Mankhwala a NovoRapid ndi chida chatsopano cha mbadwo womwe ungabwezeretse kuchepa kwa insulin ya anthu. Ili ndi zopindulitsa zingapo m'njira zinanso zofananira, imagwiritsidwa ntchito mosavuta komanso imapangika msanga, imasintha shuga m'magazi, itha kugwiritsidwa ntchito mosasamala kanthu za kudya, popeza ndi insulin.
NovoRapid imapangidwa m'mitundu iwiri: zolembera zopangidwa ndi Flexpen zopangidwa kale, zotsekedwa ndi ma Penfill cartridge. Kapangidwe ka mankhwalawa ndi chimodzimodzi pazochitika zonse ziwiri - madzi omveka bwino a jekeseni, ml imodzi imakhala ndi 100 IU yogwira ntchito. Katoni, monga cholembera, imakhala ndi 3 ml ya insulin.
Mtengo wa 5 NovoRapid penfill insulin cartridgeges pa average adzakhala pafupifupi ma ruble 1800, FlexPen imawononga pafupifupi 2000 rubles. Phukusi limodzi lili ndi zolembera 5 za syringe.
Zolemba za mankhwala
Chofunikira chachikulu cha mankhwalawa ndi insulin aspart, imakhala ndi mphamvu ya hypoglycemic, ndi analogue yaifupi ya insulin, yomwe imapangidwa m'thupi la munthu. Katunduyu amapezeka pogwiritsa ntchito ukadaulo wa DNA.
Mankhwalawa amakumana ndi ma cell am'mimba a cytoplasmic amino acid, amapanga zovuta za insulin, amayamba zomwe zimachitika mkati mwa maselo. Pambuyo kuchepa kwa shuga m'magazi kumadziwika:
- kuchuluka kwanyumba;
- kuchuluka kugaya kwamisempha;
- kutsegula kwa lipogenesis, glycogeneis.
Kuphatikiza apo, ndizotheka kukwaniritsa kuchepa kwa kuchuluka kwa kupanga kwa shuga ndi chiwindi.
NovoRapid imalumikizidwa bwino ndi mafuta osakanikira kuposa insulin yamunthu, koma kutalika kwa zotsatirazi kumakhala kotsika kwambiri. Kuchita kwa mankhwalawa kumachitika pakadutsa mphindi 10-20 pambuyo pa jekeseni, ndipo nthawi yake ndi maola 3-5, kuchuluka kwakukulu kwa insulin kumadziwika pambuyo pa maola 1-3.
Kafukufuku wamankhwala a odwala omwe ali ndi matenda amtundu woyamba wa 1 awonetsa kuti kugwiritsa ntchito mwanjira ya NovoRapid kumachepetsa mwayi wa nocturnal hypoglycemia nthawi zingapo. Kuphatikiza apo, pali umboni wa kuchepa kwakukulu kwa postprandial hypoglycemia.
Mankhwala a NovoRapid amalimbikitsidwa kwa odwala omwe ali ndi matenda osokoneza bongo a mellitus woyamba (wodalira insulin) komanso wachiwiri (osagwirizana ndi insulin). Contraindication kuti agwiritse ntchito adzakhala:
- kumva kwambiri kwa thupi pazigawo za mankhwala;
- ana osakwana zaka 6.
Mankhwala amaloledwa kugwiritsidwa ntchito pochiza matenda wamba.
Malangizo ogwiritsira ntchito mankhwalawa
Kuti mupeze zotsatira zoyenera, timadzi timeneti tiyenera kuphatikiza ndi ma insulin a nthawi yayitali komanso apakati. Kuwongolera kuchuluka kwa glycemia, muyezo wamagazi amasonyezedwa, kusintha kwa mankhwala ngati kuli kofunikira.
Nthawi zambiri, tsiku ndi tsiku mlingo wa insulini wa odwala matenda ashuga amasiyanasiyana pakati 0,5-1 magawo pa kilogalamu ya kulemera. Jakisoni imodzi ya mahomoni imapatsa wodwala zosowa za tsiku ndi tsiku za 50-70%, zotsalazo ndi insulin.
