Mikstard® 30 NM Yapakatikati nthawi ya insulin yaumunthu yosakanikirana ndi insulin yochepa

Kuyimitsidwa kwa kayendetsedwe ka subcutaneous, 100 IU / ml

1 ml ya mankhwala ali

ntchito yogwira - genetically opanga insulin ya anthu 3.50 mg (100 IU) 1,

zokopa: zinc chloride, glycerin, phenol, metacresol, sodium hydrogen phosphate dihydrate, protamine sulfate, hydrochloric acid 2 M yankho, sodium hydroxide 2 M yankho, madzi a jekeseni.

1 Mankhwalawa ali ndi 30% sungunuka wa anthu komanso 70% isofan-insulin

Kuyimitsidwa koyera, pakuyimilira, kumapangidwa kukhala chinthu chowonekera, chopanda utoto kapena chosawoneka bwino komanso choyera. Mtengo umasinthidwa mosavuta ndikugwedezeka modekha.

Mankhwala

Pharmacokinetics

Hafu ya moyo wa insulini m'magazi ndi mphindi zingapo, chifukwa chake, zotsatira za mankhwala omwe ali ndi insulin zimatsimikiziridwa kokha ndi mawonekedwe ake a mayamwidwe. Kutalika kwa nthawi ya kukonzekera kwa insulin kumachitika makamaka chifukwa cha kuchuluka kwa mayamwidwe, zomwe zimatengera zinthu zingapo (mwachitsanzo, pa mlingo wa insulin, njira ndi malo oyendetsera, makulidwe a subcutaneous mafuta wosanjikiza ndi mtundu wa matenda osokoneza bongo). Chifukwa chake, magawo a pharmacokinetic a insulin ali ndi kusinthasintha kwakukulu kwapakati pa intaneti ndi munthu payekha.

Mkulu pazambiri (Cmax) wa insulin mu plasma umatheka mkati 1.5 mpaka 2.5 pambuyo subcutaneous makonzedwe.

Palibe zomangamanga zomanga mapuloteni a plasma zimadziwika, kupatulapo ma antibodies a insulin (ngati alipo).

Insulin yaumunthu imapukusidwa ndi zochita za insulin proteinase kapena ma enzyme okhala ndi insulin, komanso, mwina, mwa mapuloteni omwe amachititsa kuti mapuloteni azikhala asomerase. Amaganiziridwa kuti mu molekyulu ya insulin ya anthu pali malo angapo a cleavage (hydrolysis), komabe, palibe amodzi a metabolites omwe amapangidwa chifukwa cha cleavage akugwira ntchito.

Hafu ya moyo (T½) imatsimikiziridwa ndi kuchuluka kwa kuyamwa kuchokera kuzinthu zowoneka bwino. Chifukwa chake, T½ ili ndi gawo lina la mayamwidwe, m'malo mochulukitsa kwenikweni kwa insulini kuchokera ku plasma (T½ ya insulin m'magazi ndi mphindi zochepa chabe). Kafukufuku awonetsa kuti T½ ili pafupifupi maola 5-10.

Mankhwala

Mikstard® 30 NM ndi insulini yochita kawiri yopangidwa ndi kubwereza kwa michere ya DNA pogwiritsa ntchito mtundu wa Saccharomyces cerevisiae. Imalumikizana ndi cholandirira chapadera pa cell ya cytoplasmic cell ndipo imapanga insulini-receptor. Kudzera mwa kuchulukitsa kwa cAMP biosynthesis (m'maselo amafuta ndi m'maselo a chiwindi), kapena kulowa mwachindunji mu cell (minofu), insulini-receptor tata imapangitsa njira zina, kuphatikizira kaphatikizidwe angapo ofunikira a michere (hexokinase, pyruvate kinase, glycogen synthetase, etc.). Kutsika kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa kayendedwe ka intracellular, kuchuluka kwa minofu, kukondoweza kwa lipogenesis, glycogenogenesis, kaphatikizidwe ka mapuloteni, kuchepa kwa kuchuluka kwa glucose opangidwa ndi chiwindi, ndi zina zambiri.

Mphamvu ya mankhwalawa Mikstard® 30 NM imayamba mkati mwa theka la ola pambuyo pa kutsata, ndipo mphamvu yakeyo imawonekera mkati mwa maola 2-8, pomwe nthawi yonseyi ikuchitika pafupifupi maola 24.

Mlingo ndi makonzedwe

Kukonzekera kwa insulin kophatikizidwa nthawi zambiri kumaperekedwa kamodzi kapena kawiri pa tsiku ngati kuphatikiza koyambirira ndi zotsatira zazitali zimafunikira.

Mlingo wa mankhwalawa amasankhidwa payekha, poganizira zosowa za wodwala. Nthawi zambiri, zofunika za insulin zimakhala pakati pa 0.3 ndi 1 IU / kg / tsiku. Kufunika kwa insulini 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.

Ngati odwala matenda a shuga akwaniritsa kwambiri glycemic control, ndiye kuti zovuta za shuga mwa iwo, monga lamulo, zimawonekera pambuyo pake. Pankhani imeneyi, munthu ayenera kuyesetsa kukhathamiritsa kagayidwe kachakudya, makamaka, amayang'anitsitsa kuchuluka kwa shuga m'magazi.

Mankhwalawa umaperekedwa kwa mphindi 30 asanadye kapena chakudya.

Kwa subcutaneous makonzedwe. Palibe chifukwa chilichonse ngati insulin kuyimitsidwa iyenera kuperekedwa. Mikstard® 30 NM nthawi zambiri imayendetsedwa mwachisawawa m'chigawo cha khoma 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. Kupanga jakisoni pakhungu kumachepetsa chiopsezo cholowera minofu. Ndikofunikira nthawi zonse kusintha malo a jekeseni mkati mwa anatomical dera kuti muchepetse chiopsezo cha lipodystrophy.

Malangizo ogwiritsira ntchito Mikstard® 30 NM, omwe ayenera kuperekedwa kwa wodwala.

Musagwiritse ntchito Mikstard® 30 NM:

M'mapampu a insulin.

Ngati pali ziwengo (hypersensitivity) kwa insulin ya anthu kapena chilichonse chomwe chimapanga kukonzekera kwa Mikstard® 30 NM.

Ngati hypoglycemia imayamba (shuga m'magazi).

Ngati insulin sinasungidwe bwino, kapena ngati yauma

Ngati kapu yodzitchinjiriza ikusowa kapena yatayidwa. Bokosi lirilonse limakhala ndi kapu pulasitiki yoteteza.

Ngati insulin singakhale yoyera komanso yamtambo mutasakaniza.

Musanagwiritse ntchito Mikstard® 30 Nm:

Chongani cholembera kuti muwonetsetse kuti mukugwiritsa ntchito mtundu woyenera wa insulin.

Chotsani chophimba.

Momwe mungagwiritsire ntchito mankhwala Mikstard® 30 NM

Mankhwala a Mikstard® 30 NM amapangidwira ma subcutaneous makonzedwe. Musamapereke insulin kapena kudzera m'mitsempha. Nthawi zonse sinthani malo opangira jakisoni mkati mwa anatomical dera kuti muchepetse chiwopsezo cha zisindikizo ndi zilonda pamalowa. Malo abwino oti jakisoni ndi: matako, ntchafu kapena phewa.

Onetsetsani kuti mukugwiritsa ntchito syringe wa insulin pomwe muyeso umagwiritsidwa ntchito poyesa kuchuluka kwa zochita.

Jambulani mpweya mu syringe muyezo wogwirizana ndi insulin yomwe mukufuna.

Mukangomwa kumwa mankhwalawo, gubuduzani pakati pa manja anu mpaka insuliniyo ikhale yoyera komanso yamitambo. Kupatsanso mphamvu kumathandizidwa ngati mankhwalawo ali ndi kutentha kwa chipinda.

Lowani insulin pansi pa khungu.

Gwirani singano pansi pakhungu kwa mphindi zosachepera 6 kuti muwonetsetse kuti mulingo wa insulin umayendetsedwa kwathunthu.

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.

