NovoRapid Penfill umarnin > Jiyya da rigakafin

Insulin kewayon * (Insulin kewayawa *)

Ciwon sukari mellitus a cikin manya, matasa da yara sama da 2 years old.

Increara ƙwaƙwalwar mutum zuwa insulin kewayawa ko kowane ɓangaren magunguna.

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

Haihuwa da lactation:

NovoRapid ® Penfill ® za'a iya tsara shi yayin daukar ciki. Bayanai daga gwaji na asibiti guda biyu da aka tsara (157 + 14 mata masu ciki) ba su bayyanar da wani mummunan tasirin insulin game da ciki ba ko kuma lafiyar lafiyar tayin / jariri idan aka kwatanta da insulin mutum (duba Pharmacodynamics).

Ana ba da shawara sosai akan matakan glucose na jini da saka idanu ga mata masu juna biyu da masu ciwon sukari (nau'in 1 na sukari, nau'in ciwon sukari na 2 ko ciwon sukari). Bukatar insulin, a matsayin mai mulkin, yana raguwa a cikin farkon farkon kuma a hankali yana ƙaruwa a cikin watanni na biyu da na uku na ciki. Jim kaɗan bayan haihuwa, buƙatar insulin da sauri ya koma matakin da ya kasance kafin yin juna biyu.

Yayin shayarwa, ana iya amfani da NovoRapid ® Penfill ®, saboda Gudanar da insulin ga mahaifiyar da take reno ba barazana ce ga jariri ba. Koyaya, yana iya zama dole don daidaita sashin maganin.

Abubuwan da ba a san matsala ba a cikin marasa lafiya da ke amfani da NovoRapid ® Penfill ® galibi saboda tasirin magunguna ne na insulin.

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 a cikin sarrafa glycemic na iya haifar da yanayin mummunan ciwo na neuropathy, wanda yawanci yakan sake 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.

Dukkanin raunin da aka ambata a ƙasa, dangane da bayanan gwaji na asibiti, an tattara su gwargwadon haɓakar haɓakawa bisa ga tsarin MedDRA da tsarin kwayoyin. An bayyana faruwar mummunan sakamako kamar haka: sau da yawa (? 1/10), sau da yawa (? 1/100, Magani don gudanarwa da aikin inshorar ciki1 ml abu mai aiki: insulin cirewaCIGABA 100 (3.5 MG) tsofaffi: glycerol - 16 mg, phenol - 1.5 mg, metacresol - 1.72 mg, zinc chloride - 19.6 μg, sinadarin sodium - 0.58 mg, sinadarin hydrogen phosphate dihydrate - 1.25 mg, sodium hydroxide 2M - kimanin 2.2 MG, 2M hydrochloric acid - game da 1.7 MG, ruwa don yin allura - har zuwa 1 ml Cartayan katako ɗaya ya ƙunshi 3 ml na bayani, daidai yake da 300 PIECES.
Sashi da gudanarwa:

NovoRapid ® Penfill logue analogue ne wanda yake aiki dashi. Matsayin NovoRapid ® Penfill ® likita ne ya ƙaddara shi daban-daban, bisa ga 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 nauyin jiki 0,5 zuwa 1 U / kg. Tare da gabatarwar miyagun ƙwayoyi kafin abinci, NovoRapid ® Penfill ® da kashi 50-70% na samar da insulin, ana buƙatar ragowar buƙatar insulin ta hanyar ƙara yawan aiki insulin. Ara yawan aikin jiki na mai haƙuri, canji a cikin abincin al'ada, ko cututtukan haɗaka na iya buƙatar daidaita sashi.

NovoRapid ® Penfill ® yana da hanzari farawa da gajarta lokacin aiki fiye da insulin ɗan adam mai narkewa. Sakamakon farawa da sauri, ya kamata a gudanar da NovoRapid ® Penfill ®, a matsayin mai mulkin, kai tsaye kafin cin abinci, idan ya cancanta, ana iya gudanar da shi jim kaɗan bayan abincin.

Sakamakon ɗan gajeren lokacin aiki idan aka kwatanta da insulin ɗan adam, haɗarin haɓaka ƙarancin jini a cikin marasa lafiya da ke karɓar NovoRapid ® Penfill ® yayi ƙasa.

Groupsungiyoyin haƙuri na musamman. Kamar yadda ake amfani da wasu shirye-shiryen insulin, a cikin tsofaffi marassa lafiya da marasa lafiya da na koda ko hepatic kasawa, yakamata a kula da yawan hawan glucose a cikin jini kuma a daidaita yadda aka raba ashel daban-daban.

Yara da matasa. Amfani da NovoRapid ® Penfill ® maimakon insulin ɗan adam mai narkewa a cikin yara ya fi dacewa idan ya zama dole a hanzarta fara aiwatar da miyagun ƙwayoyi, alal misali, lokacin da yake wahala ga yaro ya lura da lokacin tazara da ake buƙata tsakanin allura da cin abinci.

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

NovoRapid ® Penfill ® allurar sc kenan a cikin yankin bango na ciki, cinya, kafada, ƙyalƙyali ko yankin ƙazamar iska. 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 na insulin 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, NovoRapid ® kada a haɗa shi da sauran nau'ikan insulin.

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 karin insulin a cikin su idan akwai wani rushewar tsarin jiko.

A / cikin gabatarwar. Idan ya cancanta, ana iya gudanar da NovoRapid ® iv, amma ta ƙwararrun likitocin ne kaɗai ke ba da izinin gudanar da su.

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

NovoRapid ® Penfill ® da allura sune don amfanin kai kawai. Kar a cika matattarar Penfill ®.

Ba za a iya amfani da NovoRapid ® Penfill if ba idan ya daina nuna gaskiya da launi ko kuma daskararre. Ka umurci mai haƙuri ya zubar da allura bayan kowane allura.

NovoRapid ® za'a iya amfani dashi a cikin famfan insulin (duba. "Sashi da gudanarwa"). Tubes, ciki na ciki wanda aka yi da PE ko polyolefin, an gwada su kuma an gano cewa sun dace don amfani da su a cikin famfo.

A cikin lokuta na gaggawa (asibiti, ɓarna da na'ura don gudanarwar insulin) NovoRapid ® don gudanarwa ga mai haƙuri za a iya cire shi daga cikin katun ta amfani da sirinjin insulin na U100.

Sashi da gudanarwa

P / c, cikin / in. NovoRapid Penfill 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 Penfill, a matsayin mai mulkin, kai tsaye kafin cin abinci, idan ya cancanta, ana iya gudanar da shi jim kaɗan bayan cin abinci.

