"Novorapid" (insulin): malangizo ntchito, mlingo makonzedwe njira, ndemanga

Mankhwala "NovoRapid" (insulin) ndi zatsopano mankhwala. Mtima kuchepa kwa insulin munthu ndipo ali m'njira zambiri pa ena mitundu mahomoni. Mwamsanga odzipereka ndi kuchepetsa shuga mosayembekezereka. Thiabendazole angagwiritsidwe ntchito kaya chakudya. Amati ndi ultrashort insulin.

Zikuchokera wothandizila ashuga

Zikutanthauza kuti odwala matenda ashuga "NovoRapid" (insulin) amapangidwa m'njira ziwiri - ndi makatiriji replaceable "Penfill" ndi wokonzeka cholembera "FleksPen".

Zikuchokera katiriji ndi kusamalira chomwecho - madzi mandala jekeseni, kumene 1 ml lili yogwira pophika mu kuchuluka kwa insulin aspart 100 U. Mu katiriji wina mosinthana monga munthu chogwirira mbali za 3 ml ya njira imene mayunitsi 300.

Makatiriji anapangidwa kuchokera galasi hydrolytic kalasi I. Tatseka pa wina mawilo mbali ya polyisoprene ndi bromobutyl labala zosiyana - mphira pistons wapadera. The zotayidwa chithuza ndi m'malo makatiriji asanu, ndipo unazunguliridwa katoni chithuza wina. Nawonso anapita cholembera "FleksPen". Iwo disposable ndi anaikira Mlingo angapo. The katoni ya ndalama zisanu.

kukonzekera amasungidwa malo ozizira pa 2-8 ° C. Izo sungazimitsidwe pafupi ndi mufiriji ndi amaundana. Komanso, makatiriji zochotseka ndi cholembera ayenera kutetezedwa zotsatira matenthedwe dzuwa. Ngati insulin "NovoRapid" (katiriji) anatsegula, kuti sangathe kusungidwa mu firiji, koma ayenera kugwiritsidwa ntchito mwa masabata anayi. Kutentha yosungirako, ayenera kukhala wamkulu kuposa 30 ° C. Alumali moyo wa insulin osatsegulidwa ndi miyezi 30.

mankhwala

The medicament "NovoRapid" (insulin) ali kanthu hypoglycemic, ndi yogwira pophika - insulin aspart - Tinanyamuka wotenga timadzi analogi opangidwa ndi munthu. nkhaniyi linakonzedwa ndi ntchito yapadera zophatikizananso DNA umisiri. Apa anawonjezera mtundu wa Saccharomyces cerevisiae, ndi kwa amino asidi amatchedwa "proline" mongoyembekezera m'malo mwa aspartic.

Mankhwala chimamanga kwa maselo cytoplasmic akunja maselo, mmene ndi njira zovuta za mathero insulin imayendetsa njira zonse zikuchitika mkati mwa selo. Pambuyo kuchepetsa kuchuluka kwa shuga mu madzi ndi kuwonjezeka mu zoyendera okhudza maselo ambiri, kuwonjezera digestibility wa zimakhala zosiyanasiyana, kutsegula kwa lipogenesis ndi glikogenogeneza. Yafupika mlingo wa ulimi shuga ndi chiwindi.

M'malo a kwa amino asidi proline pa aspartic pansi zochita za insulin aspart amachepetsa katundu wa mamolekyulu kulenga hexamers. Mtundu bwino chosakanikirana timadzi subcutaneous mafuta, amakhudza thupi mofulumira kuposa mmene sungunuka anthu insulin muyezo.

M'nthawi ya maola anayi pambuyo chakudya, insulin aspart msanga Sachita shuga mu madzi kuposa timadzi sungunuka anthu. Koma zotsatira za "Novorapid" makonzedwe subcutaneous ndi lalifupi kuposa munthu sungunuka.

