Levemir - insulin aiki mai tsawo

Kula da ciwon sukari yana cikin hanyar maye gurbi. Tunda insulin na kansa baya iya taimakawa wajen daukar glucose daga jini, ana gabatar da analog na wucin gadi. Tare da nau'in ciwon sukari na 1, wannan ita ce hanya daya tilo don kula da lafiyar marasa lafiya.

A halin yanzu, alamomi don magani tare da shirye-shiryen insulin sun fadada, tunda tare da taimakonsu yana yiwuwa a rage matakin sukari a cikin nau'in ciwon sukari mai nau'in 2, tare da cututtuka masu haɗari, ciki da ayyukan tiyata.

Gudanar da ilimin insulin ya kamata yayi daidai da na halitta da kuma ƙaddamar da insulin daga cututtukan fata. Don wannan dalili, ba kawai ana amfani da insulins na gajere ba, har ma da na matsakaitan-lokaci, har da insulin masu aiki na dogon lokaci.

Ka'idojin maganin insulin

Tare da asirin al'ada na insulin, yana kasancewa cikin jini koyaushe a cikin nau'i na matakin basal (tushen). An tsara shi don rage tasirin glucagon, wanda kuma ya haifar da ƙwayoyin alpha ba tare da tsangwama ba. Bayanan asirin kanana karami - kusan 0.5 ko guda 1 a kowace awa.

Domin marasa lafiya da ciwon sukari don ƙirƙirar irin wannan matakin basal na insulin, ana amfani da magunguna masu amfani da dogon lokaci. Wadannan sun hada da insulin Levemir, Lantus, Protafan, Tresiba da sauransu. Gudanar da insulin-aiki mai tsawo ana yin shi sau ɗaya ko sau biyu a rana. Lokacin da aka gudanar sau biyu, tazara tsakanin awa 12.

An zabi kashi na maganin ne akayi daban-daban, tunda ana iya samun babbar bukatar insulin da daddare, sannan kashi na maraice yana ƙaruwa, idan har ana buƙatar raguwa mafi kyau da rana, to sai a tura babban sashi zuwa safiya. Matsakaicin adadin maganin da aka sarrafa yana dogara da nauyi, abinci, aikin jiki.

Baya ga ɓoyewar asalin, ana kuma haifar da samarda insulin don cin abincin. Lokacin da matakan glucose na jini ya tashi, aiki mai aiki da ɓoye insulin ya fara ɗaukar carbohydrates. A yadda aka saba, 12 g na carbohydrates suna buƙatar raka'a 1-2 na insulin.

A matsayin madadin insulin "abinci", wanda ke rage haɓakar hyperglycemia bayan cin abinci, ana amfani da magungunan gajeriyar hanya (Actrapid) da ultrashort (Novorapid). Ana gudanar da irin wannan insulins sau 3-4 a rana kafin kowane babban abinci.

Short insulin na bukatar abun ciye-ciye bayan sa'o'i 2 don lokacin aiki. Wato, tare da gabatarwar na 3, kuna buƙatar cin wani lokaci 3. Shirye-shiryen Ultrashort basu buƙatar irin wannan abincin ba. Matsakaicin aikinsu yana ba ku damar ɗaukar carbohydrates da aka karɓa tare da babban abincin, bayan abin da aikinsu ya daina.

Babban tsarin kula da insulin sun hada da:

1. Gargajiya - da farko, ana lissafin kashi na insulin, sannan abinci, carbohydrates a ciki, ana daidaita ayyukan jiki don dacewa da shi. Ranar ta cika yinin da sa'a. Ba za ku iya canza komai ba a ciki (adadin abinci, nau'in abinci, lokacin shigar da).
2. Intensified - insulin ya saba da tsarin yau da kullun kuma yana ba da 'yanci don gina jadawalin gudanar da aikin insulin da abincin abinci.

Tsarin insulin na motsa jiki yana amfani da duka bango - tsawa da insulin sau ɗaya ko sau biyu a rana, da gajeru (ultrashort) kafin kowane abinci.

Levemir Flexpen - abubuwa da kayan aikin aikace-aikace

Kamfanin kera magunguna Novo Nordisk ne ke kera Levemir Flexpen. Fitar saki wani ruwa ne mara launi, wanda akayi nufin shi kawai don allurar subcutaneous.

Tsarin insulin Levemir Flexpen (analog na insulin na mutum) ya hada da kayan aiki - detemir.An samar da magungunan ne ta injiniyan kwayoyin, wanda ya sa ya yiwu a iya tsara shi ga masu cutar da rashin lafiyan zuwa insulin na asalin dabbobi.

A cikin 1 ml na Levemir insulin ya ƙunshi 100 PIECES, ana sanya mafita a cikin alkalami mai sikelin, wanda ya ƙunshi 3 ml, wato, 300 PIECES. A cikin fakitin 5 filastik kayan diski. Farashin Levemir FlekPen yayi kadan fiye da na magungunan da aka siyar a cikin katako ko kwalaben.

Umarnin don yin amfani da Levemir yana nuna cewa marasa lafiya zasu iya amfani da wannan insulin na farko da na biyu na nau'in ciwon sukari, kuma yana da kyau don maye gurbin maganin cutar siga a cikin mata masu juna biyu.

An gudanar da bincike game da tasirin magungunan a kan nauyin nauyin marasa lafiya. Lokacin da aka gudanar da shi sau ɗaya a rana bayan makonni 20, nauyin marasa lafiya ya karu da 700 g, kuma ƙungiyar kwatancen da ta karɓi insulin-isophan (Protafan, Insulim) ƙari mai haɓaka shine 1600 g.

Dukkanin insulins sun kasu kashi-kashi bisa ga tsawon lokacin aikin:

• Tare da ultrashort-rage tasirin sukari - farawa na aiki a cikin minti na 10-15. Aspart, Lizpro, Khmumulin R.
• M takaice - farawa bayan minti 30, ganiya bayan sa'o'i 2, jimlar lokaci - awanni 4-6. Kannada, Farmasulin N.
• Matsakaicin tsawon lokacin aiki - bayan sa'o'i 1.5 yana fara rage sukarin jini, ya kai kololuwa bayan sa'o'i 4-11, sakamakon yana gudana daga awanni 12 zuwa 18. Insuman Rapid, Protafan, Vozulim.
• Haɗin kai - aiki yana bayyana kanta bayan minti 30, mafi girman hankali daga 2 zuwa 8 hours daga lokacin gudanarwa, yana ɗaukar awanni 20. Mikstard, Novomiks, Farmasulin 30/70.
• Tsawan aikin ya fara ne bayan sa'o'i 4-6, ganiya - 10-18 hours, jimlar tsawon aikin har zuwa rana guda. Wannan rukunin ya hada da Levemir, Protamine.
• Ultra-dogon insulin yana aiki awanni 36-42 - insulin Tresiba.

Levemir insulin aiki ne mai dorewa. Bayanin aikin miyagun ƙwayoyi ba shi da m fiye da isofan-insulin ko glargine. Tsawancin aikin Levemir ya tabbata ne sakamakon cewa kwayoyin halitta a wurin allurar sun samar da hadaddun kuma suna daure wa albumin. Saboda haka, wannan insulin ya kasance sannu a hankali yana isar da sako ga tsokoki.

An zabi Isofan-insulin a matsayin misali don kwatantawa, kuma an tabbatar da cewa Levemir yana da madaidaiciyar shigarwar jini a cikin jini, wanda ke tabbatar da aiwatar da kullun a cikin kullun. Tsarin saukarda glucose yana da alaƙa da samuwar insulin receptor hadadden ƙwayoyin sel.

Levemir yana da irin wannan tasiri akan tafiyar matakai na rayuwa:

1. Yana haɓaka aikin enzymes a cikin tantanin halitta, gami da haɓakar glycogen - glycogen synthetase.
2. Yana motsa motsin glucose cikin tantanin halitta.
3. Yana haɓaka ƙwayoyin tsoka daga kwayoyin jini.
4. Yana ƙarfafa samuwar mai da glycogen.
5. Yana hana aikin glucose a cikin hanta.

Sakamakon rashin bayanan aminci game da amfani da Levemir, ba a ba da shawarar ga yara da ke ƙasa da shekara 2 ba. Lokacin amfani dashi a cikin mata masu juna biyu, babu wani mummunan tasiri akan lokacin daukar ciki, lafiyar jariri, da kuma bayyanar rashin daidaito.

Babu wani bayani kan tasirin kan jarirai yayin shayarwa, amma tunda ya kasance rukunin sunadarai ne masu saurin lalacewa a cikin narkewar abinci da kuma mamaye hanjin, ana iya zaton cewa baya shiga cikin nono.

Yaya ake amfani da Levemir Flexpen?

Amfanin Levemir shine yaduwar kwantar da hankalin magani a cikin jini duk tsawon lokacin aikin. Idan ana gudanar da allurai na 0.2-0.4 IU a 1 kilogiram na nauyin haƙuri, to, iyakar tasirin yana faruwa bayan sa'o'i 3-4, ya kai ga farantin kuma ya kasance har zuwa awanni 14 bayan gudanarwa. Jimlar zaman tsayawar cikin jini shine awanni 24.

Amfanin Levemir shine cewa bashi da takamaiman matakin aiki, saboda haka, idan aka gabatar da shi, babu wani haɗarin yawan sukarin jini mai yawa.An gano cewa hadarin hawan jini a cikin rana yana faruwa kasa da 70%, kuma harin dare cikin kashi 47%. An gudanar da karatun ne na shekaru 2 a cikin marasa lafiya.

Duk da gaskiyar cewa Levemir yana da tasiri yayin rana, ana ba da shawarar ayi shi sau biyu don ragewa da kuma kula da matakan sukari na jini. Idan ana amfani da insulin don haɗuwa tare da gajeren insulins, ana yinsa da safe da maraice (ko a lokacin bacci) tare da tazara na awanni 12.

Don lura da ciwon sukari na 2, za a iya gudanar da Levemir sau ɗaya kuma a lokaci guda ku ɗauki Allunan tare da tasirin hypoglycemic. Matsayi na farko ga irin wannan marasa lafiya shine raka'a 0.1-0.2 da 1 kg na nauyin jikin. An zabi sashi na kowane mara lafiya daban-daban, gwargwadon matakin glycemia.

Ana gudanar da Levemir a karkashin fata na saman farfajiyar cinya, kafada, ko ciki. Dole ne a canza wurin allurar kowane lokaci. Don gudanar da maganin ya zama dole:

• Tare da mai zaɓin kashi, zaɓi adadin rakaɗan da ake so.
• Saka allura cikin shafawar fata.
• Latsa maɓallin Fara.
• Jira 6 - 8 seconds
• Cire allura.

Yin gyare-gyare na ƙirar na iya zama dole ga marasa lafiya tsofaffi waɗanda ke da raunin koda ko aikin hanta, tare da ƙari da kamuwa da cuta, canje-canje a cikin abinci ko tare da ƙara yawan aiki na jiki. Idan an canja mai haƙuri zuwa Levemir daga wasu insulins, to, zaɓin sabon kashi da kuma kula da glycemic na yau da kullun sun zama dole.

Gudanar da daskararru na daukar lokaci mai tsawo, wanda ya hada da Levemir, ba a aiwatar da shi ba saboda hadarin cututtukan hawan jini. Tare da gabatarwar intramuscularly, farawa na aikin Levemir ya bayyana a baya fiye da allurar subcutaneous.

Ba'a yi amfani da magunguna don amfani da pumps insulin ba.

Rashin amsawa yayin amfani da Levemir Flexpen

Abubuwan da ke haifar da sakamako a cikin marasa lafiya da ke amfani da Levemir Flexpen sune yawanci-dogaro ne da haɓaka saboda aikin magani na insulin. Hypoglycemia a tsakanin su yana faruwa mafi yawan lokuta. Yawancin lokaci ana danganta shi da zaɓin mara kyau ko rashin abinci mai gina jiki.

