"Novorapid" (insulin): imiyalelo ukusetyenziswa, umthamo, ulawulo indlela, ncomo

Drug "NovoRapid" (insulin) sisiyobisi entsha ngokupheleleyo. Phezulu ngenxa yokunqongophala insulin oluntu kwaye inani yeenzuzo phezu kwezinye iintlobo hormone. Ngokukhawuleza sathatha kwaye yehlise iswekile ngephanyazo. Singasebenza kungakhathaliseki ukuba ukutya. Kucingwa insulin ultrashort.

Ukwakheka komzimba seswekile

Kuthetha ukuba seswekile "NovoRapid" (insulin) kuveliswe iifom ezimbini - a neekhatriji replaceable "Penfill" yaye ukulungele pen "FleksPen".

Kwalo iCartridge nokusingatha efanayo - ulwelo neselubala ngenaliti, apho isi-1 Ml iqulethe isithako esebenzayo isixa insulin aspart 100 Kaya Kwenye iCartridge interchangeable njengakuleyo kumqheba inxalenye malunga ml 3 isisombululo esiquka umntu iiyunithi 300.

Nemoto ezenziwe iglasi kwiklasi I. hydrolytic Kuvaliwe ngamavili icala polyisoprene kunye bromobutyl irabha, okwahlukileyo - Pistons yerabha ezizodwa. Le blister aluminium neekhatriji ezintlanu endaweni, yaye zifakwe elinye ibhokisi blister. Ngokufanayo wenza usiba "FleksPen". Ba ezilahlwayo kwaye yakhelwe amathamo ezininzi. Ibhokisi lamaqhosha ezintlanu.

Amalungiselelo lugcinwe kwindawo epholileyo kwi 2-8 ° C. It ayikwazi ukubeka ecaleni kwisikhenkcezisi kunye ngumkhenkce. Kwakhona, nemoto asuswayo kwaye peni kufuneka bakhuselwe kwiimpembelelo thermal kwelanga. Ukuba insulin "NovoRapid" (iCartridge) wavula, mayingabi sakhululwa zigcinwe efrijini, kodwa kufuneka isetyenziswe kwisithuba seeveki ezine. yokugcina lobushushu, kufuneka ibe nkulu kwe-30 ° C. Ubude bethuba ubomi insulin bengawatyi na iinyanga ezingama-30.

Pharmacology

Le medicament "NovoRapid" (insulin) iye inyathelo hypoglycemic, kwaye esisebenza - insulin aspart - yinto-esebenza elifutshane hormone analog eziveliswa ngabantu. Le izinto yalungiselelwa kukusetyenziswa ezikhethekileyo amayeza DNA biotechnology. Apha uhlobo ezongezelelekileyo ze Saccharomyces cerevisiae, kwaye asidi acid ebizwa ngokuba "proline" indawo okwethutyana aspartic.

Ichiza enebana receptors cytoplasmic lwangaphandle inwebu, apho kukho iintlobo oluntsonkothileyo neziphelo insulin iyazingenela zonke iinkqubo ezenzekayo ngaphakathi kwiseli. Emva ukunciphisa ubungakanani glucose plasma kukunyuka kwezothutho intracellular, ukunyusa digestibility izicwili ezahlukeneyo, ubulunga lipogenesis kunye glikogenogeneza. izinga Ukuncipha yemveliso glucose sisibindi.

Ukuthathwa amino acid proline kwi aspartic phantsi insulin aspart kunciphisa iimpawu iimolekyuli ukudala hexamers. Olu hlobo ako ngcono hormone amanqatha ongama, ichaphazela umzimba ngokukhawuleza kunokuba nefuthe enyibilikayo oluntu standard insulin.

Kule iiyure ezine zokuqala emva kwesidlo, insulin aspart ngokukhawuleza lihlisa amaqondo eswekile yegazi kwi plasma ngaphezu hormone abantu emanzini. Kodwa isiphumo wolawulo "Novorapid" ongama mfutshane abantu emanzini.

Zingaphi izenzo 'NovoRapid "? olu emibuzo achaphazelekayo abantu abaninzi abanesifo seswekile. Ngenxa yoko, isenzo beziyobisi kwenzeka emva kwemizuzu 10-20 emva kokuba isitofu. Ukufumaneka liphezulu hormone egazini waphawula emva kweeyure 1-3 emva kokuba isicelo iziyobisi. Oku iziphumo umzimba iiyure 3-5.

