Menene kuma wanene yake buƙatar Insulin Humalog?

An gudanar da taron ƙwararrun majalisa akan yin amfani da insulin-Hulinlog Mix 50 mai ƙarfi a cikin jiyya na nau'in ciwon sukari na 2 (T2DM). A cikin tsarin taron majalisar kwararrun, an tattauna matsalolin cimma ingantaccen sarrafa kwayar cutar a cikin marasa lafiya da ke dauke da ciwon sukari na 2 da kuma ingancin asibiti da kuma hanyoyin amfani da hadewar insulin da aka shirya. A matsayin ɓangare na tattaunawar, yiwuwar cimma maƙasudin kula da marasa lafiya da masu ciwon sukari na type 2 tare da taimakon Humalog Mix 50 insulin, takamaiman alamomi da contraindications, kazalika da inganta tsarin lura da marasa lafiya da ke karɓar maganin insulin tare da ƙoshin insulin Humalog Mix 50 cakuda.

Keywords: nau'in ciwon sukari na 2 na sukari, insulin, cakuda da aka yi, lispro, Humalog Mix 50.

Ganawa da kwamiti na kwararru kan amfanin hada-hadar insulin Humalog Mix 50 a nau'in ciwon sukari guda 2

Kwamitin masana ya gudanar da tattaunawa kan inganci da dabarun sarrafa kwayar cutar ta hanyar insulin hade-hade da aka shirya a cikin T2DM. An ba da kulawa ta musamman ga ɓangarorin kulawa tare da Humalog Mix 50, ciki har da alamomi da contraindications, yiwuwar cimma nasarar burin warkewa da haɓaka saka idanu na haƙuri.

Keywords: mellitus na sukari type 2, insulin, pre-mixed, lispro, Humalog Mix 50

A cikin tsarin majalisar kwararru, rahotannin memba na Kungiyar berungiyar Kwalejin Kimiyya ta Rasha M.V. Shestakova game da matsalolin cimma ingantaccen iko na glycemic a cikin marasa lafiya tare da T2DM da S.V. Elizarova (“Eli Lilly”) akan ingancin asibiti na amfani da cakudaddun insulin na Humalog Mix 50 da algorithm don amfanin sa.

Tattaunawar ta mayar da hankali kan mahimmancin asibiti da kuma yiwuwar cimma maƙasudin kulawa da marasa lafiya tare da nau'in ciwon sukari na 2 tare da taimakon Humalog Mix 50 insulin, bayanan bayanan marasa lafiya waɗanda aka nuna wannan maganin tare da cakuda insulin Humalog Mix 50, da kuma maganin aikace-aikacen asibiti.

A cikin rahoton nasa, M.V. Shestakova ya lura cewa a kowace shekara yawan masu haƙuri da ke fama da T2DM da kuma ɗaukar insulin suna ƙaruwa sosai, duk da haka, a cikin adadin abubuwan lura, ba a cimma nasarar alamun alamun glycemic. Dalili guda na wannan shine farkon farawar maganin insulin. Don haka, bisa ga binciken CREDIT, farawar maganin insulin ya faru ne a matakin HbA1c na 9.7%. Nazarin ACHIEVE (Shirin A1chieve a Rasha: wani bincike mai zurfi mai mahimmanci na binciken inganci da aminci na farawa da haɓaka aikin insulin tare da insulin analogues a cikin marasa lafiya da nau'in ciwon sukari na 2 wanda bai taɓa karɓar insulin a cikin aikin asibiti na yau da kullun ba) ya nuna cewa a cikin marasa lafiya suna farawa da basal insulin, matakin HbA1c ya kasance 9.7%, kuma daga gaurayawan da aka shirya - 10.1%, tare da maganin cutar bolus (BBT) - 10.4%. A duk wataƙila, wannan saboda endocrinologists suna da ra'ayi mai ƙarfi cewa yakamata a fara maganin insulin a matakin HbA1c sama da 9%.

Tare da wannan, a yawancin lokuta, farkon rashin insulin jiyya shine sakamakon mummunan fahimta ta marasa lafiya na tsarin kulawa da insulin da kanta da fassarar fassarar ma'anar ilimin insulin. A lokaci guda, likitoci sau da yawa suna da damuwa game da yiwuwar ci gaban rikice-rikice na maganin insulin, kamar haɗarin hauhawar jini da hauhawar nauyi a cikin marasa lafiya. Ya kamata a lura cewa shingen da ke tashi a cikin marasa lafiya ya canza tare da farawar insulin. Don haka, binciken da F.J. Snoek et al. , ya nuna cewa a cikin marasa lafiya da suka fara samun insulin, ba a rage tsinkayen yadda ake amfani da maganin insulin idan aka kwatanta da marasa lafiyar insulin-butulci. A wannan yanayin, ba shakka, tambaya ta taso game da buƙatar ingantaccen horo na marasa lafiya da masu ciwon sukari, tunda ta hanyar ƙara ƙwarewar marasa lafiya, gami da zurfafa ilimin game da cutar, yana yiwuwa a cimma ƙarancin shinge na likitancin lokaci zuwa ingantaccen ilimin insulin.

Bukatar tsananin tsayayyen sarrafa glycemic na buƙatar ba kawai farawar insulin na lokaci ba, har ma zaɓi na isasshen ƙwayar insulin, wanda aka ƙaddara don cimma burin ƙima na glycemia.

Akwai hanyoyin da yawa don farawa da ƙaruwa na ilimin insulin. Dangane da shawarwarin ADA / EASD, marasa lafiya waɗanda ba su sami biyan diyya ba don maganin ƙwaƙwalwar ƙwayar cuta yawanci ana rubanya maganin basal insulin therapy. Lokacin da ba a cimma burin kula da glycemic ba ko kuma baza'a iya kiyaye shi tare da tsarin kulawa na yanzu ba, ƙara insulin prandial. Ana amfani da hanyoyin warkewa tare da gaurayawar abubuwan da aka yi da shiri azaman madadin zaɓi a cikin farawa da ƙaruwa na ilimin insulin. A cikin shawarwarin na Rasha, sabanin shawarwarin ADA / EASD, ana amfani da gaurayawan abubuwan da aka shirya a duka farkon farawar insulin, tare da insulin basal, kuma kamar yadda ƙaruwa tare da insulin paldial. Zaɓin tsarin kulawa da insulin na insulin ya dogara, da farko, akan matakin glycemia, biɗan magani da aka tsara da salon rayuwar mai haƙuri.

Tattaunawa da mahimman fannoni don cimma nasarar sarrafa sukari masu inganci, masana sun kammala da cewa endocrinologists sun yi imanin cewa fara aikin insulin a matakin HbA1c na 9% na iya kasancewa yana da alaƙa da algorithm wanda ke saita wannan alamar ga marasa lafiya tare da T2DM a cikin halayen farko na maganin rage sukari, inda insulin shine magani na farko. Masana sun bayyana buƙatar ma'anar bayyananniyar manufa ta glycemic, tunda yana yiwuwa keɓancewar mutum ya rusa burin duniya na maganin. Bugu da ƙari, akwai buƙatar mafi sauƙin fasalin tsarin algorithms don dabarun warkewa don tsara hanyoyin rage sukari ga marasa lafiya tare da T2DM. Dangane da matsalolin cimma burin kwantar da hankali a cikin hadakar marasa lafiya da suka fara karbar insulin, kwararru sun yanke cewa maganin insulin da aka tsara yana buƙatar tallafi mai ƙarfi, wato, sa ido na yau da kullun na cutar glycemia, ƙididdigar carbohydrates da aka cinye a abinci da kuma gyaran insulin allurai da ake sarrafawa, in ba haka ba ta kasa aiki.

Ofaya daga cikin hanyoyin samun ingantaccen iko na metabolism a cikin T2DM shine gabatarwar cikin ayyukan asibiti na analogs na zamani tare da ingantattun magunguna da ƙirar magunguna, ba ka damar zaɓar ingantaccen maganin kwantar da hankali wanda ke yin la’akari da halayen mutum na haƙuri. Amintattun insulins da aka kafa tare da tsayayyen rabo na insulins na gajere da na dogon lokaci, waɗanda suka fi dacewa kuma sun cancanci marasa lafiya waɗanda ke buƙatar jigilar maganin insulin mai sauƙi da dacewa, ana amfani da su sosai a cikin lura da marasa lafiya da masu ciwon sukari na 2.

Humalog Mix 50 sabon abu ne a cikin Russia wanda aka shirya wanda aka cakuda shi da maganin insulin wanda yake dauke da sinadarin insulin lispro da kuma dakatarwar protamine a cikin kashi 50:50. Matsakaicin tsawon lokacin aiki ana bayar da shi ne ta hanyar dakatar da aikin insulin lispro (50%), wanda yake kwaikwayon ƙwayar insulin, da kuma insulin lispro (50%) wani abu ne wanda yake rage yawan motsa jiki bayan ya ci abinci. Wannan magani yana haɗuwa da sauƙin amfani da halaye na musamman na aikin ultrashort na maganin Humalog.

