Tšoaetso ea litokisetso tsa insulin

Insulin ke sethethefatsi se theolelang tsoekere ka ho khetheha, se na le matla a ho laola metabolism ea carbohydrate, e ntlafatsa tsoekere ea tsoekere ka lithane mme e khothalletsa phetoho ea eona ho glycogen, hape e thusa ho kenella ha tsoekere ho lisele tsa lisele.

Ntle le phello ea hypoglycemic (ho fokotsa tsoekere ea mali), insulin e na le litlamorao tse ling: e eketsa mabenkele a mesifa a glycogen, e tsosa peptide, e fokotsa tšebeliso ea protheine, jj.

Ho pepesehela insulin ho tsamaisana le ho hlohlelletsa kapa ho thijoa (khatello) ea li-enzyme tse ling, glycogen synthetase, pyruvate dehydrogenase, hexokinase ea tsosoa, lipase le ts'ebetso ea mafura acid ea li-adipose tis, lipoprotein lipase, e fokotsang mali ka mor'a lijo tse nang le mafura a mangata.

Tekanyo ea "biosynthesis" le secretion (secretion) ea "insulin" e ipapisitse le phallo ea tsoekere maling. Ka keketseho ea litaba tsa eona, secretion ea insulin ke manyeme e ea eketseha, ka lehlakoreng le leng, ho fokotseha ha khatello ea "glucose" maling ho fokotsa sekhahla sa insulin.

Insulin ke eona kalafo e ikhethang bakeng sa lefu la tsoekere, hobane e fokotsa hyperglycemia (ho eketseha ha tsoekere maling) le glycosuria (ho ba teng ha tsoekere ka har'a moroto), ho khutlisa depo ea glycogen ka har'a sebete le mesifa, e fokotsa ho etsoa ha tsoekere, hape e fokotsa phapang ea lefu la tsoekere maling (ho ba teng ha mafura maling). e ntlafatsa boemo bo akaretsang ba mokuli.

Insulin bakeng sa ts'ebeliso ea bongaka e fumanoa ho manyeme a likhomo le likolobe. Ho na le mokhoa oa motsoako oa lik'hemik'hale oa insulin, empa ha o khonehe. Morao tjena ho qapiloe mekhoa ea biotechnological bakeng sa ho hlahisa insulin ea motho. Insulin e fumanoeng ke boenjiniere ba liphatsa tsa lefutso e lumellana ka botlalo le letoto la amino acid ea insulin ea motho.

Maemong moo insulin e fumanoang ho manyeme a liphoofolo, litšila tse fapaneng (li-proinsulin, glucagon, self-statin, liprotheine, polypeptides, jj) li ka ba teng tokisetsong ka lebaka la tlhoekiso e sa lekanang. Litokisetso tsa insulin tse hloekisitsoeng hampe li ka baka karabelo e fapaneng.

Mekhoa ea sejoale-joale e etsa hore ho khonehe ho fumana tlhoekiso (monopic - chromatographic e hloekisitsoeng ka "top" ea insulin), e hloekisitsoeng haholo (monocomponent) le litokisetso tsa insulin. Hona joale, insulin ea insulin ea motho e ntse e sebelisoa le ho feta. Bakeng sa litokisetso tsa insulin tsa tlhaho ea liphoofolo, khetho e fanoa ho insulin e fumanoang mokhoapong oa likolobe.

Ts'ebetso ea "insulin" e khetholloa ka biologic (ka bokhoni ba ho theola tsoekere ea mali ho mebutlanyana e phetseng hantle) le ka e 'ngoe ea mekhoa ea fisiks (electrophoresis e pampiring kapa chromatography pampiring). Bakeng sa yuniti e le 'ngoe ea ts'ebetso (UNIT), kapa yuniti ea machabeng (IE), nka ts'ebetso ea 0404082 mg ea crystalline insulin.

Mokhoa oa Tiriso:

Ha ho phekoloa lefu la tsoekere, ho sebelisoa litokisetso tsa insulin tsa linako tse fapaneng tsa tšebetso (bona ka tlase).

Insulin e sebetsang ka nako e khuts'oane e sebelisoa le lits'ebetsong tse ling tsa pathological: ho baka boemo ba hypoglycemic (ho theola tsoekere ea mali) ka mekhoa e meng ea schizophrenia, joalo ka anabolic (e ntlafatsa tlhahiso ea protheine) ka mokhathala o akaretsang, khaello ea phepo e nepahetseng, furunculosis (ho hloekisoa hoa letlalo ka makhetlo a mangata) , thyrotoxicosis (lefu la qoqotho), le mafu a ka mpeng (atony / ho fokotseha ha molumo /, gastroptosis / prolfall ea mala /), hepatitis e sa foleng (ho ruruha ha lisele tsa sebete), nyh mefuta e meng ea ho thatafala ha sebete sebete, hammoho le motsoako o "polarizing" ditharollo sebelisoa ho tsoara hlobaetsang gogoga insufficiency (mismatch pakeng tlhokeho cardiac oksijene le pelehi lona).

Khetho ea insulin bakeng sa kalafo ea lefu la tsoekere e itšetlehile ka ho teba le litšobotsi tsa nako ea lefu lena, boemo bo akaretsang ba mokuli, hammoho le lebelo la ho qala le nako ea phello ea moriana. Morero oa mantlha oa insulin le ho theha litekanyetso li etsoa ka mokhoa o khethehileng sepetlele (sepetlele).

Litokisetso tsa insulin tse nkang nakoana ke tharollo e etselitsoeng tsamaiso e poteletseng kapa ea methapo. Haeba ho hlokahala, e boetse e tsamaisoa ka matla. Li na le phello e potlakileng le e khuts'oanyane ea ho fokotsa tsoekere. Hangata li fanoa ka mokhoa o sa ts'oaneng kapa ka mokhoa o ts'oaroang ka metsotso e 15-20 pele ho lijo ho tloha ho le leng ho ea ho makhetlo a 'maloa ka nako ea letsatsi. Tšusumetso kamora hore ente ea subcutaneous e hlahe kamora metsotso e 15-20, e fihlella ka mora lihora tse peli, nako eohle ea ts'ebetso ha e fetelle lihora tse 6. Ba sebelisoa haholo sepetlele ho theha tekanyetso e hlokahalang ea insulin bakeng sa mokuli, hammoho le maemong ao ho hlokahalang ho fihlella ka potlako liphetoho mosebetsing oa insulin 'meleng - o na le lefu la tsoekere le precom (ho lahleheloa ke kelello ka botlalo kapa ho sa utloahaleng ka lebaka la keketseho e tšohanyetso ea tsoekere ea mali).

Ntle le tog 9, litokisetso tsa insulin tse haufinyane li sebelisoa e le moemeli oa anabolic mme li laetsoe, e le molao, ka litekanyetso tse nyane (likarolo tsa 4-8 makhetlo a 1-2 ka letsatsi).

Litokisetso tsa insulin tsa nako e telele (ea nako e telele) li fumaneha ka mefuta e fapaneng ea litekanyetso ka linako tse fapaneng tsa phello e fokotsang tsoekere (semylong, nako e telele, Ultralong). Bakeng sa lithethefatsi tse fapaneng, phello e nka lihora tse 10 ho isa ho tse 36. Ka lebaka la lithethefatsi tsena, palo ea liente tsa letsatsi le letsatsi e ka fokotsoa. Hangata li hlahisoa ka mokhoa oa ho emisa (ho emisoa ha likaroloana tse thata tsa moriana ka mokelikeli), ho tsamaisoa feela ka mokhoa o ikhethileng kapa ka methapo, tsamaiso ea methapo ha e lumelloe. Maemong a ho ba le lefu la tsoekere le maemo a matle, lithethefatsi tse telele ha li sebelisoe.

Ha u khetha ho hlophisoa ha insulin, ho hlokahala ho etsa bonnete ba hore nako ea ho fokotsa tsoekere e ngata e tsamaisana le nako eo u e jang. Ha ho hlokahala, lithethefatsi tse peli tsa ketso ea nako e telele li ka tsamaisoa ka seropeng se le seng. Bakuli ba bang ha ba hloke nako e telele feela, empa hape le boemo bo potlakileng ba tsoekere ea mali. Ba tlameha ho fana ka litokisetso tsa insulin tsa nako e telele le tse liehang ho sebetsa.

Ka tloaelo, lithethefatsi tse sebetseng ka nako e telele li fanoa pele ho lijo tsa hoseng, empa haeba ho hlokahala, ente e ka etsoa ka lihora tse ling.

Litokisetso tsohle tsa insulin li sebelisoa ho latela mokhoa oa ho latela lijo. Tlhaloso ea boleng ba matla (ho tloha 1700 ho isa ho 3000 khal) e lokela ho khethoa ke boima ba 'mele oa mokuli nakong ea kalafo, ka mofuta oa ketsahalo. Kahoo, ka ho fokotseha hoa phepo e nepahetseng le mosebetsi o boima oa 'mele, palo ea lik'hilojule tse hlokahalang ka letsatsi bakeng sa mokuli li bonyane 3000, ka phepo e nepahetseng le mokhoa oa bophelo oa ho lula, ha oa lokela ho feta 2000.

Ho kenyelletsa tekanyetso e phahameng haholo, hammoho le khaello ea lik'habohaedreite ka lijo, ho ka baka boemo ba hypoglycemic (ho theola tsoekere ea mali), ho tsamaisana le maikutlo a tlala, bofokoli, ho fufuleloa, ho thothomela hoa mmele, hlooho e bohloko, ho tsekela, ho hlonama, ho hlasimoloha. . Kamora moo, ho ba le komello ea hypoglycemic e ka ba teng (ho felloa ke kelello, ho tšoauoa ka ho se sebetse hantle hoa 'mele ho susumetso ea kantle ka lebaka la ho fokotseha ho matla hoa tsoekere ea mali) ka ho lahleheloa ke kelello, ho tsitsipana le ho fokotseha ho hoholo hoa ketsahalo ea pelo. Ho thibela boemo ba hypoglycemic, bakuli ba hloka ho noa tee e tsoekere kapa ho ja likotoana tsa tsoekere.

Ka coma ea hypoglycemic (e amanang le ho fokotseha ha tsoekere ea mali), tharollo ea tsoekere ea 40% e kenngoa mothapong ka bongata ba 10-40 ml, ka linako tse ling ho fihla ho 100 ml, empa ha e sa le eo.

Khalemelo ea hypoglycemia (ho theola tsoekere ea mali) ka mokhoa o thata e ka etsoa ka ts'ebetso ea methapo ea methapo kapa tsamaiso ea "glucagon".

