I-Insulin NovoMiks - umuthi oqukethe izichasiso zehomoni yabantu eyehlisa ushukela. Ilawulwa ekwelapheni i-mellitus yesifo sikashukela, zombili izinhlobo ezincike ku-insulin nezingathembeki ku-insulin. Okwamanje i-melon, lesi sifo sisakazeka kuwo wonke amagumbi omhlaba, kuyilapho ama-90% esifo sikashukela ehlushwa uhlobo lwesibili lwalesi sifo, ama-10% asele - asefomu lokuqala.
Imijovo ye-insulin ibalulekile, ngokulawulwa okunganele, imiphumela engaphenduki emzimbeni futhi nokufa kwenzeka. Ngakho-ke, umuntu ngamunye otholwa nesifo sikashukela i-mellitus, umndeni wakhe nabangane kudingeka "bahlome" ngolwazi ngezidakamizwa ze-hypoglycemic ne-insulin, nangokusebenzisa kwayo okufanele.
Indlela yokusebenza yesidakamizwa
I-insulin itholakala eDenmark ngesimo sokumiswa, okuyi-cartridge eyi-3 ml (NovoMix 30 Penfill) noma ngo-3 ml syringe pen (NovoMix 30 FlexPen). Ukumiswa kunemibala emhlophe, kwesinye isikhathi ukwakheka kwama-flakes kungenzeka. Ngokwakhiwa kwe-white precipitate kanye noketshezi olunwebekayo ngaphezulu kwalo, udinga nje ukuwushukumisa, njengoba kushiwo kwimiyalo enamathiselwe.
Izinto ezisebenzayo zomuthi zi-soluble insulin aspart (30%) namakristalu, kanye ne-insulin protart protamine (70%). Ngaphezu kwalezi zingxenye, umuthi uqukethe inani elincane le-glycerol, metacresol, i-sodium hydrogen phosphate dihydrate, i-zinc chloride nezinye izinto.
Imizuzu eyi-10 ukuya kwengama-20 ngemuva kokwethulwa komuthi ngaphansi kwesikhumba, kuqala umphumela wawo we-hypoglycemic. I-insulin aspart ibopha kuma-receptors ama-hormone, ngakho-ke i-glucose idonswa amaseli we-peripheral kanye ne-inhibition yokukhiqizwa kwayo kusuka esibindini kwenzeka. Umphumela omkhulu kakhulu wokuphathwa kwe-insulin ubonwa ngemuva kwamahora we-1-4, futhi umphumela wawo uhlala amahora angama-24.
Izifundo ze-Chemacological lapho zihlanganisa i-insulin nama-hypoglycemic agents of Type II diabetesics zikufakazele ukuthi uNovoMix 30 ngokuhlanganiswa ne-metformin unomphumela omkhulu we-hypoglycemic ukwedlula ukuhlanganiswa kwe-sulfonylurea ne-metformin.
Kodwa-ke, ososayensi abakahloli umphumela wezidakamizwa ezinganeni ezincane, kubantu asebekhulile futhi bahlushwa yi-pathologies yesibindi noma yezinso.
Imiyalo yokusebenzisa umuthi
Ngaphandle, udokotela unelungelo lokunquma umthamo ofanele we-insulin, ebheka izinga le-glucose egazini lesiguli. Kufanele kukhunjulwe ukuthi umuthi uphathwa zombili kuhlobo lwesifo sokuqala kanye nangendlela yokwelashwa okungasebenzi yohlobo lwesibili.
Uma unikezwe ukuthi i-biphasic hormone isebenza ngokushesha okukhulu kunehomoni yomuntu, ivame ukuphathwa ngaphambi kokudla ukudla, yize kungenzeka futhi ukuyiphathisa ngemuva nje kokugcwala ukudla.
