Insulin P: farashi da mai ƙira, bambance-bambance

A yau, godiya ga masana kimiyya a cikin ƙungiyar endocrinologists akwai shirye-shiryen insulin tare da lokutan aiki daban-daban: gajeru ko tsawanta. Bi da bi, kowane ɗayansu ya kasu kashi biyu. Irin wannan rarraba magungunan yana taimaka wa kwararru suyi kyau sosai yayin jigilar magunguna, kirkirar hanyoyin kulawa da glycemic na mutum, hada nau'ikan insulin.

Ultra Short-aiki insulin

Ya bambanta a cikin wani ƙarancin lokaci daga lokacin allura zuwa farkon raguwar cutar glycemia. Dangane da nau'in abu, tasirin rage sukari ya bayyana riga 10-20 mintuna bayan allurar, mafi girman sakamakon mafi yawa ana yin shi ne bayan sa'o'i 1-3, tsawon lokacin aikin shine awanni 3-5. Idan kana buƙatar inganta glycemia da sauri: Apidra, Humalog ko Novorapid (Flexpen da Penfill).

Short insulin

Magunguna na wannan rukunin suna fara aiki minti 30-60 bayan allura, ana lura da matakin mafi girma bayan awa 2-4, sakamakon yana kan matsakaicin awoyi 6-8. M abubuwa na asali iri (dabba ko ɗan adam) sun mallaki waɗannan kaddarorin:

Sunaye na kwayoyi: Actrapid MS, Actrapid NM, Biogulin R, Gensulin R, Monosuinsulin MK, Rinsulin R, Humulin Regular, Humodar R.

Insulin aiki mai tsawo

Tushen magungunan shine haɗuwa da abubuwa tare da matsakaiciyar matsakaiciya da tsawon lokaci. Rarraba cikin insulin na matsakaici da tsawan lokaci. Magungunan nau'ikan farko sun fara yin awo 1.5-2 bayan allura, suna samar da matakan jini mafi girma tsakanin awanni 3-12 bayan allura, da sarrafa abubuwan glucose na awanni 8-12.

Magunguna tare da matsakaicin matsakaici: Br-Insulmidi MK, Biosulin N, Gensulin N, Protafan NM, Protafan MS, Humulin NP, Insuman Bazal, Humodar B.

Karin insulin

Yana da tasiri na rage sukari bayan sa'o'i 4-8 bayan allura, ana samun sakamako mai girma zuwa kololuwa bayan sa'o'i 8-18 kuma yana kula da sarrafa glycemia na matsakaita na 20-30 hours.

Shirye-shirye: Lantus, Levemir (Penfill da Flexpen).

Hada magungunan insulin

Tasirin hypoglycemic yana bayyana rabin sa'a bayan gudanarwa a ƙarƙashin fata, yana ƙaruwa bayan sa'o'i 2-8 kuma yana sarrafa abubuwan glucose yawanci daga 18 zuwa 20 hours.

Shirye-shirye: Biosulin 30/70, Gansulin 30P, Gensulin M30, Insuman Comb 15 GT, Rosinsulin M mix 30/70, NovoMix 30 (Penfill da FlexPen).

Janar halaye na kwayoyi tare da matakan daban-daban na aiki

Ultrashort insulin

Shirye-shirye na wannan nau'in analog ne na kayan mutum. An tabbatar da cewa insulin da jiki ya samar a cikin sel na farji da kwayoyin dake cikin guntun kwayoyi sune maganin hexamers. Bayan gudanarwa a karkashin fata, ana shan su a cikin jinkirin farashi, sabili da haka mafi girman taro, daidai yake da abin da aka kafa a cikin jiki bayan cin abinci, ba a cimma ruwa ba.

Farkon gajeren insulin, wanda aka sha sau 3 cikin sauri fiye da ɗan adam, shine lyspro. Wannan abune na asalin halitta, wanda aka samo bayan an canza amino acid guda biyu a tsarinsa. Abubuwan da ke da sabon ginin ma suna da kaddarorin daban daban: yana hana samuwar hexamers sabili da haka yana samar da mafi girman shigar azzakari cikin ƙwayoyi a cikin jini da kuma samar da dabi'un ayyukan ƙima.