Pali umboni wowunikiranso kuchuluka kwa ndalama zomwe zaperekedwa:
- kuchuluka zolimbitsa thupi odwala matenda ashuga;
- kusintha kwa zakudya;
- kupitilira kwa matenda oyanjana.
Insulin NovoRapid Flekspen, mosiyana ndi mahomoni amtundu wa anthu, amachitapo kanthu mwachangu, koma posakhalitsa. Amawonetsedwa kuti mugwiritse ntchito mankhwalawa musanadye, koma amaloledwa kuchita izi mukatha kudya, ngati pakufunika.
Chifukwa chakuti mankhwalawa amagwira ntchito kwakanthawi kochepa, mwayi wokhala ndi hypoglycemia usiku umachepetsedwa kwambiri. Ngati mankhwalawa amagwiritsidwa ntchito pochiza matenda ashuga okalamba, ndi vuto la chiwindi kapena matenda a impso, ndikofunikira kuwongolera kuchuluka kwa shuga m'magazi, sankhani kuchuluka kwa insulin payekha.
Ndikofunikira kupaka insulin m'dera lakunja lam'mimba, matako, brachial, minofu yothina. Popewa lipodystrophy, ndikofunikira kusintha dera lomwe mankhwalawo amathandizira. Koma muyenera kudziwa kuti kumayambiriro kwam'mimba kumapangitsa kuti mankhwalawo amwayike mwachangu kwambiri, poyerekeza ndi jakisoni mbali zina za thupi.
Kutalika kwa mphamvu ya insulin kumakhudzidwa mwachindunji ndi:
- Mlingo
- tsamba la jakisoni;
- odwala ntchito;
- kuchuluka kwa magazi;
- kutentha kwa thupi.
Ma infusions okhala ndi vuto lalitali omwe amalimbikitsidwa kwa odwala matenda ashuga, omwe amatha kuchitidwa pogwiritsa ntchito pampu yapadera. Kukhazikitsidwa kwa mahomoni kumawonetsedwa kukhoma kwamkati, koma, monga momwe zinalili kale, malo ayenera kusintha.
Pogwiritsa ntchito pampu ya insulin, musasakanikize mankhwalawo ndi ma insulini ena. Odwala omwe amalandila ndalama pogwiritsa ntchito dongosololi ayenera kukhala ndi muyeso wosiyanasiyana wa mankhwalawo ngati chida chawonongeka. NovoRapid ndi yoyenera kugwiritsidwa ntchito kwa mtsempha, koma kuwombera koteroko kuyenera kuperekedwa kokha ndi dokotala.
Pa chithandizo, muyenera kupereka magazi pafupipafupi kuti muyeze magazi.
Momwe mungawerengere kuchuluka kwake
Kuti muwerengere molondola kuchuluka kwa mankhwalawa, ndikofunikira kudziwa kuti insulin ya mahomoni ndi ultrashort, yochepa, yapakati, yowonjezereka ndikuphatikizidwa. Kubwezeretsanso shuga m'magazi, mankhwala osakanikirana amathandizira, amatumizidwa pamimba yopanda kanthu ndi matenda a shuga a mtundu woyamba kapena wachiwiri.
Ngati wodwala m'modzi akuwonetsedwa insulin yayitali, ndiye, ngati kuli kotheka, kupewa kusintha kwadzidzidzi mu spikes ya shuga, NovoRapid akuwonetsedwa pokhapokha. Zochizira hyperglycemia, ma insulin afupiafupi ndi aatali amatha kugwiritsidwa ntchito nthawi imodzi, koma nthawi zosiyanasiyana. Nthawi zina, kuti mukwaniritse zomwe mukufuna, kuphatikiza insulin kokha ndikoyenera.
Posankha chithandizo, dokotala amaganizira zina, mwachitsanzo, chifukwa cha insulin yayitali yokha, ndizotheka kusunga shuga ndikuperekera jakisoni wamankhwala osakhalitsa.
Kusankha kwa nthawi yayitali kumafunikira motere:
- shuga wamagazi amayeza pamaso chakudya cham'mawa;
- Maola atatu mutatha kudya masana, tengani muyeso wina.
Kufufuzanso kwina kuyenera kuchitika ola lililonse. Patsiku loyamba kusankha mlingo, muyenera kulumpha chakudya chamasana, koma idyani chakudya chamadzulo. Pa tsiku lachiwiri, miyezo ya shuga imachitika ola lililonse, kuphatikiza usiku. Pa tsiku lachitatu, miyezo imachitika mwanjira yotere, chakudya sichikhala ndi malire, koma samaba jakisoni wochepa. Zotsatira zabwino zam'mawa: tsiku loyamba - 5 mmol / l; tsiku lachiwiri - 8 mmol / l; tsiku lachitatu - 12 mmol / l.
Tiyenera kukumbukira kuti NovoRapid amachepetsa kuchuluka kwa shuga m'magazi kamodzi ndi theka kuposa mphamvu zake. Chifukwa chake, muyenera kupaka jekeseni ya 0,4 ya insulin yochepa. Molondola, mulingo wokhawo womwe ungayambitsidwe poyeserera, poganizira zovuta za matenda ashuga. Kupanda kutero, bongo umayamba, womwe umayambitsa zovuta zingapo.
Malamulo akulu othandiza kudziwa kuchuluka kwa insulin kwa odwala matenda ashuga:
- matenda oyamba a shuga a mtundu woyamba - 0,5 PISCES / kg;
- ngati matenda ashuga amawonetsedwa koposa chaka - 0,6 U / kg;
- shuga wovuta - 0,7 U / kg;
- shuga wowola - 0,8 U / kg;
- matenda a shuga kumbuyo kwa ketoacidosis - 0,9 PIECES / kg.
Amayi oyembekezera mu trimester yachitatu amawonetsedwa kuperekera insulin 1 U / kg. Kuti mudziwe mtundu umodzi wa chinthu, ndikofunikira kuchulukitsa kulemera kwa thupi tsiku lililonse, kenako ndikugawa awiri. Zotsatira zake ndizofanana.
NovoRapid Flexpen
Kukhazikitsa kwa mankhwalawa kumachitika pogwiritsa ntchito cholembera, imakhala ndi dispenser, color coding. Kuchuluka kwa insulini kungakhale kuyambira 1 mpaka 60 mayunitsi, gawo mu syringe ndi 1 unit. Wothandizira NovoRapid amagwiritsa ntchito singano ya 8 mm Novofayn, Novotvist.
Kugwiritsa ntchito cholembera kuti mulenge mahomoniwo, muyenera kuchotsa chitsa chakecho, ndikupukuta mpaka cholembera. Nthawi iliyonse ikagwiritsa ntchito singano yatsopano jakisoni, izi zimathandiza kupewa kukula kwa mabakiteriya. Singano ndi yoletsedwa kuti iwononge, kugwada, kusamutsa kwa odwala ena.
Cholembera cha syringe chimatha kukhala ndi mpweya wochepa mkati, kuti mpweya usaunjike, mlingowo walowetsedwa molondola, umawonetsedwa kuti umatsatira malamulo awa:
- kuyimba 2 mayunitsi potembenuzira mlingo wosankha;
- ikani cholembera ndi singano kumtunda, ikani bokosi pang'ono ndi chala chanu;
- kanikizani batani loyambira njira yonse (wosankhayo abwerere ku 0).
Ngati dontho la insulin silikuwoneka pa singano, njirayi imabwerezedwa (osatinso nthawi 6). Ngati yankho silikuyenda, zikutanthauza kuti cholembera sichingagwiritsidwe ntchito.
Asanakhazikitse Mlingo, wosankhayo ayenera kukhala pamalopo 0. Pambuyo pake, kuchuluka kwa mankhwalawo kumayimbidwa, ndikusintha wosankhidwa mbali zonse ziwiri.
