Cov lus qhia insulin detemir rau kev siv

Tam sim no, theem ntawm kev nce qib tshuaj tso cai txawm tias muaj mob loj los tswj kev ua kom lub neej nyob tus. Cov tshuaj niaj hnub tuaj rau hauv kev cawm. Kev cuam tshuam cov piam thaj hauv ntshav tam sim no yog ib qho kev kuaj mob nquag, tab sis nrog mob ntshav qab zib koj tuaj yeem nyob thiab ua haujlwm ib txwm muaj. Cov tib neeg raug mob los ntawm hom 1 thiab hom 2 tsis tuaj yeem ua yam tsis muaj yam tshuaj insulin. Thaum kev tawm dag zog lub cev thiab kev noj zaub mov kom zoo tsis pub ua kom cov ntshav qab zib tsis txaus, tom qab ntawd Detemir insulin los cawm. Tab sis ua ntej siv cov tshuaj no, tus neeg mob ntshav qab zib yuav tsum to taub cov lus nug tseem ceeb: yuav ua li cas tswj hwm qhov tshuaj hormones thaum nws siv tsis tau kiag thiab qhov kev tsis txaus siab tsis tuaj yeem tuaj yeem ua rau dab tsi?

Insulin "Detemir": qhov kev piav qhia ntawm cov tshuaj

Cov tshuaj muaj nyob rau hauv daim ntawv tsis muaj xim pob tshab tov. Hauv 1 ml ntawm nws muaj cov khoom siv tseem ceeb - insulin detemir 100 PIECES. Tsis tas li ntawd, nws muaj lwm cov khoom ntxiv: glycerol, phenol, metacresol, zinc acetate, sodium hydrogen phosphate dihydrate, sodium chloride, hydrochloric acid q.s. los yog sodium hydroxide q.s., dej rau kev txhaj tshuaj txog li 1 ml.

Cov tshuaj muaj nyob rau hauv daim duab syringe, uas muaj 3 ml ntawm kev daws, ib qho sib npaug ntawm 300 PIECES. 1 ntu ntawm cov tshuaj insulin muaj 0.142 mg ntawm cov ntsev tsis muaj tshuaj tua kab mob insulin.

Detemir ua haujlwm li cas?

Detemir insulin (lub npe ua lag luam yog Levemir) yog tsim tawm siv cov roj av deoxyribonucleic acid (DNA) biotechnology siv hom tshuaj hu ua Saccharomyces cerevisiae. Cov tshuaj insulin yog qhov tseem ceeb ntawm Levemir flekspen thiab yog ib qho khoom noj tsis haum ntawm tib neeg cov tshuaj hormones uas khi rau peripheral cell receptors thiab ua kom tag nrho cov txheej txheem lom. Nws muaj ntau yam teebmeem ntawm lub cev:

stimulates kev siv cov piam thaj los ntawm kev sib luag cov ntaub so ntswg thiab cov hlwb,
tswj cov metabolism hauv qabzib,
inhibits gluconeogenesis,
nce protein synthesis,
tiv thaiv lipolysis thiab proteolysis hauv cov rog rog.

Nws ua tsaug rau kev tswj hwm los ntawm tag nrho cov txheej txheem no uas cov ntshav qab zib kom tsawg. Tom qab kev qhia ntawm cov tshuaj, nws cov nyhuv tseem ceeb pib tom qab 6-8 teev.

Yog tias koj nkag mus nws ib hnub ob zaug, tom qab ntawd ua tiav kev sib npaug ntawm cov suab thaj tuaj yeem tiav tom qab ob mus rau peb koob. Cov tshuaj muaj tib yam nkaus rau tus poj niam thiab tus txiv neej. Nws qhov kev faib khoom nruab nrab yog nyob hauv 0.1 l / kg.

Ib nrab-lub neej ntawm insulin, uas tau txhaj rau hauv qab daim tawv nqaij, nyob ntawm qhov koob tshuaj thiab yog kwv yees li 5-7 teev.

Cov yam ntxwv ntawm kev ua ntawm cov tshuaj "Detemir"

Detemir insulin (Levemir) muaj kev cuam tshuam ntau dua li cov tshuaj insulin xws li Glargin thiab Isofan. Nws cov txiaj ntsig ntev ntawm lub cev yog vim muaj qhov tshwm sim tus kheej ntawm cov koom haum hauv cov qauv molecular thaum lawv dock nrog cov sab fatty acid saw nrog cov kab mob albumin. Piv nrog rau lwm cov insulins, nws disperses maj mam thoob plaws lub cev, tab sis vim qhov no, nws txoj kev nqus nws muaj zog dua. Tsis tas li, hauv kev sib piv nrog rau lwm cov kev sib piv, Detemir insulin yog qhov ua kom paub tseeb dua, thiab yog li nws yooj yim dua los tswj nws cov nyhuv. Thiab qhov no yog vim muaj ntau yam:

cov khoom tseem nyob rau hauv lub xeev ua kua los ntawm lub sijhawm thaum nws yog nyob rau hauv lub cwj mem zoo li rab koob kom txog thaum nws tau nkag mus rau hauv lub cev,
nws cov lus khi rau albumin lwg me me hauv cov ntshav cov los ntawm txoj kev tsis.

Cov tshuaj cuam tshuam rau cell loj hlob tus nqi tsawg, uas tsis tuaj yeem hais txog lwm yam insulins. Nws tsis muaj cov genotoxic thiab tshuaj lom rau hauv lub cev.

Yuav siv "Detemir" li cas?

Cov koob tshuaj ntawm cov tshuaj tau xaiv ib tus zuj zus rau txhua tus neeg mob ntshav qab zib. Koj tuaj yeem nkag mus nws ib zaug lossis ob zaug hauv ib hnub, qhov no tau qhia los ntawm kev qhia. Cov lus pov thawj ntawm kev siv Detemir insulin siv thov tias yuav ua kom txoj kev tswj ntawm glycemia, kev txhaj tshuaj yuav tsum tau txhaj ob zaug ib hnub: thaum sawv ntxov thiab yav tsaus ntuj, tsawg kawg 12 teev yuav tsum ncua ntawm kev siv.

Rau cov neeg laus uas muaj ntshav qab zib thiab cov uas muaj mob siab thiab siab lub raum tsis ua hauj lwm, cov koob tshuaj yog xaiv nrog ceev faj.

Cov tshuaj insulin yog txhaj rau hauv qab ntawm lub xub pwg, tus ncej puab thiab thaj av hauv thaj chaw. Lub zog ntawm kev nqis tes ua yog nyob ntawm qhov twg tshuaj. Yog tias qhov kev txhaj tshuaj tau ua rau hauv ib thaj chaw, tom qab ntawd qhov chaw hno tuaj yeem hloov tau, piv txwv li, yog tias cov tshuaj insulin txhaj rau hauv daim tawv nqaij ntawm lub plab, ces qhov no yuav tsum tau ua 5 cm los ntawm cov ntaws thiab hauv lub voj voos.

Nws yog ib qho tseem ceeb kom tau txais kev txhaj tshuaj kom yog. Txhawm rau ua qhov no, koj yuav tsum coj tus cwj mem syringe nrog chav kub tshuaj, tshuaj tua kab mob thiab ntaub paj rwb.

