Insulin Protafan: malangizo, mayendedwe, ndemanga

• Pharmacokinetics
• Zizindikiro zogwiritsidwa ntchito
• Njira yogwiritsira ntchito
• Zotsatira zoyipa
• Contraindication
• Mimba
• Kuchita ndi mankhwala ena
• Bongo
• Malo osungira
• Kutulutsa Fomu
• Kupanga
• Zosankha

Protafan NM - mankhwala antidiabetes.
Kuchulukitsa kwa shuga kwa insulin ndikulimbikitsa kutuluka kwa glucose pogwiritsa ntchito minofu pambuyo pomangiriza insulini mpaka ma cell a minofu ndi mafuta, komanso kuletsa kutulutsa kwa glucose ku chiwindi.
Pafupifupi, mbiri ya kanthu pambuyo pobayira jakisoni ili motere: kuyambika kwa zochita kuli mkati mwa maola 1.5, mphamvu yayikulu imachokera ku 4 mpaka 12:00, nthawi ya kuchitapo kanthu ili pafupifupi maola 24.

Pharmacokinetics

Hafu ya moyo wa insulini kuchokera m'magazi ndi mphindi zingapo, chifukwa chake, mawonekedwe a kukonzekera kwa insulin amatsimikiziridwa ndi mawonekedwe a mayamwidwe okha. Njirayi imatengera zinthu zingapo (mwachitsanzo, pamankhwala a insulin, njira ndi malo omwe jakisoni, kukula kwa minyewa yamkati, mtundu wa matenda ashuga), omwe umasinthira kwakukulu pakukhudzidwa kwa kukonzekera kwa insulin mwa odwala ndi odwala osiyanasiyana.
Mafuta Chiwonetsero chachikulu cha plasma chimafikiridwa patangotha ​​maola 2-18 atatha kugwiritsa ntchito mankhwala.
Kugawa. Kumanga kwofunikira kwa insulini kumapuloteni a plasma, kupatulapo kuzungulira kwa ma antibodies kwa iye (ngati alipo), sikunapezeke.
Kupenda. Insulin yaumunthu imapangidwa ndi ma insulin protein kapena ma enzyme a insulindegradable ndipo mwina, ndi mapuloteni a disulfide isomerase. Masamba angapo adadziwika komwe kuphulika (hydrolysis) ya molekyulu ya insulin yamunthu imachitika. Palibe imodzi mwa metabolites yomwe imapangidwa pambuyo pa hydrolysis imakhala ndi zochita zachilengedwe.
Kuswana. Kutalika kwa theka la moyo wa insulini kumatsimikiziridwa ndi kuchuluka kwa mayamwidwe ake kuchokera ku minofu yokhala ndi subcutaneous. Ichi ndichifukwa chake nthawi ya theka-lomaliza la moyo (t½) imawonetsa kuchuluka kwa mayamwidwe, osati kuchotsedwa (mwakutero) kwa insulini kuchokera m'madzi a m'magazi (t½ ya insulin kuchokera m'magazi ochepa mphindi). Malinga ndi kafukufuku, t½ ndi maola 5-10.

Njira yogwiritsira ntchito

Protafan NM ndi kukonzekereratu kwa insulin, kotero ingagwiritsidwe ntchito nokha kapena kuphatikiza ndi insulin yochepa.
Mlingo wa insulin ndi munthu payekha ndipo amatsimikiza ndi dokotala mogwirizana ndi zosowa za wodwala.
Chofunikira cha insulin tsiku lililonse chimakhala kuyambira pa 0.3 mpaka 1.0 IU / kg / tsiku. Kufunika kwa insulin tsiku ndi tsiku kumawonjezereka kwa odwala omwe ali ndi insulin kukaniza (mwachitsanzo, kutha msonkho kapena kunenepa kwambiri) ndikuchepa kwa odwala omwe ali ndi zotsalira za insulin.
Kusintha kwa Mlingo
Matenda obvuta, makamaka matenda ndi kutentha thupi, nthawi zambiri zimawonjezera kufunikira kwa insulin. Matenda a impso, chiwindi, kapena adrenal, pituitary, kapena matenda a chithokomiro amafuna kusintha kwa mlingo.
Kusintha kwa Mlingo kumafunikanso ngati odwala asintha zomwe akuchita kapena zolimbitsa thupi. Kusankha kwa dose kungafunikenso posamutsa odwala ku insulin ina.
Kuyamba
Protafan NM anaupangira jekeseni wa subcutaneous yekha. Kuyimitsidwa kwa insulin sikuperekedwa konse.
Protafan HM nthawi zambiri imayendetsedwa pansi pa khungu la ntchafu. Mutha kulowanso m'dera la khoma lamkati, matako kapena minyewa yolimba ya phewa.
Ndi jakisoni wothira mkati mwa ntchafu, kuyamwa kwa insulini kumayamba pang'onopang'ono kuposa ndikabayidwa mbali zina za thupi.
Kukhazikitsidwa kwa khola lakukhazikika kwa khungu kumachepetsa chiopsezo chofika minofu.
Pambuyo pa jekeseni, singano imayenera kukhalabe pansi pakhungu kwa masekondi 6 osachepera. Izi zikuthandizira kukhazikitsa mlingo wathunthu.
Kuti muchepetse chiwopsezo cha lipodystrophy, tsamba la jekeseni liyenera kusinthidwa nthawi zonse mkati mwa thupi limodzi.
Protafan NM mu mbale omwe amagwiritsidwa ntchito ndi ma syringes apadera a insulin, omwe ali ndi maphunziro oyenera. Protafan HM imabwera ndi malangizo oikidwa ndi zidziwitso zofunikira kuti agwiritse ntchito.
Malangizo ogwiritsira ntchito mankhwala Protafan NM kwa wodwala
Osagwiritsa ntchito Protafan NM:
- mu mapampu olowetsera,
- ngati mukusowa (hypersensitive) kwa insulin ya anthu kapena mankhwala ena aliwonse
- ngati mukukayikira kuti mukupanga hypoglycemia (shuga wamagazi ochepa)
- ngati chitetezo chapulasitiki sichikhala chopanda tanthauzo kapena chikusoweka
(Bokosi lirilonse limakhala ndi chotetezera pulasitiki chosonyeza kutseguka, ngati botolo litalandira, kapu yakeyo siyabwino kapena ikasowa, botolo liyenera kubwezeredwa ku pharmacy)
- ngati mankhwalawo adasungidwa mosayenera kapena adazizira,
- ngati kuyimitsidwa kwa insulini kumakhala loyera komanso kwamtambo mutasakaniza.
Musanagwiritse ntchito mankhwala Protafan NM:
- yang'aninso cholembera kuti muwonetsetse kuti mtundu wa insulin ndi wokhazikitsidwa,
- chotsani kapu yapulasitiki yachitetezo.
Momwe mungagwiritsire ntchito insulin iyi
Protafan NM kutumikiridwa ndi jakisoni pansi pakhungu (subcutaneally). Osabaya insulini mwachindunji kapena m'mitsempha. Nthawi zonse sinthani malo opaka jekeseni, ngakhale mkati mwa gawo lomwelo la thupi kuti muchepetse chiopsezo chotenga zisindikizo kapena zikwangwani pakhungu. Malo abwino kwambiri odzivulaza ndi matako, kutsogolo kwa ntchafu kapena mapewa.
Lowetsani Protafan NMngati imayendetsedwa yokha kapena ikasakanizidwa ndi insulin yochepa
- Onetsetsani kuti mukugwiritsa ntchito syringe ya insulin yomwe imakhala ndi maphunziro oyenera.
- Jambulani mu syringe voliyumu yofanana ndi mlingo wa insulini yomwe mukufuna ndikuyiyika mu vial.
- Tsatirani malangizo omwe dokotala wanu kapena anamwino anu akudziwa pankhani yothandizira mankhwalawo.
- Musanagwiritse ntchito musanayambe kugwiritsa ntchito botolo la Protafan ® NM pakati pama manja anu mpaka madziwo atasanduka oyera ndi mitambo. Kusuntha ndikwabwino kwambiri ngati insulini imayatsidwa kutentha kutentha.
- Patsani jakisoni wofukizira wa insulin. Gwiritsani ntchito njira ya jakisoni yomwe dokotala wanu kapena namwino anu adayambitsa.
- Gwirani singano pansi pa khungu kwa mphindi zosachepera 6 kuti muwonetsetse kuti mlingo wathunthu waperekedwa.
Ana. Kukonzekera kwa inshuwaransi yaumunthu yogwiritsira ntchito insulin ndi mankhwala othandiza komanso otetezeka pochiza matenda amishuga amisinkhu yosiyanasiyana ya ana ndi achinyamata. Kufunika kwatsiku ndi tsiku kwa ana ndi achinyamata zimatengera gawo la matendawa, kuchuluka kwa thupi, zaka, kudya, kuchita masewera olimbitsa thupi, kuchuluka kwa insulini komanso mphamvu ya glycemia.

