Novomix - malamulo ogwiritsira ntchito, mlingo ndi kusintha

NovoMix 30 FlexPen lakonzedwa kuti SC iwongoleredwe. Mankhwala sangathe kutumizidwa iv. izi zimatha kuyambitsa kwambiri hypoglycemia. M'pofunikanso kupewa kutsekeka kwa NovoMix 30 FlexPen. Osagwiritsa ntchito NovoMix 30 Penfill wa subcutaneous insulin kulowetsedwa (PPII) pamapampu a insulin.

Mlingo wa NovoMix 30 FlexPen umatsimikiziridwa ndi dokotala aliyense payekha, mogwirizana ndi zosowa za wodwala. Kuti mupeze milingo yoyenera ya glycemia, ndikulimbikitsidwa kuti kuyang'anitsitsa kwa shuga wamagazi ndi kusintha kwa mankhwalawa kuyang'aniridwa.

Odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga a mellitus NovoMix 30 Flexpen atha kutumikiridwa monga mankhwala a monotherapy komanso osakanikirana ndi mankhwala amkamwa a hypoglycemic komanso muzochitika izi pomwe kuchuluka kwa shuga m'magazi sikungoyatsidwa mokwanira ndi mankhwala amkamwa a hypoglycemic.

Kwa odwala omwe ali ndi matenda a shuga a mtundu woyamba omwe ayambitsidwa ndi insulin, muyezo wa NovoMix 30 FlexPen ndi magawo 6 musanadye chakudya cham'mawa komanso magawo 6 musanadye chakudya chamadzulo. Kukhazikitsidwa kwa magawo khumi a 12 a NovoMix 30 Flexpen ndikololedwa 1 nthawi / tsiku madzulo (musanadye chakudya chamadzulo).

Kusamutsa wodwala kuchokera kukonzekera kwina kwa insulin

Mukasamutsa wodwala kuchokera ku biphasic insulin ya anthu kupita ku NovoMix 30 FlexPen, wina ayenera kuyamba ndi mlingo womwewo ndi makonzedwe ake. Kenako sinthani mlingo wake mogwirizana ndi zofunikira za wodwala

Malangizo mu tebulo, monga gawo la mankhwalawa. Monga nthawi zonse posamutsa wodwala kupita ku mtundu wina wa insulin, kuyang'aniridwa mosamala kwachipatala ndikofunikira pakusintha kwa wodwalayo komanso m'milungu yoyamba yogwiritsa ntchito mankhwalawa.

Kupititsa patsogolo chithandizo cha NovoMix 30 FlexPen ndikotheka posintha kuchokera ku gawo limodzi la mankhwala tsiku ndi tsiku kupita pawiri. Ndikulimbikitsidwa kuti mutatha kutenga magawo 30 a mankhwalawa kuti mugwiritse ntchito NovoMix 30 Thirani 2 nthawi / tsiku, ndikugawa mlingo mu magawo awiri ofanana - m'mawa ndi madzulo (musanadye chakudya cham'mawa komanso chamadzulo).

Kusintha kwa kugwiritsa ntchito NovoMix 30 Flexpen 3 nthawi / tsiku ndikotheka ndikugawa mlingo wa m'mawa m'magawo awiri ofanana ndikupereka magawo awiriwa m'mawa komanso pachakudya (katatu katatu tsiku).

Pofuna kusintha kwa mlingo, NovoMix 30 FlexPen imagwiritsa ntchito shuga wotsika kwambiri yemwe amapezeka masiku atatu apitawa.

Kuti muwone kukwana kwa mlingo wapitalo, gwiritsani ntchito phindu la kuchuluka kwa shuga m'magazi chakudya chotsatira.

Kusintha kwa dozi kumachitika kamodzi pa sabata mpaka pomwe phindu la HbA1C lifikiridwa.

Musachulukitse mlingo wa mankhwalawa ngati hypoglycemia idawonedwa panthawiyi.

Kusintha kwa Mlingo kumakhala kofunikira pakulimbitsa thupi la wodwalayo, kusintha zakudya zake, kapena kukhala ndi vuto.

Monga momwe amagwiritsidwira ntchito pokonzekera insulin, m'magulu apadera odwala muyenera kuyang'anitsitsa kuchuluka kwa shuga m'magazi ndikusintha mlingo wa insulin aspart payekha.

NovoMix 30 Flexpen imatha kuperekedwa kwa odwala okalamba, komabe, momwe amamugwiritsira ntchito limodzi ndi mankhwala amkamwa a hypoglycemic odwala omwe ali ndi zaka zoposa 75 ali ndi malire.

Odwala omwe ali ndi vuto la impso kapena hepatic, kuchepa kwa insulin kumatha kuchepetsedwa.

NovoMix 30 FlexPen itha kugwiritsidwa ntchito pochiza ana ndi achinyamata azaka zopitilira zaka 10 pochitika kuti amakonda kugwiritsa ntchito insulin yosakanizika kale. Zambiri zamankhwala azachipatala zimapezeka kwa ana azaka za 6-9.

NovoMix 30 FlexPen iyenera kutumikiridwa musanadye. Ngati ndi kotheka, mutha kulowa mankhwalawa mutatha kudya.

NovoMix30 Flexpen iyenera kuperekedwa ku sc mpaka ntchafu kapena kunja kwam'mimba khoma. Ngati angafune, mankhwalawa amatha kuperekedwa kwa phewa kapena matako.

Ndikofunikira kusintha malo a jekeseni mkati mwa anatomical dera kuti muchepetse kukula kwa lipodystrophy.

Monga kukonzekera kwina konse kwa insulin, kutalika kwa nthawi ya NovoMix 30 FlexPen kumatengera mlingo, malo oyendetsera, kutsika kwa magazi, kutentha ndi mulingo wa zolimbitsa thupi.

Malangizo ogwiritsira ntchito mankhwalawa NovoMix 30 Flexpen

NovoMix 30 FlexPen ndi cholembera cholembera insulin ndi chothandizira. Mlingo wa insulin womwe umayendetsedwa, kuyambira 1 mpaka 60 mayunitsi, umatha kusiyanasiyana mu 1 unit.

NovoMix 30 FlexPen imagwiritsidwa ntchito ndi singano zotayika NovoFayn kapena NovoTvist mpaka 8 mm kutalika. Monga chisamaliro, muyenera kusamala nthawi zonse ndi pulogalamu ya inshuwaransi kuti mutayike kapena kuwonongeka kwa NovoMix 30 FlexPen.

Kukonzekera NovoMix 30 FlexPen

Yang'aninso chizindikiro kuti NovoMix 30 FlexPen ili ndi mtundu woyenera wa insulin. Pamaso jakisoni woyamba, insulin iyenera kusakanikirana: - kuti mupange kusakanikirana, lolani kuti mankhwalawa asungike kutentha kwa chipinda.

Chotsani kapu ku cholembera, - gulitsani cholembera pakati pa manja nthawi 10 - ndikofunikira kuti chikhale pamalo opingasa, - kwezani cholembera chokwera nthawi 10 kuti galasi la galasi lisunthe kuchokera kumphepete mwa katiriji kupita mbali inayo.

Pamaso jekeseni aliyense, sakanizani zomwe zili mkati nthawi 10 mpaka zomwe zili mu cartridge zikhale zoyera komanso mitambo. Pambuyo posakaniza, jakisoni ayenera kuperekedwa nthawi yomweyo.

Nthawi zonse onetsetsani kuti magawo 12 a insulini amakhalabe mu katiriji kuonetsetsa kuti kusakanikirana kofanana. Ngati magawo ochepera 12 atsala, NovoMix 30 FlexPen yatsopano iyenera kugwiritsidwa ntchito.

Chotsani chomata kuchotsekera ku singano yotaya. Yanikani singano mosamala komanso mwamphamvu pa NovoMix 30 FlexPen. Chotsani thumba lakunja la singano, koma osalitaya. Chotsani ndikutaya kapu yamkati ya singano.

Gwiritsani ntchito singano yatsopano jekeseni aliyense kupewa matenda. Chisamaliro chiyenera kuchitidwa kuti musamakande kapena kuwononga singano musanagwiritse ntchito. Popewa kubayidwa mwangozi, musabwezeretse cholowera chamkati pa singano.

- dinayani magawo awiri a mankhwalawa potembenuza chosankha, - mutagwira NovoMix 30 FlexPen ndi singano, ikani bokosilo kangapo ndi chala chanu kuti thovu la mpweya lisunthe pamwamba pa cartridge,

- akugwirizira cholembera ndi singano kumtunda, kanikizani batani loyambira njira yonse. Mlingo wosankha ubwerera ku zero. Dontho la insulin liyenera kuonekera kumapeto kwa singano. Ngati izi sizingachitike, sinthani singano ndikubwereza njirayi, koma osapitirira 6.

Mlingo woyika

Onetsetsani kuti chosankha cha mankhwalawo chikhala "0." - Dinani kuchuluka kwa jakisoni. Mlingo umatha kusinthidwa ndikusintha chosankha cha mtundu uliwonse kufikira mulingo woyenera waikidwa patsogolo pa chizindikirocho.

Mukazungulira chosankha cha mankhwala, samalani kuti musakanize mwangozi batani loyambira kuti muchepetse kutulutsa kwa insulin. Sizotheka kukhazikitsa mlingo wowonjezera wa kuchuluka kwa zigawo zotsalira mu cartridge - kuchuluka kwa otsalira sikungagwiritsidwe ntchito kuyeza kuchuluka kwa insulin.

Ikani singano pansi pa khungu. Wodwala ayenera kugwiritsa ntchito jakisoni monga momwe dokotala wavomerezera.

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.

Wongoletsani singano mumkono wakunja wa singano musakhudze kapu. Pamene singano ilowa, valani chida chakunja ndikuvula singano. Taya singano, samalira chitetezo, ndikutseka cholembera ndi chophimba.

Singano imayenera kuchotsedwa pambuyo pobayidwa aliyense ndipo osasunga NovoMix 30 FlexPen ndi singano yomata. Kupanda kutero, madzi amatha kutuluka kuchokera ku NovoMix 30 FlexPen, zomwe zingayambitse kuyambitsa kwa cholakwika.

Osamalira amayenera kusamala pochotsa ndi kutaya singano popewa ngozi.

Tayetsani NovoMix 30 FlexPen wogwiritsa ntchito ndi singano yodulidwa.

NovoMix 30 FlexPen ndi yogwiritsa ntchito inu nokha.

Kusunga ndi chisamaliro

NovoMix 30 Flexpen idapangidwa kuti ikhale yogwira ntchito komanso yotetezeka ndipo imafunikira kuisamalira mosamala. Pakakhala dontho kapena kupanikizika kwamakina mwamphamvu, cholembera cha syringe chimatha kuwonongeka ndipo insulin ikhoza kutayikira.

Pamwamba pa NovoMix 30 FlexPen akhoza kutsukidwa ndi thonje swab choviikidwa mu mowa. Osamiza chindapusa mu mowa, osasamba kapena mafuta izi zitha kuwononga makina. Kudzazidwa kwa NovoMix 30 FlexPen sikuloledwa.

NovoMix 30 FlexPen ndi yogwiritsa ntchito inu nokha. Sichiloledwa kuziziritsa cholembera cha NovoMix 30 FlexPen syringe.

NovoMix 30 flexpen silingagwiritsidwe ntchito ngati mutasakaniza madzi osakhala oyera komanso mitambo.

Ndikofunikira kufotokozera wodwalayo kufunika kosakaniza kuyimitsidwa kwa NovoMix 30 FlexPen musanayambe kugwiritsidwa ntchito.

Musagwiritse ntchito NovoMix 30 FlexPen ngati yazizira.
Odwala ayenera kuchenjezedwa kuti ataye singano pambuyo jekeseni aliyense.

Kuyanjana kwa mankhwala

Zotsatira zoyipa zomwe zimachitika mwa odwala omwe amalandila NovoMix 30 FlexPen, zimachitika makamaka chifukwa cha mankhwalawa. Chochitika chovuta kwambiri chambiri ndi insulin ndi hypoglycemia.

Pafupipafupi mavuto obwera chifukwa chogwiritsa ntchito NovoMix 30 FlexPen amasiyanasiyana malinga ndi kuchuluka kwa odwala, mulingo wa mankhwalawa, komanso kayendedwe ka glycemic.

Pa gawo loyambirira la insulin, zolakwika zotupa, edema ndi zochita zake zimatha kupezeka pamalo a jakisoni (kuphatikiza ululu, redness, urticaria, kutupa, kuphulitsa, kutupa ndi kuyabwa pamalowo jakisoni.

Kulimbitsa kwa insulin mankhwala ndikusintha kolimba kwa mphamvu ya kagayidwe kazakudya kungayambitse kuwonongeka kwakanthawi mu matenda a shuga, pomwe kusintha kwakanthawi kwakanthawi ka glycemic kumachepetsa chiopsezo cha kupitirira kwa matenda ashuga retinopathy.

Zotsatira zonse zoyipa zomwe zaperekedwa pansipa, kutengera za mayeso azachipatala, zimayikidwa m'magulu molingana ndi kukula kwa chitukuko malinga ndi MedDRA ndi kachitidwe ka zida.

Kudziwitsa kuchuluka kwa zoyipa: pafupipafupi (≥1 / 10), kawirikawiri (≥1 / 100 kwa) Tikukulimbikitsani kuti muwerenge: Yesani mayeso a glucose - njira yoyendetsera ndi kusindikiza

Pa mbali ya chitetezo chathupi: pafupipafupi - urticaria, zotupa pakhungu, zotupa pakhungu, kawirikawiri - anaphylactic reaction.

Kuchokera kumbali ya kagayidwe: nthawi zambiri - hypoglycemia.

Kuchokera ku dongosolo lamanjenje: kawirikawiri - zotumphukira neuropathy ("ululu wammbuyo"

Kuchokera kumbali ya gawo la masomphenyawo: pafupipafupi - zolakwika zatsopano, matenda ashuga retinopathy.

Kuchokera pakhungu ndi subcutaneous zimakhala: pafupipafupi - lipodystrophy.

Mavuto ambiri: pafupipafupi - edema.

Zomwe zimachitika mdelalo: pafupipafupi - zimachitika jekeseni.

Osowa kwambiri zomwe zimachitika makamaka ku hypersensitivity (kuphatikizapozotupa pakhungu, kuyabwa, thukuta, kusokonezeka m'matumbo, angioedema, kupuma movutikira, kukomoka kwa mtima, kuchepa kwa kuthamanga kwa magazi), zomwe zingathe kuwononga moyo.

Hypoglycemia ndi njira yodziwika kwambiri yotsatirira. Zimatha kukhala ngati mlingo wa insulini ndiwokwera kwambiri poyerekeza ndi kufunika kwa insulin. Hypoglycemia yayikulu imatha kuwononga chikumbumtima ndi / kapena kukhudzika, kusokonezeka kwakanthawi kapena kosasintha kwa ubongo kugwira ntchito mpaka pakufa.

Zizindikiro za hypoglycemia, monga lamulo, zimayamba mwadzidzidzi. Izi zitha kuphatikizira thukuta “lozizira”, khungu .

Kafukufuku wachipatala adawonetsa kuti kuchuluka kwa hypoglycemia kumasiyana malinga ndi kuchuluka kwa odwala, dosing regimen, ndi glycemic control. M'mayesero azachipatala, panalibe kusiyana kulikonse pazochitika za hypoglycemia pakati pa odwala omwe amalandila chithandizo cha inshuwaransi ndi odwala omwe amalandila kukonzekera kwa insulin.

Lipodystrophy

Nthawi zambiri za lipodystrophy zalembedwa. Lipodystrophy imatha kupezeka pamalo a jakisoni.

Pali mankhwala angapo omwe amakhudza kufunika kwa insulin.

kanthu Hypoglycemic mankhwala 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.

Mphamvu ya hypoglycemic ya mankhwalawa imachepetsedwa ndi kulera kwapakamwa, corticosteroids, mahomoni a chithokomiro, thiazide diuretics, heparin, tridclic antidepressants, sympathomimetics, somatropin, danazole, clonidine, "wosakwiya" calcium blockers, diazoxide, morphine, pphitto.

Beta-blockers amatha kufinya zizindikiro za hypoglycemia.

Octreotide / lanreotide imatha kuwonjezeka ndikuchepetsa kufunikira kwa insulin.

Ethanol ikhoza kukulitsa kapena kuchepetsa kuchepa kwa insulin.

Popeza maphunziro ophatikizira sanachitike, NovoMix 30 FlexPen sayenera kusakanikirana ndi mankhwala ena.

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 kapena matenda ashuga a ketoacidosis. Monga lamulo, zizindikiro zoyambirira za hyperglycemia zimawonekera pang'onopang'ono, kwa maola angapo kapena masiku.

Zizindikiro za hyperglycemia ndi ludzu, kukodza kwambiri, kusanza, kugona, kugona, kuyanika komanso khungu, kukamwa kowuma, kusowa chilimbikitso, komanso kununkhira kwa acetone mu mpweya wotuluka.

Kudumpha zakudya kapena kuchita masewera olimbitsa thupi mosakonzekera kungayambitse hypoglycemia. Hypoglycemia imatha kukhazikikanso ngati mlingo wa insulin ndiwokwera kwambiri poyerekeza ndi zosowa za wodwala.

Poyerekeza ndi biphasic insulin yaumunthu, NovoMix 30 FlexPen imatanthauzanso hypoglycemic kwambiri mkati mwa maola 6 pambuyo pa kuperekedwa. Pankhani imeneyi, nthawi zina, pangafunike kusintha mtundu wa insulin komanso / kapena mtundu wa zakudya.