Kwararrun sun sake nazarin sakamakon binciken asibiti wanda yake kwatanta insulin Humalog Mix 50 tare da makirci: insulin glargine sau ɗaya a rana da injections na insulin lyspro kafin manyan abinci a cikin marasa lafiya tare da T2DM, tare da rashin isasshen iko a cikin jiyya tare da insulin glargine da magungunan maganganu na bakin jini. Babban manufar binciken shine ya nuna amfanin insulin lyspro mix 50 idan aka kwatanta shi da tsarin kulawa na tushen motsa jiki. A yayin binciken, ba'a sami iyakancewa ba wanda ke tabbatar da daidaitaccen aiki na cakuda insulin na Humalog Mix 50 idan aka kwatanta da tsarin kulawa na bolus na asali, amma an nuna babban ingancin wannan tsarin dangane da bayanan da aka samo don rage gemocated haemoglobin, wanda ya mamaye rukuni 1 , 87% na ƙimar farko, yayin da matsakaicin HbA1c a cikin duka rukuni ya kasance 6.95% tare da manufa HbA1c na 7.0%. A lokaci guda, a cikin rukuni na marasa lafiya da ke karɓar insulin glargine a hade tare da kulawa na sau uku na insulin lyspro kafin manyan abinci, raguwar haemoglobin shine 2,09% kuma ya kai matsakaici na 6.78% a cikin rukuni. An lura cewa fiye da 80% na marasa lafiya a bangarorin biyu sun cimma burin HbA1c na 7.5%. Adadin marasa lafiya da suka cimma HbA1c na 7.0% ya kasance 69% a cikin rukuni-basus kuma 54% a cikin kungiyar Humalog Mix 50.

Lokacin da muke tattaunawa game da yawan maganganu na hypoglycemic, an lura cewa duka hanyoyin insulin na kwantar da hankali suna daidai da lafiya. Dukkanin jumlar tsotsar jini a cikin jini da yawan lokutan rashin haila da tsananin rashin haila bai bambanta cikin rukuni.

Sakamakon gwaji na asibiti wanda aka gabatar da inganci da amincin yin amfani da Humalog Mix 50 azaman madadin BBT, masanan sun fahimci matsayin asibiti mai mahimmanci kuma sun yanke shawarar cewa Humalog Mix 50 na iya kasancewa cikin buƙata a kasuwar Rasha, fadada yiwuwar endocrinologist a zaɓin dabarun insulin mafi kyawu wanda ke ba ku damar inganta ƙwararrun likitancin insulin. jiyya.

Masana sun ba da shawarar yin amfani da miyagun ƙwayoyi a matsayin wani ɓangare na alamun rajista don lura da marasa lafiya da masu ciwon sukari waɗanda ke buƙatar maganin insulin.

A yayin tattaunawar, masanan sun yi nazarin bayanan martaba daban-daban na marasa lafiya da ke dauke da ciwon sukari na 2, wanda aikin insulin Humalog Mix 50 zai zama mafi kyawun zaɓi:

• - azaman madadin tsarin basal-bolus na insulin far ga marasa lafiya waɗanda ke da wahalar yin allura iri-iri na insulin guda biyu kuma ba sa iya yin gwajin kulawa na yau da kullun na glycemia, ya zama dole don fa'idar jijiyar-bolus therapy,
• - ga marasa lafiya waɗanda ke buƙatar maganin insulin don daidaitawa da azumi da glycemia na postprandial, amma a lokaci guda ƙasa da aka ƙaddara maƙasudin burin rashin lafiya - HbA1c 7.5% ko fiye,
• - don marasa lafiya waɗanda ba a rama su don haɗuwa da gaurayawar insulin (30/70 da 25/75) a cikin tsarin kulawa na 2-sau (da safe da kuma abincin dare), saboda mummunan postprandial glycemia (BCP), wanda ke buƙatar ƙarin allurar insulin gajere don sarrafawa BCP bayan abincin rana. Ga irin waɗannan marasa lafiya, Humalog Mix 50 a cikin tsarin injections 3 a kowace rana zai zama mai sauƙi kuma mai dacewa ba tare da buƙatar ƙara nau'in insulin na biyu ba,
• - don marasa lafiya waɗanda ba a rama su da insulin basal, tare da BCP mai ƙarfi saboda amfani da abinci mai wadatar da ƙwayoyin carbohydrates, kuma ba a shirye don canza halayensu ba,
• - ga marasa lafiya waɗanda ke karɓar tsarin kula da insulin-bolus na insulin far a cikin kashi 50% na kayan basal da kashi 50% na prandial, duk da haka, suna buƙatar sauƙaƙe tsarin kula da insulin, misali, lokacin da aka kori marasa lafiya daga asibiti zuwa tsarin kula da marasa lafiya.

Hakanan an dauki nauyin Humalog Mix 50 na tsarin insulin da titration regimen a matsayin wani bangare na kwararrun majalisa.Ga yawan yau da kullun da adadin alluran wannan nau'in insulin ya dogara ne da bukatun mutum na mai haƙuri, salon rayuwarsa, abincinsa da kuma cutar glycemia. Idan Humalog Mix 50 shine madadin tsarin basal-bolus na insulin therapy kuma zai zama mataki na gaba bayan insulin basal, to jimlar yau da kullun na insulin basal wanda mai haƙuri ya karɓa a baya ya kasu kashi uku daidai kuma an gabatar dashi azaman Humalog Mix 50 kafin manyan abinci . Koyaya, ana iya fara amfani da allurar insulin duka biyu tare da allura guda a cikin abinci mafi girma, kuma tare da allura 2 da 3 kowace rana. Bayan haka, zakka na kashi ɗaya daga cikin injections ukun yana faruwa ga darajar da ke tabbatar da nasarar burin warkewa na sarrafa glycemic. A cikin sharuddan amfani, yana da mahimmanci a lura cewa Humalog Mix 50 yana adana dukkanin kaddarorin insulin Humalog, kuma amfaninsa mai yiwuwa ne nan da nan kafin abinci, da lokacin abinci da kuma bayan abinci, wanda ke haɓaka ingancin haƙuri.

Tasirin Insulin Humalog

Magungunan insulin na asibiti

• by lokaci da aikinsu - tsayi, matsakaici, gajeru, ultrashort, tsawanta da hade,
• ta hanyar asalin abu mai aiki - naman alade da kayansa na semisynthetic, kayan injiniyar ɗan adam da kayan aikin gyaran da ake amfani dashi.

Insulin Humalog shine sunan da aka mallaka don alamar Faransar ta miyagun ƙwayoyi tare da sinadaran aiki Lyspro (Insulin lispro) - ana ana-sake sake fasalin analog na abubuwa na hormonal wanda ƙwayoyin beta na ɗan adam suka samar. Banbancin da ya banbanta daga yanayin halittar insulin na mutum shine tsarin juzu'i na proline (A'a. 28) da lysine (No. 29) amino acid ragowar kwayoyin.

Irin wannan bambancin an ƙirƙira shi da gangan. Godiya gareshi, ana amfani da insulin Humalog da kuma ma'anarta ta dukkan marassa lafiya da ke dauke da ciwon sukari na 1, cike da rashi na jigilar jigilar kwayar cutar, da kuma marassa lafiya da ke da nau'in ciwon sukari na 2, wanda membranes din jikinsu ya samar da juriyar insulin (rigakafi) zuwa jarin nasu na insulin.

Insulin - hormone jigilar kaya wanda ke "buɗe" ƙwayar sel don glucose

Magungunan ƙwayoyin cuta tare da Lizpro-sake-sake kwayoyin halitta suna cikin homonin insulin na aikin ultrashort. Lokaci da ake tsammanin faɗuwar glucose a cikin jini shine minti 10-20 bayan gudanarwa a fata. Matsakaicin mafi girman yanayi za'a lura da shi cikin awa 1 zuwa 3, kuma jimlar tasirin hypoglycemic shine 3-5 awanni.

Don bayani. Masu ƙwararrun masu fama da cutar insulin sun san, kuma “masu farawa” ya kamata su tuna cewa allurar da ake kira ultrashort hormone zata shafi duka manya da yaro - bayan mintuna 10, idan kun shigar dashi ƙarƙashin fata a cikin ƙananan ciki, kuma bayan minti 20, idan allurar ta kasance sanya a kafada. Ko yaya dai, tsawon lokacin tasirin yana da nasaba da mutum ne, kuma yana iya canzawa kan lokaci.

Babban hanyar aiwatar da aiki shine tsarin metabolism-lipid metabolism da taimako a cikin amfani da glucose ta sel, saboda sake gina adadin insulin din da ya bace, ba tare da wannan babban tushen makamashi (glucose) ba zai iya zuwa ta membranes din sel a tsakiyarsu.

Bugu da ƙari ga ɗaukar glucose da rage yawanta a cikin jini, insulin Humalog yana da waɗannan tasirin:

• Yana kara yawan kiwan acid, glycerol da glycogen a cikin sel na tsotsan tsoka,
• yana haɓaka samar da ƙwayoyin gina jiki,
• yana ƙara yawan amfani da amino acid,
• lowers cikin adadin kumburin glycogenolysis da gluconeogenesis.

