Tresiba® Penfill® Insulin degludec

Ente 100 U / ml

1 ml ea tharollo e na le

ntho e sebetsang - insulin degludec * - 100 PIECES (3.66 mg),

baamohelang: phenol, metacresol, glycerol, zinki, hydrochloric acid / sodium hydroxide (bakeng sa khalemelo ea pH), metsi bakeng sa ente.

* e hlahisitsoe ke recombinant DNA biotechnology e sebelisang strain Saccharomycescerevisiae

Cartridge e le 'ngoe e na le 3 ml ea tharollo, e lekanang le PIERES tse 300.

Tharollo e se nang mebala.

Melemo ea pharmacological

Mofumahali

Kamora ho ente ea subcutaneous, sebopeho sa liforomo tse tsitsitseng tsa insulin tsa insuludec multhexamers, tse bōpang depositi ea "insulin" ka hara subcutaneous adipose tiske. Li-Multihexamers li ikarola hanyane ka hanyane, li lokolla li-insludec insulin monomers, e leng se etsang hore lithethefatsi li tsamaee butle maling.

Khokahano ea tekano ea Tresiba® ho plasma e fihlella ka mor'a matsatsi a 2-3 a ts'ebeliso ea letsatsi le letsatsi.

Ketso ea insulin degludec ea lihora tse 24 le tsamaiso ea eona ea letsatsi le letsatsi hanngoe ka letsatsi e ajoa ka mokhoa o lekanang pakeng tsa linako tsa pele le tsa bobeli tsa lihora tse 12 (AUCGIR, 0-12h, SS / AUCGIR, vene, SS = 0.5).

Ho amana ha insludec insulin bakeng sa serum albin ho tsamaisana le matla a kopanyang a protheine ea plasma> 99% ho plasma ea mali a motho.

Linearity

Ka tsamaiso e poteletseng, lits'oants'o tsohle tsa plasma li ne li lekana le lethal dose le fanoang lethathamong la litekanyetso tsa kalafo.

Lihlopheng tse ikhethang tsa bakuli

Bakuli ba baholo, bakuli ba merabe e fapaneng, bakuli ba bong bo fapaneng, bakuli ba nang le bothata ba ho lemala kapa ho sebetsa ha sebete

Ho ne ho se na phapang e kholo litabeng tsa pharmacokinetics ea Tresiba Penfill® lipakeng tsa bakuli ba tsofetseng le ba banyenyane, lipakeng tsa bakuli ba merabe e fapaneng, pakeng tsa bakuli ba nang le bothata ba ho ruruha ba mokokotlo kapa bo amanang le hepatic le bakuli ba phetseng hantle.

Hape ho ne ho se na phapang lipapaling tsa pharmacokinetic tsa lithethefatsi ho latela bong ba mokuli.

Bana le bacha

Melemo ea pharmacokinetic ea lithethefatsi Tresiba Penfill® thutong ea bana (ea lilemo tse 1-11) le bacha (lilemo tse 12-18) ba nang le mofuta oa 1 lefu la tsoekere ba bapisoa le bakuli ba baholo ba nang le ente e le 'ngoe.

Kameho e felletseng ea tekanyetso ea insulin ea insludec ho bana le lilemong tsa bocha e phahame haholo ha e bapisoa le ho bakuli ba baholo ba nang le tsamaiso e le 'ngoe ea lithethefatsi ho bakuli ba nang le lefu la tsoekere la 1.

Pharadodynamics

Tresiba® Penfill ® ke mokelikeli oa insulin ea motho ea nkileng nako e telele e hlahisoang ke li-biotechnology tsa DNA tse sebelisitsoeng hape tse sebelisang mofuta oa Saccharomyces cerevisiae.

Tciousba® Penfill ® ke analogue ea mantlha ea insulin ea motho ea nkileng nako e telele. Kamora ho ente ea subcutaneous, karolo ea basal ea lithethefatsi (insulin degludec) e qhibiliha ka bongata ka bongata ka har'a depo ea subcutaneous, moo ho kenang insuludec e tsoelang pele butle, ho fana ka boemo bo bataletseng ba ts'ebetso le phello e tsitsitseng ea hypoglycemic ea lithethefatsi.

Nakong ea tlhaiso ea lihora tse 24 ea phello ea hypoglycemic ea lithethefatsi ho bakuli ba sebelisitsoeng ka tekanyetso ea insludec insulin hang ka letsatsi, sethethefatsi sa Tresiba Penfill®, ho fapana le insulin glargine, se bonts'a palo e lekanang ea karolelano lipakeng tsa liketso tse nakong ea pele le ea bobeli ea lihora tse 12. (AUCGIR, 0-12h, SS / AUCGIR, kakaretso, SS = 0.5)

Sa feiga. 1. Palo ea tlhahiso ea tsoekere ea lihora tse 24 ka lihora tse 24 - tekanyetso ea insulin ea insiludec ea 100 PIECES / ml 0,6 PIECES / kg (boithuto ba 1987)

Nako ea ts'ebetso ea lithethefatsi Tresiba Penfill® ke lihora tse fetang tse 42 ho lethathamo la litekanyetso tsa kalafo. Khokahano e lekanang ea lithethefatsi ho plasma ea mali e fihlelleha matsatsi a 2-3 kamora ho tsamaisoa ha moriana.

