Insulin Detemir daidai yake da insulin mutum. Magungunan an yi niyya don maganin cututtukan zuciya na marasa lafiya da ke fama da cutar sankara (mellitus). Ana nuna shi ta hanyar tsawaita aiki da raguwar yiwuwar haɓaka ƙarancin ƙwayar cuta a cikin dare.
Sunan kasa da kasa mai zaman kansa
INN na wannan maganin shine Insulin detemir. Sunayen kasuwanci sune Levemir Flekspan da Levemir Penfill.
ATX
Wannan magani ne na hypoglycemic na ƙungiyar insulin. Lambar ATX ita ce A10AE05.
Saki siffofin da abun da ke ciki
Ana samun maganin ta hanyar maganin allura wanda aka yi nufin gudanarwa ƙarƙashin fata. Sauran nau'ikan sashi, gami da allunan, ba a ƙera su ba. Wannan saboda gaskiyar cewa a cikin narkewar hanzarin ƙwayar cuta ya rushe zuwa cikin amino acid kuma ba zai iya cika aikinsa ba.
Insulin Detemir daidai yake da insulin mutum.
Abubuwan da ke aiki suna wakiltar insulin detemir. Abunda ke cikin 1 ml na maganin shine 14.2 MG, ko raka'a 100. Comarin abun da ke ciki ya haɗa da:
- sodium chloride;
- glycerin;
- hydroxybenzene;
- metacresol;
- sinadarin sodium hydrogen phosphate dihydrate;
- zinc acetate;
- tsarma hydrochloric acid / sodium hydroxide;
- ruwan allura.
Ya yi kama da tsattsauran ra'ayi, wanda ba a shafa ba, mai haɗa kai. An rarraba shi cikin katako 3 ml (Penfill) ko sirinji na alkalami (Flekspen). Kayan katako na waje. Umarni a haɗe yake.
Aikin magunguna
Magungunan ƙwaƙwalwar ƙwayar cuta ne. An samo shi ta hanyar ƙirƙirar rDNA a cikin yisti mai yisti. A saboda wannan, gusar plasmids ana maye gurbinsu da kwayoyin halittu waɗanda ke tantance ƙayyadaddun yanayin insulin da ke faruwa. Wadannan plasmids na DNA an saka su cikin sel na Saccharomyces cerevisiae, kuma sun fara samar da insulin.
Lokacin amfani da wannan magani, hadarin nocturnal hypoglycemia ya rage da 65% (idan aka kwatanta da sauran hanyoyi).
Wakili a karkashin la'akari shine analog na hormone da tsibiri na Langerhans ke cikin jikin mutum. An kwatanta shi da tsawan lokacin aiki har ma an sake shi ba tare da an yi tsalle-tsalle ba a cikin abubuwan da ke aiki a cikin ruwan.
Kwayoyin insulin sun zama kungiyoyi a wurin allurar, kuma sun daure wa albumin. Sakamakon wannan, ƙwayar ta sha kuma ta shiga cikin ƙwayar manufa a kan gefen sannu a hankali, wanda ya sa ya fi tasiri kuma mai lafiya fiye da sauran shirye-shiryen insulin (Glargin, Isofan). A kwatancen su, haɗarin hauhawar jini a cikin dare yana rage zuwa 65%.
Ta hanyar yin aiki akan masu karɓa na salula, sashin aiki na miyagun ƙwayoyi yana haifar da hanyoyin aiwatarwa da yawa, gami da haɗakar mahimman enzymes kamar glycogen synthetase, pyruvate da hexokinase. An samar da raguwar glucose din plasma ta:
- rage abin da yake samarwa a cikin hanta;
- ƙarfafa sufuri na cikin gida;
- kunna gwagwarmaya a kyallen takarda.
- imuarfafa aiki a cikin glycogen da mai mai.
Sakamakon magungunan ƙwayar cuta ya zama daidai da sikelin da aka gudanar. Tsawon lokacin fallasa ya dogara da wurin allura, sashi, zafin jiki, saurin kwararar jini, aikin jiki. Zai iya kaiwa awanni 24, don haka ana yin allura sau 1-2 a rana.
Halin da kodan baya shafar metabolism na abu.
Yayin gudanar da karatun, ba a bayyanar da gaskiyar yanayin maganin, cututtukan cututtukan carcinogenic, da bayyanar tasirin ci gaban kwayar halitta da ayyukan haihuwa ba.
Pharmacokinetics
Don samun mafi yawan maida hankali na plasma, awanni 6-8 ya kamata ya murmure daga lokacin gudanarwa. Bioavailability kusan kashi 60%. An ƙididdige daidaituwa tare da gudanarwa na lokaci biyu bayan inje 2-3. Matsakaicin rarraba rarraba 0.1 l / kg. Yawancin insulin allurar da ke ciki ya kewaya tare da kwararar jini. Magungunan ba ta yin hulɗa tare da mai mai kitse da wakilan magunguna waɗanda ke ɗaukar sunadarai.
