Rinsulin® NPH (Rinsulin NPH)

Dzinalo: Rinsulin r

Kupanga ndi mawonekedwe a kumasulidwa

Njira yothetsera jakisoni ndi yowonekera, yopanda utoto. 1 ml ili ndi 100 IU ya sungunuka wa chibadwa cha anthu. Othandizira: metacresol - 3 mg, glycerol - 16 mg, madzi d / i - mpaka 1 ml.

Kuchuluka kwa botolo ndi 10 ml. Atanyamula bokosi la makatoni.

Kuchuluka kwa katiriji komwe kumakhala ndi ma syringes ambiri, ndi cholembera, 3 ml. Pali ma cartridge asanu pa paketi iliyonse.

Zachipatala ndi gulu la mankhwala

Wamtundu waifupi insulin

Gulu la Pharmacotherapeutic

Mwachidule kuchita insulin

Pharmacological zochita za mankhwala Rinsulin R

Insulin yochepa yamunthu yomwe idapeza pogwiritsa ntchito ukadaulo wa DNA. Imalumikizana ndi cholandirira chapadera pa cell ya cytoplasmic maselo ndikupanga insulini-receptor zovuta zomwe zimapangitsanso njira zina, kuphatikizapo kaphatikizidwe angapo ofunikira a michere (hexokinase, pyruvate kinase, glycogen synthetase). Kutsika kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa kayendedwe ka intracellular, kuchuluka kwa mayamwidwe ndi kuphatikizika ndi minofu, kukondoweza kwa lipogenesis, glycogenogeneis, ndi kuchepa kwa kuchuluka kwa shuga ndi chiwindi.

Kutalika kwa nthawi ya kukonzekera kwa insulin kumachitika makamaka chifukwa cha kuchuluka kwa mayamwidwe, zomwe zimatengera zinthu zingapo (mwachitsanzo, pa mlingo, njira ndi malo oyang'anira), chifukwa chake zochitika za insulin zimasinthasintha kwambiri, mwa anthu osiyanasiyana komanso chimodzimodzi munthu.

Nthawi zambiri, pambuyo pa kukonzekera kwa sc, mankhwalawa amayamba kugwira ntchito pambuyo pa mphindi 30, mphamvu yayikulu imayamba pakati pa ola limodzi ndi maola atatu, kutalika kwa maola ndi maola 8.

Pharmacokinetics

Kukwanira kwathunthu ndi kuyambika kwa mphamvu ya insulini kumatengera njira yoyendetsera (s / c, i / m), tsamba la jakisoni (m'mimba, ntchafu, matako), mlingo (kuchuluka kwa insulini), komanso kuchuluka kwa insulin pokonzekera.

Imagawidwa mosiyanasiyana munsiyo, simalowerera chotchinga ndi mkaka wa m'mawere.

Kutetemera ndi chimbudzi

Amawonongedwa ndi insulinase makamaka m'chiwindi ndi impso. T 1/2 ndi mphindi zochepa. Amachotsa impso (30-80%).

Type 1 shuga mellitus, mtundu 2 shuga mellitus: gawo la kukana mankhwalawa a hypoglycemic, kuperewera pakamwa zamankhwala hypoglycemic (kuphatikiza mankhwala), matenda ashuga a ketoacidosis, ketoacidotic ndi hyperosmolar coma, matenda osokoneza bongo omwe adachitika panthawi yoyembekezera (ngati sichothandiza pakudya) ntchito pafupipafupi kwa odwala omwe ali ndi matenda a shuga ku matenda opatsirana ndimatenda akulu, ndi maopareshoni omwe akubwera, kuvulala, kubala mwana, ndi kuphwanya malamulo pazokhudza Ene zinthu akuyendera mankhwala yaitali kukonzekera insulin.

Contraindication Rinsulin P

Hypoglycemia, kukulitsa chidwi cha munthu pa insulin kapena chilichonse cha mankhwala.

Mlingo komanso njira yogwiritsira ntchito Rinsulin P

Mankhwalawa adapangira SC, mu / m ndi / poyambitsa. Mlingo ndi njira yothandizira makonzedwe a mankhwala amatsimikiziridwa ndi dokotala aliyense payekha, malinga ndi kuchuluka kwa shuga m'magazi.

Pafupifupi, tsiku lililonse mlingo wa mankhwalawa umachokera ku 0,5 mpaka 1 IU / kg thupi (kutengera umunthu wa wodwalayo komanso kuchuluka kwa shuga).

Kutentha kwa insulin yovundikira kuyenerana ndi kutentha kwa chipinda.

Mankhwalawa umaperekedwa kwa mphindi 30 asanadye kapena chakudya.

Ndi monotherapy ndi mankhwala, pafupipafupi makonzedwe ndi 3 zina / tsiku (ngati kuli kotheka, nthawi 5-6 / tsiku). Pa mlingo wa tsiku ndi tsiku wopitilira 0.6 IU / kg, ndikofunikira kulowa mu mawonekedwe a jekeseni a 2 kapena kuposa m'malo osiyanasiyana a thupi.

Mankhwalawa nthawi zambiri amawathandizira sc mpaka khoma lakumbuyo yam'mimba. Zilonda zitha kuchitika mu ntchafu, matako, kapena dera la minofu yolumikizana phewa. Ndikofunikira kusintha malo a jekeseni mkati mwa anatomical dera kuti muchepetse kukula kwa lipodystrophy.

Ndi s / c makonzedwe a insulini, chisamaliro chimayenera kutengedwa kuti musalowe mumtsempha wamagazi. Pambuyo pa jakisoni, tsamba la jakisidwe siliyenera kutenthedwa. Odwala ayenera kuphunzitsidwa bwino kugwiritsa ntchito insulin yobereka.

Mankhwala a IM ndi IV amatha kuperekedwa kokha moyang'aniridwa ndi achipatala.

Rinsulin ® P ndi insulin yochepa ndipo imakonda kugwiritsidwa ntchito limodzi ndi insulin (Rinsulin ® NPH).

