Levemir Penfill

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'ayoyin ku 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 ba a cikin bayanin. 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).

Rage yawan glucose a cikin jini shine saboda karuwa a cikin jijiyoyin zuciya, karuwar karɓar ƙwayoyin cuta, haɓakar lipogenesis, glycogenogenesis, da raguwa a cikin yawan samar da glucose ta hanta.

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

Bayanin bayanan sarrafa glucose na dare yana da fadi kuma har ma ga insulin detemir, idan aka kwatanta shi da isofan insulin, wanda aka nuna a cikin hadarin ƙananan haɓakar ƙwanƙwasawar dare.

Abun ciki

Insulin na insulin + magabata.

Pharmacokinetics

Cmax a cikin plasma an kai shi awanni 6-8 bayan gudanarwa. Tare da yin aiki sau biyu na aikin Css na maganin a cikin plasma jini an sami 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 ɗan adam, 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.

Alamu

• 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 wanda ba shi da insulin-ciki (nau'in ciwon sukari na 2).

Sakin Fom

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 karkashin ƙasa na gilashin gilashin gilashin Levemir Flexpen na 300 PIECES (3 ml) a cikin allon da za'a iya amfani dashi da yawa na allurar rigakafin 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 2 a rana dangane da bukatun mai haƙuri. Marasa lafiya waɗanda ke buƙatar yin amfani da miyagun ƙwayoyi sau 2 a rana don ingantaccen iko na glycemic na iya shigar da kashi na maraice ko dai a lokacin abincin dare, ko kafin lokacin bacci, ko 12 sa'o'i bayan safiya.

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 daidaitawa na zafin jiki idan an ƙara yawan aikinsa na haƙuri, an canza 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. Ana iya buƙatar gyaran concomitant hypoglycemic therapy (kashi da lokacin gudanar da shirye-shiryen insulin gajeren aiki ko kuma magungunan baka na hancin jini).

Side sakamako

• 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 da gajiya, 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 tayi
• 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),
• cututtukan cututtukan ciwon sukari (ingantawa na dogon lokaci a cikin tsarin glycemic na rage haɗarin ci gaba na ciwon sukari, duk da haka, ƙaruwar insulin therapy tare da ingantacciyar ci gaba a cikin kulawar 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.

Contraindications

• 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 daukar ciki, 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 samo tsakanin amfrayo da tasirin teratogenic na detemir da insulin na mutum.

Yi amfani da yara

Ba da shawarar amfani da insulin Levemir Penfill da Levemir Flexpen a cikin yara 'yan ƙasa da shekaru 6.

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.

Umarni na musamman

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 (dangane 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.

Ski abinci ko kuma wani mummunan aiki na jiki wanda ba a shirya shi ba zai iya haifar da rashin lafiyar jiki.

Bayan ramawa game da metabolism na metabolism, alal misali, tare da ƙwaƙwalwar insulin mai ƙarfi, marasa lafiya na iya fuskantar alamu na alamu na abubuwan da ke faruwa na hypoglycemia, game da abin da ya kamata a sanar da marasa lafiya. Alamun gargaɗi na yau da kullun na iya ɓacewa tare da dogon lokaci na ciwon sukari.

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, tunda wannan na iya haifar da matsanancin ƙwayar cuta.

Haɗa Levemir Penfill da Levemir FlexPen insulin tare da yin amfani da insalin insulin mai sauri, kamar insulin aspart, yana haifar da bayanan aikin tare da ragewa da jinkiri mafi girman sakamako idan aka kwatanta da gwamnatansu daban.

Tasiri kan ikon tuka motoci da hanyoyin sarrafa abubuwa

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

Hulɗa da ƙwayoyi

Hypoglycemic 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, kamar waɗanda ke ɗauke da thiol ko sulfite, lokacin da aka ƙara detemir a cikin insulin, na iya haifar da lalata insulin detemir.

