NovoRapid Flekspen - umarnin * amfani don amfani

A cikin wannan labarin, zaku iya karanta umarnin don amfani da miyagun ƙwayoyi NovoRapid. Yana ba da ra'ayi daga baƙi zuwa shafin - masu amfani da wannan magani, da kuma ra'ayoyin kwararrun likitocin game da amfani da NovoRapid a cikin ayyukansu. Babban buƙatar shine a ƙara ra'ayoyinku game da miyagun ƙwayoyi: maganin ya taimaka ko bai taimaka kawar da cutar ba, menene rikice-rikice da sakamako masu illa da aka lura, mai yiwuwa ba sanar da mai masana'anta a cikin bayanin ba. Analogs na NovoRapida a gaban isassun tsarin analogues. Amfani don kula da ciwon sukari mellitus insulin-dogara da nau'in 1 da ba insulin-dogara da nau'in 2 a cikin manya, yara, da lokacin ciki da lactation. Abun da magani.

NovoRapid - Rashin daidaituwa na insulin ɗan adam na matsakaici na tsawon lokaci. A cikin tsarin kwayar halitta ta wannan insulin, proino amino acid a matsayi B28 an maye gurbinsu da aspartic acid, wanda ke rage yawan motsin kwayoyin da zasu iya samar da hexamers, wanda aka lura dashi a cikin maganin insulin na yau da kullun.

Yana hulɗa tare da takamaiman mai karɓa akan ƙwayar cytoplasmic na waje na sel kuma yana samar da hadaddun insulin-receptor wanda ke motsa ayyukan ciki, gami da haɗakar enzymes da yawa (hexokinase, pyruvate kinase, glycogen synthetase). Tasirin hypoglycemic yana da alaƙa da haɓakar jigilar kwayar ciki da haɓaka yawan glucose ta kyallen, haɓakar lipogenesis, glycogenogenesis, da rage raguwar haɓakar glucose ta hanta.

Insulin kewayawa (abu mai aiki na Novorapid) da insulin na ɗan adam suna da aiki iri ɗaya a cikin molar daidai.

Insulin aspart yana narkewa daga ƙwaƙwalwar adipose nama mai sauri da sauri fiye da aikin insulin ɗan adam mai narkewa.

Tsawan lokacin aikin insulin ya kasance bayan ansa subcutaneous na ƙasa da na insulin ɗan adam mai narkewa.

Abun ciki

Manyan likitancin insulin +.

Pharmacokinetics

Bayan subcutaneous management na insulin kewayawa, lokacin isa zuwa mafi yawan maida hankali (Tmax) a cikin jini plasma a kan matsakaita 2 sau kasa da bayan gudanar da insulin mutum. Matsakaicin mafi yawan hankali a cikin jini na jini (Cmax) ana samun shi a matsakaici na mintina 40 bayan gudanarwa na subcutaneous na kashi 0.15 IU da 1 kg na nauyin jiki a cikin marasa lafiya da ke dauke da ciwon sukari na 1. Cutar insulin ya dawo cikin matakin sa na asali bayan sa'o'i 4-6 bayan gudanar da maganin. Yawan sha yana da ɗan ƙarami a cikin marasa lafiya da ke fama da ciwon sukari na 2, wanda ke haifar da ƙananan Cmax kuma daga baya Tmax (minti 60).

Alamu

• type 1 ciwon sukari mellitus (insulin-dogara),
• nau'in ciwon sukari na 2 na ciwon sukari (wanda ba shi da insulin-insulin) ba: yanayin tsayayya da wakilai na bakin jini, juriya ga waɗannan kwayoyi (yayin haɗuwa da jiyya), cututtukan cikin zuciya.

Sakin Fom

Magani don subcutaneous and intravenous management of 100 PIECES a cikin kwatin 1 ml na 3 ml (Penfill).

Magani don subcutaneous and intravenous management na 100 PIECES a cikin kwatin 1 ml a cikin alƙalin sirinji 3 ml (Flexpen).

Umarnin don amfani da tsarin kulawa

NovoRapid (Flexpen da Penfill) wani abu ne wanda yake aiki da insulin. Matsayin NovoRapid an ƙaddara ta likita daban-daban dangane da bukatun mai haƙuri. Yawanci, ana amfani da miyagun ƙwayoyi a hade tare da matsakaici na tsaka-tsaki ko shirye-shiryen insulin na dogon lokaci, waɗanda ake gudanar dasu aƙalla sau 1 a rana.

Don cimma ingantaccen iko na glycemic, ana bada shawara don auna yawan kwantar da hankali a cikin jini da daidaita matakan insulin.

Yawanci, buƙatun mutum na yau da kullun don insulin a cikin manya da yara shine daga 0.5 zuwa 1 IU a 1 kg na nauyin jiki. Tare da gabatarwar miyagun ƙwayoyi kafin abinci, NovoRapid yana iya samar da buƙatar insulin ta hanyar kashi 50-70%, ragowar buƙatar insulin ana bayar dashi ta hanyar tsawaita aikin insulin.