Na biyu analog na hormone mutum shine insulin a kwance. Hakanan an samo shi bayan an maye gurbin abubuwanda aka tsara, amma a wannan lokacin, aspartic acid wanda aka caji mara kyau an gabatar dashi cikin insulin mai sauƙi maimakon proline. A kwance, kamar Lyspro, kuma yana aiki da sauri kuma yana karyewa cikin babban gudu.

Hakanan an gano insulin glulisin bayan aspargin (amino acid) wanda aka maye gurbin shi da lysine a cikin kayan ɗan adam, kuma an canza wani lysine a matsayin B29 zuwa glutamic acid. Godiya ga wannan, an samo abu mai sauri mai sauri.

Shirye-shiryen insulin da aka kirkiro akan waɗannan abubuwan sun fara aiki kusan nan da nan. An basu izinin shiga jim kaɗan kafin abinci ko kuma nan da nan bayan ɗaukar shi.

Short insulin

Shirye-shiryen wannan rukuni ana kiranta mai narkewa, saboda sune mafita tare da rashin daidaituwa na acid. An tsara shi don sakawa a karkashin fata, amma idan ya cancanta, an allura su a cikin tsoka, kuma a lokuta masu tsananin rauni, gabatarwar shigowa jijiya.

An nuna su ta hanyar fara aiki da sauri (a kan matsakaici bayan mintuna 15-25) kuma ba a daɗe ba don adana tasirin hypoglycemic (kusan awanni 6). Mafi sau da yawa, ana amfani da insulin mai saurin aiki a sassan marasa lafiya don tantance yawan magunguna ga mai haƙuri. Amma ana amfani da shi a cikin mawuyacin yanayi na mai haƙuri, lokacin da ya zama dole don gaggauta tsayar da masu ciwon sukari a cikin halin rashin farin ciki ko asalinsu. Tare da kunnawa / a cikin sakamako an samu bayan mintina 5, saboda haka, ana gudanar da maganin ne don shan ƙarancin haɗarin canji mai sauri a cikin taro na glycemia. Bugu da ƙari, gajeren insulin ana amfani dashi azaman anabolic, sannan kuma an tsara shi a cikin ƙananan allurai.

Matsakaici tsawon insulin

Magunguna na wannan rukunin suna aiki da kwanciyar hankali: suna narkewa mafi muni, suna hankali a hankali daga wurin allura, don haka tasirin hypoglycemic yana daɗe. Hanyar aiki ana aiwatar dashi ta hanyar gabatar da abubuwa na musamman tare da ikon hana aikin insulin matsakaici. Yawancin lokaci, ana amfani da protamine ko zinc don wannan.

Dogon aiki insulin

Magungunan wannan rukuni sun dogara ne da glargine - wani abu mai kama da na ɗan adam, wanda aka samu ta hanyar haɓaka aikin injiniya. Ita ce farkon abin da ba shi da wata ma'anar matsakaiciyar matakin aikin. An samo Glargine ta hanyar hanyar sake sarrafa abubuwa a cikin sarƙoƙi na DNA: canza aspargin zuwa glycine, sannan kuma an haɗa ɓangarorin arginine.

Glargine-tushen insulin yana samuwa azaman bayani mai ma'ana tare da pH na 4. Acikinta acid yana kwantar da insulin hexamers, yana bayar da gudummawa ga tsawan lokaci da sanyin hankali na shan magungunan daga yadudduka na fata. Saboda wannan, ana iya saka shi ƙasa sau da yawa, tun da tsawon insulin yana sarrafa matakin cutar glycemia a ko'ina cikin rana.

Ba kamar sauran kwayoyi ba, waɗanda suke yanzu cikin jini daban-daban, suna samar da dabi'un mafi girma na aikin (kuma, sabili da haka, tsalle-tsalle a cikin glycemia), insulin tsawan lokaci baya haifar da ƙimar girma, tunda ya shiga cikin tsarin wurare dabam dabam a cikin kuɗin.

