Ihe ngosi maka ojiji na akụrụngwa insulin Detemir

Teknụzụ ndị DNA e jiri mee ihe ugbu a emeela ka profaịlụ nke insulin dị mfe (na-adịkarị). A na - emepụta insulin ihe insemir site na ihe omimi nke ihe omimi nke DNA site na iji eriri Saccharomyces cerevisiae, bụ anaal soluble basal analog nke insulin na-arụ ọrụ ogologo oge yana profaịlụ na-enweghị atụ. Profaịlụ a na-agbanwebeghị dị ukwuu ma e jiri ya tụnyere isofan-insulin na gulingine insulin. Ogologo oge a mere bụ n'ihi nkwupụta nke onwe nke elektrọnik detemir nke a na-agbanye n'ahụ ya na ntinye ụmụ irighiri ihe na albumin site na mkpo nwere agịgị acid. Tụnyere estofan-insulin, detemir insulin na-ekesa nwayọ nwayọ na anụ ahụ dị mkpa. Usoro ndị a na-egbu oge na-egbu oge na-enye nnabata nnabata ọzọ na profaịlụ insulin nke detemir. A na - amata insulin ihe eji eme ka onye na - eme nyocha nke ihe dị ukwuu n'ahụ ndị ọrịa ma e jiri ya tụnyere insulin NPH ma ọ bụ insulin insulin. Ngosipụta nke amamịghe ahụ sitere na ihe abụọ: insulin detemir ka nọ n ’ọnọdụ etisasịworo n’ ọkwa niile site n’usoro onodu ogwu ya ruo na njikọta insulin nnabata ya na nsonazụ nke ijikọ ya na albumin.
Site na iso otu onye na-anabata ihe dị na sel nke cytoplasmic nke mkpụrụ ndụ, ọ na - emepụta insulin-receptor complex nke na - akpali usoro intracellular, gụnyere njikọ nke ọtụtụ enzymes isi (hexokinase, pyruvate kinase, glycogen synthetase, wdg). Mbelata nke glucose ọbara bụ n'ihi mmụba na njem ya na intracellular, mmụba anụ ahụ, mkpali nke lipogenesis, glycogenogenesis, mbelata ọnụego glucose na-emepụta site na imeju, wdg Maka usoro nke 0.2-0.4 U / kg 50%, mmetụta kachasị na-apụta na oke site na 3 4 awa ka awa iri na anọ mgbe ọ nwụsịrị. Mgbe nchịkwa subcutaneous gasịrị, azịza ọgwụ bụ nke kwekọrọ na usoro a na-achịkwa (mmetụta kachasị elu, oge ọrụ, mmetụta izugbe). Mgbe ogwu SC gachara, detemir na-ejikọ ya na albumin site na ụyọkọ acid ya. Ya mere, na ọnọdụ kwụsiri ike, a na-ebelata mkpụkọ insulin na-enweghị ego, nke na-eduga na ọkwa glycemia. Ogologo oge nke detemir na usoro 0.4 IU / n'arọ bụ ihe dị ka awa 20, ya mere, edepụtara ọgwụ ahụ ugboro abụọ n'ụbọchị maka ọtụtụ ndị ọrịa. N'ime ọmụmụ ogologo oge (ọnwa 6), plasma glucose na-ebu ọnụ n'ime ndị ọrịa nwere ụdị ọrịa shuga dị mma ma e jiri ya tụnyere isofan-insulin, nke edepụtara na ntọala / ọgwụgwọ bolus. Njikwa glycemic (glycosylated haemoglobin - HbA1c) n'oge ọgwụgwọ insulin detemir bụ nke a pụrụ iji tụnyere ya na usoro ọgwụgwọ nke isofan-insulin, na-enwe ntakịrị ihe ize ndụ nke ịmalite hypoglycemia nocturnal na enweghị mmụba nke ahụ mmadụ n'oge eji ya. Ihe profaịlụ nke nchịkwa glucose abalị dị larịị ma karịa maka detemir insulin ma e jiri ya tụnyere insulin isofan, nke a na-egosipụta na ọ nwere obere nsogbu nke hypoglycemia n'abalị.
Oke nlebara anya nke detemir insulin n'ime ọbara ọbara erutela ruo awa isii n’otu nlekọta nchịkwa. Site na usoro nchịkwa okpukpu abụọ kwa ụbọchị, a na-enweta ọgwụ ike n'usoro ọbara n'ọbara tupu 2-3.
Inacering yiri nke nhazi insulin, mmadụ mepụtara metabolites adịghị arụ ọrụ. Ọmụmụ ihe eji egbochi protein in vitro na na vivo gosi enweghị mmekọrịta dị n'etiti ụlọ ọgwụ dị n'etiti insulin detemir na ọdụdụ ọdụdụ ma ọ bụ ọgwụ ndị ọzọ na-ejikọ protein protein.
Ọkara ndụ mgbe a gbasasịrị sc, na-ekpebi ogo nke mkpanaka site na anụ ahụ dị n'okpuru wee bụrụ awa 5-7, dabere na nha.
Mgbe s / ka iwebata nke ịta ke ọbara ọbara bụ nke kwekọrọ ka a na-achịkwa (ọnụọgụ kachasị, ogo nnabata).
Ndị otu ọrịa pụrụ iche
A gụrụ ụlọ ọgwụ Pharmacokinetic na ụmụaka (6–12 afọ) na ụmụaka (13-17 afọ) ma e jiri ya tụnyere ndị okenye nwere ụdị ọrịa shuga mellitus. Enweghị ọdịiche dị ukwuu na ụlọ ọgwụ na ọgwụ ọgwụ detemir n'etiti ndị agadi na ndị ọrịa na-eto eto, ma ọ bụ n'etiti ndị ọrịa nwere ezumike mkpirikpi arụ ọrụ yana ịba ọcha n'anya na ndị ọrịa nwere ahụike.

