Umarnin don yin amfani da insulin: abun da ke ciki, analogues, bita, farashin a cikin kantin magunguna

Akwai shi a cikin tsari biyu - Rinsulin R da Rinsulin NPH. Siffar saki - harsashi na mil 3 (tare da ba tare da yaren alkalami ba) ko kwalban 10 ml. Idan waɗannan ƙananan katako ne, to, akwai guda 5 a cikin kunshin. Hakanan kwalallen kwalallen kwali a cikin kwali.

Haɗin ya dogara da nau'in "Rinsulin."

• P: 100 IU na insulin ɗan adam, 3 MG na metacresol, 16 MG na glycerol, har zuwa 1 ml na ruwa don allura.
• NPH: 100 IU na insulin mutum, 0.34 mg na furotin protamine, 16 mg na glycerol, 0.65 mg na crystalline phenol, 1.6 mg na metacresol, 2.25 mg na sodium hydrogen phosphate dihydrate, har zuwa 1 ml na ruwa don allura.

Bambanci tsakanin Rinsulin P da NPH

Rinsulin R shine maganin allurar, kuma Rinsulin NPH dakatarwa ce don gudanar da aikin subcutaneous. Na farko za'a iya gudanar da subcutaneously, intravenously da intramuscularly (kashi na yau da kullun daga 0.3 IU / kg). Na biyu kawai subcutaneous (daga 0.5 IU / kg).

Babban bambanci tsakanin nau'in "Rinsulin" shine tsawon lokacin aikin su. "P" - insulin gajere, yana fara aiki minti 30 bayan gudanarwar, tsawon lokacin tasirin yana kusan awa 8. "Rinsulin NPH" ya fara aiki bayan sa'o'i 1.5 - 2, yana aiki har zuwa rana.

Kudin magunguna ya bambanta kaɗan.

Aikin magunguna

Yana da tasirin hypoglycemic. An samu ta hanyar sake gina DNA. Yana hulɗa tare da masu karɓar, wanda ya haifar da hadaddun insulin-receptor. Yana haɓaka jigilar ƙwayar glucose, yana ba shi damar mafi kyawun ƙwayoyin ƙwayoyin cuta da kyallen takarda, kuma yana ƙarfafa lipogenesis da glycogenesis. Wannan yana rage mahimmancin samar da glucose ta hanta.

Tsawon lokacin aikin ya dogara da nau'in Rinsulin. Ana iya amfani da nau'ikan biyu a haɗuwa da warkewa.

Pharmacokinetics

Farkon aikin, saurin da cikar ƙarfin maganin ya dogara da wurin allurar, sashi da sauran abubuwan. An rarraba shi mara iyaka, abubuwan da ke tattare da magunguna ba su ƙetare shingen cikin ƙasa ba. Rabin-rabi gajere ne, ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa ta lulluɓe da ƙoshin.

• Ciwon sukari na mellitus na farko da na biyu.
• Ciwon sukari yayin daukar ciki.
• Yanayi tare da lalata metabolism na metabolism a cikin mutanen da ke fama da ciwon sukari.

Umarnin don amfani (hanya da sashi)

An zaɓi sashi ne ta ƙwararren masani bisa alamu na bincike da kuma bukatun mutum na jiki don insulin.

Ana gudanar da "Rinsulin P" a cikin subcutaneously, na ciki ko intramuscularly minti 30 kafin cin abinci. Tare da monotherapy, ana nuna allura sau 3 a rana, gwargwadon buƙatu na musamman, likita zai iya ƙara yawan injections zuwa shida.

Kasuwancin magani "NPH" ana sarrafa shi kawai a ƙarƙashin ƙasa.

Za'a iya yin amfani da wuraren allurar cikin wurare masu zuwa:

• kwatangwalo
• gindi
• ciki (bangon ciki na ciki),
• kafadu.

Wajibi ne a sauya wuraren allura don a guji lipodystrophy. Wajibi ne a koyar da mara lafiyar haƙuri game da maganin, don guje wa shiga cikin jini.

Magungunan da ake sarrafawa ya kamata ya kasance a zazzabi a ɗakin.

Side effects

• Yanayin hypoglycemic.
• Allergic halayen, Quincke ta edema.
• Kumburi da itching a wurin allurar.
• Lipodystrophy.
• Rage ƙarancin gani na gani (musamman a farkon farfajiya).
• Kwari.

Duk waɗannan abubuwan ana cire su ta hanyar sauya kashi na maganin ko kuma sokewarsa.

Yawan abin sama da ya kamata

Haɓaka ƙwanƙwasawar jini. Alamar ta: pallor, rauni, rashin iyawa har zuwa asara da kwaro, yunwar ciki, amai.

Ana cire fom din haske ta hanyar cin abinci mai-carbohydrate. Matsakaici kuma mai tsanani - tare da allura na glucagon ko wani bayani na dextrose, kawo mutum cikin sani, cin abinci tare da carbohydrates, da bin buƙatun likita don canza sashi na maganin.

Hulɗa da ƙwayoyi

Kada ku sarrafa tare da sauran abubuwan insulins.

Abubuwan da zasu iya inganta tasirin maganin:

• na baki hypoglycemic kwayoyi,
• bromocriptine
• MAO, ATP da hanawar anhydrase carbonic,
• sulfonamides,
• ba zaɓin beta-blockers ba,
• magungunan anabolic steroid
• octreotide
• ketoconazole,
• pyridoxine
• karafarini,
• tetracyclines
• Clofibrate
• shirye-shiryen lithium
• mebendazole,
• fenfluramine,
• akarijin
• shirye-shirye dauke da ethanol.

Abubuwan da ke motsa jiki:

• glucagon,
• maganin hana haihuwa
• somatropin,
• glucocorticosteroids,
• estrogens
• thiazide diuretics, dip,
• tausayawa
• aidin dake dauke da sinadarai na thyroid,
• heparin
• clonidine
• tricyclic maganin rigakafin,
• masu amfani da tashoshin alli "jinkirin",
• danazol
• phenytoin
• epinephrine
• diazoxide
• H1 talla mai talla mai karɓa,
• ƙwayar cuta
• nicotine.

Reserpine da salicylates na iya samun duka mai rauni da haɓakawa.

MUHIMMIYA! An yarda da maganin haɗin gwiwa tare da likitan halartar ba tare da faɗuwa ba!

Umarni na musamman

Ana buƙatar kula da matakan glucose na jini a lokacin yin jiyya.

Akwai haɗarin hauhawar jini. Zai iya tayar da damuwa, tsallake abinci, daɗa yawan motsa jiki, wasu cututtuka. Hyperglycemia da mai ciwon sukari na ketoacidosis na iya haɓaka nan gaba idan an zaɓi kashi na maganin ba daidai ba.

A cikin marasa lafiya tare da stenosis na jijiya da jijiyoyin zuciya, yi amfani da hankali. Kazalika da marasa lafiya da cututtukan fata, rikicewar cututtukan ƙwayar thyroid, hanta, kodan, tare da tarihin cutar ta Addison, haka kuma tsofaffi sama da 65 saboda haɗarin cututtukan hypoglycemia.

Yana shafar ikon fitar da abin hawa, don haka ya kamata ka rabu da tuki har tsawon lokacin magani.

Ba'a ba da shawarar a haɗaka tare da pumps insulin da catheters.

Ana fitowa da shi kawai a kan takardar sayan magani.

Haihuwa da lactation

An ba shi izinin amfani da shi a lokacin daukar ciki da kuma bayan haihuwa, tunda samfurin ba shi da aminci ga jikin jaririn. A cikin mahaifiya a cikin farkon farkon, buƙatar insulin na iya raguwa, yayin da a cikin watanni masu zuwa, yawanci yakan tashi. Ya kamata a gudanar da jiyya a ƙarƙashin kulawa mai zurfi na kwararren likita. Rashin jini na mahaifa yana da haɗari ga yaro.

Kwatanta tare da analogues

Wannan insulin din yana da adadin analogues wadanda zasuma zama da amfani a la'akari.

Levemir. Abunda yake aiki shine insulin-detemir. Matsakaicin matsakaici na wakilin Kamfanin masana'antu - Novo Nordisk, Denmark. Farashin kayan kwalliyar katako da alƙarya sirrin zai kasance kusan 1800 rubles. Da kyau. Da wuya sa rashin lafiyan ke haifar da rashin lafiyar. Koyaya, a babban farashin yana da isasshen jerin tasirin sakamako kuma ba a bada shawara ga yara underan shekaru 6 ba.

"Insuman Rapid." Ya ƙunshi mai narkewa, injin ɗabi'a, mai saurin aiki insulin. Kamfanin Sanofi-Aventis ne a Faransa ke yin sa. Farashin kwandunan guda biyar shine 1100 rubles. Abubuwan suna kusa da kaddarorin Rinsulin. Ana iya amfani dashi a cikin ƙuruciya, amma tare da zaɓi mai mahimmanci na sashi. Sideashin baya shine babban farashi.

