Matsalar ɗan adam da aka kera ta hanyar insulin da kuma duk game da shi

Hormones da gajeren zango na antagonists / insulins.

100ME / ml-5ml D.t.d.№5 a cikin flac.

S.: Subcutaneously 30 minti kafin abinci sau 4 a rana

Rp.: Insulini 40 ME (5 ml)

S. A sa a cikin babban abu sau 0,5 a sau 3 a rana mintuna 30 kafin abinci.

Yin hulɗa tare da takamaiman mai karɓa akan membrane na sel, yana samar da hadaddun mai karɓar insulin

Nau'in 1, 2 na ciwon sukari, masu ciwon suga, ketoacidotic da hyperosmolar coma, ciwon sukari na mata masu ciki, kafin sauya sheka zuwa jiyya tare da shirye-shiryen insulin tsawan lokaci.

Allergic halayen, hypoglycemia, hypoglycemic coma, tashin hankali na gani na yau da kullun (yawanci a farkon farfajiya), hyperemia, pruritus, da lipodystrophy (a wurin allura).

50 Insulin-Isophan (Injin Injiniyan ɗan adam)

Matsakaici tsawon insulin

S.: Allurar dakatar da shi sau biyu sau biyu a rana

Rp.: Insulini-isophani 40 ME (5 ml)

S. A sa a cikin babban abu sau biyu a 0.5 ml sau 2 a rana mintuna 30 kafin abinci.

Yana hulɗa tare da takamaiman masu karɓa na ƙwayar cytoplasmic na ƙwayar sel kuma yana samar da hadaddun insulin-receptor wanda ke motsa ayyukan cikin ciki

Nau'in mellitus na ciwon sukari guda biyu, nau'in ciwon sukari guda 2 a cikin mata masu juna biyu.

yanayin hypoglycemic yanayin hypoglycemic coma. kumburi, kurakurai na m na kurakurai

51 ipratropium bromide

Rp.: Sol.Atroventi 0.25% -20ml pro inh.

S.: 0.5 MG (saukad da 40) sau 3-4 a rana ta hanyar nebulizer, a baya an kirkiri shi cikin 4 ml na Saline.

Rp.: Sol. Ipratropiibromidi 0.25% - 20ml

D.S: 2 ml (saukad da 40) da aka narkar da a cikin 2 ml na 0.9% sodium chloride bayani, zuba a cikin nebulizer. Inhalation sau 3 a rana.

Ciwon mara na yau da kullun yana fama da cutar sankara (ciwon hanji da ke fama da ita, ciwon huhun hanta), amai da fata (matsakaici da laushi).

Hypersensitivity to atropine da abubuwan da ya samo asali, da sauran abubuwan da ke tattare da miyagun ƙwayoyi, ciki (I trimester), yara underan shekaru 6 da haihuwa.

ciwon kai, tashin zuciya, bushewar bakin ciki, tachycardia, palpitations, hargitsi na masauki, rage raguwar gland gland, rashin motsin ciki, nakasar motsi, riƙewar urinary, halayen rashin lafiyan.

52 Itracanazole. Magungunan rigakafi na rukunin asali na triazole

Rp.: Intraconazoli 0.1

S.: A cikin kawa 1 lokaci 1 kowace rana.

yana hana cytochrome-P450-synthesis na ergosterol - muhimmin ɓangaren ƙwayoyin sel na fungi.

Mycoses na fata, na bakin mucosa da idanu, onychomycosis sakamakon dermatophytes, yisti da molds, candidiasis tare da lalacewar fata da mucous membranes, ciki har da vulvovaginal candidiasis, sadriasis versicolor, mycoses na tsari

dyspepsia, ciwon ciki, ƙaruwar aikin hanta na hanta, ciwon kai, farin ciki, jijiyoyin jiki, gajiya, rashin barci.

Mene ne bambanci tsakanin shirye-shiryen insulin daga juna

1. Matsayi na tsarkakewa.
2. Tushen karɓa shine alade, bovine, insulin mutum.
3. Componentsarin abubuwan da aka haɗa cikin maganin maganin shine abubuwan kiyayewa, tsawan aiki da sauran su.
4. Taro.
5. pH na mafita.
6. Ikon haɗu da magunguna gajere da tsayi

Insulin wani kwaro ne wanda ke fitowa daga sel na musamman a cikin hanji. Sinadari iri ne guda biyu, wanda ya hada da amino acid 51.

Kimanin raka'a 6 na insulin ana cinye shi kowace shekara a cikin duniya (1 naúrar ita ce microgram na abu guda 42). Samun insulin na zamani ne mai fasaha kuma ana yin shi ne kawai ta hanyoyin masana'antu.

Tushen insulin

A halin yanzu, dangane da tushen samarwa, an ware insulin alade da shirye-shiryen insulin na mutane.

Insulin alade yanzu yana da babban matsayi na tsarkakewa, yana da kyakkyawan tasirin hypoglycemic, kuma kusan babu wasu halayen rashin lafiyan da ake dashi.

Shirye-shiryen insulin na mutum suna cikakkiyar daidaituwa a tsarin sunadarai tare da kwayar halittar mutum. Yawancin lokaci ana yin su ta hanyar biosynthesis ta amfani da fasahar injiniyan kwayoyin.

Manyan masana'antun suna amfani da irin waɗannan hanyoyin samarwa waɗanda ke ba da garantin cewa samfuransu sun cika duk matakan inganci. Babu wani bambance-bambance masu mahimmanci a cikin aikin ɗan adam da porcine monocomponent insulin (i tsarkakakke) an samo su; dangane da tsarin na rigakafi, a cewar binciken da yawa, bambanci yana da kaɗan.

Abubuwa masu taimako da aka yi amfani da su wajen samar da insulin

A cikin kwalban tare da miyagun ƙwayoyi ya ƙunshi bayani wanda ya ƙunshi ba kawai insulin na hormone ba, har ma da sauran mahadi. Kowannensu yana da takamaiman matsayi:

• tsawo daga cikin aikin da miyagun ƙwayoyi,
• maganin warwarewa
• kasancewar kaddarorin abubuwan da ke samar da wutar lantarki da kuma samar da tsaka-tsakin pH (ma'aunin acid-acid).

Ensionaukar insulin

Don ƙirƙirar insulin-mai-aiki, ɗayan abubuwa biyu, zinc ko protamine, an haɗa su zuwa maganin insulin na al'ada. Dangane da wannan, ana iya raba abubuwa biyu zuwa rukuni biyu:

• protamine insulins - protafan, insuman basal, NPH, humulin N,
• zinc-insulins - insulin-zinc-suspensions na mono-tard, tef, humulin-zinc.

Protamine furotin ne, amma halayen da ba a yarda da su ba sunada yawa.

Don ƙirƙirar matsakaici na mafita, an ƙara phosphate buffer a ciki. Ya kamata a tuna cewa insulin dauke da sinadarin phosphates haramun ne a hada su da insulin-zinc dakatar (ICS), tunda zinc-phosphate precipitates a wannan yanayin, kuma aikin zinc-insulin ya gajarta ne a hanyar da ba a iya tsammani ba.

Abubuwa masu rarrabuwar kawuna

Wasu daga cikin mahadi waɗanda, bisa ga ka'idodin magunguna da fasaha, yakamata a gabatar dasu cikin shirye-shiryen, suna da tasirin sakamako. Waɗannan sun haɗa da cresol da phenol (dukansu suna da ƙanshin wari), da methyl parabenzoate (methyl paraben), a cikin babu wari.

Gabatarwar ɗayan waɗannan abubuwan kiyayewa kuma yana haifar da ƙanshin ƙanshi na wasu shirye-shiryen insulin. Duk abubuwan kiyayewa a cikin adadin da aka samo su a cikin shirye-shiryen insulin ba su da wani mummunan tasiri.

Magungunan protamine yawanci sun hada da cresol ko phenol. Ba za a iya kara Phenol a cikin mafita na ICS ba saboda yana canza kayan jikin mutum na barbashi. Wadannan kwayoyi sun hada da methyl paraben. Hakanan, ion c zinc a cikin bayani yana da tasirin antimicrobial.

Godiya ga wannan rigakafin ƙwayoyin cuta mai cutarwa iri-iri, an hana ɗaukar abubuwa daga haɓaka yiwuwar rikitarwar da zai iya faruwa ta hanyar ƙwayar ƙwayar cuta yayin da ake sa allurar cikin maimaita maganin.

Saboda kasancewar irin wannan kayan aikin kariya, mai haƙuri na iya amfani da sirinji guda ɗaya don injections na miyagun ƙwayoyi na kwanaki 5 zuwa 7 (muddin kawai yana amfani da sirinji). Haka kuma, abubuwan hana haihuwa suna iya yiwuwa a daina amfani da barasa don maganin fatar kafin allura, amma kuma kawai idan mai haƙuri ya saka kansa da sirinji tare da allura na bakin ciki (insulin).

Insulin Syringe Calibration

A cikin shirye-shiryen insulin na farko, raka'a ɗaya daga cikin kwayoyin sun kasance a cikin ml na maganin. Daga baya, taro ya ƙara ƙaruwa. Yawancin shirye-shiryen insulin a cikin kwalaben da ake amfani da su a Rasha suna da raka'a 40 a cikin 1 ml na bayani. Ana yiwa alamar vials yawanci tare da alamar U-40 ko raka'a 40 / ml.

An yi niyya don yin amfani da ko'ina, kawai don irin wannan insulin kuma ana yin kwalliyar su bisa ga ka'idar da ke gaba: lokacin da sirinji ya cika da 0.5 ml na mafita, mutum ya sami raka'a 20, 0.35 ml yayi dace da raka'a 10, da sauransu.

Kowane alamar akan sirinji daidai yake da wani ƙarar, kuma mai haƙuri ya riga ya san adadin raka'a da suke ƙunshe a cikin wannan ƙarar. Don haka, daidaituwa na sirinji shine daidaituwa ta hanyar yawan maganin, wanda aka ƙididdige shi akan amfani da insulin U-40.Rukunin insulin 4 suna cikin 0.1 ml, raka'a 6 - a cikin 0.15 ml na miyagun ƙwayoyi, da sauransu har zuwa raka'a 40, wanda ya dace da 1 ml na bayani.

Wasu Mills suna amfani da insulin, 1 ml wanda ya ƙunshi raka'a 100 (U-100). Don irin waɗannan kwayoyi, ana samar da sirinji na insulin na musamman, waɗanda suka yi kama da waɗanda aka tattauna a sama, amma suna da canjin aiki daban.

Yana yin la’akari da wannan takaddama na musamman (yana sau 2.5 sau da yawa fiye da matsayin). A wannan yanayin, adadin insulin ga mara lafiya, ba shakka, ya kasance iri ɗaya ne, tunda yana biyan bukatun jikin mutum don takamaiman adadin insulin.

Wato, idan mai haƙuri a baya ya yi amfani da miyagun ƙwayoyi U-40 kuma ya sanya raka'a 40 na hormone a rana ɗaya, to, ya kamata ya karɓi raka'a 40 daidai lokacin da suke allurar insulin U-100, amma allurar ta cikin adadin sau 2.5. Wato, raka'a 40 guda ɗaya za'a ƙunshi cikin 0.4 ml na mafita.

Abin baƙin ciki, ba duk likitoci ba ne musamman ma masu ciwon sukari sun san wannan. Matsalolin farko sun fara ne yayin da wasu daga cikin marassa lafiyar suka sauya zuwa yin amfani da allurar insulin (alkalami mai narkewa), wanda ke amfani da penfills (katako na musamman) dauke da insulin U-40.

Idan kun cika sirinji tare da bayani mai taken U-100, alal misali, har zuwa alamar 20 raka'a (i.e. 0.5 ml), to wannan ƙarar zata ƙunshi adadin 50 na magani.

Kowane lokaci, cike cingire insulin na U-100 tare da sirinji na yau da kullun da kuma kallon rabe-rabensu, mutum zai sami kashi 2.5 sau sama da wanda aka nuna a matakin wannan alamar. Idan babu likita ko mai haƙuri a lokacin da suka lura da wannan kuskuren, to, yiwuwar haɓaka mummunan ciwo yana da yawa saboda yawan yawan ƙwayoyi, wanda a aikace yawanci yakan faru.

A gefe guda, wasu lokuta akwai insirines insulines wanda aka sanya musamman don maganin U-100. Idan irin wannan sirinjin kuskure ne ya cika da maganin U-40 na yau da kullun, to, kashi na insulin a cikin sirinji zai zama sau 2.5 ƙasa da wanda aka rubuta kusa da alamar da ta dace akan sirinji.

Sakamakon wannan, ƙaruwar rashin daidaituwa a cikin glucose jini yana yiwuwa da farko a kallon farko. A zahiri, hakika, komai abu ne mai ma'ana - don kowane taro na miyagun ƙwayoyi ya zama dole don amfani da sirinji wanda ya dace.

A wasu ƙasashe, alal misali, Switzerland, an tsara wani shiri a hankali, wanda a sa'ilinda aka sami canjin canji ga shirye-shiryen insulin mai taken U-100. Amma wannan yana buƙatar kusanci ga duk waɗanda ke da sha'awar: likitoci na yawancin fannoni, marasa lafiya, ma'aikatan aikin jinya daga kowane ɓangare, masana'antun magunguna, masana'antun, hukumomi.

A cikin ƙasarmu, yana da matukar wahala don canja wurin duk marasa lafiya zuwa yin amfani da insulin U-100 kawai, saboda, mafi kusantarwa, wannan zai haifar da karuwa a cikin adadin kurakurai a ƙayyade kashi.

Daidaita amfani da insulin gajere da tsawa

A cikin magungunan zamani, lura da ciwon sukari, musamman nau'in farko, yawanci yakan faru ne ta amfani da haɗuwa da nau'ikan insulin guda biyu - gajere da tsawaita aiki.

