Mayina amalonda ndi malangizo ogwiritsira ntchito insulin Levemir

Yang'anani! Pamwambapa pali tebulo lowoneka bwino, zambiri zitha kukhala kuti zasintha. Zambiri pa mitengo ndi kupezeka kwake zimasintha pa nthawi yeniyeni kuti muwone - mutha kugwiritsa ntchito kusaka (zidziwitso zonse zatsopano pakusaka), komanso ngati muyenera kusiya lamulo la mankhwalawo, sankhani malo amzindawu kuti musakale, kapena kusaka pokhapokha potsegulidwa mankhwala.

Mndandanda womwe uli pamwambapa umasinthidwa pafupifupi maola 6 aliwonse (adasinthidwa 07/15/2019 nthawi ya 14: 21 - nthawi ya Moscow). Fotokozani mitengo ndi kupezeka kwa mankhwalawa pofufuza (tsamba lofufuzira limapezeka pamwamba), komanso manambala a foni asananyamuke. Zomwe zili patsamba lino sizingagwiritsidwe ntchito ngati njira zodziyambitsira nokha. Musanagwiritse ntchito mankhwala, onetsetsani kuonana ndi dokotala.

Mankhwala

Levemir ndi mawonekedwe osungunuka a insulin yaumunthu ya anthu. Ili ndi mphamvu yayitali komanso imagwiritsidwa ntchito pochiza matenda omwe amapezeka ndi anthu amishuga a mtundu woyamba.

Mankhwalawa amatha kudziwiratu kuuma komanso chikhalidwe chake (ngati tingayerekeza ndi insulin glargine, komanso NPH-insulin). Kuthandiza kwachakudya kotenga nthawi yayitali kumalumikizidwa ndi kulumikizana kwakukulu kwa zinthu za insulin detemir, komanso kaphatikizidwe kazinthu zogwiritsa ntchito mankhwala omwe ali ndi albumin (kumangika kumachitika ndi kutenga nawo mbali kwamitundu yamafuta acids).

Nthawi yomweyo, mphamvu yotalikirapo ya mankhwalawa imaperekedwa ndi kuthekera kwa insulir insulin kuti ikhale yochedwa kuchepera (ngati izi zikuyerekeza ndi NPH-insulin) zomwe zimagawidwa mkati mwa ziwonetsero zomwe zimakhala. Njira yophatikizidwira yotalikitsira nthawi yayitali imathandizira kuti pakhale njira yolosera zamankhwala.

Mphamvu ya kufooka kwa mankhwalawa imachitika chifukwa cha kusintha kwamphamvu kwa magwiridwe ake a minyewa. (Kuphatikiza kwa insulin ndi minyewa yapadera ya minofu, komanso minofu yamafuta), komanso kuwonjezera kuchepa kwa mphamvu ya chiwindi kumasula shuga.

Mphamvu ya mankhwalawa imatha kwa maola 24 (kuchuluka kwa nthawi kumatengera kukula kwa mlingo womwe ukugwiritsidwa ntchito), kotero kuti mutha kutumiza yankho limodzi kapena kawiri. Pafupifupi, jekeseni wa mankhwala a 2-3 ndiofunikira kuti akwaniritse kuyesedwa kwa glycemic mukamaperekedwa kawiri.

Pa mayeso, kugwiritsa ntchito mankhwalawa gawo la 0.2-0.4 U / kg kunapangitsa chitukuko cha 50% cha chiwonetsero chachikulu kwambiri pa ora la 3-4 pambuyo pa jekeseni (kwakukulu, zotsatira zake zimatenga maola 14).

Njira yothetsera vutoli ili ndi magawo otseguka pamzere - zonse komanso zowonjezera, komanso kutalika kwa mankhwala ndizofanana ndi kukula kwa Mlingo.

Kugwiritsa ntchito mankhwalawa kwakanthawi kwamayesero azachipatala kunawonetsa pang'ono (poyerekeza ndi zomwe zimayambitsidwa ndi NPH-insulin) basal kusiyanasiyana kwa shuga mkati mwa seramu.

Komabe, pakuyesa kwakanthawi kachipatala, kusintha kwakuchepera kwa kulemera kunapezeka mwa anthu omwe adalandira Levemire (Poyerekeza ndi anthu omwe amagwiritsa ntchito mitundu ina ya insulin).

Mwa anthu omwe ali ndi matenda a shuga a mtundu wachiwiri omwe amagwiritsa ntchito insulin kuwonjezera pamankhwala othandizirana pakamwa, panali kuchepa kwa zochitika za nocturnal hypoglycemia atatha kugwiritsa ntchito Levemir.