Don haka tsarin aikin hypoglycemic aikin insulin a Levemir yana da ƙasa da magunguna masu kama. Idan, duk da haka, ƙananan taro na glucose a cikin jini yana faruwa, to wannan yana haɗuwa da tsananin damuwa, ƙarancin yunwar, rauni mai rauni. Thearuwar bayyanar cututtuka na iya bayyana kanta cikin ƙarancin sani da haɓakar ƙwaƙwalwar ƙwayar cuta.

Abubuwan da ke faruwa na gida suna faruwa a yankin allura kuma na ɗan lokaci ne. More sau da yawa, jan da kumburi, itching da fata. Idan ba a kiyaye ka'idodin gudanarwa na miyagun ƙwayoyi da injections ba a wuri guda, lipodystrophy na iya haɓaka.

Gabaɗaya halayen gaba ɗaya game da amfani da Levemir yana faruwa ba ƙasa da kullun ba kuma alama ce ta rashin lafiyar mutum. Wadannan sun hada da:

1. Kumburi a cikin kwanakin farko na miyagun ƙwayoyi.
2. Urticaria, rashes akan fata.
3. Rashin Tsarin ciki.
4. Matsalar numfashi.
5. Yawan itching na fata.
6. Cutar Angioneurotic.

Idan kashi yana ƙasa da buƙatar insulin, to, karuwa a cikin sukari na jini zai iya haifar da ci gaban ketoacidosis mai ciwon sukari.

Kwayar cutar sannu a hankali tana ƙaruwa tsawon sa'o'i da yawa ko a kwanaki: ƙishirwa, tashin zuciya, ƙaruwar fitar fitsari, bacci, jan fata, da ƙamshin acetone daga bakin.

A hade amfani da levemir tare da wasu kwayoyi

Magungunan da ke haɓaka kayan ƙira na Levemir akan sukari na jini sun haɗa da allunan rigakafin ƙwayoyin cuta, Tetracycline, Ketoconazole, Pyridoxine, Clofibrate, Cyclophosphamide.

An inganta tasirin hypoglycemic tare da haɗin gwiwar gudanarwar wasu magungunan antihypertensive, magungunan anabolic steroid, da magunguna waɗanda ke ɗauke da barasa na ethyl. Hakanan, barasa a cikin ciwon sukari na iya haifar da karuwa na dogon lokaci wanda ba a sarrafa shi daga rage karfin sukari na jini.

Corticosteroids, maganin hana haihuwa, magungunan da ke dauke da heparin, antidepressants, diuretics, musamman thiazide diuretics, morphine, nicotine, clonidine, hormone girma, masu hana alli na iya rage tasirin Levemir.

Idan ana amfani da reserpine ko salicylates, kazalika da octreotide tare da Levemir, to suna da tasiri mai yawa, kuma zasu iya raunana ko haɓaka kaddarorin magunguna na Levemir.

Bidiyo a cikin wannan labarin yana ba da taƙaitaccen nazarin insulin Levemir Flexpen.

Siffofin

Levemir yana da dukkan halayen insulin na tsawon lokaci, yana da sakamako mai kama da juna ba tare da yawan karfi na tsawon awanni 24 ba, an rage zubar jini a cikin dare, ba a lura da samun nauyi a nau'in masu ciwon suga guda 2 ba. Magungunan yana da tasirin hypoglycemic, wanda ya dogara da halayen mutum na jiki. Wannan yana sauƙaƙa zaɓi na sashi.

Fom ɗin saki

Flexspen da Penfil nau'i biyu ne na Levemir. Ana samar da Penfil a cikin katako, wanda za'a iya maye gurbinsa a cikin alkalannin sirinji ko zana magani daga gare su tare da sirinji na yau da kullun.

Flekspen shine alkalami wanda za'a iya amfani dashi wanda za'a iya amfani dashi har sai an gama magani, ba a bada kayan maye a irin waɗannan samfuran. Sashi yana gyara a cikin kayan guda ɗaya. Novofine needles an saya daban don alkalam. Diamita na samfurin shine 0.25 da 0.3 mm. Kudin tattarawa na allura 100 shine 700 p.

Alƙalami ya dace da marasa lafiya tare da salon rayuwa mai aiki da jadawalin aiki. Idan buƙatar magani ba ta da mahimmanci, koyaushe ba zai yiwu a buga lambar da ake buƙata ba. Ga irin waɗannan marasa lafiya, likitoci suna ba da umarnin Levemir Penfill a hade tare da ingantaccen na'urar don isasshen allurar.

Umarnin don amfani

Sashi yana ƙayyade tsawon lokacin maganin. A farkon hanya, ana yin allura sau daya a rana kafin abinci ko kafin hutawa. Ga marasa lafiya waɗanda ba su yi allurar allurar insulin ba, kashi ɗaya ne raka'a 10 ko kuma kashi 0.1-0.2 a kowace kilogiram.

Ga marasa lafiya da ke amfani da magunguna masu rage sukari, likitoci sun ƙayyade adadin kashi 0.2-0.4 a kowace kilo 1 na nauyi. An kunna aikin bayan sa'o'i 3-4, yana ɗaukar tsawon sa'o'i 14. Ana amfani da kashi na tushe sau 1-2 a cikin yini. Zaku iya shigar da cikakken girma kai tsaye ko rarraba zuwa sassa 2. A wannan yanayin, ana yin allura da safe da maraice tare da tazara ta awanni 12.

Lokacin yin sauyawa daga wani nau'in insulin zuwa Levemir, sashin ba a daidaitawa.

Isarar maganin yana ƙaddara ta hanyar endocrinologist, la'akari da bayanan da ke gaba:

Innovation a cikin ciwon sukari - kawai sha kowace rana.

• mataki na haƙuri aiki
• yanayin wuta
• jini jini
• wahalar yin ciwon sukari,
• tsarin aiki
• pathology na kwastomomi.

Ana gyara maganin idan akwai bukatar tiyata.

Side effects

10% na marasa lafiya suna koka da sakamako masu illa yayin amfani da maganin. Rabin misalai suna halin hypoglycemia. Sauran sakamakon bayan allura ana bayyana su azaman edema, fitar fata, jin zafi, da sauran nau'ikan kumburi. Wani lokacin barnata ya bayyana, ana kawar da tasirin sakamako bayan wasu weeksan makonni.

Sau da yawa yanayin marasa lafiya yana taɓarɓaka da haɓakar ciwon sukari, m zafi ya bayyana ko wasu alamu suna ƙaruwa. Wannan yanayin yana faruwa ne sakamakon mummunan iko na glucose da glycemia. Ana sake gina garkuwar dan Adam, ya zama yana amfani da muggan kwayoyi, alamu na tafi ba tare da magani ba.

Sakamakon sakamako na yau da kullun:

• matsaloli tare da tsarin juyayi na tsakiya,
• zafin hankali yana ƙaruwa
• hannu da kafafu suna tafe
• akwai matsaloli da hangen nesa, hankali na idanu zuwa haske yana ƙaruwa,
• tingling da kona ji a cikin yatsunsu
• matsaloli tare da carbohydrate metabolism,
• kumburi
• cututtuka a cikin ƙoshin mai da ke lalata jiki.

An daidaita cututtukan tare da magani, idan ba zai yiwu a kawar da su ba, likitancin endocrinologist ya zaɓi wani nau'in hormones na wucin gadi. Ana gudanar da magunguna a ƙarƙashin ƙasa, injections na intramuscular suna haifar da nau'i mai rikitarwa na hypoglycemia.

Yawan maganin da zai haifar da yawan zubar jini, likitoci ba zasu iya tantance daidai ba. Ara yawan sannu a hankali yana haifar da hypoglycemia, harin yana farawa yayin barci ko cikin yanayin tashin hankali mai juyayi. Wani mai saukin kamuwa da cuta shine ke dakatar da mai shi a jikinsa, don wannan zaka iya cin wani abu mai zaki. Tare da tsari mai rikitarwa, mutum ya rasa hankali, an allura shi da 1 MG na glucagon cikin ciki. Irin waɗannan alluran ana amincewa da su ta hanyar kwararru ne kawai, idan mara lafiyar bai sake murmurewa ba, ana saka glucose a ciki.

Wajibi ne a gudanar da insulin daidai da jadawalin; ba za a iya daidaita sashi cikin kansa ba, tunda yiwuwar cutar glycemic ko kuma yawan cutar neuropathy yana ƙaruwa.

Umarni na musamman

Kada kayi amfani da Insulin Levemir ga yara 'yan ƙasa da shekaru shida. M far da irin wannan miyagun ƙwayoyi ba ya tsokane kiba. Ana rage yiwuwar haɓaka ƙarancin bacci a cikin dare, saboda haka likitoci za su iya zaɓar mafi kyau gwargwadon ikon sarrafa adadin glucose a cikin jiki.

Levemir insulin yana ba ku damar sarrafa glycemia mafi kyau dangane da canzawar glucose zuwa cikin komai a ciki. Wannan ya bambanta maganin daga Isofan insulin.

Hyperglycemia ko ketoacidosis yana haɓaka tare da ƙarancin insulin a cikin nau'in masu ciwon sukari na 1. Alamomin farkon cutar hauhawar jini suna faruwa a hankali a cikin sa'o'i da yawa ko kwanaki.

• ƙishirwa
• m ugboro ga komai a mafitsara,
• gagging
• tashin zuciya
• koyaushe so barci,
• fatar ta bushe, ta yi ja
• bushe bakin
• talaucin abinci
• yana da ƙanshi kamar acetone.

A cikin nau'in 1 na ciwon sukari, ba tare da ingantaccen jiyya ba, hyperglycemia yana haifar da ketosis mai kisa. Hypoglycemia yana faruwa lokacin da yawan insulin yayi yawa, jiki yana buƙatar ƙasa da haka. Idan kun tsallake abinci ko kuma ku ƙara nauyi a jiki, zazzabin kumburi yana bayyana.

Abubuwan da ke tattare da rikice-rikice na kamuwa da cuta, zazzabi da sauran rikice-rikice suna kara buƙatar haƙuri ga insulin. Canja wurin masu ciwon sukari zuwa sabon nau'in magani daga wasu masana'antun suna buƙatar kulawa ta musamman da kuma daidaitawar sashi. Duk wani canji yakamata ya kula dashi ta hanyar binciken ilimin halittu.

Domin kada ya haifar da hadaddun cututtukan jini, an haramtawa gudanar da maganin cikin maganin. Haɗuwa tare da analog mai sauri-yana nufin rage girman sakamako, idan aka kwatanta da amfani guda.

Insulin yana shafar aiki da tsarin mai juyayi, saboda haka likitoci sun ba da shawarar ku ƙi fitar da motoci ko kayan aiki masu inganci waɗanda ke buƙatar jan hankali da saurin amsawa. Endocrinologists sun fahimci jadawalin yau da kullun na masu ciwon sukari, suna taimakawa wajen daidaita salon rayuwa don samun sakamako mai mahimmanci daga hanya da kuma rage haɗarin yanayi mai haɗari.

Hypoglycemia da hyperglycemia suna da wahalar tattarawa da amsa ga canje-canje mai sauri a cikin yanayin aiki, a wasu yanayi yana da haɗari ga rayuwar mai haƙuri da sauran su. An shawarci marasa lafiya su dauki matakan hana wannan yanayin yayin aiwatar da abubuwan hawa ko kuma hanyoyin kera su. A cikin wasu mutane, wannan yanayin ba tare da alamu na baya ba, yana tasowa da sauri kuma ba zato ba tsammani.

Sashi da gudanarwa

Don Levemir Flexpen, ana amfani da hanyar subcutaneous na gudanarwa. Ana yin amfani da adadin da adadin inje in akayi daban-daban ga kowane mutum.

