Kukonzekera kwa insulini kophatikizira, analogue ya insulin ya anthu. Kuyimitsidwa kwa biphasic kuphatikiza sungunuka wa insulin (30%) ndi makhiristo a insulin protart (70%). Insulin aspart yomwe imapezedwa ndi maumboni a DNA obwerezabwereza pogwiritsa ntchito kupsinjika Saccharomyces cerevisiae , mu maselo osakanikirana ndi insulin, amino acid proline pamalo a B28 m'malo mwake ndi aspartic acid.

Pharmacology

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 ma molekyulu 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.

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.

Mlingo

Njira yothetsera jakisoni, 100 PESCES / ml

1 ml ya mankhwala ali

ntchito yogwira - insulin aspart 100 U (3.5 mg),

zokopa: glycerol, phenol, metacresol, zinc, sodium chloride, sodium hydrogen phosphate dihydrate, sodium hydroxide 2 M, hydrochloric acid 2 M, madzi a jakisoni.

Botolo imodzi ili ndi 10 ml ya yankho, lofanana ndi 1000 PIECES.

Transparent colorless madzi.

Mankhwala

Pharmacokinetics

Pambuyo subcutaneous makonzedwe a insulini, nthawi yofika pazipita ndende (tmax) mu madzi am`magazi ndi pafupifupi 2 zina zosakwana pambuyo makonzedwe a sungunuka munthu insulin. Kuchuluka kwa plasma ndende (Cmax) pafupifupi 492 ± 256 pmol / L ndipo kufikiridwa patatha mphindi 40 pambuyo poyendetsa makina a thupi kwa 0.15 U / kg kwa odwala omwe ali ndi mtundu wa matenda a shuga 1. Maola 6 pambuyo pa mankhwala. Kuchuluka kwa mayamwa kumacheperachepera odwala omwe ali ndi matenda a shuga a mtundu wa 2, omwe amachititsa kuti azikhala ndi chidwi chochepa (352 ± 240 pmol / L) ndi tmax pambuyo pake (mphindi 60). Kusinthika koyanjana kwa tmax kumachepa kwambiri mukamagwiritsa ntchito insulin, poyerekeza ndi insulin yamunthu, pomwe kusiyanasiyana kwa Cmax kwa insulin aspart ndikokulira.

Palibe maphunziro a pharmacokinetic omwe adachitidwapo odwala okalamba kapena odwala omwe ali ndi vuto la impso kapena kwa chiwindi.

Pharmacokinetics mwa ana (azaka 6 mpaka 12) ndi achinyamata (azaka 13 mpaka 17) omwe ali ndi vuto la matenda ashuga 1. Kuthiridwa kwa insulin kumachitika msanga m'magulu onse awiriwa, wokhala ndi tmax wofanana ndi wamkulu. Komabe, pali zosiyana mu Cmax m'magulu awiri azaka, zomwe zimagogomezera kufunika kwa kuchuluka kwa mankhwala.

Odwala okalamba (≥Zaka 65)

NovoRapid ® ikhoza kugwiritsidwa ntchito mwa odwala okalamba.

Odwala okalamba, kuchuluka kwa shuga m'magazi kuyenera kuyang'aniridwa mosamala kwambiri ndi mlingo wa insulin asprat payokha.

Odwala aimpso ndi kwa chiwindi kusakwanira

Odwala omwe ali ndi vuto la impso kapena hepatic, insulin ikhoza kuchepetsedwa.

Odwala omwe ali ndi vuto la kuwonongeka kwa impso kapena kwa chiwindi, muyezo wama glucose omwe ali m'magazi amayenera kuyang'aniridwa kwambiri ndi mlingo wa insulin asprat payokha.

Mankhwala

NovoRapid ® ndi analogue yaifupi ya insulini yaanthu yopangidwa ndi recombinant DNA biotechnology pogwiritsa ntchito kupsyinjika Saccharomyces cerevisiaemomwe amino acid proline pa B28 imayimidwira ndi aspartic acid.

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, etc.). Kutsika kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa kayendedwe kake kakang'ono kwambiri, kukweza kwa minofu, kukondoweza kwa lipogenesis, glycogenogeneis, kuchepa kwa kuchuluka kwa shuga ndi chiwindi, etc.

Kulowetsedwa kwa amino acid proline pamalo a B28 okhala ndi aspartic acid mu kukonzekera kwa NovoRapid ® kumachepetsa chizolowezi chopanga ma molekyulu kupanga hexamers, yomwe imawonedwa mu yankho la insulin wamba. Motere, NovoRapid ® imatengedwa mwachangu kuchokera kumafuta amkati ndipo imayamba kuchita zinthu mwachangu kuposa insulin yamunthu. NovoRapid ® imachepetsa shuga wamagazi kwambiri maola 4 atatha kudya kusiyana ndi insulin yaumunthu. Odwala omwe ali ndi vuto la matenda a shuga 1, am'magazi a m'magazi am'madzi am'mbuyomu amadziwika ndi makonzedwe a NovoRapid®, poyerekeza ndi insulin ya anthu osungunuka.

Kutalika kwa mankhwala a NovoRapid ® pambuyo pothandizidwa ndi subcutaneous ndizofupikirapo kuposa kosungunuka kwa anthu a insulin.

Pambuyo subcutaneous makonzedwe, mphamvu ya mankhwalawa imayamba pakadutsa mphindi 10-20 pambuyo pa kuperekera. Kuchuluka kwake kumawonedwa patatha maola atatu jekeseni. Kutalika kwa mankhwalawa ndi maola 3-5.

