Momwe mungagwiritsire ntchito mankhwala a Rosinsulin M?
Kuyimitsidwa kwa s / c makonzedwe oyera, ataimirira, kuyimitsidwa kumatha. Madzimadzi omwe ali pamwamba pa mpweya wotumphukira ndiwowonekera, wopanda mtundu kapena pafupifupi wopanda khungu. Mtengo umasinthidwa mosavuta ndikugwedezeka modekha.
1 ml | |
insulin biphasic umisiri wamtundu wa anthu | 100 IU |
Othandizira: protamine sulfate 0,12-0.20 mg, sodium hydrogen phosphate dihydrate 0,26 mg, crystalline phenol 0.65 mg, metacresol 1.5 mg, glycerol (glycerin) 16 mg, madzi d / mpaka 1 ml.
5 ml - mabotolo (5) - matumba otulutsa (aluminium / PVC) (1) - mapaketi a makatoni.
10 ml - mabotolo (1) - mapaketi a makatoni.
3 ml - makatoni (5) - ma CD a matuza (aluminium / PVC) (1) - mapaketi a makatoni.
Zotsatira za pharmacological
Kusakaniza kwa Rosinsulin M 30/70 ndi kukonzekereratu kwa insulin. Kapangidwe ka mankhwalawa kumaphatikiza insulin (30%) ndi insulin-isophan (70%). Insulin imalumikizana ndi cholandilira chapadera pa cell ya cytoplasmic ya maselo ndikupanga insulini-receptor. Kudzera mwa kuchulukitsa kwa cAMP biosynthesis (m'maselo amafuta ndi m'maselo a chiwindi), kapena kulowa mwachindunji mu cell (minofu), insulini-receptor tata imapangitsa njira zina, kuphatikizira kaphatikizidwe angapo ofunikira a michere (hexokinase, pyruvate kinase, glycogen synthase, etc.). Kutsika kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa kayendedwe kake ka chidwi, kuchuluka kwa zotupa, kukondoweza kwa lipogenesis, glycogenogenesis, kaphatikizidwe ka mapuloteni, kuchepa kwa kuchuluka kwa shuga m'magazi, ndi zina.
Kutalika kwa nthawi ya kukonzekera kwa insulin makamaka chifukwa cha kuchuluka kwa mayamwidwe, zomwe zimatengera zinthu zingapo (mwachitsanzo, pa mlingo, njira ndi malo oyendetsera). Chifukwa chake, mawonekedwe a insulini akuchita kusinthasintha kwakukulu, onse mwa anthu osiyanasiyana komanso mwa munthu yemweyo.
Pafupifupi, pambuyo pa utsogoleri wa sc, Rosinsulin M kusakaniza 30/70 imayamba kugwira ntchito maola 0,5, mphamvu kwambiri imayamba pamtunda kuchokera maola 4 mpaka 12, nthawi yochita mpaka maola 24.
Zisonyezero za mankhwala a Rosinsulin M kusakaniza 30/70
- lembani matenda ashuga 1 mwa akulu,
- lembani matenda ashuga a 2 matenda a shuga: gawo la kukana kwa othandizira pakamwa.
Khodi ya ICD-10 | Chizindikiro |
E10 | Mtundu woyamba wa shuga |
E11 | Type 2 shuga |
Mlingo
Kusakaniza kwa Rosinsulin M 30/70 kwapangidwa kuti ikwaniritse sc. Mlingo wa mankhwalawa umatsimikiziridwa ndi dokotala aliyense payekhapayekha, potengera 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 m'magazi.
Kutentha kwa insulin yoyenera kuyenera kukhala kutentha kwambiri. Asanagwiritse ntchito, kuyimitsidwa kumakhala kosakanikirana pang'ono mpaka yunifolomu. Kuphatikizika kwa Rosinsulin M 30/70 nthawi zambiri kumabayidwa pakhungu pa ntchafu. Jakisoni amathanso kuchitika mkati mwa khoma lakunja, matako kapena paphewa pang'onopang'ono.
Ndikofunikira kusintha malo a jekeseni mkati mwa anatomical dera kuti muchepetse kukula kwa lipodystrophy.
Zotsatira zoyipa
Chifukwa cha kuchuluka kwa kagayidwe kazakudya: michere yamkati (khungu la khungu, kuchuluka thukuta, kugunda, kugwedezeka, njala, kukwiya, paresthesia mkamwa, kupweteka pamutu). Matenda oopsa a hypoglycemia angayambitse kukula kwa chikomokere kwa hypoglycemic.
