I-drug insulin NovoMix 30 FlexPen ukumiswa kwezigaba ezimbili, okuqukethe izidakamizwa ezinjalo:
- i-insulin aspart (i-analogue yemvelo yesikhathi esifushane se-insulin);
- i-insulin aspart protamine (ukuhlukahluka kwe-insulin esezingeni eliphakathi komuntu).
Ukwehla okukhulu ushukela wegazi ngaphansi kwethonya le-insulin aspart kwenzeka ngenxa yokubopha kwawo ama-insulin receptors akhethekile. Lokhu kukhuthaza ukuthathwa koshukela ngamaseli we-lipid kanye nemisipha ngenkathi kuvimbela ukukhiqizwa kwe-glucose yisibindi.
INovomix inamaphesenti angama-30 i-insulle insulin aspart, eyenza ukuthi ikwazi ukunikeza ngokushesha okukhulu (ngokuqhathaniswa ne-insulin yomuntu e-soluble) ukuqala kokuvezwa. Ngaphezu kwalokho, ukwethulwa komuthi kungenzeka ngokushesha ngaphambi kokudla (imizuzu eyi-10 ngaphambi kokudla).
Isigaba se-crystalline (amaphesenti angama-70) siqukethe i-protamine insulin aspart enephrofayili yomsebenzi efana ne-insulin engathathi hlangothi.
I-NovoMix 30 FlexPen iqala ukusebenza ngemuva kwemizuzu eyi-10-20 kusukela ngesikhathi sokufakwa kwayo ngaphansi kwesikhumba. Umphumela omkhulu ungatholakala kungakapheli amahora ama-1-4 ngemuva komjovo. Isikhathi sesenzo singamahora angama-24.
Ukuhlushwa kwe-hemoglobin ye-glycosylated ngohlobo 1 no-2 sikashukela abathola ukwelashwa ngezidakamizwa izinyanga ezi-3 kuyafana nomphumela we-insulin we-biphasic insulin.
Njengomphumela wokwethulwa komthamo ofanayo we-molar, i-insulin aspart ihambelana ngokuphelele nezinga lomsebenzi we-hormone yomuntu.
Kwenziwe izifundo zemitholampilo ezigulini ezinaluphi uhlobo lwesifo sikashukela. Zonke iziguli zahlukaniswa zaba ngamaqembu ama-3:
- itholwe kuphela i-NovoMix 30 Flexpen;
- uthole i-NovoMix 30 Flexpen ngokuhlanganiswa ne-metformin;
- uthole i-metformin ene-sulfonylurea.
Ngemuva kwamaviki ayi-16 selokhu kwaqala ukwelashwa, ama-glycosylated hemoglobin indices eqenjini lesibili nelesithathu acishe afana. Kulesi sivivinyo, amaphesenti angama-57 eziguli athola i-hemoglobin ngezinga elingaphezulu kwamaphesenti ayi-9.
Eqenjini lesibili, ukuhlanganiswa kwezidakamizwa kubangele ukwehla okukhulu kwe-hemoglobin kuqhathaniswa neqembu lesithathu.
Inani eliphakeme le-insulin ye-hormone ku-serum yegazi ngemuva kokusebenzisa i-NovoMix 30 FlexPen lizoba cishe ngamaphesenti angama-50, futhi isikhathi sokulifinyelela lishesha amahlandla ama-2 uma liqhathaniswa ne-insulin 30 yabantu.
Abahlanganyeli abanempilo bezilingo ngemuva kokuphathwa kobuhlakani besidakamizwa ngamanani amayunithi angama-0,2 ngekhilogremu ngalinye lesisindo bathola ukuqoqwa okuphezulu kwe-insulin aspart egazini ngemuva kwehora elilodwa.
Ukuphila kwesigamu seNovoMix 30 FlexPen (noma ukufakwa kwayo kwe-analog), okubonisa izinga lokufakwa kwengxenyana ye-protamine, bekungamahora ayisishiyagalombili.
Ukuba khona kwe-insulin egazini kubuyela endaweni yokuqala ngemuva kwamahora we-15-18. Ngohlobo lwesifo sikashukela sohlobo II, ukugxila okuphezulu kwafinyelelwa emizuzwini engama-95 ngemuva kokuphathwa kwezidakamizwa futhi kwaba uphawu olungaphezulu kwesisekelo cishe amahora ayi-14.
Izinkomba kanye ne-contraindication yokusebenzisa umuthi
I-NovoMix 30 Flexpen ikhonjiswa kwisifo sikashukela. I-Pharmacokinetics ayifundwanga kulezi zigaba zeziguli:
- abantu asebekhulile;
- izingane
- iziguli ezinenkinga yesibindi nomsebenzi wezinso.
