Tsarin aikin insulin "Detemir", sunan cinikayyar, lokacin da aka wajabta shi, abin da ya ƙunsa, analogues, farashi, sake dubawa game da magani tare da miyagun ƙwayoyi, farashin

Shirye-shiryen insulin sun bambanta sosai. Wannan shi ne saboda buƙatar yin amfani da kwayoyi waɗanda suka dace da mutanen da ke da halaye daban-daban.

Idan kun kasance masu haƙuri da abubuwan da ke cikin magani ɗaya, kuna buƙatar amfani da wani, wanda shine dalilin da ya sa masana magunguna ke haɓaka sabbin abubuwa da magunguna waɗanda za a iya amfani da su don magance alamomin cutar sankara. Ofayansu shine Detemir insulin.

Babban bayani da kayan aikin magunguna

Wannan magani yana cikin rukuni na insulin. Yana fasalta tsawan aiki. Sunan kasuwanci na miyagun ƙwayoyi shine Levemir, kodayake akwai wani magani da ake kira Insulin Detemir.

Hanyar da aka rarraba wannan wakili shine mafita don gudanar da aikin subcutaneous. Tushen sa abu ne da aka samu ta amfani da fasahar DNA ta sake-juzu - Detemir.

Wannan kayan yana ɗayan ɗayan man ƙwari na insulin ɗan adam. Dalilin aikin sa shine rage yawan glucose a jikin mai ciwon suga.

Yi amfani da magani kawai bisa umarnin. Doka da likitan allura sune likita suka zaba su. Canjin kai da kai ko rashin yarda da umarni na iya haifar da yawan abin sha, wanda yake haifar da ƙwanƙwasa jini. Hakanan, bai kamata ku daina shan maganin ba tare da sanin likita ba, tunda wannan yana da haɗari tare da rikitarwa na cutar.

Abubuwan da ke aiki na miyagun ƙwayoyi shine kwatankwacin insulin na mutum. Aikinta ya sha bamban da tsawon lokaci. Kayan aiki ya shiga cikin hulɗa tare da masu karɓar membranes na sel, saboda shaƙar ta tayi sauri.

Achievedayyade matakan glucose tare da taimakonsa ana samunsa ta hanyar ƙaruwa da yawan amfani da ita ta hanyar ƙwayar tsoka. Wannan magani kuma yana hana samarwar glucose ta hanta. A ƙarƙashin tasirinsa, ayyukan lipolysis da proteolysis yana raguwa, yayin da ƙarin ayyukan furotin yake aiki.

Mafi yawan adadin Detemir a cikin jini shine awa 6-8 bayan an yi allura. Imiididdigar wannan abun yana faruwa kusan daidai a cikin duk masu haƙuri (tare da ƙarami sauƙaƙa), ana rarraba shi a cikin adadin 0.1 l / kg.

Lokacin da ya shiga cikin haɗuwa da ƙwayoyin plasma, ana kafa metabolites marasa aiki. Shaye-shaye ya dogara da irin yadda aka gudanar da maganin ga mai haƙuri da yadda sauƙin shaƙar take faruwa. Rabin abin da aka gudanar yana shafe jikin mutum bayan sa'oin 5-7.

Alamu, hanyar gudanarwa, allurai

Dangane da shirye-shiryen insulin, umarnin don amfani ya kamata a lura da kyau. Ya kamata a yi nazari a hankali, amma daidai yake da mahimmanci a la'akari da shawarar likita.

Tasirin magani tare da miyagun ƙwayoyi ya dogara da yadda aka tantance hoton cutar daidai. A dangane da shi, an ƙaddara yawan maganin da jadawalin allura.

Amfani da wannan kayan aikin yana nuna don maganin cutar sankara. Cutar na iya kasancewa cikin nau'ikan farko da na biyu. Bambanci shine cewa tare da ciwon sukari na nau'in farko, yawanci ana amfani da Detemir azaman monotherapy, kuma tare da nau'in cuta ta biyu, ana haɗuwa da miyagun ƙwayoyi tare da wasu hanyoyi. Amma za'a iya samun wasu abubuwa saboda halayen mutum daban-daban.

Sashi yana ƙaddara ta hanyar halartar likita, la'akari da peculiarities na cutar, yanayin salon mai haƙuri, ƙa'idodin abincinsa da kuma matakin motsa jiki. Canje-canje a cikin kowane ɗayan waɗannan abubuwan suna buƙatar daidaitawa ga jadawalin da sashi.

Za'a iya yin allura a kowane lokaci, lokacin da ya dace da haƙuri. Amma yana da mahimmanci cewa maimaita inje ɗin ana yin su kusan a lokaci guda wanda aka kammala farkon. An ba shi izinin shigar da samfurin a cinya, kafada, bangon ciki, gindi. Ba a ba da damar bayar da allura a cikin yanki guda ba - wannan na iya haifar da lipodystrophy. Don haka, yakamata a motsa a cikin yankin da za'a yarda.

Darasi na Bidiyo akan dabarar sarrafa insulin ta amfani da alkairin sirinji:

Contraindications da gazawa

Ya kamata ka san da wane yanayi ne ake amfani da wannan maganin. Idan ba'a la'akari da shi ba, mai haƙuri na iya zama mummunar cutar.

Dangane da umarnin, insulin yana da ƙananan contraindications.

Wadannan sun hada da:

1. Hypersensitivity ga abubuwan da ke cikin miyagun ƙwayoyi. Saboda shi, marasa lafiya suna da halayen rashin lafiyan wannan magani. Wasu daga cikin wadannan halayen suna haifar da babbar barazana ga rayuwa.
2. Shekarun yara (kasa da shekaru 6). Binciken tasiri na miyagun ƙwayoyi ga yara na wannan zamanin ya gaza. Bugu da kari, babu bayanai kan amincin amfani a wannan zamanin.

Hakanan akwai yanayi wanda an ba da izinin amfani da wannan maganin, amma yana buƙatar kulawa ta musamman.

Daga cikinsu akwai:

1. Cutar hanta. Idan sun kasance, aikin sashi na aiki na iya zama gurbata, sabili da haka, dole ne a daidaita sashi matakin.
2. Bala'i a cikin aikin kodan. A wannan yanayin, canje-canje a cikin ka'idodin aikin miyagun ƙwayoyi ma yana yiwuwa - yana iya ƙaruwa ko raguwa. Kulawa ta dindindin a tsarin kulawa yana taimakawa magance matsalar.
3. Tsufa. Jikin mutane sama da 65 da haihuwa yana fuskantar canje-canje da yawa. Baya ga cutar sankara, irin wadannan masu cutar suna da wasu cututtuka, gami da cututtukan hanta da koda. Amma har cikin rashi, wadannan gabobin basa aiki kamar yadda yakamata a cikin matasa. Sabili da haka, ga waɗannan marasa lafiya, madaidaicin sashi na maganin yana da mahimmanci.

Lokacin da aka yi la'akari da waɗannan abubuwan duka, haɗarin mummunan sakamako daga amfanin Detemir insulin zai iya raguwa.

Dangane da binciken da suka dace kan wannan batun, magungunan ba su da tasiri a kan hanyar daukar ciki da kuma ci gaban amfrayo. Amma wannan bai ba shi cikakken tsaro ba, don haka likitoci suna tantance haɗarin da ke tattare da nada mahaifiyarsa ta gaba.

Lokacin amfani da wannan magani, dole ne ka sa ido sosai a kan hanyar kulawa, duba matakin sukari. A lokacin haila, alamun glucose na iya canzawa, saboda haka, sarrafa su kuma gyara lokaci na allurar insulin ya zama dole.

Babu cikakken bayani game da shigarwar abu mai aiki a cikin madara. Amma an yi imanin cewa koda ya isa ga jariri, mummunan sakamako bai kamata ya faru ba.

Insulin na Detemir na asalin furotin ne, saboda haka ake samun saukin sawa. Wannan yana nuna cewa yiwa mahaifiyar wannan magani ba zai cutar da jaririn ba. Koyaya, mata a wannan lokacin suna buƙatar biye da abin da ake ci, kazalika da duba yawan haɗuwar glucose.

Side effects da yawan abin sama da ya kamata

Duk wani magani, gami da insulin, na iya haifar da sakamako masu illa. Wasu lokuta sukan bayyana na ɗan gajeren lokaci, har sai da jiki ya daidaita da aikin abu mai aiki.

A wasu halayen, bayyanar cututtukan cututtukan cuta ana haifar da su ne ta hanyar contraindications marasa bincike ko kuma adadin wuce kima. Wannan yana haifar da rikitarwa mai wahala, wanda wani lokacin ma yana iya haifar da mutuwar mai haƙuri. Saboda haka, duk wata damuwa da ke tattare da wannan magani ya kamata a sanar da likita mai halartar.