Metabolization ba ya bambanta da sarrafa insulin na halitta. Cire rabin rayuwa yana yin sa'o'i 5 zuwa 7 (gwargwadon yawan da aka yi amfani da shi). Pharmacokinetics bai dogara da jinsi da shekarun mai haƙuri ba. Halin da kodan da hanta kuma baya tasiri ga waɗannan alamun.
Alamu don amfani
Magungunan suna nufin magance hyperglycemia a gaban nau'in 1 da nau'in ciwon sukari na 2.
An tsara insulin don yaƙar hauhawar jini a gaban nau'in 1 da nau'in ciwon sukari na 2.
Contraindications
Ba a sanya wannan kayan aikin don nuna damuwa ga ayyukan insulin na ciki ko rashin haƙuri ga magabata ba. Iyakar shekarun shine shekaru 2.
Yadda ake ɗaukar Insulin Detemir
Ana amfani da mafita don gudanar da aikin subcutaneous, jiko na ciki na iya haifar da matsanancin rashin ƙarfi na hypoglycemia. Ba a allurar dashi intramuscularly kuma ba'a amfani dashi a cikin magungunan insulin ba. Za'a iya yin allurar ta fannin:
- kafada (jin dadi);
- kwatangwalo
- bangon gaba na peritoneum;
- gindi
Dole ne a canza wurin allurar koyaushe don rage yiwuwar alamun lipodystrophy.
Zaɓin jigilar hanyar sashi ne aka zaɓa akayi daban-daban. Allurai sun dogara ne akan glucose din plasma na azumi. Daidaitawar sashi na iya zama dole don ƙoƙarin jiki, canje-canje a cikin abincin, cututtuka masu haɗuwa.
Ana amfani da miyagun ƙwayoyi a wurare daban-daban, ciki har da bangon bango na peritoneum.
An yarda da amfani da maganin:
- da kansa;
- tare da haɗin injections na bolus;
- ban da samar da abinci mai gina jiki;
- tare da wakilan maganin antidiabetic na baka.
Tare da hadaddun maganin cututtukan zuciya, ana bada shawara don gudanar da maganin sau 1 a rana. Kuna buƙatar zaɓar kowane lokacin da ya dace kuma ku mance da shi lokacin yin allurar yau da kullun. Idan akwai buƙatar yin amfani da maganin sau 2 a rana, ana gudanar da kashi na farko da safe, kuma na biyu tare da tazara na awanni 12, tare da abincin dare ko kafin lokacin kwanciya.
Bayan allurar subcutaneous na kashi, maɓallin maballin yadin da aka saukar a ƙasa, kuma an bar allura a cikin fata na akalla aƙiƙa 6.
Lokacin yin sauyawa daga wasu shirye-shiryen insulin zuwa Detemir-insulin a cikin makonni na farko, yakamata a kiyaye kulawar glycemic index ya zama dole. Yana iya zama mahimmanci don sauya tsarin magani, sashi da lokacin shan magungunan antidiabetic, gami da na baka.
Wajibi ne a kula da matakin sukari da kuma daidaita sashi a tsofaffi.
Wajibi ne a lura da matakin sukari da kuma daidaita sashi a tsofaffi da marassa lafiya da cututtukan koda.
Sakamakon sakamako na Insulin Detemir
Wannan wakilin magunguna yana da haƙuri sosai. Abubuwan da ke tattare da haɗari suna da alaƙa da magungunan insulin.
A wani bangare na bangaren hangen nesa
Rashin hankali na shakatawa (batar da hoto, haifar da ciwon kai da bushewa daga farfajiyar ido) wasu lokuta ana lura dasu. Zai yiwu maganin ciwon sukari mai saurin kamuwa da cuta. Hadarin ci gabanta yana ƙaruwa tare da aikin kwantar da hankalin insulin.
Daga tsoka da kashin haɗin kai
A lokacin jiyya, lipodystrophy na iya haɓaka, wanda aka bayyana a cikin atrophy da tsopose hypertrophy.
Tsarin juyayi na tsakiya
Wani lokacin jijiyoyin jijiyoyin jiki suna tasowa. A mafi yawan lokuta, ana juyawa. Mafi sau da yawa, alamunta suna bayyana tare da ƙaƙƙarfan ƙa'idar tsarin glycemic index.
Daga gefen metabolism
Sau da yawa akwai rage yawan sukari a cikin jini. Wata ƙarancin hypoglycemia yana haɓaka a cikin kawai 6% na marasa lafiya. Zai iya haifar da bayyananniyar bayyanar, kasala, aikin kwakwalwa mai rauni, mutuwa.
