I-Levemir Flexpen nePenfil - imiyalo yokusebenzisa, ama-analogues, ukubuyekezwa

I-Levemir isidakamizwa se-hypoglycemic esifana nesakhiwo saso samakhemikhali nesenzo ku-insulin yomuntu. Lesi sidakamizwa singokwesigaba se-insulin esebenza kabusha yabantu.

I-Levemir Flexpen ipeni le-insulin elihlukile ne-dispenser. Ngenxa yayo, i-insulin ingalawulwa isuka kuyunithi eyi-1 iye kumayunithi angama-60. Ukulungiswa komdosi kuyatholakala ngaphakathi kweyunithi eyodwa.

Emashalofini emakhemisi ungathola iLevemir Penfill kanye neLevemir Flekspen. Bahluke kanjani komunye nomunye? Konke ukwakhiwa nomthamo, indlela yokuphatha iyafana. Umehluko phakathi kwabamele usesimweni sokukhululwa. I-Levemir Penfill yibhokisi lemoto elingena esikhundleni sepeni eligcwaliswayo. Futhi i-Levemir Flekspen ipeni lesirinji elilahlayo elinekhabethe elihlanganisiwe ngaphakathi.

Ukwakheka

Isithako esikhulu somuthi esisebenzayo i-insulin detemir Kuyi-insulin yomuntu esetshenziswayo futhi eyakhiwe kusetshenziswa ikhodi yofuzo yohlobo lwamagciwane weS Saccharomyces cerevisiae. Umthamo wento esebenzayo ku-1 ml wesisombululo ngu-100 IU noma 14.2 mg. Ngaphezu kwalokho, iyunithi eli-1 le-insulin levemir ephindaphindayo ilingana neyunithi elilodwa le-insulin yabantu.

Izingxenye ezingeziwe zinomphumela osizayo. Ingxenye ngayinye inomsebenzi wemisebenzi ethile. Baqinisa ukuqina kwesisombululo, banikeze izinkomba zekhwalithi ezikhethekile kulo muthi, bandise isikhathi sokugcina nempilo eshalofini.

Futhi, lezi zinto zisiza ukwenza ngokwejwayelekile futhi zithuthukise ama-pharmacokinetics kanye ne-pharmacodynamics yesithako esiyisisekelo esisebenzayo: zithuthukisa i-bioavailability, izicubu zomzimba, zinciphisa ukubopha kumaphrotheni egazi, ukulawula imetabolism nezinye izindlela zokuqothula.

Izinto ezengeziwe ezengeziwe zifakiwe kwikhambi lezidakamizwa:

• I-Glycerol - 16 mg;
• I-Metacresol - 2.06 mg;
• I-Zinc acetate - 65.4 mcg;
• I-Phenol - 1,8 mg;
• I-chloride ye-Sodium - 1,17 mg;
• IHydrochloric acid - q.s .;
• I-hydrogen phosphate dihydrate - 0,89 mg;
• Amanzi wokujova - aze afike ku-1 ml.

I-Pharmacodynamics

I-Levemir insulin iyi-analogue ye-insulin yabantu enesikhathi eside, iphrofayili eyisicaba. Isenzo sohlobo olubambezekile kungenxa yemiphumela ephezulu ezimele yokuzibandakanya yam molecule wezidakamizwa.

Baphinde babopha amanye amaprotheni esifundeni samaketanga aseceleni. Konke lokhu kwenzeka esizeni somjovo, ngakho-ke i-insulin detemir ingena egazini kancane kancane. Futhi izicubu eziqondisiwe zithola umthamo odingekayo kamuva ngokuhlobene nabanye abamele i-insulin. Lezi zinqubo zezinyathelo zinomphumela ohlangene ekusatshalisweni komuthi, ohlinzeka ngencwadi eyamukelekayo yokufaka kanye ne-metabolism.

Umthamo ophakanyisiwe we-0,0-0.4 U / kg ufinyelela uhhafu wokusebenza kahle ngemuva kwamahora ama-3. Kwezinye izimo, le nkathi ingabambezeleka kuze kufike emahoreni ayi-14.

Ngokuphathelene ne-pharmacodynamics kanye ne-pharmacokinetics yezidakamizwa zeLevemir, umthamo oyisisekelo we-insulin ungahanjiswa izikhathi ezi-1-2 ngosuku. Isikhathi esijwayelekile sokusebenza amahora angama-24.

