Ukwelashwa kwe-insulin kunomlingiswa wokufaka esikhundleni, ngoba umsebenzi oyinhloko wokwelapha ukunxephezela ukungasebenzi kahle ku-carbohydrate metabolism ngokuletha umuthi okhethekile ngaphansi kwesikhumba. Umuthi onjalo uthinta umzimba kanye ne-insulin yemvelo ekhiqizwa yi-pancreas. Kulokhu, ukwelashwa kugcwele noma kuyingxenye.
Phakathi kwezidakamizwa ezisetshenziselwa isifo sikashukela, enye yezinhle kakhulu yi-insulin Isofan. Umuthi uqukethe i-insulin eyenziwe yofuzo yomuntu yesikhathi esiphakathi.
Ithuluzi litholakala ngezindlela ezahlukahlukene. Iphathwe ngezindlela ezintathu - ngokungaxhunyiwe, ngokuxhunyiwe ngaphakathi nangokuxhunywa ngaphakathi emzimbeni. Lokhu kuvumela isiguli ukuthi sikhethe inketho engcono kakhulu yokulawula izinga le-glycemia.
Izinkomba zokusetshenziswa nokuhweba amagama wesidakamizwa
Ukusetshenziswa kwesidakamizwa kukhonjiswa kwifomu lesifo sikashukela esincike ku-insulin. Ngaphezu kwalokho, ukwelashwa kufanele kube okokuphila konke.
I-insulin njenge-Isofan isidakamizwa esenziwe ngofuzo somuntu esinqunyelwe ezimweni ezinjalo:
- thayipha isifo sikashukela 2 (sincike ku-insulin);
- izinqubo zokuhlinzwa;
- ukumelana nama-ejenti we-hypoglycemic athathwe ngomlomo njengengxenye yokwelashwa okuyinkimbinkimbi;
- isifo sikashukela sokuthambisa (ekubeni kungekho kusebenza kokulashwa kokudla);
- Psychology yokuhlangana.
Izinkampani ezenza umuthi zikhiqiza i-insulin eyenziwe ngabantu ngofuzo ngaphansi kwamagama ahlukahlukene. Okuthandwa kakhulu yiVozulim-N, Biosulin-N, Protafan-NM, Insuran-NPH, Gensulin-N.
Ezinye izinhlobo ze-Isofan insulin zisetshenziswa ngamagama alandelayo okuhweba:
- Insumal;
- I-Humulin (NPH);
- I-Pensulin;
- Isofan insulin NM (Protafan);
- I-Actrafan
- Insulidd H;
- I-Biogulin N;
- I-Protafan-NM penifill.
Kuhle ukuqaphela ukuthi ukusetshenziswa kwanoma isiphi isichasiso se-Insulin Isofan kufanele kuvunyelwane nodokotela.
Isenzo se-Pharmacological
I-insulin yomuntu inomphumela we-hypoglycemic. Umuthi uxhumana nama-receptors we-cytoplasmic cell membrane, enza i-insulin-receptor complex. Isebenzisa izinqubo ezenzeka ngaphakathi kwamangqamuzana futhi ihlanganise ama-enzyme ayinhloko (i-glycogen synthetase, i-pyruvate kinase, i-hexokinase, njll.).
Ukwehlisa ukugcwala koshukela kwenziwa ngokwandisa ukuthutha kwawo okungaphakathi, kwehlise izinga lokukhiqizwa koshukela ngesibindi, kuvusele ukumuncwa kanye nokufakwa kweglucose izicubu izicubu. Futhi, i-insulin yomuntu isebenza ku-protein synthesis, i-glycogenogeneis, i-lipogenesis.
Isikhathi sokusebenza kwesidakamizwa sincike ijubane lokutholwa, futhi kungenxa yezici ezahlukahlukene (indawo yokuphatha, indlela kanye nomthamo). Ngakho-ke, ukusebenza kwe-Isofan insulin kungaba isikhukhula kuzo zombili iziguli nakwabanye abanesifo sikashukela.
Imvamisa ngemuva komjovo, umphumela wezidakamizwa uphawulwa ngemuva kwamahora ayi-1.5. Inani eliphakeme kakhulu ekusebenzeni kahle lisebenza emahoreni angama-4-12 ngemuva kokuphatha. Isikhathi sokusebenza - ngolunye usuku.
Ngakho-ke, ukuphelela kokutholwa kanye nokuqala kokusebenza komenzeli kuya ngezinto ezifana:
- indawo yomjovo (isicubu, ithanga, isisu);
- ukuhlangana kwezinto
- umthamo.
Ukulungiswa kwe-insulin yomuntu kusatshalaliswa ngendlela engafaniyo ezicutshini. Abangeni phakathi kwe-placenta futhi abangenwa ubisi lwebele.