Zoyesa zamankhwala zokhudzana ndi odwala omwe ali ndi matenda amtundu wa 1 asonyeza kuti ali ndi vuto la kuchepa kwa mankhwalawa akamagwiritsa ntchito insulin aspart poyerekeza ndi insulin ya anthu. Chiwopsezo cha masana hypoglycemia sichinachuluke kwambiri.

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

Akuluakulu Zoyesa zamankhwala zokhudzana ndi odwala omwe ali ndi matenda amtundu wa 1 amawonetsa kuchepa kwam'magazi a shuga ndi makonzedwe a NovoRapid® poyerekeza ndi insulin ya insulle ya anthu.

Ana ndi achinyamata Kugwiritsidwa ntchito kwa NovoRapid® mwa ana kuwonetsa zotsatira zofananira ndikuyang'anira shuga kwa nthawi yayitali mukayerekeza ndi insulin yamunthu yosungunuka.

Kafukufuku wazachipatala yemwe amagwiritsa ntchito insulin yaumunthu yosungunuka asanadye komanso insulin aspart atatha kudya amapangidwa mu ana aang'ono (odwala 26 azaka za pakati pa 2 mpaka 6), ndipo kafukufuku umodzi wa FC / PD unachitika mwa ana ( Wazaka 6-12) ndi achinyamata (wazaka 13-17). Mbiri ya pharmacodynamic ya insulin aspart mwa ana inali yofanana ndi ya akuluakulu.

Mimba Kafukufuku wachipatala wokhudzana ndi chitetezo chokwanira komanso mphamvu ya insulin aspart ndi insulin ya anthu pochiza amayi apakati omwe ali ndi vuto la matenda a shuga 1: amayi apakati 322 omwe adawunikira, omwe insulin aspart: 157, insulin yaumunthu: 165) sanawone zotsatira zoyipa za insulin kapena pakakhala thanzi mwana wosabadwa / wakhanda.

Maphunziro owonjezera azachipatala a azimayi 27 omwe ali ndi gestational matenda a shuga omwe amalandila insulin aspart ndi insulin yaumunthu (insulin aspart analandila azimayi 14, insulin 13 yaumunthu) adawonetsa kufananizidwa ndikutheka kwa chiwonetsero cha chitetezo cha postprandial glucose ndi chithandizo cha insulin.

Mlingo ndi makonzedwe

NovoRapid ® yakonzedwa kuti ikwaniritse makina osokoneza bongo. NovoRapid ® ndi analogue yochita mwachangu insulin.

Chifukwa cha kuyambika kwachangu, NovoRapid® iyenera kuperekedwa, ngati lamulo, chakudya chisanachitike, ngati kuli kotheka, chitha kuperekedweratu chakudya chisanafike.

Mlingo wa mankhwalawa umatsimikiziridwa ndi dokotala aliyense payekha, malinga ndi kuchuluka kwa shuga m'magazi. Nthawi zambiri, NovoRapid ® imagwiritsidwa ntchito limodzi ndi nthawi yayitali kapena insulin yokonzekera yomwe imayendetsedwa kamodzi pa tsiku.

Munthu tsiku lililonse insulin zofunika mu akulu ndi ana ochokera 2 zaka nthawi zambiri imachokera ku 0,5 mpaka 1.0 U / kg kulemera kwa thupi. Mankhwala akaperekedwa musanadye, kufunika kwa insulin kungaperekedwe ndi NovoRapid® ndi 50-70%, kufunika kwa insulin kumachitika ndi insulin yotalikilapo. Kutentha kwa insulin yoyenera kuyenera kukhala kutentha kwambiri. NovoRapid® imayendetsedwa mosadukiza mdera lakhoma lamkati, ntchafu, phewa kapena matako. Mawebusayiti omwe ali mkati mwa thupi limodzi amayenera kusinthidwa pafupipafupi kuti muchepetse chiwopsezo cha lipodystrophy. Monga kukonzekera kwina konse kwa insulin, kutalika kwa NovoRapid® kutengera mlingo, malo a jakisoni, kuchuluka kwa magazi, kutentha ndi kuchuluka kwa zochitika zolimbitsa thupi.

Kuwongolera kwa khoma lakhoma lam'mimba kumathandizira kuti lizichotsa mofulumira poyerekeza ndi kayendetsedwe ka malo ena. Komabe, kuyambitsa mwachangu poyerekeza ndi insulin ya anthu sungunuka mosasamala malo omwe jakisoniyo anali.

Ngati ndi kotheka, NovoRapid® imatha kutumikiridwa kudzera m'mitsempha, koma okhawo omwe ndi akatswiri azachipatala.

Pa makonzedwe amtsempha, makina a kulowetsedwa ndi NovoRapid ® 100 IU / ml okhala ndi 0.05 IU / ml mpaka 1 IU / ml insulin katsitsidwe mu 0.9% sodium chloride solution, 5% kapena 10% dextrose solution yokhala ndi 40 mmol imagwiritsidwa ntchito / l potaziyamu mankhwala ena, pogwiritsa ntchito polypropylene muli kulowetsedwa. Njira zoterezi ndizokhazikika pofunda kwa maola 24. Panthawi ya insulin infusions, kuchuluka kwa shuga m'magazi kuyenera kuyang'aniridwa nthawi zonse.

Magulu apadera a odwala

Monga ndi ma insulin ena, mwa odwala okalamba komanso odwala aimpso kapena a hepatic insuffidence, magazi a glucose ayenera kuyang'aniridwa mosamala kwambiri ndi mlingo wa aspart insulin payokha.

Ana ndi achinyamata

Ndikofunika kugwiritsa ntchito NovoRapid m'malo mwa insulin yaumunthu m'magulu a ana ngati kuli kofunikira kuyambitsa machitidwe a mankhwalawa, mwachitsanzo, pakakhala zovuta kuti mwana athe kuwona nthawi yayitali pakati pakubayira ndi kudya.

