Nws yuav tsis muaj qhov exaggeration hais tias nrog kev tawm ntawm insulin analogues lub sijhawm tshiab pib nyob rau hauv lub neej ntawm cov neeg mob ntshav qab zib. Vim yog lawv cov qauv tshwj xeeb, lawv tso cai glycemia tswj hwm tau zoo dua li ua ntej. Insulin Levemir yog ib tus neeg sawv cev ntawm cov tshuaj niaj hnub, ib qho tshuaj noj ntawm cov tshuaj hormones basal. Nws tau tshwm sim tsis ntev los no: hauv Tebchaws Europe xyoo 2004, hauv tebchaws Russia ob xyoos tom qab.
Levemir muaj tag nrho cov yam ntxwv ntawm qhov ntev tshaj plaws insulin: nws ua haujlwm zoo ib yam, tsis muaj peaks rau 24 teev, ua rau txo qis thaum tsaus ntuj hypoglycemia, tsis pab txhawb qhov hnyav ntawm cov neeg mob, uas yog tshwj xeeb rau tus mob ntshav qab zib hom 2. Nws cov nyhuv ua kom pom tseeb dua thiab tsawg dua ntawm cov yam ntxwv ntawm ib tus neeg dua li ntawm NPH-insulin, yog li cov koob tshuaj tau yooj yim dua rau xaiv. Hauv kev hais lus, nws tsim nyog ua tibzoo saib cov tshuaj no.
Qhia me ntsis
Levemir yog lub hlwb ntawm lub tuam txhab Danish Novo Nordisk, paub txog nws cov kev kho mob ntshav qab zib. Cov tshuaj tau dhau los ntawm kev tshawb fawb ntau yam, suav nrog menyuam yaus thiab cov hluas, thaum cev xeeb tub. Txhua tus ntawm lawv tau lees paub tsis tsuas yog kev nyab xeeb ntawm Levemir, tab sis kuj tseem muaj txiaj ntsig ntau dua li siv insulins yav dhau los. Kev tswj xyuas piam thaj muaj txiaj ntsig ib yam li cov ntshav qab zib hom 1 thiab hauv cov kev mob xav tau qis dua: hom 2 thaum pib siv tshuaj tua kab mob ntshav qab zib thiab mob ntshav qab zib hauv lub plab.
Cov lus qhia luv luv txog cov tshuaj los ntawm cov lus qhia rau kev siv:
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%
| Kev piav qhia | Cov xim tsis muaj kob uas muaj qhov tsis txaus ntawm U100, ntim rau hauv daim iav cartridges (Levemir Penfill) lossis cov xaum xaum uas tsis tas yuav ntim khoom (Levemir Flexpen). |
| Muaj pes tsawg leeg | Lub npe txawv teb chaws tsis muaj npe rau cov khoom lag luam nquag hauv Levemir (INN) yog insulin detemir. Ntxiv nrog rau nws, cov tshuaj muaj excipients. Txhua qhov sib xyaw ua ke tau kuaj xyuas tus mob toxicity thiab carcinogenicity. |
| Cov Tshuaj Hauv Tshuaj | Tso cai rau koj kom ntseeg siab rau qhov kev tso tawm ntawm cov kua dej hauv paus. Nws muaj qhov txawv txav tsawg, uas yog, cov nyhuv tsis txawv me ntsis hauv ib tus neeg mob ntshav qab zib nyob rau txawv hnub, tab sis kuj nyob rau lwm tus neeg mob. Kev siv cov tshuaj insulin Levemir ua rau nws txo cov ntshav qog ntshav qab zib tsawg dua, txhim kho lawv txoj kev paub. Cov tshuaj no tam sim no tsuas yog "qhov hnyav-nruab nrab" insulin, nws zoo dua cuam tshuam rau lub cev qhov hnyav, ua kom nrawm zoo li qhov pom ntawm lub siab. |
| Cov yam ntxwv ntawm kev nqus | Levemir yooj yim tsim cov tshuaj insulin sib xyaw - hexamers, khi rau cov protein ntawm qhov chaw txhaj tshuaj, yog li nws tso tawm ntawm cov nqaij mos subcutaneous qeeb thiab yam tsis zoo. Cov tshuaj yog devoid ntawm lub siab tshaj plaws yam ntxwv ntawm Protafan thiab Humulin NPH. Raws li cov chaw tsim khoom, Levemir qhov kev coj ua yog qhov txawv dua li ntawm cov neeg sib tw tseem ceeb los ntawm tib pawg insulin - Lantus. Nyob rau hauv cov nqe lus ntawm kev ua haujlwm lub sijhawm, Levemir surpasses tsuas yog qhov tseem niaj hnub thiab kim Tresiba tshuaj, kuj tsim los ntawm Novo Nordisk. |
