Chithandizo cha insulini chili ndi mawonekedwe enaake, chifukwa ntchito yayikulu yothandizira pakubwezerera kwa malfunction mu chakudya cha metabolism mwa kuyambitsa mankhwala apadera pansi pa khungu. Mankhwala oterowo amakhudza thupi komanso insulini yachilengedwe yopangidwa ndi kapamba. Pankhaniyi, mankhwalawa amakhala athunthu kapena osapatula.
Mwa mankhwala omwe amagwiritsidwa ntchito popanga matenda ashuga, imodzi mwabwino ndi insulin Isofan. Mankhwala ali ndi chibadwa chomanga insulin ya nthawi yayitali.
Chidachi chimapezeka m'njira zosiyanasiyana. Amayendetsedwa m'njira zitatu - subcutanely, intramuscularly komanso kudzera m'mitsempha. Izi zimathandiza wodwala kusankha njira yabwino kwambiri yolamulirira glycemia.
Zizindikiro zogwiritsidwa ntchito ndi mayina ogulitsa a mankhwalawa
Kugwiritsa ntchito mankhwalawo kumasonyezedwa ngati mtundu wa shuga womwe umadalira insulin. Komanso, chithandizo chamankhwala chiyenera kukhala moyo wonse.
Insulin monga Isofan ndi mankhwala opangidwa ndi chibadwa cha anthu omwe amalembedwa mu milandu yotere:
- mtundu 2 shuga (wodalira insulin);
- opaleshoni njira;
- kukana hypoglycemic wothandizila anatengedwa pakamwa ngati gawo la zovuta mankhwala;
- matenda a shuga (osagwiritsa ntchito mankhwalawa);
- pafupipafupi matenda.
Makampani opanga mankhwala opanga ma insulin opangidwa ndi anthu kuchokera ku mayina osiyanasiyana. Odziwika kwambiri ndi Vozulim-N, Biosulin-N, Protafan-NM, Insuran-NPH, Gensulin-N.
Mitundu ina ya Isofan insulin imagwiritsidwa ntchito ndi mayina otsatsa awa:
- Zopanda pake;
- Humulin (NPH);
- Pensulin;
- Isofan insulin NM (Protafan);
- Actrafan
- Insulidd H;
- Biogulin N;
- Chitetezo cha Protafan-NM.
Ndizofunikira kudziwa kuti kugwiritsa ntchito tanthauzo lililonse la Insulin Isofan kuyenera kuvomerezana ndi adokotala.
Zotsatira za pharmacological
Insulin yamunthu imakhala ndi vuto la hypoglycemic. Mankhwala amalumikizana ndi ma membrane a cell a cytoplasmic, ndikupanga insulini-receptor. Imayendetsa njira zomwe zimapezeka mkati mwa maselo ndikupanga ma enzymes akuluakulu (glycogen synthetase, pyruvate kinase, hexokinase, etc.).
Kuchepetsa kuchuluka kwa shuga kumachitika ndikuwonjezera kayendedwe kake kakang'ono kwambiri, kutsitsa kuchuluka kwa shuga m'magazi, ndikulimbikitsa mayamwidwe ndikuwonjezera kuyamwa kwa glucose ndi minofu. Komanso, insulin yaumunthu imayendetsa kaphatikizidwe wa mapuloteni, glycogenogeneis, lipogeneis.
Kutalika kwa mankhwala kumadalira kuthamanga kwa mayamwidwe, ndipo chifukwa cha zinthu zosiyanasiyana (dera la kayendetsedwe, njira ndi mlingo). Chifukwa chake, mphamvu ya Isofan insulin ikhoza kusefukira mwa odwala komanso odwala matenda ashuga.
Nthawi zambiri pambuyo pa jekeseni, mphamvu ya mankhwalawa imadziwika pambuyo pa maola 1.5. Pamwamba kwambiri pazogwira ntchito limapezeka maola 4-12 pambuyo pa kukhazikitsa. Kutalika kwa chochitika - tsiku limodzi.
Chifukwa chake, kuperekera kwathunthu ndi kuyambika kwa ntchito kwa wothandizirazi zimatengera zinthu monga:
- dera la jakisoni (matako, ntchafu, pamimba);
- yogwira mankhwala ndende;
- Mlingo.
Kukonzekera kwa insulin kwa anthu kumagawidwa mosiyanasiyana mu minofu. Samalowa m'matumbo ndipo samayamwa mkaka wa m'mawere.
Amawonongedwa ndi insulinase makamaka mu impso ndi chiwindi, amene amachotsa impsozo 30-80%.
Mlingo ndi makonzedwe
Malangizo ogwiritsidwira ntchito ndi insulin Izofan akuti amathandizira kawiri kawiri patsiku musanadye kadzutsa (mphindi 30-45). Potere, muyenera kusintha malo a jekeseni tsiku ndi tsiku ndikusungira syringe yomwe imagwiritsidwa ntchito kutentha kwa chipinda, ndi yatsopano mufiriji.
Nthawi zina mankhwala kutumikiridwa intramuscularly. Ndipo njira yolowerera yogwiritsira ntchito insulin yomwe sing'onoting'ono sikugwiritsidwa ntchito.
Mlingo amawerengedwa payekhapayekha kwa wodwala aliyense, potengera kuchuluka kwa kuchuluka kwa shuga m'magazi achilengedwe komanso kutsimikizika kwa matendawa. Monga lamulo, avareji ya tsiku ndi tsiku imachokera ku 8-24 IU.
Ngati odwala ali ndi insulin, ndiye kuti tsiku lililonse mankhwalawo ndi 8 IU. Ndi chiwopsezo chovuta cha mahomoni, mlingo umawonjezeka - kuyambira 24 IU patsiku.
Ngati voliyumu ya tsiku ndi tsiku la mankhwala imaposa 0,6 IU pa 1 makilogalamu, ndiye kuti jakisoni awiri amapangidwa mbali zosiyanasiyana za thupi. Odwala omwe ali ndi tsiku lililonse la 100 IU kapena kuposerapo ayenera kugonekedwa m'chipatala ngati insulin italowedwa m'malo.
Komanso, posamutsa kuchokera ku mtundu wina wamtundu kupita ku wina, ndikofunikira kuwunika zomwe zili ndi shuga.
Zochita Zosiyanasiyana
Kugwiritsa ntchito insulin yaumunthu kumatha kuyambitsa matupi awo. Nthawi zambiri, ndi angioedema (hypotension, kupuma movutikira, malungo) ndi urticaria.
Komanso, kupitilira muyeso kungayambitse hypoglycemia, yowonetsedwa ndi zizindikiro zotsatirazi:
- kusowa tulo
- khungu pakhungu;
- Kukhumudwa
- hyperhidrosis;
- mantha
- dziko lokondwa;
- kukoka kwamtima;
- mutu
- chisokonezo cha chikumbumtima;
- Vuto lama vestibular;
- njala
- kugwedezeka ndi zinthu.
Zotsatira zoyipa zimaphatikizira diabetesic acidosis ndi hyperglycemia, zomwe zimawonetsedwa ndi kutulutsa nkhope, kugona, kusowa kudya komanso ludzu. Nthawi zambiri, mikhalidwe yotere imachitika motsutsana ndi maziko a matenda opatsirana komanso kutentha thupi, jekeseni ikaphonya, mulingo wake sukulondola, ndipo ngati zakudya sizitsatiridwa.
Nthawi zina kuphwanya kwa chikumbumtima kumachitika. Pamavuto, mkhalidwe wonyansa komanso wopanda nkhawa umakula.
Kumayambiriro kwa mankhwalawa, kusokonezeka kwa nthawi yochepa kumatha kuchitika. Kuwonjezeka kwa gawo la anti-insulin matupi kumadziwikanso ndi kupita patsogolo kwa glycemia komanso zochita zamagetsi zamtundu wa mtanda ndi insulin ya anthu.
Nthawi zambiri tsamba la jakisoni limatupa ndikuluma. Poterepa, mafuta onunkhira am'mutu kapena ma atrophies. Ndipo pa gawo loyambirira la zamankhwala, kuphwanya kwakanthawi kotsutsa komanso kutupa kungachitike.
Ngati mankhwala osokoneza bongo ochulukirapo, shuga m'magazi amatsika kwambiri. Izi zimayambitsa hypoglycemia, ndipo nthawi zina wodwala amagwa.
Ngati mulingo wachepera, muyenera kumwa zakudya zamatumbo ambiri (chokoleti, mikate yoyera, mpukutu, maswiti) kapena kumwa chakumwa chokoma kwambiri. Pakukomoka, yankho la dextrose (40%) kapena glucagon (s / c, v / m) limaperekedwa kwa wodwala mu / mu.
