Zowonetsa ntchito ndi katundu wa insulin Detemir

Tekinoloje zamakono zomwe zimapangidwanso mu DNA zakonzanso mbiri ya zochita za insulin yosavuta (yanthawi zonse). Detemir insulin imapangidwa ndi recombinant DNA biotechnology pogwiritsa ntchito kupopera Saccharomyces cerevisiae, ndi chosungunuka basalle analog ya insulin ya anthu yotenga nthawi yayitali yokhala ndi mbiri yopanda kanthu yochitapo kanthu. Mbiri yakuchitikaku ndiyosasiyana kwenikweni poyerekeza ndi isofan-insulin ndi insulin glargine. Kuchitikira kwanthawi yayitali kumachitika chifukwa chodziyimira pawokha wa mamolekyu a insulir pamalo omwe amapangira jekeseni komanso kumanga mamolekyu kupita ku albumin pogwiritsa ntchito phula lomwe limakhala ndi unyolo wamafuta acid. Poyerekeza ndi isofan-insulin, insulir ya detemir imagawiridwa pang'onopang'ono mu zotumphukira za chandamale. Njira zophatikizidwazo zomwe zimathandizira kuti muchepetse magazi zimathandizanso kuti khungu lizitha kubereka komanso lizikhala ndi insulini. Dermul ya Detemir imadziwika ndi kudziwikiratu kwakanthawi kokwanira kwa odwala poyerekeza ndi insulin NPH kapena insulin glargine. Kukuwonetseredwa kwa kuchitapo kanthu kumachitika chifukwa cha zinthu ziwiri izi: cholowa cha insulini chimakhalabe chosungunuka pamagawo onse kuchokera pamtundu wa mlingo mpaka kumangiriza ku insulin receptor komanso kugwedezeka kwa chomangika ndi serum albumin.
Mwa kulumikizana ndi cholandilira chapadera pa cytoplasmic membrane yamaselo, imapanga insulin-receptor zovuta zomwe zimapangitsa njira zamkati, kuphatikiza kapangidwe kazinthu zingapo za enzymes (hexokinase, pyruvate kinase, glycogen synthetase, ndi zina). Kutsika kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa kayendedwe kabisikulidwe, kuchuluka kwa minofu, kukondoweza kwa lipogenesis, glycogenogeneis, kutsika kwa kuchuluka kwa shuga ndi chiwindi, etc. Pazinthu za 0,0-0.4 U / kg pa 50%, kuchuluka kwakukulu kumachitika pamtunda kuchokera pa 3-- Maola 4 mpaka maola 14 mutakhazikitsa. Pambuyo subcutaneous makonzedwe, pharmacodynamic mayankho anali olingana ndi mlingo kutumikiridwa (pazipita mphamvu, nthawi ya zochita, ambiri zotsatira). Pambuyo pa jekeseni wa SC, detemir imamangiriza ku albin kudzera mu unyolo wamafuta ake. Chifukwa chake, mumkhalidwe wokhazikika, kuchuluka kwa insulin yopanda malire kumachepetsedwa kwambiri, komwe kumapangitsa kuti glycemia ikhale yokhazikika. Kutalika kwa nthawi ya detemir pa mlingo wa 0,4 IU / kg ndi pafupifupi maola 20, motero mankhwalawa amayikidwa kawiri patsiku kwa odwala ambiri. M'maphunziro a nthawi yayitali (miyezi isanu ndi umodzi), shuga wa plasma wothamanga mwa odwala omwe ali ndi mtundu wa shuga I anali bwino poyerekeza ndi isofan-insulin, yodziwika mu maziko / mankhwala a bolus. Glycemic control (glycosylated hemoglobin - HbA1c) pa mankhwalawa ndi insulin detemir anali ofanana ndi omwe amathandizidwa ndi isofan-insulin, omwe ali ndi chiopsezo chocheperako cha kuchepa kwa thupi usiku chifukwa chogwiritsidwa ntchito. Mbiri yakuwongolera shuga usiku ndi yosalala komanso yowonjezera insulin poyerekeza ndi isofan insulin, yomwe imawonetsedwa pangozi yochepera usiku ya hypoglycemia.
Pazipita kuchuluka kwa insulir insulin mu magazi seramu amafikiridwa maola 6-8 pambuyo makonzedwe. Ndi regimen yowonjezera ya tsiku ndi tsiku, kukhazikika kwa mankhwala mu seramu ya magazi kumatheka pambuyo pobayira katatu.
Kuchulukitsa ndizofanana ndi kukonzekera kwa insulin yaumunthu, ma metabolites onse omwe amapangidwa satha ntchito. Maphunziro Omanga Mapuloteni mu vitro ndi mu vivo awonetsere kusowa kwa kulumikizana kwakukulu pakati pa chiphuphu cha insulin ndi mafuta acids kapena mankhwala ena omwe amamangilira mapuloteni amwazi.
Hafu ya moyo pambuyo pa jekeseni wa sc imatsimikiziridwa ndi kuchuluka kwa kuyamwa kwa minofu yaying'ono ndipo ndi maola 5-7, kutengera mlingo.
Pamene s / kumayambiriro kwa ndende mu magazi seramu anali olingana ndi mlingo kutumikiridwa (pazipita ndende, kuchuluka kwa mayamwidwe).
Magulu apadera a odwala
Malo a Pharmacokinetic amaphunzitsidwa mwa ana (a zaka 6 mpaka 12) ndi achinyamata (wazaka 13 mpaka 17) ndikuyerekeza ndi akulu omwe ali ndi mtundu wa matenda a shuga a shuga. Panalibe kusiyana kulikonse pamakampani a pharmacokinetic. Panalibe kusiyana kwakukulu pama pharmacokinetics a detemir insulin pakati pa odwala okalamba ndi achinyamata, kapena pakati pa odwala omwe ali ndi vuto laimpso ndi kwa chiwindi ndi odwala athanzi.

