Insulin Actrapid: mtengo ndi malangizo ogwiritsira ntchito

Njira zachikhalidwe zochepetsera shuga mutatha kudya zimaphatikizanso ma insulin aanthu achidule. Chimodzi mwa mankhwala otchuka kwambiri, Actrapid, akhala akulimbana ndi matenda ashuga kwa zaka zoposa 3. Pazaka zonsezi, watsimikizira mtundu wake wabwino kwambiri ndikupulumutsa anthu mamiliyoni ambiri.

Pakadali pano, ma insulin atsopano, omwe alipo kale, omwe amapezeka kale omwe amapereka glycemia wabwinobwino ndipo ali omasuka pazofooka za omwe anawatsogolera. Ngakhale izi, Actrapid samataya maudindo ake ndipo amagwiritsidwa ntchito mosamala pochiza matenda amtundu wa 2 komanso matenda a shuga.

Malangizo achidule ogwiritsira ntchito

Actrapid ndi imodzi mwazinthu zoyambirira zomwe zimapezeka ndi ma genetic engineering. Idapangidwa koyamba mu 1982 ndi nkhawa yama mankhwala a Novo Nordisk, m'modzi mwa opanga mankhwala akulu kwambiri padziko lonse lapansi. Panthawiyo, odwala matenda ashuga amayenera kukhala okhutira ndi insulin ya nyama, yomwe inali yokhala ndi kuyeretsa kochepa komanso kugwirira ntchito kwambiri.

Actrapid imapezeka pogwiritsa ntchito mabakiteriya osinthidwa, chinthu chomalizidwa chimangobwerezeranso insulin yomwe imapangidwa mwa anthu. Tekinoloje yopanga imalowetsa kukwaniritsa zotsatira zabwino za hypoglycemic komanso kuyera kwambiri kwa yankho, lomwe linachepetsa chiopsezo cha ziwopsezo zam'mimba ndi zotupa pa malo opangira jekeseni. Radar (kaundula wamankhwala omwe amalembetsa ndi Unduna wa Zaumoyo) akuwonetsa kuti mankhwalawa amatha kupanga ndikupanga ku Denmark, France ndi Brazil. Kuwongolera kwa zotsatira kumachitika kokha ku Europe, chifukwa chake palibe kukayikira za mtundu wa mankhwalawa.

Zambiri mwachidule za Actrapide kuchokera kuzomwe angagwiritse ntchito, zomwe aliyense wodwala matenda ashuga ayenera kudziwa:

Ngati mulingo wawonjezereka, hypoglycemia imachitika, zomwe zingayambitse kupweteka patatha maola angapo. Kutsika pang'ono kwa shuga kumapangitsa kuti mitsempha isawonongeke, kufufutira zizindikiro za hypoglycemia, zomwe zimapangitsa kuti zizindikire.

Pophwanya njira ya jakisoni wa Actrapid insulin kapena chifukwa cha zomwe zimachitika ndi minyewa yokhala ndi subcutaneous, lipodystrophy ndiyotheka, pafupipafupi kupezeka kwawo kumakhala kochepera 1%.

Malinga ndi malangizo, mukamasinthira ku insulin ndi kutsika msanga, kuthana ndi kwakanthawi kumatheka, komwe kumatha pazokha: kuwonongeka kwamawonekedwe, kutupa, neuropathy.

Insulin ndi mankhwala osalimba, mu syringe imodzi imatha kusakanikirana ndi saline komanso ma insulin apakati, kuposa opanga omwewo (Protafan). Actrapid insulin dilution ndiyofunikira kwa odwala matenda ashuga omwe ali ndi chidwi chachikulu ndi mahomoni, mwachitsanzo, ana aang'ono. Kuphatikizidwa ndi mankhwala ochepetsa mphamvu amagwiritsidwa ntchito pa matenda a shuga a 2, nthawi zambiri okalamba.

Kugwiritsa ntchito mankhwala munthawi yomweyo kungakhudze zochita za insulin. Hormonal ndi diuretics zimatha kufooketsa mphamvu ya Actrapid, ndipo mankhwala amakono opsinjika ngakhale tetracycline wokhala ndi aspirin angalimbitse. Odwala omwe ali ndi mankhwala a insulin ayenera kuphunzira mosamala gawo la "mogwirizana" ndi mankhwala omwe akukonzekera kugwiritsa ntchito. Zitapezeka kuti mankhwalawa angakhudze zochita za insulin, mlingo wa Actrapid uyenera kusinthidwa kwakanthawi.

Chaka chilichonse, Actrapid imaphatikizidwa mndandanda wazamankhwala ofunikira, kotero anthu odwala matenda ashuga angathe kuzipeza kwaulere, ndi mankhwala kuchokera kwa dokotala.

Zowonjezera

Actrapid NM amatanthauza zazifupi (mndandanda wa ma insulin afupiafupi), koma osati mankhwala a ultrashort. Amayamba kuchita pakatha mphindi 30, motero amamuzindikiritsa pasadakhale. Glucose pazakudya zomwe zili ndi GI yotsika (mwachitsanzo, buckwheat ndi nyama) imatha "kugwira" insulin iyi ndikuchotsa magaziwo munthawi yake. Ndi chakudya chamagulu othamanga (mwachitsanzo, tiyi wokhala ndi keke), Actrapid satha kumenya nkhondo mwachangu, chifukwa chake mukadya hyperglycemia zimachitika mosalephera, zomwe zimayamba kuchepa pang'onopang'ono. Kulumpha mu shuga sikumangowonjezera thanzi la wodwalayo, komanso kumathandizira kupita patsogolo kwa zovuta za matenda ashuga. Kuti muchepetse kukula kwa glycemia, chakudya chilichonse ndi Insulin Actrapid chimayenera kukhala ndi fiber, protein kapena mafuta.

Kutalika kwa nthawi

Actrapid amagwira ntchito mpaka maola 8. Maola asanu oyamba - chinthu chachikulu, ndiye - mawonetseredwe otsalira. Ngati insulin imayendetsedwa pafupipafupi, mphamvu ya milingo iwiri imadutsana. Nthawi yomweyo, ndizosatheka kuwerengera kuchuluka kwa mankhwalawa, omwe amawonjezera chiopsezo cha hypoglycemia. Kuti mugwiritse ntchito bwino mankhwalawa, zakudya ndi jakisoni wa insulin amafunika kugawidwa maola 5 aliwonse.

Mankhwalawa ali ndi chiwopsezo pambuyo pa maola 1.5-3,5. Pofika nthawi ino, chakudya chochuluka chimakhala ndi nthawi yogaya, motero hypoglycemia imachitika. Kuti mupewe izi, muyenera kugwiritsa ntchito mankhwalawa kwa 1-2 XE. Zokwanira, ndimatenda a shuga patsiku, zakudya zitatu ndi zitatu zowonjezera zimapezeka.Insulin Actrapid imayendetsedwa isanayambike yayikulu, koma mlingo wake umawerengeredwa pang'onopang'ono.

Malamulo oyambira

Mbale zokhala ndi Actrapid NM zitha kugwiritsidwa ntchito ndi ma insulin okhala ndi U-100. Makatoni - okhala ndi ma syringe ndi ma syringe: NovoPen 4 (kipimo unit 1), NovoPen Echo (mayunitsi 0,5).

Kuti insulini igwire bwino ntchito ndi matenda ashuga, muyenera kuphunzira njira ya jakisoni mu malangizo ogwiritsira ntchito ndikutsatira ndendende. Nthawi zambiri, Actrapid amalowetsedwa ndi crease pamimba, syringe imasungidwa pakona mpaka pakhungu. Pambuyo poyikapo, singanoyo samachotsa masekondi angapo kuti yankho lithe kutuluka. Insulin iyenera kukhala firiji. Pamaso pa makonzedwe, ndikofunikira kuyang'ana tsiku lomwe linatha ndi mawonekedwe ake.

Botolo lomwe lili ndi chimanga, matope kapena makhiristo mkati ndizoletsedwa.

Fananizani ndi ma insulini ena

Ngakhale kuti molekyulu ya Actrapid ndi yofanana ndi insulin yaumunthu, zomwe zimachitika ndizosiyana. Ichi ndi chifukwa subcutaneous makonzedwe. Amasowa nthawi yosiya mafuta am'magazi ndikukwaniritsa kuthamanga kwa magazi. Kuphatikiza apo, insulini imakonda kupanga mapangidwe azovuta m'misempha, zomwe zimathandizanso kuchepetsa shuga.

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!

Ma insulin amakono ambiri - ma Humalog, NovoRapid ndi Apidra - amalephera zolakwitsa izi. Amayamba kugwira ntchito m'mbuyomu, chifukwa chake amatha kuchotsa ngakhale mafuta othamanga. Kutalika kwake kumachepetsedwa, ndipo palibe kuchuluka, kotero zakudya zimatha kukhala zowonjezereka, ndipo zokhwasula-khwasula sizofunikira. Malinga ndi kafukufuku, mankhwala a ultrashort amapereka bwino kuwongolera glycemic kuposa Actrapid.

Kugwiritsa ntchito mankhwala a Actrapid insulin a shuga kungakhale koyenera:

• odwala omwe amatsatira zakudya zamafuta ochepa, makamaka ndi matenda a shuga a 2,
• mwa ana omwe amadya maola atatu aliwonse.

Kodi mankhwalawo ndi angati? Ubwino wosakayikitsa wa insuliniyi umaphatikizapo mtengo wake wotsika: 1 unit ya Actrapid imawononga 40 kopecks (ma ruble 400 pa botolo la 10 ml), mahomoni a ultrashort - katatu konse mtengo.

Mapulogalamu a insulin yaumunthu amakhala ndi mawonekedwe ofanana a maselo ndi zinthu zofanana:

Kusintha kuchokera ku insulin kupita kwina kuyenera kuchitidwa pokhapokha pazotsatira zamankhwala, chifukwa kubwezeretsedwera kwa shuga kumakulirakulira pakusankhidwa kwa mlingo.

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

Pharmacodynamics ndi pharmacokinetics

Actulin insulin yopangidwa ndi recombinant DNA biotechnology pogwiritsa ntchito kupsinjika Saccharomyces cerevisiae. INN yake ndi - Insulin munthu.

Mankhwala amalumikizana ndi cholandilira chakunja cha cytoplasmic cell. Amapanga insulin receptor zovuta. Imayendetsa njira za intracellular polimbikitsa biosynthesis. cAMP kapena kulowa mkatikati mwa minofu.

Kuchepa kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa mayendedwe amkati komanso kumizidwa ndi minofu, kutseguka lipojiaiskaphatikizidwe ka mapuloteni ndipo glycogenogenesis, komanso kuchepa kwa kuchuluka kwa shuga m'magazi, etc.

Zochita za mankhwalawa zimayamba pakatha mphindi 30 mutatha kugwiritsa ntchito. Kuchuluka kwake kumaonekera pa avareji mkati mwa maola 2,5. Kutalika konse kwa kuchitapo kanthu ndi maola 7-8.

Zowonekera kwa odwala ndizotheka, kuphatikiza zomwe zimatengera kukula kwa mankhwalawa.

Malangizo ogwiritsira ntchito Actrapid (Njira ndi Mlingo)

Malangizo a Actrapid akunena kuti mankhwalawa amaperekedwa mosavuta kapena m'mitsempha. Mlingo amasankhidwa ndi katswiri payekha, kutengera zosowa za wodwala. insulin. Monga lamulo, mlingo ndi 0.3-1 IU / kg pa tsiku. At insulin kukanazofuna zitha kukhala zokwera, komanso zatsalira kupanga amkati insulin - pansipa. Odwala ayenera kuyang'anitsitsa shuga wawo magazi.