I-Pharmacokinetics

Umuthi ufinyelela ekugxileni kwawo okuphezulu egazini ngemuva kwamahora angama-6-8 ngemuva kokuphathwa. Ukuhlushwa okungapheli komuthi kutholakala ngokuphathwa kabili ngosuku futhi kuzinza ngemuva kwemijovo emi-3. Ngokungafani namanye ama-insulin we-basal, ukungafani kokufakwa kanye nokusatshalaliswa kuncike ebuthaka ezimweni ezithile. Futhi, akukho ukuncika kohlanga nobulili.

Ucwaningo lukhombisa ukuthi i-insulin ye-Levemir i-insulin empeleni ayibophele amaprotheni, kanti inqwaba yomuthi ijikeleza ku-plasma yegazi (okuhlushwa isilinganiso sokwelapha esivamile sifinyelela ku-0.1 l / kg). I-insulin eyenziwe nge-insulin esibindini ngokususwa kwama-metabolites angasebenzi.

Isigamu sempilo sinqunywa ukuxhomekeka esikhathini sokufakwa kwegazi ngemuva kokuphathwa kobuhlakani. Ukulinganiselwa kwesigamu sempilo yomthamo othembekile kungamahora angama-6-7.

Izinkomba kanye ne-contraindication

Ukuxhumanisa ukusetshenziswa komuthi ubukhona bokungabekezelelani ngakunye ezintweni eziphambili ezisebenzayo nezingxenye ezisizayo. Futhi, lokhu kudla kuthathelwa ezinganeni ezingaphansi kweminyaka emi-2 ubudala ngenxa yokuntuleka kwezifundo zokwelapha kuleli qembu leziguli.

Imiyalo yokusebenzisa

I-insulini esebenza isikhathi eside i-insulin Levemir ithathwa izikhathi ezi-1 noma ezi-2 ngosuku njengendlela eyisisekelo yokwelapha i-bolus. Ngaphezu kwalokho, omunye wemithamo uphathwa kangcono kusihlwa ngaphambi kokulala noma ngesikhathi sokudla. Lokhu kuphinda kuvimbele amathuba we-hypoglycemia yasebusuku.

Imithamo ikhethwe ngudokotela ngawodwa esigulini ngasinye. Umthamo kanye nemvamisa yokuphatha kuncike ekusebenzeni ngokomzimba komuntu, imigomo yokudla okunempilo, izinga likashukela, ubukhulu besifo kanye nohlobo lweziguli lansuku zonke lwesiguli. Ngaphezu kwalokho, ukwelashwa okuyisisekelo akukwazi ukukhethwa kanye. Noma yikuphi ukushintshashintsha kwamaphuzu okungenhla kufanele kubikwe kudokotela, futhi lonke umthamo wansuku zonke kufanele uphinde uphinde uphinde ube kabusha.

Futhi, ukwelashwa kwezidakamizwa kuyashintsha ngokuthuthukiswa kwanoma yisiphi isifo esijwayelekile noma isidingo sokungenelela kokuhlinzwa.

I-Levemir ingasetjenziswa njenge-monotherapy, futhi ihlanganiswe nekwethulwa kwama-insulin amafushane namaphilisi we-hypoglycemic tablet. Kukhona ukwelashwa okuphelele, imvamisa ephambili yokwamukelwa isikhathi sokuqala. Umthamo oyisisekelo amayunithi ayi-10 noma i-0,1 - 0,2 amayunithi / kg.

Isikhathi sokuphatha phakathi nosuku sinqunywa isiguli uqobo, njengoba kufaneleka kuye. Kepha nsuku zonke udinga ukujova umuthi ngokuqinile ngasikhathi sinye.

I-Levemir ihanjiswa kuphela ngaphandle kokuzenzela. Eminye imizila yokuphatha ingadala izinkinga ezinzima ngendlela ye-hypoglycemia enzima. Awukwazi ukuphathwa ngokuhlinzwa futhi ukuphathwa kwe-intramuscular kufanele kugwenywe. Umuthi awukwazi ukusetshenziswa kumaphampu we-insulin.

I-Levemir Flekspen isiza ukujova kahle umuthi emafutheni angaphansi kwe-subcutaneous. Njengoba ubude benaliti bukhulu ngokukhethekile. Umjovo ngamunye kufanele wethulwe endaweni entsha ukugwema ukuthuthukiswa kwe-lipodystrophy. Uma umuthi ungeniswa endaweni yesifunda esisodwa, awukwazi ukufaka umuthi endaweni efanayo.

