Malangizo ogwiritsira ntchito insulin: kapangidwe, ma analogues, ndemanga, mitengo yama pharmacies

Amapezeka m'mitundu iwiri - Rinsulin R ndi Rinsulin NPH. Kutulutsidwa - 3 ml makatiriji (opanda kapena cholembera) kapena botolo la 10 ml. M'malo awa muli ma cartridge, ndiye kuti pali zidutswa 5 paphukusi. Botolo limanyamulidwanso mukatoni.

Zomwe zimapangidwazo zimatengera mtundu wa "Rinsulin."

• P: 100 IU ya insulin yaumunthu, 3 mg ya metacresol, 16 mg ya glycerol, mpaka 1 ml ya madzi a jekeseni.
• NPH: 100 IU ya insulin yaumunthu, 0,34 mg ya protamine sulfate, 16 mg ya glycerol, 0,65 mg ya crystalline phenol, 1.6 mg wa metacresol, 2.25 mg wa sodium hydrogen phosphate dihydrate, mpaka 1 ml ya madzi a jekeseni.

Kusiyana pakati pa Rinsulin P ndi NPH

Rinsulin R ndi yankho la jakisoni, ndipo Rinsulin NPH ndi kuyimitsidwa kwa makonzedwe a subcutaneous. Yoyamba imatha kutumikiridwa mosazindikira, kudzera m'mitsempha ndi intramuscularly (tsiku lililonse kuchokera ku 0,3 IU / kg). Lachiwiri limangokhala subcutaneous (kuchokera ku 0,5 IU / kg).

Kusiyana kwakukulu pakati pa mitundu ya "Rinsulin" ndiko kutalika kwa zochita zawo. "P" - insulin yocheperako, imayamba kugwira ntchito mphindi 30 pambuyo pa makonzedwe, kutalika kwa zotulukazo kumatha pafupifupi maola 8. "Rinsulin NPH" imayamba kuchita pambuyo pa maola 1.5 - 2, ikugwira ntchito mpaka tsiku.

Mtengo wa mankhwala umasiyanasiyana.

Zotsatira za pharmacological

Ili ndi vuto la hypoglycemic. Kupezeka ndi kubwerezanso kwa DNA. Zimathandizira ndi ma receptors, zomwe zimapangitsa kuti insulini-receptor zovuta. Imawonjezera kunyamula kwa glucose mwachidwi, kumalola kuti izitha kutengeka ndi maselo ndi minyewa, komanso imathandizira lipogenis ndi glycogeneis. Izi zimachepetsa kwambiri kupanga shuga ndi chiwindi.

Kutalika kwa zochita zimatengera mtundu wa Rinsulin. Mitundu yonseyi ingagwiritsidwe ntchito pophatikiza mankhwala.

Pharmacokinetics

Kuyamba kwa kuchitapo kanthu, kuthamanga ndi kukwaniritsidwa kwa mankhwala kumadalira malo a jakisoni, Mlingo ndi zina. Kugawikaku sikufanana, zigawo za mankhwala sizidutsa pazolepheretsa. Hafu ya moyo ndiyfupi, mankhwalawa amachotsedwa kwathunthu ndi impso.

• Matenda a shuga a mtundu woyamba ndi wachiwiri.
• Matenda a shuga panthawi yoyembekezera.
• Momwe kuvomerezedwa kwa kagayidwe kazakudya kwa anthu odwala matenda ashuga.

Malangizo ogwiritsira ntchito (njira ndi Mlingo)

Mlingo wake umasankhidwa ndi katswiri wozikidwa pazowunikira ndi zosowa za thupi la insulin.

"Rinsulin P" imayendetsedwa mosavuta, mkati kapena m'mitsempha mphindi 30 asanadye. Ndi monotherapy, jakisoni amawonetsedwa katatu patsiku, malinga ndi zosowa zapadera, dokotala amatha kuwonjezera kuchuluka kwa jakisoni mpaka zisanu ndi chimodzi.

Gulu la mankhwala "NPH" limayendetsedwa kokha.