Malamulo a kayendetsedwe ka mankhwala

Simungathe kugwiritsa ntchito mankhwalawa ngati chidziwitso chikuwoneka mu yankho.

Mukamagwiritsa ntchito mtundu umodzi wokha wa insulin

1. Patulani khungu pamtundu wa vial.

2. Jambulani mpweya mu syringe muyezo wofanana ndi kuchuluka kwa insulini. Lowetsani mpweya mu vala ya insulin.

3. Tembenuza vial ndi syringe mozondoka ndikujambula gawo la insulini mu syringe. Chotsani singano mu vial ndikuchotsa mpweya ku syringe. Onani kulondola kwa insulin.

4. Lowani nthawi yomweyo.

Ngati mukufuna kusakaniza mitundu iwiri ya insulin

1. Patulani zimbudzi zam'mimbamo.

2. Nthawi yomweyo musanayimbe, muyenera kukuta botolo la insulin yayitali ("yamitambo") pakati pa manja anu mpaka insulini itayamba kukhala yoyera komanso yamitambo.

3. Thirani mpweya mu syringe muyezo wofanana ndi mlingo wa insulin yamitambo. Lowetsani mpweya mumtambo wa insulin vial ndikuchotsa singano mu vial.

4. Kukoka mpweya mu syringe mu voliyumu yofanana ndi mlingo wa insulin yochepa ("mandala"). Lowetsani mpweya mu vial "insulin" yowonekera. Tembenuzani botolo ndi syringe mozungulirapo ndikusonkhanitsa kuchuluka kwa insulin "yowonekera". Chotsani singano ndikuchotsa mpweya ku syringe. Onani kulondola kwa mlingo.

5. Ikani singano mu vial ndi insulin "yamtambo", sinthani vial ndi syringe pansi ndikusonkhanitsa kuchuluka kwa insulini. Chotsani mpweya mu syringe ndikuwonetsetsa ngati mulondola. Jekeseni wa insulin yosakanikirana nthawi yomweyo.

6. Muyenera kulembanso insulini munthawi yomweyo monga tafotokozera pamwambapa.

Ndikofunikira kupha tizilombo toyambitsa matenda pakhungu lomwe insulin ingalowe.

Ndi zala ziwiri, sonkhanitsani khola, ikani singano m'munsi mwa khola pakona pafupifupi 45 ° ndikuvulaza insulin pansi pa khungu.

Pambuyo pa jekeseni, singano iyenera kusiyidwa pansi pakhungu kwa masekondi osachepera 6 kuti muwonetsetse kuti insulini idayikidwa kwathunthu.

Ngati magazi atuluka pamalo a jakisoni atachotsa singano, pang'onopang'ono dinani jakisoniyo ndi swab wothira ndi njira yotsatsira matenda (mwachitsanzo, mowa).

Ndikofunikira kusintha tsamba la jakisoni.

Zotsatira zoyipa

Zotsatira zoyipachifukwa cha kuchuluka kwa kagayidwe kazakudya: Hypoglycemic zinthu (pallor of the khungu, thukuta kwambiri, palpitations, kugwedeza, kuzizira, njala, kukwiya, paresthesia wa mucosa mkamwa, kupweteka mutu, chizungulire, utachepa kuwona acuity). Matenda oopsa a hypoglycemia angayambitse kukula kwa chikomokere kwa hypoglycemic.

Zotsatira zoyipa: zotupa pakhungu, edema ya Quincke, kuwopsa kwa anaphylactic.

Zomwe zimachitika: Hyperemia, kutupa ndi kuyabwa pamalowo jekeseni, ndikugwiritsa ntchito nthawi yayitali - lipodystrophy pamalo opangira jekeseni.

Zina: kutupa, kuchepa kwakanthawi pang'onopang'ono mu mawonekedwe acuity (nthawi zambiri kumayambiriro kwa chithandizo).

Wodwalayo ayenera kudziwitsidwa kuti ngati adazindikira kukula kwa vuto la hypoglycemia kapena ngati ali ndi vuto loti azindikira, ayenera kudziwitsa dokotala nthawi yomweyo.

Ngati zovuta zina zomwe sizinafotokozeredwe pamwambapa zizindikirika, wodwalayo ayenera kuonana ndi dokotala.

Mimba komanso kuyamwa

Palibe choletsa pa chithandizo cha matenda osokoneza bongo a shuga ndi insulin panthawi yapakati, chifukwa insulin siyidutsa chotchinga. Mukakonzekera kukhala ndi pakati komanso panthawi imeneyi, ndikofunikira kulimbikitsa chithandizo cha matenda ashuga. Kufunika kwa insulin nthawi zambiri kumachepera mu trimester yoyamba ya kutenga pakati ndipo kumawonjezeka pang'onopang'ono kwachiwiri komanso kachitatu.

Nthawi yobadwa pambuyo pokhapokha ndipo mwayamba kubadwa, zofunika za insulin zimatha kugwa kwambiri. Pambuyo pobadwa, kufunikira kwa insulin kumabwereranso msanga momwe kunaliri asanakhale ndi pakati. Palibe choletsa pa chithandizo cha matenda osokoneza bongo a shuga ndi insulin panthawi yoyamwitsa. Komabe, zingakhale zofunikira kuchepetsa mlingo wa insulin, chifukwa chake, kuwunikira mosamala kwa miyezi ingapo ndikofunikira musanakhazikitse kufunika kwa insulin.

Kugwiritsa ntchito kwa chiwindi chodwala Muli wa insulin uyenera kuwongolera kuti chiwindi chitsekeke.

Gwiritsani ntchito odwala okalamba

Mlingo wa insulin uyenera kuwongoleredwa kwa odwala omwe ali ndi zaka zopitilira 65.

Malangizo apadera a kuvomerezedwa Rinsulin P

Potengera maziko a mankhwala a insulin, kuyang'anira kuchuluka kwa shuga m'magazi ndikofunikira.

