Ana amfani da magungunan Antithyroid don hyperthyroidism (thyrotoxicosis, cutar bazedova). A halin yanzu, ana amfani da magungunan antithyroid musamman. tsararrun (merkazolil)wanda ke hana thyroperoxidase kuma saboda haka yana hana iodination na shawo kan ɓarna na thyroglobulin kuma ya lalata aikin T₃ da kuma T₄. Sanya ciki. Lokacin amfani da wannan magani, leukopenia, agranulocytosis, rashes na fata yana yiwuwa. Zai yiwu a haɓaka ƙwayar thyroid.

Kamar yadda magungunan antithyroid, aidin an wajabta su a ciki - kalia iodide ko sodium aidin a allurai masu girma (160-180 MG). A wannan yanayin, aidin yana rage yawan haɓakar ƙwayoyin haɓakar ƙwayoyin hanji na ƙwayar pituitary, bi da bi, kira da ɓoyewar T yana raguwa.₃ da kuma T₄ . Hakanan ana amfani da irin wannan tsari na hanawa daga sakin hormone da yake karfafawa diiodotyrosine. Ana gudanar da magunguna ta baka. Suna haifar da raguwa a cikin yawan ƙwayar thyroid. Sakamakon sakamako: ciwon kai, lacrimation, conjunctivitis, jin zafi a cikin glandon salivary, laryngitis, rashes fata.

Abubuwan insulin na yau da kullun

Insulin allura: tsanaki daban-daban.

Matsakaicin mafi kyau ya kamata ya rage glucose na jini zuwa al'ada, kawar da glucosuria da sauran alamun cututtukan sukari.

Yankin Alluba (rashi daban daban): gaban gaban bangon ciki, gaban al'aura, kafada ta gaba, cinya, gindin gwiwa.

Short takaice kwayoyi - a cikin ciki (hanzarin sha),

Magunguna masu dadewa - a cikin kwatangwalo ko gindi.

Kafafu basu da matsala don allurar kai.

Ana saukaka tasirin magani ta

-sabataccen tsari na '' yunwar jini '' sukari jini da

- fitar dashi da fitsari a rana

Mafi kyawun zaɓi don maganin cututtukan type 1 shine

Bayanan allurar insulin da yawa wadanda suke kwaikwayon kwayar halittar insulin.

A cikin yanayin ilimin mutum

basal (bango) insulin insulin yana faruwa a kullun kuma yanki 1 ne na insulin awa daya.

Yayin aiki na jiki yawan insulin insulin a kullum yana ragewa.

Ana buƙatar ƙarin (motsawa) rufin insulin (raka'a 1-2 a kowace g 10 na carbohydrates).

Wannan hadadden insulin sirrin za a iya misaltawa kamar haka:

Kafin kowane abinci, ana ba da magunguna ga gajeriyar hanya.

Amfani da tsare sirri na tushe yana da goyan bayan magunguna masu amfani da dogon lokaci.

Hadarin insulin far:

Abun Lalacewar Cutar Rana

rashin amfani da insulin,

Ba tare da kulawa mai zurfi ba, coma mai ciwon sukari (tare da haɓakar cerebral)

ko da yaushe m.

- CNara yawan maye ga CNS tare da jikin ketone,

Gaggawa likita da za'ayi na ciki gabatarwar insulin.

A ƙarƙashin rinjayar babban adadin insulin a cikin sel tare da glucose ya hada da potassium

(hanta, ƙwayar tsoka),

Tsarin potassium na jini saukad da kazanta. Sakamakon haka, rikicewar zuciya.

Cutar rashin lafiyan insulin, juriya insulin.

Lipodystrophy a wurin allurar.

Don hanawa, ana bada shawara don canza wuraren kula da insulin a cikin yanki ɗaya.

Shiryayyar hormone na Parathyroid

Hannun kwayoyin parathyroid na parathyroid na parathyroid yana shafar metabolism na alli da phosphorus. Yana haifar da raguwa da ƙashin ƙashi. Yana haɓaka ɗaukar ƙwayoyin ions na alli daga ƙwayar gastrointestinal, yana ƙaruwa da reabsorption na alli da rage reabsorption na phosphate a cikin tubules na koda. Game da wannan, aikin hormone na parathyroid yana kara matakin Ca 2+ a cikin jini na jini. Gidan mara lafiya parathyroid miyagun ƙwayoyi parathyroidin amfani da shi don maganin hypoparathyroidism, spasmophilia.

1. Shirye-shiryen insulin da haɓakar mahaifa

Insulin yana motsa masu karɓar ƙwayoyin membrane waɗanda ke haɗuwa da ƙwayar cuta ta tyrosine. A wannan batun, insulin:

yana haɓaka ɗaukar glucose ta ƙwayoyin nama (ban da na tsakiya na juyayi), yana sauƙaƙe jigilar glucose ta cikin membranes cell,

rage gluconeogenesis a cikin hanta,

3) yana karfafa samuwar glycogen da ajiyar sa a hanta,

4) yana haɓaka aikin sunadarai da mai da kuma hana haɓakar haɓakar su,

5) rage glycogenolysis a cikin hanta da kasusuwa.

Tare da isasshen samar da insulin, ciwon sukari yana haɓakawa, wanda carbohydrate, mai da metabolism metabolism ya rikice.

Nau'in na ciwon sukari na mellitus (wanda ke dogara da insulin) yana da alaƙa da lalata β-sel na tsibirin na Langerhans. Babban alamomin nau'in ciwon sukari mellitus: hyperglycemia, glucosuria, polyuria, ƙishirwa, polydipsia (ƙara yawan ci), ketonemia, ketonuria, ketacidosis. Mummunan nau'ikan ciwon sukari ba tare da magani ba yana ƙarewa mai rauni, mutuwa tana faruwa a cikin yanayin hyperglycemic coma (gagarumar hyperglycemia, acidosis, rashin sani, ƙanshin acetone daga bakin, bayyanar acetone a cikin fitsari, da dai sauransu). A nau'in ciwon sukari mellitus, kawai magunguna masu inganci sune shirye-shiryen insulin waɗanda ake gudanarwa a kan gaba.

Nau'in sukari na II na ciwon sukari mellitus (wanda ba shi da insulin-insaba) yana hade da raguwar narkewar insulin (rage yawan aiki β-sel) ko tare da haɓakar juriya na insulin. Zai iya danganta jurewar insulin tare da raguwa a cikin adadin ko hankalin mai karɓar insulin. A wannan yanayin, matakan insulin na iya zama al'ada ko ma an ɗaukaka su. Matsakaicin matakan insulin na ba da gudummawa ga kiba (hormone anabolic), wanda shine dalilin da ya sa wani nau'in II na ciwon sukari wani lokacin ake kira da cutar sankara obese. A cikin nau'in ciwon sukari na II na II, ana amfani da wakilai na hypoglycemic, wanda, tare da isasshen tasiri, ana haɗuwa tare da shirye-shiryen insulin.

A halin yanzu, mafi kyawun shirye-shiryen insulin sune shirye-shiryen insulin na ɗan adam. Bugu da kari, suna amfani da kwayoyi na insulin da aka samu daga cututtukan aladu (insulin alade).

An shirya shirye-shiryen insulin na mutum ta injiniyan kwayoyin.

Hasken jikin mutum (Actrapid NM) ana samarwa a cikin kwalabe na 5 da 10 ml tare da abun ciki na 40 ko 80 PIECES a cikin 1 ml, da kuma a cikin katako na 1.5 da 3 ml na almarar sirinji. Yawancin magani ana sarrafa shi a karkashin fata 15-20 mintuna kafin cin abinci sau 1-3 a rana. An zabi kashi akayi daban-daban dangane da tsananin matsalar hyperglycemia ko glucosuria. Tasirin yana tasowa bayan mintuna 30 kuma yana ɗaukar tsawon sa'o'i 6-8. Lipodystrophy na iya haɓakawa a cikin wuraren allurar insulin subcutaneous, saboda haka ana bada shawara don canza wurin allura koyaushe. A cikin coma mai ciwon sukari, ana iya gudanar da insulin a cikin ciki. Idan kuma yawan insulin ya wuce, to jinin haila zai hayayyafa. Pallor, gumi, jin karfi na yunwar, rawar jiki, bugun kirji, tashin hankali, rawar jiki ya bayyana. Rashin hauhawar jini (rashin hankali, rashi, aikin zuciya). A farkon alamun hypoglycemia, mai haƙuri ya kamata ya ci sukari, kukis, ko wasu abinci masu wadatar glucose. Idan yanayin girgizawa, glucagon ko 40% glucose bayani ana allurar dashi.

Zinirƙira na zinc na dakatar da insulin ɗan adam (Ultratard HM) ana yinsa ne kawai a karkashin fata. Insulin yana hankali a hankali daga ƙwayar subcutaneous, tasirin yana haɓaka bayan sa'o'i 4, mafi girman tasirin bayan sa'o'i 8-12, tsawon lokacin aiki shine sa'o'i 24. Za'a iya amfani da miyagun ƙwayoyi azaman wakili na asali a hade tare da kwayoyi masu sauri da gajeru.

Shirye-shiryen insulin na allurar rigakafi iri daya ne a aikace ga shirye shiryen insulin na mutane. Koyaya, halayen rashin lafiyan suna yiwuwa tare da amfanin su.

Insulinmai narkewatsaka tsaki an samar da shi cikin kwalaben 10 ml tare da abun ciki na 40 ko 80 SHAWARA a cikin 1 ml. Shigar da fata kafin mintuna 15 kafin abinci sau 1-3 a rana. Gudun cikin ciki da jijiyoyin jini yana yiwuwa.

Insulin-zincdakatarwaamorphous ana sarrafawa ne kawai a karkashin fata, yana ba da jinkirin ɗaukar insulin daga wurin allurar kuma, gwargwadon haka, aikin da ya fi tsayi. An fara aikin ne bayan sa'o'i 1.5, mafi girman aiki bayan awanni 5-10, tsawon lokacin aiki shine awanni 12-16.

Insulin Zinc Crystal Dakatarwa ana sarrafa fata ne kawai a karkashin fata. Zafin fara aiki bayan sa'o'i 3-4, mafi girman aiki bayan sa'o'i 10-30, tsawon lokacin aiki shine awanni 28-36.

Roba hypoglycemic jami'ai

An bambanta rukunoni masu zuwa na wakilai na roba:

1) Abubuwan da suka samo asali na sulfonylurea,

Abubuwan da suka samo asali na sulfonylureas - butamide, chlorpropamide, glibenclamide wajabta shi a ciki. Waɗannan kwayoyi suna tayar da ɓoye insulin ta β-sel daga tsibirin na Langerhans.

Hanyar aiwatar da abubuwan da aka samo asali na sulfonylurea yana da alaƙa tare da toshewar tashoshin tashar K-dogara da ATP na sel-cells-sel da depolarization ƙwayoyin sel. A wannan yanayin, ana amfani da tashoshin Ca 2+ mai ƙarfi, shigowar Ca g + yana ƙarfafa ɓoye insulin. Bugu da kari, wadannan abubuwan suna kara karfin mai karbar insulin zuwa matakin insulin. Hakanan an nuna cewa abubuwan da ke haifar da sulfonylurea suna haɓaka tasirin insulin a cikin jigilar glucose a cikin sel (mai, tsoka). Ana amfani da abubuwan da ke cikin Sulfonylurea don nau'in ciwon sukari na II na mellitus. Tare da nau'in ciwon sukari na I, ba su da tasiri. Ciki cikin narkewar hanzari da sauri gaba daya. Yawancinsu suna ɗaure wa furotin plasma. Metabolized a cikin hanta. Kwayoyin suna dauke da mafi yawancin kodan, kuma za'a iya cire wasu ƙananan abubuwa tare da bile.

Sakamakon sakamako: tashin zuciya, dandano na ƙarfe a cikin bakin, jin zafi a ciki, leukopenia, halayen rashin lafiyan. Tare da ƙarin yawan abubuwan da ke haifar da abubuwan sulfonylurea, hypoglycemia mai yiwuwa ne. Magungunan kwayoyi suna cikin cututtukan hanta na hanta, koda, da tsarin jini.

Biguanides - metformin wajabta shi a ciki. Mallakar:

1) yana haɓaka tasirin glucose ta kyallen guda ɗaya, musamman tsokoki,

2) yana rage gluconeogenesis a cikin hanta,

3) yana rage yawan shan glucose a cikin hanji.

Bugu da ƙari, metformin yana rage yawan ci, yana ƙarfafa lipolysis kuma yana hana lipogenesis, yana haifar da rage nauyin jiki. An wajabta shi don nau'in ciwon sukari na II II. Magungunan suna da kyau sosai, tsawon lokacin aiki har zuwa sa'o'i 14. Sakamakon sakamako: lactic acidosis (karuwa a cikin matakin lactic acid a cikin jini), jin zafi a cikin zuciya da tsokoki, gajeriyar numfashi, da kuma dandano mai ƙarfe a bakin, tashin zuciya, amai, zawo.

2.3.1.2. Hotunan cututtukan cututtukan cututtukan daji da na maye

Kankana na ɓoye homoniya guda biyu: insulin da glucagon, waɗanda ke da tasirin sakamako mai yawa a matakin glucose a cikin jini. Insulin yana rage glucose na jini, yana tabbatar da jigilar ta ta cikin membranes cell da kuma amfani da kyallen takarda, yana motsa samuwar glucose-6-phosphate, yana motsa ayyukan samar da makamashi, yana karfafa ayyukan sunadarai da mai mai. Rashin insulin shine ya haifar da ciwon sukari mellitus - mummunan cuta, wanda ya bayyana ta karuwa da sukari jini da bayyanar shi a cikin fitsari, hanyoyin lalata abubuwa (tare da tarawar sassan jikin ketone), ƙarancin abinci mai narkewa da haɓakar ƙwayoyin jijiyoyin bugun jini (cututtukan cututtukan angiopathies). Matsananciyar ƙwayar Carbohydrate na sel (insulin-insulin kyallen), rashin daidaituwa na electrolyte da ketoacidosis suna haifar da ci gaban bayyanuwar cututtuka na ciwon sukari mellitus - coma mai ciwon sukari.

Insulin wani sinadari ne wanda ya kunshi sarkoki biyu na polypeptide da ke hade da gadoji. A halin yanzu, an aiwatar da aikin insulin na mutum da na dabba, hanyar ingantacciyar hanya don samar da ita (insulin da aka yiwa injin halitta). Ana amfani da insulin don insulin-dogara da ciwon sukari mellitus tare da hali na ketoacidosis. Gabatar da insulin a cikin marasa lafiya tare da ciwon sukari yana haifar da raguwa cikin sukari jini da tara glycogen a cikin kyallen. Rage glucosuria da sakamakon polyuria da polydipsia. Tsarin gina jiki da na abinci mai guba na al'ada ne, wanda ke haifar da raguwa cikin abubuwan da ke cikin tasoshin nitrogenous a cikin fitsari. An daina gano gawar Ketone a cikin jini da fitsari.

A cikin aikin likita, ana amfani da shirye-shiryen insulin tare da durations daban-daban na aiki (gajere, matsakaici, tsayi). Ana yin lissafin kashi akayi daban-daban, la'akari da tsananin aikin. Don rage yawan allura, bayan an cimma biyan diyya, ana tura marasa lafiya zuwa insulin-insulin tsayayye, dakatar da sinadarin insulin-ultralong, protamine-zinc - insulin. Sau da yawa, ana amfani da abubuwan haɗuwa daban-daban (dangane da tsawon lokacin aiki) nau'ikan insulin don magani. Shirye-shiryen insulin ba su da matsala. Insulinase yana cikin aiki a cikin hanta ta hanyar insulinase, wanda ke haifar da ƙarancin lokacin aikinsa (awa 4-6). Inje allurar insulin na da matukar raɗaɗi; infiltrates na iya faruwa a wurin allurar. Insulin da nau'ikan sa na tsawo na iya haifar da rashin lafiyar jiki. Tare da yawan wuce haddi na insulin, ƙin jinin haila na iya haɓaka. Tare da ƙarancin digiri na hypoglycemia, ana iya rama shi ta hanyar yawan sukari ko abinci mai wadatar carbohydrates, tare da coma, dole ne a gudanar da glucose parenterally.

Baya ga insulin, ana amfani da haɓakar hypoglycemic a matsayin wakilai na hypoglycemic. Wadannan sun hada da abubuwanda suka samo asali na sulfonylurea: tolbutamide (butamide), chlorpropamide, biguanides: buformin (glibutide, metformin (glucophage, glyformin)) An sanya allurar sillanlureas don kamuwa da cutar matsakaici hade da maganin rage cin abinci .. Yana da kyau ayi amfani da biguanides don ciwon sukari mellitus tare da insulin. Har ila yau, tare da insulin da sulfonamides.The samarwa tsarin aikin na bakin antidiabetic jamiái hade da ƙara insulin ɓoyewa da kwayar ji da hankali a kai sheney. sassa na mataki na biguanide Kalam tsokoki sa ta ruri na glucose fahimta da kuma danniya na glucose sha tafiyar matakai.