Ara yawan aikin jiki na mai haƙuri, canji a cikin abincin al'ada, ko cututtukan haɗaka na iya buƙatar daidaita sashi.

NovoRapid yana da hanzari farawa da gajarta lokacin aiki fiye da insulin ɗan adam mai narkewa. Saboda lokacin farawa da sauri, ya kamata a gudanar da NovoRapid, a matsayin mai mulkin, kai tsaye kafin cin abinci, idan ya cancanta, ana iya gudanar da shi jim kaɗan bayan cin abinci. Sakamakon ɗan gajeren lokacin aiki idan aka kwatanta da insulin ɗan adam, haɗarin haɓakar ƙarancin jini a cikin marasa lafiyar da ke karɓar NovoRapid yana da ƙasa.

NovoRapid yana allurar subcutaneously a cikin yankin na bangon ciki na ciki, cinya, kafada, ƙwararraki ko gluteal yankin. Ya kamata a canza wuraren allurar da ke cikin yanki ɗaya na jiki akai-akai don rage haɗarin lipodystrophy. Kamar yadda yake da duk shirye-shiryen insulin, gudanarwa ƙarƙashin ƙasa zuwa bango na ciki na ba da sauri cikin sauri idan aka kwatanta da gudanarwa zuwa wasu wurare. Tsawan lokacin aikin ya dogara da kashi, wurin gudanarwa, tsananin zubar da jini, yawan zafin jiki da kuma matakin motsa jiki. Koyaya, yana farawa da sauri da sauri idan aka kwatanta da insulin ɗan adam mai ƙarfi ana kiyaye shi ba tare da la'akari da wurin da allurar take ba.

Ana iya amfani da NovoRapid don ci gaba da insusions insulin na subcutaneous (PPII) a cikin famfunan insulin wanda aka tsara don infusions insulin. FDI yakamata a samar dashi a bangon ciki na ciki. Ya kamata a canza wurin jiko lokaci-lokaci.

Lokacin amfani da famfon na insulin don jiko, NovoRapid bai kamata ya hade da sauran nau'ikan insulin ba.

Ya kamata a horar da marassa lafiya da ke amfani da FDI cikakkiyar horarwa ta amfani da famfo, rafin da ya dace, da kuma tsarin yin famfo. Ya kamata a maye gurbin saiti jiko (bututu da catheter) daidai da littafin mai amfani wanda aka haɗe zuwa saitin jiko.

Marasa lafiya waɗanda ke karɓar NovoRapid tare da FDI yakamata su sami ƙarin insulin a cikin su idan akwai fashewar tsarin jiko.

Idan ya cancanta, za a iya gudanar da NovoRapid a ciki, amma ta ƙwararrun likitocin ne kaɗai ke iya gudanar da su.

Don gudanarwa na ciki, ana amfani da tsarin jiko tare da NovoRapid 100 IU a cikin 1 ml tare da maida hankali na 0.05 IU a cikin 1 ml zuwa 1 IU a cikin 1 ml na insulin aspart a cikin 0.9% sodium chloride bayani, 5% dextrose bayani ko 10% dextrose bayani ana amfani dashi mai dauke da kilogram 40 mmol / L potassium ta amfani da kwantena jiko na polypropylene. Wadannan hanyoyin suna da tsayayye a zazzabi a daki na tsawon awanni 24. Duk da kwanciyar hankali na ɗan lokaci, wani adadin insulin yana farawa ta hanyar kayan jiko. A lokacin insus infusions, ya zama dole don kulawa da hankali akai-akai na tattarawar glucose jini.

Side sakamako

• hypoglycemia (ƙara yawan shaye-shaye, pallor na fata, juyayi ko rawar jiki, damuwa, gajiya sabon abu ko rauni, hankula mai lalacewa, rashi hankali, tsananin farin ciki, matsanancin gani na ɗan lokaci, ciwon kai, tashin zuciya, tachycardia). Mai tsananin rashin ƙarfi na iya haifar da asarar da / ko raɗaɗi, rushewar kwakwalwa da mutuwa,
• urticaria, fatar fata, itching,
• anaphylactic halayen,
• ƙara yin gumi
• rikicewar ƙwayar gastrointestinal (GIT),
• angioedema,
• wahalar numfashi
• tachycardia (hawan jini a zuciya),
• saukar da saukar karfin jini (BP),
• halayen gida: halayen rashin lafiyan (redness, kumburi, itching na fata a wurin allurar), yawanci lokaci-lokaci da wucewa yayin da ake ci gaba da jiyya,
• lipodystrophy,
• take hakkin tunani.

Contraindications

• hawan jini,
• hypersensitivity to insulin kewayawa.

Haihuwa da lactation

Kwarewar asibiti tare da NovoRapida a lokacin daukar ciki yana da iyakatacce.

