INSULIN NOVORAPID: TSHUAJ XYUAS, COV LUS QHIA, TUS NQI

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Qhov no yog yeeb tshuaj nrog cov nyhuv hypoglycemic, uas yog ib qho piv txwv ntawm luv luv ua yeeb yam rau cov neeg insulin. Cov tshuaj insulin novorapid yog tsim los ntawm txoj kev tso tawm DNA biotechnology txoj kev siv tshuaj Saccharomyces cerevisiae lim, thaum cov kab mob (amino acid) ntawm txoj hauj lwm B28 hloov nrog aspartic acid.

Cov tshuaj no khi rau cov receptors tshwj xeeb nyob rau sab nraud cytoplasmic membrane ntawm cov hlwb.

Raws li qhov tshwm sim, ib qho insulin-receptor complex tau tsim, uas ua rau qee cov txheej txheem hauv cov hlwb, nrog rau kev ua kom cov synthesis ntawm cov enzymes tseem ceeb (glycogen synthetase, hexokinase, pyruvate kinase).

Kev txo qis hauv cov concentration ntawm cov piam thaj hauv cov ntshav tshwm sim los ntawm qhov kev nce ntxiv hauv nws txoj kev thauj hauv cov hlwb, ua kom cov kab mob sib kis los ntawm cov ntaub so ntswg ntawm lub cev, thiab tseem vim qhov kev txhawb ntawm cov txheej txheem ntawm glycogenogenesis, lipogenesis thiab txo qis ntawm cov ntshav qabzib tsim nyob rau hauv lub siab.

Thaum hloov cov amino acid proline ntawm qhov chaw B28 nrog aspartic acid nyob rau hauv Novo Rapid Flexpen tshuaj, cov nyiam ntawm cov lwg me me los tsim hexamers poob qis, thiab cov nyiam no tau khaws cia hauv kev daws teeb meem ntawm cov tshuaj insulin.

Hauv qhov no, cov tshuaj no tau zoo dua nqus los ntawm kev tswj hwm subcutaneous, thiab nws cov kev coj ua tshwm sim ntau ntxov dua li ntawm kev kho nyob rau hauv tib neeg cov tshuaj insulin.

NovoRapid Flexpen txo cov ntshav qabzib hauv thawj plaub teev tom qab noj zaub mov zoo dua li cov kua dej ntawm tib neeg. Hauv cov neeg uas muaj hom ntshav qab zib hom mellitus, thaum siv tus neeg sawv cev no, qis dua tom qab cov piam thaj yog pom hauv qhov sib piv nrog tib neeg cov tshuaj insulin.

Novo Rapid Flexpen muaj lub sijhawm sijhawm luv dua ntawm kev ua nrog kev tswj hwm subcutaneous dua li cov neeg tsis txaus siab rau lub cev.

Nrog kev txhaj tshuaj subcutaneous, cov tshuaj pib ua hauv kaum rau nees nkaum feeb, thiab cov txiaj ntsig siab tshaj plaws tsim tawm 1 mus rau 3 teev tom qab kev tswj hwm. Lub sijhawm tiv thaiv ntawm cov tshuaj yog peb mus rau tsib teev.

Kev siv Novo Sai nrawm rau hauv cov neeg mob ntshav qab zib nrog hom 1 yam yuav txo qhov kev pheej hmoo ntawm nocturnal hypoglycemia piv rau kev tiv thaiv tib neeg lub cev. Ib qho kev pheej hmoo tseem ceeb ntawm cov neeg mob hypoglycemia ntau ntxiv thaum nruab hnub tsis pom.

Cov tshuaj no nyob rau hauv cov nqe lus ntawm molarity yog equipotential rau tib neeg soluble insulin.

Cov Tshuaj Pharmacokinetics

Xuas

Nrog kev tswj hwm ntawm subulinaneous ntawm cov tshuaj insulin, aspart muaj 2 lub sijhawm luv dua mus cuag lub siab nyob rau hauv ntshav ntshav ntau dua nrog kev qhia txog soluble tib neeg cov insulin.

Qhov siab tshaj plaws ntawm plasma cov ntsiab lus yog nyob rau nruab nrab 492 + 256 mmol / litre thiab ua tiav thaum cov tshuaj tau muab rau cov neeg mob uas muaj ntshav qab zib hom 1 ntawm qhov siab ntawm 0.15 U / kg lub cev hnyav tom qab txog plaub caug feeb. Txog qib pib, cov ntsiab lus insulin los 5 tom qab kev txhaj tshuaj.

Hauv hom 2 mob ntshav qab zib mellitus, qhov nqus dej poob qis me ntsis thiab qhov no piav qhia qhov qis siab tshaj plaws (352 + 240 mmol / litre) thiab lub sijhawm ntev dua ntawm nws qhov ua tiav (kwv yees li ib teev).

