NovoMix 30 Flexpen: umarnin don amfani, contraindications, farashin, sake dubawa, bayanin, tasirin sakamako

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Ba a ba da izinin amfani da kayan kayan kasuwanci ba.

Bayanin an yi nufin ne don ƙwararrun likitoci.

Labarai masu alaƙa

Sakamakon Dioxidine don Ciwon sukari

Victoza Drug: umarnin don amfani

Yaya za a bi da ciwon sukari tare da Tiogamma?

Principlea'idar miyagun ƙwayoyi Novomix

Magungunan suna shiga cikin kantin magunguna a cikin katako ko allon alkalami na musamman. Volumearar duka nau'ikan sashi shine 3 ml. Dakatarwar ta kunshi bangarori 2.

Lokacin da aka shiga, ƙwayar:

1. Shafar insulin masu karɓa,
2. Yana hana abinci mai yawa na sukari,
3. Yana rage sukarin jini
4. Normalizes matakin glucose, wanda yakan tashi sosai bayan cin abinci.

Magungunan ba ya tasiri da ikon samun yara kuma ba ya haifar da ci gaban maye gurbi da ciwan kansa. Novomix magani ne mai ƙoshin lafiya wanda ba shi da illa ko sakamako idan aka yi amfani da shi daidai.

Kwayar, wanda shine tushen maganin, yayi kama da insulin na halitta sabili da haka baya haifar da barazana ga jiki.

Contraindications, amfani lokacin ɗaukar yaro da ciyar da shi

Magungunan yana contraindicated idan akwai wani tashin hankali zuwa insulin kewayawa ko zuwa kayan taimako. Ba'a ba da shawarar maganin ga yara 'yan ƙasa da shekara 6 ba. Lokacin ɗaukar ɗa, Novomix an wajabta shi kawai a cikin lokuta masu amfani da suka wuce haɗarin ga ɗan da ba a haifa ba.

Lokacin ɗaukar yaro, a hankali kula da matakin glucose a cikin jini kuma kula da shi koyaushe. A cikin farkon watanni na ciki, ana buƙatar sakaci na insulin, a cikin sati na 2 da na 3 yana ƙaruwa. Bayan haihuwa, za a iya rage takin, tun da bukatar jikin mutum na yin insulin ya ragu sosai.

Zai yiwu sakamako masu illa

Tare da amfani mara kyau ko tsawaitawa, Novomix yana da ikon cutar da jikin mai haƙuri. Marasa lafiya suna nuna tasirin da ba a so:

1. Hypoglycemia. Wannan wani yanayi ne yayin da matakin sukari na jini ya sauka sosai ga alamu masu sanadi (kasa da mil 3.3 a lita 1). Hypoglycemia yana tasowa a cikin waɗannan marasa lafiyar waɗanda aka ba su babban adadin magunguna. Kwayar cutar rashin abinci mai saurin faruwa. Fatar ta zama mai kauri, mutum yakan yi gumi kullum, da sauri yana gajiya kuma yana fama da yawan damuwa. Marasa lafiya tare da raguwar sukari suna girgiza hannun, sun rasa ƙarfi kuma su rikice. Mayar da hankalin ya lalace, bugun zuciya yana da sauri kuma yana bacci koyaushe. Sau da yawa, marasa lafiya da ke fama da cutar tarin fuka suna fuskantar yunwar da ba a sarrafawa. Hangen nesa ba ya ragu kuma tashin zuciya ya bayyana. A cikin mummunan rauni na hypoglycemia, mai haƙuri yana haɓaka rashi da aikin kwakwalwa mai rauni. Idan ba a ba da taimako akan lokaci ba, cutar tarin yawa yana haifar da mutuwar mai haƙuri,

Effectsarin tasirin sakamako - rikicewar gani mai alaƙa da haɓaka turgor nama, retinopathy na ciwon sukari, neuropathy na gefe, jin zafi a wurin allura.

Novomiks: umarnin aikace-aikacen

Kafin amfani da samfurin, ansu rubuce-rubucen katuno ko alkalami da za a iya zubar kuma girgiza. Kula da launi na akwati - inuwa ya kamata ya kasance daidai da fararen fata. Kwakwalwa da ke manne da bangon kicin din kada ta kasance. Kawai amfani da guda ɗaya na allura an yarda - idan kun manta da wannan dokar, to kuna iya haɗarin kamuwa da kwayar cutar.

Kafin amfani, yana da mahimmanci a kula da ka'idodi da matakan kiyayewa:

• Karka taɓa amfani da miyagun ƙwayoyi in kafin wannan lokacin yana kwance a cikin injin daskarewa,
• Idan mai haƙuri ya ji cewa sukari ya yi ƙasa, to haramun ne a gudanar da maganin. Don haɓaka glucose, isa
• Ku ci carbohydrates masu sauki (kamar alewa)

Ka tuna don saka idanu da matakan sukari akai-akai. Bi umarnin don hana mummunan yanayi da raguwa mai yawa a cikin glucose.

