Insuman® Rapid GT Yachidule-insulin ya anthu

Jekeseni 100 IU / ml

1 ml yankho lili

ntchito: insulin ya anthu 100 IU (3,571 mg),

zokopa: 85% glycerol, metacresol, sodium dihydrogen phosphate dihydrate, sodium hydroxide, anaikira hydrochloric acid, madzi a jakisoni.

Transparent wopanda khungu kapena pafupifupi wopanda mafuta.

Mankhwala

Pharmacokinetics

Insuman® RapT GT imadziwika ndi kuyambanso mwachangu komanso kwakanthawi kachitidwe. Kuchepetsa mphamvu kwa shuga kumawonekera mkati mwa mphindi 30 pambuyo pa kayendetsedwe ka subcutaneous, ndikufika pazokwanira mkati mwa maola 1-4. Zotsatira zimatha kwa maola 7-9.

Hafu ya seramu theka moyo wa insulin pafupifupi mphindi 4-6. Imatalikirana kwambiri kulephera. Tiyenera kudziwa kuti pharmacokinetics ya insulin sikuwonetsa metabolic yake.

Mankhwala

Insuman® Rapid ndi yankho la insulin yokhazikika.

Insuman® Rapid HT imakhala ndi insulin yofanana ndi ya insulin yaumunthu, yomwe imapezedwa ndi ukadaulo wa maumboni a DNA ogwiritsa ntchito Escherichia coli.

Monga insulin yaumunthu, insuman® Wofulumira GT

- imatsitsa shuga wamagazi ndikuwonjezera zotsatira za anabolic, mkati

ndikumachepetsa zotsatira za catabolic

- kumawonjezera mayendedwe a shuga mkati mwa maselo ndi mapangidwe a glycogen mu minofu ndi chiwindi, bwino magwiritsidwe a pyruvate, linalake glycogenolysis ndi glyconeogeneis

- kumawonjezera lipogenesis mu chiwindi ndi adipose minofu ndi ziletsa lipolysis

- amalimbikitsa kumwa amino acid ndi maselo ndikuwonjezera kuphatikiza mapuloteni

- kumawonjezera kutuluka kwa potaziyamu m'maselo

Mlingo ndi makonzedwe

Magazi a glucose ofunikira, kukonzekera kwa insulin kuti agwiritsidwe ntchito komanso mlingo wa mankhwala (kuchuluka kwa magawo, nthawi yogawa) amasankhidwa payekha malinga ndi kadyedwe, mulingo wakuchita zolimbitsa thupi komanso moyo wa wodwalayo.

Mlingo watsiku ndi tsiku ndi nthawi yoyendetsera

Palibe malamulo osasinthika a insulin dosing. Chofunikira masiku onse a insulini ndi 0,5-1.0 IU pa 1 kg ya odwala thupi. Chofunikira cha metabolic chofunikira ndi 40-60% ya tsiku ndi tsiku la insulin. Insuman® Rapid HT imayendetsedwa mosadukiza mphindi 15-20 asanadye.

Mankhwalawa a hyperglycemia kapena ketoacidosis, kagwiritsidwe ka insulin ndi gawo limodzi la njira zochizira zokwanira, zomwe zimaphatikizapo njira zoteteza wodwala ku zovuta zazikulu zokhudzana ndi kuchepa msanga kwa shuga m'magazi. Chithandizo choterechi chimafuna kuwunika wodwala mosamala (kuwunika kwa metabolic, acid-base ndi electrolyte bwino, zisonyezo zothandizira ziwalo zofunika, etc.) m'chipinda cholandirira odwala kapena zofanana.

Kusintha kwa mlingo wachiwiri

Kupititsa patsogolo kayendedwe ka metabolic kungayambitse kuwonjezeka

sensulivity insulin, zomwe zimapangitsa kuchepa kwa insulin. Kusintha kwa Mlingo kungafunike ngati wodwalayo asintha kapena momwe moyo wake wasinthira, nthawi zina zomwe zingapangitse kuti hypoglycemia kapena hyperglycemia (onani "malangizo apadera").

Magulu apadera a odwala

Kufunika kwa insulin kungachepetse vuto la chiwindi kapena matenda a impso komanso mukalamba (onani "Malangizo apadera").

Insuman® Rapid GT imayendetsedwa mosavuta. Intravenous makonzedwe a mankhwala amaloledwa.

The mayamwidwe insulin ndipo, chifukwa chake, hypoglycemic zotsatira, zingasiyane kutengera ndi tsamba la jakisoni (mwachitsanzo, khoma lam'mimba poyerekeza ndi dera la femoral).Tsamba la jakisoni liyenera kusinthidwa nthawi iliyonse mkati mwa malo omwewo.

Intravenous insulin Therapy iyenera kuchitikira kumalo osamalirako odwala kwambiri kapena poyang'anira ndi zida zoyenera.

Makhalidwe wamba

Insuman Rapid ndi mankhwala opangira matenda a shuga. Amapezeka mu mawonekedwe amadzimadzi ndikugwiritsa ntchito jakisoni.

Muzochita zamankhwala, imagwiritsidwa ntchito ndi mitundu inanso ya insulin. Amasankhidwa kuti akhale ndi matenda ashuga amtundu 1 komanso mtundu wachiwiri wa shuga ndi kusagwira kwa mapiritsi ochepetsa shuga, kusalolera kwawo kapena zotsutsana nawo.

Homoni amakhala ndi vuto la hypoglycemic. Kuphatikizika kwa mankhwalawa ndi insulin yaumunthu ndi 100% solubility yochepa. Thupi limapezeka mu labotale ndi genetic engineering.

Sungunuka insulini - yogwira mankhwala. Zotsatirazi zidagwiritsidwa ntchito ngati chowonjezera: m-cresol, glycerol, madzi oyeretsedwa, hydrochloric acid, sodium hydroxide, sodium dihydrogen phosphate dihydrate.

Kutulutsa mawonekedwe ndi kapangidwe kake

Fomu ya Mlingo - jakisoni: wopanda mabala, wowonekera (5 ml aliyense m'mabotolo agalasi osakhala ndi maonekedwe, mabotolo asanu mu chikatoni, 3 ml m'matumba opanda galasi osavala, makatoni asanu m'matumba a chithuza, 1 paketi pamakatoni. mu makatoni amtundu wamagalasi osakhazikitsidwa amalembera amtopola umodzi wa SoloStar, mu makatoni okhala ndi ma syringe 5, paketi iliyonse ilinso ndi malangizo ogwiritsira ntchito Insuman Rapid GT).

Muli 1 ml ya yankho:

ntchito yogwira: insulin ya insulle (maumboni amtundu wa anthu) - 100 IU (Mayunitsi apadziko lonse lapansi), omwe amafanana ndi 3,571 mg,
othandizira: madzi a jakisoni, glycerol 85%, sodium dihydrogen phosphate dihydrate, metacresol (m-cresol), komanso hydrochloric acid ndi sodium hydroxide (kusintha pH).

Mankhwala

The yogwira mankhwala a hypoglycemic mankhwala Insuman Rapid GT ndi sungunuka insulini, wopezeka ndi genetic mainjiniya pogwiritsa ntchito K12 kufinya kwa E. coli, ndi chimodzimodzi mu kapangidwe ka insulin yaumunthu.

Mankhwala amachepetsa kuchuluka kwa shuga m'magazi, amachepetsa zotsatira za catabolic ndikuthandizira kukulitsa zotsatira za anabolic. Kuchulukitsa kayendedwe ka glucose ndi potaziyamu kumaselo, lipogenesis m'chiwindi ndi minofu ya adipose, mapangidwe a glycogen mu minofu ndi chiwindi. Amalepheretsa lipolysis, glycogenolysis ndi gluconeogeneis. Zimasintha kugwiritsidwa ntchito kwa pyruvate. Imakulitsa kaphatikizidwe kazakudya zamapuloteni komanso kutuluka kwa ma amino acid m'maselo.

Insuman Rapid GT ndi kukonzekera kwa insulini mwachangu komanso nthawi yayitali. Hypoglycemic zotsatira pambuyo subcutaneous (sc) makonzedwe amakula mkati mphindi 30, ukufika pazambiri pambuyo maola 1 - 4, ndipo amalimbikira kwa maola 7-9.

Zizindikiro zogwiritsidwa ntchito

Chithandizo cha matenda ashuga omwe amafuna insulin,
Chithandizo cha ketoacidosis ndi matenda ashuga,
kukwaniritsa kagayidwe kachakudya kagayidwe kachakudya kwa odwala omwe ali ndi matenda osokoneza bongo nthawi ya opaleshoni (asanachitike komanso nthawi ya opaleshoni, komanso nthawi ya postoperative).

Contraindication

Kugwiritsa ntchito Insuman Rapid GT kumatsutsana mwa odwala omwe ali ndi hypoglycemia ndi hypersensitivity ku gawo lililonse la mankhwala (yogwira kapena yothandizira).

Pankhani zotsatirazi, mankhwalawa ayenera kugwiritsidwa ntchito mosamala (kuwunika mosamala mkhalidwe wa wodwala ndikofunikira, kusintha kwa insulin kungafunike):

aimpso / chiwindi kulephera,
proliferative retinopathy, makamaka kwa odwala omwe sanalandire chithandizo ndi Photocoagulation (laser therapy),
matenda oyamba nawo
stenosis yamphamvu yam'mimba / yam'mimba,
ukalamba.

Insuman Rapid GT, malangizo ogwiritsira ntchito: njira ndi mlingo

Palibe malamulo okhwima omwe amafunika insulin dosing.The mankhwala, chandamale glucose m'magazi, mlingo dosing (mlingo ndi nthawi ya makonzedwe) amatsimikiza ndi kusintha kwa kupezeka kwa dokotala aliyense wodwala, amaganizira zakudya zake, moyo wake komanso kuchuluka kwa zolimbitsa thupi.

Mlingo wa tsiku ndi tsiku pafupifupi ndi 0.5-1 IU / kg, pomwe 40-60% ya okwanira tsiku ndi tsiku a insulin ndi gawo la insulin ya anthu omwe amakhala nthawi yayitali.

Insuman Rapid GT imathandizidwa kwambiri s / c 15-20 mphindi musanadye, kusinthana malo owonetsera jakisoni m'dera lomwelo la anatomical. Kusintha tsamba la jakisoni (mwachitsanzo, kuyambira pamimba mpaka ntchafu) ndizotheka pokhapokha pokhapokha ndi dokotala, chifukwa pamakhala chiopsezo chochepetsedwa pakupezeka kwa insulin ndipo, chifukwa chake, zotsatira zake za hypoglycemic.

Ngati ndi kotheka, Insuman Rapid GT imaloledwa kupatsidwa mankhwala a mkati (iv), komabe, pankhaniyi, chithandizo chimachitika kuchipatala kapena kwina, koma malinga ndi kuperekedwa kwa machitidwe ofanana ndi kuwunika.

Nthawi yomweyo isanakhazikitsidwe / kuyambitsa, muyenera kuwunika yankho - liyenera kukhala lowonekera komanso lopanda utoto, popanda mawonekedwe akunja. Ngati mankhwalawo ali ndi mawonekedwe osiyana, simungathe kuwagwiritsa ntchito.

Insuman Rapid GT ndi yoletsedwa kugwiritsa ntchito mapampu amtundu wa insulin ambiri (kuphatikizapo mapampu amadzalo) omwe amakhala ndi machubu a silicone.

Mankhwala sayenera kusakanikirana ndi insulin ochokera ku nyama, ma insulini ya ndende ina, insulin analogues ndi mankhwala ena aliwonse.

Amaloledwa kusakaniza Insuman Rapid GT ndi zokonzekera zonse za insulin zopangidwa ndi kampani yomweyo (Sanofi-Aventis).

Pochita pakumwa mankhwala, syringes zotayika za pulasitiki zokha ndi zomwe zizigwiritsidwa ntchito poika ndende yoyenera - mukamagwiritsa ntchito Mbale 5 ml, OptiPen Pro1 kapena zolembera ma syringe a ClickSTAR - mukamagwiritsa ntchito makatoni 3 ml.

Dokotalayo ayenera kupereka malangizo omveka bwino kwa wodwala aliyense pafupipafupi pofotokoza kuchuluka kwa shuga m'magazi ndi malingaliro a mtundu wa Insuman Rapid GT ngati angasinthe m'moyo kapena zakudya.

Mu kwambiri hyperglycemia ndi ketoacidosis, kugwiritsa ntchito insulin ndi gawo lofunikira la zovuta mankhwala, zomwe zimaphatikizanso njira zoteteza wodwala ku zovuta zazikulu chifukwa cha kuchepa kwambiri kwa shuga m'magazi. Malangizo a mankhwalawa amafunika kuwunika mosamalitsa m'chipinda choperekera chisamaliro chokwanira, chomwe chimaphatikizapo kuyang'anira zofunikira za thupi, kudziwa kagayidwe kazinthu, kuchuluka kwa electrolyte ndi acid-base.

Kusintha kwa Mlingo

Kusintha kwa mlingo wa Insuman Rapid GT kungafunike pazotsatira zotsatirazi:

kusintha kwa kagayidwe kazachilengedwe (kuchuluka kwa chidwi cha insulin, chifukwa chomwe kufunikira kwa thupi kumachepa),
Kusintha kwa thupi la wodwala kapena moyo wake, kuphatikizapo kuchuluka kwa zolimbitsa thupi, chakudya, ndi zina zambiri,
Nthawi zina, mothandizidwa ndi zomwe zitha kukulitsa vuto lakukula kwa hypo- kapena hyperglycemia,
ukalamba
kulephera kwa aimpso.

Kusintha kwa Insuman Rapid GT kuchokera ku mtundu wina wa insulin

Mlingo wa Insuman Rapid GT ungafunike potsatira izi: kusintha kwa insulin kuchokera kwachinyama, kusintha kuchokera ku mtundu wina wa insulin ya munthu, kusintha kuchokera ku insulin ya nthawi yina yochitapo kanthu.

Posamutsa wodwala kupita ku Insuman Rapid GT kuchokera ku insulin yochokera ku ziweto, kuchepetsa kuchuluka kwa mankhwalawa kungafunike, makamaka kwa odwala omwe ali ndi vuto la hypoglycemia, lomwe kale limafunikira Mlingo wambiri wa insulin chifukwa cha kupezeka kwa ma antibodies kwa iwo, omwe kale amapangidwa mozungulira shuga. .

Kuchepetsa kwa mankhwalawa kungafunike onse mukangosintha mtundu wa insulin, komanso milungu ingapo.Chifukwa chake, atangolowa m'malo mwa insulin yakale ndi Insuman Rapid GT komanso m'masabata oyamba omwe amagwiritsidwa ntchito, ndikofunikira kuti wodwalayo awonerere bwino za boma komanso kuchuluka kwa shuga m'magazi. Odwala omwe adalandira insulin mu Mlingo wambiri chifukwa cha kupezeka kwa ma antibodies ayenera kuthandizidwa ku chipatala, chifukwa pali mwayi wopitilira kuyang'aniridwa ndi achipatala.

Kugwiritsa ntchito Insuman Rapid GT mu mbale

Chotsani kapu ya pulasitiki m'botolo watsopano.
Sungani mpweya mu syringe mu gawo lofanana ndi kuchuluka kwa insulini, ndikuyiyika mu vial (osakhala yankho).
Popanda kuchotsa syringe, tembenuzani botolo mozungulira ndikuyimbira mlingo wa insulin.
Chotsani thovu zam'mlengalenga mu syringe.
Tenga khungu pakati pa jakisoni, ikani singano pansi pakhungu, ndipo pang'onopang'ono jekeseni insulin.
Chotsani singano ndikufinya jakisoni ndi swab ya thonje kwa masekondi angapo.
Lembani pa cholembera vala tsiku loyamba la insulini yochokera ku vial.