Zai iya zama mafi dacewa ga marasa lafiya idan magunguna tare da durations daban-daban na aiki zasu iya haɗuwa a cikin sirinji guda ɗaya kuma ana gudanar dasu lokaci guda don guje wa bugun fata sau biyu.

Yawancin likitoci ba su san abin da ke ƙayyade ikon haɗu da insulins daban-daban ba. Dalilin wannan shine sunadarai da galenic (wanda aka tsara da abun da aka gindaya) jituwa na tsawaita da gajeriyar aiki.

Yana da mahimmanci cewa lokacin da ake haɗuwa da nau'ikan kwayoyi guda biyu, saurin farawa na gajeren insulin ba ya buɗe ko ɓacewa.

An tabbatar da cewa za a iya haɗaka magani na ɗan gajeren lokaci a cikin allura guda tare da protamine-insulin, yayin da farawar insulin ɗan gajeren lokaci ba a jinkirta ba, saboda insulin narkewa baya ɗaure da protamine.

A wannan yanayin, mai ƙirar maganin ba shi da matsala.Misali, za'a iya haɗe shi da humulin H ko protafan. Bayan haka, ana iya adana abubuwan hadewar wadannan shirye-shiryen.

Game da shirye-shiryen zinc-insulin, an daɗe da kafaɗa cewa insulin-zinc-dakatar (crystalline) ba za a haɗe shi da gajeren insulin ba, saboda yana ɗaure da ƙwayoyin zinc mai yawa kuma yana canzawa zuwa insulin tsawanta, wani lokacin kuma wani ɓangare.

Wasu marasa lafiya sun fara yin amfani da magani na ɗan gajeren lokaci, to, ba tare da cire allura daga ƙarƙashin fata ba, dan kadan canza alkiblarsa, kuma ana amfani da allurar zinc-insulin.

Dangane da wannan hanyar gudanarwa, an gudanar da 'yan karancin karatun kimiyya, don haka ba za a iya yanke hukunci cewa a wasu yanayi tare da wannan hanyar allura wani hadadden sinadarin zinc-insulin da kuma wani gajeran magani wanda zai iya samar da fata, wanda zai kai ga shan sashi na karshen.

Don haka, yana da kyau a gudanar da gajeren insulin gabaɗaya daga zinc-insulin, a sanya allura dabam dabam a cikin fagen fata da ke aƙalla 1 cm baya ga juna.Wannan bai dace ba, ba a maimaida daidaitaccen matakin ba.

Hada insulin

Yanzu masana'antar masana'antu suna samar da shirye-shiryen haɗuwa waɗanda ke ɗauke da insulin gajere da aiki tare da protamine-insulin a cikin tsayayyen ƙaddarar yawan kashi. Wadannan kwayoyi sun hada da:

Abubuwan da suka fi tasiri sune waɗanda ragon gajere zuwa ga insulin tsawon shine 30:70 ko 25:75. Ana amfani da wannan rabo koyaushe a cikin umarnin don amfanin kowane takamammen magani.

Irin waɗannan kwayoyi sun fi dacewa da mutanen da ke bin tsarin cin abinci na yau da kullun, tare da motsa jiki na yau da kullun. Misali, tsofaffi suna amfani dasu da masu ciwon sukari na 2.

Abubuwan insulins masu haɗari basu dace da aiwatar da abin da ake kira 'insulin' insulin therapy ba, lokacin da ya zama dole don canza yanayin insulin na ɗan gajeren lokaci.

Misali, wannan yakamata ayi lokacin canza adadin carbohydrates a abinci, rage ko kara yawan motsa jiki, da sauransu. A wannan halin, yawan insulin basal (tsawan lokaci) kusan ba shi da canji.

Tsarin, sunan sunadarai: babu bayanai.
Kungiyar magunguna: hormones da abokan adawar su / insulins.
Aikin magunguna: hypoglycemic.

Kayan magunguna

Insulin ɗan adam wani shiri ne na matsakaici wanda yake samu ta hanyar fasahar DNA. Insulin ɗan adam yana daidaita tattarawar glucose a cikin jini, adanawa da metabolism na carbohydrates, fats, sunadarai a cikin gabobin manufa (ƙwayar tsoka, hanta, tsopose nama). Insulin ɗan adam yana da kaddarorin anabolic da anti-catabolic sakamako. A cikin ƙwayar tsoka, akwai karuwa a cikin abun da ke ciki na glycerol, glycogen, kitse mai yawa, haɓakar haɓakar furotin da karuwa a cikin yawan amino acid, amma akwai raguwa a cikin gluconeogenesis, lipolysis, glycogenolysis, ketogenesis, catabolism protein da kuma sakin amino acid. Insulin ɗan adam yana ɗaure wa mai membrane (tetramer, wanda ya ƙunshi ƙananan ƙananan 4, 2 wanda (beta) yana cikin nutsuwa a cikin membrane na cytoplasmic kuma sune masu ɗaukar nauyin tyrosine kinase, da sauran 2 (alpha) abubuwa masu ƙwaƙwalwa kuma suna da alhakin ɗaukar hormone), samar da hadaddin mai insulin, wanda ya gudanar da aikin kansa. Wannan hadaddun a cikin sel mai rai yana samar da threonine da kuma serine iyakar kinases mai gina jiki, wanda hakan ke haifar da samuwar phosphatidylinositol kuma yana haifar da phosphorylation, wanda ke kunna aikin enzymatic a cikin kwayoyin halittar masu hankali. A cikin tsokoki da sauran kyallen takarda (banda kwakwalwa), yana haɓaka juyar da ƙwayar ƙwayar ƙwayar ciki da amino acid, yana rage jinkirin furotin, kuma yana haɓaka ayyukan haɓaka.Insulin mutum yana inganta tarin glucose a cikin hanta kamar glycogen kuma yana hana glycogenolysis (gluconeogenesis). Bambancin daidaikun mutane a cikin aikin insulin ya dogara da kashi, wurin allura, ayyukan jiki na mai haƙuri, abinci da sauran dalilai.
Rashin insulin na ɗan adam ya dogara da hanya da kuma wurin gudanarwa (cinya, cinya, buttocks), maida hankali na insulin, ƙarar allura. An rarraba insulin na mutum ba tare da daidaituwa ba tsakanin kyallen, ba ya shiga cikin madarar nono da kuma ta hanyar shinge na mahaifa. Rushewa da miyagun ƙwayoyi yana faruwa a cikin hanta a ƙarƙashin aikin insulinase (glutathione-insulin transhydrogenase), wanda ke ɗaukar nauyin abubuwan haɗin gwiwa tsakanin sarƙoƙi A da B kuma yana samar da su don enzymes na kariya. Insulin ɗan adam ya cire ta da ƙodan (30 - 80%).

Nau'in na 1 da nau'in ciwon sukari na 2 wanda ke buƙatar maganin insulin (tare da tsayayya da maganganu na maganganu na baki ko tare da magani, yanayin tsaka-tsaki), ciwon sukari mellitus yayin daukar ciki.

Sashi da gudanarwar insulin na mutum

Hanya na sarrafa magunguna ya dogara da nau'in insulin. Likita ya saita kashi daban-daban, gwargwadon matakin glycemia.
Ana aiwatar da allurar Subcutaneous a cikin yankin bangon ciki na ciki, cinya, kafada, gindi. Dole ne a sauya wuraren da ake yin allurar domin kada a yi amfani da wurin iri ɗaya fiye da sau ɗaya a wata. Tare da yin aiki da insulin ƙasa na insulin, dole ne a kula da kar a shigar da jini lokacin allura. Yakamata a horar da marassa lafiya yadda yakamata ayi amfani da ingin insulin. Kar a yi masa allurar bayan allura. Zazzabi na miyagun ƙwayoyi da aka sarrafa ya kamata ya kasance da zazzabi a ɗakin.
Rage yawan allura na yau da kullun ana samunsa ta hanyar haɗa insulin abubuwa daban daban na aiki.
Tare da haɓakar halayen rashin lafiyan, asibiti na mai haƙuri, gano ɓangaren miyagun ƙwayoyi wanda shine allergen, ganawar isasshen jiyya da maye gurbin insulin ya zama dole.
Rushewar jiyya ko amfani da isasshen allurai na insulin, musamman ma a cikin marassa lafiya da ke dauke da cutar sukari ta type 1, na iya haifar da cutar sikari da cutar ketoacidosis (yanayin da ke haifar da haɗarin rayuwar mai haƙuri).
Ci gaban hypoglycemia lokacin amfani da miyagun ƙwayoyi yana ba da gudummawa ga yawan wuce gona da iri, aikin jiki, keta cin abinci, lalacewar ƙwayar ƙwayar cuta, hanta mai ƙiba.
Yankin insulin yakamata a daidaita shi idan yanayin aikin pituitary, gland shine yake, glandon hanji, hanta da / ko hanta sun lalace, cutar Addison, ciwon sikari, da kuma ciwon sukari a cikin marasa lafiya da suka haura shekaru 65. Hakanan, ana iya buƙatar canji a cikin adadin insulin tare da karuwa da yawan motsa jiki ko canji a cikin abincin da aka saba. Amfani da abinci na Ethanol (gami da shaye-shaye mara ƙanƙan giya) na iya haifar da cututtukan jini. Kar a dauki ethanol a ciki. Tare da wasu cututtukan haɗin gwiwa (musamman ma na ciki), yanayin da ke haɗuwa da zazzabi, damuwa na damuwa, buƙatar insulin na iya ƙaruwa.
Bayyanar cututtukan cututtukan jini na asali tare da yin amfani da insulin na ɗan adam a cikin wasu marasa lafiya na iya zama ƙarancin bayyanawa ko bambanta da waɗanda aka lura da asalin asalin dabba. Tare da daidaituwa na glucose a cikin jini, alal misali, tare da kulawa mai zurfi tare da insulin, duk ko wasu alamu na abubuwan da ke faruwa na hypoglycemia na iya ɓacewa, game da abin da ya kamata a sanar da marasa lafiya. Kwayar cutar cututtukan cututtukan jini na iya zama ƙasa da faɗi ko canza tare da tsawan lokaci na ciwon sukari mellitus, ciwon sukari mai ciwon sukari, da kuma amfani da beta-blockers.
Ga wasu marasa lafiya, gyaran kwayar na iya zama dole yayin juyawa daga insulin dabbobi da aka samu zuwa insulin mutum. Wannan na iya faruwa a farkon aikin insulin na mutum ko a hankali cikin weeksan makonni ko watanni bayan canja wurin.
Canjin daga wani nau'in insulin zuwa wani dole ne a aiwatar dashi karkashin tsaftataccen aikin likita da kuma sarrafa glucose na jini. Canje-canje a cikin aiki, alama (masana'anta), nau'in, nau'in (ɗan adam, dabba, analogs na ɗan adam) da / ko hanyar samarwa (insulin maimaita insulin ko insulin na asalin dabbobi) na iya buƙatar daidaita sashi.
Lokacin amfani da shirye-shiryen insulin lokaci guda tare da magungunan ƙungiyar thiazolidinedione, haɗarin haɓakar edema da rauni na zuciya yana ƙaruwa, musamman a cikin marasa lafiya tare da cututtukan cututtukan jijiyoyin jini da kasancewar abubuwan haɗari don raunin zuciya.
Tare da hypoglycemia a cikin haƙuri, saurin halayen psychomotor da maida hankali ne na iya raguwa. Wannan na iya zama haɗari lokacin da waɗannan damar ke da muhimmanci musamman (misali, sarrafa kayan inji, tuki motoci da sauransu). Ya kamata a shawarci marasa lafiya su yi taka-tsantsan don hana ci gaban hauhawar jini yayin aiwatar da ayyukan haɗari waɗanda ke buƙatar halayen psychomotor cikin sauri da haɓaka hankali (gami da tuki motoci, aiki tare da hanyoyin). Wannan yana da mahimmanci musamman ga marasa lafiya waɗanda ba su da rashi ko kuma alamu masu sassaucin alamun rashin ƙarfi na hypoglycemia, kazalika da ci gaba da ɗimin hauhawar jini. A irin waɗannan halayen, likita dole ne ya kimanta yiwuwar haƙuri don yin irin waɗannan ayyukan.

Haihuwa da lactation

A lokacin daukar ciki, yana da mahimmanci musamman don kula da kyakkyawar kulawa ta glycemic a cikin matan da suke karɓar maganin insulin. A lokacin daukar ciki da lactation, ya zama dole don daidaita sashin insulin don rama ciwon suga. Bukatar insulin yawanci yana raguwa a cikin farkon farkon ciki kuma yana ƙaruwa a cikin watanni na biyu da na uku na ciki. Bukatar insulin na iya raguwa sosai yayin haihuwa da kuma bayanta. Matan da ke da ciwon sukari suna buƙatar sanar da likita game da ciki ko shirinta. A cikin mata masu fama da ciwon sukari mellitus, ana buƙatar daidaita sashin insulin da / ko rage cin abinci yayin shayarwa. Insulin ɗan adam ba mutagenic bane a cikin in vitro da kuma jerin vivo a cikin nazarin kwayoyin cutar guba.

Me yasa ake kira insulin "kayan injiniyan asali"

Wasu daga cikin marasa lafiya suna firgita da kalmar “masu ilimin kimiya ta asali,” suna tunatar da su “GMOs mafi girman laifi.”

A zahiri, kirkirar wannan magani ne ya ceci miliyoyin rayuwar mutane masu ciwon sukari.

A farkon, likitoci sunyi amfani da insulin daga cikin dabbobi (galibi aladu da shanu). Ko yaya, wannan hormone ba baƙon bane kawai ga ɗan adam, amma kuma ya shiga cikin jini nan take, yana haifar da tsalle-tsalle a cikin glucose kuma yana haifar da rikitarwa masu yawa.

Ingantaccen insulin ya kasance yana yin la'akari da duk abubuwan da ake buƙata na mai haƙuri tare da ciwon sukari, yana lalata halayen ƙwayoyin cuta daban-daban. Bayan ƙarshen aikinsa, ya rushe zuwa cikin amino acid na yau da kullun kuma an fitar dashi daga jiki.

