Raws li cov lus pom zoo los ntawm Ministry of Health, kev kho mob insulin hauv hom 2 ntshav qab zib tau pib nrog insulin ntev lossis nrog biphasic. NovoMix (Novomix) - nto moo tshaj plaws ob-theem sib xyaw ua los ntawm ib tus thawj coj kev lag luam hauv cov tshuaj tiv thaiv ntshav qab zib, lub tuam txhab NovoNordisk los ntawm Denmark. Kev qhia ua ntu zus ntawm NovoMix rau kev kho mob tso cai rau kev tswj ntshav qab zib kom zoo dua, pab kom zam dhau nws cov kev mob ntau yam. Cov tshuaj muaj nyob hauv daim cartridges thiab cov xaum xaum qhuav.
Txoj kev kho mob pib nrog 1 txhaj tshuaj ib hnub, thaum tshuaj ntsiav hypoglycemic tsis tso tseg.
Cov lus qhia rau kev siv
NovoMix 30 yog kev daws teeb meem rau subcutaneous thawj tswj hwm, uas muaj:
- 30% ntawm cov insulin tsis tu ncua. Nws yog cov tshuaj tiv thaiv hluav taws xob cov khoom siv ntawm cov tshuaj insulin thiab kev ua tom qab 15 feeb txij li lub sijhawm tswj hwm.
- 70% puas tsuaj aspart. Qhov no yog qhov nruab nrab ntawm kev ua yeeb yam, lub sijhawm ua haujlwm ntev yog ua tiav los ntawm kev sib txuas ntawm aspart thiab protamine sulfate. Ua tsaug rau nws, qhov kev txiav txim ntawm NovoMix kav ntev mus txog 24 teev.
Cov tshuaj uas muab cov tshuaj insulin nrog cov sij hawm sib txawv ntawm cov tshuaj hu ua biphasic. Lawv tsim los them rau cov mob ntshav qab zib hom 2, vim lawv tau txais txiaj ntsig zoo tshaj rau cov neeg mob uas tseem tsim lawv cov tshuaj hormones. Nrog rau hom kab mob 1, Novomix yog cov kws kho mob uas tsis tshua muaj mob yog tias cov ntshav qab zib tsis tuaj yeem suav lossis tswj cov insulin cais luv thiab ntev. Feem ntau cov no yog cov neeg laus lossis cov neeg mob hnyav.
| Kev piav qhia | Zoo li txhua yam tshuaj nrog cov tshuaj tiv thaiv, NovoMix 30 tsis yog cov tshuaj ntshiab, tab sis ncua kev kawm. Thaum so, nws exfoliates nyob rau hauv lub raj mis rau hauv translucent thiab dawb feem, flakes tuaj yeem pom. Tom qab sib tov, cov ntsiab lus ntawm lub vial ua tusyees dawb. Tus txheem insulin txheem hauv kev daws yog 100 units. |
| Tso daim ntawv thiab tus nqi | NovoMix Penfill yog 3 ml iav cartridges. Ib qho kev daws teeb meem ntawm lawv tuaj yeem raug tswj hwm uas yog siv cov koob txhaj tshuaj lossis koob txhaj tshuaj ntawm lub chaw tsim khoom qub: NovoPen4, NovoPen Echo. Lawv sib txawv hauv cov qib theem tshuaj, NovoPen Echo tso cai rau koj hu rau ib koob hauv qhov sib npaug ntawm 0.5 units, NovoPen4 - hauv qhov sib npaug ntawm 1 chav tsev. Tus nqi ntawm 5 daim cartridge NovoMix Penfill - txog 1700 rubles. NovoMix Flexpen yog ib qho kev npaj tau siv ib tus cwj mem nrog ib theem ntawm 1 chav tsev, koj tsis tuaj yeem hloov lub pob nyob hauv lawv. Txhua tus muaj 3 ml ntawm insulin. Tus nqi ntawm ib pob ntawm 5 syringe cwjmem yog 2000 rubles. Cov tshuaj nyob rau hauv cartridges thiab cwjmem yog qhov zoo ib yam, yog li ntawd tag nrho cov ntaub ntawv hais txog NovoMix FlexPen siv rau Penfill. Original NovoFine thiab NovoTvist koob yog haum rau txhua qhov NovoNordisk koob txhaj tshuaj. |
