Ncua Zinc Insulin Txhaj Rau Cov Ntshav Qab Zib

Kev ncua ntawm crystalline zinc insulin rau kev txhaj tshuaj (insulin "K" ultralente) - kev npaj tshuaj insulin mus ntev rau kev kho mob ntshav qab zib mellitus.

Kev ncua ntawm crystalline zinc insulin yog hais txog kev ua yeeb yaj kiab uas muaj suab thaj ntau tshaj, uas tshwm sim 6-8 teev tom qab kev tswj hwm, cov nyhuv nce mus txog nws qhov siab tshaj plaws 16-20 teev tom qab kev tswj hwm thiab kav ntev txog 30-36 teev.

Kev thov cov cai

Cov koob tshuaj ntawm ncua kev kawm thiab tus naj npawb ntawm kev txhaj tshuaj rau ib hnub yog tau tsim ib leeg rau txhua tus neeg mob, noj mus rau hauv tus lej cov suab thaj tso tawm hauv cov zis nyob rau lub sijhawm sib txawv ntawm hnub, ntshav qab zib cov ntshav, thiab tseem siv sijhawm li ntawm cov nyhuv hypoglycemic.

Txhua qhov ua haujlwm tawm-tso tawm tshuaj insulin tsuas yog tswj ua subcutaneously xwb.

Zinc Insulin Ncua Sijhawm Ncaj Ncees

Kev ncua ntawm crystalline zinc insulin rau kev txhaj tshuaj (Suspensio Zinc-insulini crystallisati pro txhaj tshuaj tiv thaiv kab mob) yog cov tshuaj tiv thaiv tsis haum ntawm crystalline insulin nyob rau hauv acetate tsis nrog pH ntawm 7.1-7.5. 1 ml ntawm kev ncua kev kawm muaj 40 IU ntawm cov tshuaj insulin.

Ib qho kev ncua tawm yog tso tawm hauv 5 ml thiab 10 ml sterile kaw vials.

Cov lus qhia rau kev siv tshuaj

Kev siv ntawm cov tshuaj ncua ncua ntawm zinc insulin rau kev txhaj tshuaj yog pom zoo hauv kev kho mob ntawm hom 1 mob ntshav qab zib mellitus, suav nrog hauv menyuam yaus thiab poj niam hauv txoj haujlwm. Tsis tas li ntawd, cov cuab yeej no tuaj yeem siv rau hauv kev kho mob rau hom 2 mob ntshav qab zib mellitus, tshwj xeeb tshaj yog nrog kev tsis muaj txiaj ntsig ntawm cov piam thaj txo cov ntsiav tshuaj, tshwj xeeb, sulfonylurea derivatives.

Zinc insulin yog dav siv los kho cov teeb meem ntshav qab zib, xws li kev puas tsuaj rau lub plawv thiab cov hlab ntsha, ntshav qab zib taw thiab qhov muag tsis pom kev. Tsis tas li ntawd, nws yog qhov tseem ceeb rau kev kho mob ntshav qab zib ua haujlwm zoo thiab thaum rov qab los ntawm lawv, nrog rau kev raug mob hnyav lossis muaj lub siab zoo.

Raug tshem tawm zinc insulin yog npaj tshwj xeeb rau kev txhaj tshuaj subcutaneous, tab sis, tsis tshua muaj neeg tuaj yeem muab cov tshuaj intramuscularly. Tso tawm cov tshuaj ntawm cov tshuaj no yog nruj me ntsis txwv tsis pub, vim nws tuaj yeem ua rau muaj mob ntshav qab zib ntau heev.

Qhov ntau npaum li cas ntawm cov tshuaj Insulin Zinc yog xam ntawm tus kheej rau txhua tus neeg mob. Ib yam li lwm cov insulins ntev ntev, nws yuav tsum tau noj 1 lossis 2 zaug hauv ib hnub, nyob ntawm seb tus neeg mob xav tau dab tsi.

Thaum siv kev ncua ntawm insulin zinc thaum cev xeeb tub, nws yog qhov tseem ceeb heev kom nco ntsoov tias hauv thawj 3 lub hlis ntawm kev nqa tus menyuam yaus tus poj niam tuaj yeem txo qhov xav tau ntawm insulin, thiab hauv 6 lub hlis tom ntej, ntawm qhov tsis tooj, nws yuav nce ntxiv. Qhov no yuav tsum tau coj mus rau hauv tus account thaum suav qhov ntau npaum li cas ntawm cov tshuaj.

Tom qab yug menyuam hauv ntshav qab zib mellitus thiab thaum lub sijhawm pub niam mis, nws yog ib qho tseem ceeb kom ua tib zoo saib xyuas ntshav qab zib cov ntshav thiab, yog tias tsim nyog, kho qhov koob tshuaj zinc insulin.

Kev ua tib zoo saib xyuas cov piam thaj yuav tsum tau txuas ntxiv mus kom txog thaum tus mob zoo li qub lawm.

Niaj hnub no, insulin zinc raug tshem tawm yog qhov tsis tshua muaj hauv cov chaw muag tshuaj hauv cov nroog Lavxias. Qhov no feem ntau vim yog qhov tshwm sim ntawm ntau hom niaj hnub ua kom ntev li ntawm cov kua dej ntev, uas tshem cov tshuaj no los ntawm cov khw muag tshuaj.

Yog li, nws yog qhov nyuab dua kom hais qhov tseeb tus nqi ntawm insulin zinc. Hauv cov chaw muag tshuaj, cov tshuaj no raug muag hauv cov npe lag luam Insulin Semilent, Brinsulmidi MK, Iletin, Insulin Lente "HO-S", Insulin Lente SPP, Insulin Lt VO-S, Insulin-Ntev SMK, Insulong SPP thiab Monotard.

Kev txheeb xyuas txog cov tshuaj no feem ntau ua tau zoo. Ntau tus neeg mob ntshav qab zib tau ua tiav siv nws tau ntau xyoo. Txawm hais tias nyob rau hauv xyoo tsis ntev los lawv tau nce hloov nws nrog ntau niaj hnub counterparts.

Raws li cov analogues ntawm zinc insulin, koj tuaj yeem lub npe txhua yam ua ntev insulin npaj. Cov no suav nrog Lantus, Insulin Ultralente, Insulin Ultralong, Insulin Ultratard, Levemir, Levulin thiab Insulin Humulin NPH.

Cov tshuaj no yog cov tshuaj rau ntshav qab zib ntawm tiam tshiab. Cov kua dej hauv lawv cov kev sib xyaw yog ib qho piv txwv ntawm cov tshuaj insulin, tau los ntawm kev tsim hluav taws xob. Yog li, nws xyaum tsis ua rau ua xua thiab ua siab ntev rau tus neeg mob.

Cov yam ntxwv tseem ceeb tshaj plaws ntawm insulin yog tau piav qhia hauv daim yeeb yaj kiab hauv tsab xov xwm no.

