Insulin ya Novorapid: Flekspen, Penfill, malangizo ndi kuwunika, kuchuluka kwake?

NovoRapid imakhala ndi hypoglycemic ndipo ndi ya m'badwo watsopano wa insulin wokhala ndi kukonzekera, popeza, limodzi ndi mitundu ina ya mankhwala ofanana ndi omwewo, amathandizira kuchepetsedwa kwamwadzidzidzi kuchuluka kwa shuga m'magazi. Amadziwika ndi digestibility yachangu. Kugwiritsidwa ntchito kwake sikugwirizana ndi nthawi yakudya. Amapangidwa ngati njira yopanda utoto yopangira jakisoni wofowoka komanso wamkati.

ZOFUNIKA KUDZIWA! Ngakhale odwala matenda ashuga kwambiri amatha kuchiritsidwa kunyumba, popanda opaleshoni kapena zipatala. Ingowerenga zomwe Marina Vladimirovna akunena. werengani zonena zake.

Kusiyana kwa mankhwala osokoneza bongo

Polimbana ndi matenda ashuga, mitundu iwiri ya mankhwala imagwiritsidwa ntchito. NovoRapid Penfill imayimiriridwa ndi makatiriji (otha kusintha) opangidwa ndi galasi la hydrolytic la kalasi yoyamba, zidutswa zisanu mu chithuza cholongedzedwa m'bokosi. NovoRapid Flexpen imapezeka mu zolembera 5 zotayika mu paketi imodzi. Ngakhale mawonekedwe osiyanasiyana, mankhwalawa ndi ofanana - amadzimadzi osakhala ndi utoto, mu 1 ml momwe insulin aspart imakhala ndi 100 PIECES. Chidebe chimodzi chaching'ono chimakhala ndi mayunitsi 300. (3 ml) madzi.

Shuga amachepetsedwa nthawi yomweyo! Matenda a shuga m'kupita kwa nthawi angayambitse matenda ambiri, monga mavuto amawonedwe, khungu ndi tsitsi, zilonda zam'mimba, zilonda zam'mimba komanso matenda otupa! Anthu amaphunzitsa zinzake zowawa kuti azisintha shuga. werengani.

Zizindikiro ndi contraindication

Mankhwalawa amalembera odwala onse omwe amadalira insulin komanso osadalira insulin. Zifukwa zokanira kugwiritsa ntchito:

• achina,
• tsankho kwa insulin kapena ziwalo zina za mankhwala,
• ana osakwana zaka 2 (chifukwa cha kusowa kwa kafukufuku wofufuza yemwe angatsimikizire chitetezo cha NovoRapida cha gulu ili).

Kugwiritsa

Kukhazikitsidwa kwa "Flexpen" ndi "Penfill" kumachitika pogwiritsa ntchito njira ziwiri - jekeseni wamkati ndi subcutaneous. Dokotala amasankha mtundu wa aliyense wa odwala matenda ashuga. Chifukwa chakuti NovoRapid ndi insulin yachangu, imagwiritsidwa ntchito limodzi ndi wothandizira kwa nthawi yayitali. Mulimonsemo, ndikofunikira kuti mulamulire shuga ndikuwongolera kuchuluka kwa mankhwala omwe amaperekedwa. Mlingo wa tsiku ndi tsiku ndi 0,5-1 magawo. pa kilogalamu imodzi yakulemera kwa thupi. Ngati muzibayira mankhwala musanadye, ndiye kuti insulini ingapatse thupi 50-70%, yonseyo imapangidwa ndi analogue yomwe imatenga nthawi yayitali.

Kufunika kosinthira kwa mankhwalawa kumachitika ngati mukuwonjezeka zolimbitsa thupi, ndikusintha kwa zakudya kapena matenda ophatikizika. "Flexspen" ndi "Penfill" amagwiritsidwa ntchito pang'onopang'ono, kusankha nthawi zambiri jakisoni m'dera la khoma lamkati lamkati (pakadali pano pali kuyamwa kwazomwe zimapangitsa kuti pakhale mankhwala. Popewa kukula kwa lipodystrophy, kusintha kwa jakisoni ndikofunikira. Jakisoni wamkati amaloledwa kwa okhawo ophunzitsidwa bwino.

NovoRapid saloledwa kuperekedwa intramuscularly.

Munjira, ziyenera kukumbukiridwa kuti pansi pa khungu singano ikhale osachepera 6 masekondi. Sungani batani mpaka atachotsedwa. Izi ndizofunikira kuti mankhwalawo azilandira kwathunthu, komanso kuti magazi asalowe ndi singano kapena chidebe chokhala ndi mankhwalawo. Chidebe sichitha kudzazidwa ndi insulin.

Zosunga

Mankhwala "FlexPen" ndi "Penfill" ayenera kusungidwa ndi ana, kutali ndi kutentha, kutentha kwa 2-8 ° C.Sungani mufiriji kutali ndi mufiriji, mankhwalawo sayenera kuzizira. Tetezani ku kuwala (mankhwalawa ayenera kukhala m'bokosi). Chipewa chikuyenera kuvalidwa pachikono. Moyo wa alumali ndi miyezi 30. Zotseguka zotsegulidwa ndi zolembera zomwe zimagwiritsidwa ntchito kale sizitha kuikidwanso mufiriji. Zitha kusungidwa mu mawonekedwe awa osaposa masiku 28 pa kutentha mpaka 30 ° C.

Zotsatira zoyipa

Kuthamanga insulini kungayambitse vuto, monga kupezeka kwa hypoglycemia. Mawonekedwe ake:

• kutuluka thukuta kwambiri
• chikopa,
• nkhawa zosafotokozedwa
• miyendo ndi mikono itanjenjemera
• zosokoneza
• kusayang'ana bwino malo,
• kufooka
• chizungulire
• nseru
• mutu
• kusawona bwino,
• kukomoka mtima,
• kupezeka kwa chilakolako chambiri.

Glycemia imathandizidwanso ndi kukhudzidwa, kuiwala, kusokonezeka kwa ubongo ndipo imatha kuyambitsa zotsatira zakupha. Mwinanso kupezeka kwalephera m'matumbo am'mimba komanso mawonetseredwe a thupi lawo. Nthawi zina pamakhala kuchepa kwa kukakamizidwa. Nthawi zina, pakhungu la jakisoni limakhala lofiira ndi kutupa, kuyamwa kumachitika. Mawonetsedwe onsewa ndi osagwirizana ndipo amakwiya chifukwa cha kuwonekera kwa mankhwalawa kwa odwala omwe akudwala matenda a shuga.

Kusankha chida

Anthu odwala matenda ashuga amtundu wa 1 amakonda kugwiritsa ntchito Penfill chifukwa mankhwalawa amachepetsa shuga chifukwa mankhwalawa amatha kwa maola 4 atatha kudya. Panthawi ya kuperekera mankhwala mwachindunji pakhungu, pakatha mphindi 10, chinthu chogwira ntchito chimayamba kugwira ntchito. Kwa maola ena awiri, mphamvu ya mankhwalawo imafika pachimake, ndipo patatha maola ena 4 muyenera kuyambiranso. Ngakhale zili zofanana, odwala ena amawonetsa kuti mankhwalawa omwe ali mu cartridgeges ndi osavuta kugwiritsa ntchito kuposa FlexPen, chipangizo cha ma syringe pensulo chomwe sichitha kukhala chovuta panthawi yolakwika kwambiri. Kusankhidwa kwa chithandizo chimodzi kapena chimzake kumadalira zomwe anthu amakonda.

Kodi zikuwonekabe zosatheka kuchiritsa matenda ashuga?

Poona kuti mukuwerenga izi tsopano, kupambana polimbana ndi shuga wambiri sikuli kumbali yanu.

Ndipo mudaganizapo kale za chithandizo kuchipatala? Ndizomveka, chifukwa shuga ndi matenda oopsa, omwe, ngati sanapatsidwe, amatha kufa. Udzu wokhazikika, kukodza mwachangu, masomphenya osalala. Zizindikiro zonsezi mumazidziwa nokha.

Koma kodi ndizotheka kuchitira zomwe zimayambitsa m'malo mothandizira? Timalimbikitsa kuwerenga nkhani yokhudza matenda aposachedwa a shuga. Werengani nkhani >>

Insulin Novorapid Penfill ndi Flekspen: mawonekedwe a ntchito, mtengo wake ndi kuwunika

Zovuta mu metabolism zomwe zimayambitsidwa ndi kusokonezeka kwa mahomoni zimatha kuyambitsa kuwonongeka koopsa m'moyo wabwino.

Kulipira kusowa kwa mahomoni, njira zambiri zapangidwa kale zomwe zimakhala ndi katundu wosiyana, mawonekedwe a pharmacological omasulidwa ndi mawonekedwe a ntchito.

Osati kale kwambiri, mankhwala atsopano othandizira odwala matenda ashuga adawonekera - Novorapid. Kodi zake ndi ziti ndipo ndi zosavuta kugwiritsa ntchito?

Pharmacological mitundu ndi katundu

Novorapid imakhala ndi kaphikidwe kogwiritsa ntchito kwambiri - insulin aspart (kuchuluka kwa 100 PIECES) ndi zinthu zothandiza (zinc chloride, metacresol, phosphate dehydrate, madzi). Gawo lalikulu limapezeka pobwereza za DNA ya yisiti microorganism Saccharomyces cerevisiae.

Insulin Novorapid Penfill

Mankhwalawa amathandizira kuchepetsa kupanga shuga, amalimbitsa mphamvu zake zamagetsi, kuchepetsa shuga. Zimayambitsa kuwonjezeka kwa mapangidwe a glycogen ndi ndondomeko ya lipogenesis. Ma mamolekyulu am'madzi amakhala ndi mayankho ambiri othamanga komanso ogwira ntchito kwambiri.

Posachedwa, mawonekedwe osavuta kwambiri a mankhwalawo, Flexpen, apangidwa.Chipangizochi ndi cholembera chodzaza ndi yankho. Kulondola kwa miyeso kumakhala kwakukulu kwambiri ndipo kuchokera ku 1 mpaka 60 mayunitsi.

Mukamagula Novorapid, muyenera kudziwa bwino malangizo omwe amaphatikizidwa ndi mankhwalawa.

Mawonekedwe a ntchito ndi mlingo

Lowani ku Novorapid tikulimbikitsidwa musanadye kapena musanadye. Chombocho chimayamba kuwonetsa zochitika pambuyo pa mphindi 10, ndipo pazokwanira zimafikika mkati mwa maola 1-3.