A bayanin kula. Af, idan aka kwatanta da kwayar halitta ta dan adam mai narkewa na insulin hormone, darajar raguwar hauhawar jini bayan cin abinci a cikin Lizpro Insulin shine yafi bayyana.

Ana amfani da duk shirye-shiryen insulin a kan tushen tsarin abincin da iyakarta 1700-3000 kcal

Alamu, contraindications, sakamako masu illa da sauran nuances

Umarnin don maganin Insulin Humalog yana ɗauke da abubuwa masu zuwa:

• Alamu - T1DM, T2DM, ciwon suga na cikin mahaifa, matsanancin insulin jinkirin insulin, rashin lafiyar postprandial hyperglycemia, ba zato ba tsammani ya haɗu da cuta wanda ke rikita yanayin ciwon sukari, da tiyata ga mai fama da ciwon sukari.
• Contraindications - yanayin hyperglycemic, ƙara yawan hankalin mutum.
• Tasirin sakamako - insulin ruwan tabarau na wucin gadi, kumburin insulin da alamu na yau da kullun na hypoglycemic:
  1. ciwon kai
  2. m pallor na fata,
  3. gumi, karuwar haɓakar hauka,
  4. bugun zuciya da yawan zuciya
  5. reshe na rawar hannu, murkushe tsoka, karkatarwar mahaifa, paresthesias da nau'ikan paresis,
  6. raguwa cikin ayyukan ilimi,
  7. tashin hankalin bacci
  8. damuwa.

Glucagon allura dole ne ya kasance cikin kayan agaji na kayan agaji na mutum

• Yawan shaye-shaye - yawan ƙwayoyin cuta da ƙwayar cuta. Waɗannan sharuɗɗan an dakatar da su ta hanyar amfani da subcutaneous ko gudanarwar intanet na glucagon. Idan babu irin wannan magunguna ko kuma sakamakon amfanin sa na abin da ake so bai samu ba, ana yin allurar gaggawa game da ƙasan glucose din a cikin jijiya.
• Gargadi. A cikin marasa lafiya da kodan matsala da hanta, yayin tsananin motsawa ta jiki, a cikin rashin carbohydrates a cikin abinci, haka kuma a cikin maganin beta-blockers, sulfonamides ko MAO inhibitors, lokacin shan barasa ko barasa mai dauke da kwayoyi, buƙatar maganin yana iya ƙima. Beara yawan kashi na iya buƙata yayin cuta mai saurin kamuwa, yayin abubuwan jin daɗi, yayin cin zarafin abinci, yayin jiyya tare da thiazide diuretics, maganin hana haihuwa, maganin tricyclo-antidepressants da glucocorticosteroids.
• Sashi Lizpro (Humalog) yana sanya fata a karkashin fata, daga sau 4 zuwa 6 a rana. Ana amfani da kashi ɗaya, adadi da lokacin kowane allura ta hanyar endocrinologist. Jectionaya daga cikin allura tare da kashi sama da 40 SHAWARA ya halatta a lokuta na musamman. Lokacin canzawa zuwa Lizpro monotherapy tare da analogues na naman alade da sauri, ana iya buƙatar daidaita sashi. Yayin bayarwa kuma kai tsaye bayan sa, ana bada shawarar rage yawan magungunan. Uwa mai shayarwa da mahaifiyar ta mai fama da cutar sanƙara kuma na iya buƙatar awo da / ko daidaita abinci.
• Siffofin ajiya da amfani. Ya kamata a adana shirye-shiryen insulin a saman shiryayyen firiji. Kafin gudanar da aikin, kashi 'ana dumama', ana mirgine shi tsakanin tafin hannu daga sau 10 zuwa 20. Hakanan ya kamata a kula don tabbatar da cewa allurar bata shiga cikin jini ba.

Gargadi! Tare da gabatarwar shirye-shiryen sanyi, idan barasa ya shiga fata, ko kuma kawai saboda tasirinta anabolic na gida, lahani na kwaskwarima (lipohypertrophy) na iya samarda, wanda zai rage yawan shan ƙwayoyi. Sabili da haka, lokacin yin allura, kuna buƙatar canza kullun wuraren injections, kuma lokacin huda a yanki ɗaya, alal misali, kan ciki, barin nesa na 1 cm tsakanin su.

Bambanci Humalog Mix 50 da Mix 25 daga ultramort Humalog

A cikin shirye-shiryen da aka haɗaka Humalog a containsari yana exunshe da tsofaffi 6

Insulin Humalog Mix 50 da Insulin Humalog Mix 25 wakilai ne na haɗin gungun insulin. Sunadarai ne na maganin maganin Lizpro na ultrashort tare da dakatarwar prozine na Lizpro, wanda ke alakanta kwayoyin hoko na matsakaici. Matsakaicin waɗannan abubuwan a cikin Mix shine 50 - 1 zuwa 1, kuma a cikin Mix 25 - 1 zuwa 3.

Saurin farawa na aiki ga duk Humalogs iri ɗaya ne, amma tsawon lokacin ganiya (matsakaiciyar ƙwaƙwalwar jini a cikin jini) ya bambanta, kuma saboda haɗin Lizzpro protamine, aikin na bayanan insulin yana da tsawo. Godiya ga wannan, allura 3-2 a kowace rana na MIX50 ko 2-1 na MIX25 zai isa ga wasu marasa lafiya.

Fasali na amfanin hada shirye-shiryen Humalog

Katin katako da ɗayan nau'ikan Saurin Pen-injector

Masu ciwon sukari da suka haɗa nau'ikan Insulin Humalog, saboda gaskiyar cewa Lizpro protamine yana cikin dakatarwa, kuma akwai magabata cikin shirye-shiryen, ba wai kawai yakamata a shayar da ƙwayar ne kafin allura ba, amma ya kamata a kiyaye matakan kiyayewa kamar haka:

• sake tayar da ruwa ta jujjuya kirinin ko siraran alkalami 180 digiri,
• yawan juyawa - sau 10-12,
• saurin yanayi da yanayin motsi suna da laushi, kusan sau 1 a dakika daya,
• yi hattara da bayyanar kumfa, wanda za a iya nunawa a rage raguwa,
• idan kun ji amo yayin yin tsegumi, kada ku firgita kuma kada ku girgiza miyagun ƙwayoyi don ban sha'awa - kowane katifa ko alƙalmi mai sauri yana ƙunshe da ƙaramin ƙwallon da ke taimakawa haɗe dukkan abubuwan maganin.

Mahimmanci! Idan, bayan wiggling, haɗin haɗuwa bai sami daidaitaccen daidaituwa ba kamar madara, amma flakes ya bayyana, an haramta amfani da irin wannan shiri.

Sharuɗɗa don amfani da Allonn Dokoki na Sifet

Idan maɓallin an matsa shi da ƙarfi a cikin bin duk ƙa'idodin ƙaddamarwar gabatarwar, maye gurbin alkairin sirinji tare da sabon

A halin yanzu, duka mai insulin Humalog mai tsabta ta ƙarshe, da kuma haɗin Humalog Mix-50 da Humalog Mix-25, ana samun su cikin allon alkawuran da za'a iya amfani dashi.

Lokacin amfani da irin waɗannan na'urorin da suka dace, dole ne a kiyaye waɗannan ƙa'idodi da matakan kiyayewa:

• kar a sanya allurar sirinjika ga wasu masu cutar sikari,
• don kowane allura mai zuwa, ɗaukar sabon allurar Becton Dickinson & C,
• Kada kayi amfani da alkalami mai lalacewa, kuma koyaushe ka ɗauki na biyu tare da kai, wanda zai zama da amfani idan aka gano "kwatsam" gano ƙarancin kayan da ake buƙata don allura guda,
• masu ciwon sukari na gani na gani don allura da alkalami suna buƙatar taimakon mutanen da za su iya ganinta da kyau, wa za su iya amfani da shi,
• kar a cire alamar mai launin daga maɓallin shigar da siket, zai iya zama da amfani a lokuta na gaggawa, gaya wa likitan motar asibiti wanne magani ya kasance asalin cutar hypoglycemic precoma ko coma,
• al'adun gargajiya na yau da kullun kafin kowane allura ya kamata su kasance masu lura da rayuwar ƙwayar cuta da kuma bincika shirye-shiryen sirinji don amfani (sakewa da ɗan adadin ruwa a cikin rafi na bakin ciki), kuma bayan an gama aikin, sa idanu sauran adadin maganin,
• stiarfin bugun bugun maɓallin shigarwar kashi yana aiki ne da diamita na allura da take hakkin ƙarfinta, da sauri da matsi mai kaifi, ƙura ko wasu ƙananan ƙwayoyin injina na shiga cikin na'urar,
• ci gaba da sirinji da allura na keɓance musamman, ajiya tare da allura da aka haɗe zai haifar da iska ta shiga cikin maganin, wanda zai haifar da raguwar ganuwa cikin gwargwadon kulawa,
• lokacin zafi, lokacin amfani da alƙalami mai suturar gida a waje, yi amfani da murfin murfin musamman don adana shi,
• Nemi shawara daga likitan kimiyar endocrinologist akan inda kuma yadda zaka zubar da allura, sirinji, da kuma cika makullan foda.

