Dangane da shawarar Ma'aikatar Lafiya, maganin insulin a cikin nau'in masu ciwon sukari na 2 yana farawa ko dai tare da dogon insulin ko tare da biphasic. NovoMix (Novomix) - sanannen sananniyar cakuda kashi biyu da daya daga cikin shugabannin kasuwar ya haifar da magungunan masu ciwon sukari, kamfanin NovoNordisk daga Denmark. Gabatarwar NovoMix na kan lokaci cikin tsarin kulawa yana ba da damar sarrafa cutar sikari mafi kyau, yana taimakawa a guji rikitarwa masu yawa. Ana amfani da miyagun ƙwayoyi a cikin katukan katako da allon alkalami mai cike.
Jiyya yana farawa da allura 1 a kowace rana, yayin da allunan rigakafin ƙwayoyin cuta ba a soke su ba.
Umarnin don amfani
NovoMix 30 shine mafita ga gudanarwar subcutaneous, wanda ya ƙunshi:
- 30% na insulin na yau da kullun. Maganin insulin ultrashort ne wanda yake aiki bayan mintuna 15 daga lokacin gudanarwa.
- 70% protaminated kewayawa. Wannan hormone mai matsakaici ne, ana samun tsawan lokacin aiki ta hanyar haɓaka azaba da furotin protein. Godiya gareshi, aikin NovoMix ya kai har awanni 24.
Magunguna masu haɗuwa da insulin tare da lokaci daban-daban na aiki ana kiransu biphasic. An tsara su don rama don ciwon sukari na type 2, saboda suna da tasiri sosai a cikin waɗannan marasa lafiyar waɗanda har yanzu suna samar da nasu hormone. Tare da nau'in cuta ta 1, an tsara Novomix da wuya idan mai ciwon sukari ya kasa yin lissafin kansa ko sarrafa kansa insulin gajere da tsayi. Yawancin lokaci waɗannan ko dai tsofaffi ne ko marasa lafiya marasa lafiya.
| Bayanin | Kamar kowane kwayoyi tare da protamine, NovoMix 30 ba shine bayyananne bayani ba, amma dakatarwa ce. A hutawa, shi exfoliates a cikin kwalba a cikin wani translucent da fari guntu, ana iya ganin flakes. Bayan haɗuwa, abubuwan da ke cikin murfin sun zama fari fat. Daidaitaccen ƙwayar insulin a cikin bayani shine raka'a 100. |
| Fitar saki da farashi | NovoMix Penfill ita ce gilashin gilashin gilashin mil 3. Za'a iya gudanar da maganin su ta amfani da ko sirinji ko yatsan sirinji na masana'antun guda ɗaya: NovoPen4, NovoPen Echo. Sun bambanta a matakan sashi, NovoPen Echo yana ba ku damar buga lamba a cikin raka'a 0.5, NovoPen4 - a cikin ɓangarori da yawa na 1 naúrar. Farashin katako 5 NovoMix Penfill - kusan 1700 rubles. NovoMix Flexpen shiri ne da aka yi amfani da shi tare da mataki na 1, baza ku iya canza harsashi ba. Kowane yana dauke da 3 ml na insulin. Farashin kayan haɓaka na 5 sirinji shine 2000 rubles. Maganin a cikin katako da alƙaluma daidai suke, saboda haka duk bayanin game da NovoMix FlexPen ya shafi Penfill. Asali na NovoFine da NovoTvist allura sun dace da dukkan alkalannin sirinji na NovoNordisk. |
| Aiki | Insulin aspart yana ɗaukar daga ƙwayar subcutaneous cikin jini, inda yake yin ayyukan guda ɗaya kamar insulin endogenous: yana haɓaka ƙaddamar da glucose a cikin kyallen takarda, galibi tsoka da mai, kuma yana hana haɓakar glucose ta hanta. NovoMix baya amfani da insulin biphasic don saurin daidaitawar hypoglycemia, tunda akwai babban haɗarin sanya tasirin sakamako ɗaya akan wani, wanda zai haifar da cutar hauhawar jini. Don saurin saurin sukari mai sauri, insulins mai sauri kawai ya dace. |
| Alamu | Cutar sankarau guda biyu sune nau'ikan cututtukan guda biyu - 1 da 2. Ana iya ba da magani ga yara daga shekaru 6. A cikin yara, marasa lafiya na tsakiya da tsufa, lokacin aiki da nasiha daga jiki suna kusa. |
| Zaɓin sashi | Ana zabar kashi na insulin NovoMix a matakai da yawa. Nau'in cututtukan mahaifa 2 suna fara sarrafa maganin tare da raka'a 12. kafin abincin dare, ya kuma ba da izinin gabatarwa sau biyu safe da maraice na raka'a 6. Bayan farawar magani na kwanaki 3, ana sarrafa glycemia kuma ana daidaita yawan kashi na NovoMix FlexPen gwargwadon sakamakon da aka samu. |
