I-NovoNorm iyisikhuthazo se-pancreatic. Ku-mellitus yesifo sikashukela, lesi sidakamizwa sisetshenziswa lapho i-insulin inganele egazini lesiguli, futhi ukukhiqizwa kwaso kumele kuqiniswe. Isici salo muthi ngumphumela waso wesikhashana nesikhathi esifushane, okukuvumela ukuthi usisebenzise ukulawula izinga le-postprandial glycemia, okungukuthi, ukunciphisa ushukela ekudleni.
Uma isetshenziswe ngokungalungile, i-NovoNorm ingadala i-hypoglycemia, ngakho-ke kubaluleke kakhulu ukukhetha umthamo owanele. Umthamo wokuqala unqunywe ngudokotela, ubhala futhi negciwane, ngokusho ngalo ongathenga ngalo umuthi. Ngokuzayo, onesifo sikashukela angalungisa ngokuzimela umthamo, esebenzisa izincomo ezivela emiyalweni yokusetshenziswa.
Ukwakheka nefomu lokukhululwa
I-NovoNorm yethulwa ukukhathazeka kweNovoNordisk, umenzi owaziwayo waseDenmark wezokwelapha nemikhiqizo ehlobene nesifo sikashukela. Amacwecwe enziwa eJalimane naseDenmark. Into esebenzayo yesidakamizwa, i-repaglinide, isuselwa kuma-amino acid futhi ingeyama secretogens abambela amafushane. Ivela emvelaphi yaseJalimane (umkhiqizi uBeringer Ingelheim).
Isifo sikashukela nokucindezela kuzoba yinto yesikhathi esedlule
- Ukwehlela ushukela -95%
- Ukuqedwa kwe-vein thrombosis - 70%
- Ukuqedwa kokushaya kwenhliziyo okuqinile -90%
- Ukuqeda umfutho wegazi ophakeme - 92%
- Ukwanda kwamandla ngesikhathi sosuku, ngcono ukulala ebusuku -97%
Ithebhulethi eyodwa yeNovoNorm ingaqukatha u-0.5, 1 noma 2 mg wento esebenzayo. Ngaphezu kwalokho, kufakwa isitashi, i-povidone, i-potassium polyacrylate, ipluronic, i-glycerin, i-calcium hydrogen phosphate, kanye nodayi. Bayizingxenye ezisizayo, okungukuthi, abanawo umphumela wokwelapha.
Ungawuthola kanjani umuthi wokuqala:
- Ukuvikela ezifeni, ithebhulethi ngayinye imakwe uphawu lweNovoNordisk - inkunzi engcwele yaseGibhithe lasendulo.
- Umuthi ubekwa emabhulini e-foil, ngalinye liqukethe amaphilisi ayi-15.
- I-blister ifakwe nge-cosmetics, ekuvumela ukuthi uhlukanise umthamo wansuku zonke ngaphandle kokusebenzisa isikere.
- Umbala wezibhebhe zemithamo ehlukile uhlukile: ngu-0.5 mg omhlophe, 1 mg ophuzi, 2 mg pinkish.
Intengo yephakeji enamathebhulethi angama-30 ayidluli kuma-ruble angama-230. Umuthi ungagcinwa iminyaka emi-5 emazingeni okushisa ayi-15-30 ° C.
Umgomo wokusebenza kweNovoNorma
I-Repaglinide iyingxenye yeqembu lemithi ebizwa ngokuthi i-meglitinides. Ungababona ekugcineni kwe-glinid egameni. Zithathwe kuma-amino acid ahlukahlukene, ikakhulukazi i-repaglinide - i-carbamoyl-methyl-benzoic. Umuthi uyakwazi ukubopha endaweni ekhethekile yeziteshi ze-potassium etholakala kulwelwesi lwamangqamuzana e-pancreatic beta. Ngaphansi kwethonya le-repaglinide, lezi ziteshi zivinjelwe, okuholela ekungeneni kwe-calcium emangqamuzaneni nokwenyuka kokuhlanganiswa kwe-insulin.
Ukukhishwa kwe-insulin okucasulwe uNovoNorm kuqala imizuzu eyi-10 ngemuva kokuthi ithebulethi lingene emgodini wokugaya ukudla. Izinga eliphakeme egazini liyatholakala ngemuva kwemizuzu engama-50. Uma uthatha umuthi imizuzu engu-15 ngaphambi kokudla, ukukhula kweglucose egazini nokuvuselelekile kwe-insulin kuhlangana ngesikhathi, okusho ukuthi ushukela ushiya imithambo ngokushesha nangokuphelele.
