I-NovoRapid yezidakamizwa iyithuluzi lesizukulwane esisha elinganxephezela ukushoda kwe-insulin yomuntu. Inezinzuzo eziningana ngaphezu kwezinye izindlela ezifanayo, zitholwa kalula futhi ngokushesha, i-ushukela wegazi ejwayelekile, ingasetshenziswa ngokungakhathaleli ukudla, ngoba yi-insulin ye-ultrashort.
I-NovoRapid ikhiqizwa ngezinhlobo ezi-2: Amapeni weFlexpen enziwe ngomumo, ama-cartridge wePenfill angalungiswa. Ukwakheka kwalo muthi kuyafana kuzo zombili lezi zimo - uketshezi olucacile lomjovo, ml owodwa uqukethe i-100 IU yento esebenzayo. I-cartridge, efana nepeni, iqukethe i-3 ml ye-insulin.
Intengo yama-cartridge we-5 NovoRapid Penfill insulin ngokwesilinganiso izoba ngama-ruble ayi-1800, i-FlexPen ibiza cishe ama-ruble ayizinkulungwane ezimbili. Iphakethe elilodwa liqukethe amaphenti wesirinji angama-5.
Izici zesidakamizwa
Isithako esiyisisekelo somuthi yi-insulin aspart, sinomphumela we-hypoglycemic onamandla, yi-analogue ye-insulin emfushane, ekhiqizwa emzimbeni womuntu. Le nto itholakala ngokusetshenziswa kobuchwepheshe be-DNA esebenza kabusha.
Umuthi uthintana nolwelwesi lwangaphandle lwe-cytoplasmic lwama-amino acid, lwakhiwe yinkimbinkimbi yokuphela kwe-insulin, luqale izinqubo ezenzeka ngaphakathi kwamangqamuzana. Ngemuva kokuncipha koshukela wegazi kuyaphawulwa:
- ukukhushulwa kwezokuhamba kwangaphakathi;
- ukukhuphuka kwe-digestibility yezicubu;
- ku-activation of lipogenesis, glycogeneis.
Ngaphezu kwalokho, kungenzeka ukufezekisa ukwehla kwesilinganiso sokukhiqizwa kweglue ngesibindi.
I-NovoRapid idonswa kangcono ngama-subcutaneous fat kunokuba i-insulin ethambile yomuntu, kepha ubude bomphumela buphansi kakhulu. Isenzo somuthi senzeka ngaphakathi kwemizuzu eyi-10-20 ngemuva komjovo, futhi isikhathi sawo singamahora angama-3-5, inani eliphakeme kakhulu le-insulin liqashelwa ngemuva kwamahora ama-1-3.
Izifundo zezokwelapha zeziguli ezinesifo sikashukela sohlobo loku-1 zikhombisile ukuthi ukusetshenziswa okuhleliwe kweNovoRapid kunciphisa amathuba okuba ne-nocturnal hypoglycemia ngokushesha kaningana. Ngaphezu kwalokho kunobufakazi bokwehla okukhulu kwe-postprandial hypoglycemia.
I-NovoRapid yezidakamizwa iyanconywa ezigulini ezinesifo sikashukela i-mellitus sohlobo lokuqala (olungathengelwanga i-insulin) nohlobo lwesibili (olungathembisi i-insulin). Ukuxhumana okusetshenziswayo kuzoba:
- ukuzwela ngokweqile komzimba ezingxenyeni zomuthi;
- izingane ezingaphansi kweminyaka engu-6.
Umuthi uvunyelwe ukusetshenziselwa ukwelapha izifo ezithinta umzimba.
Imiyalo yokusebenzisa umuthi
Ukuthola umphumela omuhle, le-hormone kumele ihlanganiswe nokufakwa isikhathi eside naphakathi nendawo okubambelela kulo. Ukulawula izinga le-glycemia, kuyakhonjiswa isilinganiso soshukela egazini, ukulungiswa komthamo uma kudingekile.
Imvamisa, umthamo wansuku zonke we-insulin wesifo sikashukela uhluka phakathi kwamayunithi angama-0.5-1 ngekhilogremu ngayinye. Ukujova okukodwa kwe-hormone kunikeza isiguli isidingo sansuku zonke se-insulin cishe ngama-50-70%, okuseleyo insulin esebenza isikhathi eside.