A cikin nazarin dabbobi na gwaji, babu bambance-bambance da aka samu tsakanin amfrayo da kuma teratogenicity na insulin aspart da insulin na mutum. A cikin lokacin yiwuwar farawar ciki kuma a duk tsawon lokacinsa, Wajibi ne a lura da yanayin marasa lafiya da masu ciwon sukari da kuma lura da matakin glucose a cikin jini. Bukatar insulin, a matsayin mai mulkin, yana raguwa a cikin watanni 1 kuma sannu a hankali yana ƙaruwa a cikin shekaru biyu da na uku na ciki. Lokacin kuma kai tsaye bayan haihuwa, buƙatun insulin na iya raguwa kwatsam. Jim kaɗan bayan haihuwa, buƙatar insulin da sauri ya koma matakin da ya kasance kafin yin juna biyu.

Ana iya amfani da insulin aspart yayin shayarwa (shayarwa), kuma ana iya buƙatar daidaita sashin insulin.

Yi amfani da yara

Ba da shawarar don amfani da yara a ƙarƙashin shekaru 6 ba.

Yi amfani da shi a cikin tsofaffi marasa lafiya

Kamar yadda yake da amfani da sauran shirye-shiryen insulin, a cikin tsofaffi marasa lafiya ya zama dole a lura da hankali na yawan kwantar da hankali a cikin jini kuma daidaita sashi na NovoRapid daban-daban.

Umarni na musamman

Insuarancin insulin ko dakatarwar magani, musamman tare da nau'in ciwon sukari na 1 na sukari, na iya haifar da haɓakar haɓaka ko ƙwanƙwasa ciwon suga. Bayyanar cututtukan hyperglycemia yawanci suna bayyana ne sannu a hankali tsawon lokacin sa'o'i da yawa ko kuma kwanaki. Bayyanar cututtukan hyperglycemia sune tashin zuciya, amai, amai, ja da bushewar fata, bushewar baki, karuwar fitar fitsari, ƙishirwa da asarar ci, da kuma bayyanar ƙamshin acetone a cikin iska mai ƙonewa. Idan ba tare da magani da ya dace ba, hauhawar jini na iya haifar da mutuwa. Bayan ramawa game da metabolism na metabolism, alal misali, tare da ƙwayar insulin mai zurfi, marasa lafiya na iya fuskantar alamu na alamu na abubuwan da ke faruwa na rashin lafiyar hypoglycemia.

A cikin marasa lafiya da masu ciwon sukari tare da ingantaccen kulawa na rayuwa, ƙarshen rikice-rikice na ciwon sukari ya inganta daga baya kuma ci gaba da hankali. A wannan batun, an ba da shawarar aiwatar da ayyukan da aka tsara don inganta sarrafa metabolism, gami da saka idanu kan matakin glucose a cikin jini.

Sakamakon sifofin kemikal na insulin analogues na yin gajere shine cewa haɓakar ƙwayar cuta yayin da aka yi amfani da ita ya fara aiki da amfani da insulin ɗan adam mai narkewa.

Ya kamata yayi la'akari da babban hauhawar haɓakar tasirin hypoglycemic a cikin lura da marasa lafiya tare da cututtukan haɗin gwiwa ko shan magunguna waɗanda ke rage yawan shan abinci. A gaban cututtukan concomitant, musamman na asali na kamuwa da cuta, buƙatar insulin, a matsayin mai mulkin, yana ƙaruwa. Paarancin nakasar yara ko aikin hepatic na iya haifar da raguwar bukatun insulin.

Lokacin canza mai haƙuri zuwa wasu nau'in insulin, alamu na farkon abubuwan da ke haifar da maganin rashin daidaituwa na iya canzawa ko zama mara ma'ana idan aka kwatanta da waɗanda suke amfani da nau'in insulin na baya.

Canjin mara lafiya daga NovoRapid zuwa sabon nau'in insulin ko kuma shirin insulin wani mai kamfanin dole ne a aiwatar dashi karkashin kulawar likita. Idan kun canza maida hankali, nau'in, masana'anta da nau'in (insulin ɗan adam, insulin dabbobi, analogue na insulin mutum) na shirye-shiryen insulin da / ko hanyar masana'anta, ana iya buƙatar canjin kashi.

Canjin kashi na insulin na iya buƙata tare da canji a abinci kuma tare da ƙaruwa ta jiki. Yi motsa jiki nan da nan bayan cin abinci na iya ƙara yawan haɗarin kumburi. Ski abinci ko motsa jiki mara tsari na iya haifar da ci gaban haɓakar ƙwanƙwasa.

Babban ci gaba a cikin halin biyan diyya ga ƙwayoyin carbohydrate na iya haifar da yanayin mummunan ciwon neuropathy, wanda yawanci yakan sake juyawa.

Dogaro mai tsawo a cikin kulawar glycemic yana rage haɗarin ci gaban cututtukan cututtukan zuciya. Koyaya, daɗaɗawar insulin tare da ƙara haɓakawa a cikin kulawar glycemic na iya kasancewa tare da lalacewa ta ɗan lokaci na ciwon sukari.