Kuphatikiza pa kuchuluka kwa insulin, zomwe zimayambitsa hypoglycemia zimatha kuphatikizira mankhwala osokoneza bongo, kudumpha chakudya, kusanza, kutsegula m'mimba, kuchuluka kwa zochitika zolimbitsa thupi, matenda omwe amachepetsa kufunikira kwa insulin (kuwonongeka kwa chiwindi ndi ntchito ya impso, hypofunction ya adrenal cortex, pituitary kapena chithokomiro cha chithokomiro), komanso kusintha kwa jakisoni wambiri, komanso kucheza ndi mankhwala ena.

Dosing yolakwika kapena kusokonezedwa mu kayendetsedwe ka insulin, makamaka kwa odwala omwe ali ndi matenda amtundu wa 1, angayambitse matenda a hyperglycemia. Nthawi zambiri, zizindikiro zoyambirira za hyperglycemia zimayamba pang'onopang'ono kwa maola angapo kapena masiku. Izi zikuphatikiza ludzu, kukodza kwambiri, nseru, kusanza, chizungulire, khungu ndi kuwuma pakhungu, pakamwa pouma, kusowa chilimbikitso, kununkhira kwa acetone mu mpweya wotuluka. Ngati sanalandire, hyperglycemia mu mtundu 1 wa shuga angayambitse kukula kwa matenda ashuga a ketoacidosis.

Mlingo wa insulini uyenera kukonzedwa kuti matenda a chithokomiro asokonezeka, matenda a Addison, hypopituitarism, chiwindi ndi impso, komanso odwala matenda a shuga a zaka zopitilira 65.

Wodwala akachulukitsa mphamvu zolimbitsa thupi kapena asintha chizolowezi chake, kusintha kwa insulin kungafunike.

Kusintha kuchokera ku mtundu wina wa insulin kupita ku wina kuyenera kuchitika mothandizidwa ndi kuchuluka kwa shuga m'magazi.

Mankhwala amachepetsa kulolera kwa mowa.

Chifukwa cha kuthekera kwanyengo m'matumba ena, kugwiritsa ntchito mankhwalawa m'mapampu a insulin sikulimbikitsidwa.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Pokhudzana ndi cholinga choyambirira cha insulini, kusintha kwa mtundu wake, kapena kupanikizika kwakukulu kwamthupi kapena m'maganizo, ndizotheka kuchepetsa kuyendetsa galimoto kapena kuwongolera kayendedwe kosiyanasiyana, komanso kuchita zochitika zina zowopsa zomwe zimafuna chidwi chochulukirapo komanso kuthamanga kwa kayendedwe ka malingaliro ndi magalimoto.

Bongo

Ndi mankhwala osokoneza bongo, hypoglycemia imayamba.

Chithandizo: wodwalayo amatha kuthetsa hypoglycemia wofatsa mwa kudya shuga kapena zakudya zopatsa mphamvu. Chifukwa chake, ndikulimbikitsidwa kwa odwala matenda ashuga kuti azinyamula shuga, maswiti, makeke kapena mandimu okoma zipatso.

Zikakhala zovuta, wodwala akayamba kuzindikira, njira ya 40% ya dextrose (glucose) imayendetsedwa iv, i / m, s / c, iv glucagon. Pambuyo pakupezanso chikumbumtima, wodwalayo akulimbikitsidwa kudya zakudya zamafuta ambiri kuti aletse kukonzanso kwa hypoglycemia.

Kuchita ndi Mankhwala Ena

Mankhwala osagwirizana ndi mayankho a mankhwala ena. Mphamvu ya hypoglycemic imapangidwira ndi sulfonamides (kuphatikizapo mankhwala a hypoglycemic, sulfonamides), ma inhibitors a MAO (kuphatikizapo furazolidone, procarbazine, selegiline), carbonic anhydrase inhibitors, ACE inhibitors, NSAIDs (kuphatikizapo salicylates), anabolic (kuphatikiza stanozolol, oxandrolone, methandrostenolone), androgens, bromocriptine, tetracyclines, clofibrate, ketoconazole, mebendazole, theophylline, cyclophosphamide, phenfluramine, Li + kukonzekera, pyridoxine, quinidine, quinine, etloroquin, etloro. Zotsatira Hypoglycemic wa kulemala glucagon, kukula timadzi, corticosteroids m'kamwa kulera, estrogens, thiazide ndi kuzungulira okodzetsa, mahomoni BCCI, chithokomiro, heparin, sulfinpyrazone, sympathomimetics, danazol, tricyclics, clonidine, calcium muzikangana, diazoxide, morphine, chamba, fodya, phenytoin, epinephrine, H1-histamine receptor blockers. Beta-blockers, reserpine, octreotide, pentamidine imatha kuwongolera ndi kufooketsa mphamvu ya hypoglycemic ya insulin.

Mankhwala Okhala Pamalo a Pharmacy

Mankhwala ndi mankhwala.

Migwirizano ndi magwiritsidwe akusungidwa Rinsulin P

Mankhwalawa amayenera kusungidwa pamalo osavomerezeka kwa ana, otetezedwa ku kuwala, kutentha kwa 2 ° mpaka 8 ° C, osazizira. Moyo wa alumali ndi zaka 2.

Kugwiritsa ntchito mankhwala Rinsulin r pokhapokha ngati adokotala adafotokoza, mafotokozedwewo amaperekedwa kuti awathandize!

Gulu la Nosological (ICD-10)

Mlingo ndi makonzedwe

Intravenous makonzedwe a Rinsulin ® NPH ndi contraindicated.

Mlingo wa mankhwalawa amadziwitsidwa ndi dokotala aliyense payekhapayekha malinga ndi kuchuluka kwa shuga m'magazi. Pafupifupi, tsiku lililonse mlingo wa mankhwalawa umachokera ku 0,5 mpaka 1 IU / kg (kutengera umunthu wa wodwalayo komanso kuchuluka kwa shuga m'magazi).