Daga cikin illolin da ake dasu sun hada da:

1. Hypoglycemia. Wannan yanayin yana da alaƙa da raguwa mai yawa a cikin sukari na jini, wanda kuma ya cutar da lafiyar lafiyar masu ciwon sukari. Marasa lafiya suna fuskantar matsaloli kamar su ciwon kai, rawar jiki, tashin zuciya, tachycardia, asarar hankali, da sauransu. A cikin matsanancin rashin ƙarfi na hypoglycemia, mai haƙuri yana buƙatar taimako na gaggawa, tunda a cikin rashi da ba a iya canzawa canje-canje a cikin tsarin kwakwalwa zai iya faruwa.
2. Rashin gani. Mafi na kowa shine maganin ciwon sukari.
3. Cutar Al'aura. Zai iya bayyana kansa a cikin nau'in ƙananan halayen (fuka, jan fata), kuma tare da bayyanar cututtuka bayyananne (anaphylactic shock). Saboda haka, don hana irin wannan yanayi, ana yin gwaje-gwaje na fahimi kafin amfani da Detemir.
4. Bayyanar Gida. Suna faruwa saboda amsawar fata ga gudanar da maganin. Ana samun su a wuraren allura - wannan yanki na iya yin ja, wani lokacin akwai 'yar kumburi. Irin wannan halayen yakan faru ne a farkon matakin maganin.

Ba shi yiwuwa a faɗi daidai wane bangare na maganin zai iya haifar da yawan zubar jini, tunda wannan ya dogara ne akan halaye na mutum. Sabili da haka, kowane mai haƙuri dole ne ya bi umarnin da likita ya karɓa.

Yawan marasa lafiyar da suka ɗanɗano fiye da ɗayan haɗarin hypoglycemia a lokacin jiyya tare da insulin Detemir ko insulin Glargin

Umarni na musamman da hulɗar magunguna

Amfani da wannan magani yana buƙatar wasu matakan kulawa.

Domin jinya ya zama mai inganci kuma mai lafiya, dole ne a kiyaye ƙa'idodin waɗannan masu zuwa:

1. Kada ku yi amfani da wannan magani don ciwon sukari a cikin yara 'yan ƙasa da shekaru shida.
2. Kada ku tsallake abinci (akwai haɗarin hauhawar jini).
3. Kar ku cika shi da aikin jiki (wannan yana haifar da faruwar yanayin rashin haila).
4. Ka sa a ranka cewa saboda cututtukan da ke kama da ƙwayar cuta, ƙwayar jikin insulin na iya ƙaruwa.
5. Kada ku sarrafa magani a cikin jijiya (a wannan yanayin, ciwo mai ƙwanƙwasa yana faruwa).
6. Tuna da yiwuwar jawo hankalin mai raunin ji da kuma yawan ragi idan akwai damuwa da haɓaka hyperglycemia.

Dole ne mai haƙuri ya san duk waɗannan abubuwan aikin don aiwatar da aikin da ya dace.

Sakamakon amfani da kwayoyi daga wasu ƙungiyoyi, sakamakon gurɓatar insulinir insulin ya gurbata.

Yawancin lokaci, likitoci sun fi son su bar irin waɗannan haɗuwa, amma wani lokacin wannan ba zai yiwu ba. A irin waɗannan halaye, ana bayar da ma'aunin magani na tambaya.

Wajibi ne a kara yawan cutar yayin shan shi da irin kwayoyi kamar:

• tausayawa
• glucocorticosteroids,
• kamuwa da cuta
• magunguna da aka shirya don maganin hana haihuwa,
• wani ɓangare na maganin ɓarna, da sauransu.

Wadannan kwayoyi suna rage tasiri na samfurin da ke dauke da insulin.

Sau da yawa ana amfani da sashi yayin amfani dashi tare da magunguna masu zuwa:

• tetracyclines
• carbonic anhydrase inhibitors, ACE, MAO,
• maharan hypoglycemic
• magungunan anabolic steroid
• beta hanawa,
• magunguna dauke da barasa.

Idan ba ku daidaita sashi na insulin ba, shan waɗannan kwayoyi na iya haifar da hypoglycemia.

Wasu lokuta mara lafiya kan tilasta shi ganin likita don maye gurbin magani ɗaya da wani. Dalilin wannan na iya zama daban (faruwa na sakamako masu illa, hauhawar farashi, rashin damuwa na amfani, da sauransu). Akwai magunguna da yawa waɗanda sune analogues na Detemir insulin.

Wadannan sun hada da:

Wadannan kwayoyi suna da sakamako iri ɗaya, saboda haka ana amfani da su azaman sauyawa. Amma mutumin da ke da ilimin da ake buƙata da ƙwarewa ya kamata ya zaɓi daga cikin jerin don kada magani ya cutar.

Farashin Levemir Flexpen (sunan kasuwanci na Detemir) na kayan Danish ya kasance daga 1 390 zuwa 2 950 rubles.

Pharmacology

Ana ɗaukar "Detemir" anaal anaal na insulin na ɗan adam, ana nuna shi ta sakamako mai ɗorewa, bayanin martaba. Abun yana ɗaukar takamaiman ga masu karɓar raɗaɗin, suna ba da damar haifuwar sakamakon ilmin halitta. Insulin yana shafar metabolism, yana daidaita shi. A miyagun ƙwayoyi rage loda jini, glucose ne mafi alhbedri tunawa a cikin kyallen takarda.

Idan ana gudanar da maganin sau biyu a cikin sa'o'i 24, to yana yiwuwa a cimma daidaituwa a cikin jini bayan kusan injections 2-3. Jikin kowane mutum yana da halaye na mutum ɗaya na sha "Detemir, amma, gabaɗaya, yana da ƙananan kwatancen tare da wasu magungunan maye gurbin, kada ku nuna aiki.

"Detemir" baya hulɗa tare da mai mai, mai magunguna wanda ya haɗu da sunadarai. Lokaci na ƙarshe na cirewa ya dogara da sashi na miyagun ƙwayoyi, ƙimar sha daga ƙwayar subcutaneous. Kimanin sa'o'i 5-7 ne.

"Detemir" yana da waɗannan ayyuka:

• imuarfafawa glucose sha a cikin sel, yadudduka na yanki,
• sarrafa gulukul metabolism,
• Ingantaccen tsarin furotin
• hanawa na glucogenesis.

Ta hanyar sarrafa waɗannan matakan, ana rage glucose. Bayan janyewa, babban aikin zai fara ne kawai bayan awanni 6.

Dangane da kowane magani na insulin, ana buƙatar bin umarnin sosai. Wajibi ne a bincika umarnin a hankali, yana da mahimmanci don aiwatar da alƙawarin likita. Sakamakon gyaran yanayin ya dogara da daidai na kimantawa na ƙididdigar asibiti. A wannan batun, sashi na miyagun ƙwayoyi, lokacin ƙungiyar allurar rigakafi an ƙaddara.

Amfani da "Detemir" an wajabta shi don ciwon sukari. Ciwon sukari shine na farko ko na biyu. Bambanci shine cewa a farkon, ana nuna magungunan don monotherapy, a na biyu - an haɗo shi da wasu. Akwai banbancen saboda halayen mutum na mai haƙuri da cutar sa.

Yin amfani da kashi "Detemir"

Za'a iya amfani da magani ta hanya daya - wannan shine allurar subcutaneous. Maganin shiga cikin ciki yana da haɗari saboda karuwar aiki sau da yawa. A cikin wannan yanayin, mummunan hauhawar jini na haɓaka.

Dosing an ƙaddara ta likita, la'akari da halayen jikin mai haƙuri. Ana buƙatar canji a cikin sashi ɗin da aka zaɓa lokacin da abinci mai narkewa ya canza, motsa jiki yana ƙaruwa, kuma yanayin abubuwan haɗuwa yana bayyana. Ana amfani da "Detemir" a matsayin magani don maganin tauhidi, tare da wakilai na hypoglycemic don gudanar da maganin baka.

An gabatar da "Detemir" a daidai lokacin da ya dace da mutum, amma bayan saita lokaci, dole ne a bi jadawalin yau da kullun. Ana amfani da allurar subcutaneously a cikin sashin cikin kashi na kashin, cinya, kafada, gindi, da kuma cikin sashin tsoka.