Chotsani kuchokera kukonzekera kwina kwa insulin

Posamutsa wodwala kuchokera ku kukonzekera kwa insulin ina ku NovoRapid ®, kusintha kwa NovoRapid® kungafunike

ndi basulin insulin.

Malangizo a odwala pakugwiritsa ntchito NovoRapid ®

Musanagwiritse ntchito NovoRapid® Chongani cholembera kuti muwonetsetse kuti mtundu woyenera wa insulini wasankhidwa.

Nthawi zonse onani botolo, kuphatikizapo pisitoni ya mphira. Musagwiritse ntchito ngati ili ndi zowonongeka zowoneka, kapena ngati kusiyana pakati pa piston ndi Mzere Woyera pa botolo ukuwonekera. Kuti mupeze malangizo owonjezereka, onani malangizo ogwiritsira ntchito kachitidwe ka insulin.

Muzipetsa utoto wa mphira ndi swab ya thonje osenda mu mowa wamankhwala.

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

Osagwiritsa ntchito NovoRapid® ngati

dongosolo la vial kapena la insulin limatsitsidwa, kapena vial imawonongeka kapena kuphwanyidwa, popeza kuti pamakhala ngozi yotuluka kwa insulin,

kusungidwa kwa insulin sikunafanane ndi zomwe zikuwonetsedwa, kapena mankhwalawo adapanga chisanu,

insulin simulinso wowonekera komanso wopanda khungu.

NovoRapid ® yakonzedwa kuti ilowetse jakisoni wa subcutaneous kapena kulowetsedwa kosalekeza mu insulin pump system (PPII). NovoRapid® itha kugwiritsidwanso ntchito kudzera m'mitsempha moyang'aniridwa ndi dokotala.

Malowo a jakisoni amayenera kusinthidwa nthawi zonse kupewa mapangidwe a lipodystrophies. Malo abwino kubayira ndi awa: khoma lamkati lakumbuyo, matako, ntchafu ya kunja, kapena phewa. Insulin imachita zinthu mwachangu ngati itayambitsidwa khoma lakumbuyo lamkati. Malo olowetsedwa amayenera kusinthidwa nthawi ndi nthawi.

NovoRapid ® mu vial imagwiritsidwa ntchito ndi ma insulin ma insulin omwe ali ndi mulingo woyenera zigawo zingapo.

Ngati NovoRapid® ndi insulini ina imagwiritsidwa ntchito nthawi yomweyo mu penfill® vial kapena cartridge, muyenera kugwiritsa ntchito ma cell awiri osiyana a insulin kapena jekeseni awiri osiyana a insulin.

NovoRapid ® vial siyikutenganso.

Monga kusamala, nthawi zonse muzikhala ndi kulowetsa insulin yobereka ngati mungataye kapena kuwononga NovoRapid ®.

Momwe mungapangire jakisoni

Insulin iyenera kuyikiridwa pansi pa khungu. Gwiritsani ntchito jakisoni wololedwa ndi dokotala kapena namwino, kapena tsatirani malangizo a insulini mu buku lanu la insulin.

Gwirani singano pansi pakhungu lanu kwa masekondi 6 kuti muwonetsetse kuti mwapereka mankhwala onse.

Onetsetsani kuti mwataya singano pambuyo jakisoni aliyense.Kupanda kutero, madzimadzi amatha kutayikira, omwe angayambitse Mlingo wosakwanira wa insulin.

Gwiritsani ntchito pulogalamu ya insulin pump pakagwiritsidwe ntchito kwakanthawi.kulowetsedwa

Ikagwiritsidwa ntchito pokoka madzi, NovoRapid ® sayenera kusakanikirana ndi mitundu ina ya insulin.

Tsatirani malangizo a dotolo ndi malingaliro a kugwiritsa ntchito NovoRapid ® mumapampu. Musanagwiritse ntchito NovoRapid ® mu pampu yolumikizira, ndikofunikira kuwerenga mosamalitsa malangizo onse ogwiritsira ntchito dongosololi ndi chidziwitso pazinthu zilizonse zomwe zimayenera kutengedwa ngati mukudwala, shuga wambiri kapena wotsika kwambiri, kapena ngati vuto la PPI lasokonekera.

Musanaikemo singano, sambani manja ndi khungu lanu pamalo opukusira jakisoni ndi sopo kuti musatenge matenda aliwonse kulowetsedwa.

Mukadzaza thanki yatsopano, fufuzani ngati thovu kapena thumba lalikulu.

Makulidwe a kulowetsedwa (chubu ndi catheter) ayenera m'malo mwake mogwirizana ndi buku la ogwiritsa lomwe limayendera kulowetsedwa.

Kuonetsetsa kuti chipukutiro choyenera cha matenda a carbohydrate metabolism ndi kupezeka kwakanthawi kwa vuto la pampu ya insulin, tikulimbikitsidwa kuyang'anira shuga wamagazi nthawi zonse.

Zoyenera kuchita ngati dongosolo la insulin pump silikugwira ntchito

Ngati chisamaliro, nthawi zonse muziyenda nanu insulin ngati mungataye kapena kuwonongeka.

Njira zopewera kugwiritsa ntchito ndi kutaya

NovoRapid ® iyenera kugwiritsidwa ntchito pokhapokha ndi zinthu zomwe zimagwirizana nayo ndikuonetsetsa kuti ikuyenda bwino komanso moyenera.

NovoRapid® idapangidwa kuti igwiritsidwe ntchito payekha.