Izindawo ezinconyelwe zokuphatha ngokufiphalisa:

1. I-Hip
2. Ihlombe
3. Amabhokisi
4. Udonga lwesisu esisezingeni eliphakeme;
5. Indawo yomsipha odabukisayo.

Ukusetshenziswa Okufanele kweLevemir Grip

Ngaphambi kokuthenga umkhiqizo, kufanele uqinisekise ubuqotho be-cartridge nepiston yerabha. Ingxenye ebonakalayo ye-piston akufanele idlule engxenyeni ebanzi yomugqa wokufaka amakhodi omhlophe. Ngaphandle kwalokho, lokhu kuzosebenza njengomcimbi wokubuyiselwa kwezimpahla kumphakeli.

Ngaphambi kokujova, udinga ukubheka i-Levemir Flekspen futhi uqiniseke ukuthi iyasebenza, ukulungiselela ipeni lesirinji ukuze lisebenze:

1. Bheka i-piston yerabha;
2. Hlola ubuqotho be-cartridge;
3. Bheka igama lomuthi futhi uqiniseke ukuthi kukhethwe uhlobo olufanele lwe-insulin;
4. Isikhathi ngasinye, sebenzisa inaliti entsha ukuphatha umthamo ukuvikela ukutheleleka kwenxeba.

Isibambo asikwazi ukusetshenziswa ne:

• Uma kwenzeka uphelelwe yisikhathi noma uqandiswe umuthi;
• Ukwephulwa kokwethembeka kwe-cartridge noma ukusebenza kwesibambo;
• Uma isixazululo siguqukela kusuka kokucacile siye kufwini;
• Ukungabekezelelani komuntu ngamunye ezingxenyeni;
• Ngoshukela omncane wegazi.

Ngemuva kokusebenzisa i-cartridge, awukwazi ukuyifaka kabusha nge-insulin. Futhi, njengesilinganiso sokuphepha, uhlelo lokuphatha okungelula kufanele ligqokwe ukugwema umuthi olahlekile ngenxa yokungasebenzi kahle ohlelweni oluphambili. Ekwelashweni okuyinkimbinkimbi okunama-insulin amaningana, kuyadingeka ukuthi ngamunye abe nohlelo oluhlukile ukukhipha ukuhlanganiswa kwezinto ezisebenzayo.

Imiyalo yesinyathelo ngesinyathelo yeLevemir Flekspen

Inaliti kufanele iphathwe ngokunakekelwa okuthile futhi ukunakekelwa kufanele kuthathwe ukuze kungagobeki noma kube buthuntu. Gwema ukubeka ingaphakathi kwinaliti. Lokhu kuzokhuphula ama-punctuff angeziwe.

1. Susa ithiphu ekhethekile epeni lesirinji;
2. Thatha inaliti elahliweyo bese ususa ngokucophelela ifilimu elivikelayo enalithi ngokulisongela epeni lesirinji;
3. Inaliti inethimba elikhulu lokuvikela elingaphandle okufanele lisuswe futhi ligcinwe;
4. Bese ususa cap yangaphakathi evikelekile yenaliti, okufanele ilahlwe;
5. Hlola ukuphuza i-insulin. Le yinqubo edingekayo, ngoba imvamisa ukusetshenziswa kwesibambo kaningi akuvezi i-bubble yomoya engenzeka. Ukuze angangeni emafutheni angaphansi kwe-subcutaneous, udinga ukusetha ukudayela ama-2 PIECES usebenzisa isithombisi sedosi;
6. Vula ipeni lesirinji ukuze inaliti likhombe. Thepha ku-cartridge ngesikhonkwane sakho somunwe ukuze wonke ama-bubble omoya aqoqeke eyodwa enkulu ngaphambili kwenaliti;
7. Ukuqhubeka nokubamba isibambo kulesi sikhundla, udinga ukucindezela inkinobho yokuqala yonke indlela ukuze okhethiweyo womthamo akhombise ama-0 PIECES. Imvamisa, iconsi lesisombululo kufanele libonakale ngenaliti. Ngaphandle kwalokho, uma lokhu kungenzekanga, udinga ukuthatha inaliti entsha bese uphinda lezi zinyathelo ezingenhla. Ukuphindaphindwa kwemizamo akufanele kudlule izikhathi ezi-6. Uma yonke imizamo ingaphumelelanga, khona-ke ipeni lesirinji linephutha futhi lingalahlwa;
8. Manje udinga ukusetha umthamo odingekayo wokwelapha. Kulokhu, okhethiwe kufanele abonise u-0. Bese sibeka umthamo owuthandayo usebenzisa isikhethi. Ingajikeleza kunoma iyiphi indlela. Ngesikhathi somthethonqubo, kuyadingeka ukuphatha okhethiwe ngokucophelela ukuze ungashayi ngokungafanele inkinobho yokuqalisa futhi uthulule i-insulin ethayishiwe. Inzuzo yepeni yeLevemir Flexpen nayo ilele eqinisweni lokuthi akunakwenzeka ukusetha umthamo wezidakamizwa ngokweqile kokuba khona kwangempela kwamaunithi we-insulin ebhokisini;
9. Faka inaliti ngaphansi kwesikhumba usebenzisa inqubo ejwayelekile. Ngemuva kokuba inaliti ifakiwe emafutheni angaphansi, udinga ukucindezela inkinobho yokuqala kuze kube yilapho ime. Futhi ugcine ukulesi sikhundla kuze kube yilapho inkomba yedosi ikhombisa u-0. Uma ucindezela noma ujikeleza okhethiwe ngesikhathi sokuphatha, umuthi uzohlala esibayeni, ngakho-ke udinga ukuqapha iminwe yakho ngokucophelela;
10. Inaliti kufanele idonswe ku-trajectory efanayo njengoba yayifakiwe. Inkinobho yokuqalisa igcinwa icindezelwe sonke lesi sikhathi ukuphuma okuphelele komthamo obekiwe;
11. Usebenzisa cap enkulu yangaphandle, khipha inaliti uyilahle ngaphandle kokuyisusa.