Analogues na miyagun ƙwayoyi Levemir

Tsarin analogues na mai aiki abu:

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

Analogs a cikin rukunin magunguna (insulins):

• Aiki
• Apidra
• Apidra SoloStar,
• Berlinsulin,
• Berlinsulin N Basal,
• Berlinsulin N al'ada,
• Biosulin
• Brinsulmidi
• Brinsulrapi
• Bari doka ta 30/70,
• Gensulin
• Asarar insulin C,
• Isofan insulin Gasar Cin Kofin Duniya,
• Iletin 2,
• Insulin kewayawa,
• Insulin glargine,
• Insulin glulisin,
• Insulin ya ɓata,
• 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,
• Lantakiya,
• 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
• Tsarin Humulin.

Yadda ake amfani: sashi da hanya na jiyya

S / c a cinya, bango na ciki ko kafada. Ya kamata a canza wurin allurar a kai a kai. Ana ƙaddara adadin da mitar gudanarwa (sau 1-2 a rana) daban.

Lokacin da za a gudanar da shi sau biyu don ingantaccen kulawa da hankali na glucose, ana iya gudanar da kashi na maraice a lokacin abincin dare, a lokacin barci, ko awanni 12 bayan alfijir na safe.

Lokacin canzawa daga insulins na matsakaici da tsawan tsawan insulin zuwa detemir insulin, ana iya buƙatar kashi da lokacin daidaitawa (kulawa da hankali game da tattarawar glucose jini yayin canja wuri kuma a farkon makonni na jiyya ana bada shawarar).

Aikin magunguna

Analog mai narkewa na insulin na mutum wanda aka tsawaita aiki (saboda bayyanar da haɗin kai na kwayoyin detemir insulin kwayoyin a wurin allurar da ɗaukar kwayoyi masu ƙwayoyi zuwa albumin ta hanyar fili tare da sarkar acid mai gefen) tare da bayanin martaba na aiki (mafi ƙarancin m fiye da insulin-isophan da insulin glargine).

Idan aka kwatanta da insulin-isophan, an fi rarrabewa a hankali a cikin ƙananan ƙwayoyin cuta na gefe, wanda ke ba da bayanin martaba mafi sauƙi na haihuwa da aikin magani.

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).

Rage yawan haɗuwa da glucose a cikin jini shine saboda karuwa a cikin jijiyoyin zuciya, karuwar ƙwayar cuta ta kyallen, ƙaruwa na lipogenesis, glycogenogenesis, da raguwa a cikin yawan samar da glucose ta hanta.

Bayan gabatarwar 0.2-0.4 U / kg 50%, ana samun mafi girman tasirin a cikin kewayon daga awanni 3-4 zuwa awa 14, tsawon lokacin aikin har zuwa awanni 24.

Side effects

Akai-akai (sau da yawa 1/100, amma galibi sau 1/10): hypoglycemia (, pallor na fata, karuwar gajiya, fargaba, rawar jiki, damuwa, gajiya mai rauni ko rashin ƙarfi, rarrabuwa, raguwa, tashin hankali, matsananciyar yunwar, rashin gani na gani) , ciwon kai, tashin zuciya, palpitations, a cikin mawuyacin yanayi - asarar hankali da / ko matattarar ciki, wucin gadi ko ba zai iya canzawa ba daga aikin kwakwalwa har zuwa mutuwa), halayen gida (hauhawar jini, kumburi da itching a wurin allura) yawanci na ɗan lokaci ne kuma bace tare da ci gaba da magani.

Rare (yawanci 1/1000, amma da wuya 1/100): lipodystrophy a wurin allura (sakamakon rashin bin ka'idar canza wurin allura a cikin yanki guda), kumburi a matakin farko na maganin insulin (yawanci na ɗan lokaci), halayen rashin lafiyan (urticaria, fata fitsari, itching na fata, zufa, rashin aiki na ciki, angioedema, wahalar numfashi, bugun kirji, rage karfin jini), kurakurai masu narkewa a matakin farko na maganin insulin (yawanci na wucin gadi), maganin ciwon sukari (ciwon sukari) na ciwon kai zhaet hadarin ci gaban m retinopathy, duk da haka, intensification na insulin far da ba zato kyautata a cikin iko da carbohydrate metabolism iya haifar da wani wucin gadi worsening da m retinopathy jihar).