Zotsatira zoyipa

Zotsatira zoyipa zomwe zimawoneka mu odwala munthawi ya mankhwala a Mikstard® 30 NM zimadalira mlingo wa mankhwala ndipo zimachitika chifukwa cha mankhwala a insulin.

Izi ndi malingaliro a pafupipafupi pazomwe zimachitika pazochitika zamankhwala, zomwe zimawerengedwa kuti zimagwirizanitsidwa ndi kugwiritsa ntchito mankhwala a Mikstard® 30 NM. Pafupipafupi pamakhala zotsimikiza motere: pafupipafupi (≥1 / 1,000 kuti

Kusungidwa kwa mankhwala Mikstard ® 30 NM Penfill ®

Pewani kufikira ana.

kuyimitsidwa kwa subcutaneous makonzedwe a 100 IU / ml - zaka 2,5.

Osagwiritsa ntchito tsiku lotha ntchito likusonyezedwa pa phukusi.

Siyani ndemanga yanu

Chidziwitso Chaposachedwa Chosowa Chidziwitso, ‰

Zikalata zolembetsera Mikstard ® 30 NM Penfill ®

Chithandizo choyamba
Ogulitsa pa intaneti
Za kampani
Zambiri

Wofalitsa:
+7 (495) 258-97-03
+7 (495) 258-97-06
Imelo: Imelo yotetezedwa
Adilesi: Russia, 123007, Moscow, ul. 5 Thunthu, d.12.

Webusayiti yovomerezeka ya Radar Gulu la Makampani ®. Ensaikulopediya yayikulu ya mankhwala osokoneza bongo ndi katundu wa mankhwala omwe amapezeka ku Russia Internet. Ndondomeko yamankhwala Rlsnet.ru imapatsa ogwiritsa ntchito malangizo, mitengo ndi mafotokozedwe a mankhwala, zowonjezera pazakudya, zida zamankhwala, zida zamankhwala ndi zina. Maupangiri a pharmacological akuphatikiza chidziwitso cha kapangidwe ndi mawonekedwe amamasulidwe, zochitika zamankhwala, zisonyezo zogwiritsidwa ntchito, contraindication, zotsatira zoyipa, kugwiritsa ntchito mankhwala, njira yogwiritsira ntchito mankhwala, makampani opanga mankhwala. Ndondomeko ya mankhwala ili ndi mitengo yamankhwala ndi mankhwala ku Moscow ndi mizinda ina ya Russia.

Sizoletsedwa kufalitsa, kukopera, kufalitsa zambiri popanda chilolezo cha RLS-Patent LLC.
Mukamagwiritsa ntchito zidziwitso zofalitsidwa pamasamba a webusayiti ya www.rlsnet.ru, kulumikizana ndi gwero lachidziwitso ndikofunikira.

Tili pamawebusayiti:

Maumwini onse ndi otetezedwa.

Kugwiritsa ntchito malonda pazinthu sikuloledwa.

Chidziwitsochi cholinga chake ndi akatswiri azaumoyo.

Mikstard 30 NM ndi insulin yachiwiri. Mankhwalawa amapezeka pogwiritsa ntchito mitundu iwiri ya DNA pogwiritsa ntchito Saccharomycescerevisiae. Imalumikizana ndi ma membrane a cell membrane, chifukwa pomwe insulin-receptor complex imawonekera.

Mankhwala amakhudza machitidwe omwe amapezeka mkati mwa maselo, kudzera kutsegula kwa biosynthesis mu chiwindi ndi maselo amafuta. Kuphatikiza apo, chidachi chimalimbikitsa kubisalira kwa michere yofunika, monga glycogen synthetase, hexokinase, pyruvate kinase.

Kuchepetsa shuga m'magazi kumachitika kudzera mu kuyenda kwa mkati mwake, kuyamwa kokwanira komanso kuyamwa bwino kwa shuga ndi minofu yake. Kuchita kwa insulin kumamveka kale patatha theka la ola jakisoni. Ndipo kuphatikiza kwakukulu kumatheka pambuyo pa maola 2-8, ndipo kutalika kwa zotulukazo ndi tsiku limodzi.

Makhalidwe a pharmacological, zikuwonetsa komanso contraindication

Mikstard ndi insulin yamagawo awiri yokhala ndi kuyimitsidwa kwa nthawi yayitali isofan-insulin (70%) ndi insulin yofulumira (30%). Hafu ya moyo wa magazi imatenga mphindi zingapo, chifukwa chake, mawonekedwe a mankhwalawa amatsimikiziridwa ndi mawonekedwe a mayamwidwe.

Njira yolerera imatengera zinthu zosiyanasiyana. Chifukwa chake, imakhudzidwa ndi mtundu wa matenda, mlingo, dera komanso njira yoyendetsera, komanso ngakhale makulidwe a minofu yapamtunda.

Popeza mankhwalawa ndi a mtundu umodzi, kuyamwa kwake kumatenga nthawi yayitali komanso kuthamanga. Kuzindikira kwambiri m'magazi kumatheka pambuyo pa maola 1.5-2 pambuyo pa kuperekedwa kwa sc.

Kugawidwa kwa insulini kumachitika pamene imagwirizana ndi mapuloteni a plasma. Chosiyana ndi ichi ndi mapuloteni omwe amawazungulira pamaso pake omwe sanazindikiridwe.

Insulin yaumunthu imapangidwa ndi ma enzymes osokoneza bongo a insulin kapena mapuloteni a insulin, komanso, mwina, ndi protein disulfide isomerase. Kuphatikiza apo, madera anapezeka pomwe ma hydrolysis a mamolekyulu a insulin amachitika. Komabe, metabolites omwe amapangidwa pambuyo pa hydrolysis sagwira ntchito kwachilengedwe.

Hafu ya moyo wa yogwira zimadalira mayamwidwe ake kuchokera minofu subcutaneous. Nthawi yayitali ndi maola 5-10. Nthawi yomweyo, pharmacokinetics sichimayambitsidwa ndi zokhudzana ndi zaka.

Zizindikiro zogwiritsira ntchito insulin ya Mikstard ndi mtundu 1 komanso mtundu 2 wa shuga, pomwe wodwalayo akayamba kutsutsana ndi mapiritsi ochepetsa shuga.

Contraindication ndi hypoglycemia ndi hypersensitivity.

Choyambirira chofunikira kudziwa ndikuti mankhwalawa amayenera kutumizidwa ndi dokotala payekhapayekha. Pulogalamu yayikulu ya insulini kwa munthu wamkulu wodwala matenda ashuga ndi 0.5-1 IU / kg pa kulemera kwa mwana - 0,7-1 IU / kg.

Koma polipirira matendawa, kumwa mankhwalawa ndikofunikira kuti muchepetse mulingo, ndipo ngati vuto la kunenepa kwambiri komanso kutha msinkhu, kuchuluka kofunikira kungakhale kofunikira. Komanso, kufunika kwa mahomoni kumachepa ndimatenda a hepatic ndi aimpso.

Majakisoni amayenera kuperekedwa kwa theka la ola musanadye zakudya zopatsa mphamvu. Komabe, ndikofunikira kukumbukira kuti ngati mukudumpha chakudya, kupsinjika ndi kuchuluka kwa zochitika zolimbitsa thupi, mlingo uyenera kusinthidwa.

Musanapange mankhwala a insulin, malamulo angapo ayenera kuphunziridwa:

Kuyimitsidwa sikuloledwa kuthandizidwa.
Jakisoni wotsekemera amachitidwa khoma lam'mimba, ntchafu, ndipo nthawi zina mumisempha ya phewa kapena matako.
Lisanayambike, ndikofunikira kuti muchepetse khungu lanu, zomwe zimachepetsa mwayi wosakanikirana womwe umalowetsa minofu.
Muyenera kudziwa kuti ndi jakisoni wa s / c wa insulin m'matupa am'mimba, mayamwidwe ake amachitika mwachangu kuposa momwe mankhwalawo amayamba ndi mankhwala.
Popewa kukula kwa lipodystrophy, tsamba la jakisoni liyenera kusinthidwa pafupipafupi.