Pharmacodynamics ndi pharmacokinetics

Tiyenera kudziwa kuti Protafan NM ndi insulin munthu wokhala ndi nthawi yayitali mphamvu, wopangidwa ndi njira yobwererera ma biotechnology a DNA pogwiritsa ntchito kupsinjika Saccharomyces cerevisiae. Mankhwalawa amalumikizana ndi cholandilira china chomwe chili kunja kwa ziwalo za cytoplasmic cell ndikupanga insulini-receptor. Pankhaniyi, kukondoweza kwa njira za intracellular, mwachitsanzo, kaphatikizidwe kofunikira michere: pyruvate kinase, hexokinase, glycogen synthetase ndi ena.

Glucose mu kapangidwe magazi imawonjezeka chifukwa cha mayendedwe ake olowerera, omwe amalimbikitsa kukoka minofu, komanso yolimbikitsa lipogenesis ndi glycogenogeneis, kutsitsa kuchuluka kwa shuga ndi chiwindi, ndi zina zambiri.

Pankhaniyi, Protafan insulin imamenyedwa pamlingo womwe umatengera zinthu monga mlingo, njira, njira yoyendetsera ndi mtundu wa matenda ashuga. Pazifukwa izi, mawonekedwe a insulin ogwira ntchito amatha kusintha.

Mankhwalawa amayamba kugwira ntchito mkati mwa maola 1-1,5 kuyambira nthawi yoyendetsera, zotsatira zabwino zimatheka pambuyo maola 4-12 ndipo ndizovomerezeka kwa maola osachepera 24.

Kuyamwa kwathunthu ndi kuthandizira kwa mankhwalawa zimatengera malo ndi njira yoyendetsera, komanso mlingo komanso kugwiritsidwa ntchito kwakukulu kwa mankhwala. Kukwaniritsa kwambiri insulin magazi a m'magazi amapezeka pambuyo 2-18 maola chifukwa subcutaneous makonzedwe.

Mankhwalawa salowa muubwenzi wapadera ndi mapuloteni a plasma, amangopeza ma antibodies omwe amapanga insulin. At kagayidwe insulin zingapo zomwe zimapangidwa zimapangidwa kuchokera ku insulin yaumunthu metabolitesomwe amalowa mthupi.

Zotsatira zoyipa

Pa mankhwala ndi mankhwalawa, monga osakaniza Protafan -Chifwamba, mavuto obwera amakumana, kuopsa kwa zomwe zimatengera Mlingo komanso mankhwala a insulin.

Makamaka nthawi zambiri, ngati vuto lotsatira, hypoglycemia imachitika. Chomwe chikuwonekera chikuwoneka mu kuchuluka kwakukulu kwa insulin ndi kufunika kwake. Nthawi yomweyo, ndizosatheka kudziwa nthawi yomwe zimachitika.

Hypoglycemia yayikulu imatha kutsagana ndi kusazindikira, kugwedezeka, kuwonongeka kwakanthawi kapena kosatha kwa ntchito zaubongo, ndipo nthawi zina kumatha.

Kuphatikiza apo, zoyipa ndizotheka zomwe zimakhudza kugwira ntchito kwa chitetezo chathupi, kwamanjenje ndi zina.

