Masiku ano, insulin ndi mankhwala ofunikira omwe anthu odwala matenda a shuga amafunikira. Pambuyo pakupanga kwake, kusinthika kwenikweni kunachitika m'moyo wa anthu odwala matenda ashuga, popeza odwala pamapeto pake adapeza mwayi wokhala ndi moyo wonse, ngakhale atadwala matenda azitsamba.
M'mbiri ya pharmacology ya zaka makumi awiri, maantibayotiki ali ndi kufunikira kofanana kwa anthu. Mankhwalawa, limodzi ndi insulin, adapulumutsa miyoyo ya odwala ambiri ndikukhala njira imodzi yothanirana ndi matenda.
Homoni ya insulin idapezeka ndi Canada Katswiri wazolimbitsa thupi wa ku Canada Frederick Bunting molumikizana ndi John James Richard MacLeod. Mu 1922, wasayansi wachinyamata kwa nthawi yoyamba adatha kupulumutsa moyo wa munthu wazaka 14 wazovuta za shuga mwa kubweretsa muyeso wa mankhwala omwe adayamba kulowa mthupi. Pakulemekeza bambo uyu, Tsiku la Anthu Akuluakulu padziko lonse lapansi limakondwerera tsiku lililonse.
Kusiyana pakukonzekera kwa insulin
Mitundu yosiyanasiyana ya kukonzekera kwa insulin imatha kusiyanasiyana, kuyeretsa, kuchuluka kwa asidi yankho. Kutengera momwe insulin imapezekera, bovine, nkhumba, ndi mahomoni aanthu zimasiyanitsidwa.
Komanso, kusiyana kungagoneke pamaso pa zinthu zowonjezera zomwe ndi gawo la mankhwala - zoteteza, nthawi yayitali komanso zinthu zina. Pali ma insulin omwe amatha kusakanikirana ndi mankhwala achidule komanso osakhalitsa.
Insulin ndi mahomoni opangidwa ndi maselo apadera a pancreatic. Izi ndi mapuloteni okhala ndi mitundu iwiri, ali ndi ma amino acid okwana 51.
Insulin imapangidwa pogwiritsa ntchito maluso apamwamba kwambiri mwanjira ya mafakitale.
Momwe mungapezere insulin: magwero akulu
Kutengera ndi gwero lomwe limagwiritsidwa ntchito popanga timadzi tating'onoting'ono, ma insulin a nkhumba ndi kukonzekera kwa insulin yaumunthu kumasungidwa masiku ano. Kuchulukitsa mphamvu ya nkhumba insulin, kuyeretsedwa kochulukirapo kumagwiritsidwa ntchito. Mankhwalawa ali ndi vuto la hypoglycemic ndipo kwenikweni sayambitsa kuyanjana.
Kapangidwe ka mankhwala a insulin yaumunthu ndikofanana ndi kapangidwe ka timadzi ta munthu. Mankhwala otere amapangidwa pogwiritsa ntchito biosynthesis pogwiritsa ntchito matekinoloje achilengedwe.
Pakadali pano, mankhwalawa amapangidwa ndi makampani akuluakulu odalirika, malonda awo amakhala ndi chitsimikizo chotsata miyezo yonse yabwino. Anthu ndi porcine multicomponent omwe amayeretsedwa kwambiri ndi insulin alibe kusiyana kwakukulu pokhudzana ndi zotsatira za chitetezo cha mthupi, monga zikuwonetsedwera ndi maphunziro osiyanasiyana.
Kapangidwe kake ka mankhwalawo nthawi zambiri sikumaphatikizapo ma insulin okha, komanso mankhwala othandizira omwe amagwira ntchito zina zofunika. Makamaka, kukhalapo kwa zigawo zina kumapangitsa kuti vutoli lithe, limakulitsa mphamvu ya mankhwalawo, ndikukhalabe ndi mbali yosagwirizana ndi asidi.
Yaitali insulin
Kuti apange insulin yowonjezera, protamine kapena zinc zimawonjezeredwa ku yankho ndi insulin yokhazikika - imodzi mwazinthu ziwirizi. Kutengera ndi chowonjezera, mankhwala onse amagawidwa m'magulu awiri akuluakulu.
Protamine-insulin imakhala ndi protafan, insumanabazal, NPH, humulin N. Zinc insulin ili ndi humulin-zinc, tepi, insulin-zinc kuyimitsidwa kwa mono-tard. Protamine ndi puloteni, ngakhale izi, mavuto omwe amabwera chifukwa cha matupi awo sagwirizana kwambiri ndi odwala matenda ashuga.
Kupanga malo osalowerera ndale, gawo la phosphate limawonjezeredwa ku yankho. Pankhaniyi, aliyense wodwala matenda ashuga ayenera kukumbukira kuti mankhwalawa sayenera kuphatikizidwa ndi insulin-zinc. Chowonadi ndi chakuti phosphate ya zinc imayamba kukhazikika, kufupikitsa nthawi yomweyo zotsatira za zinc insulin.
Kusakaniza koteroko kumatha kubweretsa zotsatirapo zosayembekezereka.
Zotsatira zoyipa za zinthuzi
Monga mankhwala ophera tizilombo toyambitsa matenda, mankhwala amagwiritsidwa ntchito omwe, chifukwa cha mawonekedwe awo a mankhwala, nthawi zambiri amabweretsedwa pakupanga mankhwala. Izi zimaphatikizapo phenol ndi cresol, zinthuzi zimakhala ndi fungo linalake.
Methyl parabenzoate, yemwe ndi wopanda fungo, amawonjezeredwa ndi yankho la insulin. Zina zilizonse zophatikiza ndi izi sizimakhudza thupi.
Phenol ndi cresol nthawi zambiri amawonjezeredwa ku protamine insulin. Phenol sakuphatikizidwa pakuyimitsidwa kwa insulin-zinc, chifukwa chinthu ichi chimakhudza katundu wazinthu zazikulu za mahomoni. M'malo mwake, methylparaben imawonjezeredwa. Kuphatikiza antimicrobial zotsatira kumatha kukhala ndi zinc ion, zomwe zimakhalanso gawo la yankho.
- Chifukwa choteteza pakatikati pa mabakiteriya mothandizidwa ndi mankhwala osokoneza bongo, kufalitsa matenda ashuga sikuloledwa ngati mukubweretsanso singano mu botolo ndi mankhwala. Kupanda kutero, kulowetsedwa kwa singano kumatha kuyambitsa zovuta zambiri.
- Njira yodzitetezera yofananayo imalola jakisoni wamkati ndi syringe yomweyo kwa sabata. Komanso, pakalibe njira yothetsera vutoli, wodwala matenda ashuga amatha kupereka jakisoni popanda kuchiritsa khungu, koma singano yopyapyala ya insulin iyenera kugwiritsidwa ntchito pamenepa.
Mlingo wa mankhwala
Kukonzekera koyambirira kwa insulin komwe kumapangika mu millilita imodzi ya yankho gawo limodzi lokha la mahomoni. Zaka zotsatila, kuchuluka kwa mankhwalawa kunachuluka, ndipo masiku ano pafupifupi ma insulin onse omwe amagwiritsidwa ntchito ku Russia amagulitsidwa m'mabotolo a 40 magawo 1 ml yankho. Pa mankhwalawa. Monga lamulo, mutha kuwona chizindikiro cha U-40 kapena 40 mayunitsi / ml.
Mitundu yonse yamtundu wa insulin imapangidwira kukonzekera mozama, kotero imakhala ndi mawonekedwe apadera. Chizindikiro chilichonse chimafanana ndi buku linalake. Kuphatikiza ndi syringe 0,5 ml ya mankhwalawa, odwala matenda ashuga amalandira 20 magawo a mahomoni, 0,35 ml amafanana ndi magawo 10. Chifukwa chake, 1 ml ya syringe ya insulin ndi magawo 40.
Maiko ena akunja amatulutsa insulin U-100, pomwe 1 ml yankho limafanana ndi magawo zana a mahomoni. Kuti mugwiritse ntchito mankhwalawa, muyenera kugwiritsa ntchito syringe yapadera ya insulin, imafanana ndi muyezo, koma imakhala ndi vuto lililonse.
Komabe, ndikofunikira kumvetsetsa kuti pankhani iyi kuchuluka kwa mankhwala omwe amaperekedwa kuyenera kuchepetsedwa ndi 2,5, chifukwa 40 IU yomweyo ya insulin idzakhala mu 0,4 ml ya mankhwalawa.
Mukalakwitsa posankha mlingo, komanso wodwala matenda ashuga, hypoglycemia imayamba.
Kuphatikiza kwa insulin yayifupi komanso yayitali
Masiku ano, matenda a shuga a mtundu woyamba amathandizidwa pogwiritsa ntchito ma insulin osakhalitsa komanso ma insulin omwe amakhala nthawi yayitali. Ndikofunikira kwambiri posakaniza mankhwalawa ndikuwonetsetsa kuti insulini yochepa imagwira thupi mwachangu momwe mungathere.
Mankhwala omwe amagwira ntchito mwachidule amatha kugwiritsidwa ntchito limodzi mu syringe yomweyo ndi protamine insulin. Ndi kuphatikiza uku, insulini yochepa imayamba kugwira ntchito nthawi yomweyo, chifukwa insulin yosungunuka sikugwirizana ndi protamine. Pankhaniyi, opanga osakanikirana akhoza kukhala osiyana.
Zokhudza kukonzekera kwa zinc-insulin, kuyimitsidwa kwake sikungaphatikizidwe ndi insulin yochepa. Izi ndichifukwa choti kuyimitsidwa kwa makristasi a insulin-zinc kumaphatikizidwa ndi kuchuluka kwa ma zinc a ion ndipo amasinthidwa kukhala insulin ya nthawi yayitali.
Anthu ena odwala matenda ashuga amapanga jakisoni wongokhala pang'ono, pambuyo pake, osachotsa singano, jakisoni wa zinc insulin, malangizo a singano asinthidwe pang'ono. Komabe, madokotala amawona ngati jakisoniyu sanachite bwino, chifukwa insulin yochepa singatengeke bwino m'thupi, zomwe zimabweretsa zosokoneza.
Chifukwa chake, ndibwino kubaya insulini yochepa popanda kudziimira insulin.
Mankhwala amalumikizidwa mosiyanasiyana m'malo osiyanasiyana, khungu limayenera kukhala lotalika 1 cm.
Mankhwala osakanikirana
Lero pakugulitsa mutha kupeza mankhwala osakanikirana, omwe pamodzi amakhala ndi insulin yochepa komanso protamine-insulin malinga ndi mitundu yayikulu. Mankhwalawa akuphatikiza Insuman comb, Actrafan ndi Mikstard.
Ma insulin osakanikirana, momwe chiwerengelo cha mahomoni ofupikira ndi nthawi yayitali chimakhala 30 mpaka 70 kapena 25 mpaka 75, amatengedwa ngati mankhwala othandiza kwambiri. Chiwerengerochi chikuwoneka mu malangizo omwe aphatikizidwa a mankhwalawa.
Mankhwala osakanikirana ndi abwino kwa anthu omwe amayang'anitsitsa zakudya zawo, kusuntha mwachangu ndikuchita masewera olimbitsa thupi nthawi zonse.
Nthawi zambiri, mankhwalawa amasankhidwa ndi anthu okalamba omwe ali ndi matenda amtundu wa 2.
Mankhwalawa siabwino ngati munthu wodwala matenda ashuga amakonda kusinthasintha kwa insulin mankhwala ndipo amasintha mlingo wa insulin yochepa.
Kupereka odwala matenda ashuga ndi insulin
Lamulo lapadera la Federal Russian la Russian Federation ndi lomwe limayang'anira kupereka kwa nthawi yayitali komanso kokwanira kwa anthu odwala matenda ashuga ndi mahomoni a insulin. Chitetezo chalamulo chili ndi ufulu wonse wa odwala omwe apezeka ndi matenda osokoneza bongo komanso zomwe mabungwe azamaboma akuchita popereka ufuluwu ku Russia.
Malinga ndi Federal Law "Pa Social Aid", anthu aku Russia, komanso nzika zomwe zimakhala mdziko muno ndikukhala ndi chilolezo chokhala, zitha kulandira insulin kuchokera kuboma mwaulere. Kuphatikiza apo, anthu odwala matenda ashuga amapatsidwa magazi a shuga am'magazi, zinthu zina, ma insulin, mankhwala ochepetsa shuga ndi njira zothetsera matenda.
Odwala ambiri amachita chidwi ndi komwe angapeze insulini yaulere komanso zomwe zimafunika pa izi. Choyamba, muyenera kufunsa dokotala endocrinologist pamalo omwe akukhalako, dokotala ali ndi ufulu wopereka mankhwala kuti azilandira ngati mahomoni ali ndi chidwi.
Kuti mupeze mankhwala aulere, muyenera kupitiriza motere:
- Mankhwala a insulin yaulere amaperekedwa ndi dokotala wa endocrinologist panthawi yovomerezeka, atatha kuyesa ndi maphunziro onse ofunikira. Wodwala matenda a shuga ali ndi ufulu kulandira chikalata chachipatala kamodzi pamwezi, mlingo wake umatsimikiziridwa pamaziko azidziwitso zamankhwala.
- Dokotala palibe amene ali ndi ufulu wolemba mafomu opangira mankhwala kwa miyezi ingapo pasadakhale, ndipo chikalata cha kuchipatala sichiperekedwa kwa abale ake. Chifukwa chakuti wodwala matenda ashuga amafunikira kukaonana ndi dokotala mwezi uliwonse, kuwunikira nthawi zonse za matendawa ndi kuthandizira kwake kwamankhwala kumachitika. Pankhaniyi, endocrinologist, ngati pakufunika, angasinthe Mlingo wa insulin.
- Dokotala wa endocrinologist alibe ufulu wokana wodwala matenda ashuga kuti apereke fomu yolembetsera, zomwe zikusonyeza kuchepa kwa chuma pachipatala. Chowonadi ndi chakuti ndalama zonse zomwe zimaperekedwa popereka odwala ndi insulin yaulere sizimatengedwa ndi chipatala, koma ndi aboma kapena akuluakulu aboma. Zofunikira zonse zimaphatikizidwa ku bajeti ya boma.
Ngati simupereka insulin, mungadandaule kuti? Ngati muli ndi zovuta zotsutsana, ngati dokotala akukana kupereka mankhwala othandizira odwala matenda ashuga, muyenera kulumikizana ndi dotolo wamkulu wachipatala.
Ngati sizotheka kuthetsa vutoli, nthambi yanthawi Yachikulu ya Inshuwaransi Insurance Fund ndi mabungwe oyang'anira zamalamulo omwe ali ndi udindo wokwaniritsa ntchito zomwe zikugwirizana ndi odwala omwe ali ndi matenda ashuga atha kuthetsa vutoli.
Insulin imaperekedwa ku pharmacy, adilesi yomwe iyenera kufotokozeredwa ndi adokotala popereka fomu yolembetsa. Akalandira kukana kupereka mankhwala aulere, chitsimikizo cholembedwa chiyenera kupezedwa kuchokera kwa akatswiri azamankhwala, pambuyo pake alumikizane ndi oyang'anira a pharmacy.
Ngati mankhwala kulibe, wodwalayo ayenera kuperekedwa ndi insulin mwa masiku khumi otsatira. Ngati izi sizinachitike, mutha kutumiza madandaulo kwa olamulira akuluakulu. Kanemayo munkhaniyi akuwonetsa momwe mungapangire insulin.
