Mikstard® 30 NM Penfill® Medium bolelele ba insulin e tsoakiloeng hammoho le insulin

Hypoglycemic moemeli oa nako e mahareng. E sebetsana le receptor e itseng kahare ho li-membrane tse ka ntle tsa lisele mme e etsa mochini o amohelang insulin. Ka ho kenya ts'ebetso ea biosynthesis ea cAMP liseleng tsa mafura le lisele tsa sebete kapa ho kenella ka ho toba liseleng tsa mesifa, mohopolo oa isulin receptor o hlohlelletsa mekhoa e kenang kahare ho eona, ho kenyeletsa synthetise ea li-enzymes tse 'maloa tsa bohlokoa (hexokinase, pyruvate kinase, glycogen synthetase, jj.). Ho fokotseha ha khatello ea tsoekere maling ho bakiloe ke ho eketseha ha lipalangoang tsa eona tse ka hare ho kenyelletsa ho eketsehileng le ho ts'oaroa ha lisele, ho khothaletsoa ha glycogeneis, glycogenogeneis, syntheine ea protheine, e fokotse tlhahiso ea tsoekere ke sebete, jj.

Nako ea ts'ebetso ea "insulin" e bakoa haholo ke tekanyo ea ho monya, eo ka lehlakoreng le leng e itšetlehileng ka lintlha tse 'maloa (ho kenyelletsa le lethal dose, mokhoa le sebaka sa tsamaiso). Ho qala ha ts'ebetso kamora ho tsamaisoa ha sc ho le teng ka metsotso e 30, phello e kholo e ba teng ka lihora tse 2-8, nako ea ts'ebetso e fihla ho lihora tse 24. Hangata ho laetsoe hammoho le litokisetso tsa insulin tsa nakoana.

Litlamorao

Litla-morao tse o utloisang bohloko (urticaria, angioedema - feberu, ho hema ka thata, ho fokotseha ha khatello ea mali), ho kenyelletsa sebakeng (hyperemia, ho ruruha, ho hlohlona ha letlalo sebakeng sa ente), lipodystrophy sebakeng sa ente, hypoglycemia (pallor ea letlalo, mofufutso o eketsehileng, ho fufuleloa, ho thothomela, tlala, ho ruruha, ho tšoenyeha, pherekano ka hanong, hlooho, ho otsela) , ho hloka boroko, tšabo, ho sithabela maikutlo, ho se tsitse, boitšoaro bo sa tloaelehang, ho se sireletsehe ha motsamao, puo e sa bonahaleng le pono), komello ea hypoglycemic.

Qalong ea kalafo - ho ruruha le ho holofala 'metso (ke tsa nakoana ebile lia nyamela ka kalafo e tsoelang pele).

Sesebelisoa le litekanyetso

S / c sebakeng sa serope (sebaka seo ho sona ho kenngoang lithethefatsi tse tsamaeang butle le ka bongata), e boetse e lumelloa ka s / c ho kenella ka mpeng ea mpa ea mpa, mokokotlong kapa mesifa e boreleli ea lehetla.

Tekanyetso ea lithethefatsi e khethoa ke ngaka ka bonngoe boemong bo bong le bo bong ho latela khatello ea tsoekere maling. Tekanyetso e tloaelehileng ea letsatsi le letsatsi e tloha ho 0.5 ho isa ho 1 IU / kg boima ba mmele. Setlhare sena se tšeloa metsotso e 30 pele ho lijo tse nang le lik'habohaedreite. Mocheso oa tharollo e kentsoeng e lokela ho ba mocheso oa kamore.

Ho etsa ente ka lesakeng la letlalo ho fokotsa kotsi ea ho kena mosing.

Hoa hlokahala ho fetola sebaka sa ente kahare ho sebaka sa anatomical ho thibela nts'etsopele ea lipodystrophy.

Setlhare sena se sebelisoa e le monotherapy ebile se sebetsa hammoho le insulin. Ka kalafo e matla, moriana o sebelisoa e le basal insulin makhetlo a 1-2 ka letsatsi (tsamaiso ea mantsiboea le hoseng) hammoho le insulin e tsamaeang le nakoana (tsamaiso pele ho lijo tsa motšeare).