NovoRapid ® ikhoza kugwiritsidwa ntchito pamapampu a insulin. Ma machubu, mkati mwake omwe amapangidwa ndi polyethylene kapena polyolefin, adayesedwa ndikupezeka kuti ndi oyenera kugwiritsidwa ntchito pamapampu.

Mayankho a kulowetsedwa muminyezo ya polypropylene yokonzedwa kuchokera ku NovoRapid ® 100 IU / ml yokhala ndi kuchuluka kwa 0.05 mpaka 1.0 IU / ml insulin katsitsidwe mu 0.9% sodium chloride solution, 5% dextrose solution kapena 10% dextrose solution yokhala ndi 40 mmol / L potaziyamu potaziyamu, khola lotentha kwa maola 24.

Ngakhale kukhazikika kwake kwakanthawi, kuchuluka kwina kwa insulin kumayamba chifukwa cha zinthu zomwe zimayambitsa kulowetsedwa.

Pa kulowetsedwa kwa insulin, kuchuluka kwa shuga m'magazi kuyenera kuyang'aniridwa nthawi zonse.

NovoRapid ® siyingagwiritsidwe ntchito ngati yasiya kuwonekera komanso yopanda utoto.

Zinthu zosagwiritsidwa ntchito ndi zinthu zina ziyenera kutayidwa malinga ndi malamulo apafupi.

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.

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.

Kuchita ndi mankhwala ena ndi malangizo apadera

Mphamvu ya hypoglycemic imatha kupitilizidwa ndikuphatikiza kuperekera kwa biphasic insulin ndi makonzedwe apakamwa potsatira mankhwala:

mankhwala okhala ndi zakumwa zoledzeretsa komanso hypoglycemic,
Mao zoletsa / kaboni anhydrase / ACE,
Fenfluramine,
Bromocriptine
Cyclophosphamide,
Somatostatin analogues,
Theofylline
Sulfonamides,
Pyridoxine
Anabolic steroids.

Kugwiritsa ntchito ma tetracyclines, Mebendazole, Disopyramide, Ketonazole, Fluoxetine ndi Fibrate kumathandizanso kuchepetsa shuga. Ndipo ma tridclic antidepressants, mankhwala opatsirana pakamwa, nikotini, sympathomimetics, glucocorticosteroids, thiazide diuretics, mahomoni a chithokomiro komanso mankhwala ena amathandizira kufooketsa mphamvu ya hypoglycemic.

Mankhwala ena amatha kukweza ndi kutsitsa shuga. Izi zimaphatikizapo kukonzekera kwa lithiamu, beta-blockers, salicylates, clonidine ndi reserpine.

Ndikofunika kudziwa kuti Flekspen yogwiritsidwa ntchito iyenera kusungidwa kutentha, ndi cholembera chatsopano mu firiji. Pamaso pa makonzedwe, zomwe zili mu vial ndizofunikira kusakaniza bwino.

Ndi kuchuluka kwa masewera olimbitsa thupi, matenda otupa kapena opatsirana, kuwonjezereka kwa mlingo wa insulin ndikofunikira. Ndipo kumayambiriro kwa zamankhwala, sizikulimbikitsidwa kuti muzilamulira machitidwe ndi magalimoto ovuta. Kanemayo munkhaniyi atchulanso za mahomoni.

Zotsatira za mankhwala a insulin aspart * (insulin aspart *) zimaperekedwa, molingana ndi terminology yachipatala, yotchedwa "ma syonyms" - mankhwala osinthika omwe ali ndi chinthu chimodzi kapena zingapo zomwe zimagwira mothandizidwa ndi zomwe zimachitika m'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 * (Insulin aspart *), omwe ali ndi mawonekedwe ofanana, motero mutha kusankha nokha m'malo mwake, mukuganizira mawonekedwe ndi mankhwalawa a mankhwalawa omwe adokotala adapereka. 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 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 kupita ku Pharmacological

Aspart insulin, kwenikweni, imangokhala ndi mankhwala amodzi okha, omwe, komabe, ndiwofunika kwambiri. Uku ndiko kuthamanga kwa mankhwalawa.

Izi zimatheka chifukwa cholumikizana mwachangu ndi ma insulin receptors ambiri osati minofu, komanso maselo amafuta. Kutsika kwa kuchuluka kwa shuga m'magazi kumachitika chifukwa cha zinthu monga:

kukakamiza kayendedwe kake mkati mwa maselo,
kuchulukitsa ndi kuthamanga kwa magwiritsidwe ntchito ndi magulu osiyanasiyana.
kutsika kwa kuchuluka kwa shuga mu chiwindi.

Mokulira zimachulukitsa kukula kwa machitidwe amachitidwe monga lipogenesis ndi glycogenogeneis, komanso kaphatikizidwe ka mapuloteni.

Pambuyo popukusira kwa subcutaneous, mphamvu yake imayamba pasanathe mphindi 20, ndipo imafika pazaka zambiri, maola atatu ndipo imatenga maola atatu mpaka asanu.

Izi ndi zomwe zimapangitsa kuti Aspart insulin ifunike kwambiri pakati pa odwala matenda ashuga.

About amino acid ndi Aspart

Kuyenera kudziwika komanso kuyamwa mwachangu kwambiri kwa mafuta osakanikira kuchokera ku CHIKWANGWANI. Izi ndichifukwa choti kulowetsedwa kwa amino acid proline pamalo a B28, momwe aspicic acid amachitikira, amachepetsa chizolowezi chopanga ma mamolekyulu kupanga ma hexamers osiyanasiyana. Chifukwa chake, izi ndizomwe zimakulitsa kuchuluka kwa mayamwidwe (poyerekeza ndi insulin yodziwika bwino yamtundu wa anthu, mtengo womwe pafupifupi umakhala wokwera nthawi zonse).