Idan ana maganar magunguna tare da wakilai masu rage sukari don sarrafa bakin, ana yaba yin amfani da shi sau ɗaya a rana akan maganin 0.1-0.2 U / kg ko 10 U.

Idan ana amfani da wannan magani azaman kayan haɗin tushen-bolus, to an tsara shi gwargwadon buƙatun mai haƙuri 1 ko sau 2 a rana. Idan mutum yana buƙatar yin amfani da insulin sau biyu don kula da daidaitaccen glucose, to, ana iya gudanar da maganin maraice a lokacin abincin dare ko lokacin bacci, ko kuma bayan sa'o'i 12 bayan safiya.

Abubuwan da ke cikin Levemir Penfill an allurar da su subcutaneously a cikin kafada, bangon ciki na ciki ko yankin cinya, ana iya samun ƙarin cikakkun bayanai akan gidan yanar gizon mu. Ko da an yi allura a ɗayan sashin jiki, an buƙaci canza wurin allurar.

Alamu don amfani

Ana ba da shawarar maganin don amfani da masu ciwon sukari tare da nau'ikan cutar. Lokacin da sukari sukari na jini ya yawaita a cikin manya da yara 'yan shekaru 2 da haihuwa, likitoci sun kirkiri Insulin Levemir Flekspen. Don tsara ƙwayar cutar glycemia daidai, da farko allura da miyagun ƙwayoyi sau ɗaya.

Flexspen da Penfil nau'i biyu ne na Levemir. Ana samar da Penfil a cikin katako, wanda za'a iya maye gurbinsa a cikin alkalannin sirinji ko zana magani daga gare su tare da sirinji na yau da kullun.

Contraindications

An hana insulin amfani dashi tare da rashin yarda da mutum ga abubuwan da ke cikin maganin. Ba a tsara Levemir ga yara 'yan ƙasa da shekaru 6 ba.

Don ingantaccen magani na ciwon sukari a gida, masana sun ba da shawara DiaLife . Wannan kayan aiki ne na musamman:

• Normalizes jini glucose
• Yana tsara aikin cututtukan farji
• Cire puffness, yana sarrafa metabolism ruwa
• Inganta hangen nesa
• Ya dace da manya da yara.
• Ba shi da maganin hana haifuwa

Muna ba da ragi ga masu karanta shafinmu!

Sayi kan gidan yanar gizon hukuma

Kada kayi amfani da Insulin Levemir ga yara 'yan ƙasa da shekaru shida. M far da irin wannan miyagun ƙwayoyi ba ya tsokane kiba. Ana rage yiwuwar haɓaka ƙarancin bacci a cikin dare, saboda haka likitoci za su iya zaɓar mafi kyau gwargwadon ikon sarrafa adadin glucose a cikin jiki.

Levemir insulin yana ba ku damar sarrafa glycemia mafi kyau dangane da canzawar glucose zuwa cikin komai a ciki. Wannan ya bambanta maganin daga Isofan insulin.

Hyperglycemia ko ketoacidosis yana haɓaka tare da ƙarancin insulin a cikin nau'in masu ciwon sukari na 1. Alamomin farkon cutar hauhawar jini suna faruwa a hankali a cikin sa'o'i da yawa ko kwanaki.

• ƙishirwa
• gagging
• tashin zuciya
• koyaushe so barci,
• fatar ta bushe, ta yi ja
• bushe bakin
• talaucin abinci
• yana da ƙanshi kamar acetone.

Idan ba tare da ingantacciyar jiyya ba, hyperglycemia ya zama mai mutuwa. Hypoglycemia yana faruwa lokacin da yawan insulin yayi yawa, jiki yana buƙatar ƙasa da haka. Idan kun tsallake abinci ko kuma ku ƙara nauyi a jiki, zazzabin kumburi yana bayyana.

Abubuwan da ke tattare da rikice-rikice na kamuwa da cuta, zazzabi da sauran rikice-rikice suna kara buƙatar haƙuri ga insulin. Canja wurin masu ciwon sukari zuwa sabon nau'in magani daga wasu masana'antun suna buƙatar kulawa ta musamman da kuma daidaitawar sashi. Duk wani canji yakamata ya kula dashi ta hanyar binciken ilimin halittu.

Domin kada ya haifar da hadaddun cututtukan jini, an haramtawa gudanar da maganin cikin maganin. Haɗuwa tare da analog mai sauri-yana nufin rage girman sakamako, idan aka kwatanta da amfani guda.

Insulin yana shafar aiki da tsarin mai juyayi, saboda haka likitoci sun ba da shawarar ku ƙi fitar da motoci ko kayan aiki masu inganci waɗanda ke buƙatar jan hankali da saurin amsawa. Endocrinologists sun fahimci jadawalin yau da kullun na masu ciwon sukari, suna taimakawa wajen daidaita salon rayuwa don samun sakamako mai mahimmanci daga hanya da kuma rage haɗarin yanayi mai haɗari.

Hypoglycemia da hyperglycemia suna da wahalar tattarawa da amsa ga canje-canje mai sauri a cikin yanayin aiki, a wasu yanayi yana da haɗari ga rayuwar mai haƙuri da sauran su. An shawarci marasa lafiya su dauki matakan hana wannan yanayin yayin aiwatar da abubuwan hawa ko kuma hanyoyin kera su. A cikin wasu mutane, wannan yanayin ba tare da alamu na baya ba, yana tasowa da sauri kuma ba zato ba tsammani.

Ana ɗaukar irin waɗannan matakan a cikin yanayi masu zuwa:

• matakin sugar ya canza a kan komai a ciki,
• hypoglycemia yana tasowa a cikin mafarki ko kuma daga baya da yamma,
• matsaloli masu kiba a cikin yara.

Matsakaicin sakamako ana faɗi sosai a cikin kowane nau'in insulin, ban da Levemir. Yiwuwar samun hauhawar jini yana ƙaruwa, akwai raguwar sukari a cikin rana.

• wanda ake iya faɗi sakamakon aiki,
• raguwa a cikin yiwuwar haɓakar haɓakawar jini,
• masu ciwon sukari na rukuni na biyu suna ƙaruwa da nauyi, a cikin wata guda sai su yi nauyi fiye da kilogiram 1.2, lokacin amfani da NPH-insulin, nauyin yana ƙaruwa da nauyin kilogram 2.8,
• yana taimakawa wajen daidaita yunwar, yana rage ci a cikin masu fama da kiba, masu ciwon sukari suna cin abinci sau 160 kcal / day,
• sakin GLP-1 yana kara motsawa, tare da nau'in ciwon sukari na 2 yana haifar da karuwar samar da insulin na halitta,
• yana yiwuwa a sami sakamako mai amfani a cikin rabo na ruwa da gishiri a cikin jiki, da yiwuwar haɓakar hauhawar jini yana raguwa.

Levemir ya fi tsada fiye da sauran kwayoyi masu kama.

Levemir an yi shi kwanan nan, saboda haka babu masu sauƙin rahusa akan hakan. da irin wannan kaddarorin da tsawon lokacin aiki. Canjin magani yana buƙatar sake dawowa da ƙarancin magunguna, yayin da biyan diyya na ɗan lokaci yayi rauni, kuma canjin magani ana yin shi ne kawai da alamun likita.

(Ba a tantance ba tukuna)

Idan har yanzu kuna da tambayoyi ko kuna son raba ra'ayinku, gwaninta - rubuta sharhi a ƙasa.

Gluara yawan glucose a cikin ciwon sukari koyaushe shine sakamakon karancin insulin. Wannan shine dalilin da ya sa sama da shekaru 10 a cikin rarrabuwa na cutar a halin yanzu kalmomin “insulin-dependance” da “non-insulin-depend” mai ciwon sukari mellitus sun ɓace. Duk da kasancewar duk sabbin azuzuwan magunguna don maganin ciwon sukari mellitus, maganin insulin yana ci gaba da kasancewa cikin matsayi mai mahimmanci a cikin kula da ciwon sukari na 2, kuma har yanzu shine tushen kula da ciwon sukari na 1.