Insulin Mikstard m'mabotolo amagwiritsidwa ntchito mwanjira yapadera kukhala ndi maphunziro apadera. Komabe, musanagwiritse ntchito mankhwalawa, poyimitsa mphira uyenera kupulumutsidwa. Kenako botolo liyenera kumetedwa pakati pa manja mpaka madziwo atasanduka ofanana ndi oyera.

Kenako, mpweya wambiri umakokedwa mu syringe, wofanana ndi Mlingo wa insulini womwe umaperekedwa. Mpweya umalowetsedwa mu vial, pambuyo pake singano imachotsedwa, ndipo mpweya umachotsedwa mu syringe. Chotsatira, muyenera kuwunika ngati mlingo unalowetsedwa molondola.

Jakisoni wa insulini umachitika motere: kugwira khungu ndi zala ziwiri, muyenera kulibaya ndikulowetsa yankho lake pang'onopang'ono. Pambuyo pa izi, singano iyenera kumangidwa pansi pakhungu pafupifupi masekondi 6 ndikuchotsedwa. Ngati magazi, tsamba la jekeseni liyenera kukanikizidwa ndi chala chanu.

Ndizofunikira kudziwa kuti mabotolo ali ndi zoteteza za pulasitiki zomwe zimachotsedwa pamaso pa insulin kit.

Komabe, choyamba ndikofunikira kuyang'ana momwe chivundikirocho chimakwanira mwamtsuko, ndipo ngati chikusowa, ndiye kuti mankhwalawo amayenera kubwezeretsedwanso ku pharmacy.

Ndemanga za madokotala ndi odwala matenda ashuga ambiri amabwera poti ndi yosavuta kugwiritsa ntchito Mixtard 30 FlexPen.

Ichi ndi cholembera cha insulin ndi cholembera chosankha, chomwe mutha kuyikamo mlingo kuchokera pa 1 mpaka 60 mayunitsi mukukula kwa gawo limodzi.

Flexpen imagwiritsidwa ntchito ndi singano za NovoFayn S, kutalika kwake kuyenera kukwera mpaka 8 mm. Musanagwiritse ntchito, muyenera kuchotsa kapu kuchokera ku syringe ndikuonetsetsa kuti cartridge ili ndi pafupifupi PISITSI 12 za mahomoni. Kenako, cholembera cha syringe chimayenera kudulilidwa mosamala nthawi 20 mpaka kuyimitsidwa kumakhala kofiyira komanso koyera.

Pambuyo pake, muyenera kuchita izi:

Nembanemba wa rabara amathandizidwa ndi mowa.
Zolemba zachitetezo zimachotsedwa mu singano.
Singano ikuvulala pa Flexpen.
Mpweya umachotsedwa mu cartridge.

Kuti muwonetsetsetsetse kuti mwatulutsa mlingo winawake komanso kuti mpweya usalowe, ndizofunikira zingapo. Magawo awiri amayenera kukhazikitsidwa pa cholembera. Kenako, mutagwira Mikstard 30 FlexPen ndi singano mmwamba, muyenera kukoka mokoma ma cartridge kangapo ndi chala chanu kuti mpweya udziunjikire kumtunda kwake.

Kenako, mutagwira cholembera mu cholembera, sinikizani batani loyambira. Pakadali pano, wosankha wa mankhwalawa atembenukira ku zero, ndipo dontho la yankho lithe kumapeto kwa singano. Izi ngati sizichitika, ndiye kuti muyenera kusintha singano kapena chida chokha.

Choyamba, chosankha cha mtunduwu chimakhazikitsidwa ndi ziro, kenako mlingo womwe umakhazikitsidwa.Ngati wosankhayo atembenuzidwa kuti muchepetse mlingo, ndikofunikira kuyang'anira batani loyambira, chifukwa ngati likhudzidwa, ndiye kuti izi zitha kutsogolera insulin.

Ndikofunikira kudziwa kuti kukhazikitsa mlingo, simungagwiritse ntchito kuchuluka kwa kuyimitsidwa komwe kumatsala. Komanso, mlingo wopitilira kuchuluka kwa zigawo zomwe zatsalira mu cartridge sungathe kukhazikitsidwa.

Mikstard 30 FlexPen imayendetsedwa pansi pa khungu chimodzimodzi ndi Mikstard mu mbale. Komabe, zitatha izi, cholembera cha syringe sichimataya, koma singano yokha ndi yomwe imachotsedwa. Kuti muchite izi, imatsekedwa ndi chipewa chachikulu chakunja ndikuchotsa, ndikuchotsa mosamala.

Chifukwa chake, jakisoni aliyense, muyenera kugwiritsa ntchito singano yatsopano. Kupatula apo, kutentha kukasintha, insulini sitha kutuluka.

Pochotsa ndi kutaya masingano, ndikofunikira kuti mutsatire njira zotetezera kuti opereka chithandizo chamankhwala kapena anthu omwe asamalira odwala matenda ashuga sangawagwire mwangozi. Ndipo chogwiritsa kale cha Spitz chikuyenera kuponyedwa kunja popanda singano.

Kugwiritsa ntchito mankhwala a Mikstard 30 Flexpen kwakanthawi komanso motetezeka, ndikofunikira kuisamalira bwino, ndikuyang'anira malamulo osungira. Kupatula apo, ngati chipangizocho chakhala choperewera kapena kuwonongeka, ndiye kuti insulin ikhoza kutuluka.

Ndizofunikira kudziwa kuti FdeksPen sangadzazidwenso. Nthawi ndi nthawi, mawonekedwe a cholembera amayenera kutsukidwa. Chifukwa chaichi, amapukutidwa ndi ubweya wa thonje wokhazikika mu mowa.

Komabe, musadzoze mafuta, kutsuka, kapena kumiza chida mu ethanol. Kupatula apo, izi zitha kubweretsa kuwonongeka kwa syringe.

Mankhwala osokoneza bongo, kuyenderana kwa mankhwala osokoneza bongo, kusintha kosiyanasiyana

Ngakhale kuti lingaliro la mankhwala osokoneza bongo silipangidwira insulin, nthawi zina hypoglycemia imatha kupanga jakisoni wambiri ndi matenda osokoneza bongo, ndiye kutsika pang'ono kwa shuga mumayenera kumwa tiyi wokoma kapena kudya zomwe zili ndi chakudya. Chifukwa chake, ndikulimbikitsidwa kuti odwala matenda ashuga nthawi zonse azikhala ndi maswiti kapena chidutswa cha shuga.

Mu hypoglycemia yayikulu, ngati wodwalayo sakudziwa, wodwalayo amapakidwa ndi glucagon mu kuchuluka kwa 0,5-1 mg. M'chipatala, njira ya shuga imaperekedwa kwa wodwala wolumikizira, makamaka ngati munthu sakhudzidwa ndi glucagon mkati mwa mphindi 10-15. Popewa kuyambiranso, wodwala amene wayambanso kudziwa ayenera kudya zakudya zamagulu mkati.

Mankhwala ena amakhudza kagayidwe kazakudwala. Chifukwa chake, posankha insulin, izi ziyenera kukumbukiridwa.

Chifukwa chake, zotsatira za insulin zimakhudzidwa ndi:

Mowa, mankhwala a hypoglycemic, salicylates, ACE inhibitors, MaO osasankha B-blockers - amachepetsa kufunikira kwa mahomoni.
B-blockers - zigoba za hypoglycemia.
Danazole, thiazides, mahomoni okula, glucocorticoids, b-sympathomimetics ndi mahomoni a chithokomiro - amalimbikitsa kufunika kwa mahomoni.
Mowa - umakulitsa kapena kuwonjezera zochita za insulin.
Lancreotide kapena Octreotide - ikhoza kuwonjezera ndikuchepetsa mphamvu ya insulin.

Nthawi zambiri, zotsatira zoyipa mutagwiritsa ntchito Mikstard zimachitika ngati mulibe zovuta, zomwe zimabweretsa hypoglycemia ndi zovuta zolimbitsa thupi. Kuchepa kwambiri kwa msinkhu wa shuga kumachitika ndi bongo, komwe kumayendetsedwa ndi kukhudzika, kulephera kudziwa komanso kugwira ntchito kwa ubongo.

