Malinga ndi malingaliro a Unduna wa Zaumoyo, mankhwala a insulin omwe amachokera mu mtundu wa 2 odwala matenda ashuga amayamba ndi insulin yayitali kapena ndi biphasic. Novomix (Novomix) - gulu lodziwika bwino kwambiri la magawo awiri lomwe limapangidwa ndi m'modzi wa atsogoleri amsika mu mankhwala osokoneza bongo, kampani ya NovoNordisk yaku Denmark. Kukhazikitsidwa kwakanthawi kwa NovoMix mu regimen yamankhwala kumathandizira kuyendetsa bwino shuga, kumathandiza kupewa zovuta zake zambiri. Mankhwalawa amapezeka m'makalata ndi ma syringe pensulo.
Chithandizo chimayamba ndi jakisoni 1 patsiku, pomwe mapiritsi a hypoglycemic sanathe.
Malangizo ogwiritsira ntchito
NovoMix 30 yankho la subcutaneous makonzedwe, omwe ali ndi:
- 30% yokhazikika ya insulin. Ndi analogue ya ultrashort ya insulin ndipo amachita pambuyo pa mphindi 15 kuyambira nthawi ya makonzedwe.
- 70% yavitamini yoyeserera. Ichi ndi mahomoni ochita masewera olimbitsa thupi, nthawi yayitali yogwira ntchito imatheka ndikuphatikiza aspart ndi protamine sulfate. Zikomo kwa iye, machitidwe a NovoMix amakhala mpaka maola 24.
Mankhwala omwe amaphatikiza insulin ndi nthawi yayitali yochita zinthu amatchedwa biphasic. Amapangidwa kuti azilipira mtundu wa matenda ashuga amtundu wa 2, popeza ndiwothandiza kwambiri kwa odwalawo omwe amapanga mahomoni awoawo. Ndi nthenda yoyamba ya mtundu woyamba, Novomix amalembedwa kawirikawiri ngati wodwala matenda ashuga sangathe kuwerengera payokha kapena kuperekera insulin yayifupi komanso yayitali. Nthawi zambiri awa ndi odwala okalamba kwambiri kapena odwala kwambiri.
| Kufotokozera | Monga mankhwala onse okhala ndi protamine, NovoMix 30 siyankho lomveka bwino, koma kuyimitsidwa. Kupuma, imapumira m'botolo kukhala gawo lowoneka bwino ndi loyera, masamba akuwoneka. Pambuyo posakaniza, zomwe zili mu vial zimakhala zoyera bwino. Ndende ya insulin yokhazikika mu yankho ndi magawo 100. |
| Kutulutsa mawonekedwe ndi mtengo | NovoMix Penfill ndi makilogalamu atatu magalasi atatu. Njira yothetsera izi imatha kuperekedwa pogwiritsa ntchito syringe kapena cholembera cha wopanga chomwecho: NovoPen4, NovoPen Echo. Amasiyana masitepe a dosage, NovoPen Echo amakupatsani mwayi kuti mutha kuyimba kuchuluka kochulukitsa kwa mayunitsi 0,5, NovoPen4 - ochulukitsa 1 unit. Mtengo wama cartridge 5 NovoMix Penfill - pafupifupi 1700 rubles. NovoMix Flexpen ndi cholembera chokhachokha chopangidwa ndi gawo limodzi, simungathe kusintha ma cartridge. Iliyonse ili ndi 3 ml ya insulin. Mtengo wa phukusi la zolembera 5 ndi ma ruble 2000. Njira yothetsera makatoni ndi zolembera ndizofanana, chifukwa chake chidziwitso chonse cha NovoMix FlexPen chimagwira ntchito pa Penfill. Ma sindano a Original NovoFine ndi NovoTvist ndi abwino kwa zolembera zonse za NovoNordisk syringe. |
| Machitidwe | Insulin aspart imalowetsedwa kuchokera kumakankhira tam'magazi mpaka m'magazi, pomwe imagwira ntchito zofanana ndi insulin ya amkati: imalimbikitsa kusinthana kwa glucose mu minofu, makamaka minofu ndi mafuta, ndipo imalepheretsa kuphatikizika kwa shuga ndi chiwindi. NovoMix sagwiritsa ntchito insulin ya biphasic pakuwongolera mwachangu hypoglycemia, popeza pali chiopsezo chachikulu chokhazikitsa zotsatira za mlingo umodzi pamtundu wina, womwe ungayambitse kukomoka kwa hypoglycemic. Kuchepetsa msanga shuga wambiri, ma insulini okhazikika okha ndi oyenera. |