Ka mofuta oa lefu la tsoekere la mofuta oa II mellitus, sethethefatsi se tsamaisoa hammoho le lithethefatsi tsa molomo.

Litaelo tse khethehileng

Moriana ha o khone ho kenella ka / ho.

Ka kenyelletso ea insulin e lokela ho lekola khafetsa khatello ea tsoekere maling.

Setlhare ha se na thuso haeba, kamora ho sisinyeha, ho emisoa ha ho fetohe le tšoeu ebile ha le koahe ka maru. Bakeng sa kenyelletso ea moriana ha o khothalletsoe ho sebelisa lipompo tsa insulin.

Hypoglycemia e ka felisoa ke ho ja tsoekere hang hang kapa lihlahisoa tse ling tse nang le tsoekere (mokuli o tlameha ho lula a e-na le likotoana tsa tsoekere, lipompong, likuku kapa lero la litholoana).

Tsebisa beng ka uena, metsoalle le basebetsi-'moho le uena ka lefu la tsoekere, ba hlalosetse melao ea thuso ea pele haeba ho ka ba le hypoglycemia e matla.

Ka ho hlahisoa ha lethal dose le ka tlase la insulin ho feta kamoo ho hlokahalang, tlhokahalo e matla ea insulin, ho se sebetse hantle, le taolo e sa sebetseng ea insulin, hyperglycemia le amanang le lefu la tsoekere la ketoacidosis le ka hlaha (polyuria, polakiuria, lenyora, ho felloa ke takatso ea lijo, ho nyekelwa ke pelo, ho hlatsa, ho otsela, bofokoli, hyperemia, le letlalo, molomo o omileng le monko oa acetone moeeng o tsoang. Ha matšoao a pele a hyperglycemia a hlaha, insulin e lokela ho tsamaisoa hanghang.

Ho mafu a kopaneng (ho kenyeletsa le tlolo ea tšoelesa ea qoqotho, sebete, liphio, lefu la Addison, hypopituitarism) ho batho ba tsofetseng (ba fetang lilemo tse 65), ho ka hlokahala phetoho ea tekanyetso ea insulin. Matšoao a tšoaetsanoang a tsamaeang le feberu, keketseho ea mesebetsi ea 'mele, phetoho ea lijo tse tloaelehileng e eketsa tlhokahalo ea insulin.

Ho ja lijo-thollo tsa (Eththanol) (ho kenyeletsa le biri, veine) ho ka baka hypoglycemia. Se ke oa nka ethanol ka mpeng e se nang letho.

Ha o fetohela insulin ea motho, ho lokela ho hopoloa hore matšoao a pele a li-harbinger tsa hypoglycemia a ka fokotsoa ho feta kamoo a neng a le ka teng ha ho sebelisoa moriana o fetileng. Sebopeho le boholo ba matšoao ana a pele a ka fetoha nakong ea matseliso a tsitsitseng bakeng sa metabolism ea carbohydrate (ho kenyeletsoa nakong ea kalafo e matla ea insulin).

Nakong ea kemolo le nakong ea kemaro, ho kgothaletswa ho fetola tekanyetso ho boloka puseletso bakeng sa lefu la tsoekere.

Nakong ea kalafo, tlhokomelo e lokela ho nkuoa ha ho khannoa likoloi le ho etsa lintho tse ling tse ka bang kotsi tse hlokang ho tsepamisa mohopolo le ho potlaka ha maikutlo a psychomotor (nakong ea hypoglycemia, li kanna tsa fokotseha).

Tšebelisano

Ka meriana ha a lumellane le tharollo ea lithethefatsi tse ling.