Akwai insulin tsayi a cikin siffofin sigogi da yawa tare da lokuta daban-daban na tasirin hypoglycemic. A matsakaici, kwayoyi na wannan nau'in suna sarrafa glucose a cikin jini na tsawon awanni 10-36. Irin wannan aikin da aka tsawaita, tare da tasirin warkewa, ya dace saboda yana ceton marasa lafiya daga injection akai-akai. Ana samun magungunan a cikin nau'ikan dakatarwa, waɗanda aka tsara don gudanarwa ta fata ko fata.

Ba za a iya yin amfani da insulin na dogon lokaci ba don rikitarwar cututtukan siga - coma, precom.

Hada insulin

Shirye-shirye dangane da nau'ikan insulin tare da halaye daban-daban ana samun su ta hanyar dakatarwa. An haɗaka haɗuwa saboda ɗan gajeren insulin da isophane - wani abu na matsakaici tsawon lokacin aiki. Irin wannan haɗin abubuwa tare da matakan sha na daban yana ba da damar hanzarta farawa na sarrafa glycemic da tsawaita tsawon yanayin al'ada.

Asalin bambanta

Nau'in insulin ana rarrabe shi ba kawai ta hanyar matakan aiki ba, tsawon lokacin sarrafa glucose, amma sun sha bamban da asalinsu. Don ɗan lokaci, an yi amfani da magungunan asalin dabba, to, tare da haɓaka kimiyya, ɗan adam, ƙananan masu jujjuyawa sun bayyana.

Don samar da insulin na asalin dabba, ana amfani da abubuwa masu keɓewa daga cututtukan aladu da dabbobi. Akwai nau'ikan da yawa daga gare su, kuma a cikin tambaya wanne ne mafi kyawu daga gare su, galibi an karkatar da su ne zuwa ga tsarin da sifar ɗin. An yi imanin cewa mafi inganci su ne waɗanda ke da ƙarancin bambancin ra'ayi game da batun ɗan adam.

An shirya shirye-shiryen insulin na ɗan adam ta hanyar gyare-gyare. Irin waɗannan kwayoyi suna da kusanci ga abubuwan halittar, amma saboda wasu maganganu a cikin DNA, suna da halaye daban-daban. Sabili da haka, a yau likitoci sun fi son insulin wannan nau'in.

Wanne insulin ne mafi kyau - babu wani tabbataccen amsar wannan tambaya, kamar yadda masana kimiyya ke ci gaba da aiki akan sabbin kwayoyi, ƙirƙirar kwayoyi masu tasowa masu zurfi da aminci. Kuma kodayake har yanzu ba a shawo kan cutar sankara ba, taimakawa marasa lafiya yanzu ya fi sauki. A yau, akwai nau'ikan magunguna daban-daban waɗanda za a iya amfani da su a cikin kayan maye kuma don ƙirƙirar dabarun sarrafawa daban-daban ta yin amfani da insulin cikin sauri da tsawo. Tare da taimakon haɗuwa iri-iri, babban adadin marasa lafiya na iya gamsuwa da buƙatar abu.

Rinsulin P: nau'i na saki da kuma halayen magunguna

Magungunan kwayar cutar insulin na mutum ne wanda ke aiki cikin sauri ta hanyar fasahar DNA. Kayan aiki yana ɗaure wa masu karɓar ƙwayoyin sel na waje, suna samar da hadaddun insulin-receptor wanda ke kunna ayyukan da ke faruwa a cikin sel, gami da samar da enzymes masu mahimmanci.

Ana samun raguwar yawan sukari na jini ta hanyar haɓakar jigilar glucose a cikin tsakiyar sel, ɗaukar hankalin sa da ƙari ta hanyar kyallen takarda. Starfafawa na glycogenogenesis, lipogenesis shima yana faruwa kuma yawan haɓakar glucose ta hanta yana raguwa.

A matsayinka na mai mulki, tsawon lokacin sakamako na shirye-shiryen insulin an ƙaddara shi da ƙimar sha, wanda ya dogara da abubuwa da yawa (yanki da hanyar gudanarwa, kashi). Sabili da haka, bayanan bayanan aiki na iya bambanta a cikin kowane haƙuri. Amma galibi bayan gudanar da aikin ƙarƙashin ƙasa, Rinsulin P yana aiki bayan rabin sa'a, kuma ana samun mafi girman sakamako bayan sa'o'i 1-3 kuma yana zuwa 8 hours.

GEROFARM-BIO OJSC mai samar da insulin na R shine ya samar da kwayar cutar ta fannoni uku:

1. Magani (10 IU / ml) don allurar 3 ml na miyagun ƙwayoyi a cikin gilashin gilashi tare da kayan roba.
2. Kayan katako guda 5 a cikin fakiti mai laushi mai walƙiya da PVC.
3. An haɗa katun a cikin takaddun sirinji mai yawa wanda aka yi da filastik, sanya shi cikin kwali.

Cikakken mamaye abubuwa da kuma fara aiki na insulin gajeran aiki dan adam an tabbatar da shi daga yankin, wuri, hanyar gudanarwa da kuma maida hankali ga aiki mai aiki. Ba a rarraba magungunan a ko'ina cikin kyallen ba, ba ya ratsa cikin nono da kuma shinge na mahaifa.

An lalata shi ta hanyar insulinase galibi a cikin kodan da hanta. An cire magungunan a cikin 30-80% na kodan. T1 / 2 shine minti 2-3.

Umarnin don amfani da miyagun ƙwayoyi

An nuna magungunan don kowane nau'in ciwon sukari na sukari, a cikin yanayin cikakken juriya ko ɓangare ga allunan rage sukari. Hakanan ana amfani dashi a cikin yanayi na gaggawa a cikin masu ciwon sukari a kan asalin tsarin lalata metabolism na metabolism kuma a cikin yanayin cututtukan cutuka. Koyaya, ba a ba da magunguna don maganin cututtukan hypoglycemia da rashin haƙuri ɗaya zuwa abubuwan da ya ƙunsa.

Magungunan an yi niyya ne don iv, v / m, s / c gudanarwa. Hanyar gudanarwa da sashi yana wajabta ta endocrinologist dangane da halayen mutum na mai haƙuri. Matsakaicin adadin maganin shine 0.5-1 IU / kg na nauyi.

Ana gudanar da magungunan insulin na gajere a cikin minti 30. Kafin ɗaukar abincin carbohydrate. Amma da farko, ya kamata ku jira har sai yawan zafin jiki na dakatarwar ya tashi zuwa akalla digiri 15.

Game da maganin monotherapy, ana gudanar da insulin sau 3 zuwa 6 a rana. Idan kashi na yau da kullun ya fi 0.6 IU / kg, to, kuna buƙatar shigar da allura biyu ko fiye a wurare daban-daban.

A matsayinka na mai mulkin, wakili yana allurar sc zuwa bangon ciki. Amma za'a iya yin allura a kafada, gindi da cinya.

Lokaci-lokaci, dole ne a canza yankin allurar, wanda zai hana bayyanar lipodystrophy. Dangane da tsarin cutarwa na kwayoyin karkashin ciki, ya kamata ka yi taka-tsantsan don tabbatar da cewa ruwan bai shiga cikin jini ba. Hakanan, bayan allurar, ba za a iya taɓantar da yankin allura ba.

A cikin / in da / m gwamnatin mai yiwuwa ne kawai a karkashin kulawa na likita. Ana amfani da katako don kawai idan ruwan yana da launi mai tsabta ba tare da ƙazanta ba, saboda haka, lokacin da hazo ya bayyana, bai kamata a yi amfani da maganin ba.

Yana da kyau a tuna cewa katukan suna da takamaiman na’ura wacce ba ta bada izinin hada abubuwan da ke cikin su da sauran nau'in insulin. Amma tare da cikakken cika alkalami na sirinji ana iya sake amfani dasu.