M'magulu ena amtundu wa odwala omwe amathandizidwa atagwiritsa ntchito mankhwala a insulin, kupezeka kwa ma antibodies adadziwika, koma zotsatira zomwezi sizinakhudze kuchuluka kwa achire pakuyang'anira glycemic control.

Pharmacokinetics

Mitundu yayikulu ya yogwira pophika imawonekera mkati mwa seramu pambuyo pa maola 6-8 mutatha kubayidwa. Pankhani yoyendetsera yankho kawiri patsiku, kuyendetsa bwino glycemic kumadziwika pambuyo kugwiritsa ntchito jakisoni 2-3. M'magulu osiyanasiyana a odwala, pali kusiyana kocheperako kakang'ono pazomwe zimagwira gawo la yogwira (poyerekeza ndi kugwiritsa ntchito mankhwala ena akuluakulu a insulin).

Mtheradi bioavailability wa mankhwala pafupifupi 60% (pambuyo sc makonzedwe a yankho).

Gawo lalikulu la gawo lomwe limagwiritsidwa ntchito ndi mankhwalawa limazungulira mkati mwa bedi lamitsempha - izi zikuwonetsa chisonyezo cha kuchuluka kwa magawo pafupifupi 0,1 l / kg.

Kuyesedwa kwa vivo, komanso vitro, sikunawonetse mgwirizano wolumikizana pakati pamankhwala a insulin kuphatikiza ndi mafuta acids kapena mankhwala ena omwe amapangidwa ndi mapuloteni.

Kagayidwe kachakudya njira yogwira Levemir ndi ofanana ndi omwe amachitika ndi amkati insulin. Zotumphukira zonse za mankhwalawo zilibe ntchito.

Chizindikiro cha theka lomaliza la moyo pambuyo pa kuperekera mankhwala kwa s / c kumadalira phindu la kuchuluka kwa mayankho mkati mwa subcutaneous wosanjikiza ndipo, poganizira kuchuluka kwake, kumafika pakadutsa maola a 5-7.

Njira yothetsera vutoli ili ndi zigawo za pharmacokinetic parar.

Kugwiritsa ntchito levemir pa nthawi yapakati

Amayi oyembekezera omwe amagwiritsa ntchito insulir ya insulin amayenera kuwunika mosamala ma glucose omwe ali mkati mwa seramu. Pa nthawi yoyembekezera, thupi limafunikira kusintha kwa insulin, malinga ndi momwe gawo la mankhwalawa liyenera kusinthidwira. Pa trimester yoyamba, pali kuchepa kwa kufunika kwa insulin, koma pa yachiwiri ndi yachitatu trimester imakula kwambiri. Pambuyo pa kubadwa kwa mwana, pamabweranso mwachangu zisonyezo za kufunikira uku kumlingo womwe unawonedwa asanakhale ndi pakati.

Levemir siyikuwononga njira ya kubereka, komanso kukula kwabwino kwa mwana wosabadwayo, ndipo pakuyesa kunalibe kuwonjezeka kwa matenda a pathologies a mwana wosabadwayo.

Kuyesedwa kochitidwa mu nyama sikunawonetse kukhalapo kwa poizoni wazakudya chifukwa chobala.

Palibe chidziwitso chokhudza kulowa kwa mankhwalawa mkaka wa m'mawere. Kutheka kwa momwe gawo lake limakhalira pa makanda omwe amayamwitsidwa sichiri kwambiri, chifukwa chinthucho chimagawika mkati mwa chimbudzi, potenga mawonekedwe a amino acid.

Ndi mkaka wa m`mawere, kusankha mosamala gawo la insulin, komanso dongosolo la chakudya, kungakhale kofunikira.

Zotsatira zoyipa za Levemir

Zizindikiro zambiri zoyipa zomwe zapezeka poyesedwa ndi yankho lake zinali zotsatira za insulini kapena zotulukapo za matenda.

Nthawi zambiri mukamagwiritsa ntchito mankhwalawa, odwala amakhala ndi hypoglycemia.

Mukamagwiritsa ntchito syringe ya jakisoni wa subcutaneous, zimachitika mdera lanu - mwachitsanzo, edema ya minofu, kuyabwa, khungu, komanso hematomas pamalo omwe jakisoni idanenedwa. Kuphatikiza apo, zizindikiritso za hypersensitivity zimatha kupezeka pakhungu, kuphatikizapo kuyabwa, ming'oma, ndi totupa.

Zizindikiro zakumalo nthawi zambiri zimatha zokha, osafuna chithandizo chapadera. Izi mawonetseredwe amatchulidwa kwambiri poyambira kugwiritsidwa ntchito kwa mankhwalawa, kulimba kumachepa pang'onopang'ono panthawi yamankhwala.