Studies abantu Type I diabetes baye babonisa ukuhla umngcipheko izihlandlo eziliqela hypoglycemia ebusuku isicelo, "NovoRapid", ingakumbi xa kuthelekiswa nolawulo insulin yabantu emanzini. Ukongeza, kukho ukuhla okubonakalayo postprandial plasma iswekile xa lesitofu oko insulin aspart.

Iimpawu kunye Izimo

Medicine "NovoRapid" (insulin) yakhelwe abantu abanesifo seswekile njengoko uhlobo 1, nto leyo insulin, kwaye izigulane kunye nohlobo seswekile 2 - insulin oxhomekeke (ibakala yokunganyangeki ngamachiza hypoglycemic athathwe ngomlomo kunye nezifo intercurrent) .

Izimo ukuba ukusetyenziswa medicament yi hypoglycemia nobuzaza kakhulu ukuba insulin aspart, ukulungiselela excipients.

Musa ukusebenzisa "NovoRapid" abantwana abangaphantsi kweminyaka emithandathu ngenxa yokunqongophala yolingo lwezonyango.

Medicine "NovoRapid": imiyalelo yokusebenzisa

Ukulungiselela "NovoRapid" i-analogue kwencindi. Kuthatha ukusebenza ngoko nangoko emva kokuba isitofu. Esithathwa ugqirha ekhethiweyo isigulane ngamnye kunye. Ukuze ufumane iziphumo ezintle, esinokudibanisa insulin hormone okanye avareji ixesha elide yesenzo.

Ukuze ukulawula glycemia, rhoqo umlinganiselo glucose egazini kwaye zikhethwe ngononophelo ithamo insulin. Njengoko umthetho, idosi yemihla ngemihla abadala kunye nabantwana lo uluhlu 0.5-1 U / kg.

Xa injecting ichiza "NovoRapid" (umyalelo manual ikuchaza ngokweenkcukacha inkqubo isitofu) iimfuno insulin yabantu enikwa 50-70%. Intsalela ye kuhlangatyezwane nazo ulawulo insulin elide (kuyoluka) amanyathelo. Ukwanda umsebenzi yesigulana kunye utshintsho ekutyeni, kwakunye comorbidities ezikhoyo rhoqo yenza kube yimfuneko ukuba kutshintshwe idosi elawulwa.

Hormone "NovoRapid" ngokuchaseneyo yabantu enyibilikayo iqala ukwenza ngokukhawuleza, kodwa hayi rhoqo. Ibonisa Inaliti olucothayo kakhulu insulin. Inaliti algorithm kubandakanya ukusetyenziswa amayeza ngoko nangoko phambi kokuba isidlo, kwaye xa kukho imfuneko engxamisekileyo, ichiza isetyenziswa ngoko nangoko emva kwesidlo.

Ngenxa yokuba "NovoRapid" ukusebenza emzimbeni ixesha elifutshane, umngcipheko hypoglycemia ebusuku kubaguli seswekile yehliswe kakhulu.

Xa izigulane abadala, ngokunjalo abantu ulawulo kwezintso okanye hepatic insufficiency igazi glucose xi kufuneka rhoqo ngakumbi, kwaye inani insulin aspart ikhethiwe ngamnye.

Abantwana "NovoRapid" endaweni insulin enyibilikayo abantu, kodwa kuphela xa amalungiselelo ayimfuneko kunye inyathelo ngokukhawuleza. Oku kusetyenziswa xa umntwana akabi ukugcina lokuphumla efunekayo phakathi iinaliti kunye nezidlo. Ukuba isigulane iguqulelwe kwi "NovoRapid" kunye namanye amalungiselelo eziqulathe hlengiso idosi insulin iyafuneka, kwaye kananjalo insulin Uhlobo Lokuqala.

Inaliti ongama insulin (usebenzisa algorithm inaliti hormone ichazwe ngokwenkcukacha imiyalelo zokusetyenziswa) ibandakanya kuqulunqo ngenaliti kummandla phambi esiswini, ethangeni, kunye nezihlunu nomlenze deltoid, kwakunye kwi ezimpundu. Ummandla apho lwezitofu, kufuneka itshintshwe ukuthintela lipodystrophy.