Kugwiritsa ntchito Insuman Rapid GT m'makatoni

Cartridge insulin idapangidwa kuti igwiritsidwe ntchito ndi zolembera za sytiiten za OptiPen Pro1 ndi ClickSTAR. Asanaikidwe, makatoni amayenera kusungidwa kutentha kwa maola 1-2, popeza kuti jakisoni wa kukonzekera kozizira kumapweteka. Pamaso jakisoni, chotsani thovu lakumtunda.

Makatoni sanapangidwe kuti asakanikane ndi mitundu ina ya insulini, sanapangidwe kuti agwiritsenso ntchito.

Pakuswa phala la syringe, muyezo wofunikira wa mankhwalawo ukhoza kuperekedwa pogwiritsa ntchito syringe yotayidwa kuti ipatsidwe insulin.

Mukakhazikitsa cartridge, mutha kugwiritsa ntchito kwa milungu 4.

Nthawi iliyonse mukakhazikitsa katemera watsopano musanabaye jekeseni woyamba, ntchito yolondola ya cholembera iyenera kuunikanso.

Kugwiritsa ntchito Insuman Rapid GT mu syringe cholembera SoloStar

Njira yothetsera Insuman Rapid GT mu syringe cholembera SoloStar imatha kuperekedwa kokha.

Musanagwiritse ntchito koyamba, cholembera cha syringe chimasungidwa kwa maola 1-2 mufiriji. Musanagwiritse ntchito iliyonse, yang'anani cartridge mkati mwa cholembera kuti mutsimikizire kuti yankho lake lili bwino.

Ma cholembera omwe amagwiritsidwa ntchito amatha kuwonongeka, chifukwa sanapangidwe kuti azigwiritsanso ntchito.

Popewa kutenga matenda, wodwala m'modzi yekha ndiye ayenera kugwiritsa ntchito cholembera chilichonse.

Zambiri pakugwiritsa ntchito cholembera cha SoloStar:

gwiritsani singano zomwe zimagwirizana ndi SoloStar,
gwiritsani ntchito singano yatsopano nthawi zonse ndikuyesera chitetezo,
samalani kwambiri popewa ngozi zokhudzana ndi kugwiritsa ntchito singano komanso mwayi wopatsira matenda,
osagwiritsa ntchito cholembera pamaso pa zowonongeka kapena kukayikira pakuyenda bwino kwake,
Nthawi zonse tengani cholembera chotsalira kuti chitha kapena kuwonongeka kwa chachikulu.
Tetezani cholembera ku dothi ndi fumbi (pukuta ndi nsalu yoyera, yonyowa, osatsuka, mafuta, kapena kumiza m'madzi kuti muwonongeke).

Kugwiritsa ntchito cholembera SoloStar:

Ulamuliro wa insulin: isanagwiritsidwe ntchito koyamba, tikulimbikitsidwa kuti mulembe chizindikiro cholembera kuti isankhe bwino kuti mtundu wa insulini wasankhidwa bwino. Cholembera SoloStar, yopangidwira kukonzekera kwa Insuman Rapid GT, ndi yoyera ndi utoto wachikasu ndi mphete yothandizira pa izo. Mukachotsa kapu, muyenera kuyang'ana mawonekedwe a yankho lomwe limapezeka mu cholembera kuti lisungidwe, yowoneka bwino komanso kusapezeka kwa tinthu tachilendo.
Chofunika cha singano: Ndikofunikira kugwiritsa ntchito singano zogwirizana zokha. Wopanda singano yatsopano wosabala uyenera kuyikiridwa jakisoni aliyense. Ikani singano mosamala mutachotsa kapu.
Kuyesa mayeso otetezedwa (ndikofunikira kuyeseza jakisoni iliyonse isanayambe kuti mutsimikizire kuti cholembera ndi singano zikugwira ntchito, komanso kusapezeka kwa thovu): mutachotsa zipewa zakunja ndi zamkati, kuyeza muyeso wa mayunitsi awiri, ikani cholembera pakati ndi singano ndikukwera mokoma chala pa cartridge, kuti thovu lililonse la mpweya lipite pa singano, ndikudina batani lachikasu. Ngati njira yothetsera vutoli ikuwonekera pamphumi ya singano, ndiye kuti cholembera ndi singano zimagwira ntchito molondola. Ngati mankhwalawo sakuwoneka, njira yonseyo iyenera kubwerezedwa mpaka insulin itawoneka pamsonga pa singano.
Kusankha kwa dose: pa cholembera cha SoloStar chingwe nchotheka kukhazikitsa mankhwalawo molondola 1, kuyambira pazoyambira (1 unit) mpaka pazambiri (80 mayunitsi). Ngati kuli koyenera kuperekera mlingo waukulu kwambiri, chitani majakisoni awiri kapena kupitilira apo. Pakadali pano posankha mtundu womwe mwapatsidwa, manambala "0" akuyenera kuwonetsedwa pazenera.
Makonzedwe a doose: ndikofunikira kuyika singano pansi pa khungu ndikukanikiza bwino batani lachikasu. Kwa masekondi 10, sungani batani kuti lisakankhidwe ndipo musachotsere singano kuti mutsimikizire kukonzekera kwathunthu kwa insulin.
Kuchotsa ndikuwononga singano: Pakatha jakisoni aliyense, singano imayenera kuchotsedwa ndikuitaya. Pofuna kupewa ngozi komanso kupewa matenda, ndikofunikira kutsatira njira zopewera mosasamala (mwachitsanzo, ikani chipewa ndi dzanja limodzi). Mukachotsa singano, tsekani cholembera ndi chipewa.

Musanagwiritse ntchito cholembera cha SoloStar yoyamba, ndikofunikira kuti muwerenge malangizo ogwiritsa ntchito.

Zotsatira zoyipa

Zotsatira zoyipa kwambiri za insulin mankhwala ndi hypoglycemia. Amayamba nthawi zambiri pamene mlingo wa Insuman Rapid GT wothandizidwa umapitilira kufunikira kwa insulin. Ndi ma epicode obwerezabwereza, kukulitsa zizindikiro zamitsempha, kuphatikizapo kukomoka ndi chikomokere, ndikotheka. Zolemba zowopsa komanso zazitali zimakhala pangozi kwa wodwalayo.

Kuwonetsedwa kwa neuroglycopenia mwa odwala ambiri kumayambitsidwa ndi zisonyezo za Reflex activation zamtundu wachifundo zamankhwala (poyankha kukulitsa hypoglycemia), yomwe imatha kutchulidwa ndi kuchepa msanga kapena kutulutsa shuga m'magazi. Kutsika kwakukuru kwa glucose kungayambitse kukula kwa hypokalemia (kuphatikizika kwa mtima wamagazi) ndi edema yam'mimba.

Zotsatira zina zoyipa (kufotokozedwa kawirikawiri): - ≥ 1/100 mpaka

Gulu la Pharmacotherapeutic:

Zizindikiro zogwiritsidwa ntchito
Insulin-wodwala matenda a shuga. Insuman Rapid GT imawonetsedwa pochiza matenda ashuga komanso ketoacidosis, komanso kuti akwaniritse zolipiritsa za metabolic odwala omwe ali ndi matenda osokoneza bongo a pre-, intra-, ndi postoperative nthawi.

achina,
Hypersensitivity reaction insulin kapena mankhwala ena aliwonse othandizira, kupatula milandu yomwe insulin chithandizo ndiyofunika. Zikatero, kugwiritsa ntchito Insuman Rapid GT kumatheka pokhapokha pakumuyang'anirani mosamala ndipo ngati kuli kotheka, kuphatikiza ndi anti-allergen.

Njira zopewera komanso malangizo apadera

N`zotheka mtanda-immunological zochita za anthu insulin ndi insulin ya nyama. Ndi chidwi chowonjezeka cha wodwalayo kuti apange insulin yakuchokera kwa nyama, komanso m-cresol, kulekerera kwa Insuman Rapid GT kuyenera kuwunikiridwa kuchipatala pogwiritsa ntchito mayeso a intradermal. Ngati pakuyesedwa kwa insulin ya insulin ya munthu kumadziwika, zotsatira zake, monga Arthus, ndiye kuti chithandizo china chikuyenera kuyang'aniridwa ndi achipatala.Mwa kuchuluka kwakukulu kwa odwala omwe ali ndi hypersensitivity kupita ku insulin ya nyama, ndizosavuta kusinthana ndi ma insulin aumunthu chifukwa cha mtanda wa immunological wa insulini ya anthu ndi insulin yochokera ku nyama.
Hypoglycemia imatha kukhazikika ngati kuchuluka kwa insulin kudutsa kuposa kufunika kwake.
Pali zisonyezo zina zamankhwala ndizizindikiro zomwe zimayenera kuwonetsa kwa wodwala kapena ena za kutsika kwakuthwa kwa shuga. Izi ndi monga: thukuta la mwadzidzidzi, kuluma, kugwedezeka, kugona, kugona, kusokonezeka kwa tulo, mantha, kukhumudwa, kusakhazikika, zosadziwika bwino, nkhawa, paresthesia mkamwa komanso kuzungulira pakamwa, kutsekemera, kupweteka mutu, kusowa kwa mgwirizano wogwirizira komanso kuyenda kwakanthawi. kusokonezeka kwa mitsempha (kusokonezeka kwa mawu ndi masomphenya, zizindikiro za paralo) ndi zomveka zachilendo. Ndi kutsika kwakukwera m'magulu a shuga, wodwalayo amatha kulephera kudziletsa komanso ngakhale kuzindikira. Zikatero, kuzizira ndi chinyezi pakhungu kumatha kuonedwa, ndipo kupweteka kumawonekeranso.
Odwala ambiri, chifukwa cha mayendedwe a adrenergic, amatha kukhala ndi zotsatirazi, zomwe zikuwonetsa kuchepa kwa magazi: thukuta, chinyezi cha pakhungu, nkhawa, tachycardia (palpitations), kuthamanga kwa magazi, kunjenjemera, kupweteka pachifuwa, kusokonezeka kwa mtima.
Chifukwa chake, wodwala aliyense yemwe ali ndi matenda ashuga komanso kulandira insulin ayenera kuphunzira kuzindikira zizindikiro zosadziwika zomwe ndi chizindikiro cha kukhala ndi hypoglycemia. Odwala omwe amawunika shuga ndi mkodzo pafupipafupi sangakhale ndi hypoglycemia. Kukonda kwambiri hypoglycemia kumatha kulepheretsa wodwala kuyendetsa galimoto komanso kugwiritsa ntchito zida zilizonse. Wodwala amatha kukonza kuchepa kwa shuga komwe adazindikira mwa kudya shuga kapena zakudya zamagulu ochulukirapo. Pazifukwa izi, wodwalayo ayenera kukhala ndi 20 g shuga nthawi zonse. Mokulira kwambiri kwa hypoglycemia, jakisoni wokhazikika wa glucagon akuwonetsedwa (omwe angathe kuchitidwa ndi dokotala kapena antchito oyamwitsa). Pambuyo pakusintha kokwanira, wodwalayo ayenera kudya. Ngati hypoglycemia singathetsedwe mwachangu, ndiye kuti dokotala akuyenera kuyitanidwa mwachangu. Ndikofunikira kudziwitsa dokotala mwachangu za kukula kwa hypoglycemia kuti apange chisankho pakufunika kusintha kwa insulin.
Nthawi zina, zizindikiro za hypoglycemia zimatha kukhala zofowoka kapena kusapezeka. Zochitika zotere zimachitika kwa odwala okalamba, pamaso pa zotupa zamanjenje (neuropathy), odwala matenda amiseche, othandizira ena ndi mankhwala ena (onani "Kuyanjana ndi mankhwala ena"), okhala ndi shuga yochepa kwambiri posintha insulin.
Zotsatira zotsatirazi ndizotheka kuchepa kwambiri kwa shuga m'magazi: insulin yambiri, jakisoni wa insulin wosayenera (mwa odwala okalamba), kusinthana ndi mtundu wina wa insulin, kudumpha chakudya, kusanza, kutsegula m'mimba, kuchita masewera olimbitsa thupi, kuthetsa mavuto, kumwa mowa, ndi matenda omwe amachepetsa kufunika mu insulin (chiwindi chachikulu kapena matenda a impso, kuchepa kwa ntchito ya adrenal cortex, pituitary kapena chithokomiro), kusintha kwa jekeseni (mwachitsanzo, khungu la pamimba, phewa kapena ntchafu), komanso mogwirizana ndi mankhwala ena amatanthauza (onani "Kuyanjana ndi mankhwala ena")
Chiwopsezo cha kukhala ndi hypoglycemia ndi chachikulu pamayambiriro a chithandizo cha insulin, mukasinthira kukonzekera kwina kwa insulin, mwa odwala omwe ali ndi shuga ochepa.
Gulu lowopsa lomwe lili ndi odwala omwe ali ndi zigawo za hypoglycemia komanso kuchepa kwa ziwalo za ziwalo za ziwalo za ziwalo za ziwalo zake ziwalo (ziwalo za ziwalo za ziwalo za ziwalo za ziwalo za ziwalo).
Kulephera kutsatira zakudya, kudumpha jakisoni wa insulin, kuchuluka kwa insulin chifukwa cha matenda opatsirana kapena matenda ena, komanso kuchepa kwa zochitika zolimbitsa thupi kungayambitse kuchuluka kwa shuga m'magazi (hyperglycemia), mwina ndi kuchuluka kwa matupi a ketone m'magazi (ketoacidosis). Ketoacidosis imatha kumatha maola ochepa kapena masiku. Pazizindikiro zoyambirira za metabolic acidosis (ludzu, kukodza pafupipafupi, kulephera kudya, kutopa, khungu lowuma, kupuma kwambiri komanso kuthamanga, chidwi cha acetone ndi glucose mkodzo), chithandizo chamankhwala chofunikira ndichofunikira.
Pakusintha dokotala (mwachitsanzo, nthawi yakuchipatala chifukwa cha ngozi, kudwala panthawi ya tchuthi), wodwalayo ayenera kudziwitsa dokotala kuti ali ndi matenda ashuga.

Mimba komanso kuyamwa

Chithandizo cha Insuman Rapid GT ziyenera kupitilizidwa pa nthawi yapakati. Pa nthawi yoyembekezera, makamaka pambuyo pa trimester yoyamba, kuwonjezereka kwa insulin kuyenera kuyembekezeredwa. Komabe, pambuyo pobadwa, kufunika kwa insulin nthawi zambiri kumatsika, komwe kumabweretsa chiwopsezo chachikulu cha hypoglycemia. Ngati muli ndi pakati kapena mukufuna kubereka, onetsetsani kuti mwadziwitsa dokotala.
Panthawi yoyamwitsa, palibe malamulo oletsa insulin. Komabe, kusintha kwa mlingo ndi kadyedwe kungafunikire.

Mlingo ndi makonzedwe.

