Insulin aspart magawo awiri

Kukonzekera kwa insulini kophatikizira, analogue ya insulin ya anthu. Kuyimitsidwa kwa biphasic kuphatikiza sungunuka wa insulin (30%) ndi makhiristo a insulin protart (70%). Insulin aspart yomwe imapangidwanso ndi tekinoloje ya DNA yomwe imagwiritsidwanso ntchito ngati Saccharomyces cerevisiae, mu maselo a insulin, amino acid proline yomwe ili m'malo B28 imasinthidwa ndi aspartic acid.

Pharmacology

Biphasic insulin aspart imalumikizana ndi ma cell a cell a cytoplasmic maselo ndikupanga insulini-receptor zovuta zomwe zimapangitsanso ma processor, kuphatikizapo kaphatikizidwe angapo ofunikira a michere (hexokinase, pyruvate kinase, glycogen synthetase). Kuchepa kwa kuchuluka kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa kayendedwe ka intracellular, kuchuluka kwa minofu ndi minyewa ya adipose, ndi kuchepa kwa kuchuluka kwa shuga m'magazi. Ilinso ndi zochitika zofanana ndi insulin yaumunthu mu molar ofanana. Kulowetsedwa kwa amino acid proline pamalo a B28 ndi aspicic acid kumachepetsa ma molekyulu kupanga hexamers m'chigawo chosungunuka cha mankhwalawa, chomwe chimawonedwa ndi insulin ya anthu. Motere, insulin aspart imatengedwa kuchokera subcutaneous mafuta mwachangu kuposa sungunuka insulin yomwe ili ndi biphasic insulin ya munthu. Insulin aspart protamine imamizidwa nthawi yayitali. Pambuyo sc makonzedwe, zimachitika pambuyo 10-20 mphindi, pazipita zotsatira pambuyo maola maola 4, nthawi ya ntchito mpaka maola 24 (kutengera mlingo, malo makonzedwe, magazi kuthamanga, kutentha kwa thupi ndi mulingo wa zolimbitsa thupi).

Mukakhala s / 0% U / kg kulemera kwa thupi T_max - 60 Mphindi Kumangiriza kwa mapuloteni amwazi ndikochepa (0-9%). The seramu insulin ndende amabwerera zakale pambuyo 15-18 maola.

Mimba komanso kuyamwa

Gwiritsani ntchito panthawi yomwe muli ndi pakati ndikotheka ngati chithandizo chamankhwala chikuyembekezeka kupitilira chiwopsezo cha mwana wosabadwayo (maphunziro okwanira komanso okhwima omwe sanachitike). Sizikudziwika ngati insulin aspart biphasic imatha kukhala ndi mphamvu ya embryotoxic ikagwiritsidwa ntchito panthawi yapakati komanso ngati ikukhudzanso kubereka.

Munthawi ya kuyambika kwa kutenga pakati komanso nthawi yonseyo, ndikofunikira kuyang'anitsitsa momwe odwala omwe ali ndi matenda osokoneza bongo amayang'anira ndi kuchuluka kwa shuga m'magazi. Kufunika kwa insulini, monga lamulo, kumachepa mu trimester yoyamba ndipo pang'onopang'ono kumawonjezeka muyezo wachiwiri komanso wachitatu wamapazi oyembekezera.

Panthawi yobereka komanso pambuyo pawo, kufunika kwa insulini kumatha kuchepa kwambiri, koma mwachangu amabwerera pamlingo womwe unali usanachitike mimba.

Sizikudziwika ngati mankhwalawo amadutsa mkaka wa m'mawere. Panthawi yoyamwa, pakhoza kufunikira kusintha kwa mlingo.

Insulin aspart biphasic: Zotsatira zoyipa

Edema ndi zolakwika zotupa (kumayambiriro kwa chithandizo), matupi awo sagwirizana (hyperemia, kutupa, kuyabwa kwa khungu pamalo opaka jekeseni), zotupa zonse (zotupa pakhungu, kuyabwa, kutuluka thukuta, kuphwanya m'mimba, kutsekeka kwa magazi, kuchepa kwa magazi, angioedema edema), lipodystrophy pamalo opangira jekeseni.

