimpso (kuyambira nthawi yayitali mpaka kulephera kwambiri kwaimpso), pharmacokinetics ya insulin aspart itatha kukhazikitsidwa komwe. M'magawo osiyanasiyana a creatinine chilolezo, panalibe kusiyana kwakukulu pamakhalidwe a AUC, Cmax ndi CL / F a insulin aspart. Kuchuluka kwa zidziwitso za odwala omwe ali ndi ntchito yochepa komanso yopweteka kwambiri. Odwala omwe ali ndi vuto la impso akuyenda hemodialysis sanawunikidwe.

Kugwiritsa ntchito mankhwala a Novorapid flekspen

Mlingo Mlingo wa mankhwalawa NovoRapid Flexpen ndi munthu payekha ndipo amatsimikiza ndi dokotala malinga ndi mawonekedwe ndi zosowa za wodwalayo. Nthawi zambiri, NovoRapid Flexpen imagwiritsidwa ntchito limodzi ndi nthawi yayitali kapena insulin yokonzekera, yomwe imaperekedwa kamodzi kamodzi patsiku.
Chofunikira cha insulin nthawi zambiri chimakhala 0.5-1.0 U / kg / tsiku. Ngati pafupipafupi kugwiritsa ntchito molingana ndi kudya kwambiri ndi 50-70%, zofunika za insulini zimakhutitsidwa ndi NovoRapid Flexpen, ndipo zina zonse ndi nthawi yayitali kapena ma insulin.
Njira yogwiritsira ntchito mankhwalawa NovoRapid Flexpen amadziwika ndi kuyambanso mwachangu komanso kufupikitsa nthawi pochitapo kanthu poyerekeza ndi insulin yaumunthu. Chifukwa cha kuyamba kwachangu, NovoRapid Flexpen nthawi zambiri imayenera kutumizidwa musanadye. Ngati ndi kotheka, mankhwalawa amatha kuperekedwa akangomaliza kudya.
NovoRapid imayendetsedwa pansi pa khungu la khoma lakunja kwam'mimba, ntchafu, mu minyewa yonyansa ya phewa kapena matako. Malowo a jakisoni amayenera kusinthidwa ngakhale mkati momwe momwemo. Ndi subcutaneous jakisoni wakunja kwam'mimba khoma, mphamvu ya mankhwalawa imayamba Mphindi 10-20. Kuchuluka kwake kuli pakati pa 1 mpaka 3 mawola jakisoni. Kutalika kwa kuchitapo kanthu ndi maola 3-5. Momwemo ndi ma insulin onse, makina amkati mwa khoma lamkati am'mimba amathandizira kuyamwa mwachangu kuposa momwe amapangidwira malo ena. Komabe, kuyambika kwakanthawi koyamba kwa NovoRapid Flexpen, kufananizidwa ndi insulin yaumunthu, imasungidwa mosasamala malo a jekeseni.
Ngati ndi kotheka, NovoRapid Flexpen ikhoza kutumikiridwa iv, majakisoni awa amatha kuchitidwa motsogozedwa ndi dokotala.
NovoRapid itha kugwiritsidwa ntchito popitiliza sc pothandizidwa ndi mapampu olowetsa oyenerera. Kupitiliza kwa sc kumachitika mu khoma lakunja kwam'mimba, tsamba la jakisoni liyenera kusinthidwa nthawi ndi nthawi. Mukamagwiritsira ntchito mapampu a kulowetsedwa, NovoRapid sayenera kusakanikirana ndi insulin ina iliyonse. Odwala omwe amagwiritsa ntchito mapampu olowetsedwa amayenera kuphunzitsidwa zambiri za kugwiritsa ntchito makina amenewa ndikugwiritsa ntchito makontena ndi machubu oyenera. Ma kulowetsedwa (machubu ndi ma cannulas) ayenera kusinthidwa malinga ndi zofunikira za malangizo omwe aphatikizidwa. Odwala omwe amagwiritsa ntchito NovoRapid pakukonzanso ayenera kukhala ndi insulini ngati atalephera.
Kuchepa kwa chiwindi ndi impso kungathandize kuchepetsa wodwala kufunika kwa insulin. M'malo mosungunuka kwa insulin ya anthu, ana ayenera kupatsidwa mankhwala a NovoRapid FlexPen ngati kuli kofunika kupeza mwachangu insulin, mwachitsanzo, asanadye.
NovoRapid Flexpen ndi cholembera chodzaza ndi sindanoFine® chokhazikitsidwa ndi singano za NovoFine®. Ma CD omwe amaphatikiza ndi singano za NovoFine® amalembedwa dzina la S. Flexpen limakupatsani mwayi kuti mulowe kuyambira 1 mpaka 60 magawo a mankhwalawo molondola 1 unit. Muyenera kutsatira malangizo a mankhwalawa pogwiritsa ntchito mankhwalawo. NovoRapid Flexpen idapangidwa kuti igwiritsidwe ntchito payekha, singagwiritsenso ntchito.
Malangizo Mankhwala NovoRapid Flexpen
NovoRapid lakonzedwa kuti jakisoni wa subcutaneous kapena jekeseni wosalekeza wogwiritsa ntchito mapampu kulowetsedwa. NovoRapid itha kuperekedwanso kudzera m'mitsempha moyang'aniridwa ndi dokotala.
Gwiritsani ntchito mapampu a kulowetsedwa
Pakumapaka kulowetsedwa, machubu amagwiritsidwa ntchito omwe mkati mwake amapangidwa ndi polyethylene kapena polyolefin. Insulini ina imayamba kumangika mkati mwa tangi ya kulowetsedwa.
Gwiritsani ntchitoiv kuyambitsa
Machitidwe a kulowetsedwa ndi NovoRapid 100 IU / ml pa insulini aspart ndende ya 0,05 mpaka 1.0 IU / ml mu kulowetsedwa njira yokhala ndi 0.9% sodium chloride, 5 kapena 10% dextrose ndi 40 mmol / l chloride. potaziyamu, ali mum'madzi a polypropylene kulowetsedwa, amakhala osungika kutentha kwa maola 24. Pa kulowetsedwa kwa insulin, ndikofunikira kuyang'anira kuchuluka kwa shuga m'magazi.
Malangizo Mankhwala NovoRapid
Thawitsani wodwala
Musanagwiritse ntchito NovoRapid Flexpen
yang'anani chizindikiro chizindikiro choyenera
insulin Nthawi zonse gwiritsani ntchito singano yatsopano iliyonse jekeseni
kupewa matenda
Osagwiritsa ntchito cholembera: ngati cholembera cha syringe cha FlexPen chatayika, ngati chawonongeka kapena chopunduka, monga momwe izi
kutulutsa insulin. Ngati cholembera cha syringe sichisungidwe bwino kapena chinali chisanu. Ngati yankho la insulin silikuwoneka mowonekera kapena
wopanda utoto.
Popewa mapangidwe omwe amabwera, muyenera nthawi zonse
sinthani malo obayira. Malo abwino kwambiri oyambitsa ndi
khoma lakunja kwamkati, matako, ntchafu yakunja
kapena phewa. Kuchita kwa insulin kumachitika mofulumira akaperekedwa
iye mpaka m'chiuno.
Momwe mungapangire kukonzekera kwa insulin iyi: insulin iyenera kuperekedwa pakhungu, kutsatira malangizo a dokotala kapena malangizo ogwiritsa ntchito cholembera.

