Pochiza matenda a shuga, insulin ya anthu imagwiritsidwa ntchito. Opanga a NovoRapid Flexpen amapereka mankhwalawa m'njira zowakonzera.
Dzinalo Losayenerana
Insulin
Opanga a NovoRapid Flexpen amapereka mankhwalawa m'njira zopangidwa ndi insulin.
ATX
A10AB05 Insulin asparagine
Kutulutsa mafomu ndi kapangidwe kake
Mankhwalawa amapangidwa mwanjira ya yankho lamadzi amtundu womwe umakhala ndi 100 U / ml (35 μg pa 1 U). Monga zigawo zothandizira zimawonjezera:
- phosphoric acid sodium salt;
- hydrochloric acid ndi mchere wake wa zinc ndi wa sodium;
- osakaniza glycerol, phenol, metacresol;
- sodium hydroxide.
Amapezeka m'mapensulo atatu a syringe, zidutswa 5 mu bokosi lililonse.
Zotsatira za pharmacological
Mankhwalawa amachepetsa glycemia, chifukwa Imalumikizana mosamalitsa ndi michere yapadera ya insulin pamitsempha yama cell. Zotsatira zake, insulin-receptor tata imapangidwa, yomwe imayambitsa magwiritsidwe ntchito a glucose pama plasma:
- kuchuluka kwa ma cell;
- kusokonezeka kwapakati pa glucose chifukwa cha kukonzekera kwa mapangidwe a pyruvate kinase ndi hexokinase michere;
- kaphatikizidwe wamafuta amafuta achilengedwe kuchokera ku shuga;
- kuchuluka kwa masitolo a glycogen ogwiritsa ntchito glycogen synthase enzyme;
- kutsegula kwa phosphorylation njira;
- kuponderezana kwa gluconeogeneis.
Mankhwalawa amachepetsa glycemia, chifukwa Imalumikizana mosamalitsa ndi michere yapadera ya insulin pamitsempha yama cell.
Pharmacokinetics
Pambuyo jakisoni pansi pakhungu, insulin aspart imalowetsedwa m'magazi, ndikuyamba kuchita pambuyo pake Mphindi 15, ntchito zapamwamba zimachitika pambuyo pa mphindi 60-180. Kutalika kwakukulu kwa zotsatira za hypoglycemic ndi maola 5.
Kwa anthu azaka zopitilira 65 kapena kuchepa mphamvu kwa chiwindi, kuchepa kwa mayamwidwe ndi chikhalidwe, chomwe chikufotokozedwa mu kuchedwa kwa nthawi yoyambira kwambiri.
Mwachidule kapena kutalika
The biotechnologically synthesised analogue of human human Horne amasiyana mu kapangidwe ka B28 maselo locus: mmalo mwa proline, Aspartic acid imapangidwa kuti apangidwe. Izi zimathandizira kuyamwa kwa yankho kuchokera ku mafuta amkati poyerekeza ndi insulin ya anthu, chifukwa sichimapanga madzi ofanana ndi iyo pang'onopang'ono kuwonongeka kwa mayanjidwe 6 a mamolekyulu. Kuphatikiza apo, zotsatira za kusinthaku ndi zinthu zotsatirazi za mankhwalawa zomwe zimasiyana ndi ma pancreatic hormone a anthu:
- kumayambiriro kwa kuchitapo kanthu;
- chachikulu hypoglycemic zotsatira 4 mawola itatha kudya;
- yochepa hypoglycemic zotsatira.
Poganizira izi, mankhwalawa ndi a gulu la ma insulin omwe ali ndi ultrashort kanthu.
Mankhwalawa amagwiritsidwa ntchito kuti azisinthasintha komanso kuwongolera mbiri ya matenda a shuga a mtundu wa 1.