Kunobufakazi bokubuyekeza inani elinconyiwe lezimali ezinikezwe:
- ukukhuphuka komzimba kwesifo sikashukela;
- ushintsho ekudleni kwakhe;
- ukuqubuka kwezifo ezihambelanayo.
I-Insulin NovoRapid Flekspen, ngokungafani ne-hormone yomuntu encibilikayo, isebenza ngokushesha, kodwa isikhashana. Kuboniswa ukusebenzisa umuthi ngaphambi kokudla, kepha kuvunyelwe ukwenza lokhu ngemuva kokudla, uma kunesidingo.
Ngenxa yokuthi umuthi usebenza emzimbeni isikhashana, amathuba okuthuthukisa i-hypoglycemia yasebusuku ancishiswe kakhulu. Uma umuthi usetshenziselwa ukwelapha isifo sikashukela sobudala obudala, ngokuhluleka kwesibindi noma izinso, kubalulekile ukulawula amazinga kashukela egazini kaningi, khetha inani le-insulin ngawodwana.
Kuyadingeka ukujova i-insulin esifundeni esingaphandle esiswini, iziqubu, imisipha, izicubu ezithambile. Ukuvimbela i-lipodystrophy, kuyadingeka ukuthi ushintshe indawo lapho kusetshenziswa umuthi khona. Kepha kufanele wazi ukuthi ukwethulwa esiswini esingaphandle kunikeza ukumunyiswa okushesha kakhulu komuthi, uma kuqhathaniswa nemijovo kwezinye izingxenye zomzimba.
Isikhathi somphumela we-insulin sithinteka ngqo ku:
- umthamo
- indawo yomjovo;
- izinga lomsebenzi wesineke;
- izinga lokugeleza kwegazi;
- lokushisa komzimba.
Ama-infusions we-subcutaneous wesikhathi eside anconywa kwabathile abanesifo sikashukela, okungenziwa ngokusebenzisa iphampu ekhethekile. Ukwethulwa kwe-hormone kukhonjiswa odongeni lwesibeletho olungaphandle, kepha, njengasesimweni esedlule, izindawo kufanele ziguqulwe.
Usebenzisa iphampu ye-insulin, ungahlanganisi isidakamizwa namanye ama-insulin. Iziguli ezithola imali zisebenzisa uhlelo olunje kufanele zibe nethamo lokuphuza lomuthi uma kungaphulwa idivaysi. I-NovoRapid ilungele ukuphathwa kwe-intravenous, kepha ukudubula okunjalo kufanele kunikezwe kuphela ngudokotela.
Ngesikhathi sokulashwa, kufanele unikele njalo ngegazi ukuze uhlolelwe ukugxila kwe-glucose.
Ungasibala kanjani isilinganiso
Ukubalwa okunembile kwenani lomuthi, kuyadingeka ukwazi ukuthi i-insulin ye-hormone i-ultrashort, imfishane, iphakathi, iyelulwa futhi ihlanganiswe. Ukubuyisa ushukela wegazi kokujwayelekile, umuthi wokuhlanganisa uyasiza, uphathwa esiswini esingenalutho ngesifo sikashukela sohlobo lokuqala noma lwesibili.
Uma isiguli esisodwa sikhonjiswa i-insulin ende kuphela, lapho-ke, uma kunesidingo, ukuvimbela ushintsho olungazelelwe kushukela we-spikes, iNovoRapid ikhonjiswa kuphela. Ukwelashwa kwe-hyperglycemia, ama-insulin amafushane futhi amade angasetjenziswa ngasikhathi sinye, kepha ngezikhathi ezihlukile. Kwesinye isikhathi, ukufeza umphumela ohlosiwe, kulungelwa inhlanganisela ye-insulin kuphela.
Lapho ukhetha ukwelashwa, udokotela ubheka ezinye izici, ngokwesibonelo, ngenxa yesenzo se-insulin eside kuphela, kungenzeka ukugcina ushukela bese wenza ngaphandle komjovo womuthi obambela amafushane.
Ukuzikhethela kwesenzo eside kuyadingeka ngale ndlela:
- ushukela wegazi ulinganiswa ngaphambi kokudla kwasekuseni;
- 3 amahora emva kwasemini, thatha esinye isilinganiso.