Kuma a ƙarshe, muna ba da shawarar kallon umarnin bidiyo daga likitancin endocrinologist a kan ka'idoji da dabaru don gudanar da shirye-shiryen insulin, dangane da nau'in na'urar da ake amfani da waɗannan magungunan hormonal.

Form sashi

Dakatarwa na gudanarwar subcutaneous.

1 ml ya ƙunshi:
abu mai aiki: insulin lispro 100 IU,
magabata: metacresol 2.2 mg. phenol ruwa 1.0 mg, glycerol (glycerin) 16 mg, protinine sulfate 0.19 mg, sodium hydrogen phosphate heptahydrate 3.78 mg, zinc oxide qs don samun zinc ion 30.5 μg, ruwa don allura har zuwa 1 ml, maganin 10% na hydrochloric acid da / ko 10% maganin sodium hydroxide zuwa pH na 7.0-7.8.

Wani farin dakatarwa wanda ke bayyanawa, yana haifar da farin tsinkaye da bayyananne, mara launi ko kusan madaukakin launi. A sauƙaƙe za a sake tura shi cikin saurin girgiza kai.

Kayan magunguna

Pharmacodynamics
Humalog Mix 50 wani shiri ne da aka yi da kansa wanda ya kunshi maganin insulin lispro 50% (analog ɗin aikin insulin na ɗan adam) da kuma dakatarwar protamine na insulin lispro 50% (analog na insulin na ɗan adam na matsakaici).

Babban aikin insulin lyspro shine tsari na metabolism metabolism.

Bugu da ƙari, yana da tasirin anabolic da anti-catabolic akan ƙoshin jikin mutane daban-daban. A cikin ƙwayar tsoka akwai karuwa a cikin abun da ke ciki na glycogen, kitse, glycerol. increasedara yawan haɓakar furotin da karuwar amino acid, amma akwai raguwa a cikin glycogenolysis, gluconeogenesis. ketogenesis. lipolysis. furotin furotin da sakin amino acid.

An nuna insulin Lyspro daidai yake da insulin na mutum, amma tasirin sa yana da sauri kuma yana ƙaruwa.

Cikakken kamfani da kuma farawar insulin ya dogara da wurin allura (ciki, cinya, gindi), kashi (girman insulin allura), wadatar jini, zafin jiki da aikin jiki.

Bayan allurar subcutaneous na Humalog® Mix 50, ana fara ɗaukan fara aiki da farkon farawa na babban aikin insulin lispro. An fara aiwatar da maganin ne bayan kimanin mintina 15, wanda ke ba da izinin sarrafa maganin nan da nan kafin abinci (mintuna 0-15 kafin abinci), idan aka kwatanta da insulin ɗan adam na yau da kullun. Bayan allurar subcutaneous na Humalog® Mix 50, ana fara ɗaukan fara aiki da farkon farawa na babban aikin insulin lispro. Bayanin aikin insulin lyspro protamine yayi kama da bayanan aikin insulin-isophan na al'ada tare da tsawon kimanin awanni 15.

Pharmacokinetics
Pharmacokinetics na insulin lispro yana bayyanuwa ta hanyar ɗaukar hanzari zuwa hanzari da kaiwa ga mafi yawan daidaituwa a cikin jini 30-70 mintuna bayan allurar ƙarƙashin ƙasa. Magungunan magunguna na dakatarwar insulin lysproprotamine sun yi kama da na insulin-matsakaici mai aiki (insulin-isophan). Pharmacokinetics na miyagun ƙwayoyi Humalog Mix 50 an ƙaddara shi da ƙayyadaddun magunguna na mutum guda biyu na maganin.

Tare da gudanar da insulin lyspro, sha yana da sauri fiye da insulin ɗan adam mai narkewa a cikin marasa lafiya tare da gazawar koda. A cikin marasa lafiya waɗanda ke da nau'in ciwon sukari na 2 na mellitus, ana lura da bambance-bambancen magani tsakanin insulin lyspro da insulin ɗan adam mai yawa a cikin aikin aiki na renal, ba tare da la'akari da aikin na koda Tare da gudanar da insulin lyspro, ana lura da ɗaukar sauri da kawar da sauri idan aka kwatanta da insulin ɗan adam mai narkewa a cikin marasa lafiya tare da gazawar hanta.

Tare da kulawa:

Lokacin daukar ciki da shayarwa,
Tare da gazawar koda, gazawar hanta, damuwa na damuwa, ƙara yawan aiki na jiki, canji a cikin abincin da aka saba, ana buƙatar canjin insulin kuma ana buƙatar daidaita sashin insulin.
Tare da tsawan lokaci na ciwon sukari mellitus, diabetic neuropathy ko tare da yin amfani da wakilai na toshe-adrenergic tarewa, alamu waɗanda ke annabta hypoglycemia na iya canzawa ko ƙasa da aka faɗi.

Yi amfani yayin ciki da shayarwa

Nazarin dabbobi bai bayyana isasshen haihuwa ko mummunan tasirin insulin lyspro akan tayi ba. Ba a sami gwajin asibiti da aka sarrafa ba game da amfani da insulin lyspro a cikin mata masu juna biyu. Tunda bincike game da tasirin kwayoyi akan haihuwar dabbobi ba koyaushe ne ke bada izinin fassarar abubuwan da aka samu akan jikin ɗan adam ba, yakamata a yi amfani da magungunan Humalog® Mix 50 yayin samun juna biyu ne kawai idan akwai buƙataccen asibiti.

Marasa lafiya da ciwon sukari, yana da shawarar sanar da likita game da farawa ko shirin da aka shirya yi.

A lokacin daukar ciki, yana da mahimmanci musamman a kula da yanayin marasa lafiyar da ke karɓar maganin insulin. Bukatar insulin yawanci yakan ragu yayin tashin farko kuma yana ƙaruwa yayin watanni na biyu da na uku. Lokacin kuma kai tsaye bayan haihuwa, buƙatun insulin na iya raguwa kwatsam.

Marasa lafiya da ke fama da cutar sankara a lokacin shayarwa na iya buƙatar daidaita sashin insulin, abinci, ko duka biyun.

Sashi da gudanarwa

Yawan maganin Humalog Mix 50 ne likita ke ƙaddara shi daban-daban, gwargwadon maida hankali ne akan glucose na jini.

Tsarin sarrafa insulin shine mutum ɗaya.

Ya kamata a gudanar da miyagun ƙwayoyi kawai a ƙarƙashin ƙasa. Ba a yarda da kula da ƙwayar ƙwayar ƙwayar cutar Humalog® Mix 50 ba.

Zazzabi na miyagun ƙwayoyi da aka sarrafa ya kamata ya kasance da zazzabi a ɗakin.

Ya kamata a bai wa allurar da ruwa a kafada, cinya, gindi ko ciki. Dole ne a sauya wuraren allurar don kada a yi amfani da wurin iri ɗaya ba kusan sau ɗaya a wata ba. Tare da subcutaneous management na Humalog® Mix 50 shirye-shiryen, yakamata a kula don hana magungunan shiga cikin ƙwayar jijiyoyin jini. Bayan allurar, bai kamata a sanyaya wurin da allura ba.

Don shawarwari kan shigar da katun a cikin na'urar don gudanar da shirye-shiryen Humalog® Mix 50 da riƙe allura a ciki kafin gudanar da maganin, karanta umarnin masana'anta don na'urar don sarrafa insulin. Dogara bin umarnin karantawa.

Bayan subcutaneous management na Humalog® Mix 50 shirye-shiryen, ana fara fara aiki da sauri da farawa a cikin aikin insulin lyspro. Godiya ga wannan, ana iya gudanar da Humalog® Mix 50 nan da nan kafin ko bayan abincin. Yawan aiwatar da dakatarwar insulin lysproprotamine. wanda shine ɗayan Humalog Mix 50. Ya yi daidai da tsawon lokacin aikin insulin-isophan.

Bayanan martaba na aikin insulin, ba tare da la'akari da nau'inta ba, yana ƙarƙashin mahimmancin canzawa duka a cikin marasa lafiya daban-daban dangane da halaye na mutum, kuma a cikin haƙuri ɗaya dangane da wani takamaiman lokaci. Kamar kowane shiri insulin, tsawon lokacin aiwatarwar Humalog® Mix 50 ya dogara da kashi, wurin allura, wadatar jini, zafin jiki da aikin jiki.

Shirye-shirye don gabatarwar
Nan da nan kafin a yi amfani da shi, yakamata a ɗaura murfin Humalog® Mix 50 a tsakanin tafin hannu ya ninka sau goma kuma ya girgiza, yana jujjuya 180 ° sau goma don sake ɗibuwa cikin insulin har sai ya zama ruwan da zai zama ruwansa. Kada ku girgiza sosai, saboda wannan na iya haifar da bayyanar kumfa, wanda zai iya tsoma baki tare da madaidaicin kashi. Don sauƙaƙe haɗuwa, ƙaramin ƙwallon gilashi yana cikin kicin.

Kada ku yi amfani da Humalog® Mix 50. idan ya ƙunshi flakes bayan haɗuwa.

