Yuav thov li cas Levemir Flekspen?
Lub npe thoob ntiaj teb - levemir flexpen
Kev Sib Sau thiab daim ntawv ntawm kev tso tawm
Kev daws rau sc administration pob tshab, tsis muaj xim. 1 ml muaj detemir insulin 100 IU *. 1 rab koob xaum hluav taws xob muaj cov insulin detemir 300 PIECES *.
Tshwjxeeb: glycerol, phenol, metacresol, zinc acetate, sodium chloride, sodium dihydrogen phosphate dihydrate, hydrochloric acid los yog sodium hydroxide, dej d / i.
* 1 koog muaj 142 μg ntsev tsis muaj tshuaj tua kab mob insulin, uas sib haum rau 1 chav tsev. tib neeg cov insulin (IU).
3 ml - iav daim cartridges (1) - tshuaj ntsuab ntau lub taub tes uas siv cov tshuaj lim kom siv tas mus li (5) - pob ntawv los qhia.
Cov chaw soj ntsuam thiab chaw muag tshuaj
Kev ua haujlwm ntev ntev ntawm tib neeg cov tshuaj insulin.
Cov tshuaj pab pawg kho mob
Tus neeg sawv cev hypoglycemic - ua yeeb yam ntev ntev ntawm insulin.
Pharmacological kev txiav txim
Ib qho kev sib piv ntawm tib neeg cov kua dej ntawm kev ua haujlwm ntev (vim hais tias tus kheej kev sib koom tes ntawm detemir insulin lwg me me ntawm qhov chaw txhaj tshuaj thiab qhov khi ntawm cov tshuaj lwg tshuaj rau albumin los ntawm kev sib txuas nrog ib sab fatty acid saw) nrog lub tiaj tus ntawm kev ua (qhov txawv txav tsawg dua li insulin-isophan thiab insulin glargine).
Piv nrog cov tshuaj insulin-isophan, nws tau qeeb dua hauv cov phiaj los ua ke nrog cov ntaub so ntswg ntau dua, uas muab ntau qhov txuas ntxiv ntawm qhov nqus pom thiab cov yeeb tshuaj. Nws cuam tshuam nrog ib qho kev tshwj xeeb ntawm sab cytoplasmic membrane ntawm cov hlwb thiab tsim cov txheej txheem insulin-receptor complex uas txhawb cov txheej txheem intracellular, suav nrog synthesis ntawm cov naj npawb ntawm cov enzymes tseem ceeb (hexokinase, pyruvate kinase, glycogen synthetase).
Kev txo qis hauv cov concentration ntawm cov piam thaj hauv cov ntshav yog vim muaj kev nce ntxiv hauv nws txoj kev thauj mus los hauv lub cev, nce ntxiv los ntawm cov nqaij mos, ua kom muaj zog ntawm lipogenesis, glycogenogenesis, thiab qhov txo qis hauv cov ntshav qabzib los ntawm lub siab. Tom qab kev qhia ntawm 0.2-0.4 U / kg 50%, cov txiaj ntsig siab tshaj plaws tau tiav hauv qhov ntau ntawm 3-4 teev txog 14 teev, kev ua haujlwm ntev li 24 teev.
Cov Tshuaj Pharmacokinetics
Cmax hauv kev ntsuas dej tau tiav 6-8 teev tom qab kev tswj hwm. Nrog rau kev tswj hwm ob hnub ntawm kev tswj hwm ntawm Css tiav tom qab 2-3 hno.
Txoj kev hloov pauv Intraindype yog tsawg dua rau Levemir Flexpen piv nrog rau lwm cov kev npaj tshuaj insulin hauv paus. Muaj tsis muaj kev sib kis tseem ceeb hauv kev sib deev sib txawv hauv cov chaw muag tshuaj ntawm Levemir Flexpen.
Nruab Nrab Vd Levemir Flexpen (kwv yees li 0.1 l / kg) qhia tias qhov feem ntau ntawm cov insulin detemir circulates hauv cov ntshav.
Kev tsis ua hauj lwm ntawm cov tshuaj Levemir Flexpen zoo ib yam li tib neeg cov tshuaj insulin npaj, txhua hom kev tsim tawm 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 protein.
Davhlau ya nyob twg T1/2 tom qab sc txhaj tshuaj, nws yog txiav txim siab los ntawm cov degree ntawm nqus ntawm cov nqaij subcutaneous thiab yog 5-7 teev, nyob ntawm qhov koob tshuaj.
Nrog kev tswj hwm sc, ntshav ntau yog cov xwm yeem raws li cov koob tshuaj tau muab (Cmax , degree ntawm kev nqus). Tsis muaj ib qho pharmacokinetic lossis pharmacodynamic sib cuam tshuam ntawm liraglutide thiab Levemir FlexPen, hauv kev sib npaug, thaum Levemir FlexPen tau siv rau hauv ib koob li 0.5 U / kg thiab liraglutide ntawm koob tshuaj 1.8 mg rau cov neeg mob uas muaj ntshav qab zib hom 2 mellitus.
Cov pab pawg neeg tshwj xeeb
Cov chaw muag tshuaj ntawm Levemir Flexpen tau kawm txog cov menyuam yaus (6–12 xyoo) thiab cov neeg hluas (13-17 xyoo) thiab piv nrog cov chaw muag tshuaj muaj nyob hauv cov neeg laus uas muaj ntshav qab zib hom 1 Tsis muaj qhov sib txawv.