Ojiji ọgwụ insulin detemir

Ezubere maka nchịkwa subcutaneous. A na-ekpebi ọgwụ a n'otu n'otu n'ọnọdụ nke ọ bụla. Ekwesịrị ịnye insulin ọgwụ Detemir ugboro 1 ma ọ bụ ugboro abụọ kwa ụbọchị dabere na mkpa nke onye ọrịa. Ndị ọrịa chọrọ iji ugboro abụọ n'ụbọchị maka ezigbo njikwa ọkwa glucose ọbara nwere ike ịbanye na mgbede ma n'oge nri abalị, ma ọ bụ tupu ụra, ma ọ bụ awa 12 mgbe ụtụtụ gachara. A na-agbanye insulin n'ime insemir n'ime apata ụkwụ, mgbidi ihu ma ọ bụ ubu. Ekwesịrị ịgbanwe saịtị ndị ịgba agba ọbụlagodi mgbe a gbanyere ya n’otu mpaghara ahụ. Dị ka ọ dị na insulins ndị ọzọ, na ndị ọrịa agadi na ndị ọrịa nwere akụrụ ma ọ bụ ọrịa hepatic, ekwesịrị ilebara ọkwa glucose ọbara anya nke ọma na ịhazigharị nke detemir n'otu n'otu. Imeghari usoro a nwekwara ike ịdị mkpa mgbe ị na-eme ka ahụ onye ọrịa dị, na-agbanwe nri ọ na-eri, ma ọ bụ na-arịa ọrịa na-arịa ọrịa.