Tasiri kan ikon tuka motoci da hanyoyin sarrafa abubuwa

Thearfin marasa lafiya su mai da hankali kuma ana iya rage ƙarfin tashin hankali yayin raunin hypoglycemia da hyperglycemia, wanda zai iya zama haɗari a cikin yanayi inda waɗannan damar ke da mahimmanci musamman (alal misali, lokacin tuki mota ko aiki tare da injuna da injuna). Ya kamata a shawarci marassa lafiya su dauki matakan hana ci gaban hypoglycemia da hyperglycemia yayin tuki mota da aiki da hanyoyin. Wannan yana da mahimmanci musamman ga marasa lafiya da basu da cikakkun alamu na abubuwan ci gaban haila ko kuma fama da yawan cututtukan cututtukan zuciya. A cikin waɗannan halayen, ya kamata a duba yiwuwar irin wannan aikin.

Hulɗa da ƙwayoyi

Hypoglycemic mataki Novorapid inganta baka hypoglycemic jamiái, hanawa na monoamine oxidase (Mao) hanawa, angiotensin tana mayar enzyme (ACE) hanawa, carbonic anhydrase hanawa, zabe beta-blockers, bromocriptine, octreotide, sulfonamides, anabolic steroids, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, shirye-shiryen lithium, shirye-shiryen da ke kunshe da ethanol.

Tasirin hypoglycemic na NovoRapid ya raunana ta hanyar maganin hana haihuwa, glucocorticosteroids (GCS), hormones thyroid, thiazide diuretics, heparin, maganin tricyclic antidepressants, tausayawa, danazole, clonidine, allunan tashar alli, diazoxide, morphine, morphine, morphine.

A ƙarƙashin rinjayar reserpine da salicylates, duka raunana da haɓaka aikin miyagun ƙwayoyi yana yiwuwa.

Magunguna waɗanda ke ɗauke da thiol ko sulfite, lokacin da aka ƙara shi da insulin, suna haifar da lalata.

Analogues na miyagun ƙwayoyi NovoRapid

Tsarin analogues na mai aiki abu:

• Insulin kewayawa,
• Komawa ta Rosinsulin.

Analogues na miyagun ƙwayoyi NovoRapid ta ƙungiyar magunguna (insulins):

• Aiki
• Apidra
• Berlinsulin,
• Biosulin
• Brinsulmidi
• Brinsulrapi
• Bari muyi kuka
• Gensulin
• Asarar insulin C,
• Isofan insulin Gasar Cin Kofin Duniya,
• Iletin
• Insulinaspart
• Insulin glargine,
• Insulin glulisin,
• Insulin Isofanicum,
• Tekin insulin,
• Lyspro insulin
• Insulin maxirapid,
• Matsakaici insulin
• Insulin s
• Insulin na alade yana tsarkakakken babban ɗanɗani MK,
• Insulin kwalliya,
• Insulin Ultrante
• Jinin ɗan adam
• Halin ɗan adam,
• Sulin-roba ɗan adam
• Inulin na sake sarrafa mutum
• Insulin mai tsawo
• Insulin Alkairi,
• Insulong
• Insulrap
• Insuman
• Insuran
• Intal
• Lantus
• Levemir,
• Mikstard
• Monoinsulin
• Monotard
• NovoMiks,
• Pensulin,
• Alurar insulin
• Protafan
• Rinsulin
• Rosinsulin,
• Solikva SoloStar,
• Sultofay,
• Tresiba FlexTouch,
• Tujeo SoloStar,
• Karshen
• Homolong
• Homorap
• Humalog,
• Humodar
• Humulin.

Ra'ayin Endocrinologist

Kyakkyawan magani na hypoglycemic. Na rubuto Novorapid ga marasa lafiya da duka nau'ikan ciwon sukari.Tare da adadin da ya dace, yana da kyau yana riƙe da matakin karɓa mai karɓa a cikin jini. Magungunan sun dace don amfani, har ma da yaran makaranta cikin sauki kansu. Novorapid yana da haƙuri da kyau. Allergic halayen a wurin allura ne musamman rare. Amma lipodystrophy, kamar yadda, koyaushe, lokacin da ake kulawa da wasu insulins, yakan faru sau da yawa. Ya kasance akwai lokuta na ci gaba da ɗimin hauhawar jini a cikin aikina.

Propertiesungiyoyin magunguna:

Yana hulɗa tare da takamaiman mai karɓa akan ƙwayar cytoplasmic na waje na sel kuma yana samar da hadaddun insulin-receptor wanda ke motsa ayyukan ciki, gami da haɗakar enzymes da yawa (hexokinase, pyruvate kinase, glycogen synthase, da sauransu). Rage yawan glucose na jini shine saboda karuwa a cikin jijiyoyin zuciya, karuwar ƙwayar nama, haɓakar lipogenesis, glycogenogenesis, raguwa a cikin yawan samar da glucose ta hanta, da dai sauransu.