Cov tshuaj insulin (Insulinum)

Nws yog ib yam tshuaj tsim los ntawm b-cov hlwb ntawm cov txiav tawv nqaij ntawm Langerhans.

Lub zog molecular ntawm insulin yog li 12,000. Hauv kev daws teeb meem, thaum pH ntawm qhov nruab nrab hloov pauv, insulin molecule cuam tshuam rau 2 monomers nrog kev ua haujlwm hauv hormonal. Lub phaus molecular ntawm lub monomer yog kwv yees 6000.

Lub monomer lwg me me muaj ob txoj hlua polypeptide, ib tus ntawm lawv muaj 21 amino acid seem (cov saw A), qhov thib ob muaj 30 amino acid seem (saw B). Txoj sia txuas nrog ob choj disulfide.

Tam sim no, qhov kev sib txuas ntawm cov tshuaj insulin molecule tau ua tiav.

Cov tshuaj Insulin muaj lub peev xwm tshwj xeeb los tswj kev zom cov zaub mov carbohydrate, txhim kho kev nqus ntawm cov piam thaj los ntawm cov ntaub so ntswg thiab ua rau nws hloov mus rau glycogen. Nws tseem yog qhov yooj yim kom nkag mus ntawm cov piam thaj rau hauv cov hlwb.

Cov tshuaj insulin yog ib qho tshwj xeeb antidiabetic tus neeg sawv cev. Thaum qhia rau hauv lub cev, txo qis cov ntshav qab zib, txo nws cov kev qhia ntxiv hauv cov zis, tshem tawm cov kev cuam tshuam ntawm ntshav qab zib tsis nco qab lawm.

Kev kho mob ntshav qab zib koom nrog kev siv cov tshuaj insulin nyob rau tom qab ntawm kev noj zaub mov kom tsim nyog.

Kev siv tshuaj insulin yog txiav txim siab biologically (los ntawm kev muaj peev xwm ua kom ntshav qab zib hauv luav zoo). Rau ib chav ua haujlwm (UNIT) lossis ib chav ntsuas thoob ntiaj teb (1 IE), cov haujlwm ntawm 0.04082 mg ntawm crystalline insulin (tus qauv) yog coj.

Ntxiv rau cov nyhuv hauv lub qog ntshav, insulin ua rau muaj ntau yam kev cuam tshuam: kev nce hauv cov khw muag khoom noj nqaij, ua kom muaj roj ntau ntau, ua kom cov peptide synthesis, kev noj protein tsawg, thiab lwm yam.

Cov tshuaj insulin rau kev siv kho mob tau txais los ntawm tus kab mob nqaj tawv tsiaj (nyuj, npua, thiab lwm yam).

Tam sim no, nrog rau cov tshuaj insulin (cov tshuaj insulin rau kev txhaj tshuaj), muaj ntau cov tshuaj nrog kev ua ntev.

Qhov sib ntxiv ntawm zinc, protamine (protein) thiab tsis tsis raug rau cov tshuaj no hloov qhov feem ntawm qhov pib ntawm lub suab thaj txo cov txiaj ntsig, lub sijhawm ntawm cov txiaj ntsig siab tshaj plaws ("qhov kawg" ua) thiab tag nrho lub sijhawm ua.

Cov tshuaj yeeb ntev ntev muaj pH ntau dua li cov tshuaj insulin rau kev txhaj tshuaj, uas ua rau lawv cov kev txhaj tshuaj tsawg dua.

Cov tshuaj yeeb ntev ntev tuaj yeem muab rau cov neeg mob tsawg dua li cov tshuaj insulin rau kev txhaj tshuaj, uas yooj yim pab kho cov neeg mob ntshav qab zib mellitus.

Qhov kev txiav txim siab ceev thiab tsawg tshaj plaws (txog 6 teev) yog siv tshuaj los ntawm cov tshuaj insulin rau kev txhaj tshuaj, qhov kev txiav txim siab ntev dua (10-12 teev) yog tawm los ntawm kev ncua ntawm amorphous zinc-insulin, tom qab ntawd tiv thaiv protamine-zinc-insulin rau kev txhaj tshuaj (txog 20 teev), thiab insulin ncua cov tshuaj tiv thaiv (18-30 teev), ncua ntawm zinc-insulin (txog 24 teev), ncua kev tiv thaiv cov tshuaj tiv thaiv-zinc-insulin (24-36 teev) thiab ncua ntawm zinc-insulin crystalline (txog 30-36 teev).

Qhov kev xaiv ntawm cov tshuaj uas tau siv yog nyob ntawm qhov mob hnyav, nws cov chav kawm, qhov xwm txheej ntawm tus neeg mob thiab lwm yam ntxiv ntawm rooj plaub, nrog rau lub zog ntawm cov tshuaj (ceev ntawm qhov pib thiab lub sijhawm ntawm cov nyhuv hypoglycemic, pH, thiab lwm yam).

Feem ntau, cov tshuaj yeeb nrog cov kev ua ntev ntev tau sau tseg rau cov neeg mob uas muaj cov mob loj thiab mob hnyav, ntawm cov neeg mob yav tas los tau txais 2-3 los yog ntau dua kev txhaj tshuaj insulin (ib txwm) ib hnub.

Nyob rau hauv precomatous tej yam kev mob thiab mob ntshav qab zib tsis nco qab, raws li tau zoo nyob rau hauv cov ntaub ntawv mob ntshav qab zib mellitus nrog ib tug nyiam mus rau ketosis nquag thiab nrog cov kis kab mob, elongated tshuaj yog contraindicated, nyob rau hauv cov mob no, insulin tsis tu ncua rau kev txhaj tshuaj yog siv.

Cov tshuaj insulin rau kev txhaj tshuaj (Insulinum pro txhaj tshuaj).

Cov tshuaj tau los ntawm dissolving crystalline insulin (nrog kev ua haujlwm lom ntawm tsawg kawg 22 PIECES hauv 1 mg) hauv dej acidified nrog hydrochloric acid.

1.6-1.8% glycerol ntxiv rau qhov kev daws thiab phenol (0.25-0.3%) raws li kev tiv thaiv, pH ntawm kev daws yog 3.0-3.5. Cov xim tsis muaj kua pob tshab. Cov tshuaj tau tso tawm nrog ib qho haujlwm ntawm 40 lossis 80 PIECES hauv 1 ml.

Siv feem ntau rau kev kho mob ntshav qab zib.

Cov koob tshuaj tau teeb tsa tshwj xeeb nyob ntawm tus mob ntawm tus neeg mob, cov ntsiab lus qab zib hauv cov zis (ntawm tus nqi ntawm 1 ED rau 5 g suab thaj ua rau hauv cov zis). Feem ntau, txhaj tshuaj (rau cov neeg laus) thaj tsam ntawm 10 txog 20 units hauv ib hnub. Nyob rau tib lub sijhawm, kev noj haus kom tsim nyog yog cov tau noj.

