NovoRapid Flekspen - malangizo * ogwiritsidwa ntchito

Ultra-yochepa insulin NovoRapid: phunzirani zonse zomwe mukufuna. Patsambali mupezapo malangizo ogwiritsa ntchito olembedwa m'chinenerochi. Mvetsetsani momwe mungawerengere mlingo woyenera wa akulu ndi ana, kuchuluka kwa jekeseni iliyonse kumagwira ntchito, momwe mungapewere shuga wochepa wamagazi ndi zina. Dziwani zoyenera kuchita ngati jakisoni wa insulin modzidzimutsa kusiya shuga.

Novorapid ndiye insulin yachangu kwambiri padziko lapansi. Pansi pake amafanizidwa ndi analogues komanso, komanso ndi mankhwala yayitali. Jakisoni wa insulini amafunika kuphatikizidwa ndi njira zabwino zochizira zomwe zimakupatsani mwayi wopewa shuga 3.9-5,5 mmol / L khola maola 24 patsiku, monga mwa anthu athanzi. Dongosololi, lomwe lakhala ndi mtundu woyamba wa matenda ashuga kwa zaka zopitilira 70, limalola anthu akuluakulu ndi ana omwe ali ndi matenda ashuga kudziteteza ku zovuta zowopsa.

Ultrashort insulin NovoRapid: nkhani yatsatanetsatane

Zilonda zamtunduwu ndi zamtundu wina wa insulin ziyenera kuchitika ngati gawo la. Odwala a shuga a Type 2 amagwiritsa ntchito matenda awo. Udindo waukulu wokhalitsa shuga wabwinobwino wamagazi umasewera ndi zakudya, kenako insulin ndi mapiritsi. Mwachitsanzo, insulin yomwe imagwira ntchito mwachidule ndiyabwino kwa odwala matenda ashuga omwe amatsata kuposa Novorapid. Werengani zambiri pansipa.

Malangizo ogwiritsira ntchito

Mukabayidwa NovoRapid, monga mtundu wina wa insulin, muyenera kutsatira zakudya.

Zosankha zamadyedwe kutengera ndi matendawa:

Anthu ambiri omwe ali ndi matenda ashuga omwe amaba jakisoni wofulumira amakhala kuti sizingatheke kupewa hypoglycemia. M'malo mwake, izi siziri choncho. Mutha kusunga shuga wokhazikika ngakhale ndi matenda oopsa a autoimmune. Ndipo makamaka, ndi matenda a shuga a 2 ochepa. Palibe chifukwa chakuwonjezera kuchuluka kwa shuga m'magazi anu kuti mudzilimbitse nokha motsutsana ndi hypoglycemia yoopsa. Onerani kanema yemwe akufotokoza nkhaniyi ndi bambo wa mwana yemwe ali ndi matenda ashuga 1. Phunzirani momwe mungasinthire zakudya zopatsa thanzi komanso mulingo wa insulin.

Kuchita ndi mankhwala ena	Mankhwala ena amachepetsa zotsatira za jakisoni wa insulin, pomwe ena, m'malo mwake, amalimbitsa. Ma Beta blockers amatha kuimitsa zizindikiro za hypoglycemia asanakomoka. Lankhulani ndi dotolo wanu zamankhwala onse omwe mumamwa ndi pulogalamu yanu ya shuga ya insulin.
Bongo	Hypoglycemia yamphamvu imatha kutayika, kuwonongeka kwa ubongo, ngakhale kufa. Werengani momwe mungaperekere chithandizo kwa wodwala kuchipatala komanso kuchipatala. Ngati muli ndi vuto la kugona, itanani ambulansi.
Kutulutsa Fomu	Insulin NovoRapid imapezeka m'mak cartridge atatu. Makatoni awa amatha kusindikizidwa mu zolembera za FlexPen zotayika ndi gawo la 1 IU. Izi sizothandiza kwa odwala matenda ashuga omwe amafuna inshuwaransi yochepa. Mankhwala osawerengeka amagulitsidwa pansi pa dzina la Penfill.

Werengani za kupewa ndi kuchiza mavuto:

Ambiri odwala matenda ashuga akuyang'ana njira zogulira insulin ya Novorapid kuchokera m'manja mwawo, malinga ndi kulengeza kwapadera .. Insulin ndi mankhwala osalimba a mahomoni. Zimasokoneza ndikuphwanya pang'ono. Kuphatikiza apo, mtundu wake sungadziwike ndi maonekedwe. Wopaka insulin Novorapid ukhoza kukhala womveka bwino.

Kugula ndi manja anu, mukuyenera kuti muwonongedwe kapena kukhala ndi insulini yabodza. Nthawi yomweyo, mukuwononga nthawi ndi ndalama zanu, mukuthana ndi vuto lanu la matenda ashuga. Gulani Novorapid ndi mitundu ina ya insulini yokha mumapilisi odalirika, odalirika. Pewani zotsatsa zachinsinsi zogulitsa mankhwala ofunika.

Novorapid - machitidwe a insulin ndi chiyani?

Novorapid ndi mankhwala a ultrashort. Asayansi asintha kapangidwe kake pang'ono poyerekeza ndi insulin wamba yaumunthu, kotero kuti imayamba kuchita zinthu mwachangu, atangolowa jakisoni. M`pofunika kudya pasanathe mphindi 10-20 pambuyo mankhwala. Ichi chingakhale insulin yothamanga kwambiri padziko lapansi. Ngakhale jakisoni wa mahomoni amachita mosiyanasiyana kwa odwala matenda ashuga onse. Ena angazipeze mwachangu.

Mungamayike bwanji?

Phunzirani kapena. Gwiritsani ntchito moyenera insulini yothamanga ngati mbali imodzi ya njira zotithandizira kukhalabe ndi shuga. Pochiza matenda a shuga, kudya zakudya zopatsa thanzi kumatenga gawo lalikulu, kenako kusankha mitundu ya insulin yomwe imagwiritsidwa ntchito, kusankha kwa mapiritsi ndi ndondomeko ya jakisoni.

Anthu odwala matenda ashuga omwe amatsatira mankhwala a Novorapid ndi mapikidwe ake sili othandiza kwambiri ngati insulin yachangu musanadye. Chifukwa amachita zinthu mwachangu kuposa momwe akumira. Pakhoza kukhala zochitika, komanso kudumphira m'magulu a shuga. Zitha kukhala zoyenera kugwiritsa ntchito insulin yayifupi, mwachitsanzo. Komanso, zimawononga zochepa.

Ndikofunikira kwa masiku angapo kuti muzindikire za shuga. Tsimikizani musanadye chakudya chomwe mukufuna jakisoni wa insulin yofulumira. Zitha kuzindikirika kuti palibe chifukwa chobayira Novorapid katatu patsiku, koma jakisoni 1-2 ndikokwanira kapena mutha kuchita popanda iwo. Werengani nkhaniyo kuti "" kuti mumve zambiri. Jakisoni wa Novorapid amachitika mphindi 10-20 asanadye. Osayesa kulumpha chakudya mutatha kupaka insulin. Idyani motsimikiza.

Chithandizo cha matenda a shuga a insulin - komwe mungayambire:

Kodi jakisoni wa mankhwalawa amatenga nthawi yayitali bwanji?

Mlingo uliwonse wa Novorapid wa insulin umatenga pafupifupi maola anayi. Palibenso chifukwa choyezera shuga pakatha maola awiri jakisoni, chifukwa munthawi imeneyi mankhwalawa sangakhale ndi nthawi yochita mokwanira. Yembekezani maola 4, kenako kuyeza glucose wamagazi anu ndikubaya jekeseni yotsatira ngati pakufunika. Ndikwabwino kusalola milingo iwiri ya insulin kuti ichite munthawi yomweyo mthupi. Kuti muchite izi, perekani Novorapid mosinthana ndi maola osachepera anayi.

Kodi ndingapeze kuti kufanizira kwa Novorapid ndi Levemir insulin?

Novorapid ndipo - awa si mitundu yonse ya insulin. Sangafanane, chifukwa amathetsa mavuto osiyanasiyana pakulamulira matenda ashuga. Zitha kugwiritsidwa ntchito nthawi yomweyo. Ambiri odwala matenda ashuga amachita izi. Mukudziwa kale kuti Novorapid ndi insulin yotsalira-yochepa. Amamenyedwa musanadye, komanso pangozi zadzidzidzi mukafunikira kuthamangitsa shuga wambiri.

Levemir ndi mankhwala omwe akhala akuchita kwa nthawi yayitali. Imagwiritsidwa ntchito kotero kuti pali maziko a insulin m'magazi mosalekeza maola 24 patsiku. Izi zimapangitsa shuga m'magazi komanso zimalepheretsa kuchepa kwa minofu ndi ziwalo zamkati. Levemir sanapangidwe kuti achepetse kuchuluka kwa glucose pambuyo chakudya.

Mtundu wa 1 ndi matenda a shuga a 2, ovuta kwambiri, mitundu iwiri ya insulin iyenera kugwiritsidwa ntchito nthawi imodzi - yayitali komanso yochepa (ultrashort). Ikhoza kukhala Levemir ndi Novorapid kapena analogu omwe amapikisana nawo. Mankhwala olimbikitsidwa omwe adalembedwa mu nkhani "". Samalani ndi insulin yayitali, yomwe m'njira zambiri ndiyabwino kuposa Levemir.

Novorapid insulin analogues ndi mankhwala osokoneza bongo komanso. Amapangidwa ndi makampani opikisana azamankhwala. Mitundu yonse ya insulini ndiyofanana kwambiri. atero Humalog ndiwofulumira komanso wamphamvu kuposa Apidra ndi Novorapid. Komabe, m'mabungwe a matenda ashuga, zofalitsa zambiri zimatsutsa izi.

Pochita masewera olimbitsa thupi, kusiyana pakukonzekera mpikisano wa insulin sikofunika kwenikweni. Monga lamulo, odwala matenda ashuga amapaka insulin yomwe amawapatsa kwaulere. Popanda kufunikira kwakukulu, ndibwino kuti musasinthe kuchokera ku Novorapid kupita ku imodzi mwazofanana. Kusintha koteroko kumachepetsa kuyendetsa magazi kwa masiku angapo kapena masabata.

Kungakhale koyenera kusinthira ku insulin yochepa ya anthu. Mwachitsanzo, pa. Malangizo awa ndi a odwala matenda ashuga omwe amatsatira. Mbiri ya zochita za insulin yochepa ikugwirizana ndi kuchuluka kwa kukondoweza. Ndipo Novorapid ndi mankhwala ena a ultrashort amachita zinthu mwachangu kwambiri.

NovoRapid pa nthawi yapakati

Insulin Novorapid itha kugwiritsidwa ntchito kuwongolera shuga yayikulu m'magazi mwa amayi. Sichimabweretsa mavuto apadera kwa mayi kapena kwa mwana wosabadwayo. Chonde dziwani kuti Novorapid ndi mankhwala a ultrashort. Imagwira mwachangu komanso mwamphamvu kuposa insulin yokhazikika. Chiwopsezo cha wodwala chimawonjezeka, makamaka hafu yoyamba ya kubereka, pamene chidwi chokhudza thupi cha insulin chiri pamwamba kwambiri.

Izi sizitanthauza kuti muyenera kusiya kugwiritsa ntchito mankhwala a Novorapid insulin panthawi yapakati. Mankhwala omwe adanenedwa angagwiritsidwe ntchito motsogozedwa ndi dokotala. Onetsetsani kuti mayi woyembekezera akumvetsetsa kuchuluka kwake. Simuyenera kukhala aulesi kuyeza shuga la magazi anu kangapo tsiku lililonse. Sinthani mlingo wanu wa insulin malinga ndi izi. Mupeza zambiri zosangalatsa mu nkhani “” ndi “”. Nthawi zambiri ndi zakudya zoyenera zomwe mungachite popanda Novorapid insulin ndi mankhwala ena amphamvu a ultrashort.

Hypoglycemic mankhwala, analogue yaifupi osakhalitsa a insulin.
Kukonzekera: NOVORAPID® Flexpen®
The yogwira mankhwala: insulin
ATX Encoding: A10AB05
KFG: Analogue yaifupi ya insulin
Nambala yolembetsa: P No. 016171/01
Tsiku lolembetsa: 01/27/05
Mwini reg. acc: NOVO NORDISK A / S

Kutulutsa mawonekedwe a Novorapid flekspen, ma CD ndikuphatikizira ndi mankhwala.

Njira yothetsera utsogoleri wa sc / iv ndi yowonekera, yopanda utoto.

1 ml
insulin
100 PISITES *

Omwe amathandizira: glycerol, phenol, metacresol, zinc chloride, disodium phosphate dihydrate, sodium chloride, sodium hydroxide, hydrochloric acid, madzi d / i.

* 1 unit imafanana ndi 35 mcg wa mankhwala osokoneza bongo a insulin.

3 ml - ma syringe ambiri omwe ali ndi mulingo wambiri (5) - ma CD.

Kufotokozera kwa mankhwalawa kumatengera malangizo ovomerezeka omwe angagwiritsidwe ntchito.

Mankhwala zochita za Novorapid flekspen

Mankhwala osokoneza bongo a hypoglycemic, analogue of human-temporary insulin, opangidwa ndi recopinant DNA biotechnology pogwiritsa ntchito Saccharomyces cerevisiae strain momwe amino acid proline m'malo a B28 m'malo mwake 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). 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.

Kulowetsedwa kwa amino acid proline pamalo a B28 okhala ndi aspartic acid ku NovoRapid Flexpen kumachepetsa chizolowezi chopanga ma molekyulu kupanga hexamers, yomwe imawonedwa mu yankho la insulin wamba. Pankhaniyi, NovoRapid Flexpen imatengedwa mwachangu kuchokera ku mafuta a subcutaneous ndipo imayamba kuchita zinthu mwachangu kwambiri kuposa insulle yamunthu. NovoRapid Flexpen amachepetsa kuchuluka kwa shuga m'magazi anayi oyambirira atatha kudya kusiyana ndi insulin yaumunthu.

Pambuyo pa utsogoleri wa sc, mphamvu ya mankhwalawa imayamba pakadutsa mphindi 10 mpaka 10 pambuyo pa kutsata. Kuchuluka kwake kumawonedwa patatha maola atatu jekeseni. Kutalika kwa mankhwalawa ndi maola 3-5.

Mukamagwiritsa ntchito mankhwala a NovoRapid Flexpen insulin odwala omwe ali ndi matenda a shuga 1, pali kuchepa kwa chiwopsezo cha nocturnal hypoglycemia poyerekeza ndi insulin ya insuble yamunthu.Panalibe kuwonjezeka kwakukulu pachiwopsezo cha hypoglycemia masana.

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

Zoyesa zamankhwala zokhudzana ndi odwala akuluakulu omwe ali ndi matenda amtundu wa 1 asonyeza kuchuluka kwa shuga m'magazi ndi makonzedwe a NovoRapid Flexpen poyerekeza ndi insulin ya insuble yaumunthu.

Kugwiritsidwa ntchito kwa NovoRapid Flexpen mwa ana kuwonetsa zotsatira zofananira zakwanthawi yayitali kuchepetsa kuchuluka kwa shuga poyerekeza ndi insulin yaumunthu. Kuyesedwa kuchipatala pogwiritsa ntchito insulin ya anthu osungunuka musanadye ndi katsitsumzukwa pambuyo pakudya kunachitika mwa ana a zaka 2 mpaka 6 (odwala 26), ndipo kafukufuku wokhawokha wa mankhwala a pharmacokinetic / pharmacodynamic adachitika mwa ana 6-12 zaka ndi achinyamata azaka 13-17. Mbiri ya pharmacodynamic ya insulin aspart mwa ana inali yofanana ndi ya akuluakulu.

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: 322 + 27 odwala: 157 adalandira insulini, 165 alandila insulin mwana wosabadwa / wakhanda. Mayeso owonjezeredwa azachipatala azimayi omwe ali ndi gestational shuga mellitus omwe adalandira insulin aspart (odwala 14) ndi insulin ya anthu (13 odwala) amawonetsa kufananizidwa ndikuwonetsa bwino pakukonzanso kusintha kwa glucose pambuyo pa chakudya ndi chithandizo cha insulin.

Pharmacokinetics wa mankhwala.

Pambuyo sc pokonza insulin, katsabola Tmax mu plasma pafupifupi 2 kawiri poyerekeza pambuyo soluble munthu insulin. Cmax m'magazi a plasma pafupifupi 492 ± 256 pmol / L ndipo amakwaniritsidwa mphindi 40 pambuyo pa s / c pa mlingo wa 0.15 IU / kg pa kulemera kwa odwala omwe ali ndi vuto la matenda a shuga 1. mankhwala. Kuchuluka kwa mayamwa kumacheperachepera odwala omwe ali ndi mtundu wa matenda a shuga 2, omwe amatsogolera kutsika kwa Cmax (352 ± 240 pmol / L) ndipo pambuyo pake Tmax (60 min). Kusiyana kwapawiri kwa Tmax kumakhala kotsika kwambiri mukamagwiritsa ntchito insulini aspart poyerekeza ndi insulin yamunthu, pomwe kusiyanasiyana kwapadera kwa Cmax kwa insulin aspart ndikokulira.

Mlingo ndi njira ya mankhwala.

NovoRapid Flexpen lakonzedwera utsogoleri wa SC ndi iv. NovoRapid Flexpen imayamba mwachangu komanso yofupika nthawi yochitirapo kanthu kuposa insulle yamunthu insulin. Chifukwa cha kuyambika mwachangu, NovoRapid Flexpen iyenera kuperekedwa, ngati lamulo, musanadye chakudya (ngati kuli kotheka, chitha kuperekedweratu chakudya chisanafike).