About njira ntchito ndi Mlingo

Njira yayikulu yogwiritsira ntchito iyenera kuonedwa ngati yopanda tanthauzo. Pankhaniyi, ndikofunikira kuti jakisoniyo ikuchitika m'dera la khoma la m'mimba, ntchafu, phewa kapena matako. Izi zikuyenera kuchitika pokhapokha musanadye chakudya, chomwe chimatchedwa chithandizo chamankhwala kapena mutangodya - njira ya chithandizo ya postprandial. Madera omwe jakisoni jekeseni wa Aspart amayenera kukhala nthawi zonse mkati mwa gawo limodzi la thupi. Nthawi yomweyo, zimakhala zolondola kwambiri kuzisintha nthawi zambiri, monga momwe amanenera.

magawo awiri mwa atatu ali pa prandial (asanadye chilichonse) insulin,
gawo limodzi mwa magawo atatu a insulin.

Komanso, pakufunika mwachangu, Aspart insulin ikhoza kutumikiridwa kudzera m'mitsempha. Izi zimachitika pogwiritsa ntchito mitundu ina ya kulowetsedwa kwapadera. Intravenous makonzedwe ayenera kuchitika kokha ndi oyenerera ogwira ntchito zachipatala.

Zotsatira zake zoyipa ndi ziti?

Izi sizingakhale zofunikira pazofunikira kwambiri, komanso kukonza mawonekedwe abwino azaumoyo mtsogolo.

Zotsatira zoyipa

Tizikumbukira padera mavuto omwe amabwera, omwe amapangitsa kuti insulini ibwere. Izi ndi za, zomwe, zimawonetsedwa mu kufooka, thukuta "lozizira", kutsekeka kwa khungu ndi zina zambiri. Mitundu yochepera mosakhalitsa komanso kusinthanso kwakanthawi kwamaso. Kuphatikiza apo, zotsatira zoyipa zamagetsi zimachitika, zomwe zimafotokozedwa mu hyperemia, edema komanso kuyabwa kwambiri m'malo a jakisoni, lipodystrophy m'malo omwe jekeseni adapereka.

Payokha, ndikofunikira kukhazikika pazinthu zosiyanasiyana zomwe zimawopseza moyo.

Amaphatikizaponso zochitika monga anaphylaxis, kuzungulira thupi lonse ndi kuyabwa kwambiri, kupuma movutikira, kunjenjemera, tachycardia, ndi thukuta kwambiri.

Koma, ndikofunikira kudziwa kuti zoyipa zotere ndizosowa kwambiri ndipo musakhale ndi Aspart insulin kumbali yoyipa. Mankhwala osokoneza bongo amathanso kuchitika, ochulukirapo pambuyo pake.

About bongo

Mankhwala osokoneza bongo amawonekera chifukwa chogwiritsa ntchito kuchuluka kwa mankhwalawa. Pankhani ya Aspart, imadziwonetsera zilembo izi:

achina,
hypoglycemic coma,
kukokana.

Kodi chimayambitsa kukomoka ndi chiani?

Mwanjira yofatsa, wodwala matenda ashuga amatha kuthetseratu vuto la hypoglycemia mwa kuyesayesa pawokha, ngati atayika shuga kapena zakudya zopatsa mphamvu m'mimba zamagetsi. Glucagon kapena intravenous enieni dextrose njira jekeseni subcutaneally, intramuscularly komanso kudzera m`mitsempha.

Ngati chikomokere cha hypoglycemic chikapangidwa, kuyambira 20 mpaka 40 ml (pazipita 100 ml) ya 40% dextrose yothetsera jekeseni imalowetsedwa ndi njira ya jet mpaka wodwala matenda ashuga atuluke. Akadzichiritsa, akatswiri amalangizanso kusintha pakamwa. Iyi ikhala njira yabwino kwambiri yolepheretsanso kupangidwanso kwa shuga ochepa.

Zokhudza 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.

Kuphatikizidwa ndi mankhwala osokoneza bongo

Kuphatikizidwa pamndandanda (Order of the Government of the Russian Federation No. 2782-rated 12/30/2014):

A.10.A.B.05 Insulin

Amalumikizana ndi insulin receptors a adipose ndi minofu minofu, kuwonjezera intracellular shuga mayendedwe, pamene akuletsa mapangidwe a shuga mu chiwindi. Chifukwa cha kuyamwa kwa glucose ndi maselo, kuchepa kwa magazi ake m'magazi kumatheka.

Pambuyo pa subcutaneous makonzedwe, imatengedwa mwachangu kuchokera ku minofu yaying'ono. Kusintha kwa proline amino acid pamalo 28 a B unyolo wa insulini yokhala ndi spartic acid kumachepetsa mapangidwe a hexamers, omwe amapangidwa pokonzekera insulin yaumunthu. Chifukwa cha izi, kuyamwa kwa insulin aspart kumachitika mwachangu. Kuzindikira kwakukulu kwa plasma kumafika pambuyo pa mphindi 60. Kuyankhulana ndi mapuloteni a plasma ndi 0.9%. Kuchita kwa mankhwalawa kumayamba pambuyo pa mphindi 10-20, kumafika pakatha maola atatu mpaka atatu ndipo kumatha kwa maola 3-5.

Hafu ya moyo ndi mphindi 80.

Amagwiritsidwa ntchito pochotsa matenda a shuga a mtundu woyamba wa I.

IV.E10-E14.E10 Mellitus wodwala matenda a shuga

Hypoglycemia, tsankho lililonse, ana osaposa zaka 6 (palibe maphunziro azachipatala mwa ana ochepera zaka 6).

