Gensulin P (Gensulin R)

cov tshuaj nquag: 1 ml ntawm cov kev daws muaj cov tib neeg isofan-insulin 100 PIECES

kev zam: m cresol, phenol, glycerin tiv thaiv zinc sulfate oxide, sodium dihydrogen phosphate dihydrate, hydrochloric acid (diluted) dej rau kev txhaj tshuaj.

Ncua rau ntawm kev txhaj tshuaj.

Qhov yooj yim lub cev thiab tshuaj:

Ib qho kev tshem tawm dawb, uas thaum sawv tau sib cais ua rau lub qhov daus dawb thiab tsis muaj xim lossis yuav luag tsis muaj kua. Lub vial lossis daim cartridge tsis tuaj yeem siv yog tias, tom qab nplawm, qhov kev ncua yuav tseem pom tseeb lossis yog tias muaj nag lossis daus dawb tau tsim rau hauv qab. Koj tuaj yeem siv tsis tau cov tshuaj yog tias tom qab sib xyaw rau hauv lub raj mis lossis daim laub los ntab flakes teebmeem lossis dawb paug tseem nyob ntawm phab ntsa ntim, vim tias cov tshuaj zoo li khov.

Cov chaw muag tshuaj.

Gensulin H yog ib qho kev npaj ua ntawm tib neeg isofan-insulin uas tau los ntawm kev tsim kho caj ces siv hauv txoj kev hloov kho, tiam sis tsis kis tus kab mob E. coli. Cov tshuaj insulin yog ib yam tshuaj tsim los ntawm kev ua haujlwm hlwb. Cov tshuaj Insulin koom nrog hauv cov metabolism ntawm cov carbohydrates, cov protein thiab cov rog, pab txhawb, tshwj xeeb, kom txo qis hauv cov concentration ntawm cov piam thaj hauv cov ntshav. Cov tshuaj insulin nyob hauv lub cev ua rau cov ntshav qab zib. Cov tshuaj insulin, muab los ntawm kev txhaj tshuaj, ua rau tib yam li cov tshuaj hormones tsim los ntawm lub cev.

Gensulin N pib ua yeeb yam nyob rau hauv 30 feeb tom qab kev tswj hwm, qhov siab tshaj plaws tau pom ntawm 2 txog 8:00, thiab lub sijhawm ua haujlwm tau ntev txog 24 teev thiab nyob ntawm lub koob tshuaj. Hauv cov neeg muaj kev noj qab haus huv, muaj txog 5% ntawm insulin yog txuam nrog cov roj protein. Lub xub ntiag ntawm cov tshuaj insulin nyob rau hauv cerebrospinal kua hauv qhov ntau ntawm kwv yees li 25% ntawm cov ntsiab lus ntau tau kuaj hauv cov ntshav cov ntshav tau paub.

Cov tshuaj insulin yog metabolized hauv daim siab thiab lub raum. Tus nqi me yog metabolized hauv cov leeg nqaij thiab adipose. Hauv cov neeg mob ntshav qab zib, cov roj ntsha metabolism dhau raws li hauv cov neeg muaj kev noj qab haus huv. Cov tshuaj dej tawm los ntawm lub raum. Ib co kab ke nyob hauv bile. Ib nrab-lub neej ntawm tib neeg cov kua dej yuav luag 4 feeb. Cov kab mob ntawm lub raum thiab mob siab tuaj yeem ncua qhov kev tso tawm ntawm cov tshuaj insulin. Hauv cov neeg laus, qhov kev tso tawm ntawm cov tshuaj insulin yog qeeb qeeb thiab lub sijhawm muaj cov nyhuv hypoglycemic ntawm cov tshuaj nce ntxiv.

Soj ntsuam cov yam ntxwv

Kev kho mob ntawm cov neeg mob ntshav qab zib mellitus, uas yuav tsum tau siv tshuaj insulin.

Kev ntshav siab. Hypersensitivity rau yeeb tshuaj Gensulin N thiab ib qho ntawm nws cov khoom siv, nrog rau kev zam ntawm kis mob qog. Tsis txhob tswj hwm txoj leeg.

Kev ntsuas kev nyab xeeb tshwj xeeb

Tsis txhob siv Gensulin H:

• yog tias daim cartridge los yog kua mem hluav taws tau poob los sis tau ntsib kev kub siab sab nraud, vim tias qhov kev pheej hmoo ntawm kev puas tsuaj rau lawv thiab xau ntawm insulin,
• yog tias nws tau muab khaws cia tsis raug los yog khov,
• yog tias cov kua nyob rau ntawd nws tsis yog opaque yam txawv.

Haus cawv ntau yuav ua rau muaj kev phom sij ntshav qab zib txaus ntshai.

Kev sib cuam tshuam nrog lwm yam tshuaj thiab lwm yam kev sib cuam tshuam.

Tus kws kho mob yuav tsum tau qhia rau txhua yam kev kho mob uas ua nrog kev siv tib neeg lub cev.

Gensulin N yuav tsum tsis txhob xyaw nrog cov tshuaj insulin ntawm cov tsiaj keeb kwm, zoo li nrog biosynthetic insulins ntawm lwm cov tuam ntxhab. Ntau cov tshuaj (tshwj xeeb, qee cov tshuaj tiv thaiv kab mob thiab tshuaj plawv, tshuaj uas txo cov ntshav lipids, cov tshuaj siv rau cov kab mob pancreatic, qee cov tshuaj tiv thaiv kab mob, tshuaj tua kab mob, salicylates, tshuaj tua kab mob, tshuaj tiv thaiv qhov ncauj) tuaj yeem cuam tshuam rau cov tshuaj insulin thiab cov hauj lwm zoo ntawm kev kho tshuaj insulin.

