Chithandizo cha matenda a shuga chimachitika pogwiritsa ntchito mankhwala omwe, pakakhala kuti apanga mahomoni awoawo (insulin), amatha kutsika magazi kwambiri komanso kupewa mavuto a matendawa.
Mankhwala onse amatha kugawidwa m'magulu awiri akuluakulu: ma insulini osiyanasiyana olimbitsa thupi ndi mankhwala oikidwa patebulo. Mtundu woyamba wa matenda ashuga, odwala amafunikira insulin, chithandizo cha odwala omwe ali ndi matenda a shuga 2 chimaphatikizira kuphatikizidwa kwa mankhwalawa pamaso pa anthu omwe akuwonetsa.
Kuchita mankhwala a insulin kumayambiranso mtundu wachilengedwe wopanga ndikumasulidwa kwa timadzi tating'onoting'ono ta zikondamoyo, motero, mankhwala omwe ali ndi yochepa, yapakati komanso yayitali amachita.
Kodi insulini yokhala ndi protamine imagwira ntchito bwanji?
Chinthu chapadera chomwe chimatchedwa protamine chimawonjezeredwa ndi ma insulin omwe amagwiritsa ntchito pakati kuti achepetse kuyamwa kwa mankhwalawo pamalo a jekeseni. Chifukwa cha protamine, kuyamba kwa kuchepa kwa shuga m'magazi kumayambira maola awiri kapena anayi pambuyo pa kuperekedwa.
Kuchuluka kwake kumachitika pambuyo pa maola 4-9, ndipo nthawi yonseyi imachokera ku maola 10 mpaka 16. Magawo oterowo mwa kuchuluka kwa kuyambika kwa hypoglycemic amapangitsa kuti ma insulin m'malo mwatsopano azikhala pobisalira mwachilengedwe.
Protamine imayambitsa mapangidwe a makulidwe amtundu wa insulin mwanjira ya ma flakes, kotero mawonekedwe a protamine insulin ndi amtambo, ndipo kukonzekera konse kwa insulin kumakhala kowonekera. Kapangidwe ka mankhwalawa kumaphatikizanso zinc chloride, sodium phosphate, phenol (yosungirako) ndi glycerin. Mililita imodzi ya kuyimitsidwa kwa protamine-zinc-insulin ili ndi ma PISCES a 40.
Kukonzekera kwa protamine insulin kopangidwa ndi RUE Belmedpreparaty kuli ndi dzina la malonda Protamine-Insulin ChS. The limagwirira ntchito ya mankhwala akufotokozera ndi izi:
- Kuchita ndi receptor pa nembanemba.
- Mapangidwe a insulin receptor zovuta.
- M'maselo a chiwindi, minofu ndi adipose minofu, kaphatikizidwe ka michere imayamba.
- Kuwala kumalumikizidwa ndikugwidwa ndi minofu.
- Intracellular glucose transport imathandizira.
- Mapangidwe a mafuta, mapuloteni ndi glycogen amakondweretsedwa.
- Mu chiwindi, mapangidwe a mamolekyulu atsopano a shuga amachepetsa.
Njira zonsezi zimapangidwa kuti muchepetse kuchuluka kwa shuga m'magazi ndikugwiritsa ntchito kuti ipange mphamvu mkati mwa selo. Mlingo wa kuyambira ndi kutalika kwa zochita za Protamine insulin ESD zimatengera mlingo, njira ndi malo a jakisoni.
Mwa munthu yemweyo, magawo awa amatha kusiyana pamasiku osiyanasiyana.
Zisonyezero zogwiritsidwa ntchito ndi mlingo wa mankhwalawa
Kukonzekera kwa Protamine-zinc-insulin kumawonetsedwa kwa odwala omwe ali ndi mtundu woyamba wa matenda a shuga, ndipo amathanso kulimbikitsidwa kuti azikhala ndi shuga wambiri mumtundu wachiwiri wa matenda.
Izi zimatha kukhala kukana kwa mapiritsi ochepetsa shuga a magazi, ndi kuwonjezera kwa matenda opatsirana kapena matenda ena aliwonse, komanso panthawi yapakati. Odwala omwe ali ndi mtundu wachiwiri wa matenda osokoneza bongo amathandizidwanso kukalandira mankhwala a insulin ngati matenda a shuga akuphatikizidwa ndi zovuta kapena kuvulala kwamitsempha.
Mankhwala osokoneza bongo monga protamine-zinc-insulin amawonetsedwa ngati kuchitidwa opaleshoni ndikofunikira ngati matenda a shuga apezeka koyamba ndipo manambala a glycemic ndi okwera kwambiri kapena ngati pali mapiritsi.
ES protamine-insulin imayang'aniridwa pang'onopang'ono, mlingo wake umadalira zizindikiro za hyperglycemia ndipo amawerengedwa pafupifupi pa kilogalamu imodzi yakulemera kwa thupi. Kuwongolera tsiku ndi tsiku kumayambira ku 0,5 mpaka 1 unit.
Mawonekedwe a mankhwala:
- Imayendetsedwa yokha pokhapokha. Mtsempha wa magazi kuyimitsidwa kwa insulin ndi oletsedwa.
- Botolo lotsekedwa limasungidwa mufiriji, ndikugwiritsa ntchito kutentha mpaka madigiri 25 kwa milungu isanu ndi umodzi.
- Sungani insulin vial yomwe imagwiritsidwa ntchito kutentha kutentha kwa mpaka 25 ° C kwa milungu 6.
- Kutentha kwa insulin ndi kuyambitsa kuyenera kukhala kutentha kwa chipinda.
- Mothandizidwa ndi kutentha, dzuwa mwachindunji, kuzizira, insulin imataya katundu.
- Asanapereke protamine, insulini ya zinc iyenera kuzikoloweka m'miyendo mpaka yosalala ndi mitambo. Ngati izi sizingachitike, ndiye kuti mankhwalawo sanaperekedwe.
Tsamba la jakisoni limatha kusankhidwa kutengera chikhumbo cha wodwalayo, koma ziyenera kukumbukiridwa kuti imatengedwa mwachilungamo komanso pang'onopang'ono kuyambira ntchafu. Malo achiwiri omwe ali pabwino ndi dera lamapewa (minyewa). Nthawi iliyonse mukasankha malo atsopano mkati mwake momwe mungafune kuti musawonongeke.
Ngati wodwala watchulidwa kuti ayendetse machitidwe a insulin, ndiye kuti protocol zinc insulin imachitika m'mawa kapena madzulo, ndipo akaperekedwa, kawiri (m'mawa ndi madzulo). Asanadye, pali mtundu wina wa insulin womwe umagwiritsidwa ntchito.
Mtundu wachiwiri wa matenda ashuga, nthawi zambiri Protamine-insulin ES imalembedwa limodzi ndi mankhwala a glypoglycemic, omwe amaperekedwa pakamwa pakulimbikitsa, kuti athandizidwe.
Mavuto a Insulin
Vuto lalikulu kwambiri la insulin mankhwala ndi kuchepa kwamagazi a shuga m'magazi wamba. Izi zimathandizidwa ndi kuperewera kwa zakudya m'thupi ndi chakudya chochepa kwambiri komanso inshuwaransi yayikulu, kudumpha chakudya, kupsinjika kwa thupi, kusintha malo a jekeseni.
Hypoglycemia imayamba chifukwa cha matenda omwe amakhalapo, makamaka omwe ali ndi kutentha kwambiri, kutsegula m'mimba, kusanza, komanso kugwiritsa ntchito mankhwala othandizira omwe amapangitsa insulini.
Kuyambika kwadzidzidzi kwa zizindikiro za hypoglycemia kumachitika mwachithandizo cha insulin. Nthawi zambiri, odwala amakhala ndi nkhawa, chizungulire, thukuta lozizira, manja akunjenjemera, kufooka kwachilendo, kupweteka mutu ndi palpitations.
Khungu limakhala lofiirira, njala imachulukana nthawi yomweyo mseru ukayamba. Kenako chikumbumtima chimasokonezeka ndipo wodwala amagwa. Kuchepetsa kwa shuga m'magazi kumasokoneza bongo ndipo ngati sanapatsidwe, odwala ali pachiwopsezo cha kufa.
Ngati wodwala yemwe ali ndi matenda ashuga akudziwa, ndiye kuti mutha kuchepetsa nkhawa pogwiritsa ntchito shuga kapena msuzi wokoma, makeke. Ndi Hypoglycemia wambiri, njira yokhazikika ya glucose ndi glucagon ya intramus imathandizira kudzera m'mitsempha. Pambuyo pakuchita bwino, wodwalayo ayenera kudya kwambiri kuti asadzachitidwenso mobwerezabwereza.
Kusankhidwa kwa mlingo wosayenera kapena makonzedwe osoweka angayambitse kuukira kwa hyperglycemia mwa odwala omwe amadalira insulin. Zizindikiro zake zimachulukana pang'onopang'ono, chodziwika kwambiri ndi mawonekedwe ake patatha maola ochepa, nthawi zina mpaka masiku awiri. Ludzu limawonjezeka, kutuluka kwa mkodzo kumawonjezeka, kulakalaka kumachepa.
Ndipo pali mseru, kusanza, fungo la acetone kuchokera mkamwa. Popanda insulini, wodwalayo amagwera wodwala matenda ashuga. Chisamaliro chodzidzimutsa cha odwala matenda ashuga ndi gulu la ambulansi amafunika.
Kuti musankhe mlingo woyenera wa mankhwalawa, ndikofunikira kukumbukira kuti pamene wodwala kapena matenda ena asintha, kusintha kwa chithandizo kumafunika. Amawonetsedwa muzochitika zotere:
- Mavuto a chithokomiro.
- Matenda a chiwindi kapena impso, makamaka ukalamba.
- Matenda opatsirana ndi ma virus.
- Kuchulukitsa zolimbitsa thupi.
- Kusinthana ndi chakudya china.
- Kusintha kwa mtundu wa insulin, wopanga, kusintha kuchokera ku nyama kupita ku munthu.
Kugwiritsa ntchito inulin ndi mankhwala ochokera ku gulu la thiazolidinediones (Aktos, Avandia) kumawonjezera chiopsezo cha mtima. Chifukwa chake, odwala omwe ali ndi vuto la mtima amalimbikitsidwa kuti azisamalira thupi kuti azindikire edema.
Thupi lawo siligwirizana limatha kukhala lamderalo m'njira yotupa, redness, kapena pakhungu pakhungu. Nthawi zambiri zimakhala zazifupi ndipo zimangoyendera zokha. Mawonetseredwe ofala a ziwengo zimayambitsa zizindikiro zotere: kuzungulira thupi, nseru, angioedema, tachycardia, kufupika kwa mpweya. Zikachitika, chithandizo chapadera chimachitika.
Protamine-insulin yodzidzimutsa imayesedwa ngati munthu ali ndi hypersensitivity ndi hypoglycemia.
Insulin Protamine pa mimba ndi mkaka wa m`mawere
Popeza insulin siyidutsa placenta, nthawi ya pakati imatha kugwiritsidwa ntchito kulipiritsa matenda a shuga. Mukakonzekera kutenga pakati, kuwunika kwathunthu kwa amayi omwe ali ndi matenda a shuga akuwonetsedwa.
Woyamba trimester akutsutsana ndi maziko a kuchepa kwa kufunika kwa insulin, ndipo chachiwiri ndi chachitatu ndi kuwonjezeka pang'onopang'ono kwa mankhwala omwe amaperekedwa. pambuyo pobadwa, insulin mankhwala ikuchitika mwachizolowezi Mlingo. Panthawi yobereka, kuchepa kwakukulu kwa mlingo wa mankhwalawa omwe angagwiritsidwe ntchito kumachitika.
Kuchepetsa ndi kuyang'anira insulin kuphatikizidwa, chifukwa insulin imalowa mkaka wa m'mawere. Koma kusintha kwa mayeso amakono a amayi kumafunikira gawo lina la glycemia komanso kusankha kwa mankhwala oyenera.
Kuchita kwa insulin ndi mankhwala ena
Kuchita kwa insulin kumalimbikitsidwa mukagwiritsidwa ntchito limodzi ndi mapiritsi ochepetsa shuga, beta-blockers, sulfonamides, tetracycline, kukonzekera kwa lithiamu, vitamini B6.
Bromocriptine, anabolic steroids. Hypoglycemia imatha kuphatikizana ndi insulin ndi ketokenazole, clofibrate, mebendazole, cyclophosphamide, ndi mowa wa ethyl.
Odwala ali ndi chidwi ndi funso la momwe angachepetse insulin m'magazi. Nicotine, morphine, clonidine, danazole, mapiritsi oletsa kubereka, heparin, thiazide okodzetsa, glucocorticosteroids, antidepressants, mahomoni a chithokomiro, sympathomimetics ndi calcium antagonists amatha kuchepetsa insulin.
Kanema yemwe ali munkhaniyi amafotokoza nthawi yomwe insulin ingafunikire komanso momwe mungabayire.