Yarda da wasu kwayoyi

Lokacin yin lissafin kashi, la'akari da cewa wasu kwayoyi na iya shafar metabolism metabolism. Wadannan kwayoyi sun hada da:

kwayoyi waɗanda ke haifar da raguwa mai yawa a matakan sukari,

• Okreotide
• MAO hana,
• Salicylates,
• Tashin hankali
• Sulfonamides,
• Samfura dauke da barasa.

Bugu da kari, rukuni na kwayoyi sun fito fili wanda bukatar Novomix 30 FlexPen ta karu. Wannan rukuni ya hada da: kwayoyin hodar iblis, kwayoyin hana daukar ciki, danazole, thiazides, HSCs.

Tasiri kan iya tuki

Sakamakon sakamako na yau da kullun da aka lura yayin magani shine raguwa mai yawa na sukari zuwa dabi'un haɗari. Ofaya daga cikin alamun hypoglycemia shine cin zarafin maida hankali, saboda abin da mara lafiya ba zai iya fitar da injin ƙira ko tuki mota ba tare da haɗari ba.

Bayan gudanarwa, tabbatar da cewa babu haɗarin haɓaka mai yawa a matakin sukari. Idan ba a lura da alamun cututtukan hypoglycemia ba, ba da shawarar fitar da mota ba, kamar yadda sukari zai iya faɗuwa a kowane lokaci.

Allura da daidaitawa

An tsara Novomix azaman monotherapy ko tare da haɗin gwiwa tare da wasu magunguna. Sashi ya dogara da mutum halaye da irin cuta:

• A cikin ciwon sukari na nau'in na biyu, kashi na farko shine raka'a 6 kafin abincin farko da naúrar guda ɗaya kafin abincin dare. Tare da ƙarin buƙatar insulin, ana daidaita sashi zuwa raka'a 12,
• Idan mai haƙuri ya canza magani tare da insulin biphasic zuwa Novomix, sashi na farko ya kasance iri ɗaya ne da na lokacin da ya gabata. Bugu da ari, an canza kashi kamar yadda ya cancanta. Lokacin canja mai haƙuri zuwa sabon magani, ana buƙatar saka idanu sosai ta malamin halartar,
• Idan likita yana buƙatar ƙarfafawa, an wajabta mai haƙuri sau biyu na magani,
• Don canza kashi, auna glucose na azuminku na kwanaki 3 da suka gabata. Idan a cikin wannan lokacin an lura da raguwa sosai a matakin sukari, kashi ba a daidaita shi ba.

Ana daidaita maganin ba fiye da sau ɗaya a mako ba. Kuna iya samun masaniya da shawarwari don daidaitawa na kashi a cikin umarnin hukuma wanda aka haɗe a kunshin.

Yadda ake sarrafa insulin

Haɗin wani zaɓi da aka zaɓa daidai da gabatarwar sa daidai cikin jikin mutum shine babban tushen nasarar cin nasara kan cutar sankarar bargo:

1. Kafin amfani da mafita, riƙe shi tsawon awanni 1-2 a zazzabi na digiri 15-20. Sannan a bauki kicin ɗin kuma jefa shi a kwance. Riƙe kicin a tsakanin tafin hannunka, sannan sai ka haɗa hannuwan ka kamar zana mirgina itace ko wani abin sililin. Maimaita har zuwa sau 15.
2. Juya kicin a kwance kuma ta girgiza shi domin ball din da yake cikin akwati yana birgima daga wannan iyakar zuwa wancan.
3. Maimaita matakai 1 da 2 har sai abubuwan da ke cikin akwati suka zama girgije kuma suna yi fari-da-fari.
4. Sanya a hankali a cikin mai mai kitse. Kada a shigar da abinda ke cikin kidan a cikin jijiya - wannan zai haifar da karuwa sosai a cikin sukarin jini.
5. Idan kasa da IEARIN 12 na maganin an bar shi a cikin akwati, yi amfani da sabon kashi don haɗuwa sosai.

Rike maɓallin farawa har sai an cika allurar maganin a ƙarƙashin fata. Idan kun yi amfani da samfuran 2 daban-daban, kada ku taɓa haɗa su a cikin kabad guda.

A koyaushe carryauke da kayan inzatafi tare da kai in da tsohon bazai yuwu ba.

Taimako na farko don yawan shan ruwa

Babban alamar alamar yawan ƙwayar cuta ta Novomix shine rashin ƙarfi na hypoglycemia. Ana iya taimaka wa mai haƙuri a cikin wannan yanayin ta hanyoyi da yawa:

• Tare da ɗan ƙaramin sukari, ba mai haƙuri kowane samfurin da ya ƙunshi carbohydrates mai sauƙi. Wannan ya hada da kayan ado: alewa, cakulan, da sauransu. Gudanar da samfuran sukari tare da abun ciki na sukari koyaushe - buƙatar haɓakar taro na sukari na iya faruwa a kowane lokaci,
• Ana magance tsananin rashin ƙarfi tare da maganin glucagon. Wannan magani yana cikin adadin 0.5-1 MG. allurar daskararre ko kitsen ciki,
• Wani madadin glucagon shine hanyar warwarewa. An gabatar da shi a cikin matsanancin yanayi, lokacin da mai cutar ya riga ya allurar tare da glucagon, amma bai sake tsinkayewa na tsawon minti 10 ba. Ana gudanar da sarrafa Dextrose a ciki. Awararren masani ne kawai ko likita ne kaɗai zai iya yin wannan.