Babhujiswa yi-insulinase ikakhulukazi ezinso nasezibindini, okukhishwe ngezinso ngenani lama-30-80%.
Imithamo nokuphatha
Imiyalo esetshenziswe nge-insulin Izofan ithi ivame ukuphathwa ngokungafakwanga izikhathi ezi-2 ngosuku ngaphambi kokudla kwasekuseni (imizuzu engama-30 kuya kwengama-5). Kulokhu, udinga ukushintsha indawo yomjovo nsuku zonke futhi ugcine isirinji elisetshenzisiwe emazingeni okushisa asekamelweni, kanye elisha esiqandisini.
Kwesinye isikhathi lesi sidakamizwa siphathwa kahle ngaphakathi. Futhi indlela eqondile yokusebenzisa i-insulin esezingeni eliphakathi nendawo ayisetshenziswa.
Umthamo ubalwa ngawodwana esigulini ngasinye, kususelwa ezingeni lokuhlushwa ushukela emithanjeni yezinto eziphilayo kanye nokucaciswa kwalesi sifo. Njengomthetho, isilinganiso esimaphakathi sosuku sisukela ku-8-24 IU.
Uma iziguli zine-hypersensitivity to insulin, khona-ke inani elifanele losuku lomuthi liyi-8 IU. Ngokuqhathaniswa ne-hormone elula, umthamo uyanda - kusuka kuma-24 IU ngosuku.
Lapho umthamo wansuku zonke womkhiqizo ungaphezu kwe-0,6 IU nge-1 kg yesisindo, khona-ke imijovo emi-2 yenziwa ezingxenyeni ezahlukene zomzimba. Iziguli ezinomthamo wansuku zonke we-100 IU noma ngaphezulu kufanele zilaliswe esibhedlela uma i-insulin ithathelwa indawo.
Ngaphezu kwalokho, lapho kudluliswa kusuka kolunye uhlobo lomkhiqizo uye kolunye, kuyadingeka ukubheka okuqukethwe ushukela.
Ukuphendula okungalungile kanye ne-overdose ngokweqile
Ukusetshenziswa kwe-insulin yomuntu kungadala ukubonakaliswa komzimba. Imvamisa, yi-angioedema (hypotension, ukuphefumula, umkhuhlane) kanye ne-urticaria.
Futhi, ukweqa umthamo kungaholela ku-hypoglycemia, kuboniswa yizimpawu ezilandelayo:
- ukuqwasha
- ukucwilisa isikhumba;
- Ukudana
- i-hyperhidrosis;
- ukwesaba
- isimo esijabulile;
- ukuzindla kwenhliziyo;
- ikhanda
- ukudideka kokwazi;
- ukuphazamiseka kwe-vestibular;
- indlala
- ukuthuthumela nezinto.
Imiphumela emibi ifaka phakathi isifo sikashukela acidosis kanye ne-hyperglycemia, okubonakala ngokufafaza ebusweni, ukozela, isifiso sokudla kanye nokoma. Imvamisa, izimo ezinjalo zivela ngokuqhamuka ngemuva kwezifo ezithathelwanayo kanye nomkhuhlane, lapho umjovo uphuthelwa, umthamo awulungile, futhi uma ukudla kungalandelwa.
Kwesinye isikhathi ukwephulwa kokwazi. Ezimweni ezinzima, kuvela isimo sokuthandeka nesinamahlaya.
Ekuqaleni kokwelashwa, ukungasebenzi kahle kwesikhashana ekusebenzeni okubukwayo kungenzeka. Ukwanda kwe-titer yemizimba elwa ne-insulin kuyabonakala futhi ngokuqhubeka okuqhubekayo kwe-glycemia kanye nokuvela kwe-immunological kwemvelo yesiphambano nge-insulin yomuntu.
Imvamisa isiza somjovo siyakhukhumala futhi siyabhoboza. Kulokhu, ama-hypertrophies angama-subcutaneous fat noma izicubu ze-atrophies. Futhi esigabeni sokuqala sokwelashwa, ukwephulwa kwesikhashana kokuphikiswa nokuvuvukala kungenzeka.
Uma kwenzeka okweqisa izidakamizwa ze-hormonal, izinga likashukela wegazi lehla kakhulu. Lokhu kubangela i-hypoglycemia, futhi kwesinye isikhathi isiguli siwela ebuthakathakeni.
Uma umthamo udlulwa kancane, kufanele uthathe ukudla okune-carb ephezulu (ushokoledi, isinkwa esimhlophe, umqulu, uswidi) noma uphuze isiphuzo esimnandi kakhulu. Uma kwenzeka wehluleka, ikhambi le-dextrose (40%) noma i-glucagon (s / c, v / m) linikezwa isiguli ku / in.
Lapho isiguli siphinda siqaphela, kuyadingeka ukuthi simondle ngokudla okwenziwe ngama-carbohydrate.
Lokhu kuzovimbela ukubuyela emuva kwe-hypoglycemic ne-glycemic coma.
Ukuxhumana nezincomo ezibalulekile
Ukumiswa kokuphathwa kwe-sc akusetshenziswa nezixazululo zezinye izidakamizwa. I co-ukuphatha nge sulfonamides, ACE / mao / anhydrase carbonic, ama-NSAID, Ethanol inhibitor, Ama-anabolic steroid, chloroquine, androgens, i-quinine, bromocriptine, pirodoksin, tetracyclines, lithium amalungiselelo, clofibrate, fenfluramine, Ketonozolom, Tsiklofosvamidom, theophylline, sithuthukisa mebendazole umphumela hypoglycemic.
Isisindo esibuthakathaka sesenzo se-hypoglycemic sinezela ku:
- Ama-blockers e-H1-histamine receptor;
- I-Glucagon;
- Somatropin;
- I-Epinephrine;
- I-GCS;
- Phenytoin;
- izindlela zokuvimbela inzalo ngomlomo;
- I-Epinephrine;
- Ama-estrogens;
- Abamelene ne-calcium.
Ngaphezu kwalokho, ukwehla ushukela kubangela ukusetshenziswa okuhlangene kwe-Isofan insulin nge-loop ne thiazide diuretics, iKlondin, iBMKK, i-Diazoxide, iDanazol, ama-hormone egilo, ama-anticepressants ama-tricyclic, ama-sympathomimetics, amaHeparin kanye ne-sulfinpyrazone. I-Nicotine, insangu ne-morphine nakho kukhulisa i-hypoglycemia.
I-Pentamidine, i-beta-blockers, i-Octreotide ne-Reserpine ingayikhulisa noma yenze buthaka i-glycemia.
Izindlela zokuvikela ukusetshenziswa kwe-Isofan insulin ukuthi umuntu onesifo sikashukela kufanele aguqule njalo izindawo lapho enikezwa khona umjovo we-insulin. Ngemuva kwakho konke, ukuphela kwendlela yokuvimbela ukuvela kwe-lipodystrophy.
Ngokuphikisana nesizinda sokwelashwa kwe-insulin, udinga ukubheka njalo ukugcwala kwe-glucose. Ngemuva kwalokho, ngaphezu kokubambisana nezinye izidakamizwa, ezinye izinto zingadala i-hypoglycemia:
- isifo sohudo kanye nokugabha;
- ukushintshwa kwezidakamizwa;
- ukukhuphuka komzimba;
- izifo ezinciphisa isidingo se-hormone (ukuhluleka kwe-renal nesibindi, i-hypofunction ye-gland yegland, i-pituitary gland, njll);
- ukudla okungafanele;
- ukuguqulwa kwendawo yomjovo.
Umthamo ongalungile noma ikhefu elide phakathi kwemijovo ye-insulin kungaba nomthelela ekwakhiweni kwe-hyperglycemia, ikakhulukazi ngesifo sikashukela sohlobo 1. Uma ukwelashwa kungalungiswa ngesikhathi, khona-ke isiguli kwesinye isikhathi siba ne-ketoacidotic coma.
Ngaphezu kwalokho, ukuguqulwa komthamo kuyadingeka uma isiguli singaphezu kweminyaka engama-65, sikhubazekile ukusebenza kwe-yegilo yegilo, izinso noma isibindi. Kuyadingeka futhi nge-hypopituitarism kanye nesifo sika-Addison.
Ngaphezu kwalokho, iziguli kufanele zazi ukuthi amalungiselelo e-insulin omuntu anciphisa ukubekezelela utshwala. Ezigabeni zokuqala zokwelashwa, uma kwenzeka kungena elinye ikhambi, izimo ezicindezelayo, ukuzivocavoca okunamandla ngokomzimba, akudingekile ukushayela imoto nezinye izindlela eziyinkimbinkimbi noma uhlanganyele ezintweni ezinobungozi ezidinga ukukhuphuka okukhulu kanye nesivinini sokuphendula.
Iziguli ezikhulelwe kufanele zibheke ukuthi ku-trimester yokuqala isidingo se-insulin siyancipha, futhi ku-2 no-3 kuyanda. Futhi, inani elincane le-hormone lingadingeka ngesikhathi sokubeletha.
Izici zamakhemikhali ze-Isofan kuzoxoxwa ngazo kule vidiyo ekulesi sihloko.