Kodi zochita zambiri "NovoRapid"? funsoli nkhawa anthu ambiri odwala matenda a shuga. Motero, zochita za mankhwala pambuyo Mphindi 10-20 pambuyo jekeseni ya. Ndende apamwamba timadzi mu magazi anaona pambuyo maola 1-3 pambuyo ntchito mankhwala osokoneza bongo. Ndi mmene thupi kwa maola 3-5.

Maphunziro a anthu a mtundu Ine shuga asonyeza kuchepa chiopsezo nocturnal hypoglycemia kangapo ntchito, "NovoRapid", makamaka poyerekeza ka insulin sungunuka anthu. Komanso, panali kuchepetsa kwambiri postprandial plasma shuga pamene jekeseni wa insulin aspart.

Zizindikiro ndi contraindications

Medicine "NovoRapid" (insulin) lakonzedwa kuti anthu odwala matenda a shuga monga mtundu 1, chimene chiri insulin, ndi odwala matenda a shuga mtundu 2 - insulin yozungulira (siteji ya kukana mankhwala hypoglycemic anatengedwa pakamwa ndi matenda intercurrent) .

Contraindications ntchito medicament ndi hypoglycemia ndi tcheru kwambiri kuti insulin aspart, excipients kukonzekera.

Osagwiritsa "NovoRapid" ana ochepera zaka zisanu ndi chimodzi chifukwa cha kusowa mayesero matenda.

Medicine "NovoRapid": malangizo ntchito

Kukonzekera "NovoRapid" ndi analogue a insulin. Pamafunika pomwepo pambuyo jekeseni ya. Mlingo wa wodwala aliyense payekha ndi dokotala osankhidwa. Zotsatira zabwino, kuphatikiza ndi timadzi insulin kapena yaitali pafupifupi nthawi ya kanthu.

Pofuna kuchepetsa glycemia, zonse kuyeza kuchuluka kwa shuga m'magazi ndi kuwasankha mlingo wa insulin. Monga ulamuliro, mlingo tsiku akuluakulu ndi ana mu osiyanasiyana 0.5-1 U / kg.

Pamene jekeseni wa mankhwala "NovoRapid" (malangizo Buku mwatsatanetsatane ndondomeko jekeseni) zofunika insulin anthu operekedwa ndi 50-70%. Yotsala ya anakumana ndi utsogoleli wa insulin yaitali (yaitali) kanthu. Kuchuluka zolimbitsa thupi la wodwalayo komanso kusintha zakudya, komanso comorbidities alipo nthawi zambiri kofunika kusintha mlingo kutumikiridwa.

Timadzi "NovoRapid" mosiyana ndi anthu sungunuka umayamba mwamsanga, koma osati mosalekeza. Kusonyeza pang'onopang'ono jekeseni wa insulin. jekeseni aligorivimu zimaphatikizapo kugwiritsa ntchito mankhwala asanalankhule chakudya, ndipo ngati pali Akufunika, mankhwala ntchito yomweyo pambuyo chakudya.

Chifukwa chakuti "NovoRapid" zimakhudzanso thupi kanthawi, chiopsezo hypoglycemia usiku odwala matenda ashuga ali kwambiri yafupika.

Odwala okalamba, komanso anthu ndi aimpso kapena kwa chiwindi insufficiency kulamulira magazi shuga ndende ayenera kukhala pafupipafupi, ndipo chiwerengero cha insulin aspart amusankha payekha.

Ana "NovoRapid" m'malo anthu sungunuka insulin, koma pokhapokha ngati yokonza zofunika kuchita mofulumira. Izo ntchito pamene mwana sakhala kukhala imeneyi chofunika pakati jakisoni ndi chakudya. Ngati wodwalayo ndi anamasuliridwa kuti "NovoRapid" kukonzekera zina munali kusintha insulin mlingo chofunika, komanso insulin woyambira.

Subcutaneous jekeseni wa insulin (ntchito aligorivimu timadzi jakisoni limafotokoza mwatsatanetsatane mu malangizo ntchito) kumafuna chiphunzitso jekeseni m'dera kutsogolo kwa pamimba, ntchafu ndi minofu phewa deltoid, komanso matako a. dera lomwe ndi jakisoni, ayenera kusinthidwa kupewa lipodystrophy.