Abubuwan da ke cikin magunguna na asali

Magungunan insulin ɗan adam yana nufin magungunan maye gurbin insulin na gajeran lokaci.

Tare da mai karɓa na bangon tantanin halitta, ƙwayar tana samar da hadaddun mai ɗaukar insulin wanda ke motsa hanyoyin cikin ciki:

1. Keɓe enzymes don cikakken aiki da ɗaukar glucose ta kyallen,
2. Yana ƙaruwa a cikin jirgin ruwa na jijiya da haɓaka glucose,
3. Rage raguwar samuwar glycogen a cikin hanta,
4. Imarfafa samar da sunadarai da mai.

Tare da gudanar da aikin subcutaneous, miyagun ƙwayoyi sun fara aiki bayan minti 20-30, suna isa zuwa matsakaici a cikin sa'o'i 1-3, suna da kusan 5-8 hours.

An rarraba wannan magani daban a cikin kyallen takarda: alal misali, ba ya ratsa katangar mahaifa kuma baya shiga cikin madarar nono. Bayan ƙarshen aikinsa, ana keɓantar da insulin na mutum ta hanjin kodan (kusan kashi 80%) bayan lalata shi ta hanyar insulinase.

Alamu don amfani

Yawancin lokaci, likitoci suna ba da insulin mai narkewa a cikin lokuta:

• Kai jiyya ko haɗuwa da cututtukan ƙwayar cutar sankara na type 1 da 2,
• Cikakken ko m juriya (juriya) na jiki zuwa na baka (dauka ta bakin) magungunan antidiabetic,
• Ciwon sukari (mellitus) lokacin daukar ciki (idan abincin ba shi da tasiri)
• Rikice-rikice na ciwon sukari mellitus (ketoacidosis, hypersmolar ko ketoacidotic coma),
• A hanya na lura da ciwon sukari a kan tushen wasu cututtuka,
• Yanayi mai tsoratarwa a cikin masu ciwon sukari wadanda ke kan maganin baka na rage karfin magunguna (lokacin haihuwa, wani mummunan yanayi, da raunin da ya faru ko sanyi, kafin haihuwa, da sauransu),
• Cutar masu fama da cutar sankara ko rashin lafiyar hepatic,
• Kwayoyin cutar Dystrophic (furunlera, carbuncles, ulcers),
• Canji zuwa insulin tare da tsawan aiki (tsawan).

M halayen

Duk da kyakkyawan haƙuri, insulin na iya samun sakamako masu illa lokacin da aka yi amfani dasu azaman:

1. Haɓakawar hypoglycemia saboda ƙin shan miyagun ƙwayoyi ta jiki ko halayen immunological tare da insulin kansa,
2. Allergic halayen (urticaria, pruritus, ko mafi muni Quincke edema tare da tsananin kumburi da fuska da mucous membranes, pallor da gazawar numfashi),
3. Jiki ya zama
4. Rashin iya sani (lokaci-lokaci kai kawo)
5. Hyperglycemia ko mai ciwon sukari acidosis (akan asalin zazzabi ko cututtuka, abinci mara kyau, bayan allurar da aka rasa ko kwayar da ba ta dace ba),
6. Rashin kwanciyar hankali a cikin tsari na ƙishirwa, nutsuwa, raguwar ci, yanayin gyara gashi,
7. Abubuwan da ke cikin gida a cikin gabatarwar tare (ƙonewa, itching, redness, overgrowth ko atrophy na adipose tissue).

Haɗuwa da sauran ƙwayoyi

Lokacin amfani da insulin ɗan adam tare da wasu kwayoyi, tasirin hypoglycemic ɗinsa yana ƙaruwa ko ya raunana.

Tasirin rage sukari na iya ƙaruwa lokacin shan insulin tare da:

1. Sulfonamides (sulfonamide ko tsoffin jini),
2. MAO inhibitors (furazolidone, da sauransu),
3. ACE masu hanawa (captopril, enalapril, da sauransu),
4. NSAIDs (asfirin, diclofenac, da sauransu),
5. Androgens da magungunan anabolic steroid (Anavar, Androxon, da sauransu),
6. Magungunan Antimalarial (quinoline, quinidine, da sauransu),
7. Hanyar Tetracyclines (tetracycline, doxycycline),
8. Sauran kwayoyi (theophylline, pyridoxine, morphine, da sauransu)

Don rage tasirin hypoglycemic na miyagun ƙwayoyi, hulɗarta tare da:

• Glucocorticoids
• Amphetamines
• Estrogens (ciki harda azaman maganin hana daukar ciki),
• Diuretics
• Sympathomimetics
• Kwayoyin cutar ta thyroid
• Kwayoyi daban (triamterone, phenytoin, glucagon).

Hakanan, a hade tare da insulin, kwayoyi na iya rage ko haɓaka sakamako na hypoglycemic:

1. Beta masu karewa,
2. Narkataccen
3. Morphine
4. Amfani da zaɓi na sashi

Matsayi da kuma hanyar gudanar da insulin na mutum koyaushe ne keɓance daban-daban ta hanyar endocrinologist, la'akari da mahimmancin alamun alamu na glucose jini da fitsari na haƙuri.

Ana gudanar da wannan magani a cikin ciwon sukari ta hanyoyi da yawa: subcutaneously (s / c), intramuscularly (i / m) ko cikin jijiya (i / v). Sau da yawa, ana gudanar da insulin a ƙarƙashin ƙasa. Don yin wannan, yi amfani da yankin:

• Belly
• Hanya
• Fatar jiki sama da gindi.

Yawancin lokaci ana yin maganin ne a cikin jijiyoyin m cikin tsokanar cututtukan da ke haifar da ciwon sukari: ketoacidosis, coma mai ciwon sukari.

Ana ba da shawara don gudanar da insulin na mintina 15-30 kafin abinci, sau 3 a rana. Wani lokacin ana yarda da izinin kulawa guda 5-6 na miyagun ƙwayoyi.

Ana amfani da lissafin insulin yawanci a cikin adadin raka'a 0.5-1 a 1 kg na nauyi. Idan ana gudanar da insulin fiye da 0.6 MG a kilogiram na nauyin jiki, to dole ne a gudanar da maganin a kalla sau 2 a rana. A matsakaita, adadin yau da kullum shine kusan raka'a 30-40 (a cikin yara, raka'a 8).

Mata masu juna biyu yawanci ana ba su magani na 0.6 KUDI akan kilogiram na nauyi. Injewa yakan haifar da sau 3-5 a rana, gwargwadon yawan abinci.

Sau da yawa, insulin mai aiki da sauri yana haɗuwa tare da insulin aiki mai tsawo.

Dokokin gudanar da insulin

Ko da masu ilimin kwantar da hankali suna yin kuskure yayin gudanar da insulin.

Mafi mahimmancin ka'idoji don maganin insulin sune:

1. Binciken rayuwar shiryayye da yanayin ajiya na miyagun ƙwayoyi: bai kamata a fallasa shi ga yawan zafi ko hypothermia ba.
2. Sanyaya kayan kwalliyar insulin na firiji. Ya isa ya ajiye kwalban da ya fara a wuri mai duhu a zazzabi na daki.
3. Sake yin sulhu da sashi na miyagun ƙwayoyi tare da umarnin da shawarar likita.
4. Saki iska daga sirinji kafin allura. Ba lallai ba ne don shafa fata da barasa. Kamuwa da cuta tare da ilimin insulin yana da matukar wuya, kuma barasa yana rage tasirin maganin.
5. Zabi wurin da ya dace don gabatarwa. Don insulin gajeran aiki, wannan shine ciki. Idan allura a cikin kafada ko gluteal ninkaya, ƙwayar tana aiki a hankali.
6. Yin rigakafin rikitarwa a wurin allurar ta hanyar amfani da dukkan yankin farfajiyar. Ana amfani da duk ɗayan ciki don gudanar da aikin insulin gajere: daga saman ribbon tsada zuwa ɓangaren wucin gadi, tare da gefen kanggon. Yana da mahimmanci a ja da baya game da 2 cm daga tsoffin rukunin allurar, gabatar da sirinji a wani kusurwa na 45-60 digiri, don kada maganin yai ta sauka.
7. Kafin gudanar da maganin, ya fi kyau a ninka fata da yatsa da goshin ƙafa. Idan ya shiga cikin tsoka, magani zai rage aikinsa. Bayan saka allura, riƙe sirinji na kimanin 5-10 seconds.
8. A cikin ciki, ana sarrafa insulin gajere a minti 20 kafin abinci. A wasu wuraren, ana ba da magani na rabin sa'a kafin abinci.

Sunan kasuwanci na miyagun ƙwayoyi

Ana yin insulin a cikin hanyar mafita don allura kuma ana sayar dashi a cikin magunguna.

Ana iya samar da insulin na mutumtaka a ƙarƙashin sunayen alama:

Godiya ga fasahar ilimin halittar zamani, an kirkirar insulin ɗan adam. Shine mai aiki a shirye-shiryen: Humodar, Humulin, Insuman, Gansulin, Humalog, Apidra SoloStar, Mikstard. Wadannan kwayoyi sun banbanta da na farkon a jerin bayanan amino acid, wanda ke kara sabbin kaddarorin a jikinsu (alal misali, sakamako mai tsayi guda biyu), wanda yake da matukar mahimmanci ga masu fama da cutar siga.

Yawan abin sama da ya kamata

Yana faruwa cewa gudanar da insulin a wasu yanayi yana haifar da hyperglycemia.

Babban alamun bayyanar cututtukan hyperglycemia shine bayyanai a cikin hanyar:

• Rashin rauni
• Pallor
• Gumi mai sanyi
• Ajiyar zuciya
• Ciwon kai
• Jin yunwa
• Girgiza kai a jiki
• Numbness of the harshe, lebe, reshe.

Lokacin da irin wannan bayyanar cututtuka fara, mai haƙuri ya kamata nan da nan ya ɗauki wasu sauƙi digirin da abinci mai narkewa a jiki (yawanci alewa, ɗan sukari ko shayi mai zaki).

Tashin hankali

Tsawon lokaci tare da insulin na iya haifar da matsaloli daban-daban. Manyan sune:

1. Abinda ya faru na rashin lafiyar hypoglycemia. Rashin cin abinci, yawan shan ƙwayoyi, yawan motsa jiki, ƙwayoyin koda da hanta na iya ba da gudummawa ga wannan.
2. Postinjection lipodystrophy. Yin rigakafin cututtukan ƙwayar cuta shine canza wurin allurar, ƙara maganin novocaine (0.5-1.5 ml) zuwa insulin, kuma gudanar da sirinji zuwa Ѕ na kauri na tso adi nama.
3. Juriyar kwayoyi. Sauran (ana haɗuwa) an zaɓi magunguna masu rage sukari.
4. Allergic halayen.Amfani da hadadden fariya (antihistamines, glucocorticoids) da isasshen magani na magani.

Insulin mutum mai matsala shine mai ceton rayuka ga mutane da yawa masu ciwon sukari. Koyaya, yana da mahimmanci a yi amfani da wannan magani cikin hikima, la'akari da duk ka'idoji don gudanarwarsa. Wajibi ne likita ya tsara wannan magani, ya lissafa adadinsa kuma ya lura da yanayin mai haƙuri a yayin duk jiyya.

Tsarin Clinical-Pharmacological Mataki na 1

Aikin gona. Tsarin insulin gajere. Yin hulɗa tare da takamaiman mai karɓa akan membrane na sel, yana samar da hadaddun mai karɓar insulin. Ta hanyar haɓaka aikin cAMP (a cikin ƙwayoyin mai da ƙwayoyin hanta) ko kai tsaye shiga cikin sel (tsokoki), ƙwaƙwalwar mai ɗaukar insulin ɗin tana ƙarfafa ayyukan cikin ciki, gami da kira na enzymes masu yawa (hexokinase, pyruvate kinase, glycogen synthetase, da sauransu). Rage yawan haɗuwa da glucose a cikin jini ana haifar dashi ta hanyar haɓaka jigilar jijiyarsa, karɓar karɓar ƙwaƙwalwa da inganta kyallen takarda, haɓakar lipogenesis, glycogenogenesis, ƙwayar furotin, raguwa a cikin yawan samar da glucose ta hanta (raguwar fashewar glycogen), da sauransu Bayan s / c allurar, sakamakon yana faruwa a cikin 20-30 min, ya kai matsakaici bayan sa'o'i 1-3 kuma yana ci gaba, gwargwadon sashi, 5-8 awanni .. Yawancin maganin yana dogara ne akan sashi, hanyar, wurin gudanarwa kuma yana da mahimman halayen mutum.

Pharmacokinetics Cikakken mamaye abubuwa ya dogara da hanyar gudanarwa (s / c, i / m), wurin gudanarwa (ciki, cinya, buttocks), kashi, taro insulin a cikin ƙwayoyi, da dai sauransu An rarraba shi ba daidai ba a cikin kyallen takarda. Bai ƙetare katangar ƙwarya ba kuma cikin madara. An lalata shi ta hanyar insulinase, galibi a hanta da kodan. T_1/2 - daga fewan mintuna 10 zuwa 10. Kayanta ne ya banke (30-80%).

Alamu. Nau'in 1 na ciwon sukari mellitus, nau'in ciwon sukari na 2 na ciwon sukari: mataki na tsayayya da maganin cututtukan mahaifa, wani bangare na jigilar magunguna na baki (hadewar hankali), ciwon suga, ketoacidotic da hyperosmolar coma, ciwon sukari mellitus wanda ya faru a lokacin daukar ciki (idan ba shi da tasiri ga maganin rage cin abinci) Amfani da kai tsaye a cikin marasa lafiya masu ciwon sukari mellitus da cututtuka tare da zazzabi mai zafi, tare da aikin tiyata mai zuwa, raunin da ya faru, haihuwa, tare da cin zarafi game da musayar abubuwa kafin canzawa zuwa jiyya tare da shirye-shiryen insulin na tsawan lokaci.

Contraindications Hypersensitivity, hypoglycemia.

Sashi Adadin da hanyar gudanar da magani an ƙaddara daban-daban a kowane yanayi dangane da abubuwan glucose a cikin jini kafin abinci da 1-2 sa'o'i bayan cin abinci, sannan kuma ya danganta da matsayin glucosuria da halayen cutar.

Ana gudanar da maganin s / c, cikin / m, cikin / in, mintuna 15-30 kafin cin abinci. Hanyar gudanarwa mafi yawancin lokuta shine sc. Tare da ketoacidosis mai ciwon sukari, coma mai ciwon sukari, a lokacin aikin tiyata - in / in da / m.

Tare da monotherapy, yawan sarrafawa yawanci sau 3 a rana (idan ya cancanta, har zuwa 5-6 sau a rana), ana canza wurin allura kowane lokaci don guje wa ci gaban lipodystrophy (atrophy ko hauhawar mai mai subcutaneous).

Matsakaicin yawan yau da kullun shine 30-40 LATSA, a cikin yara - 8 IEaukaka, to a cikin matsakaita na yau da kullun - 0.5-1 PIECES / kg ko 30-40 LITTAFAI sau 1-3 a rana, idan ya cancanta - 5-6 sau a rana . A cikin adadin yau da kullun wanda ya wuce 0.6 U / kg, dole ne a gudanar da insulin a cikin nau'in 2 ko fiye da allura a cikin sassan daban-daban na jiki. Yana yiwuwa a haɗu tare da insulins masu aiki na dogon lokaci.

Ana tattara maganin insulin daga murfin ta hanyar huɗa tare da allura mai ƙwanƙwasa mai maɗaurin roba, an goge bayan cire kwallar alumini tare da ethanol.

Side sakamako. Allergic halayen (urticaria, angioedema - zazzabi, ƙarancin numfashi, saukar karfin jini),

hypoglycemia (pallor na fata, ƙara yawan shaye shaye, gumi, palpitations, rawar jiki, yunwar, damuwa, damuwa, paresthesias a bakin, ciwon kai, nutsuwa, rashin bacci, tsoro, yanayi na bacin rai, tashin hankali, hali mai ban mamaki, rashin motsi, magana da rikicewar magana da hangen nesa), hauhawar jini,

hauhawar jini da kuma ciwon sukari acidosis (a ƙarancin allurai, injections, abinci mara kyau, daga yanayin zazzabi da cututtukan fata): amai, ƙishirwa, rage cin abinci, fitsarin fuska),

mai rauni mara nauyi (har zuwa cigaban premaose da coma),

raunin gani na hankali (yawanci a farkon farawa),

immunological giciye-halayen da insulin na mutum, karuwa a titin na anti-insulin kwayoyin, tare da karuwa a cikin glycemia,

hyperemia, itching da lipodystrophy (atrophy ko hauhawar mai mai subcutaneous) a wurin allurar.

A farkon jiyya - busa da rauni na nakasa (suna ɗan lokaci kuma sun ɓace tare da ci gaba da jiyya).

Yawan abin sama da ya kamata. Bayyanar cututtuka: rashin ƙarfi a jiki (rauni, gumi mai sanyi, pallor na fata, palpitations, rawar jiki, juyayi, yunwar, paresthesia a hannu, kafafu, lebe, harshe, ciwon kai), ƙwanƙwasa bugun zuciya, rikicewar jiki.

Jiyya: mara lafiya na iya kawar da ciwon sikari na rashin ƙarfi ta hanyar wadatar da sukari ko abinci mai wadataccen abinci mai narkewa cikin sauƙi.

Subcutaneous, i / m ko iv allura glucagon ko iv hypertonic dextrose. Tare da haɓakar ƙwayar cuta na ƙwayar cuta, 20 40 ml (har zuwa 100 ml) na maganin 40% na dextrose ana allurar dashi a cikin rafi cikin mai haƙuri har sai mara lafiyar ya fito daga warin.

Haɗa kai. Magunguna ba tare da maganin wasu magunguna ba.

Tasirin hypoglycemic yana haɓaka ta hanyar sulfonamides (gami da magungunan maganin hypoglycemic na baka, sulfonamides), MAO inhibitors (ciki har da furazolidone, procarbazine, selegiline), inhibitors na carbonic anhydrase inhibitors, ACE inhibitors, ACE inhibitors, NSAIDs (gami da salicylates), anabolic (ciki har da stanozolol, oxandrolone, methandrostenolone), androgens, bromocriptine, tetracyclines, clofibrate, ketoconazole, mebendazole, theophylline, cyclophosphamide, phenfluramine, Li + shirye-shirye, pyridoxine, quinidine, quinine, chloroquin

Hypoglycemic effects na sosai glucagon, girma hormone, corticosteroids, na baka hana, estrogens, thiazide da madauki diuretics, BCCI, thyroid hormones, heparin, sulfinpyrazone, sympathomimetics, danazol, tricyclics, clonidine, alli antagonists, diazoxide, morphine, marijuana, nicotine, phenytoin, masu hana masu kwafin kwayoyi H₁masu karɓar maganin tsufa.

Beta-blockers, reserpine, octreotide, pentamidine zasu iya haɓakawa da raunana tasirin hypoglycemic na insulin.

Umarni na musamman. Kafin ɗaukar insulin daga murfin, ya zama dole a bincika gaskiyar mafita. Lokacin da jikin ƙasashen waje suka bayyana, girgije ko haɓaka wani abu akan gilashin murfin, baza'a iya amfani da maganin ba.

Zazzabi na insulin da ke cikin yakamata ya zama zazzabi a dakin. Yawan insulin dole ne a daidaita shi yayin da ake fama da cututtukan da ke kama da cuta, idan aka samu matsalar raguwar cututtukan thyroid, cutar Addison, cututtukan jini, rashin lafiyar koda da kuma cutar sankarau a cikin mutane sama da shekaru 65.

Abubuwan da ke haifar da cututtukan hypoglycemia na iya zama: wucewar insulin, maye gurbin miyagun ƙwayoyi, tsallake abinci, amai, gudawa, damuwa na jiki, cututtukan da ke rage buƙatar insulin (cututtukan haɓaka na hanta da hanta, da hauhawar jini a cikin adrenal cortex, pituitary ko thyroid gland shine yake, canjin wuri injections (alal misali, fata akan ciki, kafada, cinya), haka kuma ma'amala da wasu kwayoyi. Zai yiwu a rage taro na glucose a cikin jini yayin canja wurin mai haƙuri daga insulin dabbobi zuwa insulin ɗan adam.

Canza haƙuri ga insulin ɗan adam ya kamata koyaushe a likitanci kuma za'ayi shi kawai a ƙarƙashin kulawar likita.Halin haɓaka rashin ƙarfi na hypoglycemia zai iya lalata ikon marasa lafiya don taka rawa sosai ga zirga-zirgar ababen hawa, kazalika da kula da injuna da hanyoyin.

Marasa lafiya da ke fama da ciwon sukari na iya dakatar da ɗan ƙanƙanin hypoglycemia da suke ji ta hanyar cin sukari ko abinci mai girma a cikin carbohydrates (ana ba da shawarar cewa koyaushe kuna da akalla 20 g na sukari tare da ku). Game da maganin da aka canjawa wuri, yana da mahimmanci don sanar da likitan halartar don warware batun buƙata don gyaran jiyya.

A cikin lura da insulin gajeren aiki a cikin ka'idodin keɓaɓɓu, yana yiwuwa a rage ko haɓaka ƙarar adipose nama (lipodystrophy) a cikin allura. Zuwa mafi yawan lokuta, waɗannan abubuwan mamaki za a iya hana su ta hanyar canza kullun wurin allurar. A lokacin daukar ciki, ya zama dole a yi la’akari da raguwa (I trimester) ko karuwa (II - III trimesters) na bukatun insulin. Lokacin kuma nan da nan bayan haihuwa, bukatun insulin na iya raguwa da sauri. Yayin shayarwa, ana buƙatar saka idanu kowace rana don watanni da yawa (har sai an daidaita buƙatar insulin).

Marasa lafiya da ke karɓar sama da IU 100 na insulin a kowace rana, lokacin da suke canza magungunan, suna buƙatar asibiti.

Rajistar magunguna ta jihar. Buga na hukuma: a cikin vols 2. M: Majalisar Likita, 2009. - Vol. 2, part 1 - 568 s., Kashi na 2 - 560 s.

Shirye-shirye da aka samo daga albarkatun albarkatun dabbobi

Samun wannan hormone daga cututtukan aladu da shanu tsohuwar fasaha ce wacce ba kasala ake amfani da ita ba a yau. Wannan ya faru ne saboda ƙarancin magungunan da aka karɓa, halayyar sa na haifar da rashin lafiyan ƙwaƙwalwa da ƙarancin tsarkakakken tsarkakewa. Gaskiyar ita ce tunda kwayoyin sunadaran sunadarai ne, ya kunshi takamaiman tsarin amino acid.

Insulin da aka samar a jikin alade ya bambanta a cikin amino acid din daga insulin na mutum ta 1 amino acid, da kuma bovine insulin ta 3.

A farko da tsakiyar karni na 20, lokacin da irin wadannan magunguna basa wanzuwa, har ma wannan insulin ya zama nasara ga magani kuma ya bada izinin shan maganin masu cutar sukari zuwa sabon matakin. Hormones da aka samu ta wannan hanyar ya rage yawan sukarin jini, amma, galibi suna haifar da sakamako masu illa da rashin lafiyar jiki. Bambanci a cikin abun da ke tattare da amino acid da rashin illa a cikin maganin sun shafi yanayin marasa lafiya, musamman a cikin rukunan mafi rauni na marasa lafiya (yara da tsofaffi). Wani dalili na rashin haƙuri na wannan insulin shine kasancewar ƙaddarar aikinsa na rashin aiki a cikin ƙwayar (proinsulin), wanda ba shi yiwuwa a kawar da wannan bambancin magunguna.

Yau, akwai dusar dabbobin alade da ba su da wadannan gazawa. An samo su daga cututtukan alade, amma bayan hakan ana tura su ƙarin aiki da tsarkakewa. Suna da yawa kuma suna ɗauke da tsofaffi.

Ingancin insulin alade da yake a zahiri ba shi da bambanci da kwayar mutum, don haka har yanzu ana amfani dashi a aikace

Irin waɗannan magungunan suna jure wa marasa lafiya mafi kyawu kuma kusan ba sa haifar da mummunar illa, ba sa hana tsarin rigakafi kuma suna rage yawan sukarin jini. Ba a amfani da insulin na Bovine a cikin magani a yau, saboda saboda tsarinta na ƙasashen waje yana cutar da mummunar cutar rigakafi da sauran tsarin jikin mutum.

Inulin Injiniyan Inji

Insulin na mutum, wanda ake amfani dashi don masu ciwon suga, akan sikelin masana'antu ana samun shi ta hanyoyi biyu:

• yin amfani da enzymatic lura da insulin insulin,
• yin amfani da nau'in gyaran ƙwayoyin cuta na Escherichia coli ko yisti.

Tare da canjin physico-sunadarai, kwayoyin enlin insulin a karkashin aikin enzymes na musamman sun zama iri daya ga insulin na mutum.Amino acid ɗin abun da aka shirya shine ya banbanta daga abun da ke ciki na jikin mutum wanda ake samarwa cikin jikin mutum. Yayin aiwatar da masana'antu, maganin yana yin tsabtacewa mai tsabta, saboda haka ba ya haifar da rashin lafiyan halayen ko wasu bayyanannun marasa amfani.

Amma mafi yawancin lokuta, ana samun insulin ta amfani da kayan kwalliya (ingantattun abubuwa) ƙananan ƙwayoyin cuta. Yin amfani da hanyoyin ilimin halittu, ƙwayoyin cuta ko yisti ana gyara su ta wannan hanyar da kansu kansu zasu iya samar da insulin.

Baya ga samar da insulin da kanta, tsarkakewarta tana taka muhimmiyar rawa. Don kada maganin ya haifar da rashin lafiyan jiki da kumburi, a kowane mataki ya zama tilas a sanya ido ga tsarkin cututtukan kananan halittu da dukkan hanyoyin magance su, gami da sinadaran da ake amfani da su.

Akwai hanyoyi guda 2 don irin wannan samin insulin. Na farkonsu ya samo asali ne daga amfani da wasu nau'ikan nau'ikan cuta guda biyu (nau'in) nau'in kwayoyin halitta guda daya. Kowannensu yana ɗaukar sarkar guda kawai ta kwayoyin halittar DNA (akwai guda biyu a cikinsu, kuma suna daɗawa tare). Bayan haka an haɗa waɗannan sarƙoƙi, kuma a cikin sakamakon da ya haifar ya rigaya ya yiwu a ware nau'ikan insulin masu aiki daga waɗanda ba su da mahimmancin ƙwayar halitta.

Hanya ta biyu don samun magani tare da Escherichia coli ko yisti yana dogara ne akan gaskiyar cewa microbe ya fara samar da insulin mara aiki (shine, wanda ya riga shi, proinsulin). Sannan, ta amfani da magani na enzymatic, ana kunna wannan hanyar kuma ana amfani dashi a magani.

Ma'aikatan da ke da damar zuwa wuraren samarwa ko da yaushe za a sa su cikin sutura mai kare mai karewa, wanda ke kawar da hulɗa da miyagun ƙwayoyi tare da ruwayoyin halittar ɗan adam

Duk waɗannan hanyoyin yawanci suna atomatik, iska kuma dukkanin abubuwan da ke haɗuwa da ampoules da vials suna bakararre, kuma layi tare da kayan aiki suna hatimi na hermetically.

Hanyoyin ilimin kimiyyar kere-kere suna ba masana kimiyya damar yin tunani game da madadin hanyoyin magance ciwon sukari. Misali, har zuwa yau, ana gudanar da binciken kwaskwarima game da samar da kwayoyin cututtukan cututtukan cututtukan ƙwayoyin cuta, wanda za'a iya samu ta hanyar hanyoyin injin. Wataƙila a nan gaba za a yi amfani da su don inganta aikin wannan sashin a cikin mara lafiya.

Ctionirƙira na zamani tsari ne mai sauƙi na tsari, wanda ya shafi aiki da injina da kuma ɗan adam yawu

Componentsarin aka gyara

Samun insulin ba tare da magabata ba a cikin duniyar yau kusan ba zai yiwu a yi tunanin ba, saboda za su iya inganta abubuwan da ke tattare da sinadarai, su tsawaita aikin kuma su sami babban tsabta.

Ta hanyar dukiyoyinsu, dukkan ƙarin kayan abinci za'a iya raba su zuwa azuzuwan da ke biye:

• tsawanta (abubuwan da ake amfani da su don samar da tsawon lokacin aiki na maganin),
• abubuwanda ake dasu
• mai kwantar da hankula, saboda abin da ingantaccen acidity ke kiyaye cikin maganin maganin.

Tsawancin Addini

Akwai insulins masu aiki na tsawon lokaci waɗanda aikin kwayoyin halitta ya ɗauki tsawon sa'o'i 8 zuwa 42 (dangane da rukuni na miyagun ƙwayoyi). Ana samun wannan sakamako saboda ƙari na abubuwa na musamman - masu ɗorewa zuwa maganin allura. Mafi sau da yawa, ana amfani da ɗayan waɗannan mahaɗan don wannan dalili:

Sunadaran da suka tsawaita aikin da miyagun ƙwayoyi suna yin cikakken tsarkakewa kuma suna da ƙarancin-alalar cuta (alal misali, protamine). Hakanan gishirin zinc din ba su cutar da aikin insulin ko lafiyar mutum.

Abubuwan rigakafi na rigakafi

Abubuwan rarrabe a cikin haɗarin insulin wajibi ne don kada microbial flora ya ninka lokacin ajiya da amfani dashi. Wadannan abubuwa sune abubuwan kiyayewa kuma suna tabbatar da adana ayyukan ilimin halittar da miyagun ƙwayoyi.Bugu da ƙari, idan mai haƙuri ya gudanar da kwayar halittar daga vial guda ɗaya kawai zuwa kansa, to maganin zai iya kasancewa na tsawon kwanaki. Sakamakon ingantattun ƙwayoyin ƙwayoyin cuta, ba zai buƙaci ya jefar da maganin da ba a amfani da shi ba saboda ƙwaƙƙwaran ƙwayar cuta a cikin maganin ƙwayoyin cuta.

Za'a iya amfani da abubuwa masu zuwa azaman shan magungunan maye a cikin samar da insulin:

Idan mafita ta ƙunshi ion zinc, sun kuma zama azaman ƙarin abin kiyayewa saboda abubuwan da suka mallaka na rigakafi

Don haɓakar kowane nau'in insulin, wasu abubuwan gurɓatattun ƙwayoyin cuta sun dace. Abun hulɗa da su tare da kwayar halitta dole ne a bincika a mataki na gwaji na ainihin, tunda abin da aka adana dole ne ya rushe aikin kwayoyin halitta na insulin ko in ba haka ba zai cutar da kaddarorin ta.

Yin amfani da abubuwan adanawa a mafi yawan lokuta yana ba da izinin gudanar da hormone a cikin fata ba tare da magani na gaba ba tare da barasa ko wasu maganin antiseptics (mai ƙira yawanci yana nufin wannan a cikin umarnin). Wannan yana sauƙaƙe gudanar da maganin kuma yana rage yawan manipulation na shiri kafin allurar da kanta. Amma wannan shawarwarin yana aiki ne kawai idan an gudanar da maganin ta amfani da sirinji na insulin tare da allura na bakin ciki.

Mai daidaitawa

Kwantar da hankali yana da mahimmanci wanda zai sa pH na mafita ya zama daidai gwargwado. Adana miyagun ƙwayoyi, ayyukanta da amincin kaddarorin sunadarai sun dogara da matakin acidity. A cikin kera kwayoyin allura ga marasa lafiya da ke dauke da cutar sikari, yawanci ana amfani da phosphates don wannan dalilin.

Don insulin tare da zinc, ba a buƙatar masu kwantar da hankula koyaushe, tun da ions metalarfe na taimaka wajan daidaita ma'auni. Idan anyi amfani dasu duk da haka, to ana amfani da sauran ƙwayoyin mahaɗin maimakon maimakon phosphates, tunda haɗakar waɗannan abubuwan suna haifar da haɓaka da kuma rashin aiki na miyagun ƙwayoyi. Muhimman kayan da aka nuna wa duk masu kwantar da hankali shine aminci da rashin iya shiga kowane irin hali tare da insulin.

Entwararren likitancin endocrinologist ya kamata ya magance zaɓin magungunan allurar rigakafin ƙwayar cuta ga kowane haƙuri. Aikin insulin ba wai kawai don tsayar da daidaitaccen matakin sukari bane a cikin jini, amma kuma ba don cutar da sauran gabobin da tsarin ba. Ya kamata miyagun ƙwayoyi ya zama tsaka tsaki a chemically, low allergenic kuma zai fi dacewa araha. Hakanan yana dacewa sosai idan zaɓin insulin ɗin da aka zaɓa zai iya haɗuwa tare da sauran sigoginsa gwargwadon lokacin aikin.

Actrapid HM (Actrapid HM), Actrapid HM penfill (Actrapid HM penfill), Berlsulin H al'ada alkalami (Berlinsulin H al'ada alkalami), Berlsulin H al'ada U-40 (Berlinsulin H al'ada U-40), Insuman m (Insuman m), Homorap 40 (Homorap 40), Homorap 100 (Homorap 100).

Aikin magunguna

Maganin insulin ne mai tsaka tsaki iri daya da insulin na mutum. Yana nufin insulins na gajeran aiki. Yana saukar da glucose na jini, yana inganta shanshi ta hanyar kyallen, lipogenesis, glycogenogenesis, sinadarin protein, yana rage yawan samarda glucose ta hanta.

Onaddamar da miyagun ƙwayoyi shine minti 20-30 bayan gudanarwa. Matsakaicin sakamako yana haɓaka tsakanin awa 1 zuwa 3. Tsawon lokacin aikin shine awoyi 6-8.

Bayanin ayyukan insulin tsaka tsaki na jikin mutum wanda ya dogara da kashi kuma yana nuna mahimmancin rikice-rikice na ciki. Kasancewa daga wurin allura ya fi insulin tsaka tsintsiyar alade na cikin sauri.

,: mataki na jure wa mahaifa na hypoglycemic jami'ai, m jure wa baki hypoglycemic jamiái (hade magani), intercurrent cututtuka, aiki (mono- ko hade far), ciki (idan rage cin abinci magani ne m).

Ketoacidosis mai ciwon sukari, ketoacidotic da hyperosmolar coma, tare da aikin tiyata mai zuwa, rashin lafiyan zuwa shirye-shiryen insulin na asalin dabba, insulin lipoatrophy, juriya na insulin saboda babban titin rigakafin kwayoyin insulin, yayin dasa kwayoyin sel da ke cikin fitsari.

Side sakamako

Hypoglycemia (dan kadan fiye da lokacin amfani da shirye-shiryen insulin na asalin dabba), AR - sau da yawa ba sau da yawa. Kurakurai masu ragi na lokaci - yawanci a farkon farawar insulin.

Matsayi mai kyau na hormonal shine tushen cikakken ci gaban jikin mutum. Daya daga cikin mahimman kwayoyin halittar jikin mutum shine insulin. Rashin sa ko wuce haddi yana haifar da mummunan sakamako. Ciwon sukari (mellitus da hypoglycemia) abubuwa biyu ne masu illa wadanda suka zama sahabbai marasa dadi a jikin mutum, wadanda suke yin watsi da bayanai game da menene yanayin insulin da kuma yadda matakin ya kamata.

Hormone insulin

Darajar kirkirar ayyukan farko wanda ya sanya hanyar gano sinadarin nasa ne ga masanin kimiyyar Rasha Leonid Sobolev, wanda a cikin 1900 ya gabatar da shawarar amfani da fitsarin don samo magungunan cututtukan cututtukan cututtukan kuma ya ba da ma'anar menene insulin. Fiye da shekaru 20 aka kashe a kan ƙarin bincike, kuma bayan 1923 masana'antar insulin masana'antu suka fara. A yau, kimiyya tana yin nazari sosai. Yana ɗaukar kashi a cikin rushewar carbohydrates, mai alhakin metabolism da kitse mai.

Wanne kwayoyin ke samar da insulin

Pancreas, inda ake zaune a cikin ƙwayoyin sel-B, waɗanda aka sani da duniyar kimiyya kamar yadda tsibirin Lawrence ko kuma tsibiran da ke cikin farji, ke zama sinadarin samar da insulin. Takamaiman aikin sel ya yi kadan kuma ya zama kashi 3% cikin jimlar ƙwayoyin hanji. Samun insulin ta hanyar ƙwayoyin beta suna faruwa, nau'in proinsulin yana ɓoye ta hanyar hormone.

Menene nau'ikan insulin ɗin ba a san shi sosai ba. Kwayar halittar kanta, kafin ta dauki nau'i na karshe, ta shiga cikin ginin sel ɗin Golgi, inda aka ƙosar da ita zuwa yanayin cikakken hormone. Tsarin ya ƙare lokacin da aka sanya hormone a cikin manya-manyan ƙwayoyin kumburi, inda aka ajiye shi har sai mutum ya ɗauki abinci. Abubuwan da ke tattare da kwayar halittar B suna iyakance kuma cikin sauri a duk lokacin da mutum ya lalata abinci mai sauki na carbohydrate, wanda shine sanadin ciwon sukari.

Menene insulin na hormone - wannan shine mafi mahimmancin ma'aunin metabolic. Idan babu shi, glucose yana shiga jiki ta abinci ba zai iya shiga tantanin ba. Kwayar halittar tana kara girman membranes na sel, sakamakon abin da ake amfani da glucose a cikin jikin kwayar halitta. A lokaci guda, hormone yana inganta juyar da glucose a cikin glycogen, polysaccharide wanda ya ƙunshi samar da makamashi wanda jikin ɗan adam yake amfani dashi kamar yadda ya cancanta.

Ayyukan insulin sun bambanta. Yana ba da aikin ƙwayar ƙwayar tsoka, yana tasiri aiwatar da furotin da metabolism na mai. Kwayar halittar tana aiki da mai ba da labari game da kwakwalwa, wanda, bisa ga masu karɓa, ya ƙayyade buƙatar carbohydrates mai sauri: idan akwai yalwa da yawa, ƙwaƙwalwar ta ƙarasa da cewa ƙwayoyin suna cikin matsananciyar yunwa kuma dole ne a ƙirƙiri halittar. Tasirin insulin akan jiki:

1. Yana hana mahimmancin amino acid zuwa kashi mai sauki.
2. Inganta tsarin furotin - kayan yau da kullun na rayuwa.
3. Ba ya ƙyale sunadarai a cikin tsokoki su rarrabu, yana hana atrophy tsoka - sakamako na anabolic.
4. Yana iyakance tarin gawawwakin ketone, wanda yayi yawa wanda yake muni ga mutane.
5. Promaddamar da jigilar potassium da ion magnesium.

Matsayin insulin a cikin jikin mutum

Rashin hormone yana hade da wata cuta da ake kira ciwon sukari. Waɗanda ke fama da wannan cutar ana tilasta su yin allurar insulin a cikin jini akai-akai. Sauran matsanancin shine wuce haddi na hormone, hypoglycemia. Wannan cuta tana haifar da hauhawar hauhawar jini da raguwa a cikin jijiyoyin bugun jini.Theara yawan haɓakar insulin ta hanyar glucagon hormone wanda ƙwayoyin alpha na tsibirin na farji suka haifar.

Insulin dogara nama

Insulin yana ƙarfafa samar da furotin a cikin tsokoki, ba tare da abin da ƙwayar tsoka ba ta iya ci gaba. Samuwar ƙwayar adipose, wanda a kullun yana aiwatar da mahimman ayyuka, ba shi yiwuwa ba tare da hormone ba. Marasa lafiya waɗanda suka fara ciwon sukari suna fuskantar ketoacidosis, wani nau'in cuta na rayuwa wanda ya haifar da matsananciyar yunwar ciki.

Sakamakon sakamako na insulin ɗan adam

Hypoglycemia (pallor na fata, karuwar gumi, barkewa, rawar jiki, rawar jiki, zufa, tashin zuciya, tashin zuciya, tachycardia, palpitations, yunwar, tashin hankali, damuwa, paresthesia a cikin bakin, ciwon kai, amai, rashin bacci, tsoro, haushi , halayyar baƙon abu, rashin tabbas na motsi, rikicewa, magana da raunin hangen nesa, asarar hankali, coma, mutuwa), posthypoglycemic hyperglycemia (Somogy sabon abu), insulin juriya (buƙatun yau da kullun ya wuce 20 0 raka'a), edema, rauni na gani, halayen rashin lafiyan (itching, fatar fata, matsattsar matsatsi, gazawar numfashi, gazawar numfashi, dyspnea, gumi mai yawa, hauhawar zuciya, hauhawar jini, girgiza kai), halayen gida (kumburi, itching, tashin hankali, redness, post-allura lipodystrophy, wanda ke hade da rashi mai narkewa na insulin, haɓakar ciwo yayin da yanayin yanayi ya canza).

Jinin insulin na jini

Ayyukan insulin sun haɗa da tallafawa yawan adadin glucose a cikin jini, tsara yadda ma'aunin mai da furotin ke canzawa, canza abubuwan gina jiki zuwa taro. A matakin al'ada, kwayoyin halitta suna faruwa:

• Tsarin furotin don ginin tsoka,
• Ana daidaita daidaituwar metabolism da catabolism,
• yana ƙarfafa haɗin glycogen, wanda ke ƙara ƙarfin hali da kuma sabunta ƙwayoyin tsoka,
• amino acid, glucose, potassium sun shiga sel.