Kev siv cov tshuaj insulin thiab kev xaiv koob tshuaj yog ua tiav los ntawm kev tswj cov piam thaj hauv kev tso zis thiab ntshav thiab saib xyuas tus neeg mob lub cev.

Hauv kev tso ntshav qab zib tsis nco qab, cov koob tshuaj insulin tau nce rau 100 IU lossis ntau dua ib hnub (tib lub sijhawm, tus neeg mob tau txais cov tshuaj ua kua qab zib).

Cov tshuaj insulin rau kev txhaj tshuaj muaj qhov nrawm thiab txo qis qab zib cov nyhuv. Cov nyhuv feem ntau tshwm sim hauv 15-30 feeb tom qab txhaj, qhov "ncov" ntawm kev nqis tes - tom qab 2-4 teev, tag nrho lub sijhawm ntawm kev txiav txim siab txog 6 teev.

Cov tshuaj yog txhaj 1-3 zaug hauv ib hnub, cov tshuaj no tau muab tshuaj tso rau hauv qab tawv nqaij lossis ua kom tawv nqaij li 15-20 feeb ua ntej noj mov. Thaum siv peb zaug, koob tshuaj tau faib rau cov tshuaj, uas thaum txhaj tshuaj zaum kawg (ua ntej noj hmo), koob tshuaj qis qis qis dua yog tswj hwm kom tsis txhob muaj ntshav qab zib tsawg nocturnal.

Qhov mob ntshav, insulin yog muab rau (txog li 50 units) tsuas yog rau mob ntshav qab zib tsis nco qab, yog tias txhaj tshuaj subcutaneous tsis zoo txaus.

Thaum hloov los ntawm kev kho mob insulin rau kev txhaj tshuaj rau cov tshuaj tso tawm ntev, nws yog qhov yuav tsum tau ua tib zoo saib xyuas tus neeg mob cov tshuaj tiv thaiv, tshwj xeeb tshaj yog nyob rau thawj 7-10 hnub, thaum cov koob tshuaj ntawm lub sijhawm ntev yuav tsum tau teev.

Txhawm rau txheeb xyuas tus neeg mob qhov tshuaj tiv thaiv rau cov tshuaj tshiab, nws raug nquahu kom ua ntau dua kev kawm qab zib (tom qab 2-3 hnub) nyob rau hauv cov zis ntim rau hauv qhov nruab hnub, nrog rau kev kawm txog cov piam thaj hauv ntshav (thaum sawv ntxov hauv lub plab khoob).

Nyob ntawm cov ntaub ntawv tau txais, cov teev ntawm kev tswj hwm ntawm ib lub sijhawm siv tshuaj ntev tau teev tshwj xeeb rau lub sijhawm ntawm qhov pib ntawm qhov siab tshaj plaws nyob rau hauv cov piam thaj, nrog rau lub sijhawm ntawm kev tswj hwm ntxiv (yog tias tsim nyog) ntawm insulin tsis tu ncua thiab kev faib tawm ntawm carbohydrates hauv kev noj zaub mov txhua hnub.

Thaum kho ntxiv, cov piam thaj hauv cov zis yuav tau tshuaj xyuas tsawg kawg 1 zaug nyob rau ib lub lim tiam, thiab cov ntshav qab zib cov ntshav yuav 1-2 zaug hauv ib hlis.

Cov tshuaj insulin me me (4-8 ntu 1-2 zaug hauv ib hnub) yog siv rau kev noj zaub mov tsis txaus, kev noj zaub mov kom tsawg, furunculosis, thyrotoxicosis, ntau ntuav ntawm cov poj niam cev xeeb tub, mob plab (atony, gastroptosis), mob siab, thawj daim ntawv ntawm daim siab mob ntshav qab zib (ntshav qabzib yog tshuaj rau tib lub sijhawm ( )

Hauv kev xyaum ua lub hlwb, tshuaj insulin yog siv los tsim kev mob ntshav qab zib hauv kev kho mob ntawm qee hom mob schizophrenia. Insulin coma (poob siab) yog tshwm sim los ntawm kev niaj hnub subcutaneous lossis intramuscular txhaj ntawm insulin rau kev txhaj tshuaj, pib nrog 4 IU, nrog ib hnub txuas ntxiv ntawm 4 IU kom txog thaum lub ntsej muag ntawm liab qab lossis tsis hnov ​​qab.

Thaum sopor tshwm sim, qhov kev txhaj tshuaj ntawm cov tshuaj insulin tsis nce ntxiv hauv 2 hnub, nyob rau hnub 3 koob tshuaj tau nce ntxiv ntawm 4 units thiab kev kho mob txuas ntxiv hauv kev nce ntxiv kom txog thaum hnov ​​mob rov qab. Lub sijhawm ntawm kev tso thawj tsis yog 5-10 feeb, tom qab uas ib tus neeg xav nres. Nyob rau hauv lub neej yav tom ntej, lub sijhawm ntawm coma tau nce mus rau 30-40 feeb.

Hauv chav kawm ntawm kev kho mob, lawv hu ib tus neeg nce siab txog 25-30 zaug.

Txhawm rau rov qab tsis nco qab los ntawm txoj kev tuav dej khov ntawm 20 ml ntawm 40% piam thaj tov. Tom qab tawm ntawm qhov tsis txaus, tus neeg mob tau txais tshuaj yej nrog 150-200 g suab thaj thiab noj tshais. Yog tias tom qab tso cov ntshav qabzib hauv lub xeev tsis tso rov qab, nws tsis nres, 400 ml ntawm tshuaj yej muaj 200 g suab thaj yog qhia rau hauv lub plab dhau los ntawm lub raj.

Kev siv cov kua dej yuav tsum nyob rau hauv txhua qhov teeb meem ua nrog ceev faj. Nrog nws noj ntau dhau thiab tsis paub txog kev noj haus carbohydrates, kev poob siab hypoglycemic tuaj yeem tshwm sim nrog kev tsis nco qab, ua tsis taus pa thiab txo qis hauv plawv kev ua si.

Thaum cov tsos mob ntawm hypoglycemia tshwm sim, tus neeg mob yuav tsum tau muab 100 g ntawm qhob cij dawb lossis ncuav qab zib, thiab nrog ntau cov tsos mob tshaj tawm, 2-3 dia lossis ntau dua cov suab thaj granulated.

Thaum muaj kev poob siab hypoglycemic, 40% cov kua nplaum nyob rau hauv cov ntshav thiab cov ntshav qab zib ntau yog muab rau (saib saum toj no).

Cov tshuaj tiv thaiv kom tsis txhob siv cov tshuaj insulin yog cov kabmob uas tshwm sim nrog hypoglycemia, mob siab, mob ntshav siab, mob qog ntshav siab, mob caj dab, mob leeg, mob nephritis, amyloidosis ntawm ob lub raum, urolithiasis, mob plab thiab duodenal mob, lub siab tsis ua haujlwm.

