Lembetsani insulin kuti mulipire shuga

Kugwiritsa ntchito kwa basal analogues a human hormone sikumakulolani kuti nthawi zonse muziwongolera glycemia ya odwala, makamaka usiku. Matendawa akamakula, kusinthasintha mosalekeza kwa mlingo wa basal insulin kumafunikiranso, komwe kumayambitsanso zovuta zina ndipo sikumakulolani kuwongolera kuchuluka kwa shuga mutatha kudya.

Mlingo wosalondola umabweretsa kudwala.

M'zaka zaposachedwa, mankhwala a biphasic omwe ali ndi mahomoni ofupikitsa komanso osakhalitsa, monga Aspart magawo awiri a insulin, afalikira. Kugwiritsa ntchito kuphatikiza kwa base-bolus kumathandizira kuti chithandizo cha matenda ashuga chisathe, chifukwa chimachepetsa kuchuluka kwa jakisoni patsiku.

Biphasic insulin aspart * (Insulin aspart biphasic *) - Yapakatikati nthawi ya insulin yomwe imapezeka pogwiritsa ntchito ukadaulo wa DNA. Imalumikizana ndi cholandirira chapadera pa cell ya cytoplasmic maselo ndikupanga insulini-receptor zovuta zomwe zimapangitsanso njira zina, kuphatikizapo kaphatikizidwe angapo ofunikira a michere (hexokinase, pyruvate kinase, glycogen synthetase). Kutsika kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa kayendedwe ka intracellular, kuchuluka kwa mayamwidwe ndi kuphatikizika ndi minofu, kukondoweza kwa lipogenesis, glycogenogeneis, ndi kuchepa kwa kuchuluka kwa shuga ndi chiwindi.

Kutalika kwa nthawi ya kukonzekera kwa insulin kumatsimikiziridwa makamaka ndi kuchuluka kwa mayamwidwe, zomwe zimatengera zinthu zingapo (mwachitsanzo, pa mlingo, njira ndi malo oyang'anira), chifukwa chake zochitika za insulin zimasinthasintha kwambiri, mwa anthu osiyanasiyana komanso mwa munthu mmodzi .

Pafupifupi, pambuyo pa utsogoleri wa sc, Rinsulin NPH imayamba kugwira ntchito pambuyo pa maola 1.5, mphamvu yayikulu imakhala pakati pa maola 4 ndi maola 12, nthawi yayitali mpaka maola 24.

Mimba komanso kuyamwa

M'maphunziro a nyama, zidawonetsedwa kuti ndi makulidwe a insulini komanso mankhwalawa wamba mu inshuwaransi yopitilira muyeso wovomerezeka mwa anthu pafupifupi 32 (makoswe) ndi katatu (akalulu), onse amayamba ndi insulini ndi kuchepa kwa chimbudzi, komanso zam'mimba / zotupa.

Maphunziro okwanira komanso owongoleredwa mosamalitsa mwa amayi apakati sanachitike. Kuyang'anira ndi kuyang'anira shuga wamagazi amayenera kuchitika panthawi yomwe mayi angathe kutenga pakati komanso munthawi yonse yonse yodwala odwala matenda a shuga komanso azimayi omwe ali ndi mbiri ya matenda a shuga.

Kufunika kwa insulini, monga lamulo, kumachepa mu nthawi yayitali ya mimba ndikuwonjezeka kwachiwiri - trimesters yachitatu. Nthawi yobadwa pambuyo pokhapokha ndipo mwayamba kubadwa, zofunika za insulin zimatha kugwa kwambiri.

Gawo la FDA la mwana wakhanda ndi C.

Zochitika zamankhwala pakadyeretso ndizochepa. Gwiritsani ntchito mosamala (sizikudziwika ngati insulini ya insulin imayamwa mkaka wa m'mawere).

Kugwiritsa ntchito kuphatikiza kwa insulin degludec insulin aspart pa nthawi ya pakati imatsutsana, chifukwa palibe zochitika zachipatala ndi momwe zimagwiritsidwira ntchito panthawi yomwe muli ndi pakati. Kafukufuku wokhudzana ndi kubereka mu nyama sikunawonetse kusiyana pakati pa insludec insulin ndi insulin yaumunthu molingana ndi embryotoxicity ndi teratogenicity.

Kugwiritsa ntchito kuphatikiza kwa insulin degludec insulin aspart pa nthawi yoyamwitsa kumatsutsana, chifukwa Palibe zokuchitikirani zamankhwala ndi akazi opaka mkaka.

Kafukufuku wazinyama adawonetsa kuti mu makoswe, degludec insulin imachotsedwa mkaka wa m'mawere, kuyika kwake m'mkaka wa m'mawere ndikotsika kuposa plasma yamagazi. Sizikudziwika ngati insulin degludec imachotsedwa mkaka wa amayi.

Chonde. Kafukufuku wazinyama sanapeze zovuta za degludec insulin pa chonde.

Gawo la FDA la mwana wakhanda ndi C.

Maphunziro okwanira komanso osamalitsa okhazikika ogwiritsira ntchito kuphatikiza kwa insulin degludec insulin aspart mwa amayi apakati sanachitike. Pokonzekera kutenga pakati kapena kukhazikitsa, odwala ayenera kukambirana za kugwiritsa ntchito mankhwalawa ndi adokotala.

Popeza maphunziro ochulukitsa nyama sangathe kulosera mavuto omwe amabwera mwa anthu, kuphatikiza kwa insulin degludec insulin aspart kuyenera kugwiritsidwa ntchito panthawi yomwe ali ndi pakati pokhapokha ngati chiyembekezo chachipatala chikuwonjezera chiwopsezo cha mwana wosabadwayo.

Kwa odwala omwe ali ndi mbiri ya matenda ashuga kapena gestational matenda a shuga, kusamalira bwino kagayidwe kachakudya musanatenge pathupi komanso panthawi ya pakati ndikofunikira. Kufunika kwa insulini kumatha kuchepa panthawi yoyambirira ya kubereka, monga lamulo, kumawonjezeka panthawi yachiwiri komanso yachitatu ndipo kumachepera msanga pambuyo pobadwa mwana.

Kuwunikira mosamala kuchuluka kwa shuga ndikofunikira mwa odwalawa.

Sizikudziwika ngati insludec / aspart insulin imachotsedwa mkaka wa m'mawere. Popeza zinthu zambiri, kuphatikiza insulin ya anthu, zimapukusidwa mkaka wa m'mawere, kusamala kuyenera kuchitika pakamagwiritsira ntchito insulin degludec insulin aspart mwa amayi oyamwitsa. Amayi omwe ali ndi matenda ashuga nthawi ya mkaka wa m'mawere angafunike kusintha kwa mapiritsi a insulin, kaperekedwe ka chakudya, kapena zonse ziwiri.

M'maphunziro a nyama, zidawonetsedwa kuti pakukhazikitsa insulin aspart komanso insulin yodziwika bwino ya anthu mu Mlingo wopitilira muyeso womwe walimbikitsidwa mwa anthu pafupifupi 32 (makoswe) ndi katatu (akalulu), onsewa amakhala ndi insulin kutayika kwazomwe zimachitika, komanso kuvulala kwamitsempha / mafupa.

Gawo la FDA la mwana wakhanda ndi C.

Analogi ndi mitengo

Mankhwala a Novomix Flekspen amapezeka mu mawonekedwe a cholembera chokhala ndi kuyimitsidwa komwe adapangidwa kamodzi. Pali ma syringe asanu mu phukusi. Mtengo kuchokera 1559 rubles. Mayina a Novomiks Flekspen ali ndi manambala osiyanasiyana: 30, 50, 70. Amalemba nambala ya Asparts pochulukitsa.

Mtengo wa Novorapid Penfill umachokera ku 1670 mpaka 1900 rubles pa phukusi lililonse.

Ana ochepera zaka zisanu ndi chimodzi (chitetezo ndi kufunikira kosatsimikizika).

S / c, khoma lam'mimba, ntchafu, phewa kapena matako, nthawi yomweyo musanadye (prandial) kapena mukangomaliza kudya (postprandial). Masamba obayira omwe ali mdera lomwelo la thupi amayenera kusinthidwa pafupipafupi.

Mlingo ndi mtundu wa makonzedwe amatsimikiziridwa payekha. Chofunikira cha insulin nthawi zambiri chimakhala cha 0.5-1 PESCES / kg / tsiku, pomwe 2/3 imagwera pamankhwala osokoneza bongo (asanadye) insulin, 1/3 - pamsika wa insulin.

Mu / mu (ngati kuli kotheka), pogwiritsa ntchito njira zophikira. Mu / kumwambaku kutha kuchitika kokha ndi akatswiri odziwa ntchito zachipatala.

Matenda a shuga mwa akulu.

Jekeseni imachitika pang'onopang'ono (popanda malangizo ochokera kwa dokotala). Mutha kuyika chida mu malo amodzi otsatirawa:

1. Khoma pamimba
2. Thu
3. Matako
4. Nthawi zina, paphewa.

Mutha kugwiritsa ntchito kuyimitsidwa musanadye chakudya komanso nthawi yomweyo. Jakisoni amayenera kuchitika nthawi iliyonse m'malo atsopano (m'dera lomwelo la thupi - phewa, pamimba, ntchafu).

Mlingo wa mankhwalawa kamodzi pamankhwala amawerengeredwa ndi adokotala. Kufunika kwa insulin mwa wodwala aliyense ndiwokhazikika ndipo zimatengera zinthu zambiri - kulemera, zaka, mkhalidwe waumoyo.

Contraindication

Contraindication yowonetsa kuthekera kwa kugwiritsa ntchito Aspart insulin ndi ochepa. Amaphatikizaponso gawo lakumvetsetsa, komanso hypoglycemia. Milandu iyenera kufotokozedweratu nthawi yomwe kumwa kuyenera kukhala kochepa - uwu ndi zaka za mwana mpaka zaka zisanu ndi chimodzi.

Nthawi zina, Aspart insulin ndi njira yabwino komanso yothandiza kwambiri yothandizira odwala matenda ashuga kukhala athanzi labwino. Komabe, chifukwa cha izi ndikofunikira kukumbukira malingaliro onse omwe aperekedwa pamwambapa.

Biphasic insulin Aspart (analog ya Flexpen) imagwiritsidwa ntchito pochiza mtundu wa 1 ndi mtundu 2 wa shuga ngati wadutsa gawo logalira insulin.

Mankhwalawa sagwiritsidwa ntchito ndi tsankho la munthu payekhapayekha komanso chifukwa chowonjezera chidwi chawo. Kugwiritsa ntchito mwa ana ochepera zaka zisanu ndi chimodzi sikunafufuzidwe, chifukwa chake sikulimbikitsidwa kugwiritsa ntchito oimira aliwonse pazaka izi.

Kugwiritsira ntchito amayi oyembekezera kumakhalanso kochepa. Maphunziro azachipatala athunthu sanachitike. Zomwezo zimagwiranso ntchito ku FlexPen ndi Novorapid Penfill. Koma m'maphunziro awiri a mankhwala a Novorapid Penfill pa amayi apakati, palibe zomwe zimapezeka pazotsatira zoyipa za chinthucho pokhudzana ndi pakati komanso momwe mwana aliri.

Amayi oyamwitsa amatha kugwiritsa ntchito insulin pazofunikira, sizikhudza mwana. Pangakhale kofunikira kusintha mlingo wa mayiyo.

Zotsatira zoyipa zimawoneka ngati gawo lalikulu la timadzi. Mkhalidwe wa hypoglycemia mukamagwiritsa ntchito mankhwala a biphasic amakula pafupipafupi kuposa momwe amapangira mlingo waukulu.

Zotsatira zotsatirazi nthawi zina zimawonekera:

• Urticaria, zotupa pakhungu, kawirikawiri - anaphylactic zimachitika.
• Peripheral neuropathy.
• Refractory matenda (kawirikawiri kumayambiriro kwa mankhwala), retinopathy.
• Lipodystrophy pamalo opangira jekeseni.
• Zomwe zimachitika mdera lanu pamabungwe oyang'anira.

Kumwa mankhwala ena limodzi ndi kuwonjezereka kwa zotsatira za Aspart ndi kuthekera kwa hypoglycemia:

• Kulera kwamlomo.
• Zoletsa za MAO, ACE.
• Ma antidepressants.
• Thiazide okodzetsa.
• Heparin.

Mowa ungapangitse komanso kufooketsa mphamvu ya chithandizo cha mahomoni.

Kuchuluka kwa chidwi cha munthu payekha, ana ochepera zaka 18, nthawi yokhala ndi pakati komanso yoyamwitsa (palibe chidziwitso chazachipatala ndi ana, azimayi panthawi yoyembekezera komanso yoyamwitsa).

Insulin aspart imapangidwira insulin yomwe imadalira shuga. Nthawi zambiri, uwu ndi matenda amtundu woyamba komanso wamtundu wachiwiri muzochitika zomwe zimalowa mu mawonekedwe odalira insulin. Mtundu wachiwiri wa matenda ashuga, umadziwika kuti mphamvu ya mankhwala omwe amamwa pakamwa itayika kwathunthu kapena pang'ono.

Mankhwala osavomerezeka a hypersensitivity ake enieni othandizira (osinthika insulin) kapena othandizira pazinthu. Komanso kubwanya kuti mugwiritse ntchito ndi chizolowezi cha pafupipafupi kapena chosakhalitsa cha hypoglycemia. Komanso, ana osaposa zaka 6 sayenera kukhazikitsidwa, popeza mayeso azachipatala a zaka zino sanachitepo.

Kugwiritsa ntchito pa nthawi ya pakati kumafunsabe, popeza maphunziro athunthu sanachitike. Mukakonzekera kapena kukhala ndi pakati, ndikofunikira kudziwitsa endocrinologist za izi. Nthawi zina, mungafunike kusintha mankhwalawo kapena kusiya.

Ndi mkaka wa m'mawere, kusamala kumalimbikitsidwanso. Palibe maphunziro omwe akunena ngati spartame imadziunjikira mkaka wa m'mawere.