| Zizindikiro | Matenda a shuga ndi mitundu iwiri yodziwika bwino - 1 ndi 2. Chithandizo chitha kuperekedwa kwa ana kuyambira zaka 6. Mu ana, odwala a pakati ndi okalamba, nthawi yochitapo kanthu ndi kutuluka kuchokera m'thupi yayandikira. |
| Kusankha kwa Mlingo | Mlingo wa NovoMix insulin umasankhidwa m'magawo angapo. Anthu odwala matenda ashuga a Mtundu 2 amayamba kupereka mankhwalawo ndi mayunitsi 12. musanadye chakudya chamadzulo, ndinaloleranso kuyambitsa kawiri m'mawa ndi madzulo pazinthu 6. Pambuyo pa kuyamba kwa chithandizo kwa masiku atatu, glycemia imayendetsedwa ndipo mlingo wa NovoMix FlexPen umasinthidwa malinga ndi zotsatira zomwe zapezeka. |
| Sinthani mu insulin zofunika | Insulin ndi mahomoni, mahomoni ena opangidwa m'thupi ndipo amapangidwa kuchokera ku mankhwala amatha kuyambitsa zochitika zake. Pankhaniyi, zochita za NovoMix 30 sizokhazikika. Kuti mukwaniritse standardoglycemia, odwala ayenera kuwonjezera kuchuluka kwa mankhwalawa mwachangu, kulimbana ndi matenda, kupsinjika. Kupanga mankhwala owonjezera kungayambitse kusintha kwa glycemia, motero, kumafunikira kuchuluka kwa shuga. Chidwi chachikulu chiyenera kuperekedwa kwa mankhwala a mahomoni ndi antihypertensive. |
| Zotsatira zoyipa | Kumayambiriro kwa mankhwala a insulin, edema, kutupa, redness, kapena zotupa zimachitika pamalo a jekeseni. Ngati shuga anali wamkulu kwambiri kuposa wabwinobwino, kuwonongeka kwa mawonekedwe, kupweteka m'munsi m'munsi kumatha. Zotsatira zonse zoyipa izi zimatha mkati mwa kakhalidwe pambuyo pakuyamba chithandizo. Osakwana 1% ya anthu odwala matenda ashuga ali ndi lipodystrophy. Amakwiyitsidwa osati ndi mankhwala omwe, koma kuphwanya njira ya kayendetsedwe kake: kugwiritsanso ntchito singano, malo amodzi omwewo, jakisoni wosalondola wa jakisoni, kuzizira. Ngati insulin yochulukirapo yaikiridwa kuposa momwe imafunikira kuyeretsa magazi ku shuga wambiri, hypoglycemia imachitika. Malangizo ogwiritsira ntchito amawunika ngozi yake pafupipafupi, kuposa 10%. Hypoglycemia iyenera kuchotsedwa mutangozindikira, chifukwa mawonekedwe ake olimba amachititsa kuti ubongo uwonongeke komanso kufa. |
| Contraindication | Novomix sangathe kutumikiridwa kudzera m'mitsempha yama insulin. Zomwe mankhwalawa ali ndi ana osakwana zaka 6 sizinaphunziridwe, chifukwa chake, malangizowo salimbikitsa kuti aziwapatsa mankhwala a NovoMix insulin. Osachepera 0,01% ya odwala matenda ashuga, kusintha kwa anaphylactic kumachitika: kutaya mtima, kutupa, kuvuta kupuma, kutsika kwa magazi, kuchuluka kwa mtima. Ngati wodwala adachitapo kale izi ndi aspart, NovoMix Flexpen sichosankhidwa. |
| Kusunga | Ma insulin onse amataya katundu wawo pamalo osungika osayenera, chifukwa chake nkoopsa kuwagula "ndi dzanja". Kuti NovoMix 30 ichite monga akuwunikira, amafunika kuwonetsetsa kuti boma likutentha. Mankhwala ogulitsa omwe amasungidwa mufiriji, kutentha ≤ 8 ° C. Cholembera cham'mimba kapena syringe chimasungidwa kutentha kwambiri mpaka 30 ° C. |
Zambiri zakugwiritsa ntchito NovoMix
Pofuna kupewa zovuta za matenda ashuga, mabungwe apadziko lonse a endocrinologists amalimbikitsa kuyamba kwa insulin. Jekeseni amatchulidwa atangoyamba glycated hemoglobin (GH) kupitilira muyeso mukalandira mankhwala a antidiabetesic mapiritsi. Odwala amafunika kusintha kosinthika kwakanthawi. Zokonda zimaperekedwa kwa mankhwala abwino, ngakhale atakhala ndi mtengo wotani. Zothandiza kwambiri ndi ma insulin analogues.
Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale
- Matenda a shuga -95%
- Kuthetsa kwa mitsempha thrombosis - 70%
- Kuthetsa kwa kugunda kwamtima kwamphamvu -90%
- Kuthana ndi kuthamanga kwa magazi - 92%
- Kuwonjezeka kwa mphamvu masana, kukonza kugona usiku -97%
NovoMix Flexpen imagwirizana kwathunthu ndi izi. Imagwira ntchito maola 24, zomwe zikutanthauza kuti poyamba jakisoni imodzi idzakwanira. Kulimbitsa kwa insulin mankhwala ndikochulukitsa kosavuta kwa kuchuluka kwa jakisoni. Kusintha kuchokera ku magawo awiri kupita kukapangira kwakanthawi ndi kotalika kumafunikira pomwe kapamba watsala pang'ono kugwira ntchito. Insulin NovoMiks idadutsa mayeso opitilira muyeso omwe atsimikizira kuti ikuyenda bwino.
Ubwino wa NovoMix
Kutsimikiziridwa kuposa NovoMix 30 pazosankha zina
- imawerengera odwala matenda a shuga ndi 34% bwino kuposa insulini ya NPH;
- pakuchepetsa hemoglobin wa glycated, mankhwalawa ndi 38% ogwira mtima kuposa zosakanikirana za insulin za anthu;
- kuwonjezeredwa kwa Metformin NovoMix mmalo mokonzekera sulfonylurea kumathandizira kukwaniritsa kwakukulu 24% mu GH.
Ngati, mukamagwiritsa ntchito NovoMix, shuga othamanga amakhala apamwamba kuposa 6.5, ndipo GH ndi apamwamba kuposa 7%, ndi nthawi yoti musinthe kuchokera ku kusakanikirana kwa ma insulin kupita ku homoni yayitali komanso yochepa payokha, mwachitsanzo, Levemir ndi Novorapid wopanga yemweyo. Ndizovuta kwambiri kuzigwiritsa ntchito poyerekeza ndi NovoMiks, koma powerengera molondola, amapereka bwino glycemic control.
Kusankhidwa kwa insulin
Ndi mankhwala ati omwe amafunikira mtundu wa 2 odwala matenda ashuga poyambira mankhwala a insulin:
| Makhalidwe odwala, njira ya matenda | Chithandizo chothandiza kwambiri | |
| Psychological, munthu wodwala matenda ashuga amakhala wokonzeka kuphunzira ndikugwiritsira ntchito mankhwalawa. Wodwalayo amatenga nawo mbali pamasewera. | Anfupi + yayitali ya insulin, kuwerengetsa kwa milingo molingana ndi glycemia. | |
| Katundu wambiri. Wodwala amakonda njira yochepetsetsa yamankhwala. | Kuwonjezeka kwa GH kotsika kuposa 1.5%. Kuthamanga kwa hyperglycemia. | Long insulin analogue (Levemir, Lantus) nthawi 1 patsiku. |
| Kuwonjezeka kwa GH kopitilira 1.5%. Hyperglycemia atatha kudya. | NovoMix Flexpen nthawi 1-2. | |
Kupereka mankhwala a insulin sikuletsa chakudya ndi metformin.