Thiab nqa tawm cov txheej txheem raws li nram no:

kho thaj chaw puncture nrog kev siv tshuaj tua kab mob thiab tso cai rau daim tawv nqaij kom qhuav,
daim tawv nqaij tau ntes nyob rau hauv ib lub cev rog
lub koob yuav tsum tau muab tso rau ntawm lub kaum sab xis, tom qab ntawd lub piston rub tawm rov qab me ntsis, yog tias pom muaj ntshav, lub nkoj raug puas lawm, qhov chaw txhaj tshuaj yuav tsum tau hloov,
cov tshuaj yuav tsum tau muab tshuaj qeeb qeeb thiab ua kom sib luag, thaum lub piston txav nrog qhov nyuaj, thiab ntawm qhov chaw raug mob ntawm daim tawv nqaij yog inflated, lub koob yuav tsum tau ntxig tob,
tom qab kev tswj hwm tshuaj, nws yog qhov yuav tsum tau ua kom ntev rau 5 feeb, tom qab ntawd cov koob txhaj tshuaj yog tshem nrog qhov txav, thiab qhov chaw txhaj tshuaj yog kho nrog antiseptic.

Txhawm rau txhawm rau txhawm rau kom tsis muaj kev phom sij, rab koob yuav tsum ua kom nyias li qhov ua tau, daim tawv nqaij yuav tsum tsis txhob zawm, thiab txhaj yuav tsum tau ua nrog tus paub txhais tes tsis muaj kev ntshai thiab ua xyem xyav.

Yog hais tias tus neeg mob txhaj ob peb hom tshuaj insulin, ces ua ntej yog ntaus luv, thiab tom qab ntawd ntev.

Dab tsi los saib rau ua ntej nkag mus rau Detemir?

Ua ntej kev txhaj tshuaj, koj yuav tsum:

xyuas ob npaug ntawm cov nyiaj
tsau tshuaj rau daim nyias nyias nrog tshuaj tua kab mob,
ua tib zoo saib xyuas qhov ncaj ncees ntawm daim cartridge, yog tias dheev nws puas ntsoog lossis muaj kev ua xyem xyav txog nws txoj kev tsim nyog, ces koj tsis tas yuav siv nws, koj yuav tsum xa nws mus rau lub tsev muag tshuaj.

Nws yog tsim nyog kom nco ntsoov tias nws yog nruj me ntsis txwv tsis pub siv cov roj ntsha Detemir khov lossis ib qho uas tau khaws cia tsis raug. Hauv tshuaj insulin twj, cov tshuaj tsis yog siv, nrog kev qhia nws yog ib qho tseem ceeb kom soj ntsuam ntau txoj cai:

xeem tsuas yog nyob rau hauv daim tawv nqaij,
lub koob hloov tom qab txhaj txhua,
lub cav ntim tsis puv.

Sib cuam tshuam nrog lwm txoj kev

Ntxiv dag zog rau hypoglycemic kawg ua rau:

Cov tshuaj uas muaj ethanol,
cov tshuaj hypoglycemic (qhov ncauj),
Li +,
MAO inhibitors
fenfluramine,
ACE inhibitors
cyclophosphamide,
carbonic anhydrase inhibitors,
theophylline
tsis-xaiv beta-blockers,
pyridoxine
bromocriptine
mebendazole,
sulfonamides,
ketonazole
cov neeg sawv cev anabolic
clofibrate
tetracyclines.

Kev siv tshuaj txo ntshav qab zib kom tsawg

Nicotine, tshuaj tiv thaiv (qhov ncauj), corticosteroids, phenytoin, cov thyroid hormones, morphine, thiazide diuretics, diazoxide, heparin, calcium channel blockers (qeeb), tricyclic antidepressants, clonidine, danazole thiab sympathomimets txo cov nyhuv hypoglycemic.

Salicylates thiab reserpine muaj peev xwm txhim kho lossis txo cov nyhuv uas detemir muaj ntawm insulin. Lanreotide thiab octreotide nce lossis txo qis cov tshuaj insulin.

Ua tib zoo mloog! Beta-blockers, vim yog lawv cov yam ntxwv tshwj xeeb, feem ntau npog cov tsos mob ntawm kev ua kom lub qog thiab ncua cov txheej txheem ntawm kev kho cov ntshav qabzib.

Cov tshuaj Ethanol uas muaj tshuaj txhim kho thiab nce cov nyhuv hypoglycemic ntawm insulin. Cov tshuaj tsis sib xws nrog cov tshuaj raws li sulfite lossis thiol (insulin detemir raug rhuav tshem). Tsis tas li, cov khoom tsis tuaj yeem tov nrog infusion daws teeb meem.

Cov lus qhia tshwj xeeb

Koj tsis tuaj yeem nkag rau Detemir ua ke nrog, vim tias mob ntshav qab zib ntau ntau yuav tshwm sim. Kev kho hnyav nrog cov tshuaj tsis pab rau kev sau cov phaus ntxiv.

Piv nrog rau lwm cov insulins, insulin detemir txo cov kev pheej hmoo ntawm cov ntshav qog ntshav thaum hmo ntuj thiab ua rau qhov kev xaiv ntau tshaj plaws ntawm kev noj tshuaj uas yog ua kom tiav qhov kev ruaj khov ntawm cov piam thaj hauv cov ntshav.

Tseem Ceeb! Kev cheem tsis tu ncua lossis kev siv tshuaj tsis raug, tshwj xeeb rau hom ntshav qab zib hom I, pab txhawb pom kev mob ntshav qab zib lossis ketoacidosis.

Cov cim tseem ceeb ntawm hyperglycemia, feem ntau tshwm sim hauv qib. Lawv tshwm sim hauv ob peb teev lossis hnub. Cov tsos mob ntawm hyperglycemia suav nrog:

hnov tsw ntawm acetone tom qab exhalation,
kev nqhis dej
tsis qab los noj mov
polyuria
qhov ncauj qhuav
xeev siab
daim tawv nqaij qhuav
ntxhoo
hyperemia,
kev pw tsaug zog tas li.

Kev tawm dag zog tam sim thiab nquag, thiab kev noj zaub mov tsis xwm yeem kuj ua rau lub ntsej muag ntshav qab zib.

Txawm li cas los xij, tom qab pib rov ua dua ntawm cov carbohydrate metabolism, cov yam ntxwv ntawm tus mob ntshav qab zib yuav hloov, yog li tus neeg mob yuav tsum tau qhia los ntawm tus kws kho mob uas koom nrog. Cov tsos mob tshwm sim yuav npog thaum muaj mob ntev ntshav qab zib. Cov kab mob sib kis txuas ntxiv kuj tseem xav tau cov tshuaj insulin.

Hloov chaw ntawm tus neeg mob mus rau ib hom tshiab lossis insulin, tsim los ntawm lwm tus neeg tsim khoom, ib txwm ua raws li kev saib xyuas mob. Thaum qhov hloov ntawm cov khw tsim khoom, ntau npaum li cas, hom, hom lossis hom kev tsim cov tshuaj insulin, kev hloov kho ntau zaus yuav tsum tau ua.

Cov neeg mob hloov mus rau kev kho mob uas siv tshuaj tua kab mob insulin ntau zaus yuav tsum tau txhaj tshuaj ntau dua piv rau cov tshuaj insulin yav dhau los. Qhov yuav tsum tau hloov qhov ntsuas rov qab tshwm tom qab txhaj thawj zaug lossis thaum ib asthiv lossis hli. Cov txheej txheem ntawm kev nqus ntawm cov tshuaj nyob rau hauv cov ntaub ntawv ntawm intramuscular thawj coj yog heev ceev nyob rau hauv kev sib piv nrog sc tswj hwm.

Detemir yuav pauv pauv qhov feem cuam ntawm kev ua yog tias nws tau sib xyaw nrog lwm hom insulin. Nws ua ke nrog insulin aspart yuav ua rau cov kev ua ntawm kev ua haujlwm nrog qis, ncua kev ua haujlwm siab tshaj plaws hauv kev sib piv nrog lwm cov kev tswj hwm. Detemir insulin yuav tsum tsis txhob siv rau hauv cov tshuaj insulin.