Odwala okalamba omwe amagwiritsa ntchito insulin iliyonse, kuphatikiza Rinsulin ® NPH, ali pachiwopsezo cha hypoglycemia chifukwa cha kukhalapo kwa concomitant pathology komanso kulandira nthawi yomweyo mankhwala angapo. Izi zitha kuthandizira kusintha mlingo wa insulin.

Odwala omwe ali ndi vuto la kuwonongeka kwa impso ndi kwa chiwindi ali pachiwopsezo cha hypoglycemia ndipo angafunikire kusintha kawirikawiri kwa insulin komanso kuwunika pafupipafupi magazi a shuga.

Kutentha kwa insulin yoyenera kuyenera kukhala kutentha kwambiri. Mankhwala nthawi zambiri amalowetsedwa mu ntchafu. Jakisoni amathanso kuchitika mu khoma lakunja kwam'mimba, matako kapena paphewa pang'onopang'ono. Ndikofunikira kusintha malo a jekeseni mkati mwa anatomical dera kuti muchepetse kukula kwa lipodystrophy.

Ndi s / c makonzedwe a insulini, chisamaliro chimayenera kutengedwa kuti musalowe mumtsempha wamagazi. Pambuyo pa jakisoni, tsamba la jakisidwe siliyenera kutenthedwa. Odwala ayenera kuphunzitsidwa bwino kugwiritsa ntchito insulin yobereka.

Musanagwiritse ntchito, makatiriji a Rinsulin ® NPH ayenera kugulitsidwa pakati pa manja m'manja mozungulira maulendo 10 ndikugwedezeka kuti ayambitsenso insulini mpaka kukhala yunifolomu yovomerezeka kapena mkaka. Foam sayenera kuloledwa kuchitika, zomwe zingasokoneze mlingo woyenera.

Makatoni amayenera kufufuzidwa mosamala. Osagwiritsa ntchito insulini ngati ili ndi flakes mutasakaniza, tinthu tating'ono tomwe timatirira pansi kapena makhoma a cartridge, ndikuwapatsa mawonekedwe owoneka ngati achisanu.

Chipangizo cha ma cartridge sichimalola kusakanikirana ndi zomwe zili ndi insulini zina mwachindunji mu cartridge lokha.Makatoniwo sanapangidwe kuti adzazitsidwe.

Mukamagwiritsa ntchito makatoni okhala ndi cholembera cholinganiranso, malangizo a wopanga kuti akwaniritse katoni mu syringe cholembera ndikuyika singano akuyenera kutsatiridwa. Mankhwalawa amayenera kuperekedwa molingana ndi malangizo a wopanga a cholembera.

Pambuyo poti muyike, ndikofunikira kuti mutulutse singano pogwiritsa ntchito singano yakunja ndikuwonongeratu nthawi yomweyo. Kuchotsa singano mutangolowa jakisoni kumathandizira kusokonekera, kupewa kutayikira, kutsekeka kwa mpweya ndi kuboweka kwa singano. Kenako ikani chophimba chija.

Mukamagwiritsa ntchito mitundu yambiri ya syringe zolembera, ndikofunikira kusakaniza kuyimitsidwa kwa Rinsulin ® NPH mu cholembera cha syringe nthawi yomweyo musanagwiritse ntchito. Kuyimitsidwa kophatikizidwa bwino kuyenera kukhala kofanana ndi oyera komanso mitambo.

Rinsulin ® NPH cholembera sichingagwiritsidwe ntchito ngati chawuma. Mukamagwiritsa ntchito mankhwala osokoneza bongo omwe amadzaza kale, muyenera kuchotsa cholembera mufiriji musanagwiritse ntchito ndikulola kuti mankhwala afike. Malangizo enieni ogwiritsira ntchito cholembera chomwe amaperekedwa ndi mankhwalawa ayenera kutsatiridwa.

Rinsulin ® NPH mu cholembera cha syringe ndi singano zimapangidwa kuti azigwiritsa ntchito payekha. Osadzazitsanso katoni katemera.

Singano sayenera kugwiritsidwanso ntchito.

Kuteteza kuchokera ku kuwala, cholembera cha syringe chikuyenera kutsekedwa ndi chipewa.

Osasunga cholembera chogwiritsidwa ntchito mufiriji.

Rinsulin ® NPH imatha kuperekedwa palokha kapena kuphatikiza ndi insulin yochepa (Rinsulin ® P).

Sungani mankhwalawa mu firiji (15 mpaka 25 ° C) osapitilira masiku 28.

Kugwiritsa ntchito makatoni ogwiritsa ntchito zolembera zomwe zingagwiritsenso ntchito

Makatoni okhala ndi Rinsulin ® NPH angagwiritsidwe ntchito ndi zolembera zomwe zingagwiritsenso ntchito:

- syringe cholembera Avtopen Classic (Autopen Classic 3 ml 1 Yunitsi (mayunitsi 1-21) AN3810, Autopen classic 3 ml 2 Yunitsi (mayunitsi 2-42) AN3800) yopangidwa ndi Owen Mumford Ltd, United Kingdom,

- jakisoni wopangira insulin HumaPen ® Ergo II, HumaPen ® Luxura ndi HumaPen ® Savvio yopangidwa ndi "Eli Lilly ndi Company / Eli Lilly ndi Comranu", USA,

- insulin syringe cholembera OptiPen ® Pro 1 yopangidwa ndi Aventis Pharma Deutschland GmbH / Aventis Pharma Deutschland GmbH, Germany,

- syringe cholembera BiomaticPen ® chopangidwa ndi Ipsomed AG / Ypsomed AG, Switzerland,

- cholembera-piritsi la kuyambitsa insulin payekha RinsaPen I kupanga "Ipsomed AG / Ypsomed AG", Switzerland.

Tsatirani mosamala malangizo ogwiritsa ntchito zolembera zomwe amapanga ndi omwe amapanga.