Kupanga ndi mafomu omasulira

Mu 1 ml ya insulin yankho lili:

Zogwira pophika: 100 IU aspart (ofanana ndi 3.5 mg)
Zowonjezera: glycerol, phenol, metacresol, zinc chloride, sodium chloride, sodium hydroxide, hydrochloric acid, madzi d / ndi zina.

Mankhwala omwe amapangidwa ndi madzi a s / c ndi jekeseni wa iv ndi njira yosapangidwira kapena yopanda chikasu popanda kuyimitsidwa. Amayikamo bokosi lamagalasi la cholembera chomwe angathe kuyambiranso. Mu mankhwala 1 - 3 ml ya aspart. Phukusi la makatoni akuda - 5 n-zolembera, kalozera wamankhwala.

Kuphatikiza pa syringe pensulo, ma asparts amakhalanso amtundu wa makatiriji payokha. Ipezeka pansi pa dzina la Novorapid Penfill.

Kuchiritsa katundu

Mankhwala ndi analogue a insulin ya anthu mwachangu komanso yochepa. Poyerekeza ndi ma insulle ena osungunuka, spartt imatha kutsika shuga: mphamvu yake yokwanira imayamba pakatha maola 4 pambuyo pa jekeseni, ndipo zomwe zili ndi shuga zimakhala zotsika. Koma pambuyo pa utsogoleri pakhungu, nthawi yake imakhala yofupikitsa poyerekeza ndi insulin ya anthu.

Wodwalayo amamva mpumulo pambuyo pa Novorapid Flexpen pambuyo pa mphindi 10-15, mphamvu ya mankhwalawa imatha maola atatu mpaka asanu.

Kafukufuku wokhudzana ndi zamankhwala wokhudzana ndi mankhwalawa glycemia mu mtundu 1 odwala matenda ashuga adawonetsa kuti pambuyo povutirapo, chiopsezo cha hypoglycemia usiku ndizochepa kwambiri poyerekeza ndi mankhwala ofanana ndi omwe adachokera kwa anthu. Pafupipafupi milandu imafanana ndizinthu izi.

Hypoglycemic zotsatira za mankhwala zimatheka chifukwa cha insulin - chinthu chomwe chimafanana ndi insulin. Aspart imapangidwa ndi genetic engineering, yomwe imapereka mwayi woloza proline ndi aspartic acid pamavuto a Saccharomyces cerevisiae. Chifukwa cha izi, aspart imalowa mkati mwa ziwalo zamagetsi ndi kuthamanga kwambiri ndipo imakhala ndi kufunika.

Njira yogwiritsira ntchito

Kugwiritsa ntchito kwa Novorapid Flexpen kuyenera kuchitika molingana ndi dongosolo la mankhwala lomwe limapangidwa ndi endocrinologist pamaziko a shuga. Monga lamulo, mankhwalawa amaphatikizidwa ndi insulin yapakati kapena yayitali, yomwe imayendetsedwa kamodzi pa tsiku.

Nthawi yomweyo, amatsogozedwa ndi zisonyezo zakufunika kwa insulin tsiku ndi tsiku. Pafupifupi, ndi ½-1 ED pa 1 makilogalamu. Ngati mankhwalawa amaperekedwa musanadye, ndiye kuti 50-70% ya Novorapid Flexpen imagwiritsidwa ntchito, ndipo zotsalazo zimathandizidwa ndi insulin yayitali.

Mlingo uyenera kusinthidwa pakusintha zolimbitsa thupi kumbali iliyonse (kuchuluka kapena kuchepa), zakudya za tsiku ndi tsiku.

Mukamagwiritsa ntchito mankhwalawa, tiyenera kukumbukira kuti imathandizira kuchitapo kanthu mwachangu, chifukwa chake ndibwino kuti mupereke mankhwalawo kwa mphindi zochepa musanadye kapena musanadye chakudya.

Zolemba zogwiritsira ntchito

Singano ndi mankhwalawa ayenera kugwiritsidwa ntchito payokha. Sayenera kuloledwa kugwiritsidwa ntchito ndi anthu osavomerezeka.
Makatoni ogwiritsira ntchito sololedwa.
Ma cholembera a syringe okhala ndi aspart amaonedwa kuti ndi osayenera kugwiritsidwa ntchito ngati atayatsidwa ndi kutentha kwa subzero, osungidwa mufiriji kapena kutentha pamwamba pa 30 ° C.
Ana. Chifukwa chakufulumira kwa Novorapid poyerekeza ndi analogue yaumunthu, ndibwino kuti muziigwiritsa ntchito ngati mukufunikira kuthamanga kapena ngati kuli kovuta kuti mwana apirire pakati pa jakisoni ndi chakudya.
Okalamba komanso odwala matenda ashuga omwe ali ndi matenda a chiwindi ndi / kapena impso: Mankhwala a Novorapid akuyenera kuchitika mosamala kwambiri pakayang'aniridwe ka glycemic komanso kusintha komwe kumagwirizana.