Nsonaazụ nke ọgwụ insulin na-apụ

Mmeghachi omume ọjọọ na-achọpụta na ndị ọrịa na-eji insemir insịnịstrị na-adabere ma na-etolite n'ihi mmetụta ọgwụ insulin na-akpata. Hypoglycemia na-abụkarị nsonaazụ kachasị n'akụkụ. Hypoglycemia na-etolite ma ọ bụrụ na ị na-enye nnukwu ọgwụ nke ọgwụ ahụ dabere na mkpa insulin nwere ahụ.
Enwere ike ịhụ mmeghachi omume na saịtị ịgba ahụ ka ejiri ọgwụgwọ mee ihe dịka 2% nke ndị ọrịa. Ngụkọta ndị ọrịa na-anata ọgwụgwọ na ndị a na-atụ anya ịzụlite nsonaazụ dị ka 12%. Ọnọdụ nke ihe ọghọm n'oge ọnwụnwa ọgwụgwọ dị n'okpuru ebe a ka akọwapụtara n'okpuru.
Ọrịa metabolism na nri nri: ugboro ugboro (1/100, ≤1 / 10).
Hypoglycemia: mgbaàmà nke hypoglycemia na-etolite na mberede. Ndị a gụnyere “ọsụsọ oyi”, pallor nke anụ ahụ, ike ọgwụgwụ, nkụda mmụọ ma ọ bụ ịma jijiji, nchekasị, ike ọgwụgwụ pụrụ iche ma ọ bụ adịghị ike, nchegharị, mbelata, ụra, agụụ siri ike, ọhụhụ ọhụhụ, isi ọwụwa, ọgbụgbọ, palpitations. Nnukwu ọbara ọgbụgba nwere ike ibute mwepu na / ma ọ bụ ịmị mkpụrụ, ụbụrụ nwa oge, ma ọ bụ mgbanwe a na-agaghị echeghari, yana ọnwụ.
Mgbasa ozi izugbe na mmeghachi omume na saịtị ịgba ahụ: ugboro ugboro (1/100, ≤1 / 10).
Mmeghachi omume na ebe ntụtụ: Mmeghachi omume hypersensitivity na mpaghara (ọbara ọbara, ọzịza na itching na ntụtụ) nwere ike ịmalite n'oge ọgwụgwọ insulin. Mmeghachi omume ndị a na-abụkarị obere oge n'okike ma na-akwụsị na usoro ọgwụgwọ.
Oke mgbe (1/1000, ≤1 / 100).
Lipodystrophy: nwere ike tolite na saịtị ịgba nrịba n'ihi enweghị irubere iwu nke ịgbanwe ebe irighiri mmiri n'otu mpaghara ahụ. Edema: nwere ike ibido na ọkwa izizi nke insulin. Mgbaàmà ndị a anaghị adịte aka.
Ọrịa sistemụ immune: ụkọ (1/1000, ≤1 / 100).
Mmeghachi omume nfụkasị ahụ: urticaria, ihe nchapu akpụkpọ nwere ike ịmalite n'ihi hypersensitivity. Ihe ịrịba ama nke hypersesitivity nwere ike ịgụnye itching, sweating, gastrointestinal ups, angioedema, breatha ike, palpitations, ọbara mgbali elu. Mmepe nke nzaghachi hypersensitivity nwere ike ibute ndụ egwu.
Mmebi anya: ụkọ (1/1000, ≤1 / 100).
Ọgba aghara: Ngaghari iwe nwere ike ibido na ọkwa izizi nke insulin. Mgbaàmà ndị a anaghị adịte aka. Ọrịa mamịrị retinopathy. Ọganiihu ogologo oge na njikwa glycemic na-ebelata ohere ịbawanye ọrịa mamịrị nke ọrịa mamịrị mana ịbawanye uru nke insulin na-enwe mmụba dị mma na njikwa metabolism metabolism nwere ike ibute mmụba nwa oge na akara nke ọrịa mamị retinopathy.
Ọrịa nke sistem: dị ụkọ (1/10000, ≤1 / 1000).
Ọkpụkpụ akwara ozi: Mmezi ngwa ngwa na njikwa glycemic nwere ike ibute ọnọdụ nke neuropathy mgbu, nke na-agbanwegharị.