Pa gawo loyambirira la mankhwala a insulin, kuchitira anthu matendawa kumatha kukhala ndi zovuta zina, komanso minyewa ya edema, yomwe imazimiririka yokha pakumwa.

Ndi kukula kwa mphamvu yayikulu pakuwongolera glycemia, anthu omwe ali ndi matenda ashuga amatha kukhala ndi vuto la neuropathy pachimake (limachiritsidwa ndipo imachitika chifukwa cha kusintha kwamphamvu mu seramu glucose).

Pa gawo loyamba la chithandizo, komanso kuwongolera kwakukulu kwa kuwongolera kwamatenda a glycemic odwala, kufupika kwakanthawi kovuta kwa njira ya matenda ashuga a retinopathy kuyanenedwa (mwanjira iyi, kuwongolera glycemic kwa nthawi yayitali komanso kuchepera kwa chiwopsezo cha matenda.

Pazonse, pakutsatsa ndikuyesa zamankhwala, zizindikiro zotsatirazi zidadziwika mu odwala (zomwe zimawonedwa pokhapokha zimaphatikizidwa pano):

• zotupa zotupa: totupa, matupi awo sagwirizana, urticaria ndi mawonekedwe a anaphylaxis,
• kagayidwe kachakudya matenda: kukula kwa hypoglycemia,
• mavuto mu chapakati mantha dongosolo: zimachitika polyneuropathy,
• mawonetseredwe a ziwalo zam'malingaliro: mawonekedwe a shuga a retinopathy, komanso zovuta zoyipa zongowonjezera,
• zotupa zomwe zimakhudza gawo lozungulira komanso khungu: kakulidwe ka lipodystrophy (chiopsezo cha matendawa chimakulirakonso ndi jekeseni wobwereza wa mankhwala omwe amapezeka m'dera lomwelo popanda kusintha jakisoni)
• Zizindikiro zakumaloko: kutupa kwakanthawi, kuyabwa ndi hyperemia.

Kugwiritsidwa ntchito kamodzi kwa mankhwalawa kunapangitsa kuti maonekedwe a anaphylaxis (mwa zina zotere, aphedwe). Wodwala akayamba chizindikiro cha anaphylaxis kapena edema ya Quincke panthawi yamankhwala, ayenera kupita kuchipatala msanga.

Hypoglycemia yomwe imagwiritsidwa ntchito ndi Levemir nthawi zambiri imayamba chifukwa chosankha bwino gawo la insulin, ndipo kuwonjezera pa izi, kusintha kwa zakudya kapena zolimbitsa thupi. Kuphatikiza apo, chiopsezo cha hypoglycemia chimawonjezeka ngati wodwala ali ndi matenda, omwe umachitika chifukwa cha hyperthermia.

Hypoglycemia yamphamvu imatha kudzetsa kukoka, kuzindikira, kenako ndikuwonongeka kwakanthawi komanso kosatha kwa ubongo ndi imfa. Pakati pazizindikiro zoyambira za matenda: kumva kufooka, kugona ndi ludzu, kusowa poyang'ana, kukula kwa kunjenjemera, tachycardia, kupweteka mutu, nseru ndi kusokonezedwa kowoneka, komanso khungu lotuwa, kumverera kwanjala ndi thukuta lozizira. Kumbukirani kuti zizindikiro zoyambirira za matendawa zimatha kufooketsa kulimba kwawo ndi chithandizo cha nthawi yayitali ndi insulin, komanso, ndikuphatikiza mankhwala ndi mankhwala ena komanso mwa anthu omwe ali ndi matenda a shuga.

Mlingo ndi makonzedwe

Mankhwalawa amathandizidwa kudzera mwa cholembera chapadera. Mankhwala othandizira amathandizira kukulitsa zotsatira za antidiabetesic (maola 24 apamwamba), kotero, angagwiritsidwe ntchito mwanjira ya basulin, kutumikiridwa kamodzi kapena kawiri pa tsiku. Amaloledwa kugwiritsa ntchito mankhwalawa monotherapy osakaniza ndi bolus mawonekedwe a insulin, liraglutide kapena antidiabetesic oral.

Kukula kwa mankhwalawa kumatsimikiziridwa payekhapayekha, kusinthasintha kochepa tsiku ndi tsiku kwa ma basal glucose mkati mwa seramu amakupatsani mwayi kuti musankhe Mlingo wa insulin molondola momwe mungathere kuthana ndi glycemia.