Kugwiritsa ntchito mankhwala a insulin

Kapangidwe ka subcutaneous management. Mlingo umatsimikiziridwa payekhapayekha pazinthu zonse. Dermul ya Detemir iyenera kutumikiridwa 1 kapena 2 pa tsiku malinga ndi zosowa za wodwala. Odwala omwe ayenera kugwiritsa ntchito kawiri pa tsiku kuti azitha kuyendetsa magazi glucose amatha kulowa mgonero ngakhale nthawi yamadzulo, kapena asanagone, kapena maola 12 atatha kumwa kwa m'mawa. Dermul insulin imalowetsedwa mu ntchafu, khoma lakunja kwam'mimba kapena phewa. Masamba obaya ayenera kusinthidwa ngakhale atabayidwa m'dera lomwelo. Monga ndi ma insulin ena, mwa odwala okalamba komanso odwala omwe ali ndi vuto la impso kapena hepatic, kuchuluka kwa shuga wamagazi kuyenera kuyang'aniridwa mosamala kwambiri komanso njira ya kununkhira payokha ikusinthidwa. Kusintha kwa magazi kungakhale kofunikira pakulimbitsa thupi la wodwalayo, kusintha zakudya zake wamba, kapena matenda ena.

Zotsatira zoyipa za mankhwala a insulin

Zotsatira zoyipa zomwe zimawoneka mwa odwala omwe amagwiritsa ntchito insulir insulin zimadalira kwambiri mankhwalawa ndipo zimachitika chifukwa cha kupatsirana kwatsoka la insulin. Hypoglycemia nthawi zambiri zimakhala zotsatira zoyipa kwambiri. Hypoglycemia imayamba ngati mankhwalawa ataperekedwa mothandizidwa ndi kufunika kwa insulin.
Zomwe zimachitika jekeseni amatha kuthandizidwa ndi odwala pafupifupi 2%. Gawo la odwala omwe amalandila chithandizo ndipo omwe akuyembekezeka kukulitsa zovuta zake akuyembekezeredwa ngati 12%. Zomwe zimachitika pazovuta pamayesero azachipatala zawonetsedwa pansipa.
Matenda a Metabolic ndi zakudya: pafupipafupi (1/100, ≤1 / 10).
Hypoglycemia: Zizindikiro za hypoglycemia nthawi zambiri zimachitika mwadzidzidzi. Izi zimaphatikizira "thukuta lozizira", kukhuthala kwa khungu, kutopa kwambiri, mantha kapena kunjenjemera, nkhawa, kutopa kapena zachilendo, kufooka, kuchepa kwa chidwi, kugona, kugona kwambiri, kusawona bwino, mutu, nseru, palpitations. Hypoglycemia yayikulu imatha kuwononga chikumbumtima ndi / kapena kukhudzika, kusokonezeka kwakanthawi kapena kosasintha kwa ntchito yaubongo mpaka pakufa.
Zovuta zamtundu uliwonse ndi zomwe zimachitika pamalo opangira jakisoni: pafupipafupi (1/100, ≤1 / 10).
Zokhudza malo jakisoni: Matenda a hypersensitivity a m'deralo (kufupika, kutupa, ndi kuyimitsidwa pamalo a jekeseni) amatha kuchitika panthawi ya insulin. Izi zimachitika mosakhalitsa kwakanthawi ndipo zimatha ndi chithandizo chanthawi zonse.
Zosavuta (1/1000, ≤1 / 100).
Lipodystrophy: Amatha kukhala pamalo opangira jakisoni chifukwa chosagwirizana ndi lamulo losintha jakisoni m'deralo. Edema: zitha kuchitika koyambirira kwa insulin. Zizindikirozi nthawi zambiri zimakhala zakanthawi.
Matenda owononga chitetezo chamthupi: zosowa (1/1000, ≤1 / 100).
Zotsatira zoyipa: urticaria, zotupa pakhungu limayamba chifukwa cha hypersensitivity. Zizindikiro za hypersensitivity zimatha kuphatikizira kuyabwa, thukuta, m'mimba kukhumudwa, angioedema, kupuma movutikira, palpitations, kutsika magazi. Kukula kwa zochitika zama hypersensitivity kungakhale koopsa m'moyo.
Zowonongeka: zosowa (1/1000, ≤1 / 100).
Zododometsa: Zodabwitsidwazo zimatha kuchitika koyambirira kwa insulin. Zizindikirozi nthawi zambiri zimakhala zakanthawi. Matenda a shuga a retinopathy. Kusintha kwa nthawi yayitali pakulamulira kwa glycemic kumachepetsa chiopsezo cha kupitirira kwa matenda ashuga. Komabe, kulimbikitsidwa kwa insulin mankhwala osinthika kwambiri pakayang'anidwe kagayidwe kazakudya kungapangitse kuchuluka kwakanthawi kwa zizindikiro za matenda ashuga retinopathy.
Mavuto amanjenje: zosowa kwambiri (1/10000, ≤1 / 1000).
Peripheral neuropathy: Kusintha kwachangu pakuwongolera glycemic kungayambitse mkhalidwe wa ululu wammbuyo wamitsempha, womwe umatha kusintha.

