Biphasic insulin lispro ndi chisakanizo cha protamine kuyimitsidwa kwa insulin lispro (kachitidwe kenakake ka insulini kukonzekera) ndi lispro insulin (kukonzekera mwachangu insulin). Lyspro insulin ndi analogue ya DNA yophatikizananso ndi insulin ya anthu, koma mosiyana, imakhala ndi zotsalira za proline ndi lysine amino acid zotsalira pa 28 ndi 29 pa insulin B. Lyspro biphasic insulin ili ndi anabolic komanso anti-catabolic zotsatira, imayendetsa kagayidwe ka glucose. Mu minofu ndi minyewa ina (kupatula ubongo), lyspro biphasic insulin imathandizira kusintha kwa amino acid ndi glucose kulowa mu khungu, kumawonjezera zomwe zili ndi glycogen, mafuta achilengedwe, glycerol, kumwa kwa amino acid, kumathandizira kuphatikiza mapuloteni, kumalepheretsa gluconeogenesis, glycogenolysis, ketogenesis, lipolism ma amino acid, amalimbikitsa mapangidwe a glycogen kuchokera ku shuga mu chiwindi, amathandizira kusintha kwa glucose owonjezera kukhala mafuta. Lyspro insulin biphasic ndi ofanana ndi insulin ya anthu. Lyspro insulin biphasic mukayerekezera ndi insulin yachilendo yamunthu imadziwika ndi kuyambika kwachangu, kuyambiranso koyambirira kwa nthawi yayitali komanso nthawi yayifupi ya zochitika za hypoglycemic (mpaka maola 5). Lyspro biphasic insulin ili ndi mayamwidwe ambiri komanso kuyambira mwachangu (mphindi 15 pambuyo pa kuperekera), imalola kuti iperekedwe pokhapokha asanadye (mphindi 15), insulin yovomerezeka yamunthu imaperekedwa mu theka la ora. Kuyamba kwa zochita ndi kuchuluka kwa mayamwidwe a lyspro biphasic insulin kungapangidwe ndi kusankha kwa oyang'anira ndi zina. Kuchuluka kwa insulin lyspro biphasic kumawonedwa pakati pa maola 0.5 ndi 2,5, nthawi yayitali ndi maola 3 mpaka 4.
Kukwanira kwathunthu ndi kuyambika kwa mphamvu ya lyspro biphasic insulin kumadalira malo a jakisoni (ntchafu, pamimba, matako), kuchuluka kwa insulin yoyendetsedwa, kuchuluka kwa insulini mu mankhwala ndi zina. Lyspro insulin biphasic imagawidwa mosiyanasiyana m'thupi lathu. Lyspro biphasic insulin siyidutsa chotchinga ndi kulowa mkaka wa m'mawere. Lyspro biphasic insulin imawonongedwa ndi insulinase makamaka m'chiwindi ndi impso. Amachotsa impso (30 - 80%).

Type 1 shuga mellitus, makamaka osalolera ma insulin ena, postprandial hyperglycemia, yomwe singathe kuwongoleredwa ndi ma insulin ena: kuthana kwambiri kwa insulin kukana (kwathandizira kuchepa kwa insulin).
Type 2 shuga mellitus okhala ndi vuto la ma insulin ena, kukana kwapakamwa mankhwala a hypoglycemic, maopareshoni, matenda wamba.

Njira yogwiritsira ntchito insulin lyspro biphasic ndi mlingo

Lyspro biphasic insulin imayang'aniridwa pang'onopang'ono. Mlingo umayikidwa payekha kutengera mulingo wa glycemia.
Jekeseni uyenera kuchitidwa mosabisa m'mapewa, matako, m'chiuno komanso m'mimba. Masamba a jakisoni ayenera kusinthidwa kuti malo omwewo asagwiritsidwerenso osaposa kamodzi pamwezi. Ndi subcutaneous makonzedwe, chisamaliro ayenera kumwedwa kuti asalowe mumtsempha wamagazi. Pambuyo pa jakisoni, tsamba la jakisidwe siliyenera kutenthedwa.
Mtsempha wama cell a lyspro biphasic insulin ndiwosavomerezeka.
Ngati ndi kotheka, Lyspro biphasic insulin ikhoza kutumikiridwa limodzi ndi sulfonylureas pakamwa pakamwa kapena kukonzekera kwa insulin yayitali.
Odwala omwe ali ndi vuto la impso ndi / kapena chiwindi, kuchuluka kwa insulin yozungulira kumakulitsidwa, ndipo kufunika kwake kumachepetsedwa, motero, ndikofunikira kuwongolera mosamala kuchuluka kwa glycemia ndikusintha mlingo wa insulin.
Ndikofunika kuyang'anitsitsa mlingo ndi njira ya makonzedwe omwe akufuna kuti agwiritsidwe ntchito njira yomwe angagwiritsire ntchito.
Posamutsa odwala kuchokera ku insulin yothamanga yochokera ku nyama kupita ku lyspro biphasic insulin, kusintha kwa mankhwala kungafunike. Kusamutsa wodwala kupita ku mtundu wina kapena kukonzekera kwa insulin ndi dzina lina lamalonda kuyenera kuchitika moyang'aniridwa ndi achipatala. Kusamutsa kwa odwala omwe amalandira insulin tsiku lililonse kuposa 100 IU kuchokera ku mtundu umodzi wa insulin kupita ku ina akuyenera kuchitika kuchipatala. Zosintha muzochitika, wopanga, mtundu, mitundu, ndi / kapena kapangidwe ka insulin zitha kuchititsa kusintha kwa mlingo.
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, ndi mankhwala othandizira kwambiri ndi insulin, zonse kapena zizindikiro zina zakutsogolo kwa hypoglycemia zitha kuzimiririka, zomwe odwala ayenera kudziwitsidwa. Zizindikiro zakutsogolo kwa hypoglycemia mwina sizingatchulidwe kapena kusintha ndi njira yayitali ya matenda a shuga, matenda ashuga a mtima, kugwiritsa ntchito mankhwala ena.
Kugwiritsa ntchito mankhwala osakwanira kapena kuchotsedwa kwa mankhwala, makamaka odwala matenda a shuga 1, kungayambitse matenda a hyperglycemia ndi matenda ashuga a ketoacidosis (vuto lomwe lingakhale pachiwopsezo cha moyo).
Kufunika kwa insulin kumatha kuwonjezeka ndi kupsinjika kwamatenda, matenda opatsirana, kuchuluka kwa chakudya chamagulu ochulukirapo, kuchuluka kwa mankhwala omwe ali ndi vuto la hyperglycemic (glucocorticosteroids, mahomoni a chithokomiro, thiazide diuretics, kulera kwapakamwa komanso ena).
Kufunika kwa insulin kumatha kuchepa ndi kuchepa kwa kuchuluka kwa chakudya chamagulu mu chakudya, chiwindi ndi / kapena kulephera kwa aimpso, kusakwanira kwa adrenal gland, pituitary kapena chithokomiro, kuchuluka kwa zochitika zolimbitsa thupi, kugwiritsa ntchito mankhwala owonjezera ndi hypoglycemic shughuli (osasankha beta-blockers, monoamine oxidase inhibitors, sulfonamides ndi ena).
Kuwongolera mlingo wa insulin kungafunikenso ndi kuwonjezeka kwa zochitika zolimbitsa thupi kapena kusintha kwa zakudya zomwe mumakonda.
Odwala omwe ali ndi matenda ashuga amatha kuletsa hypoglycemia yofatsa yomwe amakhala nayo pakudya shuga komanso zakudya zopatsa thanzi (muyenera kukhala ndi shuga osachepera 20 g). About hypoglycemia yosamutsidwa iyenera kudziwitsidwa ndi adokotala, kuti athetse vuto la kufunika kwa kukonza mankhwala.
Mukamagwiritsa ntchito insulin lyspro biphasic limodzi ndi mankhwala a gulu la thiazolidinedione, chiopsezo chotenga matenda a edema ndi matenda osakhazikika pamtima amachulukirachulukira, makamaka kwa odwala omwe ali ndi matenda amtima komanso kupezeka kwa zinthu zomwe zingayambitse matenda oopsa a mtima.
Ndi hyperglycemia kapena hypoglycemia wodwala, kuthamanga kwa zochitika zama psychomotor ndikuwonetsetsa kwambiri kumatha kuchepa, zomwe zimakhala zowopsa nthawi zomwe maluso awa ndi ofunikira makamaka (mwachitsanzo, kuyendetsa galimoto, makina). Odwala ayenera kusamala kuti apewe kukula kwa hypoglycemia kapena hyperglycemia pochita zinthu zomwe zimafunikira chidwi chachikulu komanso kuthamanga kwa zochitika zama psychomotor (kuphatikizapo kuyendetsa, machitidwe).Chofunika kwambiri kwa odwala omwe amakhala ndi vuto la hypoglycemia kapena okhala ndi zizindikiro zosakhalapo kapena zofatsa, otsogola hypoglycemia. Zikatero, adotolo ayenera kuwunika kuthekera kwa wodwalayo pochita zinthu zomwe zimafunikira kuti azichita chidwi ndi kuthamanga kwa zochitika zama psychomotor (kuphatikizapo kuyendetsa, njira)

Model Clinical-Pharmacological Article 1

Zochita pafamu. Kusakaniza kwa lyspro insulin - kukonzekera insulin mwachangu komanso kuyimitsidwa kwa protamine kuyimitsidwa kwa lyspro insulin - kukonzekera kwa insulini pakukonzekera. Lyspro insulin ndi anomuyumu ya DNA yobwerezabwereza ya insulin yaumunthu; imasiyana mwakutero kwa proline ndi lysine amino acid zotsalira pamalo 28 ndi 29 a insulin B. Imayendetsa kagayidwe ka glucose, imakhala ndi zotsatira za anabolic. Mu minofu ndi minyewa ina (kupatula bongo) imathandizira kusintha kwa glucose ndi amino acid kulowa mu khungu, imalimbikitsa kupangika kwa glycogen kuchokera ku glucose m'chiwindi, kupondereza gluconeogeneis ndikuwonjezera kutembenuka kwa glucose ochulukirapo kukhala mafuta. Zofanana ndi insulin yaumunthu. Poyerekeza ndi insulin yaumunthu yokhazikika, imadziwika ndi kuyamba mwachangu, kuyambika koyambirira kwa kanthu komanso nthawi yayifupi ya hypoglycemic zochita (mpaka maola 5). Kuyambanso mwachangu (mphindi 15 pambuyo pa kupangika) kumalumikizidwa ndi kuthamanga kwambiri ndipo kumalola kuti liperekedwe nthawi yomweyo musanadye (15 maminiti) - insulin yaumunthu yokhazikika imaperekedwa mphindi 30. Kusankha kwa jakisoni wambiri ndi zinthu zina kungakhudze kuchuluka kwa mayamwidwe ndi kuyamba kwake. Kuchuluka kwake kumawonedwa pakati pa maola 0.5 ndi 2,5, kutalika kwa nthawi ndi maola 3-4.

Zizindikiro. Type 1 shuga mellitus, makamaka ndi tsankho la ma insulin ena, postprandial hyperglycemia yomwe singathe kuwongoleredwa ndi ma insulin ena: kuthana kwambiri kwa insulini kukana (kuthamangitsa kuchepa kwa insulin). Type 2 shuga mellitus - mu milandu kukana m`kamwa hypoglycemic mankhwala, kuphwanya mayamwidwe ena insulin, pa ntchito, matenda wamba.

Contraindication Hypersensitivity, hypoglycemia, insulinoma.

Mlingo Mlingo umatsimikiziridwa payekha kutengera mulingo wa glycemia.

Kusakaniza kwa 25% insulin lispro ndi 75% kuyimitsidwa kwa protamine kuyenera kuperekedwa kokha s / c, nthawi zambiri mphindi 15 musanadye.

Ngati ndi kotheka, mutha kulowa limodzi ndi insulin yokonzekera nthawi yayitali kapena ndi sulfonylureas pakamwa.

Majakisoni amayenera kupangidwa m'ma s, mapewa, matako, matumbo. Masamba a jakisoni ayenera kusinthidwa kuti malo omwewo asagwiritsidwerenso nthawi 1 pamwezi. Ndi s / c makonzedwe, chisamaliro chimayenera kutengedwa kuti musalowe mumtsempha wamagazi.

Odwala omwe ali ndi vuto laimpso komanso / kapena chiwindi, kuchuluka kwa insulin yozungulira kumakulitsidwa, ndipo kufunika kwake kumachepetsedwa, komwe kumafunikira kuwunika moyenera kuchuluka kwa glycemia ndi kusintha kwa insulin.

Zotsatira zoyipa. Thupi lawo siligwirizana (urticaria, angioedema - malungo, kufupika, kuchepa kwa magazi), lipodystrophy, zolakwika zosakhalitsa (nthawi zambiri mwa odwala omwe sanalandire insulin kale), hypoglycemia, hypoglycemic coma.

Bongo. Zizindikiro: ulesi, thukuta, thukuta lotupa, tachycardia, kunjenjemera, njala, nkhawa, paresthesias mkamwa, kutsekemera kwa khungu, kupweteka mutu, kunjenjemera, kusanza, kugona, kugona tulo, mantha, kuthedwa nzeru, kukwiya, zachilendo, kusatsika kwamayendedwe, kusowa kwa mawu ndi masomphenya, chisokonezo, kukomoka kwa hypoglycemic, kupweteka.

Chithandizo: ngati wodwalayo akudziwa, dextrose amalembedwa pakamwa, s / c, iv kapena iv pakamwa jekeseni kapena iv hypertonic dextrose solution.Ndi kukula kwa vuto la hypoglycemic coma, 2040 ml (mpaka 100 ml) wa 40% dextrose solution amawayikira kudzera mu mtsempha kulowa kufikira wodwalayo atatuluka.

Kuchita. Zosagwirizana ndi 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 blockers H₁histamine zolandila.

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

Malangizo apadera. Njira yoyendetsera njira yomwe ikugwiritsidwa ntchito ikuyenera kuonedwa bwino.

Posamutsa odwala kuchokera ku insulin yomwe ikuyenda mwachangu kuchokera ku insulin lispro, kusintha kwakufunikira kungafunike. Kusamutsidwa kwa odwala omwe amalandira insulin tsiku lililonse kuposa 100 IU kuchokera ku mtundu umodzi wa insulin kupita kwa ena ndikulimbikitsidwa kuti ikuchitika kuchipatala.

Kufunika kwa insulin kumatha kuwonjezeka panthawi yomwe matenda opatsirana, ndi nkhawa zam'maganizo, ndi kuchuluka kwa chakudya chamagulu ambiri, pakudya kowonjezereka kwa mankhwala omwe ali ndi vuto la hyperglycemic (mahomoni a chithokomiro, GCS, kulera kwapakamwa, thiazide diuretics).

Kufunika kwa insulin kumatha kuchepa ndi kuchepa kwaimpso komanso / kapena chiwindi, ndi kuchepa kwa kuchuluka kwa chakudya chamagulu m'zakudya, kuwonjezera kuchuluka kwa thupi, panthawi yowonjezera ya mankhwala omwe ali ndi vuto la hypoglycemic (Mao inhibitors, osasankha beta-blockers, sulfonamides).

Chizolowezi chokhala ndi hypoglycemia chimatha kuvulaza kuthekera kwa odwala kutenga nawo mbali mokwanira mumsewu, komanso kukonza makina ndi zida zake.

Odwala omwe ali ndi matenda ashuga amatha kuyimitsa pang'ono hypoglycemia mwa iwo kudzera pakudya shuga kapena zakudya zopatsa mphamvu zamafuta (tikulimbikitsidwa kuti nthawi zonse muzikhala ndi shuga osachepera 20 g). Ndikofunikira kudziwitsa adokotala za hypoglycemia yomwe yasamutsidwa kuti athetse vuto la kufunika kwa kukonza mankhwalawa.

Kufunika kwa insulin nthawi zambiri kumachepera mu trimester yoyamba ya kutenga pakati ndikuwonjezeka kwachiwiri - trimesters yachitatu. Panthawi yobereka komanso pambuyo pawo, kufunika kwa insulin kumatha kuchepa kwambiri.

Kulembetsa boma boma. Kusindikiza kovomerezeka: m'ma 2. M: Medical Council, 2009. - Vol 2, gawo 1 - 568 s., Gawo 2 - 560 s.

Mlingo

Kuyimitsidwa kwa subcutaneous makonzedwe a 100 IU / ml 3 ml

1 ml ya kuyimitsidwa kuli

ntchito yogwira - insulin lispro 100 IU, (3.5 mg)

obwera: sodium hydrogen phosphate heptahydrate, glycerol, phenol fluid, methacresol, protamine sulfate, zinc oxide (malinga ndi Zn ++), sodium hydroxide 10% yothetsera kusintha pH, kapena 10% hydrochloric acid pakusintha pH, madzi a jakisoni.

Kuyimitsidwa kwamtundu woyera, kuyimirira, kusinthidwa kukhala chowonekera, chopanda utoto kapena chosawoneka bwino komanso choyera. Mtengo umasinthidwa mosavuta ndikugwedezeka modekha.

Mimba komanso kuyamwa

Zambiri pa kugwiritsa ntchito insulin lispro pa nthawi ya pakati zimawonetsa kusapezeka kwa vuto la mankhwalawa pa mimba, mkhalidwe wa mwana wosabadwa komanso wakhanda. Pakati pa nthawi yayitali, ndikofunikira kwambiri kuti azisamalira odwala omwe amalandiridwa ndi insulin. Kufunika kwa insulin nthawi zambiri kumachepa mu trimester yoyamba ya kutenga pakati ndikuwonjezeka mu trimesters yachiwiri ndi yachitatu. Nthawi yobadwa pambuyo pokhapokha ndipo mwayamba kubadwa, zofunika za insulin zimatha kugwa kwambiri. Odwala omwe ali ndi matenda ashuga ayenera kudziwitsa dokotala za mimba kapena kukonzekera kwake. Mwa azimayi omwe ali ndi matenda a shuga, kusintha kwa insulin ndi / kapena zakudya kungafunike pakumuyamwa.
Zotsatira zoyipa za insulin lyspro biphasic
Thupi lawo siligwirizana (redness, kutupa, kuyabwa pa malo a jakisoni, angioedema, pruritus yovuta, kupuma movutikira, kuchuluka kwa mtima, kuchuluka kwa thukuta, urticaria, kutentha thupi, kuchepa kwa magazi, kufupika kwamkati), lipodystrophy, edema, zolakwika zosakhalitsa, hypoglycemia, hypoglycemia (kuphatikizapo imfa).

Kuchita kwa insulin lispro biphasic ndi zinthu zina

Lyspro insulin biphasic imakhala yogwirizana ndi mankhwala ena.
Mphamvu ya hypoglycemic ya lyspro biphasic insulin imapangidwa ndi sulfonamides (kuphatikizapo mankhwala a m'kamwa a hypoglycemic, sulfanilamides), carbonic anhydrase inhibitors, monoamine oxidase inhibitors (kuphatikizapo procarbazine, furazolidone, selegiline), angiotensin kutembenuza antioxidants ndi antioxidants, anabolic steroids (kuphatikizapo oxandrolone, stanozolol, methandrostenolone), ma tetracyclines, Captopril, enalapril, b omokriptin, clofibrate, mebendazole, ketoconazole, theophylline, fenfluramine, cyclophosphamide, kukonzekera lifiyamu, quinidine, octreotide, guanethidine, pyridoxine, cholandilira muzikangana wa angiotensin II, ndi chloroquine, kwinini, Mowa ndi etanolsoderzhaschie njira.
Mphamvu ya hypoglycemic ya lyspro biphasic insulin imafooketsedwa ndi somatropin, glucagon, glucocorticosteroids, estrogens, njira zakulera za pakamwa, pang'onopang'ono calcium blockers, thiazide ndi loop diuretics, mahomoni a chithokomiro, sulfin pyrazone, hepatin, sympathomimetic calcium, morphine, chikonga, chamba, phenytoin, chlorprotixen, salbutamol, terbutaline, ritodrin, nikotini acid, H1-histamine receptor blockers, kupanga dnye phenothiazines, isoniazid wa epinephrine.
Beta-blockers, octreotide, reserpine, pentamidine amatha kuwonjezera komanso kufooketsa mphamvu ya hypoglycemic ya lyspro biphasic insulin.
Beta-adrenergic blockers othandizira, clonidine, reserpine, akagwiritsidwa ntchito limodzi ndi biphasic insulin lyspro, amatha kubisala mawonetsedwe a zizindikiro za hypoglycemia.
Ngati kuli kofunikira kugwiritsa ntchito mankhwala okhala ndi lyspro biphasic insulin, muyenera kufunsa dokotala.