Kev saib xyuas zoo yog qhov yuav tsum tau muaj nyob hauv cov neeg mob ntshav qab zib mellitus thaum tsis pom kev txhim kho cov hlab ntsha tsis muaj ntshav txaus thiab cerebrovascular sib tsoo.

Cov tshuaj insulin tuaj yeem mob vim tias pH qis ntawm cov tshuaj.

Daim ntawv tso tawm ntawm insulin: hauv nruab nrab lub khob iav, hermetically kaw nrog roj hmab nres nrog cov hlau khiav, 5-10 ml nrog ib qho kev ua ntawm 40 thiab 80 PIECES hauv 1 ml.

Cov tshuaj insulin yog sau los ntawm lub vial los ntawm kev hno nrog rab koob ib rab koob lub koob roj hmab, yav dhau los txhuam nrog cawv los yog kua iodine.

Cia: Sau B. Ntawm qhov kub ntawm 1 txog 10 °, txias tsis tso cai.

Cov insulin tau los ntawm tus kab mob ntses ntses (whale insulin) nws txawv me ntsis ntawm cov amino acid muaj pes tsawg leeg los ntawm cov insulin zoo tib yam, tab sis nws nyob ze rau nws ntawm kev txiav ntshav qab zib.

Piv nrog cov tshuaj insulin zoo tib yam, cetacean insulin ua yeeb yam qeeb dua, thaum qhia hauv qab daim tawv nqaij, qhov pib ntawm kev ua yog pom tom qab 30-60 feeb, qhov siab tshaj plaws tom qab 3-6 teev, lub sijhawm ua yog 6-10 teev.

Siv rau ntshav qab zib (cov qauv hnyav thiab loj).

Vim tias qhov tseeb tias cov tshuaj sib txawv hauv cov qauv hauv tshuaj los ntawm cov tshuaj insulin tau los ntawm kev txiav txim siab ntawm nyuj thiab npua, qee zaus nws muaj peev xwm tiv tau cov tshuaj insulin zoo tib yam, nws kuj tseem siv thaum kev fab tshuaj yog pom los ntawm insulin zoo tib yam (txawm li cas los xij, qee kis whale insulin kuj ua rau ua xua tuaj yeem ua xua).

Nkag rau hauv qab daim tawv nqaij lossis intramuscularly 1-3 zaug hauv ib hnub. Cov koob tshuaj, kev ceev faj, cov teeb meem yuav tshwm sim, contraindications zoo ib yam rau cov tshuaj insulin rau kev txhaj tshuaj.
Whale insulin tsis pom zoo rau mob ntshav qab zib tsis nco qab, vim nws ua qeeb qeeb dua li cov insulin tsis tu ncua rau kev txhaj tshuaj.

Daim ntawv tso tawm: hauv lub raj mis hermetically kaw nrog roj hmab stoppers nrog hlau khiav, 5 thiab 10 ml nrog ib qho kev ua ntawm 40 PIECES hauv 1 ml.

Cia: saib cov insulin rau kev txhaj tshuaj.

Mob ntshav qab zib mellitus - insulin npaj

Insulin-zinc-suspension "A" (ICS "A") - amorphous zinc-insulin. Cov tshuaj pib ua yeeb yam 1-1.5 teev tom qab nws txoj haujlwm subcutaneous thiab kav rau 10-12 teev (cov txiaj ntsig zoo tshaj plaws pom los ntawm 5-7 teev tom qab txhaj tshuaj). Insulin-zinc-suspension "A" zoo ib yam li Dutch siv tshuaj "xya-kab xev".

Insulin-zinc-ncua kev kawm "K" (ICS "K") - crystalline zinc-insulin. Nrog kev txhaj tshuaj subcutaneous, nws cov nyhuv pib 6-8 teev tom qab kev tswj hwm. Nws ua tiav qhov tshwm sim loj tshaj tom qab 12-18 teev, thiab xaus tom qab 28-30 teev. Cov tshuaj noj tsis tau ntawm cov tshuaj Danish "ultra-tape."

Insulin-zinc ncua kev kawm (ISC) yog kev sib xyaw ntawm ICS "A" (30%) thiab ICS "K" (70%). Qhov pib ntawm cov tshuaj yog tom qab 1-1.5 teev thiab kav rau 24 teev. Tom qab kev tswj hwm ntawm cov tshuaj, ob qhov siab tshaj plaws ntawm nws cov kev txiav txim siab tau raug saib xyuas - tom qab 5-7 teev thiab 12-18 teev, uas tau sib haum rau lub sijhawm ntawm kev txiav txim siab zoo ntawm kev npaj muaj nyob hauv. Cov kab xev yog “daim kab xev tshiab”.

B-insulin yog ib qho tsis haum xeeb, tsis muaj kob ntawm cov kua dej ntawm cov tshuaj insulin thiab kev npaj ua kom ntev.Qhov pib ntawm lub cev hypoglycemic tshwm sim ib teev tom qab kev tswj hwm. Lub sijhawm ua ntawm 10-16 teev. Nws yog tsim nyob rau hauv lub teb chaws Yelemees.

Tag nrho cov ntawm insulin npaj ntev no muaj nyob rau hauv 5 ml fwj nrog ib cov ntsiab lus ntawm 40 units hauv ib milliliter. Ua ntej siv, lub vial yuav tsum tau shaken me ntsis kom txog thaum teeb pom kev zoo turbidity. Nws yuav tsum tau yug los hauv lub siab tias txhua yam tshuaj no tuaj yeem ua haujlwm xwb subcutaneously. Lawv txoj kev txhaj tshuaj tiv thaiv kab mob yog qhov tsis lees txais. Koj tseem tuaj yeem siv tsis tas lawv nrog kev mob taub hau mob plab.

Yuav ua li cas txhaj tshuaj insulin?

Feem ntau ntawm cov neeg mob ntshav qab zib yuav tsum tau txhaj tshuaj insulin txhua hnub (qee zaum ob peb zaug hauv ib hnub) txhawm rau tswj kev nyob zoo. Yog li, nws raug nquahu tias txhua tus neeg mob kawm paub siv cov tshuaj insulin ntawm nws tus kheej.

Kev txhaj tshuaj feem ntau yog muab rau hauv qab daim tawv nqaij rau thaj chaw ntawm qhov nrawm sab nraud thiab nraub qaum ntawm xub pwg lossis hauv qab nplooj pliav. Yog hais tias tus neeg mob txhaj tshuaj insulin ntawm nws tus kheej, nws yog qhov yooj yim tshaj plaws los ua qhov no hauv sab lauj lossis sab tav (los ntawm sab nraud), hauv qab pob tw lossis hauv nruab nrab ntawm lub plab.