Malangizo apadera ogwiritsira ntchito mankhwala a insulin

Detemir insulini imapereka chiwongolero chokwanira cha glycemic (kutengera kuchuluka kwa shuga m'magazi) poyerekeza ndi isofan-insulin. Mlingo wosakwanira wa insulini kapena kusiya chithandizo, makamaka ndi matenda a shuga a mtundu wa shuga, angayambitse kukula kwa hyperglycemia kapena matenda ashuga a ketoacidosis. Monga lamulo, zizindikiro zoyambirira za hyperglycemia zimawonekera pang'onopang'ono, kwa maola angapo kapena masiku. Zizindikiro zake zimaphatikizaponso ludzu, kukodza mwachangu, kusanza, kusanza, kugona komanso kuyanika pakhungu, pakamwa pouma, kusowa chilimbikitso, kununkhira kwa acetone mumlengalenga wotuluka. Mtundu wa I wa matenda a shuga a mellitus, popanda chithandizo choyenera, hyperglycemia imatsogolera pakupanga matenda ashuga a ketoacidosis ndipo amatha kupha. Hypoglycemia imatha kukhazikika ngati mlingo wa insulin ndiwokwera kwambiri poyerekeza ndi kufunikira kwa insulin mwa wodwala wina. Kudumpha chakudya kapena kuchita masewera olimbitsa thupi kwambiri kungayambitse matenda a hypoglycemia. Pambuyo kulipirira kagayidwe kazakudya, mwachitsanzo, pakulimbitsa mankhwala a insulin, odwala amatha kukumana ndi zisonyezo zam'mbuyomu za hypoglycemia, zomwe odwala ayenera kudziwitsidwa. Zizindikiro zachilendo zimatha kutha ndi matenda a shuga. Matenda okhala ndi vuto limodzi, makamaka opatsirana komanso kutentha thupi, nthawi zambiri amalimbikitsa kufunika kwa insulin.
Chotsani kuchokera ku mitundu ina ya insulin
Kusamutsa wodwala kupita ku mtundu wina wa insulin kapena insulin kuchokera kwa wopanga wina kuyenera kuchitika moyang'aniridwa ndi achipatala. Mukasintha ndende, wopanga, mtundu, mitundu (nyama, munthu, fanizo la insulin ya anthu) ndi / kapena njira yopangira (genetically engineered or insulin of organis) Chinyama chitha kusintha. Odwala omwe amasintha kuti awonere chithandizo cha insulin angafunike kusintha mlingo poyerekeza ndi Mlingo wa insulin yomwe kale idagwiritsidwa ntchito. Kufunika kwa kusintha kwa mankhwalawa kumatha kuchitika mutangoyambitsa kumwa koyamba kapena mkati mwa milungu yoyambirira kapena miyezi ingapo. Dermul insulin siyenera kutumikiridwa, chifukwa izi zimatha kuyambitsa kwambiri hypoglycemia. Madzi ndi makina a i / m amathamanga mwachangu komanso kwakukulu poyerekeza ndi kayendetsedwe ka subcutaneous. Ngati insulin detemir isakanikirana ndi mitundu inanso ya insulin, mbiri ya chimodzi kapena zonse ziwiri zimasintha. Kuphatikiza insulin ndi insulin yomwe imagwira mwachangu, monga insulin, imabweretsa chithunzithunzi chochepetsedwa komanso kuchepetsedwa kwakukulu poyerekeza ndi kayendetsedwe kake kosiyana.