Pambuyo kulipira kagayidwe kazakudya, mwachitsanzo, pakulimbitsa mankhwala a insulin, odwala amatha kuona zizindikiro za kutsogola kwa hypoglycemia, zomwe odwala ayenera kudziwitsidwa. Zizindikiro zachilendo zimatha kutha ndi matenda a shuga.

Kuwongolera mwamphamvu kwa glycemia mwa odwala kumatha kuwonjezera ngozi ya hypoglycemia, chifukwa chake, kuwonjezeka kwa mlingo wa NovoMix 30 FlexPen kuyenera kuchitika moyang'aniridwa ndi achipatala.

Popeza NovoMix 30 FlexPen iyenera kugwiritsidwa ntchito molumikizana ndi kudya, munthu ayenera kuganizira kuthamanga kwambiri kwa zotsatira za mankhwalawa pochiza 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 zimatha kusintha kapena kuchepa kuposa zomwe zimawonedwa ndi mtundu wakale wa insulin.

Kusamutsa wodwala kupita ku mtundu wina wa insulin kapena kukonzekera kwa insulin kwa wopanga wina kuyenera kuchitika moyang'aniridwa ndi achipatala. Mukasintha ndende, mtundu, wopanga ndi mtundu wa anthu (insulin yaumunthu, analog ya insulin yaumunthu) pokonzekera insulin ndi / kapena njira yopangira, kusintha kwa mlingo kungafunike.

Odwala omwe amasintha kuchokera ku insulin ina kukonzekera mankhwala a NovoMix 30 FlexPen angafunike kuchuluka kwa jakisoni kapena kusintha kwa mlingo poyerekeza ndi Mlingo wa kukonzekera kwa insulin kale.

Zokhudza malo jakisoni

Monga mankhwala ena a insulin, zimachitika mu jakisoni wa jekeseni, yomwe imawonetsedwa ndi kupweteka, kufiyira, ming'oma, kutupa, hematomas, kutupa ndi kuyabwa. Kusintha pafupipafupi jakisoni wambiri m'dera limodzilimodzi kumatha kuchepetsa zizindikiro kapena kuteteza kukula kwa izi.

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.

Ma insulin antibodies

Mukamagwiritsa ntchito insulin, mapangidwe a antibody ndiwotheka. Nthawi zina, mapangidwe a antibody angafunikire kusintha kwa insulin kuti mupewe milandu ya hyperglycemia kapena hypoglycemia.

Zokhudza mphamvu pakutha kuyendetsa magalimoto ndimakina

Kuthekera kwa odwala kulolera komanso kuchuluka kwa momwe angachitire amatha kusokonezeka panthawi ya hypoglycemia, zomwe zimakhala zowopsa panthawi yomwe maluso amenewa amafunikira makamaka (mwachitsanzo, poyendetsa magalimoto kapena kugwira ntchito ndi makina).

Odwala ayenera kulangizidwa kuti achitepo kanthu popewa kukulitsa kwa hypoglycemia poyendetsa magalimoto kapena kugwira ntchito ndi makina. Izi ndizofunikira kwambiri kwa odwala omwe alibe kapena kuchepa kwa zizindikiro zakutsogolo kwa hypoglycemia kapena akuvutika ndi zochitika zapafupipafupi za hypoglycemia.

Deta Yotetezera

Kafukufuku wammbuyo sanawonetse vuto lililonse kwa anthu, potengera kafukufuku wovomerezeka wazachipatala, kuwopsa kwa kugwiritsidwa ntchito mobwerezabwereza, genotoxicity komanso kubereka kawopsedwe.

Mu mayeso a in vitro, omwe anaphatikiza kumangiriza insulin ndi ma IGF-1 zolandila ndi zotsatira zake pakukula kwa maselo, zidawonetsedwa kuti zofunikira za aspart insulin ndizofanana ndi insulin yaumunthu. Zotsatira zakufufuzanso zinawonetsa kuti kudzipatula komwe kumangidwa kwa insulini receptors ndikofanana ndi insulin yaumunthu.

Mimba komanso kuyamwa

Zomwe takumana nazo muchipatala ndi NovoMix 30 Flexpen pa nthawi yapakati ndizochepa.

Kafukufuku wokhudza kugwiritsa ntchito mankhwalawa NovoMix 30 Flexpen mwa amayi apakati sanachitike. Komabe, zidziwitso za mayesero awiri azachipatala omwe adasankhidwa mosasamala (motero, amayi apakati a 157 ndi 14 omwe adalandira insulin aspart mu basic borus regimen of tiba) sanawululire zovuta zilizonse za insulin aspart pa mimba kapena thanzi la mwana wosabadwayo / wakhanda poyerekeza ndi insulin yaumunthu.

Kuphatikiza apo, mayesero azachipatala a azimayi 27 omwe ali ndi vuto la matenda osokoneza bongo omwe amalumikizana ndi insulin komanso osungunuka anthu (14 azimayi amalandila insulin, 13 insulin yaumunthu) adawonetsa mbiri yofanana ya insulin.

Munthawi ya kuyambika komanso nthawi yonse yomwe muli ndi pakati, kuwunika mosamala mkhalidwe wa odwala omwe ali ndi matenda osokoneza bongo ndikuwunika kuchuluka kwa shuga m'magazi a m'magazi ndikofunikira.

Kufunika kwa insulini, monga lamulo, kumachepera mu trimester yoyamba ndipo pang'onopang'ono kumawonjezeka pang'onopang'ono wachiwiri komanso wachitatu wokonzekera kutenga pakati. Pambuyo pobadwa, kufunikira kwa insulin kumabwereranso msanga momwe kunaliri asanakhale ndi pakati.

Panthawi yoyamwitsa, mankhwalawa amatha kugwiritsidwa ntchito popanda zoletsa. Kukhazikitsidwa kwa insulin kwa mayi woyamwitsa sikuopseza mwana. Komabe, zingakhale zofunikira kusintha mlingo wa NovoMix 30 FlexPen.

Lamulirani imodzi

Ngati zofunika kwambiri pa glycemic sizikwaniritsidwa, choyamba, onetsetsani ngati pali zolakwika zina zilizonse zomwe zingachitike pokwaniritsa zomwe dokotala akukuuzani. Kodi njira ya jakisoni wa insulin ikutsatiridwa, kodi kumwa mankhwala mopitirira muyeso, kodi ma jakisoni amatengedwa ndipo chakudya chimatenge nthawi, kodi Mlingo womwe umatulutsidwa molondola mu syringe?

Kapena mwina mudakumana ndi zovuta zowonjezera, mwachitsanzo, zinali zovuta? Simunakhale ndi matenda opumira kwambiri? Sizinachepetse kwambiri kapena, m'malo mwake, zolimbitsa thupi zidakula? Mwina mwasiya kuwongolera zakudya zanu?

Zimachitika monga chonchokuti wodwalayo (ichi ndichizolowezi cha achinyamata) amavulala ndi insulini mosakwanira Mlingo wosakwanira kuti amuchotsere matenda ndikwaniritse zolinga zina kuchokera kwa abale ake. Mafunso awa ayenera kuyankhidwa, ndipo pokhapokha mutachotsa zolakwika zonse zomwe mungathe, pitilizani ndi kusintha Mlingo wa insulin.

Lamulo lachiwiri

Pambuyo powonetsetsa kuti mukuchita zonse bwino, koma palibe zotsatira zomwe mukufuna, sankhani mtundu wa insulini yomwe imayambitsa shuga wambiri kapena wotsika kwambiri. Ngati pali glycemia yowonjezereka kapena yafupika, Vutoli ndi "insulin" yayitali, yomwe idayendetsedwa usiku watha, ngati zizindikiro zitatha kudya zidasinthidwa - amafuna kuwunikiridwa makamaka muyezo wa insulin "yayifupi".

Mapiritsi a sage a resorption: mawonekedwe

Zigawo zikuluzikulu za mankhwalawa ndi:

• mafuta ofunikira
• Chotunga chowuma,
• vitamini C

Opanga osiyanasiyana amawonjezera apulo kapena citric acid ku lozenges, zomwe zimakhudza kukoma kwake, komwe kumakhala kopepuka komanso kosangalatsa. Kuphatikizika uku kumatsimikizira machiritso onse a mankhwalawo komanso mphamvu yofananira ndi thupi.

Kuchiritsa katundu

Ngati mutayang'ana mbiri ya dzina la mapiritsi oyamwa, mayina amachokera ku chomera "Salvia", chomwe mu Latin amatanthauza "kukhala wathanzi."

Dzinali silinapatsidwe chomera mwangozi, lingathe kugwira ntchito pakuluma kwamkamwa, pakhosi, komanso kupumira kwapamwamba.

Makhalidwe ochiritsa:

• mwachangu lozenges amachotsa zilonda zapakhosi,
• Amakwanitsa kuthana ndi mkwiyo, amachepetsa ululu
• mafuta ofunikira a antioxidants abwino,
• mapiritsi okhala ndi tchire amapha majeremusi mumayendedwe amlengalenga.

Malangizo ogwiritsira ntchito

Musanayambe kumwa mankhwalawa, muyenera kuwerengera momwe mungagwiritsire ntchito mapiritsi a Sage for resorption. Nthawi zambiri amagwiritsidwa ntchito limodzi ndi mankhwala ena kuti athetse kutupa kwam'mimba kupumira komanso oropharynx. Mankhwalawa amalembedwa kwanuko (mwa resorption) kwa akulu ndi ana azaka za 14, 1 lozenge kangapo 6 pa tsiku. Nthawi yayitali ya mankhwala imakhala pafupifupi sabata limodzi.

Kwenikweni, phukusi limodzi la zidutswa 20, zomwe ndizosavuta kwambiri, ndizokwanira pa maphunziro amodzi. Mapiritsi am'mero ​​yakhosi amaperekedwa kwa ana a zaka 5.

Ana kuyambira wazaka 5 mpaka 10, tikulimbikitsidwa kugwiritsa ntchito piritsi limodzi katatu patsiku, pakapita maola anayi. Popeza zaka 10, mlingo umakhala wofanana, koma uyenera kumwedwa nthawi zinayi patsiku.

Kutafuna ndikumeza mankhwalawo sikuyenera kutero, chifukwa zotsatira zabwino zimatheka pokhapokha ngati mukusinthanso. Nthawi zina, njira ya mankhwalawa imatha kuwonjezeka mpaka milungu iwiri. Zachidziwikire, ndikofunikira kudziwa nokha momwe mungagwiritsire ntchito mapiritsi a kugwirizananso ndi Sage, izi zikuthandizani kuti mugwiritse ntchito mankhwala onse moyenera momwe mungathere ndipo musalole zotsatira zoyipa.

Ntchito mankhwalawa:

Mukatha kugwiritsa ntchito phukusi la sage resorption ku Natur Product, inhalation zotsatira zimapangidwa pamlomo wamkamwa, womwe umachotsa zizindikilo ndi kutupa mthupi.

Kupatsa ana ntchito

Palibe phindu kupatsa mapiritsi a kuyambiranso kwa Sage Evalar kwa ana osakwana zaka 5, popeza zimavuta kuti mwana afotokozere kuti amafunikira kuthetsedwa. Ana akhoza kumeza mankhwalawo. Kuphatikiza apo, ndikofunikira kudziwa bwino lomwe zotsutsana zonse za mankhwalawa ndikuwonetsetsa kuti mwana sangayanjane. Mlingo uyenera kuyang'aniridwa, chifukwa mapiritsi a Sage opangidwa ndi "Natur Product" ndizokonzekera chokoma chomwe ana angatengere maswiti. Ndikofunikira kuwateteza kuti asapezeke nawo mwaulere.

Sage pa nthawi yapakati

Poganizira mphamvu za machiritso a Sage, zimachitika kuti madokotala amawapereka kwa amayi apakati pochizira chimfine.

Komabe, ngati tingaphunzire za mankhwalawo mwatsatanetsatane, titha kuonetsetsa kuti ndizoletsedwa kugwiritsa ntchito mapiritsi omwe angathe kuyamwa pa Sage pathupi, makamaka ndi oyambayo.

Zimatha kukhudza chiberekero ndikuwonjezera kamvekedwe kake, komwe kamatha kupweteka, makamaka m'miyezi itatu yoyambirira ya kutenga pakati. Njira zotengera Sage ndizowopsa kwa mwana wosabadwa, muyenera kudziwa zomwe zingachitike.

Madokotala ambiri amati mapiritsi a Sage a zilonda zapakhosi, akagwiritsidwa ntchito ndi amayi apakati, amakhala ndi zotsatira zowongolera, koma sizili choncho chifukwa zinthuzo zimalowa m'magazi kudzera m'matumbo ndi ziwiya zamkati zamkamwa, zomwe zingasokoneze kudutsa kwapakati.

Nthawi zambiri, zotsatira za mankhwalawa, ngakhale zazing'ono, zimayambitsa vuto la kufalikira kwa magazi m'magazi ndipo zimayambitsa zovuta zambiri zam'mimba. Kuphatikiza apo, thunthu limatha kusintha kuchuluka kwa mahomoni, kutsitsa zomwe zili progesterone ndikuwonjezera kukhalapo kwa estradiol.

Mankhwalawa amatha kupangitsa kuti magazi azithamanga, omwe ndi oopsa kwambiri panthawi yomwe ali ndi pakati, kuwonjezera apo, ndizoletsedwa kutenga Sage Evalar kuti azimayi anyama.

Contraindication

Musanagwiritse ntchito mankhwalawa, ndikofunikira kuganizira za mankhwala a Sage mapiritsi ndi contraindication. Ngakhale kuti amapangidwa kuchokera ku zosakaniza zachilengedwe, pali zovuta zingapo.

• kuwonongeka kwa anthu odwala matenda ashuga,
• pakati ndi koletsedwa
• kulengeza kwa ana osakwana zaka 5 sikulimbikitsidwa,
• Sizoletsedwa kugwiritsa ntchito mapiritsi a matenda a chiwindi, impso,
• Ngati thupi lanu lisagwedezeka, mankhwalawo amayenera kuyimitsidwa nthawi yomweyo, ngati vutolo likukula, onetsetsani kuti mwapeza thandizo kwa dokotala.

Mapiritsi a Resorption okhala ndi tchire ndi njira yodziwika bwino yolimbana ndi matenda otupa a pakhosi monga tonsillitis, pharyngitis ndi zina. Amawonetsa kukhathamira, kuthandiza kuchepetsa kulimba kwa chizindikiro chachikulu, komanso kukonza zomwe zimachitika komanso kugwiritsa ntchito chitetezo chokwanira. Umu ndi momwe zimachitikira

Zochita

Kuchita kwa sage kwaphunziridwa kwanthawi yayitali. Ichi ndichifukwa chake ndi matenda opumira komanso osati mankhwala ambiri wowerengeka omwe amagwiritsidwa ntchito ndi zitsamba pophatikizika.

Mapiritsi a mayamwidwe atha kugulidwa ku pharmacy iliyonse

Ngati tikulankhula za mankhwala azachipatala, ndiye kuti zotsatirazi zimapezeka mu chomera:

• Hemostatic
• Anti-kutupa
• Mankhwala ophera tizilombo
• Wamatsenga
• Wodzikongoletsa
• Emollient
• Antipyretic,
• Chinsinsi.

Pankhani ya mapiritsi okhala ndi sage, antiseptic, emollient, disinfectant, ndi anti-yotupa yomwe imathandizira kuchepetsa kukula kwa zizindikiro ndizofunikira kwambiri. Koma, monga mankhwala aliwonse, mbewu iyi imakhala ndi zotsutsana, kuphatikizapo hypersensitivity, chifuwa, ana osaposa zaka 2, pakati komanso msambo. Kafukufuku wasonyeza kuti pa nthawi yoyembekezera, chiopsezo chogwidwa imayamba kukokoloka. Zimakhudzanso kuchuluka kwa mkaka womwe umapangidwa.

Vuto lodzitchinjiriza. Chifukwa chake, ndikofunikira kuyang'anira mosamala mlingo ndikuchepetsa njira yogwiritsira ntchito mankhwalawa kwa miyezi itatu.

Koma momwe chamomile amagwiritsidwira ntchito pozizira pa nthawi yobereka komanso momwe mankhwalawa amathandizira

Kuphatikiza pa matenda opuma monga laryngitis, tonsillitis, imathandizanso bronchitis, chibayo, ndi mphaka. Amagwiritsidwanso ntchito pa matenda a pathologies a pamlomo wamkamwa - stomatitis ndi gingivitis. ndipo maswiti otsekemera amapereka zabwino zakumaloko popanda kukhala ndi vuto lalikulu m'thupi.

Kanemayo - zofunikira za sage:

Ndemanga ya mapiritsi ndi lozenges

Pali mankhwala angapo amtunduwu omwe amachokera ku sage, omwe amawonetsa zotsatira zabwino akamagwiritsidwa ntchito pophatikiza chithandizo. Koma ali ndi mawonekedwe awo ndi malire pazomwe zimagwiritsidwa ntchito, kutengera kampani ndi kapangidwe kake. Ndiye chifukwa chake musanagwiritse ntchito ichi kapena chida chimenecho, muyenera kuwerenga mosamala malangizo ogwiritsa ntchito. Koma momwe mungakhalire kugwiritsa ntchito mankhwala osokoneza bongo a tantum verde ndipo ndi mtengo wanji wa chithandizocho, akuwonetsedwa

Mapiritsi a Sage a NATUR PRODUKT

Awa ndi mankhwala odana ndi kutupa komanso antimicrobial omwe amagwiritsidwa ntchito mu ENT. Wawonetsa kuchita bwino. Zosakaniza zomwe zimayamwa ndizoyambira ndi mafuta otentha. Mwanjira zina, vitamini C amakhalaponso, omwe amathandizira kulimbitsa ndikulimbikitsa chitetezo cha m'deralo. Mankhwalawa ali ndi zoperewera komanso zoyembekezera. Palibe chothandiza polimbana ndi chifuwa.

