Mankhwala a insulin NovoMix 30 FlexPen ndi kuyimitsidwa kwamitundu iwiri, komwe kumakhala ndi mankhwalawa:
- insulin aspart (analogue of Natural human insulin exposition yochepa);
- insulin aspart protamine (chosiyanitsa ndi insulin ya anthu apakatikati).
Kutsika kwakukulu kwa shuga m'magazi mothandizidwa ndi insulin aspart kumachitika chifukwa chomangirira ma insulin receptors apadera. Izi zimathandizira kuthana ndi shuga ndi masipisi komanso minyewa yam'mimba pomwe likulepheretsa kupanga kwa chiwindi ndi chiwindi.
Novomix imakhala ndi peresenti 30 ya sungunuka wa insulin, yomwe imapangitsa kupereka mofulumira kwambiri (poyerekeza ndi insulin ya munthu wosungunuka) kuyambitsa kuwonekera. Kuphatikiza apo, kuyambitsidwa kwa mankhwalawa ndikotheka musanadye chakudya (pazenera 10 mphindi musanadye).
Gawo la makristasi (70 peresenti) limakhala ndi protamine insulin aspart yokhala ndi zochitika zofanana ndi insulin yosalowerera m'thupi la anthu.
NovoMix 30 FlexPen imayamba kugwira ntchito pambuyo pa mphindi 10 mpaka 20 kuyambira pomwe imayambitsidwa pansi pa khungu. Kuchuluka kwakukulu kumatheka mwa maola 1-4 mutabadwa. Kutalika kwa chochitikacho ndi maola 24.
Kuchuluka kwa glycosylated hemoglobin mu mtundu 1 ndi mtundu wa 2 odwala matenda ashuga omwe amalandila mankhwala kwa miyezi itatu zinali zofanana ndi zotsatira za insulin ya anthu.
Zotsatira zake zoyambitsa mitundu yofananira ya molar, insulin imagart kwathunthu imafanana ndi kuchuluka kwa zochita za munthu.
Kafukufuku wazachipatala adachitidwa mu odwala omwe ali ndi mtundu uliwonse wa matenda ashuga. Odwala onse adagawika m'magulu atatu:
- adangolandira NovoMix 30 Flexpen;
- adalandira NovoMix 30 Flexpen kuphatikiza ndi metformin;
- analandila metformin ndi sulfonylurea.
Pambuyo pa masabata 16 kuyambira poyambira chithandizo, ma glycosylated hemoglobin indices m'gulu lachiwiri ndi lachitatu anali pafupifupi ofanana. Pa kuyesa kumeneku, 57 peresenti ya odwala adalandira hemoglobin pamlingo woposa 9 peresenti.
Mu gulu lachiwiri, kuphatikiza kwa mankhwalawa kunapangitsa kuchepa kwakukulu kwa hemoglobin poyerekeza ndi gulu lachitatu.
Kuchuluka kwa ma insulin ambiri mu seramu yamagazi mutatha kugwiritsa ntchito NovoMix 30 FlexPen kudzakhala pafupifupi 50 peresenti, ndipo nthawi yakufikirako imakhala yofulumira kwambiri 2 poyerekeza ndi insulin 30 ya anthu.
Ogwira nawo ntchito poyeserera atatha kugwiritsa ntchito mankhwalawa pang'onopang'ono kwa mayunitsi 0,2 pa kilogalamu yolemera adalandira kuchuluka kwa insulini m'magazi pambuyo pa ola limodzi.
Hafu ya moyo wa NovoMix 30 FlexPen (kapena mawonekedwe ake analog), yomwe imawonetsa kuyamwa kwa kachigawo kakang'ono ka protamine, anali maola 8-9.
Kukhalapo kwa insulin m'magazi kumabwereranso poyambira pambuyo pa maola 15-18. Mtundu wachiwiri wa anthu odwala matenda ashuga, kuchuluka komwe kunafika patadutsa mphindi 95 atatha kugwiritsa ntchito mankhwala osokoneza bongo ndipo anali wolemba pamwamba pa maola pafupifupi 14.
Zizindikiro ndi contraindication kugwiritsa ntchito mankhwalawa
NovoMix 30 Flexpen imawonetsedwa kwa matenda ashuga. Pharmacokinetics sichinaphunzire m'magulu a odwala:
- okalamba;
- ana
- odwala matenda a chiwindi ndi impso.