Liketsahalo tse sa thabiseng:

Ka tsamaiso e poteletseng ea litokisetso tsa insulin, lipodystrophy (ho fokotseha hoa tekanyo ea lisele tsa adipose liseleng tse kenang ka tlase) li ka hlaha sebakeng sa ente.

Litokisetso tsa mehleng ea kajeno tsa insulin tse hloekisitsoeng haholo ha li bake lintho tse ngata, leha ho le joalo, linyeoe tse joalo ha li qheleloe ka thoko. Nts'etsopele ea karohano e matla ea ho kulisa e hloka ho hloloheloa hang-hang (ho thibela kapa ho thibela ho tsilatsila) kalafo le ho khutlisetsa lithethefatsi.

Contraindication:

Litlamorao mabapi le ts'ebeliso ea insulin ke maloetse a etsahalang ka hypoglycemia, hepatitis e hlobaetsang, cirrhosis, hemolytic jaundice (ho soeufala ha letlalo le liphihlelo tsa mucous tsa mahlo tse bakoang ke ho phatloha ha lisele tse khubelu tsa mali), pancreatitis (ho ruruha ha manyeme) lefu la liphio le amanang le ho holofala ha protheine / amyloid metabolism), urolithiasis, mala le mala a duodenal, mathata a pelo a fokotsoang (ho nyekeloa ke pelo ka lebaka la ho hloleha ha pelo mafu a li-valve tsa hae).

Ho hlokahala tlhokomeliso e kholo kalafong ea bakuli ba nang le lefu la tsoekere la mellitus, ba nang le bothata ba ho fokola (ho se sebe hantle pakeng tsa tlhoko ea pelo le oksijene) le boko bo sa sebetseng | phallo ea mali. Ho hlokahala hore u be hlokolosi ha u sebelisa insulin! ho bakuli ba nang le lefu la qoqotho.

Motsoako oa "insulin" oa moimana o lokela ho hlahlojoa ka hloko. Nakong ea trimester ea pele ea bokhachane, tlhoko ea insulin hangata e fokotseha hanyane mme e eketseha ka trimesters ea bobeli le ea boraro.

Al-adrenergic blockers le beta-adrenostimulants, li-tetracyclines, li-salicylates li eketsa secretion ea endo native (excretion ea 'mele e thehiloeng) insulin. Thiazide diupetics (diuretics), beta-blockers, joala bo ka lebisa ho hypoglycemia.

Maemo a polokelo:

Boloka ka mocheso ho tloha +2 ho isa + 10 * C. Ho bata hoa lithethefatsi ha hoa lumelloa.

Depo-N-insulin, Isofaninsulin, Iletin I, Insulinatard, Insulin B, Insulin-B SC, Insulin BP, Insulin M, Insulin Actrapid MS, Insulin Actrapid FM, Insulin Actrapid FM Penfill, Insulin Velosulin, Insulin Tape, Insulin Tape, Insulin Tape, Insulin Tape, Insulin Tape Insulin teipi ea 'mele ea "insulin" Insulong, Insulrap GP , Insulrap R, Insulrap SPP, Insuman basal, Insuman comb, Insuman kapele, Insuman ka potlako bakeng sa optipena, Comb-N-insulin Hoechst, Tape ilethin I, Tape ilethin II, Monosuinsulin, N-Insulin Hoechst, N-Insulin Hoehst 100 Iletin I, NPH Iletin II, Iletin I ea kamehla, Iletin II ea kamehla, Suinsulin, Homorap-100, Homofan 100, Humulin L, Humulin Mi, Humulin Mj, Humulin Mz, Humulin M4, Humulin N, Humulin NPH, Humulin R Humulin S, hempe ea Humulin, Humulin khafetsa, Humulin ultralente.

1 ml ea tharollo kapa ho emisoa hangata e na le likarolo tsa 40.

Ho latela mehloli ea tlhahiso, insulin e arohantsoe le manyeme a liphoofolo ebile e entsoe ka mekhoa ea boenjiniere ba liphatsa tsa lefutso. Ho latela tekanyo ea tlhoekiso, litokisetso tsa "insulin" tse tsoang liphoofolong tsa liphoofolo li arotsoe ka monopic (MP) le monocomponent (MK). Hajoale e fumanoe ho li-pancreas tsa likolobe, li hlophisitsoe ka mokhoa o fapaneng le lengolo C (SMP - pork monopic, SMK - monocomponent ea nama ea khomo), likhomo - lengolo G (beef: GMP - beef monopick, GMK - beef monocomponent). Litokisetso tsa insulin ea motho li bontšoa ke lengolo la C.

Ho ipapisitse le hore na u nka nako e kae, li-insulin li arotsoe ka:

a) litokisetso tsa insulin tse haufinyane: ho qala hoa ts'ebetso kamora metsotso e 15-30, ketso e phahameng ka mora lihora tse 1 / 2-2, nako eohle ea tšebetso lihora tse 4,6,

b) litokisetso tsa insulin tsa nako e telele li kenyelletsa lithethefatsi tsa nako e mahareng (ho qala kamora lihora tse 1 / 2-2, tlhoro kamora lihora tse 3-12, nako e telele ea lihora tse 8-12), lithethefatsi tse nkileng nako e telele (ho qala kamora lihora tse 4-8, tlhoro kamora lihora tse 8-18, nako eohle ea lihora tse 20-30.

Litokisetso tsa ketso e ts'oanang:

Haeba u na le boiphihlelo ba ho fana ka moriana ona ho bakuli ba hau - arolelana sephetho (tlohela maikutlo)! Na moriana ona o thusitse mokuli, na ho bile le litla-morao life nakong ea kalafo? Phihlelo ea hau e tla khahla basebetsi-'moho le uena hammoho le bakuli.

Haeba moriana ona o ne o reretsoe meriana ena 'me u bile le tlhahlobo ea kalafo, mpolelle hore na e ea sebetsa (hore na ea thusa), ho na le litlamorao, tseo u li ratang / tseo u sa li rateng. Batho ba likete ba batla tlhahlobo ea marang-rang ea meriana e fapa-fapaneng. Empa ke ba fokolang feela ba ba siileng. Haeba uena ka bouena u sa tlohele maikutlo ka taba ena - ba bang kaofela ha ba na seo ba ka se balang.

Lebitso: Insulin

Matšoao a sebeliso:
Letšoao le ka sehloohong bakeng sa ts'ebeliso ea insulin ke mofuta oa lefu la tsoekere la mellitus (le itšetlehileng ka insulin), empa tlasa maemo a mang le lona le fuoe mofuta oa lefu la tsoekere la II mellitus (le sa ts'epeng insulin.

Ketso ea pharmacological:
Insulin ke sethethefatsi se theolelang tsoekere ka ho khetheha, se na le matla a ho laola metabolism ea carbohydrate, e ntlafatsa tsoekere ea tsoekere ka lithane mme e khothalletsa phetoho ea eona ho glycogen, hape e thusa ho kenella ha tsoekere ho lisele tsa lisele.
Ntle le phello ea hypoglycemic (ho fokotsa tsoekere ea mali), insulin e na le litlamorao tse ling: e eketsa mabenkele a mesifa a glycogen, e tsosa peptide, e fokotsa tšebeliso ea protheine, jj.
Ho pepesehela insulin ho tsamaisana le ho hlohlelletsa kapa ho thibela (khatello) ea li-enzyme tse itseng, glycogen synthetase, pyruvate dehydrogenase, hexokinase ea tsosoa, lipase le ho kenya li-acids acid tsa lipoprotein lipase, tse fokotsang "haze" ea serum ea mali kamora ho ja mafura.
Tekanyo ea "biosynthesis" le secretion (secretion) ea "insulin" e ipapisitse le phallo ea tsoekere maling. Ka keketseho ea litaba tsa eona, secretion ea insulin ke manyeme e ea eketseha, ka lehlakoreng le leng, phokotso ea khatello ea tsoekere maling e fokotsa sekhahla sa insulin.
Ts'ebetsong ea litlamorao tsa insulin, karolo e etelletseng pele e bapaloa ke ho sebelisana ha eona le receptor e ikhethang e fumanehang kahara membrane ea sele, le ho etsoa ha mochini oa "insulin". Receptor ea insulin hammoho le insulin e kenella ka seleng, moo e amang phosphlication ea liprotheine tsa cellular, karabelo e eketsehileng ea Intracellular ha e utloisisehe ka botlalo.
Insulin ke eona kalafo e ikhethang bakeng sa lefu la tsoekere, hobane e fokotsa hyperglycemia (keketseho ea tsoekere ea mali) le glycosuria (ho ba teng ha tsoekere ka har'a moroto), e khutlisa depo ea glycogen ka har'a sebete le mesifa, e fokotsa tlhahiso ea glucose, hape e fokotsa lefu la tsoekere maling (ho ba teng ha mafura maling). , e ntlafatsa boemo bo akaretsang ba mokuli.
Insulin bakeng sa ts'ebeliso ea bongaka e fumanoa ho manyeme a likhomo le likolobe. Ho na le mokhoa oa motsoako oa lik'hemik'hale oa insulin, empa ha o khonehe. Lilemong tsa morao tjena, ho hlahisitsoe mekhoa ea biotechnological ea ho hlahisa insulin ea motho. Insulin e fumanoeng ke boenjiniere ba liphatsa tsa lefutso e lumellana ka botlalo le letoto la amino acid ea insulin ea motho.
Maemong moo insulin e fumanoang ho manyeme a liphoofolo, litšila tse fapaneng (li-proinsulin, glucagon, selfin, protheine, polypeptides, jj) li ka ba teng sehlahisong ka lebaka la tlhoekiso e sa lekanang. Lihlahisoa tsa insulin tse hloekisitsoeng hampe li ka baka karabelo e fapaneng.
Mekhoa ea sejoale-joale e etsa hore ho khonehe ho fumana tlhoekiso (monopic - chromatographic e hloekisitsoeng ka tokollo ea "tlhoro" ea insulin), e hloekisitsoeng haholo (monocomponent) le lihlahisoa tsa insulin. Hona joale, insulin ea insulin ea motho e ntse e sebelisoa le ho feta. Bakeng sa lihlahisoa tsa insulin tsa tlhaho ea liphoofolo, khetho e fanoa ho insulin e fumanoang ho makhopho a likolobe.
Ts'ebetso ea "insulin" e khetholloa ka biologic (ka bokhoni ba ho theola tsoekere ea mali ho mebutlanyana e phetseng hantle) le ka e 'ngoe ea mekhoa ea fisiks (electrophoresis e pampiring kapa chromatography pampiring). Bakeng sa yuniti e le 'ngoe ea ts'ebetso (UNIT), kapa yuniti ea machabeng (IE), nka ts'ebetso ea 0404082 mg ea crystalline insulin.

Tekanyetso le ts'ebetso ea "insulin"
Ha ho phekoloa lefu la tsoekere, ho sebelisoa lihlahisoa tsa insulin tsa linako tse fapaneng tsa tšebetso (bona ka tlase).
Insulin e sebetsang ka nako e khuts'oane e sebelisoa le lits'ebetsong tse ling tse 'maloa tsa pathological: ho baka boemo ba hypoglycemic (ho theola tsoekere ea mali) ka mekhoa e meng ea schizophrenia, e le anabolic (e matlafatsang synthetiki) lithethefatsi ka ho tepella ka kakaretso, khaello ea phepo e nepahetseng, furunculosis (ho hloekisoa hoa letlalo ka makhetlo a mangata) ), thyrotoxicosis (lefu la qoqotho), le mafu a ka mpeng (atony / ho fokotseha ha molumo /, gastroptosis / prolfall ea mala /), hepatitis e sa foleng (ho ruruha ha lisele tsa sebete), Mefuta e sa laoleheng ea cirrhosis ea sebete, hammoho le karolo ea tharollo ea "polarizing" e sebelisetsoang ho phekola ho haella ha pelo (ho se sebe hantle pakeng tsa tlhokeho ea oksijene ea pelo le ho tsamaisoa ha eona).
Khetho ea insulin bakeng sa kalafo ea lefu la tsoekere e itšetlehile ka ho teba le litšobotsi tsa nako ea lefu lena, boemo bo akaretsang ba mokuli, hammoho le lebelo la ho qala le nako ea phello ea tlhahiso ea tsoekere. Morero oa mantlha oa insulin le ho theha litekanyetso li etsoa ka mokhoa o khethehileng sepetlele (sepetlele).
Litokisetso tsa insulin tse nkang nakoana ke tharollo e etselitsoeng tsamaiso e poteletseng kapa ea methapo. Haeba ho hlokahala, e boetse e tsamaisoa ka matla. Li na le phello e potlakileng le e khuts'oanyane ea ho fokotsa tsoekere. Hangata li fanoa ka mokhoa o sa ts'oaneng kapa ka mokhoa o ts'oaroang ka metsotso e 15-20 pele ho lijo ho tloha ho le leng ho ea ho makhetlo a 'maloa ho pholletsa le letsatsi. Tšusumetso kamora hore ente ea subcutaneous e hlahe kamora metsotso e 15- 20, e fihla hofeta kamora lihora tse peli, nako eohle ea ts'ebetso ha e fetelle lihora tse 6. Ba sebelisoa haholo sepetlele ho theha tekanyetso e hlokahalang ea insulin bakeng sa mokuli, le maemong ao ha ho hlokahala ho fihlella ka potlako liphetoho mosebetsing oa insulin 'meleng - o na le lefu la tsoekere le precom (ho lahleheloa ke kelello ka botlalo kapa ho sa utloahaleng ka lebaka la keketseho e tšohanyetso ea tsoekere ea mali).
Ntle le tog 9, lihlahisoa tsa insulin tse nkang nakoana li sebelisoa e le moemeli oa anabolic mme li laetsoe, e le molao, ka litekanyetso tse nyane (likarolo tse 4-8 makhetlo a 1-2 ka letsatsi).
Litokisetso tsa insulin tsa nako e telele (ea nako e telele) li fumaneha ka mefuta e fapaneng ea litekanyetso ka linako tse fapaneng tsa phello e fokotsang tsoekere (semylong, nako e telele, Ultralong). Bakeng sa lihlahisoa tse fapaneng, phello e nka lihora tse 10 ho isa ho tse 36. Ka lebaka la lihlahisoa tsena, palo ea liente tsa letsatsi le letsatsi e ka fokotsoa. Hangata li hlahisoa ka mokhoa oa ho emisa (ho emisoa ha likarolo tse tiileng tsa sehlahisoa ka mokelikeli), ho tsamaisoa feela ka mokhoa o ikhethileng kapa ka mokhoa oa intramuscularly, intravenous management ha e lumelloe. Maemong a ho ba le lefu la tsoekere le maemo a matle, lihlahisoa tse telele ha li sebelisoe.
Ha u khetha sehlahisoa sa insulin, ho hlokahala ho etsa bonnete ba hore nako ea ho fokotsa tsoekere e ngata e tsamaisana le nako eo u e ngolang. Ha ho hlokahala, lihlahisoa tse peli tsa ts'ebetso ea nako e telele li ka tsamaisoa ka syringe e le 'ngoe. Bakuli ba bang ha ba hloke nako e telele feela, empa hape le boemo bo potlakileng ba tsoekere ea mali. Ba tlameha ho fana ka lihlahisoa tsa insulin tse nkang nako e telele le tse bokhutšoanyane.
Hangata, lihlahisoa tse lokolloang nako e telele li fanoa pele ho lijo tsa hoseng, empa haeba ho hlokahala, ente e ka fanoa ka linako tse ling.
Lihlahisoa tsohle tsa insulin li sebelisoa haeba tlhoko ea lijo e khotsofatsoa. Tlhaloso ea boleng ba matla (ho tloha 1700 ho isa ho 3000 khal) e lokela ho khethoa ke boima ba 'mele ba mokuli nakong ea kalafo, ka mofuta oa ketsahalo. Kahoo, ka phepo e fokolang le ho ikoetlisa ka thata, palo ea lik'hilojule tse hlokahalang ka letsatsi bakeng sa mokuli li bonyane 3000, ka phepo e nepahetseng le bophelo ba ho lula fatše, ha boa lokela ho feta 2000.
Ho hlahisoa ha tekanyetso e kholo haholo, hammoho le khaello ea lik'habohaedreite ka lijo, ho ka baka boemo ba hypoglycemic (ho theola tsoekere ea mali), ho tsamaisana le maikutlo a tlala, bofokoli, ho fufuleloa, ho thothomela hoa 'mele, hlooho ea hlooho, ho tsekela, ho hlapoloha, ho hlasimoloha. Ho coma e latelang ea hypoglycemic coma e ka ba le (ho lahleheloa ke kelello, ho khetholloang ka ho se sebetse hantle hoa 'mele ho susumetso ea kantle ka lebaka la ho fokotseha ho matla hoa tsoekere ea mali) ka ho lahleheloa ke letsoalo, ho tsitsinyeha le ho fokotseha ho hoholo hoa ketsahalo ea pelo. Ho thibela boemo ba hypoglycemic, bakuli ba hloka ho noa tee e tsoekere kapa ho ja likotoana tsa tsoekere.
Ka coma ea hypoglycemic (e amanang le ho fokotseha ha tsoekere ea mali), tharollo ea tsoekere ea 40% e kenngoa mothapong ka bongata ba 10-40 ml, ka linako tse ling ho fihla ho 100 ml, empa ha e sa le eo.
Khalemelo ea hypoglycemia (ho theola tsoekere ea mali) ka mokhoa o thata e ka etsoa ka ts'ebetso ea methapo ea methapo kapa tsamaiso ea "glucagon".

Litšebeliso tsa insulin:
Litlamorao mabapi le ts'ebeliso ea insulin ke mafu a etsahalang ka hypoglycemia, hepatitis e hlobaetsang, cirrhosis, hemolytic jaundice (ho soeufala ha letlalo le liphihlelo tsa mucous tsa mahlo tse bakoang ke ho phatloha ha lisele tse khubelu tsa mali), pancreatitis (ho ruruha ha manyeme) lefu la liphio le amanang le ho holofala ha protheine / amyloid metabolism), urolithiasis, mala le mala a duodenal, likotsi tse tsoang pelong tsa pelo (ho hloleha ha pelo ka lebaka la tsitiso legumi tsa li-valve tsa eona).
Ho hlokahala tlhokomeliso e kholo kalafong ea bakuli ba nang le lefu la tsoekere la mellitus, ba nang le bothata ba ho fokola (ho se sebe hantle pakeng tsa tlhokeho ea oksijene pelong le ho tsamaisoa ha eona) le boko bo sa sebetseng | phallo ea mali. Ho hlokahala tlhokomeliso ha u sebelisa insulin! ho bakuli ba nang le lefu la qoqotho, lefu la Addison (ts'ebetso e sa lekaneng ea adrenal), ho hloleha ha methapo.
Phekolo ea "insulin" ea moimana e lokela ho etsoa> e behiloe leihlo le haufi. Nakong ea trimester ea pele ea bokhachane, tlhoko ea insulin hangata e fokotseha hanyane mme e eketseha ka trimesters ea bobeli le ea boraro.
Al-adrenergic blockers le beta-adrenostimulants, li-tetracyclines, li-salicylates li eketsa secretion ea endo native (excretion ea 'mele e thehiloeng) insulin. Thiazide diupetics (diuretics), beta-blockers, joala bo ka lebisa ho hypoglycemia.

Litla-morao tsa Insulin:
Ka tsamaiso e poteletseng ea lihlahisoa tsa insulin, lipodystrophy (ho fokotseha ha molumo oa lisele tsa adipose liseleng tse ka tlasana) li ka hlaha sebakeng sa ente.
Lihlahisoa tsa insulin tsa bohloeki ba boleng bo holimo ka seoelo li baka lintho tse kulang, leha ho le joalo, linyeoe tse joalo ha li qheleloe ka thoko. Nts'etsopele ea karohano e matla ea ho kulisa e hloka ho hloloheloa hang-hang (ho thibela kapa ho thibela ho tsilatsila) kalafo le phetoho ea sehlahisoa.

Foromo ea tokollo:
Syringe insulin e fumaneha ho | khalase ea khalase e ts'oaroe ka litlamorao tsa rabara tse nang le alamoum break-in.

Synonyms:
Depo-N-insulin, Isofaninsulin, Iletin I, Insulinatard, Insulin B, Insulin-B SC, Insulin BP, Insulin M, Insulin Actrapid MS, Insulin Actrapid FM, Insulin Actrapid FM Penfill, Insulin Velosulin, Insulin Tape, Insulin Tape, Insulin Tape, Insulin Tape, Insulin Tape Insulin teipi ea 'mele ea "insulin" Insulong, Insulrap GP , Insulrap R, Insulrap SPP, Insuman basal, Insuman comb, Insuman kapele, Insuman ka potlako bakeng sa optipena, Comb-N-insulin Hoechst, Tape ilethin I, Tape ilethin II, Monosuinsulin, N-Insulin Hoechst, N-Insulin Hoehst 100 Iletin I, NPH Iletin II, Iletin I ea kamehla, Iletin II ea kamehla, Suinsulin, Homorap-100, Homofan 100, Humulin L, Humulin Mi, Humulin Mj, Humulin Mz, Humulin M4, Humulin N, Humulin NPH, Humulin R Humulin S, hempe ea Humulin, Humulin khafetsa, Humulin ultralente.

