Mankhwala Insulin Detemir: malangizo ntchito

Insulin Detemir ndi wofanana ndi insulin ya anthu. Mankhwala anagwiritsa ntchito hypoglycemic mankhwala a odwala matenda a shuga. Amadziwika ndi kuchitapo kanthu kwanthawi yayitali komanso kuchepetsedwa kotheka kwa hypoglycemia usiku.

Dzinalo Losayenerana

INN yamankhwala awa ndi insulin. Mayina amalonda ndi Levemir Flekspan ndi Levemir Penfill.

ATX

Awa ndi mankhwala a hypoglycemic omwe ali m'gulu la mankhwala a insulin. Khodi yake ya ATX ndi A10AE05.

Kutulutsa mafomu ndi kapangidwe kake

Mankhwalawa amapezeka mu mawonekedwe a jekeseni wofunidwa kuti ayang'anire pakhungu. Mitundu ina ya mulingo, kuphatikizapo mapiritsi, siipangidwa. Izi ndichifukwa choti mumgawo wama cell insulin umagawika ma amino acid ndipo sungathe kukwaniritsa ntchito zake.

Insulin Detemir ndi wofanana ndi insulin ya anthu.

Gawo lolimbikira limayimiriridwa ndi insulin. Zomwe zili mu 1 ml ya yankho ndi 14.2 mg, kapena 100 mayunitsi. Zowonjezera zina zikuphatikiza:

• sodium kolorayidi;
• glycerin;
• hydroxybenzene;
• metacresol;
• sodium hydrogen phosphate dihydrate;
• zinc acetate;
• kuchepetsa hydrochloric acid / sodium hydroxide;
• madzi a jakisoni.

Chimawoneka ngati yankho lomveka bwino, losasankhidwa, lopanda tanthauzo. Imagawidwa m'magulu atatu a ma cartridge (Penfill) kapena cholembera (Flekspen). Katakitala wakunja. Malangizowo akuphatikizidwa.

Zotsatira za pharmacological

Mankhwala ndi mankhwala opanga ma genetic engineering. Zimapezeka ndikupanga rDNA mu yisiti yophika. Pachifukwa ichi, zidutswa za plasmids zimasinthidwa ndi majini omwe amatsimikizira biosynthesis ya insulin precursors. Ma plasmids osinthika amtunduwu amaikidwa mu maselo a Saccharomyces cerevisiae, ndipo amayamba kupanga insulin.

Mukamagwiritsa ntchito mankhwalawa, chiopsezo cha nocturnal hypoglycemia chimachepetsedwa ndi 65% (poyerekeza ndi njira zina).

Wothandiziridwayo ndikuwonetsa ma hormone omwe amatulutsidwa ndi zisumbu za Langerhans mthupi la munthu. Imadziwika ndi nthawi yayitali ndipo imamasulidwa popanda kutchulidwa kuti idalumikizidwa ndi plasma.

Ma molekyulu a insulin amapanga mayanjano pamalo opangira jakisoni, komanso omangika ku albumin. Chifukwa cha izi, mankhwalawa amamwetsedwa ndikulowetsa minofu yolumikizira pang'onopang'ono, yomwe imapangitsa kuti ikhale yothandiza komanso yotetezeka kuposa zokonzekera zina za insulin (Glargin, Isofan). Poyerekeza ndi iwo, chiwopsezo cha hypoglycemia usiku chimachepetsedwa mpaka 65%.

Pogwiritsa ntchito ma cell receptor, yogwira pophika mankhwala imayambitsa njira zingapo, kuphatikizapo kaphatikizidwe kazinthu zofunika monga glycogen synthetase, pyruvate ndi hexokinase. Kutsika kwa glucose wa plasma kumaperekedwa ndi:

• kukakamiza kupanga kwake mu chiwindi;
• kulimbitsa mayendedwe olowerera;
• kutsegula kwa assimilation mu zimakhala;
• kukondoweza kwa kukonza mu glycogen ndi mafuta acids.

Zotsatira zamankhwala zimachitika mosiyanasiyana ndi mlingo womwe umaperekedwa. Kutulutsa kwake kumadalira malo a jakisoni, mlingo, kutentha kwa thupi, kuthamanga kwa magazi, kuchita zolimbitsa thupi. Imatha kufikira maola 24, motero, jakisoni amapangidwa nthawi 1-2 patsiku.