Sichikuphatikizidwa pokhapokha pakuchitika kwa anaphylactic, zizindikiritso za hypersensitivity, kusokonezeka kwa kugwira ntchito kwa chakudya cham'mimba, angioedema,kupuma movutikirakulephera kwa mtima, kutsika kuthamanga kwa magazi ndi zina zotero.

Protafan, malangizo ogwiritsira ntchito (Njira ndi Mlingo)

Mankhwalawa amaperekedwa mosavuta. Nthawi yomweyo, mlingo wake umasankhidwa payekha, poganizira zosowa za wodwala. Chowonadi ndi chakuti odwala omwe amalimbana ndi insulin amafunikira kwambiri.

Ndiwonso dokotala yemwe amasankha kuchuluka kwa jakisoni watsiku ndi tsiku komanso momwe angagwiritsire ntchito mankhwalawa mu mawonekedwe a mono- kapena mankhwala ophatikiza, mwachitsanzo, ndi insulin, yomwe ili ndi kanthu mwachangu kapena kanthawi kochepa. Ngati ndi kotheka, insulin yokwanira imachitika pogwiritsa ntchito kuyimitsidwa uku monga insal insulin limodzi ndi insulin yofulumira kapena yochepa. Zingwe nthawi zambiri zimaperekedwa malinga ndi chakudya.

Odwala ambiri amapereka Protafan NM mosadukiza mwachangu ku ntchafu. Jekeseni khoma lam'mimba, matako ndi malo ena ndikololedwa. Chowonadi ndi chakuti mankhwalawa akailowetsa mu ntchafu, amakamizidwa pang'onopang'ono. Nthawi zina amalimbikitsidwa kusintha tsamba la jakisoni kuti musatukuke lipodystrophy.

Mlingo ndi njira yoyendetsera

Protafan ndi mankhwala osokoneza bongo apakati, motero amatha kugwiritsidwa ntchito mosiyana komanso kuphatikiza ndi mankhwala omwe amagwira mwachidule, mwachitsanzo, Actrapid. Mlingo umasankhidwa payekha. Chofunikira cha insulin tsiku ndi tsiku ndi chosiyana ndi onse odwala matenda ashuga. Nthawi zambiri, zimayenera kukhala kuchokera ku 0.3 mpaka 1.0 IU pa kg iliyonse patsiku. Ndi kunenepa kwambiri kapena kutha msinkhu, kukana insulini kumatha kukulira, motero kufunikira kwa tsiku ndi tsiku kumachuluka. Ndi kusintha kwa moyo, matenda a chithokomiro, zotupa, chiwindi, ndi impso, mlingo wa Protafan NM umakonzedwa payekhapayekha.

Mankhwala

Zotsatira za hypoglycemic zimachitika pambuyo poti insulini yaphulika komanso kumangika kwa ma cell a minofu ndi mafuta. Zopanga zazikulu:

• amachepetsa shuga
• kusintha kutulutsa shuga m'maselo,
• Amachita bwino mau,
• amalepheretsa kutulutsa shuga kwa chiwindi.

Pambuyo pothandizidwa ndi subcutaneous, nsonga zazikulu za Protafan insulin zimawonedwa mkati mwa maola 2-18. Kukhazikika kwa zochita kumachitika pambuyo pa maola 1.5, mphamvu kwambiri imachitika pambuyo pa maola 4-12, nthawi yonse ndi maola 24. M'maphunziro azachipatala, sizinali zotheka kuzindikira carcinogenicity, genotoxicity komanso zowonongeka pazokhudza kubereka, chifukwa chake Protafan imawerengedwa ngati mankhwala otetezeka.

Analogs of Protafan

Mutu	Wopanga
Insuman Bazal	Sanofi-Aventis Deutschland GmbH, Germany
Br-Insulmidi ChSP	Bryntsalov-A, Russia
Humulin NPH	Eli Lilly, United States
Actrafan HM	Novo Nordisk A / O, Denmark
Berlinsulin N Basal U-40 ndi Berlisulin N Basal chole	Berlin-Chemie AG, Germany
Humodar B	Indar Insulin CJSC, Ukraine
Biogulin NPH	Bioroba SA, Brazil
Homophane	Pliva, Croatia
Isofan Insulin World Cup	AI CN Galenika, Yugoslavia

Pansipa pali kanema yemwe amayankhula za mankhwala okhudzana ndi isofan insulin:

Ndikufuna kupanga kusintha kwanga muvidiyoyi - ndizoletsedwa kugwiritsa ntchito insulin nthawi yayitali!

Kuchita ndi mankhwala ena

Mankhwala omwe amachepetsa kufunika kwa insulin:

• ACE inhibitors (kapitawo),
• mankhwala akumwa a hypoglycemic,
• Mao monoamine oxidase inhibitors (furazolidone),
• salicylates ndi sulfonamides,
• osasankha beta-blockers (metoprolol),
• anabolic steroids

Mankhwala omwe amalimbikitsa kufunika kwa insulin:

• glucocorticoids (prednisone),
• amphanomachul
• kulera kwamlomo
• morphine, glucagon,
• odana ndi calcium
• thiazides,
• mahomoni a chithokomiro.

Momwe mungasungire insulin?

Malangizowo akuti simungathe kumasula mankhwalawo. Sungani pamalo ozizira pa kutentha kwa madigiri 2 mpaka 8. Botolo lotseguka kapena cartridge siyenera kusungidwa mufiriji m'malo amdima kwa milungu isanu ndi umodzi pa kutentha kwa madigiri 30.

Choyipa chachikulu cha Protafan ndi mawonekedwe ake ndi kukhalapo kwa chiwonetsero cha kuchitira maola 4-6 pambuyo pa kukhazikitsa. Chifukwa cha izi, wodwala matenda ashuga ayenera kukonzekereratu kadyedwe kake. Ngati simukudya panthawi imeneyi, hypoglycemia imayamba. Itha kugwiritsidwa ntchito ndi amayi oyembekezera komanso ana.

Sayansi siyimayima, pali ma inshuin atsopano osapindulitsa a Lantus, Tujeo ndi ena otero. Chifukwa chake, mtsogolomo aliyense asinthana ndi mankhwala atsopano kuti muchepetse chiopsezo cha hypoglycemia.

