I-Insuman Bazal: imiyalo yokusebenzisa, ama-analogues, intengo

Ukulungiswa koshukela oqukethwe egazini lesiguli esinoshukela kufanele kwenziwe njalo. Lokhu kudinga ukuphathwa njalo, nemijovo evame kakhulu, yezidakamizwa ze-hypoglycemic. Ukuze kube lula kakhulu, iziguli zinikezwa ukuthi zisebenzise izidakamizwa ezibayeni ezikhethekile zesirinji.

Ukuqonda okungcono, kuyadingeka ukwazi ukuthi iziphi izidakamizwa ezingasetshenziswa ngale ndlela. Enye yezidakamizwa ezijwayelekile zokunciphisa ushukela yi-Insuman Bazal GT. Lesi sidakamizwa sikhonjiswa ngokususelwa kokukhiqizwa kwe-hormone - i-insulin yomuntu.

I-Insuman Bazal inesikhathi esilinganiselwe sesenzo esenzeka ihora elilodwa ngemuva kokuphathwa komuthi. Isithako esikhulu esisebenzayo esifana ne-insulin yabantu asithathi hlangothi kweHagedorn (isofan insulin protamine).

Lesi sidakamizwa sakhiwa emuva emashumini amane amasayensi waseCanada. Isikhathi sokusebenza kwe-insulin eyethuliwe sitholakala ngokungeza kuyo iprotheni ethile - protamine. Ngibonga yena, ngokungenisa isixazululo sokwelapha, ukuqhekeka kwemithambo ye-lymphatic kanye ne-microvasculature yegazi kukhula, okunciphisa kakhulu ukufakwa komuthi egazini.

Ukwakheka nefomu lokukhululwa

I-Insulin basal itholakala ngezinguqulo ezintathu:

1. Ukupakisha ngezimbiza ezinhlanu, ngamunye ngamamililitha amahlanu;
2. Ibhodlela elilodwa kumamililitha ayishumi;
3. Ama-Cartridges ngamamililitha amathathu, wamapeni wesirinji. I-cartridge ngayinye iqukethe i-capsule ene-1 ml yento esebenzayo.

Ama-Cartridges athandwa kakhulu, ngoba ukuguquka kwawo akunzima, futhi ukusetshenziswa kwepeni yesirinji kuyindlela elula futhi ecishe ibe buhlungu.

Ebhodleleni noma ebhokisini ngalinye, ku-1 millilita wezinto ungaba yi-100 IU ye-insulin.

Lesi sidakamizwa esinciphisa ushukela siqukethe:

• I-insulin yomuntu - yisithako esiyisisekelo esisebenzayo, kuyadingeka ukuqapha ngokucophelela umthamo olawulwa, ukuze uvikele ukuphathwa ngokweqile kwe-insulin, okuzoholela emiphumeleni;
• I-M-cresol - kulokhu kulungiselela kutholakala inani elincane, lidlala indawo yokuxazulula izinto ezingeziwe, futhi njenge-antiseptic esebenzayo;
• I-Phenol - le asidi isebenza njenge-ejenti elwa namagciwane, inani elincane likhona kulo muthi. Ngokubambisana ne-m-cresol, ikuvumela ukuthi ugcine isimo somuthi esintekenteke, esizovikela isiguli ekuthelelekeni;
• I-Protamine sulfate - isebenza njengesithiyo se-insulin, esikuvumela ukuthi sandise imiphumela yaso emzimbeni. Futhi, le nto ingavimba i-lumen yemikhumbi, ephazamisa ukumuncwa Umuthi wokujova;
• I-Sodium dihydrogen phosphate - isebenza njengento ebulala izinto, ingeza izakhiwo zokugcina amanzi entweni esetshenzisiwe. Kuyadingeka ukwelula ukufakwa kwe-insulin egazini;
• I-Hydrochloric acid - ilawula i-acidity yalo muthi.

I-Pharmacodynamics ne-pharmacokinetics

Lesi sidakamizwa sisuselwa ku-insulin yomuntu, kuphela ngokufakwa kwezinto ezithinta ukumuncwa nesikhathi ubude besenzo.

Indawo yokwehlisa ushukela ye-Insuman Bazal itholakala ngokubonga:

1. Ukusheshisa ukuphuma kwe-ushukela emzimbeni - ngenkathi kunomthelela obuthakathaka ovimbela ukufakwa kwama-carbohydrate emgodini we-gastrointestinal, kanye nokusheshisa ukuphuma kwe-ushukela yizinso;
2. Ukufakwa ushukela yizicubu zomzimba kukhuphuka - ngenxa yalokho, iningi leshukela lifaka izicubu namaseli omzimba, ngenxa yokuthi ukuhlukunyezwa kwalo egazini kuncipha;
3. Ukusheshisa kwe-liponeogeneis - le mpahla iholela ekuhlelweni kwenqwaba yamafutha omzimba, ngoba ama-carbohydrate asemgodini wegazi aguqulwa kwizitho zangaphakathi. Futhi i-metabolite ephumayo ifakwa ezicutshini ezingaphansi, i-omentum, izicubu kanye nezinye izicubu njengamafutha;
4. Ukugqugquzelwa kwe-glyconeogeneis - kulokhu, kudalwa idepho ethile yeglucose, okuyipolysaccharide eyinkimbinkimbi. Ngokuntuleka kweglucose egazini, le polysaccharide izophuka inyusa izinga layo egazini;
5. Ukwehla kokuhlangana kwe-glucose yisibindi - esibindini kukhona umzimba wama-carbohydrate amaningi, amafutha kanye namaprotheni, angaphansi kwethonya lama-enzymes athile angakha ushukela;
6. Ukwakheka kwama-insulin receptors - le nkimbinkimbi itholakala kulolwelwesi lwangaphandle lwamangqamuzana omzimba, futhi yenyusa ukudlula kweglucose ngaphakathi, okunciphisa ukugxila kwayo egazini futhi kwandise kakhulu ukusebenza kweseli. Lo mphumela usetshenziswa ngempumelelo ngabasubathi abafuna ukufeza umphumela ongcono kusetshenziswa i-insulin.

Ukulandela imiyalo esetshenzisiwe, i-Insuman Bazal, kufanele iphathwe ngokungaziphathi. Lokhu kuyadingeka ukugwema ukwanda okubukhali kokuhlushwa kwe-insulin egazini. Ngakho-ke, kufanele ngaso sonke isikhathi ulawule isikhathi sokuphatha bese ubala ihora lomjovo olandelayo, ngoba umphumela womuthi utholakala emahoreni angama-1-2 ngemuva kokuphathwa, futhi umphumela omkhulu ubonwa amahora angama-20 kuya kwayi-24.

Izinkomba

Lesi sidakamizwa sisetshenziswa ekwakheni i-mellitus encike kushukela wohlobo lokuqala. Ngempela, ngalokhu kuhlukahluka kwalesi sifo, kwehla ukuvela kwe-insulin ngamaseli weLangerhans kumanyikwe ngokudalwa kokudla, okudinga ukusetshenziswa kokwenza okunye esikhundleni sokwelapha.

Lesi sidakamizwa sisetshenziswa njengendlela yokwelapha ye-insulin yesikhathi eside, ingahlanganiswa nesidakamizwa esisebenza ngokushesha se-insulin Insuman Rapid.

Umthamo

Sebenzisa i-Insuman Bazal GT esibayeni samakhomishini noma ngesirinji ye-insulin, kuyadingeka ukusebenzisana nodokotela wakho. Kulokhu, ama-receptions okuqala kufanele abanjelwe esibhedlela ngaphansi kweso likachwepheshe. Kuzosiza ukulawula isilinganiso se-insulin esidingekayo, ukulawula ukufakwa kwezidakamizwa zansuku zonke, kanye nokubona impendulo yomzimba kulokhu kwelashwa.

Ayikho imithamo ethile yokusetshenziswa kwezidakamizwa ezinjalo, ngoba kukhethwe umthamo ngamunye esigulini ngasinye. Umthamo wansuku zonke ubalwa ngokuya ngesisindo somzimba futhi ngu-0,4-1.0 U / kg.

Lapho ubala umthamo, kuyadingeka ukuthi ucabangele ukuthi isiguli sinamathela kanjani ekwelashweni kokudla okunqunyelwe, okuholela kwendlela yokuphila, umsebenzi wayo ngosuku. Lesi sidakamizwa kufanele siphathwe ngokucophelela. Imfuneko ukuguqulwa kwesayithi lomjovo. Lokhu kuyadingeka ngenxa yesenzo esithile sendawo somuthi, kanye nokuvinjwa kwentuthuko yokuqothuka kwezicubu necrosis kanye nokuphatha umuthi.

Izenzo ezinjalo kufanele zihambisane nodokotela ohambelayo. Njengoba izingxenye ezahlukahlukene zomzimba zinezinga elehlukile lokuthuthuka kwenethiwekhi yemithambo yegazi nemithambo ye-lymph, ngenxa yalokhu, ingxenye ye-insulin engena egazini ingashintsha.