Mankhwala a NovoMix
Mlingo wa insulin ndi aliyense payekhapayekha wa wodwala aliyense, chifukwa kuchuluka kwa mankhwalawa sikungotengera shuga wamagazi, komanso mawonekedwe a kuyamwa kuchokera pansi pa khungu komanso kuchuluka kwa insulin. Malangizowo akuwonetsa kuyambitsidwa kwa magawo 12 kumayambiriro kwa mankhwala a insulin. Novomix. Pakati pa sabata, mlingo sasinthidwa, shuga yofulumira imayezedwa tsiku lililonse. Pamapeto pa sabata, mlingo umasinthidwa malinga ndi tebulo:
| Shuga wosala kudya masiku atatu apitawa, mmol / l | Kusintha kwa mlingo |
| Glu ≤ 4.4 | kuchepa ndi 2 mayunitsi |
| 4,4 <Glu ≤ 6.1 | palibe kuwongolera kofunikira |
| 6.1 <Glu ≤ 7.8 | kuchuluka ndi 2 mayunitsi |
| 7.8 <Glu ≤ 10 | kuchuluka ndi 4 mayunitsi |
| Glu> 10 | kuchuluka ndi 6 mayunitsi |
Sabata yotsatira, mlingo wosankhidwa uyendera. Ngati shuga akusala kudya mwachizolowezi ndipo palibe hypoglycemia, mlingo umatengedwa kuti ndi wolondola. Malinga ndi ndemanga, kwa odwala ambiri, kusintha kawiri kotere ndikokwanira.
Malangizo a jekeseni
Mlingo woyambira umaperekedwa musanadye. Ngati wodwala matenda ashuga amafuna magawo oposa 30. insulin, mlingo umagawidwa pakati ndipo umaperekedwa kawiri: asanadye chakudya cham'mawa komanso asanadye. Ngati shuga mutatha kudya nkhomaliro sabwereranso kwina kwa nthawi yayitali, mutha kuwonjezera jakisoni wachitatu: kumudula m'mawa musanadye chakudya chamadzulo.
Njira yosavuta yoyambira
Momwe mungakwaniritsire kubwezeredwa kwa shuga ndi mitundu ingapo ya jakisoni:
- Timalowetsa muyeso musanadye chakudya chamadzulo, ndikusintha, monga tafotokozera pamwambapa. Kupitilira miyezi 4, GH idasinthika mu 41% ya odwala.
- Ngati cholinga sichikwaniritsidwa, onjezani magawo 6. NovoMix Flexpen musanadye chakudya cham'mawa, m'miyezi 4 yotsatira, GH imafika pachimake pa 70% ya odwala matenda ashuga.
- Ngati zalephera, onjezani magulu atatu. NovoMix insulin musanadye nkhomaliro. Pakadali pano, GH imakhala yodziwika bwino mwa odwala matenda ashuga okwanira 77%.
Ngati dongosololi silipereka chindapusa chokwanira cha matenda a shuga, ndikofunikira kusinthira kwa insulin yayitali + mwachidule muyezo wa jekeseni osachepera 5 patsiku.
Malamulo a chitetezo
Shuga wochepa komanso wotsika kwambiri amatha kubweretsa zovuta za matenda a shuga. Hypoglycemic coma imatheka mu diabetes iliyonse wokhala ndi mankhwala osokoneza bongo a NovoMix insulin. Chiwopsezo cha kukomoka kwa hyperglycemic ndichipamwamba, kutsika kwa mahomoni anu omwe.
Popewa zovuta, mukamagwiritsa ntchito insulin, muyenera kutsatira malamulo otetezeka:
- Mutha kulowa mankhwalawa pokhapokha kutentha. Vial yatsopano imachotsedwa mufiriji maola 2 asanafike kubayidwa.
