I kēia mau lā, ʻaʻohe maʻi maʻamau ka maʻi diabetes a ʻo nā kumu o kona helehelena ʻaʻole e hūnā ʻia i loko o kahi moena genetic. I nā hihia he nui, hoʻomohala ka maʻi mai ka ʻaoʻao o ke ʻano o kahi ala maʻalahi, ke kū mau nei ka luhi, nā hana ʻino a me ka kīnā ʻole.
Akā i kēlā me kēia pilikia, pono ka maʻi diabetes, ʻo ka neʻe ʻana o kona neʻe ʻana i ke kūkulu ʻana i kahi nui o nā hoʻopiʻi olakino. ʻO kēia mau hopena i ka hana nānā impaired, ʻeha, nā pilikia me ka ʻōnaehana cardiovascular, hypertension, nephropathy a me polyneuropathy.
Inā ʻaʻole hua ka pancreas i ka insulin i ka maʻi maʻi maʻi, a laila hoʻokō ʻia ka hormone hāmeʻa iā ia. ʻO kekahi o nā lāʻau maikaʻi loa mai kēia hui ʻo Insulin R. Akā, pehea ka hopena a pehea e hoʻohana ai?
Rinsulin P: hoʻokuʻu i ka puka a me nā hiʻohiʻona pharmacological
ʻO ka lāʻau lapaʻau ka hana wikiwiki kanaka i loaʻa ma o ka ʻenehana recombinant DNA. Hoʻohālikelike ka mea hana i nā receptors o ka membrane pūnaewele waho, hana i kahi mea hoʻohui i ka insulin-receptor e hoʻoikaika ana i nā kaʻina hana e kū mai ana i loko o nā sela, me ka hoʻokumu ʻana o nā enzyme alakaʻi.
Loaʻa ka emi ʻana o ke kō i ke koko ma o ka hoʻonui ʻana i ka halihali i ka glucose i waenakonu o nā mea i hoʻoweliweli ʻia, a me kona komo ʻana i ka nui o ke kō a me ka ʻimi ʻana ma o nā kiko. ʻO ka Stimulation o glycogenogenesis, puka ʻia ka lipogenesis a me ka pā o ka hana ʻana o ka glucose i ka lime.
Ma ke ʻano he kānāwai, ua hoʻoholo ʻia ka lōʻihi o ka hopena o ka hoʻomākaukau ʻana o ka insulin e ka nui o ka hemo ʻana, e pili ana i kekahi mau kumu (ka wahi a me ke ala o ka hoʻokele ʻana, ka pākī). No laila, ʻokoʻa ka ʻaoʻao o ka hana i kēlā me kēia mea maʻi. Akā, ka mea maoli ma hope o ka hoʻokele subutanutan, hana ʻo Rinsulin P ma hope o ka hapalua hola, a ke loaʻa ka hopena nui ma hope o nā hola 1-3 a kū i ka 8 mau hola.
ʻO GEROFARM-BIO OJSC insulin mea hana o R e hana i ka lāʻau i loko o ʻekolu ʻano:
- ʻO kahi kūmole (10 IU / ml) no ka hōʻemi ʻana i ka 3 ml o ka lāʻau lapaʻau i nā pahu pahu aniani me nā mea hao ʻoi.
- 5 i kahi pahu kāwili i ka pōpō paluhula palapala i hana ʻia me ka foil a me PVC.
- Kahi pahu pahu i hoʻohui ʻia i loko o ka peni syringe peni maha i loaʻa i ka pālani, waiho ʻia i loko o ka pahu pepa.
ʻO ka hoʻopau piha ʻana o ka ea a me ka hoʻomaka ʻana o ka hana a ke kanaka pōkole hana pōkole kanaka e hoʻoholo ʻia e ka ʻina, kahi, i ke ala o ka hoʻokele ʻana a me ka paʻa ʻana o ka waiwai hana. ʻAʻole ia i ka hūnā ʻia i ka lāʻau ma nā kiko āpau; ʻaʻole ia i komo i loko o ka waiū umauma a me ka pāpaʻi placental.
He luku ʻia ia e ka insulinase ma ka ʻōpū a me ka ate. Hoʻopauʻia ka lāʻau lapaʻau ma 30-80% o nā keiki. T1 / 2 mau minuke 2-3.
Nā ʻōkuhi no ka hoʻohana ʻana i ka lāʻau lapaʻau
Hōʻike ʻia ka lāʻau lapaʻau no kēlā me kēia ʻano maʻi mellitus, ma ke ʻano o ke kūpaʻa piha ʻana a i ʻole ʻāpana paha i nā papa hoʻohaʻahaʻa i ke kō. Hoʻohana ʻia nō hoʻi ia i nā kūlana pōpilikia i ka maʻi maʻi ma ka hope o ka decompensation o nā hana o ka hoʻohaʻamaʻa a me ke ʻano o nā maʻi o ka maʻi. Eia naʻe, ʻaʻole i kuhikuhi ʻia ka lāʻau lapaʻau no hypoglycemia a me ka intolerance pilikino i kāna mau ʻāpana.
ʻO ka lāʻau lapaʻau i manaʻo ʻia no iv, v / m, s / c hoʻokō. ʻO ke ala o ka hoʻokele a me ka dosage ua kuhikuhi ʻia e ka endocrinologist ma muli o nā ʻano pilikino o ka mea maʻi. ʻO ka nui maʻamau o ka lāʻau i ka 0.5-1 IU / kg o ka paona.
Hoʻokele ʻia nā lāʻau lapaʻau hana pōkole e 30 mau minuke. ma mua o ka lawe ʻana i ka ʻai momona. Akā ʻo ka mea mua, pono ʻoe e kali a hiki i ke kū ʻana o ke ʻano o ka pohō i ke liʻiliʻi ma ka 15 kiʻekiʻe.
I ka hihia o ka monotherapy, e mālama ʻia ka insulin i 3 a 6 mau manawa i ka lā. Inā ʻoi aku ka nui o nā lā ma kēlā me kēia lā he 0.6 IU / kg, a laila pono ʻoe e komo i ʻelua a i ʻole nā ʻauʻau i nā wahi like ʻole.
E like me ke kānāwai, ua hoʻopaʻa ʻia ka ʻaihue sc i loko o ka paia o ka ʻōpū. Akā hiki i nā kaha kiʻi ke hana i nā poʻohiwi, nā puʻupuʻu a me ka ʻūhā.
Pono kēlā me ke ʻano o ka maʻi injection, e pale i ka nānā ʻana o ka lipodystrophy. I ka hihia o ka / / ka hoʻokele o ka hormone, pono ʻoe e akahele i ka ʻike ʻole ʻana o ka wai i ka moku koko. Eia nō hoʻi, ma hope o ka ʻōlelo ʻana, ʻaʻole hiki ke hele ʻia ka wahi ʻoi.
Ma loko o / a i / m ka lawelawe ʻana i hiki ke waiho wale ʻia ma lalo o ka mākaʻi loea. Hoʻohana wale ʻia nā cartridges inā he aniani ka palahalaha ʻole nā kīnā, no laila, i ka wā e pihi ʻia ai kahi neʻe ʻana, ʻaʻole pāpā ʻia.
He mea kūpono ke hoʻomanaʻo no ka loaʻa ʻana o nā pahu kāwili i kahi mea ʻae ʻole e ʻae ai ke kāwili ʻana i kā lākou ʻike ma nā ʻano like ʻole o ka insulin. Akā me ka hoʻopiha piha ʻana i ka peni ʻo ka syringe hiki iā lākou ke hoʻohana hou ʻia.
Ma hope o ka hoʻopili ʻana, pono e huki ʻia ka pulupulu me kona pāpale waho a hoʻokuʻu ʻia. No laila, ka mea, ke pale aku i ka leakage, hiki ke mālama ʻia ka lewa, a hiki ʻole i ka lewa ke komo i ka pūa pono a lilo i ʻaihue.
Ke hoʻohana ʻia i nā peni syringe piha he nui, ma mua o ka hoʻohana mua ʻana, e kāohi i ka penikala ʻiwikā mai ka pahu friji a kali a loaʻa iā ia ka mahana o ka lumi. Eia nō naʻe, inā ua hoʻokahe a hoʻōla paha ka wai, a laila ʻaʻole hiki ke hoʻohana.
ʻO nā ʻōlelo ʻē aʻe e pono ai e mālama ʻia:
- ʻAʻole hiki ke hoʻopili hou ʻia nā pono.
- ʻO ka insulin R kahi i piha ai ka penikala ʻiwīwī, i hana wale ʻia no ka hoʻohana pilikino, ʻoiai ʻaʻole hiki ke ʻoliʻoli ʻia ka pahu penikala syringe.
- ʻaʻole pono e mālama i ka peni ʻoi i hoʻohana ʻia i loko o ka friji;
- ke pale ʻana i ka peni syringe mai ka malamalama, uhi pono iā ia me kahi pāpale.
ʻO ka lāʻau lapaʻau ua hoʻohana mua ʻia e pono ke mālama ʻia i kahi mahana o 15 i 25 mau degere no ʻaʻole 28 mau lā. Eia nō hoʻi, ʻaʻole ʻoe e ʻae i ka mea e hoʻomehana ai a ʻike ʻia i ka lā kūpono.
I ka hihia o kahi overdose i ke koko, hiki ke hoʻohaʻahaʻa loa i ke kō. Hoʻokomo ʻia ka mālama ʻana o ka hypoglycemia i ka lawe ʻana i nā meaʻai me nā mea i loaʻa mai ka calcium, a i ʻole he mea inu ʻono. No laila, nā maʻi maʻi maʻi mau e pono e loaʻa nā ʻōlima a i ʻole waiʻa me lākou.
Me ka hypoglycemia koʻikoʻi, i ka wā i maopopo ʻole i ka mea maʻi aʻai, ke kī ʻia ʻo ia me ka hopena glucose (40%) a i ʻole glucagon.
Ma hope o ka ʻike hou ʻana o kekahi i ka ʻike, pono iā ia e hānai i ka ʻai me ka ʻai momona, ka mea e pale ai i ka hoʻomohala ʻana i ka lua lua.
Nā pili hewa a me nā hopena pili i ka lāʻau
ʻO nā hopena ʻaoʻao ka pau ʻole o ka metabolism i nā hana kino. No laila, iho mai nā loiloi o nā kauka a me nā mea maʻi i ka mea ma hope o ke alakaʻi ʻana o Rinsulin P, hiki i ka hypoglycemia ke ulu. Hōʻike ʻia kēia e ka malaise, ka ʻāʻī o ka ʻili, ka ʻeha, ka palpitations, ka pā nui, ka pōloli, ka hyperhidrosis, hilahila, a me nā maʻi koʻikoʻi, ulu ka hypoglycemic coma i ka maʻi mellitus.
ʻO nā kūlou kūloko, e like me ka edema o Quincke, rashes ka ʻili, hiki nō hoʻi. Anaphylactic pilau, hiki iā ia ke alakaʻi i ka make, ulu kekahi i kekahi manawa.
Mai nā hopena kūloko, ka holo, ka pupuhi a me ka hyperemia ma kahi o ka injection e hana pinepine ʻia. A i ka ʻike ʻana o ka hoʻomehana insulin o ka lōʻihi, ʻike ʻia ka lipodystrophy ma ka pūnaewele injection.
ʻO nā hua ʻōlelo ʻē aʻe e pili ana i ka huhū a me ka nānā ʻana o ka ʻike. Akā hele pinepine mau mau maʻi i ka wā o ka lapaʻau.
Nui kekahi mau lāʻau lapaʻau e pili ana i ka pono o ka insulin. No laila, ʻōlelo ka loiloi maʻi olakino e ʻoi aku ka hopena o ke kō ʻana mai o ka insulin inā e hui pū ʻia kona hoʻohana ʻana me kēia ʻano:
- nā papa hypoglycemic;
- etanaol;
- ACE / MAO / carbonic anhydrase inhibitors;
- hoʻomākaukau ka lithium;
- ʻaʻole-koho koho β-blockers;
- Fenfluramine;
- Bromocriptine;
- Cyclophosphamide;
- salicylates;
- Mebendazole a keu aku.
ʻO Nikotine, glucagon, phenytoin, somatropin, morphine, estrogens, contraceptives waha, diazoxide a me corticosteroids e hōʻemi i ka hopena hypoglycemic. ʻO nā hormone thyroid e pili ana i ka iodine, CCB, diuretics thiazide, Epinephrine, Clonidine, Heparin, Danazole, antidepressants tricyclic a me ka sympathomimetics e hoʻonāwaliwali i ka hopena hoʻohaʻahaʻa.
ʻO ka hoʻohana ʻana o B-blockers e uhi paha i nā hōʻailona o ka hypoglycemia. Hiki i ka Lanreotide a i ʻole Octreotide a me nā waiʻona ke hoʻonui a hoʻoemi i ka koi o ka insulin.
ʻAʻole kūpono loa e hoʻoneʻeneʻe i ka insulin kanaka me nā lāʻau like ʻole a me nā huahana holoholona.
Nā ʻōlelo kikoʻī
E kū'ē i ka hope o ka lāʻau o ka insulin, he mea nui ia e kiaʻi mau i nā hōʻailona glycemia. ʻOiaʻiʻo, ma kahi o ka overdose, kekahi mau maʻi, ke loli lāʻau, hoʻonui i ka hana kino, ke nānā ʻana, ka loli ma ka wahi ʻomaʻī a hiki i kahi kīʻaha ʻole hiki ke kōkua i ka hoʻohaʻahaʻa ʻana i ke kōpaʻa.
Eia kekahi, ʻo nā hana'ē aʻe i ke keena o ka insulin a me ka hewa hewa e hiki ke hoʻoulu i ka hyperglycemia i nā mea maʻi me ka maʻi type 1. I ka loaʻa ʻole o ka lāʻau, hiki i ka ketoacidosis ka hoʻoweliweli ʻana e ola ai.
Inā he hewa i ka hana o nā keiki, ka ate, ka nui o ka glandida thyroid, hypopituitarism, maʻi a Addison a i ka wā ʻelemakule, pono ia e hoʻoponopono i ka nui o ka insulin. Eia kekahi, pono paha ke hoʻololi i ka dosage i ka wā e hoʻololi ai i ka ʻai a hoʻonui i nā hana kino.
Pono ka hoʻonui ʻana o ka insulin i ka hele ʻana o nā maʻi concomitant, ʻo ia hoʻi nā mea e pili ana i ka maʻi maʻi. He mea koʻikoʻi ia i ka wā o ke kaawale ʻana mai kekahi ʻano o ka insulin i kekahi, pono ʻoe e kiaʻi pono i ke kō o ke koko.
ʻO ke kumu kūʻai o Rinsulin R ma waena o 448 a 1124 mau rubles.
Hoʻopiliʻia ma Insulin P, aia kahi lāʻau Rinsulin NPH. Akā pehea e hiki ai kēia mau kālā?
Rinsulin NPH
ʻO ka lāʻau ʻoi pū kekahi pūnua i loaʻa i loko o ka ʻenehana DNA recombinant. Akā, i nā hoʻohālikelike me Insulin P, ʻaʻohe ia he pōkole, akā kahi hopena awelika. Hiki ke hoʻohui ʻia nā lāʻau ʻelua.
Ma ke kānāwai, ma hope o ka hoʻokele sc, hoʻomaka ka hana o ka insulin i nā hola 1.5. Loaʻa ka hopena maikaʻi loa ma hope o 4-12 mau hola a kū hoʻokahi lā.
ʻO ka pakano he keʻokeʻo keʻokeʻo, a ke kū nei ma lalo o ka pahu, he mau kahi mehameha, aia, i ka wā e hū ʻia, ua hoʻihoʻi ʻia. ʻO ka mea ikaika o ka lāʻau lapaʻau ka insulin-isophan.
Hoʻohana ʻia nā mea kōkua:
- ka wai kai;
- promin sulfate
- sodium hydrogen phosphate dihydrate;
- glycerol;
- metacresol;
- cryst i loko o loko.
Loaʻa ka hoʻokuʻu ʻia i ka pahu pahu pahu o 3 ml i kēlā me kēia, i waiho ʻia i loko o kahi kīʻaha contour pepa. Eia kekahi, hiki ke kūʻai ʻia ka huahana i nā pahu pahu aniani i hoʻokomo ʻia i nā syringes lehulehu-dosis no nā hōkuhi o Rinastra.
ʻO nā lāʻau lapaʻau a me nā hōʻailona no ka hoʻohana ʻana i ka lāʻau lapaʻau like like me ka hihia o ka hoʻohana ʻana o Rinsulin R. ʻO ka nui o ka lāʻau lapaʻau e hoʻoholo ʻia e ke kauka iho.
ʻO ka palena awelika o ka lāʻau lapaʻau he 0.5-1 IU / kg o ka paona. Akā ua contraindicated kahi hoʻokō lōkuhi.
ʻO nā ʻōlelo aʻoaʻo no ka hoʻohana ʻana o Rinsulin NPH e pili ana i nā hopena ʻaoʻao, ka nui o nā hiʻohiʻona a me nā hana o ka hoʻohana ʻana, ʻaʻole i like me ka annotation o nā hana pōkole o ka hana pōkole o ke kanaka.
ʻO ke kumu o ke kauā ʻana mai 417 a 477 mau rubles. ʻO ke wikiō ma kēia ʻatikala e kōkua iā ʻoe e aʻo pehea e lawelawe ai i ka insulin.