Txog hnub tim, tsis muaj ntaub ntawv hais txog kev siv tshuaj rau lub sijhawm kho cev xeeb tub, lactation thiab menyuam yaus hnub nyoog qis dua rau xyoo.

Tus neeg mob yuav tsum ceeb toom rau kev muaj peev xwm ntawm kev mob ntshav qab zib thiab kev mob ntshav qab zib nyob hauv tus txheej txheem ntawm kev tsav tsheb thiab tswj cov twj. Hauv qee qhov tshwj xeeb, nws yog ib qho tseem ceeb rau cov neeg muaj mob me me los yog tsis tuaj ua ntej uas muaj ntshav qab zib ua ntej.

Kev qhia rau siv thiab muab ntau npaum li cas

Ntshav qab zib mellitus yog yam kab mob tseem ceeb hauv cov tshuaj qhia tau.

Cov tswv yim yog nqa tawm hauv lub xub pwg, lub plab hauv plab lossis ncej puab. Cov chaw uas txhaj tshuaj insemir yuav tsum muab hloov mus tas li. Kev noj tshuaj thiab ntau zaus ntawm kev txhaj tshuaj yog tsim muaj tus kheej.

Thaum txhaj ob zaug los ua kom cov ntshav qabzib ntau dua, nws raug nquahu kom noj qhov tshuaj thib ob tom qab 12 teev tom qab thawj zaug, thaum noj hmo lossis ua ntej mus pw.

Yuav tau hloov kho ntau npaum li cas thiab lub sijhawm yuav tsum ua li cas yog hais tias tus neeg mob hloov los ntawm cov tshuaj insulin ntev thiab ib qho tshuaj nruab nrab rau insulin detemir.

Sab sij huam

Cov kev mob tshwm sim feem ntau (1 ntawm 100, qee zaum 1 tawm ntawm 10) suav nrog kev muaj ntshav qab zib thiab tag nrho nws cov kev mob tshwm sim: xeev siab, pallor ntawm daim tawv nqaij, nce qab los noj mov, tsis meej pem, mob hlwb, thiab txawm tias lub hlwb muaj teeb meem uas ua rau tuag. Cov kev tawm tsam hauv zos (khaus, o, hyperemia ntawm qhov chaw txhaj tshuaj) kuj tseem tuaj yeem, tab sis lawv nyob ib ntus thiab ploj thaum kho.

Tsis tshua muaj cov kev mob tshwm sim (1/1000, qee zaum 1/100) suav nrog:

txhaj tshuaj lipodystrophy,
o ib ntus uas tshwm sim thaum pib siv tshuaj insulin,
kev tsis haum tshuaj (txo cov ntshav siab, urticaria, palpitations thiab ua tsis taus pa, khaus, ua haujlwm ntawm lub plab zom mov, hyperhidrosis, thiab lwm yam),
nyob rau theem pib ntawm kev siv tshuaj insulin, kev ua txhaum ib ntus ntawm kev xa rov qab tshwm sim,
uas yog kuaj ntshav qab zib.

Hais txog retinopathy, kev tswj glycemic ntev txo qhov muaj feem ntawm kev tsim pathology, tab sis kev kho mob insulin ntau dua nrog kev nce sai sai ntawm kev tswj cov metabolism hauv cov khoom noj tuaj yeem ua rau muaj kev cuam tshuam ib ntus ntawm lub xeev ntawm cov ntshav qab zib retinopathy.

Tsis tshua muaj tshwm sim (1/10000, qee zaum 1/1000) kev phiv nrog tus leeg neuropathy lossis mob neuropathy mob, uas feem ntau yog qhov thim rov qab.

Noj ntau dhau

Cov tsos mob tseem ceeb ntawm kev siv tshuaj ntau dhau ntawm cov tshuaj yog hypoglycemia. Tus neeg mob tuaj yeem tshem ntawm kev mob ntshav qab zib tsawg kawg ntawm nws tus kheej los ntawm kev noj ntshav qabzib lossis zaub mov carbohydrate.

Nyob rau hauv cov ntaub ntawv ntawm loj s / c, i / m raug tswj hwm 0.5-1 mg ntawm glucagon los yog dextrose daws nyob rau hauv / hauv. Yog tias tom qab 15 feeb tom qab noj cov tshuaj glucagon tus neeg mob tsis rov qab nco qab, tom qab ntawv dextrose yuav tsum tau muab kev saib xyuas. Thaum ib tug neeg rov qab nco qab rau txoj kev tiv thaiv, nws yuav tsum noj zaub mov uas muaj cov carbohydrates.

Nyob rau hauv dab tsi raug yog cov tshuaj contraindicated?

Ua ntej siv Detemir, nws yog ib qho tseem ceeb kom paub txog thaum nws yog nruj me ntsis contraindicated:

yog tias tus neeg mob muaj qhov tsis sib haum xeeb ntawm cov tshuaj, nws tuaj yeem txhim kho kev fab tshuaj, qee qhov kev tuaj yeem tuaj yeem ua rau tuag taus,
rau cov menyuam yaus hnub nyoog qis dua 6 xyoo, cov tshuaj no tsis raug pom zoo, nws tsis tuaj yeem kuaj xyuas nws cov nyhuv rau menyuam, yog li ntawd nws tsis tuaj yeem twv seb nws yuav cuam tshuam licas rau lawv.

Tsis tas li ntawd, tseem muaj cov pawg zoo li no ntawm cov neeg mob uas raug tso cai siv tshuaj nyob rau hauv kev kho mob, tab sis nrog kev saib xyuas tshwj xeeb thiab kev saib xyuas tas li. Qhov no yog qhia los ntawm cov lus qhia rau kev siv. Cov tshuaj Insulin "» hauv cov neeg mob uas muaj cov kab mob, kev kho kom haum yuav tsum muaj:

Kev ua txhaum nyob rau hauv daim siab. Yog tias cov ntawv tau piav qhia hauv tus neeg mob lub keeb kwm, ces qhov kev ua ntawm lub ntsiab feem yuav cuam tshuam, yog li cov koob tshuaj yuav tsum tau kho.
Ua tsis tiav hauv lub raum. Nrog cov txuj ci zoo li no, lub hauv paus ntsiab lus ntawm kev ua ntawm cov tshuaj tuaj yeem hloov pauv, tab sis cov teeb meem yuav daws tau yog tias koj soj ntsuam tus neeg mob tas li.
Qub neeg. Tom qab lub hnub nyoog ntawm 65, muaj ntau yam kev hloov pauv hauv lub cev, uas tuaj yeem nyuaj rau kev taug qab. Hauv lub hnub nyoog laus, cov kabmob no tsis ua haujlwm zoo li hauv cov hluas, yog li ntawd, nws yog qhov tseem ceeb rau lawv xaiv cov tshuaj kom yog vim li ntawd nws pab ua kom cov piam thaj tsis zoo, thiab tsis raug mob.

Yog tias koj coj mus rau hauv tus account tag nrho cov lus qhia, tom qab ntawd qhov kev pheej hmoo ntawm qhov tsis zoo tuaj yeem raug txo kom tsawg.

