Insulin Lizpro ndi dzina lake lazamalonda

yankho la mtsempha wa mtsempha wa magazi ndi ma transcutaneous

1.0 ml ya yankho la intravenous and subcutaneous management muli:
ntchito: Lyspro Insulin 100 ME (3.47 mg),
zokopa: zinc oxide 25 μg, disubstituted sodium phosphate 1.88 mg, glycerol 16 mg, metacresol 3.15 mg, hydrochloric acid kuti pH 7.0-7.8, sodium hydroxide kuti pH 7.0-7.8, madzi a jakisoni mpaka 1,0 ml.

Transparent colorless solution.

Mankhwala

Lyspro insulin ndi analogue ya DNA yomwe imapanganso insulin ya anthu. Amasiyana ndi insulin yaumunthu mu kusintha kwa amino acid m'malo 28 ndi 29 a insulin B.

Mankhwala
Chochita chachikulu cha insulin lyspro ndi malamulo a kagayidwe ka glucose. Kuphatikiza apo, imakhala ndi anabolic komanso anti-catabolic zotsatira zosiyanasiyana zamthupi. Mu minofu ya minofu, pali kuchuluka kwa glycogen, mafuta acid, glycerol, kuchuluka kwa mapuloteni komanso kuwonjezeka kwa kumwa ma amino acid, koma kuchepa kwa glycogenolysis. gluconeogenesis, ketogeneis. lipolysis, mapuloteni catabolism ndi kutulutsidwa kwa amino acid.
Zawonetsedwa kuti inshuwaransi ya lyspro imakhala yofanana ndi insulin yaumunthu, koma zochita zake zimachitika mwachangu ndipo zimatha kwakanthawi.
Lyspro insulin imadziwika ndi kuyamba mwachangu (pafupifupi mphindi 15), popeza imakhala ndi kuyamwa kwambiri, ndipo izi zimaloleza kuti ziziperekedwa nthawi yomweyo musanadye (0-15 mphindi musanadye), mosiyana ndi insulin yokhazikika. Lyspro insulin imatulutsa msanga mphamvu zake ndipo imakhala ndi nthawi yofupikirako (kuyambira maola 2 mpaka 5), ​​koma poyerekeza ndi insulin yaumunthu wamba.
Odwala omwe ali ndi mtundu woyamba 1 ndi mtundu wa 2 shuga, hyperglycemia yomwe imatha kudya ndi lyspro insulin amachepetsa kwambiri poyerekeza ndi insulin yaumunthu.
Monga momwe akukonzekera insulin yonse, kutalika kwa nthawi ya lyspro insulin kumatha kukhala kosiyanasiyana mwa odwala kapena nthawi zosiyanasiyana wodwala yemweyo ndipo zimatengera mlingo, malo a jakisoni, magazi, kutentha kwa thupi ndi zochitika zolimbitsa thupi.
Mankhwala a lyspro insulin mwa ana ndi achinyamata ali ofanana ndi omwe amawonekera mwa akulu.
Kugwiritsa ntchito mankhwala a lyspro insulin mwa odwala omwe ali ndi matenda amtundu wa 2 ndipo amatsatana ndi kuchepa kwa pafupipafupi kwa zochitika za nocturnal hypoglycemia poyerekeza ndi insulle yamunthu. Kuyankha kwa glucodynamic kwa lispro insulin palokha popanda impso kapena kwa hepatic ntchito.

Pharmacokinetics
Pambuyo pakuyendetsa pang'onopang'ono, inshuwaransi ya Lyspro imatengedwa mwachangu ndikufika pandende yambiri ya plasma pambuyo pa mphindi 30-70.
Ndi subcutaneous makonzedwe, theka la moyo wa insulin lispro ili pafupifupi ola limodzi.
Odwala omwe amalephera kupweteka kwa impso, amakhala ndi vuto lochulukirapo la lyspro insulin poyerekeza ndi insulin yaumunthu. Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri, kusiyana kwa pharmacokinetic pakati pa inspro insulin ndi insulle ya insulin yaumunthu sikuyimira ntchito yaimpso.
Odwala omwe ali ndi hepatic insufficiency ali ndi mayamwidwe okwera komanso kuthana ndi insulin yayitali poyerekeza ndi insulin yaumunthu.

Gwiritsani ntchito pa nthawi yoyembekezera komanso panthawi yovuta kudya

Mimba
Zambiri pa kugwiritsa ntchito insulin lispro pa nthawi ya pakati zimasonyeza kusapezeka kwa vuto la mankhwalawa pa mimba kapena mkhalidwe wa mwana wosabadwa ndi wakhanda.
Pakati pa nthawi yayitali, chinthu chachikulu ndikukhazikitsa chitetezo chabwino cha glycemic mwa odwala matenda a shuga omwe akulandira chithandizo ndi insulin. Kufunika kwa insulin nthawi zambiri kumachepetsa panthawi yoyambirira ndikuwonjezeka panthawi yachiwiri komanso yachitatu. Nthawi yobadwa pambuyo pokhapokha ndipo mwayamba kubadwa, zofunika za insulin zimatha kugwa kwambiri. Odwala omwe ali ndi matenda ashuga ayenera kukaonana ndi dokotala ngati pakati pachitika kapena akukonzekera. Pankhani ya mimba kwa odwala omwe ali ndi matenda ashuga, chinthu chachikulu ndikuwunika mosamala kuchuluka kwa shuga m'magazi, komanso thanzi lonse.
Nthawi yoyamwitsa
Odwala nthawi yoyamwitsa angafunike kusintha njira ya insulin, zakudya, kapena zonse ziwiri.

Mlingo ndi makonzedwe

Mlingo wa mankhwala Insulin Lyspro mtima ndi dokotala payekha, kutengera kuchuluka kwa shuga m'magazi. Ndondomeko ya insulin makonzedwe ali payekha.
Mankhwala Insulin Lyspro angathe kutumikiridwa posachedwa musanadye (0-15 mphindi musanadye). Ngati ndi kotheka, mankhwala a Insulin Lyspro amatha kuperekedwa pambuyo chakudya.
Kutentha kwa mankhwala omwe amaperekedwa kuyenera kukhala kutentha kwambiri.
Mankhwala Insulin Lyspro amayenera kuperekedwa ngati subcutaneous jakisoni kapena yaitali subcutaneous makonzedwe ndi insulin pampu. Ngati ndi kotheka (ketoacidosis, matenda pachimake, nthawi pakati opaleshoni kapena nthawi ya postoperative), mankhwala a insulin Lyspro angathe kutumikiridwa kudzera m'mitsempha.
Subcutaneally ayenera jekeseni phewa, ntchafu, matako kapena m'mimba. Masamba a jakisoni amayenera kusinthidwa kuti malo omwewo asagwiritsidwerenso kuposa nthawi 1 pamwezi. Ndi subcutaneous makonzedwe a insulin Lyspro, chisamaliro ayenera kumwedwa kupewa mankhwala kulowa m'mitsempha. Pambuyo pa jakisoni, tsamba la jakisidwe siliyenera kutenthedwa. Wodwala ayenera kuphunzitsidwa njira yolondola ya jakisoni.

Malangizo Mankhwala insulin lispro
a) Kukonzekera koyambitsa
Njira yothetsera mankhwala a Insulin Lyspro iyenera kukhala yowonekera komanso yopanda utoto. Musagwiritse ntchito yankho la Insulin Lyspro ngati ili ndi mitambo, yothina, yopanda utoto, kapena ngati tinthu tating'onoting'ono tapezeka.
Mukakhazikitsa cartridge mu syringe cholembera, ndikukhala ndi singano ndikulowetsa insulin, tsatirani malangizo a wopanga omwe akuphatikizidwa ndi cholembera chilichonse. Makatoni okhala ndi Insulin Lyspro angagwiritsidwe ntchito ndi zolembera za EndoPen syringe zopangidwa ndi Beijing Gangan Technology Co, Ltd., China. Cartridges sangagwiritsidwe ntchito ndi zolembera zina za syringe kuti mugwiritse ntchito mobwerezabwereza, popeza kulondola kwa dosing ya mankhwalawo kunakhazikitsidwa pensulo za syringe pamwambapa.
b) dosing
1. Sambani m'manja.
2. Sankhani tsamba la jakisoni.
3. Konzani khungu lanu jakisoni monga momwe dokotala wanenera.
4. Chotsani kapu yodzitchinjiriza kunja kwa singano.
5. Tsekani khungu.
6. Ikani singano pang'onopang'ono ndikuchita jakisoni mogwirizana ndi malangizo ogwiritsa ntchito cholembera.
7. Chotsani singano ndikufinya pang'onopang'ono malo opaka jakisoni ndi swab ya thonje kwa masekondi angapo. Osatupa malo a jakisoni.
8. Pogwiritsa ntchito singano yakunja, vula singano ndikuitaya.
9. Ikani chipewa pa cholembera.
c) Mitsempha ya insulin
Jekeseni wa intravenous wa mankhwala a insulin Lyspro ayenera kuchitika malinga ndi chizolowezi chachipatala cha kulowetsedwa kwa jekeseni, mwachitsanzo, kulowetsedwa kwa bolus kapena kugwiritsa ntchito kulowetsedwa. Poterepa, nthawi zambiri ndikofunikira kuwongolera kuchuluka kwa shuga m'magazi.
Makina a kulowetsedwa okhala ndi zozungulira kuyambira 0,1 IU / ml mpaka 1.0 IU / ml ya insulin lispro mu 0.9% sodium chloride solution kapena 5% dextrose solution amakhala okhazikika firiji kwa maola 48.
d) Subcutaneous makonzedwe a insulin pogwiritsa ntchito insulin pump
Pamavuto a mankhwala a Insulin Lyspro, mutha kugwiritsa ntchito mapampu - njira yopitilira insulin yokhala ndi chizindikiro cha CE. Musanagwiritse inshuwaransi ya lyspro, onetsetsani kuti pampu ina ndiyabwino. Muyenera kutsatira mosamalitsa malangizo omwe abwera ndi pampu. Gwiritsani ntchito posungira ndi patheter yabwino pampu. Bokosi la insulin liyenera kusinthidwa mogwirizana ndi malangizo omwe amaperekedwa ndi izi. Pazochitika za hypoglycemic, makonzedwe amayimitsidwa mpaka gawo litatha. Ngati shuga wambiri m'magazi adadziwika, ndikofunikira kudziwitsa dokotala za izi ndikupereka kuchepa kapena kufafaniza kwa insulin. Kuperewera kwa pampu kapena kufalikira mu kachitidwe ka makonzedwe kungachititse kuti chiwopsezo cha glucose chiwonjezeke msanga. Ngati mukukayikira kuti akuphwanya insulin, muyenera kutsatira malangizo ake ndipo ngati kuli koyenera dziwitsani adokotala.
Mukamagwiritsa ntchito pampu, mankhwala a Insulin Lyspro sayenera kusakanikirana ndi ma insulini ena.

Zotsatira zoyipa

Hypoglycemia Matenda a shuga ndi omwe amapezeka odwala kwambiri. Kuopsa kwa hypoglycemia kungayambitse kusokonezeka kwa chikumbumtima (hypoglycemic coma) ndi. mwapadera, kufikira imfa.
Odwala amatha thupi lawo siligwirizana mwanjira yofiyira, kutupa, kapena kuyunkhira pamalo a jekeseni. Nthawi zambiri, zizindikirozi zimatha patatha masiku angapo kapena milungu. Nthawi zambiri sizichitika zotupa zosiyanasiyana. pomwe kuyabwa kumachitika mthupi lonse, urticaria, angioedema, malungo, kufupika, kuchepa kwa magazi, tachycardia. kutuluka thukuta kwambiri. Milandu ingapo yamomwe thupi limagwirira ntchito ikhoza kukhala yowopsa pamoyo.
Tsamba la jekeseni limatha lipodystrophy.
Mauthenga wamba:
Milandu ya chitukuko cha edema idadziwika, yomwe idapangidwa makamaka pambuyo poti magazi a shuga azikhala mwamphamvu panthawi yolimba kwambiri mankhwala oyamba osakhutiritsa glycemic (onani gawo "Special Instructions").

Bongo

Zizindikiro bongo ndi limodzi ndi chitukuko cha matenda a hypoglycemia: ulesi, thukuta, kuchuluka, kunjenjemera, tachycardia, kupweteka mutu, chizungulire, kusanza, chisokonezo.
Chithandizo: Mitundu yofatsa ya hypoglycemic imayimitsidwa ndi kuyamwa kwa shuga kapena shuga wina, kapena zinthu zokhala ndi shuga (tikulimbikitsidwa kuti nthawi zonse muzikhala ndi glu gose 20%).
Kuwongolera kwambiri hypoglycemia akhoza kuchitika ntchito mu mnofu kapena subcutaneous makonzedwe a glucagon, kenako ingestion wa chakudya pambuyo kukhazikika kwa mkhalidwe wa wodwalayo. Odwala omwe salabadira glucagon amapaka jekeseni wa dextrose (glucose) kudzera m'mitsempha.
Wodwala akakhala kuti akomoka, ndiye kuti glucagon amayenera kuthandizidwa kudzera mu mnofu kapena mozungulira. Pokhapokha glucagon kapena ngati palibe chochita ndi kuyambitsa kwake, ndikofunikira kupaka yankho la dextrose kudzera m'mitsempha. Atangozindikira, wodwalayo ayenera kupatsidwa chakudya chopatsa thanzi.
Kudya zakudya zowonjezera zamagalimoto ndi kuwunika kwa wodwalayo kungafunike, popeza kuyambiranso kwa hypoglycemia ndikotheka.
About hypoglycemia yosamutsidwa ndikofunikira kudziwitsa dokotala.

Kuchita ndi mankhwala ena

Kuopsa kwa zotsatira za hypoglycemic kumachepetsedwa ngati mugwiritsidwa ntchito limodzi ndi mankhwala otsatirawa: kulera kwapakamlomo, glucocorticosteroids, mahomoni okhala ndi chithokomiro, danazol, β₂-adrenomimetics (mwachitsanzo, ritodrin, salbutamol, terbutaline), tricyclic antidepressants, thiazide diuretics, chlorprotixen, diazoxide, isoniazid, lithiamu carbonate, nikotini acid, phenothiazine.
Kuopsa kwa zochita za hypoglycemic kumawonjezereka akagwiritsidwa ntchito limodzi ndi mankhwalawa: beta-blockers, ethanol ndi mankhwala okhala ndi ethanol, anabolic steroids, fenfluramine, guanethidine, tetracyclines, mankhwala a hypoglycemic, salicylates (mwachitsanzo, acetylsalicylic acid antioxidants, sulfonamides ), angiotensin akatembenuza enzyme inhibitors (Captopril, enalapril), octreotide, angio receptor antagonists Tenzin II.
Ngati mukufunika kugwiritsa ntchito mankhwala ena, kuphatikiza insulin, muyenera kufunsa dokotala (onani gawo "Malangizo apadera").

Malangizo apadera

Kusamutsa wodwala kupita ku mtundu wina kapena kukonzekera insulin kuyenera kuchitika moyang'aniridwa ndi achipatala. Kusintha kwa zochitika, mtundu (wopanga), mtundu (Wokhazikika, NPH, ndi zina), mitundu (nyama, munthu, analog ya insulin ya anthu) ndi / kapena njira yopanga (DNA recombinant insulin kapena insulini yachikhalidwe) chitha kubweretsa kufunika kosintha kwa mlingo.
Odwala omwe ali ndi vuto la hypoglycemic atasamutsidwa kuchokera ku insulin yochokera ku nyama kupita ku insulin yaumunthu, zizindikiro zoyambirira za hypoglycemia zitha kutchulidwa pang'ono kapena zosiyana ndi zomwe adakumana nazo kale ndi insulin. Tiyenera kukumbukira kuti zotsatira za pharmacodynamics of analogues yogwira anthu mwachangu ndikuti imatha kupezeka pambuyo pa jakisoni wa insulini ya anthu omwe amakhala mwachangu kale kuposa insulin ya anthu.
Kwa odwala omwe amalandira ma insulin achidule komanso oyambira, amafunika kusankha kuchuluka kwa ma insulin onse kuti akwaniritse kuchuluka kwa shuga m'magazi masana, makamaka usiku kapena pamimba yopanda kanthu.
Hypoglycemic yosasinthika kapena ma hyperglycemic zomwe zimachitika zimatha kuyambitsa chikumbumtima, chikomokere, kapena kufa.
Zizindikiro zakutsogolo kwa hypoglycemia zimatha kusintha kapena kusalankhula pang'ono ndi njira yayitali ya matenda a shuga, matenda ashuga a m'mimba kapena kugwiritsa ntchito mankhwala monga beta-blockers.
Mlingo wosakwanira kapena kusiya kulandira chithandizo, makamaka kwa odwala omwe ali ndi matenda a shuga 1, angayambitse matenda a hyperglycemia ndi matenda ashuga a ketoacidosis, mikhalidwe yomwe ikhoza kukhala pangozi kwa wodwalayo.
Kufunika kwa insulini kumatha kuchepa kwa odwala omwe amalephera kupweteka kwa impso, komanso kwa odwala omwe ali ndi vuto la chiwindi chifukwa cha kuchepa kwa njira ya gluconeogeneis ndi insulin metabolism. Komabe, mwa odwala omwe ali ndi vuto losatha la chiwindi, kukana insulini kungayambitse kufunika kwa insulin.
Kufunika kwa insulin kumatha kuwonjezeka ndi matenda ena, kapena kupsinjika mtima.
Kusintha kwa Mlingo kumafunikanso odwala akamachulukitsa zolimbitsa thupi kapena posintha zakudya wamba. Kuchita masewera olimbitsa thupi kumatha kuyambitsa chiwopsezo cha hypoglycemia.
Mukamagwiritsa ntchito insulin pokonzekera limodzi ndi mankhwala a gulu la thiazolidinedione, chiopsezo chotenga matenda a edema ndi matenda a mtima omwe amalephera chikuwonjezereka, makamaka kwa odwala omwe ali ndi matenda amtima komanso kupezeka kwa zinthu zomwe zingayambitse matenda osalephera a mtima.
Kugwiritsa ntchito mankhwala a insulin lispro mu ana m'malo mwa sungunuka waumunthu m'magazi ndikofunikira pakakhala pofunika kuyambitsa mwachangu insulin (mwachitsanzo, kuyambitsa insulin nthawi yomweyo musanadye).
Popewa kufalitsa matenda opatsirana, katemera aliyense ayenera kugwiritsidwa ntchito ndi wodwala m'modzi, ngakhale singano isinthidwe.

Zambiri

Lyspro insulin imagulitsidwa pansi pa dzina la malonda la Humalog. Mankhwalawa atha kugulidwa mu ma cartodges a hypodermic kapena mumbale za jakisoni. Iwo, mosiyana ndi mankhwalawa m'makalata, amatha kutumikiridwa osati kokha, komanso kudzera ndi intrausly komanso intramuscularly. Ngakhale kuti mankhwalawa amatha kusakanikirana ndi syringe imodzi ndi insulin yayitali, ndibwino kuti musachite izi ndikugwiritsa ntchito zida zamtundu uliwonse pakunyengerera. Chowonadi ndi chakuti zigawo zothandizira zamankhwala zimatha kulowa mosayembekezereka ndikupangitsa zovuta, chifuwa, kapena kuchepa kwa ntchito yogwira ntchito.

Ngati wodwala ali ndi matenda osachiritsika omwe mumayenera kumwa mankhwala ena nthawi zonse, muyenera kudziwitsa endocrinologist za izi. Lyspro insulin imagwirizana ndi mankhwala othamanga kwambiri a magazi komanso kuchuluka kwa ethanol. Mphamvu yake ya hypoglycemic ingachepetse kwambiri mankhwala a mahomoni pochiritsa chithokomiro, mankhwala a psychotropic komanso ma diuretics (diuretics).

Mankhwalawa amatha kugwiritsidwa ntchito pochiza odwala omwe ali ndi matenda osiyanasiyana. Monga lamulo, limalekerera bwino komanso kawirikawiri silimayambitsa mavuto. Zizindikiro zazikulu zagwiritsidwe ntchito:

• lembani matenda ashuga 1 (makamaka kwa odwala omwe salola bwino kukonzekera insulin),
• kuchuluka kwa shuga mutatha chakudya chomwe sichingakonzedwe ndi chithandizo china,
• kwambiri 2 matenda ashuga
• lembani matenda ashuga a 2 a kuchuluka kwambiri, pokhapokha ngati pali mapiritsi osachepera shuga komanso mapiritsi a shuga,
• kupewa mavuto a odwala matenda ashuga amtundu uliwonse omwe amachitidwa opaleshoni yayikulu.

Chifukwa cha ma molekyulu asinthidwe amtundu wa mankhwalawa mu mankhwalawa, Humalog imawonetsa mphamvu yokwanira yamankhwala ngakhale m'gulu lino la odwala matenda ashuga.

Zolemba zogwiritsira ntchito

Mlingo wofunikira wa lyspro insulin uyenera kusankhidwa ndi dokotala, chifukwa ndi wodwala aliyense. Zowonjezera zake ndikuti mitundu yoposa 40 ya mankhwalawa singagwiritsidwe ntchito nthawi imodzi. Kuchulukanso pazomwe zimalimbikitsidwa kumayambitsa hypoglycemia, chifuwa kapena kuledzera kwa thupi.

Mankhwalawa amayenera kuperekedwa nthawi yomweyo musanadye katatu pa tsiku. Ngati wodwala amathandizidwanso ndi insulin yowonjezereka, kuchuluka kwa mankhwala a Humalog kumatha kuchepetsedwa mpaka katatu, kutengera kuchuluka kwa shuga nthawi zosiyanasiyana masana komanso zina zomwe zimachitika pakapita nthawi ya matenda ashuga.

Contraindication ndi zoyipa

Chokhacho chotsimikizika cha lyspro insulin ndi hypoglycemia. Pa mimba ndi mkaka wa m`mawere, mankhwalawa amadziwidwa pokhapokha atakambirana ndi akatswiri omwe amadzidzimutsa. Chifukwa cha kuthupi kwa thupi la mkazi, kufunikira kwa insulini kungasinthe panthawi yomwe mwana akuyembekezera, kotero kusintha kwina kwa mankhwalawa kapena kusiya kwakanthawi ka mankhwala nthawi zina kumafunika. Sizikudziwika ngati mankhwalawo akudutsa mkaka wa m'mawere, popeza palibe maphunziro omwe amawongolera pamutuwu.

Zotsatira zoyipa za mankhwalawa zimachitika pafupipafupi. Koma nthawi zina odwala amatha:

• kuchuluka kwa shuga m'munsi mwa mulingo womwe mukufuna,
• Kutupa ndi kusapeza bwino pajekeseni,
• lipodystrophy,
• zotupa.

Biphasic insulin

Pali mankhwala ophatikizidwa omwe amakhala ndi insulin lispro (mahomoni a ultrashort) ndi kuyimitsidwa kwa protamine pa chinthu ichi, chomwe chimakhala ndi nthawi yayitali. Dzina lamalonda lamankhwala awa ndi Humalog Remix.

Popeza izi zimapezeka mu mawonekedwe a kuyimitsidwa (ndiye kuti, zakumwa zokhala ndi tinthu tating'onoting'ono tambiri mkati mwake), cartridge imafunika kuti igulike m'manja mwake isanayambike kuti igawire insulini momwemonso. Osagwedeza mwamphamvu chidebe, chifukwa izi zimatha kupangitsa kuti thovu lipangidwe ndikuwonjezera kuwerengera kwa mlingo womwe waperekedwa.

Monga mankhwala aliwonse omwe ali ndi matenda ashuga, gawo limodzi komanso gawo lachiwiri la Humalog liyenera kuyikidwa ndi dokotala. Mothandizidwa ndi kuyezetsa magazi, mutha kusankha mankhwalawo kuti muthane ndi wodwalayo komanso kuti muchepetse vuto la matendawa. Simungayesere mwadzidzidzi kusinthira ku mtundu watsopano wa insulin, chifukwa izi zingayambitse kupsinjika kwa thupi ndikupangitsa kuwonongeka.

Kukopa pa kuyendetsa magalimoto, machitidwe

Ndi hypoglycemia kapena hyperglycemia yolumikizana ndi regimen yosakwanira, kuphwanya kuthekera kwambiri komanso kuthamanga kwa zochitika zama psychomotor ndikotheka. Izi zitha kukhala pachiwopsezo cha zinthu zomwe zitha kukhala zoopsa (kuphatikizapo kuyendetsa magalimoto kapena makina).
Odwala ayenera kusamala kuti apewe hypoglycemia poyendetsa. Izi ndizofunikira kwambiri kwa odwala omwe ali ndi kuchepetsedwa kapena kusowa kwa kuzindikira kwa matendawa kwa hypoglycemia, kapena omwe zochitika za hypoglycemia ndizofala. Panthawi imeneyi, ndikofunikira kuwunika kuthekera kwa magalimoto ndi njira.

Kutulutsa Fomu

Yothetsera kudzera mu mtsempha wa magazi a 100 IU / ml.
3 ml ya mankhwalawa kapu yamagalasi oyera, opanda khungu (mtundu I). Katirijiyo amasindikizidwa kumbali imodzi ndi choletsa cha brkidutyl ndikuwombedwa ndi chipewa cha aluminium, inayo ndi brwaputyl plunger. Makatoni amtundu umodzi kapena asanu amayikidwa mu chida cholumikizira cha PVC film ndi aluminium foil. Mzere umodzi wa blister pamodzi ndi malangizo ogwiritsira ntchito udayikidwa pabokosi la makatoni. 10 ml ya mankhwalawa mu kapu yagalasi yowoneka bwino, yopanda utoto (mtundu wa I) wokhala ndi cholembera cha brkidutyl ndikufinya ndi kapu ya aluminiyamu.
Botolo 1 limodzi ndi malangizo ogwiritsira ntchito pabokosi lamakatoni.