Tshuaj thiab tshuaj uas ua rau kom muaj kev ua haujlwm ntawm insulin b-adrenolytics, chloroquine, angiotensin convertase inhibitors, MAO inhibitors (tshuaj tiv thaiv kab mob), methyldopa, clonidine, pentamidine, salicylates, anabolic steroids, cyclophosphamide, sulfanilamides, tetracycline, ethanol tshuaj tua kab mob thiab tshuaj tua kab mob.

Cov tshuaj uas txo qis ntawm cov tshuaj insulin, diltiazem, dobutamine, estrogens (kuj tseem muaj qhov ncauj txwv tsis pub muaj), phenothiazines, phenytoin, cov tshuaj hormones pancreatic, heparin, calcitonin, corticosteroids, tshuaj tiv thaiv kab mob siv rau hauv kev kho mob HIV, niacin, thiazide diuretics.

Qhov kev xav tau rau insulin tuaj yeem nce ntxiv nrog kev siv tshuaj nrog rau kev ua si hyperglycemic, piv txwv li, glucocorticoids, cov thyroid hormones thiab kev loj hlob hormone, danazol, b ₂ sympathomimetics (piv txwv, ritodrin, salbutamol, terbutaline), thiazides.

Qhov xav tau rau insulin tuaj yeem txo qis nrog kev siv cov tshuaj nrog hypoglycemic kev ua si, xws li tshuaj tiv thaiv hypoglycemic qhov ncauj, salicylates (e.g. acetylsalicylic acid), qee cov tshuaj tiv thaiv kab mob (MAO inhibitors), qee qhov ACE inhibitors (captopril, enalapril), tsis xaiv tshuaj beta-blockers lossis cawv.

Kev siv sib xyaw ua ke ntawm Gensulin MZ0 nrog pioglitazone, kev mob tshwm sim ntawm lub siab tsis tuaj yeem, tshwj xeeb tshaj yog rau cov neeg mob uas muaj kev pheej hmoo rau lub plawv tsis ua haujlwm. Yog tias qhov kev sib xyaw ua ke no tau siv, tus neeg mob yuav tsum raug soj ntsuam rau cov cim qhia thiab cov tsos mob ntawm lub plawv tsis ua hauj lwm, ua kom hnyav, thiab edema. Kev kho nrog pioglitazone yuav tsum tsum tsis ua mus ntxiv yog tias cov tsos mob hnyav dua.

Cov yam ntxwv ntawm daim ntawv thov.

Tsuas yog tus kws kho mob tuaj yeem txiav txim siab txog kev hloov pauv kev noj tshuaj, sib xyaw cov tshuaj insulin, thiab kuj hloov ntawm ib qho mus rau lwm yam tshuaj insulin. Xws li kev txiav txim siab tau ua nyob rau hauv kev saib xyuas kev noj qab haus huv ncaj qha thiab tuaj yeem cuam tshuam qhov hloov pauv ntawm kev siv tshuaj. Yog tias xav tau koob tshuaj kho, qhov tuaj yeem kho no los ntawm thawj koob tshuaj lossis tom qab ntawd rau ntau lub lis piam lossis ntau hli. Cov neeg mob yuav tsum yauv mus soj ntsuam daim tawv nqaij ua ntej pib siv tshuaj tshiab, nrog rau cov neeg uas muaj kev xav dav txog kev insulin yav dhau los. Thaum siv cov tshuaj insulin, soj ntsuam kev saib xyuas ntawm cov piam thaj hauv cov ntshav dej thiab zis, cov concentration ntawm glycosylated hemoglobin (HLA1c) thiab fructosamine. Cov neeg mob yuav tsum tau qhia rau nws tus kheej tshawb xyuas cov concentration ntawm cov piam thaj hauv cov ntshav thiab zis siv cov ntawv sim yooj yim (piv txwv, cov qauv ntsuas). Hauv cov tib neeg sib txawv, cov tsos mob ntawm kev txo cov piam thaj hauv ntshav (hypoglycemia) yuav tshwm sim txawv sijhawm thiab yuav muaj kev sib txawv. Yog li, cov neeg mob yuav tsum tau qhia kom paub txog lawv cov yam ntxwv ntawm tus mob ntshav qab zib tsawg. Hauv cov neeg mob uas hloov cov tshuaj insulin siv, uas yog, lawv tau hloov los ntawm tsiaj insulin mus rau tib neeg insulin, nws yuav tsim nyog los txo cov koob tshuaj insulin (vim tias muaj peev xwm ua kom muaj qog ntshav qab zib). Hauv qee tus neeg mob, cov tsos mob thaum ntxov ntawm hypoglycemia tom qab hloov mus rau hauv cov neeg cov tshuaj insulin yuav muaj zog me ntsis dua li thaum siv insulin ntawm tsiaj keeb kwm.

Qhov xav tau ntawm insulin tuaj yeem hloov tau vim tias kub taub hau, mob hnyav (qhov xav tau ntawm insulin tuaj yeem nce ntxiv), kev paub kev xav, kab mob thiab kev cuam tshuam ntawm lub plab zom mov, nrog rau xeev siab thiab ntuav, raws plab, cem quav, thiab malabsorption. Lub xub ntiag ntawm cov xwm txheej zoo li no ib txwm xav tau kev cuam tshuam los ntawm kws kho mob. Hauv cov xwm txheej zoo li no, cov ntsiab lus ntawm cov piam thaj hauv ntshav thiab zis yuav tsum tau kuaj xyuas ntau zaus. Hauv raum tsis ua haujlwm, insulin secretion tsawg, thiab nws lub sijhawm nce ntxiv.

Cov neeg mob uas mob ntshav qab zib mellitus cuam tshuam nrog kev kis mob rau lub cev lossis ua ke nrog Addison tus kab mob lossis lub caj pas pituitary tsis txaus yog cov tshuaj insulin thiab, raws li txoj cai, lawv yuav tsum tau noj tshuaj tsawg heev ntawm cov tshuaj.

Nrog kev ua haujlwm tsis zoo ntawm lub qog pituitary, txiav ntshav, mob qog, lub qog, lossis lub siab ua haujlwm lossis lub raum tsis ua haujlwm, lub cev xav tau cov tshuaj insulin tuaj yeem hloov.

Cov tshuaj tua kab mob tuaj yeem tsim cov tshuaj tua kab mob los kho tib neeg, txawm li cas los xij ntawm qis dua li nrog cov tsiaj cov tsiaj ua kom huv.

Thaum lub sij hawm ntev kho nrog insulin, insulin tsis kam yuav pib tuaj. Yog tias muaj cov tshuaj insulin, kev siv tshuaj insulin loj yuav tsum siv.

Kev noj tshuaj tsis haum lossis ncua kev kho mob (tshwj xeeb tshaj yog rau cov neeg mob ntshav qab zib insulin-tiv thaiv ntshav qab zib) tuaj yeem ua rau hyperglycemia thiab muaj feem ua rau tuag taus ntshav qab zib ketoacetosis. Qhov xav tau hloov qhov koob tshuaj yuav tshwm sim thaum muaj kev hloov pauv ntawm kev siv dag zog lossis kev noj lub cev ib txwm muaj.

Cov tib neeg npaj yuav mus ncig ua si ntev los ntawm kev hloov ntau lub sijhawm hauv thaj chaw yuav tsum sab laj nrog lawv tus kws kho mob txog kho lub sijhawm noj tshuaj insulin.

Siv thaum cev xeeb tub lossis lactation.

Cov tshuaj Insulin hla tsis dhau ntawm qhov chaw nres.

Rau cov neeg mob uas cov ntshav qab zib tau tsim ua ntej cev xeeb tub lossis cev xeeb tub (mob ntshav qab zib hauv plab), nws yog qhov tseem ceeb heev los tswj kev tswj hwm kom muaj txiaj ntsig zoo ntawm carbohydrate metabolism thoob plaws thaum cev xeeb tub.

Tsis muaj kev txwv txog kev siv tshuaj Gensulin N lub sijhawm pub niam mis. Txawm li cas los xij, cov pojniam nyob rau lub sijhawm pub niam mis yuav xav tau koob tshuaj thiab kho kom haum.

Lub peev xwm los cuam tshuam cov tshuaj tiv thaiv tus nqi thaum tsav tsheb lossis lwm yam txheej txheem

Lub peev xwm ntawm kev tsav tsheb tuaj yeem ua rau tsis muaj zog los ntawm kev mob ntshav qab zib, uas ua rau lub cev tsis zoo ntawm lub paj hlwb thiab nrog cov mob taub hau, ntxhov siab vim, diplopia, kev tsis sib raug zoo thiab kev kwv yees kwv yees deb. Hauv thawj lub sijhawm ntawm kev kho tshuaj insulin, thaum hloov tshuaj (thaum muaj kev ntxhov siab lossis kev tawm dag zog lub cev ntau dhau, thaum muaj kev hloov pauv loj nyob rau hauv cov concentration ntawm cov piam thaj hauv cov ntshav), qhov kev qaug zog ntawm lub peev xwm tsav tsheb thiab tswj cov khoom siv hauv cov lus tsa suab yuav tshwm sim. Nws raug nquahu kom tswj lub siab ntev ntawm cov piam thaj hauv cov ntshav thaum taug kev ntev.

Tsuas tshuaj thiab tswj hwm.

Hauv kev xyaum siv, ntau txoj kev kho rau tib neeg cov tshuaj insulin. Cov kev xaiv ntawm lawv, cov phiaj xwm ib qho haum rau ib tus neeg mob tshwj xeeb, yuav tsum ua los ntawm tus kws kho mob raws li qhov xav tau cov tshuaj insulin. Raws li kev tsim cov ntshav qabzib hauv siab, tus kws kho mob txiav txim siab tias yuav tsum tau noj ntau npaum li cas thiab hom tshuaj insulin rau tus neeg mob twg.

Gensulin N yog rau kev txhaj tshuaj subcutaneous. Hauv qee qhov tshwj xeeb, nws tuaj yeem muab tshuaj intramuscularly. Gensulin N yog muab 15-30 feeb ua ntej noj mov. 10-20 feeb ua ntej txoj kev tswj hwm tau npaj tseg, insulin yuav tsum tau txais los ntawm lub tub yees kom nws sov sov li chav sov.

Ua ntej kev tswj hwm, koj yuav tsum ua tib zoo saib xyuas lub vial lossis lub taub ntim cov kua dej nrog cov tshuaj insulin. Kev txwv Gensulin H yuav tsum hnav kom zoo nkauj (tsis xwm yeem lossis pos huab hauv qhov tsos). Lub vial lossis daim cartridge tsis tuaj yeem siv yog tias, tom qab nplawm, qhov raug tshem tawm yuav yog qhov tseeb lossis daim ntawv dawb los tom hauv qab. Koj tuaj yeem siv tsis tau cov tshuaj no yog tias, tom qab sib xyaw ua ke hauv lub raj mis lossis daim laub, dawb flakes ntab lossis dawb paug tseem nyob ntawm phab ntsa ntim, vim tias cov tshuaj zoo li khov. Kev saib xyuas tshwj xeeb yuav tsum tau them nyiaj rau kom ntseeg tau tias thaum lub sij hawm txhaj cov tshuaj insulin lub koob tsis tau muab tso rau hauv lumen ntawm cov hlab ntshav.

Cov kev qhia ntawm cov tshuaj siv syringes.

Rau kev qhia txog cov tshuaj insulin, muaj ib cov koob txhaj tshuaj tshwj xeeb rau ntawm uas muaj qhov khij lub koob tshuaj. Thaum tsis muaj tib lub koob txhaj tshuaj thiab lub koob, ntau yam kev siv koob txhaj tshuaj thiab koob tuaj yeem siv, uas yuav tsum tau ua kom huv si ua ntej txhua txoj kev txhaj tshuaj. Nws raug nquahu kom siv cov koob txhaj ntawm cov qub thiab cov tsim. Nws yog ib txwm tsim nyog los xyuas cov koob txhaj tshuaj tiav siv, ua raws li ntau npaum li cas ntawm kev siv cov tshuaj insulin.

Nws yog qhov tsim nyog kom kos lub raj mis Gensulin N hauv lub xib teg ntawm txhais tes kom txog thaum kev ncua ntawv yuav ua tsis ncaj, muaj huab lossis ntsej muag nyob rau hauv qhov tsos.

Qhov kev txiav txim ntawm kev txhaj tshuaj:

• tshem lub nplhaib tiv thaiv nyob hauv qhov chaw ntawm lub hau,
• kos rau hauv cov cua syringe nrog lub ntim sib npaug nrog cov raug xaiv koob tshuaj tiv thaiv,
• tho cov roj hmab siv nres thiab ua kom cua nkag mus rau hauv lub thauv
• tig lub raj mis nrog lub taub hau ntxeev tiaj,
• nco ntsoov tias qhov kawg ntawm rab koob yog nyob rau hauv insulin,
• kos cov ntim dej uas yuav tsum tau ntawm cov tshuaj insulin rau hauv cov koob txhaj,
• tshem cov pa npuas ntawm lub koob txhaj tshuaj mus rau hauv lub vial los ntawm txhaj cov tshuaj insulin,
• rov tshawb xyuas qhov tseeb ntawm qhov koob tshuaj thiab tshem rab koob ntawm lub vial,
• ntxuav cov tawv nqaij ntawm qhov chaw ntawm qhov npaj txhaj tshuaj,
• ruaj khov ntawm daim tawv nqaij nrog ib txhais tes, uas yog, quav nws,
• nqa cov phwj hauv lwm tes thiab tuav nws zoo li xaum. Ntxig lub koob tso rau hauv daim tawv nqaij ntawm lub kaum sab xis (90 ° kaum sab xis).

Kev sib xyaw qhov kev ncua ntawm Gensulin N nrog kev daws Gensulin R.

Qhov kev txiav txim siab sib xyaw Gensulin H nrog cov kev daws teeb meem saum toj no thiab kev ncua ntawv tsuas yog ua tau los ntawm kws kho mob.

Kev siv Gensulin N hauv lub cartridge rau koob txhaj tshuaj.

Gensulin H cartridges tuaj yeem siv nrog kev siv dua rov qab. Thaum sau cov koob txhaj tshuaj, txuas tus koob thiab cov txheej txheem ntawm kev txhaj tshuaj, cov lus qhia ntawm cov chaw tsim tshuaj paus ntawm cov koob txhaj tshuaj yuav tsum tau ua raws cai. Yog tias tsim nyog, koj tuaj yeem kos cov insulin los ntawm daim cartridge mus rau hauv cov tshuaj insulin tsis tu ncua thiab ua zoo li tau piav qhia saum toj no (nyob ntawm seb cov tshuaj insulin thiab hom tshuaj dab tsi).

Lub ncua kev kawm Gensulin N yuav tsum tau sib xyaw ua ntej txhua qhov kev txhaj tshuaj los ntawm kev sib zog thiab nqis 10 zaug los yog tig rau hauv xib teg ntawm txhais tes kom txog rau thaum qhov kev ncua ntawv yuav zoo ib yam, pos huab lossis milky.

Tsis muaj kev paub txaus rau cov tshuaj no hauv cov menyuam yaus.

Noj ntau dhau.

Thaum muaj cov tshuaj insulin ntau dhau, cov tsos mob ntawm lub qog ua rau ntshav nce siab, tshwj xeeb yog kev tshaib kev nqhis, tsis nco qab, kiv taub hau, mob tshee, tsis meej pem, ntxhov siab, mob plab, nce hws, ntuav, mob taub hau, thiab tsis meej pem.

Cov mob ntshav khov ntau heev tuaj yeem ua rau qhov chua leeg thiab tsis nco qab, thiab tseem muaj kev tuag. Yog hais tias tus neeg mob nyob hauv lub cev tsis xeev, nws yog ib qhov tsim nyog los tswj cov piam thaj hauv plab. Tom qab kev noj tshuaj ntau dhau ntawm cov tshuaj insulin rau hypoglycemia, cov tsos mob ntawm hypokalemia (ib qho kev txo qis ntawm cov poov tshuaj hauv cov ntshav) yuav koom nrog, ua raws li myopathy. Nrog rau qhov mob hypokalemia tseem ceeb, thaum tus neeg mob tsis tuaj yeem noj zaub mov noj ntawm qhov ncauj, 1 mg ntawm glucagon yuav tsum tau txhaj tshuaj rau intramuscularly thiab / lossis cov tshuaj ua kua qab zib. Tom qab nws rov qab nco qab, ib qho yuav tsum noj zaub mov. Nws kuj tseem yuav tsum tau txuas ntxiv los muab cov carbohydrates rau tus neeg mob thiab ua kev soj ntsuam tom qab ntawm cov ntshav qabzib hauv lub cev, vim tias hypoglycemia yuav tshwm sim tom qab kho mob rov zoo.

Kev phiv tshuaj

Kev ntshav siab. Kev mob ntshav qab zib feem ntau yog cov kev phiv ntau tshaj uas tshwm sim nrog kev kho mob insulin.Nws tshwm sim thaum cov koob tshuaj insulin pab tshaj li qhov xav tau ntawm nws. Kev tawm tsam ntawm cov ntshav khov qis qis kawg nkaus, tshwj xeeb yog tias lawv tshwm sim ntau zaus, tuaj yeem ua kev puas tsuaj rau cov hlab ntshav ntawm lub hlwb. Cov ntshav qog ntshav ntev lossis ntshav qis yuav ua rau muaj kev hem thawj rau tus neeg mob lub neej.

