Dakatar da sinadarin Inshora na Zinc Insulin na Ciwon sukari

Dakatar da sinadarin zinc mai daukar ciki don yin allura (insulin "K" ultralente) - shiri na insulin da dadewa domin lura da ciwon sukari mellitus.

Dakatar da sinadarin zinc din na zinari yana nufin mafi yawan tsawan-da-kanda akeyi na rage sukari, wanda ke faruwa awanni 6-8 bayan gudanarwar, tasirin ya kai iyakar sa'o'i 16-20 bayan gudanarwa kuma ya kai har zuwa awanni 30 zuwa 36.

Dokokin aikace-aikace

Ana saita adadin dakatarwa da yawan allurar maganin a kowace rana daban-daban ga kowane mara lafiya, la'akari da adadin sukari da aka fitar a cikin fitsari a lokuta daban-daban na rana, matakin sukari na jini, da kuma tsawon lokacin tasirin cutar.

Dukkan shirye-shiryen insulin mai dorewa-ana sarrafa su ne kawai.

Rubuta maganin insulin na Zinc

Dakatar da sinadarin zinc mai daukar ciki don yin allura (Suspensio zinc-insulini crystallisati pro inububus) shine dakatarwar da aka yiwa insulin din insulin a cikin buhunan acetate tare da pH na 7.1-7.5. 1 ml na dakatarwa ya ƙunshi 40 IU na insulin.

An saki fitarwa a cikin 5 ml da 10 ml bakararre shãfe haske daga vials.

Umarnin don amfani da miyagun ƙwayoyi

Yin amfani da miyagun ƙwayoyi Dakatar da sinadarin zinc don yin allura ana bada shawarar yin jiyya na ƙwayar mellitus type 1, ciki har da yara da mata a cikin matsayi. Bugu da ƙari, ana iya amfani da wannan kayan aikin a cikin ilimin likita don maganin cututtukan type 2 na ciwon sukari na 2, musamman tare da rashin ingancin allunan-sukari masu rage sukari, musamman, abubuwan samo asali na sulfonylurea.

Ana amfani da insulin na zinc sosai don magance rikice-rikice na ciwon sukari, kamar lalacewar zuciya da jijiyoyin jini, ƙafar masu ciwon sukari da kuma rauni na gani. Bugu da ƙari, yana da mahimmanci ga ayyukan cutar ciwon sukari da kuma lokacin dawowa daga gare su, kazalika da mummunan raunin da ya faru ko ƙwarewa mai ƙarfi.

Insulinda zinc insulin an yi shi ne kawai don allurar subcutaneous, amma a mafi yawan lokuta ana iya gudanar da shi ta intramuscularly. Gudun cikin jijiya na wannan magani an haramta shi sosai, saboda zai iya haifar da mummunan harin hypoglycemia.

Ana lissafin sashi na miyagun ƙwayoyi Insulin Zinc daban-daban ga kowane mara lafiya. Kamar sauran insulins na dogon lokaci, dole ne a gudanar dashi sau 1 ko 2 a rana, gwargwadon bukatun mai haƙuri.

Lokacin amfani da dakatarwar zinarin insulin yayin daukar ciki, yana da matukar muhimmanci a tuna cewa a cikin watanni 3 na farko na ɗaukar mace mace na iya rage buƙatar insulin, kuma a cikin watanni 6 masu zuwa, akasin haka, zai ƙaru. Dole ne a yi la'akari da wannan yayin yin lissafin adadin maganin.

Bayan haihuwa a cikin ciwon sukari mellitus da lokacin shayarwa, yana da mahimmanci a kula da matakin sukari na jini kuma, idan ya cancanta, daidaita sashin insulin zinc.

Ya kamata a ci gaba da kulawa da hankali akan yawan tattarawar glucose har sai yanayin ya zama ruwan dare.

A yau, dakatar da sinadarin zinc a jikinsa ba a saba da shi ba a cikin magunguna a garuruwan Rasha. Wannan ya faru ne sabili da bayyanar wasu nau'ikan insulin na zamani, wanda ya watsar da wannan magani daga shellan kantin magani.

Saboda haka, yana da wuya a faɗi ainihin farashin insulin na zinc. A cikin kantin magunguna, ana sayar da wannan magani a ƙarƙashin sunayen cinikin Insulin Semilent, Brinsulmidi MK, Iletin, Insulin Lente “HO-S”, Insulin Lente SPP, Insulin Lt VO-S, Insulin-Long SMK, Insulong SPP da Monotard.

Yin bita game da wannan magani suna da kyau a koyaushe. Yawancin marasa lafiya da ciwon sukari sunyi nasarar amfani da shi tsawon shekaru. Kodayake a cikin 'yan shekarun nan suna ci gaba da maye gurbinsa da ƙarin takwarorinsu na zamani.

A matsayin analogues na zinc insulin, zaku iya suna kowane insulin aiki. Wadannan sun hada da Lantus, Insulin Ultralente, Insulin Ultralong, Insulin Ultratard, Levemir, Levulin da Insulin Humulin NPH.

Wadannan kwayoyi sune magunguna don maganin ciwon sukari na sababbin mutanen. Insulin ɗin da aka haɗo a cikin kayan su shine anael na insulin ɗan adam, wanda aka samu ta injiniyan kwayoyin. Sabili da haka, kusan ba shi haifar da rashin lafiyan jiki kuma mai haƙuri yana haƙuri da shi.

An bayyana mahimman halayen insulin a cikin bidiyon a cikin wannan labarin.

Insulin (insulinum)

Jigilar kwayoyin halittar ne wanda kwayoyin halittar jini su ke samar da su a cikin tsibirin na Langerhans.

Yawan kwayoyin insulin shine kusan 12,000. A cikin mafita, lokacin da pH na matsakaici ya canza, kwayoyin insulin sun watsar cikin monomers guda biyu 2 tare da aikin hormonal. Tsarin kwayoyin halitta na mutum shine kusan 6000.

Kwayar halittar monomer ta kunshi sarkar polypeptide biyu, ɗayansu ya ƙunshi ragowar amino acid 21 (sarkar A), na biyun kuma ya ƙunshi ragowar amino acid (sarkar B). An haɗa sarƙoƙi da gadoji biyu masu lalacewa.