Mimba komanso kuyamwa: Mlingo ndi makonzedwe:

Pang'onopang'ono, mlingo amawerengedwa payekhapayekha. Kufunika kwa insulin tsiku lililonse ndi 0.5-1 ED / kg: pomwe 2/3 imagwera pa insulin musanadye (prandial) ndi 1/3 pa insulin (basal) yakumbuyo.

Pakati ndi zotumphukira mantha dongosolo : Khazikika pakukhazikika kwa glucose wamagazi koyambirira kwamankhwala kungayambitse ululu wammbuyo wammbuyo, womwe umakhala wosakhalitsa.

Dermatological zimachitika : lipodystrophy pamalo opangira jakisoni.

Zosangalatsa : zolakwika zolimbikitsanso, kuchepa kwakumaso kwakumaso - zimagwirizananso ndi kukhazikika kwa shuga wamagazi koyambirira kwa zamankhwala, ali ndi mawonekedwe osakhalitsa.

Ndi chitupa cha hypoglycemic coma, 20-40 (mpaka 100 ml) 40% dextrose njira imayilowetsedwa kudzera m'mitsempha mpaka wodwala atatuluka.

Mphamvu ya hypoglycemic imakonzedwa ndi cy- ndi β-blockers, salicylates, disopyramides, tetracyclines, monoamine oxidase inhibitors, zoletsa za ACE, mowa, sulfonamides, anabolic steroids.

Β-adrenergic agonists, glucocorticoids, sympathomimetics, thiazide diuretics imafooketsa insulin.

Mothandizidwa ndi mtsempha wa magazi amachitika kokha m'madipatimenti apadera a endocrinology.

Mukamagwiritsa ntchito insulin mapampu a mapampu a insulin (mapampu) oyendetsera subcutaneous, kusakaniza mankhwalawa ndi zothetsera zina ndizoletsedwa.

Cholembera chomwe amagwiritsidwa ntchito chimayenera kusungidwa kutentha. Syringe yosagwiritsidwa ntchito - mufiriji. Mankhwalawa amayenera kuperekedwa pokhapokha atasakanikirana bwino ndi syringe mpaka yunifolomu yoyera.

Kuchita zolimbitsa thupi kwambiri, komanso njira zopatsirana komanso zotupa, kumafunikira insulini yowonjezera.

Kumayambiriro kwa chithandizo, sikulimbikitsidwa kuyendetsa magalimoto ndikugwira ntchito ndi kayendedwe kazinthu mogwirizana ndi kuwonongeka kwa mawonekedwe. Ndi kupitiriza kugwiritsa ntchito mankhwalawa, muyenera kusamala pokhudzana ndi chitukuko cha hypoglycemia.

Kuphatikizidwa ndi mankhwala osokoneza bongo

Kuphatikizidwa pamndandanda (Order of the Government of the Russian Federation No. 2782-rated 12/30/2014):

A.10.A.D.05 Insulin

Kuyimitsidwa kwa biphasic kumakhala ndi insulin analogues: yochepa-insulin (insulin aspart) ndi sing'anga wochita (protamine-insulin aspart).

30% sungunuka wa insulin umapereka mwachangu: kuyambira 0 mpaka 10 mphindi.

70% ya gawo la makristasi a protamine-insulin aspart amapanga depot pansi pa khungu ndikutulutsa pang'onopang'ono kwa insulin, yomwe imayamba kuchita pakatha mphindi 10-20.

Kuchuluka kwa mankhwalawa kumatheka pambuyo pa maola a 1-4 ndipo kumatha maola 24.

Pambuyo pa subcutaneous makonzedwe, 30% sungunuka imatengedwa mwachangu kuchokera ku minofu ya subcutaneous. Kusintha kwa proline amino acid pamalo 28 a B unyolo wa insulini yokhala ndi spartic acid kumachepetsa mapangidwe a hexamers, omwe amapangidwa pokonzekera insulin yaumunthu. Chifukwa cha izi, kuyamwa kwa insulin aspart kumachitika mwachangu. Kuzindikira kwakukulu kwa plasma kumafika pambuyo pa mphindi 60. Kuyankhulana ndi mapuloteni a plasma ndi 0.9%.

Kutha kwa theka la moyo kumapangitsa maola 8-9. Mankhwala a plasma insulin amabwerera kumunsi pambuyo pa maola 15-18. Kutha kwa impso.

Amagwiritsidwa ntchito pochiza matenda a shuga a mellitus, komanso mtundu II wokhazikika wodwala matenda a shuga - mophatikiza ndi am'magazi a hypoglycemic.

IV.E10-E14.E10 Mellitus wodwala matenda a shuga

IV.E10-E14.E11 Mellitus wosadalira insulin

Hypoglycemia, tsankho lililonse, ana osakwana zaka 18.

Mimba komanso kuyamwa: Mlingo ndi makonzedwe:

Pang'onopang'ono, musanadye chakudya, kapena mutangodya.

Mlingo amawerengedwa payekhapayekha ndipo zimatengera kuchuluka kwa shuga m'magazi am'magazi. Mtundu wachiwiri wa matenda a shuga wotsekemera, njira yoyambitsira koyambirira ndi magawo 6 asanadye chakudya cham'mawa komanso magawo 6 musanadye chakudya chamadzulo limodzi ndi metformin. Kutengera ndi glucose omwe amapezeka m'madzi am'magazi, mankhwalawa amatha kuchuluka mpaka 30 IU patsiku kwa jakisoni 2 kapena 3.

