Cov npe lag luam thiab cov lus qhia rau kev siv cov tshuaj insulin Levemir

Saib xyuas! Saum toj no yog saib lub rooj, cov ntaub ntawv yuav raug hloov pauv. Cov ntaub ntawv hais txog tus nqi thiab muaj pauv hloov nyob rau ntawm lub sijhawm tiag tiag kom pom lawv - koj tuaj yeem siv cov kev tshawb nrhiav (cov ntaub ntawv qhia ib txwm dhau los hauv kev tshawb nrhiav), thiab tseem yog tias koj xav tau tawm ib qho kev txiav txim rau tshuaj, xaiv thaj chaw hauv nroog tshawb nrhiav, lossis tshawb nrhiav thaum qhib tam sim no cov khw muag tshuaj.

Cov npe saum toj no raug hloov kho yam tsawg kawg txhua 6 teev (nws tau hloov kho 07/15/2019 thaum 14:21 - lub sijhawm Moscow). Qhia txog tus nqi thiab muaj tshuaj los ntawm kev tshawb (lub npov tshawb no nyob rau sab saum toj), ntxiv rau hauv xov tooj hauv khw muag tshuaj ua ntej mus ntsib lub tsev muag tshuaj. Cov ntaub ntawv muaj nyob rau ntawm lub xaib tsis tuaj yeem siv los ua cov lus pom zoo rau kev siv tshuaj rau tus kheej. Ua ntej siv cov tshuaj, nco ntsoov sab laj nrog koj tus kws kho mob.

Cov Tshuaj Hauv Tshuaj

Levemir yog ib hom soluble basal tib neeg cov tshuaj insulin. Nws muaj qhov ua tau ntev ntev thiab siv rau kev kho mob basal ntawm cov neeg uas kuaj mob ntshav qab zib hom 1.

Cov tshuaj muaj tshwm sim pom tseeb txog qhov mob hnyav thiab qhov xwm ntawm cov nyhuv (yog tias peb piv nws nrog insulin glargine, nrog rau NPH-insulin). Nws cov kev kho mob ntev ntev tau cuam tshuam nrog kev sib txuam tseem ceeb ntawm cov kev teeb tsa ntawm insulin detemir, thiab tseem nrog cov tshuaj sib txuas ntawm cov tshuaj nquag nrog albumin (kev khi yog tshwm sim nrog kev koom tes ntawm cov saw txuas ntawm cov roj ntsha).

Nyob rau tib lub sijhawm, lub caij nyoog ntev ntawm cov tshuaj yog muab los ntawm lub peev xwm ntawm detemir insulin kom pom qis dua (yog tias cov ntsuas no piv nrog NPH-insulin) faib tawm hauv cov ntaub so ntswg. Cov txheej txheem sib xyaw ua ke rau ncua sij hawm ntev pab ua rau kom paub tseeb txheej txheem rau cov tshuaj.

Qhov tshuaj tiv thaiv kab mob ua rau cov tshuaj tiv thaiv yog vim muaj kev txhim kho hauv lub peev xwm ntawm lub hom phiaj cov ntaub so ntswg kom nqus tau cov piam thaj (tom qab cov tshuaj insulin nrog cov hnub xaus ntawm cov leeg, thiab tseem ua rau cov nqaij rog), thiab ntxiv rau qhov txo qis hauv lub peev xwm ntawm daim siab tso cov piam thaj.

Cov nyhuv ntawm cov tshuaj siv tau ntev kawg yog 24 teev (lub sijhawm pes tsawg yog nyob ntawm qhov ntau npaum li cas ntawm cov tshuaj tau siv), yog li koj tuaj yeem sau tshuaj ib zaug lossis ob zaug siv txoj kev daws teeb meem. Qhov nruab nrab, 2-3 koob tshuaj yog tsim nyog kom ua tiav kev tswj glycemic uas yuav tsum tau txhaj thaum muab ob zaug.

Thaum lub sijhawm ntsuas, kev siv tshuaj hauv ib feem ntawm 0.2-0.4 U / kg ua rau kev txhim kho ntawm 50% ntawm qhov siab tshaj plaws nyob rau ntawm 3-4 teev tom qab txhaj tshuaj (feem ntau, cov nyhuv ntev txog 14 teev).

Txoj kev daws teeb meem muaj qhov tsis xwm yeem tiv thaiv kab mob - tag nrho thiab lub siab kawg, nrog rau lub sijhawm ua haujlwm ntawm cov tshuaj yog sib npaug nrog qhov loj me ntawm cov tshuaj.

Kev siv mus ntev ntev ntawm cov tshuaj thaum lub sijhawm sim tshuaj tsom pom ib qho me me (piv rau qhov ntawd nrog kev qhia ntawm NPH-insulin) qhov sib txawv ntawm qib hauv cov piam thaj hauv qib ntshav.

Txawm li cas los xij, thaum lub sijhawm mus tshuaj xyuas ntev, cov kev hloov hauv lub cev hnyav dua tsis muaj zog hauv cov neeg tau txais Levemire (piv nrog rau cov tib neeg uas siv lwm hom tshuaj insulin).

Hauv cov neeg muaj ntshav qab zib hom 2 uas siv tshuaj insulin ntxiv rau kev kho mob nrog tshuaj tiv thaiv kab mob hauv lub qhov ncauj, muaj ib qho kev poob qis ntawm nocturnal hypoglycemia tom qab thov Levemir.

Hauv qee pawg ntawm cov neeg mob kho tom qab siv sijhawm ntev los ntawm kev siv tshuaj insulin detemir, qhov tshwm sim ntawm cov tshuaj tiv thaiv tau raug sau tseg, tab sis cov txiaj ntsig zoo sib xws tsis cuam tshuam rau kev kho kom zoo ntawm glycemic tswj.