Zotsatira zina zoyipa zomwe zimachitika ndi monga kutupa, retinopathy, zotumphukira neuropathy, lipodystrophy ndi zotupa pakhungu.

Kusokonezeka kwa khungu ndi minyewa yodukiza kumathanso kuchitika, ndipo zimachitika zakumalo komwe kumayambitsa jakisoni.

Chifukwa chake lipodystrophy mu shuga imangowoneka pokhapokha wodwala sasintha malo a jakisoni. Zomwe zimachitika m'deralo zimaphatikizapo hematomas, redness, kutupa, kutupira ndi kuyamwa komwe kumachitika m'dera la jakisoni. Komabe, ndemanga za anthu odwala matenda ashuga amati izi zimachitika zokha ndikumapitiliza mankhwala.

Ndizofunikira kudziwa kuti ngati chiwongolero cha glycemic chikukula msanga, wodwalayo atha kudwala kwambiri. Zotsatira zoyipa kwambiri zomwe zimaphatikizidwa ndi anaphylactic kugwedezeka komanso kusokonezeka komwe kumachitika kumayambiriro kwa chithandizo. Komabe, kuwunika kwa odwala ndi madotolo amati izi sizinthu zosakhalitsa komanso zosakhalitsa.

Zizindikiro za hypersensitivity yotchuka ikhoza kukhala limodzi ndi kuperewera kwa chakudya m'mimba, zotupa pakhungu, kufupika, kuyabwa, palpitations, angioedema, kuthamanga kwa magazi komanso kukomoka. Ngati zizindikiro zotere zikuwoneka, muyenera kufunsa dokotala, chifukwa kulandira chithandizo mwadzidzidzi kungayambitse imfa.

Mtengo wa mankhwala a Mikstard 30 NM ndi pafupi ma ruble 660. Mtengo wa Mikstard Flexpen ndiwosiyana. Chifukwa chake, ma cholembera a syringe amawononga ndalama kuchokera ma ruble 351, ndi makatoni kuchokera 17 rubles.

Ma fanizo odziwika bwino a insulin ya biphasic ndi: Bioinsulin, Humodar, Gansulin ndi Insuman. Mikstard iyenera kusungidwa pamalo amdima osaposa zaka 2.5.

Kanemayo munkhaniyi akuwonetsa njira yoyendetsera insulin.

Gulu la ATX: A10AD01 Insulin (munthu)
Mnn kapena dzina la gulu: Insulin ya Anthu
Gulu lamagulu:
Wopanga: Wosadziwika
Mwini Mlangizi: Osadziwika
Dziko: Osadziwika

Malangizo azachipatala

mankhwala

Mikstard® 30 NM

Dzina la malonda

Dzinalo Lopanda Padziko Lonse

Mlingo

Kuyimitsidwa kwa kayendetsedwe ka subcutaneous, 100 IU / ml

Kupanga

1 ml ya mankhwala ali

ntchito yogwira - genetically opanga insulin ya anthu 3.50 mg (100 IU) 1,

zokopa: zinc chloride, glycerin, phenol, metacresol, sodium hydrogen phosphate dihydrate, protamine sulfate, hydrochloric acid 2 M yankho, sodium hydroxide 2 M yankho, madzi a jekeseni.

1 Mankhwalawa ali ndi 30% sungunuka wa anthu komanso 70% isofan-insulin

Kufotokozera

Kuyimitsidwa koyera, pakuyimilira, kumapangidwa kukhala chinthu chowonekera, chopanda utoto kapena chosawoneka bwino komanso choyera. Mtengo umasinthidwa mosavuta ndikugwedezeka modekha.

Gulu la Pharmacotherapeutic

Insulin ndi analogues, sing'anga zochita limodzi ndi insulin.

Khodi ya PBX A10AD01

Mankhwala

Pharmacokinetics

Kuzindikira kwakukulu (C_max) insulin ya plasma imafikiridwa mkati mwa 1.5 - maola 2,5 pambuyo povomerezeka.

Palibe zomangamanga zomanga mapuloteni a plasma zimadziwika, kupatulapo ma antibodies a insulin (ngati alipo).

Hafu ya moyo (T½) imatsimikiziridwa ndi kuchuluka kwa kuyamwa kuchokera kuzinthu zowoneka bwino. Chifukwa chake T_½ m'malo mwake, ndi gawo la mayamwidwe, ndipo osati makamaka muyeso wochotsa insulini kuchokera ku plasma (T_½ insulin yochokera m'magazi ndi mphindi zochepa chabe). Kafukufuku wasonyeza kuti T_½ pafupifupi maola 5-10.

Mankhwala

Mphamvu ya mankhwalawa Mikstard® 30 NM imayamba mkati mwa theka la ola pambuyo pa kutsata, ndipo mphamvu yakeyo imawonekera mkati mwa maola 2-8, pomwe nthawi yonseyi ikuchitika pafupifupi maola 24.

Zizindikiro zogwiritsidwa ntchito

- chithandizo cha matenda ashuga

Mlingo ndi makonzedwe

Kukonzekera kwa insulin kophatikizidwa nthawi zambiri kumaperekedwa kamodzi kapena kawiri pa tsiku ngati kuphatikiza koyambirira ndi zotsatira zazitali zimafunikira.

Mankhwalawa umaperekedwa kwa mphindi 30 asanadye kapena chakudya.

Kwa subcutaneous makonzedwe. Palibe chifukwa chilichonse ngati insulin kuyimitsidwa iyenera kuperekedwa. Mikstard ® 30 NM nthawi zambiri imayendetsedwa mwachisawawa m'chigawo cha khoma 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. Kupanga jakisoni pakhungu kumachepetsa chiopsezo cholowera minofu. Ndikofunikira nthawi zonse kusintha malo a jekeseni mkati mwa anatomical dera kuti muchepetse chiopsezo cha lipodystrophy.

Malangizo ogwiritsira ntchito Mikstard® 30 NM, omwe ayenera kuperekedwa kwa wodwala.

Musagwiritse ntchito Mikstard® 30 NM:

M'mapampu a insulin.
Ngati pali ziwengo (hypersensitivity) kwa insulin ya anthu kapena chilichonse chomwe chimapanga kukonzekera kwa Mikstard® 30 NM.
Ngati hypoglycemia imayamba (shuga m'magazi).
Ngati insulin sinasungidwe bwino, kapena ngati yauma
Ngati kapu yodzitchinjiriza ikusowa kapena yatayidwa. Bokosi lirilonse limakhala ndi kapu pulasitiki yoteteza.
Ngati insulin singakhale yoyera komanso yamtambo mutasakaniza.

Musanagwiritse ntchito Mikstard® 30 Nm:

Chongani cholembera kuti muwonetsetse kuti mukugwiritsa ntchito mtundu woyenera wa insulin.
Chotsani chophimba.

Momwe mungagwiritsire ntchito mankhwala Mikstard® 30 NM

Onetsetsani kuti mukugwiritsa ntchito syringe wa insulin pomwe muyeso umagwiritsidwa ntchito poyesa kuchuluka kwa zochita.
Jambulani mpweya mu syringe muyezo wogwirizana ndi insulin yomwe mukufuna.
Mukangomwa kumwa mankhwalawo, gubuduzani pakati pa manja anu mpaka insuliniyo ikhale yoyera komanso yamitambo. Kupatsanso mphamvu kumathandizidwa ngati mankhwalawo ali ndi kutentha kwa chipinda.
Lowani insulin pansi pa khungu.
Gwirani singano pansi pakhungu kwa mphindi zosachepera 6 kuti muwonetsetse kuti mulingo wa insulin umayendetsedwa kwathunthu.

Zotsatira zoyipa zomwe zimawoneka mu odwala munthawi ya mankhwala a Mikstard® 30 NM zimadalira mlingo wa mankhwala ndipo zimachitika chifukwa cha mankhwala a insulin.

Dzinalo: Mikstard 30 NM Penfill (Mixtard 30 HM Penfill)

Kutulutsa mawonekedwe, kapangidwe kake ndi paketi

Kuyimitsidwa kwa sc makonzedwe a 1 ml osakaniza sungunuka wa munthu ndi kuyimitsidwa kwa isofan insulin 100 IU insulin yaumunthu 30% isofan insulin kuyimitsidwa kwa 70%.

