Fomu ya Mlingo - makapisozi: gelatinous olimba ndi mawonekedwe owoneka bwino amitundu iwiri: kukula No. 2 - yokhala ndi chivindikiro chofiirira, kukula 0: - lalanje lakuda, mkati mwa makapisozi - zolembera zovala zamkati zozungulira, zofanana ndi zolimba kapena zosasinthika kuyambira zofiirira mpaka zofiirira zofiirira. fungo (ma PC 10. mu matuza, mu mtolo wa makatoni awiri kapena 5).

The yogwira mankhwala a Mikrasim ndi kapamba, 1 kapisozi:

Kukula No. 2 - 10,000 IU (125 mg), omwe ali ofanana ndi zochitika zapakhomo za 168 mg kapena zochitika: amylase 7500 IU, lipase 10 000 IU, proteinase 520 IU,
Kukula Nambala 0 - 25,000 IU (312 mg), omwe ali ofanana ndi ntchito wamba ya 420 mg kapena ntchito: amylase 19,000 IU, lipase 25,000 IU, proteinase 1300 IU.

Zothandiza: enteric-soluble pellet chipolopolo - cholembera cha ethyl acrylate ndi methaconic acid (1: 1) (mwanjira yobalalitsa 30%, kuphatikiza momwe muli sodium lauryl sulfate ndi polysorbate 80), triethyl citrate, simethicone emulsion 30% (youma 32.6%) mu kapangidwe zomwe: methyl cellulose, inaimitsidwa colloidal silicon, sorbic acid, yodziwika bwino ya silicon colloidal, talc, madzi.

The kapangidwe kachulukidwe thupi: gelatin, madzi.

Kuphatikizidwa kwa chivundikiro cha kapisozi: gelatin, utoto wofiirira (Ponceau 4R), utoto wabuluu wokhala ndi utoto, utoto wachikasu, titanium dioxide, madzi.

Zizindikiro zogwiritsidwa ntchito

Pancreatic enzyme akusowa: pancreatic fibrosis (cystic fibrosis), zotupa za pakhungu, nyengo kapamba, nthawi yomwe atachitidwa opaleshoni yafinya - monga mankhwala olowa m'malo mwake,
Chizindikiro chothandizira monga gawo la zovuta mankhwala ochizira matenda am'mimba omwe amachitika pambuyo pake: mkhalidwe utatha matumbo, m'mimba, gawo lamatumbo, pathologies a m'matumbo ang'ono ndi akulu, ndi duodenum, ikuchitika ndikulimbikitsidwa kwamatumbo okhutira ndi zomwe zimachitika ndi matenda Mafuta amadzimadzi, kuphatikizapo cholecystitis, matenda a chiwindi, miyala mu ndulu, matenda amitsempha yapanja, kupindika kwa ndulu otentha thirakiti cysts ndi zotupa zophuka,
Kupititsa patsogolo chimbudzi kwa ana ndi ana omwe ali ndi ntchito yachilendo yam'mimba (GIT): zolakwika m'zakudya (kuphatikizapo kudya kwambiri, kudya zakudya zabwino komanso zamafuta, kusakhazikika kwa zakudya), kumangokhala kwanthawi yochepa, kutafuna nthawi yayitali,
Gwiritsani ntchito pokonzekera zovuta za ultrasound ndi x-ray kuyang'ana zam'mimba.

Contraindication

Pachimake kapamba
Matenda a kapamba kwambiri pachimake,
Hypersensitivity mankhwala.

Kuikidwa kwa Mikrazim pa nthawi yoyembekezera komanso kuyamwitsa kumasonyezedwa ngati chiwopsezo chotsatira cha mayiyo chikuwonjezera chiwopsezo cha mwana wosabadwayo ndi mwana.

Mlingo ndi makonzedwe

Makapisozi amatengedwa pakamwa, kutsukidwa ndi madzi pang'ono kapena madzi a zipatso (kupatula madzi amchere). Popereka mankhwala awiri kapena awiri a makapisozi, tikulimbikitsidwa kuti mumwe mankhwalawa wokwanira mankhwalawa musanadye, theka linalo - mwachindunji pakudya. Mlingo wa kapisozi 1 amatengedwa ndi zakudya.