Da wuya sosai (yawanci 1/10000, amma da wuya 1/1000): neuropathy na gefe (haɓaka haɓakawa a cikin sarrafa glycemic na iya haifar da mummunan ciwo na neuropathy, wanda yawanci ke juyawa).

Umarni na musamman

Kada a yi allurar iv (hadarin kamuwa da cuta mai tsafta)!

M jiyya tare da miyagun ƙwayoyi ba ya haifar da karuwa cikin 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 taro na glucose a cikin jini.

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. Alamun farko na cututtukan hanji, a matsayin mai mulkin, suna bayyana a hankali akan sa'o'i da yawa ko kwanaki: ƙishirwa, saurin fitar iska, tashin zuciya, amai, amai, tashin zuciya da bushewar bushe, bakin bushe, asarar ci, kamshin acetone a cikin iska mai ƙuna.

Ski abinci ko kuma wani mummunan aiki na jiki wanda ba a shirya shi ba zai iya haifar da rashin lafiyar jiki.

Bayan ramawa game da metabolism na metabolism (alal misali, tare da ƙwaƙwalwar insulin), marasa lafiya na iya fuskantar alamu na alamu na abubuwan haihuwar hypoglycemia, game da abin da ya kamata a sanar da marasa lafiya. Alamun gargaɗi na yau da kullun na iya ɓacewa tare da dogon lokaci na ciwon sukari.

Cututtukan haɗaka (masu kamuwa da cuta, gami da waɗanda zazzabi tare da zazzabi) yawanci suna ƙaruwa da buƙatar jikin mutum ga 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 suna canza magani insemir 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.

Kasancewa tare da i / m yana da sauri kuma zuwa mafi girma idan aka kwatanta da s / c gudanarwa.

Lokacin da aka haɗu da sauran shirye-shiryen insulin, bayanin ayyukan abubuwa ɗaya ko duka abubuwan zasu canza. Haɗu da miyagun ƙwayoyi tare da adawar insulin mai saurin motsa jiki (insulin aspart) yana haifar da bayanan aikin tare da ragewa da jinkiri mafi girman sakamako idan aka kwatanta da gwamnatin su.

Ba a yi nufin amfani da shi ba a cikin tukunyar insulin.

A halin yanzu babu bayanai game da amfanin asibiti na insulin detemir yayin daukar ciki da lokacin shayarwa, da kuma a cikin yara 'yan ƙasa da shekaru shida.

Ya kamata a shawarci marasa lafiya su dauki matakan hana ci gaban hypoglycemia da hyperglycemia yayin tuki motocin da shiga cikin wasu ayyukan masu haɗari waɗanda ke buƙatar karuwar hankali da saurin halayen psychomotor. Wannan yana da mahimmanci musamman ga marasa lafiya da basu da cikakkun alamu na abubuwan ci gaban haila ko tare da rikicewar yanayin yawan haila.

Haɗa kai

Na baka hypoglycemic kwayoyi, Mao hanawa, ACE hanawa, carbonic anhydrase hanawa, ba zabe beta-blockers, bromocriptine, sulphonamides, anabolic steroids, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, kwayoyi Li +, etanolsoderzhaschie kwayoyi kara da hypoglycemic sakamako.

Maganin hana daukar ciki, corticosteroids, hormones thyroid, thiazide diuretics, heparin, tricyclic antidepressants, sympathomimetics, danazole, clonidine, allunan tashar alli, diazoxide, morphine, phenytoin, nicotine sun rage tasirin cutar hypoglycemic.

Reserpine da salicylates suna ragewa ko haɓaka sakamakon maganin.

Octreotide da lanreotide suna ƙaruwa ko rage buƙatar insulin.

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

Ethanol na iya haɓakawa da tsawaita tasirin insulin.

Pharmaceutically ba a jituwa tare da magungunan magunguna waɗanda ke ɗauke da thiol ko sulfite (halakar insulin detemir)

Bai kamata a kara magungunan cikin mafita ba.