Gulu lamagulu azachipatala: Insulin yaumunthu ya nthawi yayitali.

Mikstard 30 NM Penfill ndi kuyimitsidwa kwa biosynthetic human isofan insulin ya biphasic kanthu. Kukhazikika kwa chochitika kumachitika pambuyo pa mphindi 30 pambuyo povomerezeka. Kuchuluka kwake kumachitika pakati pa maola awiri ndi maola 8. Kutalika kwa zochita kumakhala mpaka maola 24. Mbiri ya insulini imachitika: zimatengera muyeso wa chinthucho ndikuwonetsa mikhalidwe yake.

The mayamwidwe a insulin ndipo, monga chotsatira, hypoglycemic zotsatira, zimatengera malo jakisoni (pamimba, ntchafu, matako), jakisoni kuchuluka, insulin ndende ndi zina zina. M'magazi, T1 / 2 ya insulin ndi mphindi zochepa.

Chifukwa chake, mbiri ya insulin imadalira makamaka kuchuluka kwa kuyamwa kwake. Pali zinthu zambiri zomwe zimapangitsa izi, chifukwa chomwe kusiyana kwakukulu kumatheka. Mukasintha kuchokera ku insulin kuchuluka kwa 40 PIECES / ml mpaka 100 PIECES / ml, kusintha kochepa pa mayankho a insulin chifukwa cha kuchuluka kochepa kumalipiridwa ndi kuchuluka kwake.

Ndikofunika kugwiritsa ntchito insulin za biphasic zokhala ndi njira yokhazikika ya matenda ashuga.

Mawu Ogwiritsira Ntchito Cartridge

Malangizo a Penfill and Product

Musanalowetse cartridge ya Penfill mu cholembera, iyenera kugwedezeka pansi ndi pansi. Kusunthaku kuyenera kuchitidwa mwanjira yoti galasi lagalasi mu cartridge lisunthi kuchokera kumbali ina kupita kwina. Kudzimbidwa kumeneku kuyenera kubwerezedwa kangapo ka 10 - mpaka madziwo atakhala oyera ndi yunifolomu.

Ngati makatiriji a Penfill adalowetsedwa kale mu cholembera, bwerezani njira yosakanikiranayi musanabaye chilichonse. Pambuyo jakisoni, singano imayenera kukhalabe pansi pakhungu kwa masekondi 6 osachepera. Chingwe cha syringe chikuyenera kusungidwa mpaka singano itachotsedwa kwathunthu pakhungu. Pakapita jakisoni aliyense, singano imayenera kuchotsedwa nthawi yomweyo. Makatoni a Penfill ndi ogwiritsa ntchito nokha. Makatoni a Penfill angagwiritsidwe ntchito mu cholembera cha NovoPen 3, cholembera mu Innovo kapena kunyamula nanu mwezi umodzi. Cartridge ikayikidwa mu cholembera cha syvoge ya NovoPen 3, cholembera chamtundu uyenera kuwonekera kudzera pazenera la chosungira.

Zotsatira zoyipa zomwe zimakhudzana ndi kagayidwe kazachilengedwe: michere ya hypoglycemic (pallor, kutuluka thukuta, palpitations, mavuto ogona, kugwedezeka).

Thupi lawo siligwirizana: osati zambiri - zotupa pakhungu, kawirikawiri - angioedema. Zomwe zimachitika mdelalo: osati pafupipafupi - Hyperemia ndi kuyabwa pamalo opaka jekeseni wa mankhwala, ndikugwiritsa ntchito nthawi yayitali - lipodystrophy pamalo opangira jekeseni.

Mimba komanso kuyamwa

Pa nthawi yoyembekezera komanso mkaka wa m`mawere, kufunika kwa wodwala kusintha kwa insulin, komwe kuyenera kukumbukiridwa kuti azitha kuyang'anira kagayidwe kachakudya. Insulin siyidutsa chotchinga. Mukamagwiritsa ntchito mankhwala a Mikstard 30 NM Penfill panthawi yotseka, palibe chiopsezo kwa mwana.

Odwala omwe amalandila insulini yoposa 100 ya insulin patsiku amayenera kupita kuchipatala posintha mankhwalawo. Kusintha kuchokera ku mtundu wina wa insulin kupita ku wina kuyenera kuchitika mothandizidwa ndi misempha yamagazi. Mothandizidwa ndi insulin, kulekerera mowa kumachepa.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Wodwala akangosamutsira insulin yaumunthu, kuthekera kuyendetsa galimoto ndi kuchita zinthu zina zoopsa zomwe zimafuna kuwonjezeredwa mwachangu komanso kuthamanga kwa zochitika zama psychomotor kungawononge kwakanthawi.

Zizindikiro: zizindikiro zoyambirira za hypoglycemia - kuchuluka kwambiri thukuta, palpitations, kugwedeza, njala, kukwiya, paresthesia mkamwa, pallor, mutu, kugona tulo. Woopsa milandu bongo - chikomokere.

Chithandizo: wodwalayo amatha kuthetsa hypoglycemia wofatsa pogwiritsa ntchito shuga kapena shuga. Woopsa milandu, subcutaneous kapena intramuscularly kutumikiridwa 1 mg wa glucagon. Ngati ndi kotheka, chithandizo cha mankhwala chimapitilizidwa iv ndikukhazikitsa njira zothetsera dextrose.

Zotsatira za hypoglycemic za insulin zimapangidwira ndi ma inhibitor a MAO, osankha-beta-blockers, sulfonamides, anabolic steroids, tetracyclines, clofibrate, cyclophosphamide, fenfluramine, ndi zinthu zomwe zimakhala ndi ethanol.

Kulera kwapakamwa, glucocorticoids, mahomoni a chithokomiro, thiazide diuretics, heparin, mankhwala a lithiamu, ma tridclic antidepressants amachepetsa mphamvu ya insulin. Mothandizidwa ndi reserpine ndi salicylates, onse ofooketsa ndikuwonjezera zochita za insulin ndizotheka.

Ethanol, mankhwala ophera majakisoni amatha kuchepetsa zochita za insulin.

Malo osungira ndi nthawi

Makatoni okhala ndi penfill ayenera kusungidwa mu paketi pamalo otetezedwa ndi dzuwa kutentha kwa 2 ° mpaka 8 ° C, osazizira.

Makatoni a Penfill omwe adagwiritsidwa ntchito samalimbikitsa kuti asungidwe mufiriji.

Yang'anani!
Musanagwiritse ntchito mankhwalawa "Mixtard 30 NM Penfill" ndikofunikira kukaonana ndi dokotala.
Malangizowo amaperekedwa kuti mudziwe nokha " Mikstard 30 NM Penfill (Mixtard 30 HM Penfill)».

Kukonzekera: MIXTARD ® 30 Nm PENFill ® (MIXTARD ® 30 HM PENFill ®)

The yogwira pophika: biphasic isophane insulin
Code ya ATX: A10AD01
KFG: Insulin Yapakatikati Yapakati pa Anthu
Nambala za ICD-10 (Zizindikiro): E10, E11
Reg. chiwerengero: P No. 014312 / 02-2003
Tsiku lolembetsa: 06.16.03
Mwini reg. ID.: NOVO NORDISK (Denmark)

FOMU YA DOSAGE, KULIMA NDI KUSANGALATSA

3 ml - makatoni (5) a cholembera cha syvoge ya NovoPen - ma CD a ma CD (1) - makatoni.

MALANGIZO OGULITSIRA NTCHITO MALANGIZO.
Kufotokozera za mankhwala omwe adavomerezedwa ndi wopanga mu 2004

MUTU WA PHARMACOLOGICAL

Mikstard 30 NM Penfill ndi kuyimitsidwa kwa biosynthetic human isofan insulin ya biphasic kanthu. Kukhazikika kwa mphindi 30 pambuyo pakuyendetsa makina. Kuchuluka kwa zochita kumachitika pakati pa maola awiri ndi maola 8. Kutalika kwa nthawi mpaka maola 24.

Mbiri yamachitidwe a insulin ndi pafupifupi: zimatengera mlingo wa mankhwalawo ndikuwonetsa mikhalidwe yake.