Pambuyo pafupifupi maola 5, nthawi yowonetsera imatha. Izi zimakuthandizani kuti mugwiritse ntchito nthawi imodzi ndi mankhwala ena okhala ndi insulin (yokhala ndi nthawi yayitali).

Amadziwika kuti kugwiritsa ntchito Novorapid mukangodya chakudya kumadziwika ndi kugwiritsa ntchito kwambiri shuga. Kuchita bwino kwa kayendetsedwe kake ndikwakwera kwambiri kuposa kugwiritsa ntchito mankhwala a insulin.

Mlingo woyambira kuwerengera ndi 0,5-1 UNITS pa kilogalamu ya kulemera. Koma muyezo wa munthu aliyense uyenera kupangidwa ndi adokotala.

Ngati mlingo wocheperako usankhidwa, ndiye kuti hyperglycemia imatha kukula pang'onopang'ono kwa maola angapo kapena masiku. Ngati mlingo wofunikira ukadutsa, zizindikiro za hypoglycemic zimayamba.

Mukamasintha chakudyacho, kusintha zakudya kungafune kusintha kowonjezera.

Ndikulimbikitsidwa kuti mupeze yankho mu m'chiuno kapena pamphumi pa ntchafu kapena phewa, mwamphamvu. Komanso, nthawi iliyonse muyenera kusankha gawo latsopano la thupi kuti mupewe kulowetsedwa.

Nthawi zina, adotolo amavomereza kukonzekera kwa mtsempha wa Novorapid ndi kulowetsedwa ndi saline, koma njira yoyendetsera imeneyi imachitika kokha ndi wogwira ntchito yazaumoyo.

Dziwani kuti popaka jekeseni, yankho la shuga nthawi zonse ndilofunikira. Pogwiritsa ntchito munthawi yomweyo ndi ACE inhibitors, carbonic anhydrase ndi MAO, komanso pyridoxine, fenfluramine, ketoconazole, othandizira omwe ali ndi zakumwa zoledzeretsa kapena tetracyclines, zotsatira za Novorapid zimatheka.

Mukaphatikizidwa ndi mahomoni a chithokomiro, heparin, chikonga, phenytoin, diazoxide, zotsatira zotsutsana zimawonedwa. Mankhwala okhala ndi Sulfite ndi othandizira omwe ali ndi thiol amasokoneza kuwonongeka kwa mamolekyulu a insulin.

Musanagwiritse ntchito Novorapid, onetsetsani kuti:

• mlingo woyenera amasankhidwa,
• yankho la insulin silinaphule kanthu
• cholembera sichidawonongeka
• Katirijiyu sanagwiritsidwepo kale (adangogwiritsa ntchito kamodzi).

Ngati insulini, yomwe ndi gawo la Novorapid, imagwiritsidwa ntchito pochiza wodwala koyamba (koyambirira kwa chithandizo kapena kusintha mankhwala), jakisoni woyamba wa yankho amayenera kuyang'aniridwa ndi dokotala kuti adziwe nthawi yoyenera komanso kuti athandizire kusintha.

Patorfid Penfill ndi Flekspen - pali kusiyana kotani? Insulin Novorapid Penfill kwenikweni ndi makatoni omwe amatha kuyikamo cholembera cholowetsa, pomwe Flexspen kapena Quickpen ndi cholembera chotayika chomwe chili ndi makatoni omwe adayikiramo kale.

Malamulo othandizira mankhwalawa amayenera kuyang'aniridwa mosamala kuti apewe zovuta chifukwa chophwanya malamulo oyela.

Zotsatira zoyipa ndi bongo

Milandu yambiri yomwe imachitika pafupipafupi imadziwika pamayambiriro ogwiritsira ntchito ndipo, monga lamulo, imalumikizidwa ndi kufunika kosintha kwa mlingo. Amawonetsedwa pakuchepa kwambiri kwa shuga m'magazi (hypoglycemia). Wodwalayo amakula, kufooka, kuchepa kwa kupenya, kupweteka, ndi kulephera kwa mtima.

Zotsatira zoyipa:

• zotupa
• Hyperemia pamalowo jekeseni,
• anaphylactic reaction,
• kutupa
• kupuma movutikira
• kukakamiza kutsika
• matenda ammimba
• nthawi zina, mavuto ndi kukana.

Ngati mulingo wambiri wambiri, zizindikiro zotsatirazi zingaoneke:

• kukokana.
• kulephera kudziwa.
• ubongo zosagwira.
• woopsa, imfa.

Kudzisintha pang'onopang'ono muyezo wa mankhwalawo sikuti kungoyipa kokha, komanso koopsa, chifukwa hypo- ndi hyperglycemia ndizosochera kwambiri pamatenda a wodwalayo, zomwe zimatha kudzetsa kukomoka komanso kufa.

Mtengo ndi fanizo

Kwa insulin Novorapid Penfill, mtengo wapakati ndi 1800-1900 rubles pa paketi iliyonse. Flekspen imawononga ndalama pafupifupi ma ruble 2,000.

Ndipo chingabwezeretse chiyani Novorapid ndi insulin-based insulin therapy? Nthawi zambiri, mankhwalawa amasinthidwa ndi Humalog kapena Apidra, koma popanda chilolezo cha adotolo, izi siziyenera kuchitika.

Ndikofunikira kudziwa! Mavuto omwe ali ndi kuchuluka kwa shuga pakapita nthawi angayambitse matenda athunthu, monga mavuto amawonedwe, khungu ndi tsitsi, zilonda zam'mimba, zilonda zam'mimba komanso ngakhale zotupa za khansa! Anthu amaphunzitsa zomwe zinawawa kuti azisintha shuga yawo kuti asangalale ...

Ndemanga ya Novorapid ikuwonetsa kuti mankhwalawa:

• Ndi chinthu chothandiza kwambiri komanso chopanda insulini
• pamafunika mtundu wapadera wa kutentha, kotero, kuyenera kuyang'aniridwa kwambiri kuti zizisungidwa,
• amatha kuchita zinthu mwachangu, makamaka mwa ana, ndipo nthawi yomweyo amakulitsa shuga mwadzidzidzi,
• zingafune kusuta kwa nthawi yayitali ndikusintha kwa mlingo,
• Sizotsika mtengo kwambiri kwa anthu chifukwa cha mtengo wokwera.

Ndemanga za mankhwalawa ndizabwino, koma mankhwalawa sangagwiritsidwe ntchito pa upangiri wa abwenzi popanda mankhwala a dokotala.

Momwe mungatengere Penfill Penfill kuchokera ku cholembera:

Novorapid ndi chida chothandiza kusintha matenda a matenda ashuga, koma ogwiritsa ntchito ayenera kuyang'aniridwa mosamala kwambiri.

Kuwunikira mosamala kwambiri pakagwiritsidwe ntchito kake kungafunike akadali achichepere, pakati pa kulera, panthawi yapakati, kuyamwa, komanso kumayambiriro kwa chithandizo.

Ngati malamulo onse amatengedwa ndipo palibe ma contraindication, amathandizadi kuthetsa mavuto ndi shuga wambiri.

Mbadwo wamakono umagwiritsa ntchito mankhwala othandizira a NovoRapid

NovoRapid ndi mankhwala a shuga omwe amatha kubwezeretsa kuchepa kwa insulin yachilengedwe. NovoRapid insulin jakisoni m'munsi shuga. Mankhwala atsopanowa ali ndi zabwino zambiri poyerekeza ndi analogues.

Imayamba mwachangu komanso mosavuta, shuga imasinthidwa nthawi yomweyo. Mutha kugwiritsa ntchito nthawi iliyonse, ngakhale musanadye kapena mutatha kudya, chifukwa ndi gawo la insulin ya ultrashort. Thupi silizolowera mankhwalawa, nthawi iliyonse mungathe kuligwetsa kapena kusinthana ndi mankhwala ena.

Umboni wa chitetezo chake ndikuti amaloledwa ngakhale panthawi yoyembekezera.

Mankhwala

Novorapid ® FlexPen ® ndi analogue ya insulin yochepa yamunthu.

Kuchita kwa NovoRapid ® FlexPen ® kumachitika koyambirira kuposa insulin yamankhwala aumunthu, pomwe kuchuluka kwa glucose kumatsika mkati mwa 4:00 yoyamba itatha kudya. Ndi jekeseni wa subcutaneous, kutalika kwa nthawi ya NovoRapid ® FlexPen ® ndi kufupikitsidwa poyerekeza ndi insulin yaumunthu.

Mphamvu ya mankhwalawa NovoRapid ® FlexPen ® imachitika pakadutsa mphindi 10 mpaka 20 pambuyo povomerezeka. Kuchuluka kwake kumayamba pakati pa 1 mpaka 3:00 jakisoni. Kutalika kwa kuchitapo kanthu kuyambira 3 mpaka 5:00.

Mukamawerengera timadontho timene timabowoka insulini, timadziti tambiri timene timatulutsa.

Akuluakulu . M'maphunziro azachipatala odwala omwe ali ndi matenda amtundu wa I, adawonetsedwa kuti pogwiritsa ntchito NovoRapid ® FlexPen ® kuchuluka kwa glucose pambuyo chakudya kumachepa kuposa kuyambitsa insulin yaumunthu. Mayeso awiri omasuka a odwala omwe ali ndi matenda amtundu wa I amakhudza odwala 1070 ndi 884, motero. Novorapid ® inachepetsa hemoglobin ya glycosylated ndi 0,12% ndi 0,15% poyerekeza ndi insulin yamunthu yomwe singasungunuke, zomwe sizikudziwika bwino m'thupi.

Okalamba. Pophunzira za pharmacodynamics ndi pharmacokinetics of insulin aspart ndi soluble insulin yaumunthu, kusiyana kwakaphatikizidwe mu pharmacodynamics kwa okalamba omwe ali ndi mtundu II matenda ashuga anali ofanana mwa anthu athanzi komanso odwala achinyamata.

Ana ndi achinyamata. Mu ana omwe amathandizidwa ndi NovoRapid ®, kugwiritsa ntchito mphamvu yayitali ya shuga m'magazi kunali kofanana ndi insulin yamunthu yosungunuka.

Mu kafukufuku wazachipatala, mbiri ya pharmacodynamic ya aspart insulin mwa ana a zaka ziwiri mpaka 17 ndi akulu anali yemweyo.

M'mayesero azachipatala okhudzana ndi odwala omwe ali ndi matenda amtundu wa I, adawonetsedwa kuti kugwiritsa ntchito insulin aspart, chiopsezo chotenga hypoglycemia usiku ndizochepa kuposa zomwe zimagwiritsidwa ntchito posungunulira insulin yamunthu, ndipo panalibe kusiyana kwakukulu pakuchitika kwa hypoglycemia masana.