Mlingo wa mankhwalawa umatsimikiziridwa ndi dokotala payekha kutengera kuchuluka kwa shuga m'magazi. NovoRapid Flexpen nthawi zambiri imagwiritsidwa ntchito limodzi ndi nthawi yayitali kapena nthawi yayitali kukonzekera insulin, yomwe imaperekedwa osachepera 1 nthawi / tsiku.

Nthawi zambiri, zofunika tsiku lililonse kuti insulin ichoke kuyambira 0,5-1 U / kg thupi. Mothandizidwa ndi mankhwala musanadye, kufunika kwa insulin kungaperekedwe ndi mankhwala a NovoRapid Flexpen ndi 50-70%, kufunika kwa insulin kumaperekedwa ndi insulin yowonjezera.

Kutentha kwa insulin yoyenera kuyenera kukhala kutentha kwambiri.

NovoRapid Flexpen ndi jekeseni sc m'dera la anterior m'mimba khoma, ntchafu, phewa kapena matako. Masamba obayira omwe ali mdera lomwelo la thupi amayenera kusinthidwa pafupipafupi.

Monga kukonzekera kwina konse kwa insulin, kutalika kwa NovoRapid Flexpen kutengera mlingo, malo a jakisoni, kuchuluka kwa magazi, kutentha ndi kuchuluka kwa zochitika zolimbitsa thupi.

Kuwongolera kwa SC kukhoma lakumbuyo yam'mimba kumayamwa mwachangu poyerekeza ndi kayendetsedwe ka malo ena. Komabe, kuyambira mwachangu poyerekeza ndi insulin yaumunthu yosungunuka imasungidwa mosasamala malo omwe jakisoniyo anali.

Ngati ndi kotheka, NovoRapid Flexpen ikhoza kutumikiridwa iv, koma kokha ndi akatswiri azachipatala oyenerera.

Pa makonzedwe amkati, makina a kulowetsedwa amagwiritsidwa ntchito ndi NovoRapid Flexpen pen 100 U / ml ndi kuchuluka kwa 0.05 U / ml mpaka 1 U / ml insulin katsitsiro mu 0.9% sodium chloride solution, 5% kapena 10% dextrose solution yokhala ndi 40 mmol / l potaziyamu kolorayidi pogwiritsa ntchito matumba a polypropylene kulowetsedwa. Njira zoterezi ndizokhazikika pakukhazikika kwa kutentha kwa maola 24. Pa insulin infusions, ndikofunikira kuyang'anitsitsa kuchuluka kwa shuga m'magazi.

NovoRapid Flexpen itha kugwiritsidwanso ntchito popitilira s / c insulin infusions (PPII) m'mapampu a insulini opangidwa chifukwa cha insulin infusions. FDI iyenera kupangidwa khoma lakunja kwam'mimba. Malo olowetsedwa amayenera kusinthidwa nthawi ndi nthawi.

Mukamagwiritsa ntchito pampu ya insulin paku kulowetsedwa, NovoRapid Flexpen sayenera kusakanikirana ndi mitundu ina ya insulin.

Odwala omwe akugwiritsa ntchito FDI ayenera kuphunzitsidwa bwino kugwiritsa ntchito pampu, chosungira choyenera, ndi dongosolo la ma pump pump. The kulowetsedwa set (chubu ndi catheter) ziyenera m'malo mwa wogwiritsa buku malangizo ophatikizidwa ndi kulowetsedwa.

Odwala omwe amalandila NovoRapid Flexpen wokhala ndi PPI ayenera kukhala ndi insulini yowonjezera pakuwonongeka kwa kulowetsedwa.

NovoRapid Flexpen ndi cholembera chodzaza ndi syringe ndi dispenser. Cholembera chimbale cha FlexPen chidapangidwa kuti chitha kugwiritsidwa ntchito ndi jakisoni wothandizira makampani omwe amapanga insulin ndi singano yokhala ndi kapu yayifupi ya NovoFayn. Kukhazikitsa ndi singano kumakhala ndi chizindikiro "S". Syringe ya flexpen imapereka mwayi wolowera kuchokera 1 mpaka 60 magawo a mankhwalawo molondola 1 unit. Muyenera kutsatira malangizo atsatanetsatane a buku la malangizo omwe aperekedwa ndi chipangizocho.

FlexPen Syringe cholembera ndiyoti azigwiritsa ntchito payekha ndipo sangakwaniritsidwe.

Zotsatira zoyipa za Novorapid flekspen:

Zotsatira zoyipa zomwe zimakhudzana ndi kagayidwe kazachilengedwe: hypoglycemia (kutuluka thukuta, khungu, mantha kapena kunjenjemera, kuda nkhawa, kufooka kapena kufooka, kusokonezeka, kusokonezeka, chizungulire, njala yayikulu, kusokonezeka kwakanthawi, mutu , nseru, tachycardia). Hypoglycemia yayikulu imatha kutha kwamtenda ndi / kapena kukhumudwa, kusokonezeka kwakanthawi kapena kosasintha kwa ubongo ndi imfa.

Zomwe zimachitika chifukwa chotsatira zoyipa zimatchulidwa kuti: infrequent (> 1/1000, 1/10000, Mankhwala

Chofunikira chachikulu cha mankhwalawo ndi insulin, ndipo chimakhala ndi mphamvu kwambiri pa hypoglycemic, ndi analog yochepa ya insulin, yomwe imapangidwa m'thupi la munthu. Katunduyu amapezeka pogwiritsa ntchito ukadaulo wa DNA.

Mankhwalawa amakumana ndi ma cell am'mimba a cytoplasmic amino acid, amapanga zovuta za insulin, amayamba zomwe zimachitika mkati mwa maselo. Pambuyo kuchepa kwa shuga m'magazi kumadziwika:

1. kuchuluka kwanyumba,
2. kuchuluka kwa kugaya kwaminyewa,
3. kutsegulira kwa lipogenesis, glycogeneis.

Kuphatikiza apo, ndizotheka kukwaniritsa kuchepa kwa kuchuluka kwa kupanga kwa shuga ndi chiwindi.

NovoRapid imakhala bwino kwambiri ndi mafuta onunkhira kuposa insulin yaumunthu, koma kutalika kwa zotsatirazi kumakhala kotsika kwambiri. Kuchita kwa mankhwalawa kumachitika pakadutsa mphindi 10-20 pambuyo pa jekeseni, ndipo nthawi yake ndi maola 3-5, kuchuluka kwakukulu kwa insulin kumadziwika pambuyo pa maola 1-3.

Kafukufuku wazachipatala wa odwala omwe ali ndi mtundu woyamba wa matenda ashuga awonetsa kuti kugwiritsa ntchito mwanjira ya NovoRapid kumachepetsa mwayi wokhala usiku usiku kangapo. Kuphatikiza apo, pali umboni wa kuchepa kwakukulu kwa postprandial hypoglycemia.

• kumva kwambiri kwa thupi pazinthu zomwe zimapangidwa,
• ana osakwana zaka 6.

Mankhwala amaloledwa kugwiritsidwa ntchito pochiza matenda wamba.

Momwe mungawerengere kuchuluka kwake

Kuti muwerenge molondola kuchuluka kwa mankhwalawa, muyenera kudziwa kuti insulin ya mahomoni ndi ultrashort, yochepa, yapakatikati, yowonjezereka ndikuphatikizidwa. Kubwezeretsanso shuga m'magazi, mankhwala osakanikirana amathandizira, amatumizidwa pamimba yopanda kanthu ndi matenda a shuga a mtundu woyamba kapena wachiwiri.

Ngati wodwala m'modzi akuwonetseredwa insulin yayitali, ndiye, ngati kuli kotheka, kupewa kusintha kwadzidzidzi muulumbe wa shuga, NovoRapid akuwonetsedwa pokhapokha. Zochizira hyperglycemia, ma insulin afupiafupi ndi aatali amatha kugwiritsidwa ntchito nthawi imodzi, koma nthawi zosiyanasiyana. Nthawi zina, kuti mukwaniritse zomwe mukufuna, kuphatikiza insulin kokha ndikoyenera.

Posankha chithandizo, dokotala amakumbukira zina, mwachitsanzo, chifukwa cha insulin yayitali yokha, ndizotheka kusunga glucose ndikupanga popanda jakisoni wa mankhwala omwe amangokhala pang'ono.

Kusankha kwa nthawi yayitali kumafunikira motere:

1. shuga wamagazi amayeza asanadye chakudya cham'mawa,
2. Maola atatu mutatha kudya nkhomaliro, tengani muyeso wina.

Kafukufuku wowonjezereka akuyenera kuchitika maola onse. Patsiku loyamba kusankha mlingo, muyenera kudumpha chakudya chamasana, koma kudya chakudya chamadzulo. Patsiku lachiwiri, miyezo ya shuga imachitika ola lililonse, kuphatikiza usiku. Pa tsiku lachitatu, miyezo imachitika mwanjira yotere, chakudya sichikhala ndi malire, koma samaba jakisoni wochepa. Zotsatira zabwino zam'mawa: tsiku loyamba - 5 mmol / l, tsiku lachiwiri - 8 mmol / l, tsiku lachitatu - 12 mmol / l.

Tiyenera kukumbukira kuti NovoRapid amachepetsa kuchuluka kwa shuga m'magazi kamodzi ndi theka kuposa mphamvu zake. Chifukwa chake, muyenera kupaka jekeseni ya 0,4 ya insulin yochepa. Molondola, mulingo wokhawo womwe ungakhazikitsidwe poyesa, poganizira zovuta za matenda ashuga. Kupanda kutero, bongo umayamba, womwe umayambitsa zovuta zingapo.

Malamulo akulu othandiza kudziwa kuchuluka kwa insulin kwa odwala matenda ashuga:

• matenda oyamba a shuga oyamba - 0.5 PISCES / kg,
• ngati matenda ashuga amawonekera koposa chaka - 0,6 U / kg,
• shuga wovuta - 0,7 U / kg,
• shuga wowola - 0,8 U / kg,
• matenda a shuga kumbuyo kwa ketoacidosis - 0,9 PIECES / kg.

Amayi oyembekezera mu trimester yachitatu amawonetsedwa kuperekera insulin ya 1 U / kg. Kuti mudziwe mtundu umodzi wa chinthu, ndikofunikira kuchulukitsa kulemera kwa thupi tsiku lililonse, kenako ndikugawa awiri. Zotsatira zake ndizofanana.

NovoRapid Flexpen

Kukhazikitsa kwa mankhwalawa kumachitika pogwiritsa ntchito cholembera, imakhala ndi dispenser, color coding. Kuchuluka kwa insulini kungakhale kuyambira 1 mpaka 60 mayunitsi, gawo mu syringe ndi 1 unit. Ku NovoRapid, singano ya Novofine ya 8 mm imagwiritsidwa ntchito.

Kugwiritsa ntchito cholembera kuti mugwiritse ntchito timadzi tating'onoting'ono, muyenera kuchotsa chotsekera pachingano, ndikuchikula ndi cholembera. Nthawi iliyonse ikagwiritsa ntchito singano yatsopano jakisoni, izi zimathandiza kupewa kukula kwa mabakiteriya. Singano siyoletsedwa kuti iwononge, kugwada, kusamutsa kwa odwala ena.

Cholembera cha syringe chimatha kukhala ndi mpweya wochepa mkati, kuti mpweya usadziunjike, mlingowo walowetsedwa molondola, umawonetsedwa kuti umatsatira malamulo awa:

• kuyimba 2 magawo potembenuza chosankha,
• ikani cholembera ndi singano kumtunda, ikani bokosi pang'ono ndi chala chanu,
• kanikizani batani loyambira njira yonse (wosankhayo abwerere ku 0).

Ngati dontho la insulin silikuwoneka pa singano, njirayi imabwerezedwa (osaposanso 6). Ngati yankho silikuyenda, izi zikutanthauza kuti cholembera sichingagwiritsidwe ntchito.

Asanakhazikitse Mlingo, wosankhayo ayenera kukhala pamalopo 0. Pambuyo pake, kuchuluka kwa mankhwala komwe kumapangidwira, ndikusintha osankhidwa mbali zonse ziwiri.

Sizoletsedwa kukhazikitsa zomwe zili pamwamba pa zomwe zimayikidwa, gwiritsani ntchito muyeso kuti mupeze kuchuluka kwa mankhwalawo. Ndi kuyambitsa kwa mahomoni pansi pa khungu, njira yolimbikitsidwa ndi adokotala ndiyovomerezeka. Kuti mupeze jakisoni, kanikizani batani loyambira, musatulutse mpaka wosankhayo atafika 0.

Kuzungulira kwa chizindikiritso cha mlingo sikungayambitse kupita kwa mankhwalawa; pambuyo pa jakisoni, singano iyenera kugwiridwa pansi pakhungu kwa masekondi 6 ena, ndikutsata batani loyambira. Izi zikuthandizani kuti mulowe ku NovoRapid kwathunthu, monga adanenera.

Singano imayenera kuchotsedwa pambuyo pobayidwa aliyense, sayenera kusungidwa ndi syringe, apo ayi mankhwalawa adzayamba kutayikira.

Mapangidwe a odwala matenda ashuga

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

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

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

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

Pharmacology

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

Mankhwalawa amakumana ndi zolandilira zam'mimba za cytoplasmic yama cell, pomwe amapanga zovuta zonse za insulin, amapangitsa njira zonse zomwe zimachitika mkati mwa maselo. Pambuyo pakuchepa kwa kuchuluka kwa shuga mu plasma, kuchuluka kwa zoyendera zamkati, kuchuluka kwa chidwi cha minofu yambiri, kuwonjezeka kwa glycogenogeneis ndi lipogenesis. Kuchuluka kwa shuga komwe kumachitika m'chiwindi kumachepa.

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

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

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

Kafukufuku wa anthu omwe ali ndi matenda a shuga a I adawonetsa kuchepa kwakawiri pachiwopsezo cha nocturnal hypoglycemia ndi NovoRapid, makamaka poyerekeza ndi kuyamwa kwa insulin yamunthu. Kuphatikiza apo, panali kuchepa kwakukulu kwa gluprose wa postprandial mu plasma pamene adabayidwa ndi insulin aspart.

Zizindikiro ndi contraindication

Mankhwala NovoRapid (insulin) amapangidwira anthu omwe ali ndi matenda a shuga 1, omwe amadalira insulin, komanso odwala omwe ali ndi matenda a shuga 2 - osagwirizana ndi insulin omwe amadalira pakamwa motsutsana ndi hypoglycemic mankhwala omwe amatengedwa pakamwa, komanso matendawa. .

Contraindication kugwiritsa ntchito mankhwalawa ndi hypoglycemia ndi chidwi chokhudza thupi insulin aspart, okonda mankhwala.

Osagwiritsa ntchito NovoRapid wa ana ochepera zaka zisanu ndi chimodzi chifukwa chakusowa kwa maphunziro azachipatala.

Mankhwala "NovoRapid": malangizo ogwiritsira ntchito

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

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

Mukalandira jekeseni wa mankhwala a NovoRapid (malangizo omwe angagwiritsidwe ntchito amafotokozera mwatsatanetsatane dongosolo la mankhwalawa), kufunikira kwa insulin kumaperekedwa ndi 50-70%. Ena onse amakhutitsidwa ndi kuyendetsedwa kwa insulin yayitali (ya nthawi yayitali). Kuwonjezeka kwa zochitika zolimbitsa thupi kwa wodwalayo ndikusintha kwa zakudya, komanso ma concomitant pathologies nthawi zambiri kumapangitsa kusintha kwa mlingo womwe waperekedwa.

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

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

Odwala okalamba, komanso kwa anthu omwe ali ndi vuto la impso kapena hepatic, kuwongolera kwa glucose m'magazi kuyenera kuchitika pafupipafupi, ndipo kuchuluka kwa insulini ya insulin kumasankhidwa payekha.

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

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

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

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

Momwe mungawerengere kuchuluka kwa insulin?

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

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

Kusankhidwa kwa mlingo wa insulin yayitali kwakhala motere:

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

Zizindikiro zoyenera m'mawa ndi:

• tsiku la 1 - 5 mmol / l,
• patsiku la 2 - 8 mmol / l,
• pa tsiku la 3 - 12 mmol / l.

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

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

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

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

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

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

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

Malamulo oyenera kudziwa mtundu wa odwala matenda ashuga:

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

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

Zotsatira zoyipa

Mankhwala "NovoRapid" amatha kuyambitsa zovuta zingapo. Ichi ndi hypoglycemia, chomwe chimadziwonetsera mu thukuta lokwanira, khungu, mantha, malingaliro osaganizira, nkhawa, kunjenjemera, kufooka m'thupi, kusayenda bwino komanso kutsitsidwa ndende. Chizungulire, njala, kusagwira bwino ntchito kwa zida zowonekera, mseru, mutu, tachycardia kumachitikanso. Glycemia imatha kuyambitsa khungu, ziwopsezo, kusokonekera kwa ubongo ndi ntchito.

Nthawi zambiri, odwala amalankhula za mawonekedwe amtunduwu monga urticaria, totupa. Mwina kuphwanya m'mimba ndi matumbo, mawonekedwe a angioedema, tachycardia, kufupika kwa mpweya. Odwala adakumana ndi kuchepa kwa kuthamanga kwa magazi.