Kwa ana kapena odwala okalamba, kuti muthandizire kumeza, mutha kumwa mankhwalawa popanda chipolopolo, kupukuta zomwe zili mumadzimadzi kapena chakudya chamadzimadzi (pH pansi pa 5.0), zomwe sizifunikira kutafunidwa (yogati, applesauce). Kutafuna, kuphwanya pellets kapena kusakaniza ndi chakudya (pH pamwambapa 5.5) kumawononga nembanemba yawo, yomwe imateteza motsutsana ndi zotsatira za madzi a m'mimba. Ndikofunikira kukonzekera osakaniza a pellets ndi madzi kapena chakudya musanayende mwachindunji.

Kusankhidwa kwa munthu wa mlingo wa Mikrasim tikulimbikitsidwa kuganizira kupezeka kwa zakudya, kuopsa kwa Zizindikiro za matendawa komanso zaka za wodwalayo.

Kumwa mankhwalawa kumatha kutha masiku angapo ndikugaya chakudya kwa miyezi ingapo ndi zaka ndi chithandizo chamankhwala chokhala nthawi yayitali.

Mulingo wovomerezeka wa ana tsiku lililonse: mpaka chaka chimodzi ndi theka - mayunitsi a 50,000, azaka za chaka chimodzi ndi theka ndi okalamba - mayunitsi 100,000.

Mlingo woyenera wolowa m'malo mwa mitundu yosiyanasiyana ya exocrine pancreatic insuffence:

Steatorrhea, wokhala ndi mafuta ambiri okhala ndi ndowe zopitilira 15 patsiku: magawo 25,000 a lipase ndi chakudya chilichonse kwa odwala omwe ali ndi vuto la m'mimba. Ndi kulekerera bwino kwa mankhwalawa kuti akwaniritse matenda, kuwonjezereka kwa gawo limodzi mpaka magawo 30,000-35,000 a lipase akusonyezedwa. Palibe kusintha kwa zotsatira zamankhwala, ndikofunikira kufotokozera za matendawa kapena kuchepetsa kudya zamafuta ndikuganizira kukhazikitsidwa kwa nthawi yomweyo kwa proton pump inhibitors. Pokhapokha kutsegula m'mimba komanso kuchepa thupi pamunsi pa cholembera chofewa, Mikrasim imayikidwa mu gawo limodzi la magawo 10,000-25,000 a lipase,
Cystic fibrosis: mlingo umodzi woyamba wa ana osaposa zaka 4 - kutengera mayunitsi 1000 a lipase pa kilogalamu imodzi ya kulemera kwa mwana ndi magawo 500 a lipase pa 1 makilogalamu - wazaka 4 kapena kupitilira. Mlingo uyenera kusinthidwa poganizira za thanzi ndi zovuta za cholendewu. Mankhwala osungidwa a lipase 10,000 yoposa 10,000 pa kilogalamu iliyonse ya thupi patsiku samalimbikitsidwa.

Malangizo apadera

Kugwiritsa ntchito nthawi yayitali kwa Mikrasim mu milingo yayitali kuyenera kutsatiridwa ndi kuyang'aniridwa kawirikawiri kuchipatala.

Kusakwanira kwamankhwala kungawonedwe motsutsana ndi maziko a kusapangidwa kwa michere chifukwa cha acidization ya zomwe zili m'matumbo a duodenum, matenda ofanana ndi a m'matumbo ang'ono (kuphatikizapo dysbiosis ndi helminth infestations), osagwirizana ndi regimen yoyendetsedwa, ndi kayendetsedwe ka ma enzyme omwe ataya ntchito.

Mphamvu ya pancreatin pa liwiro la psychomotor ya wodwalayo, kuphatikizapo kuthekera koyendetsa magalimoto ndi maginito, sanakhazikitsidwe.