Cov tsos mob ntawm tus mob ntshav tes taw hnyav tsawg: kev tawm hws ntau dhau, kiv taub hau, tshee tshee, tshaib plab, nyob tsis tswm, twm caj dab hauv lub xib teg, taw, daim di ncauj lossis tus nplaig, tsis hnov ​​mob ntawm lub ntsej muag, tsaug zog, pw tsaug zog, tsis meej pem, mydriasis, plooj tsis pom kev, hais tsis tau lus, tsis meej, txob taus. Cov tsos mob ntawm tus mob hypoglycemia heev: tsis meej pem, tsis nco qab, tsis qaug dab peg.

Hauv ntau tus neeg mob, qhov pib ntawm cov tsos mob pom tias kev tsis muaj cov ntshav qabzib txaus rau cov nqaij mos ntawm lub hlwb (neuroglycopenia) yog ua ntej los ntawm cov cim ntawm adrenergic counter-txoj cai.

Los ntawm ob sab ntawm cov plab hnyuv siab raum ntawm lub zeem muag. Ib qho kev hloov pauv tseem ceeb ntawm cov ntshav qab zib tuaj yeem ua rau tsis pom kev ib ntus vim yog kev hloov pauv ib ntus hauv turgor thiab lub ntsej muag tsis pom kev.

Txoj kev pheej hmoo ntawm kev muaj mob ntawm cov ntshav qab zib retinopathy txo qis thaum kev tswj hwm glycemic tiav. Txawm li cas los xij, ib qho kev nce ntxiv ntawm kev siv tshuaj tua kab mob insulin nrog ib pliag li ntawm cov piam thaj hauv ntshav tuaj yeem ua rau muaj qhov tsis zoo ntawm qhov mob ntshav qab zib. Hauv cov neeg mob uas muaj kev tu ncua sai, tshwj xeeb tshaj yog cov uas tsis tau hla lub ntsej muag laser photocoagulation, cov ntshav qog ntshav tau loj tuaj yeem ua rau dig muag tsis pom kev.

Lipodystrophy. Ib yam li lwm yam tshuaj insulin, lipodystrophy tuaj yeem tshwm sim ntawm qhov chaw txhaj tshuaj, vim qhov ntawd ntawm qhov uas tus nqi nqus cov tshuaj insulin ntawm qhov chaw txhaj tshuaj txo qis. Kev hloov pauv tsis tu ncua ntawm thaj chaw txhaj tshuaj ib zaug xwb tuaj yeem txo cov xwm txheej no lossis tiv thaiv lawv qhov tshwm sim.

Cov tshuaj tiv thaiv ntawm qhov chaw txhaj tshuaj thiab kev fab tshuaj tsis haum. Cov kev mob tshwm sim ntawm qhov chaw txhaj tshuaj thiab cov tshuaj tiv thaiv tsis haum, suav nrog liab ntawm daim tawv nqaij, o, doog, mob, khaus, urticaria, o, lossis o, tuaj yeem tshwm sim. Feem ntau cov tshuaj tiv thaiv me rau cov tshuaj insulin uas tshwm sim ntawm qhov chaw txhaj tshuaj feem ntau yuav ploj mus nyob rau qee lub sijhawm dhau los ntawm ob peb hnub mus rau ntau lub lis piam.

Daim qauv kev tsis haum tshuaj cov tshuaj insulin, suav nrog cov mob hnyav, suav nrog ua pob rau tag nrho lub cev, ua tsis taus pa, ua pa tawm, txo ntshav siab, nce plawv, nce hws.

Cov hom tshuaj tiv thaiv hypersensitivity nrawm tam sim no muaj tsawg heev. Kev tshwm sim ntawm cov tshuaj tiv thaiv rau insulin lossis excipients tuaj yeem yog, piv txwv li, cov kev tawm tsam ntawm cov tawv nqaij dav dav, angioedema, bronchospasm, arterial hypotension thiab poob siab, uas tuaj yeem tsim kev hem thawj rau tus neeg mob lub neej.

Lwm yam tshuaj tiv thaiv. Cov lus qhia ntawm kev npaj insulin tuaj yeem ua rau lub cev tsim cov tshuaj tiv thaiv rau nws. Tsis tshua muaj tshwm sim, vim tias muaj cov tshuaj tiv thaiv los tiv thaiv rau cov tshuaj insulin, tej zaum yuav tsum muaj kev kho kom haum rau koob tshuaj kom tiv thaiv hypo- lossis hyperglycemia.

Cov tshuaj insulin tuaj yeem ua rau lub cev qeeb ntawm lub cev sodium thiab cov tsos ntawm edema, tshwj xeeb tshaj yog nyob rau qee qhov twg, ua tsaug rau qhov nce ntawm qhov kev siv ntawm kev kho mob insulin, nws muaj peev xwm txhim kho glycemic tswj, uas txog thaum ntawd tsis txaus.

Cia rau cov neeg mob

Tom qab qhib, khaws cov khoom ntim rau 42 hnub ntawm qhov kub thiab txias tsis tshaj 25 ° C. Khaws ntawm qhov kub ntawm 2-8 ° C hauv qhov chaw tsaus. Tsis khov. Khaws tsis ncav cuag ntawm cov menyuam yaus.

Raws li txoj cai, insulin tuaj yeem raug ntxiv rau cov yeeb yaj kiab uas qhov ua kom haum nws paub. Cov tshuaj ntxiv rau cov tshuaj insulin tuaj yeem ua rau nws qhov kev rhuav tshem, piv txwv li, kev npaj muaj thiols lossis sulfites.

10 ml hauv lub khob fwj nrog tus roj hmab nres thiab txhuas hau No. 1, 3 ml hauv daim cartridges No. 5.

Qhov chaw nyob

Chaw nyob raug cai: Bioton S.A., Poland, 02-516, Warsaw, ul. Starochinska, 5 (VIOTON SA, Poland, 02-516, Warsaw, 5 Staroscinska str.).

Chaw nyob ntau lawm: Bioton S.A., Machezhish, ul. Poznan, 12 05-850, Ozarow Mazowiecki, Poland (BIOTON SA, Macierzysz, 12 Poznanska Street, 05-850 Ozarow Mazowiecki).

Nosological kev faib tawm (ICD-10)

Cov Tshuaj Hauv Tshuaj

Gensulin P - tib neeg cov insulin tau siv thev naus laus zis DNA thev naus laus zis. Nws yog lub sijhawm luv luv-insulin npaj. Nws cuam tshuam nrog ib qho kev tshwj xeeb nyob rau sab nraud cytoplasmic ntawm lub hlwb thiab tsim cov txheej txheem insulin receptor complex uas ua rau cov txheej txheem ua tiav, suav nrog synthesis ntawm cov lej ntawm cov enzymes tseem ceeb (suav nrog rau hexokinase, pyruvate kinase, glycogen synthetase). Qhov txo qis hauv cov ntshav qab zib yog vim suav nrog nce nws txoj kev thauj mus los ntawm qhov tsis txaus, txhim kho cov nqaij ua kom zoo dua qub thiab ua kom zoo ntxiv, ua kom lub cev lipogenesis, glycogenogenesis, thiab txo qis npaum li cov piam thaj tsim tawm los ntawm lub siab.

Lub sijhawm ntawm kev ua ntawm insulin npaj feem ntau vim yog tus nqi ntawm kev nqus, uas nyob ntawm ntau yam (piv txwv, koob tshuaj, hom thiab qhov chaw ntawm kev tswj hwm), thiab yog li cov ntaub ntawv ntawm kev txiav txim ntawm insulin yog raug rau qhov txawv txav, ob qho tib si hauv tib neeg thiab tib neeg Cov.

Nkaus profile nrog kev txhaj tshuaj subcutaneous (kwv yees kwv yees): qhov pib ntawm kev ua tom qab 30 feeb, qhov ua tau zoo tshaj plaws yog nyob hauv qhov sib nrug ntawm 1 mus rau 3 teev, lub sijhawm ua haujlwm tau ntev txog 8 teev.

Cov Tshuaj Pharmacokinetics

Kev ua tiav ntawm kev nqus thiab pib ntawm cov nyhuv ntawm cov tshuaj insulin nyob ntawm los ntawm qhov chaw txhaj tshuaj (mob plab, ncej puab, pob tw), ntau npaum li cas (ntim ntawm cov tshuaj insulin), qhov concentration ntawm cov tshuaj insulin hauv cov tshuaj. Nws tau faib qhov tsis sib luag thoob plaws cov ntaub so ntswg: nws tsis nkag rau ntawm qhov chaw tiv thaiv kab mob thiab nkag mus rau niam mis. Nws yog rhuav tshem los ntawm insulinase, feem ntau yog nyob hauv daim siab thiab lub raum. Nws yog tawm los ntawm ob lub raum (30-80%).

Kev taw qhia ntawm cov tshuaj Gensulin P

ntshav qab zib hom 1

hom 2 mob ntshav qab zib mellitus: theem ntawm kev tawm tsam ntawm qhov ncauj hypoglycemic, ib nrab tsis kam rau cov tshuaj no (thaum kho sib xyaw), cov kab mob sib kis,

cov xwm txheej ceev hauv cov neeg mob ntshav qab zib mellitus, nrog los ntawm kev decompensation ntawm carbohydrate metabolism.

Sab sij huam

Vim muaj cov ntxim rau cov metabolism hauv carbohydrate: hypoglycemic tej yam kev mob (pallor ntawm daim tawv nqaij, nce tawm hws, palpitations, tshee tshee, tshaib plab, ntxhov siab, kab mob plab hauv lub qhov ncauj, mob taub hau). Kev mob ntshav qog ntshav qis tuaj yeem ua rau txhim kho kev mob hypoglycemic coma.

Kev tsis haum tshuaj: tsis tshua muaj - tawv nqaij ua pob, Quincke's edema, tsis tshua muaj tshwm sim - anaphylactic kev poob siab.

Cov tshuaj tiv thaiv hauv zos: hyperemia, o thiab khaus ntawm qhov chaw txhaj tshuaj, nrog rau siv sijhawm ntev - lipodystrophy ntawm thaj chaw txhaj tshuaj.

Lwm yam: o, kev hloov pauv hloov pauv sai (feem ntau thaum pib kho).

Kev sib txuam

Cov nyhuv hypoglycemic ntawm insulin yog txhim kho los ntawm qhov ncauj hypoglycemic, MAO inhibitors, ACE inhibitors, carbonic anhydrase inhibitors, tsis-xaiv β-adrenergic thaiv cov khoom ua haujlwm, bromocriptine, octreotide, sulfanilamides, anabolic steroids, tetracyclin, phenofphindonindinininofofindindindindindindindindindindindindindindin npaj muaj ethanol.

Cov tshuaj tiv thaiv tsis haum, tshuaj corticosteroids, cov thyroid hormones, thiazide diuretics, heparin, tricyclic antidepressants, sympathomimetics, danazole, clonidine, BKK, diazoxide, morphine, phenytoin, nicotine tsis muaj zog tiv thaiv cov ntshav ua kom tsis muaj zog.

Nyob rau hauv kev cuam tshuam ntawm reserpine thiab salicylates, ob qho tib si ua kom tsis muaj zog thiab nce ntxiv hauv kev ua ntawm cov tshuaj muaj peev xwm ua tau.

Tsuas tshuaj thiab tswj hwm

P / K / hauv / m thiab / hauv. Feem ntau s / c nyob rau hauv anterior plab phab ntsa. Kev hno tuaj yeem tuaj yeem ua tau nyob hauv tus ncej, pob tw, lossis thaj chaw deltoid ntawm lub xub pwg. Nws yog ib qho tsim nyog yuav tsum hloov chaw txhaj tshuaj nyob rau thaj tsam anatomical thiaj li tiv thaiv kev txhim kho ntawm lipodystrophy.

Intramuscular thiab leeg ntshav Gensulin P tuaj yeem raug tswj hwm nkaus xwb los ntawm kev saib xyuas mob nkeeg.

Qhov koob tshuaj thiab txoj hauv kev ntawm kev tswj hwm tshuaj yog txiav txim los ntawm tus kws kho mob ib leeg zuj zus hauv txhua kis, raws li cov piam thaj hauv ntshav. Qhov nruab nrab, qhov kev siv tshuaj txhua hnub los ntawm 0.5 mus rau 1 IU / kg (nyob ntawm tus neeg qhov yam ntxwv ntawm tus neeg mob thiab theem ntawm cov piam thaj hauv cov ntshav).

Cov tshuaj tau muab noj 30 feeb ua ntej noj mov lossis noj khoom txom ncauj uas muaj cov carbohydrates.

Qhov kub ntawm cov tshuaj insulin yuav tsum nyob ntawm chav sov.

Nrog rau cov tshuaj monotherapy nrog rau cov tshuaj, ntau zaus ntawm kev tswj hwm yog 3 zaug hauv ib hnub (yog tias tsim nyog, 5-6 zaug hauv ib hnub). Ntawm qhov koob tshuaj txhua hnub dhau ntawm 0.6 IU / kg, nws yog qhov tsim nyog yuav tsum nkag mus rau hauv daim ntawv ntawm 2 lossis ntau dua kev txhaj tshuaj nyob rau ntau qhov chaw ntawm lub cev.

Gensulin P yog lub ntsej muag luv luv insulin thiab feem ntau yog siv ua ke nrog nruab nrab-insulin (Gensulin H).

Cov lus qhia tshwj xeeb

Koj tsis tuaj yeem siv Gensulin N, yog tias tom qab co ncua kev ncua tsis tig mus dawb thiab tauv huab.

Tawm tsam keeb kwm yav dhau los ntawm kev kho mob insulin, kev tshuaj xyuas cov ntshav qabzib ntau yog tsim nyog.

Cov laj thawj ntawm cov ntshav qog ntshav ntshav ntxiv rau kev noj tshuaj insulin ntau tshaj tuaj yeem yog: hloov tshuaj, hla zaub mov, ntuav, raws plab, ua kom lub cev muaj zog ntau ntxiv, cov kab mob uas txo qis qhov xav tau rau insulin (kev mob siab rau lub siab thiab lub raum kev ua haujlwm, kev ua haujlwm ntawm adrenal cortex, pituitary lossis thyroid caj pas), hloov chaw txhaj tshuaj, ntxiv rau kev cuam tshuam nrog rau lwm cov tshuaj.

Kev noj tshuaj tsis zoo los yog cuam tshuam hauv kev tswj hwm insulin, tshwj xeeb tshaj yog nyob rau cov neeg mob ntshav qab zib hom 1, tuaj yeem ua rau mob hyperglycemia. Feem ntau, thawj cov tsos mob ntawm hyperglycemia pib maj mam dhau ob peb teev lossis hnub. Cov no suav nrog kev nqhis dej, ntxiv tso zis, xeev ntuav, ntuav, kiv taub hau, liab thiab ntawm daim tawv nqaij, qhov ncauj qhuav, tsis qab los, tsis hnov ​​tsw ntawm Acetone hauv cov pa ua pa. Yog tias tsis kho, hyperglycemia hauv ntshav qab zib hom 1 tuaj yeem ua rau muaj kev tiv thaiv cov mob ntshav qab zib ketoacidosis.

Cov koob tshuaj insulin yuav tsum raug kho rau kev ua haujlwm ntawm cov thyroid tsis zoo, Addison's disease, hypopituitarism, ua rau lub siab thiab lub raum tsis ua haujlwm thiab mob ntshav qab zib hauv cov neeg muaj hnub nyoog 65 xyoos.

Kev kho tshuaj ntawm cov tshuaj insulin kuj tseem xav tau yog tias tus neeg mob nce ntxiv ntawm kev ua haujlwm lub cev lossis hloov cov zaub mov li qub.

Cov kab mob sib xyaw tshwj xeeb, tshwj xeeb tshaj yog kis mob thiab cov kab mob nrog kub taub hau, nce ntxiv qhov xav tau ntawm insulin.

Kev hloov pauv ntawm ib hom tshuaj insulin mus rau lwm qhov yuav tsum tau ua nyob ntawm kev tswjhwm ntawm cov ntshav nyob rau qib.

Cov tshuaj txo qis cawv rau cov neeg haus cawv.

Vim tias muaj dej nag nyob hauv qee qhov ntsuas, nws tsis pom zoo kom siv cov tshuaj hauv cov tshuaj insulin.

Cuam Tshuam rau kev muaj peev xwm tsav tsheb thiab ua haujlwm nrog tshuab. Hauv kev sib txuas nrog lub hom phiaj tseem ceeb ntawm insulin, qhov kev hloov pauv ntawm nws hom lossis nyob ntawm qhov tseem ceeb ntawm lub cev lossis lub hlwb kev ntxhov siab, nws muaj peev xwm txo qis kev muaj peev xwm tsav lub tsheb los yog tswj ntau cov txheej txheem, nrog rau koom nrog lwm yam kev phom sij uas xav tau kev nce siab thiab ceev ntawm lub hlwb thiab lub cev kev xav.

Daim ntawv tso tawm

Txhaj tshuaj, 100 IU / ml. Hauv lub raj mis uas tsis muaj xim pob tshab iav (hom 1), corked nrog cov roj hmab nres, muab tso rau hauv ib qho txhuas cap nrog lub hau kaw lossis tsis tuaj yeem, 10 ml. 1 fl. hauv pob ntawv thawv.

Hauv lub khob ntim (hom 1), nruab nrog lub roj hmab piston, roj hmab disc, dov rau hauv ib lub taub hau txhuas, 3 ml. 5 cartridges nyob rau hauv lub hlwv. 1 blister hauv cardboard bundle.

Tso cov ntaub ntawv thiab cov nyob ua ke

Txoj kev daws teeb meem meej, ib qho kev tshem tawm dawb, muab tshuaj subcutaneously. Ib qho nag lossis daus yuav tshwm sim uas yaj yooj yim thaum shaken. Cov tshuaj tau ntim hauv 10 ml fwj lossis 3 ml cartridges.

Hauv 1 ml ntawm cov tshuaj, cov tshuaj tiv thaiv nquag muaj nyob rau hauv tsab ntawv ntawm recombinant tib neeg insulin 100 IU. Cov khoom siv ntxiv yog glycerol, sodium hydroxide lossis hydrochloric acid, metacresol, dej txhaj.

Hauv 1 ml ntawm cov tshuaj, cov tshuaj tiv thaiv nquag muaj nyob rau hauv tsab ntawv ntawm recombinant tib neeg insulin 100 IU.

Pharmacological kev txiav txim

Hais txog cov insulins uas ua yeeb yam luv luv. Los ntawm reacting nrog tshwj xeeb receptor rau lub cell membrane, nws txhawb nqa tsim ntawm insulin-receptor complex, uas ua kom lub zog ua haujlwm ntawm lub cell thiab kev sib txuas ntawm qee cov enzyme tebchaw.

Cov theem ntawm cov piam thaj hauv cov ntshav yog sib npaug los ntawm kev nce ntxiv hauv kev thauj mus los hauv cov hlwb, txhim kho kev nqus ntawm txhua lub cev nqaij, txo kev tsim cov suab thaj los ntawm daim siab, thiab ua rau glycogenogenesis.

Lub sijhawm sijhawm ntawm cov kev kho kom zoo ntawm cov tshuaj nyob ntawm:

• haum tus nqi ntawm cov nquag tivthaiv,
• cheeb tsam thiab txoj kev ntawm kev coj ntawm lub cev,
• tsuas tshuaj.

Cov Yuav Tsum Muaj

1. Kev tsis qaug rau tus kheej ib leeg ib feem ntawm cov tshuaj.
2. Kev ntshav siab.

Yuav noj Gensulin li cas?

Cov tshuaj tau muab tshuaj nyob rau hauv ntau txoj kev - intramuscularly, subcutaneously, intravenously. Cov koob tshuaj thiab thaj chaw rau kev txhaj tshuaj yog xaiv los ntawm cov kws kho mob koom rau txhua tus neeg mob. Cov txheej txheem ntau npaum li cas sib txawv ntawm 0.5 txog 1 IU / kg ntawm tib neeg qhov hnyav, coj mus rau hauv tus account theem ntawm qab zib.

Tshuaj insulin yuav tsum tau muab tshuaj rau ib nrab ib teev ua ntej noj mov lossis noj khoom txom ncauj raws cov khoom noj carbohydrates. Kev daws yog preheated rau chav tsev kub. Kev kho mob monotherapy cuam tshuam nrog kev txhaj tshuaj txog li 3 zaug hauv ib hnub (tshwj xeeb, qhov muab ntau ntxiv nce mus txog 6 npaug).

Yog tias qhov koob tshuaj txhua hnub tshaj li 0.6 IU / kg, nws muab faib ua ntau qhov tshuaj, kev txhaj tshuaj tso rau ntau qhov chaw ntawm lub cev - deltoid brachial leeg, lub plab ua ntej pem hauv ntej. Txhawm rau tsis tsim kho lipodystrophy, cov chaw rau kev txhaj tshuaj yog hloov tas li. Ib rab koob tshiab siv rau txhua txoj kev txhaj tshuaj. Raws li rau IM thiab IV tswj hwm, nws tsuas yog ua nyob hauv tsev kho mob los ntawm tus kws kho mob.

Siv thaum cev xeeb tub thiab lactation

Cov neeg mob kuaj mob ntshav qab zib mellitus thaum npaj lub cev xeeb tub, kev siv tes taw yuav tsum soj ntsuam cov suab thaj hauv ntshav, vim tias tej zaum koj yuav tsum tau hloov pauv qhov ntau npaum li cas ntawm cov tshuaj.

Kev pub mis niam pub rau muab tso ua ke nrog kev siv cov tshuaj insulin, yog tias qhov xwm txheej ntawm tus me nyuam tseem zoo txaus, tsis muaj mob plab. Cov koob tshuaj kuj tseem raug hloov raws li cov kua nplaum nyeem.

Gensulin Noj Ntau Tshaj

Kev siv cov insulin hauv cov neeg loj yuav ua rau lub qog ntshav qab zib. Cov neeg mob mentsis ntawm pathology yog tshem tawm los ntawm kev noj qab zib, noj cov khoom noj uas muaj carbohydrate. Nws raug nquahu kom cov neeg ib txwm muaj qab zib thiab haus dej nrog lawv.

Yog mob hnyav yuav ua rau tsis nco qab. Hauv qhov xwm txheej no, kev daws teeb meem ntawm iv dextrose yog muab rau tus neeg sai sai. Ib qho ntxiv, glucagon yog tswj hwm iv lossis s / c. Thaum ib tug neeg los, nws yuav tsum noj zaubmov carbohydrate kom txaus tiv thaiv kev ua mob zaum ob.

Yog mob hnyav yuav ua rau tsis nco qab.