Tsis muaj qhov sib txawv hauv tsev kho mob ntawm Levemir Flexpen ntawm cov neeg laus thiab cov hluas lossis los ntawm cov neeg mob uas lub raum tsis ua haujlwm thiab mob hlwb thiab cov neeg mob noj qab nyob zoo.
Kev Kawm Kev Nyab Xeeb Preclinical
Kev Tshawb Fawb hauv vitro hauv tib neeg cov kab mob ntawm tes, suav nrog kev tshawb fawb txog kev khi rau insulin receptors thiab IGF-1 (insulin-zoo li qhov kev loj hlob), pom tias insemir insulin muaj kev cuam tshuam tsawg rau ob qho tib si receptors thiab muaj feem cuam tshuam ntawm kev loj hlob ntawm tes piv rau tib neeg cov insulin. Cov ntaub ntawv tshaj tawm raws li kev tshawb fawb niaj hnub ntawm kev nyab xeeb ntawm pharmacological, rov qab siv tshuaj ntau dua tshuaj lom neeg, genotoxicity, lub cev muaj zog, cov tshuaj lom neeg muaj peev xwm ntawm kev ua me nyuam, tsis qhia txog kev phom sij rau tib neeg.
- mob ntshav qab zib rau cov neeg laus, cov hluas thiab cov menyuam muaj hnub nyoog ntau dua 2 xyoos.
Dosage regimen thiab cov qauv ntawm daim ntawv thov
Cov koob tshuaj ntawm cov tshuaj Levemir Flexpen yuav tsum tau xaiv ib tus zuj zus hauv txhua kis, raws li qhov xav tau ntawm tus neeg mob.
Raws li cov txiaj ntsig ntawm cov kev tshawb fawb, cov hauv qab no yog cov lus qhia rau koob tshuaj titration:
| Qhov Ntsuas Plasma Ntsuas qhov nruab nrab ntsuas nws tus kheej ua ntej noj tshais | Kev hloov tshuaj ntawm Levemir Flexpen (ED) |
| > 10 mmol / L (180 mg / dL) | +8 |
| 9.1-10 mmol / L (163-180 mg / dl) | +6 |
| 8.1-9 mmol / L (145-162 mg / dl) | +4 |
| 7.1-8 mmol / L (127-144 mg / dl) | +2 |
| 6.1-7 mmol / L (109-126 mg / dl) | +2 |
| 4.1-6.0 mmol / l | Tsis muaj kev hloov (lub hom phiaj nqi) |
| Yog tias ib qho txiaj ntsig ntshav qabzib: | |
| 3.1-4 mmol / L (56-72 mg / dl) | -2 |
| 1/1000, 1/100, 1/1000, 1/1000, 1/100, 1/10 000, Gynecology Qing 1 - cov ncauj lus kom ntxaws hauv cov ncauj lus ntawm European Cancer Center. Cov ntawv thiab qauvCov chaw tsim tshuaj lag luam muaj cov tshuaj Levemir FlexPen tshuaj ua ib txoj kev daws teeb meem rau kev coj ua subcutaneous. Rau kev qhia txog kev kho mob kua dej hauv cov pob nrog cov tshuaj muaj cov xaum xaum tshwj xeeb uas yooj yim rau siv thiab tso cai rau koj kom xa qhov tseeb ntawm cov tshuaj. Cov tshuaj muaj cov nyhuv ntev ntev, uas muab nws nrog cov khoom tseem ceeb - insulin detemir. Qhov tshuaj no yog soluble basal analog ntawm tib neeg cov tshuaj insulin. Lub sijhawm tiv thaiv kom zoo dua li 24 teev, nyob ntawm seb cov tshuaj tau siv licas, thiab vim qhov no, nws yuav muaj peev xwm txwv nws tus kheej rau 1 lossis 2 zaug kev tswj hwm ntawm cov tshuaj ib hnub. Nws tsis muaj qhov tshwj xeeb tshaj plaws nyob rau hauv insemir insulin. Cov yam ntxwv sib txawv ntawm cov tshuaj yeeb dej caw no yog qhov kwv yees kwv yees lub sijhawm thiab cov nyhuv kho. Qab zib yog txo tam sim ntawd! Mob ntshav qab zib ntev mus ntev tuaj yeem ua rau tag nrho cov kab mob, xws li teeb meem tsis pom kev, tawv nqaij thiab plaub hau, mob rau sab hauv, mob caj pas thiab mob qog nqaij hlav! Cov neeg qhia kev iab kev xav ua kom lawv cov suab thaj theem. nyeem rau. Nws raug nquahu kom txhaj Levemir FlexPen thaum muaj ntshav qab zib insulin-mob ntshav qab zib (hom I ntshav qab zib). Kev siv tshuaj insulin txuas ntxiv kuj tau pom zoo rau cov neeg mob uas tau txheeb xyuas tias tsis muaj cov kab mob ntshav qab zib-insulin-mob ntshav qab zib hom ntshav qab zib hom II. Hauv lwm qhov xwm txheej, qhov yuav tsum tau siv Levemir yog txiav txim siab tshwj xeeb los ntawm tus kws kho mob tsim nyog, ua raws li cov txiaj ntsig ntawm kev kuaj mob thiab tus neeg mob cov mob. Cov lus qhia rau kev siv Levemir Flekspen
