ʻO ka maʻi diabetes mellitus kahi maʻi maʻamau e pono ai ka mālama ola. No laila, i ka maʻi maʻamau o nā maʻi āpau a me nā hihia holomua me ka lua o ka papaʻaina, pono i nā mea maʻi ke hoʻomau mau i ka insulin, e kōkua ana i ka normalize glucose, e hoʻohuli koke iā ia i ka ikehu.
Hoʻohana pinepine ʻia me ka maʻi maʻi maʻi lā, e hoʻohana ʻia ka insulin Aspart. ʻO kēia kahi lāʻau lapaʻau ultrashort.
ʻO ka mea hana he mea hoʻohālikelike o ka insulin o ke kanaka, ka mea i loaʻa e ka ʻenehana DNA recombinant e hoʻohana ana i kahi kānana o Saccharomyces cerevisiae, kahi i hoʻonui ʻia ai ka prolela ma ka kūlana B28 (amino acid) me ka waikawa aspartic. ʻO ka paona molopala he 5825.8.
Ka hoʻonohonoho, hoʻokuʻu i ke ʻano a me ka hopena lāʻau lapaʻau
Hoʻopili nā insulin Biphasic i ka hoʻokaheʻana i ka Aspart a me ka protamine insulin crystalline ma kahi ratio o 30 a 70%.
He kānalua kēia no ka hoʻokele sc, me ka ʻula keʻokeʻo. 1 milliliter i loko o 100 mau pūʻulu, a i hoʻokahi like ʻo ED me ka 35 ofg o ka poulima anhydrous insulin Aspart.
Kūkulu ka inane manuahi kanaka e hoʻopili ai i kahi mea paʻa o ka insulin i ka mea kūpaʻa o ka membrane o nā membrane. Hoʻopili ka hope i ka synthesis o glycogen synthetase, pyruvate kinase a hexokinase enzymes.
ʻO ka emi ʻana o ke kō me ka hoʻonui me ka piʻi o ka halihali intracellular a me ka hoʻomaikaʻi maikaʻi ʻana i ka nui o ka glucose. Loaʻa ia ka hypoglycemia ma ka hoʻohaʻahaʻa ʻana i ka manawa no ka hoʻokuʻu o ka glucose i ka ate, glycogenogenesis a me ka hana o ka lipogenesis.
Loaʻa ka aspart insulin Biphasic ma o nā hana biotechnological i ka wā ua hoʻohālikelike ʻia ka mololi o ka prole o ka hormone e ka aspartic acid. ʻO kēlā mau insulins biphasic he hopena like i ka hemoglobin glycosylated, e like me ka insulin o ke kanaka.
ʻO nā lāʻau ʻelua e hoʻoikaika i ka kūlike molar. Eia naʻe, hana nui ka insulin o ka Aspart ma mua o ka hāmeʻa kanaka soluble. A he crystalline Aspart protamine he hopena o ka lōʻihi waena.
Hana ʻia ka hana ma hope o ka hoʻomalu sc sc o ka lāʻau ma hope o 15 mau minuke. ʻO ka kao kiʻekiʻe loa o ka lāʻau lapaʻau e loaʻa i nā hola 1-4 ma hope o ka loaʻa ʻana. ʻO ka lōʻihi o ka hopena e piʻi i 24 mau hola.
I loko o serum, Cmax o ka insulin he 50% ʻoi aku ma mua o ka hoʻohana ʻana i ka insulin o ka biphasic. Eia kekahi, ʻo ka manawa maʻamau e hōʻea ma Cmax ma mua o ka hapalua.
T1 / 2 - a hiki i nā hola 9, e hōʻike ana i ka helu o ka hoʻoulu ʻana o ka hapa o ka protamine-bound. ʻIke ʻia nā pae insulin baseline i nā hola 15-18 ma hope o ka hoʻokele ʻana.
Akā me ke ʻano type diabetes 2, ʻo ka loaʻa ʻana o Cmax ma kahi o 95 mau minuke. Mālama ia ma ka pae o lalo ma lalo o 14 a ma luna o 0 ka mākaʻi sc. Inā pili paha ke ʻano o ka hoʻokele i kahi pūnaewele o ka absorption.
ʻLoe a me ke kākele
ʻO ka pinepine ka insulin Degludek, ʻo Aspart-insulin e lawelawe ʻia ana i ka subcutaneously. Kahi ʻia ka hana ʻana i kekahi mau wahi o ke kino.
- peke;
- Aapoʻi
- ʻūhā
- ka poʻohiwi.
Pono ʻoe e hana i kahi inikini insulin ma mua o ka ʻai ʻana (ka hana prandial) a i ʻole ma hope o ka ʻai ʻana (ka hana postprandial).