Ngokwezigaba, lesi sidakamizwa akufanele sisetshenziselwe i-hypoglycemia, ukuzwela ngokweqile kwento ye-aspart noma kwesinye isakhi somuthi ochaziwe.
Imiyalo ekhethekile nezixwayiso zokusetshenziswa
Uma kusetshenziswa umthamo onganele noma ukwelashwa kuqedwa kungazelelwe (ikakhulukazi ngesifo sikashukela sohlobo 1), kungahle kwenzeke:
- i-hyperglycemia;
- isifo sikashukela sikashukela.
Zombili lezi zimo ziyingozi kakhulu empilweni futhi zingadala ukufa.
I-NovoMix 30 FlexPen noma esikhundleni sayo okufakwayo kufanele kufakwe ngokushesha ngaphambi kokudla. Kubalulekile ukuthi unake ukuqala kwalesi sidakamizwa ekwelashweni kweziguli ezihlangabezana nokugula okukhona noma ukuthatha izidakamizwa ezinganciphisa kakhulu ukufakwa kokudla kwepheshana lesisu.
Izifo ezenzeka kanye (ikakhulukazi ezithathelwanayo futhi ezinesizungu) zandisa isidingo se-insulin eyengeziwe.
Ngokuya ngokudluliselwa komuntu ogulayo kuye ezinhlotsheni ezintsha ze-insulin, okwandulelayo kokuqala kokukhula komzimba kungashintsha kakhulu futhi kuhluke kulokho okuvela ekusetshenzisweni kwe-insulin evamile yesifo sikashukela. Ngenxa yalokhu, kubaluleke kakhulu ukudlulisa isiguli kwezinye izidakamizwa ngaphansi kokuqashwa ngudokotela okuqine kakhulu.
Noma iziphi izinguquko zifaka ukulungiswa komthamo odingekayo. Sikhuluma ngalezi zimo:
- ushintsho ekuqoqweni kwento;
- ukuguqulwa kwezinhlobo noma komenzi;
- ushintsho kwimvelaphi ye-insulin (yomuntu, isilwane noma i-analogue yomuntu);
- indlela yokuphatha noma yokukhiqiza.
In the process of switching to NovoMix 30 FlexPen insulin insulin or penfill analog injection, diabetes udinga usizo lukadokotela ekukhetheni umthamo wokulawula umuthi omusha. Kubalulekile futhi emavikini okuqala nasezinyangeni emva kokukuguqula.
Uma kuqhathaniswa ne-insulin ejwayelekile ye-insulin yomuntu, umjovo weNovoMix 30 FlexPen ungadala imiphumela emibi ye-hypoglycemic. Ungahlala kuze kube amahora angama-6, okubandakanya ukubuyekezwa komthamo odingekayo we-insulin noma wokudla.
Ukumiswa kwe-insulin akunakusetshenziswa kumaphampu e-insulin ukuletha umuthi ngokuqhubekayo ngaphansi kwesikhumba.
Ukukhulelwa
Ngesikhathi sokukhulelwa nokuqunjelwa, isipiliyoni somtholampilo nomuthi sinqunyelwe. Ngesikhathi sokuhlolwa kwezesayensi ezilwaneni, kwatholakala ukuthi i-aspart njenge-insulin yomuntu ayikwazi ukuba nomphumela omubi emzimbeni (teratogenic noma embryotoxic).
Odokotela batusa ukubhekwa okwandisiwe kokwelashwa kwabesifazane abakhulelwe abanesifo sikashukela kuyo yonke le nkathi yokuzala kwengane futhi uma kukhona izinsolo zokukhulelwa.
Isidingo se-insulin ye-hormone, njengomthetho, sincipha ku-trimester yokuqala futhi sikhuphuka kakhulu ngokwanele kuma-trimesters wesibili nowesithathu. Ngokushesha ngemuva kokubeletha, isidingo somzimba se-insulin sibuyela ngokushesha kwisisekelo.
Ukwelashwa akukwazi ukulimaza umama nengane yakhe ngenxa yokungakwazi ukungena ebisini. Ngaphandle kwalokhu, kungahle kudingekile ukulungisa umthamo we-NovoMix 30 FlexPen.
Amandla wokulawula izindlela
Uma, ngenxa yezizathu ezahlukahlukene, i-hypoglycemia ikhula ngenkathi uthatha umuthi, isiguli ngeke sikwazi ukugxila ngokwanele futhi siphendule ngokwanele kulokho okwenzeka kuye. Ngakho-ke, ukushayela imoto noma umshini kufanele kukhawulelwe. Isiguli ngasinye kufanele siqaphele izindlela ezidingekayo zokuvimbela amaconsi kashukela egazini, ikakhulukazi uma udinga ukushayela.
