Gensulin N (Gensulin N)

Mlingo wa Gensulin N - kuyimitsidwa kwa ma transcutaneous (ma s / c): kuyimitsidwa koyera, phokoso lomwe limalekanitsidwa kuti likhale loyera pakapumulo komanso lopanda utoto kapena lopanda utoto, likugwedezeka modekha, phokoso limasinthidwa mwachangu (3 ml m'makalata, pafoni iliyonse) ma contour mapaketi a 5 ma cartridge, 1 pakatoni okhala ndi makatoni, 10 ml iliyonse m'mabotolo owonekera agalasi lopanda utoto, 1 botolo mumtolo wa makatoni).

Kupanga pa 1 ml ya kuyimitsidwa:

• yogwira mankhwala: insulin-isophan recombinant human - 100 IU,
• othandizira zigawo: phenol, glycerol, metacresol, protamine sulfate, sodium hydrogen phosphate dodecahydrate, zinc oxide, hydrochloric acid, madzi a jekeseni.

Zizindikiro zogwiritsidwa ntchito

Gensulin N akulimbikitsidwa kuti agwiritse ntchito mtundu woyamba wa matenda ashuga, komanso mtundu wachiwiri wa matenda ashuga mu gawo la kukana othandizira a hypoglycemic pakugwiritsa ntchito pakamwa, kukana pang'ono kwa mankhwalawa (munthawi ya chithandizo chophatikizidwa) komanso matenda wamba.

Mlingo ndi makonzedwe

Kuyimitsidwa Gensulin N cholinga chake ndikuyang'anira sc.

Dokotala amadziwitsa mtundu wa mankhwalawa munjira iliyonse malinga ndi zomwe zimapangitsa kuti magazi azikhala ndi magazi, komanso kuganizira zomwe wodwalayo ali nazo. Pafupifupi tsiku lililonse kusiyanasiyana osiyanasiyana 0,5-1 IU pa 1 makilogalamu odwala.

Jakisoni imapangidwa mu ntchafu, amathandizanso kuyambitsa mankhwalawo m'chigoba, mkati mwa khoma lam'mimba kapena minyewa yamapewa. Masamba a jakisoni mkati mwa anatomical ayenera kusinthidwa kuti apewe lipodystrophy.

Mukamayimitsa kuyimitsidwa, vial kapena cartridge sayenera kugwedezeka mwamphamvu, chifukwa izi zingapangitse kuti thovu lipangidwe, zimapangitsa kuti zikhale zovuta kukhazikitsa mankhwalawo molondola. Maonekedwe a mankhwalawa mu mbale ndi makatiriji amayenera kuwunikidwa pafupipafupi ngati ma flakes alipo mu kuyimitsidwa kapena tinthu tating'onoting'ono tawonedwa kuti amatsatira pansi / makoma a vial kapena cartridge, kupanga zotsatira za chisanu, sikuyenera kugwiritsidwa ntchito.

Kutentha kwa kuyimitsidwa koyenera kuyenerana ndi kutentha kwa chipinda.

1. Tetezani khungu ndi mowa pamalo opaka jakisoni.
2. Gwiritsani ntchito zala ziwiri kuti muduleni khungu.
3. Ikani singano pakona pafupifupi 45 ° m'munsi mwa khola ndikulowetsani insulin pansi pa khungu.
4. Pambuyo jekeseni osachepera 6 masekondi, osachotsa singano kuti mutsimikizire kuti mankhwalawo amalandiridwa kwathunthu.
5. Ngati magazi abwera pamalo a jakisoni mutachotsa singano, pindani pang'ono ndi chala chanu.
6. Masamba obayira amafunika kusinthidwa.

Gensulin N amagwiritsidwa ntchito ngati mankhwala a monotherapy komanso monga gawo la chithandizo chovuta ndi insulin yochepa (Gensulin P).

Wodwala ayenera kudziwa luso la momwe angagwiritsire ntchito mankhwalawa, kutengera zomwe zikuchitika.

Kugwiritsa ntchito kuyimitsidwa m'mbale

Kugwiritsa ntchito mtundu umodzi wa insulin:

1. Chotsani kapu yotetezera ya aluminium kuchokera ku vial.
2. Patulani khungu pa mphira.
3. Sungani mpweya mu syringe mu voliyumu yolingana ndi kuchuluka kwa insulini ndikuyambitsa mpweya mu vial.
4. Tembenukani mozungulira mosangalatsa ndi syringe yovundikiramo ndi kusungitsa muyeso wofunika wa insulin.
5. Chotsani singano mu vial, chotsani mpweya ku syringe, ndikuwonetsetsa kuti insulin ndiyofunikira.
6. Pangani jakisoni.