Maemo a polokelo:
Boloka ka mocheso ho tloha +2 ho isa + 10 * C. Leqhoa la lihlahisoa ha lea lumelloa.

Sebaka sa Insulin:
1 ml ea tharollo kapa ho emisoa hangata e na le likarolo tsa 40.
Ho latela mehloli ea tlhahiso, insulin e arohantsoe le manyeme a liphoofolo ebile e entsoe ka mekhoa ea boenjiniere ba liphatsa tsa lefutso. Ho latela tekanyo ea tlhoekiso, litokisetso tsa "insulin" tse tsoang liphoofolong tsa liphoofolo li arotsoe ka monopic (MP) le monocomponent (MK). Hajoale e fumanoe ho li-pancreas tsa likolobe, li hlophisitsoe ka mokhoa o fapaneng le lengolo C (SMP - pork monopic, SMK - monocomponent ea nama ea khomo), likhomo - lengolo G (beef: GMP - beef monopick, GMK - beef monocomponent). Litokisetso tsa insulin ea motho li bontšoa ke lengolo la C.
Ho ipapisitse le hore na u nka nako e kae, li-insulin li arotsoe ka:
a) Lihlahisoa tsa insulin tse haellang: ho qala hoa ts'ebetso kamora metsotso e 15-30, ketso ea tlhoro kamora lihora tse 1 / 2-2, nako eohle ea tšebetso lihora tse 4-6,
b) Lihlahisoa tsa insulin tse nkang nako e telele li kenyelletsa lihlahisoa tsa nako e telele (ho qala ka mor'a lihora tse 1/2, tlhoro ka mor'a lihora tse 3-12, lihora tse 8 ho isa ho tse 6) kamora lihora tse 8-18, nako eohle ea lihora tse 20-30.

Hlokomela!
Pele u sebelisa meriana ena, u lokela ho buisana le ngaka ea hau.
Litaelo li fanoe feela hore u ithute "".

Mosebetsi oa mantlha oa insulin ea "hormone" ha se ho theola boemo ba tsoekere bo phahameng haholo ho ea boemong bo tloaelehileng, empa hape ke ho bo tsamaisa, hammoho le limatlafatsi tse ling tseo motho a li fumanang ka lijo, ho lisele tsohle tsa 'mele. Sesebelisoa sa insulin se holim 'a sele e' ngoe le e 'ngoe eo mosebetsi oa eona e leng ho fetisetsa limatlafatsi le insulin kahare ho thusa lisele ho monya lintho.

Haeba manyeme, moo ho hlahisoang lihormone, a sa sebetsane le mesebetsi ebile a sa e hlahise ka bongata, motho eo ha a fumane matla lijong tse tsoang. Le ha boemo ba tsoekere maling bo le holimo, ha e sebelisoe ka morero oa eona, 'me lisele tse sa e amohelang li qala ho lapa le ho shoa kamora nakoana.

Taba ea pele, sena se lebisa ho se sebetse hantle 'meleng, ebe ho isa lefung. Lilemo tse fetang lekholo tse fetileng, mokuli ea fumanoeng a na le lefu la tsoekere o ile a felisoa. Empa kamora ho sibolloa ha insulin, batho ba nang le lefu la tsoekere ba na le monyetla oa ho phela bophelo bo phetseng hantle, haholo hobane litokisetso tsa insulin li fumaneha habonolo bakeng sa theko ea bona: litšenyehelo tsa bona ha li theko e tlase ebile li ka rekoa pharmising efe kapa efe.

Lithethefatsi tsa sehlopha sa pharmacological ha li fuoe insulin hang hang: li li etsa ka mor'a hore matlapa a fokotsang boemo ba tsoekere a se na thuso. Sebopeho sa moriana ke mokelikeli o hlakileng o se nang mmala kapa o mosehla. Sehlahisoa se etselitsoeng liente tsa lapeng se hlahisoa ka libotlolong, foromo ea tokollo ke limililone tse hlano le tse leshome. Insulin bakeng sa ts'ebeliso ea bongaka ke mokhoa oa ho lokolla phofo e tšoeu ea hygroscopic, e qhibilihang ka metsing.

Hajoale ha ho na mekhoa e meng ea ente, e fanoa ka mokhoa o sa ts'oaneng, ka methapo kapa ka methapo (e sa sebetseng hantle feela ka insulin e sa sebetseng haufinyane ka metsing e kenngoa kahare). Liente tsa inscutaneous le intramuscular li fanoa ka ente ea insulin kapa ente ea insulin. Sesebelisoa se na le sebopeho se bonolo sa ho sebetsana, li-hormone li hlahisoa li sebelisa konopo, kahoo li ka tsamaisoa le uena esita le ngoana a khona ho fana ka ente.

Le eona, motho ea nang le lefu la tsoekere ha a khone ho ipeha ente feela, empa hape o sebelisa moriana ka nepo ka nepo. Sesebelisoa se sebelisoa hape, se sebetsa feela mabokoseng a mantlha, se theko e boima, kahoo ha se motho e mong le e mong ea ka se khonang, haholo ha o nahana hore batho ba nang le lefu la tsoekere ba hloka lisebelisoa tse tharo joalo.

Insulin matlapeng ha e etsoe ho tsa bongaka, hobane mokhoa ona oa ho lokolla ha o na phello e joalo 'meleng joalo ka ente ea subcutaneous, intramuscular kapa intravenous. Ke 'nete, bo-ramahlale ba bolela hore ba khonne ho theha moriana bakeng sa tsamaiso ea molomo o ke keng oa sebetsa hantle joaloka liente, empa mokhoa ona oa ho lokolla moriana litekong tsa tleleniki ha o so fete ebile o ntse o tsoela pele ho ntlafatsoa.

Tšimoloho

Ho latela sehlopha, litokisetso tsa "insulin" li khetholloa ka tšimoloho, nako ea ketso, boemo ba tlhoekiso. Lihlahisoa tsa "insulin" li etsoa motheong oa li-hormone tse fumanoang ho makhopho a khomo, kolobe le ka mokhoa oa maiketsetso, kaha ke analogue ea lihormone tsa motho. Beef insulin e fapana le Hormone ea motho ho li-amino acid tse tharo, tse ka qetellang li baka tsitsipano e matla mme li lebise ho mathata a lefu la tsoekere nakong e tlang.

Mmele oa motho o amohela insulin ea kolobe hantle haholo: e fapana le lihormone tsa motho ka amino acid e le 'ngoe, ka hona ha e allergenic, leha e boetse e na le litšila tsa proinsulin le C-peptide, tse bakang allergies. Ka hona, haholo-holo ho batho ba nang le allergy, ho entsoe litokisetso tsa insulin tse hloekisitsoeng haholo tse fokotsang monyetla oa ho hlaha, le li-hormone tsa motho, tse fumanoeng ka lebaka la boenjiniere ba liphatsa tsa lefutso (ba bitsoa "insulin ea motho", ba hatisang boitseko bo phethahetseng).

E le karolo ea lihormone tsa maiketsetso, ha ho na proinsulin e bakang allergies, ka hona e ananeloa hamolemo ke 'mele, karabelo ea eona ho seoelo e fumanehang haholo mme sehlahisoa ha se na li-contraindication.

Hormone ena e hlahisoa ke mefuta ea tomoso e kenngoang ka har'a mofuta o khethehileng oa phepelo ea limela le mofuta o fetotsoeng liphatsa tsa lefutso tsa E. coli, e khonang ho hlahisa insulin ea motho. Kaha boholo ba ntho e hlahisitsoeng e kholo, bo-rasaense ba ikemiselitse ho nahana hore haufinyane insulin ea liphoofolo e tla nkeloa sebaka ka ho felletseng.

Nako ea netefatso

Litlhare tsa sehlopha sa meriana ea insulin li fapana nakong ea ts'ebetso: li mokhuts'oanyane, li mahareng ebile li telele.Lihlahisoa tse nang le ketso e khuts'oane (hoo e ka bang lihora tse tšeletseng) li tšoauoa ke lebelo la ho pepeseha 'mele: li qala ho e ama ka nako ea halofo ea hora kamora ts'ebetso mme li na le phello e phahameng lihora tse peli ho isa ho tse tharo kamora ho kenngoa.

Lihlahisoa tse thathamisitsoeng e le meriana ea nako e mahareng sehlopheng se na le zinki, ka lebaka leo lihormone li lokolloa butle butle. Ba qala ho nka khato hamorao - kamora lihora tse peli, litefiso tse phahameng li ka bonoa kamora lihora tse 8-14, phello e nka hoo e ka bang ka letsatsi.

Nts'etsopele ea lithethefatsi ka nako e telele e ne e bakoa ke tlhoko ea ho imolla bakuli ba ente khafetsa insulin (hoo e ka bang makhetlo a mararo ho isa ho a mane ka letsatsi): hobane psyche e sebetsana hampe lejoeng le leng le le leng, ka hona e baka bohloko. Ntle le moo, kamora ho entetsoa khafetsa sebakeng sa ente, hematomas e ka theha kapa tšoaetso e ka kena.

Maemong a mang, lingaka li eletsa ho kopanya lihlahisoa tsa insulin tse mahareng le tse khutšoane. Maemong ana, ho bohlokoa ho reka lithethefatsi ho moetsi a le mong ka har'a k'hemiste, kaha mokhoa oa ho lokolla lithethefatsi ho likhamphani tse fapaneng, leha li sa fapana, ke ente; e le karolo, ho eketsoa lintho tse fapaneng tse hlokang ho khelosa motho e mong le e mong ha a rekile ho bahlahisi ba fapaneng.

ho na le litokisetso tsa "insulin", tseo nako ea tsona e tlohang ho lihora tse 24 ho isa ho tse 36. Li qala ho ama 'mele lihora tse peli kamora ho kenya letsoho, nako ea ts'ebetso e kholo ke lihora tse 16-20, ebe e qala ho fokotseha.

Lithethefatsi tse joalo hangata li fuoa bakuli ba nang le kutloisiso e tlase ea insulin, hape li loketse bakuli kapa ba nang le mathata a pono ba sa khoneng ho fana ka ente ea bona mme ba its'etleha ka ho fihla ha mooki. Mokhoa o lokolloang oa lithethefatsi tse nkang nako e telele ke lithaelese tse 5 le 10 ml tse nang le lithibelo tse tlotsitsoeng tsa rabara.

Le ha litlamorao tsa lithethefatsi tse nkang nako e telele li nka nako e telele, lingaka li khetha li-insulin tse khutšoane le tse mahareng. Bakuli ba li mamella hamolemo: haeba matla a moriana o laetsoeng o feta lihora tse mashome a mabeli a metso e mene, hoseng ho ka ba le bothata ba hypoglycemia.