Qhov ntau npaum ntawm cov tshuaj yog nyob ntawm tus nqi ntawm cov tshuaj insulin zais cia los ntawm tus txiav txiav ib hnub. Tshaj cov duab no yuav tsum nruj me ntsis. Qhov koob tshuaj yuav tsum yog xam los ntawm cov kws kho mob profile, tab sis koj kuj tuaj yeem tshawb xyuas koj cov qib insulin. Qhov no yuav xav tau qhov kev xeem basal. Kev daws tau txhaj tshuaj rau hauv tus ncej puab txhais ceg lossis lub xub pwg. Txawm li cas los xij, insulin ua sai dua yog tias kev txhaj tshuaj rau hauv lub plab phab ntsa. Tus naj npawb ntawm kev txhaj tshuaj ib hnub twg yog xaiv tau ib qho zuj zus rau txhua tus neeg mob. Feem ntau, txhaj koob tshuaj 1 yog txaus, tab sis yog tias tsim nyog, cov tshuaj "Levemir Flexpen" tau txhaj ob zaug ib hnub. Noj ntau dhauCov tshuaj insulin Levemir Flexpen yuav tsum ua raws li cov koob tshuaj pom zoo los ntawm kws kho mob thiab cov lus qhia, lawv cov txiaj ntsig tseem ceeb yog txaus ntshai vim kev txhim kho kev noj ntau dhau, uas yog qhov txawv txav ntawm tib neeg cov ntshav qab zib. Txhawm rau kho ntshav qab zib, koj yuav tsum noj ib qho qab zib lossis ib qho khoom lag luam nplua nuj nyob hauv cov carbohydrates. Yog vim li cas cov ntshav qab zib yuav tsum nqa cov khoom qab zib nrog lawv tas li. Yog hais tias tus neeg mob tus mob tsis rov ua dua qub, nws tau siv 0,5-1 mg ntawm glucagon lossis kua qab zib tov. Thaum qhov mob rov qab zoo li qub, tus neeg mob yuav tsum tiv thaiv kom rov qab muaj ntshav qab zib hauv lub cev los ntawm kev noj zaub mov qab. Txwv tsis pub siv thiab sab tsos mobRaws li cov lus qhia, cov khoom lag luam tshuaj hauv kev txiav txim siab tsis tuaj yeem siv los ntawm cov neeg mob nrog ib tus neeg tsis mob siab rau nws cov khoom siv. Ib qho ntxiv, Levemir Flexpen tsis pom zoo rau cov neeg muaj hnub nyoog 6 xyoo, vim tias tsis muaj kev tshawb fawb hauv pawg neeg mob no. Yog tias koj siv cov tshuaj kom raug, koj yuav muaj peev xwm tiv thaiv kev txhim kho ntawm qhov tsis tuaj yeem xav tau. Txwv tsis pub, tus neeg mob yuav ntsib cov xwm txheej tsis zoo:
Daim ntawv tso tawm Levemir flekspen, ntim tshuaj thiab muaj pes tsawg leeg.Kev daws rau sc tswj hwm yog pob tshab, xim tsis muaj zog. 1 ml Cov muaj mob: mannitol, phenol, metacresol, zinc acetate, sodium chloride, disodium phosphate dihydrate, sodium hydroxide, hydrochloric acid, dej d / i. * 1 koog muaj 142 μg ntawm cov ntsev tsis muaj tshuaj tua kab mob insulin, uas sib haum rau 1 tsev. tib neeg cov insulin (IU). 3 ml - ntau-koob syringe cwjmem nrog lub dispenser (5) - pob ntawm cardboard. Cov lus piav qhia ntawm cov tshuaj yog ua raws cov lus qhia raug pom zoo rau kev siv. Pharmacological ua haujlwm ntawm levemir flekspenKev siv tshuaj hypoglycemic. Nws yog cov soluble basal analogue ntawm tib neeg cov tshuaj insulin nrog cov kev ua kom lub tiaj thiab qhov kev cia siab nrog qhov ua kom ntev. Ua los ntawm recombinant DNA biotechnology siv hom tshuaj Saccharomyces cerevisiae. Kev txiav txim ntawm cov yeeb yaj kiab Levemir Flexpen tsis txawv txav ua piv rau isofan-insulin thiab insulin glargine. Lub sijhawm ua haujlwm ntev ntawm cov tshuaj Levemir Flexpen yog vim qhov tshaj tawm tus kheej kev koom tes ntawm detemir insulin lwg me me ntawm qhov chaw txhaj tshuaj thiab qhov khi ntawm cov tshuaj molecules rau albumin los ntawm txoj kev sib txuas nrog cov hlua sab. Piv nrog isofan-insulin, detemir insulin xa mus rau lub hom phiaj peripheral qeeb dua. Cov kev sib koom ua ke ncua kev faib tawm tau muab ntau qhov kev rov ua dua kev nqus tau thiab nqis tes ntawm cov tshuaj Levemir Flexpen piv rau isofan-insulin. Nws cuam tshuam nrog ib qho kev tshwj xeeb ntawm sab cytoplasmic membrane ntawm cov hlwb thiab tsim cov txheej txheem insulin-receptor complex uas txhawb cov txheej txheem