Bongo

Ngati mankhwala osokoneza bongo a insulin okhala ndi lyspro biphasic, hypoglycemia imayamba, yomwe imakhala ndi zotsatirazi: thukuta, kupha mphamvu, thukuta, kuchuluka kwa thukuta, tachycardia, palpitations, kunjenjemera, nkhawa, njala, kupweteka pakamwa, kupweteka kwa pakhungu, khungu, wotuwa, kunjenjemera, kusanza, kusowa tulo, kukhumudwa, mantha, kusokonezeka, kusakhazikika pamayendedwe, zosadziwika bwino, malankhulidwe ndi masomphenya, chisokonezo, kupsinjika, kukomoka kwa chifuwa (kupha kutheka TH zotsatira).Mwachitsanzo, pazochitika zina, mwachitsanzo, ngati matendawo atenga nthawi yayitali kapena kuwunika kwambiri matenda ashuga, Zizindikiro zakutsogolo kwa hypoglycemia zimatha kusintha.
Hypoglycemia wofatsa nthawi zambiri imatha kuyimitsidwa ndikuwonjezera shuga kapena shuga, ndipo mungafunike kusintha mlingo wa insulin, zolimbitsa thupi kapena zakudya. Malangizo a hypoglycemia wolimbitsa amatha kuchitika pogwiritsa ntchito subcutaneous kapena mu mnofu makonzedwe a glucagon, ndikulowetsa chakudya champhamvu kwambiri. Miyezo yambiri ya hypoglycemia imayimitsidwa ndi kutsekeka kapena kutsekeka kwa glucose kapena kulowerera kwamitsempha yotsekemera, ndi hypoglycemic coma, 20 - 40 ml (mpaka 100 ml) ya 40% dextrose yovulaza jekeseni mpaka wodwala atatuluka. Pambuyo pozindikira, wodwalayo ayenera kupatsidwa chakudya chomwe chili ndi zakudya zambiri kuti asayambenso kukhudzidwa kwa hypoglycemia. Kuphatikiza chakudya chamagulu ochulukirapo komanso kuwunika wodwala kungafunike, popeza kuyambiranso kwa hypoglycemia ndikotheka.

Makhalidwe wamba

Dzina lamalonda lamankhwala ndi Humalog Mix. Zimakhazikika pa analogue ya insulin ya anthu. Katunduyo ali ndi vuto la hypoglycemic, amathandizira kuthamanga kwa glucose, komanso amawongolera momwe amasulidwire. Chidacho ndi yankho la magawo awiri.

Kuphatikiza pa chinthu chomwe chimagwira, mawonekedwewo ali ndi zinthu monga:

• metacresol
• glycerol
• sodium hydroxide mwanjira yothetsera (kapena hydrochloric acid),
• zinc oxide
• sodium heptahydrate hydrogen phosphate,
• madzi.

Kuti mugwiritse ntchito mankhwalawa, muyenera kupangira adokotala malangizo oyenera. Sizovomerezeka kusintha mlingo kapena ndandanda yogwiritsira ntchito nokha.

Pharmacological zochita ndi zikuwonetsa

Zochita za insulin yamtunduwu ndizofanana ndi mankhwala ena okhala ndi insulin. Zimalowa mthupi, chinthu chogwira ntchito chimalumikizana ndi nembanemba yama cell, motero zimapangitsa kuyamwa kwa glucose.

Njira ya mayamwidwe ake kuchokera ku plasma ndikugawa mkati mwa minofu imathandizira. Awa ndi gawo la insulin Lizpro mu malamulo a shuga.

Gawo lachiwiri lazomwe limakhudza thupi ndi kuchepa kwa kupanga kwa shuga m'maselo a chiwindi. Mwanjira iyi, shuga wambiri samalowa m'magazi. Malinga ndi izi, titha kunena kuti mankhwala a Humalog ali ndi hypoglycemic mbali ziwiri.

Insulin yamtunduwu imachita zinthu mwachangu ndipo imayambitsa mphindi 15 pambuyo pa kubayidwa. Izi zikutanthauza kuti izi zimatengedwa ndi thupi mwachangu. Chifukwa cha izi, amaloledwa kugwiritsa ntchito mankhwalawa pafupifupi asanadye.

Mlingo wa mayamwidwe umakhudzidwa ndi tsamba la jakisoni. Chifukwa chake, muyenera kuchita jakisoni, poganizira malangizo a mankhwalawo.

Ndikofunikanso kutsatira malingaliro a Lizpro insulin posankha kugwiritsa ntchito. Mankhwalawa ali ndi mphamvu kwambiri, chifukwa chake kugwiritsidwa ntchito kumaloledwa pokhapokha zikuwonetsa. Ngati mungagwiritse ntchito mankhwalawa mosafunikira, mutha kuyambitsa zowonongeka zambiri ku thanzi lanu.

Zisonyezo zakusankhidwa kwa Humalog zikuphatikiza:

• mtundu woyamba wa matenda ashuga
• hyperglycemia, zomwe zimachitika zomwe sizigwirizana ndi kugwiritsa ntchito mankhwala ena,
• mtundu wachiwiri wa matenda a shuga (posakhalitsa chifukwa chogwiritsa ntchito mankhwala osokoneza pakamwa),
• opaleshoni yopanga odwala matenda ashuga,
• kupezeka kwa mwatsatanetsatane matenda omwe amasokoneza shuga,
• mtundu wina wa insulin tsankho.

Koma ngakhale pali zisonyezo zakumwa mankhwalawa, adotolo ayenera kuunika wodwalayo ndikuwonetsetsa kuti palibe zotsutsana ndi mtundu wa mankhwala.

Kutulutsa mawonekedwe ndi kapangidwe kake

Humalog imapangidwa ngati njira yankho la intravenous (iv) ndi subcutaneous (s / c) kayendetsedwe: kopanda utoto, wowonekera (makatiriji 3 ml, phukusi lanyumba ya 5 ma cartridge, mukatoni kanyimbo 1 1 paketi, mu masentensi a QuickPen) makatoni okhala ndi 3 ml ya yankho amataikidwa m'makatoni a ma cholembera asanu).

Muli 1 ml ya yankho:

• yogwira mankhwala: insulin lispro - 100 ME,
• othandizira: madzi a jakisoni - mpaka 1 ml, yankho la sodium hydroxide 10% ndi (kapena) yankho la hydrochloric acid 10% - mpaka pH 7-8, sodium hydrogen phosphate heptahydrate - 0,00188 g, zinc oxide - ya Zn ++ 0.000 0197 g , metacresol - 0,00315 g, glycerin (glycerol) - 0,016 g.

Mlingo ndi makonzedwe

Mlingo wa mankhwalawa amatsimikiziridwa ndi dokotala payekhapayekha, poganizira kuchuluka kwa shuga m'magazi.

Njira yothetsera vutoli ndi jekeseni wa iv - ngati kuli kotheka, pazochitika pachimake, ketoacidosis, pakati pa ntchito ndi nthawi ya postoperative, s / c - mawonekedwe a jakisoni kapena infusions (kudzera pampu ya insulin) pamimba, matako, m'chiuno kapena phewa, osati kulola kuti mankhwala alowe m'mitsempha yamagazi. Masamba a jakisoni amasinthidwa nthawi iliyonse, kuti malo omwewo sagwiritsidwe ntchito zoposa 1 nthawi pamwezi. Pambuyo pa kutsata, tsamba la jakisoni silingathetsedwenso.

Munthawi zonsezi, njira yoyendetsera amakhazikitsidwa payokha. Kukhazikitsidwa kumachitika musanadye chakudya, koma kugwiritsa ntchito mankhwalawa kumaloledwa pambuyo chakudya.

Kukonzekera kwa mankhwala

Musanagwiritse ntchito, yankho lake limayang'anidwa chifukwa cha zinthu, phokoso, madontho komanso makulidwe. Gwiritsani ntchito njira yokhayo yopanda utoto ndi yowoneka bwino kutentha.

Pamaso pa jekeseni, tsukani manja anu bwino, sankhani ndikupukuta malowo. Kenako, kachipuyo kamachotsedwa ndi singano, khungu limakokedwa kapena kusungidwa mu khola lalikulu, singano imayilowetsedwa ndipo batani limakanikizidwa. Pambuyo pake, singano imachotsedwa ndipo kwa masekondi angapo malo a jakisawo amapanikizidwa mosamala ndi swab thonje. Pogwiritsa ntchito singano yodzitchinjiriza, imatembenuzidwa ndikuitaya.

Musanagwiritse ntchito Humalog mu cholembera-injector (jakisoni), QuickPen ayenera kuwerenga malangizo kuti agwiritse ntchito.

Jakisoni wa IV amachitika motsatira chizolowezi chazachipatala, mwachitsanzo, jakisoni wa IV Kuwunikira pafupipafupi kuchuluka kwa shuga m'magazi ndikofunikira.

Kukhazikika kwa kulowetsedwa ndi kuchuluka kwa 0-1-1 IU pa 1 ml ya insulin lispro mu 5% dextrose kapena 0,9% sodium chloride njira yothetsera masiku 2 imaperekedwa ngati imasungidwa kutentha kwa chipinda.

Pochita ma infusions a scet, mapampu a Disetronic ndi Minimed opangidwira insulin infusions angagwiritsidwe ntchito. Ndikofunikira kutsatira mosamalitsa malangizo a wopanga ndikutsatira malamulo a asepticism mukalumikiza dongosolo. Masiku 2 aliwonse amasintha dongosolo la kulowetsedwa. Kulowetsedwa ndi gawo la hypoglycemic kuyimitsidwa mpaka kuthe. Pankhani yokhala ndi shuga wambiri m'magazi, wodwalayo ayenera kufunsa dokotala kuti agwirizane ndikuletsa kulowetsedwa kwa insulin.

Kukwera msanga m'magazi a glucose kumatha kuonedwa ndi dongosolo lotsekeka la kulowetsedwa kapena kupopera mphamvu. Ngati kuphwanya kwa insulin yobereka kumayikiridwa ngati chifukwa chowonjezera kuchuluka kwa shuga, wodwalayo ayenera kutsatira malangizo a wopanga ndikudziwitsa adokotala (ngati kuli kofunikira).

Humalog mukamagwiritsa ntchito pampu sangaphatikizidwe ndi ma insulini ena.

Cholembera cha insulin ya QuickPen chili ndi 3 ml ya mankhwalawa ndi zochitika za 100 IU mu 1 ml. 1-60 mayunitsi a insulin amatha kuperekedwa pa jekeseni iliyonse. Mlingo ukhoza kukhazikitsidwa ndi kulondola kwa chinthu chimodzi. Ngati mayunitsi ambiri akhazikitsidwa, mlingowo ungakonzedwe popanda kutaya insulin.

Jakisoni amayenera kugwiritsidwa ntchito ndi wodwala m'modzi yekha, singano zatsopano ziyenera kugwiritsidwa ntchito pobayira iliyonse. Osagwiritsa ntchito jakisoni ngati chilichonse mwa mbali zake chiwonongeka kapena chosweka. Wodwalayo nthawi zonse azinyamula jakisoni wopopera kuti atayika kapena kuwonongeka.

Odwala omwe ali ndi vuto lowona kapena kutayika kwamaso samalimbikitsidwa kugwiritsa ntchito jakisoni popanda kuthandizidwa ndi anthu owoneka bwino omwe amaphunzitsidwa kuti azigwiritsa ntchito.

Jekeseni aliyense asanafike, ndikofunikira kutsimikizira kuti tsiku lotha ntchito lomwe lawonetsedwa pa cholembapo sichinathe ndipo kuti mtundu woyenera wa insulin uli ndi jakisoni. Pankhaniyi, sikulimbikitsidwa kuti muchepetse chizindikiro.

Mtundu wa batani lothamanga la cholembera cha QuickPen ndi imvi, umafanana ndi mtundu wa Mzere palemba lawo ndi mtundu wa insulin yomwe imagwiritsidwa ntchito.

Musanagwiritse ntchito jakisoni, muyenera kuonetsetsa kuti singanoyo imalumikizidwa kwathunthu ndi iyo. Mukatha kugwiritsa ntchito, singano imachotsedwa ndikuitaya. Cholembera sichingatheke kusungidwa ndi singano yolumikizidwa ndi iyo, chifukwa izi zimapangitsa kuti thovu la mpweya lipange cartridge ya mankhwala.

Popereka mankhwala opitilira muyeso 60, jakisoni awiri amachitidwa.

Kuti muwone zotsalira za insulini mu katiriji, muyenera kuloza jakisoni ndi nsonga ya singano kuti muwone kuchuluka kwa insulin yomwe ili pachikwangwani chonyamula cartridge. Chizindikiro ichi sichikugwiritsidwa ntchito kukhazikitsa mlingo.

Kuti muchotse kapu kuchokera ku jakisoni, muyenera kukoka. Ngati pali zovuta zilizonse, zungulirani mosamala nthawi yomweyo ndikuzikoka, kenako ndikukoka.

Nthawi iliyonse musanalowe jakisoni, amawunikira insulin, popeza popanda iwo mutha kupeza insulin yochepa kwambiri kapena yambiri. Kuti muwone, chotsani singano yakunja ndi yamkati ya singano, potembenuza batani la mlingo, mayunitsi awiri akhazikitsidwa, jekeseni amawongoleredwa kumtunda ndikugogoda pa cholembera kuti mpweya wonse usonkhane kumtunda. Kenako akanikizire batani la mlingo mpaka litayima ndipo nambala 0 ipezeka pazenera la dotolo. Kuyika batani m'malo opezekanso, pang'onopang'ono kuwerengera mpaka 5, panthawiyi insulin ikayamba kuwonekera kumapeto kwa singano. Ngati tsenga la insulin silikuwoneka, singano imasinthidwa ndi yatsopano ndikuyambiranso.

Kupereka mankhwala

• chotsani chipewa mu syringe cholembera
• ndi swab wothira mowa, pukuta chotupa cha kumapeto kwa chotengera,
• ikani singano mu kapu mwachindunji pamphepete mwa jakisoni ndikuyinya mpaka itaphatikizika kwathunthu,
• potembenuza batani la mlingo, chiwerengero chofunikira chayikidwa,
• chotsani chovalacho ndi singano ndikuchiyika pansi pa khungu.
• ndi chala chanu, kanikizani batani la mlingo mpaka litayima kwathunthu. Kuti mulowetse mlingo wathunthu, gwiritsani batani ndipo pang'onopang'ono muwerenge mpaka 5,
• singano imachotsedwa pakhungu.
• onani chizindikiro - ngati chili ndi nambala 0, mankhwalawo alembetsedwa kwathunthu,
• ikani chotsekera chakunja pa singano ndikuchotsa kumakina, kenako nkutaya,
• ikani chipewa pa syringe cholembera.

Ngati wodwala akukayikira kuti wapereka mlingo wonse, sayenera kupatsanso mlingo wobwereza.

Zotsatira zoyipa

• Nthawi zambiri: hypoglycemia (mu milandu yoopsa, imatha kuyambitsa kukhumudwa kwa hypoglycemic coma, mwapadera - kufa),
• zotheka: lipodystrophy, thupi lawo siligwirizana - kutupa, redness kapena kuyabwa pamalo jakisoni,
• kawirikawiri: zomwe thupi limatulutsa - kuchuluka thukuta, tachycardia, kutsika magazi, kufupika, malungo, angioedema, urticaria, kuyabwa mthupi lonse.

Malangizo apadera

Kusamutsa wodwala kupita ku dzina lina kapena mtundu wa insulin kumachitika moyang'aniridwa ndi achipatala. Mukasintha njira zopangira, mitundu, mtundu, mtundu ndi / kapena ntchito, kusintha kwa mlingo kungafunike.

Zizindikiro zomwe zikuwonetsa kukula kwa hypoglycemia sizingatchulidwe komanso kusakhudzidwa kwambiri ndi chithandizo cha insulin, kukhalapo kwa nthawi yayitali ndi matenda a shuga, matenda amagetsi amthupi motsutsana ndi matenda osokoneza bongo, komanso munthawi yomweyo kugwiritsa ntchito mankhwala, monga beta-blockers.

Zizindikiro zoyambirira za hypoglycemia mwa odwala omwe ali ndi vuto la hypoglycemic atasintha kuchokera ku insulin yochokera ku nyama kupita ku insulin yaumunthu akhoza kukhala ocheperako kapena osiyana ndi omwe anali nawo ndi insulin yakale panthawi yamankhwala.

Pankhani ya hyperglycemic kapena hypoglycemic yomwe sinakonzeke bwino, kukulitsa chiyembekezo, chikomokere, kapena kumwalira kumatha. Kugwiritsa ntchito mankhwalawa osakwanira kapena kusiya kumwa mankhwala, makamaka mtundu wa matenda a shuga I, kungayambitse kukula kwa hyperglycemia ndi matenda ashuga a ketoacidosis, omwe angawononge moyo wa wodwalayo.

Mu kuperewera kwa aimpso ndi hepatic, kumatha kuchepetsa kufunika kwa insulin, komwe kumalumikizidwa ndi kuchepa kwa insulin metabolism ndi njira ya gluconeogeneis. Kulephera kwa chiwindi kosatha (chifukwa cha kukana insulini), kupsinjika, matenda opatsirana, kuchuluka kwa chakudya mu chakudya, kufunika kwa insulin kumatha kuchuluka.

Pankhani ya kusintha kwazomwe mumadya komanso kuchuluka kwa zochitika zolimbitsa thupi, kusintha kwa mankhwala kungafunike. Mukamachita masewera olimbitsa thupi mutatha kudya, ndizotheka kuwonjezera chiopsezo cha hypoglycemia. Chifukwa cha pharmacodynamics yamankhwala osokoneza bongo a insulin analogues, hypoglycemia imatha kuyamba jekeseni pambuyo pogwiritsa ntchito insulin yaumunthu.

Mukamayambitsa kukonzekera kwa insulin ndi kuchuluka kwa 40 IU mu 1 ml pakanema, sikungatheke kupeza insulin kuchokera ku cartridge ndi insulin ndende ya 100 IU mu 1 ml yogwiritsira ntchito syringe kuperekera insulin ndi kuchuluka kwa 40 IU mu 1 ml.

Kugwiritsa ntchito munthawi yomweyo kukonzekera insulin ndi mankhwala a gulu la thiazolidinedione kumawonjezera mwayi wokhala ndi vuto la mtima komanso vuto la mtima, makamaka motsutsana ndi maziko a mtima ndi mawonekedwe a mtima.

Odwala panthawi ya chithandizo ayenera kusamala poyendetsa magalimoto ndikuchita zinthu zowopsa zomwe zimafuna chidwi chochulukirapo komanso kuthamanga kwa zochitika zama psychomotor.

Kuyanjana kwa mankhwala osokoneza bongo

Mphamvu ya mankhwala / zinthu pa insulin lispro ndi mankhwala osakanikirana:

• phenothiazine derivatives, nicotinic acid, lithiamu carbonate, isoniazid, diazoxide, chlorprotixene, thiazide diuretics, triceclic antidepressants, beta-2-adrenergic agonists (terbutaline, salbutamol, ritodrin, etc.), danazoleroidones kuopsa kwa mphamvu yake yamatsenga,
• angiotensin II receptor antagonists, octreotide, angiotensin - kutembenuza ma enzyme inhibitors (enapril, Captopril), ma antidepressants (monoamine oxidase inhibitors), mankhwala a sulfanilamide, salicylates (acetylsalicylic acid, etc., mankhwala a phencygencotic, hypogly ethanol ndi ethanol-mankhwala, beta-blockers: kuonjezera zovuta zake hypoglycemic kwenikweni.

Lyspro insulin yosakanikirana ndi insulin ya nyama.

Musanamwe mankhwala ena, ndikofunikira kukaonana ndi dokotala. Pomupangira, mankhwalawa angagwiritsidwe ntchito limodzi ndi insulin yaumunthu wokhala pakanthawi kake kapena mitundu yamkamwa ya sulfonylureas.

The fanizo la Humalog ndi Iletin I wokhazikika, Iletin II wokhazikika, Inutral SPP, Inutral HM, Farmasulin.

Mankhwala Okhala Pamalo a Pharmacy

Yoperekedwa ndi mankhwala.

Kodi mwapeza cholakwika m'mawuwo? Sankhani ndikusindikiza Ctrl + Lowani.

Ngakhale kuti asayansi adakwanitsa kubwereza molekyulu yonse ya insulin, yomwe imapangidwa m'thupi la munthu, zochita za mahomoniwo zidasinthiratu chifukwa nthawi yomwe amafunika kunyamula magazi. Mankhwala oyamba osinthika anali insulin Humalog. Imayamba kugwira ntchito patangodutsa mphindi 15 jakisoni, choncho shuga yochokera m'mwaziyo imasamutsidwira minofu yake munthawi yake, ndipo ngakhale hyperglycemia yochepa siyimachitika.

Ndikofunikira kudziwa! Nkhani yatsopano yomwe ikulangizidwa ndi ma endocrinologists a Kuwunika Kwachisawawa Kokulu! Ndi zofunika tsiku lililonse.

Poyerekeza ndi ma insulins omwe adapangidwa kale, Humalog ikuwonetsa zotsatira zabwino: mwa odwala, kusinthasintha kwa tsiku ndi tsiku kwa shuga kumachepetsedwa ndi 22%, magirisi am'magazi amayenda bwino, makamaka masana, ndipo mwayi wa kuchepa kwambiri kwa hypoglycemia umachepa. Chifukwa chachangu, koma chokhazikika, insulin iyi imagwiritsidwa ntchito kwambiri mu shuga.