Gudanarwa

1. Wanke hannuwanku.
2. Zaɓi wurin yin allura.
3. Shirya fata a allurar kamar yadda likitanka ya ba ka shawarar.
4. Cire kwalfar kariya ta waje daga allura.
5. Gyara fata, tattara shi a babban yanki.
6. Saka allura a ƙarƙashin abu guda biyu kuma ana yin allura daidai da umarnin don amfani da alkairin sirinji.
7. Cire allura kuma a hankali matsi wurin allurar tare da swam auduga tsawon sakanni. Kar a shafa wurin allurar.
8. Yin amfani da matattarar murfin waje, kwance allurar kuma ka watsar dashi.
9. Saka hula a allon syringe.

Don Humalog ® Haɗa shiri 50 a cikin allonnn rubutun siririn QuickPen TM.
Kafin gudanar da insulin, ya zama dole don sanin kanka tare da alƙalami na QuickPen TM.

Side sakamako

Hypoglycemia shine mafi tasirin sakamako na yau da kullun wanda ke faruwa tare da gabatarwar duk shirye-shiryen insulin, gami da Humalog Mix 50. Babban tsananin rashin ƙarfi na iya haifar da asarar hankali kuma. a lokuta na musamman, ga mutuwa.

Allergic halayen: marasa lafiya na iya fuskantar halayen rashin lafiyan gida ta hanyar jan launi, kumburi, ko ƙaiƙayi a wurin allurar. Wadannan ƙananan halayen sukan ɓace cikin withinan kwanaki ko makonni. A wasu halaye, waɗannan halayen na iya lalacewa ta hanyar dalilan da basu da nasaba da insulin, alal misali, haushi na fata tare da wakilin tsarkakewa ko allurar da ba ta dace ba.

Tsarin halayen rashin lafiyar jikilalacewa ta hanyar insulin yana faruwa ba koyaushe ba, amma mafi muni. Ana iya bayyanar da su ta hanyar itching na gaba ɗaya, gazawar numfashi, ƙarancin numfashi, Rage saukar karfin jini, tachycardia, haɓaka hawaye. Mummunan lokuta na halayen rashin lafiyan halayen na iya zama barazanar rayuwa. A cikin lokuta mafi ƙarancin rashin lafiyar mai haɗari ga Humalog® Mix 50, ana buƙatar magani na gaggawa. Kuna iya buƙatar canza insulin, ko rashin isasshen magani.

Tare da amfani da tsawan lokaci - ci gaba mai yiwuwa ne lipodystrophy a wurin allurar.

Saƙonnin mara kan gado:
Kwayoyi na haɓakar edema sun bayyana, akasari, tare da saurin kai yawan ƙwayar glucose a cikin jini sabanin asalin maganin kwantar da hankali tare da kulawar glycemic marasa ƙarfi.

Yawan abin sama da ya kamata

Yawan yawan insulin da yawa yana haifar da yawan zubar jini, tare da alamomin masu zuwa: sanyin jiki, karuwar gumi, tachycardia, pallor na fata, ciwon kai, rawar jiki, amai, rikicewa. A ƙarƙashin wasu yanayi, alal misali, tare da tsawon lokaci na cutar ko tare da sanya idanu sosai game da ciwon sukari mellitus, alamun bayyanar cututtukan jini na iya canzawa.

Sau da yawa ana iya dakatar da ƙin jinin haila ta hanyar rage yawan glucose ko sukari. Ana buƙatar buƙatar daidaita daidaituwa na insulin, abincin, ko aikin jiki. Ana iya aiwatar da gyaran hypoglycemia na matsakaici ta amfani da intramuscular ko subcutaneous management na glucagon. sai suka shigo da carbohydrates. Yanayin mawuyacin halin hypoglycemia, tare da coma, huda ko raunin jijiyoyin jiki, an dakatar da su ta hanyar gudanarwar glucagon ko gudanarwar cikin jijiya na maganin rage ƙwayar cuta (glucose). Bayan ya dawo da hankali, dole ne a bai wa mara lafiya abinci mai-carbohydrate don hana sake haɓakar cutar sikari. Ana iya buƙatar ƙarin cin abinci na carbohydrates da sa ido na mai haƙuri a gaba, tun da yiwuwar sake dawowa daga cututtukan cututtukan fata zai yiwu.

Yin hulɗa tare da wasu kwayoyi

Ragewar hypoglycemic na maganin Humalog 50 Mix 50 an rage shi lokacin da aka yi amfani dashi tare da magunguna masu zuwa: maganin hana haihuwa, glucocorticosteroids, iodine-wanda ke dauke da kwayoyin hodar thyroid, danazol. beta₂adrenergic agonists (misali, ritodrin, salbutamol, terbutaline), thiazide diuretics, chlorprothixene, diazoxide. isoniazid, nicotinic acid, abubuwan da aka samo asali na phenothiazine.

Tasirin hypoglycemic na Humalog® Mix 50 yana haɓaka ta: beta-blockers, ethanol da ethanol dauke da kwayoyi, magungunan anabolic, fenfluramine, guanethidine, tetracyclines, magungunan maganin hypoglycemic na baki. salicylates (misali acetylsalicylic acid), maganin guba na sulfonamide, wasu maganin antidepressants (monoamine oxidase inhibitors), angiotensin-canza masu inzyme enzyme (captopril, enapril), octreotide, angiotensin II receptor antagonists.

Masu tallata Beta. clonidine, reserpine na iya rufe bayyanar alamun bayyanar cututtuka na hypoglycemia.

Ba a yi nazarin hulɗan Humalog® Mix 50 tare da sauran shirye-shiryen insulin ba.

Idan kuna buƙatar amfani da wasu magunguna, ban da insulin, nemi likita.

Yin amfani da Humalog® Mix 50 a lokaci guda tare da magungunan thiazolidinedione na iya kara haɗarin edema da rauni a zuciya, musamman a cikin marasa lafiya da cututtukan cututtukan zuciya.

Umarni na musamman

Canja wurin mara lafiya zuwa wani nau'in ko shirya insulin tare da sunan kasuwanci na daban ya kamata ya faru a ƙarƙashin tsayayyar kulawar likita. Canji a cikin aiki, alama (masana'anta), nau'in (insulin narkewa, insulin-isophan, da sauransu). nau'in (dabba, ɗan adam, analog na insulin ɗan adam) da / ko hanyar samarwa (DNA na sake haɗa insulin ko insulin asalin dabbobi) na iya buƙatar daidaita sikelin.

A cikin wasu marasa lafiya, gyaran kashi na iya zama dole yayin juyawa daga insulin dabbobi da aka samo zuwa insulin mutum. Wannan na iya faruwa a farkon aikin insulin na mutum ko a hankali cikin weeksan makonni ko watanni bayan canja wurin.

Yanayin rashin daidaituwa na yanayin rashin daidaituwa ko yanayin haɓakawa na iya haifar da asarar sani, ko wari, ko mutuwa. Bayyanar cututtukan cututtukan cututtukan jini na iya canzawa ko kuma ba a faɗi ƙima tare da mellitus na sukari mai tsawo, neuropathy masu ciwon sukari, ko magani tare da kwayoyi kamar beta-blockers.

Inarancin magunguna ko dakatar da magani, musamman a cikin marasa lafiya da ke da nau'in ciwon sukari na type 1, zai iya haifar da hyperglycemia da ketoacidosis na ciwon sukari (yanayin da ke haifar da barazanar rayuwa ga mai haƙuri).

Bukatar insulin na iya raguwa tare da gazawar renal, haka kuma tare da gazawar hanta saboda raguwa a cikin ƙarfin gluconeogenesis da raguwa a cikin metabolism, duk da haka, a cikin marasa lafiya tare da gazawar hanta na rashin ƙarfi, ƙarancin juriya na insulin na iya haifar da karuwa a cikin buƙatar hakan.

Bukatar insulin na iya ƙaruwa tare da wasu cututtukan ko tare da wucewar zuciya.

Ana iya buƙatar gyaran kashi na insulin tare da karuwa a cikin aiki na jiki ko tare da canji a cikin abincin da aka saba. Motsa jiki na iya haifar da haɗarin hauhawar jini.

Lokacin amfani da shirye-shiryen insulin a hade tare da kwayoyi na rukunin thiazolidinedione, haɗarin haɓakar edema da rauni na zuciya yana ƙaruwa, musamman a cikin marasa lafiya da cututtukan tsarin zuciya da kasancewar abubuwan haɗari don raunin zuciya.

Don hana yiwuwar watsa wata cuta mai rarrafe, kowane mai haƙuri guda ɗaya zai iya amfani da shi, koda kuwa an maye gurbin allura. Ya kamata a yi amfani da katako tare da Humalog® Mix 50 tare da alkalannin sirinji waɗanda aka alama alamarsu. daidai da umarnin mai ƙirar na'urar.

Tasiri kan iya tuka motoci da injinan

A yayin hypoglycemia na haƙuri, yawan tattara hankali da saurin halayen psychomotor na iya raguwa. Wannan na iya zama haɗari a cikin yanayi inda waɗannan damar ke da mahimmanci musamman (misali, tuƙi motoci ko kayan wuta).