PHARMACOKINETICS

The mayamwidwe a insulin ndipo, monga chotsatira, hypoglycemic zotsatira, zimatengera malo jakisoni (pamimba, ntchafu, matako), jakisoni kuchuluka, insulin ndende ndi zina zina.

M'magazi T_1/2 insulin ndi mphindi zochepa. Chifukwa chake, mbiri ya insulin imadalira makamaka kuchuluka kwa kuyamwa kwake. Pali zinthu zambiri zomwe zimapangitsa izi, chifukwa chomwe kusiyana kwakukulu kumatheka.

Mukasintha kuchokera ku insulin kuchuluka kwa 40 PIECES / ml mpaka 100 PIECES / ml, kusintha kochepa pa mayankho a insulin chifukwa cha kuchuluka kochepa kumalipiridwa ndi kuchuluka kwake.

ZITHUNZI

- wodwala matenda a shuga ogwirizana ndi insulin (mtundu I),

- osagwirizana ndi insulin - wodwala matenda a shuga (mtundu II): gawo la kukana kwa othandizira am'magazi a hypoglycemic, kukana pang'ono kwa mankhwalawa (panthawi yophatikiza mankhwalawa), matenda omwewo, ntchito, pakati.

CHITSANZO CHA DOSAGE

Ndikofunika kugwiritsa ntchito insulin za biphasic zokhala ndi njira yokhazikika ya matenda ashuga. Ndi mankhwala osokoneza bongo a shuga omwe amadalira insulin, monga lamulo, gwiritsani ntchito Mikstard 30 NM Penfill.

Mlingo wa mankhwala a Mikstard 30 NM Penfill ndi dokotala aliyense payekhapayekha. Mankhwalawa amaperekedwa mosavuta. Pambuyo pa jakisoni, singano imayenera kukhalabe pansi pakhungu kwa masekondi asanu ndi limodzi, omwe amatsimikizira kuti pali mlingo wokwanira.

Mukasamutsa wodwala kuchokera ku nkhumba yotsukidwa kwambiri kapena insulin ya anthu kupita ku Mikstard 30 NM Penfill, mlingo wa mankhwalawo amakhalabe womwewo.

Mukasamutsa wodwala kuchokera ku ng'ombe kapena insulin yosakanikirana ku Mikstard 30 NM Penfill, mlingo wa insulin nthawi zambiri umachepetsedwa ndi 10%, pokhapokha ngati koyamba mlingo wake ndi wochepera 0,6 U / kg pa thupi.

Pa mlingo wa tsiku ndi tsiku wopitilira 0.6 PIECES / kg wa kulemera kwa thupi, insulin iyenera kuperekedwa ngati jakisoni 2 m'malo osiyanasiyana.

Malamulo ogwiritsira ntchito karata ya Penfill ndi kayendetsedwe ka mankhwala

Musanagwiritse ntchito, onetsetsani kuti palibe chowonongeka cha cartfill cartridge. Penfill sagwiritsidwa ntchito ngati pali zowonongeka zowoneka kapena ngati kupingasa kwa gawo looneka la piston ya rabara ndikokulirapo kuposa kupyola kwa Mzere Woyera. Musanalowetse cartridge ya Penfill mu cholembera, iyenera kugwedezeka pansi ndi pansi. Kusuntha kuyenera kupangidwa kotero kuti galasi lagalasi mu cartridge limasuntha kuchokera mbali ina kupita kumbali ina. Kudzimbidwa kumeneku kuyenera kubwerezedwa kangapo ka 10 - mpaka madziwo atakhala oyera ndi yunifolomu. Ngati makatiriji a Penfill adalowetsedwa kale mu cholembera, bwerezani njira yosakanikiranayi musanabaye chilichonse. Pambuyo pa jekeseni, singano imayenera kukhalabe pansi pakhungu kwa masekondi 6 osachepera. Chingwe cha syringe chikuyenera kusungidwa mpaka singano itachotsedwa kwathunthu pakhungu. Pakapita jakisoni aliyense, singano imayenera kuchotsedwa nthawi yomweyo.

Makatoni a Penfill ndi ogwiritsa ntchito nokha.

Makatoni a Penfill angagwiritsidwe ntchito polemba NovoPen 3, cholembera cha Innovo kapena cholembera limodzi kwa mwezi umodzi.

Cartridge ikayikidwa mu cholembera cha syvoge ya NovoPen 3, chingwe chokongola chikuyenera kuwonekera kudzera pazenera la cholembera.

ZOTHANDIZA ZONSE

Zotsatira zoyipa zomwe zimakhudza kagayidwe kazakudya: machitidwe a hypoglycemic (pallor, thukuta lomwe limachulukirachulukira, zovuta za kugona, kugwedezeka).

Zotsatira zoyipa: kawirikawiri - zotupa pakhungu, zosowa kwambiri - angioedema.

Zomwe zimachitika: kawirikawiri - hyperemia ndi kuyabwa pa jekeseni wa mankhwalawa, ndikugwiritsa ntchito nthawi yayitali - lipodystrophy pamalo opangira jekeseni.

MALANGIZO OTHANDIZA

KULAMBIRA NDI KUDZIPEREKA

Pa nthawi yoyembekezera komanso mkaka wa m`mawere, kufunika kwa wodwala kusintha kwa insulin, komwe kuyenera kukumbukiridwa kuti azitha kuyang'anira metabolic yoyenera.

Insulin siyidutsa chotchinga.

Mukamagwiritsa ntchito mankhwala a Mikstard 30 NM Penfill pa mkaka wa m`mawere, palibe ngozi kwa mwana.

MALANGIZO OTHANDIZA

Odwala omwe amalandira insulin yoposa 100 ya insulin patsiku amayenera kupita kuchipatala posintha mankhwalawa.

Kusintha kuchokera ku mtundu wina wa insulin kupita ku wina kuyenera kuchitika mothandizidwa ndi misempha yamagazi.

Mothandizidwa ndi insulin, kulekerera mowa kumachepa.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

CHONCHO

Zizindikiro woyamba zizindikiro za hypoglycemia - kuchuluka thukuta, palpitations, kugwedeza, njala, kukwiya, paresthesia mkamwa, pallor, mutu, kugona tulo. Woopsa milandu bongo - chikomokere.

Chithandizo: wodwalayo amatha kuthetsa hypoglycemia wofatsa mwa kudya shuga kapena zakudya zokhala ndi shuga. Woopsa milandu, subcutaneous kapena intramuscularly kutumikiridwa 1 mg wa glucagon. Ngati ndi kotheka, chithandizo cha mankhwala chimapitilizidwa iv ndikukhazikitsa njira zothetsera dextrose.

KUGWIRITSA NTCHITO

Zotsatira za hypoglycemic za insulin zimapangidwira ndi ma inhibitors a MAO, osagwiritsa ntchito beta-blockers, sulfonamides, anabolic steroids, tetracyclines, clofibrate, cyclophosphamide, fenfluramine, ndi kukonzekera komwe kumakhala ndi ethanol.

Kulera kwapakamwa, glucocorticoids, mahomoni a chithokomiro, thiazide diuretics, heparin, kukonzekera kwa lifiyamu, antidepressants tricyclic amachepetsa mphamvu ya insulin.

Mothandizidwa ndi reserpine ndi salicylates, onse ofooketsa ndikuwonjezera zochita za insulin ndizotheka.

Ethanol, mankhwala ophera majakisoni amatha kuchepetsa zochita za insulin.

PHARMACY HOLIDAY MALANGIZO

Mankhwala ndi mankhwala.

MITU YA NKHANI NDI ZOTHANDIZA ZA STORAGE

Makatoni olowera penitill amayenera kusungidwa phukusi, pamalo otetezedwa ndi dzuwa kutentha kwa 2 ° mpaka 8 ° C, osazizira. Makatoni a Penfill omwe adagwiritsidwa ntchito samalimbikitsa kuti asungidwe mufiriji.