Insulin degludec ka ho lekana mahloriso a lekanang e bontša tlase haholo (makhetlo a 4) ha e bapisoa le insulin glargin letsatsi le leng le le leng lipapatso tsa ts'ebetso ea hypoglycemic, e hakantsoeng ke boleng ba coeffnty ea variability (CV) bakeng sa thuto ea phello ea hypoglycemic ea lithethefatsi ka nako e le ngoe ea ho lekanya ho tloha ho li-0 ho isa ho 24 ( AUCGIR, vene, SS) le nakong ea nakoana ho tloha lihora tse peli ho isa ho tse 24 (AUCGIR, 2-24h, SS) (Lethathamo 1).

Tab. 1. Phapang ea lintlha tsa letsatsi le letsatsi tsa phello ea hypoglycemic ea lithethefatsi Tresiba le insulin glargine maemong a lekanang ho bakuli ba mofuta oa 1 lefu la tsoekere.

Phapang ea liphihlelo tsa letsatsi le letsatsi tsa ts'ebetso ea hypoglycemic ka nako e le 'ngoe ea dosing (AUCGIR, vene, SS)

Phapang ea liphihlelo tsa letsatsi le letsatsi tsa ts'ebetso ea hypoglycemic ka nako ea nako ho tloha lihora tse peli ho isa ho tse 24 (AUCGIR, 2-24 h, SS)

CV: ts'ebetso ea ho fapana ka mokhoa o ikhethileng oa%

SS: Ts'oarelo ea lithethefatsi ka ho lekana

AUCGIR, 2-24h: phello ea metabolism lihoreng tse 22 tse fetileng tsa nako ea ho nka tekanyetso (ke hore, ha ho na phello ho eona ea insulin e kenang nakong ea tlhahlobo ea tlhahlobo ea tlhahlobo)

Kamano ea mola pakeng tsa keketseho ea tekanyetso ea Tresiba Penfill® le phello ea eona e akaretsang ea hypoglycemic e netefalitsoe.

Lithuto ha lia hlahisa phapang e kholo litabeng tsa pharmacodynamics ea lithethefatsi Tresiba lipakeng tsa bakuli ba baholo le bakuli ba baholo.

Ts'ebetso ea Kliniki le Polokeho

Liteko tsa kliniki tse bulehileng tsa machabeng tse 13 tse sa sebetseng li ile tsa etsoa kalafong ea kalafo ho isa ho ea libeke tse 26, tse tšoaroang ka lihlopha tse tšoanang, tse kenyelletsang bakuli ba 4275 ba nang le lefu la tsoekere la mellitus (ba 1102 ba nang le lefu la tsoekere la 1 le bakuli ba 3173 ba nang le lefu la tsoekere. mofuta oa 2 lefu la tsoekere) e tšoaroang ke Tresiba®.

Ho sebetsa hantle ha Tresiba® ho ile ha ithutoa ho bakuli ba nang le lefu la tsoekere la mofuta oa 1 (Tafole ea 3), ho bakuli ba nang le lefu la tsoekere la mofuta oa 2 ba neng ba sa amohela insulin pele (ho qala kalafo ea insulin, Tafole ea 4), le ba fumaneng kalafo ea insulin (Tafole ea kalafo ea insulin, Tafole ea 5) ) ka mokhoa o hlophisitsoeng kapa o bonolo oa dosing ea lithethefatsi Tresiba® (Lethathamo 6).

Ho ba sieo ha bophahamo ba lithethefatsi tsa papiso (insulin detemir le insulin glargine) holim'a lithethefatsi tsa Tresiba® mabapi le ho fokotseha ha hemoglobin (HbA1c) ho tloha nakong ea ho kenyelletsoa ho fihlela qetellong ea thuto ho netefalitsoe. Phapang e ne e le lithethefatsi tsa sitagliptin, nakong ea papiso eo Tresiba® ea lithethefatsi e bonts'itseng bophahamo ba eona ba lipalo mabapi le ho fokotseha ha HbA1c (Tafole ea 5).

Liphetho tsa tlhahlobo-kholo ea meta-datha e fumanoeng nakong ea liteko tsa bongaka tse 7 tse reriloeng motheong oa "kalafo ho ea sepheo" ka ho nka karolo ha bakuli ba nang le mofuta oa 1 le mofuta oa 2 lefu la tsoekere le bonts'a melemo ea kalafo le Tresiba® mabapi le ho theoha ho tlase ha ho bapisoa le kalafo ea insulin glargine , khafetsa ea kholo ho bakuli ba nang le liketsahalo tsa "hypoglycemia" ea bosiu bosiu. Ho fokotseha hoa kholo ea hypoglycemia nakong ea kalafo le Tresib ® ho fihlelitsoe ka glucose e tlase e potlakileng ea "plasma" ho feta ka insulin glargine.

Lethathamo la 2. Meta-analysis ea data ea episode hypoglycemia

Likarolo tsa leqtumelloennoyhypoglycemialeempa

Tekanyo ea Kotsi ea Kotsi

(insulin degludec / insulin glargine)

Kakaretso

Bosius

Mofuta oa 1 lefu la tsoekere mellitus + mofuta oa 2 lefu la tsoekere (ya data ka kakaretso)

Tlhaloso ea lithethefatsi

Insulin degludec * (Insulin degludec *) - Lithethefatsi Insulin degludec * (Insulin degludec *) ® Penfill ® - insulin ea motho ea sebetsang ka nako e telele e hlahisoang ke recombinant DNA biotechnology e sebelisang mofuta oa Saccharomyces cerevisiae strain.