Xa elawulwa ukuya kummandla Icipande ichiza hormone ako peritoneum ngokukhawuleza, xa kuthelekiswa kunye iinaliti kwezinye amalungu omzimba. iziphumo traps kwi ngethuba site idosi isiphumo inaliti, iqondo yokumpompoza kwegazi, ubushushu bomzimba, inqanaba lomsebenzi yesigulana.

Lithetha "NovoRapid" esetyenziselwa infusions ongama ixesha elide, nto leyo yenziwa yi kwimpompo okhethekileyo. Alawulwa ngurhulumente iziyobisi peritoneum ngaphambili, kodwa ngamaxesha athile ukutshintsha iindawo. Ukuba kusetyenziswa impompo insulin, i "NovoRapid" akumele ukuxutywa kunye nezinye iindidi ze-insulin. Izigulane abafumana hormone ngokusebenzisa inkqubo ukumnika kufuneka unikezelo izixhobo amayeza Breakage.

"NovoRapid 'ukuze zisetyenziswe kulawulo efakwa, kodwa nkqubo kufuneka yenziwe yi zempilo oyingcali. Ngokuba lo hlobo nolawulo maxa wambi kusetyenziswa iindlela iimela, apho insulin uqulathwe isixa 100 U / ml, kwaye eyavela yi 0.05-1 U / ml. Eli chiza liye exutywe 0.9% sodium chloride, 5 kunye nesisombululo dextrose-10% oluqulathe potassium chloride 40 mmol / l. Uthe kuthetha zigcinwe bushushu kuba ngaphezu kosuku olunye. Xa insulin ukumnika kufuneka unikele rhoqo igazi kwisiqulatho layo glucose.

Indlela yokubala ithamo insulin?

Ukubala idosi kufuneka ukwazi ukuba insulin buhlanganiswe, i elide (ezongeziweyo), eliphakathi, elifutshane ultra-mfutshane. Okokuqala kukhokelela eswekile yegazi yesiqhelo. Kuqaliswa ungatyanga. Ibonisa abantu uhlobo 1 seswekile kunye nohlobo 2. Kukho abantu abaye basebenzisa enye kuphela uhlobo insulin - kwandiswa. Abanye abantu kwi "NovoRapid" lisetyenziswa ukuphepha yokwanda ngesiquphe glucose. Elifutshane, elide, insulin ingasetyenziswa ngaxeshanye ukunyanga isifo seswekile, kodwa lwenziwa ngamaxesha ahlukeneyo. Ezinye izigulane kuphela ukusetyenziswa sodade iziyobisi kunceda ukuze kufikelelwe isiphumo ezinqwenelekayo.

Ekukhetheni elide-sokubambela insulin kufuneka ithathelwe ingqalelo ezinye bokuqonda. Umzekelo, kufuneka ukuba, ngaphandle inaliti hormone kunye ezimfutshane izidlo eziphambili iswekile wahlala imini yonke kwinqanaba elinye kuphela ngenxa nefuthe a insulin elide.

yedosi Ukukhetha yokothula insulin imi ngolu hlobo lulandelayo:

• Ngentsasa elandelayo, akukho isidlo sakusasa, ukulinganisa umgangatho yeswekile.
• Lunch, adle, yaye emva kweeyure ezintathu inqanaba glucose plasma. Okulandelayo, wemilinganiso ikhutshwa phandle iyure yonke phambi lokulala. Ngosuku lokuqala kukhethwe idosi engekhoyo isidlo, kodwa isidlo sangokuhlwa.
• Ngosuku lwesibini wavumela isidlo sasemini, kodwa hayi isidlo sangokuhlwa. Sugar, kwakunye ngosuku lokuqala, kufuneka ukulawula iyure yonke, kuquka ebusuku.
• Ngosuku lwesithathu kuqhubeka ukwenza umlinganiselo, badla ngokuqhelekileyo, kodwa musa angene insulin elifutshane.

Iimpawu kusasa Perfect zezi:

• e Usuku 1 - 5 mmol / l;
• ngexesha Usuku 2 - 8 mmol / l;
• ngosuku 3 - 12 mmol / l.

amaxabiso glucose ezinjalo kufuneka kufunyanwe ngaphandle hormone-esebenza elifutshane. Umzekelo, ukuba iswekile yegazi kusasa 7 mmol / l, ngokuhlwa - 4 mmol / l, libonisa imfuneko ukunciphisa ithamo hormone elide ngamacandelo 1 okanye 2.