Kukula kwakanthawi kovomerezeka komwe kumagwiritsidwa ntchito mankhwalawa kwa anthu omwe amamwa mankhwalawa am'magazi ndi magawo 10 kapena magawo 0,1-0.2 / kg kamodzi patsiku. Ndikofunikira makamaka kuwunika za shuga mkati mwa seramu poyambira chithandizo kuti musankhe bwino kukula kwa gawo.

Ngati ma glucose amatha pambuyo podziyimira pawokha pamimba yopanda kanthu m'mawa ndi ofanana ndi 10 mmol / l, mlingo wa mankhwalawa umakulitsidwa ndi magawo 8, ndipo ngati malangizowa ali m'gulu la 9.1-10, komanso 8.1-9 ndi 6.1 -8, muyenera kuwonjezera ma servings ndi magulu a 6, 4 kapena 2, motsatana. Momwe ma glucose amayesedwa pansi pazomwe zili pamwambapa ndi 3.1-5 mmol / L, mlingo wa insulin detemir uyenera kuchepetsedwa ndi 2 PIECES, ndipo ngati utachepera 3.1 mmol / L, uyenera kuchepetsedwa ndi 4 PIECES.

Dokotala amafotokoza kuchuluka kwa jakisoni, poganizira chithandizo chothandizira komanso kufunika kwa insulin.

Anthu omwe amafunika kubayira insulin kawiri patsiku amalangizidwa kuti azichita 2nd isanayambe chakudya chamadzulo kapena asanagone.

Ndikofunikira kukumbukira kuti kukonza kwa kayendetsedwe kazinthu zolimbitsa thupi ndi zakudya, komanso, kupsinjika kwambiri kapena kukhazikika kwa matenda othandizira kungayambitse kufunika kosintha kwa mankhwalawa.

Kugwiritsa ntchito Levemir m'magulu ena a odwala.

Tiyenera kukumbukira kuti ndikusintha kwa ntchito ya chiwindi / impso, kungakhale kofunikira kusintha kuchuluka kwa mankhwalawa (popeza kufunikira kwa wodwala kusintha kwa insulin). Muyenera kuwunikira momwe anthu aku gululi alili komanso kusintha kukula kwake ngati wapezeka kuti wapezeka kuti wayamba kuchepa.

Panthawi yoyesedwa, chitetezo ndi zochiritsika zakugwiritsira ntchito mankhwalawa kwa odwala azaka 2 ndi kupitilira zidadziwika. Ana omwe amafunikira chithandizo cha insulin amafunikira kuwunika bwino ma serum glucose. Iwo amafunika kusankha mosamala kukula kwa milingo ya insulin ya ana.

Njira yosinthira Levemir ndi mitundu ina ya insulin.

Anthu omwe m'mbuyomu adagwiritsa ntchito ma insulin omwe amakhala ndi nthawi yayitali kapena yolimbitsa thupi ayenera kusankha mosamala Mlingo wa Levemir. Kukhazikitsa kwake kumafunikira kuwunika mosamala kwambiri kuchuluka kwa shuga mkati mwa seramu.

Mankhwala othandizira odwala matenda ashuga amafunika kuwunikiranso mtundu wa mankhwala ndi mtundu wa mankhwala onse omwe amagwiritsidwa ntchito posinthira mtundu wina wa insulin.

Njira yoyendetsera yankho la mankhwala.

Kubayirira ndikofunikira kokha mwa njira yodutsamo. Jakisoni wamkati ndi jakisoni wamkati amuloledwa. Ndi pa / pakukhazikitsa insulini, hypoglycemia imatha kukhazikika mwa mawonekedwe (mpaka kufa).

Simungathe kupereka jakisoni wa mankhwala okhala ndi mapampu a insulin omwe amagwira ntchito mosalekeza, mankhwalawa amatha kuperekedwa kokha kudzera mu cholembera.

Pamene ma jakisoni a s / c ayenera kusankha malo omwe ali kunja kwa chikazi, paphewa kapena kutsogolo kwa peritoneum. Jakisoni onse amalimbikitsidwa kuti azichita m'malo osiyanasiyana a thupi (ngakhale mkati yaying'ono yomweyo), apo ayi, chitukuko cha lipodystrophy chitha kupweteka.

Kutalika kwakanthawi ndikuwonetsa mphamvu ya mankhwala a antidiabetes. Mankhwalawa amatha kusintha poganizira kuthamanga kwa magazi, kutentha, gawo la mankhwalawo, malo opangira jekeseni, komanso zisonyezo za zochita zolimbitsa thupi (mogwirizana ndi kuchuluka kwa kagayidwe kake komanso mayamwidwe a yogwira mankhwala).