Bongo

Nthawi zambiri, kuchuluka kwa insulin kumabweretsa chitukuko cha matenda a hypoglycemia, omwe amatha kukhala osiyana kwambiri. Hypoglycemia ikayamba, wodwalayo amatha kuchotsa payekha mwa kumeza mankhwala okoma. Chifukwa chake, odwala matenda ashuga ambiri amakhala ndi maswiti osiyanasiyana: maswiti, makeke ndi zina zambiri.

Milandu ingapo ingachititse kuti musiwale chikumbumtima. Pankhaniyi, chithandizo chapadera chimachitika ndikuyambitsa intravenous 40% yankho Dextrose kapena Glucagon - kudzera m'mitsempha, mozungulira. Ndipo atayambanso kudziwa bwino, wodwalayo ayenera kudya chakudya chopatsa mphamvu nthawi zambiri kuti aletse kukonzanso kwa hypoglycemia ndi zizindikiro zina zosafunikira.

Malangizo achidule

Protafan imapangidwa mosiyanasiyana. DNA yofunikira pakuphatikizidwa kwa insulin imayambitsidwa mu tizilombo toyambitsa matenda, pambuyo pake amayamba kupanga proinsulin. Insulin yomwe imapezeka pambuyo pa chithandizo cha enzymatic imafanana kwathunthu ndi munthu. Kuti ichulukitse kuchitapo chake, timadzi timene timasakanikirana ndi protamine, ndipo timabisala pogwiritsa ntchito ukadaulo wapadera. Mankhwala opangidwa mwanjira iyi amadziwika ndi kupangika kosalekeza, mutha kutsimikiza kuti kusintha kwa botolo sikukhudza shuga. Kwa odwala, izi ndizofunikira: zinthu zochepa zomwe zimakhudza kugwira ntchito kwa insulin, kubwezeretsedwa bwino kwa matenda ashuga kudzakhala.

Protafan HM imapezeka m'mbale zamagalasi ndi 10 ml ya yankho. Mwanjira imeneyi, mankhwalawa amalandiridwa ndi azachipatala komanso odwala matenda ashuga omwe amaba jakisoni ndi syringe. Mu katoni 1 ndi botolo ndi malangizo ogwiritsira ntchito.

Protafan NM Penfill - awa ndi ma cartridge atatu a 3 ml omwe amatha kuyikidwa mu NovoPen 4 syringe pens (gawo 1 unit) kapena NovoPen Echo (mayunitsi 0,5). Kuti mukhale ndi mwayi wosakanikirana mu cartridge iliyonse galasi. Phukusili limakhala ndi ma cartridge 5 ndi malangizo.

Kuchepetsa shuga m'magazi ndikuwanyamula kupita nawo ku minofu, kukulitsa kapangidwe ka glycogen mu minofu ndi chiwindi. Zimapangitsa mapangidwe a mapuloteni ndi mafuta, chifukwa chake, zimathandizira kulemera.

Amagwiritsidwa ntchito popanga shuga osala kudya: usiku komanso pakati pa chakudya. Protafan sangagwiritsidwe ntchito kukonza glycemia, ma insulin amafupikitsa amapangidwira izi.

Kufunika kwa insulini kumawonjezeka ndi kupsinjika kwa minofu, kuvulala kwamthupi ndi m'maganizo, kutupa, ndi matenda opatsirana. Kugwiritsa ntchito mowa mu shuga sikwabwino, chifukwa kumathandizira kuwonongeka kwa matendawa ndipo kumayambitsa hypoglycemia.

Kusintha kwa Mlingo kumafunika mukamamwa mankhwala ena. Kuchulukitsa - kugwiritsa ntchito okodzetsa ndi mankhwala ena a mahomoni. Kuchepetsa - pankhani ya makonzedwe amodzimodzi munthawi yomweyo mapiritsi ochepetsa shuga, tetracycline, aspirin, antihypertensive mankhwala ochokera m'magulu a AT1 receptor blockers ndi ACE inhibitors.

Zotsatira zoyipa kwambiri za insulin iliyonse ndi hypoglycemia. Mukamagwiritsa ntchito mankhwala a NPH, chiopsezo chobwera ndi shuga usiku ndichokwera, popeza ali ndi chiwopsezo chochita. Nocturnal hypoglycemia ndiowopsa kwambiri mu matenda osokoneza bongo, chifukwa wodwalayo sangathe kuzindikira okha ndikuwathetsa okha. Mchere wotsika usiku chifukwa cha mlingo wosankhidwa mosayenera kapena chinthu chama metabolic.

Osachepera 1% ya anthu odwala matenda ashuga, Protafan insulin imayambitsa matenda osakhwima a m'thupi mwa zotupa, kuyabwa, kutupa m'malo a jakisoni. Kuthekera kwa mitundu yayikulu yolumikizana ndi kochepera 0.01%. Kusintha kwamafuta obisika, lipodystrophy, amathanso kuchitika. Chiwopsezo chawo chimakhala chachikulu ngati njira ya jakisoni satsatiridwa.

Protafan amaletsedwa kugwiritsa ntchito mwa odwala omwe ali ndi matendawa kapena edincke's edema ya insulin. Monga cholowa m'malo, ndibwino kuti musagwiritse ntchito ma NPH omwe ali ndi mawonekedwe ofanana, koma insulin analogues - Lantus kapena Levemir.

Protafan sayenera kugwiritsidwa ntchito ndi anthu odwala matenda ashuga okhala ndi vuto la hypoglycemia, kapena ngati zizindikiro zake zachotsedwa. Zinapezeka kuti ma insulin analogu pamilandu imeneyi ndi otetezeka kwambiri.