"Detemir" thaum cev xeeb tub thiab thaum pub niam mis

Ua tsaug rau cov kev tshawb fawb txog seb kev siv cov tshuaj insulin "Detemira» tus poj niam cev xeeb tub thiab nws tus me nyuam hauv plab, nws tau raug pov thawj pom tias cov cuab yeej tsis cuam tshuam rau txoj kev loj hlob ntawm tus menyuam. Tab sis yuav hais tias nws muaj kev nyab xeeb kiag li, nws tsis yooj yim sua, vim hais tias thaum lub sijhawm cev xeeb tub muaj kev hloov pauv hauv tus pojniam lub cev, thiab qhov tshuaj yuav ua li cas hauv qee kis tsis tuaj yeem kwv yees. Tias yog vim li cas cov kws kho mob, ua ntej sau ntawv rau nws thaum cev xeeb tub, ntsuas qhov txaus ntshai.

Thaum kho, koj yuav tsum tau saib xyuas cov qib ntawm cov piam thaj kom tas li. Qhov ntsuas tuaj yeem hloov pauv tau ntau, yog li kev saib xyuas raws sij hawm thiab txhaj tshuaj hloov kho yog qhov tsim nyog.

Nws tsis tuaj yeem hais meej meej tias cov tshuaj nkag mus rau niam mis, tab sis txawm tias nws tau txais, nws ntseeg tau tias nws yuav tsis ua rau muaj kev phom sij.

Kev cuam tshuam nrog lwm yam tshuaj

Cov nyhuv ntawm "Detemir" tuaj yeem cuam tshuam vim sib koom nrog lwm cov tshuaj. Feem ntau, cov kws kho mob sim ua kom tsis txhob muaj kev sib txuas ntawm cov tshuaj, tab sis qee zaus lawv tsuas yog ua tsis tau yam tsis muaj, thaum tus neeg mob muaj lwm yam kab mob ntev. Hauv cov xwm txheej zoo li no, qhov kev pheej hmoo tuaj yeem txo los ntawm kev hloov ntau npaum. Nws yog ib qho tsim nyog los nce lub koob tshuaj yog tias cov tshuaj no tau muab rau cov ntshav qab zib:

Lawv txo cov nyhuv ntawm insulin.

Tab sis nws yog ib qho tsim nyog los txo cov tshuaj, yog tias cov tshuaj no pom zoo:

Yog tias cov koob tshuaj tsis tau hloov kho, tom qab ntawd siv cov tshuaj no tuaj yeem ua rau kev mob ntshav qab zib tsawg.

Analogues ntawm cov tshuaj

Qee tus neeg mob yuav tsum tau nrhiav rau Detemir insulin analogues nrog kev sib sau ua ke ntawm lwm cov khoom siv. Piv txwv, cov ntshav qab zib uas muaj kev tsis haum xeeb rau cov feem ntawm cov tshuaj no. Muaj ntau ntau cov yeeb yaj kiab ntawm Detemir, suav nrog Insuran, Rinsulin, Protafan thiab lwm yam.

Tab sis nws yog tsim nyog kom nco ntsoov tias cov analogue nws tus kheej thiab nws txoj kev noj tshuaj yuav tsum raug xaiv los ntawm tus kws kho mob hauv txhua kis. Qhov no siv rau ib qho tshuaj twg, tshwj xeeb nrog rau txoj kev loj.

Tus nqi tshuaj

Tus nqi ntawm insulin Detemir Danish ntau lawm yog los ntawm 1300-3000 rubles. Tab sis nws yog tsim nyog nco ntsoov tias koj tuaj yeem tau txais nws dawb, tab sis qhov no, koj yuav tsum twv yuav raug muaj cov lus Latin sau los ntawm endocrinologist. Detemir insulin yog cov tshuaj zoo rau kev kho mob ntawm hom 1 thiab ntshav qab zib hom 2, qhov tseem ceeb yog ua raws li txhua qhov kev pom zoo, thiab nws tsuas yog muaj txiaj ntsig zoo rau cov ntshav qab zib.

Kev Ntsuam Xyuas Insulin

Tus mob ntshav qab zib thiab kws kho mob teb tau zoo rau Detemir. Nws pab txhawm rau txo cov ntshav qab zib kom tsawg, muaj qhov tsawg kawg ntawm kev sib kis thiab tsis xav pom. Qhov tsuas yog ib qho yuav tau xav txog yog qhov tseeb ntawm nws cov kev tswj hwm thiab ua raws li txhua qhov kev pom zoo yog tias, sib nrug los ntawm insulin, lwm yam tshuaj tau pom zoo rau tus neeg mob.

Ntshav qab zib mellitus tam sim no tsis yog kab lus, txawm hais tias tus kab mob no tau txiav txim siab yuav luag tuag kom txog thaum tau txais cov tshuaj insulin. Los ntawm ua raws li tus kws kho mob tau pom zoo thiab soj ntsuam cov ntshav qabzib hauv cov ntshav, koj tuaj yeem tuav lub neej zoo.

Pharmacological cov yam ntxwv ntawm cov tshuaj Insulin detemir

Niaj hnub siv DNA thev naus laus zis tau txhim kho qhov profile ntawm kev ua ntawm kev yooj yim (ib txwm) insulin. Detemir insulin yog tsim los ntawm kev tsim cov kab mob DNA biotechnology uas siv txoj siv sia lim Saccharomyces cerevisiae, yog soluble basal analog ntawm tib neeg cov kua dej los ua ntev nrog qhov kev txiav txim siab tsis kawg. Kev txiav txim qhov profile yog qhov tsawg dua li qhov sib txawv piv nrog isofan-insulin thiab insulin glargine. Lub sijhawm ua haujlwm ntev yog vim qhov tshaj tawm tus kheej kev koom tes ntawm detemir insulin cov tshuaj tua ntawm qhov chaw txhaj tshuaj thiab qhov khi ntawm cov molecules rau albumin los ntawm kev sib txuas nrog ib qho kev sib xyaw ua ke nrog fatty fatty chain. Piv nrog isofan-insulin, detemir insulin muab faib qeeb dua hauv cov phom sij lub hom phiaj. Cov kev sib koom ua ke ntawm cov khoom faib ncua tau muab ntau qhov kev rov qab ua haujlwm dua thiab cov insulin kev txiav txim siab profile ntawm detemir. Detemir insulin yog tus yam ntxwv ua rau ntau ntxiv ntawm kev cia siab ua ntej ntawm kev ua hauv cov neeg mob piv nrog insulin NPH lossis insulin glargine. Qhov qhia tau hais tias xav tau ntawm kev ua yog vim muaj ob yam: insulin detemir tseem nyob hauv lub xeev yaj nyob rau txhua theem ntawm nws daim ntawv noj tshuaj mus rau qhov khi rau cov insulin receptor thiab qhov cuam tshuam ntawm kev khi rau kom cov ntshiab albumin.