Kaninzi izigulane ukuba ukujonga idosi yemihla ngemihla usebenzisa ifomula Forshema. Ukuba glucose igazi ngonyaka kwisithuba 150-216 mg /%, yenqanaba eswekile yegazi elilinganisiweyo athabathe 150 walhule lanto inani ngo 5. Ngenxa yoko nedosi enye ye-hormone elide. Ukuba glucose igazi kune 216 mg /%, iswekile ukuba sisuswe 200 lulinganiselwa kwaye isiphumo yahlulwe ngo 10.

Ukuze ubone ithamo kwencindi mfutshane, kuyimfuneko ukuba iveki umlinganiselo iswekile yegazi. Ukuba zonke izalathisi zamihla eqhelekileyo, ngaphandle ngokuhlwa, ngoko insulin emfutshane ilawulwa nje phambi kokuba adle. Ukuba eswekile yegazi siphinda- emva kwesidlo ngasinye, wenze izitofu nje phambi kokuba atye.

Ukuze siqonde ixesha apho hormone ukuba ufakwe, kuyimfuneko ukuba umlinganiselo glucose Imizuzu yokuqala 45 phambi kokuba isidlo. Le sugar ulawulo omawenziwe yonke imizuzu emihlanu ude layo lifike kwinqanaba 0.3 mmol / L, kanye emva koko trapeznichat. Le ndlela iza ukulumkisa ekuqaleni hypoglycemia. Ukuba emva kwemizuzu engama-45 iswekile iya kunyothulwa, kuyimfuneko ukuba alinde ukuba isidlo ukuba logama nje glucose angawi enxebeni oyifunayo.

Ukuze ubone ithamo labantu insulin ultrashort kunye uhlobo 1 seswekile kwaye uchwetheze iingcebiso 2 ngeveki ukubona yokudla. Ukubeka iliso, yimalini kwaye luni iimveliso ziphele. Akufuneki idlule imali kwavumela ukutya. Kwakhona cinga umzimba yesigulane, amayeza eyanele, ubukho nezifo ezingapheliyo.

Ultra-insulin ilawulwa imizuzu 5-15 phambi kwesidlo. Indlela yokubala ithamo of "NovoRapid" insulin kule meko? Kufuneka kukhunjulwe ukuba eli chiza kunciphisa kwinqanaba glucose ngamaxesha 1.5 ngaphezu lokunye elifutshane. Ngoko ke, inani "Novorapid" ngu 0.4 idosi mfutshane hormone. Ukumisela ngqo ngakumbi rate kungenziwa kuphela esebenzisa yamava.

Xa ukhetha i ithamo insulin kufuneka athathe ingqalelo iqondo izifo, kunye nento yokuba imfuneko nayiphi hormone kwi diabetic hayi ngaphezulu kwe-1 U / kg. Kungenjalo, ezinokudala libanda, kwaye kunokubangela eziliqela iingxaki.

Imithetho esisiseko yokuqingqa ithamo eswekile of seswekile:

• Ngelo lukwisigaba sokuqala uhlobo 1 diabetes ihomoni idosi kufuneka mayingagqithi iiyunithi 0.5 / kg.
• Xa Uhlobo seswekile 1, nto leyo waphawula kunyaka nomonde okanye ngaphezulu izinga umsebenzi kwencindi yi 0.6 u / kg.
• Ukuba uhlobo 1 diabetes sikhatshwa inani kwezifo ezinzima kwaye ingazinzi parameters yegazi inqanaba iswekile, isixa hormone ilingana no 0.7 IU / kg.
• In decompensated seswekile insulin yi 0.8 u / kg.
• Ukuba seswekile kunye ketoacidosis, kufuneka ukwazisa malunga 0.9 U / kg hormone.
• Ngexa lokukhulelwa, umfazi kwithuba leenyanga ezintathu lesithathu kufuneka iiyunithi 1.0 / kg.

Kuba ekubaleni idosi enye ye-insulin kufuneka ibe idosi yemihla ngemihla liphindaphindwe ubunzima bomzimba kunye nabelane ngababini, yaye onke eli nani lokugqibela.