| Canja a cikin bukatun insulin | Insulin hormone ne, sauran kwayoyin halittar da ke cikin jiki kuma aka samo su daga kwayoyi na iya yin tasiri ga aikinsa. A wannan batun, aikin NovoMix 30 ba na dindindin ba ne. Don cimma burin Normoglycemia, marasa lafiya zasu kara yawan ƙwayar magani tare da ƙwaƙwalwar ƙwayar cuta ta jiki, cututtuka, damuwa. Adana ƙarin magani zai iya haifar da canji a cikin glycemia, sabili da haka, yana buƙatar ƙarin ma'aunin sukari akai-akai. Ya kamata a biya kulawa ta musamman ga magungunan hormonal da antihypertensive. |
| Side effects | A farkon maganin insulin, bugu, kumburi, jan launi, ko taushi na iya faruwa a wurin allurar. Idan sukari ya kasance mafi girma fiye da na al'ada, raunin gani, jin zafi a ƙananan ƙarshen zai yiwu. Duk waɗannan sakamako masu illa suna ɓacewa a cikin jinjirin bayan fara magani. Kasa da 1% na masu ciwon sukari suna da lipodystrophy. An tsokane su ba ta magungunan kanta ba, amma ta saurin fasahar gudanarwar ta: sake yin amfani da allura, shafin guda da allura iri ɗaya, zurfin injections, maganin sanyi. Idan an saka karin insulin fiye da yadda ake buƙata don tsarkake jini daga sukari mai yawa, ƙwararrakin jini yana faruwa. Umarni don amfani da kimanta haɗarin sa kamar yadda akai, fiye da 10%. Dole ne a kawar da hypoglycemia nan da nan bayan an gano shi, tunda yanayinsa mai nauyi yana haifar da lalacewar kwakwalwa da mutuwa. |
| Contraindications | Ba za a iya gudanar da Novomix a ciki ba, ana amfani dashi a cikin farashin famfo. Ba a yi nazarin halayen da miyagun ƙwayoyi a cikin yara 'yan shekaru 6 ba, saboda haka, umarnin ba ya bayar da shawarar yin amfani da insulin na NovoMix a kansu. A cikin ƙasa da 0.01% na masu ciwon sukari, halayen anaphylactic yana faruwa: raunin narkewa, kumburi, wahalar numfashi, saukar karfin, hauhawar zuciya. Idan mai haƙuri ya taɓa yin irin wannan halayen don rarrabuwa, ba a tsara NovoMix Flexpen ba. |
| Adanawa | Dukkanin insulins cikin sauƙi suna rasa kayan su a ƙarƙashin yanayin ajiyar da bai dace ba, saboda haka yana da haɗari a saya su "da hannu". Domin NovoMix 30 yayi aiki kamar yadda aka nuna a cikin umarnin, yana buƙatar tabbatar da madaidaicin tsarin zazzabi. Magunguna masu ajiya na ajiyayyu a cikin firiji, zazzabi ≤ 8 °C. Al’urar da ta haɓaka da ta almara ko ta sirinji ana kiyaye ta a zazzabi a daki (har zuwa 30 ° C). |
Aboutari game da amfani da NovoMix
Don guje wa rikice-rikice na ciwon sukari, ƙungiyoyi na kasa da kasa na endocrinologists suna ba da shawarar fara farkon maganin insulin. Ana ba da allurar rigakafin da zaran glycated haemoglobin (GH) ya fara wuce ƙa'idodi lokacin da aka kula da shi da allunan maganin antidiabetic. Marasa lafiya suna buƙatar canjin lokaci zuwa tsari mai mahimmanci. An zaɓi fifiko ga ƙwayoyi masu inganci, ba tare da la'akari da farashin su ba. Effectivearin tasiri mafi inganci sune analogues na insulin.
Ciwon sukari da hauhawar jini zai zama abin da ya wuce
- Normalization na sukari -95%
- Cirewa kan jijiyoyin mara wuya - 70%
- Cire zuciyar mai karfin zuciya -90%
- Rabu da cutar hawan jini - 92%
- Increasearuwar kuzarin rana, inganta bacci da dare -97%
NovoMix Flexpen ya cika duka waɗannan abubuwan. Yana aiki awanni 24, wanda ke nufin cewa da farko allura guda ɗaya zai isa. Intensification na insulin farji shine karamin sauki akan yawan alluran. Canji daga kashi-biyu zuwa ga gajere da tsayi na dindindin ana buƙatar lokacin fitsari ya kusan daina aiki. Insulin NovoMiks ya sami nasarar wuce fiye da gwaji dozin da ya tabbatar da ingancinsa.