Panthawi ya mkhutu aimpso kapena kwa chiwindi ntchito insulinzochepa. Chifukwa chake muyenera kusintha mankhwalawa.

Malangizo ogwiritsira ntchito Actrapid akuwonetsa kuti akhoza kugwiritsidwa ntchito limodzi akhala akuchita insulini.

Mankhwalawa amaperekedwa theka la ola musanadye kapena osafunsidwa ndi chakudya. Monga lamulo, jakisoni amapangidwa modzaza m'chigawo cha khoma lamkati lakumbuyo. Izi zimathandizira kuyamwa mwachangu. Kuphatikiza apo, jakisoni amatha kupangika m'tchafu, minofu yathanzi ya phewa kapena matako. Kupewa lipodystrophyMasamba a jakisoni ayenera kusintha.

Kuwongolera kwa mkati ndizovomerezeka pokhapokha ngati jakisoni apangidwa ndi katswiri wazachipatala. Intramuscularly, mankhwalawa amaperekedwa pokhapokha ngati akuwunikira katswiri.

Bongo

Pankhani ya bongo, izi ndizotheka: kusowa tulopallor kwambiri, zochulukitsa zokoma ndipo kulakalaka, kunjenjemera, thukuta, mutu, paresthesia mkamwa, palpitations. Pankhani yogwiritsa ntchito mankhwalawa muyezo wopitilira muyeso, wodwalayo akhoza kugwera kwa ndani.

Pankhani ya kuwala hypoglycemiamuyenera kudya shuga kapena shuga. Mwa bongo wambiri, 1 mg imayendetsedwa ndi intramuscularly Glucagon. Ngati ndi kotheka, njira zama glucose zowonjezera zimawonjezeredwa.

Kuchita

Hypoglycemic insulinzimawonjezeka makamwa hypoglycemic wothandizira, angiotensin kutembenuza enzyme zoletsa, osasankha beta-blockers, sulfonamides, mchiyama, Ketoconazole, Pyridoxine, cyclophosphamideKukonzekera kwa lifiyamu monoamine oxidase zoletsa ndi kaboni anhydrase, Bromocriptine, anabolic steroids, Clofibrate, Mebendazole, Theofylline, Fenfluramine ndi mankhwala okhala ndi ethanol. Mowa samangokulitsa, komanso umakulitsa mphamvu ya Actrapid.

Zotsatira za hypoglycemic, m'malo mwake, zimachepa mchikakamizo cha kulera kwamlomo, mahomoni a chithokomiro, Heparina, amphanomachul, Clonidine, Diazoxide, Phenytoin, glucocorticosteroids, thiazide okodzetsa, tridclic antidepressantsmu, Danazole, calcium blockers, morphine, chikonga.

Zotsatira za Actrapid zitha kukulira kapena kuchepa chifukwa chogwiritsa ntchito Reserpine ndi salicylates. Octreotide, Lanreotide itha kuchepetsa kapena kuwonjezera kufunika kwa insulin.

Phwando opanga beta imatha kubisa zizindikiro hypoglycemia ndi kupewa kuchotsedwa kwake.

Zogulitsa, mwachitsanzo, zokhala ndi ma thiolskapena sulfiteszitha kuyipitsa insulin.

Tsiku lotha ntchito

Botolo lotseguka limasungidwa kwa milungu isanu ndi umodzi. Asanatsegule, moyo wa alumali wa mankhwala ndi miyezi 30. Osagwiritsa ntchito yankho litatha tsiku lotha ntchito.

Amaunika Actrapid ngati mankhwala odalirika omwe amakupatsani mwayi wolamulira glycemia. Odwala monga kuthamanga kwa mankhwalawa. Pakati pazinthu zoyipa, mawonekedwe osasangalatsa a kumasulidwa kwa mankhwalawa mu mawonekedwe a yankho la jakisoni, kuyambitsa komwe nthawi zambiri kumafunikira kuyang'aniridwa kwa akatswiri.

Mtengo wa Actrapid, komwe mungagule

Mtengo Amakola pafupifupi 450 ma ruble. Mutha kugula chida ichi pokhapokha ngati mwalandira mankhwala.

Mtengo Insulin Actrapid HM Penfill ndi pafupifupi ma ruble 950. Chifukwa chake, mankhwalawa amawonedwa okwera mtengo. M'mayiko ena ogulitsa pa intaneti, mtengo wa Actrapid ukhoza kukhala wokwera kuposa momwe wafotokozedwera.

Kupanga ndi mawonekedwe a kumasulidwa

Njira yothetsera jakisoni - 1 ml:

• yogwira zinthu: insulin sungunuka wa chibadwa cha anthu - 100 IU (3.5 mg), 1 IU ikufanana ndi 0,035 mg wa insulin yaumunthu wamunthu,
• excipients: zinc chloride, glycerin (glycerol), metacresol, sodium hydroxide ndi / kapena hydrochloric acid (kusintha pH), madzi a jakisoni.

10 ml m'mabotolo agalasi, osindikizidwa ndi cholembera ndi chopukusira pulasitiki, mumapaketi a makatoni 1.

Njira yothetsera jakisoni ndi yowonekera, yopanda utoto.

Wamtundu waifupi insulin.

Munthu wobwerezabweretsanso insulin ya DNA. Ndi insulin ya nthawi yayitali yochitapo kanthu. Imayendetsa kagayidwe ka glucose, imakhala ndi zotsatira za anabolic. Mu minofu ndi minyewa ina (kupatula ubongo), insulin imathandizira kayendedwe ka glucose ndi amino acid, komanso zimapangitsa protein anabolism. Insulin imalimbikitsa kutembenuka kwa glucose kukhala glycogen m'chiwindi, imalepheretsa gluconeogeneis ndikuthandizira kusintha kwa glucose owonjezera kukhala mafuta.

Actrapid nm Ntchito pakati ndi ana

Pakati pa nthawi yayitali, ndikofunikira kuti pakhale chitetezo chabwino cha glycemic mwa odwala matenda ashuga. Pa nthawi ya pakati, kufunika kwa insulin nthawi zambiri kumachepetsa mu trimester yoyamba ndikuwonjezeka trimesters yachiwiri ndi yachitatu.

Ndikulimbikitsidwa kuti odwala omwe ali ndi matenda a shuga adziwitse adokotala za kutha kapena kukonza pakati.

Odwala omwe ali ndi matenda a shuga mellitus pa mkaka wa m`mawere, kusintha kwa insulin, zakudya, kapena zonse ziwiri zingafunike.

Pakufufuza koopsa kwa majini mu vitro komanso mndandanda wa vivo, insulin yaumunthu idalibe mutagenic.

Zotsatira zoyipa za Actrapid nm

Kuchokera ku endocrine system: hypoglycemia.

Hypoglycemia kwambiri ikhoza kuyambitsa kusokonezeka kwa chikumbumtima ndipo (mwapadera) kufa.

Thupi lawo siligwirizana: zimachitika matupi awo sagwirizana - hyperemia, kutupa kapena kuyunkhira pamalo a jekeseni (nthawi zambiri amayima patadutsa masiku angapo mpaka masabata angapo), kayendedwe ka ziwalo (zimachitika kawirikawiri, koma zimakhala zowopsa) - kuyamwa kambiri, kufupika, kupuma pang'ono , kuchepa kwa magazi, kuchuluka kwa mtima, kuchuluka thukuta. Milandu yambiri yokhudzana ndimomwe thupi limagwirira ntchito ikhoza kukhala pachiwopsezo cha moyo.

Hypoglycemic effect imachepetsedwa ndi kulera kwapakamwa, corticosteroids, kukonzekera kwa mahomoni a chithokomiro, thiazide diuretics, diazoxide, tridclic antidepressants.

Mphamvu ya hypoglycemic imatheka ndi mankhwala am'mlomo a hypoglycemic, ma salicylates (mwachitsanzo acetylsalicylic acid), sulfonamides, mao inhibitors, a beta-blockers, Mowa ndi ethanol.

Beta-blockers, clonidine, reserpine amatha kuphimba mawonetseredwe a zizindikiro za hypoglycemia.

Mlingo Actrapid nm

P / c, mu / mu. Mlingo wa mankhwalawa amasankhidwa payekha poganizira zosowa za wodwala. Nthawi zambiri, kufunikira kwa wodwala insulin kumachokera ku 0,3 mpaka 1 IU / kg / tsiku. Kufunikira kwa insulin tsiku lililonse kumatha kukhala kwapamwamba kwa odwala omwe ali ndi insulin (mwachitsanzo, nthawi yakutha msinkhu, komanso odwala omwe ali ndi kunenepa kwambiri) komanso otsika mwa odwala omwe ali ndi zotsalira za insulin.Ngati odwala matenda a shuga akwaniritsa kwambiri glycemic control, ndiye kuti zovuta za shuga mwa iwo, monga lamulo, zimawonekera pambuyo pake. Pankhaniyi, munthu ayenera kuyesetsa kukhathamiritsa kagayidwe kachakudya, makamaka, poyang'anira mosamala kuchuluka kwa shuga m'magazi.

Actrapid ® NM ndi insulin yochepa ndipo imatha kugwiritsidwa ntchito limodzi ndi ma insulin.

Mankhwalawa umaperekedwa kwa mphindi 30 asanadye kapena chakudya. Actrapid ® NM nthawi zambiri imayendetsedwa ku Sc mpaka dera la khomo lamkati lakumbuyo. Ngati izi ndizotheka, ndiye kuti jakisoni amathanso kupangira ntchafu, dera la gluteal kapena dera lamapeto. Ndi kuyambitsa kwa mankhwala m'dera lakhomopo lakhomopo, mayamwidwe mwachangu amatheka kuposa momwe angayambitsire madera ena. Kupanga jakisoni pakhungu kumachepetsa chiopsezo cholowera minofu.

Ndikofunikira kusintha malo a jekeseni mkati mwa anatomical dera kuti muchepetse kukula kwa lipodystrophy.

Jakisoni wa mu mnofu amathanso kuchitika, koma mokhazikika monga adokotala amafotokozera.

Actrapid ® NM ndiyothekanso kulowa mkati / momwemo, njirazi zitha kuchitidwa ndi katswiri wazachipatala.

Ndi kuwonongeka kwa impso kapena chiwindi, kufunika kwa insulin kumachepa.

Kusamutsa wodwala kupita ku mtundu wina wa insulin kapena kukonzekera kwa insulin ndi dzina lina lamalonda kuyenera kuchitika moyang'aniridwa ndi achipatala.

Zosintha mu zochitika za insulin, mtundu wake, mitundu (nkhumba, insulin ya anthu, analogue ya anthu) kapena njira yopangira (DNA recombinant insulin kapena insulini yachikhalidwe) zitha kuchititsa kusintha kwa mlingo.

Kufunika kwa kusintha kwa mankhwalawa kungafunike kale pokhazikitsidwa ndi insulin yokonzekera pambuyo pokonzekera insulin ya nyama kapena pang'onopang'ono milungu ingapo kapena miyezi ingapo atasamutsidwa.

Kufunika kwa insulini kumatha kuchepa ndi kusakwanira kwa adrenal ntchito, pituitary kapena chithokomiro, ndi kufooka kwaimpso kapena chiwindi.

Ndi matenda ena kapena kupsinjika kwamalingaliro, kufunikira kwa insulin kungakulitse.

Kusintha kwa Mlingo kumafunikanso ndi zochitika zolimbitsa thupi kapena kusintha kwa zakudya zanu.

Zizindikiro zakutsogolo kwa hypoglycemia pa nthawi ya insulin yaumwini mwa odwala ena akhoza kutchulidwa kochepa kapena zosiyana ndi zomwe zimawonedwa panthawi ya insulin ya nyama. Ndi kusintha kwa matenda a shuga m'magazi, mwachitsanzo, chifukwa cha insulin yokwanira, zonse kapena zizindikiro zina za hypoglycemia zimatha, zomwe odwala ayenera kudziwitsidwa.

Zizindikiro zakutsogolo kwa hypoglycemia zimatha kusintha kapena kusalankhula pang'ono ndi njira yayitali ya matenda a shuga, matenda a shuga, kapena kugwiritsa ntchito beta-blockers.

Nthawi zina, thupi lanu siligwirizana chifukwa cha zochita za mankhwalawa, mwachitsanzo, kuyambitsa khungu ndi wothanduka kapena jakisoni wosayenera.

Nthawi zina chitukuko cha zonse matupi awo sagwirizana, chithandizo chofunikira chimafunika. Nthawi zina, kusintha kwa insulin kapena kukakamira kungafunike.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Panthawi ya hypoglycemia, kuthekera kwa wodala kuyang'anitsitsa kumatha kuchepa mphamvu ndipo kuchuluka kwa ma psychomotor zimatha kuchepa. Izi zitha kukhala zowopsa nthawi zomwe maluso amenewa amafunikira makamaka (kuyendetsa galimoto kapena makina ogwiritsa ntchito). Odwala ayenera kulangizidwa kuti azisamala kuti asamayendetse hypoglycemia poyendetsa.Izi ndizofunikira kwambiri kwa odwala omwe ali ndi zofatsa kapena zosapezekapo zizindikiro za hypoglycemia kapena kukula pafupipafupi kwa hypoglycemia. Zikatero, adotolo amayenera kuwunika momwe wodwala angayendetsere galimoto.

Mankhwala

Actrapid ndi insulin yocheperako, yomwe imagulitsidwa ngati yankho la jakisoni. Mankhwalawa ali ndi hypoglycemic, amathandiza kuchepetsa shuga. Ichi ndichifukwa cha kayendedwe kamphamvu ka glucose kupita ku maselo a minofu ndi ziwalo, kuyamwa kwake mwachangu komanso kwathunthu. Insulin imathandizira glycogeneis ndi lipogenesis, imathandizira kupanga mapuloteni komanso imachepetsa kuchuluka kwa kaphatikizidwe ka shuga ndi chiwindi.

Mankhwalawa amakhala ndi insulin yaumunthu, yomwe imapezeka ndi kusintha kwa majini. Kuphatikiza apo, mankhwalawa amaphatikizapo glycerin, zinthu zomwe zimasunga acid-base usawa, ndi zinc chloride. Mankhwalawa amagulitsidwa m'makalata atatu apadera a 3 ml opangira cholembera.

Kutalika kwa Actrapid insulin kutengera mlingo, malo ndi njira yoyendetsera jakisoni. Chifukwa chake, jakisoni wotsekemera, zotsatira zoyambirira zimawonedwa pambuyo pa theka la ola, ndipo zotsatira zake ndizodziwika pambuyo pa maola awiri. Kutalika konse kwa insulin m'magazi ndi maola 8.

M'mafakitare mungapeze fanizo la mankhwalawa: Iletin II Wokhazikika, Actrapid MS, Betasint osalowerera E-40, Maxirapid BO-S ndi ena. Kubwezeretsedwa kwa insulini ndikovomerezeka pokhapokha ngati adokotala adamuuza.

Zotsatira zoyipa ndi bongo

Zotsatira zoyipa za Actrapid insulin zimatha kukhala zowonjezereka zolimbitsa thupi, kulephera kutsatira mlingo kapena kuperewera kwa zakudya m'thupi. Anthu odwala matenda ashuga akuda nkhawa ndi kutukusira kwa manja ndi miyendo, kutsika kwamaso owoneka bwino, kuchuluka thukuta, kunjenjemera ndi kutsekeka kwa khungu. Kusokonezeka m'malo, kuchuluka kwa mantha ndi kutopa ndikotheka.

Nthawi zambiri, odwala matenda ashuga amadandaula za kupweteka mutu komanso chizungulire, mseru komanso kumva kuti ali ndi njala. Nthawi zina, kusakhala ndi chikumbumtima komanso kukula kwa vuto la insulin ndikotheka.

Ndi chidwi chomwa mankhwalawa, odwala amakumana ndi zovuta zina. Vutoli limawonekera ndi kusanza, thukuta kwambiri, chizungulire, kukhumudwa pamtima, komanso kupuma movutikira.

Mwina chitukuko cha zochitika m'deralo jakisoni: redness, kutupa ndi kuyabwa. Ndi jakisoni pafupipafupi m'dera limodzi, lipodystrophy imatha kuchitika.

Kupitilira muyeso womwe wapezeka wa Actrapid kumabweretsa kukula kwa hypoglycemia. Amawonetsedwa ndi kufooka, njala yayikulu, miyendo ndi kunjenjemera kwa khungu. Mapeto owopsa kwambiri pamenepa ndi chipere cha hypoglycemic.

Zoyipa:

Mimba komanso kuyamwa
Palibe choletsa kugwiritsa ntchito insulin panthawi yapakati, popeza insulin siyidutsa chotchinga. Komanso, ngati matenda ashuga sawagwiritsa ntchito panthawi yoyembekezera, mwana wosabadwayo amakhala pachiwopsezo. Chifukwa chake, chithandizo cha matenda ashuga chiyenera kupitilizidwa pa nthawi yomwe muli ndi pakati.
Onse a hypoglycemia ndi hyperglycemia, omwe amatha kukhala ndi vuto losankha bwino, amalimbikitsa chiopsezo cha kusokonezeka kwa fetal ndi kufa kwa fetal. Amayi oyembekezera omwe ali ndi matenda ashuga amayenera kuyang'aniridwa panthawi yonse yomwe ali ndi pakati, ayenera kukhala ndi njira zowongolera kuchuluka kwa shuga wamagazi, malingaliro omwewo amagwiranso ntchito kwa amayi omwe akukonzekera kutenga pakati.
Kufunika kwa insulin nthawi zambiri kumachepera mu trimester yoyamba ya kutenga pakati ndipo kumawonjezeka pang'onopang'ono kwachiwiri komanso kachitatu.
Pambuyo pa kubala, kufunikira kwa insulin kumabwereranso msanga momwe zidadziwikira mwana asanabadwe.
Palibenso zoletsa kugwiritsa ntchito mankhwala a Actrapid NM pa nthawi yoyamwitsa.Kuchita insulin kwa amayi oyamwitsa sikowopsa kwa mwana. Komabe, mayi angafunike kusintha njira ya Actrapid NM ndi / kapena zakudya.

Zotsatira zoyipa:

Osowa kwambiri - anaphylactic reaction. Zizindikiro za kuphathamiritsa kwa khungu kwambiri zingaphatikizepo kuzizira pakhungu, kuyabwa, thukuta kwambiri, mavuto am'mimba, angioedema, dyspnea, palpitation, kutsika magazi, kukomoka / kusazindikira.
Maganizo achilengedwe oopsa amatha kukhala pangozi pamoyo.

Kusokonezeka kwamanjenje
Nthawi zambiri - zotumphukira neuropathy.
Ngati kusintha kwa kayendetsedwe ka shuga m'magazi kwachitika mwachangu kwambiri, vuto lotchedwa "ululu wammbuyo" limatha kupezeka lomwe limasinthiratu.

Kuphwanya gawo la masomphenyawo
Nthawi zambiri - zolakwika zoyeserera.
Zovuta zamkati zodzikongoletsera zimadziwika nthawi yoyamba gawo la insulin. Monga lamulo, Zizindikirozi ndizosintha.

Osowa kwambiri - matenda ashuga retinopathy. Ngati chiwongolero chokwanira cha glycemic chimaperekedwa kwa nthawi yayitali, chiwopsezo cha kupitirira kwa matenda ashuga amachepetsa. Komabe, kukulitsa kwa insulin mankhwala osinthika kwambiri pakulamulira kwa glycemic kungayambitse kuwonjezeka kwakanthawi kwa zovuta za matenda ashuga a retinopathy.

Kusokonezeka kwa khungu ndi minofu yolowerera
Nthawi zambiri - lipodystrophy.
Lipodystrophy imatha kukhazikika pamalo a jekeseni pomwe sizisintha mosintha malo a jekeseni mkati mwa gawo limodzi la thupi.

Kusokonezeka kwa thupi lonse, komanso zimachitika pakubaya
Nthawi zambiri - zimachitika malo jakisoni.
Poyerekeza ndi maziko a mankhwala a insulin, zimachitika pakhungu jekeseni (redness of the khungu, kutupa, kuyabwa, kupweteka, mapangidwe a hematoma pamalo a jekeseni). Komabe, nthawi zambiri, izi zimachitika mosadukiza ndipo zimatha nthawi yamankhwala.

Nthawi zambiri - kudzisunga.
Kutupa kumadziwika nthawi yoyamba ya insulin. Monga lamulo, chizindikiro ichi chimakhala chachilengedwe.

Wopanga:

Yankho la jakisoni Actrapid NM (malangizo ogwiritsa ntchito, limafotokoza momveka bwino) amalimbikitsidwa kwa anthu omwe ali ndi matenda ashuga. Mankhwala amatanthauza anthu insulin analandira biosynthetically. Wopanga ndi kampani yopanga mankhwala Novo Nordisk A / S kuchokera ku Denmark, yomwe ikugwira ntchito yopanga ndi kupanga mankhwala a shuga. Actrapid amagwiritsidwa ntchito pokhapokha ngati adalangizidwa ndi dotolo ndipo amamugawa ku pharmacies ndi fomu yodzilemba.

Yogwira pophika ndi mphamvu ya mankhwalawo, zikuwonetsa pazifukwa zake

Actrapid NM ndi othandizira a hypoglycemic omwe ali ndi kanthawi kochepa. Amapangidwa ngati mawonekedwe amadzimadzi osakhala ndi utoto ndi fungo, amakonzedwa kuti aperekedwe pansi pakhungu ndi kudzera m'mitsetse. Gawo lomwe limagwiritsa ntchito mankhwalawa limasungunuka anthu insulin, yomwe imapezeka pogwiritsa ntchito njira ya rDNA biotechnology pogwiritsa ntchito Saccharomyces cerevisiae. Mu 1 ml yankho ndi 100 IU yogwira pophika, yomwe ndi ofanana ndi 0,035 ya insulin. Kuphatikiza pazogwira ntchito, mankhwalawa amaphatikiza madzi osabala, sodium mu mawonekedwe a hydroxide, zinc chloride, metacresol ndi hydrochloric acid.

Chogulitsachi chimagulitsidwa m'mabotolo owoneka bwino a 10 ml, osindikizidwa ndi zolembera za rabara. Bokosi lirilonse limadzaza bokosi lamapepala okhathamira ndipo limapatsidwa mankhwala omasulira.

Mphamvu yotsitsa shuga ya Actrapid NM imachitika chifukwa cha kuyamwa kwa glucose ndi thupi pambuyo pomanga insulini ku ma cell receptors komanso kuletsa kwake kupanga ndi chiwindi. Chidacho chimadziwika ndi zochita zazifupi.Zomwe zimagwiritsidwa ntchito zimachitika mkati mwa theka la ola pambuyo pa kumwa ndipo zimatha mpaka maola 8. Kuchuluka kwa ndende yogwira ntchito ya Actrapid NM m'madzi am'magazi kumachitika pambuyo pa maola 1.5-2 pambuyo pa jekeseni.