Mlingo

Makapisozi ma 10,000 mayunitsi ndi 25,000 mayunitsi

10000 PIECES

Magawo 25000

Mmodzi kapisozi muli

ntchito yogwira - pancreatin mu mawonekedwe a enteric pellets,

yokhala ndi pancreatin ufa, womwe umagwirizana ndi ntchito:

* - malinga ndi ntchito mwamalemba.

chipolopolo: methaconic acid ndi ethyl acrylate kopolymer 1: 1 (mwanjira ya kupezeka kwa 30%, kuphatikiza polysorbate-80, sodium lauryl sulfate) - 25.3 mg / 63.2 mg, triethyl citrate - 5.1 mg / 12.6 mg, simethicone emulsion 30% (kulemera kowuma, kuphatikiza kuphatikiza: dimethicone, silicon colloidal, colicidal sillo, ma methyl cellulose, sorbic acid, madzi) - 0,5 mg / 0,3 mg, talc - 12.6 mg / 31.6 mg,

Mlingo wa mayunitsi 10,000: iron oxide chikasu E172 - 0,2240%, iron oxide wakuda E172 - 0,3503%, iron oxide ofiira E172 - 0.8077%, titanium dioxide E171 - 0.6699%, gelatin - mpaka 100%,

Mlingo wamagulu 25,000: wokongola wofiira E129 - 0,1400%, wachikasu chitsulo oxide E172 - 0.3000%, titanium dioxide E171 - 0.5000%, gelatin - mpaka 100%.

Makapisozi olimba a gelatin No. 2 okhala ndi mawonekedwe owoneka bwino ndi chivindikiro cha mtundu wa bulauni (mulingo wa mayunitsi 10,000) kapena kukula No. 0, ali ndi mawonekedwe owoneka bwino komanso chivindikiro cha mtundu wa lalanje wakuda (mulingo wa mayunitsi 25,000).

Zomwe zili m'mabotolo ndi ma pellets a cylindrical kapena ozungulira kapena osasinthika kuchokera ku bulauni pang'ono mpaka bulawuni wamtundu, wokhala ndi fungo.

Mankhwala

Pharmacokinetics

Pancreatin ndi mankhwala olekanitsidwa ndi ziphuphu za nyama.

MICRASIM ® ili ndi porcine pancreatin. Mankhwalawa amakhala ndi mapuloteni enanso olemera olemera kwambiri, ochepa mchere. M'maphunziro a nyama, kusapezeka kwa ma enzymes athunthu (osagawanika) adawonetsedwa ndipo, chifukwa chake, kafukufuku wakale wama pharmacokinetic sanachitike. Popeza achire ntchito yokonzekera yomwe ili ndi ma pancreatic michere imadziwika mu lumen ya m'mimba, kuthilira sikofunikira pakuwonetsa zotsatira zawo. Kuphatikiza apo, mu michere yawo, ma enzyme ndi mapuloteni motero, akamadutsa m'mimba, amapita ndi proteinolytic cleavage mpaka atalowa mu mawonekedwe a peptides ndi amino acid.

Mankhwala

Mankhwala a enzyme a digestive, amakwaniritsa kuchepa kwa michere ya pancreatic, ali ndi lipolytic, proteinolytic, amylolytic.

Mutatha kumwa mankhwalawo, kapisozi ya gelatin imasungunuka m'mimba pansi pa madzi a m'mimba, ndipo mapiritsi a pancreatin omwe amalimbana ndi gastric acid amasakanikirana mosavuta ndi zomwe zimapezeka m'mimba ndipo, limodzi ndi chakudya chotsegulidwa, amalowa m'matumbo ang'ono. Apa, ma pellets amataya michere yawo yolephera acid, kuwola ndi kutulutsa ma enzymes omwe amagwira ntchito m'matumbo a lumen, omwe amachititsa kuti chimbudzi chikhale cholimba.

Lipase amalimbikitsa kusokonekera kwa mafuta kupita ku glycerol ndi ma hydrolyzing ether bond pamaudindo 1 ndi 3 a triglycerides amafuta acids.

Ma polima a alpha-amylase hydrolyzes a glucose alpha-1,4-glycoside. Imaphwanya makamaka ma polysaccharides a extracellular (wowuma, glycogen ndi mafuta ena ena) ndipo sikugwira nawo gawo la hydrolysis ya fiber fiber. Wowuma ndi ma pectins amawola m'masamba osavuta - sucrose ndi maltose.