Udokotela kufanele acabangele ukuthi amazinga kashukela aguquka kanjani lapho i-Insuman iphathwa ezindaweni ezahlukahlukene zokujova.

Uma usebenzisa i-Insuman Bazal, izici ezilandelayo kufanele zibhekwe:

• Indawo yokwazisa;
• Izinguquko kwesisindo somzimba - ngokukhuphuka, umthamo unyuka ngokufanele, kulokhu kungenzeka ukumelana nezicubu kwe-insulin, ukwanda okukhulu kokuxineka kweglucose kanye nokuthuthukiswa kwezimo ezibulalayo;
• Ushintsho ekudleni nasendleleni yokuphila - indlela yokudla yesifo sikashukela kuhloswe ngayo ukugcina amazinga kashukela egazini ngaphakathi kokujwayelekile, uma kwenzeka kuguqulwa isimo sokondleka noma ushintshe imenyu ejwayelekile, umthamo odingekayo womuthi kufanele uphindwe kabusha. Izenzo ezinjalo kufanele zenziwe ngemuva kokushintsha indlela yabo yokuphila, kwezinye izimo, iziguli zidinga umthamo ophansi we-insulin (isithombe esisebenzayo), kuthi kwezinye, umthamo omkhulu (ukugula, umsebenzi wehlisiwe);
• Ukushintshela ku-insulin yomuntu kusuka esilwaneni - isenzo esinjalo senzeka kuphela ngaphansi kokuqondisa udokotela ohambelayo, kuphela kufanele alungise umthamo. Ku-diabetes, kunokuzwela okwengeziwe kwe-insulin yomuntu, ngakho-ke imvamisa yomuthi iyancishiswa.

Ngokuthuthuka kwezifo ezihambisana nokwehluleka kwesibindi noma okuholela kukho, ukulawulwa kweshukela kufanele kwenziwe, futhi umthamo kashukela womuthi olinciphisayo olungiselelwe kufanele wehliswe. Njengoba i-insulin metabolism incishisiwe, kanye nokufakwa kweglue kwesibindi.

Ukuphepha kokuphepha

Ngaphambi kokudayela umuthi ngokuqondile, kufanele uqinisekise ikhwalithi yawo. Ukuze wenze lokhu, udinga ukuthatha ibhodlela, futhi uqiniseke ukuthi kune-cap cap yepulasitiki ethi ayivulwanga. Bese uhlola isimo ikhambi lokutheleleka uqobo.

Kufanele ibe mhlophe, i-opaque, ihambisane ngokufana. Uma ukuna kwezulu, ukuba khona kwama-flakes, ukubonakala kokumiswa uqobo kuyabonakala, lokhu kukhombisa isimo esingesihle somuthi.

Ngaphambi kokudayela, ukumiswa kufanele kuhlanganiswe kahle. Esikhathini isirinji, donsela umoya ngokusho umthamo owuthandayo bese uwungenisa kwi-vial ngaphandle kokuthinta ukumiswa uqobo. Ngemuva kwalokho, ngaphandle kokuthatha izinaliti, jikisa ibhodlela bese uqoqa isilinganiso esifunekayo se-Insuman.

Endabeni yokusetshenziswa kwamapeni wesirinji kanye nama-cartridge, kuyadingeka futhi ukuhlola isimo sokumiswa ngokwako kanye nokusebenza kwepeni lesirinji. Ngaphambi kokuphatha, udinga ukuskena ngobunono noma ukushukumisa idivaysi kaningana ukuthola ukumiswa okungahambi kahle.

Uma amapeni wesirinji ephukile, futhi kungekho thuba lokuthenga elisha okwamanje, ungasebenzisa isirinji. I-Insuman Bazal iqukethe i-100 IU / ml, isithako esiyisisekelo esisebenzayo, ngakho-ke udinga ukusebenzisa amasirinji aklanyelwe ngqo lo umthamo womuthi.

Imiphumela emibi

Ngokuphikisana nesizinda sokusetshenziswa njalo kwe-Insuman, ukuthuthukiswa kwe:

1. I-Hypoglycemia - esimweni somuthi we-insulin odlula okwejwayelekile, noma uma umzimba ungayidingi;
2. I-Hyperglycemia - ikhula kaningi, ikhombisa umthamo onganele we-insulin noma ukwehla kokuzwa komzimba nomuthi.

Izimo ezinjalo zihambisana nesiyezi esinzima, ukulahleka okungenzeka kokungazi, ukwesaba, umuzwa onamandla wendlala. Kukhona futhi ikhanda elibuhlungu, ukukhathazeka, ukungabekezeleleki, nokuhlangana okungahambi kahle kokunyakaza.

Ukwehla okuqhubekayo kwamazinga kashukela, iziguli zakha i-tachycardia, ukwehla komfutho wegazi, nesikhumba esimpunga.

Ukuncipha okuvama futhi ukwanda kwe-glucose nakho kungashiya umphumela ongathandeki empilweni yomuntu. Ezimweni ezinjalo, i-angiopathy yemikhumbi emincane yasendaweni eyahlukahlukene iba. Esikhathini esiningi, kuba nokulimazeka okubonakalayo, kube mnyama emehlweni. Lesi simo sohlelo lokujikeleza kwegazi siholela ekukhuleni kobumpumputhe.

Ngokufakwa njalo kwe-insulin endaweni eyodwa, i-atrophy yezicubu ezingaphansi ikhula lapho, kuvela isikhumba. Futhi, lezo zenzo zingaholela ekwakhiweni kwe-abscess noma izicubu ze-necrosis.

Ukusabela kwe-hypersensitivity kungaqhamuka ezingxenyeni ze-Insuman, ezihambisana nokulunywa kanzima, ukuqhuma esikhumbeni, ukungena kobuhlungu noma indawo emnyama, okubonisa izicubu ze-tishu necrosis (i-Arthus phenomenon). Mhlawumbe ukubonakala kwezinkinga zokuphefumula, okubonisa ukuthuthukiswa kwe-bronchospasm, angioedema, redness yaso sonke isikhumba.

Ukweqisa

Ngokwethulwa komthamo omkhulu we-insulin, ukusabela okukhulu kwe-hypoglycemic komzimba kuyakhula. Lapho kuvela izimpawu zokuqala, kuyadingeka ukuthatha izinyathelo okuhloswe ngazo ukumisa lesi simo. Okokuqala, udinga ukwenza ukuhlolwa okuzwakalayo kwenqanaba loshukela wegazi. Uma izinkomba ziphansi, udinga ukuthatha inani elincane loshukela ngaphakathi.

Uma kwenzeka ulahlekelwe yimizwa, kusatshalaliswa i-glucose egxiliwe kuhlaselwa ohlukunyeziwe, ngaphakathi emzimbeni, bese kuthi i-dropper ixhunyaniswe nekhambi elihlanjulisiwe le-glucose. Ngemuva kwalokho isiguli sifakwa ngaphansi kokubhekwa futhi izinga likashukela wegazi lilinganiswa njalo.

Ukuxhumana nezinye izidakamizwa

Ukusetshenziswa kanyekanye kwezidakamizwa ezahlukahlukene ezokwehlisa ushukela kuzoholela ekwandisweni kwe-hypoglycemic coma, kuyadingeka ukuxhumanisa ukutholwa kwezidakamizwa nodokotela wakho.

Futhi kwenqatshelwe ukuthatha i-Insuman nezidakamizwa ezinganciphisa umphumela wesidakamizwa se-antidiabetes, zihlanganisa: ama-emtrogens, ama-sympathomimetics, ama-hormone e-thyroid, ama-diuretics, ama-somatotropin kanye nama-analogues akhe, izidakamizwa ze-antipsychotic.

Uma isiguli sidinga ukuphuza lezi zidakamizwa, izikhathi ezinjalo kufanele kuvunyelwane ngazo nodokotela ohambelayo.

Ama-Analog kanye nezindleko ezilinganiselwayo

Intengo yesisekelo se-Insuman esizeni saseRussia isuka kuma-ruble ayi-765,00 kuye kuma-ruble ayi-1,585.

Uma kunesidingo, singakwazi ukusebenzisana ngokusetshenziswa okuzayo kwezinye izifaniso ze-Insuman Bazal. Zicishe zifane ekwakhiweni nasikhathi sokusebenza. Futhi ziqukethe okususelwa ku-insulin yomuntu, ngokufakwa kwabanye okutholwe.

Analogs of Insuman Bazal yile:

1. I-Protafan TM, ukukhiqizwa - iDenmark. Le hypoglycemic ingathengwa ngenani lama-ruble angama-850 kuya kuma-ruble angama-985.
2. I-Rinsulin NPH, ukukhiqizwa - iRussia. Leli thuluzi liyatholakala emabhodleleni nakuma-cartridge, ungathenga ngentengo yama-ruble angama-400 kuye kuma-ruble angama-990.
3. I-Humulin NPH, Production - USA. Emakhemisi atholakala ngentengo yama-ruble ayi-150-400.