Zomwe impso sizikhudza kagayidwe ka zinthu.

M'kati mwa kafukufukuyu, kufotokozeredwa kwa mtundu, yankho la Carcinogenic, komanso zotsatira zake pakumakula kwa maselo ndi ntchito zolereka sizinawululidwe.

Pharmacokinetics

Kuti mupeze kuchuluka kwakukulu kwa plasma, maola 6-8 ayenera kutha kuchokera panthawiyi. Bioavailability pafupifupi 60%. Kuphatikizika kwa kufanana ndikuwongolera kwa nthawi ziwiri kumatsimikiziridwa pambuyo pa jekeseni wa 2-3. Kuchuluka kwa magawa pafupifupi 0,1 kg / kg. Kuchuluka kwa insulini yovulazidwa kumazungulira ndi mtsempha wamagazi. Mankhwalawa samayanjana ndi mafuta acids komanso ma pharmacological omwe amamangilira mapuloteni.

Kupanga masanjidwewo sikusiyana ndi kukonza kwa insulin yachilengedwe. Kutha kwa theka-moyo kumapangika kuyambira maola asanu mpaka asanu ndi awiri (malinga ndi mlingo womwe wagwiritsidwa ntchito). Pharmacokinetics sizimatengera jenda komanso zaka za wodwalayo. Mkhalidwe wa impso ndi chiwindi sichikhudzanso izi.

Zizindikiro zogwiritsidwa ntchito

Mankhwalawa cholinga chake ndi kuthana ndi hyperglycemia pamaso pa matenda amtundu wa 2 komanso matenda a shuga.

Insulin idapangidwa kuti ilimbane ndi hyperglycemia pamaso pa matenda amtundu wa 2 komanso matenda a shuga.

Contraindication

Chida ichi sichinafotokozeredwe kwa hypersensitivity pazochitika za insulin kapena kusalolera kwa omwe akumwa. Malire a zaka ndi zaka ziwiri.

Momwe mungatengere Insulin Detemir

Njira yothetsera vutoli imagwiritsidwa ntchito subcutaneous makonzedwe, kulowetsedwa mwa mtsempha kungayambitse kwambiri hypoglycemia. Sijowina intramuscularly ndipo sagwiritsidwa ntchito pamapampu a insulin. Zingwe zitha kuperekedwa m'dera la:

• phewa (minofu yolumikizana);
• m'chiuno
• khoma lakutsogolo kwa peritoneum;
• matako.

Tsamba la jakisoni liyenera kusinthidwa pafupipafupi kuti muchepetse kuwoneka kwa lipodystrophy.

Mlingo woyeserera amasankhidwa mosiyanasiyana. Mlingo umadalira glucose yachangu. Kusintha kwa mankhwalawa kungakhale kofunikira pakuchita zolimbitsa thupi, kusintha kwa zakudya, matenda amodzimodzi.

Mankhwalawa amaperekedwa m'malo osiyanasiyana, kuphatikizapo khoma lakunja la peritoneum.

Kugwiritsa ntchito mankhwalawa ndikuloledwa:

• palokha;
• molumikizana ndi jakisoni wa insulin;
• kuphatikiza liraglutide;
• ndi antidiabetic oyamwa.

Ndi zovuta mankhwala a hypoglycemic, tikulimbikitsidwa kupereka mankhwalawa nthawi 1 patsiku. Muyenera kusankha nthawi iliyonse yabwino ndikumamatira mukamapanga jakisoni tsiku ndi tsiku. Ngati pakufunika kugwiritsa ntchito yankho kawiri pa tsiku, muyezo woyamba umaperekedwa m'mawa, ndipo wachiwiri ndi nthawi ya maola 12, chakudya chamadzulo kapena musanagone.

Pambuyo popukusira pang'onopang'ono jakisoni, batani la cholembera limasungidwa pansi, ndipo singano imasiyidwa pakhungu kwa masekondi 6 osachepera.

