I-Insulin Rapid: isikhathi sokusebenza nemiyalo yokusebenzisa

I-Insulin Rapid iyathandwa phakathi kwababili abanesifo sikashukela kanye nokuxhomekeka kwe-insulin. Ukwehlisa i-hormone kubalulekile emzimbeni womuntu, lapho ukukhiqizwa kwawo kuyeka noma ama-cell receptors engakuboni, i-glucose iqongelela egazini futhi ibangela imiphumela emibi eminingi.

Ngokulawulwa okungafanele kokuqukethwe ushukela, i-hyperglycemia ifaka ukuqala kokufa.

Ngakho-ke, abantu abaphethwe yi- "matenda amnandi" badinga ukwazi ngama-ejenti asisekelo we-hypoglycemic ne-insulin ukuze kugcinwe ukucindezela kwe-glucose kungakapheli imingcele ejwayelekile.

Indlela yokusebenza yesidakamizwa

Itholwe yi-genetic engineering, i-insulin Insuman Rapid GT iyafana ne-hormone ekhiqizwa amaseli we-beta womuntu pancreatic. Umuthi ukhishwa ngendlela yesisombululo esingenamibala, esifakiwe.

Into esebenzayo yesidakamizwa insulin yabantu. Ngaphezu kwalokho, ukulungiselela kuqukethe inani elincane lezinye izakhi: i-glycerol (85%), i-sodium hydroxide, m-cresol, hydrochloric acid, i-sodium dihydrogen phosphate dihydrate namanzi ancishisiwe.

Isigamu sehora ngemuva kokuba i-hormone ingene emzimbeni womuntu, isenzo saso siqala. Umphumela omkhulu wokwelapha uza ngemuva kwamahora angama-1-3 umjovo futhi uqhubeke amahora angu-8. Ngesikhathi sokwenza kwayo, i-insulin inemiphumela elandelayo emzimbeni:

• ukwehla kokuxineka kwegazi glucose;
• ukuqinisa umphumela we-anabolic, okungukuthi, ukubuyekeza nokudala amaseli amasha;
• ukuvimbela kwesenzo se-catabolic - ukubola kwe-metabolic;
• ukwanda kokudluliswa kwe-glucose kumaseli, ukwakheka kwe-glycogen esibindini nasemisipha;
• ukusetshenziswa kwemikhiqizo yokuphela kwe-glucose - ama-pyruvates;
• ukucindezelwa kwe-glycogenolysis, i-glyconeogeneis kanye ne-lipolysis;
• ukukhuphuka kwe-lipojiais kwezicubu ze-adipose nesibindi;
• ngcono ukudliwa kwe-potassium ezingeni lamaselula.

Emsebenzini wezokwelapha, i-Insuman Rapid ixubene neminye insulin yabantu, ekhiqizwa uHoechst Marion Roussel, ngaphandle kwamahomoni asetshenziselwa i-pump infusions.

Imiyalo yokusebenzisa umuthi

Isheduli yokulawulwa kwe-insulin nemithamo ithuthukiswa udokotela ohambela, obheka izinkomba zikashukela kanye nobucayi besimo sesiguli.

Ngemuva kokuthenga umuthi, kufanele ufunde imiyalo enamathiselwe. Uma unemibuzo, kufanele uthintane nodokotela wakho.

Lapho usebenzisa umuthi, umuntu kufanele alandele ngokuqinile izincomo ezitholwe kudokotela nezincomo eziboniswe emiyalweni yokusetshenziswa.

Umyalo uqukethe uhlu oluphelele lwezimo lapho kusetshenziswa i-insulin:

1. yiluphi uhlobo lwesifo sikashukela esidinga ukwelashwa kwe-insulin;
2. ukuthuthukiswa komqondo wesifo sikashukela (ketoacidotic noma hypersmolar);
3. i-ketoacidosis - ukwephulwa kwe-metabolism yama-carbohydrate ngenxa yokuntuleka kwe-insulin;
4. Ukuthola isinxephezelo kwabanesifo sikashukela abazokwenza ukuhlinzwa noma phakathi nokuhlinzwa.

Emiyalweni enamathiselwe akukho datha kwimithamo yomuthi, kunqunywa udokotela kuphela. Umthamo omkhulu awuhambi ngaphezu kwe-0.5-1 IU / kg ngosuku. Ngaphezu kwalokho, i-Rapid insulin isetshenziswa yi-hormone esebenza isikhathi eside, umthamo wansuku zonke okungenani ongama-60% womthamo ophelele wazo zombili lezi zidakamizwa. Uma isiguli sisuka kwesinye isidakamizwa siye ku-Insuman Rapid, isimo sakhe kufanele siqashwe udokotela. Ungaqokomisa amaphuzu asemqoka okusebenzisa lesi sidakamizwa:

• ikhambi liphathwa imizuzu eyi-15 ukuya kwengama-20 ngaphambi kokudla;
• imijovo inikezwa ngokungaxhamazeli nange-intramuscularly;
• izindawo zemijovo zidinga ukushintshwa njalo;
• nge-hyperglycemic coma, i-ketoacidosis nesinxephezelo se-metabolic, umuthi uphathwa ngokuhlinzwa;
• umuthi awusetshenziswa emiphongolweni ye-insulin;
• I-100 IU / ml syringes isetshenziselwa umjovo;
• I-insulin esetshenziswayo ayixutshaniswe nama-hormone ezilwane kanye neminye imvelaphi, nezinye izidakamizwa;
• Ngaphambi kokujova, hlola ikhambi, uma kukhona izinhlayiya kulo - isingeniso sinqatshelwe;
• ngaphambi komjovo, umoya uthathwa kwisirinji (umthamo ulingana nevolumu le-insulin), bese ukhishwa ku-vial;
• ivolumu yesisombululo esifunekayo iqoqwa kusuka ku-vial futhi ama-bubble asuswe;
• isikhumba silungisiwe futhi i-hormone ingeniswa kancane;
• ngemuva kokususa inaliti, kufakwa i-tampon noma ikotoni ekubambeni;
• ebhodleleni bhala usuku lomjovo wokuqala.

Umuthi ugcinwa endaweni emnyama ngaphandle kokuthola izingane ezincane. Ukushisa kwesitoreji kungama-2-8 degrees, isixazululo akufanele senziwe iqhwa.

Impilo yeshalofu iyiminyaka emi-2, ngemuva kwalesi sikhathi inqatshelwe ukusebenzisa umuthi.

Contraindication, ukulimala okungenzeka kanye ne-overdose

Lesi sidakamizwa siqukethe ama-contraindication amabili kuphela - ukuzwela komuntu ngamunye kwizakhi nobudala bezingane kuze kube yiminyaka emibili.

Ukulinganiselwa kungenxa yokuthi izifundo azikenziwa ngemiphumela ye-Rapid insulin ezinganeni ezincane.

Isici salo muthi kungenzeka ukuthi sisetshenziswe ngesikhathi sokukhulelwa nokuncelisa.

Kwesinye isikhathi, ngenxa yokweqisa noma ezinye izizathu, imiphumela emibi yesidakamizwa iyenzeka:

1. I-Hypoglycemia, okuyizimpawu zayo okuwukuthi ukudakwa, i-tachycardia, ukudideka, isicanucanu, nokuhlanza.
2. Ukungasebenzi kwesikhathi esifushane kwezitho ezibonakalayo, ngezinye izikhathi ukuthuthukiswa kwezinkinga - isifo sikashukela sikashukela. Lesi sifo sidalwa ukuvuvukala kwe-retina, okuholela esithombeni esimfushane phambi kwamehlo, ukushiyeka okuhlukahlukene.
3. Ukonakala kwamafutha noma ubomvu endaweni yomjovo.
4. Ukuphendula kwe-Hypersensitivity akuvamile. Lokhu kungaba yi-angioedema, i-bronchospasm, ukwehlisa umfutho wegazi noma ukushaqeka kwe-anaphylactic.
5. Ukwakheka kwama-antibodies e-hormone eyethulwa.
6. Ukugcinwa kwe-sodium emzimbeni womuntu, ngenxa yokuvela kokuvuvukala kwezicubu.
7. Kwehliswe amazinga we-potassium emzimbeni, i-edema yamakhemikhali.

Uma isiguli sizilimaza ngethamo eliphakeme le-insulin ukwedlula elalifunwa, kukho konke lokhu kungaholela ku-hypoglycemia ku-mellitus yesifo sikashukela. Lapho isiguli sazi, sidinga ngokuphuthumayo ukudla umkhiqizo onoshukela omningi bese sidla ama-carbohydrate.

Uma umuntu engazi lutho, unikezwa umjovo we-glucagon (1 mg) nge-intramuscularly noma nesisombululo se-glucose (20 noma 30 ml). Isimo kungenzeka lapho ukuphathwa kabusha kweglucose kudingeka khona. Imithamo ye-glucagon noma i-glucose yengane ibalwa ngokuya ngesisindo sayo.

Ukuxhumana nezinye izidakamizwa

Ngesikhathi sokushintshwa kwe-Insuman Rapid GT, udokotela uhlola ukubekezelela umuthi esebenzisa izivivinyo ze-intradermal ukugwema imiphumela yokugonywa. Ekuqaleni kokwelashwa, ukuhlaselwa kwe-glycemic kungenzeka, ikakhulukazi kwabanesifo sikashukela esinokuqukethwe kweglucose ephansi.

Ukusetshenziswa kanyekanye kwehomoni yomuntu, i-hypoglycemic nezinye izindlela kungathinta isenzo se-insulin Insuman Rapid ngezindlela ezihlukile.

Uhlu oluphelele lwemithi enganconyelwanga lungatholakala emiyalweni ephelele yokusetshenziswa.

Ukusetshenziswa kwe-beta-blockers kwandisa amathuba okuthuthukisa isimo se-hypoglycemia, ngaphezu kwalokho, bayakwazi ukufihla izimpawu zayo. I-Alcohol utshwala nayo yehlisa ushukela wegazi.

Ukwehla okusheshayo kwe-glucose kubangela ukusetshenziswa kwezidakamizwa ezinjalo:

• ama-salicylates, kufaka phakathi i-acetylsalicylic acid;
• Ama-anabolic steroid, ama-amphetamines, ama-hormone ocansi abesilisa;
• i-monoamine oxidase inhibitors (MAO);
• i-angiotensin eguqula ama-enzyme (ACE) inhibitors;
• izidakamizwa ezinciphisa ushukela;
• i-tetracycline, sulfonamides, trophosphamides;
• cyclophosphamide nabanye.

Izidakamizwa nezinto ezinjalo zingaba nemiphumela emibi kakhulu ye-insulin futhi zikhuphule inani likashukela egazini:

1. i-corticotropin;
2. ama-corticosteroids;
3. ama-barbiturates;
4. danazole;
5. i-glucagon;
6. ama-estrogens, ama-progesterones;
7. i-nicotinic acid nabanye.

Ukuhlaselwa kakhulu kwe-hypoglycemia kuthinta ukunakwa kokunakwa, okubamba iqhaza elibalulekile ekuphathweni kwezimoto noma ezimotweni. Ungangezela ushukela ngokudla ucezu kashukela noma ngokuphuza ujusi omnandi.

Izimo ezifana nokungondleki, ukujova ukweqa, izifo ezithathelwanayo kanye namagciwane, nokuphila kokuhlala nakho kuyathinta amazinga kashukela.

Izindleko, ukubuyekezwa kanye nama-analogues

Wonke umuntu, ngokuthola udokotela naye, angawuthenga lo muthi ekhemisi noma awuthengise online kwi-Intanethi. Intengo ye-insulin incike ekutheni mangaki amabhodlela ezixazululo akuleli. Ngokuyisisekelo, izindleko ziyahlukahluka kusuka kuma-ruble angamaRussia ayi-1460 ngephakethe ngalinye lomuthi.

Ukubuyekezwa kwabaningi besifo sikashukela abanikezwe imijovo ye-insulin kuyinto enhle kakhulu. Baphawula ukwehla kwamazinga kashukela emazingeni ajwayelekile. I-Insulin Rapid GT inomphumela osheshayo, intengo yayo iphansi. Okuwukuphela kwento edabukisayo yomuthi ukubonakaliswa kwemiphumela yayo emibi endaweni yomjovo. Abaningi babike ubomvu nokuhaywa endaweni lapho kwakukhona khona umjovo. Le nto ingaqedwa ngokujova isikhathi ngasinye kwenye indawo noma endaweni.

Ngokuvamile, zombili iziguli nodokotela babheka lokhu kulungiswa kwe-insulin kusebenza. Iziguli zithole umphumela omuhle kakhulu kunokwelashwa kwe-insulin lapho zilandela ukudla okungabandakanyi kalula ukudla okugaya ukudla noshukela, ukuzivocavoca umzimba kanye nokulawula isisindo somzimba wazo.

Uma kwenzeka ukungabekezeleleki ngakunye kwezakhi zomuthi, udokotela unomsebenzi wokutholela enye i-insulin esigulini. Phakathi kwezidakamizwa eziningi, ukuqondanisa amagama aqukethe into efanayo esebenzayo kungahlukaniswa. Isibonelo:

• I-Actrapid NM
• I-Biosulin P,
• I-Rinsulin P,
• Rosinsulin P,
• Humulin Njalo.

Kwesinye isikhathi udokotela ukhetha ikhambi elifanayo eliqukethe enye into eyinhloko, kodwa abe nomphumela ofanayo wokwelapha. Lokhu kungaba yi-Apidra, Novorapid Penfill, Novorapid Flexspen, Humalog nezinye izidakamizwa. Zingahluka ngefomu lomthamo, kanye nezindleko. Isibonelo, inani eliphakathi lomuthi waseHumalog ngama-ruble ayi-1820, kanti imali ye-Apidra ingama-ruble ayi-1880. Ngakho-ke, ukukhethwa komuthi kuncike ezicini ezimbili ezibalulekile - ukusebenza ngempumelelo kwemiphumela yokwelapha emzimbeni wesiguli namandla ayo ezezimali.

Phakathi kwezidakamizwa eziningi ezinjenge-insulin, kusebenza kahle i-Insuman Rapid GT. Lesi sidakamizwa ngokushesha sinciphisa amazinga kashukela abe ngamazinga ajwayelekile.

Njengoba umuthi unezimpawu ezithile eziphikisayo nemiphumela emibi, ukusetshenziswa kwawo kwenziwa ngaphansi kokuqashwa kodokotela okuqinile. Kodwa ukuze kuqedwe izimpawu zesifo sikashukela futhi kuenze kube ngokwejwayelekile ukugcwala kwe-glucose, akudingekile ukwenza imijovo ye-insulin kuphela, kodwa futhi nokugcina ukondleka okufanele nendlela yokuphila esebenzayo. Kungale ndlela kuphela lapho umuntu angaqinisekisa impilo ejwayelekile negcwele. Ividiyo ekulesi sihloko izokhuluma ngezinhlobo ezithile ze-insulin.