Kutulutsa Fomu

Kuyimitsidwa kwa kayendetsedwe ka subcutaneous, 100 IU / ml.

3 ml ya mankhwalawa kapu yamagalasi yokhala ndi chopukutira cha mphira, wokumbika mu kapu yolumikizidwa yopangidwa ndi aluminiyamu ndi disc ya mphira.

Mpira wamagalasi wokhala ndi malo opukutira umakhazikika pakatoni iliyonse.

1. Makatiriji asanu amayikidwa mu chovala cholumikizira chopangidwa ndi filimu ya PVC ndi zojambulazo za aluminiyamu. Pulogalamu imodzi yazovala zamtunduwu imayikidwa pakatoni.

2. Katoni yomwe idayikidwa mu cholembera pulasitiki yoyeserera patsekeke zingapo za jekeseni wa Rinastra ® kapena Rinastra ® II. Ma syringe asanu osadzazidwa ndi malangizo ogwiritsira ntchito cholembera amaikidwa mu paketi a makatoni.

10 ml ya mankhwalawa mu botolo lagalasi lopanda utoto, losindikizidwa ndi kapu yolumikizidwa kuchokera ku aluminium ndi pulasitiki yokhala ndi disc ya mphira kapena yokhomedwa ndi chopumira cha mphira ndi chipewa cholumikizira kuchokera ku aluminium ndi pulasitiki yokhala ndi pulasitiki yopukutira. Cholemba chodzikometsera chokha chimayikidwa pa botolo lirilonse ndikuyika mu kakhadi.

Wopanga

GEROPHARM-Bio OJSC, Russia. 142279, dera la Moscow, chigawo cha Serpukhov, r.p. Obolensk, nyumba 82, p. 4.

Ma adilesi amalo opanga:

1. 142279, dera la Moscow, chigawo cha Serpukhov, r.p. Obolensk, nyumba 82, p. 4.

2.1422279, Dera la Moscow, Chigawo cha Serpukhov, pos. Obolensk, nyumba 83, lit. AAN.

Milandu yolandira bungwe: GEROPHARM LLC. 191144, Russian Federation, St. Petersburg, Degtyarny pa., 11, lit. B.

Foni: (812) 703-79-75 (makatani ambiri), fakisi: (812) 703-79-76.

Tele hotline: 8-800-333-4376 (kuyimbira mkati mwa Russia ndi kwaulere).

Tumizani zambiri zokhudzana ndi kusafuna kwanu ku imelo adilesi [email protected] kapena ndi omwe mumalumikizana ndi GEROFARM LLC akuwonetsa pamwambapa

Kupanga ndi mawonekedwe a kumasulidwa

Mankhwalawa amatanthauza mankhwala omwe amagulitsidwa ndi mankhwala, chifukwa kugwiritsa ntchito mosalamulirika kungavulaze thupi.

Ndi yankho la jakisoni, chinthu chachikulu chomwe ndi insulin yaumunthu, chopangidwa pogwiritsa ntchito ukadaulo wa DNA.

Zothandiza pa mankhwalawa ndi:

Kutulutsidwa kwa Rinsulin kumachitika ku Russia. Njira yothetsera vutoli ndi yowonekera ndipo ilibe mtundu. Amayikidwa m'mabotolo agalasi a 10 ml.

Makhalidwe

Mankhwala amakhala ndi hypoglycemic zotsatira. Kutsika kwa shuga m'magazi kumaperekedwa ndi mphamvu ya gawo lalikulu. Insulin, yomwe ilowa m'thupi la wodwalayo, imapangitsa kuti glucose ayambe kugwira ntchito yake ndikugawa maselo. Rinsulin amachepetsa nawonso shuga.

Chida ichi chili ndi nthawi yayitali yochitapo kanthu. Zimayamba kukhudza thupi theka la ola pambuyo pobayira. Imagwira kwambiri pakati pa maola 1-3 mutatha kugwiritsa ntchito. Mphamvu yake imatha patatha maola 8.

Kuchita bwino komanso nthawi yayitali ya Rinsulin zimatengera Mlingo ndi njira yoyendetsera. Kuchotsa izi m'thupi kumachitika ndi impso.

Malangizo ogwiritsira ntchito

Tikulimbikitsidwa kugwiritsa ntchito mankhwalawa mtundu 1 komanso matenda ashuga 2 ngati sizotheka kutulutsa shuga ndi mankhwala a pakamwa. Rinsulin ndi jekeseni yomwe imatha kuchitidwa intramuscularly, subcutanely and intravenous. Njira yoyenera kwambiri yogwiritsira ntchito imatsimikiziridwa payekhapayekha.

Mlingo wa mankhwalawa amawerengedwa potengera mawonekedwe azachipatala. Nthawi zambiri, 0,5-1 IU / kg ya kulemera kwa odwala amayenera kuperekedwa tsiku lililonse.

Mankhwalawa amaloledwa kugwiritsidwa ntchito limodzi ndi mankhwala ena a hypoglycemic, ngati pakufunika.

Nthawi zambiri, rinsulin imayang'aniridwa mosavuta. Zingwe ziyenera kuperekedwa kwa ntchafu, phewa, kapena khomo lam'mimba lakunja. Ndikofunikira kusinthana mawebusayiti enanso, momwe mungagwiritsire lipodystrophy.

Intramuscular makonzedwe amachitika kokha malinga ndi dokotala. Mitsempha, mankhwalawa amatha kuperekedwa ndi othandizira azaumoyo. Izi zimachitidwa m'njira zovuta.

Phunziro la kanema pakukhazikitsa insulin pogwiritsa ntchito cholembera:

Zotsatira zoyipa

Kumwa mankhwala aliwonse kungayambitse zovuta zina. Kuti mudziwe zovuta zomwe Rinsulin ingayambitse, muyenera kuphunzira malangizo ndi kuwunika pamabungwe kuchokera kwa odwala.