Zizindikiro zogwiritsidwa ntchito
Mankhwalawa amagwiritsidwa ntchito kuti azisinthasintha komanso kuwongolera mbiri ya matenda a shuga a mtundu wa 1. Cholinga chomwechi chimatsatiridwa ndikusankhidwa kwa yankho la matenda a mtundu 2. Koma sizikulimbikitsidwa kuti muyambitse mankhwala. Zomwe zimayambitsa matenda a insulini mu mtundu wa matenda a shuga a 2 ndi awa:
- osakwanira kwenikweni kapena kuchepa kwake kwa mankhwala a hypoglycemic pakamwa;
- zinthu zomwe zimayambitsa kuwonongeka kwakanthawi kapena kosatha munthawi yodwala (matenda, poyizoni, ndi zina).
Contraindication
Njira yovomerezeka ndivomerezeka kugwiritsidwa ntchito m'mibadwo yonse, kupatula miyezi yoyamba ya 24 ya moyo. Chithandizo contraindicated mu chitukuko cha tsankho zimachitikira kwa izo kapena lolingana mbiri. Ndiowopsa kupatsa vuto la hypoglycemia.
Ndi chisamaliro
Chiwopsezo chachikulu cha kutsika kwa shuga m'magazi panthawi ya mankhwala amapezeka mwa odwala:
- kumwa mankhwala oletsa chimbudzi;
- akuvutika ndi matenda omwe amatsogolera kuchepa kwa malabsorption;
- Ndi chiwindi ndi impso ntchito.
Kuyang'anira glycemia mosamala ndi kutumikiridwa Mlingo ndikofunikira kwa odwala:
- zaka zopitilira 65;
- wosakwana zaka 18;
- ndi matenda amisala kapena kuchepa kwamaganizidwe.
Momwe mungagwiritsire ntchito NovoRapid Flexpen?
Makatoni othandizira ndi magawo onse otsalira amapezeka kumapeto kwina kwa chipangizocho, ndipo chopereka ndikuyambitsa mbali inayo. Zina mwazida zimawonongeka mosavuta, motero ndikofunikira kuyang'ana kukhulupirika kwa magawo onse musanagwiritse ntchito. Masingano okhala ndi kutalika kwa 8 mm okhala ndi mayina amalonda NovoFayn ndi NovoTvist ndi oyenera chida ichi. Mutha kupukuta pamtunda ndi thonje lomwe limanyowa mu ethanol, koma kumizidwa mu zakumwa sikuloledwa.
Malangizowa akuphatikizapo njira zotsatirazi:
- pansi pa khungu (jakisoni komanso kudzera pampu yopukutira mosalekeza);
- kulowetsedwa mu mitsempha.
Pomaliza, mankhwalawa amayenera kuchepetsedwa ku 1 U / ml kapena kuchepera.
Momwe mungapangire jakisoni?
Musati mupeze jakisoni wopopera. Pa makina osunthira, monga:
- khomo lam'mimba lakunja;
- kunja kwa phewa;
- patsogolo ntchafu;
- kumtunda kwakunja kwa dera la gluteal.
Njira ndi malamulo opangira jakisoni ndi ntchito iliyonse:
- Werengani dzina la mankhwalawo papepala la pulasitiki. Chotsani chivundikiro kuchokera pabokosi.
- Skani pa singano yatsopano, musanachotse filimuyo. Chotsani zipewa zakunja ndi zamkati kuchokera singano.
- Imbani pa ma dispenser 2 units. Kugwira syringe ndi singano mmwamba, tapira pang'ono pa cartridge. Kanikizani batani lotsekera - pa dispenser, cholemba chikuyenera kupita ku ziro. Izi zikuthandizira kuti mpweya usalowe mu minofu. Ngati ndi kotheka, bwerezani mayesowo mpaka 6, kusakhalapo kwa zotsatira kumawonetsa kuyipa kwa chipangizocho.
- Popewa kukanikiza batani lotsekera, sankhani mlingo. Ngati zotsalazo ndizochepa, ndiye kuti kuchuluka kofunikira sikungasonyezedwe.
- Sankhani jakisoni wosiyana ndi woyamba. Tengani khungu lanu limodzi ndi mafuta ochulukirapo, kupewa kupewetsa minofu yam'munsi.
- Ikani singano mu crease. Dinani batani lotsekera pansi ndikulemba "0" pa dispenser. Siyani singano pansi pa khungu. Mutawerenga masekondi 6, pewani singano.
- Popanda kuchotsa singano ku syringe, valani chotsekera chakunja chotsalira (osati chamkati!). Ndiye kuchotsa ndi kutaya.
- Tsekani chitseko cha cartridge kuchokera pazida.
Mwa makina osunthika, madera monga chapamwamba kunja kwa dera la gluteal amawonedwa kukhala oyenera kwambiri.
Chithandizo cha matenda ashuga
Asanayambe chithandizo ndi insulin yochepa, wodwalayo amalimbikitsidwa kuti apite kusukulu ya matenda ashuga kuti aphunzire momwe angawerengere Mlingo wofunikira komanso kudziwa zizindikiro za hypo- ndi hyperglycemia munthawi yake. Mahomoni ocheperako pang'ono amaperekedwa nthawi yomweyo asanadye kapena pambuyo pake.
Mlingo wa insulin pakudya kwam'mawa, chakudya chamasana ndi chakudya chamadzulo chitha kuvomerezedwa ndi dokotala mu manambala okhazikika kapena kuwerengera odwala omwe akumaganizira glycemia asanadye. Mosasamala mtundu womwe angasankhe, wodwalayo ayenera kuphunzira kuyang'anira payekha mayendedwe a glucose.
Mankhwala osokoneza bongo omwe amakhala osakanikirana kwambiri amaphatikizidwa ndi kugwiritsa ntchito mankhwalawa kuti azitha kuyendetsa magazi, omwe amachokera ku 30 mpaka 50% ya kufunika kwathunthu kwa insulin. Mlingo wapakati watsiku lililonse wamankhwala amfupi ndi 0.5-1.0 U / kg kwa anthu amisinkhu yonse.
Maupangiri oyenera kudziwa kuchuluka kwa tsiku ndi tsiku pa kilogalamu imodzi ya kulemera:
- lembani matenda 1 / adapezeka koyamba / popanda zovuta komanso kuwonongeka - mayunitsi 0,5;
- Kutalika kwa nthawi yoposa chaka 1 - 0,6 magawo;
- adawonetsa zovuta za matendawa - mayunitsi 0,7;
- kuwonongeka malinga ndi glycemia ndi glycated hemoglobin - 0,8 magawo;
- ketoacidosis - mayunitsi 0,9;
- gestation - mayunitsi 1.0.
Zotsatira zoyipa za NovoRapida Flexpen
Zosafunikira zomwe mungagwiritse ntchito ndizofanana ndi zomwe zimachitika pakhungu la pancreatic, koma pafupipafupi hypoglycemia usiku ndizochepa.
Kuchokera ku chitetezo chamthupi
Nthawi zina, mawonekedwe a anaphylaxis amapangidwa:
- hypotension, mantha;
- tachycardia;
- kupuma;
- kusanza, kusanza;
- Edema wa Quincke.
Vomiting ndi imodzi mwazotsatira zamankhwala.
Pa gawo la kagayidwe ndi zakudya
Kuchepetsa kwa shuga m'magazi a plasma, omwe nthawi zambiri amayamba mwadzidzidzi ndikuwoneka ndi zizindikiro zotsatirazi:
- khungu lotuwa, lozizira, lonyowa, lachiwongola pakukhudza;
- tachycardia, ochepa hypotension;
- nseru, njala;
- kuchepa ndi kusokonezeka kwa mawonekedwe;
- kusintha kwa neuropsychiatric kuchokera ku kufooka kwapafupipafupi ndi psychomotor mukubwadamuka (mantha, kunjenjemera m'thupi) kumaliza kutsimikiza kwa chikumbumtima komanso kugwidwa.