Momwe mungalowe mu Novorapid Flexpen

Mankhwalawa amatha kuperekedwa palokha ndi odwala matenda ashuga. Masamba obayira omwe ali pansi pa khungu: m'mimba (kutsogolo kwa peritoneum), ntchafu, minofu yolimba, kumtunda kwa matako. Popewa lipodystrophy, dera la jakisoni liyenera kusinthidwa pafupipafupi.

Mankhwalawa amatha kugwiritsidwa ntchito PPI pogwiritsa ntchito mapampu a insulin. Poterepa, njirayi imachitika m'dera lakunja la peritoneum. Mankhwala sangathe kusakanikirana ndi insulin ina.

Ngati ndi kotheka, Novorapid itha kuperekedwa kudzera m'mitsempha, koma njirayi imatha kuchitika ndi madokotala omwe akudziwa bwino zamankhwala othandizira insulin.

Pa nthawi yoyembekezera komanso yoyamwitsa

Zomwe zinachitika kuchipatala ndi Novorapid Flexpen ndizochepa. Kuyesera komwe kunachitika pa nyama yamulembera sikunawululire zakusiyana pakati pa zomwe mankhwalawa amapezeka ndi insulin ya munthu pa nthawi yapakati.

Panthawi yokonzekera komanso pakukonzekera, odwala matendawa amayenera kuwunikidwa pafupipafupi ndi madokotala ndikuwunika pafupipafupi kuchuluka kwa glycemia.

Amadziwika kuti thupi limasowa insulini yochepa mu trimester yoyamba, koma kenako kufunika kwake kumawonjezeka. Nthawi yobala mwana akangobadwa, zofuna zake zimatsika kwambiri, koma kenako zimachulukanso mpaka kufika pamlingo womwe mayi anali nawo asanatenge pathupi.

Mankhwalawa amatha kugwiritsidwa ntchito mwa amayi apakati, chifukwa kuchuluka kwa insulin mthupi la mkazi nthawi ya bere kumatha kusokoneza kukula kwa mwana wosabadwayo / mwana. Kuphatikiza apo, aspart sichidutsa mu placenta.

Amayi anamwino amaloledwa kubayanso jakisoni wa mkaka pa nthawi yoyambira. Ngati ndi kotheka, Mlingo wa mankhwalawa uyenera kusintha.

Contraindication ndi Kusamala

Novorapid Flexpen, malinga ndi malangizo ogwiritsira ntchito, amaletsedwa kugwiritsa ntchito ngati wodwalayo ali ndi chidwi chachikulu kapena kusalolera kwathunthu kuzinthu zomwe zimapanga mankhwala.

Zokhudza kugwiritsa ntchito insulin

Mtengo Wapakati: (5 ma PC.) - 1852 ma ruble.

Ngati wodwala matenda ashuga amayenda kupita kumalo omwe ali ndi nthawi yosiyana, akuyenera kufunsiratu momwe angamwe mankhwalawo: nthawi yanji, kuchuluka kwake, kuti adziwe zina zokhudzana ndi kayendetsedwe ka ntchito.

Ngati Novorapid Flexpen sanagwiridwe ntchito mokwanira kapena pazifukwa zina wodwalayo asiya kuzipereka, izi zitha kuyambitsa matenda a hyperglycemia ndi matenda ashuga a ketoacidosis. Matenda a diabetes 1 omwe amakonda kwambiri izi. Zizindikiro zimayamba pang'onopang'ono, kukulira. Mutha kuweruza kusowa kwa boma ndi nseru, kusanza, kugona, khungu lowuma komanso zimagwira pakamwa. Hyperglycemia amathanso kuweruzidwa ndi fungo la acetone pakupuma.

Ngati hypoglycemia ikukayikira, chithandizo choyenera chikuyenera kugwiritsidwa ntchito mwachangu, apo ayi kuwonjezereka kwa vutoli kungayambitse kuphedwa kwa odwala matenda ashuga. Tiyenera kudziwa kuti chithandizo cha insulin chambiri chimatha kupotoza zomwe zimachitika mu hypoglycemia.

Mwa anthu odwala matenda ashuga, mwa kuwongolera kagayidwe kachakudya, zovuta zamatenda zimachepetsedwa ndikupita patsogolo pang'onopang'ono. Chifukwa chake, ndikofunikira kuchita njira zoyenera zothetsera kagayidwe kachakudya, kuphatikizapo kuwunika kuchuluka kwa shuga m'magazi.

Tiyenera kudziwa kuti njira za hypoglycemic zimapangidwa mwachangu ngati wodwala matenda ashuga ali ndi matenda ofanana kapena akuchiritsidwa ndi mankhwala omwe amalepheretsa chakudya. Ndi concomitant pathologies, makamaka ngati ali ochokera ku matenda opatsirana, kufunika kwa mankhwalawa kumawonjezeka. Ngati wodwala matenda ashuga akukumana ndi chiwindi komanso / kapena impso, ndiye kuti kufunikira kwa insulin kumachepa.

Pambuyo pa kusintha kwa odwala matenda ashuga mitundu ina ya mankhwalawo, zizindikiro zoyambirira za hypoglycemia zitha kupotozedwa kapena kuchepera mphamvu, poyerekeza ndi insulin yomwe kale idagwiritsidwa ntchito.

Kusintha kwa mtundu wina wa insulin kuyenera kuyang'aniridwa ndi madokotala. Kusintha kwa mankhwalawa kungafunike osati posintha mtundu wa mankhwala, komanso wopanga, njira yopangira.

Mlingo uyenera kusinthidwa ngati wodwala matenda ashuga asintha zakudya zina, anasintha kudya, ayamba kapena atasiya kuchita masewera olimbitsa thupi. Wodwala ayenera kukumbukira kuti kudumpha chakudya kapena kuchita masewera olimbitsa thupi mosakonzekera kungayambitse hypoglycemia.

Kuyang'aniridwa moyenera kwa glycemic kumachepetsa chiopsezo cha kufalikira kwa matenda ashuga. Kuchita insulin kwambiri komanso kuwongolera msanga m'mimba kumatha kuyipa kwakanthawi mu retinopathy.