Ntuziaka pụrụ iche maka iji ọgwụ ọgwụ insulin detemir

Insulin na Detemir na-enye aka ịchịkwa glycemic nke ọma (dabere na ibu glucose plasma na-ebu ọnụ) ma e jiri ya tụnyere isofan-insulin. Insuba insulin ma ọ bụ ịkwụsị ịgwọ ọrịa ezughi oke, nwere ụdị ọrịa mellitus nke M, nwere ike ibute mmepe nke hyperglycemia ma ọ bụ ketoacidosis mamịrị. Dịka iwu, mgbaàmà mbụ nke hyperglycemia pụtara nke nta nke nta, ọtụtụ awa ma ọ bụ ụbọchị. Ihe mgbaàmà ndị a gụnyere akpịrị ịkpọ nkụ, urination ngwa ngwa, ọgbụgbọ, vomiting, ụra, akpịrị na akpọnwụ akpịrị, akpịrị ịkpọ nkụ, agụụ, agụụ acetone na ikuku ikuku. Na ụdị nke ọrịa shuga mellitus, na-enweghị ọgwụgwọ kwesịrị ekwesị, hyperglycemia na-eduga na mmepe nke ketoacidosis mamịrị ma nwee ike ibute ọnwụ. Hypoglycemia nwere ike itolite ma ọ bụrụ na insulin nke ukwuu dị elu n’ihe metụtara insulin chọrọ n’otu onye ọrịa. Izere nri ma ọ bụ mmega ahụ siri ike nwere ike iduga hypoglycemia. Mgbe ha kwusịrị metabolism metabolism, dịka ọmụmaatụ, n'oge ọgwụgwọ insulin siri ike, ndị ọrịa nwere ike ịnwe ụdị mgbaàmà nke ebido hypoglycemia, nke a ga-eme ka ndị ọrịa mara banyere ya. Ihe mgbaàmà ịdọ aka na ntị na-adịkarị nwere ike ịnwe ọrịa shuga ogologo oge. Ọrịa concoitant, nke na-efe efe ma na-efe efe, na -emekarị ahụ insulin nwere ahụ.
Nyefee na ụdị insulin ndị ọzọ
Ntugharị onye ọrịa na ụdị insulin ma ọ bụ insulin nke onye nrụpụta ọzọ kwesịrị ịmalite n'okpuru nlekọta ahụike siri ike. Ọ bụrụ ngbanwe ịta, onye nrụpụta, ụdị, ụdị (anụmanụ, mmadụ, analogues nke insulin mmadụ) yana / ma ọ bụ usoro nke mmepụta ya (injinia ma ọ bụ insulin nke sitere anụmanụ), enwere ike ịchọ mgbanwe. Ndị ọrịa na-atụgharị maka ịchọpụta insulin nwere ike ịchọ ịgbanwe dose ahụ ma e jiri ya na usoro nke insulin na-emebu. Mkpa maka ịmeghari usoro onunu ogwu nwere ike ibilite mgbe iwere usoro izizi nke mbụ ma ọ bụ n’ime izu ole na ole ma ọ bụ ọnwa ole na ole. Ekwesighi iji insulin na insemir mee ihe, n'ihi na nke a nwere ike ibute nnukwu hypoglycemia. Ordọ aka na nchịkwa m / m na-agba ọsọsọ ma bụrụkwa nke ukwuu ma e jiri ya tụnyere ọchịchị nchịkwa. Ọ bụrụ na agwakọta insulin detemir na ụdị insulin ndị ọzọ, profaịlụ nke otu ma ọ bụ akụkụ abụọ ga-agbanwe. Inggwakọta detemir insulin na analogue na-arụ ọrụ insulin, dị ka insulin aspart, na-eduga na profaịlụ ihe na ibelata ma na-egbu oge na-emetụta oke na njikwa ha dị iche.
Nyefee site na insulins na-eme ihe na insulin ogologo oge gaa na insulin insulin nwere ike ịchọ nguzo na oge iwegharị. Dị ka ọ dị insulins ndị ọzọ, a na-atụ aro iji nlezianya nke ọkwa glucose ọbara n'oge ntụgharị na izu mbụ nke nchịkwa insulin ọhụrụ. Imezi ihe eji agwọ hypoglycemic therapy (dose na oge nchịkwa nke ụdị insulin ma ọ bụ dose nke ọnụ ọgụgụ hypoglycemic na -eme ihe) nwere ike ịdị mkpa.
Achọghị insulin insulin iji rụọ ọrụ na nfuli insulin.
Jiri n'oge ime na lactation. Ugbu a enweghi data banyere iji ọgwụ insulin detemir n'oge ọmụmụ ime na lactation. Ihe omumu banyere omumu umu anumanu ekpughere ihe di iche na insulin nke detemir na insulin nke mmadu n’arite n’onye oria na teratogenicity. Na mkpokọta, iji nlezianya nyochaa ụmụ nwanyị dị ime nke nwere ọrịa shuga n'oge dum dị ime, yana mgbe ị na-eme atụmatụ ịtụrụ ime, dị mkpa. Mkpa insulin n'ime oge nke atọ nke afọ ime na-ebelata, mgbe ahụ na nke abụọ na nke atọ ọ na-abawanye. N'oge na-adịghị anya a mụsịrị nwa, mkpa nke insulin na-alaghachi ngwa ngwa dị ka ọ dị tupu ime ime. N’ime ụmụ nwanyị ndị na-enye nwa ara, ọ ga-adị mkpa ịgbanwe ndozi nke inulin na nri.
Mmetụta ikike ịkwọ ụgbọ ala ma jiri usoro rụọ ọrụ. Ike nke ndị ọrịa itinye uche na ọnụego mmeghachi omume nwere ike ọfụma n'oge hypoglycemia ma ọ bụ hyperglycemia, nke nwere ike ịdị ize ndụ n'ọnọdụ ebe ikike ndị a dị ezigbo mkpa (dịka ọmụmaatụ, mgbe ha na-anya ụgbọ ala ma ọ bụ na-arụ ọrụ na igwe na usoro). A dụrụ ndị ọrịa ọdụ ka ha mee ihe iji gbochie mmepe nke hypoglycemia na hyperglycemia mgbe ha na-anya ụgbọ ala ma jiri usoro rụọ ọrụ. Nke a dị ezigbo mkpa maka ndị ọrịa na-enweghị ma ọ bụ belata ihe mgbaàmà nke ihe ndị na - ebido hypoglycemia ma ọ bụ nke ugboro ugboro nke hypoglycemia. N'ụdị ndị a, ekwesịrị ịtụle mkpa ịkwọ ụgbọala ma ọ bụ ịrụ ụdị ọrụ ahụ.