Insulin degludec e tlama ka ho khetheha le receptor ea insulin ea motho ea tsoetseng pele mme, e sebelisana le eona, e hlokomela phello ea eona ea pharmacological e tšoanang le phello ea insulin ea motho.

Phello ea hypoglycemic ea "insludec insulin" e bakoa ke ts'ebeliso ea tsoekere ea glucose ke lisele ka mor'a ho tlama insulin ho mesifa le mafura a lisele tsa mafura le ho fokotseha ho hongata ha sekhahla sa tlhahiso ea tsoekere ke sebete.

Lithethefatsi Tresiba penfill ® ke analogue ea motheo ea insulin ea motho ea nako e fetelletseng, kamora ho kenngoa ka ente ea manonyeletso e hlahisa li-multihexamers tse fumanehang ka har'a depotlana e poteletseng, moo ho nang le ts'oaretso e tsoelang pele le ea nako e telele ea "insludec insulin" maling, e fanang ka ts'ebetso ea nako e telele ea boemo bo phahameng. Nakong ea tlhaiso ea lihora tse 24 ea phello ea hypoglycemic ea lithethefatsi ho bakuli ba sebelisitsoeng ka tekanyetso ea insludec insulin hang ka letsatsi, sethethefatsi sa Tresiba Penfill®, ho fapana le insulin glargine, se bonts'itse palo ea phepelo e ts'oanang pakeng tsa liketso ka nako ea pele le ea bobeli ea lihora tse 12 ( Auc_{GiR, 0-12h, SS}/ Auc_{GiR, kakaretso, SS} = 0.5).

Insulin degludec ka ho lekana mahloriso a lekanang e bonts'a tlase haholo (makhetlo a 4) ha e bapisoa le lintlha tsa insulin tsa letsatsi le letsatsi tsa phapang ea ts'ebetso ea hypoglycemic, e hakantsoeng ke boleng ba coeffanele ea variability (CV) bakeng sa thuto ea phello ea hypoglycemic ea lithethefatsi nakong ea nako e le ngoe ea dosing (AUC_{GiR, t, SS}) le nakong ea nako ea lihora tse peli ho isa ho tse 24 (AUC_{GiR, 2-24h, SS}), bona Lethathamo 1.

Lethathamo 1. Phapang ea lintlha tsa letsatsi le letsatsi tsa phello ea hypoglycemic ea lithethefatsi Tresiba le insulin glargine maemong a lekanang ho bakuli ba mofuta oa 1 lefu la tsoekere.

Insulin degludec (N26) (CV%)	Insulin glargine (N27) (CV%)
Phapang ea liphihlelo tsa ts'ebetso ea "hypoglycemic" ea letsatsi le letsatsi ka makhetlo a mangata ho feta tekanyetso e le 'ngoe ea dosing (AUC_{GiR, t, SS}).	20	82
Phapang ea liphihlelo tsa letsatsi le letsatsi tsa ts'ebetso ea hypoglycemic nakong ea nako ho tloha lihora tse peli ho isa ho tse 24 (AUC_{GiR, 2-24h, SS}).	22	92

CV ke eona e sebetsang ka ho fapanang ha litaba tsa motho a le mong ka har'a%,

SS ke khatello ea lithethefatsi ka ho lekana,

Auc_{GiR, 2-24h, SS} - phello ea metabolic lihoreng tse 22 tse fetileng tsa karohano ea dosing (ke hore, ha ho na phello ho eona ea ho kenella ka insulin kahare nakong ea kenyelletso ea thuto ea bohlasoa).

Kamano ea mola pakeng tsa keketseho ea tekanyetso ea Tresiba Penfill® le phello ea eona e akaretsang ea hypoglycemic e netefalitsoe.

Lithuto ha lia hlahisa phapang e kholo litabeng tsa pharmacodynamics ea lithethefatsi Tresiba lipakeng tsa bakuli ba baholo le bakuli ba baholo.

Ts'ebetso ea Kliniki le Polokeho

E entse liteko tsa bongaka tse 11 tsa bongaka tse bulehileng tsa kalafo ea Ther-to-Target (leano la "ho fola ka sepheo") tsa libeke tse 26 le 52, tse tsamaisoang ka lihlopha tse tšoanang, tse kenyelletsang bakuli ba 4275 (bakuli ba 1102 ba nang le lefu la 1 la tsoekere le 3173 mokuli ea nang le mofuta oa 2 lefu la tsoekere mellitus) ea tšoaroang ke Tresiba®.

Ho sebetsa hantle ha Tresiba® ho ile ha ithutoa ho bakuli ba nang le lefu la tsoekere la mofuta oa 1 ba neng ba e-so ka ba amohela insulin pele, le mofuta oa lefu la tsoekere la mofuta oa 2 le ileng la amohela kalafo ea insulin, ka mokhoa o hlophisitsoeng kapa o bonolo oa litekanyetso tsa Tresiba®. Ho ba sieo ha bophahamo ba lithethefatsi tsa papiso (insulin detemir le insulin glargia) holim'a Tresiba® mabapi le ho fokotseha ha index ea HbA ho netefalitsoe_1C ho tloha motsotso oa ho kenyelletsa qetellong ea thuto. Mokhelo e ne e le sitagliptin, nakong eo Tresiba® e bontsitseng bophahamo ba eona ba lipalo ba ho fokotsa HbA_{_1C}.

Liphetho tsa boithuto ba bongaka ("phekolo bakeng sa sepheo") ea ho qala kalafo ea insulin ho bakuli ba nang le lefu la tsoekere la 2 lefu la tsoekere le bontšitse phokotso ea 36% maemong a netefalitsoeng a nocturnal hypoglycemia (e hlalositsoeng e le liketsahalo tsa hypoglycemia tse etsahetseng pakeng tsa lihora tsa zero le hora ea botšelela hoseng. e netefalitsoe ke ho lekanya khatello ea mali ea "plasma" glucose0.84*0.68* Bakuli ba baholo ≥ ba lilemo li 650.820.65* Type 1 lefu la tsoekere1.10.83 Nako ea tlhokomelo ea khase ea b1.020.75* Type 2 lefu la tsoekere0.83*0.68* Nako ea tlhokomelo ea khase ea b0.75*0.62* Ke feela kalafo ea basal ho bakuli ba neng ba sa amohela insulin pele0.83*0.64*

* Bohlokoa ka lipalo
a - g-netefalitsoeng ea hypoglycemia ke karolo ea hypoglycemia, e netefalitsoeng ke tekanyo ea plasma glucose mahloriso a b - liketsahalo tsa hypoglycemia kamora beke ea 16 ea phekolo.

Ha ho na sebopeho sa bohlokoa sa 'mele se thibelang li-insulin ka mor'a kalafo le Tresiba Penfill® ka nako e telele.

E latelang Generation Insulin e sebetsang ka nako e telele

Bakeng sa lefu la tsoekere, insulin ea NPH ea motho le lipapiso tsa eona tse telele tsa ho sebetsa li fumaneha. Tafole e ka tlase e bonts'a phapang e kholo lipakeng tsa meriana ena.

Ka Loetse 2015, ho ile ha hlahisoa insulin e ncha ea nakoana ea Abasaglar, e batlang e ts'oana le Lantus e ubiquitous.

Insulin e etsang lintho ka nako e telele

Lebitso la machabeng / motsoako o sebetsang	Lebitso la khoebo la lithethefatsi	Mofuta oa ketso	Nako ea netefatso
Insulin glargine glargine	Lantus Lantus	Nako e telele insulin - analogue	24 h
Glargin	Abasaglar Abasaglar	Nako e telele insulin - analogue	24 h
Insemir ea insulin	Levemir Levemir	Nako e telele insulin - analogue	≤ 24 h
Insulin glargine	Toujeo Tojo	Insulin e eketsehileng e sebetsang ka nako e telele	> Lihora tse 35
Motlatsi	Tresiba tresiba	Insulin e telele haholo e sebetsang - analogue	> 48 h
NPH	Humulnin N, Insulatard, Insuman Basal, Polhumin N	Insulin ea Nako e Bohareng	18 - 20 h

Tsamaiso ea Lijo le Lithethefatsi (FDA, US FDA) - Setsi sa mmuso se ka tlase ho Lefapha la Bophelo la U.S. ka 2016 se amohetse analogue e 'ngoe ea khale ea insulin, Toujeo. Sehlahisoa sena sea fumaneha 'marakeng oa lapeng' me se paka hore se sebetsa hantle kalafong ea lefu la tsoekere.

NPH insulin (NPH Neutral Protamine Hagedorn)

Ona ke mofuta oa insulin ea maiketsetso e etselitsoeng moralo oa insulin ea motho, empa o ruisitsoe ka protamine (protheine ea tlhapi) ho lieha ho sebetsa. NPH e maru. Ka hona, pele ho tsamaiso, e lokela ho potoloha ka hloko ho kopanya hantle.

NPH ke mofuta o theko e tlaase ka ho fetisisa oa insulin e sebetsang ka nako e telele. Ka bomalimabe, e na le kotsi e phahameng ea hypoglycemia le phaello ea boima ba 'mele, hobane e na le tlhoro e boletsoeng e le teng (le hoja ts'ebetso ea eona e le butle butle ebile e sa potlake joaloka ea insulin ho bolus).

Bakuli ba nang le lefu la tsoekere la mofuta oa 1 hangata ba fuoa litekanyetso tse peli tsa NPH insulin ka letsatsi. 'Me bakuli ba nang le lefu la tsoekere la mofuta oa 2 ba ka kenella hang ka letsatsi. Tsohle li itšetlehile ka boemo ba tsoekere maling le litlhahiso tsa ngaka.

O sebetsa ka nako e telele ka insulin

Insulin, metsoako ea lik'hemik'hale eo e fetotsoeng hoo li theolelang ho monya le phello ea lithethefatsi, e nkuoa e le analogue ea insulin ea motho.

Lantus, Abasaglar, Tujeo le Tresiba li na le tšobotsi e tloaelehileng - nako e telele ea ketso le tlhōrō ea tšebetso e sa tsejoeng ho feta NPH. Ntlheng ena, ho ja ka bongata ho fokotsa kotsi ea hypoglycemia le ho nona. Leha ho le joalo, litšenyehelo tsa li-analogu li phahameng haholo.

Abasaglar, Lantus le Tresiba insulin ba nooa hanngoe ka letsatsi. Bakuli ba bang le bona ba sebelisa Levemir hang ka letsatsi. Sena ha se sebetse ho mofuta oa diabetes tse 1 tseo ts'ebetso ea lithethefatsi e leng ka tlasa lihora tse 24.

Tresiba ke mofuta o mocha ka ho fetisisa 'me hajoale ke mofuta o theko e boima haholo oa insulin e fumanehang' marakeng. Leha ho le joalo, e na le monyetla oa bohlokoa - kotsi ea hypoglycemia, haholo bosiu, ke eona e tlase haholo.

Insulin e nka nako e kae

Karolo ea insulin e nkang nako e telele ke ho emela secretion ea mantlha ea insulin ka makhopho a manyeme. Kahoo, boemo bo tšoanang ba lihormone tsena maling bo tiisetsoa tšebetsong eohle ea bona. Sena se lumella lisele tsa 'mele ea rona ho sebelisa tsoekere e qhibilihileng maling maling ka lihora tse 24.

Mokhoa oa ho enta insulin

Li-insulin tsohle tse nkang nako e telele li kenella ka tlas'a letlalo libakeng moo ho nang le mafura. Karolo ea morao-rao ea serope e loketse hantle bakeng sa merero ena. Sebaka sena se lumella ho monya lithethefatsi butle, ka tsela e tsoanang. Ho latela ho khethoa ke endocrinologist, o hloka ho etsa ente e le 'ngoe kapa tse peli ka letsatsi.

Khalemelo khafetsa

Haeba sepheo sa hau ke ho boloka liente tsa insulin li le tlase ka moo ho ka khonehang, sebelisa li-analogs tsa Abasaglar, Lantus, Toujeo kapa Tresiba. Ente e le 'ngoe (hoseng kapa mantsiboea, empa ka nako e tšoanang ea letsatsi) e ka fana ka insulin e lekanang ea li-insulin ho potoloha nako.

U kanna ua hloka liente tse peli ka letsatsi ho boloka li-hormone tsa mali tse lekaneng ha u khetha NPH. Sena, leha ho le joalo, se u lumella ho fetola tekanyetso ho latela nako ea motšehare le ts'ebetso - e phahame mots'eare mme e nyane ka nako ea ho robala.

Kotsi ea hypoglycemia ts'ebelisong ea insulin

Ho netefalitsoe hore li-analog tsa nako e telele tsa insulin ha li na monyetla oa ho baka hypoglycemia (haholo-holo hypoglycemia bosiu) ha e bapisoa le NPH. Ha u li sebelisa, boleng ba sepheo sa hemoglobin HbA1c bo kanna ba khona ho fihlella.

Ho boetse ho na le bopaki ba hore tšebeliso ea li-insulin tse sebetsang ka nako e telele ha li bapisoa le isoflan NPH e baka ho fokotseha ha boima ba 'mele (mme, ka lebaka leo, ho fokotseha ha khatello ea lithethefatsi le tlhoko e akaretsang ea lithethefatsi).

Ho nka insulin nako e telele molemong oa lefu la tsoekere la mofuta oa

Haeba o na le lefu la tsoekere la mofuta oa 1, manyeme a hau ha a khone ho hlahisa insulin e lekaneng. Ka hona, kamora lijo tse ling le tse ling, o lokela ho sebelisa meriana e nkileng nako e telele e etsisang secretion ea mantlha ea insulin ke lisele tsa beta. Haeba u fetoa ke ente, ho na le kotsi ea ho ba le lefu la tsoekere le lefu la tsoekere.

Ha u khetha pakeng tsa Abasaglar, Lantus, Levemir le Tresiba, o hloka ho tseba likarolo tse ling tsa insulin.

Lantus le Abasaglar ba na le boemo bo tlase bo patehileng ho feta Levemir, mme ho bakuli ba bangata, ba mafolofolo lihora tse 24.
Levemir e ka hloka ho nkuoa habeli ka letsatsi.
U sebelisa Levemir, litlhare li ka baloa ho latela nako ea motšehare, ka hona, fokotsa kotsi ea hypoglycemia ea bosiu le ho ntlafatsa taolo ea motšehare.
Toujeo, lithethefatsi tsa Tresibia li fokotsa matšoao a kaholimo ho bapisoa le Lantus.
U boetse u lokela ho nahana ka litlamorao tsa meriana e kang lekhopho. Lintho tsena li etsahala seoelo, empa li ka etsahala.
Haeba u hloka ho fetoha ho tloha ho li-insulin analog ea nako e telele ho ea ho NPH, hopola hore tekanyetso ea lithethefatsi ka mor'a lijo e kanna ea hloka ho fokotsoa.

Ho nka insulin nako e telele bakeng sa lefu la tsoekere la mofuta oa II

Phekolo ea lefu la tsoekere la mofuta oa II hangata e qala ka ho hlahisoa ha phepo e nepahetseng le meriana ea molomo (Metformin, Siofor, Diabeteson, jj ..). Leha ho le joalo, ho na le maemo ha lingaka li qobelloa ho sebelisa kalafo ea insulin.

Tse tloaelehileng haholo li thathamisitsoe ka tlase:

Phello e sa lekaneng ea lithethefatsi tsa molomo, ho sitoa ho fihlela glycemia e tloaelehileng le hemoglobin ea glycated
Contraindication bakeng sa tsamaiso ea molomo
Tlhahlobo ea lefu la tsoekere le litheko tse phahameng tsa glycemic, matšoao a kliniki a eketsehang
Litla-morao tsa Myocardial, angiography ea coronary, stroke, tšoaetso e matla, lits'ebetso tsa ho buoa
Boimana

Boitšoaro ba insulin ea nako e telele

Tekanyetso ea pele ke hangata boima ba likarolo tse 0,2 / kg. Calculator ena e sebetsa hantle bakeng sa batho ntle le ho hanyetsa insulin, ka ts'ebetso e tloaelehileng ea sebete le a liphio. Litekanyetso tsa insulin li fanoa ke ngaka ea hau feela! (!)

Ntle le nako ea ts'ebetso (e telele ka ho fetisisa ke degludec, e khutšoanyane haholo ke enjene ea insulin-isophan ea motho), meriana ena le eona e fapana ka ponahalo. Tabeng ea insulin NPH, tlhase ea ho pepeseha e tsamaisoa ha nako e telele mme e etsahala pakeng tsa lihora tse 4 ho isa ho tse 14 kamora ho ente. Analogue e sebetsang ea semelo sa insulin se sebetsang ka nako e telele se fihla tlhōrōng ea lihora tse 6 ho isa ho tse 8 ka mor'a ho entoa, empa e lula e sa buuoe hanyane.

Ka hona, insulin glargine e bitsoa basal insulin. Tsitsipano ea eona maling e fokola haholo, ka hona menyetla ea hypoglycemia e tlase haholo.

Lethathamo la li-analogues

Fomu ea tokollo (ka tumello)	Theko, rub.
*Insulin degludec (Insulin degludec )*
Tresiba
FlexTouch 100ED / ml 3ml No. 1 syringe - pente (Novo Nordisk A / S (Denmark)	7093.20

Moeti e mong o ile a tlaleha palo ea batho ba jang letsatsi le letsatsi

Ke lokela ho nka insulin hangata hakae (Insulin degludec *)?
Boholo ba batho ba bangata khafetsa ba sebelisa moriana ona makhetlo a 3 ka letsatsi. Tlaleho e bontša hore hangata ba arabelang litlhare tse ling ba sebelisa moriana ona joang.

Litho	%
Makhetlo a 3 ka letsatsi	1	Ketso ea pharmacological Hypoglycemic. Phello ea lithethefatsi tsa insulin ea insludec e fumanoa ka mokhoa o ts'oanang le phello ea insulin ea motho ka ho tlama le ho sebelisana le li-insulin receptors tsa motho. Phello ea hypoglycemic ea insulin degludec e bakoa ke keketseho ea ts'ebeliso ea tsoekere ke tishu kamora ho ts'oaroa hoa mesifa le mesifa ea mafura le ho fokotseha ho hongata ho tekanyo ea tlhahiso ea tsoekere ke sebete. Mokhoa oa kopo Bakeng sa batho ba baholo: Ntle ho 1 nako ka letsatsi, ka ho khetheha ka nako e le 'ngoe. Tekanyetso e baloa ka bonngoe ho latela se tsoekere sa glucose e maling plasma. Bakuli ba nang le lefu la tsoekere la mofuta oa I ba hloka liente tse ling tsa litokisetso tsa insulin tse potlakileng ho netefatsa tlhokahalo ea insulin. - lefu la tsoekere ho batho ba baholo. Litlamorao - Ka lehlakoreng la tsamaiso ea 'mele ea ho itšireletsa mafung: ka seoelo - karabelo ea hypersensitivity (ho kenyelletsa ho ruruha ha leleme kapa molomo, lets'ollo, ho nyekeloa ke pelo, mokhathala le ho hlohlona ha letlalo), urticaria. - Ho tloha ka lehlakoreng la metabolism le phepo e nepahetseng: khafetsa - hypoglycemia (hypoglycemia e ka hlaha haeba tekanyo ea insulin e phahame haholo ho feta tlhoko ea mokuli ea insulin. Hypoglycemia e matla e ka lebisa ho lahleheloa ke kelello le / kapa ho tsitsinyeha hoa kelello, ts'ebeliso ea nakoana kapa e ke keng ea fetoloa ea ts'ebetso ea boko ho fihlela lefung. Matšoao a hypoglycemia hangata a hlaha ka tšohanyetso, ho kenyelletsa le mofufutso o batang oa letlalo, mokhathala o eketsehileng, ho tšoha kapa ho thothomela, ho tšoenyeha, mokhathala o sa tloaelehang kapa bofokoli, ho ferekana, ho fokotsa nako ea tlhokomelo, ho otsela, tlala e matla, pono e foufetseng, hlooho e bohloko, ho nyekeloa ke pelo, ho hlapaola kelello. - Karolong ea letlalo le lisele tse potolohileng: hangata - lipodystrophy (ho kenyeletsa lipohypertrophy, lipoatrophy e ka ntlafala sebakeng sa ente. Ho lumellana le melao ea ho fetola sebaka sa ente sebakeng se le seng sa anatomical ho thusa ho fokotsa kotsi ea ho ba le karabelo ena e bohloko). - Mathata le mathata a teng setsing sa ente: khafetsa - karabelo