Malangizo achidule

Malangizo ogwiritsira ntchito insulin Humalog ndiwosakhazikika, ndipo magawo omwe amafotokoza zoyipa ndi mayendedwe akugwiritsidwa ntchito amakhala ndi zigawo zingapo. Kufotokozera kwakutali komwe kumayendera limodzi ndimankhwala ena kumadziwika ndi odwala ngati chenjezo lokhuza kuwopsa kwawo. M'malo mwake, zonse ndizofanana: langizo lalikulu, latsatanetsatane - umboni wa mayesero ambiri kuti mankhwalawa adapirira

Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale

Matenda a shuga ndi omwe amayambitsa pafupifupi 80% yonse yamikwingwirima ndi kuduladula. Anthu 7 mwa anthu 10 amafa chifukwa cha mitsempha ya mtima kapena ubongo. Pafupifupi nthawi zonse, chifukwa chomaliza chomaliza ndi chimodzimodzi - shuga wamwazi.

Shuga akhoza ndipo amayenera kugwetsedwa, apo ayi. Koma izi sizichiritsa matendawa, koma zimangothandiza kulimbana ndi kufufuza, osati zomwe zimayambitsa matendawa.

Mankhwala okhawo omwe amavomerezeka pamankhwala othandizira odwala matenda ashuga komanso amagwiritsidwa ntchito ndi ma endocrinologists pantchito yawo ndi awa.

Kugwiritsa ntchito bwino kwa mankhwalawa, kuwerengera malinga ndi njira yokhazikika (kuchuluka kwa odwala omwe achiwonjezere kuchuluka kwa odwala omwe ali pagulu la anthu 100 omwe adachitiridwa chithandizo):

• Matenda a shuga - 95%
• Kuthetsa kwa mitsempha thrombosis - 70%
• Kuthetsa kwa kugunda kwamtima kwamphamvu - 90%
• Kuthana ndi kuthamanga kwa magazi - 92%
• Kulimbitsa tsiku, kukonza kugona usiku - 97%

Opanga si bungwe lazamalonda ndipo amalipidwa ndi chithandizo cha boma. Chifukwa chake, tsopano wokhala aliyense ali ndi mwayi.

Humalogue wavomerezedwa kuti agwiritse ntchito zaka 20 zapitazo, ndipo tsopano sizabwino kunena kuti insuliniyi ndi yotetezeka pa mlingo woyenera. Ivomerezeka kuti igwiritsidwe ntchito ndi akulu ndi ana, itha kugwiritsidwa ntchito pazochitika zonse, limodzi ndi kusowa kwa mahomoni: mtundu 1 ndi mtundu 2 wa shuga, opaleshoni ya opaleshoni ya m'mimba.

Zambiri pa Humalogue:

Zina mwazotsatira zoyipa, hypoglycemia ndi thupi lawo siligwirizana nthawi zambiri zimawonedwa (1-10% ya odwala matenda ashuga). Osakwana 1% odwala amakhala ndi lipodystrophy pamalo opangira jekeseni. Makulidwe azinthu zina zoyipa amakhala ochepera 0.1%.

Chofunika Kwambiri Zokhudza Humalog

Kunyumba, Humalog imayendetsedwa popanda kugwiritsira ntchito cholembera kapena. Ngati matenda oopsa a hyperglycemia atachotsedwa, mankhwala osokoneza bongo amathandizanso kuchipatala. Pankhaniyi, kuthana ndi shuga pafupipafupi ndikofunikira kupewa bongo.

Chithandizo chogwira ntchito cha mankhwala ndi insulin lispro. Amasiyana ndi mahomoni amunthu pakupanga ma amino acid mu molekyulu. Kusintha koteroko sikulepheretsa ma cell receptors kuzindikira mahomoni, chifukwa chake amapatsira shuga mwa iwo okha. Chiwonetserochi chimakhala ndi ma insulin monomers okha - mamolekyulu osalumikizana. Chifukwa cha izi, imakamizidwa mwachangu komanso moyenera, imayamba kuchepetsa shuga mwachangu kuposa insulin yachilendo.

Humalog ndi mankhwala osokoneza bongo kuposa, mwachitsanzo, kapena. Malinga ndi gulu, amatchulidwa ndi ma insulin omwe ali ndi ultrashort action. Kukhazikika kwa ntchito yake kumachitika mwachangu, pafupifupi mphindi 15, kotero odwala matenda ashuga sayenera kudikirira mpaka mankhwalawo atagwira, koma mutha kukonzekera chakudya mukangobaya jakisoni. Chifukwa cha kufupika kwakanthawi, kumakhala kosavuta kukonza zakudya, ndipo chiopsezo cha kuiwala chakudya jakisoni itachepa.

Kuti muthane ndi vuto labwino la glycemic, othandizira othandizira ayenera kuphatikizidwa ndi kuvomerezedwa. Chokha chosiyana ndi kugwiritsa ntchito pampu ya insulin nthawi zonse.

Sankhani

Mlingo wa Humalog umatengera zinthu zambiri ndipo umatsimikiziridwa payekhapayekha kwa aliyense wodwala matenda ashuga. Kugwiritsa ntchito njira zoyenera sikulimbikitsidwa, popeza zimakulitsa kubwezeretsanso shuga. Ngati wodwala amatsatira zakudya zamafuta ochepa, mlingo wa Humalog umakhala wocheperako kuposa momwe oyang'anira angapangire. Pankhaniyi, tikulimbikitsidwa kugwiritsa ntchito insulin yofulumira.

Hormashort ya Ultrashort imapereka mphamvu kwambiri. Mukasinthira ku Humalog, mlingo wake woyambirira amawerengedwa ngati 40% ya insulin yayifupi.Malinga ndi zotsatira za glycemia, mlingo umasinthidwa. Chofunikira pakukonzekera mkate uliwonse ndimagawo 1-1,5.

Jekeseni njira

Chakudya chimayalidwa chakudya chilichonse chisanachitike. osachepera katatu patsiku . Pankhani ya shuga wambiri, mawonekedwe okhathamira pakati pa jakisoni wamkulu amaloledwa. Malangizo ogwiritsira ntchito akutsimikizira kuwerengera kuchuluka kwa insulini yochokera pamafuta omwe akukonzekera chakudya chotsatira. Pafupifupi mphindi 15 ayenera kuchokera jakisoni kupita chakudya.

Malinga ndi ndemanga, nthawi ino nthawi zambiri zimakhala zochepa, makamaka masana, pomwe insulin kukana imakhala yotsika. Mlingo wa mayamwidwe ndi munthu payekhapayekha, umatha kuwerengeka pogwiritsa ntchito kuchuluka kwa shuga m'magazi pambuyo pobayidwa. Ngati kutsitsa kwa shuga kumawonedwa mwachangu kuposa momwe malangizowo amafunikira, nthawi yomwe chakudya chisanachitike iyenera kuchepetsedwa.

Humalog ndi imodzi mwamankhwala omwe amafulumira kwambiri, motero ndikofunikira kugwiritsa ntchito ngati thandizo ladzidzidzi kwa odwala matenda ashuga ngati wodwala ali pachiwopsezo.

Nthawi yogwira (yochepa kapena yayitali)

Peak ya insulin ya ultrashort imawonedwa patatha mphindi 60 kuchokera pakukhazikitsa. Kutalika kwa zochita zimatengera mlingo; kukula kwake ndikutalika kwa shuga, pafupifupi - pafupifupi maola 4.

Kusakaniza kwa Humalog 25

Kuti muwone molondola momwe Humalog ikuyendera, shuga ayenera kuyesedwa pambuyo pa nthawi imeneyi, nthawi zambiri izi zimachitika chakudya chotsatira chisanachitike. Miyeso yoyambirira imafunikira ngati hypoglycemia ikukayikira.

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 - Endocrinology Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsiratu matenda ashuga. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wapanga kukhazikitsidwa komwe kumavomerezana ndi kukwera mtengo kwa mankhwalawa. Ku Russia, odwala matenda ashuga mpaka Marichi 2 nditha kuipeza - Kwa ma ruble 147 okha!

Kutalika kwakanthawi kwa Humalog si koyipa, koma mwayi wa mankhwalawa. Tikuthokoza, odwala omwe ali ndi matenda osokoneza bongo sakhala ndi vuto la hypoglycemia, makamaka usiku.

Kusakaniza Kwa Humalog

Kuphatikiza pa Humalog, kampani yopanga zamankhwala Lilly France imatulutsa Humalog Remix. Ndiosakanikirana kwa lyspro insulin ndi protamine sulfate. Chifukwa cha kuphatikiza uku, nthawi yoyambira ya mahomoni imakhalabe mwachangu, ndipo nthawi yochitapo kanthu imawonjezeka kwambiri.

Kusintha kwa Humalog kumapezeka mu 2indi:

Ubwino wokhawo wa mankhwalawa ndi regimen yosavuta. Kulipira shuga kwa odwala matenda ashuga ndi kagwiritsidwe ntchito kwawo ndi koipa kuposa kukhala ndi mankhwalawa a insulin komanso kugwiritsa ntchito mtundu wina wa Humalog ana Humalog Mix sagwiritsidwa ntchito .

Insulin iyi imayikidwa:

1. Anthu odwala matenda ashuga omwe sangathe kuwerengera payekha payekha kapena kupanga jakisoni, mwachitsanzo, chifukwa cha kusawona bwino, ziwalo kapena kugwedezeka.
2. Odwala omwe ali ndi matenda amisala.
3. Okalamba odwala omwe ali ndi zovuta zambiri za matenda ashuga komanso kuperewera koyipa kwa chithandizo ngati sakufuna kuphunzira.
4. Anthu odwala matenda ashuga omwe ali ndi matenda amtundu wa 2, ngati mahomoni awo akupangidwabe.

Kuchiza matenda a shuga ndi Humalog Remix kumafuna kudya mosasangalatsa yunifolomu, zakudya zazovomerezeka pakati pa chakudya. Amaloledwa kudya mpaka 3 XE pa chakudya cham'mawa, mpaka 4 XE pachakudya chamadzulo komanso chamadzulo, pafupifupi 2 XE pachakudya chamadzulo, ndi 4 XE asanagone.

Ma Analogi a Humalog

Lyspro insulin monga chinthu chogwira imangopezeka mu Humalog yoyambayo. Mankhwala osokoneza bongo ndi (ozikidwa pa aspart) ndi (glulisin). Zida izi ndizothandizanso pofupikitsa, zilibe kanthu kuti musankhe iti. Zonse zimalekeredwa bwino ndipo zimapereka shuga msanga.Monga lamulo, zokonda zimaperekedwa kwa mankhwalawa, omwe amatha kupezeka kwaulere kuchipatala.

Kusintha kuchokera ku Humalog kupita ku analogue yake kungakhale kofunikira pakakhala zovuta zina. Ngati wodwala matenda ashuga amatsatira zakudya zamafuta ochepa, kapena amakhala ndi hypoglycemia, ndizosavuta kugwiritsa ntchito anthu m'malo mwa insulin.

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.

DNA imabweretsanso insulin ya anthu.
Kukonzekera: HUMALOG®
The yogwira mankhwala: insulin lyspro
ATX Encoding: A10AB04
KFG: Insulin yofulumira ya anthu
Nambala yolembetsa: P. 015490/01
Tsiku lolembetsa: 02.02.04
Mwini reg. acc: LILLY FRANCE S.A.S.

Njira yothetsera jakisoni ndi yowonekera, yopanda utoto.

1 ml
insulin lispro *
100 IU

Omwe amathandizira: glycerol, zinc oxide, sodium hydrogen phosphate, m-cresol, madzi d / ndi, hydrochloric acid yankho la 10% ndi sodium hydroxide solution ya 10% (kupanga pH yofunikira).

3 ml - makatoni (5) - matuza (1) - mapaketi a makatoni.

* Dongosolo la mayiko ena omwe siali eni ake omwe amavomerezedwa ndi WHO, ku Russian Federation, matchulidwe a dzina lapadziko lonse - insulin lispro amavomerezedwa.

Kufotokozera kwa mankhwalawa kumatengera malangizo ovomerezeka omwe angagwiritsidwe ntchito.

Pharmacological kanthu Humalog

DNA imabweretsanso insulin ya anthu. Amasiyana ndi omwe amasinthidwa motsatizana mwa ma amino acid m'malo 28 ndi 29 a insulin B.

Choyambitsa chachikulu cha mankhwalawa ndi kuyamwa kwa kagayidwe kazakudya. Kuphatikiza apo, ili ndi anabolic zotsatira. Mu minofu ya minofu, pali kuchuluka kwa glycogen, mafuta acid, glycerol, kuchuluka kwa mapuloteni komanso kuwonjezereka kwa kumwa ma amino acid, koma nthawi yomweyo kumachepa mu glycogenolysis, gluconeogeneis, ketogeneis, lipolysis, proteinabolism ndi kutulutsidwa kwa ma amino acid.

Odwala omwe ali ndi mtundu woyamba wa 2 ndi mtundu wa 2 shuga, akamagwiritsa ntchito insulin lyspro, hyperglycemia yomwe imachitika chakudya itatha amachepetsa kwambiri poyerekeza ndi insulin yaumunthu. Kwa odwala omwe amalandira ma insulin achidule komanso ofunika, amafunika kusankha kuchuluka kwa ma insulin onse kuti tsiku lililonse azikhala ndi shuga.

Monga momwe akukonzekera insulin yonse, kutalika kwa nthawi ya lyspro insulin kumatha kukhala kosiyanasiyana mwa odwala kapena nthawi zosiyanasiyana wodwala yemweyo ndipo zimatengera mlingo, malo a jakisoni, magazi, kutentha kwa thupi ndi zochitika zolimbitsa thupi.

Mankhwala a lyspro insulin mwa ana ndi achinyamata ali ofanana ndi omwe amawonekera mwa akulu.

Odwala omwe ali ndi matenda a shuga a 2 alandila Mlingo wambiri wa sulfonylurea, kuwonjezera kwa insulin kumapangitsa kutsika kwa hemoglobin wa glycosylated.

Mankhwala a Lyspro insulin odwala omwe ali ndi vuto la mtundu woyamba 1 komanso 2 amaperekedwera limodzi ndi kuchepa kwa ziwopsezo za nocturnal hypoglycemia.

Kuyankha kwa glucodynamic ku isulin lispro sikudalira kugwira ntchito kwa impso kapena chiwindi.

Lyspro insulin yawonetsedwa kuti imakhala yofanana ndi insulin yaumunthu, koma zochita zake zimachitika mwachangu kwambiri ndikukhalitsa kwakanthawi.

Lyspro insulin imadziwika ndi kuyamba mwachangu (pafupifupi mphindi 15), monga Ili ndi mayamwidwe ambiri, ndipo izi zimakupatsani mwayi woti mulowe musanadye (0-15 mphindi musanadye), mosiyana ndi insulin yachilendo (mphindi 30-45 musanadye). Lyspro insulin imakhala ndi nthawi yofupikirako (maola 2 mpaka 5) poyerekeza ndi insulin ya anthu wamba.

Pharmacokinetics wa mankhwala.

Zogulitsa ndi kugawa

Pambuyo pakuyang'anira sc, insulin Lyspro imatengedwa mwachangu ndikufika ku Cmax m'madzi a m'magazi pambuyo pa mphindi 30-70. Vd ya insulin lyspro ndi insulin wamba ya anthu ndi ofanana ndipo ali mgulu la 0.26-0.36 l / kg.

Ndi sc makonzedwe a T1 / 2 a insulin, lyspro ili pafupifupi ola 1. Odwala omwe ali ndi impso ndi hepatic insufficiency amakhala ndi mwayi wambiri wolowetsa lyspro insulin poyerekeza ndi masiku onse a insulin.

Mlingo ndi njira ya mankhwala.

Dokotala amawerengera aliyense payekha, kutengera zosowa za wodwalayo. Humalog imatha kuperekedweratu musanadye, ngati kuli kotheka - mutangodya.

Kutentha kwa mankhwala omwe amaperekedwa kuyenera kukhala kutentha kwambiri.

Humalog imayendetsedwa sc m'njira ya jakisoni kapena mawonekedwe a sc kulowetsedwa pogwiritsa ntchito insulin pump. Ngati ndi kotheka (ketoacidosis, matenda owopsa, nthawi pakati pa opaleshoni kapena nthawi ya postoperative) Humalog ikhoza kulowa mkati / mkati.

SC iyenera kuperekedwa kwa phewa, ntchafu, matako, kapena pamimba. Masamba a jakisoni ayenera kusinthidwa kuti malo omwewo asagwiritsidwerenso nthawi 1 pamwezi. Mukamayambitsa mankhwalawa Humalog, chisamaliro chiyenera kutengedwa kuti mupewe magazi. Pambuyo pa jakisoni, tsamba la jakisidwe siliyenera kutenthedwa. Wodwala ayenera kuphunzitsidwa njira yolondola ya jakisoni.

Malangizo oyendetsera mankhwalawa Humalog

Kukonzekera mawu oyamba

Yankho la mankhwalawa Humalog liyenera kukhala loonekera komanso lopanda utoto. Njira yothira ngati yafinya, kapena yakuwala pang'ono,

Mukakhazikitsa cartridge mu syringe cholembera (cholembera), ndikulowa ndi singano ndikuchita jakisoni wa insulin, ndikofunikira kutsatira malangizo a wopanga omwe amaphatikizidwa ndi cholembera chilichonse.

2. Sankhani tsamba la jakisoni.

3. Antiseptic kuchitira khungu malo jakisoni.

4. Chotsani kapu ku singano.

5. Sinthani khungu lanu mwakuutambasula kapena poteteza khola lalikulu. Ikani singano molingana ndi malangizo ogwiritsa ntchito cholembera.

6. Kanikizani batani.

7. Chotsani singano ndikufinya pang'onopang'ono malo a jakisoni kwa masekondi angapo. Osatupa malo a jakisoni.

8. Pogwiritsa ntchito singano, inaninso singano ndikuwononga.

9. Mawebusayiti ayenera kusinthidwa kuti malo omwewo asagwiritsenso ntchito nthawi 1 pamwezi.

I kuyang'anira insulin

Jekeseni wa intravenous wa Humalog uyenera kuchitika molingana ndi chizolowezi chachipatala cha jakisoni wamkati, mwachitsanzo, kulowetsedwa kwa bolus kapena kugwiritsa ntchito kulowetsedwa. Poterepa, nthawi zambiri ndikofunikira kulamula kuchuluka kwa shuga m'magazi.

Makina a kulowetsedwa okhala ndi zozungulira kuyambira 0,1 IU / ml mpaka 1,0 IU / ml insulin lispro mu 0,9% sodium chloride solution kapena 5% dextrose solution amakhala okhazikika firiji kwa maola 48.

Kulowetsedwa kwa insulin / P / C pogwiritsa ntchito pampu ya insulin

Pobayira mankhwala a Humalog, mapampu Ochepera ndi Disetronic angagwiritsidwe ntchito kulowetsedwa kwa insulin. Muyenera kutsatira mosamalitsa malangizo omwe abwera ndi pampu. Njira ya kulowetsedwa imasinthidwa maola 48 aliwonse. Pakachitika vuto la hypoglycemic, kulowetsaku kumayimitsidwa mpaka gawo litatsimikiza. Ngati pali shuga wobwereza mobwerezabwereza kapena wochepa kwambiri m'magazi, ndiye kuti muyenera kudziwitsa dokotala za izi ndikuganiza kuchepetsa kapena kuletsa kulowetsedwa kwa insulin. Kuperewera kwa pampu kapena kufalikira mu dongosolo la kulowetsedwa kumatha kubweretsa kukwera msanga kwamagazi. Ngati mukukayikira kuti akuphwanya insulin, muyenera kutsatira malangizowo ndipo ngati kuli koyenera dziwitsani adokotala. Mukamagwiritsa ntchito pampu, mankhwala a Humalog sayenera kusakanikirana ndi ma insulini ena.

Zotsatira zoyipa Humalog:

Zotsatira zoyipa zomwe zimakhudzana ndi zotsatira zazikulu za mankhwalawa: hypoglycemia. Hypoglycemia yayikulu imatha kutha mphamvu ya chikumbumtima (hypoglycemic chikomokere), ndipo, mwatsatanetsatane, kufa.

Zotsatira zoyipa: zamkati zimatha kugundana - kufupika, kutupa kapena kuyunkhira pamalo a jakisoni (nthawi zambiri zimatha patatha masiku angapo kapena masabata), kayendedwe ka ziwalo (zimachitika kawirikawiri, koma zimakhala zowopsa) - kuyabwa, urticaria, angioedema, kutentha, kupuma movutikira, kutsika magazi, tachycardia, kuchuluka thukuta. Milandu yambiri yokhudzana ndimomwe thupi limagwirira ntchito ikhoza kukhala pachiwopsezo cha moyo.

Zina: lipodystrophy pamalo opangira jakisoni.

