Protafan - malangizo atsatanetsatane ogwiritsira ntchito

Matenda a shuga amatanthauza matenda osakhazikika omwe amakhudza ziwalo zonse. Njira zazikulu zachitukuko zimalumikizidwa ndi kuchepa kwa insulin ya mahomoni, yomwe imayang'anira kugwiritsidwa ntchito kwa glucose ndi maselo. Zotsatira zake, pamakhala kuperewera kwa metabolism, kuchuluka kwa glucose m'magazi kumakwera. Chithandizo cha matenda osokoneza bongo a shuga chimazizira mpaka kukonzanso kwa mahomoni amoyo wonse.

Mzere wonse wa ma insulin opanga wakonzedwa. M'modzi mwa iwo ndi Protafan. Malangizo ogwiritsira ntchito ali ndi chidziwitso chonse chofunikira chothandizira pakudziyimira pawokha pakufunika kwa mankhwalawa.

Kupanga ndi mawonekedwe a kumasulidwa

Zomwe zimagwira ndi insulin yaumunthu, yopangidwa ndi maukadaulo opanga ma genetic engineering. Amapezeka mumitundu yambiri:

1. "Protafan NM": uku ndikuyimitsidwa pambale, iliyonse 10 ml, insulin ndende ya 100 IU / ml. Phukusili lili ndi botolo limodzi.
2. "Protafan NM Penfill": makatoni okhala ndi 3 ml (100 IU / ml) iliyonse. Mu chithuza chimodzi - makatoni 5, phukusi - 1 matuza.

Omwe amathandizira: madzi a jakisoni, glycerin (glycerol), phenol, sodium hydrogen phosphate dihydrate, protamine sulfate, metacresol, sodium hydroxide ndi / kapena hydrochloric acid (kusintha pH), zinc chloride.

Zotsatira za pharmacological

"Protafan" amatanthauza mankhwala a hypoglycemic a nthawi yayitali. Cholinga chachikulu ndikuonetsetsa kuti glucose alowerera kudzera mu membrane wa cell.

Kuphatikiza apo ndikuyambitsa njira izi:

• Imayendetsa ma enzyme angapo ofunikira pa moyo - glycogen synthetase, pyruvate dehydrogenase, hexokinase;
• Ma blocked adipose minofu ya lipase ndi lipoprotein lipase;
• Imayendetsa phosphorylation ya mapuloteni ama cell.

Zotsatira zake, sikuti gawo la glucose mu cell limangowonjezereka, komanso kugwiritsa ntchito kwake ndikupanga glycogen. Kuphatikiza apo, momwe mapuloteni ama cellular amayambidwira.

Mfundo zakugwiritsa ntchito Protafan

Mankhwalawa amagwiritsidwa ntchito pa mtundu uliwonse wa matenda ashuga. Mtundu I, chithandizo chimayambika nthawi yomweyo, mu mtundu II, Protafan akuwonetsedwa pazochitika za sulfonylurea zotumphukira, panthawi yoyembekezera, panthawi komanso pambuyo pa ntchito, pamaso pa matenda ophatikizika omwe amachititsa kuti matenda a shuga achuluke.

Clinical Pharmacology

Kukhazikika kwa chojambulidwa kwadulidwa maola 1.5 pambuyo panjira ya subcutaneous. Zochita bwino - pambuyo maola 4-12. Kutalika konse kokwanira ndi maola 24.

Izi pharmacokinetics imatanthauzira mfundo zomwe amagwiritsa ntchito "Protafan":

1. Insulin-wodwala matenda a shuga - monga chida chachikulu kuphatikiza ndi ma insulin omwe amakhala osakhalitsa.
2. Mellitus wosadalira insulin - onse awiri omwe amalumikizana ndi othandizira komanso kuphatikiza ndimankhwala othamanga amaloledwa.

Ngati mankhwalawa agwiritsidwa ntchito ngati chithandizo cha mono, amandidulira musanadye. Kugwiritsa ntchito koyamba, kutumikiridwa kamodzi patsiku (m'mawa kapena madzulo).