intracellular, suav nrog synthesis ntawm cov naj npawb ntawm cov enzymes tseem ceeb (hexokinase, pyruvate kinase, glycogen synthetase). Cov thawj coj hauv cov ntshav nyob rau hauv lub cev vim qhov nce ntxiv hauv nws txoj kev thauj neeg mus los, kev nqus ntawm cov nqaij mos ntau dua, kev txhawb nqa lipogenesis, glycogenogenesis, thiab txo tus nqi ntawm cov piam thaj los ntawm lub siab. Rau kev txhaj tshuaj ntawm 0.2-0.4 U / kg 50%, cov nyhuv siab tshaj plaws ntawm cov tshuaj tshwm sim hauv thaj tsam li ntawm 3-4 teev mus rau 14 teev tom qab kev tswj hwm. Lub sijhawm tiv thaiv yog txog li 24 teev, nyob ntawm seb lub koob tshuaj, uas yog qhia qhov muaj peev xwm ntawm ib leeg thiab ob zaug kev tswj hwm ib hnub. Tom qab kev tswj hwm sc, ib qho kev siv tshuaj pharmacodynamic tau muab faib rau cov koob tshuaj uas tau siv (cov txiaj ntsig siab tshaj plaws, sijhawm ua haujlwm, cov nyhuv dav dav). Hauv kev tshawb fawb ntev (> 6 lub hlis), yoo plasma ntshav qab zib hauv cov neeg mob ntshav qab zib hom ntshav qab zib tau zoo dua piv nrog isofan-insulin kho rau kev kho mob hauv paus / bolus. Glycemic tswj (glycated hemoglobin - HbA1C) thaum lub sij hawm kho nrog Levemir Flexpen tau piv rau qhov ntawd nrog isofan-insulin, nrog rau kev pheej hmoo tsawg dua hmo ntuj hypoglycemia thiab tsis muaj kev nce hauv lub cev hnyav nrog Levemir Flexpen. Hmo ntuj cov teeb meem ntshav qab zib tswj tau hais lus zoo thiab ntau heev tshaj dua nrog Levemir Flexpen piv rau isofan-insulin, uas yog qhov cuam tshuam txog kev pheej hmoo qis ntawm kev tsim hmo ntuj. Pharmacokinetics ntawm cov tshuaj.Thaum s / c tswj hwm, kev muab tshuaj ntau ntau rau cov koob tshuaj. Cmax tau nce mus txog 6-8 teev tom qab kev tswj hwm. Nrog rau kev tswj hwm ob zaug txhua hnub, Css ua tiav tom qab 2-3 tswj. Cov tshuaj tiv thaiv ib ce sib txawv nyob hauv qis dua yog qis dua hauv cov tshuaj Levemir Flexpen piv nrog rau lwm cov kev npaj tshuaj insulin uas nyob puag ncig. Kev nqus nrog i / m tswj hwm yog qhov nrawm dua thiab ua tau zoo dua piv nrog s / c tswj hwm. Qhov nruab nrab Vd ntawm Levemir FlexPen (kwv yees li 0.1 L / kg) qhia tias muaj ntau ntawm insemir insulin khiav hauv cov ntshav. Biotransformation ntawm cov tshuaj Levemir Flexpen zoo ib yam li tib neeg cov tshuaj insulin npaj, tag nrho cov metabolites tsim tau tsis ua haujlwm. Lub davhlau ya nyob twg T1 / 2 tom qab sc txhaj tshuaj yog txiav txim siab los ntawm cov degree ntawm nqus ntawm qhov nqaij subcutaneous thiab yog 5-7 teev, nyob ntawm seb ntau npaum li cas. Dosage thiab txoj hauv kev ntawm kev tswj hwm tshuaj.Cov koob tshuaj ntawm cov tshuaj tau txiav txim siab ntawm tus kheej. Cov tshuaj Levemir Flexpen yuav tsum tau muab 1 lossis 2 zaug / hnub raws li qhov xav tau ntawm tus neeg mob. Cov neeg mob uas yuav tsum tau siv cov tshuaj 2 zaug / hnub rau kev tswj hwm cov ntshav qabzib kom nkag tau rau thaum yav tsaus ntuj los yog thaum noj hmo, lossis ua ntej mus pw, lossis 12 teev tom qab noj thaum sawv ntxov. Levemir Flexpen yog txhaj sc rau hauv tus ncej puab, sab xub ntiag phab ntsa lossis xub pwg. Nws yog ib qho tsim nyog yuav tsum hloov chaw txhaj tshuaj nyob rau thaj tsam anatomical thiaj li tiv thaiv kev txhim kho ntawm lipodystrophy. Cov tshuaj insulin yuav ua nrawm dua yog tias nws nkag mus rau sab xub ntiag phab ntsa. Yog tias tsim nyog, cov tshuaj yeeb tshuaj tuaj yeem siv iv hauv qab kev saib xyuas ntawm tus kws kho mob. Hauv cov neeg mob laus, nrog rau lub siab lub raum thiab lub raum tsis ua haujlwm, cov ntshav qabzib yuav tsum ua tib zoo saib xyuas thiab kev hloov kho tshuaj yuav tsum tau nqa tawm. Kuj tseem yuav tsum tau kho dua thaum ua kom tus neeg mob lub cev ua ub no, hloov nws li kev