Don hana sukari sake faɗuwa, ku ci abincin da ke da wadataccen ƙwayoyin carbohydrates. Kar ku manta game da taka tsantsan - ku ci a ƙaramin rabo don kada ku haifar da matsalar baya.

Sunayen ciniki, farashi, yanayin ajiya

Magungunan yana zuwa kantunan kantin magani a karkashin sunayen kasuwancin da yawa. Kowane ɗayansu an samar da su a cikin ƙayyadaddun girma da kuma maida hankali akan abu mai aiki.

Farashi ya bambanta dan kadan:

1. Novomiks FlexPen - 1500-1700 rubles,
2. Novomiks 30 Penfill - 1590 rubles,
3. Insulin Aspart - 600 rubles (don alkalami-syringe).

Ana bada shawarar magani don adana shi a zazzabi wanda bai wuce digiri 25 a wuri mai duhu ba ga yara.

Idan samfurin bai dace da kai ba ko bai yarda da kai ba saboda abubuwan da suka taimaka, muna bayar da shawarar cewa ka fahimci kanka da gwajin alamun analoution:

• Novomix 30 Penfill. Wannan magani ne mai kashi biyu na asulin. Ya haɗu da kwayoyin halittun da ke aiki na ɗan gajeren lokaci da tsayi. Yana ƙarfafa samar da abubuwa masu mahimmanci, yana ƙaruwa motsi na glucose a matakin salula da kuma ƙarfinsa ta sauran kyallen takarda. Yana shafar hanta, yana rage haɓakar glucose kuma yana daidaita ƙwayar kansa a cikin jini. Ba kamar Novomix na yau da kullun ba, yana da inganci aƙalla awanni 24. Tsarin kayan aiki mai aiki yana haɗuwa tare da insulin na halitta, don haka kayan aiki ba shi da haɗari ga jiki. Tare da amfani da shi yadda ya kamata, maganin a zahiri ba ya haifar da sakamako mara amfani. Contraindicated karkashin shekara 18 years, tare da hypoklycemia da hauhawar jini,
• Novomix 30 FlexPen. Yana shafar samar da insulin kuma yana ƙarfafa ayyukan da suke gudana a cikin sel. Tsawan lokacin aikin ya dogara da yankin allura, aikin jiki, sashi da sauran abubuwan. An wajabta magungunan don maganin nau'in 1 da nau'in ciwon sukari na 2,
• Novomix 50 FlexPen. Wannan kayan aiki kusan kusan iri ɗaya ne ga magungunan nan biyu da aka bayyana a sama. Bambanci yana kasancewa ne kawai a cikin taro na abu mai aiki. A saboda wannan dalili, yakamata a nemi likita koyaushe kafin farawa da jiyya.

Lokacin zabar magungunan da suka dace, la'akari ba kawai farashi ba, har ma da sauran mahimman mahimman bayanai. Wannan ya haɗa da nau'in insulin, halayen mutum guda ɗaya, haƙuri da abubuwa da kuma cututtukan da suke da alaƙa.

Sashi da gudanarwa

Dakatarwa don allurar subcutaneous. Contraindications hypoglycemia, hypersensitivity.

Ana gudanar da Rosinsulin C a ƙarƙashin sau 1-2 a rana, kusan rabin sa'a kafin cin abinci. Kowane lokaci, ya kamata a canza wurin allurar. A cikin wasu halayen, endocrinologist na iya ba da allurar intramuscular haƙuri na miyagun ƙwayoyi.

Kula! An hana yin amfani da insulin na matsakaici tsawon lokaci! A cikin kowane yanayi, likita ya zaɓi kashi, wanda zai iya dogara da halayen hanyar cutar da abubuwan da ke cikin sukari a cikin jini da fitsari.

Matsakaicin da aka saba dashi shine 8-24 IU, wanda ana gudanar dashi sau 1 a rana, don wannan zaka iya amfani da sirinjin insulin tare da allura mai cirewa A cikin yara da manya tare da jijiyoyin jiki sosai, ana iya rage kashi zuwa 8 IU kowace rana kuma, a gefe guda, a cikin marasa lafiya tare da rage hankali - ya karu zuwa 24 IU kowace rana ko fiye.

Idan kashi na yau da kullun na miyagun ƙwayoyi ya wuce 0.6 IU / kg, ana yin shi sau 2 a rana a wurare daban-daban. Idan ana gudanar da maganin a cikin adadin 100 IU kowace rana ko fiye, ya kamata a kwantar da maraice a asibiti. Dole ne a canza canjin wani insulin zuwa wani a ƙarƙashin kulawar likitoci.

Magungunan yana nufin insulins na matsakaici, wanda aka umarce shi:

1. don rage glucose na jini
2. don ƙara yawan glucose ta kyallen,
3. don inganta glycogenogenesis da lipogenesis,
4. don rage yawan narkewar glucose da hanta,
5. don hadarin sunadarai.

• angioedema,
• karancin numfashi
• cututtukan mahaifa
• raguwa a cikin karfin jini,
• zazzabi.