Canji na amino acid proline a matsayin B28 tare da aspartic acid a cikin insulin aspart yana rage sha'awar kwayoyin don samar da hexamers, wanda aka lura dashi a cikin maganin insulin na yau da kullun. Dangane da wannan, insulin aspart yana da sauri sosai daga kitse mai ƙyalƙyali kuma yana farawa da sauri fiye da insulin ɗan adam mai narkewa. Insulin kamar yadda yana rage glucose na jini sosai a cikin awanni 4 na farko bayan cin abinci fiye da insulin na mutum. Tsawan lokacin insulin ya zama bayan an gama gudanar da ƙasa ya zama ƙasa da insulin ɗan adam mai narkewa. Bayan ƙananan ƙwaƙwalwar ƙarƙashin ƙasa, sakamakon maganin yana farawa tsakanin minti 10-20 bayan gudanarwa. Ana lura da mafi girman tasirin sa'o'i 1-3 bayan allura. Tsawon lokacin da miyagun ƙwayoyi shine 3-5 hours.

Gwaje-gwaje na asibiti wadanda suka shafi marasa lafiya da ke fama da ciwon sukari na 1 sun nuna ƙarancin haɗarin kamuwa da ciwon mara yayin amfani da insulin kamar yadda aka kwatanta da insulin ɗan adam mai narkewa. Rashin haɗarin hypoglycemia na rana ba ya ƙaruwa sosai.

Insulin aspart shine kayan abinci na mutum mai narkewa gwargwadon molar sa.

Manya Gwaje-gwaje na asibiti wanda ya shafi marasa lafiya da masu ciwon sukari na 1 ya nuna ƙananan postprandial maida hankali ne na glucose jini tare da insulin aspart idan aka kwatanta da insulin ɗan adam mai narkewa.

Dattijo: Binciken bazuwar, makafi-biyu, bincike-bincike na kantin magani da na pharmacodynamics (FC / PD) na insulin aspart da insulin ɗan adam a cikin tsofaffi marasa lafiya da ke da nau'in ciwon sukari na 2 na 19 (marasa lafiya 19 masu shekaru 65-83, yana nufin shekaru 70). Bambance-bambance na dangi a cikin abubuwan da ke tattare da keɓaɓɓiyar magunguna tsakanin insulin da keɓaɓɓe da insulin ɗan adam mai narkewa a cikin tsofaffi marasa lafiya sun kasance daidai da waɗanda ke cikin masu sa kai na lafiya da kuma a cikin marasa lafiya marasa lafiya da ciwon sukari mellitus.

Yara da matasa. Yin amfani da insulin aspart a cikin yara ya nuna irin wannan sakamako na sarrafa glycemic na dogon lokaci idan aka kwatanta da insulin ɗan adam mai narkewa.
An gudanar da binciken asibiti ta hanyar amfani da insulin mutum mai narkewa kafin abinci da keɓewa daban daban bayan cin abinci da aka gudanar a cikin ƙananan yara (26 marasa lafiya masu shekaru 2 zuwa 6), kuma an gudanar da nazarin guda ɗaya na FC / PD a cikin yara (6 -12 years old) da matasa (13-17 years old). Bayanin magunguna na insulin kamar yadda yake a cikin yara sun yi kama da na waɗanda suka manyanta.

Ciki Nazarin asibiti na kwatancen aminci da inganci na insulin kewa da insulin mutum a cikin kulawa da mata masu juna biyu da nau'in ciwon sukari na 1 na 32 (mata masu ciki 322 sunyi nazari, 157 daga cikinsu sun sami insulin aspart, 165 - insulin na mutum) basu bayyana wani mummunan tasirin insulin game da ciki ko lafiyar tayi ba. / jariri.
Studiesarin karatu na asibiti a cikin mata 27 da ke fama da cutar sankara waɗanda ke karɓar insulin da kuma insulin mutum (insulin aspart ya samu mata 14, insulin mutum 13) yana nuna jituwar bayanan martaba tare da ingantacciyar ci gaba a cikin kulawar glucose bayan abinci tare da maganin insulin.

Pharmacokinetics
Bayan subcutaneous management na insulin kewayawa, lokacin don isa iyakar maida hankali (t_max) a cikin plasma na jini a matsakaita sau 2 kasa da bayan insulin na dan adam mai narkewa. Matsakaicin ƙwayar ƙwayar plasma (Cmax) aƙalla 492 ± 256 pmol / L kuma an kai minti 40 bayan subcutaneous management na kashi 0.15 U / kg nauyin jiki ga marasa lafiya da nau'in ciwon sukari na 1. Cutar insulin ya dawo cikin matakin sa na asali bayan sa'o'i 4-6 bayan gudanar da maganin. Yawan sha yana da ɗan ƙaramin ƙarfi a cikin marasa lafiya da ke fama da ciwon sukari na 2, wanda ke haifar da ƙananan ƙarfin hankali (352 ± 240 pm / L) kuma daga baya t_max (Minti 60).

Canjin yanayin cikin mutum-mutumin a cikin t_max raguwa kaɗan lokacin amfani da insulin aspart idan aka kwatanta da insulin ɗan adam mai narkewa, yayin da rarrabewar aka nuna a C_maxdon kewaya insulin more.