Ungagcini ipeni lesirinji ngenaliti, ngoba lokhu kugcwele ukuvuza koketshezi nokuphanga komkhiqizo. Ngokucophelela udinga ukugcina nokuhlanza ipeni lesirinji. Noma yikuphi ukwethuka noma ukwehla kungalimaza i-cartridge.

Imiphumela emibi

Imiphumela emibi ethize evela ekusetshenzisweni kwe-insulin Levemir esebenza isikhathi eside yenzeka cishe ezi-12% zeziguli. Isigamu samacala akho konke ukusabela okungenzeka kuvezwe yi-hypoglycemia.

Futhi, ukuphathwa kwe-subcutaneous kubonakaliswa yimiphumela emibi yasendaweni. Zivezwa kaningi ngokwazisa kwe-insulin esetshenziswayo futhi uma kuqhathaniswa neyomuntu. Zingavela njengobuhlungu bendawo, ubomvu, ukuvuvukala, ukulimala, ukulunywa nokuvuvukala.

Ukuphendula kuvame ukuba yinto yesikhashana emvelweni futhi kuncike ezimweni eziqondile zesiguli. Imiphumela emibi kufanele inyamalale kungapheli amasonto ambalwa nokwelashwa okuhlala isikhathi eside.

Phakathi kokunye ukusabela okujwayelekile, ukuvela kokudumba nokulimala kungabhekwa. Ukwanda kwalesi simo kubuye kube ngesici esiphikisana nesizinda sokuqhamuka kwezinkinga zesifo sikashukela: ukuqaqanjelwa kobuhlungu be-neuropathy kanye ne-retinopathy yesifo sikashukela. Lokhu kungenxa yokuqala kokulawulwa kwe-glycemic kanye nokugcinwa njalo kwamazinga kashukela ajwayelekile.

Ukusabela okungelona okucacile kufaka izimpawu ezibonakaliswa emithini eminingi. Zingabantu bemvelo ngayinye futhi zincike ezimweni zendlela umzimba osabela ngayo ekutholweni kwento esebenzayo nezinto ezengeziwe zizonke.

Lokhu kufaka phakathi:

• Ukwephulwa kohlelo lwezinzwa: ukuzindla kwezingalo, i-paresthesia, ukuzwela kobuhlungu okwandayo, ukukhipha i-neuropathy, ukukhubazeka okuphazamisekile kanye nombono;
• Izinkinga nge-carbohydrate metabolism: hypoglycemia;
• Ukusabela kokuzivikela komzimba: ukulunywa, ukusabela kokuphendula kokuzivikela komzimba, i-urticaria, i-Quincke edema, ukushaqeka kwe-anaphylactic;
• Okunye: i-edema yangaphandle, i-lipodystrophy.