| Cov Khoom Qhia | Txhua hom ntshav qab zib xav tau kho cov tshuaj insulin rau cov nyiaj them zoo. Levemir ua zoo sib luag rau menyuam yaus, hluas thiab laus neeg mob, tuaj yeem siv rau kev ua txhaum daim siab thiab lub raum. Nrog ntshav qab zib hom 2, nws siv nrog rau cov kab mob hypoglycemic yog tso cai. |
| Cov Yuav Tsum Muaj | Levemir yuav tsum tsis txhob siv:
Cov tshuaj yog muab tsuas yog subcutaneously, kev tswj hwm dej num yog txwv tsis pub. Kev tshawb fawb ntawm cov menyuam yaus hauv qab ob xyoos tsis tau nqis tes ua, yog li hom kab mob ntawm cov neeg mob no tseem tau hais hauv contraindications. Txawm li cas los xij, cov insulin no tau sau tseg rau cov menyuam yaus me. |
| Cov lus qhia tshwj xeeb | Discontinuation ntawm Levemir lossis kev rov ua dua ntawm txoj kev noj tshuaj tiv thaiv tsis txaus ua rau hyperglycemia thiab ketoacidosis. Qhov no yog qhov phom sij tshwj xeeb nrog hom ntshav qab zib 1. Tshaj dhau qhov koob tshuaj, hla kev noj mov, kev thauj khoom tsis ua haujlwm yog fraught nrog hypoglycemia. Nrog kev tsis saib xyuas ntawm kev siv tshuaj insulin thiab kev hloov pauv ntau zaus ntawm cov ntshav qabzib thiab ntshav qabzib tsawg, cov teeb meem ntshav qab zib tshwm sim sai sai. Qhov xav tau ntawm Levemire nce thaum ncaws pob, thaum mob, tshwj xeeb tshaj yog muaj kub taub hau, thaum cev xeeb tub, pib nrog nws ib nrab hnub. Koob tshuaj yuav tsum tau txhaj rau mob voos thiab exacerbation ntawm mob ntev. |
| Tsuas tshuaj | Cov lus qhia tau pom zoo tias rau hom ntshav qab zib hom 1, ib qho kev suav qhov tshuaj rau txhua tus neeg mob. Nrog hom 2 tus kab mob, xaiv ntau npaum pib nrog 10 units ntawm Levemir hauv ib hnub lossis 0.1-0.2 nyob rau ib phaus, yog tias qhov hnyav sib txawv ntawm qhov nruab nrab. Hauv kev coj ua, tus nqi no yuav ntau dhau yog tias tus neeg mob ua raws li cov zaub mov tsis zoo lossis kev ua kis las. Yog li, nws yog qhov yuav tsum tau los laij lub koob tshuaj ntev ntawm cov tshuaj insulin raws li cov teeb meem tshwj xeeb, suav rau hauv glycemia hauv ob peb hnub. |
| Cia | Levemir, zoo li lwm yam insulins, yuav tsum muaj kev tiv thaiv los ntawm lub teeb, khov thiab overheating. Lub rooj npaj tsis zoo yuav tsis txawv nyob rau hauv txhua txoj kev los ntawm ib qho tshiab, yog li tshwj xeeb yuav tsum tau them rau cov kev mob cia. Qhib cov roj cartridges tau li 6 lub lim tiam thaum sov li chav nyob. Cov fwj dej khib nyiab yog cia rau hauv tub yees, lawv lub neej txee txij li hnub ntawm kev tsim khoom yog 30 hli. |
| Nqi | 5 daim cartridges ntawm 3 ml (tag nrho 1500 units) ntawm Levemir Penfill tus nqi los ntawm 2800 rubles. Tus nqi ntawm Levemir Flexpen yog me ntsis dua. |
Txog ntawm nuances ntawm kev siv Levemir
Levemir muaj lub hauv paus ntsiab lus ntawm kev ua haujlwm, ntsuas thiab contraindications zoo ib yam li lwm cov tshuaj insulin. Ib qho kev sib txawv yog lub sijhawm ua haujlwm, kev noj ntau npaum li cas, kev txhaj tshuaj pom zoo rau cov pab pawg sib txawv ntawm cov neeg mob ntshav qab zib.