Actrapid NM amagwiritsidwa ntchito pochiza matenda amisempha otengera shuga kwa anthu azaka zonse. Chifukwa cha kuchitapo kanthu mwachangu, mankhwalawa amatha kugwiritsidwa ntchito pazovuta kwambiri pamene wodwala akukumana ndi vuto la glycemic control.

Zomwe zimafunikira mosamala ndi mankhwalawa

Anthu omwe akudwala matenda a shuga ayenera kudziwa kuti kugwiritsa ntchito Actrapid NM sikuwonetsedwa kwa odwala onse. Malangizo ogwiritsa ntchito amaletsa kuikidwa kwa mankhwalawa kwa anthu omwe:

• kusalolera kwa zomwe zimakhalapo,
• hypoglycemia.

Kugwiritsa ntchito kwa Actrapid NM muzochita za ana sikutsutsana. Njira yothetsera vutoli ingagwiritsidwe ntchito pochiza ana ndi achinyamata omwe amafunika jakisoni ndi insulin kuti akhalebe ndi shuga.

Sizachilendo kuti yankho la insulin lifike potsekereza placental, choncho lingagwiritsidwe ntchito ndi odwala pakati popanda zoletsa. Amayi omwe akukonzekera kukhala amayi ayenera kusankha mtundu woyenera wa mankhwalawa, omwe angalole kuti azilamulira shuga. Kugwiritsa ntchito mankhwalawa mosakwanira kungayambitse kuchuluka kwa hypoglycemia kapena hyperglycemia - mikhalidwe yomwe pa nthawi ya pakati imatha kubweretsa kukula kosabereka komanso kufa kwa mwana wosabadwayo.

Amayi oyembekezera amayenera kusintha mosamala mlingo wa Actrapid NM. Tiyenera kukumbukira kuti m'nthawi ya trimester yoyamba, kufunika kwake kumachepa pang'ono, ndipo pambuyo pake kumawonjezeka. Mwana akabadwa, kufunika kwa insulini pang'onopang'ono kumabwelera pamlingo womwe anali nawo asanachitike "kosangalatsa".

Actrapid NM siyowononga thanzi la makanda, chifukwa chake, palibe chifukwa chochepetsera kugwiritsa ntchito amayi oyamwitsa. Nthawi zina mayi wachichepere angafunikire kusintha kwa mlingo.

Mwa anthu omwe ali ndi vuto la impso ndi hepatic, kusowa kwa thupi kwa insulin kungachepe. Afunika kuwunika bwino kuchuluka kwa shuga m'magazi ndi kuwerengetsa kuchuluka kwa mankhwalawo omwe amaperekedwa payekhapayekha, kutengera zotsatira zakuwunika.

Kugwiritsa ntchito Actrapid NM mwa anthu opitilira 65 kuyenera kuchitidwa motsutsana ndi kuyang'anira kuwonetsetsa kwa shuga. Popewa kukula kwa zovuta kuchokera ku chithandizo, odwala a m'badwo uno ayenera kuyesetsa kupitilira muyeso wa yankho.

Mankhwalawa samakhudza chonde cha munthu. Odwala omwe amawagwiritsa ntchito nthawi zonse kuti abereke ana sizoletsedwa.

Zomwe zimagwiritsidwa ntchito ndi zotsatira zosayenerera

Actrapid iyenera kuperekedwa pakhungu kapena pakhungu. Mlingo wa mankhwalawa zimatengera zosowa za wodwalayo. Endocrinologist ayenera kuyiyika molingana ndi zotsatira za mayeso a matenda ashuga. Mankhwalawa ali ndi mphamvu kwakanthawi kochepa, chifukwa chake, ngati pakufunika kuthandizidwa, amathanso kutumikiridwa limodzi ndi insulin.

Mankhwala yankho la Actrapid NM akulimbikitsidwa kuti agwiritsidwe ntchito theka la ola chakudya chisanachitike. Pogwiritsa ntchito subcutaneous, ndikofunikira kukhazikitsa mankhwalawa kukhoma lakunja kwa peritoneum. Mutha kubayanso insulin mapewa, ntchafu kapena dera la gluteal. Pofuna kupewa kufalikira kwa mafuta, wodwalayo ayenera kusintha malo oyambira yankho. Malinga ndi lingaliro la adokotala, wodwalayo angagwiritsidwe ntchito kukhazikitsa Actrapid NM kudzera m'mitsempha. Ndondomeko ikuchitika kuchipatala.

Kugwiritsidwa ntchito kwa Actrapid NM kungayambitse kukula kwa anthu.Zotsatira zosafunikira kwambiri zamankhwala ndi njirayi ndi hypoglycemia, yomwe imayamba chifukwa chogwiritsa ntchito insulin yambiri ndikupezeka kuti yatsika ndi shuga m'magazi. Ndi mtundu wofatsa wa matenda amtunduwu, munthu amakhala ndi zodandaula zakutopa, kufooka, ludzu, nseru, khungu louma, kusowa kudya, kukoka pafupipafupi, kupuma kwa acetone.

Hypoglycemia yayikulu imatha kuzindikira ndi kupweteketsa mtima, kukomoka, matenda aubongo. Pakakhala njira yokwanira yamankhwala, matendawa amatha kupha munthu. Pankhani ya hypoglycemia, odwala matenda ashuga ayenera kukana kutsatiridwa ndi insulini ndikupempha chithandizo chamankhwala posachedwa.

Kuphatikiza pa hypoglycemia, wodwala yemwe amalandira jakisoni wa Actrapid NM amatha kuona zizindikiro za kuchepa kwa magazi, zomwe zimawoneka ngati kuchepa kwa kuthamanga kwa magazi, zotupa pakhungu, kupuma movutikira, tachycardia, thukuta, dyspepsia, edema ya Quincke, kusokonezeka, kapena kusazindikira. Kuchita kotereku ngati njira yothanirana ndi mankhwala kumawoneka ngati kowopsa ndipo kumafunikira kuchipatala msanga.

Zotsatira zoyipa zomwe zimapezeka mwa anthu ena ogwiritsa ntchito Actrapid NM zimaphatikizaponso:

• zotumphukira neuropathy,
• mavuto amawonedwe (myopia, hyperopia, astigmatism, hyperopia, myopia),
• kuchepa kwamafuta,
• thupi lawo siligwirizana (kuyabwa, urticaria),
• zimachitika kwanthawi (kupweteka, kuyabwa, kutupa, hematomas, hyperemia pamalo a jakisoni wa insulin).

Zizindikiro zilizonse zosasangalatsa zomwe zimapezeka mwa munthu atayamba kugwiritsa ntchito Actrapid ziyenera kukhala chifukwa chochezera katswiri. Kunyalanyaza zoyipa zomwe zingachitike kungayambitse zotsatira zovuta zaumoyo.

Choyamba thandizo vuto la bongo, kugwiritsa ntchito mankhwala osokoneza bongo ndikusunga

Kugwiritsidwa ntchito kwa Actrapid NM mu Mlingo wopitilira muyeso kumabweretsa kukula kwa bongo, komwe kumadziwonetsa mu hypoglycemia. Kuthandiza wodwala kumatengera kuopsa kwa vuto lakelo. Kutsika pang'ono kwa shuga kumakhala kosakhazikika popanda kupita kwa dokotala. Mutha kukhazikitsa vuto lanu ndi matenda ashuga pakudya shuga pang'ono kapena chakudya china chomwe chili ndi chakudya chamagulu ambiri.

Wodwala kwambiri hypoglycemia, limodzi ndi swoon, wodwala amafunikira chithandizo chamankhwala chodzidzimutsa. Kuti athetse chiwopsezo cha moyo, amapaka jakisoni ndi dextrose. Popewa kugonja pafupipafupi kwa shuga, wodwalayo amapatsidwa zakudya zamafuta ambiri atakomoka.

Actulin insulin imagwirizana ndi magulu ena a mankhwala. Kwa iwo omwe amamwa ma beta-blockers, ma tetracycline antibayotiki, sulfonamides, steroidal anabolics, carbonic anhydrase inhibitors, monoamine oxidase ndi ACE inhibitors, ketoconazole, theophylline, mebendazole, clofibrate, mankhwala ochepetsa shuga ogwiritsa ntchito pakamwa, mankhwala onse ayenera kuganiziridwanso;

Kuchepetsa mphamvu ya hypoglycemic ya Actrapid NM mwa makonzedwe ake amodzi pamodzi ndi glucocorticosteroids, njira zakulera zamkamwa, calcium njira blockers, thiazide diuretics, sympathomimetics, morphine, heparin, danazole, tricyclic antidepressants.

Mukaphatikiza yankho la insulin ndi salicylates ndi reserpine, zimachitika mosayembekezereka. Mukamamwa mankhwala osokoneza bongo omwe ali ndi mowa komanso mankhwala a ethanol, zotsatira zake zimakhala zamphamvu komanso zimapitilira.

Actrapid NM sigwirizana ndi mankhwala ofanana ndi sulfites ndi thiols. Kuphatikiza kwawo pa yankho kumatsogolera ku chiwonongeko chake.

Moyo wa alumali wa Actrapid NM ndi wochepa miyezi 30 kuyambira tsiku lopangira.Mbale zosavomerezeka za mankhwalawa zimalimbikitsidwa kuti zizisungidwa mufiriji kutentha kwa 2 ° C mpaka 8 ° C. Ndikofunikira kuwonetsetsa kuti insulini siyizizira, popeza izi zimachepetsa mphamvu yake ya hypoglycemic.

Mutatsegula botolo ndi mankhwalawa liyenera kusungidwa m'chipinda chosungiramo malo otetezedwa kuti kuwala. Insulin yosindikizidwa imayenera kudyedwa kwa masiku 45. Mankhwala, omwe amakhalapo kumapeto kwa nthawi yino, amaletsedwa kotheratu.

Zikomo chifukwa cha ndemanga yanu.

Ndemanga

Megan92 () masabata 2 apitawo

Kodi pali amene wakwanitsa kuchiza matenda ashuga? Amati ndizosatheka kuchiritsa kwathunthu.

Daria () masabata 2 apitawo

Ndinaonanso kuti sizingatheke, koma nditawerenga nkhaniyi, ndidayiwaliratu za matenda "osachiritsika" awa.

Megan92 () masiku 13 apitawa

Daria () masiku 12 apitawo

Megan92, kotero ndidalemba mu ndemanga yanga yoyamba) Chitani izi molingana ndi - ulalo wa nkhani.

Sonya masiku 10 apitawo

Koma kodi uku si kusudzulana? Chifukwa chiyani akugulitsa pa intaneti?

Yulek26 (Tver) masiku 10 apitawo

Sonya, mukukhala m'dziko liti? Amagulitsa pa intaneti, chifukwa masitolo ndi mafakitala amaika chizindikiro chawo. Kuphatikiza apo, kulipira kokha atalandira, ndiko kuti, ankayang'ana koyamba, kufufuzidwa kenako ndi kulipira. Inde, ndipo tsopano amagulitsa chilichonse pa intaneti - kuchokera ku zovala kupita kuma TV ndi mipando.

Kuyankha Kwa mkonzi masiku 10 apitawa

Sonya, moni. Mankhwalawa othandizira matenda osokoneza bongo a shuga samagulitsika kudzera pa intaneti ya mankhwala kuti asawonongeke kwambiri. Mpaka pano, mutha kuyitanitsa pa tsamba lovomerezeka. Khalani athanzi!