Njira yogwiritsira ntchito

Mankhwalawa amapaka pakhungu. Malo achikhalidwe ndi malo m'chiuno. Zilonda zimaloledwa m'dera lakhoma lamkati, matako, ndi minofu yolumikizira mkono. Tsambalo la jakisoni liyenera kusinthidwa kuti liletse kukulira kwa lipodystrophy. Ndikofunikira kukoka khungu kuti mupewe kulowetsamo insulin.

Njira yogwiritsira ntchito cholembera cholembera insulin "Protafan"

Kukhazikika kwakanthawi kokhazikika kwa mitundu ya jakisoni kumafuna kusinthitsa njirayi momwe ndingathere. Pachifukwa ichi, cholembera cha syringe, chopangira mphamvu ndi ma cartridges a Protafana, chapangidwa.

Wodwala aliyense yemwe ali ndi matenda ashuga ayenera kudziwa momwe angagwiritsire ntchito ndi mtima:

• Musanatsirize cartridge, fufuzani ma CD kuti muwonetsetse kuti mulondola.
• Onetsetsani kuti mukuyang'ana cartridge nokha: ngati pali china chake chowonongeka kapena kuti kuwonekera pakati pa tepi yoyera ndi piston yoyikira, ndiye kuti izi sizigwiritsidwa ntchito.
• Ulusi wa mphira umachiritsidwa ndi mankhwala ogwiritsa ntchito ngati thonje.
• Asanakhazikitse cartridge, kachitidweko kamapumidwa. Kuti muchite izi, sinthani mawonekedwe kuti galasi lagalasi mkati likusunthira mbali ina kufikira nthawi 20. Zitatha izi, madziwo amafunika kukhala amtambo.
• Makatoni okha omwe ali ndi magawo 12 a insulin omwe amafunika kusakanikirana malinga ndi njira yomwe tafotokozayi. Uwu ndiye mlingo wocheperako wodzadza mu cholembera.
• Pambuyo pakuika pansi pa khungu, singano iyenera kukhalapobe kwa masekondi 6. Pokhapokha ngati mwalowa mankhwalawo.
• Pambuyo pa jekeseni aliyense, singano amachotsedwa mu syringe. Izi zimalepheretsa kutulutsa kosalamulirika kwamadzi, zomwe zimapangitsa kuti pakhale kusintha kwa zotsalazo.

Zonsezi pamwambapa zikuwonetsa kuopsa kwa kusintha kwa mankhwala a insulin kapena mankhwala ena osakwanira, omwe angapangitse kuti pakhale zovuta komanso zotsatirapo zovuta zaumoyo.

Mlingo

Wodwala aliyense yemwe ali ndi matenda a shuga ali ndi yake Mlingo komanso kuchuluka kwa mankhwala a insulin. Imawerengeredwa ndi endocrinologist payekhapayekha, kutengera mulingo wa glucose woyambira komanso kupanga kwake kwa mahomoni ake.

Kusasamala kwa mayendedwe ndi malingaliro a dokotala kumapangitsa kuti pakhale zovuta zambiri za insulin mankhwala: hypo- kapena hyperglycemic chikomokere, chomwe chitha kupangitsa kuti wodwalayo afe.

Mfundo zikuluzikulu posankha "Protafan":

1. Mankhwala ayenera kupereka zofunika kwa mahomoni, omwe ndi 0,3-1 IU / kg / tsiku.
2. Kukhalapo kwa kukana insulin kumafuna kuwonjezeka pazofunikira zazikulu, motero mlingo wa mankhwalawa. Izi zimawonedwa pa nthawi yakutha kapena kwa odwala omwe ali ndi kunenepa kwambiri.
3. Wodwala akamasunga mtundu wake wa insulin, ndiye kuti mankhwalawo amasinthiratu.
4. Matenda a chiwindi ndi impso amachepetsa kufunika kwa insulin.
5. Muyeso wa mulingo woyenera ndiye kuchuluka kwa shuga m'magazi. Izi ndizofunikira kuwunikira chizindikiritso ichi.

Kutsatira ndi malingaliro onse oyambitsa "Protafan" kumayambitsa kukhazikika kwa kagayidwe kazakudya ndipo kumathandizira kwambiri kuchedwetsa kuonekeranso kwa zovuta za matenda.

Zotsatira zoyipa

Zotsatira zoyipa zomwe zimagwiritsidwa ntchito ngati mankhwalawa zimachitika chifukwa cha zomwe zimapangitsa insulini kuphwanya mlingo wa mankhwala. Choopsa kwambiri pakati pawo ndi chikhalidwe cha hypoglycemic. Zimachitika chifukwa chakuyambitsa kuchuluka kwa insulin komwe kumadutsa kwambiri zosowa zake.

Zotsatira zake, kuchuluka kwa glucose m'magazi kumatsika kwambiri, ma neurons a ubongo amayamba kuona kuperewera kwa mphamvu, munthu amasiya kuzindikira. Popanda thandizo ladzidzidzi, chikomokere ndi imfa zimayamba.

Zotsatira zina zoyipa sizowopsa ndipo zimagwirizanitsidwa ndi zotsatira zoyipa za zigawo za mankhwala. Izi zikuphatikiza:

• Thupi lawo siligwirizana. Kuyambira ming'oma yofewa ndi totupa kupita ku mawonekedwe osiyanasiyana: totupa thupi lonse, kutupa kwa minofu, kufupika, tachycardia, kuyabwa kwambiri, thukuta. Mwazovuta kwambiri - kukomoka ndi kuwonongeka kwa chikumbumtima.
• Zizindikiro zamitsempha. Peripheral neuropathy imadziwika ndi mitundu yosiyanasiyana ya Zizindikiro: kuwonongeka kwa dongosolo la Autonomic mantha, kusokonezeka kwa chidwi ndi kupweteka miyendo, paresthesia.
• Kuchokera kumbali ya gawo la masomphenya. Nthawi zambiri, zolakwika zokonzanso zimachitika, zomwe nthawi zambiri zimachoka pakapita kanthawi. Pa gawo loyamba la chithandizo, kuchuluka kwa matenda ashuga retinopathy kungachitike.
• Khungu komanso minyewa yofinya. Ndi mankhwala a insulin nthawi yayitali pamalo amodzi, lipodystrophy imayamba.
• Zokhudza kwanuko. Pezani malo operekera mankhwala: redness, kutupa kwa zimakhala, kuyabwa, hematoma. Pakapita kanthawi, amachoka popanda kuwatsata.

Munthu aliyense yemwe ali ndi matenda ashuga ayenera kudziwa algorithm yothandizira ndi mtundu wa hypoglycemic.

Contraindication

"Protafan" yaletsedwa kugwiritsidwa ntchito pawiri pokha: dziko la hypoglycemic ndi kusalozera kumodzi mwa zigawo za yankho.

Kuchita ndi mankhwala ena

Matenda a shuga ndi matenda osachiritsika omwe nthawi zambiri amabweretsa zovuta kuchokera ku ziwalo zambiri. Mwa chithandizo chawo, wodwalayo amapatsidwa chithandizo choyenera. Pali mankhwala angapo omwe amakhudza kufunika kwa thupi kwa insulin (kuonjezera kapena kuichepetsa). Pakugwiritsa ntchito kwawo pamodzi ndi Protafan, mlingo uyenera kusinthidwa.

Imawonjezera zotsatira za "Protafan"

• Zinthu zonse zomwe zimakhala ndi ethanol. Mndandanda wawo ndiwowonjezera, motero, mukamagwiritsa ntchito mankhwala atsopano, ndikofunikira kuti muphunzire mwatsatanetsatane;
• ACE inhibitors (angiotensin-converting enzyme) - gulu la mankhwala omwe amagwiritsidwa ntchito kwambiri pochiza matenda oopsa;
• Mao inhibitors (monoamine oxidases) - ma antidepressants omwe amagwiritsidwa ntchito pochita zamisala;
• Beta-blockers (osasankha) - mankhwala a matenda a mtima;
• Anabolic steroids;
• Hypoglycemic mkamwa mankhwala;
• Carbonic anhydrase inhibitors, yomwe imaphatikizapo diuretics zambiri;
• Kukonzekera kwa Lithium;
• Mankhwala othandizira a Tetracycline ndi sulfonamides;
• Pyridoxine (Vitamini B6);
• Ketoconazole ndi antimycotic wothandizira;
• Cyclophosphamide - mankhwala antitumor;
• Clofibrate - amachepetsa magazi m'thupi;
• Fenfluramine ndi woyang'anira;
• Bromocriptine wogwiritsidwa ntchito mu gynecology;
• Theophylline ndi bronchodilator wodziwika;
• Mebendazole ndi anthelmintic.