Mapiritsi opangidwa kuchokera ku zinthu zam'mera omwe amangothandiza popanda kuvulaza thanzi

Mwa zomwe akuphwanya, ndi hypersensitivity pokha komanso chizolowezi chokhala ndi ziwengo zomwe zimalembedwa. Koma ambiri amagwiritsidwa ntchito pa gingivitis, tonsillitis, laryngitis, stomatitis, pharyngitis. Kugwiritsa ntchito kumaloledwa kuchokera zaka 2, koma kuyang'aniridwa ndi akulu okha. Mtengo wake umasiyana ndi ma ruble 105 mpaka 165.

Tengani zaka 5 - nthawi yotalikirapo kuposa maola 4, mapiritsi awiri patsiku, zaka 5 mpaka 10 - mapiritsi atatu maola 4 aliwonse, komanso zaka 10 - mpaka 6 mapiritsi 2 aliwonse. Palibe malamulo oletsa kubereka, kapena zaka. Chokhacho ndikuti mpaka zaka ziwiri mwana akhoza kumeza kapena kumangomenyetsa piritsi, osadziwa momwe angathere.

Muyeneranso kukhala ndi chidwi chofuna kudziwa zoyenera kuchita ngati

Mankhwala ochokera ku Evalar "Sage"

Mankhwala ali ndi antiseptic, antibacterial, anti-yotupa ndi emollient. Amathandizanso osati kuchepetsa zilonda zapakhosi pochepetsa kutupa, komanso kutsokomola chifuwa choyambitsa chifukwa cha khosi louma.

Mapiritsi oterewa amachepetsa kwambiri pakhosi ndipo mwachangu komanso munthawi yochepa kwambiri amathandiza

Amagwiritsidwa ntchito mu ENT kuchita ndi mano pochizira matenda am'kamwa ndi kupuma thirakiti. Zosakaniza zomwe zimagwira ndi zotupa za sage, mafuta ake, komanso hesperidin ndi vitamini C. Mankhwalawa sagwiritsidwa ntchito pa hypersensitivity, mkaka wa m'mawere ndi pakati. Koma ngati panali zilonda zapakhosi popanda kutentha kwa mwana ndi zomwe zimayenera kugwiritsidwa ntchito poyambira, zimasonyezedwa

Malangizowo akuphatikizanso chisonyezo cha kumwa mankhwalawa wazaka 14, motero, titha kunena kuti ana sanakhazikitsidwe. Tengani piritsi limodzi mpaka 4-5 pa tsiku kwa masiku 5. Phukusi limodzi, kuchuluka kwa mapiritsi kunapangidwa kuti kukhale chiwembu. Ngati ndi kotheka, maphunzirowo atha kubwereza. Mtengo wa mankhwalawa umachokera ku ma ruble 110.

Mtengo wawo umasiyanasiyana mkati mwa ma ruble 150. Zomwe zimagwiritsidwa ntchito m'magulu onse a mankhwalawa ndi mafuta ndi sage Ting, komanso ascorbic acid, uchi ndi zina, kutengera mawonekedwe.

Mukamasankha maswiti okhala ndi tchire, ndibwino kudalira kapangidwe kake. Unikani bwino ziwiya zonse, popeza shuga amagwiritsidwa ntchito kwambiri maswiti, ndizoletsedwa kugwiritsa ntchito odwala matenda ashuga.

Koma chochita ngati khosi ili yopweteka kwambiri ndikumva kuwawa, komanso njira zomwe ziyenera kugwiritsidwa ntchito, izi zikuthandizira kumvetsetsa

Zizindikiro ndizofanana: matenda a kummero, kupuma ndi pakamwa. Contraindication nthawi zambiri samasiyana: hypersensitivity, mimba, mkaka wa m'mawere. Komanso, simungagwiritse ntchito mankhwalawa matenda a shuga.

Gwiritsani ntchito piritsi limodzi pakapita maola atatu aliwonse. Palibe choletsa zakale kutsatira malangizowo, koma kwa ana, ndikofunikira kuti muchepetse pafupipafupi piritsi limodzi pakapita maola 4-5. Kumbukirani kuti mankhwalawa angayambitse zotsatira zoyipa zamtundu wam'deralo - kuchokera ku hyperemia ndi kupukusira kwa mucous mpaka edema, zomwe zimatha kutsekereza ma mlengalenga. Ndiye chifukwa chake omwe ali ndi matupi a ziwengo samalimbikitsa kuti izi zitheke.

Komanso, kutsokomola nthawi zambiri kumayikidwa.

Sage Lollipops kuchokera ku Verbena

Mankhwala enanso ndi maswiti ochokera ku Verbena. Siziikidwa ngati mankhwala, kumasula ngati zakudya zowonjezera kapena maswiti wamba a caramel odzaza. Zigawo zomwe zimagwiranso ntchito ndizopeza ndi mafuta otayika. Zochita ndizofanana ndi chida monga zida zam'mbuyomu.

Maswiti otere amatha kugwiritsidwa ntchito tsiku lililonse, mwachizolowezi ndikumatsitsimutsa kwambiri khosi lanu komanso kupumira kwanu.

Mankhwalawa amagwiritsidwa ntchito pa pathologies a matenda am'mkamwa, pharynx ndi kupuma dongosolo. Amagwiritsidwa ntchito monga class: resorption. Wopanga sanatchule za kuchuluka kwa nthawi, koma ndibwino kuti achepetse mapiritsi 6 patsiku. Popeza pali shuga mumapangidwe, mtundu uwu wa mankhwalawa sugwiritsidwa ntchito pa matenda a shuga. Mtengo wa mankhwalawa ndi pafupifupi ma ruble 70.

Mutha kukhala ndi chidwi chidziwitso cha

Ma lozenges ndi lozenges amawonetsa kukwera kwapamwamba kwambiri ngati njira yovuta yothandizira. Ndikofunika kuyang'anira kuchuluka kwa mankhwalawo kuti muchepetse vuto la kugwiritsa ntchito komanso kuti musalandire zotsatira zoyipa. Yothandiza muchipatala kwa achikulire, koma mwa ana amalembedwa kocheperako.Katswiri wodziwa ntchito yekha ndi amene angakuuzeni kuti ndi mankhwala ati omwe ali bwino ndikukufotokozerani njira yothandizira.

Sage Tab / Resorption

Mapiritsi a Sage olembedwa ndi Natur Pridukt ndi Dr. Theiss.

Mapiritsiwo ndi a cylindrical, biconvex, kuchokera ku imvi yopepuka mpaka mtundu wa bulauni wamtundu, womwe umalowa mkati mwa bulauni mpaka ubweya wakuda wakuda wokhala ndi fungo linalake.

piritsi limodzi

Tsamba lotupa limasamba youma - 12.50 mg,

Spanish sage mafuta, sorbitol, anhydrous citric acid, sodium saccharin, magnesium stearate, uchi onunkhira owonjezera (uchi ether, geranium mafuta, ethyl butyrate, ethyl maltol (E 637), maltodextrin, maltol, dextrose (E 1200), syrup (E 551) )).

lozenges.

Ndalama zina zochiritsira matenda am'kamwa.

Mphamvu zochiritsa zimaperekedwa ndi ntchito ya sage yotulutsa, imakhala ndi ma antiseptic katundu ndipo imagwira zonse pakamwa ndi pakhungu. Kuphatikiza apo, sage imakhala ndi antibacterial komanso anti-yotupa, imapangitsa chidwi ndi chiyembekezo, imachepetsa chifuwa komanso imatha kuperewera.

Mimba komanso kuyamwa

Chitetezo chogwiritsidwa ntchito panthawi yoyembekezera komanso mkaka wa m`mawere sichinakhazikitsidwe. Chifukwa cha kusowa kwa chidziwitso, imaphatikizidwa kuti mugwiritse ntchito pa nthawi ya pakati komanso pakubala.

Mukamagwiritsa ntchito mkati, masamba oposa 15 g a masamba otsetsereka (pafupifupi mapiritsi 26 a mankhwalawa) amatha kuwonetsedwa ndi kutentha, kukula kwa tachycardia, chizungulire komanso khunyu.

Pankhani ya mankhwala osokoneza bongo, ndikofunikira kusiya kugwiritsa ntchito mankhwalawa ndi kufunsa dokotala. Mankhwalawa ndi chizindikiro.

Mukakhala ndi bongo wambiri, siyani kuonana ndi dokotala.

Musapitirire kuchuluka kwa mankhwala. Sitikulimbikitsidwa kugwiritsa ntchito mankhwalawa kwa sabata limodzi. Mankhwala ali osavomerezeka kwa odwala obadwa nawo fructose tsankho. Mukhoza kukhala ndi zofatsa. Ngati mukugwiritsa ntchito mankhwalawo zizindikiro zikulimbikira kapena vutolo likukula, ndikofunikira kusiya kumwa mankhwalawo ndi kupita kwa dokotala.

Gwiritsani ntchito paubwana

Chifukwa cha kusowa kwa deta yokwanira, sikulimbikitsidwa kugwiritsa ntchito mwa ana ochepera zaka 18.

Ntchito mukamayendetsa galimoto

Kugwiritsa ntchito mankhwalawa kungakhudze kuchuluka kwa zochita mukamayendetsa kapena kugwiritsa ntchito njira zina. Ngati chizungulire komanso mavuto ena amanjenjewo amachitika, odwala sakulimbikitsidwa kuyendetsa galimoto kapena kugwira ntchito ndi makina.

Kuchita ndi mankhwala ena

Kukonzekera sage kungakhudze zotsatira za mankhwala omwe amapanga kudzera mu GABA receptors (mwachitsanzo, barbiturates, benzodiazepines). Kugwiritsa ntchito limodzi ndi mankhwalawa osavomerezeka. Kukonzekera kwa sage kumatha kulumikizana ndi hypoglycemic ndi anticonvulsants, kumathandizira kusuntha kwa mankhwala ena ndi mowa. Mankhwalawa angakhudze kuyamwa kwachitsulo ndi mchere wina.

Pa mapiritsi 10 mumtambo wokutira kuchokera ku filimu (PVC) ndi zojambulazo.

Pa 1, 2 kapena 3 matuza muthumba la katoni okhala ndi malangizo ogwiritsira ntchito.

Pamalo otetezedwa ku kuwala ndi chinyezi, kutentha sikupita +25 0 C.

Tsiku lotha ntchito - 18 miyezi

Novo Nordisk A / S Novo Nordisk A / S / Novo Nordisk LLC

Kufotokozera za mtundu wa kipimo

• Kuyimitsidwa kwa s / c kukongoletsa kwamtundu yoyera, kopanda pake (popanda mabowo, mapale amatha kuwoneka), ataimirira, opundula, ndikupanga choyera komanso chosawoneka bwino, komanso chosangalatsa chosakanizira, kuyimitsidwa koyenera kuyenera.

Mikhalidwe yapadera

• insulin aspart biphasic 100 IU * insulin aspart sungunuka 30% insulin aspart protamine crystalline 70% Otsatsa: glycerol, phenol, metacresol, zinc chloride, sodium chloride, sodium hydrogen phosphate dihydrate, protamine sulfate, sodium hydroxide, hydrochloric acid, madzi d / u. * 1 unit imafanana ndi 35 mcg wa mankhwala osokoneza bongo a insulin

NovoMix 30 FlexPen contraindication

• - kumapangitsa chidwi cha insulin kapena ziwalo zina za mankhwala, - hypoglycemia. NovoMix 30 Penfill sikulimbikitsidwa kuti igwiritsidwe ntchito mwa ana ndi achinyamata ochepera zaka 18 chifukwa cha kusowa kwa zidziwitso zamankhwala pazotetezeka ndi kuyenera kwa mankhwala kwa odwala a m'badwo uno

NovoMix 30 Kutulutsa zotsatira zoyipa

• Zotsatira zoyipa zomwe zimakhudzana ndi metabolism ya carbohydrate: hypoglycemia, Zizindikiro zimatha kuphatikizira khungu, kuzizira thukuta, mantha, kunjenjemera, nkhawa, kutopa kapena zachilendo, kusokonezeka masomphenya, mutu, mseru, tachycardia. Hypoglycemia ikhoza kuchititsa kuti musataye chikumbumtima, kusokonezeka kwakanthawi kapena kusasinthika kwa ubongo ndi kufa. Thupi lawo siligwirizana: zimachitika m`deralo (redness, kutupa, kuyabwa pa jekeseni malo), generalized - zotupa pakhungu, kuyabwa, kuchuluka thukuta, matenda am'mimba, angioedema, kuvuta kupuma, tachycardia, kutsika magazi. Zina: edema, kuphwanya kukonzanso, chitukuko cha lipodystrophy pamalo a jekeseni

Malo osungira

• Sungani kuzizira (t 2 - 5)
• osayandikira ana
• sungani pamalo amdima

Kuyimitsidwa kwa subcutaneous makonzedwe - 1 ml insulin aspart magawo awiri - 100 IU 1 IU ikufanana ndi 0,035 mg (kapena 6 nmol) wa anulinrous insulin; , hydrochloric acid, madzi a jakisoni mu masenti atatu a 3 ml, phukusi la makatoni 5 zidutswa.

Kufotokozera za mtundu wa kipimo

Homogeneous yoyera yopanda chopanda kuyimitsidwa. Mukayimirira, kuyimitsidwa kumakoma, ndikupanga choyera chamtendere komanso chopanda utoto kapena chopanda utoto. Mukasakaniza zomwe zili mu cholembera mogwirizana ndi njira yofotokozedwera malangizo omwe angagwiritsidwe ntchito, kuyimitsidwa kokhazikika kuyenera kupanga.

Hypoglycemic wothandizira, kuphatikiza kwa nthawi yayitali komanso yapakati insulin.

Mu insulin aspart, kulowetsedwa kwa amino acid proline pamalo B28 kwa aspartic acid kumachepetsa chizolowezi chopanga mamolekyulu kupanga hexamers m'chigawo chosungunuka cha NovoMix® 30 FlexPen ®, chomwe chimasungunuka mu insulin ya anthu. Pankhaniyi, insulin aspart (30%) imayamwa kuchokera ku mafuta a subcutaneous mwachangu kuposa insulle insulin yomwe ili mu biphasic insulin yamunthu. Insulin aspart (70%), monga insulin yaumunthu, imamwa nthawi yayitali. Mukamagwiritsa ntchito NovoMix® 30 FlexPen ® Cmax, insulini mu seramu imakhala yokwera 50% kuposa momwe mumagwiritsira ntchito insulin ya anthu a magawo atatu. Pafupifupi Tmax imakhala yocheperako kawiri kuposa ya insulin ya anthu a magawo awiri. Ogwira ntchito zathanzi, pogwiritsa ntchito mankhwala a Sc pa 0,2 U / kg yolemetsa, pafupifupi seramu Cmax anali (140 ± 32) pmol / L ndipo anakwaniritsidwa mphindi 60 atabayidwa. Wapakati wa T1 / 2 NovoMix ® 30 FlexPen ®, wowonetsa kuyamwa kwa kachigawo koyendetsedwa ndi protamine womangika, anali maola 8-9. Serum insulin insulin yabwerera kwawo koyamba maola 15-18 pambuyo pa utsogoleri wa s / c. Odwala omwe ali ndi matenda a shuga a 2 mtundu, seramu Cmax ya insulin imafikiridwa pambuyo pa mphindi 95 ndipo imakhala yoyenera kwa maola osachepera 14 pambuyo povomerezeka.Kwa odwala okalamba, ana, komanso odwala omwe ali ndi vuto la chiwindi kapena impso, ma pharmacokinetics a NovoMix® 30 FlexPen ® sanaphunzire.

