Matsakaici tsawon insulin (ATX A10AC)

Protafan HM wani abu ne na matsakaiciyar insulin na mutum wanda aka samar ta hanyar halittar halittar DNA ta hanyar halitta ta amfani da irin kwayar cutar Saccharomyces cerevisiae. Yana hulɗa tare da takamaiman mai karɓa akan ƙwayar cytoplasmic na waje na sel kuma yana samar da hadaddun insulin-receptor wanda ke motsa ayyukan ciki, gami da haɗakar enzymes da yawa (hexokinase, pyruvate kinase, glycogen synthetase, da sauransu). Rage yawan glucose na jini shine saboda karuwa a cikin jijiyoyin zuciya, karuwar ƙwayar nama, haɓakar lipogenesis, glycogenogenesis, raguwa a cikin yawan samar da glucose ta hanta, da dai sauransu.

Matsakaicin aikin aiwatar da shirye-shiryen insulin shine mafi yawanci saboda yawan sha, wanda ya dogara da dalilai da yawa (alal misali, akan kashi, hanyar, wurin gudanarwa da nau'in ciwon sukari). Sabili da haka, bayanan bayanan aikin insulin yana ƙarƙashin mahimman canzawa, duka mutane daban-daban da kuma mutum ɗaya. Aikinsa yana farawa ne cikin awanni 1,5 bayan gudanarwar, kuma ana nuna mafi girman tasirin a cikin sa'o'i 4-12, yayin da jimlar aikin zai kusan awa 24.

Pharmacokinetics

Cikakken mamayewa da farawar insulin ya dogara da hanyar gudanarwa (s / c, i / m), wurin allurar (ciki, cinya, gindi), kashi (yawan insulin insulin), da kuma tattarawar insulin a cikin shiri. Cmax na insulin a cikin plasma an kai shi a cikin awanni 2-18 bayan gudanarwar sc.

Babu wata ma'anar da ta ambaci sunadaran kare lafiyar plasma, wani lokacin kawai ana gano kwayoyin cuta zuwa cikin insulin.

An cire insulin na mutum ta hanyar aikin kariya na insulin ko kuma magungunan insulin-sharewa na insulin, kuma mai yiwuwa ne ta hanyar abubuwan da ke lalata furotin isomerase. Ana zaton cewa a cikin kwayar halittar insulin na mutum akwai wurare da yawa na share-fage (hydrolysis), amma, babu wani daga cikin metabolites da aka kirkira sakamakon tsinkewar aiki.

T1 / 2 an ƙaddara shi da ƙimar ɗaukar abubuwa daga ƙwayar subcutaneous. Don haka, T1 / 2 ya zama ma'aunin sha, maimakon ainihin matakin cire insulin daga plasma (T1 / 2 na insulin daga cikin jini kawai 'yan mintuna). Nazarin ya nuna cewa T1 / 2 kusan awa 5-10 ne.

Bayanai na Tsare na Haraji

A cikin karatuttukan daidaitacce, gami da karatuttukan gwaje-gwaje na maimaituwa, karatuttukan ilimin halittar jiki, damar cututtukan carcinogenic da cutarwa mai guba kan yanayin haifuwar, ba a gano takamaiman haɗarin mutane ba.

Sakawa lokacin

Magungunan an yi niyya ne don gudanar da aikin jinƙai na cikin ƙasa.

An zaɓi kashi na miyagun ƙwayoyi daban-daban, la'akari da bukatun mai haƙuri. Yawanci, bukatun insulin tsakanin 0.3 da 1 IU / kg / rana. Bukatar yau da kullun don insulin na iya zama mafi girma a cikin marasa lafiya tare da juriya na insulin (alal misali, yayin balaga, har ma a cikin marasa lafiya tare da kiba), da ƙananan cikin marasa lafiya tare da ragowar insulin na insulin. Bugu da kari, likita ya kayyade yawan allurar rigakafi a kowace rana da mai haƙuri ya kamata ya karɓa, ɗaya ko sama. Ana iya gudanar da Protafan HM ko dai azaman monotherapy, ko a hade tare da insulin mai sauri ko gajere.