Pamene kutumikiridwa mu dera zapambuyo wa timadzi mankhwala imatsala mofulumira peritoneum, poyerekeza ndi jakisoni ku ziwalo zina za thupi. Zotsatira timadzi pa nthawi ya zotsatira mlingo jekeseni malo, mlingo wa magazi, kutentha thupi, mlingo wa zolimbitsa thupi la wodwalayo.

Amatanthauza "NovoRapid" ntchito infusions yaitali subcutaneous, amene akutsatiridwa ndi mpope wapadera. Kutumikiridwa mankhwala peritoneum kutsogolo koma nthawi kusintha malo. Ngati mpope insulin ntchito, "NovoRapid" sayenera wothira zina insulin. Odwala kulandira timadzi ntchito dongosolo kulowetsedwa ayenera kotunga zida mankhwala breakage.

"NovoRapid" akhoza ntchito yoyang'anira mtsempha, koma zimatenga ziyenela kuchitidwa ndi thanzi wodziŵa. Mtundu wa utsogoleli nthawi zina amagwiritsidwa ntchito machitidwe kulowetsedwa, kumene insulin ali ndi kuchuluka kwa 100 U / ml, ndi ndende zake ndi 0.05-1 U / ml. Mankhwala anali sitimadzipereka mu sodium kolorayidi 0,9%, 5 ndi 10% dextrose yankho lomwe lili mankhwala enaake potaziyamu 40 mmol / l. Anati njira zasungidwa firiji kwa osapitirira tsiku lina. Pamene insulin kulowetsedwa ayenera nthawi zonse amapereka magazi ake okhutira a shuga.

Kodi kuwerengera insulin mlingo?

Kuwerengetsa mlingo ankafunika kudziwa kuti insulin ndi zimagwira yaitali (yaitali), sing'anga, lalifupi ndi kopitilira muyeso-yochepa. Woyamba kumabweretsa wabwinobwino shuga magazi. Chosavuta pa chopanda kanthu m'mimba. Izo zikusonyeza anthu ndi shuga mtundu 1 ndi mtundu 2. Pali anthu amene ntchito mtundu umodzi wokha wa insulin - anawonjezera. Anthu ena mu "NovoRapid" ntchito kupewa kukakhala mwadzidzidzi shuga. Short, yaitali, insulin angagwiritsidwe ntchito imodzi pa matenda a shuga, koma kutumikiridwa pa nthawi zosiyanasiyana. Odwala ena yekha ntchito ophatikizana a mankhwala kumathandiza pambali zotsatira ankafuna.

Kusankha yaitali wotenga insulin ayenera kumwedwa nkhani zina mokoma lapansi. Mwachitsanzo, muyenera, popanda jekeseni wa timadzi ndi waufupi chakudya chachikulu shuga anakhalabe tsiku lonse pa mlingo umodzi wokha chifukwa zotsatira za insulin yaitali.

Kusankha mlingo wa insulin zofikira chiri motere:

• M'mawa, palibe chakudya, kuyeza kuchuluka kwa shuga.
• Nkhomaliro, kudya, ndipo pambuyo maola atatu shuga msinkhu mu madzi. Kenako, kayesedwe ikuchitika ola lililonse pamaso yogona. Tsiku loyamba la kusankha mlingo akusowa chakudya, koma chakudya.
• Pa tsiku lachiwiri analola kadzutsa ndi nkhomaliro, koma osati chakudya. Shuga, komanso pa tsiku loyamba, muyenera kuchepetsa nthawi zonse, kuphatikizapo usiku.
• Pa tsiku lachitatu kupitiriza kuchita muyeso, akamadya bwinobwino, koma musalowe yochepa insulin.

Wangwiro zizindikiro m'mawa ndi:

• pa tsiku 1 - 5 mmol / l;
• pa Tsiku 2 - 8 mmol / l;
• pa tsiku 3 - 12 mmol / l.