A halin yanzu, an aiwatar da aikin kwayar insulin.

Insulin yana da takamaiman ikon iya sarrafa metabolism na metabolism, haɓaka sha na glucose ta kyallen kuma yana ba da gudummawa ga canzawar shi zuwa glycogen. Hakanan yana sauƙaƙa shigarwar glucose cikin sel.

Insulin takamaiman wakilin antidi ne. Lokacin da aka gabatar da shi a cikin jiki, yana rage sukari na jini, yana rage fitowar sa a cikin fitsari, yana kawar da tasirin cutar sikari.

Kula da ciwon sukari ya ƙunshi yin amfani da insulin akan asalin abincin da ya dace.

An ƙaddara aikin insulin ta hanyar halitta (ta ikon rage ƙananan sukari na jini a cikin zomaye masu lafiya). Don ɗayan ɓangare na aiki (UNIT) ko kuma naúrar ƙasa da kasa (1 IE), ana ɗaukar nauyin 0.04082 mg na insulin crystalline (misali).

Baya ga tasirin hypoglycemic, insulin yana haifar da wasu sakamako masu yawa: karuwa a cikin shagunan glycogen, haɓaka mai da yawa, haɓakar ƙwayar peptide, rage yawan furotin, da sauransu.

An samo insulin don amfanin likita daga cututtukan dabbobi masu sha daga dabbobi (dabbobi, aladu, da sauransu).

A halin yanzu, tare da insulin al'ada (insulin don allura), akwai wasu kwayoyi da yawa tare da tsawan lokaci.

Additionarin aikin zinc, protamine (furotin) da mai shayarwa ga waɗannan kwayoyi suna canza ƙimar farawa na tasirin sukari, lokacin tasirin sakamako mafi yawa ("mafi girma") da jimlar aikin.

Magunguna na dogon lokaci suna da pH mafi girma fiye da insulin don allura, wanda ke sa allurar su ba ta da ciwo.

Za'a iya ba da kwayoyi masu amfani da dogon lokaci ga marasa lafiya sau da ƙarancin insulin don allura, wanda ke sauƙaƙe jiyya ga marasa lafiya da masu ciwon sukari mellitus.

Yankin mafi sauri kuma mafi ƙarancin aiki (kusan awanni 6) ana yin aiki ta hanyar insulin don allura, wani ɗan ƙaramin aiki (10-12 hours) ana aiki dashi ta hanyar dakatar da sinadarin zinar-insulin, sai protamine-zinc-insulin don allura (har zuwa awanni 20), da dakatarwar insulin protamine (awanni 18-30), dakatarwar zinc-insulin (har zuwa awanni 24), dakatarwar protamine-zinc-insulin (awanni 24-36) da dakatarwar kukan zinc-insulin (har zuwa awanni 30-36).

Zabi na miyagun ƙwayoyi da aka yi amfani da shi ya dogara da tsananin cutar, hanyarsa, yanayin yanayin haƙuri da sauran fasali na shari'ar, da kuma kan kaddarorin miyagun ƙwayoyi (saurin farawa da tsawon lokacin sakamako na hypoglycemic, pH, da dai sauransu).

Yawanci, ana ba da magunguna tare da tsawaita aiki don marasa lafiya da ke da matsakaitan sikelin da ke tattare da cutar, a cikin yanayi inda a baya majinyata suka karɓi 2-3 ko fiye da injections na insulin (na al'ada) kowace rana.

A cikin yanayin precoatous da ciwon sukari, da kuma a cikin siffofin mai tsanani na ciwon sukari mellitus tare da hali zuwa akai-akai ketosis kuma tare da cututtuka, magungunan elongated suna contraindicated, a cikin waɗannan halayen, ana amfani da insulin na yau da kullun don allura.

Insulin don yin allura (insulinum pro inibibus).

An samo maganin ne ta hanyar narkewa cikin insulin din crystalline (tare da aikin kwayoyin halitta na akalla 22 PIECES a cikin 1 MG) a cikin ruwan acid wanda aka hade tare da acid hydrochloric.

1.6-1.8% glycerol an kara shi zuwa mafita da phenol (0.25-0.3%) azaman abin kiyayewa, pH na maganin shine 3.0-3.5. Ruwan m An fito da miyagun ƙwayoyi tare da aikin 40 ko 80 BUDE a cikin 1 ml.

Amfani da shi musamman don lura da ciwon sukari.

An sanya allurai dabam-dabam gwargwadon yanayin mai haƙuri, abubuwan da ke cikin sukari a cikin fitsari (a cikin 1 ED na 5 g na sukari da aka keɓe a cikin fitsari). Yawanci, allurai (na manya) sunada daga raka'a 10 zuwa 20 a rana. A lokaci guda, an tsara abincin da ya dace.

Yin amfani da insulin da zaɓi na allurai ana yinsu ne a ƙarƙashin ikon abubuwan da ke cikin sukari a cikin fitsari da jini da kuma sa ido kan yanayin haƙuri.

A cikin ƙwayar cutar sankara, ƙarancin insulin yana ƙaruwa zuwa 100 IU ko fiye da kowace rana (a lokaci guda, ana bai wa mai haƙuri maganin glucose na ciki).

Insulin don yin allura yana da ɗan hanzari kuma na ɗan gajarta sakamakon rage sukari. Sakamakon yakan haifar ne a tsakanin mintuna 15 zuwa 15 bayan allura, "mafi girman" aikin - bayan awa 2-4, jimlar lokacin aikin har zuwa 6 hours.

Ana amfani da miyagun ƙwayoyi sau 1-3 a rana, ana gudanar da miyagun ƙwayoyi a ƙarƙashin fata ko a cikin mintuna 15-20 na intramuscularly kafin cin abinci. Lokacin da aka yi amfani da shi sau uku, ana rarraba allurai ta yadda, a allurar karshe (kafin abincin dare), ana gudanar da ƙananan ƙwayar insulin don guje wa cututtukan ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta.

A cikin ciki, ana ba da insulin (har zuwa raka'a 50) kawai don cutar gudawa, idan allurar ta subcutaneous ba ta isa sosai.

Lokacin juyawa daga kulawar insulin don inje zuwa magungunan da aka tsawaita, ya zama dole a lura da yadda mai haƙuri zai kasance, musamman a cikin kwanakin 7-10 na farko, lokacin da yakamata a ƙayyade adadin maganin.