Mwapadera, mankhwalawa sayenera kugwiritsidwa ntchito kwa hypoglycemia, kuzindikira kwambiri kwa chinthu cha aspart kapena gawo lina la mankhwala.
Malangizo apadera ndi kuchenjeza kuti mugwiritse ntchito
Ngati mulingo woyenera wagwiritsidwa ntchito kapena mankhwalawo atha mwadzidzidzi (makamaka ndi matenda a shuga 1), zitha kuchitika:
- hyperglycemia;
- matenda ashuga ketoacidosis.
Zonsezi ziwiri zimakhala zowopsa ku thanzi ndipo zimatha kupha.
NovoMix 30 FlexPen kapena cholowa m'malo mwake ziyenera kuperekedwa mwachangu musanadye. Ndikofunikira kuganizira kumayambiriro kwa mankhwalawa pochiza odwala omwe ali ndi matendawa kapena kumwa mankhwala omwe angachedwetse kuyamwa kwa chakudya cham'mimba thirakiti.
Matenda onga (makamaka opatsirana komanso amsenda) amalimbikitsa kufunikira kwa insulin yowonjezera.
Potengera kusamutsa wodwala kupita ku mitundu yatsopano ya insulin, zomwe zimayambira kukhazikitsidwa kwa chikumbumtima zimatha kusintha ndikusiyana ndi zomwe zimachitika chifukwa chogwiritsa ntchito insulin yodziwika bwino. Poganizira izi, ndikofunikira kwambiri kusamutsa wodwala kupita ku mankhwala ena moyang'aniridwa ndi dokotala.
Kusintha kulikonse kumaphatikizapo kusintha kwa mlingo womwe umafunikira. Tikulankhula za izi:
- kusintha kwa ndende ya chinthu;
- kusintha kwa mitundu kapena wopanga;
- kusintha komwe kumayambira insulin (munthu, nyama kapena analogue ya munthu);
- njira yoyendetsera kapena kupanga.
Mukusintha kuti mupeze jakisoni wa NovoMix 30 FlexPen insulin kapena jakisoni wa analog, odwala matenda ashuga amafunika kuthandizidwa ndi dokotala posankha mlingo woyambira wa mankhwala atsopano. Ndizofunikanso mkati mwa masabata oyamba ndi miyezi mutasintha.
Poyerekeza ndi insulin wamba biphasic human insulin, jakisoni wa NovoMix 30 FlexPen angayambitse kwambiri zotsatira za hypoglycemic. Itha kukhala mpaka maola 6, zomwe zimaphatikizapo kuwunika mlingo wa insulin kapena zakudya.
Kuyimitsidwa kwa insulini sikungagwiritsidwe ntchito pamapampu a insulin kuti muperekenso mankhwalawa pansi pakhungu.
Mimba
Pa nthawi yoyembekezera komanso mkaka wa m`mawere, zovuta zamankhwala ndi mankhwala ndizochepa. Moyeserera asayansi pa nyama, zidapezeka kuti katswiriyu monga insulin yaumunthu sangathe kukhala ndi vuto lililonse mthupi (teratogenic kapena embryotoxic).
Madokotala amalimbikitsa kuwunika kuwunika kwa mankhwalawa amayi apakati omwe ali ndi matenda ashuga panthawi yonse yobereka komanso ngati pakukayikira kuti ali ndi pakati.
Kufunika kwa insulin ya mahomoni, monga lamulo, kumachepera mu trimester yoyamba ndikuwonjezeka mokwanira mu trimesters yachiwiri ndi yachitatu. Mukangobereka, thupi limafunikira insulin mwachangu.
Chithandizo sichitha kuvulaza mayi ndi mwana wake chifukwa cha kulephera kulowa mkaka. Ngakhale izi, zingakhale zofunikira kusintha mlingo wa NovoMix 30 FlexPen.
Kutha kuyendetsa zinthu
Ngati, pazifukwa zosiyanasiyana, hypoglycemia imayamba kumwa mankhwala, wodwala sangathe kuyang'ana mokwanira komanso kuyankha moyenera pazomwe zimamuchitikira. Chifukwa chake, kuyendetsa galimoto kapena makina kuyenera kukhala ochepa. Wodwala aliyense ayenera kudziwa njira zoyenera zopewera kuthana ndi shuga m'magazi, makamaka ngati muyenera kuyendetsa.
M'malo omwe FlexPen kapena penipill yake ya analog idagwiritsidwa ntchito, ndikofunikira kuyeza chitetezo ndi kufunikira koyendetsa, makamaka ngati zizindikiro za hypoglycemia zimafooka kwambiri kapena palibe.