Tambayoyi, amsoshi, sake dubawa game da miyagun ƙwayoyi Levemir Penfill

Bayanin da aka bayar an yi shi ne don ƙwararrun likitoci da magunguna. Cikakken bayani game da magani yana kunshe ne a cikin umarnin da aka haɗe zuwa marufin da mai masana'anta. Babu wani bayani da aka sanya akan wannan ko wani shafin yanar gizon mu wanda zai iya canza matsayin roko na musamman ga kwararrun.

Babban kuma ma'aikatan agaji

Levemir Penfill magani ne wanda ke zuwa ta hanyar mafita don allura, allura a ƙarƙashin fata. Babban abu mai aiki na allura shine insulin detemir. Sinadaran sunadarai yana zuwa ga analogues na insulin wanda jikin mutum ke samarwa kuma ana nuna shi ta hanyar tsawan lokaci.

Don tabbatar da babban ingancin maganin kuma ya tabbatar da amincinsa, an haɗa ƙarin ƙarin abubuwan haɗin abubuwa a cikin maganin:

• phenol
• glycerol
• sodium hydroxide
• metacresol
• sinadarin sodium
• zinc acetate
• sodium hydrogen phosphate,
• ruwa musamman da aka shirya.

Ruwan ya zama cikakke bayyananne, baya da launi ko launi ƙanshi.

Aiwatar da tsammani

Insulin Levemir Penfill magani ne da ke adana rayuwa, don haka yana da muhimmanci ga marassa lafiya su san irin tasirin da ake tsammanin amfani da shi. Don fahimtar abubuwan da ke tattare da magungunan ƙwayar cuta, ya kamata ku yi nazarin umarnin, waɗanda suka ce ana amfani da sinadaran da ke aiki ta hanyar da aka kera ta amfani da fasahar DNA. Sakamakon haka, sakamakon insulin a jikin mutum ana san shi ne ta hanyar jinkirin ɗaukar hankali da tsawon lokacin aiki idan aka kwatanta da ɗaukar kwayoyin horarwa da gajeriyar hanya.

Da zaran cikin jini, abubuwa masu aiki na insulin na roba suna aiki akan masu karbar sel. Sakamakon haka, an kirkiro shaidu waɗanda ke haɓaka ayyukan kwantar da hankali da haɓaka ƙimar samar da enzyme.

Siffofin assimilation

Levemir Penfill sananne ne saboda ƙwaƙwalwar sauri, amma wannan alamar ta dogara gaba ɗaya:

• wuraren allura
• amfani da sashi
• shekaru haƙuri
• bayanin lafiyar mutum.

Bayan awa 6-8 bayan allura, Levemir Penfill insulin ya nuna matsakaicin aiki. An kunna bangaren mai aiki cikin hanzari a cikin jini da kayan aikinsa a cikin babban taro na 0.1 l / kg.

Alamar asibiti

Duk wani magani dole ne a yi amfani da shi ainun bin umarnin ko bin duk umarnin likita. Awararren masani ne kawai ya sami damar bincika hoton cutar, la'akari da bayanan ƙididdigar asibiti kuma, daidai da tarihin da aka tattara, tsara magani.

"Levemir Penfill" ya samo aikace-aikace a cikin lura da ciwon sukari. Ana iya tsara magungunan a matsayin babban magani, amfani da shi a wasu yanayi, ko zaɓi wani hadadden magani dangane da shi da haɗuwa da insulin tare da wasu kwayoyi.

Masana sun yi iƙirarin cewa za a iya amfani da kayan aikin don magance kusan dukkanin nau'ikan marasa lafiya, ciki har da yara waɗanda suka kai shekaru shida.

Contraindications

Duk da amincin dangi da kuma yiwuwar amfani da shi a cikin ilimin yara, likitan yana da nasa tsayayyen contraindications. Umarnin zuwa Levemir Penfill ya lissafa halaye masu zuwa inda wa'adin magani ba zai yiwu ba. Wadannan sun hada da:

• tsufa na haƙuri
• koda ko cutar hanta
• daidaikun mutane.