Isikhombi esimaphakathi sesidingo sesifo sikashukela ku-hormone, ngokuya ngesisindo saso (kumakhilogremu), amayunithi we-0.5-1 wokusebenza ngosuku. Umthamo wansuku zonke wezidakamizwa ungakhuphuka neziguli zingazwisisi i-hormone (ngokwesibonelo, ukukhuluphala ngokweqile) noma zehle lapho isiguli sinemali ethile ebekiwe ye-insulin. Kungcono ukujova endaweni yamathanga, kodwa futhi kungenzeka esifundeni sesisu sezinkatho noma amahlombe. Kuyinto engathandeki ukunamathela endaweni efanayo, ngisho nasendaweni efanayo.
I-Insulin NovoMix 30 FlexPen neNovoMix 30 Penfill ingasetshenziswa njengethuluzi eliyinhloko noma lihlanganiswe nezinye izidakamizwa ze-hypoglycemic. Lapho kuhlanganiswa ne-metformin, umthamo wokuqala we-hormone amayunithi angama-0,2 esenzo ngekhilogremu ngosuku. Udokotela uzokwazi ukubala umthamo walezi zidakamizwa ezimbili ngokususelwa kuzinkomba zeglucose egazini kanye nezimpawu zesiguli. Kumele kwaziwe ukuthi ukungasebenzi kahle kwe-renal noma kwesibindi kungavusa ukuncipha kwesidingo sesifo sikashukela ku-insulin.
I-NovoMix ilawulwa kuphela ngokungenamkhawulo (okuningi mayelana ne-algorithm yokuphatha i-insulin ngokweqile), kuyenqatshelwe ngokuphelele ukwenza imijovo emsipha noma ngaphakathi. Ukuze ugweme ukwakheka kokungena, kwesinye isikhathi kuyadingeka ukuguqula indawo yomjovo. Ukufakwa kungenziwa kuzo zonke izindawo eziboniswe ngaphambili, kepha umphumela wesidakamizwa wenzeka kakhulu ekuqaleni lapho kwethulwa endaweni okhalweni.
Umuthi ugcinelwe umoya weminyaka kusukela ngosuku lokukhululwa. Isixazululo esisha esingasetshenziswanga ku-cartridge noma ipeni yesirinji sigcinwa esiqandisini sisuka ku-2 siye ku-8 degrees, futhi sisetshenziswe ekushiseni kwegumbi ngaphansi kwezinsuku ezingama-30.
Ukuvimbela ukuvezwa yilanga, faka isivalo esivikela epeni lesirinji.
Contraindication kanye nemiphumela emibi
I-NovoMix cishe ayikho imibimbi ngaphandle kokwehla okusheshayo kwezinga loshukela noma ukwanda kokutholwa kwento kunoma yikuphi okuqukethwe okuqukethwe.
Kumele kuqashelwe ukuthi ngesikhathi sokuzala kwengane, akukho miphumela emibi etholakele kumama okhulelwe nengane yakhe.
Lapho ukuncelisa ibele, i-insulin inganikezwa, ngoba ayidluliselwa enganeni ngobisi. Kodwa noma kunjalo, ngaphambi kokusebenzisa i-NovoMix 30, owesifazane kufanele abonane nodokotela ozokunikeza imithamo ephephile.
Ngokuqondene nomonakalo ongaba khona womuthi, uhlobene ikakhulu nosayizi womthamo. Ngakho-ke, kubaluleke kakhulu ukuphatha umuthi obekiwe, kulandela zonke izincomo zikadokotela. Imiphumela emibi engabakhona ingafaka:
- Isimo se-hypoglycemia (okuningi mayelana nokuthi yini i-hypoglycemia iku-mellitus yesifo sikashukela), ephelezelwa ukulahleka kwengqondo nokuqaqanjelwa.
- Ukugijima esikhunjeni, i-urticaria, ukulunywa, ukujuluka, ukusabela kwe-anaphylactic, i-angioedema, ukwanda kwe-palpitations kanye nomfutho wegazi ophansi.