Chotero shuga mfundo ayenera popanda ndi timadzi wotenga nthawi yochepa. Mwachitsanzo, ngati mwazi shuga m'mawa ndi 7 mmol / l, ndi madzulo - 4 mmol / l, izo zikusonyeza kufunika ndichepe mlingo wa timadzi yaitali ndi 1 kapena 2 mayunitsi.

Nthawi zambiri odwala kudziwa mlingo tsiku ntchito chilinganizo Forshema. Ngati magazi shuga fluctuates mkati 150-216 mg /% ya mpandawo magazi mlingo shuga nyamulani 150 gawani nambala kuti ndi 5. Chifukwa ndi mlingo umodzi wa timadzi yaitali. Ngati magazi shuga kuposa 216 mg /%, shuga ndi subtracted ku anayeza 200 ndipo chotsatira lagawidwa ndi 10.

Pofuna kudziwa mlingo wa insulin yochepa, m'pofunika kuti sabata kuyeza magazi shuga. Ngati zizindikiro zonse tsiku ndi zabwinobwino, kupatula madzulo, ndiye yochepa insulin chikuyendetsedwera chisanafike chakudyacho. Ngati magazi shuga kudumpha nthawi iliyonse chakudya, kupanga jakisoni basi asanadye.

Kudziwa nthawi imene ndi timadzi zimene tikubweretsazi, m'pofunika kuyeza shuga Mphindi 45 poyamba chakudya. Zotsatirazi ulamuliro shuga aliyense mphindi zisanu mpaka mlingo wake umalandira mlingo wa 0,3 mmol / L, pambuyo trapeznichat kuti. njira imeneyi kuchenjeza isanayambike hypoglycemia. Ngati pambuyo Mphindi 45 shuga adzaleka, m'pofunika kudikira chakudya kuti bola shuga si kugwa kwa chizindikiro ankafuna.

Pofuna kudziwa mlingo wa anthu insulin ultrashort ndi mtundu 1 shuga ndi lembani maganizo 2 kwa sabata kusunga zakudya. Polojekiti, kodi ndi mtundu wanji wa malonda iwo kudya. Sayenera upambana kuchuluka analola chakudya. Kuganiziranso thupi ntchito wodwalayo, mankhwala madyedwe, pamaso pa matenda aakulu.

Kopitilira muyeso-insulin chikuyendetsedwera kwa mphindi 5-15 pamaso chakudya. Kodi kuwerengera mlingo wa "NovoRapid" insulin mu nkhani iyi? Tiyenera kukumbukira kuti mankhwala kuchepetsa mlingo wa shuga mu nthawi 1.5 kuposa mmalo ake yochepa. Choncho, chiwerengero cha "Novorapid" ndi 0.4 mlingo lalifupi timadzi. Dziwani zambiri ndendende mlingo zitha kukhala mwa kuyesera.

Posankha ndi insulin mlingo ayenera kuganizira mlingo wa matenda, ndi chakuti kufunika timadzi aliyense mu ashuga osati oposa 1 U / kg. Apo ayi, mwina kuchititsa ambiri osokoneza ndi chifukwa chiwerengero cha matendawo.

Malamulo tingadziŵire mlingo wa shuga cha odwala matenda ashuga:

• Pa siteji oyambirira a mtundu 1 shuga timadzi mlingo sayenera upambana 0.5 mayunitsi / kg.
• Mu shuga mtundu 1, amene anamuona pa chaka mtima kapena kuposa mlingo ntchito za kapamba 0,6 u / kg.
• Ngati mtundu 1 shuga limodzi ndi chiwerengero cha matenda aakulu ndipo ali magawo kusokonekera kwa magazi shuga msinkhu, kuchuluka kwa timadzi ndi wofanana 0,7 IU / kg.
• Mu decompensated shuga kapamba 0,8 u / kg.
• Ngati shuga ndi ketoacidosis, izo chofunika kuti atchule za 0,9 U / kg timadzi.
• Pa mimba, mkazi mu trimester lachitatu ayenera 1.0 mayunitsi / kg.