Txog kev txhaj tshuaj, nws zoo dua yog siv cov koob txhaj tshuaj "insulin" tshwj xeeb lossis cov koob txhaj me me (1-2 ml) nrog 0.1 ml sib faib.

Ua ntej muab cov tshuaj insulin, nws yog qhov yuav tsum tau txiav txim siab ua ntej cov tshuaj uas yuav tsum tau txhaj rau hauv cov koob txhaj tshuaj (qhov no, yuav tsum tau coj los ntawm cov tshuaj uas kws kho mob sau tseg).

Nov yog ib qho piv txwv: yog tias 40 pawg ntawm insulin muaj ъ ml ntawm cov tshuaj, thiab tus neeg mob yuav tsum nkag mus rau 20 pawg, tom qab ntawd 0.5 ml ntawm insulin yuav tsum tau kos rau hauv cov koob txhaj, uas yuav sib haum rau 5 kev faib tawm ntawm 1-gram thiab 2.5 faib ntawm 2-gram koob txhaj.

Qhov kev xam no tau ua siv cov koob txhaj tshuaj, tab sis nws zoo dua yog siv cov koob txhaj tshuaj tshwj xeeb rau cov tshuaj insulin.

Thaum txhaj tshuaj, nws yog qhov yuav tsum tau soj ntsuam kom tsis muaj menyuam (thiaj li ua kom tsis txhob muaj kabmob sib kis).

Cov txheej txheem ntawm cov tshuaj insulin yog qhov yooj yim thiab tsis tas yuav muaj kev kawm tshwj xeeb. Txawm li cas los xij, thawj cov kev txhaj tshuaj uas tus neeg mob ua rau nws tus kheej yuav tsum tau nqa tawm los ntawm kev saib xyuas ntawm tus nais maum thiab nrog nws pab.

Ua ntej txhaj tshuaj, tus neeg mob yuav tsum muaj ampoule nrog cov tshuaj insulin, koob txhaj nrog ob rab koob, anatomical tweezers, nqus cov paj rwb, ethyl lossis methyl cawv (denatured cawv), ib qho tshuaj tua kab mob, lossis cov tais diav tshwj xeeb rau rhaub cov koob txhaj tshuaj. Nws yog ib qho tseem ceeb uas tus neeg mob txij thaum pib mus rau qhov tiag yog txhaj txhua yam thiab tau siv kom raug yog tias txhaj tshuaj. Negligence tsis tuaj yeem nyob ntawm no. Kev ua txhaum ntawm kev muaj menyuam yaus tuaj yeem ua rau muaj kev phom sij txaus ntshai (qog ntshav, thiab lwm yam).

Ua ntej txhaj tshuaj, cov koob txhaj tshuaj yog rhuav tshem, thiab tom qab ntawd, nrog rau rab koob thiab rab koob, rwj rau 5-10 feeb hauv dej huv. Cov koob txhaj tshuaj tiv thaiv yog muab tshem tawm nrog cov tais da dej thiab sib sau ua ke yam tsis kov lub nplaim piston thiab cov taub dej tsis txuas ntxiv. Ib rab koob tau tso rau hauv cov koob txhaj tshuaj nrog tweezers, qhov txav ntawm lub piston tshem tawm cov dej ntxiv los ntawm daim ntawv txhaj tshuaj.

Cov tshuaj insulin los ntawm cov vial yog sau raws li hauv qab no: lub piston ntawm cov koob txhaj tshuaj yog coj mus rau lub cim kom raug raws li qhov xav tau ntawm cov tshuaj insulin, tom qab ntawd cov roj hmab cap ntawm ampoule yog punctured nrog rab koob ntawm lub koob txhaj tshuaj.

Thaum cov koob nkag mus rau hauv ampoule (ua ntej nws tso rau hauv cov kua), cov huab cua muaj nyob hauv rab koob yog tso tawm (qhov no yog ua los ntawm nias lub piston). Tom qab ntawd, los ntawm kev qaij lub raj mis, rab koob tau muab tso rau hauv ib qho tshuaj ua kua insulin. Hauv qab qhov cua nkag, kua pib ntws mus rau hauv cov phwj.

Tom qab hu rau cov tshuaj ntawm cov tshuaj, rab koob thiab cov koob txhaj tshuaj raug tshem tawm ntawm ampoule. Lub sijhawm no cov cua nkag, cua tuaj yeem nkag mus hauv cov phwj.

Yog li ntawd, cov koob txhaj yuav tsum tau nyob ib pliag nrog rab koob, thiab tom qab ntawd tso tawm cua thiab me ntsis kua los ntawm nws (uas yog vim li cas koj yuav tsum tau ib txwm siv tshuaj insulin me ntsis ntxiv rau hauv cov koob txhaj tshuaj dua li qhov tsim nyog txhaj tshuaj).

Qhov chaw txhaj tshuaj yuav tsum xub muab cov ntaub paj rwb nrog cawv cawv. Tom qab ntawd daim tawv nqaij nrog subcutaneous cov ntaub so ntswg yog ntes nrog sab laug, thiab rab koob tau ntxig nrog sab tes xis.

Tom qab ntawd, tuav rab koob nrog sab lauj tes ntawm txoj kev sib tshuam nrog cov koob txhaj tshuaj, thiab nias lub piston kom kawg nrog sab tes xis; tom qab tshem rab koob, qhov chaw txhaj tshuaj yog ua kom zoo nrog cawv.

Thaum txhaj tshuaj, kev saib xyuas yuav tsum tau ua kom ntseeg tau tias cov tshuaj insulin tsis txeej ntawm qhov sib txuas ntawm rab koob nrog koob txhaj tshuaj (siv tsuas yog cov koob uas haum rau qhov kawg ntawm kev txhaj tshuaj).

Raws li koj tuaj yeem pom, tag nrho cov txheej txheem txhaj tshuaj tsis muaj teeb meem tshwj xeeb. Tus neeg mob sai sai txais cov txuj ci tsim nyog. Nws tsuas yog tsim nyog kom ua tau nruj ntawm txhua txoj cai tsim nyog thiab cov kev ceev faj.

Cov tshuaj insulin tau hloov kho kho ntshav qab zib. Tab sis kev kho mob nrog nws cov kev pab, raws li twb tau sau tseg, tsis yog pub dawb los ntawm qee qhov tsis zoo: nws yog qhov yuav tsum tau siv tshuaj insulin nyob rau hauv kev txhaj tshuaj 2-3, thiab qee zaum txawm tias 4 zaug hauv ib hnub, qee zaum hypoglycemia pom (yog tias koj tsis ua raws li kev noj haus), hauv qee kis muaj ib tus neeg intolerance, abscesses tom qab txhaj, thiab lwm yam.