Kugwiritsa ntchito mitundu iwiri ya insulin:

1. Chotsani zoteteza za aluminium kuchokera kumbale.
2. Siyanitsani michere ya mphira pambale.
3. Nthawi yomweyo musanayimbe, jambulani insulin ya sing'anga nthawi yayitali (njira yayitali) ngati mukuyimitsidwa pakati pa manja ndikuyamba kugawanika komanso mawonekedwe oyimitsa amtambo.
4. Sungani mpweya mu syringe mu voliyumu yofananira ndi kuchuluka kwa insulin yomwe yakhala ikuchitika kwa nthawi yayitali, ikani mpweya mu vial ndi kuyimitsidwa, kenako ndikuchotsa singano.
5. Thirani mpweya mu syringe mu voliyumu yofanana ndi ofunika kuchita mwachangu insulin, yambitsani mpweya mu vial ya insulini mu njira yodziwikiratu, sinthani vial ndi syringe mozaza ndi kudzaza muyezo wofunikira.
6. Chotsani singano mu vial, chotsani mpweya ku syringe, ndikuwonetsetsa kuti insulin ndiyofunikira.
7. Ikani singano mu vial ndi kuyimitsidwa, tembenuzani chamkati ndi syringe mozungulirapo ndikusonkhanitsa kuchuluka kwa insulin yofunikira.
8. Chotsani singano mu vial, chotsani mpweya mu syringe, ndikuwonetsetsa ngati mlingo wonse wa insulin ndi woyenera.
9. Pangani jakisoni.

Ndikofunikira kuti nthawi zonse mulembe insulini munthawi yomwe tafotokozazi.

Kugwiritsa ntchito kuyimitsidwa pama cartridge

Cartridges omwe ali ndi mankhwalawa Gensulin N adapangidwa kuti azigwiritsidwa ntchito ndi zolembera za kampani "Owen Mumford". Zofunikira zomwe zalembedwa mu malangizo ogwiritsira ntchito cholembera pokhudzana ndi insulin ziyenera kuonedwa.

Musanagwiritse ntchito Gensulin H, cartridge iyenera kuyang'aniridwa ndikuwonetsetsa kuti palibe zowonongeka (tchipisi, ming'alu); ngati zilipo, katoni sigwiritsidwe. Pambuyo kukhazikitsa cartridge mu syringe cholembera, Mzere wachikuda uyenera kuwonekera pazenera la wogwirizira.

Asanakhazikitse katiriji mu cholembera, iyenera kutembenuzidwira pansi kuti galasi laling'ono lagalasi mkati lisakanikize kuyimitsidwa. Njira yosinthira imabwerezedwa kangapo ka 10, mpaka kuyimitsidwa koyera ndi kwamtambo kukapangidwa. Pangani jakisoni pambuyo pake.

Ngati cartridge idayikidwa cholembera kale, kusakaniza kuyimitsidwa kumachitika dongosolo lonse (osachepera 10) ndikubwereza jekeseni iliyonse isanachitike.

Mukamaliza jakisoni, singano iyenera kusiyidwa pansi pakhungu kwa masekondi ena 6, ndipo batani liyenera kusungidwa mpaka singano itachotsedwa kwathunthu pakhungu. Izi zikuwonetsetsa kuti muyezo wa mankhwalawo umaperekedwa molondola ndikuchepetsa mwayi wa magazi / zamitsempha kulowa mu singano kapena katemera wa insulin.

Katoni yomwe ili ndi mankhwala Gensulin N amangopangidwira kuti azigwiritsa ntchito payekhapayekha ndipo sangathe kudzazidwanso.

Zotsatira zoyipa

• Zotsatira za kukhudzana kwa kagayidwe kazakudya kachulukidwe kazakudya: kuperewera kwa khungu, khungu, pakhungu, kuchuluka kwa thukuta, kugwedezeka, kuphwanya, njala, kupweteka pakamwa, chifukwa cha hypoglycemia, hypoglycemic coma imatha,
• Hypersensitivity reaction: kawirikawiri - totupa pakhungu, edema la Quincke, losowa kwambiri - mantha anaphylactic,
• Zomwe zimachitika jekeseni: kutupa ndi kuyabwa, Hyperemia, ngati mungagwiritse ntchito nthawi yayitali - lipodystrophy pamalo opangira jakisoni,
• Zina: edema, zolakwika zopanda kanthawi kochepa (nthawi zambiri kumayambiriro kwa maphunziro).

Zizindikiro za bongo akhoza kukhala kukula kwa hypoglycemia. Mankhwalawa mofatsa, tikulimbikitsidwa kumeza shuga kapena zakudya zamafuta ambiri. Odwala omwe ali ndi matenda ashuga ayenera kunyamula shuga, maswiti, makeke, kapena zakumwa za shuga.

Pankhani ya kuchepa kwakukulu kwa ndende ya glucose, pakutha kwa chikumbumtima, yankho la dextrose 40% limayendetsedwa kudzera m'mitsempha, glucagon imayang'aniridwa intramuscularly, kudzera m'mitsempha kapena mozungulira. Pambuyo podziwikanso, ndikofunikira kuti muzidya zakudya zokhala ndi mchere wambiri kuti muchepetse kukonzanso kwa hypoglycemia.

Malangizo apadera

Gensulin N saloledwa kugwiritsa ntchito ngati kuyimitsidwa sikusintha kukhala koyera komanso koyipa mutagwedezeka.

Mukamapangira mankhwala a insulin, ndikofunikira kuyang'anitsitsa kuchuluka kwa shuga m'magazi. Kuwunikira koteroko ndikofunikira chifukwa, kuwonjezera pa insulin yochuluka, zomwe zimayambitsa hypoglycemia zimatha kukhala: kulumpha chakudya, kuchotsa mankhwala, kutsegula m'mimba, kusanza, kuchuluka kwa zinthu zolimbitsa thupi zomwe zimachepetsa kufunika kwa matenda a insulin (aimpso / chiwindi kulephera, hypofunction ya adrenal cortex, chithokomiro cha chithokomiro kapena gland planditary). Masamba a jakisoni, kugwiritsa ntchito mankhwala ndi mankhwala ena.

Dosing yolakwika kapena kuphwanya pakati pa jakisoni wa insulin, makamaka kwa odwala omwe ali ndi matenda amtundu 1, angayambitse matenda a hyperglycemia. Nthawi zambiri, zizindikiro zoyambirira za hyperglycemia zimayamba pang'onopang'ono, kwa maola angapo kapena masiku. Pakamwa pakamwa, ludzu, nseru, kusanza, chizungulire, khungu ndi kuyanika pakhungu, kuchepa chilimbikitso, kununkhira kwa acetone mu mpweya wotuluka, kuchuluka kukodza kumawonekera. Ngati chithandizo sichikuchitika, ndiye kuti ndi mtundu woyamba wa matenda a shuga, hyperglycemia ingayambitse vuto lomwe lingakhale lowopsa - matenda ashuga ketoacidosis.

Kuwongolera mlingo wa insulini ndikofunikira kwa hypopituitarism, kukanika kwa chithokomiro, matenda a Addison, chiwindi / impso, komanso kwa odwala okalamba azaka zopitilira 65.

Kufunika kwa kusintha kwa insulin kungafunikenso ndi kuwonjezeka kwa kulimbitsa thupi kapena kusintha kwa zakudya zomwe mumakonda.

Kufunika kwa insulini kumachulukitsidwa ndimatenda ophatikizika, makamaka a matenda opatsirana, komanso mikhalidwe yoyendetsedwa ndi malungo.

Kusintha kuchokera ku mtundu wina wa insulini kupita ku wina kumafunikanso kuchitika, kuwongolera kuchuluka kwa shuga m'magazi.

Ndikofunikira kulingalira kuti kugwiritsa ntchito insulin kumachepetsa kulekerera kwa wodwala ku mowa.

Kugwiritsa ntchito kwa Gensulin N pamapampu a insulini sikulimbikitsidwa chifukwa chakuwunika kwa kuyimitsidwa kwina mu ma catheters.

Hypoglycemia imatha kulepheretsa wodwala chidwi komanso kuchepetsa kuthamanga kwa zomwe zimachitika m'maganizo, zomwe zimawonjezera chiwopsezo poyendetsa magalimoto ndi / kapena kugwira ntchito ndi njila zina zovuta.

Kuyanjana kwa mankhwala osokoneza bongo

• hypoglycemic wothandizira kwa makonzedwe m'kamwa, zoletsa wa monoamine oxidase (Mao) zoletsa, angiotensin akatembenuka enzyme (Ace) zoletsa, si kusankha β-blockers, carbonic anhydrase zoletsa, bromocriptine, sulfonamides, tetracyclines, octreotide, anabolic mankhwala, clofibrate, mebendazole, ketoconazole, theophylline, pyridoxine, cyclophosphamide, Kukonzekera kwa lifiyamu, fenfluramine, kukonzekera kwa ethanol: kumapangitsanso mphamvu ya insulin,
• thiazide diuretics, glucocorticosteroids (GCS), pakamwa kulera, mahomoni a chithokomiro, sympathomimetics, heparin, tridclic antidepressants, clonidine, danazole, diazoxide, calcium blockers, phenytoin, morphine, chikonga: kufooketsa hypoglycemic
• reserpine ndi salicylate: zimatha kufooketsa ndikuwonjezera ntchito ya insulin.

Zofanizira za Gensulin N ndi: Biosulin N, Vozulim N, Insuman Bazal GT, Insuran NPH, Protamine-insulin Emergency, Protafan NM, Protafan NM Penfill, Rinsulin NPH, Rosinsulin S, Humodar B 100 Rec.

Mankhwala Okhala Pamalo a Pharmacy

Yoperekedwa ndi mankhwala.

Zambiri zokhudzana ndi mankhwalawa ndizofanana, zimaperekedwa pazidziwitso ndipo sizilowa m'malo mwa malangizo ovomerezeka. Kudzipatsa nokha mankhwala kuopsa!

Mabakiteriya mamiliyoni ambiri amabadwa, amoyo ndi kufa m'matumbo athu. Amatha kuwoneka pa kukula kwakukulu, koma ngati atakhala palimodzi, akhoza kukhala mu kapu ya khofi yokhazikika.

Pali ma syndromes osangalatsa kwambiri azachipatala, monga kuphatikiza zinthu. M'mimba mwa wodwala m'modzi wodwala mania uyu, zinthu 2500 zakunja zidapezeka.

Munthu aliyense samangokhala ndi zala zapadera, komanso chilankhulo.

Kuti tinene ngakhale mawu afupi komanso osavuta, timagwiritsa ntchito minofu 72.

Ku UK, kuli lamulo malinga ndi momwe dokotala wothandizira amatha kukanachita opaleshoni ngati atasuta kapena wonenepa kwambiri. Munthu ayenera kusiya zizolowezi zoipa, kenako, mwina, sangafunikire opareshoni.

Mankhwala akutsokomola "Terpincode" ndi amodzi mwa atsogoleri ogulitsa, ayi chifukwa cha mankhwala ake.

Madokotala a mano adapezeka posachedwa. Kalelo m'zaka za zana la 19, inali ntchito ya tsitsi wamba kuti akatulutse mano odwala.

Kutentha kwambiri kwa thupi kudalembedwa ku Willie Jones (USA), yemwe adamulowetsa kuchipatala ndi kutentha kwa 46,5 ° C.

Chiwindi chanu chikasiya kugwira ntchito, imfa imatha pakatha tsiku limodzi.

Mankhwala odziwika bwino "Viagra" adapangidwa poyambirira pochizira matenda oopsa.

Matenda osowa kwambiri ndi matenda a Kuru. Oimira okha a fuko la Fore ku New Guinea amadwala naye. Wodwala amafa chifukwa cha kuseka. Amakhulupirira kuti chomwe chimayambitsa matendawa ndicho kudya ubongo wa munthu.

Asayansi aku America adayesera mbewa ndipo adati madzi amadzi amalepheretsa kukula kwa atherosulinosis yamitsempha yamagazi. Gulu limodzi la mbewa limamwa madzi am'madzi, ndipo lachiwiri ndi madzi a mavwende. Zotsatira zake, zombo za gulu lachiwiri zinali zopanda ma cholesterol.

Pochezera pafupipafupi pakama pofufuta, mwayi wokhala ndi khansa yapakhungu umawonjezeka ndi 60%.

Mwazi wa munthu "umayenda" m'matumbo omwe akukakamizidwa kwambiri, ndipo ngati umphumphu wake waphwanyidwa, amatha kuwombera mpaka 10 metres.

Impso zathu zimatha kuyeretsa malita atatu a magazi mphindi imodzi.

Kusowa pang'ono kwa mano kapena ngakhale adentia yathunthu imatha kukhala kuvulala, ma caries kapena chiseyeye. Komabe, mano otayika amatha kusinthidwa ndi mano.

Gulu la Nosological (ICD-10)

Mankhwala

Gensulin H - insulin yaumunthu yomwe idagwiritsidwa ntchito pogwiritsa ntchito ukadaulo wa DNA. Ndi kukonzekera kwa insulin. Imalumikizana ndi cholandirira chapadera pa cell ya cytoplasmic ya maselo ndikupanga insulin receptor zovuta zomwe zimapangitsanso zochitika zina, kuphatikizapo kaphatikizidwe angapo ofunikira a michere (kuphatikizapo hexokinase, pyruvate kinase, glycogen synthetase). Kutsika kwa shuga m'magazi kumachitika chifukwa chophatikizira kuchulukitsa kayendedwe kake ka chidwi, kupititsa patsogolo minofu ndi kugwirira ntchito, kulimbikitsa lipogenesis, glycogenogeneis, ndikuchepetsa kuchuluka kwa shuga m'magazi.

Kutalika kwa nthawi ya kukonzekera kwa insulin makamaka chifukwa cha kuchuluka kwa mayamwidwe, zomwe zimatengera zinthu zingapo (mwachitsanzo, mlingo, njira ndi malo oyang'anira), chifukwa chake zochitika za insulin zimasinthasintha kwambiri, mwa anthu osiyanasiyana komanso kwa munthu yemweyo .

Mbiri yamachitidwe ndi subcutaneous jakisoni (pafupifupi chiwerengero): kuyambika kwa maola 1.5, kutalika kokwanira kumakhala pakatikati pa maola atatu ndi 10, nthawi yayitali mpaka maola 24.

Pharmacokinetics

Kutsiriza kwa mayamwa ndi kuyambika kwa mphamvu ya insulin kumadalira kuchokera pamalowo jakisoni (m'mimba, ntchafu, matako), mlingo (kuchuluka kwa insulin), kuchuluka kwa insulin. Imagawidwa mosiyanasiyana munsiyo: simalowerera chotchinga ndi mkaka wa m'mawere. Imawonongeka ndi insulinase, makamaka m'chiwindi ndi impso. Imafufutidwa ndi impso (30-80%).

Kuchita

Hypoglycemic zotsatira za insulin patsogolo mankhwala m'kamwa hypoglycemic, Mao zoletsa, zoletsa Ace, carbonic zoletsa anhydrase, si kusankha β-blockers, bromocriptine, octreotide, sulfonamides, anabolic mankhwala, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, kukonzekera lifiyamu kukonzekera kokhala ndi Mowa.

Kulera kwapakamwa, corticosteroids, mahomoni a chithokomiro, thiazide diuretics, heparin, tridclic antidepressants, sympathomimetics, danazole, clonidine, BKK, diazoxide, morphine, phenytoin, nikotini kufooketsa mphamvu ya hypoglycemic.

Mothandizidwa ndi reserpine ndi salicylates, kufooka komanso kuwonjezeka kwa machitidwe a mankhwalawa ndizotheka.

Mlingo ndi makonzedwe

S / c m'tchafu. Zilonda zitha kupangidwanso kukhoma kwamkati, matako, kapena dera lamatumbo lamapewa.

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

Mlingo wa mankhwalawa umatsimikiziridwa ndi dokotala aliyense payekha, malinga ndi kuchuluka kwa shuga m'magazi. Pafupifupi, tsiku lililonse mlingo wa mankhwalawo umachokera ku 0,5 mpaka 1 IU / kg (kutengera umunthu wa wodwalayo komanso kuchuluka kwa shuga m'magazi).

Kutentha kwa insulin yoyenera kuyenera kukhala kutentha kwambiri.

Gensulin N imatha kutumikiridwa yokha kapena kuphatikiza ndi insulin yochepa (Gensulin P).

Bongo

Zizindikiro hypoglycemia ndizotheka.

Chithandizo: wodwalayo amatha kuthetsa hypoglycemia wofatsa mwa kudya shuga kapena zakudya zopatsa mphamvu. Chifukwa chake, ndikulimbikitsidwa kwa odwala matenda ashuga kuti azinyamula shuga, maswiti, makeke kapena mandimu okoma zipatso.

Wovulala kwambiri, wodwalayo akapanda kuzindikira, yankho la dextrose 40% limayendetsedwa iv, i / m, s / c, iv glucagon. Pambuyo pakupezanso chikumbumtima, wodwalayo akulimbikitsidwa kudya zakudya zamafuta ambiri kuti aletse kukonzanso kwa hypoglycemia.

Kutulutsa mawonekedwe, kapangidwe kake ndi ma CD

Othandizira: m-cresol - 1.5, phenol - 0,65 mg, glycerol - 16 mg, protamine sulfate - 0,27 mg, zinc oxide - 30 μg, disodium hydrogen phosphate dodecahydrate - 5.04 mg, hydrochloric acid 0.1M - 0,03 ml.

3 ml - makatoni ogwiritsira ntchito ma cholembera a syringe (5) - matuza (1) - makatoni.
10 ml - mabotolo (1) - makatoni.

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, kumalepheretsa gluconeogeneis ndikuthandizira kusintha kwa glucose owonjezera kukhala mafuta.

Mankhwala

Insulin yochita pakati. Kuchepetsa kuchuluka kwa shuga m'magazi, kuonjezera mayamwidwe ndi minofu, kumapangitsanso lipogenis ndi glycogenogeneis, kaphatikizidwe ka mapuloteni, kumachepetsa kuchuluka kwa shuga ndi chiwindi. Imalumikizana ndi cholandirira china kumtundu wakunja wamaselo ndikupanga insulini yolandirira. Kutsika kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa kayendedwe ka intracellular, kuchuluka kwa zotupa, kukondoweza kwa lipoenaisis, glycogenogeneis, kaphatikizidwe ka protein, kuchepa kwa kuchuluka kwa kupanga kwa shuga ndi chiwindi (kuchepa kwa kusweka kwa glycogen), ndi zina. Zotsatira zake zimachitika pakatikati pa maola 2 mpaka 2, nthawi ya ntchitoyo ndi - maola 18 mpaka 24, kutengera kapangidwe ka insulin ndi mlingo, zomwe zikuwonetsa kupatuka kwakapakati komanso mkati mwa munthu. Mayamwidwe ndi isanayambike ntchito zimadalira njira ya kasamalidwe (sc kapena intramuscularly), malo (pamimba, ntchafu, matako) ndi kuchuluka kwa jakisoni, kuchuluka kwa insulini mu mankhwalawa, etc. Amagawidwa mosiyanasiyana m'matumba, samalowa mchotsekera chamkati komanso pachifuwa. mkaka. Imawonongeka ndi insulinase, makamaka m'chiwindi ndi impso. Amachotsa impso.

Kugwiritsa ntchito mankhwala osokoneza bongo

Mtundu woyamba wa matenda ashuga a mtundu 1. Mellitus wa mtundu 2 wa shuga, gawo la kukana mankhwala osokoneza bongo a hypoglycemic, kukana pang'ono kwa mankhwala amkamwa hypoglycemic (kuphatikiza mankhwala), matenda omwewo, kuchitira opaleshoni (mankhwala a mono- kapena osakanikirana), matenda osokoneza bongo pa nthawi ya pakati (ngati chithandizo cha zakudya sichothandiza )

Zotsatira zoyipa zosiyanasiyana

Thupi lawo siligwirizana (urticaria, angioedema - malungo, kufupika, kutsika magazi), hypoglycemia (pallor of the khungu, thukuta lakuchuluka, thukuta, kutukwana, kugwedezeka, njala, kukalamba, nkhawa, kupweteka kwa pakamwa, kupweteka mutu, kugona, kugona, kugona mantha, kukhumudwitsa, kusakwiya, zosazolowereka, kusayenda bwino kwa kayendedwe, malankhulidwe ndi masomphenya), hypoglycemic coma, hyperglycemia and diabetesic acidosis (pamiyeso yochepa, jakisoni wambiri, kulephera kutsatira kadyedwe, e fever ndi matenda): kugona, ludzu, kuchepa kwa chakudya, nkhope yakuwonekera), kusokonezeka kwa chikumbumtima (mpaka kukhazikika kwa chikomokere), kuwonongeka kwapang'onopang'ono (nthawi zambiri kumayambiriro kwa mankhwala), kugwiritsidwa ntchito kwa immunological ndi insulin ya anthu, kuchuluka kwa anti-insulin antibodies ndi kuwonjezeka kwa glycemia, hyperemia, kuyabwa ndi lipodystrophy (atrophy kapena hypertrophy of subcutaneous fat) m'malo a jekeseni. Kumayambiriro kwa chithandizo, matenda otaya komanso kukonzanso (amakhala osakhalitsa ndipo amazimiririka ndimankhwala omwe akupitilira).

Zochita

Mankhwala osagwirizana ndi mayankho a mankhwala ena. Mphamvu ya hypoglycemic imapangidwira ndi sulfonamides (kuphatikizapo mankhwala a hypoglycemic, sulfonamides), ma inhibitors a MAO (kuphatikizapo furazolidone, procarbazine, selegiline), carbonic anhydrase inhibitors, zoletsa za ACE, zosagwiritsa ntchito mankhwala a anti-kutupa anabolic steroids (kuphatikiza stanozolol, oxandrolone, methandrostenolone), androgens, bromocriptine, tetracyclines, clofibrate, ketoconazole, mebendazole, theophylline, cyclophosphamide, fenfluramine, li + kukonzekera, pyridoxine, Quinidine Mphamvu ya hypoglycemic imafooketsedwa ndi glucagon, somatropin, glucocorticosteroids, njira zakulera zam'mimba, estrogens, thiazide ndi loop diuretics, BMCC, mahomoni a chithokomiro, heparin, sulfin pyrazone, sympathomimetics, danazole, tricyclic antidepressants, calcium tridoneide, calcium. epinephrine, blockers a H1-histamine receptors. Beta-blockers, reserpine, octreotide, pentamidine imatha kuwongolera ndi kufooketsa mphamvu ya hypoglycemic ya insulin.

Mlingo ndi njira ntchito

Pang'onopang'ono, nthawi 1-2 patsiku, mphindi 30-45 musanadye kadzutsa (sinthani malo a jekeseni nthawi iliyonse). Mwapadera, adokotala angakupatseni jakisoni wambiri wa mankhwala. Mtsempha wa magazi insulin ya sing'anga nthawi yoletsedwa! Mlingo amasankhidwa payekha ndipo zimatengera zomwe zili ndi shuga m'magazi ndi mkodzo, mawonekedwe a matendawa. Nthawi zambiri, Mlingo ndi 8-24 ME 1 nthawi patsiku. Akuluakulu ndi ana omwe ali ndi chidwi chambiri ndi insulin, mlingo wochepera 8 IU / tsiku ukhoza kukhala wokwanira, mwa odwala omwe ali ndi kuchepa kwa chidwi - oposa 24 IU / tsiku. Pa mlingo wa tsiku lililonse wopitilira 0,6 IU / kg, - wofanana ndi jakisoni 2 m'malo osiyanasiyana. Odwala omwe amalandila 100 ME kapena kuposerapo patsiku, akachotsa insulin, ndikofunika kuchipatala. Kusamutsa kuchokera ku mankhwala kupita ku wina kuyenera kuchitika mothandizidwa ndi shuga wamagazi.

Kutulutsa mawonekedwe, ma CD ndi mapangidwe Gensulin N

Kuyimitsidwa kwa s / c ya mtundu oyera, pakuyima mbewa yoyera komanso yopanda utoto kapena yopanda utoto pakapangidwa, mpweya woterewu umayambanso kugwedezeka.

Othandizira: metacresol - 1.5 mg, phenol - 0,65 mg, glycerol - 16 mg, protamine sulfate - 0,27 mg, zinc oxide - mpaka 40 μg Zn 2+ / 100 ME, sodium hydrogen phosphate dodecahydrate - 5.04 mg, hydrochloric acid - q.s. mpaka pH 7.0-7.6, madzi d / i - mpaka 1 ml.

3 ml - makatoni (5) - ma CD a contour cell.
10 ml - mabotolo (1) - mapaketi a makatoni.

Zisonyezero za mankhwala Gensulin N

• mtundu 1 shuga
• lembani matenda ashuga a 2 matenda a shuga: gawo lolimbana ndi mankhwalawa am'kamwa, pang'ono pokana mankhwalawa (panthawi yophatikiza mankhwalawa), matenda oopsa.

Mlingo

Gensulin N adakonza dongosolo lotsogolera sc. Mlingo wa mankhwalawa umatsimikiziridwa ndi dokotala aliyense payekha, malinga ndi kuchuluka kwa shuga m'magazi. Pafupifupi, tsiku lililonse mlingo wa mankhwalawo umachokera ku 0,5 mpaka 1 IU / kg thupi (kutengera umunthu wa wodwalayo komanso kuchuluka kwa shuga).

Kutentha kwa insulin yoyenera kuyenera kukhala kutentha kwambiri.

Gensulin H nthawi zambiri amakhala atailowetsa sc pa ntchafu. Jekeseni amathanso kuchitira khoma lakumbuyo kwam'mimba, matako, kapena dera lamatumbo lamapewa.

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

Gensulin N imatha kupezeka palokha pakokha komanso mophatikiza ndi insulin yochepa (Gensulin P).

Malangizo ayenera kuperekedwa kwa wodwala

Njira yolowera insulin m'mbale

Ngati wodwala amagwiritsa ntchito mtundu umodzi wokha wa insulin

1. Thirani mankhwala okhala ndi mphira pa vial.

2. Thirani mpweya mu syringe kuchuluka kogwirizana ndi insulin yomwe mukufuna. Lowetsani mpweya mu vala ya insulin.

3. Tembenuza vial ndi syringe mozondoka ndikujambula gawo la insulini mu syringe. Chotsani singano mu vial ndikuchotsa mpweya ku syringe. Onani ngati mlingo wa insulin ulondola.

4. Lowani nthawi yomweyo.

Ngati wodwala ayenera kusakaniza mitundu iwiri ya insulin

1. Tulutsani mankhwala amtundu wa mphira pambale.

2. Nthawi yomweyo musanayimbe, ikulirani botolo la insulin yayitali ("yamtambo") pakati pama manja anu mpaka insuliniyo ikhale yoyera komanso yamitambo.

3. Thirani mpweya mu syringe muyezo wofanana ndi mlingo wa insulin yamitambo. Ikani mpweya mumtambo wa insulin vial ndikuchotsa singano mu vial.

4. Jambulani mpweya mu syringe muyezo wofanana ndi mlingo wa insulin yochepa ("mandala"). Lowetsani mpweya mu botolo la insulin yabwino. Tembenuzani mosamala ndi syringe mozondoka ndikuyimba muyeso wa insulin yabwino. Tulutsani singano ndikuchotsa mpweya ku syringe. Chongani mlingo woyenera.

5. Ikani singano mu vial ndi insulin ya "mitambo" yambiri, tembenuzani vinolo ndi syringe pansi ndikuyimba insulini yomwe mukufuna. Chotsani mpweya mu syringe ndikuwonetsetsa ngati mulondola. Ikani mankhwala osakanikirana a insulin nthawi yomweyo.

6. Nthawi zonse lembani insulin mosiyanasiyana monga tafotokozera pamwambapa.

Njira Yogwiritsira Ntchito Cartridge In injion

Makatoni omwe ali ndi mankhwalawa Gensulin N adapangidwa kuti azigwiritsidwa ntchito kokha ndi zolembera za Owen Mumford (Great Britain). Wodwalayo ayenera kuchenjezedwa za kufunika kotsatira malangizo mosamala mu malangizo ogwiritsira ntchito cholembera cha syringe popereka insulin.

Musanagwiritse ntchito, onetsetsani kuti palibe zowonongeka (mwachitsanzo, ming'alu) pa cartridge ndi kukonzekera kwa Gensulin N. Osagwiritsa ntchito cartridge ngati pali zowonongeka. Kathumba katayikidwa mu cholembera, chingwe chautoto chiyenera kuwonekera kudzera pazenera la wonyamulira.

Musanayike cartridge mu syringe cholembera, tembenuzani katoni ndikutsitsa kuti galasi la galasi lisunthe kuchokera kumapeto mpaka kumapeto kwa cartridge. Njirayi iyenera kubwerezedwa nthawi 10 mpaka madzi onse atakhala oyera komanso mitambo. Zitachitika izi, jekeseni ndikofunikira.

Ngati cartridge ili kale ndi cholembera, muyenera kuyitembenuza ndi cartridge mkati ndikutentha kasanu. Ndondomeko iyenera kubwerezedwa musanayambe kubayidwa aliyense.

Pambuyo pa jekeseni, singano imayenera kukhalabe pansi pakhungu kwa masekondi 6 osachepera. Sungani batani kuti lipanikizidwe mpaka singano itachotsedwa kwathunthu pakhungu, ndikuwonetsetsa kuti mayendedwe olondola a mankhwalawo komanso kuthekera kwa magazi kapena zamitsempha kulowa mu singano kapena kathumba katemera

Katemera ndi mankhwala Gensulin N adapangidwira kuti azigwiritsa ntchito payekha ndipo sayenera kuzazidwanso.

1. Ndi zala ziwiri, ikani khola la khungu, ikani singano m'munsi mwa khola pakatundu pafupifupi 45 °, ndikujambulani insulin pansi pa khungu.

2. Pambuyo jekeseni, singano imayenera kukhalabe pansi pakhungu kwa masekondi osachepera 6, ndikuonetsetsa kuti insulin idayikidwa kwathunthu.

3. Ngati magazi abwera pamalo a jakisoni mutachotsa singano, pang'onopang'ono dinani jakisoni ndi chala chanu.

4. Ndikofunikira kusintha tsamba la jakisoni.

Zotsatira zoyipa

Chifukwa cha kuchuluka kwa kagayidwe kazakudya: michere yamkati (khungu la khungu, kuchuluka thukuta, kugunda, kugwedezeka, njala, kukwiya, paresthesia mkamwa, mutu). Matenda oopsa a hypoglycemia angayambitse kukula kwa chikomokere kwa hypoglycemic.

Zotsatira zamatsenga: kawirikawiri - zotupa pakhungu, edema ya Quincke, yosowa kwambiri - mantha anaphylactic.

Zomwe zimachitika m'deralo: hyperemia, kutupa ndi kuyabwa pamalowo jakisoni, ndikugwiritsidwa ntchito kwa nthawi yayitali - lipodystrophy pamalo opaka jekeseni.

Zina: edema, zolakwika zopanda kanthawi kochepa (nthawi zambiri kumayambiriro kwa mankhwala).

Mimba komanso kuyamwa

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.

Pophunzira za kuwopsa kwa ma genetic mu in vitro komanso mndandanda wa vivo, insulin yaumunthu idalibe mutagenic.