"Levemir Penfill" da "Levemir Flexspen" suna da tsari iri ɗaya, don haka duk nau'ikan contraindications da aka jera sun shafi nau'ikan magungunan biyu. A wannan halin, ƙuntatawa masu tsauri ne, amma ana iya gyara haƙurin rashin haƙuri a wasu halaye. A kowane yanayi, an yarda da amfani da maganin, amma gwani ya kamata ya lura da mai haƙuri kuma, idan ya cancanta, ya yi canje-canje ga sashi ko sauya dabarar magani don kowane ɓacewa daga tasirin da ake tsammanin.

Bukatar magani yadda ya kamata

Levemir Penfill, nau'i wanda ya ƙunshi ruwa kawai don allura, shiri ne mai mahimmanci ga marasa lafiya da ke fama da cutar sukari mellitus. A mafi yawan lokuta, ba tare da rubutaccen magani ba, mara lafiya na iya mutuwa. Koyaya, za a iya yin babban lahani ga kiwon lafiya idan ba ku bi ka'idodin maganin ba kuma ba ku bi duk shawarar likita.

Dole ne a yi amfani da maganin ta hanyar bayanin da aka haɗe, kuma ba za ku iya canza komai ba tare da sanin ƙwararrun masani ba. A irin wannan yanayin, aikin kai na iya juya zuwa mummunan rashin lafiya ga mai haƙuri.

Yadda ake amfani da maganin

Levemir Penfill yana a matsayin allurar subcutaneous. Sanarwar maganin kamar haka:

• kunshin ya ƙunshi katako, gilashin,
• 3 ml na tanadin bayani don allura ya dace a cikin kowane katako.

Don allura, ana buƙatar sirinji insulin na musamman. Iyayen maganin ana yinsu kawai a ƙarƙashin ƙasa, an cire wani batun amfani. Ya kamata a ba da allurar kawai a wasu sassan jikin. Wannan ya faru ne saboda gaskiyar cewa a wasu wurare ana ɗaukar abubuwan da suke aiki da sauri, wanda ke ba da tabbacin ingancin ƙwayar.

Mafi kyawun wurare don yin allura sune:

Don guje wa haɓakar bayyanar cututtuka mara kyau da sakamako masu illa, ya zama dole don maye gurbin wuraren allura lokaci-lokaci, amma cikin yankuna da aka ba da shawarar. In ba haka ba, insulin na roba zai daina shiga cikin jini da sauri kuma a sha shi yadda yakamata, wanda zai shafi inganci da nasarar jiyya.

Muna nazarin umarnin don amfani

Levemir Penfill ya ƙunshi umarnin don amfani a kowane kunshin. Dole ne a yi nazari a hankali. Koyaya, kwararrun koyaushe yana ba da izinin kwatancen insulin ne kawai daban-daban. Yawan maganin da aka sarrafa yana shafar abubuwa da yawa:

• gaban ƙarin cututtuka,
• shekaru haƙuri
• nau'i na ciwon sukari.

Hakanan, likita koyaushe zai iya daidaita sashi zuwa karamin karami ko babba, gwargwadon tasirin da ake tsammanin. Amma a lokaci guda, yana gudanar da aikin tiyata, yana bincika abubuwan da ke motsa jiki kuma, daidai da wannan, yana canza jadawalin don injections.

Wajibi ne a yi amfani da miyagun ƙwayoyi "Levemir Penfill" sau ɗaya ko sau biyu a rana. Umarnin ya kuma ce dole ne a sanya allura a lokaci guda.

Gargadi ga Patiungiyar Mai haƙuri na Musamman

Levemir Penfill yakamata ya kamata a tsara shi ta likita kawai wanda zai iya yin la'akari da wasu abubuwan rashin daidaituwa dangane da ƙungiyar marasa lafiya na musamman. A wasu halaye, tsananin taka tsantsan yana da mahimmanci, kamar yadda jikin tsofaffi ko yara ke da ikon amsa gabatarwar magungunan roba ba bisa ga tsarin da aka tsara ba.

Maganin insulin tsufa

Duk wani canje-canje da ke da dangantaka da shekaru yana nunawa a cikin yanayin kiwon lafiya. A lokaci guda, za su iya yin aiki akan ɗaukar ƙwayar roba, saboda abin da mai haƙuri yake yawan haifar da rikice-rikice. Sabili da haka, kafin amfani da maganin, ya kamata a gudanar da cikakken bincike game da tsofaffi don kafa gaban cututtukan da ke da alaƙa da ciwon sukari mellitus.