Zingwe ziyenera kuchitidwa nthawi yomweyo, yabwino kwambiri kwa wodwala.

Syringe imagwiritsidwa ntchito limodzi ndi singano zotayika (NovoTvist kapena NovoFayn), wokhala ndi kutalika kwa 8 mm. Syringe imatha kubayidwa mkati mwa 1 mayunitsi a insulin, komanso kukhala ndi gawo la 1 unit.

Chiwembu chogwiritsira ntchito cholembera kuti mupeze jakisoni.

Cholembera chimbiracho chimangolembera makina a inshuwaransi a Levemir.

Njira ya jakisoni:

• Musanayambe mawu oyamba, ndikofunikira kuyang'ana mtundu wa insulin,
• Chotsani chophimba kuthengo,
• chotsani chololembera kuchokera ku singano yamagwiritsidwe amodzi, kenako nikizani ndi syringe,
• chotsani kapu yakunja mu singano (muyenera kuyisunga kufikira kumapeto kwa jakisoni),
• chotsani chophimba chamkati ndi singano ndikuchotsa nthawi yomweyo,
• khazikitsani kukula kwake, kenako mutha kuyambitsa jakisoni. Kuti mupeze mlingo, muyenera kugwiritsa ntchito chosankha chapadera,
• ikani singano pamalo osankhidwa, kenako ndikanikizani batani la syringe,
• imafunika kugwira batani lozungulira osachotsa singano kwa masekondi 6 (kulowa mtanda wonse),
• chotsa singano ndikuchotsa mu syringe, pogwiritsa ntchito chida chakunja choteteza,
• tsekani syringe ndi chotetezera.

Pingwe yatsopano ndiyenera kuyikamo jakisoni aliyense. Ngati singano idawonongeka kapena kugwada isanachitike, muyenera kuyitaya ndikugwiritsa ntchito yatsopano. Kuti tipewe misempha mwangozi ndi singano, nkoletsedwa kuvala chophimba chamkati mutachichotsa kale.

Musanayambe makonzedwe a mankhwalawa, muyenera kuyang'ana insulin yomwe ilipo. Izi zimachitika motere:

• muyenera kusankha chosankhira magawo awiri,
• akugwirizira syriralo molunjika, ndi singano kumtunda, ikani pang'ono pang'onopang'ono pamalo a cartridge,
• akugwiritsabe syringe molunjika, muyenera kukanikiza batani. Zotsatira zake, chosankha cha meteringchi chibwereranso ku 0, ndipo dontho lamankhwala liyenera kuwoneka kumapeto kwa singano,
• Ngati mwatsata zomwe tafotokozazi, dontho la njira silinachitike, ndikofunikira kusintha singano ndikubwereza zomwe tafotokozazi,
• ndizoletsedwa kubwereza izi nthawi zopitilira 6 - posakhalapo chifukwa patayesedwa kangapo, titha kunena kuti syringe ndi yopanda pake, chifukwa chake sichingagwiritsenso ntchito.

Gawo lomwe lakhazikitsidwa pa chosankhira limaloledwa kuti lisinthidwe mbali zonse zakuchepa komanso njira yowonjezerera, pa chifukwa ichi kupukutira wosankhidwa pakufunika. Mukakhazikitsa dosing, muyenera kuyang'ana mosamala kuti batani loyambira silikakamizidwa (chifukwa izi zingapangitse insulin kutulutsa).

Kumbukirani kuti sizotheka kukhazikitsa Mlingo pa syringe Selector yomwe imaposa kuchuluka kwa mankhwalawa omwe atsalira mkati mwa cartridge. Simungagwiritsenso ntchito mulingo wa insulin zotsalira posankha servings.

Ndikofunikira kuchotsa singano ku syringe mukatha kuchita chilichonse, chifukwa mukachisiya m'malo mwake, izi zitha kupangitsa kuti mankhwalawo adutse.

Pa ntchito ya jakisoni njira, malamulo aseptic zofunika.

Tiyeneranso kukumbukira kuti syringe idapangidwa kuti igwiritsidwe ntchito payekha.

Kuyeretsa ndikusunga pang'onopang'ono kwa cholembera.

Sitikulimbikitsidwa kugwiritsa ntchito syringe ngati yagwa kapena yopunduka (chifukwa izi zingayambitse kutayikira kwa mankhwalawa).

Mbali yakunja ya syringe yomwe imagwiritsidwa ntchito iyenera kutsukidwa ndi ubweya wa thonje, womwe umanyowetsedwa kale mu ethanol. Osasunga syringe pansi pamadzi, muthiriratu ndi mowa kapena muthira mafuta m'njira zosiyanasiyana.