Mwa zina zomwe zimachitika mderalo, kuyabwa m'malo obaya, khungu, komanso kutupa kwa khungu. Nthawi zambiri, zizindikiro za lipodystrophy zachitika. Mankhwalawa amatha kuyambitsa edema koyambirira kwa chithandizo, komanso kuphwanya Refraction.

Madokotala amati mawonetseredwe onse ndi osakhalitsa ndipo amawonedwa makamaka mwa odwala omwe amadalira mlingo wa mankhwala ndipo amayamba chifukwa cha mankhwala omwe amapezeka ndi insulin.

Ngati mahomoni sagwira ntchito, ndiye kuti nthawi zonse mutha kusintha mankhwala a NovoRapid Flexpen. Ma analogues, kumene, ayenera kusankhidwa ndi adokotala. Zotchuka kwambiri ndi:

Mtengo wa mahormone

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

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

Kugwiritsa ntchito mankhwala a Novorapid flekspen

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

Malangizo apadera ogwiritsira ntchito mankhwala a Novorapid flekspen

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

Zochita ndi mankhwala a Novorapid flekspen

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

Mankhwala osokoneza bongo a Novorapid flekspen, zizindikiro ndi chithandizo

Ngakhale tanthauzo lenileni la mankhwala osokoneza bongo silinapangidwe ka insulin, hypoglycemia imatha kuchitika pambuyo pa kutsata.
Pankhani ya hypoglycemia yofatsa, shuga kapena shuga wa shuga ayenera kumwedwa pamlomo. Chifukwa chake, odwala matenda a shuga amalangizidwa kuti azikhala ndi zidutswa zingapo za shuga kapena maswiti nawo.
Mu hypoglycemia yayikulu, wodwala akakhala kuti sakudziwika, ndikofunikira kuchita jakisoni wa glucagon (0.5-1 mg), yomwe imatha kuchitidwa ndi anthu omwe adalandira malangizo oyenera. Katswiri wazachipatala amatha kupatsa shuga shuga wa iv. Glucose iyenera kutumikiridwa iv komanso ngati wodwalayo sayankha kuyendetsa glucagon kwa mphindi 10-15. Wodwalayo akadziwikanso, amayenera kudya zakudya zamagulu mkati kuti asayambenso matenda obwera chifukwa cha hypoglycemia.

Kusunga mankhwala a Novorapid flekspen

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

Mndandanda wamankhwala komwe mungagule Novorapid flekspen:

CNF (mankhwalawa akuphatikizidwa ndi boma la Kazakhstan

ALO (Yophatikizidwa ndi Mndandanda wa Mankhwala Opanda Zipatala)

ED (Yophatikizidwa ndi Mndandanda wamankhwala mkati mwamagetsi yotsimikizika yazogulitsa zamankhwala zomwe zitha kugulidwa kuchokera kwa Ogulitsa Ogwirizanitsidwa)

Wopanga: Novo Nordisk A / S

Anatomical-achire mankhwala-magulu: Insulin

Nambala Yalembetsa: No. RK-LS-5№021556

Tsiku lolembetsa: 04.08.2015 - 04.08.2020

NovoRapid Penfill zotsatira zoyipa

• Zotsatira zoyipa zomwe zimakhudzana ndi kagayidwe kazachilengedwe: hypoglycemia (kutuluka thukuta, khungu, mantha kapena kunjenjemera, kuda nkhawa, kufooka kapena kufooka, kusokonezeka, kusokonezeka, chizungulire, njala yayikulu, kusokonezeka kwakanthawi, mutu , nseru, tachycardia). Hypoglycemia yayikulu imatha kutha kwamtenda ndi / kapena kukhumudwa, kusokonezeka kwakanthawi kapena kosasintha kwa ubongo ndi imfa. Zotsatira zoyipa zidafotokozedwa ngati: infrequent (> 1/1000, 1/10000,

Zambiri za NovoRapida

NovoRapid imadziwika kuti ndi analogue mwachindunji a insulin yaumunthu, koma imakhala yamphamvu kwambiri molingana ndi momwe imagwirira ntchito. Gawo lake lalikulu ndi insulin aspart, yomwe ili ndi kufupikitsa kwa hypoglycemic. Chifukwa chakuti kusuntha kwa glucose mkati mwa maselo kumawonjezeka, ndipo mapangidwe ake m'chiwindi amachepetsa, shuga wamagazi amatsika kwambiri.

Pambuyo kuchepetsa kuchuluka kwa shuga m'magazi, njira zotsatirazi zimachitika:

NovoRapid yothetsera vutoli imatha kuperekedwa mwachangu kapena kudzera m'mitsetse.Koma makonzedwe pansi pa khungu amalimbikitsidwa, ndiye kuti NovoRapid imagwira bwino ntchito kwambiri ndipo imagwira ntchito mwachangu kwambiri poyerekeza ndi insulin yosungunuka. Koma kutalika kwa nthawi sikutalika monga momwe sungunuka wa insulin.

NovoRapid imayendetsedwa nthawi yomweyo jakisoni - itatha mphindi 10-15, kuwonekera kwakukulu kumawonekera pambuyo pa maola 2-3, ndipo nthawiyo imakhala maola 4-5.

Odwala munthawi yogwiritsira ntchito mankhwalawa amathandizanso kudziwa kuti mankhwalawa atha kukhala obwera usiku womwe hypoglycemia ikayamba. Kuphatikiza apo, simuyenera kuda nkhawa kuti NovoRapid insulin idzayamba kuzolowera thupi, nthawi zonse mumatha kusintha kapena kusintha mankhwalawa.

Zizindikiro zogwiritsa ntchito NovoRapida

Mankhwala amathandizidwa ndi matenda otsatirawa:

NovoRapid ndiwotsutsana mwa otsatirawa:

Insulin NovoRapid amavomerezedwa kuti azitsogolera matenda ashuga mwa azimayi onse panthawi yoyembekezera komanso panthawi yoyamwitsa.

Nthawi zina, ndi jekeseni ya NovoRapid, zimachitika zovuta:

Pakachitika zinthu zosokoneza bongo mthupi mumachitika izi:

1. Kukhumudwitsa
2. Hypotension,
3. Khungu pakhungu.

Kupanga kwa NovoRapida

Kampani yopanga NovoRapida - Novo Nordisk, dziko - Denmark. Dzinalo lapadziko lonse lapansi ndi insulin aspart.

NovoRapid imapezeka m'mitundu iwiri:

1. M'malo mwake ma cartridges Penfill.

Mankhwalawo pawokha ndi ofanana mumtunduwu - madzi omveka, opanda utoto, 100 ml ya chinthu chogwira ali 1 ml. Monga gawo la zolembera ndi makatiriji a 3 ml a insulin.

Kupanga kwa NovoRapid insulin kumachitika malinga ndi ukadaulo wapadera wokhazikitsidwa ndi Saccharomyces cerevisiae strain, amino acid imasinthidwa ndi asidi waartartic, chifukwa chomwe kuphatikizira kwa receptor kumachitika, kumayendetsa njira zomwe zimachitika m'maselo, komanso mankhwala omwe amapanga zigawo zikuluzikulu (glycogen synthetase, hexokinases).

Kusiyana pakati pa mitundu ya NovoRapid FlexPen ndi NovoRapid Penfill kumangokhala mwa njira yotulutsidwa: mtundu woyamba ndi cholembera, chachiwiri ndi makatoni oloweza. Koma mankhwala omwewo amawatsanulira pamenepo. Wodwala aliyense ali ndi mwayi wosankha mtundu wa insulini womwe ungamuvute kugwiritsa ntchito.

Mitundu yonseyi ya mankhwala ingagulidwe kokha m'masitolo ogulitsa ndi mankhwala.

Ma Analogs a NovoRapida

Ngati NovoRapid sioyenera kwa odwala matenda ashuga pazifukwa zilizonse, ndiye kuti dokotala amalimbikitsa kugwiritsa ntchito ma fanizo otsatirawa: Apidra, Gensulin N, Humalog, Novomiks, Rizodeg. Mtengo wawo uli wofanana.

Nthawi zambiri odwala amafunsa madokotala awo funso: "Kodi ndi chiyani - Humalog kapena NovoRapid?". Koma sipangakhale chidziwitso cholondola cha yankho, popeza mitundu yosiyanasiyana ya insulin imakhudzanso wodwala aliyense yemwe ali ndi matenda ashuga. Nthawi zambiri, ziwengo zimawoneka kuti zimayambitsa kusintha kuchokera ku mankhwala kupita ku wina.

Poyerekeza ndi ndemanga za odwala, NovoRapid ndiwothamanga kwambiri kuposa anzawo omwe amangokhala nawo mwachidule. Ndipo pali mwayi wina wofunikira wa NovoRapid insulin - azimayi amatha kuugwiritsa ntchito panthawi yomwe ali ndi pakati komanso mkaka wa m'mawere.

Kuphatikiza apo, mwa odwala omwe ali ndi matenda ashuga, funso limadzuka: "Chiti ndibwino - Apidra kapena NovoRapid?". Zachidziwikire, aliyense amasankha zosavuta. Apidra amakhalanso ndi insulin yocheperako, amayamba kuchita pakatha mphindi 4-5 jakisoni, koma iyenera kuvulazidwa mosamalitsa musanadye kapena atangodya, zomwe sizili bwino kwa wodwalayo nthawi zonse.

• Malangizo ogwiritsira ntchito AKTRAPID NM PENFill
• Kapangidwe ka mankhwala AKTRAPID NM PENFill
• Zowonetsa AKTRAPID NM PENFill
• Kusungidwa kwa mankhwala AKTRAPID NM PENFill
• Alumali moyo wa mankhwala ACTRAPID NM PENFill

Code ya ATX: Alimentary tract and metabolism (A)> Kukonzekera kwa matenda a shuga mellitus (A10)> Insulins ndi analogues awo (A10A)> Insulins ndi ma analogues awo achidule (A10AB)> Insulin (human) (A10AB01)

Kutulutsa mawonekedwe, kapangidwe kake ndi ma CD

Yankho la jakisoni zowonekera, zopanda utoto.

Othandizira: zinc chloride, glycerol, metacresol, hydrochloric acid ndi / kapena sodium hydroxide solution (kukhalabe ndi pH), madzi d / i.

* 1 IU imafanana ndi 35 μg wa insulin ya munthu wosafunikira.

3 ml - makatoni agalasi (5) - mapaketi a makatoni.

Kufotokozera za mankhwalawa PENFill YA ACTRAPID NM idapangidwa mu 2012 pamaziko a malangizo olembedwa pa tsamba lovomerezeka la Ministry of Health of the Republic of Belarus.

Mlingo

Mankhwalawa adapangira SC ndi / pakukhazikitsa.

Mlingo wa mankhwalawa amasankhidwa payekha, poganizira zosowa za wodwala.

Nthawi zambiri, zofunika za insulini zimachokera pa 0,3 mpaka 1 IU / kg / tsiku. Kufunika kwa insulin tsiku lililonse kumatha kukhala kwabwino kwambiri kwa odwala omwe ali ndi insulin (mwachitsanzo, nthawi yakutha msinkhu, komanso odwala omwe ali ndi kunenepa kwambiri), komanso otsika mwa odwala omwe ali ndi zotsalira za insulin.

Mankhwalawa umaperekedwa kwa mphindi 30 asanadye kapena chakudya. Actrapid ® NM ndi insulin yochepa ndipo imatha kugwiritsidwa ntchito limodzi ndi ma insulin.

Actrapid ® NM nthawi zambiri imayendetsedwa mwachisawawa mdera lakhoma lamkati lakumbuyo. Ngati izi ndizotheka, ndiye kuti jakisoni amathanso kuchitika m'tchafu, m'chigawo cha gluteal kapena m'dera la minofu ya m'mapazi. Ndi kuyambitsa kwa mankhwala m'dera lakhomopo lakhomopo, mayamwidwe mwachangu amatheka kuposa momwe angayambitsire madera ena. Ngati jakisoniyo wapangidwira pakhungu lalitali, ngozi ya mankhwalawo mwangozi imachepetsedwa. Singano imayenera kukhalabe pansi pakhungu kwa masekondi 6 osachepera, omwe amatsimikizira mlingo wokwanira. Ndikofunikira nthawi zonse kusintha malo a jekeseni mkati mwa anatomical dera kuti muchepetse chiopsezo cha lipodystrophy. Actrapid ® NM ndiyothekanso kulowa mkati / momwemo njirazi zitha kuchitidwa ndi katswiri wazachipatala.

Mu / pakukhazikitsa kwa mankhwala a Actrapid ® NM Penfill ® kuchokera ku cartridge ndikololedwa kokha kupatula mabotolo. Pankhaniyi, muyenera kumwa mankhwala osokoneza bongo a insulini popanda kudya mpweya kapena kulowerera pogwiritsa ntchito kulowetsedwa. Njirayi iyenera kuchitidwa kokha ndi dokotala.

Actrapid ® NM Penfill ® idapangidwa kuti izigwiritsidwa ntchito ndi mabungwe a Novo Nordisk insulin jakisoni ndi singano za NovoFine ® kapena NovoTvist ®. Malangizo atsatanetsatane ogwiritsira ntchito ndi kuyang'anira mankhwalawa amayenera kuonedwa.

Matenda okhala ndi vuto limodzi, makamaka opatsirana komanso kutentha thupi, nthawi zambiri amalimbikitsa kufunika kwa insulin. Kusintha kwa magazi kungafunikenso ngati wodwala ali ndi matenda a impso, chiwindi, mkhutu wa adrenal ntchito, pituitary kapena chithokomiro cha chithokomiro.

Kufunika kosinthidwa kwa mlingo kumatha kuonekanso posintha zolimbitsa thupi kapena zakudya zomwe wodwala amadya. Kusintha kwa Mlingo kungafunike posamutsa wodwala kuchokera ku mtundu wina wa insulin kupita ku ina.

Zosafunika

NovoRapid insulin nthawi zina imatha kupangitsa zovuta zingapo za thupi, imatha kukhala hypoglycemia, zizindikiro zake:

1. khungu
2. thukuta kwambiri
3. kugwedezeka miyendo,
4. nkhawa zopanda pake
5. kufooka kwa minofu
6. tachycardia
7. kulumikizana.

Kuwonetsera kwina kwa hypoglycemia kumakhala kuyendetsa bwino, kutsika kwakukhazikika, mavuto ammaso, ndi njala. Kusiyana kwa shuga m'magazi kungayambitse kukomoka, kuiwala, kusokonezeka kwa ubongo, imfa.

Thupi lawo siligwirizana, makamaka urticaria, komanso kusokoneza kwam'mimba, angioedema, kupuma movutikira, komanso tachycardia, ndizosowa. Zomwe zimachitika m'deralo zizitchedwa kusapeza bwino mu jekeseni:

Zizindikiro za lipodystrophy, kuphwanya kukhudzika sikugwiritsidwa ntchito.Madokotala amati mawonekedwe oterewa amakhala osakhalitsa, amawonekera kwa odwala omwe amadalira mlingo, omwe amayamba chifukwa cha insulin.

Mankhwala

Insulin aspart - analogue yaifupi yafupika ya insulini yopangidwa ndi recombinant DNA biotechnology pogwiritsa ntchito kupsyinjika Saccharomyces cerevisiae .

Mphamvu ya hypoglycemic ya insulin aspart imachitika chifukwa cha kugwiritsidwa ntchito kwa glucose pogwiritsa ntchito minofu pambuyo pomangiriza insulini kupita ku minofu ndi ma cell cell receptors komanso kuchepa kwa munthawi yomweyo.

Insulin aspart imayamba kuchita zinthu mwachangu ndipo nthawi yomweyo imachepetsa shuga m'magazi 4 maola angapo atatha kudya kuposa insulin ya munthu. Kutalika kwa insulin aspart pambuyo pa subcutaneous makonzedwe afupikitsa kuposa sungunuka wa insulin.

Chithunzi 1. Magazi a glucose pambuyo pokhapokha muyezo wa spartin insulin musanadye chakudya (mzere wolimba) kapena insulin ya munthu sungunuka pakadutsa mphindi 30 asanadye (mzere wolakwika) mwa odwala omwe ali ndi matenda a shuga 1.

Pambuyo pa utsogoleri wa sc, machitidwe a insulin aspart amayamba pasanathe mphindi 10-20 pambuyo pa kutsata. Kuchuluka kwake kumawonedwa patatha maola atatu jekeseni. Kutalika kwa mankhwalawa ndi maola 3-5.

Insulin aspart ndi insipotential sungunuka wa munthu insulin mawu molar.

Ana ndi achinyamata

Kugwiritsa ntchito insulin aspart mwa ana kuwonetsa zotsatira zofananira pakulamulira kwa glycemic kwa nthawi yayitali mukayerekeza ndi insulin yaumunthu.

Kafukufuku wazachipatala yemwe amagwiritsa ntchito insulin yaumunthu yosungunuka asanadye ndi spartart atadyetsedwa mwa ana aang'ono (odwala 20 a zaka 2 mpaka 6, 4 mwa iwo anali ochepera zaka 4 pamasabata 12), komanso kafukufuku pharmacokinetics / pharmacodynamically (kafukufuku wa FC / PD) wogwiritsa ntchito mlingo umodzi unachitika mwa ana (wazaka 6-12) ndi achinyamata (wazaka 13 mpaka 17). Mbiri ya pharmacodynamic ya insulin aspart mwa ana inali yofanana ndi ya akuluakulu.