Kufotokozera	Protafan, monga ma insulin onse a NPH, amawatulutsa mosapumira. Pansi pali yoyera yoyera, pamwambapa - madzi opatsirana. Pambuyo posakaniza, yankho lonse limakhala loyera. Ndende ya yogwira ntchito ndi magawo zana pa millilita.
Kutulutsa Mafomu
Kupanga	Chosakaniza chophatikizacho ndi insulin-isophan, wothandizira: madzi, protamine sulfate kuti ikhale nthawi yayitali yochita, phenol, metacresol ndi zinc ion ngati zosungika, zinthu zosintha acidity yankho.
Machitidwe
Zizindikiro	Matenda a shuga ndi odwala omwe amafuna insulin, ngakhale atakhala zaka zingati. Ndi matenda amtundu wa 1 - kuyambira kumayambiriro kwa zovuta za carbohydrate, ndi mtundu wachiwiri - pamene mapiritsi ochepetsa shuga satha kugwira ntchito mokwanira, ndipo hemoglobin wa glycated amaposa 9%. Matenda a shuga kwa amayi apakati.
Kusankha kwa Mlingo	Malangizowo alibe mulingo woyenera, chifukwa kuchuluka kwa insulin kwa odwala matenda ashuga osiyanasiyana ndi kosiyana kwambiri. Amawerengeredwa pamaziko a kusala kudya kwa glycemia. Mlingo wa insulin m'mawa ndi madzulo makonzedwe amasankhidwa mosiyanasiyana - kuwerengetsa kwa insulin ya mitundu yonse iwiri.
Kusintha kwa Mlingo
Zotsatira zoyipa
Contraindication
Kusunga	Pamafunika kutetezedwa ndi kuwala, kuzizira kozizira komanso kutentha kwambiri (> 30 ° C). Mbale ziyenera kusungidwa m'bokosi, insulini mu syringe pens iyenera kutetezedwa ndi chipewa. Mu nyengo yotentha, zida zapadera zozizira zimagwiritsidwa ntchito kunyamula Protafan. Mikhalidwe yoyenera kwambiri yosungirako kwa nthawi yayitali (mpaka masabata 30) ndi mashelufu kapena chitseko cha firiji. Potentha firiji, Protafan poyambira amatha sabata 6.

Kuchita

Mankhwala angapo a hypoglycemic, ma inhibitors a monoamine oxidase, angiotensin otembenuza enzyme ndi carbonic anhydrase, komanso osagwiritsa ntchito beta-blockers, sulfonamides, Bromocriptineanabolic steroids, tetracyclinesCyclophosphamide,Ketoconazole, Mebendazole,Clofibrate, Pyridoxine, Theophylline, Fenfluramine, mankhwala a lithiamu omwe ali ndi mankhwala amatha kupititsa patsogolo zotsatira za insulin.

Nthawi yomweyo, njira zakulera zamkamwa, chithokomiro chimatha kufooketsa mphamvu yake ya hypoglycemic. mahomoniglucocorticosteroids, thiazide okodzetsa, ma tridclic antidepressants, heparinamphanomachul Danazolecalcium blockers Clonidine, Diazoxide, Phenytoin, Morphine ndi chikonga.

Kuphatikiza ndi Reserpine ndisalicylates imatha kufooketsa ndikuwonjezera mphamvu ya mankhwalawa. Zizindikiro zina za beta-blockers zophimba za hypoglycemia kapena zimapangitsa kuti zitheke. Kuchulukitsa kapena kuchepa kwa insulin Octreotide ndiLanreotide.

Nthawi yogwira

Mlingo wa kulowa kwa Protafan kuchokera kuzinthu zowerengeka kulowa m'magazi mwa odwala omwe ali ndi matenda ashuga ndizosiyana, kotero ndizosatheka kuneneratu molondola nthawi yomwe insulin idzayamba kugwira ntchito. Zambiri:

1. Kuchokera pa jakisoni mpaka pakuwoneka kwa timadzi m'magazi, pafupifupi maola 1.5 amapita.
2. Protafan ili ndi chochita chapamwamba, mu odwala matenda ashuga ambiri amapezeka maola 4 kuyambira nthawi yoyendetsa.
3. Kutalika konse kwa kuchitako kumafika maola 24. Pankhaniyi, kudalira kwa nthawi yayitali yogwira ntchito pamtengowu. Ndi kukhazikitsidwa kwa magawo 10 a Protafan insulin, kutsitsa kwa shuga kumawonedwa pafupifupi maola 14, magawo 20 kwa maola pafupifupi 18.

Malangizo a jekeseni

Nthawi zambiri wodwala matenda ashuga, kuyendetsa kawiri ka Protafan ndikokwanira: m'mawa komanso asanagone. Jakisoni wamadzulo azikhala okwanira kusunga glycemia usiku wonse.

Momwe mulingo woyenera:

• shuga m'mawa ndizofanana ndi nthawi yogona
• palibe hypoglycemia usiku.

Nthawi zambiri, shuga m'magazi amakwera pambuyo pa 3 am, pamene kupanga kwa mahomoni otsutsana kumagwira kwambiri, ndipo zotsatira za insulin zimafooka. Ngati chiwonetsero cha Protafan chikutha m'mbuyomu, chiwopsezo chaumoyo ndi chotheka: hypoglycemia usiku ndi shuga m'mawa kwambiri. Kuti mupewe, muyenera kuyang'ana kuchuluka kwa shuga pa 12 ndi maola atatu. Nthawi ya jakisoni wamadzulo ikhoza kusinthidwa, kusintha mawonekedwe a mankhwalawo.

Zomwe zikuchitika pazing'ono

Ndi matenda a shuga a 2, matenda ashuga azimayi oyembekezera, ana, achikulire pachakudya chochepa cha carb, kufunika kwa NPH insulin kungakhale kochepa. Ndi mtundu umodzi wocheperako (mpaka maunitsi 7), nthawi yogwira Protafan ikhoza kuchepera maola 8. Izi zikutanthauza kuti jakisoni awiri omwe aperekedwa ndi malangizo sangakhale okwanira, ndipo pakati pa shuga magazi azikula.

Izi zitha kupewedwa pobaya jakisoni wa Protafan insulin katatu pakatha maola 8 aliwonse: jakisoni woyamba amaperekedwa akangodzuka, wachiwiri nthawi ya nkhomaliro ndi insulin yochepa, yachitatu, yayikulu kwambiri, asanagone.