Los ntawm kev sib cuam tshuam nrog lub receptor tshwj xeeb ntawm sab cytoplasmic membrane ntawm cov hlwb, nws tsim cov txheej txheem insulin-receptor complex uas txhawb cov txheej txheem intracellular, suav nrog cov synthesis ntawm ntau cov enzymes tseem ceeb (hexokinase, pyruvate kinase, glycogen synthetase, thiab lwm yam). Kev txo qis hauv cov ntshav qabzib yog vim muaj kev nce ntxiv hauv nws txoj kev thauj mus los ntawm qhov tsis txaus, kev nce siab ntawm cov nqaij mos, kev ua kom cov lipogenesis, glycogenogenesis, qhov txo qis ntawm cov piam thaj ntau dhau los ntawm lub siab, thiab lwm yam. 4 teev txog 14 teev tom qab kev tswj hwm. Tom qab kev coj ua subcutaneous, qhov lus teb pharmacodynamic tau faib rau cov koob tshuaj uas tau siv (cov txiaj ntsig siab tshaj plaws, sijhawm ua haujlwm, cov nyhuv dav dav). Tom qab SC txhaj tshuaj, detemir khi rau albumin los ntawm nws cov fatty acid saw. Yog li, nyob rau hauv lub xeev qhov kev txiav txim ruaj khov, qhov kev kub siab ntawm tsis pub dawb insulin yog qhov txo qis, uas ua rau cov qib glycemia ruaj khov. Lub sijhawm ntawm kev ua ntawm detemir ntawm ib koob ntawm 0.4 IU / kg yog li ntawm 20 teev, yog li cov tshuaj tau sau tseg ob zaug ib hnub rau feem ntau cov neeg mob. Hauv kev tshawb fawb mus ntev (6 lub hlis), yoo cov plasma ntshav qab zib hauv cov neeg mob ntshav qab zib hom I zoo dua piv nrog isofan-insulin, raws li kev kho / bolus kho mob. Kev tswj glycemic (glycosylated hemoglobin - HbA1c) thaum lub sij hawm kho nrog insulin detemir tau muab piv rau qhov ntawd hauv kev kho mob nrog isofan-insulin, nrog rau kev pheej hmoo tsawg ntawm kev txhim kho nocturnal hypoglycemia thiab qhov tsis muaj qhov nce hauv lub cev hnyav thaum nws siv. Cov ntaub ntawv ntawm hmo ntuj ua kom tsis muaj qab zib tswj tau yog nthuav thiab ntau heev tshaj dua rau qhov ua kom insulin piv nrog isofan insulin, uas yog qhov cuam tshuam txog kev pheej hmoo hmo ntuj tsis zoo.

Qhov siab tshaj plaws ntawm kev tshem tawm cov insulin hauv cov ntshav cov ntshav tau mus txog 6-8 teev tom qab kev tswj hwm. Nrog rau kev coj noj coj ua ob hnub ib zaug, kev ruaj khov ruaj khov ntawm cov tshuaj hauv ntshav cov dej yog ua tiav tom qab 2-3 hno.

Kev tsis ua haujlwm zoo ib yam li cov tib neeg cov tshuaj insulin, txhua yam kev tsim tawm yog tsis ua haujlwm. Kev Tsim Kev Tsim Protein hauv vitro thiab hauv vivo qhia qhov tsis muaj chaw kho mob sib cuam tshuam tseem ceeb ntawm insulin detemir thiab cov roj ntsha lossis lwm yam tshuaj uas cuam tshuam rau cov ntshav protein.

Ib nrab-lub neej tom qab sc txhaj tshuaj yog txiav txim siab los ntawm cov degree ntawm nqus ntawm daim ntaub subcutaneous thiab yog 5-7 teev, nyob ntawm qhov koob tshuaj.

Thaum s / rau kev qhia ntawm cov concentration hauv cov ntshav cov ntshav tau sib npaug nrog cov koob tshuaj tau muab tshuaj (qhov siab tshaj plaws, kev nqus ntawm kev nqus).

Cov chaw muaj tshuaj Pharmacokinetic tau kawm hauv cov menyuam yaus (6–12 xyoo) thiab cov neeg hluas (13-17 xyoo) thiab muab piv nrog cov neeg laus muaj ntshav qab zib hom ntshav siab hom ntshav qab zib. Tsis muaj qhov sib txawv hauv cov chaw kho mob ntawm cov tshuaj tua kab mob ntawm insemir insulin ntawm cov neeg laus thiab cov neeg mob hluas, lossis ntawm cov neeg mob uas tsis muaj mob raum thiab mob siab thiab cov neeg mob noj qab nyob zoo.

Kev siv cov tshuaj insulin detemir

Tsim qauv rau kev coj ua subcutaneous. Cov koob tshuaj yog txiav txim siab ntawm tus kheej hauv txhua kis. Detemir insulin yuav tsum tau siv tshuaj 1 lossis 2 zaug nyob rau ib hnub raws li qhov xav tau ntawm tus neeg mob. Cov neeg mob uas yuav tsum tau siv ob zaug ib hnub rau kev tswj hwm kev noj qab haus huv hauv cov ntshav tuaj yeem nkag rau qhov kev noj tshuaj yav tsaus ntuj thaum noj hmo, lossis ua ntej mus pw, lossis 12 teev tom qab noj thaum sawv ntxov. Detemir insulin yog txhaj sc hauv tus ncej puab, sab hauv plab phab ntsa lossis xub pwg. qhov chaw txhaj tshuaj yuav tsum tau hloov txawm tias thaum txhaj rau hauv tib thaj chaw. Ib yam li lwm cov insulins, hauv cov neeg laus thiab cov neeg mob lub raum lossis mob ntshav siab tsis txaus, cov ntshav qabzib feem ntau yuav tsum tau saib xyuas ntau ntxiv thiab cov tshuaj txhaj pom ib qho zuj zus. Kev hloov koob tshuaj kuj tseem ceeb thaum txhim kho tus neeg mob lub cev kev ua si, hloov nws kev noj zaub mov li qub, lossis nrog lub zog tsis xis nyob.

Kev sib cuam tshuam yeeb tshuaj Insulin detemir

Muaj ntau tus yeeb tshuaj uas cuam tshuam rau kev xav tau cov tshuaj insulin.

Cov nyhuv hypoglycemic ntawm insulin yog kho los ntawm: qhov ncauj hypoglycemic tshuaj, Mao inhibitors, ACE inhibitors, carbonic anhydrase inhibitors, uas tsis yog-xim β-blockers, bromocriptine, sulfonamides, anabolic steroids, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, lithium, tshuaj muaj ethanol.

Cov nyhuv hypoglycemic ntawm insulin tsis muaj zog: cov tshuaj tiv thaiv tsis haum, corticosteroids, cov thyroid hormones, thiazide diuretics, heparin, tricyclic antidepressants, sympathomimetics, danazole, clonidine, qeeb calcium channel blockers, diazoxide, morphine, phenytoin, nicotine. Nyob rau hauv kev cuam tshuam ntawm reserpine thiab salicylates, nws muaj peev xwm ua kom tsis muaj zog lossis txhim kho qhov kev ua ntawm cov tshuaj Octreotide / lanreotide, uas tuaj yeem ua rau ob leeg nce thiab txo qhov xav tau ntawm lub cev. Ers-adrenergic blockers tuaj yeem npog cov tsos mob ntawm kev mob hypoglycemia thiab ncua sijhawm rov qab los tom qab muaj ntshav qab zib tsawg. Cov cawv yuav pab txhim kho thiab ua kom ntev li ntawm cov nyhuv hypoglycemic ntawm insulin.

Qee cov tshuaj, piv txwv li, muaj cov thiol lossis sulfite, thaum detemir ntxiv rau cov tshuaj insulin, tuaj yeem ua rau nws rhuav tshem. Yog li, tsis txhob ntxiv cov tshuaj insulin nyob rau hauv kev daws teeb meem.

Pharmacological kev txiav txim ntawm cov quav yeeb tshuaj

Detemir insulin yog tsim tawm siv cov roj av deoxyribonucleic acid (DNA) biotechnology siv tshuaj tua kab mob hu ua Saccharomyces cerevisiae.

Cov tshuaj insulin yog cov tshuaj tseem ceeb ntawm cov tshuaj Levemir flekspen, uas tau tawm hauv qhov tsim ntawm kev daws hauv kev yooj yim 3 ml syringe cwjmem (300 PIECES).

Qhov no tib neeg cov tshuaj hormones analogue khi rau peripheral cell receptors thiab ua rau cov txheej txheem lom.