Mimba M'mayesero azachipatala okhudzana ndi amayi 322 omwe ali ndi matenda a shuga a mtundu woyamba, chitetezo ndi kufunikira kwa insulin aspart ndi insulin ya anthu kuyerekezedwa. Pankhaniyi, palibe zotsatira zoyipa za insulin zofunika pa mkazi kapena mwana wosabadwa / wongobadwa kumene zomwe zidawululidwa poyerekeza ndi zomwe zimagwiritsidwa ntchito posungunulira anthu.

Kuphatikiza apo, kafukufuku wa azimayi 27 oyembekezera omwe ali ndi matenda ashuga adawonetsa chitetezo chofanana ndi kukonzekera kwa insulin iyi, komanso kuwongolera kwakukulu pakulamulira kwa glucose pambuyo pa chakudya.

Kulowetsedwa kwa amino acid proline pamalo a B-28 a mamolekyulamu a insulin omwe amakhala ndi aspartic acid mu kukonzekera kwa NovoRapid ® FlexPen ® kumachepetsa mapangidwe a hexamers ndi kukhazikitsidwa kwa insulin ya insulin yamunthu.

Nthawi yoti ifike pazambiri zabwino ndi yochepa kwambiri kuposa theka la insulin yamunthu. Kuchuluka kwa insulini m'magazi a odwala omwe ali ndi matenda amtundu wa I - 492 ± 256 pmol / l - kumatheka patatha mphindi 40 pambuyo poika kayendedwe ka NovoRapid ® FlexPen ® pa 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 iwo kumachepera - C _max (352 ± 240 pmol / L) - ndipo imafikiridwa pambuyo pake - pambuyo pa mphindi 60. Ndi kukhazikitsidwa kwa NovoRapid ® FlexPen ®, nthawi yofikira kuchuluka kwambiri mwa wodwala yemweyo imakhala yochepa kwambiri, ndipo kuchuluka kwa ndende kumakhala kotalikirapo kuposa kukhazikitsa insulle yamadzimadzi aumunthu.

Ana ndi achinyamata . Ma pharmacokinetics ndi pharmacodynamics a NovoRapid ® FlexPen ® amaphunziridwa mwa ana ndi achinyamata omwe ali ndi matenda a shuga a mtundu wa I. Insulin aspart idalowetsedwa mwachangu m'magulu onse awiriwa, pomwe nthawi yofika kwambiri pamagazi inali yofanana ndi akulu. Komabe, kuchuluka kwambiri kwa ndende kunali kosiyana ndi ana amisinkhu yosiyanasiyana, kuwonetsa kufunikira kwa kusankha kwa Mlingo wa NovoRapid ® FlexPen ®.

Odwala okalamba. Odwala omwe ali ndi mtundu wachiwiri wodwala matenda a shuga, kusiyana kwakanthawi kwamankhwala kosakanikirana pakati pa insulin aspart ndi insulle ya insulin yaumunthu kunali chimodzimodzi monga mwa anthu athanzi komanso odwala matendawa. Odwala okalamba, kuchuluka kwa mayamwidwe kumachepetsedwa, monga zikuwonekera ndi nthawi yayitali kuti afike pazambiri za insulin (t _max ) - 82 min, pomwe mtengo wake woyang'anira (C _max ) anali ofanana ndi ang'onoang'ono odwala matenda ashuga achiwiri ndipo ochepera pang'ono poyerekeza ndi odwala I a shuga.

Kuwonongeka kwa chiwindi. Odwala omwe ali ndi vuto la chiwindi _max kuchuluka kwa 85 min (mwa anthu wamba okhala ndi chiwindi t _max = 50 min). Mtengo wa AUC, C _max ndi CL / F kwa odwala omwe ali ndi vuto la chiwindi anali ofanana ndi anthu omwe ali ndi chiwindi chokwanira.

Matenda aimpso . Mwa anthu 18 omwe ali ndi machitidwe osiyanasiyana a impso (kuchokera kwazinthu zina mpaka kufika pazovuta zambiri), pharmacokinetics ya insulin aspart itatha kukhazikitsidwa komwe. M'magawo osiyanasiyana a creatinine chilolezo, panalibe kusiyana kwakukulu pamalingaliro a AUC, C _max ndi CL / F insulin. Zambiri zokhudzana ndi odwala omwe ali ndi ntchito yochepa komanso yovuta kwambiri yaimpso zinali zochepa. Odwala omwe ali ndi vuto la aimpso omwe adakumana ndi dialysis sanayesedwe.

Chithandizo cha matenda a shuga mwa akulu ndi ana okulirapo kuposa 2 years.

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 wamankhwala a odwala omwe ali ndi matenda amtundu woyamba wa 1 awonetsa kuti kugwiritsa ntchito mwanjira ya NovoRapid kumachepetsa mwayi wa nocturnal hypoglycemia nthawi zingapo. Kuphatikiza apo, pali umboni wa kuchepa kwakukulu kwa postprandial hypoglycemia.

Mankhwala a NovoRapid amalimbikitsidwa kwa odwala omwe ali ndi matenda osokoneza bongo a mellitus oyamba (osagwirizana ndi insulin) komanso achiwiri (osagwirizana ndi insulini). Contraindication kuti agwiritse ntchito adzakhala:

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

Mankhwala amaloledwa kugwiritsidwa ntchito pochiza matenda wamba.

Malangizo ogwiritsira ntchito mankhwalawa

Kuti mupeze zotsatira zoyenera, timadzi timeneti tiyenera kuphatikiza ndi ma insulin a nthawi yayitali komanso apakati. Kuwongolera kuchuluka kwa glycemia, muyezo wamagazi amasonyezedwa, kusintha kwa mankhwala ngati kuli kofunikira.

Nthawi zambiri, tsiku ndi tsiku mlingo wa insulini wa odwala matenda ashuga amasiyanasiyana pakati 0,5-1 magawo pa kilogalamu ya kulemera. Jakisoni imodzi ya mahomoni imapatsa wodwala zofunikira za tsiku ndi tsiku za 50-70%, zotsalazo ndi insulin.

Pali umboni wowunikiranso kuchuluka kwa ndalama zomwe zaperekedwa:

1. kuchuluka kwa odwala matenda ashuga,
2. Zosintha pakudya
3. kupitilira kwa matenda oyanjana.

Insulin NovoRapid Flekspen, mosiyana ndi mahomoni amtundu wa anthu, amasintha mwachangu, koma osakhalitsa. Amawonetsedwa kuti mugwiritse ntchito mankhwalawa musanadye, koma amaloledwa kuchita izi mukatha kudya, ngati pakufunika.

Chifukwa chakuti mankhwalawa amagwira ntchito kwakanthawi kochepa, mwayi wokhala ndi nocturnal hypoglycemia umachepetsedwa kwambiri. Ngati mankhwalawa amagwiritsidwa ntchito pochiza odwala matenda ashuga okalamba, ndi kulephera kwa hepatic kapena aimpso, ndikofunikira kuwongolera shuga wamagazi pafupipafupi, sankhani kuchuluka kwa insulin payekha.

Ndikofunikira kupaka insulin m'mimba yakutsogolo, matako, brachial, minofu yothina.Popewa lipodystrophy, ndikofunikira kusintha dera lomwe mankhwalawo amathandizira. Koma muyenera kudziwa kuti kumayambiriro kwam'mimba kumapangitsa kuti mankhwalawo amvedwe mwachangu, poyerekeza ndi jakisoni mbali zina za thupi.

Kutalika kwa mphamvu ya insulin kumakhudzidwa mwachindunji ndi:

• Mlingo
• tsamba la jakisoni
• odwala ntchito
• kuchuluka kwa magazi
• kutentha kwa thupi.

Ma infusions okhala ndi vuto lalitali omwe amalimbikitsidwa kwa odwala matenda ashuga, omwe amatha kuchitidwa pogwiritsa ntchito pampu yapadera. Kukhazikitsidwa kwa mahomoni kumawonetsedwa kukhoma kwamkati, koma, monga momwe zinalili kale, malo amayenera kusintha.

Pogwiritsa ntchito pampu ya insulin, musasakanikize mankhwalawo ndi ma insulini ena. Odwala omwe amalandila ndalama pogwiritsa ntchito dongosololi ayenera kukhala ndi muyeso wosiyanasiyana wa mankhwalawo ngati chida chawonongeka. NovoRapid ndi yoyenera kuchitira mtsempha wamkati, koma jakisoni wotere ayenera kuperekedwa kokha ndi dokotala.

Pa chithandizo, muyenera kupereka magazi pafupipafupi kuti muyeze magazi.

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.

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.

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.

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:

• Kuchuluka kagayidwe mkati mwa maselo,
• Kuwongolera mayamwidwe amisempha yonse ndi thupi,
• Kuchulukitsa kwa zochitika za lepogisisi ndi glycogeneis.

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:

1. Matenda a shuga a mtundu woyamba (wodalira insulin),
2. Matenda a shuga a mtundu wachiwiri (wopanda insulin-wodziimira pawokha),
3. Pofuna kuwonjezera luso la masewera olimbitsa thupi,
4. Pofuna kuchepetsa kulemera,
5. Monga kupewa hyperglycemic chikomokere.

NovoRapid ndiwotsutsana mwa otsatirawa:

• Kukhala ndi chidwi chachikulu cha thupi pazigawo za mankhwala,
• Mitsempha yamagazi ikachepa,
• Kumwa mankhwala nthawi yomweyo ndi mowa
• Ana osakwana zaka zisanu ndi chimodzi.

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

Nthawi zina, ndi jekeseni ya NovoRapid, zimachitika zovuta:

• Matupi a ziwengo mu mawonekedwe a urticaria, edema, mphere, kumva kutentha kwa dzuwa,
• Peripheral neuropathy ndi nkhawa popanda chifukwa,
• Kutaya kolowera
• Kusintha kwatha, kuwonongeka m'maso,
• Kupititsa patsogolo,
• Mwendo ndidamponda
• Kufooka minofu, kufooka mphamvu,
• Tachycardia
• Khansa yanjala kapena njala
• Kuchepetsa chidwi,
• Mwa zina zomwe zimachitika: kuyabwa, redness kapena kufinya khungu, edema.

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. Syringe wokonzeka flexpen cholembera,
2. 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.