Ukweqisa

Umthamo ngqo obangela isithombe somtholampilo ohlukile awukho. Njengoba kuncike ekujuleni kwesimo sesiguli, ukuthembela kwi-insulin nokudla kwekhwalithi ephezulu kwesiguli.

Izimpawu ezejwayelekile ze-hypoglycemia:

• Umlomo owomile;
• Umile;
• Isiyezi
• Ukujuluka okubandayo okunamathele;
• Izimpukane ngaphambi kwamehlo;
• Tinnitus;
• Isicanucanu
• Ukuzwa okufiphele kwamazinga ahlukahlukene.

Mayelana nesikhathi i-hypoglycemia yezidakamizwa yenzeka kahle, ikakhulukazi ebusuku noma kusihlwa.

Nge-hypoglycemia emnene, isiguli singabhekana ngokuzimela nale nkinga. Ukuze wenze lokhu, thatha isisombululo sikashukela, ushukela noma omunye umkhiqizo ocebile kuma-carbohydrate asheshayo ngaphakathi. Ngenxa yokuhluleka ukulawula inqubo, abantu abanesifo sikashukela sohlobo oluthembele nge-insulin bayanconywa ukuba baphathe amaswidi nabo.

Uma isimo sishubile futhi sihambisana nokufikelwa yithemba, kuyaphuthuma ukuqala ukwelashwa ngezidakamizwa. Ngosizo lokuqala, kuyadingeka ukwethula i-insulin antagonist - i-glucagon ngevolumu engu-0,5 - 1 mg intramuscularly noma ngobuqili.

Uma isidakamizwa esinjalo singekho eduzane, ungangena ngokushesha ezinye izidakamizwa ze-hormonal - abaphikisi bemvelo be-insulin. Kulokhu, ama-glucocorticosteroids, ama-catecholamines, ama-hormone egqugquzela i-thyroid noma ama-hormone okukhula angasetshenziswa.

Njengendlela yokwesekelwa kanye ne-detoxification therapy, kuyadingeka ukuqala ukudonsa okungaphakathi kwe-dextrose (ushukela). Ngemuva kokujwayela ukwazi, phatha ukudla okunotha ama-carbohydrate asheshayo futhi aphambili.

Imigomo nemibandela yesitoreji

Gcina umuthi esiqandisini ekushiseni kwama-2-8 degrees. Indawo akufanele ibe seduze neqhwa. Kukhiqizwe ukuze kukhishwe umuthi.

Ama-cartridges avulekile agcinwa ngaphansi kwezimo ezifanayo namapheya anokulahlwa. Akumele iqandiswe noma iqandiswe. I-cartridge noma ipeni elisetshenzisiwe kufanele ligcinwe emazingeni okushisa afinyelela kuma-30 degrees. Impilo ephezulu yamashalofu ingamaviki ayi-6 ukusuka ngosuku lokuvulwa.

Kuyadingeka ukugcina umuthi endaweni emnyama, uvikelwe ukukhanya kwelanga nokukhanya ngokweqile. Uma kungenakwenzeka ukuqinisekisa izimo ezinjalo, gcina kumaphakeji wokuvikela lapho kuthengwe khona i-insulin.

Impilo yeshelufu elilungile yesidakamizwa yiminyaka engu-2,5. Ngemuva kosuku lokuphela olukhonjiswe kwiphakheji, ukusetshenziswa kwenqatshelwe.

Ama-Analog

I-Levemir Flexpen nePenfil bakhiqizwa yiNovo Nordisk, inkampani ekhiqiza amakhambi eDenmark. E-Russia, intengo ye-cartridge nepeni icishe ifane futhi iyahluka phakathi kwama-ruble ayi-1900 - 3100. Intengo ephakathi kumakhemisi eRussia ama-ruble angama-2660.

I-Levemir akuyona ukuphela kwenkampani emelele ye-insulin esebenza kabusha esebenza kabusha. Kukhona ukufana kwezidakamizwa, kepha ezweni lethu azikho eziningi:

1. ILantus;
2. I-Lantus Optiset;
3. ILantus Solostar;
4. I-Aylar;
5. I-Monodar ultralong;
6. Tozheo Solostar;
7. ITresiba Flextach.

Noma yimuphi ummeleli unezinzuzo nezinzuzo zalo. Ukuzikhethela komuthi kuhlala kuhlala nesiguli nodokotela, ngoba izici eziningi zithinta lesi sinqumo.

Ukubuyekezwa