Girman maganin yana maganin likita ne daban-daban a kowane yanayi, gwargwadon matakin glucose a cikin jini. Yawanci, ana amfani da NovoRapid® Penfill® a hade tare da shirye-shiryen insulin na matsakaici ko aiki na tsawon lokaci, ana gudanar da su a kalla sau 1 a rana.

Yawanci, yawan bukatun yau da kullun don insulin shine raka'a 0.5-1 / kg na jiki. Tare da gabatarwar miyagun ƙwayoyi kafin abinci, NovoRapid Penfill zai iya samar da yawan insulin zuwa kashi 50-70%, ragowar buƙatar insulin yana samar da ta hanyar insulin mai ƙwazo.

Zazzabi na insulin da ke cikin yakamata ya zama zazzabi a dakin. NovoRapid Penfill yana allurar subcutaneously a cikin ɓangaren bangon ciki na ciki, cinya, kafada ko gindi. Dole ne a canza wuraren allurar cikin wannan yanki na jikin a kai a kai.

Kamar yadda yake tare da kowane shiri na insulin, tsawon lokacin aikin NovoRapid Penfill ya dogara da kashi, wurin gudanarwa, tsananin zubar da jini, zafin jiki da kuma matakin motsa jiki.

Gudun ƙarƙashin ƙasa zuwa bango na gabancin ciki yana samar da hanzari a hankali idan aka kwatanta da gudanarwa zuwa wasu wurare. 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.

Idan ya cancanta, za a iya gudanar da NovoRapid Penfill iv, amma ta ƙwararrun likitocin ne kaɗai ke ba da izini. Don gudanarwa na ciki, ana amfani da tsarin jiko tare da NovoRapid Penfill 100 IU / ml tare da maida hankali na 0.05 zuwa 1 IU / ml insulin a cikin 0.9% sodium chloride-5 ko 10% dextrose bayani mai amfani da 40 mmol / l ana amfani da su potassium chloride ta amfani da kwantena jiko na polypropylene. Wadannan hanyoyin suna da tsayayye a zazzabi a daki na awanni 24. A yayin infusions insulin, ya zama dole a sanya ido a kai a kai matakin glucose na jini.

Hakanan za'a iya amfani da NovoRapid Penfill 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 NovoRapid don jiko, kar a haɗa tare da sauran nau'ikan insulin. Ya kamata a horar da marasa lafiya da ke amfani da FDI don amfani da famfo, tafki mai dacewa, da kuma tsarin 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 Penfill tare da PPI ya kamata su sami ƙarin insulin don yin amfani da su yayin taron fashewa a cikin tsarin jiko.

Yawan abin sama da ya kamata

Bayyanar cututtuka: haɓakar hauhawar jini (gumi mai sanyi, guguwar bugun zuciya, rawar jiki, yunwar, tashin hankali, haushi, ciwon kai, ciwon kai, nutsuwa, rashin motsi, magana da rashin hangen nesa, rashin damuwa). Poarfin hypoglycemia mai zurfi na iya haifar da aikin kwakwalwa da rikicewar kwakwalwa.

Jiyya: sukari ko bayani na glucose a ciki (idan mai haƙuri yana da hankali), s / c, i / m - glucagon (a kashi na 0.5-1 mg) ko i / v - glucose. Bugu da kari, iv of glucose ya zama dole a wadancan halayen idan, bayan mintuna 10-15 bayan gudanarwar glucagon, mara lafiyar baya dawo da hankalin. Bayan dawo da hankali, ana bada shawarar ci abinci na carbohydrate na baki don hana sake dawowar haila.

Kariya don amfani

Rashin isasshen kashi ko katsewa na jiyya, musamman tare da mellitus na sukari-wanda ke fama da ciwon sukari (nau'in 1), na iya haifar da hyperglycemia da ketoacidosis na ciwon sukari.

Babu ƙwarewar asibiti a cikin yara 'yan ƙasa da shekaru shida. Ya kamata a yi amfani da NovoRapid a cikin yara maimakon maimakon insulin gajeran aiki na yau da kullun kawai a lokuta inda saurin fara aiki na iya samun sakamako mafi kyau - alal misali, idan yana da wahala ga yaro ya lura da tazara tazara tsakanin injections da abinci.

Cututtukan haɗin gwiwa, musamman cututtukan cututtuka, yawanci suna ƙaruwa, da lalacewar kodan ko hanta yana buƙatar buƙatar insulin. Canjin mai haƙuri zuwa sabon nau'in ko alama na insulin ya kamata a aiwatar da shi a ƙarƙashin kulawar likita. Lokacin amfani da NovoRapid Penfill, ana buƙatar adadin adadin injections kowace rana ko canjin kashi idan aka kwatanta da waɗanda suke amfani da shirye-shiryen insulin na al'ada. Idan akwai buƙatar daidaitawar kashi, wannan na iya faruwa a farkon allurar farko ko a farkon weeksan makonni ko watanni bayan canja wurin. Bayan ramawa game da metabolism na metabolism a cikin marasa lafiya, alamu na yau da kullun na abubuwan da za su haifar da hypoglycemia na iya canzawa, wanda ya kamata a sanar da su. Ski abinci ko motsa jiki mara tsari na iya haifar da cutar rashin ƙarfi. Yi amfani da takamaiman taka tsantsan yayin aikin direbobin motoci da mutanen da aikinsu ke da alaƙa da ƙara jawo hankali, saboda hypoglycemia na iya haɓakawa, musamman a cikin marasa lafiya da ke da alamu masu sauƙi ko ba su nan, hanyoyin magance cutar hypoglycemia ko kuma abubuwan da take faruwa akai-akai. A irin waɗannan halayen, ya kamata ka yi la’akari sosai ko zai ba da shawara ga mai haƙuri ya fitar da mota. Jirgin ruwan Penfill na amfanin kai ne kawai. Bayan allura aƙalla 6 s, allura ya kamata ya kasance ƙarƙashin fata don cikakken kashi.

Siffofin

Insulin Aspart - babban kayan maganin, yana da tasiri mai ƙarfi na hypoglycemic. Wannan analog ne na gajeran insulin, wanda aka samar a jikin mutum. Insulin Aspart an yi shi ne ta hanyar fasahar DNA.

Magungunan yana hulɗa da membranes na cytoplasmic na waje na amino acid daban-daban, yana haifar da ƙarewar insulin da yawa, kuma yana inganta ayyukan cikin jijiya.