Kuchita

Gawo lachiwiri la insulini limagwirizana ndi mankhwala. Mphamvu ya hypoglycemic imatheka ndi mankhwala am'mlomo a hypoglycemic, sulfanilamides, ma inhibitors a MAO (kuphatikizapo furazolidone, procarbazine, selegiline), carbonic anhydrase inhibitors, ACE inhibitors, anabolic steroids (kuphatikizapo stanozolol, oxandrolone, metroprotinol ndi tetroprotinol tetrostanes) , disopyramide, michere, fluoxetine, ketoconazole, mebendazole, theophylline, cyclophosphamide, fenfluramine, pyridoxine, quinidine, quinine, chloroquine, Mowa ndi mankhwala okhala ndi ethanol. Zotsatira Hypoglycemic wa glucocorticoids bwino glucagon, kukula timadzi, mahomoni a chithokomiro, estrogens, progestogens (mwachitsanzo kulera m'kamwa), thiazide okodzetsa, CCB, heparin, sulfinpyrazone, sympathomimetics (monga wa epinephrine, salbutamol, terbutaline), isoniazid phenothiazine ofanana nawo, danazol, tricyclics, diazoxide, morphine, nikotini, phenytoin.

Beta-blockers, clonidine, mchere wa lithiamu, reserpine, salicylates, pentamidine - atha kuwonjezera komanso kufooketsa mphamvu ya hypoglycemic ya insulin.

Biphasic insulin aspart: Mlingo ndi makonzedwe

P / c, musanadye chakudya, ngati ndi kotheka - mutangodya. Jakisoni amachitidwa mu ntchafu kapena khoma lamkati lam'mimba, kapena paphewa kapena matako. Ndikofunikira kusintha malo a jekeseni mkati mwa anatomical dera (kuti muchepetse kukula kwa lipodystrophy). Kutentha kwa insulin yoyenera kuyenera kukhala kutentha kwambiri.

Mlingo wa insulin aspart biphasic amatsimikiza ndi dokotala aliyense payekhapayekha, potengera kuchuluka kwa shuga m'magazi. Pafupifupi, tsiku lililonse mlingo ndi 0.5-1 magawo / kg thupi. Ndi kukana kwa insulin (mwachitsanzo, kunenepa kwambiri), kufunikira kwa insulin tsiku ndi tsiku kumatha kuchuluka, ndipo odwala omwe ali ndi chinsinsi cha insulin.

Njira zopewera kupewa ngozi

Magawo awiri a insulini sayenera kutumizidwa iv. Mlingo wosakwanira kapena kusiya kulandira chithandizo (makamaka ndi matenda a shuga 1) kungayambitse kukula kwa hyperglycemia kapena matenda ashuga a ketoacidosis. Monga lamulo, hyperglycemia imadziwonekera pang'onopang'ono kwa maola angapo kapena masiku (zizindikiro za hyperglycemia: nseru, kusanza, kugona, khungu komanso kuyanika pakhungu, pakamwa pouma, mkodzo wowonjezera, ludzu komanso kusowa kwa chakudya, mawonekedwe a fungo la acetone mu mpweya wotulutsidwa), ndipo popanda chithandizo choyenera kumatha kupha.

Pambuyo kulipira kagayidwe kazakudya zakudya, mwachitsanzo, pakakulitsa mankhwala a insulin, odwala amatha kuona zizindikiro za matenda ena a hypoglycemia, omwe odwala amafunikira kudziwa. Odwala omwe ali ndi matenda ashuga omwe ali ndi vuto lalikulu la kagayidwe, zovuta za shuga zomwe zimachitika mochedwa zimayamba pambuyo pake ndikupita patsogolo pang'onopang'ono. Pankhaniyi, tikulimbikitsidwa kuti tichite zinthu zomwe zimapangitsa kuti kagayidwe ka magazi kagwiritsidwe ntchito, kuphatikizapo kuwunika kuchuluka kwa shuga m'magazi.

Gawo lachiwiri la insulin liyenera kugwiritsidwa ntchito molumikizana ndi kudya. Ndikofunikira kulingalira kuchuluka kwakukulu kwa kuyambiranso kwa mankhwalawa kwa odwala omwe ali ndi matenda oyanjana kapena kumwa mankhwala omwe amachepetsa kuyamwa kwa chakudya. Pamaso pa matenda othandizira, makamaka a matenda opatsirana, kufunikira kwa insulin kumakulirakulira. Kuchepa kwa impso ndi / kapena chiwindi kungayambitse kuchepa kwa insulin. Kudumpha chakudya kapena masewera osakonzekera kungayambitse kukula kwa hypoglycemia.

Ndi chitukuko cha hypoglycemia kapena hyperglycemia, kuchepa kwa chidwi ndi kuthamanga kwazomwe zimachitika, zomwe zimatha kukhala zowopsa poyendetsa kapena kugwiritsa ntchito makina ndi makina. Odwala ayenera kulangizidwa kuti achitepo kanthu popewa kukula kwa hypoglycemia ndi hyperglycemia. Izi ndizofunikira kwambiri kwa odwala omwe alibe kapena kuchepa kwa zizindikiro zakutsogolo kwa hypoglycemia kapena akuvutika ndi zochitika zapafupipafupi za hypoglycemia.

Mayina Ogulitsa

NovoMix 30 Malango: kuyimitsidwa kwa makina oyang'anira a 100 PIECES / ml, Novo Nordisk (Denmark)

NovoMix 30 FlexPen: kuyimitsidwa kwa makina oyang'anira a 100 PIECES / ml, Novo Nordisk (Denmark)

NovoMix 50 FlexPen: kuyimitsidwa kwa makina oyang'anira a 100 PIECES / ml, Novo Nordisk (Denmark)

NovoMix 70 FlexPen: kuyimitsidwa kwa makina oyang'anira a 100 PIECES / ml, Novo Nordisk (Denmark)

Zotsatira za pharmacological

Imakhudzana ndi ma receptor ena a cytoplasmic nembanemba yama cell ndikupanga insulini-receptor zovuta zomwe zimapangitsa njira zina, kuphatikizira kaphatikizidwe angapo ofunikira a michere (hexokinase, pyruvate kinase, glycogen synthetase). Kuchepa kwa kuchuluka kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa kayendedwe ka intracellular, kuchuluka kwa minofu ndi minyewa ya adipose, ndi kuchepa kwa kuchuluka kwa shuga m'magazi. Ilinso ndi zochitika zofanana ndi insulin yaumunthu mu molar ofanana. Kulowetsedwa kwa amino acid proline pamalo a B28 ndi aspicic acid kumachepetsa ma molekyulu kupanga hexamers m'chigawo chosungunuka cha mankhwalawa, chomwe chimawonedwa ndi insulin ya anthu. Motere, insulin aspart imatengedwa kuchokera subcutaneous mafuta mwachangu kuposa sungunuka insulin yomwe ili ndi biphasic insulin ya munthu. Insulin aspart protamine imamizidwa nthawi yayitali. Pambuyo sc makonzedwe, zimachitika pambuyo 10-20 mphindi, pazipita zotsatira pambuyo maola maola 4, nthawi ya ntchito mpaka maola 24 (kutengera mlingo, malo makonzedwe, magazi kuthamanga, kutentha kwa thupi ndi mulingo wa zolimbitsa thupi). Pamene s / kwa 0,2 U / kg kulemera kwa thupi Tmax - 60 Mphindi Kumangiriza kwa mapuloteni amwazi ndikochepa (0-9%). The seramu insulin ndende amabwerera zakale pambuyo 15-18 maola.

Zomwe zimachitika ndi insulin

Kukonzekera kwa insulini kophatikizira, analogue ya insulin ya anthu. Kuyimitsidwa kwa biphasic kuphatikiza sungunuka wa insulin (30%) ndi makhiristo a insulin protart (70%). Insulin aspart yomwe imapezedwa ndi maumboni a DNA obwerezabwereza pogwiritsa ntchito kupsinjika Saccharomyces cerevisiae, mu maselo osakanikirana ndi insulin, amino acid proline pamalo a B28 m'malo mwake ndi aspartic acid.

Zotsatira zoyipa za mankhwala Insulin aspart biphasic

Bongo

Zizindikiro hypoglycemia - "kuzizira" thukuta, kufooka kwa khungu, mantha, kunjenjemera, kuda nkhawa, kulefuka kwachilendo, kufooka, kusokonezeka kwa chidwi, chizungulire, kugona kwambiri, kusokonezeka kwakanthawi, mutu, nseru, tachycardia, kukokana, matenda amitsempha chikomokere.

Chithandizo: wodwalayo amatha kuyimitsa hypoglycemia yaying'ono pomwa shuga, shuga kapena zakudya zopatsa mphamvu. Woopsa milandu - mu / 40% dextrose yankho, mu / m, s / c - glucagon. Pambuyo pakupezanso chikumbumtima, wodwalayo akulimbikitsidwa kudya zakudya zamafuta ambiri kuti aletse kukonzanso kwa hypoglycemia.

Zinthu zofunika kusamala insulin

Simungathe kulowa iv. Mlingo wosakwanira kapena kusiya kulandira chithandizo (makamaka ndi matenda a shuga 1) kungayambitse kukula kwa hyperglycemia kapena matenda ashuga a ketoacidosis. Monga lamulo, hyperglycemia imadziwonekera pang'onopang'ono kwa maola angapo kapena masiku (zizindikiro za hyperglycemia: nseru, kusanza, kugona, khungu komanso kuyanika pakhungu, pakamwa pouma, mkodzo wowonjezera, ludzu komanso kusowa kwa chakudya, mawonekedwe a fungo la acetone mu mpweya wotulutsidwa), ndipo popanda chithandizo choyenera kumatha kupha.

Mankhwala ayenera kugwiritsidwa ntchito mogwirizana ndi kudya. Ndikofunikira kuganizira kuthamanga kwazomwe kumayambira pakuchitika kwa mankhwalawa odwala omwe ali ndi matenda oyanjana kapena kumwa mankhwala omwe amachepetsa kuyamwa kwa chakudya. Pamaso pa matenda othandizira, makamaka a matenda opatsirana, kufunikira kwa insulin kumakulirakulira. Kuchepa kwa impso ndi / kapena chiwindi kungayambitse kuchepa kwa insulin. Kudumpha chakudya kapena masewera osakonzekera kungayambitse kukula kwa hypoglycemia.

Kusamutsa wodwala kupita ku mtundu wina wa insulin kapena kukonzekera kwa insulin ya wopanga wina kuyenera kuchitika moyang'aniridwa ndi achipatala, kusintha kwa mlingo kungafunike. Ngati ndi kotheka, kusintha kwa mankhwalawa kungapangidwe kale jekeseni woyamba wa mankhwalawa kapena mkati mwa milungu yoyamba kapena miyezi ya chithandizo. Kusintha kwa mlingo kungafunike ndikusintha kwa zakudya komanso kulimbitsa thupi kwambiri. Kuchita masewera olimbitsa thupi mutangotha kudya kumakulitsa chiopsezo cha hypoglycemia.

Mfundo yogwira ntchito

Mankhwalawa amamangirira ku insulin receptors mu adipose minofu ndi minofu minofu. Mlingo wa shuga m'magazi umachepetsedwa chifukwa chakuti minofu imatha kuyamwa bwino glucose, kuwonjezera apo, imalowa bwino m'maselo, pomwe kuchuluka kwa mapangidwe ake mu chiwindi, mosiyana, kumachepa. Ntchito yogawa mafuta m'thupi imakulirakulira komanso imathandizira kapangidwe ka mapuloteni.

Kuchita kwa mankhwalawa kumayamba pakadutsa mphindi 10 mpaka 20, ndipo kuchuluka kwake kwakukulu m'magazi kumadziwika pambuyo pa maola 1-3 (izi ndi maulendo awiri mwachangu poyerekeza ndi mahomoni amunthu wamba). Insulin yokhayo yotere imakhala yogulitsidwa pansi pa dzina la malonda la NovoRapid (pambali pake, palinso gawo la insulini lachiwiri, lomwe limasiyana pakapangidwe kake).

Biphasic insulin

Biphasic insulin aspart ili ndi mfundo imodzimodziyo yamatenda amthupi. Kusiyana kwake ndikuti imakhala ndi insulin yocheperako (kwenikweni aspart) ndi mahomoni ocheperako (protamine-insulin aspart). Kuwerengera kwa ma insulin mu mankhwalawa kuli motere: 30% ndi mahomoni othamanga ndipo 70% ndi mtundu wanthawi yayitali.

Mphamvu yayikulu ya mankhwalawa imayamba nthawi yomweyo pambuyo pakupita (mkati mwa mphindi 10), ndipo 70% ya mankhwala ena onse amapanga insulin pansi pa khungu. Amamasulidwa pang'onopang'ono ndipo amachita pafupifupi maola 24.

Palinso njira yothetsera matenda omwe amakhala osakanikirana kwambiri a insulin (aspart) ndi mahomoni okhala ndi mphamvu yayitali kwambiri (degludec). Dzina lake lamalonda ndi Ryzodeg. Kulowetsa chida ichi, monga insulin iliyonse, mungathe kungosintha mwanjira ina, kusinthitsa malo a jakisoni (kuti mupewe kukula kwa lipodystrophy). Kutalika kwa mankhwala mu gawo lachiwiri mpaka masiku awiri mpaka atatu.

Ngati wodwala nthawi zambiri amafunikira kubayitsa mitundu yosiyanasiyana ya mahomoni, ndiye kuti ndikofunikira kwambiri kuti agwiritse ntchito gawo limodzi la insulin. Izi zimachepetsa kuchuluka kwa jakisoni ndikuthandizira kuyendetsa bwino glycemia. Koma ndi endocrinologist wokhayo amene angasankhe njira yolondola yochokera pazotsatira za kusanthula ndi kusanthula deta.

Ubwino ndi zoyipa

Insulin aspart (biphasic ndi single-gawo) imasiyana pang'ono ndi insulin wamba ya anthu. Mwanjira inayake, amino acid proline imasinthidwa ndi aspartic acid (yomwe imadziwikanso kuti aspartate). Izi zimangotukula mphamvu za mahomoni ndipo sizikugwirizana mwanjira iliyonse kulekerera kwake bwino, ntchito komanso kutsika pang'ono. Chifukwa cha kusinthaku, mankhwalawa amayamba kugwira ntchito mwachangu kwambiri kuposa mawonekedwe ake.

Mwa zovuta za mankhwala omwe ali ndi mtunduwu wa insulin, ndizotheka kudziwa, ngakhale sizimachitika kawirikawiri, komabe zovuta zina zoyipa.

Amatha kudziwonetsa okha:

kutupa ndi zilonda pamalowo jekeseni,
lipodystrophy,
zotupa pakhungu
khungu lowuma,
thupi lawo siligwirizana.

Contraindication

Contraindication kugwiritsa ntchito mankhwalawa munthu tsankho, chifuwa ndi magazi ochepa (hypoglycemia). Palibenso maphunziro owongoleredwa okhudza kugwiritsidwa ntchito kwa insulini iyi panthawi yoyembekezera komanso pakubala. Kuyesa kwazinyama kwadziwika kwawonetsa kuti mu Mlingo womwe sunapitirire zomwe mwalimbikitsa, mankhwalawa amakhudza thupi chimodzimodzi ndi insulin yaumunthu.

Nthawi yomweyo, pamene kutumikiridwa mlingo kudaposa nthawi 4-8 mwa nyama, zolakwika zimawonedwa koyambirira, kukulira kwa kusokonezeka kwa kubereka kwa ana ndi mavuto omwe amabwera pambuyo pake mtsogolo.

Sizikudziwika ngati mankhwalawa amalowera mkaka wa m'mawere, chifukwa chake sichikulimbikitsidwa kuti azimayi aziyamwitsa panthawi ya chithandizo. Ngati wodwala akufunika kubaya insulin panthawi yomwe ali ndi pakati, mankhwalawa amasankhidwa nthawi zonse kuyerekeza ndi zabwino zomwe zimabweretsa pa mayi ndi kuopsa kwa mwana wosabadwayo.

Monga lamulo, kumayambiriro kwa kubereka, kufunika kwa insulin kumachepa kwambiri, ndipo chachiwiri komanso chachitatu, mankhwala angafunikenso. Ndi matenda a shuga a gestational, chida ichi sichikugwiritsidwa ntchito. Mulimonsemo, osati kokha endocrinologist, komanso katswiri wowonera-gynecologist amayenera kupereka mankhwala omwewo kwa mayi wapakati.

Homoni wamtunduwu nthawi zambiri umaloledwa bwino ndi odwala, ndipo zoyipa zake zimagwiritsidwa ntchito kawirikawiri.

Mankhwala osiyanasiyana omwe ali ndi mayina osiyanasiyana ogulitsa malinga ndi zomwe amakupatsani mwayi wosankha jekeseni aliyense payekhapayekha. Pochita ndi mankhwalawa, ndikofunikira kutsatira njira zomwe adotolo adalimbikitsa kuti asayiwale za zakudya, masewera olimbitsa thupi komanso moyo wathanzi.

Kutulutsa Fomu

Kuyimitsidwa d / ndi 100 IU / ml 3 ml No. 5

Zomwe zili patsamba lomwe mukuwona zimapangidwa kuti zidziwitso zokha komanso sizimalimbikitsa kudzipatsa mankhwala mwanjira iliyonse. Chidacho chimapangidwa kuti chizolowere akatswiri azachipatala kuti awonjezere zambiri zamankhwala ena, potero amawonjezera luso lawo. Kugwiritsa ntchito mankhwala osokoneza bongo "Insulin aspart magawo awiri" mosakayikira limapereka mwayi wofunsana ndi katswiri, komanso malingaliro ake pa njira yogwiritsira ntchito ndi kuchuluka kwa mankhwala omwe mumasankha.

Insulin Aspart magawo awiri

Kukonzekera kwake kunapezedwa ndi ukadaulo wapadera wa DNA pogwiritsa ntchito Saccharomyces cerevisiae strain, momwe amino acid proline inasinthidwa ndi aspartic acid. Kugwiritsa ntchito mankhwalawa kungakulipireni matenda a shuga mellitus (DM), kuchepetsa mwayi wokhala ndi zovuta za matendawa, kapena kuchedwetsa kuchitika kwawo kosagonjetseka mwa anthu omwe ali ndi mbiri yakale.

Kupanga ndi mawonekedwe a kumasulidwa

The yogwira pophika mankhwala (insulin Aspart) ndi masinthidwe amtundu wa anthu insulin ya ultrashort kanthu. Wothandizira wa hypoglycemic amapezeka ngati yankho la magawo awiri (soluble insulin Aspart ndi makristalo a protamine) kwa subcutaneous and intravenous management. Kuphatikiza pazomwe zimagwira, mawonekedwe a mankhwalawa amaphatikiza othandizira. Onani tebulo pansipa kuti mumve zambiri.

Sodium hydrogen phosphate dihydrate

Sodium hydroxide 2M

Hydrochloric acid 2M

Mankhwala

The yogwira pophika mankhwala amakumana ndi enieni ma cell a cytoplasmic maselo, kupanga mtundu wa insulin receptor zovuta, zomwe zimapangitsa kaphatikizidwe kazinthu zingapo zofunika za ma enzymes. Zotsatira za mankhwalawa zimachitika chifukwa cha kuchuluka kwa shuga ndi minofu, komanso kuchepa kwa ntchito ya chiwindi.

Kusintha amino acid pamalo a B28 ndi aspicic acid kumachepetsa ma molekyulu kuti apange hexamers m'chigawo chosungunuka cha mankhwala, chomwe chimadziwika mu mtundu wachilengedwe wa mahomoni. Chifukwa cha izi, kuyamwa kwa Insulin Aspart kuchokera pamafuta a subcutaneous kumachitika mwachangu kuposa anthu. Pambuyo pakubaya kwa mankhwalawa, zotsatira za hypoglycemia zimayamba mkati mwa mphindi 15 mpaka 20, zimafika pazowonjezereka pambuyo pa maola 1-3, ndipo pambuyo pa maola 5-6, ndende ya glucose imabweranso pamlingo wake woyambirira.

Zizindikiro zogwiritsidwa ntchito

Insulin Aspart ndi mankhwala a shuga. Mtundu wachiwiri wa matenda ashuga, mankhwalawa amagwiritsidwa ntchito ngati wodwalayo wathera mphamvu kapena zolowa zamkati za insulin zolandilira pakamwa. Kuphatikiza apo, mankhwalawa amathandizidwa kuti agwiritsidwe ntchito ndi anthu omwe, kuphatikiza pa matenda oyambitsidwa (matenda ashuga), amakumana ndimikhalidwe yofanana.

Malangizo ogwiritsira ntchito

Njira yogwiritsira ntchito mankhwalawa ndi jakisoni wanjira. Jekeseni wamitsempha ndizoletsedwa. Ma insulin infusions amadziwika kwambiri kawirikawiri kuti apadera. Mankhwalawa amayenera kuperekedwa m'mimba khoma, ntchafu kapena matako. Mutha kugwiritsa ntchito analogi ya insulin ya anthu musanadye komanso mutatha kudya. Mlingo wa mankhwalawa amawerengedwa aliyense payekha kwa wodwala aliyense.

Ndi vuto laimpso kapena chiwindi, kusowa kwa mahomoni kumachepa, pomwe matenda opatsirana amayamba, omwe amafunikira kusintha kwa motsutsana kwa insulin Aspart. Zakudya za mankhwalawa zimagwirizanitsidwa ndi chakudya, motero ndikofunikira kulingalira kuchuluka kwakukulu kwa zotsatira za odwala omwe amamwa mankhwala omwe amachedwetsa kuyamwa kwa chakudya. Atalipira kagayidwe kazakudya, odwala amatha kuona zizindikiro zawo za hypoglycemia, amafunika kuyamwa msanga kapena shuga mkati.

