Mikstard® 30 NM Penfill® Matsakaici tsawon insulin ɗan adam ya hade a hade da insulin gajere

Hypoglycemic wakili na matsakaici na tsawon lokaci. Yana hulɗa tare da takamaiman mai karɓa a kan sel na waje kuma yana samar da mahaɗar insulin na insulin. Ta hanyar kunna biosynthesis na cAMP a cikin ƙwayoyin mai da ƙwayoyin hanta ko shiga cikin ƙwayoyin tsoka kai tsaye, ƙwaƙwalwar isulin mai karɓar isulin tana motsa matakai cikin ciki, gami da kira na enzymes masu yawa (hexokinase, pyruvate kinase, glycogen synthetase, da sauransu). Rage yawan haɗuwa da glucose a cikin jini shine saboda karuwa a cikin sufurin jirgin ruwan ciki, gami da increasedara yawan shan abubuwa da haɓakar nama, haɓakar glycogenesis, glycogenogenesis, ƙwayar furotin, rage haɓakar glucose ta hanta, da dai sauransu.

Tsawon lokacin aikin insulin ya kasance ne sabili da ƙimar sha, wanda a biyun ya dogara da dalilai da yawa (ciki har da kashi, hanyar da wurin gudanarwa). Farawar aiki bayan sc gudanarwa yana cikin minti 30, matsakaicin sakamako yana haɓakawa a cikin 2-8 hours, tsawon lokacin aikin ya kasance zuwa sa'o'i 24. Yawancin lokuta an tsara shi tare da shirye-shiryen insulin gajere.

Side effects

Allergic halayen (urticaria, angioedema - zazzabi, ƙarancin numfashi, rage karfin jini), gami da na gida (tsotsar fata, kumburi, amai na fata a wurin allura), lipodystrophy a wurin allura, zubar jini (pallor na fata, karuwar gumi, gumi, palpitations, rawar jiki, yunwar, tashin hankali, damuwa, paresthesia a bakin, ciwon kai, nutsuwa) , rashin bacci, tsoro, yanayi mai ban tausayi, tashin hankali, hali mai ban mamaki, tashin hankali na motsi, magana mara kyau da hangen nesa), cutar rashin haila.

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

Aikace-aikacen da sashi

SC a yankin cinya (wurin mafi jinkirin da mafi yawan kwayoyi na miyagun ƙwayoyi); SC a bangon ciki na gaba, buttock ko deltoid muscle na kafada kuma an yarda.

Ana amfani da maganin ne ta hanyar likita kwata-kwata a kowane yanayi dangane da tattarawar glucose a cikin jini. Matsakaicin matsakaita na yau da kullun ya tashi daga 0.5 zuwa 1 IU / kg nauyin jiki. Ana gudanar da maganin a cikin mintina 30 kafin abincin da ya ƙunshi carbohydrates. Zazzabi na allurar allurar yakamata ya zama zazzabi dakin.

Yin aiwatar da allura a cikin fatar fata yana rage haɗarin shiga cikin tsoka.

Wajibi ne don canja wurin allurar a cikin yankin na jikin mutum don hana haɓakar lipodystrophy.

Ana amfani da maganin a matsayin monotherapy kuma a hade tare da insulin gajeren aiki. Tare da maganin kwantar da hankali, ana amfani da miyagun ƙwayoyi azaman basal insulin sau 1-2 a rana (maraice da safiya) tare da insulin gajere (gudanarwa kafin abincin rana).

A cikin nau'in ciwon sukari na II na ciwon sukari na II, ana gudanar da miyagun ƙwayoyi a hade tare da magunguna na baki na hypoglycemic.

Umarni na musamman

Ba za a iya shigar da miyagun ƙwayoyi cikin / ciki ba.

Tare da gabatarwar insulin ya kamata a kai a kai saka idanu kan taro na glucose a cikin jini.

Magungunan ba su dace ba idan, bayan girgizawa, dakatarwar ba ta zama fari ba kuma gajimare. Don gabatarwar miyagun ƙwayoyi ba a ba da shawarar yin amfani da pumps insulin.