Phello ea hypoglycemic e ntlafatsoa ke li-sulfonamides (ho kenyeletsa le lithethefatsi tsa molomo tsa hypoglycemic, sulfonamides), li-inhibitors tsa MAO (ho kenyeletsoa furazolidone, procarbazine, selegiline), carbonic anhydrase inhibitors, li-inhibitors tsa ACE, li-NSAIDs (ho kenyeletsa le li-salicylates), anabolic (ho kenyelletsa stanozolol, oxandrolone, methandrostenolone), androgens, bromocriptine, tetracyclines, clofibrate, ketoconazole, mebendazole, theophylline, cyclophosphamide, phenfluramine, Li + litokisetso, pyridoxine, quinidine, quinine, chloroine, quinine, chloroine, quinine, etloro.

litla Hypoglycemic la litsebeng glucagon, khōlo hormone, corticosteroids, molomo lithibela-pelehi, estrogens, thiazide le sekgoqetsane diuretics, li-hormone BCCI, thyroid, heparin, sulfinpyrazone, sympathomimetics, danazol, tricyclics, clonidine, k'halsiamo ba khahlanong le lōna, diazoxide, morphine e, matekoane, bokoali, phenytoin, epinephrine, H1-histamine receptor blockers.

Beta-blockers, reserpine, octreotide, pentamidine ka bobeli li ka ntlafatsa le ho fokolisa phello ea hypoglycemic ea insulin.

Setsebi sa lefu la tsoekere: "Ho tsitsisa boemo ba tsoekere ea mali."

Mokhoa oa ho sebelisa: litekanyetso le kalafo

S / c sebakeng sa serope (sebaka seo ho sona ho kenngoang lithethefatsi tse tsamaeang butle le ka bongata), e boetse e lumelloa ka s / c ho kenella ka mpeng ea mpa ea mpa, mokokotlong kapa mesifa e boreleli ea lehetla.

Tekanyetso ea lithethefatsi e khethoa ke ngaka ka bonngoe boemong bo bong le bo bong ho latela khatello ea tsoekere maling. Tekanyetso e tloaelehileng ea letsatsi le letsatsi e tloha ho 0.5 ho isa ho 1 IU / kg boima ba mmele. Setlhare sena se tšeloa metsotso e 30 pele ho lijo tse nang le lik'habohaedreite. Mocheso oa tharollo e kentsoeng e lokela ho ba mocheso oa kamore.

Ho etsa ente ka lesakeng la letlalo ho fokotsa kotsi ea ho kena mosing.

Hoa hlokahala ho fetola sebaka sa ente kahare ho sebaka sa anatomical ho thibela nts'etsopele ea lipodystrophy.

Setlhare sena se sebelisoa e le monotherapy ebile se sebetsa hammoho le insulin. Ka kalafo e matla, moriana o sebelisoa e le basal insulin makhetlo a 1-2 ka letsatsi (tsamaiso ea mantsiboea le hoseng) hammoho le insulin e tsamaeang le nakoana (tsamaiso pele ho lijo tsa motšeare).

Ka mofuta oa lefu la tsoekere la mofuta oa II mellitus, moriana o fanoa hammoho le lithethefatsi tsa molomo tsa hypoglycemic.

Foromo ea litekanyetso

Ho emisoa bakeng sa tsamaiso ea subcutaneous, 100 IU / ml

1 ml ea lithethefatsi e na le

ntho e sebetsang - genetically human insulin 3.50 mg (100 IU) 1,

Baeti: zinc (ka sebopeho sa zinki ea chloride), glycerin, phenol, metacresol, sodium hydrogen phosphate dihydrate, protamine sulfate, hydrochloric acid 2 M tharollo, sodium hydroxide 2 M tharollo ea pH 7.3, metsi bakeng sa ente.

1 Setlhare se na le insulin ea insulin ea motho ea qhibilihang le 70% isofan-insulin

Ho emisoa ka tšoeu, ha e eme, e kengoe ka mokhoa o hlakileng, o se nang 'mala kapa o shebahalang o se na' mala le moea o mosoeu. Ha e le hantle pula e khutla habonolo ha e sisinngoa ka bonolo.

Melemo ea pharmacological

Mofumahali

Nako ea ts'ebetso ea litokisetso tsa insulin e haholoholo ka lebaka la ho monya, ho latela lintlha tse 'maloa (mohlala, ka tekanyetso ea insulin, mokhoa le sebaka sa taolo, botenya ba karolo e tlase ea mafura le mofuta oa lefu la tsoekere). Ka hona, lipilisi tsa "insulin" tsa pharmacokinetic li ka ba le phapang e matla ea ho fetoha ha maemo lipakeng le kahare ho motho ka mong.

The boholo ba mahloriso (Cmax) ea insulin ho plasma e fihlelloa nakong ea lihora tse 1.5 ho isa ho tse 2 kamora ho tsamaisoa ha subcutaneous.

Ha ho na polelo e tlamang ea liprotheine tsa plasma e boletsoeng, ntle le li-antibodies ho insulin (haeba li teng).

Insulin ea motho e hlakisoa ke ketso ea protheine ea insulin kapa li-enzyme tse bolokang insulin, 'me mohlomong le ketso ea protheine disulfide isomerase. Ho nahanoa hore ka molek'hule ea insulin ea motho ho na le libaka tse 'maloa tsa cleavage (hydrolysis), leha ho le joalo, ha ho na metabolites e entsoeng ka lebaka la cleavage e sebetsang.

Half-life (T½) e khethoa ke sekhahla sa ho amoheloa ho tsoa lithong tse ka tlasana. Kahoo, T½ ke mokhoa o mongata oa ho amoheloa, ho fapana le tekanyo ea 'nete ea ho tlosa insulin ho plasma (T½ ea insulin maling le metsotso e seng mekae). Boithuto bo bontšitse hore T½ e ka ba lihora tse 5-10.

Pharadodynamics

Mikstard® 30 NM Penfill ® ke insulin e sebetsang habeli e hlahisoang ke biombekthale ea DNA ea "recombinant" e sebelisang mofuta oa Saccharomyces cerevisiae. E sebetsana le receptor e itseng ho membrane e ka ntle ea cytoplasmic ea lisele mme e etsa mochini o nang le insulin-receptor. Ka ts'ebetso ea li-biosynthesis tsa cAMP (liseleng tsa mafura le lisele tsa sebete) kapa, ka ho kenella ka seqo ka seleng (mesifa), motsoako oa "insulin-receptor" o hlohlelletsa mekhoa e meng e kenelletseng synthetise ea li-enzymes tse 'maloa tsa bohlokoa (hexokinase, pyruvate kinase, glycogen synthetase, jj.). Ho fokotseha ha tsoekere ea mali ho bakoa ke keketseho ea phallo ea eona e makatsang, ho monya ho eketsehileng le ho ts'oaroa ha lisele, ho hlohlelletsa polelo lipoisis, glycogenogeneis, synthetiki ea protheine, ho fokotseha ha sekhahla sa tlhahiso ea tsoekere ke sebete, jj.

Tšusumetso ea lithethefatsi Mikstard® 30 NM Penfill® e qala nakong ea halofo ea hora kamora ts'ebetso, mme phello e phahameng e bonahala ka nako ea lihora tse 2-8, ha nako eohle ea ts'ebetso e ka ba lihora tse 24.

Tekanyetso le tsamaiso

Litokisetso tsa insulin tse kopaneng hangata li fanoa hang kapa habeli ka letsatsi haeba ho hlokahala hore ho kopanngoe litholoana tse potlakileng tsa pele le tse telele.

Tekanyo ea lithethefatsi e khethoa ka bonngoe, ho nahanela litlhoko tsa mokuli. Ka tloaelo, litlhoko tsa insulin li pakeng tsa 0,3 le 1 IU / kg / letsatsi. Tlhokahalo ea insulin ea letsatsi le leng le le leng e ka ba e phahameng ho bakuli ba hanyetsang insulin (mohlala, nakong ea ho kena bohlankaneng kapa ho bakuli ba nang le botenya), le tlase ho bakuli ba nang le tlhahiso ea insulin ea insulin.

Haeba bakuli ba nang le lefu la tsoekere ba fumana taolo e nepahetseng ea glycemic, joale mathata a lefu la tsoekere ho bona, e le molao, a hlaha hamorao. Ntlheng ena, motho o lokela ho loanela ho ntlafatsa taolo ea metabolic, haholo, ba lekola boemo ba tsoekere maling.

Moriana o fanoa ka metsotso e 30 pele ho lijo kapa lijo tse bobebe tse nang le lik'habohaedreite.

Bakeng sa tsamaiso e potolohileng. Ha ho maemong afe kapa afe ha ho lokela hore ho be le lipelaelo tsa insulin tse tsamaisoang kahare. Mikstard® 30 NM Penfill® hangata e tsamaisoa ka tsela e potelletseng sebakeng sa lebota la mpa ea ka ntle. Haeba sena se loketse, joale liente le tsona li ka etsoa thipa, sebakeng sa gluteal kapa sebakeng sa mesifa e lutlang ea mahetla (subcutaneally). Ka ho kenyelletsoa ha moriana sebakeng sa lebota la mpa ea ka ntle, ho kenngoa ka potlako ho fihlelleha ka potlako ho feta ka kenyelletso libakeng tse ling. Ho etsa ente ka lesakeng la letlalo ho fokotsa kotsi ea ho kena mosing. Hoa hlokahala hore kamehla o fetole sebaka sa ente ka hare ho sebaka sa anatomical e le ho fokotsa kotsi ea lipodystrophy.

Litaelo tsa ho sebelisoa le Mikstard® 30 NM Penfill® li fuoe mokuli.

Pele o sebelisa lithethefatsi Mikstard® 30 NMPolao®hoa hlokahala:

Lekola sephutheloana ho etsa bonnete ba hore ho khethoa mofuta o nepahetseng oa insulin.

Kamehla sheba mokotla oa katse, ho kenyelletsa le piston ea rabara. Haeba ho na le tšenyo e 'ngoe e fumanoeng, kapa haeba ho na le lekhalo pakeng tsa piston ea rabara le theipi e tšoeu e nang le tšoaea, letlapa lena le ke ke la sebelisoa. Bakeng sa tataiso e eketsehileng, bona litaelo tsa ho sebelisa sistimi bakeng sa tsamaiso ea insulin.

Kamehla sebelisa nale e ncha bakeng sa sejo se seng le se seng ho thibela tšoaetso.

Tšoaea motsoako oa rabara ka swab ea k'hothone.

Lithethefatsi Mikstard®30 nmPolao®e ka se sebelisoe maemong a latelang:

Lipompong tsa insulin (lipompo)

Haeba mokelikeli kapa sesebelisoa sa ho kenyelletsa sea tsoa, ​​kapa haeba se senyehile kapa se soetsoe, joalo ka ha ho na le monyetla oa ho tsoa ka insulin

Haeba hypoglycemia e qala (tsoekere e tlase ea mali).

Haeba insulin e ne e sa bolokoa hantle, kapa haeba e hoamme

Haeba e sa ba tšoeu ka mokhoa o tšoanang 'me ea koaheloa ke maru ka mor'a ho phumula.

Pele o sebelisa Mikstard® 30 NM Penfill®:

Lekola lebokose ho etsa bonnete ba hore o sebelisa mofuta o nepahetseng oa insulin.

Tlosa sekoaelo se sirelletsang.

Li-needle le Mikstard® 30 NM Penfill® ke tsa ts'ebeliso ea hau feela.

Mokhoa oa ho sebelisa lithethefatsi Mikstard® 30 NM Penfill®

Lithethefatsi Mikstard® 30 NM Penfill® e etselitsoe tsamaiso e tsamaeang ka tlasana. Le ka mohla u se ke oa kenya insulin ka methapo kapa kahare. Kamehla chencha libaka tsa ente kahare ho sebaka sa anatomical ho fokotsa kotsi ea litiiso le liso sebakeng sa ente. Libaka tse ntle tsa liente ke: li-buttocks, thipa ea ka ntle kapa lehetla.

Litaelo tsa mokuli hore na a ka etsa insulin joang

Pele o kenya mokotla oa Penfill ® tsamaisong ea ente ea insulin, phahamisa le ho theola mokotla bonyane makhetlo a 10 ho ea holimo le tlase pakeng tsa maemo a le b, joalo ka ha ho bonts'itsoe setšoantšong, e le hore bolo ea khalase kahare ho mokotla e tlohele pheletsong e 'ngoe ea karache ho ea ho tse ling bonyane makhetlo a 20. Pele ho ente ka 'ngoe, bonyane ho lokela ho etsoa metsamao e 10. Mekhoa ena e bolokiloeng e lokela ho phetoa ho fihlela mokelikeli o ba mosoeu ebile o le maru. Kenya hang-hang.