Qhov tshuaj insulin yog qhov tshuaj raws protein. Yog li, nws qhov kev siv qee zaum ua rau kev ua xua ntawm lub cev. Tias yog vim li cas nyob rau hauv cov rooj plaub no nws pom zoo kom hloov cov koob ntawm cov tshuaj insulin. Hauv qee tus kabmob, cov tshuaj insulin feem ntau contraindicated.

Kev quav rau cov tshuaj insulin tsis txhim kho. Nws tuaj yeem tshem tawm yooj yim, tshwj xeeb tam sim no, thaum muaj ntau yam kab mob hypoglycemic uas cov neeg mob noj ntawm qhov ncauj. Cov no suav nrog cov tshuaj ua kom cov sulfonamide uas muaj suab thaj thiab cov tshuaj loj loj.

Kev piav qhia ntawm cov tshuaj insulin zinc raug tshem tawm compound (insulin zinc raug tshem tawm, kev sib txuas): cov lus qhia, siv, contraindications thiab mis.

• Cov neeg ua zam, reagents thiab intermediates

1 ml ntawm qhov nruab nrab sterile aqueous tov muaj zinc (hauv daim ntawv ntawm chloride) 47 μg, sodium chloride 7 mg, sodium acetate 1.4 mg, methyl parahydroxybenzoate 1 mg, ntxiv rau sodium hydroxide thiab hydrochloric acid (rau kev kho pH), hauv 10 ml vials , hauv daim thawv ntawv tuab 1 lub raj mis.

Kev txiav txim siab ntawm zinc insulin npaj tsim los ntawm Novo Nordisk yuav tsum tau ua nyob rau hauv aseptic tej yam kev mob rau qib uas txiav txim siab los ntawm tus kws kho mob raws li qhov tsim nyog xav tau (feem ntau yog rau cov menyuam yaus) thiab cov kev txwv kev lag luam muaj cov tshuaj insulin ua haujlwm.

Hauv maub qhov chaw ntawm qhov kub ntawm 2 8 C. Hauv tub yees. Cia rau hauv qhov chaw tiv thaiv los ntawm tshav ntuj tso cai nyob rau hauv chav tsev tsis siab tshaj 25 C rau 6 lub lis piam.

Khaws tsis ncav cuag ntawm cov menyuam yaus.

2 xyoos Diluted rau 10 IU / ml, qhov kev npaj insulin tseem nyob ruaj khov rau 2 lub lis piam thaum muab cia rau hauv lub tub yees tsis dhau mus rau lub tub yees txias ntawm qhov kub ntawm 2-8 C.

Qee qhov xwm txheej, kev nthuav qhia kev tsis haum tshuaj ntawm cov tshuaj ntawm cov tshuaj muaj peev xwm ua tau. Tshaj dhau cov tshuaj pom zoo, kev tawm dag zog lub cev, kev noj zaub mov tsis xwm yeem, kev kis kab mob nrog rau kev zawv plab thiab ntuav tuaj yeem ua rau mob ntshav qab zib tsawg.

Nyob rau tib lub sijhawm, tus miv muaj qhov mob huam, tawm hws heev, ib qho kev xav ntawm kev tshaib plab, lub plawv dhia ceev thiab lub plawv dhia, ntshai, ntxhov siab thiab poob ntawm txoj kev xav hauv qhov chaw. Thaum cov tsos mob no tshwm sim, yuav tsum muaj kev ntsuas ntshav los txiav txim siab txog qib ntshav qab zib thiab kho cov kev kho mob. Hauv cov xwm txheej zoo li no, cov kua ua nrog cov kua nplaum ua kom zoo.

Yog tias tus tsiaj tsis tau txais insulin txaus, thiab kev txhaj tshuaj tsis tau ua tiav raws sijhawm, ces hyperglycemia (mob ntshav qab zib acidosis) yuav tshwm sim. Qhov no yog fraught nrog tshwm sim ntawm kev nqhis dej heev, tsis nco qab noj, tsaug zog thiab qaug zog.

Miv raug muab txhaj tshuaj thawj zaug thaum sawv ntxov ua ntej noj. Ntxiv mus, cov khoom noj rau noj yuav tsum yog 50% ntawm tag nrho cov zaub mov noj txhua hnub. Qhov kev pub mis thib ob yog nqa tawm tom qab 12 teev thiab tseem tom qab kev tswj hwm ntawm cov tshuaj.

Raug raws cov lus qhia, tsis muaj kev phiv hais txog. Txawm hais tias siv sijhawm ntev heev ntawm caninsulin tuaj yeem ua rau lipodystrophy. Tsis txhob muab cov tshuaj rau cov tsiaj txhu nrog cov ntshav qabzib (hypoglycemia).

E10 Mob Ntshav Qab Zib Insulin-tiv thaiv mob ntshav qab zib E11 Cov ntshav qab zib tsis yog insulin-tiv thaiv mob ntshav qab zib mellitus O24 Mob ntshav qab zib mellitus thaum cev xeeb tub

Nruab Nrab Sijhawm Insulin. Monocomponent (ua kom huv) nqaij npuas xyaw zinc-insulin. Muaj nyob rau hauv daim ntawv ntawm qhov kev ncua nruab nrab rau kev txhaj tshuaj uas muaj 30% amorphous thiab 70% cov kab mob crystalline.

Kws Tshuaj

Cov nyhuv pharmacological yog hypoglycemic.

Regulates cov metabolism ntawm carbohydrates, lipids thiab protein. Nws cuam tshuam nrog cov receptors ntawm cytoplasmic membrane ntawm cov hlwb thiab ua ib qho insulin receptor complex. Los ntawm kev ua kom muaj cAMP (hauv cov roj ntsha thiab lub siab ua haujlwm) lossis nkag ncaj qha rau hauv lub cell (leeg), cov txheej txheem ua haujlwm hauv intracellular, suav nrog

tsim cov hluavtaws tseem ceeb glycolysis enzymes ntawm hexokinase, phosphofructokinase, pyruvate kinase thiab ob peb lwm tus, suav nrog glycogen synthetase hauv phiaj cov kabmob (daim siab, cov leeg pob txha). Nce permeability ntawm cov cell ua rau qabzib thiab tus nqi ntawm nws siv los ntawm cov ntaub so ntswg.

Qhov kev txo qis hauv cov ntshav hauv lub cev yog los ntawm kev nce hauv lipogenesis, glycogenogenesis, synthesis protein thiab txo cov ntshav qabzib ntau lawm. Nws muaj qhov tsis ncaj ncaj rau ntawm dej thiab cov pa metabolism.

Kev nqus thiab qhov pib ntawm cov nyhuv yog nyob ntawm tus qauv (s / c lossis nyob rau hauv / m) thiab qhov chaw (plab, ncej, pob tw) ntawm kev tswj hwm, txhaj tshuaj ntim, insulin concentration hauv tshuaj, thiab lwm yam Nws tau faib tsis ncaj thoob plaws cov ntaub so ntswg, tsis nkag rau hauv lub cev qhov chaw thiab hauv lub hauv siab mis nyuj. T1 / 2 yog li 5-6 feeb. Nws yog rhuav tshem los ntawm insulinase hauv daim siab thiab hauv lub raum. Nws yog tawm los ntawm lub raum (30 80%).