Pharmacokinetics a cikin yara (6-12 shekara) da matasa (13-17 shekara) tare da nau'in ciwon sukari na 1. Kasancewar insulin aspart yana faruwa cikin sauri a cikin duka shekaru biyu tare da t_maxkama da wannan a cikin manya. Koyaya, akwai bambance-bambance C_max a cikin rukunoni biyu na shekaru biyu, wanda ke nuna mahimmancin ɗaukar ƙwayoyi. Dattijo: Dangane da bambance-bambance a cikin kantin magani tsakanin insulin yawu da insulin jikin mutum a cikin tsofaffi marasa lafiya (65-83 shekara, matsakaicin shekaru 70) na nau'in ciwon sukari na 2 wanda yayi kama da wanda ke cikin masu sa kai na lafiya da kuma marassa lafiya marasa galihu masu fama da ciwon sukari. A cikin tsofaffi marasa lafiya, an lura da raguwar adadin sha, wanda ya haifar da raguwa a cikin t_max (82 (bambance bambanci: 60-120)), yayin C_max iri ɗaya ne kamar yadda aka gani a cikin marassa lafiya masu fama da ciwon sukari na 2 kuma ɗan ƙasa kaɗan da marasa lafiya da ke ɗauke da ciwon sukari na 1. Rashin aikin hanta: An gudanar da binciken pharmacokinetics tare da kashi guda na insulin insulin a cikin marasa lafiya 24 waɗanda aikin hanta ya kasance daga al'ada zuwa rauni mai rauni. A cikin mutane da ke fama da aikin hanta, an rage rashi yawan insulin aspart kuma ya zama ba shi da kwanciyar hankali, wanda hakan ke haifar da raguwa a cikin t_max daga kusan mintuna 50 a cikin mutane masu aiki na hanta na al'ada zuwa kusan mintina 85 a cikin mutanen da ke fama da aikin hanta na matsakaici mai tsauri. Yankin a ƙarƙashin lokaci-lokaci na maida hankali, mafi girman maida hankali ga plasma da kuma ɓacin magani gaba ɗaya (AUC, C_max da CL / F) sun kasance irin waɗannan tituna tare da ragewa da aikin hanta na al'ada. Rashin Rashin Rashin Gashi: An gudanar da binciken ne game da wuraren harhada magunguna na insulin a cikin marasa lafiya 18 wadanda aikin su na asali ya kama daga al'ada zuwa gajiya mai rauni. Babu wani tasirin bayyanin ingancin kirkirar kirkirar kungiyar ta AUC, C_max, t_max insulin cirewa. Bayanai sun iyakance ga waɗanda ke fama da raunin matsakaiciyar matsakaici da kuma rauni. Mutane daban-daban tare da gazawar koda da ke buƙatar bugun jini ba a haɗa su a cikin binciken ba.

Bayanai na Kariya na Haihuwa:
Karatuttukan asibiti ba su bayyana wata haɗari ga ɗan adam ba, gwargwadon bayanai daga binciken da aka yarda da shi gaba ɗaya na lafiyar kimiyyar magunguna, ƙwayar cuta mai maimaituwa, ƙwayar cuta da halayyar haihuwa. A cikin gwaje-gwajen vitro, ciki har da ɗaure wa insulin masu karɓa da insulin-kamar haɓakar haɓaka-1, haka kuma tasiri akan haɓakar ƙwayar halitta, halayen insulin aspart sun yi kama da na insulin ɗan adam. Bincike ya kuma nuna cewa rarraba ɗayan insulin ga mai karɓar insulin ya yi daidai da na insulin ɗan adam.

Yardajewa:

Ba'a ba da shawarar yin amfani da miyagun ƙwayoyi NovoRapid® Flexpen® a cikin yara underan shekaru 2, saboda Nazarin asibiti a cikin yara 'yan kasa da shekaru 2 ba a gudanar da su ba.

Yi amfani da lokacin daukar ciki da lokacin shayarwa
Ana iya ba da umarnin NovoRapid® Flexpen® yayin daukar ciki. Bayanai daga gwaji na asibiti guda biyu (157 + 14 da aka bincika mata masu juna biyu) ba su bayyana wani lahani na insulin da ya shafi ciki ko lafiyar tayin / jariri ba idan aka kwatanta da insulin ɗan adam (duba sashe “

Sashi da gudanarwa:

Don cimma ingantaccen iko na glycemic, ana bada shawara don auna yawan kwantar da hankali a cikin jini da daidaita matakan insulin.

Yawanci, buƙatun mutum na yau da kullun don insulin a cikin manya da yara shine daga nauyin jiki 0,5 zuwa 1 U / kg. Lokacin da aka gudanar da magani kafin abinci, NovoRapid® FlexPen be zai iya samar da adadin insulin ta hanyar kashi 50-70%, ragowar buƙatar insulin ana bada shi ta hanyar tsawaita aikin insulin.

Ara yawan aikin jiki na mai haƙuri, canji a cikin abincin al'ada, ko cututtukan haɗaka na iya buƙatar daidaita sashi.