Pakuti mawerengedwe a mlingo umodzi wa insulin akhale mlingo tsiku kuchulukitsa ndi kulemera kwa thupi ndi kugawaniza ndi awiri, ndi kusonkhanitsa chithunzi komaliza.

Ntchito "NovoRapid FleksPen" mankhwala

Chiyambi cha timadzi akhoza ikuchitika ntchito syringe-cholembera "NovoRapid FleksPen". Iwo ali utoto wa mitundu yosiyanasiyana dispenser. Mlingo wa insulin lingayambire pakukhala 1 60 U, phazi limodzi ndi wofanana ndi 1 IU syringe. Pokonzekera "NovoRapid" singano ntchito TM "Novotvist" kapena "Novofayn" 8 mm. Ngati inu ntchito cholembera, kumbukirani kuti nthawi zonse muyenera kukhala ndi kumbuyo-m'dongosolo jekeseni wa - mwina mwake, ngati syringe kuonongeka kapena anataya.

Pamaso pa oyamba a cholembera timadzi zofunika:

• Werengani chizindikiro ndipo onetsetsani kuti "NovoRapid" Umutu ndi insulin mukufuna.
• Chotsani syringe ku-kapu kogwirira kozungulira.
• Chotsani mtengo limene lili singano disposable.
• Kagwere singano kwa chogwirira. Pakuti aliyense jekeseni muyenera singano watsopano kuteteza kukula bakiteriya. The singano ayenera kukhala wopindidwa kapena kuonongeka.
• Kupewa mwangozi singano kuzibweretsa singano kapu pambuyo ka insulin samavala.

Jekeseni cholembera "NovoRapid" anyamula mwana kuchuluka kwa mpweya mkati. Thovu mpweya musati kudziunjikira, ndi mlingo wakhala molondola anaikapo, m'pofunika kutsatira malamulo:

• ED timadzi oyimba 2 onsewo ndi metering selector.
• Pezani cholembera singano oposa ndipo dinani katiriji ndi chala. Popeza mpweya thovu imakhudzidwa m'chigawo chapamwamba.
• Akugwira syringe "FleksPen" singano oposa, tilimbikire chiyambi batani mpaka mabasi. Metering selector pa nthawi ino adzabwerera kwa "0" malo. Trainspotting adzakhala dontho timadzi. Ngati izo sizitero, ndondomeko Mungathe kubwereza kasanu ndi kamodzi. Ngati insulin samabwera, ndiye syringe zolakwika.

Musanayambe anapereka mlingo muyenera kuonetsetsa kuti mlingo selector wayikidwa kuti "0". zotsatirazi chofunika imbani nambala ya mayunitsi, kuchuluka kwa mankhwala ndi Lamulo la selector malangizo onse. Pamene wakhala mlingo muyenera kusamala ndi musayese mwangozi kukhudza chiyambi batani, mwinamwake padzakhala msanga amasulidwe timadzi lapansi. Musati kukhazikitsa iriyonse kuposa amene ali mu mankhwala, "NovoRapid." Komanso, musati ntchito moyenera lonse kudziwa timadzi mlingo.

Pa utsogoleli wa insulin subcutaneously anatsatira mwa njira analimbikitsa ndi dokotala. Jekeseni wa, tilimbikire chiyambi batani. Pitilizani bola ngati mlingo selector alibe ulamuliro wa "0". Pa jekeseni amachita chiyambi batani yekha. Mu yachibadwa kasinthasintha Cholozera mlingo insulin yobereka zimachokeradi.