Nthawi zambiri ndi kugwiritsidwa ntchito kwake, zotsutsana zotsatirazi zimachitika:

• hypoglycemic state (imayendera limodzi ndi zovuta zambiri, monga chizungulire, kufooka, nseru, tachycardia, chisokonezo, ndi zina).
• ziwengo (zotupa pakhungu, kuwopsa kwa anaphylactic, edema ya Quincke),
• kuwonongeka kwamawonekedwe
• khungu red
• kuyabwa

Nthawi zambiri, mavuto amayamba kugwiritsa ntchito mankhwalawa ngakhale osagwirizana ndi kapangidwe kake. Kuti muthane ndi zovuta izi, muyenera kulumikizana ndi katswiri. Zotsatira zina zoyipa zimatha mukangomwa kumwa; ena amafunikira chithandizo chamankhwala.

Nthawi zina kuwonekera kwa matenda kumapangitsa kuti wodwalayo asokonezeke, kenako amafunika kulandira chithandizo chachikulu kuchipatala.

Kuyanjana kwa mankhwala osokoneza bongo

Rinsulin nthawi zina amagwiritsidwa ntchito popanga zinthu zovuta, koma amayenera kukhala mwadongosolo. Pali magulu a mankhwalawa chifukwa chomwe chidwi cha thupi pakupanga insulini chimakulitsidwa kapena kufooka. Muzochitika izi, ndikofunikira kusintha kuchuluka kwa mankhwalawa.

Iyenera kuchepetsa gawo la Rinsulin pomwe mukuigwiritsa ntchito motere:

• hypoglycemic mankhwala,
• salicylates,
• beta blockers,
• Mao ndi ACE zoletsa,
• manzeru
• mankhwala antifungal.

Kuchita bwino kwa Rinsulin kumachepa ngati kugwiritsidwa ntchito limodzi ndi mankhwala monga:

• okodzetsa
• antidepressants
• mankhwala a mahomoni.

Ngati pakufunika kugwiritsa ntchito nthawi yomweyo Rinsulin ndi mankhwalawa, muyenera kuwonjezera mlingo.

Osasintha mosamala dongosolo la mankhwalawa. Ngati gawo lalikulu la insulin likulowa m'thupi, mankhwala osokoneza bongo amatha kuchitika, chiwonetsero chachikulu chomwe ndi hypoglycemia. Ngati mumagwiritsa ntchito mlingo wochepa wa mankhwalawo, chithandizo sichingathandize.

Malangizo apadera

Njira zapadera mukamamwa mankhwala nthawi zambiri zimaperekedwa kwa ana, amayi oyembekezera komanso okalamba.

Kuchiza ndi Rinsulin kumatanthauza kutsatira malamulo otsatirawa:

1. Amayi oyembekezera. Palibe chifukwa chosinthira kuchuluka kwa mankhwalawa, chifukwa zomwe zimagwira sizikhudza mayiyo. Koma nthawi imodzimodzi, ndikofunikira kuwongolera msanga wamagazi a mkazi, chifukwa mukakhala ndi mwana, chizindikiro ichi chimatha kusintha.
2. Amayi oyamwitsa. Insulin siyidutsa mkaka wa m'mawere, motero, sichikhudza mwana. Chifukwa chake, simukuyenera kusintha mlingo. Koma mayi akuyenera kuwunika zakudya zake, kutsatira malangizowo.
3. Anthu okalamba. Chifukwa chakusintha kokhudzana ndi ukalamba, matupi awo amatha kutengeka ndizovuta zamankhwala. Izi zimafuna kumuwunika wodwalayo ndi kuwerengera kwa mankhwala asanalembe Rinsulin.
4. Ana. Amaloledwa kulandira mankhwala ndi mankhwalawa, koma moyang'aniridwa ndi katswiri. Mlingowo umaperekedwa palokha.

Malangizo apadera amaperekedwanso kwa odwala omwe ali ndi matenda a chiwindi ndi impso. Mankhwalawa amakhudza chiwindi, ndipo impso zimathandizira kuchotsa mankhwalawa m'thupi. Ngati pali zovuta ndi ziwalo izi, mlingo wa Rinsulin uyenera kuchepetsedwa kuti musayambitse hypoglycemia.

Ngati mukulekerera wothandizila wodwala, muyenera kuthandizanso ndi wina. Dokotala angakuthandizeni kusankha.

Nthawi zambiri, cholowa m'malo chimalembedwa:

1. Khalid. Mankhwalawa amachokera ku insulin ya anthu ndipo amawoneka ngati kuyimitsidwa. Jekeseni wothandizirana ndi mankhwalawa amathandizira kuti magazi asungunuke. Sizoletsedwa kuzigwiritsa ntchito ndi hypoglycemia komanso tsankho pazigawo zake.
2. Rosinsulin. Chida ichi chimagulitsidwa ngati yankho la jakisoni. Amayikidwa m'makalata atatu a 3 ml. Chofunikira chake chachikulu ndi insulin yaumunthu.
3. Insuran. Mankhwalawa ndi kuyimitsidwa komwe kumagwiritsidwa ntchito poyambira. Zimasiyanasiyana pakatikati pochitika. Wopangidwa ndi Insuran kutengera isophan insulin.

Mankhwalawa amadziwika ndi zofanana, koma ali ndi kusiyana komwe kumayenera kuganiziridwa. Muyeneranso kudziwa momwe mungasinthire molondola kuchokera ku mankhwala ena kupita ku wina.

Rinsulin NPH

Mankhwalawa amafanana kwambiri ndi Rinsulin R. Muli ndi insulin isophan. Mankhwalawa amakhala ndi nthawi yayitali ndipo amayimitsa jakisoni.

Amagwiritsidwa ntchito pokhapokha, omwe amathandiza kupanga cholembera cha Rinsulin NPH.

Ndikofunikira kukhazikitsa mankhwalawa m'mimba khoma, ntchafu kapena phewa. Kuti mankhwala azitha kutengeka msanga, ma jakisoni amayenera kupangidwa m'malo osiyanasiyana a thupi mokhazikika.