Cov Tshuaj Pharmacokinetics

Peak qhov tseem ceeb ntawm cov nquag ua haujlwm ntawm cov tshuaj raug pom hauv cov ntshav tom qab 6-8 teev tom qab sc txhaj tshuaj. Nyob rau hauv kev tswjhwm ntawm kev daws ntawm ob zaug ib hnub, kev tswj hwm glycemic uas tsim nyog tau sau tseg tom qab thov kev thov 2-3 koob. Hauv cov pab pawg sib txawv ntawm cov neeg mob, muaj qhov sib txawv ntawm cov tib neeg sib txawv hauv qhov nqus tus nqi ntawm cov tshuaj tiv thaiv kev ua ub ua no (piv nrog kev siv lwm yam tshuaj insulin tseem ceeb).

Qhov tsis yooj yim ntawm bioavailability ntawm cov tshuaj yog kwv yees li 60% (tom qab sc tswj ntawm kev daws).

Qhov tseem ceeb ntawm cov feem me ntawm cov tshuaj raug xa mus rau sab hauv lub vascular txaj - qhov tseeb no tau qhia tau qhov ntsuas ntawm qhov ntsuas kev faib tawm txog 0.1 l / kg.

Kev ntsuam xyuas hauv vivo, zoo li hauv vitro, tsis tau qhia txog kev sib kis tseem ceeb ntawm cov insulin detemir hauv kev sib xyaw nrog cov roj lossis lwm yam tshuaj ua ke nrog cov protein.

Cov txheej txheem metabolic ntawm cov tshuaj nquag ntawm Levemir zoo ib yam li cov neeg uas ua nrog endulinous insulin. Txhua tus neeg raug dag zog ntawm cov tshuaj tsis muaj ib qho yeeb tshuaj.

Qhov ntsuas ntawm qhov kawg ib nrab-lub neej tom qab s / c tswj hwm ntawm cov tshuaj yog nyob ntawm qhov muaj nuj nqis ntawm kev nqus ntawm sab hauv subcutaneous txheej thiab, suav txog tus nqi, nce mus txog lub sijhawm 5-7 teev.

Txoj kev daws teeb meem muaj qhov tso tshuaj tsis yog.

Kev siv ntawm levemir thaum cev xeeb tub

Cov poj niam cev xeeb tub uas siv cov insulin detemir yuav tsum ua tib zoo saib xyuas cov piam thaj hauv ntshav dej. Thaum cev xeeb tub, lub cev xav tau cov insulin pauv, raws li qhov seem ntawm cov tshuaj yuav tsum tau kho. Thawj thawj peb lub hlis, muaj ib qho kev xav tau tsawg kawg rau qhov xav tau los ntawm insulin, tab sis nyob rau lub hlis thib ob thiab thib peb nws nce ntau. Tom qab yug menyuam, muaj qhov rov qab sai ntawm cov ntsuas ntawm qhov kev xav tau no mus rau qib uas tau pom ua ntej kev xeeb tub.

Levemir tsis muaj kev cuam tshuam tsis zoo rau lub sijhawm cev xeeb tub, nrog rau kev noj qab haus huv ntawm tus menyuam hauv plab, thiab thaum lub sijhawm kuaj tsis muaj qhov nce ntawm cov kab mob pathologies hauv menyuam.

Kev ntsuam xyuas nyob hauv cov tsiaj tsis tau ua pov thawj pom tias muaj kev phiv tshuaj lom rau hauv kev cuam tshuam ntawm kev ua me nyuam.

Tsis muaj ntaub ntawv hais txog kev nkag mus ntawm cov tshuaj mus rau niam mis. Qhov tshwm sim ntawm qhov cuam tshuam ntawm nws cov kev cuam tshuam ntawm cov menyuam mos uas noj niam mis tsis yog lub siab, vim tias cov khoom cais hauv sab hauv cov zom zaub mov, noj hom amino acids.

Nrog rau lactation, kev ua tib zoo xaiv ntawm cov feem me ntawm insulin, nrog rau kev noj zaub mov zoo, tsim nyog.

Phiv los ntawm Levemir

Feem ntau ntawm cov paib tiv thaiv tsis zoo thaum lub sijhawm kuaj cov tshuaj tiv thaiv yog qhov txiaj ntsig ntawm tshuaj tua kab mob los ntawm qhov tsis txaus los ntawm qhov tshwm sim ntawm kis tus kab mob.

Ntau zaus thaum siv cov tshuaj, cov neeg mob ua rau lub qog ntshav qab zib.

Hauv kev siv cov koob txhaj tshuaj rau kev txhaj tshuaj subcutaneous, cov tshuaj tiv thaiv hauv ib cheeb tsam yuav tsim - piv txwv, ntaub so ntswg, khaus, tawv nqaij hyperemia, thiab tseem hematomas ntawm qhov chaw txhaj tshuaj tau sau tseg. Ntxiv rau, cov cim dav dav ntawm qhov tsis haum yuav tshwm sim rau ntawm daim tawv nqaij, suav nrog khaus, ua xua thiab tawm pob.

Cov tsos mob hauv zos feem ntau ploj lawv tus kheej, yam tsis tas yuav tsum tau kho tshwj xeeb. Cov kev tshwm sim no tshaj plaws tshaj plaws nyob rau ntawm thawj theem ntawm kev siv tshuaj, kev siv maj mam tsawg zuj zus thaum lub sijhawm kho.

Thaum pib theem ntawm kev siv tshuaj insulin, kho cov neeg tuaj yeem txhim kho refractory kev mob, nrog rau cov nqaij hauv lub cev, uas ploj ntawm nws tus kheej thaum kho.