Kudzazitsa syringe nkoletsedwa.

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The zikuchokera, kumasula mawonekedwe ndi pharmacological kanthu

Levemir ikhoza kugulidwa kokha ngati yankho la jekeseni lomwe limayikidwa pansi pa khungu.

Chofunikira chakapangidwacho ndi insulin Detemir. Katunduyu ndi wa fanizo la insulin ya anthu ndipo amadziwika ndi kuwonekera nthawi yayitali.

Kuti muchite bwino komanso chitetezo, zinthu monga:

• metacresol
• phenol
• zinc acetate
• glycerol
• sodium kolorayidi
• sodium hydroxide
• sodium hydrogen phosphate,
• madzi.

Mankhwala ndi madzi owonekera popanda mtundu.

Mukamamwa mankhwala aliwonse, muyenera kudziwa zomwe mungayembekezere. Pachifukwa ichi, mankhwala ake amafunika kuphunzira. The yogwira thunthu mankhwala amapezeka synthetical ndi recombinant DNA luso. Nthawi yodziwika ndi insulin yamtunduwu imafotokozedwa chifukwa chakuti mayamwidwe ake amayamba pang'ono pang'onopang'ono kuposa momwe zimakhalira ndi mahomoni achidule komanso apakati.

Maulalo amapangidwa pakati pa gawo logwirira ntchito ndi ma receptor pama membrane a khungu, chifukwa chomwe kuchuluka kwa njira zamkati mwake kumathandizira mofulumira komanso kuchuluka kwa mapangidwe a enzyme kumawonjezeka.

Kutenga kwa mkati kwa glucose komanso kugawa kwake minofu kumachitika mwachangu, komwe kumachepetsa kuchuluka kwake m'madzi a m'magazi. Komanso Detemir amatha kutsitsa kuchuluka kwa shuga ndi chiwindi.

Mayamwidwe mankhwala zimatengera munthu wodwala, Mlingo ndi jakisoni. Insulin yamtunduwu imakhala yothandiza kwambiri pakapita nthawi yotalikirapo mpaka maolainjere. Thupi limagawidwa mu ndende ya 0,1 l / kg.

Panthawi ya metabolic, Levemir amasinthidwa kukhala metabolites osagwira, omwe amatsitsidwa ndi impso ndi chiwindi. Hafu ya moyo wa chinthu kuchokera m'thupi imatha kukhala maola 10 mpaka 14. Kutalika kwa gawo limodzi la mankhwalawa kumafika patsiku.

Zizindikiro ndi contraindication

Mankhwala aliwonse ayenera kugwiritsidwa ntchito pokhapokha potsatira malangizo, ndibwino kudziwa kuchokera kwa dokotala. Katswiri ayenera kupenda chithunzithunzi cha matendawa, kuyeserera koyenera ndipo pokhapokha - asankhe.

Mankhwalawa adapangira zochizira matenda ashuga. Itha kugwiritsidwa ntchito padera, monga mankhwala akuluakulu, kapena amatha kusankha njira zovuta pochiritsira ndi njira zina.

Amakhulupilira kuti ndioyenera kwa onse odwala wazaka zisanu ndi chimodzi, koma ali ndi zolakwika zina zomwe zimayenera kukumbukiridwa:

• chidwi chamtundu wa insulin,
• mimba
• nyere
• ukalamba
• chiwindi ndi matenda a impso.

Otsutsa omwe alembedwa si okhwima (kupatulapo tsankho). Nthawi zina, kugwiritsa ntchito mankhwalawa kumaloledwa, koma kumafunikira kuwongoleredwa ndi dokotala komanso kusintha kwa mtundu uliwonse wa zopatukazo kuchokera pakukonzekera chithandizo.

Malangizo ogwiritsira ntchito

Kukonzekera kwa insulin ndikofunikira kwambiri kwa odwala matenda ashuga. Nthawi zina, popanda iwo, wodwala amatha kufa. Koma sikuti pamakhala ngozi ngati simungatsatire malamulo oti agwiritse ntchito. Levemir amafunikanso kugwiritsidwa ntchito molingana ndi malangizo, osasintha chilichonse popanda chidziwitso cha dokotala. Kuchita kwa Amateur pazomwezi kumatha kusintha kukhala zovuta zazikulu.

Chida ichi chimagwiritsidwa ntchito ngati ma jakisoni, omwe amayenera kuperekedwa mwachangu. Zosankha zina sizimachotsedwa. Imayenera kupereka jakisoni pokhapokha - pomwe pali kulimbikitsidwa kwa zinthu zomwe zimagwira mwachangu, zomwe zimatsimikizira kuti mankhwalawo amagwira bwino ntchito.