SANARWA BASAL INSULIN
Dukkanin hanyoyin "insulin" zuwa insulin na motsa jiki sun danganta ne da maye gurbin rashi yawan tasirin wannan kwayoyi tare da kwayoyi masu aiki da dadewa, duka don rage yawan glucose da kuma shan insulin cikin sauri wanda aka ci tare da carbohydrates.
Matsayin sashin basal na insulin yana da wahalar wuce gona da iri. Yana ba da ingantaccen matakin glycemia a cikin tsaka-tsakin tsakanin abinci da lokacin bacci. A matsakaici, insulin insulin a wannan lokacin shine kusan raka'a 1 a kowace awa, kuma tare da tsawan azumi ko aikin jiki, raka'a 0.5 a awa daya. Kimanin rabin rabin jikin mutum na buƙatar insulin ya faɗi akan rabon sa ɗaya kowace rana.
Ingantaccen insulin insulin ya shafi canzawa yau da kullun, mafi girman buƙatar insulin ana lura dashi a farkon safiya, mafi ƙarancin rana da kuma farkon dare. Dukansu na nau'in 1 da nau'in ciwon sukari na 2, don tsawanta tasirin insulin "basal", ana amfani da shirye-shiryen insulin da aka tsawanta cikin aiki. Har zuwa farkon wannan ƙarnin, waɗannan sune ake kira insulins na matsakaici. Babban wakilan wannan aji shine abin da ake kira insulin din tsaka-tsakin proginine na Hagedorn (NPH).
An ƙara furotin protamine tare da kayyakin alkaline a cikin shiri na insulin, wanda ke rage jinkirin samun insulin daga ƙwayar subcutaneous. Lokacin da aka haɗa wannan furotin tare da insulin a cikin isofan (daidaitawa), an tsawaita tsawon lokacin aikin insulin zuwa awa 14-16.NPH insulins sun sami babban mashahuri a tsakanin endocrinologists da marasa lafiya da ciwon sukari, kamar yadda suka ba da damar inganta aikin cutar, inganta glycemia da dare da safe ba tare da ƙarin injections ba kowane awa 3-4.
Koyaya, shirye-shiryen NPH suna da bangarorin matsaloli da yawa:
- babban bambancin kwayoyi, wanda ya hana saurin zaɓi na yau da kullun, ya maye gurbin ɓoye “basal” na insulin,
- Rashin aiki na insulin a lokacin maganin, wanda ya buƙaci ƙarin abinci da daddare, da rana,
- Tunda shiri na insulin ya kunshi hadadden sunadarai, ya zama dole a yadda yakamata a harhada magunguna, wanda marasa lafiya basa yin sa kuma suna kara yawan samarda insulin din.
Duk waɗannan mahimman abubuwan sun sa ya zama sauƙaƙa ma'anar insulin basal insulin a cikin marasa lafiya da ciwon sukari. A kan ajanda ne da ake bukata don inganta wadatar da hanyoyin da za a bi don warkewa.
BAYANIN KYAUTA
Wannan ya zama mai yiwuwa ne tare da gano tsarin halittar DNA da kuma gabatarwar fasahohin sakewa tun 1977. Masana kimiyya suna da damar da za su iya tantance jerin abubuwan amino acid a cikin sunadarai, canza su da kimanta illolin kimiyyar abubuwan da samfuran suka haifar.
A fannin kimiyyar magunguna, sabon shugabanci ya samo asali - hadaddiyar sabon kwayoyin tare da ingantattun kaddarorin abubuwan da aka yi nazari dasu, magunguna. Don haka, ya zuwa tsakiyar karni na 90 na karni na karshe, ana hada magungunan insulin analogues a cikin maganin maganin ciwon sukari.
Fitowar insulin analogues ya inganta yanayin rayuwar marasa lafiya da masu cutar siga, rage manyan abubuwanda ke kawo cikas ga nadin insulin, kamar:
- a cikin "pre-analog" na jiyya don ciwon sukari, karuwa a cikin kashi na gajeran hancin insulins ya jujjuya ganuwar aikin miyagun ƙwayoyi kuma ana buƙatar gyara rabo na insulin / carbohydrate, lokacin amfani da analogs na aikin sauri, wannan adadin ya fi kwanciyar hankali,
- ɗaukar insulin gajere na aiki daga wurin allura ya ragu sosai ainun na analogs mai sauri, wanda ya buƙaci gudanar da maganin 30-40 mintuna kafin abinci, gabatarwar analogues da aka yarda allura a cikin mintuna 5-10,
- babban haɗarin hypoglycemia, musamman da dare, lokacin ɗaukar NPH insulin, an rage yawan gaske tare da alƙawarin analogues "basal".
Don haka, isowar insulin analogues zuwa cikin aikin asibiti ya ba likitoci da marasa lafiya damar tsara maganin insulin a kan kari, da zazzage magungunan, yadda yakamata, da karancin tsoron maganin rashin karfin jini da sauran halayen masu illa. Daga cikin insulins da suka shigo cikin sabon karni, insulin detemir (Levemir) ya mamaye wani wuri na musamman.
ABIN LEVEMIR YI KYAU
Maganin kwantar da hankali na kwayoyin halitta na insulin Levemir® magani ne na sabon shugabanci - analogues analogues a cikin lura da ciwon sukari. Wannan magani yana sannu a hankali daga wurin ajiyar allura kuma yana da tsawon lokaci saboda aiki tare da kai a cikin respot mai kitse kuma yana ɗaure ga albumin ɗan adam. Kewaya cikin jini, lokaci-lokaci magungunan sun watsar da albumin, yana haifar da tasirin insulin.
A kashi na Levemir® insulin 0.4 U / kg nauyin jiki ko fiye, nauyin gudanarwa guda ɗaya na miyagun ƙwayoyi kowace rana yana barata, tsawon lokacin miyagun ƙwayoyi shine 18-20 hours. Idan kashi na yau da kullun yakamata ya zama mafi girma, ana bada shawarar tsarin sarrafawa sau biyu, gwargwadon maganin a wannan yanayin shine 24 hours.
A cikin shekaru 3 da suka gabata, an yi amfani da insulin Levemir® a cikin Federationungiyar Rasha. Daga cikin fa'idarsa, ya kamata a lura da tsinkayewar ƙarfin aiki a cikin marasa lafiya fiye da insulin "na gargajiya" na NPH. Wannan shi ne saboda dalilai masu zuwa:
- narkar da yanayin detemir a dukkan matakai - daga matakin sashi zuwa dauri zuwa mai insulin,
- Sakamakon buffering na haduwa da maganin albumin.
Wadannan kaddarorin miyagun ƙwayoyi suna haifar da ƙarshe zuwa mafi kyawun kulawa da sukari na jini idan aka kwatanta da insulin NPH - tare da titration na miyagun ƙwayoyi don cimma burin glycemic. Tare da lura da insulin Levemir®, tare da ingantacciya ko makamancin sarrafawa na rage yawan glucose, ana lura da ƙarancin yanayin hypoglycemic (musamman da dare). Dangane da kwarewar kaina, kwarewar abokan aiki, Ina iya faɗi cewa maganin insulin Levemir is yana da daidaituwa tare da marasa lafiya da ke da nau'in 1 da nau'in ciwon sukari na 2 tare da ƙarancin ƙarfin karuwa mai nauyi (kuma a wasu karatun har ma an sami asarar nauyi). Kuma a cikin marasa lafiya tare da kiba, an lura da raguwa a cikin nauyin jiki.
A cikin nazarin mako 18 da aka gudanar a ESC don nazarin tasiri na insulin Levemir® a cikin marasa lafiya da ke da nau'in ciwon sukari na 1 a hade tare da insulin aspart (NovoRapid), an samu raguwar haemoglobin a cikin sau biyu fiye da rukunin insulin na NPH da injin injin ɗan adam. A lokaci guda, yawan hypoglycemia ya kasance 21% ƙananan a cikin rukunin insulin na Levemir®. Kamar yadda a cikin yawancin binciken da aka yi kama da kasashen waje, ba a lura da yawan amfani da nauyi a cikin rukunin farko ba.
Tare da nau'in ciwon sukari na 2, Levemir® shima ya nuna babban ingancin aikin asibiti, yana buɗe damar ba da dama ga marasa lafiya don farawa da haɓaka ilimin insulin. Dangane da bincike da yawa, gudanar da aikin insulin na Levemir® sau 1 a rana daya yafi dacewa ga mafi yawan masu fama da ciwon sukari na 2.
Da farko, an samo bayanai cewa amfani da wannan magani na shekara guda a cikin marasa lafiya waɗanda ba su yi amfani da insulin a baya ba suna da amfani kamar amfani da insulin glargine (Lantus).
Koyaya, an gano cewa lokacin amfani da miyagun ƙwayoyi Levemir® tare da nau'in ciwon sukari na 2, an lura da ƙarancin karuwar nauyin jiki. Haka kuma, samun matsakaitan ma'auni guda na matakan glucose daya, Levemir® insulin therapy an lura cewa yana da ƙananan tasirin hypoglycemia a cikin marasa lafiya idan aka kwatanta da Lantus - 5.8 da 6.2, bi da bi.
An samo irin wannan bayanan a cikin wani babban binciken - PREDICTIVE ™ 303 tare da halartar marasa lafiya fiye da 5,000. Dangane da bayanansa, a cikin marasa lafiya da ke dauke da nau'in ciwon sukari na 2, wanda aka canza shi daga NPH-insulin ko insulin glargine zuwa Levemir®, an lura da raguwa mai yawa a cikin nauyin jiki (fiye da 0.6 kg a cikin watanni 3) an lura da shi a cikin makonni 26 kan tushen ingantaccen glycemia da raguwa abin da ya faru na hypoglycemia.
Dangane da bayanan da aka samo, yakamata a gane cewa:
- ga mafi yawan masu fama da ciwon sukari na 2, amfani da insulin Levemir® 1 lokaci a rana shine mafi kyau duka,
- a kan insulin Levemir®, raguwar cutar glycemia baya haɗuwa da hauhawar nauyin jikin mutum idan aka kwatanta da insulin NPH ko glargine,
- ƙananan haɗarin abubuwa na hypoglycemia a kan asalin insulin Levemir® a kwatanta da insulin NPH tare da daidaituwa na glycemia a cikin marasa lafiya da nau'in ciwon sukari na 2.
CIKIN SIFFOFIN RAYUWA ...
Likita ya kayyade adadin Levemir® insulin daban-daban a kowane yanayi. Ya kamata a gudanar da miyagun ƙwayoyi sau 1 ko 2 a rana, kamar yadda aka ambata a sama, bisa la'akari da bukatun mai haƙuri. Haka kuma, binciken asibiti game da miyagun ƙwayoyi ya sanya ya yiwu a tsara insulin Levemir ba wai kawai a cikin manya ba, har ma a cikin yara, farawa daga shekaru 6.
Wadancan marasa lafiya da masu ciwon sukari waɗanda ke buƙatar yin amfani da miyagun ƙwayoyi sau biyu a rana don ingantaccen iko na matakan glucose na jini na iya shiga cikin maraice na yamma ko dai lokacin abincin dare, ko kafin lokacin bacci, ko kuma awanni 12 bayan asuba.
Ana gudanar da aikin Levemir® a cikin cinya, cinya na ciki ko kafada. Marasa lafiya kada su manta cewa ya zama dole don canza wurin allurar a cikin yankin ilimin jikin.
Mafi kyawun amfani shine amfani da alƙawarin Levemir® Flekspen® wanda aka cika da insulin. Veniarfafawa, daidaiton waɗannan almakunan alkalami yana ba da sauƙin gudanar da maganin, yana taimaka wajan magance kuskure a cikin kulawar insulin, gaba ɗaya yana bada tabbacin mafi kyawun ƙwayar cuta a cikin marasa lafiya da ciwon sukari.
A cikin 1 ml na miyagun ƙwayoyi ya ƙunshi IU 100 na Levemir® insulin, alkalami na syringe ya cika da 3 ml na miyagun ƙwayoyi, kunshin ya ƙunshi na'urorin Flex-Pen 5.Babu wata shakka cewa sabuwar fasahar sarrafa magunguna - mutum, mai amfani-da-yin amfani da alkalami Levemir® Flexspen® yana haɓaka ingancin rayuwar marasa lafiya da masu ciwon sukari yayin riƙe da tasirin ilimin halitta a cikin magani.
Experiencewarewa mai zurfi game da amfani da miyagun ƙwayoyi Levemir® a cikin Tarayyar Rasha a cikin 'yan shekarun nan ya ba mu damar danganta wannan ƙwayar zuwa matsayin insulin basal, kuma babban amincin miyagun ƙwayoyi yayin rashin karuwar nauyin jiki yana ba da damar yin amfani da shi sosai a cikin hadaddun rukuni na marasa lafiya, musamman ma tsofaffi da tsofaffi.

Ph.D., mataimakin farfesa a sashen
endocrinology MMA
su. I.M.Sechenova Alexey Zilov

Za a iya samo asalin labarin a shafin yanar gizon hukuma na jaridar DiaNews.

Shiri: LEVEMIR ® Flexpen ®
Abubuwan da ke aiki: insulin detemir
Lambar ATX: A10AE05
KFG: Analog mai amfani da insulin na ɗan adam
Reg. lamba: LS-000596
Ranar rajista: 07.29.05
Mai mallaka reg. acc.: NOVO NORDISK A / S

MAGANAR CIKIN SAURARA, CIGABA DA AIKATA

M halayen da ke tattare da tasirin tasirin metabolism: sau da yawa (> 1%, 0.1%, 0.1%, 0.1%, 0.01%, 0.1%, TARIHI

Individualara hankalin mutum ga insulin detemir ko kowane ɓangaren magunguna.

FASAHA DA LITTAFINSA

A halin yanzu babu bayanai game da amfanin asibiti na insulin detemir yayin daukar ciki da lactation.

A lokacin yiwuwar farawa da kuma tsawon lokacin haila, sanya idanu a hankali game da yanayin marasa lafiya da ciwon sukari da kuma lura da matakin glucose a cikin jini yana da muhimmanci. 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.

A lokacin shayarwa, yana iya zama dole don daidaita sashi na magani da abinci.

A karatun gwaji Babu wani bambanci da aka samu cikin dabbobi tsakanin amfrayo da cututtukan ƙwayoyin cuta na detemir da insulin na mutum.

Ba kamar sauran insulins ba, magani mai zurfi tare da Levemir Flexpen baya haifar da karuwa a cikin jiki.

Riskarancin haɗarin rashin jini a cikin jini idan aka kwatanta da sauran insulins yana ba da damar ƙarin zaɓi na ƙwayar cuta don cimma burin matakin glucose jini.

Levemir Flexpen yana samar da ingantacciyar ikon sarrafa glycemic (dangane da ma'aunin ma'aunin glucose plasma azumi) idan aka kwatanta da isofan-insulin.Insuarancin isasshen kashi ko dakatar da magani, musamman tare da nau'in ciwon sukari na 1 na zazzabi, na iya haifar da haɓakar hawan jini ko ketoacidosis na ciwon sukari. A matsayinka na mulkin, alamun farko na cututtukan hawan jini suna bayyana a hankali, a cikin sa'o'i da yawa ko kwanaki. Wadannan alamomin sun hada da ƙishirwa, saurin fitar iska, tashin zuciya, amai, amai, jan jiki da bushewar fata, bushewar baki, rashin ci, kamshin acetone a cikin iska mai ƙuna. A cikin nau'in 1 na ciwon sukari na mellitus, ba tare da magani da ya dace ba, hyperglycemia yana haifar da ci gaban ketoacidosis na ciwon sukari kuma yana iya haifar da mutuwa.

Hypoglycemia zai iya haɓaka idan kashi na insulin yayi yawa sosai dangane da buƙatar insulin.