Mndandanda wazofananira

Tcherani khutu! Mndandandandawu umakhala ndi mawu ofanana a Insulin aspart biphasic * (Insulin aspart biphasic *), omwe ali ndi mawonekedwe ofanana, kotero mutha kusankha nokha, poganizira mawonekedwe ndi mankhwalawa a mankhwalawa omwe adotchulidwa ndi dokotala.Perekani zokonda kwa opanga ku USA, Japan, Western Europe, komanso makampani odziwika bwino ochokera ku Eastern Europe: Krka, Gideon Richter, Actavis, Aegis, Lek, Hexal, Teva, Zentiva.

Mlendo wina adanenanso kuchuluka kwa anthu tsiku lililonse

Kodi ndiyenera kumwa kangati ka insulin aspart biphasic * (Insulin aspart biphasic *)?
Ambiri omwe amayankhidwa amamwa mankhwalawa kawiri pa tsiku. Ripotilo likuwonetsa kuti anthu ena omwe amayankha mankhwalawa amamwa mankhwalawa kangati.

Mamembala	%
2 pa tsiku	1	100.0%

Mlendo wina anafotokozera

Mamembala	%
51-100mg	1

Kukwanira kokwanira kwa glucose mu mtundu 1 ndi mtundu 2 wa shuga ndi chitsimikizo cha kuchedwa kuyambika kwa zovuta zamatenda. Mankhwala a insulin ndiye chithandizo chachikulu cha matenda a shuga 1 ndipo nthawi zina amafunikira matenda a shuga a 2 osakanikirana ndi mankhwala a hypoglycemic. Kugwiritsa ntchito mankhwala a biphasic kumapereka zotsatira zabwino.

Zambiri

Kuphatikizidwa kwa insulin Degludek / insulin Aspart kumaphatikizapo 70% ya chinthu cha superlong kanthu (Degludec) ndi 30% ya insulin Aspart yochepa, yomwe imaphatikizidwa jekeseni imodzi. Pambuyo pothandizidwa ndi subcutaneous, depot ya mahomoni imapangidwa, yomwe imakhala ndi hexamers yothandizira. Pang'onopang'ono, m'kupita kwa nthawi, mamolekyu akulu a Aspart amaphulika kukhala ma monomers, omwe amalowa m'magazi ndipo amakhala ndi vuto lofanana ndi mahomoni amkati.

Biphasic insulin Aspart imakulolani kuti mulamulire kuchuluka kwa glycemia, pafupipafupi hypoglycemia imakhala yocheperako kuposa momwe mukugwiritsira ntchito insal insulin kapena biphasic yoyambirira yokha.

Chofunika kwambiri ndikuwongolera kwa shuga usiku, chifukwa akamagwiritsa ntchito kinin kukonzekera, kuchepa kwa ndende yamagazi ndikotheka. Ndipo izi zimadetsa thanzi la odwala, zimawonjezera chiopsezo cha kufa mwadzidzidzi.

Zizindikiro ndi contraindication

Biphasic insulin Aspart (analog ya Flexpen) imagwiritsidwa ntchito pochiza mtundu wa 1 ndi mtundu 2 wa shuga ngati wadutsa gawo logalira insulin.

Mankhwalawa sagwiritsidwa ntchito ndi tsankho la munthu payekhapayekha komanso chifukwa chowonjezera chidwi chawo. Kugwiritsa ntchito mwa ana ochepera zaka zisanu ndi chimodzi sikunafufuzidwe, chifukwa chake sikulimbikitsidwa kugwiritsa ntchito oimira aliwonse pazaka izi.

Kwa ana ochepera zaka 6, kugwiritsa ntchito Insulin aspart sikulimbikitsidwa, komanso kwa amayi apakati

Kugwiritsira ntchito amayi oyembekezera kumakhalanso kochepa. Maphunziro azachipatala athunthu sanachitike. Zomwezo zimagwiranso ntchito ku FlexPen ndi Novorapid Penfill. Koma m'maphunziro awiri a mankhwala a Novorapid Penfill pa amayi apakati, palibe zomwe zimapezeka pazotsatira zoyipa za chinthucho pokhudzana ndi pakati komanso momwe mwana aliri.

Amayi oyamwitsa amatha kugwiritsa ntchito insulin pazofunikira, sizikhudza mwana. Pangakhale kofunikira kusintha mlingo wa mayiyo.

Zotsatira zoyipa zimawoneka ngati gawo lalikulu la timadzi. Mkhalidwe wa hypoglycemia mukamagwiritsa ntchito mankhwala a biphasic amakula pafupipafupi kuposa momwe amapangira mlingo waukulu.

Zotsatira zotsatirazi nthawi zina zimawonekera:

• Urticaria, zotupa pakhungu, kawirikawiri - anaphylactic zimachitika.
• Peripheral neuropathy.
• Refractory matenda (kawirikawiri kumayambiriro kwa mankhwala), retinopathy.
• Lipodystrophy pamalo opangira jekeseni.
• Zomwe zimachitika mdera lanu pamabungwe oyang'anira.

Kumwa mankhwala ena limodzi ndi kuwonjezereka kwa zotsatira za Aspart ndi kuthekera kwa hypoglycemia:

• Kulera kwamlomo.
• Zoletsa za MAO, ACE.
• Ma antidepressants.
• Thiazide okodzetsa.
• Heparin.

Mowa ungapangitse komanso kufooketsa mphamvu ya chithandizo cha mahomoni.

Njira zogwiritsira ntchito

Penorill ya Novorapid imangoperekedwa pokhapokha, monga momwe ziliri ndi mankhwala omwe ali ndi dzina losiyana, koma amafanana. Aspart pakuyimitsidwa siigwiritsidwa ntchito kulowetsamo mapampu a insulin.Mlingo wake umasankhidwa mosiyanasiyana.

Njira yodziwika bwino yodwala matenda a shuga 2 ndi jakisoni m'mawa musanadye chakudya cham'mawa kapena mutangotha ​​kamodzi ndi jakisoni imodzi ya magawo 6 musanadye chakudya.

Mukasamutsa kuchokera ku mitundu ina ya mankhwala, kuwunika mosamala kuchuluka kwa shuga m'magazi kumachitika.

Pomaliza

Chithandizo cha matenda ashuga chimayenda bwino ndi mlingo woyenera komanso mlingo woyenera. Izi zikuyenera kuchitika ndi dokotala, potengera kuchuluka kwa kuchuluka kwa shuga pamasiku angapo. Kuchiza molondola kumachepetsa chiopsezo chokhala ndi zovuta za matendawa ndipo sikukhudza thanzi lathunthu.

Thanzi ndi moyo wa munthu wodwala matenda ashuga zimadalira kusankha kwa insulini yapamwamba kwambiri. Insulin aspart ndi mankhwala otchuka komanso okwera mtengo omwe amalimbikitsa madokotala. Amagwiritsidwa ntchito ngati cholowa m'malo mwanu insulin, yomwe imakhala yosakwanira m'thupi motero imafuna kuyambitsa kwake kuchokera kunja. Izi zimathandiza kukonza mkhalidwe wa wodwalayo komanso kulipirira matenda a shuga, komanso kuchepetsa mwayi ndi kukula kwa zovuta zina.

Mankhwala othandizira ali ndi dzina lomwelo (insulin aspart). Awa ndi maini osinthika amunthu a ultrashort action. Adachipeza chifukwa chodziwonetsa kupsinjika kwapadera pogwiritsa ntchito ukadaulo wa DNA. Zotsatira zake, amino acid proline inasinthidwa ndi aspartic acid.

Amapezeka ngati kuyimitsidwa, okonzekera subcutaneous management. Kuyimitsidwa kwake ndi koyera pamtundu; ndikatayidwa, imatha kukhala yoyera pansi ndi madzi owoneka bwino kumtunda kwa vial. Ndikusuntha pang'ono kapena kugwedeza, madziwo amakhalanso amphawi.

Mtengo wa mankhwalawa ungasiyane kutengera kuchuluka kwa mankhwalawo. Pa avareji, ma cartridge 5 a 3 ml iliyonse amawononga pafupifupi 1800 - 1900 ma ruble ku malo ogulitsa mankhwala ku Moscow.

Aspartame - ndi chiyani?

Izi ndi zothira shuga, zotsekemera. Zopangira izi zidapangidwa koyamba mu 60s ya 20 century. Idalandiridwa ndi chemist J.M. Schlatter, chinthu chomwe ndi chopangidwa ndi zotsatira zake , Zakudya zake zidapezeka mwamwayi.

Pulogalamuyo imakhala yokoma kwambiri kuposa shuga. Ngakhale kuti zotsekemera zimakhala ndi zopatsa mphamvu (pafupifupi ma kilogalamu 4 pa gramu), kuti mupange kukoma kwa zinthuzo, muyenera kuwonjezera zochepa kuposa shuga. Chifukwa chake, mukamagwiritsa ntchito kuphika, mtengo wake wa caloric sukumbukiridwa. Poyerekeza sucrose, phula ili lili ndi kutanthauzira kochulukira, koma kwapang'onopang'ono.

Kodi Aspartame, mphamvu zakepi, kuvulaza kwa Aspartame

Katundu ndi methylated dipeptidezomwe zimakhala ndi zotsalira phenylalaninendi Aspartic acid. Malinga ndi Wikipedia, kulemera kwake kwa maselo = 294, 3 magalamu pa Mole, kachulukidwe kazinthu kameneka ndi pafupifupi 1.35 gramu pa kiyubiki imodzi. Chifukwa chakuti kusungunuka kwa chinthu kumachokera pa 246 mpaka 247 Celsius, sikungagwiritsidwe ntchito kuzinthu zotsekemera zomwe zimathandizidwa ndi kutentha. Pulogalamuyo imasungunuka pang'ono m'madzi ndi ena. kupuma sol sol.

Mavuto a Aspartame

Pakadali pano, chida chikugwiritsidwa ntchito ngati chowonjezera - Aspartame E951.

Amadziwika kuti atalowa m'thupi la munthu, chinthucho chimawola methanol. Methanoli yambiri imakhala poizoni. Komabe, kuchuluka kwa methanol komwe munthu amalandila chakudya nthawi zambiri kumapitilira kuchuluka kwa zinthu zomwe zimachitika chifukwa cha kuwonongeka kwa Aspartame.

Zimatsimikiziridwa kuti methanol yochuluka mokwanira imapangidwa nthawi zonse mthupi la munthu. Mutatha kudya kapu imodzi ya zipatso zamadzimadzi, zochulukazo zimapangidwa kuposa mutatha kumwa momwemonso zakumwa zotsekemera ndi Aspartame.

Kafukufuku wambiri wazakumwa ndi zapoizoni adachitidwa kuti atsimikizire kuti zotsekemera zilibe vuto. Pankhaniyi, mlingo woyenera wa tsiku lililonse wa mankhwalawa umakhazikitsidwa. Ndi 40-50 mg wa pa kilogalamu ya kulemera kwa thupi patsiku, womwe ndi wofanana ndi mapiritsi 266 a zotsekemera zopangira munthu kwa masekeli 70 kg.

Mu 2015, pawiri milandu yoyesedwa ndi placebo, pomwe panali anthu 96. Zotsatira zake, palibe zizindikiro za metabolic ndi zamaganizidwe zoyipa zomwe zimakomera zotsekemera zomwe sizinapezeke.

Aspartame, ndi chiyani, metabolism yake imayenda bwanji?

Chipangizocho chimapezeka m'mapuloteni ambiri a zakudya wamba. Thupi limakhala lokoma kwambiri kuposa shuga wokhazikika, zopatsa mphamvu zake za calorie ndizotsika kwambiri kuposa shuga. Chakudya chokhala ndi phula ili, chimalowa mwachangu m'matumbo aang'ono. Wopangidwira mankhwala mu chiwindi minofu kudzera zimachitika kusinthika. Zotsatira zake, amino acid ndi methanol amapangidwa. Zinthu zamatsenga zimapukusidwa kudzera mu mkodzo.

Zotsatira zoyipa

Aspartame ndi njira yotetezeka bwino yomwe imapangitsa kuti pakhale zovuta zilizonse zosafunikira.

Nthawi zambiri sizingachitike:

• kupweteka mutu, kuphatikiza
• kukula modabwitsa
• zotupa pakhungu, zina zovuta kufatsa.

Zokonzekera zomwe zili ndi (Analogs)

Katunduyu amalembetsedwa m'mazina otsatsa awa: Sugafri, AminoSweet, Spoonful, NutraSweet, Canderel.

Ndondomeko za insulin aspart ya mankhwalawa imaperekedwa, molingana ndi mawu omasulira azachipatala, omwe amatchedwa "ma syonyms" - mankhwala osinthika omwe ali ndi chinthu chimodzi kapena zingapo zomwe zimagwira ntchito motsatira thupi. Mukamasankha mawu ofananitsa, osangoganizira mtengo wawo, komanso dziko lakapangidwe ndi mbiri ya wopanga.

Zotsatira Za Alendo

Alendo Performance Report

Alendo Amapereka Zotsatira Zotsatira

Alendo Akufotokoza Kuthokoza

Mlendo wina adanenanso kuchuluka kwa anthu tsiku lililonse

Kodi ndiyenera kumwa kangati ka insulin aspart biphasic * (Insulin aspart biphasic *)?
Ambiri omwe amayankhidwa amamwa mankhwalawa kawiri pa tsiku. Ripotilo likuwonetsa kuti anthu ena omwe amayankha mankhwalawa amamwa mankhwalawa kangati.

Mamembala	%
2 pa tsiku	1	100.0%

Mlendo wina anafotokozera

Mamembala	%
51-100mg	1

Kukwanira kokwanira kwa glucose mu mtundu 1 ndi mtundu 2 wa shuga ndi chitsimikizo cha kuchedwa kuyambika kwa zovuta zamatenda. Mankhwala a insulin ndiye chithandizo chachikulu cha matenda a shuga 1 ndipo nthawi zina amafunikira matenda a shuga a 2 osakanikirana ndi mankhwala a hypoglycemic. Kugwiritsa ntchito mankhwala a biphasic kumapereka zotsatira zabwino.