Bayan raguwar taro a cikin jiki, irin waɗannan canje-canje suna faruwa:

sufurin jirgin sama na abubuwan da aka gano,
assimilation na nama yayi yawa
glycogenesis, lipogenesis.

Yana yiwuwa a sami raguwa a cikin yawan samar da glucose ta hanta. Novorapid yana da kyau sosai tare da nama mai ƙiba, amma tsawon lokacin aikinsa ya ƙasa da na insulin ɗan adam na halitta.

An kunna miyagun ƙwayoyi a mintuna 10 zuwa 20 bayan allura, ya kai awanni 3-5, ana lura da mafi girman yawan ƙwayar haihuwar bayan sa'o'i 1-3.

Yin amfani da shi na din-din-din na Novorapid yana rage yiwuwar hauhawar jini a cikin dare da yawa sau da yawa. Halin da ke haifar da raguwa sosai a cikin zubar jini cikin jini ya shahara. Ana bada shawarar miyagun ƙwayoyi don nau'in 1 da nau'in masu ciwon sukari na 2.

Alamu don amfani

nau'in ciwon sukari guda 1
tare da nau'in 2 idan wasu hanyoyin magani ba su da tasiri,
nau’i na biyu yayin daukar ciki.
tare da cutar sankarar mahaifa.
ketoacidotic coma, yana buƙatar magani na ɗan lokaci tare da insulin, ko wasu yanayi masu kama da juna.
steroid nau'i na ciwon sukari.

Masanin ilimin endocrinologist yana yanke hukunci lokacin da mai haƙuri zai iya ɗaukar Novorapid.

Innovation a cikin ciwon sukari - kawai sha kowace rana.

Fom ɗin saki

Akwai Novorapid Penfill a cikin katako 3 ml na kwalliya almakana. Akwai katako guda 5 a cikin fakiti 1. Novorapid Flekspen shine alkalami mai sikirin da za'a iya zubar dashi, wanda ya ƙunshi 3 ml na kayan, a cikin kunshin guda 5. Umurnin sun nuna cewa waɗannan kwayoyi suna kama da juna. Alƙalin sirinji ya dace don amfani idan kana buƙatar shigar da ƙaramin ƙwayoyi.

Umarnin don amfani

Tare da ingantaccen metabolism, ci gaban cutar yana jinkirta, alamun ba haka ba ne. Sabili da haka, wajibi ne don daidaita sarrafa metabolic, kula da adadin sukari a cikin jiki.

Tsarin cututtukan jini na haɓaka cikin hanzari idan mai ciwon sukari yana da abubuwan jituwa, kuma ana amfani da magunguna waɗanda ke rage jinkirin haɗarin abinci. Bukatar magunguna yana ƙaruwa tare da rikicewar rikice-rikice. Jiki baya buƙatar insulin idan mai haƙuri yana da matsaloli tare da gabobin ciki.

Bayan marasa lafiya sun canza zuwa wasu magunguna, alamomin cututtukan hypoglycemia sun canza ko ba a faɗi ƙima. Likitocin koyaushe suna lura da yanayin mai haƙuri lokacin da suke juyawa zuwa wani nau'in hodar. Lokacin da aka canza maganin, ana daidaita sashi. Ana buƙatar canji a cikin adadin maganin da ake amfani dashi lokacin cin sauran abinci, bayan dakatarwa ko karuwa a cikin aikin jiki.

An ƙaddara maganin ne ta hanyar endocrinologist daban-daban ga kowane mai haƙuri, la'akari da bukatunsa. Novorapid yana allura tare da insulin na matsakaici da na tsawon lokaci akalla a lokaci 1 a rana. Ana amfani da glucose na jini, yawan insulin da ya wuce haddi don nemo hanyar da ta dace don magance glycemia. Ana kulawa da yara 1.5 zuwa 1 naúrar. kowace kilogiram na nauyi. Canza abincinku ko salon ku yana buƙatar daidaita sashi.

Ana gudanar da Novorapid kafin abinci, da alama yiwuwar rashin lafiyar dare ya ragu.

Mai ciwon sukari na iya gudanar da maganin ta kansa, ana yin allurar subcutaneous a ciki, cinya, a cikin tsotsar ciki. Wurin allurar ya canza saboda lipodystrophy bai inganta ba.

Ana amfani da magunguna don PPII; ana amfani da famfon insulin don jiko. A wannan halin, ana yin allura a gaban ciki. A cikin lokuta masu wuya, Novorapid yana allurar ciki, ƙwararrun kwararru ne kawai tare da gogewa suke yin irin allurar.

Side effects

Sakamakon insulin RDNA akan jiki wasu lokuta yana kara dagula yanayin marasa lafiya. Babban sakamako na gefen shine raguwa a cikin glucose - hypoglycemia. Mitar aukuwar wannan yanayin a cikin rukuni daban-daban na marasa lafiya sun bambanta, an ƙaddara su da sashi, ingancin sarrafawa.

Muna ba da ragi ga masu karanta shafinmu!

A farkon matakan farko na aikin jiyya, canji na tunani yana faruwa, jin zafi, ciwon ciki, kumburi, da itching suna faruwa a wurin allurar. Irin waɗannan bayyanar cututtuka suna ɓace lokaci lokaci ba tare da magani ba.

Yin saurin sauri na cutar glycemia yana haifar da lalacewar cututtukan fata.

Sauran tasirin da ba a ke so ba wanda aka lura da shi a cikin masu ciwon sukari yakan haifar da nau'ikan rikice-rikice na gabobin da tsarin:

rigakafi ya raunana
tsarin juyayi yana da damuwa,
hangen nesa ya gushe
kumburi a wurin allurar.

Hypoglycemia yana haɓaka tare da wuce haddi na insulin, take hakkin hanya. Wani mummunan nau'in cuta shine barazanar kamuwa da cutar ga masu ciwon sukari. Akwai matsaloli tare da tsarin samar da jini, kwakwalwa na cikin damuwa, ana samun karuwar mutuwa.

Umarni na musamman

Lokacin tafiya zuwa wurare tare da bangarori daban-daban na lokaci, kuna buƙatar ganowa daga likitanka yadda ake amfani da maganin daidai. Idan mutum ya daina yin allura, hyperglycemia, ketoacidosis yana tasowa. A nau'in 1 masu ciwon sukari, wannan yanayin yakan faru sau da yawa. Alamu suna bayyana a hankali, suna ƙaruwa tsawon lokaci.