Gwiritsani ntchito pa nthawi yoyembekezera

Mpaka pano, palibe zotsatira zosasangalatsa za Lyspro insulin pa mimba kapena thanzi la mwana wosabadwayo / wakhanda. Palibe kafukufuku wokhudzana ndi mliri omwe adachitika.

Cholinga cha mankhwala a insulin panthawi yapakati ndikusunga chiwongolero chokwanira cha glucose mwa odwala omwe ali ndi matenda a shuga a shuga kapena omwe amadwala matenda a shuga. Kufunika kwa insulin nthawi zambiri kumachepera mu trimester yoyamba ndikuwonjezeka muyezo wachiwiri ndi wachitatu wama trimesters apakati. Nthawi yobadwa pambuyo pokhapokha ndipo mwayamba kubadwa, zofunika za insulin zimatha kugwa kwambiri.

Amayi amisinkhu yokhala ndi matenda ashuga ayenera kudziwitsa adotolo za kuyambika kapena kukhala ndi pakati. Pa nthawi yoyembekezera, odwala matenda a shuga amafunika kuwunika mosamala kuchuluka kwa shuga m'magazi, komanso kuyang'aniridwa kawirikawiri kuchipatala.

Odwala omwe ali ndi matenda a shuga mellitus nthawi yoyamwitsa, kusintha kwa insulin ndi / kapena zakudya kungafunike.

Malangizo apadera ogwiritsira ntchito Humalog.

Kusamutsa wodwala kupita ku mtundu wina kapena mtundu wa insulin kuyenera kuchitika moyang'aniridwa ndi achipatala. Kusintha kwa zochitika, mtundu (wopanga), mtundu (mwachitsanzo, Wokhazikika, NPH, Tepi), mitundu (nyama, anthu, ma insulin analogue) ndi / kapena njira yopanga (DNA recombinant insulin kapena insulini yachikhalidwe) ingafunike kusintha kwa mlingo.

Mikhalidwe yomwe zizindikiro zoyambirira za hypoglycemia zitha kukhala zosakhudzika komanso zochepa zomwe zimaphatikizidwa zimaphatikizapo kukhalapo kwa matenda a shuga, kulimbitsa kwambiri insulin, matenda amanjenje m'matenda a shuga, kapena mankhwala, monga beta-blockers.

Odwala omwe ali ndi vuto la hypoglycemic atasamutsidwa kuchokera ku insulin yochokera ku nyama kupita ku insulin yaumunthu, zizindikiro zoyambirira za hypoglycemia zitha kutchulidwa pang'ono kapena zosiyana ndi zomwe adakumana nazo kale ndi insulin. Hypoglycemic yosasinthika kapena ma hyperglycemic zomwe zimachitika zimatha kuyambitsa chikumbumtima, chikomokere, kapena kufa.

Mlingo wosakwanira kapena kutha kwa mankhwalawo, makamaka ndi matenda a shuga a shuga, amatha kutsegula ndi hyperglycemia ndi matenda ashuga a ketoacidosis, mikhalidwe yomwe ikhoza kukhala pangozi kwa wodwalayo.

Kufunika kwa insulini kumatha kuchepa kwa odwala omwe amalephera kupweteka kwa impso, komanso kwa odwala omwe ali ndi vuto la chiwindi chifukwa cha kuchepa kwa njira ya gluconeogeneis ndi insulin metabolism. Komabe, mwa odwala omwe ali ndi vuto losatha la chiwindi, kukana kwa insulini kungayambitse kuchuluka kwa insulin.

Kufunika kwa insulin kumatha kuwonjezeka ndi matenda opatsirana, kupsinjika kwamalingaliro, ndikuwonjezereka kwa kuchuluka kwa chakudya chamagulu muzakudya.

Kusintha kwa mlingo kumafunikanso ngati wodwala akuchulukitsa kapena kusintha kwachilendo kwa zakudya. Kuchita masewera olimbitsa thupi mukangomaliza kudya kumawonjezera chiopsezo cha hypoglycemia.Zotsatira za pharmacodynamics za insulin analogi zomwe zimagwira mwachangu ndikuti ngati hypoglycemia imayamba, ndiye kuti imatha kupanga jekeseni m'mbuyomu kuposa kubayidwa insulin yamunthu.

Wodwalayo ayenera kuchenjezedwa kuti ngati dokotala atayambitsa kukonzekera kwa insulin ndi kuchuluka kwa 40 IU / ml mu vial, ndiye kuti insulini sayenera kutengedwa kuchokera ku cartridge ndi insulin ya 100 IU / ml ndi syringe ya jekeseni wa insulin wochita ndi 40 IU / ml.

Ngati kuli kofunikira kumwa mankhwala ena nthawi imodzi ndi Humalog, wodwalayo ayenera kufunsa dokotala.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Ndi hypoglycemia kapena hyperglycemia yolumikizana ndi mtundu wosakwanira wa dosing, kuphwanya kuthekera kwambiri komanso kuthamanga kwa zochitika zama psychomotor ndikotheka. Izi zitha kukhala pachiwopsezo cha zinthu zoopsa (kuphatikizapo kuyendetsa galimoto kapena kugwira ntchito ndi makina).

Odwala ayenera kusamala kuti apewe hypolycemia poyendetsa. Izi ndizofunikira kwambiri kwa odwala omwe ali ndi kuchepetsedwa kapena kusamvetseka kwa zizindikiro zoneneratu za hypoglycemia, kapena omwe zochitika za hypoglycemia ndizofala. Pazochitika izi, ndikofunikira kuyesa kuwongolera kutha kuyendetsa. Odwala omwe ali ndi matenda ashuga amatha kudzithandizira kuti amvetsetse Hypoglycemia wodwala ngati atenga glucose kapena zakudya zamafuta ambiri (tikulimbikitsidwa kuti nthawi zonse mumakhala ndi shuga g) pafupifupi 20 g. Wodwala ayenera kudziwitsa adokotala za hypoglycemia yosamutsidwa.

Kuyanjana kwa Humalog ndi mankhwala ena.

Mphamvu ya Humalog's hypoglycemic imachepetsedwa ndi kulera kwapakamwa, corticosteroids, kukonzekera kwa mahomoni a chithokomiro, danazol, beta2-adrenergic agonists (kuphatikizapo rhytodrin, salbutamol, terbutaline), tricyclic antidepressants, thiazide diuretics, chlorprotixenic acid, chlorprotixenic acid, chlorprotixenic acid zotumphukira za phenothiazine.

Zotsatira za hypoglycemic za Humalog zimapangidwira ndi ophatikiza ndi beta, ma ethanol ndi mankhwala okhala ndi ethanol, anabolic steroids, fenfluramine, guanethidine, tetracyclines, mankhwala apakamwa a hypoglycemic, salicylates (mwachitsanzo, acetylsalicylic acid, aniloprilactyl antagonists, MAP inhibitors, angiotensin II zolandila.

Humalog sayenera kusakanikirana ndi kukonzekera kwa insulin ya nyama.

Humalog ikhoza kugwiritsidwa ntchito (kuyang'aniridwa ndi dokotala) kuphatikiza ndi insulin yaumunthu yotalika kapena kuphatikizira ndi othandizira a hypoglycemic, zotumphukira za sulfonylurea.

Migwirizano yosunga mankhwalawa Humalog.

Mndandanda B. Mankhwalawa amayenera kusungidwa kuti ana asawafikire, mufiriji, kutentha kwa 2 ° mpaka 8 ° C, osazizira. Moyo wa alumali ndi zaka 2.

Mankhwala omwe amagwiritsidwa ntchito akuyenera kusungidwa kutentha 15th mpaka 25 ° C, otetezedwa ku dzuwa kapena kutentha mwachindunji. Moyo wa alumali - osaposa masiku 28.

Munkhaniyi, mutha kuwerengera malangizo ogwiritsira ntchito mankhwalawa Chichewa . Amapereka ndemanga kuchokera kwa alendo omwe amabwera patsamba lino - ogwiritsa ntchito mankhwalawa, komanso malingaliro a akatswiri azachipatala pakugwiritsa ntchito Humalog machitidwe awo. Chopempha chachikulu ndikuti muwonjezere ndemanga zanu za mankhwalawa: mankhwalawo adathandizira kapena sanathandizire kuchotsa matendawa, ndizovuta ziti zomwe zimawoneka ndi zotsatirapo zake, mwina sizinalengezedwe ndi wopanga. Ma Analogs a Humalog pamakhala ma analogu apangidwe omwe amapezeka. Gwiritsani ntchito pochiza matenda amiseche 1 amtundu wa shuga (wodalira insulin komanso osadalira insulin) mwa akulu, ana, komanso panthawi yoyembekezera komanso mkaka wa m'mawere. The zikuchokera mankhwala.

Chichewa - analogue ya insulin yaumunthu, imasiyana ndi kusintha kwatsatanetsatane wa proline ndi lysine amino acid zotsalira pamalo 28 ndi 29 a insulin B. Poyerekeza ndikukonzekera kwanthaŵi yayitali insulin, lyspro insulin imadziwika ndi kuyambika mwachangu komanso kutha kwake, komwe kumachitika chifukwa chakuchotsa kwina kuchokera kumalo osasunthika chifukwa cha kusungidwa kwa mawonekedwe a monomeric a lyspro insulin mamolekyulu mu yankho. Kukhazikika kwa mphindi 15 pambuyo pa kayendetsedwe ka subcutaneous, mphamvu yayikulu imakhala pakati pa maola 0.5 ndi maola 2,5, kutalika kwa nthawi ndi maola 3-4.

Humalog Mix ndi DNA - maumboni odziwika a insulin yaumunthu ndipo ndi chosakanikirana chopangidwa chopangidwa ndi lyspro insulin solution (analog yothamanga ya insulin yaumunthu) ndi kuyimitsidwa kwa lyspro protamine insulin (anthawi yapakati ya insulin analogue).

Chochita chachikulu cha insulin lyspro ndi malamulo a kagayidwe ka glucose. Kuphatikiza apo, imakhala ndi anabolic komanso anti-catabolic zotsatira zosiyanasiyana zamthupi. Mu minofu ya minofu, pali kuchuluka kwa glycogen, mafuta acid, glycerol, kuchuluka kwa mapuloteni komanso kuwonjezereka kwa kumwa ma amino acid, koma nthawi yomweyo kumachepa mu glycogenolysis, gluconeogeneis, ketogeneis, lipolysis, proteinabolism ndi kutulutsidwa kwa ma amino acid.

Lyspro insulin + akubwera.

Kukwanira kwathunthu ndi kuyambika kwa mphamvu ya insulin kumadalira malo a jakisoni (m'mimba, ntchafu, matako), mlingo (kuchuluka kwa insulin), komanso kuchuluka kwa insulin pokonzekera. Imagawidwa mosiyanasiyana mu minofu. Simadutsana chotchinga ndi mkaka wa m'mawere. Amawonongedwa ndi insulinase makamaka m'chiwindi ndi impso. Amachotseredwa ndi impso - 30-80%.

• lembani matenda a shuga 1 mellitus (wodalira insulin), kuphatikiza ndi tsankho kukonzekera kwina kwa insulin, ndi postprandial hyperglycemia yomwe singathe kukonza ma insulin, kukonzekera kwachulukidwe kakang'ono ka insulini (kuthamanga kwa kuchepa kwa insulin),
• lembani matenda ashuga a 2 a shuga (osagwirizana ndi insulin): kukana kwa omwa m'magazi a hypoglycemic, komanso kuyamwa kwamisempha ina ya kukonzekera kwa insulin, matenda osagwirizana a postprandial hyperglycemia, pa ntchito, matenda ogwirizana.

Njira yothetsera kulowetsedwa kwamkati mwa 100 IU mu katoni kathengo ka 3 ml wophatikizidwa ndi cholembera cha QuickPen kapena cholembera.

Kuyimitsidwa kwa subcutaneous makonzedwe a 100 IU mu katoni 3 ml wophatikizidwa ndi cholembera cha QuickPen kapena cholembera (Humalog Remix 25 ndi 50).

Mitundu ina ya kumwa, ngati mapiritsi kapena mapiritsi, kulibe.

Malangizo ogwiritsira ntchito ndi njira yogwiritsira ntchito

Mlingo umayikidwa payekha. Lyspro insulin imayang'aniridwa subcutaneous, mu mnofu kapena kudzera m'mitsempha 5-15 asanadye. Mlingo umodzi ndi 40 magawo, owonjezera amangololedwa pokha pokha. Ndi monotherapy, Lyspro insulin imayang'aniridwa katatu pa tsiku, pamodzi ndi kukonzekera kwa insulin yayitali - katatu patsiku.

Mankhwalawa amayenera kuperekedwa mosavuta.

Intravenous makonzedwe a mankhwala Humalog Remix ali contraindicated.

Kutentha kwa mankhwala omwe amaperekedwa kuyenera kukhala kutentha kwambiri.

Subcutaneally ayenera jekeseni phewa, ntchafu, matako kapena m'mimba. Masamba a jakisoni ayenera kusinthidwa kuti malo omwewo asagwiritsidwerenso nthawi 1 pamwezi. Mukamayambitsa mankhwalawa Humalog, chisamaliro chiyenera kutengedwa kuti mupewe magazi. Pambuyo pa jakisoni, tsamba la jakisidwe siliyenera kutenthedwa.

Poika makatoni mu chipangizo cha jakisoni wa insulin ndikulowa ndi singano musanayendetsedwe ka insulin, malangizo a wopanga chipangizo cha insulin amayenera kuwonetsetsa.

Malangizo akukhazikitsa mankhwala Humalog Remix

Kukonzekera mawu oyamba

Musanagwiritse ntchito, cartridge yosakanikirana ya Humalog Mix iyenera kukugudwa pakati pa manja kasanu ndikugwedezeka, kutembenuka ndi 180 ° komanso maulendo khumi kuti ipatsenso insulin mpaka itakhala madzi kapena mkaka wopanda pake. Gwedezani mwamphamvu, monga izi zimatha kuyambitsa foam, zomwe zingasokoneze mlingo woyenera. Kupangitsa kusakanikirana, katiriji kamakhala ndi mkanda wawung'ono wagalasi. Mankhwala sayenera kugwiritsidwa ntchito ngati ali ndi ziphuphu mutatha kusakaniza.

Momwe mungapangire mankhwalawa

1. Sambani manja.
2. Sankhani malo pobayira.
3. Chitani khungu ndi antiseptic pamalo omwe jakisoni (wodzivulitsira, mogwirizana ndi malingaliro a dokotala).
4. Chotsani kapu yakunja yoteteza ku singano.
5. Sinthani khungu ndikakukoka kapena kusunga khola lalikulu.
6. Ikani singano pang'onopang'ono ndikuchita jakisoni mogwirizana ndi malangizo ogwiritsa ntchito cholembera.
7. Chotsani singano ndikufinya pang'onopang'ono malo a jakisoni kwa masekondi angapo. Osatupa malo a jakisoni.
8. Pogwiritsa ntchito chopukutira chakunja cha singano, dulani singano ndikuwononga.
9. Ikani chipewa pa cholembera.

• hypoglycemia (hypoglycemia yayikulu imatha kutha kwa chikumbumtima ndipo, mwapadera, mpaka kufa),
• redness, kutupa, kapena kuyabwa pamalowo jakisoni (nthawi zambiri zimatha patadutsa masiku angapo kapena masabata, nthawi zina izi zimachitika chifukwa cha zifukwa zosagwirizana ndi insulin, mwachitsanzo, kupweteka pakhungu ndi jakisoni woletsa kapena jekeseni wosayenera),
• kuyamwa kofananira
• kuvutika kupuma
• kupuma movutikira
• kutsika kwa magazi,
• tachycardia
• kutuluka thukuta kwambiri
• chitukuko cha lipodystrophy pamalo jakisoni.

• achina,
• Hypersensitivity pamagawo a mankhwala.

Mimba komanso kuyamwa

Mpaka pano, palibe zotsatira zosasangalatsa za Lyspro insulin pa mimba kapena mkhalidwe wa mwana wosabadwa ndi wakhanda zadziwika.

Cholinga cha mankhwala a insulin panthawi yapakati ndikukhazikika pakukhazikika kwa shuga. Kufunika kwa insulin nthawi zambiri kumachepera mu trimester yoyamba ndikuwonjezeka muyezo wachiwiri ndi wachitatu wama trimesters apakati. Nthawi yobadwa pambuyo pokhapokha ndipo mwayamba kubadwa, zofunika za insulin zimatha kugwa kwambiri.

Amayi amisinkhu yokhala ndi matenda ashuga ayenera kudziwitsa adotolo za kuyambika kapena kukhala ndi pakati.

Odwala omwe ali ndi matenda a shuga mellitus nthawi yoyamwitsa, kusintha kwa insulin ndi / kapena zakudya kungafunike.

Njira yoyendetsera njira yomwe imagwiritsidwa ntchito mulingo wa lyspro insulin uyenera kuyang'aniridwa bwino. Posamutsa odwala kuchokera ku insulin yomwe imakonzekera mwachangu kuchokera ku insulin lispro, kusintha kofunikira kungafunike. Kusamutsidwa kwa odwala omwe amalandira insulin tsiku lililonse mlingo wopitilira 100 kuchokera ku mtundu umodzi wa insulin kupita ku ina ndikulimbikitsidwa kuti upangidwe mu chipatala.

Kufunika kwa insulin kumatha kuwonjezeka panthawi yomwe matenda opatsirana, ndi nkhawa zam'maganizo, ndi kuchuluka kwa chakudya chamagulu mu chakudya, pazakudya zowonjezera zamankhwala omwe ali ndi vuto la hyperglycemic (mahomoni a chithokomiro, glucocorticoids, kulera kwapakamwa, thiazide diuretics).

Kufunika kwa insulini kumatha kuchepa ndi kuchepa kwa impso ndi / kapena chiwindi, ndi kuchepa kwa kuchuluka kwa chakudya chamagulu mu chakudya, ndi kuchuluka kwa thupi, pakudya kowonjezereka kwa mankhwala omwe ali ndi vuto la hypoglycemic (Mao inhibitors, osasankha beta-blockers, sulfonamides).

Malangizo a hypoglycemia mu mawonekedwe owopsa amatha kuchitika ndikugwiritsa ntchito i / m ndi / kapena s / glu wa glucagon kapena iv woyendetsa shuga.

Mphamvu ya hypoglycemic ya Lyspro insulin imakonzedwa ndi Mao inhibitors, osagwiritsa ntchito beta-blockers, sulfonamides, acarbose, ethanol (mowa) ndi mankhwala okhala ndi ethanol.

Mphamvu ya hypoglycemic ya Lyspro insulin imachepetsedwa ndi glucocorticosteroids (GCS), mahomoni a chithokomiro, njira zakulera zamkati, thiazide diuretics, diazoxide, antidepressants a tricyclic.

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

Mndandanda wa mankhwala Humalog

Zofanana muzochitika zamagulu:

• Lyspro insulin
• Humalog Mix 25,
• Kusintha kwa Humalog 50.

Analogs a pharmacological group (ma insulins):

• Actrapid HM Penfill,
• Actrapid MS,
• B-Insulin S.Ts. Berlin Chemie,
• Berlinsulin H 30/70 U-40,
• Berlinsulin H 30/70 cholembera,
• Berlinsulin N Basal U-40,
• Berlinsulin N Basal chole,
• Berlinsulin N Normal U-40,
• Berlinsulin N Wokhazikika P cholembera,
• Depot insulin C,
• Isofan Insulin World Cup,
• Iletin
• Thumba la Insulin SPP,
• Insulin c
• Nkhumba ya insulin yoyeretsedwa kwambiri,
• Insuman Comb,
• Intral SPP,
• World Cup,
• Combinsulin C
• Mikstard 30 NM Penfill,
• Monosuinsulin MK,
• Monotard
• Pensulin,
• Protafan HM Pofikira,
• Protafan MS,
• Rinsulin
• Ultratard NM,
• Nyumba 40,
• Kandachime 40,
• Humulin.

Popeza pali mankhwala a analogi omwe amagwira ntchito, mutha kulumikiza ulalo womwe umaperekedwa pamatenda omwe mankhwalawo amathandizira ndikuwona mawonekedwe ofananira achire.

Mankhwala

Lyspro insulin ndi mankhwala osokoneza bongo a m'gulu la anthu omwe amangokhala osachita kanthu. Zomwe zimagwira ndi insulin lispro, analog recompinant analog ya deoxyribonucleic acid (DNA) ya insulin yaumunthu, yomwe imasiyana ndi kukonzanso kwa amino acid m'malo a 28 ndi 29 mu gulu la insulin.

Kuphatikiza pa kuwongolera kagayidwe ka glucose, insulin lyspro imakhala ndi anabolic komanso anti-catabolic zotsatira pa thupi. Mu minofu ya minofu, amathandizira kuwonjezeka kwa zomwe zili glycogen, glycerol ndi mafuta acids, kuwonjezeka kwa kumwa amino acid, komanso kuwonjezeka kwaphatikizidwa kwa mapuloteni. Nthawi yomweyo, pali zoletsa za machitidwe a glycogenolysis, ketogenesis, gluconeogeneis, lipolysis, kumasulidwa kwa amino acid, ndi proteinabolism.