Mmekọrịta ọgwụ ọgwụ Insulin detemir

E nwere ọtụtụ ọgwụ na-emetụta mkpa maka insulin.
A na - eme ka mmetụta hypoglycemic nke insulin na: onu hypoglycemic ọgwụ ọjọọ, Mao inhibitors, Ace inhibitors, carbonic anhydrase inhibitors, ndị na-abụghị nhọrọ β-blockers, bromocriptine, sulfonamides, anabolic Steroid, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, lithium, ọgwụ ọjọọ nwere ethanol.
Mmetụta hypoglycemic nke insulin na-ebelata: ogwu ura, ogwu corticosteroids, homonu thyroid, thiazide diuretics, heparin, tricyclic antidepressants, sympathomimetics, danazole, clonidine, mgbochi calcium channel, diazoxide, morphine, phenytoin, nicotine. N'okpuru mmetụta nke reserpine na salicylates, ọ ga-ekwe omume ịkụda ma ọ bụ welie ọrụ ọgwụ Octreotide / lanreotide, nke nwere ike ịbawanye ma belata mkpa ahụ insulin nwere. Ndị na-egbochi ọgwụ ad-adrenergic nwere ike kpuchie mgbaàmà nke hypoglycemia na igbu oge na mgbake mgbe hypoglycemia. Mmanya na-egbu egbu nwere ike ịkwalite ma mee ka mmetụta insulin na hypoglycemic dịkwuo ogologo.
Ndakọrịta
Drugsfọdụ ọgwụ, dịka ọmụmaatụ, nwere thiol ma ọ bụ sulfite, mgbe agbakwunye detemir na ọgwụ insulin, nwere ike ịkpata mbibi ya. Ya mere, etinyela insulin detemir na ngwakọta infusion.