Akwai tashin zuciya, amai, amai, fata ta bushe, hydar na mucosa na baki yana raguwa, urination ya zama mafi yawan lokuta, Ina jin ƙishirwa koyaushe, rashin ci. Yana jin ƙamshin acetone daga bakina. Idan ana zargin hyperglycemia, ana aiwatar da maganin nan da nan don ceton ran mai haƙuri. Rage magani mai yawa yana canza alamun, amma hypoglycemia ya ragu.

Rashin lafiyar yana faruwa lokacin da aka wuce adadin insulin. Intensarfin ya dogara da yawan magunguna, har ma da yawan amfani, yanayin mai haƙuri, kasancewar abubuwan da ke haifar da ƙari.

Kwayar cutar hypoglycemia tana haɓaka tazara, ta zama mai rikitarwa ba tare da sarrafa adadin glucose ba. Tare da nau'i mai laushi na cutar, an shawarci marasa lafiya su ci karin sukari ko samfuran carbohydrate, shan ruwan 'ya'yan itace ko shayi mai zaki don magani.

Marasa lafiya koyaushe suna buƙatar ɗaukar kayan ciye-ciye ko wasu Sweets tare da su don daidaita matakan sukari lokacin da suka ji rashin lafiya. A cikin mummunan yanayi, marasa lafiya sun rasa hankali, likitoci ko ƙaunatattun waɗanda suka san abin da za su yi na iya taimakawa.

Don inganta yanayin masu ciwon sukari, yana allura tare da glucagon intramuscularly ko subcutaneously. Idan magani bai inganta yanayin ba, mai haƙuri ba ya sake samun nutsuwa, yi amfani da maganin dextrose, bayar da allura a cikin jijiya.

Canja wuri daga wani insulin

Canja wurin marasa lafiya zuwa wani nau'in insulin ko magani daga wani mai ƙirar ana aiwatar da shi a ƙarƙashin kulawar likitoci. Lokacin da ake tsara yawan tattara magunguna, hanyar samar da su da sauran sifofin, sauyin ya canza, yawan injections yana ƙaruwa.

A lokacin jiyya tare da wasu kwayoyi, amsawa na iya faruwa a wurin allurar, jin zafi, haushi, ƙonewa, kumburi, kurma, kumburi, itching. Alamun ba su bayyana sosai lokacin da ake canza wurin allurar, ana soke jiyya a wasu lokuta da wuya.

The endocrinologist ya zaɓi wakilan analog don maye gurbin Novorapid. Ana lissafin yawan sashin insulin ne, an zabi tsarin allura.

Kudin Novorapid Penfil shine 1799 rubles don inje 5.

Short ins na tushen insulin ana amfani dashi ga masu ciwon sukari na 1.

Likitocin suna ba da Novorapid Penfil idan yin amfani da wasu magunguna ba shi da tasiri ko kuma mara lafiyar ba shi da isasshen juriya ga abubuwan haɗin su.

Magungunan yana aiki da sauri, an shafe shi da abubuwa masu yawa, amma dole ne a daidaita jikin ga wani nau'in insulin.

Cutar sankarau koyaushe tana haifar da rikice-rikice. Wuce kima sugar yana da matukar hadari.

Aronova S.M. ya ba da bayani game da lura da ciwon sukari. Karanta cikakken

A abun da ke ciki na masu ciwon sukari

Samfurin NovoRapid mai ciwon sukari (insulin) ana samarwa a cikin nau'i biyu - waɗannan su ne maye gurbin ɗakunan pamfill Penfill da alkalami da aka shirya da FlexPen.

Abun da ke ciki na kicin ɗin da alkalami iri ɗaya ne - ruwa ne bayyananne don allura, inda 1 ml ya ƙunshi insulin ɗin da ke aiki da shi a cikin adadin 100 PIECES. Cartayaitaccen kayan maye, kamar aya ɗaya, ya ƙunshi kusan miliyan 3 na bayani, wanda shine raka'a 300.

Cartridges an yi su ne da gilashin hydrolytic na aji na. An rufe shi a gefe ɗaya tare da diski na roba na bromobutyl, a gefe guda tare da pistons na roba na musamman. Akwai katako guda biyar masu maye gurbinsu a furen aluminium, kuma ana saka bel guda ɗaya a cikin kwali. Haka kuma ana yin alkalancin sirinji na FlexPen. Ana iya jujjuya su kuma an tsara su don allurai masu yawa. A cikin akwatin kwali akwai biyar daga cikinsu.

Ana adana maganin a cikin sanyi a zazzabi na 2-8 ° C. Ba za a sanya shi kusa da injin daskarewa ba, kuma kada ya daskarewa. Hakanan, yakamata a sauya kayan katako da sirinji alƙaluma daga zafin rana. Idan aka buɗe insulin na NovoRapid (kabad), ba za a iya ajiye ta a cikin firiji ba, amma ya kamata a yi amfani da shi a cikin makonni huɗu. Yanayin zafin jiki kada ya wuce 30 ° C. Rayuwar sel mara lafiyan insulin watanni 30 kenan.

Pharmacology

Maganin NovoRapid (insulin) yana da tasirin hypoglycemic, kuma sashi mai aiki, insulin aspart, shine kwatankwacin yanayin aikin ɗan gajeren lokaci wanda ɗan adam yayi. Ana samun wannan abun ta hanyar amfani da ilimin halittu na musamman na kwayar halittar DNA. Wani nau'in Saccharomyces cerevisiae an kara shi anan, kuma amino acid da ake kira "proline" an maye gurbinsa da ɗan lokaci.

Magungunan yana haɗuwa da masu karɓar ƙwayar sel ta hanyar ƙwayar ƙwayar sel, inda yake samar da cikakken tsarin insulin endings, yana kunna duk hanyoyin da suke faruwa a cikin sel. Bayan rage adadin glucose a cikin jini, karuwa a cikin jijiyar jijiya, karuwa a cikin ƙwayoyin tsokoki daban-daban, karuwa a cikin glycogenogenesis da lipogenesis suna faruwa. Adadin yawan glucose da hanta ya ragu.

Sauya jigilar amino acid tare da aspartic acid yayin da aka fallasa shi ga insulin aspart yana rage ikon kwayoyin halitta don ƙirƙirar hexamers. Wannan nau'in hormone yana da mafi kyawun ƙwayar mai ta subcutaneous, yana shafar jikin mutum da sauri fiye da tasirin insulin daidaitaccen ɗan adam.