Nrog rau txoj kev loj hlob ntawm qhov muaj txiaj ntsig zoo nyob rau hauv kev tswj ntawm glycemia, cov neeg mob ntshav qab zib tuaj yeem tsim muaj mob neuropathy mob hnyav nyob rau theem mob (nws yog qhov tuaj yeem kho thiab tshwm sim vim muaj kev hloov pauv hauv cov ntshav qabzib muaj nuj nqis).

Nyob rau thawj theem ntawm kev kho mob, nrog rau kev txhim kho tseem ceeb hauv kev ua tau zoo ntawm glycemic tswj hauv cov neeg mob, kev hloov pauv qhov tsis zoo ntawm qhov kev kawm ntawm cov mob ntshav qab zib muaj peev xwm pom tau (hauv qhov no, kev tswj ntev thiab zoo glycemic txo qhov kev pheej hmoo ntawm kev txhim kho thiab kev loj hlob ntawm tus kab mob no).

Hauv tag nrho, thaum tom qab kev tshaj tawm thiab kev kuaj mob, cov kev mob tshwm sim hauv qab no tau sau tseg hauv cov neeg mob (cov tshuaj tiv thaiv tau pom tsuas yog nyob ntawm no):

• lub qhov txhab tiv thaiv kab mob: tawm pob, ua xua, urticaria thiab tshwm sim ntawm anaphylaxis,
• cov mob ntshaus siab: qhov kev txhim kho ntawm hypoglycemia,
• kev ntshawv siab nyob rau hauv nruab nrab lub paj hlwb: qhov tshwm sim ntawm polyneuropathy,
• kev tshwm sim ntawm cov khoom hauv lub plab (sensory plab hnyuv siab raum): kev mob ntshav qab zib ntawm kev ua yeeb yam rov qab, nrog rau cov mob tsis ua haujlwm ib ntus,
• qhov txhab mob cuam tshuam rau cov subcutaneous txheej thiab daim tawv nqaij: kev txhim kho lipodystrophy (qhov kev pheej hmoo ntawm tus kab mob no nce nrog cov kev pheej hno tshuaj ntawm thaj tsam ntawm daim tawv nqaij yam tsis tau hloov chaw txhaj tshuaj),
• cov cim hauv zos: o ib ntus, khaus thiab hyperemia.

Ib qho kev siv ntawm cov tshuaj tau ua rau pom qhov tsos mob ntawm tus mob anaphylaxis (ntawm cov mob zoo li no, muaj feem ua rau tuag taus). Yog tias tus neeg mob tau tsim muaj cov tsos mob ntawm anaphylaxis lossis Quincke's edema thaum kho, nws yuav tsum nrhiav kev pab kho mob sai.

Kev mob ntshav qab zib uas tshwm sim thaum siv Levemir feem ntau yog los ntawm kev xaiv tsis raug ntawm ib feem ntawm insulin, thiab ntxiv rau qhov no, kev hloov pauv ntawm cov zaub mov lossis lub cev ua si. Ib qho ntxiv, qhov pheej hmoo ntawm cov ntshav qog ntshav nce siab yog tias tus neeg mob tau mob, tiv thaiv qhov tshwm sim hyperthermia.

Kev mob ntshav qog ntshav hnyav tuaj yeem ua rau txhim kho qaug dab peg, tsis nco qab, thiab tom qab ntawd hloov mus rau lub cev hloov mus ib txhis thiab tas li. Ntawm cov thawj cov cim ntawm pathology: ib qho kev xav ntawm tsis muaj zog, tsaug zog thiab nqhis dej, tsis paub txog kev loj hlob, kev tsim tshee tshee, mob taub hau, mob taub hau, xeev siab thiab pom kev cuam tshuam, nrog rau cov tawv nqaij daj, ib qho kev xav ntawm kev tshaib plab thiab hws txias. Nws yuav tsum nco ntsoov tias cov tsos mob thaum ntxov ntawm tus kab mob tuaj yeem ua rau lawv tsis muaj zog nrog kev kho mob ntev ntev nrog kev siv tshuaj insulin, thiab ntxiv rau, nrog kev kho mob sib xyaw nrog lwm cov tshuaj thiab hauv cov neeg mob ntshav qab zib ntev.

Tsuas tshuaj thiab tswj hwm

Cov tshuaj yog muab tshuaj subcutaneously los ntawm ib tug cwj mem tshwj xeeb. Cov tshuaj muaj txiaj ntsig pab txhim kho cov tshuaj tua kab mob ua kom ntev (ntau tshaj 24 teev), yog li nws tuaj yeem siv rau hauv daim ntawv ntawm hom tshuaj insulin, muab ib zaug lossis ob zaug ib hnub. Nws raug tso cai siv cov tshuaj rau kev kho mob liab tshuaj nrog kev sib xyaw nrog cov tshuaj tiv thaiv insulin, liraglutide lossis tshuaj tiv thaiv kab mob hauv lub qhov ncauj.

Qhov loj me ntawm cov tshuaj tau txiav txim siab ib tus zuj zus, ib qho kev hloov pauv me me txhua hnub ntawm cov ntsuas qabzib hauv qab cov ntshav tau tso cai rau koj xaiv cov ntau npaum li cas ntawm cov tshuaj insulin kom raug raws li muaj peev xwm tswj tau glycemia.

Qhov luaj li cas ntawm qhov nruab nrab uas pom zoo ua thawj zaug muab tshuaj rau cov neeg noj tshuaj tiv thaiv kab mob hauv lub qhov ncauj yog 10 units lossis 0.1-0.2 units / kg ib hnub ib zaug. Nws yog ib qho tsim nyog tshwj xeeb tshaj yog saib xyuas qhov tseem ceeb ntawm cov piam thaj hauv cov ntshav ntawm thawj theem ntawm kev kho kom thiaj li xaiv tau qhov loj me.