Malangizo ogwiritsira ntchito NovoRapida

Pofuna kuthana ndi matenda amtundu wa 1 kapena mtundu wa matenda ashuga a 2, ndikofunikira kuti mugwiritse jekete pang'ono, ntchafu, khoma lamkati kapena phewa musanadye pamimba yopanda kanthu.

Kusankha kwa mankhwala kumalimbikitsidwa potengera kuchuluka kwa insulin:

• Kumayambiriro kwa matenda oyamba - 0.5 PIERES / kg,
• Pankhani yodwala matenda opitirira chaka chimodzi - 0,6 PESCES / kg,
• Ndi zovuta za matenda ashuga - 0,7 PESCES / kg,
• Ndi shuga wowola - 0,8 U / kg,
• Ndi matenda otsutsana ndi maziko a ketoacidosis - 0,9 PISCES / kg,
• Amayi pa nthawi yoyembekezera - 1 unit / kg.

Kuti mudziwe mlingo wa mankhwala nthawi imodzi, muyenera kuchulukitsa thupi lanu mwa kuchuluka kwa tsiku lililonse, kenako ndikugawa awiriawiri. Sinthani zotsatira zake.

Kufunika kwa wodwala kwambiri kwa insulin patsiku kuyenera kukhala kwa 0,5 mpaka 1 UNITS / kg ya kulemera. 60-70% imalipidwa ndi kukhazikitsidwa kwa mankhwalawa musanadye, ndipo ndalama zotsalazo zimapezeka ndi insulin.

NovoRapid Flexpen ndi cholembera chodzaza ndi syringe. Kuti zitheke, pali chopereka ndi mitundu yolemba. Pakupakidwa jakisoni wa insulin, ma singano atali okwana 8 mm okhala ndi kapu yochepa yotchinga kuchokera ku NovoFayn kapena Novotvist amagwiritsidwa ntchito, phukusi lawo pakhale chizindikiro cha "S".

Ndi syringe iyi, mutha kulowa 1 mpaka 60 mayunitsi a mankhwalawo molondola mpaka 1 unit. Ndikofunikira kutsogoleredwa ndi malangizo ogwiritsa ntchito chipangizocho. Cholembera chimbale cha FlexPen chimaperekedwa kuti chizigwiritsa ntchito payekha ndipo sichitha kudzazidwanso kapena kusamutsa anthu ena.

1. Gawo 1. Phunzirani mosamala dzinalo kuti mutsimikizire kuti mtundu wa insulini wasankhidwa bwino. Chotsani kapu yakunja mu syringe, koma osataya. Iretsani mbale ya mphira. Chotsani zokutira lakunja kwa singano. Ikani singano pa cholembera mpaka itasiya, koma osagwiritsa ntchito mphamvu. Singano ina imagwiritsidwa ntchito nthawi zonse jakisoni, yomwe imalepheretsa kuwoneka mabakiteriya. Singano sikufunika kuthyoledwa, kukhazikika, kuloledwa kugwiritsidwa ntchito ndi ena.
2. Gawo 2. Mphepo yocheperako imatha kuwoneka mu cholembera. Kuti okosijeniyo asasonkhanitsidwe kumeneko, ndipo muyezo umakhala wolondola, muyenera kuyimba mayunitsi 2 potembenuzira chosakanizira cha metering. Kenako tembenuza syringe ndi singanoyo, pukumbani syringe ndi chala chanu cholozera. Simungathe kukhazikitsa zomwe zili pamwamba pa malire, gwiritsani ntchito sikelo kuti mudziwe mlingo wanu. Kutentha kwa mankhwala operekedwa kuyenera kukhala kutentha kwa chipinda.
3. Gawo 3. Dinani batani mpaka pansi mpaka cholembapo chikafika pa "0" chizindikiro. Ngati kumapeto kwa singano dontho lamadzi silituluka, muyenera kuchita zonse, koma osapitilira zisanu ndi chimodzi. Ngati zotsatira zake sizikwaniritsidwa, ndiye kuti FlexPen singagwiritsidwe ntchito.
4. Gawo 4 Ngati chipangizocho chikuyenda bwino, dinani batani "Yambani" mpaka cholemba chibwererenso ku "0" chizindikiro. Kenako jekeseni insulin mu mafuta ochepa a ntchafu, matako, khoma lamkati kapena phewa. Mankhwalawa sangayambe ngati simukanikiza batani kwa masekondi ena 5-6 mutatha kuyika singano pansi pa khungu. Iyi ndiye njira yokhayo yomwe mungayambitsire mankhwalawo kwathunthu, monga adalimbikitsira adokotala. Batani loyambira liyenera kukanikizidwa mpaka singano itachotsedwa pakhungu. Malo omwe ali ndi jekeseni iliyonse ayenera kusinthidwa. Pambuyo pa jekeseni, singano zimayenera kuchotsedwa osasungidwa pafupi ndi syringe kuti madzi asatayike.
5. Gawo 5. Ikani singano mu chipewa chakunja osakhudza cap. Pamene singano ilowa mu chipewa, imangirirani ndi kuchotsa singano ku syringe. Osakhudza nsonga ya singano. Taya singano mumtsuko wolimba, ndiye muzitaya molingana ndi malangizo a dokotala. Ikani chipewa pa syringe. Muyenera kuti muzisungira kutentha firiji, osatsika, pewani kugwedezeka, musasambe, koma pewani fumbi kuti lisalowe. Botolo yatsopano iyenera kusungidwa mufiriji, koma osawunda ndipo musayike pafupi ndi mufiriji! Mukazindikira kuwala kwa dzuwa, mankhwalawo amayamba kugwira ntchito. Botolo lotseguka limatha kusungidwa kwa masiku 28 firiji.

Odwala omwe akusowa mlingo amayenera kuyang'anitsitsa magazi awo kuti athe kuyamwa kwambiri, ndipo abwerere mwakale kamodzi. Palibe vuto, mutatha kudumpha, simungathe kulowa muyezo wapawiri kuti mupange zomwe zayiwalika!

Njira yothandizira mankhwalawa nthawi zambiri imakhala yayitali, chifukwa chake masiku enieni amakhala ovuta kukhazikitsa. Kutalika kwa mankhwalawa kumakhudzidwa ndi mlingo womwe waperekedwa, jakisoni wambiri m'thupi, kuthamanga kwa magazi, kutentha ndi kuchuluka kwa zochita zolimbitsa thupi.

NovoRapid Penfill imapezeka mumtundu wa makatiriji omwe amagwiritsidwa ntchito kubaya insulin.

Kupangidwa ndi NovoNordisk, masingano a NovoFine amaphatikizidwa.

1. Gawo 1. Onetsetsani mosamala cholembera kuti muwonetsetse kuti mtundu woyenera wa insulini wasankhidwa. Ndikofunikira kulabadira dzina la insulini komanso ngati nthawi yake yatha. Pukuta pang'ono pang'onopang'ono ndi ubweya wa thonje kapena chopukutira chakhathamira mu mowa wamankhwala. Mankhwalawa sangagwiritsidwe ntchito ngati cartridge itagwa kuchokera pamenepo, itawonongeka mwanjira iliyonse kapena kuphwanyidwa, chifukwa pamenepa kutaya kwa insulin kungachitike, komanso ngati insulini idakhala ya mtambo kapena itapeza mthunzi wina.
2. Gawo 2. Ikani singano mu subcutaneous adipose minofu ya ntchafu, phewa, matako, ndi khomo lakunja kwam'mimba. Mtundu wa singano utalowetsedwa pansi pakhungu, uyenera kukhalapo kwa masekondi ena 5-6. Batani liyenera kukanikizidwa mpaka singano itulutsidwa. Pambuyo pa jekeseni onse, muyenera kuchotsa nthawi yomweyo. Simungathe kudzazitsanso cartridge yomweyo ndi insulin kachiwiri.

Insulin ya Novorapid: Flekspen, Penfill, malangizo ndi kuwunika, kuchuluka kwake?

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.

Madokotala amakambirana za Novorapidaeflexspene

Wopatsa insulin yayifupi kwambiri kuchokera ku kampani yaku Danish Novo Nordisk! Ili ndi pafupifupi mphindi 15 pambuyo pa kukhazikitsidwa, komwe kumalola kuti odwala azigwiritsa ntchito nthawi yomweyo asanadye komanso pambuyo pake (kutengera mkhalidwe ndi glycemia). Yoyenera kubayidwa jakisoni angapo komanso mankhwala a insulin. Pazochita zanga, nthawi zonse ndimakonda insulin iyi kuposa mawonekedwe ake (Humalog, Apidra).

Kusavuta kwa cholembera yotayika (flekspen) kumakupatsani mwayi kutaya cholembera mutatha kugwiritsa ntchito osati kuvutitsa ndikusintha cartridge.

Ndizosatheka kuti musakonde Novorapid. Kuchita kopitilira muyeso, komwe kumakupatsani mwayi wothandizidwa ndi insulin mphindi khumi musanadye chakudya, komanso kumathandizira kuyambitsa nthawi isanayambike, nthawi yakudya kapena itangotha ​​kumene, kumapangitsa moyo kukhala wosavuta, ndikukulolani kuti musafanane ndi matenda ashuga panthawi yangozi, koma kuti mudzisinthire nokha .

Ndemanga za wodwala za novorapidaeflexspene

Moni, ndili ndi matenda ashuga kuyambira zaka 18. M'mbuyomu, insulin ya Actrapid idalowetsedwa, shuga idalumpha ndipo inali yokwera. Tsopano kubaya "Levemir" ndi insulin yayitali, ndipo "Novorapid" ndi yochepa. Novorapid ndi insulin yabwino kwambiri, imandikwana bwino. Tithokoze kwa wopanga chifukwa cha insulini yabwinoyo. Ndikupangira aliyense yemwe ali ndi matenda ashuga 1.