A cikin sa'o'i huɗu na farko bayan cin abinci, insulin aspart yana rage matakan sukari na plasma da sauri fiye da hormone mutum. Amma tasirin NovoRapida tare da gudanarwa na ɗan ƙasa ya fi ƙasa da na mutum mai narkewa.

Har yaushe NovoRapid ke aiki? Wannan tambayar ta damu da yawancin mutane masu ciwon sukari. Don haka, sakamakon maganin yana faruwa ne bayan mintuna 10-20 bayan allura. Ana lura da mafi girman abubuwan motsa jiki a cikin jini zuwa sa'o'i 1-3 bayan amfani da miyagun ƙwayoyi. Kayan aiki yana shafar jikin mutum tsawon awanni 3-5.

Nazarin mutane da ke ɗauke da nau'in ciwon sukari guda biyu sun nuna raguwa da yawa a cikin hadarin cutar rashin jini a lokacin amfani da NovoRapida, musamman idan aka kwatanta da aikin insulin ɗan adam mai narkewa. Bugu da kari, an sami raguwa sosai a cikin kwayar cutar postprandial a cikin plasma yayin da aka allura tare da kwayoyin insulin.

Manuniya da contraindications

Magungunan NovoRapid (insulin) an yi shi ne ga mutanen da ke da nau'in ciwon sukari na 1, wanda yake dogaro da insulin, kuma ga marasa lafiya da ke da nau'in ciwon sukari na 2 - wanda ba shi da insulin (mataki na jure wa magungunan ƙwaƙwalwar ƙwayar cuta a cikin baka, da kuma cututtukan cututtukan cuta) .

Contraindication zuwa ga yin amfani da miyagun ƙwayoyi ne hypoglycemia da wuce kima ji na jiki zuwa insulin kewayon, excipients na miyagun ƙwayoyi.

Kada ku yi amfani da NovoRapid ga yara 'yan ƙasa da shekaru shida saboda rashin ingantaccen karatun asibiti.

Magungunan "NovoRapid": umarnin don amfani

Magungunan NovoRapid shine kwatankwacin insulin. Zai fara aiki nan da nan bayan allura. Sashi ga kowane mara lafiya mutum ne kuma likitan ne ya zaba shi. Don cimma sakamako mafi kyau, ana haɗa wannan hormone tare da insulin tsawanta ko matsakaici.

Don sarrafa glycemia, ana auna adadin glucose a cikin jini a koyaushe kuma an zaɓi matakin insulin a hankali. A matsayinka na mai mulki, kashi na yau da kullun ga manya da yara sun kama daga 0.5-1 U / kg.

Lokacin da aka allura tare da maganin NovoRapid (umarnin don amfani da cikakken bayani game da tsarin gudanar da maganin), ana ba da buƙatar ɗan adam ga insulin ta hanyar 50-70%. Ragowar ya gamsu da tsarin aiki na tsawon lokaci (tsawan lokaci). Anara yawan aikin jikin mai haƙuri da canji a tsarin abinci, kazalika da abubuwan da ake haɗuwa da su, yawanci suna buƙatar canji a cikin adadin da ake sarrafawa.

Hormone NovoRapid, ya bambanta da mai narkewa, yana fara aiki da sauri, amma ba ci gaba ba. Sanadiyar tafiyar insulin ya nuna. Tsarin allurar rigakafin ya ƙunshi amfani da magani kai tsaye kafin cin abinci, kuma idan akwai wata bukatar gaggawa, ana amfani da miyagun ƙwayoyi nan da nan bayan cin abinci.

Sakamakon gaskiyar cewa NovoRapid yana aiki akan jiki na ɗan gajeren lokaci, hadarin cututtukan hypoglycemia da daddare a cikin marasa lafiya da ke fama da ciwon sukari yana raguwa sosai.

A cikin tsofaffi marasa lafiya, da kuma a cikin mutanen da ke koda ko hepatic kasawa, lura da taro glucose jini ya kamata faruwa sau da yawa, kuma ana zaɓin yawan asulin insulin daban-daban.

Yara "NovoRapid" sun maye gurbin insulin na mutum mai narkewa, amma idan kuna buƙatar magani tare da aiki mai sauri. Ana amfani dashi lokacin da yarinyar ba ta kula da tazara tsakanin da ake buƙata ba tsakanin injections da abinci. Idan an canza haƙuri zuwa NovoRapid daga wasu kwayoyi waɗanda ke ɗauke da insulin, ana buƙatar daidaita suturar, kazalika da insulin basal.

Gudun insulin na insulin (an bayyana algorithm ɗin allurar cikin jiki dalla-dalla a cikin umarnin don amfani) ya haɗa da allura a cikin ciki na ciki, cinya, gwiwa da jijiyoyin wuya, har ma da gindi. Yankin da za'a yi allura don haka ya kamata a canza shi don hana lipodystrophy.

Tare da gabatarwar hormone a cikin gaban yanki na peritoneum, ƙwayar za ta kamu da sauri fiye da injections a wasu sassan jikin. Tsawon lokacin sakamako na hormone yana shafar sashi, zangon allura, matakin yaduwar jini, zafin jiki, matakin ayyukan jiki na mai haƙuri.

Ana nufin "NovoRapid" don dogon infcutaneous infusions, waɗanda ke gudana ta famfo ta musamman. Magungunan an allura zuwa cikin kasusuwa na ciki, amma ana canza wurare zuwa lokaci-lokaci. Idan ana amfani da famfon na insulin, NovoRapid bai kamata ya hade da sauran nau'ikan insulin na ciki ba. Marasa lafiya da ke karɓar homon ta amfani da tsarin jiko yakamata a sami magani idan akwai wani fashewar na'urar.

Ana iya amfani da NovoRapid don gudanarwa na jijiya, amma ƙwararren ƙwararren likita ne ya kamata ya aiwatar da aikin. Don irin wannan nau'in, ana amfani da hadaddun jiko a wasu lokuta, inda aka ƙunshi insulin a cikin adadin 100 PIECES / ml, kuma maida hankali shine 0.05-1 PIECES / ml. Magungunan an narke shi cikin 0.9% sodium chloride, 5- da 10% dextrose bayani, wanda ya ƙunshi potassium chloride har zuwa 40 mmol / L. An adana kudaden da aka ambata a zazzabi a daki ba fiye da yini guda. Tare da insusions insulin, kuna buƙatar bayar da gudummawar jini akai-akai don glucose a ciki.