Lub sij hawm mus cuag qhov siab tshaj plaws nyob rau hauv insulin aspart yog luv dua thaum siv soluble tib neeg cov tshuaj insulin, thaum lub sij hawm sib hloov sib txawv hauv cov concentration rau nws yog ntau dua.

Pharmacokinetics hauv cov chaw kuaj mob tshwj xeeb

Ua haujlwm rau lub chaw muag tshuaj ntawm cov tshuaj no tsis tau coj los ua rau cov neeg laus thiab cov neeg tsis muaj nplooj siab lossis lub raum tsis ua haujlwm.

Hauv cov menyuam muaj hnub nyoog 6 mus rau kaum ob xyoos, nrog rau cov hluas txij thaum 13 txog 17 xyoo, uas muaj ntshav qab zib hom 1, insulin aspart yog nqus sai nyob rau ob leeg hnub nyoog, thiab lub sijhawm kom ncav cuag lub siab tshaj plaws yog sib npaug rau lub sijhawm ntawm cov neeg laus.

Tab sis ntawm ob pab pawg hnub nyoog no muaj qhov sib txawv ntawm qhov ntau ntawm qhov xav tau, yog li nws tseem ceeb heev rau kev xaiv ib tus zuj zus ntawm cov tshuaj nyob ntawm seb pab pawg hnub nyoog twg tus neeg mob nyob ua ke.

Cov Khoom Qhia

Ntshav qab zib mob ntshav insulin-tiv thaiv kab mob ntshav (thawj hom).
Cov kab mob ntshav qab zib tsis yog-insulin-hom mob ntshav qab zib hom (hom 2) nyob rau theem ntawm kev tawm tsam cov tshuaj tiv thaiv kab mob hauv qhov ncauj los yog nrog ib feem ntawm cov tshuaj no (ua ib feem ntawm txoj kev kho mob), thiab nrog rau cov kab mob sib kis.

Tsuas tshuaj

Novo Rapid Flexpen muaj kev subcutaneous thiab txoj leeg ntshav ntawm kev tswj hwm. Cov tshuaj no pib ua kom nrawm dua thiab muaj lub sijhawm luv luv ntawm cov txiaj ntsig tshaj ntawm kev txhim kho tib neeg cov kua dej.

Nws yuav tsum raug tswj hwm ua ntej ua ntej noj mov lossis tam sim ntawd tom qab noj mov (vim qhov pib ntawm lub luag haujlwm sai).

Rau txhua tus neeg mob tshwj xeeb, tus kws kho mob xaiv cov koob tshuaj insulin ib leeg zuj zus, raws li cov piam thaj hauv cov ntshav. Novo Rapid Flexpen feem ntau yog ua ke nrog lwm cov tshuaj insulin (ua yeeb yam ntev lossis nruab nrab ntev), uas tau tswj hwm tsawg kawg ib zaug ib hnub.

Feem ntau, ib tug neeg xav tau cov tshuaj insulin txhua hnub yog li ntawm 0.5 thiab 1 U / kg lub cev qhov hnyav. Qhov kev xav tau no yog 50-70% txaus siab los ntawm kev qhia ntawm cov tshuaj Novo Sai nrawm Flexpen ua ntej noj mov, thiab cov nyiaj seem tau noj nrog lub sij hawm ntev insulin.

Nrog rau kev qhia ntawm qhov kub ntawm cov tshuaj yuav tsum sib haum rau qhov kub ntawm huab cua.

Txhua tus xaum xaum rau insulin muaj qhov siv ib tus kheej thiab nws yog txwv tsis pub sau ntxiv.

Yog tias Novo Ceev nrawm siv nrog rau lwm cov insulins hauv Flexpen cwj mem koob txhaj tshuaj, tom qab ntawd rau kev qhia ntawm txhua hom insulin nws yog qhov tsim nyog los siv kev sib cais txhaj tshuaj.

Ua ntej qhia cov tshuaj no, nws yog ib qho tsim nyog yuav tsum kuaj xyuas lub ntim, nyeem lub npe thiab paub tseeb tias hom insulin yog xaiv raug.

Tus neeg mob ib txwm yuav tsum tau kuaj lub duav nrog cov tshuaj, suav nrog cov roj hmab piston. Tag nrho cov lus pom zoo tau piav qhia txhua yam hauv cov lus qhia rau cov tshuaj insulin. Cov roj hmab nyias nyias yuav tsum tau kho nrog tus pas rwb los so nrog rau hauv cawv.