Ezimweni lapho i-FlexPen noma i-analog yayo isetshenziswe khona, kuyadingeka ukukala ngokucophelela ukuphepha nokululeka ukushayela, ikakhulukazi uma izimpawu ze-hypoglycemia zibuthaka kakhulu noma zingekho.
Ngabe umuthi uhlangana kanjani nezinye izidakamizwa?
Kunezidakamizwa ezimbalwa ezingathinta umqubuko woshukela emzimbeni, okufanele unakwe lapho kubalwa umthamo odingekayo.
Izindlela ezinciphisa isidingo se-insulin ye-hormone zifaka:
- i-hypoglycemic yomlomo;
- Mao inhibitors;
- i-octreotide;
- Ama-inhibitors e-ACE;
- ama-salicylates;
- ama-anabolics;
- ama-sulfonamides;
- aqukethe utshwala;
- izivimbi ezingakhethi.
Kukhona futhi amathuluzi akhulisa isidingo sokusetshenziswa okwengeziwe kwe-NovoMix 30 FlexPen insulin noma ukuhlukahluka kokufakwayo:
- izindlela zokuvimbela inzalo ngomlomo;
- danazole;
- utshwala
- ama-thiazides;
- I-GSK;
- ama-hormone egilo.
Ungasifaka kanjani isicelo futhi uphuze?
I-Dosage NovoMix 30 I-flexpen ilulodwa umuntu futhi ihlinzeka ngokuqokwa kukadokotela, ngokuya ngezidingo ezisobala zesiguli. Ngenxa yesivinini somuthi, kufanele uphathwe ngaphambi kokudla. Uma kunesidingo, i-insulin, kanye ne-penfill, kufanele iphathwe ngokushesha ngemuva kokudla.
Uma sikhuluma ngezinkomba ezimaphakathi, iNovoMix 30 FlexPen kumele isetshenziswe ngokuya ngesisindo sesiguli futhi izosuka ku-0,5 iye ku-1 UNIT ngekhilogremu ngayinye ngosuku. Isidingo singakhuphuka kulabo abanesifo sikashukela abanokuphikisana ne-insulin, futhi sinciphe ezimweni zokugcinwa okusalelayo kwehomoni yabo.
I-flexpen ivame ukuphathwa ngokungaziphathi kahle ethangeni. Ukufakwa kuyenzeka naku:
- isifunda sesisu (udonga lwesibeletho lwangaphandle);
- izinqe;
- umsipha odabukisayo wehlombe.
I-Lipodystrophy ingagwenywa inqobo nje uma amasayithi womjovo akhonjisiwe eguqulwa.
Ukulandela isibonelo sezinye izidakamizwa, isikhathi sokuchayeka kulo muthi ungahluka. Lokhu kuzoncika:
- umthamo
- amasayithi omjovo;
- izinga lokugeleza kwegazi;
- izinga lomsebenzi womzimba;
- lokushisa komzimba.
Ukuncika kwesilinganiso sokumuncwa endaweni yomjovo akukaphenywa.
Ezigulini ezinesifo sikashukela sohlobo 2, i-NovoMix 30 FlexPen (ne-penfill analog) ingabekwa njengezokwelapha eziphambili, kanye nokuhlanganiswa ne-metformin. Lesi sakamuva siyadingeka ezimweni lapho kungenzeki ukunciphisa ushukela wegazi ngezinye izindlela.
Umthamo wokuqala othunyelwe umuthi nge-metformin uzoba amayunithi angama-0,2 ngekhilogremu yesisindo sesiguli ngosuku. Ivolumu yomuthi kumele iguqulwe ngokuya ngezidingo esimweni ngasinye.
Kubalulekile futhi ukunaka izinga likashukela ku-serum yegazi. Noma imuphi umsebenzi we-renal ongasebenzi kahle noma we-hepatic unganciphisa isidingo se-hormone.
I-NovoMix 30 flexpen ayikwazi ukusetshenziselwa ukwelapha izingane.
Umuthi okukhulunywa ngawo ungasetjenziselwa umjovo wangaphansi nje. Akunakufakwa ngesigaba emsipha noma emzimbeni.
Ukuboniswa kokuphendula okungahambi kahle
Imiphumela emibi yokusetshenziswa kwomuthi ingabhekwa kuphela uma kwenzeka uguquko olusuka kwenye i-insulin noma lapho ushintsha umthamo. I-NovoMix 30 FlexPen (noma ukufakwa kwayo kwe-analog) kungasithinta kakhulu isimo sezempilo.
Njengomthetho, i-hypoglycemia iba isibonakaliso esivame kakhulu semiphumela emibi. Ingakhula lapho umthamo udlula kakhulu isidingo sangempela sehomoni, okungukuthi, kusetshenziswa i-insulin ngokweqile.