An auna yawan insulin a cikin µU / ml (0.04082 mg na abun lu'ulu'ai ana ɗauka azaman sashe ɗaya). Mutanen da ke da lafiya suna da alamar da ke daidai da 3-25 ga waɗannan raka'a. Ga yara, an rage raguwa zuwa 3-20 μU / ml. A cikin mata masu juna biyu, ƙa'idar ta bambanta - 6-27 mkU / ml, a cikin tsofaffi fiye da 60 wannan alamar ta 6-35. Canji a cikin al'ada yana nuna kasancewar manyan cututtuka.

Girma

Yawancin lokaci na insulin na yau da kullun yana barazanar da canje-canje na cututtukan cututtukan cuta. Wannan yanayin yana faruwa ne sakamakon raguwar matakan sukari. Kuna iya fahimtar wuce haddi na yawan insulin ta hanyar alamomi: rawar jiki, sweating, bugun zuciya, hare-haren kwatsam na yunwar, tashin zuciya, fitsari, laima. Manuniya masu zuwa suna tasiri hauhawar matakan hormone:

• tsananin aiki,
• na kullum damuwa
• cututtuka na hanta da alade,
• kiba
• take hakkin juriya daga kwayoyin zuwa ga carbohydrates,
• polycystic ovary,
• gazawar ƙwayar gwal,
• ciwon daji da kuma cutuka na ƙwanƙwaran ƙwayar cuta.

An saukar da

Rage yawan tattarawar insulin na faruwa ne sakamakon damuwa, matsanancin aiki na jiki, gajiya mai wahala, yawan amfanin yau da kullun na adadin carbohydrates masu ladabi. Rashin insulin ya toshe hanyoyin glucose, yana kara maida hankali. Sakamakon haka, akwai matsananciyar ƙishirwa, damuwa, hare-hare na kwatsam na yunwar, tashin hankali, da yawan kumburin jiki. Sakamakon alamu irin wannan na low da babban insulin, ana yin binciken ne ta hanyar karatu na musamman.

Abin da ake yin insulin don masu ciwon sukari

Batun samar da kayan albarkatun kasa don kirkirar kwayar halitta yana jan hankalin mutane da yawa. Insulin a jikin mutum yana fitowa ne ta pancreas, kuma ana samun nau'ikan da ke gaba kamar wucin gadi:

1. Alade ko bovine - asalin dabba. Domin samarwa da dabbobin da aka yi amfani da su.Shirya kayan albarkatun naman alade ya ƙunshi proinsulin, wanda ba za'a iya rarrabe shi ba, ya zama tushen rashin lafiyan halayen.
2. Biosynthetic ko naman alade da aka gyara - an samo shirin kwastomomi ta hanyar maye gurbin amino acid. Daga cikin fa'idodin akwai jituwa tare da jikin mutum da kuma rashin halayen jiki. Rashin daidaituwa - ƙarancin kayan albarkatun ƙasa, rikitarwa na aiki, babban farashi.
3. Binciken injiniyan kwayoyin shi - ana kiranta “insulin mutum” ta wata hanyar, saboda gaba daya yayi daidai da sihirin halitta. Ana yin sinadarin ne ta hanyar enzymes na cututtukan yisti da kuma inganta asalinsu na coli.

Umarnin don amfani da insulin

Ayyukan insulin suna da matukar muhimmanci ga jikin ɗan adam. Idan kai mai ciwon sukari ne, to kana da wasika daga likita da kuma takardar sayan magani wanda a ciki ana ba da maganin kyauta a cikin kantin magani ko asibitoci. Game da buƙatar gaggawa ana iya sayan sa ba tare da takardar sayan magani ba, amma dole ne a lura da sashi. Don guje wa yawan shan ruwa, karanta umarnin don amfani da insulin.

Alamu don amfani

Dangane da umarnin da aka lullube a cikin kowane kunshin na shirin insulin, alamun da ake amfani dashi sune nau'in 1 mellitus na sukari (wanda kuma ake kira insulin-depend) kuma, a wasu halaye, nau'in ciwon sukari na 2 na mellitus (wanda ba shi da insulin). Irin waɗannan abubuwan sun haɗa da rashin haƙuri ga ƙwayoyin tsofaffin ƙwayoyin cuta, haɓakar ketosis.

Gudanar da insulin

Likita ya ba da maganin ne bayan gwaji da gwajin jini. Don lura da ciwon sukari amfani da kwayoyi daban-daban durations na aiki: gajere da tsayi. Zabi ya dogara da tsananin cutar, yanayin mai haƙuri, saurin farawa na maganin:

1. Shirye-shiryen ayyukan gajere an yi su ne don gudanar da subcutaneous, na ciki ko gudanarwa na ciki. Yana da tasiri mai sauri, gajere, rage girman sukari, ana sarrafa shi a mintuna 15-20 kafin abinci sau da yawa / rana. Tasirin yana faruwa a cikin rabin sa'a, matsakaici - a cikin awanni biyu, kawai kimanin awa shida.
2. Dogaye ko tsawaitawa - yana da tasiri na tsawon awanni 10-36, na iya rage yawan allurar yau da kullun. Ana dakatar da dakatarwar cikin intramuscularly ko subcutaneously, amma ba a ciki ba.

Ana amfani da sirinji don sauƙaƙe ƙaddamar da yardawar sashi. Raba ɗaya tayi daidai da takamaiman adadin raka'a. Dokokin insulin far:

• ci gaba da shirye-shirye a cikin firiji, kuma waɗanda aka fara a zazzabi a ɗakin, suna daɗaɗa samfurin kafin shigar su, saboda mai sanyi yana da rauni,
• Zai fi kyau gabatar da wani hormone a takaice a karkashin fata na ciki - saka alluna a cinya ko sama da buttock yana aiki a hankali, har ma da muni - a kafada,
• magani mai dadewa yana allura cikin cinya ko hagu,
• yi kowane allura a wani yanki daban,
• tare da allurar insulin, kama dukkan sassan sassan jikin mutum - don haka za'a iya guje wa ciwo da compaction,
• baya daga allura ta ƙarshe akalla 2 cm,
• kada ku kula da fata da giya, yana lalata insulin,
• idan ruwa ya kwarara, an saka allura da ba daidai ba - kuna buƙatar ajiye ta a wani kusurwa na 45-60 digiri.

Farashin insulin

Kudin insulin ya dogara da nau'in masana'anta, nau'in magani (nau'in gajeren / lokacin aiki, ciyar da dabbobi) da kuma yawan marufi. Farashin 50 ml na insulinum na miyagun ƙwayoyi ya kai kusan rubles 150 a cikin Moscow da St. Petersburg. Insuman tare da alkalami na syringe - 1200, dakatarwar Protafan yana da farashin kusan 930 rubles. Matsayin kantin har ila yau yana shafar yawan kuɗin insulin.

Insulin mutum shine ingantaccen kayan aiki wanda aka tsara don bi da marasa lafiya da nau'ikan ciwon sukari na farko da na biyu. Samfuri ne da aka keɓance cikin jini wanda yake mai narkewa cikin ruwa. An yarda da amfani dashi koda lokacin daukar ciki.

Actrapid, Humulin, Insuran.

INN: Semi-roba ɗan adam insulin.

Pharmacokinetics

Yawan adadin insulin yawanci ya dogara da yadda aka sarrafa kayan aiki. Yawancin shine saboda kashi na ƙarshe, yawan tattarawar insulin a cikin maganin allura kuma a wurin allurar nan take. An rarraba ƙwayar ba daidai ba. Insulin ba zai iya shiga cikin abin kariya na mahaifa ba.

Ana iya lalata shi ta hanyar takamaiman insulinase kai tsaye a cikin hanta. An fizge shi musamman ta hanyar yanki. Cire rabin rayuwar ba ya wuce minti 10. Ana lura da mafi girman adadin insulin a cikin jini cikin awa daya bayan gudanarwar kai tsaye. Sakamakon zai iya zuwa 5 hours.

Yadda ake ɗaukar insulin ɗan adam

Sashi da hanyar gudanarwa kai tsaye ana ƙaddara su ne kawai a kan matsakaicin jinin jinin mai azumi, sannan kuma sa'o'i 2 bayan cin abinci. Bugu da kari, liyafar ta dogara da tsananin girman ci gaban glucosuria.

Mafi yawan lokuta, gudanarwa na ƙarƙashin ƙasa. Yi shi mintina 15 kafin babban abincin. Idan cutar ketoacidosis mai ciwon sukari ko coma, insulin allurar ana shigar da shi a cikin jet, ko da yaushe cikin ciki ko a cikin gluteus tsoka, kafin a yi wani tiyata.

An ba da shawarar gudanar da maganin a kalla sau 3 a rana. Don kauce wa m lipodystrophy, ba za ku iya tsayar da miyagun ƙwayoyi ba koyaushe a wuri guda. Sannan ba a lura da dystrophy na kitse mai ƙyalli ba.

Matsakaicin matsakaita na yau da kullun shine raka'a 40, kuma ga yara yana da raka'a 8. Tsarin gudanarwa sau 3 a rana. Idan akwai irin wannan buƙatar, to, zaku iya samun insulin har sau 5.

Umarni na musamman

Kafin ku tattara mafita kai tsaye daga kwalbar, tabbas za ku duba shi don nuna gaskiya. Idan hazo ya bayyana, irin wannan magani bai kamata a sha shi ba.

Girman insulin an daidaita shi don irin waɗannan cututtukan:

• cututtuka
• malfunctioning na thyroid gland shine yake,
• Cutar Addison
• kyakyawan magana,
• ciwon sukari a cikin tsofaffi.

Sau da yawa, bayyanar cututtuka na rashin ƙarfi na haɓaka. Dukkansu ana iya haifar dasu ta hanyar yawan shan ruwa, maye gurbi na insulin na asali iri ɗaya daga ɗan adam, matsananciyar yunwa, har da gudawa, amai da sauran alamun maye. Za'a iya tsayar da hauhawar jini ta hanyar shan sukari.

Idan ƙananan alamun hypoglycemia sun bayyana, ya kamata ka tuntuɓi kwararrun likitocin nan da nan. A cikin lokuta masu sauƙi, daidaita sashi na iya taimaka. A cikin mafi munin yanayi, ya kamata a yi amfani da maganin kawar da alamun ciwo. Ba tare da ɓata lokaci ba, ana buƙatar cikakken cire magani ko magani mai sauyawa.

Dole ne a tuna cewa a cikin yankin na gudanarwa kai tsaye, dystrophy na kitse mai ƙare yana iya bayyana. Amma ana iya magance wannan ta hanyar canza wurin don injections.

Yi amfani da lokacin daukar ciki da lactation

Gudanar da matakin sukari a jikin mace mai ciki yana da mahimmanci. A cikin farkon watanni, buƙatar insulin tsarkakakke yana raguwa kaɗan, kuma a ƙarshen lokacin yana ƙaruwa.

Yayin shayarwa, mace na iya buƙatar wasu matakan daidaita insulin da abinci na musamman.

MP ba shi da wata illa mai illa da ƙwayar cuta ta jiki.

Yin hulɗa tare da wasu kwayoyi

Maganin insulin da aka kera an haramta shi sosai a hade tare da sauran hanyoyin allura. Babban tasirin hypoglycemic yana ƙaruwa ne kawai lokacin da aka yi amfani dashi tare da wasu sulfonamides, MAO inhibitors, da steroids anabolic. Androgens, tetracyclines, bromocriptine, ethanol, pyridoxine da wasu masu amfani da beta kuma suna inganta tasirin maganin.

Tasirin hypoglycemic yana raunana lokacin ɗauka tare da babban kwayoyin hodar iblis, hana haihuwa, glucagon, estrogens, heparin, jinƙai da yawa, wasu maganin antidepressants, antagonists na alli, morphine da nicotine.

Ambiguously rinjayar insulin a kan sha na glucose beta-blocker, reserpine da pentamidine.

Iri insulin

An fara yin insulin ne daga cututtukan karnukan. Bayan shekara guda, an riga an shigar da hormone cikin amfani. Wasu shekaru 40 suka wuce, kuma ya zama mai yiwuwa a samar da insulin na chemically.

Bayan wani lokaci, samfuran tsabtace kayayyaki suka yi. Bayan morean ƙarin shekaru, ƙwararrun masana sun fara haɓakar kwayar insulin mutum. Tun daga 1983, aka fara samar da insulin a ma'aunin masana'antu.

Shekaru 15 da suka wuce, an kula da ciwon sukari tare da samfurori da aka yi daga dabbobi. A zamanin yau, an dakatar. A cikin kantin magunguna, zaka iya samun shirye-shiryen aikin injiniyan kwayoyin kawai, ƙirƙirar waɗannan kudade sun dogara ne da ɗaukar samfurin samfurin kwayoyin zuwa cikin ƙwayoyin microorganism.

A saboda wannan dalili, ana amfani da yisti ko wani nau'in ƙwayoyin cuta marasa ƙwayar cuta na Escherichia coli. A sakamakon haka, ƙananan ƙwayoyin cuta suna fara samar da insulin ga ɗan adam.

Bambanci tsakanin dukkan na'urorin lafiya da ake da su a yau shine:

• A lokacin bayyanar, dogon aiki, matsananci-gajere insulins da gajere aiki insulin.
• a cikin jerin amino acid.

Har ila yau, akwai magunguna masu haɗuwa waɗanda ake kira "cakuda", sun ƙunshi insulin duka biyu masu aiki da gajere. Dukkanin nau'ikan insulin 5 ana amfani dasu don manufarsu da aka nufa.

Short insulin

Abubuwan insulins na gajeren lokaci, wani lokacin ultrashort, sune mafita na zinc-insulin mai narkewa a cikin hadaddun tare da nau'in pH na tsaka tsaki. Wadannan kudade suna da tasiri cikin sauri, duk da haka, tasirin magungunan yana da ɗan gajeren lokaci.