Ficewa abinci ko tsananin motsa jiki na rashin tsari zai iya haifar da hauhawar jini.

Bayan ramawa game da metabolism na metabolism, alal misali, tare da ƙwaƙwalwar insulin mai ƙarfi, marasa lafiya na iya fuskantar alamu na yau da kullun na abubuwan da ke faruwa na hypoglycemia, wanda ya kamata a sanar da marasa lafiya game da. Alamun gargaɗi na yau da kullun na iya ɓace tare da doguwar cutar sankara.

Cututtukan da ke haɗuwa, musamman masu kamuwa da cuta tare da zazzabi, yawanci suna ƙaruwa da buƙatar jikin mutum na insulin.

Canza haƙuri ga sabon nau'in ko shirya insulin na wani mai ƙira dole ne ya faru a ƙarƙashin tsayayyen kulawar likita. Idan kun canza maida hankali, mai samarwa, nau'in, nau'in (dabba, ɗan adam, analogues na insulin mutum) da / ko hanyar samarwarsa (injin ƙirar asali ko insulin na asalin dabba), ana iya buƙatar daidaita sashi. Marasa lafiya da ke juyawa zuwa jiyya tare da Levemir Flexpen na iya buƙatar canza kashi idan aka kwatanta da allurai na shirye-shiryen insulin da aka yi amfani da su a baya. Bukatar daidaitawar kashi na iya tashi bayan gabatarwar kashi na farko ko a cikin makonni na farko ko watanni.

Levemir Flexpen bai kamata a gudanar da shi iv ba, tun da wannan na iya haifar da matsanancin ƙwayar cuta.

Idan Levemir Flexpen ya haɗu da sauran shirye-shiryen insulin, bayanin martaba ɗaya ko duka abubuwan zai canza. Haɗa Levemir Flexpen tare da analog mai saurin aiki, kamar insulin aspart, yana haifar da bayanin aikin tare da rage girman sakamako da jinkiri idan aka kwatanta da gwamnatansu daban.

Levemir Flexpen ba ayi niyya amfani dashi a cikin magungunan insulin ba.

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.

Akwai takamaiman kashi da ake buƙata don yawan yawan insulin yawan insulin, amma hypoglycemia na iya haɓaka a hankali idan aka gabatar da wani babban adadin ga wani haƙuri.

Jiyya: mai haƙuri na iya kawar da ɗimbin ƙwayar cuta mai narkewa ta hanyar shigar da glucose, sukari ko abinci mai-carbohydrate. Sabili da haka, an ba da shawarar ga marasa lafiya masu ciwon sukari don ɗaukar sukari, Sweets, cookies ko ruwan 'ya'yan itace mai dadi tare da su.

Game da cutar hypoglycemia mai tsanani, lokacin da mai haƙuri bai san komai ba, za a iya sarrafa 0.5 zuwa 1 na glucagon i / m ko s / c (wanda aka horar da shi) ko iv dextrose (glucose) (ƙwararren likita ne kawai) ya kamata a gudanar da shi. Hakanan wajibi ne don gudanar da maganin dextrose iv koda mai haƙuri bai sake murmurewa minti 10-15 bayan aikin glucagon. Bayan ya murmure, an shawarci mara lafiya da ya ci abinci mai arzikin carbohydrate don hana sake dawowar cutar sankara.

Sakamakon in vitro da cikin binciken da aka ɗauka na furotin sun nuna rashin ingantacciyar hulɗar asibiti tsakanin insulin detemir da mai acid ko wasu magungunan da ke ɗaukar furotin.

Hypoglycemic sakamako na insulin inganta baka hypoglycemic kwayoyi, Mao hanawa, ACE hanawa, carbonic anhydrase hanawa, zabe beta-blockers, bromocriptine, sulfonamides, anabolic steroids, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, lithium, kwayoyi, dauke da sinadarin ethanol. Maganin hana daukar ciki, GCS, hormones na thyroid, thiazide diuretics, heparin, tricyclic antidepressants, sympathomimetics, danazole, clonidine, jigilar allurar tasirin alli, diazoxide, morphine, phenytoin, nicotine suna rage karfin maganin insulin.

Underarfafawar tasirin reserpine da salicylates, duka raunana da haɓaka a cikin aikin miyagun ƙwayoyi yana yiwuwa.

Octreotide / lanreotide na iya haɓaka da rage buƙatar jiki ga insulin.

Beta-blockers na iya rufe alamun hypoglycemia da jinkirta murmurewa bayan hypoglycemia.

Ethanol na iya haɓakawa da tsawaita tasirin insulin.

Wasu kwayoyi, alal misali, dauke da thiol ko sulfite, lokacin da aka kara su da ƙwayar levemir Flexpen, na iya haifar da lalata insulinir insemir. Levemir Flexpen bai kamata a kara wa mafita mafita ba.

HUKUNCIN FARKON FARKO

Ana ba da magani tare da takardar sayan magani.

SHAWARA DA KUDURAI

Lissafi B. Ya kamata a adana allurar sirinji da ba a amfani da ita tare da miyagun ƙwayoyi Levemir Flexpen a cikin firiji a zazzabi na 2 zuwa 8 ° C (amma ba kusa da injin daskarewa ba). Kar a daskare. Rayuwar shelf shine shekaru 2.

Don kare daga haske, ya kamata a adana alkairin sirinji tare da tafiya a kunne.

Amfani ko ɗauka azaman sirinji na hutawa tare da Levemir Flexpen ya kamata a ajiye shi a zazzabi da bai wuce 30 ° C ba har zuwa makonni 6.

A cikin wannan labarin, zaku iya karanta umarnin don amfani da miyagun ƙwayoyi Levemire . Yana ba da ra'ayi daga baƙi zuwa shafin - masu amfani da wannan magani, kazalika da ra'ayoyin masana kiwon lafiya game da amfani da Levemir a cikin al'adar su. 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 Levemir a gaban wadatattun analogues na tsarin ana amfani dasu. Amfani don kula da ciwon sukari a cikin manya, yara, harda lokacin daukar ciki da lactation. Abun da magani.

Levemire - insulin da dadewa, mai narkewa ne na insulin mutum. Levemir Penfill da Levemir FlexPen ana samar da su ta hanyar fasahar halittar halittar DNA ta hanyar amfani da nau'ikan maitsarki na Saccharomyces.

Tsawan aikin da magungunan Levemir Penfill da Levemir FlexPen ya yi ne saboda hadarin da ke tattare da kwayoyin halitta na detemir insulin kwayoyin a wurin allurar da daure kwayoyin kwayoyin zuwa albumin ta hanyar hada hadadden sarkar acid mai sashin jiki. Idan aka kwatanta da isofan-insulin, ana ƙaddamar da insulin ɗin detemir zuwa ƙwayayoyin da ke a hankali a hankali.Wadannan hanyoyin rarraba jinkiri da aka bayar sun samar da karin daukar abubuwa masu daukar hankali da bayanin aikin Levemir Penfill da Levemir FlexPen idan aka kwatanta da isofan-insulin.

Yana hulɗa tare da takamaiman mai karɓa a kan ƙwayar cytoplasmic na sel na jikin mutum kuma yana samar da hadaddun insulin-receptor wanda ke motsa ayyukan cikin ciki, gami da kira na enzymes masu yawa (hexokinase, pyruvate kinase, glycogen synthetase).

Bayan subcutaneous gwamnatin, mai pharmacodynamic amsa ne gwargwado ga kashi ana gudanar (mafi girman sakamako, tsawon lokaci na aiki, general sakamako).

Bayanan martaba na sarrafa glucose na dare yana da laushi kuma har ma don detemir insulin idan aka kwatanta da insulin isofan, wanda aka nuna a cikin ƙananan haɗarin haɗarin hypoglycemia.

Insulin na insulin + magabata.

Cmax a cikin plasma an kai shi bayan sa'o'i 6-8 bayan gudanarwa. Tare da yin aiki sau biyu na aikin Css na maganin a cikin plasma jini an samu shi ne bayan inje 2-3.

Bambancin ɗaukar ciki na ciki yana da ƙananan ƙananan don Levemir Penfill da Levemir FlexPen idan aka kwatanta da sauran shirye-shiryen insulin basal.

Babu wani bambance-bambancen jinsi na asibiti a cikin magungunan likitancin Levemir Penfill / Levemir Flexpen.

Rashin ƙwayar magani Levemir Penfill da Levemir FlexPen sunyi kama da na shirye-shiryen insulin na mutum, duk metabolites da aka kafa basa aiki.

Nazarin da ke tattare da kariya a cikin protein yana nuna rashi ma'amala tsakanin likitanci tsakanin insemir insulin da kitse mai guba ko wasu magunguna masu alakanta furotin.

Matsakaicin rabin rayuwar bayan allurar subcutaneous an ƙaddara ta da girman ɗaukar daga ƙwayar subcutaneous kuma tana awanni 5-7, gwargwadon yawan.

• ciwon sukari wanda yake dogaro da insulin-da-suga wanda yake fama da shi (nau'in ciwon sukari guda 1),
• rashin lafiyar insulin-da ke fama da ciwon sukari mai suna mellitus (nau'in ciwon sukari na 2).

Magani don gudanar da aikin Levemir Penfill a cikin katako na katako na raka'a 300 (3 ml) (injections a cikin ampoules don allura).

Magani don gudanar da aikin katako na katako na gilashin gilashin Levemir Flexpen na 300 PIECES (3 ml) a cikin sirinji na ɗimbin yawa na kwayar cuta don maimaita alluran 100 PIECES a cikin 1 ml.

Umarnin don amfani, sashi da dabarar allura

Shiga cikin kashi a cinya, bangon ciki ko kafada. Wajibi ne don canja wurin allurar a cikin yankin na jikin mutum don hana haɓakar lipodystrophy. Insulin zai yi sauri idan an shigar dashi a bangon ciki na ciki.

Shigar da sau 1 ko sau biyu a rana dangane da bukatun masu haƙuri. Marasa lafiya waɗanda ke buƙatar yin amfani da miyagun ƙwayoyi sau 2 a rana don ingantaccen iko na glycemic na iya shiga cikin maraice na yamma ko dai a lokacin abincin dare, ko kafin lokacin bacci, ko kuma awanni 12 bayan lokacin asuba.

A cikin tsofaffi marasa lafiya, har ma tare da hanta mai rauni da aikin koda, ya kamata a kula da matakan glucose na jini sosai kuma ana daidaita alluran insulin.

Hakanan ana iya buƙatar daidaita yanayin zafin yayin inganta aikin mutum na mara lafiya, canza tsarin abincinsa na yau da kullun, ko tare da ciwo mai haɗari.

Lokacin canzawa daga insulins-matsakaiciyar matsakaici da tsawan insulin zuwa insulin, detemir na iya buƙatar sashi da daidaita lokaci. Kulawa sosai da matakan glucose na jini yayin fassarar kuma a cikin farkon makonni na shawarar insemir insulin magani ana bada shawara. Za'a iya buƙatar gyaran conpoffiki na hypoglycemic therapy (kashi da lokacin gudanar da shirye-shiryen insulin gajeren aiki ko kuma magunguna na maganin hypoglycemic na baka).