Kodi mankhwalawo amagwirizana bwanji ndi mankhwala ena?
Pali mitundu ingapo ya mankhwala omwe angakhudze kagayidwe kachakudya ka shuga m'thupi, kamayenera kuganiziridwanso mukamawerengera mlingo womwe umafunikira.
Njira zomwe zimachepetsa kufunika kwa insulin ya mahomoni ndi:
- m`kamwa hypoglycemic;
- Mao zoletsa;
- octreotide;
- ACE zoletsa;
- salicylates;
- anabolics;
- sulfonamides;
- zokhala ndi mowa;
- blockers osasankha.
Palinso zida zomwe zimawonjezera kufunikira kwa kugwiritsidwa ntchito kwa NovoMix 30 FlexPen insulin kapena zosintha zina za penfill:
- kulera kwamlomo;
- danazole;
- mowa
- thiazides;
- GSK;
- mahomoni a chithokomiro.
Momwe mungagwiritsire ntchito ndi kumwa?
Mlingo wa NovoMix 30 Flexpen ndi munthu payekha ndipo amasankha dokotala, kutengera zosowa za wodwalayo. Chifukwa cha kufulumira kwa mankhwalawa, ayenera kuperekedwa asanadye. Ngati ndi kotheka, insulin, komanso penfill, iyenera kuperekedwa pambuyo chakudya.
Ngati tizingolankhula za maulalo apakati, ndiye kuti NovoMix 30 FlexPen iyenera kuyikidwa kutengera kulemera kwa wodwalayo ndipo kuchokera pa 0.5 mpaka 1 UNIT pa kilogalamu iliyonse patsiku. Kufunika kwake kungawonjezeke mwa omwe ali ndi matenda ashuga omwe ali ndi insulin kukana, ndikuchepa kwa zobisika zotsalira za mahomoni awo.
Flexpen nthawi zambiri imayendetsedwa mwachangu mu ntchafu. Jekeseni ndizothekanso mu:
- dera lam'mimba (khoma lakunja lam'mimba);
- matako;
- minyewa yotsekemera ya phewa.
Lipodystrophy imatha kupewedwa pokhapokha malo omwe akuwonetsedwa atabayira.
Kutsatira chitsanzo cha mankhwala ena, kutalikirana kwa mankhwalawa kumasiyanasiyana. Izi zimatengera:
- Mlingo
- masamba a jekeseni;
- kuthamanga kwa magazi;
- mulingo wakuchita zolimbitsa thupi;
- kutentha kwa thupi.
Kudalira kwazomwe zimayamwa pa jakisoni sindinakufufuze.
Kwa odwala omwe ali ndi matenda a shuga a mtundu wa 2, NovoMix 30 FlexPen (ndi penfill analogue) akhoza kuyesedwa ngati chithandizo chachikulu, komanso kuphatikiza ndi metformin. Zotsirizazi ndizofunikira nthawi zina ngati sizotheka kuchepetsa kuchuluka kwa shuga mwa njira zina.
Mlingo woyenera wovomerezeka wa mankhwalawa ndi metformin adzakhala magawo 0,2 pa kilogalamu ya kulemera kwa odwala patsiku. Kuchuluka kwa mankhwalawa kuyenera kusinthidwa malinga ndi zosowa munthawi iliyonse.
Ndikofunikanso kulabadira kuchuluka kwa shuga mu seramu yamagazi. Ntchito iliyonse yovuta yaimpso kapena kwa chiwindi imatha kuchepetsa kufunika kwa mahomoni.
NovoMix 30 Flexpen silingagwiritsidwe ntchito pochiza ana.
Mankhwala omwe akufunsawa angagwiritsidwe ntchito pothandilitsa pang'onopang'ono. Sitha kupangika m'matumbo kapena m'mitsempha.
Kuwonetsedwa kwa zoyipa
Zotsatira zoyipa zogwiritsira ntchito mankhwalawa zitha kudziwika pokhapokha ngati munthu akusintha kuchokera ku insulin ina kapena kusintha mlingo. NovoMix 30 FlexPen (kapena mawonekedwe ake analog) ikhoza kukhudza thanzi la thanzi.
Monga lamulo, hypoglycemia imakhala chiwonetsero chambiri cha zotsatira zoyipa. Imatha kuchitika pamene muyezo upambana kwambiri pazofunikira zenizeni za mahomoni, ndiye kuti, insulin yambiri.