Doụ ọgwụ insulin gabigara ókè, mgbaàmà na ọgwụgwọ

Ọtọbeghị usoro nke na-enye ohere ikwu maka ịdoụ insulin ịba ụba, ma hypoglycemia nwere ike ịmalite nwayọ nwayọ ma ọ bụrụ na ewepụtara otu ọgwụ dị oke oke maka otu onye ọrịa. Ọrịa hypoglycemia.
Ọgwụgwọ: onye ọrịa ahụ nwere ike iwepụ hypoglycemia dị nwayọ site na ịgestụ glucose, shuga ma ọ bụ nri nwere carbohydrate. Ya mere, a na-atụ aro ka ndị na-arịa ọrịa shuga na-ebu shuga, swiiti, kuki ma ọ bụ ihe ọ fruitụ fruitụ mkpụrụ osisi na-atọ ụtọ mgbe niile.Ọ bụrụ na ọrịa hypoglycemia dị ukwuu, mgbe onye ọrịa amaghị ihe ọ bụla, 0.5-1 mg nke glucagon v / m ma ọ bụ s / c, (enwere ike ịchịkọta ya) ma ọ bụ iv dextrose (glucose).
Tinye INSERT 'info` (' ID`, 'Name', 'NameBase`,' TEXT`, 'Ishesed', `Description`,` KeyWords`) VALUES (enwere ike ibia site n'aka ndi dibia bekee). Nlekọta nke ọgbụgba ahụ na - etolite etolite dịkwa mkpa ma ọ bụrụ na onye ọrịa ahụ enwetaghị mmata na nkeji iri na ise 10-15 gachara nchịkwa glucagon. Mgbe ọ nwetasịrị onwe ya, a na-adụ onye ọrịa ọdụ iri nri nwere carbohydrate iji gbochie nlọghachi hypoglycemia.

Ndepụta nke ụlọ ọgwụ ebe ị nwere ike ịzụta Insulin detemir:

Leasedị mwepụta, ihe mejupụtara na nkwakọ

Ngwọta maka sc አስተዳደር transperent, enweghị agba.

Ndị e mere: glycerol, phenol, metacresol, zinc acetate, sodium chloride, sodium dihydrogen phosphate dihydrate, hydrochloric acid ma ọ bụ sodium hydroxide, mmiri d / i.

* Otu 1 nwere 142 μg nke insulin na-enweghị nnu, nke dabara na otu 1. insulin mmadu (IU).

3 ml - katalọgụ iko (1) - pensụl mkpụrụ ọgwụ ị ga-eji maka ọtụtụ injections (5) - ọtụtụ nke kaadiboodu.

Omume ọgwụ

Ọgwụ hypoglycemic. O bu ihe omumu banyere mmanu mmadu ji eme otutu ihe. A na-emepụta teknụzụ ihe omimi nke DNA site na iji ụdị Saccharomyces cerevisiae.

Ihe omuma nke ogwu Levemir ® FlexPen ® di obere na-adighi agbanwe agbanwe ma e jiri ya tụnyere insulin-isophan na insulin glargine.