Zothandiza zotsatirazi ndi gawo la Rinsulin NPH:

• phenol
• glycerin
• protamine sulfate,
• sodium hydrogen phosphate,
• metacresol
• madzi.

Mankhwalawa amamasulidwa m'mabotolo agalasi 10 ml. Kuyimitsidwa ndi koyera;

Mankhwalawa amagwira ntchito mofanananira ndi Rinsulin R. Amalimbikitsa kuthamanga kwa shuga m'magazi ndipo amachepetsa kupanga ndi chiwindi. Kusiyanako kukugona pakukhalitsa kwanthawi yayitali - kumatha kufikira maola 24.

Mtengo wa Rinsulin NPH umasinthasintha kuzungulira ma ruble 1100.

Mutha kudziwa kuti mankhwalawa ndi othandiza bwanji popenda ndemanga za wodwala za Rinsulin P ndi NPH. Amasiyana. Odwala ambiri amalabadira mankhwalawa, koma pali ena omwe chithandizo chotere sichinawagwire. Kusakhutira kumachitika chifukwa cha zotsatira zoyipa zomwe zingayambitse mankhwala okhala ndi insulin.

Nthawi zambiri, zovuta zinkachitika mwa anthu odwala matenda ashuga omwe sanatsatire malangizo kapena kwa iwo omwe matupi awo anali omvera pakhungu. Izi zikutanthauza kuti mphamvu ya mankhwalawa imatengera zochitika zambiri.

Rinsulin R - mafomu ofotokozera ndi kumasula

Pansipa pali zambiri zokhudzana ndi mankhwalawa omwe angapereke chithunzi chonse cha insulin.

Rinsulin P imatengedwa mwachangu m'magazi kuchokera ku minyewa yokhala ndi subcutaneous, zotsatira za hypoglycemic zimayamba pambuyo pa theka la ola. Timadzi timene timalumikizana ndi ma cell receptors, omwe amalola kutulutsa kwa glucose kuchokera m'mitsempha yamagazi kupita ku minofu. Kuchita kwa Rinsulin kuyambitsa kupangika kwa glycogen ndikuchepetsa kuchuluka kwa kapangidwe ka shuga m'chiwindi kumakhudzanso kuchepa kwa glycemia.

Zotsatira za mankhwalawa zimatengera kuchuluka kwa mayamwidwe, ndikuti, pamakulidwe ndi magazi omwe amapezeka ndi minyewa yolumikizira malo a jekeseni. Pafupifupi, pharmacodynamics ya Rinsulin P imafanana ndi ma insulin ena apafupi:

• nthawi yoyambira ndi mphindi 30
• nsapato - pafupifupi 2 hours
• chochita chachikulu ndi maola 5,
• kutalika kwa ntchito - mpaka maola 8.

Mutha kufulumizitsa kuchita insulin mwa kuilowetsa m'mimba kapena mkono wapamwamba, ndikuchepetsa pang'onopang'ono ndi kubayidwa patsogolo pa ntchafu.

Kuti alipire shuga yodwala matenda a shuga ku Rinsulin, wodwalayo ayenera kutsatira zakudya 6 patsiku, nthawi yayikulu pakati pa chakudya chachikulu 3 ayenera kukhala maola 5, pakati pawo 10-20 g a chakudya pang'onopang'ono okakamiza.

Rinsulin P imangokhala ndi chinthu chimodzi chogwira - insulin yaumunthu. Amapangidwa ndi njira yobwererera, ndiye kuti, pogwiritsa ntchito ma bakiteriya osinthika ma genetic. Nthawi zambiri E. coli kapena yisiti imagwiritsidwa ntchito pazolinga izi. Popanga ndi kapangidwe kake, insulini iyi siyosiyana ndi mahomoni omwe kapamba amapanga.

Pali magawo othandiza ochepa ku Rinsulin P kuposa momwe amachokera kunja. Kuphatikiza pa insulini, imangokhala ndi madzi, metacresol yosungirako komanso glycerol yokhazikika. Kumbali imodzi, chifukwa cha izi, mwayi wokhudzana ndi thupi lawo m'malo a jakisoni ndiwotsika. Komabe, kunyowa m'magazi ndi kutsika kwa shuga kwa Rinsulin kumasiyana pang'ono. Chifukwa chake, kusinthana ndi mankhwala ena omwe ali ndi mphamvu yomweyo kungatenge masiku angapo, pomwe kubwezeretsedwa kwa matenda a shuga kumawonjezereka.

Kutulutsa Mafomu

Rinsulin P ndi njira yopanda utoto, yowonekera kwathunthu, m'mililita yama 100 ya mahomoni.

Kutulutsa Mafomu:

1. Mbale zokhala ndi yankho la 10 ml, mankhwala kuchokera kwa iwo adzafunikira jekeseni wa insulin.
2. 3 ml makatiriji. Zitha kuyikidwa mu cholembera chilichonse chomwe chimapangidwira cartridge yokhazikika: HumaPen, BiomaticPen, Autopen Classic. Kuti muthe kulowa muyezo weniweni wa insulin, makulidwe ayenera kuperekedwa kwa zolembera zama syringe ndi kuchuluka kocheperako. Mwachitsanzo, HumaPen Luxura imakuthandizani kuti mupeze mayunitsi 0,5.
3. Syringe zolembera zotayidwa Rinastra 3 ml. Kusintha cartridge mwa iwo sikutheka, gawo 1 unit.

Zotheka zosafunikira

Kuchuluka kwa zoyipa za Rinsulin ndizochepa, odwala ambiri amangodziwa hypoglycemia wofatsa.