Idan maganin insulin mai zurfi ya zama dole, ana iya amfani da wannan dakatarwar azaman basal (ana yin allura da maraice da / ko da safe), a haɗe tare da insulin cikin sauri ko gajere, allurar da yakamata a danganta ta da abinci. Idan masu haƙuri tare da ciwon sukari sun sami cikakken iko na glycemic iko, to, rikicewar ciwon sukari a cikin su, a matsayin mai mulkin, ya bayyana daga baya. A wannan batun, yakamata mutum yayi ƙoƙari don inganta sarrafa metabolism, musamman, ta hanyar sa ido sosai a kan matakin glucose a cikin jini.

Mafi yawanci ana gudanar da Protafan HM a cikin yanki a cinya. Idan wannan ya dace, to ana iya yin allura a cikin bangon gaban ciki, a yankin gluteal ko kuma a cikin yanki na ƙwayar tsoka ta kafada. Tare da gabatarwar miyagun ƙwayoyi a cikin cinya cinya, an kula da hankali sosai fiye da gabatarwar cikin yankin bangon ciki na ciki. Idan yin allura ya zama cikin ɗakunan fata na gaba, to, a rage girman haɗarin gudanarwar ƙwayar cutar intramuscular na bazata.

Wajibi ne a canza wurin allurar a cikin yankin na jiki don hana ci gaban lipodystrophy.

Babu wani yanayi da yakamata ayi insulin dakatarwar cikin hanji.

Tare da lalacewar kodan ko hanta, an rage buƙatar insulin.

Umarnin don amfani da Protafan NM da za a ba wa mara lafiya

Za'a iya amfani da vials tare da Protafan NM tare kawai tare da sirinji na insulin, wanda akan amfani da sikelin, wanda ke ba da damar auna kashi a cikin raka'a aikin. Vials tare da miyagun ƙwayoyi Protafan NM an yi niyya ne don amfanin mutum kawai. Kafin fara amfani da sabon kwalban Protafan HM, ana bada shawara don ba da damar ƙwayar ta dumama zuwa zafin jiki a cikin ɗakin kafin motsawa.

Kafin amfani da miyagun ƙwayoyi Protafan NM ya zama dole:

Duba marufin don tabbatar cewa an zaɓi nau'in insulin daidai.
Cire matattakalar roba tare da auduga.

Ba za a iya amfani da miyagun ƙwayoyi Protafan NM a cikin waɗannan lambobin ba:

Kada kuyi amfani da miyagun ƙwayoyi a cikin famfunan insulin.
Wajibi ne ga marassa lafiya suyi bayanin cewa idan sabon kidan da aka karba daga wurin kantin ba shi da filafin kariya ko kuma bai zauna da ƙarfi ba, dole ne a mai da insulin ɗin zuwa kantin magani.
Idan ba a adana insulin da kyau ba, ko kuma a daskararre.
Idan lokacinda haɗe abin da ke cikin murfin bisa ga umarnin don amfani, insulin ɗin ba zai zama fari da gajimare ba.

Idan mara lafiya yana amfani da nau'in insulin guda ɗaya kaɗai:

Nan da nan kafin kiran, yi mirgine kwalban a tafin hannunka har sai insulin ya kasance fari farare da gajimare. An sauƙaƙe tashin hankali idan ƙwayoyi suna da zazzabi a ɗakin.
Zana iska a cikin sirinji a cikin adadin wanda yayi daidai da adadin insulin da ake so.
Shiga cikin iska cikin kwalin insulin: saboda wannan, ana hure marubucin roba tare da allura kuma an matse piston.
Juya sirinjin sirinji ya juye.
Shigar da insulin da ake so a cikin sirinji.
Cire allura daga cikin murfin.
Cire iska daga sirinji.
Duba daidai gwargwado.
Cike kai tsaye.

Idan mai haƙuri yana buƙatar haɗa Protafan NM tare da insulin gajere mai aiki:

Mirgine kwalban tare da Protafan NM (“girgije”) tsakanin tafin hannunka har sai insulin ya zama fari da gajimare. An sauƙaƙe tashin hankali idan ƙwayoyi suna da zazzabi a ɗakin.
Zuba iska a cikin sirinji a cikin adadin wanda yayi daidai da kashi na Protafan NM (insulin "girgije"). Sanya iska a cikin murfin insulin na girgije kuma cire allura daga cikin murfin.
Zana iska a cikin sirinji a cikin adadin wanda yayi daidai da kashi na insulin gajeran aiki (“m”). Sanya iska a cikin kwalba tare da wannan magani. Juya sirinjin sirinji ya juye.
Kira kashi da ake so na insulin gajeriyar aiki (“a bayyane”). Cire allurar kuma cire iska daga sirinji. Duba daidai gwargwado.
Saka allura cikin murfin tare da Protafan HM (insulin "girgije") sannan ka kunna vial tare da sirinji a sama.
Yi lambar da ake so na Protafan NM. Cire allura daga cikin murfin. Cire iska daga sirinji ka bincika ko kaɗaicin yayi daidai.
Shigar da cakudadden insulin gajere da tsayi da ka alli nan da nan.