Malangizo apadera

Mu malangizo ogwiritsira ntchito, akuti mankhwala osakwanira kapena kusokonezeka kwa mankhwala a shuga angayambitse matenda a hyperglycemia, ketoacidosis. Kugwiritsa ntchito Insulin Aspart nthawi zina kumafuna kuwonjezeka kwa majakisoni a othandizira omwe amagwiritsidwa ntchito kale a hypoglycemic. Pa mankhwalawa matenda a shuga ndi mankhwalawa, kusamala kuyenera kuchitika poyendetsa magalimoto ndi kuchita zinthu zina zowopsa zomwe zimafuna kuti anthu azikhala ndi chidwi komanso azithamanga.

Kuyanjana kwa mankhwala osokoneza bongo

Insulin Aspart siogwirizana ndi mankhwala ena. Kuchita kwa mankhwalawa kumapangidwira ndi mankhwala am'mlomo a hypoglycemic, ma inhibitors a MAO, ma inhibitors a ACE, carbonic anhydrase, sulfonamides, anabolic steroids, tetracyclines, ethanol-mankhwala. Kulera kwapakamwa, thiazide diuretics, heparin, tridclic antidepressants, morphine, chikonga choletsa hypoglycemic zotsatira za magawo awiri azigawo. Mothandizidwa ndi salicylates ndi reserpine, onse kuwonjezeka ndi kufooka kwa zochita za mankhwala kuonedwa.

Zotsatira zoyipa ndi bongo

Poyerekeza ndi ndemanga, kumayambiriro kwa chithandizo chamankhwala omwe mukufunsidwa, kuphwanya kwa Refraction kumachitika kawirikawiri, komwe nthawi zambiri kumakhala kwakanthawi. Mwina chitukuko cha thupi lawo siligwirizana mu mawonekedwe a hyperemia, kuyabwa kwa khungu pamalo jakisoni, zotupa, kutupa. Nthawi zina, mavuto ambiri amawonekera: angioedema, kutsitsa magazi, tachycardia, kupuma movutikira. Poyerekeza ndi kumbuyo kwa kuchuluka kwa insulin Aspart, zotsatirazi zam'magazi zitha kuchitika:

achina,
kukokana
hypoglycemic coma,
pachimake ululu wamitsempha,
kusokonekera kwa mawu
kukhumudwa
kuchuluka kwa matenda ashuga retinopathy,
kutuluka thukuta kwambiri.

Migwirizano yogulitsa ndikusunga

Alumali moyo wa chinthucho ndi miyezi 30 kuyambira tsiku lopangira. Insulin Aspart iyenera kutetezedwa kuti usavulaze kwambiri kutentha ndi kuwala. Sungani mahoni osinthidwa a gene pamtunda wa 2-8ºC. Mankhwalawa amagulitsidwa ndi mafakisoni kokha mwa mankhwala.

Kugwiritsa ntchito mphamvu yosintha ya mahomoni awiri magawo awiri ndizosatheka chifukwa cha kusalolera kwa ziwalo zake kapena kufunika kwa mtengo wotsika mtengo, madokotala amatipatsa mankhwala ofanana ndi Insulin Aspart. Masiku ano, ogula amapatsidwa mwayi wosankha ma hypoglycemic othandizira, koma, posankha izi kapena mankhwalawo, opanga ku USA, Japan, ndi Western Europe ayenera kusankhidwa. Nthawi zambiri, ma fanizo otsatirawa amalembedwa:

NovoRapid Flexpen,
NovoLog,
NovoRapid Penfill.

Mtengo wa Insulin Aspart

Mtengo wapakati wa mankhwala mumasitolo aku Moscow ndi pafupifupi 1700-1800 p. pa 3 ml ya hypoglycemic solution. Popeza kuti chithandizo cha matenda ashuga omwe amakhala ndi insulin yosinthidwa mwanjira zina amafunika ndalama zambiri, sizingakhale zopanda pake kulabadira zofunikira za intaneti, pomwe mtengo wa mankhwalawo ndi wotsika kwambiri kuposa momwe wafotokozedwera m'mafakisi.

Olga, wazaka 48. Ndinagwiritsa ntchito Insulin Aspart nditazindikira kuti mapiritsi a shuga amangosiya kugwira ntchito. Mlingo wa tsiku ndi tsiku wa mankhwala adokotala adauza. Kutengera ndi zomwe analandila, ndinayambitsa magawo asanu a yankho musanadye chilichonse. Chifukwa cha mankhwalawo, ndinatha kusintha kuchuluka kwa glucose panthawi yochepa.

Andrey, wazaka 50. Kwa zaka zitatu ndimadwala matenda ashuga. Mapiritsi, zakudya, moyo wokangalika sizinathandize kuchepetsa kuchuluka kwa shuga m'magazi, chifukwa chake ndinasinthira ku mankhwala a mahomoni. Dokotala adalangiza kugwiritsa ntchito Insulin Aspart. Ndinailowetsa 20 IU ya mankhwalawa tsiku lililonse kwa mwezi umodzi, pambuyo pake mkhalidwewo unakhazikika.

Elena, wazaka 56 ndakhala ndikugwiritsa ntchito Insulin Aspart kwa chaka chimodzi tsopano, ndikuyenera kuvomereza, ndikumva bwino. Izi zisanachitike, ndinakumana ndi zofowoka, kupweteka kwa minofu. Pakadali pano ndimayambitsa magawo 14 a mankhwalawa tsiku lonse. Nthawi yomweyo, ndimayang'anitsitsa kusintha kwamomwe ndimakhala, momwe ndimasinthira mlingo wa mankhwalawa tsiku lililonse.

Zokhudza mankhwalawa

Amasankhidwa kuti achepetse kuchuluka kwa dextrose mu plasma.

Kuchepetsa glucose kumayamba mwa kukonza mayamwidwe ake ndi minofu. Mankhwala amachepetsa kuchuluka kwa shuga mu chiwindi ndikuwongoletsa kuyamwa kwamaselo.

Gawo limodzi limayikidwa kwa odwala omwe ali ndi matenda a shuga 1.

Aspartum biphasic insulin imalembedwanso mtundu 2 wa shuga, ngati pali kukana antidiabetes.

Zochita za gawo limodzi ndizochepa. Zimachitika mphindi 10-20 mutatha kugwiritsa ntchito. Nthawi yowonekera mpaka maola 5.

Magawo awiri a gawo - mpaka tsiku. Zotsatira zakuchizira zimachitika pakadutsa mphindi 10, chifukwa zimakhala ndi mahomoni ofupikira komanso apakati.

Zolemba zogwiritsira ntchito

Insulin Bifaxicum ndi Aspart amatsutsana ndi odwala osakwana zaka 6. Kafukufuku wokhudzana ndi mankhwalawa pa thupi la ana sanachitike. Madokotala sakudziwa momwe mankhwalawa angakhudzire thanzi la mwana.

Timapereka kuchotsera kwa owerenga tsamba lathu!

Kumwa mankhwalawa panthawi yotsekemera sikuletsedwa. Kugwiritsa ntchito ndikololedwa ngati chiwopsezo chomwe chingakhalepo kwa mwana ndichopanda phindu kwa mayi.

Ponena za odwala okalamba, ndikofunikira kusintha mlingo. Kusintha kokhudzana ndi ukalamba m'thupi kumatha kudzetsa thanzi labwino. Popeza magwiridwe antchito amkati amasokonezeka, njira ya mankhwala a hypoglycemic imakulitsa vutoli.

Kuchita ndi mankhwala ena

Mankhwala omwe amachepetsa shuga m'magazi, omwe amatengedwa pakamwa, amathandizira gawo la yogwira. Mankhwala oterewa saloledwa. Hypoglycemia imayamba, mkhalidwe wodziwika ndi kuchepa kwa shuga m'munsi mwa zofunikira.

Anabolic steroids, Ketoconazole, Pyridoxine ndi mankhwala ena ozikidwa pa ethanol ndi tetracyclines, omwe amagwiritsidwa ntchito munthawi yomweyo ndi mankhwala a hypoglycemic, amathanso kuchepa kwambiri kwa shuga m'magazi.

Kulera kwapakamwa, heparin ndi antidepressants omwe amagwiritsidwa ntchito mu shuga mellitus kuti achepetse zizindikiro zaukali kungachepetse mphamvu ya mankhwalawa.