Kufotokozera za mankhwalawa

Kugwiritsa ntchito kwa basal analogues a human hormone sikumakulolani kuti nthawi zonse muziwongolera glycemia ya odwala, makamaka usiku. Matendawa akamakula, kusinthasintha mosalekeza kwa mlingo wa basal insulin kumafunikiranso, komwe kumayambitsanso zovuta zina ndipo sikumakulolani kuwongolera kuchuluka kwa shuga mutatha kudya. Mlingo wosalondola umabweretsa kudwala.

M'zaka zaposachedwa, mankhwala a biphasic omwe ali ndi mahomoni ofupikitsa komanso osakhalitsa, monga Aspart magawo awiri a insulin, afalikira. Kugwiritsa ntchito kuphatikiza kwa base-bolus kumathandizira kuti chithandizo cha matenda ashuga chisathe, chifukwa chimachepetsa kuchuluka kwa jakisoni patsiku.

Zambiri

Kuphatikizidwa kwa insulin Degludek / insulin Aspart kumaphatikizapo 70% ya chinthu cha superlong kanthu (Degludec) ndi 30% ya insulin Aspart yochepa, yomwe imaphatikizidwa jekeseni imodzi. Pambuyo pothandizidwa ndi subcutaneous, depot ya mahomoni imapangidwa, yomwe imakhala ndi hexamers yothandizira.Pang'onopang'ono, m'kupita kwa nthawi, mamolekyu akulu a Aspart amaphulika kukhala ma monomers, omwe amalowa m'magazi ndipo amakhala ndi vuto lofanana ndi mahomoni amkati.

Biphasic insulin Aspart imakulolani kuti mulamulire kuchuluka kwa glycemia, pafupipafupi hypoglycemia imakhala yocheperako kuposa momwe mukugwiritsira ntchito insal insulin kapena biphasic yoyambirira yokha.

Chofunika kwambiri ndikuwongolera kwa shuga usiku, chifukwa akamagwiritsa ntchito kinin kukonzekera, kuchepa kwa ndende yamagazi ndikotheka. Ndipo izi zimadetsa thanzi la odwala, zimawonjezera chiopsezo cha kufa mwadzidzidzi.

Zizindikiro ndi contraindication

Biphasic insulin Aspart (analog ya Flexpen) imagwiritsidwa ntchito pochiza mtundu wa 1 ndi mtundu 2 wa shuga ngati wadutsa gawo logalira insulin.

Mankhwalawa sagwiritsidwa ntchito ndi tsankho la munthu payekhapayekha komanso chifukwa chowonjezera chidwi chawo. Kugwiritsa ntchito mwa ana ochepera zaka zisanu ndi chimodzi sikunafufuzidwe, chifukwa chake sikulimbikitsidwa kugwiritsa ntchito oimira aliwonse pazaka izi.

Kwa ana ochepera zaka 6, kugwiritsa ntchito Insulin aspart sikulimbikitsidwa, komanso kwa amayi apakati

Kugwiritsira ntchito amayi oyembekezera kumakhalanso kochepa. Maphunziro azachipatala athunthu sanachitike. Zomwezo zimagwiranso ntchito ku FlexPen ndi Novorapid Penfill. Koma m'maphunziro awiri a mankhwala a Novorapid Penfill pa amayi apakati, palibe zomwe zimapezeka pazotsatira zoyipa za chinthucho pokhudzana ndi pakati komanso momwe mwana aliri.

Amayi oyamwitsa amatha kugwiritsa ntchito insulin pazofunikira, sizikhudza mwana. Pangakhale kofunikira kusintha mlingo wa mayiyo.

Zotsatira zoyipa zimawoneka ngati gawo lalikulu la timadzi. Mkhalidwe wa hypoglycemia mukamagwiritsa ntchito mankhwala a biphasic amakula pafupipafupi kuposa momwe amapangira mlingo waukulu.

Zotsatira zotsatirazi nthawi zina zimawonekera:

• Urticaria, zotupa pakhungu, kawirikawiri - anaphylactic zimachitika.
• Peripheral neuropathy.
• Refractory matenda (kawirikawiri kumayambiriro kwa mankhwala), retinopathy.
• Lipodystrophy pamalo opangira jekeseni.
• Zomwe zimachitika mdera lanu pamabungwe oyang'anira.

Kumwa mankhwala ena limodzi ndi kuwonjezereka kwa zotsatira za Aspart ndi kuthekera kwa hypoglycemia:

• Kulera kwamlomo.
• Zoletsa za MAO, ACE.
• Ma antidepressants.
• Thiazide okodzetsa.
• Heparin.

Mowa ungapangitse komanso kufooketsa mphamvu ya chithandizo cha mahomoni.

Njira zogwiritsira ntchito

Penorill ya Novorapid imangoperekedwa pokhapokha, monga momwe ziliri ndi mankhwala omwe ali ndi dzina losiyana, koma amafanana. Aspart pakuyimitsidwa siigwiritsidwa ntchito kulowetsamo mapampu a insulin. Mlingo wake umasankhidwa mosiyanasiyana.

Njira yodziwika bwino yodwala matenda a shuga 2 ndi jakisoni m'mawa musanadye chakudya cham'mawa kapena mutangotha ​​kamodzi ndi jakisoni imodzi ya magawo 6 musanadye chakudya.

Mukasamutsa kuchokera ku mitundu ina ya mankhwala, kuwunika mosamala kuchuluka kwa shuga m'magazi kumachitika.

Analogi ndi mitengo

Mankhwala a Novomix Flekspen amapezeka mu mawonekedwe a cholembera chokhala ndi kuyimitsidwa komwe adapangidwa kamodzi. Pali ma syringe asanu mu phukusi. Mtengo kuchokera 1559 rubles. Mayina a Novomiks Flekspen ali ndi manambala osiyanasiyana: 30, 50, 70. Amalemba nambala ya Asparts pochulukitsa.

Mtengo wa Novorapid Penfill umachokera ku 1670 mpaka 1900 rubles pa phukusi lililonse.

Pomaliza

Chithandizo cha matenda ashuga chimayenda bwino ndi mlingo woyenera komanso mlingo woyenera. Izi zikuyenera kuchitika ndi dokotala, potengera kuchuluka kwa kuchuluka kwa shuga pamasiku angapo. Kuchiza molondola kumachepetsa chiopsezo chokhala ndi zovuta za matendawa ndipo sikukhudza thanzi lathunthu.

Thanzi ndi moyo wa munthu wodwala matenda ashuga zimadalira kusankha kwa insulini yapamwamba kwambiri. Insulin aspart ndi mankhwala otchuka komanso okwera mtengo omwe amalimbikitsa madokotala.Amagwiritsidwa ntchito ngati cholowa m'malo mwanu insulin, yomwe imakhala yosakwanira m'thupi motero imafuna kuyambitsa kwake kuchokera kunja. Izi zimathandiza kukonza mkhalidwe wa wodwalayo komanso kulipirira matenda a shuga, komanso kuchepetsa mwayi ndi kukula kwa zovuta zina.

Mankhwala othandizira ali ndi dzina lomwelo (insulin aspart). Awa ndi maini osinthika amunthu a ultrashort action. Adachipeza chifukwa chodziwonetsa kupsinjika kwapadera pogwiritsa ntchito ukadaulo wa DNA. Zotsatira zake, amino acid proline inasinthidwa ndi aspartic acid.

Amapezeka ngati kuyimitsidwa, okonzekera subcutaneous management. Kuyimitsidwa kwake ndi koyera pamtundu; ndikatayidwa, imatha kukhala yoyera pansi ndi madzi owoneka bwino kumtunda kwa vial. Ndikusuntha pang'ono kapena kugwedeza, madziwo amakhalanso amphawi.

Mtengo wa mankhwalawa ungasiyane kutengera kuchuluka kwa mankhwalawo. Pa avareji, ma cartridge 5 a 3 ml iliyonse amawononga pafupifupi 1800 - 1900 ma ruble ku malo ogulitsa mankhwala ku Moscow.

Zizindikiro ndi contraindication

Insulin aspart imapangidwira insulin yomwe imadalira shuga. Nthawi zambiri, uwu ndi matenda amtundu woyamba komanso wamtundu wachiwiri muzochitika zomwe zimalowa mu mawonekedwe odalira insulin. Mtundu wachiwiri wa matenda ashuga, umadziwika kuti mphamvu ya mankhwala omwe amamwa pakamwa itayika kwathunthu kapena pang'ono.

Mankhwala osavomerezeka a hypersensitivity ake enieni othandizira (osinthika insulin) kapena othandizira pazinthu. Komanso kubwanya kuti mugwiritse ntchito ndi chizolowezi cha pafupipafupi kapena chosakhalitsa cha hypoglycemia. Komanso, ana osaposa zaka 6 sayenera kukhazikitsidwa, popeza mayeso azachipatala a zaka zino sanachitepo.

Kugwiritsa ntchito pa nthawi ya pakati kumafunsabe, popeza maphunziro athunthu sanachitike. Mukakonzekera kapena kukhala ndi pakati, ndikofunikira kudziwitsa endocrinologist za izi. Nthawi zina, mungafunike kusintha mankhwalawo kapena kusiya.

Kugwiritsa

Jekeseni imachitika pang'onopang'ono (popanda malangizo ochokera kwa dokotala). Mutha kuyika chida mu malo amodzi otsatirawa:

1. Khoma pamimba
2. Thu
3. Matako
4. Nthawi zina, paphewa.

Mutha kugwiritsa ntchito kuyimitsidwa musanadye chakudya komanso nthawi yomweyo. Jakisoni amayenera kuchitika nthawi iliyonse m'malo atsopano (m'dera lomwelo la thupi - phewa, pamimba, ntchafu).

Mlingo wa mankhwalawa kamodzi pamankhwala amawerengeredwa ndi adokotala. Kufunika kwa insulin mwa wodwala aliyense ndiwokhazikika ndipo zimatengera zinthu zambiri - kulemera, zaka, mkhalidwe waumoyo.

Nthawi zambiri, amachokera ku 0,3 mpaka 1 IU patsiku, koma amatha kusiyanasiyana panthawi yomwe ali ndi pakati, unyamata, kusintha kwa kusintha kwa thupi, komanso kusintha kwina kwa mahomoni.

Kuwongolera kwa mitsempha kumaletsedwa chifukwa cha chiwopsezo cha hypoglycemia. Koma mwapadera, zitha kuchitidwa motsogozedwa ndi ogwira ntchito pachipatala.

Mankhwala ali ndi analogues - kuyimitsidwa komwe kumakhala ndi mankhwala ofanana ndikugwiritsa ntchito pazomwe zimagwira. Amakhudzanso thupi. Komabe, atha kukhala ndi dzina lina. Analogue ya mankhwala a insulin aspart ndi NovoRapid Penfill ndi mitundu yake, NovoRapid FlexPenn, NovoLog.

Aspartame - ndi chiyani?

Izi ndi zothira shuga, zotsekemera. Zopangira izi zidapangidwa koyamba mu 60s ya 20 century. Idalandiridwa ndi chemist J.M. Schlatter, chinthu chomwe ndi chopangidwa ndi zotsatira zake , Zakudya zake zidapezeka mwamwayi.

Pulogalamuyo imakhala yokoma kwambiri kuposa shuga. Ngakhale kuti zotsekemera zimakhala ndi zopatsa mphamvu (pafupifupi ma kilogalamu 4 pa gramu), kuti mupange kukoma kwa zinthuzo, muyenera kuwonjezera zochepa kuposa shuga.Chifukwa chake, mukamagwiritsa ntchito kuphika, mtengo wake wa caloric sukumbukiridwa. Poyerekeza sucrose, phula ili lili ndi kutanthauzira kochulukira, koma kwapang'onopang'ono.

Kodi Aspartame, mphamvu zakepi, kuvulaza kwa Aspartame

Katundu ndi methylated dipeptidezomwe zimakhala ndi zotsalira phenylalaninendi Aspartic acid. Malinga ndi Wikipedia, kulemera kwake kwa maselo = 294, 3 magalamu pa Mole, kachulukidwe kazinthu kameneka ndi pafupifupi 1.35 gramu pa kiyubiki imodzi. Chifukwa chakuti kusungunuka kwa chinthu kumachokera pa 246 mpaka 247 Celsius, sikungagwiritsidwe ntchito kuzinthu zotsekemera zomwe zimathandizidwa ndi kutentha. Pulogalamuyo imasungunuka pang'ono m'madzi ndi ena. kupuma sol sol.

Mavuto a Aspartame

Pakadali pano, chida chikugwiritsidwa ntchito ngati chowonjezera - Aspartame E951.

Amadziwika kuti atalowa m'thupi la munthu, chinthucho chimawola methanol. Methanoli yambiri imakhala poizoni. Komabe, kuchuluka kwa methanol komwe munthu amalandila chakudya nthawi zambiri kumapitilira kuchuluka kwa zinthu zomwe zimachitika chifukwa cha kuwonongeka kwa Aspartame.

Zimatsimikiziridwa kuti methanol yochuluka mokwanira imapangidwa nthawi zonse mthupi la munthu. Mutatha kudya kapu imodzi ya zipatso zamadzimadzi, zochulukazo zimapangidwa kuposa mutatha kumwa momwemonso zakumwa zotsekemera ndi Aspartame.

Kafukufuku wambiri wazakumwa ndi zapoizoni adachitidwa kuti atsimikizire kuti zotsekemera zilibe vuto. Pankhaniyi, mlingo woyenera wa tsiku lililonse wa mankhwalawa umakhazikitsidwa. Ndi 40-50 mg wa pa kilogalamu ya kulemera kwa thupi patsiku, womwe ndi wofanana ndi mapiritsi 266 a zotsekemera zopangira munthu kwa masekeli 70 kg.