Ndemanga za odwala matenda ashuga, sikuti aliyense amakwanitsa kubwezera zabwino za anthu odwala matenda ashuga motere. Nthawi zina mlingo wa usiku umaleka kugwira ntchito musanadzuke, ndipo shuga m'mawa amakhala okwera. Kuonjezera mlingo kumabweretsa bongo wa insulin ndi hypoglycemia. Njira yokhayo yochotsera izi ndikusinthira ma insulin omwe ali ndi nthawi yayitali.

Zakudya zotere

Anthu odwala matenda ashuga omwe amapezeka pa insulin amakhalapo nthawi zambiri amakhala ndi insulin. Mwachidule ndikofunikira kuti muchepetse shuga omwe amalowa m'magazi kuchokera ku chakudya. Amagwiritsidwanso ntchito kukonza glycemia. Pamodzi ndi Protafan, ndibwino kugwiritsa ntchito kukonzekera kochepa kwa wopanga yemweyo - Actrapid, yemwe amapezekanso mumbale ndi ma cartridgeges a syringe pens.

Nthawi yoyendetsera insulin Protafan sikudalira zakudya mwanjira iliyonse, kuphatikiza pakati pa jakisoni ndikokwanira. Mukasankha nthawi yabwino, muyenera kutsatira nthawi zonse. Ngati chikugwirizana ndi chakudya, Protafan ikhoza kudulidwa ndi insulin yochepa. Nthawi yomweyo kuzisakaniza mu syringe yomweyo ndikosayenera, popeza ndizotheka kulakwitsa ndi mlingo ndikuchepetsera kuchitapo kanthu kwa timadzi tating'onoting'ono.

Mulingo woyenera

Mu shuga mellitus, muyenera jakisoni insulin momwe angathere kuti matenda abwinobwino azikhala ndi shuga. Malangizo ogwiritsira ntchito sanakhazikitse mlingo wapamwamba. Ngati mulingo woyenera wa Protafan insulin ukukula, izi zitha kuwonetsa kukana insulini. Ndi vutoli, muyenera kufunsa dokotala. Ngati ndi kotheka, adzalembera mapiritsi omwe amathandiza kusintha kwa mahomoni.

Kugwiritsa Ntchito Mimba

Ngati ndi gestational matenda a shuga sizingatheke kukwaniritsa glycemia kokha kudzera mu chakudya, odwala amathandizidwa ndi insulin. Mankhwala ndi mlingo wake amasankhidwa mosamala, popeza onse a hypo- ndi hyperglycemia amawonjezera chiopsezo cha kusokonezeka kwa mwana. Insulin Protafan imaloledwa kugwiritsidwa ntchito panthawi yomwe ali ndi pakati, koma nthawi zambiri, analogi yayitali imakhala yothandiza kwambiri.

Doctor of Medical Science, Mutu wa Institute of Diabetesology - Tatyana Yakovleva

Ndakhala ndikuphunzira matenda a shuga kwa zaka zambiri. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsa odwala matenda ashuga mellitus. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipira mtengo wa mankhwalawo. Ku Russia, odwala matenda ashuga mpaka Meyi 18 (kuphatikiza) nditha kuipeza - Kwa ma ruble 147 okha!

Mimba ikapezeka ndi matenda amtundu woyamba 1, ndipo mayiyo amakwaniritsa bwino matenda a Protafan, kusintha kwa mankhwala sikofunikira.

Kuyamwitsa kumayenda bwino ndi insulin. Protafan sichingavulaze thanzi la mwana. Insulin imalowa mkaka wambiri, pambuyo pake imasweka m'matumbo a mwana, ngati protein ina iliyonse.

Zotsatira zoyipa

Zotsatira zoyipa zambiri za mankhwala ndi hypoglycemia. Zimatha kuchitika pamene mlingo umakulira kwambiri wodwala pakufunika insulin. Malinga ndi kafukufuku wazachipatala, komanso deta yakugwiritsira ntchito mankhwalawa atamasulidwa pamsika, zochitika za hypoglycemia zimasiyanasiyana m'magulu osiyanasiyana a odwala, omwe ali ndi mitundu yosiyanasiyana ya mitundu komanso kuchuluka kwa kayendedwe ka glycemic.

Kumayambiriro kwa mankhwala a insulin, zolakwika zotupa, edema ndi zochita ku malo a jakisoni (kupweteka, redness, urticaria, kutupa, kutupa, kutupa ndi kuyabwa pamalowo jakisoni) zitha kuonedwa. Izi zimachitika nthawi zambiri. Kusintha kwamphamvu kwa kayendedwe ka shuga m'magazi kungayambitse kusinthika kwamphamvu kwa ululu wamitsempha. Kukhazikika kwakanthawi kokhazikika kwa glycemic kumachepetsa chiopsezo cha matenda ashuga a retinopathy. Komabe, kulimbitsa kwa insulin mankhwala kuti athe kukonza bwino glycemic control kungayambitse kuchepa kwakanthawi kwa matenda ashuga retinopathy.

Malinga ndi kafukufuku wazachipatala, zotsatirazi ndizotsatira zoyipa zomwe zimayikidwa pafupipafupi ndi magulu opanga ziwalo malinga ndi MedDRA.

Malinga ndi pafupipafupi zomwe zimachitika, izi zimagawidwa m'magawo azomwe zimachitika nthawi zambiri (≥1 / 10), nthawi zambiri (≥1 / 100 mpaka 1/1000 kuti 1/10000 kwa ® NM Penfil ® panthawi yoyamwitsa kulibe, chifukwa chithandizo cha mayi sichikhala pachiwopsezo kwa mwana. Komabe, zingakhale zofunikira kusintha muyeso ndi zakudya za mayi.

Kukonzekera kwa inshuwaransi yaumunthu yogwiritsira ntchito insulin ndi mankhwala othandiza komanso otetezeka pochiza matenda a shuga kwa ana ndi achinyamata azaka zosiyanasiyana. Kufunika kwatsiku ndi tsiku kwa ana ndi achinyamata zimatengera gawo la matendawa, kuchuluka kwa thupi, zaka, kudya, kuchita masewera olimbitsa thupi, kuchuluka kwa insulini komanso mphamvu ya glycemia.

