I-Protafan insulin isho insulin esebenza ngabantu abaphakathi.
Isidingo sokusebenzisa umuthi i-Insulin Protafan NM penfill kungenzeka ngezifo nemibandela ethile. Okokuqala, ngohlobo 1 nesifo sikashukela sohlobo 2. Ngaphezu kwalokho, umuthi ukhonjiswa esigabeni sokumelana nemithi yokuqala ye-hypoglycemic.
Isidakamizwa sibuye sisetshenziswe nokwelashwa okuhlanganisiwe (ukungatheleleki kokungazweli emithini yezidakamizwa ze-hypoglycemic) uma kutholakala ukuthi isifo sikashukela sitholakala kwabesifazane abakhulelwe futhi uma ukwelashwa kokudla kungasizi;
Izifo zangaphakathi kanye nokungenelela kokuhlinzwa (okuhlangene noma i-monotherapy) nazo zingaba isizathu sokuqokwa.
Ngingasithatha kanjani isikhundla somuthi, ama-analogues
- I-Insulin Bazal (ngentengo cishe ama-ruble ayi-1435);
- I-Humulin NPH (intengo mayelana nama-ruble angama-245);
- I-Protafan NM (ngentengo cishe ama-ruble angama-408);
- I-Aktrafan NM (intengo cishe
- I-Protafan NM Penfill (inani cishe ngama-ruble ayi-865).
Izici zesidakamizwa
Umuthi ukumiswa kwethulwa ngaphansi kwesikhumba.
Iqembu, into esebenzayo:
I-Isulin insulin-human semisynthetis (i-semisynthetic yabantu). Inobude besikhathi besenzo. I-Protafan NM icutshwe ku: insulinoma, hypoglycemia kanye ne-hypersensitivity kwento esebenzayo.
Ungayithatha kanjani futhi uyithathaphi?
I-insulin ifakwa kanye noma kabili ngosuku, isigamu sehora ngaphambi kokudla kwasekuseni. Kule ndawo, lapho imijovo izokwenziwa, kufanele iguqulwe njalo.
Umthamo kufanele ukhethwe esigulini ngasinye ngamunye. Umthamo wayo uncike enanini le-glucose kumchamo nokugeleza kwegazi, kanye nasezimpawu zenkambo yesifo. Ngokuyisisekelo, umthamo unqunyelwe isikhathi esingu-1 ngosuku futhi ngu-8-24 IU.
Ezinganeni nakubantu abadala abane-hypersensitivity to insulin, umthamo wethamo wehliselwa ku-8 IU ngosuku. Futhi ezigulini ezinezinga eliphansi lokuzwela, udokotela ohambelayo angakunquma umthamo odlula ama-24 IU ngosuku. Uma umthamo wansuku zonke udlula i-0,6 IU ngekhilogremu, khona-ke lo muthi uphathwa ngemijovo emibili, eyenziwa ezindaweni ezahlukene.
Iziguli ezithola i-100 IU noma ngaphezulu ngosuku, lapho zishintsha i-insulin, kumele zibe ngaphansi kokuqashwa kodokotela. Ukushintsha umuthi nomunye kufanele kwenziwe ngokubheka njalo amazinga kashukela egazini.
Izici ze-Pharmacological
Izakhiwo ze-Insulin Protafan:
- kwehlisa ushukela egazini;
- kuthuthukisa ukufakwa kweglucose kwezicubu;
- kunomthelela ekwakhiweni kweprotein okuthuthukile;
- kwehlisa izinga lokukhiqizwa koshukela ngesibindi;
- kuthuthukisa i-glycogenogeneis;
- kuthuthukisa i-lipogenesis.
I-Microinteraction nama-receptors kulwelwesi lwangaphandle lweseli ikhuthaza ukwakheka kwe-insulin receptor tata. Ngokukhuthaza kumaseli wesibindi nama-cell cell, i-synthesis ye-CAMP noma ukungena emsipha noma esitokisini, i-insulin receptor eyinkimbinkimbi isebenza kusebenze izinqubo ezenzeka ngaphakathi kwamangqamuzana.
Ibuye iqale ukwakheka kwama-enzyme athile abalulekile (i-glycogen synthetase, i-hexokinase, i-pyruvate kinase, njll.).
Ukwehla kweshukela egazini kubangelwa:
- ukukhuphuka kokugaya ushukela ngaphakathi kwamaseli;
- ukukhuthaza kwe-glycogenogeneis ne-lipogeneis;
- ukumuncwa okwandisiwe kanye nokumuncwa kweglucose ngezicubu;
- synthesis amaprotheni;
- ukwehla kwezinga lokukhiqizwa ushukela ngesibindi, i.e. ukwehla kokuwohloka kwe-glycogen nokunye.
Ungena nini umuthi futhi uqhubeka isikhathi esingakanani?
Ngokushesha emva kokwethulwa kokumiswa kwenziwa, umphumela awenzeki. Uqala ukwenza into ngemizuzu engama-60 - 90.
Umphumela omkhulu kwenzeka phakathi kwamahora ama-4 kuye kwangama-12. Isikhathi sokusebenza sisuka emahoreni ayi-11 kuye kwangama-24 - konke kuncike kumthamo nokwakheka kwe-insulin.
Imiphumela emibi
I-Hypoglycemia (umbono nokukhubazeka okhubazekile, isikhumba esididekile, ukunyakaza okunyukayo, isimilo esiyinqayizivele, ukubabaza, ukucasuka, ukwethuka, ukudangala, isifiso sokudla, ukwesaba, ukugabha, ukuqwasha, ukukhathazeka, ukozela, i-paresthesia emlonyeni, ikhanda lekhanda) ;
Ukungezwani komzimba (ukwehla komfutho wegazi, i-urticaria, ukuphefumula, umkhuhlane, i-angioedema);
Ukwanda kwe-titer yama-anti-insulin antibodies ngokunyuka okwengeziwe kwe-glycemia;
I-Diabetesic acidosis ne-hyperglycemia (ngokumelene nesizinda sokutheleleka kanye nomkhuhlane, ukuntuleka kokudla, umjovo ophuthelwe, imithamo emincane): ukufiphalisa ebusweni, ukozela, ukulahleka kwesifiso, ukoma okungapheli);
I-Hypoglycemic coma;
Esigabeni sokuqala sokwelashwa - amaphutha wokuphinda usebenze kabusha ne-edema (into eyenzeka okwesikhashana yokwelashwa);
Ukulimazeka kokuqwashisa (kwesinye isikhathi kukhubazeka isimo se-precomatose);
Esizeni somjovo, ukulunywa, i-hyperemia, i-lipodystrophy (i-hypertrophy noma i-atrophy yamafutha angaphansi);
Ekuqaleni kokwelashwa kungukuphazamiseka kwembonakalo okwesikhashana;
Ukusabela kwe-Cross-immunological nge-insulin yomuntu.
Izimpawu zokweqisa:
- iminyakazo
- umjuluko;
- i-hypoglycemic coma;
- izibuko
- ukuqwasha
- umbono nokukhubazeka;
- ukuthuthumela
- ukunyakaza okubambile;
- ukozela
- ukwanda kwesifiso sokudla;
- isimangaliso;
- Ukukhathazeka
- ukungaphatheki kahle
- i-paresthesia emgodini womlomo;
- Ukudana
- pallor
- ukwesaba
- ikhanda.
Ungayiphatha kanjani i-overdose?
Uma isiguli sisesimweni sokuqonda, udokotela unquma i-dextrose, enikezwa nge-dropper, intramuscularly noma intravenous. I-Glucagon noma isisombululo se-hypertonic dextrose sibuye siphathwe ngaphakathi.
Endabeni ye-hypoglycemic coma, 20 kuya ku-40 ml, i.e. 40% isixazululo se-dextrose kuze kube yilapho isiguli siphuma ekhefini.
Izincomo ezibalulekile:
- Ngaphambi kokuthatha i-insulin kwiphakheji, udinga ukubheka ukuthi isisombululo ebhodleleni sinombala obonakalayo. Uma ngabe amafu, ukuhanjiswa kwezulu noma imizimba yangaphandle ibonakala, isixazululo asivunyelwe.
- Izinga lokushisa lomuthi ngaphambi kokuphathwa kufanele libe lokushisa lasekamelweni.
- Lapho kukhona izifo ezithathelwanayo, ukungasebenzi kahle kwe-yegilo yegilo, isifo sika-Addiosn, ukwehluleka okungapheli kwe-renal, hypopituitarism, kanye nabanesifo sikashukela sokuguga, umthamo we-insulin udinga ukulungiswa ngawodwana.
Izimbangela ze-hypoglycemia zingaba:
- ukweqisa
- ukuhlanza
- ukuguqulwa kwezidakamizwa;
- izifo ezinciphisa isidingo se-insulin (izifo zesibindi nezinso, i-hypofunction ye-yegland yegland, i-pituitary gland, i-adrenal cortex);
- ukungahambisani nokudla;
- ukusebenzisana nezinye izidakamizwa;
- isifo sohudo
- ukweqisa ngokomzimba;
- ukuguqulwa kwesayithi lomjovo.
Lapho udlulisela isiguli esivela ku-insulin yezilwane siyiswa kwi-insulin yabantu, ukwehla kwamazinga kashukela egazini kungavela. Ukushintshwa kwe-insulin yabantu kufanele kube nesizathu kusuka kumbono wezokwelapha, futhi kufanele wenziwe ngaphansi kokuqashwa ngokuqinile kodokotela.
Ngesikhathi sokubeletha nangemva kokubeletha, isidingo se-insulin singehliswa kakhulu. Ngesikhathi sokuqunjelwa, udinga ukuqapha umama wakho izinyanga eziningana, kuze kube yilapho isidingo se-insulin sizinza.
Ukubekwa phambili kokuqhubekela phambili kwe-hypoglycemia kungadala ukuwohloka kwekhono lomuntu ogulayo lokushayela izimoto futhi alondoloze izindlela nemishini.
Ngokusebenzisa ushukela noma ukudla okuphezulu kuma-carbohydrate, abanesifo sikashukela bangamisa uhlobo oluthambile lwe-hypoglycemia. Kungcono ukuthi isiguli ngaso sonke isikhathi sasiba okungenani no-20 g kashukela kanye naye.
Uma i-hypoglycemia ihlehlisiwe, kuyadingeka ukwazisa udokotela ozokwenza ukulungiswa kokulashwa.
Ngesikhathi sokukhulelwa, ukwehla (i-1 trimester) noma ukwanda (ama-trimesters angama-2-3) kwesidingo somzimba se-insulin kufanele kubhekwe.
Ukuxhumana nezinye izidakamizwa
I-Hypoglycemia ithuthukiswa ngu:
- Ama-inhibitors we-MAO (selegiline, furazolidone, procarbazine);
- ama-sulfonamides (i-sulfonamides, izidakamizwa zomlomo ze-hypoglycemic);
- Ama-NSAIDs, i-ACE inhibitors nama-salicylates;
- Ama-anabolic steroid ne-methandrostenolone, stanozolol, oxandrolone;
- i-carbonic anhydrase inhibitors;
- ethanol;
- androgens;
- chloroquine;
- bromocriptine;
- i-quinine;
- ama-tetracyclines;
- i-quinidine;
- hlanganisa;
- i-pyridoxine;
- ketoconazole;
- Amalungiselelo weLi +;
- i-mebendazole;
- theophylline;
- fenfluramine;
- cyclophosphamide.
I-Hypoglycemia yenziwe ngu:
- Ama-blockers we-H1 - ama-vitamin receptors;
- i-glucagon;
- epinephrine;
- somatropin;
- phenytoin;
- I-GCS;
- i-nicotine;
- izindlela zokuvimbela inzalo ngomlomo;
- insangu;
- ama-estrogens;
- i-morphine;
- i-loop ne-thiazide diuretics;
- diazoxide;
- BMKK;
- abamelene ne-calcium;
- ama-hormone egilo;
- i-clonidine;
- i-heparin;
- ama-anticepressants ama-tricyclic;
- sulfinpyrazone;
- danazole;
- ama-audiathomimetics.
Kukhona nezidakamizwa ezingadambisa nobabili futhi zithuthukise umphumela we-glycemic we-insulin. Lokhu kufaka phakathi:
- i-pentamidine;
- ama-beta-blockers;
- i-octreotide;
- hlanganisa kabusha.