setsing sa ente (hematoma, bohloko, hemorrhage ea lehae, erythema, li-nodule tsa tishu tse kenang, ho ruruha, ho pepeseha hoa letlalo, ho hlohlona, ho teneha le ho tiisa sebakeng sa ente), hangata - edema. Lintho tse ngata tse etsahalang setsing sa ente ha li na letho ebile li ea nakoana ebile hangata li nyamela ka kalafo e tsoelang pele. Fomu ea tokollo Tharollo d / p / ho kenyelletsa tlhahiso ea 100 PIECES / 1 ml: li-cartridge 3 ml 5 likhomphutha. Tharollo ea tsamaiso ea sc e hlakile, ha e na mebala. 1 ml: motsoako oa insulin degludec le insulin aspart ka karo-karolelano ea 70/30 (e lekanang le 2.56 mg ea insulin degludec le 1.05 mg ea insulin aspart) 100 IU * Baeti: glycerol - 19 mg, phenol - 1.5 mg, metacresol - 1.72 mg, zinki 27.4 μg (as zinc acetate 92 μg), sodium chloride 0.58 mg, hydrochloric acid kapa sodium hydroxide (bakeng sa phetoho ea pH), d d le. - ho fihlela 1 ml. 3 ml (300 PIECES) - li-cartridge tsa khalase tsa Penfill® (5) - Al / PVC bloker (1) - liphutheloana tsa karete. pH ea tharollo 7.4. * 1 PIECE e na le 0,0256 mg ea "insulin" e se nang letsoai le "insulin" ea "insulin" e senang letsoai, e lumellanang le 1 IU ea "insulin" ea motho, 1 insulin ea insulin, insulin glargine kapa biphasic insulin. Tlhahisoleseling e leqepheng le o e shebileng e entsoe ka sepheo sa tlhahisoleseling feela 'me ha e phatlalatse mokhoa oa ho iphekola. Sesebelisoa se reretsoe ho tloaela litsebi tsa tlhokomelo ea bophelo bo botle ka tlhaiso-leseling e tlatselletsang mabapi le meriana e itseng, ka ho etsa joalo e eketse maemo a bona a bosebeletsi. Tšebeliso ea lithethefatsi "Insulin degludec"joang kapa joang e fana ka tumellano le setsebi, hammoho le litlhahiso tsa hae mabapi le mokhoa oa tšebeliso le litlhare tsa moriana o khethiloeng. Lingoloa tse khahlang Mokhoa oa ho khetha analog e nepahetseng Ka pharmacology, lithethefatsi li atisa ho aroloa ka li-synonyms le analogues. Sebopeho sa li-synonyms se kenyelletsa k'hemik'hale e le 'ngoe kapa tse ngata tse tšoanang tse nang le phello ea kalafo' meleng. Ka li-analog ho boleloa meriana e nang le lintho tse fapaneng tse sebetsang, empa e reretsoe kalafo ea mafu a tšoanang. Phapang lipakeng tsa tšoaetso ea vaerase le baktheria Mafu a tšoaetsanoang a bakoa ke vaerase, libaktheria, li-fungus le protozoa. Nako ea maloetse a bakoang ke vaerase le baktheria hangata e tšoana. Leha ho le joalo, ho khetholla sesosa sa lefu ho bolela ho khetha kalafo e nepahetseng e tla thusa ho sebetsana ka katleho le malaise mme e ke ke ea utloisa ngoana bohloko. Allergies ke eona e bakang serame khafetsa Batho ba bang ba tloaetse boemo boo ngoana hangata le nako e telele a tšoeroang ke sefuba se tšoanang. Batsoali ba mo isa lingakeng, ho ea etsa liteko, ho sebelisa lithethefatsi, 'me ka lebaka leo, ngoana o se a ngolisitsoe le ngaka ea bana hangata ha a kula. Lisosa tsa 'nete tsa mafu a ho phefumoloha khafetsa ha li fumanoe. Urology: kalafo ea urethritis ea chlamydial Chlamydial urethritis hangata e fumanoa ts'ebetsong ea urologist. E bakoa ke "intracellular parasite" Chlamidia trachomatis, e nang le thepa ea libaktheria le livaerase, tseo hangata li hlokang li-regimens tsa kalafo ea kalafo ea meriana e thibelang likokoana-hloko. E khona ho baka ts'oaetso e sa tsejoeng ka ho khetheha ea urethra ho banna le basali. 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Litho