- Insulin ya NovulinMix imafunika kusakaniza bwino. Malangizo ogwiritsira ntchito amalimbikitsa kugudubuza cartridge pakati pa kanjedza kakhumi, ndikusintha ndikukhazikika.
- Kubaya kuyenera kuchitidwa mukangoyambitsa.
- Ndizowopsa kugwiritsa ntchito insulin ngati, mutasakaniza, makhiristo amakhalabe khoma la cartridge, mapampu kapena ma flakes poyimitsa.
- Ngati vutoli lauma, lisiyidwa padzuwa kapena kutentha, cartridge imakhala ndi osweka, singagwiritsenso ntchito.
- Pakapita jakisoni aliyense, singano imayenera kuchotsedwa ndikuitaya, kutseka cholembera ndi cholembera.
- Musati mupeze NovoMix Penfill m'misempha kapena mtsempha.
- Pa jakisoni watsopano aliyense, malo ena amasankhidwa. Ngati redness iwoneka pakhungu, jakisoni sayenera kupangidwa m'derali.
- Kuti muwonetsetse kuti wodwala yemwe ali ndi matenda ashuga azikhala ndi cholembera chindapusa kapena katoni ndi insulin komanso syringe. Malinga ndi odwala matenda ashuga, amafunikira mpaka kasanu pachaka.
- Osagwiritsa ntchito cholembera cha wina, ngakhale singano isinthidwa mu chipangizocho.
- Ngati zikuwonetsedwa pa cholembera chotsalira kuti pali zosakwana 12 m'gudumu, sizingasokedwe. Wopangayo samatsimikizira kuti mahomoni azikhala kuti atsala bwanji yankho.
Gwiritsani ntchito ndi mankhwala ena
Novomix wavomerezedwa kuti agwiritsidwe ntchito ndi mapiritsi onse a antiidiabetes. Ndi mtundu 2 wa shuga, kuphatikiza kwake ndi metformin ndikothandiza kwambiri.
Ngati odwala matenda ashuga apatsidwa mapiritsi olembetsa matenda oopsa, beta-blockers, tetracyclines, sulfonamides, antifungals, anabolic steroids, hypoglycemia ikhoza kuchepetsedwa.
Thiazide diuretics, antidepressants, salicylates, mahomoni ambiri, kuphatikizapo pakamwa, amatha kufooketsa insulin ndikuwatsogolera ku hyperglycemia.
Mimba
Aspart, chophatikizika cha NovoMix Penfill, sichikhudza mayendedwe abambo, moyo wa mkazi, ndi kukula kwa mwana wosabadwayo. Ndiotetezeka ngati mahomoni amunthu.
Ngakhale izi, malangizowo saulimbikitsa kugwiritsidwa ntchito kwa NovoMix insulin panthawi yapakati. Munthawi imeneyi, odwala matenda ashuga amawonetsedwa mtundu wa insulin Therapy, womwe NovoMix sanapangirepo. Ndizosavuta kugwiritsa ntchito insulin yayitali komanso yayifupi payokha. Palibe choletsa kugwiritsa ntchito NovoMix mukamayamwitsa.
Ma Analogs a NovoMix
Palibenso mankhwala ena omwe ali ndi mtundu wofanana ndi NovoMix 30 (aspart + aspart protamine), ndiye kuti, analogue yathunthu. Ma bumpasic ena ma insulin, analog ndi anthu, amatha kulowezani m'malo mwake:
| Kuphatikizika | Dzinalo | Dziko lopanga | Wopanga |
| lispro + lispro protamine | Kusintha kwa Humalog 25 Kusintha kwa Humalog 50 | Switzerland | Eli Lilly |
| aspart + degludec | Ryzodeg | Denmark | NovoNordisk |
| munthu + NPH insulin | Humulin M3 | Switzerland | Eli Lilly |
| Gensulin M30 | Russia | Biotech | |
| Insuman Comb 25 | Germany | Sanofi aventis |
Kumbukirani kuti kusankha mankhwala ndi mlingo wake ndibwino ndi katswiri.