Koyaushe ɗauka insulins masu gajeru da tsayi a cikin jeri ɗaya kamar yadda aka bayyana a sama.

Ka umurci mai haƙuri ya gudanar da insulin a cikin tsarin guda ɗaya kamar yadda aka bayyana a sama.

Tare da yatsunsu biyu, tattara daɗa fata, saka allura a cikin gindin murfin a wani kusurwa na kimanin digiri 45, kuma saka allurar a ƙarƙashin fata.
Bayan allura, allura ya kamata ya kasance a karkashin fata na akalla awanni 6, don tabbatar da cewa an saka insulin gaba daya.

Side sakamako

Abubuwan da ba a sani ba sun lura a cikin marasa lafiya da aka bi da Protafan NM sun fi ƙarfin kashi-kashi kuma sun kasance ne sakamakon aikin insulin. Kamar yadda yake tare da sauran shirye-shiryen insulin, tasirin sakamako mafi yawancin shine hypoglycemia. Yana haɓakawa a cikin yanayi inda adadin insulin ya zarce buƙatarta. A lokacin gwaji na asibiti, kazalika da lokacin amfani da miyagun ƙwayoyi bayan fitarwarsa a kasuwar mabukaci, an gano cewa yawan hypoglycemia ya bambanta a cikin al'ummomin haƙuri daban-daban kuma lokacin amfani da tsarin magunguna daban-daban, don haka ba zai yiwu ba a nuna ainihin ƙimar ƙimar.

A cikin tsananin rauni, asarar hankali da / ko raɗaɗi na iya faruwa, rashi na wucin gadi ko na dindindin na aikin kwakwalwa har ma mutuwa na iya faruwa. Gwaje-gwaje na asibiti sun nuna cewa abin da ya faru a cikin ɗimbin ɗambin ƙwayar cuta yawanci bai bambanta tsakanin marasa lafiya da ke karɓar insulin na mutum da kuma marasa lafiya da ke karɓar insulin.

Followinga'idodi masu zuwa ne na yawan tasirin halayen da aka gano yayin gwaji na asibiti, waɗanda, a gaba ɗaya, an ɗauke su da alaƙa da amfani da miyagun ƙwayoyi Protafan NM. An ƙaddara mitar kamar haka: akai-akai (> 1/1000,

Siffar

Insulin Protafan yana samuwa a cikin nau'i na dakatarwa wanda aka yi nufin gudanar da aikin subcutaneous. Babban sashi mai amfani da miyagun ƙwayoyi shine insulin Isofan, analogue na hormone mutum wanda aka samar da injiniyan kwayoyin. 1 ml na miyagun ƙwayoyi ya ƙunshi 3.5 mg na isophan da ƙarin abubuwan haɗin gwiwa: zinc, glycerin, sulfate protamine, phenol da ruwa don yin allura.

Ana amfani da maganin a cikin kwalabe na milim 10, an rufe shi tare da filastik na roba kuma an shafe shi da tsare tsare na aluminium, da kuma a cikin katako na gilashin hydrolytic. Don sauƙaƙe saiti, an rufe katangar a cikin maɓallin sirinji. Kowane katun an sanye shi da ƙwallan gilashi wanda aka tsara don haɗa dakatarwa.

Kwalban insulin ya ƙunshi IU 1,000 na abu mai aiki, alkalami mai sirinji - 300 IU. Yayin ajiyar kaya, dakatarwar na iya yin tasiri da kuma fadadawa, sabili da haka, kafin gudanarwa, dole ne wakili ya girgiza har sai yayi laushi.

Ayyukan insulin na Protafan an yi niyya ne don rage matakan glucose na jini. Ana samun sakamako ta hanyar haɓaka jigilar glucose a cikin sel, ƙarfafa glycogenogenesis da lipogenesis, haɓaka sha da mamaye glucose ta kyallen, kuma yana haɓaka aikin gina jiki.

Magungunan yana cikin insulins-matsakaici masu aiki, saboda haka tasirin horar da aka shigar yana faruwa bayan minti 60-90. An lura da mafi yawan abubuwan abu a tsakanin 4 zuwa 12 sa'o'i bayan gudanarwa. Tsawon lokacin aikin ya dogara da yawan ƙwayoyi. Matsakaicin, wannan lokacin shine 11-24 hours.

Adana a tsakiyar shiryayye na firiji a zazzabi na +2 ... +8 ° С. Baza ta zama mai sanyi ba. Bayan buɗe katun, ana iya adanar shi a zazzabi a ɗakin na tsawon makonni 6.

Alamu da magunguna

Mafi sau da yawa, ana wajabta insulin Protafan don ciwon sukari na 1. Commonlyarancin yawanci, ana wajabta shi don nau'in masu ciwon sukari na 2 da mata masu juna biyu waɗanda jikinsu ke tsayayya da magungunan maganganu na baka. A wasu halaye, ana nuna tiyata don amfani. Ana iya ba da maganin ta hormone duka daban-daban kuma a hade tare da sauran insulins.

Ana amfani da miyagun ƙwayoyi sau 1-2 a rana, galibi da safe 30 mintuna kafin abinci. Don hana sakamako masu illa, sai a canza wurin allurar koyaushe. An zaɓi kashi ɗaya ga kowane mara lafiya daban-daban kuma ya dogara da halayen hanyar cutar. Yawan shawarar da aka ba da shawarar daga 8 zuwa 24 IU.

Idan akwai damuwa zuwa insulin, dole ne a daidaita sashi. Idan ƙwanƙwalwar ƙarancin hankali ta yi ƙasa, adadin ƙwayar zai iya ƙaruwa zuwa 24 IU ko sama da haka. Idan mai ciwon sukari ya sami fiye da 100 IU na Protafan kowace rana, gudanar da aikin kula da hodar ya kamata ya kasance ƙarƙashin kulawar likita koyaushe.

Dokokin aikace-aikace

Insulin Protafan an yi niyya ne don gudanar da aiki a ƙarƙashin ƙasa. Abun cikin ciki da na ciki Ba'a amfani da magunguna don famfo na insulin. Lokacin da siyan hormone a cikin kantin magani, tabbatar ka bincika amincin abin kariya. Idan ya kasance mai kwance ko a'a, ba da shawarar sayen irin wannan magani ba.

Kada ayi amfani dashi don insulin allura ta daskarewa, adana shi a ƙarƙashin yanayin da bai dace ba, ko kuma yana da fararen launi da girgije bayan haɗuwa. Abinda ke ciki yana samun fata karkashin taimakon taimakon insulin insulin ko alkalami na alkalami. Idan ana sarrafa magani a hanyar ta biyu, bi dokoki da aka bayyana a ƙasa.

Tabbatar bincika alamar da amincin alkalami.
Yi amfani da insulin a zazzabi a daki don allura.
Kafin gabatar da fitowar, cire hula kuma a cakuda shi sosai har sai yayi laushi.
Tabbatar cewa hormone a cikin alkalami ya isa aikin. Izinin mafi ƙaranci shine 12 IU. Idan akwai karancin insulin, yi amfani da sabon katun.
Karku taɓa adana alkairin tare da allura. Wannan an cika shi da yalwar insulin.

Lokacin amfani da alkalami a karon farko, yana da mahimmanci a tabbata cewa babu iska a cikin allura. Don yin wannan, danna cikin 2 UNITS na abu ta kunna mai zaɓa. Nuna allura sama ka matsa kicin din. Ya kamata kumburin iska ya tashi zuwa farfajiya. Latsa maɓallin farawa koyaushe. Tabbatar cewa mai zaɓa ya dawo kan matsayin “0”. Idan digo na insulin ya bayyana a ƙarshen allura, alkalami yana shirye don amfani. Idan babu digo, canza allura kuma maimaita hanya. Idan bayan buƙatun 6 masu canzawa guda ɗaya digon abu bai bayyana ba, ƙin yin amfani da alkalami sirinji: kuskure ne.