Ukusetyenziswa "NovoRapid FleksPen" iziyobisi

Ukuqaliswa hormone enokwenziwa usebenzisa isirinji-pen "NovoRapid FleksPen". It has umbala coded a kwisixhobo. Le ithamo insulin zingaqala-1 ukuya kuma-60 U, inyathelo elinye ilingana 1 IU isirinji. Xa Elungiselela "NovoRapid" inaliti wasebenzisa TM "Novotvist" okanye "Novofayn" 8 mm. Ukuba usebenzisa usiba, khumbula ukuba kufuneka sisoloko ukuba inkqubo back-up ukuba isitofu - nje xa kunokwenzeka, ukuba isirinji ezonakeleyo okanye ezilahlekileyo.

Phambi kokuba kuqaliswe hormone pen efunekayo:

• Funda umbhalo kwaye uqinisekise ukuba "NovoRapid" Yiloo insulin oyifunayo.
• Susa isirinji ukusuka iinqanam-cap.
• Susa sticker leyo ukwakweli inaliti elahlwayo.
• Ujije inaliti emphinini. Kuba Inaliti ngalinye kufuneka inaliti entsha ukuthintela ukukhula yebhaktiriya. Inaliti akufunekanga ungagotywa okanye yonakele.
• Ukunqanda inaliti ngengozi kwi cap inaliti emva ulawulo insulin akuthethi ziguge.

Inaliti pen "NovoRapid 'inokuba liqulathe isixa minor womoya ngaphakathi. Amadlu oxygen musa olunazo, kwaye idosi sele ifakiwe ngokuchanekileyo, kuyimfuneko ukuba bathobele imithetho ethile;

• ED hormone socofo 2 kokutshintsha umkhethi wekhadi.
• Khangela inaliti ipeni phezulu kwaye ibhokisi iCartridge a iintupha. Ekubeni amaqamza ididizeliswa kummandla eliphezulu.
• Ukubamba ngesirinji "FleksPen" inaliti phezulu, cinezela isiqalo iqhosha kude ime. Ekala yokukhetha ngeli xesha liya kubuyela kwi "0" isikhundla. Trainspotting uya kuba nethontsi hormone. Ukuba ayiwenzi, le nkqubo iya phindwa amaxesha amathandathu. Ukuba insulin akezi, ngoko ke isirinji sinesiphene.

Ngaphambi kokuba ubeke ithamo kufuneka uqinisekise ukuba umkhethi idosi isetelwe ukuba "0". Le ilandelayo kufuneka ukucofa inani units, isixa ichiza kulawulwa yi umkhethi kumacala omabini. Xa uzibekela ithamo kufuneka silumke uze uzame ukuba angamchukumisi isiqalo qhosha ngempazamo, kungenjalo kuya kubakho ukukhululwa ngaphambi hormone. Musa ukufaka nayiphi na izinga mkhulu kunalowo into imveliso, "NovoRapid." Kwakhona, awufuni ukusebenzisa isikali balance ukumisela yedosi hormone.

Ngexesha ulawulo insulin kwesikhumba kulandele ubuchule ekucetyiswa ngugqirha wakho. Kuba inaliti, cinezela isiqalo iqhosha. Gcina it up logama nje umkhethi idosi akuthethi athathe isikhundla "0". Ngexesha Inaliti ubambe isiqalo iqhosha kuphela. Xa ujikelezo isalathisi eqhelekileyo lungenzeki unikezelo balawule insulin.

Emva ngenaliti, inaliti phantsi kwesikhumba kufuneka kuqhutyelwa omnye imizuzwana ezintandathu ekuyiyekeni adubule iqhosha. Ekubeni umthamo insulin ifakiwe ngokupheleleyo. Emva inaliti isitofu sibhekiswe le chap engaphandle, yaye xa ingena kuwo, ukuba unscrewed kulahlwe, ekuqhubeni yonke imigqalisela. Le isirinji belulinganiselwe. Inaliti isusiwe emva kokuba isitofu nganye kwaye mazigcinwe ebuhlanti. Kungenjalo, ulwelo ukuvuza liya kwenzeka, okungathetha kokusebenzisa i idosi engachanekanga. Ukuze ufumane inkcazelo engakumbi ukuze ahlabe njani insulin "NovoRapid" Ndithi kuni imiyalelo ukusetyenziswa.