Za'a iya kawar da yawan zubar da jini ta hanzari na sukari ko wasu samfuran da ke dauke da sukari (mai haƙuri dole ne koyaushe yana da piecesan guntu guda na sukari, alewa, kukis ko ruwan 'ya'yan itace).

Sanar da dangi, abokai da abokan aiki nan da nan game da cutar sankara, bayyana sharudda na taimakon farko idan ana fama da matsananciyar rashin lafiya.

Tare da gabatarwar ƙananan ƙwayar insulin fiye da dole, karuwar insulin, rashin cin abinci, da kuma rashin daidaituwa na insulin, hyperglycemia da ketoacidosis mai ciwon sukari na iya haɓaka (polyuria, pollakiuria, ƙishirwa, asarar ci, tashin zuciya, amai, amai, rashin ƙarfi, rauni, da fata, bushe baki da ƙanshi na acetone a cikin iska mai ƙare). Lokacin da alamun farko na hyperglycemia suka bayyana, ya kamata a gudanar da insulin nan da nan.

A cikin cututtukan haɗaka (ciki har da aikin thyroid mai rauni, hanta, koda, cutar Addison, hypopituitarism) a cikin tsofaffi (sama da shekaru 65), ana iya buƙatar daidaita sashin insulin. Abubuwan cututtuka masu haɗari tare da zazzabi, haɓaka a cikin aikin jiki, canji a cikin abincin da aka saba yana ƙara buƙatar insulin.

Amfani da abinci na Ethanol (gami da giya, giya) na iya haifar da cututtukan jini. Kar a dauki ethanol a ciki.

Lokacin canzawa zuwa insulin ɗan adam, ya kamata a ɗauka a hankali cewa farkon alamun masu harbor na hypoglycemia na iya zama ƙasa da sanarwa kamar yadda suke lokacin amfani da magani na baya. Yanayi da tsananin irin wadannan alamu na iya canzawa yayin ajiyar ladan da za ayi don maganin metabolism (gami da lokacin maganin insulin).

Yayin cikin ciki da lokacin shayarwa, ana bada shawara don daidaita sashi don kula da diyya don ciwon sukari.

A lokacin kulawa, dole ne a kula da lokacin hawa motoci da shiga cikin wasu ayyukan masu haɗari waɗanda ke buƙatar haɓakar haɓaka da saurin halayen psychomotor (a yayin hypoglycemia, za su iya raguwa).

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, epinephrine, H1-histamine mai hana masu tallatawa.

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

Diabetologist: "Don daidaita matakin sukari na jini."

Yadda ake amfani: sashi da hanya na jiyya

SC a yankin cinya (wurin mafi jinkirin da mafi yawan kwayoyi na miyagun ƙwayoyi); SC a bangon ciki na gaba, buttock ko deltoid muscle na kafada kuma an yarda.

Ana amfani da maganin ne ta hanyar likita kwata-kwata a kowane yanayi dangane da tattarawar glucose a cikin jini. Matsakaicin matsakaita na yau da kullun ya tashi daga 0.5 zuwa 1 IU / kg nauyin jiki. Ana gudanar da maganin a cikin mintina 30 kafin abincin da ya ƙunshi carbohydrates. Zazzabi na allurar allurar yakamata ya zama zazzabi dakin.

Yin aiwatar da allura a cikin fatar fata yana rage haɗarin shiga cikin tsoka.

Wajibi ne don canja wurin allurar a cikin yankin na jikin mutum don hana haɓakar lipodystrophy.

Ana amfani da maganin a matsayin monotherapy kuma a hade tare da insulin gajeren aiki. Tare da maganin kwantar da hankali, ana amfani da miyagun ƙwayoyi azaman basal insulin sau 1-2 a rana (maraice da safiya) tare da insulin gajere (gudanarwa kafin abincin rana).

A cikin nau'in ciwon sukari na II na ciwon sukari na II, ana gudanar da miyagun ƙwayoyi a hade tare da magunguna na baki na hypoglycemic.