Kusowa kwambiri kungachititse kuti musakhale ndi chikumbumtima kapenanso kukokana, kenako ndikuwonongeka kwakanthawi kapena kwakanthawi kwa ubongo kapena ngakhale kufa.
Malinga ndi zotsatira za kafukufuku wazachipatala komanso kuchuluka kwa zomwe zidalembedwa pa NovoMix 30 pamsika, titha kunena kuti zochitika za hypoglycemia zazikulu m'magulu osiyanasiyana a odwala zimasiyana kwambiri.
Malinga ndi pafupipafupi zomwe zimachitika, zovuta zomwe zimachitika zimatha kugawidwa m'magulu:
- kuchokera ku chitetezo chathupi: anaphylactic reaction (kawirikawiri), urticaria, totupa pakhungu (nthawi zina);
- zotupa zazikuluzikulu: kuyabwa, kumva kwambiri, thukuta, kusokoneza pamimba, kunachepetsa kuthamanga kwa magazi, kugunda kwa mtima, angioedema (nthawi zina);
- ku mitsempha: zotumphukira neuropathies. Kusintha koyambirira kwamphamvu pakuwongolera shuga kungayambitse matenda owopsa a neuropathy, osakhalitsa (kawirikawiri);
- Mavuto am'maso: kukhumudwitsa (nthawi zina). Amakhala osakhalitsa m'chilengedwe ndipo amapezeka kumayambiriro kwenikweni kwa mankhwala a insulin;
- diabetesic retinopathy (nthawi zina). Ndiulamuliro wabwino kwambiri wa glycemic, mwayi wopitilira muyeso uwu udzachepetsedwa. Ngati machitidwe othandizira kwambiri agwiritsidwa ntchito, ndiye kuti izi zingayambitse kukokosera kwa retinopathy;
- kuchokera pamatumbo amkati ndi khungu, lipid dystrophy imatha kuchitika (nthawi zina). Amayamba m'malo omwe majekesedwe amapangidwa nthawi zambiri. Madokotala amalimbikitsa kusintha malo a jakisoni a NovoMix 30 FlexPen (kapena mawonekedwe ake a analog) m'dera lomwelo. Kuphatikiza apo, kumverera kwambiri kumatha kuyamba. Ndi kuyambitsa kwa mankhwala, n`zotheka kukulitsa hypersensitivity m'deralo: redness, kuyabwa pakhungu, kutupa m'malo jakisoni. Izi zimachitika pang'onopang'ono mwachilengedwe ndipo zimazimiririka ndi mankhwala;
- zovuta zina komanso zimachitika (nthawi zina). Kukula kumayambiriro kwa insulin. Zizindikiro zake ndizakanthawi.
Milandu yambiri
Mothandizidwa kwambiri ndi mankhwalawa, munthu akhoza kukhala ndi vuto la hypoglycemic.
Ngati magazi a shuga atsika pang'ono, ndiye kuti hypoglycemia imatha kuyimitsidwa pakudya zakudya zotsekemera kapena shuga. Ichi ndichifukwa chake aliyense wodwala matenda ashuga ayenera kukhala ndi maswiti ochepa, mwachitsanzo, maswiti osapatsa shuga kapena zakumwa.
Ndi kusowa kwambiri kwa shuga wamagazi, pomwe wodwalayo wagundika, ndikofunikira kuti mumupatse kuchuluka kwa glucagon kapena masekondi osawerengeka a 0,5 mpaka 1 mg. Malangizo pazinthu izi ayenera kudziwika kwa iwo omwe ali ndi matenda ashuga.
Munthu wodwala matenda ashuga akangotuluka kukomoka, amafunika kudya pang'ono mafuta mkati. Izi zimapereka mwayi wopewa kuyambiranso.
Kodi NovoMix 30 Flexpen iyenera kusungidwa bwanji?
Alumali wamba moyo wa mankhwalawa ndi zaka 2 kuyambira tsiku lomwe adapanga. Bukuli likuti cholembera chomwe chingagwiritsidwe ntchito ndi NovoMix 30 FlexPen (kapena penfill yake) sichisungidwa mufiriji. Iyenera kutengedwa nanu pamalo osungirako ndi kusungidwa kwa milungu yopitilira 4 pamtunda osapitirira 30 digiri.
Cholembera chosindikizidwa chimasungidwa pamadigiri 2 mpaka 8. Mwatsatanetsatane simungathe kumasula mankhwalawo!