Zotsatira zoyipa: kawirikawiri - zotupa pakhungu, edema ya Quincke, yosowa kwambiri - mantha anaphylactic.
Zomwe zimachitika m'deralo: hyperemia, kutupa ndi kuyabwa pamalowo jekeseni, ndikugwiritsidwa ntchito kwa nthawi yayitali - lipodystrophy pamalo opaka jekeseni.
Zina: edema, zolakwika zopanda kanthawi kochepa (nthawi zambiri kumayambiriro kwa mankhwala).
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.
Malangizo apadera
Musanagwiritse ntchito, onani mosamala mawonekedwe a zomwe zili m'botolo ndipo musagwiritse ntchito Rosinsulin M kusakaniza 30/70 ngati, mutasakaniza, kuyimitsidwa kumakhala ndi ma flakes kapena ngati tinthu tating'ono timamatira pansi kapena makhoma a botolo, ndikupanga mawonekedwe a frosty.
Musagwiritse ntchito Rosinsulin M kusakaniza 30/70 ngati, mutagwedezeka, kuyimitsidwa sikusintha kukhala koyera komanso kwamitambo.
Potengera maziko a mankhwala a insulin, kuyang'anira kuchuluka kwa shuga m'magazi ndikofunikira.
Zomwe zimayambitsa hypoglycemia kuwonjezera pa insulin yochulukirapo imatha kukhala: kuthana ndi mankhwala, kudumpha chakudya, kusanza, kutsegula m'mimba, kupsinjika kwa thupi, matenda omwe amachepetsa kufunikira kwa insulin (chiwindi ndi matenda a impso, hypofunction ya adrenal cortex, pituitary kapena chithokomiro cha chithokomiro), kusintha kwa malo a jekeseni, 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 zimaphatikizapo ludzu, kukodza kwambiri, kusanza, 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 insulin uyenera kukonzedwa kuti matenda a chithokomiro asokonekera, matenda a Addison, hypopituitarism, chiwindi ndi impso, komanso matenda a shuga opitirira zaka 65.
Kuwongolera mlingo wa insulin kungafunikenso ngati wodwala akuwonjezera kuchuluka kwa zochitika zolimbitsa thupi kapena asintha zakudya zomwe amakonda.
Matenda onga, makamaka matenda ndi machitidwe omwe amatsatana ndi malungo, amalimbikitsa kufunika kwa insulini.
Kusintha kwa Mlingo ndi kusintha kwa mtundu wina wa insulin kupita ku wina kuyenera kuchitika moyang'aniridwa ndi dokotala ndikuwunika 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 kukhalapo kwa kupanikizika kwakukulu kwakuthupi kapena kwamalingaliro, ndizotheka kuchepetsa kuyendetsa galimoto kapena kuwongolera njira zosiyanasiyana, komanso kuchita zinthu zina zomwe zingakhale zowopsa zomwe zimafuna chidwi chochulukirapo komanso kuthamanga kwa malingaliro ndi magalimoto.
Bongo
Zizindikiro: ndi bongo, hypoglycemia imayamba.
Chithandizo: wodwalayo amatha kuchotsa hypoglycemia wofinya pakumeza shuga kapena zakudya zopatsa mphamvu. Chifukwa chake, ndikulimbikitsidwa kwa odwala matenda ashuga kuti azinyamula shuga, maswiti, makeke kapena mandimu okoma zipatso. Wodwala kwambiri, wodwalayo akapanda kuzindikira, yankho la 40% limayendetsedwa iv
dextrose (glucose), mu / m, s / c, mu / mu - glucagon. Pambuyo pakupezanso chikumbumtima, wodwalayo akulimbikitsidwa kudya zakudya zamafuta ambiri kuti aletse kukonzanso kwa hypoglycemia.
Kuyanjana kwa mankhwala osokoneza bongo
Pali mankhwala angapo omwe amakhudza kufunika kwa insulin. Hypoglycemic zotsatira za insulin patsogolo mankhwala m'kamwa hypoglycemic, Mao zoletsa, zoletsa Ace, carbonic zoletsa anhydrase, kusankha beta-blockers, bromocriptine, octreotide, sulfonamides, anabolic mankhwala, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, kukonzekera lifiyamu kukonzekera kokhala ndi Mowa.