Kusamutsa insulin pakati komanso insulin yayitali kwa levemir ingafune kusintha ndi kusintha kwa nthawi. Monga ndi ma insulini ena, kuwunikira mosamala kuchuluka kwa shuga m'magazi akamamasulira komanso m'milungu yoyamba yatsopano ya insulin. Malangizo a concomitant hypoglycemicapy (mlingo ndi nthawi ya makonzedwe amtundu wa insulin kapena Mlingo wa hypoglycemic wothandizirana) angafunike.
Dongosolo la Detemir insulin silinapangidwe kuti ligwiritsidwe ntchito pamapampu a insulin.
Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere. Palibenso deta pakanthawi kovomerezeka ndi insulin. Kafukufuku wokhudzana ndi kubereka mu nyama sizinawonetse kusiyana pakati pa insulir insulin ndi insulin ya anthu malinga ndi embryotoxicity ndi teratogenicity. Mwambiri, kuwunika mosamala amayi apakati omwe ali ndi matenda ashuga panthawi yonse yomwe ali ndi pakati, komanso pokonzekera kutenga pakati, ndikofunikira. Kufunika kwa insulini mu nthawi yoyambirira ya mimba nthawi zambiri kumachepa, ndiye kuti mu trimesters yachiwiri ndi yachitatu imachulukirachulukira. Pambuyo pobadwa, kufunikira kwa insulin kumabwereranso msanga momwe kunaliri asanakhale ndi pakati. Mwa amayi omwe akuyamwitsa, kusintha kwa inulin ndi zakudya kungafunike.
Kukopa pa kuyendetsa galimoto ndikugwira ntchito ndi zinthu. Kuthekera kwa odwala kulolera komanso kuchuluka kwa momwe angachitire kungawonongeke panthawi ya hypoglycemia kapena hyperglycemia, zomwe zimatha kukhala zowopsa nthawi zomwe maluso amenewa amafunikira makamaka (mwachitsanzo, poyendetsa galimoto kapena kugwira ntchito ndi makina ndi makina). Odwala ayenera kulangizidwa kuti achitepo kanthu popewa kukulitsa kwa hypoglycemia ndi hyperglycemia poyendetsa galimoto ndikugwiritsa ntchito njira. Izi ndizofunikira kwambiri kwa odwala omwe alibe kapena kuchepa kwa zizindikiro zakutsogolo kwa hypoglycemia kapena zochitika zapafupipafupi za hypoglycemia. Muzochitika izi, muyenera kuganizira kuopa kuyendetsa kapena kugwira ntchito yofananira.