Tib neeg cov tshuaj insulin pab txhawb kev ua kom muaj kev ua haujlwm hauv qab no hauv lub cev:

stimulation ntawm qabzib uptake los ntawm peripheral hlwb thiab cov ntaub so ntswg,
piam thaj metabolism tswj,
inhibition of gluconeogenesis,
nce protein synthesis
kev tiv thaiv ntawm lipolysis thiab tiv thaiv proteolysis hauv cov rog rog.

Ua tsaug rau tag nrho cov txheej txheem no, muaj kev txo cov ntshav qab zib kom tsawg. Tom qab txhaj cov tshuaj insulin, Detemir ncav cuag nws cov txiaj ntsig zoo tshaj plaws tom qab 6-8 teev.

Yog tias koj nkag rau qhov kev daws teeb meem ob zaug hauv ib hnub, tom qab ntawv qhov sib luag ntawm cov tshuaj insulin tiav tom qab ob lossis peb qhov kev txhaj tshuaj no. Kev txiav txim siab ntawm ib tug neeg sab hauv ntawm Detemir insulin yog qis dua lwm qhov ntawm lwm cov tshuaj los ntawm insulin.

Qhov tshuaj no muaj cov nyhuv tib yam rau txiv neej thiab poj niam. Nws qhov kev faib khoom nruab nrab yog kwv yees li 0.1 l / kg.

Lub sijhawm kawg ntawm ib nrab-lub neej ntawm insulin txhaj nyob rau hauv daim tawv nqaij yog nyob ntawm kev ntau npaum li cas ntawm cov tshuaj thiab yog kwv yees li 5-7 teev.

Cov lus qhia rau kev siv tshuaj

Tus kws kho mob suav qhov ntau npaum li cas ntawm cov tshuaj, noj mus rau hauv tus account lub concentration ntawm cov piam thaj hauv ntshav qab zib.

Cov koob tshuaj yuav tsum raug kho nyob rau hauv cov ntaub ntawv ntawm kev ua txhaum ntawm tus neeg mob lub cev noj mov, nce kev ua si lossis muaj lwm yam txuj ci. Insulin Detemir tuaj yeem siv los ua cov tshuaj tseem ceeb, ua ke nrog bolus insulin los yog nrog cov tshuaj txo cov ntshav qab zib.

Qhov kev txhaj tshuaj tuaj yeem ua tsis pub dhau 24 teev nyob rau txhua lub sijhawm, qhov tseem ceeb tshaj plaws yog soj ntsuam tib lub sijhawm txhua hnub. Cov kev cai yooj yim rau kev tswj hwm cov tshuaj hormones:

Qhov kev txhaj tshuaj yog tsim nyob rau hauv daim tawv nqaij mus rau hauv thaj chaw hauv plab, xub pwg, pob tw lossis ncej puab.
Txhawm rau kom txo kev ntxim nyiam ntawm lipodystrophy (mob nqaij ntshiv nqaij), thaj chaw txhaj tshuaj yuav tsum tau hloov ua ntu zus.
Cov neeg muaj hnub nyoog tshaj 60 xyoo thiab cov neeg mob raum lossis lub siab ua rau lub siab xav soj ntsuam cov kua nplaum thiab kho cov tshuaj insulin ntau dua.
Thaum hloov pauv ntawm lwm cov tshuaj lossis hauv thawj theem ntawm txoj kev kho, nws yog qhov yuav tsum tau ua tib zoo saib xyuas theem ntawm glycemia.

Nws yuav tsum raug sau tseg tias hauv kev kho mob ntawm cov tshuaj insulin Detemir tsis xav tau qhov nce hauv qhov hnyav ntawm tus neeg mob. Ua ntej taug kev ntev ntev, tus neeg mob yuav tsum sab laj nrog tus kws kho mob tshwj xeeb txog kev siv cov tshuaj, txij li hloov lub sijhawm ib cheeb tsam cuam tshuam cov sijhawm teem rau tshuaj insulin.

Kev txiav tawm ntawm txoj kev kho kom zoo tuaj yeem ua rau lub xeev ntawm hyperglycemia - nce qib ntawm cov piam thaj ntau, lossis tseem muaj cov kab mob ntshav qab zib ketoacidosis - kev ua txhaum ntawm cov metabolism carbohydrate vim tsis muaj cov tshuaj insulin. Yog tias tus kws kho mob tsis tiv tauj sai, qhov yuav ua rau tuag tau tshwm sim.

Kev mob hypoglycemia yog tsim thaum lub cev qias lossis tsis txaus noj nrog cov zaub mov, thiab cov koob tshuaj insulin, nyeg, yog qhov siab heev. Txhawm rau txhawm rau nce ntxiv cov piam thaj hauv cov ntshav, koj yuav tsum noj ib qho qab zib, qab chocolate, qee yam qab zib.

kub taub hau lossis ntau yam mob feem ntau nce ntxiv qhov kev xav tau ntawm lub cev. Qhov kev hloov kho ntawm txoj kev daws teeb meem yuav tsim nyog hauv kev txhim kho pathologies ntawm ob lub raum, mob siab, lub qog, cov qog pituitary thiab cov qog adrenal.

Thaum muab cov tshuaj insulin thiab thiazolidinediones, nws yog ib qho tsim nyog yuav tsum coj mus rau hauv qhov tseeb tias lawv tuaj yeem pab txhawb kev txhim kho kev mob plawv thiab mob ntsws tsis ua hauj lwm.

Thaum siv yeeb tshuaj, kev hloov pauv hauv kev xav thiab psychomotor tus cwj pwm yog tau.

Cov txheej txheem ua pov thawj thiab ua rau muaj kev phom sij

Xws li, tsis muaj kev tiv thaiv kev siv rau cov tshuaj insulin Detemir. Cov kev txwv tsuas yog cuam tshuam rau tus kheej raug rau qhov khoom siv thiab ob xyoos ntawm lub hnub nyoog vim qhov kev tshawb fawb txog kev cuam tshuam ntawm cov tshuaj insulin rau cov menyuam yaus tseem tsis tau ua.

Lub sijhawm nyob hauv menyuam yaus, kev siv tshuaj yeeb tuaj yeem siv, tab sis nyob hauv kev saib xyuas ntawm tus kws kho mob.

Ntau cov kev tshawb fawb tsis tau qhia tawm cov kev mob tshwm sim hauv niam thiab nws tus menyuam tshiab nrog kev qhia ntawm kev txhaj tshuaj ntawm insulin thaum nws xeeb tub.

Nws ntseeg tau tias cov tshuaj no tuaj yeem siv nrog niam mis, tab sis tsis muaj kev tshawb nrhiav. Yog li, rau cov niam cev xeeb tub thiab lactating, tus kws kho mob kho cov tshuaj ntawm cov tshuaj insulin, kev hnyav ua ntej nws muaj txiaj ntsig rau leej niam thiab muaj kev pheej hmoo rau nws tus menyuam.

Xws li rau qhov tsis zoo rau lub cev, cov lus qhia rau kev siv muaj ib daim ntawv teev ntau:

Ib lub xeev ntawm cov ntshav ntog lub cev muaj tus yam ntxwv xws li tsaug zog, txob taus, pallor ntawm daim tawv nqaij, tshee tshee, mob taub hau, tsis meej pem, nriaj teeb, tsaus muag, tachycardia. Qhov xwm txheej no tseem tseem hu ua insulin shock.
Cov tshuaj tiv thaiv ib ce hauv ib cheeb tsam - o thiab liab ntawm thaj chaw txhaj tshuaj, khaus, nrog rau cov tsos ntawm lipid dystrophy.
Kev ua xua, angioedema, urticaria, tawv nqaij ua pob thiab tawm hws.
Ua txhaum ntawm lub plab zom mov - xeev siab, ntuav, mob plab, raws plab.
Ua tsis taus pa, ua kom ntshav siab.
Pom kev tsis pom kev - qhov hloov ntawm qhov tsis txaus siab uas ua rau retinopathy (mob ntawm qhov mob ntawm qhov retina).
Kev tsim tawm ntawm cov hlab hlwb paj hlwb.

Kev noj tshuaj ntau dhau hle tuaj yeem ua rau kom qab zib poob sai heev. Nrog cov ntshav qog ntshav qab zib tsawg, tus neeg yuav tsum haus cov khoom muaj protein ntau.

Hauv kev mob nyhav rau tus neeg mob, tshwj xeeb yog nws tsis nco qab lawm, yuav tsum tau mus pw hauv tsev kho mob sai. Tus kws kho mob txhaj ib qho kua nplaum los sis glucagon hauv qab ntawm daim tawv nqaij lossis hauv qab cov leeg nqaij.

Thaum tus neeg mob rov qab, nws tau muab ib qho qab zib los yog chocolate ua los tiv thaiv nws cov piam thaj kom pheej rov qab los.

Nqi, tshuaj xyuas, txhais tau tias zoo ib yam

Cov tshuaj Levemir flekspen, cov tshuaj tiv thaiv uas yog insulin Detemir, muag hauv khw muag tshuaj thiab cov khw muag tshuaj online.

Koj tuaj yeem yuav cov tshuaj tsuas yog tias koj muaj daim ntawv sau tshuaj los ntawm kws kho mob.

Cov tshuaj yog kim heev, nws cov nqi sib txawv ntawm 2560 txog 2900 Lavxias rubles. Hauv qhov no, tsis yog txhua tus neeg mob tuaj yeem them nws.

Txawm li cas los xij, kev txheeb xyuas ntawm Detemir insulin yog qhov zoo. Ntau tus neeg mob ntshav qab zib uas tau txhaj nrog tib neeg li cov tshuaj hormones tau sau tseg txog cov txiaj ntsig no:

maj mam txo cov ntshav qab zib,
kev saib xyuas ntawm kev ua ntawm cov tshuaj rau txog ib hnub,
yooj yim ntawm kev siv syringe cwjmem,
tsis tshua muaj tshwm sim ntawm kev phiv tshuaj,
tswj qhov hnyav ntawm cov ntshav qab zib nyob rau tib theem.

Yuav kom ua tau ib qho txiaj ntsig qabzib tuaj yeem tsuas ua tau rau txhua txoj cai ntawm kev kho mob ntshav qab zib. Qhov no tsis tsuas yog cov tshuaj insulin, tab sis kuj ua kom ib ce zuaj zuaj ib ce, qee qhov kev txwv noj zaub mov thiab tswj ntshav qab zib kom ruaj. Ua raws li cov tshuaj kho tau yog qhov tseem ceeb, txij li qhov pib ntawm kev mob ntshav qab zib, nrog rau nws cov kev mob nyhav, raug cais tawm.

Yog tias cov tshuaj hauv qee qhov tsis haum tus neeg mob, tus kws kho mob yuav sau ntawv rau lwm cov tshuaj. Piv txwv, insulin Isofan, uas yog ib qho piv txwv ntawm tib neeg cov tshuaj hormones, uas yog tsim los ntawm kev tsim kho caj ces. Isofan tsis yog siv tsis yog mob ntshav qab zib mellitus ntawm thawj thiab thib ob hom, tab sis kuj tseem nyob rau hauv nws daim ntawv yoj tes taw (hauv cov poj niam cev xeeb tub), intercurrent pathologies, ntxiv rau kev phais mob.

Nws lub sijhawm ntawm qhov kev txiav txim siab yog tsawg dua li ntawm Detemir insulin, txawm li cas los xij, Isofan tseem muaj qhov ua tau zoo hypoglycemic zoo. Nws muaj yuav luag tib qhov kev phiv tshuaj, lwm yam tshuaj tuaj yeem cuam tshuam nws cov hauj lwm zoo. Isofan tivthaiv muaj nyob hauv ntau cov tshuaj, piv txwv li, Humulin, Rinsulin, Pensulin, Gansulin N, Biosulin N, Insuran, Protafan thiab lwm yam.

Nrog rau kev siv txoj cai ntawm Detemir insulin, koj tuaj yeem tshem tawm cov tsos mob ntshav qab zib. Nws cov analogues, kev npaj kom muaj cov tshuaj insulin Isofan, yuav pab tau thaum kev siv cov tshuaj tsis txwv. Yuav ua li cas nws ua haujlwm thiab vim li cas koj xav tau insulin - hauv video hauv kab lus no.

Tso cov ntaub ntawv thiab cov nyob ua ke

Cov tshuaj muaj nyob rau hauv daim ntawv ntawm cov tshuaj txhaj rau npaj rau kev tswj hwm hauv qab daim tawv nqaij. Lwm cov ntawv me, nrog rau cov ntsiav tshuaj, tsis yog tsim. Qhov no yog vim qhov tseeb tias nyob rau hauv cov hnyuv hauv cov zom dej tau tawg ua rau cov amino acids thiab tsis tuaj yeem ua tiav nws txoj haujlwm.

Insulin Detemir yog qhov sib npaug ntawm tib neeg cov insulin.

Qhov nquag ua haujlwm yog sawv cev los ntawm insulin detemir. Nws cov ntsiab lus hauv 1 ml ntawm kev daws yog 14,2 mg, lossis 100 units. Muaj pes tsawg leeg ntxiv xws li:

sodium tshuaj dawb
tshuaj glycerin
hydroxybenzene
metacresol
sodium hydrogen phosphate dihydrate,
zinc acetate
dilute hydrochloric acid / sodium hydroxide,
txhaj dej.

Nws zoo li kev daws teeb meem ntshiab, tsis ua haujlwm, homogeneous. Nws tau muab faib rau hauv 3 ml daim cartridges (Penfill) lossis cwj mem xaum (Flexspen). Cov thawv ntim khoom. Cov kev qhia yog txuas.

Cov Tshuaj Pharmacokinetics

Yuav kom tau txais qhov siab tshaj plaws ntshav plasma, 6-8 teev yuav tsum elapse los ntawm lub sijhawm tswj hwm. Bioavailability yog li ntawm 60%. Qhov sib txuam ua ke nrog kev tswj hwm ntawm ob zaug yog txiav txim siab tom qab 2-3 hno. Qhov faib khoom nruab nrab yog 0.1 l / kg. Feem ntau ntawm cov insulin txhaj ntxiv rau cov ntshav ntws. Cov tshuaj tsis cuam tshuam nrog cov roj ntsha thiab cov chaw muag tshuaj uas khi rau cov protein.

Kev zom zaub mov tsis txawv ntawm kev ua haujlwm ntawm cov tshuaj insulin. Txoj kev tshem tawm ib nrab-lub neej ua los ntawm 5 txog 7 teev (raws li qhov siv koob tshuaj). Pharmacokinetics tsis nyob ntawm tus tub los ntxhais thiab hnub nyoog ntawm tus neeg mob. Qhov mob ntawm ob lub raum thiab mob siab kuj tsis cuam tshuam rau cov ntsuas no.

Yuav Ua Li Cas Noj Insulin

Qhov kev daws yog siv rau kev tswj hwm subcutaneous, kev tso ntshav ntawm qhov leeg tuaj yeem ua rau mob ntshav qab zib heev. Nws tsis raug txhaj tshuaj intramuscularly thiab tsis yog siv hauv cov tshuaj insulin. Txhaj tshuaj tuaj yeem muab rau hauv thaj chaw ntawm:

xub pwg (deltoid leeg),
lub duav
phab ntsa sab pem hauv ntej ntawm peritoneum,
pob tw.