Ngokungafani nokususelwa kokuthandwa kwe-sulfonylurea (Maninil, Amaril, Glibenclamide, njll.), Isenzo seNovoNorm sincike glycemia. Ushukela ojwayelekile, awusebenzi izikhathi eziningana kunoshukela oshukela. Ngemuva kokusebenzisa i-Repaglinide, amazinga we-insulin abuyele kokujwayelekile ngemuva kwamahora ama-3. Ngokusho kodokotela, lesi sici sinciphisa kakhulu imvamisa nobukhali be-hypoglycemia uma kungenzeka kusetshenziswe ngokweqile. Ukugqugquzela okufushane okunjalo kokukhishwa kwe-insulin kubhekwa njengokuphelisa, ukuvimbela ukuncipha ngokushesha kwamaseli we-beta, futhi ngenxa yalokho ukuqhubeka kwesifo sikashukela.
Izici zokuqothula emzimbeni
I-Repaglinide iyakwazi ukungeniswa ngokushesha emgodini wokugaya ukudla, okubangelwa ukuqala kwangaphambi kokusebenza kwayo. I-Bioavailability kanye nokuqoqwa kokugcina kwento esegazini kuyehluka kakhulu (kuze kufike ku-60%) kwizazi zesifo sikashukela esihlukile, ngakho-ke, umthamo wesiguli ngasinye kufanele ukhethwe ngamunye.
I-Repaglinide ivunywa yisibindi, ngemuva kwehora ukugxila kwayo kuncishiswe ngesigamu. Isici esiyisisekelo se-pharmacokinetics yento ukungcola okuvela emzimbeni ikakhulukazi emgodini wokugaya ukudla. Ngokwemiyalo, ama-92% e-repaglinide aphuma nama-ndun, ama-2% awo esesimweni esisebenzayo, ama-90% asele ngendlela yama-metabolites. Izinso zibiza cishe i-8%, evumela ukuthi iNovoNorm isetshenziswe kwabanesifo sikashukela esinezifo ezinzima zezinso. Ngemuva kwamahora ama-5, i-repaglinide ayisatholakali egazini.
Ubekwa ubani umuthi
INovoNorm imiselwe abanesifo sikashukela sohlobo 2 emacaleni alandelayo:
- Ngokubambisana ne-metformin ngokushesha ngemuva kokuxilongwa kwalesi sifo, uma i-glycated hemoglobin ingaphezulu kuka-9%, okukhombisa ukutholwa okungafanele kwesifo sikashukela noma ukuqhubeka kwawo ngokushesha.
- Njengokubuyiselwa kwe-sulfonylureas, uma zichithwe ngenxa yesifo sezinso, ukusabela komzimba.
- Njengengxenye yokwelapha okuyinkimbinkimbi, iziguli ezinesifo sikashukela sesikhathi eside, uma zinezinkinga ze-insulin noma isigaba 1 sokukhiqizwa kwayo ziyaphazamiseka (ushukela ukhuphuka ngokushesha futhi ungawi isikhathi eside ngemuva kokudla).
- Iziguli ezinesifo sikashukela ezingakwazi ukuhlela ukudla kwazo. Umthamo weNovoNorm ungashintshwa ngokuya ngenani lama-carbohydrate ekudleni.
Umyalo wokusetshenziswa ululeka ukuthatha i-NovoNorm nge-metformin nama-glitazones. Ngokusho kokubuyekezwa, lesi sidakamizwa sihamba kahle nawo wonke amaqembu ama-hypoglycemic agents, kufaka phakathi i-insulin. Okuwukuphela kokukodwa ngamalungiselelo we-sulfonylurea. Inhlanganisela yabo neNovoNorm yamukelekile, kepha ayinconywa, ngoba ingadala i-hypoglycemia enkulu futhi ithinte kabi isimo samaseli we-beta.