Kodi Novorapid Flexpen insulin imakhudza momwe zimachitikira

Mikhalidwe yokhala ndi hypo- ndi hyperglycemia imakhudza kuthamanga kwa kayendedwe komanso chidwi chokhazikika, zimatha kuyambitsa zochitika zangozi mukamayendetsa magalimoto kapena maginito ovuta. Odwala ayenera kuchitapo kanthu pasadakhale kuti ateteze kukula. Izi ndizowona makamaka kwa omwe ali ndi matenda ashuga omwe zizindikiro za matenda amaphatikizika, amawonekera pang'onopang'ono. Muzochitika izi, odwala matenda ashuga amalimbikitsidwa kuti aganizire zosiya mtundu uwu.

Kuchita mankhwala osokoneza bongo

Tiyenera kudziwa kuti mankhwalawa amatha kusokoneza magazi a magazi. Chifukwa chake, ngati munthu wodwala matenda ashuga akukakamizidwa kumwa mankhwala ena, ayenera kudziwitsa adotolo za iwo pasadakhale kuti adziwe momwe angagwiritsire bwino jakisoni.

Mankhwala osokoneza bongo omwe amachepetsa kufunikira kwa insulin: Mankhwala ochepetsa shuga a pakamwa, maMAO, beta-blockers, mankhwala osokoneza bongo a magulu a salicylates ndi sulfanilamide, anabolics.
Mankhwala omwe amachititsa kuti pakhale kufunika kwa insulin: Kulera pakamwa, GCS, thiazide diuretics, mahomoni a chithokomiro, mankhwala osokoneza bongo a adrenomimetics, kukula kwa hormone, Danazole, mankhwala opangira lithiamu, morphine, nikotini.
Ngati pakufunika kuphatikiza insulin ndi beta-blockers, ziyenera kukumbukiridwa kuti mankhwala aposachedwa amatha kubisa mawonetsedwe a hypoglycemia.
Zakumwa zokhala ndi zakumwa zoledzeretsa (zakumwa kapena mankhwala osokoneza bongo), Oktreotid, Lantreoyt akaphatikizidwa ndi insulini zitha kusintha mosayembekezereka: kulimbikitsa kapena kuchepetsa.
Ngati munthu wodwala matenda ashuga, kuphatikiza insulin, atha kumwa mankhwala ena, ayenera kukambirana za momwe angamwere mankhwala ndi adokotala.

Zotsatira zoyipa

Zotheka kukhala zovuta panthawi ya Novorapid Flexpen ndi chifukwa cha zomwe zimapangitsa kuti likhale ndi RDNA insulin. Zotsatira zoyipa zomwe zimachitika kwambiri odwala matenda ashuga, monga mitundu ina ya insulin, kuchepa kwamphamvu kwa glucose ndi hypoglycemia yotsatira. Pafupipafupi momwe amapezekera zimasiyanasiyana m'magulu osiyanasiyana a odwala matenda ashuga, omwe amatsimikiziridwa ndi kuchuluka ndi kuwongolera.

Kumayambiriro kwa maphunzirowa, kusokonezeka kwa kukonzanso kumachitika kawirikawiri, mu jakisoni wa meta - kutupa, kutupa, kupweteka mtima, kutupa, kuyabwa. Zomwe zimachitika mdera lanu nthawi zambiri zimakhala zachilendo, maphunzirowo akamapitiliza, amapita okha. Kuwongolera mwachangu kwa glycemia, makamaka kwambiri, kungayambitse kuchepa kwa matenda ashuga retinopathy, komanso kuyang'anira nthawi moyenera kumalepheretsa kupitilira kwake.

Zotsatira zina zosayenera zomwe zimapezeka mu odwala matenda ashuga amadziwonetsa amtundu wazovuta zosiyanasiyana za kugwira ntchito kwamkati ndi ziwalo:

Chitetezo cha mthupi: totupa, urticaria, nthawi zina - anaphylactic zimachitika, mu osakwatiwa - erythema
NS: kusokonezeka kwa zotumphukira za NS (kuchepa kwa chidwi cha mathero a mitsempha, kufooka kwa minofu, kawirikawiri, kupweteka)
Masompheny: kusokonekera kwamatenda, retinopathy
Khungu ndi minyewa yolumikizira: lipodystrophy, zotupa zosiyanasiyana, zotupa pa malo a jekeseni

Hypoglycemia

Vutoli limayamba ndi mulingo wokwanira, kudumpha kapena kusiya mankhwala. Ngati hypoglycemia imayamba kukula kwambiri, ndiye kuti kupita patsogolo kwam'tsogolo kumabweretsa chiopsezo pamoyo wamunthu. Ali ndi kuphwanya CVS, pali zovuta zakanthawi kapena zosagwirizana ndi kagwiridwe ka ntchito ka GM, zomwe zimatha kupha.

Zizindikiro zimayamba kukhala mosayembekezereka, zimawonetsedwa ngati thukuta lozizira, kutsokomola kwa khungu, kutopa msanga, kukwiya msanga komanso manjenjemera, kunjenjemera, kugona, kuona, kusawona bwino, kumva kulira kwamtendere, nseru, komanso kugunda kwamtima mwachangu. Kukula kwa mkhalidwe kumayendetsedwa ndi regimen ya mankhwala, kupezeka kwa mipata pochiritsa. Hypomatology ndi pafupipafupi za hypoglycemia, kwakukulu, ndizofanana ndi zomwe zimatuluka chifukwa cha jakisoni wa insulin ya anthu.

Ana, okalamba, odwala matenda ashuga okhala ndi vuto la impso ndi / kapena chiwindi

Zotsatira zoyipa za odwala a maguluwa sizimasiyana ndi zomwe zimachitika mwa odwala ena.

Bongo

Mwakutero, lingaliro la bongo pambuyo jakisoni wa insulin silinapangidwe. Kukhazikitsidwa kwa mlingo waukulu wa mankhwala aliwonse omwe ali ndi zomwe zingayambitse kukula kwa hypoglycemia. Kuchuluka kwa mphamvu pamilandu iyi sikungotengera kuchuluka kwa mankhwalawo, komanso momwe amagwiritsidwira ntchito kangapo, makamaka matenda a matenda ashuga, kupezeka kapena kusapezeka kwa zinthu zomwe zikukulitsa.