| Nkaus | Insulin aspart yog nqus los ntawm cov nqaij mos subcutaneous mus rau hauv cov ntshav, qhov twg nws ua lub luag haujlwm zoo li cov insulin endogenous: nws txhawb txoj kev hloov chaw ntawm cov kua nplaum mus rau hauv cov ntaub so ntswg, feem ntau cov leeg thiab cov rog, thiab inhibits synthesis ntawm qabzib los ntawm daim siab. NovoMix tsis siv cov tshuaj insulin biphasic rau kev txhim kho sai ntawm hypoglycemia, vim tias qhov muaj kev pheej hmoo loj heev los ua rau muaj kev cuam tshuam ntawm ib koob rau lwm, uas tuaj yeem ua rau lub siab tsis nco qab lawm. Rau kev txo nrawm ntawm cov piam thaj hauv siab, tsuas yog insulins ceev tau haum. |
| Cov Khoom Qhia | Mob ntshav qab zib mellitus yog ob hom tshuaj feem ntau - 1 thiab 2. Txoj kev kho mob tuaj yeem kho rau menyuam yaus txij li 6 xyoo. Hauv cov menyuam yaus, cov neeg mob ntawm hnub nyoog nruab nrab thiab laus, lub sijhawm ntawm kev ua thiab kev tawm ntawm lub cev yog nyob ze. |
| Xaiv xaiv | Qhov koob tshuaj NovoMix insulin yog xaiv nyob rau hauv ntau theem. Tus mob ntshav qab zib hom 2 pib tswj cov tshuaj nrog 12 ntu. ua ntej noj hmo, tseem tso cai qhia ob chav thaum sawv ntxov thiab yav tsaus ntuj ntawm 6 chav. Tom qab pib kev kho mob rau 3 hnub, glycemia yog tswj hwm thiab qhov tshuaj ntawm NovoMix FlexPen tau kho raws li cov txiaj ntsig tau. |
| Hloov hauv kev xav tau hauv insulin | Cov tshuaj insulin yog ib qho tshuaj hormones, lwm cov tshuaj hormones cuam tshuam hauv lub cev thiab tau los ntawm cov tshuaj tuaj yeem cuam tshuam nws txoj haujlwm. Hauv qhov no, qhov kev txiav txim ntawm NovoMix 30 tsis ruaj khov. Txhawm rau ntsuas normoglycemia, cov neeg mob yuav tsum nce ntxiv ntawm cov tshuaj nrog cov kev tawm dag zog lub cev tsis zoo, kis kab mob, ntxhov siab. Kev noj tshuaj ntxiv yuav tuaj yeem ua rau muaj kev hloov hauv glycemia, yog li ntawd, yuav tsum muaj kev ntsuas ntsuas qab zib ntau zaus. Kev saib xyuas tshwj xeeb yuav tsum them rau cov tshuaj hormonal thiab antihypertensive. |
| Sab sij huam | Thaum pib ntawm insulin txoj kev kho, edema, o, liab lossis ua pob rau ntawm thaj chaw txhaj tshuaj. Yog tias muaj piam thaj ntau dua li ib txwm muaj, qhov muag pom, qhov mob nyob hauv qis qis yog ua tau. Tag nrho cov kev mob tshwm sim tsis pub dhau lub crescent tom qab pib ntawm kev kho mob. Tsawg dua 1% ntawm cov neeg mob ntshav qab zib muaj lipodystrophy. Lawv raug ntxias tsis yog los ntawm cov tshuaj nws tus kheej, tab sis los ntawm kev ua txhaum ntawm cov txheej txheem ntawm nws cov thawj