An ba da kulawa ta musamman ga aikin hanta da ƙodan, duk da haka, ba za a iya yin jayayya da cewa tsofaffi haƙuri ya saba wa nadin wannan nau'in insulin ba. Likitoci suna amfani da maganin ne wajen lura da irin wannan marasa lafiya, amma a hankali suna lura da lafiyarsu kuma, idan ya cancanta, a rage sashi.

Siffofin kula da yara

"Levemir Penfill" za'a iya tsara shi don gyara insulin a cikin jiki ga yara sama da shekaru 6 da haihuwa. Koyaya, ƙarami shine madaidaicin contraindication don rubuta wannan magani.

Babu wani binciken da aka gudanar kan tasirin abubuwan detemir insulin a jikin waɗannan yara ƙanana. Saboda haka, babu wani kwararren da zai fara haɗarin lafiyar mai haƙuri kuma ya rubuta magunguna daban-daban waɗanda aka bada shawarar wannan rukuni na masu haƙuri.

Shaida game da levemir flekspen

Duk ɗaukar ciki ya kasance ciwon sukari ne. Ta mallaki kanta, ba ta cin sukari, kukis, jam, da sauransu, ta bi abinci mai tsauri tare da lissafin rukunin burodi da adana littafin abinci. Amma, da rashin alheri, duk wannan bai taimake ni ba. Akwai sukari mai yawa sosai, wani lokacin har raka'a 13 suka cika bayan cin abinci (kuma ƙa'idar shine 7). A endocrinologist ya wajabta insulin, kamar yadda Allunan ke contraindicated ga mata masu juna biyu. Na damu kwarai da gaske, na yi tunani cewa zan ci gaba da yin allurar, amma sun bayyana min cewa ina yin wannan ne ga jaririn. Farashin "Novo-cikin sauri" a cikin raka'a gurasa sau 3 a rana 5 mintuna kafin abinci, da kuma "raka'a Levemir" 2 da dare. Nan da nan na koyi yin amfani da allon alkalami, da gaske ya dace. Abin sani kawai Dole a fallasa adadin raka'a, don allura a cikin tsoka. Kusan ba shi da rauni, mafita ba ya tsunkule, amma wani lokacin ina da rauni, watakila bai isa wurin ba. Abubuwan da aka buƙata don alkalami-pen ba su da arha, amma ban canza ba bayan kowace amfani, saboda wannan shine insulin na kaina. Nan da nan sukari sukari ya dawo. Bayan makonni 35, yaron ya fara fama da cutar huhu kuma ya fara taimaka wa kansa da sukari, kuma aka “Levemir” dare ya yi.Na haifi diya mace lafiyayye, amma saboda yawan haihuwa da ciwon suga na, jariri yana da karancin sukari a lokacin haihuwa.

Short Short

Levemir Flexpen shine insulin tsawon lokaci mai aiki. Don samun magungunan, ana amfani da hanyar ilimin ilimin halittu, wanda ya haɗa da shiga cikin abubuwan rayayyun halittu da hanyoyin nazarin halittu don samar da magunguna. A wannan yanayin, ana amfani da yisti mai giya - wani nau'in fungi na microscopic fungi daga aji na saccharomycetes. Dogon aiki yana da alaƙa da halayen ƙwayoyin ƙwayoyin cuta, gami da ikon su na yin haɗin kai da hulɗa tare da albumin. Ana amfani da miyagun ƙwayoyi ta hanyar jinkirin rarrabewa a cikin kyallen na yanki, wanda ke sa ɗaukar hoto da bayanan aikin magunguna su zama mafi yuwu. Rage yawan matakan glucose na plasma yana da alaƙa da haɓakar sufuri a cikin sel, ƙarin amfani da ƙwaƙwalwa a cikin kyallen takarda, ƙarfafa motsawar acetyl-CoA zuwa fat mai, tasirin glycogen daga glucose, da raguwa a cikin samuwar glucose a cikin hanta. Matsakaicin sakamako na hypoglycemic na miyagun ƙwayoyi an ƙaddara shi da sashi wanda aka yi amfani dashi kuma zai iya zuwa 24 hours. An bambanta maganin ta hanyar har ma, ba tare da bayanin martaba mafi girma na sarrafawar dare ba, kuma, a saboda haka, ƙananan rauni na rashin ƙarfi a cikin dare. Rabin rayuwar miyagun ƙwayoyi bayan gudanarwar subcutaneous ya bambanta daga 5 zuwa 7 hours. Za'a iya gabatar da gabatarwar a sassa daban daban na jikin mutum (wani bangare na kafa daga ƙashin ƙugu har zuwa gwiwa, gwiwa ta sama zuwa gwiwar gwiwar gwiwa, bangon ciki). Yana da kyau a canza wurin don hana ƙarancin mai mai gari. Lokacin yin allura a cikin bangon ciki na ciki, tasirin hypoglycemic zai haɓaka da sauri. Mitar kulawa da miyagun ƙwayoyi ana ƙaddara shi da buƙatun mutum na mai haƙuri kuma yana sau 1-2 a rana. Idan kana buƙatar maganin biyu na miyagun ƙwayoyi, ana ba da kashi na biyu ko dai kafin abincin dare, ko kafin zuwa gado. Mafi kyawun tsakanin tsakanin safiya da maraice shine sa'o'i 12. A cikin tsofaffi, har ma da marasa lafiya da ke fama da matsalar koda da hepatic, ya kamata a shirya ƙarin saurin kulawar likita don daidaita yanayin ƙimar lokacin in ya cancanta.

Buƙatar canji a cikin kashi na sarrafawa na iya tashi tare da karuwa da yawan motsa jiki, canji a cikin abincin da aka saba, da kuma kasancewar haɗuwa da cuta. Babban sakamako wanda ba a ke so ba wanda zai iya faruwa yayin amfani da miyagun ƙwayoyi shine hypoglycemia. Alamomin ta sune: rashin fatar fata, bayyanar zufa, gajiya mai yawa, yawan tashin hankali, rawar jiki da yatsu, rarrabuwa, damuwa, tashin hankali, yawan tashin hankali, matsalar rashin gani, ciwon kai, tsananin tashin hankali, bugun kirji, yawan bugun kirji. Tare da mummunan hypoglycemia, asarar hankali yana yiwuwa. Muguwar glycemia na iya zama mai mutuwa. Yana yiwuwa a haɓaka halayen gida a wurin allurar: hyperemia, kumburi, abin mamakin jin zafin azabar fata, haifar da buƙatar tofar da wurin haushi. Abubuwan da suka shafi gida a cikin mafi yawan lokuta suna da ɗan lokaci a yanayi kuma suna ɓacewa kwatsam ba tare da wani maganin warkewa ba. Ba a cire maganganun halayen halayen rashin lafiyan ba: urticaria, fatar fata. A cikin ilimin yara, Ina amfani da magani a cikin marasa lafiya waɗanda suka kai shekaru 6. Magunguna mai zurfi tare da Levemir baya tasiri sosai a jikin jikin mai haƙuri. Rage magunguna ko rashin isasshen ƙwayar cuta na iya haifar da rashin lafiyar hyperglycemia. Alamomin halayyar sa: isowar shaye shaye, yawan kumburin kumburi, kumburin amai (ciki harda ingantacce), amai, fata, fata, rashin isasshen abinci, kamshin acetone daga bakin. Tare da ƙarancin babban adadin, hypoglycemia na iya haɓaka. Hakanan ci gaban sa kuma mai yiwuwa ne tare da tsawan rashin isowar abinci a cikin jiki, yawan motsa jiki. Kasancewar cututtukan da ke tattare da rikice-rikice (da farko cututtukan cututtuka waɗanda ke faruwa tare da alamar ƙaruwa a cikin zafin jiki) na iya buƙatar haɓaka kashi na miyagun ƙwayoyi.

Pharmacology

An samar da shi ta hanyar kimiyyar halittar halittar DNA ta hanyar amfani da nau'in Saccharomyces cerevisiae. Yana da kwatankwacin kwatanci mai narkewa na insulin aikin ɗan adam tare da bayanan ayyukan lebur.