Mukamasintha insulin ina kukonzekera Detemir-insulin m'milungu yoyamba, kuyang'anira mosamalitsa kwa glycemic index ndikofunikira. Pangakhale kofunikira kusintha mankhwalawa, mankhwalawa komanso nthawi yodwala mankhwala opatsirana pogwiritsa ntchito mankhwala osokoneza bongo.

Ndikofunikira kuyang'anitsitsa kuchuluka kwa shuga ndikusintha panthawi yake muyezo wa okalamba.

Ndikofunikira kuyang'anitsitsa kuchuluka kwa shuga ndikusintha panthawi yake mu okalamba ndi odwala omwe ali ndi aimpso.

Zotsatira zoyipa za Insulin Detemir

Wothandizila mankhwalawa amalekeredwa bwino. Zotheka zomwe zimachitika zimagwirizanitsidwa ndimatenda a insulin.

Pa mbali ya gawo la masomphenyawo

Ma anomalies a Refraction (kupindika kwa chithunzicho, kupangitsa kupweteka mutu ndikuwuma pamaso pamaso) nthawi zina zimadziwika. Matenda a shuga omwe angayambike. Chiwopsezo cha kupita patsogolo kwake chikuchulukirachulukira ndi insulin.

Kuchokera minofu ndi mafupa

Mankhwala, lipodystrophy imatha kukhazikika, yomwe ikuwonetsedwa mu atrophy ndi adipose minofu hypertrophy.

Pakati mantha dongosolo

Nthawi zina zotumphukira neuropathy amakula. Nthawi zambiri, zimasinthidwanso. Nthawi zambiri, zizindikiro zake zimawonekera ndi kukhazikika kwa mtundu wa glycemic index.

Mankhwalawa amatha kuyambitsa kusakanikirana, kumayendetsedwa ndi mutu komanso maso owuma.

Kuzindikira komanso kuthamanga kwa kuyankha kumatha kusokonezeka ndi hypo- kapena hyperglycemia.

Monga chiwonetsero cha matenda osiyanasiyana, tachycardia ndi yotheka.

Kuchokera kumbali ya kagayidwe

Nthawi zambiri pamakhala kuchuluka kwa shuga m'magazi. Hypoglycemia yayikulu imayamba mwa 6% yokha mwa odwala. Zitha kuchititsa mawonetsero okhudzika, kukomoka, kusokonekera kwa ubongo ntchito, imfa.

Matupi omaliza

Nthawi zina zimachitika kupezeka jakisoni. Pankhaniyi, kuyabwa, khungu rede, zotupa, matupa angaoneke. Kusintha tsamba la jakisoni wa insulin kungachepetse kapena kupatula mawonetseredwe awa; kukana kwa mankhwala kumafunika kawirikawiri. Kugwirizana kwakuthekera ndikotheka (matumbo kukhumudwa, kupuma movutikira, kusintha kwa matenda, kuchepa kwa mawonekedwe, kutuluka tachycardia, anaphylaxis).

Zokhudza mphamvu pakuwongolera njira

Kuzindikira komanso kuthamanga kwa kuyankha kumatha kusokonezeka ndi hypo- kapena hyperglycemia. Ndikofunikira kuti muchepetse kuwoneka kwa izi mukamachita ntchito yowopsa ndikuyendetsa galimoto.

Malangizo apadera

Kuchepa kwa shuga m'misempha usiku kumachepetsedwa poyerekeza ndi mankhwala omwewo, omwe amathandizira kukulitsa mawonekedwe a matenda a glycemic a odwala. Njira izi sizimayambitsa kukwera kwamphamvu kwa thupi (mosiyana ndi zothetsera zina za insulin), koma zimatha kusintha zizindikiro zazikulu za hypoglycemic.

Kuchepetsa kwa insulin mankhwala kapena osakwanira mlingo kungayambitse hyperglycemia.

Kuchepetsa kwa insulin mankhwala kapena kugwiritsa ntchito mankhwalawa osakwanira kungayambitse hyperglycemia kapena kupangitsa ketoacidosis, kuphatikizapo imfa. Ziwopsezo makamaka za mtundu wa matenda a shuga. Zizindikiro za kuchuluka kwa shuga:

• ludzu
• kusowa kwa chakudya;
• kukodza pafupipafupi;
• kulumikizana;
• gag Reflex;
• bongo wa mucosa;
• kuyanika ndi kuyabwa kwa chotsegulira;
• hyperemia;
• kumverera kwa fungo la acetone;
• kugona

Kufunika kwa insulini kumawonjezeka ndi masewera olimbitsa thupi osakonzekera, kupatuka pa dongosolo la chakudya, matenda, kutentha thupi. Kufunika kosintha nthawi kumafunikira kuchipatala.