Kufotokozera kwapfupi

NovoRapid Flexpen ndi insulin yochepa, mawonekedwe a anthu.Mu molekyu yake, pyrrolidine-alpha-carboxylic acid pamalo 28 amaloledwa ndi aminobutanedioic acid, omwe amaletsa mapangidwe a ma hemulin hexamers, monga zimakhalira ndi insulin yachilendo. Zimalimbikitsa kayendedwe ka glucose mu cell ndikugwiritsa ntchito pambuyo pake. Imayendetsa njira yosinthira acetyl-CoA (gawo lapakatikati mu kagayidwe kazinthu zosavuta) kukhala mafuta acids. Imachepetsa kuchuluka kwa shuga m'magazi. Mankhwala amalowetsedwa kudzera mu hypodermis mwachangu kuposa insulin yaumunthu, motero, amayamba kuchita zinthu mwachangu. Kutalika kwa kuchitapo kanthu kumakhala kochepa kuposa insulin yaumunthu. Mlingo wa mankhwalawa umatsimikiziridwa payekhapayekha, kutengera mtundu wawo wa shuga. Mankhwalawa amavomerezedwa kuti agwiritsidwe ntchito mwa ana ndi achinyamata, kuyambira zaka ziwiri, ndipo amagwiritsidwa ntchito kwambiri pochiza matenda osokoneza bongo omwe amadalira odwala a insulin komanso osagwirizana ndi insulin. Mankhwala othandizira omaliza mwa ana ndi achinyamata ali ndi zinthu zingapo zosiyana ndipo amafunikira chisamaliro chapadera. Zofunikira kwambiri pazamankhwala omwe amagwiritsidwa ntchito zimatsimikiziridwa ndi zinthu zingapo, kuphatikizapo mawonekedwe ogona ndi zakudya, kuchuluka kwa chidwi cha zotumphukira mpaka insulini, kusayembekezereka pakuwonjezeka ndikuchepa kwa ntchito zamagalimoto, matenda a pafupipafupi a bacteria ndi bakiteriya, kuchuluka kochepa kwa malo a jakisoni wa insulin (koyambirira) zaka), kufunikira kotenga nawo mbali kwa makolo pakuchiritsa, ndi zina zambiri. Ma insulin NovoRapid Flexpen omwe amangokhala osavomerezeka amatha kupereka njira yosinthira ya mankhwala a insulin chifukwa cha magawo a pharmacokinetic ndi pharmacodynamic. Mankhwalawa angagwiritsidwe ntchito ngati njira yothandizira pampu (m'mapampu a pampu) pakulowetsa kosalekeza. Kukhazikitsidwa kwa mankhwala mu nkhani iyi kumachitika m'chigawo cha khomo lamkati lakumbuyo. Njira yofananira yogwiritsira ntchito mankhwalawa ili ndi zabwino zingapo.

Choyamba, kupereka mankhwalawa pogwiritsa ntchito mapampu othandizira pakompyuta kumapereka mphamvu zowongolera kwambiri za metabolic komanso zimakhudzanso kutsata (kutsatira chithandizo) kwa odwala achichepere, zimaphatikizapo insulin. Kachiwiri, zida zamapompo ndizida zazing'ono zazing'ono zomwe zimamangidwa pazovala zakunja ndipo zobisika kwa ena. Chachitatu, m'maphunziro azachipatala zidatsimikiziridwa kuti njira yofananira ya insulin yoyendetsera bwino imasintha moyo. Kutheka komwe kungachitike mutamwa mankhwalawa: hypoglycemia (zizindikiro - hyperhidrosis, kufooka kwa khungu, kukwiya kochita, osati chizindikiro chaching'ono chakunja, kunjenjemera kwa zala, kuchuluka kwa nkhawa, kufooka, kusokonezeka, kulephera chidwi, Vertigo, njala, kusokonezeka kwa mawonekedwe, cephalgia, kukakamiza kusanza, palpitations), matupi awo owoneka (zotupa za pakhungu, urticaria, zimachitika zam'deralo zomwe zimachitika pakadutsa insulin. Pa gawo loyambirira la chithandizo, nthawi zina, edema imatha kupanga. Mlingo wochepa wa insulin kapena kusokonezeka kwa mankhwala a insulin, poyambirira - ndi matenda a shuga omwe amadalira insulin kumawonjezera chiopsezo cha hyperglycemia. Zizindikiro zake zimawonekera patatha maola ochepa kapena masiku. Izi zikuphatikiza: kufuna kusanza (kuphatikiza kupanga), Hypersomnia, kuyanika pakhungu, Hyperuria, kusadya bwino, ludzu, kununkhira kwa acetone kuchokera mkamwa. Popanda njira zochizira zokwanira, hyperglycemia imatha kupha. Zotsatira za hypoglycemic za mankhwalawa zimatha kuphatikizidwa ndi mapiritsi a antidiabetes, capopril, enalapril ndi zina za ACE zoletsa, acetazolamide, dorzolamide, brinzolamide ndi zina zomwe zimapangitsa kuti pakhale mpweya wambiri wa carbonic anhydrase, propranolol, sotalol, pindolol ndi ena osasankha beta-blockers.zolimbikitsa za chapakati komanso zotumphukira dopamine zolandilira D2 bromocriptine, tetracycline mankhwala.

Pharmacology

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 spartic acid mu insulin aspart kumachepetsa chizolowezi cha mamolekyulu kupanga hexamers, yomwe imawonedwa mu yankho la insulin wamba. Motere, insulin aspart imatengedwa mwachangu kuchokera kumafuta amkati ndipo imayamba kuchita zinthu mwachangu kuposa insulin yamunthu. Insulin aspart amachepetsa shuga m'magazi 4 koyamba pambuyo chakudya asanapezeke insulin yaumunthu.

Kutalika kwa nthawi ya insulin aspart pambuyo pa sc ndi kufupikirapo kuposa sungunuka wa insulin.

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.

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.

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

M'maphunziro azachipatala okhudza odwala akuluakulu omwe ali ndi matenda a shuga 1, amawonetsedwa kuti ndi makulidwe a insulin, mashuga am'magazi am'mimba amawonedwa poyerekeza ndi insulin yamunthu.

Kafukufuku wopangidwa mosasinthika, wakhungu lambiri, wophatikizidwa, wopangidwa ndi pharmacokinetics ndi pharmacodynamics of insulin aspart ndi soluble human insulin mwa okalamba omwe ali ndi matenda a shuga a 2 (odwala 19 azaka 65-83 zaka, zaka zapakati pa 70 zaka). 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.

Pogwiritsa ntchito insulin aspart mwa ana ndi achinyamata, zotsatira zofananira za kuwongolera kwa shuga kwa nthawi yayitali poyerekeza ndi insulle yamunthu insulin imawonetsedwa. Kafukufuku wazachipatala yemwe amagwiritsa ntchito insulin ya anthu osungunuka musanadye komanso insulin aspart atatha kudya ana omwe ali ndi zaka 2 mpaka 6 (odwala 26), ndipo kafukufuku wofanana 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 odwala: 157 adalandira insulini, 165 alandila insulini) sanawonetse zotsatira zoyipa za insulin pa mimba kapena thanzi la fetal / mwana watsopano.Kafukufuku wowonjezera wa azimayi 27 omwe ali ndi gestational shuga mellitus omwe adalandira insulin aspart (odwala 14) ndi insulin ya anthu (13 odwala) adawonetsa kuyesana kwa mbiri ya chitetezo komanso kusintha kwakukulu pakulandila kwa glucose wa postprandial ndi chithandizo cha insulin.

Pharmacokinetics

Pambuyo sc makonzedwe a insulin zofunika T_max plasma, pafupifupi, 2 nthawi zosakwana pambuyo makonzedwe a sungunuka wa munthu insulin. C_max mu madzi am'magazi, pafupifupi, ndi 492 ± 256 pmol / l ndipo amakwaniritsidwa mphindi 40 pambuyo pa utsogoleri wa s / c pamlingo wa 015 U / kg thupi kwa odwala omwe ali ndi matenda a shuga 1. The kuchuluka kwa insulin kubwerera ku chiyambi chake pambuyo maola 4-6 pambuyo makonzedwe a mankhwala. Kuchuluka kwa mandimu kumachepera pang'ono odwala omwe ali ndi matenda a shuga a 2, omwe amatsogolera kutsika C_max (352 ± 240 pmol / L) ndipo pambuyo pake T_max (60 min). Kusiyanasiyana kwa munthu payekha T_max kutsika kwambiri mukamagwiritsa ntchito insulin aspart poyerekeza ndi insulin yamunthu, pomwe kusiyanasiyana kwapadera kwa C_max kwa aspart insulin yambiri.

Pharmacokinetics mu milandu yapadera yamankhwala

Ana (wazaka 6 mpaka 12) ndi achinyamata (wazaka 13 mpaka 17) wokhala ndi mtundu woyamba wa matenda ashuga: kuyamwa kwa insulini kumachitika msanga m'magulu onse a zaka ndi T_maxchimodzimodzi ndi akuluakulu. Komabe, pali zosiyana C_max m'magulu awiri azaka, zomwe zimagogomezera kufunika kwa kumwa 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 matenda ashuga anali ofanana ndi odzipereka athanzi komanso odwala achinyamata omwe ali ndi matenda a shuga. Mwa odwala okalamba, kuchepa kwa mayamwidwe kunawonedwa, zomwe zidapangitsa kutsika kwa T_max (82 (kusiyanasiyana: 60-120 min)), pomwe C_max zinali zofanana ndi zomwe zimawonedwa mwa odwala ang'onoang'ono omwe ali ndi matenda a shuga a 2 komanso ochepera pang'ono poyerekeza ndi odwala matenda a shuga 1.

Kuperewera kwa chiwindi: kafukufuku wa pharmacokinetics adachitika ndi limodzi mlingo wa aspart insulin mwa odwala 24 omwe chiwindi chawo chimagwira kuchokera pakulakwitsa kwambiri. Odwala omwe ali ndi vuto la chiwindi, kuchuluka kwa mayamwidwe a insulini kunachepetsedwa komanso kusinthasintha, zomwe zimapangitsa kutsika kwa T._max kuchokera pafupifupi 50 min mwa anthu omwe ali ndi chiwindi chokwanira mpaka pafupifupi 85 min mwa anthu omwe ali ndi vuto la chiwindi chokwanira komanso mwamphamvu. AUC, C_max ndi chilolezo chonse cha mankhwalawo chinali chofanana ndi anthu omwe ali ndi chiwindi chochepa kwambiri.

Kulephera kwamkati: Kafukufuku adachitika mu pharmacokinetics of insulin aspart mwa odwala 18 omwe ntchito yawo yaimpso imachokera pachizolowezi mpaka kuwonongeka kwambiri. Palibe zotsatira zochokera pachilolezo cha creatinine pa AUC, C_max, T_max insulin. 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.

Kutulutsa Fomu

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

Omwe amathandizira: glycerol - 16 mg, phenol - 1.5 mg, metacresol - 1.72 mg, zinc chloride - 19.6 μg, sodium kolorayidi - 0,58 mg, sodium hydrogen phosphate dihydrate - 1,25 mg, sodium hydroxide 2M - pafupifupi 2.2 mg, hydrochloric acid 2M - pafupifupi 1,7 mg, madzi d / i - mpaka 1 ml.