Contraindication
Uhlu lwe-contraindication ukusetshenziswa kweNovoNorm ku-mellitus yesifo sikashukela:
| Contraindication | Isizathu sokuvinjelwa |
| Hypersensitivity ezingxenyeni zephilisi. | Ukuphendula okungaba nzima komzimba kuze kufike ekuqhekekeni kwe-anaphylactic. |
| 1 uhlobo lwesifo sikashukela. | Lolu hlobo lwesifo sikashukela lubonakala ngokuwohloka ngokuphelele kwamaseli we-beta, okungafaki ukukhiqizwa kwe-insulin yayo. |
| I-ketoacidosis kanye nezinkinga ezalandela ezilandelayo - i-thoroma ne-coma. | Ukufakwa nokuqedwa kwe-repaglinide kungathikamezeka, ngakho-ke iziguli zidluliselwa okwesikhashana ekwelashweni nge-insulin. Ukubuyekezwa kukhombisa ukuthi ngemuva kokukhululeka kwesimo esibi, iziguli eziningi zibuyela kuNovoNorm. |
| Izifo ezinzima, ukungenelela kokuhlinzwa, ukulimala okusongela impilo. | |
| Ukukhulelwa, i-hepatitis B, iminyaka engaphansi kuka-18 nangaphezulu kweminyaka engama-75. | Ukusetshenziswa kwenqatshelwe ngenxa yokuntuleka kwezifundo eziqinisekisa ukuphepha kweNovoNorm kula maqembu abanesifo sikashukela. |
| Ukwehluleka kwesibindi okukhulu. | Isibindi sibandakanyeka kumetabolism ye-repaglinide, ngokuntuleka kwayo, ukuqoqwa kwento esegazini kuyanda. |
| Ukuthatha i-gemfibrozil ukulungisa i-lipids yegazi. | Umuthi uthuthukisa isenzo seNovo Norm, kungahle kuholele ku-hypoglycemia. I-repaglinide inyuka ngezikhathi ezingama-2.4, isikhathi esilinganiselwe sokukhululwa sinwetshwa amahora ama-3. |
Ukukhetha umthamo
AbakwaNovoNorm baphuza imizuzu engu-15 ngaphambi kokudla ukudla kwe-carbohydrate. Umyalo uncoma ukuyisabalalisa ngemithamo engama-2-2 ngosuku ngosuku izingxenye ezilinganayo.
Ukukhetha umthamo kwenziwa ngokuqapha njalo kwe-glycemia. Imithetho Yokukhetha:
- Umuthi wokuqalisa olulodwa ngu-0.5 mg.
- Uma isinxephezelo sikashukela singatholakali, sikhushulwa ngemuva kweviki eli-1 kuye ku-1 mg.
- Ngokukhulisa ngempumelelo umthamo ngo-0,5 mg, ungalethwa ku-4 mg ngethamo elilodwa. Isilinganiso esiphezulu sansuku zonke yi-16 mg. Uma inganikezeli ukulawulwa kwesifo sikashukela, isiguli sidinga ukuguqula indlela odla ngayo, futhi uma ngabe le ndlela ingasebenzi, shintshela kuzidakamizwa ezinamandla noma ku-insulin.
Izenzo ezingafuneki
Ngokusho kokubuyekezwa kwabanesifo sikashukela abaphuza umuthi, imvamisa bahlangabezana nokwehla okungathandeki koshukela ngemuva kokudla iphilisi. Imbangela yayo ingaba umthamo ngokweqile we-repaglinide, ukuntuleka kwama-carbohydrate ekudleni, ukugaya umuntu ngamunye, ukucindezela ngokomzimba nangokwengqondo. Ingozi ye-hypoglycemia ihlolwa ngemiyalo njengokuvamisile (1-10%). Ngethuba elifanayo kungenzeka - isifo sohudo nobuhlungu esifundeni sesisu.
Imiphumela emibi eseleyo ayivamile kakhulu, ezingaphansi kwe-0,1% yeziguli. I-NovoNorm ingadala ukungezwani komzimba, ukuqunjelwa, isicanucanu, ukufaka isandla ekukhiqizweni kwama-enzyme wesibindi.
Analogs kanye esikhundleni NovoNorma
Yini engangena esikhundleni seNovoNorm uma ingabekezeleli noma ingekho kumakhemisi:
| Iqembu le-Analog | Igama, umenzi | |
| I-analogues ephelele, into esebenzayo - i-repaglinide | Ukuxilonga kusuka ku-Akrikhin. | |
| I-Iglinid evela ku-Pharmasynthesis. | ||
| Ama-analogues eqembu, ama-meglitinides | I-Starlix (into esebenzayo - nateglinide, i-NovartisPharma yomkhiqizi). | |
| Okunye ukuhlanganiswa kwe-insulin okuthuthukisa amaphilisi avela kwamanye amaqembu | Sulfonylureas | I-Diabeteson (gliclazide, i-Servier), iManinil (glibenclamide, Berlin-Chemie), Amaryl (glimepiride, Sanofi), Glurenorm (glycvidone, Beringer Ingelheim) kanye nezimpawu zabo. |
| Ama-Dhib4 Inhibitors | I-Xelevia (sitagliptin, Berlin-Chemie), Onglisa (saxagliptin, AstraZeneca), Galvus (vildagliptin, NovartisFarma), njll. | |
Ku-mellitus yesifo sikashukela, ukushintshwa kweNovoNorm ene-analogues ephelele kungenziwa ngokuzimela, baphuza umuthi omusha ngethamo elifanayo. Ukushintshela kunoma yimaphi amanye amaphilisi kusuka etafuleni elingenhla kudinga ukukhethwa komthamo futhi kungenziwa kuphela ngaphansi kokuqashwa nokunikezwa udokotela.