Fa'idodin NovoMix
Tabbatar da darajar NovoMix 30 akan wasu zaɓuɓɓukan magani:
- yana rama ciwon sukari mellitus da kashi 34% fiye da insulin NPH na basal;
- don rage haemoglobin glycated, ƙwayar tana da 38% mafi inganci fiye da haɗuwawar hanyoyin kwatankwacin ɗan adam;
- ƙari na Metformin NovoMix maimakon shirye-shiryen sulfonylurea yana ba da damar cimma raguwar 24% mafi girma a cikin GH.
Idan, lokacin amfani da NovoMix, sukari mai azumi ya wuce 6.5, kuma GH ya fi 7%, lokaci yayi da za a canza daga cakuda insulins zuwa tsoho da gajeriyar horarwa daban, misali, Levemir da Novorapid na masana'antun guda. Zai fi wahala a yi amfani da su fiye da NovoMiks, amma tare da ƙididdigar daidai na kashi, suna ba da kyakkyawan ikon sarrafa glycemic.
Zaɓin insulin
Wanne magani ya kamata a fi son masu ciwon sukari na 2 don farawa a cikin insulin:
| Halayyar haƙuri, hanya ta cutar | Mafi inganci jiyya | |
| A tunanin mutum, mai ciwon sukari ya shirya tsaf don yin nazari da kuma amfani da tsarin kula da tsananin jinya. Mai haƙuri yana motsa jiki sosai a cikin wasanni. | Short + tsawon analog na insulin, lissafin allurai gwargwadon glycemia. | |
| Kayan matsakaici. Mai haƙuri ya fi son tsarin kulawa mafi sauƙi. | Increasearuwar matakin GH ƙasa da 1.5%. Azumi hauhawar jini. | Dogon insulin analog (Levemir, Lantus) 1 lokaci a rana. |
| Haɓaka matakin GH ya wuce 1.5%. Hyperglycemia bayan cin abinci. | NovoMix Flexpen sau 1-2. | |
Adana insulin baya warware abinci da metformin.
Zaɓin sashi na NovoMix
Yawan insulin shine mutum daban-daban ga masu ciwon sukari, tunda yawan ƙwayar da ake buƙata ya dogara da sukarin jini kawai, har ma a kan sifofin ɗaukar ciki daga ƙarƙashin fata da matakin juriya na insulin. Koyarwar ta ba da shawarar gabatarwar raka'a 12 a farkon farawar insulin. Novomix. A cikin mako, ba a canza kashi ba, ana auna sukari mai azumi kowace rana. A ƙarshen mako, an daidaita sashi daidai da tebur:
| Matsakaicin azumi mai sukari a cikin kwanakin 3 na ƙarshe, mmol / l | Yadda za a daidaita kashi |
| Glu ≤ 4.4 | rage da raka'a 2 |
| 4.4 <Glu ≤ 6.1 | babu gyara da ake bukata |
| 6.1 <Glu ≤ 7.8 | karuwa da raka'a 2 |
| 7.8 <Glu ≤ 10 | karuwa da raka'a 4 |
| Glu> 10 | karuwa da raka'a 6 |
A mako mai zuwa, ana duba yawan maganin da aka zaɓa. Idan sukari mai azumi al'ada ne kuma babu hypoglycemia, sashi yana ɗauka daidai ne. Dangane da sake dubawa, ga yawancin marasa lafiya, biyu irin waɗannan gyare-gyare sun isa.
Bayanin allura
Ana gudanar da aikin farawa kafin abincin dare. Idan mai ciwon sukari yana buƙatar raka'a sama da 30. insulin, kashi ya kasu kashi biyu kuma ana sarrafa shi sau biyu: kafin karin kumallo da kuma abincin dare. Idan sukari bayan abincin rana bai dawo al'ada ba na dogon lokaci, zaku iya ƙara allura ta uku: saka farawar safe kafin abincin rana.
Sauƙaƙan jiyya na farawa
Yadda za a cimma biyan diyyar cutar sankara tare da mafi karancin alluran:
- Muna gabatar da farawa kafin abincin dare, kuma daidaita shi, kamar yadda muka ambata a sama. Sama da watanni 4, GH bisa al'ada a cikin 41% na marasa lafiya.
- Idan ba'a cimma burin ba, ƙara raka'a 6. NovoMix Flexpen kafin karin kumallo, a cikin watanni 4 masu zuwa, GH ya kai matakin manufa a cikin 70% na masu ciwon sukari.
- Game da gazawa, ƙara raka'a 3. NovoMix insulin kafin abincin rana. A wannan matakin, GH an saba shi a cikin kashi 77 cikin dari na masu ciwon sukari.