Ukuntuleka okungatheni kungadala ukulahleka kwengqondo noma ngisho namaqhubu, kulandele ukuphazamiseka kwengqondo okuhlala njalo noma okwesikhashana noma nokufa.
Ngokwemiphumela yezifundo zemitholampilo kanye nedatha eqoshwe ngemuva kokukhishwa kweNovoMix 30 emakethe, kungashiwo ukuthi izigameko ze-hypoglycemia ezinzima emaqenjini ehlukene eziguli zizohluka kakhulu.
Ngokuya ngokuvama kokuvela, ukusabela okungalungile kungahlukaniswa ngombandela ngamaqembu:
- kusuka emasosheni omzimba: ukusabela kwe-anaphylactic (akuvamile kakhulu), i-urticaria, ukuqubuka esikhunjeni (ngesinye isikhathi);
- ukusabela okujwayelekile: ukulunywa, ukuzwela ngokweqile, ukujuluka, ukuphazamiseka komgudu wokugaya ukudla, ukunciphisa umfutho wegazi, ukushaya kwenhliziyo okuhamba kancane, i-angioedema (ngesinye isikhathi);
- kusuka ohlelweni lwezinzwa: i-peropheral neuropathies. Ukuthuthuka kokuqala kokulawulwa kweshukela egazini kungaholela enkambeni eyingozi ye-neuropathy ebuhlungu, yesikhashana (akuvamile);
- Izinkinga zokubuka: Isiphazamiso esibi (kwesinye isikhathi). Kuhamba kancane emvelweni futhi kwenzeka ekuqaleni kokwelashwa nge-insulin;
- isifo sikashukela i-retinopathy (kwesinye isikhathi). Ngokulawulwa okuhle kwe-glycemic, amathuba okuqhubeka kwale nkinga azoncishiswa. Uma kusetshenziswa amaqhinga wokunakekela kakhulu, lokhu kungadala ukukhuphuka kwe-retinopathy;
- kusuka kwezicubu zesikhumba ezingasukeki nesikhumba, i-lipid dystrophy kungenzeka (ngesinye isikhathi). Ikhula kulezo zindawo lapho imijovo yayenziwa kaningi. Odokotela batusa ukuguqula indawo yokujova yeNovoMix 30 FlexPen (noma i-analog penfill yayo) endaweni efanayo. Ngaphezu kwalokho, ukuzwela ngokweqile kungaqala. Ngokwazisa kwalo muthi, kungenzeka ukuthuthukisa i-hypersensitivity yendawo: ubomvu, ukulunywa kwesikhumba, ukuvuvukala endaweni yomjovo. Lokhu kusabela kuhamba kancane emvelweni futhi kunyamalale ngokuphelele ngokwelashwa okuqhubekayo;
- ezinye izinkinga nokuphazamiseka (kwesinye isikhathi). Thuthukisa ekuqaleni kwe-insulin therapy. Izimpawu zesikhashana.
Amacala okweqa
Ngokuphathwa ngokweqile komuthi, ukuthuthukiswa kwesimo se-hypoglycemic kungenzeka.
Uma izinga loshukela wegazi sehle kancane, khona-ke i-hypoglycemia ingamiswa ngokudla ukudla okumnandi noma ushukela. Kungakho wonke umuntu onesifo sikashukela kufanele abe nesilinganiso esincane samaswidi, ngokwesibonelo, amaswidi noma iziphuzo ezingenashukela.
Ngokuntuleka okukhulu kwe-glucose yegazi, lapho isiguli siwele enkingeni, kuyadingeka ukumhlinzeka ngokuphathwa kwe-intramuscular noma subcutaneous kwe-glucagon ekubalweni kwe-0,5 kuye ku-1 mg. Imiyalo yalezi zenzo kufanele yaziwe kulabo abaphila nesifo sikashukela.
Lapho nje umuntu onesifo sikashukela ephuma ukhubazekile, udinga ukuthatha inani elincane lama-carbohydrate ngaphakathi. Lokhu kuzonikeza ithuba lokuvikela ukuqala kabusha.
Ngabe i-NovoMix 30 Flexpen kufanele igcinwe kanjani?
Impilo esezingeni eliphansi yesidakamizwa yiminyaka emi-2 ukusuka ngosuku ekwenziwe ngalo. Le ncwadi ithi ipeni elilungele ukusetshenziswa neNovoMix 30 FlexPen (noma ukugcwaliswa kwalo okulinganayo) alikwazi ukugcinwa esiqandisini. Kufanele kuthathwe kanye nawe ekubhukeni futhi kugcinwe isikhathi esingaphezu kwamaviki ama-4 lapho izinga lokushisa lingadluli kuma-30 degrees.
Ipeni le-insulin evaliwe kufanele ligcinwe kuma-2 kuya ku-8 degrees. Ngokwezigaba awukwazi ukukhulula umuthi!