Zizindikiro za hypoglycemia zimayamba kukhala m'magawo, zikuwonjezereka chifukwa chosalephera kugwiritsira ntchito shuga.

Ngati matendawa adziwoneka bwino, kenako kuti athetse, wodwalayo akulimbikitsidwa kudya zakudya zam'madzi kapena shuga, kumwa tiyi wokoma kapena msuzi. Odwala ayenera kumakhala ndi chilichonse chokoma nawo kuti nthawi zonse pamakhala mwayi woti uzithandiza wokha munthawi yake.

Wovulala kwambiri, wodwala amasiya kuzindikira, ndipo akatswiri kapena anthu omwe akudziwa zofananazi amatha kumuthandiza. Kuti odwala matenda ashuga abwererenso, amamuboola pansi pakhungu kapena kubayikirana ndi glucagon mu minofu. Mowonjezereka, ngati machitidwe am'mbuyomu sanapereke zotsatira zomwe akufunazo, ndipo wodwalayo akupitilizika kukomoka, amatsanulidwa mu / yankho la dextrose lalitali. Wodwala matenda ashuga akadzazindikira, kuti apewe kugwa kwambiri kwa glucose m'magazi, amapatsidwa mphamvu yodya maswiti kapena zakudya zopatsa mphamvu kwambiri.

Ndi okhawo omwe amapita ku endocrinologist omwe amatha kusankha ma analogu kapena m'malo mwa mankhwalawa, omwe amatha kudziwa kuchuluka kwa insulini ndikusankha ndondomeko yoyenera ya jakisoni. Mankhwala omwe angathe kuyikidwa: Actrapid (MS, NM, NM-Penfill), Apidra, Biosulin R, Insuman Rapid GT, Rinsulin R, Rosinsulin R, Humalog, Humulin Regular.

Chifungo cha Novorapid

Novo Nordisk PF do Brasil (Brazil)

Mtengo wapakati: (5 ma PC.) - 1799 rub.

Kukonzekera kwapafupipafupi kwa insulin kukonzekereratu kwa mtundu wa matenda ashuga 1, ndipo ngati kuli kotheka, kugwiritsa ntchito mtundu wa 2 wodwala, ngati kugwiritsa ntchito kwina kwa mankhwalawo sikunathandize kapena wodwalayo angatsutse pang'ono kapena ayi.

Penfill amapangidwa mu mawonekedwe a yankho la s / c ndi jekeseni wa iv. Amadzazana m'makalata agalasi. Mu gawo limodzi - 100 ZINSINSI za aspart. Mankhwalawa amagwiritsidwa ntchito mu machitidwe a Novo Nordisk.

Mtundu wa jakisoni ndi kuchuluka kwa njira zomwe Penfill amatsimikiza ndi katswiri.

Ubwino:

Kuchita mwachangu
Chimodzi mwazinthu zabwino kwambiri zakutsuka.

Chuma:

Siwothandiza aliyense
Zimatenga nthawi yayitali mutatha kusintha insulin ina.

Kutulutsa mafomu ndi kapangidwe kake

Mankhwalawa amapangidwa mwa njira yothetsera madzi amadzimadzi omwe amapezeka ndi 100 IU / ml (35 μg pa 1 IU). Monga zigawo zothandizira zimawonjezera:

phosphoric acid sodium salt,
hydrochloric acid ndi nthaka yake ndi mchere wa sodium,
osakaniza glycerol, phenol, metacresol,
sodium hydroxide.

Amapezeka m'mapensulo atatu a syringe, zidutswa 5 mu bokosi lililonse.

Zotsatira za pharmacological

Mankhwalawa amachepetsa glycemia, chifukwa Imalumikizana mosamala ndi ma cell enaake amtundu wa insulin omwe ali ndi ziwalo za cell. Zotsatira zake, insulin-receptor tata imapangidwa, yomwe imayambitsa magwiritsidwe ntchito a glucose pama plasma:

kuchuluka kwa maselo,
kusokonezeka kwapakati pa shuga chifukwa cha kukonzekera kwa mapangidwe a pyruvate kinase ndi hexokinase michere,
kaphatikizidwe wamafuta amafuta achilengedwe a shuga,
kuchuluka kwa malo ogulitsa glycogen ogwiritsa ntchito glycogen synthase enzyme,
kutsegula kwa phosphorylation njira,
kuponderezana kwa gluconeogeneis.

Mankhwalawa amachepetsa glycemia, chifukwa Imalumikizana mosamala ndi ma cell enaake amtundu wa insulin omwe ali ndi ziwalo za cell.

Pharmacokinetics

Pambuyo jakisoni pansi pakhungu, insulin aspart imalowetsedwa m'magazi, kuyambira pafupifupi mphindi 15, kuchuluka kwa ntchito kumachitika pamphindi 60-180. Kutalika kwakukulu kwa zotsatira za hypoglycemic ndi maola 5.

Kwa anthu azaka zopitilira 65 kapena kuchepa kwa chiwindi, kuchepa kwa mayamwidwe ndi machitidwe, omwe akuwonetsedwa mu kuchepa kwa nthawi yakuyamba kwambiri.

Mwachidule kapena kutalika

The biotechnologically synthesized analogue of human human Horne amasiyana mu kapangidwe ka B28 maselo locus: mmalo mwa proline, Aspartic acid imapangidwa kuti apangidwe. Izi zimathandizira kuyamwa kwa yankho kuchokera ku mafuta amkati poyerekeza ndi insulin ya anthu, chifukwa Sipangokhala madzi ofanana ndi iyo pang'onopang'ono kuwonongeka kwa mayanjidwe 6 a mamolekyulu. Kuphatikiza apo, zinthu zotsatirazi zamankhwala zimasiyanitsidwa ndi kusintha kwa mahomoni a kapamba amunthu:

kumayambiriro kwa kuchitapo kanthu
zotsatira zoyipa kwambiri pakatha maola 4 mutatha kudya,
yochepa ya hypoglycemic zotsatira.

Popeza awa, mankhwalawa ndi a gulu la ma insulin omwe ali ndi vuto la ultrashort.

