Rapid Insulin: nthawi yochita ndi malangizo ogwiritsira ntchito

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

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

Mndandanda wazofananira

Tcherani khutu! Mndandandandawu umakhala ndi mawu ofanana a Insuman Rapid GT, omwe ali ndi mawonekedwe ofanana, kotero mutha kusankha nokha, poganizira mawonekedwe ndi mankhwalawa omwe adokotala adapereka. Perekani zokonda kwa opanga ku USA, Japan, Western Europe, komanso makampani odziwika bwino ochokera ku Eastern Europe: Krka, Gideon Richter, Actavis, Aegis, Lek, Hexal, Teva, Zentiva.

Alendo 11 adanenanso zakudya za tsiku ndi tsiku

Kodi ndiyenera kumwa kangati la Insuman Rapid GT?
Ambiri omwe amayankhidwa nthawi zambiri amamwa mankhwalawa katatu patsiku. Ripotilo likuwonetsa kuti anthu ena omwe amayankha mankhwalawa amamwa kangati

Mlendo wina adafotokoza za nthawi yokumana

Ndi nthawi yanji yabwino kutenga Insuman Rapid GT: pamimba yopanda kanthu, musanachitike, mutatha kapena chakudya?
Ogwiritsa ntchito patsamba ambiri nthawi zambiri amati amamwa mankhwalawa asanadye. Komabe, adotolo atha kuvomereza nthawi ina. Ripotilo likuwonetsa pamene ena onse omwe adawafunsidwa amamwa mankhwalawo.

Makhalidwe wamba. Zopangidwa:

Zogwira ntchito: insulin ya anthu (100% sungunuka wa munthu insulin) - 3,571 mg (100 IU),
zotuluka: metacresol (m-cresol), sodium dihydrogen phosphate dihydrate, glycerol (85%), sodium hydroxide (womwe umagwiritsidwa ntchito kusintha pH), hydrochloric acid (womwe umagwiritsidwa ntchito kusintha pH), madzi obayira.
Kufotokozera: madzi osalala, opanda khungu.

Katundu

Mankhwala Insuman® Rapid GT ilinso ndi insulin yofanana ndi insulin yaumunthu ndipo yopezeka ndi mainjiniya ogwiritsa ntchito K12 kufinya E. Coli. Limagwirira zake insulin:
- amachepetsa kuchuluka kwa shuga m'magazi, amalimbikitsa zotsatira za anabolic komanso amachepetsa zotsatira za ma catabolic,
- kumawonjezera kusintha kwa shuga m'maselo ndi mapangidwe a glycogen mu minofu ndi chiwindi ndikuwongolera kugwiritsa ntchito pyruvate, tikuletsa glycogenolysis ndi glyconeogeneis,
- kumawonjezera lipogenesis mu chiwindi ndi adipose minofu ndi ziletsa lipolysis,
- amalimbikitsa kutulutsa kwa amino acid mu maselo ndi kaphatikizidwe wa mapuloteni,
- kumawonjezera kutuluka kwa potaziyamu m'maselo.
Insuman® Rapid GT ndi insulini yomwe imayamba mwachangu komanso nthawi yayitali. Pambuyo pakuyang'aniridwa kwa subcutaneous, zotsatira za hypoglycemic zimachitika mkati mwa mphindi 30 ndikufika pazokwanira mkati mwa maola 1-4. Zotsatira zimatha kwa maola 7-9.

Zisonyezero zogwiritsidwa ntchito:

Matenda a shuga odwala matenda a insulin.
- Chithandizo cha matenda a shuga.
- Kukwaniritsa kubwezeretsa kwa metabolic kwa odwala omwe ali ndi matenda osokoneza bongo nthawi ya opaleshoni (asanachitidwe opareshoni, panthawi ya opaleshoni komanso nthawi ya postoperative).

Zofunika! Onani chithandizo

Mlingo ndi makonzedwe:

Kusankhidwa kwa mlingo wa insulin mwa wodwala kumachitika ndi dokotala payekha, kutengera zakudya, mulingo wakuchita zolimbitsa thupi ndi moyo. Mlingo wa insulin umatsimikizika molingana ndi kuchuluka kwa shuga m'magazi, komanso pamaziko a kuchuluka kwa zochitika zolimbitsa thupi ndi mkhalidwe wa metabolism ya carbohydrate. Werengani zambiri za kuwerengera kuchuluka kwa matenda amtundu wa 1 ndi mtundu 2. Chithandizo cha insulin chimafuna kudziphunzitsa koyenera kwa wodwala. Dokotala ayenera kupereka malangizo ofunikira kangati kuti azindikire kuchuluka kwa shuga m'magazi ndipo, mwina, mkodzo, ndikuwapatsanso malangizo oyenera osintha zakudya kapena machitidwe a insulin.
Wapakati tsiku lililonse insulin amachokera ku 0,5 mpaka 1.0 ME pa kilogalamu ya thupi la wodwalayo, ndipo 40-60% ya mlingo imagwera munthu insulin yayitali.
Posintha kuchokera ku insulin ya nyama kupita ku insulin ya anthu, kuchepetsedwa kwa insulin kungafunike. Kusintha kuchokera ku mitundu ina ya insulin kupita ku mankhwalawa kutha kuchitika kokha moyang'aniridwa ndi achipatala. Makamaka kuyang'anira mkhalidwe wa kagayidwe kazachilengedwe ndikofunikira mu masabata oyambilira pambuyo pa kusintha kumeneku.
Insuman Rapid GT nthawi zambiri imaperekedwa kwa mphindi 15-20 asanadye chakudya. Mgwirizano wamankhwala mankhwala amaloledwa. Tsamba la jakisoni liyenera kusinthidwa nthawi iliyonse. Kusintha kwa jekeseni (mwachitsanzo, kuyambira pamimba mpaka ntchafu) kuyenera kuchitika pokhapokha mukaonana ndi dokotala.
Insuman Rapid GT imatha kuperekedwa kudzera mu mankhwalawa mu hyperglycemic coma ndi ketoacidosis, komanso kukwaniritsa kufotokozera kagayidwe kachakudya koyambirira, intra- komanso postoperative nthawi ya odwala omwe ali ndi matenda osokoneza bongo.
Insuman Rapid GT sigwiritsidwe ntchito mitundu yosiyanasiyana ya mapampu a insulini (kuphatikizapo omwe adalowetsedwa), komwe kuphimba kwa silicone kumagwiritsidwa ntchito.
Osasakaniza Insuman Rapid GT ndi insulin ya ndende ina (mwachitsanzo, 40 IU / ml ndi 100 IU / ml), ndi insulini yoyambira nyama kapena mankhwala ena. Gwiritsani ntchito mayankho omveka okha, opanda khungu la Insuman Rapid GT popanda zozizwitsa zilizonse.
Kumbukirani kuti kuchuluka kwa insulini mu vial ndi 100 IU / ml, kotero muyenera kugwiritsa ntchito syringes zapulasitiki zopangidwira insulin iyi. Syringe siyenera kukhala ndi mankhwala ena onse kapena zotsalira zake.
Pamaso gawo loyambirira la insulin kuchokera pambale, chotsani kapulasitiki (kukhalapo kwa kapu ndi umboni wa vial wosatsutsana). Njira yothetsera jakisoni iyenera kukhala yowonekera komanso yopanda utoto.
Asanatenge insulini kuchokera ku vial, mpweya wofanana ndi mankhwala omwe amaperekedwa ndi insulin umayamwa mu syringe ndikujowina mu vial (osalowa madzi). Kenako vala yokhala ndi syringe imasinthidwa mozungulira ndi syringe ndipo kuchuluka kwa insulini kumatengedwa. Pamaso jakisoni, chotsani thovu lakumanzere mu syringe.
Khungu limatengedwa pamalo a jakisoni, singano imayikidwa pansi pakhungu, ndipo insulin imayamwa pang'onopang'ono. Pambuyo pa jekeseni, singano imachotsedwa pang'onopang'ono ndipo tsamba lamalowo limakanikizidwa ndi swab ya thonje kwa masekondi angapo. Tsiku lokhala ndi insulin kit kuchokera pa vial iyenera kulembedwa pa cholembera cha vial.
Mutatsegula mabotolo amatha kusungidwa pa kutentha osaposa + 25 ° C kwa masabata anayi pamalo otetezedwa ku kuwala ndi kutentha.

Zomwe Mungagwiritse Ntchito:

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

Zotsatira zoyipa:

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

Mogwirizana ndi mankhwala ena:

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

Zoyipa:

Hypoglycemia.
- Kuchita kwa hypersensitivity insulini kapena chilichonse chothandiza cha mankhwalawo.
Ngati muli ndi amodzi mwa matenda kapena mikhalidwe imeneyi, onetsetsani kuti mukumana ndi dokotala musanagwiritse ntchito mankhwalawa. Ndi chisamaliro
- Pomwe (ndizotheka kuchepetsa kufunika kwa insulini chifukwa kuchepa kwa insulin metabolism).
- Odwala okalamba (kutsika kwapang'onopang'ono kwa impso kungathe
zimayambitsa kuchepa kwamphamvu kwa zofunikira za insulin).
- Odwala omwe ali ndi vuto la kuchepa kwa hepatic (kufunika kwa insulini kumatha kuchepa chifukwa kuchepa kwa kuthekera kwa gluconeogeneis ndi kuchepa kwa insulin metabolism).
- Odwala omwe ali ndi stenosis yamphamvu kwambiri ya m'magazi komanso matenda amitsempha yama cell (hypoglycemic episode atha kukhala ndi kufunikira kwapadera kuchipatala, chifukwa pali chiopsezo cha mtima kapena matenda a mtima) a hypoglycemia.
- Odwala omwe ali ndi proliferative retinopathy, makamaka omwe sanalandire chithandizo ndi Photocoagulation (laser therapy), popeza ali ndi chiopsezo chochepa kwamayurosis okhala ndi hypoglycemia wathunthu - khungu lathunthu.
- Odwala omwe ali ndi matenda ophatikizana (popeza matenda omwe amagwirizana nthawi zambiri amawonjezera kufunika kwa insulin).
Ngati muli ndi amodzi mwa matenda kapena mikhalidwe imeneyi, onetsetsani kuti mukumana ndi dokotala musanagwiritse ntchito mankhwalawa. Mimba komanso kuyamwa
Chithandizo cha Insuman® Rapid GT panthawi yoyembekezera ziyenera kupitilizidwa. Insulin siyidutsa chotchinga. Kusunga moyenera kagayidwe kazakudya panthawi yonse yoyembekezera ndikovomerezeka kwa azimayi omwe ali ndi matenda ashuga asanabadwe, kapena amayi omwe apanga matenda a shuga.
Kufunika kwa insulin panthawi yapakati kumatha kuchepa panthawi yayitali ya kubereka ndipo nthawi zambiri kumawonjezeka panthawi yachiwiri komanso yachitatu ya kutenga pakati. Pambuyo pobadwa, insulini ikucheperachepera (chiwopsezo cha hypoglycemia). Pa nthawi ya pakati komanso makamaka mukabereka mwana, kuwunika mosamala kuchuluka kwa shuga m'magazi kumafunika.
Ngati muli ndi pakati kapena mukufuna kubereka, onetsetsani kuti mwadziwitsa dokotala.
Palibe zoletsa pa insulin mankhwala panthawi yoyamwitsa.
kupezeka, komabe, mlingo wa insulin komanso kusintha kwa zakudya kungafunike.

Bongo

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

Malo opumulira:

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

Wopanga - Sanofi-Aventis (France), Sanofi

Mutu: Insuman® Rapid GT, Insuman® Rapid GT

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

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

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

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

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

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

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

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

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

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

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

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

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

Novorapid ndi mankhwala osinthika mwanjira inayake, omwe safuna kudya zakudya zowonjezera, ndipo jakisoni amatha kuchitidwa mukatha kudya komanso musanadye. Achire zotsatira kumatenga pafupifupi 4 maola. Insuman Rapid ndi analogue ya munthu mahomoni, kudya komwe kumalumikizidwa ndi chakudya kapena kusuta nthawi zonse, komanso kuyambitsa jekeseni wa subcutaneous mphindi 40 asanadye. Kutalika kwa zotsatira zake ndi pafupifupi maola 6. Zithandizo zonse ziwiri ndizifupi, ndipo madokotala nthawi zambiri amasintha zina ndi zina popanda kuvulaza thanzi la wodwalayo.

Chidule cha Mankhwala Osokoneza bongo

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

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

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

Zophatikizira ndi kapangidwe

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

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

Chida chake ndi yankho lomveka popanda mtundu wotchulidwa, phokoso.

Magazi

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

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

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

Zizindikiro ndi contraindication

Mankhwalawa ali ndi chidziwitso chachikulu - matenda a shuga amtundu uliwonse mwa ana kuyambira zaka 2, achinyamata ndi odwala akuluakulu.

Kugwiritsa ntchito othandizira a hypoglycemic ayenera kuthandizidwa mosamala chifukwa cha zovuta zina. Novorapid ali osavomerezeka kuti agwiritsidwe ntchito ndi tsankho la munthu pazigawo zina, zimayambitsa matupi amtundu uliwonse wa Novorapid. Zowonjezera zothandizira ana osaposa zaka 2 sizikudziwika chifukwa cha kuchepa kwa maphunziro azachipatala kwa odwala a m'badwo uno.

Malangizo apadera

Chimodzi mwazovuta zomwe zimachitika ndi makonzedwe atsatanetsatane ndi hypoglycemia. Nthawi zambiri, kusokonezekaku kumachitika chifukwa cha kuchuluka kwa mankhwalawa, ndikuphwanya kwa regimen. Novorapid ali ndi nthawi yofupikirako, koma amayambira mwachangu. Izi zimachepetsa chiopsezo cha nocturnal hypoglycemia. Mlingo umasankhidwa mosiyanasiyana payekha, zomwe zimachitika chifukwa cha mbiri yakale yachipatala, zomwe zimayambitsa matenda ochulukirapo, matenda ndi chikhalidwe cha matenda ashuga. Ndi mbiri yodwala matenda, tikulimbikitsidwa kuyang'anitsitsa index ya glycemic m'magulu onse a odwala. Novorapid angayambitse kuyipa kwa ana aang'ono.

Limagwirira a zochita za mankhwala

Kupanga ma genetic engineering, insulin Insuman Rapid GT ndi yofanana ndi timadzi tomwe timapangidwa ndi ma cell a pancreatic beta. Mankhwalawa amasulidwa mwanjira yothetsera mtundu wopanda mtundu, womwe umabayidwa.

Chithandizo chogwira mankhwalawa ndi insulin yaumunthu. Kuphatikiza apo, kukonzekera kumakhala ndi zinthu zina zochepa: glycerol (85%), sodium hydroxide, m-cresol, hydrochloric acid, sodium dihydrogen phosphate dihydrate ndi madzi osungunuka.

Hafu ya ola limodzi atalowa m'thupi la munthu, zochita zake zimayamba. Achire kwambiri achire zotsatira zimabwera pambuyo pa mawola atatu pambuyo poti jakisoni atenga maola 8. Panthawi yonseyi, insulin imakumana ndi zotsatirazi:

• kutsika kwa ndende ya magazi,
• kukulitsa zotsatira za anabolic, ndiko kuti, kukonza ndi kupanga maselo atsopano,
• chopinga wa catabolic kanthu - kagayidwe kachakudya,
• kuchuluka kwa shuga mumaselo, mapangidwe a glycogen mu chiwindi ndi minofu,
• kugwiritsa ntchito mankhwala omaliza a glucose - mapeto,
• kuletsa kwa glycogenolysis, glyconeogeneis ndi lipolysis,
• kuchuluka kwa maujiais mu minofu ya adipose ndi chiwindi,
• kudya kwa potaziyamu yambiri m'magawo a ma cell.

Muzochita zachipatala, Insuman Rapid imasakanikirana ndi ma insulin ena aumunthu, omwe amapangidwa ndi Hoechst Marion Roussel, kupatula mahomoni omwe amagwiritsidwa ntchito kupangira mapampu.

Analogi ndi ma genetic

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

Novomix itha kukhala m'malo mwa Novorapid.

Kufotokozera kwa mahormone

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

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

Mankhwala a Pharmacodynamic

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

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

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

Zotsatira zotsatirazi ziyenera kudziwitsidwa ndikuwonetsa zazikulu:

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

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

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

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

Mtengo Zimatengera zinthu zambiri zosiyanasiyana.

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

Insuman Rapid GT Muli insulini yofanana ndi insulin yaumunthu ndipo yopezeka ndi ma genetic engineering ogwiritsa ntchito K12 kufinya E. Coli.

Contraindication Insuman Rapid GT

• achina,
• Hypersensitivity zimachitikira insulin kapena chilichonse chothandiza cha mankhwala.

Ndi chisamaliro Mankhwala ayenera kugwiritsidwa ntchito ngati aimpso kulephera (kuchepa kwa insulin chifukwa cha kuchepa kwa insulin metabolism ndikotheka), mwa odwala okalamba (kuchepa kwapang'onopang'ono kwa ntchito ya impso kungayambitse kuchepa kosafunikira kwa insulin), mwa odwala omwe ali ndi vuto la chiwindi (kufunika kwa insulin kungachepe chifukwa kuchepa kwa kuthekera kwa gluconeogenesis ndi kuchepa kwa insulin kagayidwe) mwa odwala omwe ali ndi vuto lalikulu la chithokomiro chamitsempha cham'mimba makamaka ndi zamankhwala, popeza pali chiopsezo cha mtima kapena matenda a mtima (hypoglycemia), mwa odwala omwe ali ndi proliferative retinopathy (makamaka omwe sanalandire chithandizo ndi photocoagulation (laser therapy), chifukwa ali ndi chiopsezo chocheperapo kapenaurosis yokhala ndi hypoglycemia - khungu lonse ), mwa odwala omwe ali ndi matenda ogwirizana (kufunika kwa insulin nthawi zambiri kumawonjezeka).

Mlingo umasankhidwa payekha, moyang'aniridwa ndi dokotala. Lowani nthawi zambiri maola 4 kapena 6 aliwonse

Hypoglycemic mankhwala, osakhalitsa insulin. Insuman Rapid ili ndi insulin, yofanana ndi insulin yaumunthu ndipo yopezeka ndi mainjiniya ogwiritsira ntchito K12 kufinya E. coli.

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

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

Zotsatira zoyipa Insuman Rapid GT

Kuchokera pamtima: pafupipafupi osadziwika - kuchepa kwa magazi.

Kuchokera kumbali ya kagayidwe ndi zakudya: Nthawi zambiri - edema, osadziwika pafupipafupi - posungira sodium. Zotsatira zomwezi zimatheka ndikusintha kwa kusakwanira kwa kagayidwe kachakudya chifukwa chogwiritsa ntchito kwambiri insulin.

Kuchokera kumbali ya gawo la masomphenyawo: kusunthika sikudziwika - kusokonezeka kowoneka kwakanthawi (chifukwa chakusintha kwakanthawi kwa ma mandala amaso ndi ma index awo othandizanso), kuwonongeka kwakanthawi machitidwe a matenda ashuga (chifukwa cha insulin yochulukirapo ndikusintha kolimba pakulamulira kwa glycemic), maurosis osakhalitsa (odwala omwe ali ndi prinifosic prinopathy. alandire chithandizo cha Photocoagulation (laser mankhwala).

Pa khungu ndi subcutaneous minofu: pafupipafupi sizikudziwika - kukula kwa lipodystrophy pamalo opangira jakisoni ndikuchepetsa kwa insulin. Kusintha komwe kumayambira jakisoni mkati mwa malo oyendetsera othandizira kungathandize kuchepetsa kapena kuyimitsa izi.

Zovuta ndi zovuta zina pamalo opangira jakisoni: pafupipafupi sizikudziwika - redness, ululu, kuyabwa, urticaria, kutupa kapena kutupa pakhungu. Zinthu zomwe zimatchulidwa kwambiri ndi insulini pamalo opangira jakisoni nthawi zambiri zimatha patatha masiku angapo kapena milungu ingapo.

Zizindikiro kuchuluka kwa insulin, mwachitsanzo, kuyambitsa insulin yochulukirapo kuyerekeza ndi chakudya kapena mphamvu, kumatha kudzetsa matenda oopsa ndipo nthawi yayitali.

Chithandizo: Zolemba zofatsa za hypoglycemia (wodwalayo amadziwa) zitha kuyimitsidwa ndikutenga chakudya mkati. Pangakhale kofunikira kusintha mtundu wa insulin, kudya zakudya ndi zochita zolimbitsa thupi. Ziwonetsero zoopsa za hypoglycemia ndi chikomokere, kukomoka kapena kuwonongeka kwa mitsempha zitha kuyimitsidwa ndi / m kapena s / c makonzedwe a glucagon kapena iv wokhala ndi yankho lokwanira la dextrose. Mu ana, kuchuluka kwa dextrose kutumikiridwa kumayikidwa molingana ndi kulemera kwa thupi la mwana. Pambuyo pakuwonjezera kuchuluka kwa shuga m'magazi, kudya zakudya zopatsa mphamvu komanso kuunika kungafunike, popeza Pambuyo pakuwonekera kachipatala pakutha kwa zizindikiro za hypoglycemia, kuyambiranso kwake ndikotheka. Mlandu wa hypoglycemia wowopsa kapena wowerengeka wothandizidwa ndi jekeseni wa glucagon kapena makonzedwe a dextrose, tikulimbikitsidwa kuti njira yotsika kwambiri ya dextrose imayikiridwa kuti tipewe kukonzanso kwa hypoglycemia. Mu ana aang'ono, ndikofunikira kuyang'anitsitsa kuchuluka kwa shuga m'magazi, molingana ndi chitukuko chachikulu cha hyperglycemia. Pazinthu zina, ndikulimbikitsidwa kuti wodwala azigonekedwa m'chipinda cha odwala osamala kwambiri kuti athe kuyang'anitsitsa momwe alili komanso kuwunika kwa chithandizo chanthawi zonse.

Kugwiritsa ntchito mosiyanasiyana ndi mankhwala am'mlomo a hypoglycemic, ACE inhibitors, disopyramide, fibrate, fluoxetine, Mao inhibitors, pentoxifylline, propoxyphene, salicylates, amphetamine, anabolic steroids ndi mahomoni ogonana amuna, cybenzoline, phenophosphamine, phenophosphamine ndi phenophosphamine ake analogues, sulfonamides, tetracyclines, tritokvalin kapena trophosphamide amatha kupititsa patsogolo hypoglycemic zotsatira za insulin komanso draspolozhennost hypoglycemia.

The ntchito munthawi yomweyo corticotropin, corticosteroids, danazol, diazoxide, okodzetsa, glucagon, isoniazid, oestrogens ndi gestagens (mwachitsanzo, kupezeka PDA), phenothiazine ofanana nawo, kukula timadzi, mankhwala sympathomimetic (mwachitsanzo, wa epinephrine, salbutamol, terbutaline), mahomoni a chithokomiro, barbiturates, nicotinic acid, phenolphthalein, mankhwala a phenytoin, doxazosin imatha kufooketsa mphamvu ya insulin.

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

Ethanol imatha kupanga kapena kufooketsa mphamvu ya insulin. Kudya kwa Ethanol kumatha kuyambitsa hypoglycemia kapena kuchepetsa shuga wambiri m'magazi kuti akhale owopsa. Kulekerera kwa Ethanol mwa odwala omwe amalandira insulin kumachepetsedwa. Dokotala ayenera kudziwa kuchuluka kovomerezeka kwa Mowa.

Pogwiritsa ntchito munthawi yomweyo pentamidine, kukula kwa hypoglycemia ndikotheka, komwe nthawi zina kumatha kukhala hyperglycemia.

Pogwiritsa ntchito munthawi yomweyo ndi othandizira achifundo, monga beta-blockers, clonidine, guanethidine ndi reserpine, kufooka kapena kusakhalapo kwa zizindikiritso za Reflex (poyankha hypoglycemia) kutsegulira kwa mantha am'magazi kumatha.

Mankhwalawa amayenera kusungidwa m'malo amdima, osawonekera kwa ana pa kutentha kwa 2 ° C mpaka 8 ° C. Moyo wa alumali: zaka ziwiri.

Mankhwala Opezeka

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

Kodi matenda ashuga ndi chiani?

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

Pankhaniyi, wodwalayo akhoza kumva zotsatirazi:

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

Kodi ndichifukwa chiyani insulin ndi yofunika kwambiri kwa thupi?

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

Ntchito zomwe amathetsa ndi izi:

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

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

Mitundu ya insulin

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

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

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

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

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

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

Zomwe amamwa mankhwalawo

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

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

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

Chida ichi chimanena za mankhwalawa omwe amagwiritsidwa ntchito kwa odwala matenda a shuga. Wopangayo ndi kampani yopanga mankhwala yaku France.

Kodi mankhwalawa ndi otani, momwe mungagwiritsire ntchito moyenera, zabwino zake ndizotani pamankhwala ena, ndipo amasonyezedwa kwa odwala onse? Pali mafunso ambiri, koma kwa aliyense wa iwo mutha kupeza yankho m'nkhaniyi.

Makhalidwe ndi kapangidwe

Mankhwala Insuman mwachangu amapezeka mu mawonekedwe amadzimadzi, iyi ndi yankho, imalowetsedwa pakhungu. Zizindikiro zazikulu zogwiritsidwa ntchito ndi matenda: shuga mellitus, ketoacidosis, chikomokere.

Zinthu zomwe zimagwira ndi insulin ya anthu mwa mawonekedwe a 100% (3,571 mg).

Zinthu zina monga: m-cresol, sodium dihydrogen phosphate dihydrate, sodium hydroxide, glycerol, hydrochloric acid, madzi ogwiritsira ntchito jakisoni.

Mankhwala alibe mtundu, ali wowonekera kwathunthu.

Makhalidwe

Katundu wofanana ndi insulin yaumunthu amapangidwa mwanjira yamakono pogwiritsa ntchito ma genetic engineering. Vuto la K 12 la E. Coli adatengedwa ngati chuma choyambira.

Mankhwala a pharmacodynamic a mankhwala ndi awa:

Insuman Rapid HT ndi insulini "yothamanga" kwambiri yomwe imatha kukwaniritsa vuto la hypoglycemic mkati mwa theka la ola pambuyo pakubayidwa kwapansipansi, ndipo mkati mwa maola 3-4 pamakhala kuwululidwa kwathunthu kwa luso lalikulu lazithandizo lomwe limatenga nthawi yayitali, pafupifupi maola 9.

Ntchito, Mlingo wamagulu osiyanasiyana a odwala

M'pofunika kunena kuti mulingo womwewo umagwirizana ndi zambiri za wodwalayo.

Dokotala yemwe ali ndi inu amakwaniritsa nthawi yomwe magawo otsatirawa amagwiritsidwa ntchito:

Chofunika ndichakuti wodwalayo azitha kuchitira insulin mankhwala, zomwe sizimangotanthauza kuyesa kuchuluka kwa shuga mumkodzo ndi magazi, komanso kuperekera jakisoni.

Mankhwala akamapita, adotolo amawerengera zakudya zomwe amapeza pafupipafupi komanso amadyanso masinthidwe ena. M'mawu ena, chithandizo chamankhwala chodalirika ichi chimafuna kuti munthu azikhala ndi chidwi ndi chidwi ndi zomwe ali nazo.

Pali mlingo womwe ukutuluka, umadziwika ndi kuchuluka kwa insulin pa kilogalamu ya thupi la wodwalayo ndipo umachokera ku 0.5 mpaka 1.0 IU. Pankhaniyi, pafupifupi 60% ya mankhwalawa ndi insulin yayitali ya anthu.

Ngati Insuman Rapid HT isanachitike, odwala matenda ashuga omwe amagwiritsa ntchito mankhwala omwe amapezeka, ndiye kuti kuchuluka kwa insulin yaumunthu kuyenera kuchepetsedwa poyamba.

Simuyenera kuchoka pa mitundu ina ya mankhwalawa kupita kwa uyu popanda kudziwa dokotala; chisamaliro chofunikira chikufunika pano, pena vutoli lingachitike mwadzidzidzi ndipo matendawa akuipiraipira. Nthawi yosinthira iyi ikuwonetsedwa pakusintha kwa kagayidwe kazakudya kwa masiku angapo.

Kukhazikitsa kwa mankhwala omwe mukufunsidwa kumachitika pansi pa khungu kapena minofu musanadye mphindi 20. Malowo jakisoni amayenera kusinthidwa nthawi zonse, jakisoni sayenera kuperekedwa pafupipafupi m'dera limodzi la thupi, koma kusintha kwa malo kumachitika kokha ndi adokotala, atakambirana.

Zofunika! Ndi zoletsedwa kusakaniza Insulin Rapid ndi mitundu ina ya insulini kapena mankhwala a ndende ina. Kuti mugwiritse ntchito, njira yokhayo yodziwika bwino kapena yopanda utoto yomwe siyikhala ndi zodetsa zowoneka ndi zosayenera ziyenera kugwiritsidwa ntchito.

Ndi ma syringe ati omwe angagwiritse ntchito jakisoni? Kumbukirani, muyenera kugwiritsa ntchito syringes zapulasitiki pokhapokha jakisoni, ziyenera kupangidwira mwachindunji muyezo ndi ndende zomwe zimaperekedwa. Mu cholembera sichingakhale zinthu zina zosadetsa kapena zotsalira.

Monotherapy imakhudzana ndikupereka insulin katatu patsiku ndikusintha kwa jekeseni. Izi zimathandiza kupewa kukula kwa atrophic phenomena mu subcutaneous mafuta dongosolo.

Malangizo apadera

Mlingo uyenera kupangidwa poganizira za munthu payekha komanso zomwe zingachitike ndi matenda, zomwe zimaphatikizira

Kwa azimayi apakati mu trimester yoyamba, kuchepa kwa insulin kumakhala ndi zochitika, ndipo nthawi yotsatira, kufunikira kumawonjezeka pang'ono. Panthawi yogwira ntchito komanso pambuyo pa nthawi yobereka, kufunikira kumachepetsedwa. Kwa amayi oyamwitsa ana - chidwi chapadera cha madokotala chimafunikira mpaka kukhazikika, nthawi imeneyi imatha kupitirira mwezi umodzi.

Odwala omwe amalandira mlingo wa mapiritsi a 100 a insulin kapena zambiri patsiku, pazoyenera kusintha mankhwalawo, zofunikira kuchipatala ndizofunikira.

Kukonzekera - analogues

Mtengo Insuman Rapid GT ukhoza kukhala wosiyana kutengera dera. Pafupipafupi, amachokera ku ruble 1,400 mpaka 1,600 pa paketi iliyonse. Zachidziwikire, izi si mtengo wotsika kwambiri, chifukwa anthu amakakamizidwa "kukhala" pa insulin nthawi zonse.

Malangizo ogwiritsira ntchito mankhwalawa

Makonzedwe a insulin makonzedwe ndi mlingo wake amapangidwa ndi adokotala, omwe amaganizira zomwe zikuwonetsa shuga komanso kuopsa kwa mkhalidwe wa wodwalayo.

Mukatha kugula mankhwalawa, muyenera kuwerenga malangizo omwe aphatikizidwa. Ngati muli ndi mafunso, muyenera kufunsa dokotala.

Mukamagwiritsa ntchito mankhwalawa, munthu ayenera kutsatira mosamalitsa malangizo omwe adalandira kuchokera kwa dokotala ndi malingaliro omwe akuwonetsa mu malangizo omwe angagwiritsidwe ntchito.

Malangizowa ali ndi mndandanda wathunthu wa machitidwe omwe insulin imagwiritsidwa ntchito:

1. mtundu uliwonse wa matenda ashuga ofuna insulin,
2. chitukuko cha matenda a shuga (ketoacidotic kapena hypersmolar),
3. ketoacidosis - kuphwanya kagayidwe ka chakudya chifukwa chosowa insulin,
4. kukwanitsa kulipira anthu odwala matenda ashuga omwe adzachitidwa opaleshoni kapena opaleshoni.

M'mayendedwe ophatikizidwa mulibe kuchuluka kwa kuchuluka kwa mankhwalawa, amangotchulidwa ndi dokotala. Mlingo wapamwamba sapitirira 0,5-1 IU / kg patsiku. Kuphatikiza apo, Rapid insulin imagwiritsidwa ntchito ngati timadzi tomwe timakhala nthawi yayitali, mlingo wa tsiku ndi tsiku womwe ndi osachepera 60% ya kuchuluka kwa mankhwalawa. Wodwala akatembenuka kuchokera ku mankhwala ena kupita ku Insuman Rapid, vuto lake liyenera kuyang'aniridwa ndi dokotala. Mutha kuwunikira mfundo zazikuluzikulu zakugwiritsa ntchito mankhwalawa:

• yankho limaperekedwa kwa mphindi 15 mpaka 20 musanadye,
• jakisoni amapatsidwa subcutaneously komanso intramuscularly,
• malo a jakisoni amayenera kusinthidwa pafupipafupi
• ndi hyperglycemic chikomokere, ketoacidosis ndikukwaniritsa kagayidwe kachakudya kagayidwe kachakudya, mankhwalawa amaperekedwa kudzera mu mtsempha wa magazi,
• mankhwalawa sagwiritsidwa ntchito pamapampu a insulin,
• 100 IU / ml syringes amagwiritsidwa ntchito jakisoni,
• Insulin yodzala simasakanikirana ndi mahomoni a nyama ndi zina, mankhwala ena,
• musanabaye jekeseni, yang'anani yankho, ngati pali ma cell mkati mwake - kuyambitsa ndikuloletsedwa.
• pamaso pa jakisoni, mpweya umatengedwa mu syringe (voliyumu imakhala yolingana ndi kuchuluka kwa insulin), kenako ndikutulutsidwa m'botolo
• kuchuluka kwa yankho kumachotsedwa mu botolo ndipo thovu limachotsedwa,
• Khungu limakhazikika ndipo mahomoni amayambitsidwa pang'onopang'ono,
• mutachotsa singano, tampon kapena swab thonje imayikidwa pamtengo.
• tsiku la jakisoni woyamba walembedwa pabotolo.

Mankhwalawa amasungidwa m'malo amdima osapeza ana aang'ono. Kutentha kosungirako ndi madigiri 2-8, yankho lake sayenera kuzizira.

Moyo wa alumali ndi zaka ziwiri, atatha nthawi imeneyi kugwiritsa ntchito mankhwalawo ndizoletsedwa.

Contraindication, zotheka kuvulaza ndi bongo

Mankhwalawa ali ndi ma contraindication awiri okha - kuzindikira kwamunthu pazigawo ndi msinkhu wa ana mpaka zaka ziwiri.

Kuchepetsa kumeneku kumachitika chifukwa chakuti palibe kafukufuku yemwe adachitapo zokhudzana ndi Rapid insulin pa ana aang'ono.

Chizindikiro cha mankhwalawa ndi mwayi woti angagwiritse ntchito pakhungu ndi poyamwitsa.

Nthawi zina, chifukwa cha bongo kapena zifukwa zina, zotsatira zoyipa za mankhwalawa zimachitika:

1. Hypoglycemia, zomwe zizindikiro zake ndi kugona, tachycardia, chisokonezo, mseru, ndi kusanza.
2. Kutalika kwakanthawi kwa ziwalo zooneka, nthawi zina kukula kwa zovuta - matenda ashuga retinopathy. Matendawa amayamba chifukwa cha kutukusira kwa retina, komwe kumabweretsa chithunzi chosalala pamaso pa maso, zolakwika zosiyanasiyana.
3. Kuwonongeka kwamafuta kapena redness m'dera la jakisoni.
4. Hypersensitivity zochita zimakhala zosowa. Izi zitha kukhala angioedema, bronchospasm, kutsitsa magazi kapena kukhumudwa kwa anaphylactic.
5. Mapangidwe a ma antibodies ku hormone yoyambitsidwa.
6. Kusungidwa kwa sodium mthupi la munthu, chifukwa cha kupezeka kwa kutupika kwa minofu.
7. Akuchepetsa kuchuluka kwa potaziyamu m'thupi, edema yam'mimba.

Ngati wodwalayo adadzipweteka yekha ndi insulin yayikulu kuposa momwe amafunidwira, mwanjira iliyonse izi zimabweretsa hypoglycemia mu matenda a shuga. Wodwala akazindikira, ayenera kudya zakudya zabwino kwambiri, kenako kudya zakudya zamafuta.

Ngati munthuyo sakudziwa, amapatsidwa jakisoni wa glucagon (1 mg) intramuscularly kapena njira ya glucose (20 kapena 30 ml). Zotheka kuchitika komwe kukonzanso shuga kumafunikira. Mlingo wa glucagon kapena glucose wa mwana amawerengeredwa potengera kulemera kwake.

Zotsatira za pharmacological

Insuman Rapid ilinso ndi insulin yofanana ndi insulin yaumunthu ndipo yoyambitsidwa ndi mainjinijeni ogwiritsa ntchito K12 kufinya E. Coli.

Imachepetsa glucose wamagazi ndikuwonjezera zotsatira za anabolic, komanso imachepetsa zotsatira za catabolic,

Imapititsa patsogolo mayendedwe a glucose kupita ku maselo, komanso mapangidwe a glycogen mu minofu ndi chiwindi, zimathandizira kugwiritsa ntchito kwa pyruvate. Imalepheretsa glycogenolysis ndi glyconeogeneis,

Imakulitsa lipogenis mu chiwindi ndi adipose minofu ndi ziletsa lipolysis,

Imathandizira kudya ma amino acid ndi maselo ndikuwonjezera kuphatikiza mapuloteni,

Imalimbikitsa kumwa potaziyamu ndi maselo.

Mphamvu ya hypoglycemic imachitika pakadutsa mphindi 30, ndipo imafika pakatha maola 1 mpaka 4 mutatha kugwiritsa ntchito mankhwalawa. Zotsatira zimatha kwa maola 7-9.

Pharmacokinetics

Hafu ya moyo wa seramu insulini m'maphunziro athanzi ndi pafupifupi maminiti 4-6. Kulephera kwambiri kwa impso, kumatenga nthawi.

Tiyenera kudziwa kuti pharmacokinetics ya insulin sikuwonetsa metabolic yake.

Zotsatira Zoyesera Za chitetezo

Kafukufuku wokhudzana ndi kawopsedwe wazovuta adachitika pambuyo poyendetsa makina mpaka makoswe. Palibe zoyipa zomwe zapezeka. Kafukufuku wokhudzana ndi pharmacodynamic zotsatira za subcutaneous kayendetsedwe ka mankhwala kwa akalulu ndi agalu adavumbulutsa zomwe zimayembekezereka zimachitika.

Mimba komanso kuyamwa

Palibe maphunziro azachipatala omwe amagwiritsidwa ntchito popanga insulin yaumunthu panthawi yapakati. Insulin siyidutsa chotchinga. Popereka mankhwala kwa amayi apakati, muyenera kusamala.

Pankhani ya odwala preexisting kapena gestational shuga mellitus, ndikofunikira kusungabe kuchuluka koyenera kwa metabolic panthawi yonse yokhala ndi pakati. Kufunika kwa insulini mu nthawi yoyambirira ya kubereka kumatha kuchepa, koma m'nthawi yachiwiri ndi yachitatu matupi awo amakula. Pambuyo pobadwa, insulin imafunikira imatsika mofulumira (chiwopsezo chowonjezereka cha hypoglycemia). Kuwunikira mosamala kuchuluka kwa shuga m'magazi kumafunika.

Panthawi yoyamwitsa, palibe zoletsa pa insulin. Komabe, mlingo wa insulin komanso kusintha kwa zakudya kungafunike.

Zotsatira zoyipa

Hypoglycemia, njira yodziwika bwino kwambiri, imatha kupezeka ngati mlingo wa insulin woperekedwa umapitilira kufunikira kwake. Sizingatheke kufotokoza kuchuluka kwa vuto la hypoglycemia, chifukwa kufunika kwa mayesero azachipatala komanso kugwiritsa ntchito mankhwala ogulitsa kumatha kusiyanasiyana malinga ndi kuchuluka kwa anthu komanso kuchuluka kwake. Chifukwa chake, sikotheka kuwonetsa pafupipafupi. Zochitika zowopsa za hypoglycemia, makamaka ngati zibwerezedwa, zimatha kuyambitsa kukulitsa kwa mitsempha, kuphatikizapo kukomoka, kukokana. Nthawi zina, zochitika ngati izi zitha kupha.

Odwala ambiri, zizindikiro za kuwonongeka kwa hypoglycemic kwa chapakati mantha amayamba ndi zizindikiro za kutsutsana ndi adrenergic. Monga lamulo, pamene kuchuluka kwa glucose m'magazi kumachepera, ndiye kuti tanthauzo la kutsutsana ndi zizindikiro zake.

Zotsatira zotsatirazi zotsutsana ndi kugwiritsa ntchito mankhwalawa ndikuwonetsedwa m'mayesero azachipatala amalembedwa ndi magulu a ziwalo zamankhwala komanso kuchepa kwa zochitika: zofala kwambiri (> 1/10), zofala (> 1/100, 1 / 1.000, 1/10000 Limagwirira a zochita za mankhwala

Kupanga ma genetic engineering, insulin Insuman Rapid GT ndi yofanana ndi timadzi tomwe timapangidwa ndi ma cell a pancreatic beta. Mankhwalawa amasulidwa mwanjira yothetsera mtundu wopanda mtundu, womwe umabayidwa.

Chithandizo chogwira mankhwalawa ndi insulin yaumunthu. Kuphatikiza apo, kukonzekera kumakhala ndi zinthu zina zochepa: glycerol (85%), sodium hydroxide, m-cresol, hydrochloric acid, sodium dihydrogen phosphate dihydrate ndi madzi osungunuka.

Hafu ya ola limodzi atalowa m'thupi la munthu, zochita zake zimayamba.Achire kwambiri achire zotsatira zimabwera pambuyo pa mawola atatu pambuyo poti jakisoni atenga maola 8. Panthawi yonseyi, insulin imakumana ndi zotsatirazi:

• kutsika kwa ndende ya magazi,
• kukulitsa zotsatira za anabolic, ndiko kuti, kukonza ndi kupanga maselo atsopano,
• chopinga wa catabolic kanthu - kagayidwe kachakudya,
• kuchuluka kwa shuga mumaselo, mapangidwe a glycogen mu chiwindi ndi minofu,
• kugwiritsa ntchito mankhwala omaliza a glucose - mapeto,
• kuletsa kwa glycogenolysis, glyconeogeneis ndi lipolysis,
• kuchuluka kwa maujiais mu minofu ya adipose ndi chiwindi,
• kudya kwa potaziyamu yambiri m'magawo a ma cell.

Muzochita zachipatala, Insuman Rapid imasakanikirana ndi ma insulin ena aumunthu, omwe amapangidwa ndi Hoechst Marion Roussel, kupatula mahomoni omwe amagwiritsidwa ntchito kupangira mapampu.

Kuchita ndi mankhwala ena

Pakusintha kwa Insuman Rapid GT, adotolo amawunika kupirira kwa mankhwalawa pogwiritsa ntchito mayeso a intradermal kuti apewe zotsatira zoyipa. Kumayambiriro kwa zamankhwala, kuukira kwa glycemic ndikotheka, makamaka odwala matenda ashuga okhala ndi shuga wochepa.

Kugwiritsa ntchito nthawi imodzimodzi ya anthu mahomoni amunthu, hypoglycemic ndi njira zina zingakhudze zochita za insulin Insuman Rapid mosiyanasiyana.

Kugwiritsa ntchito kwa beta-blockers kumawonjezera mwayi wokhala ndi chikhalidwe cha hypoglycemia, kuphatikiza, amatha kuyesa kuziziritsa. Zakumwa zoledzeretsa zimathandizanso magazi a m'magazi.

Kutsika kwamphamvu kwa glucose kumayambitsa kugwiritsa ntchito mankhwalawa:

• salicylates, kuphatikizapo acetylsalicylic acid,
• anabolic steroids, amphetamines, mahomoni ogonana amuna,
• monoamine oxidase inhibitors (MAO),
• angiotensin kutembenuza ma enzyme (ACE) zoletsa,
• mankhwala ochepetsa shuga,
• tetracycline, sulfonamides, trophosphamides,
• cyclophosphamide ndi ena.

Mankhwala ndi zinthu zoterezi zimatha kukulitsa zovuta za insulin ndikuwonjezera kuchuluka kwa shuga m'magazi:

1. corticotropin,
2. corticosteroids
3. barbiturates
4. danazol
5. glucagon,
6. estrogens, progesterones,
7. nicotinic acid ndi ena.

Kuwukira kwambiri kwa hypoglycemia kumakhudzanso chidwi cha anthu, omwe amathandiza kwambiri pakuwongolera magalimoto kapena magalimoto. Mutha kuonjezera zomwe zili ndi shuga pakudya chidutswa cha shuga kapena kumwa msuzi wokoma.

Zochitika monga kadyedwe kabwino, jakisoni wodumphadwala, matenda opatsirana komanso ma virus, komanso kukhala moyo wokhala chete kumakhudzanso shuga.

Mtengo, ndemanga ndi fanizo

Aliyense, wokhala ndi malangizo a dokotala, amatha kugula mankhwalawo ku pharmacy kapena kuyitanitsa pa intaneti. Mtengo wa insulini umatengera kuchuluka kwa mabotolo amtunduwu. Kwenikweni, mtengo umasiyanasiyana kuchokera ku 1000 mpaka 1460 ma ruble aku Russia pacholo lililonse la mankhwalawo.

Ndemanga ya anthu ambiri odwala matenda ashuga omwe adapatsidwa jakisoni wa insulin ndiabwino kwambiri. Amazindikira kuchepa kwa shuga m'miyezo yayikulu. Insulin Rapid GT imakhaladi ndi zotsatira zake, mtengo wake umakhala wotsika. Choyipa chokha cha mankhwalawa ndikuwonetsera zotsatira zake zoyipa pamalo a jekeseni. Ambiri adanenanso redness ndi kuyabwa m'dera lomwe panali jekeseni. Chodabwitsachi chimatha kuchotsedwa pakubayira nthawi iliyonse kumalo ena kapena dera lina.

Mwambiri, odwala komanso madokotala onse amawona kukonzekera kwa insulin kumeneku. Odwala adapeza zabwino kuchokera ku insulin mankhwala pomwe amatsata zakudya zomwe zimapatula zovuta zam'mimba komanso shuga, masewera olimbitsa thupi ndikuwongolera thupi.

Pankhani ya tsankho la munthu payekha pazamankhwala, dokotala ali ndi ntchito yotola insulini ina kwa wodwala. Mwa mankhwala ambiri, maulumikizidwe omwe amakhala ndi zinthu zomwezi amatha kusiyanitsidwa. Mwachitsanzo:

• Actrapid NM
• Biosulin P,
• Rinsulin P,
• Rosinsulin P,
• Humulin Wokhazikika.

Nthawi zina adotolo amasankha mankhwala ofanana omwe ali ndi chinthu china chachikulu, koma amathandizanso chimodzimodzi. Izi zitha kukhala Apidra, Novorapid Penfill, Novorapid Flexspen, Humalog ndi mankhwala ena. Amatha kukhala osiyanasiyana pamtundu wa Mlingo, komanso mtengo. Mwachitsanzo, mtengo wamba wa mankhwala a Humalog ndi ma ruble 1820, ndipo ndalama za Apidra ndi ma ruble 1880. Chifukwa chake, kusankha kwa mankhwalawa kumatengera zinthu ziwiri zofunika kwambiri - kuchuluka kwa njira zochiritsira thupi la wodwalayo komanso kuthekera kwake pazachuma.

Pakati pa mankhwala ambiri a insulin, kugwiritsa ntchito Insuman Rapid GT ndikofunikira kudziwa. Mankhwalawa amachepetsa msanga misempha yochepa.

Popeza mankhwalawa ali ndi zotsutsana ndi zovuta zina, kugwiritsa ntchito kwake kumachitika motsogozedwa ndi dokotala. Koma kuti tithane ndi matenda a shuga ndikusintha kuchuluka kwa shuga, ndikofunikira kuti musangopanga jakisoni wa insulin, komanso kuti muzitha kupeza zakudya zoyenera komanso moyo wokangalika. Mwanjira imeneyi ndi pomwe munthu angatsimikizire kukhala ndi moyo wabwino komanso wanthawi zonse. Kanemayo munkhaniyi ayankhula za mitundu ina ya insulin.

Mikhalidwe yapadera

• 1 ml sungunuka wa insulin (maumboni amtundu wa anthu) 3.571 mg (100 IU) Othandizira: metacresol (m-cresol) - 2.7 mg, sodium dihydrogen phosphate dihydrate - 2.1 mg, glycerol 85% - 18.824 mg, sodium hydroxide (kusintha pH) - 0.576 mg, hydrochloric acid (kusintha pH) - 0,232 mg, madzi d / i - mpaka 1 ml. soluble insulin (genetic engineering) 3.571 mg (100 IU) Othandizira: metacresol (m-cresol), sodium dihydrogen phosphate dihydrate, glycerol 85%, sodium hydroxide (kusintha pH), hydrochloric acid (kusintha pH), madzi / ndi. soluble insulin (genetic engineering) 3.571 mg (100 IU) Othandizira: metacresol (m-cresol), sodium dihydrogen phosphate dihydrate, glycerol 85%, sodium hydroxide (kusintha pH), hydrochloric acid (kusintha pH), madzi / ndi.

Insuman Rapid GT Zowonetsa

• - Mankhwala othandizira kugwidwa mwachisawawa, kapena mwachidule, kwa odwala omwe ali ndi zaka 16 ndi akulu. Wimpat ® mu mawonekedwe a infusions amalembedwa pokhapokha ngati mankhwala ndi osatheka kutenga mkati

Insuman Rapid GT zotsutsana

• - hypoglycemia, - hypersensitivity zimachitika ku insulin kapena chilichonse chothandiza cha mankhwala. Mochenjera, mankhwalawa ayenera kugwiritsidwa ntchito ngati mankhwalawa amalephera (kuchepa kwa insulin chifukwa cha kuchepa kwa insulin metabolism), mwa odwala okalamba (kuchepa kwapang'onopang'ono kwa ntchito yaimpso kungayambitse kuchepa kwakukulu kwa insulin), mwa odwala omwe ali ndi vuto la insulin (insulin ingafunike kuchepa chifukwa cha kuchepa kwa kuthekera kwa gluconeogeneis ndi kuchepa kwa insulin kagayidwe kake, mwa odwala omwe ali ndi vuto lalikulu la mitsempha ya m'mimba ndi mitsempha ya m'magazi zigawo zamatenda zimatha kukhala ndizofunikira zamankhwala, popeza pali chiopsezo cha mtima kapena matenda a mtima (hypoglycemia) mwa odwala omwe ali ndi proliferative retinopathy (makamaka omwe sanalandire chithandizo ndi Photocoagulation (laser therapy), popeza ali ndi chiopsezo chocheperapo kapenaurosis yokhala ndi hypoglycemia - khungu lathunthu ,

Insuman Rapid GT mavuto

• Hypoglycemia Hypoglycemia, njira yofala kwambiri yamankhwala a insulin, imatha kupezeka ngati mlingo wa insulin woperekedwa umapitilira kufunikira kwake. Magawo obwerezabwereza a hypoglycemia angayambitse kukula kwa zizindikiro zamitsempha, kuphatikizapo chikomokere, kukokana.Kukhalitsa kwa nthawi yayitali kapena koopsa kwa hypoglycemia kumatha kukhala pachiwopsezo cha moyo. Odwala ambiri, zizindikiro ndi mawonekedwe a neuroglycopenia atha kukhala patsogolo ndi zizindikiro za Reflex (poyankha kukulitsa hypoglycemia) kutsegulira kwa mtima wamanjenje. Nthawi zambiri, ndi kuchepa kwambiri kapena kuchepa msanga kwa kuchuluka kwa shuga m'magazi, chodabwitsa cha kutseguka kwa mphamvu yamanjenje yomvera chisoni ndikuonetsa zizindikiro zake. Ndi kuchepa kwakukulu kwa kuchuluka kwa shuga m'magazi, kukulitsa kwa hypokalemia (zovuta kuchokera ku mtima) kapena kukula kwa edema ya ubongo. Otsatirawa ndi zochitika zoyipa zomwe zimayesedwa m'mayesero azachipatala omwe amadziwika ndi magulu a organic ndi kuchepa kwa zochitika: nthawi zambiri (? 1/10), kawirikawiri (? 1/100 ndi

Malo osungira

• khalani pamalo owuma
• Sungani kuzizira (t 2 - 5)
• osayandikira ana
• sungani pamalo amdima

• Brinsulrapi MK, Brinsulrapi Ch, Insulin Actrapid, Levulin

Mankhwala a Hypoglycemic amapatsidwa shuga. Mankhwala a insulin amakulolani kusintha shuga. Gulu la mankhwalawa limaphatikizapo Insuman Rapid GT.

Soluble insulin (umisiri wa majini a anthu).

Kutulutsa mafomu ndi kapangidwe kake

Njira yothetsera vutoli imapezeka m'mbale kapena ma cartridge. Kuyika ndi jekeseni ya solostar yotayikira ikuchitika.

Chithandizo chophatikizika m'madzi ndi insulin yaumunthu. Kuzungulira kwa yankho ndi 3.571 mg, kapena 100 IU / 1 ml.

Momwe mungatengere Insuman Rapid GT

Njira yothetsera vutoli ndi yothandiza kuti mtsempha wake alowetse magazi mkati. Palibe yunifolomu yovomerezeka yamankhwala. Njira zochizira zimafunikira kusintha kwa dokotala. Odwala osiyanasiyana ali ndi magawo osiyanasiyana a glucose omwe amafunikira kuti azisamalira, motero, kuchuluka kwa mankhwalawo ndi njira zochizira zowerengedwa zimawerengedwa payekhapayekha. Dokotala wopezekapo amaganizira zochita za wodwalayo.

Kufunika kusintha kuchuluka kwa mankhwalawa kumatha kuchitika:

1. Mukamasintha mankhwalawo ndi mtundu wina wa insulin.
2. Ndi kukhudzika kowonjezereka kwa chinthucho chifukwa cha kuwongolera kwa kagayidwe kazinthu.
3. Mukataya kapena kulemera ndi wodwala.
4. Mukamakonza zakudya, kusintha kuchuluka kwa katundu.

Makina oyendetsera zinthu ndi ozama. Ndi bwino kuchita njirayi kwa mphindi 15 kapena 20 musanadye. Ndikofunikira kusintha malo a jakisoni ndi jakisoni aliyense. Komabe, kutengera gawo la kayendetsedwe ka yankho, ma pharmacokinetics a mankhwalawa amatha kusintha, kotero kusintha kwa malo oyang'anira kuyenera kuvomerezedwa ndi adokotala.

Ndikofunika kulabadira kupezeka kwa chipewa. Izi zikuwonetsa kukhulupirika kwa nkhanizo. Palibe zidutswa zomwe zimayenera kukhalapo mu yankho, madziwo ayenera kukhala owonekera.

Zotsatirazi ziyenera kulingaliridwa:

1. Mukamagwiritsa ntchito njirayi mosamala, gwiritsani ntchito syringe yoyenera yapulasitiki.
2. Choyamba, mpweya umasonkhanitsidwa mu syringe, kuchuluka kwake kuli kofanana ndi mlingo wa yankho. Lowetsani malo opanda kanthu m'botolo. Kuchita kutembenuka. Yothetsera ikuchitika. Pasapezeke thovu lililonse mu syringe. Pang'onopang'ono Lowani yankho mu khola la khungu lopangidwa ndi zala.
3. Pa zilembo muyenera kufotokoza tsiku lomwe mankhwala oyamba adachitika.
4. Mukamagwiritsa ntchito makatoniji, kugwiritsa ntchito ma jakisoni (zolembera) pamafunika.
5. Katoniyo amalimbikitsidwa kuti asiyidwe firiji kwa 1 kapena 2 maola, monga kuyambitsidwa kwazinthu zopweteka kumakhala kowawa. Pamaso jakisoni, chotsani mpweya wotsalira.
6. Katiriji sikulembedwanso.
7. Ndi cholembera chosagwira ntchito, syringe yoyenera imaloledwa.

Kukhalapo kwa zotsalira za mankhwala ena mu syringe ndikosavomerezeka.

Pa mbali ya ziwalo zamasomphenya

Kusinthasintha komwe kumanenedwa pakuwongolera glycemic kungayambitse kusokonezeka kwakanthawi kwa khungu la mandala amaso, kusintha kwa mlozera. Kusintha kwakuthwa kwa zizindikiro chifukwa cha kuchuluka kwa mankhwala kungakhale limodzi ndi kuwonongeka kwakanthawi mkhalidwe wa retinopathy.

Mu kwambiri hypoglycemia yokhala ndi retinopathy yowonjezereka, kuwonongeka kwa retina kapena kuwala kwa minyewa yochepa kwakanthawi kumatha.

Kuphatikiza kophatikizidwa

Kuphatikiza kwa mankhwalawa ndi insulin ya nyama ndi analogues sikuyikidwa pambali.

Kuphatikiza kwa Pentamidine kumapangitsa kuti pakhale zovuta.

Zinthu zotsatirazi ndi kukonzekera kumafooketsa mphamvu yotsitsa shuga:

• corticosteroids
• adrenocorticotropic timadzi,
• zotumphukira za phenothiazine ndi phenytoin,
• glucagon,
• mahomoni ogonana achikazi,
• kukula kwamafuta,
• nicotinic acid
• phenolphthalein,
• okodzetsa
• mankhwala osokoneza bongo
• kupanga androgen Danazole,
• anti-TB mankhwala a Isoniazid,
• adrenoblocker Doxazosin.

Sympathomimetics ndi iodinated tyrosine zotumphukira zimafooketsa mayankho a yankho.

Kuphatikiza komwe kumafunikira kusamala

Mankhwala otsatirawa amalimbikitsa chiopsezo cha zovuta:

• endrogens ndi anabolics,
• Mankhwala angapo ochizira matenda amtima komanso a mtima.
• CNS zolimbikitsa,
• antiarrhythmic mankhwala cybenzoline,
• propoxyphene analgesic,
• Pentoxifylline angioprotector,
• cytostatic mankhwala trophosphamide,
• angapo antidepressants
• sulfonamides,
• mankhwala angapo omwe akufuna kutsitsa cholesterol,
• tetracycline mankhwala opha tizilombo,
• kukonzekera kutengera somatostatin ndi mayendedwe ake,
• wothandizira wa hypoglycemic
• chakudya chilolezo fenfluramine,
• antitumor mankhwala ifosfamide.

Kusamala kumafuna kumwa mankhwala potengera msuzi wa salicylic acid, tritokvalin, cyclophosphamide, guanethidine ndi phentolamine.

Mchere wa Lithium ukhoza kusintha kapena kuwonjezera phindu la mankhwalawo. Reserpine ndi clonidine amasiyana mu zomwezo.

Kugwiritsa ntchito ma beta-blockers kumawonjezera chiopsezo cha zovuta.

Kuyenderana ndi mowa

Pazakumwa zoledzeretsa, kuchuluka kwa glycemia kumasintha. Ndi matenda ashuga, kulolera mowa kumachepa, ndipo kufunsa kwa dokotala ndikofunikira pankhani ya kumwa moledzera. Kuchulukitsa kwa glucose kumatha kutsika kwambiri.

Mukatha kugwiritsa ntchito koyamba, botolo limatha kusungidwa kwa maola 4, cartridge - kwa masiku 28 mutatha kuyika. Pakusunga, kuyatsa kuwala kuyenera kupewedwa ndipo kutentha sikuyenera kuloledwa kukwera pamwamba + 25 ° C.

Wopanga

Mankhwalawa amapangidwa ndi Sanofi-Aventis. Dziko lopanga limatha kukhala Germany kapena Russia.

Insulin amakonzekera Insuman Rapid ndi Insuman Bazal

Chida ichi chimanena za mankhwalawa omwe amagwiritsidwa ntchito kwa odwala matenda a shuga. Wopangayo ndi kampani yopanga mankhwala yaku France.

Kodi mankhwalawa ndi otani, momwe mungagwiritsire ntchito moyenera, zabwino zake ndizotani pamankhwala ena, ndipo amasonyezedwa kwa odwala onse? Pali mafunso ambiri, koma kwa aliyense wa iwo mutha kupeza yankho m'nkhaniyi.