Yog tias cov piam thaj muaj nuj nqis tom qab lawv muaj kev ntsuas ywj pheej rau ntawm lub plab khoob thaum sawv ntxov yog sib npaug ntau dua 10 mmol / l, qhov tshuaj ntawm cov tshuaj tau nce ntxiv 8 pawg, thiab yog tias cov nqi no nyob hauv thaj tsam ntawm 9.1-10, nrog rau 8.1-9 thiab 6.1 -8, koj yuav tsum nce ntxiv ntawm cov kev pabcuam los ntawm 6, 4 lossis 2 units, ntsig txog. Thaum cov piam thaj qhov ntsuas tau ntsuas raws li cov xwm txheej saum toj no yog 3.1–4 mmol / L, qhov koob tshuaj insulin detemir yuav tsum tau txo los ntawm 2 PIECES, thiab yog tias nws tsawg dua 3.1 mmol / L, nws yuav tsum tau txo 4 PIECES.

Tus kws kho mob tau sau tseg tias yuav tau txhaj tshuaj ntau npaum li cas, coj mus rau hauv qhov kev pabcuam pabcuam pabcuam thiab tus neeg mob xav tau cov tshuaj insulin.

Cov tib neeg uas yuav tsum tau txhaj tshuaj insulin ob zaug ib hnub yuav tsum tau qhia tus txheej txheem thib 2 ua ntej noj hmo lossis ua ntej yuav mus pw.

Nws yog ib qho tsim nyog yuav tsum tau coj mus rau hauv qhov kev txiav txim siab ntawm kev kho lub zog ntawm kev tawm dag zog ntawm lub cev thiab kev noj zaub mov, thiab ntxiv rau, kev ntxhov siab loj lossis kev txhim kho ntawm concomitant pathology tuaj yeem ua rau qhov kev hloov pauv ntawm cov tshuaj.

Kev Siv Levemir hauv qee pawg ntawm cov neeg mob.

Nws yuav tsum nco ntsoov tias nrog kev hloov pauv hauv kev ua haujlwm ntawm lub siab / raum, nws yuav tsum kho cov tshuaj ntau npaum li cas (txij li tus neeg mob xav tau insulin hloov). Koj yuav tsum ua tib zoo saib xyuas cov xwm txheej ntawm cov neeg los ntawm pab pawg no thiab hloov qhov kev pabcuam loj yog tias qhov txo qis hauv glycemic tswj tau pom.

Thaum lub sijhawm ntsuas, kev nyab xeeb thiab kho kev ua tau zoo ntawm kev siv tshuaj hauv cov neeg mob hnub nyoog 2 xyoos thiab laus dua tau sau tseg. Cov menyuam yaus xav tau cov tshuaj insulin yuav tsum ua tib zoo saib kom paub cov ntshav qabzib. Nws yog qhov yuav tsum tau ua tib zoo xaiv qhov ntau thiab tsawg ntawm cov tshuaj insulin rau cov menyuam.

Lub tswvyim ntawm kev hloov mus rau Levemir nrog lwm cov insulin.

Cov neeg uas yav dhau los siv cov insulins nrog lub sijhawm ntev lossis nruab nrab ntawm kev sib kis yuav tsum ua tib zoo xaiv cov tshuaj hauv cov txheej txheem ntawm kev hloov mus rau Levemir. Qhov kev siv yuav tsum tau ua tib zoo saib xyuas ntawm qib hauv piam thaj sab hauv lub ntshiab.

Kev kho mob ntshav qab zib ua ke yuav tsum tau tshuaj xyuas cov tshuaj thiab kev noj ntawm txhua yam tshuaj uas siv rau hauv kev hloov mus rau lwm hom tshuaj insulin.

Lub tswvyim rau kev tswj hwm kev daws tshuaj.

Kev txhaj tshuaj yog tsim nyog tsuas yog siv cov subcutaneous. Kev txhaj tshuaj rau cov leeg ntshav thiab txhaj tshuaj rau cov ntshav yog txwv. Nrog rau / hauv cov lus qhia ntawm insulin, hypoglycemia tuaj yeem tsim kho hauv ib qho qauv (hais txog thaum tuag).

Koj tsis tuaj yeem sau ntawv txhaj tshuaj ntawm cov tshuaj nrog cov tshuaj insulin uas muaj kev ua haujlwm ntawm kev tswj hwm tas mus li, cov tshuaj tuaj yeem muab tau los ntawm kev xaum xaum xwb.

Thaum s / c txhaj tshuaj yuav tsum xaiv ib qho chaw nyob hauv thaj chaw poj niam sab xub ntiag, sab xub pwg lossis pem hauv ntej peritoneum. Txhua qhov kev txhaj tshuaj tau pom zoo kom ua rau thaj chaw sib txawv ntawm lub cev (txawm tias nyob hauv thaj chaw me me xwb), txwv tsis pub txhim kho lipodystrophy tuaj yeem ua rau mob.

Lub sijhawm siv tshuaj tiv thaiv thiab qhov tshwm sim ntawm cov tshuaj tiv thaiv kab mob sib txawv tuaj yeem hloov mus rau hauv tus account cov ntshav khiav ceev, qhov kub thiab txias, qhov loj me ntawm cov tshuaj, qhov chaw txhaj tshuaj, nrog rau qhov ntsuas ntawm kev ua haujlwm (muaj feem nrog metabolic tus nqi thiab nqus ntawm lub hauv paus ntawm cov tshuaj).