Lyspro insulin ndi insulin yaumunthu ndiyofanana, koma yakale imadziwika ndi kuyamba mwachangu komanso nthawi yayifupi. Chifukwa cha kuchuluka kwa mayamwidwe, kuchuluka kwa hypoglycemic kwa Lyspro insulin kumawonekera 1/4 h pambuyo pa makonzedwe, omwe amalola kuti mankhwalawa azigwiritsidwa ntchito musanadye.

Kutalika kwa mankhwalawa kumachokera maola 2 mpaka 5. Amatha kukhala osiyanasiyana odwala komanso nthawi imodzi. Kusintha munthawi yochitapo kanthu kumayendetsedwa ndi mlingo, jakisoni malo, kutentha kwa thupi, magazi ndi zochita za wodwala.

Poyerekeza ndi insulin yaumunthu yosungunuka, kugwiritsa ntchito lyspro insulin kumachepetsa pafupipafupi zochitika za nocturnal hypoglycemia, kwambiri kuchepetsa hyperglycemia yomwe imapezeka mwa odwala omwe ali ndi matenda amtundu wa 1 komanso a 2 atatha kudya.

Akuluakulu, ana ndi achinyamata, pharmacodynamics yofanana ya insulin lyspro imawonedwa.

Kuyankha kwa glucodynamic ku insulin lispro sikudalira mkhalidwe wa impso kapena wodwala.

Zizindikiro zogwiritsidwa ntchito

Kugwiritsa ntchito Insulin Lyspro akuwonetsera zochizira matenda amtunduwu a shuga mwa akulu ndi ana:

• kudalira insulini (mtundu 1 wa matenda osokoneza bongo): kuphatikiza odwala osalolera kukonzekera insulin ina, ndikupanga mankhwala ena omwe sangakonzedwe ndi insulin pambuyo podya
• osadalira insulini (mtundu wachiwiri wa matenda ashuga a m'mimba:

Lyspro insulin, malangizo: ntchito ndi Mlingo

Yankho la Insulin Lyspro lakonzedwa kwa utsogoleri wa SC ndi iv. Jekeseni zimachitika osapitirira mphindi 15 chakudya chisanachitike kapena mutangodya.

Pansi pa khungu, mankhwalawa amatha kupakidwa phula kapena ngati jekeseni wa nthawi yayitali pogwiritsa ntchito pampu ya insulin.

Msempha, kuyamwa kwa lyspro insulin kumasonyezedwa ketoacidosis, matenda owopsa, pakati pa opereshoni kapena pambuyo pa opareshoni.

Kutentha kwa njira yovulazidwa kuyenerana ndi kutentha kwa chipinda.

Asanayambe kuyendetsa, zomwe zili mu cartridge kapena vial ziyenera kuwunikiridwa moyenera kuti zitheke. Madzimadzi ayenera kukhala owoneka bwino komanso opanda khungu. Ngati ikukhala mitambo, yodinira, yokhala ndi utoto pang'ono kapena ngati ma cell achilendo akupezeka mmenemo - yankho liyenera kutayidwa.

Dokotalayo ndi amene amawerengera mtundu wa mankhwala a insulin Lyspro payekhapayekha, kutengera kuchuluka kwa shuga m'magazi.

Subcutaneous makonzedwe ndi syringe cholembera

S / c Insulin Lyspro ikhoza kuyilowetsedwa m'matumbo a m'mimba, phewa, ntchafu kapena matako, kupewa njira yolowera m'mitsempha yamagazi. Tsamba la jakisoni liyenera kusinthidwa pafupipafupi, kupewa kugwiritsa ntchito malo omwewo nthawi zambiri kuposa nthawi 1 pamwezi. Pambuyo pa jakisoni, tsamba la jakisidwe siliyenera kutenthedwa.

Cartridges iyenera kugwiritsidwa ntchito ndi EndoPen Syringe Pens opangidwa ndi Bagging Gangan Technology Co. Ltd. ”(China), popeza kulondola kwa dosing kumayikidwa kokha pa zolembera zowonetsedwa.

Popereka mankhwala, dokotalayo ayenera kuphunzitsa wodwalayo njira yodziyendetsera jekeseni wa sc, ndikuwonetsetsa kuti wodwalayo ali ndi jakisoni wabwino ndi kuthekera kugwiritsa ntchito cholembera.

Katoniyo amayenera kuyikamo cholembera ndipo amalowetsa motsatira malangizo a wopanga kuti agwiritse ntchito cholembera.

Malangizo a pang'onopang'ono operekera mlingo wa insulin lispro:

1. Sambani m'manja bwinobwino.
2. Sankhani malo pobayira.
3. Konzani khungu pamalo opaka jekeseni malinga ndi malangizo a dokotala.
4. Chotsani kapu yakunja yoteteza ku singano.
5. Konzani khungu.
6. Ikani singano pansi pa khungu, pangani jakisoni mogwirizana ndi malangizo a cholembera.
7. Chotsani singano, pang'onopang'ono kukanikiza jakisoniyo ndi swab ya thonje kwa masekondi angapo, osapukuta jakisoni.
8. Tulutsani singano ndi kapu yachitetezo chakunja ndikuitaya.
9. Ikani chipewa pa cholembera.

Subcutaneous makonzedwe ndi insulin pampu

Pampu ya insulin ingagwiritsidwe ntchito ndi dongosolo lopitiliza kuperekera insulin yokhala ndi chizindikiro cha CE. Lisanayambike chilichonse, ndikofunikira kutsimikizira kuphatikizika kwa pampu ina ndikuwonetsetsa mosamalitsa zofunikira zonse za malangizo ake. Kusunga koyenera ndi patheter pampu kuyenera kugwiritsidwa ntchito; Mu gawo la hypoglycemic, mankhwala osokoneza bongo amayenera kusiyidwa mpaka gawo litatsimikiza. Ngati mukupezeka kuchuluka kwa shuga m'magazi, muyenera kufunsa dokotala. Ndikofunikira kuganizira kuchepetsa kumwa kapena kuimitsa makina a lyspro insulin.

Kusokonezeka pakupereka yankho chifukwa chobowola jakisoni kapena vuto la pampu ya insulin kungapangitse wodwala kuwonjezera kuchuluka kwa shuga. Chifukwa chake, pakukayikira pang'ono komwe kuli kukhalapo kwa kuphwanya kulikonse m'dongosolo, ndikofunikira kutsatira malangizo ndikudziwitsa dokotala ngati pakufunika kutero.

Osasakaniza Insulin Lyspro ndi ma insulini ena mukamagwiritsa ntchito pampu.

Jekeseni wamkati

Insulinven insulin ikhoza kutumikiridwa ndi bolus kapena kukokana, limodzi ndi kuyang'anira kuchuluka kwa shuga m'magazi.

Pa kulowetsedwa, insulin lyspro imatha kusungunuka mu 5% dextrose solution kapena 0,9% sodium chloride solution.Pamene kuchuluka kwa insulini mu kulowetsedwa kwa njira kumakhala mu mayendedwe a 0.1-1 IU pa 1 ml, yankho lokonzekera limakhala lokhazikika kwa maola 48 osungirako kutentha.

Kukopa pa kuthekera koyendetsa magalimoto ndi njira zowerengeka

Pogwiritsa ntchito Insulin Lyspro poyendetsa magalimoto kapena magwiridwe antchito ovuta, ndikofunikira kulingalira kuphwanyidwa kwothamanga kwa psychomotor reaction komanso kuthekera kwazinthu zamagulu panthawi ya kukonzekera kwa hypo- kapena hyperglycemia chifukwa cha kuchuluka kwa mlingo woyenera. Chenjezo makamaka kwa odwala omwe ali ndi zigawo za hypoglycemia, ndi kuchepetsedwa kwakumverera kwa zizindikiro zakutsogolo kwa hypoglycemia kapena kusowa kwawo. Ndikofunikira kuyeserera payekha pazoyenera kuyendetsa.

Ndemanga za Insulin Lyspro

Pamasamba apadera masiku ano palibe ndemanga za Insulin Lyspro kuchokera kwa odwala ndi mabanja awo.

Akatswiri amalimbikitsa kugwiritsa ntchito mankhwala osokoneza bongo a insulin, ochita zinthu mwachangu - insulin lispro, vuto la matenda obwera chifukwa cha matenda ashuga chifukwa cha matenda osakhazikika a shuga (matenda ashuga ketoacidosis), m'malo mwa chithandizo chamankhwala chofulumira (ins iv Popeza pankhaniyi imagwira ntchito mwachangu kuposa insulin wamba komanso imaletsa kulowetsedwa mosakhalitsa, nthawi zambiri imafuna kuti wodwala azigonekedwa m'chipinda chothandizira kwambiri.

Mtengo wa insulin lispro m'masitolo ogulitsa mankhwala

Mtengo wa Insulin Lyspro phukusi lomwe lili ndi 1 cartridge ndi yankho likhoza kukhala kuchokera ku ruble 252, ma cartridge 5 kuchokera ku ruble 1262, botolo 1 (10 ml) - kuchokera ma ruble 841.

Maphunziro: Yoyamba University State Medical University yotchedwa I.M. Sechenov, wapadera "General Medicine".

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

Pa moyo, munthu wamba amapanga miyala yocheperako yoposa awiri.

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.

Poyesera kuti wodwalayo atuluke, madokotala nthawi zambiri amapita kutali kwambiri. Ndiye, mwachitsanzo, Charles Jensen wina mzaka kuyambira 1954 mpaka 1994. adapulumuka ntchito zopitilira 900 neoplasm.

Poyamba zinkakhala kuti kumatheka kumapangitsa thupi kukhala ndi mpweya wabwino. Komabe, izi zidatsutsidwa. Asayansi atsimikizira kuti kutulutsa, munthu kuziziritsa ubongo ndikuwongolera magwiridwe ake.

Munthu aliyense samangokhala ndi zala zapadera, komanso chilankhulo.

Ngakhale mtima wa munthu sugunda, akhoza kukhalabe ndi moyo nthawi yayitali, monga asodzi aku Norweji a Jan Revsdal. "Galimoto" yake idayima kwa maola 4 asodzi atasowa ndikugona mu chisanu.

Ngati mumamwetulira kawiri kokha patsiku, mutha kuchepetsa kuthamanga kwa magazi ndikuchepetsa chiopsezo cha matenda a mtima ndi stroko.

Okonda akapsopsona, aliyense wa iwo amataya 6.4 kcal pamphindi, koma nthawi yomweyo amasinthana mitundu pafupifupi 300 ya mabakiteriya osiyanasiyana.

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

Mankhwala ambiri poyamba anali ogulitsidwa ngati mankhwala osokoneza bongo. Mwachitsanzo, a heroin adagulitsidwa ngati mankhwala a chifuwa. Ndipo cocaine adalimbikitsidwa ndi madokotala ngati opaleshoni komanso ngati njira yowonjezerera kupirira.

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.

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

Vibrator woyamba adapangidwa m'zaka za zana la 19. Adagwira ntchito pa injini yankhonya ndipo adapangira kuti azitsatira khungu la akazi.

Amayi ambiri amatha kusangalala mwakuganizira za thupi lawo lokongola pakalilore kuposa kugonana. Chifukwa chake, akazi, yesetsani kuyanjana.

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

Polyoxidonium imakhudza mankhwala a immunomodulatory. Imagwira mbali zina za chitetezo chamthupi, potero zimathandizira kukulitsa kukhazikika kwa.

Malangizo ogwiritsira ntchito

Kuti mupewe mavuto chifukwa chogwiritsa ntchito Lizpro insulin, muyenera kutsatira mosamalitsa malangizo omwe mankhwalawa amachokera.

Mlingo wa mankhwalawa umatengera mawonekedwe ambiri. Izi zimakhudza zaka za wodwalayo, mawonekedwe a matendawa komanso kuopsa kwake, matenda ena, ndi zina zotere.

Koma katswiriyo akhoza kukhala akulakwitsa, chifukwa chake njira ya chithandizo iyenera kuyang'aniridwa ndikuwunika shuga nthawi zonse ndikuwasintha mayendedwe ake. Wodwalayo amayeneranso kukhala ndi chidwi ndi thanzi lake ndikudziwitsa dokotalayo za zoyipa zilizonse zomwe zimachitika m'thupi ndi mankhwalawo.

Humalog imakhala yoyendetsedwa mosavuta. Koma mosiyana ndi mankhwala ofanana ndi ena, jakisoni wa intramus amaloledwa, komanso kuyambitsa insulin m'mitsempha. Jakisoni wamkati ayenera kuchitidwa ndi kutenga gawo la othandizira azaumoyo.

Malo oyenera a jakisoni wotsekemera ndi malo a ntchafu, malo amapewa, matako, matumbo am'mimba. Kukhazikitsidwa kwa mankhwala m'dera lomwelo sikuloledwa, chifukwa izi zimayambitsa lipodystrophy. Kuyenda pafupipafupi mkati mwa malo osankhidwa ndikofunikira.

Zingwe ziyenera kuchitika nthawi imodzi yatsiku. Izi zimalola kuti thupi lizisinthasintha ndikupereka chidziwitso mosalekeza ku insulin.

Ndikofunika kwambiri kuganizira zovuta zaumoyo wa wodwala (kupatula matenda ashuga). Chifukwa cha ena a iwo, zovuta za chinthuchi zimatha kupotozedwa mpaka pansi. Pankhaniyi, muyenera kuwerengeranso mlingo. Pokhudzana ndi ma pathologies ena, dokotala akhoza kuletsa kugwiritsa ntchito Humalog.

Phunziro la kanema wa syringe:

Zomwe zimayenderana ndi mankhwala ena

Chofunikira kwambiri pamankhwala aliwonse ndizofanana ndi mankhwala ena. Madokotala nthawi zambiri amayenera kuchitira ma pathologies angapo nthawi imodzi, chifukwa chomwe ndikofunikira kuphatikiza kulandira mitundu yosiyanasiyana ya mankhwala. Ndikofunikira kuti mupange mankhwalawo kuti mankhwalawo asatseke kuchitirana.

Nthawi zina pamakhala kufunika kogwiritsa ntchito mankhwala omwe amatha kusokoneza zochita za insulin.

Mphamvu yake imalimbikitsidwa ngati, kuwonjezera pamenepo, wodwala amatenga mitundu yotsatirayi ya mankhwala:

• Clofibrate
• Ketoconazole,
• Mao zoletsa
• sulfonamides.

Ngati simungakane kuzilandira, muyenera kuchepetsa kuchuluka kwa Humalog yomwe yakambidwayo.

Zinthu zotsatirazi ndi magulu a othandizira amatha kufooketsa mphamvu ya mankhwalawo omwe mukufunsidwa:

• estrogens
• chikonga
• mahomoni mankhwala oletsa kubereka,
• Glucagon.

Chifukwa cha mankhwalawa, kugwira ntchito kwa Lizpro kumatha kuchepa, chifukwa chake dokotala amayenera kuti alimbikitse kuchuluka.

Mankhwala ena ali ndi zotsatira zosayembekezereka. Amatha kuwonjezera ndikuchepetsa ntchito yogwira ntchito. Izi zikuphatikizapo Octreotide, Pentamidine, Reserpine, beta-blockers.

Mtengo ndi fanizo la mankhwala

Kuchiza ndi Insulin Lyspro ndi okwera mtengo. Mtengo wa phukusi limodzi la mankhwalawa umasiyanasiyana 1800 mpaka 200 rubles. Ndi chifukwa cha kukwera mtengo komwe odwala nthawi zina amapempha dokotala kuti athetse mankhwalawa ndi analogue yawo ndi mtengo wotsika mtengo.

Pali zambiri zofananira za mankhwalawa. Amayimiridwa ndi mitundu yosiyanasiyana ya kumasulidwa, amatha kusiyanasiyana pakupanga kwawo.

Mwa zina zazikulu zingatchulidwe:

Kusankha kwa mankhwala kuti athetse insulin yamtunduwu kuyenera kuperekedwa kwa katswiri.

Mlingo ndi makonzedwe

Mlingo wa Humalog Remix 50 umatsimikiziridwa ndi dokotala payekha, kutengera zosowa za wodwala. Humalog® Mix 50 ikhoza kutumikiridwa musanadye, ndipo ngati ndi kotheka, mukatha kudya. Mankhwalawa amayenera kuperekedwa pokhapokha! Intravenous makonzedwe a mankhwala Humalog Remix 50 chosokoneza. Kutentha kwa mankhwala omwe amaperekedwa kuyenera kukhala kutentha kwambiri. Ndondomeko ya insulin makonzedwe ndi munthu!

Jakisoni wotsekemera ayenera kuperekedwa kwa phewa, ntchafu, matako kapena pamimba. Masamba a jakisoni ayenera kusinthidwa kuti malo omwewo sawagwiritsanso ntchito mwina kamodzi pamwezi.

Ndi makina osunthira a Humalog® Mix 50 50, chisamaliro chimayenera kutengedwa kuti musalowe mu mtsempha wamagazi. Pambuyo pa jakisoni, tsamba la jakisidwe siliyenera kutenthedwa. Odwala ayenera kuphunzitsidwa njira yolondola ya jakisoni.

Kutalika kwa mankhwalawa kumasintha mosiyanasiyana kuchokera kwa munthu wina kupita kwa anthu ena komanso panthawi zosiyanasiyana mwa munthu yemweyo. Kutalika kwa zochita za Humalog® Mix 50 zimatengera mlingo, malo a jakisoni, magazi, kutentha ndi zochitika zolimbitsa thupi kwa wodwalayo.

Asanagwiritse ntchito, cartridge ya Humalog® Mix 50 imayenera kukukhidwira pakati pama manja khumi ndikugwedezeka, ndikusintha 180 °, maulendo khumi kuti mutsitsenso insulin mpaka itakhala yunifolomu yamadzi. Bwerezani izi mpaka zomwe zidasakanikirana kwathunthu. Osagwedezeka mwamphamvu, chifukwa izi zingapangitse mawonekedwe a chithovu, omwe amatha kusokoneza mlingo woyenera.

Chipangizo cha ma cartridge sichimalola kusakanikirana ndi zomwe zili ndi insulini zina mwachindunji mu cartridge lokha. Makatoniwo sanapangidwe kuti adzazitsidwe.

Zomwe zili zama cartridge zimayenera kupendedwa pafupipafupi, ndipo siziyenera kugwiritsidwa ntchito pamaso pa zigawenga, mapepala kapena pakumatira kwa tinthu tating'ono totsika pansi kapena khoma la cartridge, ndikuwapatsa matte.

Ndikofunikira kutsatira mosamalitsa zomwe wopanga amapanga pa cholembera chilichonse ndikadzazitsa katoni, ndikulowa ndi singano, ndikubaya Humalog® Remix 50.

Sankhani tsamba la jakisoni.

Tetezani khungu pakhungu la jekeseni mogwirizana ndi malangizo.

Chotsani kapu yakunja yoteteza ku singano.

Konzani khungu pakuliphatikiza khola lalikulu.

Ikani singano mosadukiza malinga ndi malangizo.

Chotsani singano ndikufinya pang'onopang'ono malo a jakisoni ndi swab ya thonje kwa masekondi angapo. Osatupa malo a jakisoni.

Pogwiritsa ntchito chopukutira chakunja cha singano, chovulani singano ndikuitaya motsatira malamulo achitetezo.

Ndikofunikira kusinthana mawebusayiti enanso kuti tsamba lomwelo lisagwiritsidwe ntchito koposa kamodzi pamwezi.

Contraindication

• achina,
• tsankho limodzi ndi zigawo zikuluzikulu za mankhwala.

Mlingo ndi makonzedwe

Mlingo wa mankhwalawa amatsimikiziridwa ndi dokotala payekhapayekha, poganizira kuchuluka kwa shuga m'magazi.

Njira yothetsera vutoli ndi jekeseni wa iv - ngati kuli kotheka, pazochitika pachimake, ketoacidosis, pakati pa ntchito ndi nthawi ya postoperative, s / c - mawonekedwe a jakisoni kapena infusions (kudzera pampu ya insulin) pamimba, matako, m'chiuno kapena phewa, osati kulola kuti mankhwala alowe m'mitsempha yamagazi. Masamba a jakisoni amasinthidwa nthawi iliyonse, kuti malo omwewo sagwiritsidwe ntchito zoposa 1 nthawi pamwezi. Pambuyo pa kutsata, tsamba la jakisoni silingathetsedwenso.

Munthawi zonsezi, njira yoyendetsera amakhazikitsidwa payokha. Kukhazikitsidwa kumachitika musanadye chakudya, koma kugwiritsa ntchito mankhwalawa kumaloledwa pambuyo chakudya.

Kukonzekera kwa mankhwala

Musanagwiritse ntchito, yankho lake limayang'anidwa chifukwa cha zinthu, phokoso, madontho komanso makulidwe. Gwiritsani ntchito njira yokhayo yopanda utoto ndi yowoneka bwino kutentha.