Kusankhidwa kwa mlingo wa insulin mwa wodwala kumachitika ndi dokotala payekha, kutengera zakudya, mulingo wakuchita zolimbitsa thupi ndi moyo. Mlingo wa insulin umatsimikizika molingana ndi kuchuluka kwa shuga m'magazi, komanso pamaziko a kuchuluka kwa zochitika zolimbitsa thupi ndi mkhalidwe wa metabolism ya carbohydrate. Chithandizo cha insulin chimafuna kudziphunzitsa koyenera kwa wodwala. Dokotala ayenera kupereka malangizo ofunikira kangati kuti azindikire kuchuluka kwa shuga m'magazi ndipo, mwina, mkodzo, ndikuwapatsanso malangizo oyenera osintha zakudya kapena machitidwe a insulin.
Wapakati tsiku lililonse insulin amachokera ku 0,5 mpaka 1.0 ME pa kilogalamu ya thupi la wodwalayo, ndipo 40-60% ya mlingo imagwera munthu insulin yayitali.
Posintha kuchokera ku insulin ya nyama kupita ku insulin ya anthu, kuchepetsedwa kwa insulin kungafunike. Kusintha kuchokera ku mitundu ina ya insulin kupita ku mankhwalawa kutha kuchitika kokha moyang'aniridwa ndi achipatala. Makamaka kuyang'anira mkhalidwe wa kagayidwe kazachilengedwe ndikofunikira mu masabata oyambilira pambuyo pa kusintha kumeneku.
Insuman Rapid GT nthawi zambiri imaperekedwa kwa mphindi 15-20 asanadye chakudya. Mgwirizano wamankhwala mankhwala amaloledwa. Tsamba la jakisoni liyenera kusinthidwa nthawi iliyonse. Kusintha kwa jekeseni (mwachitsanzo, kuyambira pamimba mpaka ntchafu) kuyenera kuchitika pokhapokha mukaonana ndi dokotala.
Insuman Rapid GT imatha kuperekedwa kudzera mu mankhwalawa mu hyperglycemic coma ndi ketoacidosis, komanso kukwaniritsa kufotokozera kagayidwe kachakudya koyambirira, intra- komanso postoperative nthawi ya odwala omwe ali ndi matenda osokoneza bongo.
Insuman Rapid GT sigwiritsidwe ntchito mitundu yosiyanasiyana ya mapampu a insulini (kuphatikizapo omwe adalowetsedwa), komwe kuphimba kwa silicone kumagwiritsidwa ntchito.
Osasakaniza Insuman Rapid GT ndi insulin ya ndende ina (mwachitsanzo, 40 IU / ml ndi 100 IU / ml), ndi insulini yoyambira nyama kapena mankhwala ena. Gwiritsani ntchito mayankho omveka okha, opanda khungu la Insuman Rapid GT popanda zozizwitsa zilizonse.
Kumbukirani kuti kuchuluka kwa insulini mu vial ndi 100 IU / ml, kotero muyenera kugwiritsa ntchito syringes zapulasitiki zopangidwira insulin iyi.Syringe siyenera kukhala ndi mankhwala ena aliwonse kapena zotsalira zake.
Pamaso gawo loyambirira la insulin kuchokera pambale, chotsani pulasitiki (kukhalapo kwa kapuyo ndi umboni wa vial wosatsutsana). Njira yothetsera jakisoni iyenera kukhala yowonekera komanso yopanda utoto.
Asanatenge insulini kuchokera ku vial, mpweya wofanana ndi mankhwala omwe amaperekedwa ndi insulin umayamwa mu syringe ndikujowina mu vial (osalowa madzi). Kenako vala yokhala ndi syringe imasinthidwa mozungulira ndi syringe ndipo kuchuluka kwa insulini kumatengedwa. Pamaso jakisoni, chotsani thovu lakumanzere mu syringe.
Khungu limatengedwa pamalo a jakisoni, singano imayikidwa pansi pakhungu, ndipo insulin imayamwa pang'onopang'ono. Pambuyo pa jekeseni, singano imachotsedwa pang'onopang'ono ndipo tsamba lamalowo limakanikizidwa ndi swab ya thonje kwa masekondi angapo. Tsiku lokhala ndi insulin kit kuchokera pa vial iyenera kulembedwa pa cholembera cha vial.
Mutatsegula mabotolo amatha kusungidwa pa kutentha osaposa + 25 ° C kwa masabata anayi pamalo otetezedwa ku kuwala ndi kutentha.

Kuchita ndi mankhwala ena

Kugwiritsa ntchito munthawi yomweyo mankhwala ambiri kumatha kufooketsa kapena kuwonjezera mphamvu yochepetsera shuga ya Insuman Rapida GT. Chifukwa chake, mukamagwiritsa ntchito insulin, simungatenge mankhwala ena popanda chilolezo chapadera cha dokotala.
Hypoglycemia imatha kuchitika ngati odwala nthawi yomweyo omwe ali ndi insulin amalandila ACE inhibitors, acetylsalicylic acid ndi ma salicylates ena, amphetamine, anabolic steroids ndi mahomoni ogonana amuna, cybenzoline, fibrate, disopyramide, cyclophosphamide, phenoxyfin amine, glucose, glucose, glucose , pentoxifylline, phenoxybenzamine, phentolamine, propoxyphene, somatostatin ndi mayendedwe ake, sulfonamides, tetracyclines, tritocqualin kapena trophosphamide.
Kuchepetsa mphamvu ya insulin kumatha kuwonedwa limodzi ndi insulin ndi corticotropin, corticosteroids, diazoxide, heparin, isoniazid, barbiturates, nicotinic acid, phenolphthalein, phenothiazine, phenytoin, diuretics, danazrogen, estrogen, estrogen. zotulutsa.
Odwala omwe amalandila insulin ndi clonidine, reserpine kapena mchere wa lithiamu, zonse zimafooketsa komanso zomwe zimapangitsa kuti ntchito ya insulin iwoneke. Pentamidine imatha kuyambitsa hypoglycemia kenako hyperglycemia.
Kumwa mowa kumatha kuyambitsa hypoglycemia kapena kuchepetsa shuga wochepa wokhala m'magazi kuti akhale woopsa. Kulekerera kwa mowa kwa odwala omwe amalandira insulin kumachepetsedwa. Mitundu yovomerezeka ya zakumwa ziyenera kutsimikiziridwa ndi dokotala. Uchidakwa wambiri, komanso kugwiritsa ntchito mankhwala osokoneza bongo mopitirira muyeso, umatha kukhudza glycemia.
Ma Beta-blockers amawonjezera chiopsezo cha hypoglycemia ndipo, pamodzi ndi othandizira ena achifundo (clonidine, guanethidine, reserpine) amatha kufooketsa kapena ngakhale kufinya chiwonetsero cha hypoglycemia.

Hypoglycemia, zotsatira zoyipa kwambiri, zimatha kukhala ngati mlingo wa insulin woperekedwa umaposa kufunikira kwake (onani "Njira zopewera komanso malangizo apadera").
Kusintha kwakukulu mu shuga m'magazi kumatha kubweretsa zosokoneza pang'ono. Komanso, makamaka ndi insulin Therapy, kuwonjezereka kwakanthawi kwa matenda ashuga retinopathy ndikotheka. Odwala omwe ali ndi proliferative retinopathy, osagwiritsa ntchito njira ya laser, zovuta kwambiri zam'magazi zingayambitse khungu.
Nthawi zina atrophy kapena hypertrophy ya adipose minofu imatha kuchitika malo a jekeseni, omwe amatha kupewedwa ndikusintha malo a jekeseni nthawi zonse. Nthawi zina, kufupikiratu kumatha kuchitika pamalowo jekeseni, ndikusowa ndikupitiliza mankhwala.Ngati erythema yofunika ikakhazikitsidwa, limodzi ndi kuyabwa ndi kutupa, ndikufalikira mwachangu mpaka pamalo a jakisoni, komanso zotsatira zina zovuta pazigawo za mankhwala (insulin, m-cresol), ndikofunikira kudziwitsa dokotala mwachangu, monga nthawi zina Kuchita kotereku kukhoza kuwononga moyo wa wodwalayo. Kusintha kwakukulu kwa Hypersensitivity kumachitika kawirikawiri. Amathanso kuphatikizidwa ndi chitukuko cha angioedema, bronchospasm, kugwa kwa magazi komanso kusowa kwa anaphylactic. Hypersensitivity reaction imafunikira kukonza mwachangu pakanthawi kovomerezeka ndi insulin komanso kukhazikitsidwa kwa njira zoyenera zadzidzidzi.
Mwina kupangika kwa ma antibodies ku insulin, komwe kungafune kusintha kwa mlingo wa insulin. Ndiwothekanso kusungidwa kwa sodium komwe kumayamba chifukwa cha kutupa kwa minofu, makamaka mukamaliza kumwa mankhwalawa.
Ndi kuchepa kwambiri kwa shuga m'magazi, ndizotheka kukhala ndi hypokalemia (zovuta kuchokera ku mtima) kapena kukula kwa edema ya ubongo.
Popeza zovuta zina zimatha kukhala zowopsa pamoyo, ndikofunikira kudziwitsa adokotala zikafika.
Ngati mukuwona mavuto aliwonse, chonde onani dokotala!

Bongo

Mankhwala osokoneza bongo kwambiri amatha kuyambitsa matenda oopsa ndipo nthawi zina amatha kukhala oopsa kwa hypoglycemia. Ngati wodwalayo akudziwa, ayenera kumwa shuga kenako ndikumatenga zinthu zomwe zili ndi chakudya (onani "Malangizo ndi malangizo apadera"). Ngati wodwala ali osazindikira, 1 mg ya glucagon / m iyenera kuperekedwa. Ngati njira ina, kapena ngati jakisoni wa glucagon sagwira ntchito, 20-30 ml ya 30% -50% iv solution ya glucose imaperekedwa. Ngati ndi kotheka, kuyambiranso kwa shuga pamwambapa ndi kotheka. Mwa ana, kuchuluka kwa shuga komwe kumayendetsedwa kumayikidwa molingana ndi kulemera kwa thupi la mwana.
Milandu ya hypoglycemia yoopsa kwambiri kapena yayitali yotsata shuga, tikulimbikitsidwa kupaka njira yochepetsera shuga pofuna kupewa kukonzanso kwa hypoglycemia. Mu ana aang'ono, ndikofunikira kuyang'anitsitsa kuchuluka kwa shuga m'magazi, molingana ndi chitukuko chachikulu cha hyperglycemia.
Pazinthu zina, ndikulimbikitsidwa kuti odwala azigonekedwa m'chipinda cha odwala osamala kwambiri kuti athe kuwunika moyenera komanso kuwunika.

Kutulutsa Fomu

Injection solution 100 IU / ml mu 5 ml Mbale ..
Mu phukusi la mabotolo 5 limodzi ndi malangizo ogwiritsira ntchito.

Malo osungira

Sungani kutentha kwa + 2 ° C mpaka + 8 ° C (gawo lama masamba a firiji yanyumba). Pewani kuzizira, popewa kulumikizana mwachindunji ndi botolo ndi makoma a chipinda chaulere kapena chosungira pozizira.
Pewani patali ndi ana!

Tsiku lotha ntchito

Moyo wa alumali ndi zaka 2.
Mankhwalawa sangathe kugwiritsidwa ntchito atatha tsiku lotha kusonyezedwa phukusi.

Tchuthi kuchokera ku malo ogulitsa mankhwala: mankhwala

Yopangidwa ndi Aventis Pharma Deutschland GmbH, Germany.
Bruningstrasse 50, D-65926, Frankfurt, Germany.

Zodandaula za ogula ziyenera kutumizidwa ku adilesi ya ofesi yoimira Russia:
101000, Moscow, Ulansky Lane, 5

Zizindikiro ndi contraindication

Mankhwalawa amalembedwa motere:

DM 1 (fomu yodalira insulin) ndi DM 2,
zochizira zovuta kwambiri,
kuthetsa matenda a shuga,
kulandira malipiro opatsirana pokonzekera ndi pambuyo pa opareshoni.

Hormoni sinafotokozedwe motere:

aimpso / chiwindi kulephera,
kukana ntchito yogwira,
stenosis yamitsempha / matenda amitsempha,
tsankho la mankhwala,
anthu omwe ali ndi matenda oyanjana,
anthu omwe amapitilira retinopathy.

Zofunika! Ndi chisamaliro chachikulu, odwala matenda ashuga okalamba ayenera kumwedwa.

Malangizo ogwiritsira ntchito

Kusankha ndi kusintha kwa mankhwalawa kumatumizidwa payekhapayekha. Dokotala amatsimikiza kuchokera kuzowonetsa shuga, kuchuluka kwa zochita zolimbitsa thupi, mkhalidwe wa kagayidwe kazakudya. Wodwalayo amapatsidwa malangizo poyesa kusintha kwa glucose.

Mlingo wa tsiku ndi tsiku wa mankhwalawa, poganizira kulemera kwake, ndi 0,5 IU / kg.

Hormoni imayendetsedwa kudzera m'mitsempha, intramuscularly, subcutaneally. Njira yogwiritsira ntchito subcutaneous kwambiri. Jakisoni amachitika mphindi 15 asanadye.

Ndi monotherapy, pafupipafupi kayendetsedwe ka mankhwala amakhala pafupifupi katatu, nthawi zina amatha kufikira kangapo patsiku. Tsamba la jakisoni limasintha nthawi ndi nthawi mkati mwake. Kusintha kwa malo (mwachitsanzo, kuchokera pamanja mpaka pamimba) kumachitika pambuyo pofunsa dokotala. Kwa subcutaneous makonzedwe a mankhwala, tikulimbikitsidwa kugwiritsa ntchito cholembera.

Zofunika! Kuyamwa kwa zinthu kumasiyana malinga ndi jakisoni malo.

Mankhwalawa akhoza kuphatikizidwa ndi insulin yayitali.

Maphunziro a kanema wa syringe-cholembera insulin

Kusintha kwa Mlingo

Mlingo wa mankhwalawa ungasinthidwe milandu:

ngati moyo ukusintha
kuchuluka kwa chidwi ndi ntchito yogwira,
kusintha kwa odwala
mukamasintha kuchokera ku mankhwala ena.

Nthawi yoyamba mutasintha chinthu china (mkati mwa masabata awiri), kuyendetsa bwino shuga kumalimbikitsidwa.

Kuchokera pamitengo yapamwamba yamankhwala ena, ndikofunikira kusinthana ndi mankhwalawa moyang'aniridwa ndi achipatala.

Mukasintha kuchokera ku nyama kupita ku insulin yaumunthu, kusintha kwamankhwala kumachitika.

Kuchepetsa kwake kumafunikira pagulu lotsatira la anthu:

shuga woyika kale pamankhwala,
kumwa mankhwala mosamala kwambiri,
makonzedwe a kupangika kwa dziko la hypoglycemic.

Malangizo apadera ndi odwala

Mimba ikachitika, chithandizo cha mankhwala sichimaleka. Chidacho sichidutsa placenta.

Ndi mkaka wa m`mawere, palibe zoletsedwa. Chowonadi chachikulu ndichakuti insulin dosing ikusinthidwa.

Pofuna kupewa kukhudzika kwa hypoglycemic, chithandizo cha okalamba omwe ali ndi mankhwalawa chimachitika mosamala.

Anthu omwe ali ndi vuto la chiwindi / impso amasinthira ku Insuman Rapid ndikusintha mlingo woyang'aniridwa ndi katswiri.

Kutentha kwa njira yovulazidwa kuyenera kukhala 18-28ºº. Insulin imagwiritsidwa ntchito mosamala mu matenda opatsirana pachimake - kusintha kwa mlingo kumafunika pano. Mukamamwa mankhwalawo, wodwalayo sapatula mowa. Zitha kuyambitsa hypoglycemia.

Zofunika! Makamaka chidwi ndi kumwa mankhwala ena. Zina mwazo zimatha kuchepetsa kapena kuwonjezera mphamvu ya Insuman.

Mukamamwa mankhwalawa, wodwalayo ayenera kumvetsera mosamala kusintha kwina kulikonse. Izi ndizofunikira kuti chizindikiritso cha nthawi yake chizindikiritso cha hypoglycemia chichitike.