Mazovetsky A.G., Velikov V.K. Matenda a shuga, Mankhwala -, 1987. - 288 p.
Tsonchev Laboratory diagnostic matenda amisempha / Tsonchev, ena V. ndi. - M.: Sofia, 1989 .-- 292 p.
Daeidenkoea E.F., Liberman I.S. Mitundu ya matenda ashuga. Leningrad, yosindikiza nyumba "Mankhwala", 1988, 159 mas.

Ndiloleni ndidziwitse. Dzina langa ndi Elena. Ndakhala ndikugwira ntchito ya endocrinologist kwa zaka zoposa 10. Ndikukhulupirira kuti pakadali pano ndili katswiri pantchito yanga ndipo ndikufuna kuthandiza alendo onse omwe amapezeka pamalowo kuti athetse zovuta osati ntchito. Zinthu zonse za tsambalo amazisonkhanitsa ndikuzikonza mosamala kuti athe kufotokoza zambiri zofunikira. Musanagwiritse ntchito zomwe zikufotokozedwa pa webusaitiyi, kufunsana ndi akatswiri ndizofunikira nthawi zonse.

Malangizo ogwiritsira ntchito mankhwalawa

Musanapange mankhwala a insulin, malamulo angapo ayenera kuphunziridwa:

Kuyimitsidwa sikuloledwa kuthandizidwa.
Jakisoni wotsekemera amachitidwa khoma lam'mimba, ntchafu, ndipo nthawi zina mumisempha ya phewa kapena matako.
Lisanayambike, ndikofunikira kuti muchepetse khungu lanu, zomwe zimachepetsa mwayi wosakanikirana womwe umalowetsa minofu.
Muyenera kudziwa kuti ndi jakisoni wa s / c wa insulin m'matupa am'mimba, mayamwidwe ake amachitika mwachangu kuposa momwe mankhwalawo amayamba ndi mankhwala.
Popewa kukula kwa lipodystrophy, tsamba la jakisoni liyenera kusinthidwa pafupipafupi.

Ndizofunikira kudziwa kuti mabotolo ali ndi zoteteza za pulasitiki zomwe zimachotsedwa pamaso pa insulin kit.

Komabe, choyamba ndikofunikira kuyang'ana momwe chivundikirocho chimakwanira mwamtsuko, ndipo ngati chikusowa, ndiye kuti mankhwalawo amayenera kubwezeretsedwanso ku pharmacy.

Mikstard 30 Flexpen: malangizo ogwiritsira ntchito

Ndemanga za madokotala ndi odwala matenda ashuga ambiri amabwera poti ndi yosavuta kugwiritsa ntchito Mixtard 30 FlexPen.

Ichi ndi cholembera cha insulin ndi cholembera chosankha, chomwe mutha kuyikamo mlingo kuchokera pa 1 mpaka 60 mayunitsi mukukula kwa gawo limodzi.

Pambuyo pake, muyenera kuchita izi:

Nembanemba wa rabara amathandizidwa ndi mowa.
Zolemba zachitetezo zimachotsedwa mu singano.
Singano ikuvulala pa Flexpen.
Mpweya umachotsedwa mu cartridge.

Choyamba, chosankha cha mtunduwu chimakhazikitsidwa ndi ziro, kenako mlingo womwe umakhazikitsidwa. Ngati wosankhayo atembenuzidwa kuti muchepetse mlingo, ndikofunikira kuyang'anira batani loyambira, chifukwa ngati likhudzidwa, ndiye kuti izi zitha kutsogolera insulin.

Chifukwa chake, jakisoni aliyense, muyenera kugwiritsa ntchito singano yatsopano. Kupatula apo, kutentha kukasintha, insulini sitha kutuluka.

Ndizofunikira kudziwa kuti FdeksPen sangadzazidwenso. Nthawi ndi nthawi, mawonekedwe a cholembera amayenera kutsukidwa.Chifukwa chaichi, amapukutidwa ndi ubweya wa thonje wokhazikika mu mowa.

Komabe, musadzoze mafuta, kutsuka, kapena kumiza chida mu ethanol. Kupatula apo, izi zitha kubweretsa kuwonongeka kwa syringe.

Kuyanjana ndi mankhwala ena ndi mitundu ina yoyanjana

Monga mukudziwa, mankhwalawa amakhudza kagayidwe kakang'ono ka glucose.

Mankhwala omwe angachepetse insulin

Oral hypoglycemic agents (PSS), monoamine oxidase inhibitors (MAO), osasankha b-blockers, ACE inhibitors (ACE), salicylates, anabolic steroids ndi sulfonamides.

Mankhwala omwe angakulitse kufunikira kwa insulin

Kulera kwapakamwa, thiazides, glucocorticoids, mahomoni a chithokomiro, sympathomimetics, kukula kwa mahomoni ndi danazole.

adrenergic blockers amatha kuphimba zizindikiro za hypoglycemia ndikuchepetsa kuchira pambuyo pa hypoglycemia.

Octreotide / lanreotide imachepetsa ndikuwonjezera kufunika kwa insulin.

Mowa ungapangitse kapena kuchepetsa mphamvu ya insogulin.

Zolemba ntchito

Kusakwanira dosing kapena kusiya kulandira chithandizo (makamaka ndi matenda a shuga a mtundu wa I) kungayambitse hyperglycemia ndi matenda ashuga ketoacidosis. Nthawi zambiri, zizindikiro zoyambirira za hyperglycemia zimayamba pang'onopang'ono kwa maola angapo kapena masiku. Amaphatikizaponso ludzu, kukokana pafupipafupi, kusanza, kusanza, kugona komanso kuyanika pakhungu, pakamwa pouma, kusowa chilakolako cha chakudya, komanso kununkhira kwa acetone mumlengalenga.

Mtundu woyamba wa matenda a shuga, a hyperglycemia, omwe samathandizidwa, amatsogolera ku matenda ashuga a ketoacidosis, omwe mwina ndi omwe amapha.

Hypoglycemia zitha kuchitika ngati mlingo wa insulin ndiwokwera kwambiri poyerekeza ndi kufunika kwa insulin. Pankhani ya hypoglycemia kapena ngati hypoglycemia ikukayikira, musamwe mankhwalawo.

Kudumpha zakudya kapena kuchita masewera olimbitsa thupi mosayembekezereka kungayambitse hypoglycemia.

Odwala omwe atukula kwambiri kuchuluka kwa shuga m'magazi chifukwa chokhudza insulin yokwanira amatha kuwona kusintha kwa chizolowezi chawo, okhazikika a hypoglycemia, omwe ayenera kuchenjezedwa pasadakhale.

Zizindikiro zachilendo zimatha kutha kwa odwala omwe ali ndi matenda ashuga a nthawi yayitali.

Comorbidities, makamaka matenda ndi nthenga, zimakulitsa kufunika kwa insulini. Matenda obwera ndi impso, chiwindi, gland wa adrenal, gland pituitary, gland ya chithokomiro chitha kupangitsa kuti masinthidwe a insulin alowe. Wodwala akapatsidwa mtundu wina wa insulin, zizindikiro za hypoglycemia zimatha kusintha kapena kuyamba kutchulidwa.

Kusamutsa wodwala kupita ku mtundu wina kapena mtundu wa insulin kumachitika moyang'aniridwa ndi achipatala. Kusintha kwa ndende, mtundu (wopanga), mtundu, magwero a insulin (yaumunthu kapena analog ya insulin ya anthu) ndi / kapena njira yopangira ingapangitse kusintha kwa insulin. Odwala omwe amasamutsidwa ku Mikstard ® 30 NM ndi mtundu wina wa insulin angafunike kuchuluka kwa jakisoni tsiku ndi tsiku kapena kusintha kwa mulingo poyerekeza ndi insulin yomwe amagwiritsa ntchito kale. Kufunika kochita kusankha kwa mankhwalawa kumatha kuchitika pakukhazikitsa mankhwala atsopano, komanso pakubwera milungu ingapo kapena miyezi ingapo yogwiritsidwa ntchito.

Mukamagwiritsa ntchito mankhwala aliwonse a insulini, zimachitika mu jakisoni wa jekeseni, zomwe zingaphatikizepo kupweteka, kufiyira, kuyamwa, ming'oma, kutupa, kufinya, ndi kutupa.