3 ml (300 PIECES) - makatoni am'magalasi (1) - zolembera zowerengeka zamankhwala angapo a jakisoni angapo (5) - mapaketi a makatoni.

NovoRapid ® FlexPen ® ndi mndandanda wofulumira wa insulin. Mlingo wa NovoRapid ® Flexpen ® umatsimikiziridwa ndi dokotala payekha malinga ndi zosowa za wodwala.

Nthawi zambiri, mankhwalawa amagwiritsidwa ntchito limodzi ndi insulin pokonzekera nthawi yayitali kapena nthawi yayitali, yomwe imayendetsedwa 1 nthawi / tsiku. 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 pochita kuposa insulin yamunthu yosungunuka. Chifukwa cha kuyambika mwachangu, NovoRapid ® FlexPen ® iyenera kuyendetsedwa, ngati lamulo, chakudya chisanachitike, ngati kuli kotheka, chitha kuperekedweratu chakudya chisanafike.

Chifukwa chakufupika kwakanthawi poyerekeza ndi insulin yaumunthu, chiopsezo chokhala ndi nocturnal hypoglycemia mwa odwala omwe amalandila NovoRapid ® FlexPen ® ndi yotsika.

Monga ndi ma insulin ena, mwa odwala okalamba komanso odwala aimpso kapena a hepatic insuffential, kuchuluka kwa glucose m'magazi kuyenera kuyang'aniridwa mosamala kwambiri komanso mlingo wa aspart aspart payekha.

Ndikofunika kugwiritsa ntchito NovoRapid ® FlexPen ® m'malo mwa sungunuka waumunthu m'magulu a ana ngati kuli koyenera kuyambitsa machitidwe a mankhwalawa, mwachitsanzo, pakakhala zovuta kuti mwana athe kupeza nthawi yayitali pakati pa jakisoni ndi zakudya.

Mukasamutsa wodwala kuchokera ku kukonzekera kwina kwa insulin kupita ku NovoRapid ® FlexPen ®, kusintha kwa NovoRapid ® FlexPen ® ndi insulin ya basal kungafunike.

Njira zopewera kugwiritsa ntchito

NovoRapid ® FlexPen ® ndi singano ndizongogwiritsa ntchito nokha. Osadzazitsanso katoni katemera.

NovoRapid ® FlexPen ® silingagwiritsidwe ntchito ngati singakuwonekere komanso yopanda utoto, kapena ngati yawuma. Chenjezo wodwala kutaya singano pambuyo pobayira chilichonse.

NovoRapid ® ikhoza kugwiritsidwa ntchito pamapampu a insulin. Ma machubu, mkati mwake omwe amapangidwa ndi polyethylene kapena polyolefin, adayesedwa ndikupezeka kuti ndi oyenera kugwiritsidwa ntchito pamapampu. Pazifukwa zofunikira (kuchipatala, kuvuta kwa chipangizo cha insulin management) NovoRapid ® yoyendetsera wodwala imatha kuchotsedwa mu FlexPen ® pogwiritsa ntchito syringe ya U100.

Muyenera kuchenjeza wodwala za milandu yomwe NovoRapid ® FlexPen ® singagwiritsidwe ntchito:

- ndi chifuwa (hypersensitivity) ku insulin aspart kapena mankhwala ena alionse

- ngati hypoglycemia iyamba,

- ngati FlexPen ® imagwa, kapena yawonongeka kapena yoponderezedwa,

- ngati malo osungiramo mankhwalawo adaphwanyidwa kapena ndiuma;

- ngati insulini yasiya kukhala yowonekera komanso yopanda utoto.

Musanagwiritse ntchito NovoRapid ® FlexPen ®, wodwalayo ayenera:

- yang'aninso cholembera kuti muwonetsetse kuti mtundu woyenera wa insulin ndi wosankhidwa,

- Gwiritsani ntchito singano yatsopano jakisoni iliyonse popewa matenda.

- kumbukirani kuti NovoRapid ® FlexPen ® ndi singano zimangogwiritsidwa ntchito payekha,

- osabaya jekeseni wa insulin m'mafuta,

- Nthawi iliyonse kusintha tsamba la jakisoni mkati mwa anatomical, izi zithandiza kuchepetsa chiwopsezo cha zisindikizo ndi zilonda pamalo oyang'anira.

- nthawi zonse kuyeza kuchuluka kwa shuga m'magazi.

Malangizo a kayendetsedwe ka mankhwala

NovoRapid ® Flexpen ® imayendetsedwa mosadukiza m'chigawo cha khomo lachiberekero cham'mimba, ntchafu, phewa, dera lotetemera kapena gluteal. Mawebusayiti omwe ali mkati mwa thupi limodzi amayenera kusinthidwa pafupipafupi kuti muchepetse vuto la lipodystrophy. Monga kukonzekera konse kwa insulin, kuyika kwina kwa khoma lakunja kumapereka kuyamwa 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 popitilira s / c insulin infusions (PPII) m'mapampu a insulin opangira insulin infusions. FDI iyenera kupangidwa khoma lakunja kwam'mimba. Malo olowetsedwa amayenera kusinthidwa nthawi ndi nthawi. Mukamagwiritsa ntchito pampu ya insulin paku 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.

Ngati ndi kotheka, NovoRapid ® imatha kuperekedwera iv, koma kokha ndi akatswiri azachipatala oyenerera. Pa makonzedwe amkati, machitidwe a kulowetsedwa omwe ali ndi NovoRapid ® 100 IU / ml amagwiritsidwa ntchito ndi kuchuluka kwa 0.05 IU / ml mpaka 1 IU / ml insulin aspart mu 0.9% sodium chloride solution, 5% dextrose solution kapena 10% dextrose solution yokhala ndi 40 mmol / l potaziyamu mankhwala ena, pogwiritsa ntchito polypropylene muli kulowetsedwa. Njira zoterezi ndizokhazikika pamtunda wa kutentha kwa maola 24. Ngakhale kukhazikika kwakanthawi, chiwopsezo china cha insulin choyambirira chimatengedwa ndi zinthu zam'kati mwa kulowetsedwa. Pa insulin infusions, ndikofunikira kuyang'anira kuchuluka kwa shuga m'magazi.

NovoRapid ® FlexPen ® ndi cholembera cha insulini ndipo chokhala ndi dispenser komanso-code-color. Mlingo wa insulin womwe umayendetsedwa, kuyambira 1 mpaka 60 mayunitsi, umatha kusiyanasiyana mu 1 unit. NovoRapid ® FlexPen ® idapangidwa kuti izigwiritsidwa ntchito ndi NovoFine ® ndi NovoTvist ® singano mpaka 8 mm kutalika. Monga chisamaliro, muyenera kukhala ndi pulogalamu yopuma kuti mupereke insulin chifukwa cha kuwonongeka kapena kuwonongeka kwa NovoRapid ® FlexPen ®.

Musanagwiritse ntchito cholembera

1. Chongani cholembayo kuti mutsimikizire kuti NovoRapid ® FlexPen ® ili ndi mtundu woyenera wa insulin.

2. Chotsani kapu mu cholembera.

3. Chotsani chimata chomuteteza ku singano yotaya. Lowetsani singanoyo mokoma komanso mwamphamvu pa NovoRapid ® FlexPen ®. Chotsani kapu yakunja kuchokera singano, koma osataya. Chotsani ndikutaya kapu yamkati ya singano.

Gwiritsani ntchito singano yatsopano jekeseni aliyense kupewa matenda. Osapinda kapena kuwononga singano musanagwiritse ntchito. Popewa kubayidwa mwangozi, musabwezeretse cholowera chamkati pa singano.

Chingwe cha Insulin

Ngakhale mutagwiritsidwa ntchito moyenera ndi cholembera, mpweya wochepa umatha kudziunjikira mu cartridge musanadye jekeseni iliyonse. Poletsa kulowa kwa kuwira kwa mpweya ndikuwonetsetsa kuti mankhwala ayambitsidwa molondola:

1. Imbani 2 magawo a mankhwala ndikusintha chosankha.

2. Mutagwira NovoRapid ® FlexPen ® ndi singano mmwamba, ikani bokosilo kangapo ndi chala chanu kuti thovu la mlengalenga lipite pamwamba pa cartridge.

3. Mukugwira NovoRapid ® FlexPen ® ndi singano mmwamba, kanikizani batani loyambira njira yonse. Osankha Mlingo abwerera ku "0".

Dontho la insulin liyenera kuonekera kumapeto kwa singano. Ngati izi sizingachitike, sinthani singano ndikubwereza njirayi, koma osapitirira 6. Ngati insulini siyikuchokera singano, izi zikuwonetsa kuti cholembera sichili chosalongosoka ndipo sayenera kugwiritsanso ntchito.

Wosankha mlingo uyenera kukhala "0".

Sungani ziwerengero zomwe zimafunikira jakisoni. Mlingo umatha kusinthidwa ndikusinthanitsa ndi mtundu wosankhidwa mwanjira iliyonse mpaka mlingo woyenera wakhazikitsidwa kutsogolo kwa chizindikiro. Mukazungulira chosankha cha mankhwala, samalani kuti musakanize mwangozi batani loyambira kuti muchepetse kutulutsa kwa insulin. Sizotheka kukhazikitsa mlingo woposa kuchuluka kwa zigawo zomwe zatsalira mu cartridge.

Osagwiritsa ntchito mulingo wotsalira kuti mupeze Mlingo wa insulin.

1. Ikani singano sc. Wodwala ayenera kugwiritsa ntchito jakisoni wovomerezeka ndi dokotala. Kuti mupeze jakisoni, dinani batani loyambira mpaka "0" akuwonekera kutsogolo kwa chizindikiro. Mukapereka mankhwala, batani loyambira lokha lomwe liyenera kukanikizidwa. Mlingo wosankha ngati utasinthidwa, makonzedwe a mlingo sangachitike.

2. Mukachotsa singano pansi pa khungu, gwiritsani batani loyambira ndikukhumudwa kwathunthu. Pambuyo pa jekeseni, siyani singano pansi pa khungu kwa masekondi 6 osachepera. Izi zikuthandizira kukhazikitsidwa kwa insulin yonse.

3. Yambitsirani singano mumkono wakunja wa singano osakhudza cap. Pamene singano ilowa, valani chipewa ndikuvula singano. Taya singano, samalira chitetezo, ndikutseka cholembera ndi chophimba.

Singano imayenera kuchotsedwa pambuyo pobayidwa aliyense ndipo osasunga NovoRapid ® FlexPen ® ndi singano yokhomedwa. Kupanda kutero, madzi amatha kutuluka kuchokera ku NovoRapid ® FlexPen ®, komwe kungayambitse mlingo woyenera.

Osamalira amayenera kusamala pochotsa ndi kutaya singano kuti apewe ngozi yotenga singano mwangozi.

Tayani ntchito NovoRapid ® FlexPen ® ndi singano yololedwa.

NovoRapid ® FlexPen ® idapangidwa kuti igwiritsidwe ntchito payekha.

Kusunga ndi chisamaliro

NovoRapid ® FlexPen ® idapangidwa kuti igwiritsidwe ntchito moyenera komanso mosatetezeka ndipo imafunikira kuisamalira mosamala. Pakakhala dontho kapena kupanikizika kwamakina mwamphamvu, cholembera cha syringe chimatha kuwonongeka ndipo insulin ikhoza kutayikira. Pamwamba pa NovoRapid ® FlexPen ® ikhoza kutsukidwa ndi thonje swab choviikidwa mu mowa. Osamiza chindapusa mu mowa, osasamba kapena mafuta ikhoza kuwononga makina. Kudzazidwa kwa NovoRapid ® FlexPen ® sikuloledwa.

Bongo

Mlingo wa insulin wofunidwa wowonjezera wa insulin sunakhazikitsidwe.

Zizindikiro: hypoglycemia, yomwe imatha kukula pang'onopang'ono ngati mlingo waukulu kwambiri umaperekedwa mogwirizana ndi zosowa za wodwala.

Chithandizo: wodwalayo amatha kuthetsa hypoglycemia wofatsa pogwiritsa ntchito shuga kapena shuga wokhala ndi shuga. Chifukwa chake, ndikulimbikitsidwa kwa odwala omwe ali ndi matenda ashuga kuti azitha kutenga zakudya zomwe zili ndi shuga. Ngati hypoglycemia yayamba kwambiri, wodwala akakhala kuti alibe chikumbumtima, 500 mcg mpaka 1 mg ya glucagon mu / m kapena s / c (akhoza kuyendetsedwa ndi munthu wophunzitsidwa bwino), kapena mu / njira ya glucose (dextrose) (katswiri wazachipatala yekha ndi amene angalowe) ayenera kulandira . M'pofunikanso kuyang'anira dextrose iv ngati wodwalayo asadzayambenso chikumbumtima cha mphindi 10-15 atatha kugwiritsa ntchito shuga. Pambuyo podzikanso, wodwalayo amalangizidwa kuti azidya zakudya zokhala ndi mchere wambiri kuti muchepetse kubwerezanso kwa hypoglycemia.

Kuchita

Hypoglycemic zotsatira za insulin patsogolo mankhwala m'kamwa hypoglycemic, Mao zoletsa, zoletsa Ace, carbonic zoletsa anhydrase, kusankha beta-blockers, bromocriptine, sulfonamides, anabolic mankhwala, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, mankhwala lifiyamu salicylates.

Hypoglycemic zotsatira za insulin zimafooketsedwa ndi kulera kwapakamwa, corticosteroids, mahomoni a chithokomiro, thiazide diuretics, heparin, tridclic antidepressants, sympathomimetics, somatropin, danazole, clonidine, "wosakwiya" calcium blockers, diazoxide, morphine, pphto.

Beta-blockers amatha kufinya zizindikiro za hypoglycemia.

Octreotide / lanreotide imatha kuwonjezeka ndikuchepetsa kufunika kwa insulin.

Ethanol imatha kukulitsa ndikuchepetsa mphamvu ya insulin.

Mankhwala okhala ndi magulu a thiol kapena sulfite, akaphatikizidwa ku mankhwala a NovoRapid ® FlexPen ® angayambitse kuwonongeka kwa insulin aspart. NovoRapid ® FlexPen ® sayenera kusakanikirana ndi mankhwala ena. Kupatula kwake ndi insulin-isophan ndi mayankho a kulowetsedwa omwe alembedwa pamwambapa.

Malangizo apadera

Asananyamuke ulendo wamtunda wophatikizapo kusintha kwa malo, wodwalayo ayenera kufunsa dokotala, chifukwa kusintha nthawi kumatanthauza kuti wodwalayo ayenera kudya ndi kupatsa insulin panthawi ina.

Mlingo wosakwanira wa mankhwalawa kapena kusiya kulandira chithandizo, makamaka mtundu wa matenda a shuga 1, angayambitse kukula kwa hyperglycemia ndi matenda ashuga a ketoacidosis. Zizindikiro za hyperglycemia nthawi zambiri zimawonekera pang'onopang'ono pakupita kwa maola angapo kapena masiku. Zizindikiro za hyperglycemia ndi mseru, kusanza, kugona, kuwuma ndi khungu, pakamwa pouma, kutuluka kwamkodzo, ludzu komanso kusowa chilimbikitso, komanso mawonekedwe a fungo la acetone m'mlengalenga. Popanda chithandizo choyenera, hyperglycemia imatha kupha.

Kudumpha chakudya, osakonzekera masewera olimbitsa thupi, kapena mlingo wa insulin wokwanira kwambiri pazosowa za wodwalayo kungayambitse hypoglycemia.

Pambuyo kulipirira kagayidwe kazakudya, mwachitsanzo, ndi mankhwala olimbitsa kwambiri a insulin, odwala amatha kukumana ndi zisonyezo zam'mbuyomu za hypoglycemia, zomwe odwala ayenera kudziwitsidwa.

Zizindikiro zachilendo zimatha kutha ndi matenda a shuga.

Zotsatira za pharmacodynamic zomwe zimapangira insulin analogues ndikuti kupanga kwa hypoglycemia pakugwiritsa ntchito kumatha kuyamba kale kuposa kugwiritsa ntchito insulin ya insulin.

Popeza NovoRapid ® FlexPen ® iyenera kugwiritsidwa ntchito mwachindunji ndi chakudya, ndikofunikira kuganizira kuthamanga kwazomwe kumayambira kwa mankhwalawa mankhwalawa odwala omwe ali ndi matenda opatsirana kapena kumwa mankhwala omwe amachepetsa kuyamwa kwa chakudya.

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.

Mukasamutsa wodwala ku mitundu ina ya insulini, zizindikiro zoyambirira za hypoglycemia zitha kutchulidwa pang'ono poyerekeza ndi omwe amagwiritsa ntchito mtundu wakale wa insulin.

Kusamutsa wodwalayo kukonzekera insulin ina

Kusamutsa wodwala kupita ku mtundu wina wa insulin kapena kukonzekera kwa insulin kwa wopanga wina kuyenera kuchitika moyang'aniridwa ndi achipatala.Ngati musintha ndende, mtundu, wopanga ndi mtundu wa anthu (insulin ya anthu, insulin ya anthu, analogue ya anthu) za kukonzekera kwa insulin ndi / kapena njira yopangira, mungafunike kusintha mlingo kapena kuwonjezera kuchuluka kwa jakisoni poyerekeza ndi momwe kale anagwiritsira ntchito insulin. Ngati ndi kotheka, kusintha kwa mlingo, mutha kupanga kale jakisoni woyamba wa mankhwalawa kapena mkati mwa milungu yoyamba kapena miyezi ya chithandizo.

Zokhudza malo jakisoni

Monga momwe zilili ndi kukonzekera kwa insulini, zimachitika mu jakisoni wa jekeseni, yomwe imawonetsedwa ndi kupweteka, redness, urticaria, kutupa, hematoma, kutupa ndi kuyabwa. Kusintha pafupipafupi jakisoni m'malo omwewo zimapangitsa kuti magazi asamasinthe. Nthawi zina, mwina pangafunike kuletsa NovoRapid ® FlexPen ®.

Kugwiritsa ntchito munthawi yomweyo mankhwala a gulu la thiazolidinedione komanso kukonzekera insulin

Milandu yokhudzana ndi matenda a mtima omwe amayamba chifukwa cha kulephera kwa mtima adanenedwa mothandizidwa ndi odwala omwe ali ndi thiazolidinediones kuphatikiza kukonzekera kwa insulin, makamaka ngati odwala oterewa ali pachiwopsezo chotukuka kwa mtima wosalephera. Izi zimayenera kukumbukiridwa popereka mankhwala ophatikiza ndi thiazolidatediones ndi insulin yokonzekera odwala. Ndi mankhwala osakanikirana oterowo, ndikofunikira kuchita mayeso azachipatala kwa odwala kuti azindikire zizindikiritso za mtima kulephera, kulemera kwa thupi ndi kupezeka kwa edema. Ngati zizindikiro za kulephera kwa mtima zikuchulukirachulukira kwa odwala, chithandizo ndi thiazolidatediones ziyenera kusiyidwa.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Kuthekera kwa odwala kulolera komanso kuchuluka kwa momwe angachitire amatha kusokonezeka panthawi ya hypoglycemia, zomwe zimatha kukhala zowopsa nthawi zomwe maluso amenewa amafunikira makamaka (mwachitsanzo, poyendetsa magalimoto kapena kugwira ntchito ndi makina ndi makina). Odwala ayenera kulangizidwa kuti achitepo kanthu popewa kukula kwa hypoglycemia poyendetsa magalimoto ndikugwira ntchito ndi njira. Izi ndizofunikira kwambiri kwa odwala omwe alibe kapena kuchepa kwa zizindikiro zakutsogolo kwa hypoglycemia kapena akuvutika ndi zochitika zapafupipafupi za hypoglycemia.

Mlingo ndi makonzedwe

Mlingo Mlingo wa mankhwalawa NovoRapid ® FlexPen ® ndi munthu payekha ndipo amatsimikiza ndi dokotala mogwirizana ndi zosowa za wodwala. Novorapid ® Flexpen ® imakonda kugwiritsidwa ntchito limodzi ndi insulini kapena yochita nthawi yayitali kukonzekera insulin, yomwe imaperekedwa kamodzi pa tsiku. Kuti mukwaniritse bwino kwambiri kuwongolera glycemic, kuyang'anira shuga wamagazi ndikusintha kwa insulin ndikulimbikitsidwa.

Chofunikira cha insulin mwa akulu ndi ana nthawi zambiri chimachokera ku 0.5 mpaka 1.0 mayunitsi / kg / tsiku. Ndi regalen yoyambira ya basal-bolus, 50-70% ya zofunika za insulin imakwaniritsidwa ndi NovoRapid ® FlexPen ®, ndi ena onse - pakatikati kapena nthawi yayitali. Kusintha kwa Mlingo kumakhala kofunikira ndi zochitika zolimbitsa thupi, kusintha kwa zakudya, kapena panthawi yodwala.

