Ukwelashwa kwesifo sikashukela sanamuhla kubandakanya ukusetshenziswa kwezinhlobo ezimbili ze-insulin: ukumboza izidingo eziyisisekelo kanye nokunxephezela ushukela ngemuva kokudla. Phakathi kwezidakamizwa zesenzo esiphakathi noma esiphakathi, umugqa wokuqala kulesikhundla uhlala yi-insulin Protafan, isabelo semakethe sayo singama-30%.
Umenzi, inkampani uNovo Nordisk, udume umhlaba wonke ekulweni nesifo sikashukela. Ngenxa yocwaningo lwabo, i-insulin yavela ngonyaka we-1950 ngesinyathelo eside, okwenza ukuba kube lula ukwenza impilo yeziguli ibe lula. I-Protafan inezinga eliphakeme lokuhlanzwa, umphumela ozinzile futhi ongabikezelwa.
Umyalo omfishane
I-Protafan ikhiqizwa ngendlela yokuphilayo. I-DNA edingekayo ekuhlanganiseni kwe-insulin ingeniswa kuma-microorganisms emvubelo, emva kwalokho aqala ukukhiqiza i-proinsulin. I-insulin etholakala ngemuva kokwelashwa kwe-enzymatic ifana ngokuphelele nomuntu. Ukwelula isenzo sawo, i-hormone ixubene ne-protamine, futhi ikhethiwe ngokusebenzisa ubuchwepheshe obukhethekile. Umuthi okhiqizwa ngale ndlela ubonakala ngokuqanjwa njalo, ungaqiniseka ukuthi ushintsho ebhodleleni ngeke luphazamise ushukela wegazi. Ezigulini, lokhu kubalulekile: izici ezimbalwa ezithinta ukusebenza kwe-insulin, isinxephezelo esingcono sesifo sikashukela sizoba.
| Incazelo | I-Protafan, njengawo wonke ama-insulin we-NPH, i-exfoliates ngokwe-vial. Ngezansi kune-precipitate emhlophe, ngaphezulu - uketshezi olunqwabelanayo. Ngemuva kokuxuba, sonke isixazululo siba mhlophe ngokufana. Ukuqoqwa kwento esebenzayo ngamayunithi ayi-100 nge-millilita ngayinye. |
| Khipha amafomu | I-Protafan NM iyatholakala ku-vials yengilazi ene-10 ml yesisombululo. Kuleli fomu, lesi sidakamizwa sitholwa izikhungo zezokwelapha kanye nabanesifo sikashukela abajova i-insulin ngesirinji. Ebhokisini lekhadibhodi 1 ibhodlela nemiyalo esetshenzisiwe. I-Protafan NM Penfill ngamabhokisi ama-3 ml wama-cartridge angabekwa kuNvovoPen 4 syringe pens (isinyathelo 1 unit) noma i-NovoPen Echo (amayunithi ayi-0.5). Ukuze kube lula ukuxubana ebhokisini ngalinye ibhola lengilazi. Iphakethe liqukethe ama-cartridge angu-5 nemiyalo |
| Ukwakheka | Isithako esisebenzayo i-insulin-isophan, umsizi: amanzi, i-protamine sulfate yokwelula isikhathi sokusebenza, i-phenol, i-metacresol ne-zinc ion njenge-preservatives, izinto zokulungisa i-acidity yesisombululo. |
| Isenzo | Yehlisa ushukela wegazi ngokuyihambisa kwezicubu, ithuthukisa ukwakheka kwe-glycogen emisipha nasesibindi. Kukhuthaza ukwakheka kwamaprotheni namafutha, ngakho-ke, kunomthelela ekuzuzeni isisindo. Isetshenziselwa ukugcina ushukela ojwayelekile wokuzila: ebusuku naphakathi kokudla. I-Protafan ayikwazi ukusetshenziselwa ukulungisa i-glycemia, ama-insulin amafushane enzelwe lezi zinhloso. |
| Izinkomba | Isifo sikashukela i-mellitus ezigulini ezidinga ukwelashwa kwe-insulin, kungakhathalekile iminyaka yobudala. Ngesifo sohlobo 1 - kusukela ekuqaleni kokuphazamiseka kwe-carbohydrate, ngohlobo 2 - lapho amaphilisi anciphisa ushukela nokudla kungasebenzi ngokwanele, futhi i-hemoglobin ye-glycated idlula i-9%. Isifo sikashukela sokutholwa kwabesifazane abakhulelwe. |
| Ukukhetha umthamo | Imiyalo ayiqukethe umthamo ophakanyisiwe, ngoba inani elidingekayo le-insulin labanesifo sikashukela esihlukile lihluke kakhulu. Kubalwa ngesisekelo sedatha ye-glycemia esheshayo. Umthamo we-insulin wokuphathwa kwasekuseni nakusihlwa ukhethwa ngokuhlukile - ukubalwa komthamo we-insulin kuzo zombili lezi zinhlobo. |
| Ukulungiswa kwedosi | Isidingo se-insulin sanda ngokucindezelwa kwemisipha, ukulimala ngokomzimba nangokwengqondo, ukuvuvukala nezifo ezithathelwanayo. Ukusetshenziswa kotshwala kushukela akunasidingo, ngoba kuthuthukisa ukubola kwesifo futhi kungavusa i-hypoglycemia enzima. Ukulungiswa komdosi kuyadingeka lapho uthatha imishanguzo ethile. Ukukhuphuka - ukusetshenziswa kwama-diuretics neminye imishanguzo ye-hormonal. Ukuncishiswa - esimweni sokuphatha kanyekanye namathebhulethi anciphisa ushukela, i-tetracycline, i-aspirin, izidakamizwa ze-antihypertensive ezivela emaqenjini ama-AT1 receptor blockers nama-ACE inhibitors. |
| Imiphumela emibi | Umphumela ongemuhle kakhulu wanoma iyiphi insulin yi-hypoglycemia. Lapho usebenzisa izidakamizwa ze-NPH, ubungozi bokwehla ushukela ebusuku kuphezulu, ngoba banokuphakama kwesenzo. I-nocturnal hypoglycemia iyingozi kakhulu kwisifo sikashukela, ngoba isiguli asikwazi ukuxilonga siziqede ngokwaso. Ushukela ophansi ebusuku ungumphumela womthamo okhethwe ngokungafanele noma isici esithile se-metabolic. Ngaphansi kwe-1% yesifo sikashukela, i-Protafan insulin ibangela ukusabela okuncane komzimba wendawo ngendlela yokuqhuma, ukulunywa, ukuvuvukala endaweni yomjovo. Amathuba okulimala okuvamile aqukethe amandla angaphansi kuka-0,01%. Izinguquko emafutheni angaphansi kwe-subcutaneous, lipodystrophy, nazo zingavela. Ingozi yabo iphakeme uma inqubo yokujova ingalandelwa. |
| Contraindication | I-Protafan ayenqatshelwa ukusebenzisa iziguli ezinomlando wokungezwani komzimba noma i-edincke's edema yale insulin. Njengomuntu obambele, kungcono ukungasebenzisi ama-insulin angama-NPH anokwakheka okufanayo, kepha ama-insulin analogues - uLantus noma uLevemir. I-Protafan akufanele isetshenziswe ngabanesifo sikashukela abanomkhuba we-hypoglycemia, noma uma izimpawu zayo zisusiwe. Kwatholakala ukuthi ama-analogues we-insulin kuleli cala aphephe kakhulu. |
| Isitoreji | Dinga ukuvikelwa emalangeni okushisa akhanyayo, aqandayo kanye nokushisa ngokweqile (> 30 ° C). Izimbotshana kufanele zigcinwe ebhokisini, i-insulin esibayeni sesirinji kufanele ivikeleke nge-cap. Esimweni sezulu esishisayo, amadivayisi akhethekile wokupholisa asetshenziselwa ukuthutha iProtafan. Izimo ezifanele zokubekelwa isikhathi eside (kuze kube ngamaviki angama-30) ziyishalofu noma umnyango wesiqandisi. Ezingeni lokushisa lasekamelweni, i-Protafan kule vial eqalayo ihlala amasonto ayi-6 |
Imininingwane eyengeziwe mayelana neProtafan
Ngezansi lonke ulwazi oluyisisekelo mayelana nomuthi.
Isikhathi sokwenza
Izinga lokungena kweProtafan lisuka ezingxenyeni ezingaphansi kwegazi lingene egazini ezigulini ezinesifo sikashukela lihlukile, ngakho-ke akunakwenzeka ukubikezela ngokunembile ukuthi i-insulin iqala nini ukusebenza. Imininingwane eguquliwe:
Isifo sikashukela nokucindezela kuzoba yinto yesikhathi esedlule
- Ukwehlela ushukela -95%
- Ukuqedwa kwe-vein thrombosis - 70%
- Ukuqedwa kokushaya kwenhliziyo okuqinile -90%
- Ukuqeda umfutho wegazi ophakeme - 92%
- Ukwanda kwamandla ngesikhathi sosuku, ngcono ukulala ebusuku -97%
- Ukusuka komjovo kuya ekubonakaleni kwe-hormone egazini, kudlula amahora angama-1.5.
- I-Protafan inesenzo esiphakeme, kubantu abaningi abanesifo sikashukela kwenzeka amahora angama-4 kusukela ngesikhathi sokuphatha.
- Isikhathi sonke sesenzo sifinyelela emahoreni angama-24. Kulokhu, ukuthembela kwesikhathi somsebenzi ku-umthamo kudalulwe. Ngokwazisa kwamayunithi ayi-10 e-Protafan insulin, umphumela wokwehlisa ushukela uzobhekwa amahora angama-14, amayunithi angama-20 cishe amahora angama-18.
Uhlobo lokufaka
Ezimweni eziningi ezinesifo sikashukela, ukuphathwa kwezikhathi ezimbili zeProtafan kwanele: ekuseni nangaphambi kokulala. Umjovo wakusihlwa kufanele ubeanele ukugcina i-glycemia ubusuku bonke.
Izindlela zomuthi ofanele:
- ushukela ekuseni kuyafana nasesitolo sokulala;
- akukho-hypoglycemia ebusuku.
Imvamisa, ushukela wegazi ukhuphuka ngemuva kuka-3 ekuseni, lapho ukukhiqizwa kwama-hormone aphikisayo kusebenza kakhulu, futhi umphumela we-insulin ube buthaka. Uma inani eliphakeme leProtafan liphela ngaphambili, ingozi yezempilo ingenzeka: i-hypoglycemia engaziwa ebusuku noshukela ophezulu ekuseni. Ukuze ukugweme, udinga ukubheka ngezikhathi ezithile isilinganiso sikashukela ngamahora ayi-12 nayi-3. Isikhathi somjovo wakusihlwa singashintshwa, uzivumelanise nezimpawu zomuthi.
Izici zesenzo semithamo emincane
Ngohlobo 2 sikashukela, isifo sikashukela sokukhulelwa sabesifazane abakhulelwe, ezinganeni, kubantu abadala esidlweni esiphansi se-carb, isidingo se-NPH insulin singaba sincane. Ngomthamo omncane owodwa (kufika kumayunithi angama-7), isikhathi sokusebenza kweProtafan singakhawulelwa emahoreni angama-8. Lokhu kusho ukuthi imijovo emibili enikezwe imiyalo ngeke yanele, futhi phakathi koshukela wegazi kuzokwanda.
Lokhu kungagwenywa ngokujova i-Protafan insulin izikhathi ezi-3 njalo emahoreni ayi-8: umjovo wokuqala unikezwa ngokushesha ngemuva kokuvuka, owesibili ngesikhathi sasemini ne-insulin emfushane, okwesithathu, ngobukhulu, ngaphambi nje kokulala.
Ukubuyekezwa kwesifo sikashukela, akuwona wonke umuntu ophumelela ukuthola isinxephezelo esihle sesifo sikashukela ngale ndlela. Kwesinye isikhathi umthamo wobusuku uyeka ukusebenza ngaphambi kokuvuka, noshukela ekuseni uphezulu. Ukungezelela umthamo kuholela ekwandisweni kwe-insulin ne-hypoglycemia. Ukuphela kwendlela yokuphuma kwalesi simo ukushintshela kuma-insulin analoges isikhathi eside sokwenza.
Umlutha wokudla
Abantu abanesifo sikashukela ekwelapheni i-insulin bavame ukunikezwa i-insulin ephakathi nendawo nefish. Okufushane kuyadingeka ukwehlisa ushukela ongena egazini usuka ekudleni. Ibuye isetshenziselwe ukulungisa i-glycemia. Ngokubambisana neProtafan kungcono ukusebenzisa ukulungiswa okufushane komkhiqizi ofanayo - i-Actrapid, etholakala futhi ku-vials kanye nama-cartridgeges wezipeni zesirinji.
Isikhathi sokuphathwa kwe-insulin Protafan ayixhomeki ekudleni nganoma iyiphi indlela, cishe izikhathi ezifanayo phakathi kwemijovo zanele. Uma usukhethe isikhathi esikahle, udinga ukunamathela kuso njalo. Uma ihlangana nokudla, iProtafan ingagxivazwa nge-insulin emfushane. Ngasikhathi sinye ukuzixubanisa kwisirinji efanayo akunasidingo, ngoba kungenzeka enze iphutha ngomthamo futhi wehlise ijubane isenzo sehomoni emfushane.
Umthamo omkhulu
Ku-mellitus yesifo sikashukela, udinga ukujova i-insulin ngangokunokwenzeka ukuze ijubane le-glucose lifakwe. Umyalo wokusebenzisa umthamo omkhulu awusunguliwe. Uma isilinganiso esifanele se-Protafan insulin sikhula, lokhu kungabonisa ukumelana ne-insulin. Ngale nkinga, kufanele uthintane nodokotela wakho. Uma kunesidingo, uzobeka amaphilisi athuthukisa isenzo sehomoni.
Ukusetshenziswa Kwezisu
Uma ngesifo sikashukela sokukhulelwa akunakwenzeka ukufeza i-glycemia ejwayelekile ngokudla, iziguli zinqunyelwe ukwelashwa kwe-insulin. Umuthi kanye nomuthi wawo kukhethwe ngokucophelela, ngoba zombili i-hypo- ne-hyperglycemia zandisa ubungozi bokungaziphathi kahle enganeni. I-Insulin Protafan ivunyelwe ukusetshenziswa ngesikhathi sokukhulelwa, kepha ezimweni eziningi, ama-analogues amade azosebenza kangcono.
Uma ukukhulelwa kwenzeka ngesifo sikashukela sohlobo 1, futhi umuntu wesifazane unxephezela ngempumelelo lesi sifo i-Protafan, akudingeki ukuthi kuguqulwe isidakamizwa.
Ukuncelisa ibele kuhamba kahle nge-insulin therapy. I-Protafan ngeke ibangele noma iyiphi ingozi empilweni yengane. I-insulin ingena ebisini ngobuningi obuncane, emva kwalokho iphulwe emgodini wokugaya wengane, njenganoma iyiphi enye iprotheni.
I-Protafan analogues, ishintshela kwenye i-insulin
Ama-analogues aphelele weProtafan NM anezinto ezifanayo ezisebenzayo nesikhathi esiseduze sokusebenza yilezi:
- I-Humulin NPH, e-USA - umgadli ophambili, unesabelo semakethe esingaphezu kwama-27%;
- I-Insuman Bazal, eFrance;
- Biosulin N, RF;
- I-Rinsulin NPH, RF.
Ngokombono wokubuka umuthi, ukuguqulwa kweProtafan kuya kwesinye isidakamizwa se-NPH akusona esokushintshela kwenye i-insulin, futhi nakwezindlela zokupheka kuphela kuboniswa into esebenzayo, hhayi uhlobo oluthile. Empeleni, ukufaka esikhundleni okunjalo ngeke kumane kulimaze okwesikhashana ukulawulwa kwe-glycemic futhi kudinga ukulungiswa komthamo, kodwa futhi kungasusa ukungezwani komzimba. Uma i-hemoglobin ye-glycated ijwayelekile futhi i-hypoglycemia iyivelakancane, akusizi ukwenqaba i-insulin Protafan.
Umehluko we-insulin analogues
Ama-analogia amade we-insulin, anjengoLantus noTujeo, awanalo inani eliphakeme, abekezelelwa kangcono futhi mancane amathuba okuba kubange phakathi kwama-allergies. Uma umuntu onesifo sikashukela engenayo i-hypoglycemia noma ushukela weqa ngaphandle kwesizathu, i-Protafan kufanele ithathelwe indawo nge-insulin yanamuhla esebenza isikhathi eside.
Ububi babo obukhulu izindleko zabo eziphakeme. Intengo yeProtafan imayelana nama-ruble angama-400. ngebhodlela no-950 wokupakisha ama-cartridge ama-syringe pens. Ama-insulin analogue acishe abe yizikhathi ezi-3 ezibizayo.