Yaya za a lissafa adadin insulin?

Don yin lissafin sashi, kuna buƙatar sanin cewa insulin yana haɗuwa, tsawo (tsawaita), matsakaici, gajere da ultrashort. Na farko yana daidaita sukari na jini. An gabatar da shi a kan komai a ciki. An nuna shi ga mutanen da ke da nau'in 1 da nau'in ciwon sukari na 2. Akwai mutanen da suke amfani da nau'in insulin guda ɗaya kaɗai - aka ƙara. Wasu mutane suna amfani da NovoRapid kawai don kaucewa kwatsam a cikin glucose. Ana iya amfani da gajere, tsayi na insulins lokaci guda a cikin lura da ciwon sukari, amma ana gudanar dasu a lokuta daban-daban. Ga wasu marasa lafiya, kawai amfani da magunguna yana taimakawa don cimma sakamako da ake so.

Lokacin zabar insulin tsawanta, wasu lamura yakamata a la'akari. Misali, ya zama dole cewa ba tare da yin allurar gajere ba da abinci na yau da kullun, sukari ya kamata ya kasance daidai da matakin a cikin rana kawai saboda aikin dogon insulin.

Zabin wani kaso na insulin mai tsawo kamar haka:

Da safe, ba tare da karin kumallo ba, auna matakin sukari.
Abincin rana yana ci, kuma bayan sa'o'i uku, an ƙaddara matakin glucose na plasma. Ana yin ƙarin ma'aunin kowane awa kafin zuwa gado. A ranar farko ta zaɓin kashi, tsallake abincin rana, amma ku ci abincin dare.
A rana ta biyu, an yarda da karin kumallo da abincin rana, amma ba a yarda da abincin dare ba. Suga, har ma da ranar farko, yana buƙatar sarrafawa a kowane sa'a, gami da dare.
A rana ta uku, suna ci gaba da yin ma'aunai, suna ci kullum, amma ba su yin insulin gajeriyar hanyar.

Manuniyar alamun safe sune:

a ranar farko - 5 mmol / l,
a rana ta biyu - 8 mmol / l,
a rana ta 3 - 12 mmol / l.

Irin waɗannan alamu na glucose yakamata a samu ba tare da hormone na ɗan gajeren lokaci ba. Misali, idan da safe sugar sukari shine 7 mmol / l, kuma da yamma - 4 mmol / l, to wannan yana nuna buƙatar rage ƙarancin ƙwayar tsufa ta hanyar raka'a 1 ko 2.

Sau da yawa, marasa lafiya suna amfani da dabara ta Forsham don tantance adadin yau da kullun. Idan glycemia ya kama daga 150-216 mg /%, to ana ɗaukar 150 daga matakin sukari wanda aka auna sannan an rarraba adadin sakamakon ta 5. Sakamakon haka, ana samun kashi ɗaya na dogon tsayi. Idan glycemia ya wuce 216 mg /%, an rage 200 daga cikin sukari da aka auna, kuma sakamakon ya kasu kashi 10.

Don sanin ƙarancin insulin gajeren lokaci, kuna buƙatar auna matakin sukari a duk mako. Idan duk dabi'un yau da kullun al'ada ne, banda maraice, to, ana yin gajeren insulin ne kawai kafin abincin dare. Idan matakin sukari ya tashi bayan kowace abinci, to ana bayar da allura nan da nan kafin abinci.

Don tantance lokacin da yakamata a yiwa kulawar, ana buƙatar auna glucose da farko a minti 45 kafin abinci. Na gaba, ya kamata ku sarrafa sukari a kowane minti biyar har sai matakin ya kai matakin 0.3 mmol / l, bayan wannan ya kamata ku ci. Wannan hanyar za ta hana farawar hawan jini. Idan bayan minti 45 sukari baya raguwa, dole ne a jira tare da abinci har sai glucose ta faɗo zuwa matakin da ake so.

Don tantance kashi na insulin ultrashort, ana ba da shawarar mutanen da ke da nau'in 1 da nau'in ciwon sukari guda 2 su bi tsarin abincin har sati guda. Ka lura da yawan su da kuma irin abincin da suke ci. Kar a wuce adadin abincin da aka yarda. Hakanan ya kamata kuyi la'akari da aikin jiki na mai haƙuri, magani, kasancewar cututtukan fata.

Ana gudanar da insulin Ultrashort a minti 5-15 kafin cin abinci. Yaya za a lissafa kashi na insulin NovoRapid a wannan yanayin? Ya kamata a tuna cewa wannan magani yana rage matakin glucose sau 1.5 fiye da gajeren sautinsa. Sabili da haka, adadin NovoRapid shine 0.4 na kashi na gajeren hormone. Za'a iya tantance madaidaicin daidai ta hanyar gwaji.

Lokacin zaɓin ƙwayar insulin, ya kamata a la'akari da matakin cutar, kazalika da gaskiyar cewa buƙatar kowane mai ciwon sukari a cikin ƙwayar ba ta wuce 1 U / kg ba. In ba haka ba, yawan abin sama da ya kamata na iya faruwa, wanda zai haifar da rikitarwa da yawa.

Ka'idoji na yau da kullun don tantance kashi ga masu ciwon sukari:

A farkon matakin nau'in ciwon sukari na 1 na sukari, kashi na hormone bai kamata ya wuce 0.5 U / kg ba.
A cikin nau'in ciwon sukari na 1, wanda aka lura a cikin haƙuri har shekara ɗaya ko fiye, adadin lokaci na insulin wanda aka gudanar shine 0.6 U / kg.
Idan nau'in 1 na ciwon sukari yana tare da wasu manyan cututtuka da yawa kuma suna da alamun da ba a iya tabbatar da suwar glucose na jini ba, adadin sinadarin shine 0.7 U / kg.
A cikin cututtukan sukari da aka lalata, yawan insulin shine 0.8 U / kg.
Idan ciwon sukari yana tare da ketoacidosis, to ana buƙatar 0.9 U / kg na hormone.
A lokacin daukar ciki, mace ta uku-uku tana bukatar 1.0 U / kg.

Don lissafin kashi ɗaya na insulin, kashi na yau da kullun ya kamata ya ninka da nauyin jikin mutum ya kasu biyu, kuma alama ta ƙarshe ya kamata a zagaye.