Insulin kuyimitsidwa sayenera kugwiritsidwa ntchito insulin mapampu kwa insulin.

Kuphatikiza kwa thiazolidinediones ndi mankhwala a insulin

Pamene thiazolidinediones amagwiritsidwa ntchito limodzi ndi insulin, milandu yovuta ya mtima yanenedwa, makamaka kwa odwala omwe ali pachiwopsezo cha mtima wosweka. Izi ziyenera kuganiziridwa popereka mankhwala ndi mankhwala a thiazolidatediones ndi insulin. Ndi kuphatikiza kwa mankhwalawa, odwala ayenera kuyang'aniridwa ndi dokotala kuti apangitse zizindikiro ndi zizindikiro za mtima wosakhazikika, kuchuluka kwa kulemera komanso kupezeka kwa edema. Pakakhala kuwonongeka mu ntchito ya mtima, mankhwalawa ndi thiazolidatediones ayenera kusiyidwa.

Okalamba okalamba (> wazaka 65).

Mankhwala a Mikstard® 30 NM angagwiritsidwe ntchito mwa odwala okalamba.

Mwa odwala okalamba, kuwunika kwa glucose kuyenera kulimbikitsidwa ndi mlingo wa insulin payokha ikusinthidwa.

Kulephera kwamkati ndi chiwindi.

Kulephera kwa renal ndi hepatic kumatha kuchepetsa kufunika kwa insulin. Odwala omwe ali ndi vuto laimpso komanso kwa hepatic, kuwunika kwa shuga kuyenera kulimbikitsidwa komanso mlingo wa insulin payokha.

Gwiritsani ntchito pa nthawi yoyembekezera kapena mkaka wa m'mawere .

Popeza insulin siyidutsa chotchinga, palibe malire ku chithandizo cha matenda ashuga omwe ali ndi insulin panthawi yapakati.

Kufunika kwa insulin nthawi zambiri kumachepa mu trimester yoyamba ya kutenga pakati ndikuwonjezeka kwambiri kwachiwiri ndi kwachiwiri

Pambuyo pobadwa, kufunikira kwa insulin kumabweza msanga.

Palibenso zoletsa zina pa matenda a matenda a shuga ndi insulin panthawi yoyamwitsa, popeza chithandizo cha mayi sichikhala pachiwopsezo chilichonse kwa mwana. Komabe, zingakhale zofunikira kusintha mlingo wa mankhwala ndi / kapena chakudya cha mayi.

Maphunziro owonetsa poizoni a nyama pogwiritsa ntchito insulin ya anthu

sanawonetse vuto lililonse chonde.

Kutha kukopa momwe zinthu zikuyendera mukamayendetsa magalimoto kapena njila zina.

Kuyankha kwa wodwalayo komanso kuthekera kwake kochita chidwi kukhoza kukhala ndi vuto la hypoglycemia.

Izi zimatha kukhala pangozi pazochitika zomwe luso ili ndilofunika kwambiri (mwachitsanzo, poyendetsa galimoto kapena makina).

Odwala ayenera kulangizidwa kuti azichita zinthu zoteteza hypoglycemia musanayendetse. Izi ndizofunikira kwambiri kwa odwala omwe afooka kapena kulibe zizindikiro za kutsogola kwa hypoglycemia kapena zochitika za hypoglycemia zimachitika pafupipafupi. Zikatero, kuyendetsa bwino kuyenera kuyesedwa.

Kupanga ndi mawonekedwe a kumasulidwa

1 ml ya kuyimitsidwa kwa jakisoni uli ndi biosynthet insulin 100 IU (sungunuka insulin 30% ndi isofan-insulin kuyimitsidwa 70%), mu 3 ml Penfill makatoni ogwiritsira ntchito ndi phula la NovoFen 3 insulin komanso singano za NovoFine ntchito mu NovoPen kapena NovoPen II syringe pensulo, mu chithuza paketi ya ma 5 ma PC. kapena m'mabotolo a 10 ml.

Zotsatira zoyipa

Zotsatira zoyipa zambiri za mankhwala ndi hypoglycemia. Malinga ndi kafukufuku wazachipatala, komanso deta yakugwiritsira ntchito mankhwalawa atamasulidwa pamsika, kuchuluka kwa hypoglycemia kumasiyana m'magulu osiyanasiyana a odwala, omwe ali ndi mitundu yosiyanasiyana ya mankhwalawa komanso kuchuluka kwa kayendetsedwe ka glycemic (onani. Chidziwitso pansipa).

Kumayambiriro kwa mankhwala a insulin, zolakwika zotupa, edema ndi zochita ku malo a jakisoni (kupweteka, redness, urticaria, kutupa, kufinya, kutupa ndi kuyabwa pamalowo jekeseni) zitha kuonedwa. Izi zimachitika nthawi zambiri. Kusintha kwachilengedwe pakuwongolera shuga m'magazi kungayambitse kusintha kwakukulu kwamitsempha yam'mimba.

Kusintha kwakanthawi kwamayendedwe a glycemic chifukwa cha kukulitsa kwa mankhwala a insulini kungayende limodzi ndi kufalikira kwakanthawi kwa matenda ashuga, pomwe kuwongolera kwakanthawi kokhazikika kwa matenda a glycemic kumachepetsa chiopsezo cha kupitirira kwa matenda ashuga a retinopathy.

Malinga ndi kafukufuku wazachipatala, zotsatirazi ndizotsatira zoyipa zomwe zimayikidwa pafupipafupi ndi magulu opanga ziwalo malinga ndi MedDRA.

Malinga ndi pafupipafupi zomwe zimachitika, izi zimagawidwa m'magawo azomwe zimachitika nthawi zambiri (≥1 / 10), nthawi zambiri (≥1 / 100 mpaka 1/1000 kuti 1/10000 mpaka ® 30 NM iyenera kusungidwa mufiriji pamtunda wa 2 - 8 ° C (osayandikira kwambiri mufiriji). Osamawuma.

Sungani choyikiratu choyambirira kwa ana.

Pewani kutentha kapena dzuwa.

Bokosi lirilonse limakhala ndi kapu pulasitiki wokhala ndi utoto. Ngati kapu ya pulasitiki yotetezeka sikokwanira kapena ikasowa, botolo liyenera kubwezerezedwanso ku mankhwala.

Mbale Mikstard ® 30 NM yomwe imagwiritsidwa ntchito siyenera kusungidwa mufiriji. Zitha kusungidwa m'chipinda chochepera (osati kupitirira 25 ° C) kwa milungu 6 mutatsegula kapena kwa masabata 5 pa kutentha kosaposa 30 ° C.

Kukonzekera kwa insulini komwe kwawuma sikuyenera kugwiritsidwa ntchito.

Osagwiritsa ntchito insulin pambuyo pake kumaliza ntchito kusindikiza phukusi.

Mikstard® 30 NM siyenera kugwiritsidwa ntchito ngati, mutangophatikiza zomwe zili mundime, madziwo samasanduka oyera komanso kwamitambo.

Zotsatira za pharmacological

Amalumikizana ndi membrane membrane wa plasma ndikulowa mu cell, momwe imayambitsa phosphorylation ya mapuloteni am'magazi, imalimbikitsa glycogen synthetase, pyruvate dehydrogenase, hexokinase, inhibits minofu ya lipip ndi lipoprotein lipase. Kuphatikiza ndi cholandilira china chake, chimathandizira kulowa kwa glucose m'maselo, kumathandizira kukoka kwake ndi minofu ndikulimbikitsa kutembenuka kukhala glycogen. Kuchulukitsa minofu ya glycogen, kumapangitsa kaphatikizidwe ka peptide.

Njira zopewera kupewa ngozi

Makatoni a Penfill ndi ogwiritsa ntchito nokha. Pambuyo jekeseni osachepera 6 s, singano imayenera kukhalabe pansi pa khungu pakumwa zonse. Tiyenera kukumbukira kuti kuthekera kuyendetsa galimoto mutasamutsa odwala kupita ku insulin ya anthu kumatha kuchepa kwakanthawi. Simuyenera kugwiritsa ntchito mankhwalawa ngati mukuyambitsa kuyimitsidwa sikukhala wolakwika.