Don gano abin da mai haƙuri ya ɗauka game da sabon ƙwayar cuta, ana bada shawara don gudanar da binciken mafi yawan lokuta na sukari (bayan kwanaki 2-3) a cikin fitsari da aka tattara a cikin sassan rana, kazalika da nazarin sukari na jini (da safe a kan komai a ciki).

Ya danganta da bayanan da aka samo, an ƙayyadadden lokutan gudanar da magani na tsawan lokaci yayin yin la’akari da lokacin fara tasirin rage ƙwayar sukari, da lokacin ƙarin gudanarwar (idan ya cancanta) na insulin na yau da kullun da kuma rarraba carbohydrates a cikin abincin yau da kullun.

A yayin ƙarin magani, ana bincika abubuwan sukari a cikin fitsari aƙalla sau 1 a mako, kuma matakin sukari na jini shine sau 1-2 a wata.

Ana amfani da ƙananan allurai na insulin (raka'a 4-8 sau 1-2 a rana) don ƙarancin abinci na gaba ɗaya, raguwar abinci mai gina jiki, furunlera, thyrotoxicosis, matsanancin amai na mata masu juna biyu, cututtukan ciki (atony, gastroptosis), hepatitis, alamun farko na hanta cirrhosis (ana ba da umarnin glucose a lokaci guda) )

A cikin ilimin hauka, ana amfani da insulin don haifar da yanayin hypoglycemic a cikin lura da wasu nau'ikan schizophrenia. Insulin coma (shock) ana faruwa ne ta hanyar subcutaneous na yau da kullun ko allurar ciki ta insulin don allura, farawa daga 4 IU, tare da ƙari na yau da kullun na 4 IU har zuwa bayyanar ƙage ko coma.

Lokacin da sopor ya bayyana, ba a kara yawan insulin a cikin kwanaki 2, a rana ta 3 ana ƙara yawan kashi ta hanyar raka'a 4 kuma ana ci gaba da jiyya a cikin ƙarin allurai har sai coma ta bayyana. Tsawon lokacin fari na farko shine minti 5-10, bayan haka kowa yana buƙatar tsayawa. A nan gaba, tsawon lokacin coma yana ƙaruwa zuwa minti 30-40.

Yayin gudanar da aikin jiyya, suna kiran wani har zuwa sau 25-30.

Dakatar da coma ta hanyar shigarwar ciki na 20 ml na maganin glucose 40%. Bayan barin coma, mai haƙuri yana karɓar shayi tare da 150-200 g na sukari da karin kumallo. Idan bayan gudanarwar glucose din cikin ciki kwayar cutar ba ta daina ba, to 400 ml na shayi wanda yake dauke da sukari 200 na sukari an shigar dashi cikin ciki ta bututu.

Yin amfani da insulin yakamata a duk halaye da hankali. Tare da yawan yawan ƙarfinsa da karɓa na ƙwayoyin carbohydrates, rawar jiki na rashin ƙarfi na iya faruwa tare da asarar ƙwaƙwalwa, tashin zuciya da raguwa a cikin aiki na zuciya.

Lokacin da alamun hypoglycemia ya bayyana, dole ne a ba wa mai haƙuri 100 g farin burodi ko kukis, kuma tare da ƙarin alamun bayyanar, 2-3 tablespoons ko fiye da sukari mai girma.

Idan hawan jini ya cika, zazzabin kashi 40% na glucose ya shiga cikin jijiya kuma ana bayar da sukari mai yawa (duba sama).

Contraindications ga yin amfani da insulin sune cututtukan da ke faruwa tare da hypoglycemia, hepatitis, cirrhosis, hemolytic jaundice, pancreatitis, nephritis, amyloidosis na kodan, urolithiasis, ciki da duodenal raunuka, lahani zuciya.

Ana buƙatar kulawa mai zurfi a cikin marasa lafiya da ciwon sukari na mellitus a gaban rashi na jijiyoyin zuciya da haɗari na cerebrovascular.

Injections na insulin na iya zama mai raɗaɗi saboda ƙarancin pH na maganin.

Hanyar sakin insulin: a cikin kwalaben gilashin tsaka tsaki, an rufe hatimin ta tare da dakatarwar roba tare da gudummawar ƙarfe, 5-10 ml tare da aiki na 40 da 80 PIECES a cikin 1 ml.

Ana tattara insulin daga cikin murfin ta hanyar huɗa tare da allura a maɗaurin roba, a baya an shafa tare da barasa ko maganin aidin.

Adana: Jerin B. A zazzabi of 1 zuwa 10 °, ba a yarda daskarewa.

Insulin da aka samo daga ƙwayoyin whales (whale insulin) ya ɗan bambanta cikin tsarin amino acid daga insulin na yau da kullun, amma yana kusa da shi dangane da ayyukan rage sukari.

Idan aka kwatanta da insulin na yau da kullun, insulin cetacean yana aiki da ɗan hankali a hankali, lokacin da aka gabatar da shi a ƙarƙashin fata, ana lura da farawa bayan mintuna 30-60, matsakaici bayan sa'o'i 3-6, tsawon lokacin aiki 6 hours 6.

Anyi amfani dashi don ciwon sukari (matsakaici da tsauraran siffofin).

Saboda gaskiyar cewa magani ya bambanta da tsarin sunadarai daga insulin da aka samo daga cututtukan shanu da aladu, wani lokacin yana da tasiri a lokuta da ke tsayayya da insulin na yau da kullun, ana amfani dashi yayin da aka lura da halayen ƙwayar cuta daga insulin na al'ada (duk da haka, a wasu yanayi whale insulin kuma yana haifar da rashin lafiyar jiki).

Shigar da fata ko intramuscularly sau 1-3 a rana. Allurai, rigakafin, yiwu rikitarwa, contraindications iri ɗaya ne na insulin don yin allura.
Ba'a bada shawarar insulin na Whale don kamuwa da cutar sankara ba, saboda yana yin aiki a hankali fiye da insulin na yau da kullun don allura.

Siffar saki: a cikin kwalabe na hermetically hatimi tare da roba tsayawa da karfe gudu, in 5 da 10 ml tare da aiki na 40 PIECES a cikin 1 ml.