Kev txhaj tshuaj yuav tsum tau ua nyob rau tib lub sijhawm ntawm hnub, qhov yooj yim tshaj plaws rau tus neeg mob.

Cov koob txhaj tshuaj yog siv ua ke nrog cov koob uas siv pov tseg (NovoTvist lossis NovoFayn), muaj qhov ntev ntawm 8 hli. Cov koob txhaj tshuaj muaj peev xwm hno li 1-60 ntu ntawm cov tshuaj insulin, kuj muaj kauj ruam 1 ntu.

Txheej txheem ntawm kev siv rab koob xev rau kev txhaj tshuaj.

Tus xaum xaum yog siv rau txoj kev tswj hwm ntawm Levemir cov tshuaj insulin.

Tswv yim ntawm kev txhaj tshuaj:

• Ua ntej pib kev qhia, nws yog ib qho tsim nyog yuav tsum kuaj xyuas hom insulin,
• tshem cov tiv thaiv lub hau ntawm cov koob txhaj tshuaj,
• hle cov ntim ntim ntawm rab koob siv ib leeg xwb, thiab tom qab ntawd muab khi kom ruaj rau hauv cov phwj,
• tshem cov hau sab nraud ntawm rab koob (koj yuav tsum txuag nws kom txog thaum kawg ntawm kev txhaj tshuaj),
• hle lub hau tiv thaiv sab hauv los ntawm rab koob thiab pov tseg tam sim ntawd,
• teeb tsa qhov loj me, tom qab uas koj tuaj yeem pib txhaj tshuaj. Txhawm rau teeb qhov tsuas tshuaj, koj yuav tsum siv tus xaiv tshwj xeeb,
• ntxig rau rab koob rau hauv qhov chaw xaiv, thiab tom qab ntawd nias lub khawm ntawm cov koob txhaj tshuaj,
• nws yog qhov yuav tsum tau tuav lub pob nyem clamped tsis tshem tawm rab koob tsawg kawg 6 vib nas this (kom nkag mus rau tag nrho cov pob),
• hle tawm rab koob tawm thiab hle nws tawm ntawm cov koob txhaj tshuaj, siv lub hau sab nraud tiv thaiv,
• kaw cov koob txhaj tshuaj nrog lub hau tiv thaiv.

Ib rab koob tshiab yuav tsum raug teeb tsa rau txhua qhov kev txhaj tshuaj. Yog tias rab koob puas ntsoog los yog khoov ua ntej txheej txheem, koj yuav tsum tau muab nws pov tseg thiab siv lub tshiab. Txhawm rau tiv thaiv kom tsis txhob raug mob uas xaum xaim nrog ib rab koob, nws raug txwv tsis pub tso rau sab hauv lub hau tiv thaiv ntxiv tom qab tshem tawm.

Ua ntej pib txoj kev tswj hwm kev siv tshuaj, koj yuav tsum xyuas cov tshuaj insulin tam sim no. Qhov no yog ua tiav raws li hauv qab no:

• koj yuav tsum teeb tus xaiv rau 2 chav nyob,
• tuav cov koob txhaj tshuaj nyob rau hauv txoj hauj lwm ncaj, nrog lub koob nce, maj mam muab coj mus rhaub rau nws hauv thaj chaw ntawm daim cartridge,
• tseem tuav syringe tsa sawv, koj yuav tsum nias lub khawm. Raws li qhov tshwm sim, tus metering selector yuav tsum rov qab mus rau 0, thiab ib qho tee tshuaj yuav tsum tshwm nyob rau qhov taub ntawm rab koob,
• yog hais tias tom qab ua tiav cov kev ntsuas saum toj no txoj kev daws teeb meem tsis tshwm sim, nws yog ib qho tsim nyog los hloov lub rab koob thiab rov ua cov txheej txheem tau piav qhia saum toj no,
• nws yog txwv tsis pub rov siv cov kev dag no ntau dua 6 zaug - nyob rau qhov uas tsis muaj txiaj ntsig tom qab xws li ntau qhov kev sim, nws tuaj yeem xaus lus tias koob txhaj tshuaj tsis zoo thiab yog li tsis siv nws ntxiv lawm.

Qhov seem nruab rau ntawm tus xaiv tau tso cai hloov ob qho tib si hauv kev txo qis thiab hauv kev nce ntxiv, rau lub hom phiaj no khij tus xaiv nyob rau hauv qhov xav tau. Thaum lub sij hawm teeb tsa ntawm kev noj tshuaj, koj yuav tsum ua tib zoo saib xyuas tias lub pob pib pib tsis nias (vim tias qhov no yuav ua rau cov tshuaj insulin to).

Nws yuav tsum nco ntsoov tias nws tsis tuaj yeem tsim qhov tshuaj rau lub koob txhaj tshuaj uas ntau tshaj qhov muaj cov tshuaj nyob sab hauv lub taub hau. Koj tseem tuaj yeem tsis siv cov nplai ntawm insulin seem rau xaiv cov servings.

Nws yog ib qho tsim nyog yuav tsum tau tshem tawm rab koob ntawm cov koob txhaj tshuaj tom qab txhua tus txheej txheem, vim tias yog koj tso nws nyob hauv qhov chaw, qhov no yuav ua rau cov tshuaj xau tawm.

Thaum lub sijhawm ua tiav ntawm kev txhaj tshuaj, cov kev cai aseptic feem ntau yuav tsum tau ua.

Nws tseem yuav tsum nco ntsoov tias daim phwj yog rau cov tib neeg siv nkaus xwb.

Kev ntxuav thiab tom qab khaws cia ntawm cov xaum xim.

Nws tsis raug nquahu kom siv cov koob txhaj tshuaj yog tias nws poob lossis deformed (vim tias qhov no tuaj yeem ua rau xau tshuaj ntawm cov tshuaj).

