Zomwe insulin imapangidwa (kupanga, kupanga, kukonza, kaphatikizidwe)

Insulin ndi mankhwala ofunikira, yasintha miyoyo ya anthu ambiri omwe ali ndi matenda ashuga.

M'mbiri yonse ya zamankhwala ndi mankhwala azaka za 20, mwina gulu limodzi lokha lamankhwala lofunikanso lomwe lingathe kusiyanitsidwa - awa ndi maantibayotiki. Iwo, monga insulin, adalowa mankhwala mwachangu ndikuthandizira kupulumutsa miyoyo yambiri ya anthu.

Tsiku la Matenda a shuga limakumbukiridwa ndi zoyambitsidwa ndi World Health Organisation chaka chilichonse, kuyambira 1991 pa tsiku lobadwa la akatswiri azanyama ku Canada F. Bunting, yemwe adapeza insulini ya mahomoni ndi J.J. Macleod. Tiyeni tiwone momwe timadzi timeneti timapangidwira.

Kodi pali kusiyana kotani pakukonzekera insulin

1. Kuchuluka kwa kuyeretsa.
2. Zomwe zimalandila ndiku nkhumba, bovine, insulin ya anthu.
3. Zowonjezera zomwe zimaphatikizidwa ndi yankho la mankhwalawa ndizosunga, othandizira, ndi ena.
4. Kusintha
5. pH yankho.
6. Kutha kusakaniza mankhwala achidule komanso osakhalitsa.

Insulin ndi mahomoni omwe amapangidwa ndi maselo apadera mu kapamba. Ndi puloteni wokhala ndi mitundu iwiri, yomwe imaphatikizapo 51 amino acid.

Pafupifupi magawo 6 biliyoni a insulini amwedwa chaka chilichonse padziko lapansi (gawo limodzi ndi ma micil 42 a zinthu). Kupanga kwa insulini ndikwaphamwamba kwambiri ndipo kumachitika kokha kudzera mwa njira za mafakitale.

Magwero a insulin

Pakadali pano, kutengera gwero la zopangidwazo, nkhumba insulin ndi kukonzekera kwa insulin ya anthu ndizayokha.

Ma insulin a nkhumba tsopano ali ndi kuyeretsa kwambiri, ali ndi vuto labwino, ndipo palibenso zotsutsana nazo.

Kukonzekera kwa insulin kwaumunthu kumagwirizana kwathunthu pakupanga kwamankhwala ndi mahomoni amunthu. Nthawi zambiri zimapangidwa ndi biosynthesis pogwiritsa ntchito ma genetic engineering technology.

Makampani akuluakulu opanga amagwiritsa ntchito njira zopangira zomwe zimatsimikizira kuti malonda awo amakwaniritsa zonse zabwino. Palibe kusiyana kwakukulu machitidwe aumunthu ndi porcine monocomponent insulin (i.e., oyeretsedwa kwambiri) adapezeka; mokhudzana ndi chitetezo cha mthupi, malinga ndi maphunziro ambiri, kusiyana kwake ndi kochepa.

Zinthu zothandiza zomwe zimagwiritsidwa ntchito popanga insulin

Mu botolo lomwe muli mankhwala muli yankho lomwe silikhala ndi insulin ya mahomoni okha, komanso mankhwala ena. Aliyense wa iwo ali ndi gawo linalake:

• kuchuluka kwa mankhwala;
• kusazindikira njira;
• kukhalapo kwa buffer katundu wa yankho ndi kukhalabe wosalimba pH (acid-base balance).

Kukula kwa insulin

Kuti apange insulin yowonjezera, yomwe ndi imodzi mwa mankhwala awiri, zinc kapena protamine, imawonjezeredwa ku yankho la insulin yachilendo. Kutengera izi, ma insulin onse amatha kugawidwa m'magulu awiri:

• ma protamine insulin - protafan, insuman basal, NPH, humulin N;
• zinc-insulin - insulin-zinc-suspensions a mono-tard, tepi, humulin-zinc.

Protamine ndi mapuloteni, koma mayendedwe osokoneza monga mawonekedwe a ziwonetsero kwa iwo ndi osowa kwambiri.

Kuti apange gawo losagwirizana ndi yankho, yankho la phosphate limawonjezedwanso kwa ilo. Tiyenera kukumbukira kuti insulini yokhala ndi phosphates ndi yoletsedwa kuphatikiza insulin-zinc kuyimitsidwa (ICS), chifukwa zinc phosphate imayambira munthawi iyi, ndipo zochita za zinc-insulin zimafupikitsidwa m'njira yosadalirika.

Zida zophera tizilombo

Zina mwazomwe zimapangidwira, malinga ndi njira zamatenda ndi tekinoloje, ziyenera kuyambitsidwa pokonzekera, zimakhala ndi zotsukira matenda. Izi zimaphatikizapo cresol ndi phenol (onse aiwo ali ndi fungo linalake), komanso methyl parabenzoate (methyl paraben), momwe mulibe kununkhira.

Kukhazikitsidwa kwa zotetezazi kumatsimikizira fungo la insulin. Zosungirako zonse zomwe zimapezeka kuti zimapezeka mu insulin zilibe zolakwika.

Protamine insulins nthawi zambiri amaphatikizapo cresol kapena phenol. Phenol sangathe kuwonjezeredwa ku mayankho a ICS chifukwa amasintha mphamvu ya ma cell ma cell. Mankhwalawa akuphatikizapo methyl paraben. Komanso, ayoni a zinc amagwiritsa ntchito njira yotsatsira.

Chifukwa cha chitetezo chamtunduwu cha anti-bacterial ambiri, chitetezo chimagwiritsidwa ntchito popewa kukula kwa zovuta zomwe zingayambike chifukwa cha kuipitsidwa kwa bakiteriya pamene singano imayikidwa mobwerezabwereza mu vial yankho.

Chifukwa cha kukhalapo kwa njira yotchinjirizira, wodwalayo angagwiritse ntchito syringe yomweyo popanga jakisoni wa mankhwalawa kwa masiku 5 mpaka 7 (malinga ngati amangogwiritsa ntchito syringe). Kuphatikiza apo, mankhwala osungira amayesetsa kuti asamwe mowa pakhungu lisanalowe, koma pokhapokha ngati wodwalayo adzivulaza ndi syringe ndi singano yopyapyala.

Insulin Syringe Calibration

Pokonzekera insulin yoyamba, gawo limodzi lokha la mahomoni linali mu mlomo umodzi wa yankho. Pambuyo pake, kupsinjika kunawonjezeka. Zokonzekera zambiri za insulin m'mabotolo omwe amagwiritsidwa ntchito ku Russia zimakhala ndi magawo 40 mu 1 ml ya yankho. Mbale zambiri zimayikidwa chizindikiro cha U-40 kapena 40 mayunitsi / ml.

Ma syringes a insulin omwe amagwiritsidwa ntchito kufalikira amangopangidwira insulin yotere ndipo kuyerekeza kwawo kumachitika molingana ndi mfundo iyi: syringe ikadzazidwa ndi yankho la 0.5 ml, munthu amapeza magawo 20, 0,35 ml amagwirizana ndi magawo 10 ndi zina zotero.

Chizindikiro chilichonse pa syringe ndi chofanana ndi voliyumu inayake, ndipo wodwalayo amadziwa kale kuchuluka kwamagawo omwe ali mgawoli. Chifukwa chake, kuwerengera kwa ma syringes ndikumaliza kwa kuchuluka kwa mankhwalawa, kuwerengera pakugwiritsa ntchito insulin U-40. Magawo anayi a insulin ali mu 0,1 ml, 6 ma unit - mu 0,15 ml ya mankhwalawo, ndi zina zotero mpaka 40 magawo, omwe amafanana ndi 1 ml ya yankho.

Ma millor ena amagwiritsa ntchito insulin, 1 ml yomwe muli mayunitsi 100 (U-100). Mankhwala oterowo, ma syringe amtundu wapadera amapangidwa, omwe ali ofanana ndi omwe takambirana pamwambapa, koma amawayika mosiyanasiyana.

Ikutengera izi ndende iyi (ndiyokwera ka2,5 kuposa muyezo). Pankhaniyi, kuchuluka kwa insulin kwa wodwalayo, kumene kumakhalabe chimodzimodzi, chifukwa kumakwaniritsa kufunikira kwa thupi kwa kuchuluka kwa insulini.

Ndiye kuti, ngati kale wodwalayo adagwiritsa ntchito mankhwalawo U-40 ndikulipira magawo 40 a mahomoni patsiku, ndiye kuti alandilanso magawo 40 omwewo akaba jakisoni wa U-100, koma ayenera kuwapereka mankhwalawo nthawi zopitilira 2.5. Ndiye kuti, magawo 40 omwewo azikhala mu 0,4 ml ya yankho.

Tsoka ilo, si madokotala onse komanso makamaka odwala matenda a shuga omwe amadziwa izi. Mavuto oyamba adayamba pomwe ena mwa odwala adayamba kugwiritsa ntchito majakisoni a insulini (ma syringe pens) omwe amagwiritsa ntchito ma penfill (ma cartridge apadera) okhala ndi insulin U-40.

Ngati mudzaza syringe ndi yankho lolembedwapo U-100, mwachitsanzo, mpaka mpaka mayunitsi 20 (i.e. 0.5 ml), ndiye kuti bukuli lidzakhala ndi magawo 50 a mankhwalawo.

Nthawi iliyonse, ndikudzaza ma syringe ndi U-100 ndi ma syringe wamba ndikungoyang'ana pazidutswa zamayunitsi, munthu adzalandira mlingo wa 2,5 kuposa womwe wawonetsedwa pamlingo wa chizindikiro ichi. Ngati dokotala kapena wodwala sazindikira vuto ili, ndiye kuti mwayi wokhala ndi vuto lalikulu la hypoglycemia ndiwokwera chifukwa cha mankhwala osokoneza bongo omwe nthawi zambiri amachitika.

Kumbali ina, nthawi zina pamakhala ma insulin omwe amawongolera makamaka mankhwala a U-100. Ngati syringe yotere ikadzazidwa molakwika ndi njira yokhazikika ya U-40, ndiye kuti mlingo wa insulini mu syringe udzakhala wocheperako ndi 2,5 kuposa womwe walembedwa pafupi ndi chizindikiro chofananira pa syringe.

Zotsatira zake, kuwonjezereka kwamphamvu kwa glucose kumatha kuchitika koyamba. M'malo mwake, zonse, ndizomveka - pachidutswa chilichonse cha mankhwalawa ndikofunikira kugwiritsa ntchito syringe yoyenera.

M'mayiko ena, monga Switzerland, mapulani adaganiziridwa mosamalitsa, malinga ndi kusintha koyenera pokonzekera insulin ndi chisonyezo cha U-100 kunachitika. Koma izi zimafunikira kuyanjana kwambiri ndi onse omwe ali ndi chidwi: madokotala a akatswiri ambiri, odwala, anamwino ochokera m'madipatimenti aliwonse, akatswiri a zamankhwala, opanga, olamulira.

M'dziko lathu, ndizovuta kwambiri kusinthitsa odwala onse kuti azigwiritsa ntchito insulin U-100 kokha, chifukwa, mwakuthekera, izi zidzatsogolera kuchuluka kwa zolakwika posankha mtundu.

Kugwiritsa ntchito insulin yochepa komanso yayitali

Mankhwala amakono, chithandizo cha matenda ashuga, makamaka mtundu woyamba, nthawi zambiri chimachitika pogwiritsa ntchito mitundu iwiri ya insulin - yochepa komanso yayitali.

Zingakhale zosavuta kwa odwala ngati mankhwala omwe ali ndi mphamvu zosiyanasiyana atha kuphatikizidwa mu syringe imodzi ndikuperekedwa nthawi yomweyo kuti musavulaze khungu kawiri.

Madokotala ambiri sakudziwa chomwe chimapangitsa kuti athe kusakaniza ma insulin osiyanasiyana. Maziko a izi ndi mankhwala ndi galenic (yotsimikizika ndi kapangidwe kake) yoyanjanitsidwa kwautali ndi waufupi wakuchita insulin.

Ndikofunikira kwambiri kuti posakaniza mitundu iwiri ya mankhwala, kuyambitsa mwachangu insulin sikufupika kapena kutha.

Zatsimikiziridwa kuti mankhwala omwe amagwira ntchito mwachidule amatha kuphatikizidwa jekeseni m'modzi ndi protamine-insulin, pomwe kuyamba kwa insulin yocheperako sikuchepetsedwa, chifukwa insulle insulin siyimangiriza protamine.

Poterepa, wopanga mankhwalawa alibe ntchito. Mwachitsanzo, insulin actrapide ikhoza kuphatikizidwa ndi humulin H kapena protafan. Kuphatikiza apo, zosakaniza izi zimatha kusungidwa.

Ponena za kukonzekera kwa zinc-insulin, kwakhala kuti kwayamba kalekale kuti insulini-zinc-suspension (crystalline) singaphatikizidwe ndi insulin yochepa, chifukwa imamangilira ma ioni a zinc ndikusintha kukhala insulin yayitali, nthawi zina pang'ono.

Odwala ena amapereka mankhwala ochepetsa, ndiye, osachotsa singano pansi pa khungu, amasintha pang'ono pang'ono, ndipo zinc-insulin imabayidwa.

Malinga ndi kayendetsedwe ka kayendetsedwe kameneka, kafukufuku wina wasayansi wambiri wachitika, kotero sizingatheke kunena kuti nthawi zina ndi njira iyi ya jakisoni kuphatikizika kwa insulin-insulin ndi mankhwala omwe amangogwiritsa ntchito pakanthawi kochepa kumatha kupanga pansi pa khungu, komwe kumapangitsa kuti mayiyo asavutike.

Chifukwa chake, ndikwabwino kupaka insulin yotalikirana ndi zinc-insulin, pangani jekeseni awiriawiri m'malo a khungu omwe ali osachepera 1 cm kupatula wina ndi mnzake.

Wophatikiza insulin

Tsopano makampani opanga mankhwala amapanga kukonzekera komwe kumakhala ndi insulin yocheperako limodzi ndi protamine-insulin mwa kuchuluka kwamankhwala. Mankhwalawa akuphatikizapo:

• mixtard
• Actrafan
• insuman chip.

Zophatikiza zomwe ndizothandiza kwambiri ndizomwe kuchuluka kwa insulin kwa nthawi yayitali kuli 30:70 kapena 25:75. Kuwerengera kumeneku kumasonyezedwa nthawi zonse mu malangizo ogwiritsira ntchito mtundu uliwonse wa mankhwala.

Mankhwala oterewa ndi oyenera kwambiri kwa anthu omwe amatsatira kudya kosalekeza, olimbitsa thupi nthawi zonse. Mwachitsanzo, nthawi zambiri amagwiritsidwa ntchito ndi odwala okalamba omwe ali ndi matenda amtundu wa 2.

Ma insulin osakanikirana sakhala oyenera kukhazikitsidwa kwa mankhwala omwe amadziwika kuti "osinthika" a insulin, pakakhala koyenera kuti asinthe kawirikawiri mlingo wa insulin yochepa.

Mwachitsanzo, izi zikuyenera kuchitika pakusintha kuchuluka kwa chakudya chamagulu m'zakudya, kuchepetsa kapena kukulitsa zochitika zolimbitsa thupi, ndi zina zambiri. Pankhaniyi, mlingo wa basal insulin (womwe umakhala nthawi yayitali) sungasinthe.

Matenda a shuga ndi gawo lachitatu lofala kwambiri padziko lapansi. Amatsalira kumbuyo kokha kwamatenda amtima komanso matenda a oncology. Malinga ndi magwero osiyanasiyana, kuchuluka kwa odwala matenda ashuga padziko lapansi kumachokera pa anthu 120 mpaka 180 miliyoni (pafupifupi 3% ya onse okhala padziko lapansi). Malinga ndi kulosera kwina, kuchuluka kwa odwala kudzachulukanso kawiri pachaka 15 chilichonse.

Kuchita bwino mankhwala a insulin, ndikokwanira kukhala ndi mankhwala amodzi okha, insulin yochepa, ndi insulin imodzi yayitali, amaloledwa kuphatikiza. Komanso nthawi zina (makamaka kwa odwala okalamba) pakufunika mankhwala ophatikizira pamodzi.

Malangizo omwe apezeka pakadali pano ndi omwe angatsatire njira zosankhira insulin:

1. Chiyeretso chachikulu.
2. Kuthekera kosakanikirana ndi mitundu ina ya insulin.
3. Neutral pH
4. Kukonzekera kuchokera pagulu la insulin yowonjezera kuyenera kukhala ndi nthawi yayitali kuyambira maola 12 mpaka 18, kotero ndikokwanira kuwapatsa kawiri pa tsiku.