Makhetlo a 3 ka letsatsi

Ketso ea pharmacological

Hypoglycemic. Phello ea lithethefatsi tsa insulin ea insludec e fumanoa ka mokhoa o ts'oanang le phello ea insulin ea motho ka ho tlama le ho sebelisana le li-insulin receptors tsa motho. Phello ea hypoglycemic ea insulin degludec e bakoa ke keketseho ea ts'ebeliso ea tsoekere ke tishu kamora ho ts'oaroa hoa mesifa le mesifa ea mafura le ho fokotseha ho hongata ho tekanyo ea tlhahiso ea tsoekere ke sebete.

Mokhoa oa kopo

Bakeng sa batho ba baholo: Ntle ho 1 nako ka letsatsi, ka ho khetheha ka nako e le 'ngoe. Tekanyetso e baloa ka bonngoe ho latela se tsoekere sa glucose e maling plasma. Bakuli ba nang le lefu la tsoekere la mofuta oa I ba hloka liente tse ling tsa litokisetso tsa insulin tse potlakileng ho netefatsa tlhokahalo ea insulin.

- lefu la tsoekere ho batho ba baholo.

Litlamorao

- Ka lehlakoreng la tsamaiso ea 'mele ea ho itšireletsa mafung: ka seoelo - karabelo ea hypersensitivity (ho kenyelletsa ho ruruha ha leleme kapa molomo, lets'ollo, ho nyekeloa ke pelo, mokhathala le ho hlohlona ha letlalo), urticaria.
- Ho tloha ka lehlakoreng la metabolism le phepo e nepahetseng: khafetsa - hypoglycemia (hypoglycemia e ka hlaha haeba tekanyo ea insulin e phahame haholo ho feta tlhoko ea mokuli ea insulin. Hypoglycemia e matla e ka lebisa ho lahleheloa ke kelello le / kapa ho tsitsinyeha hoa kelello, ts'ebeliso ea nakoana kapa e ke keng ea fetoloa ea ts'ebetso ea boko ho fihlela lefung. Matšoao a hypoglycemia hangata a hlaha ka tšohanyetso, ho kenyelletsa le mofufutso o batang oa letlalo, mokhathala o eketsehileng, ho tšoha kapa ho thothomela, ho tšoenyeha, mokhathala o sa tloaelehang kapa bofokoli, ho ferekana, ho fokotsa nako ea tlhokomelo, ho otsela, tlala e matla, pono e foufetseng, hlooho e bohloko, ho nyekeloa ke pelo, ho hlapaola kelello.
- Karolong ea letlalo le lisele tse potolohileng: hangata - lipodystrophy (ho kenyeletsa lipohypertrophy, lipoatrophy e ka ntlafala sebakeng sa ente. Ho lumellana le melao ea ho fetola sebaka sa ente sebakeng se le seng sa anatomical ho thusa ho fokotsa kotsi ea ho ba le karabelo ena e bohloko).
- Mathata le mathata a teng setsing sa ente: khafetsa - karabelo setsing sa ente (hematoma, bohloko, hemorrhage ea lehae, erythema, li-nodule tsa tishu tse kenang, ho ruruha, ho pepeseha hoa letlalo, ho hlohlona, ho teneha le ho tiisa sebakeng sa ente), hangata - edema. Lintho tse ngata tse etsahalang setsing sa ente ha li na letho ebile li ea nakoana ebile hangata li nyamela ka kalafo e tsoelang pele.

Fomu ea tokollo

Tharollo d / p / ho kenyelletsa tlhahiso ea 100 PIECES / 1 ml: li-cartridge 3 ml 5 likhomphutha.
Tharollo ea tsamaiso ea sc e hlakile, ha e na mebala.
1 ml:
motsoako oa insulin degludec le insulin aspart ka karo-karolelano ea 70/30
(e lekanang le 2.56 mg ea insulin degludec le 1.05 mg ea insulin aspart) 100 IU *
Baeti: glycerol - 19 mg, phenol - 1.5 mg, metacresol - 1.72 mg, zinki 27.4 μg (as zinc acetate 92 μg), sodium chloride 0.58 mg, hydrochloric acid kapa sodium hydroxide (bakeng sa phetoho ea pH), d d le. - ho fihlela 1 ml.

3 ml (300 PIECES) - li-cartridge tsa khalase tsa Penfill® (5) - Al / PVC bloker (1) - liphutheloana tsa karete.
pH ea tharollo 7.4.
* 1 PIECE e na le 0,0256 mg ea "insulin" e se nang letsoai le "insulin" ea "insulin" e senang letsoai, e lumellanang le 1 IU ea "insulin" ea motho, 1 insulin ea insulin, insulin glargine kapa biphasic insulin.

Tlhahisoleseling e leqepheng le o e shebileng e entsoe ka sepheo sa tlhahisoleseling feela 'me ha e phatlalatse mokhoa oa ho iphekola. Sesebelisoa se reretsoe ho tloaela litsebi tsa tlhokomelo ea bophelo bo botle ka tlhaiso-leseling e tlatselletsang mabapi le meriana e itseng, ka ho etsa joalo e eketse maemo a bona a bosebeletsi. Tšebeliso ea lithethefatsi "Insulin degludec"joang kapa joang e fana ka tumellano le setsebi, hammoho le litlhahiso tsa hae mabapi le mokhoa oa tšebeliso le litlhare tsa moriana o khethiloeng.

Lingoloa tse khahlang

Mokhoa oa ho khetha analog e nepahetseng
Ka pharmacology, lithethefatsi li atisa ho aroloa ka li-synonyms le analogues. Sebopeho sa li-synonyms se kenyelletsa k'hemik'hale e le 'ngoe kapa tse ngata tse tšoanang tse nang le phello ea kalafo' meleng. Ka li-analog ho boleloa meriana e nang le lintho tse fapaneng tse sebetsang, empa e reretsoe kalafo ea mafu a tšoanang.

Phapang lipakeng tsa tšoaetso ea vaerase le baktheria
Mafu a tšoaetsanoang a bakoa ke vaerase, libaktheria, li-fungus le protozoa. Nako ea maloetse a bakoang ke vaerase le baktheria hangata e tšoana. Leha ho le joalo, ho khetholla sesosa sa lefu ho bolela ho khetha kalafo e nepahetseng e tla thusa ho sebetsana ka katleho le malaise mme e ke ke ea utloisa ngoana bohloko.

Allergies ke eona e bakang serame khafetsa
Batho ba bang ba tloaetse boemo boo ngoana hangata le nako e telele a tšoeroang ke sefuba se tšoanang. Batsoali ba mo isa lingakeng, ho ea etsa liteko, ho sebelisa lithethefatsi, 'me ka lebaka leo, ngoana o se a ngolisitsoe le ngaka ea bana hangata ha a kula. Lisosa tsa 'nete tsa mafu a ho phefumoloha khafetsa ha li fumanoe.

Urology: kalafo ea urethritis ea chlamydial
Chlamydial urethritis hangata e fumanoa ts'ebetsong ea urologist. E bakoa ke "intracellular parasite" Chlamidia trachomatis, e nang le thepa ea libaktheria le livaerase, tseo hangata li hlokang li-regimens tsa kalafo ea kalafo ea meriana e thibelang likokoana-hloko. E khona ho baka ts'oaetso e sa tsejoeng ka ho khetheha ea urethra ho banna le basali.