Mankhwala sangathe kugwiritsidwa ntchito:

1. Mothandizidwa, intramuscularly, kulowetsedwa mapampu.
2. Mtundu ndi mawonekedwe amadzi zitasintha.
3. Ngati tsiku lotha ntchito latha, yankho lake linasungidwa m'malo osayenera kapena lauma.
4. Pambuyo poponya kapena kufinya katoni / syringe.

Dermul ya Detemir saloledwa kuperekedwa kudzera m'mitsetse yamkati.

Gwiritsani ntchito mu ukalamba

Kwa odwala okalamba, kuchuluka kwa glucose amayenera kuyang'aniridwa makamaka ndi chisamaliro. Ngati ndi kotheka, sinthani koyamba mlingo.

Kupatsa ana

Palibe chokuchitikirani pakugwiritsidwa ntchito kwa mankhwalawa kwa ana aang'ono (mpaka zaka 2). Mlingo wa ana ndi achinyamata ayenera kusankhidwa mosamala.

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere

Mukamachititsa maphunziro, zotsatira zoyipa kwa ana omwe amayi awo amagwiritsa ntchito mankhwalawa panthawi yoyembekezera sizinazindikiridwe. Komabe, gwiritsani ntchito pakunyamula mwana ayenera kugwiritsidwa ntchito mosamala. Munthawi yoyambirira ya kubereka, mkazi amafunikira insulini amachepetsa pang'ono, ndipo pambuyo pake amawonjezeka.

Palibe umboni wotsimikiza kuti insulin ikadutsa mkaka wa m'mawere. Kudya kwake kwa pakamwa mwa khanda sikuyenera kuwonetseredwa moipa, chifukwa m'mimba mwake, mankhwalawo amasungunuka msanga ndipo umatengedwa ndi thupi ngati amino acid. Mayi woyamwitsa angafunikire kusintha kwa mlingo ndi kusintha kwa zakudya.

Palibe chokuchitikirani pakugwiritsidwa ntchito kwa mankhwalawa kwa ana aang'ono (mpaka zaka 2).

Ngati chiwindi ntchito, chiwongolero chachikulu cha shuga ndi kusintha komwe kumagwirizana.

Mukamachititsa maphunziro, zotsatira zoyipa kwa ana omwe amayi awo amagwiritsa ntchito mankhwalawa panthawi yoyembekezera sizinazindikiridwe.

The ntchito aimpso kuwonongeka

Mlingo umatsimikiziridwa payekhapayekha. Kufunika kwa mankhwalawa kumatha kuchepetsedwa ngati wodwala wayamba kuwonongeka kwaimpso.

Gwiritsani ntchito ntchito yolakwika ya chiwindi

Kuwongolera kwakukulu kwa msinkhu wa shuga ndi kusintha komwe kumagwirizana pamankhwala othandizira amafunika.

Kuchuluka kwa Insulin Detemir

Palibe mitundu yodziwika bwino yomwe ingayambitse mankhwala osokoneza bongo. Ngati kuchuluka kwa jakisoni kupitirira muyeso womwe mukufunikira, zizindikiro za hypoglycemic zingachitike pang'onopang'ono. Zizindikiro Zodandaula:

• blurging wa chikhazikitso;
• thukuta lozizira;
• mutu
• njala
• kufooka, kutopa, kugona;
• kulumikizana;
• nkhawa, kusokoneza;
• palpitations
• zonyansa zowoneka.

Kutsika pang'ono kwa index ya glycemic kumachotsedwa ndi kugwiritsa ntchito shuga, shuga, etc.