Qhov kev ua ntawm insulin levemir yog dab tsi
Levemir yog insulin ntev ntev. Nws cov nyhuv yog ntev dua li cov tshuaj ib txwm muaj - sib xyaw ntawm tib neeg cov tshuaj insulin thiab tshuaj tiv thaiv. Ntawm ib koob tshuaj ntawm txog 0.3 units. ib kilogram, cov tshuaj ua haujlwm 24 teev. Qhov me dua qhov yuav tsum tau noj, lub sijhawm ua haujlwm luv luv. Hauv cov neeg mob ntshav qab zib, tom qab cov zaub mov tsis muaj carb, qhov kev txiav txim yuav xaus tom qab 14 teev.
Cov insulin ntev ntev tsis tuaj yeem siv los kho cov glycemia thaum nruab hnub lossis thaum mus pw. Yog tias muaj cov piam thaj ntau ntxiv nyob rau yav tsaus ntuj, nws yog ib qho tsim nyog yuav tau txhaj tshuaj rau luv luv ntawm cov tshuaj insulin, thiab tom qab nws, qhia qhov tshuaj tiv thaiv ntev nyob hauv tib lub tshuaj. Koj tsis tuaj yeem muab cov tshuaj insulin sib xyaw ntawm cov tshuaj sib txawv hauv tib cov koob txhaj.
Tso Tawm Cov Ntawv
Cov tshuaj Insulin Levemir hauv lub thauv
Levemir Flexpen thiab Penfill sib txawv tsuas yog hauv daim ntawv, cov tshuaj hauv lawv zoo ib yam. Penfill - cov no yog cov cartridges uas tuaj yeem tso rau hauv cov xaum xaum los yog hom insulin los ntawm lawv nrog tus qauv insulin koob txhaj tshuaj. Levemir Flexpen yog tus sau ua ntej syringe cwj mem uas tau siv kom txog rau thaum cov tshuaj ua tiav. Lawv yuav tsis rov ua haujlwm dua. Cwjmem tso cai rau koj kom nkag mus rau cov tshuaj insulin hauv qhov nce ntxiv ntawm 1 pawg. Lawv yuav tsum tau yuav nyias NovoFayn koob. Ua raws li cov tuab ntawm subcutaneous ntaub so ntswg, tshwj xeeb tshaj yog nyias (0.25 mm inch) 6 hli ntev lossis nyias (0.3 hli) 8 hli yog xaiv. Tus nqi ntawm ib pob ntawm 100 koob yog li 700 rubles.
Levemir Flexpen yog qhov tsim nyog rau cov neeg mob ua lub neej nquag thiab tsis muaj sijhawm. Yog tias qhov xav tau rau cov tshuaj insulin yog ib qho me me, ib theem ntawm 1 chav tsev yuav tsis tso cai rau koj hu rau qhov koob uas xav tau. Rau cov neeg zoo li no, Levemir Penfill raug pom zoo kom ua ke nrog cov xaum xaum uas raug dua, piv txwv li NovoPen Echo.
Cov tshuaj kom raug
Qhov koob tshuaj ntawm Levemir yog suav tias yog yog tias tsis tsuas yoo suab thaj, tab sis kuj glycated hemoglobin nyob rau hauv ib txwm muaj. Yog tias them nyiaj rau ntshav qab zib tsis txaus, koj tuaj yeem hloov cov tshuaj insulin ntev ntev txhua 3 hnub. Txhawm rau txiav txim siab kho qhov tsim nyog, cov neeg tsim khoom pom zoo kom noj qab zib nruab nrab ntawm lub plab khoob, 3 hnub dhau los koom nrog hauv qhov muab xam
| Glycemia, mmol / l | Koob pauv | Kev hloov kho tus nqi, ntsuas |
| < 3,1 | Txo tsawg | 4 |
| 3,1-4 | 2 | |
| 4,1-6,5 | Tsis hloov pauv | 0 |
| 6,6-8 | Nce ntxiv | 2 |
| 8,1-9 | 4 | |
| 9,1-10 | 6 | |
| > 10 | 10 |
Cov ntawv nyeem uas cuam tshuam: cov cai rau xam cov koob tshuaj insulin rau kev txhaj tshuaj
Cov sijhawm txhaj tshuaj
- Nrog ntshav qab zib hom 1 cov kev qhia tau pom zoo kom tswj hwm cov tshuaj insulin ob zaug: tom qab sawv thiab ua ntej yuav mus pw. Cov txheej txheem zoo li no muab cov nyiaj zoo dua los kho cov ntshav qab zib ntau dua li ib qho. Koob tshuaj yog suav nyias. Txog rau cov tshuaj insulin thaum sawv ntxov - raws li kev siv yoo qab zib txhua hnub, rau yav tsaus ntuj - raws nws cov nuj nqis txhua hmo.