Hom 1 mob ntshav qab zib mellitus, suav nrog hauv cov menyuam yaus thiab cov poj niam cev xeeb tub (nrog qhov tsis muaj txiaj ntsig ntawm kev noj zaub mov noj), hom 2 mob ntshav qab zib mellitus (nrog kev tiv thaiv kab mob rau lub qhov ncauj hypoglycemic los ntawm sulfonylureas), nrog cov kab mob sib kis, kev phais mob ntau ntxiv, hauv lub sijhawm postoperative, nrog kev raug mob thiab kev ntxhov siab hauv cov neeg mob ntshav qab zib mellitus.

Cov Yuav Tsum Muaj

Kev ua haujlwm tsis txaus ntseeg, kev ua ntshav qab zib, insuloma.

Thaum cev xeeb tub, nws yog qhov tsim nyog yuav tsum coj mus rau hauv tus lej txo qis (kuv plaub hlis) lossis nce ntxiv (II thiab III trimesters) ntawm cov tshuaj insulin. Thaum pub niam mis, kev saib xyuas tas li rau ob peb lub hlis raug pom zoo (txog thaum xav tau cov tshuaj insulin nyob ruaj khov).

Kev mob ntshav qab zib (nrog rau cov koob tshuaj loj, ua kom dhau los lossis ncua sijhawm noj zaub mov, ua lub cev hnyav dhau los, tawm tsam ntawm tus mob los yog kab mob, tshwj xeeb yog ntuav thiab mob raws plab): pallor, tawm hws, palpitations, insomnia, tshee tshee thiab lwm yam tsos mob, txog ntua thiab tsis nco qab,

hyperglycemia thiab ntshav qab zib acidosis (ntawm kev siv tshuaj tsawg kawg, ncua kev txhaj tshuaj, noj zaub mov tsis zoo, tawm tsam keeb kwm ntawm kev kis tus kab mob thiab kub taub hau), nrog rau kev ua kom nkees, nqhis dej, tsis qab los, ua ntsej muag tawm thiab lwm cov tsos mob, mus txog tom qab thiab tsis nco qab,

ua xua, incl. anaphylactoid kev tsis haum (tsis tshua muaj), tawm pob, angioedema, laryngeal edema, anaphylactic ceeb, hyperemia thiab khaus ntawm qhov chaw txhaj tshuaj (hauv thawj lub lis piam ntawm kev kho mob), lipodystrophy (nrog rau kev tswj hwm ntev nyob ntawm tib qhov chaw).

Kev sib txuam

qhov ncauj tshuaj tiv thaiv hormonal contraceptives, steroidal anti-inflammatory tshuaj, cov thyroid hormones, heparin, lithium npaj, nicotine (haus luam yeeb), thiazide thiab voj diuretics. Ethanol thiab tshuaj tua kab mob txo qis kev ua si (kev sib txuam ntawm kev sib koom tes), nws yog qhov tsis sib xyaw (tsis tuaj yeem sib xyaw) nrog phosphate-muaj cov insulins, thiab lwm yam kev ncua ntawm zinc-insulin.

Noj ntau dhau

Cov tsos mob: cov cim ntawm hypoglycemia, hws txias, tsis muaj zog, pallor ntawm daim tawv nqaij, palpitations, tshee tshee, poob siab, xeev siab, tingling nyob rau hauv nqua, daim di ncauj, tus nplaig, mob taub hau, nyob rau hauv mob hnyav, hypoglycemic coma.

Kev Kho Mob: rau qhov mob ntshav qab zib tsawg thiab mob ntshav qab zib, noj qabzib (cov ntsiav tshuaj qabzib, kua txiv, zib ntab, lwm yam zaub mov qab zib), nrog rau cov ntshav qabzib heev, tshwj xeeb nrog poob ntawm kev nco qab thiab coma 50 ml ntawm 50% iv qabzib cov tshuaj tom qab ua tas mus li Txoj kev lis ntshav ntawm 5 10% aqueous glucose tov, lossis 1 2 mg ntawm glucagon (i / m, s / c, iv), qee qhov, diazoxide iv 300 mg rau 30 min txhua 4 teev,

Kev mob ntshav qab zib (nrog rau cov koob tshuaj loj, ua kom dhau los lossis ncua sijhawm noj zaub mov, ua lub cev hnyav dhau los, tawm tsam ntawm tus mob los yog kab mob, tshwj xeeb yog ntuav thiab mob raws plab): pallor, tawm hws, palpitations, insomnia, tshee tshee thiab lwm yam tsos mob, txog ntua thiab tsis nco qab,

hyperglycemia thiab ntshav qab zib acidosis (ntawm kev siv tshuaj tsawg kawg, ncua kev txhaj tshuaj, noj zaub mov tsis zoo, tawm tsam keeb kwm ntawm kev kis tus kab mob thiab kub taub hau), nrog rau kev ua kom nkees, nqhis dej, tsis qab los, ua ntsej muag tawm thiab lwm cov tsos mob, mus txog tom qab thiab tsis nco qab,

ua xua, incl. anaphylactoid tshua (tsis tshua muaj) - ua pob liab liab, mob caj dab, mob lub cev laryngeal, mob anaphylactic, ntawm qhov chaw txhaj tshuaj - hyperemia thiab khaus (hauv thawj lub lis piam ntawm kev kho mob), lipodystrophy (nrog rau kev tswj hwm ntev nyob ntawm tib qhov chaw).

qhov ncauj tshuaj tiv thaiv hormonal contraceptives, tshuaj steroidal los tiv thaiv cov tshuaj, cov thyroid hormones, heparin, lithium npaj, nicotine (haus luam yeeb), thiazide thiab lub voj diuretics. Ethanol thiab tshuaj tua kab mob txo qis kev ua si (kev sib txuam ntawm kev sib koom tes), nws yog qhov tsis sib haum (tsis tuaj yeem sib xyaw) nrog phosphate-muaj cov insulins, thiab lwm yam kev ncua ntawm zinc-insulin.

Pharmacological pawg

Kev npaj ntawm cov tshuaj insulin-zinc-suspension pawg muaj qhov sib txawv ntev ntev. Cov tshuaj insulin-zinc-ncua kev kawm A (amorphous zinc-insulin) pom qhov ua tau zoo tshaj plaws ntawm cov piam thaj tom qab 1 11/2 teev tom qab txhaj, uas kav ntev li 7 teev, thiab tom qab ntawd maj mam pib poob qis. Lub sijhawm tag nrho ntawm cov suab thaj txo qis ntawm cov tshuaj no yog 10 12 teev.