Idan wannan tsarin ba ya bayar da isasshen diyya ga mellitus na ciwon sukari, yana da mahimmanci don sauya zuwa gajeren insulin a cikin ajali na akalla allura 5 kowace rana.
Ka'idojin aminci
Dukansu rashin ƙarfi da ƙarancin sukari na iya haifar da matsanancin ciwon sukari. Coma na hypoglycemic yana yiwuwa a kowane mai ciwon sukari tare da yawan yawan insulin na NovoMix. Hadarin hyperglycemic coma yana da girma, ƙananan matakin hormone naka.
Don hana rikicewa, lokacin amfani da insulin, dole ne a bi ka'idodin aminci:
- Kuna iya shigar da miyagun ƙwayoyi kawai a zazzabi a ɗakin. Ana cire sabon vial daga firiji 2 hours kafin allura.
- Insulin na NovulinMix yana buƙatar haɗa shi da kyau. Umarni don amfani yana bada shawarar jujjuya katako tsakanin tafin hannu sau 10, sannan juya shi zuwa matsayin tsaye kuma ya kara da rage girman sau 10.
- Ya kamata a yi allurar nan da nan bayan an motsa su.
- Yana da haɗari don amfani da insulin idan, bayan haɗuwa, lu'ulu'u ya zauna akan bangon katun, lumps ko flakes a dakatarwa.
- Idan mafita ya daskarewa, an bar shi a rana ko zafi, kicin ɗin yana da fashewa, ba za a iya amfani da shi ba.
- Bayan kowace allura, dole ne a cire allurar kuma a watsar, rufe alƙawarin sirinji tare da hula da aka haɗe.
- Karku shigar da allurar NovoMix cikin ƙwayar tsoka ko jijiya.
- Don kowane sabon allura, an zaɓi wurin daban. Idan za a iya ganin jan launi a fata, ba za a yi allura ba a wannan fannin.
- Don tabbatar da cewa mai haƙuri da ciwon sukari yakamata ya kasance yana da amare na sikari ko kifin tare da insulin da sirinji. A cewar masu ciwon sukari, ana buƙatar su har sau 5 a shekara.
- Kada kayi amfani da alkairin sirinji wani, koda ya canza allura a cikin na'urar.
- Idan aka nuna akan ragowar sikelin sirinji cewa akwai ƙasa da raka'a 12 a cikin katun, ba za'a iya saka farashi ba. Wanda aka ƙera bai bada garantin daidai tattarawar kwayar halittar cikin ragowar maganin ba.
Yi amfani da wasu magunguna
An amince da Novomix don amfani dashi tare da duk allunan rigakafin ƙwayoyin cuta. Tare da nau'in ciwon sukari na 2, haɗuwa da metformin yana da tasiri sosai.
Idan masu ciwon sukari an sanya su kwayoyin hana daukar ciki don hauhawar jini, masu hana jini, tetracyclines, sulfonamides, antifungals, steroids anabolic, hypoglycemia na iya faruwa, kashi na NovoMix FlexPen dole ne a rage.
Thiazide diuretics, maganin cututtukan fata, salicylates, yawancin kwayoyin, ciki har da maganin hana haihuwa, na iya yin rauni ga aikin insulin kuma yana haifar da hauhawar jini.
Ciki
A gefe guda, kayan aiki na NovoMix Penfill, ba ya cutar da yanayin daukar ciki, da lafiyar mace, da ci gaban tayin. Yana da aminci kamar hormone mutum.
Duk da wannan, umarnin bai bada shawarar amfani da insulin na NovoMix ba yayin daukar ciki. A wannan lokacin, masu ciwon sukari ana nuna tsari mai zurfi na aikin insulin, wanda NovoMix ba'a tsara shi ba. Zai fi dacewa amfani da insulin mai tsayi da gajere dabam. Babu ƙuntatawa akan amfanin NovoMix lokacin shayarwa.
Analogs na NovoMix
Babu wani magani kuma yana da tsari iri ɗaya kamar NovoMix 30 (aspart + aspart protamine), shine, cikakkiyar analog. Sauran insulins biphasic, analog da na mutum, zasu iya maye gurbin sa:
| Abun cakuda | Suna | Kasar samarwa | Mai masana'anta |
| lispro + lispro protamine | Humalog Mix 25 Humalog Mix 50 | Switzerland | Eli Lilly |
| kewayawa + degludec | Ryzodeg | Kasar Denmark | NovoNordisk |
| ɗan adam + NPH insulin | Humulin M3 | Switzerland | Eli Lilly |
| Gensulin M30 | Rasha | Halittu | |
| Insuman Comb 25 | Jamus | Sanofi aventis |
Ka tuna cewa zabar magani da kuma maganin sa ya fi kyau tare da gwani.