Cutar Al'aura
Wani lokaci wani abu yakan faru a wurin allura. A wannan yanayin, itching, jan launi na fata, kumburi, kumburi na iya bayyana. Canza wurin allurar insulin na iya rage ko ware waɗannan bayyanannun; ƙin yarda da miyagun ƙwayoyi ana buƙatar a wasu lokuta da wuya. Cutar rashin lafiyar jiki mai yuwuwarwa mai yiwuwa ne (haushi na hanji, gajeriyar numfashi, yanayin jijiyoyin jiki, kwanciyar hankali a ciki, gumi, tachycardia, anaphylaxis).
Tasiri kan ikon sarrafa abubuwan inji
Mai saurin jawo hankali da saurin amsawa yana iya lalacewa tare da hypo- ko hyperglycemia. Wajibi ne a hana bayyanar waɗannan yanayin yayin yin aikin mai haɗari da tuki.
Umarni na musamman
Ana rage yiwuwar faɗuwar matakan sukari da daddare idan aka kwatanta da magunguna masu kama, wanda ke ba da damar ƙarfafa tsarin daidaitattun abubuwan kwantar da hankali na marasa lafiya. Wadannan matakan ba sa haifar da ƙaruwa mai ƙarfi a cikin nauyin jiki (sabanin sauran mafita insulin), amma na iya canza alamun farko na alamomin hypoglycemic.
Cutar da hankali na insulin ko kuma rashin isasshen magani na iya haifar da hauhawar jini.
Rage aikin insulin ko kuma rashin isasshen magunguna na iya haifar da cutar hauka ko tsokani ketoacidosis, gami da mutuwa. Musamman babban haɗari da nau'in ciwon sukari da ke dogaro da cutar sankara. Bayyanar cututtuka na kara yawan sukari:
- ƙishirwa
- rashin ci;
- urination akai-akai;
- yawan tashin zuciya;
- gag reflex;
- yawan wuce gona da iri na mucosa.
- bushewa da itching da na ciki;
- hyperemia;
- ƙanshin ƙwayar acetone;
- nutsuwa
Bukatar insulin yana ƙaruwa tare da aikin motsa jiki wanda ba a shirya ba, karkacewa ga tsarin abinci, kamuwa da cuta, zazzabi. Bukatar canza yankin lokaci yana buƙatar tuntuɓar likita kafin.
Ba za a iya amfani da miyagun ƙwayoyi ba:
- Cikin ciki, cikin intramuscularly, a cikin jiko na jiko.
- Lokacin da launi da bayyanar da ruwa suka canza.
- Idan lokacin karewa ya ƙare, an adana mafita cikin yanayin da bai dace ba ko kuma an daskarewa.
- Bayan faduwa ko matse kicin / sirinji.
Ba a yarda da gudanar da insulin na insemir ba a cikin gudanarwa.
Yi amfani da tsufa
A cikin tsofaffi marasa lafiya, ya kamata a saka idanu cikin abubuwan da ke cikin ƙwayar plasma tare da kulawa ta musamman. Idan ya cancanta, daidaita kashi na farko.
Aiki yara
Babu ƙwarewar asibiti tare da amfani da miyagun ƙwayoyi don yara na ƙaramin rukuni (har zuwa shekaru 2). Ya kamata a zaɓi yara da matasa allurai tare da kulawa ta musamman.
Yi amfani da lokacin daukar ciki da lactation
Lokacin gudanar da karatun, ba a gano sakamako mara kyau ga yara waɗanda iyayensu mata sun yi amfani da miyagun ƙwayoyi ba yayin bayyanar ciki. Koyaya, yi amfani da shi lokacin ɗaukar yaro ya kamata a yi amfani dashi da taka tsantsan. A farkon lokacin daukar ciki, mace ta bukatar insulin ta ragu kadan, daga baya kuma tayi ƙaruwa.
Babu tabbacin ko insulin ya shiga cikin nono. Bai kamata ayi amfani da abin da ya sha a cikin jariri ba, saboda a cikin tsarin narkewar abinci da sauri magungunan ya watsar kuma jiki ya karbe shi ta hanyar amino acid. Mahaifa mai shayarwa na iya buƙatar gyara sashi da sauƙin abinci.
Aikace-aikacen aiki mara kyau
Sashi ne m akayi daban-daban. Za'a iya rage bukatar da akeyi na dan magani idan mai haƙuri ya kasa aiki.
Amfani don aikin hanta mai rauni
Dogara mai ƙarfi na matakan sukari da canji mai dacewa a cikin abubuwan da ake sarrafawa ana buƙatar su.