Morero oa kamohelo

Ke mofuta ofe oa lithethefatsi ho tsoa ho sehlopha sa insulin ho nka, mme ho eona litekanyetso, ngaka e lokela ho khetha le ho fana ka litaelo tse tobileng: matšoao ntlheng ka 'ngoe ke motho ka mong mme ha ho na mokhoa o le mong oa khalemelo. Sekhahla sa tsoekere maling se lokela ho lula se beiloe leihlo, 'me haeba ho hlokahala, e ntlafatsoe.

Haeba re bua ka Hormone eo makhopho a motho ea phetseng hantle a e hlahisang, joale boholo ba eona ka letsatsi bo tsoa ho 30 ho isa ho 40. Tloaelo e tšoanang (ho tloha ho tse 30 ho isa ho tse 50 unit) lia hlokahala bakeng sa lefu la tsoekere, ho sa tsotelehe tšimoloho ea insulin. Maemong ana, 2/3 ea tloaelo e lokela ho nkuoa hoseng, ba bang kaofela - ka shoalane. Ho etsa phetoho ho tloha ho phoofolo ho ea ho insulin ea motho, ho latela litaelo, lethal dose le lula le fokotseha, kaha lihomone tse entsoeng ka liphatsa tsa lefutso li ananeloa hamolemo ke 'mele.

Ho lumeloa hore litholoana tse ntle ka ho fetisisa li ka fihlelleha ka ho kopanya meriana e khutshwane le e mahareng; ka hona, kemiso ea taolo ea lithethefatsi e its'etleha ho eona. Har'a palo e kholo ea mefuta ea kalafo, ho se ho etsoa tse latelang:

hoseng nakong ea lijo tsa hoseng, nka moriana ka nako e khuts'oane ea ketso, le nako e mahareng (ho etsa sena, ngaka e tla u joetsa). Pele ho lijo tsa mantsiboea - ho nka nakoana, bosiu, ka lihora tse 22 kapa tse 23 - litokisetso tsa nako e mahareng,
insulin e nang le nako e khuts'oane ea ts'ebetso, enta pele ho lijo tsa hoseng, lijo tsa motšeare le lijo tsa mantsiboea, pele u robala, ka li-23 tsa o'alot - litokisetso tsa insulin tsa nako e telele kapa e bohareng,
insulin e mahareng kapa e telele e sebetsang hoseng, hanyane - pele ho lijo tsa hoseng, lijo tsa mots'eare le lijo tsa mantsiboea (mokhoa o batla o le bobebe ho feta oa pele).

Haeba ngaka e laetse moriana o le mong feela, moriana o nang le nako e khuts'oane ea ts'ebetso o khothalletsoa hore o kenngoe makhetlo a mararo ka letsatsi, ea bolelele ba nako - habeli ka letsatsi: liente li lokela ho fuoa metsotso e 45 pele ho lijo tsa hoseng le pele ho lijo tsa mantsiboea. Ntlha e 'ngoe e sa lokelang ho lebaloa ha u bua ka ts'ebeliso ea insulin ke hore insulin e sa jeleng paate e ka kenngoa ka ente eseng ka methapo feela, empa hape le kahare. Moriana o nkileng nako e telele (foromo ea ho tsoa 5 le 10 ml) ha e fanoe kahare.

Litlamorao

Insulin ha e na ho ba le li-contraindication: haeba sehlahisoa se le seng se sa tšoanelehe, se ka lula se nkeloa sebaka ke se seng, empa litla-morao li ka hlaha. Ho bohlokoa haholo kalafong ea lefu la tsoekere ho boloka litekanyetso: ho ikenya kapa ho fokotsa tekanyetso ho thibetsoe ka tieo. Ka bobeli ka lebaka la ho haelloa ke tsoekere le ho fetela ho tloaelehileng, o ka oela komeng mme oa shoa (ho latela lipalo, liperesente tse 'ne tsa bakuli ba ka tlase ho lilemo tse mashome a mahlano ba shoa ka lebaka lena).

Bothata bo bong bo tloaelehileng ke ba kulang, bo ka hlahang litokisong tsa insulin tsa tlhaho ea liphoofolo. Mats'oao a pele (ho bonahala eka ho hlohlona, ho mpefala ha bophelo bo botle), o lokela ho ea ngakeng 'me o fetole insulin ea motho. Ho bohlokoa ho etsa phetoho e joalo sepetlele tlasa tlhokomelo ea ngaka, moo ho ka etsahalang ho lula u lekola boemo ba tsoekere le ho lokisa tekanyetso e nepahetseng.

Tsela e 'ngoe e ka bakoang ke atrophy kapa hypertrophy ea lithane tsa adipose sebakeng sa ente. Hangata bothata bona bo teng ka tšebeliso ea insulin ea nama ea khomo ebile ha e sebelisoe hangata ha ho sebelisoa porcine e hloekisitsoeng kapa insulin ea motho. Sena ha se hlahise kotsi e ngata, empa sebaka sa ente se tlameha ho fetoloa, kaha ho kenngoa ha insulin ho na le mathata. Sena se lokela ho etsoa feela ka ho buisana le ngaka, kaha sebaka se seng le se seng sa 'mele se na le karohano e fapaneng ea moriana.

Insulin ke sethethefatsi se theolang tsoekere ka ho khetheha. , e na le matla a ho laola metabolism ea carbohydrate, e ntlafatsa ho ts'oaroa ha tsoekere le ho khothaletsa phetoho ea eona hore e be glycogen, hape e thusa ho kenella ha tsoekere ho lisele tsa lisele.
Ntle le phello ea hypoglycemic (ho fokotsa tsoekere ea mali), insulin e na le litlamorao tse ling: e eketsa mabenkele a mesifa a glycogen, e tsosa peptide, e fokotsa tšebeliso ea protheine, jj.

Ho pepesehela insulin ho tsamaisana le ho tsosa kapa ho inhibition (inhibition) ea li-enzyme tse itseng , glycogen synthetase, pyruvate dehydrogenase, hexokinase lia tsosoa, lipase li kenya li-acid tse ngata tsa tiske ea adipose, lipoprotein lipase, li fokotsa ho fokotseha ha mali ka mor'a lijo tse nang le mafura.
Tekanyo ea "biosynthesis" le secretion (secretion) ea "insulin" e ipapisitse le phallo ea tsoekere maling.
Ka keketseho ea litaba tsa eona, secretion ea insulin ke manyeme e ea eketseha, ka lehlakoreng le leng, phokotso ea khatello ea tsoekere maling e fokotsa sekhahla sa insulin.

Ts'ebetsong ea litlamorao tsa insulin, karolo e etelletseng pele e bapaloa ke ho sebelisana ha eona le receptor e ikhethang e fumanehang kahara membrane ea sele, le ho etsoa ha mochini oa "insulin".
Ho amohelang insulin hammoho le insulin ho kenella ka seleng , moo e amang phapang ea liprotheine tsa cellular, karabelo e eketsehileng ea intracellular ha e utloisisehe ka botlalo.
Insulin ke eona kalafo e ikhethang bakeng sa lefu la tsoekere, hobane e fokotsa hyperglycemia (keketseho ea tsoekere ea mali) le glycosuria (ho ba teng ha tsoekere ka har'a moroto), e khutlisa depo ea glycogen ka har'a sebete le mesifa, e fokotsa tlhahiso ea glucose, hape e fokotsa lefu la tsoekere maling (ho ba teng ha mafura maling). , e ntlafatsa boemo bo akaretsang ba mokuli .

Insulin bakeng sa ts'ebeliso ea bongaka e fumanoa ho manyeme a likhomo le likolobe . Ho na le mokhoa oa motsoako oa lik'hemik'hale oa insulin, empa ha o khonehe.
Morao tjena ho qapiloe mekhoa ea biotechnological bakeng sa ho hlahisa insulin ea motho. Insulin e fumanoeng ke boenjiniere ba liphatsa tsa lefutso e lumellana ka botlalo le letoto la amino acid ea insulin ea motho.
Maemong moo insulin e fumanoang ho manyeme a liphoofolo, litšila tse fapaneng (li-proinsulin, glucagon, self-statin, liprotheine, polypeptides, jj) li ka ba teng tokisetsong ka lebaka la tlhoekiso e sa lekanang.
Litokisetso tsa insulin tse hloekisitsoeng hampe li ka baka karabelo e fapaneng.

Mekhoa ea sejoale-joale e etsa hore ho khonehe ho fumana tlhoekiso (monopic - chromatographic e hloekisitsoeng ka "top" ea insulin), e hloekisitsoeng haholo (monocomponent) le litokisetso tsa insulin.
Hona joale, insulin ea insulin ea motho e ntse e sebelisoa le ho feta.
Bakeng sa litokisetso tsa insulin tsa tlhaho ea liphoofolo, khetho e fanoa ho insulin e fumanoang mokhoapong oa likolobe.

Ts'ebetso ea "insulin" e hlahisoa ka tlhaho (ka bokhoni ba ho theola tsoekere ea mali maling a bophelo bo botle) le e 'ngoe ea mekhoa ea fisiks (electrophoresis e pampiring kapa chromatography pampiring). Bakeng sa yuniti e le 'ngoe ea ts'ebetso (UNIT), kapa yuniti ea machabeng (IE), nka ts'ebetso ea 0404082 mg ea crystalline insulin.

Letšoao le ka sehloohong bakeng sa ts'ebeliso ea insulin ke mofuta oa lefu la tsoekere la mellitus (le itšetlehileng ka insulin), empa tlasa maemo a mang le lona le fuoe mofuta oa lefu la tsoekere la II mellitus (le sa ts'epeng insulin.

Ha ho phekoloa lefu la tsoekere sebelisa insulin litokisetso tsa linako tse fapaneng tsa ketso .
Insulin e nkang nakoana hape le lits'ebetsong tse ling tsa pathological tsa ho baka boemo ba hypoglycemic (ho theola tsoekere ea mali) ka mekhoa e meng ea schizophrenia, joalo ka moemeli oa anabolic (ea ntlafatsang protheine) ka mokhathala o akaretsang, khaello ea phepo e nepahetseng, furunculosis (ho hloekisoa hoa letlalo ka makhetlo a mangata), thyrotoxicosis (lefu la qoqotho) litšoelesa), ka mafu a mpeng (ho hlohlona / ho felloa ke lentsoe /, gastroptosis / ho hlohlona ha mpeng /), hepatitis e sa foleng (ho ruruha ha lisele tsa sebete), mefuta ea pele ea cirrhosis, le motsoako "polarizing" ditharollo sebelisoa ho tsoara hlobaetsang gogoga insufficiency (mismatch pakeng tlhokeho cardiac oksijene le pelehi lona).

Khetho ea insulin bakeng sa kalafo ea lefu la tsoekere e itšetlehile ka ho teba le litšobotsi tsa nako ea lefu lena, boemo bo akaretsang ba mokuli, hammoho le lebelo la ho qala le nako ea phello ea moriana.
Khetho ea pele ea insulin le ho theha lethaliti ka kotloloho e etsoa sepetlele (lipetlele).

Litokisetso tsa insulin tse haufinyane - tsena ke tharollo e reretsoeng ho tsamaisa lintho ntle ho tšitiso ea letho.
Haeba ho hlokahala, e boetse e tsamaisoa ka matla.
Li na le phello e potlakileng le e khuts'oanyane ea ho fokotsa tsoekere.
Hangata li fanoa ka mokhoa o sa ts'oaneng kapa ka mokhoa o ts'oaroang ka metsotso e 15-20 pele ho lijo ho tloha ho le leng ho ea ho makhetlo a 'maloa ka nako ea letsatsi.
Tšusumetso kamora ho kenngoa ka ente ea subcutaneous e etsahala ka metsotso e 15-20, e fihla hofihlella kamora lihora tse peli, nako eohle ea ts'ebetso ha e fetang lihora tse 6.
Li sebelisoa haholo sepetlele ho theha tekanyetso ea insulin e hlokahalang ho mokuli, le maemong ao ho hlokahalang ho fihlela phetoho e potlakileng ea ts'ebetso ea insulin 'meleng - ka lefu la tsoekere le komello (ho lahleheloa ke kelello ka botlalo kapa ka lebaka la ho eketseha ho tšohanyetso ha tsoekere ea mali) .
Ho feta moo, litokisetso tsa insulin tse haufinyane li sebelisoa e le moemeli oa anabolic mme ho laetsoe e le molao bakeng sa litekanyetso tse nyane (likarolo tse 4-8 makhetlo a 1-2 ka letsatsi).

Litokisetso tsa insulin tsa nako e telele (ea nakoana) li fumaneha ka mefuta e fapaneng ea litekanyetso li nang le linako tse fapaneng tsa phello e fokotsang tsoekere (semylong, nako e telele, Ultralong).
Bakeng sa lithethefatsi tse fapaneng, phello e nka lihora tse 10 ho isa ho tse 36.
Ka lebaka la lithethefatsi tsena, u ka fokotsa palo ea liente tsa letsatsi le letsatsi.
Hangata li hlahisoa ka mokhoa oa ho emisa. (ho emisoa ha dikarolwana tse thata tsa moriana ka selikalikoe), e tsamaisoang feela ka mokhoa o ikhethileng kapa ka mokhoa o kopaneng, tsamaiso ea methapo ha e lumelloe. Maemong a ho ba le lefu la tsoekere le maemo a matle, lithethefatsi tse telele ha li sebelisoe.

Ha u khetha ho hlophisoa ha insulin, ho hlokahala ho etsa bonnete ba hore nako ea ho fokotsa tsoekere e ngata e tsamaisana le nako eo u e jang.
Ha ho hlokahala, lithethefatsi tse peli tsa ketso ea nako e telele li ka tsamaisoa ka seropeng se le seng.
Bakuli ba bang ha ba hloke nako e telele feela, empa hape le boemo bo potlakileng ba tsoekere ea mali. Ba tlameha ho fana ka litokisetso tsa insulin tsa nako e telele le tse liehang ho sebetsa.
Hangata lithethefatsi tse nkang nako e telele li fanoa pele ho lijo tsa hoseng leha ho le joalo, haeba ho hlokahala, ente e ka etsoa ka linako tse ling.

Litokisetso tsohle tsa insulin li sebelisoa ho latela mokhoa oa ho latela lijo.
Tlhaloso ea boleng ba matla (ho tloha 1700 ho isa ho 3000 khal) e lokela ho khethoa ke boima ba 'mele oa mokuli nakong ea kalafo, ka mofuta oa ketsahalo. Kahoo, ka ho fokotseha hoa phepo e nepahetseng le mosebetsi o boima oa 'mele, palo ea lik'hilojule tse hlokahalang ka letsatsi bakeng sa mokuli li bonyane 3000, ka phepo e nepahetseng le mokhoa oa bophelo oa ho lula, ha oa lokela ho feta 2000.

Ho kenyelletsoa ha tekanyetso e phahameng haholo, hammoho le khaello ea ho ja lijo tse nang le lik'habohaedreite ka lijo, ho ka baka boemo ba hypoglycemic (ho theola tsoekere ea mali) e tsamaeang le maikutlo a tlala, bofokoli, ho fufuleloa, ho thothomela hoa 'mele, hlooho ea hlooho, ho tsekela, palpitations, euphoria (ho se tsotelle ho sa tsotelleng) kapa mabifi.
Kamora moo, ho ba le komello ea hypoglycemic e ka ba teng (ho felloa ke kelello, ho tšoauoa ka ho se sebetse hantle hoa 'mele ho susumetso ea kantle ka lebaka la ho fokotseha ho matla hoa tsoekere ea mali) ka ho lahleheloa ke kelello, ho tsitsipana le ho fokotseha ho hoholo hoa ketsahalo ea pelo.
Ho thibela boemo ba hypoglycemic, bakuli ba hloka ho noa tee e tsoekere kapa ho ja likotoana tsa tsoekere.

Le hypoglycemic (e amanang le ho fokotseha ha tsoekere ea mali) coma Tharollo ea tsoekere ea 40% e kenngoa mothapong ka bongata ba 10-40 ml, ka linako tse ling ho fihla ho 100 ml, empa ha e sa le eo.
Khalemelo ea hypoglycemia (e fokotsa tsoekere ea mali) ka foromo e matla e ka etsoa ho sebelisa intramuscular kapa subcutaneous tsamaiso ea glucagon.

Ka tsamaiso e poteletseng ea litokisetso tsa insulin, lipodystrophy (ho fokotseha hoa tekanyo ea lisele tsa adipose liseleng tse kenang ka tlase) li ka hlaha sebakeng sa ente.

Ho hlokahala tlhokomelo e kholo kalafong ea bakuli ba nang le lefu la tsoekere la mellitus, ba nang le bothata ba ho fokola (ho se sebe hantle pakeng tsa tlhoko ea pelo le oksijene) le tšenyo ea kelello | phallo ea mali.
Ho hlokahala hore motho a be hlokolosi ha a sebelisa insulin ho bakuli ba nang le lefu la tšoelesa ea qoqotho, lefu la Addison (mosebetsi o sa lekaneng oa adrenal) le ho se sebetse hantle ha methapo.

Motsoako oa "insulin" oa moimana o lokela ho shebeloa haufi-ufi.
Nakong ea trimester ea pele ea bokhachane, tlhoko ea insulin hangata e fokotseha hanyane mme e nyoloha ka har'a li-trimesters tsa bobeli le tsa boraro.
Al-adrenergic blockers le beta-adrenostimulants, li-tetracyclines, li-salicylates li eketsa secretion ea endo native (excretion ea 'mele e thehiloeng) insulin.
Thiazide diupetics (diuretics), beta-blockers, joala bo ka lebisa ho hypoglycemia.

Puisano le
lingaka tse ling
ka:

Phello ea hypoglycemic ea insulin e matlafatsoa hypoglycemic lithethefatsi molomo, Mao inhibitors, Ace inhibitors, k'habone anhydrase inhibitors, khetha beta-blockers, bromocriptine, octreotide, sulfonamides, anabolic steroid, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, lithium, lithethefatsi tse nang ethanol .

Hypoglycemic phello ea insulin ea fokolisa lithibela-pelehi tsa molomo, li-corticosteroids, lihormone tsa qoqotho, li-diaztics tsa thiazide, heparin, li-antidepressants tsa trousclic, li-audiathomimetics, danazole, clonidine, calcium block blockers, diazoxide, morphine, phenytoin, nikotine.

Tlas'a tšusumetso ea reserpine le salicylates, ho fokolisa le ho eketsa ts'ebetso ea moriana ho ka khoneha.
Meriana e nang le thiol kapa sulfite, ha e eketsoa ho insulin, e baka tšenyo.

Nakong ea kemolo, mofuta oa insulin, lethal dose le litekanyetso tsa tsamaiso li khethoa ke ngaka e eang.
Haeba mofuta oa kalafo o khethiloeng o sa tšoanelehe, ho hlokahala hore o botse ngaka hape 'me u khethe, hape, mofuta o nepahetseng le o sebetsang oa kalafo.

Matšoao : bofokoli ba mesifa, mokhathala o bobebe, tlala, pherekano, botenya ba menoana, ho thothomela, ho hlapoloha, ho hlapoloha, ho fifala, ho opeloa ke hlooho, ho longoa khafetsa, chewing, ho fifala ha letsoalo, khatello kapa ho tsofala, liketso tse sa amaneng le letho. mme qetellong, komello.

Phekolo ea boemo ba hypoglycemic e lokela ho qala hang-hang.
Maemong a bonolo, ho lekane ho fa kahare tee e tsoekere, lero la litholoana, mahe a linotsi.
Ka tahlehelo e felletseng ea kelello (coma) hang hang kenya tharollo ea glucose e kenelletseng (10-20 ml ea glucose ea 20-40%).
Ha ho na le monyetla oa ho kenella ka har'a ente ea tharollo ea tsoekere, ho kgothaletswa ho ts'oara entramuscularly 0.001-0.002 g ea glucagon kapa 0.5 ml ea tharollo ea 0,1% ea adrenaline hydrochloride tlasa letlalo.
Re lokela ho hopola hore ka ho hlahisoa ha adrenaline, litla-morao li ka hlaha - ho thothomela, ho thothomela, khatello e phahameng ea mali, matšoenyeho, jj.

Syringe insulin e fumaneha ka likhalase tsa khalase tse tiisitsoeng ka li-Stop Stop tse nang le aluminium break-in.
Ka libotlolong 10 ml, ka lebokoseng li-pcs tse 5 kapa penfill (li-cartridge) 1.5 le 3 ml lipentšele tsa syringe .

Litokisetso tsa insulin (ka bobeli le li-cartridge) tse sa sebelisoeng, e lokela ho bolokoa ka 2-8 ° C sebakeng se lefifi , i.e. sehatsetsing (ka ho khetheha sehatsetsing se ka tlase), hole le sehatsetsi.
Ka mocheso ona, li boloka thepa ea tsona ea tlhaho le lintho tse sa sebetseng ho fihlela bophelo ba lishelefo bo bontšitsoe ka har'a sephutheloana. Insulin ha ea lokela ho hlahlojoa ha e fofa ka sefofane ho qoba kotsi ea ho bata.
Mocheso o phahameng haholo o baka ho fokotseha butle-butle mesebetsing ea lithethefatsi. Khanya ea letsatsi e tobileng e boetse e ama hampe, e potlakisa tahlehelo ea mesebetsi ea likokoana-hloko ka makhetlo a 100.
Transulin e nang le lero le qhibilihang le ka fetoha mongobo . Li-granules le li-flakes li theha ho emisoa ha insulin. Ho kopana ha mocheso le ho sisinyeha ha nako e telele ho mpefatsa mokhoa ona.

Botlolo ea "insulin" e sebelisoang ke mokuli e ka bolokoa ka mocheso oa kamoreng e sa feteng 25 ° C, sebakeng se lefifi ho fihlela libeke tse 6. Nako ena e fokotseha hore e be libeke tse 4 ha u sebelisa mabokose a Penfill, hobane lipentšele tsa syringe hangata li tsamaisoa ka pokothong ea hau ka lithemparetjha tse haufi le mocheso oa 'mele. Li-insulin li ka bolokoa ka sehatsetsing likhoeli tse 3 kamora ts'ebeliso ea pele.

Frenzen insulin e ke ke ea sebelisoa ka mor'a ho e qeta. Sena ke nnete haholo bakeng sa ho emisoa. Nakong ea ho bata, likristale kapa likaroloana li bokellana 'me li se qhibilihe kamora ho qepha, e leng se etsang hore ho se khonehe ho fumana ho emisoa hape. Kahoo, menyetla ea ho hlahisa lethal e sa lekanang e eketseha haholo.

Insulin e lokela ho nkoa e senyehile ka mor'a ho qhekella. Mefuta ea "insulin" e hlakileng e ka se sebelisoe ha ho hlatsuoa mahlo, ho fetoha moferefere kapa ponahalo ea likaroloana tse emisitsoeng.
Litšisinyeho tsa insulin, tseo kamora ho kopanya ha li etse ho emisoa ho soeufetseng kapa ho ba le makhopho, likhoele, 'mala o fetolang, ha li tšoanelehe bakeng sa tšebeliso.

1 ml ea tharollo kapa ho emisoa hangata e na le likarolo tsa 40.
Ho latela mehloli ea tlhahiso, insulin e arohantsoe le manyeme a liphoofolo ebile e entsoe ka mekhoa ea boenjiniere ba liphatsa tsa lefutso.

Ho latela tekanyo ea tlhoekiso, litokisetso tsa "insulin" tse tsoang liphoofolong tsa liphoofolo li arotsoe ka monopic (MP) le monocomponent (MK).
Hajoale e fumanoe ho li-pancreas tsa likolobe, li hlophisitsoe ka mokhoa o fapaneng le lengolo C (SMP - pork monopic, SMK - monocomponent ea nama ea khomo), likhomo - lengolo G (beef: GMP - beef monopick, GMK - beef monocomponent).
Litokisetso tsa insulin ea motho li bontšoa ke lengolo la C.

Ho ipapisitse le hore na u nka nako e kae, li-insulin li arotsoe ka:
- litokisetso tsa insulin tse haufinyane : ho qala ho nka khato kamora metsotso e 15-30, bohato bo boholo kamora lihora tse 1 / 2-2, nako e telele ea tšebetso lihora tse 4-6,
- litokisetso tsa insulin tsa nako e telele kenyelletsa lithethefatsi nako e telele ea ketso (ho qala kamora lihora tse 1 / 2-2, tlhoro kamora lihora tse 3-12, nako eohle ea lihora tse 8-12), lithethefatsi tse nang le nako e telele (ho qala kamora lihora tse 4 - 8, tlhoro kamora lihora tse 8-18, kakaretso ea lihora tse 20-30).

Kajeno, indasteri ea meriana e hlahisa mefuta e fapaneng ea insulin. Hajoale, ho sebelisoa mefuta e mengata ea insulin ho tsa bongaka.

Sehlopha sa insuline hangata se khethoa ho latela hore na ba nka bohato bofe kamora ho busa 'meleng oa motho. Ho tsa bongaka, lithethefatsi tsa nako e latelang li khetholloa:

ultrashort
haufinyane
nako e telele ea ketso
lithethefatsi tse nkang nako e telele.

Tšebeliso ea mofuta o le mong kapa oa mofuta o mong oa insulin o itšetlehile ka litšobotsi tsa motho ka mong le kalafo ea kalafo ea mellitus ea lefu la tsoekere ka insulin.

Mefuta e fapaneng ea "insulin" e fapana ho latela sebopeho le ka mokhoa oa motsoako. Bakeng sa mofuta o mong le o mong oa ho itokisetsa insulin, litaelo tsa tšebeliso li ntlafatsoa ho latela litšobotsi tsa sebopeho le mokhoa oa ho itukisetsa.

Ntle le moo, ho na le litlhoko tse akaretsang tse lokelang ho lateloa ha ho etsoa kalafo ea insulin. Litokisetso tsohle tsa insulin li na le lipontšo le li-contraindication tse ling bakeng sa ts'ebeliso.

Melemo ea pharmacological

Detemir insulin ke analogue ea "insulin" ea "solulin" ea insulin, ts'ebetso ea nako e telele e nang le sephiri sa ts'ebetso, e hlahisoang ke recombinant DNA biotechnology e sebelisang mofuta oa Saccharomyces cerevisiae. Insulin e tlama ho li-receptor tse itseng, ka ho etsa joalo, litlamorao tsa likokoana-hloko. Insulin e laola metabolism ea glucose. E fokotsa boemo ba tsoekere maling maling, e susumetsa tšebeliso ea eona ka lisele tsa 'mele le ho thibela gluconeogeneis. Insulin e ntlafatsa biosynthesis, inhibits protheine le lipolysis liseleng tsa mafura. Palo e phahameng ea "insulin" ea "insulin" ea mali serum e fihlelloa kamora lihora tse 6 ho isa ho tse robeli ka mor'a taolo. Ka mofuta oa tsamaiso ka makhetlo a mabeli ka letsatsi, litekanyetso tsa ho lekana tsa insulin Detemir ho serum ea mali li fihlelleha ka mor'a liente tse peli ho isa ho tse tharo. Phapang e teng pakeng tsa monko oa insulin e tlase ha e bapisoa le litokisetso tse ling tsa insulin ea insulin. Ho pharmacokinetics ea insulin detemir, ha ho liphapang tse tebileng tsa bong le bong tse ileng tsa fumanoa. Bophahamo bo boholo ba karolelano ea "insulin" ke hoo e ka bang 0,1 l / kg. Ho kenyelletsa insemir ea insulin ho tšoana le litokisetso tsa insulin ea motho, lihlahisoa tsohle tsa metabolic ha li sebetse. Ha ho na tšebelisano-'moho e bohlokoa lipakeng tsa insulin detemir le mafura acid kapa lithethefatsi tse ling tse tlama ho liprotheine. Bophelo ba halofo ea ho qetela ka ente ea subcutaneous bo itšetlehile ka tekanyo ea lithethefatsi le tekanyo ea ho amoheloa ho tsoa linthong tse sa sebetseng 'me ke lihora tse 5 ho isa ho tse 7.

Lefu la tsoekere ho bakuli ba lilemo li ka tlase ho tse peli.

Tekanyetso ea monko oa insulin le litekanyetso

Detemir insulin e etselitsoe feela tsamaiso ea subcutaneous, sethethefatsi se ke ke sa tsamaisoa ka matla, kaha sena se ka lebisa ho hypoglycemia e matla. Tekanyetso e ikemiselitsoe ho latela litlhoko tsa mokuli. Ho ka hlokahala hore u fetole litekanyetso tsa moruo haeba lijo tse tloaelehileng tsa mokuli li fetoha, mesebetsi ea hae ea 'mele e eketseha, kapa ka bokuli bo tšoanang. Detemir insulin e ka sebelisoa ka mokhoa oa monotherapy le ka insulin, hammoho le lithethefatsi tsa hypoglycemic bakeng sa tsamaiso ea molomo. Detemir insulin e ka tsamaisoa ka nako efe kapa efe e loketseng motšehare, empa kamora ho beha nako ea ente, o tlameha ho e latela letsatsi le leng le le leng. Detemir insulin e kenngoa ka mokhoa o sa reng letho sebakeng sa lebota la mpa ea ka mpeng, thipa, lehetla, gluteal kapa sebaka se boreleli. Litsi tsa ente e tlameha ho fetoloa khafetsa ho fokotsa kotsi ea lipodystrophy. Joalo ka litokisetso tse ling tsa insulin, ho bakuli ba tsofetseng le bakuli ba nang le mokokotlo oa mokokotlo kapa mosebetsi o amanang le hepatic, ho hlokahala leihlo le hlokolosi la litekanyetso tsa tsoekere ea mali le tokiso ea monko oa motho ka mong. Joalo ka litokisetso tse ling tsa insulin, ho khothalletsoa hore u hlahlobe tsoekere ea mali ka hloko nakong ea phetolelo le libekeng tsa pele tsa ho fana ka moriana o mocha.
Insemir insulin e na le phello e telele (ho fihlela letsatsi).
Phekolo ea "insulin" ea "insulin" ha e eketse boima ba 'mele.
Pele ho leeto le lelelele, le amanang le phetoho ea libaka, mokuli o lokela ho buisana le ngaka ea hau, kaha ho fetola nako ho bolela hore mokuli o tla kenya insulin le ho e ja ka nako e 'ngoe.
Ho khaotsa ho phekoloa kapa tekanyetso e sa lekaneng ea lithethefatsi ho ka lebisa ho hyperglycemia kapa lefu la tsoekere la lefu la tsoekere. Hyperglycemia hangata e hola butle butle ka lihora tse ngata kapa matsatsi. Matšoao a hyperglycemia a kenyelletsa ho choacho khafetsa, lenyora, ho nyekeloa, ho hlatsa, bofubelu le ho omella ha letlalo, ho otsela, molomo o omileng, monko oa asetone moeeng o tsoang, ho felloa ke takatso ea lijo. Ntle le kalafo e nepahetseng, hyperglycemia e lebisa ho lefu la tsoekere la lefu la tsoekere le lefu.
Hypoglycemia e ka hlaha ka ts'ebetso e matla e sa reroang kapa ho tlōla lijo haeba tekanyetso ea insulin e le phahame haholo kamanong le tlhoko ea insulin. Ha ho lefella metabolism ea carbohydrate ho bakuli, matšoao a bona a tloaelehileng a hypoglycemia a ka fetoha, bakuli ba lokela ho tsebisoa ka sena. Ka thuto ea lefu la tsoekere ea nako e telele, matšoao a tloaelehileng a pele a ka nyamela.
Psychitant pathology, haholoholo e tsamaeang le feberu le mafu a tšoaetsanoang, hangata e eketsa tlhoko ea mmele ea insulin.
Phetoho ea monko oa litlolo tsa insulin le eona e ka hlokahala haeba mokuli a e-na le mafu a kopaneng a sebete, liphio, litšoelesa tsa adrenal, tšoelesa ea qoqotho.
Ho na le litlaleho tsa nts'etsopele ea ho se sebetse hantle ha pelo ho phekoleng bakuli ba nang le thiazolidatediones hammoho le litokisetso tsa "insulin", haholo haeba mokuli a e-na le mabaka a kotsi a ho holisa ho se sebetse hantle hoa pelo. Ntlha ena e lokela ho tsotelloa ha u fa bakuli kalafo e kopaneng le litokisetso tsa insulin le thiazolidatediones. Ka kalafo e kopaneng joalo, ho hlokahala ho etsa tlhahlobo ea bongaka ea bakuli ho bona matšoao a bona le matšoao a ho se atlehe ha pelo, boteng ba edema, boima ba 'mele. Haeba matšoao a ho hloleha ha pelo a bonoa kapa a mpefala, kalafo ea thiazolidatedione e lokela ho khaotsa.
Ka hypoglycemia, e ka ntlafalang ha u ntse u nka Detemir, lebelo la karabelo le bokhoni ba ho tsepamisa maikutlo lia senyeha. Ka hona, ka nts'etsopele ea eona, bakuli ba lokela ho hana ho kenella mesebetsing moo ho hlokahalang tlhokomelo e eketsehileng le lebelo la maikutlo a psychomotor (ho kenyeletsa le likoloi tsa ho khanna).

Bokhachane le pelehi

Ha u sebelisa lithethefatsi nakong ea kemolo, ho a hlokahala ho ela hloko melemo e lebelletsoeng ho mme le kotsi e ka bang teng ho lesea. Teko e le 'ngoe ea bongaka e laoloang ka mokhoa o hlophisitsoeng, ho ne ho se na liphapang liphellong tsa bokhachane, profilaneng ea polokeho ka kakaretso nakong ea kemolo, bophelo bo botle ba lesea le lesea le sa tsoa hlaha ha le bapisa litokisetso tsa insulin le detemir le insulin. Tlhahisoleseling e 'ngoe mabapi le polokeho le katleho ea kalafo ea lithethefatsi nakong ea ts'ebeliso ea morao-rao e bontša ho ba sieo ha litlhaloso tse mpe tse sa lebelloang tse ka lebisang ho ho senyeha ha tlhaho kapa ho ba kotsi ho lesea. Ho liphoofolo, phello e nang le chefo ea lithethefatsi tsamaisong ea ho ikatisa ha ea ka ea fumanoa. Bakhachane ba nang le lefu la tsoekere ba hloka ho hlahlojoa ka hloko nakong eohle ea bokhachane ba bona, le nakong ea kemiso ea bokhachane. Ka "trimester" ea pele ea bokhachane, tlhoko ea "insulin" hangata e ea fokotseha le lilemo ho tse tharo le tsa boraro. Tlhokahalo ea insulin ka mor'a ho beleha ngoana kapele e khutlela boemong bo neng bo le pele ho ima. Ha ho na tlhahisoleseling ea hore na insulin e kenella kahare ho Detemir lebese la matsoele. Ho nahanoa hore sethethefatsi sena ha se ame metabolism 'meleng oa masea nakong ea ho anyesa, kaha sethethefatsi ke peptide e robeha habonolo kahara pampitšana ea gastrointestinal ho liamino acid tse ananelang' mele. Nakong ea kanyeso ho basali, ho ka hlokoa tokiso ea lijo le tekanyetso ea insulin.

Litla-morao tsa insulin

Mathata a Metaboliki: hypoglycemia (matšoao a hypoglycemia: mofufutso o batang, ho tepella ho eketsehileng ha letlalo, ho thothomela, ho tšoha, ho tšoenyeha, mokhathala, ho khathala ho sa tloaelehang, ho ferekana, ho otsela, ho fokotseha ha tlala, tlala e matla ea hlooho, ho nyekelwa ke pelo, pono e fifalitsoeng, ho hlonama), ho lahleheloa ke kelello, ho tsitsinyeha, ho senyeha hoa nakoana kapa ho sa fetoheng hoa tšebetso ea boko, lefu).
Mathata a akaretsang le lintho tse etsahalang setsing sa ente: karabelo ea hypersensitivity ea sebakeng seo (ho ruruha, bofubelu, ho hlohlona sebakeng sa ente), lipodystrophy, edema.
Mathata a tsamaiso ea 'mele ea ho itšireletsa mafung: urticaria, ho kula hohle, lekhopho la letlalo, ho hlohlona, ho ruruha, angioedema, ho ferekana ha mpa, mathata a ho hema, ho fokotse khatello ea mali.
Ho sitisoa ha pono: li-refraction mafu a amanang le "retinopathy" ea tsoekere.
Mokhoa o hlasimolohileng: peripheral neuropathy.

Ho sebelisana ha insulin ho hlohlona le lintho tse ling

Ho na le lithethefatsi tse amang tlhokahalo ea insulin. Phello ea hypoglycemic ea insulin e hlahisoa ke glucocorticosteroids, lithibela-pelehi tsa molomo, li-iodine tse nang le qoqotho, thiazide diuretics, somatropin, heparin, sympathomimetics, li-antidepressants tsa danazole, li-blockcode tsa li-calcium tsa butle, clonidine, diafin oxide, Phello ea hypoglycemic ea insulin e ntlafatsoa ke li-inhibitors tsa monoamine oxidase, lithethefatsi tsa hypoglycemic tsa molomo, li-angiotensin tse fetolang enzyme inhibitors, li-beta-blockers tse sa sebetseng, li-anhibrase tsa carbonic, lithethefatsi tsa sulfonamide, tetracycline phospholife. tse nang le ethanol. Octreotide le lanreotide ka bobeli li ka fokotsa le ho eketsa tlhoko ea mmele ea insulin. Tlas'a ketso ea li-salicylates le reserpine, ho eketsa le ho fokolisa ketso ea moriana hoa khoneha. Joala bo ka baka le ho lelefatsa phello ea hypoglycemic ea insulin. Beta-blockers ba ka pata lipontšo tsa hypoglycemia le ho lieha ho hlaphoheloa ka mor'a hypoglycemia. Lithethefatsi tse ling, ka mohlala, tse nang le lihlopha tsa sulfite kapa thiol, ha li eketsoa ho insulin, detemir e ka e senya. Detemir insulin ha ea lokela ho eketsoa tharollo ea infusion.

Bongata

Tekanyetso e itseng eo ho eona ho nang le insulin e fetisisang ea insulin ha e e-so theoe, empa hypoglycemia e ka hola butle-butle ka ho hlahisa lethal dose e phahameng bakeng sa mokuli ea itseng. Phekolo: mokuli a ka tlosa hypoglycemia ka boeena ka ho inela tsoekere, tsoekere le lijo tse nang le lik'habohaedreite tse ngata. Ka hona, bakuli ba nang le lefu la tsoekere ba lokela ho lula ba nkile liswiti, tsoekere, lero la litholoana tse monate, likuku.
Ho hypoglycemia e matla, ha mokuli a sa tsebe letho, ho hlokahala hore a kenelle ka 0.5 - 1 mg ea glucagon ka tsela e kenang kapa ka methapo, kapa a kenya tharollo ea glucose (dextrose) kahare. Ho boetse hoa hlokahala ho tsamaisa tsoekere e kenang kahare ha mokuli a sa hlaphoheloe kelello metsotso e 10 ho isa ho e 15 kamora ho tsamaisoa ha glucagon. Ha ho khutlisa kelello ho thibela ho pheta-pheta ha hypoglycemia, ho kgothaletswa mokuli ho ja lijo tse nang le lik'habohaedreite tse ngata.

Insulin ke eng?

Insulin ke litokisetso tsa protheine-peptide ea tlhaho ea lihormone. Insulin e sebelisoa e le sesebelisoa se ikhethang kalafong ea lefu la tsoekere.

Insulin ke hormone e sebetsang ka mafolofolo ho metabolism ea carbohydrate mme e thusa ho fokotsa bongata ba glucose maling a mali a mokuli. Ho fokotsa lik'habohaedreite maling ho fumanoa ka ho eketsa tšebeliso ea tsoekere ke linama tse itšetlehileng ka insulin tlasa ts'usumetso ea insulin. Insulin e kenya letsoho ho kenngoeng ha glycogen ke lisele tsa sebete 'me e thibela ho fetoloa ha mafura le liamino acid ka lik'habohaedreite.

Ka lebaka la ho haella ha insulin 'meleng oa motho, keketseho ea maemo a tsoekere ea mali e bonoa. Ho eketseha ha tsoekere ea mali ho qholotsa nts'etsopele ea lefu la tsoekere le mathata a amanang le ona. Khaello ea insulin 'meleng e hlaha ka lebaka la mathata a manyeme, a hlahang ka lebaka la ts'ebetso e mpe ea tsamaiso ea endocrine, kamora ho lemala kapa ka mojaro o matla oa kelello' meleng o amanang le ho ba teng hoa maemo a sithabetsang.

Litokisetso tse nang le insulin li etsoa ka lisele tsa manyeme a liphoofolo.

Hangata, tlhahiso ea lithethefatsi e sebelisa linama tsa manyeme a likhomo le a likolobe.

Matšoao a sebelisang litokisetso tsa insulin

Ho felisa tšebeliso e ngata ea lithethefatsi tse nang le insulin, ho hlokahala hore o nke ligrama tse 100 tsa bohobe bo tšoeu, tee e tsoekere kapa likhaba tse 'maloa tsa tsoekere matšoao a pele a moriana.

Ha ho na le matšoao a boletsoeng a ho makala, tsoekere e lokela ho fuoa mokuli kahare. Haeba ho hlokahala, o ka tsamaisa adrenaline ka mokhoa o ikhethileng.

Ho hlokahala tlhokomeliso e khethehileng maemong a ts'ebeliso ea insulin ea maiketsetso ho bakuli ba nang le lefu la tsoekere, nakong ea ho haella ha coronary le ts'ebetsong ea mathata a ho potoloha ha litho tsa 'mele. Tabeng ea ts'ebeliso ea insulin ea nako e telele, ho hlahlojoa moroto oa mokuli le mali ka botlalo bakeng sa litaba tsa tsoekere ho tsona hoa hlokahala. Boithuto bo joalo ho hlakisa nako e nepahetseng ea ho sebelisa moriana ho fihlela sephetho se nepahetseng.

Ho tsamaisa lithethefatsi, li-syringe tse khethehileng tsa insulin kapa lisenstene tse khethehileng tsa pene li sebelisoa hangata.