Adana: duba insulin don allura.

Ciwon sukari mellitus - shirye-shiryen insulin

Insulin-zinc-dakatar "A" (ICS "A") - amorphous zinc-insulin. Magungunan yana fara aiki sa'o'i 1-1.5 bayan aikinta na subcutaneous kuma yana ɗaukar tsawon awanni 10-12 (ana lura da mafi girman sakamako daga saurin 5-7 bayan allura). Insulin-zinc-dakatar "A" yayi kama da magungunan Dutch "tef bakwai".

Insulin-zinc-dakatarwa "K" (ICS "K") - zinc-insulin mai narkewa. Tare da allurar subcutaneous, tasirin sa yana farawa awanni 6-8 bayan gudanarwa. Yana samun sakamako mafi girma bayan sa'o'i 12-18, kuma yana ƙare bayan sa'o'i 28-30. Anonymous na Danish magani "matsananci-tef."

Dakatar da insulin-zinc (ISC) cakuda ICS "A" (30%) da ICS "K" (70%). An fara amfani da miyagun ƙwayoyi ne bayan 1-1.5 hours kuma yana ɗaukar tsawon awanni 24. Bayan gudanar da miyagun ƙwayoyi, ana lura da matsayin biyu na aikinsa - bayan sa'o'i 5-7 da awanni 12-18, wanda yayi dace da lokacin ingantaccen aikin magungunan da ke cikin sa. Analogue shine "sabon tef".

B-insulin din-din ne, mara sinadaran insulin da mai tsayayyen kayan maye.Theaddamar da tasirin hypoglycemic yana faruwa awa daya bayan gudanarwa. Yawan aiki shine sa'o'i 10-16. An yi shi a Jamus.

Duk waɗannan shirye-shiryen insulin na dogon lokaci ana samun su a cikin kwalabe 5 ml tare da abun ciki na raka'a 40 a cikin milliliter ɗaya. Kafin amfani da shi, murfin ya kamata a girgiza shi kaɗan har sai riguna ta bayyana ta bayyana. Dole ne a ɗauka cikin zuciya cewa dukkanin waɗannan magungunan za a iya ba da izini kawai. Abubuwan shigar allurar ciki ba su yarda da su ba. Ba za ku iya amfani da su ba tare da cutar siga.

Yadda ake yin allurar insulin?

Yawancin marasa lafiya da ciwon sukari suna buƙatar allura ta yau da kullun na insulin (wani lokacin sau da yawa a rana) don ci gaba da samun lafiya. Sabili da haka, yana da kyau kowane haƙuri ya koyi sarrafa insulin da kansa.

Yawancin lokaci ana ba da allurar a karkashin fata zuwa yankin na waje da na baya na kafada ko ƙarƙashin rata kafada. Idan mai haƙuri ya sa insulin da kansa, ya fi dacewa a yi wannan a hagu ko cinya ta dama (daga waje), a cikin gindi ko tsakiyar ɓangaren ciki.

Don yin allura, zai fi kyau a yi amfani da sirinji na “insulin” musamman da aka kera shi ko kuma wasu siraran ƙananan ƙananan (1-2 ml) tare da rarrabuwa 0.1 ml.

Kafin gudanar da insulin, ya zama dole a ƙayyade a gaba adadin ƙwayar da za a allurar a cikin sirinji (a wannan yanayin, ya kasance da jagorar da likita ya tsara).

Ga misali: idan rukunin insulin 40 na insulin sun ƙunshi ъ ml na miyagun ƙwayoyi, kuma mai haƙuri ya buƙaci shigar da raka'a 20, to ya kamata a jawo kakin insulin 0.5 na 0.5 a cikin sirinji, wanda zai dace da sassan 5 na 1-gram da 2 na sassan 2 na sirinji na 2 gram.

Ana yin wannan lissafin ta amfani da sirinji na al'ada, amma ya fi kyau a yi amfani da sirinji na musamman don allurar insulin.

Lokacin yin allura, ya zama dole a lura da tsaftataccen lokacin haila (don kauce wa shigar da kamuwa da cuta).

Hanyar sarrafa insulin mai sauki ce kuma baya buƙatar horar da likitoci. Koyaya, allurar farko da mara lafiyar ta yi da kanshi dole ne a aiwatar dashi a karkashin kulawar malamin kuma tare da taimakon ta.

Kafin yin allura, mai haƙuri yakamata ya sami ampoule tare da insulin, sirinji tare da allura guda biyu, hancin ɗan adam, auduga mai narkewa, ethyl ko giya methyl (barasa mai ƙyamar), sterilezer ko kayan kwalliya musamman da aka shirya don tafasa sirinji. Yana da mahimmanci cewa mai haƙuri daga farkon ya ɗauki kowane allura mai mahimmanci kuma ya sami ƙwarewa tare da injections. Yin sakaci ba a yarda da shi ba anan. Take hakkin sterility na iya haifar da rikitarwa mai haɗari (rashin kuzari, da sauransu).

Kafin allurar, an watsa syringe, sannan, tare da allura da hancin, tafasa na mintuna 5-10 a cikin tsaftataccen ruwa. Ana cire sirinji mai narkewa tare da hanzarta kuma an tattara tare ba tare da taɓa saman piston da gefan syringe ba. An saka allura a cikin sirinji tare da hancin, motsi na piston yana cire ragowar ruwa daga sirinji.

Ana tattara insulin daga murfin kamar haka: an kawo pistin na sirinji zuwa alamar da ta dace da yawan insulin ɗin da ake buƙata, bayan haka an ɗora murfin roba na ampoule tare da allura da aka sa a kan sirinji.

Lokacin da aka shigar da allura a cikin ampoule (kafin ta nutse cikin ruwa), iskar da take ƙunshe cikin sirinji tana fitowa (ana yin wannan ta latsa piston). Sa'an nan, ta karkatar da kwalbar, allurar an nutsar da ita cikin maganin insulin. A karkashin matsin iska, ruwa ya fara gudana cikin sirinji.

Bayan buga adadin maganin da ya dace, an cire allura da sirinji daga ampoule. A lokacin wannan juyawar, iska zata iya shiga sirinji.

Sabili da haka, ya kamata a riƙe sirinji na ɗan lokaci tare da allura sama, sannan sai a bar iska da ɗan ruwa kaɗan daga ciki (shine dalilin da ya sa koyaushe kuna ɗaukar ƙarin insulin a cikin sirinji fiye da yadda ake buƙatar allura).

Wurin allurar dole ne da farko a goge shi da ulu auduga tare da barasa. Bayan haka, ana kama fatar da keɓaɓɓen nama tare da hagu, kuma an saka allura tare da hannun dama.

Bayan wannan, riƙe allura tare da hannun hagu a cikin haɗin tare da sirinji, kuma tare da hannun dama danna piston zuwa ƙarshen, bayan cire allurar, an sake sanya allurar a hankali tare da barasa.

Lokacin yin allura, dole ne a kula da lafiya don tabbatar da cewa insulin bai zube a ƙarshen allura tare da sirinji (yi amfani da allura kawai waɗanda suka dace da ƙarshen buɗewar sirinji).

Kamar yadda kake gani, duk aikin allurar ba ya gabatar da wasu matsaloli na musamman. Mai haƙuri ya hanzarta samun mahimmancin dabarun. Abin sani kawai ya zama dole ne a tsayar da kiyaye dukkan ƙa'idodi da kuma kiyayewa.

Insulin ya canza salon magance ciwon sukari. Amma farji tare da taimakonsa, kamar yadda aka riga aka ambata, ba shi da 'yanci daga wasu koma baya: ya zama dole a gudanar da insulin ta hanyar injections 2-3, kuma wani lokacin har sau 4 a rana, ana lura da cutar hypoglycemia (idan ba ku bi abincin ba), a wasu yanayi akwai mutum rashin haƙuri, ƙurji bayan allura, da sauransu.

Insulin magani ne mai gina jiki. Saboda haka, amfani dashi wani lokacin yana haifar da rashin lafiyar jiki. Abin da ya sa a cikin waɗannan halayen ana bada shawara don canza jerin insulin da aka gudanar. A cikin cututtuka da dama, insulin an saba dashi.

Add buri ga insulin baya haɓaka. Ana iya warware shi cikin sauƙi, musamman yanzu, lokacin da akwai nau'ikan ƙwayar jini da marasa lafiya ke ɗauka ta bakin. Waɗannan sun haɗa da rage ƙwayoyin sulfonamide na sukari da kuma biguanides.

Bayanin sinadarin dakatarwar zinc din insulin (dakatar da sinadarin zinc, fili): umarni, amfani, contraindications da dabara.

• Masu kari, reagents da tsaka-tsaki

1 ml na tsaka mai wuya mai sulke ya ƙunshi zinc (a cikin nau'i na chloride) 47 μg, sodium chloride 7 mg, sodium acetate 1.4 mg, methyl parahydroxybenzoate 1 mg, kazalika da sodium hydroxide da hydrochloric acid (don daidaitawa ta pH), a cikin 10 ml vials , cikin kwalban kwali 1 kwalban.

Dilution na zinulin shirye-shiryen insulin da Novo Nordisk yakamata a yi a karkashin yanayin aseptic zuwa matakin da likita ya ƙayyade daidai da adadin da ake buƙata (galibi ga yara) da iyakokin fasaha na sirinjin insulin na kasuwanci.

A cikin duhu a zazzabi na 2 8 C. A cikin firiji. Adana a cikin wurin da aka kiyaye shi daga hasken rana an yarda dashi a zazzabi a cikin daki wanda bai wuce 25 C ba makonni 6.

Ayi nesa da isar yara.

Shekaru 2 An yanke shi zuwa 10 IU / ml, shirin insulin ya kasance tsayayye na makonni 2 lokacin da aka adana shi a cikin firiji ba kusa da injin daskarewa a zazzabi na 2-8 C.

A wasu halaye, bayyanar halayen rashin lafiyan ga abubuwan da ke tattare da miyagun ƙwayoyi yana yiwuwa. Wuce shawarar da aka bayar da shawarar, matsanancin motsa jiki, ciyarwar mara ta yau da kullun, cututtuka masu yaduwa tare da gudawa da amai na iya haifar da cututtukan jini.

A lokaci guda, cat ɗin yana da wata cuta mai narkewa, ɗaci mai ɗaci, jin yunwar kullun, saurin bugun zuciya da bugun zuciya, tsoro, damuwa, da ɓatarwar yanayin cikin sarari. Lokacin da waɗannan bayyanar cututtuka suka bayyana, gwajin jini ya zama dole don sanin matakin sukari na jini da daidaita magani. A irin waɗannan halayen, ana amfani da dropper tare da maganin glucose.

Idan dabba ba ta sami isasshen insulin ba, kuma ba a yin allurar ta hanyar da ta dace, to za a iya faruwa hyperglycemia (acid na ciwon sukari). Wannan ya wadatar da faruwa da tsananin kishirwa, cutar kansa, rashin nutsuwa da nutsuwa.

Ana bai wa cat allurar farko da safe kafin cin abinci. Haka kuma, adadin abinci ya zama kashi 50 cikin 100 na abincin yau da kullun. Na biyu ana aiwatar da ciyarwa bayan awanni 12 sannan kuma bayan gudanar da maganin.

Abubuwan da ke ƙarƙashin umarnin, ba a lura da sakamako masu illa ba. Kodayake yin tsawan amfani da caninsulin na iya haifar da lipodystrophy. Kada ku ba da magani ga dabbobi masu ƙarancin glucose na jini (hypoglycemia).

E10 na rashin lafiyar insulin-da-kwayar mellitus mai ciwon sukari O24

Matsakaici tsawon insulin. Monocomponent (an tsarkake sosai) naman alade hade da zinc-insulin. Akwai shi a cikin nau'in dakatarwa ta tsaka tsaki don allura wanda ya ƙunshi 30% amorphous da insulin na crystalline 70%.

Pharmacology

Tasirin pharmacological shine hypoglycemic.