Mu 2015, pawiri milandu yoyesedwa ndi placebo, pomwe panali anthu 96. Zotsatira zake, palibe zizindikiro za metabolic ndi zamaganizidwe zoyipa zomwe zimakomera zotsekemera zomwe sizinapezeke.

Zotsatira za pharmacological

Pharmacodynamics ndi pharmacokinetics

Aspartame, ndi chiyani, metabolism yake imayenda bwanji?

Chipangizocho chimapezeka m'mapuloteni ambiri a zakudya wamba. Thupi limakhala lokoma kwambiri kuposa shuga wokhazikika, zopatsa mphamvu zake za calorie ndizotsika kwambiri kuposa shuga. Chakudya chokhala ndi phula ili, chimalowa mwachangu m'matumbo aang'ono. Wopangidwira mankhwala mu chiwindi minofu kudzera zimachitika kusinthika. Zotsatira zake, amino acid ndi methanol amapangidwa. Zinthu zamatsenga zimapukusidwa kudzera mu mkodzo.

Zizindikiro zogwiritsidwa ntchito

Aspartame imagwiritsidwa ntchito kuchepetsa zopatsa mphamvu za zakumwa ndi chakudya ndi kapena. Ndi chida ichi, mutha kuwongolera kulemera ndi shuga m'magazi.

Contraindication

• ngati alipo pa lokoma;
• ndi matenda osowa.

Chenjezo liyenera kuchitidwa ndi amayi apakati ndi ana.

Zotsatira zoyipa

Aspartame ndi njira yotetezeka bwino yomwe imapangitsa kuti pakhale zovuta zilizonse zosafunikira.

Nthawi zambiri sizingachitike:

• kupweteka mutu, kuphatikiza
• kukula modabwitsa
• zotupa pakhungu, zina zovuta kufatsa.

Aspartame, malangizo ogwiritsira ntchito (Njira ndi Mlingo)

Thupi limatengedwa pakamwa. Osatengera mtundu wa chakudya kapena mankhwala.

Aspartame, malangizo ogwiritsira ntchito

Kuchuluka kwa zotsekemera zomwe zimatha kudyedwa patsiku, popanda kuvulaza thupi ndi 40-50 mg pa kilogalamu ya thupi.

Bongo

Palibe umboni wa kuchuluka kwa mankhwalawa. Amakhulupirira kuti kugwiritsa ntchito tsiku lililonse mankhwala akuluakulu kungachititse kuti neoplasms yoyipakapena matenda ashuga.

Kuchita

Thupi silimayenderana ndi mankhwala osiyanasiyana.

Malonda ogulitsa

Palibe njira yofunikira.

Malo osungira

Malangizo apadera

Pakutentha kwa nthawi yayitali, mankhwalawa amawola ndipo amasiya kukoma.

Kuchepetsa thupi

E951 Nthawi zambiri amaphatikizidwa ndi zakumwa zakumwa. Ndi chida ichi mutha kuwongolera kunenepa.

Pa mimba ndi mkaka wa m`mawere

Zokonzekera zomwe zili ndi (Analogs)

Katunduyu amalembetsedwa m'mazina otsatsa awa: Sugafri, AminoSweet, Spoonful, NutraSweet, Canderel.

Ndondomeko za insulin aspart ya mankhwalawa imaperekedwa, molingana ndi mawu omasulira azachipatala, omwe amatchedwa "ma syonyms" - mankhwala osinthika omwe ali ndi chinthu chimodzi kapena zingapo zomwe zimagwira ntchito motsatira thupi. Mukamasankha mawu ofananitsa, osangoganizira mtengo wawo, komanso dziko lakapangidwe ndi mbiri ya wopanga.

Kufotokozera za mankhwalawa

Imalumikizana ndi cholandirira chapadera pa cell ya cytoplasmic maselo ndikupanga insulini-receptor zovuta zomwe zimapangitsanso njira zina, kuphatikizapo kaphatikizidwe angapo ofunikira a michere (hexokinase, pyruvate kinase, glycogen synthetase). Mphamvu ya hypoglycemic imalumikizidwa ndi kuchuluka kwa kayendedwe kazinthu zamagetsi ndikuwonjezera kuyamwa kwa glucose ndi minofu, kukondoweza kwa lipogenesis, glycogenogeneis, ndi kuchepa kwa kuchuluka kwa kupanga kwa chiwindi ndi chiwindi.

Insulin aspart ndi insulin yaumunthu imakhala ndi zochitika zofanana mu molar ofanana.

Insulin aspart imatengeka kuchokera subcutaneous adipose minofu mwachangu komanso mwachangu kuposa zochita za sungunuka wa insulin.

Kutalika kwa nthawi ya insulin aspart pambuyo pa sc ndi ocheperako ngati sungunuka wa munthu.

Mndandanda wazofananira

Tcherani khutu! Mndandandandawu umakhala ndi mawu ofanana a Insulin aspart, omwe ali ndi mawonekedwe ofanana, motero mutha kusankha nokha m'malo mwake, mukumaganizira mawonekedwe ndi mankhwalawa a mankhwalawa omwe adotchulidwa ndi dokotala. Perekani zokonda kwa opanga ku USA, Japan, Western Europe, komanso makampani odziwika bwino ochokera ku Eastern Europe: Krka, Gideon Richter, Actavis, Aegis, Lek, Hexal, Teva, Zentiva.

Zotsatira Za Alendo

Alendo asanu adanenanso zakudya za tsiku ndi tsiku

Kodi ndiyenera kumwa mankhwalawa kangati?
Ambiri omwe amayankhidwa nthawi zambiri amamwa mankhwalawa katatu patsiku. Ripotilo likuwonetsa kuti anthu ena omwe amayankha mankhwalawa amamwa mankhwalawa kangati.

Mamembala	%
Katatu patsiku	2	40.0%
4 pa tsiku	2	40.0%
2 pa tsiku	1	20.0%

Alendo asanu adafotokoza

Mamembala	%
1-5mg	3	60.0%
11-50mg	1	20.0%
51-100mg	1	20.0%

Mlendo wina adanenapo za tsiku lotha ntchito

Zimatenga nthawi yayitali bwanji kuti munthu atenge insulin aspart kuti amve bwino?
Ochita kafukufuku mu nthawi zambiri atatha sabata limodzi adasintha. Koma izi sizingafanane ndi nthawi yomwe musinthe. Funsani dokotala wanu kuti mupeze mankhwalawa kwa nthawi yayitali bwanji. Gome ili pansipa likuwonetsa zotsatira za kafukufuku pa zoyambira kuchitapo kanthu.

Mlendo wina adafotokoza za nthawi yokumana

Ndi nthawi yanji ndibwino kuti mumwa mankhwala a insulin: pamimba yopanda kanthu, musanayambe kudya kapena mutatha kudya?
Ogwiritsa ntchito mawebusayiti nthawi zambiri amapereka lipoti la kumwa mankhwalawa mukatha kudya. Komabe, adotolo atha kuvomereza nthawi ina. Ripotilo likuwonetsa pamene ena onse omwe adawafunsidwa amamwa mankhwalawo.

Dzina lamalonda ndi mawonekedwe omasulira

Aspart imapangidwa zonse zabwino komanso ngati gawo lokonzekera zovuta. Pali mitundu ingapo yamomwe mulingo wothandizila ndi insulin aspart. Dzina lazamalonda limatengera mawonekedwe ndi mankhwalawo.

Mtundu	Chizindikiro	Kutulutsa Fomu
Gawo limodzi	NovoRapid® Penfill®	Zowongolera ma cartridge
	NovoRapid® Flexpen ®	Cholembera
Biphasic	NovoMix® 30 Penfill®	Zowongolera ma cartridge
	NovoMix® 30 FlexPen ®	Cholembera
	Ryzodeg Pen Penfill ®	Zowongolera ma cartridge
	Risedeg® FlexTouch ®	Cholembera

Chizindikiro ichi ndi cha kampani ya Danish Novo Nordisk.

Malangizo ogwiritsira ntchito

Njira yogwiritsira ntchito ndi Mlingo wa mankhwalawa zimatengera mtundu wa matenda, mtundu wa matenda, kupezeka kwa matendawa ndi kuchuluka kwa odwala.

• Majakisoni amayikidwa pang'onopang'ono (m'mizere yamafuta), popeza insulin yochepa pang'ono imataya katundu wake ndipo imatulutsa msanga m'thupi, ndi jekeseni wamitsempha.
• Masamba a jakisoni amayenera kusinthidwa pafupipafupi, chifukwa mafuta amatha kupanga mu mafuta.
• Madera a Lipodystrophic,
• Singano sikulimbikitsidwa kuti igwiritsidwenso ntchito pofuna kupewa matenda.

Momwe mungagwiritsire ntchito insulin aspart? Malangizo ogwiritsira ntchito ali ndi malangizo osiyanasiyana am'magawo awiri komanso mankhwala a gawo limodzi.

Kugwiritsa ntchito gawo limodzi la aspart

Woimira gulu ili la mankhwala a hypoglycemic ndi NovoRapid. Ndi mankhwala osokoneza bongo omwe ali ndi nthawi yochepa. Mphamvu ya glycemic imawonekera pambuyo pa mphindi 10-20, atatha kubaya jekeseni kapena kulowetsedwa. Kuchuluka kwake kumawonedwa pambuyo pa mphindi 40 ndipo pang'onopang'ono kumachepa, kufikira osachepera maola 5.

Kusungitsa glycemia wabwinobwino, popanda magawo a kuchuluka kapena kuchepa kwa shuga (kunja kwa magawo abwinobwino), kuwunikira mosamala kuchuluka kwa shuga m'magazi ndikofunikira.

Imachitika pogwiritsa ntchito njira zotsatirazi:

Muyeso uyenera kumwedwa musanadye komanso mutamaliza kudya. Kuwerengera molondola kwa mlingo umodzi wa mankhwalawa, kuchuluka kwa shuga musanadye chakudya kumaganiziridwa, ndipo mfundo za pambuyo pake zimagwiritsidwa ntchito kukonza zizindikiro.

NovoRapid imayendetsedwa pang'onopang'ono pogwiritsa ntchito syringe ya insulin ya U 100, cholembera kapena pampu ya insulin. Kuwongolera kwa intraven kumaloledwa kokha ndi ogwira ntchito oyenerera azachipatala, pazoyang'anira mwadzidzidzi. Kuchuluka kwa mayunitsi a jekeseni amodzi a mankhwala amatsimikiziridwa ndi dokotala.

Kufunikira kwa tsiku ndi tsiku kumawerengeredwa payekhapayekha, kutengera mphamvu ya wodwalayo komanso kulemera kwa thupi. Zofunikira masiku onse zili mumtundu wa 0,5-1 ED / kg pa thupi. Simungathe kulowa muyezo wa tsiku ndi tsiku wa aspart nthawi yomweyo, chifukwa izi zimabweretsa hypoglycemia ndi chikomokere. Mlingo umodzi umawerengeredwa payokha pachakudya chilichonse chomanga thupi.

LAPANI ZOTSATIRA! Kuwerengera limodzi mlingo wa NovoRapid kumachitika poganizira zigawo za mkate (XE) zomwe zimadyedwa mukamadya.

Kufunika kwakanthawi kothana ndi insulin kumadalira mphamvu ya thupi ndi ntchito, komanso nthawi ya tsiku. M'mawa m'mawa, kufunikira kumatha kuwonjezeka, ndipo pambuyo polimbitsa thupi kwambiri kapena madzulo - amatha kuchepa.

Kugwiritsa ntchito biphasic aspart

NovoMix (woimira biphasic aspart) amagwiritsidwa ntchito kwa odwala omwe ali ndi matenda amtundu wa 2. Mlingo woyenera, kumayambiriro kwa mankhwala, ndi magawo 12, omwe amaperekedwa madzulo, asanadye. Kuti mupeze zotsatira zoyendetsedwa bwino, akuyenera kugawa gawo limodzi mumagawo awiri. Ndi mawu oyambira, amaika magawo 6 a NovoMix asanadye chakudya cham'mawa komanso madzulo, komanso asanakadye.

Makina okhazikika a biphasic aspart okha ndi omwe amaloledwa. Kuti muthane ndi kuchuluka kwa shuga ndikusintha kwa mankhwalawa, ndikofunikira kuyeza kuchuluka kwa magazi. Kusintha kwa Mlingo kumachitika pambuyo pakupanga dongosolo la mbiri yanu, poganizira kuthamanga kwa shuga (m'mawa, pamimba yopanda kanthu), kwa masiku atatu.

Mtengo ndi fanizo

Mtengo wa mankhwalawa umatengera mawonekedwe omwe insulin aspart imapangidwira. Mtengo wa mankhwala osokoneza bongo ndi ma analogu akuwonetsedwa patebulopo.

Mutu	Kutulutsa Fomu	Mtengo wapakati, pakani.
NovoRapid® Penfill®	3 ml / 5 ma PC	1950
NovoRapid® Flexpen ®		1700
NovoMix® 30 FlexPen ®		1800
Apidra SoloStar		2100
Biosulin		1100

Ma Analogs a aspart ali ndi vuto lofananalo, koma amapangidwa pamaziko a zinthu zina zomwe zimagwira ntchito. Mankhwalawa amapangidwira kuti apatsidwe mankhwala.

Insulin aspart ndi wothandizira wa hypoglycemic. Ilibe kuchuluka kwakukulu kwa contraindication ndipo imagwiritsidwa ntchito ngati gawo la zovuta kuchiza matenda a shuga mellitus, mitundu yonse iwiri. Mankhwalawa ndi oyenera ana ndi akulu, komanso okalamba.

