I-Insulin Protafan: ama-analogues (amanani), imiyalo, izibuyekezo

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

1. I-Insulin Bazal (ngentengo cishe ama-ruble ayi-1435);
2. I-Humulin NPH (intengo mayelana nama-ruble angama-245);
3. I-Protafan NM (ngentengo cishe ama-ruble angama-408);
4. I-Aktrafan NM (intengo cishe
5. 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:

1. Ngaphambi kokuthatha i-insulin kwiphakheji, udinga ukubheka ukuthi isisombululo ebhodleleni sinombala obonakalayo. Uma ngabe amafu, ukuhanjiswa kwezulu noma imizimba yangaphandle ibonakala, isixazululo asivunyelwe.
2. Izinga lokushisa lomuthi ngaphambi kokuphathwa kufanele libe lokushisa lasekamelweni.
3. 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:

1. Ama-blockers we-H1 - ama-vitamin receptors;
2. i-glucagon;
3. epinephrine;
4. somatropin;
5. phenytoin;
6. I-GCS;
7. i-nicotine;
8. izindlela zokuvimbela inzalo ngomlomo;
9. insangu;
10. ama-estrogens;
11. i-morphine;
12. i-loop ne-thiazide diuretics;
13. diazoxide;
14. BMKK;
15. abamelene ne-calcium;
16. ama-hormone egilo;
17. i-clonidine;
18. i-heparin;
19. ama-anticepressants ama-tricyclic;
20. sulfinpyrazone;
21. danazole;
22. 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.