Mwa kuyamba kwachangu, NovoRapid ® FlexPen ® iyenera kuperekedwa mwachangu musanadye kapena nthawi yomweyo mukatha kudya. Chifukwa chakufupika kwakanthawi kogwiritsa ntchito mankhwalawa NovoRapid ® FlexPen ® ali ndi chiopsezo chocheperako cha magawo a usiku a hypoglycemia.

Magulu apadera a odwala

Monga momwe zimagwiritsidwira ntchito kukonzekera kwina kwa insulin, mwa odwala okalamba komanso odwala omwe ali ndi vuto la impso kapena kwa chiwindi, kuyang'anira shuga kuyenera kulimbikitsidwa ndi mlingo wa aspart insulin payokha.

Novorapid ® Flexpen ® ikhoza kukhala ndi mwayi ngati imagwiritsidwa ntchito mwa ana poyerekeza ndi insulin yamtundu wa munthu, pamene kuyambira kumafunikira mwachangu (mwachitsanzo, jekeseni wokhudzana ndi kudya).

Chotsani kuchokera kukonzekera kwina kwa insulin

Mukasamutsa kuchokera ku mitundu ina ya insulini, kusintha kwa NovoRapid ® FlexPen ® ndi mlingo wa insulin yofunika ungafunike.

Novorapid ® Flexpen ® imayendetsedwa pansi pa khungu la khoma lakunja kwam'mimba, ntchafu, m'misempha yonyansa ya phewa kapena matako. Malowo a jakisoni amayenera kusinthidwa ngakhale mkati momwe mthupi momwemo kuti muchepetse chiopsezo cha lipodystrophy. Monga ndi ma insulin onse, kayendetsedwe ka subcutaneous kukhoma kwamkati kwam'mimba kumayamwa mofulumira kuposa momwe kumathandizira kwina. Monga ndi ma insulin onse, nthawi yamachitidwe imasiyanasiyana malinga ndi mlingo, malo omwe jakisoni, kuthamanga kwa magazi, kutentha, ndi kuchuluka kwa zolimbitsa thupi. Komabe, kuyambika mwachangu poyerekeza ndi insulin yaumunthu yosungunuka imasungidwa mosasamala malo a jekeseni.

Ma syringe cholembera osadzazidwa NovoRapid ® FlexPen ® adapangidwa kuti azigwiritsidwa ntchito ndi singano za NovoFayn ® kapena NovoTvist ® 8 mm.

Ma cholembera a syvoge a NovoRapid ® FlexPen ® ali ndi makatoni amitundu osiyanasiyana ndi malangizo omwe ali ndi chidziwitso chokwanira chogwiritsira ntchito amaperekedwa.

Ntchito kulowetsedwa mapampu

Novorapid ® FlexPen ® ikhoza kugwiritsidwa ntchito pakulamulira kwa nthawi yayitali pogwiritsa ntchito mapampu olowetsedwa oyenerera. Kukhalitsa kwa nthawi yayitali kumachitika mu khoma lakunja kwam'mimba. Tsamba la jakisoni liyenera kusinthidwa nthawi ndi nthawi.

Mukamagwiritsira ntchito mapampu a kulowetsedwa NovoRapid ® FlexPen ® sangathe kusakanikirana ndi insulin ina iliyonse. Odwala omwe amagwiritsa ntchito makina opompera amayenera kuphunzitsidwa mwakuya za kugwiritsa ntchito makina amenewa ndikugwiritsa ntchito zida ndi machubu oyenerera. Seti ya kulowetsedwa (machubu ndi ma cannulas) iyenera kusinthidwa monga momwe amafunikira malangizo omwe aperekedwa. Odwala omwe amalandila NovoRapid ® FlexPen ® mumapompo ayenera kukhala ndi insulin posungira ngati dongosolo litha.

Gwiritsani ntchito makina amkati

Ngati ndi kotheka, NovoRapid ® FlexPen ® imatha kutumikiridwa kudzera m'mitsempha, ndi dokotala wokha yemwe amatha kuchita jakisoni. Makina a kulowetsedwa ogwiritsira ntchito mafinya (matumba a kulowetsedwa kwa polyethylene) okhala ndi NovoRapid ® FlexPen ® 100 IU / ml okhala ndi insulini aspart kuchokera ku 0.05 IU / ml mpaka 1.0 IU / ml mu kulowetsedwa kwa 0,9% sodium chloride, 5% shuga (dextrose) kapena 10% glucose (dextrose) wokhala ndi 40 mmol / l potaziyamu wa potaziyamu, wokhazikika m'chipinda kwa maola 24. Ngakhale kukhazikika kwa mlingo pa kulowetsedwa, kuchuluka kwa insulini kumatha kukhala kotsatsa kumtundu wa kulowetsedwa. Kuwunika kwa shuga m'magazi kumafunika pa kulowetsedwa kwa insulin.

Njira zopewera kusamalira ndi kutaya

Ma singano ndi NovoRapid ® FlexPen ® ayenera kugwiritsidwa ntchito payokha.

Musadzaze makatoni.

Osagwiritsa ntchito Novorapid ® FlexPen ® ngati yankho silikumveka kapena lopanda utoto kapena cholembera sichingakhale chouza.

Wodwala ayenera kudziwitsidwa za kufunika kotaya singano pambuyo pobayira iliyonse.

Mankhwalawa amatha kugwiritsidwa ntchito pomapaka kulowetsedwa, monga momwe gawo la "Mlingo ndi Ulamuliro" limafotokozera. Zipangizo zam'kati mwa mkati zomwe zimapangidwa ndi polyethylene kapena polyolefin ziyenera kuyesedwa kuti zikuyenere kugwiritsidwa ntchito ndi mapampu.

Pothana ndi vuto la odwala omwe akugwiritsa ntchito NovoRapid ® (kuchipatala kapena vuto la cholembera), muyezo wa NovoRapid ® umatha kufotokozedwa kuchokera mu cholembera cha syringe ya FlexPen ® pogwiritsa ntchito cholembera cha insulin pa 100 PIECES.

Malangizo ogwiritsira ntchito mankhwalawa NovoRapid ® Flexpen ® wodwalayo

Musanagwiritse ntchito NovoRapid ® FlexPen ®:

▶ Onani kuti zilembozo zili kuti syringe ya NovoRapid ® FlexPen ® ili ndi mtundu wa insulin wofunikira.

Nthawi zonse gwiritsani ntchito singano yatsopano musanalowe jekeseni aliyense kuti mupewe matenda.

▶ Novorapid ® FlexPen ® ndi singano ndizogwiritsa ntchito payekha.

Insulin NovoRapid: malangizo, ntchito, mankhwala

Kukonzekera kwa insulin kumagwiritsidwa ntchito kukonza milingo ya shuga mwa odwala matenda a shuga. NovoRapid ndi m'modzi mwa oimira m'badwo waposachedwa wa othandizira a hypoglycemic. Amagwiritsidwa ntchito ngati gawo la mankhwala a shuga kuti apange kuchepa kwa insulin ngati kapangidwe kake m'thupi kamalemala.

NovoRapid ndi wosiyana pang'ono ndi mahomoni abwinobwino amunthu, chifukwa chomwe amayamba kuchita zinthu mwachangu, ndipo odwala amatha kuyamba kudya atangoyambitsa.

Poyerekeza ndi ma insulins achikhalidwe, NovoRapid amawonetsa zotsatira zabwino: m'magulu a shuga odwala shuga amakhazikika mutatha kudya, ndipo kuchuluka ndi zovuta za nocturnal hypoglycemia zimachepa.

Mphamvu zake zimaphatikizanso mphamvu ya mankhwalawo, yomwe imalola anthu ambiri omwe ali ndi matenda ashuga kuchepetsa shuga.

Moni Dzina langa ndine Galina ndipo sindilinso ndi matenda ashuga! Zinanditengera milungu itatu yokhakubwezeretsa shuga kwachikhalidwe komanso kusakhala mankhwala osathandiza
>>Mutha kuwerenga nkhani yanga apa.

Gulu la mankhwala

NovoRapid amaonedwa ngati insulin yotsalira-yochepa. Kutsitsa kwa shuga pambuyo pa kayendetsedwe ake kumawonedwa kale kuposa momwe mumagwiritsira ntchito Humulin, 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

Poyerekeza ndi ma insulins afupifupi, NovoRapid amachita zochepa, pafupifupi maola 4. Nthawi ino ndikokwanira kuti shuga onse kuchokera pachakudyacho adutse kulowa m'magazi kenako ndikulowetsa minofu. Chifukwa chofulumira, pambuyo pakukhazikitsa kwa mahomoni, kuchepa kwa hypoglycemia sikuchitika, makamaka koopsa usiku.

Mafuta a m'magazi amayesedwa patadutsa maola 4 jekeseni kapena chakudya chotsatira. Mlingo wotsatira wa mankhwalawa sagwiritsidwa kale kuposa momwe umatha, ngakhale wodwalayo ali ndi shuga wambiri.

Ndikofunikira kwambiri: Lekani kudyetsa mafia azakudya nthawi zonse. Ma Endocrinologists amatipangitsa kuti tiziwonongeratu ndalama pamapiritsi pomwe shuga m'magazi amatha kukhala ngati ma ruble 147 ... >>werengani nkhani ya Alla Viktorovna

Malamulo oyambira

Ndikotheka kubaya inshuwaransi ya NovoRapid pogwiritsa ntchito cholembera, pampu ndi syringe yokhazikika ya insulin. Imaperekedwa pokhapokha. Jekeseni wokhazikika wa mankhwalawa si wowopsa, koma mulingo woyenera wa insulin umatha kupereka zotsatira zosayembekezereka, nthawi zambiri zimathamanga, koma osakhalitsa.

Malinga ndi malangizo, kuchuluka kwa insulin patsiku, kuphatikiza yayitali, sikudutsa gawo limodzi pa kilogalamu ya kulemera.

Ngati nambalayo ndi yayikulupo, muyenera kufunsa dokotala, chifukwa izi zitha kuwonetsa kuvutitsidwa kwa carbohydrate, kukulitsa insulin, njira yolakwika ya jakisoni, komanso mankhwala osayenera.

Mlingo watsiku ndi tsiku suyenera kubayidwa nthawi imodzi, chifukwa izi zimapangitsa kuti shuga achepe. Mlingo umodzi umayenera kuwerengedwa payokha pachakudya chilichonse. Nthawi zambiri, dongosolo lama mkate limagwiritsidwa ntchito kuwerengera.

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.

Itha kukhala:

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 kapena Levemir? 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.