coj: rov qab siv rab koob, ib qho thiab tib qhov chaw txhaj tshuaj, qhov tsis yog qhov tob ntawm kev txhaj tshuaj, cov tshuaj txias. Yog tias muaj cov tshuaj insulin ntau dua li qhov xav tau los ua kom cov ntshav huv ntxiv cov ntshav qab zib, kev mob ntshav qab zib tsawg. Cov lus qhia rau kev siv ntsuas nws txoj kev pheej hmoo ntau npaum li ntau tshaj 10%. Kev mob ntshav qab zib yuav tsum raug tshem tawm sai sai tom qab kuaj pom, vim nws daim ntawv hnyav ua rau lub hlwb tsis ua haujlwm thiab tuag. |
| Cov Yuav Tsum Muaj | Novomix tsis tuaj yeem muab cov tshuaj khov, siv rau hauv cov tshuaj insulin. Cov tshuaj tiv thaiv rau cov tshuaj hauv cov menyuam yaus hnub nyoog qis dua 6 xyoo tsis tau kawm, yog li ntawd, kev qhia tsis pom zoo kom muab cov tshuaj NovoMix insulin rau lawv. Tsawg dua li 0.01% ntawm cov neeg mob ntshav qab zib, qhov tsis txaus ntseeg tshwm sim: lub plab zom mov, o, ua pa nyuaj, poob siab, nce siab. Yog tias ib tug neeg mob tau ua yav dhau los ua qhov xav tau rau aspart, NovoMix Flexpen tsis tau hais kom ua. |
| Cia | Txhua yam insulins yooj yim plam lawv cov khoom hauv qhov tsis tsim nyog cia, yog li nws txaus ntshai yuav lawv "los ntawm txhais tes". Txhawm rau NovoMix 30 ua raws li cov lus qhia, nws yuav tsum ua kom muaj kev tswj hwm kub kom raug. Cov tshuaj hauv cov khoom lag luam tso rau hauv tub yees, txias ≤ 8 ° C. Tus tsim vial lossis syringe cwj mem tau khaws cia hauv chav sov (txog li 30 ° C). |
Ntau txog kev siv NovoMix
Txhawm rau zam kom tsis txhob muaj ntshav qab zib, cov koom haum thoob ntiaj teb ntawm endocrinologist pom zoo kom pib ua ntej ntawm kev siv tshuaj insulin. Kev hno tshuaj yog kho mob sai li sai sai glycated hemoglobin (GH) pib tshaj li qhov kev cai thaum kho nrog tshuaj tiv thaiv kab mob. Cov neeg mob xav tau lub sijhawm hloov mus rau cov phiaj xwm hnyav. Qhov muaj siab nyiam tau muab rau cov tshuaj tsis zoo, tsis hais lawv tus nqi. Kev ua tau zoo dua yog cov tshuaj insulin analogues.
Mob ntshav qab zib thiab siab surges yuav yog ib yam dhau los
- Li qub ntawm qab zib -95%
- Kev tshem tawm ntawm cov hlab ntsha thrombosis - 70%
- Ntaus tau ntawm lub plawv dhia muaj zog -90%
- Kev tshem tawm ntshav siab - 92%
- Qhov nce hauv lub zog nruab hnub, txhim kho pw tsaug zog thaum hmo ntuj -97%
NovoMix Flexpen yeej ua tau raws li cov cai no. Nws ua haujlwm 24 teev, uas txhais tau tias thaum thawj zaug txhaj ib yuav txaus. Kev siv zog ntawm kev hloov tshuaj insulin yog qhov yooj yim nce ntxiv ntawm ntau npaum li cas ntawm kev txhaj tshuaj. Qhov kev hloov ntawm ob-theem mus rau luv thiab ntev npaj yog yuav tsum tau ua thaum lub cev tiav yuav luag poob nws txoj haujlwm. Insulin NovoMiks tau dhau mus ua tiav ntau tshaj ntau qhov kev sim uas ua pov thawj nws cov hauj lwm zoo.
