Tsamba loipa

ntchito: insulin yamunthu (rDNA)

1 ml ya jakisoni uli ndi 100 IU ya insulin yaumunthu (yopangidwa pogwiritsa ntchito ukadaulo wa rDNA mu Saccharomycescerevisiae )

1 vial ya manditis 10 ml, ofanana ndi 1000 IU.

1 IU (mayunitsi apadziko lonse lapansi) ndi wofanana ndi 0,035 mg wa insulin ya anthu.

zokopa: zinc chloride, glycerin, metacresol, sodium hydroxide, kuchepetsa hydrochloric acid, madzi a jakisoni.

Mankhwala

Kuchulukitsa kwa shuga kwa insulin ndikulimbikitsa kutuluka kwa glucose pogwiritsa ntchito minofu pambuyo pomangiriza insulini mpaka ma cell a minofu ndi mafuta, komanso kuletsa kutulutsa kwa glucose ku chiwindi.

Zotsatira zakufufuza kwamankhwala kuchipinda chimodzi chamankhwala osamalira odwala a hyperglycemia (kuchuluka kwa shuga m'magazi pamwamba pa 10 mmol / L) mwa odwala 204 omwe ali ndi matenda osokoneza bongo komanso 1344 odwala popanda matenda a shuga omwe adachitidwa opaleshoni yayikulu adawonetsa kuti standardoglycemia (glucose level 4, 4-) 6.1 mmol / L), yoyendetsedwa ndi kayendetsedwe ka Actrapid ® NM, yachepetsa kufa kwa 42% (8% poyerekeza ndi 4.6%).

Actrapid ® NM ndikonzanso insulin yochepa.

Kukhazikika kwa zochita kumawonedwa pakadutsa mphindi 30, mphamvu yake imatheka mkati mwa maola 1.5-3,5 ndipo nthawi yayitali imakhala pafupifupi maola 7-8.

Pharmacokinetics Hafu ya moyo wa insulini kuchokera m'magazi ndi mphindi zochepa. Chifukwa chake, mawonekedwe a machitidwe a kukonzekera kwa insulini ndi chifukwa cha mayamwidwe okha. Njirayi imatengera zinthu zingapo (mwachitsanzo, kuchuluka kwa insulin, njira ndi malo a jakisoni, makulidwe a minofu ya subcutaneous, mtundu wa matenda ashuga), omwe amatsogolera pakuwoneka kofunikira pakukonzekera kwa insulin mwa odwala ndi odwala osiyanasiyana.

Mafuta Chiwonetsero chachikulu cha magazi m'magazi chimafikiridwa mkati mwa maola 1.5-2,5 pambuyo pa kupatsidwa mankhwala.

Kugawa. Kumanga kwofunikira kwa insulini kumapuloteni a plasma, kupatulapo kuzungulira kwa ma antibodies kwa iye (ngati alipo), sikunapezeke.

Kupenda. Insulin yaumunthu imapangidwa ndi ma insulin protein kapena ma enzyme osokoneza insulin ndipo, mwina, ndi protein disulfide isomerase. Masamba angapo adadziwika komwe hydrolysis ya molekyulu ya insulin yamunthu imachitikira. Palibe imodzi mwa metabolites yomwe imapangidwa pambuyo pa hydrolysis imakhala ndi zochita zachilengedwe.

Kuswana. Kutalika kwa theka la moyo wa insulini kumatsimikiziridwa ndi kuchuluka kwa mayamwidwe ake kuchokera ku minofu yokhala ndi subcutaneous. Ichi ndichifukwa chake nthawi ya theka-lomaliza la moyo (t½) imawonetsa kuchuluka kwa mayamwidwe, osati kuchotsedwa (mwakutero) kwa insulini kuchokera m'madzi a m'magazi (t½ ya insulin kuchokera m'magazi ochepa mphindi). Malinga ndi kafukufuku, t½ ndi maola 2-5.

Ana ndi achinyamata. Mbiri ya pharmacokinetic ya Actrapid ® NM adaphunziridwa mu chiwerengero chochepa (n = 18) cha ana (wazaka 6-12) ndi achinyamata (azaka 13 mpaka 17) odwala matenda ashuga. Zambiri zochepa zimatsimikizira kuti mbiri ya pharmacokinetic ya insulin mwa ana, achinyamata ndi achikulire ali ofanana. Komabe mulingo c _max (pazambiri kuchuluka) anali osiyana ana a misinkhu yosiyanasiyana, zomwe zikuwonetsa kufunikira kwa kusankha kwa mankhwala.

Zambiri zotetezera.

Kafukufuku wambiri (kawopsedwe kamankhwala obwereza, genotoxicity, carcinogenicity, zotsatira zakupha pakubala) sizinawonetse vuto lililonse la mankhwala a Actrapid ® NM.

Chithandizo cha matenda ashuga.

Kuyanjana ndi mankhwala ena ndi mitundu ina yoyanjana

Monga mukudziwa, mankhwalawa amakhudza kagayidwe kakang'ono ka glucose.

Mankhwala omwe amatha kuchepetsa kufunika kwa insulin.

Oral hypoglycemic agents (PSS), monoamine oxidase inhibitors (MAO), osasankha b-blockers, ACE inhibitors (ACE), salicylates, anabolic steroids ndi sulfonamides.

Mankhwala omwe amatha kukulitsa kufunika kwa insulin.

Kulera kwapakamwa, thiazides, glucocorticoids, mahomoni a chithokomiro, sympathomimetics, kukula kwa mahomoni ndi danazole.

• adrenergic blockers amatha kuphimba zizindikiro za hypoglycemia ndikuchepetsa kuchira pambuyo pa hypoglycemia.

Octreotide / lanreotide imachepetsa ndikuwonjezera kufunika kwa insulin.

Mowa ungapangitse kapena kuchepetsa mphamvu ya insogulin.

Zolemba zogwiritsira ntchito

Kusakwanira dosing kapena kusiya kulandira chithandizo (makamaka ndi matenda a shuga a mtundu wa I) kungayambitse hyperglycemia ndi matenda ashuga ketoacidosis. Nthawi zambiri, zizindikiro zoyambirira za hyperglycemia zimayamba pang'onopang'ono kwa maola angapo kapena masiku. Amaphatikizaponso ludzu, kukokana pafupipafupi, kusanza, kusanza, kugona komanso kuyanika pakhungu, pakamwa pouma, kusowa chilakolako cha chakudya, komanso kununkhira kwa acetone mumlengalenga.

Mtundu woyamba wa matenda a shuga, a hyperglycemia, omwe samathandizidwa, amatsogolera ku matenda ashuga a ketoacidosis, omwe mwina ndi omwe amapha.

Hypoglycemia zitha kuchitika ngati mlingo wa insulin ndiwokwera kwambiri poyerekeza ndi kufunika kwa insulin. Pankhani ya hypoglycemia kapena ngati hypoglycemia ikukayikira, musamwe mankhwalawo.

Kudumpha zakudya kapena kuchita masewera olimbitsa thupi mosayembekezereka kungayambitse hypoglycemia.

Odwala omwe atukula kwambiri kuchuluka kwa shuga m'magazi chifukwa chokhudza insulin yokwanira amatha kuwona kusintha kwa chizolowezi chawo, okhazikika a hypoglycemia, omwe ayenera kuchenjezedwa pasadakhale.

Zizindikiro zachilendo zimatha kutha kwa odwala omwe ali ndi matenda ashuga a nthawi yayitali.

Comorbidities, makamaka matenda ndi nthenga, zimakulitsa kufunika kwa insulini.

Kusamutsa wodwala kupita ku mtundu wina kapena mtundu wa insulin kumachitika moyang'aniridwa ndi achipatala. Kusintha kwa ndende, mtundu (wopanga), mtundu, magwero a insulin (yaumunthu kapena analog ya insulin ya anthu) ndi / kapena njira yopangira ingapangitse kusintha kwa insulin. Odwala omwe amasamutsidwa ku Actrapid ® NM ndi mtundu wina wa insulin angafunike kuchuluka kwa jakisoni watsiku ndi tsiku kapena kusintha kwa Mlingo poyerekeza ndi insulin yomwe nthawi zambiri amagwiritsa ntchito. Kufunika kosankha kwa mankhwalawa kumatha kuchitika pakukhazikitsa mankhwala atsopano, komanso pakubwera milungu ingapo kapena miyezi ingapo yogwiritsidwa ntchito.

Mukamagwiritsa ntchito mankhwala aliwonse a insulini, zimachitika mu jakisoni wa jekeseni, zomwe zingaphatikizepo kupweteka, kufiyira, kuyamwa, ming'oma, kutupa, kufinya, ndi kutupa. Kusintha pafupipafupi jakisoni m'dera limodzi kumachepetsa kapena kupewa izi. Amakumana zimatha patapita masiku angapo kapena milungu. Nthawi zina, zomwe zimachitika jakisoni jakisoni zingafune kutha kwa mankhwalawa ndi Actrapid ® NM.

Asanayende ndikusintha kwamagawo, odwala ayenera kufunsa dokotala, chifukwa izi zimasintha jakisoni wa insulin komanso kudya.

Actrapid ® NM sayenera kugwiritsidwa ntchito pochita mapampu a insulin chifukwa chogwiritsa ntchito insulin nthawi yayitali chifukwa choopsa choterera m'matumba awo.

Kuphatikiza kwa thiazolidinediones ndi mankhwala a insulin.

Pamene thiazolidinediones amagwiritsidwa ntchito limodzi ndi insulin, milandu yovuta ya mtima yanenedwa, makamaka kwa odwala omwe ali pachiwopsezo cha mtima wosweka.

Actrapid ® NM imakhala ndi metacresol, yomwe imatha kuyambitsa thupi.

Okalamba okalamba (> wazaka 65).

Mankhwala Actrapid® NM angagwiritsidwe ntchito mwa okalamba odwala.

Mwa odwala okalamba, kuwunika kwa glucose kuyenera kulimbikitsidwa ndi mlingo wa insulin payokha ikusinthidwa.

Kulephera kwamkati ndi chiwindi

Kulephera kwa renal ndi hepatic kumatha kuchepetsa kufunika kwa insulin. Odwala omwe ali ndi vuto laimpso komanso kwa hepatic, kuwunika kwa shuga kuyenera kulimbikitsidwa komanso mlingo wa insulin payokha.

Mankhwala Actrapid® NM angagwiritsidwe ntchito mwa ana ndi achinyamata.

Gwiritsani ntchito pa nthawi yoyembekezera kapena mkaka wa m'mawere .

Chifukwa insulin siidutsa chotchinga, palibe malire ku chithandizo cha matenda ashuga omwe ali ndi insulin panthawi yapakati. Ndikulimbikitsidwa kulimbikitsa kuwunika kwa Glucose m'magazi ndikuwunika momwe amayi apakati omwe ali ndi matenda ashuga panthawi yonse yomwe ali ndi pakati, komanso ndi pakati, chifukwa kuyang'anira matenda ashuga kumawonjezera chiopsezo cha kubadwa kwa mwana wosabadwa.

Kufunika kwa insulin nthawi zambiri kumachepa mu trimester yoyamba ya kutenga pakati ndikuwonjezeka kwambiri mu trimesters yachiwiri ndi yachitatu.

Pambuyo pobadwa, kufunikira kwa insulin kumabweza msanga.

Palibenso zoletsa zina pa matenda a matenda a shuga ndi insulin panthawi yoyamwitsa, popeza chithandizo cha mayi sichikhala pachiwopsezo chilichonse kwa mwana.

Maphunziro owonetsa poizoni a nyama pogwiritsa ntchito insulin ya anthu

sanawonetse vuto lililonse chonde.

Kutha kukopa momwe zinthu zikuyendera mukamayendetsa magalimoto kapena njila zina.

Kuyankha kwa wodwalayo komanso kuthekera kwake kochita chidwi kukhoza kukhala ndi vuto la hypoglycemia. Izi zimatha kukhala pangozi pazochitika zomwe luso ili ndilofunika kwambiri (mwachitsanzo, poyendetsa galimoto kapena makina).

Odwala ayenera kulangizidwa kuti azichita zinthu zoteteza hypoglycemia musanayendetse. Izi ndizofunikira kwambiri kwa odwala omwe afooka kapena kulibe zizindikiro zomwe ndi zizindikiro za hypoglycemia, kapena zochitika za hypoglycemia zimachitika pafupipafupi. Zikatero, kuyendetsa bwino kwambiri kuyenera kuyesedwa.

Mlingo ndi makonzedwe

Actrapid ® NM ndi mankhwala osokoneza bongo, chifukwa chake amagwiritsidwa ntchito limodzi ndi insulin.

Mlingo wa insulin ndi munthu payekha ndipo amatsimikiza ndi dokotala mogwirizana ndi zosowa za wodwala.

Chofunikira cha insulin tsiku lililonse chimakhala kuyambira pa 0.3 mpaka 1.0 IU / kg / tsiku. Kufunika kwa insulin tsiku ndi tsiku kumawonjezereka kwa odwala omwe ali ndi insulin kukaniza (mwachitsanzo, kutha msonkho kapena kunenepa kwambiri) ndikuchepa kwa odwala omwe ali ndi zotsalira za insulin.

Jekeseni iyenera kuchitidwa mphindi 30 chakudya chachikulu kapena chowonjezera chomwe chili ndi chakudya.

Matenda obvuta, makamaka matenda ndi kutentha thupi, nthawi zambiri zimawonjezera kufunikira kwa insulin. Matenda a impso, chiwindi, kapena adrenal, pituitary, kapena matenda a chithokomiro amafunikira kusintha kwamankhwala a insulin.

Kusintha kwa Mlingo kumafunikanso ngati odwala asintha zomwe akuchita kapena zolimbitsa thupi.

Actrapid ® NM adapangira jekeseni wamkati kapena wamkati.

Actrapid ® NM nthawi zambiri imayendetsedwa mosazungulira m'malo a khoma lakumbuyo kwam'mimba, komanso m'chiuno, matako kapena minofu ya m'mapazi.

Ndi jakisoni wotsekemera m'chigawo cha khoma lachiberekero lam'mimba, kulowetsedwa kwa insulin kumachitika mofulumira kuposa pakubayidwa mbali zina za thupi.

Kukhazikitsidwa kwa khola lakukhazikika kwa khungu kumachepetsa chiopsezo chofika minofu.

Pambuyo pa jekeseni, singano imayenera kukhalabe pansi pakhungu kwa masekondi 6 osachepera. Izi zikuthandizira kukhazikitsa mlingo wathunthu.

Kuti muchepetse chiwopsezo cha lipodystrophy, tsamba la jekeseni liyenera kusinthidwa nthawi zonse ngakhale m'gawo limodzi la thupi.

Jakisoni wa mu mnofu amatha kuchitika poyang'aniridwa ndi achipatala.

Actrapid ® NM imatha kutumikiridwa kudzera m'mitsempha. Majakisoni amayenera kuchitidwa ndi dokotala okha.

Actrapid ® NM mu mbale amagwiritsidwa ntchito ndi ma syringe ena apadera omwe ali ndi maphunziro oyenera. Actrapid ® NM imabwera ndi buku lomwe lakhala ndi zofunikira zambiri kuti ligwiritse ntchito.

Kufunsira kwa mtsempha wa magazi.

Machitidwe a kulowetsedwa ndi Actrapid ® NM pamsasa wa insulin wa anthu 0,55 IU / ml mpaka 1.0 IU / ml mu kulowetsedwa kokhala ndi 0.9% sodium chloride, 5% kapena 10% glucose ndi 40 mmol / lita potaziyamu chloride. ndipo ili m'mipanda ya kulowetsedwa kwa polypropylene, khola maola 24 kutentha kwa firiji. Ngakhale ndikukhazikika kwanthawi yayitali, kuchuluka kwa insulini kumatha kutsindikidwa mkati mwatanki yolowetsa. Pa kulowetsedwa, ndikofunikira kuyang'anira kuchuluka kwa shuga m'magazi.

Actrapid ® NM sichinapangidwe kuti agwiritse ntchito mapampu a insulin pakuyendetsedwera kwa nthawi yayitali.

Malangizo ogwiritsira ntchito mankhwala a Actrapid ® NM kwa wodwala.

Musagwiritse ntchito Actrapid ® NM:

▶ M'mapampu olowetsera.

Ngati wodwala allergen (hypersensitive) kwa insulin ya anthu kapena mankhwala ena aliwonse a Actrapid ® NM,

Ngati wodwala akuganiza kuti akutenga hypoglycemia (shuga wamagazi ochepa).

Ngati chitetezo kapulasitiki sichingoyambira chabe kapena chosowa.

Bokosi lirilonse limakhala ndi chotetezera pulasitiki chosonyeza kutseguka.

Mukalandira vial, chikopacho sichikulankhula mwachisawawa kapena chikusoweka, valaleyo uyenera kubwezeredwa ku pharmacy.

Ngati katunduyo wasungidwa mosayenera kapena wazizira.

Ngati insulin siyowonekera komanso yopanda maonekedwe.

Musanagwiritse ntchito mankhwala Actrapid ® NM:

▶ Chongani lembalo kuti muwonetsetse kuti mtundu wa insulin ndi wokhazikika.

Chotsani kapu yapulasitiki yachitetezo.

Momwe mungagwiritsire ntchito insulin iyi.

Actrapid ® NM imayendetsedwa ndi jakisoni pansi pa khungu (subcutaneously). Nthawi zonse sinthani malo opaka jekeseni ngakhale m'dera lomwelo kuti muchepetse zovuta zopanga zisindikizo kapena zikwangwani pakhungu. Malo abwino kwambiri odzivulaza ndi kutsogolo pamimba, matako, kutsogolo kwa ntchafu kapena mapewa. Insulin imayenda mwachangu ngati itabayidwa m'chiuno.

Ngati ndi kotheka, Actrapid ® NM imatha kutumikiridwa kudzera m'mitsempha, ndi dokotala yekha yemwe amatha kuchita jakisoni.

Lowani Actrapid ® NM, ngati imayendetsedwa yokha kapena ikasakanizidwa ndi insulin yayitali.

Onetsetsani kuti wodwala akugwiritsa ntchito insulin yomwe imamaliza.

Jambulani mu syringe mpweya wofanana ndi muyezo wa insulin yomwe wodwala amafunikira.

Tsatirani malangizo omwe dokotala kapena anamwino anu adapereka.

Pangani jakisoni wokhazikika wa insulin. Gwiritsani ntchito njira ya jakisoni yomwe dokotala wanu kapena namwino anu adayambitsa.

▶ Gwiritsani singano pansi pakhungu kwa mphindi zosachepera 6 kuti muwonetsetse kuti mlingo wonsewo waperekedwa.

Kukonzekera kwa inshuwaransi yaumunthu yogwiritsira ntchito insulin ndi mankhwala othandiza komanso otetezeka pochiza matenda osokoneza bongo amisinkhu yosiyanasiyana ya ana ndi achinyamata.

Kufunika kwa insulin tsiku lililonse mwa ana ndi achinyamata kumatengera gawo la matendawa, kulemera kwa thupi, zaka, kudya, kuchita masewera olimbitsa thupi, kuchuluka kwa insulin komanso DYNAMICS ya msinkhu wa glycemia.

Bongo

Ngakhale lingaliro lenileni la mankhwala osokoneza bongo silinapangidwe kuti apange insulin, hypoglycemia mwa njira zotsatizana ikhoza kukhazikitsidwa pambuyo pa kayendetsedwe kake ngati Mlingo womwe ndi wokwera kwambiri poyerekeza ndi zomwe wodwala akufuna.

Hypoglycemia yofatsa imatha kuthandizidwa pakukulitsa shuga kapena shuga. Chifukwa chake, odwala matenda ashuga amalimbikitsidwa kuti azikhala ndi zinthu zingapo zomwe zimakhala ndi chakudya.

Ngati wodwala wakula kwambiri, wodwala akakhala kuti sakomoka, amene alandila malangizo oyenera ayenera kumamupatsa glucagon mosadukiza kapena m'mitsempha (kuchokera pa 0.5 mpaka 1.0 mg).

Wodwala akafika, ayenera kudya zakudya zomwe zimakhala ndi zakudya kuti asayambenso kudwala.

Zotsatira zoyipa

Zotsatira zoyipa zambiri za mankhwala ndi hypoglycemia. Malinga ndi kafukufuku wazachipatala, komanso deta yakugwiritsira ntchito mankhwalawa atamasulidwa pamsika, kuchuluka kwa hypoglycemia kumasiyana m'magulu osiyanasiyana a odwala, omwe ali ndi mitundu yosiyanasiyana ya mankhwalawa komanso kuchuluka kwa kayendetsedwe ka glycemic (onani. Chidziwitso pansipa).

Kumayambiriro kwa mankhwala a insulin, zolakwika zotupa, edema ndi zochita ku malo a jakisoni (kupweteka, redness, urticaria, kutupa, kufinya, kutupa ndi kuyabwa pamalowo jekeseni) zitha kuonedwa. Izi zimachitika nthawi zambiri. Kusintha kwamphamvu kwa kayendedwe ka shuga m'magazi kungayambitse kusinthika kwamphamvu kwa ululu wamitsempha.

Kusintha kwakanthawi kwamayendedwe a glycemic chifukwa cha kukulitsa kwa mankhwala a insulini kungayende limodzi ndi kufalikira kwakanthawi kwa matenda ashuga, pomwe kuwongolera kwakanthawi kokhazikika kwa matenda a glycemic kumachepetsa chiopsezo cha kupitirira kwa matenda ashuga a retinopathy.

Malinga ndi kafukufuku wazachipatala, zotsatirazi ndizotsatira zoyipa zomwe zimayikidwa pafupipafupi ndi magulu opanga ziwalo malinga ndi MedDRA.

Malinga ndi pafupipafupi zomwe zimachitika, izi zimagawidwa m'magawo azomwe zimachitika nthawi zambiri (≥1 / 10), nthawi zambiri (≥1 / 100 mpaka 1/1000 kuti Sungani 1/10000 ku ® NMSlide mufiriji pamtunda wa 2 ° С -

8 ° C (osati pafupi kwambiri ndi mufiriji). Osamawuma. Sungani choyikiratu choyambirira kwa ana.

Pewani kutentha kapena dzuwa.

Bokosi lirilonse limakhala ndi kapu pulasitiki wokhala ndi utoto. Ngati kapu ya pulasitiki yotetezeka singagwire mwachisawawa kapena ikusowa, botolo liyenera kubwezeredwa ku mankhwala.

Mabotolo Actrapid ® NM, zomwe zimagwiritsidwa ntchito sayenera kusungidwa mufiriji. Zitha kusungidwa kwa milungu isanu ndi umodzi pa kutentha mpaka 30 ° C mutatsegulidwa.

Kukonzekera kwa insulini komwe kwawuma sikuyenera kugwiritsidwa ntchito.

Musagwiritse ntchito insulin pambuyo poti nthawi ya kumaliza ntchito ipatsidwe. Mutha kugwiritsa ntchito yankho lomveka bwino lopanda mtundu wa Actrapid ® HM.

Kusagwirizana

Monga lamulo, insulini imatha kuwonjezeredwa kwa mankhwala omwe mawonekedwe ake amakhazikitsidwa. Mankhwala omwe amawonjezeredwa ndi insulin angayambitse chiwonongeko chake, mwachitsanzo, kukonzekera komwe kumakhala ndi thiols kapena sulfites.

10 ml mu botolo, 1 botolo mu katoni.

Kuyambitsa Njira

Subcutaneous, mu mnofu ndi mtsempha wama khosi amaloledwa kuloledwa. Ndi subcutaneous makonzedwe, odwala akulangizidwa kuti asankhe ntchafu ya jakisoni, apa ndi pomwe mankhwalawa amatsimikiza pang'onopang'ono komanso moyenera.

Kuphatikiza apo, mutha kugwiritsa ntchito jakisoni matako, mikono yakutsogolo ndi khoma lakumaso kwa m'mimba (mutabayidwa m'mimba, mphamvu ya mankhwalawa imayamba posachedwa). Musati mupeze jakisoni m'dera limodzi kangapo pamwezi, mankhwalawa angayambitse lipodystrophy.

Ngati kuli kofunikira kuwonjezera insulin yayitali ndiutali, algorithm yotsatirayi imachitika:

1. Mpweya umalowetsedwa mu ma ampoules onse awiri (omwe amafupikitsidwa komanso aafupi),
2. Choyamba, insulin yokhala ndi kanthawi kochepa imakokedwa ndi syringe, ndiye kuti imathandizidwa ndi mankhwala okhala ndi nthawi yayitali,
3. Mphepo imachotsedwa pogogoda.

Anthu odwala matenda ashuga omwe sakudziwa bwino samalimbikitsidwa kuyambitsa okha Actropide mapewa, chifukwa pamakhala chiopsezo chokhazikika chamafuta a khungu ndikubaya mankhwalawa intramuscularly. Ndizofunikira kudziwa kuti mukamagwiritsa ntchito singano mpaka 4-5 mm, mafutawo ochepa mafuta sanapangike konse.

Sizoletsedwa kupaka mankhwalawo muzinthu zosinthika ndi lipodystrophy, komanso m'malo a hematomas, zisindikizo, zipsera ndi zipsera.

Actropid imatha kuperekedwa pogwiritsa ntchito syringe yachilendo, cholembera kapena pampu yodziwira yokha. Potsirizira pake, mankhwalawo amalowetsedwa mu thupi lokha, mwa zoyambirira ziwiri ndikuyenera kudziwa njira yoyendetsera.

• Nkhope yotayika ndiyiyika,
• Mankhwalawa amasakanikirana mosavuta, mothandizidwa ndi dispenser 2 magulu a mankhwalawa amasankhidwa, amabweretsedwa mlengalenga,
• Pogwiritsa ntchito kusinthaku, mtengo woyenera wokhazikitsa
• Mafuta omwe amapezeka pakhungu, monga tafotokozera kale.
• Mankhwalawa amayamba ndi kukanikiza piston njira yonse,
• Pambuyo masekondi 10, singano imachotsedwa pakhungu, khola limamasulidwa.

Singano imaponyedwa kunja.

Ngati agwira ntchito mwachidule agwiritsidwa ntchito, sikofunikira kusakaniza musanagwiritse ntchito.

Kupatula kulowetsedwa kosayenera kwa mankhwalawa komanso kuchitika kwa hypoglycemia, komanso hyperglycemia, insulin siyenera kuyikidwa m'malo osagwirizana ndi madokotala omwe sanavomerezane ndi adokotala ayenera kugwiritsidwa ntchito. Kugwiritsa ntchito Actrapid yomwe yatha ntchito sikuletsedwa, mankhwalawa angayambitse insulin.

Kupanga kudzera mu intravenly kapena intramuscularly kumachitika kokha moyang'aniridwa ndi adokotala. Actrapid imalowetsedwa m'thupi theka la ola chakudya chisanachitike, chakudya chimayenera kukhala ndi chakudya chamafuta.

Langizo: ndibwino kubaya insulini kutentha kwa firiji, kotero kuti ululu wa jakisoni suwonekera.

Kodi Actrapid ali bwanji

Insulin Actrapid ndi m'gulu la mankhwala, zomwe zimapangitsa kuti magazi achepetse shuga. Ndi mankhwala osokoneza bongo.

Kuchepetsa shuga kumachitika chifukwa cha:

Kukula ndi kufulumira kwa mankhwala a chiwalo kumadalira zinthu zingapo:

1. Mlingo wa kukonzekera kwa insulin,
2. Njira yakayendetsere (syringe, cholembera, pampu ya insulin),
3. Malo osankhidwa pokonzekera mankhwala (m'mimba, pamphumi, ntchafu kapena matako).

Ndi subcutaneous makonzedwe a Actrapid, mankhwalawa amayamba kugwira ntchito patatha mphindi 30, imafika pakulimbikitsidwa kwambiri m'thupi pambuyo pa maola 1-3 kutengera mawonekedwe a wodwala, zotsatira za hypoglycemic zimagwira maola 8.

Zotsatira zoyipa

Mukamasintha ku Actrapid mu odwala kwa masiku angapo (kapena masabata, kutengera mawonekedwe a wodwalayo), kutupa kwa malekezero ndi mavuto omveka bwino amawonedwa.

Zotsatira zina zoyipa zalembedwa ndi:

Zotsatira zoyipa kwambiri ndizo hypoglycemia. Ngati wodwalayo ali ndi khungu lotumbululuka, kusakwiya kwambiri komanso kumva kuti ali ndi njala, chisokonezo, kunjenjemera komanso kutuluka thukuta kumawonedwa, shuga ya m'magazi ikhoza kutsika pansi pazovomerezeka.

Pa kuwonetsedwa koyamba kwa zisonyezo, ndikofunikira kuyeza shuga ndikudya mosavuta kugaya chakudya m'magazi, ngati mutayika, glucose amaphatikizidwa ndi intramuscularly kwa wodwalayo.

Zinthu zikuluzikulu, hypoglycemia imatha kusanduka chikomokere ndi kufa.

Nthawi zina, Actrapid insulin imatha kuyambitsa thupi lomwe siligwirizana:

Ngati wodwala samatsatira malamulo a jakisoni m'malo osiyanasiyana, lipodystrophy imayamba.
Odwala omwe hypoglycemia imawonedwa mosalekeza, ndikofunikira kufunsa dokotala kuti musinthe Mlingo womwe umaperekedwa.

Malangizo apadera

Ndi chithandizo chanthawi zonse cha matenda a shuga omwe ali ndi Actrapid, ndikofunikira kwambiri kuti asungire kuchuluka kwa shuga m'magazi pogwiritsa ntchito glucometer. Kudziletsa kumalepheretsa kulumpha kwakuthwa mu shuga.

Nthawi zambiri, hypoglycemia imayamba chifukwa cha kuchuluka kwa mankhwala, komanso pazifukwa zina zingapo:

Wodwala akayamba kugwiritsa ntchito mankhwala osakwanira kapena kudumpha mawu oyamba, amakhala ndi vuto la hyperglycemia (ketoacidosis), lomwe ndi loopsa kwambiri, lomwe lingayambitse vuto.

Gwiritsani ntchito pa nthawi yoyembekezera

Chithandizo cha Actrapid chololedwa ngati wodwala ali ndi pakati. Nthawi yonseyi, ndikofunikira kuti mulamulire kuchuluka kwa shuga ndikusintha mlingo. Chifukwa chake, mkati mwa trimester yoyamba, kufunika kwa mankhwalawa kumachepa, panthawi yachiwiri ndi yachitatu - motsutsana, imawonjezeka.

Pambuyo pobereka, kufunikira kwa insulin kumabwezeretsedwera pamlingo womwe unali usanakhale ndi pakati.

Panthawi ya mkaka wa m'mawere, kuchepetsa mlingo kungakhale kofunikira. Wodwala amafunika kuwunika mosamala kuchuluka kwa shuga kuti magazi asatayike panthawi yomwe kufunika kwa mankhwala kumakhazikika.

Kugula ndi kusunga

Mutha kugula Actrapid mu mankhwala monga mankhwala a dokotala.

Ndikofunika kusunga mankhwalawo mufiriji pa kutentha kwa madigiri 2 mpaka 7 Celsius. Musalole kuti chochitikacho chiwonekere kutentha kwawokha kapena dzuwa. Mukazizira, Actrapid amataya mawonekedwe ake ochepetsa shuga.

Pamaso jakisoni, wodwalayo ayenera kudziwa nthawi yomwe mankhwalawo atha, kugwiritsa ntchito insulin yomwe idatha ntchito sikuloledwa. Onetsetsani kuti mwatsimikiza kapena mulibe kanthu ndi Actrapid wamayendedwe ndi zakunja.

Actrapid amagwiritsidwa ntchito ndi odwala onse amtundu wa 1 ndi mtundu 2 shuga . Kugwiritsa ntchito moyenera komanso kutsatira mlingo womwe dokotala akuwonetsa, sizimayambitsa kukula kwa zoyipa mthupi.

Kumbukirani kuti matenda ashuga amayenera kuthandizidwa mokwanira: kuwonjezera pa jakisoni wa tsiku ndi tsiku wa mankhwala, muyenera kudya zakudya zina, kuyang'anira zochitika zolimbitsa thupi osati kuwonetsa thupi pamavuto.

Chithandizo cha matenda ashuga ndi njira yayitali komanso yodalirika. Matendawa ndi oopsa ndi zovuta, kuphatikiza apo, wodwalayo amatha kufa ngati sanalandire chithandizo chofunikira cha mankhwala.

Zambiri pazamankhwala

Actrapid akulimbikitsidwa pakulimbana ndi matenda ashuga. Dzina lake lapadziko lonse lapansi (MHH) limasungunuka.

Ichi ndi mankhwala odziwika a hypoglycemic omwe ali ndi zotsatira zochepa. Imapezeka mu mawonekedwe a yankho lomwe limagwiritsidwa ntchito jekeseni. Mkhalidwe wophatikizika wa mankhwalawa ndi madzi wopanda khungu. Kuyenera kwa yankho kumatsimikiziridwa ndi kuwonekera kwake.

Mankhwalawa amagwiritsidwa ntchito pochiza matenda amtundu wa 2 komanso matenda a shuga. Imathandizanso mu hyperglycemia, chifukwa chake nthawi zambiri imagwiritsidwa ntchito popereka chithandizo chamankhwala kwa odwala pakagwidwa.

Odwala omwe ali ndi shuga omwe amadalira insulin amayenera kuwongolera shuga m'magazi moyo wawo wonse. Izi zimafunikira jakisoni wa insulin. Kusintha zotsatira zamankhwala, akatswiri amaphatikiza mitundu ya mankhwalawa malinga ndi mawonekedwe a wodwala komanso chithunzi cha matenda.

Zotsatira za pharmacological

Insulin Actrapid HM ndi mankhwala osakhalitsa. Chifukwa cha momwe zimakhalira, kuchuluka kwa shuga m'magazi kumatsitsidwa. Izi ndizotheka chifukwa chakuyendetsa kwake kwadongosolo.

Nthawi yomweyo, mankhwalawa amachepetsa kuchuluka kwa shuga ndi chiwindi, zomwe zimathandizanso kuti shuga azikhala bwino.

Mankhwalawa amayamba kugwira ntchito patatha pafupifupi theka la ola jakisoni ndi kukhalanso ndi mphamvu kwa maola 8. Zotsatira zazikulu zimawonedwa pakadutsa maola 1.5-3,5 pambuyo pa kubayidwa.

Kutulutsa mafomu ndi kapangidwe kake

Pogulitsa pali Actrapid mwanjira yothetsera jakisoni. Mitundu ina yotulutsira kulibe. Zake zogwira ntchito zimasungunuka insulini yambiri 3,5 mg.

Kuphatikiza apo, mapangidwe a mankhwalawa amakhala ndi zinthu zothandiza monga:

• glycerin - 16 mg,
• mankhwala a zinc chloride - 7 mcg,
• sodium hydroxide - 2.6 mg - kapena hydrochloric acid - 1,7 mg - (amafunikira malamulo a pH),
• metacresol - 3 mg,
• madzi - 1 ml.

Mankhwalawa ndi madzi amtundu wowoneka bwino. Amapezeka mumbale agalasi (voliyumu 10 ml). Phukusili lili ndi botolo limodzi.

Zizindikiro zogwiritsidwa ntchito

Mankhwalawa amapangidwa kuti azilamulira shuga.

Iyenera kugwiritsidwa ntchito pa matenda ndi zovuta zotsatirazi:

• mtundu 1 shuga
• lembani matenda ashuga a 2 omwe ali ndi matenda osakwanira kapena osafunikira kwenikweni kwa othandizira pakhungu.
• shuga ya gestational, yomwe idawoneka munthawi ya kubala mwana (ngati palibe zotsatira kuchokera ku chithandizo chamankhwala),
• matenda ashuga ketoacidosis,
• kutentha kwambiri matenda opatsirana odwala matenda ashuga,
• opaleshoni yomwe ikubwera kapena kubereka.

Kudzichiritsa nokha ndi Actrapid koletsedwa, mankhwalawa amayenera kutumizidwa ndi dokotala atatha kuphunzira chithunzithunzi cha matendawa.

Mlingo ndi makonzedwe

Malangizo ogwiritsira ntchito mankhwalawa ndiofunikira kuti mankhwalawa azigwira bwino, ndipo mankhwalawa samavulaza wodwala. Musanagwiritse ntchito Actrapid, muyenera kuiphunzira, komanso upangiri wa akatswiri.

Mankhwalawa amaperekedwa kudzera m'mitsempha kapena mozungulira. Dokotala amayenera kusankha mlingo wa tsiku ndi tsiku wa wodwala aliyense. Pa avareji, ndi 0,3-1 IU / kg (1 IU ndi 0,035 mg wa insulin). M'magulu ena a odwala, amatha kuwonjezereka kapena kuchepetsedwa.

Mankhwalawa amayenera kuperekedwa pafupifupi theka la ola musanadye, zomwe ziyenera kukhala ndi chakudya chamafuta. Ndikofunika kupaka jekeseni mkati mwa khoma lamkati mwamkati - chifukwa chake kunyamula kumachitika mwachangu. Koma amaloledwa kupereka mankhwalawa m'matako ndi matako kapena mumisempha yotupa ya brachial. Popewa lipodystrophy, muyenera kusintha tsamba la jakisoni (kukhalabe mkati mwa malo omwe analimbikitsidwawa). Kuti mupeze mlingo wokwanira, singano ikuyenera kusungidwa pansi pakhungu kwa masekondi 6 osachepera.

Palinso kugwiritsidwa ntchito moyenera kwa Actrapid, koma katswiri ayenera kuyendetsa mankhwalawa mwanjira iyi.

Ngati wodwala ali ndi matenda ofanana, mlingo wake umayenera kusinthidwa. Chifukwa cha matenda opatsirana okhala ndi mawonekedwe owoneka, kufunikira kwa insulin kumakulirakulira.

Malangizo a kanema wa insulin

Muyeneranso kusankha mlingo woyenera wopatuka monga:

• matenda a impso
• kuyanʻanila ntchito ya adrenal glands,
• matenda a chiwindi
• matenda a chithokomiro.

Kusintha kwa kadyedwe kapena kuchuluka kwa zochita zolimbitsa thupi kwa wodwalayo kungasokoneze kufunika kwa insulin, chifukwa chofunikira kusintha mlingo womwe umaperekedwa.

Odwala apadera

Kuchiza ndi Actrapid panthawi ya gestation sikuletsedwa. Insulin siyidutsa mu placenta ndipo sikuvulaza mwana wosabadwayo.

Koma poyerekeza ndi amayi oyembekezera, ndikofunikira kusankha mosamala mankhwalawa, ngati akapanda kugwiritsidwa ntchito molakwika, pamakhala chiopsezo chotenga hyper- kapena hypoglycemia.

Mavuto onse awiriwa amatha kukhudza thanzi la mwana wosabadwa, ndipo nthawi zina zimamupangitsa kuti apite padera. Chifukwa chake, madokotala amayenera kuwunika kuchuluka kwa shuga mwa amayi apakati mpaka kubadwa.

Kwa ana akhanda, mankhwalawa si owopsa, chifukwa chake kugwiritsa ntchito pa mkaka wa m'mawere kumaloledwa.Koma nthawi yomweyo, muyenera kuyang'anitsitsa zakudya za mayi woyamwitsa ndikusankha mlingo woyenera.

Actrapid sinafotokozeredwe ana ndi achinyamata, ngakhale maphunziro sanapeze zoopsa zina paumoyo wawo. Mwachidziwitso, chithandizo cha matenda osokoneza bongo omwe ali ndi mankhwalawa m'gulu lino amaloledwa, koma mlingo uyenera kusankhidwa payekha.

Contraindication ndi zoyipa

Actrapid ali ndi zotsutsana zochepa. Izi zimaphatikizapo hypersensitivity pazigawo za mankhwala ndi kupezeka kwa hypoglycemia.

Kuopsa kwa zovuta zoyenera kugwiritsa ntchito mankhwalawa ndizochepa. Nthawi zambiri, hypoglycemia imachitika, chomwe ndi zotsatira za kusankha kwa mlingo womwe suyenera wodwala.

Imayendera limodzi ndi zochitika monga:

Woopsa milandu, hypoglycemia angayambitse kukomoka kapena khunyu. Odwala ena amatha kufa chifukwa cha izo.