Mankhwalawa amagwiritsidwa ntchito kuti achepetse ndikuwongolera mbiri ya matenda a shuga a mtundu wa 1.

Zizindikiro zogwiritsidwa ntchito

Mankhwalawa amagwiritsidwa ntchito kuti achepetse ndikuwongolera mbiri ya matenda a shuga a mtundu wa 1. Cholinga chomwechi chimatsatiridwa ndikusankhidwa kwa yankho la matenda a mtundu 2. Koma nthawi zambiri samalimbikitsidwa kuti ayambitse mankhwala. Zomwe zimayambitsa insulin mu regimen yochizira matenda amtundu wa 2 ndi awa:

kusakwanira kwenikweni kapena kusowa kwa mankhwala a hypoglycemic pakamwa,
zinthu zomwe zimayambitsa kuwonongeka kwakanthawi kapena kosatha munthawi yodwala (matenda, poyizoni, poizoni).

Ndi chisamaliro

Chiwopsezo chachikulu cha kutsika kwa shuga m'magazi panthawi ya mankhwala amapezeka mwa odwala:

zotchinga zotchingira
akudwala matenda obweretsa kutsika kwa malabsorption,
Ndi chiwindi ndi impso ntchito.

Kuyang'anira glycemia mosamala ndi kutumikiridwa Mlingo ndikofunikira kwa odwala:

zaka zopitilira 65
osakwana zaka 18
ndi matenda amisala kapena kuchepa kwamaganizidwe.

Kuwunika mosamala glycemia ndi kutumikiridwa Mlingo ndikofunikira kwa odwala osakwana zaka 18.
Kuyang'anira glycemia mosamala ndi kuperekera Mlingo ndikofunikira kwa odwala azaka zopitilira 65.
Kuyang'anira glycemia mosamala ndi kutumikiridwa Mlingo ndikofunika kwa odwala omwe ali ndi vuto la chiwindi.
Kusamala kwambiri kwa glycemia ndi kutumikiridwa Mlingo ndikofunika kwa odwala omwe ali ndi vuto laimpso.

Momwe mungagwiritsire ntchito NovoRapid Flexpen?

Makatoni othandizira ndi mulingo wotsalira uli kumapeto kwa chipangizocho, ndipo chopereka ndikuyambitsa mbali inayo. Zina mwazida zimawonongeka mosavuta, motero ndikofunikira kuyang'ana kukhulupirika kwa magawo onse musanagwiritse ntchito. Masingano okhala ndi kutalika kwa 8 mm okhala ndi mayina amalonda NovoFayn ndi NovoTvist ndi oyenera chida ichi. Mutha kupukuta pamtunda ndi thonje swab yomwe inanyowa mu ethanol, koma kumizidwa mu zakumwa sikuloledwa.

Malangizowa akuphatikizapo njira zotsatirazi:

pansi pa khungu (jakisoni komanso kudzera pampu yopitilira infusions),
kulowetsedwa mu mitsempha.

Pomaliza, mankhwalawa amayenera kuchepetsedwa ku 1 U / ml kapena kuchepera.

Momwe mungapangire jakisoni?

Musati mupeze jakisoni wopopera. Pa makina osunthira, monga:

khomo lam'mimba lakunja
kunja kwa phewa
patsogolo pa ntchafu
kumtunda kwakunja kwa dera la gluteal.

Njira ndi malamulo opangira jakisoni ndi ntchito iliyonse:

Werengani dzina la mankhwalawo papepala la pulasitiki. Chotsani chivundikiro kuchokera pabokosi.
Skani pa singano yatsopano, musanachotse filimuyo. Chotsani zipewa zakunja ndi zamkati kuchokera singano.
Imbirani mayunitsi 2 pa dispenser. Kugwira syringe ndi singano mmwamba, dinani mopepuka pa cartridge. Kanikizani batani lotsekera - pa dispenser, cholemba chikuyenera kupita ku ziro. Izi zikuthandizira kuti mpweya usalowe mu minofu. Ngati ndi kotheka, bwerezani mayesowo mpaka 6, kusowa kwa zotsatira kukuwonetsa kuyipa kwa chipangizocho.
Popewa kukanikiza batani lotsekera, sankhani mlingo. Ngati zotsalazo ndizochepa, ndiye kuti kuchuluka kofunikira sikungasonyezedwe.
Sankhani jakisoni wosiyana ndi woyamba. Tola khola limodzi ndi mafuta othinana, kupewa kupewetsa minofu yam'munsi.
Ikani singano mu crease. Dinani batani lotsekera pansi ndikulemba "0" pa dispenser. Siyani singano pansi pa khungu. Mutawerenga masekondi 6, pewani singano.
Popanda kuchotsa singano ku syringe, valani chotsekera chakunja chotsalira (osati chamkati!). Ndiye kuchotsa ndi kutaya.
Tsekani chophimba cha cartridge kuchokera pazida.

Mwa makina osunthika, madera monga chapamwamba kunja kwa dera la gluteal amawonedwa kuti ndi abwino kwambiri.

Chithandizo cha matenda ashuga

Asanayambe chithandizo ndi insulin yochepa, wodwalayo amalimbikitsidwa kuti apite kusukulu ya matenda ashuga kuti aphunzire momwe angawerenge Mlingo wofunikira komanso kudziwa zizindikiro za hypo- ndi hyperglycemia munthawi yake. Mahomoni ocheperako pang'ono amaperekedwa nthawi yomweyo asanadye kapena pambuyo pake.

Mlingo wa insulin pakudya kwam'mawa, chakudya chamasana ndi chakudya chamadzulo chitha kuvomerezedwa ndi dokotala mu manambala okhazikika kapena kuwerengera odwala omwe amaganizira glycemia asanadye. Mosasamala mtundu womwe angasankhe, wodwalayo ayenera kuphunzira kuyang'anira pawokha magazi.

Mankhwala osokoneza bongo omwe amakhala osakanikirana kwambiri amaphatikizidwa ndi kugwiritsa ntchito mankhwala kuti azitha kuyendetsa magazi, omwe amachokera ku 30 mpaka 50% ya kufunika kwathunthu kwa insulin. Mlingo wapakati watsiku lililonse wamankhwala apafupi ndi 0,5-1.0 U / kg kwa anthu amisinkhu yonse.

