Namuhla, isifo sikashukela asisona isifo esingandile futhi izimbangela zokubonakala kwaso akuhlali kufihlwa ukungasebenzi kahle kofuzo. Ezimweni eziningi, lesi sifo siqala ngokuphila ngemuva kokuhlala phansi, ukucindezelwa okungapheli, imikhuba emibi nokungondleki.
Kodwa kunoma yikuphi, isifo sikashukela sidinga ukwelashwa, ngoba ukuthuthuka kwayo kuholela ekwakhiweni kwezinkinga eziningi eziyingozi. Le miphumela ifaka umsebenzi ongaboni kahle wokutheleleka, ukutheleleka, izinkinga ngohlelo lwezinhliziyo, umfutho wegazi ophakeme, i-nephropathy ne-polyneuropathy.
Uma i-pancreas ingakhiqizi i-insulin kwisifo sikashukela, khona-ke ihanjiswa i-hormone yokufakelwa. Enye yezidakamizwa ezinhle kakhulu kuleli qembu yi-Insulin R. Kepha iyini, uyini umphumela wayo nokuthi ungayisebenzisa kanjani?
I-Rinsulin P: ifomu lokukhipha nezimpawu ze-pharmacological
Isidakamizwa i-insulin esebenza ngokushesha komuntu etholakala kubuchwepheshe obusebenzisa i-DNA. Ithuluzi libopha kuma-receptors of ulwelwesi lwangaphandle lwamaseli, lwakha i-insulin-receptor complex eyenza kusebenze izinqubo ezenzeka ngaphakathi kwamangqamuzana, kufaka phakathi ukukhiqizwa kwama-enzymes aholayo.
Ukwehla ushukela wegazi kutholakala ngokwandisa ukuthuthwa kwe-glucose phakathi kwamangqamuzana, ukumunca okunamandla kanye nokufakwa kamuva kwezicubu. Ukugqugquzelwa kwe-glycogenogeneis, i-lipogenesis nayo yenzeka futhi izinga lokukhiqizwa koshukela ngesibindi liyancipha.
Njengomthetho, ubude bomphumela wamalungiselelo we-insulin bunqunywa ngezinga lokufakwa, ngokuya ngezici ezimbalwa (indawo kanye nendlela yokuphatha, umthamo). Ngakho-ke, iphrofayili yesenzo ingahluka esigulini ngasinye. Kepha, ngokuyisisekelo, ngemuva kokuphathwa ngokunqenqemeni, i-Rinsulin P isebenza ngemuva kwengxenye yehora, futhi umphumela omkhulu utholakala ngemuva kwamahora ama-1-3 futhi uqhubeka ufike emahoreni angama-8.
IGEROFARM-BIO OJSC i-insulin ikhiqiza lo muthi ngezindlela ezintathu:
- Isixazululo (i-10 IU / ml) somjovo ka-3 ml wesidakamizwa emigodini yamagilasi enamabhola enjoloba
- Ama-cartridge amahlanu e-blister strip emaphaketheni enziwe nge-foil ne-PVC.
- I-cartridge ehlanganiswe esibayeni se-syringe elahlekayo enziwe ngepulasitiki, efakwa ebhokisini lekhadibhodi.
Ukugcwala kokumunyiswa kanye nokuqala kokusebenza kwe-insulin yabantu esebenza isikhashana kunqunywa yisifunda, indawo, indlela yokuphatha kanye nokuqoqwa kwento esebenzayo. Umuthi awusatshalaliswa ngokulingene kuzo zonke izicubu; awungene ebisini lesibeletho nasezithintelweni ze-placental.
Ubhujiswa yi-insulinase ikakhulukazi ezinso nasezibindini. Umuthi ukhishwa ku-30-80% wezinso. I-T1 / 2 yimizuzu engama-2-3.
Imiyalo yokusebenzisa umuthi
Umuthi ukhonjiswa nganoma yiluphi uhlobo lwe-mellitus yesifo sikashukela, esimweni sokumelana okugcwele noma okuyingxenye kumatafula anciphisa ushukela. Ibuye isetshenziswe ezimweni eziphuthumayo ezinesifo sikashukela ngokumelene nesizinda sokuwohloka kwe-carbohydrate metabolism esimweni sezifo ezithinta umzimba. Kodwa-ke, umuthi awubekelwe i-hypoglycemia nokungabekezelelani ngakunye ezingxenyeni zawo.
Umuthi wenzelwe ukuphathwa kwe-iv, v / m, s / c. Indlela yokuphatha nomthamo inqunywe yi-endocrinologist kuya ngezimpawu zomuntu eziguli. Inani eliphakathi lomuthi ngu-0.5-1 IU / kg wesisindo.
Izidakamizwa ze-insulin ezisebenza ngokushesha zenziwa ngemizuzu engama-30. ngaphambi kokuthatha ukudla kwe-carbohydrate. Kepha okokuqala, kufanele ulinde kuze kufike lapho izinga lokushisa lokumiswa likhuphuka lifinyelela okungenani kuma-15 degrees.
Endabeni ye-monotherapy, i-insulin ikhishwa amahlandla ama-3 kuye kwayi-6 ngosuku. Uma umthamo wansuku zonke ungaphezu kwe-0.6 IU / kg, khona-ke udinga ukufaka imijovo emibili noma ngaphezulu ezindaweni ezihlukile.
Njengomthetho, i-ejenti ifakwa isaladi odongeni lwesisu. Kepha imijovo nayo ingenziwa ehlombe, emabhulokeni nasethangeni.
Ngezikhathi ezithile, indawo yomjovo kufanele ishintshwe, ezovikela ukubonakala kwe-lipodystrophy. Ngokwesimo sokuphathwa kwe-hormone, udinga ukuqaphela ukuthi uketshezi alungeni emgodini wegazi. Futhi, ngemuva komjovo, indawo yomjovo ayikwazi ukulungiswa.
Ukuphatha ngaphakathi / ku kanye / m kungenzeka kuphela ngaphansi kokubhekwa kwezokwelapha. Ama-Cartridges asetshenziswa kuphela uma uketshezi lunombala ocacile ngaphandle kokungcola, ngakho-ke, lapho kuvela ingozi, isixazululo akufanele sisetshenziswe.
Kuhle ukukhumbula ukuthi ama-cartridge anamadivayisi athile angavumeli ukuxutshwa kokuqukethwe kwawo nezinye izinhlobo ze-insulin. Kepha ngokugcwaliswa okulungile kwepeni yesirinji bangasetshenziswa futhi.
Ngemuva kokufakwa, inaliti kufanele ingasuswa ngephepha layo elingaphandle bese ilahlwa. Ngakho-ke, ukuvuza kungavinjelwa, inzalo ingaqinisekiswa, nomoya awukwazi ukungena ngenalithi uvalwe.
Lapho usebenzisa amapeni e-syringe egcwele i-multi-densinge, ngaphambi kokuqala kokusebenzisa, susa ipeni lesirinji esiqandisini bese ulinda lize lithole ukushisa kwegumbi. Kodwa-ke, uma uketshezi luye lwanda noma lube namafu, khona-ke alunakusetshenziswa.
Eminye imithetho isadinga ukubonwa:
- izinaliti azikwazi ukusetshenziswa futhi;
- I-insulin R lapho ipeni lesirinji ligcwele khona ihloselwe ukusetshenziswa komuntu ngamunye, kuyilapho i-syringe pen cartridge ingenakugcwaliswa kabusha;
- ipeni lesirinji elisetshenzisiwe akumele ligcinwe esiqandisini;
- ukuvikela ipeni lesirinji elikhanyayo, lisimboze ngaso sonke isikhathi nge cap.
Umuthi osuvele usetshenzisiwe kufanele ugcinwe emazingeni okushisa angama-15 kuye kwangama-25 degrees okungenani izinsuku ezingama-28. Futhi, akufanele uvumele insiza ukuthi ishise noma ivezwe ukukhanya kwelanga.
Uma kwenzeka kuba ne-overdose egazini, ukuhlangana koshukela kunganciphisa kakhulu. Ukwelashwa kwe-hypoglycemia kuqukethe ekudleni okuqukethe i-carbohydrate noma isiphuzo esiphundu. Ngakho-ke, abanesifo sikashukela kufanele ngaso sonke isikhathi babe namaswidi noma ujusi nabo.
Nge-hypoglycemia enkulu, lapho onesifo sikashukela engazi lutho, ufakwa ngesisombululo se-glucose (40%) noma i-glucagon.
Ngemuva kokuba umuntu ebuye ukwazi, kufanele anikezwe ukudla kwe-carbohydrate, okuzovimbela ukukhula kokuhlaselwa kwesibili.
Ukuphendula Okubi Nokusebenzelana Kwezidakamizwa
Imiphumela emibi ukwehluleka kuma-carbohydrate metabolism. Ngakho-ke, ukubuyekezwa kodokotela neziguli kwehlela ukuthi ngemuva kokuphathwa kweRinsulin P, i-hypoglycemia ingaqala ukukhula. Lokhu kuboniswa ukuqothuka kwesikhumba, ukukhanda ikhanda, ukukhala, ukwethuka, indlala, i-hyperhidrosis, isiyezi, futhi ezimweni ezinzima, ukuqina kwe-hypoglycemic kukhula ku-mellitus yesifo sikashukela.
Ukuphendula okwenziwa yi-allergic, njenge-edema kaQuincke, ukuqubuka kwesikhumba nakho kuyenzeka. Ukushaqeka kwe-anaphylactic, okungaholela ekufeni, ngezikhathi ezithile kuyavela.
Ukusuka kokusabela kwendawo, ukulunywa, ukuvuvukala kanye ne-hyperemia endaweni yomjovo kuvame ukwenzeka. Futhi esimweni sokwelashwa isikhathi eside kwe-insulin, i-lipodystrophy ivela endaweni yomjovo.
Okunye ukusabela okungekuhle kufaka ukuvuvukala kanye nokukhubazeka okubukwayo. Kodwa kaningi lezi zimpawu zihamba ngesikhathi sokwelashwa.
Kunemithi eminingana ethinta izidingo ze-insulin. Ngakho-ke, izibuyekezo zezokwelapha zithi umphumela wokwehlisa ushukela we-insulin uba namandla uma ukusetshenziswa kwawo kuhlangene nezindlela ezilandelayo:
- amaphilisi we-hypoglycemic;
- ethanol;
- I-ACE / MAO / i-carbonic anhydrase inhibitors;
- amalungiselelo e-lithium;
- ama-block-ers-engakhethi;
- I-Fenfluramine;
- Bromocriptine;
- ICyclophosphamide;
- ama-salicylates;
- Mebendazole nokuningi.
I-Nicotine, i-glucagon, i-phenytoin, i-somatropin, i-morphine, i-estrogens, izindlela zokuvimbela inzalo ngomlomo, i-diazoxide ne-corticosteroids zinciphisa umphumela we-hypoglycemic. Ama-hormone e-thyroid aqukethe iodine, i-CCB, i-thiazide diuretics, i-Epinephrine, i-Clonidine, iHeparin, neDanazole, nama-antidepressant ama-tridclicants kanye ne-sympathomimetics nawo enza buthaka umphumela wokwehlisa ushukela.
Ukusetshenziswa kwe-B-blockers kungavala uphawu lwe-hypoglycemia. I-Lanreotide noma i-Octreotide notshwala ingakhuphula noma inciphise ukufunwa kwe-insulin.
Akuhambelani ngokuphelele ukuxuba i-insulin yabantu nezidakamizwa ezifanayo kanye nemikhiqizo yezilwane.
Imiyalo ekhethekile
Ngokuphikisana nesizinda sokwelashwa kwe-insulin, kubalulekile ukubheka njalo izinkomba ze-glycemia. Ngempela, ngaphezu kwe-overdose, ezinye izifo, ukufakwa kwezidakamizwa, ukwanda kokuzivocavoca komzimba, isifo sohudo, ushintsho endaweni yomjovo kanye nokudla okungafanele kungasiza ukwehlisa izinga likashukela.
Ngaphezu kwalokho, ukuphazamiseka ekuphathweni kwe-insulin nomthamo ongalungile kungadala i-hyperglycemia ezigulini ezinesifo sikashukela sohlobo 1. Uma kungekho makhambi, i-ketoacidosis esongela impilo ingakheka.
Uma kunokuphulwa kokusebenza kokusebenza kwezinso, isibindi, i-thyroid gland, i-hypopituitarism, isifo sika-Addison futhi lapho esemdala, kubalulekile ukulungisa umthamo we-insulin. Ngaphezu kwalokho, ukuguqulwa komthamo kungadingeka lapho ushintsha indlela odla ngayo futhi ukhulisa ukusebenza komzimba.
Isidingo se-insulin sanda phambi kwezifo ezikhona, ikakhulukazi lezo ezihambisana nomkhuhlane. Kuyaqapheleka ukuthi ngesikhathi sokushintsha kusuka kolunye uhlobo lwe-insulin kuya kolunye, kufanele ubheke ushukela wegazi ngokucophelela.
Izindleko zeRinsulin R zisukela kuma-ruble angama-448 kuya kwangama-1124.
Ngaphezu kwe-Insulin P, kune-Rinsulin NPH yezidakamizwa. Kepha le mali ingahluka kanjani?
I-Rinsulin NPH
Umuthi ubuye ne-insulin yabantu etholakala ngobuchwepheshe be-DNA esebenza kabusha. Kodwa-ke, uma kuqhathaniswa ne-Insulin P, ayinayo imfushane, kodwa umphumela omaphakathi. Zombili lezi zidakamizwa zingahlanganiswa.
Njengomthetho, ngemuva kokuphathwa kwe-sc, isenzo se-insulin siqala emahoreni angama-1.5. Umphumela omkhulu kakhulu utholakala ngemuva kwamahora we-4-12 futhi uhlala usuku olulodwa.
Ukumiswa kunombala omhlophe, kuthi lapho kumi ezansi kwebhodlela, amafomu aqondile, athi lapho ethuthumela, akhishwe. Into esebenzayo yesidakamizwa yi-insulin-isophan.
Njengoba kusetshenziswa izakhi ezisizayo:
- amanzi agcobhoziwe;
- phakamisa sulfate;
- i-sodium hydrogen phosphate dihydrate;
- glycerol;
- metacresol;
- i-crystalline phenol.
Ukumiswa kuyatholakala kumabhilidi eglasi we-3 ml ngayinye, kufakwe kwekhadibhodi ye-contour package. Futhi, umkhiqizo ungathengwa kuma-cartridge weglasi afakwe kuma-syringes amaningi wethamo lokujova okuningi kwe-Rinastra.
I-pharmacokinetics kanye nezinkomba zokusetshenziswa kwomuthi ziyefana nasendabeni yokusetshenziswa kweRinsulin R. Umthamo womuthi unqunywa udokotela ngawodwana.
Umthamo ojwayelekile wesidakamizwa ngu-0.5-1 IU / kg wesisindo somzimba. Kepha ukuphathwa kwe-intravenous kuyaphulwa.
Imiyalo yokusebenzisa i-Rinsulin NPH maqondana nemiphumela emibi, ukusetshenziswa ngokweqile kwezimpawu nezindlela zokusebenzisa akuzange kwehlukane nesichasiselo se-insulin yomuntu omfushane.
Intengo yokumiswa isuka kuma-ruble angama-417 kuya kwangama-477. Ividiyo ekulesi sihloko izokusiza ufunde ukuthi ungayisebenzisa kanjani i-insulin.