Nws yog txwv tsis pub siv cov tshuaj Novo Sai nrawm Flexpen yog tias:

lub taub hau tsheb los yog daim ntawv xaum hluav taws xob tau nqis;
lub laub raug nplawm los yog puas ntsoog, vim tias qhov no yuav ua rau cov kua dej hauv cov dej tuaj;
pom cov ntu ntawm cov roj hmab piston yog qhov dav dua li cov hlua dawb;
cov tshuaj insulin tau muab tso rau hauv cov xwm txheej uas tsis phim rau cov uas tau teev tseg hauv cov lus qhia, lossis khov;
cov tshuaj insulin tau dhau los ua xim los sis cov tshuaj yog pos huab.

Rau kev txhaj tshuaj, rab koob yuav tsum tau muab tso rau hauv qab daim tawv nqaij thiab nias lub khawm pib txhua txoj kev. Tom qab txhaj, koob txhaj tshuaj yuav tsum tau nyob hauv qab daim tawv nqaij tsawg kawg 6 feeb. Lub khob ntim xaum yuav tsum nias kom txog thaum lub koob raug tshem tawm tag nrho.

Tom qab txhua qhov kev txhaj tshuaj, rab koob yuav tsum tau muab tshem tawm, vim tias yog tias qhov no tsis ua tiav, ces cov kua los ntawm daim cartridge yuav tawm tuaj (vim yog qhov kub tsis sib xws) thiab cov concentration ntawm cov kua dej yuav hloov pauv.

Txwv tsis pub rov qab rau daim cartridge nrog cov kua dej yog txwv.

Thaum siv cov txheej txheem insulin rau lub caij nyoog ntev ua ntej, yuav tsum ua raws li cov cai hauv qab no:

Cov hlab siv nrog sab hauv polyolefin lossis polyethylene yuav tsum dhau kev tswj hwm thiab pom zoo rau kev siv hauv cov txheej txheem thau khoom.
Ib qhov nqi ntawm cov insulin, txawm hais tias nws txoj kev ruaj khov, tuaj yeem nqus tau los ntawm cov khoom uas cov kab ke ua.
Thaum siv Novo Cov twj siv ceev nrawm, nws tsis tuaj yeem ua ke nrog lwm hom insulin.
Txhua tus kws kho mob cov lus qhia thiab cov lus qhia siv Novo Sai nrawm rau hauv lub twj tso kua mis yuav tsum ua raws li kev cai.
Ua ntej koj pib siv lub system, koj yuav tsum ua tib zoo kawm cov ntaub ntawv ntawm kev ntsuas uas yuav tsum tau ua thaum muaj mob, nce lossis txo qis cov ntshav qab zib lossis thaum lub hlwb ua haujlwm tawg.
Ua ntej txhaj koob, tes thiab tawv nqaij yuav tsum ntxuav nrog xab npum kom tiv thaiv tau kab mob ntawm qhov chaw txhaj tshuaj.
Thaum txhaws lub tank, nco ntsoov tias tsis muaj cua loj npuas hauv lub phwj lossis raj.
Hloov cov hlab thiab koob tsuas yog ua raws cov lus qhia uas tuaj nrog txoj kev lis ntshav no.
Nws yog ib qho tsim nyog yuav tsum tau soj ntsuam txuas ntxiv cov kev mloog ntawm cov piam thaj nyob rau hauv kev txiav txim siab kom paub tseeb tias qhov ua tau tawg ntawm insulin twj tso kua mis thiab tiv thaiv kev ua txhaum ntawm carbohydrate metabolism.
Thaum ua tsis tiav ntawm cov tshuaj insulin twj tso kua mis, koj yuav tsum nco ntsoov khaws cov tshuaj insulin rau cov kab mob subcutaneous nrog koj kom tiv thaiv kev txhim kho hyperglycemia.

Sab sij huam

Cov kev mob tshwm sim los ntawm cov tshuaj cuam tshuam nrog nws cov nyhuv ntawm cov metabolism hauv kev ua kom rog yog hypoglycemia. Nws ces:

nce hws;
pallor ntawm daim tawv nqaij;
tshee hnyo, tshee hnyo, ntxhov siab;
qaug zog lossis txawv txawv;
ua txhaum ntawm kev xav thiab taw qhia hauv qhov chaw;
kiv taub hau thiab mob taub hau;
zoo nkaus kev tshaib kev nqhis;
tsis pom kev ib ntus;
tachycardia, poob siab.

Kev mob ntshav khov ntau heev tuaj yeem ua rau qhov tsis meej pem thiab tsis nco qab, ua rau lub hlwb khiav tsis zoo (ib ntus lossis hloov tsis tau) thiab tuag.