Ogologo oge nke ọgwụ Levemir ® FlexPen ® bụ n'ihi nkwupụta nke njikọta nke ụmụ irighiri ihe detemir insulin na ntanetị na njikọ nke ụmụ irighiri ọgwụ ahụ na albumin site na njikọta na njikọ akụkụ. E jiri ya tụnyere insulin-isophan, insulin detemir dị nwayọ karịa uru anụ ahụ dị iche iche. Usoro ndị a na-egbu oge na-egbu oge na-enye nnabata nnabata ọzọ na profaịlụ Levemir ® FlexPen ® ma e jiri ya tụnyere insulin-isophan.

Ọ na - emekọrịta otu onye na - anabata ihe n'ụsọ akpụkpọ ahụ cytoplasmic nke mkpụrụ ndụ ma mepụta ogige insulin-receptor na-akpali usoro intracellular, gụnyere njikọ nke ọtụtụ isi enzymes (hexokinase, pyruvate kinase, glycogen synthetase).

Mbelata nke glucose na ọbara bụ n'ihi mmụba na njem nke akwara umeji ya, nba ụba site na anụ ahụ, mkpali nke lipogenesis, glycogenogenesis, na mbelata nke mmụkọ nke imeju.

Maka usoro 0.2-0.4 U / n'arọ 50%, mmetụta kachasị nke ọgwụ ahụ na-apụta na oke site na awa 3-4 ruo awa iri na anọ mgbe nchịkwa gasịrị. Ogologo oge omume a dị ka awa iri abụọ na anọ, dabere na ntụtụ, nke a na-eme ka o kwe omume ịhazi oge 1 / ụbọchị ma ọ bụ ugboro 2 / ụbọchị.

Mgbe sc ochichi, a pharmacodynamic nzaghachi bụ kwekọrọ na dose ndinọ (kacha mmetụta, oge nke ihe, izugbe mmetụta).

N'ime ọmụmụ ogologo oge na ndị ọrịa nwere ụdị shuga 2 bụ onye natara ọgwụ insal na ọgwụ ọgwụ hypoglycemic, a gosipụtara na njikwa glycemic (na usoro nke glycosylated haemoglobin - НbА_1s) megidere usoro ọgwụgwọ na Levemir ® FlexPen ®, o jiri ya tụnyere nke insulin-isophan na insulin glargine nwere uru dị ala.

Withgbanwe ibu ahu na insulin therapy

Na nyocha, ojiji nke ijikọ ọgwụ na Levemir ® FlexPen ® na ọgwụ hypoglycemic ọgwụ na 61-65% nke ikpe belatara ohere nke ịmalite hypoglycemia dị nro, n'ụzọ dị iche na insulin-isophan.

N'ime ọmụmụ ogologo oge (ọnwa ≥6), glucose plasma glucose na ndị ọrịa nwere ụdị 1 mellitus ọrịa shuga dị mma ma e jiri ya tụnyere ọgwụgwọ na Levemir ® FlexPen ® ma e jiri ya tụnyere insulin-isophan ka edepụtara maka usoro ọgwụgwọ isi / bolus, gụnyere ọmụmụ metụtara ụmụaka na ndị nọ n’afọ iri na isii ruo afọ iri na asaa. Njikwa nchịkwa (HbA_1s) n'oge ọgwụgwọ na Levemir ® FlexPen ® dị ka nke ahụ site na ọgwụgwọ insulin-isophan, nwere obere ọrịa hypoglycemia n'abalị na enweghị mmụba na ahụ ya na Levemir ® FlexPen ®.

Ihe ngosi banyere njikwa glycemic nke abalị dị larịị ma karịa na Levemir ® FlexPen ® ma e jiri ya tụnyere insulin-isophan, nke a na-egosi na ọ nwere ike ibute ọrịa hypoglycemia n'abalị.

Mgbe ị na-eji Levemir ® FlexPen ®, a na-ahụ ihe ndị na - eme ihe na - eme ihe n'oge ochie. Agbanyeghị, eziokwu a anaghị emetụta njikwa glycemic.