Maupangiri oyenera kudziwa kuchuluka kwa tsiku ndi tsiku pa kilogalamu imodzi ya kulemera:

lembani matenda 1 / dokotala woyamba kupezeka / wopanda zovuta ndi kuwonongeka - mayunitsi 0,5,
Kutalika kwa matenda kudutsa chaka 1 - 0,6,
adavumbulutsa zovuta za matendawa - 0,7 PESCES,
kuwonongeka malinga ndi glycemia ndi glycated hemoglobin - 0,8 PIECES,
ketoacidosis - 0,9 PESCES,
gestation - 1.0 PISCES.

Kuchokera ku chitetezo chamthupi

Nthawi zina, anaphylaxis wapanga:

hypotension, mantha
tachycardia
kupuma, kufupika,
kusanza, kusanza,
Edema wa Quincke.

Vomiting ndi imodzi mwazotsatira zamankhwala.

Pa gawo la kagayidwe ndi zakudya

Kuchepetsa kwa shuga m'magazi a plasma, omwe nthawi zambiri amayamba mwadzidzidzi ndikuwoneka ndi zizindikiro zotsatirazi:

khungu lotuwa, kuzizira kukhudza, chinyezi, kunenepa,
tachycardia, ochepa hypotension,
nseru, njala,
kuchepa ndi kusokoneza kwamaso,
kusintha kwa neuropsychiatric kuchokera ku kufooka kwapafupipafupi ndi psychomotor mukubwadamuka (mantha, kunjenjemera m'thupi) kuti mutsirize kukhumudwa komanso kugwidwa.

Pakati mantha dongosolo

Zizindikiro zoyipa zimayambika motsutsana ndi maziko a hypoglycemia ndipo zimawonetsedwa ndi zizindikiro zotsatirazi:

mutu
chizungulire
kugona
kusakhazikika pakuyimirira ndi kukhala,
kusokoneza mlengalenga ndi nthawi,
kuchepa kapena kupsinjika kwa chikumbumtima.

Ndikukwaniritsidwa mwachangu kwa mbiri yabwino ya glycemic, kupweteka kwaposachedwa kwapadera kwam'mimba kunawonedwa.

Kuchokera kumbali yamanjenje yapakati, mutu umayamba.

Malangizo apadera ogwiritsira ntchito mankhwala a Novorapid flekspen

Mlingo wocheperako kapena kusiya kulandira chithandizo (makamaka mtundu wa matenda a shuga I) kungayambitse matenda a hyperglycemia ndi matenda ashuga a ketoacidosis, omwe mwina amapha. Odwala omwe atukula kwambiri kuchuluka kwa shuga m'magazi, mwachitsanzo chifukwa chodwala kwambiri, atha kuzindikira kusintha kwawo - zizindikilo za hypoglycemia, zomwe odwala ayenera kuchenjezedwa pasadakhale.
Zotsatira za pharmacodynamics zama insulin analogi othamanga ndizotheka kwambiri kukula kwa hypoglycemia poyerekeza ndi insulle yamunthu.
NovoRapid Flexpen iyenera kutumikiridwa musanadye. Kuyambika kwake mwachangu kumayenera kuganiziridwanso pochiza odwala omwe ali ndi matenda opatsirana kapena kumwa mankhwala omwe amachepetsa kuyamwa kwa chakudya m'mimba.
Matenda obvuta, makamaka matenda ndi matenda otupa, nthawi zambiri amawonjezera kufunikira kwa insulin.
Kusamutsa odwala kukhala mtundu watsopano kapena mtundu wa insulin kuyenera kuchitika moyang'aniridwa ndi achipatala. Mukasintha ndende, mtundu, mtundu, magwiritsidwe antchito a insulin (nyama, anthu, ma insulin analogue) ndi / kapena njira yake yopangira, zingakhale zofunikira kusintha mlingo. Odwala omwe akutenga NovoRapid Flexpen angafunikire kuwonjezera kuchuluka kwa jakisoni kapena kusintha mlingo poyerekeza ndi insulin yokhazikika. Kufunika kosankha kwa mankhwalawa kumatha kuchitika pakukhazikitsa mankhwala atsopano, komanso pakubwera milungu ingapo kapena miyezi ingapo yogwiritsidwa ntchito.
Kudumpha zakudya kapena kuchita masewera olimbitsa thupi mosayembekezereka kungayambitse hypoglycemia. Kuchita masewera olimbitsa thupi mutangotha kudya kumawonjezera chiopsezo cha hypoglycemia.
NovoRapid Flexpen imakhala ndi metacresol, omwe nthawi zina amatha kuyambitsa mavuto.
Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere
Novorapid (insulin aspart) imatha kugwiritsidwa ntchito pa nthawi yapakati. Malinga ndi mayeso a 2 omwe adayang'aniridwa mwachisawawa (amayi 157 ndi amayi 14 omwe adalandira insulin aspart, motero), palibe zovuta zoyipa za insulini pa mayi wapakati kapena mwana wosabadwa / wakhanda poyerekeza ndi insulin ya anthu. Kuwunikira mosamala ndikuwonetsetsa kuchuluka kwa shuga m'magazi kuyenera kuchitika mwa amayi apakati omwe ali ndi matenda ashuga (mtundu I kapena mtundu II matenda ashuga, matenda ashuga) nthawi yonse yomwe ali ndi pakati, komanso azimayi omwe akukonzekera kutenga pakati. Kufunika kwa insulin nthawi zambiri kumachepa mu trimester yoyamba ya kutenga pakati ndikuwonjezeka mu trimesters yachiwiri ndi yachitatu. Pambuyo pa kubala, kufunikira kwa insulin kumabwereranso msanga momwe zinaliri asanakhale ndi pakati. Palibe choletsa kuchiza matenda a shuga ndi Novorapid panthawi yoyamwitsa.
Kuchiza mayi woyamwitsa sikuika pachiwopsezo kwa mwana. Komabe, zingakhale zofunikira kusintha mlingo wa Novorapid.
Kukopa pa luso loyendetsa magalimoto ndi zida. Kuyankha kwa wodwalayo komanso kuthekera kwake kochita chidwi kukhoza kukhala ndi vuto la hypoglycemia. Izi zitha kukhala zowopsa nthawi zomwe maluso akakhala
tanthauzo lapadera (mwachitsanzo mukamayendetsa galimoto kapena makina ogwiritsa ntchito).
Odwala ayenera kulangizidwa kuti azichita zinthu zoteteza hypoglycemia musanayendetse. Izi ndizofunikira kwambiri kwa odwala omwe afooka kapena kulibe zizindikiro - zotsogola za hypoglycemia kapena zochitika za hypoglycemia zimachitika pafupipafupi. Zikatero, kuyendetsa bwino kuyenera kuyesedwa.