Yana daidaita metabolism na carbohydrates, lipids da sunadarai. Yana hulɗa tare da takamaiman masu karɓa na ƙwayoyin cytoplasmic ƙwayoyin sel kuma suna samar da hadaddun mai karɓar insulin. Ta hanyar kunnawar ƙwaƙwalwar ƙwaƙwalwa (a cikin ƙwayoyin mai mai da ƙwayoyin hanta) ko kai tsaye cikin sel (tsokoki), hadaddun yana kunna hanyoyin cikin ciki, gami da

yana haifar da ƙirar maɓallin enzymes na glycolysis na hexokinase, phosphofructokinase, pyruvate kinase da sauransu da dama, gami da ƙwayar glycogen synthetase a gabobin da ke cikin hanta (hanta, ƙwayar tsoka). Theara yawan permeability na membranes na sel don glucose da ƙimar amfaninsa ta hanyar kyallen takarda.

Rage glucose na jini yana haɗuwa tare da karuwa a cikin lipogenesis, glycogenogenesis, haɗin furotin da raguwa a cikin samar da glucose na hanta. Yana da tasirin da bai dace da ruwa da kuma ma'adinai ba.

Oradewa da farawa ya dogara da hanyar (s / c ko a / m) da kuma wurin (ciki, cinya, gindi) na gudanarwa, ƙarar allura, ƙwayar insulin a cikin ƙwayoyi, da sauransu An rarraba shi ba tare da bambanci ba a duk kyallen, ba ya shiga cikin shinge na ƙarancin ciki da cikin kirji madara. T1 / 2 shine mintuna 5-6. An lalata shi ta hanyar insulinase a cikin hanta da ƙodan. Kodan ya cire shi (30 80%).

Nau'in 1 na ciwon sukari mellitus, ciki har da a cikin yara da mata masu juna biyu (tare da rashin ingancin maganin rashin lafiya), nau'in mellitus na sukari na 2 (tare da juriya ga wakilai na hypoglycemic na mutum wanda aka samo daga sulfonylurea), tare da cututtukan cutuka, tsaka-tsakin aikin tiyata, a cikin bayan aikin, tare da raunin rauni da yanayin damuwa a cikin marasa lafiya tare da ciwon sukari mellitus.

Contraindications

Hypersensitivity, hypoglycemia, insuloma.

A lokacin daukar ciki, ya zama tilas a yi la’akari da raguwa (I trimester) ko karuwa (II da III trimesters) na bukatun insulin. Yayin shayarwa, ana bada shawarar cigaba da kulawa tsawon watanni (har sai an daidaita bukatar insulin).

Hypoglycemia (tare da manyan allurai, tsallakewa ko jinkirta shan kayan abinci, matsanancin motsa jiki, a kan asalin cututtukan fata ko cututtuka, musamman tare da amai da gudawa): pallor, sweating, palpitations, rashin bacci, rawar jiki da sauran alamu, har zuwa cakulan da gudawa,

hauhawar jini da kuma ciwon sukari acidosis (a ƙananan allurai, injections da aka rasa, abinci mara kyau, a kan tushen kamuwa da cuta), tare da nutsuwa, ƙishirwa, rashin ci, fitsari a fuska da sauran alamomi, har zuwa maarma da coma,

rashin lafiyan, incl halayen anaphylactoid (wanda ba kasafai ba), rauni, angioedema, laryngeal edema, tashin hankali anaphylactic, hyperemia da itching a wurin allurar (a farkon makonni na jiyya), lipodystrophy (tare da tsawaita gudanarwa a wuri guda).

Haɗa kai

maganin hana haihuwa, maganin anti-mai kumburi, steroidal thyroid, heparin, shirye-shiryen lithium, nicotine (shan sigari), thiazide da kuma dipile diparis. Ethanol da masu maye sun rage aiki (hulɗa a kan magunguna), ba a haɗa shi (ba za a iya haɗawa da shi) tare da insulins na foshate, da sauran abubuwan dakatarwar sinadarin zinc-insulin.

Yawan abin sama da ya kamata

Bayyanar cututtuka: alamun hypoglycemia, gumi mai sanyi, rauni, pallor na fata, palpitations, rawar jiki, tashin hankali, tashin zuciya, tingling a cikin wata gabar jiki, lebe, harshe, ciwon kai, a cikin manyan lokuta, hypoglycemic coma.

Jiyya: don hypoglycemia mai sauƙi da matsakaici, shigo da glucose (Allunan glucose, ruwan 'ya'yan itace, zuma, sukari da sauran abinci mai cike da sukari), tare da mummunan hypoglycemia, musamman tare da asarar sani da coma 50 ml na 50% iv glucose bayani yana ci gaba da ci gaba jiko na 5 10% na maganin glucose, ko 1 2 mg na glucagon (i / m, s / c, iv), a wasu yanayi, diazoxide iv 300 MG na 30 min kowane 4 hours,

Hypoglycemia (tare da manyan allurai, tsallakewa ko jinkirta shan kayan abinci, matsanancin motsa jiki, a kan asalin cututtukan fata ko cututtuka, musamman tare da amai da gudawa): pallor, sweating, palpitations, rashin bacci, rawar jiki da sauran alamu, har zuwa cakulan da gudawa,

hauhawar jini da kuma ciwon sukari acidosis (a ƙananan allurai, injections da aka rasa, abinci mara kyau, a kan tushen kamuwa da cuta), tare da nutsuwa, ƙishirwa, rashin ci, fitsari a fuska da sauran alamomi, har zuwa maarma da coma,

rashin lafiyan, incl halayen anaphylactoid (da wuya) - kurji, angioedema, laryngeal edema, girgizawar anaphylactic, a wurin allurar - hyperemia da itching (a cikin makonni na farko na jiyya), lipodystrophy (tare da tsawaita gudanarwa a wuri guda).

maganin hana haihuwa, maganin anti-mai kumburi, steroidal thyroid, heparin, shirye-shiryen lithium, nicotine (shan sigari), thiazide da kuma dipile diparis. Ethanol da masu maye sun rage aiki (hulɗa a kan magunguna), ba a haɗa shi (ba za a iya haɗawa da shi) tare da insulins na foshate, da sauran abubuwan dakatarwar sinadarin zinc-insulin.

Kungiyar magunguna

Shirye-shiryen ƙungiyar insulin-zinc-dakatar da ƙungiyar suna da tsawon lokaci dabam. Magungunan insulin-zinc-dakatar A (amorphous zinc-insulin) yana nuna sakamako mafi girma na rage sukari bayan 1 11/2 hours bayan allura, wanda ya kai kimanin 7 hours, sannan a hankali ya fara raguwa. Jimlar sakamakon rage darajar sukari na wannan magani shine sa'o'i 10 12.

Magungunan insulin-zinc-dakatarwar K (crystalline zinc-insulin) yana da mafi girman jimlar aiki har zuwa awanni 30 bayan allura, an gano mafi girman aikin bayan 12 zuwa 18 sa'o'i. Dakatar da sinadarin insulin-zinc (amorphous hade da lu'ulu'u) yana da jimlar aiki har zuwa awanni 24 tare da tasirin gaske bayan 8 zuwa 12.

Lokacin canja mai haƙuri zuwa allura na insulin-zinc-dakatar A shirye-shiryen, jimlar adadin rakarorin insulin da aka yiwa allurar a cikin guda biyu ko fiye a lokacin day ake allurar kai tsaye kafin karin kumallo.

Lokacin canja wurin zuwa allurar protamine-zinc-insulin ko zuwa wasu nau'ikan dakatarwar insulin-zinc-dakatar (K ko haɗe) a ranar farko kafin karin kumallo, ana shigar da insulin mai sauƙi a cikin adadin kusan kashi ɗaya cikin uku na adadin insulin da aka karɓa ranar da ta gabata, sannan kuma allurar da aka tsara. Likita na ɗayan insulin ɗin da aka ambata na tsawon lokaci a cikin adadin daidai yake da sauran kashi biyu cikin uku na adadin kashi na yau da kullun.

A nan gaba, daga gobe, kamar yadda likita ya umarce ku, zaku iya canzawa zuwa allurar guda daya na insulin-mai aiki a cikin kullun kafin karin kumallo ko ci gaba da ɗaukar injections na gaba-gaba a hade tare da allurar insulin mai sauƙi, kamar yadda aka bayyana a sama.

Lokacin canza mai haƙuri zuwa ga injections na protamine-zinc-insulin ko dakatarwar insulin-zinc na nau'in ICC da ICSC, ya kamata a sake gina abincinsa wanda ya sa yawancin adadin abinci masu wadataccen wadataccen carbohydrates kasance a safiya da maraice.

Wannan yana da mahimmanci don cimma sakamako mai lalacewa na yau da kullun tare da allurar yau da kullun na miyagun ƙwayoyi kuma don kauce wa farawar jinin haila da dare. A saboda wannan, an shawarci marasa lafiya su bar karamin yanki na abinci don cin abinci na lokacin kwanciya (alal misali, gilashin madara ko kefir da burodi 50 na burodi).

Don zaɓar shirin insulin da ya dace tare da tsawaita sakamako kuma don daidaita sashi ga likita wanda yake lura da mara lafiya, ya zama dole a sami bayanai akan adadin sukari da aka sanya wa marassa lafiya a lokuta daban-daban na rana. Don wannan, mai haƙuri dole ne ya tattara fitsari kowace rana don bincike a cikin rabo da yawa.

Idan ya juya cewa mai haƙuri, yana bin tsarin abincin, yana fitar da sukari a cikin fitsari a cikin farkon rabin ranar (bayan karin kumallo da kuma bayan abincin rana), to a wannan yanayin dakatarwar insulin-zinc A ana yawanci sanyata.

Tare da rarraba yawancin sukari a cikin fitsari, ba kawai lokacin rana ba, har ma da maraice, likita ya ba da izinin dakatarwar insulin-zinc ga mai haƙuri. Idan akwai yawan narkewar sukari tare da fitsari a cikin dare da safe kafin karin kumallo, to, an sanya maganin a insulin-zinc-dakatar K. A lokuta biyu na gaba, gudanar da aikin protamine-zinc-insulin na iya zama ya dace.

Ciwon sukari, N.R. Pyasetskiy

Umarni na musamman

Yayin aiwatar da jiyya tare da Caninsulin, cat ya kamata ya kasance a kan tsayayyen abincin. Bai kamata a sanya magani ba idan dabbar tana da nauyin kiba. Ba za a iya amfani da insulin lokaci guda tare da maganin rigakafi na tetracycline, corticosteroids, sulfonamides da progestogens.

Idan tsarin canza yanayin yanayin abinci ya canza, to sashi na Caninsulin yana canzawa daidai gwargwado. Hakanan ana daidaita alurar yayin cututtukan koda da hanta, bayan tiyata, yayin daukar ciki da cututtukan da ke kama da juna.

Ra'ayoyi game da miyagun ƙwayoyi

Katarina. Karen mu ya wuce shekara 10, kuma kwanannan ta kamu da cutar sankarau. Likitan ya ba da shawarar allurar ta Caninsulin, sau biyu a rana. Ba zan iya faɗi cewa ana lura da tasirin sosai ba, amma cat na ɗan jin daɗi, matakin glucose a hankali yana raguwa.

Anna Na yi farin ciki da miyagun ƙwayoyi. Mun daɗe muna amfani da maganin caninsulin, saboda cat ɗin tana fama da ciwon sukari da ya dogara da insulin kusan shekaru 5. Ban lura da wani sakamako masu illa ba, amma allurar ba ta karu ba. Yana da mahimmanci a bi tsayayyen abinci don inganta yanayin dabbar.

Olga A Intanet, sau da yawa ana sake samun sabani game da maganin. Anan, da yawa na iya dogaro da tasirin mutum na jiki ga abubuwanda ke tattare da Caninsulin. Kayan cat mu yana jurewa da kyau, kawai nan da nan bayan allura akwai karuwa na ɗan lokaci.

Short da tsayi insulin - hade hade

A cikin ilimin zamani don mellitus na ciwon sukari, ana amfani da insulin dogon aiki da insulin gajere. Zai fi dacewa da yawancin marasa lafiya waɗanda suke amfani da hadaddun magani don haɗa ɗan gajeren lokaci da tsawaita insulin a cikin sirinji ɗaya, don haka yin fatar fata ɗaya kawai maimakon biyu.

Raba

Insulin-gajere mai aiki da gajere kuma insulin ba koyaushe zai yiwu gauraya ba. T.N. sinadarai (galenic) karfinsu na shirye-shiryen insulin zuwa mafi girma yana ba ku damar haɗuwa da insulin gajere da aiki.

• Lokacin haɗuwa, ya zama dole la'akari da cewa gajeren insulin ya fi aiki kuma, idan haɗaɗar da ba ta dace ba, tasirinsa zai ɓace. An tabbatar da cewa za a iya gauraya wa insulin gajeren abu a cikin sirinji iri ɗaya tare da maganin maganin protamine-insulin. Sakamakon insulin gajere ba ya ragewa, saboda haka insulin abinci mai narkewa baya ɗaukar protamine.
• Ba shi da wata ma'ana ko waɗanne kamfanoni suka samar da waɗannan magungunan. Saboda haka, abu ne mai sauqi ka haɗu da actrapid tare da humulin H ko actrapid tare da protafan. Wadannan abubuwan hadewar insulin ana adana su kamar yadda aka saba.
• Koyaya, dakatarwar insulin-zinc bazata hade da takaitaccen insulin ba, kamar yadda haɗe tare da ion ion zinari, gajeran insulin ya ɗan canza shi zuwa tsawan aikin insulin.

Ba abin mamaki ba ne ga marasa lafiya su fara yin insulin gajere, sannan, ba tare da ɗaukar allura daga ƙarƙashin fata ba, suna yin insulin zinc. Ba'a tabbatar dashi a kimiyance ba, koyaya, za'a iya ɗauka cewa tare da irin wannan gabatarwar, cakuda gajeren insulin da siffofin insulin na zinc a cikin fata, kuma wannan ba makawa yana haifar da rikicewar ɓangaren farko.

Don guje wa sakamako mara kyau, yaduwar ikon insulin na ɗan gajeren insulin da zinc insulin an bada shawarar sosai (a cikin nau'ikan injections daban-daban a cikin fagage daban-daban na fata, nisan da ke tsakanin wuraren allura ya kasance aƙalla 1 cm).

Alamu don amfani da dakatarwar protamine-zinc-insulin

Anyi amfani da dakatarwar insulin din ta zinc wacce take amfani da ita don maganin ciwon siga na mellitus na matsakaici da tsauri.

Masu masana'antar insulin na sukari suma suna samarda insulin hade. Irin waɗannan kwayoyi haɗuwa ne na insulin gajeren lokaci da protamine insulin a cikin wani ƙayyadadden rabo (mixtard, actrafan, insuman comb, da sauransu).

Mafi kyawun hadewar tasiri wanda ya ƙunshi 30% gajeren insulin da insulin 70% na insulin ko 25% insulin insulin da 75% na insulin. An nuna rabo daga abubuwan hade a cikin umarnin don amfani.

Irin waɗannan magungunan sun dace da marasa lafiya waɗanda ke bin wani abinci na yau da kullun, suna jagorantar rayuwa mai aiki, da sauransu. (mafi yawa tsofaffi suna ƙauna tare da nau'in ciwon sukari na II).

Koyaya, shirye-shiryen insulin ba su da matsala don sassaucin maganin insulin. Tare da wannan magani, ya zama dole kuma sau da yawa mai yiwuwa ne don canza sashi na gajeren insulin, dangane da abubuwan da ke tattare da carbohydrates a cikin abinci, aikin jiki, da sauransu. Sashi na tsawon lokaci (basal) insulin ya sha bamban.

Sashi da gudanarwa

S / c zurfi (a cikin goshin hannu, a cinya na sama, gindi, ciki), kafin amfani, girgiza kwalban har sai an sami fitowar mai kama da juna, nan da nan tattara kuma shigar da gwargwadon aikin da ya dace, kada a yi tausa wurin.

An saita kashi a tsanake daban-daban (dangane da yawan glucose a cikin jini da nauyin jikin mutum). A cikin adadin yau da kullun fiye da 0.6 U / kg, ya zama dole don gudanar da abubuwa ta hanyar 2 ko fiye da injections a cikin bangarori daban-daban na jiki.

Lokacin canzawa daga injections na tsarkakakken porcine ko insulin na mutum, satin ba ya canzawa, lokacin maye gurbin bovine ko wasu insulin hadewa (lura da glucose na jini ya zama dole), yawanci ana rage shi da kusan 10% (sai dai idan bai wuce 0.6 ba. U / kg). Marasa lafiya da ke karɓar IU 100 ko sama da haka a kowace rana, lokacin da ake maye gurbin insulin, yana da kyau a asibiti.

Kariya da aminci

Daidaita gyaran jiki ya zama dole lokacin da ake canza yanayi da abinci, kara yawan aiki na jiki, cututtukan da ke kama da zazzabi, zazzabi, zawo, gastroparesis da sauran yanayi wadanda ke jinkirta shakar abinci, ayyukan tiyata, dysfunctions na cututtukan thyroid, glandar adrenal (cutar Addison), cututtukan cututtukan ciki (huhu), gazawar koda, ci gaban cututtukan hanta, ciki, shayar da jarirai, a cikin yara da aka zaɓi da masu shekaru fiye da 65 da haihuwa (ƙara haɗarin hauhawar jini).

Rage kashi yayin taron shan sigari mai kaifi, tare da nau'in ciwon sukari na 1 na 1, haɓaka tazara tsakanin gwamnatoci da rage kashi a bangon wakilai waɗanda ke haifar da cutar haɓakawa (haɓaka - tare da alƙawarin magungunan cututtukan zuciya).

Gyara matakan kashi yana yiwuwa a farkon makonni 1-2 bayan maye gurbin nau'in insulin tare da wani. Ana buƙatar yin taka tsantsan a cikin alƙawarin farko, canjin insulin, damuwa ta jiki ko ta tunani a cikin mutanen da ke haɗuwa da tuki, sarrafa abubuwa da sauran ayyukan haɗari waɗanda ke buƙatar ƙara kulawa da saurin halayen psychomotor.

Yayin aikin jiyya, kowane watanni 3 (ko fiye da sau da yawa tare da yanayin rashin daidaito), an ƙaddara yawan yawan glucose a cikin jini kuma, idan ya kasance sama da 11.1 mmol / l, matakin ketones (acetone, keto acid) a cikin fitsari an kiyasta shi. Tare da hypoglycemia da ketoacidosis, ana yin rikodin pH da taro na ion potassium a cikin jijiyoyin jini,