• hypoglycemia, alamomin wanda yawanci suna haɓaka ba zato ba tsammani kuma suna iya haɗawa da fatar jiki, gumi mai sanyi, ƙarancin jiki, damuwa, damuwa, damuwa, gajiya ko rauni, yanayin damuwa, matsanancin damuwa, nutsuwa, matsananciyar yunwar, wahalar gani, ciwon kai zafi, tashin zuciya, palpitations. Mai tsananin rashin ƙarfi na iya haifar da asarar hankali da / ko raɗaɗi, raunin na ɗan lokaci ko kuma ba zai iya juyawa ga aikin kwakwalwa har zuwa mutuwa,
• halayen cututtukan gida (jan launi, kumburi da itching a wurin allurar) yawanci na ɗan lokaci ne, i.e. bace tare da ci gaba da magani,
• lipodystrophy (sakamakon rashin bin ka'idodin canza wurin allura tsakanin yankin guda),
• cututtukan mahaifa
• fata fitsari
• fata ƙaiƙayi
• sweating,
• rikicewar ciki,
• angioedema,
• wahalar numfashi
• samarin
• raguwa a cikin karfin jini,
• take hakkin shakatawa (mafi yawa na ɗan lokaci kuma ana lura dashi a farkon jiyya tare da insulin),
• retinopathy na ciwon sukari (ingantawa na tsawon lokaci a cikin kulawar glycemic yana rage haɗarin ci gaba na ciwon sukari, duk da haka, ƙaruwar insulin therapy tare da ingantacciyar haɓakawa a cikin sarrafa metabolism na metabolism na iya haifar da lalacewa ta ɗan lokaci a cikin yanayin maganin ciwon sukari),
• na gefe na neuropathy, wanda yake yawan juyawa ne,
• kumburi.

• haɓaka ƙwaƙwalwar insulin na mutum ɗaya.

Haihuwa da lactation

A halin yanzu, babu bayanai game da amfani da asibiti na Levemir Penfill da Levemir FlexPen yayin ciki da lactation.

A lokacin yiwuwar farawa da kuma tsawon lokacin haila, sanya idanu a hankali game da yanayin marasa lafiya da ciwon sukari da kuma lura da matakin glucose a cikin jini yana da muhimmanci. 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.

A lokacin shayarwa, yana iya zama dole don daidaita sashi na magani da abinci.

A cikin nazarin dabbobi na gwaji, babu bambance-bambance da aka samu tsakanin amfrayo da tasirin cutar ta detemir da insulin na mutum.

Yi amfani da shi a cikin tsofaffi marasa lafiya

A cikin tsofaffi marasa lafiya, matakan glucose na jini ya kamata a sa ido sosai kuma allurai insulin su.

An yi imani cewa kulawa mai zurfi tare da insulin disemir baya ƙaruwa da nauyin jiki.

Riskarancin haɗarin rashin jini a cikin jini idan aka kwatanta da sauran insulins yana ba da damar ƙarin zaɓi na ƙwayar cuta don cimma burin matakin glucose jini.

Insemir insulin yana samar da ingantaccen iko na glycemic (bisa la'akari da ma'aunin glucose na plasma azumi) idan aka kwatanta shi da insulin isofan. Insuarancin magunguna ko dakatar da magani, musamman tare da nau'in ciwon sukari na 1 na ciwon sukari, na iya haifar da haɓakar cututtukan hyperglycemia ko ketoacidosis na ciwon sukari. A matsayinka na mulkin, alamun farko na cututtukan hawan jini suna bayyana a hankali, a cikin sa'o'i da yawa ko kwanaki. Wadannan alamomin sun hada da ƙishirwa, saurin fitar iska, tashin zuciya, amai, amai, jan jiki da bushewar fata, bushewar baki, rashin ci, kamshin acetone a cikin iska mai ƙuna. A cikin nau'in 1 na ciwon sukari na mellitus, ba tare da magani da ya dace ba, hyperglycemia yana haifar da ci gaban ketoacidosis na ciwon sukari kuma zai iya zama mai mutuwa.

Hypoglycemia zai iya haɓaka idan kashi na insulin yayi yawa sosai dangane da buƙatar insulin.

Ficewa abinci ko tsananin motsa jiki na rashin tsari zai iya haifar da hauhawar jini.

Bayan ramawa game da metabolism na metabolism, alal misali, tare da ƙwaƙwalwar insulin mai ƙarfi, marasa lafiya na iya fuskantar alamu na yau da kullun na abubuwan da ke faruwa na hypoglycemia, wanda ya kamata a sanar da marasa lafiya game da. Alamun gargaɗi na yau da kullun na iya ɓace tare da doguwar cutar sankara.

Cututtukan da ke haɗuwa, musamman masu kamuwa da cuta tare da zazzabi, yawanci suna ƙaruwa da buƙatar jikin mutum na insulin.

Canza haƙuri ga sabon nau'in ko shirya insulin na wani mai ƙira dole ne ya faru a ƙarƙashin tsayayyen kulawar likita.Idan kun canza maida hankali, mai samarwa, nau'in, nau'in (dabba, ɗan adam, analogues na insulin mutum) da / ko hanyar samarwarsa (injin ƙirar asali ko insulin na asalin dabba), ana iya buƙatar daidaita sashi.

Bai kamata a gudanar da insulin na insemir a cikin ciki ba, saboda yana iya haifar da matsanancin ƙwayar cuta.

Haɗa Levemir Penfill da Levemir FlexPen insulin tare da yin amfani da insalin insulin cikin sauri, kamar insulin aspart, yana haifar da bayanin aikin tare da ragewa da jinkiri mafi girman sakamako idan aka kwatanta da na gwamnatinsu.

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.

Hypoglycemic sakamako na insulin inganta baka hypoglycemic kwayoyi, Mao hanawa, ACE hanawa, carbonic anhydrase hanawa, zabe beta-blockers, bromocriptine, sulfonamides, anabolic steroids, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, lithium, kwayoyi, dauke da sinadarin ethanol. Maganin hana daukar ciki, GCS, hormones na thyroid, thiazide diuretics, heparin, tricyclic antidepressants, sympathomimetics, danazole, clonidine, jigilar allurar tasirin alli, diazoxide, morphine, phenytoin, nicotine suna rage karfin maganin insulin.

A ƙarƙashin rinjayar reserpine da salicylates, duka raunana da haɓaka aikin insulin detemir yana yiwuwa.

Octreotide / lanreotide na iya haɓaka da rage buƙatar jiki ga insulin.

Beta-blockers na iya rufe alamun hypoglycemia da jinkirta murmurewa bayan hypoglycemia.

Ethanol (barasa) na iya haɓakawa da tsawaita tasirin insulin.

Wasu kwayoyi, irin su waɗanda ke ɗauke da thiol ko sulfite, lokacin da aka ƙara detemir a cikin insulin, na iya haifar da lalata insulin detemir.

Analogs na miyagun ƙwayoyi Levemir

Tsarin analogues na mai aiki abu:

• Insulin ya fice,
• Levemir Penfill,
• Levemir FlexPen.

Analogs a cikin rukunin magunguna (insulins):

• Aiki
• Apidra
• Apidra SoloStar,
• Berlinsulin,
• Kalabinal Basal,
• Berlinsulin N al'ada,
• Biosulin
• Brinsulmidi
• Brinsulrapi
• Zamu yi mulki 30/70,
• Gensulin
• Asarar insulin C,
• Isofan insulin Gasar Cin Kofin Duniya,
• Iletin 2,
• Insulin kewayawa,
• Insulin glargine,
• Insulin glulisin,
• Insulin ya fice,
• Insulin Isofanicum,
• Tekin insulin,
• Lyspro insulin
• Insulin maxirapid,
• Matsakaici insulin
• Insulin s
• Insulin na alade yana tsarkakakken babban ɗanɗani MK,
• Insulin kwalliya,
• Insulin Ultralente,
• Jinin ɗan adam
• Halin ɗan adam,
• Sulin-roba ɗan adam
• Inulin na sake sarrafa mutum
• Insulin Tsawon QMS,
• Insulin Ultralong SMK,
• Insalong SPP,
• Sanya SPP,
• Insuman Bazal,
• Insumanci Comb,
• Insuman Rapid,
• Insuran
• Intal
• Combinsulin C
• Lantus
• Lantus SoloStar,
• Levemir Penfill,
• Levemir Flexpen,
• Mikstard
• Monoinsulin
• Monotard
• NovoMiks,
• Lakaya,
• Pensulin,
• Alurar insulin
• Protafan
• Rysodeg Penfill,
• Rysodeg FlexTouch,
• Reulinbin ɗan adam,
• Rinsulin
• Rosinsulin,
• Sultofay,
• Tresiba,
• Tujeo SoloStar,
• UltMard NM,
• Homolong 40,
• Homorap 40,
• Humalog,
• Humalog Kuka,
• Humodar
• Humulin
• Humulin akai-akai.

Idan babu analogues na miyagun ƙwayoyi don ƙwayar abu mai aiki, zaku iya danna hanyoyin da ke ƙasa zuwa cututtukan da maganin da ya dace ya taimaka daga kuma duba magungunan analogues na maganin warkewa.

Insvepen dinda yake yin aiki na dogon lokaci yana da muhimmanci domin ya sami damar kula da yanayin glucose din a cikin jini a cikin yanayin azumi a daidai wannan adadin da yake haifar da kwanciyar hankali. Wannan ya zama dole, saboda in babu homon, jikin zai fara narke kayan jikinshi da kitsen sa, yana haifar da faruwar cutar ketoacidosis mai ciwon sikila (gurbataccen metabolism, wanda yake haifar da mutuwa).

Babban bambanci tsakanin mai yin aiki mai tsayi da magani mai saurin motsa jiki shine yawan hauhawar sukari na jini, wanda koyaushe yana faruwa bayan cin abinci, ba a nufin rage shi ba: yana da jinkirin wannan. Saboda haka, Levemir Flexpen galibi yana haɗuwa tare da kwayoyi na gajeren lokaci (insulin lispro, aspart) ko wasu magunguna masu rage sukari.

Kamfanin Levemir Flexpen ne ya samar da kamfanin sarrafa magunguna na kasar Novo Nordisk A / S (da yawa sun gamsu da cewa wannan insulin na Rasha ne, tunda kamfanin yana da shuka a yankin Kaluga inda yake samar da magunguna masu rage sukari). Fitar saki ce mai launin fari, mara launi wacce akayi nufin kawai allurar subcutaneous. Dangane da umarnin, an kirkiro maganin don marasa lafiya na biyu da na biyu nau'in ciwon sukari, ya tabbatar da kansa a cikin maganin ciwon sukari.

Levemir Flexpen mai aiki mai aiki shine Detemir - analogue na hormone mutum wanda aka samu ta hanyar injiniyan kwayoyin, sabili da haka, baya haifar da rashin lafiyan, sabanin magungunan asalin dabbobi. Wani mahimmancin amfani da maganin, bisa ga sake dubawa, shine cewa kusan ba shi da tasiri a cikin asarar nauyi.

Bincike ya nuna cewa idan kun kwatanta wannan magani da keɓewa, zaku iya ganin cewa bayan makonni ashirin da amfani da detemir (sau ɗaya), nauyin batutuwa ya karu da nauyin 0.7 kg, yayin da kwayoyi daga ƙungiyar insulin-isofan suka ƙara nauyinsu da nauyin kilogram 1.6 . Tare da allura biyu, bayan makonni ashirin da shida, nauyin jikin ya karu da nauyin 1.2 da 2.8, bi da bi.

Yawan aiki

Akwai manyan nau'ikan magunguna guda biyu: hormone mai narkewa yana nufin magani mai gajeriyar aiki, ana samun su ta hanyar dakatarwa - tsawaita. A lokaci guda, sun kasu kashi uku, kuma mafi kusa, zuwa kashi hudu ko biyar.

