Lefu la tsoekere le bua ka maloetse a sa foleng a amang litho tsohle tsa 'mele. Mokhoa oa mantlha oa ntlafatso o amahanngoa le khaello ea "insulin" ea hormone, e ikarabellang bakeng sa ts'ebeliso ea tsoekere ke lisele. Ka lebaka leo, ho na le ho se leka-lekane ho metabolism, boemo ba glucose maling bo nyoloha. Phekolo ea lefu la tsoekere mellitus e theohela phetong ea nako eohle ea hormone.
Mokelikeli o mong oa insulin oa maiketsetso o se o hlahisitsoe. E 'ngoe ea tsona ke Protafan. Litaelo tsa tšebeliso li na le tlhaiso-leseling e phethahetseng bakeng sa ts'ebeliso e ikemetseng ea moriana ona oa bohlokoa.
Sebopeho le mofuta oa tokollo
Ntho e sebetsang ke insulin ea motho, e hlophisitsoeng ke theknoloji ea boenjiniere ba liphatsa tsa lefutso. E fumaneha ka mefuta e mengata ea litekanyetso:
- "Protafan NM": hona ke ho emisoa ka liphoofolong, e mong le e mong 10 ml, mahloriso a insulin ea 100 IU / ml. Pakete e na le botlolo e le 'ngoe.
- Protfill ea "Protafan NM": mabokose a nang le 3 ml (100 IU / ml) ka 'ngoe. Ho blister e le 'ngoe - mabokose a 5, sephuthelong - 1 blister.
Lihlahisoa: metsi a ente, glycerin (glycerol), phenol, sodium hydrogen phosphate dihydrate, protamine sulfate, metacresol, sodium hydroxide le / kapa hydrochloric acid (ho fetola pH), zinki chloride.
Ketso ea pharmacological
"Protafan" e bua ka lithethefatsi tsa hypoglycemic tsa nako e mahareng. Morero oa mantlha ke ho netefatsa ho kenella ha tsoekere ka har'a membrane ea sele.
Ntle le moo o qala mekhoa e latelang:
- E kenya tšebetsong li-enzymes tse 'maloa tse hlokahalang bakeng sa bophelo - glycogen synthetase, pyruvate dehydrogenase, hexokinase;
- Lithunya li-adase tsa lipase le lipoprotein lipase;
- E susumetsa phosphorylation ea liprotheine tsa cellular.
Ka lebaka leo, ha se feela karolo ea tsoekere e ka seleng e ntlafalitsoeng, empa le ts'ebeliso ea eona ka sebopeho sa glycogen. Ho feta moo, ho hlahisoa protheine ea li-protein tsa cellular.
Melao-motheo ea ho sebelisa Protafan
Setlhare sena se sebelisetsoa mofuta ofe kapa ofe oa lefu la tsoekere. Ka mofuta oa I, kalafo e qala hang-hang ka eona, ka mofuta oa II, Protafan e bonts'oa maemong a ho se sebetse hantle hoa sulfonylurea, nakong ea kemaro, nakong ea ts'ebetso le ka mor'a ts'ebetso, ho na le mafu a kopaneng a lefu la tsoekere.
Clinical Pharmacology
Ho qala ha ts'ebetso ho tlalehiloe lihora tse 1.5 kamora ho tsamaisoa ha subcutaneous. Ho sebetsa hantle - kamora lihora tse 4-12. Nako eohle ea ts'ebetso ke lihora tse 24.
Ena pharmacokinetics e hlalosa melao-motheo e akaretsang ea ts'ebeliso ea "Protafan":
- Insulin e itšetlehileng ka lefu la tsoekere - e le sesebelisoa sa mantlha se kopantsoeng le li-insulin tse haufinyane.
- Mellitus ea lefu la tsoekere e sa itšetleheng ka insulin - monotherapy ka bobeli le moemeli enoa le motsoako le lithethefatsi tse sebetsang ka potlako li lumelloa.
Haeba moriana o sebelisoa e le kalafo ea mono, o tšeloa pele ho lijo. Ts'ebeliso ea mantlha, e fanoa hang ka letsatsi (hoseng kapa ka shoalane).