Ucwaningo olwengeziwe kufanele lwenziwe njalo ngehora. Ngosuku lokuqala lokukhetha umthamo, kufanele weqe ukudla kwasemini, kepha udle isidlo sakusihlwa. Ngosuku lwesibili, isilinganiso sikashukela senziwa njalo ngehora, kufaka phakathi nobusuku. Ngosuku lwesithathu, izilinganiso zenziwa ngale ndlela, ukudla akunqunyelwe, kepha akufaki i-insulin efushane. Imiphumela emihle yasekuseni: usuku lokuqala - 5 mmol / l; usuku lwesibili - 8 mmol / l; ngosuku lwesithathu - 12 mmol / l.
Kufanele kukhunjulwe ukuthi iNovoRapid inciphisa ukugcwala koshukela wegazi kanye nengxenye kunamandla kune-analogues yayo. Ngakho-ke, udinga ukujova imithamo ye-0,4 ye-insulin emfushane. Ngokucacile, umthamo ungasungulwa kuphela ngokuhlolwa, kucatshangelwa ubunzima besifo sikashukela. Ngaphandle kwalokho, kuvela i-overdose, okuzobangela izinkinga eziningi ezingemnandi.
Imithetho eyinhloko yokuthola inani le-insulin yesifo sikashukela:
- ushukela wesigaba sokuqala wohlobo lokuqala - ama-0.5 PIECES / kg;
- uma isifo sikashukela sigcina isikhathi esingaphezu konyaka - 0,6 U / kg;
- ushukela oyinkimbinkimbi - 0,7 U / kg;
- ushukela obolile - 0,8 U / kg;
- isifo sikashukela ngemuva kwe-ketoacidosis - 0,9 PIECES / kg.
Abesifazane abakhulelwe ku-trimester yesithathu baboniswa ukuphatha i-1 U / kg ye-insulin. Ukuthola umthamo owodwa wento, kuyadingeka ukuphindaphinda isisindo somzimba ngethamo losuku, bese uhlukanisa ngababili. Umphumela uzungezwe.
I-NovoRapid Flexpen
Isingeniso somuthi senziwa kusetshenziswa ipeni yesirinji, ine-dispenser, color coding. Umthamo we-insulin ungasukela kumayunithi ama-1 kuye kwangama-60, igxathu lesirinji liyunithi elilodwa. Umenzeli weNovoRapid usebenzisa inalithi engu-8 mm yeNovofayn, Novotvist.
Usebenzisa ipeni lesirinji ukwethula i-hormone, udinga ukukhipha isinamatheli ngenaliti, usikhafule esibayeni. Njalo lapho kusetshenziswa inalithi entsha ngomjovo, lokhu kuyasiza ukuvikela ukukhula kwamagciwane. Inaliti yenqatshelwe ukulimaza, ukugoba, ukudlulisela kwezinye iziguli.
Ipeni lesirinji lingaqukatha inani elincane lomoya ngaphakathi, ukuze umoya-mpilo ungaqokeleli, umthamo ufakwe ngokunembile, kukhonjiswa ukuthi kugcinwa imithetho enjalo:
- shayela amayunithi ama-2 ngokuguqula isikhethi sesilinganiso;
- beka ipeni lesirinji ngenaliti phezulu, uthepha ibhokisi elincane umunwe;
- cindezela inkinobho yokuqala yonke indlela (okhethiweyo ubuyela kumaki 0).
Uma ukwehla kwe-insulin kungaveli ngenaliti, inqubo iyaphindwa (hhayi izikhathi ezingaphezu kwezi-6). Uma isixazululo singahambi, kusho ukuthi ipeni lesirinji alifanele ukusetshenziswa.
Ngaphambi kokubeka umthamo, okhethiweyo kufanele abe esesimweni 0. Ngemuva kwalokho, inani elidingakalayo lomuthi liyashaywa, lungisa okhethi kuzo zombili izinkomba.
Kuyenqatshelwa ukusetha okujwayelekile ngaphezulu kwesilinganiso esibekiwe, sebenzisa isikali ukuthola umthamo womuthi. Ngokwazisa kwehomoni ngaphansi kwesikhumba, inqubo enikezwe ngudokotela iyimpoqo. Ukuze wenze umjovo, cindezela inkinobho yokuqala, ungayikhiphi kuze kube yilapho okhethiwe efika ku-0.