noj zaub mov kom zoo dua qub, lossis muaj mob hnyav. Thaum hloov los ntawm cov insulins nruab nrab thiab ntev insulin rau Levemir FlexPen insulin, koob tshuaj thiab lub sijhawm hloov kho yuav tsim nyog. Ua tib zoo saib xyuas cov ntshav qabzib hauv lub sijhawm txhais lus thiab hauv thawj lub limtiam ntawm cov tshuaj tshiab pom zoo. Yuav tsum kho cov kev kho cov ntshav qog ntshav kom ntshav (koob thiab sijhawm uas tswj cov tshuaj insulin sai li sai tau lossis siv tshuaj ntawm qhov ncauj hypoglycemic). Tus Neeg Mob Cov Lus Qhia rau Kev Siv FlexPen® Insulin Cwj mem nrog Dispenser Lub FlexPen koob txhaj tshuaj yog tsim los siv nrog Novo Nordisk insulin txhaj tshuaj thiab NovoFine koob. Muab tshuaj rau cov tshuaj insulin hauv thaj tsam li 1 txog 60 units. tuaj yeem hloov pauv hauv nce ntxiv ntawm 1 chav tsevNovoFine S koob ntev txog 8 hli lossis luv dua hauv qhov ntev yog tsim rau kev siv nrog FlexPen koob txhaj tshuaj. S khij tau luv luv-tipped koob. Rau kev ceev faj txog kev nyab xeeb, ib txwm nqa ib qho twj tshiab los hloov nrog koj yog tias FlexPen ploj lossis puas lawm. Yog tias koj tab tom siv Levemir Flexpen thiab lwm qhov insulin hauv thaj chaw Flexpen cwj mem, koj yuav tsum siv ob txoj kev txhaj tshuaj cais los tswj cov tshuaj insulin, ib qho rau txhua hom insulin. Levemir Flexpen yog rau kev siv tus kheej nkaus xwb. Ua ntej siv Levemir FlexPen, koj yuav tsum kuaj lub ntim ntim kom paub tseeb tias hom roj ntsha insulin raug xaiv. Tus neeg mob yuav tsum tau kuaj xyuas lub taub hau tas li, suav nrog cov roj hmab piston (cov lus qhia ntxiv yuav tsum tau txais nyob rau hauv cov lus qhia rau kev siv qhov system rau cov tshuaj insulin), cov roj hmab membrane yuav tsum tau muab tshuaj tua kab nrog cov paj rwb los so hauv dej cawv kho mob. Levemir Flexpen tsis tuaj yeem siv yog tias daim cartridge lossis insulin txhaj tshuaj poob qis, hauv daim cartridge raug puas los yog tsoo, vim tias muaj kev pheej hmoo ntawm cov tshuaj insulin, qhov dav ntawm qhov pom ntawm cov roj hmab piston yog ntau dua qhov dav ntawm cov hlua dawb kab, cov chaw cia ntawm cov tshuaj insulin tsis phim cov uas tau qhia, lossis cov tshuaj tau khov, lossis insulin tsis ua pob tshab thiab tsis muaj xim. Txhawm rau txhawm rau kev txhaj tshuaj, koj yuav tsum ntxig ib rab koob tso rau hauv qab daim tawv nqaij thiab nias lub khawm pib txhua qhov. Tom qab txhaj, koob yuav tsum nyob twj ywm hauv qab daim tawv nqaij tsawg kawg 6 vib nas this. Lub tes tsho xuas tes xoos yuav tsum tau nias cia kom txog thaum rab koob raug tshem tawm hauv qab ntawm daim tawv nqaij. Tom qab txhua qhov kev txhaj tshuaj, rab koob yuav tsum tau muab tshem tawm (vim tias yog tias koj tsis tshem tawm rab koob, tom qab ntawd vim qhov kub hloov pauv, kua yuav tawm ntawm daim cartridge thiab insulin concentration yuav txawv). Tsis txhob rov qab ntim cov roj cartridge nrog cov kua dej. Sab sij huam Levemir flekspen:Cov kev tsis zoo tshwm sim pom hauv cov neeg mob siv Levemir Flexpen feem ntau yog koob tshuaj thiab tsim kho vim yog cov tshuaj pharmacological ua haujlwm ntawm cov tshuaj insulin. Cov kev mob tshwm sim feem ntau yog hypoglycemia, uas tshwm sim thaum uas cov tshuaj ntau dhau los siv rau ntawm tus neeg lub cev xav tau cov tshuaj insulin. Los ntawm cov kev tshawb fawb hauv chav kho mob nws tau paub tias mob ntshav qab zib ntau, txhais tau tias yuav tsum muaj kev cuam tshuam ntawm tus neeg thib peb, txhim kho thaj tsam li ntawm 6% ntawm cov neeg mob tau txais Levemir Flexpen. Qhov feem ntawm cov neeg mob tau txais kev kho mob nrog Levemir Flexpen, uas xav tias yuav muaj kev mob tshwm sim, kwv yees li 12%. Qhov tshwm sim ntawm cov kev mob tshwm sim, uas feem ntau kwv yees muaj feem