Pamaso pa jekeseni, tsukani manja anu bwino, sankhani ndikupukuta malowo. Kenako, kachipuyo kamachotsedwa ndi singano, khungu limakokedwa kapena kusungidwa mu khola lalikulu, singano imayilowetsedwa ndipo batani limakanikizidwa. Pambuyo pake, singano imachotsedwa ndipo kwa masekondi angapo malo a jakisawo amapanikizidwa mosamala ndi swab thonje. Pogwiritsa ntchito singano yodzitchinjiriza, imatembenuzidwa ndikuitaya.

Musanagwiritse ntchito Humalog mu cholembera-injector (jakisoni), QuickPen ayenera kuwerenga malangizo kuti agwiritse ntchito.

Jakisoni wa IV amachitika motsatira chizolowezi chazachipatala, mwachitsanzo, jakisoni wa IV Kuwunikira pafupipafupi kuchuluka kwa shuga m'magazi ndikofunikira.

Kukhazikika kwa kulowetsedwa ndi kuchuluka kwa 0-1-1 IU pa 1 ml ya insulin lispro mu 5% dextrose kapena 0,9% sodium chloride njira yothetsera masiku 2 imaperekedwa ngati imasungidwa kutentha kwa chipinda.

Pochita ma infusions a scet, mapampu a Disetronic ndi Minimed opangidwira insulin infusions angagwiritsidwe ntchito. Ndikofunikira kutsatira mosamalitsa malangizo a wopanga ndikutsatira malamulo a asepticism mukalumikiza dongosolo. Masiku 2 aliwonse amasintha dongosolo la kulowetsedwa. Kulowetsedwa ndi gawo la hypoglycemic kuyimitsidwa mpaka kuthe. Pankhani yokhala ndi shuga wambiri m'magazi, wodwalayo ayenera kufunsa dokotala kuti agwirizane ndikuletsa kulowetsedwa kwa insulin.

Kukwera msanga m'magazi a glucose kumatha kuonedwa ndi dongosolo lotsekeka la kulowetsedwa kapena kupopera mphamvu. Ngati kuphwanya kwa insulin yobereka kumayikiridwa ngati chifukwa chowonjezera kuchuluka kwa shuga, wodwalayo ayenera kutsatira malangizo a wopanga ndikudziwitsa adokotala (ngati kuli kofunikira).

Humalog mukamagwiritsa ntchito pampu sangaphatikizidwe ndi ma insulini ena.

Cholembera cha insulin ya QuickPen chili ndi 3 ml ya mankhwalawa ndi zochitika za 100 IU mu 1 ml. 1-60 mayunitsi a insulin amatha kuperekedwa pa jekeseni iliyonse. Mlingo ukhoza kukhazikitsidwa ndi kulondola kwa chinthu chimodzi. Ngati mayunitsi ambiri akhazikitsidwa, mlingowo ungakonzedwe popanda kutaya insulin.

Jakisoni amayenera kugwiritsidwa ntchito ndi wodwala m'modzi yekha, singano zatsopano ziyenera kugwiritsidwa ntchito pobayira iliyonse. Osagwiritsa ntchito jakisoni ngati chilichonse mwa mbali zake chiwonongeka kapena chosweka. Wodwalayo nthawi zonse azinyamula jakisoni wopopera kuti atayika kapena kuwonongeka.

Odwala omwe ali ndi vuto lowona kapena kutayika kwamaso samalimbikitsidwa kugwiritsa ntchito jakisoni popanda kuthandizidwa ndi anthu owoneka bwino omwe amaphunzitsidwa kuti azigwiritsa ntchito.

Jekeseni aliyense asanafike, ndikofunikira kutsimikizira kuti tsiku lotha ntchito lomwe lawonetsedwa pa cholembapo sichinathe ndipo kuti mtundu woyenera wa insulin uli ndi jakisoni. Pankhaniyi, sikulimbikitsidwa kuti muchepetse chizindikiro.

Mtundu wa batani lothamanga la cholembera cha QuickPen ndi imvi, umafanana ndi mtundu wa Mzere palemba lawo ndi mtundu wa insulin yomwe imagwiritsidwa ntchito.

Musanagwiritse ntchito jakisoni, muyenera kuonetsetsa kuti singanoyo imalumikizidwa kwathunthu ndi iyo. Mukatha kugwiritsa ntchito, singano imachotsedwa ndikuitaya. Cholembera sichingatheke kusungidwa ndi singano yolumikizidwa ndi iyo, chifukwa izi zimapangitsa kuti thovu la mpweya lipange cartridge ya mankhwala.

Popereka mankhwala opitilira muyeso 60, jakisoni awiri amachitidwa.

Kuti muwone zotsalira za insulini mu katiriji, muyenera kuloza jakisoni ndi nsonga ya singano kuti muwone kuchuluka kwa insulin yomwe ili pachikwangwani chonyamula cartridge.Chizindikiro ichi sichikugwiritsidwa ntchito kukhazikitsa mlingo.

Kuti muchotse kapu kuchokera ku jakisoni, muyenera kukoka. Ngati pali zovuta zilizonse, zungulirani mosamala nthawi yomweyo ndikuzikoka, kenako ndikukoka.

Nthawi iliyonse musanalowe jakisoni, amawunikira insulin, popeza popanda iwo mutha kupeza insulin yochepa kwambiri kapena yambiri. Kuti muwone, chotsani singano yakunja ndi yamkati ya singano, potembenuza batani la mlingo, mayunitsi awiri akhazikitsidwa, jekeseni amawongoleredwa kumtunda ndikugogoda pa cholembera kuti mpweya wonse usonkhane kumtunda. Kenako akanikizire batani la mlingo mpaka litayima ndipo nambala 0 ipezeka pazenera la dotolo. Kuyika batani m'malo opezekanso, pang'onopang'ono kuwerengera mpaka 5, panthawiyi insulin ikayamba kuwonekera kumapeto kwa singano. Ngati tsenga la insulin silikuwoneka, singano imasinthidwa ndi yatsopano ndikuyambiranso.

Kupereka mankhwala

• chotsani chipewa mu syringe cholembera
• ndi swab wothira mowa, pukuta chotupa cha kumapeto kwa chotengera,
• ikani singano mu kapu mwachindunji pamphepete mwa jakisoni ndikuyinya mpaka itaphatikizika kwathunthu,
• potembenuza batani la mlingo, chiwerengero chofunikira chayikidwa,
• chotsani chovalacho ndi singano ndikuchiyika pansi pa khungu.
• ndi chala chanu, kanikizani batani la mlingo mpaka litayima kwathunthu. Kuti mulowetse mlingo wathunthu, gwiritsani batani ndipo pang'onopang'ono muwerenge mpaka 5,
• singano imachotsedwa pakhungu.
• onani chizindikiro - ngati chili ndi nambala 0, mankhwalawo alembetsedwa kwathunthu,
• ikani chotsekera chakunja pa singano ndikuchotsa kumakina, kenako nkutaya,
• ikani chipewa pa syringe cholembera.

Ngati wodwala akukayikira kuti wapereka mlingo wonse, sayenera kupatsanso mlingo wobwereza.

Zotsatira zoyipa

• Nthawi zambiri: hypoglycemia (mu milandu yoopsa, imatha kuyambitsa kukhumudwa kwa hypoglycemic coma, mwapadera - kufa),
• zotheka: lipodystrophy, thupi lawo siligwirizana - kutupa, redness kapena kuyabwa pamalo jakisoni,
• kawirikawiri: zomwe thupi limatulutsa - kuchuluka thukuta, tachycardia, kutsika magazi, kufupika, malungo, angioedema, urticaria, kuyabwa mthupi lonse.

Malangizo apadera

Kusamutsa wodwala kupita ku dzina lina kapena mtundu wa insulin kumachitika moyang'aniridwa ndi achipatala. Mukasintha njira zopangira, mitundu, mtundu, mtundu ndi / kapena ntchito, kusintha kwa mlingo kungafunike.

Zizindikiro zomwe zikuwonetsa kukula kwa hypoglycemia sizingatchulidwe komanso kusakhudzidwa kwambiri ndi chithandizo cha insulin, kukhalapo kwa nthawi yayitali ndi matenda a shuga, matenda amagetsi amthupi motsutsana ndi matenda osokoneza bongo, komanso munthawi yomweyo kugwiritsa ntchito mankhwala, monga beta-blockers.

Zizindikiro zoyambirira za hypoglycemia mwa odwala omwe ali ndi vuto la hypoglycemic atasintha kuchokera ku insulin yochokera ku nyama kupita ku insulin yaumunthu akhoza kukhala ocheperako kapena osiyana ndi omwe anali nawo ndi insulin yakale panthawi yamankhwala.

Pankhani ya hyperglycemic kapena hypoglycemic yomwe sinakonzeke bwino, kukulitsa chiyembekezo, chikomokere, kapena kumwalira kumatha. Kugwiritsa ntchito mankhwalawa osakwanira kapena kusiya kumwa mankhwala, makamaka mtundu wa matenda a shuga I, kungayambitse kukula kwa hyperglycemia ndi matenda ashuga a ketoacidosis, omwe angawononge moyo wa wodwalayo.

Mu kuperewera kwa aimpso ndi hepatic, kumatha kuchepetsa kufunika kwa insulin, komwe kumalumikizidwa ndi kuchepa kwa insulin metabolism ndi njira ya gluconeogeneis. Kulephera kwa chiwindi kosatha (chifukwa cha kukana insulini), kupsinjika, matenda opatsirana, kuchuluka kwa chakudya mu chakudya, kufunika kwa insulin kumatha kuchuluka.

Pankhani ya kusintha kwazomwe mumadya komanso kuchuluka kwa zochitika zolimbitsa thupi, kusintha kwa mankhwala kungafunike. Mukamachita masewera olimbitsa thupi mutatha kudya, ndizotheka kuwonjezera chiopsezo cha hypoglycemia. Chifukwa cha pharmacodynamics yamankhwala osokoneza bongo a insulin analogues, hypoglycemia imatha kuyamba jekeseni pambuyo pogwiritsa ntchito insulin yaumunthu.

Mukamayambitsa kukonzekera kwa insulin ndi kuchuluka kwa 40 IU mu 1 ml pakanema, sikungatheke kupeza insulin kuchokera ku cartridge ndi insulin ndende ya 100 IU mu 1 ml yogwiritsira ntchito syringe kuperekera insulin ndi kuchuluka kwa 40 IU mu 1 ml.

Kugwiritsa ntchito munthawi yomweyo kukonzekera insulin ndi mankhwala a gulu la thiazolidinedione kumawonjezera mwayi wokhala ndi vuto la mtima komanso vuto la mtima, makamaka motsutsana ndi maziko a mtima ndi mawonekedwe a mtima.

Odwala panthawi ya chithandizo ayenera kusamala poyendetsa magalimoto ndikuchita zinthu zowopsa zomwe zimafuna chidwi chochulukirapo komanso kuthamanga kwa zochitika zama psychomotor.

Kuyanjana kwa mankhwala osokoneza bongo

Mphamvu ya mankhwala / zinthu pa insulin lispro ndi mankhwala osakanikirana:

• phenothiazine derivatives, nicotinic acid, lithiamu carbonate, isoniazid, diazoxide, chlorprotixene, thiazide diuretics, triceclic antidepressants, beta-2-adrenergic agonists (terbutaline, salbutamol, ritodrin, etc.), danazoleroidones kuopsa kwa mphamvu yake yamatsenga,
• angiotensin II receptor antagonists, octreotide, angiotensin - kutembenuza ma enzyme inhibitors (enapril, Captopril), ma antidepressants (monoamine oxidase inhibitors), mankhwala a sulfanilamide, salicylates (acetylsalicylic acid, etc., mankhwala a phencygencotic, hypogly ethanol ndi ethanol-mankhwala, beta-blockers: kuonjezera zovuta zake hypoglycemic kwenikweni.

Lyspro insulin yosakanikirana ndi insulin ya nyama.

Musanamwe mankhwala ena, ndikofunikira kukaonana ndi dokotala. Pomupangira, mankhwalawa angagwiritsidwe ntchito limodzi ndi insulin yaumunthu wokhala pakanthawi kake kapena mitundu yamkamwa ya sulfonylureas.

The fanizo la Humalog ndi Iletin I wokhazikika, Iletin II wokhazikika, Inutral SPP, Inutral HM, Farmasulin.

Migwirizano ndi magwiritsidwe akusungidwa

Sungani 2-8 ° C mufiriji, cholembera / cholembera - mpaka 30 ° C kwa milungu 4. Pewani kufikira ana.

Moyo wa alumali ndi zaka zitatu.

Mankhwala Okhala Pamalo a Pharmacy

Yoperekedwa ndi mankhwala.

Kodi mwapeza cholakwika m'mawuwo? Sankhani ndikusindikiza Ctrl + Lowani.

Ngakhale kuti asayansi adakwanitsa kubwereza molekyulu yonse ya insulin, yomwe imapangidwa m'thupi la munthu, zochita za mahomoniwo zidasinthiratu chifukwa nthawi yomwe amafunika kunyamula magazi. Mankhwala oyamba osinthika anali insulin Humalog. Imayamba kugwira ntchito patangodutsa mphindi 15 jakisoni, choncho shuga yochokera m'mwaziyo imasamutsidwira minofu yake munthawi yake, ndipo ngakhale hyperglycemia yochepa siyimachitika.

Ndikofunikira kudziwa! Nkhani yatsopano yomwe ikulangizidwa ndi ma endocrinologists a Kuwunika Kwachisawawa Kokulu! Ndi zofunika tsiku lililonse.

Poyerekeza ndi ma insulins omwe adapangidwa kale, Humalog ikuwonetsa zotsatira zabwino: mwa odwala, kusinthasintha kwa tsiku ndi tsiku kwa shuga kumachepetsedwa ndi 22%, magirisi am'magazi amayenda bwino, makamaka masana, ndipo mwayi wa kuchepa kwambiri kwa hypoglycemia umachepa. Chifukwa chachangu, koma chokhazikika, insulin iyi imagwiritsidwa ntchito kwambiri mu shuga.

Malangizo achidule

Malangizo ogwiritsira ntchito insulin Humalog ndiwosakhazikika, ndipo magawo omwe amafotokoza zoyipa ndi mayendedwe akugwiritsidwa ntchito amakhala ndi zigawo zingapo. Kufotokozera kwakutali komwe kumayendera limodzi ndimankhwala ena kumadziwika ndi odwala ngati chenjezo lokhuza kuwopsa kwawo. M'malo mwake, zonse ndizofanana: langizo lalikulu, latsatanetsatane - umboni wa mayesero ambiri kuti mankhwalawa adapirira

Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale

Matenda a shuga ndi omwe amayambitsa pafupifupi 80% yonse yamikwingwirima ndi kuduladula. Anthu 7 mwa anthu 10 amafa chifukwa cha mitsempha ya mtima kapena ubongo. Pafupifupi nthawi zonse, chifukwa chomaliza chomaliza ndi chimodzimodzi - shuga wamwazi.

Shuga akhoza ndipo amayenera kugwetsedwa, apo ayi. Koma izi sizichiritsa matendawa, koma zimangothandiza kulimbana ndi kufufuza, osati zomwe zimayambitsa matendawa.

Mankhwala okhawo omwe amavomerezeka pamankhwala othandizira odwala matenda ashuga komanso amagwiritsidwa ntchito ndi ma endocrinologists pantchito yawo ndi awa.

Kugwiritsa ntchito bwino kwa mankhwalawa, kuwerengera malinga ndi njira yokhazikika (kuchuluka kwa odwala omwe achiwonjezere kuchuluka kwa odwala omwe ali pagulu la anthu 100 omwe adachitiridwa chithandizo):

• Matenda a shuga - 95%
• Kuthetsa kwa mitsempha thrombosis - 70%
• Kuthetsa kwa kugunda kwamtima kwamphamvu - 90%
• Kuthana ndi kuthamanga kwa magazi - 92%
• Kulimbitsa tsiku, kukonza kugona usiku - 97%

Opanga si bungwe lazamalonda ndipo amalipidwa ndi chithandizo cha boma. Chifukwa chake, tsopano wokhala aliyense ali ndi mwayi.

Humalogue wavomerezedwa kuti agwiritse ntchito zaka 20 zapitazo, ndipo tsopano sizabwino kunena kuti insuliniyi ndi yotetezeka pa mlingo woyenera. Ivomerezeka kuti igwiritsidwe ntchito ndi akulu ndi ana, itha kugwiritsidwa ntchito pazochitika zonse, limodzi ndi kusowa kwa mahomoni: mtundu 1 ndi mtundu 2 wa shuga, opaleshoni ya opaleshoni ya m'mimba.

Zambiri pa Humalogue:

Zina mwazotsatira zoyipa, hypoglycemia ndi thupi lawo siligwirizana nthawi zambiri zimawonedwa (1-10% ya odwala matenda ashuga). Osakwana 1% odwala amakhala ndi lipodystrophy pamalo opangira jekeseni. Makulidwe azinthu zina zoyipa amakhala ochepera 0.1%.

Chofunika Kwambiri Zokhudza Humalog

Kunyumba, Humalog imayendetsedwa popanda kugwiritsira ntchito cholembera kapena. Ngati matenda oopsa a hyperglycemia atachotsedwa, mankhwala osokoneza bongo amathandizanso kuchipatala. Pankhaniyi, kuthana ndi shuga pafupipafupi ndikofunikira kupewa bongo.

Chithandizo chogwira ntchito cha mankhwala ndi insulin lispro. Amasiyana ndi mahomoni amunthu pakupanga ma amino acid mu molekyulu. Kusintha koteroko sikulepheretsa ma cell receptors kuzindikira mahomoni, chifukwa chake amapatsira shuga mwa iwo okha. Chiwonetserochi chimakhala ndi ma insulin monomers okha - mamolekyulu osalumikizana. Chifukwa cha izi, imakamizidwa mwachangu komanso moyenera, imayamba kuchepetsa shuga mwachangu kuposa insulin yachilendo.

Humalog ndi mankhwala osokoneza bongo kuposa, mwachitsanzo, kapena. Malinga ndi gulu, amatchulidwa ndi ma insulin omwe ali ndi ultrashort action. Kukhazikika kwa ntchito yake kumachitika mwachangu, pafupifupi mphindi 15, kotero odwala matenda ashuga sayenera kudikirira mpaka mankhwalawo atagwira, koma mutha kukonzekera chakudya mukangobaya jakisoni. Chifukwa cha kufupika kwakanthawi, kumakhala kosavuta kukonza zakudya, ndipo chiopsezo cha kuiwala chakudya jakisoni itachepa.

Kuti muthane ndi vuto labwino la glycemic, othandizira othandizira ayenera kuphatikizidwa ndi kuvomerezedwa. Chokha chosiyana ndi kugwiritsa ntchito pampu ya insulin nthawi zonse.

Sankhani

Mlingo wa Humalog umatengera zinthu zambiri ndipo umatsimikiziridwa payekhapayekha kwa aliyense wodwala matenda ashuga. Kugwiritsa ntchito njira zoyenera sikulimbikitsidwa, popeza zimakulitsa kubwezeretsanso shuga. Ngati wodwala amatsatira zakudya zamafuta ochepa, mlingo wa Humalog umakhala wocheperako kuposa momwe oyang'anira angapangire. Pankhaniyi, tikulimbikitsidwa kugwiritsa ntchito insulin yofulumira.

Hormashort ya Ultrashort imapereka mphamvu kwambiri. Mukasinthira ku Humalog, mlingo wake woyambirira amawerengedwa ngati 40% ya insulin yayifupi. Malinga ndi zotsatira za glycemia, mlingo umasinthidwa. Chofunikira pakukonzekera mkate uliwonse ndimagawo 1-1,5.

Jekeseni njira

Chakudya chimayalidwa chakudya chilichonse chisanachitike. osachepera katatu patsiku . Pankhani ya shuga wambiri, mawonekedwe okhathamira pakati pa jakisoni wamkulu amaloledwa. Malangizo ogwiritsira ntchito akutsimikizira kuwerengera kuchuluka kwa insulini yochokera pamafuta omwe akukonzekera chakudya chotsatira. Pafupifupi mphindi 15 ayenera kuchokera jakisoni kupita chakudya.

Malinga ndi ndemanga, nthawi ino nthawi zambiri zimakhala zochepa, makamaka masana, pomwe insulin kukana imakhala yotsika. Mlingo wa mayamwidwe ndi munthu payekhapayekha, umatha kuwerengeka pogwiritsa ntchito kuchuluka kwa shuga m'magazi pambuyo pobayidwa. Ngati kutsitsa kwa shuga kumawonedwa mwachangu kuposa momwe malangizowo amafunikira, nthawi yomwe chakudya chisanachitike iyenera kuchepetsedwa.

Humalog ndi imodzi mwamankhwala omwe amafulumira kwambiri, motero ndikofunikira kugwiritsa ntchito ngati thandizo ladzidzidzi kwa odwala matenda ashuga ngati wodwala ali pachiwopsezo.

Nthawi yogwira (yochepa kapena yayitali)

Peak ya insulin ya ultrashort imawonedwa patatha mphindi 60 kuchokera pakukhazikitsa. Kutalika kwa zochita zimatengera mlingo; kukula kwake ndikutalika kwa shuga, pafupifupi - pafupifupi maola 4.