NovoRapid® Flexpen® yana da hanzari farawa da gajarta lokacin aiki fiye da insulin ɗan adam mai narkewa. Sakamakon fara aiki da sauri, ya kamata a gudanar da NovoRapid® FlexPen®, a matsayin mai mulkin, kai tsaye kafin cin abinci, kuma idan ya cancanta, ana iya gudanar da shi jim kadan bayan abincin. Sakamakon ɗan gajeren lokacin aiki idan aka kwatanta da insulin ɗan adam, haɗarin haɓakar ƙarancin ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa a cikin marasa lafiya da ke karɓar NovoRapid® Flexpen® ya yi ƙasa.

Groupsungiyoyin haƙuri na musamman
Kamar yadda yake a cikin sauran insulins, a cikin tsofaffi marasa lafiya da marasa lafiya da na koda ko hepatic kasawa, yakamata a kula da yawan glucose na jini da kuma daidaita yadda aka raba kamar yadda aka raba daban daban.

Yara da matasa
Zai fi kyau a yi amfani da NovoRapid® FlexPen® maimakon insulin ɗan adam mai narkewa a cikin yara yayin da ya zama tilas a hanzarta fara aiwatar da miyagun ƙwayoyi, alal misali, lokacin da wahala ga yaro ya lura da tazara tazara tsakanin allurar da abinci.

Canja wuri daga sauran shirye-shiryen insulin
Lokacin canja mai haƙuri daga wasu shirye-shiryen insulin zuwa NovoRapid® FlexPen®, ana iya buƙatar daidaita sashi na NovoRapid® FlexPen® da basal insulin.

NovoRapid® Flexpen® yana cikin allurar ciki a cikin yanki na bangon ciki na ciki, cinya, kafada, daskararren yanki ko gluteal. Ya kamata a canza wuraren allurar da ke cikin yanki ɗaya na jiki akai-akai don rage haɗarin lipodystrophy. Kamar yadda yake da duk shirye-shiryen insulin, gudanarwa ƙarƙashin ƙasa zuwa bango na ciki na ba da sauri cikin sauri idan aka kwatanta da gudanarwa zuwa wasu wurare. Tsawan lokacin aikin ya dogara da kashi, wurin gudanarwa, tsananin zubar da jini, yawan zafin jiki da kuma matakin motsa jiki. Koyaya, yana farawa da sauri da sauri idan aka kwatanta da insulin ɗan adam mai ƙarfi ana kiyaye shi ba tare da la'akari da wurin da allurar take ba.

Ana iya amfani da NovoRapid® don ci gaba da insusions insulin na subcutaneous (PPII) a cikin famfunan insulin wanda aka tsara don infusions insulin. FDI yakamata a samar dashi a bangon ciki na ciki. Ya kamata a canza wurin jiko lokaci-lokaci.

Lokacin amfani da famfon na insulin don jiko, NovoRapid® bai kamata a hade shi da sauran nau'ikan insulin ba.

Ya kamata a horar da marassa lafiya da ke amfani da FDI cikakkiyar horarwa ta amfani da famfo, rafin da ya dace, da kuma tsarin yin famfo. Ya kamata a maye gurbin saiti jiko (bututu da catheter) daidai da littafin mai amfani wanda aka haɗe zuwa saitin jiko.

Marasa lafiya waɗanda ke karɓar NovoRapid® tare da FDI yakamata su sami ƙarin insulin don suma idan akwai rushewar tsarin jiko.

Gudanarwa na ciki
Idan ya cancanta, ana iya gudanar da NovoRapid® a ciki, amma ta ƙwararrun likitocin ne kaɗai.

Don gudanarwa na ciki, tsarin jiko tare da NovoRapid® 100 IU / ml tare da maida hankali na 0.05 IU / ml zuwa 1 IU / ml insulin a cikin 0.9% sodium chloride bayani, 5% dextrose bayani ko 10% dextrose bayani yana dauke 40 mmol / L potassium chloride ta amfani da kwantena jiko na polypropylene. Wadannan hanyoyin suna da tsayayye a zazzabi a daki na tsawon awanni 24. Duk da kwanciyar hankali na ɗan lokaci, wani adadin insulin yana farawa ta hanyar kayan jiko. A lokacin insus infusions, ya zama dole don kulawa da hankali akai-akai na tattarawar glucose jini.

Side sakamako:

Halin da ya fi dacewa da rikicewar cuta shine hypoglycemia. Halin tasirin sakamako masu bambanci ya dogara da yawan masu haƙuri, tsarin allurai, da sarrafa glycemic (duba ɓangaren da ke ƙasa).

A matakin farko na maganin insulin, kurakurai masu narkewa, edema da halayen na iya faruwa a wurin allurar (jin zafi, redness, amya, kumburi, hematoma, kumburi da itching a wurin allura). Wadannan alamu yawanci lokaci ne a yanayi. Ingantaccen haɓakawa cikin kulawar glycemic na iya haifar da yanayin "matsanancin raunin neuropathy," wanda yawanci za'a iya juyawa. Intensation na insulin farjin tare da ingantacciyar ci gaba a cikin sarrafa metabolism na metabolism na iya haifar da lalacewa ta ɗan lokaci a cikin yanayin ciwon sukari, yayin da ci gaba na dogon lokaci a cikin kulawar glycemic yana rage haɗarin ci gaban cututtukan ciwon sukari.