Ya kamata a shawarci marassa lafiya su yi taka-tsantsan don kauce wa hauhawar jini yayin tuki motoci da na inji. Wannan yana da mahimmanci musamman ga marasa lafiya da alamu masu raɗaɗi ko rashi, masu gabatar da ƙanƙanin jini ko tare da haɓakar haɓakawar jini. A irin waɗannan halayen, likita dole ne ya kimanta yiwuwar tuki mai haƙuri tare da abubuwan hawa da ƙwararorin inji.

Fom ɗin saki

Dakatarwa ga subcutaneous management na 100 IU / ml.

Mawartattun hotuna:
3 ml na miyagun ƙwayoyi a kowane gwal. Kayan katako guda biyar a cikin leda. Blaya daga cikin laushi tare da umarnin don amfani a fakitin kwali.

Siffar kalmomin QuickPM TM:
3 ml na miyagun ƙwayoyi a cikin katangar, an gina shi cikin alƙalin sihiri na Pen TM. Biyar maɓallin syringe guda biyu na QuickPen TM, kowannensu tare da umarnin yin amfani da shi da alkalami mai sihiri na QuickPEN TM, don amfani a cikin fakitin kwali.

Suna da adireshin mai samarwa

Mai masana'anta da kwantena:
Lilly Faransa, Faransa
2 Ru du Colonel Lilly. 67640 Fegersheim, Faransa

Kwali da bayarda ingantaccen iko:
Lilly Faransa, Faransa
2 Ru du Colonel Lilly. 67640 Fegersheim
ko
Eli Lilly da Kamfanin Kamfanin Amurka (Quick Pen Syringe TM)
Indianapolis. Indiana 46285

Nazarin likitoci game da haɗakar humalogue 50

Rage yawan allura daga 5-6 zuwa 3 (ana amfani da insulin sau uku a rana kafin manyan abinci). Penaya daga cikin alkalami guda biyu maimakon biyu - babu ruɗami ga tsofaffi kuma ba sosai ga marasa lafiya ba. Yana aiki mai kyau tare da nau'in ciwon sukari na 2 lokacin da ake buƙatar gyaran postprandial fiye da basal. Ga marasa lafiya da keɓaɓɓen ƙwayar cuta tsakanin abinci (saboda insulin basal ya ƙasa da na sauran haɗuwa).

Haɗin farko na 50 zuwa 50 - rabin basal, rabi ultrashort. Zai fi dacewa ga marasa lafiya da masu ciwon sukari na 2 wanda a baya suka karɓi aikin insulin a cikin tsarin maganin 'bolus basic'. Yanzu, masu haƙuri na da dogon tarihin ciwon sukari, tare da encephalopathy, ba za su taɓa rikitar da insulin “dogon” tare da “gajere” ba!

Yawan allura sau 2 a rana maimakon 4-5.

Ana buƙatar ingantaccen tsarin kula da abinci da abinci.

Amfani da haɗakar insulins yana buƙatar kyakkyawan hankali don ƙididdige menu da abincin, kyakkyawar ƙwarewa wajen ƙididdigewa da kimanta ƙimar macronutrients. Kuna iya kallon wannan a matsayin tabbatacce, yayin da horar da kai na haƙuri ya karu, an kawar da kuskuren abinci mai gina jiki.

Da fatan za a karanta waɗannan umarni kafin amfani.

Gabatarwa
M Pen Syringe Pen yana da sauƙin amfani. Na'ura ce don gudanar da insulin (wani “insulin insringe pen”) mai ɗauke da 3 ml (raka'a 300) na shirin insulin tare da yin 100 IU / ml. Zaka iya yin allura daga 1 zuwa 60 raka'a insulin a allurar. Zaka iya saita kashi tare da daidaitaccen raka'a ɗaya. Idan ka sanya raka'a da yawa. Kuna iya gyara kashi ba tare da asarar insulin ba.

Kafin amfani da sirinjin alkalami na QuickPen, karanta wannan jagorar gaba ɗaya kuma bi umarnin ta daidai. Idan ba ku cika bin waɗannan umarnin ba, zaku iya karɓar ko mara nauyi ko ya yi yawa a insulin.

Dole a yi amfani da allon insulin na QuickPen don allurar ka. Kada a sanya alkalami ko allura ga wasu, saboda wannan na iya haifar da watsa kwayar cutar. Yi amfani da sabon allura don kowane allura.

KADA KA YI AMFANI da maɓallin sirinji idan wani ɓangarorin sa ya lalace ko ya karye. Koyaushe riƙi alkalami na sihiri wanda aka rasa idan ya rasa alkairin syringe ko kuma ya lalace.

Ba'a ba da shawarar yin amfani da maɓallin sirinji don marasa lafiya da cikakkiyar asarar hangen nesa ko mai rauni na gani ba tare da taimakon mutane masu gani sosai da aka horar da su don amfani da maɓallin sirinji ba.

Shiri Na Saurin Syringe

Bayani masu mahimmanci

• Karanta kuma bi kwatance don amfani da aka bayyana a cikin umarnin don amfani da miyagun ƙwayoyi.
• Bincika lakabin akan almalin syringe kafin kowane allura don tabbatar da cewa sam sam ɗin ɗin bai ƙare ba kuma kana amfani da insulin daidai: kar a cire alamar ta daga alkairin sirinji.

Lura: launin launi na mabuɗin sakin layi na QuickPen alkalami wanda ya dace da launi na tsiri a kan alamar sirinji kuma ya dogara da nau'in insulin. A cikin wannan jagorar, an saka maɓallin kashi. Wakar shuɗi mai saurin canzawa ta jiki watau QuickPen pen syringe pen tana nuna hakan. an yi nufin amfani dashi tare da samfuran Humalog®.

Short Short

Humalog Mix 50 - insulin na insulin-gajeran aiki da insulin na yau da kullun. Ya lowers sukari jini. Yana nuna tasirin anabolic, yana hana catabolism a cikin gabobin jiki da kyallen takarda da yawa. Yana da taro iri ɗaya tare da insulin ɗan adam, amma yana farawa da sauri. Bayan subcutaneous management, ya fara aiki a kan matsakaici bayan mintina 15, wanda zai ba ka damar yin allura nan da nan kafin cin abinci. Matakan insulin cikin jini ana lura da mintuna 30-70 bayan gudanarwa. Shawarwarin amfani da na'urar don gudanar da maganin an saita su a cikin kunshin kunshin. Kafin yin aikin, ya wajaba a bayar da daidaiton bayani na insulin, wanda kifin tare da maganin yana birgima sau da yawa tsakanin tafin hannu ya juya. Ba a bada shawarar girgiza mai ƙarfi ba saboda A wannan yanayin, kumfa na iya tsoma baki tare da ingantaccen allurar. Don sauƙaƙe tashin ruwa, an sanya ƙaramin ƙaramar gilashi a cikin kicin. Kasancewar flakes bayan haɗuwa shine tushe don ƙin amfani da miyagun ƙwayoyi. A wanke hannaye sosai kafin allurar. Ana yin allura cikin tarin fatar jiki wanda aka gyara tare da yatsun hannun kyauta. Bayan an cire allura, sai a matattar da allurar a hankali har na daƙiƙa tare da swab na auduga. Bayan allura, an sake sake amfani da allurar, kuma an rufe alkairin sirinji tare da maɓallin kariya. Kafin gudanarwa, dole ne a kawo maganin zuwa ɗakin zazzabi. Ana yin allurar subcutaneous a cikin ƙwayar tsoka, quadriceps, bangon ciki, gluteus maximus. Dole ne a kula sosai don gabatar da mafita a cikin jinin jini. Agingarfafa shafin injection ba da shawarar ba. Daga cikin halayen da ba a so ba tare da alaƙa da amfani da haɗin Humalog 50 ba, har ma da sauran shirye-shiryen insulin, mafi yawan cututtukan jini. A cikin lokuta mawuyacin hali, asarar rai tare da yuwuwar sakamako mai illa ba a cire shi.

Wasu lokuta marasa lafiya na iya haɓaka halayen ƙwayar cuta na gida, wanda aka nuna ta hyperemia, kumburi, itching a wurin allurar. Irin waɗannan halayen ba su da muhimmiyar mahimmanci a asibiti kuma a mafi yawan lokuta suna wucewa ne ba tare da wani maganin warkewa ba. Commonarancin gama gari (amma mafi tsananin rauni, ciki har da barazanar rayuwa) alamun bayyanar rashin lafiyan tsari ne: ƙoshin kai, gajeriyar numfashi da saurin numfashi, tashin zuciya, bugun zuciya, bugun zuciya. A irin waɗannan halayen, ana buƙatar matakan warkewa da gaggawa. Tare da yin amfani da tsawan lokaci tare da gudanarwa akai-akai a wuri guda a jere, lipodystrophy na gida na iya haɓaka. Tasirin miyagun ƙwayoyi yana raguwa lokacin da ake amfani dashi tare da rigakafin kwamfutar hannu, hormones glucocorticosteroid, sinadarin iodine-mai dauke da sinadarin beta, 2 adrenoreceptor, thiazide diuretics, antipsychotic chlorprotixene, potassium channel activator diazoxide, isotonic tarin fuka. Masu hana Beta-adrenoreceptor, samfuran ethanol, magungunan anabolic, mai sarrafa abinci fenfluramine, mai juyayi guanethidine, maganin tetracycline da ƙwayoyin sulfonamide, magungunan ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta, magungunan salicylic acid, masu hanawa amfani da maganin cutar. Beta-adrenergic blockers, clonidine, reserpine na iya rufe alamun hypoglycemia. Yin amfani da wasu magunguna a cikin haɗin gwiwa tare da Humalog Mix 50 zai yiwu ne kawai ta hanyar yarjejeniya da likita. Yin amfani da miyagun ƙwayoyi tare da glitazones (rosiglitazone, pioglitazone) na iya ba da gudummawa ga haɓakar edema da lalata ƙwaƙwalwar zuciya.