Kuwunikiranso kwambiri zamagulu a glucose kumalimbikitsidwanso. Chiwopsezo cha hypoglycemia chogwiritsidwa ntchito ndi mankhwalawa chimakhala chachikulu mwa anthu omwe ali ndi shuga osachepera. Wodwala nthawi zonse azikhala ndi glucose 20 g.

Mosamala kwambiri, tengani:

ndimankhwala amodzimodzi,
likasamutsidwa kupita ku insulin ina,
Anthu omwe amakhala ndi shuga
okalamba
anthu omwe amapanga pang'onopang'ono hypoglycemia,
ndi matenda amisala.

Zindikirani! Mukasinthira ku Insuman, kuunika kwa kulekerera kwamankhwala kumachitika. Mlingo wochepa wa mankhwalawa umalowetsedwa m'njira zina. Kumayambiriro kwa makonzedwe, kuwukira kwa hypoglycemia kumatha kuoneka.

Kuchita ndi mankhwala ena

Popanda upangiri wa dokotala, kugwiritsa ntchito mitundu inanso ya mankhwala osavomerezeka sikulimbikitsidwa.Amatha kuchulukitsa kapena kuchepetsa mphamvu ya insulin kapena kupangitsa kuti pakhale zovuta.

Kutsika kwa mphamvu ya mahomoni kumawonedwa ndikugwiritsira ntchito njira zakulera, ma glucocorticosteroids mahomoni (progesterone, estrogen), diuretics, mankhwala angapo a antipsychotic, adrenaline, mahomoni a chithokomiro, glucagon, barbiturates.

Kukula kwa hypoglycemia kumatha kuchitika limodzi ndi mankhwala ena othandizira odwala matenda ashuga. Izi zimagwiranso ntchito ku mankhwala a sulfonamide, Mao inhibitors, acetylsalicylic acid, fibrate, testosterone.

Mowa ndi mahomoni amachepetsa shuga mpaka pamavuto, amachititsa hypoglycemia. Mlingo wovomerezeka ndi dokotala. Muyeneranso kusamala pakumwa mankhwala oletsa - - kudya kwawo mopitirira muyeso kumakhudza kwambiri shuga.

Pentamidine imatha kuyambitsa zochitika zosiyanasiyana - hyperglycemia ndi hypoglycemia. Mankhwala amatha kupweteketsa mtima. Makamaka mwa anthu omwe ali pachiwopsezo.

Zindikirani! Moyo wa alumali wa yankho mu cholembera sichikhala kupitirira mwezi. Tsiku la kudya koyamba kwa mankhwala liyenera kudziwika.

Mankhwala ozindikiritsa (ofananitsa mafomu otulutsira komanso kupezeka kwa chinthu chomwe chikugwira ntchito) akuphatikiza: Actrapid Hm, Vosulin-R, Insuvit N, Rinsulin-R, Humodar, Farmasulin N. Mankhwalawa amaphatikizapo insulin ya anthu.

Wopanga - Sanofi-Aventis (France), Sanofi

Mutu: Insuman® Rapid GT, Insuman® Rapid GT

Zopangidwa: 1 ml ya njira yopanda mbali ya jakisoni ili ndi 100 IU ya insulin ya anthu.
Omwe amathandizira: m-cresol, sodium dihydrogen phosphate dihydrate, glycerol, sodium hydroxide, hydrochloric acid, madzi a jakisoni.

Machitidwe Insuman Rapid GT imakhala ndi insulin, yofanana mu insulin yaumunthu ndipo imapezeka ndi mainjiniine. Kutsitsa kwa shuga kumachitika msanga, mkati mwa mphindi 30, ndikufikira pakatha maola 1-4 mutatha kugwiritsa ntchito mankhwalawa. Zotsatira zimatha kwa maola 7-9. Insuman Rapid GT imatha kusakanikirana ndi ma insulin onse a anthu kuchokera ku Hoechst Marion Roussel, kupatula insulin yomwe cholinga chake ndi kupopa pampu.

Zisonyezero zogwiritsidwa ntchito: Insulin-wodwala matenda a shuga. Insuman Rapid GT imawonetsedwa pochiza matenda ashuga komanso ketoacidosis, komanso kuti akwaniritse zolipiritsa za metabolic odwala omwe ali ndi matenda osokoneza bongo a m'mbuyomu -, intra -, komanso nthawi ya postoperative.

Njira yogwiritsira ntchito: Insuman Rapid GT nthawi zambiri imaperekedwa kwa mphindi 15-20 asanadye chakudya. Mgwirizano wamankhwala mankhwala amaloledwa. Tsamba la jakisoni liyenera kusinthidwa nthawi iliyonse. Insuman Rapid GT imatha kuperekedwa kudzera mu mankhwalawa mu hyperglycemic coma ndi ketoacidosis, komanso kukwaniritsa kufotokozera kagayidwe kachakudya koyambirira, intra- komanso postoperative nthawi ya odwala omwe ali ndi matenda osokoneza bongo. Insuman Rapid GT sigwiritsidwe ntchito mitundu yosiyanasiyana ya mapampu a insulini (kuphatikizapo omwe adalowetsedwa), komwe kuphimba kwa silicone kumagwiritsidwa ntchito.

Zotsatira zoyipa: Nthawi zina atrophy kapena hypertrophy ya adipose minofu imatha kuchitika malo a jekeseni, omwe amatha kupewedwa ndikusintha malo a jekeseni nthawi zonse.

Nthawi zina, kufupikiratu kumatha kuchitika pamalowo jekeseni, ndikusowa ndikupitiliza mankhwala. Ngati erythema yofunika ikakhazikitsidwa, limodzi ndi kuyabwa ndi kutupa, ndikufalikira mwachangu mpaka pamalo a jakisoni, komanso zotsatira zina zovuta pazigawo za mankhwala (insulin, m-cresol), ndikofunikira kudziwitsa dokotala mwachangu, monga nthawi zina Kuchita kotereku kukhoza kuwononga moyo wa wodwalayo.

Kusintha kwakukulu kwa Hypersensitivity kumachitika kawirikawiri.Amathanso kuphatikizidwa ndi chitukuko cha angioedema, bronchospasm, kugwa kwa magazi komanso kusowa kwa anaphylactic. Hypersensitivity reaction imafunikira kukonza mwachangu pakanthawi kovomerezeka ndi insulin komanso kukhazikitsidwa kwa njira zoyenera zadzidzidzi.

Mwina kupangika kwa ma antibodies ku insulin, komwe kungafune kusintha kwa mlingo wa insulin. Ndiwothekanso kusungidwa kwa sodium komwe kumayamba chifukwa cha kutupa kwa minofu, makamaka mukamaliza kumwa mankhwalawa.

Zoyipa: Hypersensitivity reaction insulin kapena zilizonse zothandiza za mankhwala, pokhapokha ngati insulin yofunikira. Zikatero, kugwiritsa ntchito Insuman Rapid GT kumatheka pokhapokha pakumuyang'anirani mosamala ndipo ngati kuli kotheka, kuphatikiza ndi anti-allergen.

Zochita Zamankhwala: Kuchepetsa mphamvu ya insulin kumatha kuwonedwa limodzi ndi insulin ndi corticotropin, corticosteroids, diazoxide, heparin, isoniazid, barbiturates, nicotinic acid, phenolphthalein, phenothiazine, phenytoin, diuretics, danazrogen, estrogen, estrogen. zotulutsa. Odwala omwe amalandila insulin ndi clonidine, reserpine kapena mchere wa lithiamu, zonse zimafooketsa komanso zomwe zimapangitsa kuti ntchito ya insulin iwoneke. Pentamidine imatha kuyambitsa hypoglycemia kenako hyperglycemia. Kumwa mowa kumatha kuyambitsa hypoglycemia kapena kuchepetsa shuga wochepa wokhala m'magazi kuti akhale woopsa. Kulekerera kwa mowa kwa odwala omwe amalandira insulin kumachepetsedwa. Mitundu yovomerezeka ya zakumwa ziyenera kutsimikiziridwa ndi dokotala. Uchidakwa wambiri, komanso kugwiritsa ntchito mankhwala osokoneza bongo mopitirira muyeso, umatha kukhudza glycemia. Ma Beta-blockers amawonjezera chiopsezo cha hypoglycemia ndipo, pamodzi ndi othandizira ena achifundo (clonidine, guanethidine, reserpine) amatha kufooketsa kapena ngakhale kufinya chiwonetsero cha hypoglycemia.

Mimba ndi kuyamwa: Chithandizo cha Insuman Rapid GT ziyenera kupitilizidwa pa nthawi yapakati. Pa nthawi yoyembekezera, makamaka pambuyo pa trimester yoyamba, kuwonjezereka kwa insulin kuyenera kuyembekezeredwa. Komabe, pambuyo pobadwa, kufunika kwa insulin nthawi zambiri kumatsika, komwe kumabweretsa chiwopsezo chachikulu cha hypoglycemia. Panthawi yoyamwitsa, palibe malamulo oletsa insulin. Komabe, kusintha kwa mlingo ndi kadyedwe kungafunikire.

Malo osungira: Sungani kutentha kwa + 2 ° C mpaka + 8 ° C. Pewani kuzizira, popewa kulumikizana mwachindunji ndi botolo ndi zipupa za chipinda chaulere kapena chosungira pozizira.

Chosankha: Mochenjera, mankhwalawa amasankhidwa kwa odwala omwe ali ndi vuto la ubongo m'mbuyomu malinga ndi mtundu wa ischemic komanso mitundu yayikulu ya matenda a mtima a ischemic. Kufunika kwa insulin kungasinthe mukasinthira mtundu wina wa insulini (mukachotsa insulin ya nyama kuchokera ku Insuman Rapid, mlingo umachepetsedwa), ndikusintha kwa zakudya, kutsegula m'mimba, kusanza, kusintha kwa chizolowezi chochita zolimbitsa thupi, matenda a impso, chiwindi, ndulu ya pituitary, chithokomiro England, kusintha kwa malo a jekeseni. Wodwalayo ayenera kudziwitsidwa za zomwe zimachitika mu vuto la hypoglycemic, za zizindikiro zoyambirira za kukomoka kwa matenda ashuga komanso kufunika kofotokozera dokotala za kusintha kulikonse pamatenda ake.

Insulin "Insuman Rapid GT" ithandizanso kupereka msanga-kuchepetsa msanga mu zochitika zomwe mphindi iliyonse imawerengeka. Kupatula apo, matenda ashuga ndi matenda oopsa omwe nthawi zambiri amachititsa kufa kapena kulumala. Kuti mupeze yankho la panthawi yake, othandizira osasinthika ndi jakisoni wa insulin yofulumira.

Kapangidwe ndi mfundo zowonetsera thupi

Mu 1 ml ya mankhwala muli:

100 IU ya insulin yosungunuka yofanana ndi anthu, omwe amafanana ndi 3,571 mg ya mahomoni amunthu.
Zowonjezera:
- glycerol 85%,
- metacresol
- sodium hydroxide
- hydrochloric acid
- sodium dihydrogen phosphate dihydrate,
- madzi osungunuka.

Mankhwala a hypoglycemic "Insuman Rapid GT" amatanthauza insulin yochepa. Dzinalo Losayenerana Padziko Lonse (INN) -. Akatswiri opanga magesi a Gene adatha kusungunuka kwathunthu, ofanana ndi anthu, insulini. Imakhala ndi njira yochizira, yokhala ndi maola 9. Mphamvu yotsitsa shuga imadziwonekera pakatha mphindi 30, kufikira kufika pachimake, patadutsa maola awiri ndi atatu, kutengera mphamvu ya impso.

Mankhwala amakhudza thupi motere:

Mankhwala amathandizira kupanga glycogen.

amathandiza kuchepetsa shuga
imayambitsa kaphatikizidwe kazakudya,
Imathandizira kukhutitsa maselo amwazi ndi potaziyamu
amaletsa kusweka kwa lipid,
imathandizira njira yosinthira shuga kuchokera ku chakudya chamafuta kukhala mafuta acids,
amakwaniritsa maselo okhala ndi ma amino acid,
kumawonjezera mapangidwe a glycogen,
bwino kugwiritsa ntchito mankhwala omaliza a shuga kagayidwe,
amachepetsa kuchuluka kwa njira za catabolic.

Syringe cholembera "Solostar" yogwiritsidwa ntchito kamodzi ingapangitse kuti magwiritsidwe ntchito a insulin akhale ochepa. Sichitenga nthawi yayitali komanso mosamala kukoka mankhwalawo mu syringe ya insulin: jakisoni yayamba kale jakisoni.

Zizindikiro ndi malangizo ogwiritsa ntchito

Insulin yovomerezeka imasonyezedwa kuti igwiritsidwa ntchito:

odwala omwe amadalira insulin omwe ali ndi matenda a shuga,
pochotsa matenda a hyperglycemic coma ndi kuchiza ketoacidosis,
ngati cholowa pakuthandizira opaleshoni ya matenda ashuga.

Kuti mupeze mankhwala molondola, ndibwino kuti muwerenge malangizo musanawagwiritse ntchito.

Kuti muchepetse kuopsa kwa muyezo wolakwika wa mankhwalawa musanagwiritse ntchito, sikokwanira kungowerenga malangizo oti mugwiritse ntchito. Ndikofunikira kufunsa dokotala ndikuwerengera payekha payekha, zomwe zimatengera zinthu zambiri. Zambiri mwa izo ndi:

kuchuluka kwa zochita zolimbitsa thupi za wodwala,
kakhalidwe
chakudya
jenda, zaka komanso kulemera
kumwa mankhwala ena
kukhalapo kwa matenda osachiritsika.

Tiyenera kudziwa kuti ngati chimodzi mwazina zomwe zalembedwazo zasinthidwa, muyenera kufunsa dokotala kuti mupezenso kuchuluka kwa mankhwalawa. Ngakhale kusintha pang'ono kwa thupi kumatha kubweretsa zotsatirapo zosasangalatsa ngati simusintha mlingo wa insulin nthawi.

Malangizowa ali ndi malangizo onse kwa odwala onse:

Mankhwalawa amaperekedwa pansi pa khungu musanadye kwa mphindi 15-20.
Popewa kutulutsa khungu, ndikofunikira kupaka jakisoni m'malo osiyanasiyana nthawi zonse.
Mtengo wa metabolism ndi pafupifupi 50% ya tsiku lililonse la insulin.
Patsiku, thupi limafunikira insulini ndi 0,5-1.0 IU pa 1 kg yakulemera kwa thupi.
Mankhwalawa amatha kuthandizidwa kudzera mu kuyang'aniridwa ndi madokotala kuchipatala.

Chidule cha Mankhwala Osokoneza bongo

Novorapid ndi m'gulu la mankhwala aposachedwa kwambiri. Mankhwalawa amathandizira kupanga kuperewera kwa mahomoni amunthu, ali ndi mawonekedwe komanso zabwino zingapo pazamankhwala ena amtundu womwewo:

Mwachangu digestibility.
Kuponya shuga msanga.
Kuperewera kwa kudalira zakudya zazosalekeza.
Chiwonetsero cha Ultrashort.
Mafomu otulutsidwa.

Novorapid motsutsana ndi endocrine matenda amapezeka m'malo obweretsera magalasi (Penfill) ndi ma pensulo okonzeka (FlexPen). Gawo la mankhwala omwe ali mumitundu yonseyi kumasulidwa ndi zofanana. Mankhwalawa amaikidwa bwino, ndipo mahomoni enieniwo ndi osavuta kugwiritsa ntchito mu mtundu uliwonse wa mankhwala.