Cov txiaj ntsig ntawm NovoMix
Ua pov thawj superiority ntawm NovoMix 30 tshaj lwm txoj kev kho mob:
- nws them rau cov mob ntshav qab zib mellitus los ntawm 34% zoo dua li ntawm basal NPH insulin;
- hauv kev txo glycated hemoglobin, cov tshuaj yog 38% zoo dua tshaj kev sib xyaw biphasic ntawm tib neeg cov insulins;
- qhov sib ntxiv ntawm Metformin NovoMix es tsis txhob sulfonylurea npaj tso cai kom ua tiav 24% kev txo qis hauv GH.
Yog tias, thaum siv NovoMix, kev yoo mov qab zib ntau dua 6.5, thiab GH yog siab dua 7%, nws yog lub sijhawm hloov los ntawm kev sib xyaw ntawm cov tshuaj insulins mus rau ntev thiab luv luv cov tshuaj hormones cais, piv txwv li, Levemir thiab Novorapid ntawm cov khoom lag luam tib yam. Nws nyuab nyuab rau siv lawv dua NovoMiks, tab sis nrog txoj kev xam qhov tseeb ntawm lub koob tshuaj, lawv muab cov kev tswj zoo glycemic.
Kev xaiv insulin
Cov tshuaj twg yuav tsum yog qhov zoo rau hom 2 mob ntshav qab zib rau kev pib kho insulin:
| Tus yam ntxwv ntawm tus neeg mob, chav kawm ntawm tus kab mob | Txoj kev kho tau zoo tshaj plaws | |
| Kev xav, tus kws kho ntshav qab zib tau npaj siab kawm ntawv thiab siv cov txheej txheem kev kho mob siab. Tus neeg mob tau koom nrog kev ua kis las. | Luv luv + ntev ntawm cov tshuaj ntawm cov tshuaj insulin, kev suav ntawm cov koob tshuaj raws li glycemia. | |
| Thauj khoom me me. Tus neeg mob yuav nyiam qhov kev kho mob yooj yim dua. | Qhov nce ntawm theem GH yog tsawg dua 1.5%. Kev yoo mov hyperglycemia. | Cov tshuaj insulin ntev ntev (Levemir, Lantus) 1 zaug nyob rau ib hnub. |
| Kev nce qib hauv GH yog ntau dua 1.5%. Hyperglycemia tom qab noj mov. | NovoMix Flexpen 1-2 zaug. | |
Kev sau tshuaj insulin tsis tso tseg kev noj haus thiab metformin.
NovoMix koob tshuaj xaiv
Qhov koob tshuaj insulin yog tus kheej rau txhua tus mob ntshav qab zib, vim tias yuav tsum tau ntau npaum li cas ntawm cov tshuaj tsis yog nyob ntawm cov ntshav qab zib nkaus xwb, tab sis kuj nyob ntawm cov yam ntxwv ntawm kev nqus los ntawm hauv qab daim tawv nqaij thiab qib ntawm insulin tsis kam. Cov kev qhia tau qhia txog kev qhia ntawm 12 units thaum pib ua haujlwm ntawm insulin. Novomix. Nyob hauv lub lim tiam, cov koob tshuaj tsis hloov, kev yoo mov ntsuas qhov ntsuas txhua hnub. Thaum kawg ntawm lub asthiv, cov koob tshuaj raug hloov kho raws li lub rooj:
| Qhov nruab nrab ceev cov piam thaj hauv 3 hnub dhau los, mmol / l | Yuav kho li cas cov koob tshuaj |
| Glu ≤ 4.4 | txo los ntawm 2 chav nyob |
| 4.4 <Glu ≤ 6.1 | tsis muaj kev txhim kho dab tsi |
| 6.1 <Glu ≤ 7.8 | nce los ntawm 2 chav nyob |
| 7.8 <Glu ≤ 10 | nce los ntawm 4 chav nyob |
| Glu> 10 | nce los ntawm 6 chav nyob |
Lub lim tiam tom ntej, cov tshuaj raug xaiv tau kuaj xyuas. Yog tias yoo mov qab zib yog qhov qub thiab tsis muaj ntshav qab zib tsis ntau, kev noj tshuaj yog suav tias yog. Raws li kev txheeb xyuas, rau feem ntau ntawm cov neeg mob, ob qhov kev hloov kho no yog txaus.