Qhov chaw txhaj tshuaj yuav tsum tau hloov tas li txhawm rau txhawm rau txo qhov zoo li qhov tshwm sim ntawm lipodystrophy.

Kev noj tshuaj ntau dua yog xaiv ncaj qha. Cov koob tshuaj yog nyob ntawm kev yoo ntshav ntshav qabzib. Kev noj tshuaj kho kom haum yuav tsim nyog rau kev tawm dag zog lub cev, hloov pauv ntawm kev noj zaub mov, kab mob concomitant.

Cov tshuaj no tau muab coj los siv rau ntau qhov chaw, suav nrog phab ntsa anterior ntawm peritoneum.

Kev siv ntawm cov tshuaj tso cai:

ntawm kuv tus kheej
tau nrog cov tshuaj bolus insulin los,
ntxiv rau liraglutid,
nrog cov tshuaj tiv thaiv kab mob hauv qhov ncauj.

Nrog txoj kev kho ntshav qab zib kom tsis txhob mob, nws raug nquahu kom muab tshuaj rau 1 zaug nyob rau ib hnub. Koj yuav tsum xaiv txhua lub sijhawm uas yooj yim thiab lo rau nws thaum ua qhov kev txhaj tshuaj txhua hnub. Yog tias muaj qhov xav tau los siv cov tshuaj 2 zaug hauv ib hnub, thawj koob tau muab thaum sawv ntxov, thiab zaum thib ob nrog ncua sijhawm 12 teev, nrog noj hmo lossis ua ntej mus pw.

Tom qab txhaj tshuaj subcutaneous ntawm qhov koob tshuaj, cov tes ntawm cov koob txhaj tshuaj yog tuav, thiab lub koob tau tawm hauv daim tawv nqaij kom ntev li 6 lij.

Thaum hloov los ntawm lwm cov tshuaj insulin npaj rau Detemir-insulin hauv thawj lub lis piam, kev tswj nruj ntawm glycemic index yog qhov tsim nyog. Nws yuav tsim nyog hloov pauv kev kho mob, kev noj tshuaj thiab lub sijhawm noj tshuaj tiv thaiv kab mob, nrog rau hauv lub qhov ncauj.

Nws yog ib qho tsim nyog yuav tsum tau ua tib zoo soj ntsuam kom tsis txhob muaj suab thaj thiab kho lub sij hawm tshuaj hauv cov neeg laus.

Nws yog ib qho tsim nyog yuav tsum tau ua tib zoo soj ntsuam kom tsis txhob muaj piam thaj ntau thiab kho lub sij hawm tshuaj rau cov neeg laus thiab cov neeg mob raum-mob siab.

Nruab nrab hauv lub paj hlwb

Qee zaum cov leeg hlwb muaj kev cia siab loj tuaj. Feem ntau, nws thim rov qab. Feem ntau, nws cov tsos mob tshwm sim nrog cov ntawv qhov tseeb ntawm glycemic index.

Los ntawm ib sab ntawm cov metabolism

Feem ntau muaj qhov txo qis cov piam thaj hauv cov ntshav. Kev mob ntshav qog ntshav siab nyob hauv tsuas yog 6% ntawm cov neeg mob. Nws tuaj yeem ua rau pom qhov tsis meej, tsaus muag, ua haujlwm tsis zoo ntawm lub hlwb, kev tuag.

Qee zaum muaj tshuaj tiv thaiv tshwm sim ntawm qhov chaw txhaj tshuaj. Hauv qhov no, khaus, liab ntawm daim tawv nqaij, tawm pob, o tuaj yeem tshwm sim. Hloov chaw txhaj tshuaj ntawm cov tshuaj insulin tuaj yeem txo lossis tshem tawm cov kev tsis txaus siab no; kev tsis kam ntawm cov tshuaj yog qhov tsim nyog. Kev phiv txhua yam yog ua tau (mob plab hnyuv, ua tsis taus pa, mob ntshav ncig hypotension, blanching ntawm lub integument, tawm hws, tachycardia, anaphylaxis).

Siv thaum cev xeeb tub thiab lactation

Thaum ua qhov kev tshawb fawb, qhov tshwm sim tsis zoo rau cov menyuam yaus uas nws niam siv cov tshuaj thaum cev xeeb tub tsis tau txheeb xyuas. Txawm li cas los xij, siv nws thaum coj menyuam yuav tsum siv nrog ceev faj. Hauv thawj lub sijhawm cev xeeb tub, tus poj niam xav tau cov tshuaj insulin tsawg dua, thiab tom qab tau nce ntxiv.

Tsis muaj ib qho pov thawj dab tsi qhia tau hais tias insulin xa mus rau niam mis. Nws lub qhov ncauj tawm ntawm cov menyuam hauv lub cev yuav tsum tsis txhob xav txog qhov tsis zoo, txij li nyob rau hauv txoj hnyuv cov tshuaj sai sai sai thiab nqus tau los ntawm lub cev hauv daim ntawv ntawm cov amino acids. Tus niam tsev saib xyuas menyuam me tej zaum yuav tsum tau txais kev hloov pauv tshuaj thiab kev noj zaub mov noj kom tsawg.

Kev cuam tshuam nrog lwm yam tshuaj

Cov lus sib xyaw tsis tuaj yeem tov nrog ntau cov kua tshuaj thiab haus dej ntawm txoj kev ua kua. Thiols thiab sulfites ua rau kev puas tsuaj ntawm tus qauv ntawm tus neeg saib xyuas hauv nqe lus nug.

Lub zog ntawm cov tshuaj nce ntxiv nrog rau kev siv thooj:

Clofibrate
Fenfluramine,
Pyridoxine
Bromocriptine
Cyclophosphamide,
Mebendazole
Ketoconazole
Theophylline
tshuaj noj tiv thaiv kab mob hauv lub qhov ncauj
ACE inhibitors
tshuaj tiv thaiv kev nyuaj siab ntawm IMAO pawg,
tsis-xaiv beta-blockers,
inhibitors ntawm carbonic anhydrase kev ua si,
lithium npaj
sulfonamides,
derivatives ntawm salicylic acid,
tetracycline
anabolics.

Hauv kev sib xyaw nrog Heparin, Somatotropin, Danazole, Phenytoin, Clonidine, Morphine, corticosteroids, cov thyroid hormones, sympathomimetics, calcium antagonists, thiazide diuretics, TCAs, tshuaj tiv thaiv qhov ncauj, nicotine, insulin nyhuv txo.

Nws raug nquahu kom tsis txhob haus cawv.

Hauv qab ntawm Lanreotide thiab Octreotide, cov tshuaj ntawm cov tshuaj tuaj yeem txo qis thiab nce ntxiv. Kev siv cov beta-blockers ua rau kev hloov kho qhov tseeb ntawm cov qog ntshav qab zib thiab inhibits qhov kev kho dua ntawm cov piam thaj.

Cawv tau zoo

Nws raug nquahu kom tsis txhob haus cawv. Kev ua ntawm ethyl cawv tsis yooj yim rau kev twv, vim nws muaj peev xwm ob leeg txhim kho thiab ua kom cov nyhuv hauv lub ntsej muag tsis zoo.

Ua tiav analogues ntawm Detemir-insulin yog Levemir FlexPen thiab Penfill. Tom qab sab laj nrog tus kws kho mob, lwm yam tshuaj insulins (glargine, Insulin-isophan, thiab lwm yam) tuaj yeem siv los hloov cov tshuaj.