Bayan sakawa, dole ne a kwance allurar tare da hula ta waje sannan a watsar da shi. Don haka, ana iya hana yaduwar ruwa, ana iya amintar da iskar ruwa, kuma iska ba zata iya shiga allura kuma ta rufe ba.

Lokacin amfani da allon alkalami mai cike da yawa, ɗauki alkairin sirinji daga firiji kafin amfani da farko ka jira ta isa zazzabi ɗakin. Koyaya, idan ruwan ya daskare ko ya kasance mai girgiza, to baza'a iya amfani dashi ba.

Wasu dokoki har yanzu suna buƙatar a kiyaye:

• Ba za a iya sake amfani da allura,
• Insulin P wanda aka cika alkairin sirinji ana amfani dashi ne kawai don amfanin mutum, yayin da kayan kwantar da siraran ba za'a iya cika su ba,
• Kada a adana alkalami wanda aka yi amfani dashi a cikin firiji,
• don kare sirinji na sirinji daga haske, kullun rufe shi da hula.

Dole ne a adana maganin da aka riga aka yi amfani dashi da shi a zazzabi na 15 zuwa 25 don bai wuce kwanaki 28 ba. Hakanan, baza'a bada izinin na'urar ta yi zafi ba kuma ta bayyanar da hasken rana kai tsaye.

Game da yawan abin sama da ya kamata a cikin jini, yawan sukari zai iya raguwa sosai. Kula da cututtukan hypoglycemia ya ƙunshi ɗaukar abinci mai ɗauke da carbohydrate ko abin sha mai dadi. Sabili da haka, masu ciwon sukari ya kamata koyaushe suna da Sweets ko ruwan 'ya'yan itace tare da su.

Tare da matsanancin rashin ƙarfi, lokacin da mai ciwon sukari bai san komai ba, ana allura shi da maganin glucose (40%) ko glucagon.

Bayan mutum ya sake tunani, ya kamata a ciyar da shi abincin carbohydrate, wanda zai hana ci gaba da kai hari na biyu.

Rashin Amincewa da Hadin Gwiwa

Abubuwan da ke haifar da sakamako sune gazawa a cikin metabolism metabolism. Don haka, sake dubawar likitoci da marasa lafiya sun gangaro gaskiyar cewa bayan gudanarwar Rinsulin P, hypoglycemia na iya haɓaka. An bayyana wannan ta hanyar malaise, fata mai narkewa, ciwon kai, bugun jini, rawar jiki, yunwar, hyperhidrosis, dizziness, kuma a cikin manyan lokuta, hypoglycemic coma tasowa a cikin ciwon sukari mellitus.

Hakanan zai yiwu a sami halayen halayen da ke tattare da cutar, kamar su Quincke's edema, rashes na fata. Tashin hankalin Anaphylactic, wanda zai haifar da mutuwa, lokaci-lokaci yana ci gaba.

Daga halayen gida, itching, kumburi da hyperemia a cikin allurar mafi yawan lokuta suna faruwa. Kuma game da yanayin ilimin insulin na tsawan lokaci, lipodystrophy yana fitowa a wurin allurar.

Sauran halayen da ba su dace ba sun hada da kumburi da raunin gani. Amma sau da yawa, waɗannan bayyanar cututtuka suna shuɗewa yayin jiyya.

Akwai magunguna da yawa waɗanda ke shafar abubuwan insulin. Don haka, ra'ayoyin likitoci sun ce sakamakon rage karfin sukari na insulin ya yi karfi idan aka hada amfani da shi tare da wadannan hanyoyin:

1. allunan haila,
2. ethanol
3. ACE / MAO / maganin hana ƙwayoyin cuta,
4. shirye-shiryen lithium
5. masu zaɓar β-ba zaɓaɓɓu ba,
6. Fenfluramine,
7. Bromocriptine
8. Santabankan,
9. salicylates,
10. Mebendazole da ƙari.