Pakati ndi zotumphukira mantha dongosolo : Khazikika pakukhazikika kwa glucose wamagazi koyambirira kwamankhwala kungayambitse ululu wammbuyo wammbuyo, womwe umakhala wosakhalitsa.

Dermatological zimachitika : lipodystrophy pamalo opangira jakisoni.

Zosangalatsa : zolakwika zolimbikitsanso, kuchepa kwakumaso kwakumaso - zimagwirizananso ndi kukhazikika kwa shuga wamagazi koyambirira kwa zamankhwala, ali ndi mawonekedwe osakhalitsa.

Osowa kwambiri - hypoglycemia. Amayamba pomwe mankhwalawa amaperekedwa kuposa momwe akufunikira.

Kuchiza ndi mawonekedwe ofatsa ndikulowetsa shuga (shuga, maswiti, msuzi wa zipatso wokoma).

Mu kwambiri hypoglycemia, jekeseni wosakanizira wa glucagon mu 0.5-1 mg. Mitsempha - 40% dextrose yankho mu kuchuluka kofanana ndi kutumikiridwa kwa insulin.

Mphamvu ya hypoglycemic imakonzedwa ndi cy- ndi β-blockers, salicylates, disopyramides, tetracyclines, monoamine oxidase inhibitors, zoletsa za ACE, mowa, sulfonamides, anabolic steroids.

Β-adrenergic agonists, glucocorticoids, sympathomimetics, thiazide diuretics imafooketsa insulin.

Mankhwalawa sanapangidwe kuti apangidwe mtsempha. Kuyimitsidwa kwa insulin sikumagwiritsidwa ntchito pamapampu a insulin (mapampu) a subcutaneous makonzedwe.

Kuchita zolimbitsa thupi kwambiri, komanso njira zopatsirana komanso zotupa, kumafunikira insulini yowonjezera.

Insulin Aspart magawo awiri - mawonekedwe ndi malangizo ogwiritsira ntchito

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.

Malangizo ogwiritsira ntchito

Mankhwalawa angagwiritsidwe ntchito ngati matenda a shuga a mellitus 1 ndi 2. Koma izi zikuyenera kuchitika pokhapokha ngati akuwongolera dokotala. Katswiri ayenera kuphunzira chithunzithunzi cha matendawa, kudziwa momwe thupi la wodwalayo alilire ndi njira zina zochizira.

Mtundu woyamba wa shuga, mankhwalawa amagwiritsidwa ntchito ngati njira yayikulu yothandizira. Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri, amadziwikiridwa kuti sipangachitike zotsatira za mankhwalawa ndi othandizira pakamwa.

Momwe mungagwiritsire ntchito mankhwalawa atsimikiza ndi dokotala. Amawerengetsanso kuchuluka kwa mankhwalawo, makamaka ndi 0.5-1 UNITS pa 1 kg yolemera. Kuwerengera kumakhazikitsidwa pakuyesa kwa magazi pazomwe zili ndi shuga. Wodwala amayenera kupenda mkhalidwe wake ndikufotokozera zovuta zilizonse kwa dotolo kuti asinthe kuchuluka kwa mankhwalawa munthawi yake.

Mankhwalawa amapangidwira ma subcutaneous makonzedwe. Nthawi zina jekeseni wamkati amatha kuperekedwa, koma izi zimachitika kokha mothandizidwa ndi katswiri wazachipatala.

Kubweretsa mankhwala nthawi zambiri kumachitika kamodzi patsiku, musanadye kapena mutangomaliza kudya. Zingwe zimayikidwa paphewa, khoma lakunja lam'mimba kapena matako. Pofuna kupewa kupezeka kwa lipodystrophy, nthawi iliyonse yomwe mukufuna kusankha malo atsopano.

Maphunziro a kanema wa syringe-cholembera insulin

Contraindators ndi malire

Pokhudzana ndi mankhwala aliwonse, zotsutsana ziyenera kukumbukiridwa kuti zisawononge thanzi la munthu. Ndi kusankhidwa kwa Aspart, izi ndizofunikanso. Mankhwalawa ali ndi zotsutsana zochepa.

Chachikulu kwambiri ndi kuphatikiza mankhwala osokoneza bongo. Cholepheretsa china ndi kuchuluka kwa odwala. Ngati wodwalayo ali ndi zaka zosakwana 6, muyenera kupewa kumwa mankhwalawa, chifukwa sizikudziwika kuti zingakhudze bwanji thupi la ana.

Palinso zolephera zina. Ngati wodwala ali ndi vuto la hypoglycemia, ayenera kusamala. Mlingo wa iye ayenera kuchepetsedwa ndikuwongolera njira yochizira. Ngati zizindikiro zoyipa zikapezeka, ndibwino kukana kumwa mankhwalawo.

Mlingo umafunikanso kusinthidwa popereka mankhwala kwa achikulire. Kusintha kokhudzana ndi ukalamba m'thupi lawo kumatha kubweretsa kusokonezeka kwa ziwalo zamkati, chifukwa chake zotsatira za mankhwalawa zimasintha.

Zomwezi zitha kunenedwa za odwala omwe ali ndi matenda a chiwindi ndi impso, chifukwa omwe insulin imayamwa kwambiri, yomwe ingayambitse hypoglycemia. Sizoletsedwa kugwiritsa ntchito mankhwalawa kwa anthu otere, koma mlingo wake uyenera kuchepetsedwa, ndipo kuchuluka kwa shuga kuyenera kuwunikidwa pafupipafupi.

Zotsatira zamankhwala zomwe zimafunsidwa pamimba sizinaphunzire. Mu maphunziro a nyama, zovuta zoyipa zomwe zimachokera ku chinthuchi zimangoyambika pokhazikitsa Mlingo waukulu. Chifukwa chake, nthawi zina kugwiritsa ntchito mankhwalawa panthawi yapakati kumaloledwa. Koma izi zimayenera kuchitika pokhapokha poyang'aniridwa ndi ogwira ntchito pachipatala ndikuwongolera nthawi zonse.