Odwala omwe amafunikira chithandizo ndi mankhwalawa, ndikofunikira kuti muchepetse kwakanthawi mankhwala omwe amakhala ndi insulin.

Chepetsani zotsatira za "Protafan"

• Mahomoni a chithokomiro omwe amagwiritsidwa ntchito pochotsa hypothyroidism;
• Ochepetsa calcium tubule blockers (calcium antagonists), omwe nthawi zambiri amagwiritsidwa ntchito pochiza matenda oopsa;
• Glucocorticosteroids;
• Sympathomimetics, odziwika kwambiri omwe ndi Ephedrine;
• Thiazide okodzetsa;
• Njira zakulera za pakamwa;
• Tricyclic antidepressants;
• Clonidine ndi othandizira ena;
• Phenytoin ndi antiepileptic;
• Diazoxide yokhala ndi diuretic ndi hypotensive zotsatira;
• Kukula kwa mahomoni (kukula kwa mahomoni);
• Nicotinic acid;
• Morphine;
• Nikotine;
• Heparin;
• Danazole amathandizira endometriosis komanso zotupa zina za mano.

Mankhwala ena ndi mankhwala ena amapanga mbali zosiyanasiyana, zonsezo zimakulitsa ndikuletsa zotsatira za Protafan. Awa ndimowa, octreotide / lanreotide, reserpine, salicylates.

Malo osungira

Kusungidwa koyenera kwa Protafan kumatsimikizira kuti insulin idzaperekedwa, zomwe zikutanthauza kuti zitha kupewa mavuto ambiri:

1. Botolo losindikizidwa lili mufiriji (2-8 ° C), koma kutali ndi mufiriji. Kuzizira ndi koletsedwa. Nthawi ndi miyezi 30.
2. Phukusi lotseguka limasungidwa kutentha kwa chipinda osapitirira 25 ° C kwa milungu 6. Tetezani ku kuwala.

Mankhwala ayenera kutetezedwa kwa ana. Amapezeka m'mafakitala kokha ndi mankhwala. Mtengo wapakati ndi ma ruble a 350-400 a botolo, 800-100 ma ruble a cartridge. Ma analogi ena ndi otsika mtengo (mwachitsanzo, Humulin NPH), ena amapitilira mtengo wake (Insuman Bazal GT, Biosulin N).

Malangizo apadera

Mankhwalawa a shuga mellitus "Protafan" palibe zinyengo. Talemba mndandanda wa "zobisika" zomwe moyo wodwala ungadalire:

1. Pambuyo pakutha kwa mankhwalawa, mkhalidwe wa hyperglycemia ukhoza kuchitika (kufooka, nseru, mkamwa wouma, kusowa chilimbikitso, kununkhira kwa acetone, kukodza pafupipafupi, kufupika kwa khungu ndi kuuma pang'onopang'ono.
2. Ngati munthawi ya chithandizo muli nkhawa yayikulu, matenda (makamaka ndi malungo) kapena kuchita masewera olimbitsa thupi, izi zimakwiyitsa hypoglycemia.
3. Kusintha kwa mankhwalawo ndi mtundu wina wa insulin (kapena mankhwala a mtundu wina) uyenera kuchitika moyang'aniridwa ndi achipatala ndikuwunikira kosalekeza misempha ya magazi.
4. Asananyamuke ulendo wautali komanso kusintha kwa malo, wodwalayo ayenera kuonana ndi endocrinologist.
5. Protafan NM sichinapangidwe pampu ya insulin.

Mankhwala samalowa m'matumbo, kotero amatha kugwiritsidwa ntchito ndi amayi oyembekezera. Ndikofunikira kusintha mankhwalawa kutengera nthawi yomwe mayi ali ndi pakati (mu trimester yoyamba, kufunika kwa insulin kumachepa, kenako kumawonjezeka pang'onopang'ono, ndipo pambuyo pobala mwana amabwerera ku zomwe adayamba).