Kuchita bwino ndi chitetezo cha insulin aspart, yomwe imayendetsedwa ngati insulini ya insulin kuphatikiza ndi insulin kapena insulin degludec monga basal insulin, idawerengedwa m'mayesero awiri azachipatala omwe amafikira mpaka miyezi 12 mwa achinyamata ndi ana a zaka 1 mpaka 18 zaka (n = 712). Phunziroli linali la ana 167 a zaka zapakati pa 5 mpaka 5, 260 - wazaka 6 mpaka 11, ndi 28 - wazaka 12 mpaka 17. Kusintha kwa HbA 1c ndi mbiri zawo zachitetezo zinali zofanana pamitundu yonse.

Ziyeso zamankhwala zokhudzana ndi odwala omwe ali ndi matenda amtundu wa 1 asonyeza kuchuluka kwa shuga m'magazi a shuga omwe amapezeka ndi insulin aspart poyerekeza ndi insulin ya insuble ya anthu (onani Chithunzi 1).

Malinga ndi zotsatira za kafukufuku awiri watali wotseguka omwe akukhudza odwala omwe ali ndi mtundu wa 1 shuga mellitus (1070 ndi 884 odwala, motsutsana), insulini aspart inathandizira kuti kuchepa kwa matenda a glycated Hb a 0.12% (95% CI: 0.03, 0.22) ndi 0. 15 peresenti (95% CI: 0.05, 0.26) poyerekeza ndi insulin yamunthu yosungunuka, kusiyana kwake kuli ndi tanthauzo laling'ono lachipatala.

Zoyesa zamankhwala zokhudzana ndi odwala omwe ali ndi matenda amtundu woyamba a 1 asonyeza kuti ali ndi vuto la kuchepa kwa mankhwalawa chifukwa cha insulin. Chiwopsezo cha masana hypoglycemia sichinachuluke kwambiri.

Kafukufuku wosasinthika, wakhungu lambiri, wophatikizidwa mwachidule wa FC / PD wa insulin aspart ndi solulle insulin ya anthu odwala okalamba omwe ali ndi mtundu wa 2 matenda a shuga (19 odwala azaka 65-83 zaka, zaka zapakati pa 70 zaka).Kusiyana kwazomwe zimachitika mu pharmacodynamic katundu (GIR max, AUC GIR, 0-120 min) pakati pa insulin aspart ndi insulin ya anthu odwala okalamba anali ofanana ndi omwe ali odzipereka athanzi komanso odwala achinyamata omwe ali ndi matenda a shuga.

Kafukufuku wachipatala wokhudzana ndi chitetezo chokwanira komanso mphamvu ya insulin aspart ndi insulin ya anthu pochiza amayi apakati omwe ali ndi vuto 1 matenda osokoneza bongo (322 azimayi apakati omwe adawunikira, 157 adalandira insulini, 165 insuble human insulin mwana wosabadwa / wakhanda.

Maphunziro owonjezera azachipatala mwa azimayi 27 omwe ali ndi gestational matenda a shuga omwe amalandila insulin aspart ndi insulin ya anthu (insulin aspart adalandira amayi 14, sungunuka wa insulin - 13), akuwonetsa kuyanjana kwa mbiri ya chitetezo komanso kusintha kwakukulu pakuwongolera ndende ya glucose mutatha kudya mukamamwa mankhwala a insulin.

Mimba komanso kuyamwa

NovoRapid ® Flexpen ® (insulin aspart) imatha kulembedwera panthawi yapakati. Zambiri kuchokera kwa mayesero awiri azachipatala omwe adayang'aniridwa mosasamala (322 + 27 yoyesedwa ndi amayi apakati) sizinawonetse zovuta zilizonse za insulin aspart pa mimba kapena thanzi la mwana wosabadwayo / wakhanda poyerekeza ndi insulin ya insulin ya anthu (onani Pharmacodynamics).

Kuwunikira mosamala kuchuluka kwa shuga m'magazi ndikuwunika azimayi oyembekezera omwe ali ndi matenda osokoneza bongo a mtundu wa shuga (mtundu 1, mtundu 2 kapena matenda osokoneza bongo) panthawi yonse yomwe ali ndi pakati komanso panthawi yomwe ali ndi pakati ndikulimbikitsidwa. Kufunika kwa insulini, monga lamulo, kumachepa mu trimester yoyamba ndipo pang'onopang'ono kumawonjezeka muyezo wachiwiri komanso wachitatu wamapazi oyembekezera. Pambuyo pobadwa, kufunikira kwa insulin kumabwereranso msanga momwe kunaliri asanakhale ndi pakati.

Panthawi yoyamwitsa, NovoRapid ® FlexPen ® ikhoza kugwiritsidwa ntchito, chifukwa kuperekera insulin kwa mayi woyamwitsa sikuopseza mwana. Komabe, zingakhale zofunikira kusintha mlingo wa mankhwalawo.

Zotsatira zoyipa

Zotsatira zoyipa zomwe zimawoneka mwa odwala omwe amagwiritsa ntchito NovoRapid ® FlexPen ® zimachitika makamaka chifukwa cha kupangika kwa mankhwala a insulin.

Zotsatira zoyipa zomwe zimanenedwa nthawi ya mankhwala ndi hypoglycemia. Kuchuluka kwa hypoglycemia kumasiyana malinga ndi kuchuluka kwa odwala, kuchuluka kwa mankhwalawa, komanso kayendedwe ka glycemic (onani. Kufotokozera kwa zomwe zimachitika munthu akamakumana ndi mavuto ).

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 wammbuyo, womwe nthawi zambiri 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.

Zotsatira zoyipa zonse zomwe zaperekedwa pansipa, kutengera deta yomwe imapezeka pazoyeserera zamankhwala, zimagawidwa m'magulu malinga ndi kufalikira kwa chitukuko motsatira MedDRA ndi ziwalo zamagulu. Zomwe zimachitika pakakhala zovuta zimafotokozedwa motere: nthawi zambiri (≥1 / 10), nthawi zambiri (≥1 / 100, zabodza zomwe endocrinologists amalangizira Kuwunika Kwachisawawa Kokulu! Ndi zofunika tsiku lililonse.

NovoRapid ndi wosiyana pang'ono ndi mahomoni abwinobwino amunthu, chifukwa chomwe amayamba kuchita zinthu mwachangu, ndipo odwala amatha kuyamba kudya atangoyambitsa . Poyerekeza ndi ma insulin achikhalidwe, NovoRapid amawonetsa zotsatira zabwino: m'magulu a shuga odwala shuga amakhazikika mukatha kudya, ndipo kuchuluka ndi zakumwa zakumwa usiku kumachepetsedwa. Mphamvu zake zimaphatikizanso mphamvu ya mankhwalawo, yomwe imalola anthu ambiri omwe ali ndi matenda ashuga kuchepetsa shuga.

Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale

Matenda a shuga ndi omwe amayambitsa pafupifupi 80% yonse yamikwingwirima ndi kuduladula. Anthu 7 mwa anthu 10 amafa chifukwa cha mitsempha ya mtima kapena ubongo. Pafupifupi nthawi zonse, chifukwa chomaliza chomaliza ndi chimodzimodzi - shuga wamwazi.

Shuga akhoza ndipo amayenera kugwetsedwa, apo ayi. Koma izi sizichiritsa matendawa, koma zimangothandiza kulimbana ndi kufufuza, osati zomwe zimayambitsa matendawa.

Mankhwala okhawo omwe amalimbikitsidwa mwalamulo kwa odwala matenda ashuga komanso ogwiritsidwa ntchito ndi endocrinologists pantchito yawo ndi Ji Dao Diabetes Adhesive.

Kugwiritsa ntchito bwino kwa mankhwalawa, kuwerengera malinga ndi njira yokhazikika (kuchuluka kwa odwala omwe achiwonjezere kuchuluka kwa odwala omwe ali pagulu la anthu 100 omwe adachitiridwa chithandizo):

• Matenda a shuga - 95%
• Kuthetsa kwa mitsempha thrombosis - 70%
• Kuthetsa kwa kugunda kwamtima kwamphamvu - 90%
• Kuthana ndi kuthamanga kwa magazi - 92%
• Kulimbitsa tsiku, kukonza kugona usiku - 97%

Opanga Ji Dao si bungwe lazamalonda ndipo amalipiridwa ndi boma. Chifukwa chake, tsopano wokhala aliyense ali ndi mwayi wopeza mankhwalawo kuchotsera 50%.

NovoRapid ndi njira yokonzekera yopanga subcutaneous makonzedwe, imagwiritsidwa ntchito pamitundu yonse ya matenda ashuga, ngati mukusowa kwambiri insulin yanu. Mankhwalawa amaloledwa mwa ana (kuyambira zaka 2) ndi ukalamba, amayi oyembekezera. Itha kudulidwa mothandizidwa ndi zolembera za syringe ndipo. Zochizira pachimake hyperglycemic zinthu, mtsempha wa magazi n`zotheka.

Zambiri zofunikira za odwala matenda ashuga za NovoRapid insulin kuchokera kuzomwe angagwiritse ntchito:

Ipezeka m'mitundu iwiri:

• NovoRapid Penfill - 3 ml makatoni ogwiritsira ntchito zolembera, mu phukusi la zidutswa 5.
• NovoRapid Flekspen - zotayika, syringe-zosadzaza zolembera ndi 3 ml ya aspart, 5 zidutswa m'bokosi. Mlingo wolondola - 1 unit.

Malinga ndi malangizo, insulin Penfill ndi Flekspen ndi ofanana kapangidwe ndi ndende. Penfill ndiwosavuta kugwiritsa ntchito ngati mulingo wochepa wa mankhwalawo ukufunika.

Zovuta zoyipa kwambiri za insulin. Amayamba pamene mulingo wa insulin wophatikizira umaposa zofunikira za thupi. Nthawi zambiri (0-1-1% ya anthu odwala matenda ashuga) matupi am'mimba amatha kuchitika m'malo a jakisoni ndikuwonetsa. Zizindikiro: kutupa, kutupa, kuyabwa, mavuto am'mimba, kufiyanso. Mu 0.01% ya milandu, anaphylactic zimachitika.

Pakanthawi kochepa kwambiri pa kuchepa kwa glycemia mu matenda ashuga, zizindikiro za kuchepa kwa m'mimba, kuwonongeka kwa mawonekedwe, ndi kutupa zimawonedwa. Zotsatira zoyipa izi zimatha pazokha popanda chithandizo.

Mankhwala	Chochita chachikulu cha NovoRapid, monga insulin ina iliyonse, ndikuchepetsa shuga la magazi. Imakonza bwino kuchuluka kwa ma membrane am'magazi, kulola kuti shuga adutse, kuthandizira kusintha kwa glucose, kuwonjezera masitolo a glycogen m'misempha ndi chiwindi, komanso kumapangitsanso kapangidwe ka mafuta ndi mapuloteni.
Kutulutsa Fomu
Zizindikiro	Mtundu woyamba wa shuga Mtundu 2, ngati mapiritsi ochepetsa shuga komanso zakudya sizothandiza, Type 2 pa mimba, machitidwe ofunikira insulin mankhwala mwachitsanzo, ketoacidotic chikomokere, Mitundu 3 ndi 5.
Zotsatira zoyipa
Sankhani	Mlingo woyenera amawerengedwa kutengera chakudya chamagulu azakudya. Mlingo ukuwonjezeka ndi kulimbitsa thupi, kupsinjika, matenda omwe ali ndi malungo.
Zotsatira za mankhwala	Mankhwala ena amatha kukulitsa kapena kuchepetsa kufunika kwa insulin. Awa ndi mankhwala a mahomoni, antidepressants, mapiritsi othandizira matenda oopsa.Ma blocker a Beta amatha kuchepetsa zizindikiro za hypoglycemia, ndikupangitsa kuti zikhale zovuta kuzizindikira. Zakumwa zoledzeretsa ndizoletsedwa ndi NovoRapid , popeza imakulitsa kwambiri kubwezeretsa kwa anthu odwala matenda ashuga.
Malamulo ndi nthawi yosungirako	Malinga ndi malangizowo, insulini yosagwiritsidwa ntchito imasungidwa mufiriji yomwe imatha kusunga kutentha kwa 2-8 ° C. Makatoni - mkati mwa miyezi 24, ma syringe zolembera - miyezi 30. Ma CD oyambira amatha kusungidwa kutentha kwa milungu inayi. Aspart amawonongeka padzuwa pamtunda wotsika 2 ndi kupitirira 35 digiri.

Chifukwa chakuti NovoRapid amamva kwambiri malo osungirako, odwala omwe ali ndi matenda ashuga ayenera kupeza zida zapadera zozizira kuti aziyendetsa. Insulin singagulidwe ndi zolengeza, chifukwa mankhwala omwe awonongeka sangakhale osiyana ndi abwinobwino.

Mtengo wapakati wa NovoRapid insulin:

• Makatoni: 1690 rub. pa paketi lililonse, ma ruble 113. pa 1 ml.
• Mapensulo a syringe: 1750 rub. phukusi lililonse, ma ruble 117. pa 1 ml.

Tiyeni tikambirane mwatsatanetsatane momwe mungapangire NovoRapid moyenera, momwe ntchito yake iyamba ndikutha, momwe ma insulin sangathe kugwira ntchito, omwe mankhwalawa amafunika kuphatikizidwa.

Novorapid (Flekspen ndi Penfill) - mankhwalawa amachita mwachangu kwambiri

Gulu la mankhwala

NovoRapid amaonedwa ngati insulin yotsalira-yochepa. Kutsitsa kwa shuga pambuyo pa kayendetsedwe kake kumawonedwa kale kuposa momwe amagwiritsira ntchito Actrapid ndi fanizo lawo. Kukhazikikako kumakhala pakati pa mphindi 10 mpaka 20 jekeseni. Nthawi imatengera machitidwe a munthu wodwala matenda ashuga, makulidwe a minofu ya subcutaneous pamalo a jakisoni ndi magazi ake. Kuchuluka kwake ndi maora 1-3 pambuyo pa jekeseni. Amaba jakisoni wa NovoRapid Mphindi 10 asanadye . Chifukwa chakufulumizitsa, amangochotsa shuga obwera, osalola kuti achulukane m'magazi.

Nthawi zambiri aspart imagwiritsidwa ntchito molumikizana ndi insulin yayitali komanso yapakati. Ngati wodwala matenda ashuga ali ndi pampu ya insulin, amangofunika mahomoni amafupiafupi.

Nthawi yogwira

Popewa kuwonongeka kwambiri pakhungu ndi minyewa yolumikizira malo a jakisoni, inshuwaransi ya NovoRapid iyenera kukhala kokha kutentha, ndipo singano ikhale yatsopano nthawi iliyonse. Tsamba la jakisoni likusintha nthawi zonse, khungu lomwelo limatha kugwiritsidwanso ntchito pakatha masiku atatu ndipo pokhapokha ngati palibe jekeseni yemwe watsala. Kuyamwa kofulumira kwambiri ndi mawonekedwe a khoma lakunja lam'mimba. Muli m'dera mozungulira navel ndi ma rolling am'mbali ndipo ndikofunika kuti mupeze insulin yayifupi.

Musanagwiritse ntchito njira zatsopano zoyambira, zolembera kapena mapampu, muyenera kuphunzira malangizo kuti mugwiritse ntchito mwatsatanetsatane. Poyamba, nthawi zambiri nthawi zambiri kuposa momwe ndimanenera kuyeza shuga. Kuti mukhale otsimikiza pamtundu woyenera wa malonda, zonse zomwe ziyenera kuyenera kukhala zotayidwa kwambiri . Kugwiritsa ntchito kwawo mobwerezabwereza kuli ndi chiwopsezo chowonjezereka cha zotsatira zoyipa.

Zochita

Ngati kuchuluka kwa insulin sikugwira, ndipo hyperglycemia imatha, imatha kuthetsedwa pokhapokha maola 4. Asanayambitsidwe gawo lotsatira la insulin, muyenera kukhazikitsa chifukwa chomwe sichinagwire ntchito.

Doctor of Medical Science, Mutu wa Institute of Diabetesology - Tatyana Yakovleva

Ndakhala ndikuphunzira matenda a shuga kwa zaka zambiri. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsa odwala matenda ashuga mellitus. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipira mtengo wapamwamba wa mankhwalawa. Ku Russia, odwala matenda ashuga mpaka pa Epulo 23 (kuphatikiza) nditha kuipeza - Kwa ma ruble 147 okha!

1. Katundu wopera kapena malo osungira osayenera. Ngati mankhwalawo aiwalika padzuwa, chisanu, kapena kwakhala kutentha kwa nthawi yayitali popanda thumba lamafuta, botolo liyenera kulowedwa ndi watsopano kuchokera mufiriji. Njira yowonongeka imatha kukhala pamtambo, pomwe masamba amayatsidwa mkati. Kupanga kwamakristali pansi ndi makhoma.
2. Jekeseni wolakwika, mlingo wowerengeka. Kuwongolera kwa mtundu wina wa insulin: yayitali m'malo mofupikitsa.
3. Kuwonongeka kwa cholembera, singano yopanda vuto. Kukula kwa singano kumayendetsedwa ndikufinya dontho la yankho kuchokera ku syringe. Kugwira kwa cholembera sikungayang'anitsidwe, chifukwa chake imasinthidwa pakukayikira koyamba kwa kuphwanya. Munthu wodwala matenda ashuga nthawi zonse ayenera kukhala ndi insulin yowonjezera.
4. Kugwiritsa ntchito pampu kungatsekeke kulowetsedwa. Pankhaniyi, iyenera m'malo m'malo mwake. Pompo limachenjeza za kusweka kwina ndi chizindikiro chomveka kapena uthenga wapamwamba.