Kutsika pang'ono kwa index ya glycemic kumachotsedwa ndi kugwiritsa ntchito shuga, shuga, zakudya zamafuta ambiri kapena zakumwa zomwe wodwala matenda ashuga ayenera kukhala naye nthawi zonse (ma cookie, maswiti, shuga woyengedwa, etc.). Mu hypoglycemia yayikulu, wodwala wosazindikira amapakidwa ndi minyewa kapena pansi pa khungu la glucagon kapena jekeseni wamagazi. Ngati wodwala sadzuka pakatha mphindi 15 atabayidwa jakisoni, ayenera kuyambitsa yankho la shuga.

Kuchita ndi mankhwala ena

Kuphatikizikako sikungasakanizidwe ndimadzi osiyanasiyana azakumwa ndi mayankho amakanidwe. Ziwawa ndi ma sulfite zimayambitsa kuwonongeka kwa kapangidwe ka wothandizirayo.

Mphamvu ya mankhwalawa imachulukanso ndikugwiritsanso ntchito:

• Clofibrate;
• Fenfluramine;
• Pyridoxine;
• Bromocriptine;
• Cyclophosphamide;
• Mebendazole;
• Ketoconazole;
• Theophylline;
• mankhwala a antiidiabetesic pamlomo;
• ACE zoletsa;
• antidepepressants a gulu la IMOA;
• osasankha beta-blockers;
• kaboni anhydrase ntchito zoletsa;
• kukonzekera kwa lithiamu;
• sulfonamides;
• zotumphukira za salicylic acid;
• tetracyclines;
• anabolics.

Kuphatikiza ndi Heparin, Somatotropin, Danazole, Phenytoin, Clonidine, Morphine, corticosteroids, mahomoni a chithokomiro, sympathomimetics, calcium antagonists, thiazide diuretics, TCAs, kulera kwapakamwa, nikotini, kugwira insulin kumachepa.

Ndikulimbikitsidwa kuti musamwe mowa.

Mothandizidwa ndi Lanreotide ndi Octreotide, mphamvu ya mankhwalawa imatha kuchepa ndikukula. Kugwiritsa ntchito kwa beta-blockers kumabweretsa kuwongolera kwa kuwonetsa kwa hypoglycemia ndikuletsa kubwezeretsanso kuchuluka kwa shuga.

Kuyenderana ndi mowa

Ndikulimbikitsidwa kuti musamwe mowa. Kuchita kwa mowa wa ethyl ndizovuta kudziwiratu, chifukwa imatha kuwonjezera ndikulimbikitsa kufooka kwa vutoli.

Analogi

Zofananira zonse za Detemir-insulin ndi Levemir FlexPen ndi Penfill. Pambuyo pokambirana ndi dokotala, ma insulin ena (glargine, Insulin-isophan, ndi ena otero) angagwiritsidwe ntchito ngati cholowa m'malo mwa mankhwalawo.

Kupita kwina mankhwala

Kupeza mankhwala ndi kochepa.

Kodi ndingagule popanda kulandira mankhwala?

Mankhwala omwe mumalandira amamasulidwa.

Mtengo

Mtengo wa yankho la jakisoni Levemir Penfill - kuchokera ku ma ruble 2154. kwa ma cartridge 5.

Zosungidwa zamankhwala

Insulin imasungidwa m'matumba pa kutentha kwa + 2 ... + 8 ° C, kupewa kuzizira. Cholembera chogwiritsidwa ntchito ndi mankhwalawo chimatetezedwa ku kutentha kopitilira muyeso (kutentha mpaka + 30 ° C) ndi kuwala.

Tsiku lotha ntchito

Mankhwalawa amatha kusungidwa kwa miyezi 30 kuyambira tsiku lopangidwa. Alumali moyo wankho lomwe limagwiritsidwa ntchito ndi milungu 4.

Wopanga

Mankhwalawa amapangidwa ndi kampani yopanga mankhwala ku Danish, Novo Nordisk.

Ndemanga

Nikolay, wazaka 52, Nizhny Novgorod

Ndakhala ndikugwiritsa ntchito insulin iyi chaka chachitatu. Imachepetsa shuga, imagwira ntchito nthawi yayitali komanso bwino kuposa jakisoni wam'mbuyomu.

Galina, wazaka 31, Ekaterinburg

Zakudya sizinathandize, ndinadwala matenda ashuga okhathamira ndimankhwala. Mankhwalawa amalekeredwa bwino, jakisoni, ngati utachitidwa moyenera, ululu.