NovoMix® 30 FlexPen ® ndi kuyimitsidwa kwamitundu iwiri komwe kumapangika sungunul insulin aspart (30% yochepa-insulin analog) ndi makhiristo a aspart protamine insulin (70% yapakati-insulin analog). Insulin aspart yomwe imapangidwanso ndi biotechnology ya DNA yogwiritsidwanso ntchito pogwiritsa ntchito Saccharomyces cerevisiae. 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. Poyerekeza ndi insulin ya insulle yaumunthu, insulin aspart (yolimba mofulumira ya insulin ya anthu) imayamba kuchita zinthu mwachangu, kotero imatha kuperekedwa mwachangu musanadye (koma osapitirira mphindi 10 musanadye). Gawo lachigiriki (70%) limakhala ndi insulini ya puloteni (analogue ya insulin ya anthu a nthawi yayitali), momwe imafanana ndi zochita za isofan insulin. Pambuyo pa sc makonzedwe a NovoMix® 30 FlexPen ®, matendawa amakula pakadutsa mphindi 10-20. Kuchuluka kwakukulu kumawonedwa pamtunda kuchokera pa 1 mpaka maola 4 jekeseni. Kutalika kwa mankhwalawa kumafika maola 24. Kuyesedwa kwa miyezi itatu kwa odwala omwe ali ndi mtundu woyamba 1 ndi mtundu wa 2 matenda a shuga kumawonetsa kuti NovoMix® 30 FlexPen ® ikukhudzanso glycosylated hemoglobin monga insulin ya anthu awiri magawo atatu a insulin. zofanana mu molar ofanana. Mu kafukufuku wazachipatala wokhudzana ndi odwala 341 omwe ali ndi mtundu wa matenda a shuga 2, odwala adasinthidwa mosiyanasiyana m'magulu azithandizo okha a NovoMix® 30, NovoMix® 30 FlexPen® kuphatikiza ndi metformin ndi metformin kuphatikiza ndi sulfonylurea. Kusintha kwakukulu koyambirira - HbA1C pambuyo pa milungu 16 ya chithandizo - sizinasiyane mwa odwala omwe adalandira NovoMix® 30 FlexPen® kuphatikiza ndi metformin komanso odwala omwe adalandira metformin osakanikirana ndi sulfonylurea. Phunziroli, 57% ya odwala anali ndi magulu a HbA1C oyambira 9%. Odwala awa, chithandizo cha NovoMix® 30 chophatikizana ndi metformin chinapangitsa kutsika kwakukulu kwa HbA1C kuposa kwa odwala omwe amalandila metformin osakanikirana ndi sulfonylurea. Zambiri zotetezera za Preclinical In vitro test, zomwe zimaphatikizapo kumangiriza insulin ndi ma IRF-1 zolandilira ndi zotsatira za kukula kwa maselo, zidawonetsedwa kuti zofunikira za aspart insulin ndizofanana ndi insulin yaumunthu. Kuphatikiza apo, zidapezeka kuti insulin aspart imamangiriza ma insulin receptors mwanjira yofanana ndi insulin yaumunthu. Pophunzira za pachimake (mwezi umodzi) ndi chodwala (miyezi 12) kawopsedwe, deta sizinapezeke pamaso pa zida zofunika kwambiri za poizoni.

Novomix 30 flekspen Gwiritsani ntchito pakati ndi ana

Zochitika zamankhwala ndi NovoMix® 30 FlexPen ® pa nthawi yapakati ndizochepa.

Kafukufuku wokhudza kugwiritsa ntchito NovoMix® 30 FlexPen® mwa amayi apakati sanachitike. Komabe, zidziwitso kuchokera ku mayesero awiri azachipatala omwe adayang'aniridwa mosasamala (momwemo, amayi 157 ndi amayi 14 omwe adalandira ma insulin aspart ndi regulen yotsogola) sanawonetse zovuta zilizonse za insulin aspart pa mimba kapena fetal / thanzi latsopanoli poyerekeza ndi insulin ya munthu wosungunuka.Kuphatikiza apo, mayesero azachipatala a azimayi 27 omwe ali ndi vuto la matenda osokoneza bongo omwe amalumikizana ndi insulin komanso osungunuka anthu (14 azimayi amalandila insulin, 13 insulin yaumunthu) adawonetsa mbiri yofanana ya insulin.

Munthawi ya kuyambika komanso nthawi yonse yomwe muli ndi pakati, kuwunika mosamala mkhalidwe wa odwala omwe ali ndi matenda osokoneza bongo ndikuwunika kuchuluka kwa shuga m'magazi a m'magazi ndikofunikira. Kufunika kwa insulini, monga lamulo, kumachepera mu trimester yoyamba ndipo pang'onopang'ono kumawonjezeka pang'onopang'ono wachiwiri komanso wachitatu wokonzekera kutenga pakati. Pambuyo pobadwa, kufunikira kwa insulin kumabwereranso msanga momwe kunaliri asanakhale ndi pakati.

Panthawi yoyamwitsa, mankhwalawa amatha kugwiritsidwa ntchito popanda zoletsa. Kukhazikitsidwa kwa insulin kwa mayi woyamwitsa sikuopseza mwana. Komabe, zingakhale zofunikira kusintha mlingo wa NovoMix® 30 FlexPen ®.

NovoMix® 30 FlexPen ® ikhoza kugwiritsidwa ntchito pochiza ana ndi achinyamata azaka zopitilira zaka 10 ngati milandu ya insulin yosakaniza isanachitike. Zambiri zamankhwala azachipatala zimapezeka kwa ana azaka za 6-9. Kwa ana ochepera zaka 6, palibe maphunziro azachipatala omwe adachitidwa.

Novomix 30 flekspen Zotsatira zoyipa

Zotsatira zoyipa zomwe zimapezeka mwa odwala omwe amagwiritsa ntchito NovoMix® 30 makamaka zimachitika chifukwa cha kupatsirana kwamatenda. Chochitika chovuta kwambiri chambiri ndi insulin ndi hypoglycemia. Pafupipafupi mavuto obwera chifukwa chogwiritsa ntchito NovoMix® 30 zimasiyana malinga ndi kuchuluka kwa odwala, kuchuluka kwa mankhwalawa, komanso kayendedwe ka glycemic.

Pa gawo loyambirira la insulin, zolakwika zotupa, edema ndi zimachitika zimapezeka pamalo a jakisoni (kuphatikiza ululu, kufiyira, ming'oma, kutupa, kuphwanya, kutupa ndi kuyunkhira pamalo a jekeseni. Zizindikirozi nthawi zambiri zimakhala zakanthawi. Kusintha kwapang'onopang'ono pakuwongolera glycemic kumatha kubweretsa mkhalidwe wa ululu wammbuyo wammbuyo, womwe nthawi zambiri umatha kusintha. Kulimbitsa kwa insulin mankhwala ndikusintha kolimba kwa mphamvu ya kagayidwe kazakudya kungayambitse kuwonongeka kwakanthawi mu matenda a shuga, pomwe kusintha kwakanthawi kwakanthawi ka glycemic kumachepetsa chiopsezo cha kupitirira kwa matenda ashuga retinopathy.

Mndandanda wazotsatira zoyipa zimaperekedwa pagome.

Zoyipa zonse zomwe zafotokozedwa pansipa, kutengera mtundu wa mayeso azachipatala, zimayikidwa m'magulu molingana ndi kukula kwa chitukuko malinga ndi MedDRA ndi machitidwe a ziwalo. Zomwe zimachitika pakakhala zovuta zimafotokozedwa motere: pafupipafupi (≥1 / 10), nthawi zambiri (≥1 / 100,

* Onani Mafotokozedwe amachitidwe amodzi osiyana

Mafotokozedwe amachitidwe amodzi osiyana

Machitidwe a anaphylactic. Zochitika kawirikawiri kwambiri zamagulu a hypersensitivity (kuphatikizapo kuphathamira pakhungu, kuyabwa, thukuta, kusokonezeka kwa m'mimba, angioedema, kupuma movutikira, kutsitsa kwamtima, kuchepa kwa magazi), zomwe zimatha kukhala pachiwopsezo cha moyo, zimadziwika.

Hypoglycemia. Hypoglycemia ndi njira yodziwika kwambiri yotsatirira.Zimatha kukhala ngati mlingo wa insulini ndiwokwera kwambiri poyerekeza ndi kufunika kwa insulin. Hypoglycemia yayikulu imatha kuwononga chikumbumtima ndi / kapena kukhudzika, kusokonezeka kwakanthawi kapena kosasintha kwa ubongo kugwira ntchito mpaka pakufa. Zizindikiro za hypoglycemia, monga lamulo, zimayamba mwadzidzidzi. Izi zitha kuphatikizira thukuta lozizira, kutsekeka kwa khungu, kutopa kwambiri, mantha kapena kunjenjemera, nkhawa, kutopa kapena zachilendo, kusokonezeka, kuchepa, kugona, kugona kwambiri, kusawona bwino, kupweteka mutu, kusanza, komanso kusokonezeka kwa mtima. Kafukufuku wachipatala adawonetsa kuti kuchuluka kwa hypoglycemia kumasiyana malinga ndi kuchuluka kwa odwala, dosing regimen, ndi glycemic control. M'mayesero azachipatala, panalibe kusiyana kulikonse pazochitika za hypoglycemia pakati pa odwala omwe amalandila mankhwala a insart insulin ndi odwala omwe amagwiritsa ntchito kukonzekera kwa insulin.

Lipodystrophy. Nthawi zambiri za lipodystrophy zalembedwa. Lipodystrophy imatha kupezeka pamalo a jakisoni.

Hypoglycemic zotsatira za insulin patsogolo mankhwala m'kamwa hypoglycemic, Mao zoletsa, zoletsa Ace, carbonic zoletsa anhydrase, kusankha beta-blockers, bromocriptine, octreotide, sulfonamides, anabolic mankhwala, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, kukonzekera lifiyamu Muli okonzekera ethanol. Njira zakulera za pakamwa, GCS, mahomoni a chithokomiro, thiazide diuretics, heparin, tridclic antidepressants, sympathomimetics, danazole, Clonidine, calcium njira blockers, diazoxide, morphine, phenytoin, nikotini zimafooketsa mphamvu ya hypoglycemic. Mothandizidwa ndi reserpine ndi salicylates, kufooka komanso kuwonjezeka kwa machitidwe a mankhwalawa ndizotheka. Beta-blockers amatha kufinya zizindikiro za hypoglycemia. Mowa umatha kukulitsa mphamvu ya hypoglycemic ya insulin. Kuchita zamankhwala. Mankhwala okhala ndi thiols kapena sulfite, akaphatikizidwa ndi insulin, aspart amawononga. NovoMix® 30 FlexPen ® siyingowonjezeredwa pazomwe zimayambitsa kulowetsedwa.

Mlingo wa Novomix 30 flekspen

NovoMix® 30 FlexPen ® cholinga chake ndi kuyang'anira sc. Osayang'anira NovoMix® 30 FlexPen ® iv chifukwa izi zimatha kuyambitsa kwambiri hypoglycemia. Makina a NovoMix® 30 FlexPen ® nawo ayenera kupewedwa. Osagwiritsa ntchito NovoMix ® 30 FlexPen ® chifukwa cha kulowerera kwa insulin (PPII) pamapampu a insulin.

Mlingo wa NovoMix® 30 FlexPen ® umatsimikiziridwa ndi dokotala aliyense payekha, mogwirizana ndi zosowa za wodwala. Kuti mukwaniritse bwino kwambiri matenda a glycemia, tikulimbikitsidwa kuwongolera kuchuluka kwa shuga m'magazi ndikusintha mlingo wa mankhwalawa.

NovoMix® 30 FlexPen ® imatha kuperekedwa kwa odwala omwe ali ndi mtundu wa 2 shuga mellitus onse monga monotherapy komanso kuphatikiza ndi mankhwala amkamwa a hypoglycemic panthawi yomwe kuchuluka kwa shuga m'magazi kumangoyendetsedwa kokha ndi mankhwala amkamwa a hypoglycemic.

Kwa odwala omwe ali ndi matenda a shuga a mtundu woyamba omwe amapatsidwa insulin yoyamba, mankhwalawa a NovoMix ® 30 FlexPen ® ndi magawo 6 musanadye chakudya cham'mawa komanso 6 gawo musanadye chakudya. Kukhazikitsidwa kwa magawo 12 a NovoMix® 30 Flexpen® kamodzi patsiku madzulo (musanadye chakudya chamadzulo) ndikololedwa.

Kusamutsa wodwala kuchokera kukonzekera kwina kwa insulin

Mukasamutsa wodwala kuchokera ku biphasic insulin ya anthu kupita ku NovoMix® 30 FlexPen ®, wina ayenera kuyamba ndi kumwa ndi mtundu womwewo wa makonzedwe. Kenako sinthani za mankhwalawa mogwirizana ndi zofunikira za wodwalayo (onani malingaliro otsatirawa okhudza kuchuluka kwa mankhwalawo).Monga nthawi zonse, posamutsa wodwala kupita ku mtundu wina wa insulin, kuyang'aniridwa mosamala kuchipatala ndikofunikira pakusintha kwa wodwalayo komanso m'masabata oyamba ogwiritsa ntchito mankhwalawa.

Kulimbikitsanso chithandizo cha NovoMix® 30 FlexPen ® ndikutheka ndikusintha kuchokera ku mlingo umodzi wa tsiku lililonse kupita pawiri. Ndikulimbikitsidwa kuti mutatha kulandira magawo 30 a mankhwalawa kuti mugwiritse ntchito NovoMix® 30 FlexPen ® katatu pa tsiku, mugawa mgawo m'magawo awiri ofanana - m'mawa ndi madzulo (musanadye chakudya cham'mawa komanso chamadzulo).

Kusinthika kwa kugwiritsidwa ntchito kwa NovoMix® 30 FlexPen ® katatu pa tsiku ndikotheka ndikugawa mlingo wa m'mawa m'magawo awiri ofanana ndikuyambitsa magawo awiriwa m'mawa komanso pachakudya chamasana (katatu tsiku tsiku).

Magulu apadera a odwala

Monga momwe amagwiritsidwira ntchito pokonzekera insulin, mwa odwala omwe ali m'magulu apadera, shuga wamagazi amayenera kuyang'aniridwa mosamala komanso mlingo wa aspart aspart payekha.

Okalamba komanso odwala a senile. NovoMix® 30 FlexPen ® ikhoza kugwiritsidwa ntchito mwa odwala okalamba, komabe, zomwe zimawagwiritsa ntchito limodzi ndi mankhwala am'mlomo a hypoglycemic odwala omwe ali ndi zaka zoposa 75 ndizochepa.

Odwala ndi opuwala ntchito usiku ndi chiwindi. Odwala omwe ali ndi vuto la impso kapena hepatic, kuchepa kwa insulin kumatha kuchepetsedwa.

Ana ndi achinyamata. NovoMix® 30 FlexPen ® ikhoza kugwiritsidwa ntchito pochiza ana ndi achinyamata azaka zopitilira zaka 10 milandu ikakhala kuti amakonda kugwiritsa ntchito insulin yosakanizika kale. Zambiri zamankhwala azachipatala zimapezeka kwa ana azaka zapakati pa 6-9 (onani Pharmacodynamics).

NovoMix® 30 FlexPen ® iyenera kuperekedwa mwachangu mu ntchafu kapena kunja kwamimba khoma. Ngati angafune, mankhwalawa amatha kuperekedwa kwa phewa kapena matako.

Ndikofunikira kusintha malo a jekeseni mkati mwa anatomical dera kuti muchepetse kukula kwa lipodystrophy.

Monga kukonzekera kwina konse kwa insulin, kutalika kwa nthawi ya NovoMix® 30 FlexPen ® kutengera mlingo, malo oyendetsera, kutsika kwa magazi, kutentha ndi mulingo wakuchita zolimbitsa thupi.

Poyerekeza ndi biphasic insulin ya anthu, NovoMix® 30 FlexPen ® imayamba kuchita zinthu mwachangu, chifukwa chake iyenera kuperekedwa mwachangu musanatenge wopemphayo. Ngati ndi kotheka, NovoMix® 30 FlexPen ® ikhoza kutumikiridwa patangotha ​​kumeza.

Malangizo kwa wodwala

FlexPen ® ndi cholembera cha syringe yomwe imapangidwa kuti ipereke insulin. FlexPen ® imagwiritsidwa ntchito ndi singano zazifupi za NovoFayn ®. Kukhazikitsidwa kwa singano zazifupi za NovoFine ® sikulembedwera S. Musagwiritse ntchito NovoMix® 30 FlexPen ® ngati, mutagwedezeka, kuyimitsidwa sikusintha kukhala koyera komanso koyenda mofananirana. Mankhwalawa sangathe kugwiritsidwa ntchito ngati zotupa zoyera zikupezekamo kapena tinthu tating'onoting'ono timamatira pansi kapena makhoma a cartridge, ndikupangitsa kuti iwoneke ngati yowuma. Cholembera chimbale cha FlexPen ® chimapangidwira kuti chizingogwiritsa ntchito payekha ndipo sichingakwaniritsidwenso. Malangizo mwatsatanetsatane ogwiritsira ntchito amaperekedwa mu malangizo ogwiritsira ntchito omwe aikidwa phukusi lililonse.

Zizindikiro: hypoglycemia imayamba. Chithandizo: wodwalayo amatha kuyimitsa shuga wofatsa pogwiritsa ntchito shuga, shuga kapena zakudya zamafuta ambiri. Chifukwa chake, ndikulimbikitsidwa kwa odwala omwe ali ndi matenda ashuga kuti azikhala ndi shuga, maswiti kapena mandimu okoma zipatso nthawi zonse. Zikakhala zovuta, wodwalayo akapanda kuzindikira, yankho la 40% dextrose (shuga) limayendetsedwa ndi iv, glucagon (0.5-1 mg) IM kapena SC. Pambuyo pakupezanso chikumbumtima, wodwalayo akulimbikitsidwa kudya zakudya zamafuta ambiri kuti aletse kukonzanso kwa hypoglycemia.

Zambiri zakugwiritsa ntchito NovoMix

Pofuna kupewa zovuta za matenda ashuga, mabungwe apadziko lonse a endocrinologists amalimbikitsa kuyamba kwa insulin. Jekeseni amatchulidwa atangoyamba glycated hemoglobin (GH) kupitilira muyeso mukalandira mankhwala a antidiabetesic mapiritsi.Odwala amafunikira kusintha kwakanthawi kuti athe kukhala chiwembu. Zokonda zimaperekedwa kwa mankhwala abwino, ngakhale atakhala ndi mtengo wotani. Zothandiza kwambiri ndi ma insulin analogues.

Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale

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

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

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

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

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

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

NovoMix Flexpen imagwirizana kwathunthu ndi izi. Imagwira ntchito maola 24, zomwe zikutanthauza kuti poyamba jakisoni imodzi idzakwanira. Kutsimikizika kwa mankhwala a insulin ndikuwonjezereka kwa chiwerengero cha jakisoni. Kusintha kuchokera ku magawo awiri kupita ku mankhwala osokoneza bongo kumafunika pamene kapamba watsala pang'ono kugwira ntchito. Insulin NovoMiks idadutsa mayeso opitilira muyeso omwe atsimikizira kuti ikuyenda bwino.

Ubwino wa NovoMix

Kutsimikiziridwa kuposa NovoMix 30 pazosankha zina

• imakulitsa shuga 345% kuposa insulins basal NPH,
• pakuchepetsa hemoglobin wa glycated, mankhwalawa ndi othandizira 38% kuposa zosakanikirana za insulin za anthu,
• kuwonjezera kwa NovoMix ku metformin m'malo mwa kukonzekera kwa sulfonylurea kumatha kuchepetsa 24% ya GH.

Ngati, mukamagwiritsa ntchito NovoMix, shuga othamanga amakhala apamwamba kuposa 6.5, ndipo GH ndi apamwamba kuposa 7%, ndi nthawi yoti musinthe kuchokera ku kusakanikirana kwa ma insulin kupita ku hormone yayitali komanso yochepa payokha, mwachitsanzo, yopanga yemweyo. Ndizovuta kwambiri kuzigwiritsa ntchito kuposa NovoMix, koma powerengera molondola, amapereka bwino glycemic control.

Kusankhidwa kwa insulin

Ndi mankhwala ati omwe amafunikira mtundu wa 2 odwala matenda ashuga poyambira mankhwala a insulin:

Kupereka mankhwala a insulin sikuletsa chakudya ndi metformin.

Mankhwala a NovoMix

Mlingo wa insulin ndi wa munthu aliyense pa matenda ashuga aliyense, chifukwa kuchuluka kwa mankhwalawa sikungotengera shuga wamagazi, komanso mawonekedwe a kuyamwa kuchokera pansi pa khungu komanso mulingo wa kukana insulin. Malangizowo akuwonetsa kuyambitsidwa kwa mayunitsi 12 kumayambiriro kwa mankhwala a insulin. Novomix Pakati pa sabata, mlingo sasinthidwa, shuga yofulumira imayezedwa tsiku lililonse. Pamapeto pa sabata, mlingo umasinthidwa malinga ndi tebulo:

Sabata yotsatira, mlingo wosankhidwa uyendera. Ngati shuga akusala kudya mwachizolowezi ndipo palibe hypoglycemia, mlingo umatengedwa ngati wolondola. Malinga ndi ndemanga, kwa odwala ambiri, kusintha kawiri kotere ndikokwanira.

Njira yosavuta yoyambira

Momwe mungakwaniritsire kubwezeredwa kwa shuga ndi mitundu ingapo ya jakisoni:

1. Timalowetsa muyeso wa chakudya musanadye, ndikusintha, monga tafotokozera pamwambapa. Kupitilira miyezi 4, GH idasinthasintha mu 41% ya odwala.
2. Ngati cholinga sichikwaniritsidwa, onjezani magawo 6. NovoMix Flexpen musanadye chakudya cham'mawa, m'miyezi 4 yotsatira, GH imafika pachimake pa 70% ya odwala matenda ashuga.
3. Ngati zalephera, onjezani magulu atatu. NovoMix insulin musanadye chakudya chamadzulo. Pakadali pano, GH imakhala yokhazikika mu 77% ya odwala matenda ashuga.

Ngati dongosololi silipereka chindapusa chokwanira cha matenda a shuga, ndikofunikira kusinthira kwa insulin yayitali + mwachidule muyezo wa jekeseni osachepera 5 patsiku.

Malamulo a chitetezo

Onse shuga komanso otsika kwambiri angayambitse. Hypoglycemic coma imatheka mu diabetes iliyonse yemwe ali ndi bongo wa NovoMix insulin. Chiwopsezo cha kukomoka kwa hyperglycemic ndikweza, kutsika kwa mahomoni anu omwe.

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

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

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russia Academy of Medical Science idatha kupanga mankhwala omwe amachiritsiratu matenda ashuga. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipira mtengo wapamwamba wa mankhwalawa. Ku Russia, odwala matenda ashuga mpaka April 22 (wophatikizidwa) nditha kuipeza - Kwa ma ruble 147 okha!

Popewa zovuta, mukamagwiritsa ntchito insulin, muyenera kutsatira malamulo otetezeka:

1. Mutha kulowa mankhwalawa pokhapokha kutentha. Vala yatsopano imachotsedwa mufiriji maola 2 asanafike kubayidwa.
2. Insulin ya NovulinMix imafunika kusakaniza bwino. Malangizo ogwiritsira ntchito amalimbikitsa kugudubuza cartridge pakati pa kanjedza kakhumi, ndikuyisintha m'malo osasunthika ndikukweza kwambiri mpaka ma 10.
3. Kubaya kuyenera kuchitidwa mukangoyambitsa.
4. Ndizowopsa kugwiritsa ntchito insulin ngati, mutasakaniza, makhiristo amakhalabe khoma la cartridge, mapampu kapena ma flakes poyimitsa.
5. Ngati vutoli lauma, litasiyidwa padzuwa kapena kutentha, cartridge imakhala ndi osweka, singagwiritsenso ntchito.
6. Pakapita jakisoni aliyense, singano imayenera kuchotsedwa ndikuitaya, kutseka cholembera ndi cholembera.
7. Musati mupeze NovoMix Penfill mu minofu kapena mtsempha.
8. Pa jakisoni watsopano aliyense, malo ena amasankhidwa. Ngati redness iwoneka pakhungu, jakisoni sayenera kupangidwa m'derali.
9. Kuti muwonetsetse kuti wodwala yemwe ali ndi matenda ashuga azikhala ndi cholembera chokha kapena katoni ndi insulin komanso syringe. Malinga ndi odwala matenda ashuga, amafunikira mpaka 5 pachaka.
10. Osagwiritsa ntchito cholembera cha wina, ngakhale singano isinthidwa mu chipangizocho.
11. Ngati zikuwonetsedwa pa cholembera chotsalira kuti pali zosakwana 12 m'gudumu, sizingasokedwe. Wopangayo samatsimikizira kuti mahomoni azikhala kuti atsala bwanji yankho.

Gwiritsani ntchito ndi mankhwala ena

Novomix wavomerezedwa kuti agwiritsidwe ntchito ndi mapiritsi onse a antiidiabetes. Ndi mtundu 2 wa matenda ashuga, kuphatikiza kwake ndi metformin ndikothandiza kwambiri.

Ngati odwala matenda ashuga apatsidwa mapiritsi olembetsa matenda oopsa, beta-blockers, tetracyclines, sulfonamides, antifungals, anabolic steroids, hypoglycemia ikhoza kuchepetsedwa.

Thiazide diuretics, antidepressants, salicylates, mahomoni ambiri, kuphatikizapo pakamwa, amatha kufooketsa insulin ndikuwatsogolera ku hyperglycemia.

Lamulo Lachinayi

Ngati zifukwa zoyipa zili mu insulin "yochepa", mlingo wawo umatha kusinthidwa pafupipafupi (ngakhale tsiku lililonse) - malinga ndi zotsatira za kudzipenda nokha kwa glycemia. Ngati shuga ndiwambiri musanadye, onjezani mankhwalawo kuti 1 unit ya insulini ithetse shuga pafupi 2 IU mmol / L - munakwaniritsa mlingo waposachedwa (mwasintha mwadzidzidzi).Kupewa hyperglycemia nthawi yomweyo mawa, kupereka mankhwala nthawi zambiri, pokhapokha ngati chakudya chofananira chikhale ndi chiwerengero chofanana cha chakudya chamagulu.

Ma Analogs a NovoMix

Palibenso mankhwala ena omwe ali ndi mtundu wofanana ndi NovoMix 30 (aspart + aspart protamine), ndiye kuti, analogue yathunthu. Ma insulin ena a biphasic, analog ndi anthu, akhoza kulowezani m'malo mwake:

Kumbukirani kuti kusankha mankhwala ndi mlingo wake ndibwino ndi katswiri.

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

NovoMix 30 FlexPen ndi kuyimitsidwa kwamitundu iwiri komwe kumakhala kusakanikirana kwa insulin analogen: insulin aspart (analog ya human insulin-insulin) ndi protamine-insulin aspart (analog ya insulin ya anthu omwe amakhala nthawi yayitali). Kutsika kwa shuga m'magazi mothandizidwa ndi insulin aspart kumachitika pambuyo povomerezana ndi insulin receptors, zomwe zimapangitsa kuti pakhale shuga ndi minyewa komanso mafupa am'magazi ndipo nthawi imodzi imalepheretsa kutulutsa shuga m'chiwindi. NovoMix 30 FlexPen ndi kuyimitsidwa kwamitundu iwiri komwe kumakhala ndi 30% ya soluble aspart insulin. Izi zimathandizira kuyambira mwachangu poyerekeza ndi insulin yamunthu ndipo imalola kuti mankhwalawa athandizidwe mwachangu musanadye (kuyambira 0 mpaka 10). Gawo lachigiriki (70%) limakhala ndi protamine-insulin aspart, mawonekedwe a zochitika omwe ali ofanana ndi protamine-insulin Hagedorn (NPH) yotsutsana ndi anthu. NovoMix 30 FlexPen imayamba kuchita mphindi 10 mpaka 10 pambuyo pa jekeseni wa sc. Kuchuluka kwake kumakwaniritsidwa maola a 1-4 pambuyo pa utsogoleri. Kutalika kwa kuchitapo kanthu mpaka maola 24.
Mlingo wa hemoglobin wa glycosylated odwala omwe ali ndi mtundu woyamba 1 ndi mtundu wa 2 shuga, omwe amaperekedwa ndi NovoMix 30 kwa miyezi itatu, ndi chimodzimodzi ngati akuwonetsa insulin ya anthu. Mlingo wofananira womwewo utaperekedwa, insulin imagart ikufanana ndi zochitika za insulin ya anthu. Pakafukufuku wazachipatala, odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga a mellitus (anthu 341), ogawika m'magulu malinga ndi mfundo zosasinthika, adangolandira NovoMix 30 FlexPen, kapena NovoMix 30 FlexPen kuphatikiza ndi metformin, kapena metformin palimodzi ndi sulfonylurea. Pambuyo pa chithandizo cha milungu 16, malingaliro a glycosylated hemoglobin НbА1с mulingo wa odwala omwe amalandila NovoMix 30 osakanikirana ndi metformin kapena metformin osakanikirana ndi sulfonylurea anali ofanana. Phunziroli, mu 57% ya odwala, mulingo wa HbA1c ndiwokwera kuposa 9%. Mwa odwalawa, kuphatikiza kwa NovoMix 30 FlexPen ndi metformin kunapangitsa kuchepa kwambiri kwa HbA1c poyerekeza ndi kuphatikiza kwa metformin ndi sulfonylurea.
Pakufufuza kwa odwala matenda amtundu wa II omwe amawongolera
glycemia kudzera pakamwa hypoglycemic mankhwala
idatsika, ndipo imathandizira pakubwera kwa mankhwala
NovoMix 30 kawiri patsiku (odwala 117) kapena mwa makina
insulin glargine kamodzi patsiku (odwala 116). Pambuyo pa masabata 28
Chithandizo cha NovoMix 30, limodzi ndi
Kusankhidwa kwa Mlingo, mulingo wa HbA1c watsika ndi 2.8% (pafupifupi
Makhalidwe a HbA1c akaphatikizidwa mu kafukufuku = 9.7%). Munthawi yamankhwala a NovoMix 30, HbA1c yotsika ndi 7% idafika pa 66% ya odwala, ndipo ochepera 6.5% - 42% mwa odwala.
kuthamanga kwa plasma glucose kumeneku kunachepa
pafupifupi 7 mmol / l (kuyambira 14.0 mmol / l musanalandire chithandizo - mpaka 7.1
mmol / l).
Pharmacokinetics . Mu insulin, aspart, amino acid proline yomwe ili pa 28 ya B ya molekyulu ya insulin imasinthidwa ndi spartic acid, yomwe imachepetsa mapangidwe a hexamers omwe amapangidwa pokonzekera insulin yaumunthu. Mu gawo losungunuka la NovoMix 30 FlexPen, gawo la insulin aspart ndi 30% ya insulin yonse.Amatengedwa m'magazi kuchokera ku minyewa yothamanga mofulumira kuposa insulle insulin ya biphasic insulin yamunthu. 70% yotsalayo imawerengedwa ndi mtundu wa crystalline wa protamine-insulin aspart, womwe umayamwa nthawi yayitali ndendende ndi insulin NPH ya munthu.
Kuchuluka kwa insulini mu seramu yamagazi pambuyo pa kutumikiridwa kwa NovoMix 30 Flexpen ndi 50% kuposa, ndipo nthawi yakufikirako ndi theka la mabapasic insulin 30. Mwa odzipereka athanzi, pambuyo pa sc ya NovoMix 30 pamlingo wa 0,20 U / kg kuchuluka kwa thupi kuchuluka kwa insulini mu seramu kunatheka pambuyo mphindi 60 ndipo anali 140 ± 32 pmol / L. Hafu ya moyo wa NovoMix 30, yomwe imawonetsa kuyamwa kwa kachigawo kakang'ono ka protamine, anali maora 8-9. Mlingo wa insulin m'magazi seramu unangobwerera kumene maola 15-18 itatha. Odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga, amakhala ndi chidwi chofika mphindi 95 atakhazikitsa ndipo amakhala osachepera maola 14.
Ana ndi achinyamata.
The pharmacokinetics of NovoMix 30 FlexPen mwa ana ndi achinyamata sichinafufuzidwe. Komabe, mwa ana (azaka 6 mpaka 12) ndi achinyamata (azaka 13 mpaka 17) omwe ali ndi matenda amtundu woyamba 1, a pharmacokinetics ndi pharmacodynamics a soluble aspart insulin adaphunzira. Zinali zotengeka mwachangu kwa odwala a magulu onse awiriwa, pomwe zofunikira za nthawi kuti zitheke kuzunzidwa zinali zofanana ndi za akulu. Nthawi yomweyo, mitengo ya Cmax yamagulu osiyanasiyana inali yosiyana kwambiri, zomwe zikuwonetsa kufunikira kwa kusankha kwa mankhwala a insulin.
Ma pharmacokinetics a NovoMix 30 sanaphunziridwe payekha.
okalamba, ana ndi odwala omwe ali ndi vuto la ntchito
impso kapena chiwindi.

Lamulo Lachisanu

Sinthani mosamala mlingo - osaposa 1-2, okwanira 3-4 UNITS, akutsatiridwa mosamala ndi shuga wamagazi. Ngati hyperglycemia ikadali yotalikirapo, ndibwino kubwereza kukhazikitsidwa kwa mapiritsi a 2-5 a insulin "yayifupi" pambuyo 2 maola. Simuyenera kuthamangira ndi kuwonjezeka Mlingo, chifukwa mumadziwa kale kuti kuchepa kothamanga kwa shuga msanga ndizowopsa kuposa momwe zimakhazikika koma modekha (mwachidziwikire, ngati kulibe ketosis, koma tidakambirana kale izi pofotokoza zovuta za matenda ashuga).
Mu zolemba zina muli malingaliro a hyperglycemia pamwambapa 18 mmol / l kuti awonjezere magawo 12 (!) Ku mlingo womwe wakonzedwa wa insulin "yifupi".

Tiwerenge. 1 unit ya insulin imachepetsa shuga wa magazi ndi 2 mmol / L. Chulukitsani 2 ndi 12 ndikupeza 24 mmol / L Koma palinso mlingo wa insulin "wafupikitsa". Ndiye timakhala ndi chani pamapeto? Zambiri hypoglycemia, mosakaikira. Ngati shuga ndiwokwera kwambiri - oposa 18 mmol / l, ndibwino kuwonjezera magawo awiri a 2-4 pamankhwala omwe anakonzedwa kuti ayang'anire shuga pambuyo maola 1.5-2, ndipo ngati chizindikirocho chikadalinso chimodzimodzi, pangani "pop" ina yamagulu atatu omwewo "Mwachidule" insulin. Pambuyo pa maola 1-1.5, mudzafunikiranso kuwona shuga.

Ngati palibe chomwe chasintha, ndibwino kukaonana ndi dokotala posachedwa. Pokhapokha ngati chithandizo chachipatala sichikupezeka (wodwalayo ali kutali kwambiri ndi chipatala), mutha kuyesanso kuwonjezera jakisoni wa insulin "yayifupi" pa 1 kg ya kulemera kwa ola limodzi.

Mwachitsanzo, wodwala amalemera 80 kg. 0.05 kuchulukitsa ndi 80 ndikupeza zotsatila - 4 mayunitsi. Mlingowu ukhoza kuperekedwa nthawi imodzi pa ola limodzi, pokhapokha ngati magazi a shuga nawonso atsimikiziridwa ola lililonse. Ngati kuchepa kwa glycemia kukhala ochulukirapo kwa 4 mmol / l pa ola limodzi, muyenera kuyimitsa "jabs" ndikupitiliza kudziwa shuga wamagazi ola lililonse. Mulimonse momwe zingakhalire, gawo limodzi lokha la insulin "yochepa" sayenera kupitirira magawo 14-16 (okonzedwa kuphatikizanso kuwongolera). Ngati ndi kotheka, jakisoni wowonjezera wa "lalifupi" wa insulin ungathe kuchitika ma ola a 6,6 m'mawa.

