Isifo sikashukela i-mellitus yisifo esivamile esidinga ukwelashwa impilo yonke. Ngakho-ke, ohlotsheni lokuqala lwesifo nasezimweni ezithuthukile ezinefomu lesibili le-pathology, iziguli zidinga ukuphathwa njalo kwe-insulin, okusiza ukuguqula ushukela ngokujwayelekile, ukuguqula ngokushesha kube namandla.
Imvamisa nesifo sikashukela, kusetshenziswa i-insulin Aspart. Lesi isidakamizwa se-ultrashort.
Ithuluzi iyi-analogue ye-insulin yabantu, etholakala ngobuchwepheshe be-DNA obuphinda busebenzise uhlobo lwe-Saccharomyces cerevisiae, lapho iprotheyini esesikhundleni B28 (amino acid) ithathelwa indawo nge-aspartic acid. Isisindo samangqamuzana angama-5825.8.
Ukwakheka, ifomu lokukhulula nomphumela we-pharmacological
I-Biphasic insulin ihlanganisa i-Aspart enyibilikayo ne-crystalline insulin protamine kwisilinganiso esingama-30 kuye kwangama-70%.
Lokhu ukumiswa kokuphathwa kwe-sc, ukuba nombala omhlophe. I-millilita eyi-1 iqukethe amayunithi ayi-100, kanti i-ED eyodwa ihambelana nama-35 μg we-insulin Aspart ye-anhydrous.
I-anulinue yomshuwalense womuntu yakha i-insulin receptor eyinkimbinkimbi ne-cytoplasmic cell membrane receptor yangaphandle. Lesi sakamuva sisebenza ngokusetshenziswa kwe-glycogen synthetase, i-pyruvate kinase ne-hexokinase enzymes.
Ukwehla ushukela kwenzeka ngokukhuphuka kwezokuhamba kwe-intracellular kanye nokwenza ngcono izicubu ze-glucose. I-Hypoglycemia iyatholakala futhi ngokunciphisa isikhathi sokukhishwa kwe-glucose esibindini, i-glycogenogeneis kanye nokwenza kusebenze i-lipogenesis.
I-biphasic insulin aspart itholakala ngokusebenzisa imanyoloyilo ye-biotechnological lapho i-molecule ye-hormone proline ithathelwa indawo yi-aspartic acid. Ama-insulin anjalo we-biphasic anethonya elifanayo ku-glycosylated hemoglobin, njengoba kwenza i-insulin yabantu.
Zombili lezi zidakamizwa zisebenza ngokulinganayo ngokulinganayo kwe-molar. Kodwa-ke, i-Aspart insulin isebenza ngokushesha kunehomoni yabantu. Futhi i-crystalline Aspart protamine inomphumela wesikhathi esiphakathi.
Isenzo ngemuva kokuphathwa kwesidakamizwa sitholakala ngemuva kwemizuzu engu-15. Ukuqunjelwa okuphezulu kakhulu kwezidakamizwa kwenzeka emahoreni angama-1-4 ngemuva komjovo. Isikhathi somphumela sifinyelela emahoreni angama-24.
Ku-serum, i-Cmax ye-insulin ingu-50% ngaphezulu uma usebenzisa i-insulin yomuntu. Ngaphezu kwalokho, isikhathi esimaphakathi sokufika ku-Cmax singaphansi kwesigamu.
I-T1 / 2 - kufinyelela emahoreni angama-9, ikhombisa izinga lokufakwa kwengxenyeni eboshwe nge-protamine. Amazinga e-insulin asisekelo abonwa ngemuva kwamahora ayi-15-18.
Kepha ngesifo sikashukela sohlobo 2, ukuphumelela kweCmax cishe imizuzu engama-95. Igcina isezingeni elingaphansi kuka-14 nangaphezulu elingu-0 ngemuva kokuphathwa kwe-sc. Ukuthi indawo yezokuphatha iyayithinta indawo yokufakwa emzimbeni ayifundwanga yini.
Imithamo nokuphatha
Imvamisa i-insulin Degludek, i-Aspart-insulin ilawulwa ngokungaziphathi. Umjovo wenziwa ezingxenyeni ezithile zomzimba:
- ukuqothuka;
- Belly
- ithanga
- ehlombe.
Udinga ukwenza umjovo we-insulin ngaphambi kokudla (indlela ye-prandial) noma ngemuva kokudla (indlela ye-postprandial).
I-algorithm kanye nomthamo wokuphatha kunqunywa udokotela ohambelayo. Kepha imvamisa inani losuku lomuthi liyi-0,5-1 UNITS nge-1 kg yesisindo.
Ezimweni ezinzima, i-insulin Aspart biphasic iyalawulwa iv. Inqubo yenziwa kusetshenziswa amasistimu wokungenela esimweni sokuphuma noma sokungena ngaphakathi.
Ukuphendula okuhlukile, ama-contraindication ne-overdose
Ukusetshenziswa kwe-insulin Asparta kungathinta umsebenzi weSishayamthetho Sikazwelonke, ngoba ukujwayela okusheshayo kwamapharamitha kashukela kwesinye isikhathi kubangela i-neuropathy yobuhlungu obukhulu. Kodwa-ke, lesi simo sidlula isikhathi.
Futhi, i-insulin ye-biphasic iholela ekubonakala kwe-lipodystrophy endaweni yomjovo. Engxenyeni yezitho zomzwelo, ukonakala kokubonakalayo nokungasebenzi kahle kokuphikisiwe kuyaphawulwa.
Contraindication ukubekezelela ngakunye ezingxenyeni zomuthi kanye ne-hypoglycemia.
Ngaphezu kwalokho, ukusetshenziswa kwe-Insulin Aspart akuyona into efiselekayo kuze kube seminyakeni engu-18. Njengoba ingekho idatha yomtholampilo eqinisekisa ukusebenza nokuphepha komuthi wesitho esivelayo.
Uma kwenzeka kusetshenziswa i-overdose, kuzoba nezimpawu ezilandelayo:
- iminyakazo
- ukwehla okukhulu kwe-glucose;
- I-hypoglycemic coma kushukela.
Ngokweqile kancane komthamo, ukwenza i-glucose ijwayelekile, kwanele ukuthatha izakhamzimba ezisheshayo noma uphuze isiphuzo esimnandi. Ungafaka i-glucagon ngokwezifiso noma nge-intramuscularly noma ngesixazululo se-dextrose (iv).
Esimweni se-hypoglycemic coma, kusuka ku-20 kuye ku-100 ml we-dextrose (40%) kufakwa umzila we-jet-intravenous kuze kube yilapho isimo sesiguli sesijwayelekile. Ukuvimbela ukuthuthukiswa kwamacala anjalo, ukuthathwa kwe-carbohydrate yomlomo kuyanconywa.
Ukuxhumana nezinye izidakamizwa nemiyalo ekhethekile
Umphumela we-hypoglycemic ungathuthukiswa uma ukuphathwa kwe-insulin ye-biphasic kuhlanganiswa nokuphathwa ngomlomo kwezidakamizwa ezilandelayo:
- izidakamizwa eziqukethe utshwala kanye ne-hypoglycemic;
- I-MAO / i-carbonic anhydrase / ACE inhibitors;
- I-Fenfluramine;
- Bromocriptine;
- ICyclophosphamide;
- somatostatin analogues;
- Theophylline;
- Ama-Sulfonamides;
- I-Pyridoxine;
- Ama-anabolic steroid.
Ukusetshenziswa kwama-tetracyclines, Mebendazole, Disopyramide, Ketonazole, Fluoxetine kanye nama-Fibrate kuholela ekwehlisweni okukhulu koshukela. Futhi ama-antidepressants ama-tricyclic, izindlela zokuvimbela inzalo ngomlomo, i-nicotine, i-sympathomimetics, i-glucocorticosteroids, i-thiazide diuretics, ama-hormone egilo kanye nezinye izidakamizwa anegalelo ekwenzeni buthaka umphumela we-hypoglycemic.
Ezinye izidakamizwa zingakhuphuka futhi zinciphise amazinga kashukela. Lokhu kufaka phakathi ukulungiswa kwe-lithium, i-beta-blockers, ama-salicylates, i-clonidine ne-reserpine.
Kuyaqapheleka ukuthi i-Flekspen esetshenzisiwe kufanele igcinwe emazingeni okushisa asekamelweni, kanye nepeni yesirinji entsha esiqandisini. Ngaphambi kokuphatha, okuqukethwe Vial kubalulekile ukuxuba kahle.
Ngomsebenzi owandayo womzimba, izifo zokuvuvukala noma ezithathelwanayo, ukwanda komthamo we-insulin kuyadingeka. Futhi ekuqaleni kokwelashwa, akunconywa ukulawula izindlela eziyinkimbinkimbi nezimoto. Ividiyo ekule ndatshana izokhuluma futhi ngehomoni.