Ya kamata a canza wuraren allurar lokaci zuwa lokaci don hana lipodystrophy. Kamar yadda a yayin jiyya tare da wasu magunguna na insulin na tsofaffi, mutanen da ke da matsalar koda da hanta, ya zama dole a kula da glucose a cikin jini koyaushe. Wajibi ne don daidaita sashi daban. Karo na farko bayan alƙawarin Detemir, yana da mahimmanci don sarrafa sukari musamman a hankali. Jiyya baya bada gudummawa ga yawan kiba.

Iyakokin

Ga wasu marasa lafiya, ana rubuta Detemir ne kawai a ƙarƙashin kulawa na likita na yau da kullun, tare da taka tsantsan. Wannan tilas ne a wajabta shi a cikin umarnin. Ana iya amfani da "Detemir" tare da taka tsantsan kuma bayan an daidaita gyaran kashi don a tsara wa marasa lafiya da irin wannan ƙarin rikice-rikice a cikin jiki:

• matsaloli na hanta, saboda suna iya karkatar da aikin babban bangaren Detemir,
• cuta da kodan - tushen tasirin maganin yana canzawa,
• tsufa - bayan shekaru 65 a cikin jiki, canje-canje daban-daban masu alaƙa da tsufa suna farawa, gabobin suna aiki da ƙarfi, don haka ana iya rage sashi don kar a cutar da cuta.

Side effects

Duk wani insulin, ciki har da Detemir, na iya haifar da mummunar halayen da ake ci. Wasu lokuta suna haɓaka ɗan gajeren lokaci, yayin da jiki bai riga ya sami lokacin da zai dace da tasirin maganin ba. A wasu halaye, sakamako na gaba daya yana da alaƙa da abubuwan da ba a bayyana ba da kuma abubuwan da suka faru na yawan zubar ciki.

Abubuwan da ba su dace ba suna iya haifar da sakamako masu haɗari, da wuya kisa.

Yana da mahimmanci a ba da rahoton jinya ga likita a kan kari. Abubuwa masu cutarwa sun hada da:

• hypoglycemia - raguwa cikin sukari na jini, wanda ke da mummunar tasiri kan ƙoshin lafiya,
• ciwon kai
• rawar jiki
• tashin zuciya
• bugun zuciya
• suma.

Tare da mummunan rauni na hypoglycemic attack, ana buƙatar kulawa ta gaggawa, in ba haka ba canje-canje na cututtukan cututtukan cututtukan jijiyoyi a cikin sassan kwakwalwa.

Kamar yadda rikitarwa, gabobin gani suke sha wahala sau da yawa. Yawancin lokaci ciwon sukari yana tare da retinopathy.

Har ila yau, rashin lafiyan yana haifar da tasirin sakamako - redness na fata, rashes, har zuwa harin anaphylactic. Gwajin hankali da hankali zai taimaka wajen hana maganganu marasa kyau.

Abubuwan da ba su dace ba sun hada da bayyane a kan fata a wurin allurar - sai ya yi ja, wani lokacin ya yi kumburi kaɗan. Wannan yakan faru sau da yawa a farkon matakan jiyya.

Haɗa kai

Wasu magunguna suna shafan buƙatar ku na insulin. Rinjawar jini yana rauni ta:

• hana haihuwa don amfanin ciki,
• glucocorticosteroids,
• hormones thyroid tare da aidin,
• alli mai tashar alli,
• diuretics na kungiyar thiazide,
• heparin
• girma hormone,
• tausayawa
• ƙwayar cuta
• maganin alada
• nicotine.

An inganta tasirin hypoglycemic na allurar Detemir ta hanyar hulɗa da:

• hypoglycemic jami'ai don baka,
• enzymes
• ba zaɓin beta-blockers ba,
• magungunan anabolic steroid
• karafarini
• pyridoxine
• shirye-shiryen lithium
• shirye-shirye tare da ethanol a cikin abun da ke ciki.

Al'adun giya na kara karfi, suna kara bukatar insulin. Magunguna daga thiol, ƙungiyoyin sulfite suna lalata insulin. Magungunan ba su dace da jiko ba.

Yawan abin sama da ya kamata

Takamaiman girman insulin wanda zai haifar da yawan shan ruwa ba a tantance shi ba, sashi daya ne. Hypoglycemia sau da yawa ba ya faruwa nan da nan, amma a jere tare da gabatarwar manyan allurai don wani mai haƙuri.

Ragewar jini mai sauƙi zai iya tsayawa da kanta. Don yin wannan, kawai sha glucose, ku ci wani sukari, wani abu mai dadi, mai arziki a cikin carbohydrates. A saboda wannan dalili, mutanen da ke fama da ciwon sukari suna da maciji a hannu - dunƙule sugar, Sweets, cookies.

A cikin mummunan hari, idan mutum ya rasa hankali, subcutaneous management na 0.5-1 mg na glucagon ana buƙatar, jiko glucose ya dace. Lokacin da wanda aka azabtar bai sake tsinkayewar kwata na awa daya ba bayan glucagon, ana buƙatar glucose.

Don hana maimaita yawan lalacewa da wadatar rayuwa, kuna buƙatar ku ci wani abu mai cike da ƙwayoyin carbohydrates.

Zaɓin Analog

Wani lokacin mai ciwon sukari yakan tilasta wa likita tambaya game da maye gurbin insulin tare da analog. Dalilan sun banbanta: sakamako masu illa, hauhawar farashi, rashin daidaituwa na amfani. An san yawancin maye gurbin Detemir. Ana nuna mafi mashahuri a cikin tebur.

Magunguna sunyi kama da juna a aikace, saboda haka sukan maye gurbin junan su. Amma kawai ƙwararren masani ne ya zaɓi, don kada a cutar.

Ni mai ciwon sukari ne tare da gogewa"Detemir" yana taimaka mini rage sukarin jini, yayin da baya haifar da sakamako masu illa, sabanin nau'in insulin da ya gabata. Babban abin da likita yayi magana akai shine koyaushe don ɗaukar lokaci guda don karɓar, kada su wuce ko rage adadin.

Ina da nau'in ciwon sukari irin na 1 tun shekara 22, na yi amfani da wasu nau'ikan insulin kafin, amma kwanan nan likita ya yi wasiyya"Detemir." Magungunan suna aiki a ko'ina, sakamakon yana tsawan tsawon awanni 24. Abubuwan sha'awar maganin suna da kyau, Ina amfani da shi sama da makonni 3.

Kudin "Detemir" ya tashi daga 1300 zuwa 3000 rubles, amma a wasu asibitocin ana iya samun kyauta, idan akwai takardar sayen magani da ya rubuta zuwa ga endocrinologist a Latin. "Detemir" yana da tasiri idan kun bi duk umarnin akan bayanin, nadin kwararrun.

Kammalawa

"Detemir" kwatanci ne mai narkewa na insulin na mutum, yana da tsawaita aiki, bayanin martaba. A cikin rayuwar yau, ciwon sukari ba magana ba ce. Bayan ƙirƙirar insulin na roba, mutane suna yin cikakken rayuwar rayuwa. Yana da mahimmanci a gare su su sa idanu a kan matakan sukari akai-akai, amfani da magunguna na musamman kamar yadda likitoci suka umurce su.