Pambuyo jekeseni, singano pansi pa khungu chiyenela kuchitika masekondi wina asanu popanda potulutsa choyambitsa batani. Popeza insulin mlingo analowa kwathunthu. Pambuyo singano jekeseni walangizidwa kapu lakunja, ndipo tikafika mu izo, ndi unscrewed ndi kutayidwa, akuchita kusamalitsa onse. syringe anali chili pamwamba. The singano amachotsedwa pambuyo lililonse jekeseni osati kusungidwa ndi cholembera. Apo ayi, madzimadzi kutayikira zidzachitika, zomwe mwina zikuphatikizapo kugwiritsira ntchito mlingo pachithunzichi. Kuti mudziwe mmene pokha insulin "NovoRapid" kukuuzani malangizo zambiri ntchito.

zotsatira zoyipazi

Mankhwala "NovoRapid" zingachititse angapo mavuto. Ndi hypoglycemia, amene kumaonekera mwa mawonekedwe a thukuta kwambiri, wotumbululuka khungu, manjenje, popanda nkhawa, kugwedeza wa malekezero, kufooka thupi, disorientation ndi kuchepetsedwa ndende. Komanso, pali chizungulire, kumverera njala, ndi wonongeka wa zithunzi zida, nseru, mutu, ndi tachycardia. Glycemia angachititse imfa ya chikumbumtima, khunyu, ubongo ndi imfa.

Infrequently, odwala kunena za maganizo awo sagwirizana monga ming'oma, totupa. N'zotheka kusokonezeka kwa m'mimba ndipo matumbo, pakutchulidwa wa angioedema, tachycardia, kufupika kwa mpweya. Odwala anati kutsitsa magazi.

zochita Local anati kuyabwa m'dera la jekeseni, redness, kutupa kwa khungu. Infrequently zinachitika zizindikiro lipodystrophy. Mankhwala zikhoza siteji koyamba mankhwala edema kulakwila refraction.

Madokotala amanena kuti mawonetseredwe onse yochepa chabe ndipo anati makamaka odwala ndi mlingo amadalira ndi chifukwa zochita za mankhwala insulin.

analogs

Ngati timadzi si woyenera, inu nthawi zonse m'malo mankhwala "NovoRapid FleksPen". Analogs, ndithudi, ndi kusankha dokotala. Otchuka kwambiri monga:

• "Novomiks".
• "Apidra".
• "Humalog".
• "Actrapid."
• "Rayzodeg".
• "Protafan".
• "Gensulin H".

Mtengo wa timadzi wa

Chogulitsidwa mosamalitsa pa mankhwala, "NovoRapid." Mtengo wa makatiriji zisanu "Penfill" kuzungulira 1,800 rubles. Mtengo wa timadzi "FleksPen" ndi 2000 rubles. Aliyense paketi lili asanu zolembera insulin jekeseni "Novorapid". Price malingana maukonde malonda zosiyanasiyana pang'ono.

umboni

ndi "NovoRapid" kukonzekera ndemanga chiyani? Anthu amanena kuti izi ndi zabwino ndi wofatsa insulin. Chili msanga. Oyenera zochizira matenda a shuga mtundu 1, kumene shuga magazi ndi zovuta kuchepetsa. Ambiri odwala ntchito pa matenda a mtundu 2 shuga. odwala matenda ashuga kwambiri womasuka kwambiri cholembera "FleksPen". Iwo kuthetsa kufunika payokha kugula syringes.

Monga ulamuliro, odwala ntchito mankhwala "NovoRapid" ndi maziko a insulin yaitali, amene amathandiza kukhala zabwinobwino shuga tsiku lonse. Amathandiza kuchepetsa shuga magazi kuchepetsa pambuyo chakudya, amene kwambiri facilitates miyoyo ya odwala matenda ashuga ambiri ndipo walola kudya ataweruka. Anthu ena akulangizidwa pa siteji koyamba za matenda yekha ntchito timadzi izi.

Pali anthu amene amati mankhwala - pamene kutumikiridwa kwa tiana - amachititsa mu alili zapitazi lakuthwa mu shuga magazi, chifukwa mwa ana chisoni. Popewa izi, makolo ambiri amakonda "NovoRapid" yaitali insulin.

Odwala dziwani kuti molondola chikufanana kumwa mankhwala kawirikawiri amakwiya hypoglycemia ndi impairs thanzi. Kupewa zotsatira zimenezi si kudziletsa medicate, ndi kufunafuna chithandizo cha akatswiri.