Masamba a jakisoni amatha kutulutsidwa m'malo awa:

• m'chiuno
• matako
• m'mimba (khoma lakunja kwamkati),
• mapewa.

Ndikofunikira nthawi zonse kusintha mfundo za jakisoni kuti mupewe lipodystrophy. Ndikofunikira kuphunzitsa wodwalayo kasamalidwe koyenera ka mankhwalawo, kuti asalowe mumtsempha wamagazi.

Mankhwala omwe akutsatiridwa ayenera kukhala otentha kwambiri.

Zotsatira zoyipa

• Hypoglycemic zinthu.
• Zotsatira zamatsenga, edema ya Quincke.
• Kutupa ndi kuyabwa pamalowa jakisoni.
• Lipodystrophy.
• Kuchepa kwa mawonekedwe owoneka (makamaka koyambirira kwa mankhwala).
• Kutupa.

Zotsatira zonsezi zimachotsedwa ndikusintha mlingo wa mankhwalawo kapena kuthetsedwa kwake.

Bongo

Kukula kwa hypoglycemia. Zizindikiro zake: kufooka, kufooka, kusokonezeka kwa chikumbumtima mpaka kuwonongeka kwake ndi kupuma, njala, chizungulire.

Fomu yakuwala imachotsedwa pakudya zakudya zamafuta owonjezera mphamvu. Wocheperako komanso wowopsa - jakisoni wa glucagon kapena njira yothetsera dextrose, kumapangitsa munthu kuti adziwe, kudya ndi chakudya chamagulu, ndikutsatira pempho la dokotala kuti musinthe kuchuluka kwa mankhwalawa.

Kuyanjana kwa mankhwala osokoneza bongo

Osamayendetsa limodzi ndi ma insulini ena.

Zinthu zomwe zingalimbikitse mphamvu ya mankhwalawa:

• mankhwala akumwa a hypoglycemic,
• bromocriptine
• MAO, ATP ndi kaboni anhydrase inhibitors,
• sulfonamides,
• osasankha beta-blockers,
• anabolic steroids
• octreotide
• ketoconazole,
• pyridoxine
• cyclophosphamide,
• manzeru
• onjezerani
• Kukonzekera kwa lifiyamu
• mebendazole,
• fenfluramine,
• theofylline
• kukonzekera kokhala ndi Mowa.

Zinthu zomwe zimafooketsa izi:

• glucagon,
• kulera kwamlomo
• somatropin,
• glucocorticosteroids,
• estrogens
• thiazide okodzetsa, zida zotulutsa,
• amphanomachul
• mahomoni okhala ndi chithokomiro.
• heparin
• clonidine
• mankhwala antidepressants,
• blockers a "pang'onopang'ono" calcium njira,
• danazol
• phenytoin
• epinephrine
• diazoxide
• H1 histamine receptor blockers,
• morphine
• chikonga.

Reserpine ndi salicylates zimatha kukhala ndi zofowoka komanso zowonjezera.

Zofunika! Mankhwala ophatikizika amavomerezedwa ndi adotolo opezekapo mosalephera!

Malangizo apadera

Kuyang'anira kuchuluka kwa shuga m'magazi panthawi ya chithandizo ndikofunikira.

Pali chiopsezo cha hypoglycemia. Zimatha kupsinjika, kudumpha chakudya, kuwonjezera masewera olimbitsa thupi, matenda ena. Hyperglycemia ndi matenda ashuga ketoacidosis amatha kukula ngati mankhwalawa amasankhidwa molakwika.

Odwala omwe ali ndi stenosis yamitsempha yamagazi ndi ubongo, gwiritsani ntchito mosamala. Komanso odwala retinopathy, matenda a chithokomiro, chiwindi, impso, ali ndi mbiri ya matenda a Addison, komanso okalamba omwe ali ndi zaka zopitilira 65 chifukwa choopsa cha hypoglycemia.

Zimakhudza kuyendetsa galimoto, choncho muyenera kusiya kuyendetsa galimoto kwa nthawi yayitali.

Sitikulimbikitsidwa kuphatikiza ndi mapampu a insulin ndi catheters.

Amangotulutsidwa ndi mankhwala okha.

Mimba komanso kuyamwa

Amaloledwa kugwiritsidwa ntchito panthawi yoyembekezera komanso atabereka mwana, popeza mankhwalawo ndi otetezeka thupi la mwana. Amayi omwe ali mu trimester yoyamba, kufunika kwa insulin kumatha kuchepa, pomwe m'miyezi yotsatira, nthawi zambiri amadzuka. Chithandizo chikuyenera kuchitika moyang'aniridwa ndi adokotala. Matenda a hypoglycemia ndi owopsa kwa mwana.

Fananizani ndi fanizo

Insulin iyi imakhala ndi mitundu yambiri yomwe ingakhale yothandiza kuiganizira.

Levemir. Chosakaniza chophatikizacho ndi insulin-detemir. Kampani yapakatikati ya hypoglycemic agent Yopanga - Novo Nordisk, Denmark. Mtengo wonyamula ma cartridge ndi ma syringe phula uzikhala pafupifupi 1800 rubles. Yothandiza. Si kawirikawiri zomwe zimayambitsa ziwengo. Komabe, pamtengo wokwera amakhala ndi mndandanda wokwanira wazotsatira zoyipa ndipo samalimbikitsidwa kwa ana ochepera zaka 6.

"Insuman Rapid." Muli madzi osungunuka, okonzedwa kuti asinthane ndi majini. Amapangidwa ndi kampani ya Sanofi-Aventis ku France. Mtengo wamakatheleti asanu ndi ma ruble 1100. Katunduyu ali pafupi ndi katundu wa Rinsulin. Itha kugwiritsidwa ntchito muubwana, koma posankha mwanzeru mankhwala. Pansi ndiye mtengo wokwera.

"Actrapid." Zomwe zimagwiritsidwa ntchito ndi insulin yosungunuka ya anthu. Wopanga - "Novo Nordisk", Denmark. Mtengo wa ma ruble 370, umaperekedwa m'mabotolo a 10 ml. Chochita chachifupi, choyenera kuphatikiza mankhwala. Itha kuperekedwa kudzera m'mitsempha, intramuscularly, subcutaneously.

"Biosulin." Kuyimitsidwa kumeneku kuli ndi isophan insulin. Amapanga kampani yotchedwa Pharmstandard-Ufavita, Russia. Mtengo umatengera mtundu wa kumasulidwa: botolo la 10 ml - 370 ma ruble, makatoni ndi ma syringe - ochokera ku ma ruble a 1000. Mwambiri, malowa ndi ofanana. Kutsitsa ndiye mtengo wake. Koma kuchuluka kwa mankhwalawa kumapangitsa izi.

Kusinthira ku mtundu wina wamankhwala kumachitika kokha ndi chilolezo cha dokotala! Kudzipatsa nokha koletsedwa!

Ndemanga Zahudwala

Mwambiri, mankhwalawa ali ndi mawunikidwe abwino. Odwala odwala matenda ashuga amafotokozera kusakhazikika, mtengo wokwanira komanso kuchita bwino. Koma ena amati insulini iyi sinawakwane.

Ekaterina: “Kwa nthawi yayitali ndinapezeka kuti ndimadwala matenda a shuga. Osati kale kwambiri pomwe ndimagwiritsa ntchito Rinsulin NPH. Ndimakonda kuti ndi yosavuta kugwiritsa ntchito, pali cholembera. Ndimatsatira kadyedwe, motero sindimakumana ndi mavuto ena aliwonse. Ndimakonda kwambiri mankhwalawa. ”

Eugene: “Dokotala adasamukira ku Rinsulin NPH, ndimaba jakisoni kawiri patsiku. Ndimagwiritsa ntchito syringe yosinthika, ndiyabwino kwambiri ndipo ndiyofunika kugwiritsa ntchito ndalama. Nthawi zonse ndimatsimikiza kuti chakudya chisasokonezedwe, ndipo ndikudya sindikhala kunyumba, ndimayikiranso "P" ina. Ili ndi mphamvu yochepa, imayenda bwino ndi "NPH". Mankhwalawa ndi oyenera, shuga amasungidwa pamlingo wovomerezeka. "

Igor: “Rinsulin sankagwirizana ndi ine. Shuga anapitilizabe kukula. Dokotala adasamukira ku mankhwala ena. Koma ndinamva kuti wina ali woyenera. Zikuwoneka kuti si mankhwala anga okha. ”

Olga: “Poyamba ndinkagwiridwa ndi Actrapid. Kenako adasiya kudzipereka ku mankhwalawo - zovuta zina ndi omwe amapereka. Dokotala adandiwuza kuti ndiyesere Rinsulin NPH. Ndidatulukira. Mlingo wa shuga ndi wabwinobwino, sindinapeze zotsatira zoyipa. Ndine wokondwa ndi chilichonse, chonse. ”

Kutulutsa Fomu

Insulin imamasulidwa poyimitsa jakisoni, wopakidwa m'mabotolo ndi choletsa labala, wosindikizidwa ndi kapu ya aluminium pamwamba. Amapezekanso ma ampoules a 5 kapena 10 ml. Madziwo ndi oyera, owonekera, osayipitsidwa. Kulongedza kotereku kumapangidwira kuti atenge ndi kuyipeza yankho ndi syringe yapadera ya insulin. 5 ma PC ma galasi mabotolo zokhala ndi makatoni olembetsera limodzi ndi kufotokoza. Insulin yomwe imafunsidwa kwambiri imapezeka mu cholembera. Awa ndi njira yabwino yopangira odwala matenda ashuga, chifukwa makatiriji omwe angathe kusinthika ali ndi Mlingo wambiri, kotero mutha kulowa osangokhala kunyumba, komanso kupita nawo kuntchito. Ndiosavuta kugwiritsa ntchito, sizifunikira kudziwa mwapadera komanso maluso. Insulin siyimatulutsidwa m'mapiritsi;

Alumali moyo wa mankhwalawa ndi miyezi 15, koma ngakhale mu chidebe chomata mwamphamvu, mankhwalawo amatha kuwonongeka ngati atasungidwa molakwika. Kuchedwa kwa mankhwalawa kumasonyezedwa ndi kunyengerera, mapokoso kapena zosakhudzana zilizonse zomwe zimapezeka mu vial. Ampoules amafunika kuti azikonzedwa ndi kusungidwa ndi kutentha osaposa 2-8 * C. Mankhwala omwe amagwiritsidwa ntchito nthawi zambiri amatha kusungidwa m'chipinda, koma m'malo amdima kuti asagwere padzuwa. Botolo lotere limagwiritsidwa ntchito osaposa mwezi umodzi. Kenako iyenera kutayidwa, ngakhale ngati tsiku la kumaliza ntchito lisanathe.

Zofunika! Simuyenera kusankha nokha mankhwala. Chitsanzo cha regimen yogwiritsa ntchito mankhwalawa chimalimbikitsidwa ndi dokotala zokhudzana ndi mayeso azachipatala. M'tsogolomu, malinga ndi lingaliro la dokotala, njira yosankhidwa ya mankhwala imasankhidwa, mlingo umasinthidwa.

Pharmacodynamics ndi pharmacokinetics

Insulin imatha kuchepetsa shuga m'magazi ndi mkodzo, imapangitsa kuti shuga azituluka. Homoni imalimbikitsa kutembenuka kwa glucose kukhala glycogen, kuchuluka kwake mu minofu ndi chiwindi. Kuphatikiza apo, insulin imachepetsa kupanga shuga, imalepheretsa kukula kwa lipemia (mafuta a magazi) amtundu wa matenda ashuga. Kapangidwe kake ka ma insulin onse ndi chimodzimodzi - kupanga kwa insulin receptor zovuta, ndipo nthawi yochitapo imadalira mtundu wa insulin, mtundu wake. Komanso tsamba la jakisoni, kutentha, kuchuluka ndi kuchuluka kwa mankhwalawa zimakhudza kuthamanga kwa mankhwalawa. Insulin imalowa m'magazi, imawonongeka mu impso ndi chiwindi, ndipo imatulutsidwa mwachangu mkodzo ndi bile. Ma insulini othamanga komanso oyenda kwambiri amayamba kuchita pambuyo pa mphindi 3 mpaka 10, ndipo amakhala nthawi yayitali pambuyo pa mphindi 25-30.

Zizindikiro ndi contraindication

M'badwo wamakono ndi wonenepa kwambiri mosiyanasiyana. Izi zimabweretsa chakudya chopanda malire, cholowa, kupsinjika kosalekeza ndi zinthu zina. Chifukwa chake, adokotala atatsimikizira kuti ali ndi matenda osokoneza bongo, amakakamizidwa kugwiritsa ntchito mankhwala ochepetsa shuga. Mankhwala a insulin amasonyezedwa pamitundu yosiyanasiyana yamatenda.

1. Kudalira insulin ndi mtundu woyamba wa matenda omwe shuga ya magazi imakwera chifukwa cha kuchepa kwa insulin. Izi zimachitika chifukwa cha zikondamoyo zosakwanira zomwe zimachitika chifukwa chobadwa nako chifukwa cha zifukwa zina.
2. Mtundu wodziyimira pawokha wa insulin (mtundu 2) umayamba chifukwa cha kuchepa kwa ubale pakati pa maselo amthupi ndi mahomoni.
3. Matenda a gestational ndi matenda a azimayi oyembekezera. Kuchulukitsa shuga panthawi yapakati. Pambuyo pobereka, nthawi zambiri zimakhala zabwinobwino.
4. Matenda a shuga Zotsatira za kusinthika, mapuloteni ngati insulini amasintha machitidwe ake, omwe amakhala oyambitsa kukula kwa matenda, chifukwa amakhudzidwa ndi kapangidwe ka thupi, kapangidwe ka endocrine ndi machitidwe ena a fetal.

Kuphatikiza apo, insulin imalowetsedwa mu diabetes kwa matenda opatsirana omwe amayambitsidwa ndi malungo. Lembani mankhwala kwa odwala omwe ali ndi vuto la metabolic mukamasinthira ku insulin yayitali. Ikani mankhwalawa poyesa insulin.

Insulin yolumikizana ndi odwala omwe ali ndi:

• matupi awo sagwirizana ndi insulin komanso magawo a mankhwalawa.
• shuga wamagazi pansipa.

Hypoglycemia imachitika ndi:

• kapamba
• nephropathy,
• pachimake chiwindi
• matenda a chiwindi,
• amyloidosis a impso,
• ICD
• matenda am'mimba
• matenda a mtima owonongeka.

Mosamala, amalembedwa kwa odwala omwe amapezeka ndi:

• kuperewera kwa coronary
• kukanika kwa aimpso,
• kusokoneza chithokomiro,
• Matenda a Addison.

Chithandizo cha amayi apakati omwe ali ndi insulin imayang'aniridwa mosamala ndi dokotala wazachipatala nthawi yonse yomwe ali ndi pakati. Munthawi imeneyi, kusintha kwa mlingo kumachitika kangapo.

Mlingo ndi bongo

Cholinga chomwa mankhwalawa ndikuchepetsa magazi. Insulin yokhala ndi nthawi yayitali imayendetsedwa s / c kapena m. Kuti muwonetsetse ngati zotsatira zoyipa kwambiri (zadzidzidzi), insulini imagwiritsidwa ntchito pang'onopang'ono, mayina a mankhwalawa adzalengezedwa ndi dokotala. Sizoletsedwa kuyambitsa prolongator ndi sing'anga wa insulin mu mtsempha kapena kugwiritsira ntchito mapampu olowetsera. Pamaso makonzedwe, muyenera kutentha njira yofundira. Njira yothetsera kuzizira imachepetsa kuyambika kwa zinthu ndipo imatha kuwonjezera mphamvu ya mankhwalawo.

Mlingo wa mankhwala umasankhidwa payekha kwa wodwala aliyense. Gwiritsani ntchito shuga patsogolo musanadye komanso maola awiri mutatha kudya. Pakatikati, lingalirani za mulingo woyenera wa 30- 40 PESCES 1-3 patsiku kapena 0,5-1 PISCES / kg yolemetsa. Ngati pali wachibale wothandizila kapena mankhwalawa siabwino kwa wodwalayo, ndiye kuti insulin yokhala ndi ultrashort ingaphatikizidwe ndi mankhwala omwe amakhala ndi mphamvu yayitali.

Zofunika! Anthu odwala matenda ashuga ayenera kuyang'anitsitsa mosamala mankhwalawa popereka mankhwalawo kuti asapitirire mlingo woyenera. Izi zimapangitsa kuti pakhale insulin yambiri komanso kukula kwa zizindikiro za hypoglycemia.

Kuchita

Ma insulini ndiogwirizana, koma kusintha kwa mankhwalawa kumafunikira ndikusintha kuchokera ku mtundu wina kupita ku wina. Popereka mankhwala, dokotalayo amathandizira kudziwa mapiritsi omwe wodwala akumwabe, chifukwa mankhwala ambiri amachepetsa kapena amalimbikitsa mphamvu ya insulin. Kutalikitsa mphamvu ya kutenga:

• mahomoni a chithokomiro,
• nicotinic acid ndi zotumphukira zake,
• antidepressants.

Kuphatikiza kwa mowa ndi insulin kumathandizira kuchuluka kwa hypoglycemic ya mankhwalawa. Pali magulu azamankhwala omwe amachepetsa kuchiritsa kwa mankhwalawa. Izi ndi:

• zoletsa za MAO, NPF, NSAIDs,
• mankhwala okhala ndi salicylic acid,
• kukonzekera kwa zinc
• mankhwala a steroid.

Mankhwala a insulin samakhudza kuchuluka kwa momwe munthu angachitire, choncho odwala matenda ashuga amatha kugwira ntchito ndiukadaulo wokha.

Kugawidwa kwa mankhwala kumachitika pokhudzana ndi nthawi yochitapo kanthu, kapangidwe kake, chiyambi cha zopangira.

Gulu la gulu la insulin

Ngati wodwala akufunika kusintha mtundu wina wa insulin kupita ku wina, ndiye adokotala okha omwe amasintha motero. Poganizira kusiyana kwa nthawi yochitapo kanthu, mlingo wake umasankhidwa.

Maganizo a odwala

Ndemanga ya odwala matenda ashuga okhudza kugwiritsa ntchito mankhwalawa.

Svetlana, wazaka 54, Samara. Ndimadwala matenda a shuga kuyambira ndili ndi zaka 46. Ndimagwiritsa ntchito "Insulin Glargin", ndimagwiritsa ntchito mankhwalawa pafupipafupi, motero ndimamva bwino. Chachikulu ndichakuti musazengeretse nthawi yolandirira ndi kumamwa mankhwala olimbikitsidwa.

Daria, wa zaka 32, Rostov. Ovutika ndi shuga spikes. Tsopano ndimatsatira kadyedwe ndipo ndikubaya panthawi "Insuman Bazal." Zimandithandiza kukhala ndi moyo ndikugwira ntchito mokwanira.

Marina Pavlovna, endocrinologist. Ma insulin osavuta amavomerezedwa ndi odwala ngati zakudya zoyenera ndi mlingo woyenera zimawonedwa. Zolakwika mu zakudya zimayambitsa kuwoneka ngati "zotsatira zoyipa".

Mtengo wa mankhwala osiyanasiyana okhala ndi insulin umatengera wopanga ndi ma CD. Amasiyana kuchokera ku ma ruble 400. mpaka 2800 rub. kunyamula.

Pomaliza pang'ono

Pali mabuku apadera pomwe hypoglycemia imafotokozedwa mwatsatanetsatane. Izi sizongokhudza odwala matenda ashuga okha, chifukwa zifukwa zomwe zimabweretsa kukhazikikaku kwa matenda zimasonyezedwa pamenepo. Palinso mndandanda wamankhwala omwe amagwiritsidwa ntchito pochizira insulin. Ndikofunika kuti musangoyambira nokha chithandizo. Onetsetsani kuti mukuyendera endocrinologist kuti musadzivulaze.