Form sashi

Dakatarwa don gudanarwar subcutaneous, 100 IU / ml

1 ml na miyagun ƙwayoyi ya ƙunshi

abu mai aiki - asalin ilimin ɗan adam na jikin ɗan adam 3.50 mg (100 IU) 1,

magabata: zinc (a cikin nau'in zinc chloride), glycerin, phenol, metacresol, sodium hydrogen phosphate dihydrate, sulfate protamine, hydrochloric acid 2 M bayani, sodium hydroxide 2 M bayani zuwa pH 7.3, ruwa don allura.

1 Magungunan ya ƙunshi insulin ɗan adam mai narkewa 30% da 70% isofan-insulin

Fitar farin, lokacin da yake tsaye, an daidaita shi cikin m, mara launi ko kusan madaukaki mai launi da farin haske. A sauƙaƙe za a sake tura shi cikin saurin girgiza kai.

Kayan magunguna

Pharmacokinetics

Tsawon lokacin aiwatar da shirye-shiryen insulin shine mafi yawanci saboda yawan sha, wanda ya dogara da dalilai da yawa (alal misali, kan yawan insulin, hanyar da wurin gudanarwa, kauri daga cikin yawan kitse mai cutarwa da nau'in ciwon sukari mellitus). Sabili da haka, sashin magungunan insulin na insulin ya shafi mahimmancin canzawa tsakanin mutum-da-ciki.

Matsakaicin ƙwayar insulin (Cmax) na insulin a cikin plasma an samu shi ne tsakanin awa 1.5 zuwa 2.5 bayan gudanarwar ƙarƙashin ƙasa.

Babu wata ma'anar da aka ambata ta danganta ga furotin na plasma da aka ambata, banda abubuwan rigakafi zuwa insulin (idan akwai).

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

Rabin-rabi (T½) an ƙaddara shi da ƙimar sha daga ƙwaƙwalwar subcutaneous. Don haka, T½ shine mafi girman matakan sha, maimakon ainihin matakin cire insulin daga plasma (T½ na insulin daga cikin jini kawai 'yan mintuna). Bincike ya nuna cewa T½ kusan awa 5-10.

Pharmacodynamics

Mikstard® 30 NM Penfill® wani insulin ne mai aiki da abubuwa biyu wanda aka samar da shi ta hanyar kimiyyar halittar halittar DNA ta hanyar amfani da nau'in cerechaia na Saccharomyces. Yana hulɗa tare da takamaiman mai karɓa a kan ƙwayar cytoplasmic na sel kuma yana samar da hadaddun insulin-receptor. Ta hanyar kunnawar biosynthesis na CAMP (a cikin ƙwayoyin mai da ƙwayoyin hanta) ko, kai tsaye shiga cikin tantanin halitta (tsokoki), hadaddiyar insulin-receptor tana ƙarfafa ayyukan cikin ciki, gami da kira na enzymes masu yawa (hexokinase, pyruvate kinase, glycogen synthetase, da sauransu). Rage yawan glucose na jini ana haifar dashi ta hanyar haɓaka aikin jigilar kwayar cutar ta ciki, karuwar yawanshi da kuma ƙaddara kyallen takarda, haɓakar lipogenesis, glycogenogenesis, ƙwayar sunadarai, raguwa a cikin yawan samar da glucose ta hanta, da dai sauransu.

Tasirin miyagun ƙwayoyi Mikstard® 30 NM Penfill® yana farawa tsakanin rabin sa'a bayan gudanarwa, kuma ana nuna mafi girman sakamako a cikin 2-8 awanni, yayin da jimlar aikin ta kusan awa 24.

Sashi da gudanarwa

Ana shirya shirye-shiryen insulin yawanci sau ɗaya ko sau biyu a rana idan ana buƙatar haɗuwa da saurin farko da tasirin tsayi.

An zaɓi kashi na miyagun ƙwayoyi daban-daban, la'akari da bukatun mai haƙuri. Yawanci, bukatun insulin tsakanin 0.3 da 1 IU / kg / rana. Bukatar yau da kullun don insulin na iya zama mafi girma a cikin marasa lafiya tare da juriya na insulin (alal misali, yayin balaga, har ma a cikin marasa lafiya tare da kiba), da ƙananan cikin marasa lafiya tare da ragowar insulin na insulin.

Idan marasa lafiya da masu ciwon sukari sun sami cikakkiyar iko na glycemic, to, rikice-rikice na ciwon sukari a cikinsu, a matsayin mai mulkin, ya bayyana daga baya. A wannan batun, yakamata mutum yayi ƙoƙari don inganta kulawar metabolism, musamman, suna lura da matakin glucose a cikin jini.

Ana gudanar da maganin a cikin mintina 30 kafin cin abinci ko abun ciye-ciye wanda ya ƙunshi carbohydrates.

Don gudanar da aikin ƙarƙashin ƙasa. Babu wani yanayi da yakamata ayi insulin dakatarwar cikin hanji. Mikstard® 30 NM Penfill® mafi yawanci ana gudanar da shi ƙarƙashin ƙasa a cikin ɓangaren bango na ciki. Idan wannan ya dace, to kuwa za'a iya yin allura a cinya, yankin gluteal ko a cikin yanki na ƙwayar tsoka ta kafada (subcutaneously). Tare da shigar da miyagun ƙwayoyi a cikin yankin bangon ciki na ciki, ana samun saurin ɗaukar sauri fiye da gabatarwar zuwa wasu yankuna. Yin aiwatar da allura a cikin fatar fata yana rage haɗarin shiga cikin tsoka. Wajibi ne a canza wurin allurar a koyaushe a cikin yankin na jiki don rage haɗarin lipodystrophy.

Umarnin don amfani da Mikstard® 30 NM Penfill® da za a ba wa mara lafiya.

Kafin amfani da miyagun ƙwayoyi Mikstard® 30 NMPenfill®ya zama dole:

Duba marufin don tabbatar cewa an zaɓi nau'in insulin daidai.

Kullum sai a bincika katun, gami da pistin na roba. Idan aka gano wata lahani, ko kuma an sami rata tsakanin pistin na roba da farin tef ɗin alama, to wannan ba za a yi amfani da wannan katun ba. Don ƙarin jagora, duba jagora don amfani da tsarin don gudanar da insulin.

Koyaushe yi amfani da sabon allura don kowane allura don hana kamuwa da cuta.

Cutar da membrane na roba tare da swab na auduga.

Magungunan Mikstard®30 nmPenfill®ba za a iya amfani da shi ga waɗannan lamura masu zuwa ba:

A cikin famfo na insulin (farashinsa)

Idan katun kwalliyar ta ko kayan sawa suke zubarwa, ko kuma ta lalace ko ta lalace, kamar yadda akwai haɗarin zubar ruwan insulin

Idan jinin haila ya fara (sukarin jini).

Idan ba a adana insulin da kyau ba, ko kuma a daskararre

Idan bai zama fari fari da girgije ba bayan sake faruwar yanayin.

Kafin amfani da Mikstard® 30 NM Penfill®:

Binciki alamar don tabbatar da cewa kuna amfani da insulin da ya dace.

Cire kwalban kariya.

Abubuwan da aka buƙata da Mikstard® 30 NM Penfill® don amfanin kai kaɗai.

Yadda ake amfani da miyagun ƙwayoyi Mikstard® 30 NM Penfill®

Magungunan miyagun ƙwayoyi Mikstard® 30 NM Penfill intended an yi shi ne don gudanar da ayyukan ƙarƙashin ƙasa. Karka taɓa sarrafa insulin cikin ciki ko intramuscularly. Koyaushe canza wuraren allura a cikin yanki na jiki don rage haɗarin ɗamarar hanji da ƙura a wurin allurar. Mafi kyawun wurare don injections sune: buttocks, gwiwoyi na baya ko kafada.

Umarnin don mara lafiya yadda ake gudanar da insulin

Kafin shigar da katun Penfill® a cikin allurar insulin, ɗaga da ƙananan katako a ƙalla sau 10 sama da ƙasa tsakanin matsayi a da b, kamar yadda aka nuna a cikin adadi, saboda ƙwallon gilashin da ke cikin ggar ɗin yana motsawa daga ƙarshen katako zuwa ɗayan a ƙalla sau 20. Kafin kowane allura, akalla irin waɗannan motsi 10 yakamata a yi. Wadannan manipulation ya kamata a maimaita su har sai ruwan ya zama fari da gajimare. Cike kai tsaye.