Pakudyetsa mwana mkaka wa m'mawere, Aspart amagwiritsidwanso ntchito nthawi zina - ngati phindu kwa mayi limaposa chiwopsezo cha mwana.

Palibe chidziwitso chokwanira chomwe chalandira pofufuza momwe kapangidwe kamankhwala kamakhudzira mkaka wa m'mawere.

Izi zikutanthauza kuti mukamagwiritsa ntchito mankhwalawa, ziyenera kusamalidwa bwino.

Zotsatira zoyipa

Kugwiritsa ntchito mankhwalawa kwathunthu kungatchedwa kotetezeka kwa odwala. Koma ngati sizikugwirizana ndi malangizo azachipatala, komanso chifukwa cha zomwe zimachitika m'thupi la wodwalayo, zotsatira zoyipa zimatha kugwiritsidwa ntchito.

Izi zikuphatikiza:

Hypoglycemia. Zimayambitsa insulini yambiri mthupi, chifukwa chake kuchuluka kwa shuga m'magazi kumatsika kwambiri. Kupatuka kumeneku ndi kowopsa kwambiri, chifukwa pakalibe chithandizo chamankhwala chapanthawi yake, wodwala amayang'anizana ndi imfa.
Zokhudza kwanuko. Amawoneka ngati okwiyitsa kapena chifuwa pamasamba a jakisoni. Zomwe zimapangitsa kuti zikhale kuyabwa, kutupa ndi kufiyanso.
Zosokoneza. Amatha kukhala osakhalitsa, koma nthawi zina chifukwa cha kuchuluka kwa insulin, kuwona kwa wodwalayo kumatha kuwonongeka kwambiri, komwe sikungasinthe.
Lipodystrophy. Kupezeka kwake kumalumikizidwa ndi kuphwanya kwamtundu wa mankhwala omwe amaperekedwa. Kuti mupewe izi, akatswiri amalimbikitsa jekeseni kulowa m'malo osiyanasiyana.
Ziwengo. Mawonekedwe ake ali osiyanasiyana. Nthawi zina zimakhala zovuta komanso zowopsa kwa wodwala.

Muzochitika zonsezi, ndikofunikira kuti adokotala amuunikire ndikusintha kuchuluka kwa mankhwalawo kapena kusiya zonse.

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 mankhwalawa agwiritsidwa ntchito monga momwe dokotala angagwiritsire, ndiye kuti mankhwala osokoneza bongo amayamba kuchitika. Nthawi zambiri, zochitika zosasangalatsa zimagwirizanitsidwa ndi kusasamala kwa wodwalayo, ngakhale nthawi zina vutoli limatha kukhala machitidwe a thupi.

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

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

Dokotala amatha kusintha mankhwalawa pogwiritsa ntchito mankhwala otsatirawa:

Protafan. Maziko ake ndi insulin Isofan. Mankhwala ndi kuyimitsidwa komwe kuyenera kuperekedwa mwachangu.
Novomiks. Mankhwalawa amachokera ku insulin Aspart. Imakhazikitsidwa ngati kuyimitsidwa kwa makonzedwe pansi pa khungu.
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.

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.

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

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.

Kuchita kwa insulin aspart ndi zinthu zina

Mphamvu ya hypoglycemic ya insulin aspart imafooketsedwa ndi glucagon, glucocorticoids, somatropin, estrogens, chithokomiro mahomoni, progestogens (mwachitsanzo, njira zakulera zam'mlomo), calcium blockers blockers, thiazide diuretics, sulfinpyrazone, heparin, sympathomimetics azameramamamamazamamamazamamamamazamamamazamamamazamamamazam ndiam. , danazole, diazoxide, ma tridclic antidepressants, nikotini, morphine, phenytoin.
Mphamvu ya hypoglycemic ya insulin aspart imapangidwira ndi sulufilamides, mankhwala osokoneza bongo a hypoglycemic, monoamine oxidase inhibitors (kuphatikiza procarbazine, furazolidone, selegiline), angiotensin kutembenuza enzyme inhibitors, carbonic anhydrase inhibitors, anabolic sterolodinites, oxididolidiids, maabolic, maabolic, maabolic, maabolic, maabolic, maabolone, maabolone, maabolone, maabolone, maabolone, maabolic, maabolic, aabolone. fluoxetine, mebendazole, ketoconazole, theophylline, fenfluramine, cyclophosphamide, pyridoxine, quinine, chloroquinine, quinidine,
Beta-blockers, mchere wa lithiamu, clonidine, reserpine, pentamidine, salicylates, ethanol ndi ethanol okhala ndi mankhwala amatha kufooka ndikuwonjezera mphamvu ya hypoglycemic ya insulin aspart.
Insulin aspart imagwirizana mosiyanasiyana ndi mayankho a mankhwala ena.
Pali malipoti a kakulidwe ka matenda osalephera a mtima mu mankhwalawa odwala omwe ali ndi thiazolidatediones limodzi ndi kukonzekera kwa insulin, makamaka ngati odwala oterewa ali pachiwopsezo chotenga matenda a mtima osalephera. Popereka mankhwala ophatikizira pamodzi, ndikofunikira kuwunika odwala kuti muwone ngati ali ndi vuto la mtima, kupezeka kwa edema, kuwonda. Ngati zizindikiro za kulephera kwa mtima zikuchulukirachulukira, mankhwala a thiazolidatedione ayenera kusiyidwa.

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.