"Aiki." Abunda yake aiki shine insulin ɗan adam. Mai samarwa - "Novo Nordisk", Denmark. Kudin 370 rubles, an bayar dashi a cikin kwalaben 10 ml. Short mataki, dace da hade far. Ana iya gudanar dashi ta hanyar sadarwa, intramuscularly, subcutaneously.

"Biosulin." Wannan dakatarwar tana dauke da insulin na kwance. Ya samar da kamfanin Pharmstandard-Ufavita, Rasha. Farashin ya dogara da nau'in sakin: kwalban 10 ml - 370 rubles, katako da alƙalamar sirinji - daga 1000 rubles. Gabaɗaya, kaddarorin iri ɗaya ne. Debe shi ne kudin. Amma bayanan miyagun ƙwayoyi gaba ɗaya suna rama wannan.

Sauyawa zuwa wani nau'in magani daban ana yin shi da izinin likita! An haramta shan magani!

Nazarin masu ciwon sukari

Gabaɗaya, wannan magani yana da kyakkyawan bita. Marasa lafiya masu ciwon sukari bayar da rahoton amfani, m farashin da tasiri. Amma wasu sun ce wannan insulin bai dace da su ba.

Ekaterina: “An daɗe na kamu da ciwon sukari mellitus. Ba haka ba da dadewa Ina amfani da Rinsulin NPH. Ina son cewa ya dace a yi amfani da shi, akwai alkalami na syringe. Ina bin tsarin cin abinci, don haka ba ni da matsala tare da kowane sakamako masu illa. Ina son miyagun ƙwayoyi sosai. ”

Eugene: “Likita ya koma Rinsulin NPH, Ina yin allura sau biyu a rana. Ina amfani da sirinji wanda za'a sake amfani dashi, yana da matukar dacewa kuma ya cancanci kuɗin da aka kashe. A koyaushe ina tabbatar da cewa abincin ba ya rikita shi, kuma lokacin da ban ci abinci a gida ba, Ina kuma amfani da ƙarin “P”. Yana da ɗan gajeren sakamako, yana tafiya da kyau tare da "NPH". Magungunan sun dace, ana kiyaye sukari a matakin da aka amince da shi. "

Igor: “Rinsulin bai dace da ni ba. Suga na ci gaba da girma. Likita ya canza zuwa wani magani. Amma na ji cewa wani ya dace sosai. A bayyane yake, ba kawai magani na ba. "

Olga: “An kasance ana jinyar da ni tare da Actrapid. Sannan sun daina isar da kantin magani - wasu matsaloli tare da masu samar da kayayyaki. Likita ya shawarce ni in gwada Rinsulin NPH. Na zo. Matsayin sukari daidai ne, ban sami sakamako ba. Ina farin ciki da komai, gaba daya. ”

Fom ɗin saki

An fitar da insulin a cikin dakatarwa don allurar, a cikin kwalabe tare da marikin roba, an rufe shi da hat na alumini a saman. Hakanan ana samun shi cikin ampoules na 5 ko 10 ml. Ruwan mai tsabta ne, m, ba tare da ƙazantawa ba. Irin wannan suturar an yi niyya don tattarawa da sikari da mai tare da sirinji na musamman. 5 inji mai kwakwalwa gilashin cushe a cikin kwali kwalaye tare da kwatancin. Ana samun insulin da aka fi yawan nema a cikin alƙalin syringe. Wannan nau'ikan tsari ne mai dacewa don masu ciwon sukari, saboda katako masu sauƙin maye suna ɗauke da allurai masu yawa, saboda haka zaku iya shigar da shi ba kawai a gida ba, har ma ku dauke shi kuyi aiki. Abu ne mai sauki don amfani, baya buƙatar ƙwarewa da ƙwarewa na musamman. Ba a fitar da insulin a cikin allunan; wannan nau'in har yanzu yana kan ci gaba.

Rayuwar shiryayye na miyagun ƙwayoyi shine watanni 15, amma har ma a cikin akwati da aka rufe sosai, magungunan na iya lalata idan an adana shi ba daidai ba. An jinkirta jinkirta a cikin maganin ta hanyar laka, flakes ko wasu lahani da ke cikin murfin. Ampoules yana buƙatar a firiji kuma a adana shi a zazzabi da bai wuce 2-8 * C ba. Yawancin lokaci ana amfani da magunguna don amfani dashi a cikin ɗaki, amma a wuri mai duhu don kada ya faɗi akan rana. Ana amfani da irin wannan kwalban ba fiye da wata ɗaya ba. Sannan dole ne a zubar dashi, koda kuwa ranar karewa bata kare ba.

Mahimmanci! Ba kwa buƙatar ɗaukar magani don kanku ba. Misali na lokacin yin amfani da magani zai zama likita ya zuga shi game da gwajin asibiti. A nan gaba, bisa shawarar likita, an zaɓi zaɓin magani da ake so, an daidaita sashi.

Magunguna da magunguna

Insulin yana da ikon rage yawan sukarin jini da fitsari, yana inganta karuwar glucose da kyallen. Kwayar halittar tana inganta canjin glucose zuwa glycogen, yawanta a cikin tsokoki da hanta. Bugu da ƙari, insulin yana rage samar da glucose, yana hana haɓakar lipemia (mai jini) na nau'in masu ciwon sukari. Hanyar aiwatar da dukkanin insulins iri ɗaya ce - ƙirƙirar hadaddun mai karɓar insulin, kuma tsawon lokacin aikin ya dogara da nau'in insulin, nau'ikansa. Hakanan, wurin allurar, zazzabi, adadin da taro na mafita suna shafar saurin maganin. Insulin yana shiga cikin jini, yana yin rushewa a kodan da hanta, kuma yana fitowa cikin hanzari a cikin fitsari da bile. Abubuwan hawa masu sauri da na matsananci suna fara aiki bayan mintuna 3-10, kuma masu tsawan lokaci bayan mintuna 25-30.

Manuniya da contraindications

Zamanin zamani yana da kiba ga matakai dabam dabam. Wannan yana haifar da rashin daidaitaccen tsarin cin abinci, gado, gado na damuwa da sauran abubuwan. Sabili da haka, bayan likita ya tabbatar da bayyanar cututtuka na ciwon sukari mellitus, ana tilasta su koyaushe yin amfani da magunguna masu rage sukari. Ana nuna ilimin insulin don nau'ikan cututtuka daban-daban.

1. Amfani da insulin shine nau'in cuta ta farko da sukari cikin jini zai tashi saboda karancin insulin. Wannan na faruwa ne sakamakon rashin isasshen ƙwayar cutar ƙwayar cuta wanda ya haifar da cututtukan cututtukan cututtukan cikinku na wasu dalilai da yawa.
2. Wani nau'in cutar insulin-mai 'yanci (nau'in 2) yana tasowa saboda asarar haɗin haɗin tsakanin sel jikin mutum.
3. Cutar sankarar mahaifa cuta ce ta mata masu juna biyu. Sugarara yawan sukari a lokacin daukar ciki. Bayan haihuwa, matakin yawanci al'ada ne.
4. Cutar sankarar mahaifa Sakamakon maye gurbi, sinadarin insulin-kwatankwacinsa yana canza sifofinsa, wanda ya zama sanadin ci gaban Pathology, saboda yana shiga cikin tsarin jiki, samuwar endocrine da sauran tsarin tayin.

Bugu da kari, allurar ta insulin cikin masu ciwon suga ga cututtukan da ke kama da zazzabi. Bayar da magani ga marasa lafiya da cuta na rayuwa yayin juyawa zuwa dogon insulin far. Aiwatar da maganin don gwajin insulin.

Contraindicated insulin a cikin marasa lafiya da:

• rashin lafiyan insulin da abubuwan da ke tattare da maganin,
• ƙananan glucose na jini a ƙasa da al'ada.

Hypoglycemia yana faruwa tare da:

• maganin cututtukan farji
• zakarya,
• m hepatitis
• cirrhosis na hanta,
• amyloidosis na kodan,
• ICD
• cututtukan gastrointestinal
• decompensated cututtukan zuciya.

Tare da taka tsantsan, an wajabta wa marasa lafiya waɗanda ke fama da cutar:

• rashin wadatar zuciya
• mai rauni daskararction,
• hargitsi na thyroid gland shine yake,
• Cutar Addison.

Kulawa da mata masu juna biyu da insulin ana yin su ne karkashin kulawa ta hanyar kula da likitan mata a duk lokacin da suke cikin ciki. A wannan lokacin, ana aiwatar da daidaituwa sashi sau da yawa.

Sashi da yawan abin sama da ya kamata

Dalilin shan maganin shine don rage glucose jini. Ana yin insulin dogon aiki s / c ko m. Don tabbatar da sakamako mai sauri-yanayin (yanayin gaggawa), ana amfani da insulin tare da ɗan gajeren sakamako, za a sanar da sunayen magungunan ta hanyar likita. Haramun ne a gabatar da insulin matsakaici da matsakaici a cikin jijiya ko amfani dashi a cikin abubuwan sahun jiko. Kafin gudanarwa, kuna buƙatar dumama da mafita zuwa zazzabi a ɗakin. Maganin sanyi yana rage jinkirin fara aiki kuma yana da ikon tsawan sakamakon cutar.

An zaɓi kashi na magani daban-daban ga kowane mara lafiya. Girman glucose da aka riga aka auna kafin abinci da awa 2 bayan cin abinci. A kan matsakaici, yi la'akari da mafi kyawun kashi 30-40 PIECES sau 1-3 a rana ko 0.5-1 PIECES / kg na nauyi. Idan akwai maganin warkewa na dangi ko wannan kashi bai dace da mai haƙuri ba, to za a iya haɗa insulin tare da aikin ultrashort tare da kwayoyi waɗanda ke da tasirin gaske.

Mahimmanci! Masu ciwon sukari suna buƙatar kulawa da hankali sosai yayin amfani da maganin don ƙin karɓar maganin da aka ba da shawarar. Wannan zai haifar da wuce haddi na insulin da haɓaka alamun bayyanar cututtukan jini.

Haɗa kai

Insulins suna dacewa da juna, amma ana buƙatar daidaita sashi yayin juyawa daga wani nau'in zuwa wani. Lokacin da yake rubuta magunguna, likitan ya jawo hankali ga abin da kwayar cutar ke ci gaba da ɗauka, tunda magunguna da yawa suna rage ko haɓaka sakamakon insulin. Don tsawaita sakamakon shan:

• hodar iblis,
• nicotinic acid da abubuwan ta,
• maganin alada.

Haɗin ruwan barasa da insulin yana inganta tasirin maganin ƙwayar cuta. Akwai rukunin magunguna waɗanda ke rage tasirin magani. Wannan shi ne:

• inhibitors na MAO, NPF, NSAIDs,
• magunguna dauke da acid na salicylic,
• shirye-shiryen zinc
• magungunan steroid.

Magungunan insulin ba su shafar yawan ƙarfin mutum, don haka masu ciwon sukari na iya aiki tare da fasaha na atomatik.

Rarraba magunguna ana aiwatar da dangi ne da lokacin aiki, abun da aka yi, asalin kayan abinci ne.

Table insulin tebur

Idan mai haƙuri yana buƙatar canzawa daga wannan nau'in insulin zuwa wani, to, likita kawai ne ke yin irin wannan gyaran. Bayar da bambanci a lokacin aiki, an zaɓi sashi.

Ra'ayoyin masu haƙuri

Nazarin masu ciwon sukari game da amfani da maganin.

Svetlana, ɗan shekara 54, Samara. Ina fama da cutar sankara tun shekaru 46 da suka gabata. Ina amfani da "Insulin Glargin", Ina amfani da miyagun ƙwayoyi a kai a kai, don haka sai na ji yana da kyau. Babban abu shine kada a jinkirta lokacin liyafar ba kuma a biya yawan shawarar da aka bayar.

Daria, dan shekara 32, Rostov. Sha wahala daga sukari spikes. Yanzu na bi tsarin abinci kuma akan saiti akan lokaci "Insuman Bazal." Ya taimaka min rayuwa da aiki cikakke.

Marina Pavlovna, endocrinologist. Abun da ba a haɗa shi ba yana haƙuri da haƙuri idan an lura da abinci mai kyau da abubuwan da suka dace. Kurakurai cikin abinci mai gina jiki suna haifar da bayyanar “sakamako mai illa”.

Kudin magungunan insulin daban-daban sun dogara da masana'anta da marufi. Ya bambanta daga 400 rubles. har zuwa 2800 rub. don shiryawa.

Conclusionarshen ƙarshe

Akwai takamaiman wallafe-wallafe inda aka bayyana hypoglycemia daki-daki. Wannan bayanin ba wai kawai ga masu ciwon sukari ba ne, tunda dalilan da suka haifar da ci gaban ilimin cuta an nuna su a can. Akwai kuma jerin magungunan da ake amfani da su don maganin insulin. Yana da mahimmanci kada ku fara jiyya da kanku. Tabbatar ziyarci wani endocrinologist don kada ku cutar da kanku.