Kufunika kwa mapulogalamu a insulini kumachitika chifukwa cha matenda a shuga a mtundu woyamba kapena wachiwiri, pamene ntchito zolimbitsa thupi komanso zakudya zoyenera sizingapangitse matenda a shuga.
Musanagwiritse ntchito insulin Detemir ayenera kumvetsetsa momwe angayendetsere mahomoni moyenera, momwe iwo sangagwiritsidwe ntchito komanso mavuto omwe angayambitse.
Pharmacological zochita za chinthu
Detemir insulin imapangidwa pogwiritsa ntchito michere ya michere yotchedwa recombinant deoxyribonucleic acid (DNA) pogwiritsa ntchito mtundu wina wotchedwa Saccharomyces cerevisiae.
Insulin ndiye chinthu chachikulu cha mankhwala a Levemir flekspen, omwe amatulutsidwa monga njira yankho mu zolembera za 3 ml syringe (300 PIECES).
Ma analogue amtundu waumunthu amamangiririka ndi zotumphukira zomwe zimagwira mu cell ndipo zimapangitsa njira zachilengedwe.
Mndandanda wa insulin wa anthu umalimbikitsa kutsegulira kwa zotsatirazi mthupi:
- kukondoweza kwa glucose amatengedwa ndi zotumphukira maselo ndi minofu;
- shuga kagayidwe kachakudya;
- kuletsa kwa gluconeogeneis;
- kuchuluka kwa mapuloteni;
- kupewa lipolysis ndi proteinolysis mu mafuta maselo.
Chifukwa cha njirazi zonse, pali kuchepa kwa ndende yamagazi. Pambuyo pa jakisoni wa insulin, Detemir amayamba kuchita bwino kwambiri atatha maola 6-8.
Ngati mumalowetsa yankho kawiri patsiku, ndiye kuti insulini yofanana ndi insulin imatheka pambuyo pobayidwa kawiri kapena atatu. Kusintha kwamkati kwamkati mwa Detemir insulin kumakhala kotsika kwambiri poyerekeza ndi mankhwala ena a basal insulin.
Hormone iyi imakhudzanso zomwe zimagonana ndi amuna ndi akazi. Voliyumu yake yogawa pafupifupi ndi 0,1 l / kg.
Kutalika kwa theka la moyo wa insulin yovomerezeka pakhungu limatengera mlingo wa mankhwalawa ndipo pafupifupi maola 5-7.
Malangizo ogwiritsira ntchito mankhwalawa
Dokotala amawerengera kuchuluka kwa mankhwalawa, poganizira kuchuluka kwa shuga kwa odwala matenda ashuga.
Mlingo uyenera kusinthidwa ngati kuphwanya zakudya za wodwala, kuwonjezera zolimbitsa thupi kapena kuwoneka kwa ma pathologies ena. Insulin Detemir ikhoza kugwiritsidwa ntchito ngati mankhwala akuluakulu, kuphatikiza ndi bolus insulin kapena mankhwala ochepetsa shuga.
Jakisoni amatha kuchitika mkati mwa maola 24 nthawi iliyonse, chinthu chachikulu ndikutsata nthawi yomweyo tsiku lililonse. Malamulo oyambira kuperekera mahomoni:
- Jakisoni amapangidwa pansi pa khungu kulowa m'mimba, mapewa, matako kapena ntchafu.
- Pofuna kuchepetsa kuthekera kwa lipodystrophy (matenda am'mafuta am'magazi), malo a jekeseni ayenera kusinthidwa pafupipafupi.
- Anthu opitilira zaka zopitilira 60 ndipo odwala omwe ali ndi vuto la impso kapena chiwindi amafunika kuyang'anitsitsa shuga ndi kusinthanso kwa insulin.
- Mukasamutsidwa kuchokera ku mankhwala ena kapena koyambirira kwa mankhwalawa, ndikofunikira kuyang'anitsitsa kuchuluka kwa glycemia.
Tisaiwale kuti mankhwalawa a insulin Detemir samatengera kuwonjezeka kwa wodwala. Asanapite maulendo ataliatali, wodwalayo ayenera kufunsa katswiri wothandizirana ndi mankhwalawa chifukwa chogwiritsa ntchito mankhwalawa.
Kuchepetsa kwakanema kwa zamankhwala kumatha kubweretsa mkhalidwe wa hyperglycemia - kuchuluka kwambiri kwa shuga, kapena ngakhale matenda ashuga a ketoacidosis - kuphwanya kwa kagayidwe kazakudya chifukwa chosowa insulin. Ngati dokotala sakulumikizidwa mwachangu, zotsatira zake zingachitike.
Hypoglycemia imapangidwa pamene thupi limatha kapena silikhuta mokwanira ndi chakudya, ndipo mlingo wa insulin, nawonso umakhala wokwera kwambiri. Kuti muwonjezere kuchuluka kwa shuga m'magazi, muyenera kudya chidutswa cha shuga, kapu ya chokoleti, china chokoma.
kutentha thupi kapena matenda osiyanasiyana nthawi zambiri kumakulitsa kufunikira kwa mahomoni. Kusintha kwa mlingo wa yankho kungakhale kofunikira pakukula kwa matenda a impso, chiwindi, chithokomiro, tiziwalo timene timatulutsa tiziwalo timene timatulutsa.
Mukamaphatikiza insulin ndi thiazolidatediones, ndikofunikira kuganizira kuti akhoza kuthandiza kukulitsa matenda a mtima ndi kulephera kosalekeza.
Mukamagwiritsa ntchito mankhwalawa, kusintha kwa ndende ndi psychomotor kumatha.
Contraindication ndi zotheka kuvulaza
Mwakutero, contraindication yogwiritsira ntchito insulin Detemir siyipezeka. Zolepheretsa zimangokhudza zovuta za munthu payekha komanso zaka ziwiri chifukwa chakuti kafukufuku wazokhudza ana a insulin sanachitepo kanthu.
Munthawi ya bere, mankhwalawa angagwiritsidwe ntchito, koma moyang'aniridwa ndi dokotala.
Kafukufuku wambiri sanawonetse mavuto kwa mayi ndi mwana wake wakhanda pobweretsa jakisoni wa insulin panthawi yomwe anali ndi bere.
Amakhulupirira kuti mankhwalawa amatha kugwiritsidwa ntchito poyamwitsa, koma palibe maphunziro omwe adachitika. Chifukwa chake, kwa amayi omwe ali ndi pakati komanso kuyamwitsa, adokotala amasintha muyeso wa insulin, kulemera pamaso pake phindu la mayi ndi chiwopsezo cha mwana wawo.
Zokhudza momwe thupi limakhudzira, malangizo omwe angagwiritsidwe ntchito ali ndi mndandanda woyenera:
- Mkhalidwe wa hypoglycemia wodziwika ndi zizindikiro monga kugona, kukwiya, kutsekeka kwa khungu, kunjenjemera, kupweteka mutu, chisokonezo, kukwiya, kukomoka, tachycardia. Vutoli limatchulidwanso kuti insulin.
- Hypersensitivity yapafupi - kutupa ndi kufupika kwa jekeseni, kuyabwa, komanso mawonekedwe a lipid dystrophy.
- Thupi lawo siligwirizana, angioedema, urticaria, zotupa pakhungu ndi thukuta kwambiri.
- Kuphwanya kwam'mimba thirakiti - nseru, kusanza, kupweteka m'mimba, kutsegula m'mimba.
- Kufupika, kunachepetsa kuthamanga kwa magazi.
- Zowonongeka - kusintha kwa kukonzanso komwe kumatsogolera ku retinopathy (kutupa kwa retina).
- Kukula kwa zotumphukira neuropathy.
Mankhwala osokoneza bongo amachititsa kuti shuga ayambe kugwa mofulumira. Ndi hypoglycemia wofatsa, munthu ayenera kudya mankhwala omwe amakhala ndi chakudya chamagulu ambiri.
Wodwalayo akavulala kwambiri, makamaka ngati sakudziwa, kufunikira kuchipatala mwachangu ndikofunikira. Dokotala amapaka jakisoni wa shuga kapena glucagon pansi pa khungu kapena pansi pa minofu.
Wodwalayo akachira, amapatsidwa shuga kapena chokoleti kuti aletse shuga.
Kuchita ndi njira zina
Mukamapangira mankhwala ovuta chifukwa chogwiritsa ntchito mankhwala angapo, ntchito za insulin zimatha kuchepa ndikukula.
Pali mndandanda wamankhwala omwe angakhudze kufunika kwa thupi la munthu mu hormone yotsitsa shuga.
Kuwonetsedwa kwa insulin kumatha kuchepetsedwa ndi:
- glucocorticosteroids;
- mahomoni okhala ndi chithokomiro;
- njira zakulera zogwiritsira ntchito pakamwa;
- thiazide okodzetsa;
- ma tridclic antidepressants;
- somatropin, heparin ndi sympathomimetics;
- odana ndi calcium;
- clonidine, diazoxide ndi phenytoin;
- morphine, danazole ndi chikonga.
Kulimbitsa kutsitsa kwa shuga kwa insulin kumachitika mukamudya:
- ATP zoletsa;
- Mao zoletsa;
- hypoglycemic mankhwala opaka pakamwa;
- kaboni anhydrase zoletsa;
- anabolic steroids, bromocriptine;
- sulfonamides, tetracyclines, ketoconazole;
- clofibrate, mebendazole, theophylline, pyridoxine;
- osasankha beta-blockers;
- mankhwala a lithiamu, fenfluramine;
- zakumwa zoledzeretsa ndikukonzekera ndi ethanol.
Ma salicylates, reserpins, lanreotides ndi octreotides amatha kukhala ndi zotsatira zosiyanasiyana pakufunika kwa mahomoni, kumawonjezera kapena kuchepa. Kugwiritsa ntchito kwa beta-blockers kumapangitsa kuzindikira kwa hypoglycemia. Insulin sayenera kumwa ndi mankhwala, kuphatikizapo thiols kapena sulfites, chifukwa amawononga kapangidwe kake.
Hormoni singagwiritsidwenso ntchito ndi kulowetsedwa njira.
Mtengo, ndemanga, njira zofananira
Mankhwala a Levemir flekspen, omwe amagwira ntchito omwe ndi Detemir insulin, amagulitsidwa m'malo ogulitsa mankhwala osokoneza bongo ndi malo ogulitsa pa intaneti.
Mutha kugula mankhwalawa pokhapokha ngati mwalandira dokotala.
Mankhwalawa ndiokwera mtengo kwambiri, mtengo wake umasiyana kuchokera ku 2560 mpaka 2900 rubles aku Russia. Pankhaniyi, si wodwala aliyense amene angakwanitse.
Komabe, ndemanga za Detemir insulin ndizabwino. Anthu ambiri odwala matenda ashuga omwe adalawa ndi mahanoid mahomoni adziwa izi:
- kutsika kwapang'onopang'ono kwa shuga m'magazi;
- kukhalabe ndi mankhwalawa kwa pafupifupi tsiku limodzi;
- kugwiritsa ntchito bwino zolembera;
- kawirikawiri zimachitika zovuta;
- kukhalabe ndi kulemera kwa odwala matenda ashuga chimodzimodzi.
Kukwaniritsa shuga wabwinobwino kumatheka pokhapokha kutsatira malamulo onse a mankhwala a shuga. Uku sikuti ndi jakisoni wa insulini kokha, komanso masewera olimbitsa thupi, zovuta zina zokhudzana ndi zakudya komanso kudziletsa pakukhazikika kwa magazi. Kuthana ndi ma dosages olondola ndikofunikira kwambiri, popeza kuyambika kwa hypoglycemia, komanso zotsatirapo zake zovuta, siziyikidwa pambali.
Ngati mankhwalawa pazifukwa zina sizigwirizana ndi wodwalayo, dokotala amatha kukupatsirani mankhwala ena. Mwachitsanzo, insulin Isofan, yomwe ndi analogue ya mahomoni amunthu, omwe amapangidwa ndi mainjiniine. Isofan imagwiritsidwa ntchito osati mtundu wachiwiri ndi mtundu wachiwiri wa matenda ashuga, komanso mawonekedwe ake (mwa azimayi apakati), pathways yothandizirana, komanso njira zopangira opaleshoni.
Kutalika kwa nthawi yake ndizochepa kwambiri kuposa Detemir insulin, komabe, Isofan ilinso ndi hypoglycemic kwambiri. Ili ndi zovuta ngati zomwezi, mankhwala ena amatha kuthana ndi mphamvu yake. Gawo la Isofan limapezeka m'mankhwala ambiri, mwachitsanzo, Humulin, Rinsulin, Pensulin, Gansulin N, Biosulin N, Insuran, Protafan ndi ena.
Pogwiritsa ntchito bwino insulin Detemir, mutha kuchotsa zizindikilo za matenda ashuga. Zofananira zake, kukonzekera komwe kuli ndi insulin Isofan, kudzakuthandizani pamene kugwiritsa ntchito mankhwalawo ndikoletsedwa. Momwe imagwirira ntchito komanso chifukwa chake mukufuna insulini - mu kanema munkhaniyi.