Zochita ndi mankhwala a insulin

Pali mankhwala angapo omwe amakhudza kufunika kwa insulin.
Hypoglycemic zotsatira za insulin zimatheka ndi: hypoglycemic mankhwala m'kamwa, Mao zoletsa, zoletsa Ace, carbonic anhydrase zoletsa, si kusankha β-blockers, bromocriptine, sulfonamides, anabolic mankhwala, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, lifiyamu, mankhwala okhala ndi Mowa.
Hypoglycemic momwe insulin imafooketsa: njira zakulera za pakamwa, corticosteroids, mahomoni a chithokomiro, thiazide okodzetsa, heparin, ma tridclic antidepressants, sympathomimetics, danazole, clonidine, pang'onopang'ono calcium njira blockers, diazoxide, morphine, phenytoin, nikotini. Mothandizidwa ndi reserpine ndi salicylates, ndizotheka kufooketsa kapena kuwonjezera zochita za mankhwala Octreotide / lanreotide, yomwe imatha kuwonjezeka ndikuchepetsa kufunikira kwa insulin. Ma blockers a Β-adrenergic amatha kubweza zizindikiro za hypoglycemia ndikuchedwa kuchira pambuyo pa hypoglycemia. Mowa umatha kukulitsa mphamvu ya hypoglycemic ya insulin.
Kusagwirizana
Mankhwala ena, mwachitsanzo, okhala ndi thiol kapena sulfite, pamene kuwonda kumawonjezeredwa ndi yankho la insulin, amatha kuwononga. Chifukwa chake, musamawonjezere insulin chifukwa cha kulowetsedwa.

Mankhwala osokoneza bongo a insulin, zizindikiro ndi chithandizo

Mlingo wapadera womwe umalola kuyankhula za mankhwala osokoneza bongo ambiri sanakhazikitsidwe, koma hypoglycemia imatha kukula pang'onopang'ono ngati wodwala wapeza mlingo waukulu kwambiri. Zizindikiro hypoglycemia.
Chithandizo: wodwalayo atha kuthetsa shuga wofatsa mwakukula shuga, shuga kapena zakudya zamafuta ambiri. Chifukwa chake, ndikulimbikitsidwa kwa odwala matenda ashuga kuti azikhala ndi shuga, maswiti, makeke kapena mandimu okoma zipatso.Ngati hypoglycemia yayikulu, wodwala akakhala kuti alibe chikumbumtima, 0.5-1 mg wa glucagon v / m kapena s / c, (akhoza kuyendetsedwa ndi munthu wophunzitsidwa bwino, kapena iv dextrose (glucose), amayenera kuperekedwa.
INSERT INTO `info` (` ID`, `Name`,` NameBase`, `TEXT`,` IsUsed`, `Kufotokozera`,` KeyWords`) VALUES (ingathe kuloledwa ndi katswiri wazachipatala). Mothandizidwa ndi intravenous kwa dextrose ndikofunikira ngati wodwalayo asadzayambenso chikumbumtima cha mphindi 10-15 atatha kugwirira ntchito kwa glucagon. Pambuyo pozindikira, wodwalayo amalangizidwa kuti azidya zakudya zopatsa thanzi kuti alepheretse kubwerezanso kwa hypoglycemia.

Mndandanda wamankhwala komwe mungagule insulin:

Kutulutsa mawonekedwe, kapangidwe kake ndi ma CD

Njira yothetsera makonzedwe a sc zowonekera, zopanda utoto.