• matsananci-gajere mataki - yayin da magani na gajeren lokaci ya fara aiki cikin rabin sa'a, kuma waɗannan magunguna - da sauri, cikin mintuna goma zuwa goma sha biyar (insulin Aspart, Liulinpro insulin, mai tsara Humulin),
• gajarta aiki - rabin sa'a bayan allura, ganiya yana farawa a cikin sa'o'i ɗaya da rabi zuwa uku, tsawon lokacin aikin yana daga sa'o'i huɗu zuwa shida. Daga cikin waɗannan magungunan, mutum na iya bambanta insulin Actrapid ChS (Denmark), Farmasulin N (Russia),
• matsakaici tsawon lokaci - yana farawa awoyi daya da rabi bayan allura, ganiya yana faruwa bayan sa'o'i 4-12, tsawon lokaci - daga 12 zuwa 18 sa'o'i (Insuman Rapid GT),
• hada aiki - mai aiki tuni mintuna talatin bayan allura, ya kai kololuwa bayan awanni 2-8, sakamakon ya kai har zuwa awanni ashirin (NovoMiks 30, Mikstard 30 NM, Humodar, insulin Aspart two-phase, Farmasulin 30/70),
• aiki na dogon lokaci: fara aiki bayan sa'o'i 4-6, ganiya - tsakanin 10 da 18 sa'o'i, tsawon lokaci har zuwa awanni 24 (insulin Levemir, gaggawa insulin),
• matsanancin aiki - tasirin miyagun ƙwayoyi a jikin mutum ya kasance tsawon awanni 36 zuwa 42 (Degludek).

Duk da cewa an bayyana Levemir Flexpen a cikin umarnin a matsayin magani mai amfani da dogon lokaci, bisa ga sake dubawa, bai isa ba kwana guda: tsawon lokacin da tasirin maganin zai kasance, ya dogara da nau'in cutar. Don masu ciwon sukari na 2, sakamakon maganin zai iya ɗaukar tsawon sa'o'i ashirin da huɗu. Game da nau'in masu ciwon sukari na farko, shirin insulin yana bada damar allura ba sau biyu a rana.

Ga masu ciwon sukari na nau'o'in farko da na biyu, don guje wa haɓakar sukari da cimma daidaituwa a cikin jini, da yawa suna ba da shawarar yin amfani da Levemir Flexpen sau biyu a rana: a wannan yanayin, bayan allurai biyu ko uku na farko, zaku iya cimma yawan adadin glucose da ake buƙata a jiki.

Magungunan ya fi dacewa daga sa'o'i uku zuwa goma sha huɗu, wanda yayi kama da magani tare da kwayoyi tare da matsakaicin tsawon lokacin aiki, alal misali, daga ƙungiyar insulin-isofan. Abu mai aiki a cikin jini ya kai matsayin da yafi maida hankali akai shida zuwa takwas bayan allurar. Yawancin marasa lafiya sun lura cewa a tsakiyar akwai kololuwa, amma ba a faɗi shi kamar na magunguna masu amfani da dogon lokaci waɗanda aka haɓaka da shi ba. An fi nuna rashin ƙarfi musamman a cikin marasa lafiya da ke fama da ciwon sukari na 2.

Rabin-rabi ya dogara da sashi, gwargwadon sha daga ƙwayar subcutaneous kuma yana ɗaukar awowi biyar zuwa bakwai bayan allurar. Sakamakon maganin na tsawon lokaci shine saboda gaskiyar cewa abu mai aiki yana saurin saki jikin mutum a cikin ƙananan ƙwayoyin mai mai rauni, saboda adadinta a cikin jini ya kasance kusan canzawa a duk tsawon lokacin aikin.

Gyara daidaitawa

A cikin marasa lafiya a cikin tsufa ko a gaban renal ko hepatic kasawa, gyara kashi na wannan magani ya kamata a za'ayi, kamar yadda sauran insulin. Farashi bai canza daga wannan ba.

Ya kamata a zaba yawan insulin din insemir daban-daban tare da lura da lura da glucose a cikin jini.

Hakanan, sake dubawa ya zama dole tare da ƙara yawan aiki na jiki na mai haƙuri, kasancewar cututtukan haɗuwa ko canji a cikin abincinsa na yau da kullun.

Juyawa daga wasu shirye-shiryen insulin

Idan akwai bukatar canja wurin mai haƙuri daga tsawan insulin ko magunguna na matsakaiciyar lokacin aiki zuwa Levemir Flexpen, to za a buƙaci canji a cikin tsarin mulki na wucin gadi, gami da daidaita sashi.

Kamar yadda ake amfani da wasu kwayoyi masu kama da juna, ya zama dole a sa ido sosai a kan abubuwan da ke cikin glucose na jini yayin sauyin kanta da kuma lokacin fewan makonni na farko na amfani da sabon magani.

A wasu halaye, dole ne a sake nazarin hanyoyin magance matsalar rashin daidaituwa, alal misali, kashi na miyagun ƙwayoyi don maganin baka ko kuma sashi da lokacin gudanar da shirye-shiryen insulin na gajeran lokaci.

Yi amfani da lokacin daukar ciki da lactation

Babu ƙwarewar asibiti da yawa tare da amfani da Levemir Flexpen a lokacin haihuwar yaro da shayarwa. A cikin nazarin aikin haihuwa a cikin dabbobi, babu bambance-bambance a cikin tayi da teratogenicity tsakanin insulin mutum da insulin detemir.

Idan mace ta kamu da ciwon sukari, za a sa ido sosai a matakan shirin da kuma cikin lokacin haihuwar.

A cikin farkon farkon, yawanci bukatar insulin ya ragu, kuma a cikin lokuta masu zuwa na ƙaruwa. Bayan haihuwa, yawanci bukatar wannan hormone da sauri ya kan fara zuwa matakin farko wanda yake kafin yin ciki.

Yayin shayarwa, mace na iya buƙatar daidaita abincin ta da kuma yawan insulin.

Side sakamako

A matsayinka na doka, sakamako masu illa a cikin mutane da ke amfani da miyagun ƙwayoyi Levemir Flexpen suna dogara ne kai tsaye akan kashi kuma sune sakamakon aikin magunguna na insulin.

Sakamakon mafi yawan tasirin cuta shine hypoglycemia.Yana faruwa lokacin da aka gudanar da magunguna masu yawa da suka wuce buƙatun jiki na insulin.

Nazarin asibiti ya nuna cewa kusan 6% na marasa lafiya waɗanda ke shan magani na Levemir Flexpen suna haɓaka ƙarancin cututtukan cututtukan jini waɗanda ke buƙatar taimakon wasu mutane.

Amsawa ga gudanar da miyagun ƙwayoyi a wurin allura lokacin amfani da Levemir Flexpen sun fi yawa fiye da lokacin da aka bi da su tare da insulin mutum. An bayyana wannan ta hanyar redness, kumburi, kumburi da itching, kurma a wurin allurar.

Yawanci, irin waɗannan halayen ba a furta kuma suna kasancewa na ɗan lokaci (ɓace tare da ci gaba da jiyya na kwanaki ko makonni).

Haɓaka sakamako masu illa a cikin marasa lafiya da ke gudana tare da wannan magani yana faruwa a cikin kusan kashi 12% na lokuta. Duk mummunan halayen da miyagun ƙwayoyi suka haifar Levemir Flexpen sun kasu kashi biyu:

1. Tsarin abinci na rayuwa da rashin abinci mai gina jiki.

Mafi yawan lokuta, cututtukan jini suna faruwa, suna da alamomin masu zuwa:

• gumi mai sanyi
• gajiya, gajiya, rauni,
• pallor na fata
• jin damuwa
• tashin hankali ko rawar jiki,
• rage hankali span da disorientation,
• jin karfi na yunwar
• ciwon kai
• karancin gani
• karuwar zuciya.

A cikin matsanancin rashin ƙarfi, mai haƙuri na iya rasa hankali, zai iya fuskantar cramps, rikicewar wucin gadi ko ba a iya warwarewa a cikin kwakwalwa na iya faruwa, kuma sakamako mai kisa na iya faruwa.

1. Amsawa a wurin allurar:

• redness, itching da kumburi sau da yawa ana faruwa a wurin allurar. Yawancin lokaci suna ɗan lokaci kuma suna wucewa tare da ci gaba da jiyya.
• lipodystrophy - da wuya ya faru, yana iya farawa saboda gaskiyar cewa ba a kiyaye dokar canza wurin allura a cikin yankin guda ba,
• edema na iya faruwa a farkon matakan insulin.

Duk waɗannan halayen ba yawanci ba ne.

1. Canje-canje a cikin tsarin rigakafi - fatar fata, amya, da sauran halayen rashin lafiyan jiki na iya faruwa a wasu lokuta.

Wannan shi ne sakamakon jigilar cutarwar jiki. Sauran alamun na iya haɗawa da ɗumi, amai, amai, raunin jijiyoyi, wahalar numfashi, saukar da saukar karfin jini, da bugun zuciya.

Bayyanar bayyanar cututtukan da ke haifar da rashin daidaituwa (halayen anaphylactic) na iya zama haɗari ga rayuwar mai haƙuri.

1. Rashin gani da gani - a lokuta da ƙarancin yanayi, cututtukan fuka-fukan ciwon sikila ko kuma raunin nakuda na iya faruwa.

Yawan abin sama da ya kamata

Ba a tabbatar da takamaiman matakin ba na iya haifar da yawan insulin na insulin, amma idan aka yi babban aiki ana baiwa wani mutum, sannu a hankali jini zai fara.

Tare da digiri mai sauƙi na wannan yanayin, mai haƙuri zai iya yin haƙuri da kansa ta hanyar cin abinci mai girma a cikin carbohydrates, kazalika da ɗaukar glucose ko sukari. Sabili da haka, marasa lafiya da ciwon sukari ya kamata koyaushe suna ɗaukar cookies, Sweets, sukari ko ruwan 'ya'yan itace.

Insvepen dinda yake yin aiki na dogon lokaci yana da muhimmanci domin ya sami damar kula da yanayin glucose din a cikin jini a cikin yanayin azumi a daidai wannan adadin da yake haifar da kwanciyar hankali. Wannan ya zama dole, saboda in babu homon, jikin zai fara narke kayan jikinshi da kitsen sa, yana haifar da faruwar cutar ketoacidosis mai ciwon sikila (gurbataccen metabolism, wanda yake haifar da mutuwa).

Babban bambanci tsakanin mai yin aiki mai tsayi da magani mai saurin motsa jiki shine yawan hauhawar sukari na jini, wanda koyaushe yana faruwa bayan cin abinci, ba a nufin rage shi ba: yana da jinkirin wannan. Saboda haka, Levemir Flexpen galibi yana haɗuwa tare da kwayoyi na gajeren lokaci (insulin lispro, aspart) ko wasu magunguna masu rage sukari.

Kamfanin Levemir Flexpen ne ya samar da kamfanin sarrafa magunguna na kasar Novo Nordisk A / S (da yawa sun gamsu da cewa wannan insulin na Rasha ne, tunda kamfanin yana da shuka a yankin Kaluga inda yake samar da magunguna masu rage sukari). Fitar saki ce mai launin fari, mara launi wacce akayi nufin kawai allurar subcutaneous. Dangane da umarnin, an kirkiro maganin don marasa lafiya na biyu da na biyu nau'in ciwon sukari, ya tabbatar da kansa a cikin maganin ciwon sukari.

Levemir Flexpen mai aiki mai aiki shine Detemir - analogue na hormone mutum wanda aka samu ta hanyar injiniyan kwayoyin, sabili da haka, baya haifar da rashin lafiyan, sabanin magungunan asalin dabbobi. Wani mahimmancin amfani da maganin, bisa ga sake dubawa, shine cewa kusan ba shi da tasiri a cikin asarar nauyi.

Bincike ya nuna cewa idan kun kwatanta wannan magani da keɓewa, zaku iya ganin cewa bayan makonni ashirin da amfani da detemir (sau ɗaya), nauyin batutuwa ya karu da nauyin 0.7 kg, yayin da kwayoyi daga ƙungiyar insulin-isofan suka ƙara nauyinsu da nauyin kilogram 1.6 . Tare da allura biyu, bayan makonni ashirin da shida, nauyin jikin ya karu da nauyin 1.2 da 2.8, bi da bi.

Ciki da yara

Dole ne a kula da mata masu ciwon sukari yayin daukar ciki kuma ya kamata a daidaita sashi gwargwadon yanayin sa a matakan daban-daban na haihuwar yara. Yawancin lokaci, a cikin watanni na farko, buƙatar jikin mutum na insulin yana raguwa sosai, a cikin watanni biyu na gaba yana ƙaruwa, bayan haihuwar jariri, ya koma matakin da yake a gaban ciki.