Yin amfani da miyagun ƙwayoyi "NovoRapid Flexpen"

Za'a iya aiwatar da gabatarwar hormone ta amfani da alkairin sirinji "NovoRapid Flexpen." Yana da lambar canza launi da kuma mai raba wutar lantarki. Yawan aikin insulin da aka gudanar na iya zama daga raka'a 1 zuwa 60, mataki guda na sirinji shine 1 raka'a. A cikin miyagun ƙwayoyi "NovoRapid" allura ana amfani da TM "Novotvist" ko "Novofine" tare da tsawon 8 mm. Idan kayi amfani da sirinji na alkalami, tuna: koyaushe kuna buƙatar samun saiti don allura tare da ku - idan sirinji ya lalace ko ya ɓace.

Kafin gudanar da hormone tare da siki-syringe, kuna buƙatar:

Karanta alamar kuma tabbatar cewa NovoRapid shine insulin da kake buƙata.
Cire hula daga alkalami.
Cire kwalin kwali wanda yake akan allura na diski.
Matsa allura zuwa hannun. Ana buƙatar sabon allura don kowane allura don hana haɓakar ƙwayoyin cuta. Dole allura ba zai lanƙwasa ko ya lalace ba.
Don hana allurar bazata a kan allura bayan kulawar insulin, ba a sa hula ba.

Alƙalin sifar NovoRapid na iya ƙunsar ƙaramin adadin iska a ciki. Don kada kumburin oxygen ya tara, kuma ana gudanar da kashi daidai, ya kamata a bi wasu ƙa'idodi:

Kira 2 KUDI na hormone ta hanyar zaɓar sashi.
Sanya maɓallin sirinji tare da allura sama ka matsa kicin ɗin tare da yatsanka. Don haka kumburin iska zai matsa zuwa yankin na sama.
Riƙe sirinji na FlexPen tare da allura, danna maɓallin farawa koyaushe. Mai yanke allurar a wannan lokacin zai dawo zuwa matsayin "0". Dropaya daga cikin digon kwayar halitta zai bayyana akan allura. Idan wannan bai faru ba, za a iya maimaita hanyar sau shida. Idan insulin ba ya kwarara, to sirinji yana da lahani.

Kafin saita kashi, kuna buƙatar tabbatar cewa mai zaɓin dosing yana cikin matsayi "0". Sannan kuna buƙatar buga lambar raƙuman da ake buƙata, ƙarar maganin yana da izini ta mai zaɓar ta hanyoyin biyu. Lokacin saita kashi, kuna buƙatar yin hankali da ƙoƙarin kada ku buga maɓallin farawa ba da gangan ba, in ba haka ba saki premature na hormone zai faru. Ba shi yiwuwa a tsai da doka fiye da wadda ke cikin shiri "NovoRapid". Hakanan, kada kuyi amfani da ma'aunin saura don tantance adadin sinadarin.

Yayin gudanar da aikin insulin, hanyar da likitocin da ke halartar suka bada shawara ana bin su sau biyu. Don yin allura, danna maɓallin farawa. Riƙe ta har sai mai zaɓin sashi yana wurin “0”. Yayin allurar, kawai maballin farawa ne yake riƙewa. Yayin juyawa na al'ada na nuna sashi, isar insulin baya faruwa.

Bayan allura, allura a karkashin fata ya kamata a riƙe shi na wani sakan shida, ba tare da sakin maɓallin farawa ba. Don haka an gabatar da kashi na insulin gaba daya. Bayan allura, an aika da allura zuwa mashin na waje, kuma lokacin da ta shiga, ba a kwance kuma aka watsar da shi, yana ɗaukar duk matakan kariya. Sannan an rufe sirinji tare da hula. Ana cire allurar bayan kowane allura kuma ba za a iya aje shi da firinji ba. In ba haka ba, ruwa zaiyi ruwa, wanda zai iya haifar da gabatarwar kashi ba daidai ba. Umarnin don amfani zai gaya muku ƙarin bayani game da yadda ake yin insulin NovoRapid.

Kudin Hormone

Magungunan NovoRapid an fito da shi ne bisa ga umarnin likita. Farashin katifar Penfill guda biyar ya kusan 1800 rubles. Kudin kwayar ta FlexPen shine 2,000 rubles. Packageaya daga cikin kunshin ya ƙunshi alkalami na Novorapid guda biyar. Farashi dangane da rarraba cibiyar sadarwa na iya bambanta dan kadan.

Neman Mai haƙuri

Menene sake dubawa game da NovoRapid? Mutane suna cewa yana da kyau kuma yana da laushi insulin. Ayyukan yi sauri. Ya dace da lura da ciwon sukari irin 1, wanda sukari cikin jini ke da wuya a rage shi. Yawancin marasa lafiya suna amfani da shi wajen maganin ciwon sukari na 2. Yawancin masu ciwon sukari suna samun sirinji na flexpen wanda ya dace. Sun kawar da buƙatar siyan sirinji daban.

A matsayinka na mai mulki, marasa lafiya suna amfani da maganin NovoRapid a kan asalin aikin dogon insulin, wanda ke taimakawa kula da matakan sukari na yau da kullun. Yana taimakawa rage matakan glucose na jini bayan abinci, wanda ke sauƙaƙa rayuwa ga masu ciwon sukari da yawa kuma yana ba ku damar cin abinci a waje da lokutan makaranta. Wasu mutane suna ba da shawara a matakin farko na cutar don amfani da wannan hormone kawai.

Akwai mutanen da suke cewa lokacin da ake kulawa da yara kanana, miyagun ƙwayoyi suna haifar da canje-canje kwatsam a cikin sukari na jini a ƙarshen, sakamakon abin da yara ke jin rashin lafiya. Don hana wannan faruwa, iyaye da yawa sun fi son insulin dogon lokaci na NovoRapida.

Patientsarin marasa lafiya sun lura cewa wani zaɓi da aka zaɓa ba daidai ba sau da yawa yana haifar da faruwar haɗarin hypoglycemia da ci gaba da rashin kwanciyar hankali. Don guje wa irin waɗannan tasirin, kar a ba da magani na kai, amma nemi taimako daga kwararru.

Tsarin ilimin rayuwa (ICD-10)

Magani don gudanarwa da aikin inshorar ciki	1 ml
abu mai aiki:
insulin cirewa	CIGABA 100 (3.5 MG)
magabata: glycerol - 16 mg, phenol - 1.5 mg, metacresol - 1.72 mg, zinc chloride - 19.6 μg, sinadarin sodium - 0.58 mg, sinadarin hydrogen phosphate dihydrate - 1.25 mg, sodium hydroxide 2M - kimanin 2 , 2 MG, 2M hydrochloric acid - game da 1.7 MG, ruwa don yin allura - har zuwa 1 ml
Cartayan katako ɗaya ya ƙunshi 3 ml na bayani, daidai yake da 300 PIECES.