Qhov siv sab nrauv ntawm cov tes phwj uas siv yuav tsum tau muab ntxuav nrog cov ntaub plaub, uas yog pre-wetted hauv ethanol. Tsis txhob tuav phwj hauv qab cov dej ntws, ua kom ntub nws hauv cawv lossis ntub nws nrog ntau txoj kev.

Txwv tsis pub rov ntim cov taub hau yog txwv.

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Kev Sau, tso daim foos thiab txiav txim pharmacological

Tsuas tau yuav Levemir los ua cov tshuaj txhaj uas tau txhaj hauv qab daim tawv nqaij.

Cov khoom tseem ceeb ntawm cov pes tsawg leeg yog cov tshuaj insulin Detemir. Qhov khoom no zwm rau cov tshuaj ntawm tib neeg cov tshuaj insulin thiab yog tus cwj pwm kis los ntawm lub sijhawm ntev.

Kom ua hauj lwm zoo thiab nyab xeeb, Cheebtsam xws li:

• metacresol
• phenol
• zinc acetate
• glycerol
• sodium tshuaj dawb
• sodium hydroxide
• sodium hydrogen phosphate,
• dej.

Cov tshuaj yog cov kua ntshiab ntshiab yam tsis muaj xim.

Thaum noj ib qho tshuaj twg, koj yuav tsum paub dab tsi txiav txim siab los ntawm nws. Rau qhov no, nws lub zog pharmacological yuav tsum kawm. Cov tshuaj nquag ntawm cov tshuaj tau txais synthetically los ntawm kev siv DNA thev naus laus zis thev naus laus zis. Lub sijhawm siv ntawm cov tshuaj insulin no tau piav qhia los ntawm qhov tseeb tias nws nqus tau qeeb dua li nyob rau hauv cov teeb meem nrog luv thiab nruab nrab.

Kev sib txuas yog tsim los ntawm cov nquag tivthaiv thiab cov txais ntawm lub ntsej muag ntawm tes, vim tias qhov twg ntawm cov txheej txheem txheej txheem sai dua thiab qhov nqi ntawm enzyme ntau lawm.

Kev tso ntshav qab zib thiab kev faib tawm hauv cov nqaij yog tshwm sim sai, uas ua rau nws txo qis hauv plasma. Tsis tas li, Detemir muaj lub peev xwm los txo cov feem ntau ntawm cov piam thaj los ntawm lub siab.

Kev tsis haus cov tshuaj nyob ntawm tus neeg yam ntxwv ntawm tus neeg mob, noj thiab chaw txhaj tshuaj. Qhov hom tshuaj insulin no ua tau zoo nyob rau ntu sij hawm 6-8 teev tom qab txhaj tshuaj. Cov tshuaj raug faib nyob rau hauv kev saib xyuas ntawm 0.1 l / kg.

Thaum cov txheej txheem metabolic, Levemir tau hloov mus rau hauv cov roj ntsha uas tsis ua haujlwm, uas tawm los ntawm lub raum thiab daim siab. Ib nrab-lub neej ntawm ib yam khoom los ntawm lub cev tuaj yeem sib txawv ntawm 10 txog 14 teev. Lub sijhawm tiv thaiv ib ntu ntawm cov tshuaj nce mus rau ib hnub.

Kev taw qhia thiab contraindications

Ib qho tshuaj twg yuav tsum tsuas yog siv raws li cov lus qhia, thiab nws yog qhov zoo tshaj plaws kom nrhiav tau los ntawm koj tus kws kho mob. Tus kws kho mob tshwj xeeb yuav tsum tshawb xyuas daim duab ntawm tus kabmob, ua qhov kev ntsuas tsim nyog thiab tsuas yog tom qab ntawd - teem caij.

Cov tshuaj yog npaj rau kev kho mob ntshav qab zib. Nws tuaj yeem siv sib cais, ua cov tshuaj tseem ceeb, lossis lawv tuaj yeem xaiv cov kev kho nyuaj hauv kev sib xyaw nrog lwm txoj kev.

Nws ntseeg tau tias nws tsim nyog rau txhua tus neeg mob txij thaum muaj hnub nyoog rau xyoo, tab sis nws muaj qee qhov contraindications uas yuav tsum tau coj mus rau hauv:

• cov neeg rhiab rau hom insulin,
• cev xeeb tub
• kev pub mis
• laus lawm
• mob siab thiab mob raum.

Cov npe contraindications tsis nruj (tshwj tsis yog muaj kev zam txim rau tau). Hauv lwm qhov xwm txheej, kev siv tshuaj yeeb raug tso cai, tab sis nws yuav tsum tswj hwm los ntawm tus kws kho mob koom nrog thiab muab tshuaj kho rau qee qhov txawv txav los ntawm txoj kev npaj kho mob.

Cov lus qhia rau kev siv

Kev npaj tshuaj insulin yog qhov tseem ceeb heev rau cov neeg mob ntshav qab zib. Muaj qee kis, tsis muaj lawv, tus neeg mob tuaj yeem tuag taus. Tab sis tsis muaj kev phom sij tsawg yog tias koj tsis ua raws li txoj cai rau lawv siv. Levemir tseem yuav tsum tau siv raws li cov lus qhia, tsis tas hloov dab tsi uas tsis paub txog ntawm tus kws kho mob. Kev pib xyaum ua haujlwm hauv qhov xwm txheej zoo sib xws tuaj yeem hloov mus rau qhov mob hnyav.