cuam tshuam nrog Levemir Flexpen thaum kho mob sim, tau hais hauv qab no. Cov kev phiv tshuaj tiv thaiv cuam tshuam nrog kev cuam tshuam ntawm cov metabolism hauv cov metabolism: feem ntau (> 1%, 0.1%, 0.1%, 0.1%, 0.01%, 0.1%, 2013-03-20) Analogues ntawm cov tshuajHloov "Levemir Flekspen" muaj peev xwm ntawm cov tshuaj uas muaj qhov sib xws hauv kev muaj pes tsawg leeg thiab kev ua haujlwm ntawm kev ua haujlwm. Qhov sib txawv ntawm lawv tuaj yeem nyob rau hauv daim ntawv tso tawm, lub sijhawm ntawm cov txiaj ntsig kho, kuj yog txhua qhov tshuaj noj, uas yog ib qho piv txwv ntawm Levemir, nws muaj nws cov kev txwv ntawm kev noj thiab lwm yam ntawm kev kho: Muab khaws cia zooTxhawm rau Levemir khaws nws cov kev kho mob kom ntev li ntev tau, nws yuav tsum muab nws nrog kev mob zoo rau txuag. Rau qhov no, cov tshuaj muab tso rau hauv lub tub yees, txawm li cas los xij, nws yog txwv tsis pub kom khov nws. Daim ntawv xaj hluav taws xob tom qab siv tau tuaj yeem khaws cia rau 6 lub lis piam, ntawm qhov kub tsis tshaj 30 degrees Celsius. Tom qab siv, tus txhaj rau rau kev tswj hwm subcutaneous yuav tsum kaw kom nruj nrog lub hau thiaj li daws qhov teeb meem nrog kev tiv thaiv kom zoo los ntawm lub teeb ci ci. Txee lub neej yog 30 lub hlis. Cov lus qhia tshwj xeebThaum siv Levemir, nws yog ib qho tseem ceeb uas yuav tau soj ntsuam xyuas kev noj tshuaj kom zoo. Tshaj dhau cov koob tshuaj, qhov kev pheej hmoo ntawm kev txhim kho hypoglycemia nce. Ib qho ntxiv, kev ua haujlwm hauv lub cev lossis kev noj zaub mov tsis txaus ua rau txo cov suab thaj kom tsawg. Koj tsis tuaj yeem nkag mus rau cov tshuaj qhov quav, vim tias qhov no tsuas yuav ua rau qhov xwm txheej hnyav thiab ua rau muaj ntshav nce siab ntau. Cov tib neeg uas ua haujlwm nrog cov txheej txheem uas xav tau kev mloog zoo thiab tswj TSIB yuav tsum tau soj ntsuam cov qib ntawm cov piam thaj hauv cov ntshav thiab tiv thaiv kev txhim kho ntawm hyperglycemia thiab hypoglycemia, vim hais tias nrog cov kab kev no cov tshuaj tiv thaiv ceev thiab muaj peev xwm mloog zoo. Nws puas tseem zoo li tsis tuaj yeem kho ntshav qab zib?Kev txiav txim los ntawm qhov tseeb tias koj tab tom nyeem cov kab no tam sim no, ib qho kev yeej ntawm kev tawm tsam cov ntshav qab zib hauv ntshav tsis nyob ntawm koj sab. Thiab koj puas tau xav txog tsev kho mob? Nws yog kev nkag siab, vim tias ntshav qab zib yog ib qho txaus ntshai heev, uas, yog tias tsis kho, yuav ua rau muaj kev tuag. Kev nqhis dej ib txwm, tso zis ceev ceev, qhov muag plooj. Tag nrho cov tsos mob no yog paub txog koj tus kheej. Tab sis nws puas tuaj yeem kho qhov laj thawj ntau dua li cov nyhuv? Peb pom zoo kom nyeem ib tsab xov xwm txog kev kho mob ntshav qab zib tam sim no. Nyeem kab lus >> Qee qhov tseebCov tshuaj Levemir Flexpen (tsim los ntawm NovoNordisk, Denmark) yog daim ntawv tshuaj ntawm tib neeg cov tshuaj insulin rau kev kho ntawm cov piam thaj hauv cov ntshav cov ntshav ntawm cov neeg mob ntshav qab zib. Muaj nyob hauv cov kis yooj yim taug kev.
Raws li International Statistical Classification ntawm kab mob thiab teeb meem kev noj qab haus huv, 1989. (ICD-10), Levemir Flexpen yuav tsum tau siv rau rooj plaub no:
Ntshav qab zib nrog rau kev nce ntxiv hauv cov piam thaj hauv thawj hom yog ib qho ntawm cov chaw pib ntawm cov kab mob endocrine nrog lub txim hnyav rau lub cev. Hyperglycemia muaj feem cuam tshuam rau kev ua neej, yuam tus neeg mob kom nruj rau kev noj haus, kev siv lub cev, kev noj zaub mov thiab kev kho cov ntshav qabzib hauv cov ntshav nrog kev pab los ntawm kev txhaj tshuaj insulin tas li. Txawm li cas los xij, qhov no tsis yog ib txwm ua tau, tshwj xeeb yog cov menyuam yaus pib mob ntshav qab zib.