Ukujikeleza okujwayelekile kwesikhombisi somthamo ngeke kuqale ukuhamba komuthi; ngemuva komjovo, inaliti kufanele ibanjelwe ngaphansi kwesikhumba eminye imizuzwana eyi-6, ibambe inkinobho yokuqalisa. Lokhu kuzokuvumela ukuthi ufake i-NovoRapid ngokuphelele, njengoba kuyalelwe ngudokotela.
Inaliti kufanele isuswe ngemuva komjovo ngamunye, akufanele igcinwe nesirinji, ngaphandle kwalokho umuthi uzovuza.
Imiphumela engafuneki
I-NovoRapid insulin kwezinye izimo ingavusa ukusabela okuningana komzimba, kungaba yi-hypoglycemia, izimpawu zayo:
- indlala yesikhumba;
- ukujuluka ngokweqile;
- ukuzamazama kwemilenze;
- ukukhathazeka okungenasisekelo;
- ubuthakathaka bemisipha;
- i-tachycardia;
- izikhathi zokucanuzelelwa kwenhliziyo.
Okunye ukubonakaliswa kwe-hypoglycemia kuzolungiswa ukuguquguquka, kunciphise isikhathi sokunakwa, izinkinga zokubuka kanye nendlala. Izinguquko ku-glucose yegazi zingadala ukubanjwa ngamandla, ukulahleka kwengqondo, ukulimala okukhulu kobuchopho, ukufa.
Ukuphendula komzimba, ikakhulukazi i-urticaria, kanye nokuphazamiseka komgudu wokugaya ukudla, i-angioedema, ukuphefumula kobunzima, i-tachycardia, akuvamile. Ukuphendula kwasendaweni kufanele kubizwe ngokuthi ukungajabuli endaweni yomjovo:
- ukuvuvukala
- ubomvu
- ukulunywa
Izimpawu ze-lipodystrophy, isiphazamiso esikhubazekile azikhishwa. Odokotela bathi ukubonakaliswa okunjalo kungokwesikhashana ngokwemvelo, kuvela ezigulini ezincike kumthamo, okubangelwa isenzo se-insulin.
Ama-analog, ukubuyekezwa kweziguli
Uma kwenzeka ukuthi uNovoRapid Penfill insulin engahambelani nesiguli ngasizathu simbe, udokotela uncoma ukusetshenziswa kwama-analogues. Izidakamizwa ezaziwa kakhulu yi-Apidra, Gensulin N, Humalog, Novomiks, Ryzodeg. Izindleko zabo zicishe zifane.
Iziguli eziningi sezivele zikwazile ukuhlola umuthi i-NovoRapid, ziqaphela ukuthi umphumela uyeza ngokushesha, imiphumela emibi ayivelakancane. Umuthi muhle kakhulu ekwelapheni isifo sikashukela i-mellitus sohlobo lokuqala nolwesibili. Iningi labanesifo sikashukela likholelwa ukuthi leli thuluzi lilula impela, ikakhulukazi isirinji, balisusa isidingo sokuthenga isirinji.
Ekusebenzeni, i-insulin isetshenziswa ngokumelene nesizinda sesikhathi se-insulin ende, kuyasiza ukugcina ushukela wegazi ezingeni elifanele phakathi nosuku, kunciphisa ushukela ngemuva kokudla. I-NovoRapid iboniswa kwezinye iziguli kuphela ekuqaleni kwesifo.
Ukuntuleka kwemali kungabizwa ngokuthi ukwehla okubukhali kwe-glucose ezinganeni, ngenxa yalokho, iziguli zingazizwa zimbi. Ukuvimbela lezo zinkinga, kuyadingeka ukushintshela ku-insulin isikhathi eside.
Futhi, abanesifo sikashukela baphawula ukuthi uma umthamo ukhethwe ngokungalungile, izimpawu ze-hypoglycemia ziyavela, kanye nesimo sezempilo siba sibi. Ividiyo ekulesi sihloko izoqhubeka nesihloko seNovorapid insulin.