Pakati mantha dongosolo
Zizindikiro zoyipa zimayambika motsutsana ndi maziko a hypoglycemia ndipo zimawonetsedwa ndi zizindikiro zotsatirazi:
- mutu
- Chizungulire
- kugona
- kusakhazikika pakuyimirira ndi kukhala;
- kusokoneza mlengalenga ndi nthawi;
- kuchepa kapena kupsinjika kwa chikumbumtima.
Ndikukwaniritsidwa mwachangu kwa mbiri yakale ya glycemic, kupweteka kwakumapeto kwa zotumphukira za bongo kunawonedwa.
Kuchokera kumbali yamanjenje apakati, mutu umayamba.
Pa mbali ya gawo la masomphenyawo
Refractory matenda ena sananenapo konse. Kupambana kwakuthwa kwa kayendetsedwe ka glycemic kunayambitsa kuwonongeka mkati mwa matenda ashuga a retinopathy, omwe adakhazikika ndikuchepetsa pang'onopang'ono ndi mankhwala ena.
Pa khungu
Zomwe zimachitika m'deralo ku subcutaneous makonzedwe kapena zizindikiro za tsankho zimatheka: zotupa, redness, kuyabwa, edema yakumaso, urticaria.
Matupi omaliza
Kuwonetsedwa kwa tsankho kumadziwika ndi khungu komanso mawonekedwe anaphylactic.
Zokhudza mphamvu pakuwongolera njira
Pokhudzana ndi kufooka kwa ntchito yaubongo ndi kusokonezeka kowoneka motsutsana ndi maziko a hypoglycemia, kusamala kuyenera kugwiritsidwa ntchito poyang'anira magwiridwe antchito ndikuchita mitundu yowopsa ya ntchito.
Malangizo apadera
Mungafunike kusintha kwa Mlingo:
- mukasintha kuchokera ku mahomoni ena;
- kusintha zakudya
- matenda okhathamira.
Pokhudzana ndi kusokonezeka kwa ubongo ndi kusokonezeka kwa mawonekedwe a hypoglycemia, kusamala kuyenera kugwiritsidwa ntchito poyang'anira njira zosunthira.
Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere
M'maphunziro omwe amachitika ndi kutenga nawo gawo kwa amayi apakati ndi kuyamwitsa, palibe zoyipa pa mwana wosabadwayo ndi mwana yemwe adapezeka. Mlingo wothandizila watsimikiza ndi dokotala. Njira zotsatirazi zidazindikirika:
- Masabata 0 mpaka 13 - kufunika kwa mahomoni kumachepetsedwa;
- Sabata 14 - 40 - kuchuluka kwa kufunikira.
Kuyenderana ndi mowa
Kuphatikiza kumeneku sikulimbikitsidwa, chifukwa zotsatira zake ndi zosatsimikizika: pakhoza kukhala kuti pali kuchepa kwa glucose komanso kuchepa kwakukulu kwa kuchuluka kwake m'magazi am'magazi.
Mankhwala ochulukirapo a NovoRapida Flexpen
Pa jekeseni yankho mu Mlingo woposa zofunikira za thupi, zizindikiro za hypoglycemia zimayamba. Munthu amene ali ndi chikumbumtima amatha kudzipatsa yekha chakudya mwa kugwiritsa ntchito chakudya chamafuta ochepa. Popanda kudziwa, glucagon imayendetsedwa pansi pa khungu kapena minofu muyezo wa 0,5-1.0 mg kapena glucose wamkati.
Kuchita ndi mankhwala ena
Kuonjezera insulin pamlomo mankhwala a hypoglycemic angayambitse kuchepa kwambiri kwa glycemia. Mankhwala ena a antimicrobial and antiparasitic nawonso ali ndi vuto lofananalo: ma tetracyclines, sulfnylamides, ketoconazole, mebendazole.
M'maphunziro omwe amachitika ndi amayi apakati, palibe zoyipa pamwana ndi mwana zomwe zimapezeka.