Cov cuab yeej no tsuas yog siv los ntawm kev txhaj tshuaj, uas yuav tsum tau ua haujlwm rau subcutaneously. Lwm yam kev xaiv raug cais tawm. Nws yog qhov tsim nyog yuav tsum tau txhaj tshuaj nkaus xwb nyob rau qee thaj chaw - muaj qhov kev cia siab ntawm cov tshuaj yeeb dej caw sai dua, uas ua kom cov tshuaj muaj txiaj ntsig.

Cov chaw no suav nrog lub xub ntiag ntawm phab ntsa, xub pwg thiab ncej puab. Txhawm rau kom tsis txhob txhim kho kev phiv, koj yuav tsum tau hloov mus rau lwm qhov chaw txhaj tshuaj nyob rau hauv thaj chaw tshwj xeeb, txwv tsis pub cov tshuaj tsis tuaj yeem nqus tau raws li xav tau, uas txo cov kev kho kom zoo.

Cov koob tshuaj ntawm cov tshuaj yuav tsum tau txiav txim siab ntawm tus kheej. Qhov no tau cuam tshuam los ntawm ntau yam, suav nrog lub hnub nyoog ntawm tus neeg mob, nws cov kabmob ntxiv, hom mob ntshav qab zib, thiab lwm yam. Tsis tas li ntawd, cov koob tshuaj tuaj yeem hloov pauv, yog tias tsim nyog, hauv qhov loj dua lossis me. Tus kws kho mob tshwj xeeb yuav tsum saib xyuas chav kawm ntawm txoj kev kho mob, tshuaj xyuas qhov muaj zog thiab hloov pauv lub sijhawm rau kev txhaj tshuaj.

Kev txhaj tshuaj yog ua tiav 1 lossis 2 zaug hauv ib hnub, uas tau txiav txim siab raws li daim duab ntawm tus kabmob. Nws yog qhov tsim nyog tias lawv yuav tsum tau tuav ntawm kwv yees tib lub sijhawm.

Video qhia siv kev xaum xim:

Cov Neeg Mob Tshwj Xeeb thiab Cov Lus Qhia

Thaum sau daim ntawv yuav tshuaj, tus kws kho mob yuav tsum coj mus rau hauv qhov kev ceev faj yuav tsum muaj qee yam ntawm cov neeg mob, vim tias lub cev ntawm cov neeg no yuav tsis teb rau cov tshuaj raws li tau npaj tseg.

Cov neeg mob no suav nrog:

1. Cov menyuamCov. Tus neeg mob lub hnub nyoog qis dua 6 xyoo yog qhov laj thawj uas tsis kam siv cov tshuaj no. Cov kev tshawb fawb txog qhov tseem ceeb ntawm Detemir insulin rau cov menyuam yaus tseem tsis tau ua, yog li tsis txhob pheej hmoo rau lawv txoj kev noj qab haus huv.
2. Qub neegCov. Cov kev hloov pauv hauv hnub nyoog hauv lub cev tuaj yeem cuam tshuam qhov kev ua ntawm cov tshuaj hormones, vim tias tus neeg mob yuav muaj kev ntxhov siab. Yog li, ua ntej sau cov tshuaj, nws yog ib qho tsim nyog yuav tsum ua ib qho kev tshawb fawb kom pom cov kab mob dab tsi, dua li mob ntshav qab zib, ib tug neeg muaj. Tshwj xeeb yog ua tib zoo txheeb xyuas kev ua haujlwm ntawm lub raum thiab mob siab. Tab sis nws tsis tuaj yeem hais tias lub hnub nyoog laus yog nruj contraindication. Cov kws kho mob tshwj xeeb tshaj tawm txoj kev kho rau cov neeg mob zoo li no, tab sis saib xyuas lawv kev noj qab haus huv ntau dua thiab txo cov tshuaj tsawg.
3. Cov poj niam cev xeeb tubCov. Cov ntaub ntawv hais txog qhov ua tau raug mob los ntawm kev siv tshuaj insulin thaum lub sijhawm cev xeeb tub tsis muaj. Yog tias tsim nyog, cov cuab yeej tuaj yeem siv tau, tab sis nws yog qhov tsim nyog los tswj cov qib ntawm cov piam thaj, uas tuaj yeem sib txawv raws li lub sijhawm.
4. LactationCov. Txij thaum insulin yog protein ntau, nws nkag mus rau niam mis tsis suav tias yog kev phom sij rau cov menyuam yug tshiab - koj tuaj yeem siv Levemir ntxiv mus, tab sis koj yuav tsum ua raws li kev noj haus thiab ua raws li cov tshuaj uas kws kho mob tau hais tseg.

Ceev faj txog kev hwm rau cov neeg no yuav pab tiv thaiv kom tsis txhob phiv tshuaj thaum kho.

Kev saib xyuas tsis zoo tuaj yeem ua rau muaj kev phom sij txog kev sib raug zoo nrog cov neeg mob uas tsis ua haujlwm ntawm lub siab thiab lub raum. Cov tshuaj hormones cuam tshuam rau kev ua haujlwm ntawm lub siab, ua haujlwm qeeb hauv qab ntawm cov piam thaj.

Nrog rau daim siab ua haujlwm, cov nyhuv ntawm cov tshuaj yuav hypertrophied, uas ua rau lub xeev hypoglycemic.

Kev puas tsuaj hauv lub raum tuaj yeem ua rau ncua kev tshem tawm ntawm cov tshuaj lom neeg ua haujlwm hauv lub cev. Cov ntsiab lus no ua rau ua rau ntshav qis.

Txawm li cas los xij, nrog cov teeb meem zoo li no, lawv tsis kam lees siv cov tshuaj. Tus kws kho mob yuav tsum coj mus rau hauv tus lej qhov hnyav ntawm cov kab mob pathology thiab kho cov koob tshuaj ntau raws li cov cwj pwm no.