A matsayinka na mai mulkin, ana sarrafa irin waɗannan magungunan a ƙarƙashin mintuna 30-45 kafin abinci. Hakanan za'a iya shayar da magunguna iri guda biyu kamar na ciki da na ciki, da kuma insulin mai daukar dogon lokaci.

Lokacin da wakilin ultrashort ya shiga cikin jijiya, matakin sukari na plasma ya ragu sosai, ana iya lura da tasirin bayan minti 20-30.

Ba da daɗewa ba jinin zai kawar da miyagun ƙwayoyi, kuma kwayoyin irin su catecholamines, glucagon da STH zasu kara yawan glucose zuwa matakin asali.

Tare da cin zarafin samar da kwayoyin cuta na rigakafin haila, matakin sukari na jini ba ya ƙaruwa don sa'o'i da yawa bayan allurar samfurin, saboda yana da tasiri a jiki da kuma bayan an cire shi daga jini.

Hormone mai gajeriyar aiki dole ne a allurar dashi a cikin jijiya:

1. yayin tsananin kulawa da kulawa mai zurfi,
2. marasa lafiya masu fama da cutar ketoacidosis,
3. idan jiki yayi sauri ya canza bukatarsa ​​ta insulin.

A cikin marasa lafiya tare da tsayayyen hanya na ciwon sukari mellitus, irin waɗannan kwayoyi ana ɗaukar su a hade tare da tasiri na dogon lokaci da tsawon lokacin aiki.

Ultra-gajere insulin shine magani na musamman da mara haƙuri zai iya kasancewa tare dashi tare da na'urar ta musamman.

Don cajin mai watsa, ana amfani da samfuran buffuna. Wannan ba ya barin insulin yin kuka a karkashin fata a cikin catheter yayin gudanar da jinkiri mai sauƙi.

A yau, ana gabatar da hormone na gajeren tasiri a cikin hanyar hexamers. Kwayoyin wannan abun sunadarai ne. Hexamers yana shan hankali a hankali, wanda baya ba da damar kaiwa ga matakin insulin a cikin ƙwayar lafiyar mutum bayan ya ci abinci.

Wannan halin shine farkon farkon ƙirƙirar shirye-shirye na roba waɗanda ke wakiltar:

An gudanar da gwaje-gwaje na asibiti da yawa, sakamakon haka, ingantattun kayan aikin, sunayen shahararrun

Wadannan nau'ikan insulin suna sha daga jikin fata sau 3 cikin sauri idan aka kwatanta da insulin mutum. Wannan yana haifar da gaskiyar cewa mafi girman matakin insulin a cikin jini ya isa da sauri, kuma magani don rage glucose yana da sauri.

Tare da gabatarwar wani shiri na semisynthetic mintina 15 kafin cin abinci, sakamakon zai zama iri ɗaya kamar tare da allurar insulin ga mutum sau 30 kafin cin abinci.

Wadannan kwayoyin halittun da ke saurin tasiri sun hada da lyspro-insulin. Wani abu ne da ya samo asali daga insulin ɗan adam ta hanyar canza proline da lysine a cikin sarkar 28 da 29 B.

Kamar yadda yake a cikin insulin ɗan adam, a cikin shirye-shiryen da aka ƙera, lyspro-insulin yana wanzu a cikin nau'ikan hexamers, duk da haka, bayan wakili ya shiga jikin mutum, sai ya zama monomers.

Don wannan, lipro-insulin yana da sakamako mai sauri, amma tasirin yana ɗan lokaci kaɗan. Lipro-insulin ya ci nasara idan aka kwatanta da sauran magunguna na wannan nau'in don dalilai masu zuwa:

• ya sa ya yiwu a rage barazanar yawan zubar jini da kashi 20-30%,
• sami damar rage adadin he1c glycosylated haemoglobin, wanda ke nuna ingantaccen lura da ciwon sukari.

A cikin samuwar insulin na aspart, an ba da sashi mai mahimmanci don canzawa yayin da aka maye gurbin aspartic acid ta hanyar Pro28 a cikin sarkar B. Kamar yadda yake a cikin lyspro-insulin, wannan magani, yana shiga jikin mutum, sannu a hankali ya kasu kashi biyu.

Magungunan Pharmacokinetic na insulin

A cikin ciwon sukari na mellitus, ƙirar pharmacokinetic na insulin na iya zama daban. Lokacin mafi girman matakan insulin na plasma kuma mafi girman tasirin rage sukari na iya bambanta da kashi 50%. Wasu mahimmancin waɗannan juzu'ai sun dogara da ƙimar rage ƙwayar magunguna daga ƙwayar subcutaneous. Har yanzu, tsawon lokacin da gajeruwar insulin ma sun sha bamban.

Abubuwan da suka fi karfi sune hormones na matsakaici da sakamako na tsawon lokaci. Amma kwanan nan, masana sun gano cewa magungunan gajerun hanyoyin suna da irin kaddarorin.

Dogaro da insulin, ya zama dole don shafa kwayoyin a kai a kai a cikin kashin da ke cikin subcutaneous. Hakanan ya shafi waɗannan marasa lafiya waɗanda basu iya rage yawan glucose a cikin plasma ba saboda abinci da kwayoyi waɗanda ke rage sukari, da kuma ga matan da ke fama da ciwon sukari yayin daukar ciki, marasa lafiya waɗanda ke da rashin lafiya da aka kafa a dalilin maganin rashin lafiyar pacreatectomy. Anan zamu iya cewa ba koyaushe suke ba da tasirin da ake tsammanin ba.

Kula da insulin ya zama dole ga cututtuka kamar:

1. akasari coma,
2. mai ciwon sukari ketoacidosis,
3. bayan tiyata ga masu fama da cutar siga,
4. yayin da ake sarrafa insulin yana taimakawa wajen daidaita yawan sukari a cikin jini,
5. kawar da sauran cututtukan kwayoyin cuta.

Ana iya samun sakamako mafi kyau tare da hanyoyin magani masu wahala:

Bukatar yau da kullun don insulin

Mutumin da ke da ƙoshin lafiya da ƙwararren jiki yana samar da raka'a 18-40 a kowace rana, ko kuma raka'a 0.2-0.5 / kilogiram na tsawon lokacin insulin. Kimanin rabin wannan ƙimar shine maganin ɓoye na ciki, sauran an raba su bayan sun ci abinci.

Ana samar da kwayoyin cikin raka'a 0.5-1 a kowace awa. Bayan sukari ya shiga cikin jini, toshewar kwayoyin halittar yana kara zuwa raka'a 6 a cikin awa daya.

Mutanen da suke da kiba kuma suna da juriya na insulin waɗanda ba sa fama da ciwon sukari suna da saurin insulin sau 4 bayan cin abinci. Akwai haɗin haɓakar hormone wanda tsarin portal na hanta ya ɓoye, inda an lalata sashi ɗaya kuma bai kai ga matakin jini ba.

A cikin marasa lafiya na nau'in 1 sukari mellitus, bukatun yau da kullum na insulin na hormone ya bambanta:

1. Ainihin, wannan alamar ta bambanta daga raka'a 0.6 zuwa 0.7 / kg.
2. Tare da nauyi mai yawa, buƙatar insulin yana ƙaruwa.
3. Lokacin da mutum yake buƙatar raka'a 0.5 / kg a rana kawai, yana da isasshen samar da hormone ko kyakkyawan yanayin lafiyar jiki.

Bukatar insulin na hormone yana da nau'ikan 2:

Kimanin rabin bukatun yau da kullun suna cikin hanyar basal. Wannan hormone yana da hannu wajen hana fashewar sukari a cikin hanta.

Ta hanyar bayan-prandial, ana ba da buƙatar yau da kullun ta hanyar injections kafin abinci.Halin yana shiga cikin shan abubuwan gina jiki.

Sau ɗaya a rana, ana bai wa mai haƙuri allurar insulin tare da matsakaicin tsawon lokacin aiki, ko kuma ana gudanar da wakili mai haɗuwa wanda ya haɗu da insulin tare da ɗan gajeren lokacin tasiri da kuma matsakaiciyar tsayi. Wannan bazai isa ba don kula da glycemia a matakin al'ada.

Sannan ana amfani da tsarin kulawa da rikitarwa mafi rikitarwa, inda ake amfani da insulin na matsakaiciyar tsaka-tsaki tare da insulin gajeran aiki ko insulin gajere tare da yin aiki da gajere.

Yawancin lokaci ana bi da mara lafiyar ne bisa ga tsarin magani na gauraya, lokacin da yake yin allura guda daya lokacin karin kumallo, kuma daya yayin cin abincin dare. Hormone a cikin wannan yanayin ya ƙunshi insulin na ɗan gajeren lokaci da matsakaici na tsawon lokaci.

Lokacin karɓar kashi na maraice na NPH na hormone ko insulin, tef ɗin ba ya ba da matakin da ake buƙata na glycemia da dare, to allurar ta kasu kashi biyu: kafin abincin dare, an saka mai haƙuri tare da allurar insulin gajere, kuma kafin lokacin bacci ana saka su insulin NPH ko tef ɗin insulin.

Actrapid HM (Actrapid HM), Actrapid HM penfill (Actrapid HM penfill), Berlsulin H al'ada alkalami (Berlinsulin H al'ada alkalami), Berlsulin H al'ada U-40 (Berlinsulin H al'ada U-40), Insuman m (Insuman m), Homorap 40 (Homorap 40), Homorap 100 (Homorap 100).

Yin hulɗa da insulin ɗan adam tare da sauran abubuwa

Tasirin hypoglycemic na insulin ɗan adam yana ragewa ta hanyar glucocorticoids (dexamethasone, betamethasone, hydrocortisone, prednisone da sauransu), amphetamines, adrenocorticotropic hormone, flucrocortisone, allunan tashar alli, estrogens, baclofen, heparin, cututtukanku na jini, levothyroroidinal diuretics (hydrochlorothiazide, indapamide da sauransu), amprenavir, danazol, isoniazid, diazoxide, lithium carbonate, chlorprotixen, mai tausayawa, sinadarin nicotinic acid, beta-adrenergic agonists (alal misali, ritodrin, salbutamol, terbutaline da sauransu), maganin tricyclic antidepressants, epinephrine, glucagon, morphine, clonidine, somatotropin, phenytoin, abubuwan tarihin phenothiazine. Zai iya zama dole a kara kashi na injin injin-dan adam kashi biyu idan aka yi amfani da su a hade tare da wadannan kwayoyi.
A hypoglycemic sakamako na mutum insulin fadada metformin, sulfonamides, repaglinide, androgens, na baka hypoglycemic jamiái, testosterone, anabolic steroids, bromocriptine, disopyramide, guanethidine, monoamine oxidase hanawa, angiotensin II tsoka mai amsa sigina antagonists, carbonic anhydrase hanawa, fluoxetine, carvedilol, fenfluramine, angiotensin tana mayar enzyme hanawa (captopril , enalapril da sauransu), tetracyclines, octreotide, mebendazole, ketoconazole, clofibrate, theophylline, quinidine, chloroquine, non-steroid magungunan anti-mai kumburi, salicylates, cyclophosphamide, pyridoxine, beta-blockers (betaxolol, metoprolol, pindolol, sotalol, bisoprolol, timolol da sauransu) (bogi bayyanar cututtukan hypoglycemia, gami da tachycardia, hawan jini), ethanol da ethanol. Zai iya zama dole a rage kashi biyu na insulin aikin injinin mutum sau biyu yayin amfani dashi tare da wadannan kwayoyi.
Beta-blockers, clonidine, reserpine na iya ɓoye bayyanar alamun bayyanar cututtuka na hypoglycemia.
A kan tushen atenolol (sabanin wanda ba mai zaɓar beta-blockers ba), tasirin ba shi da karuwa sosai, yana da mahimmanci a faɗakar da mai haƙuri cewa tare da haɓakar hypoglycemia, tachycardia da rawar jiki na iya kasancewa ba tare da ɓacin rai ba, amma rashin jin daɗi, yunwa, tashin zuciya ya kamata ci gaba, kuma gumi har ma yana ƙaruwa.
Thearfafa yawan insulin mutum a cikin jini yana ƙaruwa (saboda haɓakar sha) magungunan nicotine da shan sigari.
A kan asalin octreotide, reserpine, canji a cikin tasirin hypoglycemic mai yiwuwa ne (duka fadadawa da rauni), suna buƙatar daidaita sashin insulin.
A kan asalin clarithromycin, ƙarancin lalata yana ragewa kuma, a wasu halaye, sakamakon insulin na iya ƙaruwa.
A kan asalin diclofenac, sakamakon maganin yana canzawa, idan aka yi amfani da shi tare, ya zama dole don sarrafa matakin glucose a cikin jini.
A ƙarshen asalin metoclopramide, wanda ke hanzarta kwashewa na ciki, yana iya zama dole a canza allurai ko tsarin kula da insulin.
Insulin ɗan adam ba ya jituwa da hanyoyin magunguna.
Idan ya zama dole don amfani da wasu magunguna, ban da insulin ɗan adam, ya zama dole a nemi likita.

Amfani da barasa

Shan insulin bai dace da shan giya ba. Alamun maye shine karuwa, kuma sakamakon rage ƙwayoyi yana raguwa sosai.

Akwai da yawa analogues:

• Berlinsulin N al'ada,
• Mai ba da labari CR,
• Insulidd
• Insulin,
• Insuman Rapid,

Yanayin ajiya na miyagun ƙwayoyi

An adana shi a zazzabi wanda ba ya wuce + 25 ° C a cikin mafi girman kariya daga ƙananan yara. Yana da kyau a guji hasken rana kai tsaye.

Wajibi ne a tabbatar da cewa mafita ba zai rasa ma'anarsa ba, kuma ba tsarin kwantar da hankali a kasan ba. Idan wannan ya faru, to ba za a iya amfani da maganin ba.

Mai masana'anta

Akwai kungiyoyi da yawa waɗanda ke samar da insulin na mutum:

• Sanofi (Faransa),
• NovoNordisk (Denmark),
• EliLilly (Amurka),
• Pharmstandard OJSC (Russia),
• National Biotechnology OJSC (Rasha).

Matsayin insulin a cikin jiki ba gaskiya bane don ƙima. Kowane mataki na karancin insulin ya cika da mummunan cutar endocrine - ciwon sukari. Shekaru 40 da suka gabata, masu ciwon sukari sunyi rayuwa basu wuce shekaru 10-15 ba.

Magungunan zamani yana amfani da insulin ɗan adam wanda ya fi dacewa da asalin halitta don inganta yanayin glucose na jini. Godiya ga wannan magani, ciwon sukari ya daina zama jumla, yana bawa marasa lafiya damar cikakkiyar rayuwa da tsawon rai.

Contraindications

• hawan jini,
• mutum rashin haƙuri ko hypersensitivity ga abubuwan da miyagun ƙwayoyi.

Wadannan contraindications dole ne a yi la’akari kafin fara magani.

Yadda ake ɗaukar insulin ɗan adam

Sashi da hanyar gudanarwa kai tsaye ana ƙaddara su ne kawai a kan matsakaicin jinin jinin mai azumi, sannan kuma sa'o'i 2 bayan cin abinci. Bugu da kari, liyafar ta dogara da tsananin girman ci gaban glucosuria.

Mafi yawan lokuta, gudanarwa na ƙarƙashin ƙasa. Yi shi mintina 15 kafin babban abincin. Idan cutar ketoacidosis mai ciwon sukari ko coma, insulin allurar ana shigar da shi a cikin jet, ko da yaushe cikin ciki ko a cikin gluteus tsoka, kafin a yi wani tiyata.

An ba da shawarar gudanar da maganin a kalla sau 3 a rana. Don kauce wa m lipodystrophy, ba za ku iya tsayar da miyagun ƙwayoyi ba koyaushe a wuri guda. Sannan ba a lura da dystrophy na kitse mai ƙyalli ba.

Matsakaicin matsakaita na yau da kullun shine raka'a 40, kuma ga yara yana da raka'a 8. Tsarin gudanarwa sau 3 a rana. Idan akwai irin wannan buƙatar, to, zaku iya samun insulin har sau 5.

Sakamakon sakamako na insulin ɗan adam

Lokacin amfani dashi, halayen masu raunin da suka biyo baya galibi suna haɓaka:

• Bayyanar bayyanar rashin lafiyan: urticaria, edema na Quincke,
• mai saurin numfashi, matsanancin raguwa,
• hypoglycemia: karuwar gumi, mai gyaran fata, rawar jiki da yawan damuwa, matsananciyar yunwar, tashin hankali, rashin bacci, migraine, yawan damuwa da gajiya, hangen nesa da magana, gurguwar gani da magana, raunin fuska,
• cutar rashin daidaituwa
• hyperglycemia da acidosis: bushe bakin baki koyaushe, kazamar cin abinci, jan farji na fuskar fuska,
• mai raunin hankali
• rage gani
• itching da kumburi a wurin da aka gudanar da maganin,
• bayyanar kumburi fuska da wata gabar jiki, cin zarafi ne.

Irin waɗannan halayen na ɗan lokaci ne kuma basa buƙatar takamaiman magani na magani. Suna wucewa hankali bayan soke kudaden.

Tasiri kan ikon sarrafa abubuwan inji

Tare da insulin far, wani sashi na wasu psychomotor halayen da rikicewar rikice-rikice na yiwuwa. Sabili da haka, ya fi kyau mu guji tuƙin kansa da kayan aiki masu nauyi.

Umarni na musamman

Kafin ku tattara mafita kai tsaye daga kwalbar, tabbas za ku duba shi don nuna gaskiya. Idan hazo ya bayyana, irin wannan magani bai kamata a sha shi ba.

Girman insulin an daidaita shi don irin waɗannan cututtukan:

• cututtuka
• malfunctioning na thyroid gland shine yake,
• Cutar Addison
• kyakyawan magana,
• ciwon sukari a cikin tsofaffi.

Sau da yawa, bayyanar cututtuka na rashin ƙarfi na haɓaka. Dukkansu ana iya haifar dasu ta hanyar yawan shan ruwa, maye gurbi na insulin na asali iri ɗaya daga ɗan adam, matsananciyar yunwa, har da gudawa, amai da sauran alamun maye. Za'a iya tsayar da hauhawar jini ta hanyar shan sukari.

Idan ƙananan alamun hypoglycemia sun bayyana, ya kamata ka tuntuɓi kwararrun likitocin nan da nan. A cikin lokuta masu sauƙi, daidaita sashi na iya taimaka. A cikin mafi munin yanayi, ya kamata a yi amfani da maganin kawar da alamun ciwo. Ba tare da ɓata lokaci ba, ana buƙatar cikakken cire magani ko magani mai sauyawa.

Dole ne a tuna cewa a cikin yankin na gudanarwa kai tsaye, dystrophy na kitse mai ƙare yana iya bayyana. Amma ana iya magance wannan ta hanyar canza wurin don injections.

Yi amfani da lokacin daukar ciki da lactation

Gudanar da matakin sukari a jikin mace mai ciki yana da mahimmanci. A cikin farkon watanni, buƙatar insulin tsarkakakke yana raguwa kaɗan, kuma a ƙarshen lokacin yana ƙaruwa.

Yayin shayarwa, mace na iya buƙatar wasu matakan daidaita insulin da abinci na musamman.

MP ba shi da wata illa mai illa da ƙwayar cuta ta jiki.

Aikace-aikacen aiki mara kyau

Idan mai haƙuri yana da wasu cututtukan koda, ana buƙatar daidaita sashi na insulin.

Yi amfani da shi don aikin hanta mai rauni

Tare da taka tsantsan, mutanen da ke da cututtukan hanta ya kamata su sha maganin. A ƙananan canje-canje a cikin samfuran hanta, ana bada shawara don daidaita sashi.

Yawan abin sama da ya kamata

Yawan alamun bayyanar cututtuka na iya faruwa akai-akai:

• hypoglycemia - rauni, wuce kima, gumi, pallor na fata, rawar jiki daga ƙarshen, harshen rawar jiki, yunwar,
• cutar rashin haihuwa tare da cututtukan mahaifa.

A lura shine yafi alama. Poarancin hypoglycemia na iya wucewa bayan cinye sukari ko abinci mai-carbohydrate.

Don dakatar da alamun cutar yawan zafin jiki, allurar glucagon ce. Idan ya kasance kwatsam cikin ƙwayar cuta, to kusan 100 ml na dilken dextrose ana shigar da shi cikin nutsuwa har sai mai haƙuri ya fito cikin rashin lafiya.

Yin hulɗa tare da wasu kwayoyi

Maganin insulin da aka kera an haramta shi sosai a hade tare da sauran hanyoyin allura. Babban tasirin hypoglycemic yana ƙaruwa ne kawai lokacin da aka yi amfani dashi tare da wasu sulfonamides, MAO inhibitors, da steroids anabolic. Androgens, tetracyclines, bromocriptine, ethanol, pyridoxine da wasu masu amfani da beta kuma suna inganta tasirin maganin.

Tasirin hypoglycemic yana raunana lokacin ɗauka tare da babban kwayoyin hodar iblis, hana haihuwa, glucagon, estrogens, heparin, jinƙai da yawa, wasu maganin antidepressants, antagonists na alli, morphine da nicotine.

Ambiguously rinjayar insulin a kan sha na glucose beta-blocker, reserpine da pentamidine.

Amfani da barasa

Shan insulin bai dace da shan giya ba. Alamun maye shine karuwa, kuma sakamakon rage ƙwayoyi yana raguwa sosai.

Akwai da yawa analogues:

• Berlinsulin N al'ada,
• Mai ba da labari CR,
• Insulidd
• Insulin,
• Insuman Rapid,

Sharuɗɗan hutu na kantin

Za'a iya siyan insulin na mutum ne kawai a magunguna na musamman.

Zan iya siye ba tare da takardar sayan magani ba

Sayar da girke-girke na musamman.

Kudin ya dogara da kantin magani da kuma adadin kwalban da ke kunshin. Matsakaicin farashin ya tashi daga 500 zuwa 1700 rubles.

Yanayin ajiya na miyagun ƙwayoyi

An adana shi a zazzabi wanda ba ya wuce + 25 ° C a cikin mafi girman kariya daga ƙananan yara. Yana da kyau a guji hasken rana kai tsaye.

Wajibi ne a tabbatar da cewa mafita ba zai rasa ma'anarsa ba, kuma ba tsarin kwantar da hankali a kasan ba. Idan wannan ya faru, to ba za a iya amfani da maganin ba.

Ranar karewa

Cire bude kwalban yana da ingancin kwanaki 30 kacal. Bayan wannan lokacin, ana zubar da maganin.

Mai masana'anta

Akwai kungiyoyi da yawa waɗanda ke samar da insulin na mutum:

• Sanofi (Faransa),
• NovoNordisk (Denmark),
• EliLilly (Amurka),
• Pharmstandard OJSC (Russia),
• National Biotechnology OJSC (Rasha).

Matsayin insulin a cikin jiki ba gaskiya bane don ƙima. Kowane mataki na karancin insulin ya cika da mummunan cutar endocrine - ciwon sukari. Shekaru 40 da suka gabata, masu ciwon sukari sunyi rayuwa basu wuce shekaru 10-15 ba.

Magungunan zamani yana amfani da insulin ɗan adam wanda ya fi dacewa da asalin halitta don inganta yanayin glucose na jini. Godiya ga wannan magani, ciwon sukari ya daina zama jumla, yana bawa marasa lafiya damar cikakkiyar rayuwa da tsawon rai.

Me yasa ake kira insulin "kayan injiniyan asali"

Wasu daga cikin marasa lafiya suna firgita da kalmar “masu ilimin kimiya ta asali,” suna tunatar da su “GMOs mafi girman laifi.”

A zahiri, kirkirar wannan magani ne ya ceci miliyoyin rayuwar mutane masu ciwon sukari.

A farkon, likitoci sunyi amfani da insulin daga cikin dabbobi (galibi aladu da shanu). Ko yaya, wannan hormone ba baƙon bane kawai ga ɗan adam, amma kuma ya shiga cikin jini nan take, yana haifar da tsalle-tsalle a cikin glucose kuma yana haifar da rikitarwa masu yawa.

Ingantaccen insulin ya kasance yana yin la'akari da duk abubuwan da ake buƙata na mai haƙuri tare da ciwon sukari, yana lalata halayen ƙwayoyin cuta daban-daban. Bayan ƙarshen aikinsa, ya rushe zuwa cikin amino acid na yau da kullun kuma an fitar dashi daga jiki.

Abubuwan da ke cikin magunguna na asali

Magungunan insulin ɗan adam yana nufin magungunan maye gurbin insulin na gajeran lokaci.

Tare da mai karɓa na bangon tantanin halitta, ƙwayar tana samar da hadaddun mai ɗaukar insulin wanda ke motsa hanyoyin cikin ciki:

1. Keɓe enzymes don cikakken aiki da ɗaukar glucose ta kyallen,
2. Yana ƙaruwa a cikin jirgin ruwa na jijiya da haɓaka glucose,
3. Rage raguwar samuwar glycogen a cikin hanta,
4. Imarfafa samar da sunadarai da mai.

Tare da gudanar da aikin subcutaneous, miyagun ƙwayoyi sun fara aiki bayan minti 20-30, suna isa zuwa matsakaici a cikin sa'o'i 1-3, suna da kusan 5-8 hours.

An rarraba wannan magani daban a cikin kyallen takarda: alal misali, ba ya ratsa katangar mahaifa kuma baya shiga cikin madarar nono. Bayan ƙarshen aikinsa, ana keɓantar da insulin na mutum ta hanjin kodan (kusan kashi 80%) bayan lalata shi ta hanyar insulinase.

Alamu don amfani

Yawancin lokaci, likitoci suna ba da insulin mai narkewa a cikin lokuta:

Contraindications

Wannan magani yawanci yana yarda da shi ta jiki, saboda ba ya bambanta da na ƙayyadaddun ƙwayar ƙwayar cuta ta jiki.

Contraindicated don amfani da insulin a:

• Rage glucose na jini (hypoglycemia),
• 'Sara hankalin mutum ga insulin.

Aikace-aikacen da zaɓi na sashi

Matsayi da kuma hanyar gudanar da insulin na mutum koyaushe ne keɓance daban-daban ta hanyar endocrinologist, la'akari da mahimmancin alamun alamu na glucose jini da fitsari na haƙuri.

Ana gudanar da wannan magani a cikin ciwon sukari ta hanyoyi da yawa: subcutaneously (s / c), intramuscularly (i / m) ko cikin jijiya (i / v). Sau da yawa, ana gudanar da insulin a ƙarƙashin ƙasa. Don yin wannan, yi amfani da yankin:

Yawancin lokaci ana yin maganin ne a cikin jijiyoyin m cikin tsokanar cututtukan da ke haifar da ciwon sukari: ketoacidosis, coma mai ciwon sukari.

Ana ba da shawara don gudanar da insulin na mintina 15-30 kafin abinci, sau 3 a rana. Wani lokacin ana yarda da izinin kulawa guda 5-6 na miyagun ƙwayoyi.

Ana amfani da lissafin insulin yawanci a cikin adadin raka'a 0.5-1 a 1 kg na nauyi. Idan ana gudanar da insulin fiye da 0.6 MG a kilogiram na nauyin jiki, to dole ne a gudanar da maganin a kalla sau 2 a rana. A matsakaita, adadin yau da kullum shine kusan raka'a 30-40 (a cikin yara, raka'a 8).

Mata masu juna biyu yawanci ana ba su magani na 0.6 KUDI akan kilogiram na nauyi. Injewa yakan haifar da sau 3-5 a rana, gwargwadon yawan abinci.

Sau da yawa, insulin mai aiki da sauri yana haɗuwa tare da insulin aiki mai tsawo.