Kev txhaj tshuaj kom rov zoo tuaj
Qhov muab pib rau noj yog muab ua ntej noj hmo. Yog tus mob ntshav qab zib xav tau ntau dua 30 ntsuas. insulin, qhov koob tshuaj tau muab faib hauv ib nrab thiab muab ob zaug: ua ntej noj tshais thiab ua ntej noj hmo. Yog tias cov piam thaj tom qab noj su tsis rov qab zoo rau lub sijhawm ntev, koj tuaj yeem ntxiv qhov ntxiv thib peb: txhaj rau thaum sawv ntxov ntxov ua ntej noj su.
Yooj yim pib kho lub sijhawm
Yuav ua li cas kom ua tiav cov nyiaj mob ntshav qab zib nrog tsawg kawg ntawm kev txhaj tshuaj:
- Peb qhia cov tshuaj pib ua ntej noj hmo, thiab kho nws, raws li tau hais los saum toj no. Tshaj li 4 lub hlis, GH li qub hauv 41% ntawm cov neeg mob.
- Yog tias lub hom phiaj tsis ua tiav, ntxiv 6 pawg. NovoMix Flexpen ua ntej noj tshais, dhau 4 lub hlis tom ntej, GH mus txog qib hom hauv 70% ntawm cov ntshav qab zib.
- Thaum tsis ua haujlwm ntxiv, ntxiv 3 pawg. NovoMix cov kua dej ua ntej noj su. Nyob rau theem no, GH yog neeg ib txwm mob hauv 77% ntawm cov ntshav qab zib.
Yog tias cov qauv no tsis muab nyiaj txaus rau cov ntshav qab zib mellitus, nws yog qhov yuav tsum tau hloov mus rau ntev + luv luv insulin hauv kev tswj hwm ntawm tsawg kawg 5 kev txhaj tshuaj ib hnub twg.
Txoj cai kev nyab xeeb
Ob qhov qis thiab ntau dhau ntawm cov piam thaj ntau tuaj yeem ua rau cov ntshav qab zib tsis txaus. Hypoglycemic coma yog ua tau rau cov mob ntshav qab zib nrog kev noj tshuaj tshaj ntawm NovoMix insulin. Kev pheej hmoo ntawm hyperglycemic coma yog ntau dua, qis dua qib ntawm koj tus kheej hormone.
Txhawm rau kom tsis txhob muaj teeb meem, thaum siv cov tshuaj insulin, koj yuav tsum ua raws li txoj cai kev nyab xeeb:
- Koj tuaj yeem nkag mus rau cov tshuaj tsuas yog nyob hauv chav tsev kub. Lub vial tshiab raug tshem tawm ntawm lub tub yees 2 teev ua ntej kev txhaj tshuaj.
- NovulinMix insulin yuav tsum tau muab sib xyaw kom zoo. Cov lus qhia rau kev siv pom zoo yob lub pob hauv nruab nrab ntawm xib teg 10 npaug, tom qab ntawd tig nws mus rau hauv txoj hauj lwm ntsug thiab ntse nce thiab txo qis 10 zaug.
- Kev txhaj tshuaj yuav tsum tau ua tam sim ntawd tom qab nplawm.
- Nws yog qhov txaus ntshai siv cov tshuaj insulin yog tias, tom qab sib xyaw, muaju nyob ntawm phab ntsa ntawm daim cartridge, lumps lossis flakes hauv kev ncua.
- Yog tias cov tshuaj tau ua rau khov, tawm hauv lub hnub lossis cua sov, daim ntawv yuav tsum tau tawg, nws tsis tuaj yeem siv ntxiv.
- Tom qab txhua txoj kev txhaj tshuaj, rab koob yuav tsum tau muab tshem tawm thiab muab pov tseg, kaw cov xaum xaum nrog lub hau uas txuas.