Zochita ndi mankhwala a Novorapid flekspen

Mankhwala angapo amakhudza kagayidwe kazakudwala.
Mankhwala omwe amatha kuchepetsa kufunika kwa insulin: othandizira a hypoglycemic othandizira, octreotide, Mao inhibitors, osasankha β-adrenergic receptor blockers, ACE inhibitors, salicylates, mowa, anabolic steroids, sulfonamides.
Mankhwala omwe angakulitse kuchuluka kwa insulin: kulera kwamlomo, thiazides, corticosteroids, mahomoni a chithokomiro, sympathomimetics, danazol. Ma blockers a ren-adrenergic amatha kubisa zizindikiro za hypoglycemia.
Mowa umatha kukulitsa mphamvu ya hypoglycemic ya insulin.
Kusagwirizana. Kuphatikiza kwa mankhwala ena ku insulin kungayambitse kuyambitsa kwake, mwachitsanzo, mankhwala okhala ndi thiols kapena sulfite.

Kusunga mankhwala a Novorapid flekspen

Moyo wa alumali ndi zaka 2,5. Cholembera chogwiritsidwa ntchito ndi NovoRapid Flexpen sayenera kusungidwa mufiriji. Cholembera cha syringe, chomwe chimagwiritsidwa ntchito kapena kunyamulidwa napo ngati chosungirako, chiyenera kusungidwa osaposera milungu 4 (kutentha osapitirira 30 ° C). Cholembera chosagwiritsidwa ntchito Ndi mankhwala a NovoRapid Flexpen ayenera kusungidwa mufiriji kutentha kwa 2-8 ° C (kutali ndi mufiriji). Osamawuma. Kuti muteteze ku zotsatira za kuwala, sungani cholembera ndi chovalacho.

Mndandanda wamankhwala komwe mungagule Novorapid flekspen:

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere

M'maphunziro omwe amachitika ndi kutenga nawo gawo kwa amayi apakati komanso oyamwitsa, palibe vuto lililonse kwa mwana wosabadwa ndi mwana yemwe adapezeka. Mlingo wothandizila watsimikiza ndi dokotala. Njira zotsatirazi zidazindikirika:

Masabata 0 mpaka 13 - kufunika kwa mahomoni kumachepa,
Sabata 14 mpaka 40 - kuchuluka kwa kufunikira.

Kuchita ndi mankhwala ena

Kuonjezera insulin pamlomo mankhwala a hypoglycemic angayambitse kuchepa kwambiri kwa glycemia. Mankhwala ena a antimicrobial and antiparasitic ali ndi zofanana: tetracyclines, sulfnilamides, ketoconazole, mebendazole.

M'maphunziro omwe amachitika ndi amayi apakati, palibe zoyipa pamwana ndi mwana zomwe zimapezeka.

Pochiza matenda a mtima, zimadziwika kuti beta-blockers amatha kubisala chipatala cha hypoglycemia, ndipo calcium blockers ndi clonidine amachepetsa mphamvu ya mankhwalawa.

Pochita ndi mankhwala a psychotropic, kuwunikira mosamala ndikofunikira, popeza mankhwala monga monoamine oxidase inhibitors, mankhwala okhala ndi lithiamu, bromocriptine angalimbikitse zotsatira za hypoglycemic, komanso ma tridclic antidepressants ndi morphine, m'malo mwake, amatha kuchepetsedwa.

Kugwiritsa ntchito njira zakulera, mahomoni a chithokomiro, timadzi ta m'mimba ta adrenal, kukula kwa mahomoni kumachepetsa chidwi cha zolandilira ku mankhwalawa kapena kugwira ntchito kwake.

Octreotide ndi lanreotide zimayambitsa onse hypo- ndi hyperglycemia kumbuyo kwa insulin.

Zinthu zathanzi ndi sulfite zimawononga insulin.

Pakusakaniza mu kachitidwe kamodzi, isofan-insulin yokha, njira ya sodium chloride, 5 kapena 10% dextrose solution (yokhala ndi 40 mmol / l potaziyamu wa potaziyamu) imaloledwa.

Yothetsera ndi insulin aspart yomwe ili mu NovoRapid Penfill. Ndalama zomwe zikufanana ndi nthawi komanso nthawi yakusintha kwake zimaphatikizapo:

Ndemanga za NovoRapida Flexpen

Irina S., endocrinologist, Moscow

Kugwiritsa ntchito ma insulin kwakanthawi komanso kwakanthawi kumathandizira kuti glycemic ichotse. Mutha kusankha mtundu womwe umasintha moyo wa wodwalayo, kwinaku mutaletsa kupititsa patsogolo matendawa.

Gennady T., wothandizira, St.

Anthu odwala matenda ashuga amatenga mankhwalawo. Kutha kuperekera popanda gawo lakudya kumapangitsa kuti odwala asamavutike kukonza tsiku. Ndiosavuta komanso ndikosavuta kugwiritsa ntchito kukonzekera kutengera mphamvu ya munthu.

Elena, wazaka 54, Dubna

Ndakhala ndikugwiritsa ntchito mankhwalawa kwa zaka ziwiri. Ubwino wambiri: jakisoni wokha, alibe ululu. Kuphatikizikako kumavomerezedwa bwino.

Pavel, wazaka 35, Novosibirsk

Potumizidwa ku mankhwala opitilira miyezi isanu ndi umodzi yapitayo, adazindikira mwachangu kanthu. Mankhwalawa ndi othandizika: hemoglobin ya glycated imakhala yotsika kwambiri.