Sonya masiku 10 apitawo

Insulin Actrapid ndi mankhwala ogwiritsira ntchito mtundu woyamba wa 2 ndi matenda a shuga, komanso kupumitsa kwa vuto la matenda oopsa a hyperglycemia. Imasintha shuga m'magazi ndipo imathandizira kukhala bwino. Kusintha kwake ndikukhala mulingo wambiri wa glucose, tikulimbikitsidwa kuphatikiza mankhwalawa ndi insulin yayitali komanso mankhwala ena a antidiabetes.

Malangizo apadera

Kuti mupeze zotsatira zoyenera kugwiritsa ntchito mankhwalawa, ziyenera kuphatikizidwa ndi insulin yotalikilapo kapena yapakatikati. Munthawi yamankhwala, yang'anirani kuchuluka kwa shuga m'magazi kuti muwone panthawi yake komanso kupewa kutulutsa kwa hyper- kapena hypoglycemia.

Popewa lipodystrophy, sinthani malo a jakisoni nthawi zonse.

Insulin Actrapid imagwiritsidwa ntchito panthawi yapakati. Mu 1 trimester, kufunika kwa mahoni kumachepa, ndipo pambuyo pake kumawonjezeka, motero, pang'onopang'ono kuchuluka kwake. Mlingo watsimikiza ndi dokotala aliyense payekha, poganizira zomwe zimachitika mthupi komanso nthawi yomwe ali ndi pakati.

Pambuyo pobala, mkazi ayenera kubwerera ku kuchuluka kwa insulin yomwe adalandira asanalandire. Komabe, munthawi yoyatsa, kufunika kwa mahomoni kumatha kuchepa, motero ndikofunikira kuyang'anira kuchuluka kwa glucose komanso thanzi lanu.

Mukamagwiritsa ntchito mankhwalawa, lekani ntchito yomwe imafuna kuyankhidwa mwachangu ndikuwonjezera chidwi. Kuletsa kotereku kumagwira ntchito pakuyendetsa. Izi ndichifukwa choti ndi hypoglycemia, kuchuluka kwa mayankho kuzosangalatsa zakunja zitha kuchepetsedwa.

Hypo- ndi hyperglycemia mukamagwiritsa ntchito mankhwalawa

Kugwiritsidwa ntchito kwa Actrapid insulin kungayambitse kukula kwa hypoglycemia (kuchepa kwambiri kwa shuga) kapena hyperglycemia (kuchuluka kwa shuga). Izi zimachitika chifukwa chosagwirizana ndi mlingo woyenera, kuperewera kwa chakudya m'thupi (kudya zakudya zina kapena kudya kwambiri), kuchuluka kwa thupi, komanso kudumphira jakisoni kapena kuyendetsa bwino yankho.

Zizindikiro zotsatirazi ndizodziwika bwino za hyperglycemia: ludzu lalikulu, kukodza pafupipafupi, kuchepa kwa chilakolako chofuna kudya, nseru komanso khungu. Ndi ketoacidosis, fungo la acetone lochokera pamlomo wamkati limawonekera.Zizindikiro zowopsa zikusonyeza kuti muyenera kuyang'ana shuga wanu wamagazi ndipo ngati kuli kotheka, muzibweretsanso jekeseni wa Actrapid.

Hypoglycemia imadziwika ndi kuwonjezeka kwa chilakolako chofuna kudya, khungu lotumbululuka komanso miyendo yake ikunjenjemera. Kuti aletse zizindikirazo komanso kuti muchepetse kukula kwa chikomokere cha hypoglycemic, wodwalayo amalimbikitsidwa kudya shuga pang'ono kapena mankhwala apamwamba kwambiri (makeke, maswiti), kumwa msuzi wokoma kapena tiyi. Pofuna kutaya chikumbumtima, 40% dextrose solution ndi glucagon amawathandizira kudzera m'mitsempha. Popewa kutayidwanso pambuyo pathupi, wodwalayo akulimbikitsidwa kudya zakudya zomwe zili ndi zakudya zamafuta ambiri.

Malo osungira

Khala kutali ndi dzuwa. Pewani kutentha kwambiri kapena kuzizira kwambiri ndipo musalole kuti yankho liwume. Kanani kugwiritsa ntchito mankhwalawa ngati wasintha mtundu kapena matanga (matope) aonekera. Pewani mankhwalawo kuti ana sangathe.

Actrapid HM Penfill (Actrapid HM) - kukonzekera kwa insulin yaumunthu, yomwe imapangidwa pogwiritsa ntchito genetic engineering.

Ili ndi nthawi yayifupi yochita komanso pH yosatenga nawo mbali. Imayikidwa mosasamala. HM mu dzina la mankhwala mu Latin amatanthauza "umisiri wa chibadwa cha anthu, monocomponent."

Munkhaniyi tikambirana chifukwa chake madokotala amapereka mankhwala a Actrapid NM, kuphatikizapo malangizo ogwiritsira ntchito, analogi ndi mitengo ya mankhwalawa m'masitolo ogulitsa mankhwala. ZOONA ZONSE za anthu omwe agwiritsa kale ntchito Actrapid akhoza kuwerengedwa ndemanga.

Zotsatira za pharmacological

Munthu wobwerezabweretsanso insulin ya DNA. Ndi insulin ya nthawi yayitali yochitapo kanthu.

Imayendetsa kagayidwe ka glucose, imakhala ndi zotsatira za anabolic. Mu minofu ndi minyewa ina (kupatula ubongo), insulin imathandizira kayendedwe ka glucose ndi amino acid, komanso zimapangitsa protein anabolism. Insulin imalimbikitsa kutembenuka kwa glucose kukhala glycogen m'chiwindi, imalepheretsa gluconeogeneis ndikuthandizira kusintha kwa glucose owonjezera kukhala mafuta.

Zizindikiro zogwiritsidwa ntchito

Panthawi ya mkhutu aimpso kapena kwa chiwindi ntchito insulinzochepa. Chifukwa chake muyenera kusintha mankhwalawa.

Malangizo ogwiritsira ntchito Actrapid akuwonetsa kuti akhoza kugwiritsidwa ntchito limodzi akhala akuchita insulini.

Mankhwalawa amaperekedwa theka la ola musanadye kapena osafunsidwa ndi chakudya. Monga lamulo, jakisoni amapangidwa modzaza m'chigawo cha khoma lamkati lakumbuyo. Izi zimathandizira kuyamwa mwachangu. Kuphatikiza apo, jakisoni amatha kupangika m'tchafu, minofu yathanzi ya phewa kapena matako. Kupewa lipodystrophyMasamba a jakisoni ayenera kusintha.

Kuwongolera kwa mkati ndizovomerezeka pokhapokha ngati jakisoni apangidwa ndi katswiri wazachipatala. Intramuscularly, mankhwalawa amaperekedwa pokhapokha ngati akuwunikira katswiri.

Njira yogwiritsira ntchito

Actrapide wongochita mwachidule amalembedwa kwa anthu odwala matenda ashuga - payekhapayekha. Zonse zimatengera kuchuluka kwa shuga m'magazi. Dokotala endocrinologist asanakulembeni chithandizo ndi mankhwala a Actrapid omwe ali ndi insulin, muyenera kuphunzira malangizo. Malangizo ogwiritsira ntchito mankhwalawa amafotokozera mwatsatanetsatane:

• machitidwe a mankhwala
• njira ntchito
• contraindication
• mavuto
• kapangidwe.

Njira yogwiritsira ntchito actrapid imatengera mtundu wa kumasulidwa. Insulin yofupikitsa imabayidwa. Itha kuperekedwa pansi pakhungu pakabaya, m'manja ndi pamimba. Kusiyana ndi pamene mankhwala amafunikira kuti aperekedwe kudzera m'mitsempha kapena m'mitsempha. Mankhwalawa, omwe amaperekedwa mosavuta, ali ndi mawonekedwe a cartridge.

• mankhwala kutumikiridwa mphindi 30 asanadye,
• mobwerezabwereza pamalo omwewo, osaba jakisoni
• kulowa m'mitsempha yamagazi kuyenera kupewedwa,
• pambuyo pa insulini, tsamba la jakisoni silikulimbikitsidwa kuti likhudzidwe ndikupsinjidwa,
• ngati musakaniza yochepa insulin, muyenera kupereka jakisoni nthawi yomweyo,
• Mlingo amawerengedwa kutengera amene akudwala, wamkulu kapena mwana,
• Mlingo amawongolera kutengera kuphatikiza kwa mankhwala,
• vuto la chikomokere kapena acidosis, mankhwalawa amaperekedwa kudzera mu mtsempha wa magazi,
• jakisoni amachitika moyang'aniridwa ndi adokotala.

Pali anthu omwe ali ndi matenda ashuga, omwe amapanikizika ndi matenda oyanjana. Pankhaniyi, ndikofunikira kuganizira za momwe alili. Mukamamwa Actrapid potengera insulin, tikulimbikitsidwa kuwerenga malangizo kuti agwiritse ntchito. Komanso pezani malangizo kuchokera kwa dokotala. Zochita zodziyimira pakumwa mankhwala zimabweretsa zotsatira zoyipa.

Malangizo, kutsatira zomwe ayenera kuyang'aniridwa, kudzakupulumutsani ku mavuto ambiri. Koma pali milandu yotere yomwe munthu amachitika. Chifukwa chake, tikulimbikitsidwa kuti mutchere khutu ku zomwe siziri zachindunji:

• mutu
• kutopa
• kufunika kosagona
• arrhasmia,
• thukuta lalikulu, ngakhale nthawi yozizira,
• chisokonezo,
• Khungu limakhala lotuwa
• kusanza
• mkhalidwe wa makolo.

Tiyenera kudziwa kuti munthu amene amayang'anira vutoli kwakutali, amamwa mankhwala ena, sazindikira zizindikiro zake. Zizindikiro zimasiyanasiyana ndi mankhwala othandizira. Malangizo a wodwalayo vuto la bongo lingathe kugwiritsidwa ntchito:

• kuyambitsa njira yapadera pansi pa khungu,
• kukhazikitsidwa kwa mtsempha wamagazi.

Njira zoterezi zimathandizira wodwala yemwe ali ndi matenda osokoneza bongo komanso kumamulepheretsa kugona.

Kupanga ndi mawonekedwe a kumasulidwa

Chosakaniza chophatikizika pakuphatikizika ndi insulin yaumunthu mu mawonekedwe osungunuka. Omwe amaphatikizidwa: zinc chloride, glycerol, madzi a jakisoni, metacresol, sodium hydroxide.

Mankhwalawa amagulitsidwa mu mawonekedwe a jekeseni, palinso mawonekedwe a actrapid nm penfill, omwe amagulitsanso mawonekedwe a yankho la jakisoni wa subcutaneous.

Limagwirira a Actrapid NM

Chogulitsachi chimakhala ndi insulin yaumunthu yomwe imachokera ku genetic engineering. Popanga, DNA kuchokera ku saccharomycetes yisiti imagwiritsidwa ntchito.

Insulin imamangilira ma cell ku maselo ndipo kuphatikiza uku kumapereka kuchuluka kwa glucose kuchokera m'magazi kupita mu khungu.

Kuphatikiza apo, Actrapid insulin imawonetsa zochitika pamachitidwe a metabolic:

1. Imathandizira mapangidwe a glycogen mu chiwindi ndi minofu minofu
2. Imathandizira kugwiritsidwa ntchito kwa glucose ndi maselo a minofu ndi minyewa ya adipose yopanga mphamvu
3. Kuwonongeka kwa glycogen kumachepetsedwa, monganso momwe amapangira mamolekyu atsopano a chiwindi mu chiwindi.
4. Imathandizira kupanga mafuta acid ndikuchepetsa kuchepa kwamafuta
5. M'magazi, kapangidwe ka lipoproteins kamawonjezeka
6. Insulin imathandizira kukula kwa maselo ndikugawika
7. Imathandizira kaphatikizidwe kabwino ka protein komanso kuchepetsa kuchepa kwake.

Kutalika kwa zochita za Actrapid NM kutengera mlingo, malo a jakisoni ndi mtundu wa matenda ashuga. Mankhwala akuwonetsa katundu wake theka la ola pambuyo pa utsogoleri, kuchuluka kwake kumadziwika pambuyo pa maola 1.5 - 3.5. Pambuyo pa maola 7 - 8, mankhwalawa amasiya kuchita ndipo amawonongeka ndi ma enzyme.

Chizindikiro chachikulu chogwiritsa ntchito Actrapid insulin ndikuchepa kwa shuga m'magititus a shuga kuti azigwiritsidwa ntchito pafupipafupi komanso kuti apange zochitika zadzidzidzi.

Actrapid pa mimba

Insulin Actrapid NM itha kutumizidwa kuti muchepetse hyperglycemia mwa amayi apakati, popeza siwodutsa chotchinga chachikulu. Kuperewera kwa chindapusa cha shuga kwa amayi apakati kungakhale koopsa kwa mwana.

Kusankhidwa kwa Mlingo kwa amayi apakati ndikofunikira kwambiri, chifukwa kuchuluka kwakukulu komanso kochepa kwa shuga kumasokoneza mapangidwe a ziwalo ndikupangitsa kuti zisachitike bwino, komanso kumawonjezera chiopsezo cha kufa kwa fetal.

Kuyambira kuyambira gawo lakukonzekera kutenga pakati, odwala matenda ashuga amayenera kuyang'aniridwa ndi endocrinologist, ndipo akuwonetsedwa kuwunika kwamagazi a shuga.Kufunika kwa insulin kumatha kuchepa mu trimester yoyamba ya kutenga pakati ndikuwonjezeka kwachiwiri ndi kwachitatu.

Pambuyo pobereka, kuchuluka kwa glycemia nthawi zambiri kumabwerera ku ziwerengero zam'mbuyomu zomwe zinali zisanachitike mimba.

Kwa amayi oyamwitsa, kuyang'anira Actrapid NM sikulinso pachiwopsezo.

Koma poganizira kuchuluka kwa michere, zakudya ziyenera kusintha, motero mlingo wa insulin.

Momwe mungagwiritsire ntchito Actrapid NM?

Jakisoni wa insulini amaperekedwa m'njira zosiyanasiyana. Mlingo umasankhidwa mosiyanasiyana. Nthawi zambiri, zofunika za insulini zili pakati pa 0,3 ndi 1 IU patsiku pa kilogalamu yodwala. Ndi kukana kwa insulini mu achinyamata kapena kunenepa kwambiri, kumakhala kwakukulu, ndipo kwa omwe ali ndi chinsinsi cha insulin yawo, amakhala otsika.

Mothandizidwa ndi matenda ashuga, zovuta za matendawa zimayamba kuchepa pafupipafupi komanso pambuyo pake. Chifukwa chake, kuyang'anitsitsa shuga wamagazi ndikusankhidwa kwa Mlingo wa insulin womwe umapitilira chizindikiritso ichi ndizofunikira.

Actrapid NM ndi insulin yochepa, chifukwa chake nthawi zambiri imaphatikizidwa ndi mitundu yayitali ya mankhwalawa. Iyenera kuperekedwa kwa theka la ola musanadye, kapena chakudya chopepuka chomwe chili ndi chakudya chamafuta.

Njira yothamanga kwambiri yolowera ndi jakisoni m'mimba. Kuti muchite izi, onetsetsani kuti mwalowa mu jakisoni wa insulini. Malo amchiuno, matako, kapena mapewa amagwiritsidwanso ntchito. Tsambalo la jakisoni liyenera kusinthidwa pafupipafupi kuti lisawononge minofu yamkati.

Ndi chitukuko cha matenda ashuga nephropathy, kufunika kwa insulin kumachepa, ndiye kuti mankhwalawa amakonzedwanso poganizira kuchuluka kwa kusefera kwa msana komanso mseru wa aimpso. Mu matenda a adrenal gland, chithokomiro England, pituitary gland, komanso kuwonongeka kwa chiwindi, kuchuluka kwa insulin kungasinthe.

Kufunika kwa insulini kumasinthanso ndikukhala ndi nkhawa, kusintha kwa zochitika zolimbitsa thupi kapena kusintha kwa zakudya zina. Matenda aliwonse ndi chifukwa chokonzera kugwiritsidwa ntchito kwa insulin komwe mukugwirizana ndi adokotala.

Ngati mlingo wa insulin ndi wochepa, kapena ngati wodwalayo watha insulin, hyperglycemia ikhoza kukhala ndi zotsatirazi:

• Kuchulukitsa kugona komanso ulesi.
• Kuchulukitsa ludzu.
• Kusanza ndi kusanza pang'ono.
• Khungu lofiira ndi louma.
• Kuchulukitsa pokodza.
• Kuchepetsa chidwi.
• Pakamwa pakamwa.

Zizindikiro za hyperglycemia zimayamba pang'onopang'ono - maola angapo kapena masiku. Ngati simusintha shuga m'magazi anu, amayamba. Chizindikiro chake ndicho kununkhira kwa acetone mu mpweya wotulutsidwa. Chiwopsezo cha hyperglycemia chimawonjezeka ndi matenda opatsirana komanso kutentha thupi.

Kusintha kuchokera ku mtundu wina wa insulin kupita ku wina kumafuna kusankha kwa mtundu watsopano. Kuti muchite izi, muyenera kufunsa wa endocrinologist. Insulin Actrapid silingagwiritsidwe ntchito pamapampu a insulin, pakalibe zotchingira pakanema, ngati ikasungidwa molakwika kapena ngati madzi oundana, komanso ngati yankho lake limakhala mitambo.

Kuti mupeze jakisoni, muyenera kutsatira malamulo awa:

1. Sungani mpweya mu syringe, wofanana ndi mlingo womwe umaperekedwa.
2. Ikani syringe kudzera pa pulagi ndikusindikiza piston.
3. Tembenuzani botolo pansi.
4. Tengani mlingo wa insulin mu syringe.
5. Chotsani mpweya ndikuyang'ana.

Pambuyo pa izi, muyenera kubaya nthawi yomweyo: tengani khungu pakulipika ndikulowetsanso syringe ndi singano m'munsi mwake, pakona madigiri 45. Insulin iyenera kulowa pakhungu.

Pambuyo pa jekeseni, singano iyenera kukhala pansi pa khungu kwa masekondi 6 kuti mugwiritse ntchito bwino mankhwalawo.

Zotsatira zoyipa za Actrapid

Zotsatira zoyipa kwambiri zikaledzera pofika insulin ndi hypoglycemia. Nthawi zambiri zimachitika mwadzidzidzi komanso zimayendera limodzi ndi khungu, kutentha thukuta, kutopa kwambiri kapena kufooka, kusokonekera kwa malo, nkhawa, mantha komanso kugwedezeka manja.

Chidwi cha chidwi chimachepa, kugona komweko kumayamba, kumverera kwanjala, kuwonongeka kwazinthu kumakulirakulira.Mutu ndi chizungulire, mseru komanso palpitation zimayenda bwino. Mitundu yambiri ya shuga yakugwa ikhoza kusokoneza ubongo kugwira ntchito ndi kusazindikira kapena ngakhale kufa.

Ngati matenda ashuga amatenga nthawi yayitali, okhala ndi matenda ashuga a mankhwalawa, mankhwalawa opanga beta-blockers kapena mankhwala ena omwe amagwira ntchito pamitsempha, ndiye kuti zizindikiro zoyambirira za hypoglycemia zitha kukhala zosadabwitsa, choncho nthawi zonse muyenera kungoyang'ana kuchuluka kwa shuga m'magazi.

Pofatsa, muyenera kumwa shuga kapena madzi, makeke, mapiritsi a shuga. Milandu yayikulu, 40% ya shuga imaperekedwa kudzera m'mitsempha, ndipo glucagon imayang'aniridwa kudzera mu intramuscularly kapena subcutaneally. Wodwalayo akayambanso kudziwa bwino, amafunika kudya chakudya chopatsa thanzi.

Kuukira kwa glycemia kumatha kubwerezedwa patsiku limodzi, chifukwa chake, ngakhale matenda a shuga, ndikofunikira kumangiriza kuyang'anira pazomwe zili. Odwala oterewa amafunika kudya kawirikawiri chakudya.

Zotsatira zoyipa sizisowa ndipo zimatha kuchitika motere:

• Zotupa kapena ming'oma. Osowa kwambiri ndi munthu hypersensitivity - anaphylactic zimachitika.
• Kutupa, nseru, ndi mutu.
• Kuchuluka kwa mtima.
• Peripheral neuropathy.
• Kuchepetsa kukonzanso kapena kukula kwa retinopathy.
• Lipodystrophy pa jekeseni malo, kuyabwa, hematoma.
• Kufatsa, makamaka masiku oyamba kugwiritsa ntchito.

Njira yotulutsidwa ndikusungidwa kwa insulin Actrapid NM

Mankhwala omwe ali mu reta network ali mu mawonekedwe a: Actrapid NM Penfill insulin (amafunika cholembera chapadera cha insulin), komanso insulini mumbale (insulin yomwe imafunikira jakisoni).

Mitundu yonseyi yokonzekera imakhala ndi yankho ndi kuchuluka kwa 100 IU mu 1 ml. Mabotolo amakhala ndi 10 ml, ndi makatoni - 3 ml a 5 zidutswa pa paketi iliyonse. Mtundu uliwonse wamasulidwa umatsatiridwa ndi malangizo ogwiritsira ntchito.

Mtengo wa Actrapid m'mabotolo ndi wotsika kuposa mawonekedwe a penfil. Mtengo wa mankhwalawa umatha kukhala osiyanasiyana m'misika yosiyanasiyana. Kuphatikiza apo, kusinthasintha kwa ndalama kusinthitsa mitengo, chifukwa ichi ndi mankhwala ochokera kunja. Chifukwa chake, mtengo wa Actrapid ndiwofunikira patsiku logulidwa.

Insulin imasungidwa mufiriji kutali ndi freezer pa kutentha kwa madigiri awiri mpaka asanu ndi atatu. Simungathe kuzimitsa. Botolo lotseguka limatha kusungidwa kutentha kwa masabata 6, onetsetsani kuti mwaliteteza ku kuwala ndi kutentha m'bokosi lamatoni. Kanemayo munkhaniyi ayankha funso lokhudza insulin.

Omwe amangogwiritsa ntchito mwachidule ndi Actrapid insulin. Imapezeka ngati jakisoni ndipo imagwiritsidwa ntchito pochiza matenda amtundu wa 2 komanso matenda a 2, komanso chisamaliro chadzidzidzi cha hyperglycemia. Makamaka nthawi zambiri amagwiritsidwa ntchito mu matenda a shuga a shuga. Odwala otere amafunika jakisoni wa insulin. Kuti muwongolere bwino shuga yamagazi, mitundu yosiyanasiyana ya mankhwalawa imaphatikizidwa. Ndipo imodzi mwa mankhwala osankhidwa ndi Actrapid - insulin yochepa.

Makhalidwe azamankhwala

Insulin "Actrapid NM Penfill" ndi yankho la jakisoni. Mankhwalawa amakhala ndi mahomoni a pancreatic a anthu omwe amapezeka ndi kusintha kwa majini. 1 ml yankho lili ndi 3.5 mg ya insulin. Kuphatikiza apo, glycerin, zinc chloride ndi zinthu zapadera zimasungunuka m'madzi a jekeseni, omwe amapanga mulingo woyenera wa acid-base usawa. Mankhwalawa amapezeka m'mathumba apadera a cholembera cha 3 ml. Uwu ndi muyezo umodzi wokha, koma nthawi zina umafunikira kuti uwonjezeke.

Kuphatikiza pa fomu yotulutsayi, pali insulin ya Actrapid NM m'mbale 10 ml. Mulinso ndi mahomoni osungunuka a anthu omwe amapezeka pogwiritsa ntchito njira zopangira ma genetic. Palinso analogue ya mankhwalawa - Actrapil MS. Mankhwalawa amagwiritsidwa ntchito pafupipafupi, chifukwa ndi insulin ya ndudu.

Zochita za mankhwalawa

Insulin imalowa m'maselo ndipo imakhudza njira za metabolic, kukonza kayendedwe ka glucose. Chifukwa cha izi, kuyamwa kwa zimakhala zake kumawonjezeka. Kuphatikiza kwa Glycogen m'maselo a chiwindi kumalimbikitsidwanso ndikukula. Insulin "Actrapid" imanena za mankhwala osakhalitsa. Zotsatira zake za hypoglycemic zitha kukhala zosiyana kutengera njira ndi malo a jakisoni, Mlingo ndi mawonekedwe a moyo wa wodwalayo. Koma nthawi zambiri, mphamvu ya mankhwalawa imayamba patatha mphindi 30 ndipo imatha mpaka maola 8. Kuchuluka kwake kumagwera maola 2-3 mutangoyambitsa yankho. Mlingo wapamwamba kwambiri wokhala ndi Actrapid NM, makamaka ngati walowetsedwa molondola. Ndikwabwino kubaya jekeseni pakhungu pakhungu, ndiye kuti mankhwalawa ayamba kuchita mwachangu.

Contraindication ndi zoyipa

Odwala ena amadana ndi insulin yaumunthu. Nthawi zina thupi limagwidwa ndi zigawo zina za mankhwalawo. Milandu iyi, insulin ina imayikidwa. Kugwiritsa ntchito mankhwalawa kumadziwikanso ngati pali hypoglycemia. Chifukwa chake, isanayambike, ndikofunikira kuyang'ana kuchuluka kwa shuga m'magazi. Simungagwiritse ntchito "Actrapid" wa khansa ya pancreatic - insuloma. Kugwiritsa ntchito mankhwalawa sikuti kumawerengera ana, komanso amayi apakati.

Mukamagwiritsira ntchito insulin "Actrapid", zotsatirazi zingachitike:

Kukhazikitsidwa kwa insulin "Actrapid"

Njira yoyendetsera mankhwalawa, nthawi zina, imalowa. Kwa izi, ma syringe apadera a insulin amafunikira. Ali ndi maphunziro omaliza omwe amakupatsirani mwayi woyesa kuchuluka kwa mankhwalawa. Nthawi zambiri cholembera chapadera cha insulin "Actrapid NM" chimagwiritsidwa ntchito. Mwanjira imeneyi, jakisoni ndiwosavuta. Jekeseni iyenera kuchitidwa m'mimba kapena phewa, pokhapokha pokhazikika, kupewa jekeseni wamitsempha. Nthawi zina, jakisoni amaphatikizidwa m'tchafu kapena pachakudonth, koma pamenepa mankhwalawa amawonjezereka.

Momwe mungayendetsere insulin ya Actrapid? Malangizowa akufotokoza motere:

• muyenera kujambula yankho lolondola mu syringe kuchokera m'botolo kapena kuyikamo katiriji mu cholembera chapadera,
• ndi dzanja lanu lamanzere kuti mutengere ndi zala ziwiri pakhungu pamimba, ntchafu kapena phewa,
• phatikizani singano m'munsi mwa khola pakadutsa madigiri 45,
• phatikizani pang'onopang'ono njira yothetsera khungu.
• siyani singano kwa masekondi 5-6,
• konzani mosamala, ngati magazi atuluka, muyenera kufinya pang'onopang'ono malo a jekeseni.

Insulin "Actrapid": malangizo ogwiritsira ntchito

Ndi madokotala okhawo omwe angadziwe kuchuluka kwa mankhwalawo komanso kuchuluka kwa mankhwalawa. Zimatengera kuchuluka kwa kagayidwe kazakudya wodwala, kakhalidwe, kadyedwe kake ndi zofunika za insulin. Pafupifupi, zosaposa 3 ml zimafunikira patsiku, koma chizindikirocho chimatha kukhala chachikulu mwa anthu onenepa kwambiri, panthawi yokhala ndi pakati kapena ngati chitetezo chazirala. Ngati kapamba amatulutsa insulin yaying'ono, iyenera kutumikiridwa muyezo yaying'ono. Kufunika kwa insulini kumacheperanso matenda a chiwindi ndi impso.

Zingwe za "Actrapid" zimachitika katatu patsiku. Ngati ndi kotheka, mutha kuwonjezera njira yogwiritsira ntchito mpaka nthawi 5-6. Hafu ya ola limodzi pambuyo pa jekeseni, muyenera kudya kapena osadya pang'ono.

Ndizotheka kusakaniza mankhwalawa ndi mankhwala omwe akhala akuchita kwa nthawi yayitali. Mwachitsanzo, kuphatikiza kumagwiritsidwa ntchito nthawi zambiri: insulin "Actrapid" - "Protafan". Koma ndi dokotala yekhayo amene angasankhe mtundu wa glycemic control regimen. Ngati ndi kotheka, ikani ma insulini awiri nthawi imodzi omwe atengedwa mu syringe imodzi: woyamba - "Actrapid", kenako - insulin yayitali.

Zoyenera kuchita pa vuto la hypoglycemia

Nthawi zina, wodwala amakhala ndi bongo wambiri. Itha kuonekera ngati jakisoni atadwala asanadye kapena awonetsa kuchita zinthu zolimbitsa thupi kwambiri.Vutoli limachitika mwadzidzidzi. Wodwalayo amakumana ndi zotsatirazi:

• tachycardia
• nseru
• kusweka kwapafupipafupi, kugona,
• thukuta
• mantha, nkhawa,
• mutu
• kulakalaka kwamphamvu
• kusokoneza kayendedwe ka kayendedwe.

Kukhazikika kwa hypoglycemia ndikosavuta kuwona. Choyambirira kuchita ndikudya china chokoma. Pazomwezi, odwala matenda ashuga nthawi zonse amakhala ndi maswiti, makeke, msuzi wokoma kapena chidutswa cha shuga nawo. Ngati wodwalayo akuipiraipira, wakomoka kapena wakomoka, jakisoni wa glycogen ndi wofunikira. Muyenera kuwona dokotala ndikusintha kuchuluka kwa Actrapid kuti muchepetse kukula kwa hypoglycemia.

Hyperglycemia mukamagwiritsa ntchito mankhwalawa

Nthawi zina vutoli limakhalanso lotheka shuga wa magazi akakwera kwambiri. Izi zitha kukhala ndi kuwonjezeka kwa kutentha, ndi matenda opatsirana, kuchepa kwa kuchuluka kwa mankhwalawa kapena kuwonjezeka kwa chakudya chamafuta. osati kutchulidwa, koma matendawo nawonso ndi oopsa, chifukwa angayambitse kukula kwa ketoacidosis ndi chikomokere. Mfundo yoti shuga yachuluka titha kuizindikira kuchokera pazizindikiro izi:

• ludzu lalikulu
• kukodza pafupipafupi
• nseru, kutaya chakudya,
• kufooka
• khungu louma ndi nembanemba
• Fungo lamphamvu la acetone kuchokera mkamwa.

Ngati muli ndi zina mwazizindikirozi, muyenera kuwunika msanga msanga, mungafunike kupanga jekeseni lina la Actrapid.

Pharmacokinetics

Hafu ya moyo wa insulini kuchokera m'magazi ndi mphindi zochepa chabe.

Kutalika kwa nthawi ya kukonzekera kwa insulin kumachitika makamaka chifukwa cha kuchuluka kwa mayamwidwe, zomwe zimatengera zinthu zingapo (mwachitsanzo, pa mlingo wa insulin, njira ndi malo oyendetsera, makulidwe a subcutaneous mafuta wosanjikiza ndi mtundu wa matenda osokoneza bongo). Chifukwa chake, magawo a pharmacokinetic a insulin ali ndi kusinthasintha kwakukulu kwapakati pa intaneti ndi munthu payekha.

Kuzungulira kwakukulu (C max) kwa insulin mu plasma kumatheka mkati mwa maola 1.5-2,5 pambuyo pothandizidwa ndi subcutaneous.

Palibe zomangamanga zomanga mapuloteni a plasma zimadziwika, kupatulapo ma antibodies a insulin (ngati alipo).

Insulin yaumunthu imapangidwa ndi ma insulinase kapena ma enzyme osokoneza bongo a insulin, komanso mwina ndi protein disulfide isomerase.

Amaganiziridwa kuti mu molekyulu ya insulin ya anthu pali malo angapo a cleavage (hydrolysis), komabe, palibe amodzi a metabolites omwe amapangidwa chifukwa cha cleavage akugwira ntchito.

Nthawi yodzaza hafu (T ½) imatsimikiziridwa ndi kuchuluka kwa kuyamwa kwa tinthu timene timalowa pansi. Chifukwa chake, T ½ imakhala njira yodziwira, m'malo mochotsa insulini kuchokera ku plasma (T ½ ya insulin m'magazi ndi mphindi zochepa chabe). Kafukufuku awonetsa kuti T ½ ili pafupifupi maola 2-5.

Ana ndi achinyamata

Mbiri ya pharmacokinetic ya Actrapid ® NM adaphunziridwa mu gulu laling'ono la ana omwe ali ndi matenda osokoneza bongo (anthu 18) azaka 6 - 6, komanso achinyamata (azaka 13 mpaka 17). Ngakhale zambiri zomwe zimawerengedwa zimawonedwa ngati zochepa, komabe amawonetsa kuti mbiri ya pharmacokinetic ya Actrapid ® NM mwa ana ndi achinyamata ndi chimodzimodzi ndi zomwe zimachitika mwa akulu. Nthawi yomweyo, kusiyana kunawululidwa pakati pa mibadwo yosiyanasiyana ndi chizindikiro monga C max, chomwe chikugogomezeranso kufunika kwa kusankha kwa munthu payekha.

Deta Yotetezera

M'maphunziro a preclinical, kuphatikizapo maphunziro a chitetezo cha pharmacological, maphunziro a kawopsedwe omwe ali ndi Mlingo wambiri, maphunziro a genotoxicity, chiwopsezo cha carcinogenic ndi zotsatira zoyipa pazinthu zoberekera, palibe vuto lililonse kwa anthu lomwe linadziwika.

Mimba komanso kuyamwa

Palibe choletsa kugwiritsa ntchito insulin panthawi yapakati, popeza insulin siyidutsa chotchinga.

Onse a hypoglycemia ndi hyperglycemia, omwe amatha kukhala ndi vuto losankha bwino, amalimbikitsa chiopsezo cha kusokonezeka kwa fetal ndi kufa kwa fetal. Amayi oyembekezera omwe ali ndi matenda ashuga amayenera kuyang'aniridwa panthawi yonse yomwe ali ndi pakati, ayenera kukhala ndi njira zowongolera kuchuluka kwa shuga wamagazi, malingaliro omwewo amagwiranso ntchito kwa amayi omwe akukonzekera kutenga pakati.

Kufunika kwa insulin nthawi zambiri kumachepera mu trimester yoyamba ya kutenga pakati ndipo kumawonjezeka pang'onopang'ono kwachiwiri komanso kachitatu.

Pambuyo pobadwa mwana, kufunika kwa insulin, monga lamulo, kumabwereranso msanga pazomwe zimawonedwa musanakhale ndi pakati.

Palibenso zoletsa kugwiritsa ntchito mankhwalawa Actrapid ® NM panthawi yoyamwitsa. Kuchita insulin kwa amayi oyamwitsa sikowopsa kwa mwana. Komabe, mayi angafunike kusintha njira ya Actrapid ® NM ndi / kapena zakudya

Kuchiritsa katundu

Mankhwalawa ali ndi chithandizo chamankhwala mwachangu, chifukwa ndi cha gulu la mankhwala omwe amapangira insulini mwachangu. Chogulitsachi chimapangidwa pogwiritsa ntchito ukadaulo wa bioengineering ya DNA yomwe ikubwereranso poyambitsa chikhalidwe cha yisiti yophika mkate. Pambuyo mankhwala mwachindunji mosamala, yogwira mankhwala amayamba kulumikizana ndi ma cytoplasmic receptors mu cell membrane. Thupi limayambitsa zochitika mkati mwa khungu ndikulimbikitsa biosynthesis ya cAMP, yomwe imalola kulowa mkati mozama.

Monga momwe radar ikusonyezera, kuchepa kwa shuga m'magazi kumayamba chifukwa cha kuchuluka kwa kayendedwe ka magazi ndi kuyamwa ndi ziwalo za thupi, zomwe zimathandizira kusungidwa kwa mafuta m'thupi, kapangidwe kazinthu zopanga mapuloteni, glycogenogeneis zimachitika, komanso kuchepa kwa kupanga kwa shuga ndi chiwindi. Mankhwalawa amayamba kugwira ntchito mwachangu mu theka la ola mutatha kugwiritsa ntchito. Mphamvuyi imatheka pambuyo pa maola a 2,5, ndipo nthawi yonse yowonekera ili pafupifupi maola 7-8.

Kuchita mankhwala osokoneza bongo

Zinthu zomwe zimapangitsa kuti ntchito yochepetsera shuga ikhale yothandiza: mankhwala a hypoglycemic mankhwala, mankhwala a anabolic, ndi androgen, ketoconazole, tetracycline, vitamini B6, bromocriptine, mebendazole, theophylline, osagwiritsa ntchito beta-blockers, zakumwa zoledzeretsa, zomwe sizimangochulukitsa zotsatira, komanso kuwonjezera nthawi yofunikira.

Mwazi wamagazi ukuwonjezeka: Kulera kwamkamwa kwachulukidwe (mankhwala ophatikizira a progesterone ndi estradiol), mahomoni a chithokomiro, anticoagulants, clonidine, diazoxide, danazole, triceclic antidepressants, calcium blockers, opioid analgesics, nicotinic acid ndi nicoteroids, Reserpine, salicylates, octreotide, lanreotide zimakhudza kugwira ntchito kwa insulin mwachisawawa. Zinthu izi zimatha kuchepetsa ndikuwonjezera kufunika kwa Mlingo wa mankhwalawa.

Ziwawa ndi sulfite zimathandizira kuwonongeka kapena kuwonongeka kwa yankho la mankhwalawa, ndipo beta-blockers amachititsa zisonyezo zabodza za hypoglycemia.

Kuyambitsa Njira

Subcutaneous, mu mnofu ndi mtsempha wama khosi amaloledwa kuloledwa. Ndi subcutaneous makonzedwe, odwala akulangizidwa kuti asankhe ntchafu ya jakisoni, apa ndi pomwe mankhwalawa amatsimikiza pang'onopang'ono komanso moyenera.

Kuphatikiza apo, mutha kugwiritsa ntchito jakisoni matako, mikono yakutsogolo ndi khoma lakumaso kwa m'mimba (mutabayidwa m'mimba, mphamvu ya mankhwalawa imayamba posachedwa). Musati mupeze jakisoni m'dera limodzi kangapo pamwezi, mankhwalawa angayambitse lipodystrophy.

Ngati kuli kofunikira kuwonjezera insulin yayitali ndiutali, algorithm yotsatirayi imachitika:

1. Mpweya umalowetsedwa mu ma ampoules onse awiri (omwe amafupikitsidwa komanso aafupi),
2. Choyamba, insulin yokhala ndi kanthawi kochepa imakokedwa ndi syringe, ndiye kuti imathandizidwa ndi mankhwala okhala ndi nthawi yayitali,
3. Mphepo imachotsedwa pogogoda.

Anthu odwala matenda ashuga omwe sakudziwa bwino samalimbikitsidwa kuyambitsa okha Actropide mapewa, chifukwa pamakhala chiopsezo chokhazikika chamafuta a khungu ndikubaya mankhwalawa intramuscularly. Ndizofunikira kudziwa kuti mukamagwiritsa ntchito singano mpaka 4-5 mm, mafutawo ochepa mafuta sanapangike konse.

Sizoletsedwa kupaka mankhwalawo muzinthu zosinthika ndi lipodystrophy, komanso m'malo a hematomas, zisindikizo, zipsera ndi zipsera.

Actropid imatha kuperekedwa pogwiritsa ntchito syringe yachilendo, cholembera kapena pampu yodziwira yokha. Potsirizira pake, mankhwalawo amalowetsedwa mu thupi lokha, mwa zoyambirira ziwiri ndikuyenera kudziwa njira yoyendetsera.

• Nkhope yotayika ndiyiyika,
• Mankhwalawa amasakanikirana mosavuta, mothandizidwa ndi dispenser 2 magulu a mankhwalawa amasankhidwa, amabweretsedwa mlengalenga,
• Pogwiritsa ntchito kusinthaku, mtengo woyenera wokhazikitsa
• Mafuta omwe amapezeka pakhungu, monga tafotokozera kale.
• Mankhwalawa amayamba ndi kukanikiza piston njira yonse,
• Pambuyo masekondi 10, singano imachotsedwa pakhungu, khola limamasulidwa.

Singano imaponyedwa kunja.

Ngati agwira ntchito mwachidule agwiritsidwa ntchito, sikofunikira kusakaniza musanagwiritse ntchito.

Kupatula kulowetsedwa kosayenera kwa mankhwalawa komanso kuchitika kwa hypoglycemia, komanso hyperglycemia, insulin siyenera kuyikidwa m'malo osagwirizana ndi madokotala omwe sanavomerezane ndi adokotala ayenera kugwiritsidwa ntchito. Kugwiritsa ntchito Actrapid yomwe yatha ntchito sikuletsedwa, mankhwalawa angayambitse insulin.

Kupanga kudzera mu intravenly kapena intramuscularly kumachitika kokha moyang'aniridwa ndi adokotala. Actrapid imalowetsedwa m'thupi theka la ola chakudya chisanachitike, chakudya chimayenera kukhala ndi chakudya chamafuta.

Langizo: ndibwino kubaya insulini kutentha kwa firiji, kotero kuti ululu wa jakisoni suwonekera.

Kodi Actrapid ali bwanji

Insulin Actrapid ndi m'gulu la mankhwala, zomwe zimapangitsa kuti magazi achepetse shuga. Ndi mankhwala osokoneza bongo.

Kuchepetsa shuga kumachitika chifukwa cha:

Kukula ndi kufulumira kwa mankhwala a chiwalo kumadalira zinthu zingapo:

1. Mlingo wa kukonzekera kwa insulin,
2. Njira yakayendetsere (syringe, cholembera, pampu ya insulin),
3. Malo osankhidwa pokonzekera mankhwala (m'mimba, pamphumi, ntchafu kapena matako).

Ndi subcutaneous makonzedwe a Actrapid, mankhwalawa amayamba kugwira ntchito patatha mphindi 30, imafika pakulimbikitsidwa kwambiri m'thupi pambuyo pa maola 1-3 kutengera mawonekedwe a wodwala, zotsatira za hypoglycemic zimagwira maola 8.

Gwiritsani ntchito pa nthawi yoyembekezera

Chithandizo cha Actrapid chololedwa ngati wodwala ali ndi pakati. Nthawi yonseyi, ndikofunikira kuti mulamulire kuchuluka kwa shuga ndikusintha mlingo. Chifukwa chake, mkati mwa trimester yoyamba, kufunika kwa mankhwalawa kumachepa, panthawi yachiwiri ndi yachitatu - motsutsana, imawonjezeka.

Pambuyo pobereka, kufunikira kwa insulin kumabwezeretsedwera pamlingo womwe unali usanakhale ndi pakati.

Panthawi ya mkaka wa m'mawere, kuchepetsa mlingo kungakhale kofunikira. Wodwala amafunika kuwunika mosamala kuchuluka kwa shuga kuti magazi asatayike panthawi yomwe kufunika kwa mankhwala kumakhazikika.

Kugula ndi kusunga

Mutha kugula Actrapid mu mankhwala monga mankhwala a dokotala.

Ndikofunika kusunga mankhwalawo mufiriji pa kutentha kwa madigiri 2 mpaka 7 Celsius. Musalole kuti chochitikacho chiwonekere kutentha kwawokha kapena dzuwa. Mukazizira, Actrapid amataya mawonekedwe ake ochepetsa shuga.

Pamaso jakisoni, wodwalayo ayenera kudziwa nthawi yomwe mankhwalawo atha, kugwiritsa ntchito insulin yomwe idatha ntchito sikuloledwa. Onetsetsani kuti mwatsimikiza kapena mulibe kanthu ndi Actrapid wamayendedwe ndi zakunja.

Actrapid amagwiritsidwa ntchito ndi odwala onse amtundu wa 1 ndi mtundu 2 shuga . Kugwiritsa ntchito moyenera komanso kutsatira mlingo womwe dokotala akuwonetsa, sizimayambitsa kukula kwa zoyipa mthupi.

Kumbukirani kuti matenda ashuga amayenera kuthandizidwa mokwanira: kuwonjezera pa jakisoni wa tsiku ndi tsiku wa mankhwala, muyenera kudya zakudya zina, kuyang'anira zochitika zolimbitsa thupi osati kuwonetsa thupi pamavuto.

Chithandizo cha odwala omwe ali ndi matenda a shuga 1 amachitika mwa njira ya insulin. Kuphatikiza pa zoletsedwa za chakudya, kayendetsedwe ka insulini kumatha kulepheretsa odwala oterewa kukhala ndi vuto lalikulu la matenda ashuga.

Mukamapereka mankhwala a insulin, ndikofunikira kuyesa kubereka moyandikira momwe mungathere mwanjira yachilengedwe yolowa m'magazi. Mwa izi, mitundu iwiri ya insulini imakonda kupatsidwa kwa odwala - yayitali komanso yochepa.

Insulins wautali wofanana ndi kubisala (kwa nthawi yayitali) kubisala. Ma insulin amafupiziridwa kuti apatsidwe chakudya chamafuta. Amaperekedwa musanadye muyezo wofanana ndi kuchuluka kwa mkate muzogulitsidwa. Actrapid NM ndi amtundu wotere.