Phiv thiab haus tshaj

Thaum kho, nws yog qhov tseem ceeb heev uas yuav tsum them sai sai rau cov kev hloov pauv tshiab. Txoj kev ua haujlwm zoo yog qhov tseem ceeb, tab sis cov tsos ntawm cov tsos mob tsis zoo yog qhov tseem ceeb tshaj, vim tias cov xwm txheej tsis zoo qhia tau tias muaj teeb meem. Ntau zaus lawv tau tshwm sim los ntawm qhov tseeb uas siv cov tshuaj tsis haum rau tus neeg mob.

Tom qab kuaj xyuas kev tshuaj xyuas txog cov tshuaj, koj tuaj yeem pom tias ntawm cov kev mob tshwm sim tshwm sim yog:

1. Kev ntshav siab. Nws qhov tsos yog vim qhov ntau dhau ntawm koob tshuaj insulin, vim tias lub cev tau muaj qhov tsis txaus siab dhau los ntawm cov piam thaj. Qhov xwm txheej no tuaj yeem ua rau pom los ntawm ntau cov tsos mob, suav nrog kev tsis nco qab, xeev siab, tachycardia, tshee, thiab lwm yam.
2. Cov tsos mob hauv zosCov. Nws tau suav hais tias yog kev phom sij tshaj plaws, vim nws tshwm sim los ntawm lub cev tsis xwm yeem ntawm kev ua yeeb tshuaj. Tom qab lub sijhawm luv luv ntawm kev yoog, cov kev cuam tshuam no yog nruab nrab. Cov no suav nrog o ntawm qhov chaw txhaj tshuaj, liab ntawm daim tawv nqaij, ua pob.
3. Ua xuaCov. Yog tias koj yav dhau los ua qhov kev sim rau rhiab rau cov tshuaj hauv tshuaj, tom qab ntawd kev fab tshuaj tsis tshwm sim. Tab sis qhov no tsis tas ua tas li, yog li ntawd, ib tus neeg yuav hnov ​​tawm pob, khaus khaus, ua tsis taus pa, qee zaum txawm tias anaphylactic kev poob siab.
4. Pom kev tsis pom kevCov. Lawv qhov tshwm sim yog piav qhia los ntawm kev hloov pauv hauv cov kua nplaum nyeem. Sai li sai tau glycemic profile yog tus ruaj khov, kev ua txhaum yuav tsum tau muab tshem tawm.

Lub hauv paus ntsiab lus ntawm kev ua nyob rau hauv cuam tshuam nrog rau txhua sab tshwm sim yuav tsum tau xaiv los ntawm tus kws tshwj xeeb. Hauv qee kis, kev kho mob tus yam ntxwv yog tshuaj, nyob hauv lwm qhov, cov tshuaj kho mob raug muab tso tseg.

Vim tias qhov no, hypoglycemic lub xeev ntawm kev ua txhaum loj tshwm sim. Tus neeg mob tuaj yeem kho qhov teeb meem los ntawm kev noj zaub mov uas muaj cov khoom noj uas muaj cov carbohydrate ntau (yog tias qhov tshwm sim ntawm kev mob ntshav qab zib yog qhov tsawg). Thaum lub sijhawm nyuaj, yuav tsum tau txais kev kho mob.

Kev sib cuam tshuam nrog lwm yam tshuaj, analogues

Cov khoom lag luam ntawm cov tshuaj Levemir yog muaj zog los ntawm yam xws li nws qhov kev sib xyaw nrog lwm cov tshuaj. Daim ntawv sau yuav tshuaj, tus kws kho mob yuav tsum nrhiav pom hom tshuaj twg tus neeg mob siv. Qee qhov ntawm lawv tuaj yeem ua rau txo qis hauv cov txiaj ntsig ntawm cov tshuaj insulin.

Cov no suav nrog:

• tshuaj kho mob
• sympathomimetics
• muaj qee yam tshuaj tiv thaiv kev ntxhov siab,
• tshuaj hormonal.

Tseem muaj cov npe tshuaj uas txhim kho cov txiaj ntsig ntawm Levemir, uas ua rau muaj qhov tshwm sim ntawm kev noj tshuaj ntau dhau thiab phiv.

• sulfonamides,
• beta blockers,
• MAO thiab ACE inhibitors,
• tetracyclines
• cov kab mob hypoglycemic.

Thaum siv cov nyiaj saum toj no, ua ke nrog cov tshuaj insulin, nws yuav tsum kho qhov koob tshuaj nce siab lossis nqis.

Sib piv cov yam ntxwv ntawm cov insulin Lantus thiab Levemir:

Nws tsis tsim nyog los hloov Levemir nrog lwm cov tshuaj ntawm koj tus kheej, rau qhov no koj xav tau kev paub tshwj xeeb uas tus kws tshaj lij muaj.

Qhov tseem ceeb ntawm cov analogues yog:

1. ProtafanCov. Cov tshuaj no tseem raug muag raws li kev daws teeb meem. Nws lub ntsiab tivthaiv yog insulin Isofan. Nws siv yog tsim nyog rau cov neeg mob uas nws lub cev nkag siab rau Detemir.
2. Neeg lim hiamCov. Nws sawv cev los ntawm cov tshuaj siv raws li tib neeg cov insulin.

Tsis tas li, tus kws kho mob tuaj yeem sau tshuaj rau qhov ncauj hypoglycemic, uas muaj cov ntsiab cai zoo sib xws, tab sis ib txoj kev sib txawv ntawm kev siv.

Cov tshuaj yuav muag hauv khw muag tshuaj ntawm tus nqi ntawm 2500 txog 3000 rubles. Yuav nws, koj xav tau daim ntawv qhia.