Yawan adadin insulin Detemir
Babu wani takamaiman matakin allurar da zai haifar da yawan shan magungunan. Idan ƙarar da aka saƙa ta wuce abin da ake buƙata na mutum, alamomin hypoglycemic na iya faruwa a hankali. Damuwa da bayyanar cututtuka:
- blanching na ciki;
- gumi mai sanyi;
- ciwon kai
- yunwa
- rauni, gajiya, bacci;
- yawan tashin zuciya;
- damuwa, damuwa;
- palpitations
- nakuda na gani.
Decreasearancin raguwa a cikin glycemic index an cire shi ta hanyar amfani da glucose, sukari, da dai sauransu.
Decreasearamin raguwa a cikin ƙididdigar glycemic ana cire shi ta hanyar amfani da glucose, sukari, abinci mai cike da carbohydrates ko abin sha wanda mai ciwon sukari ya kamata ya kasance tare da shi koyaushe (cookies, alewa, sukari mai ladabi, da sauransu). A cikin maƙarƙashiya mai ƙwanƙwasa, mara lafiya mai rashin sani yana allura tare da tsoka ko a ƙarƙashin fata glucagon fata ko cikin glucose / dextrose na ciki. Idan mai haƙuri bai farka ba a cikin mintina 15 bayan allurar glucagon, to yana buƙatar gabatarwar da maganin glucose.
Yin hulɗa tare da wasu kwayoyi
Ba za a iya haɗa abun da ke ciki tare da magudanan ruwa da magunguna na jiko ba. Thiols da sulfites suna haifar da rushewar tsarin wakili a cikin tambaya.
Strengtharfin magungunan yana ƙaruwa tare da amfani da layi daya:
- Clofibrate;
- Fenfluramine;
- Pyridoxine;
- Bromocriptine;
- Cyclophosphamide;
- Mebendazole;
- Ketoconazole;
- Theophylline;
- magungunan baka na antidiabetic;
- ACE masu hanawa;
- maganganun aladu na kungiyar IMOA;
- marasa zaɓi na beta-blockers;
- carbonic anhydrase ayyukan hanawa;
- shirye-shiryen lithium;
- sulfonamides;
- abubuwanda ake amfani da su na salicylic acid;
- hanyoyin tetracyclines;
- anabolics.
A hade tare da Heparin, Somatotropin, Danazole, Phenytoin, Clonidine, Morphine, corticosteroids, hormones thyroid, sympathomimetics, alluran antagonists, thiazide diuretics, TCAs, maganin hana haihuwa, nicotine, ingancin insulin ya ragu.
An bada shawara a guji shan giya.
Karkashin tasirin Lanreotide da Octreotide, tasirin magungunan na iya raguwa da haɓaka. Amfani da beta-blockers yana haifar da sauƙaƙe bayyanar cututtuka na hypoglycemia kuma yana hana dawo da matakan glucose.
Amfani da barasa
An bada shawara a guji shan giya. Ayyukan ethyl barasa yana da wuya a hango ko hasashen, saboda yana da ikon haɓakawa da raunana tasirin maganin ƙwaƙwalwar ƙwayar cuta.
Analogs
Cikakkun analogues na Detemir-insulin sune Levemir FlexPen da Penfill. Bayan tattaunawa tare da likita, ana iya amfani da sauran insulins (glargine, Insulin-isophan, da sauransu) azaman madadin magungunan.
Magunguna kan bar sharuɗan
Samun damar magani yana da iyaka.
Zan iya siye ba tare da takardar sayan magani ba
An sake sayan magani.
Farashi
Kudin maganin allurar Levemir Penfill - daga 2154 rubles. don katako guda 5.
Yanayin ajiya na miyagun ƙwayoyi
Ana adana insulin a cikin kayan ɗorawa da zazzabi na + 2 ... + 8 ° C, guje wa daskarewa. An kare alkairin da aka yi amfani dashi tare da maganin yana kariya daga aikin wuce haddi mai zafi (zafin jiki har zuwa + 30 ° C) da haske.
Ranar karewa
Ana iya adana maganin har tsawon watanni 30 daga ranar da aka ƙera shi. Rayuwar shiryayye na mafita wanda aka yi amfani dashi shine makonni 4.
Mai masana'anta
Kamfanin kamfanin kera magunguna na Novo Nordisk ne ya kera shi.
Nasiha
Nikolay, dan shekara 52, Nizhny Novgorod
Ina amfani da wannan insulin don shekara ta uku. Yana iya rage sukari da kyau, yana yin aiki mai tsayi kuma yafi kyau injections na baya.
Galina, shekara 31, Ekaterinburg
Lokacin da abincin bai taimaka ba, na shawo kan ciwon sukari a lokacin daukar ciki tare da wannan magani. An yarda da magani sosai, inje, idan an yi shi daidai, ba shi da ciwo.