Ma protein a Proteolytic - trypsin, chymotrypsin ndi elastase - agwetsa mapuloteni kukhala amino acid. Kuphatikiza apo, trypsin, yowononga cholecystokinin kumasula chinthu, ndi lingaliro lamalingaliro limalepheretsa katemera wa pancreatic, yemwe amachepetsa katundu pazinthuzi ndipo potero amapereka zotsatira za analgesic mu pachimake pancreatitis. Trypsin, yolumikizana ndi ma RAP-2 receptors a enterocytes, ndichinthu chofunikira kuyang'anira kuyendetsa matumbo aang'ono.

Mankhwala bwino magwiridwe antchito am'mimba thirakiti, normalization njira chimbudzi.

Mosiyana ndi mapiritsi a pancreatin, mawonekedwe am'mimba a pancreatin amatsimikizira kuti mankhwalawa amapezeka mofulumira mpaka m'mimba, ndipo michere yambiri imalembedwa patatha mphindi 30 mpaka 55 kuchokera pakamwa.

M'munsi mwa matumbo aang'ono, zochitika za michere ya pancreatin zimachepetsa kwambiri, pamene zimayenda m'matumbo am'mimba, zimakhala zopanda pake komanso zonyansa, zotsalira za mankhwalawa zimachotsedwa m'matumbo limodzi ndi zinthu zofunika kugaya chakudya.

Mlingo ndi makonzedwe

Mlingo wa mankhwala amasankhidwa payekha. Mlingo wa mankhwalawa (malinga ndi lipase) zimatengera zaka komanso kuchuluka kwa kuchepa kwa enzyme. Komanso muzindikire zomwe zili ndi ma enzymes omwe mapuloteni a hydrolyze ndi zakudya, kutengera kapangidwe kazakudya ndi matenda ena okhudzana ndi izi.

Akuluakulu amatenga mankhwalawa akudya. Makapisozi amamezedwa lonse, osasweka kapena kutafuna, ndi madzi ambiri. Osagwiritsa ntchito mchere wamchere wamchere pochapa. Ngati mlingo umodzi woposa kapisozi imodzi, muyenera kumwa theka kapena gawo limodzi mwa magawo atatu a mankhwala omwe asankhidwa musanadye, ena onse pakudya.

Kutenga mankhwalawa, akuluakulu omwe amavuta kumeza ndi ana ayenera kutsegula kapisozi ndikuwonjezera ma pellets ku chakudya chomwe sichimafuna kutafuna (phala, apsa, yogati, ndi zina). Osakaniza okonzedwayo ayenera kumwedwa nthawi yomweyo. Kukukuta kapena kutafuna ma pellets kumayambitsa kuphwanya membrane wawo wosagwirizana ndi asidi, kumasulidwa kwa michere ya pancreatic kutaya ntchito mwachangu, kuphatikiza, kumayambitsa kukhumudwitsa kwa mucous membrane wamkamwa ndi esophagus.

Cystic fibrosis. Mlingo woyamba kuwerengera ana osakwanitsa zaka 4 ndi ziwonetsero za lipase ya 1000 ya kilogalamu imodzi ya thupi pakudya iliyonse, kwa ana azaka zopitilira 4 - 500 PISCES ya lipase pa kilogalamu pa chakudya chilichonse. Mlingo uyenera kusankhidwa aliyense payekha, kutengera kuopsa kwa matendawa, kuopsa kwa chinyezi komanso thanzi. Mlingo wokonzanso odwala ambiri sayenera kupitirira 10,000 mayendedwe a lipase pa kilogalamu ya thupi patsiku.

Mlingo wa tsiku ndi tsiku ungagawanike maudindo angapo pakapita maola awiri ndi awiri.

Popeza ndizovuta kugawa zomwe zili mumapukusiwo mu Mlingo wambiri, tikulimbikitsidwa kuti chithandizo chokhala ndi MIKRAZIM ® 10000 UNIT chiyambike mwa ana omwe ali ndi thupi lolemera zosachepera 10 kg, ndipo chithandizo ndi MIKRAZIM® 25000 UNIT ndikulimbikitsidwa kuti uyambe kwa ana omwe ali ndi thupi lolemera 25 kg.