1. sweating,
2. pallor na fata,
3. yunwa
4. bugun zuciya
5. damuwa
6. gumi
7. farin ciki
8. rawar jiki
9. paresthesia a baki,
10. nutsuwa
11. yanayin bakin ciki
12. sabon abu hali
13. haushi
14. rashin tabbas na ƙungiyoyi
15. tsoro
16. magana da hangen nesa,
17. rashin bacci
18. ciwon kai.

Idan ka rasa allura, ƙananan kaso, kan asalin kamuwa da cuta ko zazzabi, kuma idan ba ku bi cin abinci ba, zaku iya haɓaka cutar kansar acid da ta hauka

• rage cin abinci
• ƙishirwa
• nutsuwa
• hyperemia na fuska,
• mai rauni sani har zuwa maarma
• tarancin hankali na gani a farkon farawa.

Kafin ka tattara magungunan daga murhun, ka tabbata cewa maganin zai fito fili. Idan an lura da laka ko ɓarna a cikin shiri, to ba za'a iya amfani dashi ba.

Yanayin zafin jiki na mafita don gudanarwa ya dace da zazzabi a ɗakin.

Mahimmanci! Idan mai haƙuri yana da cututtukan cututtuka, cututtukan thyroid, hypopituitarism, cutar Addison, raunin ƙwayar ƙwayar ƙwayar cuta, da kuma ga mutanen da suka haura shekaru 65, gyaran insulin kashi ya zama dole.

Sanadin cututtukan hypoglycemia na iya zama:

1. Canza magani.
2. Yawan abin sama da ya kamata.
3. Skipping abinci.
4. Cututtukan da ke rage buƙatar maganin.
5. Vomiting, zawo.
6. Hypofunction na adrenal bawo.
7. Damuwar jiki.
8. Canjin wurin allura.
9. Yin hulɗa tare da wasu kwayoyi.

Lokacin canja mai haƙuri daga insulin dabbobi zuwa insulin ɗan adam, rage raguwar ƙwayar sukari jini yana yiwuwa.

Bayani game da aikin miyagun ƙwayoyi Rosinsulin P

Rosinsulin P yana nufin magunguna tare da ɗan gajeren sakamako na hypoglycemic. Haɗa tare da mai karɓa daga cikin membrane na waje, mafita tana samar da hadaddun mai karɓar insulin. Wannan hadadden:

• yana ƙaruwa da kira na cyclic adenosine monophosphate a cikin hanta da ƙwayoyin mai,
• yana ƙarfafa hanyoyin kwantar da hankali (pyruvate kinases, hexokinases, glycogen synthases da sauransu).

Rage yawan sukari na jini yana faruwa saboda:

1. transportara safarar kayayyaki,
2. kara kuzari na glycogenogenesis, lipogenesis,
3. sunadaran gina jiki
4. haɓaka sha na ƙwayoyi ta kyallen,
5. raguwa cikin rushewar glycogen (saboda raguwa a cikin samar da glucose ta hanta).

Bayan subcutaneous management, sakamakon maganin yana faruwa a cikin minti 20-30.Matsakaicin mafi girman hankali a cikin jini an samu shi ne bayan sa'o'i 1-3, kuma ci gaba da aiki ya dogara da wuri da hanyar gudanarwa, kashi da halaye na mutum na mai haƙuri.

Alamu don amfani

Ana amfani da Rosinsulin P a cikin waɗannan masu zuwa:

1. Ciwon sukari irin na 1 da na 2.
2. M jurewa da maganin hana daukar ciki na maganadisu.
3. Hada magani
4. Ketoacidotic da ƙwayar cutar hyperosmolar.
5. Ketoacidosis mai ciwon sukari.
6. Ciwon sukari dake faruwa yayin daukar ciki.

Don amfani da kai tsaye:

• yayin haihuwa, raunin da ya faru, aikin tiyata mai zuwa,
• Kafin canzawa zuwa allura tare da shirye-shiryen insulin tsawan,
• tare da cuta na rayuwa,
• tare da cututtuka tare da zazzabi mai zafi.

Contraindications da sashi

Contraindications hypoglycemia, hypersensitivity.

Hanyar gudanar da miyagun ƙwayoyi da kashi a cikin kowane yanayi an ƙaddara akayi daban-daban. Dalilin tantance kashi shine abun da ke cikin sukari a cikin jini kafin da kuma bayan abinci, hanyar cutar da kuma darajar glucosuria.

Rosinsulin P an yi niyya ne don gudanar da aiki da jijiyoyin ciki da jijiyoyin jini. Ana yin allura sau 15-30 kafin cin abinci. Mafi sau da yawa, ana sarrafa maganin a ƙarƙashin ƙasa.

a cikin ayyukan tiyata, ketoacidosis na ciwon sukari da na coma, rosinsulin P ana gudanar dashi ne cikin jijiya da jijiyoyin jiki, domin wannan ya zama dole don sanin yadda ake allurar insulin daidai kuma daidai.

Tare da monotherapy, yawan injections kowace rana sau 3. Idan ya cancanta, ana iya ƙara su har sau 5-6. Don kauce wa haɓakar lipodystrophy, hauhawar ƙwayar nama, atrophy, ya zama dole don canza wurin allura a kowane lokaci.

• angioedema,
• karancin numfashi
• raguwa a cikin karfin jini,
• cututtukan mahaifa
• zazzabi.

1. sweating,
2. samarin
3. farin ciki
4. nutsuwa
5. pallor na fata,
6. yunwa
7. jin damuwa
8. gumi
9. rawar jiki
10. paresthesia a baki,
11. magana da hangen nesa,
12. rashin tabbas na ƙungiyoyi
13. bacin rai
14. bakon hali
15. haushi
16. rashin kulawa
17. rashin bacci
18. ciwon kai.

A kan asalin kamuwa da cuta ko zazzabi, tare da allurar da aka rasa, maras nauyi, kuma idan ba a bi cin abincin ba, mai haƙuri na iya haɓakar ciwon sukari da hawan jini:

• asarar ci
• ƙishirwa
• nutsuwa
• kumburi da fuska
• mai rauni sani har zuwa maarma
• tarancin hankali na gani a farkon farawa.

Kafin ka tattara rosinsulin C daga murfin, kana buƙatar tabbatar da cewa mafita a fili take. Idan aka lura da laka ko turba a cikin insulin, to baza'ayi amfani dashi ba. Zazzabi na allura ya kamata ya kasance da zazzabi a dakin.

Kula! Idan mai haƙuri yana da cututtukan cututtuka, rikice-rikice na glandar thymus, cututtukan zuciya, cutar Addison, raunin ƙwayar ƙwayar ƙwayar cuta, da kuma ga mutanen da suka haura shekaru 65, ana buƙatar sarrafa sashin insulin.

Sakamakon cututtukan hypoglycemia na iya zama:

1. Canjin magani.
2. Yawan wuce haddi.
3. Skipping abinci.
4. Cututtukan da ke rage buƙatar maganin.
5. Ciwon ciki, gudawa.
6. Rashin aiki adrenal cortex mai aiki.
7. Aiki na Jiki.
8. Canjin wurin allura.
9. Yin hulɗa tare da wasu magunguna.

Lokacin canja mai haƙuri daga insulin dabbobi zuwa insulin na mutum, raguwar matakan sukari na jini yana yiwuwa.

Analogs na NovoMix

Babu wani magani kuma yana da tsari iri ɗaya kamar NovoMix 30 (propartine aspart + aspart protamine), shine cikakkiyar analog. Sauran insulins biphasic, analog da na mutum, zasu iya maye gurbin sa:

Humalog Mix 25

Humalog Mix 50

Ka tuna cewa zabar magani da kuma maganin sa ya fi kyau tare da gwani.

Tabbatar koya! Shin kuna tsammanin kulawa da kwayoyin hana daukar ciki da insulin shine hanya daya tilo da za'a kula da sukari? Ba gaskiya bane! Kuna iya tabbatar da wannan da kanku ta hanyar amfani da ... karanta ƙarin >>

Manuniya da contraindications

Ana amfani da insulin na insulin Aspart (analog na Flexpen) a cikin lura da nau'in 1 da nau'in ciwon sukari na 2 idan ya wuce zuwa tsarin insulin-dogara.

Ba'a amfani da miyagun ƙwayoyi tare da rashin haƙuri ɗaya ga abubuwan haɗinsa kuma tare da ƙaruwa mai hankali a gare su. Ba a bincika aikace-aikacen a cikin yara 'yan shekaru 6 ba, saboda haka ba a ba da shawarar amfani da kowane wakilin su a wannan zamanin.

Hakanan ana iyakance amfani da shi. Ba a gudanar da cikakken gwaji na asibiti ba. Wannan ya shafi FlexPen da Novorapid Penfill. Amma a cikin binciken guda biyu na miyagun ƙwayoyi Novorapid Penfill a kan mata masu juna biyu, ba a sami wani bayani ba game da mummunan tasirin abu a kan ciki da yanayin jariri.

Iyayen mata masu shayarwa na iya amfani da insulin a cikin adadin da ake buƙata, ba ta shafi ɗan. Yana iya zama dole don daidaita sashi don mahaifiyar.

Abubuwan da ba su dace ba sun bayyana a matsayin babban aikin hormone. Matsayin hypoglycemia lokacin amfani da ƙwayar biphasic yana haɓaka ƙasa da kullun fiye da yadda ake amfani da tsarin ajali na yau da kullun.

Wadannan halayen da ba daidai ba a wasu lokuta suna bayyana:

• Urticaria, rashes na fata, da wuya - halayen anaphylactic.
• Peripheral neuropathy.
• Rashin rikicewa (da wuya a farkon farawar), retinopathy.
• Lipodystrophy a wurin allurar.
• Ayyukan gida a wuraren gudanarwa.

Shan wasu magunguna yana haɗuwa da haɓaka sakamako na Aspart da kuma yiwuwar haɓakar haɓakawar jini:

• Na'urar hana haihuwa.
• Masu hana MAO, ACE.
• Kusanci.
• Thiazide diuretics.
• Heparin.

Alkahol zai iya haɓakawa da rauni sakamakon aikin jiyya.

