Matenda a shuga ndi matenda ofala omwe amafuna chithandizo cha moyo wonse. Chifukwa chake, mu mtundu woyamba wa matenda komanso muzochitika zapamwamba ndi mtundu wachiwiri wa matenda, odwala amafunikira insulin mosalekeza, yomwe imathandizira kusintha shuga, posinthira mwachangu kukhala mphamvu.
Nthawi zambiri ndi shuga, insulin Aspart imagwiritsidwa ntchito. Ichi ndi mankhwala a ultrashort.
Chidacho ndi analogue of insulin ya anthu, yomwe imapangidwa ndi tekinoloje ya DNA yogwiritsidwanso ntchito ngati gawo la Saccharomyces cerevisiae, pomwe proline pamalo a B28 (amino acid) amasinthidwa ndi aspartic acid. Kulemera kwa maselo ndi 5825.8.
The zikuchokera, kumasulidwa mawonekedwe ndi pharmacological kwenikweni
Biphasic insulin imaphatikiza Aspart yosungunuka ndi crystalline insulin protamine muyezo wa 30 mpaka 70%.
Uku ndi kuyimitsidwa kwa kachitidwe ka sc, kokhala ndi khungu loyera. Mililita imodzi imakhala ndi mayunitsi 100, ndipo ED imodzi imafanana ndi 35 μg ya insulin Aspart.
Mafuta a insulin omwe amapanga munthu amapanga insulin receptor zovuta ndi cell ya cell ya pattoplasmic cell membrane. Otsatirawa adayambitsa kaphatikizidwe ka glycogen synthetase, pyruvate kinase ndi hexokinase michere.
Kuchepa kwa shuga kumachitika ndikuwonjezereka kwa mayendedwe amkati komanso kusintha kwa minofu. Hypoglycemia imathandizanso pakuchepetsa nthawi yotulutsa shuga ndi chiwindi, glycogenogeneis ndi kutsegula kwa lipogenesis.
Biphasic insulin aspart imapezeka kudzera mu kubwezeretsa kwa biotechnological pamene molekyulu ya proline ya mahomoni imaloŵedwa m'malo ndi aspartic acid. Ma insulin a biphasic oterowo amakhala ndi vuto lofanananso ndi glycosylated hemoglobin, monga insulin yaumunthu.
Mankhwala onse awiriwa amagwira ntchito molingana molar. Komabe, Aspart insulin imagwira ntchito mwachangu kuposa mahomoni amtundu wa anthu. Ndipo crystalline Aspart protamine imakhudzanso nthawi yayitali.
Zochita pambuyo sc makonzedwe a mankhwala zimatheka pambuyo 15 Mphindi. Kuphatikiza kwakukulu kwa mankhwalawa kumachitika patatha maola 1-4 jekeseni. Kutalika kwa vutoli mpaka maola 24.
Mu seramu, Cmax ya insulin ndi 50% kuposa pamene mugwiritsa ntchito insulin ya biphasic. Komanso, nthawi yayitali kuti afike ku Cmax ndi ochepera theka.
T1 / 2 - mpaka maola 9, zimawonetsa kuyamwa kwa kachigawo kakumapeto ka protamine. Msuzi insulin amawona pambuyo 15-18 mawola.
Koma ndi matenda a shuga a mtundu 2, kupezeka kwa Cmax ndi pafupifupi mphindi 95. Imakhala pamalo ochepera 14 komanso pamwamba 0 pambuyo pa sc. Kaya dera loyang'anira likukhudza malo omwe kunyamulidwa sikunaphunzire.
Mlingo ndi makonzedwe
Nthawi zambiri insulin Degludek, Aspart-insulin imayang'aniridwa pang'onopang'ono. Jakisoni amapangidwa mbali zina za thupi:
- matako;
- Belly
- ntchafu
- phewa.
Muyenera kuchita jakisoni wa insulin musanadye (njira yotsimikizika) kapena mutatha kudya (njira ya postprandial).
Algorithm ndi kuchuluka kwa makonzedwe amatsimikiziridwa ndi dokotala. Koma nthawi zambiri kuchuluka kwa mankhwalawa tsiku lililonse ndi 0,5-1 UNITS pa 1 kg yolemera.
Woopsa, insulin Aspart biphasic imayendetsedwa iv. Ndondomeko ikuchitika pogwiritsa ntchito kulowetsedwa machitidwe mu outpatient kapena inpatient.
Zosiyanasiyana zochita, contraindication ndi bongo
Kugwiritsa ntchito insulin Asparta kungasokoneze ntchito ya Nyumba Yamalamulo, popeza kusintha kwachulukidwe ka magawo a shuga nthawi zina kumayambitsa kupweteka kwam'mimba. Komabe, izi zimadutsa nthawi.
Komanso, insulin ya biphasic imatsogolera pakuwoneka kwa lipodystrophy mu gawo la jekeseni. Pa mbali ya ziwalo zam'maganizo, kuwonongeka kwa mawonekedwe ndi zolakwika pakuzindikiritsa zimadziwika.
Contraindication ndi tsankho limodzi pazigawo za mankhwala ndi hypoglycemia.
Kuphatikiza apo, kugwiritsidwa ntchito kwa Insulin Aspart sikuli koyenera kufikira zaka 18. Popeza palibe deta yamankhwala yovomerezeka yothandiza ndi chitetezo cha mankhwalawa m'thupi lomwe limatuluka.
Ngati mankhwala osokoneza bongo, zizindikiro zotsatirazi zimachitika:
- kukokana
- kutsika kwamphamvu kwa shuga;
- hypoglycemic chikomokere mu shuga.
Kuchepetsa pang'ono kwa mankhwalawo, kuti magazi azikhala ndi glucose, ndikwanira kudya chakudya cham'madzi mwachangu kapena kumwa zakumwa zotsekemera. Mutha kulowa glucagon subcutaneously kapena intramuscularly kapena yankho la dextrose (iv).
Pankhani ya kukomoka kwa hypoglycemic, kuchokera pa 20 mpaka 100 ml ya dextrose (40%) jekeseni ndi njira yolowera mkati mpaka mawonekedwe a wodwalayo atasintha. Pofuna kupewa kukula kwa zochitika zoterezi, kudya pakamwa.
Kuchita ndi mankhwala ena ndi malangizo apadera
Hypoglycemic effect ikhoza kupititsidwa patsogolo ngati makonzedwe a biphasic insulin akaphatikizidwa ndi kukonzekera kwa pakamwa mankhwala otsatirawa:
- mankhwala okhala ndi zakumwa zoledzeretsa ndi hypoglycemic;
- Mao / carbonic anhydrase / ACE zoletsa;
- Fenfluramine;
- Bromocriptine;
- Cyclophosphamide;
- somatostatin analogues;
- Theophylline;
- Sulfonamides;
- Pyridoxine;
- Ma -abolic mankhwala.
Kugwiritsa ntchito ma tetracyclines, Mebendazole, Disopyramide, Ketonazole, Fluoxetine ndi Fibates kumathandizanso kuchepetsa shuga. Ndipo ma tridclic antidepressants, mankhwala opatsirana pakamwa, nikotini, sympathomimetics, glucocorticosteroids, thiazide diuretics, mahomoni a chithokomiro komanso mankhwala ena amathandizira kufooketsa mphamvu ya hypoglycemic.
Mankhwala ena amatha kuchulukitsa komanso kuchepetsa shuga. Izi zimaphatikizapo kukonzekera kwa lithiamu, beta-blockers, salicylates, clonidine ndi reserpine.
Ndikofunika kudziwa kuti Flekspen yogwiritsidwa ntchito iyenera kusungidwa kutentha, ndi cholembera chatsopano mu firiji. Pamaso pa makonzedwe, zomwe zili mu vial ndizofunikira kusakaniza bwino.
Ndi kuchuluka kwa masewera olimbitsa thupi, matenda otupa kapena opatsirana, kuwonjezereka kwa mlingo wa insulin ndikofunikira. Ndipo kumayambiriro kwa zamankhwala, sizikulimbikitsidwa kuti muzilamulira machitidwe ndi magalimoto ovuta. Kanemayo munkhaniyi atchulanso za mahomoni.