Lamulo Chisanu ndi chiwiri

Ngati shuga alibe kwambiri (osaposa 15-17 mmol / l), sinthani mlingo umodzi wa insulin kamodzi, mwachitsanzo, "kukulitsidwa". Yembekezerani masiku atatu, pomwe muyeso wa shuga, ngati ungachepetse pang'onopang'ono, kufikira zomwe mukufuna, simungasinthe mlingo wa insulin "yayifupi". Ngati nthawi yomweyo masana, kuphatikiza mukatha kudya, shuga amangodutsa, magawo awiri a insulin "yayifupi" akufunika kuwonjezeredwa. M'malo mwake, siyani kuchuluka kwa insulini "yowonjezereka" yomweyo, koma sinthani imodzi "yayifupi", koma pang'ono pang'ono - magawo 1-2, pazofunikira 3 (izi zimatengera kuchuluka kwa shuga m'magazi musanadye).

Onetsetsani kuti mwayang'anitsitsa chakudya mukatha kudya (pambuyo pa maola 1-2, kutengera nthawi yomwe mwakhala mukugwira ntchito kwambiri - zochita zapamwamba) -

Lamula Nine

Ngati mulingo wanu wa shuga umakwezedwa kuzungulira koloko, yesani kaye kuchotsa mtengo wapamwamba kwambiri. Kusiyana kwazidziwitso masana ndizochepa - kopanda 2.8 mmol / l? Kenako sinthani manambala a m'mawa. Mwachitsanzo, ngati kusala kudya kwa magazi ndi 7,2 mmol / L, ndi maola awiri mutatha kudya - 13.3 mmol / L, sinthani shuga yofupikira mwachangu ndi 7.2 mmol / L, ndipo mutatha kudya - 8, 9 mmol / l? Pang'onopang'ono sinthani insulin "yowonjezera", ndipo pokhapokha, ngati kuli kotheka, tengani "mwachidule".

Lamulira Khumi

Ngati kuchuluka kwa insulin tsiku lonse ndi gawo limodzi pa kilogalamu imodzi ya kulemera kwa thupi, kuchuluka kwa insulini kwambiri kumachitika. Ndi kuchuluka kwa insulin yovulaza, matenda osokoneza bongo ochulukirapo amakula, zochitika zowonjezera za hypoglycemia zimasinthidwa ndikukwera kwambiri kwa shuga kupita pamitengo yapamwamba, chilimbikitso chimakulirakulira ndipo, ngakhale kuwonongeka kwa matenda ashuga, kulemera koyimba sikumachepa, koma m'malo mwake kumakula.

Kuphatikiza apo, chiwonetsero cha mankhwala osokoneza bongo a insulin yamadzulo ikhoza kukhala chochitika cha Somogy, pamene hyperglycemia imayamba m'mawa poyankha usiku wa hypoglycemia, womwe nthawi zambiri umapangitsa kuchuluka kwamankhwala a insulin ndipo kumangokulitsa kuvuta kwa vutoli. Kuwonjezeka kwa shuga ndi chodabwitsa cha Somoji kumatha kupitiliza kwa maola 72, ndipo nthawi zina kumabweretsa ketoacidosis.

Wolamulira Eleven

Ngati mukulephera kuzindikira machitidwe a hypoglycemic, muyenera kuwonjezera chiyembekezo chanu cha shuga.

Kuphatikiza pakusintha Mlingo wa insulin, zakudya komanso masewera olimbitsa thupi ziyeneranso kuunikidwanso. Ngati hypoglycemia imakhala pafupipafupi, ndikofunikira kusintha makabatiwidi: onjezerani chakudya chosafunikira pakatikati kapena muwonjezere kuchuluka kwawo pakudya cham'mawa, nkhomaliro kapena chakudya chamadzulo (makamaka masana akudya).

Ponena za zolimbitsa thupi, ziyenera kuchepetsedwa pankhaniyi. Koma ngati shuga ndiwosakhwima, ndikofunikira, m'malo mwake, kuti muchepetse kudya zakudya zamagulu ambiri panthawi yakudya komanso kuchita masewera olimbitsa thupi. Sikoyenera kuti tiletse zokhwasula-khwasula kapena zoziziritsa kukhosi - izi zimatha kuwonjezera kusinthasintha kwa glycemia.
Malangizo othandizira insulin zabwino kwa aliyense, koma mwa odwala ena sizingagwire ntchito. Mwachitsanzo, anthu okalamba kapena omwe sangathe kudzisamalira sangathe kudzisankhira pawokha kusintha kwa jekeseni ndikupanga jakisoni moyenera. Zofananazo zinganenedwe kwa iwo omwe ali ndi matenda amisala kapena omwe ali ndi maphunziro ochepa.

Njirayi ndiyothekanso kwa odwala omwe alibe kuyesera pawokha kuyeza kuchuluka kwa shuga m'magazi, ngakhale kuti ma glucometer tsopano ndi okwera mtengo kwambiri kotero kuti mavuto otere ndi osowa kwambiri. Palibe chomwe chingagwire ntchito ndi njira yolimbikikira mwa anthu osaphunzira. Zachidziwikire, ndizosatheka, ngati munthu akukana jakisoni wambiri komanso ndikutulutsa dontho lamwazi kuchokera chala. Zikatero, gwiritsani ntchito chikhalidwe cha insulin mankhwala.
Munthawi yachikhalidwe 2 pa tsiku panthawi yolimba - musanadye chakudya cham'mawa komanso musanadye - yikani Mlingo wofanana wa insulin "yochepa" komanso "yayitali". Ndi dongosolo lotere la chithandizo kotero kuti amaloledwa kusakaniza ma insulin afupia ndi apakati mu syringe imodzi palokha. Komanso, zosakanikirana zazifupi "zazifupi" ndi "zapakatikati" tsopano zalowa m'malo mwa zosakanikirana zoterezi. Njirayi ndiyabwino komanso yosavuta (odwala ndi abale awo amamvetsetsa bwino zomwe akuyenera kuchita), kuphatikiza apo, amafunika jakisoni ochepa. Ndipo glycemic control ikhoza kuchitidwa kangapo poyerekeza ndi pulogalamu yowonjezereka, zidzakhala zokwanira kuchita izi kawiri pa sabata.

Ichi ndichifukwa chake ndibwino kwa anthu osakwatira osakwatiwa komanso odwala omwe ali ndi zilema pakudziyang'anira.

Tsoka ilo, kukwaniritsa kutsata kwachilengedwe kwambiri kwa insulin ndipo, chifukwa chake, kubwezera kwabwino kwa shuga munjira imeneyi ndikosatheka. Munthu amakakamizidwa kuvomereza mosamalitsa kulandira kuchuluka kwa chakudya chamafuta omwe amatsimikiziridwa malinga ndi mlingo wosankhidwa wa insulin, nthawi zonse muzidya chakudya nthawi yomweyo, muziyang'anira maulamuliro a tsikulo ndi zochitika zolimbitsa thupi. Kusiyana kwa kadzutsa ndi chakudya chamadzulo sikuyenera kupitirira maola 10. Kwa anthu omwe akukhala ndi moyo wogwira ntchito, njira iyi yothandizira mankhwalawa siyabwino kwenikweni, koma popeza ilipo ndipo imagwiritsidwa ntchito, tidzalankhula zambiri mwatsatanetsatane.

Mukudziwa kale za kupezeka kwa mankhwala ophatikiza, omwe ali ndi kaphatikizidwe ka "kafupikitsidwe" ndi "insulin" yayitali.
Tcherani khutu Pafupifupi dzina lililonse la insulini yophatikizika mumakhala mawu akuti "kusakaniza", omwe amatanthauza kusakaniza, kapena "chisa" ndi chidule cha mawu oti "kuphatikiza". Atha kukhala zilembo zazikulu "K" kapena "M". Uku ndikulemba kwapadera kwa insulini, kofunikira kuti musasokoneze mitundu yachilendo ndi zosakaniza.

Kuphatikiza apo, botolo lirilonse liyenera kukhala ndi mawonekedwe a digito ofanana ndi magawo a insulin "yayifupi" komanso "yayitali." Mwachitsanzo, lingalirani Humalog Remix 25: humalog ndi dzina la insulin palokha, kusakaniza ndi chisonyezo kuti ichi ndi chisakanizo cha "kufupikira" ndipo "Olonjezedwa" humalogue, 25 - gawo la "lalifupi" la insulini muzosakaniza ndi 25%, ndipo gawo la "kukulitsidwa", motsatana, 75% yotsala.

NovoMix 30

Mu NovoMiks 30 gawo la insulin "lalifupi" likhala 30%, ndipo "lidzakhalitsa" - 70%.
Monga nthawi zonse, adokotala ayenera kudziwa kuchuluka kwa insulin tsiku lililonse. Kenako, 2/3 ya mlingo amatumizidwa musanadye kadzutsa, ndipo 1/3 - musanadye chakudya chamadzulo. M'mawa uno, gawo la insulin "lalifupi" likhala 30 40%, ndipo gawo la "kukulitsidwa", motero, 70-60%. Madzulo, insulin "yayitali" komanso "yochepa" nthawi zambiri imayendetsedwa molingana, kotero zosintha ziwiri ziyenera kupezeka, mwachitsanzo 30/70 ndi 50/50.

Inde, pa mtundu uliwonse wa zosakaniza muyenera kupatula zolembera. Odziwika kwambiri ndi zosakaniza zomwe zimakhala ndi insulin 30 yochepa (NovoMiks 30, Mikstard NM30, Humulin M3, etc..). Madzulo, ndikwabwino kugwiritsa ntchito zosakaniza momwe kuchuluka kwa "kufupika" ndi "kukulira" insulin kuyandikira limodzi (NovoMix 50, Humalog Remix 50). Popeza kufunika kwa insulin, kusakaniza ndi mankhwala a 25/75 ngakhale 70/30 kungafunikenso.
Odwala a shuga a Type 1 sikulimbikitsidwa kugwiritsa ntchito mankhwala a insulin, koma ngati muyenera kuchita izi, ndikosavuta kugwiritsa ntchito kuphatikiza ndi insulin yayitali "lalifupi". )
Kukhazikika, kuchuluka ndi kutalika kwa zochita za muyezo insulin osangodalira mlingo womwe waperekedwa (monga mitundu ina yonse), komanso kuchuluka kwa insulin "yofupikira" komanso "yayitali" mwa iwo: kwambiri ngati kusakaniza koyamba, zotsatira zake zimayamba ndikutha kale, mosinthana. Mu malangizo a botolo lirilonse, magawo ake - kuchuluka kwa insulin yomwe ilipo - amawonetsedwa nthawi zonse. Mumawongolera.
Ponena za nsonga za kuchitapo kanthu, pali awiri a iwo: imodzi imatanthawuza kuchuluka kwa insulin "yayifupi", yachiwiri ku "yayitali". Amasonyezedwanso nthawi zonse mu malangizo.Pakadali pano, NovoMix 30 insulin yosakanikirana idapangidwa, yopangidwa ndi "ultrashort" aspart (30%) ndi "kukulitsa" protamine crystalline aspart (70%). Aspart ndi analogue of insulin ya anthu. Gawo lake la ultrashort limayamba kugwira ntchito pakangodutsa mphindi 10-20 pambuyo pa utsogoleri, kukonzekera kwa zochitika kumachitika mu maola 1-4, ndipo gawo lowonjezereka "limagwira" mpaka maola 24.
NovoMix 30 imatha kutumikiridwa nthawi 1 patsiku musanadye komanso ngakhale mutadya.
Mukamagwiritsa ntchito NovoMix 30 glycemia mukatha kudya imachepetsedwa kwambiri ndipo, chomwe ndichofunika kwambiri, kuchuluka kwa ma hypoglycemic amachepetsa nthawi yomweyo, ndipo izi zimapangitsa kuwongolera kuwongolera kwa nthawi yayitali. Mankhwalawa ndi abwino makamaka kwa matenda a shuga a 2, pamene glycemia yausiku ingathe kuyendetsedwa ndi mapiritsi.
Tanena kale kuti kugwiritsa ntchito mankhwala osakanikirana a insulin sikulola kuyang'anira glycemia mosamala. Mulimonse momwe zingathekere, ngati kuli kotheka, makonda ayenera kupatsidwa mankhwala othandizira.
Kuphatikiza apo, m'zaka zaposachedwa, njira yapadera yothandizira insulin yakhala ikugwiritsidwa ntchito mochulukirapo - kupezeka kwamasana masana - yaying'ono. Chitani izi ndi pampu ya insulin.

Kugwiritsa ntchito mankhwala Novomix 30 flekspen

Mlingo wa insulin ndi munthu payekha ndipo amatsimikiza ndi dokotala mogwirizana ndi zosowa za wodwala. Popeza mphamvu ya NovoMix 30 FlexPen imafulumira msanga poyerekeza ndi insulin ya anthu, iyenera kutumikiridwa musanadye. Ngati ndi kotheka, NovoMix 30 FlexPen imatha kuperekedwanso kanthawi kochepa itatha chakudya. Pafupifupi, kufunikira kwa wodwala insulin kumatengera kulemera kwa thupi kuyambira 0,5 mpaka 1.0 mayunitsi / kg / tsiku. Itha kuperekedwa kwathunthu kapena pang'ono mwa kukhazikitsidwa kwa mankhwala a NovoMix 30 Flexpen. Kufunikira kwa insulin tsiku ndi tsiku kumatha kuchuluka kwa odwala omwe amakana (mwachitsanzo, kunenepa kwambiri) ndikuchepa kwa odwala omwe ali ndi zotsalira za insulin.
NovoMix 30 FlexPen nthawi zambiri imatumizidwa sc mpaka ntchafu. Zilonda zitha kupangidwanso m'chigawo cha khomo lamkati, matako kapena minyewa yamapewa. Popewa lipodystrophy, tsamba la jekeseni liyenera kusinthidwa ngakhale mkati mwa thupi limodzi.
Monga kukonzekera kwina kwa insulin, kutalika kwa zochita kumatha kusintha kutengera mlingo, jakisoni siteji, kuthamanga kwa magazi, kutentha ndi kuchuluka kwa zochita zolimbitsa thupi. Kudalira kwazomwe zimayamwa pa jakisoni sindinakufufuze.
NovoMix 30 FlexPen itha kutumizidwa kwa odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga a mellitus onse omwe ali mu mawonekedwe a monotherapy komanso osakanikirana ndi othandizira a hypoglycemic (PSS) pazinthu izi pamene kuchuluka kwa glucose m'magazi sikungathe kulamulidwa bwino pogwiritsa ntchito PSS yokha. Kwa odwala omwe ali ndi mtundu wachiwiri wa shuga wambiri, njira yoyamba ya NovoMix 30 FlexPen yolumikizidwa ndi metformin ndi magawo 6 musanadye chakudya cham'mawa komanso magawo 6 musanadye chakudya chamadzulo. Mutha kuyambitsa makonzedwe ake ndi gawo la magawo 12 musanadye chakudya. Pambuyo pofika pa 30 IU, nthawi zambiri amalimbikitsidwa kusintha kuchokera jakisoni imodzi mpaka jekeseni awiri patsiku la 15 IU musanadye chakudya cham'mawa komanso chakudya chamadzulo. Ndiye kuti mutha kusinthira mosamala majakisoni atatu patsiku ndikuyika theka la m'mawa musanadye kadzutsa komanso nkhomaliro.
Mukamasankha mulingo, amalimbikitsidwa kuti azitsogolera ndi zomwe zalembedwa pansipa

Muyenera kuyang'ana kwambiri kutsika kwa shuga m'masiku atatu apitawa. Ngati pakhala pali magawo a hypoglycemia panthawiyi, mlingo wa insulin suwonjezereka. Kusankha kwa dose kumachitika kamodzi pa sabata mpaka mulingo wa HbA1c ufike. Miyezo ya shuga ndende musanadye chakudya chimawonetsa kuyenera kwa zomwe zidaperekedwa kale.
Kuchepa kwa chiwindi kapena impso kungathandize kuchepetsa wodwala kufunika kwa insulin.
NovoMix 30 Flexpen itha kugwiritsidwa ntchito mwa ana ndi achinyamata azaka zapakati pa 10 ndi kupitirira, mukamayambitsa kuyamwa kwa insulin. Zambiri kuchokera kuzipatala zakuchipatala pakugwiritsa ntchito mankhwalawa kwa ana azaka za 6-16 ndizochepa. Kafukufuku mu ana osaposa zaka 6 sanachitike.
NovoMix 30 FlexPen ikhoza kugwiritsidwa ntchito mwa odwala okalamba, komabe, momwe amagwiritsidwira ntchito palimodzi ndi PSS mwa anthu azaka zopitilira 75 ndi ochepa.
Palibe chifukwa choti NovoMix 30 FlexPen iperekedwe iv.
Malangizo Mankhwala NovoMiks 30
Thawirani wodwala
Kufunika kophatikizidwa kwathunthu kuyenera kutsimikiziridwa.
kuyimitsidwa kwa insulin musanagwiritse ntchito. Pambuyo poyambitsa
Kuyimitsidwa kwake kumayenera kukhala koyera komanso kwamitambo. NovoMix 30 FlexPen idapangidwa kuti igwiritsidwe ntchito payekha.
Musadzadzenso NovoMix 30 FlexPen.
NovoMix 30 FlexPen imagwiritsidwa ntchito ndi singano zazifupi za NovoFine®.
Musanagwiritse ntchito NovoMix 30
Flekspen: ndikofunikira kuyang'ana pa label kuti mupeze mtundu woyenera wa mankhwala a insulin. Nthawi zonse gwiritsani ntchito singano yatsopano jekeseni iliyonse.
Osagwiritsa ntchito NovoMix 30 FlexPen:

• mapampu a insulin,
• ngati cholembera cha syringe cha FlexPen chatayika, ngati chawonongeka kapena chopunduka, monga pamenepa insulin ikhoza kutayikira,
• ngati cholembera sichinasungidwe bwino kapena ngati chikuwuma, ngati chitayambitsa kuyimitsidwa sichikhala choyera komanso chamtambo, ngati ziphuphu zoyera kapena tinthu tating'onoting'ono tating'ono tikuwoneka pokonzekera, kutsatira pansi kapena makoma a cartridge, ndikuwapatsa mawonekedwe owoneka ngati achisanu.