- Shintsha ekuphikiseni, kwesinye isikhathi - ukuthuthukiswa kwe-retinopathy (ukungasebenzi komkhumbi we-retina).
- I-Lipid dystrophy esizeni somjovo, kanye nokubomvu nokuvuvukala endaweni yomjovo.
Ezimweni ezihlukile, ngenxa yokunganakekeli kwesiguli, kungavela i-overdose, izimpawu zazo ziyahlukahluka, ngokuya ngobukhulu besimo. Izimpawu ze-hypoglycemia ukudakwa, ukudideka, isicanucanu, ukugabha, i-tachycardia.
Nge-overdose emnene, isiguli sidinga ukudla umkhiqizo oqukethe ushukela omningi. Lokhu kungaba amakhukhi, uswidi, ujusi omnandi, kungakuhle ukuthi ube nokuthile kulolu hlu. I-overdose enzima idinga ukuphathwa ngokushesha kwe-glucagon ngokungenasisekelo, uma umzimba wesiguli ungaphenduli ekujovweni kwe-glucagon, umhlinzeki wezempilo kufanele aphathe ushukela.
Ngemuva kokulungisa lesi simo, isiguli sidinga ukusebenzisa ama-carbohydrate kalula ukugaya i-hypoglycemia.
Ukuxhumana neminye imithi
Lapho usingatha imijovo ye-insulin yeNovoMix 30, ukubaluleka kufanele kunikezwe iqiniso lokuthi ezinye izidakamizwa zinethonya kumphumela wazo we-hypoglycemic.
Utshwala ikakhulukazi bukhulisa umthelela wehlise ushukela we-insulin, kanye ne-beta-adrenergic blockers mask izimpawu zesimo se-hypoglycemic.
Ngokuya ngezidakamizwa ezisetshenziswa ngokuhlanganiswa ne-insulin, umsebenzi wayo ungakhuphuka futhi wehlise.
Ukwehla kwesidingo sehomoni kuyabonakala uma usebenzisa izidakamizwa ezilandelayo:
- izidakamizwa zangaphakathi ze-hypoglycemic;
- i-monoamine oxidase inhibitors (MAO);
- i-angiotensin eguqula ama-enzyme (ACE) inhibitors;
- ama-blocka-adrenergic blockers angakhethi;
- i-octreotide;
- ama-anabolic steroid;
- ama-salicylates;
- ama-sulfonamides;
- iziphuzo ezidakayo.
Ezinye izidakamizwa zinciphisa umsebenzi we-insulin futhi zandisa isidingo sesiguli ngazo. Inqubo enjalo yenzeka lapho usebenzisa:
- ama-hormone egilo;
- glucocorticoids;
- i-sympathomimetics;
- i-danazole ne-thiazides;
- izindlela zokuvimbela inzalo ezithatha ngaphakathi.
Ezinye izidakamizwa azihambelani neNovoMix insulin. Okokuqala, imikhiqizo equkethe ama-thiols nama-sulfite. Umuthi futhi wenqatshelwe ukufaka ikhambi lokufakwa. Sebenzisa i-insulin ngalezi zidakamizwa kungaholela emiphumeleni emibi kakhulu.
Ukubuyekezwa kwezindleko nezidakamizwa
Njengoba umuthi ukhiqizwa phesheya, intengo yawo iphakeme impela. Ingathengwa ngemithi ekhemisi noma ifakwe ku-inthanethi kuwebhusayithi yomthengisi. Izindleko zalo muthi zincike ekutheni isixazululo sikukopeleji noma ipeni yesirinji nokuthi kuliphi iphakheji. Intengo iyahlukahluka kuNovoMix 30 Penfill (ama-cartridge angu-5 ngephakethe ngalinye) - kusuka kuma-ruble angama-1670 kuya kwayi-1800 ama-ruble aseRussia, kanye neNovoMix 30 FlexPen (amapeni ama-syringe angu-5 ngephakethe ngalinye) anezindleko ebangeni kusuka ku-1630 kuya ku-2000 ama-ruble aseRussia.