Mokhoa oa kopo
Setlhare se kenngoa ka tlasa letlalo. Sebaka sa setso ke sebaka sa mokokotlo. Ho entoa ho lumelloa sebakeng sa lebota la ka mpeng la mpa, marapo le mesifa e boreleli letsohong. Sebaka sa ente se lokela ho fetoloa ho thibela nts'etsopele ea lipodystrophy. Ho hlokahala hore o hule 'mele hantle hore o thibele insulin.
Mokhoa oa ho sebelisa pene ea syringe bakeng sa "insulin" ea "insulin"
Ho ipusa nako e telele ea mefuta ea ente ho hloka ho nolofatsa mokhoa ona ka hohle kamoo ho ka khonehang. Bakeng sa morero ona, ho entsoe pene ea syringe, e matlafatsang ka lireletso tsa mabokose a Protelana.
Mokuli e mong le e mong ea nang le lefu la tsoekere o lokela ho tseba litaelo tsa tšebeliso ea eona ka pelo:
- Pele o tlatsa mokotla, hlahloba sephutheloana ho etsa bonnete ba hore litekanyetso li nepahetse.
- Etsa bonnete ba ho lekola mokotla ka boeona: haeba ho na le tšenyo e 'ngoe kapa lekhalo le hlahang pakeng tsa theipi e tšoeu le piston ea rabara, ebe sephutheloana sena ha se sebelisoe.
- Membrane ea rabara e tšoaroa ka sehlahisoa se bolaeang likokoana-hloko a sebelisa swab ea k'hothone.
- Pele o kenya mokotla, sisteme e pumtsoe. Ho etsa sena, fetola maemo e le hore bolo ea khalase e kahare e tlohele pheletsong e 'ngoe ho isa ho e meng bonyane makhetlo a 20. Kamora sena, mokelikeli o lokela ho ba le maru ka mokhoa o lekanang.
- Ke li-cartridge feela tse nang le bonyane likarolo tse 12 tsa insulin tse hlokang ho tsoakoa ho latela mokhoa o hlalositsoeng ka holimo. Ena ke tekanyetso e nyane ea ho tlatsoa ka penseng ea syringe.
- Kamora ho kenngoa ka tlasa letlalo, nale e lokela ho lula moo bonyane metsotsoana e tšeletseng. Ke maemong ana feela lethal dose le tla kenngoa ka botlalo.
- Kamora ho entoa ka leng, nale e tlosoa syringe. Sena se thibela ho lutla ho sa laoleheng ha mokelikeli, ho lebisang phetohong ea tekanyetso e setseng.
Tsena tsohle tse kaholimo li supa kotsi ea liphetoho mokhoeng oa ho kenella ka har'a insulin ka moriana kapa ho se sebetse hoa oona, o ka lebisang ho se be le phello le litlamorao tse mpe tsa bophelo bo botle.
Dose
Mokuli e mong le e mong ea nang le lefu la tsoekere o na le litekanyetso le makhetlo a tsamaiso ea insulin. E baloa ke endocrinologist ka bonngoe, ho latela boemo ba tsoekere ea glucose le tlhahiso ea eona ea hormone.
Boikutlo bo sa tsotelleng litekanyetso le litlhahiso tsa ngaka li lebisa nts'etsong ea mathata a tebileng a kalafo ea insulin: hypo- kapa hyperglycemic coma, e ka lebisang lefung la mokuli.
Mekhoa e metle ea ho khetha tekanyetso ea "Protafan":
- Moriana o lokela ho fana ka tlhoko ea mmele bakeng sa li-hormone, e leng 0,3-1 IU / kg / letsatsi.
- Ho ba teng ha khanyetso ea insulin ho hloka keketseho tlhoko ea mantlha, ke ka hona lethal dose la moriana. Sena se bonoa nakong ea ho kena bohlankaneng kapa ho bakuli ba nang le botenya.
- Haeba mokuli a boloka mofuta o mong oa insulin ea hae, litekanyetso li fetoloa ka tlase.
- Mafu a sa foleng a sebete le a liphio le ona a fokotsa tlhoko ea 'mele ea insulin.
- Mohloli oa litekanyetso li nepahetseng ke boemo ba tsoekere bo sa tsoeng maling. Sena se hloka tlhaiso ea kamehla ea letšoao lena.
Ho ikamahanya le litlhahiso tsohle bakeng sa ho kenyelletsa "Protafan" ho lebisa ho tsitsitseng metabolism ea carbohydrate mme ho chechisa haholo ponahalo ea mathata a tloaelehileng a lefu lena.
Lintho tse fapaneng tse tla etsahala
Phello e mpe e kholo ka mor'a ts'ebeliso ea lithethefatsi e bakoa ke ketso ea insulin e khahlanong le mofuta oa moriana. E kotsi ka ho fetisisa har'a bona ke boemo ba hypoglycemic. E hlaha ka lebaka la ho hlahisoa ha palo ea insulin e ngata haholo e fetang litlhoko tsa eona.
Ka lebaka leo, khatello ea tsoekere maling e fokotseha haholo, methapo ea kelello e qala ho ba le khaello ea matla, motho a lahleheloa ke kelello. Ha ho se na thuso ea tšohanyetso, ho akheha le ho shoa hoa hlaha.
Litlamorao tse ling tse mpe ha li kotsi ebile li amana le litlamorao tse mpe tsa likarolo tsa moriana. Tsena li kenyeletsa:
- Litla-morao. Ho tloha hives hives le rashes ho ea akaretsang karabelo: rashes ho pholletsa le mmele, ho ruruha ha lisele, bokhutšoanyane ba moea, tachycardia, ho hlohlona haholo, ho ruruha. Maemong a boima haholo - ho akheha le ho felloa ke letsoalo.
- Matšoao a Neurological. Pheripalal neuropathy e tšoauoa ka matšoao a fapaneng: ho senyeha ha tsamaiso ea methapo ea kutlo, ho sithabela ha maikutlo le bohloko maqaeng, paresthesia.
- Ho tloha lehlakoreng la setho sa pono. Khafetsa, ho etsahala phoso e hlakileng, e atisang ho tloha kamora nakoana. Boemong ba pele ba kalafo, ho ka mpefala ho eketsehileng ha lefu la tsoekere.
- Letlalo le lisele tse nyane. Ka tsamaiso ea insulin ea nako e telele sebakeng se le seng, lipodystrophy ea hlaha.
- Boitšoaro ba lehae. Hlaha sebakeng sa taolo ea lithethefatsi: redness, ho ruruha ha lisele, ho hlohlona, hematoma. Kamora nakoana, lia nyamela ntle ho tšitiso ea letho.
Motho e mong le e mong ea nang le lefu la tsoekere o lokela ho tseba algorithm bakeng sa ho thusa ka boemo ba hypoglycemic.
Contraindication
"Protafan" e thibetsoe ho sebelisa maemong a mabeli feela: boemo ba hypoglycemic le ho se mamellane ho e 'ngoe ea likarolo tsa tharollo.
Ho sebelisana le lithethefatsi tse ling
Lefu la tsoekere ke lefu le sa foleng le atisang ho baka mathata a tsoang litho tse ngata. Bakeng sa kalafo ea bona, mokuli o fuoa kalafo e loketseng. Hona le lithethefatsi tse 'maloa tse amang tlhoko ea mmele ea insulin (eketsa kapa ho e fokotsa). Maemong a ts'ebeliso ea bona e kopaneng le Protafan, lethal dose le lokela ho fetoloa.
E ntlafatsa phello ea "Protafan"
- Lihlahisoa tsohle tse nang le ethanol. Lenane la bona le pharaletse, ka hona, ha o sebelisa moriana o mocha, ho bohlokoa ho ithuta sebopeho sa oona ka botlalo;
- ACE inhibitors (angiotensin-e fetolang enzyme) - sehlopha sa lithethefatsi se sebelisoang haholo ho phekola khatello ea mali;
- Li-inhibitors tsa MAO (monoamine oxidases) - li-antidepressants tse sebelisitsoeng ho mafu a kelello;
- Beta-blockers (e seng khetho) - kalafo ea maloetse a amanang le lefu la pelo;
- Li-steroid tsa anabolic;
- Litlolo tsa molomo tsa Hypoglycemic;
- Li-inhibitors tsa Carbonic anhydrase, tse kenyelletsang diuretics tse ngata;
- Litokisetso tsa Lithium;
- Lithibela-mafu tsa Tetracycline le sulfonamides;
- Pyridoxine (Vitamin B6);
- Ketoconazole ke moemeli oa antimycotic;
- Cyclophosphamide - sethethefatsi sa antitumor;
- Clofibrate - e theola cholesterol ea mali;
Fenfluramine ke molaoli oa takatso ea takatso ea lijo;- Bromocriptine e sebelisitsoeng gynecology;
- Theophylline ke bronchodilator e tsebahalang;
- Mebendazole ke anthelmintic.
Fenfluramine ke molaoli oa takatso ea takatso ea lijo;Ho bakuli ba hlokang kalafo ka lithethefatsi tsena, ho hlokahala hore ka nakoana u theole litekanyetso tsa sethethefatsi se nang le insulin.
Fokotsa phello ea "Protafan"
- Lihormone tsa qoqotho tse sebelisetsoang kalafo ea phetisetso ea hypothyroidism;
- Slow calcium tubule blockers (li-antagonists tsa calcium), tse atisang ho sebelisoa kalafo ea khatello ea mali;
- Glucocorticosteroids;
- Sympathomimetics, e tsebahalang haholo ho eona ke Ephedrine;
- Thiazide diuretics;
- Lithibela-pelehi tsa molomo;
- Li-antidepressants tsa Tricyclic;
- Clonidine ke moemeli ea matlafatsang;
- Phenytoin ke antiepileptic;
- Diazoxide e nang le matla a ho hlohlora le ho ferekanya kelello;
Hormone ea ho hola (hormone ea ho hola);- Asiti ea Nicotinic;
- Morphine;
- Nikotine;
- Heparin;
- Danazole o ne a tloaetse ho phekola endometriosis le mofuta o mong oa mokokotlo ho lefu la bongaka.
Hormone ea ho hola (hormone ea ho hola);Lithethefatsi le lik'hemik'hale tse ling li sebetsa ka litsela tse fapaneng, ka bobeli li matlafatsa le ho thibela litlamorao tsa Protafan. Tsena ke joala, octreotide / lanreotide, reserpine, salicylates.
Maemo a polokelo
Ho bolokoa ka nepo ha Protafan ho tla netefatsa hore poloko ea insulin e phatlalalitsoeng e bolela hore e tla thibela mathata a mangata.
- Botlolo e tiisitsoeng e ka sehatsetsing (2-8 ° C), empa hole le sehatsetsi. Leqhoa le thibetsoe ka thata. Nako ke likhoeli tse 30.
- Sephutheloana se bulehileng se bolokoa ka mocheso oa kamoreng e sa feteng 25 ° C bakeng sa libeke tse 6. Sireletsa ho tloha leseli.
Moriana o lokela ho sireletsoa ho bana. E fumaneha likhoebong tsa litlhare feela ka taelo ea ngaka. Theko e tloaelehileng ke li-ruble tsa 350-400 bakeng sa botlolo, li-ruble tse 800-100 bakeng sa mabokose. Tse ling tsa li-analogu li theko e tlaase (mohlala, Humulin NPH), tse ling li feta ka litšenyehelo (Insuman Bazal GT, Biosulin N).
Litaelo tse ikhethang
Ka kalafo ea lefu la tsoekere mellitus "Protafan" ha ho na liphoso. Re fana ka lethathamo la "lintho tse bohlasoa" tseo bophelo ba mokuli bo ka itšetlehang ka tsona:
- Kamora ho khaotsa lithethefatsi, boemo ba hyperglycemia bo ka hlaha (bofokoli, ho nyekeloa, molomo o omileng, ho felloa ke takatso ea lijo, monko o pepesitsoeng oa asetone, ho ruruha khafetsa, bofubelu ba letlalo le ho omella butle-butle).
- Haeba nakong ea kalafo ho na le khatello ea maikutlo e matla, bokuli (haholoholo ke feberu) kapa ho ikoetlisa ka matla, sena se halefisa hypoglycemia.
- Ho khutlisetsa lithethefatsi ka mofuta o mong oa "insulin" (kapa lithethefatsi tsa mofuta o mong) ho lokela ho etsoa tlasa tlhokomelo ea bongaka le tlhahlobo e sa khaotseng ea maemo a tsoekere ea mali.
- Pele ho leeto le lelelele le phetoho ea libaka, mokuli o lokela ho buisana le setsebi sa endocrinologist.
- Protafan NM ha e reretsoe pompo ea insulin.
Setlhare ha se kene ka bongata, kahoo se ka sebelisoa ke basali baimana. Ho bohlokoa ho fetola tekanyetso ho latela nako ea kemaro (ho trimester ea pele, tlhoko ea insulin e fokotseha, ebe butle-butle ea eketseha, mme kamora ho beleha ngoana o khutlela litekanyetsong tsa eona tsa pele).