Mlọ ọgwụ

Site na nlekọta nchịkwa sc, nchịkọta nke ọbara bụ ihe ruru ka usoro a na-achịkwa (C_max, ogo nke nnabata).

C_max mezuru awa 6-8 ka nchịkwa gasị. Site na usoro nlekọta okpukpu abụọ kwa ụbọchị nke nchịkwa nke C_ss mezuru mgbe agwara 2-3.

Mgbakwunye nnabata intraindividual dị obere maka Levemir ® FlexPen ® ma e jiri ya kwado insulin ndị ọzọ.

Ọkara V_d insemir insulin (ihe dị ka 0.1 l / kg) na-egosi na oke oke nke insulin insulin na-ekesa n'ime ọbara.

Na nyocha na inyocha protein na-egosi enweghị enweghị mmekọrịta dị n'etiti ụlọ ọgwụ detemir na abụba abụba ma ọ bụ ọgwụ ndị ọzọ na-ejikọ protein.

Ntughari ihe anakpo insulin detemir yiri nke nkwadebe insulin, ihe ndi metabolites guzobere adigh eme.

Ọnụ T_1/2 mgbe ogwu nchara, a na-ekpebi ya site n ’ogo nke mkpụkọ si n’ọkpụkpụ anụ ma ọ bụ awa 5-7, dabere n’ dose ahụ.

Pharmacokinetics n'ihe gbasara ọrịa

Enweghị ọdịiche dị n'etiti ụmụ nwanyị na ụlọ ọgwụ dị iche iche na ọgwụ ọgwụ nke Levemir ® FlexPen ®.

A mụrụ Njirimara ọgwụ ọgwụ Levemir ® FlexPen in na ụmụaka (afọ 6-12) na ụmụaka (13-17 afọ) ma atụnyere. Enweghị ọdịiche dị na Njirimara ọgwụ ma e jiri ya tụnyere ndị okenye nwere ọrịa shuga nke 1.

Enweghị ọdịiche dị ukwuu na-adakarị na ụlọ ọrụ ọgwụ nke Levemir ® FlexPen ® n'etiti ndị agadi na ndị ọrịa na-eto eto, ma ọ bụ n'etiti ndị ọrịa nwere ọrịa ezumike mkpirikpi na ọrụ ịba ọcha n'anya na ndị ọrịa nwere ahụike.

Ọmụmụ Nche Ọrịa

Na nyocha nke vitro na ahịrị nke mmadụ, gụnyere ọmụmụ gbasara njikọta nke ndị na - anabata insulin na IGF-1 (ihe dị ka insulin etolite), gosipụtara na detemir insulin nwere obere mmekọrịta maka ndị na - anabata ya ma ọ nweghị obere mmetụta na uto sel ya na insulin nke mmadụ.

Ihe omuma ndi preclinical dabere na nyocha nke ihe omumu nke ihe banyere ogwu, ihe ojoo ugboro ugboro, ihe ndi mmadu n’eme ihe, ugwọ ogwu n’olu na omumu ekpughere mmadu.

Usoro usoro onunu ogwu

Levemir ® FlexPen ® ezubere maka nchịkwa sc.

Onu ya na ugboro ole ochichi nke ọgwụ Levemir ® FlexPen ® kpebisiri ike n’otu n’otu.

Ọgwụgwọ na Levemir ® FlexPen ® yana ọgwụ hypoglycemic nke ọgwụ, a na-atụ aro ka ịmalite na 1 oge / ụbọchị na oke 10 PIECES ma ọ bụ 0.1-0.2 PIECES / kg. Ekwesịrị ịhọrọ dose nke Levemir ® FlexPen individ n'otu n'otu dabere na uru glucose plasma. Dabere na nsonaazụ nke ọmụmụ a, ihe ndị a na-atụ aro maka titration dose: