Mpaka pano, makampani opanga ma pharmacological amapanga mitundu yambiri ya insulin yokonzekera odwala matenda ashuga, omwe adapangira jakisoni. Mankhwalawa osiyanasiyana amatha kukhala ndi mayina osiyanasiyana, mtundu wake komanso mtengo wake. Chimodzi mwa izo ndi Humalog insulin.
Mankhwala
Humalog insulin ndi ma DNA omwe amafunikanso kuchuluka kwa ma cell a thupi la munthu. Kusiyana pakati pa Humalog ndi insulin yachilengedwe ndi njira yotsutsana ya amino acid pamalo a 29 ndi 28 a insulin B. Zotsatira zazikulu zomwe ali nazo ndi kuyendetsa kwa kagayidwe kazakudya
Humalog ilinso ndi anabolic. M'maselo am'misempha, kuchuluka kwa mafuta acids, glycogen ndi glycerol kumawonjezera, kupanga mapuloteni kumawonjezeka, kuchuluka kwa ma amino acid kumawonjezeka, koma mphamvu ya glycogenolysis, gluconeogeneis, ndi kutulutsidwa kwa ma amino acid kumatsika.
Mthupi la odwala omwe ali ndi matenda ashuga a mitundu yonse iwiri chifukwa chogwiritsidwa ntchito ndi Humalog, zovuta za hyperglycemia zomwe zimawonekera pambuyo chakudya zimachepetsedwa kwakukulu pokhudzana ndi kugwiritsidwa ntchito kwa insulin yaumunthu.
Kwa odwala omwe amalandira mtundu wa insulin nthawi imodzi ndi kanthawi kochepa, muyenera kusankha mlingo wa mitundu yonse ya insulin kuti mukwaniritse zomwe zili ndi shuga tsiku lonse.
Momwemonso kukonzekera kwina kwa insulin, kutalika kwa zotsatira za mankhwala a Humalog kumasiyana mwa odwala osiyanasiyana kapena nthawi zosiyanasiyana wodwala m'modzi. Pharmacodynamics ya Humalog mu ana imagwirizanitsa ndi pharmacodynamics ake akuluakulu.
Odwala omwe ali ndi matenda a shuga a 2 ndipo amatenga mankhwala a sulfonylurea mu milingo yayikulu, kugwiritsa ntchito Humalog kumapangitsa kugwa kwa hemoglobin. Humalog akamagwiritsa ntchito mitundu yonse iwiri ya matenda ashuga, pamakhala kuchepa kwa chiwerengero cha zochitika za hypoglycemic usiku.
Machitidwe a glucodynamic ku Humalog samalumikizidwa ndi kuperewera kwa hepatic ndi impso. Kukula kwa mankhwalawa kwakhazikitsidwa ndi insulin ya anthu, komabe, mphamvu ya mankhwalawa imachitika mwachangu ndipo imakhala yochepa.
Humalog imadziwika kuti zotsatira zake zimayamba mwachangu (pafupifupi mphindi 15) chifukwa cha kuchuluka kwa mayamwidwe, zomwe zimapangitsa kuti zizinenedwazo musanadye (m'mphindi 1 mpaka 15), pomwe insulin wamba, yomwe imakhala ndi nthawi yochepa, imatha kutumizidwa mu 30 -45 Mphindi asanadye.
Pharmacokinetics
Ndi jekeseni wa subcutaneous, kuyamwa kwa lyspro insulin kumachitika mwachangu, Cmax yake imatheka pambuyo pa maola 1-2. Vd ya insulin popanga mankhwala ndi insulin wamba ya anthu ndiofanana, amachokera pa 0,26 mpaka 0,36 malita pa kilogalamu.
Zizindikiro
Njira yodalira shuga ya insulin: tsankho la munthu payekha kukonzekera insulin ina; postprandial hyperglycemia, yomwe singathe kukonza ma insulin ena.
Njira yodalirika ya shuga yosadalira insulin: kukana mankhwala osokoneza bongo omwe amamwa pakamwa (malabsorption a insulin kukonzekera, postprandial hyperglycemia, osavomerezeka kuwongolera); ma opaleshoni othandizira ndi othandizira pamagulu (omwe amaphatikizira njira ya matenda ashuga).
Kugwiritsa
Mlingo Humalog umatsimikiziridwa payekhapayekha. Humalog mu mawonekedwe a Mbale imayendetsedwa zonse subcutanely and intrarally and intramuscularly. The humalogue mu mawonekedwe a cartridgeges ndi subcutaneous okha. Jekeseni ikuchitika mphindi 1-15 asanadye.