- Nrog ntshav qab zib hom 2 ob leeg thiab ob chav thawj coj yog ua tau. Cov kev tshawb fawb qhia tias thaum pib cov tshuaj insulin, ib qho kev txhaj tshuaj rau ib hnub yog txaus kom ua tiav cov phiaj yam qab zib. Kev noj tshuaj ib zaug ib leeg tsis tas yuav nce ntxiv hauv cov koob tshuaj suav. Nrog rau tus mob ntshav qab zib ntev mellitus, cov tshuaj insulin ntev dua yog qhov xav paub ntau tshaj los tswj ob zaug ib hnub.
Siv rau menyuam yaus
Txhawm rau tso cai rau kev siv Levemir hauv ntau pab pawg neeg, yuav tsum muaj kev tshawb fawb loj nrog cov neeg ua haujlwm pab dawb. Rau cov menyuam yaus hnub nyoog qis dua 2 xyoos, qhov no cuam tshuam nrog ntau yam nyuaj, yog li ntawd, hauv cov lus qhia rau kev siv, muaj hnub nyoog txwv. Ib qho xwm txheej zoo sib xws nrog lwm cov insulins niaj hnub. Dua li ntawm qhov no, Levemir tau ua tiav tau zoo hauv cov menyuam yaus txog li ib xyoos. Kev kho mob nrog lawv yog qhov ua tau zoo ib yam li cov menyuam yaus hnub nyoog loj. Raws li cov niam txiv, tsis muaj dab tsi zoo.
Hloov mus rau Levemir nrog NPH insulin yog qhov tsim nyog yog tias:
- yoo suab thaj tsis ruaj khov,
- Kev mob ntshav qog ntshav yog pom thaum hmo ntuj lossis yav tsaus ntuj,
- tus me nyuam yog thawj.
Sib piv ntawm Levemir thiab NPH-insulin
Tsis zoo li Levemir, tag nrho cov insulin nrog protamine (Protafan, Humulin NPH thiab lawv cov analogues) muaj cov txiaj ntsig tshaj plaws, uas ua rau muaj kev pheej hmoo ntawm hypoglycemia, ntshav qab zib jumps tshwm sim thawm hnub.
Pov Thawj Cov txiaj ntsig Levemir:
- Nws muaj qhov ua kom paub tseeb dua.
- Txo qhov tshwm sim ntawm kev txo tus kabmob ntshav qab zib: mob hnyav 69%, hmo ntuj tau 46%.
- Nws ua rau cov rog hnyav dua nrog cov ntshav qab zib hom 2: hauv 26 lub lis piam, qhov hnyav hauv cov neeg mob ntawm Levemir nce ntxiv ntawm 1.2 phaus, thiab hauv cov neeg mob ntshav qab zib ntawm NPH-insulin los ntawm 2.8 kg.
- Nws tswj hwm qhov kev xav ntawm kev tshaib kev nqhis, uas ua rau kev poob qis hauv cov neeg mob rog nrog cov rog. Tus mob ntshav qab zib hauv Levemir noj thaj tsam li 160 kcal / hnub tsawg dua.
- Nce zais ntawm GLP-1. Nrog ntshav qab zib hom 2, qhov no ua rau muaj kev sib txuas ntxiv ntawm lawv tus kheej insulin.
- Nws muaj cov txiaj ntsig zoo ntawm dej-ntsev dej metabolism, uas txo cov kev pheej hmoo ntawm tawg.
Tib qho kev tsis zoo ntawm Levemir piv rau NPH npaj tau yog nws tus nqi siab. Xyoo tsis ntev los no, nws tau muaj nyob rau hauv cov npe ntawm cov tshuaj tseem ceeb, yog li cov neeg mob ntshav qab zib tuaj yeem tau txais nws dawb.