Bayanin ayyukan miyagun ƙwayoyi Levemir ® FlexPen ® yana da ƙasa da canji fiye da isofan-insulin da insulin glargine.

Tsawan aikin na Levemir ® FlexPen ® ya kasance ne sakamakon bayyanar da haɗin kai na kwayoyin ƙwararru daga detemir insulin a wurin yin allurar da kuma ɗaukar kwayar magungunan zuwa albumin ta hanyar fili tare da 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 samar suna samar da karin daukar abubuwa na daukar hoto da kuma aikin daukar hoto na Levemir ® FlexPen ® idan aka kwatanta da isofan-insulin.

Don allurai na 0.2-0.4 U / kg 50%, matsakaicin tasirin miyagun ƙwayoyi yana faruwa a cikin kewayon daga 3-4 hours zuwa 14 hours bayan gudanarwa. Tsawan lokacin aikin ya kasance har zuwa awanni 24, gwargwadon sigar, wanda ya sa ya yiwu a gudanar da 1 lokaci / rana ko 2 sau / rana. Tare da tsarin aikin yau da kullun sau biyu na C_ss an cimma shi bayan gudanar da allurai na 2-3 na magani.

Bayan sc gwamnati, mai ba da magani ya kasance daidai gwargwado ga adadin da aka gudanar (mafi girman sakamako, tsawon lokacin aiki, sakamako na gaba ɗaya).

Karatun karatu na dogon lokaci ya nuna karancin maida hankali a kullum.
glucose ta jini a cikin kulawa da marasa lafiya tare da Levemir ® FlexPen ® sabanin isofan-insulin.

A cikin binciken na dogon lokaci a cikin marasa lafiya da masu ciwon sukari na 2 wanda suka karɓi basal na insulin a haɗe tare da magunguna na baki na hypoglycemic, an nuna cewa sarrafa glycemic (cikin sharuddan glycosylated haemoglobin - НbА_1s) a bango na farfajiya tare da Levemir ® FlexPen ®, ya kasance daidai da wannan a cikin maganin isofan-insulin da insulin glargine tare da ƙarancin nauyi.

Tebur 1. Canji a jikin mutum yayin aikin insulin

A cikin binciken, yin amfani da maganin haɗin gwiwa tare da Levemir ® FlexPen ® da magungunan maganganu na baki ya rage haɗarin haɓakar haɓakar hypoglycemia mai sauƙi ta hanyar 61-65%, sabanin isofan-insulin.

An gudanar da gwajin asibiti mai buɗewa, bazuwar marasa lafiya tare da marasa lafiya da masu ciwon sukari na nau'in 2 waɗanda ba su cimma burin su da glycemic matakan ba tare da maganin maganin magana na baki.

Nazarin ya fara ne daga lokacin shiri na mako-mako 12, a lokacin da marasa lafiya suka karɓi magani tare da liraglutide a hade tare da metformin, kuma a kan wannan ne kashi 61% na marasa lafiya suka samu HbA_1s FlexPen ® a cikin adadin guda ɗaya na yau da kullun, ɗayan haƙuri ya ci gaba da karɓar ƙwayar liraglutide a hade tare da metformin don makonni 52 na gaba. A wannan lokacin, ƙungiyar warkewa, wanda ya karɓa, ban da liraglutide tare da metformin, allurar yau da kullun na Levemir ® FlexPen ®, ya nuna ƙarin raguwa a cikin tsarin HbA_1s daga farkon 7.6% zuwa matakin 7.1% a ƙarshen lokacin makonni 52, a cikin rashin ɓarkewar ƙwayar cuta. Ta hanyar ƙara adadin Levemir ® FlexPen ® zuwa liraglutide far, ɗayan na ƙarshe ya sami fa'ida dangane da ƙididdigar mahimmancin ƙididdigar jiki a cikin marasa lafiya (duba Table 2).

Tebur 2. Bayanin gwaji na asibiti - magani tare da Levemir ®, an tsara shi ban da hadewar tsarin kulawa tare da liraglutide tare da metformin