Littattafai

1. Antsiferov M. B., Dorofeeva L. G., Petraneva E. V. Amfani da insulin glargine (Lantus) a cikin lura da ciwon sukari mellitus (gwaninta na sabis na endocrinological Moscow) // Farmateka. 2005.V. 107. A'a. 12. P. 24-29.
2. Cryer P. E., Davies S. N., Shamoon H. Hypoglycemia a cikin ciwon sukari // Kula da ciwon sukari. 2003, kundi 26: 1902-1912.
3. DeWitt D. E., Hirsch I. B. Magungunan insulin na waje a cikin nau'in 1 da nau'in ciwon sukari na 2 na mellitus. Nazarin ilimin kimiyya // JAMA. 2003, 289: 2254-2264.
4. Betel M. A., Feinglos M. N. Insulin analog: sabbin hanyoyin kwantar da hankali don nau'in ciwon sukari na 2 mellitus // Curr. Diab Tunani 2002, 2: 403-40.
5. Fritsche A., Hoering H., Toegel E., Schweitzer M. HOE901 / 4001 Kungiyar Nazarin. Jiyya-da-manufa tare da ƙara-kan basal insulin - shin insulin glargin zai iya rage shingen da ke kaiwa ga cimma buri? // Ciwon sukari. 2003, 52 (lamba 1): A119.
6. Fritsche A. et al. Glimepiride yana haɗuwa tare da glargin insulin na safe, lokacin NPH na bacci, ko kuma glargine insulin lokacin bacci a cikin marasa lafiya da ke fama da nau'in ciwon sukari na 2 na sukari. Wata jarabawar sarrafawa ba ta tsari // Ann.Intern. Med. 2003, 138: 952-959.
7. Herz M. et al. Rukunin Nazari na Mix25. Kwatantawa da sarrafa glycemic tare da allurar cin abinci ta gaba bayan allurar cin abinci ta Humalog Mix25 a cikin tsofaffi marasa lafiya da ke fama da ciwon sukari na 2. Littafin starshe: 61 na ilimin kimiyya: Yuni 22 zuwa 26, 2001 a Philadelphia, Pennsylvania (Amurka) - stasashe 1823-PO.
8. Herz M., Arora V., Campaigne B. N. et al. Humalog Mix25 yana inganta bayanan bayanan glucose na jini na awa 24 idan aka kwatanta da cakuda insulin na ɗan adam 30/70 a cikin marasa lafiya waɗanda ke da nau'in ciwon sukari na 2 na sukari // S.A.fr. Med. J. 2003, 93: 219-223.
9. Gerstein H. C., Yale J-F., Harris S. B. et al. / Gwajin da ba a saba da shi ba na farkon amfani da glargine don cimma daidaitattun matakan A1c a cikin insulin Na_ve mutane masu nau'in ciwon sukari na 2. An gabatar da shi a Taron Ilimin Kimiyya na 65th na Diungiyar Maƙasudin Ciwon Fata na Amurka. San Diego, California (Amurka). 2005.
10. Jacobsen L. V., Sogaard B., Riis A. Pharmacokinetics da Pharmacokinetics na ingantaccen tsari mai narkewa mai narkewa da protamine-retarded insulin as // // Eur J. Clin. Pharmacol. 2000, 56: 399-403.
11. Mattoo V., Milicevic Z., Malone J.K. et al. Ga Rukunin Nazarin Azumin Ramalana. Amfani da insulin lispro Mix25 da insulin na mutum 30/70 a lura da nau'in 2 yayin Azumin Rama // Rashin Ciwon Ciwon. C / in Aiwatarwa. 2003, 59: 137-1143.
12. Malone J. L., Kerr L. F., Campaigne B. N. et al. Don Studyungiyar Nazarin Lispro Cakuda-Glargine. Hada magunguna tare da insulin Lispo Mix 75/25 da metformin ko inslulin glargine da metformin: wani mako-16 ne, bazuwar, buɗaɗɗen rubutu, binciken crossover a cikin marasa lafiya da nau'in ciwon sukari na 2 wanda ya fara maganin insulin // Clin. Ther. 2004, 26: 2034–2044.
13. Malone J. L., Bai S., Campaigne B. N. et al. Sau biyu-da-pre-gauraye insulin maimakon basal insulin farji kadai ke haifar da mafi kyawun sarrafa glycemic sarrafawa a cikin marasa lafiya da nau'in ciwon sukari na 2 // Ciwon.M.M. 2005, 22: 374-381.
14. Pieber T. R., Plank J. Goerzer E. et al. Adadin aikin, bayanin harhada magunguna da kuma tsakanin bambancin insulin detemir a batutuwa da nau'in ciwon sukari na 1 // Diabetologia. 2002, 45 Suppl 2: 254.
15. Roach P., Woodworth J. R. Pharmacokinetics na asibiti da kuma magunguna na insulin lispro hadewar // Clin. Pharmacokinet. 2002, 41: 1043-1057.
16. Roach P., Yue L., Arora V. Ga Rukunin Nazarin Humalog Mix25. Inganta ƙwayar glycemic postprandial yayin kulawa tare da Humalog Mix25, tsarin inslulin lispro mai gina jiki na proproine mai gina jiki // Kulawar Ciwon Ciwon. 1999, 22: 1258–1261.
17. Roach P., Trautmann M., Arora V. et al. Ga Rukunin Nazari na Mix25. Inganta glucose jini na postprandial da rage yawan zafin jiki na nocturnal hypoglycemia yayin jiyya tare da allurai insulin lispro-protamine guda biyu, insulin lispro mix25 da insulin lispro mix50 // Clin.Ther. 1999, 21: 523-534.
18. Rikicin analallen R. Insulin analog ɗin yana haɗuwa da sarrafa nau'in ciwon sukari na 2 na mellitus // Pract.Diabetol. 2002, 21: 36-43.
19. Rosenstock J., Schwarts S. L., Clark C. M. et al. Harkokin insulin insulin a cikin nau'in ciwon sukari na 2: kwatancen 28-mako na insulin glargin (HOE 901) da NPH insulin // Kulawar Ciwon sukari. 2001, 24: 631-636.
20. Vague P., Selam J. L., Skeie S. et al. Insulin detemir yana da alaƙa da mafi kyawun ƙarfin sarrafa glycemic da rage haɗarin hypoglycaemia fiye da insulin NPH a cikin marasa lafiya da nau'in ciwon sukari na 1 a kan gwamnatocin basal-bolus tare da insulin insulin aspart // Kulawar Ciwon sukari. 2003, 26: 590-596.

A. M. Mkrtumyan, Likita na Kimiyyar Likita, Farfesa
A. N. Oranskaya, dan takarar likita
MGMSU, Moscow

Aikin magunguna na kayan

Ana yin insulin ta insemir ta amfani da kwayoyin halitta na deoxyribonucleic acid (DNA) da ƙasan halayyar da ake kira Saccharomyces cerevisiae.

Insulin shine babban sinadarin Levemir flekspen, wanda aka saki a cikin hanyar mafita a cikin alkalami 3 sirinji mai dacewa (300 PIECES).

Wannan analog na mutum ɗan adam yana ɗaure wa masu karɓar sel kuma yana haifar da hanyoyin ƙirar halitta.

Analog na insulin na mutum yana inganta kunnawar hanyoyin da ke gaba a jikin mutum:

• motsawar glucose din ta sel da ke jikin tsoka,
• sarrafa gulukul metabolism,
• hanawa na gluconeogenesis,
• proteinarin haɓakar furotin,
• rigakafin lipolysis da proteolysis a cikin ƙwayoyin mai.

Godiya ga duk waɗannan hanyoyin, akwai raguwa a cikin yawan sukari jini. Bayan allurar insulin, Detemir ya sami babban tasiri bayan sa'oin 6-8.

Idan kun shigar da mafita sau biyu a rana, to ana samun daidaituwa na insulin bayan kashi biyu ko uku. Bambancin rushewar cikin gida na Detemir insulin ya ragu sosai da na wasu magungunan insulin basal.

Wannan kwayar tana da tasiri iri daya a jikin namiji da mace. Matsakaicin rarrabuwarsa kusan 0.1 l / kg.

Matsakaicin rabin rayuwa ta ƙarshe na insulin allura a ƙarƙashin fata ya dogara da sashi na ƙwayoyi kuma yakai kimanin awanni 5-7.

Umarnin don amfani da miyagun ƙwayoyi

Likita yayi lissafin sashi na maganin, la'akari da yawan sukari a cikin masu ciwon suga.

Dole ne a daidaita allurai idan akwai wani batun cin abincin mara lafiya, karuwar ayyukan jiki ko kuma bayyanar wasu cututtukan. Ana iya amfani da insulin Detemir a matsayin babban magani, hade tare da insalin '' bolus insulin 'ko tare da magunguna masu rage sukari.

Za a iya yin allura a cikin awanni 24 a kowane lokaci, babban abin lura shi ne kiyaye lokaci ɗaya kowace rana. Ka'idojin ka'idodi na gudanar da sinadarin hormone:

1. Ana yin allura a karkashin fata zuwa cikin yankin, abar, kafada ko cinya.
2. Don rage yiwuwar lipodystrophy (cutar nama mai ƙiba), ya kamata a canza yankin allura a kai a kai.
3. Mutanen da suka haura shekara 60 da marasa lafiya da koda ko ƙwanƙwasa hanta na buƙatar tsayayyen glucose da kuma daidaita matakan insulin.
4. Lokacin canja wurin daga wani magani ko kuma a farkon matakin maganin, yana da mahimmanci don saka idanu sosai a matakin matakin glycemia.

Ya kamata a lura cewa a cikin lura da insulin Detemir ba ya ɗaukar ƙaruwa a cikin nauyin mai haƙuri. Kafin tafiye-tafiye masu tsawo, mai haƙuri yana buƙatar yin shawara da ƙwararrun masu kulawa game da amfani da miyagun ƙwayoyi, tun lokacin da aka canza bangarorin lokaci yana rikita jadawalin shan insulin.

Cutar kwantar da hankali na iya haifar da yanayin hauhawar jini - saurin haɓaka matakan sukari, ko da cutar ketoacidosis mai ciwon sukari - cin zarafin ƙwayar carbohydrate a sakamakon rashin insulin. Idan ba'a tuntuɓi likitan likita da sauri ba, sakamako na mutuwa zai iya faruwa.

Hypoglycemia yana kasancewa ne lokacin da jiki ya cika ko bai ishe ta abinci ba, kuma sinadarin insulin, bi da bi, yana da girma sosai. Don haɓaka tarin glucose a cikin jini, kuna buƙatar cin ɗan sukari, mashaya cakulan, wani abu mai daɗi.

zazzabi ko ciwace-ciwace daban-daban sau da yawa suna kara buƙatar hormone. Sauya kashi na maganin zai iya zama dole a cikin ci gaban cututtukan ƙwayoyin cuta na hanta, hanta, glandon gland, glandon gland da glandon adrenal.

Lokacin haɗuwa da insulin da thiazolidinediones, wajibi ne don yin la'akari da gaskiyar cewa zasu iya ba da gudummawa ga ci gaban cututtukan zuciya da gazawar jiki.

Lokacin amfani da miyagun ƙwayoyi, canje-canje a cikin taro da halayyar psychomotor yana yiwuwa.

Contraindications da yiwu cutar

Saboda haka, babu magungunan hana amfani da insulin Detemir. Iyakokin sun shafi yiwuwar mutum kawai ga abu kuma shekara biyu saboda gaskiyar cewa binciken da aka yi a kan tasirin insulin a kan ƙananan yara har yanzu ba a gudanar da su ba.

A lokacin haihuwar ɗa, ana iya amfani da miyagun ƙwayoyi, amma a ƙarƙashin kulawar likita.

Yawancin karatu ba su bayyana sakamako masu illa ba a cikin mahaifiya da jaririnta tare da gabatarwar allurar insulin a lokacin haihuwarsa.

An yi imanin cewa za a iya amfani da maganin tare da shayarwa, amma ba a gudanar da binciken ba. Don haka, ga uwaye masu juna biyu da masu shayarwa, likita ya daidaita yadda ake amfani da insulin, yana yin nauyi a gaban sa da amfani ga uwa da kuma hadarin da ke tattare da jaririnta.

Amma game da halayen da ba su dace da jiki ba, umarnin yin amfani da su sun ƙunshi jerin abubuwa:

1. Halin hauhawar jini wanda ke alamta da alamomi kamar suma, zafin rai, fatar jiki, rawar jiki, ciwon kai, ruɗani, raɗaɗi, fainting, tachycardia. Wannan yanayin ana kuma kiransa insulin shock.
2. Tsarin ciki na gida - kumburi da jan launi na allura, itching, da kuma bayyanar liyst dystrophy.
3. Allergic halayen, angioedema, urticaria, rashes fata da kuma wuce kima gumi.
4. Take hakkin narkewar fili - tashin zuciya, amai, ciwon mara, zawo.
5. Rage numfashi, rage karfin jini.
6. Rashin gani na gani - canji ne na tunani wanda ke haifar da kwayar cutar retinapathy (kumburin retina).
7. Haɓaka ƙwayar jijiyoyin mahaifa.

Yawan shaye-shaye na miyagun ƙwayoyi na iya haifar da raguwar sukari cikin sauri. Tare da hypoglycemia mai sauƙi, mutum ya kamata ya cinye samfurin a cikin carbohydrates.

A cikin matsanancin hali na mai haƙuri, musamman idan bai san komai ba, ana buƙatar asibiti da gaggawa. Likita ya saka maganin kwanciyar hankali ko glucagon a karkashin fata ko a karkashin tsoka.

Lokacin da mai haƙuri ya murmure, ana ba shi ɗan sukari ko cakulan don hana sake komawa sukari.

Kudin, sake dubawa, makamantan hakan

Magungunan Levemir flekspen, mai aiki wanda shine insulin Detemir, ana siyar dashi a shagunan magunguna da kuma kantin magani na kan layi.

Zaka iya siyan magungunan kawai idan kana da takardar izinin likita.

Magungunan suna da tsada sosai, farashinsa ya bambanta daga 2560 zuwa 2900 rubles na Rasha. A wannan batun, ba kowane mai haƙuri ne zai iya wadatar da shi ba.

Koyaya, sake duba insulin na insulin na da inganci. Yawancin masu ciwon sukari da aka allura tare da hormone kamar mutum sun lura da waɗannan fa'idodin:

• saukar da jini a hankali,
• adana aikin da miyagun ƙwayoyi na kusan a rana,
• sauƙi na amfani da sirinji,
• da wuya abin ya faru na m halayen,
• rike da nauyin mai ciwon sukari a daidai matakin.

Don cimma ƙimar glucose na yau da kullun za a iya bin duk ka'idodin magani don maganin ciwon sukari. Wannan ba wai kawai allurar insulin bane, amma har da motsa jiki, wasu takunkumi na abinci da kuma tsayayyen iko na sanya sukari cikin jini. Yarda da ingantattun sashi na da matukar muhimmanci, tunda ana cire jini, da kuma mummunan tasirinsa, ba a ciki.

Idan magani don wasu dalilai bai dace da mai haƙuri ba, likitan na iya ba da wani magani. Misali, insulin Isofan, wanda shine kwatancen kwayar halittar dan adam, wanda injiniyan kwayoyin halitta ne yake samarwa. Ana amfani da Isofan ba kawai a cikin ciwon sukari na mellitus na farko da na biyu ba, har ma a cikin tsarin gestational (a cikin mata masu juna biyu), cututtukan cututtukan cututtukan ciki, har ma da ayyukan tiyata.

Tsawon lokacin aikinsa yana da ƙasa da na Detemir insulin, duk da haka, Isofan shima yana da kyakkyawan tasirin hypoglycemic. Yana da kusan halayen masu illa iri ɗaya, wasu kwayoyi na iya shafar tasiri. Ana samun sashin Isofan a cikin magunguna da yawa, alal misali, Humulin, Rinsulin, Pensulin, Gansulin N, Biosulin N, Insuran, Protafan da sauransu.

Ta hanyar amfani da insulin din Detemir da kyau, zaku iya kawar da alamun cutar sankarau. Ana amfani da magungunan analogues, shirye-shiryen dauke da insulin Isofan, zasu taimaka lokacin da aka haramta amfani da maganin. Yadda yake aiki da kuma dalilin da yasa kuke buƙatar insulin - a cikin bidiyo a cikin wannan labarin.

Analogs a cikin kayan haɗin da nuni don amfani

Jerin da aka bayar na magungunan analogues na miyagun ƙwayoyi, wanda ke nuna maye gurbin insulin, ya fi dacewa saboda suna da tsari iri ɗaya na abubuwa masu aiki da daidaituwa bisa ga nuni don amfani

Insulin "Detemir": bayanin maganin

Ana samun maganin ta hanyar samar da mafita mai cike da launi mara launi. A cikin 1 ml na shi ya ƙunshi babban abun ciki - insulin detemir 100 PIECES. Bugu da ƙari, akwai ƙarin abubuwan da aka haɗa: glycerol, phenol, metacresol, zinc acetate, sodium hydrogen phosphate dihydrate, sodium chloride, hydrochloric acid q.s. ko sodium hydroxide q.s., ruwa don yin allura har zuwa 1 ml.

Ana samun magungunan a cikin sirinji na syringe, wanda ya ƙunshi 3 ml na bayani, daidaituwa na 300 PIECES. 1 na insulin ya ƙunshi 0.142 mg na insulin-gishiri mara gishiri.

Yaya Detemir yake aiki?

Detemir insulin (sunan cinikayyar Levemir) ana yin shi ne ta amfani da kwayoyin halitta na deoxyribonucleic acid (DNA) ta ƙasan halayyar da ake kira Saccharomyces cerevisiae. Insulin shine babban bangaren Levemir flekspen kuma kwatanci ne na kwayar halittar mutum wacce ke hade da masu karuwar kwayar halitta kuma yana aiki da dukkanin hanyoyin halittu. Yana da ayyuka da yawa akan jiki:

• yana ƙarfafa amfani da glucose ta kasusuwa na waje da sel,
• yana sarrafa metabolism,
• yana hana gluconeogenesis,
• yana haɓaka aikin furotin,
• yana hana lipolysis da proteolysis a cikin ƙwayoyin mai.

Yana da godiya ga ikon sarrafa duk waɗannan hanyoyin wanda matakan sukari na jini ya ragu. Bayan gabatarwar miyagun ƙwayoyi, babban tasiri yana farawa bayan sa'o'i 6-8.

Idan kun shigar dashi sau biyu a rana, to, ana iya samun cikakken daidaituwa na matakin sukari bayan allura biyu zuwa uku. Magungunan suna da tasiri iri ɗaya ga mata da maza. Matsakaicin matsakaiciyar rarraba yana tsakanin 0.1 l / kg.

Rabin rayuwar insulin, wanda aka allura a karkashin fata, ya dogara da kashi kuma yakai kimanin awanni 5-7.

Siffofin aikin miyagun ƙwayoyi "Detemir"

Insemir insulin (Levemir) yana da tasiri sosai fiye da samfuran insulin kamar Glargin da Isofan. Tasirinsa na tsawon lokaci akan jikin mutum ya samo asali ne ta hanyar hadewar jikin kwayoyin halittu yayin da suke tare da sarkar acid mai guba tare da kwayoyin albumin. Idan aka kwatanta shi da sauran insulins, yana bazu a hankali cikin jiki, amma saboda wannan, inganta ƙwaƙwalwar shi yana haɓaka sosai. Hakanan, idan aka kwatanta da sauran analogs, Detemir insulin shine mafi tsinkaye, sabili da haka yafi sauƙin sarrafa tasirin sa. Kuma wannan saboda dalilai da yawa:

• kayan yana wanzuwa cikin yanayin ruwa daga lokacin da yake cikin allurar-kamar sirinji har sai an gabatar dashi a jiki,
• kwayoyin dake jikinta suna daure wa kwayoyin albumin a cikin jini ta hanyar hanyar saiti.

Magungunan yana shafar ƙimar ƙwayar ƙasa ƙasa, wanda ba za a iya faɗi ba game da sauran insulins. Ba shi da illa da ƙwayoyin cuta a jikin mutum.

Yaya ake amfani da "Detemir"?

An zaɓi kashi na miyagun ƙwayoyi daban-daban ga kowane haƙuri tare da ciwon sukari. Kuna iya shigar da shi sau ɗaya ko sau biyu a rana, wannan ya nuna ta hanyar umarnin. Shaida akan amfanin Detemir insulin amfani da da'awar cewa don haɓaka sarrafa glycemia, ya kamata a ba da allura sau biyu a rana: da safe da maraice, akalla awanni 12 ya kamata yawuce tsakanin amfani.

Ga tsofaffi masu fama da ciwon sukari da waɗanda ke fama da hanta da koda, an zaɓi kashi tare da taka tsantsan.

Insulin an allurar da shi ya shiga cikin kafada, cinya da tsinkayen yankin. Intensarfin aikin ya dogara da inda ake sarrafa maganin. Idan an yi allura a yanki daya, to za a iya canza fagen murfin, alal misali, idan an saka insulin a cikin fatar ciki, to wannan ya kamata a yi 5 cm daga cibiya kuma a kewaya.

Yana da mahimmanci don samun allura daidai. Don yin wannan, kuna buƙatar ɗaukar alkalami na syringe tare da ƙwayar zazzabi na daki, maganin rigakafi da ulu ulu.

Kuma aiwatar da tsari kamar haka:

• kula da shafin fitsari tare da maganin ƙwari kuma ƙyale fata ta bushe,
• fatar an kama ta da man shafawa
• Dole a saka allura a wani kusurwa, bayan wannan an kunna piston a ɗan kaɗan, idan jini ya bayyana, jirgin ruwa ya lalace, dole ne a canza wurin allurar,
• ya kamata a gudanar da maganin a hankali kuma a ko'ina, a cikin abin da piston ya motsa tare da wahala, kuma a farjin fatar an sanya fatar, ya kamata a saka allura mai zurfi,
• bayan kula da magunguna, ya zama dole ya yi kwanciyar hankali na wani sakan 5, bayan haka an cire sirinji tare da motsi mai kaifi, kuma ana kula da wurin allurar tare da maganin taɗama.

Don yin allurar mara zafi, allura ya zama kamar bakin ciki kamar yadda zai yiwu, bai kamata a matsi fatar fatar ba, kuma ya kamata a yi allura da hannun amintacce ba tare da tsoro da shakka ba.

Idan mai haƙuri ya saka nau'ikan insulin, to da farko ana lasafta gajere, sannan ya daɗe.

Me ake nema kafin shiga Detemir?

Kafin yin allura, kana buƙatar:

• sake bincika nau'in kudaden
• kewaya da membrane tare da maganin kashe kwayoyin cuta,
• a hankali bincika amincin katun, idan kwatsam ya lalace ko kuma akwai shakku game da cancantarsa, to ba kwa buƙatar amfani da shi, yakamata ku mayar dashi kantin magani.

Yana da kyau a tuna cewa an haramta shi sosai don amfani da insulin Detemir mai sanyi ko wanda aka ajiye ba daidai ba. A cikin famfo na insulin, ba a yi amfani da maganin ba, tare da gabatarwar yana da mahimmanci a kiyaye dokoki da yawa:

• gudanar kawai a karkashin fata,
• allura ya canza bayan kowace allura,
• kabad ba ya cika.

A cikin wane yanayi ne maganin yake shan wahala?

Kafin amfani da Detemir, yana da matukar muhimmanci a gano lokacin da ake yin takaddama mai ƙarfi:

• idan mai haƙuri yana da hankalin mutum ga abubuwan da ke tattare da ƙwayar, zai iya haɓaka ƙwayar cuta, wasu halayen na iya haifar da mutuwa,
• ga yara 'yan kasa da shekaru 6, ba a ba da shawarar wannan maganin ba, ba shi yiwuwa a bincika tasirinsa ga jarirai, saboda haka ba shi yiwuwa a faɗi yadda zai cutar da su.

Bugu da ƙari, akwai irin waɗannan nau'ikan marasa lafiya waɗanda aka ba su izinin amfani da miyagun ƙwayoyi a cikin magani, amma tare da kulawa ta musamman kuma a ƙarƙashin kulawa koyaushe. An nuna wannan ta umarnin don amfani. Insulin "Detemir» A cikin waɗannan marasa lafiya tare da irin wannan cututtukan, ana buƙatar daidaita sashi:

• Take hakkin a cikin hanta. Idan an bayyana waɗancan a cikin tarihin mai haƙuri, to, aikin babban ɓangaren na iya gurbata, don haka dole ne a daidaita sashi.
• Rashin nasarar cikin kodan. Tare da irin waɗannan cututtukan, ana iya canza tushen aikin miyagun ƙwayoyi, amma za'a iya magance matsalar idan kun lura da mai haƙuri koyaushe.
• Tsofaffi mutane. Bayan shekaru 65, yawancin canje-canje da yawa suna faruwa a cikin jikin mutum, wanda zai iya zama mai wahala sosai waƙa. A cikin tsufa, gabobin basa aiki kamar yadda suke a cikin yara, sabili da haka, yana da mahimmanci a gare su su zaɓi madaidaicin sashi domin ya taimaka wajen daidaita matakan glucose, kuma ba cutarwa ba.

Idan kayi la'akari da duk waɗannan shawarwarin, to, ana iya rage haɗarin mummunan sakamako.

"Detemir" yayin ciki da yayin shayarwa

Godiya ga karatu kan ko amfanin insulin "Detemira» mace mai ciki da tayi, an tabbatar da cewa kayan aikin ba su shafi ci gaban jariri. Amma a faɗi cewa yana da cikakken hadari, ba shi yiwuwa, saboda yayin canje-canjen hormonal na faruwa a jikin matar, da kuma yadda magungunan za su yi halinsa a cikin wani yanayi ba zai iya faɗi ba. Abin da ya sa likitoci, kafin rubuta shi yayin daukar ciki, tantance haɗarin.

Yayin aikin jiyya, kuna buƙatar saka idanu akan matakan glucose koyaushe. Manuniya na iya canzawa da sauri, don haka saka idanu akan lokaci da kuma daidaita matakan wajibi ne.

Ba shi yiwuwa a faɗi daidai ko maganin yana shiga cikin madarar nono, amma koda ya samu, an yi imanin cewa ba zai kawo lahani ba.

Umarni na musamman don amfani

Umarnin don yin insulin "Detemir" yayi kashedin cewa yin amfani da miyagun ƙwayoyi yana buƙatar taka tsantsan. Domin yin aikin likita ya ba da sakamakon da ake so kuma ya zama lafiya, dole ne ku bi waɗannan ƙa'idodin:

• Kada ku yi amfani da magani a cikin lura da yara thean shekaru 6,
• kada ku tsallake abinci, akwai haɗarin hauhawar jini,
• kada ku zagi aikin jiki,
• Tabbatar yin la'akari da cewa saboda haɓakar kamuwa da cuta, jiki zai buƙaci ƙarin insulin,
• kada ku sarrafa magani a cikin jijiya,
• tuna cewa raunin amsawa da rashin kulawa na iya canzawa idan hauhawar jini - da hauhawar jini.

Domin jiyya don ci gaba daidai, kowane mai ciwon sukari ta amfani da insulin dole ne ya san ka'idodin. Dole ne likitan da ke halartar ya jagoranci tattaunawa, yana bayanin ba kawai yadda ake yin allura da auna sukari na jini ba, har ma yana magana game da canje-canje a salon rayuwa da abinci.

Analogues na miyagun ƙwayoyi

Wasu marasa lafiya dole ne su nemi maganin ana amfani da su ta Detemir insulin tare da hadewar wasu abubuwan da aka gyara. Misali, masu ciwon sukari wadanda suke da tasirin gaske game da abubuwan wannan magani. Akwai wasu analogues na Detemir, ciki har da Insuran, Rinsulin, Protafan da sauransu.

Amma yana da mahimmanci a tuna cewa likitan ɗin ana buƙatar zaɓin analog ɗin da sigar ta ta kowane yanayi. Wannan ya shafi kowane magani, musamman tare da irin wannan mummunan cututtukan.

Kudin magani

Farashin insulin din Detemir dan kasar Denmark ya kama daga 1300-3000 rubles. Amma yana da mahimmanci a tuna cewa zaku iya samun shi kyauta, amma a wannan yanayin, lallai ne ku sami takardar izini ta Latin wanda endocrinologist ya rubuta. Insemir insulin magani ne mai inganci don magance nau'in 1 da nau'in ciwon sukari na 2, babban abu shine bin duk shawarwarin, kuma kawai zai amfana da masu ciwon sukari.

Nazarin insulin

Masu ciwon sukari da likitoci suna ba da amsa da kyau ga Detemir. Yana taimakawa rage jini mai hawan jini, yana da mafi karancin abubuwan contraindications da bayyanuwar rashin so. Abinda kawai za'a yi la’akari da shi shine daidaiton aikinta da kuma yarda da duk shawarwari idan, banda insulin, ana bada shawarar wasu magunguna ga mai haƙuri.

A halin yanzu ciwon sukari mellitus ba magana bane, kodayake cutar ta kasance kusan mai rauni har sai an sami insulin na roba. Ta bin shawarar likita da saka idanu kan matakin glucose a cikin jini, zaku iya kula da rayuwar yau da kullun.

Yaya za a iya samun analogue mai tsada na magani mai tsada?

Don neman analog mai rahusawa ga magani, jana'iza ko alaƙa, da farko muna bada shawara a kula da abun da ke ciki, wato ga abubuwa masu aiki iri ɗaya da alamomi don amfani. Abubuwa masu aiki iri ɗaya na ƙwayoyi zasu nuna cewa maganin yana da alaƙa tare da miyagun ƙwayoyi, daidai da magunguna ko madadin magunguna. Koyaya, kar ka manta game da abubuwanda suka lalace na irin kwayoyi, wanda zai iya shafar aminci da tasiri. Kar ku manta game da shawarar likitoci, maganin shan magani na iya cutar da lafiyar ku, don haka koyaushe ku nemi likitanku kafin amfani da kowane magani.

Umarnin insulin

Aikin magunguna:
Insulin wani takamammen magani ne na rage sukari, yana da ikon daidaita tsarin metabolism, yana inganta tasirin glucose ta kyallen kuma yana inganta jujjuyawar shi zuwa glycogen, kuma yana sauƙaƙe shigar da glucose cikin ƙwayoyin nama.
Baya ga tasirin hypoglycemic (rage girman sukari na jini), insulin yana da wasu sauran tasirin: yana ƙara ɗakunan glycogen tsoka, yana haɓaka ƙirar peptide, rage yawan furotin, da dai sauransu.
Fitar insulin yana tattare da motsawa ko hanawa (hanawa) na wasu enzymes, glycogen synthetase, pyruvate dehydrogenase, hexokinase suna zuga, lipase yana kunna kitse na adipose nama, lipoprotein lipase, rage yawan hadarin jini bayan abinci mai cike da mai, ana hana shi.
Matsayin biosynthesis da ɓoye (ɓoye) na insulin ya dogara da tattarawar glucose a cikin jini. Tare da haɓaka abubuwan da ke ciki, ƙwayar insulin ta hanyar ƙwayar ƙwayar ƙwayar cuta ta kara ƙaruwa, akasin haka, raguwa a cikin taro na glucose a cikin jini yana rage jinkirin insulin.
A aiwatar da tasirin insulin, rawar da take takawa ana yin ta ne ta hanyar hulɗa da takamaiman mai karɓa wanda aka keɓance shi a cikin ƙwayoyin plasma na tantanin halitta, da samuwar insulin receptor complex. Mai karɓar insulin a hade tare da insulin ya shiga cikin tantanin halitta, inda yake shafar haɓakar sinadaran salula, ba a cika fahimtar abubuwan da ke cikin ƙwayoyin ciki ba.
Insulin shine ainihin takamaiman magani don ciwon sukari mellitus, saboda yana rage hyperglycemia (haɓakar glucose jini) da glycosuria (kasancewar sukari a cikin fitsari), yana sake cika ma'aunin glycogen a cikin hanta da tsokoki, rage haɓakar glucose, kuma yana rage yawan ciwon sukari (gaban mai a cikin jini) yana inganta yanayin mai haƙuri.
An samo insulin don amfanin likita daga cututtukan shanu da aladu. Akwai wata hanyar sunadarai na insulin, amma ba ta da yawa. Hannun hanyoyin samar da ilimin halittu na kwanan nan don samar da insulin mutum. Insulin da aka samu ta injiniyan kwayoyin shi ya cika daidai da jerin amino acid na insulin mutane.
A cikin yanayin inda aka samo insulin daga cututtukan dabbobi, abubuwa da yawa masu rauni (proinsulin, glucagon, statin kai, sunadarai, polypeptides, da dai sauransu) na iya kasancewa a cikin shirye-shiryen saboda karancin tsarkakewa. Rashin ingantaccen shirin insulin na iya haifar da sakamako masu illa iri iri.
Hanyoyin zamani suna ba da damar samun tsarkakakke (monopic - chromatographically tsarkakakke tare da sakin wani "ganiya" na insulin), tsarkakakke (monocomponent) da kuma shirye-shiryen insulin mai narkewa. A halin yanzu, ana ƙara yin amfani da insulin na ɗan adam. Daga shirye-shiryen insulin na asalin dabba, an zaɓi fifiko ga insulin wanda aka samo daga cututtukan aladu.
An ƙaddara aikin insulin ta hanyar halitta (ta ikon rage ƙananan glucose jini a cikin zomaye masu lafiya) da kuma ɗayan hanyoyin nazarin halittar jiki (electrophoresis akan takarda ko chromatography akan takarda). Don yanki ɗaya na aikin (UNIT), ko naúrar ƙasa (IE), ɗauki aikin 0.04082 mg na insulin ruwan kwalliya.

Alamu don amfani:
Babban mahimmancin amfani da insulin shine nau'in I diabetes mellitus (wanda ke dogara da insulin), amma a ƙarƙashin wasu yanayi an kuma tsara shi don nau'in ciwon sukari na II wanda ba shi da insulin-insulin.

Hanyar amfani:
A cikin lura da ciwon sukari, ana amfani da shirye-shiryen insulin na durations daban-daban na aiki (duba ƙasa).
Hakanan ana amfani da insulin na ɗan gajeren lokaci a cikin wasu sauran hanyoyin cututtukan: don haifar da yanayin hypoglycemic (saukar da sukari na jini) a wasu nau'ikan schizophrenia, azaman anabolic (haɓaka ƙwaƙwalwar furotin) magani tare da ƙoshin abinci, rashin abinci mai gina jiki, furunlera (kumburi da yawa na fata) , thyrotoxicosis (cututtukan thyroid), tare da cututtuka na ciki (atony / asarar sautin /, gastroptosis / prolapse na ciki /), hepatitis na kullum (kumburi da hanta hanta), nyh siffofin hanta cirrhosis, kazalika da bangaren "polarizing" mafita amfani da su bi m jijiyoyin zuciya insufficiency (mismatch tsakanin cardiac oxygen bukatar da ta ceto).
Zaɓin insulin don lura da ciwon sukari ya dogara da tsananin da halayen cutar, yanayin yanayin mai haƙuri, da saurin farawa da tsawon lokacin sakamako na hypoglycemic na miyagun ƙwayoyi. Babban mahimmancin insulin da kashi shine mafi dacewa ana aiwatar dashi a asibiti (asibiti).
Shirye-shiryen insulin na gajeran lokaci sune mafita don subcutaneous ko gudanarwa na wucin gadi. Idan ya cancanta, ana kuma sarrafa su ta intanet. Suna da tasiri mai saurin rage sukari. Yawancin lokaci ana gudanar dasu a ƙarƙashin ƙasa ko minti 15 kafin abinci daga ɗayan zuwa sau da yawa a cikin rana. Tasirin bayan allurar subcutaneous yana faruwa ne bayan mintuna 15-20, ya kai matsakaici bayan awanni 2, jimlar aikin bai wuce awa 6. Ana amfani da su ne musamman a asibiti don tsayar da sinadarin insulin da ake buƙata ga mai haƙuri, da kuma a lokuta inda ya zama dole a cimma saurin canje-canje a cikin aikin insulin a cikin jikin mutum - tare da cutar siga mai ciwon sukari da precom (cikakke ko ɓataccen asarar hankali sakamakon haɓakar haɓaka mai yawa na sukari jini)
Baya ga tog 9, ana amfani da shirye-shiryen insulin gajere kuma a matsayin wakili na anabolic kuma an wajabta shi, a matsayin mai mulkin, a cikin ƙananan allurai (4-8 raka'a 1-2 sau a rana).
Ana samun shirye-shiryen insulin na tsawon lokaci (mai aiki) a cikin siffofin sashi daban-daban tare da durations daban-daban na tasirin sukari (semylong, tsawo, ultralong). Don magunguna daban-daban, tasirin yana gudana daga sa'o'i 10 zuwa 36. Godiya ga waɗannan magungunan, ana iya rage adadin injections na yau da kullun. Ana haifar dasu koyaushe a cikin nau'ikan dakatarwa (dakatar da m barbashi na miyagun ƙwayoyi a cikin ruwa), ana gudanar da subcutaneously ko intramuscularly, gudanar da jijiya ba a yarda. A cikin cututtukan cututtukan cututtukan mahaifa da yanayin precoatous, ba a amfani da magunguna na tsawan lokaci.
Lokacin zabar shiri insulin, ya zama dole don tabbatar da cewa tsawon lokacin tasirin rage sukari yayi daidai da lokacin da kuka dauka. Idan ya cancanta, ana iya gudanar da magunguna 2 na tsawan mataki a cikin sirinji ɗaya. Wasu marasa lafiya suna buƙatar ba kawai tsawon lokaci ba, har ma da sauri daidaituwa na matakan glucose na jini. Dole ne su rubanya shirye-shiryen insulin na dogon lokaci da gajere.
Yawanci, ana ba da magunguna masu amfani da dogon lokaci kafin karin kumallo, amma idan ya cancanta, za a iya yin allurar a wasu awanni.
Ana amfani da duk shirye-shiryen insulin a ƙarƙashin yarda da abinci. Ya kamata a ƙaddara ma'anar darajar makamashi rubuta (daga 1700 zuwa 3000 khal) ta nauyin jikin mai haƙuri a lokacin maganin, ta nau'in ayyukan. Don haka, tare da rage cin abinci mai gina jiki da aiki mai ƙarfi na jiki, adadin adadin kuzari da ake buƙata kowace rana ga mai haƙuri ya zama aƙalla 3000, tare da ƙarancin abinci mai gina jiki da kuma yanayin rayuwa, bai kamata ya wuce 2000 ba.
Roaddamar da allurai masu yawa, da kuma rashin carbohydrates tare da abinci, na iya haifar da yanayin hypoglycemic (saukar da sukari na jini), tare da jin haushi, rauni, gumi, rawar jiki, ciwon kai, tsananin farin ciki, bugun zuciya, rashin lafiyar jiki (rashin yanayin motsa jiki) ko tashin hankali . Bayan haka, cutar sikila tana iya haɓaka (asarar hankali, halin cikakken rashin halayen jiki ga ƙwarin waje sakamakon raguwar sukari cikin jini) tare da asarar hankali, tashin zuciya, da hauhawar aiki a cikin aikin zuciya. Don hana hypoglycemic jihar, marasa lafiya suna buƙatar sha shayi mai dadi ko cin eatan guda kaɗan na sukari.
Tare da hauhawar jini na hypoglycemic (hade da rage yawan sukari na jini), ana shigar da maganin glucose 40% a cikin jijiya a cikin adadin 10-40 ml, wani lokacin har zuwa 100 ml, amma ba ƙari ba.
Ana iya aiwatar da gyaran hypoglycemia (saukar da sukari na jini) a cikin mummunar hanyar amfani da intramuscular ko subcutaneous management na glucagon.

Sakamako masu illa:
Tare da gudanar da aikin insulin na shirye-shiryen insulin, lipodystrophy (raguwa a cikin adadin adipose nama a cikin ƙwayar subcutaneous) na iya faruwa a wurin allurar.
Shirye-shiryen insulin na zamani da aka saba dasu kwata-kwata ba sa haifar da farji, kodayake, irin waɗannan halayen ba a cire su. Haɓaka mummunan amsawar rashin lafiyar yana buƙatar desensitizing nan da nan (hana ko hana halayen rashin lafiyan) farjin magani da maye gurbinsu.

Yarjejeniyar:
Contraindications zuwa ga yin amfani da insulin sune cututtukan da ke faruwa tare da hypoglycemia, hepatitis, cirrhosis, hemolytic jaundice (yellowing na fata da mucous membranes na girare wanda ke lalacewa ta hanyar rushewar ƙwayoyin sel ja), cututtukan cututtukan cututtukan fata (kumburi da ƙwayar ƙwayar cuta), cututtukan ƙwayar jijiya (kumburi da koda) cututtukan koda wanda ke da alaƙa da ƙwayar ƙwayar cuta / amyloid metabolism), urolithiasis, ciki da cututtukan duodenal, lahani na zuciya (lalata zuciya saboda rashin zuciya cututtuka na bawuloli).
Ana buƙatar yin taka tsantsan wajen lura da marasa lafiya da masu ciwon sukari, masu fama da ƙarancin ƙwayar cuta (rashin daidaituwa tsakanin buƙatar zuciyar oxygen da isar da ita) da kwakwalwa mai rauni | jini. Tsanaki wajibi ne lokacin da ake ji insulin! a cikin marasa lafiya da cututtukan thyroid, cutar ta Addison (isasshen aikin adrenal), gazawar renal.
Ya kamata a kula da lafiyar insulin ciki wanda ya kamata a sa ido sosai>. A lokacin farko-farko na ciki, bukatar insulin yawanci yakan dan ragu kadan kuma yana ƙaruwa cikin na biyu da na uku.
Alfa-adrenergic blockers da beta-adrenostimulants, tetracyclines, salicylates suna ƙara ɓoyewar ƙwayar endogenous (excretion na sashin jikin) insulin. Diupetics na Thiazide (diuretics), beta-blockers, barasa na iya haifar da hypoglycemia.

Sakin saki:
Akwai insuline insuline a cikin | gilashin gilashin hermetically shãfe haske tare da roba Stoppers tare da aluminum gushewa.

Yanayin ajiya:
Adana a zazzabi daga +2 zuwa + 10 * C. Ba a yarda daskarewa da kwayoyi ba.

Abun ciki:
1 ml na bayani ko dakatarwa yawanci ya ƙunshi raka'a 40.
Ya danganta da tushen samar da kayan, ana keɓe insulin daga cututtukan dabbobi kuma ana yin shi ta amfani da hanyoyin injin. Dangane da matsayin tsabtacewa, shirye-shiryen insulin daga kyallen dabba ya kasu zuwa monopic (MP) da monocomponent (MK). A halin yanzu an samo su daga ƙwan alade, ƙari ga wannan kuma ana musanta musu da harafin C (SMP - alade naman alade, SMK - naman alade naman alade), shanu - wasiƙar G (naman sa: GMP - naman sa na naman sa, GMK - naman sa mai nama). An nuna shirye-shiryen insulin na mutum ta hanyar wasika C.
Ya danganta da tsawon lokacin aikin, insulins sun kasu kashi biyu:
a) shirye-shiryen insulin gajeran aiki: farawa aiki bayan mintuna 15-30, mafi girman aiki bayan sa'o'i 1 / 2-2, jimlar aiki na awa 4-6,
b) Shirye-shiryen insulin tsawon lokaci sun hada da magunguna na matsakaici (farawa bayan 1 / 2-2 hours, ganiya bayan 3-12 hours, jimlar tsawon 8-12 hours), magunguna masu aiki da yawa (farawa bayan 4-8 hours, ganiya bayan 8-18 hours, jimlar tsawon 20-30 hours).

Kungiyar magunguna:
Hormones, analogues da magungunan antihormonal
Magungunan cututtukan hormone na pancreatic da magungunan roba na roba
Magungunan Insulin Group