Zotsatira zoyipa:

Zotsatira zoyipa zomwe zimawoneka mwa odwala omwe amagwiritsa ntchito NovoRapid® Penfill ® zimachitika makamaka chifukwa cha kupangika kwa mankhwala a insulin.
Chotsatira chovuta kwambiri ndi hypoglycemia. Zotsatira zoyipa zimasiyanasiyana malinga ndi kuchuluka kwa odwala, ma regimen regimen, ndi kayendedwe ka glycemic (onani gawo pansipa).
Pa gawo loyambirira la insulin, zolakwika zotupa, edema ndi zochita zake zimatha kupezeka pamalo a jakisoni (kupweteka, kufiyira, ming'oma, kutupa, hematoma, kutupa ndi kuyabwa pamalowo jakisoni. Zizindikirozi nthawi zambiri zimakhala zachilendo mwachilengedwe. 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.

Kusokonezeka Kwa Magazi	Kanthawi kochepa - Ming'oma, totupa pakhungu, zotupa pakhungu
Osowa kwambiri - Anaphylactic reaction *
Matenda a metabolism komanso zakudya	Nthawi zambiri - Hypoglycemia *
Kusokonezeka kwamanjenje	Nthawi zambiri - zotumphukira neuropathy ("ululu wammbuyo"
Kuphwanya gawo la masomphenyawo	Nthawi zambiri - kuphwanya Refraction
Nthawi zambiri - matenda ashuga retinopathy
Kusokonezeka kwa khungu ndi minofu yolowerera	Nthawi zambiri - lipodystrophy *
Zovuta ndi zovuta zina pamalo a jakisoni	Nthawi zambiri - zimachitika malo jakisoni
Nthawi zambiri - edema

* Onani "Kufotokozera kwamachitidwe amodzi osiyana"
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 ngati: pafupipafupi (≥ 1/10), nthawi zambiri (≥ 1/100 mpaka. Kupita kwa pharmacological - hypoglycemic.

Imakhudzana ndi ma receptor ena a cytoplasmic nembanemba yama cell ndikupanga insulini-receptor zovuta zomwe zimapangitsa njira zina, kuphatikizira kaphatikizidwe angapo ofunikira a michere (hexokinase, pyruvate kinase, glycogen synthetase). Kuchepa kwa kuchuluka kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa kayendedwe ka intracellular, kuchuluka kwa minofu ndi minyewa ya adipose, 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 sc makonzedwe, zotsatira zake zimachitika pambuyo pa mphindi 10 mpaka 20, mphamvu yayikulu - pambuyo pa maola 1-4, nthawi yochitapo - mpaka maola 24 (kutengera mlingo, malo oyendetsera, kutsika kwa magazi, kutentha kwa thupi ndi kuchuluka kwa zochitika zolimbitsa thupi).

Mukamayambitsa kukhazikitsa mlingo wa 0,2 PESCES / kg ya kulemera kwa thupi T max - mphindi 60 Kumangiriza kwa mapuloteni amwazi ndikochepa (0-9%).The seramu insulin ndende amabwerera zakale pambuyo 15-18 maola.

Kuchita

Thupi silimayenderana ndi mankhwala osiyanasiyana.

Malonda ogulitsa

Palibe njira yofunikira.

Malo osungira

Malangizo apadera

Pakutentha kwa nthawi yayitali, mankhwalawa amawola ndipo amasiya kukoma.

Kuchepetsa thupi

E951 Nthawi zambiri amaphatikizidwa ndi zakumwa zakumwa. Ndi chida ichi mutha kuwongolera kunenepa.

Pa mimba ndi mkaka wa m`mawere

Zokonzekera zomwe zili ndi (Analogs)

Katunduyu amalembetsedwa m'mazina otsatsa awa: Sugafri, AminoSweet, Spoonful, NutraSweet, Canderel.

Ndondomeko za insulin aspart ya mankhwalawa imaperekedwa, molingana ndi mawu omasulira azachipatala, omwe amatchedwa "ma syonyms" - mankhwala osinthika omwe ali ndi chinthu chimodzi kapena zingapo zomwe zimagwira ntchito motsatira thupi. Mukamasankha mawu ofananitsa, osangoganizira mtengo wawo, komanso dziko lakapangidwe ndi mbiri ya wopanga.

Kufotokozera za mankhwalawa

Imalumikizana ndi cholandirira chapadera pa cell ya cytoplasmic maselo ndikupanga insulini-receptor zovuta zomwe zimapangitsanso njira zina, kuphatikizapo kaphatikizidwe angapo ofunikira a michere (hexokinase, pyruvate kinase, glycogen synthetase). Mphamvu ya hypoglycemic imalumikizidwa ndi kuchuluka kwa kayendedwe kazinthu zamagetsi ndikuwonjezera kuyamwa kwa glucose ndi minofu, kukondoweza kwa lipogenesis, glycogenogeneis, ndi kuchepa kwa kuchuluka kwa kupanga kwa chiwindi ndi chiwindi.

Insulin aspart ndi insulin yaumunthu imakhala ndi zochitika zofanana mu molar ofanana.

Insulin aspart imatengeka kuchokera subcutaneous adipose minofu mwachangu komanso mwachangu kuposa zochita za sungunuka wa insulin.

Kutalika kwa nthawi ya insulin aspart pambuyo pa sc ndi ocheperako ngati sungunuka wa munthu.

Mndandanda wazofananira

Tcherani khutu! Mndandandandawu umakhala ndi mawu ofanana a Insulin aspart, omwe ali ndi mawonekedwe ofanana, motero mutha kusankha nokha m'malo mwake, mukumaganizira mawonekedwe ndi mankhwalawa a mankhwalawa omwe adotchulidwa ndi dokotala. Perekani zokonda kwa opanga ku USA, Japan, Western Europe, komanso makampani odziwika bwino ochokera ku Eastern Europe: Krka, Gideon Richter, Actavis, Aegis, Lek, Hexal, Teva, Zentiva.

Zotsatira Za Alendo

Mlendo wina adafotokoza zomwe zidachitika

Mlendo wina adafotokoza za kuyerekeza mtengo

Mamembala	%
Zodula	1	100.0%

Alendo asanu adanenanso zakudya za tsiku ndi tsiku

Kodi ndiyenera kumwa mankhwalawa kangati?
Ambiri omwe amayankhidwa nthawi zambiri amamwa mankhwalawa katatu patsiku. Ripotilo likuwonetsa kuti anthu ena omwe amayankha mankhwalawa amamwa mankhwalawa kangati.

Mamembala	%
Katatu patsiku	2	40.0%
4 pa tsiku	2	40.0%
2 pa tsiku	1	20.0%

Alendo asanu adafotokoza

Mamembala	%
1-5mg	3	60.0%
11-50mg	1	20.0%
51-100mg	1	20.0%

Mlendo wina adanenapo za tsiku lotha ntchito

Zimatenga nthawi yayitali bwanji kuti munthu atenge insulin aspart kuti amve bwino?
Ochita kafukufuku mu nthawi zambiri atatha sabata limodzi adasintha. Koma izi sizingafanane ndi nthawi yomwe musinthe. Funsani dokotala wanu kuti mupeze mankhwalawa kwa nthawi yayitali bwanji. Gome ili pansipa likuwonetsa zotsatira za kafukufuku pa zoyambira kuchitapo kanthu.

Mlendo wina adafotokoza za nthawi yokumana

Ndi nthawi yanji ndibwino kuti mumwa mankhwala a insulin: pamimba yopanda kanthu, musanayambe kudya kapena mutatha kudya?
Ogwiritsa ntchito mawebusayiti nthawi zambiri amapereka lipoti la kumwa mankhwalawa mukatha kudya. Komabe, adotolo atha kuvomereza nthawi ina. Ripotilo likuwonetsa pamene ena onse omwe adawafunsidwa amamwa mankhwalawo.

Alendo atatu adafotokoza zaka za odwala

Alendo amawunika

Palibe ndemanga pano.

Malangizo ovomerezeka ogwiritsa ntchito

NOVORAPID P PENFill ® (NOVORAPID P PENFill ®)

Nambala yolembetsa:

Fomu ya Mlingo:

Gulu la Pharmacotherapeutic:

Katundu

Zisonyezero zogwiritsidwa ntchito:

Zoyipa:

Mlingo ndi makonzedwe:

Zotsatira zoyipa:

Zotsatira zoyipa zomwe zimawoneka mwa odwala omwe amagwiritsa ntchito NovoRapid® Penfill ® zimachitika makamaka chifukwa cha kupangika kwa mankhwala a insulin.
Chotsatira chovuta kwambiri ndi hypoglycemia. Zotsatira zoyipa zimasiyanasiyana malinga ndi kuchuluka kwa odwala, ma regimen regimen, ndi kayendedwe ka glycemic (onani gawo pansipa).
Pa gawo loyambirira la insulin, zolakwika zotupa, edema ndi zochita zake zimatha kupezeka pamalo a jakisoni (kupweteka, kufiyira, ming'oma, kutupa, hematoma, kutupa ndi kuyabwa pamalowo jakisoni. Zizindikirozi nthawi zambiri zimakhala zachilendo mwachilengedwe. 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.

Kusokonezeka Kwa Magazi	Kanthawi kochepa - Ming'oma, totupa pakhungu, zotupa pakhungu
Osowa kwambiri - Anaphylactic reaction *
Matenda a metabolism komanso zakudya	Nthawi zambiri - Hypoglycemia *
Kusokonezeka kwamanjenje	Nthawi zambiri - zotumphukira neuropathy ("ululu wammbuyo"
Kuphwanya gawo la masomphenyawo	Nthawi zambiri - kuphwanya Refraction
Nthawi zambiri - matenda ashuga retinopathy
Kusokonezeka kwa khungu ndi minofu yolowerera	Nthawi zambiri - lipodystrophy *
Zovuta ndi zovuta zina pamalo a jakisoni	Nthawi zambiri - zimachitika malo jakisoni
Nthawi zambiri - edema

* Onani "Kufotokozera kwamachitidwe amodzi osiyana"
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 ngati: pafupipafupi (≥ 1/10), nthawi zambiri (≥ 1/100 mpaka. Kupita kwa pharmacological - hypoglycemic.

Imakhudzana ndi ma receptor ena a cytoplasmic nembanemba yama cell ndikupanga insulini-receptor zovuta zomwe zimapangitsa njira zina, kuphatikizira kaphatikizidwe angapo ofunikira a michere (hexokinase, pyruvate kinase, glycogen synthetase). Kuchepa kwa kuchuluka kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa kayendedwe ka intracellular, kuchuluka kwa minofu ndi minyewa ya adipose, 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 sc makonzedwe, zotsatira zake zimachitika pambuyo pa mphindi 10 mpaka 20, mphamvu yayikulu - pambuyo pa maola 1-4, nthawi yochitapo - mpaka maola 24 (kutengera mlingo, malo oyendetsera, kutsika kwa magazi, kutentha kwa thupi ndi kuchuluka kwa zochitika zolimbitsa thupi).

Mukamayambitsa kukhazikitsa mlingo wa 0,2 PESCES / kg ya kulemera kwa thupi T max - mphindi 60 Kumangiriza kwa mapuloteni amwazi ndikochepa (0-9%). The seramu insulin ndende amabwerera zakale pambuyo 15-18 maola.

Kugwiritsa ntchito mankhwala a insulin aspart biphasic

Mtundu woyamba wa matenda a shuga 1. Mellitus wa mtundu 2 wa matenda osokoneza bongo omwe amatsutsa pakamwa.

Contraindication

Zoletsa ntchito

Zaka mpaka zaka 18 (chitetezo ndi kufunikira sizotsimikizika).

Mimba komanso kuyamwa

Maphunziro a kubereka nyama pogwiritsa ntchito insulin aspart biphasic sanachitike. Komabe, maphunziro owonetsa poizoni, komanso kuphunzira kwa teratogenicity mu makoswe ndi akalulu omwe ali ndi sc management of insulin (insulin aspart ndi insulin yachibadwa yamunthu) adawonetsa kuti, kwakukulu, zotsatira za ma insulin sizosiyana. Insulin aspart, ngati insulin ya anthu, pamiyeso yopitilira kukonzedwa kwa anthu mwa maulendo 32 (makoswe) ndi katatu, (akalulu), amachititsa kuwonongeka koyamba komanso pambuyo pake, komanso kuvulala kwamitsempha / mafupa. Mlingo wambiri kuposa momwe amakonzera makina osachepera 8 (makoswe) kapena pafupifupi wofanana ndi Mlingo wa anthu (akalulu), palibe zotsatira zazikulu.

Gwiritsani ntchito panthawi yomwe muli ndi pakati ndikotheka ngati chithandizo chamankhwala chikuyembekezeka kupitilira chiwopsezo cha mwana wosabadwayo (maphunziro okwanira komanso okhwima omwe sanachitike). Sizikudziwika ngati insulin aspart biphasic imatha kukhala ndi mphamvu ya embryotoxic ikagwiritsidwa ntchito panthawi yapakati komanso ngati ikukhudzanso kubereka.

Munthawi ya kuyambika kwa kutenga pakati komanso nthawi yonseyo, ndikofunikira kuyang'anitsitsa momwe odwala omwe ali ndi matenda osokoneza bongo amayang'anira ndi kuchuluka kwa shuga m'magazi. Kufunika kwa insulini, monga lamulo, kumachepa mu trimester yoyamba ndipo pang'onopang'ono kumawonjezeka muyezo wachiwiri komanso wachitatu wamapazi oyembekezera.

Panthawi yobereka komanso pambuyo pawo, kufunika kwa insulini kumatha kuchepa kwambiri, koma mwachangu amabwerera pamlingo womwe unali usanachitike mimba.

Sizikudziwika ngati mankhwalawo amadutsa mkaka wa m'mawere. Panthawi yoyamwa, pakhoza kufunikira kusintha kwa mlingo.

Zotsatira zoyipa za mankhwala Insulin aspart biphasic

Edema ndi zolakwika zotupa (kumayambiriro kwa chithandizo), matupi awo sagwirizana (hyperemia, kutupa, kuyabwa kwa khungu pamalo opaka jekeseni), zotupa zonse (zotupa pakhungu, kuyabwa, kutuluka thukuta, kuphwanya m'mimba, kutsekeka kwa magazi, kuchepa kwa magazi, angioedema edema), lipodystrophy pamalo opangira jekeseni.