Hypoglycemic zotsatira za insulin chakhungu kulera m'kamwa, corticosteroids, chithokomiro timadzi, thiazide okodzetsa, heparin, tricyclic antidepressants, sympathomimetics, danazol, clonidine, calcium njira blockers pang'onopang'ono, diazoxide, morphine, phenytoin, chikonga, sulfinpyrazone, Epinephrine, histamine H 1 cholandilira.
Mothandizidwa ndi reserpine ndi salicylates, kufooka komanso kuwonjezeka kwa machitidwe a mankhwalawa ndizotheka.
Momwe mungagwiritsire ntchito: Mlingo ndi njira ya chithandizo
Mankhwala adapangira subcutaneous makonzedwe. Mlingo wa mankhwalawa umatsimikiziridwa ndi dokotala aliyense payekhapayekha, potengera kuchuluka kwa shuga m'magazi. Pafupifupi, tsiku lililonse mlingo wa mankhwalawo umachokera ku 0,3 mpaka 1 IU / kg kulemera kwa thupi, kutengera umunthu wa wodwalayo komanso kuchuluka kwa shuga m'magazi.
Kufunika kwa insulin tsiku lililonse kumatha kukhala kwabwino kwambiri kwa odwala omwe ali ndi insulin kukaniza (mwachitsanzo, nthawi yakutha msinkhu, komanso odwala omwe ali ndi kunenepa kwambiri), komanso kutsika mwa odwala omwe ali ndi zotsalira za insulin.
Kutentha kwa insulin yoyenera kuyenera kukhala kutentha kwambiri. Asanagwiritse ntchito, kuyimitsidwa kumakhala kosakanikirana pang'ono mpaka yunifolomu. Mankhwalawa nthawi zambiri amaperekedwa pachiwuno. Zilonda zitha kupangidwanso m'chigawo cha khomo lamkati, matako kapena dera la minofu ya m'mapewa. Ndi kukhazikitsidwa kwa mankhwalawa mu ntchafu, pali kuyamwa pang'onopang'ono kuposa komwe kumayambitsidwa m'malo ena.
Ndikofunikira nthawi zonse kusintha malo a jekeseni mkati mwa anatomical dera kuti muchepetse kukula kwa lipodystrophy.
Mukamagwiritsira ntchito zolembera zama syringe zosadzaza kale, muyenera kuchotsa cholembera mufiriji musanagwiritse ntchito ndikulola kuti mankhwalawo afikire kutentha kwa chipinda. Ndikofunikira kusakaniza kuyimitsidwa kwa ROSINSULIN M kusakaniza 30/70 mu cholembera cha syringe nthawi yomweyo musanagwiritse ntchito. Kuyimitsidwa kophatikizidwa bwino kuyenera kukhala kofanana ndi oyera komanso mitambo. Mankhwala omwe ali mu cholembera china chake sangathe kugwiritsidwa ntchito ngati atawuma. Ndikofunikira kuti mutsatire malangizo ogwiritsira ntchito cholembera chomwe amaperekedwa ndi mankhwalawo.
Matenda okhala ndi vuto limodzi, makamaka opatsirana komanso kutentha thupi, nthawi zambiri amalimbikitsa kufunika kwa insulin. Kusintha kwa magazi kungafunikenso ngati wodwala ali ndi matenda a impso, chiwindi, mkhutu wa adrenal ntchito, pituitary kapena chithokomiro cha chithokomiro.
Kufunika kosinthidwa kwa mlingo kumatha kuonekanso posintha zolimbitsa thupi kapena zakudya zomwe wodwala amadya. Kusintha kwa Mlingo kungafunike posamutsa wodwala kuchokera ku mtundu wina wa insulin kupita ku ina.
Zotsatira zoyipa
Chochitika chovuta kwambiri chambiri ndi insulin ndi hypoglycemia. Panthawi ya mayeso azachipatala, komanso munthawi yogwiritsa ntchito mankhwalawa atamasulidwa pamsika wa ogula, zidapezeka kuti zochitika za hypoglycemia zimasiyanasiyana malinga ndi kuchuluka kwa odwala, momwe mankhwalawo amathandizira pakuwongolera kwa mankhwalawa komanso glycemic.