Mitundu ina ya exocrine pancreatic insuffence. M'malo mankhwala kwa odwala matenda kapamba, Mlingo wa michere amasankhidwa payekha kutengera kuchuluka kwa exocrine kusowa, komanso wodwalayo kudya zizolowezi.

Ndi zofunika kwambiri (zoposa magalamu 15 patsiku) mafuta mu ndowe, komanso pamaso pa m'mimba ndi kuwonda, pomwe chakudyacho sichikupereka tanthauzo, zigawo za 25,000 za lipase zimayikidwa (zomwe zili kapu imodzi imodzi ya zigawo za MICRASIM® 25,000) pachakudya chilichonse. Ngati ndi kotheka, komanso kulekerera bwino kwa mankhwalawo, mlingo umodzi ukuwonjezeka mpaka 30,000 - 35,000 (makapisozi atatu a MICRAZIM ® 10000 UNIT kapena kapisozi imodzi ya MICRAZIM ® 10000 UNIT ndi MICRAZIM ® 25000 UNIT, motsatana).

Kuwonjezeka kwina kwa mlingo, nthawi zambiri, sikubweretsa zotsatira za chithandizo ndipo kumafuna kuwunikanso matenda, kuchepa kwamafuta azakudya.

Mapiritsi a Mikrazim: momwe mungatengere akuluakulu a kapamba?

Micrazim (dzina ladziko lonse losagwirizana ndi chakudya chopatsa mphamvu) ndi mankhwala ophatikiza mankhwala omwe amaphatikiza ma enzyme osiyanasiyana omwe amagwira ntchito motsutsana ndi michere yonse. Zogwiritsidwa ntchito kutulutsa mawonekedwe am'mimba ndikuthandizira kugaya chakudya.

Chifukwa chakuti kuphatikiza kwakukulu kwa michere yam'mimba kumachitika m'maselo a kapamba, momwe kaphatikizidwe ndi katemera wawo amasokonezekera chifukwa cha njira ya pathological.

Zikatero, funso ndi lokhudza kuperekedwa kwa chithandizo chamankhwala. Ndi chifukwa chotere kuti mankhwala a enzyme adayikidwa.
Izi ndi mankhwala amapezeka mu mawonekedwe a ma microspheres omwe ali mu ma kapisozi a gelatin. Makapisozi, molingana ndi miyezo yapadziko lonse yosungirako ndi kugawa kwa mankhwala, amaikidwa mu matuza apadera achitsulo. Ichi ndi ichi chomwe chimateteza kwathunthu ma kapisolo ku zinthu zowononga zachilengedwe. Matumba amaikidwa pabokosi lamakhadi. Bokosi lililonse lili ndi matuza angapo. Kuphatikiza apo, phukusi lililonse lili ndi malangizo.

Yogwira pophika mankhwala ali kapamba pancreatin. Amawonetsedwa ngati mawonekedwe a ufa, wotulutsa ma encyme a nkhumba. Choyimira chikuyimiriridwa ndi ma enzyme otsatirawa:

lipase, puloteni inayake yomwe imayambitsa kuphwanya kwa ziwalo za lipid,
amylase, enzyme yomwe imalimbikitsa chimbudzi cha polysaccharides,
trypsin, omwe amachititsa kuti mapuloteni awonongeke.

Mu msika wogulitsa mankhwala, mankhwala amaperekedwa m'njira ziwiri:

Mlingo wa magawo 10,000 a ntchito. Ndi zili ndi milligramama 125 a yogwira ntchito.
Micrasim ndi Mlingo wa 25000 muli 312 mamiligalamu a pancreatin ufa.

Mankhwalawa amapangidwa ndi munthu wodziwika bwino wopanga mankhwala - "ABBA-RUS". Dzina la mankhwalawa limagwirizanitsidwa ndi mawonekedwe a masanjidwewo, ndipo chinthu chogwira ntchito ndi enzyme.

Popanga ma enzyme angapo pogwiritsa ntchito zida zopangira zochokera ku nyama - kachilombo kamene kamachokera ku zikondamoyo za nyama za pafamu, zomwe ndi nkhumba.