Zolemba zogwiritsira ntchito

Kusakwanira dosing kapena kusiya kulandira chithandizo (makamaka ndi matenda a shuga a mtundu wa I) kungayambitse hyperglycemia . Nthawi zambiri, zizindikiro zoyambirira za hyperglycemia zimayamba pang'onopang'ono kwa maola angapo kapena masiku. Amaphatikizaponso ludzu, kukokana pafupipafupi, kusanza, kusanza, kugona komanso kuyanika pakhungu, pakamwa pouma, kusowa kudya, komanso kununkhira kwa acetone mumlengalenga.

Mtundu woyamba wa matenda a shuga, a hyperglycemia, omwe samathandizidwa, amatsogolera ku matenda ashuga a ketoacidosis, omwe mwina ndi omwe amapha.

Hypoglycemia zitha kuchitika ndi mlingo waukulu kwambiri wa insulini wokhudzana ndi kufunika kwa insulin.

Kudumpha zakudya kapena kuchita masewera olimbitsa thupi mosayembekezereka kungayambitse hypoglycemia.

Odwala omwe atukula kwambiri kuchuluka kwa shuga m'magazi chifukwa chokhudza insulin yokwanira amatha kuwona kusintha kwa chizolowezi chawo, okhazikika a hypoglycemia, omwe ayenera kuchenjezedwa pasadakhale.

Zizindikiro zachilendo zimatha kutha kwa odwala omwe ali ndi matenda ashuga a nthawi yayitali.

Kusamutsa wodwala kupita ku mtundu wina kapena mtundu wa insulin kumachitika moyang'aniridwa ndi achipatala. Kusintha kwa ndende, mtundu (wopanga), mtundu, magwero a insulin (yaumunthu kapena analog ya insulin ya anthu) ndi / kapena njira yopangira ingapangitse kusintha kwa insulin. Odwala omwe amasamutsidwa ku Protafan ® NM Penfil ® ndi mtundu wina wa insulin angafunike kuchuluka kwa jakisoni watsiku ndi tsiku kapena kusintha kwa Mlingo poyerekeza ndi insulin yomwe amagwiritsa ntchito kale. Kufunika kochita kusankha kwa mankhwalawa kumatha kuchitika pakukhazikitsa mankhwala atsopano, komanso pakubwera milungu ingapo kapena miyezi ingapo yogwiritsidwa ntchito.

Mukamagwiritsa ntchito mankhwala aliwonse a insulini, zimachitika mu jakisoni wa jekeseni, zomwe zingaphatikizepo kupweteka, kufiyira, kuyamwa, ming'oma, kutupa, kufinya, ndi kutupa. Kusintha pafupipafupi jakisoni m'dera limodzi kumachepetsa kapena kupewa izi. Amakumana zimatha patapita masiku angapo kapena milungu. Nthawi zina, zomwe zimachitika jakisoni jakisoni ungafune kutha kwa mankhwalawa ndi Protafan ® NM Penfil ®.

Asanayende ndikusintha kwamagawo, odwala ayenera kufunsa dokotala, chifukwa izi zimasintha jakisoni wa insulin komanso kudya.

Insulin kuyimitsidwa sayenera kugwiritsidwa ntchito insulin mapampu kwa nthawi yayitali subcutaneous makonzedwe a insulin.

Kuphatikiza kwa thiazolidinediones ndi mankhwala a insulin

Ngati thiazolidinediones amagwiritsidwa ntchito limodzi ndi insulin, milandu yovuta ya mtima yanenedwa, makamaka kwa odwala omwe ali pachiwopsezo cha mtima wosweka. Izi ziyenera kuganiziridwa popereka mankhwala ndi mankhwala a thiazolidatediones ndi insulin. Ndi kuphatikiza kwa mankhwalawa, odwala ayenera kuyang'aniridwa ndi dokotala kuti apangitse zizindikiro ndi zizindikiro za mtima wosakhazikika, kuchuluka kwa kulemera komanso kupezeka kwa edema. Pakakhala kuwonongeka mu ntchito ya mtima, mankhwalawa ndi thiazolidatediones ayenera kusiyidwa.

Kutha kukopa momwe zinthu zikuyendera mukamayendetsa magalimoto kapena njila zina

Kuyankha kwa wodwalayo komanso kuthekera kwake kochita chidwi kukhoza kukhala ndi vuto la hypoglycemia. Izi zitha kukhala zowopsa nthawi zomwe maluso amenewa ali ofunika kwambiri (mwachitsanzo, poyendetsa galimoto kapena kugwiritsa ntchito njira zina).

Odwala ayenera kulangizidwa kuti azichita zinthu zoteteza hypoglycemia musanayendetse. Izi ndizofunikira kwambiri kwa odwala omwe afooka kapena kulibe zizindikiro za kutsogola kwa hypoglycemia kapena zochitika za hypoglycemia zimachitika pafupipafupi. Zikatero, kuyendetsa bwino kuyenera kuyesedwa.

Kusiyana kwa insulin analogues

Ma enulin omwe ali ndi insulin yayitali monga Lantus ndi Tujeo alibe nsapato, amatha kuloledwa bwino ndipo samayambitsa matenda. Ngati munthu wodwala matenda ashuga atasiya kusowa kapena chifukwa cha shuga popanda chifukwa, Protafan iyenera kusinthidwa ndi ma insulin amakono.

Zowonongeka zawo zazikulu ndizokwera mtengo kwawo. Mtengo wa Protafan ndi pafupifupi ruble 400. kwa botolo ndi 950 yonyamula ma cartridge a ma syringe pens. Ma insulin analogu ali pafupifupi 3 times okwera mtengo.

Onetsetsani kuti mwaphunzira! Kodi mukuganiza kuti kuyamwa kwa mapiritsi ndi insulini kwa nthawi yonse yokhayo ndi njira yokhayo yothanirana ndi shuga? Sichowona! Mutha kutsimikizira izi nokha ndikuyamba kuzigwiritsa ntchito. werengani zambiri >>

Basic zida zachilengedwe

kuyimitsidwa koyera, komwe mbewa yoyera komanso yamphamvu yopanda utoto kapena yopanda utoto ikapangidwa, chilombocho chimatha kugwedezeka mosavuta. Mukayang'anidwa pansi pa makina oonera tinthu tating'ono, tinthu timene timawoneka ngati makhiristo amtali wamtali, kutalika kwa makristali ambiri ndi ma micron 1-20.