Kuchulukitsidwa kwa NovoRapid insulin kumatha kuwonedwa ndi mankhwala osokoneza bongo, mowa, chiwindi osakwanira komanso impso.

Kusintha NovoRapida Levemir

NovoRapid ndi Levemir ndi mankhwala omwe amapanga omwe ali ndi zotsatira zosiyana. Kodi pali kusiyana kotani: Levemir ndi insulin yayitali, imaperekedwa mpaka 2 pa tsiku kuti ipangitse kubisalira kwa secretion ya mahomoni a base.

NovoRapid ndi ultrashort, yofunikira kuti muchepetse shuga mutatha kudya. Palibe pokhapokha wina atha kulowa m'malo mwa wina, izi zimatsogolera ku hyper- ndipo, patatha maola ochepa, ku hypoglycemia.

Matenda a shuga amafunikira chithandizo chovuta, kuti shuga asamangidwe, mumafunikira mahomoni azitali komanso amafupikitsa. NovoRapid insulin nthawi zambiri imaphatikizidwa ndendende ndi Levemir, popeza kulumikizana kwawo kwaphunziridwa bwino.

Pakadali pano, NovoRapid insulin ndi mankhwala okhawo a ultrashort ku Russia okhala ndi aspart ngati chinthu chogwira ntchito. Mu 2017, Novo Nordisk adakhazikitsa insulin yatsopano, Fiasp, ku United States, Canada ndi Europe. Kuphatikiza pa aspart, ilinso ndi zinthu zina, kotero kuti machitidwe ake amakhala achangu komanso okhazikika. Insulin yotereyi ingathandize kuthana ndi vuto la shuga wambiri mutatha chakudya chokhala ndi chakudya chambiri. Itha kugwiritsidwanso ntchito ndi anthu odwala matenda ashuga osakhala ndi vuto losakhazikika, popeza timadzi timeneti timatha kubayidwa mutangomaliza kudya, powerengetsa zomwe zidyedwa. Sizotheka kugula izo ku Russia, koma ndikulamula kuchokera kumaiko ena, mtengo wake umakhala wokwera kwambiri kuposa wa NovoRapid, pafupifupi ma ruble 8500. kunyamula.

Ma analogu a NovoRapid ndi ma Humalog ndi Apidra. Mbiri yawo ya zochita imangofanana, ngakhale kuti zinthu zomwe sizigwirizana ndizosiyana. Kusintha insulini kukhala analogue ndikofunikira pokhapokha ngati thupi lanu siligwirizana ndi mtundu winawake, popeza kulocha kumafuna kusankhidwa kwa mankhwala atsopano ndipo mosakayikira kumabweretsa kuwonongeka kwakanthawi mu glycemia.

Zizindikiro zogwiritsidwa ntchito

Njira za Hypoglycemic zimakula msanga ngati wodwala matenda ashuga ali ndi matenda othandizirana, ndipo mankhwala omwe amachepetsa kuyamwa kwa chakudya amagwiritsidwa ntchito. Kufunika kwamankhwala kumawonjezeka ndi zovuta zamtundu umodzi. Thupi silifunikira insulin ngati wodwalayo ali ndi mavuto ndi ziwalo zamkati.

Pambuyo poti odwala asintha kupita ku mankhwala ena, zizindikiro za hypoglycemia zimasinthika kapena kusayamba kutchulidwa. Madokotala nthawi zonse amawunika momwe wodwalayo akusinthira mtundu wina wa mahomoni. Mankhwala akasinthidwa, mlingo umasinthidwa. Kusintha kwa kuchuluka kwa mankhwala omwe mumagwiritsidwa ntchito kumafunikira mukamadya zakudya zina, mutachotsedwa kapena kuwonjezeka kwa zolimbitsa thupi.

Mlingowo umatsimikiziridwa ndi endocrinologist payekhapayekha kwa wodwala aliyense, poganizira zosowa zake. Novorapid amaphatikizidwa ndi insulin yayitali komanso yayitali osachepera 1 nthawi patsiku. Magazi a glucose, insulin yochulukirapo imayendetsedwa kuti ipeze njira yoyenera yothanirana ndi glycemia.Ana amapatsidwa 1.5 mpaka 1 unit. pa kilogalamu ya kulemera. Kusintha kadyedwe kanu kapena moyo wanu pamafunika kusintha kwa mlingo.

Novorapid imayendetsedwa asanadye, mwayi wa usiku wa hypoglycemia umachepetsedwa.

Munthu wodwala matenda ashuga amatha kuperekera mankhwalawo payekha, jakisoni wokhazikika amapangidwa m'mimba, ntchafu, mu minyewa yolimba. Tsamba la jakisoni limasintha kuti lipodystrophy isamere.

Mankhwala amagwiritsidwa ntchito PPII; mapampu a insulin amagwiritsidwa ntchito kulowetsedwa. Panthawi imeneyi, jakisoni amapangidwa kutsogolo kwa m'mimba. Mwakamodzikamodzi, Novorapid amalowa jekeseni wamkati, akatswiri okhawo omwe amadziwa bwino amapanga jakisoni.

Zotsatira za insulin ya rDNA m'thupi nthawi zina zimadetsa nkhawa za odwala. Zotsatira zoyipa kwambiri ndi kutsika kwa shuga - hypoglycemia. Pafupipafupi mwadzidzidzi vutoli limapezeka m'magulu osiyanasiyana a odwala ndilosiyana, limatsimikiziridwa ndi Mlingo, mawonekedwe oyang'anira.

Pochiza matenda a shuga kunyumba, akatswiri akulangizani DiaLife . Ichi ndi chida chapadera:

• Amasinthasintha shuga
• Amayang'anira ntchito ya pancreatic
• Chotsani puffness, limayendetsa madzi kagayidwe
• Amawongolera masomphenya
• Zoyenera akulu ndi ana.
• Alibe zotsutsana

Opanga alandila ziphaso zonse zofunika ndi ziphaso za mbiri ku Russia komanso m'maiko oyandikana.

Timapereka kuchotsera kwa owerenga tsamba lathu!

Gulani pa tsamba lovomerezeka

Pa magawo oyambilira a maphunziro, kusintha kosinthika kumachitika, kupweteka, Hyperemia, kutupa, ndi kuyabwa kumachitika pamalo a jakisoni. Zizindikiro zotere zimazimiririka pakapita nthawi popanda chithandizo.

Kuchepetsa kwambiri glycemia kumadzetsa kuwonongeka.

Zina zoyipa zomwe zimawonedwa mu anthu odwala matenda ashuga zimachitika mwanjira zosiyanasiyana zamatenda a ziwalo ndi machitidwe:

• chitetezo chofooka
• misempha imasokonekera,
• masomphenya amawonongeka
• Kutupa pa malo a jekeseni.

Hypoglycemia imayamba ndi kuchuluka kwa insulin, kuphwanya njira ya zamankhwala. Vuto lalikulu la matendawa ndi loopsa kwa munthu wodwala matenda ashuga. Pali mavuto ndi dongosolo lamagazi, ubongo umasokonekera, mwayi woti imfa umachulukitsidwa.

Contraindication

kukulitsa chidwi cha munthu payekha kuti apange insulin kapena chilichonse chomwe chimapangitsa mankhwalawo.

Mimba komanso kuyamwa

NovoRapid ® Flexpen ® (insulin aspart) imatha kulembedwera panthawi yapakati. Zambiri kuchokera kwa mayesero awiri azachipatala omwe adayang'aniridwa mosasamala (322 + 27 yoyesedwa ndi amayi apakati) sizinawonetse zovuta zilizonse za insulin aspart pa mimba kapena thanzi la mwana wosabadwayo / wakhanda poyerekeza ndi insulin ya insulin ya anthu (onani Pharmacodynamics).

Kuwunikira mosamala kuchuluka kwa shuga m'magazi ndikuwunika azimayi oyembekezera omwe ali ndi matenda osokoneza bongo a mtundu wa shuga (mtundu 1, mtundu 2 kapena matenda osokoneza bongo) panthawi yonse yomwe ali ndi pakati komanso panthawi yomwe ali ndi pakati ndikulimbikitsidwa. Kufunika kwa insulini, monga lamulo, kumachepa mu trimester yoyamba ndipo pang'onopang'ono kumawonjezeka muyezo wachiwiri komanso wachitatu wamapazi oyembekezera. Pambuyo pobadwa, kufunikira kwa insulin kumabwereranso msanga momwe kunaliri asanakhale ndi pakati.

Panthawi yoyamwitsa, NovoRapid ® FlexPen ® ikhoza kugwiritsidwa ntchito, chifukwa kuperekera insulin kwa mayi woyamwitsa sikuopseza mwana. Komabe, zingakhale zofunikira kusintha mlingo wa mankhwalawo.

Zotsatira zoyipa

Zotsatira zoyipa zomwe zimawoneka mwa odwala omwe amagwiritsa ntchito NovoRapid ® FlexPen ® zimachitika makamaka chifukwa cha kupangika kwa mankhwala a insulin.

Zotsatira zoyipa zomwe zimanenedwa nthawi ya mankhwala ndi hypoglycemia. Kuchuluka kwa hypoglycemia kumasiyana malinga ndi kuchuluka kwa odwala, kuchuluka kwa mankhwalawa, komanso kayendedwe ka glycemic (onani. Kufotokozera kwa zomwe zimachitika munthu akamakumana ndi mavuto ).

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 wammbuyo, womwe nthawi zambiri 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.

Zotsatira zoyipa zonse zomwe zaperekedwa pansipa, kutengera deta yomwe imapezeka pazoyeserera zamankhwala, zimagawidwa m'magulu malinga ndi kufalikira kwa chitukuko motsatira MedDRA ndi ziwalo zamagulu. Zomwe zimachitika pakakhala zovuta zimafotokozedwa motere: nthawi zambiri (≥1 / 10), nthawi zambiri (≥1 / 100, zabodza zomwe endocrinologists amalangizira Kuwunika Kwachisawawa Kokulu! Ndi zofunika tsiku lililonse.

NovoRapid ndi wosiyana pang'ono ndi mahomoni abwinobwino amunthu, chifukwa chomwe amayamba kuchita zinthu mwachangu, ndipo odwala amatha kuyamba kudya atangoyambitsa . Poyerekeza ndi ma insulin achikhalidwe, NovoRapid amawonetsa zotsatira zabwino: m'magulu a shuga odwala shuga amakhazikika mukatha kudya, ndipo kuchuluka ndi zakumwa zakumwa usiku kumachepetsedwa. Mphamvu zake zimaphatikizanso mphamvu ya mankhwalawo, yomwe imalola anthu ambiri omwe ali ndi matenda ashuga kuchepetsa shuga.

Malangizo ogwiritsira ntchito

Insulin NovoRapid imapangidwa ndi kampani yopanga mankhwala ku Danish, Novo Nordisk, yomwe cholinga chake chachikulu ndikupititsa patsogolo kulamulidwa kwa glycemic kwa odwala omwe ali ndi matenda osokoneza bongo. Yogwira pophika mu mankhwala ndi aspart. Molekyulu yake ndi analogue ya insulini, imabwereza momwemo kupatula kusiyanitsa kokha koma kwakukulu - wina wogwirizira amino acid. Chifukwa cha izi, mamolekyu a aspart samamatira limodzi ndikupanga ma hexamers, ngati insulin wamba, koma ali omasuka, chifukwa chake amayamba kugwira ntchito mwachangu kuti achepetse shuga. M'malo motere zidatheka chifukwa cha ukadaulo wamakono wa bioengineering. Kuyerekezera kwa aspart ndi insulin yaumunthu sikunawululire zotsatira zoyipa zakusintha kwa molekyu. M'malo mwake, zotsatira za kayendetsedwe ka mankhwala idakhala yamphamvu ndikukhazikika .

Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale

Matenda a shuga ndi omwe amayambitsa pafupifupi 80% yonse yamikwingwirima ndi kuduladula. Anthu 7 mwa anthu 10 amafa chifukwa cha mitsempha ya mtima kapena ubongo. Pafupifupi nthawi zonse, chifukwa chomaliza chomaliza ndi chimodzimodzi - shuga wamwazi.

Shuga akhoza ndipo amayenera kugwetsedwa, apo ayi. Koma izi sizichiritsa matendawa, koma zimangothandiza kulimbana ndi kufufuza, osati zomwe zimayambitsa matendawa.

Mankhwala okhawo omwe amalimbikitsidwa mwalamulo kwa odwala matenda ashuga komanso ogwiritsidwa ntchito ndi endocrinologists pantchito yawo ndi Ji Dao Diabetes Adhesive.

Kugwiritsa ntchito bwino kwa mankhwalawa, kuwerengera malinga ndi njira yokhazikika (kuchuluka kwa odwala omwe achiwonjezere kuchuluka kwa odwala omwe ali pagulu la anthu 100 omwe adachitiridwa chithandizo):

• Matenda a shuga - 95%
• Kuthetsa kwa mitsempha thrombosis - 70%
• Kuthetsa kwa kugunda kwamtima kwamphamvu - 90%
• Kuthana ndi kuthamanga kwa magazi - 92%
• Kulimbitsa tsiku, kukonza kugona usiku - 97%

Opanga Ji Dao si bungwe lazamalonda ndipo amalipiridwa ndi boma. Chifukwa chake, tsopano wokhala aliyense ali ndi mwayi wopeza mankhwalawo kuchotsera 50%.

NovoRapid ndi njira yokonzekera yopanga subcutaneous makonzedwe, imagwiritsidwa ntchito pamitundu yonse ya matenda ashuga, ngati mukusowa kwambiri insulin yanu. Mankhwalawa amaloledwa mwa ana (kuyambira zaka 2) ndi ukalamba, amayi oyembekezera.Itha kudulidwa mothandizidwa ndi zolembera za syringe ndipo. Zochizira pachimake hyperglycemic zinthu, mtsempha wa magazi n`zotheka.

Zambiri zofunikira za odwala matenda ashuga za NovoRapid insulin kuchokera kuzomwe angagwiritse ntchito:

Ipezeka m'mitundu iwiri:

• NovoRapid Penfill - 3 ml makatoni ogwiritsira ntchito zolembera, mu phukusi la zidutswa 5.
• NovoRapid Flekspen - zotayika, syringe-zosadzaza zolembera ndi 3 ml ya aspart, 5 zidutswa m'bokosi. Mlingo wolondola - 1 unit.

Malinga ndi malangizo, insulin Penfill ndi Flekspen ndi ofanana kapangidwe ndi ndende. Penfill ndiwosavuta kugwiritsa ntchito ngati mulingo wochepa wa mankhwalawo ukufunika.

Zovuta zoyipa kwambiri za insulin. Amayamba pamene mulingo wa insulin wophatikizira umaposa zofunikira za thupi. Nthawi zambiri (0-1-1% ya anthu odwala matenda ashuga) matupi am'mimba amatha kuchitika m'malo a jakisoni ndikuwonetsa. Zizindikiro: kutupa, kutupa, kuyabwa, mavuto am'mimba, kufiyanso. Mu 0.01% ya milandu, anaphylactic zimachitika.

Pakanthawi kochepa kwambiri pa kuchepa kwa glycemia mu matenda ashuga, zizindikiro za kuchepa kwa m'mimba, kuwonongeka kwa mawonekedwe, ndi kutupa zimawonedwa. Zotsatira zoyipa izi zimatha pazokha popanda chithandizo.

Mankhwala	Chochita chachikulu cha NovoRapid, monga insulin ina iliyonse, ndikuchepetsa shuga la magazi. Imakonza bwino kuchuluka kwa ma membrane am'magazi, kulola kuti shuga adutse, kuthandizira kusintha kwa glucose, kuwonjezera masitolo a glycogen m'misempha ndi chiwindi, komanso kumapangitsanso kapangidwe ka mafuta ndi mapuloteni.
Kutulutsa Fomu
Zizindikiro	Mtundu woyamba wa shuga Mtundu 2, ngati mapiritsi ochepetsa shuga komanso zakudya sizothandiza, Type 2 pa mimba, machitidwe ofunikira insulin mankhwala mwachitsanzo, ketoacidotic chikomokere, Mitundu 3 ndi 5.
Zotsatira zoyipa
Sankhani	Mlingo woyenera amawerengedwa kutengera chakudya chamagulu azakudya. Mlingo ukuwonjezeka ndi kulimbitsa thupi, kupsinjika, matenda omwe ali ndi malungo.
Zotsatira za mankhwala	Mankhwala ena amatha kukulitsa kapena kuchepetsa kufunika kwa insulin. Awa ndi mankhwala a mahomoni, antidepressants, mapiritsi othandizira matenda oopsa. Ma blocker a Beta amatha kuchepetsa zizindikiro za hypoglycemia, ndikupangitsa kuti zikhale zovuta kuzizindikira. Zakumwa zoledzeretsa ndizoletsedwa ndi NovoRapid , popeza imakulitsa kwambiri kubwezeretsa kwa anthu odwala matenda ashuga.
Malamulo ndi nthawi yosungirako	Malinga ndi malangizowo, insulini yosagwiritsidwa ntchito imasungidwa mufiriji yomwe imatha kusunga kutentha kwa 2-8 ° C. Makatoni - mkati mwa miyezi 24, ma syringe zolembera - miyezi 30. Ma CD oyambira amatha kusungidwa kutentha kwa milungu inayi. Aspart amawonongeka padzuwa pamtunda wotsika 2 ndi kupitirira 35 digiri.

