Monoinsulin CR > Chithandizo ndi kupewa

Mlingo ndi njira yoyendetsera mankhwalawa imatsimikiziridwa payekhapayekha pazotsatira zilizonse za glucose m'magazi musanadye ndi maola 1-2 mutatha kudya, komanso malinga ndi kuchuluka kwa glucosuria ndi machitidwe a matendawa.

Mankhwala amatumizidwa s / c, mu / m, mu / mkati, mphindi 15-30 musanadye. Njira yodziwika kwambiri yoyendetsera ntchito ndi sc. Ndi matenda ashuga ketoacidosis, chikomokere matenda a shuga, pa nthawi ya opaleshoni - mu / mu ndi / m.

Ndi monotherapy, pafupipafupi makonzedwe nthawi zambiri amakhala 3 katatu patsiku (ngati kuli kotheka, mpaka nthawi 5-6 patsiku), tsamba la jakisoni limasinthidwa nthawi iliyonse kupewa chitukuko cha lipodystrophy (atrophy kapena hypertrophy ya subcutaneous mafuta).

Pafupifupi tsiku lililonse 30-30 IU ana - 8 IU, ndiye muyezo tsiku lililonse - 0,5-1 IU / kg kapena 30-40 IU 1-3 pa tsiku, ngati n`koyenera - 5-6 pa tsiku . Pa mlingo wa tsiku ndi tsiku wopitilira 0,6 U / kg, insulin iyenera kuperekedwa ngati ma jakisoni a 2 kapena kuposa m'malo osiyanasiyana a thupi. Ndikotheka kuphatikiza ndi ma insulin omwe amakhala nthawi yayitali.

Zotsatira za pharmacological

Munthu wobwerezabweretsanso insulin ya DNA. Ndi insulin ya nthawi yayitali yochitapo kanthu. Imayendetsa kagayidwe ka glucose, imakhala ndi zotsatira za anabolic. Mu minofu ndi minyewa ina (kupatula ubongo), insulin imathandizira kayendedwe ka glucose ndi amino acid, komanso zimapangitsa protein anabolism. Insulin imalimbikitsa kutembenuka kwa glucose kukhala glycogen m'chiwindi, kumalepheretsa gluconeogeneis ndikuthandizira kusintha kwa glucose owonjezera kukhala mafuta.

Zotsatira zoyipa

Kuchokera ku endocrine system: hypoglycemia.

Hypoglycemia yamphamvu imatha kubweretsa kusokonezeka kwa chikumbumtima ndipo (makamaka zikachitika) kufa.

Thupi lawo siligwirizana: zimachitika matupi awo sagwirizana - hyperemia, kutupa kapena kuyunkhira pamalo a jekeseni (nthawi zambiri amayima patadutsa masiku angapo mpaka masabata angapo), zotsatira zoyipa zamkati (zimachitika kangapo, koma zimakhala zowopsa) - kuyamwa pang'ono, kufupika, kupuma pang'ono , kuchepa kwa magazi, kuchuluka kwa mtima, kuchuluka thukuta. Milandu yambiri yokhudzana ndimomwe thupi limagwirira ntchito ikhoza kukhala pachiwopsezo cha moyo.

Malangizo apadera

Kusamutsa wodwala kupita ku mtundu wina wa insulin kapena kukonzekera kwa insulini ndi dzina lina lamalonda kuyenera kuchitika moyang'aniridwa ndi achipatala.

Zosintha mu zochitika za insulin, mtundu wake, mitundu (nkhumba, insulin ya anthu, analogue ya anthu) kapena njira yopangira (DNA recombinant insulin kapena insulin yazomwe nyama zimachokera) zitha kuchititsa kusintha kwa mlingo.

Kufunika kwa kusintha kwa mankhwalawa kungafunike kale pokhazikitsidwa ndi insulin yokonzekera pambuyo pokonzekera insulin ya nyama kapena pang'onopang'ono patadutsa milungu ingapo kapena miyezi ingapo mutasamutsidwa.

Kuchita

Hypoglycemic effect imachepetsedwa ndi kulera kwapakamwa, corticosteroids, kukonzekera kwa mahomoni a chithokomiro, thiazide diuretics, diazoxide, tridclic antidepressants.

Mphamvu ya hypoglycemic imatheka ndi mankhwala am'mlomo a hypoglycemic, ma salicylates (mwachitsanzo acetylsalicylic acid), sulfonamides, mao inhibitors, a beta-blockers, Mowa ndi ethanol.

Beta-blockers, clonidine, reserpine amatha kuphimba mawonetseredwe a zizindikiro za hypoglycemia.