Malo osungira

Sungani mufiriji pamtunda wa 2 ° C - 8 ° C. Osamazizira.

Sungani makatoni oikidwa mumtundu wachiwiri kuti mutetezedwe pakuwala.

Mukatsegula: gwiritsani ntchito pasanathe milungu 6. Osasunga mufiriji. Sungani ku kutentha kosaposa 30 ° C.

Osagwiritsa ntchito tsiku lotha ntchito lisindikizidwe pa phukusi.

Pewani kufikira ana.

Makatoni amtundu wamtundu (mtundu 1) wokhala ndi mphamvu ya 3 ml, yomwe ndi pistoni ya rabara (robututyl wa rabara) komanso yotsekedwa ndi rabara la rabara (brkidutyl / polyisoprene rabara). Katoniyo amakhala ndi mkanda wamgalasi wophatikizira. Makatoni 5 pa katoni iliyonse.

Zolemba za mankhwala

Mankhwala ndi kuyimitsidwa komwe kumayambitsidwa pansi pa khungu.

Gulu, ntchito:

Isulin insulin-human semisynthetis (semisynthetisita wa anthu). Ili ndi nthawi yayitali yochitapo kanthu. Protafan NM imaphatikizidwa mu: insulinoma, hypoglycemia ndi hypersensitivity pazomwe zimagwira.

Kodi mutenge ndi kumwa bwanji?

Insulin imalowetsedwa kamodzi kapena kawiri patsiku, theka la ola musanadye chakudya cham'mawa. Pankhaniyi, momwe ma jakisoni amapangidwira, ayenera kusinthidwa nthawi zonse.

Mlingo uyenera kusankhidwa kwa wodwala aliyense payekhapayekha. Kuchuluka kwake kumadalira kuchuluka kwa shuga mumkodzo ndi magazi, komanso machitidwe a matendawa. Kwenikweni, mlingo umayikidwa 1 nthawi patsiku ndipo ndi 8-24 IU.

Mu ana ndi akulu omwe ali ndi hypersensitivity kupita ku insulin, kuchuluka kwa mlingo kumachepetsedwa mpaka 8 IU patsiku. Ndipo kwa odwala omwe ali ndi vuto lotsika, madokotala omwe akupezekapo amatha kukupatsani mankhwala okwanira 24 IU patsiku. Ngati mlingo wa tsiku ndi tsiku umaposa 0,6 IU pa kg, ndiye kuti mankhwalawa amaperekedwa ndi jakisoni awiri, omwe amachitika m'malo osiyanasiyana.

Odwala omwe amalandira 100 IU kapena kuposerapo patsiku, amasintha insulin, ayenera kuyang'aniridwa ndi madokotala nthawi zonse. Kusintha mankhwalawo ndi kwina kuyenera kuchitika ndikuwunikira kuchuluka kwa shuga m'magazi.

Kodi kuchitira bongo?

Ngati wodwalayo ali ndi vuto lakelo, ndiye kuti dokotala amakupatsani mankhwala a dextrose, omwe amaperekedwa kudzera mwa dontho la magazi, kudzera m'mitsempha kapena m'mitsempha. Glucagon kapena hypertonic dextrose solution imayendetsedwanso kudzera m'mitsempha.

Ngati chitukuko cha kuperewera kwa hypoglycemic, 20 mpaka 40 ml, i.e. 40% dextrose yankho mpaka wodwala atatuluka chikomokere.

1. Musanatenge insulini phukusi, muyenera kuwona kuti yankho mu botolo ili ndi mtundu wowonekera. Ngati kusefukira, matenthedwe kapena matupi akunja kumaoneka, yankho limaletsedwa.
2. Kutentha kwa mankhwala musanakhazikitsidwe kuyenera kukhala kutentha kwa chipinda.
3. Pamaso pa matenda opatsirana, kuvuta kwa chithokomiro, matenda a Addiosn, kulephera kwa impso, hypopituitarization, komanso odwala matenda ashuga okalamba, mlingo wa insulin umayenera kusinthidwa payekhapayekha.

Zomwe zimayambitsa hypoglycemia zitha kukhala:

• bongo
• kusanza
• kusintha kwa mankhwala
• matenda omwe amachepetsa kufunika kwa insulin (matenda a chiwindi ndi impso, hypofunction ya chithokomiro, pituitary gland, adrenal cortex),
• kusasamala kudya zakudya,
• mogwirizana ndi mankhwala ena
• kutsegula m'mimba
• kuchulukitsa kwakuthupi,
• kusintha kwa jekeseni.

Posamutsa wodwala kuchokera ku insulin ya nyama kupita ku insulin ya anthu, kuchepa kwa shuga m'magazi kungaoneke. Kusintha kwa insulin yaumunthu kuyenera kuvomerezeka kuchokera ku malingaliro azachipatala, ndipo akuyenera kuchitika moyang'aniridwa ndi dokotala.

Nthawi yobadwa komanso yobereka, kufunika kwa insulini kumatha kuchepetsedwa kwambiri. Pa mkaka wa m`mawere, muyenera kuwunika amayi anu kwa miyezi ingapo, mpaka kufunika kwa insulin kukhazikika.

Kuwona kwa kupitirira kwa hypoglycemia kungayambitse kuwonongeka kwa wodwala kuyendetsa magalimoto ndikusunga makina ndi makina.

Mwa kudya shuga kapena zakudya zopatsa mphamvu, odwala matenda ashuga amatha kusiya mtundu wofatsa wa hypoglycemia. Ndikofunika kuti wodwalayo nthawi zonse amakhala naye 20 g shuga.

Ngati hypoglycemia yayimitsidwa, ndikofunikira kudziwitsa dokotala yemwe apange chithandizo.

Pa nthawi yoyembekezera, kuchepa (1 trimester) kapena kuwonjezereka (katatu trimesters) pakufunika kwa insulin kuyenera kuganiziridwanso.