Ukubuyekezwa kwabanesifo sikashukela abaningi abafake i-biphasic hormone kulungile. Abanye bathi bashintshela kuNovoMix 30 ngemuva kokusebenzisa amanye ama-insulin okwenziwa. Kulokhu, kungenzeka ukugqamisa izinzuzo ezinjalo zomuthi njengokusebenziseka kalula kanye nokwehla kwamathuba wesimo se-hypoglycemic.
Ngaphezu kwalokho, yize umuthi unohlu olubonakalayo lokuphendula okungalungile okungenzeka, akuvamile kakhulu. Ngakho-ke, iNovoMix ingabhekwa njengesidakamizwa esiphumelela ngokuphelele.
Vele, bekukhona ukubuyekeza ukuthi kwezinye izimo ubengafanele. Kepha umuthi ngamunye unezimpawu zokuphambana.
Izidakamizwa ezifanayo
Ezimweni lapho ikhambi lingasifanele isiguli noma libangela imiphumela emibi, udokotela ohambelayo angaguqula irejimeni yokwelashwa. Ukuze wenze lokhu, uguqula umthamo wesidakamizwa noma aze akhansele ukusetshenziswa kwawo. Ngakho-ke, kunesidingo sokusebenzisa umuthi onomphumela ofanayo we-hypoglycemic.
Kumele kuqashelwe ukuthi amalungiselelo uNovoMix 30 FlexPen neNovoMix 30 Penfill awanayo i-analogu engxenyeni esebenzayo - insulin aspart. Udokotela angabeka umuthi onomphumela ofanayo.
Le mithi ithengiswa ngomuthi. Ngakho-ke, uma kunesidingo, ukwelashwa kwe-insulin, isiguli kufanele sibonane nodokotela.
Izidakamizwa ezinomphumela ofanayo yile:
- I-Humalog Mix 25 iyi-analogue yokwenziwa ye-hormone ekhiqizwa umzimba womuntu. Isakhi esiyinhloko i-insulin lispro. Umuthi futhi unomphumela omfushane ngokulawula amazinga kashukela kanye ne-metabolism yawo. Ukumiswa okumhlophe, okukhishwa esibayeni sesirinji esibizwa ngePrime Pen. Izindleko ezijwayelekile zomuthi (amapeni ama-5 syringe ka-3 ml ngayinye) angama-ruble ayi-1860.
- I-Himulin M3 iyi-insulin esezingeni eliphakathi ekhishwa ngendlela yokumiswa. Izwe okuvela kulo muthi yiFrance. Into esebenzayo yesidakamizwa i-insulin yezinto eziphilayo. Ihlisa ngempumelelo ukugcwala kwe-glucose egazini ngaphandle kokubangela ukuqala kwe-hypoglycemia. Emakethe yezokwelapha yaseRussia, zingathengwa izinhlobo eziningana zemithi, njengeHumulin M3, iHumulin Regular, noma iHumulin NPH. Intengo ephakathi yesidakamizwa (amapeni ama-5 syringe ka-3 ml) angama-ruble ayi-1200.
Umuthi wanamuhla usuthuthukile, manje imijovo ye-insulin idinga ukwenziwa izikhathi ezimbalwa ngosuku. Amapeni wesirinji alula enza le nqubo izikhathi eziningi. Imakethe yamakhemikhali ihlinzeka ngokukhethwa okuningi kwama-insulin ahlukahlukene okwenziwa. Enye yezidakamizwa ezaziwa kakhulu yiNovoMix, ehlisa amazinga kashukela kumanani ajwayelekile futhi angaholeli ku-hypoglycemia. Ukusetshenziswa kwayo okufanele, kanye nokudla kanye nokuzivocavoca komzimba kuzoqinisekisa impilo ende nebuhlungu yabanesifo sikashukela.
