Maupangiri a Mankhwala a Geotar

Insulin Actrapid: pezani zonse zomwe mukufuna. Pansipa mupeza malangizo ogwiritsira ntchito olembedwa m'chinenerochi. Kumvetsetsa momwe mungasankhire mlingo woyenera, kangati patsiku ndi malo omwe angadulidwe, kuposa momwe mankhwalawa angathere. Phunzirani momwe mungaphatikizire Actrapid ndi Protafan. Werengani momwe mungapewere shuga wochepa kwambiri wa magazi ndi zotsatira zina zoyipa. Actrapid ndi insulin yocheperako yopangidwa ndi kampani yotchuka yapadziko lonse Novo Nordisk. Awa ndi mankhwala ochokera kunja abwino. Munkhaniyi, amamufanizira ndi ma chithunzi a ultrashort a Humalog, Apidra ndi NovoRapid.

Actrapid: nkhani yatsatanetsatane

Zimafotokozedwa mwatsatanetsatane zomwe mitundu ina ya insulin Actrapid NM ingasinthidwe nawo. Dziwani ngati mungasinthe kuchokera ku mankhwala osafupika kupita ku a ultrashort one. Dziwani kuti insulin yowonongeka nthawi zambiri imakhala yomveka bwino. Chifukwa chake, simuyenera kugula Actrapid kuchokera m'manja mwa zilengezo zachinsinsi. Pezani insulin kuchokera ku malo ogulitsa odalirika.

Mukabayidwa jakisoni wa Actrapid, monga mtundu wina uliwonse wa insulin, muyenera kutsatira zakudya.

Zosankha zamadyedwe kutengera ndi matendawa:

Anthu ambiri odwala matenda ashuga omwe amathandizidwa ndi insulin sawona kuti ndizotheka kupewa kukhala ndi vuto la hypoglycemia. M'malo mwake, izi siziri choncho. Mutha kusunga shuga wokhazikika ngakhale ndi matenda oopsa a autoimmune. Ndipo makamaka, ndi matenda a shuga a 2 ochepa. Palibe chifukwa chakuwonjezera kuchuluka kwa shuga m'magazi anu kuti mudzilimbitse nokha motsutsana ndi hypoglycemia yoopsa. Onerani kanema yemwe akufotokoza nkhaniyi ndi bambo wa mwana yemwe ali ndi matenda ashuga 1.

Chithandizo cha matenda a shuga a insulin - komwe mungayambire:

Zotsatirazi ndizowonjezera pazamankhwala a Actrapid.

Kodi insulin nchiyani?

Actrapid ndi insulin yochepa. Osasokoneza ndi mankhwala omwe akupanga ultrashort. Ultrashort mitundu ya insulin pambuyo makonzedwe amayamba kuchita zinthu mwachangu kuposa zazifupi. Komanso zochita zawo zimatha posachedwa. Actrapid si insulin wothamanga kwambiri. Koma kwa odwala omwe ali ndi matenda amtundu wa 1 komanso a 2 omwe amawonera, mankhwalawa ndiabwino kuposa mitundu ya insulin Humalog, NovoRapid ndi Apidra.

Chowonadi ndi chakuti thupi la munthu limayamba kudya zakudya zamafuta ochepa. Choyamba muyenera kugaya mapuloteni omwe adadyawo. Pambuyo pake, gawo lina limasandulika kukhala glucose, yomwe imalowa m'magazi. Pokhapokha mafuta abwino mu zakudya, kukonzekera kwa insulini kumachitika mwachangu. Amatha kuyambitsa ma spikes a magazi. Actrapid ali bwino pankhaniyi.

Mungamayike bwanji?

Actrapid nthawi zambiri amabayidwa katatu patsiku musanadye, mphindi 30 asanadye. Komabe, kuti mupeze chiwongolero chabwino cha matenda a shuga, sizingatheke popanda kusankha mtundu wa mankhwala a insulin. Simungadalire ulangizi wokhazikika pazakudya ndi kusankha kwa mankhwala a insulin.

Sinthani ku, ndikuwona kusintha kwa shuga kwa masiku angapo. Simungafunike jakisoni wa insulin mwachangu musanadye. Actrapid sifunikira kuvulazidwa ngati, popanda iyo, kuchuluka kwa shuga m'masiku 3-5 pambuyo chakudya kumasungidwa pamlingo wa anthu athanzi - 4.0-5.5 mmol / l.

Werengani nkhaniyo ”. Imakuwuzani momwe mungapereke jakisoni popanda kupweteka. Pewani kuyendetsa miyeso yambiri ya Actrapid kapena insulin ina mwachangu pakanthawi kochepera maola 4-5.Kuphatikiza pa zochitika zothamanga pamene shuga odwala matenda ashuga ali kwambiri, zovuta zimakhalapo zomwe zimafunikira chisamaliro chadzidzidzi.

Kodi jakisoni aliyense amatalika bwanji?

Jekeseni aliyense wa mankhwala Actrapid ndiwothandiza kwa maola pafupifupi asanu. Zotsalira zotsalira zimatha mpaka maola 6-8, koma sizofunikira. Sikoyenera kuti milingo iwiri ya insulin yochepa ichite munthawi yomweyo mthupi. Odwala odwala matenda ashuga kwambiri amatha kudya katatu patsiku ndi kubaya insulin mwachangu musanadye ndi nthawi yayitali ya maola-5-5. Chakudya chomwe mumagawana pafupipafupi sichingawathandize, koma kuwapweteketsa. Shuga sayenera kukumbukiridwanso koyambirira kuposa maola 4 mutatha jakisoni wa Actrapid. Chifukwa kufikira nthawi ino, mlingo womwe umayendetsedwa sudzakhala ndi nthawi yochitapo kanthu.

Kodi chitha kusintha chani ndi mankhwalawa?

Chonde dziwani kuti kusinthira kuti muchepetse kuchuluka kwa insulin ndi 2-8 nthawi. Mukamagwiritsa ntchito Mlingo wocheperako, palibe zotsatira zoyipa zomwe zimayambitsa. Simungafunikenso kufunafuna m'malo mwa Actrapid. Uwu ndi mtundu wabwino kwambiri, wotsimikiziridwa komanso wotsika mtengo wa insulin. Ndikofunika kuti mupitirizebe kukhala pamenepo.

Werengani za kupewa ndi kuchiza mavuto:

Komabe, mankhwala ena amagulitsidwa ku malo ogulitsa mankhwala, omwe ali ndi chidwi ndi omwe ndi insulin yochepa ya anthu. Mwachitsanzo, Humulin Regular, Insuman Rapid kapena Biosulin R. Tikubwerezanso kuti kwa anthu odwala matenda ashuga omwe amatsata zakudya zama carb otsika pang'ono, insulin yochepa ya munthu ndiyabwino kuposa ma analoge-yochepa. Komabe, odwala omwe safuna kusiya zakudya zamavuto zowonongeka, ndibwino kusinthana ndi amodzi mwa mankhwala a ultrashort -, kapena. Mitundu ya insulin imeneyi imatha kuthetsa shuga m'magazi itatha kudya mwachangu kuposa Actrapid.

Kodi ndingasakanize Actrapid ndi Protafan?

Actrapid ndi Protafan sangasakanikidwe, monga mtundu wina wa insulin. Amatha kudulidwa nthawi yomweyo, koma ndi ma syringe osiyanasiyana komanso m'malo osiyanasiyana.

Osayesa kupulumutsa pama syringes posakaniza mitundu yosiyanasiyana ya insulini. Muyenera kuwononga botolo lonse la mankhwala okwera mtengo. Anthu odwala matenda ashuga omwe amatsata ndikuyesayesa kusunga shuga wabwinobwino samalimbikitsidwa kugwiritsa ntchito mankhwala aliwonse okonzekera insulin.

Werengani chifukwa chomwe simuyenera kumenya Protafan, koma muyenera kuyisintha ndi, kapena. Nthawi yomweyo, odwala matenda ashuga omwe amadya ochepa-carb amalangizidwa kuti azigwiritsa ntchito Actrapid osayesa kusintha pomwepo kuti akhale chithunzi cha Humalog, Apidra kapena Novorapid.

Analogues a Actrapid ndi mitundu ina ya insulin yomwe imakhala ndi maselo omwe amapanga komanso nthawi yayitali ya jakisoni. M'mayiko olankhula Chirasha mutha kupeza Humulin Regular, Insuman Rapid, Biosulin R, Rosinsulin R komanso, mwina, mankhwala enanso a shuga. Ena mwa iwo amalowetsedwa, ena ndi akwawo.

Mu malingaliro, kusintha kuchokera ku Actrapid insulin kupita ku imodzi ya analogues kuyenera kuyenda bwino, osasintha mlingo. Pochita izi, kusintha kotereku kumakhala kovuta. Muyenera kukhala masiku angapo kapena masabata kuti musankhe mlingo woyenera, kusiya kudumpha kwa shuga. Kusintha mankhwala ogwiritsira ntchito insulin yofulumira komanso yayitali ndikofunikira pangozi zokha.

Omwe amangotsatira ndiye Actrapid insulin. Imapezeka ngati jakisoni ndipo imagwiritsidwa ntchito pochiza matenda amtundu wa 2 komanso matenda a 2, komanso chisamaliro chadzidzidzi cha hyperglycemia. Makamaka nthawi zambiri amagwiritsidwa ntchito mu matenda a shuga a shuga. Odwala otere amafunika jakisoni wa insulin. Kuti muwongolere bwino shuga yamagazi, mitundu yosiyanasiyana ya mankhwalawa imaphatikizidwa. Ndipo imodzi mwa mankhwala osankhidwa ndi Actrapid - insulin yochepa.

Makhalidwe azamankhwala

Insulin "Actrapid NM Penfill" ndi yankho la jakisoni.Mankhwalawa amakhala ndi mahomoni a pancreatic a anthu omwe amapezeka ndi kusintha kwa majini. 1 ml yankho lili ndi 3.5 mg ya insulin. Kuphatikiza apo, glycerin, zinc chloride ndi zinthu zapadera zimasungunuka m'madzi a jekeseni, omwe amapanga mulingo woyenera wa acid-base usawa. Mankhwalawa amapezeka m'mathumba apadera a cholembera cha 3 ml. Uwu ndi muyezo umodzi wokha, koma nthawi zina umafunikira kuti uwonjezeke.

Kuphatikiza pa kutulutsidwa kumeneku, pali Insulin Actrapid NM m'mbale 10 ml. Mulinso ndi mahomoni osungunuka a anthu omwe amapezeka pogwiritsa ntchito njira zopangira ma genetic. Palinso analogue ya mankhwalawa - Actrapil MS. Mankhwalawa amagwiritsidwa ntchito pafupipafupi, chifukwa ndi insulin ya ndudu.

Zochita za mankhwalawa

Insulin imalowa m'maselo ndipo imakhudza njira za metabolic, kukonza kayendedwe ka glucose. Chifukwa cha izi, kuyamwa kwa zimakhala zake kumawonjezeka. Kuphatikiza kwa Glycogen m'maselo a chiwindi kumalimbikitsidwanso ndikukula. Insulin "Actrapid" imanena za mankhwala osakhalitsa. Zotsatira zake za hypoglycemic zitha kukhala zosiyana kutengera njira ndi malo a jakisoni, Mlingo ndi mawonekedwe a moyo wa wodwalayo. Koma nthawi zambiri, mphamvu ya mankhwalawa imayamba patatha mphindi 30 ndipo imatha mpaka maola 8. Kuchuluka kwake kumagwera maola 2-3 mutangoyambitsa yankho. Mlingo wapamwamba kwambiri wokhala ndi Actrapid NM, makamaka ngati walowetsedwa molondola. Ndikwabwino kubaya jekeseni pakhungu pakhungu, ndiye kuti mankhwalawa ayamba kuchita mwachangu.

Zizindikiro zogwiritsidwa ntchito

Insulin yomwe imagwiritsidwa ntchito kwambiri ndi Actrapid pochiza matenda a shuga 1. Anthu omwe amafunikira kupaka jakisoni pafupipafupi kangapo patsiku amatha kuphatikiza mankhwalawa ndi ena. Insulin yongokhala ngati imeneyi imaperekedwa musanadye, koma siwokhawo omwe amapereka. Ndikofunikira kugwiritsa ntchito insulin yayitali 1-2 patsiku, yomwe imayang'anira kuchuluka kwa shuga tsiku lonse, ngakhale zakudya.

Mankhwalawa nthawi zina amagwiritsidwa ntchito pochiza matenda a shuga a 2, koma malinga ndi malangizo a dokotala. Izi zimachitika ngati thupi la wodwala sililandira chithandizo cha hypoglycemic mapiritsi. Kuphatikiza apo, m'magulu ena a odwala, njira yothandizira mankhwalawa ndi yotetezeka, mwachitsanzo, panthawi yoyembekezera komanso mkaka wa m'mawere.

"Actrapid" imayamba kugwira ntchito nthawi yomweyo, chifukwa chake imagwiritsidwa ntchito pazovuta zadzidzidzi pakafunika kuchepetsa msanga msanga. Izi ndizofunikira, mwachitsanzo, ndi ketoacidosis kapena musanachite opareshoni.

Contraindication ndi zoyipa

Odwala ena amadana ndi insulin yaumunthu. Nthawi zina thupi limagwidwa ndi zigawo zina za mankhwalawo. Milandu iyi, insulin ina imayikidwa. Kugwiritsa ntchito mankhwalawa kumadziwikanso ngati pali hypoglycemia. Chifukwa chake, isanayambike, ndikofunikira kuyang'ana kuchuluka kwa shuga m'magazi. Simungagwiritse ntchito "Actrapid" wa khansa ya pancreatic - insuloma. Kugwiritsa ntchito mankhwalawa sikuti kumawerengera ana, komanso amayi apakati.

Mukamagwiritsira ntchito insulin "Actrapid", zotsatirazi zingachitike:

Kukhazikitsidwa kwa insulin "Actrapid"

Njira yoyendetsera mankhwalawa, nthawi zina, imalowa. Kwa izi, ma syringe apadera a insulin amafunikira. Ali ndi maphunziro omaliza omwe amakupatsirani mwayi woyesa kuchuluka kwa mankhwalawa. Nthawi zambiri cholembera chapadera cha insulin "Actrapid NM" chimagwiritsidwa ntchito. Mwanjira imeneyi, jakisoni ndiwosavuta. Jekeseni iyenera kuchitidwa m'mimba kapena phewa, pokhapokha pokhazikika, kupewa jekeseni wamitsempha. Nthawi zina jakisoni amadzibayira m'tchafu kapena pachakudonth, koma pamenepa mankhwalawa amawonjezereka.

Momwe mungayendetsere insulin ya Actrapid? Malangizowa akufotokoza motere:

• muyenera kujambula yankho lolondola mu syringe kuchokera m'botolo kapena kuyikamo cartridge mu cholembera chapadera,
• ndi dzanja lanu lamanzere kuti mutengere ndi zala ziwiri pakhungu pamimba, ntchafu kapena phewa,
• phatikizani singano m'munsi mwa khola pakadutsa madigiri 45,
• phatikizani pang'onopang'ono njira yothetsera khungu.
• siyani singano kwa masekondi 5-6,
• konzani mosamala, ngati magazi atuluka, muyenera kufinya pang'onopang'ono malo a jekeseni.

Insulin "Actrapid": malangizo ogwiritsira ntchito

Ndi madokotala okhawo omwe angadziwe kuchuluka kwa mankhwalawo komanso kuchuluka kwa mankhwalawa. Zimatengera kuchuluka kwa chakudya cha wodwala cha mu chakudya, makhalidwe, kadyedwe ndi zofunika za insulin. Pa avareji, zosaposa 3 ml zimafunikira patsiku, koma chizindikirochi chimatha kukhala chachikulu mwa anthu onenepa kwambiri, panthawi yomwe ali ndi pakati kapena ngati chitetezo chamatenda chikule. Ngati kapamba amatulutsa insulin yaying'ono, iyenera kutumikiridwa muyezo yaying'ono. Kufunika kwa insulini kumacheperanso matenda a chiwindi ndi impso.

Zingwe za "Actrapid" zimachitika katatu patsiku. Ngati ndi kotheka, mutha kuwonjezera njira yogwiritsira ntchito mpaka nthawi 5-6. Hafu ya ola limodzi pambuyo pa jekeseni, muyenera kudya kapena osadya pang'ono.

Ndizotheka kusakaniza mankhwalawa ndi mankhwala omwe akhala akuchita kwa nthawi yayitali. Mwachitsanzo, kuphatikiza kumagwiritsidwa ntchito nthawi zambiri: insulin "Actrapid" - "Protafan". Koma ndi dokotala yekhayo amene angasankhe mtundu wa glycemic control regimen. Ngati ndi kotheka, ikani ma insulini awiri nthawi imodzi omwe atengedwa mu syringe imodzi: woyamba - "Actrapid", kenako - insulin yayitali.

Malangizo apadera mukamagwiritsa ntchito mankhwalawa

Kuti muthane ndi kuchuluka kwa shuga mothandizidwa ndi "Actrapid", muyenera kutsatira malamulo angapo ogwiritsira ntchito insulin iyi:

• tsamba la jakisoni liyenera kusinthidwa pafupipafupi kuti tipewe kukula kwa lipodystrophy,
• Odwala omwe ali ndi vuto la chiwindi ndi impso ayenera kuchepetsa mankhwalawa.
• kuti zitheke mwachangu, jakisoni uyenera kuchitidwa panjira yolumikizana pamimba,
• osagwiritsa ntchito mankhwalawa ngati atayika poyera kapena ngati maphukusi adasweka,
• mutatsegula botolo, yankho lake liyenera kusungidwa mufiriji, osati kuzizira, ndipo liyenera kugwiritsidwa ntchito kwa mwezi ndi theka,
• simungagwiritse ntchito "Actrapid" ya,
• posinthana ndi "Actrapid" kuchokera ku mankhwala ena, ndikofunikira kuti dokotala asinthe mlingo, poyamba ndikofunikira kuyeza kuchuluka kwa shuga, popeza zizindikiro za hypoglycemia zimayamba kuonekera.

Zoyenera kuchita vuto la hypoglycemia

Nthawi zina, wodwala amakhala ndi bongo wambiri. Itha kuonekera ngati jakisoni atadwala asanadye kapena awonetsa kuchita zinthu zolimbitsa thupi kwambiri. Vutoli limachitika mwadzidzidzi. Wodwalayo amakumana ndi zotsatirazi:

• tachycardia
• nseru
• kusweka kwapafupipafupi, kugona,
• thukuta
• mantha, nkhawa,
• mutu
• kulakalaka kwamphamvu
• kusokoneza kayendedwe ka kayendedwe.

Kukhazikika kwa hypoglycemia ndikosavuta kuwona. Choyambirira kuchita ndikudya china chokoma. Pazomwezi, odwala matenda ashuga nthawi zonse amakhala ndi maswiti, makeke, msuzi wokoma kapena chidutswa cha shuga nawo. Ngati wodwalayo akuipiraipira, wakomoka kapena wakomoka, jakisoni wa glycogen ndi wofunikira. Muyenera kuwona dokotala ndikusintha kuchuluka kwa Actrapid kuti muchepetse kukula kwa hypoglycemia.

Hyperglycemia mukamagwiritsa ntchito mankhwalawa

Nthawi zina vutoli limakhalanso lotheka shuga wa magazi akakwera kwambiri. Izi zitha kukhala ndi kuwonjezeka kwa kutentha, ndi matenda opatsirana, kuchepa kwa kuchuluka kwa mankhwalawa kapena kuwonjezeka kwa chakudya chamafuta. osati kutchulidwa, koma matendawo nawonso ndi oopsa, chifukwa angayambitse kukula kwa ketoacidosis ndi chikomokere. Zowona kuti shuga wakula zitha kuzindikirika ndi izi:

• ludzu lalikulu
• kukodza pafupipafupi
• nseru, kutaya chakudya,
• kufooka
• khungu louma komanso ma mucous membrane,
• Fungo lamphamvu la acetone kuchokera mkamwa.

Ngati muli ndi zina mwazizindikirozi, muyenera kuwunika msanga msanga, mungafunike kupanga jekeseni lina la Actrapid.

Kuchita ndi mankhwala ena

Insulin imafunikira makonzedwe okhazikika. Chifukwa chake, nthawi zambiri zimakhala kuti zimaphatikizidwa ndi mankhwala ena. Ndipo muyenera kudziwa momwe Actrapid insulin imalumikizirana ndi mitundu yosiyanasiyana ya mankhwala. Mwachitsanzo, pali mankhwala omwe amachepetsa mphamvu yake yochepetsera shuga: beta-blockers, thiazide diuretics, mahomoni ena ndi chikonga. Kuphatikiza ndi mankhwala ena, m'malo mwake, mphamvu yotsitsa shuga ya Actrapid imatheka. Awa ndi ma tetracyclines, sulfonamides, Ketoconazole, Theophilin, ndi zinthu zomwe zili ndi mowa.

Wodwala yekha sangathe kudziwa ngati insuliniyi imagwirizana ndi mankhwala ena, chifukwa chake ngati muli ndi mafunso, muyenera kufunsa dokotala. Mlingo woyenera komanso kutsatira zonse za mankhwalawa, wodwala matenda ashuga amatha kukhala moyo wabwinobwino.

Sodium hydroxide ndi / kapena hydrochloric acid.

Pharmacodynamics ndi pharmacokinetics

Actulin insulin yopangidwa ndi recombinant DNA biotechnology pogwiritsa ntchito kupsinjika Saccharomyces cerevisiae . INN yake ndi - Insulin munthu .

Mankhwala amalumikizana ndi cholandilira cha kunja kwa cytoplasmic cell. Amapanga insulin receptor zovuta. Imayendetsa njira za intracellular polimbikitsa biosynthesis. cAMP kapena kulowa mkatikati mwa minofu.

Kuchepa kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa mayendedwe amkati komanso kumizidwa ndi minofu, kutseguka lipojiaiskaphatikizidwe ka mapuloteni ndipo glycogenogenesis, komanso kuchepa kwa kuchuluka kwa shuga m'magazi, etc.

Zochita za mankhwalawa zimayamba pakatha mphindi 30 mutatha kugwiritsa ntchito. Kuchuluka kwake kumaonekera pa avareji mkati mwa maola 2,5. Kutalika konse kwa kuchitapo kanthu ndi maola 7-8.

Zowonekera kwa odwala ndizotheka, kuphatikiza zomwe zimatengera kukula kwa mankhwalawa.

Bongo

Pankhani ya bongo wambiri, zotsatirazi ndizotheka: kuchuluka kwambiri, paresthesia mkamwa, palpitations. Pankhani yogwiritsa ntchito mankhwalawa muyezo waukulu kwambiri kuposa masiku onse, wodwala amatha kugwera.

Pankhani ya kuwala hypoglycemiamuyenera kudya shuga kapena shuga. Mwa bongo wambiri, 1 mg imayendetsedwa ndi intramuscularly. Ngati ndi kotheka, njira zama glucose zowonjezera zimawonjezeredwa.

Tsiku lotha ntchito

Botolo lotseguka limasungidwa kwa milungu isanu ndi umodzi. Asanatsegule, moyo wa alumali wa mankhwala ndi miyezi 30. Osagwiritsa ntchito yankho litatha tsiku lotha ntchito.

1 ml ya mankhwala ali:

ntchito: soluble insulin (genetic engineering) 100 IU (3.5 mg), 1 IU imafanana ndi 0,035 mg wa insulin ya anthu.

zokopa: zinc chloride pafupifupi 7 mcg, glycerol (glycerol) 16 mg, metacresol 3.0 mg, sodium hydroxide pafupifupi 2.6 mg ndi / kapena hydrochloric acid pafupifupi 1.7 mg (kusintha pH), madzi a jakisoni mpaka 1.0 ml .

Transparent, wopanda mafuta amadzimadzi.

Zotsatira za pharmacological

Hypoglycemic mankhwala, omwe ndi yochepa kuchita insulin.

Pharmacodynamics ndi pharmacokinetics

Actulin insulin yopangidwa ndi recombinant DNA biotechnology pogwiritsa ntchito kupsinjika Saccharomyces cerevisiae . INN yake ndi - Insulin munthu .

Mankhwala amalumikizana ndi cholandilira cha kunja kwa cytoplasmic cell. Amapanga insulin receptor zovuta. Imayendetsa njira za intracellular polimbikitsa biosynthesis. cAMP kapena kulowa mkatikati mwa minofu.

Kuchepa kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa mayendedwe amkati komanso kumizidwa ndi minofu, kutseguka lipojiaiskaphatikizidwe ka mapuloteni ndipo glycogenogenesis, komanso kuchepa kwa kuchuluka kwa shuga m'magazi, etc.

Zochita za mankhwalawa zimayamba pakatha mphindi 30 mutatha kugwiritsa ntchito. Kuchuluka kwake kumaonekera pa avareji mkati mwa maola 2,5. Kutalika konse kwa kuchitapo kanthu ndi maola 7-8.

Zowonekera kwa odwala ndizotheka, kuphatikiza zomwe zimatengera kukula kwa mankhwalawa.

Zizindikiro zogwiritsidwa ntchito

Panthawi ya mkhutu aimpso kapena kwa chiwindi ntchito insulinzochepa. Chifukwa chake muyenera kusintha mankhwalawa.

Malangizo ogwiritsira ntchito Actrapid akuwonetsa kuti akhoza kugwiritsidwa ntchito limodzi akhala akuchita insulin.

Mankhwalawa amaperekedwa theka la ola musanadye kapena osafunsidwa ndi chakudya. Monga lamulo, jakisoni amapangidwa modzaza m'chigawo cha khoma lamkati lakumbuyo. Izi zimathandizira kuyamwa mwachangu. Kuphatikiza apo, jakisoni amatha kupanga ntchafu, minofu yofiyira ya phewa kapena matako. Kupewa lipodystrophyMasamba a jakisoni ayenera kusinthidwa.

Kuwongolera kwa mkati ndizovomerezeka pokhapokha ngati jakisoni apangidwa ndi katswiri wazachipatala. Intramuscularly, mankhwalawa amaperekedwa pokhapokha ngati akuwunikira katswiri.

Bongo

Pankhani ya bongo wambiri, zotsatirazi ndizotheka: kuchuluka kwambiri, paresthesia mkamwa, palpitations. Pankhani yogwiritsa ntchito mankhwalawa muyezo waukulu kwambiri kuposa masiku onse, wodwala amatha kugwera.

Pankhani ya kuwala hypoglycemiamuyenera kudya shuga kapena shuga. Mwa bongo wambiri, 1 mg imayendetsedwa ndi intramuscularly. Ngati ndi kotheka, njira zama glucose zowonjezera zimawonjezeredwa.

Kuchita

Hypoglycemic insulinzimawonjezeka m`kamwa hypoglycemic wothandizira, angiotensin otembenuza zoletsa, osasankha beta-blockers, sulfonamides, machezKukonzekera kwa lifiyamu monoamine oxidase zoletsa ndi kaboni anhydrase, anabolic steroids, Clofibrate, Fenfluramine ndi mankhwala okhala ndi ethanol. Mowa samangokulitsa, komanso umakulitsa mphamvu ya Actrapid.

Zotsatira za hypoglycemic, m'malo mwake, zimachepa mchikakamizo cha kulera kwamlomo, chithokomiro ma thiolskapena sulfiteszitha kuyipitsa insulin.

Malonda ogulitsa

Kugulitsa ndi mankhwala okha.

Malo osungira

Sungani yankho mufiriji pa kutentha kwa 2-8 ° C. Osamawuma. Mutatsegula, Mbale zimasungidwa kutentha. Kuwasunga mufiriji ndikosayenera. Mbale ziyenera kutetezedwa kuti zisamawonekere kutentha ndi kuwala. Pewani kufikira ana.

Tsiku lotha ntchito

Botolo lotseguka limasungidwa kwa milungu isanu ndi umodzi. Asanatsegule, moyo wa alumali wa mankhwala ndi miyezi 30. Osagwiritsa ntchito yankho litatha tsiku lotha ntchito.

1 ml ya mankhwala ali:

ntchito: soluble insulin (genetic engineering) 100 IU (3.5 mg), 1 IU imafanana ndi 0,035 mg wa insulin ya anthu.

zokopa: zinc chloride pafupifupi 7 mcg, glycerol (glycerol) 16 mg, metacresol 3.0 mg, sodium hydroxide pafupifupi 2.6 mg ndi / kapena hydrochloric acid pafupifupi 1.7 mg (kusintha pH), madzi a jakisoni mpaka 1.0 ml .

Transparent, wopanda mafuta amadzimadzi.

Zotsatira za pharmacological

Actrapid ® NM ndikapangidwe ka insulin kofupikitsika kamene kamapangidwanso ndi DNA yaumboni wamatsenga pogwiritsa ntchito Saccharomyces cerevisiae. Kutsika kwa glucose m'magazi kumachitika chifukwa cha kuwonjezereka kwa mayendedwe ake amkati atatha kumangiriza insulini kupita ku insulin zolandila minofu ndi adipose minofu ndikuchepa kwamtundu womwewo kwa shuga.

Matenda a plasma glucose (mpaka 4,4-6.1 mmol / L) kudzera mwa intravenous makonzedwe a Actrapid ® NM mu chithandizo chachikulu cha odwala omwe anachitidwa opaleshoni yayikulu (odwala 204 omwe ali ndi matenda a shuga a mellitus ndi 1344 odwala popanda matenda a shuga), yemwe anali ndi hyperglycemia (plasma glucose concentration> 10 mmol / L), adachepetsa kufa ndi 42% (4.6% m'malo mwa 8%).

Machitidwe a Actrapid ® NM a mankhwalawa amayamba pakati pa theka la ola pambuyo pa kuwongolera, ndipo mphamvu yayikulu ikuwonekera mkati mwa maola 1.5-3,5, pomwe nthawi yonseyi ikuchitika pafupifupi maola 7-8.

Pharmacokinetics

Hafu ya moyo wa insulini kuchokera m'magazi ndi mphindi zochepa chabe.

Kutalika kwa nthawi ya kukonzekera kwa insulin kumachitika makamaka chifukwa cha kuchuluka kwa mayamwidwe, zomwe zimatengera zinthu zingapo (mwachitsanzo, pa mlingo wa insulin, njira ndi malo oyendetsera, makulidwe a subcutaneous mafuta wosanjikiza ndi mtundu wa matenda osokoneza bongo). Chifukwa chake, magawo a pharmacokinetic a insulin ali ndi kusinthasintha kwakukulu kwapakati pa intaneti ndi munthu payekha.

Kuzungulira kwakukulu (C max) kwa insulin mu plasma kumatheka mkati mwa maola 1.5-2,5 pambuyo pothandizidwa ndi subcutaneous.

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

Insulin yaumunthu imapangidwa ndi ma insulinase kapena ma enzyme osokoneza bongo a insulin, 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.

Nthaka-mayamwidwe nthawi (T ½) imatsimikiziridwa ndi kuchuluka kwa mayamwidwe kuchokera ku ziwopsezo zam'mimba. Chifukwa chake, T ½ imakhala njira yodziwira, m'malo mochotsa insulini kuchokera ku plasma (T ½ ya insulin m'magazi ndi mphindi zochepa chabe). Kafukufuku awonetsa kuti T ½ ili pafupifupi maola 2-5.

Ana ndi achinyamata

Mbiri ya pharmacokinetic ya mankhwala a Actrapid ® NM adaphunziridwa mgulu la ana omwe ali ndi matenda ashuga (anthu 18) azaka 6 - 6, komanso achinyamata (azaka 13 mpaka 17). Ngakhale zambiri zomwe zimawerengedwa zimawonedwa ngati zochepa, komabe amawonetsa kuti mbiri ya pharmacokinetic ya Actrapid ® HM mwa ana ndi achinyamata ndi chimodzimodzi 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.

Deta Yotetezera

M'maphunziro a preclinical, kuphatikizapo maphunziro a chitetezo cha pharmacological, maphunziro a kawopsedwe omwe ali ndi Mlingo wambiri, maphunziro a genotoxicity, chiwopsezo cha carcinogenic komanso zotsatira zoyipa pamagawo obala, palibe vuto lililonse kwa anthu lomwe linadziwika.

Mimba komanso kuyamwa

Palibe choletsa kugwiritsa ntchito insulin panthawi yapakati, popeza insulin siyidutsa chotchinga.

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 kuti amawongolera 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 mu chachiwiri ndi chachitatu trimesters.

Pambuyo pobadwa mwana, kufunika kwa insulin, monga lamulo, kumabwereranso msanga pazomwe zimawonedwa musanakhale ndi pakati.

Palibenso zoletsa kugwiritsa ntchito mankhwalawa Actrapid ® NM panthawi yoyamwitsa. Kuchita insulin kwa amayi oyamwitsa sikowopsa kwa mwana. Komabe, mayi angafunike kusintha njira ya Actrapid ® NM ndi / kapena zakudya

Mlingo ndi makonzedwe

Mankhwala anaupanga subcutaneous ndi mtsempha wa magazi makonzedwe.

Mlingo wa mankhwalawa amasankhidwa payekha, poganizira zosowa za wodwala.

Nthawi zambiri, zofunika za insulin zimakhala pakati pa 0.3 ndi 1 IU / kg / tsiku. Kufunika kwa 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.

Mankhwalawa umaperekedwa kwa mphindi 30 asanadye kapena chakudya.

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

Actrapid ® NM nthawi zambiri imayendetsedwa mwachisawawa mdera lakhoma lamkati lakumbuyo. Ngati izi ndizotheka, ndiye kuti jakisoni amathanso kuchitika m'tchafu, m'chigawo cha gluteal kapena m'dera la minofu ya m'mapazi. Ndi kuyambitsa kwa mankhwala m'dera lakhomopo la khomo lachiberekero, kuyamwa mwachangu kumachitika bwino kuposa momwe mungayambitsire madera ena. Ngati jakisoniyo wapangidwira pakhungu lalitali, ngozi ya mankhwalawo mwangozi imachepetsedwa. Singano imayenera kukhalabe pansi pakhungu kwa masekondi 6 osachepera, omwe amatsimikizira mlingo wokwanira. Ndikofunikira nthawi zonse kusintha malo a jekeseni mkati mwa anatomical dera kuti muchepetse chiopsezo cha lipodystrophy.

Actrapid ® NM ndiyothekanso kutumikiridwa kudzera m'mitsempha ndipo njira zoterezi zitha kuchitidwa ndi akatswiri azachipatala.

Mothandizidwa ndi intravenous mankhwala a Actrapid ® NM Penfill ® kuchokera pagatalo amaloledwa pokhapokha ngati palibe Mbale. Pankhaniyi, muyenera kumwa mankhwala osokoneza bongo a insulini popanda kudya mpweya kapena kulowerera pogwiritsa ntchito kulowetsedwa. Njirayi iyenera kuchitidwa kokha ndi dokotala.

Actrapid ® NM Penfill ® idapangidwa kuti izigwiritsidwa ntchito ndi mabungwe a Novo Nordisk insulin jakisoni ndi singano za NovoFine ® kapena NovoTvist ®. Malangizo atsatanetsatane ogwiritsira ntchito ndi kuyang'anira mankhwalawa amayenera kuonedwa (onani "Malangizo ogwiritsa ntchito Actrapid ® NM Penfill ®,ziyenera kuperekedwa kwa wodwala ” ).

Matenda okhala ndi vuto limodzi, makamaka opatsirana komanso kutentha thupi, nthawi zambiri amalimbikitsa kufunika kwa insulin. Kusintha kwa magazi kungafunikenso ngati wodwala ali ndi matenda a impso, chiwindi, mkhutu wa adrenal ntchito, pituitary kapena chithokomiro cha chithokomiro.

Kufunika kosinthidwa kwa mlingo kumatha kuonekanso posintha zolimbitsa thupi kapena zakudya zomwe wodwalayo amadya. Kusintha kwa Mlingo kungafunike posamutsa wodwala kuchokera ku mtundu wina wa insulin kupita ku ina.

Zotsatira zoyipa

Chochitika chovuta kwambiri chambiri ndi insulin ndi hypoglycemia. Panthawi ya mayeso azachipatala, komanso munthawi yogwiritsa ntchito mankhwalawa atamasulidwa pamsika waogula, zidapezeka kuti zochitika za hypoglycemia zimasiyanasiyana malinga ndi kuchuluka kwa odwala, kuchuluka kwa mankhwalawa, komanso kuchuluka kwa kayendedwe ka glycemic (onani. "Kufotokozerazosintha zimasiyana " ).

Pa gawo loyambirira la insulin, zolakwika zotupa, edema ndi zimachitika zimapezeka pamalo a jakisoni (kuphatikiza ululu, kufiyira, ming'oma, kutupa, kuphwanya, kutupa ndi kuyunkhira pamalo a jekeseni. Zizindikirozi nthawi zambiri zimakhala zakanthawi. Kusintha kwapang'onopang'ono pakuwongolera glycemic kumatha kubweretsa mkhalidwe wa "ululu wammbuyo wamitsempha," womwe umatha kusintha. Kulimbitsa insulin mankhwala ndikusintha kolimba kwa mphamvu ya kagayidwe kazakudya kungayambitse kuwonongeka kwakanthawi pamikhalidwe ya matenda ashuga, pamene kusintha kwakanthawi kwakanthawi ka glycemic kumachepetsa chiopsezo cha kupitirira kwa matenda ashuga retinopathy.

Mndandanda wazotsatira zoyipa zimaperekedwa pagome.

Zotsatira zonse zoyipa zomwe zaperekedwa pansipa, kutengera deta kuchokera ku mayeso azachipatala, zimayikidwa m'magulu molingana ndi kukula kwa chitukuko malinga ndi MedDRA ndi kachitidwe ka ziwalo. Zotsatira zoyipa zimafotokozedwa ngati: pafupipafupi (≥ 1/10), nthawi zambiri (≥ 1/100 to

Kuchita ndi mankhwala ena

Pali mankhwala angapo omwe amakhudza kufunika kwa insulin. Hypoglycemic zotsatira za insulin patsogolo m'kamwa wothandizila hypoglycemic, monoamine oxidase zoletsa, angiotensin akatembenuka zoletsa enzyme, carbonic zoletsa anhydrase, kusankha beta-blockers, bromocriptine, sulfonamides, anabolic mankhwala, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, mankhwala lifiyamu salicylates .

Mphamvu ya hypoglycemic ya insulin imafooketsedwa ndi kulera kwapakamwa, glucocorticosteroids, mahomoni a chithokomiro, thiazide diuretics, heparin, tridclic antidepressants, sympathomimetics, kukula kwa mahomoni (somatropin), danazol, clonidine, liwiro la calcium calcium blockers, difenin, diazoxide.

Beta-blockers amatha kufinya zizindikiro za hypoglycemia ndikupangitsa kuti zikhale zovuta kuchira ku hypoglycemia.

Octreotide / lanreotide imatha kuwonjezeka ndikuchepetsa kufunikira kwa insulin.

Mowa ungapangitse kapena kuchepetsa mphamvu ya insogulin.

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

Zolemba zogwiritsira ntchito

Mlingo wosakwanira wa mankhwalawa kapena kusiya chithandizo, makamaka ndi matenda amtundu wa 1, angayambitse kukula kwa hyperglycemia .

Monga lamulo, zizindikiro zoyambirira za hyperglycemia zimawonekera pang'onopang'ono, kwa maola angapo kapena masiku. Zizindikiro za hyperglycemia zimaphatikizaponso ludzu, kukodza kwambiri, kusanza, kusanza, kugona, kuyanika komanso khungu, kukamwa kowuma, kusowa chilakolako cha thupi, ndi mawonekedwe a fungo la acetone m'mlengalenga. Popanda chithandizo choyenera, hyperglycemia odwala omwe ali ndi matenda amtundu wa 1 angayambitse matenda a shuga a ketoacidosis, vuto lomwe lingathe kupha.

Hypoglycemia imatha kukhazikika ngati insulin yapamwamba kwambiri imaperekedwa poyerekeza ndi zosowa za wodwala.

Kudumpha zakudya kapena kuchita masewera olimbitsa thupi mosakonzekera kungayambitse hypoglycemia.

Pambuyo kulipirira kagayidwe kazakudya, mwachitsanzo, ndi insulin yokwanira, odwala amatha kukumana ndi zisonyezo zam'mbuyomu za hypoglycemia, zomwe odwala ayenera kudziwitsidwa. Zizindikiro zachilendo zimatha kutha ndi matenda a shuga.

Kusamutsa odwala ku mtundu wina wa insulin kapena insulin ya wopanga wina uyenera kuchitika kokha moyang'aniridwa ndi achipatala. Mukasintha ndende, wopanga, mtundu, mtundu (insulin ya anthu, analog ya insulin ya anthu) ndi / kapena njira yopangira, mungafunike kusintha mlingo wa insulin. Odwala omwe akuchitidwa ndi Actrapid ® NM angafunike kusintha kwa mlingo kapena kuwonjezeka kwa jekeseni poyerekeza ndi zomwe anakonzera insulin kale. Ngati kusintha kwa mlingo kuli kofunikira posamutsa odwala kuti alandire mankhwala ndi Actrapid ® NM, izi zitha kuchitika kale ndikuyambitsidwa kwa mlingo woyamba kapena milungu yoyamba kapena miyezi.

Monga mankhwala ena a insulin, zimachitika mu jakisoni wa jekeseni, yomwe imawonetsedwa ndi kupweteka, kufiyira, ming'oma, kutupa, kutupa, kutupa, ndi kuyabwa.Kusintha kwatsiku ndi jekeseni pafupipafupi m'dera lomwelo kumathandizira kuchepetsa zizindikiritso kapena kuletsa kukula kwa izi. Kuchitidwa nthawi zambiri kumatha patatha masiku angapo mpaka milungu ingapo. Nthawi zina, Actrapid ® NM ingafunike kuimitsidwa chifukwa cha zomwe zimachitika pamalo opangira jakisoni.

Asanayende ndikusintha kwa magawo a nthawi, wodwalayo ayenera kufunsa othandizira awo, popeza kusintha nthawi kumatanthawuza kuti wodwalayo ayenera kudya ndikupereka insulin panthawi ina.

Pamene Actrapid ® NM iwonjezeredwa pazomwe zimayambitsa kulowetsedwa, kuchuluka kwa insulin komwe kumayamwa ndi kulowetsedwa sikungatheke, chifukwa chake, ntchito ya Actrapid ® NM mu FDI siyololedwa.

Kugwiritsa ntchito munthawi yomweyo mankhwala a gulu la thiazolidinedione komanso kukonzekera insulin

Milandu yokhudzana ndi kukhazikika kwa mtima wosakanika wafotokozedwanso chithandizo cha odwala omwe ali ndi thiazolidinediones osakanikirana ndi insulin, makamaka ngati odwala oterewa ali pachiwopsezo cha kukula kwa mtima wovuta. Izi zimayenera kukumbukiridwa popereka mankhwala ophatikiza ndi thiazolidatediones ndi insulin yokonzekera odwala. Mukamapereka mankhwala othandizira, muyenera kuyeserera kwa odwala kuti muwone ngati ali ndi vuto la mtima, kulemera kwake komanso kupezeka kwa edema. Ngati zizindikiro za kulephera kwa mtima zikuchulukirachulukira kwa odwala, chithandizo ndi thiazolidatediones ziyenera kusiyidwa.

Kukopa pa kuyendetsa galimoto ndikugwira ntchito ndi zinthu

Kuthekera kwa odwala kulolera komanso kuchuluka kwa momwe angachitire amatha kusokonezeka panthawi ya hypoglycemia, zomwe zimakhala zowopsa nthawi zomwe maluso amenewa amafunikira makamaka (mwachitsanzo, poyendetsa galimoto kapena kugwira ntchito ndi makina ndi makina). Odwala ayenera kulangizidwa kuti achitepo kanthu popewa kukula kwa hypoglycemia mukamayendetsa galimoto. Izi ndizofunikira kwambiri kwa odwala omwe alibe kapena kuchepa kwa zizindikiro zakutsogolo kwa hypoglycemia kapena akuvutika ndi zochitika zapafupipafupi za hypoglycemia. Muzochitika izi, kuyendetsa bwino ndikuchita ntchito yotereyi kuyenera kuganiziridwa.

Njira zopewera kupewa ngozi

Pa kulowetsedwa kwa mtsempha, makina a kulowetsedwa omwe amakhala ndi Actrapid ® NM 100 IU / ml amagwiritsidwa ntchito poika zinthu 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% dextrose mayankho, kuphatikiza potaziyamu mankhwala ena mwa 40 mmol / L, amagwiritsa ntchito matumba a IV opangidwa ndi polypropylene mu dongosolo la intravenous management; zothetsera izi zimakhala zokhazikika kwa maola 24 kutentha kwa chipinda.

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.

Makatoni amayenera kugwiritsidwa ntchito pokhapokha pazogwirizana ndi zinthu zomwe zimatsimikizira kutetezeka kwawo komanso kuchita bwino kwawo.

Actrapid ® NM Penfill ® ndi masingano adapangidwa kuti azigwiritsa ntchito payekha. Kudzazidwa kwa cartridge sikuloledwa.

Osagwiritsa ntchito kukonzekera kwa insulini ngati achisanu.

Simungagwiritse ntchito insulin ngati yasiya kuwonekera komanso yopanda maonekedwe.

Actrapid ® NM sangagwiritsidwe ntchito pamapampu a insulin chifukwa cha kulowetsedwa kwa nthawi yayitali.

Mupangitseni wodwala kutaya singano pambuyo povulala iliyonse.

Mu milandu yayikulu (hospitalization, kusagwira bwino kwa chipangizo cha insulin) Actrapid ® NM yoyendetsera wodwala imatha kuchotsedwa mu katoni pogwiritsa ntchito insulin syringe U100.

Kutulutsa Fomu

Imapezeka ngati jakisoni. Zodziwikanso ndi mawonekedwe amasulidwe monga Actrapid NM Penfill . Amagulitsanso ngati jakisoni.

Zotsatira za pharmacological

Hypoglycemic mankhwala, omwe ndi yochepa kuchita insulin.

Pharmacodynamics ndi pharmacokinetics

Actulin insulin yopangidwa ndi recombinant DNA biotechnology pogwiritsa ntchito kupsinjika Saccharomyces cerevisiae . INN yake ndi - Insulin munthu .

Mankhwala amalumikizana ndi cholandilira cha kunja kwa cytoplasmic cell. Amapanga insulin receptor zovuta. Imayendetsa njira za intracellular polimbikitsa biosynthesis. cAMP kapena kulowa mkatikati mwa minofu.

Kuchepa kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa mayendedwe amkati komanso kumizidwa ndi minofu, kutseguka lipojiaiskaphatikizidwe ka mapuloteni ndipo glycogenogenesis, komanso kuchepa kwa kuchuluka kwa shuga m'magazi, etc.

Zochita za mankhwalawa zimayamba pakatha mphindi 30 mutatha kugwiritsa ntchito. Kuchuluka kwake kumaonekera pa avareji mkati mwa maola 2,5. Kutalika konse kwa kuchitapo kanthu ndi maola 7-8.

Zowonekera kwa odwala ndizotheka, kuphatikiza zomwe zimatengera kukula kwa mankhwalawa.

Zizindikiro zogwiritsidwa ntchito

Panthawi ya mkhutu aimpso kapena kwa chiwindi ntchito insulinzochepa. Chifukwa chake muyenera kusintha mankhwalawa.

Malangizo ogwiritsira ntchito Actrapid akuwonetsa kuti akhoza kugwiritsidwa ntchito limodzi akhala akuchita insulin.

Mankhwalawa amaperekedwa theka la ola musanadye kapena osafunsidwa ndi chakudya. Monga lamulo, jakisoni amapangidwa modzaza m'chigawo cha khoma lamkati lakumbuyo. Izi zimathandizira kuyamwa mwachangu. Kuphatikiza apo, jakisoni amatha kupanga ntchafu, minofu yofiyira ya phewa kapena matako. Kupewa lipodystrophyMasamba a jakisoni ayenera kusinthidwa.

Kuwongolera kwa mkati ndizovomerezeka pokhapokha ngati jakisoni apangidwa ndi katswiri wazachipatala. Intramuscularly, mankhwalawa amaperekedwa pokhapokha ngati akuwunikira katswiri.

Bongo

Pankhani ya bongo wambiri, zotsatirazi ndizotheka: kuchuluka kwambiri, paresthesia mkamwa, palpitations. Pankhani yogwiritsa ntchito mankhwalawa muyezo waukulu kwambiri kuposa masiku onse, wodwala amatha kugwera.

Pankhani ya kuwala hypoglycemiamuyenera kudya shuga kapena shuga. Mwa bongo wambiri, 1 mg imayendetsedwa ndi intramuscularly. Ngati ndi kotheka, njira zama glucose zowonjezera zimawonjezeredwa.

Kuchita

Hypoglycemic insulinzimawonjezeka m`kamwa hypoglycemic wothandizira, angiotensin otembenuza zoletsa, osasankha beta-blockers, sulfonamides, machezKukonzekera kwa lifiyamu monoamine oxidase zoletsa ndi kaboni anhydrase, anabolic steroids, Clofibrate, Fenfluramine ndi mankhwala okhala ndi ethanol. Mowa samangokulitsa, komanso umakulitsa mphamvu ya Actrapid.

Zotsatira za hypoglycemic, m'malo mwake, zimachepa mchikakamizo cha kulera kwamlomo, chithokomiro ma thiolskapena sulfiteszitha kuyipitsa insulin.

Malonda ogulitsa

Kugulitsa ndi mankhwala okha.

Malo osungira

Sungani yankho mufiriji pa kutentha kwa 2-8 ° C. Osamawuma. Mutatsegula, Mbale zimasungidwa kutentha. Kuwasunga mufiriji ndikosayenera. Mbale ziyenera kutetezedwa kuti zisamawonekere kutentha ndi kuwala. Pewani kufikira ana.

Tsiku lotha ntchito

Botolo lotseguka limasungidwa kwa milungu isanu ndi umodzi. Asanatsegule, moyo wa alumali wa mankhwala ndi miyezi 30. Osagwiritsa ntchito yankho litatha tsiku lotha ntchito.

1 ml ya mankhwala ali:

ntchito: soluble insulin (genetic engineering) 100 IU (3.5 mg), 1 IU imafanana ndi 0,035 mg wa insulin ya anthu.

zokopa: zinc chloride pafupifupi 7 mcg, glycerol (glycerol) 16 mg, metacresol 3.0 mg, sodium hydroxide pafupifupi 2.6 mg ndi / kapena hydrochloric acid pafupifupi 1.7 mg (kusintha pH), madzi a jakisoni mpaka 1.0 ml .

Transparent, wopanda mafuta amadzimadzi.

Zotsatira za pharmacological

Actrapid ® NM ndikapangidwe ka insulin kofupikitsika kamene kamapangidwanso ndi DNA yaumboni wamatsenga pogwiritsa ntchito Saccharomyces cerevisiae. Kutsika kwa glucose m'magazi kumachitika chifukwa cha kuwonjezereka kwa mayendedwe ake amkati atatha kumangiriza insulini kupita ku insulin zolandila minofu ndi adipose minofu ndikuchepa kwamtundu womwewo kwa shuga.

Matenda a plasma glucose (mpaka 4,4-6.1 mmol / L) kudzera mwa intravenous makonzedwe a Actrapid ® NM mu chithandizo chachikulu cha odwala omwe anachitidwa opaleshoni yayikulu (odwala 204 omwe ali ndi matenda a shuga a mellitus ndi 1344 odwala popanda matenda a shuga), yemwe anali ndi hyperglycemia (plasma glucose concentration> 10 mmol / L), adachepetsa kufa ndi 42% (4.6% m'malo mwa 8%).

Machitidwe a Actrapid ® NM a mankhwalawa amayamba pakati pa theka la ola pambuyo pa kuwongolera, ndipo mphamvu yayikulu ikuwonekera mkati mwa maola 1.5-3,5, pomwe nthawi yonseyi ikuchitika pafupifupi maola 7-8.

Pharmacokinetics

Hafu ya moyo wa insulini kuchokera m'magazi ndi mphindi zochepa chabe.

Kutalika kwa nthawi ya kukonzekera kwa insulin kumachitika makamaka chifukwa cha kuchuluka kwa mayamwidwe, zomwe zimatengera zinthu zingapo (mwachitsanzo, pa mlingo wa insulin, njira ndi malo oyendetsera, makulidwe a subcutaneous mafuta wosanjikiza ndi mtundu wa matenda osokoneza bongo). Chifukwa chake, magawo a pharmacokinetic a insulin ali ndi kusinthasintha kwakukulu kwapakati pa intaneti ndi munthu payekha.

Kuzungulira kwakukulu (C max) kwa insulin mu plasma kumatheka mkati mwa maola 1.5-2,5 pambuyo pothandizidwa ndi subcutaneous.

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

Insulin yaumunthu imapangidwa ndi ma insulinase kapena ma enzyme osokoneza bongo a insulin, 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.

Nthaka-mayamwidwe nthawi (T ½) imatsimikiziridwa ndi kuchuluka kwa mayamwidwe kuchokera ku ziwopsezo zam'mimba. Chifukwa chake, T ½ imakhala njira yodziwira, m'malo mochotsa insulini kuchokera ku plasma (T ½ ya insulin m'magazi ndi mphindi zochepa chabe). Kafukufuku awonetsa kuti T ½ ili pafupifupi maola 2-5.

Ana ndi achinyamata

Mbiri ya pharmacokinetic ya mankhwala a Actrapid ® NM adaphunziridwa mgulu la ana omwe ali ndi matenda ashuga (anthu 18) azaka 6 - 6, komanso achinyamata (azaka 13 mpaka 17). Ngakhale zambiri zomwe zimawerengedwa zimawonedwa ngati zochepa, komabe amawonetsa kuti mbiri ya pharmacokinetic ya Actrapid ® HM mwa ana ndi achinyamata ndi chimodzimodzi 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.

Deta Yotetezera

M'maphunziro a preclinical, kuphatikizapo maphunziro a chitetezo cha pharmacological, maphunziro a kawopsedwe omwe ali ndi Mlingo wambiri, maphunziro a genotoxicity, chiwopsezo cha carcinogenic komanso zotsatira zoyipa pamagawo obala, palibe vuto lililonse kwa anthu lomwe linadziwika.

Zizindikiro zogwiritsidwa ntchito

Contraindication

Hypersensitivity kwa insulin ya anthu kapena chinthu chilichonse chomwe ndi gawo la mankhwalawa. Hypoglycemia.

Mimba komanso kuyamwa

Palibe choletsa kugwiritsa ntchito insulin panthawi yapakati, popeza insulin siyidutsa chotchinga.

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 kuti amawongolera 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 mu chachiwiri ndi chachitatu trimesters.

Pambuyo pobadwa mwana, kufunika kwa insulin, monga lamulo, kumabwereranso msanga pazomwe zimawonedwa musanakhale ndi pakati.

Palibenso zoletsa kugwiritsa ntchito mankhwalawa Actrapid ® NM panthawi yoyamwitsa. Kuchita insulin kwa amayi oyamwitsa sikowopsa kwa mwana. Komabe, mayi angafunike kusintha njira ya Actrapid ® NM ndi / kapena zakudya

Mlingo ndi makonzedwe

Mankhwala anaupanga subcutaneous ndi mtsempha wa magazi makonzedwe.

Mlingo wa mankhwalawa amasankhidwa payekha, poganizira zosowa za wodwala.

Nthawi zambiri, zofunika za insulin zimakhala pakati pa 0.3 ndi 1 IU / kg / tsiku. Kufunika kwa 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.

Mankhwalawa umaperekedwa kwa mphindi 30 asanadye kapena chakudya.

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

Actrapid ® NM nthawi zambiri imayendetsedwa mwachisawawa mdera lakhoma lamkati lakumbuyo. Ngati izi ndizotheka, ndiye kuti jakisoni amathanso kuchitika m'tchafu, m'chigawo cha gluteal kapena m'dera la minofu ya m'mapazi. Ndi kuyambitsa kwa mankhwala m'dera lakhomopo la khomo lachiberekero, kuyamwa mwachangu kumachitika bwino kuposa momwe mungayambitsire madera ena. Ngati jakisoniyo wapangidwira pakhungu lalitali, ngozi ya mankhwalawo mwangozi imachepetsedwa. Singano imayenera kukhalabe pansi pakhungu kwa masekondi 6 osachepera, omwe amatsimikizira mlingo wokwanira. Ndikofunikira nthawi zonse kusintha malo a jekeseni mkati mwa anatomical dera kuti muchepetse chiopsezo cha lipodystrophy.

Actrapid ® NM ndiyothekanso kutumikiridwa kudzera m'mitsempha ndipo njira zoterezi zitha kuchitidwa ndi akatswiri azachipatala.

Mothandizidwa ndi intravenous mankhwala a Actrapid ® NM Penfill ® kuchokera pagatalo amaloledwa pokhapokha ngati palibe Mbale. Pankhaniyi, muyenera kumwa mankhwala osokoneza bongo a insulini popanda kudya mpweya kapena kulowerera pogwiritsa ntchito kulowetsedwa. Njirayi iyenera kuchitidwa kokha ndi dokotala.

Actrapid ® NM Penfill ® idapangidwa kuti izigwiritsidwa ntchito ndi mabungwe a Novo Nordisk insulin jakisoni ndi singano za NovoFine ® kapena NovoTvist ®. Malangizo atsatanetsatane ogwiritsira ntchito ndi kuyang'anira mankhwalawa amayenera kuonedwa (onani "Malangizo ogwiritsa ntchito Actrapid ® NM Penfill ®,ziyenera kuperekedwa kwa wodwala ” ).

Matenda okhala ndi vuto limodzi, makamaka opatsirana komanso kutentha thupi, nthawi zambiri amalimbikitsa kufunika kwa insulin. Kusintha kwa magazi kungafunikenso ngati wodwala ali ndi matenda a impso, chiwindi, mkhutu wa adrenal ntchito, pituitary kapena chithokomiro cha chithokomiro.

Kufunika kosinthidwa kwa mlingo kumatha kuonekanso posintha zolimbitsa thupi kapena zakudya zomwe wodwalayo amadya. Kusintha kwa Mlingo kungafunike posamutsa wodwala kuchokera ku mtundu wina wa insulin kupita ku ina.

Zotsatira zoyipa

Chochitika chovuta kwambiri chambiri ndi insulin ndi hypoglycemia. Panthawi ya mayeso azachipatala, komanso munthawi yogwiritsa ntchito mankhwalawa atamasulidwa pamsika waogula, zidapezeka kuti zochitika za hypoglycemia zimasiyanasiyana malinga ndi kuchuluka kwa odwala, kuchuluka kwa mankhwalawa, komanso kuchuluka kwa kayendedwe ka glycemic (onani. "Kufotokozerazosintha zimasiyana " ).

Pa gawo loyambirira la insulin, zolakwika zotupa, edema ndi zimachitika zimapezeka pamalo a jakisoni (kuphatikiza ululu, kufiyira, ming'oma, kutupa, kuphwanya, kutupa ndi kuyunkhira pamalo a jekeseni. Zizindikirozi nthawi zambiri zimakhala zakanthawi. Kusintha kwapang'onopang'ono pakuwongolera glycemic kumatha kubweretsa mkhalidwe wa "ululu wammbuyo wamitsempha," womwe umatha kusintha. Kulimbitsa insulin mankhwala ndikusintha kolimba kwa mphamvu ya kagayidwe kazakudya kungayambitse kuwonongeka kwakanthawi pamikhalidwe ya matenda ashuga, pamene kusintha kwakanthawi kwakanthawi ka glycemic kumachepetsa chiopsezo cha kupitirira kwa matenda ashuga retinopathy.

Mndandanda wazotsatira zoyipa zimaperekedwa pagome.

Zotsatira zonse zoyipa zomwe zaperekedwa pansipa, kutengera deta kuchokera ku mayeso azachipatala, zimayikidwa m'magulu molingana ndi kukula kwa chitukuko malinga ndi MedDRA ndi kachitidwe ka ziwalo. Zotsatira zoyipa zimafotokozedwa ngati: pafupipafupi (≥ 1/10), nthawi zambiri (≥ 1/100 to

Bongo

Mlingo wa insulin wofunikira wowonjezera womwe sunakhazikitsidwe, koma hypoglycemia imatha kukula pang'onopang'ono ngati mulingo wambiri wa insulin umayendetsedwa molingana ndi zosowa za wodwala.

Wodwala amatha kuthetsa hypoglycemia wofatsa mwa kudya shuga kapena zakudya zomwe zili ndi shuga. Chifukwa chake, ndikulimbikitsidwa kwa odwala omwe ali ndi matenda ashuga kuti azitha kutenga zakudya zomwe zili ndi shuga.

Ngati hypoglycemia yayikulu, wodwala akakhala kuti alibe chikumbumtima, 0,5 mg mpaka 1 mg ya glucagon amayenera kuthandizidwa kudzera mu intramuscularly kapena subcutaneously (munthu wophunzitsidwa bwino angagwiritsidwe ntchito) kapena njira ya intravenous glucose (katswiri wazachipatala yekha angayendetse). M'pofunikanso kuperekera shuga m'mitsempha ngati wodwalayo asadzayambenso chikumbumtima cha mphindi 10-15 atatha kugwirira ntchito kwa glucagon. Pambuyo podzikanso, wodwalayo amalangizidwa kuti azidya zakudya zokhala ndi mchere wambiri kuti muchepetse kubwerezanso kwa hypoglycemia.

Kuchita ndi mankhwala ena

Pali mankhwala angapo omwe amakhudza kufunika kwa insulin. Hypoglycemic zotsatira za insulin patsogolo m'kamwa wothandizila hypoglycemic, monoamine oxidase zoletsa, angiotensin akatembenuka zoletsa enzyme, carbonic zoletsa anhydrase, kusankha beta-blockers, bromocriptine, sulfonamides, anabolic mankhwala, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, mankhwala lifiyamu salicylates .

Mphamvu ya hypoglycemic ya insulin imafooketsedwa ndi kulera kwapakamwa, glucocorticosteroids, mahomoni a chithokomiro, thiazide diuretics, heparin, tridclic antidepressants, sympathomimetics, kukula kwa mahomoni (somatropin), danazol, clonidine, liwiro la calcium calcium blockers, difenin, diazoxide.

Beta-blockers amatha kufinya zizindikiro za hypoglycemia ndikupangitsa kuti zikhale zovuta kuchira ku hypoglycemia.

Octreotide / lanreotide imatha kuwonjezeka ndikuchepetsa kufunikira kwa insulin.

Mowa ungapangitse kapena kuchepetsa mphamvu ya insogulin.

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

Zolemba zogwiritsira ntchito

Mlingo wosakwanira wa mankhwalawa kapena kusiya chithandizo, makamaka ndi matenda amtundu wa 1, angayambitse kukula kwa hyperglycemia .

Monga lamulo, zizindikiro zoyambirira za hyperglycemia zimawonekera pang'onopang'ono, kwa maola angapo kapena masiku. Zizindikiro za hyperglycemia zimaphatikizaponso ludzu, kukodza kwambiri, kusanza, kusanza, kugona, kuyanika komanso khungu, kukamwa kowuma, kusowa chilakolako cha thupi, ndi mawonekedwe a fungo la acetone m'mlengalenga. Popanda chithandizo choyenera, hyperglycemia odwala omwe ali ndi matenda amtundu wa 1 angayambitse matenda a shuga a ketoacidosis, vuto lomwe lingathe kupha.

Hypoglycemia imatha kukhazikika ngati insulin yapamwamba kwambiri imaperekedwa poyerekeza ndi zosowa za wodwala.

Kudumpha zakudya kapena kuchita masewera olimbitsa thupi mosakonzekera kungayambitse hypoglycemia.

Pambuyo kulipirira kagayidwe kazakudya, mwachitsanzo, ndi insulin yokwanira, odwala amatha kukumana ndi zisonyezo zam'mbuyomu za hypoglycemia, zomwe odwala ayenera kudziwitsidwa. Zizindikiro zachilendo zimatha kutha ndi matenda a shuga.

Kusamutsa odwala ku mtundu wina wa insulin kapena insulin ya wopanga wina uyenera kuchitika kokha moyang'aniridwa ndi achipatala. Mukasintha ndende, wopanga, mtundu, mtundu (insulin ya anthu, analog ya insulin ya anthu) ndi / kapena njira yopangira, mungafunike kusintha mlingo wa insulin. Odwala omwe akuchitidwa ndi Actrapid ® NM angafunike kusintha kwa mlingo kapena kuwonjezeka kwa jekeseni poyerekeza ndi zomwe anakonzera insulin kale. Ngati kusintha kwa mlingo kuli kofunikira posamutsa odwala kuti alandire mankhwala ndi Actrapid ® NM, izi zitha kuchitika kale ndikuyambitsidwa kwa mlingo woyamba kapena milungu yoyamba kapena miyezi.

Monga mankhwala ena a insulin, zimachitika mu jakisoni wa jekeseni, yomwe imawonetsedwa ndi kupweteka, kufiyira, ming'oma, kutupa, kutupa, kutupa, ndi kuyabwa. Kusintha kwatsiku ndi jekeseni pafupipafupi m'dera lomwelo kumathandizira kuchepetsa zizindikiritso kapena kuletsa kukula kwa izi. Kuchitidwa nthawi zambiri kumatha patatha masiku angapo mpaka milungu ingapo. Nthawi zina, Actrapid ® NM ingafunike kuimitsidwa chifukwa cha zomwe zimachitika pamalo opangira jakisoni.

Asanayende ndikusintha kwa magawo a nthawi, wodwalayo ayenera kufunsa othandizira awo, popeza kusintha nthawi kumatanthawuza kuti wodwalayo ayenera kudya ndikupereka insulin panthawi ina.

Pamene Actrapid ® NM iwonjezeredwa pazomwe zimayambitsa kulowetsedwa, kuchuluka kwa insulin komwe kumayamwa ndi kulowetsedwa sikungatheke, chifukwa chake, ntchito ya Actrapid ® NM mu FDI siyololedwa.

Kugwiritsa ntchito munthawi yomweyo mankhwala a gulu la thiazolidinedione komanso kukonzekera insulin

Milandu yokhudzana ndi kukhazikika kwa mtima wosakanika wafotokozedwanso chithandizo cha odwala omwe ali ndi thiazolidinediones osakanikirana ndi insulin, makamaka ngati odwala oterewa ali pachiwopsezo cha kukula kwa mtima wovuta. Izi zimayenera kukumbukiridwa popereka mankhwala ophatikiza ndi thiazolidatediones ndi insulin yokonzekera odwala. Mukamapereka mankhwala othandizira, muyenera kuyeserera kwa odwala kuti muwone ngati ali ndi vuto la mtima, kulemera kwake komanso kupezeka kwa edema. Ngati zizindikiro za kulephera kwa mtima zikuchulukirachulukira kwa odwala, chithandizo ndi thiazolidatediones ziyenera kusiyidwa.

Kukopa pa kuyendetsa galimoto ndikugwira ntchito ndi zinthu

Kuthekera kwa odwala kulolera komanso kuchuluka kwa momwe angachitire amatha kusokonezeka panthawi ya hypoglycemia, zomwe zimakhala zowopsa nthawi zomwe maluso amenewa amafunikira makamaka (mwachitsanzo, poyendetsa galimoto kapena kugwira ntchito ndi makina ndi makina). Odwala ayenera kulangizidwa kuti achitepo kanthu popewa kukula kwa hypoglycemia mukamayendetsa galimoto. Izi ndizofunikira kwambiri kwa odwala omwe alibe kapena kuchepa kwa zizindikiro zakutsogolo kwa hypoglycemia kapena akuvutika ndi zochitika zapafupipafupi za hypoglycemia. Muzochitika izi, kuyendetsa bwino ndikuchita ntchito yotereyi kuyenera kuganiziridwa.

Njira zopewera kupewa ngozi

Pa kulowetsedwa kwa mtsempha, makina a kulowetsedwa omwe amakhala ndi Actrapid ® NM 100 IU / ml amagwiritsidwa ntchito poika zinthu 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% dextrose mayankho, kuphatikiza potaziyamu mankhwala ena mwa 40 mmol / L, amagwiritsa ntchito matumba a IV opangidwa ndi polypropylene mu dongosolo la intravenous management; zothetsera izi zimakhala zokhazikika kwa maola 24 kutentha kwa chipinda.

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.

Makatoni amayenera kugwiritsidwa ntchito pokhapokha pazogwirizana ndi zinthu zomwe zimatsimikizira kutetezeka kwawo komanso kuchita bwino kwawo.

Actrapid ® NM Penfill ® ndi masingano adapangidwa kuti azigwiritsa ntchito payekha. Kudzazidwa kwa cartridge sikuloledwa.

Osagwiritsa ntchito kukonzekera kwa insulini ngati achisanu.

Simungagwiritse ntchito insulin ngati yasiya kuwonekera komanso yopanda maonekedwe.

Actrapid ® NM sangagwiritsidwe ntchito pamapampu a insulin chifukwa cha kulowetsedwa kwa nthawi yayitali.

Mupangitseni wodwala kutaya singano pambuyo povulala iliyonse.

Mu milandu yayikulu (hospitalization, kusagwira bwino kwa chipangizo cha insulin) Actrapid ® NM yoyendetsera wodwala imatha kuchotsedwa mu katoni pogwiritsa ntchito insulin syringe U100.

Kutulutsa Fomu

Njira yothetsera jakisoni 100 IU / ml.

3 ml ya mankhwalawa makatoni a galasi 1 hydrolytic kalasi, otsekemera ndi ma disc ndi ma pisitoni. Makatoni 5 ndi malangizo ogwiritsira ntchito pabokosi lamakalata.

Anthu odwala matenda a shuga amadalira mankhwala osokoneza bongo. Ngati mumaswa zakudya zanu ndipo osamwa mankhwalawo, thanzi lanu limatha kukulirakulira. Asayansi apanga mankhwala omwe amalowa m'malo mwa shuga ndi insulin. Mankhwalawa amapangidwa pogwiritsa ntchito matekinoloje atsopano. Imatha kukhazikika thupi kwanthawi yayitali.

Insulin ndi mahomoni omwe amayendetsa kagayidwe kazachilengedwe m'thupi. Munthu yemwe wapezeka ndi matenda a shuga samalandira mapuloteni okwanira am'mapapo. Wodwala wotere ayenera kulandira insulin kuchokera kunja. Actrapid ali ndi zotere. Zimathandizira kuchepetsa shuga wamagazi ndi kusintha kagayidwe. The yogwira mankhwala: insulin, yochepa komanso yachangu.

Insulin, kapena dzina lina la actrapid, limapangidwa pogwiritsa ntchito injini yosinthidwa ma genetis. Imasiyana ndi nkhumba. Mankhwalawa amayeretsedwa ndipo amakhala ndi zochita zambiri. Amapezeka m'mitundu ingapo:

• jakisoni yankho lili Mbale
• yankho la jekeseni m'njira yama cartridge.

Kuthekera kwa insulin yocheperako pang'ono ndi kuchepa msanga kwa magazi.Odwala omwe ali ndi matenda ashuga, pazifukwa zosiyanasiyana, shuga wamagazi ndi plasma zimawonjezeka. Jakisoni wa Actrapid kwa mphindi 30 amatha kuchepetsa shuga ndikupangitsa matenda kukhala osiyanasiyana. Insulin imayendetsa kagayidwe kachakudya. Pogwiritsa ntchito minofu ndi adipose, zimathandiza kuti mamolekyu a glucose afike komwe akupita. Mukapanda kumwa mankhwalawa, ndiye kuti izi sizingatheke. Kuchuluka kwa shuga kumayamba m'magazi, ndipo kumayambitsa kuphwanya kwa hypoglycemic.

Komanso, actrapid, yomwe imaphatikizapo insulin yokhala ndi zinthu zochepa, imathandizira kuyamwa kwa glucose m'misempha. Zabwino pa magwiridwe antchito amthupi. Ntchito za mankhwalawa:

• Amatembenuza shuga owonjezera kukhala adipose minofu.
• Imathandizira shuga kulowa m'chiwindi, ndipo imapanga glycogen.
• Ili ndi katundu wa anabolic.
• Amatenga nawo gawo la glucogeneis.

Dokotala endocrinologist amapereka mankhwala acupressure molumikizana ndi mankhwala ena omwe amakhala ndi zotsatira zazitali. Zonse zimatengera momwe wodwalayo alili komanso momwe amvera mankhwala omwe adalandira.

Zanyama insulin kulowererapo kapangidwe kofanana ndi anthu. Pogwiritsa ntchito genetic engineering, asayansi apanga mankhwala omwe amaphatikiza bwino ndi zinthu zonse za mthupi ndipo samakhala ndi vuto. Dokotala endocrinologist amapereka Actrapid kwa odwala omwe ali ndi matenda:

• lembani matenda ashuga 1 ogwirizana ndi insulin,
• lembani matenda a shuga a 2 panthawi ya pakati, opaleshoni kapena kumwa mankhwala okhala ndi kuchuluka kwa shuga,
• matenda ashuga oyamba
• tsankho kwa mankhwala opangira insulin,
• matenda oyamba nawo
• postprandial hyperglycemia,
• mankhwala okhala ndi insulin.

Odwala omwe adakumana ndi endocrinologist amatha kulandira chithandizo ndi Actrapid. Dokotala adzafufuza mwatsatanetsatane mbiri ya wodwalayo ndikupereka mayeso. Pambuyo pazotsatira za kuyesedwa, endocrinologist imapereka mankhwala. Insulin imayikidwa pa vuto la magazi acid. Awa ndi odwala omwe amawonedwa.

Zotsatira zoyipa

Mankhwala aliwonse amakhala ndi zoyipa. Izi zikuwonetsa kuti thupi likuyesera kumwa mankhwalawo. Zilinso chimodzimodzi ndi insulin yochepa. Omwe amatchulidwa kwambiri ndi awa:

• ndi kagayidwe kazakudya: kugona, kuchuluka thukuta, pallor, komanso kunjenjemera malekezero, kugona mosagona, kumva kwambiri, kusokonezeka kwamanjenje,
• kulephera kudziwa
• zotsatira zakupha
• kupuma pang'ono komanso kutsokomola
• kutupa, kuyabwa, zotupa zopanda pake,
• kutsitsa magazi
• lipodystrophy.

Zotsatira zonsezi zimawoneka mosiyanasiyana. Nthawi zina wodwala alibe. Ngati zoterezi zikuwoneka, muyenera kufunsa katswiri.

Odwala omwe amadalira insulin, kufunikira kwa kuchuluka kwa mankhwalawa kumatha kuchitika ndi zochitika zamphamvu zamatenda, matenda opatsirana komanso kulephera kudya. Izi zimalimbikitsidwa kuti zizilamulidwa, chifukwa mankhwalawa omwe amagwira ntchito mwachidule sangakhale othandiza nthawi zonse. Ndikofunikira kutsatira malamulo a mlingo ndipo popanda kufunsa musachulukitse mlingo nokha. Mukuyenera kudziwa kuti kuchuluka kwa insulini koperewera kungayambitse chikomokere cha hypoglycemic, mkhalidwe wa makolo, kapena ketoacidosis. Odwala omwe amalandira Actrapid amakhala ndi mavuto ambiri pazinthu. Izi zili choncho makamaka kwa zakumwa zoledzeletsa.

Katundu

Deta Yotetezera
M'maphunziro oyambira, kuphatikiza maphunziro a kawopsedwe a kawopsedwe, maphunziro a genotoxicity, zotsatira za carcinogenic ndi zotsatira zoyipa pakubala, palibe vuto lililonse kwa anthu lomwe linadziwika.

Zoyipa:

Mimba komanso kuyamwa
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 a shuga 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 kuti amawongolera 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 mu chachiwiri ndi chachitatu trimesters.
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.

Wopanga:

Actrapid HM Penfill (Actrapid HM) - kukonzekera kwa insulin yaumunthu, yomwe imapangidwa pogwiritsa ntchito genetic engineering.

Ili ndi nthawi yayifupi yochita komanso pH yosatenga nawo mbali. Imayikidwa mosasamala. HM mu dzina la mankhwala mu Latin amatanthauza "umisiri wa chibadwa cha anthu, monocomponent."

Munkhaniyi tikambirana chifukwa chake madokotala amapereka mankhwala a Actrapid NM, kuphatikizapo malangizo ogwiritsira ntchito, analogi ndi mitengo ya mankhwalawa m'masitolo ogulitsa mankhwala. ZOONA ZONSE za anthu omwe agwiritsa kale ntchito Actrapid akhoza kuwerengedwa ndemanga.

Kupanga ndi mawonekedwe a kumasulidwa

Actrapid imapezeka mu mawonekedwe a jakisoni wopanda jakisoni, m'mabotolo 10 ml (40 PIECES of yogwira zinthu / ml), komanso ma cartrges a 1.5 ml kapena 3 ml.

1. Chomwe chimagwiritsidwa ntchito ndi gawo limodzi losagwirizana ndi insulin yofanana ndi insulin yaumunthu. 1 IU (gawo lapadziko lonse lapansi, lolemba la Russia - UNIT) limafanana ndi 35 μg ya insulin ya munthu wosafunikira. Umisiri wamtundu wa anthu.
2. Omwe amathandizira: zinc chloride (insulin stabilizer), glycerol, metacresol (njira yothimbirira njira yotsalazo, imakupatsani mwayi kuti mugwiritse ntchito botolo lotseguka mpaka masabata 6), hydrochloric acid ndi / kapena sodium hydroxide (kuti musunge mbali ya pH), madzi a jekeseni.
3. Ndende ya zinthu zomwe zimagwira ndi 100 PESCES / ml.

Gulu la ma Clinical and pharmacological: DNA ikubwerezanso insulin yaumunthu.

Malangizo ogwiritsira ntchito

Malinga ndi malangizo ogwiritsira ntchito, mlingo wa Actrapid NM umatsimikiziridwa ndi dokotala aliyense payekha malinga ndi momwe wodwalayo alili. Mukamagwiritsa ntchito Actrapid NM mu mawonekedwe ake oyera, nthawi zambiri imakhazikitsidwa katatu patsiku (mwina mpaka nthawi 5-6). Mankhwalawa amatha kuperekedwa mosavuta, kudzera m'mitsempha kapena m'mitsempha.

Pakatha mphindi 30 mutatha kugwiritsa ntchito mankhwalawa, muyenera kudya chakudya. Mukasankha mankhwala a insulin, mutha kugwiritsa ntchito Acrapid NM osakanikirana ndi ma insulin omwe amakhala nthawi yayitali. Actrapid NM ikhoza kusakanizidwa mu syringe yomweyo ndi ma insulin ena oyeretsedwa kwambiri. Akaphatikizidwa ndi insulin, inshuwaransi iyenera kuchitidwa mwachangu. Akasakanizidwa ndi ma insulin omwe amakhala ndi nthawi yayitali, a HMrrid ayenera kuyambitsidwa mu syringe.

Kugwiritsira ntchito kwofananira kwa corticosteroids, zoletsa za MAO, kulera kwa mahomoni, mowa, kuchiritsa kwa mahomoni a chithokomiro kungapangitse kuti pakufunika insulin.

Zosungirako ndi moyo wa alumali

Actrapid HM iyenera kusungidwa 2 ... 8 ° C. Kuzizira sikuloledwa.Vial ya insulin yomwe imasungidwa kutentha firiji iyenera kugwiritsidwa ntchito pakatha milungu isanu ndi umodzi.

Mankhwalawa sangathe kugwiritsidwa ntchito ngati atayika mphamvu zake zonse komanso ngati pali madontho.

Sodium hydroxide ndi / kapena hydrochloric acid.

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 mamolekyulu 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'magititis a shuga, onse ogwiritsidwa ntchito pafupipafupi komanso kuti apangidwe mwadzidzidzi.

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 lakonzekera kutenga pakati, odwala matenda ashuga ayenera 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.

Momwe mungagwiritsire ntchito Actrapid NM?

Jakisoni wa insulini amaperekedwa m'njira zosiyanasiyana. Mlingo umasankhidwa mosiyanasiyana. Nthawi zambiri, zofunika za insulini zili pakati pa 0,3 ndi 1 IU patsiku pa kilogalamu yodwala. Ndi kukana kwa insulini mu achinyamata kapena kunenepa kwambiri, kumakhala kwakukulu, ndipo kwa omwe ali ndi chinsinsi cha insulin yawo, amakhala otsika.

Mothandizidwa ndi matenda ashuga, zovuta za matendawa zimayamba kuchepa pafupipafupi komanso pambuyo pake. Chifukwa chake, kuyang'anitsitsa shuga wamagazi ndikusankhidwa kwa Mlingo wa insulin womwe umapitilira chizindikiritso ichi ndizofunikira.

Actrapid NM ndi insulin yochepa, chifukwa chake nthawi zambiri imaphatikizidwa ndi mitundu yayitali ya mankhwalawa. Iyenera kuperekedwa kwa theka la ola musanadye, kapena chakudya chopepuka chomwe chili ndi chakudya chamafuta.

Njira yothamanga kwambiri yolowera ndi jakisoni m'mimba. Kuti muchite izi, onetsetsani kuti mwalowa mu jakisoni wa insulini. Malo amchiuno, matako, kapena mapewa amagwiritsidwanso ntchito. Tsambalo la jakisoni liyenera kusinthidwa pafupipafupi kuti lisawononge minofu yamkati.

Ndi chitukuko cha matenda ashuga nephropathy, kufunika kwa insulin kumachepa, ndiye kuti mankhwalawa amakonzedwanso poganizira kuchuluka kwa kusefera kwa msana komanso mseru wa aimpso.Mu matenda a adrenal gland, chithokomiro England, pituitary gland, komanso kuwonongeka kwa chiwindi, kuchuluka kwa insulin kungasinthe.

Kufunika kwa insulini kumasinthanso ndikukhala ndi nkhawa, kusintha kwa zochitika zolimbitsa thupi kapena kusintha kwa zakudya zina. Matenda aliwonse ndi chifukwa chokonzera kugwiritsidwa ntchito kwa insulin komwe mukugwirizana ndi adokotala.

Ngati mlingo wa insulin ndi wochepa, kapena ngati wodwalayo watha insulin, hyperglycemia ikhoza kukhala ndi zotsatirazi:

• Kuchulukitsa kugona komanso ulesi.
• Kuchulukitsa ludzu.
• Kusanza ndi kusanza pang'ono.
• Khungu lofiira ndi louma.
• Kuchulukitsa pokodza.
• Kuchepetsa chidwi.
• Pakamwa pakamwa.

Zizindikiro za hyperglycemia zimayamba pang'onopang'ono - maola angapo kapena masiku. Ngati simusintha shuga m'magazi anu, amayamba. Chizindikiro chake ndicho kununkhira kwa acetone mu mpweya wotulutsidwa. Chiwopsezo cha hyperglycemia chimawonjezeka ndi matenda opatsirana komanso kutentha thupi.

Kusintha kuchokera ku mtundu wina wa insulin kupita ku wina kumafuna kusankha kwa mtundu watsopano. Kuti muchite izi, muyenera kufunsa wa endocrinologist. Insulin Actrapid sayenera kugwiritsidwa ntchito pamapampu a insulini, pakalibe zotchingira pakanema, ngati ikasungidwa molakwika kapena ngati madzi oundana, komanso ngati yankho likakhala mitambo.

Kuti mupeze jakisoni, muyenera kutsatira malamulo awa:

1. Sungani mpweya mu syringe, wofanana ndi mlingo womwe umaperekedwa.
2. Ikani syringe kudzera pa pulagi ndikusindikiza piston.
3. Tembenuzani botolo pansi.
4. Tengani mlingo wa insulini mu syringe.
5. Chotsani mpweya ndikuyang'ana.

Pambuyo pa izi, muyenera kubaya nthawi yomweyo: tengani khungu pakulipika ndikulowetsanso syringe ndi singano m'munsi mwake, pakona madigiri 45. Insulin iyenera kulowa pakhungu.

Pambuyo pa jekeseni, singano iyenera kukhala pansi pa khungu kwa masekondi 6 kuti mugwiritse ntchito bwino mankhwalawo.

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,

Zotsatira zoyipa ndi bongo

Zotsatira zoyipa za Actrapid insulin zimatha kukhala zowonjezereka zolimbitsa thupi, kulephera kutsatira mlingo kapena kuperewera kwa zakudya m'thupi. Anthu odwala matenda ashuga akuda nkhawa ndi kutukusira kwa manja ndi miyendo, kutsika kwamphamvu kwa thukuta, kutuluka thukuta, kunjenjemera komanso khungu. Kusokonezeka m'malo, kuchuluka kwa mantha ndi kutopa ndikotheka.

Nthawi zambiri, odwala matenda ashuga amadandaula za kupweteka mutu komanso chizungulire, mseru komanso kumva kuti ali ndi njala. Nthawi zina, kusakhala ndi chikumbumtima komanso kukula kwa vuto la insulin ndikotheka.

Ndi chidwi chomwa mankhwalawa, odwala amakumana ndi zovuta zina. Vutoli limawonekera ndi kusanza, thukuta kwambiri, chizungulire, kukhumudwa pamtima, komanso kupuma movutikira.

Mwina chitukuko cha zochitika m'deralo jakisoni: redness, kutupa ndi kuyabwa. Ndi jakisoni pafupipafupi m'dera limodzi, lipodystrophy imatha kuchitika.

Kupitilira muyeso womwe wapezeka wa Actrapid kumabweretsa kukula kwa hypoglycemia. Amawonetsedwa ndi kufooka, njala yayikulu, miyendo ndi kunjenjemera kwa khungu. Mapeto owopsa kwambiri pamenepa ndi chipere cha hypoglycemic.

Hypo- ndi hyperglycemia mukamagwiritsa ntchito mankhwalawa

Kugwiritsidwa ntchito kwa Actrapid insulin kungayambitse kukula kwa hypoglycemia (kuchepa kwambiri kwa shuga) kapena hyperglycemia (kuchuluka kwa shuga). Izi zimachitika chifukwa chosagwirizana ndi mlingo woyenera, kuperewera kwa chakudya m'thupi (kudya zakudya zina kapena kudya kwambiri), kuchuluka kwa thupi, komanso kudumphira jakisoni kapena kuyendetsa bwino yankho.

Zizindikiro zotsatirazi ndizodziwika bwino za hyperglycemia: ludzu lalikulu, kukodza pafupipafupi, kuchepa kwa chilakolako chofuna kudya, nseru komanso khungu. Ndi ketoacidosis, fungo la acetone lochokera pamlomo wamkati limawonekera. Zizindikiro zowopsa zikusonyeza kuti muyenera kuyang'ana shuga wanu wamagazi ndipo ngati kuli kotheka, muzibweretsanso jekeseni wa Actrapid.

Hypoglycemia imadziwika ndi kuwonjezeka kwa chilakolako chofuna kudya, khungu lotuwa komanso miyendo yolunjenjemera. Kuti tisiye zizindikirazi komanso kuti tiletse kukula kwa chikomokere cha hypoglycemic, wodwalayo amalimbikitsidwa kudya shuga pang'ono kapena mankhwala opatsa mphamvu kwambiri (makeke, maswiti), kumwa msuzi wokoma kapena tiyi. Pofuna kutaya chikumbumtima, 40% dextrose solution ndi glucagon amawathandizira kudzera m'mitsempha. Popewa kutayidwanso pambuyo pathupi, wodwalayo akulimbikitsidwa kudya zakudya zomwe zili ndi zakudya zamafuta ambiri.

Malangizo achidule ogwiritsira ntchito

Actrapid ndi imodzi mwazinthu zoyambirira zomwe zimapezeka ndi ma genetic engineering. Idapangidwa koyamba mu 1982 ndi nkhawa yama mankhwala a Novo Nordisk, m'modzi mwa opanga mankhwala akulu kwambiri padziko lonse lapansi. Panthawiyo, odwala matenda ashuga amayenera kukhala okhutira ndi insulin ya nyama, yomwe inali yokhala ndi kuyeretsa kochepa komanso kugwirira ntchito kwambiri.

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 amalimbikitsidwa mwalamulo kwa odwala matenda ashuga komanso ogwiritsidwa ntchito ndi ma endocrinologists pantchito yawo ndi Dzhi Dao Diabetes Adhesive.

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%
• Kuwonjezeka kwa mphamvu masana, kukonza kugona usiku - 97%

Opanga Ji Dao si bungwe lazamalonda ndipo amalipiridwa ndi boma. Chifukwa chake, tsopano wokhala aliyense ali ndi mwayi wopeza mankhwalawo kuchotsera 50%.

Actrapid imapezeka pogwiritsa ntchito mabakiteriya osinthidwa, chinthu chomalizidwa chimangobwerezeranso insulin yomwe imapangidwa mwa anthu. Tekinoloje yopanga imalowetsa kukwaniritsa zotsatira zabwino za hypoglycemic komanso kuyera kwambiri kwa yankho, lomwe linachepetsa chiopsezo cha ziwopsezo zam'mimba ndi zotupa pa malo opangira jekeseni. Radar (kaundula wamankhwala omwe amalembetsa ndi Unduna wa Zaumoyo) akuwonetsa kuti mankhwalawa amatha kupanga ndikupanga ku Denmark, France ndi Brazil. Kuwongolera kwa zotsatira kumachitika kokha ku Europe, chifukwa chake palibe kukayikira za mtundu wa mankhwalawa.

Zambiri mwachidule za Actrapide kuchokera kuzomwe angagwiritse ntchito, zomwe aliyense wodwala matenda ashuga ayenera kudziwa:

Ngati mulingo wawonjezereka, hypoglycemia imachitika, zomwe zingayambitse kupweteka patatha maola angapo. Kutsika pang'ono kwa shuga kumapangitsa kuti mitsempha isawonongeke, kufufutira zizindikiro za hypoglycemia, zomwe zimapangitsa kuti zizindikire.

Pophwanya njira ya jakisoni wa insulin Actrapid kapena chifukwa cha zomwe zimachitika ndi minyewa yokhala ndi subcutaneous, lipodystrophy ndiyotheka, mafupidwe azomwe zimachitika ndi osakwana 1%.

Malinga ndi malangizowo, mukasinthira ku insulin ndikuchepetsa kwambiri shuga, zotulukapo zakakanthawi zimatha zomwe zimatha zokha: kusawona bwino, kutupa,.

Insulin ndi kukonzekera kosalimba, mu syringe imodzi imatha kusakanikirana ndi saline komanso ma insulin apakati, kuposa opanga omwewo (Protafan). Actrapid insulin dilution ndiyofunikira kwa odwala matenda ashuga omwe ali ndi chidwi chachikulu ndi mahomoni, mwachitsanzo, ana aang'ono. Kuphatikizidwa ndi mankhwala ochepetsa mphamvu amagwiritsidwa ntchito pa matenda a shuga a 2, nthawi zambiri okalamba.

Kugwiritsa ntchito mankhwala munthawi yomweyo kungakhudze zochita za insulin. Hormonal ndi diuretics zimatha kufooketsa mphamvu ya Actrapid, ndipo mankhwala amakono opsinjika ngakhale tetracycline wokhala ndi aspirin angalimbitse. Odwala omwe ali ndi mankhwala a insulin ayenera kuphunzira mosamala gawo la "mogwirizana" ndi mankhwala omwe akukonzekera kugwiritsa ntchito.Zitapezeka kuti mankhwalawa angakhudze zochita za insulin, mlingo wa Actrapid uyenera kusinthidwa kwakanthawi.

Chaka chilichonse, Actrapid imaphatikizidwa mndandanda wazamankhwala osokoneza bongo a Vital and Essential, kotero odwala matenda ashuga amatha kuzipeza mwaulere, ndi mankhwala kuchokera kwa dokotala.

Zowonjezera

Actrapid NM amatanthauza mafupifupi (), koma osati mankhwala a ultrashort. Amayamba kuchita pakatha mphindi 30, motero amamuzindikiritsa pasadakhale. Glucose pazakudya zomwe zili ndi GI yotsika (mwachitsanzo, buckwheat ndi nyama) imatha "kugwira" insulin iyi ndikuchotsa magaziwo munthawi yake. Ndi chakudya chamagulu othamanga (mwachitsanzo, tiyi wokhala ndi keke), Actrapid satha kumenya nkhondo mwachangu, chifukwa chake mukadya hyperglycemia zimachitika mosalephera, zomwe zimayamba kuchepa pang'onopang'ono. Kulumpha mu shuga sikumangowonjezera thanzi la wodwalayo, komanso kumathandizira kupita patsogolo kwa zovuta za matenda ashuga. Kuti muchepetse kukula kwa glycemia, chakudya chilichonse chomwe chili ndi Insulin Actrapid chimayenera kukhala ndi fiber, protein kapena mafuta.

Kutalika kwa nthawi

Actrapid amagwira ntchito mpaka maola 8. Maola asanu oyamba - chinthu chachikulu, ndiye - mawonetseredwe otsalira. Ngati insulin imayendetsedwa pafupipafupi, mphamvu ya milingo iwiri imadutsana. Nthawi yomweyo, ndizosatheka kuwerengera kuchuluka kwa mankhwalawa, omwe amawonjezera chiopsezo cha hypoglycemia. Kuti mugwiritse ntchito bwino mankhwalawa, zakudya ndi jakisoni wa insulin amafunika kugawidwa maola 5 aliwonse.

Mankhwalawa ali ndi chiwopsezo pambuyo pa maola 1.5-3,5. Pofika nthawi ino, chakudya chochuluka chimakhala ndi nthawi yogaya, motero hypoglycemia imachitika. Kuti mupewe izi, muyenera kugwiritsa ntchito mankhwalawa chifukwa cha 1-2 XE. Zokwanira, ndimatenda a shuga patsiku, zakudya zitatu ndi zitatu zowonjezera zimapezeka. Insulin Actrapid imayendetsedwa isanayambike yayikulu, koma mlingo wake umawerengeredwa pang'onopang'ono.

Malamulo oyambira

Mbale zokhala ndi Actrapid NM zitha kugwiritsidwa ntchito ndi ma insulin omwe amalembedwa kuti U-100. Makatoni - okhala ndi ma syringe ndi ma syringe: NovoPen 4 (gawo la unit 1), NovoPen Echo (mayunitsi 0,5).

Kuti insulini igwire bwino mu shuga, muyenera kuphunzira njira ya jekeseni muzomwe mungagwiritse ntchito ndikutsatira ndendende. Nthawi zambiri, Actrapid amalowetsedwa ndi crease pamimba, syringe imasungidwa pakona mpaka pakhungu. Pambuyo poyikapo, singanoyo samachotsa masekondi angapo kuti yankho lithe kutuluka. Insulin iyenera kukhala firiji. Pamaso pa makonzedwe, ndikofunikira kuyang'ana tsiku lomwe linatha ndi mawonekedwe ake.

Botolo lomwe lili ndi chimanga, matope kapena makhiristo mkati ndizoletsedwa.

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 wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipira mtengo wa mankhwalawo. Ku Russia, odwala matenda ashuga mpaka April 22 (wophatikizidwa) nditha kuipeza - Kwa ma ruble 147 okha!

Fananizani ndi ma insulini ena

Ngakhale kuti molekyulu ya Actrapid ndi yofanana ndi insulin yaumunthu, zomwe zimachitika ndizosiyana. Ichi ndi chifukwa subcutaneous makonzedwe. Amasowa nthawi yosiya mafuta am'magazi ndikukwaniritsa kuthamanga kwa magazi. Kuphatikiza apo, insulini imakonda kupanga mapangidwe azovuta m'misempha, zomwe zimathandizanso kuchepetsa shuga.

Zolakwika izi zimalandidwa ma insulin amakono ambiri -,. Amayamba kugwira ntchito m'mbuyomu, chifukwa chake amatha kuchotsa ngakhale mafuta othamanga. Kutalika kwake kumachepetsedwa, ndipo palibe kuchuluka, kotero zakudya zimatha kukhala zowonjezereka, ndipo zokhwasula-khwasula sizofunikira. Malinga ndi kafukufuku, mankhwala a ultrashort amapereka bwino kuwongolera glycemic kuposa Actrapid.

Kugwiritsa ntchito mankhwala a Actrapid insulin a shuga kungakhale koyenera:

• odwala omwe amatsatira zakudya zamafuta ochepa, makamaka ndi matenda a shuga a 2,
• mwa ana omwe amadya maola atatu aliwonse.

Kodi mankhwalawo ndi angati? Ubwino wosakayikitsa wa insulin iyi ndi mtengo wotsika: 1 unit ya Actrapid imatengera 40 kopecks (ma ruble 400 pa botolo la 10 ml), mahomoni a ultrashort - katatu konse mtengo.

Mapulogalamu a insulin yaumunthu amakhala ndi mawonekedwe ofanana a maselo ndi zinthu zofanana:

Kusintha kuchokera ku insulin kupita kwina kuyenera kuchitidwa pokhapokha pazotsatira zamankhwala, chifukwa kubwezeretsedwa kwa matenda ashuga kumakulirakulira pakusankhidwa kwa mlingo.

Zikhala mutu :

Onetsetsani kuti mwaphunzira! Kodi mukuganiza kuti kuyamwa kwa mapiritsi ndi insulini kwa nthawi yonse yokhayo ndi njira yokhayo yothanirana ndi shuga? Sichowona! Mutha kutsimikizira izi nokha ndikuyamba kuzigwiritsa ntchito.

Insulin Actrapid ndi mankhwala ogwiritsira ntchito mtundu woyamba wa 2 ndi matenda a shuga, komanso kupumitsa kwa vuto la matenda oopsa a hyperglycemia. Imasintha shuga m'magazi ndipo imathandizira kukhala bwino. Kusintha kwake ndikukhala mulingo wambiri wa glucose, tikulimbikitsidwa kuphatikiza mankhwalawa ndi insulin yayitali komanso mankhwala ena a antidiabetes.

Kuchita ndi njira zina

Actrapid sangagwiritsidwe ntchito nthawi imodzi ndi magulu ena a mankhwala omwe amachepetsa kapena kufooketsa mphamvu yake ya hypoglycemic. Chifukwa chake, kugwiritsa ntchito kwa anabolic steroid, Mao inhibitors, ACE inhibitors ndi carbonic anhydrase, sulfonamides, quinine, pyridoxine, chitin, ethanol, tetracycline, androgens, ketonazole, theophylline, etc. kumabweretsa kuwonjezeka kwa ntchito ya insulin.

Mankhwala otsatirawa amachepetsa hypoglycemic katundu wa Actrapid: reserpine, pakamwa kulera, octreotide, glucagon, nikotini, calcium antagonists, morphine, chamba, diuretics (kuzungulira ndi thiazide), tricyclic antidepressants, diazoxide, H1-histamine receptor blockers. Ma Beta-blockers ndi pentademin amatha kukulitsa kapena kuchepetsa mphamvu ya insulin.

Ngati pakufunika kugwiritsa ntchito mankhwalawa limodzi ndi Actrapid insulin, funsani dokotala. Kusintha kwa mankhwala a insulini kapena kusintha kwa ndondomeko ya mankhwala a antidiabetes kungafunike.