Sizoletsedwa kukhazikitsa zomwe zili pamwamba pa zomwe zimayikidwa, gwiritsani ntchito muyeso kuti mupeze kuchuluka kwa mankhwalawo. Ndi kuyambitsa kwa mahomoni pansi pa khungu, njira yolimbikitsidwa ndi adokotala ndiyovomerezeka. Kuti mupeze jakisoni, kanikizani batani loyambira, musatulutse mpaka wosankhayo atafika 0.
Kuzungulira kwa chizindikiritso cha mlingo sikungayambitse kupita kwa mankhwalawa; pambuyo pa jakisoni, singano iyenera kugwiridwa pansi pakhungu kwa masekondi ena 6, ndikutsata batani loyambira. Izi zikuthandizani kuti mulowe ku NovoRapid kwathunthu, monga adanenera.
Singano imayenera kuchotsedwa pambuyo pobayira jakisoni aliyense, sayenera kusungidwa ndi syringe, apo ayi mankhwalawa angatayike.
Zosafunika
NovoRapid insulin nthawi zina imatha kupangitsa zovuta zingapo za thupi, ikhoza kukhala hypoglycemia, zizindikiro zake:
- kutsekeka kwa khungu;
- thukuta kwambiri;
- kugwedezeka kwamiyendo;
- nkhawa zopanda pake;
- kufooka kwa minofu;
- tachycardia;
- kulumikizana.
Kuwonetsera kwina kwa hypoglycemia kumakhala kuyendetsa bwino, kutsika kwakukhazikika, mavuto ammaso, ndi njala. Kusintha kwa shuga m'magazi kungayambitse kukomoka, kuiwalika, kuwonongeka kwakatundu mu ubongo, imfa.
Thupi lawo siligwirizana, makamaka urticaria, komanso kusokoneza kwam'mimba, angioedema, kupuma movutikira, komanso tachycardia, ndizosowa. Zomwe zimachitika m'deralo zizitchedwa kusapeza bwino mu jekeseni:
- kutupa
- redness
- kuyabwa
Zizindikiro za lipodystrophy, kuphwanya kukhudzika sikugwiritsidwa ntchito. Madokotala amati mawonekedwe ngati amenewa amakhala osakhalitsa, amawonekera kwa odwala omwe amadalira mlingo, omwe amayamba chifukwa cha insulin.
Analogs, ndemanga za odwala
Ngati zidachitika kuti NovoRapid Penfill insulini sanagwirizane ndi wodwalayo pazifukwa zina, dokotalayo amalimbikitsa kugwiritsa ntchito ma analogues. Mankhwala odziwika bwino ndi Apidra, Gensulin N, Humalog, Novomiks, Ryzodeg. Mtengo wawo uli wofanana.
Odwala ambiri adatha kuyesa mankhwala a NovoRapid, amadziwa kuti zotsatira zimabwera mwachangu, zimayambitsa ndizovuta. Mankhwalawa ndi abwino kwambiri pochiza matenda a shuga a mtundu woyamba ndi wachiwiri. Ochuluka a odwala matenda ashuga amakhulupirira kuti chida ndichosavuta, makamaka ma syringe, amachotsa kufunika kogulira syringes.
Pochita, insulin imagwiritsidwa ntchito motsutsana ndi maziko a insulin yayitali, imathandizira kuti shuga wamagazi azikhala pamlingo woyenera kwambiri masana, amachepetsa shuga pambuyo chakudya. NovoRapid amawonetsedwa kwa odwala ena makamaka kumayambiriro kwa matendawa.
Kuperewera kwa ndalama kumatha kutchedwa kutsika kwakuthwa kwa glucose mwa ana, chifukwa chake, odwala amatha kumva bwino. Pofuna kupewa zovuta zoterezi, ndikofunikira kusinthana ndi insulin nthawi yayitali.
Komanso, odwala matenda ashuga amadziwa kuti ngati mankhwalawa asankhidwa molakwika, zizindikiro za hypoglycemia zimayamba, ndipo mkhalidwe waumoyo umakulirakulira. Kanemayo munkhaniyi apitiliza mutu wa Novorapid insulin.