Mndandanda wazotsatira zosafunikira malinga ndi malangizo:

1. Hypoglycemia ndiyotheka ngati mankhwalawa amawerengedwa molakwika ndipo amaposa kufunikira kwa mahomoni. Kusagwirizana ndi malangizo ogwiritsira ntchito kumapangitsanso kutsika kwa shuga: njira yolakwika ya jakisoni (insulin idalowa mu minofu), kutentha kwa malo a jekeseni (kutentha kwambiri kwa mpweya, kuponderezana, kukangana), cholembera cholakwika, syringe zolimbitsa thupi. Hypoglycemia iyenera kuthetsedwa zizindikiro zake zoyambirira zikaoneka: malaise, kunjenjemera, njala, mutu. Nthawi zambiri, 10-15 g yamakanizo othamanga amakhala okwanira izi: shuga, madzi, mapiritsi a shuga. Hypoglycemia ingayambitse kuwonongeka kwamitsempha yamagetsi, ndikupangitsa kukomoka.
2. Vuto lachiwiri lodziwika bwino ndi kugwidwa ndi thupi lanu. Nthawi zambiri, amawonetsedwa mwachangu kapena pakawonekanso m'malo obayira jekeseni ndikusowa masabata angapo pambuyo pokhazikitsidwa ndi insulin. Ngati kuyanika kulipo, ma antihistamines akhoza kutengedwa. Ngati ziwopsezo zasintha kukhala mtundu, urticaria kapena edema ya Quincke zachitika, Rinsulin R idzasinthidwa.
3. Ngati wodwalayo akhala ndi hyperglycemia kwa nthawi yayitali, mlingo woyambirira wa insulin amawerengedwa kotero kuti shuga ya magazi amachepetsa bwino, wopitilira mwezi. Ndi dontho lakuthwa la glucose kukhala labwinobwino, kuwonongeka kwakanthawi kwakukhalapo ndikutheka: kusawona bwino, kutupa, kupweteka miyendo - momwe mungawerengere kuchuluka kwa insulin.

Zinthu zingapo zimasonkhezera zochitika za insulin, chifukwa chake odwala omwe ali ndi matenda a shuga pamankhwala othandizira insulin amayenera kugwirizanirana ndi dokotala mankhwala onse, mankhwala azikhalidwe ndi njira zina zomwe akukonzekera kugwiritsa ntchito.

Malangizowo amalangizanso kusamalira mwapadera magulu otsatirawa a mankhwalawa:

• mankhwala a mahomoni: njira zakulera, mahomoni a chithokomiro, glucocorticosteroids,
• Zithandizo za matenda oopsa: okodzetsa a gulu la thiazide, mankhwala onse omwe atha mu - andril, ndi lazartan,
• Vitamini B3
• Kukonzekera kwa lifiyamu
• manzeru
• aliyense wothandizira,
• acetylsalicylic acid
• antidepressants.

Kulipiritsa kwa matenda a shuga amayamba kulipira ndipo mankhwalawa onse komanso zakumwa zoledzeretsa zingayambitse hypoglycemia - onani zomwe matenda obwezeretsawa amayambitsa. Mankhwala a Beta-blocker ogwiritsidwa ntchito m'matenda a mtima amasuntha bwino zizindikiro za hypoglycemia ndikuletsa kuti asapezeke nthawi.

Zolemba zogwiritsira ntchito

Pambuyo pa chochita, insulin imawonongeka m'chiwindi ndi impso. Ngati wodwala matenda ashuga ali ndi matenda amodzi mwa ziwalo izi, mlingo wa Rinsulin ungafunike kusintha. Kufunika kwakukulu kwa insulin kumawonedwa munthawi ya kusintha kwa mahomoni, ndimatenda opatsirana, malungo, zoopsa, kupsinjika, kutopa kwamanjenje. Mlingo wa mankhwalawa ukhoza kukhala wosalondola ngati wodwala yemwe ali ndi matenda ashuga asanza, amatsegula m'mimba, komanso kutupa m'mimba.

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!

Ma fanizo odziwika kwambiri a Rinsulin R ndi Danish Actrapid ndi American Humulin Regular. Zambiri zakufufuza zikuwonetsa kuti zisonyezo za Rinsulin zili pamlingo wofanana ndi European.

Ndemanga za anthu odwala matenda ashuga alibe chiyembekezo chotere. Ambiri, mukasinthana ndi mankhwala omwe mumalowetsedwera kupita kwina, mumazindikira kufunika kosintha kwa mlingo, kulumpha mu shuga, ndi chiwonetsero chakuthwa kwambiri. Pali ndemanga zabwino za rinsulin pakati pa odwala omwe amagwiritsa ntchito insulin kwa nthawi yoyamba. Amakwanitsa kulipira bwino shuga komanso kupewa hypoglycemia.

Ngati kulimbana kosalekeza kumachitika, Rinsulin amayenera kusiyidwa. Nthawi zambiri, ma insulin ena aumunthu amayambitsa zomwezo, motero amagwiritsa ntchito njira za ultrashort - Humalog kapena NovoRapid.

Mtengo wa Rinsulin P - kuchokera ku ma ruble 400. pa botolo lililonse mpaka 1150 pa ma cholembera asanu.

Kusiyana pakati pa Rinsulin P ndi NPH

Rinsulin NPH ndi mankhwala osokoneza bongo omwe amapanga opanga omwewo. Malinga ndi malangizo, umagwiritsidwa ntchito potipitsira shuga osala kudya. Rinsulin NPH ili ndi mfundo zofananira, mawonekedwe omasulira, mawonekedwe ofanana, contraindication ndi zovuta monga Rinsulin R. Monga lamulo, ndi insulin chithandizo mitundu yonse ya insulin imaphatikizidwa - yochepa komanso yapakati. Ngati chinsinsi cha mahomoni anu chikusungidwa pang'ono (mtundu 2 ndi matenda ashuga), mutha kugwiritsa ntchito mankhwala amodzi okha.

Zambiri za Rinsulin NPH:

Mtengo wa Botolo la Rinsulin NPH

400 rub., Ma cartridge asanu

1000 rub., Ma syringe asanu

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 >>