Zophatikizira ndi kapangidwe

Kupanga kwakukulu kwa Novorapid kumawerengeredwa potengera zonse zomwe zimapangidwa ndi 1 ml ya mankhwalawa. The yogwira ndi insulin aspar 100 magawo (pafupifupi 3.5 mg). Pazinthu zothandizira, pali:

Glycerol (mpaka 16 mg).
Metacresol (pafupifupi 1.72 mg).
Zink chloride (mpaka 19.7 mcg).
Sodium chloride (mpaka 0,57 mg).
Sodium hydroxide (mpaka 2.2 mg).
Hydrochloric acid (mpaka 1,7 mg).
Phenol (mpaka 1.5 mg).
Madzi oyeretsedwa (1 ml).

Chida chake ndi yankho lomveka popanda mtundu wotchulidwa, phokoso.

Magazi

Novorapid ali ndi tanthauzo la hypoglycemic chifukwa chachikulu cha insulin. Mtundu wa insulin uwu ndi chithunzi cha mahomoni amfupi aanthu. Thupi limapezeka chifukwa cha njira zosiyanasiyana zaumisiri pamlingo wa DNA yomwe ikubwezeretsanso. Insulin Novorapid amalowa muubwenzi wachilengedwe ndi ma cell receptors, ndikupanga zovuta zingapo zamathero amitsempha.

Mankhwalawa amatha kugwiritsidwa ntchito ngati mtundu uliwonse wa matenda ashuga mwa akulu ndi ana kuyambira zaka 2!

Poyerekeza ndi kuchepa kwa mndandanda wa glycemic, kuwonjezereka kwazowonjezera kwamitsempha yama cell, kuyambitsa kwa mapikidwe a lipogenesis ndi glycogenogeneis, komanso kuwonjezeka kwa mayamwidwe osiyanasiyana a minofu yofewa. Nthawi yomweyo, kupanga shuga ndi ziwindi kumachepetsa. Novorapid imalumikizidwa bwino ndi thupi, imakhala ndi machiritso othamanga kwambiri kuposa insulin yachilengedwe. Maola atatu oyambirira atatha kudya, insulin aspart imachepetsa shuga ya plasma mwachangu kwambiri kuposa insulin yomweyo yaumunthu, koma zotsatira za Novorapid ndizofupikitsa ndi jakisoni wa subcutaneous kuposa kuchokera ku insulin yachilengedwe yopangidwa ndi thupi la munthu.

Analogi ndi ma genetic

Hororapid ya mahomoni ingathe kusinthidwa ndi mankhwala ena a gulu lomweli. Analogs amasankhidwa pokhapokha atamuwunika mozama kuchipatala. Zofananira zazikulu zimaphatikizapo Humalog, Actrapid, Protafan, Gensulin N, Apidra, Novomiks ndi ena. Mtengo wa mahomoni a Novorapid m'malo osiyanasiyana umasiyana 1800 mpaka 2200 phukusi lililonse.

Novomix itha kukhala m'malo mwa Novorapid.

Kufotokozera kwa mahormone

Hormone insulin 3,571 mg (100 IU 100% ya anthu sungunuka).
Metacresol (mpaka 2.7 mg).
Glycerol (pafupifupi 84% = 18.824 mg).
Madzi a jakisoni.
Sodium dihydrogen phosphate dihydrate (pafupifupi 2.1 mg).

Insuman insuman mwachangu gt choyimiriridwa ndi madzi opanda khungu owonekera bwino kwambiri. Ndi m'gulu la othandizirana mwachidule. Insuman siimapanga ngakhale malo osungika nthawi yayitali.

Mankhwala a Pharmacodynamic

Insuman Rapid GT ili ndi mahomoni ofanana mwanjira yofanana ndi mahomoni amunthu. Mankhwalawa amapezeka ndi mainjiniya. Njira zazikuluzikulu za zochita za Insuman ndi monga:

Kutsika kwa m'magazi a m'magazi.
Kuchepetsa njira za catabolic.
Kulimbikitsa kusunthira kwa shuga mkati mwamaselo.
Kuwongolera akuti lepogisis m'magazi a chiwindi.
Kulimbikitsa kulowa kwa potaziyamu.
Kukhazikitsa kwa mapuloteni ndi amino acid.

Insuman Rapid GT Imayamba mwachangu, koma ili ndi nthawi yochepa. Hypoglycemic kwenikweni zimatheka kale theka la ola pambuyo subcutaneous makonzedwe a mankhwala. Zotsatira zimatha mpaka maola 9.

Zotsatira zotsatirazi ziyenera kudziwitsidwa ndikuwonetsa zazikulu:

Matenda a shuga (mtundu wodalira insulin).
Coma pa maziko a matenda ashuga.
Kupita patsogolo ketoacidosis.
Kufunika kokulipitsidwa kwa metabolic (mwachitsanzo, musanachitike kapena pambuyo pa opaleshoni).

Milandu yayikulu ikuphatikiza hypoglycemia kapena chiwopsezo chachikulu cha kuchepa kwambiri kwa shuga m'magazi, matupi awo sagwirizana ndi magawo aliwonse omwe amapangidwa ndi mankhwala, kumva kwambiri.

Popereka mankhwala Insuman Rapid GT adokotala amatenga zifukwa zingapo: zaka, mbiri yakale yachipatala, njira zambiri za matenda ashuga, kupezeka kwa matenda opweteka a ziwalo zamkati ndi ziwonetsero zina za pathologies. Nthawi zina kumwa mankhwala a shuga kumalepheretsa kuyendetsa galimoto kapena kugwira ntchito m'mafakitori owopsa.

Mtengo wapakati wa mankhwalawa m'magawo osiyanasiyana umasiyana 700 mpaka 1300 rubles pa phukusi lililonse.

Mtengo Zimatengera zinthu zambiri zosiyanasiyana.

Mankhwalawa onse ndi omugwiritsa ntchito mwachidule. Kusintha kulikonse kwa mankhwala motsutsana ndi matenda a shuga kumachitika pokhapokha mukaonana ndi katswiri. Insuman Rapid GT imakupatsani mwayi wokhala ndi moyo wabwino wodwalayo pazinthu zosiyanasiyana za matenda ashuga. Novorapid ali ndi katundu wofanana ndi Insuman Rapid GT, koma pafupifupi chimabwereza kwathunthu insulin ya anthu.

Kukonzekera: INSUMAN ® RAPID GT (INSUMAN ® RAPID GT)

Chithandizo chogwira ntchito: munthu wa insulin
Code ya ATX: A10AB01
KFG: Insulin yofulumira ya anthu
Reg. chiwerengero: P N011995 / 01
Tsiku lolembetsa: 03.03.11
Mwini reg. acc.: SANOFI-AVENTIS Deutschland (Germany)

FOMU YA DOSAGE, KULIMA NDI KUSANGALATSA

Yankho la jakisoni zowonekera, zopanda utoto.

Othandizira: metacresol (m-cresol), sodium dihydrogen phosphate dihydrate, glycerol 85%, sodium hydroxide (kusintha pH), hydrochloric acid (kusintha pH), madzi d / i.

3 ml - makatoni amaso amtundu (5) - ma CD a ma CD (1) - makatoni.
3 ml - makatoni amtundu wamagalasi osakhala ndi utoto woyika mu zolembera za SoloStar ® (5) - mapaketi a makatoni.

Yankho la jakisoni zowonekera, zopanda utoto.

Othandizira: metacresol (m-cresol), sodium dihydrogen phosphate dihydrate, glycerol 85%, sodium hydroxide (kusintha pH), hydrochloric acid (kusintha pH), madzi d / i.

Yankho la jakisoni zowonekera, zopanda utoto.

Othandizira: metacresol (m-cresol), sodium dihydrogen phosphate dihydrate, glycerol 85%, sodium hydroxide (kusintha pH), hydrochloric acid (kusintha pH), madzi d / i.

5 ml - mabotolo agalasi lopanda utoto (5) - mapaketi a makatoni.

MALANGIZO OGULITSIRA NTCHITO MALANGIZO.
Kufotokozera za mankhwala omwe adavomerezedwa ndi wopanga mu 2012

Insuman® Rapid GT ilinso ndi insulin yofanana ndi insulin yaumunthu ndipo yopezeka ndi mainjiniya ogwiritsa ntchito K12 kufinya E. Coli. Limagwirira zake insulin:

Amachepetsa kuchuluka kwa shuga m'magazi, amalimbikitsa zotsatira za anabolic komanso amachepetsa zotsatira za catabolic,

Zimawonjezera kuyendetsa shuga mkati mwa maselo ndikupanga glycogen mu minofu ndi chiwindi ndikuwongolera kugwiritsa ntchito pyruvate, tikuletsa glycogenolysis ndi glyconeogeneis,

Kuchulukitsa lipogenesis mu chiwindi ndi adipose minofu ndi ziletsa lipolysis,

Zimalimbikitsa kutulutsa kwa ma amino acid m'maselo ndi kaphatikizidwe wa mapuloteni,

Kuchulukitsa kwa potaziyamu kumaselo.

Insuman® Rapid GT ndi insulini yomwe imayamba mwachangu komanso nthawi yayitali. Pambuyo pa subcutaneous makonzedwe, mphamvu ya hypoglycemic imachitika pakangotha mphindi 30 ndikufika pazokwanira mkati mwa maola 1-4.

Matenda a shuga odwala matenda a insulin

Chithandizo cha matenda ashuga komanso ketoacidosis,

Kukwaniritsa kulipira kwa metabolic kwa odwala omwe ali ndi matenda osokoneza bongo nthawi ya opaleshoni (asanachitike opaleshoni, panthawi ya opaleshoni komanso nthawi ya postoperative).

Cholinga cha shuga m'magazi, kukonzekera kwa insulin komwe kumayenera kugwiritsidwa ntchito, njira ya insulin dosing (mlingo ndi nthawi ya makonzedwe) iyenera kutsimikizika ndikusintha payekhapayekha kuti mugwirizane ndi chakudya, mulingo wakuchita zolimbitsa thupi komanso moyo wa wodwalayo.

Palibe malamulo oyendetsedwa bwino a insulin. Komabe, pafupifupi tsiku lililonse insulin ndi 0,5-1.0 INI pa kilogalamu ya thupi patsiku, ndipo insulin ya anthu yayitali imakhala ndi 40-60% ya kuchuluka kwa insulin tsiku lililonse.

Dokotala amayenera kupereka malangizo ofunikira kuti azindikire kuchuluka kwa shuga m'magazi, komanso apereke malangizo oyenera pazosintha zilizonse m'zakudya kapena muyezo wa insulin.

Mankhwalawa kwambiri hyperglycemia kapena, makamaka ketoacidosis, insulin makonzedwe ndi gawo limodzi la machitidwe azachipatala omwe amaphatikiza njira zoteteza odwala ku zovuta zazikulu chifukwa cha kuchepa kwambiri kwa ndende yamagazi. Malangizo a mankhwalawa amafunika kuwunika mosamalitsa m'chipinda chopangira chisamaliro (kudziwa kagayidwe kazinthu, acid-base olimba ndi electrolyte bwino, kuwunika zofunikira za thupi). Kusintha kuchokera ku mtundu wina wa insulin kupita ku Insuman® Rapid GT

Posamutsa wodwala kuchokera ku mtundu wina wa insulin kupita ku wina, kagwiritsidwe ntchito ka mankhwalawo a insulin: mwina mukasintha kuchokera ku insulin yochokera ku nyama kupita ku insulin yaumunthu, kapena mukasintha njira ina yopangira insulin yaumunthu kupita ku ina. , kuphatikizapo insulin.

Pambuyo pakusintha kuchokera ku insulin yochokera ku nyama kupita ku insulin ya anthu, mwina pangafunike kuchepetsa kuchuluka kwa insulin, makamaka kwa odwala omwe kale anali ndi zovuta zamagazi, odwala omwe ali ndi chizolowezi chokhala ndi hypoglycemia, mwa odwala omwe kale amafuna kuchuluka kwa insulin yayikulu chifukwa cha ndi kukhalapo kwa ma antibodies a insulin. Kufunika kosinthira kwa mlingo (kuchepetsa) kumatha kuchitika mukangosintha mtundu watsopano wa insulin kapena kuyamba pang'onopang'ono milungu ingapo.

Mukasintha kuchokera ku mtundu umodzi wa insulini kupita ku wina ndipo mu masabata oyambilira pambuyo pa kusinthaku, tikulimbikitsidwa kuyang'anitsitsa kuchuluka kwa shuga m'magazi. Odwala omwe amafuna kwambiri Mlingo wa insulin chifukwa cha antibodies, tikulimbikitsidwa kusinthana ndi mtundu wina wa insulin moyang'aniridwa ndi achipatala kuchipatala.

Kusintha kowonjezera kwa insulin

Kuwongolera kagayidwe ka metabolic kumatha kuyambitsa chidwi cha insulini, zomwe zingapangitse kuchepa kwa kufunika kwa insulin.

Kusintha kwa mlingo kungafunikenso ngati:

Zosintha pamlingo wa wodwala,

Kusintha kwamoyo (kuphatikizapo zakudya, kuchuluka kwa zolimbitsa thupi, ndi zina).

Nthawi zina zomwe zimapangitsa kuti chiwopsezo cha hypo- kapena hyperglycemia chidziwike (onani malangizo apadera).

Mlingo wampingo wamagulu apadera odwala

Atokalamba zofunikira za insulini zitha kuchepetsedwa (onani magawo "Mosamala," Malangizo apadera "). Ndikulimbikitsidwa kuti kuyambitsidwa kwa chithandizo, kuyamwa kwa mankhwalawa ndikusankha mankhwalawa kwa odwala okalamba omwe ali ndi matenda osokoneza bongo kuchitike mosamala kuti popewa kukhudzana ndi hypoglycemic.

Odwala ndi hepatic kapena aimpso kulephera zofuna za insulini zitha kuchepetsedwa.

Kupanga kwa Insuman® Rapid GT

Insuman® Rapid GT nthawi zambiri imaperekedwa kwa mphindi 15-20 asanadye chakudya. Tsamba la jakisoni mkati mwa jekeseni lomwelo limayenera kusinthidwa nthawi iliyonse. Kusintha kwa gawo la kayendetsedwe ka insulin (mwachitsanzo, kuyambira pamimba mpaka m'chafu) kuyenera kuchitika pokhapokha mukaonana ndi dokotala, popeza kuyamwa kwa insulini ndipo, zotsatira zake, kutsitsa kuchuluka kwa shuga m'magazi kumatha kusiyanasiyana malinga ndi dera lomwe akukonzekera.

Insuman® Rapid GT imatha kutumikiridwa kudzera m'mitsempha. Intravenous insulin Therapy iyenera kuchitika kuchipatala kapena m'malo omwe kuwunika kofananirako ndi chithandizo kungalandire.

Insuman® Rapid GT sigwiritsidwe ntchito mitundu yosiyanasiyana ya mapampu a insulini (kuphatikizapo mapampu amadzalo) pomwe machubu a silicone amagwiritsidwa ntchito. Osasakaniza Insuman® Rapid GT ndi insulin ya ndende ina, ndi insulin ya nyama, insulin analogs kapena mankhwala ena.

Insuman® Rapid GT ikhoza kusakanizika ndi magulu onse amakono a insulin-aventis. Insuman® Rapid GT siyenera kusakanikirana ndi insulin yomwe cholinga chake amagwiritsidwe ntchito pamapampu a insulin. Kumbukirani kuti kuchuluka kwa insulin m'makonzedwe a Insuman® Rapid GT ndi 100 IU / ml (kwa ma ml 5 kapena ma cartilges a 3 ml), motero ndikofunikira kugwiritsa ntchito syringes zapulasitiki zopangidwira insulin iyi chifukwa chogwiritsa ntchito mbale, kapena ma cholembera a sytiiten a OptiPen Pro1 kapena ClickSTAR ngati mugwiritsa ntchito makatoni. Syringe ya pulasitiki siyenera kukhala ndi mankhwala ena aliwonse kapena zotsalira zake.

Pamaso gawo loyambirira la insulin kuchokera pambale, chotsani pulasitiki (kukhalapo kwa kapuyo ndi umboni wa vial wosatsutsana). Njira yothetsera jakisoni iyenera kukhala yowonekera bwino komanso yopanda utoto, popanda ma tinthu tina akunja.

Asanatenge insulini kuchokera ku vial, mpweya wofanana ndi mankhwala omwe amaperekedwa ndi insulin umayamwa mu syringe ndikujowina mu vial (osalowa madzi). Kenako vala yokhala ndi syringe imasinthidwa mozungulira ndi syringe ndipo kuchuluka kwa insulini kumatengedwa. Pamaso jakisoni, chotsani thovu lakumanzere mu syringe. Khungu limatengedwa pamalo a jakisoni, singano imayikidwa pansi pakhungu, ndipo insulin imayamwa pang'onopang'ono. Pambuyo pa jekeseni, singano imachotsedwa pang'onopang'ono ndipo tsamba lamalowo limakanikizidwa ndi swab ya thonje kwa masekondi angapo. Tsiku lokhala ndi insulin kit kuchokera pa vial iyenera kulembedwa pa cholembera cha vial.

Mutatsegula mabotolo amatha kusungidwa pamtunda osapitirira + 25 ° C kwa milungu 4 m'malo ozizira otetezedwa pakuwala.

Musanalowetse cartridge (100 IU / ml) mu cholembera cha sytiit ya OptiPen Pro1 ndi ClickSTAR, gwiritsani ntchito kwa maola 1-2 kutentha kwa chipinda (jakisoni a insulin yodziwika bwino imapweteka kwambiri). Chotsani zotumphukira zilizonse zamagetsi pamkatikati musanabayidwe (onani Malangizo pakugwiritsa ntchito zolembera za OptiPen Pro1 kapena ClickSTAR syringe).

Katoniyo sanapangire kusakaniza Insuman® Rapid GT ndi ma insulini ena. Makatoni opanda kanthu sangakwaniritsidwe. Pakuswa phala la syringe, mutha kulowa muyezo wofunika kuchokera pa cartridge pogwiritsa ntchito syringe yachizolowezi. Kumbukirani kuti kuchuluka kwa insulini mu cartridge ndi 100 IU / ml, kotero muyenera kugwiritsa ntchito syringes zapulasitiki zopangidwira insulin. Syringe siyenera kukhala ndi mankhwala ena aliwonse kapena zotsalira zake.

Pambuyo kukhazikitsa cartridge, itha kugwiritsidwa ntchito milungu 4. Ndikulimbikitsidwa kusungitsa cholembera ndi makatoni omwe amaikidwa pa kutentha osaposa + 25 ° C pamalo otetezedwa ku kuwala ndi kutentha, koma osati mufiriji (popeza jakisoni wodziwika ndi insulin yovuta kwambiri).

Mukayika makatoni atsopano, yang'anani ntchito yoyenera ya cholembera usanalowe jekeseni woyamba (onani Malangizo Ogwiritsira Ntchito OptiPen Pro1 Syringe Pens kapena ClickSTAR).

Zotsatira zoyipa zimakhudzana ndi kagayidwe kazachilengedwe: Nthawi zambiri - hypoglycemia, yomwe imatha kukhala ngati mlingo wa insulini womwe umathandizidwa upitilira kufunikira kwake (onani "Maupangiri Apadera"). Magawo obwerezabwereza a hypoglycemia angayambitse kukulira kwa minyewa, kuphatikizapo chikomokere (onani gawo "Overdose"). Kukhalitsa kwa nthawi yayitali kapena koopsa kwa hypoglycemia kumatha kukhala pachiwopsezo cha moyo.

Odwala ambiri, zizindikiro ndi mawonekedwe a neuroglycopenia atha kukhala patsogolo ndi zizindikiro za Reflex (poyankha kukulitsa hypoglycemia) kutsegulira kwa mtima wamanjenje. Nthawi zambiri, ndi kuchepa kwambiri kapena kuchepa msanga kwa kuchuluka kwa shuga m'magazi, chodabwitsa cha kutseguka kwa mphamvu yamanjenje yomvera chisoni ndikuonetsa zizindikiro zake.

Ndi kuchepa kwakukulu kwa kuchuluka kwa shuga m'magazi, kukulitsa kwa hypokalemia (zovuta kuchokera ku mtima) kapena kukula kwa edema ya ubongo.

Otsatirawa ndi zochitika zoyipa zomwe zimayesedwa m'mayesero azachipatala omwe amatsatiridwa ndi magulu opatsirana mwatsatanetsatane komanso kuchepa kwa zochitika: kawiri kawiri (> 1/10), pafupipafupi (> 1/100 ndi 1/1000 ndi 1/10000 ndi CONTRAINDICATIONS

Hypersensitivity zimachitika ndi insulin kapena chilichonse chothandiza cha mankhwalawa.

Ndi chisamaliro Mankhwala ayenera kugwiritsidwa ntchito ngati aimpso kulephera (kuchepa kwa insulin chifukwa kuchepa kwa insulin metabolism ndikotheka), mwa okalamba (kuchepa kwapang'onopang'ono kwa ntchito ya impso kungayambitse kuchepa kwakukulu kwa kufunika kwa insulin), mwa odwala omwe ali ndi vuto la insulin chifukwa kuchepa kwa kuthekera kwa gluconeogeneis ndi kuchepa kwa insulin kagayidwe kachakudya, odwala omwe ali ndi vuto lalikulu la matenda amitsempha yamagazi ndi matenda a m'magazi (hypoglycemic epi Zodiachi imatha kukhala ndi vuto lapadera lachipatala, popeza pali chiopsezo cha mtima kapena matenda a mtima (hypoglycemia) mwa odwala omwe ali ndi proliferative retinopathy (makamaka omwe sanalandire chithandizo ndi photocoagulation (laser therapy), popeza ali ndi chiopsezo chocheperapo kapenaurosis yokhala ndi hypoglycemia - khungu lathunthu - Odwala omwe ali ndi matenda ophatikizana (popeza matenda omwe nthawi zonse amakumana nawo amafunikira kufunika kwa insulin).

KULAMBIRA NDI KUDZIPEREKA

Chithandizo cha Insuman® Rapid GT panthawi yoyembekezera ziyenera kupitilizidwa. Insulin siyidutsa chotchinga. Kusunga moyenera kagayidwe kazakudya panthawi yonse yoyembekezera ndikovomerezeka kwa azimayi omwe ali ndi matenda ashuga asanabadwe, kapena amayi omwe apanga matenda a shuga.

Kufunika kwa insulin panthawi yapakati kumatha kuchepa panthawi yayitali ya kubereka ndipo nthawi zambiri kumawonjezeka panthawi yachiwiri komanso yachitatu ya kutenga pakati. Pambuyo pobadwa, insulini ikucheperachepera (chiwopsezo cha hypoglycemia). Pa nthawi ya pakati komanso makamaka mukabereka mwana, kuwunika mosamala kuchuluka kwa shuga m'magazi kumafunika.

Panthawi yoyamwitsa, palibe zoletsa pazotsatira za insulin, komabe, Mlingo wa insulin komanso kusintha kwa zakudya kungafunike.

Popeza kuperekera kwa munthawi yomweyo mankhwala angapo (onani gawo la "Kuyanjana ndi Mankhwala Ena") kungafooketse kapena kukulitsa mphamvu ya hypoglycemic ya mankhwala a Insuman® Rapid GT, palibe mankhwala ena omwe ayenera kumwedwa pakugwiritsidwa ntchito kwake popanda chilolezo chadokotala.

Hypoglycemia imachitika ngati mlingo wa insulini uposa kufunika kwake. Chiwopsezo cha kukhala ndi hypoglycemia ndi chachikulu pamayambiriro a chithandizo cha insulin, mukasinthira kukonzekera kwina kwa insulin, mwa odwala omwe ali ndi shuga yayitali m'magazi.

Monga ndi ma insulin onse, chisamaliro chapadera chiyenera kutengedwa ndikuwunika kwambiri kuchuluka kwa shuga m'magazi omwe odwala hypoglycemic episode angakhale ndi vuto lapadera la matenda, monga odwala omwe ali ndi vuto lalikulu la mitsempha kapena matenda a mitsempha (chiwopsezo cha mtima kapena matenda a m'magazi a hypoglycemia), akulimbikitsidwa. , komanso odwala omwe ali ndi proliferative retinopathy, makamaka ngati sanachite nawo mankhwala opatsirana pogwiritsa ntchito mankhwala a laser, popeza ali ndi chiopsezo chocheperako amaurosis (kwathunthu khungu) ndi chitukuko cha hypoglycemia.

Pali zisonyezo zina zamankhwala ndizizindikiro zomwe zimayenera kuwonetsa kwa wodwala kapena ena za kukhala ndi hypoglycemia.Izi zimaphatikizapo thukuta lomwe limakulirakulira, chinyezi pakhungu, tachycardia, kusokonezeka kwa mtima, kuchuluka kwa magazi, kupweteka pachifuwa, kunjenjemera, nkhawa, njala, kugona, kusokonezeka kwa tulo, mantha, kukhumudwa, kusazolowereka, zosadziwika bwino, nkhawa, paresthesia mkamwa ndi kuzungulira pakamwa, kutsekeka kwa khungu, kupweteka mutu, kusokonekera kwa kayendedwe ka kayendedwe, komanso kuchepa kwa minyewa yamitsempha yamagazi (kufooka kwa mawu ndi masomphenya, zizindikiro zakuwala) ndi zomveka zachilendo. Ndi kuchepa kwakukulu kwa ndende ya glucose, wodwalayo amatha kulephera kudziletsa ngakhalenso kuzindikira. Zikatero, kuzizira ndi chinyezi pakhungu kumatha kuonedwa, ndipo kupweteka kumawonekeranso.

Chifukwa chake, wodwala aliyense yemwe ali ndi matenda a shuga omwe amalandila insulin ayenera kuphunzira kuzindikira zizindikiro zomwe ndi chizindikiro cha kukhala ndi hypoglycemia. Odwala omwe nthawi zonse amayang'anira kuchuluka kwa shuga m'magazi samatha kukhala ndi hypoglycemia. Wodwalayo amatha kuwongolera kuchepa kwa kuchuluka kwa shuga m'magazi ake mwa kuthira shuga kapena zakudya zamafuta ambiri. Pazifukwa izi, wodwalayo ayenera kukhala ndi 20 g shuga nthawi zonse. Mokulira kwambiri kwa hypoglycemia, jakisoni wokhazikika wa glucagon akuwonetsedwa (omwe angathe kuchitidwa ndi dokotala kapena antchito oyamwitsa). Pambuyo pakusintha kokwanira, wodwalayo ayenera kudya. Ngati hypoglycemia singathetsedwe mwachangu, ndiye kuti dokotala akuyenera kuyitanidwa mwachangu. Ndikofunikira kudziwitsa dokotala mwachangu za kukula kwa hypoglycemia, kotero kuti apange lingaliro pakufunika kusintha kwa insulin. Kulephera kutsatira zakudya, kudumphira jakisoni wa insulin, kuchuluka kwa insulini chifukwa cha matenda opatsirana kapena matenda ena, komanso kuchepa kwa zochitika zolimbitsa thupi kungapangitse kuwonjezeka kwa ndende yamagazi (hyperglycemia), mwina ndi kuchuluka kwa matupi a ketone m'magazi (ketoacidosis). Ketoacidosis imatha kumatha maola ochepa kapena masiku. Pazizindikiro zoyambirira za metabolic acidosis (ludzu, kukodza pafupipafupi, kulephera kudya, kutopa, khungu lowuma, kupuma kwambiri komanso kuthamanga, chidwi cha acetone ndi glucose mkodzo), chithandizo chamankhwala chofunikira ndichofunikira.

Pakusintha dokotala (mwachitsanzo, nthawi yakuchipatala chifukwa cha ngozi, kudwala panthawi ya tchuthi), wodwalayo ayenera kudziwitsa dokotala kuti ali ndi matenda ashuga.

Odwala ayenera kuchenjezedwa za mikhalidwe yomwe ingasinthe, osatchulidwanso kapena kuchenjeza zizindikiro zosapezekeratu pakukula kwa hypoglycemia, mwachitsanzo:

Kusintha kwakukulu pakayendetsedwe ka glycemic,

Ndi kukula kwapang'onopang'ono kwa hypoglycemia,

Odwala okalamba,

Odwala omwe ali ndi vuto la neuronomic,

Odwala omwe ali ndi mbiri yayitali ya matenda ashuga,

Odwala omwe amalandira chithandizo nthawi yomweyo ndi mankhwala ena (onani gawo "Kuyanjana ndi mankhwala ena). Zochitika zoterezi zimatha kuyambitsa kukula kwa hypoglycemia (komanso kutayika kwa magazi) wodwalayo asanadziwe kuti akupanga hypoglycemia.

Ngati ma glycosylated hemoglobin apezeka bwino, muyenera kuganiziranso kuti mungathe kukhala ndi gawo la hypoglycemia lomwe limachitika mobwerezabwereza.

Kuchepetsa chiopsezo cha hypoglycemia, wodwalayo ayenera kutsatira mosamala mlingo woyenera ndi zakudya zopatsa thanzi, kupereka jakisoni wa insulin, ndikuwachenjezedwa za zizindikiro za kukhala ndi hypoglycemia.

Zinthu zomwe zimawonjezera kutsimikizira kwa chitukuko cha hypoglycemia zimafuna kuwunikira mosamala ndipo zingafune kusintha kwa mlingo. Izi ndi monga:

Kusintha kwa dera la kayendetsedwe ka insulin,

Kuchuluka kwa insulin (mwachitsanzo kuchotsa zinthu zopsinjika),

Zosazolowereka (zowonjezera kapena zolimbitsa thupi nthawi yayitali),

Matenda amkati (kusanza, kutsegula m'mimba),

Zakudya zokwanira

Kudumpha chakudya

Matenda ena a insocrine osawerengeka (monga hypothyroidism ndi anterior pituitary insufficiency kapena adrenal cortex insuffence),

Kugwiritsa ntchito pamodzi mankhwala ena (onani gawo "Kuyanjana ndi mankhwala ena").

Pa matenda apawiri, kuyendetsa kagayidwe kolimba kumafunika. Nthawi zambiri, kuyesedwa kwa mkodzo kukhalapo kwa matupi a ketone kumasonyezedwa, ndikusintha kwa insulin nthawi zambiri ndikofunikira. Kufunika kwa insulin nthawi zambiri kumachuluka. Odwala omwe ali ndi matenda amtundu wa 1 ayenera kupitiliratu kudya pang'ono, ngakhale atangomaliza kudya pang'onopang'ono kapena kusanza, ndipo sayenera konse kusiya kuyang'anira insulin.

Zotsatira zamtanda

Mwa kuchuluka kwakukulu kwa odwala omwe ali ndi hypersensitivity kupita ku insulin ya nyama, ndizovuta kusinthira kwa insulin yaumunthu chifukwa cha mtanda wa immunological wa insulini ya anthu ndi insulin yochokera nyama. Ndi chidwi chowonjezeka cha wodwalayo kuti apange insulin yakuchokera kwa nyama, komanso m-cresol, kulekerera kwa mankhwala a Insuman® Rapid GT kuyenera kuwunikiridwa kuchipatala pogwiritsa ntchito mayeso a intradermal. Ngati mayeso a intradermal awonetsa kuchuluka kwa insulin ya munthu (zomwe zimachitika mwachangu ngati Arthus), ndiye kuti chithandizo china chikuyenera kuchitika moyang'aniridwa ndi achipatala.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Mphamvu ya wodwalayo yokhazikika komanso kuthamanga kwa zochitika zama psychomotor zimatha kuwonongeka chifukwa cha hypoglycemia kapena hyperglycemia, komanso chifukwa chododometsa. Izi zimatha kukhala pachiwopsezo china chake munthawi yomwe maluso amafunikira (magalimoto oyendetsa kapena njira zina). Odwala ayenera kulangizidwa kuti asamale komanso kupewa hypoglycemia poyendetsa. Izi ndizofunikira kwambiri kwa odwala omwe achepetsa kapena kusazindikira zizindikiro zomwe zikuwonetsa kukula kwa hypoglycemia, kapena okhala ndi zochitika zapafupipafupi za hypoglycemia. Mwa odwalawa, funso loti akhoza kuwayendetsa ndi magalimoto kapena njira zina ayenera kusankha payekha.

Kugwiritsa ntchito kwambiri insulin, monga kupereka insulin yochulukirapo kuyerekeza ndi chakudya kapena mphamvu, kumatha kudzetsa matenda oopsa komanso obwera kwa nthawi yayitali.

Chithandizo: Zochitika zofatsa za hypoglycemia (wodwalayo amadziwa) zitha kuyimitsidwa ndikutenga chakudya mkati. Pangakhale kofunikira kusintha mtundu wa insulin, kudya zakudya ndi zochita zolimbitsa thupi.

Ziwonetsero zoopsa za hypoglycemia ndi chikomokere, kukomoka kapena kuchepa kwa mitsempha zimatha kuyimitsidwa ndi kutsekeka kapena kulowereratu kwa glucagon kapena kulowererapo kwa njira yokhazikika ya dextrose. Mu ana, kuchuluka kwa dextrose kutumikiridwa kumayikidwa molingana ndi kulemera kwa thupi la mwana. Pambuyo pakuwonjezera kuchuluka kwa shuga m'magazi, kuthandizira kudya zakudya zamagulu ndi kuwunika kungafunike, popeza pambuyo poti kuchipatala chithetsa zizindikiro za hypoglycemia, kukhazikikanso kwake ndikotheka. Mlandu wa hypoglycemia wowopsa kapena wotalika potsatira jakisoni wa glucagon kapena dextrose, tikulimbikitsidwa kuti kulowetsedwa kuchitike ndi yankho lozama la dextrose pofuna kupewa kukonzanso kwa hypoglycemia.Mu ana aang'ono, ndikofunikira kuyang'anitsitsa kuchuluka kwa shuga m'magazi, molingana ndi chitukuko chachikulu cha hyperglycemia.

Kugwiritsira ntchito mosiyanasiyana ndi othandizira pakamwa a hypoglycemic, angiotensin kutembenuza ma enzyme inhibitors, disopyramide, fibrate, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, propoxyphene, salicylates, amphetamine, anabolic steroids ndi abambo phenylphosphamphometrate, hemclophosphinometrate, hemclophosphometormin, hemocorhlometromu, hosphorphormines. , somatostatin ndi mawonekedwe ake, sulfonamides, tetracyclines, tritocqualin kapena trophosphamide l hypoglycemic zotsatira za insulin ndikuwonjezera kutengera kwa chitukuko cha hypoglycemia.

The ntchito kuphatikiza a corticotropin, corticosteroids, danazol, diazoxide, okodzetsa, glucagon, isoniazid, estrogens ndi progestogens (monga kupezeka mu kulera zosiyanasiyanazi kuphatikiza), opangidwa kuchokera phenothiazine, kukula timadzi, mankhwala sympathomimetic (mwachitsanzo, wa epinephrine, salbutamol, terbutaline), chithokomiro timadzi, barbiturates, nicotinic acid, phenolphthalein, phenytoin zotumphukira, doxazosin akhoza kufooketsa hypoglycemic zotsatira za insulin.

Beta-blockers, clonidine, mchere wa lithiamu ukhoza kukhala wowonjezera kapena kufooketsa mphamvu ya hypoglycemic ya insulin.

Ethanol imatha kukhala yothandiza kapena kufooketsa mphamvu ya insulin. Kudya kwa Ethanol kumatha kuyambitsa hypoglycemia kapena kuchepetsa shuga wambiri m'magazi kuti akhale owopsa. Kulekerera kwa Ethanol mwa odwala omwe amalandira insulin kumachepetsedwa. Mitundu yovomerezeka ya zakumwa ziyenera kutsimikiziridwa ndi dokotala.

Ndi munthawi yomweyo makonzedwe a pentamidine, kukula kwa hypoglycemia ndikotheka, komwe nthawi zina kumatha kukhala hyperglycemia.

Mukaphatikizidwa ndi othandizira achifundo, monga beta-blockers, clonidine, guanethidine ndi reserpine, kufooka kapena kusakhalapo kwa zizindikiro za Reflex (poyankha hypoglycemia) kutsegulira kwamanjenje kwamanjenje kumatha.

PHARMACY HOLIDAY MALANGIZO

MITU YA NKHANI NDI ZOTHANDIZA ZA STORAGE

Kusunga pamalo otetezedwa kuchokera ku kuwala, malowa, osapezeka kwa ana, pamtunda wa 2 ° C mpaka 8 ° C. Osamawuma.

Moyo wa alumali ndi zaka 2. Osagwiritsa ntchito tsiku lotha ntchito likusonyezedwa pa phukusi.

Wamtundu waifupi insulin

Kutulutsa mawonekedwe, kapangidwe kake ndi ma CD

Yankho la jakisoni zowonekera, zopanda utoto.

Othandizira: metacresol (m-cresol) - 2.7 mg, sodium dihydrogen phosphate dihydrate - 2.1 mg, glycerol 85% - 18.824 mg, sodium hydroxide (kusintha pH) - 0,576 mg, hydrochloric acid (kusintha pH) - 0,232 mg, madzi d / i - mpaka 1 ml.

3 ml - makatoni amaso amtundu (5) - ma CD a ma CD (1) - makatoni.
3 ml - makatoni amtundu osavala magalasi okhala ndi zolembera za SoloStar zotayira (5) - makatoni.
5 ml - mabotolo agalasi lopanda utoto (5) - mapaketi a makatoni.

Zotsatira za pharmacological

Hypoglycemic mankhwala, osakhalitsa insulin. Insuman Rapid GT ilinso ndi insulin yofanana ndi insulin yaumunthu ndipo yoyambitsidwa ndi genetic engineering pogwiritsa ntchito K12 kufinya E. coli.

Insulin imachepetsa ndende ya magazi, imalimbikitsa zotsatira za anabolic ndikuchepetsa zotsatira za catabolic. Imawonjezera mayendedwe a glucose mkati mwa maselo ndi mapangidwe a glycogen mu minofu ndi chiwindi, imathandizira kugwiritsa ntchito pyruvate, ndipo imalepheretsa glycogenolysis ndi glyconeogeneis. Insulin imakulitsa lipogenesis mu chiwindi ndi minofu ya adipose ndikuletsa lipolysis. Zimathandizira kutuluka kwa ma amino acid m'maselo ndi kaphatikizidwe wa mapuloteni, kumapangitsa kuti potaziyamu ayambe kuyenda.

Insuman Rapid GT ndi insulin yomwe imayamba mwachangu komanso yotalikilapo nthawi yochitapo kanthu.Pambuyo pa utsogoleri wa sc, mphamvu ya hypoglycemic imachitika pakangotha mphindi 30, ikafika pazowonjezereka mu maola 1-4, imapitilira maola 7- 7.

Pharmacokinetics

Zambiri za pharmacokinetics za mankhwala a Insuman Rapid GT siziperekedwa.

- matenda a shuga omwe amafunikira chithandizo cha insulin,

- mankhwala a matenda ashuga komanso ketoacidosis,

- kukwaniritsidwa kwa metabolic kulipidwa mwa odwala omwe ali ndi matenda osokoneza bongo nthawi ya opaleshoni (asanachitidwe opaleshoni, panthawi ya opaleshoni komanso nthawi ya postoperative).

Zomwe Mungagwiritse Ntchito:

Ngati vuto la glycemic likulephera kapena ngati matendawa ali ndi vuto la hyper- kapena hypoglycemia, musanaganize zosintha muyezo wa insulin, onetsetsani kuti mwalamulira insulin, onetsetsani kuti insulini idalowa mu malo omwe akutsimikiziridwa, yang'anani kulondola kwa njira ya jakisoni ndi zina zonse zomwe zingakhudze zotsatira za insulin.
Popeza kuperekera kwa munthawi yomweyo mankhwala angapo (onani gawo la "Kuyanjana ndi Mankhwala Ena") kungafooketse kapena kukulitsa mphamvu ya hypoglycemic ya mankhwala a Insuman® Rapid GT, palibe mankhwala ena omwe ayenera kumwedwa pakugwiritsidwa ntchito kwake popanda chilolezo chadokotala.
Hypoglycemia imachitika ngati mlingo wa insulini uposa kufunika kwake. Chiwopsezo cha kukhala ndi hypoglycemia ndi chachikulu pamayambiriro a chithandizo cha insulin, mukasinthira kukonzekera kwina kwa insulin, mwa odwala omwe ali ndi shuga yayitali m'magazi.
Monga ndi ma insulin onse, chisamaliro chapadera chiyenera kutengedwa ndikuwunika kwambiri kuchuluka kwa shuga m'magazi omwe odwala hypoglycemic episode angakhale ndi vuto lapadera la matenda, monga odwala omwe ali ndi vuto lalikulu la mitsempha kapena matenda a mitsempha (chiwopsezo cha mtima kapena matenda a m'magazi a hypoglycemia), akulimbikitsidwa. , komanso odwala omwe ali ndi proliferative retinopathy, makamaka ngati sanachite nawo mankhwala opatsirana pogwiritsa ntchito mankhwala a laser, popeza ali ndi chiopsezo chocheperako amaurosis (kwathunthu khungu) ndi chitukuko cha hypoglycemia.
Pali zisonyezo zina zamankhwala ndizizindikiro zomwe zimayenera kuwonetsa kwa wodwala kapena ena za kukhala ndi hypoglycemia. Izi zikuphatikiza: thukuta kwambiri, chinyezi pakhungu, kusokonezeka kwa mtima, kuchuluka kwa magazi, kupweteka pachifuwa, nkhawa, njala, kugona, mantha, kusokonekera, chikhalidwe chosadziwika, nkhawa, paresthesia mkamwa komanso kuzungulira pakamwa, pakhungu pakhungu. , kusokonezeka kwa kayendedwe ka kayendedwe ka kayendedwe, komanso kuchepa kwa minyewa yamitsempha yamagetsi (malankhulidwe owoneka ndi masomphenya, zizindikiro zakufa) ndi zomveka zachilendo. Ndi kuchepa kwakukulu kwa ndende ya glucose, wodwalayo amatha kulephera kudziletsa ngakhalenso kuzindikira. Zikatero, kuzizira ndi chinyezi pakhungu kumatha kuonedwa, komanso kuoneke.
Chifukwa chake, wodwala aliyense yemwe ali ndi matenda a shuga omwe amalandila insulin ayenera kuphunzira kuzindikira zizindikiro zomwe ndi chizindikiro cha kukhala ndi hypoglycemia. Odwala omwe nthawi zonse amayang'anira kuchuluka kwa shuga m'magazi samatha kukhala ndi hypoglycemia. Wodwalayo amatha kuwongolera kuchepa kwa kuchuluka kwa shuga m'magazi ake mwa kuthira shuga kapena zakudya zamafuta ambiri. Pazifukwa izi, wodwalayo ayenera kukhala ndi 20 g shuga nthawi zonse. Mokulira kwambiri kwa hypoglycemia, jakisoni wokhazikika wa glucagon akuwonetsedwa (omwe angathe kuchitidwa ndi dokotala kapena antchito oyamwitsa). Pambuyo pakusintha kokwanira, wodwalayo ayenera kudya. Ngati hypoglycemia singathetsedwe mwachangu, ndiye kuti dokotala akuyenera kuyitanidwa mwachangu. Ndikofunikira kudziwitsa dokotala mwachangu za kukula kwa hypoglycemia kuti apange chisankho pakufunika kusintha kwa insulin.Kulephera kutsatira zakudya, kudumphira jakisoni wa insulin, kuchuluka kwa insulini chifukwa cha matenda opatsirana kapena matenda ena, komanso kuchepa kwa zochitika zolimbitsa thupi kungapangitse kuwonjezeka kwa ndende yamagazi (hyperglycemia), mwina ndi kuchuluka kwa matupi a ketone m'magazi (ketoacidosis). Ketoacidosis imatha kumatha maola ochepa kapena masiku. Pazizindikiro zoyambirira (ludzu, kukodza pafupipafupi, kulephera kudya, kutopa, khungu louma, kupumira mwamphamvu komanso kuthamanga, kuthamanga kwamatumbo ndi glucose mu mkodzo), chithandizo chamankhwala chofunikira ndichofunikira.
Pakusintha dokotala (mwachitsanzo, nthawi yakuchipatala chifukwa cha ngozi, kudwala panthawi yopuma), wodwalayo ayenera kudziwitsa dokotala zomwe ali nazo.
Odwala ayenera kuchenjezedwa za mikhalidwe yomwe ingasinthe, osatchulidwanso kapena kuchenjeza zizindikiro zosapezekeratu pakukula kwa hypoglycemia, mwachitsanzo:
- ndi kusintha kwakukulu pakulamulira kwa glycemic,
- ndi kufalikira pang'onopang'ono kwa hypoglycemia,
- odwala okalamba,
- odwala omwe ali ndi vuto la neuronomic,
- odwala omwe ali ndi matenda a shuga,
- odwala nthawi yomweyo amalandila chithandizo ndi mankhwala ena (onani gawo "Kuyanjana ndi mankhwala ena). Zochitika zoterezi zimatha kuyambitsa kukula kwa hypoglycemia (komanso kutayika kwa magazi) wodwalayo asanadziwe kuti akupanga hypoglycemia.
Ngati ma glycosylated hemoglobin apezeka bwino, muyenera kuganiziranso kuti mungathe kukhala ndi gawo la hypoglycemia lomwe limachitika mobwerezabwereza.
Kuchepetsa chiopsezo cha hypoglycemia, wodwalayo ayenera kutsatira mosamala mlingo woyenera ndi zakudya zopatsa thanzi, kupereka jakisoni wa insulin, ndikuwachenjezedwa za zizindikiro za kukhala ndi hypoglycemia.
Zinthu zomwe zimawonjezera kutsimikizira kwa chitukuko cha hypoglycemia zimafuna kuwunikira mosamala ndipo zingafune kusintha kwa mlingo. Izi ndi monga:
- kusintha m'dera loyang'anira insulin,
- kuchuluka kwa chidwi ndi insulin (mwachitsanzo, kuchotsa kwa zopsinjika),
- zachilendo (kuchuluka kapena zolimbitsa thupi nthawi yayitali),
- matenda amiseche (kusanza,),
- Zakudya zokwanira
- kudumpha chakudya,
- mowa,
- matenda ena a uncocrensated endocrine (monga kuchepa kwa anterior pituitary kapena kusakwanira kwa adrenal cortex),
- kugwiritsa ntchito munthawi yomweyo mankhwala ena (onani gawo "Kuyanjana ndi mankhwala ena"). Matenda apakati
Pa matenda apawiri, kuyendetsa kagayidwe kolimba kumafunika. Nthawi zambiri, kuyesedwa kwa mkodzo kukhalapo kwa matupi a ketone kumasonyezedwa, ndikusintha kwa insulin nthawi zambiri ndikofunikira. Kufunika kwa insulin nthawi zambiri kumachuluka. Odwala omwe ali ndi matenda amtundu wa 1 ayenera kupitiliratu kudya pang'ono, ngakhale atangomaliza kudya pang'ono kapena ngati ali ndi imodzi, ndipo sayenera kusiya kumwa mankhwala a insulin. Zotsatira zamtanda
Mwa kuchuluka kwakukulu kwa odwala omwe ali ndi hypersensitivity kupita ku insulin ya nyama, ndizovuta kusinthira kwa insulin yaumunthu chifukwa cha mtanda wa immunological wa insulini ya anthu ndi insulin yochokera nyama. Ndi chidwi chowonjezeka cha wodwalayo kuti apange insulin yakuchokera kwa nyama, komanso m-cresol, kulekerera kwa mankhwala a Insuman® Rapid GT kuyenera kuwunikiridwa kuchipatala pogwiritsa ntchito mayeso a intradermal.Ngati pakuyesedwa kwa insulin ya insulin ya munthu kumadziwika, zotsatira zake, monga Arthus, ndiye kuti chithandizo china chikuyenera kuyang'aniridwa ndi achipatala.
Zokhudza mphamvu pakuyendetsa magalimoto kapena njila zina
Kuchita kwa wodwalayo chidwi komanso kuthamanga kwa zochitika zama psychomotor zitha kufooketsedwa ndi hypoglycemia kapena, komanso kusokonezeka kowoneka. Izi zimatha kukhala pachiwopsezo china chake munthawi yomwe maluso amafunikira (magalimoto oyendetsa kapena njira zina).
Odwala ayenera kulangizidwa kuti asamale komanso kupewa hypoglycemia poyendetsa. Izi ndizofunikira kwambiri kwa odwala omwe achepetsa kapena kusazindikira zizindikiro zomwe zikuwonetsa kukula kwa hypoglycemia, kapena okhala ndi zochitika zapafupipafupi za hypoglycemia. Mwa odwalawa, funso loti akhoza kuwayendetsa ndi magalimoto kapena njira zina ayenera kusankha payekha.

Mogwirizana ndi mankhwala ena:

Kuthandizirana ndi othandizira a hypoglycemic operekera pakamwa, angiotensin-kutembenuza ma enzyme zoletsa, disopyramide, fibrate, fluoxetine, monoamine oxidase inhibitors,
pentoxifylline, propoxyphene, salicylates, amphetamine, anabolic steroids ndi mahomoni ogonana amuna, cybenzoline, cyclophosphamide, fenfluramine, guanethidine, ifosfamide, phenoxybenzamine, phentolamine, somatostatin ndi tetroformonilamideam, soproformonitamideam, soproformonitamideam, soproformonitamideam, soproformonitamideam, soproformonamonam kukula kwa hypoglycemia.
The ntchito kuphatikiza a corticotropin, corticosteroids, danazol, diazoxide, okodzetsa, glucagon, isoniazid, estrogens ndi progestogens (monga kupezeka mu kulera zosiyanasiyanazi kuphatikiza), opangidwa kuchokera phenothiazine, kukula timadzi, mankhwala sympathomimetic (mwachitsanzo, wa epinephrine, salbutamol, terbutaline), chithokomiro timadzi, barbiturates, nicotinic acid, phenolphthalein, phenytoin zotumphukira, doxazosin akhoza kufooketsa hypoglycemic zotsatira za insulin.
Beta-blockers, clonidine, mchere wa lithiamu ukhoza kukhala wowonjezera kapena kufooketsa mphamvu ya hypoglycemic ya insulin.
Ndi Mowa
Ethanol imatha kukhala yothandiza kapena kufooketsa mphamvu ya insulin. Kudya kwa Ethanol kumatha kuyambitsa hypoglycemia kapena kuchepetsa shuga wambiri m'magazi kuti akhale owopsa. Kulekerera kwa Ethanol mwa odwala omwe amalandira insulin kumachepetsedwa. Mitundu yovomerezeka ya zakumwa ziyenera kutsimikiziridwa ndi dokotala. Ndi pentamidine
Ndi makonzedwe munthawi yomweyo, kukulitsa kwa hypoglycemia ndikotheka, komwe nthawi zina kumatha kukhala hyperglycemia.
Mukaphatikizidwa ndi othandizira achifundo, monga beta-blockers, clonidine, guanethidine ndi reserpine, kufooka kapena kusakhalapo kwa zizindikiro za Reflex (poyankha hypoglycemia) kutsegulira kwamanjenje kwamanjenje kumatha.

Bongo

Zizindikiro
Mankhwala osokoneza bongo kwambiri a insulin, monga kuphatikiza insulin yochulukirapo poyerekeza ndi chakudya kapena mphamvu zamagetsi, imatha kuyambitsa hypoglycemia yayitali komanso nthawi yayitali.
Zochitika zofatsa za hypoglycemia (wodwalayo amadziwa) zitha kuyimitsidwa ndikutenga chakudya mkati. Pangakhale kofunikira kusintha mtundu wa insulin, kudya zakudya ndi zochita zolimbitsa thupi.
Ziwonetsero zoopsa za hypoglycemia ndi chikomokere, kukomoka kapena kuchepa kwa mitsempha zimatha kuyimitsidwa ndi kutsekeka kapena kulowereratu kwa glucagon kapena kulowererapo kwa njira yokhazikika ya dextrose.Mu ana, kuchuluka kwa dextrose kutumikiridwa kumayikidwa molingana ndi kulemera kwa thupi la mwana. Pambuyo pakuwonjezera kuchuluka kwa shuga m'magazi, kuthandizira kudya zakudya zamagulu ndi kuwunika kungafunike, popeza pambuyo poti kuchipatala chithetsa zizindikiro za hypoglycemia, kukhazikikanso kwake ndikotheka. Mlandu wa hypoglycemia wowopsa kapena wotalika potsatira jakisoni wa glucagon kapena dextrose, tikulimbikitsidwa kuti kulowetsedwa kuchitike ndi yankho lozama la dextrose pofuna kupewa kukonzanso kwa hypoglycemia. Mu ana aang'ono, ndikofunikira kuyang'anitsitsa kuchuluka kwa shuga m'magazi, molingana ndi chitukuko chachikulu cha hyperglycemia.
Pazinthu zina, ndikulimbikitsidwa kuti odwala azigonekedwa m'chipinda cha odwala osamala kwambiri kuti athe kuwonetsetsa momwe aliri.

Malo opumulira:

Njira yothetsera jakisoni 100 IU / ml.
5 ml ya mankhwalawa mu botolo la galasi looneka komanso lopanda utoto (mtundu I). Botolo limapangidwa m'maso, limafinya ndi chipewa cha aluminium ndikutchinga ndi kapu ya pulasitiki yoteteza. Mbale 5 yokhala ndi malangizo ogwiritsira ntchito pabokosi lamakatoni. 3 ml ya mankhwalawa mu katoni yamagalasi oyera ndi opanda khungu (mtundu I). Katirijiyo amakhazikika mbali imodzi ndi nkhata ndipo imamizidwa ndi kapu ya aluminiyamu, mbali inayo - ndi phula. Makatoni asanu pazinthu zilizonse za filimu ya PVC ndi zojambulazo. Mzere umodzi wa blister pamodzi ndi malangizo ogwiritsira ntchito pabokosi la makatoni.
3 ml ya mankhwalawa mu katoni yamagalasi oyera ndi opanda khungu (mtundu I). Katirijiyo amakhazikika mbali imodzi ndi nkhata ndipo imamizidwa ndi kapu ya aluminiyamu, mbali inayo - ndi phula. Makatoni amaikamo cholembera cha SoloStar®. Pa 5 SoloStar sy syringe pensulo limodzi ndi malangizo ogwiritsira ntchito pakatoni.

Chikhumbo cha munthu chokhala ndi moyo wathanzi, kuletsa kugwiritsa ntchito zinthu zovulaza, kuchita masewera olimbitsa thupi komanso kusapezeka kwa zizolowezi zoyipa ndizofunikira kwambiri kuti pakhale thanzi laumunthu nthawi zambiri. Komabe, nthawi zina, mosiyana ndi malingaliro aliwonse, munthu amene amagwiritsa ntchito bwino thanzi lake mosamala, amakumana ndi vuto lalikulu la metabolic. Kodi zingachitike bwanji ngati munthu sanamwe, sanamwe mowa mopitirira muyeso, kupewa nkhawa ndikuchita masewera olimbitsa thupi? Cholinga chake, mwatsoka, chagona mu chibadwa chamtsogolo, chomwe ndicho chofunikira kudziwa pamenepa, umboni womwe ungakhale matenda a matenda a shuga 1. Kodi chodabwitsa cha matenda awa ndi chiyani ndipo ndi makina ake amakula?

Kodi matenda ashuga ndi chiani?

Mtundu woyamba wa matenda a shuga ndi matenda omwe amayamba chifukwa cha kufa kwa maselo ena omwe amapanga insulini ya mahomoni mu kapamba. Kutha kwa maselo ndi kuchepa kwa insulini kumayambitsa vuto lalikulu la metabolic njira ndi hyperglycemia.

Pankhaniyi, wodwalayo akhoza kumva zotsatirazi:

Matendawa, osapezeka m'nthawi yake, amatha kutsogolera impso, mtima, kudula miyendo ngakhale kufa. Ichi ndichifukwa chake ndikofunikira kwambiri kuti munthu agwiritse matendawa ndikangofunika kuti ayambe kulandira chithandizo munthawi yake.

Kodi ndichifukwa chiyani insulin ndi yofunika kwambiri kwa thupi?

Popeza matenda amtunduwu amawonekera motsutsana ndi kusowa kwa insulin, ndiye kuti chithandizo chamankhwala chiyeneranso kugwirizananso ndi kubwezeretsanso kuchepa kwa timadzi ta m'thupi totere. Komabe, poyambira ndikofunikira kumvetsetsa kuti ntchito yake ndi yotani?

Ntchito zomwe amathetsa ndi izi:

Kuwongolera kuwonongeka kwa glucose, komwe ndi gwero lalikulu la zakudya zamafupa am'mimba ndi ma neurons aubongo.
Phatikizani kulowerera kwa glucose kudzera m'makoma a minofu ya minofu.
Kusintha kukula kwa mapangidwe a mafuta ndi mapuloteni, kutengera zosowa za thupi.

Popeza insulini ndiye hormone yokhayo yomwe imagwira ntchito zosiyanasiyana komanso zosiyanasiyana, ndiyofunikira kwambiri m'thupi la munthu. Ichi ndichifukwa chake ndi matenda ashuga, wodwalayo amakakamizidwa kutenga chinthu chomwe mawonekedwe ake ali pafupi ndi timadzi timeneti. Mankhwalawa amapulumutsa wodwalayo pakukula kwa ziwalo zamkati ndi mitsempha yamagazi.

Mitundu ya insulin

Kusiyana kwakukulu pakati pa kufananizira kwa insulin ya anthu masiku ano ndi zifukwa izi:

Zomwe mankhwalawa amapangidwa.
Kutalika kwa mankhwalawa.
Mlingo wa kuyeretsedwa kwa mankhwalawa.

Mwa kapangidwe kake, kukonzekera kumatha kugawidwa ngati ndalama zomwe zimaperekedwa kuchokera ku ng'ombe, zomwe nthawi zambiri zimayambitsa mavuto ndi chifuwa, kuchokera ku nkhumba ndikupezeka ndi genetic engineering. Mankhwalawa amaphatikizapo, mwachitsanzo, Germany Insulin Rapid GT.

Malinga ndi nthawi yowonekera, mankhwalawa amagawidwa m'mitundu yotere:

Insulin yochepa, yomwe imaperekedwa kotala la ola limodzi asanadye, kuti ifanane ndi kukula kwa mahomoni mwa munthu wathanzi atatha kudya. Ndalamazi ndi monga Insulin Insuman Rapid.
Yaitali, yomwe imayenera kutumikiridwa kamodzi kapena kawiri pa tsiku, kuti athe kutsata kupangika kwa mahomoni.

Nthawi zambiri, mitundu yonse iwiri ya mahomoni imaperekedwa kwa wodwala kuti akwaniritse zofunikira za thupi tsiku ndi tsiku. Komabe, kwa anthu omwe sangathe kuwongolera mkhalidwe wawo chifukwa cha ukalamba kapena matenda amisala, muyezo woyeserera wa mankhwala umaperekedwa. Wodalirika komanso wowonetsetsa kusintha kwa mkhalidwe wake, munthu amatha kuwerengera payekha mlingo wa Short Insulin Rapid.

Zomwe amamwa mankhwalawo

Kumwa mankhwala osokoneza bongo kumathandizira wodwala kuti azitha kukonza yekha zakudya, osadalira kwambiri zakudya komanso zochita za tsiku ndi tsiku. Kuti muchite izi, ndikofunikira kuwerengera moyenera kuchuluka kwa chakudya komanso kuchuluka kwa shuga m'magazi musanadye.

Kulandila kwa Insulin Insuman Rapid GT kumatha kusintha kwambiri moyo wa wodwalayo, chifukwa zimapangitsa kuti muzitha kuganizira za mtundu wa moyo wa munthu, chakudya chake.

Njira yogwiritsira ntchito mankhwalawa ndi muyezo, komanso mawonekedwe a kuvomereza ndi contraindication, ayenera kuphunziridwa mosamala malinga ndi malangizo a Insulin Rapid, komanso kukambirana ndi dokotala. Chofunikanso kwambiri ndikuti wodwalayo athe kuwerengetsa moyenera mankhwalawo.

Gulu la Nosological (ICD-10)

Yankho la jakisoni	1 ml
ntchito:
insulin ya anthu (100% sungunuka wa munthu insulin)	3,571 mg (100 IU)
zokopa: metacresol, sodium dihydrogen phosphate dihydrate, glycerol (85%), sodium hydroxide (womwe umagwiritsidwa ntchito kusintha pH), hydrochloric acid (womwe umagwiritsidwa ntchito kusintha pH), madzi a jakisoni

Mimba komanso kuyamwa

Chithandizo cha Insuman ® Rapid GT panthawi yoyembekezera ziyenera kupitilizidwa. Insulin siyidutsa chotchinga. Kusunga moyenera kagayidwe kazakudya panthawi yonse yoyembekezera ndikovomerezeka kwa azimayi omwe ali ndi matenda ashuga asanabadwe, kapena amayi omwe apanga matenda a shuga.

Ngati muli ndi pakati kapena mukufuna kubereka, onetsetsani kuti mwadziwitsa dokotala.

Panthawi yoyamwitsa, palibe zoletsa pazotsatira za insulin, komabe, Mlingo wa insulin komanso kusintha kwa zakudya kungafunike.

Wopanga

1. Sanofi-Aventis Deutschland GmbH, Germany.Industrialpark Hoechst D-65926, Bruningstrasse 50, Frankfurt, Germany.

Zodandaula za ogula ziyenera kutumizidwa ku adilesi ku Russia: 125009, Moscow, ul. Tverskaya, 22.

Tele. ((495) 721-14-00, fakisi: (495) 721-14-11.

2. CJSC Sanofi-Aventis Vostok, Russia. 302516, Russia, Dera la Oryol, Chigawo cha Oryol, s / n Bolshekulikovskoye, ul. Livenskaya, 1.

Pankhani yopanga mankhwalawa ku Sanofi-Aventis Vostok CJSC, Russia, zodandaula za ogula ziyenera kutumizidwa ku adilesi iyi: 302516, Russia, Oryol Region, Oryol District, s / n Bolshekulikovskoye, ul. Livenskaya, 1.

Tel./fax: (486) 2-44-00-55.