Protafan insulin e bua ka insulin ea motho ea mahareng.
Tlhokahalo ea tšebeliso ea lithethefatsi Insulin Protafan NM e ka hlaha ka mafu le maemo a mangata. Pele ho tsohle, ka lefu la tsoekere la mofuta oa 1 le la 2. Ntle le moo, moriana o bontšoa mothating oa ho hanana le lithethefatsi tsa pele tsa hypoglycemic.
Setlama se sebelisoa le kalafo e kopaneng (ho itšireletsa ka 'mele ho lithethefatsi tsa hypoglycemic) haeba lefu la tsoekere le fumanoa ho basali baimana le haeba kalafo ea ho ja e sa thusa;
Maloetse a pakeng tsa methapo le ts'ebetso ea ho buoa (e kopantsoeng kapa ea monotherapy) e ka ba lebaka la ho khethoa.
Nka fetola lithethefatsi joang, li-analogues?
- Insulin Bazal (theko e ka bang li-ruble tse 1435);
- Humulin NPH (theko e ka bang li-ruble tse 245);
- Protafan NM (theko e ka bang li-ruble tse 408);
- Aktrafan NM (theko ka
- Protafan NM Penfill (theko e ka bang li-ruble tse 865).
Litšobotsi tsa moriana
Setlhare ke ho emisoa ka tlasa letlalo.
Sehlopha, ntho e sebetsang:
Isulin insulin-human semisynthetis (semisynthetic ea motho). E na le nako e lekanang ea ketso. Protafan NM e tšoaelitsoe ho: insulinoma, hypoglycemia le hypersensitivity ho ntho e sebetsang.
Ho nka le ho sebelisa litekanyetso li kae?
Insulin e kenngoa hanngoe kapa habeli ka letsatsi, halofo ea hora pele ho lijo tsa hoseng. Sebakeng sena, moo liente li tla etsoa, li lokela ho fetoloa khafetsa.
Tekanyetso e lokela ho khethoa bakeng sa mokuli ka mong. Bophahamo ba eona bo itšetlehile ka tekanyo ea tsoekere e ngata ka har'a moroto le phallo ea mali, hammoho le litšobotsi tsa lefu lena. Ha e le hantle, lethal dose le behiloe nako e le 'ngoe ka letsatsi mme ke 8-24 IU.
Ho bana le ho batho ba baholo ba nang le hypersensitivity ho insulin, bophahamo ba modumo bo fokotsoa ho 8 IU ka letsatsi. Bakeng sa bakuli ba nang le maikutlo a fokolang, ngaka e eang e ka u fa lethal dose le fetang 24 IU ka letsatsi. Haeba tekanyetso ea letsatsi le letsatsi e feta 0,6 IU ka kilo, joale moriana o fanoa ka liente tse peli, tse etsoang libakeng tse fapaneng.
Bakuli ba fumanang IU 100 kapa ho feta ka letsatsi, ha ba fetola insulin, ba tlameha ho lula ba le tlasa tlhokomelo ea lingaka. Ho fetola moriana le o mong ho lokela ho etsoa ka ho lekola khafetsa maemo a tsoekere ea mali.
Melemo ea pharmacological
Properties of Insulin Protafan:
- e fokotsa khatello ea tsoekere ea mali;
- e ntlafatsa ho monya ha tsoekere ho linama;
- kenya letsoho ho ntlafatseng liprotheine tse ntlafalitsoeng;
- e fokotsa sekhahla sa tlhahiso ea tsoekere ke sebete;
- e ntlafatsa glycogenogeneis;
- ntlafatsa lipognisis.
Microinteraction le li-receptor ho membrane ea sele ea kantle e khothaletsa sebopeho sa mochini oa "insulin" receptor. Ka ho susumetsa liseleng tsa sebete le lisele tsa mafura, motsoako oa CAMP kapa ho kenella ka har'a mesifa kapa sele, motsoako oa "insulin" o kenya ts'ebetsong lits'ebetso tse etsahalang ka har'a lisele.
E boetse e qala motsoako oa li-enzyme tsa bohlokoa (glycogen synthetase, hexokinase, pyruvate kinase, joalo-joalo).
Ho fokotseha ha tsoekere ea mali ho bakoang ke:
- ho tsamaisa tsoekere e ngata ka har'a lisele;
- ho hlohlelletsa glycogenogeneis le lipogeneisis;
- ho kenyelletsa le ho monya ha glucose e ngata ka lisele;
- protheine ea tlhaho;
- ho fokotseha ha sekhahla sa tlhahiso ea tsoekere ke sebete, i.e. phokotso ea glycogen le tse ling.
Setlhare se kena neng mme se nka nako e kae?
Hang ka mor'a hore ho hlahisoe ho emisoa ho entsoe, phello ha e etsahale. O qala ho nka bohato ka metsotso e 60 ho isa ho e 90.
Phello e phahameng e etsahala pakeng tsa lihora tse 4 ho isa ho tse 12. Nako ea ts'ebetso e qala ho tloha lihora tse 11 ho isa ho tse 24 - kaofela ho latela tekanyetso le sebopeho sa insulin.
Litlamorao
Hypoglycemia (pono e sa sebetseng le puo, pallor ea letlalo, mekhathala e ferekaneng, mofufutso o eketsehang, boits'oaro bo makatsang, palpitations, ho tsitsipana, ho tetebela maikutlo, ho eketsa takatso ea lijo, tšabo, ho ferekana, ho hloka boroko, matšoenyeho, ho otsela, paresthesia molomong, hlooho e opang ;
Litla-morao (ho fokotseha ha khatello ea mali, urticaria, ho hema hanyane, feberu, angioedema);
Keketseho ea karolo ea antibodies ea anti-insulin ka keketseho e eketsehileng ea glycemia;
Diabetesic acidosis le hyperglycemia (khahlano le semelo sa tšoaetso le feberu, ho se je lijo, ente e lahlehileng, tekanyetso e nyane): sefahleho se tetebela, ho otsela, ho felloa ke takatso ea lijo, lenyora le sa khaotseng;
Hypoglycemic coma;
Boemong ba pele ba kalafo - liphoso tse hlahang hape le edema (ketsahalo ea nakoana e etsahalang ka kalafo e tsoelang pele);
Ho sitisoa ke letsoalo (ka linako tse ling ho ba le komello le boemo ba boiketlo);
Sebakeng sa ente, ho hlohlona, hyperemia, lipodystrophy (hypertrophy kapa atrophy ea mafura a subcutaneous);
Qalong ea kalafo ke bokuli ba nakoana ba pono;
Boitšoaro bo amanang le 'mele bo amanang le insulin ea motho.
Matšoao a bosholu bo feteletseng:
- cramps
- mofufutso;
- hypoglycemic coma;
- palpitations
- ho hloka boroko
- pono le puo e sa sebetseng;
- thothomela
- metsamao e ts'oanang;
- ho otsela
- takatso e matla ea lijo;
- boits'oaro bo makatsang;
- Matšoenyeho
- ho se khonehe
- paresthesia molomong oa molomo;
- Ho sithabela maikutlo
- pallor
- tshabo
- hlooho e bohloko.
Mokhoa oa ho phekola bongoana bo feteletseng?
Haeba mokuli a le maemong a hlokofatsang, ngaka e fana ka taelo ea dextrose, e tsamaisoang ka mokokotlo ka mokokotlo kapa ka mokokotlong. Glucagon kapa tharollo ea hypertonic dextrose le eona e tsamaisoa ka matla.
Tabeng ea hypa-hypoglycemic coma, 20 ho isa ho 40 ml, i.e. Tharollo ea dextrose ea 40% ho fihlela mokuli a tsoa ho opa.
Litlhahiso tsa bohlokoa:
- Pele o nka insulin ka har'a sephutheloana, o hloka ho hlahloba hore na tharollo ea ka botlolong e na le 'mala o hlakileng. Haeba ho bonahala maru, pula kapa litopo tsa basele, tharollo e thibetsoe.
- Mocheso oa lithethefatsi pele ho tsamaiso e lokela ho ba mocheso oa kamore.
- Ha ho na le mafu a tšoaetsanoang, ho se sebetse hantle ha tšoelesa ea qoqotho, lefu la Addiosn, ho se sebetse hantle ha renal, hypopituitarism hammoho le lefu la tsoekere la botsofe, tekanyetso ea insulin e hloka ho fetoloa ka bo bona.
Lisosa tsa hypoglycemia e ka ba:
- overdose
- ho hlatsa
- phetoho ea lithethefatsi;
- mafu a fokotsang tlhoko ea insulin (mafu a sebete le a liphio, hypofunction ea tšoelesa ea qoqotho, pituitary gland, adrenal cortex);
- ho se latele lijo tsa batho ba bang;
- ho sebelisana le lithethefatsi tse ling;
- lets'ollo
- ho fetelletsa lintho tse ngata 'meleng;
- phetoho ea sebaka sa ente.
Ha u fetisetsa mokuli ho tsoa ho insulin ea liphoofolo ho ea ho insulin ea motho, ho theoha ha maemo a tsoekere ea mali ho ka hlaha. Phetoho ea insulin ea motho e lokela ho fanoa ka mabaka a bongaka, mme e lokela ho etsoa tlasa taolo e tiileng ea ngaka.
Nakong ea ho beleha le ka mor'a ho pepa, tlhoko ea insulin e ka fokotsoa haholo. Nakong ea ho nyekeloa, o hloka ho hlokomela mme oa hau ka likhoeli tse 'maloa, ho fihlela tlhoko ea insulin e tsitsitse.
Ho tseba esale pele tsoelo-pele ea hypoglycemia ho ka baka tšenyo kelellong ea motho ea kulang ho khanna makoloi le ho boloka metjeko le metjhini.
Ka ho sebelisa tsoekere kapa lijo tse nang le lik'habohaedreite tse ngata, batho ba nang le lefu la tsoekere ba ka emisa mofuta o bobebe oa hypoglycemia. Ho bohlokoa hore kamehla mokuli a be le bonyane 20 g ea tsoekere le eena.
Haeba hypoglycemia e chechisitsoe morao, ho bohlokoa ho tsebisa ngaka e tla etsa phetoho ea kalafo.
Nakong ea kemolo, ho lokela ho nahanoa ka ho fokotseha ha (1 trimester) kapa keketseho ea (trimesters tse peli) tsa mmele bakeng sa insulin.
Ho sebelisana le lithethefatsi tse ling
Hypoglycemia e ntlafatsoa ke:
- Li-inhibitors tsa MAO (selegiline, furazolidone, procarbazine);
- sulfonamides (sulfonamides, lithethefatsi tse tsoang ka molomo tsa hypoglycemic);
- Li-NSAID, li-inhibitors tsa ACE le salicylates;
- anabolic steroids le methandrostenolone, stanozolol, oxandrolone;
- li-inhibitors tsa carbonic anhydrase;
- ethanol;
- androgens;
- chloroquine;
- bromocriptine;
- quinine;
- litopo;
- quinidine;
- clofribate;
- pyridoxine;
- ketoconazole;
- Litokisetso tsa Li +;
- mebendazole;
- theophylline;
- fenfluramine;
- cyclophosphamide.
Hypoglycemia e tsamaisoa ke:
- Li-blockers tsa H1 - li-receptor tsa vithamine;
- glucagon;
- epinephrine;
- somatropin;
- phenytoin;
- GCS;
- nikotine;
- lithibela-pelehi tsa molomo
- matekoane;
- estrogens;
- morphine;
- loopide le thiazide diuretics;
- diazoxide;
- BMKK;
- lihanyetsi tsa calcium
- lihormone tsa qoqotho;
- clonidine;
- heparin;
- li-antidepressants tsa tricyclic;
- sulfinpyrazone;
- danazole;
- kutloelo-bohloko.
Ho boetse ho na le lithethefatsi tse ka fokolisang le ho ntlafatsa phello ea glycemic ea insulin. Tsena li kenyeletsa:
- pentamidine;
- beta-blockers;
- octreotide;
- reserpine.