Yayin binciken, an yanke shawarar lura da mata dari uku masu ciki waɗanda aka bi da su da insulin ɗan adam (waɗanda ake kira analogs na lafiyar insulin na ɗan adam, waɗanda aka samo ta injiniyan kwayoyin). Rabin matan an bi da su tare da Levemir Flexpen, sauran suna da magungunan isofan.

Wannan shine sunan insulin NPH, ɗayan abubuwa masu aiki wanda shine insulin protamine wanda aka samo daga madara mai ƙwayar ruwa (alal misali, Asulin kashi biyu na insulin, Mikstard 30 NM), wanda aikin shi shine rage jinkirin shan kwayar. Yawanci, insulin NPH ya ƙunshi protamine da insulin a cikin daidai gwargwado. Amma kwanan nan, insulin NPH ya bayyana, hormone mai ilimin ɗan adam ba tare da gano asalin dabba ba (Insuman Rapid GT, gaggawa insulin insulin).

An gano cewa yawan glucose na azumi a cikin matan da suka dauki Levemir Flexpen a makonni 24 da na 36 suna dauke da ciki ya fi wadanda aka wajabta musu magani da magunguna na isofan insulin, abu mai aiki wanda shima kayan kwastomomi ne (insulin). Insuman, gaggawa insulin, insulin Humulin, Humodar). Dangane da abin da ya faru da hypoglycemia, babu wani bambanci na musamman tsakanin abubuwa masu aiki da ke lalata insulin da kuma isofan insulin.

Hakanan an lura cewa sakamakon da ba a so a cikin magani na Levemir Flexpen da insulin tare da keɓaɓɓe don jikin mutum sun yi kama kuma ba sa bambanta sosai. Amma sakamakon da aka samu ya nuna cewa akwai karancin mummunan sakamako mara kyau a cikin mata masu juna biyu da yara bayan haihuwarsu, wadanda aka sanya musu insulin isofan: 39% a kan 40% a cikin mata, 20% kuma 24% a cikin yara. Amma yawan yaran da aka haife su da cutar ta asali ya zama 5% a kan 7% a madadin Levemir Flexpen, yayin da adadin mummunan rikice-rikice na haihuwa daidai yake.

Yadda daidai da miyagun ƙwayoyi ke shafar yara yayin shayarwa a halin yanzu ba a san shi ba, amma ana ɗauka cewa ba shi da tasiri ga metabolism na jarirai. Don kaucewa rikice-rikice, kashi na maganin da abinci don mata masu shayarwa suna buƙatar gyara. Dangane da kula da yara daga shekaru biyu, bincike ya nuna cewa lokacin amfani da Levemir Flexpen, lura da detemir ya fi dacewa dangane da ƙananan haɓakar ƙoshin jini da rashin tasiri akan nauyi.

Cikakken likita

Tun da Levimir Flexpen magani ne na dogon lokaci, yana da kyau a hada shi da insulins na “gajere”. Tare da rikicewar jiyya, ana sanya magani a sau ɗaya ko sau biyu a rana, dangane da cutar. Yayi kyau tare da magunguna na gajeriyar hanya (insulin Actrapid gaggawa) da ultrashort (insulin Aspart, insulin Lizpro), waɗanda kuma samfurori ne na aikin injiniya.

Insulin Novorapid Penfill da insulin Lizpro sun sa ya yiwu a kimanta yanayin yawan abubuwan sukari a cikin masu ciwon sukari ga wadanda ke cikin koshin lafiya da rage hawan jini wanda ke faruwa bayan cin abinci:

• Novorapid (insulin aspart) - insulin da aka shigo dashi daga masana'antun Sweden, yana rage hadarin kamuwa da kowane nau'in cutar glycemia, gami da masu rauni,
• Insulin Humalog magani ne na Faransa, wanda ya haɗa da insulin lispro, ɗayan magungunan ultrashort na farko da aka ba da izini a cikin ilimin insulin na yara. Abubuwan da aka shirya na Humalog Mix 25 shine cewa, ba kamar shirye-shiryen insulin da yawa ba, ana iya yin allura daidai kafin abinci: daga 0 zuwa mintina 15,
• Insulin Humulin Regular (kashi 70% na maraicinta, 30% insulin mai narkewa),

Ya kamata a lura cewa insulin Aspart, insulin Lizpro, insulin Humulin Regulator - gyare-gyaren insulin na '' ainihin '' ɗan adam, wanda ke ba su damar rage matakan sukarinsu da sauri. Amma yana da kyau a ƙi haɗa Levemir tare da insulin Apidra, wanda kuma yana da wani ɗan gajeren mataki: insulin glulisin, kayan aiki na miyagun ƙwayoyi, ba a ba da shawarar haɗa shi da shirye-shiryen insulin, ban da isofan (insulin PNH).

Wasu lokuta ya zama dole don maye gurbin Levimir Flexpen tare da wani magani. Wannan na iya zama saboda rashin siyarwarsa, ko kuma bisa ga sakamakon gwaje-gwaje, lokacin da likita ya yanke shawarar soke wannan maganin. Yawancin lokaci ana maye gurbinsu ta hanyar analogues na insulin aiki na tsayi ko na matsakaici: kodayake ana rarrabe su ta hanyoyi daban-daban, lokacin bayyanar jikin mutum kusan iri ɗaya ne.

Babban analog na miyagun ƙwayoyi shine Lantus (abu mai aiki shine glargine). Hakanan zaka iya maye gurbin Khumudar na kashi biyu ko Aspart insulin (magunguna na haɗin gwiwa), tare da Insumam Rapid GT, wani lokacin ana yanke shawarar a madadin magungunan tabbatar da aiki. Misali, lokacin aiki na daglude ya kasance daga sa'o'i 24 zuwa 42: a hankali hankali yake shiga cikin jini, yana samar da ingantaccen tasirin sukari kusan kwana biyu.

Sau da yawa, ana amfani da magungunan biphasic na haɗin gwiwa a cikin jiyya. Misali, insulin kashi biyu na NovoMix 30 ya fara aiki da mintuna talatin bayan gudanarwar subcutaneous, ana lura da mafi girman abubuwan aiki a cikin lokacin daga sa'o'i biyu zuwa takwas, tsawon lokacin maganin - har zuwa awanni ashirin.

Ryzodeg Penfill kashi biyu kuma yana da tasiri, wanda ya ƙunshi degludec da insulin aspart: deglyudec yana ba wa miyagun ƙwayoyi lokaci mai tsawo, yayin da aspart yana aiki da sauri. Wannan haɗin mai sauri da jinkirin aiki ya sa ya yiwu a sarrafa glucose koyaushe kuma a guji ƙin jini.

Shin, ana iya samarda insulin a ciki? Dogo ne ko gajeru?

Levemir insulin aiki ne mai dadewa. Kowane kashi ana sarrafa lowers sukari na jini a cikin awanni 18 zuwa 24. Ko yaya, marasa lafiya masu ciwon sukari wadanda ke biye suna buƙatar ƙarancin allurai, sau 2-8 sau da ƙarancin allurai. Lokacin amfani da irin waɗannan sigogin, sakamakon maganin yana ƙare da sauri, a cikin awanni 10-16. Ba kamar insulin na matsakaici ba, Levemir bashi da wani matakin da yake nunawa. Kula da sabon magani wanda ya fi tsayi, har zuwa awanni 42, da ƙari.

Nawa ne amfanin wannan maganin don shigar da shi cikin yaro mai shekaru 3?

Ya dogara da irin nau'in abincin da yaro mai ciwon sukari yake bi.Idan an canza shi zuwa, to, allurai kaɗan, kamar dai homeopathic, za'a buƙaci hakan. Wataƙila, kuna buƙatar shiga Levemir da safe da maraice a allurai waɗanda basu wuce 1 raka'a ba. Kuna iya farawa da raka'a 0.25. Don yin daidai da irin waɗannan allurai kaɗan, yana da mahimmanci don tsarmar maganin masana'antar don yin allura. Kara karantawa game da wannan.

A lokacin sanyi, guban abinci da sauran cututtuka masu yaduwa, yakamata a kara alluran insulin kimanin sau 1.5. Lura cewa shirye-shiryen Lantus, Tujeo da Tresiba ba za a iya gurbata su ba. Saboda haka, ga ƙananan yara na nau'ikan nau'ikan insulin, Levemir kawai kuma zauna. Karanta labarin “”. Koyi yadda za ku fadada lokacin tafiyar ku kuma ku tabbatar da kyakkyawan ikon sarrafa glucose na yau da kullun.

Harkokin ciwon sukari na insulin - inda zan fara:

Wanne ya fi kyau: Levemir ko Humulin NPH?

Humulin NPH wani insulin ne mai matsakaici, kamar Protafan. NPH shine protamine na tsaka tsaki na Hagedorn, furotin guda wanda yakan haifar da rashin lafiyan yanayi. halayen. Bai kamata a yi amfani da Humulin NPH ba saboda dalilai iri ɗaya kamar Protafan.

Levemir Penfill da Flekspen: Menene Banbancin?

Flekspen sune allon alkalami wanda aka sa kwalliya a jikin katako wanda aka kera Levemir. Penfill magani ne na Levemir wanda ake siyarwa ba tare da ƙyamar sirinji don haka zaka iya amfani da sirinjin insulin na yau da kullun. Fensspen alkalami yana da sashi na 1 na sashi. Wannan na iya zama da wahala cikin lura da ciwon sukari a cikin yaran da ke buƙatar karancin allurai. A irin waɗannan halayen, yana da kyau a samo kuma amfani da Penfill.

Levemir bashi da alamun analogues mai arha. Saboda tsari yana kiyaye shi ta wani lamuni wanda ingancinsa bai ƙare ba. Akwai nau'ikan nau'ikan insulin na dogon lokaci daga wasu masana'antun. Waɗannan kwayoyi ne, kuma. Kuna iya nazarin cikakkun labarai game da kowannensu. Koyaya, duk waɗannan magungunan ba su da arha. Matsakaici na tsawon lokaci, alal misali, ya fi araha sosai. Koyaya, yana da mahimmancin hasara, saboda wanda shafin yanar gizon baya bada shawarar amfani da shi.

Levemir ko Lantus: wane insulin ne ya fi kyau?

An ba da cikakkiyar amsa ga wannan tambayar a. Idan Levemir ko Lantus sun dace da ku, to ku ci gaba da amfani da shi. Kada ku canza magani ɗaya zuwa wani sai dai idan takan zama dole. Idan kuna shirin fara allurar dogon insulin ne, to sai a fara Levemir da farko. Sabuwar insulin ta fi Levemir da Lantus kyau, saboda yana dadewa kuma ya fi dacewa. Koyaya, yana da kusan kusan sau 3 mafi tsada.

Levemir yayin daukar ciki

An gudanar da babban binciken asibiti wanda ya tabbatar da amincin da kuma tasiri na gudanarwar Levemir yayin daukar ciki. Tsarin insulin nau'ikan Lantus, Tujeo da Tresiba ba zasu iya yin alfahari da wannan tabbataccen shaidar amincin su ba. A ba da shawarar mace mai juna biyu da ke da yawan sukari mai jini sosai ta fahimci yadda ake lissafin allurai da suka dace.

Insulin bashi da hadari ko dai ga mahaifiyar ko kuma tayi, idan har aka zaɓi sashi. Cutar sankarar mahaifa, idan ba a kula da ita ba, na iya haifar da manyan matsaloli. Sabili da haka, yi ƙarfin zuciya da allurar Levemir idan likita ya umurce ku da yin hakan. Yi ƙoƙarin yin ba tare da maganin insulin ba, bin ingantaccen tsarin abinci. Karanta labaran "" da "" don cikakken bayani.