Pharmacology

Humalog Mix 50 wani shiri ne da aka yi da kansa wanda ya kunshi maganin insulin lispro 50% (analog ɗin aikin insulin na ɗan adam) da dakatarwar protamine na insulin lispro 50% (analog na insulin na ɗan adam na matsakaici).

Babban aikin insulin lyspro shine tsari na metabolism metabolism.

Bugu da ƙari, yana da tasirin anabolic da anti-catabolic akan ƙoshin jikin mutane daban-daban. A cikin ƙwayar tsoka, akwai karuwa a cikin abun da ke ciki na glycogen, kitse mai narkewa, glycerol, haɓakar haɓakar furotin da karuwa a cikin yawan amino acid, amma a lokaci guda akwai raguwa a cikin glycogenolysis, gluconeogenesis, ketogenesis, lipolysis, catabolism na furotin da kuma sakin amino acid.

An nuna cewa insulin Lyspro yayi daidai da insulin na mutum, amma tasirin sa yana da sauri kuma yana raguwa. Bayan da allurar subcutaneous na Humalog Mix 50, ana fara ɗaukan fara aiki da farkon farawa na babban aikin inshin lyspro. Farkon maganin yana kamar mintina 15 daga baya, wanda zai baka damar sarrafa maganin nan da nan kafin abinci (mintuna 0-15 kafin abinci), in an kwatanta da insulin na ɗan adam. Bayan da allurar subcutaneous na Humalog Mix 50, ana fara ɗaukan fara aiki da farkon farawa na babban aikin inshin lyspro. Bayanan aikin insulin lyspro protamine yayi kama da bayanan bayanan aikin insulin-isophan na al'ada tare da tsawon kimanin awanni 15.

Pharmacokinetics

Cikakken kamfani da kuma haifar da tasirin insulin ya dogara da wurin allura (ciki, cinya, buttocks), kashi (girman insulin allurar), yawan insulin a cikin magunguna, da dai sauransu An rarraba shi ba tare da bambanci ba a jikin kyallen, kuma ba ya shiga cikin shinge na mahaifa da kuma cikin madara. An lalata shi ta hanyar insulinase galibi a cikin hanta da kodan. Kodan ya fitar da ita (kashi 30-80%).

Side effects

Hypoglycemia shine mafi tasirin sakamako wanda ke faruwa tare da gudanar da duk shirye-shiryen insulin, ciki har da Humalog Mix 50. Babban tsananin rashin ƙarfi na iya haifar da asarar hankali kuma, a lokuta na musamman, mutuwa.

Allergic halayen: marasa lafiya na iya fuskantar halayen rashin lafiyan gida ta hanyar jan launi, kumburi, ko itching a wurin allurar. Wadannan ƙananan halayen sukan ɓace cikin withinan kwanaki ko makonni. A wasu halaye, waɗannan halayen na iya lalacewa ta hanyar dalilan da basu da nasaba da insulin, alal misali, haushi na fata tare da wakilin tsarkakewa ko allurar da ba ta dace ba.

Abubuwan da suka shafi rashin lafiyar ƙone-ƙwaƙwalwar ƙwayar cuta ta hanyar insulin na faruwa sau da yawa, amma sun fi damuwa. Ana iya bayyanar da su ta hanyar itching na gaba ɗaya, gajeriyar numfashi, gajeriyar numfashi, Rage hauhawar jini, hauhawar zuciya, da gumi mai yawa. Mummunan lokuta na halayen rashin lafiyan halayen na iya zama barazanar rayuwa. A cikin lokuta mafi ƙarancin rashin lafiyan ƙwayar cuta zuwa Humalog Mix 50, ana buƙatar magani na gaggawa. Kuna iya buƙatar canza insulin, ko rashin isasshen magani.

Tare da yin amfani da dogon lokaci - haɓakar lipodystrophy a wurin allurar yana yiwuwa.

Haihuwa da lactation

Ba a gudanar da isasshen bincike mai kyau a cikin mata masu juna biyu. An shawarci marasa lafiya da masu ciwon sukari mellitus su gaya wa likita game da wata mai gudana ko kuma shirin yin ciki. A lokacin daukar ciki, yana da mahimmanci musamman a kula da yanayin marasa lafiyar da ke karɓar maganin insulin. Bukatar insulin yawanci yana raguwa yayin watanni 1 na ƙaruwa kuma yana ƙaruwa yayin watanni na II da III. Lokacin kuma kai tsaye bayan haihuwa, buƙatun insulin na iya raguwa kwatsam.

Marasa lafiya da ke fama da cutar sankara a lokacin shayarwa na iya buƙatar daidaita sashin insulin, abinci, ko duka biyun.

Tsarin launi na Maɓallin Sashi:

• Likita likitanku ya wajabta muku nau'in insulin mafi dacewa. Duk wani canje-canje a cikin ilimin insulin ya kamata a yi shi kawai a ƙarƙashin kulawar likita.
• Ana bada shawarar QuickPen Syringe Pen don amfani da allurar Becton. Dickinson da Kamfanin (BD) don allon alkalami.
• Kafin yin amfani da alkairin sirinji, tabbatar cewa allura ta kasance a haɗe da alkalami na syringe.
• Bi umarnin da aka bayar anan.

Tambayoyi akai-akai game da shirya QuickPen Syringe Pen don amfani

• Menene ya kamata shirin insulin ya yi? Wasu shirye-shiryen insulin sune dakatarwa, yayin da wasu ke bayyane mafita, tabbatar da karanta bayanin insulin a cikin Umarnin don amfani.
• Me yakamata in yi idan maganin da aka ƙayyade ya wuce raka'a 60? Idan maganin da aka wajabta muku ya wuce raka'a 60. Kuna buƙatar allura ta biyu, ko kuma zaku iya tuntuɓarku da likitan ku game da wannan.
• Me yasa zanyi amfani da sabon allura don kowane allura? Idan aka sake amfani da allura, zaku iya samun insulin kashi na kuskure, allura na iya toshewa, ko alkalami zai iya ɗaukar ciki, ko kuma ana iya kamuwa da ku saboda matsalar rashin ƙarfi.
• Me yakamata in yi idan ban tabbata ba nawa insulin ya rage a cikin kabad? Ansu rubuce-rubucen da hannun don haka tip na allura nuna ƙasa. Sikeli akan mai riƙe da katifar mai ƙarfi yana nuna kimanin adadin rakaɗan insulin ɗin da suka rage. KADA KA YI amfani da waɗannan lambobin don saita kashi.
• Me yakamata in yi idan ba zan iya cire hula daga almar syringe ba? Don cire hula, ja kan sa. Idan kuna fuskantar matsalar cire hula, a hankali juya kwallan a agogo kuma a juya kai tsaye kafin sakin shi. to, ja, cire hula.

Dubawa QuickPen Syringe Pen don Insulin

Bayani masu mahimmanci

• Duba insulin din din dinka kowane lokaci. Tabbatar da isar da insulin daga alkairin sirinji yakamata a yi kafin kowane allura har sai tarin asulin ya bayyana don tabbatar da cewa alkalami na shirye don kashi.
• Idan ba ku bincika cin insulin ɗinku ba kafin ƙyalli ta bayyana, zaku sami insulin kaɗan ko da yawa.

Tambayoyi akai-akai Game da yin insulin Insulin

• Me yasa zan bincika ci insulin kafin kowane allura?
  1. Wannan yana tabbatar da cewa alkalami yana shirye don kashi.
  2. Wannan yana tabbatar da cewa tulin insulin ya fito daga allura lokacin da ka latsa maɓallin kashi.
  3. Wannan yana cire iska wanda zai iya tattarawa a allura ko kabad din insulin a yayin amfani na yau da kullun.
• Me yakamata in yi idan ba zan iya danna maɓallin kashi ɗaya ba yayin binciken insulin na QuickPen?
  1. Haɗa sabon allura.
  2. Duba insulin daga alkalami.
• Me zan yi idan na ga kumburin iska a cikin kicin?
• Dole ne a bincika insulin daga alkalami.
  Ka tuna cewa ba za ku iya adana alkalami mai allura tare da allura da ke a bisansa ba, saboda wannan na iya haifar da haifar da kumburin iska a cikin jakar insulin. Blearamin kumfa ba ya shafar kashi, kuma zaku iya shigar da kashi kamar yadda kuka saba.