Kusakaniza kwa Humalog 25

Kuti muwone molondola momwe Humalog ikuyendera, shuga ayenera kuyesedwa pambuyo pa nthawi imeneyi, nthawi zambiri izi zimachitika chakudya chotsatira chisanachitike. Miyeso yoyambirira imafunikira ngati hypoglycemia ikukayikira.

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 - Endocrinology Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsiratu matenda ashuga. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wapanga kukhazikitsidwa komwe kumavomerezana ndi kukwera mtengo kwa mankhwalawa. Ku Russia, odwala matenda ashuga mpaka Marichi 2 nditha kuipeza - Kwa ma ruble 147 okha!

Kutalika kwakanthawi kwa Humalog si koyipa, koma mwayi wa mankhwalawa. Tikuthokoza, odwala omwe ali ndi matenda osokoneza bongo sakhala ndi vuto la hypoglycemia, makamaka usiku.

Kusakaniza Kwa Humalog

Kuphatikiza pa Humalog, kampani yopanga zamankhwala Lilly France imatulutsa Humalog Remix. Ndiosakanikirana kwa lyspro insulin ndi protamine sulfate. Chifukwa cha kuphatikiza uku, nthawi yoyambira ya mahomoni imakhalabe mwachangu, ndipo nthawi yochitapo kanthu imawonjezeka kwambiri.

Kusintha kwa Humalog kumapezeka mu 2indi:

Ubwino wokhawo wa mankhwalawa ndi regimen yosavuta. Kulipira shuga kwa odwala matenda ashuga ndi kagwiritsidwe ntchito kwawo ndi koipa kuposa kukhala ndi mankhwalawa a insulin komanso kugwiritsa ntchito mtundu wina wa Humalog ana Humalog Mix sagwiritsidwa ntchito .

Insulin iyi imayikidwa:

1. Anthu odwala matenda ashuga omwe sangathe kuwerengera payekha payekha kapena kupanga jakisoni, mwachitsanzo, chifukwa cha kusawona bwino, ziwalo kapena kugwedezeka.
2. Odwala omwe ali ndi matenda amisala.
3. Okalamba odwala omwe ali ndi zovuta zambiri za matenda ashuga komanso kuperewera koyipa kwa chithandizo ngati sakufuna kuphunzira.
4. Anthu odwala matenda ashuga omwe ali ndi matenda amtundu wa 2, ngati mahomoni awo akupangidwabe.

Kuchiza matenda a shuga ndi Humalog Remix kumafuna kudya mosasangalatsa yunifolomu, zakudya zazovomerezeka pakati pa chakudya. Amaloledwa kudya mpaka 3 XE pa chakudya cham'mawa, mpaka 4 XE pachakudya chamadzulo komanso chamadzulo, pafupifupi 2 XE pachakudya chamadzulo, ndi 4 XE asanagone.

Ma Analogi a Humalog

Lyspro insulin monga chinthu chogwira imangopezeka mu Humalog yoyambayo. Mankhwala osokoneza bongo ndi (ozikidwa pa aspart) ndi (glulisin). Zida izi ndizothandizanso pofupikitsa, zilibe kanthu kuti musankhe iti. Zonse zimalekeredwa bwino ndipo zimapereka shuga msanga. Monga lamulo, zokonda zimaperekedwa kwa mankhwalawa, omwe amatha kupezeka kwaulere kuchipatala.

Kusintha kuchokera ku Humalog kupita ku analogue yake kungakhale kofunikira pakakhala zovuta zina. Ngati wodwala matenda ashuga amatsatira zakudya zamafuta ochepa, kapena amakhala ndi hypoglycemia, ndizosavuta kugwiritsa ntchito anthu m'malo mwa insulin.

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.

DNA imabweretsanso insulin ya anthu.
Kukonzekera: HUMALOG®
The yogwira mankhwala: insulin lyspro
ATX Encoding: A10AB04
KFG: Insulin yofulumira ya anthu
Nambala yolembetsa: P. 015490/01
Tsiku lolembetsa: 02.02.04
Mwini reg. acc: LILLY FRANCE S.A.S.

Njira yothetsera jakisoni ndi yowonekera, yopanda utoto.

1 ml
insulin lispro *
100 IU

Omwe amathandizira: glycerol, zinc oxide, sodium hydrogen phosphate, m-cresol, madzi d / ndi, hydrochloric acid yankho la 10% ndi sodium hydroxide solution ya 10% (kupanga pH yofunikira).

3 ml - makatoni (5) - matuza (1) - mapaketi a makatoni.

* Dongosolo la mayiko ena omwe siali eni ake omwe amavomerezedwa ndi WHO, ku Russian Federation, matchulidwe a dzina lapadziko lonse - insulin lispro amavomerezedwa.

Kufotokozera kwa mankhwalawa kumatengera malangizo ovomerezeka omwe angagwiritsidwe ntchito.

Pharmacological kanthu Humalog

DNA imabweretsanso insulin ya anthu. Amasiyana ndi omwe amasinthidwa motsatizana mwa ma amino acid m'malo 28 ndi 29 a insulin B.

Choyambitsa chachikulu cha mankhwalawa ndi kuyamwa kwa kagayidwe kazakudya. Kuphatikiza apo, ili ndi anabolic zotsatira. Mu minofu ya minofu, pali kuchuluka kwa glycogen, mafuta acid, glycerol, kuchuluka kwa mapuloteni komanso kuwonjezereka kwa kumwa ma amino acid, koma nthawi yomweyo kumachepa mu glycogenolysis, gluconeogeneis, ketogeneis, lipolysis, proteinabolism ndi kutulutsidwa kwa ma amino acid.

Odwala omwe ali ndi mtundu woyamba wa 2 ndi mtundu wa 2 shuga, akamagwiritsa ntchito insulin lyspro, hyperglycemia yomwe imachitika chakudya itatha amachepetsa kwambiri poyerekeza ndi insulin yaumunthu. Kwa odwala omwe amalandira ma insulin achidule komanso ofunika, amafunika kusankha kuchuluka kwa ma insulin onse kuti tsiku lililonse azikhala ndi shuga.

Monga momwe akukonzekera insulin yonse, kutalika kwa nthawi ya lyspro insulin kumatha kukhala kosiyanasiyana mwa odwala kapena nthawi zosiyanasiyana wodwala yemweyo ndipo zimatengera mlingo, malo a jakisoni, magazi, kutentha kwa thupi ndi zochitika zolimbitsa thupi.

Mankhwala a lyspro insulin mwa ana ndi achinyamata ali ofanana ndi omwe amawonekera mwa akulu.

Odwala omwe ali ndi matenda a shuga a 2 alandila Mlingo wambiri wa sulfonylurea, kuwonjezera kwa insulin kumapangitsa kutsika kwa hemoglobin wa glycosylated.

Mankhwala a Lyspro insulin odwala omwe ali ndi vuto la mtundu woyamba 1 komanso 2 amaperekedwera limodzi ndi kuchepa kwa ziwopsezo za nocturnal hypoglycemia.

Kuyankha kwa glucodynamic ku isulin lispro sikudalira kugwira ntchito kwa impso kapena chiwindi.

Lyspro insulin yawonetsedwa kuti imakhala yofanana ndi insulin yaumunthu, koma zochita zake zimachitika mwachangu kwambiri ndikukhalitsa kwakanthawi.

Lyspro insulin imadziwika ndi kuyamba mwachangu (pafupifupi mphindi 15), monga Ili ndi mayamwidwe ambiri, ndipo izi zimakupatsani mwayi woti mulowe musanadye (0-15 mphindi musanadye), mosiyana ndi insulin yachilendo (mphindi 30-45 musanadye). Lyspro insulin imakhala ndi nthawi yofupikirako (maola 2 mpaka 5) poyerekeza ndi insulin ya anthu wamba.

Pharmacokinetics wa mankhwala.

Zogulitsa ndi kugawa

Pambuyo pakuyang'anira sc, insulin Lyspro imatengedwa mwachangu ndikufika ku Cmax m'madzi a m'magazi pambuyo pa mphindi 30-70. Vd ya insulin lyspro ndi insulin wamba ya anthu ndi ofanana ndipo ali mgulu la 0.26-0.36 l / kg.

Ndi sc makonzedwe a T1 / 2 a insulin, lyspro ili pafupifupi ola 1. Odwala omwe ali ndi impso ndi hepatic insufficiency amakhala ndi mwayi wambiri wolowetsa lyspro insulin poyerekeza ndi masiku onse a insulin.

Zisonyezo zogwiritsidwa ntchito:

Shuga mellitus mwa akulu ndi ana, omwe amafunikira chithandizo cha insulin kuti akhalebe ndi shuga.

Mlingo ndi njira ya mankhwala.

Dokotala amawerengera aliyense payekha, kutengera zosowa za wodwalayo. Humalog imatha kuperekedweratu musanadye, ngati kuli kotheka - mutangodya.

Kutentha kwa mankhwala omwe amaperekedwa kuyenera kukhala kutentha kwambiri.

Humalog imayendetsedwa sc m'njira ya jakisoni kapena mawonekedwe a sc kulowetsedwa pogwiritsa ntchito insulin pump.Ngati ndi kotheka (ketoacidosis, matenda owopsa, nthawi pakati pa opaleshoni kapena nthawi ya postoperative) Humalog ikhoza kulowa mkati / mkati.

SC iyenera kuperekedwa kwa phewa, ntchafu, matako, kapena pamimba. Masamba a jakisoni ayenera kusinthidwa kuti malo omwewo asagwiritsidwerenso nthawi 1 pamwezi. Mukamayambitsa mankhwalawa Humalog, chisamaliro chiyenera kutengedwa kuti mupewe magazi. Pambuyo pa jakisoni, tsamba la jakisidwe siliyenera kutenthedwa. Wodwala ayenera kuphunzitsidwa njira yolondola ya jakisoni.

Malangizo oyendetsera mankhwalawa Humalog

Kukonzekera mawu oyamba

Yankho la mankhwalawa Humalog liyenera kukhala loonekera komanso lopanda utoto. Njira yothira ngati yafinya, kapena yakuwala pang'ono,

Mukakhazikitsa cartridge mu syringe cholembera (cholembera), ndikulowa ndi singano ndikuchita jakisoni wa insulin, ndikofunikira kutsatira malangizo a wopanga omwe amaphatikizidwa ndi cholembera chilichonse.

2. Sankhani tsamba la jakisoni.

3. Antiseptic kuchitira khungu malo jakisoni.

4. Chotsani kapu ku singano.

5. Sinthani khungu lanu mwakuutambasula kapena poteteza khola lalikulu. Ikani singano molingana ndi malangizo ogwiritsa ntchito cholembera.

6. Kanikizani batani.

7. Chotsani singano ndikufinya pang'onopang'ono malo a jakisoni kwa masekondi angapo. Osatupa malo a jakisoni.

8. Pogwiritsa ntchito singano, inaninso singano ndikuwononga.

9. Mawebusayiti ayenera kusinthidwa kuti malo omwewo asagwiritsenso ntchito nthawi 1 pamwezi.

I kuyang'anira insulin

Jekeseni wa intravenous wa Humalog uyenera kuchitika molingana ndi chizolowezi chachipatala cha jakisoni wamkati, mwachitsanzo, kulowetsedwa kwa bolus kapena kugwiritsa ntchito kulowetsedwa. Poterepa, nthawi zambiri ndikofunikira kulamula kuchuluka kwa shuga m'magazi.

Makina a kulowetsedwa okhala ndi zozungulira kuyambira 0,1 IU / ml mpaka 1,0 IU / ml insulin lispro mu 0,9% sodium chloride solution kapena 5% dextrose solution amakhala okhazikika firiji kwa maola 48.

Kulowetsedwa kwa insulin / P / C pogwiritsa ntchito pampu ya insulin

Pobayira mankhwala a Humalog, mapampu Ochepera ndi Disetronic angagwiritsidwe ntchito kulowetsedwa kwa insulin. Muyenera kutsatira mosamalitsa malangizo omwe abwera ndi pampu. Njira ya kulowetsedwa imasinthidwa maola 48 aliwonse. Pakachitika vuto la hypoglycemic, kulowetsaku kumayimitsidwa mpaka gawo litatsimikiza. Ngati pali shuga wobwereza mobwerezabwereza kapena wochepa kwambiri m'magazi, ndiye kuti muyenera kudziwitsa dokotala za izi ndikuganiza kuchepetsa kapena kuletsa kulowetsedwa kwa insulin. Kuperewera kwa pampu kapena kufalikira mu dongosolo la kulowetsedwa kumatha kubweretsa kukwera msanga kwamagazi. Ngati mukukayikira kuti akuphwanya insulin, muyenera kutsatira malangizowo ndipo ngati kuli koyenera dziwitsani adokotala. Mukamagwiritsa ntchito pampu, mankhwala a Humalog sayenera kusakanikirana ndi ma insulini ena.

Zotsatira zoyipa Humalog:

Zotsatira zoyipa zomwe zimakhudzana ndi zotsatira zazikulu za mankhwalawa: hypoglycemia. Hypoglycemia yayikulu imatha kutha mphamvu ya chikumbumtima (hypoglycemic chikomokere), ndipo, mwatsatanetsatane, kufa.

Zotsatira zoyipa: zamkati zimatha kugundana - kufupika, kutupa kapena kuyunkhira pamalo a jakisoni (nthawi zambiri zimatha patatha masiku angapo kapena masabata), kayendedwe ka ziwalo (zimachitika kawirikawiri, koma zimakhala zowopsa) - kuyabwa, urticaria, angioedema, kutentha, kupuma movutikira, kutsika magazi, tachycardia, kuchuluka thukuta. Milandu yambiri yokhudzana ndimomwe thupi limagwirira ntchito ikhoza kukhala pachiwopsezo cha moyo.

Zina: lipodystrophy pamalo opangira jakisoni.

Zotsatira zamankhwala:

Hypersensitivity pamagawo a mankhwala.

Gwiritsani ntchito pa nthawi yoyembekezera

Mpaka pano, palibe zotsatira zosasangalatsa za Lyspro insulin pa mimba kapena thanzi la mwana wosabadwayo / wakhanda. Palibe kafukufuku wokhudzana ndi mliri omwe adachitika.

Cholinga cha mankhwala a insulin panthawi yapakati ndikusunga chiwongolero chokwanira cha glucose mwa odwala omwe ali ndi matenda a shuga a shuga kapena omwe amadwala matenda a shuga. Kufunika kwa insulin nthawi zambiri kumachepera mu trimester yoyamba ndikuwonjezeka muyezo wachiwiri ndi wachitatu wama trimesters apakati. Nthawi yobadwa pambuyo pokhapokha ndipo mwayamba kubadwa, zofunika za insulin zimatha kugwa kwambiri.

Amayi amisinkhu yokhala ndi matenda ashuga ayenera kudziwitsa adotolo za kuyambika kapena kukhala ndi pakati. Pa nthawi yoyembekezera, odwala matenda a shuga amafunika kuwunika mosamala kuchuluka kwa shuga m'magazi, komanso kuyang'aniridwa kawirikawiri kuchipatala.

Odwala omwe ali ndi matenda a shuga mellitus nthawi yoyamwitsa, kusintha kwa insulin ndi / kapena zakudya kungafunike.

Malangizo apadera ogwiritsira ntchito Humalog.

Kusamutsa wodwala kupita ku mtundu wina kapena mtundu wa insulin kuyenera kuchitika moyang'aniridwa ndi achipatala. Kusintha kwa zochitika, mtundu (wopanga), mtundu (mwachitsanzo, Wokhazikika, NPH, Tepi), mitundu (nyama, anthu, ma insulin analogue) ndi / kapena njira yopanga (DNA recombinant insulin kapena insulini yachikhalidwe) ingafunike kusintha kwa mlingo.

Mikhalidwe yomwe zizindikiro zoyambirira za hypoglycemia zitha kukhala zosakhudzika komanso zochepa zomwe zimaphatikizidwa zimaphatikizapo kukhalapo kwa matenda a shuga, kulimbitsa kwambiri insulin, matenda amanjenje m'matenda a shuga, kapena mankhwala, monga beta-blockers.

Odwala omwe ali ndi vuto la hypoglycemic atasamutsidwa kuchokera ku insulin yochokera ku nyama kupita ku insulin yaumunthu, zizindikiro zoyambirira za hypoglycemia zitha kutchulidwa pang'ono kapena zosiyana ndi zomwe adakumana nazo kale ndi insulin. Hypoglycemic yosasinthika kapena ma hyperglycemic zomwe zimachitika zimatha kuyambitsa chikumbumtima, chikomokere, kapena kufa.

Mlingo wosakwanira kapena kutha kwa mankhwalawo, makamaka ndi matenda a shuga a shuga, amatha kutsegula ndi hyperglycemia ndi matenda ashuga a ketoacidosis, mikhalidwe yomwe ikhoza kukhala pangozi kwa wodwalayo.

Kufunika kwa insulini kumatha kuchepa kwa odwala omwe amalephera kupweteka kwa impso, komanso kwa odwala omwe ali ndi vuto la chiwindi chifukwa cha kuchepa kwa njira ya gluconeogeneis ndi insulin metabolism. Komabe, mwa odwala omwe ali ndi vuto losatha la chiwindi, kukana kwa insulini kungayambitse kuchuluka kwa insulin.

Kufunika kwa insulin kumatha kuwonjezeka ndi matenda opatsirana, kupsinjika kwamalingaliro, ndikuwonjezereka kwa kuchuluka kwa chakudya chamagulu muzakudya.

Kusintha kwa mlingo kumafunikanso ngati wodwala akuchulukitsa kapena kusintha kwachilendo kwa zakudya. Kuchita masewera olimbitsa thupi mukangomaliza kudya kumawonjezera chiopsezo cha hypoglycemia. Zotsatira za pharmacodynamics za insulin analogi zomwe zimagwira mwachangu ndikuti ngati hypoglycemia imayamba, ndiye kuti imatha kupanga jekeseni m'mbuyomu kuposa kubayidwa insulin yamunthu.

Wodwalayo ayenera kuchenjezedwa kuti ngati dokotala atayambitsa kukonzekera kwa insulin ndi kuchuluka kwa 40 IU / ml mu vial, ndiye kuti insulini sayenera kutengedwa kuchokera ku cartridge ndi insulin ya 100 IU / ml ndi syringe ya jekeseni wa insulin wochita ndi 40 IU / ml.

Ngati kuli kofunikira kumwa mankhwala ena nthawi imodzi ndi Humalog, wodwalayo ayenera kufunsa dokotala.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Ndi hypoglycemia kapena hyperglycemia yolumikizana ndi mtundu wosakwanira wa dosing, kuphwanya kuthekera kwambiri komanso kuthamanga kwa zochitika zama psychomotor ndikotheka. Izi zitha kukhala pachiwopsezo cha zinthu zoopsa (kuphatikizapo kuyendetsa galimoto kapena kugwira ntchito ndi makina).

Odwala ayenera kusamala kuti apewe hypolycemia poyendetsa. Izi ndizofunikira kwambiri kwa odwala omwe ali ndi kuchepetsedwa kapena kusamvetseka kwa zizindikiro zoneneratu za hypoglycemia, kapena omwe zochitika za hypoglycemia ndizofala. Pazochitika izi, ndikofunikira kuyesa kuwongolera kutha kuyendetsa. Odwala omwe ali ndi matenda ashuga amatha kudzithandizira kuti amvetsetse Hypoglycemia wodwala ngati atenga glucose kapena zakudya zamafuta ambiri (tikulimbikitsidwa kuti nthawi zonse mumakhala ndi shuga g) pafupifupi 20 g. Wodwala ayenera kudziwitsa adokotala za hypoglycemia yosamutsidwa.

Mankhwala osokoneza bongo:

Zizindikiro: hypoglycemia, limodzi ndi zizindikiro zotsatirazi: ulesi, kuchuluka thukuta, tachycardia, kupweteka mutu, kusanza, chisokonezo.

Chithandizo: Matenda ofooketsa a hypoglycemia nthawi zambiri amayimitsidwa ndikuwonjezera shuga kapena shuga wina, kapena zinthu zokhala ndi shuga.

Kuwongolera kwa hypoglycemia moyenera kumatha kuchitika mothandizidwa ndi / m kapena s / c kukhudzana ndi glucagon, kenako kutsekeka kwa chakudya chamagulu pambuyo pakhazikika pakudwala. Odwala omwe samalabadira glucagon amapatsidwa njira ya iv dextrose (glucose).

Wodwala akakhala kuti akomoka, ndiye kuti glucagon uyenera kutumikiridwa / m kapena s / c. Pokhapokha glucagon kapena ngati palibe chochita ndi kayendetsedwe kake, ndikofunikira kuyambitsa njira yokhazikika ya dextrose (glucose). Atangozindikira, wodwalayo ayenera kupatsidwa chakudya chopatsa thanzi.

Zakudya zowonjezera zowonjezera zamafuta othandizira ndikuwunikira odwala zingafunike, popeza kuyambiranso kwa hypoglycemia ndikotheka.