Raws li kev tshawb fawb, txog li 80% ntawm cov menyuam yaus ntxov lossis ntxov dua tuaj rau qhov chaw kho mob ceev nrog ntsuas tus kab mob ntshav qab zib ketoacidosis. Cov ua rau mob ketoacidosis lossis mob ntshav qab zib tsis xeev yog:
Tshwj xeeb feem ntau, cov teeb meem ntshav qab zib tshwm sim sab nraum lub tsev, qhov chaw teeb tsa tshuaj thiab khoom siv (cov koob txhaj tshuaj, tshuaj tua kab mob) feem ntau khaws cia. Ntau zaus, hyperglycemia tshwm sim rau qee qhov uas ib tus neeg tsis tuaj yeem mus txog tsev kom ncav sijhawm (tsheb khiav, tsheb khiav mus los) rau ntau yam laj thawj. Qhov tshwm sim ntawm me hyperglycemia, tshwm sim los ntawm cov ntsiab lus saum toj no, thiab tsis txheeb xyuas raws sij hawm, tuaj yeem ua rau tsis meej pem hauv lub sijhawm, uas, nyeg, tuaj yeem ua rau hla dhau ntawm kev txhaj tshuaj ntxiv.
Kev xiam oob qhab vim hyperglycemia tseem tuaj yeem ua rau tus neeg tsis muaj peev xwm ua tau yooj yim nrog kev txhaj tshuaj thiab sau / tshuaj ntawm cov tshuaj, tshwj xeeb tshaj yog nyob rau cov menyuam yaus, cov neeg laus laus, cov neeg qaug zog los ntawm kev kis mob, mob lossis lwm yam. Hauv cov xwm txheej no, nws yog qhov tseem ceeb rau cov neeg mob ntshav qab zib kom muaj cov tshuaj insulin nyob rau hauv cov qauv yooj yim rau kev txhaj tshuaj, uas txo cov teeb meem tsis haum thaum txhaj rau hauv qhov chaw tsis muaj qhov tsis huv, tsis tas ua cov qauv kev xav tau uas yuav tsum tau txhaj tshuaj subcutaneous ntawm cov tshuaj. Tshwj xeeb rau cov xwm txheej zoo li no, cov tshuaj Levemir Flexpen tau tsim los. Cov chaw muag tshuajDetemir insulin yog ib qho kev tsim kho biotechnological raws li tib neeg cov tshuaj insulin, muaj lub cev ua kom ntev ntawm lub cev. Cov tshuaj yog tsim tawm los ntawm kev siv lub tshuab nqus ntawm tsis muaj kab mob hu ua fungi. Hauv cov kev kuaj pom, ob lossis ntau dua deoxyribonucleic acid ntu yog recombined (ua ke). Yog li no, cov tshuaj Levemir Flexpen yog cov khoom lag luam ntawm cov tshuaj lom neeg.
Qhov txiaj ntsig ntawm kev tsim khoom no yog lub sij hawm ua yeeb yam ntev ntev. Vim nws lub koom haum nrog cov proteinin, cov kab mob insemir yog nqus los ntawm cov ntaub so ntswg ntev dua. Thiab kom txog thaum nws nkag mus rau hauv lub cell, daim ntawv no ntawm insulin yog nyob rau hauv lub xeev yaj. Ib qhov tshwj xeeb ntawm kev siv tshuaj insulin yog qhov tsis muaj qhov tseem ceeb tshaj plaws vim nws yog nqus los ntawm lub cev, uas tsis ua rau muaj kev cuam tshuam loj heev ntawm hypoglycemia, thiab muaj cov txiaj ntsig zoo ntawm tus neeg mob thiab kev noj qab haus huv. Cov kev tshawb fawb (M. Vardi, 2008, M. Monami, 2009, A. Trikko, 2014 - tag nrho ntawm 39 kev tshawb fawb sib piv) qhia tau hais tias cov tshuaj insulin ntev ntev ua tau zoo dua thiab muaj kev nyab xeeb dua rau tus neeg mob uas muaj ntshav qab zib hom 1. Cov kws tshawb fawb tau teeb tsa qhov tseeb tias kev siv ntawm Levemir tsis ua rau nce tus neeg mob lub cev nyhav dhau sijhawm, thiab txo qis cov mob nocturnal hypoglycemia. Kev siv tshuaj rau qhov siv tau yog 24 teev (qhov ntsuas raws raws qhov koob tshuaj). Nrog kev qhia txog ob zaug ib hnub, kev ua kom cov ntshav qab zib cov ntshav tau ua tiav nyob hauv ob hnub. Qhov mob siab tshaj plaws hauv cov tshuaj hauv cov ntshav tau mus txog thaum xya teev tom qab txhaj tshuaj. Ib lub raj mis ntawm Levemir Flexspen muaj 100.00 units ntawm tib neeg insulin daim ntawv Detemir ib milliliter ntawm kev daws. Qhov ntim tag nrho ntawm cov tshuaj yog 14,2 milligrams. Ib qho xaum xaum ib qho muaj peb plhom dej ntawm kev daws (300.00 units ntawm insulin detemir). 1 pawg ntawm insulin detemir yog sib npaug rau 1 chav ntawm ME (tib neeg cov insulin), thiab muaj cov insulin 0.142 milligrams. Muaj pes tsawg leeg ntxiv: propane-1,2,3-triol, carbolic acid, polymethylene-meta-cresol sulfonic acid, zinc acetate, sodium dihydrogen phosphate, txhaj tshuaj isotonic, caustic soda, dej distilled. General kev ntsuasCov insulin daim ntawv ntawm detemir yog tshuaj:
Cov pab pawg muaj kev pheej hmooCov xwm txheej hauv cov tshuaj uas tau hais tseg hauv kev ua raws li kev tshawb fawb biochemical ntxiv muaj:
Cov neeg mob los ntawm cov pab pawg ntau dua qhov kev pheej hmoo ntawm hypo- thiab hyperglycemia yuav tsum ntsuas ntsuas ntshav suav tas li, tom qab ntawd rov suav dua cov koob tshuaj ntawm cov tshuaj. Kev sib xyaw nrog glitazones (rosiglitazone, pioglitazone) tuaj yeem ua rau lub siab ua haujlwm hauv lub siab. Kev siv tib lub zuj zus ntawm ob yam tshuaj yuav tsum muaj kev saib xyuas mob. Kev cuam tshuam nrog lwm yam tshuajLevemir Flexpen yuav tsum tau ua ke nrog kev saib xyuas tshwj xeeb nrog cov tshuaj uas cuam tshuam cov piam thaj hauv qhov kev tshuaj xyuas ntshav. Cov tshuaj noj uas muaj cov nyhuv hypoglycemic:
Cov tshuaj uas tseev kom muaj qhov nce ntxiv ntawm cov koob tshuaj insulin:
Kev siv adrenergic blockers kuj tseem tuaj yeem nkag siab yuam kev hais txog kev ua kom tsis muaj ntshav qab zib. Cov tshuaj tiv thaiv tshuaj hormonal, nrog rau kev haus dej cawv, ua haujlwm tsis txaus ntseeg txog qib ntawm cov piam thaj hauv cov hlab ntshav. Qee cov theol lossis sulfite-raws li cov khoom lag luam muaj peev xwm ua kom cov tshuaj insulin thiab yuav tsum tsis txhob muab sib xyaw ua ke hauv kev daws teeb meem. Sab sij huamFeem ntau pom cov kev tsis zoo yog cov yam ntxwv ntawm kev kho tshuaj insulin thiab, ntawm qhov nruab nrab, lawv qhov tshwm sim yog kwv yees li 12% ntawm tag nrho cov neeg mob. Cov kev mob tshwm sim ntau tshaj plaws ntawm cov tshuaj yuav tsum xav txog kev txhim kho ntshav qab zib (mob ntshav qab zib tsawg - txog 6% ntawm tag nrho cov neeg mob). Kev tsis haum tshuaj hauv zos rau kev tswj hwm ntawm cov tshuaj feem ntau kuj tseem muaj, uas suav nrog o, liab, khaus, mob ntawm daim tawv nqaij thiab urticaria. Raws li txoj cai, dhau los ntawm nws tus kheej hauv lub sijhawm txog li ob lub lis piam los ntawm kev pib kho. Thaum pib ntawm txoj kev kho yog feem ntau cuam tshuam nrog cov kev mob siab rau hauv retina ntawm lub pob muag, zoo li neuropathy ntawm nqaj nrog qhov kev cia siab ntawm qhov mob cuam tshuam. Cov kev tshwm sim yeej thim rov qab. Hauv thaj tsam ntawm cov hlab plawv thiab cov hlab plawv: cov ntshav qab zib hauv lub cev feem ntau yog pom, tachycardia yog tus tsos mob nrog hypoglycemia. Hauv lub plab zom mov thiab lub chaw tso pa tawm: cov tsos mob ua ke nrog lub xeev ntawm kev kub siab - "hma" kev tshaib plab, xeev siab. Hauv qhov teb ntawm lub zeem muag thiab hnov lus: kev hloov pauv hauv cov ntshav ncig hauv retina cuam tshuam nrog cov ntshav qab zib, qhov tsis pom kev. Hauv qhov kev ua haujlwm ntawm lub hauv nruab nrab lub paj hlwb: qee zaum mob neuropathy ntawm qhov mob siab heev. Hauv thaj teb ntawm dermatology: dystrophy ntawm subcutaneous adipose nqaij ntawm qhov chaw txhaj tshuaj yog tsis tshua pom. Ua xua: ntau zaus - urticaria, hloov nqaij hauv zos ntawm qhov chaw txhaj tshuaj, tsis tshua muaj - o ua pa ntawm txoj hlab pa. Cia rau cov neeg mobCov koob txhaj tshuaj nrog cov tshuaj ntsiav, uas tau qhib thiab siv, yuav tsum khaws cia hauv chav sov, kom deb ntawm cov khoom hluav taws xob, tawm ntawm qhov ncav cuag cov menyuam, tab sis tsis dhau plaub caug hnub. Cov tsis muaj koob txhaj tshuaj yuav tsum tau muab cia rau hauv tub yees ntawm qhov kub ntawm 2-8 degrees Celsius, deb ntawm qhov chaw tub yees txias. Tsis raug rau khov.
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