Hoʻoholo ʻia ka algorithm a me ka helu o ka hoʻokele ʻana e ke kauka komo. Akā pinepine ka nui o kēlā me kēia lā o ka lāʻau i ka 0.5-1 UNITS i 1 kg o ka paona.
I nā pilikia koʻikoʻi, e lawelawe ka insulin Aspart biphasic iv. Hoʻoholo ʻia ke kaʻina hana me nā ʻōnaehana infusion i kahi hoʻonohonoho outpatient a inpatient paha.
ʻO nā hopena ʻino, contraindications a me ka overdose
Hiki i ka hoʻohana ʻana o ka insulin Asparta ke hoʻopilikia i ka hana a ka National Assembly, ʻoiai ka wikiwiki koke o ka nui o nā sugar sugar i kekahi manawa e hoʻonāukiuki i ka neuropathy ʻeha. Eia naʻe, ua hala kēia kūlana i ka manawa.
Eia pū kekahi, ʻo ka biphasic insulin e alakaʻi i ke ʻano o ka lipodystrophy i ka wahi o ka injection. Ma ka ʻāpana o nā hui sensory, ʻike ʻia ka ʻike ʻana o ka ʻike maka a me nā glitches i ka hoʻokaʻina ʻana.
ʻO nā contraindlence kekahi kūloko pilikino i nā māhele o ka lāʻau a me ka hypoglycemia.
Eia kekahi, ʻaʻole pono ka hoʻohana ʻana o Insulin Aspart a hiki i ka makahiki 18. No ka mea ʻaʻohe ʻikepili data e hōʻoia ana i ka pono a me ka palekana o ka lāʻau lapaʻau no ka mea hou mai.
Ma kahi o kahi overdose, loaʻa nā hōʻailona like ʻole:
- nahoa
- kahi emi nui o ka glucose;
- piko comog hypoglycemic i ka maʻi diabetes.
Me ka hapa iki o ka hopena, e hoʻomaʻamaʻa i ke kukuna o ka glucose, ua lawa ia e lawe i nā kīmaki wikiwiki a inu paha i kahi mea momona. Hiki iā ʻoe ke komo i ka glucagon subcutaneously a i ʻole intramuscularly a i ʻole he hopena no ka dextrose (iv).
I ka hihia o kahi comog hypoglycemic, mai 20 a 100 ml o ka dextrose (40%) ua hopu ʻia e kahi ala jet-intravenous a hiki i ke ʻano o ka maʻi o ka maʻi. I mea e pale ai i ka hoʻomohala ʻana o ia mau hihia, ʻoi aku ka nui o ka lilo ʻana o ke kalaiwa momona.
Hoʻopili ʻia me nā lāʻau lapaʻau a me nā ʻōlelo kūikawā
Hiki ke hoʻonui ʻia ka hopena hypoglycemic inā ka hui pū ʻana o ka insulin biphasic me ka hoʻoponopono waha ma loko o nā lāʻau lapaʻau e hiki mai ana:
- nā mea inu olakino a me ka hypoglycemic lāʻau;
- Hoʻomoʻa MAO / carbonic anhydrase / ACE inhibitors;
- Fenfluramine;
- Bromocriptine;
- Cyclophosphamide;
- somatostatin analogues;
- Theophylline;
- Sulfonamides;
- Pyridoxine;
- ʻO nā mea maʻi anabolic.
ʻO ka hoʻohana ʻana o tetracyclines, Mebendazole, Dizopyramide, Ketonazole, Fluoxetine a me Fibrates e alakaʻi ana i kahi hoʻoilo nui i ke kō. A me nā antidepresan tricyclic, contraceptives waha, nikotine, sympathomimetics, glucocorticosteroids, thiazide diuretics, thyroid hormones a me nā lāʻau lapaʻau hou i nā nāwaliwali o ka hopena hypoglycemic.
Hiki i kekahi mau lāʻau ke hoʻonui a hoʻoemi i nā kiʻekiʻe o ka kō. Hoʻopili kēia ma ka hoʻomākaukau o ka lithium, nā beta-blockers, salicylates, clonidine a me ka reserpine.
He mea pono ia e mālama pono ʻo ka Flekspen i hoʻohana ʻia i ka pā lumi, a me kahi peniʻi hou i loko o ka friji. Ma mua o ka hoʻokele ʻana, pono e hoʻopili pono ʻia nā ʻike o ke kīʻaha.
Me ka nui o nā hana kino, maʻi a hoʻoulu ʻia paha, he nui ka hoʻonui ʻana o ka nui o ka insulin. A ma ka hoʻomaka ʻana o ke ʻano, ʻaʻole ia e kuhikuhi ʻia e hoʻomalu i nā mīkini me nā kaʻa. ʻO ke wikiō i kēia ʻatikala e ʻōlelo hou e pili ana i ka hormone.