Madera ngati awa ndi khoma lakunja lam'mimba, phewa ndi ntchafu. Pofuna kupewa kukulitsa zotsatira zoyipa, muyenera kusinthitsa malo ena omwe ali ndi jekeseni m'dera lomwe mwakhala mukufotokozera, apo ayi, chinthucho chimaleka kumizidwa ngati chikufunika, chomwe chimachepetsa chithandizo.

Mlingo wa mankhwalawa uyenera kutsimikiziridwa payekhapayekha. Izi zimakhudzidwa ndi zinthu zambiri, kuphatikiza zaka za wodwalayo, matenda ake owonjezera, mawonekedwe a shuga, ndi zina zambiri. Kuphatikiza apo, mulingo ungathe kusinthidwa, ngati kuli kotheka, m'njira yayikulu kapena yaying'ono. Katswiri amayenera kuyang'anitsitsa njira yamankhwala, kupenda zamphamvu ndi kusintha dongosolo la majekeseni.

Jekeseni amachita kamodzi kapena kawiri patsiku, zomwe zimatsimikiziridwa kutengera chithunzi cha matendawa. Ndikofunikira kuti azichitika nthawi yomweyo.

Phunziro la kanema pogwiritsa ntchito cholembera:

Odwala Apadera ndi Mayendedwe

Popereka mankhwala, dokotalayo ayenera kukumbukira kuti chisamaliro chimafunikira pamagulu ena a odwala, chifukwa thupi la anthu awa silingayankhe mankhwalawo monga momwe anakonzera.

Odwala awa akuphatikizapo:

1. Ana. Zaka za wodwalayo ndizosakwana zaka 6 ndi chifukwa chokana kugwiritsa ntchito mankhwalawa. Kafukufuku wokhudza kufunikira kwa Detemir insulin kwa ana aang'ono sichinachitike, choncho musayike moyo wawo pachiwopsezo.
2. Anthu okalamba. Kusintha kokhudzana ndi ukalamba mthupi kumatha kusokoneza mayendedwe a mahomoni, chifukwa pomwe wodwalayo amakhala ndi zosokoneza. Chifukwa chake, musanapereke mankhwala, ndikofunikira kuchita kafukufuku kuti mudziwe matenda omwe ali nawo, kupatula shuga. Makamaka anapenda mosamala magwiridwe antchito a impso ndi chiwindi. Koma sizinganene kuti ukalamba ndi kuphwanya malamulo kwambiri. Akatswiri amapereka mankhwala kwa odwala otere, koma yang'anirani thanzi lawo kwambiri ndikuchepetsa gawo la mankhwalawo.
3. Amayi oyembekezera. Zambiri pazovuta zomwe zingachitike chifukwa chogwiritsa ntchito insulin panthawi ya bere sizikupezeka. Ngati ndi kotheka, chidachi chitha kugwiritsidwa ntchito, koma ndikofunikira kuwongolera kuchuluka kwa shuga, omwe amatha kusiyanasiyana kutengera nthawi.
4. Kuchepetsa. Popeza insulin ndi gulu la mapuloteni, kulowa kwake mkaka wa m'mawere sikumawonetsedwa ngati kowopsa kwa wakhanda - mutha kupitiliza kugwiritsa ntchito Levemir, koma muyenera kutsatira kadyedwe ndikutsatira Mlingo woperekedwa ndi katswiri.

Kusamala pokhudzana ndi kuchuluka kwa mankhwalawa kungathandize kupewa zovuta pamankhwala.

Kusasamala kungakhale koopsa pokhudzana ndi odwala omwe ali ndi vuto la chiwindi ndi impso. Mahomoni amakhudza ntchito ya chiwindi, amachepetsa kupanga shuga.

Ndi kulephera kwa chiwindi, mphamvu ya mankhwalawa imatha kukhala yopindika, yomwe imatsogolera dziko la hypoglycemic.

Kusokonezeka kwa impso kumatha kuyambitsa kuzengereza kwa zinthu zofunikira m'thupi. Izi zimayambitsa hypoglycemia.

Komabe, ndi zovuta zotere, amakana kugwiritsa ntchito mankhwalawa. Dotolo ayenera kuganizira kuuma kwa matenda ndi kukonza mlingo wa mankhwalawa malinga ndi izi.