Mwanjira yake yoyenera, mankhwalawa amathandizidwa katatu patsiku, kuphatikiza ndi insulin kukonzekera ndi nthawi yayitali, katatu tsiku lililonse. Kukula kwa gawo limodzi sikungathe kupitirira 40. Humalog mu Mbale ikhoza kusakanikirana ndi mankhwala a insulin omwe amakhala ndi mphamvu yayitali mu syringe imodzi.
Katoniyo sanapangirepo kuphatikiza Humalog ndi insulin ina yokonzekera mmenemo ndikuigwiritsa ntchito mobwerezabwereza.
Kufunika kochepetsa mlingo wa insulini kungachitike ngati kuchepa kwamankhwala kumapangidwe azakudya, kupsinjika kwakukulu kwa thupi, mankhwala owonjezera omwe ali ndi vuto la hypoglycemic - sulfonamides, osasankha beta-blockers.
Zotsatira zoyipa
Zotsatira zazikulu za mankhwalawa zimayambitsa zotsatirazi: kutuluka thukuta, mavuto atulo, chikomokere. Nthawi zina, chifuwa ndi milomo zingachitike.
Mimba
Pakadali pano, palibe zovuta zoyipa za Humalog pamikhalidwe ya mayi woyembekezera komanso mluza wapezeka. Palibe maphunziro omwe adachitika.
Mzimayi wazaka zakubadwa yemwe ali ndi matenda ashuga ayenera kudziwitsa dokotala za mimba yomwe yakonzekereratu kapena yomwe ikubwera. Kwa odwala matenda ashuga, mkaka wa m'mawere nthawi zina umafuna kusintha kwa mlingo wa insulin kapena zakudya.
Bongo
Mawonekedwe: kutsika kwa glucose wamagazi, omwe amaphatikizidwa ndi ulesi, thukuta, kuthamanga kwa mtima, kupweteka pamutu, kusanza, chisokonezo.
Chithandizo: mwa mawonekedwe ofatsa, hypoglycemia imatha kuyimitsidwa ndi kudya mkati mwa shuga kapena chinthu china kuchokera pagulu la shuga, kapena zinthu zomwe zimakhala ndi shuga.
Hypoglycemia pamlingo wocheperako imatha kuwongoleka ndi jakisoni wa intramus kapena subcutaneous wa glucagon ndikuwonjezera kudya kwamkati kwamatumbo pambuyo poti wodwalayo athe kukhazikika.
Odwala omwe salabadira glucagon amapatsidwa njira yowonjezera shuga. Pankhani ya chikomokere, glucagon imathandizidwa mosavuta kapena kudzera m'mitsempha. Pokhapokha glucagon kapena njira yothetsera jakisoni wa chinthuchi, kuyikiridwa kwamkati yankho la glucose kuyenera kuchitidwa.
Wodwala akangodwalanso, amafunika kudya zakudya zopatsa mphamvu. Mungafunike kudya zakudya zam'tsogolo, mudzafunikanso kuyang'anira wodwalayo, chifukwa pamakhala chiwopsezo cha kubwereranso kwa hypoglycemia.
Kusunga
Humalog iyenera kusungidwa pa kutentha kwa +2 mpaka +5 (mufiriji). Kuzizira sikuvomerezeka. Bokosi kapena botolo lomwe layamba kale silingathenso kupitirira masiku 28 kutentha kwa firiji. Muyenera kuteteza Humalog ku dzuwa.
Ndizosavomerezeka kugwiritsa ntchito yankho muvuto lomwe lili ndi mawonekedwe amtambo, komanso lothinitsidwa kapena utoto, komanso pamaso pa tizinthu totsimikizika mkati mwake.
Kukhudzana kwa mankhwala
Mphamvu ya hypoglycemic ya mankhwalawa imachepetsedwa mukamamwa mankhwala a pakhungu a chithokomiro, beta2-adrenergic agonists, danazole, antidepressants, thiazide-mtundu diuretics, diazoxide, chlorprotixen, isoniazid, nicotinic acid, lithiamu carbonate, lithiamu carbonate.
Zotsatira za hypoglycemic za Humalog zimawonjezeka ndi beta-blockers, ethyl mowa komanso mankhwala osokoneza bongo omwe ali ndi, fenfluramine, anabolic steroids, tetracyclines, guanethine, salicylates, pakamwa hypoglycemic mankhwala, sulfonamides, ACE zoletsa ndi MAO ndi octre.
Humalog ikhoza kugwiritsidwa ntchito (kuyang'aniridwa ndi achipatala) kuphatikiza ndi insulin yaumunthu, yomwe imakhala yothandiza kwakanthawi kochepa, kapena kuphatikiza ndi mankhwala a hypoglycemic, omwe amachokera ku sulfonylurea.