Kuchita

Oral hypoglycemic mankhwala, mao inhibitors, ACE inhibitors, carbonic anhydrase inhibitors, bromocriptine, somatostatin analogs (octreotide), sulfanilamides, anabolic steroids, tetracyclines, phenoxyfenfilfindofilfinfilofinfilininfinfinfinfinfinogulinfluin ikulengedwera mapuloteni a insulin. mankhwala a ethanol ndi ethanol.

Kulera kwapakamwa, glucocorticoids, mahomoni a chithokomiro, thiazide diuretics, heparin, tridclic antidepressants, sympathomimetics, danazole, BKK, diazoxide, morphine, phenytoin, nikotini zimafooketsa mphamvu ya hypoglycemic ya insulin. Mothandizidwa ndi beta-blockers, clonidine, lithiamu kukonzekera, reserpine ndi salicylates, zonse zofooketsa komanso kuwonjezeka kwa kuchitapo kanthu ndizotheka.

Bongo

Palibe umboni wa kuchuluka kwa mankhwalawa. Amakhulupirira kuti kugwiritsa ntchito tsiku lililonse mankhwala akuluakulu kungachititse kuti neoplasms yoyipakapena matenda ashuga.

Kuchita

Thupi silimayenderana ndi mankhwala osiyanasiyana.

Malonda ogulitsa

Palibe njira yofunikira.

Malo osungira

Malangizo apadera

Pakutentha kwa nthawi yayitali, mankhwalawa amawola ndipo amasiya kukoma.

Kuchepetsa thupi

E951 Nthawi zambiri amaphatikizidwa ndi zakumwa zakumwa. Ndi chida ichi mutha kuwongolera kunenepa.

Pa mimba ndi mkaka wa m`mawere

Zokonzekera zomwe zili ndi (Analogs)

Katunduyu amalembetsedwa m'mazina otsatsa awa: Sugafri, AminoSweet, Spoonful, NutraSweet, Canderel.

Ndondomeko za insulin aspart ya mankhwalawa imaperekedwa, molingana ndi mawu omasulira azachipatala, omwe amatchedwa "ma syonyms" - mankhwala osinthika omwe ali ndi chinthu chimodzi kapena zingapo zomwe zimagwira ntchito motsatira thupi. Mukamasankha mawu ofananitsa, osangoganizira mtengo wawo, komanso dziko lakapangidwe ndi mbiri ya wopanga.

Kufotokozera za mankhwalawa

Imalumikizana ndi cholandirira chapadera pa cell ya cytoplasmic maselo ndikupanga insulini-receptor zovuta zomwe zimapangitsanso njira zina, kuphatikizapo kaphatikizidwe angapo ofunikira a michere (hexokinase, pyruvate kinase, glycogen synthetase). Mphamvu ya hypoglycemic imalumikizidwa ndi kuchuluka kwa kayendedwe kazinthu zamagetsi ndikuwonjezera kuyamwa kwa glucose ndi minofu, kukondoweza kwa lipogenesis, glycogenogeneis, ndi kuchepa kwa kuchuluka kwa kupanga kwa chiwindi ndi chiwindi.

Insulin aspart ndi insulin yaumunthu imakhala ndi zochitika zofanana mu molar ofanana.

Insulin aspart imatengeka kuchokera subcutaneous adipose minofu mwachangu komanso mwachangu kuposa zochita za sungunuka wa insulin.

Kutalika kwa nthawi ya insulin aspart pambuyo pa sc ndi ocheperako ngati sungunuka wa munthu.

Mndandanda wazofananira

Tcherani khutu! Mndandandandawu umakhala ndi mawu ofanana a Insulin aspart, omwe ali ndi mawonekedwe ofanana, motero mutha kusankha nokha m'malo mwake, mukumaganizira mawonekedwe ndi mankhwalawa a mankhwalawa omwe adotchulidwa ndi dokotala. Perekani zokonda kwa opanga ku USA, Japan, Western Europe, komanso makampani odziwika bwino ochokera ku Eastern Europe: Krka, Gideon Richter, Actavis, Aegis, Lek, Hexal, Teva, Zentiva.

Zotsatira Za Alendo

Mlendo wina adafotokoza zomwe zidachitika

Mlendo wina adafotokoza za kuyerekeza mtengo

Mamembala	%
Zodula	1	100.0%

Alendo asanu adanenanso zakudya za tsiku ndi tsiku

Kodi ndiyenera kumwa mankhwalawa kangati?
Ambiri omwe amayankhidwa nthawi zambiri amamwa mankhwalawa katatu patsiku. Ripotilo likuwonetsa kuti anthu ena omwe amayankha mankhwalawa amamwa mankhwalawa kangati.

Mamembala	%
Katatu patsiku	2	40.0%
4 pa tsiku	2	40.0%
2 pa tsiku	1	20.0%

Alendo asanu adafotokoza

Mamembala	%
1-5mg	3	60.0%
11-50mg	1	20.0%
51-100mg	1	20.0%

Mlendo wina adanenapo za tsiku lotha ntchito

Zimatenga nthawi yayitali bwanji kuti munthu atenge insulin aspart kuti amve bwino?
Ochita kafukufuku mu nthawi zambiri atatha sabata limodzi adasintha. Koma izi sizingafanane ndi nthawi yomwe musinthe. Funsani dokotala wanu kuti mupeze mankhwalawa kwa nthawi yayitali bwanji. Gome ili pansipa likuwonetsa zotsatira za kafukufuku pa zoyambira kuchitapo kanthu.

Mlendo wina adafotokoza za nthawi yokumana

Ndi nthawi yanji ndibwino kuti mumwa mankhwala a insulin: pamimba yopanda kanthu, musanayambe kudya kapena mutatha kudya?
Ogwiritsa ntchito mawebusayiti nthawi zambiri amapereka lipoti la kumwa mankhwalawa mukatha kudya. Komabe, adotolo atha kuvomereza nthawi ina. Ripotilo likuwonetsa pamene ena onse omwe adawafunsidwa amamwa mankhwalawo.

Alendo atatu adafotokoza zaka za odwala

Alendo amawunika

Palibe ndemanga pano.

Malangizo ovomerezeka ogwiritsa ntchito

NOVORAPID P PENFill ® (NOVORAPID P PENFill ®)

Nambala yolembetsa:

Fomu ya Mlingo:

Gulu la Pharmacotherapeutic:

Katundu

Zisonyezero zogwiritsidwa ntchito:

Zoyipa:

Mlingo ndi makonzedwe:

Zotsatira zoyipa:

Zotsatira zoyipa zomwe zimawoneka mwa odwala omwe amagwiritsa ntchito NovoRapid® Penfill ® zimachitika makamaka chifukwa cha kupangika kwa mankhwala a insulin.
Chotsatira chovuta kwambiri ndi hypoglycemia. Zotsatira zoyipa zimasiyanasiyana malinga ndi kuchuluka kwa odwala, ma regimen regimen, ndi kayendedwe ka glycemic (onani gawo pansipa).
Pa gawo loyambirira la insulin, zolakwika zotupa, edema ndi zochita zake zimatha kupezeka pamalo a jakisoni (kupweteka, kufiyira, ming'oma, kutupa, hematoma, kutupa ndi kuyabwa pamalowo jakisoni. Zizindikirozi nthawi zambiri zimakhala zachilendo mwachilengedwe. 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.

Kusokonezeka Kwa Magazi	Kanthawi kochepa - Ming'oma, totupa pakhungu, zotupa pakhungu
Osowa kwambiri - Anaphylactic reaction *
Matenda a metabolism komanso zakudya	Nthawi zambiri - Hypoglycemia *
Kusokonezeka kwamanjenje	Nthawi zambiri - zotumphukira neuropathy ("ululu wammbuyo"
Kuphwanya gawo la masomphenyawo	Nthawi zambiri - kuphwanya Refraction
Nthawi zambiri - matenda ashuga retinopathy
Kusokonezeka kwa khungu ndi minofu yolowerera	Nthawi zambiri - lipodystrophy *
Zovuta ndi zovuta zina pamalo a jakisoni	Nthawi zambiri - zimachitika malo jakisoni
Nthawi zambiri - edema

* Onani "Kufotokozera kwamachitidwe amodzi osiyana"
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 ngati: pafupipafupi (≥ 1/10), nthawi zambiri (≥ 1/100 mpaka. Kupita kwa pharmacological - hypoglycemic.

Imakhudzana ndi ma receptor ena a cytoplasmic nembanemba yama cell ndikupanga insulini-receptor zovuta zomwe zimapangitsa njira zina, kuphatikizira kaphatikizidwe angapo ofunikira a michere (hexokinase, pyruvate kinase, glycogen synthetase). Kuchepa kwa kuchuluka kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa kayendedwe ka intracellular, kuchuluka kwa minofu ndi minyewa ya adipose, 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 sc makonzedwe, zotsatira zake zimachitika pambuyo pa mphindi 10 mpaka 20, mphamvu yayikulu - pambuyo pa maola 1-4, nthawi yochitapo - mpaka maola 24 (kutengera mlingo, malo oyendetsera, kutsika kwa magazi, kutentha kwa thupi ndi kuchuluka kwa zochitika zolimbitsa thupi).

Mukamayambitsa kukhazikitsa mlingo wa 0,2 PESCES / kg ya kulemera kwa thupi T max - mphindi 60 Kumangiriza kwa mapuloteni amwazi ndikochepa (0-9%). The seramu insulin ndende amabwerera zakale pambuyo 15-18 maola.

Kugwiritsa ntchito mankhwala a insulin aspart biphasic

Mtundu woyamba wa matenda a shuga 1. Mellitus wa mtundu 2 wa matenda osokoneza bongo omwe amatsutsa pakamwa.

Contraindication

Zoletsa ntchito

Zaka mpaka zaka 18 (chitetezo ndi kufunikira sizotsimikizika).

Mimba komanso kuyamwa

Maphunziro a kubereka nyama pogwiritsa ntchito insulin aspart biphasic sanachitike. Komabe, maphunziro owonetsa poizoni, komanso kuphunzira kwa teratogenicity mu makoswe ndi akalulu omwe ali ndi sc management of insulin (insulin aspart ndi insulin yachibadwa yamunthu) adawonetsa kuti, kwakukulu, zotsatira za ma insulin sizosiyana.Insulin aspart, ngati insulin ya anthu, pamiyeso yopitilira kukonzedwa kwa anthu mwa maulendo 32 (makoswe) ndi katatu, (akalulu), amachititsa kuwonongeka koyamba komanso pambuyo pake, komanso kuvulala kwamitsempha / mafupa. Mlingo wambiri kuposa momwe amakonzera makina osachepera 8 (makoswe) kapena pafupifupi wofanana ndi Mlingo wa anthu (akalulu), palibe zotsatira zazikulu.

Gwiritsani ntchito panthawi yomwe muli ndi pakati ndikotheka ngati chithandizo chamankhwala chikuyembekezeka kupitilira chiwopsezo cha mwana wosabadwayo (maphunziro okwanira komanso okhwima omwe sanachitike). Sizikudziwika ngati insulin aspart biphasic imatha kukhala ndi mphamvu ya embryotoxic ikagwiritsidwa ntchito panthawi yapakati komanso ngati ikukhudzanso kubereka.

Munthawi ya kuyambika kwa kutenga pakati komanso nthawi yonseyo, ndikofunikira kuyang'anitsitsa momwe odwala omwe ali ndi matenda osokoneza bongo amayang'anira ndi kuchuluka kwa shuga m'magazi. Kufunika kwa insulini, monga lamulo, kumachepa mu trimester yoyamba ndipo pang'onopang'ono kumawonjezeka muyezo wachiwiri komanso wachitatu wamapazi oyembekezera.

Panthawi yobereka komanso pambuyo pawo, kufunika kwa insulini kumatha kuchepa kwambiri, koma mwachangu amabwerera pamlingo womwe unali usanachitike mimba.

Sizikudziwika ngati mankhwalawo amadutsa mkaka wa m'mawere. Panthawi yoyamwa, pakhoza kufunikira kusintha kwa mlingo.

Zotsatira zoyipa za mankhwala Insulin aspart biphasic

Edema ndi zolakwika zotupa (kumayambiriro kwa chithandizo), matupi awo sagwirizana (hyperemia, kutupa, kuyabwa kwa khungu pamalo opaka jekeseni), zotupa zonse (zotupa pakhungu, kuyabwa, kutuluka thukuta, kuphwanya m'mimba, kutsekeka kwa magazi, kuchepa kwa magazi, angioedema edema), lipodystrophy pamalo opangira jekeseni.

Kuchita

Oral hypoglycemic mankhwala, mao inhibitors, ACE inhibitors, carbonic anhydrase inhibitors, bromocriptine, somatostatin analogs (octreotide), sulfanilamides, anabolic steroids, tetracyclines, phenoxyfenfilfindofilfinfilofinfilininfinfinfinfinfinogulinfluin ikulengedwera mapuloteni a insulin. mankhwala a ethanol ndi ethanol.

Kulera kwapakamwa, glucocorticoids, mahomoni a chithokomiro, thiazide diuretics, heparin, tridclic antidepressants, sympathomimetics, danazole, BKK, diazoxide, morphine, phenytoin, nikotini zimafooketsa mphamvu ya hypoglycemic ya insulin. Mothandizidwa ndi beta-blockers, clonidine, lithiamu kukonzekera, reserpine ndi salicylates, zonse zofooketsa komanso kuwonjezeka kwa kuchitapo kanthu ndizotheka.

Bongo

Zizindikiro hypoglycemia - "kuzizira" thukuta, kufooka kwa khungu, mantha, kunjenjemera, kuda nkhawa, kulefuka kwachilendo, kufooka, kusokonezeka kwa chidwi, chizungulire, kugona kwambiri, kusokonezeka kwakanthawi, mutu, nseru, tachycardia, kukokana, matenda amitsempha chikomokere.