NovoMix 30 Flexpen idapangidwa jakisoni wa SC.
Mankhwalawa sangathe kulowa mkati / mkati kapena mwachindunji.
Popewa kulowetsedwa, malo opangira jakisoni amayenera kusinthidwa nthawi zonse. Malo abwino owongolera ndi khoma lakunja lam'mimba, matako, kunja kwa ntchafu kapena phewa. Kuchita kwa insulin kumachitika mwachangu mukabayidwa m'chiuno.

Zotsatira zoyipa za mankhwala Novomix 30 flekspen

Zotsatira zoyipa zomwe zimachitika mwa odwala omwe amagwiritsidwa ntchito ndi NovoMix 30 FlexPen zimagwirizana kwambiri ndi kuchuluka kwa mankhwala omwe amaperekedwa ndipo ndikuwonetsedwa kwa insulin. Zotsatira zoyipa kwambiri za insulin mankhwala ndi hypoglycemia. Zimatha kuchitika ngati mlingo umakulirakulira wodwala amafuna insulin. Hypoglycemia yayikulu imatha kuyambitsa chikumbumtima ndi / kapena kukhudzidwa, kutsatiridwa ndi kuwonongeka kwakanthawi kapena kosatha kwa ntchito yaubongo ngakhale kufa. Malinga ndi zotsatira za kafukufuku wazachipatala, komanso kuchuluka kwa deta yomwe idayambitsidwa pamsika, chiwopsezo cha hypoglycemia chimasiyanasiyana m'magulu osiyanasiyana a odwala komanso ndi mitundu yosiyanasiyana ya mankhwala, kuchuluka kwa hypoglycemia mwa odwala omwe amalandira insulin aspart ndi chimodzimodzi kwa omwe amalandila anthu insulin
Otsatirawa ndi pafupipafupi pazomwe zimachitika zomwe, malinga ndi kafukufuku wazachipatala, zitha kuphatikizidwa ndikuyambitsa kwa mankhwala a NovoMix 30 Flexpen.
Malinga ndi kuchuluka kwa zomwe zimachitika, izi zimachitika nthawi zina (1/1000, ≤1 / 100) ndi sikawirikawiri (1/10 000, ≤1 / 1000). Zina mwadzidzidzi zimachitika kawirikawiri (≤1/10 000).
Kuchokera ku chitetezo chamthupi
Si kawirikawiri: anaphylactic zochita.
Nthawi zina: urticaria, kuyabwa, zotupa pakhungu.
Mitundu yambiri ya Hypersensitivity imatha kuphatikizira zotupa pakhungu, kuyabwa, thukuta, kusokonezeka m'mimba, angioedema, kupuma movutikira, palpitations komanso kutsika kwa magazi. Izi ndi zoopsa pamoyo.
Kuchokera ku dongosolo lamanjenje
Zosowa: zotumphukira neuropathies. Kusintha kwamphamvu kwa kayendedwe ka shuga m'magazi kungayambitse ululu wammbuyo wammbuyo, womwe nthawi zambiri umakhala wosakhalitsa.
Kuphwanya gawo la masomphenyawo
Nthawi zina: Kusokonezeka kwa kukonzanso, kumatha kuchitika kumayambiriro kwa insulin mankhwala ndipo kumakhala kochepa m'chilengedwe.
Nthawi zina: matenda ashuga retinopathy. Kukonzanso kwanthawi yayitali glycemic kuchepetsa kumachepetsa chiwopsezo cha matenda ashuga a retinopathy. Komabe, kulimbitsa kwa insulin mankhwala kuti athe kukonza bwino glycemic control kungayambitse kuchepa kwakanthawi kwa matenda ashuga retinopathy.
Pa khungu ndi subcutaneous minofu
Nthawi zina: lipodystrophy, imatha kupezeka m'malo a jakisoni chifukwa chosagwirizana ndi malingaliro oti asinthe jakisoni m'dera lomwelo, hypersensitivity. Insulin ikalowetsedwa, hypersensitivity ya m'deralo imatha kuchitika (redness, kutupa, ndi kuyabwa pamalo opaka jekeseni). Izi zimachitika nthawi zambiri ndipo zimatha mosakhalitsa.
Matenda osakanikirana komanso zimachitika m'malo opezeka jakisoni
Nthawi zina : Edema yachilengedwe, imatha kuyamba kumayambiriro kwa insulin. Zizindikirozi nthawi zambiri zimakhala zosakhalitsa.

Kugwiritsa ntchito mankhwala Novomix 30 flekspen

Mankhwala angapo amakhudza kagayidwe kazakudwala, kamene kamayenera kuganiziridwa posankha mtundu wa insulin.
Mankhwala omwe amachepetsa kufunika kwa insulin: othandizira a hypoglycemic othandizira, octreotide, Mao inhibitors, osasankha β-adrenoreceptor blockers, ACE inhibitors, salicylates, mowa, anabolic steroids ndi sulfonamides.
Mankhwala omwe amalimbikitsa kufunika kwa insulin: kulera kwamlomo, thiazides, corticosteroids, mahomoni a chithokomiro, sympathomimetics ndi danazole. Ma blockers a Β-adrenergic amatha kumasula zizindikiro za hypoglycemia, mowa umatha kukulitsa ndikuwonjezera mphamvu ya insulin.
Kusagwirizana. Kuphatikizidwa kwa mankhwala ena ku insulin kungayambitse kuwonongeka kwake, mwachitsanzo, mankhwala okhala ndi thiols kapena sulfites. NovoMix 30 Flexpen silingathe kuwonjezeredwa ku mayankho a kulowetsedwa.

Zotsatira zoyipa

Zotsatira zoyipa zomwe zimakhudzana ndi kagayidwe kazachilengedwe: pafupipafupi - hypoglycemia, Zizindikiro zomwe zingaphatikizidwe ndi khungu, thukuta lakuzizira, mantha, kunjenjemera, nkhawa, kutopa mwadzidzidzi kapena kufooka, kusokonezeka m'malo, kuchepa ndende, chizungulire, kumva anjala, kuwonongeka kwakanthawi, mutu, nseru, tachycardia. Hypoglycemia ikhoza kuchititsa kuti musataye chikumbumtima, kusokonezeka kwakanthawi kapena kusasinthika kwa ubongo ndi kufa.

Thupi lawo siligwirizana: zimachitika m`deralo - redness, kutupa, kuyabwa pa jakisoni malo, generalized - zotupa pakhungu, kuyabwa, kuchuluka thukuta, matenda am'mimba, angioedema, kuvuta kupuma, tachycardia, kutsika magazi.

Zina: edema, kuphwanya kukonzanso (nthawi zambiri kwakanthawi ndikuwoneka kumayambiriro kwa chithandizo cha insulin), kukula kwa lipodystrophy pamalo opangira jekeseni.

Kuchita ndi mankhwala ena

ipoglikemicheskoe mankhwala kanthu 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, kukonzekera lifiyamu etanolsoderzhaschie kukonzekera .

Mphamvu ya hypoglycemic ya mankhwalawa imachepetsedwa ndi kulera kwapakamwa, corticosteroids, kukonzekera kwa mahomoni a chithokomiro, thiazide diuretics, heparin, tridclic antidepressants, sympathomimetics, danazol, clonidine, calcium blockers, diazoxide, morphine, phenytoin, nikotini.

Mothandizidwa ndi reserpine ndi salicylates, onse ofooketsa ndikuwonjezera zochita za NovoMix® 30 FlexPen ® ndizotheka.

Beta-blockers amatha kufinya zizindikiro za hypoglycemia.

Octreotide / lanreotide imatha kuwonjezeka ndikuchepetsa kufunika kwa insulin.

Ethanol imatha kukulitsa ndi kukulitsa mphamvu ya insulin.

Popeza maphunziro ophatikizira sanachitike, NovoMix® 30 FlexPen ® sayenera kusakanikirana ndi mankhwala ena.

yogwira mankhwala: insulin aspart biphasic 100 PESCES *

excipients: mannitol, phenol, metacresol, zinc chloride, sodium chloride, disodium phosphate dihydrate, protamine sulfate, sodium hydroxide, hydrochloric acid, madzi d / ndi.

Mfundo za mankhwalawa Novomix

Mankhwalawa amalowa m'mashelefu am'magazi mu makatiriji kapena pensulo zapadera za syringe. Kuchuluka kwa mitundu yonse ya Mlingo ndi 3 ml. Kuyimitsidwa kumakhala ndi magawo awiri.

Mukamwetsa, mankhwala:

1. Zimakhudza ma insulin receptor,
2. Imalepheretsa kwambiri shuga,
3. Amachepetsa shuga
4. Matenda amasinthasintha shuga, omwe amadzuka kwambiri atatha kudya.

Mankhwalawa sasokoneza kuthekera kukhala ndi ana ndipo samatsogolera pakukula kwa masinthidwe am'mimba komanso zotupa za khansa. Novomix ndi mankhwala otetezeka omwe samakhala ndi zotsatira zoyipa akamagwiritsa ntchito moyenera.

Mahomoni, omwe ndi maziko a mankhwalawo, ali ofanana ndi insulin yachilengedwe motero samawopseza thupi.

Zotsatira zoyipa zomwe zingachitike

Pogwiritsa ntchito molakwika kapena nthawi yayitali, Novomix imatha kusokoneza thupi la wodwalayo. Odwala amawonetsa mavuto:

1. Hypoglycemia. Izi ndi zofunikira kwambiri pamene kuchuluka kwa shuga m'magazi kumatsika kwambiri kuzidziwitso za pathological (osakwana 3.3 mmol pa lita imodzi). Hypoglycemia imayamba mwa odwala omwe adapatsidwa mankhwala okwanira. Zizindikiro za shuga wochepa zimachitika mwadzidzidzi. Khungu limakhala lofiirira, munthu amangokhalira thukuta, kutopa msanga komanso kudwala nkhawa. Odwala omwe amakhala ndi shuga yochepetsedwa amagwirana manja, amachepera mphamvu ndipo amasokonezeka. Maganizo a anthu amakhala ndi nkhawa, mtima wawo umathamanga komanso kugona. Nthawi zambiri, odwala omwe ali ndi hypoglycemia amakhala ndi njala yosalamulirika. Masomphenya akucheperachepera ndipo nseru ikuwonekera. Wodwalayo akayamba kudwala matenda obwera chifukwa cha hypoglycemia. Ngati thandizo siliperekedwa pa nthawi, hypoglycemia imabweretsa kudwala kwa wodwala,

Novomiks: Malangizo a ntchito

Musanagwiritse ntchito, gwiritsani katoni kapena cholembera ndi kutulutsa. Samalani mtundu wa chidebe - mthunziwo uziyenera kukhala yunifolomu ndi yoyera. Zotupa zomatira kukhoma kwa cartridge siziyenera. Kugwiritsa ntchito singano kamodzi kokha - ngati mutanyalanyaza lamuloli, ndiye kuti mutha kutenga kachilombo.

Musanagwiritse ntchito, ndikofunikira kutsatira mfundo zoyambirira ndi kusamala:

• Osagwiritsa ntchito mankhwalawo ngati kale anali mu freezer,
• Ngati wodwala akuwona kuti shuga ndi ochepa, ndizoletsedwa kupereka mankhwalawo. Kuchulukitsa shuga, zokwanira
• Idyani zakudya zosavuta (monga maswiti)

Musaiwale za kuwunikira pafupipafupi kuchuluka kwa shuga. Tsatirani malangizo kuti muchepetse zovuta komanso kutsika kwamphamvu kwa shuga.

Kugwirizana kwina ndi mankhwala ena

Mukamawerengera mlingo, onani kuti mankhwalawa amatha kuthana ndi kagayidwe kazakudya. Mankhwalawa akuphatikizapo:

mankhwala omwe amachititsa kutsika kwamphamvu kwa shuga,

• Okreotide
• Mao zoletsa,
• Salicylates,
• Anabolics
• Sulfonamides,
• Zinthu zomwe zimakhala ndi mowa.

Kuphatikiza apo, gulu la mankhwala likuyimira pomwe kufunikira kwa Novomix 30 FlexPen kumawonjezeka. Gawoli limaphatikizapo: mahomoni a chithokomiro, mapiritsi othandizira kubala, danazole, thiazides, HSC.

Zokhudza mphamvu pakuyendetsa

Zotsatira zoyipa kwambiri zomwe zimawonedwa pa chithandizo chakuchuluka kwa shuga ndizovuta zowopsa.Chimodzi mwazizindikiro za hypoglycemia ndikuphwanya kwa kupsinjika, chifukwa chomwe wodwalayo sangathe kuyendetsa makina ovuta kapena kuyendetsa galimoto popanda chiwopsezo.

Pambuyo pa utsogoleri, onetsetsani kuti palibe chiopsezo chowonjezeka kwambiri mu shuga. Ngati zizindikiro za hypoglycemia sizikuwoneka, sizikulimbikitsidwa kuyendetsa galimoto, chifukwa shuga imatha kugwa nthawi iliyonse.

Mlingo ndi kusintha

Novomix amaikidwa ngati monotherapy kapena molumikizana ndi mankhwala ena. Mlingo umatengera umunthu ndi mtundu wa matenda:

• Mu matenda a shuga amtundu wachiwiri, mlingo woyambirira ndi magawo 6 musanadye chakudya choyamba ndi gawo limodzi musanadye chakudya. Ndi kuchuluka kwa insulini, mlingo umasinthidwa kukhala magawo 12,
• Ngati wodwalayo asintha mankhwalawa ndi biphasic insulin kukhala ku Novomix, mlingo woyambirira amakhalabe wofanana ndi njira yapitayi. Kupitilira apo, mlingo umasinthidwa ngati pakufunika. Posamutsa wodwala watsopano mankhwala, kuwunikira mosamalitsa kwa adokotala amafunikira,
• Ngati chithandizo chikufunika kulimbikitsidwa, wodwalayo amapatsidwa mankhwala awiri,
• Kuti musinthe mlingo, muyeze glucose wanu wothira masiku atatu apitawa. Ngati munthawi imeneyi kuchepa kwambiri kwa shuga munthawi yake, mulingo wakewo sunasinthidwe.

Momwe mungapangire insulin

Kuphatikiza kwa mankhwala osankhidwa bwino ndikulowetsa koyenera m'thupi ndi njira yayikulu yoperekera chithandizo cha matenda a shuga:

1. Musanagwiritse ntchito yankho, gwirirani kwa maola 1-2 pa kutentha kwa madigiri 15-20. Ndiye kunyamula katiriji ndikumujambulira molondola. Gwirani cartridge pakati pa manja anu, ndikusakaniza manja anu ngati kuti mukugubuduza ndodo kapena chinthu china chilichonse chofunikira kwambiri. Bwerezani mpaka ma 15.
2. Pindani katiriji mozungulira ndikuigwedeza kotero kuti mpira mkati mwa chidebe umagudubuka kuchokera mbali ina kupita mbali ina.
3. Bwerezaninso magawo 1 ndi 2 mpaka zomwe zili mumtsukozo zikhale mitambo ndikuyera.
4. Phatikizani pang'onopang'ono mafuta osaneneka. Osalowetsa mkatikati mwa katiriji m'mitsempha - izi zimapangitsa kuwonjezeka kwa shuga m'magazi.
5. Ngati mankhwala osakwana 12 PIERESESI atasiyidwa mumtsuko, gwiritsani ntchito mlingo watsopano kuphatikiza wogawana.

Sungani batani loyambira litapanikizidwa mpaka mlingo wonse wa mankhwalawo utabayidwa pakhungu. Ngati mumagwiritsa ntchito zinthu ziwiri, musasakanikize mu katoni imodzi.

Thandizo loyamba la bongo

Chizindikiro chachikulu cha bongo wa Novomix ndi hypoglycemia yayikulu. Wodwala yemwe ali ndi vutoli amatha kuthandizidwa m'njira zingapo:

• Ndi kuchuluka pang'ono kwa shuga, perekani kwa wodwala chilichonse chomwe chili ndi mafuta osavuta. Izi zimaphatikizapo confectionery: maswiti, chokoleti, ndi zina zambiri. Zonyamula zokhala ndi shuga nthawi zonse - kufunika kowonjezera kuchuluka kwa shuga kumatha kuchitika nthawi iliyonse,
• Hypoglycemia yayikulu imathandizidwa ndi njira ya glucagon. Mankhwala ali mu kuchuluka kwa 0,5-1 mg. jekeseni wamafuta kapena mafupa a mkati,
• Njira ina yothandizira glucagon ndi yankho la dextrose. Zimayambitsidwa kwambiri, pomwe wodwalayo wadwala kale glucagon, koma samadzidwalanso kwa nthawi yopitilira mphindi 10. Dextrose amathandizira kudzera m'mitsempha. Ndiophunzitsidwa kapena dotolo wapadera yekhayo amene angachite izi.

