Rosinsulin R, C ndi M - mawonekedwe achidule ndi malangizo ogwiritsira ntchito

Mankhwala

Rinsulin P ndi insulin yaumunthu yomwe imapezedwa pogwiritsa ntchito tekinoloje ya DNA. Mwachidule kuchita insulin. Imalumikizana ndi cholandirira chapadera pa cytoplasmic membrane ya maselo ndikupanga insulini-receptor zovuta zomwe zimapangitsa njira zamagawo, kuphatikiza kaphatikizidwe kazinthu zingapo za michere (hexokinase, pyruvate kinase, glycogen synthase, etc.). Kutsika kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa kayendedwe ka intracellular, kuchuluka kwa minofu, kukondoweza kwa lipogenesis, glycogenogeneis, kuchepa kwa kuchuluka kwa shuga ndi chiwindi, etc.
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. Pafupifupi, pambuyo pa kayendetsedwe ka subcutaneous, Rinsulin P imayamba kugwira ntchito patatha mphindi 30, mphamvu yayikulu imayamba pakati pa 1 ndi 3 maola, nthawi yayitali ndi maola 8.

Pharmacokinetics
Kukwanira kwathunthu ndi kuyambika kwa mphamvu ya insulin kumadalira njira ya kasamalidwe (subcutaneally, intramuscularly, intravenously), malo oyang'anira (pamimba, ntchafu, matako), mlingo (kuchuluka kwa insulin), kuchuluka kwa insulini mu mankhwala, ndi zina. chotchinga chachikulu ndi mkaka wa m'mawere. Amawonongedwa ndi insulinase makamaka m'chiwindi ndi impso. Kuchotsa theka-moyo kumapanga mphindi zingapo. Amachotsa impso (30-80%).

Zizindikiro zogwiritsidwa ntchito

• Mtundu woyamba wa shuga
• Type 2 shuga mellitus: gawo la kukana kwamlomo hypoglycemic wothandizila, kukana pang'ono kwa mankhwalawa (panthawi yophatikiza mankhwala), matenda oyanjana
• Mtundu wachiwiri wa matenda ashuga mwa amayi apakati
• Zochitika zadzidzidzi kwa odwala omwe ali ndi matenda osokoneza bongo omwe amaphatikizidwa ndi kuwonongeka kwa kagayidwe kazakudya

Mlingo ndi makonzedwe

Mlingo wothandizira ndi njira yoyendetsera

Mankhwalawa adapangira kuti azigwiritsa ntchito, subramaneous, intramuscular and intravenous.
Mlingo ndi njira makonzedwe a mankhwala mtima 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).
Mankhwalawa umaperekedwa kwa mphindi 30 asanadye kapena chakudya.
Kutentha kwa insulin yoyenera kuyenera kukhala kutentha kwambiri. Ndi monotherapy ndi mankhwala, pafupipafupi makonzedwe ndi 3 pa tsiku (ngati ndi kotheka, mpaka 5-6 pa tsiku). Pa mlingo wa tsiku ndi tsiku wopitilira 0,6 IU / kg, mankhwalawa amayenera kuperekedwa ngati jekeseni 2 kapena kuposerapo m'malo osiyanasiyana a thupi. Mankhwala nthawi zambiri amabayidwa pang'onopang'ono kukhoma kwamkati mwa m'mimba. Jekeseni amatha kuchitanso mu ntchafu, matako kapena paphewa pang'onopang'ono mwa minofu yolimba.
Ndikofunikira kusintha malo opangira jekeseni mkati mwa anatomical dera kuti muchepetse kukula kwa lipo-dystrophy. Ndi subulinaneous ya insulin, chisamaliro chimayenera kumwedwa kuti musalowe m'mitsempha yamagazi pakubaya. Pambuyo pa jakisoni, tsamba la jakisidwe siliyenera kutenthedwa. Odwala ayenera kuphunzitsidwa bwino kugwiritsa ntchito insulin yobereka.
Intramuscularly komanso kudzera m'mitsempha, mankhwalawa amatha kuperekedwa kokha moyang'aniridwa ndi dokotala.
Mbale zitha kugwiritsidwa ntchito ngati zopezeka zawo ndizomveka bwino, zopanda maonekedwe opanda ma tinthu owoneka. Simungathe kugwiritsa ntchito mankhwalawa ngati chidziwitso chikuwoneka mu yankho. Rinsulin ® P ndi insulin yochepa ndipo imakonda kugwiritsidwa ntchito limodzi ndi insulin (Rinsulin ® NPH).
Ndikotheka kusunga mankhwala omwe amawagwiritsa ntchito kutentha kwa firiji (kuyambira 15 mpaka 25 ° C) osaposa masiku 28.

Zotsatira zoyipa

Chifukwa cha kuchuluka kwa kagayidwe kazakudya: Hypoglycemic zinthu (pallor of the khungu, thukuta kwambiri, palpitations, kugwedeza, kuzizira, njala, kusakhazikika, paresthesia wa mucosa mkamwa, kufooka, kupweteka kwa mutu, chizungulire, kuchepa kwamphamvu kuona). Matenda oopsa a hypoglycemia angayambitse kukula kwa chikomokere kwa hypoglycemic.
Thupi lawo siligwirizana: zotupa pakhungu, edema ya Quincke, kuwopsa kwa anaphylactic.
Zokhudza kwanuko: hyperemia, kutupa ndi kuyabwa pamalowo jakisoni, pogwiritsa ntchito nthawi yayitali - lipodystrophy pamalo opangira jakisoni.
Zina: edema, kuchepa kwakanthawi kwakanthawi kwamaso owoneka (nthawi zambiri kumayambiriro kwa mankhwala).
Ngati wodwala adazindikira kukula kwa hypoglycemia kapena ngati mwazindikira. akuyenera kudziwitsa dokotala nthawi yomweyo.
Ngati zovuta zina zomwe sizinafotokozedwe pamwambapa zizindikirika, wodwalayo mukuyeneranso kufunsa dokotala.

Malangizo apadera

Njira zopewera kugwiritsa ntchito

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, kuchuluka kwa zochitika zolimbitsa thupi, matenda omwe amachepetsa kufunikira kwa insulin (chiwindi ndi matenda a impso, hypofunction ya adrenal cortex, pituitary kapena chithokomiro cha chithokomiro), kusintha kwa jekeseni wa jekeseni, komanso kuyanjana 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 ntchito ndi anthu odwala azaka zopitilira 65.
Kuwongolera mlingo wa insulin kungafunikenso ngati wodwala akuwonjezera kuchuluka kwa zolimbitsa thupi kapena asintha zakudya zomwe amakonda.
Matenda onga, makamaka matenda ndi machitidwe omwe amatsatana ndi malungo, amalimbikitsa kufunika kwa insulini.
Kusamutsa wodwala ku mtundu wina wa insulin kapena kukonzekera kwa insulin kwa wopanga wina kuyenera kuchitika moyang'aniridwa ndi dokotala.
Chifukwa cha kuthekera kwanyengo m'matumba ena, kugwiritsa ntchito mankhwalawa m'mapampu a insulin sikulimbikitsidwa.

Zokhudza mphamvu pakutha kuyendetsa magalimoto ndi zida

Pokhudzana ndi cholinga choyambirira cha insulin, kusintha kwa mtundu wake, kapena kupanikizika kwakukulu kwamthupi kapena m'maganizo, imatha kufooketsa kuyendetsa magalimoto kapena magalimoto osiyanasiyana osunthika, komanso kuchita zochitika zina zowopsa zomwe zimafuna chidwi chochulukirapo komanso kuthamanga kwa kuchitapo kanthu.

Wopanga

Ma adilesi amalo opanga:

1. 142279, dera la Moscow, chigawo cha Serpukhov, r.p. Obolensk, nyumba 82, p. 4.
2. 142279, dera la Moscow, chigawo cha Serpukhov, pos. Obolensk, nyumba 83, lit. AAN.

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

Malangizo ayenera kuperekedwa kwa wodwala

Simungathe kugwiritsa ntchito mankhwalawa ngati chidziwitso chikuwoneka mu yankho.
Njira yolowera insulin m'mbale

Ngati wodwala amagwiritsa ntchito mtundu umodzi wokha wa insulin

1. Patulani khungu pa vial
2. Jambulani mpweya mu syringe mu kuchuluka kogwirizana ndi insulin yomwe mukufuna. Lowetsani mpweya mu vala ya insulin.
3. Tembenuza vial ndi syringe mozondoka ndikujambulitsa kufunika kwa insulin mu syringe. Chotsani singano mu vial ndikuchotsa mpweya ku syringe. Onani ngati mlingo wa insulin ulondola.
4. Lowetsani nthawi yomweyo.

1. Santhani utoto wa mphira wa Mbale.
2. Nthawi yomweyo musanayimbe, ikani chingwe cha insulin ("yamtambo") pakati pa manja anu mpaka insulini itayamba kuyera ndi mitambo.
3. Sungani mpweya mu syringe mu volumu yolingana ndi mlingo wa insulin yamitambo. Ikani mpweya mumtambo wa insulin vial ndikuchotsa singano mu vial.
4. Lowetsani mpweya mu syringe muyezo lofanana ndi mlingo wa insulin yochepa ("mandala"). Lowetsani mpweya mu botolo la insulin yabwino. Tembenuzani botolo ndi syringe mozondoka ndikuyimba muyezo wa insulin "yoyenera". Tulutsani singano ndikuchotsa mpweya ku syringe. Chongani mlingo woyenera.
5. Ikani singano mu vial ndi insulini "yamtambo", sinthani vial ndi syringe pansi ndikuyimba insulin yomwe mukufuna. Chotsani mpweya mu syringe ndikuwonetsetsa ngati mulondola. Ikani mankhwala osakanikirana a insulin nthawi yomweyo.
6. Nthawi zonse imwani insulin mosiyanasiyana monga tafotokozera pamwambapa.

• Ndikofunikira kupha tizilombo toyambitsa matenda pakhungu lomwe insulin ingalowe.
• Ndi zala ziwiri, sonkhanitsani khola, ndikulowetsani singano m'munsi mwa khola pafupi madigiri 45, ndi kubaya insulin pansi pakhungu.
• Pambuyo pa jekeseni, singano imayenera kukhalabe pansi pakhungu kwa masekondi osachepera 6, ndikuonetsetsa kuti insulin idayikidwa kwathunthu.
• Ngati magazi abwera pamalo a jakisoni mutachotsa singano, pofinyani pang'onopang'ono jakisoniyo ndi swab wothira ndi yankho la mankhwala ophera tizilombo (monga mowa).
• Ndikofunikira kusintha tsamba la jakisoni.

Zambiri

Mankhwalawa cholinga chake ndi kuchepetsa shuga. Gawo lake lalikulu ndi insulin yaumunthu.

Kuphatikiza apo, kapangidwe ka mankhwalawa akuphatikiza:

Rosinsulin imapezeka ngati jakisoni. Palibe mtundu komanso wopanda fungo.

Mankhwala ali ndi mitundu ingapo:

1. P - imadziwika ndi kufalikira kowonekera.
2. C - machitidwe ake ndi a nthawi yayitali.
3. M - dzina lina - Rosinsulin sakanizani 30-70. Amaphatikiza zinthu ziwiri: sungunuka wa insulin (30%) ndi isophan insulin (70%).

Pankhani imeneyi, mankhwalawa omwe ali ndi mndandanda ali ndi zosiyana zina, ngakhale kwakukulu pamachitidwe awo ali ofanana.

Mankhwalawa amayenera kugwiritsidwa ntchito pokhapokha ngati adokotala adawafotokozera, popeza ndi okhawo amene mungapeze malangizo olondola kuchokera kwa iye. Popanda iwo, mankhwalawa amatha kukhala owopsa ngakhale kwa odwala omwe amawonetsedwa.

Kutulutsa mawonekedwe ndi kapangidwe kake

"Rosinsulin" amatanthauza mankhwala a hypoglycemic. Kutengera kuthamanga kwa mankhwalawa ndi nthawi, pali:

• "Rosinsulin S" amatanthauza mankhwala osokoneza bongo,
• "Rosinsulin R" - mwachidule,
• Rosinsulin M ndi njira yophatikiza.

Mankhwala ndi a insulin, omwe amapezeka kokha kuchokera ku thupi la munthu kudzera pakusintha kwa DNA. Monga momwe malangizo a Rosinsulin C agwiritsira ntchito, mfundo zake zimakhazikitsidwa mogwirizana ndi gawo lalikulu la mankhwala omwe ali ndi maselo. Zotsatira zake, amapanga insulin.

Mankhwala ndi kuyimitsidwa anafuna kuti subcutaneous makonzedwe. Zotsatira zake zimachitika makamaka chifukwa cha zomwe insulin-isophan imapangika. Awa ndi mankhwala oyera okhala ndi imvi pang'ono. Ngati singagwedezeke, ndiye kuti imagawidwa pamadzi pabwino ndi matope. Ichi ndichifukwa chake malinga ndi malangizo, musanayambitse mankhwalawa muyenera kugwedeza pang'ono.

Mankhwalawa ali ndi mtengo wokwanira. Malangizo ogwiritsira ntchito "Rosinsulin R" akuwonetsa kuti chida ichi ndi insulin yongokhala yochepa. Zimathandizirana mosavuta ndi cholandirira chapadera pa membrane wa khungu, ndikupanga insulini yolandirira.

Pogwiritsa ntchito mankhwala awa, shuga Zigawo zikuluzikulu zimalowa m'misempha ya minofu, zomwe zimapangitsa kuti ntchito za intracellular process.

Chifukwa cha kuchuluka kwa mapuloteni, kuchuluka kwa shuga m'magazi ndikuwonongeka kwa glycogen kumachepetsedwa. Pambuyo jakisoni, achire zotsatira zimayamba pakadutsa mphindi 30. Kutalika kwa gawo limodzi lokha ndi pafupifupi maola 8. Mtengo wake umatengera mlingo, njira ndi madera oyang'anira.

Mankhwala "Rosinsulin C" amaperekedwa mwa mtundu wa isophane ndi nthawi yayitali. Mankhwalawa amathandiza kuchepetsa kuchuluka kwa shuga m'magazi, ndikuwonjezera kuyamwa kwake ndi minofu. Izi zimachepetsa kuchuluka kwa shuga m'magazi. Pambuyo pa kukhazikitsa mankhwala, mankhwalawa amayamba kugwira ntchito maola 2. Zotsatira zabwino zimatheka pambuyo maola 12. Achire zotsatira zimatha tsiku.

Ndani anapatsidwa

Musanayambe chithandizo, malangizo ogwiritsira ntchito ndi mafotokozedwe a "Rosinsulin S" ayenera kuphunziridwa kuti adziwe momwe mankhwalawo amalembedwera ndikugwiritsa ntchito moyenera. Onetsetsani kuti mwawonana ndi dokotala, ndikofunikira kudziwa kuyenera kwa kugwiritsa ntchito kwake. Sizoletsedwa kugula pawokha ndikugwiritsa ntchito mankhwalawa, chifukwa pali mwayi wazotsatira zoyipa. Madotolo amalimbikitsa kumwa mankhwalawo pamaso pa zinthu monga izi:

• lembani 1 ndikulemba matenda ashuga 2
• matenda a shuga pa nthawi yomwe ali ndi pakati
• pambuyo pa ntchito kapena pambuyo pa ntchito.

Kuphatikiza apo, mankhwalawa amalembedwa pakalibe zotsatira za kumwa mankhwala ena a hypoglycemic, komanso kuwonjezera pa chithandizo chachikulu.

Mankhwala

Malinga ndi malangizo ogwiritsira ntchito, "Rosinsulin C" amatanthauza kukonzekera komwe kumayendetsedwa ndi khungu. Mlingo amasankhidwa poganizira matendawo komanso kuchuluka kwa shuga m'magazi. Musanayambe chithandizo, muyenera kupita kwa dokotala kuti akawerengere mankhwala omwe mumalandira. Mlingo wovomerezeka wapakati umadalira mtundu wa mankhwalawo. 1 ml ya kuyimitsidwa kuli ndi 100 IU.

Malinga ndi malangizo ogwiritsira ntchito, Rosinsulin M imayikidwa muyezo wa 0,5-1 IU pa kg iliyonse ya wodwala. Pambuyo pake, mawonekedwe a kapangidwe ka magazi ndi shuga amaphunziridwa, ndipo mulingo woyenera amasankhidwa.

Monga tafotokozera m'malamulo ogwiritsira ntchito, "Rosinsulin R" imayikidwa pa 40 magawo patsiku. Njira yoyendetsera imadalira kuchuluka kwa magazi isanayambe kapena itatha kudya. Mankhwalawa atha kuperekedwa:

• mochenjera
• kudzera m'mitsempha
• kudzera m'mitsempha.

Nthawi zambiri, Rosinsulin R imayendetsedwa mosavomerezeka. Ngati wodwala matenda ashuga apezeka kapena wachita opaleshoni akuwonetsedwa, mankhwalawa amaperekedwa kudzera m'mitsempha kapena m'mitsempha. Ndi monotherapy, mankhwalawa amagwiritsidwa ntchito katatu patsiku. Nthawi zina, pafupipafupi kayendedwe ka mankhwala amakhala mpaka sikisi pa tsiku. Popewa lipodystrophy ndi atrophy, tsamba la jakisoni likuyenera kusinthidwa nthawi iliyonse.

Malinga ndi malangizo ogwiritsira ntchito, Rosinsulin S imayikidwa muyezo wa zosaposa 24 IU. Mankhwala chikuyendetsedwera 1-2 pa tsiku subcutaneally. Wopanga amalimbikitsa kuti asinthe gawo la jakisoni nthawi iliyonse. Mankhwala amatengedwa mphindi 30 asanadye chakudya cham'mawa. Nthawi zina, wodwalayo amapatsidwa jekeseni wamitsempha, ndipo makonzedwe amkati amaletsedwa.

Musanagwiritse ntchito mankhwalawa, muyenera kuwotha kutentha.Muyeneranso kugwedeza botolo kuti mupatsenso mankhwala ena. Malo oyang'anira amakhudzidwa ndi adokotala. Izi makamaka khoma lam'mimba, ntchafu, phewa kapena matako.

M'mikhalidwe yokhazikika, malinga ndi malangizo ogwiritsira ntchito, Rosinsulin N imayikidwa 8-16 IU kamodzi patsiku. Ngati wodwalayo amakhala ndi chidwi chachikulu ndi insulin, ndiye kuti mankhwalawa amadziwitsidwa muyezo wocheperako, komanso ndi kuchepetsedwa kwa chidwi, muyezo woposa 24 IU patsiku.

Mimba

Monga tafotokozera mu malangizo ogwiritsira ntchito, Rosinsulin C pa nthawi ya pakati komanso yoyamwitsa ingagwiritsidwe ntchito pochizira, popeza zigawo zomwe sizigwira ntchito sizilowa mu placenta.

Musanakonzekere kukhala ndi pakati, ndikulimbikitsidwa kuti mupeze magazi omwe ali ndi shuga. Ngati chiwonetsero chikuwonjezeka, adotolo amamuikira Rosinsulin. Mukamayamwitsa, amaloledwa kugwiritsa ntchito mankhwalawa, chifukwa palibe chidziwitso chokhudza kulowa kwake mkaka wa m'mawere.

Gwiritsani ntchito muubwana ndi ukalamba

"Rosinsulin" itha kugwiritsidwa ntchito pochiza ana, komabe, muyenera kusintha mlingo. Ndikofunikanso kuwunika momweumoyo ulili komanso umboni.

Mankhwala amaloledwa kuchiza okalamba, koma ayenera kugwiritsidwa ntchito mosamala, popeza ali ndi chiopsezo chotenga matenda a hypoglycemia komanso kuchulukitsa matenda ena oyamba.

Contraindication

Musanagwiritse ntchito mankhwalawa, ndikofunikira kuphunzira malangizo ogwiritsira ntchito "Rosinsulin C". Mtengo wa mankhwalawa umakhala ma ruble 926. Ndi zoletsedwa mwamphamvu kugwiritsa ntchito popanda kufunsa dokotala. Ichi ndichifukwa cha kutsika kwa glucose komwe kungayambike pazofunikira kwambiri.

Popewa kukula kwamavuto, muyenera kutsatira malangizo, komanso kutenga zotsutsana. Ndi koletsedwa kugwiritsa ntchito chida ichi pamaso pa hypersensitivity pamagawo a mankhwalawo, komanso shuga ya magazi.

Zotsatira zoyipa

Kugwiritsidwa ntchito molakwika kwa "Rosinsulin" kumayambitsa mavuto obwera chifukwa cha thupi. Kuti muchite izi, ndikulimbikitsidwa kuti mutsatire zomwe dokotala amuuzidwa momveka bwino, osasintha mankhwalawo. Zotsatira zoyipa ndi izi:

• kusokonezeka kwa mtima
• zotupa pakhungu,
• womvera
• mutu
• kutupa ndi kuwotcha pamalo a jekeseni,
• mtsempha wamagazi wosefukira.

Pakachitika zovuta, muyenera kufunsa dokotala kuti musinthe mankhwalawa.

Kuyanjana kwa mankhwala osokoneza bongo

Mankhwala "Rosinsulin" ndi oyenera kulandira chithandizo chovuta limodzi ndi mankhwala ena. Musanayambe kuphatikiza mankhwala, muyenera kufunsa dokotala. Adzaitanitsa nthawi, komanso kuwerengetsa mlingo wowerengera momwe amagwirira ntchito zigawo zikuluzikulu.

Mosamala, muyenera kutenga "Rosinsulin" limodzi ndi njira zina zomwe zimapangitsa kuti shuga yamagazi ikhale yofanana. Kufooka kwa zotsatira zomwe zimafunidwa kumawonedwa ndi makonzedwe omwewo munthawi imodzi ndi okodzetsa, zoletsa kulera, antidepressants.

Mitu ya mankhwalawa

Musanagule mankhwalawa, muyenera kuphunzira momwe mungagwiritsire ntchito ndi kuwunika kwa "Rosinsulin" Mtengo wa mankhwalawo ndi pafupifupi ma ruble 100. Ali ndimankhwala angapo ofanana omwe amaperekedwa ngati pali contraindication. Mwa fanizo, ndikofunikira kufotokoza monga:

Mankhwala "Novomix" ndi insulin ya magawo awiri. Imasiyanitsidwa ndi kuthamanga kwake komanso kugwira ntchito kwawo. Sichimakhazikitsidwa kwa ana osakwana zaka 6. Nthawi zambiri pamalowa jakisoni, kupezeka kwa ziwengo kumadziwika.

Mankhwala "Insuman" 3 mitundu ya zochita. Amagwiritsidwa ntchito pochiza ana ndi akulu. Chida ichi sichimayambitsa zotsatira zoyipa.

Mankhwala "Protafan" amangoperekedwa kokha, amagwiritsidwa ntchito pochiza odwala azaka zilizonse. Itha kugwiritsidwa ntchito ndi amayi oyembekezera panthawi yoyembekezera.

Madokotala malangizo

Madokotala ati panthawi yobereka ndi pambuyo pobadwa, kufunika kwa insulini kumachepa kwambiri. Pankhaniyi, mkazi ayenera kuyang'aniridwa ndi madokotala. Madokotala amati mankhwalawa ali ndi zotsatira zabwino kwambiri ndikugwiritsa ntchito pafupipafupi.

Amanena kuti mankhwalawa alibe zotsutsana ndi zoyipa zilizonse ngati agwiritsidwa ntchito moyenera.

Ndemanga za Odwala

Ndemanga za anthu odwala matenda ashuga omwe akudziwa za mankhwalawa amakhala zabwino. Amazindikira kupezeka kosavuta kugwiritsa ntchito, kuthekera kophatikiza mitundu ingapo ya insulini. Komabe, pali anthu omwe sikofunikira kwathunthu.

Ambiri amati ichi ndi mankhwala apakhomo, koma mumtunduwo sikuti wapamwamba kuposa wina wakunja. Koma nthawi zina, zimayambitsa hypoglycemia.

Momwe mungagwiritsire ntchito: Mlingo ndi njira ya chithandizo

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).

Pulogalamu ya tsiku ndi tsiku imakhala ya 30 kapI PESCES, mwa ana - 8 PIERES, ndiye kuti muyezo wa tsiku ndi tsiku - 0,5-1 PIECES / kg kapena 30 mpaka 40 PIECES katatu pa tsiku, ngati kuli kotheka - 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.

Njira yothetsera insulini imatengedwa kuchokera ku vial ndi kuboola ndi singano yosalala ya singano yoyimitsira ndi waya yopukutira mutachotsa kapu ya aluminium ndi ethanol.

Zotsatira za pharmacological

Kukonzekera kwa insulin kochepa. Kuyanjana ndi cholandirira kumtundu wakunja kwa maselo, ndikupanga insulini yolandirira. Mwa kukulitsa kaphatikizidwe ka cAMP (m'maselo amafuta ndi maselo a chiwindi) kapena kulowa mwachindunji mu cell (minofu), insulini yolandirira insulin imapangitsa njira zina, kuphatikizira kaphatikizidwe angapo ofunikira a michere (hexokinase, pyruvate kinase, glycogen synthase, etc.). Kuchepa kwa kuchuluka kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa kayendedwe ka intracellular, kuchuluka kwa zotupa, kukondoweza kwa lipogenesis, glycogenogeneis, kaphatikizidwe ka mapuloteni, kuchepa kwa kuchuluka kwa shuga ndi chiwindi (kuchepa kwa kufalikira kwa glycogen), ndi zina zambiri.

Pambuyo pa jekeseni wa sc, matendawa amapezeka mkati mwa mphindi 20-30, umafika patadutsa maola 1-3 ndipo umatha, kutengera mlingo, maola 5-8. Kutalika kwa mankhwalawa kumatengera mlingo, njira, malo oyendetsera ndipo ali ndi machitidwe amodzi payekha .

Zotsatira zoyipa

Thupi lawo siligwirizana (urticaria, angioedema - malungo, kufupika, kuchepa kwa magazi),

hypoglycemia (pallor of the khungu, thukuta kwambiri, thukuta, pakamwa, kunjenjemera, njala, kusokonezeka, nkhawa, paresthesias mkamwa, kupweteka mutu, kugona, kugona, mantha, kupsinjika, kusakwiya, chikhalidwe chosazolowereka, kusowa kwa kayendedwe, vuto lakulankhula ndi kuyankhula komanso masomphenya), hypoglycemic coma,

hyperglycemia ndi matenda ashuga acidosis (pa Mlingo wochepera, kulumpha jakisoni, kusadya bwino, motsutsana ndi maziko akumatenda ndi matenda): kugona, ludzu, kusowa kudya, kutulutsa nkhope),

kuda nkhawa (mpaka kukula kwa precomatose ndi chikomokere),

kuchepa kwakanthawi kowoneka (nthawi zambiri kumayambiriro kwa zamankhwala),

immunological cross-reaction ndi insulin ya anthu, kuwonjezeka kwa gawo la anti-insulin antibodies, kenako kuwonjezeka kwa glycemia,

Hyperemia, kuyabwa ndi lipodystrophy (atrophy kapena hypertrophy of subcutaneous fat) pamalo a jekeseni.

Kumayambiriro kwa mankhwalawa - kutupa ndi kusokonezeka komwekonso (ndizosakhalitsa ndipo kumatha ndikupitilira chithandizo).

Kuchita

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, methanedienone), androgens, bromocriptine, tetracyclines, clofibrate, ketoconazole, mebendazole, theophylline, cyclophosphamide, phenfluramine, Li + kukonzekera, pyridoxine, quinidine, quinine, ethlinequin.

Zotsatira Hypoglycemic wa kulemala glucagon, kukula timadzi, corticosteroids m'kamwa kulera, estrogens, thiazide ndi "kuzungulira" okodzetsa, BCCI, chithokomiro mahomoni, heparin, sulfinpyrazone, sympathomimetics, danazol, tricyclics, clonidine, BCCI, diazoxide, morphine, chamba, fodya, phenytoin , epinephrine, H1-histamine receptor blockers.

Beta-blockers, reserpine, octreotide, pentamidine imatha kuwongolera ndi kufooketsa mphamvu ya hypoglycemic ya insulin.

Rinsulin P - malangizo ogwiritsira ntchito

Rinsulin P imadziwika kuti ndi insulin ya anthu. Inapezeka chifukwa chogwiritsa ntchito ukadaulo wa DNA. Insulin ya soluble ndi mtundu wopanda mafuta, wowoneka bwino. Mankhwalawa adapangira jekeseni kudzera m'mitsempha, intramuscularly komanso subcutaneous. Wothandizira wa hypoglycemic umalimbikira iwo omwe shuga yawo yamwazi imatsikira kwambiri.

Kupanga ndi mawonekedwe a kumasulidwa

Yankho la jakisoni

Insulin yaumunthu

Othandizira amapezeka pokonzekera: glycerol (glycerin) - 16 mg, metacresol - 3 mg, madzi d / i - mpaka 1 ml. Kuchuluka kwa botolo ndi 10 ml. Wokhazikitsidwa mu katoni katoni, chithuza chamtundu wazokongoletsera chili ndi makatoni 5. Vala yagalasi yotsekedwa mu cholembera cha syringe yotayika yambiri, yopangira jakisoni wobwereza, imakhala ndi 3 ml.

Pharmacodynamics ndi pharmacokinetics

Kutalika kwa mankhwalawa kumatsimikiziridwa ndi kuchuluka kwa mayamwidwe a insulin m'magazi ndipo zimatengera zinthu zinayi:

• kuchuluka kwa mankhwala (kuchuluka kwa insulin)
• kuchuluka kwa insulin mankhwala
• mawebusayiti (ntchafu, matako, pamimba),
• njira yoyendetsera (intramuscularly, intravenly, subcutaneally).

Pafupifupi, pambuyo pa kuperekera, insulin imayamba kuchita mphindi 20-30, mphamvu yayikulu imatheka pakati pa maola 1-3. Mphamvu ya mankhwalawa, kutengera mlingo, amatha maola 8. Choipa cha mankhwalawa ndikuti yankho limagawidwa mosasiyananso minofu minofu. Mamolekyulu a insulin amawonongeka ndi insulinase mu chiwindi ndi impso. Rinsulin imachotsedwapo, monga lamulo, ndi impso.

Mlingo ndi makonzedwe

Mlingo ndi njira ya mankhwala ayenera kutsimikiziridwa ndi dokotala.

Kuwongolera kwa subcutaneous ndiyo njira yofala kwambiri. Mothandizidwa ndi intravenly komanso intramuscularly, mankhwalawa amaperekedwa nthawi zambiri, mwachitsanzo, opaleshoni yomwe ikubwera kapena matenda a shuga.

Insulin imaperekedwa kwa mphindi 20-30 musanadye chakudya chomwe chimakhala ndi chakudya. Njira yothetsera vutoli iyenera kukhala kutentha kwambiri.

Mankhwalawa amalowetsedwa kukhoma kwamkati, komwe kumayamwa kwambiri. Mutha kubaya ntchafu, matako, kapena dera laling'ono la phewa. Mukamayendetsa insulin pang'ono, ndikofunikira kuti musavulaze mitsempha ya magazi. Simungathe kumangika m'malo amodzi kangapo motsatizana, pamakhala chiopsezo cha lipodystrophy.

Pankhani ya monotherapy, mankhwalawa amayenera kuyikidwa mthupi katatu patsiku (kwa odwala ena - nthawi 5-6). Kutengera ndi kuchuluka kwa shuga m'magazi, tsiku lililonse mankhwalawa amachokera ku 0,3 mpaka 1 IU / kg pa kulemera kwa thupi.

Kugwiritsa ntchito katiriji sikovomerezeka ngati njira yothetsera chisanu kapena yowuma yaoneka. Cartridge ndi singano zingagwiritsidwe ntchito kamodzi.

Kugwiritsa ntchito cholembera kuyenera kuchitika mosiyanasiyana malinga ndi malangizo a wopanga. Musanakwaniritse njirayi, muyenera kuchotsa cholembera chimodzi kuchokera mufiriji ndikudikirira mpaka yankho la insulini lifike potentha, ndiye kuti mugwiritsa ntchito singano yomwe mungalowe nawo mankhwalawo. Pambuyo pa jakisoni, singano iyenera kutulutsidwa ndi chipewa ndikuchotsa nthawi yomweyo kuti chitetezeke.

Analogs Rinsulin P

Pali chiwerengero chokwanira chofananira cha mankhwalawa, achi Russia komanso akunja.

• Actrapid NM (Novo Nordisk, Denmark),
• Biosulin (Pharmstandard-UfaVITA, Russia),
• Gensulin R ("Bioton S. A.", Poland),
• Vosulim-R (Wokhard Ltd, India),
• Insuran R (Institute of Bioorganic Chemistry RAS, Russia),
• Rosinsulin R (Honey Synthesis, Russia),
• Monoinsulin CR (Belmedpreparaty, Belarus),
• Mitsinje ya Humodar R 100 (Indar, Ukraine),
• Humulin Regular (Lilly France, France).

Rinsulin R ndi mankhwala opangidwa ndi GEROPHARM-Bio. Mitengo yachitsanzo ya mankhwala opangira mankhwala ku Moscow:

Gawo logwira ntchito la magulu P ndi C

Rosinsulin P imaganiziridwa wosakhalitsa sungunuka insulin. Imalumikizana mosavuta ndi cholandirira chapadera pazinthu zakunja za maselo, ndikupanga insulini yolandirira. Potengera maziko a zamankhwala, kaphatikizidwe ka cAMP mu chiwindi ndi maselo amafuta amakwera. Zomwe zimapangidwa ndi mankhwalawa zimalowanso m'maselo am'matumbo, zomwe zimapangitsa kuti ntchito ya hexokinase ndi njira zina zina zamkati.

Chifukwa cha kuchuluka kwa mapuloteni, kuchuluka kwa shuga m'magazi ndikuwonongeka kwa glycogen kumachepetsedwa. Pambuyo jekeseni, kukhudzana kumawonedwa kwa mphindi 30. Kutalika kwa gawo limodzi kuchokera ku mlingo umodzi kumafika maola 8. Kufunika kwa chizindikirocho kumadalira mlingo, njira ndi malo oyendetsera.

Rosinsulin C imaperekedwa ngati insulin-isophan yokhala ndi zotsatira zabwino. Mankhwalawa amachepetsa kuchuluka kwa shuga m'magazi, ndikuwonjezera kuyamwa kwake ndi minofu, kukulitsa lipogenis. Izi zimachepetsa kuchuluka kwa shuga m'magazi.

Pambuyo jakisoni, kapangidwe kake kamayamba kugwira ntchito patatha maola awiri. Mphamvu yayitali imatheka pambuyo maola 12. The achire zotsatira kumatenga mpaka tsiku. Kufunika kwa chizindikirocho kumakhudzidwa mwachindunji ndi kuchuluka kwa mankhwalawo.

Zizindikiro ndi contraindication

Zizindikiro zoika mankhwalawa ndizambiri.

Izi zikuphatikiza:

• lembani 1 ndikulembapo matenda ashuga a m'matenda a 2 (posakhala ndi zotsatira za mankhwalawa ndi othandizira pakamwa kapena osakwanira),
• matenda ashuga omwe adachitika panthawi yamatumbo,
• ketoacidosis
• ketoacidotic chikomokere,
• Mankhwalawa okonzekera ma insulin,
• matenda opatsirana mwa odwala matenda ashuga.

Izi zimafuna chithandizo ndi othandizira okhala ndi insulin, koma kupezeka kwawo sikutanthauza kuti mankhwalawa amayenera kuyamba nthawi yomweyo. Choyamba, onetsetsani kuti palibe zotsutsana. Chifukwa cha iwo, nthawi zambiri muyenera kusiya kugwiritsa ntchito Rosinsulin.

Main contraindication ndi:

Kupezeka kwa izi kukufunika kusankha njira zina, chifukwa kugwiritsa ntchito Rosinsulin kungayambitse kuwonongeka.

Malangizo ogwiritsira ntchito

Kuti mupeze zotsatira, mankhwala aliwonse ayenera kugwiritsidwa ntchito molingana ndi malangizo. Kutsata kwa Rosinsulin sikumathandiza kwambiri, chifukwa wodwala aliyense amatha kukhala ndi zinthu zofunika kukonza ndi kusintha kwake. Chifukwa chake, malangizo omveka bwino kuchokera kwa dokotala amafunikira.

Mankhwalawa amagwiritsidwa ntchito ngati jakisoni, yemwe amaperekedwa mosazindikira. Nthawi zina intravenous kapena intramuscular management imaloledwa, koma imachitika kokha ndi katswiri.

Pafupipafupi jakisoni ndi mlingo wa mankhwalawa amawerengedwa pawokha malinga ndi mawonekedwe a chithunzi cha chipatalachi.Ngati palibe zowonjezera, kulemera kwa 0,5-1 IU / kg kumagwiritsidwa ntchito patsiku. M'tsogolomu, kusintha kwa shuga m'magazi kumaphunziridwa ndipo mlingo umasinthidwa ngati pakufunika.

Rosinsulin nthawi zina amagwiritsidwa ntchito limodzi ndi insulin yokonzekera. Pankhaniyi, mlingo wa mankhwala uyenera kusinthidwa.

Jekeseni ayenera kuperekedwa musanadye (kwa mphindi 20-30). Kunyumba, mankhwalawa amathandizidwa mosagwirizana ndi ntchafu, phewa, kapena khomo lamkati. Ngati Mlingo wolembedwa ndi adokotala uposa 0,6 IU / kg, umayenera kugawidwa m'magawo angapo. Masamba obayira ayenera kusinthidwa kuti pasakhale mavuto a khungu.

Malangizo a kanema pakuyambitsa insulin ndi cholembera:

Odwala Apadera ndi Mayendedwe

Odwala ena amafunika kusamala mwapadera. Izi ndichifukwa cha mawonekedwe a thupi lawo, chifukwa chomwe Rosinsulin ingawakhudze mwanjira yachilendo.

Odwala awa akuphatikizapo:

1. Ana. Muubwana, chithandizo cha insulin sichimaletsedwa, koma chimafunikira owunika mosamala ndi madokotala. Mlingo wa mankhwalawo amawapatsa mankhwala ochepera shuga.
2. Amimba Mankhwalawa samavulaza azimayi pakubala mwana, chifukwa chake nthawi zambiri amagwiritsidwa ntchito kusokoneza zizindikiro za matenda ashuga. Koma panthawi yokhala ndi pakati, kufunika kwa insulini kumatha kusiyanasiyana ndi nthawi, motero muyenera kuyang'anira kuwerengera kwa glucose ndikusintha gawo la mankhwalawo.
3. Amayi oyamwitsa. Amaletsedwanso ku insulin. Zigawo zogwira ntchito za mankhwalawa zimatha kudutsa mkaka wa m'mawere, koma sizikhala ndi vuto kwa mwana. Insulin ndi puloteni yomwe thupi la mwana limayamba kutengera. Koma mukamagwiritsa ntchito Rosinsulin, azimayi omwe amadyetsa mwachilengedwe ayenera kutsatira zakudya.
4. Anthu okalamba. Pakufunika kwawo kwa kusamala ndi chifukwa cha kusintha kokhudzana ndi zaka. Kusintha kumeneku kukhoza kukhudza ziwalo zambiri, kuphatikizapo chiwindi ndi impso. Pamaso pa kuphwanya ntchito mwa ziwalozi, insulin excretion imachepetsa. Chifukwa chake, odwala omwe ali ndi zaka zopitilira 65 amapatsidwa mankhwala ochepa.

Muyenera kusamalanso chithandizo cha anthu omwe ali ndi ma pathologies osiyanasiyana. Zina mwazo zimakhudza zochita za Rosinsulin.

Mwa iwo amatchedwa:

1. Kusokonekera mu ntchito ya impso. Chifukwa cha iwo, mawonekedwe a zinthu zogwira ntchito amachepetsa, zomwe zingayambitse kudzikundikira kwawo komanso kupezeka kwa hypoglycemia. Chifukwa chake, anthu otere ayenera kuwerengetsa mosamala.
2. Matenda a chiwindi. Mothandizidwa ndi insulin, chiwindi chimachepetsa kupanga shuga. Ngati pali zovuta mu ntchito yake, glucose imatha kupangidwa mochulukirapo, zomwe zimapangitsa kuperewera kwake. Izi zikutanthauza kuti pakafunika kuphwanya zochita za thupi, mlingo wa mankhwalawa uyenera kuchepetsedwa.

Mankhwala Rosinsulin okha samayambitsa kupatuka pakulimba mtima ndipo samabweza m'mbuyo zomwe zimachitika. Amatha kukwiyitsidwa ndi vuto la hypoglycemic lomwe limachitika chifukwa chogwiritsa ntchito molakwika wothandizirayi. Pankhani imeneyi, kuyendetsa galimoto komanso kuchita zoopsa mukamagwiritsa ntchito mankhwalawa ndikosayenera.

Chithandizo

Mankhwala a gulu C amaperekedwa kawiri pa tsiku. Wopanga amalangiza nthawi ina iliyonse kuti asinthe jakisoni. Mankhwala amatengedwa mphindi 30 asanadye chakudya cham'mawa. Nthawi zambiri, jakisoni wa intramuscular ndi Rosinsulin C amaperekedwa kwa wodwala.

Mlingo umasankhidwa payekha. Zimatengera kuchuluka kwa shuga mumkodzo ndi magazi, machitidwe a matendawa. M'mikhalidwe yokhazikika, ndikokwanira kulowa 8-24 IU kamodzi patsiku. Ngati wodwalayo amakhala ndi chidwi chachikulu ndi insulin, mankhwalawa amadziwitsidwa muyezo wocheperako, komanso ndi kuchepetsedwa kwa chidwi - muyezo wa 24 IU patsiku. Ngati masana mulingo uposa 0.6, jakisoni awiri amatumizidwa m'malo osiyanasiyana. Odwala omwe adalandira zoposa IU 100 patsiku amagonekedwa m'chipatala ndi kulowetsedwa kwa insulin.

Kuchiza ndi Rosinsulin P ndi munthu payekha. Mlingo ndi njira yolowera zimadalira kuwerengera magazi asanadye komanso chakudya, kuchuluka kwa glycosuria. Njira zoyendetsera:

Nthawi zambiri Rosinsulin P imayendetsedwa mosavomerezeka. Ngati wodwala matenda ashuga atsimikiziridwa kapena opaleshoni akuwonetsedwa, mapangidwe ake amathandizidwa ndi intramuscularly kapena kudzera m'mitsempha. Ndi monotherapy, mankhwalawa amagwiritsidwa ntchito katatu patsiku. Nthawi zina, pafupipafupi oyang'anira amafika kangapo pa 6 pa tsiku. Popewa atrophy, lipodystrophy, tsamba la jakisoni limasintha nthawi ina iliyonse yotsatira.

Mlingo wa tsiku ndi tsiku sayenera kupitirira 40 mayunitsi. Ana anaikidwa mlingo wa 8 mayunitsi. Ngati mankhwala opitirira 0,6 pa kilogalamu imodzi ya kulemera amalembedwa, insulin imayendetsedwa kawiri m'malo osiyanasiyana a thupi. Ngati ndi kotheka, Rosinsulin C imaphatikizidwa ndi insulin yayitali.

Zotsatira zoyipa

Mankhwala a gulu lililonse lomwe lingafunsidwe angayambitse ziwengo mu uritisaria. Dyspnea imawoneka kawirikawiri, kukakamiza kumachepa. Zizindikiro zina zoyipa za Rosinsulin P ndi C:

• kusowa tulo
• migraine
• kusadya bwino
• mavuto azikumbumtima
• kuchuluka titer wa anti-insulin antibodies.

Pa gawo loyambirira la chithandizo, odwala nthawi zambiri amadandaula ndi edema komanso kuwonongeka kwakanthawi. Zizindikiro zimatha mofulumira. Chisamaliro chachikulu chimalipidwa malinga ndi botolo. Pamaso pa makonzedwe, yankho limayang'aniridwa kuti liziwonekera. Ngati pali matupi achilendo mumadzimadzi, Rosinsulin sagwiritsidwa ntchito.

Mlingo wa mankhwalawa umasinthidwa kuti utenge matenda, chithokomiro cha chithokomiro, matenda a Addison. Hypoglycemia nthawi zambiri imakhala chizindikiro cha bongo. Chizindikiro chofananacho chikuwonetsedwa ndikusintha Rosinsulin C ndi P ndikuthandizira wina. Zizindikiro zina za bongo:

• kusanza
• kutsegula m'mimba
• kuchepa kwa ntchito.

Ngati chipatala chomwe chatchulidwa pamwambapa chikuwoneka, ndikulimbikitsidwa kudziwitsa dokotala. Nthawi zambiri wodwala amalangizidwa kupita kuchipatala. Njira yotsatirayi imasankhidwa pambuyo popenda wodwalayo mosamalitsa.

Ngati wodwala ali ndi matenda a chiwindi ndi impso, kufunikira kwa mankhwala kumachepetsedwa. Kuzungulira kwa glucose kumatha kusintha pamene wodwala wasamutsidwa kuchokera ku nyama kupita ku insulin yaumunthu. Kusamutsa koteroko kuyenera kukhala koyenera mwachipatala. Imachitika moyang'aniridwa ndi madokotala.

Malangizo azachipatala

Anthu odwala matenda ashuga amasiya kumva kupweteka kwa hypoglycemia pakudya shuga. Vutolo likamakulirakulira, chithandizo chimasinthidwa. Ngati wodwala ali ndi pakati. zotsatirazi zikumbukiridwa:

• Mu 1 trimester, mlingo umachepetsedwa.
• Mu trimesters 2 ndi 3, kufunikira kwa Rosinsulin kumawonjezeka.

Nthawi yobala ndikubala, kufunika kwa mankhwalawa kumacheperachepera. Ndi mkaka wa m`mawere, mkazi amayang'aniridwa ndi madokotala tsiku ndi tsiku.

Kuchokera pamalingaliro azachipatala, Rosinsulin P ndi C sagwirizana ndi mayankho a mankhwala ena. Hypoglycemic effect imatheka chifukwa cha kudya kwa sulfonamides, monoamine oxidase inhibitors ndi angiotensin-kutembenuza enzyme. Mphamvu ya achire imafooka ndi glucagon, glucocorticoids, njira zakulera zam'mlomo, Danazole. Beta-blockers imathandizira ndikuchepetsa mphamvu ya Rosinsulin.