Tsarin insulin

Bovine, alade, da insulin na ɗan adam suna ɓoye, dangane da asalinsu. Nau'in nau'ikan 2 na farko ba a yin amfani da su yau. Na uku, musamman da aka samo ta amfani da fasahar injiniya, ita ce zaɓi na farko don maganin insulin.

Dangane da tsawon lokacin aikin, akwai:

• IUD - matsananci mai daukar hankali,
• ICD - abubuwan ba da agaji
• ISD - kwayoyi na matsakaiciyar lokacin aiki,
• IDD - mai dadewa
• hade insulins (sun ƙunshi insulin abubuwa daban daban na aiki).

Ka'idojin aikin insulin da tasirin sa

Insulin shine kwayoyin polypeptide. Yawanci, a cikin the-sel na pancreas an samar da kaddarawar - proinsulin, daga inda C-peptide zai kasance sannan kuma aka samar da insulin. Tare da karuwa a cikin glucose na jini, tare da haushi na jijiyoyin farji, kamar yadda kuma a ƙarƙashin rinjayar wasu dalilai, ana aiwatar da sakin insulin.

Ta hanyar ɗaure wa mai karɓa a kan membrane na ƙwayar manufa, hormone yana aiki, yana motsa tasirin sa:

• raguwa cikin sukari na jini (yana karfafa shaye-shaye na glucose ta kyallen, yana hana aiwatar da samuwar shi a cikin jiki daga wasu abubuwan),
• yana aiki da haɗin glycogen,
• yana hana samuwar kwayoyin ketone,
• yana hana samuwar glucose daga mahallin da ba a carbohydrate,
• yana haifar da samar da wadataccen abinci mai ɗimbin yawa kuma triglycerides,
• yana aiki da tsarin sunadarai daban-daban,
• stimulates samar da glycogen, wanda taka da rawar da jiki na ajiyar makamashi,
• yana hana fashewar kitse, yana haifar da samuwar kitse daga carbohydrates.

Yadda insulin na waje yake aiki cikin jiki

Babban hanyar insulin shine subcutaneous, amma a cikin yanayi na gaggawa, don cimma sakamako mai sauri, ana iya allurar da ƙwayar cikin tsoka ko jijiya.

Matsakaicin yawan shan kwayoyin daga yankin na karkashin kulawa na subcutaneous ya dogara da wurin allura, nau'in da kashi na miyagun ƙwayoyi, ingancin kwararar jini da aikin ƙwayar tsoka a cikin allurar, har ma da bin ka'idojin allura.

• Abubuwan insulins na gajere-gajere suna dauke da sauri kuma tuni a cikin mintuna 10 zuwa 20 bayan allura suna haifar da raguwar glucose jini. Suna da tasiri sosai bayan mintoci 30-180 (dangane da maganin). Ingantacce na tsawon 3-5.
• Tasirin insulins na gajeran lokaci yana faruwa awanni 30-45 bayan gudanarwar su. Matsakaicin aiki yana daga awa 1 zuwa 4, lokacinta shine 5-8 awanni.
• Matsakaic na tsawon lokaci yana narkewa daga wurin allura kuma yana samar da raguwar sukari jini kawai 1-2 hours bayan allurar subcutaneous. Ana yin rikodin mafi girman sakamako a cikin sa'o'i 4-12, jimlar yawan maganin shine kwanaki 0.5-1.
• Insulin na aiki mai tsawo yana fara aiki sa'o'i 1-6 bayan gudanarwar subcutaneous, yana rage sukari a ko'ina - ba a bayyana ganiya mafi yawa daga cikin waɗannan magungunan, yana zuwa tsawon awanni 24, wanda ya sa ya zama dole a allurar irin wannan ƙwayoyi kawai 1 lokaci a rana.

Hakanan "halayen" insulin a jikin mutum bayan gudanarwar shi kuma ya shafi:

• kashi na miyagun ƙwayoyi (mafi girma shi ne, a hankali da miyagun ƙwayoyi da ake tunawa da dogon ya yi aiki),
• yanki na jikin da aka yi allura (a cikin ciki, ɗaukar abu ne mafi girma, a kafada ƙasa, a cikin kyallen cinya)
• Hanyar gudanarwa (tare da allurar subcutaneous, ana amfani da miyagun ƙwayoyi a hankali fiye da lokacin da aka sa shi a cikin tsoka, amma yana tsawan lokaci),
• zazzabi nama a fannin gudanarwa (idan ya haɓaka, yawan sha yana ƙaruwa),
• lipomas ko lipodystrophy na kyallen takarda (game da abin da yake, karanta a kasa),
• tausa ko aikin tsoka (ana ɗaukar matakan narkewa).

A wasu ƙasashe, ƙwararru suna binciken shirye-shiryen insulin tare da ƙarin hanyoyin da suka dace na haƙuri don haƙuri. Don haka, a Amurka akwai insulin don gudanarwa ta hanyar inhalation. Zai fara aiki bayan mintuna 30 (wanda ya yi daidai da IUD), an lura da babban matakin aiki bayan kimanin awa 2, lokacinta ya kai awowi 8 (wanda yayi daidai da ICD).

Abinda ke ciki NovoMix 30 FlexPen

Dakatarwar don s / c gudanar da fararen launi, mai kama da juna (ba tare da lumps ba, flakes na iya bayyana a cikin samfurin), lokacin da yake tsaye, delaminates, ƙirƙirar fararen farashi da launin launi ko kusan madaukaki mara launi, dakatarwar da aka yi daidai ya kamata ya tashi tare da motsa hankali.

Wadanda suka kware: glycerol, phenol, metacresol, chloride zinc, sodium chloride, sodium hydrogen phosphate dihydrate, sulfate protamine, sodium hydroxide, acid hydrochloric, ruwa d / da.

* Naúrar 1 ta dace da mcg 35 na insulin na cikin damuwa.

3 ml - gilashin gilashin gilashi (1) - alkalami da yawa ana iya rarraba allurar siyarwa don maimaita allura (5) - fakitoci na kwali.

Matsakaicin insulin ɗan adam-ɗan lokaci tare da farawa da sauri

Analog na insulin na ɗan adam na ɗan lokaci tare da saurin farawa na aiki.

NovoMix ® 30 FlexPen ® wani rashi ne na fuska-biyu wanda ya kunshi insulin asulin mai narkewa (30% analog insulin insulin) da lu'ulu'u na asulin protamine insulin (70% matsakaiciyar insulin insulin).

An samo shi ta hanyar insulin ta hanyar kimiyyar halittar halittar DNA ta amfani da iri na Saccharomyces cerevisiae.

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). Tasirin hypoglycemic yana da alaƙa da haɓakar jigilar kwayar ciki da haɓaka yawan glucose ta kyallen, haɓakar lipogenesis, glycogenogenesis, da rage raguwar haɓakar glucose ta hanta.

Idan aka kwatanta da insulin ɗan adam mai narkewa, ana amfani da insulin (ana ana yin aiki da sauri cikin insulin na mutum) yana farawa da sauri, saboda haka ana iya gudanar da shi nan da nan kafin abinci (daga mintuna 0 zuwa 10 kafin abinci). Lokaci mai fashewa (kashi 70%) yana kunshe da kwayar insulin kamar yadda ake magana (analog na insulin na mutum na matsakaici), sakamakon wanda yayi kama da aikin insulin isophane na mutum.

Bayan gudanarwar s / c na miyagun ƙwayoyi NovoMix F 30 FlexPen ®, sakamakon yana haɓaka bayan minti 10-20. Ana lura da mafi girman tasirin sa'o'i 1-4 bayan allura. Tsawon lokacin da miyagun ƙwayoyi ya kai awanni 24.

Lokacin da aka yi amfani da shi a cikin marasa lafiya da nau'in 1 da type 2 diabetes mellitus, NovoMix F 30 FlexPen ® suna da sakamako iri ɗaya a kan matakin glycated hemoglobin kamar insulin na ɗan adam na biphasic 30. Insulin aspart da insulin na ɗan adam suna da aiki iri ɗaya a cikin molar daidai.

Nazarin asibiti na watanni uku wanda ya shafi marasa lafiya da ke da nau'in 1 da nau'in ciwon sukari na 2 ya nuna cewa NovoMix® 30 FlexPen® yana da sakamako iri ɗaya a cikin glycated hemoglobin kamar insulin na ɗan adam mai ƙwaƙwalwa 30. Insulin aspart yana da aiki iri ɗaya kamar insulin ɗan adam a cikin molar daidai.

A cikin binciken asibiti wanda ya shafi marasa lafiya da ke da nau'in ciwon sukari na 2 na nellitus (n = 341), marasa lafiya sun kasance bazuwar zuwa rukunin jiyya kawai tare da NovoMix F 30 FlexPen M, NovoMix ® 30 FlexPen ® a hade tare da metformin da metformin hade tare da ƙirar sulfonylurea. Ingancin ingancin inganci na HbA 1c bayan makonni 16 na jiyya bai bambanta a cikin marasa lafiya da suke karɓar NovoMix F 30 FlexPen ® a hade tare da metformin kuma a cikin marasa lafiya suna karɓar metformin a hade tare da wani abin da ya samo asali na sulfonylurea. A cikin wannan binciken, 57% na marasa lafiya suna da matakin HbA 1c mai mahimmanci sama da 9%; a cikin waɗannan marasa lafiya, NovoMix F 30 FlexPen ® a hade tare da metformin ya haifar da raguwa mafi mahimmanci a cikin HbA 1c fiye da marasa lafiya da aka bi da metformin a hade tare da maganin ƙira na sulfonylurea.

A cikin wani binciken, marasa lafiya da ke dauke da nau'in ciwon sukari na 2 wanda ba za a iya sarrafa su da kyau ba ta hanyar shan magunguna na bakin jini a cikin rukunin masu zuwa: NovoMix F 30 FlexPen times 2 sau / rana (marasa lafiya 117) da insulin glargine 1 lokaci / rana (116 mara lafiya). Bayan makonni 28 na sarrafa magunguna, matsakaicin raguwa a cikin HbA 1c a cikin rukunin NovoMix F 30 FlexPen was ya kasance 2.8% (darajar ma'anar farko shine 9.7%). 66% da 42% na marasa lafiya da ke amfani da NovoMix F 30 FlexPen ®, a ƙarshen binciken, suna da ƙimar HbA 1c a ƙasa da 7% da 6.5%, bi da bi. Ma'anar plasma glucose mai azumi ta ragu da kimanin 7 mmol / L (daga 14 mmol / L a farkon binciken zuwa 7.1 mmol / L).

An gudanar da binciken asibiti na makonni 16 a cikin yara da matasa waɗanda ke kwatanta glucose jini bayan cin abinci tare da NovoMix F 30 FlexPen ® (kafin abinci), insulin / biphasic mutum na 30 30 (kafin abinci) da insulin-isophan ( ana sarrafa shi kafin lokacin bacci). Binciken ya shafi marasa lafiya 167 masu shekaru 10 zuwa 18. Matsakaicin ƙimar HbA 1c a cikin ƙungiyoyin biyu sun kasance kusa da ƙimar farko a duk binciken. Hakanan, lokacin amfani da NovoMix ® 30 FlexPen ® ko insulin mutum ɗan adam 30, babu wani bambance-bambance a cikin yanayin tashin hankali. An kuma gudanar da binciken kashi-biyu makafi a cikin yawan marasa lafiya wadanda ke tsakanin shekaru 6 zuwa 12 (jimlar marasa lafiya 54, makonni 12 ga kowane nau'in magani).Haɓakar hypoglycemia da karuwa a cikin glucose bayan cin abinci a cikin rukuni ta amfani da NovoMix F 30 FlexPen ® sun kasance ƙasa idan aka kwatanta da ƙimar da aka yi a cikin rukunin ta amfani da insulin mutum na biphasic 30. Theimar HbA 1c a ƙarshen binciken a cikin rukunin ta yin amfani da insulin na ɗan adam na 30 30 ya kasance ƙasa da ƙasa a cikin kungiyar da suka yi amfani da NovoMix F 30 FlexPen ®.

A cikin insulin aspart, musanya amino acid a matsayin B28 don aspartic acid yana rage sha'awar kwayoyin don samar da hexamers a cikin narkewa na NovoMix F 30 FlexPen ®, wanda aka lura cikin insulin mutum mai narkewa. Dangane da wannan, insulin aspart (30%) yana narkewa daga mai mai ƙiba da sauri fiye da insulin mai narkewa wanda yake cikin insulin na ɗan adam. Insulin sittin protamine (70%), kamar isofan insulin, ana shan shi tsawon rai.

Lokacin amfani da insulin NovoMix ® 30 FlexPen ® C max a cikin magani yana kan matsakaicin 50% sama da lokacin amfani da insulin mutum-kashi na mutum 30, yayin da lokacin isa C max shine matsakaita sau 2 ƙasa da ƙasa. Lokacin da aka gudanar da maganin ga masu sa kai na lafiya a kashi 0.2 U / kg nauyin jiki, matsakaicin C max shine 140 ± 32 pmol / L kuma an kai shi bayan minti 60.

A cikin marasa lafiya masu fama da ciwon sukari na 2 na sukari, ana samun C max bayan mintuna 95 kuma ana kiyaye shi a matakin da ya fi 0 girma aƙalla awanni 14 bayan gudanarwar sc.

Maganin insulin insulin ya koma matakin sa na farko bayan awanni 15-18 bayan allurar sc.

Matsakaicin T 1/2, yana nuna yawan adadin ƙwayar protamine, yana awo 8-9.

Pharmacokinetics a cikin lokuta na musamman na asibiti

Ba a yi nazarin kaddarorin magungunan NovoMix F 30 FlexPen ® a cikin yara da matasa ba. Koyaya, an bincika abubuwan da ke cikin magungunan ƙwayoyin magani da na magunguna na insulin asulin a cikin yara (shekaru 6 zuwa 12) da matasa (shekaru 13 zuwa 17) tare da nau'in ciwon sukari na 1. A cikin marasa lafiya na duka bangarorin biyu, insulin aspart ya kasance yana nunawa ta hanyar ɗaukar sauri da ƙimar T max mai kama da waɗanda ke cikin manya. Koyaya, dabi'un C max a cikin shekaru biyu sun banbanta, wanda ke nuna mahimmancin zaɓi ɗaya na alluran insulin allurai.

A cikin tsofaffi marasa lafiya, har ma da marasa lafiya da raunin hanta ko aikin koda, ba a yi nazarin magungunan likitancin NovoMix F 30 FlexPen ® ba.

Bayanai na Kariyar Haraji

A cikin gwaje-gwajen vitro, wanda ya haɗa da ɗaure wa insulin da masu karɓa na IGF-1 da tasirin ci gaban kwayar halitta, an nuna cewa kadarorin asulin insulin sun yi kama da na insulin ɗan adam. Bugu da kari, an gano cewa insulin aspart yana daure wa masu karbar insulin ta hanyar kwatankwacin insulin mutum. A cikin binciken m (1 watan) da na kullum (12 watanni) yawan guba, ba a samu bayanai kan kasancewar manyan abubuwa masu guba a cikin insulin.