Othandizira: glycerol, phenol, metacresol, nthaka acetate, sodium kolorayidi, sodium dihydrogen phosphate dihydrate, hydrochloric acid kapena sodium hydroxide, madzi d / i.

* 1 unit ili ndi 142 μg ya insulin yopanda mchere, yomwe imagwirizana ndi 1 unit. insulin yamunthu (IU).

3 ml - makatoni am'magalasi (1) - ma syringe ambiri omwe amatulutsa jakisoni wa jakisoni wobwereza (5) - mapaketi a katoni.

Zotsatira za pharmacological

Hypoglycemic mankhwala. Ndi tsamba losungunuka la insulin ya anthu omwe akhala akuchita zinthu zazitali mwachinsinsi. Yopangidwa ndi recompinant DNA biotechnology pogwiritsa ntchito Saccharomyces cerevisiae.

Mbiri yamankhwala a Levemir ® FlexPen ® ndiosasintha kwambiri poyerekeza ndi insulin-isophan ndi insulin glargine.

Kuchita kwanthawi yayitali kwa mankhwala a Levemir ® FlexPen ® ndi chifukwa chodziyimira pawokha wa maselo a insulir pamalo a jekeseni komanso kumanga kwa mamolekyulu a mankhwalawa kuti a albumin kudzera pachiwonetsero cha chingwe. Poyerekeza ndi insulin-isophan, kudziwikitsa kwa insulini kumayamba kuchepa kwambiri. Njira zophatikizidwazo zomwe zimaperekedwako zimapereka chidziwitso chambiri cha levemir ® FlexPen ® poyerekeza ndi insulin-isophan.

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 zotupa, kukondoweza kwa lipogenesis, glycogenogeneis, ndi kuchepa kwa kuchuluka kwa shuga ndi chiwindi.

Mlingo wa 0.2-0.4 U / kg 50%, kuchuluka kwake kwa mankhwalawa kumachitika mosiyanasiyana kuyambira maola 3-4 mpaka maola 14 atatha kutsata. Kutalika kwa nthawi mpaka maola 24, kutengera mlingo, zomwe zimapangitsa kupereka nthawi 1 / tsiku kapena 2 nthawi / tsiku.

Pambuyo sc makonzedwe, pharmacodynamic poyankha anali wofanana mlingo kutumikiridwa (pazipita, nthawi ya zochita, ambiri zotsatira).

M'maphunziro a nthawi yayitali omwe ali ndi odwala omwe ali ndi mtundu wachiwiri wa shuga omwe adalandira insal insulin mankhwala osakanikirana ndi mankhwala a hypoglycemic, adawonetsedwa kuti amawongolera glycemic (malinga ndi glycosylated hemoglobin -_1s) motsutsana ndi machitidwe azachipatala ndi Levemir ® FlexPen ®, inali yofanana ndi insulin-isophan ndi insulin glargine yokhala ndi kulemera kochepa.

Sinthani kulemera kwa thupi ndi mankhwala a insulin

Mu maphunziro, kugwiritsa ntchito mankhwala osakanikirana ndi mankhwala a Levemir ® FlexPen ® ndi mankhwala a hypoglycemic a 61-65% milanduyi kunachepetsa mwayi wokhala ndi hypoglycemia wofatsa usiku, mosiyana ndi insulin-isophan.

M'maphunziro a nthawi yayitali (miyezi ≥6), kuthamanga kwa shuga m'magazi a odwala matenda a shuga 1 kunali bwino kuyerekeza ndi chithandizo ndi Levemir ® FlexPen ® poyerekeza ndi insulin-isophan yokhazikitsidwa pazomwe zimagwiritsidwa ntchito masiku oyambira / bolus ana ndi achinyamata azaka za 6 mpaka 17. Glycemic control (HbA_1s) pochita ndi Levemir ® FlexPen ® anali wofanana ndi mankhwala a insulin-isophan, omwe ali ndi chiopsezo chocheperako cha usiku hypoglycemia komanso osachulukitsa thupi ndi Levemir ® FlexPen ®.