Zotsatira zoyipa ndi bongo

Pa chithandizo, ndikofunikira kulabadira kusintha komwe kukubwera. Mphamvu zowoneka bwino ndizofunikira, koma kuwonekera kwa zizindikiro zoipa ndikofunikira kwambiri, chifukwa zochitika zovuta zimawonetsa zovuta. Nthawi zambiri zimachitika chifukwa chakuti mankhwalawa sagwiritsidwa ntchito kwa wodwala.

Mutatha kuunikanso ndemanga zamankhwala, mutha kuwona kuti zina mwazotsatira zoyipa ndizotsatira:

1. Hypoglycemia. Mawonekedwe ake amadza chifukwa cha kuchuluka kwa insulin, chifukwa thupi limakumana ndi vuto lalikulu la shuga. Vutoli limatha kudziwika ndi zizindikiro zosiyanasiyana, kuphatikizaponso kusazindikira, nseru, tachycardia, kugwedezeka, etc. milandu yayikulu ikhoza kutha ngati wodwala sanapatsidwe chithandizo.
2. Zizindikiro zakomweko. Amawonetsedwa ngati wopanda vuto lililonse, chifukwa amayamba chifukwa cha kulephera kwa thupi kuchitapo kanthu kamankhwala. Pambuyo kanthawi kocheperako, izi zimachitika. Izi zimaphatikizapo kutupa pamalo a jakisoni, kufiyira khungu, zotupa.
3. The ziwengo. Ngati m'mbuyomu mumayesa kuti mumvetsetse momwe mankhwalawo amachitikira, ndiye kuti zotsatira zake sizigwirizana. Koma izi sizimachitika nthawi zonse, chifukwa chake, munthu amatha kukhala ndi totupa, ming'oma, kupuma movutikira, nthawi zina ngakhale kugwedezeka kwa anaphylactic.
4. Zowonongeka. Kupezeka kwawo kukufotokozedwa ndi kusinthasintha kwa kuwerenga kwa shuga. Mtundu wa glycemic utakhazikika, kuphwanya kuyenera kuthetsedwa.

Mfundo zoyendetsera gawo lililonse pazotsatira zamtundu uliwonse ziyenera kusankhidwa ndi katswiri. Nthawi zina, mankhwala operekera mankhwala amalembedwa, mwa ena, mankhwala omwe amakhazikitsidwa amatha.

Chifukwa cha izi, chikhalidwe cha hypoglycemic cha kusinthasintha kosiyanasiyana kumachitika. Wodwala amatha kukonza vutoli mwa kudya chakudya chamafuta ambiri (ngati mawonekedwe a hypoglycemia ndi ochepa). Panthawi yovuta, chithandizo chamankhwala ndichofunikira.

Mogwirizana ndi mankhwala ena, analogi

Kupanga kwa mankhwala Levemir amakopeka mwamphamvu ndi zinthu monga kuphatikiza kwake ndi mankhwala ena. Popereka mankhwala, adotolo ayenera kudziwa zomwe odwala amagwiritsa ntchito. Zina mwazo zimatha kutsitsa zotsatira za kuwonekera kwa insulin.

Izi zikuphatikiza:

• okodzetsa
• amphanomachul
• Mitundu ina ya mankhwala ochepetsa nkhawa,
• mankhwala a mahomoni.

Palinso mndandanda wamankhwala omwe amalimbikitsa zotsatira za Levemir, zomwe zimapangitsa kuti pakhale mankhwala ochulukirapo komanso zotsatira zoyipa.

• sulfonamides,
• beta blockers,
• Mao ndi ACE zoletsa,
• manzeru
• othandizira a hypoglycemic.

Mukamagwiritsa ntchito ndalama zomwe zili pamwambazi, limodzi ndi insulini, amayenera kusintha mlingoyo pansi kapena pansi.

Zofanana poyerekeza ndi insulin Lantus ndi Levemir:

Sikoyenera kuyika Levemir ndi mankhwala ena nokha, chifukwa muyenera kudziwa zomwe katswiri ali nazo.

Omaliza pakati pa fanizo ndi:

1. Protafan. Mankhwalawa amagulitsanso ngati yankho. Gawo lake lalikulu ndi insulin Isofan. Kugwiritsidwa ntchito kwake ndikoyenera kwa odwala omwe thupi lawo limakhudzidwa ndi Detemir.
2. Humulin. Imayimiridwa ndi yankho lomwe lingabayidwe kutengera insulin ya anthu.

Komanso, adotolo atha kukulemberani mankhwala akumwa a hypoglycemic, omwe ali ndi mfundo zofananira, koma njira ina yogwiritsira ntchito.

Mankhwalawa amagulitsidwa muma pharmacies pamtengo wa 2500 mpaka 3000 rubles. Kuti mugule, muyenera Chinsinsi.