Pharmacodynamics

Insulin kamar yadda ake ciki - ana ana ana insulin ne na ɗan adam-mai yin insulin ta hanyar kimiyyar halittar DNA ta keɓaɓɓu ta amfani da damuwa Saccharomyces cerevisiae wanda aka maye gurbin amino acid a matsayin B28 tare da aspartic acid.

Yana hulɗa tare da takamaiman mai karɓa akan ƙwayar cytoplasmic na ƙwayoyin sel kuma yana samar da hadaddun insulin mai karɓar ƙwayar ciki wanda ke motsa ayyukan cikin ciki, gami da kira na enzymes masu yawa (ciki har da hexokinase, pyruvate kinase, glycogen synthase). Rage yawan glucose na jini ya kasance sakamakon sun hada da itsara yawan jigilar ƙwayoyin jikinsa, haɓaka haɓakar ƙwayar cuta, ƙarfafa lipogenesis, glycogenogenesis, da rage ƙimar samar da glucose ta hanta.

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. Tsawon lokacin aikin insulin ya tashi bayan sc gwamnati ya takaita fiye da na insulin mutum mai narkewa.

Bayan sc gwamnatin, da miyagun ƙwayoyi fara a tsakanin 10-20 minti bayan gwamnati. 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 a cikin marasa lafiya da ke dauke da nau'in 1 na ciwon sukari mellitus suna nuna ƙananan ƙananan postprandial maida hankali ne na glucose jini tare da insulin aspart idan aka kwatanta da insulin ɗan adam mai narkewa.

Tsofaffi. Binciken da aka saba dashi, mai sau biyu, makafi, sashen bincike na kantin magani da na pharmacodynamics (FC / PD) na insulin aspart da insulin dan adam a cikin tsofaffi marassa lafiya da ke dauke da nau'in ciwon sukari guda 2 (masu cutar 19 masu shekaru 65 zuwa83, 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.

Nazarin na asibiti ta yin amfani da insulin mutum kafin abinci da keɓewa daban daban bayan an ci abinci a cikin yara ƙanana (marasa lafiya 26 masu shekaru 2 zuwa 6), kuma an gabatar da nazarin guda ɗaya na FC / PD a cikin yara (6– Shekaru 12) 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 masu cutar sukari na 1 masu jini a ciki (322 mata masu juna biyu sunyi nazari, 157 daga cikinsu sun sami insulin aspart, 165 - insulin na mutum) basu bayyana wani mummunan tasirin insulin kamar yadda ya shafi ciki ko lafiyar tayin ba. / jariri.

Trialsarin gwaji na asibiti na mata 27 da ke fama da ciwon sukari wanda ke karɓar insulin da kuma insulin mutum (insulin aspart ya karbi mata 14, insulin mutum 13) ya nuna kwatancen bayanan martaba tare da ingantacciyar ci gaba a cikin kulawar glucose na postprandial tare da kulawar insulin.

Bayanai na Tsare na Haraji

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-gwaje a cikin vitro , ciki har da ɗaure wa masu karɓar insulin da insulin-kamar haɓakar haɓaka-1, haka kuma tasiri akan haɓakar ƙwayar halitta, halayen insulin na kwance suna 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.

Pharmacokinetics

Bayan sc gudanar da insulin aspart T _max a cikin plasma, matsakaita, sau 2 kasa da bayan insulin insulin na mutum. Tare da _max a cikin plasma, a matsakaita (492 ± 256) pmol / l kuma ana samun sa'o'i arbain 40 bayan sc kulawa da kashi 0.15 U / kg ga marassa lafiya da ke ɗauke da cutar sukari irin ta 1. Cikewar insulin ya koma matakinsa na asali sau 4-6 bayan gwamnatin magani. Yawan sha yana da ɗan ƙaramin ƙarfi a cikin marasa lafiya da ke fama da ciwon sukari na 2, wanda ke haifar da ƙananan ƙananan hankali - (352 ± 240) pmol / L - da T _max (60 min). Canji cikin mutum-mutumin 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 _max don kewaya insulin more.

Pharmacokinetics a cikin yara (6-12 years old) da matasa (13-17 shekara) tare da type 1 ciwon sukari mellitus. Komawa daga cikin insulin yana faruwa cikin sauri a cikin duka shekaru biyu tare da T _max kama da wannan a cikin manya. Koyaya, akwai bambance-bambance C _max a cikin rukunoni biyu na shekaru biyu, wanda ke nuna mahimmancin sashin maganin.

Tsofaffi. Bambance-bambance na dangi a cikin kantin magani tsakanin insulin da mutum mai narkewa a cikin tsofaffi marasa lafiya (65-83 shekara, matsakaici shekaru 70) na type 2 ciwon sukari mellitus sun yi kama da waɗanda ke cikin masu sa kai na lafiya da kuma a cikin marasa lafiya marasa lafiya da ciwon sukari mellitus. A cikin tsofaffi marasa lafiya, an lura da raguwar adadin sha, wanda ya haifar da karuwar T _max - 82 (canji 60-120) min, yayin da C _max iri ɗaya ne kamar yadda aka gani a cikin marassa lafiya masu fama da ciwon sukari na 2 kuma ɗan ƙasa kaɗan a cikin marasa lafiya masu fama da ciwon sukari na 1.

Rashin aikin hanta. An gudanar da nazarin likitancin magunguna tare da gabatar da kashi ɗaya na insulin a kusa da marasa lafiya 24 waɗanda aikin hanta ya kasance cikin kewayon daga al'ada zuwa rauni mai wahala. A cikin marasa lafiya da ke fama da aikin hanta, an rage rashi yawan insulin aspart kuma yana da yawa, wanda yake haifar da karuwa 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 rauni na hanta na matsakaici da matsanancin ƙarfi. AUC, C _max a cikin plasma da kuma cikakken sharewa (Cl / F) sun kasance iri ɗaya a cikin mutane tare da ragewa da aikin hanta na al'ada.

Rashin wahala. Anyi nazarin binciken magunguna na insulin kashi a cikin marasa lafiya 18 waɗanda aikin su na asali ya tashi daga al'ada zuwa rauni mai rauni. Babu wani sakamako mai tasiri da Cl creatinine ya yi a AUC, C aka samu _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.