Wodwala akayambanso kudziwa bwino, ndikofunikira kumudyetsa chakudya chamafuta ambiri.
Izi zimapangitsa kuti matenda obwera chifukwa cha hypoglycemic ayambirenso kuchepa.
Kuchita ndi malingaliro ofunikira
Kuyimitsidwa kwa oyang'anira sc sikugwiritsidwa ntchito ndi njira zina zamankhwala ena. A Co-makonzedwe ndi sulfonamides, Ace / Mao / carbonic anhydrase, NSAIDs, Mowa zoletsa, anabolic mankhwala, ndi chloroquine, androgens, kwinini, bromocriptine, pirodoksin, tetracyclines, kukonzekera lifiyamu, clofibrate, fenfluramine, Ketonozolom, Tsiklofosvamidom, theophylline, mebendazole Angathe hypoglycemic kwenikweni.
Kufooka kwa hypoglycemic zochita kumathandizira:
- H1-histamine receptor blockers;
- Glucagon;
- Somatropin;
- Epinephrine;
- GCS;
- Phenytoin;
- kulera kwamlomo;
- Epinephrine;
- Estrogens;
- odana ndi calcium.
Kuphatikiza apo, kuchepa kwa shuga kumayambitsa kugwiritsidwa ntchito kophatikizana kwa Isofan insulin yokhala ndi loopide ndi thiazide diuretics, Klondin, BMKK, Diazoxide, Danazol, mahomoni a chithokomiro, ma tridclic antidepressants, sympathomimetics, Heparin ndi sulfinpyrazone. Nikotini, chamba ndi morphine zimakulitsanso hypoglycemia.
Pentamidine, beta-blockers, Octreotide ndi Reserpine angalimbikitse kapena kufooketsa glycemia.
Njira zopewera kugwiritsidwa ntchito kwa Isofan insulin ndikuti munthu wodwala matenda ashuga asinthidwe malo omwe jakisoni wa insulin adzaperekedwe. Kupatula apo, njira yokhayo yolepheretsa kuwoneka kwa lipodystrophy.
Poyerekeza ndi maziko a mankhwala a insulin, muyenera kuyang'anira kuchuluka kwa shuga. Kupatula kuthandizira pakumwa limodzi ndi mankhwala ena, zinthu zina zimayambitsa hypoglycemia:
- matenda ashuga komanso kusanza;
- m'malo mankhwala;
- kuchuluka zolimbitsa thupi;
- matenda omwe amachepetsa kufunika kwa mahomoni (aimpso ndi chiwindi kulephera, kuchepa kwa chithokomiro, chithokomiro cha pituitary, etc.);
- kudya kwadzidzidzi;
- kusintha kwa jakisoni malo.
Mlingo wosalondola kapena kupumira kwakatikati pakati pa jakisoni wa insulin kungathandize kukulitsa hyperglycemia, makamaka ndi matenda a shuga 1. Ngati chithandizo sichinasinthidwe mu nthawi, ndiye kuti wodwala nthawi zina amakhala ndi vuto la ketoacidotic.
Kuphatikiza apo, kusintha kwa mlingo kumafunika ngati wodwalayo akuposa zaka 65, ndiye kuti wasokonekera kugwira ntchito kwa chithokomiro, impso kapena chiwindi. Ndikofunikira pa hypopituitarism ndi matenda a Addison.
Kuphatikiza apo, odwala ayenera kudziwa kuti kukonzekera kwa insulin ya anthu kumachepetsa kulolera kwa mowa. M'migawo yoyambirira yamankhwala, pakakhala njira yothetsera vutoli, kupanikizika, kulimbitsa thupi mwamphamvu, sikofunikira kuyendetsa galimoto komanso njira zina zovuta kapena kuchita nawo zinthu zoopsa zomwe zimafuna kuwonjezeredwa chidwi komanso kuthamanga.
Odwala omwe ali ndi pakati ayenera kuganizira kuti m'nthawi yoyambirira kufunikira kwa insulin kumachepa, ndipo mu 2 ndi 3 kumawonjezeka. Komanso mahomoni ocheperako amatha kufunikira ntchito.
Mankhwala a Isofan afotokozeredwa mu kanema munkhaniyi.