Kev ua xua tshwm sim tsis xws luag, urticaria lossis ua pob rau ntawm daim tawv nqaij yuav tshwm sim. Anaphylactic shock tsis tshua muaj tshwm sim. Kev phiv txhua yam tuaj yeem pom tshwm los ntawm daim tawv nqaij ua pob khaus, khaus khaus, tawm hws ntau ntxiv, mob plab zom mov, mob caj dab, mob tachycardia thiab txo qis siab, ua pa nyuaj.

Kev tawm tsam hauv zos (ua kom tawv nqaij liab, liab, khaus ntawm qhov chaw txhaj tshuaj) feem ntau yog ib ntus thiab dhau mus raws li kev kho mob txuas ntxiv.

Tsis tshua muaj, lipodystrophy tuaj yeem tshwm sim.

Lwm cov kev phiv suav nrog kev o (tsis tshua muaj) thiab tsis hnov qab (nyob tsis tau). Cov tshwm sim no feem ntau kuj yog ib ntus.

Qhov kev txiav txim ntawm cork ntawm Novo Rapid Flexpen feem ntau yog koob tshuaj thiab tshwm sim vim qhov kev txiav txim ntawm pharmacological ntawm cov tshuaj insulin.

Cov Yuav Tsum Muaj

Kev ntshav siab.
Ib leeg tsis kam rau insulin aspart lossis lwm yam tshuaj ntawm cov tshuaj.
Novo Rapid Flexpen tsis siv rau cov menyuam yaus hnub nyoog qis dua rau xyoo, vim tias tsis muaj kev tshawb fawb txog yam muaj feem cuam tshuam.

Cev xeeb tub thiab lactation

Tsis muaj kev paub ntau nrog kev siv Novo Sai nrawm Flexpen hauv cov poj niam cev xeeb tub. Cov kev sim hauv cov tsiaj sim tsis tau qhia qhov sib txawv ntawm insulin aspart thiab tib neeg insulin hauv embryotoxicity thiab teratogenicity.

Thaum lub sijhawm yug menyuam thiab tag nrho lub sijhawm cev xeeb tub, koj yuav tsum ua tib zoo saib xyuas tus pojniam muaj ntshav qab zib, thiab saib xyuas cov ntshav qabzib hauv cov ntshav.

Hauv thawj peb lub hlis, feem ntau xav tau cov tshuaj insulin txo qis, thiab hauv seem thib ob thiab thib peb cov kab kev pib nce zuj zus.

Thaum yug menyuam thiab tam sim ntawd tom qab lawv, qhov kev xav tau yuav poob dua. Feem ntau, tom qab yug menyuam tas, nws maj nroos rov qab mus rau theem pib uas yog ua ntej muaj menyuam.

Thaum lub sijhawm pub mis niam, kev siv Novo Rapid Flexpen yog kev tso cai yam tsis muaj kev txwv, vim nws txoj kev tswjfwm rau tus pojniam laus tsis ua rau menyuam muaj kev phom sij. Tab sis qee lub sijhawm nws tsim nyog los ua cov kev hloov kho koob tshuaj.

Noj ntau dhau

Cov tsos mob tseem ceeb ntawm kev siv ntau tshaj yog hypoglycemia, qee kis, kev kho mob kub ceev rau hypoglycemic coma kuj yuav tsum tau.

Nrog rau qhov kev kawm qib siab me me, tus neeg mob tuaj yeem tiv thaiv nws tus kheej los ntawm kev noj zaub mov qab zib, piam thaj lossis carbohydrate. Cov neeg mob yuav tsum muaj qab zib, ncuav qab zib los yog kua txiv ntoo nrog lawv ua ke txhua lub sijhawm.

Hauv cov ntshav qog ntshav hnyav thiab tsis nco qab, tus neeg yuav tsum txhaj 40% qabzib cov ntshav ua kom haum, subcutaneously lossis intramuscularly glucagon nyob rau hauv ib koob ntawm 0.5-1 mg.

Tom qab nws rov qab nco qab, tus neeg mob yuav tsum noj zaub mov carbohydrate kom tiv thaiv kom tsis txhob mob ntxiv ntshav qab zib.

Cia rau cov neeg mob thiab txee lub neej

Cov tshuaj muaj npe B.

Cov pob tsis tau qhib yuav tsum muab cia rau hauv tub yees ntawm qhov txias ntawm 2-8 degrees. Tsis txhob tso cov tshuaj insulin ze rau hauv lub tub yees thiab khov. Yuav tsum hnav lub taub hau tiv thaiv tiv thaiv Novo Rapid Flexpen los ntawm lub teeb.

Lub txee lub neej ntawm cov tshuaj yog 2 xyoos.

Nws tsis pom zoo kom khaws cov xwj syringe pib hauv lub tub yees. Lawv tsim nyog siv nyob rau hauv 1 hlis tom qab qhib thiab khaws cia ntawm qhov kub ntawm tsis ntau tshaj 30 degrees.