Chithandizo: wodwalayo amatha kuyimitsa hypoglycemia yaying'ono pomwa shuga, shuga kapena zakudya zopatsa mphamvu. Woopsa milandu - mu / 40% dextrose yankho, mu / m, s / c - glucagon. Pambuyo pakupezanso chikumbumtima, wodwalayo akulimbikitsidwa kudya zakudya zamafuta ambiri kuti aletse kukonzanso kwa hypoglycemia.

Zinthu zofunika kusamala insulin

Simungathe kulowa iv. Mlingo wosakwanira kapena kusiya kulandira chithandizo (makamaka ndi matenda a shuga 1) kungayambitse kukula kwa hyperglycemia kapena matenda ashuga a ketoacidosis. Monga lamulo, hyperglycemia imadziwonekera pang'onopang'ono kwa maola angapo kapena masiku (zizindikiro za hyperglycemia: nseru, kusanza, kugona, khungu komanso kuyanika pakhungu, pakamwa pouma, mkodzo wowonjezera, ludzu komanso kusowa kwa chakudya, mawonekedwe a fungo la acetone mu mpweya wotulutsidwa), ndipo popanda chithandizo choyenera kumatha kupha.

Pambuyo kulipira kagayidwe kazakudya zakudya, mwachitsanzo, pakakulitsa mankhwala a insulin, odwala amatha kuona zizindikiro za matenda ena a hypoglycemia, omwe odwala amafunikira kudziwa. Odwala omwe ali ndi matenda ashuga omwe ali ndi vuto lalikulu la kagayidwe, zovuta za shuga zomwe zimachitika mochedwa zimayamba 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.

Mankhwala ayenera kugwiritsidwa ntchito mogwirizana ndi kudya. Ndikofunikira kuganizira kuthamanga kwazomwe kumayambira pakuchitika kwa mankhwalawa odwala omwe ali ndi matenda oyanjana kapena kumwa mankhwala omwe amachepetsa kuyamwa kwa chakudya. Pamaso pa matenda othandizira, makamaka a matenda opatsirana, kufunikira kwa insulin kumakulirakulira. Kuchepa kwa impso ndi / kapena chiwindi kungayambitse kuchepa kwa insulin. Kudumpha chakudya kapena masewera osakonzekera kungayambitse kukula kwa hypoglycemia.

Kusamutsa wodwala kupita ku mtundu wina wa insulin kapena kukonzekera kwa insulin ya wopanga wina kuyenera kuchitika moyang'aniridwa ndi achipatala, kusintha kwa mlingo kungafunike. Ngati ndi kotheka, kusintha kwa mankhwalawa kungapangidwe kale jekeseni woyamba wa mankhwalawa kapena mkati mwa milungu yoyamba kapena miyezi ya chithandizo. Kusintha kwa mlingo kungafunike ndikusintha kwa zakudya komanso kulimbitsa thupi kwambiri. Kuchita masewera olimbitsa thupi mutangotha ​​kudya kumakulitsa chiopsezo cha hypoglycemia.

Ndi chitukuko cha hypoglycemia kapena hyperglycemia, kuchepa kwa chidwi ndi kuthamanga kwazomwe zimachitika, zomwe zimatha kukhala zowopsa poyendetsa kapena kugwiritsa ntchito makina ndi makina. Odwala ayenera kulangizidwa kuti achitepo kanthu popewa kukula kwa hypoglycemia ndi hyperglycemia. Izi ndizofunikira kwambiri kwa odwala omwe alibe kapena kuchepa kwa zizindikiro zakutsogolo kwa hypoglycemia kapena akuvutika ndi zochitika zapafupipafupi za hypoglycemia.

Mukamagwiritsa ntchito mankhwala osokoneza bongo, ndikofunikira kuti mumvetsetse momwe angagwiritsire ntchito. Mankhwala aliwonse amatha kukhala ovulaza ngati atagwiritsidwa ntchito molakwika. Izi ndizowona makamaka kwa mankhwala omwe amagwiritsidwa ntchito mu ma pathologies omwe ali ndi chiopsezo chakufa.

Izi zikuphatikiza mankhwala opangidwa ndi insulin. Pakati pawo pali insulin yotchedwa Aspart. Muyenera kudziwa mawonekedwe a mahomoni, kotero kuti mankhwalawo amathandizanso kwambiri.

Zambiri

Dzina lazamalonda lamankhwala awa ndi NovoRapid. Ndiwachiwerengero cha ma insulin omwe amachitika mwachidule, amathandiza kuchepetsa kuchuluka kwa shuga m'magazi.

Madokotala amamulembera odwala omwe amadwala matenda a shuga. Yogwira ntchito ya mankhwala ndi insulin Aspart. Vutoli limafanana kwambiri ndi momwe limakhalira ndi mahomoni amunthu, ngakhale amapangidwa ndimapangidwe.

Aspart imapezeka mu mawonekedwe a yankho lomwe limayendetsedwa mosagwirizana kapena kudzera m'mitsetse. Ili ndi yankho la magawo awiri (soluble insulin Aspart ndi ma protein a protamine).

Kuphatikiza pazinthu zazikulu, pakati pazigawo zake zimatha kutchedwa:

• madzi
• phenol
• sodium kolorayidi
• glycerol
• hydrochloric acid
• sodium hydroxide
• zinc
• metacresol
• sodium hydrogen phosphate dihydrate.

Insulin Aspart imagawidwa mu mbale 10 ml. Kugwiritsidwa ntchito kwake kumaloledwa pokhapokha ngati wodwala akupita komanso mogwirizana ndi malangizo.

Mankhwala

Asparta ili ndi vuto la hypoglycemic. Zimachitika pamene gawo logwira ntchito limalumikizana ndi insulin receptors mumaselo a adipose minofu ndi minofu.

Izi zimathandizira kuthamanga kwa shuga pakati pama cell, omwe amachepetsa kuyika kwake m'magazi. Chifukwa cha mankhwalawa, minofu yamthupi imagwiritsa ntchito glucose mwachangu kwambiri.Chitsogozo china chokhudzana ndi mankhwalawa ndikuchepetsa njira yopanga shuga m'magazi.

Mankhwala amalimbikitsa glycogenogeneis ndi lipogeneis. Komanso, zikagwiritsidwa, mapuloteni amapangidwa mwachangu.

Amasiyanitsidwa ndi kufulumira. Jakisoni atapangidwa, ziwalo zomwe zimagwira ntchito zimatengedwa ndi maselo amisempha minofu. Njirayi imayamba mphindi 10-20 pambuyo pa kubayidwa. Zotsatira zamphamvu kwambiri zimatha kuchitika pambuyo pa maola 1.5-2. Kutalika kwa mankhwalawa nthawi yayitali pafupifupi maora 5.

Kuyanjana kwa mankhwala osokoneza bongo, bongo, analogi

Mukamamwa mankhwala aliwonse, ndikofunikira kudziwitsa adokotala za iwo, chifukwa mankhwala ena sayenera kugwiritsidwa ntchito limodzi.

Nthawi zina, kusamala kungafunike - kuwunikira ndi kuwunika pafupipafupi. Pangakhalebe pakufunika kusintha kwa mlingo.

Mlingo wa Aspart insulin uyenera kuchepetsedwa panthawi ya mankhwala ndi mankhwala monga:

• hypoglycemic mankhwala,
• mankhwala okhala ndi mowa
• anabolic steroids
• ACE zoletsa
• manzeru
• sulfonamides,
• Fenfluramine,
• Pyridoxine
• Theofylline.

Mankhwalawa amalimbikitsa ntchito ya mankhwala omwe amafunsidwa, chifukwa chake njira yogwiritsira ntchito shuga imakulitsidwa m'thupi la munthu. Ngati mlingo sunachepe, hypoglycemia imatha kuchitika.

Kuchepa kwa mphamvu ya mankhwalawa kumawonedwa ndikuphatikizidwa ndi njira zotsatirazi:

• thiopad
• amphanomachul
• Mitundu ina ya mankhwala ochepetsa nkhawa,
• mankhwala oletsa kubereka,
• glucocorticosteroids.

Mukamagwiritsa ntchito, kusintha kwa mlingo kumafunikira pamwamba.

Palinso mankhwala omwe amatha kuwonjezeka ndikuchepetsa mphamvu ya mankhwalawa. Izi zimaphatikizapo salicylates, beta-blockers, reserpine, mankhwala okhala ndi lifiyamu.

Nthawi zambiri ndalamazi zimayesetsa kusaphatikiza ndi Aspart insulin. Ngati kuphatikiza kotereku sikungapewedwe, onse dokotala ndi wodwala ayenera kusamala makamaka ndi zomwe zimachitika mthupi.

Ngati mankhwala osokoneza bongo, hypoglycemia ya zovuta zosiyanasiyana imachitika. Nthawi zina, maswiti okoma kapena supuni ya shuga amatha kuchepetsa zovuta zake.

Panthawi yovuta, wodwalayo amatha kuzindikira. Nthawi zina nthenda ya hypoglycemic imayamba. Kenako wodwalayo amafunikira chithandizo chamankhwala chothamanga komanso chapamwamba, apo ayi zotsatira zake zingakhale imfa yake.

Kufunika m'malo mwa Aspart kumatha kuchitika pazifukwa zosiyanasiyana: kusalolera, mavuto, kutsutsana kapena kuvuta kugwiritsa ntchito.

Dokotala amatha kusintha mankhwalawa pogwiritsa ntchito mankhwala otsatirawa:

1. Protafan . Maziko ake ndi insulin Isofan. Mankhwala ndi kuyimitsidwa komwe kuyenera kuperekedwa mwachangu.
2. Novomiks . Mankhwalawa amachokera ku insulin Aspart. Imakhazikitsidwa ngati kuyimitsidwa kwa makonzedwe pansi pa khungu.
3. Apidra . Mankhwala ndi yankho la jakisoni. Zomwe zimagwirira ntchito ndi insulin glulisin.

Kuphatikiza pa mankhwala omwe angathe kubayidwa, adokotala amatha kupatsa mankhwala osokoneza. Koma kusankha kuyenera kukhala kwa katswiri kuti pasakhale mavuto ena owonjezera paumoyo.

Pharmacology

Amamangirira ma insulin receptors pamisempha yamafuta ndi mafuta. Kutsika kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa kayendedwe kazinthu zamagalimoto, kugwiritsa ntchito minofu yambiri, komanso kuchepa kwa kuchuluka kwa shuga m'magazi. Kuchulukitsa kukula kwa lipogenesis ndi glycogenogeneis, kaphatikizidwe kazakudya. Pambuyo pa jekeseni wa sc, matulukidwewo amapezeka mkati mwa mphindi 10 mpaka 20, mumafika pazowonjezera pambuyo pa maola 1-3 ndipo mumatha maola 3-5.

Mwamsanga odzipereka kuchokera subcutaneous mafuta. Kulowetsedwa kwa amino acid proline pamalo a B28 omwe amakhala ndi spartic acid kumachepetsa ma molekyulu kuti apange hexamers, zomwe zimapangitsa kuti mayamwidwe ambiri (poyerekeza ndi insulin yamunthu wamba).Pambuyo pa utsogoleri wa s / c, T max ndi 40-50 mphindi, kumanga mapuloteni kumakhala kotsika kwambiri (0-9%), T 1/2 - maminiti 81.

Carcinogenicity, mutagenicity, zimabweretsa chonde

Maphunziro a biennial omwe amawunika kupezeka kwa insulin aspart sanachitike. Mu maphunziro a chaka chimodzi cha oncogenicity, makoswe a Sprague-Dawley adabayidwa sc mu insulin aspart pamiyeso ya 10, 50, ndi 200 unit / kg (pafupifupi 2, 8, ndi 32 kawiri mlingo wa anthu ataperekedwa). Zotsatira zake zinawonetsa kuti pa mlingo wa mayunitsi 200 / kg mwa akazi, kuchuluka kwa zotupa zam'mawere kumakhala kwakukulu poyerekeza ndi kuwongolera (izi zikuwoneka sizimasiyana kwenikweni ndi zomwe zimapezeka ndi insulin yachilendo yamunthu). Tanthauzo la zomwe zimapezeka kwa anthu sizikudziwika.

Mutagenicity wa insulin aspart sanapezeke mwa mayeso angapo a genotoxic (kuphatikiza mayeso a Ames, kuyesa kwa kusintha kwa majini m'maselo a lymphoma, kuyesa kwa kuchotsedwa kwa chromosome mu chikhalidwe cha anthu cha lymphocyte), ndipo mu vivo pa mayeso a micronucleus mu mbewa ndipo ex vivo pa mayeso a UDS (kaphatikizidwe ka DNA kosaphatikizika) pa hepatocytes ya rat.

Panalibe chovala chovuta mu makoswe amphongo ndi amuna pamiyeso ya spart insulini, pafupifupi 32 nthawi yomwe amalimbikitsa kumwa kwa sc.

The zikuchokera, kumasulidwa mawonekedwe ndi pharmacological kwenikweni

Biphasic insulin imaphatikiza Aspart yosungunuka ndi crystalline insulin protamine muyezo wa 30 mpaka 70%.

Uku ndi kuyimitsidwa kwa kachitidwe ka sc, kokhala ndi khungu loyera. Mililita imodzi imakhala ndi mayunitsi 100, ndipo ED imodzi imafanana ndi 35 mcg wa insulin Aspart.

Mafuta a insulin omwe amapanga munthu amapanga insulin receptor zovuta ndi receptor panja la cytoplasmic cell membrane. Otsatirawa adayambitsa kaphatikizidwe ka glycogen synthetase, pyruvate kinase ndi hexokinase michere.

Kuchepa kwa shuga kumachitika ndikuwonjezereka kwa mayendedwe amkati komanso kusintha kwa minofu. Hypoglycemia imapezekanso pakuchepetsa nthawi yotulutsidwa kwa shuga ndi chiwindi, glycogenogeneis ndi kutsegula kwa lipogenesis.