Kuyanjana kwa Humalog ndi mankhwala ena.

Mphamvu ya Humalog's hypoglycemic imachepetsedwa ndi kulera kwapakamwa, corticosteroids, kukonzekera kwa mahomoni a chithokomiro, danazol, beta2-adrenergic agonists (kuphatikizapo rhytodrin, salbutamol, terbutaline), tricyclic antidepressants, thiazide diuretics, chlorprotixenic acid, chlorprotixenic acid, chlorprotixenic acid zotumphukira za phenothiazine.

Zotsatira za hypoglycemic za Humalog zimapangidwira ndi ophatikiza ndi beta, ma ethanol ndi mankhwala okhala ndi ethanol, anabolic steroids, fenfluramine, guanethidine, tetracyclines, mankhwala apakamwa a hypoglycemic, salicylates (mwachitsanzo, acetylsalicylic acid, aniloprilactyl antagonists, MAP inhibitors, angiotensin II zolandila.

Humalog sayenera kusakanikirana ndi kukonzekera kwa insulin ya nyama.

Humalog ikhoza kugwiritsidwa ntchito (kuyang'aniridwa ndi dokotala) kuphatikiza ndi insulin yaumunthu yotalika kapena kuphatikizira ndi othandizira a hypoglycemic, zotumphukira za sulfonylurea.

Migwirizano yogulitsa m'mafakisi.

Mankhwala ndi mankhwala.

Migwirizano yosunga mankhwalawa Humalog.

Mndandanda B. Mankhwalawa amayenera kusungidwa kuti ana asawafikire, mufiriji, kutentha kwa 2 ° mpaka 8 ° C, osazizira. Moyo wa alumali ndi zaka 2.

Mankhwala omwe amagwiritsidwa ntchito akuyenera kusungidwa kutentha 15th mpaka 25 ° C, otetezedwa ku dzuwa kapena kutentha mwachindunji. Moyo wa alumali - osaposa masiku 28.

Munkhaniyi, mutha kuwerengera malangizo ogwiritsira ntchito mankhwalawa Chichewa . Amapereka ndemanga kuchokera kwa alendo omwe amabwera patsamba lino - ogwiritsa ntchito mankhwalawa, komanso malingaliro a akatswiri azachipatala pakugwiritsa ntchito Humalog machitidwe awo.Chopempha chachikulu ndikuti muwonjezere ndemanga zanu za mankhwalawa: mankhwalawo adathandizira kapena sanathandizire kuchotsa matendawa, ndizovuta ziti zomwe zimawoneka ndi zotsatirapo zake, mwina sizinalengezedwe ndi wopanga. Ma Analogs a Humalog pamakhala ma analogu apangidwe omwe amapezeka. Gwiritsani ntchito pochiza matenda amiseche 1 amtundu wa shuga (wodalira insulin komanso osadalira insulin) mwa akulu, ana, komanso panthawi yoyembekezera komanso mkaka wa m'mawere. The zikuchokera mankhwala.

Chichewa - analogue ya insulin yaumunthu, imasiyana ndi kusintha kwatsatanetsatane wa proline ndi lysine amino acid zotsalira pamalo 28 ndi 29 a insulin B. Poyerekeza ndikukonzekera kwanthaŵi yayitali insulin, lyspro insulin imadziwika ndi kuyambika mwachangu komanso kutha kwake, komwe kumachitika chifukwa chakuchotsa kwina kuchokera kumalo osasunthika chifukwa cha kusungidwa kwa mawonekedwe a monomeric a lyspro insulin mamolekyulu mu yankho. Kukhazikika kwa mphindi 15 pambuyo pa kayendetsedwe ka subcutaneous, mphamvu yayikulu imakhala pakati pa maola 0.5 ndi maola 2,5, kutalika kwa nthawi ndi maola 3-4.

Humalog Mix ndi DNA - maumboni odziwika a insulin yaumunthu ndipo ndi chosakanikirana chopangidwa chopangidwa ndi lyspro insulin solution (analog yothamanga ya insulin yaumunthu) ndi kuyimitsidwa kwa lyspro protamine insulin (anthawi yapakati ya insulin analogue).

Chochita chachikulu cha insulin lyspro ndi malamulo a kagayidwe ka glucose. Kuphatikiza apo, imakhala ndi anabolic komanso anti-catabolic zotsatira zosiyanasiyana zamthupi. Mu minofu ya minofu, pali kuchuluka kwa glycogen, mafuta acid, glycerol, kuchuluka kwa mapuloteni komanso kuwonjezereka kwa kumwa ma amino acid, koma nthawi yomweyo kumachepa mu glycogenolysis, gluconeogeneis, ketogeneis, lipolysis, proteinabolism ndi kutulutsidwa kwa ma amino acid.

Lyspro insulin + akubwera.

Kukwanira kwathunthu ndi kuyambika kwa mphamvu ya insulin kumadalira malo a jakisoni (m'mimba, ntchafu, matako), mlingo (kuchuluka kwa insulin), komanso kuchuluka kwa insulin pokonzekera. Imagawidwa mosiyanasiyana mu minofu. Simadutsana chotchinga ndi mkaka wa m'mawere. Amawonongedwa ndi insulinase makamaka m'chiwindi ndi impso. Amachotseredwa ndi impso - 30-80%.

• lembani matenda a shuga 1 mellitus (wodalira insulin), kuphatikiza ndi tsankho kukonzekera kwina kwa insulin, ndi postprandial hyperglycemia yomwe singathe kukonza ma insulin, kukonzekera kwachulukidwe kakang'ono ka insulini (kuthamanga kwa kuchepa kwa insulin),
• lembani matenda ashuga a 2 a shuga (osagwirizana ndi insulin): kukana kwa omwa m'magazi a hypoglycemic, komanso kuyamwa kwamisempha ina ya kukonzekera kwa insulin, matenda osagwirizana a postprandial hyperglycemia, pa ntchito, matenda ogwirizana.

Njira yothetsera kulowetsedwa kwamkati mwa 100 IU mu katoni kathengo ka 3 ml wophatikizidwa ndi cholembera cha QuickPen kapena cholembera.

Kuyimitsidwa kwa subcutaneous makonzedwe a 100 IU mu katoni 3 ml wophatikizidwa ndi cholembera cha QuickPen kapena cholembera (Humalog Remix 25 ndi 50).

Mitundu ina ya kumwa, ngati mapiritsi kapena mapiritsi, kulibe.

Malangizo ogwiritsira ntchito ndi njira yogwiritsira ntchito

Mlingo umayikidwa payekha. Lyspro insulin imayang'aniridwa subcutaneous, mu mnofu kapena kudzera m'mitsempha 5-15 asanadye. Mlingo umodzi ndi 40 magawo, owonjezera amangololedwa pokha pokha. Ndi monotherapy, Lyspro insulin imayang'aniridwa katatu pa tsiku, pamodzi ndi kukonzekera kwa insulin yayitali - katatu patsiku.

Mankhwalawa amayenera kuperekedwa mosavuta.

Intravenous makonzedwe a mankhwala Humalog Remix ali contraindicated.

Kutentha kwa mankhwala omwe amaperekedwa kuyenera kukhala kutentha kwambiri.

Subcutaneally ayenera jekeseni phewa, ntchafu, matako kapena m'mimba. Masamba a jakisoni ayenera kusinthidwa kuti malo omwewo asagwiritsidwerenso nthawi 1 pamwezi.Mukamayambitsa mankhwalawa Humalog, chisamaliro chiyenera kutengedwa kuti mupewe magazi. Pambuyo pa jakisoni, tsamba la jakisidwe siliyenera kutenthedwa.

Poika makatoni mu chipangizo cha jakisoni wa insulin ndikulowa ndi singano musanayendetsedwe ka insulin, malangizo a wopanga chipangizo cha insulin amayenera kuwonetsetsa.

Malangizo akukhazikitsa mankhwala Humalog Remix

Kukonzekera mawu oyamba

Musanagwiritse ntchito, cartridge yosakanikirana ya Humalog Mix iyenera kukugudwa pakati pa manja kasanu ndikugwedezeka, kutembenuka ndi 180 ° komanso maulendo khumi kuti ipatsenso insulin mpaka itakhala madzi kapena mkaka wopanda pake. Gwedezani mwamphamvu, monga izi zimatha kuyambitsa foam, zomwe zingasokoneze mlingo woyenera. Kupangitsa kusakanikirana, katiriji kamakhala ndi mkanda wawung'ono wagalasi. Mankhwala sayenera kugwiritsidwa ntchito ngati ali ndi ziphuphu mutatha kusakaniza.

Momwe mungapangire mankhwalawa

1. Sambani manja.
2. Sankhani malo pobayira.
3. Chitani khungu ndi antiseptic pamalo omwe jakisoni (wodzivulitsira, mogwirizana ndi malingaliro a dokotala).
4. Chotsani kapu yakunja yoteteza ku singano.
5. Sinthani khungu ndikakukoka kapena kusunga khola lalikulu.
6. Ikani singano pang'onopang'ono ndikuchita jakisoni mogwirizana ndi malangizo ogwiritsa ntchito cholembera.
7. Chotsani singano ndikufinya pang'onopang'ono malo a jakisoni kwa masekondi angapo. Osatupa malo a jakisoni.
8. Pogwiritsa ntchito chopukutira chakunja cha singano, dulani singano ndikuwononga.
9. Ikani chipewa pa cholembera.

• hypoglycemia (hypoglycemia yayikulu imatha kutha kwa chikumbumtima ndipo, mwapadera, mpaka kufa),
• redness, kutupa, kapena kuyabwa pamalowo jakisoni (nthawi zambiri zimatha patadutsa masiku angapo kapena masabata, nthawi zina izi zimachitika chifukwa cha zifukwa zosagwirizana ndi insulin, mwachitsanzo, kupweteka pakhungu ndi jakisoni woletsa kapena jekeseni wosayenera),
• kuyamwa kofananira
• kuvutika kupuma
• kupuma movutikira
• kutsika kwa magazi,
• tachycardia
• kutuluka thukuta kwambiri
• chitukuko cha lipodystrophy pamalo jakisoni.

• achina,
• Hypersensitivity pamagawo a mankhwala.

Mimba komanso kuyamwa

Mpaka pano, palibe zotsatira zosasangalatsa za Lyspro insulin pa mimba kapena mkhalidwe wa mwana wosabadwa ndi wakhanda zadziwika.

Cholinga cha mankhwala a insulin panthawi yapakati ndikukhazikika pakukhazikika kwa shuga. Kufunika kwa insulin nthawi zambiri kumachepera mu trimester yoyamba ndikuwonjezeka muyezo wachiwiri ndi wachitatu wama trimesters apakati. Nthawi yobadwa pambuyo pokhapokha ndipo mwayamba kubadwa, zofunika za insulin zimatha kugwa kwambiri.

Amayi amisinkhu yokhala ndi matenda ashuga ayenera kudziwitsa adotolo za kuyambika kapena kukhala ndi pakati.

Odwala omwe ali ndi matenda a shuga mellitus nthawi yoyamwitsa, kusintha kwa insulin ndi / kapena zakudya kungafunike.

Njira yoyendetsera njira yomwe imagwiritsidwa ntchito mulingo wa lyspro insulin uyenera kuyang'aniridwa bwino. Posamutsa odwala kuchokera ku insulin yomwe imakonzekera mwachangu kuchokera ku insulin lispro, kusintha kofunikira kungafunike. Kusamutsidwa kwa odwala omwe amalandira insulin tsiku lililonse mlingo wopitilira 100 kuchokera ku mtundu umodzi wa insulin kupita ku ina ndikulimbikitsidwa kuti upangidwe mu chipatala.

Kufunika kwa insulin kumatha kuwonjezeka panthawi yomwe matenda opatsirana, ndi nkhawa zam'maganizo, ndi kuchuluka kwa chakudya chamagulu mu chakudya, pazakudya zowonjezera zamankhwala omwe ali ndi vuto la hyperglycemic (mahomoni a chithokomiro, glucocorticoids, kulera kwapakamwa, thiazide diuretics).

Kufunika kwa insulini kumatha kuchepa ndi kuchepa kwa impso ndi / kapena chiwindi, ndi kuchepa kwa kuchuluka kwa chakudya chamagulu mu chakudya, ndi kuchuluka kwa thupi, pakudya kowonjezereka kwa mankhwala omwe ali ndi vuto la hypoglycemic (Mao inhibitors, osasankha beta-blockers, sulfonamides).

Malangizo a hypoglycemia mu mawonekedwe owopsa amatha kuchitika ndikugwiritsa ntchito i / m ndi / kapena s / glu wa glucagon kapena iv woyendetsa shuga.

Mphamvu ya hypoglycemic ya Lyspro insulin imakonzedwa ndi Mao inhibitors, osagwiritsa ntchito beta-blockers, sulfonamides, acarbose, ethanol (mowa) ndi mankhwala okhala ndi ethanol.

Mphamvu ya hypoglycemic ya Lyspro insulin imachepetsedwa ndi glucocorticosteroids (GCS), mahomoni a chithokomiro, njira zakulera zamkati, thiazide diuretics, diazoxide, antidepressants a tricyclic.

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

Mndandanda wa mankhwala Humalog

Zofanana muzochitika zamagulu:

• Lyspro insulin
• Humalog Mix 25,
• Kusintha kwa Humalog 50.

Analogs a pharmacological group (ma insulins):

• Actrapid HM Penfill,
• Actrapid MS,
• B-Insulin S.Ts. Berlin Chemie,
• Berlinsulin H 30/70 U-40,
• Berlinsulin H 30/70 cholembera,
• Berlinsulin N Basal U-40,
• Berlinsulin N Basal chole,
• Berlinsulin N Normal U-40,
• Berlinsulin N Wokhazikika P cholembera,
• Depot insulin C,
• Isofan Insulin World Cup,
• Iletin
• Thumba la Insulin SPP,
• Insulin c
• Nkhumba ya insulin yoyeretsedwa kwambiri,
• Insuman Comb,
• Intral SPP,
• World Cup,
• Combinsulin C
• Mikstard 30 NM Penfill,
• Monosuinsulin MK,
• Monotard
• Pensulin,
• Protafan HM Pofikira,
• Protafan MS,
• Rinsulin
• Ultratard NM,
• Nyumba 40,
• Kandachime 40,
• Humulin.

Popeza pali mankhwala a analogi omwe amagwira ntchito, mutha kulumikiza ulalo womwe umaperekedwa pamatenda omwe mankhwalawo amathandizira ndikuwona mawonekedwe ofananira achire.

Humalog: malangizo ogwiritsa ntchito

1 ml muli:

yogwira mankhwala: insulin lispro 100 IU / ml,

zotuluka: glycerol (glycerin), zinc oxide, sodium hydrogen phosphate heptahydrate, metacresol, madzi a jakisoni, hydrochloric acid solution 10% ndi sodium hydroxide solution 10% kukhazikitsa pH.

Zotsatira za pharmacological

Chochita chachikulu cha insulin lyspro ndi malamulo a kagayidwe ka glucose.

Kuphatikiza apo, ma insulin ali ndi mitundu yosiyanasiyana ya anabolic komanso anti-catabolic yamitundu yosiyanasiyana. Mu minofu ya minofu, pali kuchuluka kwa glycogen, mafuta acid, glycerol, kuchuluka kwa mapuloteni komanso kuwonjezereka kwa kumwa ma amino acid, koma nthawi yomweyo kumachepa mu glycogenolysis, gluconeogeneis, ketogeneis, lipolysis, proteinabolism ndi kutulutsidwa kwa ma amino acid.

Lyspro insulin imadziwika ndi kuyamba mwachangu (pafupifupi mphindi 15), yomwe imalola kuti iperekedwe nthawi yomweyo musanadye (0-15 mphindi musanadye), mosiyana ndi insulin yokhazikika (mphindi 30-45 musanadye). Kuchita kwa insulin lyspro kumadziwika ndi kuyamba mwachangu, imakhala ndi nthawi yofupikirako (kuyambira 2 mpaka 5 maola) poyerekeza ndi insulin yachilendo.

Kafukufuku wachipatala omwe amachitika kwa odwala omwe ali ndi mtundu woyamba 1 ndi mtundu wa 2 matenda a shuga awonetsa kuti ndi insulin lyspro, postprandial hyperglycemia imachepetsa kwambiri poyerekeza ndi insulin yamunthu.

Monga momwe akukonzekera insulin yonse, kutalika kwa nthawi ya lyspro insulin kumatha kukhala kosiyanasiyana mwa odwala kapena nthawi zosiyanasiyana wodwala yemweyo ndipo zimatengera mlingo, malo a jakisoni, magazi, kutentha kwa thupi ndi thupi.

Zoyesa zamankhwala zidachitidwa zokhudzana ndi ana (odwala 61 azaka za 2 mpaka 11), komanso ana ndi achinyamata (odwala 481 azaka za pakati pa 9 mpaka 19), zomwe zimayerekezera insulin lispro ndi insulle ya anthu osungunuka.Mankhwala a lyspro insulin mwa ana ndi ofanana ndi akulu.

Ikagwiritsidwa ntchito pampu ya insulin, kuchepa kwa hemoglobin wodziwikiratu kwambiri kumawonedwa pa mankhwala ndi inspro insulin poyerekeza ndi mankhwalawa omwe amasungunuka ndi insulin yaumunthu. Pakufufuza kwamaso kawiri, kutsika kwa glycosylated hemoglobin pambuyo pa milungu 12 ya mankhwala anali 0.37% mu gulu la inspro insulin poyerekeza ndi 0,03% mu gulu losungunuka la insulin ya anthu (p = 0.004).

Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri omwe amalandila Mlingo wambiri wa sulfonylurea, kuwonjezera kwa insulin kumapangitsa kuchepa kwamankhwala a hemoglobin a glycosylated. Mankhwala ochepetsedwa a HbAic ayeneranso kuyembekezeredwa ndi kukonzekera kwina kwa insulin, monga soluble kapena NPH.

Kafukufuku wachipatala adawonetsa kuti chithandizo cha insulin ndi odwala lyspro omwe ali ndi matenda a shuga 1 ndi 2 zimayendera limodzi ndi kuchepa kwa ziwonetsero za nocturnal hypoglycemia poyerekeza ndi insulle ya anthu osungunuka. M'maphunziro ena, kuchepa kwa ziwonetsero za nocturnal hypoglycemia kumalumikizidwa ndi kuchuluka kwa episode masana hypoglycemia.

Kuyankha kwa glucodynamic ku lyspro insulin palokha popanda kuwonongeka kwa impso kapena hepatic. Kusiyana kwa glucodynamics pakati pa insulin lispro ndi sungunuka wa munthu insulin yomwe imapezeka mu euglycemic hyperinsulinemic clamp test idathandizidwa m'njira zambiri zaimpso. Lyspro insulin yawonetsedwa kuti ndi ofanana ndi insulin yaumunthu, koma zochita zake zimathamanga ndipo zimatha kwakanthawi.

Pharmacokinetics

Odwala omwe amalephera kupweteka kwa impso, chiwopsezo chambiri cha lyspro insulin chimasungidwa poyerekeza ndi insulin yamunthu. Odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga, mankhwalawa amasiyana pakati pa inspro insulin ndi insulle ya insulin yaumunthu amasungidwa pamtundu wambiri waimpso, ngakhale ntchito yaimpso. Odwala ndi hepatic kusowa, kuchuluka kwa mayamwidwe ndi kuthetsa lyspro insulin amasungidwa poyerekeza ndi masiku onse a insulin.

Zizindikiro zogwiritsidwa ntchito

Chithandizo cha odwala omwe ali ndi matenda ashuga omwe amafunikira insulini kuti azikhalanso ndi glucose homeostasis. Humalog® imawonetsedwanso pakukhazikika kwa matenda ashuga.

Contraindication

Hypersensitivity kuti insulin lyspro kapena chilichonse cha mankhwala. Hypoglycemia.

Mimba komanso kuyamwa

Zambiri zokhudzana ndi kuchuluka kwa milandu yogwiritsira ntchito pakati sizinafotokoze zovuta zilizonse za insulin lispro pa mimba kapena thanzi la mwana wosabadwa / wakhanda.

Cholinga cha mankhwala a insulin panthawi yapakati ndikusunga chiwongolero chokwanira kwa odwala omwe ali ndi matenda a shuga omwe amadalira shuga kapena omwe ali ndi matenda osokoneza bongo. Kufunika kwa insulin nthawi zambiri kumachepera mu trimester yoyamba ndikuwonjezeka muyezo wachiwiri ndi wachitatu wama trimesters apakati. Amayi amisinkhu yokhala ndi matenda ashuga ayenera kudziwitsa adotolo za kuyambika kapena kukhala ndi pakati. Pa nthawi yoyembekezera, odwala matenda a shuga amafunika kuwunika mosamala kuchuluka kwa shuga m'magazi, komanso kuwunika kachipatala kawirikawiri.

Kwa odwala matenda a shuga, kusintha kwa insulin ndi / kapena zakudya kungafunike pakumuyamwa.