Kowane sirinji ya ƙunshi cikakkun bayanai don amfani. A takaice, ana iya bayanin hanyar kamar haka. Tara kashi ana buƙatar insulin. Don yin wannan, juya mai zaɓa zuwa maɓallin da ake so. Yi hankali da danna maɓallin farawa, in ba haka ba duk abubuwan zasu fashe. Shirya wani yanki na fata kuma saka allura a cikin gindi a kwana na 45 °. Latsa maɓallin kuma jira lokacin allurar insulin. Bayan mai zaɓin ya kasance a “0”, riƙe allura a ƙarƙashin fata don wani tsawan 6. Cire allura yayin rike maɓallin farawa. Saka hula a ciki ka cire shi daga sirinji.

Contraindications da sakamako masu illa

Insulin Protafan yana da kusan babu contraindications. Banda shi ne hankalin mutum na aiki ga kayan aiki ko abubuwan taimako.

Rashin bin umarnin da aka wajabta na iya haifar da cututtukan jini. Alamar raguwa sosai a cikin sukarin jini sune tsananin bacci, ciwon kai, damuwa, haushi, harin yunwar, gumi, rawar jiki, bugun zuciya.

Mummunan lokuta na rashin lafiyar hypoglycemia yana haɗuwa tare da aikin kwakwalwa masu rauni, haɓakar disorientation da rikicewa. Duk waɗannan alamu tare zasu iya haifar da rashin daidaituwa.

Don kawar da ƙwayar cuta mai sauƙi, ya isa ga masu ciwon sukari su ci wani abu mai daɗi (alewa, cokali mai yawan zuma) ko shan abin sha mai ɗauke da sukari (shayi, ruwan 'ya'yan itace). A cikin bayyanannun bayyanar cututtuka na glycemia, ambulance ya kamata a kira shi nan da nan kuma ya kamata a ba wa mai haƙuri maganin glucose na ciki ko glucagon intramuscular.

Yawancin lokaci rashin haƙuri yana haɗuwa da halayen rashin lafiyan a cikin nau'in huhu, itching, urticaria ko dermatitis.A cikin wasu marasa lafiya, a farkon jiyya tare da miyagun ƙwayoyi, an lura da kurakurai masu narkewa da haɓakar retinopathy, kumburi, da lalacewar ƙwayoyin jijiya. Bayan samun wadannan alamomin sun bace.

Idan sakamako masu illa suna ɗauka na dogon lokaci, likita zai iya maye gurbin Protafan tare da alamun rashin amfani da shi. Misali, Insulin Bazal, Humulin, Actrafan NM da Protafan NM Penfill.

Yin hulɗa tare da wasu kwayoyi

Wasu kwayoyi na iya raguwa ko haɓaka aikin insulin na Protafan. Daga cikin magungunan da ke haɓaka tasirin miyagun ƙwayoyi, ya kamata a lura da maganin hana ƙwaƙwalwar ƙwayoyin cuta na monoamine, kamar su Pyrazidol, Moclobemide da Silegilin, da magungunan antihypertensive: Enap, Kapoten, Lisinopril, Ramipril ya kamata a lura dasu. Hakanan ana iya haifar da cututtukan jini a jiki kamar su bromocriptine, steroids anabolic, colfibrate, ketoconazole da bitamin B₆.

Glucocorticosteroids, hormones thyroid, maganin hana haihuwa, maganin tricyclic antidepressants, thiazide diuretics da sauran magungunan hormonal suna rage tasirin Protafan. Tare da alƙawarin Heparin, masu hana tashar alli, Danazole da Clonidine, ana iya buƙatar daidaita sashin hormone. Detailedarin cikakken bayanai game da hulɗa tare da wasu kwayoyi ya kamata a samu a cikin umarnin.

Insulin Protafan hanya ce mai kyau don rage sukarin jini da inganta lafiyar gaba ɗaya. Yawancin masu ciwon sukari sun lura da ingancinsa da mafi ƙarancin halayen da ba a sani ba. Koyaya, don hormone ya shafi jiki sosai kuma ba haifar da matsala ba, ya zama dole a yi amfani da tsarin zaɓaɓɓen magani wanda aka zaɓa daidai. Sabili da haka, kada ku sami magunguna da kanku kuma ku tabbatar da daidaita ayyukan amfani da miyagun ƙwayoyi.