Biphasic insulin aspart imapezeka kudzera mu kubwezeretsa kwachilengedwenso pamene molekyulu ya proline ya mahomoni imaloŵedwa m'malo ndi aspartic acid. Ma insulin a biphasic oterowo amakhala ndi vuto lofanananso ndi glycosylated hemoglobin, monga insulin yaumunthu.

Mankhwala onse awiriwa amagwira ntchito molingana molar. Komabe, Aspart insulin imagwira ntchito mwachangu kuposa mahomoni amtundu wa anthu. A crystalline aspart ya protamine imakhudzanso nthawi yayitali.

Zochita pambuyo pazoyang'anira wothandizirazo zimatheka pambuyo mphindi 15. Kuphatikizika kwakukulu kwa mankhwalawa kumachitika patatha maola 1-4 pambuyo pa jekeseni. Kutalika kwa izi mpaka maola 24.

Mu seramu Cmax, insulin ndi 50% kuposa mukamagwiritsa ntchito insulin ya anthu. Komanso, nthawi yayitali kuti afike ku Cmax ndi ochepera theka.

T1 / 2 - mpaka maola 9, amawonetsa kuthamanga kwa kuyamwa kwa kachidutswa kamene kamakhala ndi protamine. Msuzi insulin amawona pambuyo 15-18 pambuyo kukhazikitsa.

Koma ndi matenda a shuga a mtundu wachiwiri, kupezeka kwa Cmax kuli pafupifupi mphindi 95. Amakhala pamalo ochepera 14 komanso pamwamba 0 pambuyo pa sc. Kaya dera loyang'anira likukhudza malo omwe kunyamulidwa sikunaphunzire.

Mlingo ndi makonzedwe

Nthawi zambiri insulin Degludek, Aspart. Jakisoni amapangidwa mbali zina za thupi:

Muyenera kupanga jakisoni wa insulin musanadye (njira yotsimikizika) kapena mutatha kudya chakudya (njira ya postprandial).

Algorithm ndi kuchuluka kwa makonzedwe amatsimikiziridwa ndi adokotala. Koma nthawi zambiri kuchuluka kwa mankhwalawa tsiku lililonse ndi 0,5-1 UNITS pa 1 kg yolemera.

Woopsa, insulin Aspart biphasic imayendetsedwa iv. Ndondomeko ikuchitika ntchito kulowetsedwa machitidwe mu outpatient kapena inpatient.

Zosiyanasiyana zimakhudzana, contraindications ndi mankhwala osokoneza bongo

Kugwiritsa ntchito insulin Asparta kungasokoneze ntchito ya National Assembly, popeza kusintha kwachilengedwe kwamphamvu kwa shuga nthawi zina kumayambitsa kupweteka kwamitsempha. Komabe, izi zimadutsa nthawi.

Komanso, insulin ya biphasic imatsogolera pakuwoneka kwa lipodystrophy mu gawo la jekeseni. Pa mbali ya ziwalo zam'malingaliro, kuwonongeka kwa mawonekedwe ndi zolakwika pakuzindikiritsa zimadziwika.

Contraindication ndi tsankho la munthu pazigawo za mankhwala ndi hypoglycemia.

Kuphatikiza apo, kugwiritsidwa ntchito kwa Insulin Aspart sikuli koyenera kufikira zaka 18. Popeza palibe deta yamankhwala yovomerezeka yothandiza ndi chitetezo cha mankhwalawa m'thupi lomwe limatuluka.

Ngati mankhwala osokoneza bongo, zizindikiro zotsatirazi zimachitika:

• kukokana
• kutsika kwamphamvu kwa shuga,

Kuchepetsa pang'ono kwa mankhwalawa, kuti magazi azikhala ndi shuga, ndikwanira kudya chakudya cham'madzi mwachangu kapena kumwa zakumwa zotsekemera. Mutha kulowa glucagon subcutaneous kapena intramuscularly kapena yankho la dextrose (iv).

Pankhani ya kukomoka kwa hypoglycemic, kuyambira 20 mpaka 100 ml ya dextrose (40%) jekeseni wa jet-intravenous mpaka mkhalidwe wa wodwalayo ukhale wabwinobwino. Pofuna kupewa kukula kwa milandu yotere, kudya zakumwa zamkati kumalimbikitsidwanso.

Kutulutsa Fomu

Mankhwalawa amasulidwa mwamaonekedwe ake, komanso gawo la mankhwala ovuta. Dzina lamalonda la Aspart insulin ndi NovoRapid, dzina la magawo awiri ndi NovoMix (30 FlexPen kapena Penfill, 70 ndi 50 FlexPen) ndi Raizodeg.

Odwala Insulin Aspart amamasulidwa. INN (mu Chilatini) - Insulinum aspartum, magawo awiri - Insulinum aspartum biphasicum.

Pali mitundu ingapo ya mulingo, yogwira yomwe ndi insulin. Amapezeka mu makatoni othandizira.

Wapakati - 1700-1800 r kwa 3 ml ya hypoglycemic solution. Mtengo umasiyanasiyana kutengera mtundu wa kumasulidwa.

Pakukonzekera gawo limodzi ndi 350 μg ya chinthu chomwe chikugwira ntchito, chomwe chofanana ndi 100 PISCES.

Yankho la biphasic lili ndi 30% ya insulin aspart ndi 70% protamine mu mawonekedwe a kristalo.

Njira yogwiritsira ntchito imatengera mtundu wa mankhwalawo komanso mtundu wa endocrine pathology. Mlingo umakhudzidwa ndi matenda osachiritsika komanso owopsa, m'badwo wa wodwala.

Malangizo ogwiritsira ntchito Insulin Aspart:

• Wothandizirana ndi gawo limodzi wamtundu wina amathandizidwa ndi sc. Pafupifupi 0,5-1 magawo pa kilogalamu imodzi yakulemera kwa thupi. Mlingo wa tsiku ndi tsiku umagawidwa zingapo zingapo, apo ayi hypoglycemia imawonekera, izi zimayambitsa kukomoka. Amaloledwa kuperekedwa kudzera m'mitsempha yokha kwa ogwira ntchito kuchipatala, kudzilamulira nokha kwa iv kungayambitse zovuta zomwe sizingachitike.
• Wogawana magawo awiri amagwiritsidwa ntchito mosiyana. Mlingo woyambirira ndi magawo khumi ndi awiri, umaperekedwa usiku usiku chakudya chisanafike. Zoyambitsidwa yekha s / c, mu / mu ndi / m kuyambitsa kumaletsedwa. Pambuyo masiku atatu, mlingo umasinthidwa, poganizira kuchuluka kwa glucose, komwe kuyenera kuyezedwa mkati mwa masiku atatu.

Lowetsani mankhwalawo m'malo a lipodystrophic. Zala ziwiri zimagwira khungu, ndikupanga crease. Jakisoni wa mankhwalawa amapangidwa momwemo.

Kumwa mankhwalawa panthawi yotsekemera sikuletsedwa. Kugwiritsa ntchito ndikololedwa ngati chiwopsezo chomwe chingakhalepo kwa mwana ndichopanda phindu kwa mayi.

Ponena za odwala okalamba, ndikofunikira kusintha mlingo. Kusintha kokhudzana ndi ukalamba m'thupi kumatha kudzetsa thanzi labwino. Popeza magwiridwe antchito amkati amasokonezeka, njira ya mankhwala a hypoglycemic imakulitsa vutoli.

Mankhwala omwe amachepetsa shuga m'magazi, omwe amatengedwa pakamwa, amathandizira gawo la yogwira. Mankhwala oterewa saloledwa. Hypoglycemia imayamba, mkhalidwe wodziwika ndi kuchepa kwa shuga m'munsi mwa zofunikira.

Anabolic steroids, Ketoconazole, Pyridoxine ndi mankhwala ena ozikidwa pa ethanol ndi tetracyclines, omwe amagwiritsidwa ntchito munthawi yomweyo ndi mankhwala a hypoglycemic, amathanso kuchepa kwambiri kwa shuga m'magazi.

Kulera kwapakamwa, heparin ndi antidepressants omwe amagwiritsidwa ntchito mu shuga mellitus kuti achepetse zizindikiro zaukali kungachepetse mphamvu ya mankhwalawa.

Kuchulukitsa mlingo kumalimbikitsidwa pang'onopang'ono, chifukwa kukhazikika kwa shuga kumayambiriro kwa chithandizo kumayambitsa zovuta kuchokera pakatikati ndi zotumphukira zamitsempha. Izi zimabweretsa kupweteka kwambiri, komwe kumakhala kwakanthawi.

Pomwe jekeseni limawonekera, komanso redness. Mbali yamawonedwe, odwala amadandaula za aniseikonia. Refraction imalephera, ndiye kuti, chinthu chomwecho mu retinas chimawoneka mosiyana. Zotsatira zoyipa ndizosintha.

Ndi jekeseni wautali malo amodzi amayamba. Ndikotheka kupewa ngati mungasinthe malo oyang'anira insulin mkati momwemo.

Zolemba zochepa za hypersensitivity zimachitika. Awa ndi odwala matenda ashuga owopsa, milandu yanenedwa.

Mankhwala aliwonse amakhala ndi zotsutsana. Ndizofunikira kuganizira kuti mudziteteze pakukula kwa zovuta zoyipa.

Insulin Aspart ili ndi zotsutsana zochepa. Chofunikira ndi chidwi cha wodwalayo kuti apangidwe. Ngati zotupa zikuwoneka panthawi yoyamba kugwiritsa ntchito, jakisoniyo amatembenukira pinki kapena ofiira, osavomerezeka kugwiritsa ntchito mankhwalawa osavomerezeka. Ndi ntchito yotsatira, thupi lanu lonselo lingakulitse.

Kugwiritsa ntchito mankhwalawa panthawi ya gestation ndikuloledwa. Mlingo uyenera kukhala wocheperako. Kafukufuku wasonyeza kuti Mlingo waukulu wa mankhwalawa umabweretsa zotsatira zoyipa kwa mwana wosabadwayo.

Mlingo wa insulin aspart ndi mlingo

Insulin aspart imayang'aniridwa subcutaneous, kudzera m'mitsempha. Pang'onopang'ono, m'dera la ntchafu, khoma lam'mimba, matako, mapewa mutangotha ​​kudya (postprandial) kapena musanadye chakudya (prandial). Ndikofunikira kuti musinthe nthawi zonse jekeseni yomwe ili m'dera limodzi la thupi. Njira zowongolera ndi kumwa zimayikidwa payekhapayekha. Childs, kufunikira kwa insulin ndi 0,5 - 1 PIECES / kg patsiku, 2/3 yomwe imagwera pa prandial (asanadye) insulin, 1/3 - kumbuyo (basal) insulin.
Kuthandizira moyenera ngati kuli kotheka, ndikugwiritsa ntchito kulowetsedwa, njira zoterezi zitha kuchitika kokha ndi akatswiri azachipatala.
Ndi kusokonezeka kwa chithandizo chamankhwala kapena mtundu wosakwanira (makamaka ndi mtundu 1 wa matenda a shuga), hyperglycemia ndi matenda ashuga a ketoacidosis amatha. Hyperglycemia nthawi zambiri imayamba pang'onopang'ono kwa maola angapo kapena masiku. Zizindikiro za hyperglycemia: nseru, kugona, kusanza, kuyanika komanso khungu, kuchuluka kwa mkodzo wotulutsidwa, kamwa yowuma, kusowa chilimbikitso, ludzu, kununkhira kwa acetone kupuma. Hyperglycemia popanda chithandizo choyenera kumatha kupha.
Ngati vuto la impso kapena chiwindi, kusowa kwa insulin nthawi zambiri kumachepa, ndipo pamaso pa matenda ophatikizika, makamaka matenda opatsirana, umachuluka. Kuchepa kwa pituitary gland, adrenal gland, ndi chithokomiro cha chithokomiro zimatha kusintha kufunika kwa insulin.
Kusamutsa wodwala kupita ku dzina la mtundu watsopano kapena mtundu wa insulin kuyenera kuyang'aniridwa mwamphamvu.
Mukamagwiritsa ntchito insulin, mungasinthe jakisoni kapena kuchuluka kwa jakisoni patsiku, mosiyana ndi insulin. Kusintha kwa Mlingo kungafunike kale pakagwidwe koyamba.
Odwala atatha kulipira chakudya cha carbohydrate metabolism, zizindikiro zawo zamtsogolo za hypoglycemia zimatha kusintha, odwala ayenera kudziwitsidwa za izi.
Kuchita masewera olimbitsa thupi osakonzekera kapena kudumphira chakudya kumatha kuyambitsa hypoglycemia.
Chifukwa cha mawonekedwe a pharmacodynamic, hypoglycemia yogwiritsa ntchito insulin aspart imatha kuyamba kale kuposa kugwiritsa ntchito insulle yamunthu.
Popeza insulin aspart iyenera kugwiritsidwa ntchito molumikizana ndi chakudya, ndikofunikira kuyang'ana kuthamanga kwa zotsatira za mankhwalawa pochiza odwala omwe ali ndi concomitant pathology, kapena kumwa mankhwala omwe amachepetsa kuyamwa kwa chakudya.
Chithandizo cha insulin ndi kuwongolera kwakanthawi kwamayendedwe a glycemic atha kukhala limodzi ndi kukula kwa ululu wamitsempha ndikuwonjezereka kwa maphunziro a matenda ashuga a retinopathy. Kupitilizabe kopitilira ka glycemic control kumachepetsa chiopsezo cha neuropathy ndi matenda ashuga a retinopathy.
Pochita mankhwalawa, kusamala kumafunikira pochita zinthu zowopsa (kuphatikizapo magalimoto oyendetsa galimoto), komwe pamafunika chidwi chochulukirapo komanso kuthamanga kwa ma psychomotor, chifukwa hypoglycemia imatha kupezeka, makamaka kwa odwala omwe ali ndi zochitika kapena osakhala ndi zizindikiro zapafupipafupi.