Pochiza matenda a mtima, amadziwika kuti beta-blockers amatha kubisala chipatala cha hypoglycemia, ndipo calcium blockers blocker ndi clonidine amachepetsa mphamvu ya mankhwalawa.
Mukamapereka mankhwala a psychotropic, kuwunikira mosamala ndikofunikira, chifukwa mankhwalawa monga monoamine oxidase inhibitors, mankhwala okhala ndi lithiamu, bromocriptine angalimbikitse zotsatira za hypoglycemic, komanso ma tridclic antidepressants ndi morphine, m'malo mwake, amatha kuchepetsedwa.
Kugwiritsa ntchito njira zakulera, mahomoni a chithokomiro, timadzi tambiri ta adrenal, kukula kwa mahomoni kumachepetsa chidwi cha zolandilira ku mankhwala kapena kugwira kwake ntchito.
Octreotide ndi lanreotide zimayambitsa onse hypo- ndi hyperglycemia kumbuyo kwa insulin.
Zinthu zathanzi ndi sulfite zimawononga insulin.
Pofuna kusakaniza machitidwe omwewo, yankho la isofan-insulin, solution ya sodium chloride, 5 kapena 10% dextrose solution (yokhala ndi 40 mmol / l potaziyamu wa potaziyamu) ndizololedwa.
Analogi
Yothetsera ndi insulin aspart yomwe ili mu NovoRapid Penfill. Ndalama zomwe zikufanana ndi nthawi komanso nthawi yakusintha kwake zimaphatikizapo:
- Humalogue;
- Apidra.
Kupita kwina mankhwala
Ndi mankhwala.
Kodi ndingagule popanda kulandira mankhwala?
Ayi, chifukwa mtengowo uli ndi zizindikiro zowonetsera cholinga. Sagulitsa mankhwalawa kwa anthu azaka zosakwana 18.
Mankhwala amaperekedwa kuchokera ku mankhwala ndi mankhwala.
Mtengo wa NovoRapid Flexpen
Kuyambira 1,606.88 rub. mpaka 1865 rub. kunyamula.
Zosungidwa zamankhwala
Chida chogwiritsidwa ntchito ndikusinthira chimasungidwa kutentha. Katirijiyo amatetezedwa ku dzuwa mwachindunji ndikuvala chophimba. Pansi pazosungika zoterezi, moyo wa alumali ndi wochepa mwezi umodzi.
Njira zosagwiritsidwa ntchito ndi yankho ziyenera kusungidwa pa kutentha kwa + 2 ... + 8 ° C. Osamawuma.
Tsiku lotha ntchito
Zaka 2,5.
Wopanga
Novo Nordisk (Denmark).
Ndemanga za NovoRapida Flexpen
Madokotala
Irina S., endocrinologist, Moscow
Kugwiritsa ntchito ma insulin kwakanthawi komanso kwakanthawi kumathandizira kuti glycemic control. Mutha kusankha njira yamomwe mungakhalire wodwalayo, pomwe mukupewa kukula kwa matendawo.
Gennady T., wothandizira, St.
Anthu odwala matenda ashuga amatenga mankhwalawo. Kutha kuperekera popanda gawo lakudya kumapangitsa kuti odwala asamavutike kukonza tsiku. Ndiosavuta komanso ndikosavuta kugwiritsa ntchito kukonzekera kutengera mphamvu ya munthu.
Odwala
Elena, wazaka 54, Dubna
Ndakhala ndikugwiritsa ntchito mankhwalawa kwa zaka ziwiri. Ubwino wambiri: jakisoni wokha, alibe ululu. Kuphatikizikako kumavomerezedwa bwino.
Pavel, wazaka 35, Novosibirsk
Mankhwalawa adasamutsidwa zoposa miyezi 6 yapitayo, adazindikira mwachangu kanthu. Mankhwalawa ndi othandizika: hemoglobin ya glycated imakhala yotsika kwambiri.