Gabatarwar kashi na wajibi

Bayani masu mahimmanci

• Bi dokokin asepsis da maganin antiseptics da likitanku ya ba ku.
• Tabbatar shigar da adadin da ake buƙata ta latsa da riƙe maɓallin kashi kuma sannu a hankali ƙidaya zuwa 5 kafin cire allura. Idan insulin yana faduwa daga allura, wataƙila. Ba ku riƙe allura a ƙarƙashin fata ba har ya isa.
• Samun digo na insulin a saman allurar al'ada ce. Wannan bazai shafi amfanin ku ba.
• Alƙalin sirinji ba zai ba ku damar zana awo a yawan adadin ɗakunan insulin da ke saura a cikin kicin ba.
• Idan kuna cikin shakka kun gudanar da cikakken maganin, kar ku sake yin wani magani. Kira wakilinku na Lilly ko ganin likitan ku don neman taimako.
• Idan adadinka ya wuce adadin adadin kuɗin da suka rage a cikin kicin. Kuna iya shigar da ragowar insulin a cikin wannan alkairin sirinji sannan sai a yi amfani da sabon alƙalami don kammala gudanarwar aikin da ake buƙata, KO shigar da duka kashi da ake buƙata ta amfani da sabon sirinji na siirin.
• Kayi ƙoƙarin yin allurar ta hanyar jujjuya maɓallin kashi. Ba za ku sami insulin ba idan kun juya maɓallin kashi. Dole ne a gwada maɓallin kashi a madaidaicin madaidaitan don karɓar kashi na insulin.
• Kada ayi ƙoƙarin canza sashin insulin yayin allurar.
• Ya kamata a zubar da allurar da aka yi amfani dashi daidai da bukatun zubar da shara na gida.
• Cire allurar bayan allura.

Kwayoyi Tambayoyi akai-akai

• Me yasa yake da wuya a danna maɓallin kashi lokacin da na yi kokarin yin allura?
  1. Za a iya rufe allurar ka. Yi ƙoƙarin haɗa sabon allura. Da zaran kun yi shi. Kuna iya ganin yadda insulin yake fitowa daga allura. Sannan a duba alkalami don insulin.
  2. Danna sauri akan maɓallin kashi na iya sa maballin latsa m. Mitar maɓallin kashi kaɗan na iya saukakawa sauƙi.
  3. Yin amfani da allura mafi girma diamita zai sa ya sauƙaƙa danna maɓallin kashi yayin allurar. Tuntuɓi mai ba da lafiya game da abin da girman allura ya fi muku.
  4. Idan latsa maɓallin lokacin gudanar da aikin ya kasance m bayan an gama duk abubuwan da ke sama, to, dole ne a maye gurbin alkairin sirinji.
• Me yakamata in yi idan sandunan kiakia Pen Pen ya kasance lokacin amfani dashi?
  Alkalarku zata makale idan da wahala yin allura ko saita kashi. Don hana waƙaƙan sirinji mai toshewa:
  1. Haɗa sabon allura. Da zaran kun yi shi. Kuna iya ganin yadda insulin yake fitowa daga allura.
  2. Bincika don ɗaukar insulin.
  3. Saita adadin da ake buƙata da allura.
  Karka yi yunƙurin sanya mai maƙarƙashiya mai sa maye, saboda wannan na iya lalata aikin injin ɗin sirinji.
  Latsa maɓallin sashi zai iya zama mawuyacin idan al'amari na ƙasa (datti, ƙura, abinci, insulin ko kowane ruwa) ya shiga cikin alkairin sirinji. Karka bari abar ƙazanta ta shigar da alkairin syringe.
• Me yasa insulin ta fita daga allura bayan na gama bayar da nawa?
  Wataƙila. Kun cire allurar da sauri daga fata.
  1. Tabbatar cewa kun ga lamba "O" a cikin taga alamar kashi.
  Don gudanar da kashi na gaba, danna kuma riƙe maɓallin kashi kuma a hankali ƙidaya zuwa 5 kafin cire allura.
• Me yakamata in yi idan an saita nawa kuma maɓallin sashi na bazata ya shiga ciki ba tare da allura da aka makala wa alkalami na silaji ba
  1. Juya maɓallin kashi ɗin zuwa sifili.
  2. Haɗa sabon allura.
  3. Yi insulin insulin.
  4. Saita kashi da allura.
• Me yakamata in yi idan na saita abin da bai dace ba (ya yi ƙasa sosai ko ya yi yawa)?
  Juya maɓallin kashi don dawowa ko gaba don daidaita kashi.
• Me yakamata in yi idan na ga insulin ta fito daga ɗimbin mitsitsin abu yayin zaɓin kashi ko daidaitawa?
  Kada kuyi amfani da magani, saboda maiyuwa ba za ku iya samun cikakken kashi ba. Saita maɓallin sirinji zuwa sifilin lamba kuma sake bincika wadatar insulin daga alkairin sirinji (duba ɓangaren "Ana bincika Alkalami na Silinda na QuickPen don isar da insulin"). Saita adadin da ake buƙata da allura.
• • Me yakamata in yi idan ba a iya tabbatar da cikakken magunguna na ba?
  Alƙalin sirinji ba zai ba ku damar saita sashi fiye da adadin raka'a insulin da ke cikin kicin ba. Misali, idan kuna buƙatar raka'a 31, kuma raka'a 25 ne kawai suka rage a cikin kicin, to ba za ku sami damar biye da lamba 25 ba yayin shigarwa. Kada ku yi ƙoƙarin saita adadin ta hanyar wucewa ta wannan lambar. Idan an bar sashin kashi a alƙalami, to zaka iya ko dai:
  1. Shigar da wannan kashi ɗin, sannan shigar da ragowar kashi ta amfani da sabon sirinji na alkairin.
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  2. Gabatar da cikakken kashi daga sabon sirinji na sirinji.
• Me zai hana in saita kashi don amfani da karamin insulin da aka rage a cikin kabad na?
  An tsara alkairin syringe don samar da aƙalla kalla. Raka'a 300 na insulin. Na'urar alkalami mai kariya tana kare katangar daga ɗaukacin fanko, tunda ƙaramin adadin insulin ɗin da ya saura a jikin katun ba zai iya allurar tare da ingantaccen daidaito ba.

Adana da watsewa

Bayani masu mahimmanci

• Ba za a iya amfani da alkalami mai sirinji ba idan yana waje da firiji fiye da lokacin da aka ayyana a cikin Umarnin don Amfani.
• Kar a ajiye alkairin sirinji tare da allura da aka haɗe da shi. Idan aka bar allura a haɗe, insulin na iya fita daga alƙalami, ko insulin na iya bushewa a cikin allura, ta haka ya rufe allura, ko kuma kumburin iska na iya tashi a cikin kicin.
• Ya kamata a adana alkawuran sirinji waɗanda ba sa amfani da su a cikin firiji a zazzabi na 2 ° C zuwa 8 ° C. Kar a yi amfani da alkairin sirinji idan ya daskare.
• Alƙalin sirinji da kuke amfani da shi yanzu ya kamata a ajiye shi a zazzabi da bai wuce 30 ° C ba kuma a cikin wani wuri mai kariya daga zafi da haske.
• Koma zuwa Umarni don amfani don cikakken famili tare da yanayin ajiya na alƙalin sirinji.
• Kiyaye alkalami mai rauni daga wurin isar yara.
• A jefa allura da aka yi amfani da su a cikin hujin huji, kwantena masu kama da juna (alal misali, kwantena na abubuwan da ke tattare da abubuwa masu shaye shaye ko sharar gida), ko kuma yadda likitan lafiyarku ya ba ku shawarar.
• Zub da allunan sirinji ba tare da allura da aka haɗa da su ba kuma yana dacewa da shawarar likitanka.
• Kar a sake amfani da akwati mai cikar sharps.
• Tambayi likitanka game da hanyoyin da zaka iya zubar da kwantena na shimfidar sharps a cikin yankinka.
• Jagororin don amfani da allura ba su maye gurbin dokokin zubar da ciki, dokokin da likitanku ya ba ku ko bukatun sashen.

Idan kuna da wasu tambayoyi ko matsaloli game da amfani da QuickPen Syringe Pen, to, tuntuɓi likitan ku.

Sunaye da adireshin masana'anta:
Eli Lilly da Kamfanin. Amurka

"Eli Lilly da Kamfanin",
Indianapolis, IN 46285, Amurka.

Eli Lilly da Kamfanin.
Indianapolis. Indiana 46285. Amurka.

Wakilai a Rasha:
"Eli Lilly Vostok S.A.", 123317. Moscow
Gudanarwa na Presnenskaya, d. 10

Humalog®, Humalog® a cikin Allon rubutu na QuickPen syringe Humalog in Mix 50 a cikinn alli na QuickPen ™ sirinji, Humalog in Mix 25 a cikin Alƙaliman sifan syPe shine alamun kasuwanci na Eli Lilly & Kamfanin.

Alkalamiin QuickPen ™ sirinji ya cika ainihin ƙididdigar aiki da buƙatun ISO 11608 1: 2000