An gabatar da jerin halayen masu illa a cikin tebur.

Rashin Tsarin Tsarin na rigakafi

Akai-akai - Hives, rashes na fata, rashes na fata Da wuya sosai - halayen Anaflactic * Tsarin abinci na rayuwa da rashin abinci mai gina jikiMafi sau da yawa - Hypoglycemia * Rashin lafiyar tsarin juyayiDa wuya - na gefe neuropathy ("m zafi neuropathy")

Vioarya ta sashin hangen nesa

Akai-akai - kurakurai marasa tunani Akai-akai - ciwon sukari na retinopathy Rashin lafiyar fata da ƙananan ƙwayar cutaAkai-akai - lipodystrophy *

Janar cuta da rikice-rikice a wurin allurar

Akai-akai - halayen a wurin allurar Akai-akai - edema

Dukkanin raunin da aka gabatar a ƙasa, bisa ga bayanan da aka samo daga shigarwar gwaji na asibiti, an kasu kashi biyu cikin ƙungiyar yawan adadin ci gaba daidai da tsarin na MedDRA da tsarin gabobin. An bayyana haɗarin halayen masu illa kamar: sau da yawa (≥ 1/10), sau da yawa (00 1/100 to) Ga kowane allura, yi amfani da sabon allura don hana kamuwa da cuta.
Yi hankali da kada ka lanƙwasa ko lalata allura kafin amfani.
Don hana allurar bazata, kar a sake sanya murfin ciki da allura.

Duba insulin
Ko da tare da amfani da alkalami da kyau, karamin adadin iska zai iya tarawa a cikin kicin kafin kowane allura.
Don hana shigowar kumfa iska da tabbatar da bayyanar da daidai ƙwayar magani:

E. Kira lambobi 2 na miyagun ƙwayoyi ta hanyar zaɓin sashi na zaɓin.

F. Yayin riƙe NovoRapid® FlexPen® tare da allura sama, taɓa maɓallin a ɗan 'yan lokuta tare da yatsanka saboda iska kuzari ta hau saman katun.

G. Yayin riƙe NovoRapid® FlexPen® tare da allura sama, danna maɓallin farawa koyaushe. Mai za ~ i zai dawo zuwa sifili.
Wani digo na insulin yakamata ya bayyana a ƙarshen allura. Idan wannan bai faru ba, maye gurbin allura kuma maimaita hanya, amma ba fiye da sau 6.
Idan insulin bai fito daga allura ba, wannan yana nuna cewa alkairin sirar yana da lahani kuma bai kamata a sake amfani da shi ba.

Sashi saiti
Tabbatar an saita mai zazzage sigar “O”.

H. Kira lambar rakarorin da ake buƙata don allurar. Za'a iya yin gyaran ta hanyar juyawa mai zaɓin sashi a kowane bangare har sai an saita madaidaicin kashi a gaban mai nuna sashi. Lokacin juyawa da zaɓin sashi, yi hankali kar a danna maɓallin farawa ba da gangan ba don hana sakin ƙwayar insulin. Ba zai yiwu ba saita adadin da yawansu ya rage adadin adadin sassan da ke cikin kicin.

Adanawa da kulawa
NovoRapid® Flexpen® an tsara shi don ingantaccen amfani mai aminci kuma yana buƙatar kulawa da hankali. Idan ya kasance digo ko damuwa mai ƙarfi na injin, ana iya lalata alkairin mai sihiri kuma insulin na iya zuba.
Ana iya tsabtace farfaɗo da NovoRapid® FlexPen sw tare da auduga a ciki. Kada a nutsar da alkalami cikin ruwa, kar a wanke ko sanya mai, kamar yadda wannan na iya lalata injin.
Refilling na NovoRapid® FlexPen® ba a yarda ba.

Gudanar da insulin
Saka allura a ƙarƙashin fata. Yi amfani da dabarar allura ta likitanka ya ba ka shawarar.

I. Don yin allura, danna maɓallin farawa gaba ɗaya har sai “0” ta bayyana a gaban mai nuna sashi. Yi hankali da hankali: lokacin gudanar da maganin, danna maɓallin farawa.
Lokacin da zaɓin sashi zai juya, tsarin kulawa ba zai faruwa ba.

J Lokacin cire allura daga ƙarƙashin fata, riƙe maɓallin farawa da bacin rai sosai.
Bayan allurar, bar allura a karkashin fata na akalla awanni 6. Wannan zai tabbatar da gabatar da cikakken sinadarin insulin.

K. Nuna allura a cikin mabulen bayan allura ba tare da taɓa hula ba. Lokacin da allura ta shiga, saka hula kuma cire allurar.
Jefar da allura, lura da kiyayewar kariya, da rufe alƙalamar sirinji da hula.