Nicotine, glucagon, phenytoin, somatropin, morphine, estrogens, maganin hana haihuwa, diazoxide da corticosteroids suna rage tasirin hypoglycemic. Kwayoyin cutar ta thyroid dauke da sinadarin aidin, CCB, thiazide diuretics, Epinephrine, Clonidine, Heparin, Danazole, tricyclic antidepressants da tausayawa ma sun kara lalata tasirin sukari.

Yin amfani da B-blockers na iya rufe alamun hypoglycemia. Lanreotide ko Octreotide da barasa na iya haɓaka ko rage yawan insulin.

Ba shi da cikakkiyar dacewa don haɗa insulin ɗan adam tare da kwayoyi masu kama da samfuran dabbobi.

Umarni na musamman

A gaba da asalin ilimin insulin, yana da mahimmanci koyaushe kula da alamun glycemia. Lallai, ban da yawan shaye-shaye, wasu cututtuka, maye gurbin miyagun ƙwayoyi, ƙara yawan motsa jiki, zawo, canji a cikin allurar har ma abinci mara kan gado na iya taimakawa wajen rage yawan sukarin.

Bugu da ƙari, katsewa a cikin aikin insulin da kuma sashi mara kyau na iya haifar da hyperglycemia a cikin marasa lafiya da nau'in ciwon sukari na 1. Idan babu maganin, ketoacidosis na barazanar rayuwa na iya haɓaka.

Idan akwai cin zarafi a cikin aiki na kodan, hanta, glandar glandon fata, hypopituitarism, cutar Addison da kuma lokacin tsufa, ya zama dole don daidaita sashin insulin. Bugu da ƙari, canji na sashi na iya zama dole lokacin da ake canza abinci da haɓaka aikin jiki.

Bukatar insulin yana ƙaruwa a gaban cututtukan concomitant, musamman waɗanda ke haɗuwa da zazzabi. Yana da kyau a lura cewa yayin sauyawa daga wani nau'in insulin zuwa wani, ya kamata a lura da sukarin jini a hankali.

Kudin Rinsulin P ya tashi daga 448 zuwa 1124 rubles.

Baya ga Insulin P, akwai magani Rinsulin NPH. Amma ta yaya waɗannan kudaden za su bambanta?

Rinsulin NPH

Magungunan shima insulin na mutum ne wanda aka samu ta hanyar fasahar DNA. Koyaya, a kwatanta da Insulin P, ba shi da ɗan gajeru, amma matsakaicin sakamako. Duk magungunan za a iya haɗuwa.

A matsayinka na mai mulkin, bayan sc gwamnati, aikin insulin ya fara ne bayan awa 1.5. Ana samun babban sakamako bayan sa'o'i 4-12 kuma yana kwana ɗaya.

Dakatarwar tana da fararen launi, kuma lokacin da take tsaye a ƙasan kwalbar, fasalin haɓaka, wanda, lokacin da aka girgiza, an sake farfadowa. Abubuwan da ke aiki na miyagun ƙwayoyi shine insulin-isophan.

Kamar yadda aka yi amfani da abubuwan taimako:

• distilled ruwa
• Al'adari ya cika
• sodium hydrogen phosphate foda,
• glycerol
• metacresol
• crystalline phenol.

Ana samun fitowar a cikin gilashin gilashin 3 ml kowannensu, an sanya shi cikin fakiti. Hakanan, za'a iya siyan samfurin a cikin katako na gilashin da aka sanya a cikin sirinji mai yawa don injections na Rinastra.

Pharmacokinetics da alamomi don amfani da miyagun ƙwayoyi iri ɗaya ne kamar yadda ake amfani da Rinsulin R. Maganin likitan an ƙayyade shi daban-daban.

Matsakaicin adadin maganin shine 0.5-1 IU / kg na nauyin jiki. Amma shigar cikin jijiyoyin cuta contraindicated.

Umarnin don yin amfani da Rinsulin NPH game da tasirin sakamako, yawan abubuwan amfani da hanyoyin yin amfani da su bai bambanta da bayanin insulin ɗan adam ba.

Farashin dakatarwar daga 417 zuwa 477 rubles. Bidiyo a cikin wannan labarin zai taimaka maka koyon yadda ake sarrafa insulin.