Kuti muchepetse shuga kuti asagwere kachiwiri, idyani zakudya zomwe zili ndi mafuta osavuta komanso ovuta. Musaiwale za kusamala - idyani m'magawo ang'onoang'ono kuti musayambitse kuwonongeka.

Mayina amalonda, mtengo wake, malo osungira

Mankhwala amapita ku mashelufu ammagazi pansi pa mayina angapo amalonda. Iliyonse yaiwo imapangidwa m'njira inayake ndikuyambitsa ntchito yogwira.

Mtengo umasiyana pang'ono:

1. Novomiks FlexPen - ma ruble 1500-1700,
2. Novomiks 30 Penfill - 1590 rubles,
3. Insulin Aspart - ma ruble 600 (a syringe).

Mankhwala tikulimbikitsidwa kuti asungidwe pamtunda osapitirira 25 digiri m'malo opanda ana..

Novomiks: analogues

Ngati mankhwalawo sakugwirizana ndi inu kapena sakuvomerezedwa ndi thupi chifukwa cha zida zothandizira, tikukulimbikitsani kuti muzidziwika bwino ndi mitundu yotsimikiziridwa:

• Novomix 30 Penfill. Ili ndi mankhwala awiri omwe amapangira insulin. Zimaphatikiza mahomoni omwe amakhala kwa nthawi yayitali komanso yayitali. Zimathandizira kupanga zinthu zofunika kwambiri, zimapangitsa kuyenda kwa glucose pama cellular komanso kuthekera kwake kuzingidwa ndi minofu ina. Imakhudza chiwindi, imachepetsa kupanga shuga ndipo imachepetsa kuchuluka kwake m'magazi. Mosiyana ndi classic Novomix, ndizovomerezeka kwa maola osachepera 24. Kapangidwe kazinthu zomwe zimagwira ntchito zimasinthana ndi insulin yachilengedwe, kotero chida ndichotetezeka m'thupi. Kugwiritsa ntchito moyenera, mankhwalawa sikuyambitsa mavuto. Contraindified asanafike zaka 18, ndi hypoklycemia ndi hypersensitivity,
• Novomix 30 FlexPen. Zimakhudza kupanga kwa insulini ndipo imalimbikitsa zomwe zimachitika mkati mwa maselo. Kutalika kwa nthawi kumatengera dera la jakisoni, zolimbitsa thupi, Mlingo ndi zinthu zina. Mankhwala amapatsidwa mankhwala ochizira matenda amiseche 1 ndi mtundu 2,
• Novomix 50 FlexPen. Chida ichi ndi chofanana ndendende ndi mankhwala awiri omwe tafotokozawa. Kusiyanaku kumachitika pang'onopang'ono pazogwira ntchito. Pachifukwa ichi, muyenera kufunsa dokotala musanayambe chithandizo.

Mukamasankha mankhwala oyenera, musangoganizira mtengo wake, komanso mfundo zina zofunika. Izi zimaphatikizapo mtundu wa insulin, zomwe zimachitika mthupi lanu, kulolera zinthu komanso matenda ena.

Zotsatira za pharmacological

NOVOMIX 30 FLEXPEN ndi analogue ya insulin ya anthu nthawi yayitali yochita. Amapanga zovuta za insulin-receptor yokhala ndi cholandilira chapadera pa michere ya cytoplasmic yama cell, ndikulimbikitsa kapangidwe ka hexokinase, pyruvate kinase, ndi glycogen synthetase enzymes. Mphamvu ya hypoglycemic imalumikizidwa ndi kuchuluka kwa kayendedwe kazinthu zamagetsi ndikuwonjezera kuyamwa kwa glucose ndi minofu, kukondoweza kwa lipogenesis, glycogenogeneis, ndi kuchepa kwa kuchuluka kwa kupanga kwa shuga ndi chiwindi.

NovoMix 30 Flexpen ndi kuyimitsidwa kwamitundu iwiri komwe kumakhala soluble insulin aspart (30%) ndi crystalline insulin aspart protamine (70%). Insulin aspart yomwe imapangidwa ndi biotechnology (mu maselo a insulin, primine wa amino acid pamalo a B28 m'malo mwake ndi aspartic acid.

Ikagwiritsidwa ntchito kwa odwala omwe ali ndi mtundu woyamba wa 2 ndi mtundu wa 2 shuga, NovoMix 30 FlexPen imathandizanso pamlingo wa glycosylated hemoglobin monga biphasic insulin yaumunthu. Insulin aspart ndi insulin yaumunthu imakhala ndi zochitika zofanana mu molar ofanana.

Mu insulin aspart, kulowetsedwa kwa amino acid proline pamalo B28 kwa aspartic acid kumachepetsa chizolowezi chopanga mamolekyulu kupanga hexamers m'chigawo chosungunuka cha NovoMix 30 FlexPen, chomwe chimawonedwa mu insulin ya anthu. Motere, insulin aspart imatengedwa kuchokera subcutaneous mafuta mwachangu kuposa sungunuka insulin yomwe ili ndi biphasic insulin ya munthu. Insulin aspart protamine, monga insulin ya munthu, imatengedwa nthawi yayitali.

Poyerekeza ndikusungunuka kwa insulin ya anthu, insulin aspart (yolimbitsa thupi insulin ya anthu) imayamba kuchita zinthu mwachangu, kotero imatha kutumikiridwa musanadye (kuyambira 0 mpaka 10 mphindi musanadye). Zotsatira za crystalline insulin aspart protamine (an-medium-dude analogue of insulin ya anthu) ndizofanana ndi za insulin ya munthu. Pambuyo s / c makonzedwe a mankhwala a NovoMix 30 Flexpen, zotsatira zimayambika pambuyo 10 mphindi.Kuchuluka kwake kumawonedwa patatha maola 1-4 mutabayidwa. Kutalika kwa mankhwalawa kumafika maola 24.

Pharmacokinetics

Mu insulin aspart, m'malo mwa proline amino acid pamalo a B28 a aspartic acid amachepetsa chizolowezi chopanga mamolekyulu kupanga hexamers m'chigawo chosungunuka cha NovoMix® 30 Penfill ®, chomwe chimasungunuka mu insulin ya anthu. Pankhaniyi, insulin aspart (30%) imayamwa kuchokera ku mafuta a subcutaneous mwachangu kuposa insulle insulin yomwe ili mu biphasic insulin yamunthu. 70% yotsalayo imawerengedwa ndi mtundu wa crystalline wa protamine-insulin aspart, kuchuluka kwa mayamwidwe komwe kuli kofanana ndi komwe kumapangitsa insulin NPH.

Serum Cmax wa insulin pambuyo pa NovoMix ® 30 Penfill® ndi 50% kuposa kuposa ya biphasic insulin 30 ndipo Tmax ndiyofupikirapo kuposa ya biphasic insulin 30.

Mu odzipereka athanzi, atatha subcutaneous makonzedwe a NovoMix® 30 pamlingo wa 0.2 U / kg Cmax, insulin aspart mu seramu idatheka pambuyo pa mphindi 60 ndipo imakhala (140 ± 32) pmol / L. Kutalika kwa T1 / 2 kwa kukonzekera kwa NovoMix® 30, komwe kumawonetsera kuyamwa kwa kachigawo kakumangiriridwa ka protamine, kanali maola 8-9 Mlingo wa insulin m'magazi seramu unabweranso koyamba ma 15-18 mawola atatha kugwiritsa ntchito mankhwalawa. Odwala omwe ali ndi matenda a shuga 2, Cmax adawonetsedwa pambuyo pa 95 ndipo amakhala pamwamba pa maola 14 osachepera.

Okalamba komanso odwala a senile. Kafukufuku wa pharmacokinetics a NovoMix® 30 mwa odwala okalamba ndi a senile sanachitike. Komabe, kusiyana kwakaphatikizidwe mu pharmacokinetics pakati pa insulin aspart ndi insulle insulin ya anthu okalamba odwala mtundu wa 2 matenda a shuga (azaka 65-83 zaka, zaka zapakati - zaka 70) anali ofanana ndi odzipereka athanzi komanso odwala achinyamata omwe ali ndi matenda a shuga. Mwa odwala okalamba, kuchepa kwa mayamwidwe kunawonedwa, komwe kunapangitsa kutsika kwa T1 / 2 (82 min (interquartile range - 60-120 min), pomwe Cmax wamba inali yofanana ndi yomwe imawonedwa mwa odwala ang'onoang'ono omwe ali ndi mtundu wa matenda a shuga 2, komanso pang'ono pang'ono kuposa odwala matenda a shuga 1.

Odwala ndi mkhutu aimpso ndi kwa chiwindi ntchito. Kafukufuku wa pharmacokinetics a NovoMix® 30 Penfill® kwa odwala omwe ali ndi vuto la impso ndi kwa chiwindi sikuchitika. Komabe, ndi kuwonjezeka kwa mlingo wa mankhwalawa odwala omwe ali ndi vuto losiyanasiyana laimpso ndi kwa chiwindi, sizinasinthe mu pharmacokinetics ya soluble insulin aspart.

Ana ndi achinyamata. Mankhwala a NovoMix® 30 Penfill ® mu ana ndi achinyamata sanaphunzire. Komabe, mankhwala a pharmacokinetic ndi pharmacodynamic a soluble insulin aspart amaphunzitsidwa mwa ana (azaka 6 mpaka 12) komanso achinyamata (azaka 13 mpaka 17) ndi mtundu wa matenda a shuga 1. Mwa odwala a misinkhu yonse iwiri, insulin aspart imadziwika ndi kulowerera mwachangu ndi mfundo za Tmax zofanana ndi zomwe mwa akulu. Komabe, chikhalidwe cha Cmax m'magulu awiriwa chinali chosiyana, zomwe zikuwonetsa kufunikira kwa kusankha kwa mankhwala a insulin.

Mlingo ndi makonzedwe

Mankhwalawa adapangira sc. Mankhwala a NovoMix 30 FlexPen sangathe kulowa / kulowa!

Mlingo umayikidwa payekha malinga ndi zomwe zimapangitsa shuga. Wapakati tsiku lililonse mlingo kuyambira 0,5 kuti 1 U / kg thupi. Ndi kukana kwa insulini (mwachitsanzo, odwala onenepa kwambiri), kufunikira kwa insulin tsiku ndi tsiku kumatha kuwonjezereka, ndipo odwala omwe ali ndi chinsinsi cha insulin yotulutsa, amatha kuchepetsedwa.

NovoMix 30 FlexPen iyenera kutumikiridwa musanadye, ngati n`kofunika mukangomaliza kudya.

Kutentha kwa mankhwala omwe amaperekedwa kuyenera kukhala kutentha kwambiri.

Jekeseni imagwiritsidwa ntchito mu ntchafu kapena khoma lamkati, ngati mukufuna - paphewa kapena m'manja.Ndikofunikira kusintha malo a jekeseni mkati mwa anatomical dera kuti muchepetse kukula kwa lipodystrophy.

Monga kukonzekera kwina konse kwa insulin, kutalika kwa nthawi ya NovoMix 30 FlexPen kumatengera mlingo, malo oyendetsera, kutsika kwa magazi, kutentha ndi magawo olimbitsa thupi. Kudalira kwa mayamwidwe a NovoMix 30 FlexPen pa tsamba la jakisoni sikunaphunzire.

Kuyimitsidwa kwa subcutaneous makonzedwe - 1 ml insulin aspart magawo awiri - 100 IU 1 IU ikufanana ndi 0,035 mg (kapena 6 nmol) wa anulinrous insulin; , hydrochloric acid, madzi a jakisoni mu masenti atatu a 3 ml, phukusi la makatoni 5 zidutswa.

Kufotokozera za mtundu wa kipimo

Homogeneous yoyera yopanda chopanda kuyimitsidwa. Mukayimirira, kuyimitsidwa kumakoma, ndikupanga choyera chamtendere komanso chopanda utoto kapena chopanda utoto. Mukasakaniza zomwe zili mu cholembera mogwirizana ndi njira yofotokozedwera malangizo omwe angagwiritsidwe ntchito, kuyimitsidwa kokhazikika kuyenera kupanga.

Hypoglycemic wothandizira, kuphatikiza kwa nthawi yayitali komanso yapakati insulin.

Mu insulin aspart, kulowetsedwa kwa amino acid proline pamalo B28 kwa aspartic acid kumachepetsa chizolowezi chopanga mamolekyulu kupanga hexamers m'chigawo chosungunuka cha NovoMix® 30 FlexPen ®, chomwe chimasungunuka mu insulin ya anthu. Pankhaniyi, insulin aspart (30%) imayamwa kuchokera ku mafuta a subcutaneous mwachangu kuposa insulle insulin yomwe ili mu biphasic insulin yamunthu. Insulin aspart (70%), monga insulin yaumunthu, imamwa nthawi yayitali. Mukamagwiritsa ntchito NovoMix® 30 FlexPen ® Cmax, insulini mu seramu imakhala yokwera 50% kuposa momwe mumagwiritsira ntchito insulin ya anthu a magawo atatu. Pafupifupi Tmax imakhala yocheperako kawiri kuposa ya insulin ya anthu a magawo awiri. Ogwira ntchito zathanzi, pogwiritsa ntchito mankhwala a Sc pa 0,2 U / kg yolemetsa, pafupifupi seramu Cmax anali (140 ± 32) pmol / L ndipo anakwaniritsidwa mphindi 60 atabayidwa. Wapakati wa T1 / 2 NovoMix ® 30 FlexPen ®, wowonetsa kuyamwa kwa kachigawo koyendetsedwa ndi protamine womangika, anali maola 8-9. Serum insulin insulin yabwerera kwawo koyamba maola 15-18 pambuyo pa utsogoleri wa s / c. Odwala omwe ali ndi matenda a shuga a 2 mtundu, seramu Cmax ya insulin imafikiridwa pambuyo pa mphindi 95 ndipo imakhala yoyenera kwa maola osachepera 14 pambuyo povomerezeka. Kwa odwala okalamba, ana, komanso odwala omwe ali ndi vuto la chiwindi kapena impso, ma pharmacokinetics a NovoMix® 30 FlexPen ® sanaphunzire.

NovoMix® 30 FlexPen ® ndi kuyimitsidwa kwamitundu iwiri komwe kumapangika sungunul insulin aspart (30% yochepa-insulin analog) ndi makhiristo a aspart protamine insulin (70% yapakati-insulin analog). Insulin aspart yomwe imapangidwanso ndi biotechnology ya DNA yogwiritsidwanso ntchito pogwiritsa ntchito Saccharomyces cerevisiae. 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. Poyerekeza ndi insulin ya insulle yaumunthu, insulin aspart (yolimba mofulumira ya insulin ya anthu) imayamba kuchita zinthu mwachangu, kotero imatha kuperekedwa mwachangu musanadye (koma osapitirira mphindi 10 musanadye).Gawo lachigiriki (70%) limakhala ndi insulini ya puloteni (analogue ya insulin ya anthu a nthawi yayitali), momwe imafanana ndi zochita za isofan insulin. Pambuyo pa sc makonzedwe a NovoMix® 30 FlexPen ®, matendawa amakula pakadutsa mphindi 10-20. Kuchuluka kwakukulu kumawonedwa pamtunda kuchokera pa 1 mpaka maola 4 jekeseni. Kutalika kwa mankhwalawa kumafika maola 24. Kuyesedwa kwa miyezi itatu kwa odwala omwe ali ndi mtundu woyamba 1 ndi mtundu wa 2 matenda a shuga kumawonetsa kuti NovoMix® 30 FlexPen ® ikukhudzanso glycosylated hemoglobin monga insulin ya anthu awiri magawo atatu a insulin. zofanana mu molar ofanana. Mu kafukufuku wazachipatala wokhudzana ndi odwala 341 omwe ali ndi mtundu wa matenda a shuga 2, odwala adasinthidwa mosiyanasiyana m'magulu azithandizo okha a NovoMix® 30, NovoMix® 30 FlexPen® kuphatikiza ndi metformin ndi metformin kuphatikiza ndi sulfonylurea. Kusintha kwakukulu koyambirira - HbA1C pambuyo pa milungu 16 ya chithandizo - sizinasiyane mwa odwala omwe adalandira NovoMix® 30 FlexPen® kuphatikiza ndi metformin komanso odwala omwe adalandira metformin osakanikirana ndi sulfonylurea. Phunziroli, 57% ya odwala anali ndi magulu a HbA1C oyambira 9%. Odwala awa, chithandizo cha NovoMix® 30 chophatikizana ndi metformin chinapangitsa kutsika kwakukulu kwa HbA1C kuposa kwa odwala omwe amalandila metformin osakanikirana ndi sulfonylurea. Zambiri zotetezera za Preclinical In vitro test, zomwe zimaphatikizapo kumangiriza insulin ndi ma IRF-1 zolandilira ndi zotsatira za kukula kwa maselo, zidawonetsedwa kuti zofunikira za aspart insulin ndizofanana ndi insulin yaumunthu. Kuphatikiza apo, zidapezeka kuti insulin aspart imamangiriza ma insulin receptors mwanjira yofanana ndi insulin yaumunthu. Pophunzira za pachimake (mwezi umodzi) ndi chodwala (miyezi 12) kawopsedwe, deta sizinapezeke pamaso pa zida zofunika kwambiri za poizoni.