imiphumela emibi

Drug "NovoRapid" kunokubangela eziliqela yeziphumo ebezingalindelekanga. Kuyinto hypoglycemia, esizibonakalisa ngokohlobo ukubila ngokugqithisileyo, isikhumba lipholi, uvalo, ixhala asifanelekanga, lafa kweqondo, ubuthathaka emzimbeni, nokudideka nokuncipha ingqalelo. Kwakhona, kukho nesiyezi, imvakalelo yindlala, sibangelwa okubonakalayo apparatus, isicaphucaphu, intloko ebuhlungu, kunye tachycardia. Glycemia kungabangela ukulahlekelwa osezingqondweni, ukuxhuzula, ukonakala kwengqondo kunye nokufa.

Akuvamile, izigulane zithi malunga negazi ezifana izigxala, irhashalala. uphazamiseko kangangoko isisu kunye namathumbu, lubandakanywe nezenzo angioedema, tachycardia, bamba umphefumlo. Xa izigulane waphawula ukwehlisa uxinzelelo lwegazi.

reactions Local waphawula ukurhawuzelela kwindawo isitofu, ububomvu, ukudumba kwesikhumba. kwenzeka Akuvamile iimpawu lipodystrophy. Eli chiza ingenza lokuqala nokudumba unyango kunye nokunyhashwa refraction.

Oogqirha bathi bonke mpawu umzuzwana ngokwendalo kuvandlakanywa ikakhulu izigulane yedosi-oxhomekeke kwaye ngenxa yesenzo amayeza insulin.

analogs

Ukuba hormone wenza akaphenduli, ungasoloko indawo imveliso "NovoRapid FleksPen". Analogs, Kakade ke, kukuba ukhethe nogqirha. Ethandwa kakhulu ziquka:

• "Novomiks".
• "Apidra".
• "Humalog".
• "Actrapid."
• "Rayzodeg".
• "Protafan".
• "Gensulin H".

Ixabiso le-hormone

Kuthengiswa ngqongqo enemithi, "NovoRapid." Ixabiso neekhatriji ezintlanu "Penfill" ngeenxa 1800 engange. Iindleko hormone "FleksPen" ngu 2000 engange. Umqulu ngamnye iqulethe ezintlanu iintlanti inaliti insulin "Novorapid". Price ngokuxhomekeke kumsebenzi womnatha yorhwebo ingahluka kancinci.

baqinisekiswa

Yintoni ncomo kulungiselelwa 'NovoRapid "? Abantu bathi lo insulin elungileyo kunye nowobulali. Esisebenza ngayo ngokukhawuleza. Ifanele ukuba unyango lwe uhlobo seswekile 1, apho iswekile yegazi kunzima ukunciphisa. Uninzi izigulane zakhe sebenzisa kwi unyango lwe type 2 diabetes. Abaninzi abanesifo seswekile va pen bakhululeke kakhulu "FleksPen". Abasusa imfuneko yokuthenga ngokwahlukileyo neesirinji.

Njengomgaqo, izigulane ukusebenzisa iziyobisi "NovoRapid" ngokuchasene nentsukaphi yolwabiwo-insulin elide, nto leyo inceda ukugcina amaqondo yesiqhelo iswekile yegazi imini yonke. Kuyanceda ukuba ehlise amazinga iswekile yegazi emva kwesidlo, leyo lula kakhulu ubomi seswekile ezininzi kwaye ivumela ukuba adle emva kweeyure. Abanye abantu bacetyiswa kwi lokuqala sifo ukusebenzisa kuphela oku hormone.

Kukho abantu abathi ukuba ichiza - xa kubhalwa kubantwana abancinane - ibangela kwi kukutshintshatshintsha elibukhali edlulileyo iswekile egazini, nto leyo abantwana bazive embi. Ukuze uphephe oku, abazali abaninzi bakhetha "NovoRapid" insulin elide.

izigulane Okuninzi qaphela ukuba ngokuchanekileyo ofanayo umthamo rhoqo kudale hypoglycemia kwaye ikhono impilo. Ukuze siphephe iziphumo ezinjalo abayi self-medicate, uze ufune uncedo lobungcali.