Njira yogwiritsira ntchito

Kwa akuluakulu: Dokotala amakhazikitsa mlingo payekhapayekha, kutengera mlingo wa glycemia.
Njira yoyendetsera zimadalira mtundu wa insulin.

- shuga mellitus pamaso pazisonyezo za insulin mankhwala,
- omwe adapezeka ndi matenda a shuga,
- Mimba ndi mtundu 2 shuga mellitus (osadalira insulini).

Kutulutsa Fomu

Njira yothetsera jakisoni yopanda utoto, wowonekera.
1 ml insulin sungunuka (umisiri wa majini) 100 UNITS
Othandizira: metacresol - 3 mg, glycerol - 16 mg, madzi d / i - mpaka 1 ml.

10 ml - mabotolo agalasi lopanda utoto (1) - mapaketi a makatoni

Zomwe zili patsamba lomwe mukuwona zimapangidwa kuti zidziwitso zokha komanso sizimalimbikitsa kudzipatsa mankhwala mwanjira iliyonse. Chidacho chimapangidwa kuti chizolowere akatswiri azachipatala kuti awonjezere zambiri zamankhwala ena, potero amawonjezera luso lawo. Kugwiritsa ntchito mankhwala "Monoinsulin CR"mosakayikira imapereka mwayi wothandizidwa ndi katswiri, komanso malingaliro ake pa njira yogwiritsira ntchito ndi mlingo wa mankhwala omwe mwasankha.

Kupanga ndi mawonekedwe a kumasulidwa

Zinthu zomwe zimagwira ntchito: insulle insulin (maumboni amtundu wa anthu) 100 PESCES,
Othandizira: metacresol - 3 mg, glycerol - 16 mg, madzi d / i - mpaka 1 ml.

Njira Zothetsera. 10 ml - botolo lagalasi lopanda utoto.

Njira yothetsera jakisoni yopanda utoto, wowonekera.

Wamtundu waifupi insulin.

Njira yoyendetsera zimadalira mtundu wa insulin.

Monoinsulin sp Mimba ndi ana

Pakati pa nthawi yayitali, ndikofunikira kuti pakhale chitetezo chabwino cha glycemic mwa odwala matenda ashuga. Pa nthawi ya pakati, kufunika kwa insulin nthawi zambiri kumachepetsa mu trimester yoyamba ndikuwonjezeka mu trimesters yachiwiri ndi yachitatu.

Ndikulimbikitsidwa kuti odwala omwe ali ndi matenda a shuga adziwitse adokotala za kutha kapena kukonza pakati.

Odwala odwala matenda a shuga mellitus pa mkaka wa m`mawere, kusintha kwa insulin, zakudya, kapena onse angafunike.

Pophunzira za kuwopsa kwa ma genetic mu in vitro komanso mndandanda wa vivo, insulin yaumunthu idalibe mutagenic.

Mlingo Monoinsulin

Dokotala amakhazikitsa mlingo payekhapayekha, kutengera mlingo wa glycemia.

Kusamutsa wodwala kupita ku mtundu wina wa insulin kapena kukonzekera kwa insulini ndi dzina lina lamalonda kuyenera kuchitika moyang'aniridwa ndi achipatala.

Kufunika kwa insulini kumatha kuchepa ndi kusakwanira kwa adrenal ntchito, pituitary kapena chithokomiro, ndi aimpso kapena kwa chiwindi.

Ndi matenda ena kapena kupsinjika kwamalingaliro, kufunikira kwa insulin kungakulitse.

Kusintha kwa Mlingo kumafunikanso pakuwonjezera zochitika zolimbitsa thupi kapena kusintha zakudya zamagulu.

Zizindikiro zakutsogolo kwa hypoglycemia panthawi ya insulin yaumwini mwa odwala ena akhoza kutchulidwa kochepa kapena zosiyana ndi zomwe zimawonedwa panthawi ya insulin yoyambira nyama. Ndi kusintha kwa matenda a shuga m'magazi, mwachitsanzo, chifukwa cha insulin yokwanira, zonse kapena zizindikiro zina zakutsogolo kwa hypoglycemia zitha kuzimiririka, zomwe odwala ayenera kudziwitsidwa.

Zizindikiro zakutsogolo kwa hypoglycemia zimatha kusintha kapena kusalankhula pang'ono ndi njira yayitali yodwala matenda ashuga, matenda a shuga, kapena kugwiritsa ntchito beta-blockers.

Nthawi zina, thupi lanu siligwirizana chifukwa cha zochita za mankhwalawa, mwachitsanzo, kuyambitsa khungu ndi wothanduka kapena jakisoni wosayenera.

Nthawi zina mankhwalawa amachitika mosiyanasiyana. Nthawi zina, kusintha kwa insulin kapena kukakamira kungafunike.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu:

Panthawi ya hypoglycemia, kuthekera kwa wodekha kuyang'anitsitsa kumatha kuchepa ndipo kuchuluka kwa ma psychomotor zimatha kuchepa. Izi zitha kukhala zowopsa nthawi zomwe maluso amenewa amafunikira makamaka (kuyendetsa galimoto kapena makina ogwiritsa ntchito). Odwala ayenera kulangizidwa kuti azisamala kuti asamayendetse hypoglycemia poyendetsa. Izi ndizofunikira kwambiri kwa odwala omwe ali ndi zofatsa kapena zosapezekapo zizindikiro za hypoglycemia kapena kukula pafupipafupi kwa hypoglycemia. Zikatero, adotolo amayenera kuwunika momwe wodwala angayendetsere galimoto.

Pharmacokinetics

The mayamwidwe ndi isanayambike zotsatira za insulin zimatengera njira makonzedwe (subcutaneously, intramuscularly), malo oyang'anira (m'mimba, ntchafu, matako) ndi kuchuluka kwa jakisoni. Pafupifupi, pambuyo pa kayendetsedwe ka subcutaneous, Monoinsulin CR imayamba kugwira ntchito mu 1/2 ora, imakhala ndi mphamvu pakati pa 1 ndi 3 maola, nthawi ya mankhwalawa imakhala pafupifupi maola 8.

Imagawidwa mosiyanasiyana munsiyo, simalowerera chotchinga ndi mkaka wa m'mawere. Imawonongeka ndi insulinase, makamaka m'chiwindi ndi impso. Kuchotsa theka-moyo kumapanga mphindi zingapo. Amachotsa impso (30-80%).

Zizindikiro zogwiritsidwa ntchito

Mtundu woyamba wa matenda a shuga 1

Type 2 shuga mellitus (osadalira insulini): gawo la kukana kwa othandizira am'magazi a hypoglycemic, kukana pang'ono kwa mankhwalawa (panthawi yophatikiza), matenda apakati, pakati,

· Zina mwadzidzidzi odwala odwala matenda ashuga.

Mimba komanso kuyamwa

Palibe choletsa kuchiza matenda osokoneza bongo a shuga ndi insulin pa nthawi yomwe ali ndi pakati, popeza 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, popeza chithandizo cha amayi omwe ali ndi insulin ndiyabwino kwa mwana. Komabe, kuchepetsa kwa insulin kungafunike, chifukwa chake kuyang'anira mosamala ndikofunikira mpaka insulini ikukhazikika.

Zotsatira zoyipa

Chochitika chovuta kwambiri chambiri ndi insulin ndi hypoglycemia. Zizindikiro za hypoglycemia nthawi zambiri zimachitika mwadzidzidzi. Izi zitha kuphatikizaponso: thukuta lozizira, khungu, mantha kapena kunjenjemera, nkhawa, kutopa kapena zachilendo, kulimbitsa thupi, kusokonezeka mutu, chizungulire, kugona kwambiri, kusokonezeka kwakanthawi, mutu, nseru, tachycardia. Hypoglycemia yamphamvu imatha kuyambitsa khungu, kusokonezeka kwakanthawi kapena kusasintha kwa ubongo, kapena kufa.

Pochiza ndi insulin, khungu lanu limadwala (redness, kutupira kwakanthawi, khungu lanu pamalo a jekeseni). Izi zimachitika nthawi zambiri, ndipo zimadutsa pomwe chithandizo chikuchitikabe.

Nthawi zina thupi limagwa. Amakhala akulu kwambiri ndipo amatha kupangitsa kuti pakhale zotupa pakhungu, kuyabwa pakhungu, kutuluka thukuta, kusokonezeka kwa m'mimba thirakiti, angioedema, kupuma movutikira, tachycardia, ochepa hypotension. Zotsatira zoyipa zamagetsi zimakhala zowopsa m'moyo, zimafunikira chithandizo chapadera.

Ngati simusintha tsamba la jakisoni m'dera la anatomical, lipodystrophy pamalo opangira jakisoni amatha.

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.

Woopsa milandu, pamene wodwala ataya chikumbumtima, 40% njira ya glucose imayendetsedwa kudzera m'mitsempha, intramuscularly, subcutaneally, kudzera m'mitsempha - glucagon. Pambuyo pakupezanso chikumbumtima, wodwalayo akulimbikitsidwa kudya zakudya zamafuta ambiri kuti aletse kukonzanso kwa hypoglycemia.

Njira zopewera kupewa ngozi

Poyerekeza ndi maziko a mankhwala a insulin, kuyang'anira kuchuluka kwa shuga m'magazi ndikofunikira. Zifukwa hypoglycemia Kuphatikiza pa kuchuluka kwa insulin, pakhoza kukhala: kusintha kwa mankhwalawa, kudumpha chakudya, kusanza, kutsekula m'mimba, kupsinjika kwa thupi, matenda omwe amachepetsa kufunika kwa insulin (chiwindi ndi matenda a impso, hypofunction ya adrenal cortex, pituitary kapena chithokomiro) ndi mankhwala ena.

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

Mlingo wa insulin uyenera kukonzedwa kuti matenda a chithokomiro asokonekera, matenda a Addison, hypopituitarism, chiwindi ndi impso ntchito ndi anthu odwala azaka zopitilira 65.

Matenda onga, makamaka matenda ndi machitidwe omwe amatsatana ndi malungo, amalimbikitsa kufunika kwa insulini.

Kuwongolera mlingo wa insulin kungafunikenso ngati wodwala akuwonjezera kuchuluka kwa zochitika zolimbitsa thupi kapena asintha zakudya zomwe amakonda.

Kusintha kuchokera ku mtundu kapena mtundu wa insulin kupita ku wina kuyenera kuchitika moyang'aniridwa ndi dokotala. Zosintha pama ndende, dzina lamalonda (wopanga), mtundu (waufupi, wapakati, wa insulini, ndi zina zambiri), mtundu (waumunthu, nyama) ndi / kapena njira yopangira (chiyambi cha nyama kapena mainjini) angafunike kukonza Mlingo wa insulin. Kufunika kwa kusintha kwa mankhwala a insulin kumatha kuwonekera pambuyo pa ntchito yoyamba, komanso pakatha milungu ingapo kapena miyezi ingapo.

Posintha kuchokera ku insulin yochokera ku nyama kupita ku CR Monoinsulin, odwala ena adazindikira kusintha kapena kufooka kwa zizindikiro zoneneratu za hypoglycemia.

Milandu yolipirira chakudya cha kagayidwe kachakudya, mwachitsanzo, chifukwa cholimbitsa insulin, Zizindikiro zomwe zimakhazikitsidwa ndi hypoglycemia zimatha kusintha, zomwe odwala ayenera kuchenjezedwa.

Milandu yakulephera kwa mtima yanenedwa pamodzi ndi kuphatikiza kwa insulin ndi thiazolidatediones, makamaka kwa odwala omwe ali ndi chiopsezo cha mtima. Izi ziyenera kukumbukiridwa pakugawa kuphatikiza uku.

Ngati kuphatikiza pamwambapa kumayikidwa, ndikofunikira kuzindikira zizindikiritso za mtima wake, kulemera kwake, edema. Kugwiritsa ntchito pioglitazone kuyenera kuyimitsidwa ngati zizindikiro zikukulira mtima wamtima.

Kuwongolera mayendedwe ndikugwira ntchito ndi njira

Kuthekera kwa odwala kulolera komanso kuchuluka kwa zomwe zimachitika amatha kulemala panthawi ya hypoglycemia ndi hyperglycemia, zomwe zimakhala zowopsa, mwachitsanzo, poyendetsa galimoto kapena kugwira ntchito ndi makina ndi makina. Odwala ayenera kulangizidwa kuti achitepo kanthu popewa kukulitsa kwa hypoglycemia ndi hyperglycemia poyendetsa galimoto ndikugwiritsa ntchito njira. Izi ndizofunikira kwambiri kwa odwala omwe alibe kapena kuchepetsedwa Zizindikiro zakutsogolo kwa hypoglycemia kapena akuvutika ndi zochitika zapafupipafupi za hypoglycemia. Zikatero, kuyenerera koyendetsa kuyenera kuganiziridwanso.

Sungani insulin vial yomwe imagwiritsidwa ntchito kutentha kutentha mpaka 25 ° C kwa milungu yopitilira 6.

Tetezani mankhwala ku kuwala. Pewani kutentha. Pewani kufikira ana.

Osagwiritsa ntchito Monoinsulin CR ngati yankho laleka kuonekera, lopanda utoto kapena lopanda utoto.

Osagwiritsa ntchito tsiku lotha ntchito lisindikizidwe pa phukusi.