Zotsatira zina zoyipa za Actrapid zimaphatikizapo:

Izi ndizosowa komanso mawonekedwe a gawo loyambirira la chithandizo. Ngati amawonedwa kwa nthawi yayitali, ndipo mphamvu zawo zimachuluka, ndikofunikira kufunsa dokotala wanu za kufunikira kwa mankhwalawa.

Kuchita ndi mankhwala ena

Actrapid iyenera kuphatikizidwa molondola ndi mankhwala ena, chifukwa mitundu ina ya mankhwala ndi zinthu zina zimatha kukulitsa kapena kufooketsa kufunika kwa insulin. Palinso mankhwala omwe kugwiritsa ntchito kwawo kumawononga zochita za Actrapid.

Gome mogwirizana ndi mankhwala ena:

Mukamagwiritsa ntchito beta-blockers, zimakhala zovuta kwambiri kuzindikira hypoglycemia, chifukwa mankhwalawa amaphatikizanso chizindikiro chake.

Wodwala akamamwa mowa, kufunikira kwake kwa insulin kumatha kuwonjezeka komanso kuchepa. Chifukwa chake, ndikofunikira kuti odwala matenda ashuga asiye mowa.

Mankhwala okhala ndi vutoli

Chogulitsachi chili ndi ma analogues omwe amatha kugwiritsidwa ntchito posagwiritsa ntchito Actrapid.

Mitu ikuluikulu ndi:

• Gensulin P,
• Tikuyenda P,
• Monoinsulin CR,
• Biosulin R.

Migwirizano ndi machitidwe akusungidwa, mtengo

Chida chake chimayenera kusungidwa kuti chisafike kwa ana. Kusunga katundu wa mankhwalawa, ndikofunikira kuti mutetezere dzuwa. Kutentha kwambiri kosungirako ndi madigiri 2-8. Chifukwa chake, Actrapid amatha kusungidwa mufiriji, koma sayenera kuyikidwa mufiriji. Pambuyo pa kuzizira, yankho limakhala losatheka. Moyo wa alumali ndi zaka 2,5.

Mutatsegulira botolo mufiriji sayenera kuyikika, chifukwa kusungidwa kwake kumafunika kutentha kwama degree 25. Kuchokera pakuwala kwa dzuwa kuyenera kutetezedwa. Alumali moyo wotseguka unayikidwa kwa mankhwala ndi 6 milungu.

Mtengo woyenerera wa mankhwala a Actrapid ndi ma ruble 450. Insulin Actrapid HM Penefill ndi wokwera mtengo kwambiri (pafupifupi ma ruble 950). Mitengo imatha kusiyanasiyana ndi dera komanso mtundu wa mankhwala.

Actrapid sioyenera kudzipatsanso mankhwala, chifukwa chake, mutha kugula mankhwala kokha mwa mankhwala.

NOVO NORDISK NOVO NORDISK + FEREIN Novo Nordisk A / C

Mikhalidwe yapadera

• soluble insulin (maumboni amtundu wa anthu) 100 IU * Othandizira: zinc chloride, glycerol, metacresol, hydrochloric acid ndi / kapena sodium hydroxide (kukonza pH), madzi d / ndi. * 1 IU imafanana ndi 35 μg ya insulin ya inshuwaransi yaumunthu (maumboni amtundu wa anthu) 100 IU * Othandizira: zinc chloride, glycerol, metacresol, hydrochloric acid ndi / kapena sodium hydroxide (kukonza pH), madzi d / ndi.

Zizindikiro za Actrapid nm zogwiritsidwa ntchito

• insulin-wodwala matenda a shuga a mtundu wa mellitus (mtundu I), - osachiritsika omwe amadalira matenda a shuga (mtundu II): siteji yotsutsana ndi othandizira pakamwa a hypoglycemic, kukana pang'ono kwa mankhwalawa (panthawi yophatikiza mankhwalawa), ndi matenda apakati, ntchito, komanso mimba.

Zotsatira za Actrapid nm

• Zotsatira zoyipa zomwe zimawoneka mu odwala munthawi ya Acrapid NM zimadalira kwambiri mankhwala ndipo zimachitika chifukwa cha mankhwala a insulin. Monga momwe amakonzera insulin ina, zotsatira zoyipa kwambiri ndizo hypoglycemia. Amayamba pomwe milandu ya insulin imakulitsa kwambiri kufunika kwake. Panthawi ya mayeso azachipatala, komanso munthawi yogwiritsa ntchito mankhwalawa atamasulidwa pamsika wa ogula, zidapezeka kuti ma frequog a hypoglycemia amasiyana m'magulu osiyanasiyana a odwala komanso mukamagwiritsa ntchito mitundu yosiyanasiyana ya mankhwalawa, kotero sizingatheke kudziwa kuchuluka kwa pafupipafupi. Mu hypoglycemia yayikulu, kuchepa kwa chikumbumtima komanso / kapena kukhudzika kumatha kuchitika, kusokonezeka kwakanthawi kapena kosatha kwa ubongo kugwira ntchito ngakhale kufa kumatha kuchitika. Kafukufuku wachipatala awonetsa kuti zochitika za hypoglycemia nthawi zambiri sizinali zosiyana pakati pa odwala omwe amalandila insulin yaumunthu ndi odwala omwe amalandila insulin. Izi ndi malingaliro a pafupipafupi pazomwe zimachitika pazochitika zamankhwala, zomwe zimawerengedwa kuti zimakhudzana ndi kugwiritsa ntchito mankhwala a Actrapid NM. Pafupipafupi amatengedwa motere: kawirikawiri (> 1/1000,

Malo osungira

• khalani pamalo owuma
• Sungani kuzizira (t 2 - 5)
• osayandikira ana
• sungani pamalo amdima

• Brinsulrapi MK, Brinsulrapi Ch, Insulin Actrapid, Levulin

Dzina lachi Latin: mangochita
Code ya ATX: A10AB01
Chithandizo: insulin yosungunuka
Wopanga: Novo Nordisk, Denmark
Matchuthi ku pharmacy: Ndi mankhwala
Malo osungira: 2-8 madigiri kutentha
Tsiku lotha ntchito: Zaka 2,5 - botolo lotsekedwa
inatsegulidwa - mwezi umodzi ndi theka.

Actrapid ndi insulin yochepa yomwe imagwiritsidwa ntchito mu matenda ashuga pamaso pa kuperewera kwa mahomoni.

Insulin Actrapid nm ndi yoyenera kugwiritsidwa ntchito pochiza odwala matenda a shuga mellitus. Itha kugwiritsidwa ntchito onse pamaso pa mawonekedwe a insulin osagwira komanso osagwirizana ndi insulin. Amadziwika ndi njira yothanirana mwachangu, pomwe wodwala amafunika kuyika mndandanda wake wa glycemic mwadongosolo.

Kupanga ndi mawonekedwe a kumasulidwa

Chosakaniza chophatikizika pakuphatikizika ndi insulin yaumunthu mu mawonekedwe osungunuka. Omwe amaphatikizidwa: zinc chloride, glycerol, madzi a jakisoni, metacresol, sodium hydroxide.

Mankhwalawa amagulitsidwa mu mawonekedwe a jekeseni, palinso mawonekedwe a actrapid nm penfill, omwe amagulitsanso mawonekedwe a yankho la jakisoni wa subcutaneous.

Kuchiritsa katundu

Mankhwalawa ali ndi chithandizo chamankhwala mwachangu, chifukwa ndi cha gulu la mankhwala omwe amapangira insulini mwachangu. Chogulitsachi chimapangidwa pogwiritsa ntchito ukadaulo wa bioengineering ya DNA yomwe ikubwereranso poyambitsa chikhalidwe cha yisiti yophika mkate. Pambuyo mankhwala mwachindunji mosamala, yogwira mankhwala amayamba kulumikizana ndi ma cytoplasmic receptors mu cell membrane. Thupi limayambitsa zochitika mkati mwa khungu ndikulimbikitsa biosynthesis ya cAMP, yomwe imalola kulowa mkati mozama.

Monga momwe radar ikusonyezera, kuchepa kwa shuga m'magazi kumayamba chifukwa cha kuchuluka kwa kayendedwe ka magazi ndi kuyamwa ndi ziwalo za thupi, zomwe zimathandizira kusungidwa kwa mafuta m'thupi, kapangidwe kazinthu zopanga mapuloteni, glycogenogeneis zimachitika, komanso kuchepa kwa kupanga kwa shuga ndi chiwindi. Mankhwalawa amayamba kugwira ntchito mwachangu mu theka la ola mutatha kugwiritsa ntchito. Mphamvuyi imatheka pambuyo pa maola a 2,5, ndipo nthawi yonse yowonekera ili pafupifupi maola 7-8.

Kuchita mankhwala osokoneza bongo

Zinthu zomwe zimapangitsa kuti ntchito yochepetsera shuga ikhale yothandiza: mankhwala a hypoglycemic mankhwala, mankhwala a anabolic, ndi androgen, ketoconazole, tetracycline, vitamini B6, bromocriptine, mebendazole, theophylline, osagwiritsa ntchito beta-blockers, zakumwa zoledzeretsa, zomwe sizimangochulukitsa zotsatira, komanso kuwonjezera nthawi yofunikira.

Mwazi wamagazi ukuwonjezeka: Kulera kwamkamwa kwachulukidwe (mankhwala ophatikizira a progesterone ndi estradiol), mahomoni a chithokomiro, anticoagulants, clonidine, diazoxide, danazole, triceclic antidepressants, calcium blockers, opioid analgesics, nicotinic acid ndi nicoteroids, Reserpine, salicylates, octreotide, lanreotide zimakhudza kugwira ntchito kwa insulin mwachisawawa. Zinthu izi zimatha kuchepetsa ndikuwonjezera kufunika kwa Mlingo wa mankhwalawa.

Ziwawa ndi sulfite zimathandizira kuwonongeka kapena kuwonongeka kwa yankho la mankhwalawa, ndipo beta-blockers amachititsa zisonyezo zabodza za hypoglycemia.

Zotsatira zoyipa ndi bongo

Nthawi zina pamachitika zinthu zina zosakhudzana ngati zotupa pakhungu kapena kutupa, nthawi zambiri pamakhala kusintha kwa minofu ya adipose pamalo a jekeseni. Ngakhale kawirikawiri, kupezeka kwa kukana (kusavomera) kwa exulin.

Ngati mankhwala osokoneza bongo, zosasangalatsa zoterezi ndizotheka: kutha kugona mwachizolowezi, khungu, kupweteka, psychomotor, kuchuluka kwa chilimbikitso, kunjenjemera kwa manja, hyperhidrosis, mutu, migraines, paresthesia mkamwa, tachycardia. Ndi bongo wamphamvu, hypoglycemia yamphamvu yodwala imayamba ndipo wodwalayo amagwa.

Ngati pali ziwonetsero zofatsa za hypoglycemia, ndiye kuti ndikokwanira kugwiritsa ntchito zakudya zopezeka mwachangu (shuga, mipiringidzo chokoleti, mapiritsi a shuga). Ndi zovuta, mphamvu ya shuga imapangidwira kudzera mu dontho. Vuto lalikulu, gulu la ambulansi limatchedwa ndi glucagon, ndipo kuyang'aniridwa kuchipatala kumafunikanso mpaka mkhalidwe utasintha.

Lilly France, France

Mtengo wapakati ku Russia - ma ruble 1720 phukusi lililonse.

Zomwe zimagwira mu humalogue ndi insulin lispro. Ichi ndi chimodzi mwazifanizo zambiri za Actrapide pamtengo wokwera mtengo. Humalog imakhala ndi mphamvu yochizira, zotsatira zake zowonjezera zimayamba kuwonekera pakatha mphindi 15 jakisoni, koma nthawi yochitikanso ndi yochepa, kuyambira maola awiri mpaka asanu motsatana.

Sanofi Avensis Deutschland, Germany

Mtengo wapakati ku Russia - ma ruble 2060 phukusi lililonse.

Apidra imakhala ndi insulin mu mawonekedwe a gluzilin, omwe, monga analogue yakunja, imalola kuti ichitepo kanthu pafupipafupi, koma kutalika kwa zotsatirapo sikutalika - maola ochepa okha.

• Zotsatira zake
• Zimathandiza kwambiri.

Chithandizo cha odwala omwe ali ndi matenda a shuga 1 amachitika mwa njira ya insulin. Kuphatikiza pa zoletsedwa za chakudya, kayendetsedwe ka insulini kumatha kulepheretsa odwala oterewa kukhala ndi vuto lalikulu la matenda ashuga.

Mukamapereka mankhwala a insulin, ndikofunikira kuyesa kubereka moyandikira momwe mungathere mwanjira yachilengedwe yolowa m'magazi. Mwa izi, mitundu iwiri ya insulini imakonda kupatsidwa kwa odwala - yayitali komanso yochepa.

Insulins wautali wofanana ndi kubisala (kwa nthawi yayitali) kubisala. Ma insulin amafupiziridwa kuti apatsidwe chakudya chamafuta. Amaperekedwa musanadye muyezo wofanana ndi kuchuluka kwa mkate muzogulitsidwa. Actrapid NM ndi amtundu wotere.

Limagwirira a Actrapid NM

Chogulitsachi chimakhala ndi insulin yaumunthu yomwe imachokera ku genetic engineering. Popanga, DNA kuchokera ku saccharomycetes yisiti imagwiritsidwa ntchito.

Insulin imamangilira ma cell ku maselo ndipo kuphatikiza uku kumapereka kuchuluka kwa glucose kuchokera m'magazi kupita mu khungu.

Kuphatikiza apo, Actrapid insulin imawonetsa zochitika pamachitidwe a metabolic:

1. Imathandizira mapangidwe a glycogen mu chiwindi ndi minofu minofu
2. Imathandizira kugwiritsidwa ntchito kwa glucose ndi maselo a minofu ndi minyewa ya adipose yopanga mphamvu
3. Kuwonongeka kwa glycogen kumachepetsedwa, monganso momwe amapangira mamolekyu atsopano a chiwindi mu chiwindi.
4. Imathandizira kupanga mafuta acid ndikuchepetsa kuchepa kwamafuta
5. M'magazi, kapangidwe ka lipoproteins kamawonjezeka
6. Insulin imathandizira kukula kwa maselo ndikugawika
7. Imathandizira kaphatikizidwe kabwino ka protein komanso kuchepetsa kuchepa kwake.

Kutalika kwa zochita za Actrapid NM kutengera mlingo, malo a jakisoni ndi mtundu wa matenda ashuga. Mankhwala akuwonetsa katundu wake theka la ola pambuyo pa utsogoleri, kuchuluka kwake kumadziwika pambuyo pa maola 1.5 - 3.5. Pambuyo pa maola 7 - 8, mankhwalawa amasiya kuchita ndipo amawonongeka ndi ma enzyme.

Chizindikiro chachikulu chogwiritsa ntchito Actrapid insulin ndikuchepa kwa shuga m'magititus a shuga kuti azigwiritsidwa ntchito pafupipafupi komanso kuti apange zochitika zadzidzidzi.

Actrapid pa mimba

Insulin Actrapid NM itha kutumizidwa kuti muchepetse hyperglycemia mwa amayi apakati, popeza siwodutsa chotchinga chachikulu. Kuperewera kwa chindapusa cha shuga kwa amayi apakati kungakhale koopsa kwa mwana.

Kusankhidwa kwa Mlingo kwa amayi apakati ndikofunikira kwambiri, chifukwa kuchuluka kwakukulu komanso kochepa kwa shuga kumasokoneza mapangidwe a ziwalo ndikupangitsa kuti zisachitike bwino, komanso kumawonjezera chiopsezo cha kufa kwa fetal.

Kuyambira kuyambira gawo lakukonzekera kutenga pakati, odwala matenda ashuga amayenera kuyang'aniridwa ndi endocrinologist, ndipo akuwonetsedwa kuwunika kwamagazi a shuga. Kufunika kwa insulin kumatha kuchepa mu trimester yoyamba ya kutenga pakati ndikuwonjezeka kwachiwiri ndi kwachitatu.

Pambuyo pobereka, kuchuluka kwa glycemia nthawi zambiri kumabwerera ku ziwerengero zam'mbuyomu zomwe zinali zisanachitike mimba.

Kwa amayi oyamwitsa, kuyang'anira Actrapid NM sikulinso pachiwopsezo.

Koma poganizira kuchuluka kwa michere, zakudya ziyenera kusintha, motero mlingo wa insulin.

Kupanga ndi mawonekedwe a kumasulidwa

Njira yothetsera jakisoni - 1 ml:

• yogwira zinthu: insulin sungunuka wa chibadwa cha anthu - 100 IU (3.5 mg), 1 IU ikufanana ndi 0,035 mg wa insulin yaumunthu wamunthu,
• excipients: zinc chloride, glycerin (glycerol), metacresol, sodium hydroxide ndi / kapena hydrochloric acid (kusintha pH), madzi a jakisoni.

10 ml m'mabotolo agalasi, osindikizidwa ndi cholembera ndi chopukusira pulasitiki, mumapaketi a makatoni 1.

Njira yothetsera jakisoni ndi yowonekera, yopanda utoto.

Wamtundu waifupi insulin.

Munthu wobwerezabweretsanso insulin ya DNA. Ndi insulin ya nthawi yayitali yochitapo kanthu. Imayendetsa kagayidwe ka glucose, imakhala ndi zotsatira za anabolic. Mu minofu ndi minyewa ina (kupatula ubongo), insulin imathandizira kayendedwe ka glucose ndi amino acid, komanso zimapangitsa protein anabolism. Insulin imalimbikitsa kutembenuka kwa glucose kukhala glycogen m'chiwindi, kumalepheretsa gluconeogeneis ndikuthandizira kusintha kwa glucose owonjezera kukhala mafuta.

Actrapid nm Ntchito pakati ndi ana

Pakati pa nthawi yayitali, ndikofunikira kuti pakhale chitetezo chabwino cha glycemic mwa odwala matenda ashuga. Pa nthawi ya pakati, kufunika kwa insulin nthawi zambiri kumachepetsa mu trimester yoyamba ndikuwonjezeka trimesters yachiwiri ndi yachitatu.

Ndikulimbikitsidwa kuti odwala omwe ali ndi matenda osokoneza bongo adziwitse adokotala za kutha kapena kukonza pakati.

Odwala omwe ali ndi matenda a shuga mellitus pa mkaka wa m`mawere, kusintha kwa insulin, zakudya, kapena zonse ziwiri zingafunike.

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

Kutulutsa mawonekedwe, kapangidwe kake ndi ma CD

Njira yothetsera jakisoni ndi yowonekera, yopanda utoto.

Omwe amathandizira: zinc chloride, glycerol, metacresol, hydrochloric acid ndi / kapena sodium hydroxide (kukhalabe ndi pH level), madzi d / ndi.

* 1 IU imafanana ndi 35 μg ya insulin ya munthu wosafunikira.

10 ml - mabotolo agalasi (1) - mapaketi a makatoni.

Mlingo Actrapid nm

P / c, mu / mu. Mlingo wa mankhwalawa amasankhidwa payekha poganizira zosowa za wodwala. Nthawi zambiri, kufunikira kwa wodwala insulin kumachokera ku 0,3 mpaka 1 IU / kg / tsiku. Kufunikira kwa insulin tsiku lililonse kumatha kukhala kwapamwamba kwa odwala omwe ali ndi insulin (mwachitsanzo, nthawi yakutha msinkhu, komanso odwala omwe ali ndi kunenepa kwambiri) komanso otsika mwa odwala omwe ali ndi zotsalira za insulin. Ngati odwala matenda a shuga akwaniritsa kwambiri glycemic control, ndiye kuti zovuta za shuga mwa iwo, monga lamulo, zimawonekera pambuyo pake. Pankhaniyi, munthu ayenera kuyesetsa kukhathamiritsa kagayidwe kachakudya, makamaka, poyang'anira mosamala kuchuluka kwa shuga m'magazi.

Actrapid ® NM ndi insulin yochepa ndipo imatha kugwiritsidwa ntchito limodzi ndi ma insulin.

Mankhwalawa umaperekedwa kwa mphindi 30 asanadye kapena chakudya. Actrapid ® NM nthawi zambiri imayendetsedwa ku Sc mpaka dera la khomo lamkati lakumbuyo. Ngati izi ndizotheka, ndiye kuti jakisoni amathanso kupangira ntchafu, dera la gluteal kapena dera lamapeto. Ndi kuyambitsa kwa mankhwala m'dera lakhomopo lakhomopo, mayamwidwe mwachangu amatheka kuposa momwe angayambitsire madera ena. Kupanga jakisoni pakhungu kumachepetsa chiopsezo cholowera minofu.

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

Jakisoni wa mu mnofu amathanso kuchitika, koma mokhazikika monga adokotala amafotokozera.

Actrapid ® NM ndiyothekanso kulowa mkati / momwemo, njirazi zitha kuchitidwa ndi katswiri wazachipatala.

Ndi kuwonongeka kwa impso kapena chiwindi, kufunika kwa insulin kumachepa.

Kusamutsa wodwala kupita ku mtundu wina wa insulin kapena kukonzekera kwa insulini ndi dzina lina lamalonda kuyenera kuchitika moyang'aniridwa ndi achipatala.

Zosintha mu zochitika za insulin, mtundu wake, mitundu (nkhumba, insulin ya anthu, analogue ya anthu) kapena njira yopangira (DNA recombinant insulin kapena insulin yazomwe nyama zimachokera) zitha kuchititsa kusintha kwa mlingo.

Kufunika kwa kusintha kwa mankhwalawa kungafunike kale pokhazikitsidwa ndi insulin yokonzekera pambuyo pokonzekera insulin ya nyama kapena pang'onopang'ono patadutsa milungu ingapo kapena miyezi ingapo mutasamutsidwa.

Kufunika kwa insulini kumatha kuchepa ndi kusakwanira kwa adrenal ntchito, pituitary kapena chithokomiro, ndi aimpso kapena kwa chiwindi.

Ndi matenda ena kapena kupsinjika kwamalingaliro, kufunikira kwa insulin kungakulitse.

Kusintha kwa Mlingo kumafunikanso pakuwonjezera zochitika zolimbitsa thupi kapena kusintha zakudya zamagulu.

Zizindikiro zakutsogolo kwa hypoglycemia panthawi ya insulin yaumwini mwa odwala ena akhoza kutchulidwa kochepa kapena zosiyana ndi zomwe zimawonedwa panthawi ya insulin yoyambira nyama. Ndi kusintha kwa matenda a shuga m'magazi, mwachitsanzo, chifukwa cha insulin yokwanira, zonse kapena zizindikiro zina zakutsogolo kwa hypoglycemia zitha kuzimiririka, zomwe odwala ayenera kudziwitsidwa.

Zizindikiro zakutsogolo kwa hypoglycemia zimatha kusintha kapena kusalankhula pang'ono ndi njira yayitali ya matenda a shuga, matenda a shuga, kapena kugwiritsa ntchito beta-blockers.

Nthawi zina, thupi lanu siligwirizana chifukwa cha zochita za mankhwalawa, mwachitsanzo, kuyambitsa khungu ndi wothanduka kapena jakisoni wosayenera.

Nthawi zina mankhwalawa amachitika mosiyanasiyana. Nthawi zina, kusintha kwa insulin kapena kukakamira kungafunike.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Panthawi ya hypoglycemia, kuthekera kwa wodekha kuyang'anitsitsa kumatha kuchepa ndipo kuchuluka kwa ma psychomotor zimatha kuchepa. Izi zitha kukhala zowopsa nthawi zomwe maluso amenewa amafunikira makamaka (kuyendetsa galimoto kapena makina ogwiritsa ntchito). Odwala ayenera kulangizidwa kuti azisamala kuti asamayendetse hypoglycemia poyendetsa. Izi ndizofunikira kwambiri kwa odwala omwe ali ndi zofatsa kapena zosapezekapo zizindikiro za hypoglycemia kapena kukula pafupipafupi kwa hypoglycemia. Zikatero, adotolo amayenera kuwunika momwe wodwala angayendetsere galimoto.

Pharmacokinetics

The kukwana mayamwidwe ndi isanayambike mphamvu ya insulin zimatengera njira ya makonzedwe (subcutaneously, intramuscularly), malo oyang'anira (m'mimba, ntchafu, matako), mlingo (kuchuluka kwa insulin), kuchuluka kwa insulin, mankhwala ambiri a C max mkati mwa maola 1.5-2.5 pambuyo povomerezeka. Kugawa

Palibe chomangiriza kuti mapuloteni a plasma, nthawi zina amangopezeka ma antibodies a insulin okha.

Insulin yaumunthu imapukusidwa ndi zochita za insulin proteinase kapena ma enzyme okhala ndi insulini, komanso, mwina, ndi protein disulfide isomerase. Amaganiziridwa kuti mu molekyulu ya insulin ya anthu pali malo angapo a cleavage (hydrolysis), komabe, palibe amodzi a metabolites omwe amapangidwa chifukwa cha cleavage akugwira ntchito.

Hafu ya moyo (T 1/2) imatsimikiziridwa ndi kuchuluka kwa mayamwidwe ochokera ku ziwopsezo zam'mimba. Chifukwa chake, T 1/2 ikhoza kukhala kuyamwa, m'malo mochotsa insulini kuchokera ku plasma (T 1/2 ya insulin m'magazi ndi mphindi zochepa chabe). Kafukufuku awonetsa kuti T 1/2 ili pafupi maola 2-5.

Pharmacokinetics mu milandu yapadera yamankhwala

Mbiri ya pharmacokinetic ya Actrapid NM adaphunziridwa mgulu la ana omwe ali ndi matenda a shuga (anthu 18) azaka za 6 mpaka 12, komanso achinyamata (azaka 13 mpaka 17). Ngakhale zambiri zomwe zimawerengedwa zimawonedwa ngati zochepa, komabe amawonetsa kuti mbiri ya pharmacokinetic ya Actrapid NM mwa ana ndi achinyamata ndiofanana ndi zomwe zimachitika mwa akulu. Nthawi yomweyo, kusiyana kunawululidwa pakati pa mibadwo yosiyanasiyana ndi chizindikiro monga C max, chomwe chikugogomezeranso kufunika kwa kusankha kwa munthu payekha.

Mlingo

Mankhwalawa adapangira SC ndi / pakukhazikitsa.

Mlingo wa mankhwalawa amasankhidwa payekha, poganizira zosowa za wodwala. Nthawi zambiri, zofunika za insulini zimachokera pa 0,3 mpaka 1 IU / kg / tsiku. Kufunika kwa insulin tsiku lililonse kumatha kukhala kwabwino kwambiri kwa odwala omwe ali ndi insulin (mwachitsanzo, nthawi yakutha msinkhu, komanso odwala omwe ali ndi kunenepa kwambiri), komanso otsika mwa odwala omwe ali ndi zotsalira za insulin.

Ngati odwala matenda a shuga akwaniritsa kwambiri glycemic control, ndiye kuti zovuta za shuga mwa iwo, monga lamulo, zimawonekera pambuyo pake. Pankhaniyi, munthu ayenera kuyesetsa kukhathamiritsa kagayidwe kachakudya, makamaka, poyang'anira mosamala kuchuluka kwa shuga m'magazi.

Actrapid NM ndi insulin yochepa ndipo imagwiritsidwa ntchito limodzi ndi ma insulin omwe amakhala nthawi yayitali.

Mankhwalawa umaperekedwa kwa mphindi 30 asanadye kapena chakudya.

Actrapid NM nthawi zambiri imayendetsedwa mwachangu kudera lakhoma lamkati lakumbuyo. Ngati izi ndizotheka, ndiye kuti jakisoni amathanso kuchitika m'tchafu, m'chigawo cha gluteal kapena m'dera la minofu ya m'mapazi. Ndi kuyambitsa kwa mankhwala m'dera lakhomopo lakhomopo, mayamwidwe mwachangu amatheka kuposa momwe angayambitsire madera ena. Kupanga jakisoni pakhungu kumachepetsa chiopsezo cholowera minofu.

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

Jakisoni wa mu mnofu amathanso kuchitika, koma mokhazikika monga adokotala amafotokozera.

Actrapid NM ndiyothekanso kulowa mkati mwake ndipo njirazi zitha kuchitidwa ndi akatswiri azachipatala.

Ndi kuwonongeka kwa impso kapena chiwindi, kufunika kwa insulin kumachepa.

Malangizo ogwiritsira ntchito ndi kuwongolera

Pazowongolera zamkati, makina a kulowetsedwa omwe amakhala ndi Actrapid NM 100 IU / ml amagwiritsidwa ntchito pozama kuyambira 0,05 IU / ml mpaka 1 IU / ml ya insulin yaumunthu mu mayankho a kulowetsedwa, monga 0.9% sodium chloride solution, 5% ndi 10% yankho dextrose, kuphatikizapo potaziyamu mankhwala enaake mwa 40 mmol / l, kachitidwe ka / akuwongolera amagwiritsa ntchito matumba a kulowetsedwa opangidwa ndi polypropylene, zothetsera izi zimakhazikika kwa maola 24 kutentha kwa firiji.

Ngakhale mavutowa amakhala okhazikika kwakanthawi, poyambira, kuyamwa kwa insulini kumadziwika ndi zinthu zomwe chikwama cha kulowetsamo chimapangidwira. Pa kulowetsedwa, ndikofunikira kuyang'anira kuchuluka kwa shuga m'magazi.

Malangizo ogwiritsira ntchito Actrapid NM, omwe ayenera kuperekedwa kwa wodwala.

Mbale zokhala ndi mankhwala a Actrapid NM zitha kugwiritsidwa ntchito limodzi ndi ma insulin, pomwe muyeso umayikidwa, womwe umakulolani kuyeza muyeso mu magawo a ntchito. Mbale zokhala ndi Actrapid NM zimapangidwira anthu okha.

Musanagwiritse ntchito Actrapid ® NM, ndikofunikira: Yang'anirani cholembera kuti muwonetsetse kuti mtundu woyenera wa insulini wasankhidwa, tengani mankhwala oyimitsa ndi mphira wa thonje.

Mankhwala a Actrapid ® NM sangathe kugwiritsidwa ntchito pazinthu zotsatirazi:

- m'mapampu a insulin,

- ndikofunikira kuti odwala afotokozere kuti ngati palibe zoteteza pa botolo latsopano, lomwe linangolandiridwa kuchokera ku mankhwala, kapena siligwirizana mwamphamvu, insulin yotere iyenera kubwezeretsedwa ku pharmacy,

- ngati insulin idasungidwa molakwika, kapena ngati yauma.

- ngati insulini yasiya kukhala yowonekera komanso yopanda utoto.

Ngati wodwala amagwiritsa ntchito mtundu umodzi wokha wa insulin

1. Jambulani mpweya mu syringe mu chiwerengero chogwirizana ndi insulin yomwe mukufuna.

2. Lowetsani mpweya mu vial insulin. Kuti muchite izi, kuboola pakamira ndi mphira ndi pulasitiki.

3. Sinthani botolo la syringe pansi.

4. Lowani muyezo wa insulin mu syringe.

5. Chotsani singano mu vial.

6. Chotsani mpweya mu syringe.

7. Onetsetsani kuti mlingo wa insulin ndi wolondola.

8. Lowani nthawi yomweyo.

Ngati wodwala akuyenera kusakaniza Actrapid® NM ndi insulin yayitali

1. Pereka gawo la insulin yayitali (yamitambo) pakati pama manja anu mpaka insuliniyo ikhale yoyera komanso yamitambo.

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

3. Jambulani mpweya mu syringe muyezo wogwirizana ndi mlingo wa Actrapid NM ("mandala"). Lowani mlengalenga mu vial ndi Actrapid NM.

4. Tembenuzani mosamala ndi syringe ("yowoneka bwino") pansi ndikuyimba muyezo wa Actrapid HM. Tulutsani singano ndikuchotsa mpweya ku syringe. Chongani mlingo woyenera.

5. Ikani singano mu mitambo ya insulin.

6. Tembenuza vial ndi syringe pansi.

7. Lowetsani muyezo mafuta a insulin.

8. Chotsani singano mu vial.

9. Chotsani mpweya mu syringe ndikuwonetsetsa kuti mulondola.

10. Jekesani nthawi yomweyo jekeseni wa insulin waifupi ndi
kuchitapo kanthu kwa nthawi yayitali.

Nthawi zonse muzingotenga nthawi yayitali komanso yayitali pochita zinthu zofanana monga tafotokozazi.

Phunzitsani wodwala momwe angapangire insulin

1. Ndi zala ziwiri, ikani khola la khungu, ikani singano m'munsi mwa khola pakadutsa pafupifupi madigiri 45, ndi kubaya insulin pansi pakhungu.

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

Zotsatira zoyipa

Zotsatira zoyipa zomwe zimawoneka mu odwala munthawi ya Acrapid NM zimadalira kwambiri mankhwala ndipo zimachitika chifukwa cha mankhwala a insulin. Monga momwe amakonzera insulin ina, zotsatira zoyipa kwambiri ndizo hypoglycemia. Amayamba pomwe milandu ya insulin imakulitsa kwambiri kufunika kwake. Panthawi ya mayeso azachipatala, komanso munthawi yogwiritsa ntchito mankhwalawa atamasulidwa pamsika wa ogula, zidapezeka kuti ma frequog a hypoglycemia amasiyana m'magulu osiyanasiyana a odwala komanso mukamagwiritsa ntchito mitundu yosiyanasiyana ya mankhwalawa, kotero sizingatheke kudziwa kuchuluka kwa pafupipafupi.

Mu hypoglycemia yayikulu, kuchepa kwa chikumbumtima komanso / kapena kukhudzika kumatha kuchitika, kusokonezeka kwakanthawi kapena kosatha kwa ubongo kugwira ntchito ngakhale kufa kumatha kuchitika. Kafukufuku wachipatala awonetsa kuti zochitika za hypoglycemia nthawi zambiri sizinali zosiyana pakati pa odwala omwe amalandila insulin yaumunthu ndi odwala omwe amalandila insulin.

Izi ndi malingaliro a pafupipafupi pazomwe zimachitika pazochitika zamankhwala, zomwe zimawerengedwa kuti zimakhudzana ndi kugwiritsa ntchito mankhwala a Actrapid NM. Pafupipafupi amatchulidwa motere: pafupipafupi (> 1/1000, kusokonezeka kwa dongosolo la chitetezo cha mthupi) kutupa, kufupika kwa mpweya, kulimba, kuchepa kwa magazi, kukomoka / kusazindikira Maganizo a hypersensitivity angawononge moyo.

Kusokonezeka kwa dongosolo lamanjenje: kawirikawiri - zotumphukira neuropathy. Ngati kusintha kwa kayendetsedwe ka shuga m'magazi kwakwaniritsidwa mwachangu kwambiri, vuto lotchedwa "ululu wammbuyo" limatha kupezeka lomwe limasinthiratu.

Kuphwanya gawo la masomphenyawo: pafupipafupi - kuphwanya Refraction. Zovuta zamkati zodzikongoletsera zimadziwika nthawi yoyamba gawo la insulin. Monga lamulo, Zizindikirozi ndizosintha. Osowa kwambiri - matenda ashuga retinopathy. Ngati chiwongolero chokwanira cha glycemic chimaperekedwa kwa nthawi yayitali, chiwopsezo cha kupitirira kwa matenda ashuga amachepetsa. Komabe, kukulitsa kwa insulin mankhwala osinthika kwambiri pakulamulira kwa glycemic kungayambitse kuwonjezeka kwakanthawi kwa zovuta za matenda ashuga a retinopathy.

Kusokonezeka kwa khungu ndi minyewa yodutsa: pafupipafupi - lipodystrophy. Lipodystrophy imatha kukhazikika pamalo a jekeseni pomwe sizisintha mosintha malo a jekeseni mkati mwa gawo limodzi la thupi.

Kusokonezeka kwa thupi lonse, komanso zomwe zimachitika jakisoni: jekeseni, zomwe zimachitika jakisoni. Poyerekeza ndi maziko a mankhwala a insulin, zimachitika pakhungu jekeseni (redness of the khungu, kutupa, kuyabwa, kupweteka, mapangidwe a hematoma pamalo a jekeseni). Komabe, nthawi zambiri, izi zimachitika mosadukiza ndipo zimatha mwanjira yopitilira chithandizo. Nthawi zambiri - kudzisunga. Kutupa kumadziwika nthawi yoyamba ya insulin. Monga lamulo, chizindikiro ichi chimakhala chachilengedwe.

Kugwiritsa ntchito mankhwalawa pa mimba komanso mkaka wa m`mawere

Palibe choletsa kugwiritsa ntchito insulin panthawi yapakati, popeza insulin siyidutsa chotchinga. Komanso, ngati matenda ashuga sawagwiritsa ntchito panthawi yoyembekezera, mwana wosabadwayo amakhala pachiwopsezo. Chifukwa chake, chithandizo cha matenda ashuga chiyenera kupitilizidwa pa nthawi yomwe muli ndi pakati.

Onse a hypoglycemia ndi hyperglycemia, omwe amatha kukhala ndi vuto losankha bwino, amalimbikitsa chiopsezo cha kusokonezeka kwa fetal ndi kufa kwa fetal.Amayi oyembekezera omwe ali ndi matenda ashuga amayenera kuyang'aniridwa panthawi yonse yomwe ali ndi pakati, ayenera kukhala ndi njira zowongolera kuchuluka kwa shuga wamagazi, malingaliro omwewo amagwiranso ntchito kwa amayi omwe akukonzekera kutenga pakati.

Kufunika kwa insulin nthawi zambiri kumachepera mu trimester yoyamba ya kutenga pakati ndipo kumawonjezeka pang'onopang'ono kwachiwiri komanso kachitatu.

Pambuyo pa kubala, kufunikira kwa insulin kumabwereranso msanga momwe zidadziwikira mwana asanabadwe.

Palibenso zoletsa kugwiritsa ntchito mankhwala a Actrapid NM pa nthawi yoyamwitsa. Kuchita insulin kwa amayi oyamwitsa sikowopsa kwa mwana. Komabe, mayi angafunike kusintha njira ya Actrapid NM ndi / kapena zakudya.

Kuyanjana kwa mankhwala osokoneza bongo

Pali mankhwala angapo omwe amakhudza kufunika kwa insulin.

Hypoglycemic zotsatira za insulin patsogolo m'kamwa wothandizila hypoglycemic, zoletsa monoamine oxidase, zoletsa Ace, carbonic zoletsa anhydrase, kusankha beta-blockers, bromocriptine, sulfonamides, anabolic mankhwala, tetracyclines, klofiorat, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, lifiyamu, mankhwala, yokhala ndi Mowa.

Njira zakulera za pakamwa, GCS, mahomoni a chithokomiro, thiazide diuretics, heparin, tridclic antidepressants, sympathomimetics, danazole, Clonidine, calcium njira blockers, diazoxide, morphine, phenytoin, nikotini zimafooketsa mphamvu ya hypoglycemic.

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

Beta-blockers amatha kufinya zizindikiro za hypoglycemia ndikupangitsa kuti zithetse kuthetsa hypoglycemia.

Octreotide / lanreotide imachepetsa ndikuwonjezera kufunika kwa insulin.

Mowa umatha kukulitsa mphamvu ya hypoglycemic ya insulin.

Actrapid NM imatha kuwonjezeredwa pazophatikizira zomwe zimadziwika kuti ndizogwirizana. Mankhwala ena (mwachitsanzo, mankhwala okhala ndi ma thiols kapena sulfite) akawonjezeredwa ndi yankho la insulin angayambitse kuchepa.

Migwirizano ndi magwiritsidwe akusungidwa

Sungani mufiriji kutentha kwa 2 ° C mpaka 8 ° C (osayandikira kwambiri ndi mufiriji) pabokosi lamakatoni. Osamawuma. Mankhwalawa ayenera kutetezedwa kuti asatenthedwe ndi kutentha ndi dzuwa. Pewani kufikira ana. Moyo wa alumali ndi miyezi 30. Osagwiritsa ntchito tsiku lanu litatha.

Botolo lotseguka: Sungani kutentha osapitirira 25 ° C kwa milungu 6. Sitikulimbikitsidwa kusunga mufiriji. Sungani botolo m'bokosi lamakatoni kuti mutetezedwe pakuwala.