Pa gawo loyambirira la insulin, zolakwika zotupa, zotumphukira ndi zomwe zimachitika pamalo opangira jakisoni (kuphatikizapo kupweteka, redness, urticaria, kutupa, hematoma, kutupa ndi kuyunkhira pamalo a jekeseni. Zizindikirozi nthawi zambiri zimakhala zakanthawi. Kusintha kwachangu pakuwongolera glycemic kungayambitse mkhalidwe wa 'ululu wammbuyo wam'mimba', womwe nthawi zambiri umatha kusintha. Kulimbitsa insulin mankhwala ndikusintha kolimba kwa mphamvu ya kagayidwe kazakudya kungayambitse kuwonongeka kwakanthawi pamikhalidwe ya matenda ashuga, pamene kusintha kwakanthawi kwakanthawi ka glycemic kumachepetsa chiopsezo cha kupitirira kwa matenda ashuga retinopathy.
Kutulutsa mafomu ndi kapangidwe kake
Kuyimitsidwa kwa kayendetsedwe ka kayendedwe ka 100 IU / ml akupezeka m'njira ya:
- botolo la 5 ndi 10 ml,
- 3 ml katoni.
1 ml ya mankhwala ali:
- Chofunikira chachikulu ndi insulin ya anthu 100 100 IU.
- Zothandiza: protamine sulfate (0.12 mg), glycerin (16 mg), madzi a jakisoni (1 ml), metacresol (1.5 mg), crystalline phenol (0.65 mg), sodium hydrogen phosphate dihydrate (0.25 mg).
Kuyimitsidwa kwa subcutaneous makonzedwe a 100 IU / ml akupezeka mu mawonekedwe a: botolo la 5 ndi 10 ml, cartridge of 3 ml.
Pharmacokinetics
Mayamwidwe wathunthu ndi kuwonekera kwa zotsatira zimatengera Mlingo, njira ndi malo a jekeseni, insulin ndende. Mankhwala amawonongedwa ndi zochita za insulinase mu impso. Imayamba kuchita theka la ola pambuyo pa utsogoleri, ikafika pakapita maola atatu kapena atatu m'thupi, imasiya kugwira ntchito pakatha tsiku limodzi.
Fomu, kapangidwe ndi kapangidwe ka ntchito
"Rosinsulin" amatanthauza mankhwala a gulu la "hypoglycemic agents". Kutengera kuthamanga ndi kutalika kwa kuchitapo, pali:
Shuga amachepetsedwa nthawi yomweyo! Matenda a shuga m'kupita kwa nthawi angayambitse matenda ambiri, monga mavuto amawonedwe, khungu ndi tsitsi, zilonda zam'mimba, zilonda zam'mimba komanso matenda otupa! Anthu amaphunzitsa zinzake zowawa kuti azisintha shuga. werengani.
- Rosinsulin S nthawi yayitali yochita,
- "Rosinsulin R" - mwachidule,
- "Rosinsulin M" ndi wophatikiza wa 30% sungunuka wa insulini ndi 70% insulin-isophan.
Mankhwala amtundu wa insulin omwe amapezeka m'thupi la munthu kudzera pakusintha kwa DNA. Malangizowo akuwonetsa kuti lingaliro la chochita limatengera kulumikizana kwa chinthu chachikulu cha mankhwala omwe ali ndi maselo komanso mapangidwe a insulin zovuta. Zotsatira zake, kuphatikiza kwa ma enzyme ofunikira pakugwira ntchito bwino kwa thupi kumachitika. Matenda a mtundu wa shuga amapezeka chifukwa cha michere ya intracellular ndi mayamwidwe okwanira. Malinga ndi akatswiri, zotsatira za ntchito zimawonekera patatha maola 1-2 mutayendetsa pakhungu.
"Rosinsulin" ndi kuyimitsidwa koyendetsedwa pansi pa khungu. Kuchitikako kumachitika chifukwa cha zomwe zili ndi insulin-isophan.
Kunja, mankhwalawa ndi oyera ndi pang'ono pang'ono imvi. Popanda kugwedezeka, imasiyanitsidwa ndimadzimadzi ndikuwonekera. Malinga ndi malangizo, "Rosinsulin" iyenera kugwedezeka isanayambike. Kuphatikiza apo, kapangidwe kake ka mankhwalawa kamaphatikizidwa ndi zinthu zomwe zafotokozedwa pagome: