Mikstard 30 HM > Insulin

Hypoglycemic wothandizira wa nthawi yayitali. Imalumikizana ndi cholandirira china kumtundu wakunja wamaselo ndikupanga insulini yolandirira. Pogwiritsa ntchito biosynthesis ya cAMP m'maselo amafuta ndi maselo a chiwindi kapena kulowa mwachindunji m'maselo a minofu, mapangidwe a isulin receptor amathandizira njira zina, kuphatikizapo kaphatikizidwe angapo ofunikira a michere (hexokinase, pyruvate kinase, glycogen synthetase, etc.). Kuchepa kwa kuchuluka kwa shuga m'magazi chifukwa chakuwonjezeka kwa mayendedwe ake, kuphatikizapo kuchuluka mayamwidwe ndi chidwi minofu, kukondoweza kwa glycogeneis, glycogenogeneis, mapuloteni kaphatikizidwe, kuchepa kupanga shuga ndi chiwindi, etc.

Kutalika kwa insulin kanthu makamaka chifukwa cha kuchuluka kwa mayamwidwe, komwe kumadalira zinthu zingapo (kuphatikizapo mlingo, njira ndi malo oyang'anira). Kukhazikika kwa zochita pambuyo pa sc makonzedwe kumakhala m'mphindi 30, kuchuluka kwake kumachitika mu 2-8 maola, nthawi yayitali imatha mpaka maola 24. Nthawi zambiri zotchulidwa limodzi ndi insulin kukonzekera.

Zotsatira zoyipa

Thupi lawo siligwirizana (urticaria, angioedema - malungo, kufupika, kuchepa kwa magazi), kuphatikiza wamba (hyperemia, kutupa, kuyabwa kwa khungu pamalo a jakisoni), lipodystrophy pamalo opangira jakisoni, hypoglycemia (pallor of the khungu, thukuta lambiri, thukuta, kutukwana, kugwedezeka, njala, kukwiya, nkhawa, kupweteka pakamwa, kupweteka mutu, kugona. , kusowa tulo, mantha, kusowetsa mtendere, kusakwiya, kusazolowereka, kusakhazikika pamayendedwe, kusokonekera kwa kulankhula ndi masomphenya), hypoglycemic coma.

Kumayambiriro kwa mankhwalawa - kutupa ndi kusokonezeka komwekonso (ndizosakhalitsa ndipo kumatha ndikupitilira chithandizo).

Ntchito ndi mlingo

SC m'dera la ntchafu (malo omwe amachepetsa kwambiri komanso mwamphamvu yunifolomu); SC kukhoma kwam'mimba khomalo, matako kapena minyewa yolimba ya phewa imaloledwa.

Mlingo wa mankhwalawa amadziwitsidwa ndi dokotala aliyense payekhapayekha malinga ndi kuchuluka kwa shuga m'magazi. Wapakati tsiku lililonse mlingo kuyambira 0,5 kuti 1 IU / kg thupi. Mankhwalawa umaperekedwa kwa mphindi 30 chakudya chisanachitike. Kutentha kwa njira yovulazidwa kuyenera kukhala kutentha kwa chipinda.

Kupanga jakisoni pakhungu kumachepetsa chiopsezo cholowera minofu.

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

Mankhwalawa amagwiritsidwa ntchito ngati onse monotherapy komanso kuphatikiza insulin yochepa. Ndi mankhwala othandizira, mankhwalawa amagwiritsidwa ntchito monga basal insulin 1-2 kawiri patsiku (madzulo ndi m'mawa makonzedwe) pamodzi ndi insulin yochepa (makonzedwe asanadye chakudya chamadzulo).

Mtundu wachiwiri wa matenda a shuga a mellitus, mankhwalawa amaperekedwa limodzi ndi mankhwala am'mlomo a hypoglycemic.

Malangizo apadera

Mankhwala sangathe kulowa / kulowa.

Mothandizidwa ndi insulin amayenera kuyang'anira kuchuluka kwa shuga m'magazi.

Mankhwalawa ndi osayenera ngati, atagwedezeka, kuyimitsidwa sikusintha kukhala koyera komanso kwamitambo. Pa kuyambitsa mankhwala ali osavomerezeka kugwiritsa ntchito insulin mapampu.

Hypoglycemia itha kuthetsedwa ndi kudya shuga kapena zinthu zina zokhala ndi shuga (wodwalayo ayenera kukhala ndi zidutswa zingapo za shuga, maswiti, makeke kapena madzi a zipatso).

Adziwitseni achibale, abwenzi komanso ogwira nawo ntchito ogwira nawo ntchito pafupi ndi matenda ashuga, afotokozereni malamulo othandizira odwala matenda a hypoglycemia.

Ndi kukhazikitsidwa kwa mlingo wochepera wa insulini kuposa momwe muyenera, kuchuluka kwa insulini, kusowa kwa zakudya, komanso kusakhazikika kwa matenda a shuga, matenda ena am'mimba, matenda am'mimba, kusanza, kugona, kufooka, kusanza, kufooka, Hyperemia, ndi khungu, pakamwa pouma ndi kununkhira kwa acetone mu mpweya wotuluka). Zizindikiro zoyambirira za hyperglycemia zikaonekera, insulini iyenera kuperekedwa mwachangu.

Matenda ophatikizika (kuphatikizapo matenda a chithokomiro operewera, chiwindi, impso, matenda a Addison, hypopituitarism) mwa okalamba (zaka zopitilira 65), kusintha kwa mlingo wa insulin kungafunike. Matenda olumikizana ndi kutentha thupi, kuchuluka kwa zochita zolimbitsa thupi, kusintha kwa zakudya zomwe zimachitika tsiku lililonse kumawonjezera kufunika kwa insulin.

Kudya kwa Ethanol (kuphatikizapo mowa, vinyo) kungayambitse hypoglycemia. Osamamwa ethanol pamimba yopanda kanthu.

Mukasinthira ku insulin yaumunthu, ziyenera kukumbukiridwa kuti zizindikiro zoyambirira za harbinger za hypoglycemia zitha kutchulidwa pang'ono kuposa momwe anali akugwiritsira ntchito kale mankhwala. Chikhalidwe komanso kukula kwa zizindikiro zakutsogolo izi zimatha kusintha pakanthawi kokhazikika pothandizidwa ndi kagayidwe kazakudya (kuphatikizapo panthawi ya insulin Therapy).

Pa nthawi yoyembekezera komanso nthawi yotsekemera, tikulimbikitsidwa kuti musinthe mankhwalawa kuti muperekenso malipiro a shuga.

Munthawi yamankhwala, chisamaliro chimayenera kuthandizidwa poyendetsa magalimoto ndikuchita zina zomwe zingakhale zowopsa zomwe zimafunikira chidwi chochulukirapo komanso kuthamanga kwa zochitika zama psychomotor (panthawi ya hypoglycemia, amatha kuchepa).

Kuchita

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, ACE inhibitors, NSAIDs (kuphatikizapo salicylates), anabolic (kuphatikiza stanozolol, oxandrolone, methandrostenolone), androgens, bromocriptine, tetracyclines, clofibrate, ketoconazole, mebendazole, theophylline, cyclophosphamide, phenfluramine, Li + kukonzekera, pyridoxine, quinidine, quinine, etloroquin, etloro.

Zotsatira Hypoglycemic wa kulemala glucagon, kukula timadzi, corticosteroids m'kamwa kulera, estrogens, thiazide ndi kuzungulira okodzetsa, mahomoni BCCI, chithokomiro, heparin, sulfinpyrazone, sympathomimetics, danazol, tricyclics, clonidine, calcium muzikangana, diazoxide, morphine, chamba, fodya, phenytoin, epinephrine, H1-histamine receptor blockers.

Beta-blockers, reserpine, octreotide, pentamidine imatha kuwongolera ndi kufooketsa mphamvu ya hypoglycemic ya insulin.

Katswiri wa matenda ashuga: "kukhazikika pamlingo wamagazi."

Momwe mungagwiritsire ntchito: Mlingo ndi njira ya chithandizo

SC m'dera la ntchafu (malo omwe amachepetsa kwambiri komanso mwamphamvu yunifolomu); SC kukhoma kwam'mimba khomalo, matako kapena minyewa yolimba ya phewa imaloledwa.

Kupanga jakisoni pakhungu kumachepetsa chiopsezo cholowera minofu.

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

Mtundu wachiwiri wa matenda a shuga a mellitus, mankhwalawa amaperekedwa limodzi ndi mankhwala am'mlomo a hypoglycemic.

Mlingo

Kuyimitsidwa kwa kayendetsedwe ka subcutaneous, 100 IU / ml

1 ml ya mankhwala ali

ntchito yogwira - genetically opanga insulin ya anthu 3.50 mg (100 IU) 1,

zokopa: zinc (mwanjira ya zinc chloride), glycerin, phenol, metacresol, sodium hydrogen phosphate dihydrate, protamine sulfate, hydrochloric acid 2 M yankho, sodium hydroxide 2 M yankho la pH 7.3, madzi a jakisoni.

1 Mankhwalawa ali ndi 30% sungunuka wa anthu komanso 70% isofan-insulin

Kuyimitsidwa koyera, pakuyimilira, kumapangidwa kukhala chinthu chowonekera, chopanda utoto kapena chosawoneka bwino komanso choyera. Mtengo umasinthidwa mosavuta ndikugwedezeka modekha.

Mankhwala

Pharmacokinetics

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.

Mkulu pazambiri (Cmax) wa insulin mu plasma umatheka mkati 1.5 mpaka 2.5 pambuyo subcutaneous makonzedwe.

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

Insulin yaumunthu imapukusidwa ndi zochita za insulin proteinase kapena ma enzyme okhala ndi insulin, komanso, mwina, mwa mapuloteni omwe amachititsa kuti mapuloteni azikhala asomerase. 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.

Hafu ya moyo (T½) imatsimikiziridwa ndi kuchuluka kwa kuyamwa kuchokera kuzinthu zowoneka bwino. Chifukwa chake, T½ ili ndi gawo lina la mayamwidwe, m'malo mochulukitsa kwenikweni kwa insulini kuchokera ku plasma (T½ ya insulin m'magazi ndi mphindi zochepa chabe). Kafukufuku awonetsa kuti T½ ili pafupifupi maola 5-10.

Mankhwala

Mikstard® 30 NM Penfill® ndi insulin yochita zinthu ziwiri yopangidwa ndi recombinant DNA biotechnology pogwiritsa ntchito Saccharomyces cerevisiae strain. Imalumikizana ndi cholandirira chapadera pa cell ya cytoplasmic cell ndipo imapanga insulini-receptor. Kudzera mwa kuchulukitsa kwa cAMP biosynthesis (m'maselo amafuta ndi m'maselo a chiwindi), kapena kulowa mwachindunji mu cell (minofu), insulini-receptor tata imapangitsa njira zina, kuphatikizira kaphatikizidwe angapo ofunikira a michere (hexokinase, pyruvate kinase, glycogen synthetase, etc.). Kutsika kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa kayendedwe ka intracellular, kuchuluka kwa minofu, kukondoweza kwa lipogenesis, glycogenogenesis, kaphatikizidwe ka mapuloteni, kuchepa kwa kuchuluka kwa glucose opangidwa ndi chiwindi, ndi zina zambiri.

Mphamvu ya mankhwalawa Mikstard® 30 NM Penfill® imayamba mkati mwa theka la ola pambuyo pa kuwongolera, ndipo kuchuluka kwake kumawonekera mkati mwa maola 2-8, pomwe nthawi yonse ya kuchitapo kanthu ili pafupifupi maola 24.

Mlingo ndi makonzedwe

Kukonzekera kwa insulin kophatikizidwa nthawi zambiri kumaperekedwa kamodzi kapena kawiri pa tsiku ngati kuphatikiza koyambirira ndi zotsatira zazitali zimafunikira.

Mlingo wa mankhwalawa amasankhidwa payekha, poganizira zosowa za wodwala. Nthawi zambiri, zofunika za insulin zimakhala pakati pa 0.3 ndi 1 IU / kg / tsiku. Kufunika kwa insulini tsiku lililonse kumatha kukhala kwabwino kwambiri 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. Pankhani imeneyi, munthu ayenera kuyesetsa kukhathamiritsa kagayidwe kachakudya, makamaka, amayang'anitsitsa kuchuluka kwa shuga m'magazi.

Mankhwalawa umaperekedwa kwa mphindi 30 asanadye kapena chakudya.

Kwa subcutaneous makonzedwe. Palibe chifukwa chilichonse ngati insulin kuyimitsidwa iyenera kuperekedwa. Mikstard® 30 NM Penfill ® nthawi zambiri imayendetsedwa mosazungulira mdera lakhoma lamkati lakumbuyo. Ngati izi ndizotheka, ndiye kuti jakisoni amathanso kuchitika m'tchafu, m'chigawo cha gluteal kapena m'dera la minofu ya m'mapazi. Ndi kuyambitsa kwa mankhwala m'dera lakhomopo lakhomopo, mayamwidwe mwachangu amatheka kuposa momwe angayambitsire madera ena. Kupanga jakisoni pakhungu kumachepetsa chiopsezo cholowera minofu. Ndikofunikira nthawi zonse kusintha malo a jekeseni mkati mwa anatomical dera kuti muchepetse chiopsezo cha lipodystrophy.

Malangizo ogwiritsira ntchito ndi Mikstard® 30 NM Penfill® kuti apatsidwe wodwala.

Musanagwiritse ntchito mankhwala Mikstard® 30 NMChifwamba®ndikofunikira:

Chongani ma CD kuti muwonetsetse mtundu woyenera wa insulin.

Nthawi zonse muziyang'ana cartridge, kuphatikizapo pisitoni ya mphira. Ngati kuwonongeka kulikonse kwapezeka, kapena ngati pakapezeka kusiyana pakati pa pisitoni ya mphira ndi tepi yoyera yoyikika, ndiye kuti bokosi ili silingagwiritsidwe ntchito. Kuti mupeze malangizo owonjezereka, onani malangizo ogwiritsira ntchito kachitidwe ka insulin.

Nthawi zonse gwiritsani ntchito singano yatsopano jekeseni iliyonse kuti mupewe matenda.

Muzipetsa utoto wa mphira ndi swab thonje.

Mankhwala Mikstard®30 nmChifwamba®silingagwiritsidwe ntchito pazotsatirazi:

M'mapampu a insulini (mapampu)

Ngati katoni kapena chida cholowetsa chitha kutayikira, kapena ngati chawonongeka kapena chakwinyika, chifukwa chiopsezo chotayira insulini

Ngati hypoglycemia imayamba (shuga m'magazi).

Ngati insulin sinasungidwe bwino, kapena ngati yauma

Ngati sichikhala choyera komanso chokhala ndi mitambo pambuyo pakukonzanso.

Musanagwiritse ntchito Mikstard® 30 NM Penfill®:

Chongani cholembera kuti muwonetsetse kuti mukugwiritsa ntchito mtundu woyenera wa insulin.

Chotsani chophimba.

Singano ndi Mikstard® 30 NM Penfill® ndizogwiritsa ntchito nokha.

Momwe mungagwiritsire ntchito mankhwala a Mikstard® 30 NM Penfill®

Mankhwala a Mikstard® 30 NM Penfill® adapangidwa kuti akwaniritse kayendedwe ka mankhwalawa. Musamapereke insulin kapena kudzera m'mitsempha. Nthawi zonse sinthani malo opangira jakisoni mkati mwa anatomical dera kuti muchepetse chiwopsezo cha zisindikizo ndi zilonda pamalowa. Malo abwino oti jakisoni ndi: matako, ntchafu kapena phewa.

Malangizo kwa wodwala momwe angapangire insulin

Musanakhazikitse cartridge ya Penfill ® mu insulin, jambulani ndikukhazikitsa kanyumba kakang'ono ka 10 mmwamba ndikutsika pakati pa malo ndi a, monga akuwonetsera, kuti galasi mpira mkati mwa cartridge lisunthike kuchokera kumapeto kwenikweni kwa cartridge kupita kwina nthawi 20. Pamaso pa jekeseni iliyonse, osachepera 10 mayendedwe otere ayenera kupangidwa. Manambala awa ayenera kubwerezedwa mpaka madzi atayamba kukhala oyera komanso mitambo. Lowetsani nthawi yomweyo.