Mbiri yakuwongolera usiku wa glycemic ndi yosalala komanso yowonjezereka ndi Levemir ® FlexPen ® poyerekeza ndi insulin-isophan, yomwe imawonetsedwa pachiwopsezo chochepa chokhala ndi hypoglycemia yausiku.

Mukamagwiritsa ntchito Levemir ® FlexPen ®, kupanga antibody kunawonedwa. Komabe, izi sizikhudza kuwongolera kwa glycemic.

Pharmacokinetics

Ndi sc makonzedwe, seramu wozungulira anali olingana ndi mlingo kutumikiridwa (C_max, kuchuluka kwa mayamwidwe).

C_max anakwaniritsa maola 6-8 atatha kukhazikitsa. Ndi kaimidwe kawiri tsiku lililonse kwamakonzedwe a C_ss akwaniritsidwa pambuyo jekeseni 2-3.

Kusiyanitsa kwapakati pa intraind payekha ndikotsika kwa Levemir ® FlexPen ® poyerekeza ndi kukonzekera kwina kwa insulin.

Pakati V_d detemir insulin (pafupifupi 0,1 l / kg) imawonetsa kuti gawo lalikulu la insulin limazungulira m'magazi.

Mu in vitro ndi mu vivo protein zomangira mapuloteni zikuwonetsa kusowa kwa kuyanjana kwakukulu pakati pa chinyengo cha insulin ndi mafuta acids kapena mankhwala ena omanga mapuloteni.

Mapangidwe a biotransformation a insulin detemir ali ofanana ndi omwe amakonzekera insulin yaumunthu, ma metabolites onse omwe amapangidwa satha ntchito.

Pokwelera T_1/2 pambuyo pa jekeseni wa sc, amatsimikiza ndi kuchuluka kwa kuyamwa kwa minofu yaying'ono ndipo ndi maola 5-7, kutengera mlingo.

Pharmacokinetics mu milandu yapadera yamankhwala

Panalibe kusiyana kwakanema pakati pa amuna ndi akazi mu pharmacokinetics of Levemir ® FlexPen ®.

Mankhwala a pharmacokinetic a mankhwala Levemir ® FlexPen ® anaphunzitsidwa ana (azaka 6-12) ndi achinyamata (azaka 13 mpaka 17) ndikuyerekeza. Panalibe kusiyana kwazinthu za pharmacokinetic poyerekeza ndi odwala achikulire omwe ali ndi matenda a shuga 1.

Palibe kusiyana kwakanthawi kwamankhwala mu Levemir ® FlexPen ® pakati pa odwala okalamba ndi achinyamata, kapena pakati pa odwala omwe ali ndi vuto laimpso ndi chiwindi ntchito ndi odwala athanzi.

Maphunziro Otetezeka

Kafukufuku wa in vitro mu mzere wam'magazi a anthu, kuphatikiza kafukufuku wokhudza kumanga ma insulin receptors ndi IGF-1 (insulin-like grow factor), adawonetsa kuti insulir insulin ili ndi chiyanjano chotsika kwambiri cha ma receptor onse ndipo ilibe chidwi kwenikweni ndi kukula kwa maselo poyerekeza ndi insulin yaumunthu.

Zambiri zam'mbuyomu potsatira kupenda kwatsoka kwamatendawa, kawopsedwe wa mankhwalawa, genotoxicity, mphamvu ya carcinogenic, zotsatira zoyipa pakubala, sizinawonetse vuto lililonse kwa anthu.

Mlingo

Levemir ® FlexPen ® idapangidwa kuti iziyang'anira.

Mlingo ndi pafupipafupi wa kugwiritsa ntchito mankhwala Levemir ® FlexPen ® amatsimikiziridwa payekhapayekha.

Kuchiza ndi Levemir ® FlexPen ® kuphatikiza ndimankhwala a hypoglycemic, tikulimbikitsidwa kuti muyambe ndi 1 nthawi / tsiku pa mlingo wa 10 PIECES kapena 0.1-0.2 PIECES / kg. Mlingo wa Levemir ® FlexPen ® uyenera kusankhidwa payekha kutengera mphamvu ya glucose ya plasma. Kutengera zotsatira za phunziroli, zotsatirazi ndi malingaliro a kumwa mankhwala: