Kodi glucagon wamafuta ndi glucagon wa mankhwala ndi chiani?

Glucagon wa "njala" sadziwika pang'ono kuyerekeza ndi insulin, ngakhale zinthu ziwiri izi zimagwira ntchito m gulu lolimba ndikuchita gawo lofunikira mthupi lathu. Glucagon ndi amodzi mwa mahomoni akuluakulu a kapamba, omwe, limodzi ndi insulin, omwe ali ndi udindo wokhazikitsa shuga m'magazi. Kukonzekera kwa mahomoni potengera apo kumagwiritsidwa ntchito mwachangu mankhwala kuti achire matenda a shuga komanso kukonzekera matenda am'mimba.

Kapangidwe ndi kaphatikizidwe ka glucagon

Glucagon amatchedwa mosiyana, koma nthawi zambiri amatchulidwa ngati mahomoni - wotsutsana ndi insulin. Asayansi a H. Kimball ndi J. Murlin adatulukira chinthu chatsopano mu kapamba mu 1923, patatha zaka ziwiri atapeza insulini. Komano, ndi anthu ochepa omwe amadziwa za gawo la glucagon m'thupi lomwe silingabwezedwe.

Masiku ano pantchito zamankhwala, ntchito zazikulu ziwiri za "mahomoni am'magazi" zimagwiritsidwa ntchito - hyperglycemic and diagnostic, ngakhale kwenikweni chinthucho chimagwira ntchito zingapo zofunika mthupi nthawi imodzi.

Glucagon ndi mapuloteni, makamaka, mahomoni a peptide mu kapangidwe kake kama mankhwala. Mwa kapangidwe kake, ndi polypeptide imodzi yolumikizira ya 29 amino acid. Amapangidwa kuchokera ku preproglucagon, polypeptide yamphamvu kwambiri yomwe imaphatikizira 180 amino acid.

Ngakhale kufunikira kwa glucagon m'thupi, kapangidwe kake ka amino acid ndikosavuta, ndipo ngati tigwiritsa ntchito chilankhulo cha sayansi, "ndizovuta kwambiri". Chifukwa chake, mwa anthu, ng'ombe, nkhumba ndi makoswe, kapangidwe ka timadzi timeneti ndi chimodzimodzi. Chifukwa chake, kukonzekera kwa glucagon nthawi zambiri kumapezeka kuchokera ku zikondamoyo za ng'ombe kapena nkhumba.

Ntchito ndi zotsatira za glucagon m'thupi

Katulutsidwe wa glucagon amapezeka gawo la kumapeto kwa kapamba pansi pa dzina lochititsa chidwi "zisumbu za Langerhans." Gawo lachisanu mwa mabanjawa ndi maselo apadera a alpha omwe amapanga mahomoni.

Zinthu zitatu zomwe zimakhudza kupanga kwa glucagon:

1. Kuchuluka kwa shuga m'magazi (kutsika kwa shuga mpaka kutsikira koopsa kungapangitse kuchuluka kwamankhwala ambiri m'magazi).
2. Kuwonjezeka kwa kuchuluka kwa amino acid m'magazi, makamaka alanine ndi arginine.
3. Kuchita masewera olimbitsa thupi (Kuchita zolimbitsa thupi mopitirira malire a mphamvu za anthu kumawonjezera kuchuluka kwa mahomoni nthawi 4-5).

Kamodzi m'magazi, "mahomoni am'magazi" amathamangira kumalo olowera maselo a chiwindi, amawamanga ndikulimbikitsa kutulutsa shuga m'magazi, ndikusunga mosasunthika. Komanso, glucagon wa mahanya amachititsa ntchito zotsatirazi mthupi:

• imayambitsa kuphwanya kwa lipid ndikutsitsa cholesterol yamagazi
• timapitiriza kuyenda kwa magazi mu impso
• amalimbikitsa kukhathamira kwa sodium kuchokera m'thupi (ndipo izi zimathandiza kugwira ntchito kwa mtima)
• nawo kukonzanso maselo a chiwindi
• imalimbikitsa kutulutsa kwa insulin m'maselo

Komanso, glucagon ndi gawo lofunikira kwambiri pamanja mwa adrenaline popereka zomwe thupi "limachita kapena kuthawa". Adrenaline akatulutsidwa m'magazi, glucagon imakulitsa kuchuluka kwa glucose pafupifupi nthawi yomweyo kuti ipitsetse minofu yamatumbo, komanso imathandizira kupatsidwa minofu ya oxygen.

Limagwirira

Mphamvu yamachitidwe a glucagon imachitika chifukwa chomangirira zigawo zina za glucagon zama cell a chiwindi. Izi zimabweretsa kuwonjezeka kwa ntchito ya G-protein-mediated adenylate cyclase ndikuwonjezereka kwa mapangidwe a cAMP. Zotsatira zake ndikuwonjezereka kwa catabolism ya glycogen yomwe imayikidwa mu chiwindi (glycogenolysis). gwero silinatchulidwe masiku 2198 Glucagon wa hepatocytes amagwira ntchito ngati chizindikiro chakunja chokhudza kutulutsa shuga m'magazi chifukwa chakutha kwa glycogen (glycogenolysis) kapena kaphatikizidwe ka glucose kazinthu zina - gluconeogenesis. Hormoni imamangirira ku receptor pa membrane wa plasma ndikuyambitsa adenylate cyclase, yomwe imapangitsa kupangika kwa cAMP kuchokera ku ATP, kudzera pa mapuloteni a G. Otsatirawa ndi kusinthika kwa machitidwe komwe kumatsogolera m'chiwindi ku activation ya glycogen phosphorylase ndi kuletsa kwa glycogen synthase. Njira imeneyi imatsogolera kutulutsidwa kwa glucose-1-phosphate kuchokera ku glycogen, yomwe imasinthidwa kukhala glucose-6-phosphate. Kenako, mothandizidwa ndi shuga-6-phosphatase, shuga waulere amapangidwa, omwe amatha kutulutsa cell kulowa m'magazi. Chifukwa chake, glucagon m'chiwindi, cholimbikitsa kutsika kwa glycogen, amathandizira kukhalabe ndi glucose m'magazi mosalekeza. Glucagon imathandiziranso gluconeogeneis, lipolysis, ndi ketogenesis m'chiwindi.

Glucagon ilibe mphamvu pa glycogen ya mafupa amchiberekero, mwachidziwikire chifukwa cha kusowa kwathunthu kwa ma glucagon receptors mwa iwo. Glucagon imayambitsa kuwonjezeka kwa insulin secretion kuchokera kwa anc-cell pancreatic and-cell and inhibition of insulinase zochita. Awa, mwachionekere, amodzi mwa njira zolimbitsa thupi zolimbana ndi glucagon-inachititsa hyperglycemia.

Glucagon ili ndi mphamvu yotchedwa inotropic komanso chronotropic pa myocardium chifukwa cha kuchuluka kwa mapangidwe a cAMP (ndiye kuti, ili ndi zotsatira zofanana ndi zochita za β-adrenergic receptor agonists, koma osakhudzana ndi β-adrenergic system pakuzindikira izi). Zotsatira zake ndikuwonjezereka kwa kuthamanga kwa magazi, kuwonjezereka kwa pafupipafupi komanso kulimba kwa mgwirizano wamtima.

Pakukhudzidwa kwakukulu, glucagon imayambitsa mphamvu ya antispasmodic, kupumula kwa minofu yosalala ya ziwalo zamkati, makamaka matumbo, osayanjanitsidwa ndi adenylate cyclase.

Glucagon imathandizira pakukhazikitsa "kugunda kapena kuthamanga", kukulitsa kupezeka kwa mphamvu zamagawo (makamaka, glucose, mafuta achilengedwe, keto acids) kwa minofu yamafupa ndikuwonjezera magazi kumatsempha a chigoba pakukulitsa kugwira ntchito kwa mtima. Kuphatikiza apo, glucagon imawonjezera kubisala kwa catecholamines ndi adrenal medulla ndikuwonjezera chidwi cha minofu ya makatekolamines, yomwe imakondanso kukhazikitsidwa kwa "kugunda kapena kuthamanga".

Kutulutsa Fomu

Ampoules pansi pa mayina 669, 668, 667, 666.

Lyophilised ufa wa jakisoni wa makolo mu mbale:

• mtundu umodzi wa mankhwala, 1 mg ya yogwira mankhwala, yathunthu ndi zosungunulira voliyumu ya 5 ml,
• mawonekedwe osinthika a mankhwala, 2 mg ya yogwira mankhwala mu kashiamu ndi zosungunulira voliyumu ya 5 ml kapena 10 mg yogwira thunthu mu zida ndi zosungunulira voliyumu ya 10 ml

Pharmacodynamics ndi pharmacokinetics

Glucagon ndi chida chokhala ndi biosynthetic ofanana ndi Glucagon waumunthu, zonse ziwiri ndizofanana mu kapangidwe kake.

Mankhwala

Glucagon ndi timadzi tomwe timalumikizitsa chiwindi cha glycogen, chomwe chimatulutsidwa shuga m'magazi. Glucagon sikugwira ntchito pakusowa glycogen mu chiwindi. Zotsatira za mahomoni Glucagon ndizosavomerezeka kwa odwala omwe samatha kudya kwa nthawi yayitali, mwa anthu omwe ali ndi matenda oopsa a hypoglycemia, adrenal insufficiency kapena aledzera hypoglycemia.

Komanso, ntchito ya glucagon ndikupangitsa secretion. katekisolite. At pheochromocytoma zingayambitse kumasulidwa kwambiri katekisolite, zomwe zimatsogolera kukuchulukirachulukira kwa mavuto. Imalepheretsa mawu komanso kufooketsa mphamvu ya minofu yosalala yothandiza kugaya chakudya.

Pharmacokinetics

Amamamatira mothandizidwa ndi ma enzymes mu ziwalo ndi madzi a m'magazi. Chiwindi ndi impso zimatha kusintha zochita zake pakubwera kwa mahomoni. Kuchotsa hafu ya moyo kumapangitsa mphindi 4-5. Mothandizidwa ndi mtsempha wa magazi, mphamvu yake imayamba kukhazikitsidwa patangotha ​​mphindi imodzi. Kutalika kwa kuchitapo kanthu kuyambira mphindi 5 mpaka 20.

Pambuyo pamakonzedwe a intramuscular, kuyambiranso kumachitika pambuyo pa mphindi 7 mpaka 15 ndipo kumatha mpaka mphindi 40. Mankhwalawa kwambiri mitundu hypoglycemiclimati kukhudzidwa kwa ndende shuga m'magazi amayembekezeredwa pafupifupi mphindi 10 mutatha kugwiritsa ntchito.

Zizindikiro zogwiritsidwa ntchito

• mankhwala hypoglycemiaodwala ovutika matenda ashuga,
• monga chida chowonjezera mu maphunziro a radiology a kapamba, m'mimba ndi matumbo,
• mankhwala othandizira ndi matenda amisala.

Zotsatira zoyipa

Zotsatira zoyipa zomwe ambiri amakhala nazo ndikusanza ndi mseru, makamaka mukamagwiritsa ntchito mlingo wopitilira 1 mg kapena kuthamanga kwa mankhwalawa (mpaka 1 miniti). Nthawi zina, yachiwiri hypoglycemia.

• chitetezo chokwanira: Hypersensitivity zimachitikira mpaka anaphylactic mantha,
• m'mimba dongosolo kusanza, kusanza, kupweteka kwam'mimba.

Malangizo a glucagon (njira ndi Mlingo)

Malinga ndi mawonetseredwe azachipatala, mankhwalawa nthawi zambiri amaperekedwa pa mlingo wa 0,5 kapena 1 unit subcutaneally, kudzera m'mitsempha kapena intramuscularly.

Kubwezeretsa katundu glycogen m'maselo a chiwindi komanso kupewa yachiwiri hypoglycemia chakudya ayenera kumwedwa pambuyo jakisoni wa mankhwala. Ngati kugwiritsa ntchito glucagon sikothandiza, makonzedwe ake amalimbikitsidwa shuga kudzera m'mitsempha.

Bongo

Ndi kukhazikitsa mlingo waukulu wa mankhwalawa, nseru kapena kusanza zitha kuchitika. Chithandizo chapadera mu izi, monga lamulo, sichofunikira. Kutsika kwazinthu kumawonekeranso. potaziyamum'magazi amwazi. Izi zimafunikira kukonzedwa ndikuwunika ngati kuli koyenera.

Kuchita

Glucagon kanthu akutsutsa kuchitapo kanthu insulin.

Pa maziko chithandizo opanga beta kuyambitsa kwa mankhwala kumatha kukhala wamphamvu tachycardia ndi kuchuluka kwa mavuto.

Ndi munthawi yomweyo kugwiritsa ntchito Indomethacin Mankhwala amatha kulephera kuloza ndende shugam'magazi.

Akaphatikizidwa ndi Warfarin imatha kupititsa patsogolo zotsatira zake.

Zizindikiro zogwiritsidwa ntchito

Kugwiritsa ntchito mankhwala osokoneza bongo akuwonetsedwa motere:

• Chithandizo cha matenda a hypoglycemia (otsika kwambiri m'magazi a shuga) mwa anthu omwe ali ndi matenda ashuga
• Kuti mupeze gawo lothandiza pakuwunika kwa radiology ya kapamba ndi m'mimba thirakiti
• Mankhwala othandizira odwala mankhwalawa.

Chikhalidwe cha glucagon m'magazi ndi zovuta zake

Mlingo wa glucagon m'magazi umasiyanasiyana kwa ana ndi akulu. Mwa ana a zaka 4 mpaka 14, msambo wa "mahomoni a njala" amatha kusiyanasiyana pakati pa 0-148 pg / ml, kwa akulu kuthamanga kwa 20-100 pg / ml ndikuloledwa. Koma ngati chizindikiro cha glucagon chikugwa kapena chikukwera pansipa, izi zitha kuonetsa mavuto osiyanasiyana mthupi.

Kutsika kwa glucagon m'magazi nthawi zambiri kumawonetsa cystic fibrosis, pancreatitis yosatha, ndipo amadziwika pambuyo pancreatectomy (kuchotsedwa kwa kapamba).

Kukula kwa mahomoni ndi chizindikiro cha zotsatirazi:

• mtundu 1 shuga
• glucagonoma (chotupa cha maselo a alpha m'mapapo)
• pachimake kapamba
• matenda ammbuyo
• Cushing's syndrome
• aakulu aimpso kulephera
• pachimake hypoglycemia
• kupsinjika kali konse (kuvulala, kuwotcha, kugwira ntchito, ndi zina).

Kupanga ndi mawonekedwe a kumasulidwa

Mu 1 ampoule No. 666 muli 49 mg wa lactose ndi 1 mg wa glucagon mu mawonekedwe a hydrochloride. Botolo imodzi ya No. 667 - glycerin, phenol (yosungirako) komanso mankhwala othandizira pazomwezi. Botolo imodzi ya 668 ya chinthu chimodzi chomwechi yogwira ntchito zomwezo ndi 140 mg ya lactose. Botolo 1 No. 669 ili ndi 10 mg ya glucagon hydrochloride, glycerol ndi phenol.

White lyophilisate mu ampoules ya dilution ndi madzi osabala. Pa limodzi makonzedwe - 1 mg wa yogwira othandizira + 5 ml ya zosungunulira. Kutulutsanso mawonekedwe - 2 mg ya mankhwala + 5 ml ya zosungunulira kapena 10 mg ya mankhwala ndi 10 ml ya zosungunulira.

Kuchiritsa katundu

Glucagen ili ndi katundu wa hyperglycemic, i.e. - Amawonjezera shuga m'magazi, kukhala wotsutsana ndi insulin. Mankhwala opanga ali ofanana kwathunthu ndi mahomoni achilengedwe mkati mwa thupi la munthu. Hormoni iyi imatha kusokoneza glycogen, kapangidwe kake kamene kamachitika m'chiwindi, kenako kumatulutsidwa m'magazi ngati glucose. Ngati malo ake osungidwa m'chiwindi atha kwambiri, ndiye kuti mankhwalawo sangathandize.

Mankhwalawa ali ndi vuto loipa kwa odwala omwe akhala ndi njala kwa nthawi yayitali, amamwa mowa, komanso odwala omwe ali ndi vuto la kusakwanira kwa adrenal. Mankhwalawa ali ndi ntchito yolimbikitsa catecholamines, kuti kuthamanga kwa magazi kuchitika. Komanso, pambuyo pa makonzedwe, kamvekedwe ka minofu yam'mimba imachepa, ma peristalsis amayamba kufooka, omwe pambuyo pake amatha kubweretsa matumbo a m'matumbo ndikuyamba kudzimbidwa.

Pambuyo polowa m'thupi laumunthu, mankhwalawa mothandizidwa ndi enzyme mankhwala amawonongeka minofu, ziwalo ndi madzi a m'magazi. Chilolezo cha Hormonal chimatengera magawo a chiwindi ndi impso mwachindunji. Hafu ya moyo wa thupi ndiyifupi kwambiri, mpaka mphindi zisanu. Ngati mutha kupaka mankhwalawa m'mitsempha, imakhala ndi zotsatira zake zochizira pambuyo pa masekondi 60, ndipo kutalika kwake kumakhala mpaka mphindi 20 motsatana. Ngati glucagon imalowetsedwa mu minofu, ndiye kuti kusintha kwa mankhwalawa kumayamba pang'onopang'ono, mpaka mphindi 10, koma kutalika kwa zotulukazo kumatha mphindi 40.

Njira yogwiritsira ntchito

Mtengo wamba wa mankhwala ku Russia ndi pafupifupi ma ruble 800 pa paketi iliyonse.

Malangizo a Glucagon amawonetsa kuti mulingo woyambira ndi 0,5 IU kapena 1 IU ya mankhwalawa nthawi. Itha kuperekedwa mwachisawawa, kudzera m'mitsempha kapena m'mitsempha. Chowonjezera ndi chakuti pambuyo pa jakisoni ndibwino kudya chakudya chamagulu am'thupi kuti mudzabwezeretsanso m'misika ya glycogen m'chiwindi. Ngati mankhwalawa sathandiza, ndibwino kupaka shuga m'magazi.

Pa nthawi yoyembekezera komanso yoyamwitsa

Ndizotheka, koma mosamala kwambiri, ndikuwongolera kwathunthu momwe wodwalayo alili ndi mwana wosabadwayo kapena khanda.

Malo osungira

• osaloleza kuzizira kwa mankhwalawo, kuti mwangozi musawononge syringe ndi zosungunulira zomwe zili momwemo,
• sungani pamatenthedwe mpaka 25 ° C kokha m'mawu oyambira,
• osayandikira kuwala.
• Zomwe zakonzedwa kuti zizigwiritsidwa ntchito ziyenera kutumikiridwa nthawi yomweyo mukakonzekera. Osasiya njira yokonzekereratu kuti mudzayigwiritse ntchito pambuyo pake.
• Pewani kufikira ana
• osagwiritsanso ntchito atatha tsiku lotha kusonyezedwa phukusi.

Malangizo apadera

Tiyenera kukumbukira kuti insulin ndi wotsutsana ndi glucagon.

Osagwiritsa ntchito yankho la mankhwalawa ngati atenga kusasinthika kwa gel kapena ufa sunasungunuke kwathunthu.

GlucaGen 1 mg HypoKit.

Glucagon Novo.

Mlingowo umawerengeredwa malinga ndi zaka kapena kulemera kwa mwana malinga ndi dongosolo lotsatira:

• ngati zolemetsa ndizoposa 25 kg kapena mwana ali ndi zaka zopitilira 6-8, ndiye kuti zonse za 1 ml ya botolo zimaperekedwa kwathunthu,
• ngati kulemera kumakhala kochepera 25 kg kapena mwana ali ndi zaka zosakwana 6-8, ndiye kuti theka la zomwe zili m'botolo 1 ml limaperekedwa.

Pa mimba ndi mkaka wa m`mawere

Amayi oyembekezera ayenera kupatsidwa mankhwala pokhapokha pakufunika.

Nthawi kuyamwitsa mankhwalawa amagwiritsidwa ntchito mosamala kwambiri.

Mankhwalawa amagwiritsidwa ntchito ngati akuwoneka ngati mankhwala osokoneza bongo ndipo ndiwosankha kwambiri HypoglycemicKufunika chithandizo chamwadzidzidzi.

Mtengo wa Glucagon, komwe mungagule

Gulani Glucagon (1 ml ya mankhwalawa ndi 1 ml ya zosungunulira) ku Russia adzagula ma ruble 730-970, ku Ukraine mtengo wamtunduwu wa kutulutsidwa kwa mankhwalawa ndi pafupifupi h hpnias 350.

Maphunziro: Omaliza maphunziro ku Vitebsk State Medical University omwe ali ndi digiri ku Opaleshoni. Ku yunivesiteyo, adatsogolera Council of the Student Science Science Society.Maphunziro ena mu 2010 - mu "Oncology" apadera komanso mu 2011 - mu apadera "Mammology, mawonekedwe a oncology".

Zokumana nazo: Gwirani ntchito pachipatala chodziwikiratu kwa zaka zitatu monga dokotala wa opaleshoni (Vitebsk emergency hospital, Liozno CRH) ndi oncologist wachigawo komanso wa traumatologist wa nthawi yayitali. Gwira ntchito ngati nthumwi yaulimi mzaka zonse ku Rubicon.

Adapereka malingaliro atatu omasulira pamutu wakuti "Kukhathamiritsa kwa mankhwala opha maantibayotiki kutengera mtundu wa microflora", 2 ntchito zidapeza mphotho mu republican mpikisano-wamaapepala owerengera ophunzira (magawo 1 ndi 3).

Udindo wa glucagon m'thupi la munthu

Glucagon ndi mahomoni a polypeptide opangidwa ndi 29 amino acid. Glucagon alpha yopangidwa ndi maselo a islet. Ntchito zotsatirazi za glucagon zimatha kusiyanitsidwa:

• kumawonjezera shuga m'magazi (gawo lalikulu la mahomoni).

Mu chiwindi, shuga amasungidwa mu mawonekedwe a glycogen. Mukamasala kudya kapena kuchita masewera olimbitsa thupi kwa nthawi yayitali, glucagon imayambitsa zochitika zosiyanasiyana, zomangiriza ku zolimba za chiwindi, ndipo zimayambitsa kuphwanya kwa glycogen. Glucose imamasulidwa ndikulowa m'magazi, ndikwaniritsa mphamvu zamthupi.

Tcherani khutu! Glucagon saphwanya glycogen mu minofu, chifukwa mulibe ma receptor enieni.

• imayambitsa kupanikizika kwa shuga m'chiwindi kuchokera pazinthu zopanda mafuta osokoneza bongo omwe ali ndi vuto,
• amalepheretsa kugwiritsa ntchito shuga,
• amalimbikitsa kuwonongeka kwa malo osungirako mafuta. Chifukwa chake, glucagon akapangidwa, zomwe zimakhala ndimafuta m'magazi zimatuluka,
• imayambitsa mapangidwe a matupi a ketone (zinthu zapadera zomwe, zikagawika, zimapatsa mphamvu mphamvu pakuchepa kwazinthu zina, i.e pamene glucose palibe),
• imathandizira kubisalira kwa insulin pofuna kupewa kuchuluka kwa shuga m'magazi,
• imakweza kuthamanga kwa magazi mwakuwonjezera pafupipafupi ndi mphamvu ya kugunda kwa mtima,
• imawonetsetsa kupulumuka kwa thupi movuta kwambiri pakuwonjezera mphamvu zomwe zimapezeka m'magazi (shuga, mafuta acids, matupi a ketone), omwe amatha kugwidwa ndi ziwalo ndikugwiritsidwa ntchito,

Kuthamanga kwa magazi kumathandizanso kuti chakudya chamagulu chikhale bwino.

• imalimbikitsa kupanga makatekolamaini ndi adrenal medulla,
• mu chidwi champhamvu kwambiri chimamasula minofu ya minofu yosalala (antispasmodic effect),
• zochita za glucagon amathandizidwa ndi adrenaline ndi cortisol, amenenso ali ndi vuto la hyperglycemic.

Kuwongolera katulutsidwe wa glucagon

Thupi laumunthu ndi dongosolo lolinganizidwa bwino, motero chilengedwe chapanga njira zopangira kuchuluka kwa glucagon m'magazi pamlingo woyenera. Chomwe chimapangitsa chidwi cha maselo a alpha ndi katulutsidwe ka glucagon ndi:

• kuchepa kwa shuga ndende. Chifukwa chokhala ndi mphamvu yayitali kapena kufa ndi njala, magazi ake amakhala otsika kwambiri. Thupi limafa ndi njala ndipo limafunikira shuga. Glucagon imapangidwa ndikupulumutsa shuga m'magulu,
• ma amino acid - arginine, alanine, omwe amasulidwa panthawi yomwe kuwonongeka kwa mapuloteni omwe amalandiridwa ndi chakudya. Mukakhala ndi mapuloteni omwe amapezeka muzakudya, glucagon yambiri amapangidwa. Chifukwa chake, chakudyacho chikuyenera kukhala ndi kuchuluka kwa mapuloteni athunthu,
• kuchuluka kwa insulin: kupewa kuchepa kwambiri kwa shuga,
• mahomoni opangidwa ndi chakudya chamagaya - gastrin, cholecystokinin,
• mankhwala - beta-adrenostimulants.

Imalepheretsa katulutsidwe wa glucagon:

• kuchuluka kwa shuga, mafuta acids kapena matupi a ketone m'magazi,
• somatostatin opangidwa mu delta maselo a islet zida.

Ntchito yolondola ya thupi imapereka chiwonetsero choyenera cha kuyambitsa ndi kuletsa kwa kupanga shuga, yemwe amakhala osamala.

Contraindication ndi Kusamala

Amayesedwa chifukwa cha kuchepetsedwa kwa shuga mpaka misinkhu yovuta, hypersensitivity kapena kusakwanira kwa ntchito ya adrenal.

Chenjezo - pakati ndi kuyamwa.

Kuchita mankhwala osokoneza bongo

Glucagon ndi wotsutsa insulin. Beta-blockers, akaphatikizidwa, amayambitsa chisokonezo chachikulu cha mtima. Indomethacin amachulukitsa kuchuluka kwa zinthu m'magazi; zotsatira za warfarin zimawonjezeka ndi munthawi yomweyo.

Glucagen 1 mg HypoKit

Novo Nordisk, Denmark

Mtengo wapakati ku Russia - ma ruble 725 phukusi lililonse.

Glucagen HypoKit ili ndi 1 mg wa mankhwala mumabotolo. Ndi mndandanda wathunthu.

Ubwino:

Chuma:

• Osotsika mtengo
• Pali zovuta zina.

Humulin Regulator

Eli Lilly East, Switzerland

Mtengo wapakati ku Russia - ma ruble 810 pa paketi iliyonse.

Humulin Regulator - insulin yochepa kwambiri, wotsutsana kwathunthu wa glucagen. Ndikofunikira pakuchepa kwa mahomoni, okhala ndi vuto la hyperglycemia.

Glucagon ndi Metabolism

Zikondwererozi zimagwira ntchito zingapo. Procrine imapanga kupanga chakudya cha m'mimba, chomwe chimapukutidwa kudzera mu ma ducts mu duodenum 12. Ntchito ya endocrine ndikupanga ndikumasulidwa mwachindunji m'magazi a polypeptides ndi mahomoni: insulin, glucagon, somatostatin, ghrelin ndi ena. Kuphatikizika kwa zinthu izi kumalimbikitsidwa muzilumba za Langerhans, ntchitozi zimagawidwa pakati pamagulu angapo amitundu. Glucagon imapangidwa ndi ma cell; amaŵerengetsa pafupifupi 20% ya maselo onse am'misamba yopanda pancreatic.

Glucagon amatanthauza mahomoni a polypeptide, amakhudza mitundu yonse ya kagayidwe. Ntchito yayikulu ya glucagon ndikutsutsana ndi insulin:

Mwa munthu wathanzi, shuga wamagazi amasintha pang'ono, atatha kudya amapita mwachangu. Kuwongolera glycemia ndi njira yovuta, yomwe imaphatikizapo ubongo, m'mimba, minofu, zotupa za chithokomiro, chithokomiro ndi kapamba, impso, chiwindi ndi ziwalo zina. Chifukwa cha ntchito yawo yoyendetsedwa, mulingo woyenera wa glucose wa metabolism umasungidwa.

Kuphatikizika kwa thupi

Ngati shuga m'magazi amatsika chifukwa chochita zolimbitsa thupi kapena kusowa kwa chakudya, kaphatikizidwe ka glucagon kamawonjezeka kwambiri. Zomwe zimachitika pochita izi:

1. Malo ogulitsira a Glycogen omwe amasungidwa m'chiwindi amachitidwa. Glycogen akaphwanya, amaponyedwera m'magazi ngati glucose, glycemia amakhala ndi matenda. Mphamvu ya glucagon sigwiritsa ntchito glycogen amana mu minofu minofu.
2. Chiwindi chimayamba kupanga mwachangu glucose kuchokera ku pyruvate ndi zinthu zina zopanda mafuta.
3. Kugwiritsa ntchito shuga pakupanga mphamvu kumachepetsa.
4. Zofunikira zamthupi zimayamba kukumana ndi minofu yamafuta, kuchuluka kwa mafuta m'magazi kumawonjezeka. Nthawi yomweyo, matupi a ketone, zopangidwa ndi kuwonongeka kwa mafuta, zimayamba kulowa m'magazi.
5. Kutulutsidwa kwa glucagon, kupanga kwa insulini kumakwera. Chifukwa cha kuthana nawo, hyperglycemia imaletsedwa.
6. Glucagon yamagalasi imapereka kukhudzidwa kwa mtima, kuwonjezeka kwa mphamvu ndi pafupipafupi kwake. Chifukwa cha kuchuluka kwa kupsinjika, thanzi lathupi lonse lathupi limayenda bwino.
7. Kutulutsidwa kwa makatekolamaini kumachulukitsa, kutulutsa kwamkati kumachitika. Munthu akhoza kukhala ndi mantha, kukwiya. Zizindikiro zowoneka bwino zoterezi zimakupangitsani kuti musamale ndi vuto lanu ndikuchotsa hypoglycemia.
8. Pakukhudzidwa kwakukulu, mahomoni amakhala ngati antispasmodic: amatsitsimutsa minofu yamatumbo.

Glucagon amapangidwa poyankha kutsika kwa glycemia, kuchuluka kwa insulin. Kuphatikizika kwa Glucagon kumalimbikitsidwa ndi dongosolo laumwini la autonomic, kotero kupanga kwake kumawonjezeka ndikugwiritsa ntchito sympathomimetics ndi adrenostimulants.

Mwazi wamagazi ambiri, matupi ochulukirapo a ketone ndi ma acid acids m'mitsempha yamagazi, komanso gawo lokwezeka la somatostatin limasokoneza kupanga kwa glucagon.

Kugwiritsa ntchito shuga

M'magawo oyamba, hypoglycemia imalephereka mosavuta ndi kayendetsedwe kamlomo ka zakudya zilizonse zomwe zimatengedwa mwachangu: uchi, shuga, maswiti, timadziti ta zipatso. Ngati mphindi iyi yakusowa ndipo wodwalayo afooka, pali njira ziwiri zokulitsira glycemia: popereka shuga kapena glucagon. Kwa shuga, makonzedwe amkati amafunika, chifukwa chake, sioyenera kukhala othandizira osunthira mwachangu. Koma glucagon amatha kubayidwa intramuscularly, ndipo pogwiritsa ntchito njira iyi, amayamba kuchita pambuyo mphindi 5 mpaka 15.

Kapangidwe ka glucagon m'magulu onse amtundu pafupifupi ofanana; mwa anthu, mahomoni a nyama amatha kugwiritsidwa ntchito bwino. Poletsa hypoglycemia, mankhwala omwe amapezeka kuchokera ku ng'ombe kapena kapamba wa nkhumba amagwiritsidwa ntchito. Kapangidwe ka glucagon ndikodziwika, chifukwa chake, kupanga kwa mahomoni kwakhazikitsidwa pogwiritsa ntchito njira zopangira ma genetic.

Pakadali pano, pali mankhwala amodzi okha a glucagon omwe adalembetsedwa mu renti la mankhwala aku Russia - GlucaGen HypoKit, opangidwa ndi kampani yaku Danish NovoNordisk. Zomwe zimagwiritsidwa ntchito momwemo ndi glucagon hydrochloride, yopangidwa ndi njira zogwiritsira ntchito labotale, pogwiritsa ntchito mtundu wosandulika wa bacterium Escherichia coli. Zomwe zimagwiritsidwa ntchito zili ngati mawonekedwe a ufa, wophatikizidwa mu botolo lagalasi.

Bokosi limaphatikizapo botolo lokhala ndi 1 mg ya glucagon ufa, syringe yokhala ndi zosungunulira, pensulo yonyamula pensulo yosavuta kunyamula nanu malangizo, malangizo. Mtengo wa zomwe zakonzedwazo ndi kuchokera pa ma ruble 635 mpaka 750.

Kusankhidwa

Munda womwe ukugwiritsidwa ntchito kwa mankhwalawa ndi mpumulo wa hypoglycemia panthawi yomwe kukonzekera kwa pakamwa kwa glucose sikungatheke chifukwa chitha kuzindikira kapena kusachita bwino. Zomwe zimayambitsa hypoglycemia zimatha kukhala kuchuluka kwa insulin, mankhwala ena okhudzana ndi matenda ashuga, njala, kupsinjika kwa nthawi yayitali.

M'malo azachipatala, glucagon amagwiritsidwa ntchito ngati imodzi mwazithandizo zadzidzidzi poyambitsa poizoni ndi mankhwala osokoneza bongo. Itha kugwiritsidwanso ntchito pakuwunika kwa m'mimba motayirira ngati njira yopumitsira minofu.

Doctor of Medical Science, Mutu wa Institute of Diabetesology - Tatyana Yakovleva

Ndakhala ndikuphunzira matenda a shuga kwa zaka zambiri. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russia Academy of Medical Science idatha kupanga mankhwala omwe amachiritsiratu matenda ashuga. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipira mtengo wa mankhwalawo. Ku Russia, odwala matenda ashuga mpaka Meyi 18 (kuphatikiza) nditha kuipeza - Kwa ma ruble 147 okha!

Ntchito yayikulu ya glucagon ndikumemeza masitolo a glycogen. Homoni yoyambitsayo imayambira njira ya glycogenolysis, chifukwa chomwe glycogen imasweka m'chiwindi kupita ku phosphorylated glucose. Nthawi yoyambira ya mahomoni imatengera njira yoyendetsera. Ndi mtsempha wamagazi amkati amayamba kukula pambuyo pa mphindi 1, zotsatira zake zimakhala mpaka mphindi 20. Njira yochititsa chidwi ya makonzedwe imakondedwa ngati simuli katswiri wazachipatala. Glycemia imayamba kuchuluka pambuyo pa mphindi 5. Mphindi 10 pambuyo pa jakisoni, wodwalayo nthawi zambiri amayambiranso kuzindikira. Kutalika kokwanira kwa zochita kumafika mphindi 40. Ndi subcutaneous makonzedwe, kuyamwa kwa glucagon m'magazi ndiye wosachedwa kwambiri - kuchokera theka la ora.

Mankhwala ndi osathandiza kwa odwala omwe achedwa glycogen nkhokwe. Zomwe zimayambitsa kusowa kwa glycogen zimatha kukhala matenda ashuga omwe amakhala ndi hypoglycemia pafupipafupi, zakudya zamafuta osapatsa mafuta, njala, uchidakwa, kuledzera, kutsata shuga. Glycogen sangakhale wokwanira ndi mankhwala osokoneza bongo ambiri omwe amachepetsa shuga.

Malamulo oyambira

Glucagon imayenera kukonzekera kuyang'anira. Ndondomeko

1. Timachotsa kapu m'botolo, ndi kapu ku singano ya syringe.
2. Ikani singano mu choletsera, kuti mumasule madzi onse mu syringe kulowa.
3. Popanda kuchotsa singano, gwiranani vinini kwa mphindi imodzi kuti mumalize ufa.
4. Tisonkhanitsa yankho lomalizidwa mu syringe.
5. Kwezani syringe ndi singano mmwamba, kumasula mpweya ndikanikizira pisitoni.

Jakisoni amatha kuchitidwa minofu iliyonse, koma bwino pabowo kapena ntchafu. Malinga ndi malangizo ogwiritsira ntchito, akulu amapatsidwa yankho lonse, ophunzitsira komanso ana olemera osakwana 25 kg - theka la mahomoni. Munthu wodwala matenda ashuga atayambanso kudziwa bwino, ayenera kupatsidwa shuga kuti amwe: yankho la mankhwala, tiyi wokoma kapena msuzi. Ngati odwala sasintha kwa mphindi 10 kapena kuposerapo, amafunika kuthandizidwa mwachangu.

Njira zopewera kupewa ngozi

Mukamayendetsa shuga, zotsatirazi ziyenera kuganiziridwa:

1. Ndi hyperglycemia, glucagon imatha kukulitsa vuto la wodwala. Zizindikiro za hyper- ndi hypoglycemia ndizofanana, motero ndikofunika kuyeza shuga musanapereke mahomoni.
2. Wodwalayo amatha kukhala osavomerezeka ndi zigawo zina za mankhwalawo, chiopsezo chodzidzimutsa chimawerengedwa ngati chotsika kwambiri.
3. Hormoni imatha kuperekedwa pa nthawi yoyembekezera komanso HB popanda chiopsezo kwa mwana.
4. Glucagon silingagwiritsidwe ntchito pheochromocytoma, popeza izi ndizodzala ndi kuwonjezeka kowopsa kwa mavuto.
5. Kukhazikitsidwa kwa mankhwalawa sikungakhale kopanda phindu ndikulowetsa kwa indomethacin kwa nthawi yayitali. Nthawi zina, hypoglycemia imachulukirachulukira.
6. Hormayo imawonjezera zochita za anticoagulants.

Pambuyo pa kutsekemera kwa glucagon, palpitations imatha kuchuluka, kupanikizika kungachuluke, tachycardia yochepa ikhoza kuchitika, ndipo mseru ungayambike. Mukamamwa beta-blockers, zizindikirozi nthawi zambiri zimatchulidwa.

Onetsetsani kuti mwaphunzira! Kodi mukuganiza kuti kuyamwa kwa mapiritsi ndi insulini kwa nthawi yonse yokhayo ndi njira yokhayo yothanirana ndi shuga? Sichowona! Mutha kutsimikizira izi nokha ndikuyamba kuzigwiritsa ntchito. werengani zambiri >>

Pharmacological zochita za glucagon

Mphamvu ya kapangidwe ka mankhwala a glucagon ndi ofanana ndi zolimbitsa mphamvu ya amkati amkati:

• Imaphwanya glycogen m'chiwindi mpaka glucose, yomwe imalowa m'magazi. Mankhwala akaphatikizidwa m'mitsempha, chochita chimadziwika pambuyo pa mphindi 5 - 25, ndi mu mnofu - pambuyo pa mphindi 15 - 26, modzitchinjiriza - pambuyo pa mphindi 30 - 45, motero, kuti muwonetse zotsatira, ndikofunikira kudikirira nthawi,
• Amamasula minofu yosalala (antispasmodic effect). Ndi mtsempha wa intravenous pambuyo pa masekondi 45-60, ndi makonzedwe amtsempha pambuyo pa mphindi 8-10,
• Kuchulukitsa pafupipafupi kufupi kwa minofu yamtima.

Malangizo ogwiritsira ntchito akuti zotsatira zake sizikula pambuyo pake kwa nthawi yayitali, kumwa mowa. Kuchuluka kwa glycogen m'chiwindi kumachepetsedwa kotero kuti glucagon imatha kupereka mphamvu ya hyperglycemic.

Pogwiritsa ntchito shuga kwa nthawi yayitali, mphamvu ya m'mimba imaletseka ndipo kudzimbidwa kumayamba.

Contraindication pa ntchito ya glucagon

• hyperglycemia: pamene glucagon ipangidwa, shuga wamagazi amatuluka kwambiri,
• Hypersensitivity kuti ng'ombe ndi nkhumba mapuloteni mu chakudya,
• insulinoma (chotupa cha kanyumba kogwiritsira ntchito kapamba), chifukwa izi zitha kuchititsa munthu kusayembekezereka - hypoglycemia),
• pheochromocytoma (chotupa cha adrenal medulla yomwe imatulutsa kuchuluka kwa adrenaline. Popeza ndi synergist ya glucagon, izi zingayambitse hyperglycemia,
• shuga mellitus (chiopsezo cha hyperglycemia)

• Glucagon ya mahoni samadutsa chotchinga, chifukwa chitha kugwiritsidwa ntchito mwa amayi apakati. Komabe, sizikudziwika ngati mankhwalawo apita mkaka wa mayi, chifukwa chake, munthawi imeneyi, mankhwalawa ayenera kugwiritsidwa ntchito mosamala,
• Imawonjezera mphamvu ya anticoagulants osalunjika.