Insulin: mawonekedwe ndi mawonekedwe, malangizo ogwiritsira ntchito mankhwala

P / c, mwapadera - v / m, mphindi 15 musanadye. Mlingo woyamba mwa akulu ndi kuyambira 8 mpaka 24 IU, mwa ana - ochepera 8 IU. Ndi kuchepetsedwa kwa chidwi ndi insulin - waukulu. Mlingo umodzi siwaposa 40 IU. Posintha mankhwalawa ndi insulin yaumunthu, kuchepetsa mlingo kumafunika. Mu chikomokere matenda ashuga ndi acidosis, mankhwalawa nthawi zambiri amaperekedwa iv.

Mafotokozedwe a magulu a nosological

Siyani ndemanga yanu

Chidziwitso Chaposachedwa Chosowa Chidziwitso, ‰

Zikalata zolembetsa Insulin S

• S-8-242 N006174

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Chidziwitsochi cholinga chake ndi akatswiri azachipatala.

Munthu insulin jakisoni

Actrapid HM (Actrapid HM), Actrapid HM penfill (Actrapid HM penfill), Berlsulin H cholembera chokhazikika (Berlinsulin H cholembera chokhazikika), Berlsulin H yokhazikika U-40 (Berlinsulin H yachibadwa U-40), Insuman mwachangu (Insuman mwachangu), Homorap 40 (Homorap 40), Homorap 100 (Homorap 100).

Zotsatira za pharmacological

Ndi njira ya insulin yosalowerera ndendende yofanana ndi insulin ya anthu. Amatanthauzanso ma insulin osakhalitsa. Kuchepetsa glucose wamagazi, kumathandizira kuyamwa kwake ndi minofu, lipogenesis, glycogenogeneis, kaphatikizidwe ka mapuloteni, kumachepetsa kuchuluka kwa shuga ndi chiwindi.

Kukhazikika kwa mankhwalawa ndi mphindi 20-30 pambuyo pa kuperekedwa. Kuchuluka kwake kumachitika pakati pa maola 1 ndi 3. Kutalika kwa kuchitapo kanthu ndi maola 6-8.

Mbiri ya insulin yosakanikirana ndi insulin yaumunthu ya munthu imadalira mlingo ndikuwonetsa kupatuka kwakapakati komanso kwakonda pakati. Mafuta ochokera kumalo opakidwa jakisoni amayenda msanga kuposa nkhumba zosakanizira zosungunulira.

Mtundu woyamba wa matenda ashuga a mtundu wa 2, matenda a shuga a 2: gawo la kukana kwa othandizira pakamwa.

Matenda a shuga a ketoacidosis, ketoacidotic ndi hyperosmolar coma, ndi opaleshoni yomwe ikubwera, allergies kukonzekera insulin yoyambira nyama, insulin lipoatrophy, insulini chifukwa cha kuchuluka kwa ma cell a anti-insulin, pakuthana kwa maselo apakhungu a kapamba.

Kugwiritsa

Dokotala amakhazikitsa mlingo payekha. Mukamagwiritsidwa ntchito ngati monotherapy, mankhwalawa amapatsidwa 3-6 r / tsiku. Lowani s / c, mu / m kapena mu / mu. Mukasamutsa odwala kuchokera ku insulin yoyesedwa kwambiri kukhala mankhwala a munthu, sasintha.

Mukasamutsa insulin ya bovine kapena yosakaniza (nkhumba / bovine), mlingo uyenera kuchepetsedwa ndi 10%, pokhapokha ngati koyamba mlingo wake umakhala wochepera 0,6 U / kg. Ndikofunika kuti muzipatala odwala omwe amalandila mayunitsi zana kapena kupitilira tsiku lililonse pakusintha kwa insulin. Ndi cholembera, syringe imangoperekedwa pokhapokha.

Mlingo wa insulin uyenera kusinthidwa pazochitika zotsatirazi: kusintha kwa chikhalidwe komanso kudya, kulimbitsa thupi kwambiri, matenda opatsirana, chithandizo cha opaleshoni, kutenga pakati, chithokomiro cha chithokomiro, matenda a Addison, hypopituitism, kulephera kwa impso ndi matenda ashuga kwa anthu azaka zopitilira 65.

Ndi cholinga choyambirira cha insulini, kusintha kwa mtundu wake kapena kukhalapo kwa kulimbitsa thupi kwakukulu kapena kupsinjika kwa m'maganizo, kuchepa kwa mphamvu yoganizira, kuthamanga kwa malingaliro ndi magalimoto amayenda.

Mankhwala

Rinsulin P ndi insulin yaumunthu yomwe imapezedwa pogwiritsa ntchito tekinoloje ya DNA. Mwachidule kuchita insulin. Imalumikizana ndi cholandirira chapadera pa cytoplasmic membrane ya maselo ndikupanga insulini-receptor zovuta zomwe zimapangitsa njira zamagawo, kuphatikiza kaphatikizidwe kazinthu zingapo za michere (hexokinase, pyruvate kinase, glycogen synthase, etc.). Kutsika kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa kayendedwe ka intracellular, kuchuluka kwa minofu, kukondoweza kwa lipogenesis, glycogenogeneis, kuchepa kwa kuchuluka kwa shuga ndi chiwindi, etc.
Kutalika kwa nthawi ya kukonzekera kwa insulin kumachitika makamaka chifukwa cha kuchuluka kwa mayamwidwe, zomwe zimatengera zinthu zingapo (mwachitsanzo, pa mlingo, njira ndi malo oyang'anira), chifukwa chake zochitika za insulin zimasinthasintha kwambiri, mwa anthu osiyanasiyana komanso chimodzimodzi munthu. Pafupifupi, pambuyo pa kayendetsedwe ka subcutaneous, Rinsulin P imayamba kugwira ntchito patatha mphindi 30, mphamvu yayikulu imayamba pakati pa 1 ndi 3 maola, nthawi yayitali ndi maola 8.

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

Zizindikiro zogwiritsidwa ntchito

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

Zotsatira zoyipa

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

Malangizo apadera

Njira zopewera kugwiritsa ntchito

Potengera maziko a mankhwala a insulin, kuyang'anira kuchuluka kwa shuga m'magazi ndikofunikira.
Zomwe zimayambitsa hypoglycemia kuwonjezera pa insulin yochulukirapo imatha kukhala: kusintha kwa mankhwala, kudumpha chakudya, kusanza, kutsegula m'mimba, kuchuluka kwa zochitika zolimbitsa thupi, matenda omwe amachepetsa kufunikira kwa insulin (chiwindi ndi matenda a impso, hypofunction ya adrenal cortex, pituitary kapena chithokomiro cha chithokomiro), kusintha kwa jekeseni wa jekeseni, komanso kuyanjana ndi mankhwala ena.
Dosing yolakwika kapena kusokonezedwa mu kayendetsedwe ka insulin, makamaka kwa odwala omwe ali ndi matenda amtundu wa 1, angayambitse matenda a hyperglycemia. Nthawi zambiri zizindikiro zoyambirira za hyperglycemia zimayamba pang'onopang'ono kwa maola angapo kapena masiku. Izi zikuphatikiza ludzu, kukodza kwambiri, nseru, kusanza, chizungulire, khungu ndi kuwuma pakhungu, pakamwa pouma, kusowa chilimbikitso, kununkhira kwa acetone mu mpweya wotuluka. Ngati sanalandire, hyperglycemia mu mtundu 1 wa shuga angayambitse kukula kwa matenda ashuga a ketoacidosis.
Mlingo wa insulin uyenera kukonzedwa kuti matenda a chithokomiro asokonekera, matenda a Addison, hypopituitarism, chiwindi ndi impso ntchito ndi anthu odwala azaka zopitilira 65.
Kuwongolera mlingo wa insulin kungafunikenso ngati wodwala akuwonjezera kuchuluka kwa zolimbitsa thupi kapena asintha zakudya zomwe amakonda.
Matenda onga, makamaka matenda ndi machitidwe omwe amatsatana ndi malungo, amalimbikitsa kufunika kwa insulini.
Kusamutsa wodwala ku mtundu wina wa insulin kapena kukonzekera kwa insulin kwa wopanga wina kuyenera kuchitika moyang'aniridwa ndi dokotala.
Chifukwa cha kuthekera kwanyengo m'matumba ena, kugwiritsa ntchito mankhwalawa m'mapampu a insulin sikulimbikitsidwa.

Zokhudza mphamvu pakutha kuyendetsa magalimoto ndi zida

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

Wopanga

Ma adilesi amalo opanga:

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

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

Malangizo ayenera kuperekedwa kwa wodwala

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

Ngati wodwala amagwiritsa ntchito mtundu umodzi wokha wa insulin

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

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

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

Protein-peptide hormonal mankhwala, insulin imagwiritsidwa ntchito ngati chida chothandiza pochiza matenda ashuga.

Insulin imakhudzanso kagayidwe kazakudya - imathandiza kuchepetsa magazi ndipo imalowetsedwa ndi minofu, imathandizira kulowetsedwa kwa glucose m'maselo, imathandizira kaphatikizidwe ka glycogen, komanso kupewa kutembenuka kwamafuta ndi ma amino acid kukhala chakudya.

Malamulo ogwiritsira ntchito

Nthawi zambiri, insulin imayendetsedwa mobwerezabwereza kapena kudzera m'mitsempha, muzibongo - makamaka pokhapokha ngati munthu akudwala matenda a shuga, kukonzekera komwe kumayendetsedwa kumachitika pokhapokha.

Jekeseni wa tsiku ndi tsiku mlingo amapangidwa mu 2-3 Mlingo theka la ola - ola pamaso chakudya, mphamvu imodzi ya mankhwala amayamba pambuyo 30-60 mphindi ndipo kumatenga maola 4-8.

Mothandizidwa ndi insulin, inshuwaransi yapamwamba imatheka pambuyo pa mphindi 20-30, shugayo imabweleranso muyeso pambuyo pa maola 1-2.

Asanadzaze syringe ya insulin yokonzekera nthawi yayitali, zomwe zili mkati ziyenera kugwedezeka mpaka kuyimitsidwa koyenera mu botolo.

At matenda ashuga Mankhwalawa ikuchitika pokhapokha pakudya panthawi yomweyo, mulingo umatsimikiza molingana ndi kuopsa kwa matendawa, momwe wodwalayo alili ndi shuga mumkodzo (kutengera gawo limodzi la magalamu asanu alionse a shuga omwe amatsitsidwa mkodzo). Nthawi zambiri, Mlingo wa insulin umachokera ku magawo 10 mpaka 40 patsiku.

At wodwala matenda ashuga Mlingo wa tsiku lililonse wa mankhwalawa womwe ungayambitsidwe mosavomerezeka ungathe kubweretsedwa mpaka 100 PIERESES, ndikuwonjezera makonzedwe - mpaka 50 PISCES patsiku.

At matenda ashuga toxidermia insulin ndi mankhwala Mlingo waukulu, womwe umadalira kuopsa kwa matenda.

Pazowonetsa zina, milingo yaying'ono ya insulin imakonda kutumikiridwa (mayunitsi 6-10 patsiku), kawirikawiri (kutopa konse, matenda a chiwindi) limodzi ndi kuchuluka kwa shuga.

Zotsatira zoyipa

Ngati bongo wa insulin kwambiri kapena kudya kwadzidzidzi kwamakina, mantha a hypoglycemic amatha kukhala - chizindikiro chowopsa chomwe chimagwirizana ndi kufooka kwathunthu, kukhetsa thukuta, kutsekeka, chizungulire, kukomoka, kupuma movutikira, pamavuto akulu - kutaya chikumbumtima, kupuma, kukomoka, kukomoka.

Mankhwala a insulin

Insulin ya jakisoni imatulutsidwa mumbale zosavomerezeka ndi 5 ml ndi 10 ml, zochitika za 20 PIECES, 40 PISCES kapena 80 PISCES mu 1 ml yankho.

Insulin yogwiritsidwa ntchito kuchipatala ndi yoyera ya hygroscopic ufa, wosungunuka m'madzi, womwe umapezeka ndi kuphipha kwa zikondamoyo zakumwa zophera nyama (insulin) kapena kudzera mwa kupanga. Muli sulufule 3.1%.

Mayankho a Insulin ndi njira yomveka bwino, yopanda utoto kapena ya chikasu acidic pH 2.0-3-3.5, yomwe imakonzedwa ndikuthira insulin m'madzi a jekeseni, acidified ndi hydrochloric acid ndi kuwonjezera kwa yankho la 0,25-0.3%, kapena kumalongeza.

Kuyimitsidwa-kumasulidwa kumasulidwa kumasulidwa osakwana 5 ml ndi 10 ml mbale, hermetically losindikizidwa ndi zotsekemera zotsekemera ndi zotumphukira zotayidwa zotayidwa.

Kukonzekera kwa insulin

Swinsulin - yankho lamadzimadzi lamatumbo a insulin omwe amachokera ku kapamba wa nkhumba. Mankhwalawa amagwiritsidwa ntchito kwa odwala omwe amakana mankhwala omwe amapezeka kuchokera ku kapamba ka ng'ombe.

Monosuinsulin - kukonzekera kwakanthawi kokhala ndi insulin. Amagwiritsidwa ntchito kukana insulini, lipodystrophy, zochitika wamba komanso zamkati chifukwa cha jakisoni wa kukonzekera kwina kwa insulin. Monosuinsulin imayang'aniridwa subcutaneous kapena mu mnofu 15-16 mphindi asanadye, imodzi kangapo patsiku. Zochitikazo zimachitika pambuyo pa mphindi 15 mpaka 20, kuchuluka kwake kumachitika pambuyo pa maola 2, nthawi ya mankhwalawa si yopitilira maola 6. Pankhani ya thupi lawo siligwirizana, kuyeserera kwa intradermal (0.02-0.04 U) kumachitika musanayambe kugwiritsa ntchito monosuinsulin. Ndi lipodystrophy, yankho limayendetsedwa mosavuta pamalire a thanzi komanso malo omwe akukhudzidwa ndi mafuta osunthika: ana, magulu a 2-5, achikulire, magawo 4-8 masiku 30-30. Ngati ndi kotheka, bwerezani mankhwalawo. Ngati bongo, njala, kufooka, thukuta, palpitations, chizungulire (mkhalidwe wa hypoglycemia) ndizotheka. Kusamala ndikofunikira pakukula kwa coronary, ngozi ya cerebrovascular.

Kuyimitsidwa kokhala ndi kuyimitsidwa kwa amorphous ndi crystalline zinc-insulin.

Kuyimitsidwa mu mawonekedwe a amorphous ufa mu acetate buffer ndi kutalika kwa maola 12-12 ndipo pazotheka kwakukulu panthawi yoyamba ya maola 7.

Kuyimitsidwa kotsika kwa crystalline insulin mu acetate buffer, mankhwala omwe amakhala ndi nthawi yayitali ya maola 36, ​​okwera amapezeka maola 16-20 pambuyo pa kukhazikitsa.

Kuyimitsidwa kokhazikika kwa makristasi a insulin movuta ndi protamine mu phosphate buffer.

10 ml Mbale, mankhwala zikuchokera: insulin - 40 PIECES, nthaka mankhwala enaake - 0,08 mg, triprotamine - 0,8 ml, shuga - 40 mg, disubstituted sodium phosphate - pafupifupi 4 mg, tricresol - 3 mg.

Mankhwala osakhalitsa, malinga ndi nthawi yayitali, amatenga malo apakati pakati pa mankhwala wamba ndi Triprotamine-zinc-insulin.

Kuyimitsidwa kwakanthawi koyera. A mawonekedwe a kuyimitsidwa, poyerekeza ndi mankhwala ochiritsira, ndizoyenda pang'onopang'ono komanso nthawi yayitali.

Kuyimitsidwa kokhazikika kwa crystalline insulin, protamine, calcium chloride ndi sodium phosphate, mankhwala omwe amakhala nthawi yayitali.

Yaitali insulin ndi kuwonjezera kwa aminoquinocarbamide hydrochloride.

Insulin yayitali - amorphous nkhumba insulini yosakanikirana ndi zinc ndi crystalline ng'ombe insulin yovuta ndi zinc (muyezo 3: 7). Mankhwalawa ndiwothandizika kwa nthawi yayitali, umaperekedwa mobwerezabwereza komanso mu intramuscularly ndi zolimbitsa komanso zovuta matenda a shuga. Kutsitsa kwa shuga kumachitika mu maola 2-5, kumafika pazinthu zambiri mu maola 8-10 ndipo kumatenga maola 20- 24. Mlingo ndi kuchuluka kwa jakisoni patsiku amakhazikitsidwa payekhapayekha, poganizira kuchuluka kwa shuga amene amatuluka mumkodzo nthawi zosiyanasiyana masana, kuchuluka kwa shuga. Mankhwalawa sagwiritsidwa ntchito chifukwa cha matenda osokoneza bongo.Ngati mankhwala osokoneza bongo, hypoglycemic state ndi thupi lawo siligwirizana (urticaria, zidzolo, kuyabwa kwa khungu, edema ya Quincke) imayamba.

Insulin semilong kuyimitsidwa - imakhala ndi insulini ya nkhumba ya amorphous movuta ndi zinc. Mankhwalawa ndiwotalikilapo. Wothandizidwa ndi matenda osokoneza bongo a shuga oledzera komanso mawonekedwe owopsa, masana hyperglycemia ndi glucosuria, kutumikiridwa mosakakamiza kapena m'mitsempha. Zotsatira zake zimawonedwa pambuyo maola 1-1.5, ntchito yayitali - pambuyo maola 5-8. Kutalika kwa mankhwalawa ndi maola 10-12.

Kuyimitsidwa kwa Insulin Ultralong - imakhala ndi ma crystalline ng'ombe insulin mu zovuta ndi zinc. Ikani mankhwalawa subcutaneally komanso intramuscularly ndi matenda osokoneza bongo a shuga oopsa komanso owopsa mawonekedwe, theka lachiwiri lausiku komanso m'mawa kwambiri. Kuchepetsa mphamvu ya shuga kumawonedwa pambuyo maola 6-8. Kutalika kwa maola 30-36.

(Insulinum) - puloteni yayikulu kwambiri yolemetsa, mahomoni opangidwa ndi ma pancreas a mamalia, imasungidwa ndi basophilic insulocytes (β-cell of pancreatic islets of Langerhans).

Frederick Bunting, Charles Best, ndi James Collip koyamba adalandira insulin kuchokera ku zikondamoyo za nyama mu 1921.

Insulin ndi mtundu wina wa kagayidwe kazakudya, pochita ma hexokinase omwe amalimbikitsa kugwiritsidwa ntchito kwa glucose - kulowa kwake mu minofu (makamaka minofu) ndi kuyaka, komanso kumapangitsanso kapangidwe ka glycogen kuchokera ku glucose mu minofu minofu ndi chiwindi, komanso kufooketsa gluconeogenesis.

Ntchito yochepetsera shuga ya 0,045 mg ya crystalline insulin imatengedwa ngati gawo la kanthu (IU) (40 IU ili mu 1 ml ya yankho la insulin).

The achire zotsatira ndi kufunika kwa insulin mu shuga mellitus zimayenderana ndi kuchotsedwa kwa mavuto omwe amadza chifukwa cha matendawa pakasinthidwe kazakudya ndi mafuta. Izi zimawonetsedwa pakukonzanso odwala, kutsitsa shuga m'magazi, kuchepetsa kapena kuthetsa kwathunthu glucosuria ndi acetonuria, komanso kufooketsa zovuta zingapo za thupi zomwe zimatsagana ndi matenda osokoneza bongo a mellitus (furunculosis, polyneuritis, polyarthritis, etc.).

Insulin imasinthidwa mosavuta ndi kaolin, activated kaboni ndi ma adsorbents ena, imasungunuka mosavuta m'madzi, alkali, ma acid komanso njira zochepa zoledzera, zosagwiritsidwa ntchito mu 96% mowa, acetone ndi ether.

Horm imapangidwa ndi zochita za kuwala kwa dzuwa (ma radiation a UV), kuchepetsa othandizira ndi othandizira, ndipo amawonongeka mosavuta ndi michere ya proteinolytic (makamaka trypsin). Kwambiri insulin kutengera pH wa sing'anga - mu njira yothetsera asidi, insulin akhoza kupirira kuwira kwa ola limodzi, kukhazikika mu zamchere njira yotsika kwambiri.

Kupanga kwa insulin

Njira yofala kwambiri yopangira insulin ya nyama kuchokera ku zikondamoyo za nkhumba ndi ng'ombe ndi izi: (opanga osiyanasiyana amasintha njira zazikulu):

1. Momwe zimayambira kakhansa koyambirira kamene kamakhala ndi zakumwa za asidi.
2. Kusintha kwa mowa kumayamba pansi pa vakuyumu, kupukuta ndi kusungunukiranso mu 80% mowa, pomwe insulin imayamba ndi mowa wambiri kapena ether.
3. Kusungunuka kwa insulin yosafunikira m'madzi osungunuka ndikuyeretsa kwake komwe kumagwiritsa ntchito imodzi mwanjira zotsatirazi: mpweya kuchokera pamchere wamadzimadzi amchere, mpweya wa insulini ndi picric acid, mpweya wa insulini pamalo a isoelectric panjira yothetsera pH = 5.0, adsorption pa kaolin kapena activated kaboni.

Onse mchere wa insulin (nthawi zambiri chloride) ndi maziko a insulin akhoza kukonzekera.

Insulin ndi mankhwala enaake ochepetsa shuga. , imatha kuyendetsa kagayidwe kazachilengedwe, imathandizira kukoka minofu ndikuyambitsa kusintha kwake kukhala glycogen, imathandizanso kulowerera kwa glucose m'maselo a minofu.
Kuphatikiza pa zotsatira za hypoglycemic (kutsitsa shuga), insulin imakhala ndi zotsatirapo zingapo: imachulukitsa masitolo a minofu ya glycogen, imalimbikitsa kaphatikizidwe ka peptide, imachepetsa kumwa kwa mapuloteni, ndi zina zambiri.

Kuwonetsedwa kwa insulin kumayendetsedwa ndi kukondoweza kapena kuletsa (kuletsa) kwa michere ina , glycogen synthetase, pyruvate dehydrogenase, hexokinase imapangidwira, lipase ikuyambitsa mafuta acids a adipose minofu, lipoprotein lipase, kuchepetsa magazi pambuyo chakudya chamafuta ambiri, tikulephera.
Mlingo wa biosynthesis ndi secretion (secretion) wa insulin zimatengera kuchuluka kwa shuga m'magazi.
Ndi kuchuluka kwa zomwe zili mkati mwake, katulutsidwe ka insulin ndi kapamba kumawonjezera, m'malo mwake, kutsika kwa kuchuluka kwa shuga m'magazi kumachepetsa kubisalira kwa insulin.

Pakukhazikitsa zotsatira za insulini, gawo lotsogolera limaseweredwa ndi kulumikizana kwina ndi cholandilira chapadera pamadzi am'mimba, ndi mapangidwe a insulin receptor tata.
Cholandirira insulin limodzi ndi insulin chimalowa m'chipindacho , komwe zimakhudza kuphatikizika kwa mapuloteni am'magazi, kuphatikiza kwina kwakukhudzana sikumveka bwino.
Insulin ndiye chithandizo chenicheni cha matenda a shuga; chifukwa amachepetsa hyperglycemia (kuchuluka kwa shuga m'magazi) ndi glycosuria (kukhalapo kwa shuga mumkodzo), amabwezeretsanso kuchuluka kwa glycogen mu chiwindi ndi minofu, amachepetsa kupanga shuga, ndikuchepetsa matenda a shuga m'magazi (kukhalapo kwamafuta m'magazi) , Amathandizira wodwalayo .

Insulin yogwiritsira ntchito kuchipatala imapezeka kuchokera ku zikondamoyo za ng'ombe ndi nkhumba . Pali njira yothandizira kuphatikizira mankhwala a insulin, koma ndi osatheka.
Posachedwa apanga njira za biotechnological zopangira insulin yaumunthu. Insulin yomwe imapezeka ndi ma genetic engineering imagwirizana kwathunthu ndi amino acid angapo insulin ya anthu.
Milandu yomwe insulin imapezeka kuchokera ku zikondamoyo za nyama, zodetsa zosiyanasiyana (ma proinsulin, glucagon, kudzipereka, mapuloteni, ma polypeptides, ndi zina zotere) zitha kupezeka pokonzekera chifukwa chosakwanira kuyeretsa.
Kukonzekera bwino kwambiri kwa insulin kumatha kuyambitsa mavuto osiyanasiyana.

Njira zamakono zimapangitsa kuti zitheke (monopic - chromatographic oyeretsedwa ndikutulutsa "nsonga" ya insulin), yoyeretsedwa kwambiri (monocomponent) ndikukonzekera insulin.
Pakadali pano, mafuta a insulin a insulin amagwiritsidwa ntchito kwambiri.
Pazokonzekera za insulin, nyama zimakonda kusankha insulin chifukwa cha nkhumba.

Ntchito ya insulin imatsimikizika biologic (mwakutha kutsitsa glucose wamagazi mu akalulu athanzi) ndi imodzi mwanjira zanzeru (electrophoresis pa pepala kapena chromatography papepala). Pa gawo limodzi la ntchito (IU), kapena gulu lapadziko lonse lapansi (IE), chitani zochitika za 0404082 mg wa crystalline insulin.

Chizindikiro chachikulu chogwiritsa ntchito insulin ndi mtundu I shuga mellitus (wodwala insulin), koma m'malo ena umalembedwanso mtundu II wa matenda a shuga (osagwirizana ndi insulin).

Mankhwalawa matenda a shuga gwiritsani insulin kukonzekera kosiyana kachitidwe .
Mwachangu insulin komanso munjira zina za pathological zomwe zimayambitsa matenda a hypoglycemic (kutsitsa shuga m'magazi) m'njira zina za schizophrenia, monga anabolic (kuwonjezera mapuloteni kaphatikizidwe) wothandizira kutopa kwathunthu, kusowa kwa zakudya m'thupi, furunculosis (angapo purulent kutupa kwa khungu), thyrotoxicosis (matenda a chithokomiro) matenda a m'mimba (matenda a m'mimba) (matenda am'mimba / kuchepa kwa kamvekedwe,, gastroptosis / kuchuluka kwa m'mimba /), matenda a kutupa chiwindi (kutupa kwa minofu ya chiwindi), mitundu yoyambira ya matenda a chiwindi, komanso chigawo "polarizing" zothetsera ntchito azichitira pachimake inatsekeratu insufficiency (mismatch pakati kufunika mtima mpweya ndi yobereka ake).

Kusankhidwa kwa insulin pochiza matenda ashuga kumadalira kuopsa kwa matendawa, momwe wodwalayo alili, komanso pamlingo woyambira komanso nthawi yayitali ya mankhwala.
Kukhazikitsidwa koyambirira kwa insulin ndi kukhazikitsidwa kwa mankhwalawa makamaka kumachitika mu chipatala (zipatala).

Kukonzekera mwachidule insulin - Izi ndi njira zothetsera subcutaneous kapena mu mnofu makonzedwe.
Ngati ndi kotheka, amaperekedwanso kudzera m'mitsetse yamkati.
Ali ndi mphamvu yochepetsera shuga yochepa komanso yochepa.
Nthawi zambiri amamuthandizira mphindi 15 mpaka 15 asanadye chakudya kamodzi kapena kangapo patsiku.
Zotsatira pambuyo subcutaneous jakisoni amapezeka 15-20 Mphindi, ukufika pazipita pambuyo 2 hours, nthawi yonse ya kuchita si zoposa 6 maola.
Amagwiritsidwa ntchito makamaka kuchipatala kukhazikitsa mtundu wa insulin yofunikira kwa wodwala, komanso ngati pakufunika kusintha kosangalatsa pantchito ya insulin mthupi - wodwala matenda ashuga komanso precom (kutaya kwathunthu kapena pang'ono pang'ono pang'ono chifukwa cha kuchuluka kwakuchuluka kwa shuga m'magazi) .
Kuphatikiza apo, kukonzekera kwakanthaŵi kwa insulin kumagwiritsidwa ntchito ngati anabolic wothandizirana ndipo amalembera, monga lamulo, mumiyeso yaying'ono (4-8 mayunitsi 1-2 patsiku).

Kukonzekera kwa insulin kwa nthawi yayitali amapezeka mu mitundu yosiyanasiyana ya mulingo wokhala ndi nthawi yosiyanasiyana yotsitsa shuga (semylong, yayitali, ultralong).
Mankhwala osiyanasiyana, zotsatira zake zimatenga maola 10 mpaka 36.
Chifukwa cha mankhwalawa, mutha kuchepetsa kuchuluka kwa jakisoni tsiku lililonse.
Nthawi zambiri amapangidwa mwa mawonekedwe a kuyimitsidwa. (kuyimitsidwa kwa tinthu tokhazikika tomwe timadzi tomwe timatulutsa mu madzi), kumayendetsedwa kokha kapena intramuscularly, mtsempha wamkati samaloledwa. Pazakudya zokhala ndi matenda ashuga komanso mikhalidwe yoyipa, mankhwalawa amakhala osagwiritsidwa ntchito.

Mukamasankha kukonzekera kwa insulin, ndikofunikira kuonetsetsa kuti nthawi ya kutsika kwambiri kwa shuga ikugwirizana ndi nthawi yomwe mumamwa.
Ngati ndi kotheka, mankhwala 2 a nthawi yayitali amatha kuperekedwa mu syringe imodzi.
Odwala ena amafunika osati motalika, komanso mwachangu kuchuluka kwa shuga m'magazi. Ayenera kupatsidwa mankhwala okhala ndi insulin.
Nthawi zambiri mankhwala ogwira ntchito kwa nthawi yayitali amaperekedwa musanadye chakudya cham'mawa komabe, ngati pangafunike, jakisoni itha kuchitika nthawi zina.

Zokonzekera zonse za insulin zimagwiritsidwa ntchito potsatira zakudya.
Tanthauzo la kulemba kwa mphamvu (kuyambira 1700 mpaka 3000 khal) kuyenera kutsimikiziridwa ndi kulemera kwamthupi la wodwalayo panthawi yamankhwala, ndi mtundu wa zochita. Chifukwa chake, chifukwa cha kuchepa kwa zakudya komanso kulimbitsa thupi, kuchuluka kwa zopatsa mphamvu patsiku kwa wodwala kuli osachepera 3000, okhala ndi zakudya zopatsa thanzi komanso moyo wokhala pansi, sayenera kupitilira 2000.

Kukhazikitsidwa kwa Mlingo wambiri, komanso kusowa kwa chakudya ndi zakudya, kumayambitsa vuto la hypoglycemic (kutsitsa shuga) limodzi ndi kumva njala, kufooka, thukuta, kunjenjemera kwa thupi, kupweteka mutu, chizungulire, palpitations, euphoria (kusachita kufunikira) kapena kuchita ukali.
Pambuyo pake, hypoglycemic coma ikhoza kukhala (kuiwalika kwa chikumbumtima, chodziwika ndi kuperewera konse kwa thupi pakukhudzidwa kwakunja chifukwa chakuchepa kwambiri kwa shuga m'magazi) ndi kutaya chikumbumtima, kugwidwa, komanso kuchepa kwamphamvu kwa mtima.
Pofuna kupewa matenda a hypoglycemic, odwala ayenera kumwa tiyi wokoma kapena kudya shuga pang'ono.

Ndi hypoglycemic (yogwirizana ndi kuchepa kwa shuga) magazi 40% yankho la glucose imalowetsedwa m'mitsempha mu 1040 ml, nthawi zina mpaka 100 ml, koma osatinso.
Malangizo a hypoglycemia (kutsitsa shuga) m'magazi owopsa angathe kuchitidwa ntchito mu mnofu kapena subcutaneous makonzedwe a glucagon.

Ndi subcutaneous makonzedwe a insulini, lipodystrophy (kuchepa kwa kuchuluka kwa minofu ya adipose mu minofu yaying'ono) imatha kupezeka pamalo a jekeseni.

Kukonzekera kwamakono kwambiri kwa insulin komwe kumayambitsa zovuta zomwe sizigwirizana, komabe, milandu yotereyi siyiperekedwe. Kukula kwa matenda oopsa sayanjana pafupipafupi kumafuna kufooketsa (kuletsa kapena kuletsa zimagwirira) mankhwala ndi mankhwala.

Zotsatira zakugwiritsira ntchito insulin ndi matenda omwe amapezeka ndi hypoglycemia, hepatitis yacute, cirrhosis, hemolytic jaundice (chikasu cha pakhungu ndi zotupa za m'maso zimayambitsa kupindika kwa maselo ofiira am'magazi), kapamba (kutupa kwa impso), nephritis (kutupa kwa impso) matenda a impso ogwirizana ndi kuphwanya mapuloteni / amyloid metabolism, urolithiasis, m'mimba ndi zilonda zam'mimba, zotupa za mtima (mtima kulephera chifukwa chakomoka mtima matenda a mavavu ake).

Kusamala kwakukulu kumafunikira pochiza odwala omwe ali ndi matenda osokoneza bongo, omwe akudwala matenda a coronary insufficiency (cholakwika pakati pa kufunikira kwa mpweya ndi kubereka kwake) ndi kuwonongeka kwa ubongo | magazi.
Kusamala ndikofunikira pakugwiritsa ntchito insulin kwa odwala omwe ali ndi matenda a chithokomiro, matenda a Addison (vuto losakwanira la adrenal), komanso kulephera kwa aimpso.

Mankhwala a insulin oyembekezera amayenera kuyang'aniridwa bwino.
Pa trimester yoyamba ya kubereka, kufunika kwa insulin nthawi zambiri kumacheperachepera ndikuwuka mu trimesters yachiwiri ndi yachitatu.
Alfa-adrenergic blockers ndi beta-adrenostimulants, ma tetracyclines, salicylates amawonjezera kubisala kwa endo native (excretion ya thupi lopangidwa) insulin.
Thiazide diupetics (diuretics), beta-blockers, mowa ungayambitse hypoglycemia.

Kuyanjana ndi
mankhwala ena
kudzera:

Mphamvu ya hypoglycemic ya insulin imakulitsidwa hypoglycemic mankhwala m'kamwa, Mao zoletsa, Ace zoletsa, carbonic anhydrase zoletsa, kusankha beta-blockers, bromocriptine, octreotide, sulfonamides, anabolic mankhwala, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, lifiyamu, mankhwala okhala ndi Mowa .

Hypoglycemic zotsatira za insulin zimafooka njira zakulera za pakamwa, corticosteroids, mahomoni a chithokomiro, thiazide okodzetsa, heparin, ma tridclic antidepressants, sympathomimetics, danazole, clonidine, calcium njira blockers, diazoxide, morphine, phenytoin, nikotini.

Mothandizidwa ndi reserpine ndi salicylates, kufooka komanso kuwonjezeka kwa machitidwe a mankhwalawa ndizotheka.
Mankhwala okhala ndi thiol kapena sulfite, akaphatikizidwa ndi insulin, amachititsa kuti awonongeke.

Pa mimba, mtundu wa insulin, mlingo wake ndi makonzedwe ake amatsimikiziridwa ndi adokotala.
Ngati njira yoyambira yosankhidwa siyabwino, ndikofunikira kukaonana ndi dokotala ndikusankha, makamaka, njira yabwino kwambiri yovomerezeka.

Zizindikiro : kufooka kwa minofu, kufooka pang'ono, njala, kupindika mphamvu, kufinya, kufinya, kupindika, kupweteka kwa mutu, kumatuluka pafupipafupi, kutafuna, kutopa kwa chikumbumtima, kuponderezana, kapena kukwiya, zinthu zosagwirizana ndipo pomaliza, chikomokere.

Chithandizo cha vuto la hypoglycemic iyenera kuyamba pomwe.
Muzochepa, ndikokwanira kupereka tiyi wokoma, timadziti ta zipatso, uchi.
Mukakhala ndi chikumbumtima chokwanira (chikomokere) pomwepo jekeseni wa shuga (10-20 ml ya glucose 20-25%).
Pokhapokha ngati mwina kubaya jakisoni wa njira ya glucose, tikulimbikitsidwa kupaka kulowetsedwa kwa 0.001-0.002 g ga glucagon kapena 0,5 ml ya yankho la 0.1% ya adrenaline hydrochloride pansi pa khungu.
Tiyenera kukumbukira kuti pakukhazikitsa adrenaline, mavuto amatha kuchitika - palpitations, kunjenjemera, kuthamanga kwa magazi, nkhawa, ndi zina zambiri.

Syringe insulin imapezeka m'mbale zamagalasi losindikizidwa ndi zoletsa za mphira ndi aluminium yopuma.
M'mabotolo 10 ml, mu bokosi 5 ma PC kapena mu penfill (makatiriji) 1.5 ndi 3 ml zolembera ma syringe .

Zokonzekera za insulin (zonse ziwiri ndi ma cartridge) omwe sagwiritsidwe ntchito, ziyenera kusungidwa pa 2-8 ° C m'malo opanda kanthu , i.e. mufiriji (makamaka pashelufu pansi), kutali ndi mufiriji.
Kutentha kumeneku, amasunga zachilengedwe komanso zofunikira kwambiri mpaka nthawi ya alumali yomwe ikusonyezedwa phukusi. Insulin siyenera kuyikidwa mukamauluka pa ndege kuti mupewe ngozi yozizira.
Kutentha kwambiri kosungirako kumayambitsa kutsika kwapang'onopang'ono kwa zochita za mankhwala. Kuwala kwam'masiku mwachindunji kumakhudzanso zovuta, zomwe zikufulumizitsa kuchepa kwa zochita za thupi ndi zana.
Transulin ya mafuta osungunuka amatha kupendekeka ndikuyamba kukhala kwamitambo . Ma granules ndi ma flakes amapanga kuyimitsidwa kwa insulin. Kuphatikizidwa kwa kutentha ndikugwedezeka kwa nthawi yayitali kumathandizira njirayi.

Botolo la insulin lomwe wodwalayo angagwiritse ntchito amatha kusungidwa kutentha kwambiri osapitirira 25 ° C, m'malo ampaka milungu 6. Nthawi imeneyi imachepetsedwa mpaka masabata 4 mukamagwiritsa ntchito ma cartfillamu a Penfill, chifukwa zolembera za syringe nthawi zambiri zimatengedwa m'thumba lanu kutentha kotentha pang'ono. Mbale za insulin zimatha kusungidwa mufiriji kwa miyezi itatu itatha kugwiritsidwa ntchito koyamba.

Frozen insulin siyingagwiritsidwe ntchito pambuyo poyipitsa. Izi ndizowona makamaka pakuyimitsidwa. Mukamazizira, makhiristo kapena tinthu tating'onoting'ono timachulukana ndipo samasungunuka pambuyo pang'onopang'ono, zomwe zimapangitsa kuti zikhale zosatheka kuyimitsidwanso. Chifukwa chake, chiopsezo chobweretsa mlingo wosakwanira chimakulitsidwa kwambiri.

Insulin iyenera kuonedwa kuti iwonongeka. Mitundu ya insulin yomwe singathe kugwiritsidwa ntchito posintha, kutulutsa kapena kuwoneka ngati tinthu tosiyidwa.
Kuyimitsidwa kwa insulin, yomwe ikasakanikirana sikupanga kuyimitsidwa koyera kapena kukhala ndi ziphuphu, ulusi, kusintha mtundu, sikuyenera kugwiritsidwa ntchito.

1 ml ya yankho kapena kuyimitsidwa nthawi zambiri kumakhala magawo 40.
Kutengera ndi zomwe zimapangidwa, insulini imadzipatula ku zikondamoyo za nyama ndipo imapangidwa pogwiritsa ntchito njira zopangira ma genetic.

Malinga ndi kuchuluka kwa kuyeretsedwa, kukonzekera kwa insulini kuchokera ku minofu yanyama kumagawidwa kukhala monopic (MP) ndi monocomponent (MK).
Pano omwe amapezeka kuchokera ku kapamba ka nkhumba, amapangidwanso ndi zilembo C (SMP - nkhumba monopic, SMK - monocomponent ya nkhumba), ng'ombe - kalata G (ng'ombe: GMP - ng'ombe monopick, GMK - ng'ombe monocompitute).
Kukonzekera kwa insulin yaumunthu kumasonyezedwa ndi kalata C.

Kutengera kutalika kwa kuchitapo kanthu, ma insulins amagawidwa:
- kukonzekera insulin kukonzekera : kuyamba kwa mphindi 15-30, nthawi yayitali pambuyo maola 1 / 2-2, Kutalika kwa maola 4 mpaka 6,
- kukonzekera insulin kukonzekera phatikizani mankhwala omwe ali ndi nthawi yayitali yochita (kuyambira pambuyo pa 1 / 2-2 maola, kuchuluka pambuyo pa maola 3-12, kuchuluka kwa maola 8-12), mankhwala osokoneza bongo kwa nthawi yayitali (kuyamba pambuyo pa maola 4-8, kuchuluka pambuyo pa maola 8-18, kutalika kwa maola 20-30).

Matenda a shuga ndi matenda oopsa osachiritsika mwachilengedwe. Pancreas yaumunthu ndi gawo la dongosolo la endocrine lomwe limatulutsa insulin yofunika. Insulin imachita kusinthana kwa glucose, ndikofunikira kuti bongo ndi thupi lonse lizigwira ntchito. Mu shuga mellitus, kapamba amalephera kugwira ntchito mwachizolowezi. Chifukwa chake, wodwalayo amafunikira kumwa mankhwala pafupipafupi. Nthawi zambiri, mapiritsi okwanira. Koma mtundu wodwala wa shuga womwe umadalira insulin umafunikira jakisoni wokhazikika wa insulin.

Chithandizo

Mitundu yofatsa ya matenda a shuga imatha kuthandizidwa pongodya. Koma nthawi zambiri wodwala amafunikira kumwa mankhwala. Mtundu woopsa kwambiri wa matenda ashuga - mtundu wodwala wa insulin - umapezeka pafupifupi 10-15% ya milandu yodwala. Koma mtundu wina umatha kutembenukira ku wina.

Odwala omwe ali ndi matenda a shuga omwe amadalira insulin nthawi zambiri amafunikira insulin. Nthawi zambiri imapangidwa ndi bovine kapena insulin ya nkhumba, yomwe imakhala ndi zosafunika zosiyanasiyana. Izi zimasiyanitsa ndi insulin ya wodwala ku mahomoni omwe amapangidwa ndi kapamba amunthu.

Zotsatira zoyipa

Mukamagwiritsa ntchito jakisoni wa insulin kuti mukhalebe odwala Zina mwa izo sizimayambitsa nkhawa yayikulu, koma mawonekedwe ena ndiowopsa.

Izi sizitanthauza kuti wodwala amakana jakisoni wa insulin. Ndizowopsa pamoyo wake. Ndikofunika kungosankha mankhwala oyenera kuti agwirizane ndi wodwala wina. Nthawi zambiri, kusinthira ku insulin yoyeretsedwa kumachotsa zotsatira zosafunikira zambiri. Ngati izi sizikuthandizani, ndiye kuti wodwala amayenera kupita kukaphunzitsidwako. Mulimonsemo, kukana jakisoni kwa munthu wodwala matenda a shuga ndi mtundu wodalira insulin sikungatheke.

Zotheka kutulutsa thupi

Mukabayidwa insulin, mavuto osiyanasiyana amatha.

Hypoglycemia ndi njira yodziwika bwino yothandizira. Awa ndi mkhalidwe wa m'magazi womwe umadziwika ndi shuga m'magazi ocheperako pang'ono. Izi zimachitika ndi mankhwala osokoneza bongo. Mulingo wamtima wa munthu umafulumizitsa, nkhawa ndi mantha zimabuka, khungu limawonedwa. Chizungulire, kukomoka, thukuta kwambiri komanso kunjenjemera ndizotheka. Pali kumverera kwachilendo kwamanjala, omwe amayenera kuzimitsidwa kuti athetse vuto la wodwalayo (ndibwino kugwiritsa ntchito mafuta othamanga). M'mavuto ovuta kwambiri, khunyu imatha, chikomokere ndi kufa ndikotheka.

Chinanso chomwe chimachitika ndi vuto la insulin. Nthawi zambiri zimakhudzana ndi zomwe zimachitika pakumwa mankhwala osokoneza bongo. Nthawi zambiri imathandizidwa ndi atrophy ya minofu pamalo opangira jakisoni.

Somoji syndrome ndi posthypoglycemic hyperglycemia. Kusintha kwa glucose m'magazi kumabweretsa zotsatira zosayenerera kwa odwala matenda ashuga.

Lipodystrophy ndi njira yodutsitsa tinthu tating'onoting'ono tomwe timayikidwa mu jekeseni, yomwe imadziwoneka yokha pakutha kwake kapena kukula kwambiri. Ndikulimbikitsidwa kusintha malo a jakisoni pafupipafupi.

Insulin edema - imakonda kumayambika chithandizo, koma pamapeto pake imatha. Osafuna chithandizo.

Chifukwa chiyani pakufunika thandizo la matenda ashuga kufunafuna thandizo kuchokera ku malangizo ogwiritsira ntchito insulin. Ndi momwe malamulo otetezeka a mankhwalawa angakhudzire thanzi la wodwalayo.

Insulin ndi mankhwala othandizira matenda a shuga, omwe maziko ake ndi mahomoni a kapamba. Malangizo ogwiritsira ntchito mankhwalawa ndi memo yovomerezeka popereka mankhwala. Chithandizo cha Latin chikuyenera kuperekedwa ndi dokotala.

Pharmacology

Insulin, yomwe imapezeka m'magazi a anthu, imakhala ndi mahomoni omwe amachititsa kagayidwe kazakudya m'thupi la munthu, amachepetsa shuga m'magazi ndipo amathandizira kuti glucose amidwe. Chifukwa chosakwanira kupanga mahomoni ndi kapamba, kapena mosinthanitsa, munthu wowonjezera amayamba kumufuna kuchokera kunja.

Katunduyu amapangidwa mochita kufuna kuti azichiritsa kuchokera ku zikondamoyo za ng'ombe, nkhumba komanso chifukwa chopanga ma genetic engineering.

Zizindikiro zogwiritsidwa ntchito

Kwenikweni, insulin imagwiritsidwa ntchito ngati mankhwala othandizira matenda a shuga mellitus (mtundu 1) komanso pansi pa matenda ena a endocrine (ogwiritsira ntchito insulin ya matenda a matenda a shuga 2).

Insulin yomwe imagwira ntchito mwachidule imagwiritsidwa ntchito kuchepetsa shuga m'magazi ena a matenda a schizophrenia, kukula kwa furunculosis, ndi matenda am'mimba. Komanso matenda a chiwindi ndi gawo loyambirira la matenda a chiwindi.

Kuphatikiza apo, insulini imalembedwa ngati wothandizila (kuwonjezera kuchuluka kwa thupi), kwa odwala omwe ali ndi vuto la kuperewera kwa zakudya komanso okhala ndi vuto la kuperewera kwa zakudya.

Kugwiritsa ntchito insulin kumadziwika kuti ndi gawo limodzi la yankho la polarizable lomwe limagwiritsidwa ntchito pochiza matenda a m'matumbo.

Momwe mungagwiritsire ntchito

Kugwiritsa ntchito mankhwalawa kumaphatikizanso kuyambitsa kwake kukhala mu minofu kapena pansi pa khungu komanso pokhapokha pazovuta (kukhalapo kwa matenda a shuga) kudzera m'mitsempha.

Mu shuga mellitus, mlingo wovomerezeka wa insulin umayikidwa payekha malinga ndi zotsatira za kusanthula, kuphatikiza kuchuluka kwa shuga, mahomoni aproteni m'magazi, pazomwe zimangoyenera kungolankhula zokhazokha zovomerezeka. Ndipo kwa funso, pazomwe insulin ya shuga imabayidwa, titha kunena pafupifupi - 12 mmol / lita.

Mlingo wofunika wa insulini ya matenda ashuga pafupifupi magawo 10 mpaka 40 patsiku. Ndi matendawa odwala matenda ashuga, kugwiritsa ntchito insulin kutha kuwerengeka patsiku kuposa magawo zana (subcutaneously) osati oposa 50 magawo omwe ali ndi mtsempha wamitsempha yama cell.

Zowonetsa zina, mankhwalawa amatha kuikidwa mu yaying'ono Mlingo - 5-10 magawo patsiku.

Pakugwiritsa ntchito insulin, syringe yomwe imagwiritsidwa ntchito jekeseni ndi yapadera, ndi singano yomanga, ukadaulo womwe umaphatikizira jakisoni wathunthu wa zomwe zili mkati kuti musunge dosing yolondola ya mankhwala.

Ngati mankhwala adayimitsidwa pakuyimitsidwa, ndikulimbikitsidwa kugwedeza zomwe zili m'botolo musanadzaze mu syringe.

Kwa matenda ashuga, chinthu chofotokozedwera chimagwiritsidwa ntchito mu Mlingo wa 2-3. Jakisoni amachitika mphindi 30 asanayambike kudya. Mlingo umodzi mu mawonekedwe a jakisoni umayamba kugwira ntchito pakatha mphindi 60 ndikutalika kwa maola 4-8. Anayambitsa insulin m'mitsempha amayamba kuchita pambuyo pa mphindi 30, pomwe amachepetsa shuga kuti ikhale yofanana pambuyo pa ola limodzi kapena awiri.

Kutulutsa Mafomu

Mankhwala amamasulidwa mwanjira yothetsera, kuyimitsidwa, m'mabotolo, m'matotolo ena (makatiriji, makatoni ndi machitidwe omwe amagwiritsidwa ntchito kuti agwiritse ntchito cholembera).

Makamaka, yankho la jakisoni limapezeka m'mabotolo osungidwa osalala mu 5 ndi 10 ml, ntchito yomwe, monga lamulo, ili ndi magawo 20 mpaka 100 mu 1 ml yamadzi.

Mankhwalawa ndi ufa woyera wokhala ndi sulufufu wofikira 3,1%.

Njira yothetsera jakisoni ndi madzi oyera oyera achikasu ndi pH kuyambira 2 mpaka 3.5. Kupanga yankho, ufa umasungunuka m'madzi apadera a jekeseni, ndikuphatikiza HCI acid, glycerin ndi yankho la phenol kapena tricresol kuti isungidwe.

Kuyimitsa kukhudzika kwa nthawi yayitali kumatha kugulidwa m'masitolo am'madzi a 5 ndi 10 ml. Chilichonse chotere chimakhala chotsekedwa mwamphamvu ndi chivindikiro chowotchera kuti chimakulungidwa ndi kapu yokhala ndi zotayidwa.

Contraindication

Pachimake hepatitis, kapamba, nephritis, impso mwala, zilonda zam'mimba ndi duodenum, matenda a mtima.

Malangizo apadera

Kusamala pakugwiritsa ntchito insulin ndikofunikira popereka mankhwala kwa odwala omwe ali ndi vuto la kupindika kwa coronary ndi ngozi ya cerebrovascular.

Mukamagwiritsa ntchito mankhwala a nthawi yayitali pokhudzana ndi kuthekera kwa kusinthasintha kwa mankhwalawo pakubwera kwa ndalama izi, tikulimbikitsidwa kuti muphunzire mkodzo wa 3-4 wa shuga, mkodzo wa tsiku ndi tsiku wa shuga, komanso misempha yamagazi. Izi zimakuthandizani kuti mumveke bwino ma insulin, makamaka nthawi yanthawi yoyambira kuchuluka kwa insulin.

Kukonzekera kwa insulin kokhazikika sikoyenera (chifukwa cha kufalikira pang'onopang'ono kwa mankhwalawo) pochizira odwala matenda ashuga.

Mphamvu ya insulin imapangidwira ndi munthawi yomweyo.

Kupanga ndi mawonekedwe a kumasulidwa

Mankhwala a insulin

Insulin ya jakisoni imatulutsidwa mumbale zosavomerezeka ndi 5 ml ndi 10 ml, zochitika za 20 PIECES, 40 PISCES kapena 80 PISCES mu 1 ml yankho.

Insulin yogwiritsidwa ntchito kuchipatala ndi yoyera ya hygroscopic ufa, wosungunuka m'madzi, womwe umapezeka ndi kuphipha kwa zikondamoyo zakumwa zophera nyama (insulin) kapena kudzera mwa kupanga. Muli sulufule 3.1%.

Mayankho a Insulin ndi njira yomveka bwino, yopanda utoto kapena ya chikasu acidic pH 2.0-3-3.5, yomwe imakonzedwa ndikuthira insulin m'madzi a jekeseni, acidified ndi hydrochloric acid ndi kuwonjezera kwa yankho la 0,25-0.3%, kapena kumalongeza.

Kuyimitsidwa-kumasulidwa kumasulidwa kumasulidwa osakwana 5 ml ndi 10 ml mbale, hermetically losindikizidwa ndi zotsekemera zotsekemera ndi zotumphukira zotayidwa zotayidwa.

Moyo wa alumali ndi malo osungira

Sungani mosamala (mndandanda B) pa kutentha kwa 0,5 ° C, kukonzekera kwa insulini sikuyenera kuzizira.

Alumali moyo wa insulin wa jekeseni ndi zaka ziwiri.

Kukonzekera kwa insulin

Swinsulin - yankho lamadzimadzi lamatumbo a insulin omwe amachokera ku kapamba wa nkhumba. Mankhwalawa amagwiritsidwa ntchito kwa odwala omwe amakana mankhwala omwe amapezeka kuchokera ku kapamba ka ng'ombe.

Monosuinsulin - kukonzekera kwakanthawi kokhala ndi insulin. Amagwiritsidwa ntchito kukana insulini, lipodystrophy, zochitika wamba komanso zamkati chifukwa cha jakisoni wa kukonzekera kwina kwa insulin. Monosuinsulin imayang'aniridwa subcutaneous kapena mu mnofu 15-16 mphindi asanadye, imodzi kangapo patsiku. Zochitikazo zimachitika pambuyo pa mphindi 15 mpaka 20, kuchuluka kwake kumachitika pambuyo pa maola 2, nthawi ya mankhwalawa si yopitilira maola 6. Pankhani ya thupi lawo siligwirizana, kuyeserera kwa intradermal (0.02-0.04 U) kumachitika musanayambe kugwiritsa ntchito monosuinsulin. Ndi lipodystrophy, yankho limayendetsedwa mosavuta pamalire a thanzi komanso malo omwe akukhudzidwa ndi mafuta osunthika: ana, magulu a 2-5, achikulire, magawo 4-8 masiku 30-30. Ngati ndi kotheka, bwerezani mankhwalawo. Ngati bongo, njala, kufooka, thukuta, palpitations, chizungulire (mkhalidwe wa hypoglycemia) ndizotheka. Kusamala ndikofunikira pakukula kwa coronary, ngozi ya cerebrovascular.

Kuyimitsidwa kokhala ndi kuyimitsidwa kwa amorphous ndi crystalline zinc-insulin.

Kuyimitsidwa mu mawonekedwe a amorphous ufa mu acetate buffer ndi kutalika kwa maola 12-12 ndipo pazotheka kwakukulu panthawi yoyamba ya maola 7.

Kuyimitsidwa kotsika kwa crystalline insulin mu acetate buffer, mankhwala omwe amakhala ndi nthawi yayitali ya maola 36, ​​okwera amapezeka maola 16-20 pambuyo pa kukhazikitsa.

Kuyimitsidwa kokhazikika kwa makristasi a insulin movuta ndi protamine mu phosphate buffer.

10 ml Mbale, mankhwala zikuchokera: insulin - 40 PIECES, nthaka mankhwala enaake - 0,08 mg, triprotamine - 0,8 ml, shuga - 40 mg, disubstituted sodium phosphate - pafupifupi 4 mg, tricresol - 3 mg.

Mankhwala osakhalitsa, malinga ndi nthawi yayitali, amatenga malo apakati pakati pa mankhwala wamba ndi Triprotamine-zinc-insulin.

Kuyimitsidwa kwakanthawi koyera. A mawonekedwe a kuyimitsidwa, poyerekeza ndi mankhwala ochiritsira, ndizoyenda pang'onopang'ono komanso nthawi yayitali.

Kuyimitsidwa kokhazikika kwa crystalline insulin, protamine, calcium chloride ndi sodium phosphate, mankhwala omwe amakhala nthawi yayitali.

Yaitali insulin ndi kuwonjezera kwa aminoquinocarbamide hydrochloride.

Insulin yayitali - amorphous nkhumba insulini yosakanikirana ndi zinc ndi crystalline ng'ombe insulin yovuta ndi zinc (muyezo 3: 7). Mankhwalawa ndiwothandizika kwa nthawi yayitali, umaperekedwa mobwerezabwereza komanso mu intramuscularly ndi zolimbitsa komanso zovuta matenda a shuga. Kutsitsa kwa shuga kumachitika mu maola 2-5, kumafika pazinthu zambiri mu maola 8-10 ndipo kumatenga maola 20- 24. Mlingo ndi kuchuluka kwa jakisoni patsiku amakhazikitsidwa payekhapayekha, poganizira kuchuluka kwa shuga amene amatuluka mumkodzo nthawi zosiyanasiyana masana, kuchuluka kwa shuga. Mankhwalawa sagwiritsidwa ntchito chifukwa cha matenda osokoneza bongo. Ngati mankhwala osokoneza bongo, hypoglycemic state ndi thupi lawo siligwirizana (urticaria, zidzolo, kuyabwa kwa khungu, edema ya Quincke) imayamba.

Insulin semilong kuyimitsidwa - imakhala ndi insulini ya nkhumba ya amorphous movuta ndi zinc. Mankhwalawa ndiwotalikilapo. Wothandizidwa ndi matenda osokoneza bongo a shuga oledzera komanso mawonekedwe owopsa, masana hyperglycemia ndi glucosuria, kutumikiridwa mosakakamiza kapena m'mitsempha. Zotsatira zake zimawonedwa pambuyo maola 1-1.5, ntchito yayitali - pambuyo maola 5-8. Kutalika kwa mankhwalawa ndi maola 10-12.

Kuyimitsidwa kwa Insulin Ultralong - imakhala ndi ma crystalline ng'ombe insulin mu zovuta ndi zinc. Ikani mankhwalawa subcutaneally komanso intramuscularly ndi matenda osokoneza bongo a shuga oopsa komanso owopsa mawonekedwe, theka lachiwiri lausiku komanso m'mawa kwambiri. Kuchepetsa mphamvu ya shuga kumawonedwa pambuyo maola 6-8. Kutalika kwa maola 30-36.

(Insulinum) - puloteni yayikulu kwambiri yolemetsa, mahomoni opangidwa ndi ma pancreas a mamalia, imasungidwa ndi basophilic insulocytes (β-cell of pancreatic islets of Langerhans).

Frederick Bunting, Charles Best, ndi James Collip koyamba adalandira insulin kuchokera ku zikondamoyo za nyama mu 1921.

Insulin ndi mtundu wina wa kagayidwe kazakudya, pochita ma hexokinase omwe amalimbikitsa kugwiritsidwa ntchito kwa glucose - kulowa kwake mu minofu (makamaka minofu) ndi kuyaka, komanso kumapangitsanso kapangidwe ka glycogen kuchokera ku glucose mu minofu minofu ndi chiwindi, komanso kufooketsa gluconeogenesis.

Ntchito yochepetsera shuga ya 0,045 mg ya crystalline insulin imatengedwa ngati gawo la kanthu (IU) (40 IU ili mu 1 ml ya yankho la insulin).

The achire zotsatira ndi kufunika kwa insulin mu shuga mellitus zimayenderana ndi kuchotsedwa kwa mavuto omwe amadza chifukwa cha matendawa pakasinthidwe kazakudya ndi mafuta. Izi zimawonetsedwa pakukonzanso odwala, kutsitsa shuga m'magazi, kuchepetsa kapena kuthetsa kwathunthu glucosuria ndi acetonuria, komanso kufooketsa zovuta zingapo za thupi zomwe zimatsagana ndi matenda osokoneza bongo a mellitus (furunculosis, polyneuritis, polyarthritis, etc.).

Insulin imasinthidwa mosavuta ndi kaolin, activated kaboni ndi ma adsorbents ena, imasungunuka mosavuta m'madzi, alkali, ma acid komanso njira zochepa zoledzera, zosagwiritsidwa ntchito mu 96% mowa, acetone ndi ether.

Horm imapangidwa ndi zochita za kuwala kwa dzuwa (ma radiation a UV), kuchepetsa othandizira ndi othandizira, ndipo amawonongeka mosavuta ndi michere ya proteinolytic (makamaka trypsin).Kwambiri insulin kutengera pH wa sing'anga - mu njira yothetsera asidi, insulin akhoza kupirira kuwira kwa ola limodzi, kukhazikika mu zamchere njira yotsika kwambiri.

Kupanga kwa insulin

Njira yofala kwambiri yopangira insulin ya nyama kuchokera ku zikondamoyo za nkhumba ndi ng'ombe ndi izi: (opanga osiyanasiyana amasintha njira zazikulu):

1. Momwe zimayambira kakhansa koyambirira kamene kamakhala ndi zakumwa za asidi.
2. Kusintha kwa mowa kumayamba pansi pa vakuyumu, kupukuta ndi kusungunukiranso mu 80% mowa, pomwe insulin imayamba ndi mowa wambiri kapena ether.
3. Kusungunuka kwa insulin yosafunikira m'madzi osungunuka ndikuyeretsa kwake komwe kumagwiritsa ntchito imodzi mwanjira zotsatirazi: mpweya kuchokera pamchere wamadzimadzi amchere, mpweya wa insulini ndi picric acid, mpweya wa insulini pamalo a isoelectric panjira yothetsera pH = 5.0, adsorption pa kaolin kapena activated kaboni.

Onse mchere wa insulin (nthawi zambiri chloride) ndi maziko a insulin akhoza kukonzekera.

Insulin ndi mankhwala enaake ochepetsa shuga. , imatha kuyendetsa kagayidwe kazachilengedwe, imathandizira kukoka minofu ndikuyambitsa kusintha kwake kukhala glycogen, imathandizanso kulowerera kwa glucose m'maselo a minofu.
Kuphatikiza pa zotsatira za hypoglycemic (kutsitsa shuga), insulin imakhala ndi zotsatirapo zingapo: imachulukitsa masitolo a minofu ya glycogen, imalimbikitsa kaphatikizidwe ka peptide, imachepetsa kumwa kwa mapuloteni, ndi zina zambiri.

Kuwonetsedwa kwa insulin kumayendetsedwa ndi kukondoweza kapena kuletsa (kuletsa) kwa michere ina , glycogen synthetase, pyruvate dehydrogenase, hexokinase imapangidwira, lipase ikuyambitsa mafuta acids a adipose minofu, lipoprotein lipase, kuchepetsa magazi pambuyo chakudya chamafuta ambiri, tikulephera.
Mlingo wa biosynthesis ndi secretion (secretion) wa insulin zimatengera kuchuluka kwa shuga m'magazi.
Ndi kuchuluka kwa zomwe zili mkati mwake, katulutsidwe ka insulin ndi kapamba kumawonjezera, m'malo mwake, kutsika kwa kuchuluka kwa shuga m'magazi kumachepetsa kubisalira kwa insulin.

Pakukhazikitsa zotsatira za insulini, gawo lotsogolera limaseweredwa ndi kulumikizana kwina ndi cholandilira chapadera pamadzi am'mimba, ndi mapangidwe a insulin receptor tata.
Cholandirira insulin limodzi ndi insulin chimalowa m'chipindacho , komwe zimakhudza kuphatikizika kwa mapuloteni am'magazi, kuphatikiza kwina kwakukhudzana sikumveka bwino.
Insulin ndiye chithandizo chenicheni cha matenda a shuga; chifukwa amachepetsa hyperglycemia (kuchuluka kwa shuga m'magazi) ndi glycosuria (kukhalapo kwa shuga mumkodzo), amabwezeretsanso kuchuluka kwa glycogen mu chiwindi ndi minofu, amachepetsa kupanga shuga, ndikuchepetsa matenda a shuga m'magazi (kukhalapo kwamafuta m'magazi) , Amathandizira wodwalayo .

Insulin yogwiritsira ntchito kuchipatala imapezeka kuchokera ku zikondamoyo za ng'ombe ndi nkhumba . Pali njira yothandizira kuphatikizira mankhwala a insulin, koma ndi osatheka.
Posachedwa apanga njira za biotechnological zopangira insulin yaumunthu. Insulin yomwe imapezeka ndi ma genetic engineering imagwirizana kwathunthu ndi amino acid angapo insulin ya anthu.
Milandu yomwe insulin imapezeka kuchokera ku zikondamoyo za nyama, zodetsa zosiyanasiyana (ma proinsulin, glucagon, kudzipereka, mapuloteni, ma polypeptides, ndi zina zotere) zitha kupezeka pokonzekera chifukwa chosakwanira kuyeretsa.
Kukonzekera bwino kwambiri kwa insulin kumatha kuyambitsa mavuto osiyanasiyana.

Njira zamakono zimapangitsa kuti zitheke (monopic - chromatographic oyeretsedwa ndikutulutsa "nsonga" ya insulin), yoyeretsedwa kwambiri (monocomponent) ndikukonzekera insulin.
Pakadali pano, mafuta a insulin a insulin amagwiritsidwa ntchito kwambiri.
Pazokonzekera za insulin, nyama zimakonda kusankha insulin chifukwa cha nkhumba.

Ntchito ya insulin imatsimikizika biologic (mwakutha kutsitsa glucose wamagazi mu akalulu athanzi) ndi imodzi mwanjira zanzeru (electrophoresis pa pepala kapena chromatography papepala). Pa gawo limodzi la ntchito (IU), kapena gulu lapadziko lonse lapansi (IE), chitani zochitika za 0404082 mg wa crystalline insulin.

Chizindikiro chachikulu chogwiritsa ntchito insulin ndi mtundu I shuga mellitus (wodwala insulin), koma m'malo ena umalembedwanso mtundu II wa matenda a shuga (osagwirizana ndi insulin).

Mankhwalawa matenda a shuga gwiritsani insulin kukonzekera kosiyana kachitidwe .
Mwachangu insulin komanso munjira zina za pathological zomwe zimayambitsa matenda a hypoglycemic (kutsitsa shuga m'magazi) m'njira zina za schizophrenia, monga anabolic (kuwonjezera mapuloteni kaphatikizidwe) wothandizira kutopa kwathunthu, kusowa kwa zakudya m'thupi, furunculosis (angapo purulent kutupa kwa khungu), thyrotoxicosis (matenda a chithokomiro) matenda a m'mimba (matenda a m'mimba) (matenda am'mimba / kuchepa kwa kamvekedwe,, gastroptosis / kuchuluka kwa m'mimba /), matenda a kutupa chiwindi (kutupa kwa minofu ya chiwindi), mitundu yoyambira ya matenda a chiwindi, komanso chigawo "polarizing" zothetsera ntchito azichitira pachimake inatsekeratu insufficiency (mismatch pakati kufunika mtima mpweya ndi yobereka ake).

Kusankhidwa kwa insulin pochiza matenda ashuga kumadalira kuopsa kwa matendawa, momwe wodwalayo alili, komanso pamlingo woyambira komanso nthawi yayitali ya mankhwala.
Kukhazikitsidwa koyambirira kwa insulin ndi kukhazikitsidwa kwa mankhwalawa makamaka kumachitika mu chipatala (zipatala).

Kukonzekera mwachidule insulin - Izi ndi njira zothetsera subcutaneous kapena mu mnofu makonzedwe.
Ngati ndi kotheka, amaperekedwanso kudzera m'mitsetse yamkati.
Ali ndi mphamvu yochepetsera shuga yochepa komanso yochepa.
Nthawi zambiri amamuthandizira mphindi 15 mpaka 15 asanadye chakudya kamodzi kapena kangapo patsiku.
Zotsatira pambuyo subcutaneous jakisoni amapezeka 15-20 Mphindi, ukufika pazipita pambuyo 2 hours, nthawi yonse ya kuchita si zoposa 6 maola.
Amagwiritsidwa ntchito makamaka kuchipatala kukhazikitsa mtundu wa insulin yofunikira kwa wodwala, komanso ngati pakufunika kusintha kosangalatsa pantchito ya insulin mthupi - wodwala matenda ashuga komanso precom (kutaya kwathunthu kapena pang'ono pang'ono pang'ono chifukwa cha kuchuluka kwakuchuluka kwa shuga m'magazi) .
Kuphatikiza apo, kukonzekera kwakanthaŵi kwa insulin kumagwiritsidwa ntchito ngati anabolic wothandizirana ndipo amalembera, monga lamulo, mumiyeso yaying'ono (4-8 mayunitsi 1-2 patsiku).

Kukonzekera kwa insulin kwa nthawi yayitali amapezeka mu mitundu yosiyanasiyana ya mulingo wokhala ndi nthawi yosiyanasiyana yotsitsa shuga (semylong, yayitali, ultralong).
Mankhwala osiyanasiyana, zotsatira zake zimatenga maola 10 mpaka 36.
Chifukwa cha mankhwalawa, mutha kuchepetsa kuchuluka kwa jakisoni tsiku lililonse.
Nthawi zambiri amapangidwa mwa mawonekedwe a kuyimitsidwa. (kuyimitsidwa kwa tinthu tokhazikika tomwe timadzi tomwe timatulutsa mu madzi), kumayendetsedwa kokha kapena intramuscularly, mtsempha wamkati samaloledwa. Pazakudya zokhala ndi matenda ashuga komanso mikhalidwe yoyipa, mankhwalawa amakhala osagwiritsidwa ntchito.

Mukamasankha kukonzekera kwa insulin, ndikofunikira kuonetsetsa kuti nthawi ya kutsika kwambiri kwa shuga ikugwirizana ndi nthawi yomwe mumamwa.
Ngati ndi kotheka, mankhwala 2 a nthawi yayitali amatha kuperekedwa mu syringe imodzi.
Odwala ena amafunika osati motalika, komanso mwachangu kuchuluka kwa shuga m'magazi.Ayenera kupatsidwa mankhwala okhala ndi insulin.
Nthawi zambiri mankhwala ogwira ntchito kwa nthawi yayitali amaperekedwa musanadye chakudya cham'mawa komabe, ngati pangafunike, jakisoni itha kuchitika nthawi zina.

Zokonzekera zonse za insulin zimagwiritsidwa ntchito potsatira zakudya.
Tanthauzo la kulemba kwa mphamvu (kuyambira 1700 mpaka 3000 khal) kuyenera kutsimikiziridwa ndi kulemera kwamthupi la wodwalayo panthawi yamankhwala, ndi mtundu wa zochita. Chifukwa chake, chifukwa cha kuchepa kwa zakudya komanso kulimbitsa thupi, kuchuluka kwa zopatsa mphamvu patsiku kwa wodwala kuli osachepera 3000, okhala ndi zakudya zopatsa thanzi komanso moyo wokhala pansi, sayenera kupitilira 2000.

Kukhazikitsidwa kwa Mlingo wambiri, komanso kusowa kwa chakudya ndi zakudya, kumayambitsa vuto la hypoglycemic (kutsitsa shuga) limodzi ndi kumva njala, kufooka, thukuta, kunjenjemera kwa thupi, kupweteka mutu, chizungulire, palpitations, euphoria (kusachita kufunikira) kapena kuchita ukali.
Pambuyo pake, hypoglycemic coma ikhoza kukhala (kuiwalika kwa chikumbumtima, chodziwika ndi kuperewera konse kwa thupi pakukhudzidwa kwakunja chifukwa chakuchepa kwambiri kwa shuga m'magazi) ndi kutaya chikumbumtima, kugwidwa, komanso kuchepa kwamphamvu kwa mtima.
Pofuna kupewa matenda a hypoglycemic, odwala ayenera kumwa tiyi wokoma kapena kudya shuga pang'ono.

Ndi hypoglycemic (yogwirizana ndi kuchepa kwa shuga) magazi 40% yankho la glucose imalowetsedwa m'mitsempha mu 1040 ml, nthawi zina mpaka 100 ml, koma osatinso.
Malangizo a hypoglycemia (kutsitsa shuga) m'magazi owopsa angathe kuchitidwa ntchito mu mnofu kapena subcutaneous makonzedwe a glucagon.

Ndi subcutaneous makonzedwe a insulini, lipodystrophy (kuchepa kwa kuchuluka kwa minofu ya adipose mu minofu yaying'ono) imatha kupezeka pamalo a jekeseni.

Kukonzekera kwamakono kwambiri kwa insulin komwe kumayambitsa zovuta zomwe sizigwirizana, komabe, milandu yotereyi siyiperekedwe. Kukula kwa matenda oopsa sayanjana pafupipafupi kumafuna kufooketsa (kuletsa kapena kuletsa zimagwirira) mankhwala ndi mankhwala.

Zotsatira zakugwiritsira ntchito insulin ndi matenda omwe amapezeka ndi hypoglycemia, hepatitis yacute, cirrhosis, hemolytic jaundice (chikasu cha pakhungu ndi zotupa za m'maso zimayambitsa kupindika kwa maselo ofiira am'magazi), kapamba (kutupa kwa impso), nephritis (kutupa kwa impso) matenda a impso ogwirizana ndi kuphwanya mapuloteni / amyloid metabolism, urolithiasis, m'mimba ndi zilonda zam'mimba, zotupa za mtima (mtima kulephera chifukwa chakomoka mtima matenda a mavavu ake).

Kusamala kwakukulu kumafunikira pochiza odwala omwe ali ndi matenda osokoneza bongo, omwe akudwala matenda a coronary insufficiency (cholakwika pakati pa kufunikira kwa mpweya ndi kubereka kwake) ndi kuwonongeka kwa ubongo | magazi.
Kusamala ndikofunikira pakugwiritsa ntchito insulin kwa odwala omwe ali ndi matenda a chithokomiro, matenda a Addison (vuto losakwanira la adrenal), komanso kulephera kwa aimpso.

Mankhwala a insulin oyembekezera amayenera kuyang'aniridwa bwino.
Pa trimester yoyamba ya kubereka, kufunika kwa insulin nthawi zambiri kumacheperachepera ndikuwuka mu trimesters yachiwiri ndi yachitatu.
Alfa-adrenergic blockers ndi beta-adrenostimulants, ma tetracyclines, salicylates amawonjezera kubisala kwa endo native (excretion ya thupi lopangidwa) insulin.
Thiazide diupetics (diuretics), beta-blockers, mowa ungayambitse hypoglycemia.

Kuyanjana ndi
mankhwala ena
kudzera:

Mphamvu ya hypoglycemic ya insulin imakulitsidwa hypoglycemic mankhwala m'kamwa, Mao zoletsa, Ace zoletsa, carbonic anhydrase zoletsa, kusankha beta-blockers, bromocriptine, octreotide, sulfonamides, anabolic mankhwala, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, lifiyamu, mankhwala okhala ndi Mowa .

Hypoglycemic zotsatira za insulin zimafooka njira zakulera za pakamwa, corticosteroids, mahomoni a chithokomiro, thiazide okodzetsa, heparin, ma tridclic antidepressants, sympathomimetics, danazole, clonidine, calcium njira blockers, diazoxide, morphine, phenytoin, nikotini.

Mothandizidwa ndi reserpine ndi salicylates, kufooka komanso kuwonjezeka kwa machitidwe a mankhwalawa ndizotheka.
Mankhwala okhala ndi thiol kapena sulfite, akaphatikizidwa ndi insulin, amachititsa kuti awonongeke.

Pa mimba, mtundu wa insulin, mlingo wake ndi makonzedwe ake amatsimikiziridwa ndi adokotala.
Ngati njira yoyambira yosankhidwa siyabwino, ndikofunikira kukaonana ndi dokotala ndikusankha, makamaka, njira yabwino kwambiri yovomerezeka.

Zizindikiro : kufooka kwa minofu, kufooka pang'ono, njala, kupindika mphamvu, kufinya, kufinya, kupindika, kupweteka kwa mutu, kumatuluka pafupipafupi, kutafuna, kutopa kwa chikumbumtima, kuponderezana, kapena kukwiya, zinthu zosagwirizana ndipo pomaliza, chikomokere.

Chithandizo cha vuto la hypoglycemic iyenera kuyamba pomwe.
Muzochepa, ndikokwanira kupereka tiyi wokoma, timadziti ta zipatso, uchi.
Mukakhala ndi chikumbumtima chokwanira (chikomokere) pomwepo jekeseni wa shuga (10-20 ml ya glucose 20-25%).
Pokhapokha ngati mwina kubaya jakisoni wa njira ya glucose, tikulimbikitsidwa kupaka kulowetsedwa kwa 0.001-0.002 g ga glucagon kapena 0,5 ml ya yankho la 0.1% ya adrenaline hydrochloride pansi pa khungu.
Tiyenera kukumbukira kuti pakukhazikitsa adrenaline, mavuto amatha kuchitika - palpitations, kunjenjemera, kuthamanga kwa magazi, nkhawa, ndi zina zambiri.

Syringe insulin imapezeka m'mbale zamagalasi losindikizidwa ndi zoletsa za mphira ndi aluminium yopuma.
M'mabotolo 10 ml, mu bokosi 5 ma PC kapena mu penfill (makatiriji) 1.5 ndi 3 ml zolembera ma syringe .

Zokonzekera za insulin (zonse ziwiri ndi ma cartridge) omwe sagwiritsidwe ntchito, ziyenera kusungidwa pa 2-8 ° C m'malo opanda kanthu , i.e. mufiriji (makamaka pashelufu pansi), kutali ndi mufiriji.
Kutentha kumeneku, amasunga zachilengedwe komanso zofunikira kwambiri mpaka nthawi ya alumali yomwe ikusonyezedwa phukusi. Insulin siyenera kuyikidwa mukamauluka pa ndege kuti mupewe ngozi yozizira.
Kutentha kwambiri kosungirako kumayambitsa kutsika kwapang'onopang'ono kwa zochita za mankhwala. Kuwala kwam'masiku mwachindunji kumakhudzanso zovuta, zomwe zikufulumizitsa kuchepa kwa zochita za thupi ndi zana.
Transulin ya mafuta osungunuka amatha kupendekeka ndikuyamba kukhala kwamitambo . Ma granules ndi ma flakes amapanga kuyimitsidwa kwa insulin. Kuphatikizidwa kwa kutentha ndikugwedezeka kwa nthawi yayitali kumathandizira njirayi.

Botolo la insulin lomwe wodwalayo angagwiritse ntchito amatha kusungidwa kutentha kwambiri osapitirira 25 ° C, m'malo ampaka milungu 6. Nthawi imeneyi imachepetsedwa mpaka masabata 4 mukamagwiritsa ntchito ma cartfillamu a Penfill, chifukwa zolembera za syringe nthawi zambiri zimatengedwa m'thumba lanu kutentha kotentha pang'ono. Mbale za insulin zimatha kusungidwa mufiriji kwa miyezi itatu itatha kugwiritsidwa ntchito koyamba.

Frozen insulin siyingagwiritsidwe ntchito pambuyo poyipitsa. Izi ndizowona makamaka pakuyimitsidwa. Mukamazizira, makhiristo kapena tinthu tating'onoting'ono timachulukana ndipo samasungunuka pambuyo pang'onopang'ono, zomwe zimapangitsa kuti zikhale zosatheka kuyimitsidwanso.Chifukwa chake, chiopsezo chobweretsa mlingo wosakwanira chimakulitsidwa kwambiri.

Insulin iyenera kuonedwa kuti iwonongeka. Mitundu ya insulin yomwe singathe kugwiritsidwa ntchito posintha, kutulutsa kapena kuwoneka ngati tinthu tosiyidwa.
Kuyimitsidwa kwa insulin, yomwe ikasakanikirana sikupanga kuyimitsidwa koyera kapena kukhala ndi ziphuphu, ulusi, kusintha mtundu, sikuyenera kugwiritsidwa ntchito.

1 ml ya yankho kapena kuyimitsidwa nthawi zambiri kumakhala magawo 40.
Kutengera ndi zomwe zimapangidwa, insulini imadzipatula ku zikondamoyo za nyama ndipo imapangidwa pogwiritsa ntchito njira zopangira ma genetic.

Malinga ndi kuchuluka kwa kuyeretsedwa, kukonzekera kwa insulini kuchokera ku minofu yanyama kumagawidwa kukhala monopic (MP) ndi monocomponent (MK).
Pano omwe amapezeka kuchokera ku kapamba ka nkhumba, amapangidwanso ndi zilembo C (SMP - nkhumba monopic, SMK - monocomponent ya nkhumba), ng'ombe - kalata G (ng'ombe: GMP - ng'ombe monopick, GMK - ng'ombe monocompitute).
Kukonzekera kwa insulin yaumunthu kumasonyezedwa ndi kalata C.

Kutengera kutalika kwa kuchitapo kanthu, ma insulins amagawidwa:
- kukonzekera insulin kukonzekera : kuyamba kwa mphindi 15-30, nthawi yayitali pambuyo maola 1 / 2-2, Kutalika kwa maola 4 mpaka 6,
- kukonzekera insulin kukonzekera phatikizani mankhwala omwe ali ndi nthawi yayitali yochita (kuyambira pambuyo pa 1 / 2-2 maola, kuchuluka pambuyo pa maola 3-12, kuchuluka kwa maola 8-12), mankhwala osokoneza bongo kwa nthawi yayitali (kuyamba pambuyo pa maola 4-8, kuchuluka pambuyo pa maola 8-18, kutalika kwa maola 20-30).

Matenda a shuga ndi matenda oopsa osachiritsika mwachilengedwe. Pancreas yaumunthu ndi gawo la dongosolo la endocrine lomwe limatulutsa insulin yofunika. Insulin imachita kusinthana kwa glucose, ndikofunikira kuti bongo ndi thupi lonse lizigwira ntchito. Mu shuga mellitus, kapamba amalephera kugwira ntchito mwachizolowezi. Chifukwa chake, wodwalayo amafunikira kumwa mankhwala pafupipafupi. Nthawi zambiri, mapiritsi okwanira. Koma mtundu wodwala wa shuga womwe umadalira insulin umafunikira jakisoni wokhazikika wa insulin.

Chithandizo

Mitundu yofatsa ya matenda a shuga imatha kuthandizidwa pongodya. Koma nthawi zambiri wodwala amafunikira kumwa mankhwala. Mtundu woopsa kwambiri wa matenda ashuga - mtundu wodwala wa insulin - umapezeka pafupifupi 10-15% ya milandu yodwala. Koma mtundu wina umatha kutembenukira ku wina.

Odwala omwe ali ndi matenda a shuga omwe amadalira insulin nthawi zambiri amafunikira insulin. Nthawi zambiri imapangidwa ndi bovine kapena insulin ya nkhumba, yomwe imakhala ndi zosafunika zosiyanasiyana. Izi zimasiyanitsa ndi insulin ya wodwala ku mahomoni omwe amapangidwa ndi kapamba amunthu.

Zotsatira zoyipa

Mukamagwiritsa ntchito jakisoni wa insulin kuti mukhalebe odwala Zina mwa izo sizimayambitsa nkhawa yayikulu, koma mawonekedwe ena ndiowopsa.

Izi sizitanthauza kuti wodwala amakana jakisoni wa insulin. Ndizowopsa pamoyo wake. Ndikofunika kungosankha mankhwala oyenera kuti agwirizane ndi wodwala wina. Nthawi zambiri, kusinthira ku insulin yoyeretsedwa kumachotsa zotsatira zosafunikira zambiri. Ngati izi sizikuthandizani, ndiye kuti wodwala amayenera kupita kukaphunzitsidwako. Mulimonsemo, kukana jakisoni kwa munthu wodwala matenda a shuga ndi mtundu wodalira insulin sikungatheke.

Zotheka kutulutsa thupi

Mukabayidwa insulin, mavuto osiyanasiyana amatha.

Hypoglycemia ndi njira yodziwika bwino yothandizira. Awa ndi mkhalidwe wa m'magazi womwe umadziwika ndi shuga m'magazi ocheperako pang'ono. Izi zimachitika ndi mankhwala osokoneza bongo.Mulingo wamtima wa munthu umafulumizitsa, nkhawa ndi mantha zimabuka, khungu limawonedwa. Chizungulire, kukomoka, thukuta kwambiri komanso kunjenjemera ndizotheka. Pali kumverera kwachilendo kwamanjala, omwe amayenera kuzimitsidwa kuti athetse vuto la wodwalayo (ndibwino kugwiritsa ntchito mafuta othamanga). M'mavuto ovuta kwambiri, khunyu imatha, chikomokere ndi kufa ndikotheka.

Chinanso chomwe chimachitika ndi vuto la insulin. Nthawi zambiri zimakhudzana ndi zomwe zimachitika pakumwa mankhwala osokoneza bongo. Nthawi zambiri imathandizidwa ndi atrophy ya minofu pamalo opangira jakisoni.

Somoji syndrome ndi posthypoglycemic hyperglycemia. Kusintha kwa glucose m'magazi kumabweretsa zotsatira zosayenerera kwa odwala matenda ashuga.

Lipodystrophy ndi njira yodutsitsa tinthu tating'onoting'ono tomwe timayikidwa mu jekeseni, yomwe imadziwoneka yokha pakutha kwake kapena kukula kwambiri. Ndikulimbikitsidwa kusintha malo a jakisoni pafupipafupi.

Insulin edema - imakonda kumayambika chithandizo, koma pamapeto pake imatha. Osafuna chithandizo.

Chifukwa chiyani pakufunika thandizo la matenda ashuga kufunafuna thandizo kuchokera ku malangizo ogwiritsira ntchito insulin. Ndi momwe malamulo otetezeka a mankhwalawa angakhudzire thanzi la wodwalayo.

Insulin ndi mankhwala othandizira matenda a shuga, omwe maziko ake ndi mahomoni a kapamba. Malangizo ogwiritsira ntchito mankhwalawa ndi memo yovomerezeka popereka mankhwala. Chithandizo cha Latin chikuyenera kuperekedwa ndi dokotala.

Pharmacology

Insulin, yomwe imapezeka m'magazi a anthu, imakhala ndi mahomoni omwe amachititsa kagayidwe kazakudya m'thupi la munthu, amachepetsa shuga m'magazi ndipo amathandizira kuti glucose amidwe. Chifukwa chosakwanira kupanga mahomoni ndi kapamba, kapena mosinthanitsa, munthu wowonjezera amayamba kumufuna kuchokera kunja.

Katunduyu amapangidwa mochita kufuna kuti azichiritsa kuchokera ku zikondamoyo za ng'ombe, nkhumba komanso chifukwa chopanga ma genetic engineering.

Zizindikiro zogwiritsidwa ntchito

Kwenikweni, insulin imagwiritsidwa ntchito ngati mankhwala othandizira matenda a shuga mellitus (mtundu 1) komanso pansi pa matenda ena a endocrine (ogwiritsira ntchito insulin ya matenda a matenda a shuga 2).

Insulin yomwe imagwira ntchito mwachidule imagwiritsidwa ntchito kuchepetsa shuga m'magazi ena a matenda a schizophrenia, kukula kwa furunculosis, ndi matenda am'mimba. Komanso matenda a chiwindi ndi gawo loyambirira la matenda a chiwindi.

Kuphatikiza apo, insulini imalembedwa ngati wothandizila (kuwonjezera kuchuluka kwa thupi), kwa odwala omwe ali ndi vuto la kuperewera kwa zakudya komanso okhala ndi vuto la kuperewera kwa zakudya.

Kugwiritsa ntchito insulin kumadziwika kuti ndi gawo limodzi la yankho la polarizable lomwe limagwiritsidwa ntchito pochiza matenda a m'matumbo.

Momwe mungagwiritsire ntchito

Kugwiritsa ntchito mankhwalawa kumaphatikizanso kuyambitsa kwake kukhala mu minofu kapena pansi pa khungu komanso pokhapokha pazovuta (kukhalapo kwa matenda a shuga) kudzera m'mitsempha.

Mu shuga mellitus, mlingo wovomerezeka wa insulin umayikidwa payekha malinga ndi zotsatira za kusanthula, kuphatikiza kuchuluka kwa shuga, mahomoni aproteni m'magazi, pazomwe zimangoyenera kungolankhula zokhazokha zovomerezeka. Ndipo kwa funso, pazomwe insulin ya shuga imabayidwa, titha kunena pafupifupi - 12 mmol / lita.

Mlingo wofunika wa insulini ya matenda ashuga pafupifupi magawo 10 mpaka 40 patsiku. Ndi matendawa odwala matenda ashuga, kugwiritsa ntchito insulin kutha kuwerengeka patsiku kuposa magawo zana (subcutaneously) osati oposa 50 magawo omwe ali ndi mtsempha wamitsempha yama cell.

Zowonetsa zina, mankhwalawa amatha kuikidwa mu yaying'ono Mlingo - 5-10 magawo patsiku.

Pakugwiritsa ntchito insulin, syringe yomwe imagwiritsidwa ntchito jekeseni ndi yapadera, ndi singano yomanga, ukadaulo womwe umaphatikizira jakisoni wathunthu wa zomwe zili mkati kuti musunge dosing yolondola ya mankhwala.

Ngati mankhwala adayimitsidwa pakuyimitsidwa, ndikulimbikitsidwa kugwedeza zomwe zili m'botolo musanadzaze mu syringe.

Kwa matenda ashuga, chinthu chofotokozedwera chimagwiritsidwa ntchito mu Mlingo wa 2-3. Jakisoni amachitika mphindi 30 asanayambike kudya. Mlingo umodzi mu mawonekedwe a jakisoni umayamba kugwira ntchito pakatha mphindi 60 ndikutalika kwa maola 4-8. Anayambitsa insulin m'mitsempha amayamba kuchita pambuyo pa mphindi 30, pomwe amachepetsa shuga kuti ikhale yofanana pambuyo pa ola limodzi kapena awiri.

Kutulutsa Mafomu

Mankhwala amamasulidwa mwanjira yothetsera, kuyimitsidwa, m'mabotolo, m'matotolo ena (makatiriji, makatoni ndi machitidwe omwe amagwiritsidwa ntchito kuti agwiritse ntchito cholembera).

Makamaka, yankho la jakisoni limapezeka m'mabotolo osungidwa osalala mu 5 ndi 10 ml, ntchito yomwe, monga lamulo, ili ndi magawo 20 mpaka 100 mu 1 ml yamadzi.

Mankhwalawa ndi ufa woyera wokhala ndi sulufufu wofikira 3,1%.

Njira yothetsera jakisoni ndi madzi oyera oyera achikasu ndi pH kuyambira 2 mpaka 3.5. Kupanga yankho, ufa umasungunuka m'madzi apadera a jekeseni, ndikuphatikiza HCI acid, glycerin ndi yankho la phenol kapena tricresol kuti isungidwe.

Kuyimitsa kukhudzika kwa nthawi yayitali kumatha kugulidwa m'masitolo am'madzi a 5 ndi 10 ml. Chilichonse chotere chimakhala chotsekedwa mwamphamvu ndi chivindikiro chowotchera kuti chimakulungidwa ndi kapu yokhala ndi zotayidwa.

Contraindication

Gwiritsani ntchito mosamala insulin

• Anthu odwala matenda ashuga omwe amazindikira kufupika kwa magazi m'thupi kapena kuwonongeka kwa ubongo
• Anthu omwe ali ndi matenda a chithokomiro
• Ndi matenda a genitourinary system,
• Ndi osakwanira magwiridwe antchito a impso.

Ikabayidwa pansi pakhungu, chinthu cham'magazi chitha kuwoneka ngati lipodystrophy ndikuwonetsedwa kwa atrophy mu minofu, pamalo a jekeseni.

Popeza mapangidwe a insulin aposachedwa amayeretsedwa bwino, samayambitsa matenda, koma milandu yofananira imatha kuchitika.

Mayina a kukonzekera insulin kochepa, malangizo ogwiritsira ntchito

Posachedwa, chithandizo chamankhwala chakhala chodziwika bwino cha matenda ashuga 1. Matenda a shuga a Type 2 sanaphunzire, mankhwalawo chifukwa sanali othandiza. Mwachidziwikire, mtundu wachiwiri wa matenda ashuga, omwe umatchedwa kuti osagwirizana ndi insulin, ndiwowopsa ndi zovuta zovuta zakhazikika.

Masiku ano, mankhwala ambiri amapangidwira pakamwa komanso kubayidwa. Kwa milandu yosiyanasiyana, mitundu yosiyanasiyana ya ma insulin yapangidwa - yocheperako, yocheperako komanso yocheperako.

Makampani opanga zamankhwala amapanga mita ya shuga m'magazi kwa odwala matenda ashuga, kuti athe kuzindikira kulumpha kwa shuga m'magazi mu nthawi ndikupanga jakisoni wa mankhwalawo.

Chilichonse chachitika kuti odwala azikhala ndi moyo wonse.

Mitundu ya insulin

Kukonzekera kwa insulin kumagawika m'magulu kutengera nthawi yomwe thupi likudwala. Pali mitundu isanu ya mankhwala - insulin yotsalira-yochepa, yochepa, yapakatikati, yopitilira (yowonjezereka) komanso yosakanikirana.

Nthawi yomwe amagwira ntchito mthupi amasiyanasiyana ndipo amayambira ola limodzi mpaka maola 24.

Mankhwala a ultrashort amayamba kuchita mphindi zochepa ndipo zotsatira zake zimakhala 1 mpaka 3 maola, kukulitsa insulin pambuyo pa ola limodzi ndikupitilizabe kuchepetsa shuga kwa maola 24.

Kukonzekera kwa insulin kumasiyana mosiyanasiyana momwe amagwiritsidwira ntchito.

Ngati insulin yotalika imathandizira wodwala kukhalabe ndi shuga masana, ndiye kuti insulin yocheperako imatchulidwanso kuti insulin - imagwira thupi pakudya ndipo imalepheretsa kusintha kwa mafuta omwe amapezeka panthawi ya chakudya. Ultrashort insulin imapangidwira kuti azikulumpha mwadzidzidzi mu glucose, ngati ikufunika kuchepetsedwa mwachangu.

Kukonzekera kwapafupifupi insulin

Si ma insulin onse omwe amagwiritsa ntchito mwachidule omwe amatha kusinthana wina ndi mnzake. Amakhala ndi machitidwe awo pakuwonekera komanso momwe amapangira magazi komanso thanzi la wodwalayo. Chowonadi ndichakuti mitundu yonse yachangu yamankhwala imayamba kugwira ntchito pafupifupi mphindi 30 pambuyo pa kubayidwa.

Amachepetsa kwambiri shuga. Kugwiritsa ntchito kuyambira maola atatu mpaka 8. Atalowa mkati mwa thupi, ndalamazi zimathiridwa ndi ma katekisimu, STH ndi mahomoni ena. Koma, ngakhale mankhwalawo atatha magazi, amapitilizabe m'maselo.

Mayina a mankhwalawo ndi mafotokozedwe ake aperekedwa pansipa.

Mankhwalawa, malinga ndi malangizo, ndi analogue ya mahomoni achilengedwe omwe amapangidwa m'thupi la munthu. Pogwira ntchito, ndizothamanga kwambiri zazifupi. M'mafotokozedwe ena, mankhwalawa ndi a gulu la ma insulin a ultrashort. Mankhwalawa amayamba kuchepetsa kuchuluka kwa shuga pakatha mphindi 15 pambuyo pa kuperekedwa, koma zotsatira zake zimadutsa maola atatu.

Mankhwalawa amalembedwa motere:

• Type 2 shuga
• Kusagwirizana ndi kukonzekera kwa insulin ya mitundu ina,
• Kuchuluka kwa shuga nditatha kudya,
• Chitetezo chokwanira kapena kusalolera kwa mankhwala osapatsa insulin omwe amachepetsa shuga.
• Mtundu wachiwiri wa matenda osokoneza bongo omwe amachititsa kuti munthu azikhala ndi matenda oopsa nthawi ya opaleshoni komanso ngati pali matenda ena.

Mlingo wa mankhwala ofotokozedwawo amawerengedwa ndi dokotala. Tengani mankhwalawa mu mawonekedwe a jakisoni subcutaneous, kudzera m'mitsempha, kudzera m'mitsempha. Ngati mankhwalawa apakidwa paokha, ndiye kuti wodwalayo amagwiritsa ntchito njira ina yoyambira. Mankhwalawa amalembedwa kuti ayang'anitsidwe musanadye ndipo izi ndizosiyana ndi ma insulin oyambira pang'ono.

Actrapid NM

Insulin yofulumira imeneyi imachepetsa shuga mkati mwa ola limodzi pambuyo pa jekeseni ndikupanga mpaka maola 8. NM yoyambirira ya dzinalo ikuwonetsa kuti mankhwalawo ndi mahomoni amunthu wopangidwa ndi kupanga. Mankhwala wolembedwa:

• Ndi matenda a shuga a 2,
• Ndi chitetezo chokwanira cha kuchepetsa shuga m'magome,
• Panthawi ya opareshoni
• Pa nthawi yoyembekezera.

Actrapid amalembera zovuta zama metabolic chifukwa cha kusowa kwa kuchuluka kwa mahomoni. Imayendetsedwa ndi chikomokere chifukwa chophwanya kwambiri kagayidwe kamkati. Komanso, mankhwalawo akuwonetsedwa kuti asalole mankhwala ochokera ku nyama.

Mankhwalawa amathandizidwa tsiku lililonse kuyambira katatu mpaka 6 maola 24. Ngati nthawi yomweyo wodwala amatenga mitundu ina ya mahomoni opanga, izi siziyenera kukhudza mlingo. Pokhapokha ngati mukugwiritsa ntchito kukonzekera kwa nyama, mlingowo ungathe kuchepetsedwa ndi 10%.

Insuman Rapid

Mankhwalawa malinga ndi zomwe akuwonetsa komanso zomwe wachita ndi zofanana ndi zapita. Ndi insulin yothamanga. Kutalika kwa mphamvu yochepetsa glucose ndiko, mothandizidwa ndi mankhwalawa, mpaka maola 7. Mankhwalawa amapezeka mu mbale zama insulin ndi ma cartridgeges a syringe pens modzigwiritsa ntchito.

Mankhwala chikuyendetsedwera mphindi 20 asanadye chakudya. Insuman Rapid imayenda bwino ndi insulin yayitali, yomwe imakhala ndi mapuloteni ochepa-kulemera kwa protein.

Humulin Wokhazikika

Ichi ndi insulin yaumunthu, ya gulu la ICD, yopezeka ndi mainjiniering. Monga mahomoni ena amtunduwu, amapezeka kuti jekeseni ndi syringe ndi cholembera. Zingwe ziyenera kupakidwa m'mimba (m'deralo - 2 cm kuchokera ku navel), ntchafu kapena mkono wam'mwamba. Tsamba la jakisoni liyenera kusinthidwa. Kuyala pafupi ndi tsamba jekeseni lomwe silinakhalepo.

Zotsatira zoyipa za mahomoni osokoneza bongo kapena bongo wambiri:

• Kuchepa kwa shuga kwambiri
• Thupi lawo siligwirizana
• Kuchepetsa kwamphamvu mafuta ochepetsa.

Homorap 40

Ichi ndi mankhwala othandiza okhudzana ndi ma insulin afupiafupi. Zochita zake zimayambira mphindi 30 pambuyo pa kuperekedwa ndipo zimatha mpaka maola 8.Zochita za insulin iliyonse yayifupi zimadalira malo omwe akuwongolera, njira ya jakisoni, mlingo wowerengeka molondola komanso momwe munthu amvera ndi mankhwala a wodwala.

Mankhwala amagwiritsidwa ntchito mwachangu ngati munthu ali ndi vuto la wodwala kapena wamisala. Amamenyedwa panthawi ya opareshoni. Mankhwalawa ndi oyenera kuthandizira mwana ndi mayi wapakati.

Jekeseni amapatsidwa katatu patsiku. Pobayira, mapampu a insulini amagwiritsidwa ntchito. Mutha kupanganso jakisoni polemba 1 syringe yokhala ndi insulin yayitali. Tiyenera kukumbukira kuti ndi kuphatikiza uku, mahomoni ofupikirapo amayikidwa mu syringe, kenako owonjezera.

Wamba zimatha insulin

Pazokonzekera zonse zomwe zimapangitsa kuti insulin ikonzekere, malamulo otsatirawa posungira ndi kusamutsa ndiwothandiza:

• Mbale zokhala ndi mankhwala ziyenera kutsekedwa. Ndikofunika kuwasunga pakhomo la firiji kuti lizizizirira koma osati kuzizira.
• Chipinda chofunda pansi pa madigiri 30, mahomoni ndi oyenera kugwiritsidwa ntchito osaposa mwezi umodzi. Kutentha kwambiri, sikungasungidwe.
• Mutha kunyamula katiriji ndi mankhwalawo muchikwama chanu, chikwama cha zodzikongoletsera, mthumba.
• Insulin yochepa, ndi wina aliyense, salekerera dzuwa mwachindunji. Kutentha kwambiri kumamuvulaza. Osasungira mankhwala osokoneza bongo m'galimoto yagalimoto yomwe yatsalira padzuwa.

Zizindikiro zotsatirazi zikuwonetsa kuti mankhwalawa sioyenera kugwiritsidwa ntchito:

• Njira yothetsera vutoli ndi mitambo
• Tsiku lotha ntchito lolemba pamapulawo latha kale,
• Mankhwalawo achita mazira, ndipo tsopano afungika.
• Malupu kapena ma flakes akuwonekera mu bubble,
• Botolo lidatsegulidwa ndipo lidali mwezi wopitilira.

Kulimbitsa Thupi

Pomanga thupi, mankhwalawa amagwiritsidwa ntchito m'malo mwa anabolic steroids. Zotsatira zake ndikuti glucose amasamutsidwa kupita ku minofu, chifukwa chake kukula kwakukulu kumachitika.

Mlingo wa omanga thupi amasankhidwa payekha ndi dokotala wamasewera. Chowonadi ndi chakuti kumwa mankhwala osokoneza bongo osakwanira kuchita masewera olimbitsa thupi kumabweretsa kunenepa kwambiri, chifukwa glucose amalowa osati minofu yokha, komanso mafuta ochulukirapo.

Insulin - mlingo, kanthu, malangizo

Insulin - mlingo, kanthu, malangizo

Insulin ndi mankhwala othandizira pancreatic mahomoni. Kugwiritsa ntchito kwakukulu kwa mankhwalawa chithandizo chamankhwala a matenda a shuga 1. Nthawi zina, amagwiritsidwanso ntchito pa matenda a shuga 2.

Insulin ndi mankhwala othandizira pancreatic mahomoni.

Zotsatira zoyipa

Mankhwala akaperekedwa mosavuta, lipodystrophy imayamba. Komanso, mankhwalawa amatha kuyambitsa chifuwa.

Insulin yomwe idakwezedwa chifukwa cha bongo wake wambiri imatha kudzetsa vuto la hypoglycemic. Zizindikiro: kupendekera kwachulukidwe, thukuta, kufooka, kupuma movutikira, chizungulire, palpitations, kawirikawiri - chikomokere, kukokana, kuperewera, kuzindikira.

Kodi insulin ndi chiyani?

Insulin ndi kukonzekera kwa mapuloteni-peptide a mahomoni. Insulin imagwiritsidwa ntchito ngati chida chothandiza pochiza matenda ashuga.

Insulin ndi mahomoni omwe amathandizira kagayidwe kazakudya ndipo amathandiza kuchepetsa kuchuluka kwa shuga m'magazi a wodwala. Kuchepetsa chakudya m'magazi kumatheka chifukwa cha kuchuluka kwa shuga pogwiritsa ntchito zinthu zotengera insulin mothandizidwa ndi insulin. Insulin imathandizira pakupanga glycogen ndi maselo a chiwindi ndikulepheretsa kusintha kwamafuta ndi ma amino acid kukhala chakudya.

Ndi kusowa kwa insulin mthupi la munthu, kuwonjezeka kwa shuga m'magazi kumawonedwa. Kuwonjezeka kwa shuga m'magazi kumatsutsa kukula kwa matenda a shuga komanso zovuta zina. Kuperewera kwa insulini m'thupi kumachitika chifukwa cha zovuta m'matumbo, zomwe zimawoneka chifukwa cha kusakhazikika kwa dongosolo la endocrine, pambuyo povulala kapena chifukwa champhamvu kwambiri pamalingaliro okhudzana ndi zochitika zamavuto.

Kukonzekera komwe kumakhala ndi insulin kumapangidwa kuchokera ku minofu ya zikondamoyo za nyama.

Nthawi zambiri, kupanga mankhwala kumagwiritsa ntchito minyewa ya kapamba wama ng'ombe ndi nkhumba.

Malamulo osungira

Zosungirako za insulin ndizofunikira kutsatira malamulo apadera omwe odwala matenda ashuga ambiri komanso mabanja awo sawatsata pakuyiwala kwawo. Nkhaniyi itikumbutsanso owerenga ake za momwe ma insulin angatengereko ndi momwe angaisungire bwino kunyumba.

Ndipo kotero, momwe mungasungire insulin? Malangizo pazomwe zili.

Popeza insulin ndi timadzi tambiri tokhala ndi mapuloteni, munthu amatha kupereka mwachidule chitsanzo cha kusinthasintha kwa kutentha kwa kapangidwe kake. Ndikokwanira kukumbukira kusokerera kwa mazira okazinga, pomwe kutentha kwakukulu kokwanira kumapangitsa puloteni ya dzira kupindika nthawi yomweyo. Kutentha kochepa kumakhudzanso mapuloteni ndikusintha kapangidwe kake.

Zofunika! Insulin iyenera kusungidwa popanda kutenthedwa ndi kutentha pang'ono komanso kutentha kwambiri. Zabwino kwambiri kutentha.

Zinthu zimasungidwa mu botolo, osati mufiriji, koma kutentha osaposa 25 digiri.

Momwe mungasungire insulin kunyumba, momwe ndi momwe zingawonongere? Mukamaima:

• Pa windowsill - m'chilimwe chifukwa cha kutentha kwambiri ndi kuwotchera kwadzuwa, nyengo yachisanu chifukwa cha kuzizira.
• Tikasungidwa m'mabatire pamwamba pa mafuta kapena chitofu chamagetsi,
• Pafupifupi ndi magetsi othandizira.

Kodi ndingathe kusunga insulin mufiriji? Zimachitika kuti m'chilimwe kutentha kwa mpweya kumakwera kwambiri, ndichifukwa chake amalimbikitsidwa kuti azisunga mankhwalawo mufiriji. Sikulimbikitsidwa kusunga insulin yomwe yatola mu syringe.

Zofunika! Ngati insulini yauma, simuyenera kuiwala kutenthetsa mutakhala mufiriji, ndibwino kumanja.

Botolo lotseguka la mahormoni limalimbikitsidwa kuti ligwiritsidwe ntchito mwezi umodzi. Popeza ikadatha nthawi iyi mankhwalawo amachotsa mphamvu. Moyo wa alumali pazomwe tafotokozazi si chaka, monga momwe nthawi zina amaganizira, koma pafupifupi zaka zitatu. Ngati mankhwalawo atha, ndiye kuti vial ndi mankhwalawo ayenera kutayidwa nthawi yomweyo.

Kutsatira malamulo a malangizo ogwiritsira ntchito mankhwalawa komanso malingaliro a dokotala yemwe akupezekapo, mutha kuyembekeza kusiya matenda oopsa monga matenda a shuga ndikubwerera ku moyo wabwino komanso wabwinobwino wopanda matenda.

Njira yogwiritsira ntchito mankhwala

Nthawi zambiri, kuphatikiza mankhwala okhala ndi insulin amachitika kudzera m'mitsempha kapena munsi. Ndi kukula kwa chikomokere, insulin imayendetsedwa ndi jekeseni wamkati.

Mlingo wofunika wa insulini pochiza matenda a shuga ndi insulin.

Pafupifupi mlingo wa insulin wofunsira wa insulin wa matenda a shuga mellitus amatha kuyambira 10 mpaka 40 mayunitsi.

Ngati khansa ya matenda ashuga ipezeka, mpaka magawo 100 a mankhwalawa amatha kuperekedwa pansi pakhungu kuti alipirire chipere patsiku. Ndipo mukamagwiritsa ntchito njira yolowerera yoyendetsera, osapitirira 50 mayunitsi. Nthawi zina, mlingo wa mankhwalawa umachokera magawo 6 mpaka 10.

Ngati jakisoni, syringe yapadera imagwiritsidwa ntchito, yomwe imapangitsa kuti pakhale piritsi lonse la mankhwala popanda zotsalira, zomwe zimapewe zolakwika za mlingo.

Mlingo wa tsiku ndi tsiku wa insulin umalowetsedwa m'thupi motsatira malangizo ake komanso kutengera mtundu wa mankhwalawa omwe amagwiritsidwa ntchito. Jekeseni zimachitika mogwirizana ndi chiwembu chopangidwa ndi endocrinologist.

Mphamvu ya mankhwalawa imayamba pambuyo pa makonzedwe, kutengera mtundu wake:

• ultrashort amayamba kuchita pakatha mphindi 15,
• yaitali mankhwala amayamba kugwira ntchito pambuyo maola 1-2

Botolo lagalasi limagwiritsidwa ntchito kusunga insulin. Sungani mankhwalawo pamalo ozizira otetezedwa ndi dzuwa.

Kanemayo munkhaniyi amakuuzani insulin ikafunika.