Chifukwa chakuti NovoRapid amamva kwambiri malo osungirako, odwala omwe ali ndi matenda ashuga ayenera kupeza zida zapadera zozizira kuti aziyendetsa. Insulin singagulidwe ndi zolengeza, chifukwa mankhwala omwe awonongeka sangakhale osiyana ndi abwinobwino.

Mtengo wapakati wa NovoRapid insulin:

• Makatoni: 1690 rub. pa paketi lililonse, ma ruble 113. pa 1 ml.
• Mapensulo a syringe: 1750 rub. phukusi lililonse, ma ruble 117. pa 1 ml.

Tiyeni tikambirane mwatsatanetsatane momwe mungapangire NovoRapid moyenera, momwe ntchito yake iyamba ndikutha, momwe ma insulin sangathe kugwira ntchito, omwe mankhwalawa amafunika kuphatikizidwa.

Novorapid (Flekspen ndi Penfill) - mankhwalawa amachita mwachangu kwambiri

Gulu la mankhwala

NovoRapid amaonedwa ngati insulin yotsalira-yochepa. Kutsitsa kwa shuga pambuyo pa kayendetsedwe kake kumawonedwa kale kuposa momwe amagwiritsira ntchito Actrapid ndi fanizo lawo. Kukhazikikako kumakhala pakati pa mphindi 10 mpaka 20 jekeseni. Nthawi imatengera machitidwe a munthu wodwala matenda ashuga, makulidwe a minofu ya subcutaneous pamalo a jakisoni ndi magazi ake. Kuchuluka kwake ndi maora 1-3 pambuyo pa jekeseni. Amaba jakisoni wa NovoRapid Mphindi 10 asanadye . Chifukwa chakufulumizitsa, amangochotsa shuga obwera, osalola kuti achulukane m'magazi.

Nthawi zambiri aspart imagwiritsidwa ntchito molumikizana ndi insulin yayitali komanso yapakati. Ngati wodwala matenda ashuga ali ndi pampu ya insulin, amangofunika mahomoni amafupiafupi.

Nthawi yogwira

Popewa kuwonongeka kwambiri pakhungu ndi minyewa yolumikizira malo a jakisoni, inshuwaransi ya NovoRapid iyenera kukhala kokha kutentha, ndipo singano ikhale yatsopano nthawi iliyonse. Tsamba la jakisoni likusintha nthawi zonse, khungu lomwelo limatha kugwiritsidwanso ntchito pakatha masiku atatu ndipo pokhapokha ngati palibe jekeseni yemwe watsala. Kuyamwa kofulumira kwambiri ndi mawonekedwe a khoma lakunja lam'mimba. Muli m'dera mozungulira navel ndi ma rolling am'mbali ndipo ndikofunika kuti mupeze insulin yayifupi.

Musanagwiritse ntchito njira zatsopano zoyambira, zolembera kapena mapampu, muyenera kuphunzira malangizo kuti mugwiritse ntchito mwatsatanetsatane. Poyamba, nthawi zambiri nthawi zambiri kuposa momwe ndimanenera kuyeza shuga. Kuti mukhale otsimikiza pamtundu woyenera wa malonda, zonse zomwe ziyenera kuyenera kukhala zotayidwa kwambiri . Kugwiritsa ntchito kwawo mobwerezabwereza kuli ndi chiwopsezo chowonjezereka cha zotsatira zoyipa.

Zochita

Ngati kuchuluka kwa insulin sikugwira, ndipo hyperglycemia imatha, imatha kuthetsedwa pokhapokha maola 4. Asanayambitsidwe gawo lotsatira la insulin, muyenera kukhazikitsa chifukwa chomwe sichinagwire ntchito.

Doctor of Medical Science, Mutu wa Institute of Diabetesology - Tatyana Yakovleva

Ndakhala ndikuphunzira matenda a shuga kwa zaka zambiri. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsa odwala matenda ashuga mellitus. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipira mtengo wapamwamba wa mankhwalawa. Ku Russia, odwala matenda ashuga mpaka pa Epulo 23 (kuphatikiza) nditha kuipeza - Kwa ma ruble 147 okha!

1. Katundu wopera kapena malo osungira osayenera. Ngati mankhwalawo aiwalika padzuwa, chisanu, kapena kwakhala kutentha kwa nthawi yayitali popanda thumba lamafuta, botolo liyenera kulowedwa ndi watsopano kuchokera mufiriji. Njira yowonongeka imatha kukhala pamtambo, pomwe masamba amayatsidwa mkati. Kupanga kwamakristali pansi ndi makhoma.
2. Jekeseni wolakwika, mlingo wowerengeka. Kuwongolera kwa mtundu wina wa insulin: yayitali m'malo mofupikitsa.
3. Kuwonongeka kwa cholembera, singano yopanda vuto. Kukula kwa singano kumayendetsedwa ndikufinya dontho la yankho kuchokera ku syringe. Kugwira kwa cholembera sikungayang'anitsidwe, chifukwa chake imasinthidwa pakukayikira koyamba kwa kuphwanya. Munthu wodwala matenda ashuga nthawi zonse ayenera kukhala ndi insulin yowonjezera.
4. Kugwiritsa ntchito pampu kungatsekeke kulowetsedwa. Pankhaniyi, iyenera m'malo m'malo mwake. Pompo limachenjeza za kusweka kwina ndi chizindikiro chomveka kapena uthenga wapamwamba.

Kuchulukitsidwa kwa NovoRapid insulin kumatha kuwonedwa ndi mankhwala osokoneza bongo, mowa, chiwindi osakwanira komanso impso.

Kusintha NovoRapida Levemir

NovoRapid ndi Levemir ndi mankhwala omwe amapanga omwe ali ndi zotsatira zosiyana. Kodi pali kusiyana kotani: Levemir ndi insulin yayitali, imaperekedwa mpaka 2 pa tsiku kuti ipangitse kubisalira kwa secretion ya mahomoni a base.

NovoRapid ndi ultrashort, yofunikira kuti muchepetse shuga mutatha kudya. Palibe pokhapokha wina atha kulowa m'malo mwa wina, izi zimatsogolera ku hyper- ndipo, patatha maola ochepa, ku hypoglycemia.

Matenda a shuga amafunikira chithandizo chovuta, kuti shuga asamangidwe, mumafunikira mahomoni azitali komanso amafupikitsa. NovoRapid insulin nthawi zambiri imaphatikizidwa ndendende ndi Levemir, popeza kulumikizana kwawo kwaphunziridwa bwino.

Pakadali pano, NovoRapid insulin ndi mankhwala okhawo a ultrashort ku Russia okhala ndi aspart ngati chinthu chogwira ntchito. Mu 2017, Novo Nordisk adakhazikitsa insulin yatsopano, Fiasp, ku United States, Canada ndi Europe. Kuphatikiza pa aspart, ilinso ndi zinthu zina, kotero kuti machitidwe ake amakhala achangu komanso okhazikika. Insulin yotereyi ingathandize kuthana ndi vuto la shuga wambiri mutatha chakudya chokhala ndi chakudya chambiri. Itha kugwiritsidwanso ntchito ndi anthu odwala matenda ashuga osakhala ndi vuto losakhazikika, popeza timadzi timeneti timatha kubayidwa mutangomaliza kudya, powerengetsa zomwe zidyedwa. Sizotheka kugula izo ku Russia, koma ndikulamula kuchokera kumaiko ena, mtengo wake umakhala wokwera kwambiri kuposa wa NovoRapid, pafupifupi ma ruble 8500. kunyamula.

Ma analogu a NovoRapid ndi ma Humalog ndi Apidra. Mbiri yawo ya zochita imangofanana, ngakhale kuti zinthu zomwe sizigwirizana ndizosiyana. Kusintha insulini kukhala analogue ndikofunikira pokhapokha ngati thupi lanu siligwirizana ndi mtundu winawake, popeza kulocha kumafuna kusankhidwa kwa mankhwala atsopano ndipo mosakayikira kumabweretsa kuwonongeka kwakanthawi mu glycemia.

Mimba

Kafukufuku wachipatala awonetsa kuti NovoRapid insulin siyowopsa ndipo siyikhudza kukula kwa mwana wosabadwayo, motero amaloledwa kuigwiritsa ntchito panthawi yomwe ali ndi pakati. Malinga ndi malangizo, pakubala kwa mwana yemwe ali ndi matenda a shuga, kusinthanso kwa mankhwalawa kumafunikira: kuchepa kwa trimester 1, kuchuluka kwa 2 ndi 3. Panthawi yobereka, insulini imafunikira zochepa, pambuyo pobala mwana nthawi zambiri amabwerera pamankhwala omwe amawerengedwa asanakhale ndi pakati.

Aspart simalowa mkaka, chifukwa chake kuyamwitsa sikungavulaze mwana.

Onetsetsani kuti mwaphunzira! Kodi mukuganiza kuti kuyamwa kwa mapiritsi ndi insulini kwa nthawi yonse yokhayo ndi njira yokhayo yothanirana ndi shuga? Sichowona! Mutha kutsimikizira izi nokha ndikuyamba kuzigwiritsa ntchito.

M'badwo watsopano wa Novorapid Penfill umathandizira kuwonjezera kuchuluka kwa insulin.

Chipangizocho chimatha mosavuta komanso mwachangu, chogwiritsidwa ntchito mosasamala chakudya, chimatanthauzira mtundu wa insulin yochepa kwambiri.

Amapezeka mu mawonekedwe a zolembera zotayika komanso makatiriji omwe mungathe kubwezeretsa jakisoni.

Makalata ochokera kwa Owerenga

Mutu: Magazi a agogo aakazi abwerera mwakale!

Kupita ku: Webusayiti yoyang'anira

Christina
Moscow

Agogo anga akhala akudwala matenda a shuga kwa nthawi yayitali (mtundu 2), koma posachedwapa mavuto atuluka pamiyendo ndi ziwalo zamkati.

Insulin Aspart - gawo lalikulu la mankhwalawa, lili ndi mphamvu ya hypoglycemic. Ichi ndi chiwonetsero cha insulin yochepa, yomwe imapangidwa m'thupi la munthu. Insulin Aspart imapangidwa ndi ukadaulo wa ma DNA a recombinant.

Mankhwalawa amalumikizana ndi ma cell am'mimba a cytoplasmic osiyanasiyana amino acid, amapanga mapangidwe ambiri a insulini, ndipo amathandizira njira zamkati.

Pambuyo kuchepa kwa kuchuluka kwa shuga mthupi, kusintha kotere kumachitika:

• kayendedwe kazinthu zatsatanetsatane,
• kukondoweza kwa minofu kumachuluka
• glycogeneis, lipogeneis.

Ndikotheka kukwaniritsa kuchepa kwa kuchuluka kwa shuga m'magazi. Novorapid imagwira bwino ntchito ndiminyewa yamafuta, koma nthawi yake yochita ndizochepa kuposa ya insulin yaumunthu.

Mankhwalawa adamulowetsa pambuyo pa mphindi 10-20 pambuyo pa jakisoni, amatha maola 3-5, kuchuluka kwakukulu kwa mahomoni kumawonedwa pambuyo pa maola 1-3.

Kugwiritsa ntchito mwadongosolo kwa Novorapid kumachepetsa kugona kwa hypoglycemia usiku kangapo. Milandu ya kuchepa kwakukulu kwa postprandial hypoglycemia imadziwika. Mankhwala tikulimbikitsidwa.

Zizindikiro zogwiritsidwa ntchito

Njira za Hypoglycemic zimakula msanga ngati wodwala matenda ashuga ali ndi matenda othandizirana, ndipo mankhwala omwe amachepetsa kuyamwa kwa chakudya amagwiritsidwa ntchito. Kufunika kwamankhwala kumawonjezeka ndi zovuta zamtundu umodzi.Thupi silifunikira insulin ngati wodwalayo ali ndi mavuto ndi ziwalo zamkati.

Pambuyo poti odwala asintha kupita ku mankhwala ena, zizindikiro za hypoglycemia zimasinthika kapena kusayamba kutchulidwa. Madokotala nthawi zonse amawunika momwe wodwalayo akusinthira mtundu wina wa mahomoni. Mankhwala akasinthidwa, mlingo umasinthidwa. Kusintha kwa kuchuluka kwa mankhwala omwe mumagwiritsidwa ntchito kumafunikira mukamadya zakudya zina, mutachotsedwa kapena kuwonjezeka kwa zolimbitsa thupi.

Mlingowo umatsimikiziridwa ndi endocrinologist payekhapayekha kwa wodwala aliyense, poganizira zosowa zake. Novorapid amaphatikizidwa ndi insulin yayitali komanso yayitali osachepera 1 nthawi patsiku. Magazi a glucose, insulin yochulukirapo imayendetsedwa kuti ipeze njira yoyenera yothanirana ndi glycemia. Ana amapatsidwa 1.5 mpaka 1 unit. pa kilogalamu ya kulemera. Kusintha kadyedwe kanu kapena moyo wanu pamafunika kusintha kwa mlingo.

Novorapid imayendetsedwa asanadye, mwayi wa usiku wa hypoglycemia umachepetsedwa.

Munthu wodwala matenda ashuga amatha kuperekera mankhwalawo payekha, jakisoni wokhazikika amapangidwa m'mimba, ntchafu, mu minyewa yolimba. Tsamba la jakisoni limasintha kuti lipodystrophy isamere.

Mankhwala amagwiritsidwa ntchito PPII; mapampu a insulin amagwiritsidwa ntchito kulowetsedwa. Panthawi imeneyi, jakisoni amapangidwa kutsogolo kwa m'mimba. Mwakamodzikamodzi, Novorapid amalowa jekeseni wamkati, akatswiri okhawo omwe amadziwa bwino amapanga jakisoni.

Zotsatira za insulin ya rDNA m'thupi nthawi zina zimadetsa nkhawa za odwala. Zotsatira zoyipa kwambiri ndi kutsika kwa shuga - hypoglycemia. Pafupipafupi mwadzidzidzi vutoli limapezeka m'magulu osiyanasiyana a odwala ndilosiyana, limatsimikiziridwa ndi Mlingo, mawonekedwe oyang'anira.

Pochiza matenda a shuga kunyumba, akatswiri akulangizani DiaLife . Ichi ndi chida chapadera:

• Amasinthasintha shuga
• Amayang'anira ntchito ya pancreatic
• Chotsani puffness, limayendetsa madzi kagayidwe
• Amawongolera masomphenya
• Zoyenera akulu ndi ana.
• Alibe zotsutsana

Opanga alandila ziphaso zonse zofunika ndi ziphaso za mbiri ku Russia komanso m'maiko oyandikana.

Timapereka kuchotsera kwa owerenga tsamba lathu!

Gulani pa tsamba lovomerezeka

Pa magawo oyambilira a maphunziro, kusintha kosinthika kumachitika, kupweteka, Hyperemia, kutupa, ndi kuyabwa kumachitika pamalo a jakisoni. Zizindikiro zotere zimazimiririka pakapita nthawi popanda chithandizo.

Kuchepetsa kwambiri glycemia kumadzetsa kuwonongeka.

Zina zoyipa zomwe zimawonedwa mu anthu odwala matenda ashuga zimachitika mwanjira zosiyanasiyana zamatenda a ziwalo ndi machitidwe:

• chitetezo chofooka
• misempha imasokonekera,
• masomphenya amawonongeka
• Kutupa pa malo a jekeseni.

Hypoglycemia imayamba ndi kuchuluka kwa insulin, kuphwanya njira ya zamankhwala. Vuto lalikulu la matendawa ndi loopsa kwa munthu wodwala matenda ashuga. Pali mavuto ndi dongosolo lamagazi, ubongo umasokonekera, mwayi woti imfa umachulukitsidwa.

Contraindication

• tsankho ku ziwalo za mankhwala,
• Musalole ana osakwana zaka 6.

Madokotala samapereka mankhwala a Novorapid ngati odwala ali ndi matendawo pazinthu zina za mankhwalawa.

Mukamapita kumalo okhala ndi nthawi yosiyanasiyana, muyenera kudziwa kuchokera kwa dokotala momwe mungagwiritsire ntchito mankhwalawo moyenera. Ngati munthu waleka kubayidwa, hyperglycemia imayamba,. Mu diabetes 1, matenda amtunduwu amapezeka nthawi zambiri. Zizindikiro zimawoneka pang'onopang'ono, kukulira nthawi.

Pali mseru, kusanza, kugona, khungu limaphwa, chinyezi pakamwa chimachepa, nthawi zonse mumamva ludzu, komanso kusowa kudya. . Ngati hyperglycemia ikukayikiridwa, chithandizo chamankhwala chimachitika nthawi yomweyo kuti apulumutse moyo wa wodwalayo. Kuchuluka kwa mankhwalawa kumasintha zizindikirazo, koma hypoglycemia imakhalabe.

Vutoli limachitika mlingo wa insulini ukadutsa.Kukula kwake sikungotengera kuchuluka kwa mankhwalawa, komanso kuchuluka kwamagwiritsidwe ntchito, momwe wodwalayo alili, kupezeka kwa zinthu zomwe zikukulitsa.

Zizindikiro za hypoglycemia zimayambira motsatizana, zimavuta popanda kuyendetsa shuga. Ndi mtundu wofatsa wa matendawa, odwala amalangizidwa kuti azidya shuga wambiri kapena zakudya zam'madzi, amwe madzi a zipatso kapena tiyi wokoma wowerengeka.

Odwala nthawi zonse amafunika kunyamula maswiti kapena maswiti ena ndi iwo kuti azisinthasintha shuga awo akamva kuti sakukonda. M'mavuto akulu, odwala amasiya kuzindikira, madokotala kapena okondedwa omwe amadziwa zoyenera kuchita.

Kusintha kwa odwala matenda ashuga, amadzipaka ndi glucagon intramuscularly kapena subcutaneally. Ngati mankhwalawa sakulitsa, wodwalayo sayambiranso, gwiritsani ntchito njira ya dextrose, jekeseni kudzera m'mitsempha.

NovoRapid Flexpen ndi analogue yaifupi yogwira insulin yopangidwa ndi biotechnology (amino acid proline pa malo 28 a B unyolo amaloledwa ndi aspartic acid). Mphamvu ya hypoglycemic ya insulin aspart imakhala mukupanga kukhathamiritsa kwa glucose pomanga minyewa pambuyo pomanga insulin kuti minofu ndi mafuta cell receptors, komanso kuletsa kwa shuga kutulutsa chiwindi.

Mphamvu ya mankhwalawa NovoRapid Flexpen imachitika kale kuposa kukhazikika kwa insulin yamunthu, pomwe shuga ya m'magazi imatsika mkati mwa maola 4 atatha kudya. Ndi sc makonzedwe, nthawi ya zochita za NovoRapid Flexpen ndi yofupikirapo kuposa ya sungunuka wa munthu insulin ndipo imachitika 10-20 min pambuyo makonzedwe. Kuchuluka kwake kumachitika pakati pa 1 ndi 3 mawola jakisoni. Kutalika kwa kuchitapo kanthu - maola 3-5.

Zotsatira za mayesero azachipatala a odwala omwe ali ndi mtundu wa matenda a shuga I amveketsa kuti pakukhazikitsa mankhwala a NovoRapid Flexpen, kuchuluka kwa shuga pambuyo podya ndi kotsika poyerekeza ndi kuyambitsa insulin.

Ana ndi achinyamata. Mu ana omwe amathandizidwa ndi NovoRapid Flexpen, mphamvu ya kuwunika kwakanthawi kwamagazi a shuga ndi chimodzimodzi ndi insulin yaumunthu. Mu kafukufuku wazachipatala wa ana 26 wazaka 2 - 6, mphamvu ya glycemic control idayerekezeredwa ndi kayendetsedwe ka madzi osungunuka musanadye chakudya komanso aspart atatha kudya, ndipo pharmacokinetics ndi pharmacodynamics adatsimikiza mwa ana a zaka 6 mpaka 12 ndi achinyamata 13- Zaka 17 zakubadwa. Mbiri ya pharmacodynamic ya insulin aspart mwa ana ndi akulu inali yomweyo. Zoyesa zamankhwala za odwala omwe ali ndi mtundu woyamba wa matenda a shuga I amellletus adawonetsa kuti mukamagwiritsa ntchito insulin aspart, chiwopsezo chokhala ndi hypoglycemia usiku chimachepa poyerekeza ndi insulin yaumunthu, ponena za pafupipafupi milandu ya hypoglycemia masana, panalibe kusiyana kwakukulu. Mukamawerengera mlingo (wa timadontho-timadontho), insulin yokwanira imaphatikizika kuti isungunuke insulin yaumunthu. Kulowetsedwa kwa amino acid proline pamalo a B-28 a mamolekyulamu a insulin omwe ali ndi spartic acid mu mankhwala a NovoRapid Flexpen kumapangitsa kuchepa kwa mapangidwe a hexamers omwe amawonetsedwa ndikuyambitsa kwa insulin ya insulin yamunthu. Chifukwa chake, NovoRapid Flexpen imatengedwa mwachangu m'magazi kuchokera pamafuta ochulukirapo poyerekeza ndi insulin yamtundu wa munthu. Nthawi yoti ifike pazokwanira kuchuluka kwa insulini m'magazi ndi pafupifupi theka pomwe mukupaka insulin yaumunthu. Kuchuluka kwa insulini m'magazi a odwala omwe ali ndi mtundu wa shuga I mellitus 492 ± 256 pmol / l kumatheka pambuyo pa 30 -40 pambuyo pa mankhwala a NovoRapid Flexpen pamlingo wa 0,15 U / kg thupi. Minyewa ya insulini ibwerera kumayambira maola 4-6 pambuyo pa kukhazikitsa. Kuchuluka kwa mayamwa kumacheperachepera odwala omwe ali ndi matenda amtundu II.Chifukwa chake, kuchuluka kwambiri kwa insulin mu odwala koteroko kumachepera - 352 ± 240 pmol / L ndipo kufikiridwa pambuyo pake - pafupifupi pambuyo pa mphindi 60 (50-90). Ndi kukhazikitsidwa kwa NovoRapid Flexpen, kusiyanasiyana kwakanthawi kokwanira kufikira wodwala yemweyo kumakhala kochepa kwambiri, ndipo kusiyanasiyana kwa kuchuluka kwa ndende kumakhala kwakukulu kuposa ndikuyambitsa insulin yaumunthu.

Odwala okalamba kapena vuto la chiwindi kapena impso, a pharmacokinetics a NovoRapid Flexpen sanaphunzire. Ma pharmacokinetics ndi pharmacodynamics a NovoRapid Flexpen anaphunziridwa mwa ana (wazaka 6 - 12) ndi achinyamata (azaka 13 mpaka 17) okhala ndi matenda a shuga a mtundu wa I. Insulin aspart idalowetsedwa mwachangu m'magulu azaka zophunziridwa, pomwe nthawi yofika kwambiri pamagazi inali yofanana ndi akulu. Komabe, kuchuluka kwa kuchuluka kwa ndende ndi kosiyana mwa ana amisinkhu yosiyanasiyana, zomwe zikuwonetsa kufunikira kwa kusankha kwa milingo ya NovoRapid Flexpen.

Chenjezo pakugwiritsa ntchito

Matenda obvuta, makamaka matenda ndi matenda otupa, nthawi zambiri amawonjezera kufunikira kwa insulin.

Kusamutsa odwala kukhala mtundu watsopano kapena mtundu wa insulin kuyenera kuchitika moyang'aniridwa ndi achipatala. Mukasintha ndende, mtundu, mtundu, magwiritsidwe antchito a insulin (nyama, anthu, ma insulin analogue) ndi / kapena njira yake yopangira, zingakhale zofunikira kusintha mlingo. Odwala omwe akutenga NovoRapid Flexpen angafunikire kuwonjezera kuchuluka kwa jakisoni kapena kusintha mlingo poyerekeza ndi insulin yokhazikika. Kufunika kochita kusankha kwa mankhwalawa kumatha kuchitika pakukhazikitsa mankhwala atsopano, komanso pakubwera milungu ingapo kapena miyezi ingapo yogwiritsidwa ntchito.

Kudumpha zakudya kapena kuchita masewera olimbitsa thupi mosayembekezereka kungayambitse hypoglycemia. Kuchita masewera olimbitsa thupi mutangotha ​​kudya kumawonjezera chiopsezo cha hypoglycemia. NovoRapid Flexpen imakhala ndi metacresol, omwe nthawi zina amatha kuyambitsa mavuto.

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere. Zomwe mungagwiritse ntchito mankhwalawa NovoRapid Flexpen pa nthawi ya pakati ndizochepa. Kafukufuku wazinyama adawonetsa kuti insulin, monga insulin ya munthu, ilibe mphamvu ya embryotoxic ndi teratogenic. Kuwongolera kowonjezereka kumalimbikitsidwa pochiza amayi apakati omwe ali ndi matenda ashuga panthawi yonse yovutikira, komanso pazochitika zomwe akuganiza kuti ali ndi pakati. Kufunika kwa insulin nthawi zambiri kumachepera mu trimester yoyamba ya kutenga pakati ndikuwonjezeka kwambiri mu yachiwiri ndi yachitatu trimester. Palibe choletsa kuchiza matenda a shuga ndi NovoRapid Flexpen panthawi yoyamwitsa. Kuchiza pa nthawi ya pakati sikubweretsa chiopsezo kwa mwana. Komabe, panthawiyi, zingakhale zofunika kuti mayi asinthe mlingo.

Kukopa pa luso loyendetsa magalimoto ndi zida. Kuyankha kwa wodwalayo komanso kuthekera kwake kuchita zinthu zambiri zitha kusokonezedwa ndi hypoglycemia. Izi zitha kukhala zowopsa nthawi zomwe chidwi chimafunikira (mwachitsanzo, poyendetsa galimoto kapena pamakina ogwiritsa ntchito). Odwala ayenera kulangizidwa kuti athe kutenga njira zopewa hypoglycemia musanayendetse. Izi ndizofunikira kwambiri kwa odwala omwe afooka kapena kulibe zizindikiro - zotsogola za hypoglycemia kapena zochitika za hypoglycemia zimachitika pafupipafupi. Zikatero, kuyendetsa bwino kuyenera kuyesedwa.

Zochita Zamankhwala

Mankhwala omwe amatha kuchepetsa kufunika kwa insulin: othandizira pakamwa a hypoglycemic, octreotide, MAO inhibitors, osasankha β-adrenergic receptor blockers, ACE inhibitors, salicylates, mowa, anabolic steroids, sulfonamides.

Mankhwala omwe angapangitse kufunika kwa insulin: kulera kwapakamwa, thiazides, GCS, mahomoni a chithokomiro, sympathomimetics, danazole.

Ma blockers a ren-adrenergic amatha kubisa zizindikiro za hypoglycemia.

Mowa umatha kukulitsa mphamvu ya hypoglycemic ya insulin.

Kusagwirizana. Kuphatikiza kwa mankhwala ena ku insulin kungayambitse kuyambitsa kwake, mwachitsanzo, mankhwala okhala ndi thiols kapena sulfite.

Analogs, ndemanga za odwala

Ngati zidachitika kuti NovoRapid Penfill insulin pazifukwa zina sizigwirizana ndi wodwalayo, adotolo akuvomereza kuti agwiritsidwe ntchito ndi ma analogues. Zina zotchuka kwambiri ndi Apidra, Gensulin N, Humalog, Novomiks, Rizodeg. Mtengo wawo uli wofanana.

Odwala ambiri adatha kuyeserera mankhwala a NovoRapid, amadziwa kuti zotsatira zimabwera mwachangu, zimachitika sizovuta. Mankhwalawa ndi abwino kwambiri pochiza matenda a shuga a mtundu woyamba ndi wachiwiri. Ochuluka a odwala matenda ashuga amakhulupirira kuti chida ndichosavuta, makamaka ma syringe, amathetsa kufunika kogulira syringes.

Pochita, insulin imagwiritsidwa ntchito motsutsana ndi maziko a insulin yayitali, imathandizira kuti shuga wamagazi azikhala pamlingo woyenera masana, kuchepetsa shuga pambuyo chakudya. NovoRapid amawonetsedwa kwa odwala ena makamaka kumayambiriro kwa matendawa.

Kuperewera kwa ndalama kumatha kutchedwa kutsika kwakuthwa kwa glucose mwa ana, chifukwa chake, odwala amatha kumva bwino. Pofuna kupewa zovuta zoterezi, ndikofunikira kusinthana ndi insulin nthawi yayitali.

Komanso, odwala matenda ashuga amati ndikasankhidwa mwanjira yolakwika, Zizindikiro za hypoglycemia zimayamba, ndipo matenda akuwonjezeka. Kanemayo munkhaniyi apitiliza mutu wa Novorapid insulin.

Mlingo ndi makonzedwe a Novorapid

Chofunikira cha insulin nthawi zambiri chimakhala 0.5-1.0 U / kg / tsiku. Ngati pafupipafupi kugwiritsa ntchito molingana ndi kudya kwakuthupi ndi 50-70%, kufunika kwa insulin kumakhutitsidwa ndi NovoRapid Flexpen, ndipo ena onse ndi nthawi yayitali kapena otenga nthawi yayitali.

Njira yogwiritsira ntchito mankhwalawa NovoRapid Flexpen imadziwika ndi kuyambika mwachangu komanso kufupikitsa kwa nthawi poyerekeza ndi insulin yamunthu. Chifukwa cha kuyamba kwachangu, NovoRapid Flexpen nthawi zambiri imayenera kutumizidwa musanadye. Ngati ndi kotheka, mankhwalawa amatha kuperekedwa akangomaliza kudya.

NovoRapid imayendetsedwa pansi pa khungu la khoma lakunja kwam'mimba, ntchafu, mu minyewa yonyansa ya phewa kapena matako. Malowo a jakisoni amayenera kusinthidwa ngakhale mkati momwe momwemo. Ndi subcutaneous jakisoni wakunja kwam'mimba khoma, mphamvu ya mankhwalawa imayamba Mphindi 10-20. Kuchuluka kwake kuli pakati pa maola 1-3 pambuyo pa kubayidwa. Kutalika kwa kuchitapo kanthu ndi maola 3-5. Momwemo ndi ma insulin onse, makina amkati mwa khoma lamkati am'mimba amathandizira kuyamwa mwachangu kuposa momwe amapangidwira malo ena. Komabe, kuyambika kwakanthawi kothana ndi mankhwala a NovoRapid Flexpen poyerekeza ndi insulin ya anthu sungunuka mosasamala malo a jekeseni. Ngati ndi kotheka, NovoRapid Flexpen ikhoza kutumikiridwa iv, majakisoni awa amatha kuchitidwa motsogozedwa ndi dokotala. NovoRapid itha kugwiritsidwa ntchito popitiliza sc pothandizidwa ndi mapampu olowetsa oyenerera. Kupitiliza kwa sc kumachitika mu khoma lakunja kwam'mimba, tsamba la jakisoni liyenera kusinthidwa nthawi ndi nthawi. Mukamagwiritsira ntchito mapampu a kulowetsedwa, NovoRapid sayenera kusakanikirana ndi insulin ina iliyonse. Odwala omwe amagwiritsa ntchito mapampu olowetsedwa amayenera kuphunzitsidwa zambiri za kugwiritsa ntchito makina amenewa ndikugwiritsa ntchito makontena ndi machubu oyenera. Ma kulowetsedwa (machubu ndi ma cannulas) ayenera kusinthidwa malinga ndi zofunikira za malangizo omwe aphatikizidwa.Odwala omwe amagwiritsa ntchito NovoRapid pakukonzanso ayenera kukhala ndi insulini ngati atalephera. Kuchepa kwa chiwindi ndi impso kungathandize kuchepetsa wodwala kufunika kwa insulin. M'malo mosungunuka kwa insulin ya anthu, ana ayenera kupatsidwa mankhwala a NovoRapid FlexPen ngati kuli kofunika kupeza mwachangu insulin, mwachitsanzo, asanadye. NovoRapid Flexpen ndi cholembera chodzaza ndi sindanoFine ® chokhazikitsidwa ndi singano za NovoFine®. Ma CD omwe amaphatikiza ndi singano za NovoFine® amalembedwa dzina la S. Flexpen limakupatsani mwayi kuti mulowe kuyambira 1 mpaka 60 magawo a mankhwalawo molondola 1 unit. Muyenera kutsatira malangizo a mankhwalawa pogwiritsa ntchito mankhwalawo. NovoRapid Flexpen idapangidwa kuti igwiritsidwe ntchito payekha, singagwiritsenso ntchito.

Malangizo Mankhwala NovoRapid Flexpen

NovoRapid lakonzedwa kuti jakisoni wa subcutaneous kapena jekeseni wosalekeza wogwiritsa ntchito mapampu kulowetsedwa. NovoRapid itha kuperekedwanso kudzera m'mitsempha moyang'aniridwa ndi dokotala.

Gwiritsani ntchito mapampu a kulowetsedwa

Pakumapaka kulowetsedwa, machubu amagwiritsidwa ntchito omwe mkati mwake amapangidwa ndi polyethylene kapena polyolefin. Insulini ina imayamba kumangika mkati mwa tangi ya kulowetsedwa.

Gwiritsani ntchito yolamulira

Machitidwe a kulowetsedwa ndi NovoRapid 100 IU / ml pa insulini aspart ndende ya 0,05 mpaka 1.0 IU / ml mu kulowetsedwa njira yokhala ndi 0.9% sodium chloride, 5 kapena 10% dextrose ndi 40 mmol / l chloride. potaziyamu, ali mum'madzi a polypropylene kulowetsedwa, amakhala osungika kutentha kwa maola 24. Pa kulowetsedwa kwa insulin, ndikofunikira kuyang'anira kuchuluka kwa shuga m'magazi.

Katundu

Imalumikizana ndi cholandirira chapadera pa cytoplasmic membrane ya maselo ndikupanga insulini-receptor zovuta zomwe zimapangitsa njira zamagawo, kuphatikiza kaphatikizidwe kazinthu zingapo za michere (hexokinase, pyruvate kinase, glycogen synthase, 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 spartic acid mu insulin aspart kumachepetsa chizolowezi cha mamolekyulu kupanga hexamers, yomwe imawonedwa mu yankho la insulin wamba. Motere, insulin aspart imatengedwa mwachangu kuchokera ku mafuta a subcutaneous ndipo imayamba kuchita zinthu mwachangu kuposa insulin yamunthu. Insulin aspart amachepetsa shuga m'magazi 4 koyamba pambuyo chakudya asanapezeke insulin yaumunthu. Kutalika kwa insulin aspart pambuyo pa subcutaneous makonzedwe afupikitsa kuposa sungunuka wa 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 vuto la matenda a shuga 1 amawonetsa kuchepa kwam'magazi kwa glucose wama cell ndi insulin aspart poyerekeza ndi insulin yamunthu.

Okalamba: Kafukufuku wosasinthika, wakhungu lambiri, wopanga magawo a pharmacokinetics ndi pharmacodynamics (FC / PD) wa insulin aspart ndi sungunuka wa insulin wa anthu odwala okalamba omwe ali ndi mtundu wa 2 matenda a shuga (19 odwala zaka 65-83 zaka, amatanthauza zaka 70). Kusiyana kwazomwe zimachitika mu pharmacodynamic katundu pakati pa insulin aspart ndi insulle ya insulin ya anthu odwala okalamba anali ofanana ndi odzipereka athanzi komanso odwala achinyamata omwe ali ndi matenda osokoneza bongo.

Ana ndi achinyamata. Kugwiritsa ntchito insulin aspart mwa ana kuwonetsa zotsatira zofananira pakulamulira kwa glycemic kwa nthawi yayitali mukayerekeza ndi insulin yaumunthu.
Kafukufuku wazachipatala yemwe amagwiritsa ntchito insulle ya anthu osungunuka musanadye chakudya komanso asipilini atatha kudya amapangidwa mwa ana aang'ono (odwala 26 azaka za pakati pa 2 mpaka 6), ndipo kafukufuku umodzi wa FC / PD unachitika mwa ana (6 Wazaka 12) ndi achinyamata (wazaka 13 mpaka 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 1 shuga mellitus (azimayi apakati 322 omwe adawunikira, 157 mwa iwo adalandira insulin ,art - insulin yaanthu / chatsopano.
Maphunziro owonjezera azachipatala mwa azimayi 27 omwe ali ndi gestational matenda a shuga omwe amalandila insulin aspart ndi insulin yaumunthu (insulin aspart analandila azimayi 14, insulin 13 ya anthu) amawonetsa kuyanjana kwa mbiri ya chitetezo komanso kusintha kwakukulu pakulamulira kwa glucose pambuyo pa chakudya.

Pharmacokinetics
Pambuyo subcutaneous makonzedwe a insulini, nthawi yofika pazipita ndende (t max) mu madzi am'magazi ndi pafupifupi 2 nthawi zosakwana pambuyo makonzedwe a sungunuka munthu insulin. The pazipita plasma ndende (Cmax) pafupifupi 492 ± 256 pmol / L ndipo 40 mphindi pambuyo subcutaneous makonzedwe a 0,15 U / kg thupi kulemera kwa odwala matenda amtundu 1 shuga. The kuchuluka kwa insulini amabwerera yake yoyambira 4-6 mawola pambuyo mankhwala. Kuchuluka kwa mayamwa kumacheperachepera odwala omwe ali ndi matenda a shuga a 2, omwe amachititsa kuti azikhala ndi chiwopsezo chochepa kwambiri (352 ± 240 pmol / L) komanso pambuyo pake ma ma (60 maminiti).

Kusinthika kwapakati pa t max kumatsika kwambiri tikamagwiritsa ntchito insulin, poyerekeza ndi insulin yaumunthu, pomwe kusiyana kwa C max kwa insulin aspart kumakulirakulira.

Pharmacokinetics mu ana (wazaka 6-12) ndi achinyamata (wazaka 13 mpaka 17) wokhala ndi matenda amtundu wa 1. Kuchepetsa kwa insulin aspart kumachitika msanga m'magulu onse aamuna ndi t max wofanana ndi wamkulu. Komabe, pali zosiyana ndi max m'misinkhu iwiri, zomwe zimagogomezera kufunikira kwa kuchuluka kwa mankhwalawa. Okalamba: Kusiyana kwapakati pa pharmacokinetics pakati pa insulin aspart ndi soluble insulin ya anthu odwala okalamba (zaka 65-83, zaka zapakati pa 70 zaka) zamtundu wa 2 wodwala mellitus anali ofanana ndi odzipereka athanzi komanso odwala achinyamata omwe ali ndi matenda a shuga. Mwa odwala okalamba, kuchepa kwa mayamwidwe kunawonedwa, komwe kunapangitsa kutsika kwa ma max (82 (kusiyanasiyana: mphindi 60-120), pomwe C max anali ofanana ndi omwe amawerengedwa mwa odwala achichepere omwe ali ndi matenda a shuga a 2 komanso pang'ono poyerekeza ndi lembani odwala 1 a shuga. Kuperewera kwa chiwindi: Kafukufuku wa pharmacokinetics adachitika ndi mlingo umodzi wa aspart insulin mwa odwala 24 omwe chiwindi chawo chimagwira kuchokera pakulakwitsa kwambiri. Mwa anthu omwe ali ndi vuto la chiwindi, kuchuluka kwa mayankho a insulin kunachepetsedwa komanso kusinthasintha, zomwe zimapangitsa kutsika kwa max kuchokera mphindi pafupifupi 50 mwa anthu omwe ali ndi chiwindi chokwanira mpaka mphindi 85 mwa anthu omwe ali ndi vuto la chiwindi chokwanira komanso mwamphamvu.Dera lomwe linali pansi pa nthawi yokhomerera, kuchuluka kwa plasma ndende ndikuwongolera kwathunthu kwa mankhwalawo (AUC, C max ndi CL / F) zinali zofanana ndi misewu yochepetsedwa komanso yolimba ya chiwindi. Kulephera kwamkati: Kafukufuku adachitika mu pharmacokinetics of insulin aspart mwa odwala 18 omwe ntchito yawo yaimpso imachokera pachizolowezi mpaka kuwonongeka kwambiri. Palibe zotsatira zoonekeratu za kulengedwa kwa creatinine pa AUC, C max, t max insulin aspart. Zomwe zidasungidwazo zinali zochepa kuzomwe zikuwonetsa kwa anthu omwe ali ndi vuto laimphuwofu wofatsa komanso wowonda. Anthu omwe ali ndi vuto la aimpso omwe amafunikira dialysis sanaphatikizidwe mu phunziroli.

Zambiri Zachitetezo Chachikulu:
Kafukufuku wammbuyo sanawonetse vuto lililonse kwa anthu, potengera kafukufuku wovomerezeka wazachipatala, kuwopsa kwa kugwiritsidwa ntchito mobwerezabwereza, genotoxicity komanso kubereka kawopsedwe. M'mayeso a in vitro, kuphatikizapo kumangiriza ma insulin receptors ndi insulin-grow grow-1, komanso momwe zimakhudzira kukula kwa maselo, machitidwe a insulin aspart amafanana kwambiri ndi insulin yamunthu. Kafukufuku adawonetsanso kuti kudzipatula kumangiriza kwa insulin receptor ndikofanana ndi insulin yaumunthu.

Mlingo ndi makonzedwe:

Kuti mukwaniritse bwino glycemic control, tikulimbikitsidwa kuyeza kuchuluka kwa shuga m'magazi ndikusintha mlingo wa insulin.

Mwachizolowezi, chinthu chofunikira tsiku lililonse cha insulin mwa akulu ndi ana kuyambira 0,5 mpaka 1 U / kg thupi. Mankhwala akaperekedwa musanadye, kufunika kwa insulin kungaperekedwe ndi NovoRapid® FlexPen® ndi 50-70%, kufunikira kwotsalira kwa insulin kumaperekedwa ndi insulin yotalikilapo.

Kuwonjezeka kwa zochita zolimbitsa thupi kwa wodwala, kusintha kwa zakudya zomwe timakonda, kapena matenda okhudzana ndi zina zitha kuchititsa kusintha kwa mlingo.

NovoRapid® Flexpen ® imayamba mwachangu komanso yofupikitsa nthawi pochitapo kuposa insulin ya munthu wosungunuka. Chifukwa cha kuyambika kwachangu, NovoRapid® FlexPen ® iyenera kuperekedwa, ngati lamulo, nthawi yomweyo chakudya chisanachitike, ngati kuli koyenera, chitha kuperekedweratu chakudya chisanafike. Chifukwa chakufupika kwakanthawi poyerekeza ndi insulin yaumunthu, chiopsezo chokhala ndi nocturnal hypoglycemia mwa odwala omwe amalandila NovoRapid® Flexpen® ndiwotsika.

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

Ana ndi achinyamata
Ndikofunika kugwiritsa ntchito NovoRapid® FlexPen ® m'malo mwa sungunuka wa anthu mu ana pakafunika kuyamba mwachangu zochita za mankhwalawa, mwachitsanzo, pakakhala zovuta kuti mwana athe kupeza nthawi yayitali pakati pa jakisoni ndi zakudya.

Chotsani kuchokera kukonzekera kwina kwa insulin
Mukasamutsa wodwala kuchokera ku kukonzekera kwa insulin ina ku NovoRapid® FlexPen ®, kusintha kwa NovoRapid® FlexPen ® ndi basulin insulin kungafunike.

NovoRapid Fle Flexpen ® jekeseni subcutaneally m'dera la anterior m'mimba khoma, ntchafu, phewa, deltoid kapena gluteal dera. Mawebusayiti omwe ali mkati mwa thupi limodzi amayenera kusinthidwa pafupipafupi kuti muchepetse chiwopsezo cha lipodystrophy. Monga kukonzekera konse kwa insulin, kuyika kwina kwa khoma lakunja kwam'mimba kumayamwa mwachangu poyerekeza ndi kayendetsedwe ka malo ena. Kutalika kwa zochita zimatengera mlingo, malo oyendetsera, kutsika kwa magazi, kutentha ndi kuchuluka kwa zochitika zolimbitsa thupi.Komabe, kuyambitsa mwachangu poyerekeza ndi insulin ya anthu sungunuka mosasamala malo omwe jakisoniyo anali.

NovoRapid ® ikhoza kugwiritsidwa ntchito popanga ma subulinane insulin infusions (PPII) m'mapampu a insulin omwe amapangidwira insulin infusions. FDI iyenera kupangidwa khoma lakunja kwam'mimba. Malo olowetsedwa amayenera kusinthidwa nthawi ndi nthawi.

Mukamagwiritsa ntchito pampu ya insulini kulowetsedwa, NovoRapid® sayenera kusakanikirana ndi mitundu ina ya insulin.

Odwala omwe akugwiritsa ntchito FDI ayenera kuphunzitsidwa bwino kugwiritsa ntchito pampu, chosungira choyenera, ndi dongosolo la ma pump pump. The kulowetsedwa set (chubu ndi catheter) ziyenera m'malo mwa wogwiritsa buku malangizo ophatikizidwa ndi kulowetsedwa.

Odwala omwe amalandila NovoRapid ® ndi FDI ayenera kukhala ndi insulini yowonjezera kuti ikwaniritse kulowetsedwa.

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

Pa makonzedwe amkati, 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% dextrose solution kapena 10% dextrose yankho 40 mmol / L potaziyamu potaziyamu pogwiritsa ntchito kulowetsera kwa polypropylene. Njira zoterezi ndizokhazikika pofunda kwa maola 24. Ngakhale kukhazikika kwakanthawi, kuchuluka kwa insulin kumayamba chifukwa cha zinthu zomwe zimayambitsa kulowetsedwa. Pa insulin infusions, ndikofunikira kuyang'anira kuchuluka kwa shuga m'magazi.

Zotsatira zoyipa:

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 zakudyaNthawi zambiri - Hypoglycemia * Kusokonezeka kwamanjenjeNthawi zambiri - zotumphukira neuropathy ("ululu wammbuyo"

Kuphwanya gawo la masomphenyawo

Nthawi zambiri - zolakwika zoyeserera Nthawi zambiri - matenda ashuga retinopathy Kusokonezeka kwa khungu ndi minofu yolowereraNthawi 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 tafotokozazi pansipa, zochokera pazowonjezera zomwe zimapezeka pazoyeserera zamankhwala, zimayikidwa m'magulu molingana ndi kufalikira kwa chitukuko malinga ndi MedDRA ndi machitidwe a ziwalo. Zomwe zimachitika pakakhala zovuta zimadziwika kuti: kawirikawiri (≥ 1/10), nthawi zambiri (Kamutu 1/100 kwa Zolemba Zofanana

Akulima nthomba kuyambira nthawi zakale. Chikhalidwe ichi sichimangogwiritsidwa ntchito popanga nsalu, komanso chili ndi mndandanda wambiri wazinthu zofunikira. Mitundu yodziwika bwino imakhalapo kuti mbeu izikhala ndi mafuta ambiri.

Kaloti - imodzi yamasamba otchuka, okhazikika mu zakudya zapafupifupi dziko lonse lapansi. Chomera ichi chimagwiritsidwa ntchito mwachilengedwe komanso monga mbale zosiyanasiyana. Chimodzi mwazakudya izi ndi kaloti wokazinga ndi zonona wowawasa.

Mukamayambitsa matenda ofewa komanso mucous nembanemba, mankhwala a Sodium tetraborate ndi omwe amaperekedwa mu mtundu wovuta wa mankhwalawa. Njira yothetsera vutoli idapangidwa kuti izigwiritsidwa ntchito kunja, yodziwika ndi zochita za mthupi lanu.

Kutulutsa mafomu ndi kapangidwe kake

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

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

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

Mwachidule kapena kutalika

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

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

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

Ndi chisamaliro

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

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

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

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

Momwe mungagwiritsire ntchito NovoRapid Flexpen?

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

Malangizowa akuphatikizapo njira zotsatirazi:

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

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

Momwe mungapangire jakisoni?

Musati mupeze jakisoni wopopera. Pa makina osunthira, monga:

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

Njira ndi malamulo opangira jakisoni ndi ntchito iliyonse:

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

Chithandizo cha matenda ashuga

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

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

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

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

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

Pa gawo la kagayidwe ndi zakudya

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

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

Pakati mantha dongosolo

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

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

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

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere

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

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

Mankhwala ochulukirapo a NovoRapida Flexpen

Pa jekeseni yankho mu Mlingo woposa zofunikira za thupi, zizindikiro za hypoglycemia zimayamba. Munthu amene ali ndi chikumbumtima akhoza kudzipereka yekha thandizo pogwiritsa ntchito chakudya chamafuta ochepa. Popanda kudziwa, glucagon imayendetsedwa pansi pa khungu kapena minofu muyezo wa 0,5-1.0 mg kapena glucose wamkati.

Kuchita ndi mankhwala ena

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

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

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

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

Zinthu zathanzi ndi sulfite zimawononga insulin.

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

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

Wopanga

Novo Nordisk (Denmark).

Novorapid (NovoRapid) - analogue ya insulin ya anthu

Mankhwala a NovoRapid ndi chida chatsopano cha mbadwo womwe ungabwezeretse kuchepa kwa insulin ya anthu. Ili ndi zopindulitsa zingapo m'njira zinanso zofananira, imagwiritsidwa ntchito mosavuta komanso imapangika msanga, imasintha shuga m'magazi, itha kugwiritsidwa ntchito mosasamala zakudya, popeza ndi insulin.

NovoRapid imapangidwa m'mitundu iwiri: zolembera zopangidwa ndi Flexpen zopangidwa kale, zotsekedwa ndi ma Penfill cartridge. Kapangidwe ka mankhwalawa ndi chimodzimodzi pazochitika zonse ziwiri - madzi omveka bwino a jekeseni, ml imodzi imakhala ndi 100 IU yogwira ntchito. Katoni, monga cholembera, imakhala ndi 3 ml ya insulin.

Mtengo wa 5 NovoRapid Penfill insulin cartridge pa average adzakhala pafupifupi 1800 rubles, FlexPen imawononga pafupifupi 2000 rubles. Phukusi limodzi lili ndi zolembera 5 za syringe.

Zolemba za mankhwala

Chofunikira chachikulu cha mankhwalawo ndi insulin, ndipo chimakhala ndi mphamvu kwambiri pa hypoglycemic, ndi analog yochepa ya insulin, yomwe imapangidwa m'thupi la munthu. Katunduyu amapezeka pogwiritsa ntchito ukadaulo wa DNA.

Mankhwalawa amakumana ndi ma cell am'mimba a cytoplasmic amino acid, amapanga zovuta za insulin, amayamba zomwe zimachitika mkati mwa maselo. Pambuyo kuchepa kwa shuga m'magazi kumadziwika:

1. kuchuluka kwanyumba,
2. kuchuluka kwa kugaya kwaminyewa,
3. kutsegulira kwa lipogenesis, glycogeneis.

Kuphatikiza apo, ndizotheka kukwaniritsa kuchepa kwa kuchuluka kwa kupanga kwa shuga ndi chiwindi.

NovoRapid imakhala bwino kwambiri ndi mafuta onunkhira kuposa insulin yaumunthu, koma kutalika kwa zotsatirazi kumakhala kotsika kwambiri. Kuchita kwa mankhwalawa kumachitika pakadutsa mphindi 10-20 pambuyo pa jekeseni, ndipo nthawi yake ndi maola 3-5, kuchuluka kwakukulu kwa insulin kumadziwika pambuyo pa maola 1-3.

Kafukufuku wazachipatala wa odwala omwe ali ndi mtundu woyamba wa matenda ashuga awonetsa kuti kugwiritsa ntchito mwanjira ya NovoRapid kumachepetsa mwayi wokhala usiku usiku kangapo. Kuphatikiza apo, pali umboni wa kuchepa kwakukulu kwa postprandial hypoglycemia.

• kumva kwambiri kwa thupi pazinthu zomwe zimapangidwa,
• ana osakwana zaka 6.

Mankhwala amaloledwa kugwiritsidwa ntchito pochiza matenda wamba.