- Tsis txhob txhaj NovoMix Penfill rau hauv cov leeg nqaij lossis hlab ntshav.
- Rau txhua qhov kev txhaj tshuaj tshiab, qhov chaw sib txawv yog xaiv tau. Yog tias liab liab tau pom ntawm daim tawv nqaij, tsis tas yuav tsum tsis txhob ua rau thaj chaw no.
- Yuav kom ntseeg tau tias tus neeg mob ntshav qab zib yuav tsum muaj cov xaum xaum lossis cov cartridge uas muaj tshuaj insulin thiab koob txhaj tshuaj tas li. Raws li cov mob ntshav qab zib, lawv xav tau txog li 5 zaug hauv ib lub xyoo.
- Tsis txhob siv lwm tus neeg lub koob txhaj tshuaj, txawm tias tau hloov pauv hauv rab koob.
- Yog tias nws tau qhia nyob rau hauv cov seem ntawm daim ntawv xaum uas muaj tsawg dua 12 units hauv daim cartridge, lawv tsis tuaj yeem muab pov tseg. Cov chaw tsim khoom tsis tuaj yeem lav qhov ua kom tau qhov tseeb ntawm cov tshuaj hormones hauv qhov seem ntawm kev daws.
Siv nrog lwm cov tshuaj
Novomix raug pom zoo rau kev siv nrog txhua cov tshuaj tiv thaiv kab mob. Nrog ntshav qab zib hom 2, nws ua ke nrog metformin ua hauj lwm zoo tshaj.
Yog tias cov neeg mob ntshav qab zib tau muab tshuaj rau cov ntshav siab, beta-blockers, tetracyclines, sulfonamides, antifungals, anabolic steroids, hypoglycemia yuav tshwm sim, qhov tshuaj ntawm NovoMix FlexPen yuav tau txo.
Thiazide diuretics, tshuaj tiv thaiv kab mob, salicylates, feem ntau cov tshuaj hormones, nrog rau cov tshuaj tiv thaiv qhov ncauj, tuaj yeem ua kom qaug zog ntawm kev ua dej ntawm insulin thiab ua rau hyperglycemia.
Cev xeeb tub
Aspart, cov khoom xyaw nquag ntawm NovoMix Penfill, tsis muaj kev cuam tshuam tsis zoo rau lub sijhawm cev xeeb tub, kev nyob zoo ntawm tus pojniam, thiab kev loj hlob ntawm tus menyuam hauv plab. Nws muaj kev nyab xeeb li tib neeg cov tshuaj hormones.
Dua li ntawm qhov no, qhov kev qhia tsis pom zoo kom siv NovoMix insulin thaum siv cev xeeb tub. Nyob rau lub sijhawm no, cov kab mob ntshav qab zib tau pom tias yog kev kho mob insulin ntau dua, uas NovoMix tsis tsim los rau. Nws yog xav paub ntau tshaj yog siv cov insulin ntev thiab luv luv sib cais. Tsis muaj kev txwv txog kev siv NovoMix thaum pub niam mis.
Cov qauv ntawm NovoMix
Tsis muaj lwm yam tshuaj nrog cov qub muaj xws li NovoMix 30 (aspart + aspart protamine), uas yog, ua tiav analogue. Lwm yam biphasic insulins, analog thiab tib neeg, tuaj yeem hloov nws:
| Sib xyaw | Npe | Lub teb chaws ntau lawm | Chaw tsim tshuaj paus |
| lispro + lispro tshuaj ntsuab | Neej Neeg Sib Xws 25 Neej Neeg Qhia 50 | Switzerland | Eli Lilly |
| aspart + degludec | Ryzodeg | Denmark | NovoNordisk |
| tib neeg + NPH insulin | Humulin M3 | Switzerland | Eli Lilly |
| Gensulin M30 | Lavxias | Biotech | |
| Insuman Comb 25 | Lub teb chaws Yelemees | Sanofi aventis |
Nco ntsoov tias xaiv cov tshuaj thiab nws cov tshuaj yog qhov zoo tshaj plaws nrog kws tshwj xeeb.
