Rosinsulin P, S, M

Hypoglycemic wothandizira, wosakhalitsa insulin. Kuyanjana ndi cholandirira kumtundu wakunja kwa maselo, ndikupanga insulini yolandirira. Mwa kukulitsa kaphatikizidwe ka cAMP (m'maselo amafuta ndi maselo a chiwindi) kapena kulowa mwachindunji mu cell (minofu), insulini yolandirira insulin imapangitsa njira zina, kuphatikizira kaphatikizidwe angapo ofunikira a michere (kuphatikizapo hexokinase, pyruvate kinase, glycogen synthetase).

Kuchepa kwa kuchuluka kwa shuga m'magazi kumachitika chifukwa cha kuchuluka kwa kayendedwe ka intracellular, kuchuluka kwa mayamwidwe ndi kutikita minofu, kukondoweza kwa lipogenesis, glycogenogeneis, kaphatikizidwe ka mapuloteni, komanso kuchepa kwa kuchuluka kwa kupanga kwa shuga ndi chiwindi (kuchepa kwa kuchepa kwa glycogen).

Kukhazikika kwa zochita kumachitika pambuyo pa mphindi 30, mphamvu yayikulu ikatha maora atatu, nthawi yayitali ndi maola 8.

Mlingo

Mlingo ndi njira yoyendetsera mankhwalawa imatsimikiziridwa payekhapayekha malinga ndi kuchuluka kwa shuga m'magazi musanadye ndi maola 1-2 mutatha kudya, komanso malinga ndi kuchuluka kwa glucosuria ndi machitidwe a matendawa.

Monga lamulo, s / c imaperekedwa kwa mphindi 15-20 asanadye. Masamba a jakisoni amasinthidwa nthawi iliyonse. Ngati ndi kotheka, kayendetsedwe ka IM kapena IV ndikuloledwa.

Itha kuphatikizidwa ndi ma insulin omwe amakhala nthawi yayitali.

Zotsatira zoyipa

Thupi lawo siligwirizana: urticaria, angioedema, malungo, kufupika, kuchepa kwa magazi.

Kuchokera ku dongosolo la endocrine: hypoglycemia yokhala ndi mawonekedwe monga pallor, kuchuluka thukuta, palpitations, kusokonezeka kwa tulo, kugwedezeka, mitsempha, kusokonezeka kwa chitetezo chamthupi ndi insulin yaumunthu, kuwonjezeka kwa gawo la anti-insulin antibodies ndi kuwonjezereka kwa glycemia.

Kuchokera kumbali ya gawo la masomphenyawo: kuwonongeka kowoneka pang'onopang'ono (nthawi zambiri kumayambiriro kwa chithandizo).

Zomwe zimachitika mdera: hyperemia, kuyabwa ndi lipodystrophy (atrophy kapena hypertrophy of subcutaneous fat) m'malo a jekeseni.

Zina: kumayambiriro kwa chithandizo, edema ndiyotheka (kudutsa ndikupitilira chithandizo).

Mimba komanso kuyamwa

Pa nthawi ya pakati, ndikofunikira kuganizira za kuchepa kwa insulin mu trimester yoyamba kapena kuwonjezeka kwa trimesters yachiwiri ndi yachitatu. Nthawi yobadwa pambuyo pokhapokha ndipo mwayamba kubadwa, zofunika za insulin zimatha kugwa kwambiri.

Pa mkaka wa m`mawere, wodwalayo ayenera kuwunika tsiku lililonse kwa miyezi ingapo (mpaka kukhazikika kwa kufunika kwa insulin).

Malangizo apadera

Mosamala, kusankha kwa mankhwalawa kumachitika ndi odwala omwe ali ndi vuto laubwino wa m'magazi malinga ndi mtundu wa ischemic komanso mitundu yayikulu ya matenda a mtima.
Kufunika kwa insulin kungasinthe mu milandu yotsatirayi: mukasinthana ndi mtundu wina wa insulin, mukamasintha zakudya, kutsegula m'mimba, kusanza, pakusintha kuchuluka kwa zochitika zolimbitsa thupi, matenda a impso, chiwindi, pituitary, chithokomiro cha chithokomiro.
Kusintha kwa mlingo wa insulin kumafunikira matenda opatsirana, matenda a chithokomiro, matenda a Addison, hypopituitarism, kulephera kwaimpso, komanso matenda osokoneza bongo omwe ali ndi zaka zopitilira 65.

Kusamutsa wodwala kupita ku insulin yaumunthu kuyenera kukhala kovomerezeka nthawi zonse ndikuchitika moyang'aniridwa ndi dokotala.

Zomwe zimayambitsa hypoglycemia zimatha kukhala: insulin, mankhwala osokoneza bongo, kudumpha chakudya, kusanza, kutsegula m'mimba, kupsinjika kwa thupi, matenda omwe amachepetsa kufunikira kwa insulin (matenda a impso ndi chiwindi, komanso hypofunction ya adrenal cortex, pituitary kapena chithokomiro cha chithokomiro) (mwachitsanzo, khungu pamimba, phewa, ntchafu), komanso mogwirizana ndi mankhwala ena. Ndikotheka kuchepetsa kuchuluka kwa shuga m'magazi mukachotsa wodwala kuchokera ku insulin ya nyama kupita ku insulin ya anthu.

Wodwalayo ayenera kudziwitsidwa za zomwe zimachitika mu vuto la hypoglycemic, za zizindikiro zoyambirira za kukomoka kwa matenda ashuga komanso kufunika kofotokozera dokotala za kusintha kulikonse pamatenda ake.

Pankhani ya hypoglycemia, ngati wodwalayo akudziwa, adayikidwa dextrose mkati, s / c, i / m kapena iv pakubaya glucagon kapena iv hypertonic dextrose solution. Ndikupanga chikomokere cha hypoglycemic, 20-40 ml (mpaka 100 ml) wa 40% dextrose solution amawayilowetsa mu mtsinje mpaka wodwala atatuluka.

Odwala omwe ali ndi matenda ashuga amatha kuyimitsa pang'ono hypoglycemia mwa iwo podya shuga kapena zakudya zambiri zamagulu ochulukirapo (odwala amalimbikitsidwa kuti azikhala ndi shuga osachepera 20 g).

Kulekerera kwa mowa kwa odwala omwe amalandira insulin kumachepetsedwa.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Chizolowezi chokhala ndi hypoglycemia chimatha kuperewera kuthekera kwa odwala kuyendetsa magalimoto ndi kugwira ntchito ndi zida.

Kuyanjana kwa mankhwala

Mphamvu ya hypoglycemic imapangidwira ndi sulfonamides (kuphatikizapo mankhwala a hypoglycemic, sulfonamides), ma inhibitors a MAO (kuphatikizapo furazolidone, procarbazine, selegiline), carbonic anhydrase inhibitors, ACE inhibitors, NSAIDs (kuphatikizapo salicylides), anabolic (kuphatikiza stanozolol, oxandrolone, methandrostenolone), androgens, bromocriptine, tetracyclines, clofibrate, ketoconazole, mebendazole, theophylline, cyclophosphamide, fenfluramine, kukonzekera kwa lithiamu, pyridoxine, quinidine, quinine, quinidine, quinidine, quinidine, quinidine, etinoro, quinidine, quinidine, quinidine, quinidine, quinidine.

Glucagon, GCS, histamine H 1 receptor blockers, kulera kwapakamwa, estrogens, thiazide ndi "loop" okodzetsa, osachepera calcium njira blockers, sympathomimetics, chithokomiro mahomoni, tricyclic antidepressants, heparin, morphine diazropin amachepetsa mphamvu ya hypoglycemic , chamba, chikonga, phenytoin, epinephrine.

Beta-blockers, reserpine, octreotide, pentamidine akhoza zonse kutsitsa ndi kuchepetsa hypoglycemic zotsatira za insulin.

Kugwiritsa ntchito pamodzi kwa beta-blockers, clonidine, guanethidine kapena reserpine kungathe kubisa zizindikiro za hypoglycemia.

Mankhwala osagwirizana ndi mayankho a mankhwala ena.

Kutulutsa mawonekedwe, kapangidwe kake ndi ma CD

Amapezeka m'mitundu itatu:

1. P - yocheperako, yopanda mtundu komanso yankho.
2. C - kutalika kwapakatikati, kuyimitsidwa kwa mtundu woyera kapena wopaka.
3. M - sakanizani 30/70, magawo awiri. Yapakatikati ndi kusintha koyambira, kuyimitsidwa.

Kuphatikizikako ndikuphatikizapo:

• 100 IU ya insulin yokhudza chibadwa cha anthu,
• protamine sulfate,
• sodium hydrogen phosphate dihydrate,
• kristalo phenol,
• metacresol
• glycerol (glycerin),
• madzi a jakisoni.

Omwe amaphatikizidwa ndikuphatikizika ndizosiyana pang'ono pa mtundu uliwonse. Rosinsulin M ili ndi biphasic insulin - sungunuka + isophane.

Amapezeka m'mabotolo (zidutswa 5 za 5 ml) ndi makatoni (5 zidutswa za 3 ml).

Pharmacokinetics

Mtundu P umayamba kuchita theka la ola pambuyo pobayira, nsapato - 2-4 maola. Kutalika mpaka maola 8.

Mtundu C umayamba kugwira ntchito pambuyo pa maola 1-2, nsombazi zimachitika pakati pa 6 ndi 12. Zotsatira zimatha patsiku limodzi.

M akuyamba kugwira ntchito theka la ora, nsonga ndi 4-12, chochitikacho chikutha maola 24.

Amawonongedwa ndi insulinase mu impso ndi chiwindi. Amachotsa impso. Jakisoni wokhazikika pokhapokha ndiomwe amaloledwa pawokha.

• Mitundu yonse iwiri ya matenda ashuga
• Matenda a shuga mwa amayi apakati
• Matenda apakati
• Mankhwala osokoneza bongo a hypoglycemic.

Malangizo ogwiritsira ntchito (njira ndi Mlingo)

Njira yayikulu yoyendetsera ndi jekeseni wanjira. Mlingo amasankhidwa payekha kutengera umboni ndi zosowa za thupi. Tsamba la jakisidwe ndi matako, m'chiuno, pamimba, m'mapewa. Muyenera kusintha tsamba la jakisoni pafupipafupi.

Wapakati tsiku ndi tsiku ndi 0,5-1 IU / kg.

"Rosinsulin R" imagwiritsidwa ntchito theka la ola musanadye. Chiwerengero cha jakisoni ndi mankhwala ndi dokotala.

Zotsatira zoyipa

• Zomwe zimachitika mderalo komanso mwatsatanetsatane.
• Hypoglycemia,
• Kukhala ndi nkhawa mpaka kugona.
• Kuchepetsa BP
• Hyperglycemia ndi matenda ashuga,
• Kuwonjezeka kwa gawo la anti-insulin antibodies, lotsatiridwa ndi kuchuluka kwa glycemia,
• Zowonongeka
• Zokhudza immunological ndi insulin yaumunthu,
• Hyperemia,
• Lipodystrophy,
• Kutupa.

Bongo

Mwina chitukuko cha hypoglycemia. Zizindikiro zake: Njala, kukomoka, kusokonezeka khungu, nseru, kusanza ndi ena. Fomu yakuwala imatha kuchotsedwa pakudya zakudya zotsekemera (maswiti, chidutswa cha shuga, uchi). M'mitundu yochepa komanso yoopsa, jakisoni wa glucagon kapena dextrose solution adzafunika, atatha - chakudya ndi chakudya. Onetsetsani kuti mukumane ndi dokotala kuti musinthe mlingo.

Fananizani ndi fanizo

Rosinsulin ali ndi mitundu ingapo ya mankhwala ofanana, omwe ndi othandiza kuzidziwitsa poyerekeza katundu.

Novomiks. Insulin aspart, magawo awiri. Yopangidwa ndi Novo Nordisk ku Denmark. Mtengo - mpaka 1500 rubles. kunyamula. Mphamvu ya nthawi yayitali, mwachangu komanso moyenera. Mankhwalawa saloledwa ana osakwana zaka 6, ndipo amawayang'anira mosamala pakapita zaka komanso ukalamba. Thupi lawo siligwirizana pa malo a jakisoni nthawi zambiri limadziwika.

"Insuman." Insulin yaumunthu, mitundu itatu ya zochita. Zimawononga kuchokera ku ma ruble 1100. Wopanga - "Sanofi Aventis", France. Amagwiritsidwa ntchito pochiza onse akulu ndi ana. Si kawirikawiri zomwe zimayambitsa mavuto. Mnzanu wazabwino.

"Protafan." Komanso insulin yaumunthu ndi mtundu wopangidwa ndi majini. Cheker - 800 ma ruble. makatiriji, yankho - ma ruble 400. Yopangidwa ndi Novo Nordisk, Denmark. Imaperekedwa pokhapokha, imagwiritsidwa ntchito pochiza odwala azaka zilizonse. Ndikothekera kwa amayi apakati komanso oyembekezera. Wotsika mtengo komanso mnzake wotsika mtengo.

"Biosulin." Isulin insulin. Wopanga - Pharmstandard, Russia. Mtengo wake ndi pafupifupi ma ruble 900. (makatoni). Ndi nthawi yayitali. Itha kugwiritsidwa ntchito pochiza odwala azaka zonse.

Humulin. Ndi insulin yosungunuka ya chibadwa. Mtengo - kuchokera ku ma ruble 500. kwa mabotolo, ma cartridge amakhala okwera mtengo kawiri. Makampani awiri amapanga mankhwalawa nthawi yomweyo - Eli Lilly, USA ndi Bioton, Poland. Ntchito zamagulu onse azaka, mwa amayi apakati omwe ali ndi matenda ashuga. Okalamba ayenera kugwiritsidwa ntchito mosamala. Amapezeka m'mafakisi ndi pazabwino.

Lingaliro la kusamutsa wodwala kuchokera ku mtundu wina wamankhwala kupita ku wina limapangidwa ndi adotolo. Kudzipatsa nokha koletsedwa!

Kwenikweni, odwala matenda ashuga omwe akudziwa bwino za mankhwalawa amakhala ndi malingaliro abwino. Kugwiritsa ntchito mosavuta, kuthekera kophatikiza mitundu ingapo kumadziwika. Koma pali anthu omwe mankhwalawa sanawakwane.

Galina: “Ndimakhala ku Yekaterinburg, ndimalandira chithandizo cha matenda ashuga. Posachedwa, ndimalandila Rosinsulin. Ndimakonda mankhwalawa, othandiza. Ndimayika zazifupi ndi zapakati, zonse zimakwanira. Nditazindikira kuti awa ndi mankhwala apakhomo, ndidadabwa. Umunthu wake ndiwosiyananso ”.

Victor: "Protafan adandichitira. Dokotalayo adalangiza mankhwala omwe amtengo wokwera mtengo ku Russia, Rosinsulin. Ndakhala ndikugwiritsa ntchito kwa miyezi ingapo tsopano, ndikusangalala ndi chilichonse. Shuga umagwira, palibe mavuto, samayambitsa hypoglycemia. Posachedwa, ndinayamba kulandira zabwino, zomwe zimandisangalatsa kwambiri. ”

Vladimir: "Wogwiritsa ntchito" Humalog "ndi" Humulin NPH. " Nthawi inayake, adasinthidwa ndi Rosinsulin kuti apindule. Ndimagwiritsa ntchito lalifupi komanso lalifupi. Kuti ndikuuzeni zowona, sindinazindikire kusiyana kulikonse kuchokera ku mankhwala akale. Shuga ali bwino, palibe hypoglycemia. Ngakhale zitsulo zopendazo zidakhala bwino. Chifukwa chake ndimalangizira mankhwalawa, osawopa kuti ndi achi Russia - zida ndi zopangira, monga adokotala ananena, ndizachilendo, zonse ndizotsatira. Ndipo zotsatira zake zili bwino koposa. "

Larisa: “Dokotalayo anasamukira ku Rosinsulin. Analandira chithandizo kwa miyezi ingapo, koma pang'onopang'ono mayeso adakula. Ngakhale zakudya sizinathandize. Ndinasinthira njira ina, osati yopindulitsa, koma ndalama zanga. Ndi zamanyazi, chifukwa mankhwalawa ndi okwera mtengo komanso abwino kwambiri. "

Anastasia: “Wolembedwa ndi matenda ashuga. Iwo adapatsa Rosinsulin sing'anga monga chithandizo. Mwachidule pogwiritsa ntchito Actrapid. Ndidamva kuchokera kwa ena kuti amathandizanso, koma kunyumba sindinapezebe kusintha kwenikweni. Ndikufuna kufunsa adotolo kuti akasamule ku mankhwala ena, chifukwa posachedwa panali vuto la hypoglycemia. Mwina sizikundiyenera, sindikudziwa. ”