Analogs
Levemir yog cov tshuaj insulin tshiab, yog li nws tsis muaj qhov pheej yig generics. Qhov ze tshaj plaws hauv cov khoom thiab lub sijhawm ntawm kev nqis tes yog cov tshuaj los ntawm cov pab pawg ntawm ntev insulin analogues - Lantus thiab Tujeo. Hloov mus rau lwm lub tshuaj insulin yuav tsum tau txhaj tshuaj kom rov zoo dua thiab ua rau lub cev tsis ua haujlwm nyob rau hauv cov nyiaj mob ntshav qab zib mellitus, yog li, cov tshuaj yuav tsum hloov pauv rau kev kho mob nkaus xwb, piv txwv li, nrog tus neeg tsis kam txais.
Levemir lossis Lantus - uas zoo dua
Cov chaw tsim khoom tau nthuav tawm qhov zoo ntawm Levemir hauv kev sib piv nrog nws cov neeg sib tw loj - Lantus, uas nws zoo siab tau qhia hauv cov lus qhia:
- cov kev ua ntawm cov tshuaj insulin yog cov tas mus li;
- cov tshuaj muab kom hnyav ntxiv.
Raws li kev txheeb xyuas, cov kev sib txawv no yuav luag pom tsis tau, yog li cov neeg mob nyiam siv tshuaj, cov tshuaj uas yooj yim rau hauv thaj av no.
Qhov txawv tsuas yog qhov tseem ceeb rau cov neeg mob uas ntxuav cov kua dej: Levemir sib xyaw zoo nrog kua ntsev, thiab Lantus qee qhov poob nws cov khoom thaum diluted.
Cev xeeb tub thiab Levemir
Levemir tsis cuam tshuam rau txoj kev loj hlob ntawm tus menyuamYog li, nws tuaj yeem siv tau los ntawm cov poj niam cev xeeb tub, suav nrog cov neeg mob ntshav qab zib hauv lub cev. Cov koob tshuaj ntawm cov tshuaj thaum cev xeeb tub xav tau kho ntau zaus, thiab yuav tsum tau xaiv ua ke nrog kws kho mob.
Muaj tus mob ntshav qab zib hom 1, cov neeg mob thaum lub sijhawm nqa tus menyuam nyob twj ywm ntawm cov tshuaj insulin uas lawv tau txais dhau los, tsuas yog nws qhov ntau npaum hloov. Kev hloov pauv ntawm NPH tshuaj mus rau Levemir lossis Lantus yog tsis tsim nyog yog tias cov piam thaj ib txwm ua.
Nrog cov ntshav qab zib hauv lub cev hauv plab, qee qhov nws muaj peev xwm ua tiav qhov glycemia tsis muaj insulin, tshwj xeeb rau kev noj zaub mov zoo thiab kev kawm lub cev. Yog tias cov piam thaj ntau zaus nce siab, kev kho mob insulin yog qhov xav tau kom tsis txhob muaj menyuam hauv plab thiab ketoacidosis hauv leej niam.
Xyuas
Feem coob ntawm cov neeg mob tshuaj xyuas txog Levemir yog qhov zoo. Ntxiv nrog rau kev txhim kho glycemic tswj, cov neeg mob nco tau yooj yim ntawm kev siv, kev tiv thaiv zoo, kev ua tau zoo ntawm lub fwj thiab cov npiv, cov koob ib txwm uas tso cai rau koj los ua kom tsis muaj tshuaj tsis haum. Feem ntau cov neeg mob ntshav qab zib tau thov tias qhov hypoglycemia ntawm cov insulin no tsawg dua thiab ua rau tsis muaj zog.
Cov kev xav tsis zoo muaj qhov tsawg. Lawv feem ntau yog los ntawm niam thiab txiv ntawm cov menyuam muaj ntshav qab zib thiab cov poj niam uas muaj ntshav qab zib gestational. Cov neeg mob no xav kom txo qis cov tshuaj insulin, yog li Levemir Flexpen tsis xis nyob rau lawv. Yog tias tsis muaj lwm txoj hauv kev, thiab tsuas yog siv cov tshuaj zoo li no, cov neeg mob ntshav qab zib yuav tsum tau tawg tawm cov khoom muag los ntawm cov xaum xoob pov tseg thiab rov ua dua rau lwm qhov lossis ua ib qho kev txhaj tshuaj nrog cov koob txhaj tshuaj.
Levemir qhov kev ua yog qhov txaus ntshai worsens 6 lub lis piam tom qab qhibCov. Cov neeg mob uas tsis tshua xav siv tshuaj insulin ntev ntev tsis muaj sijhawm siv 300 units ntawm cov tshuaj, yog li cov khoom seem yuav tsum muab pov tseg.