Cov tshuaj insulin-zinc-tshem tawm K (crystalline zinc-insulin) muaj qhov loj tshaj tag nrho cov kev txiav txim siab txog 30 teev tom qab txhaj tshuaj, qhov kev txiav txim siab tshaj plaws tau pom tom qab 12 txog 18 teev. Cov tshuaj insulin-zinc raug tshem tawm (sib xyaw amorphous thiab crystalline) muaj lub sijhawm tag nrho ntawm kev nqis tes ua txog 24 teev nrog cov nyhuv siab tshaj plaws tom qab 8 txog 12 teev.

Thaum pauv tus neeg mob mus txhaj tshuaj insulin-zinc-ncua kev kawm Ib qho kev npaj, tag nrho cov naj npawb ntawm cov tshuaj insulin yav tas los tau txhaj rau tus neeg mob hauv ob lossis ntau dua kev txhaj tshuaj thaum nruab hnub tau txhaj tam sim ua ntej noj tshais.

Thaum hloov mus rau kev txhaj tshuaj ntawm cov tshuaj tiv thaiv-zinc-insulin lossis rau lwm hom insulin-zinc-ncua kev kawm (K lossis sib xyaw) rau thawj hnub ua ntej noj tshais, insulin yooj yim yog txhaj rau hauv qhov nyiaj txog li ib feem peb ntawm cov koob tshuaj tiv thaiv insulin tau txais ib hnub ua ntej, thiab tom qab ntawd ces raug txhaj tshuaj. kws kho mob ntawm ib qho ntawm qhov tau hais dhau los ua insulins ntev hauv ib qho nyiaj sib npaug ntawm seem ob feem peb ntawm kev txhaj tshuaj insulin txhua hnub.

Yav tom ntej, txij hnub tom qab, raws li kws kho mob tau qhia, koj tuaj yeem hloov mus rau ib qho kev txhaj tshuaj ntawm cov tshuaj insulin nyob rau hauv ib koob tshuaj txhua hnub ua ntej noj tshais lossis txuas ntxiv rau kev txhaj tshuaj insulin ntxiv nrog kev txhaj tshuaj insulin yooj yim, raws li tau piav saum toj no.

Thaum hloov mus rau tus neeg mob mus rau kev txhaj tshuaj tiv thaiv cov tshuaj tiv thaiv-zinc-insulin lossis insulin-zinc ncua kev kawm ntawm hom ICC thiab ICSC, nws cov khoom noj yuav tsum rov ua kom cov zaub mov ntau tshaj plaws nyob hauv carbohydrates thaum sawv ntxov thiab yav tsaus ntuj.

Qhov no yog qhov tseem ceeb kom ua tiav cov txiaj ntsig ib yam qab zib-txo qis thaum nruab hnub nrog kev txhaj tshuaj txhua hnub thiab kom tsis txhob muaj qhov pib ntawm hmo ntuj hypoglycemia. Rau qhov no, cov neeg mob kuj tseem qhia kom tseg ib qho me me ntawm cov khoom noj rau lub sijhawm mus pw (piv txwv li, lub khob mis lossis kefir thiab 50 grams ntawm ncuav).

Txhawm rau xaiv cov tshuaj insulin tsim nyog nrog kev cuam tshuam txuas ntxiv thiab kho qhov tshuaj kom haum rau tus kws kho mob soj ntsuam tus neeg mob, nws yog qhov tsim nyog yuav tsum muaj cov ntaub ntawv qhia txog cov piam thaj uas tau faib rau cov neeg mob nyob txawv sijhawm. Rau qhov no, tus neeg mob yuav tsum khaws cov zis ib hnub rau kev tshawb xyuas hauv ntau feem.

Yog hais tias nws hloov tawm tias tus neeg mob, ua raws li lub cev kev noj haus, tshem tawm cov piam thaj hauv cov zis feem ntau ntawm txhua yam hauv thawj ib nrab ntawm ib hnub (tom qab noj tshais thiab tom qab noj su), tom qab no cov tshuaj insulin-zinc raug tshem tawm A feem ntau yog tshuaj.

Nrog rau kev txiav txim siab tshaj plaws hauv qab zib hauv cov zis, tsis tsuas yog nruab hnub, tab sis tseem nyob rau yav tsaus ntuj, tus kws kho mob tau sau ib qho tshuaj insulin-zinc rau cov neeg mob. Thaum muaj cov kua qab zib ntau ntxiv nrog cov zis thaum hmo ntuj thiab thaum sawv ntxov ua ntej noj tshais, tom qab ntawv cov tshuaj yog cov tshuaj insulin-zinc-tshem tawm K. Hauv ob kis tom ntej no, kev tswj hwm ntawm cov tshuaj tiv thaiv-zinc-insulin kuj tseem tsim nyog.

Qab zib muaj mob, N.R. Pyasetskiy

Cov lus qhia tshwj xeeb

Hauv chav ntawm kev kho nrog Caninsulin, tus miv yuav tsum noj kom nruj. Cov tshuaj yuav tsum tsis txhob raug txwv yog tias tus tsiaj yog qhov hnyav tshaj. Kev siv tshuaj insulin tsis tuaj yeem siv thooj txhij nrog tetracycline tshuaj tua kab mob, corticosteroids, sulfonamides thiab progestogens.

Yog hais tias kev hloov kho thiab qhov txawv ntawm kev noj haus hloov, ces kev noj zaub mov ntawm Caninsulin hloov pauv raws li. Cov koob tshuaj kuj tseem hloov kho thaum mob raum thiab mob siab, tom qab phais mob, thaum cev xeeb tub thiab kab mob kis.

Kev tshuaj xyuas txog cov tshuaj

Catherine. Peb tus miv dhau 10 xyoo, thiab tsis ntev los no nws tau kuaj ntshav qab zib. Tus kws kho mob qhia kev txhaj tshuaj Caninsulin, ob zaug ib hnub. Kuv tsis tuaj yeem hais tias cov nyhuv pom tau zoo heev, tab sis tus miv pom zoo me ntsis, qhov piam thaj qis zuj zus.

Anna Kuv txaus siab nrog tshuaj. Peb tau siv cov caninsulin tau ntev ntev, vim tias miv tau mob insulin-mob ntshav qab zib li 5 xyoo. Kuv tsis tau soj ntsuam ib qho mob tshwm sim, tab sis qhov tsuas tshuaj tsis ntxiv zog. Nws yog ib qho tseem ceeb kom ua raws li kev noj zaub mov nruj kom txhim kho kev mob ntawm tus tsiaj.

Olga Hauv Is Taws Nem, muaj ntau lub sij hawm tsis sib haum xeeb tshuaj xyuas txog cov tshuaj no. Ntawm no, ntau tuaj yeem nyob ntawm qhov kev cuam tshuam ntawm lub cev ntawm lub cev mus rau qhov sib txuam Cheebtsam ntawm Caninsulin. Peb tus miv kam rau nws zoo, tsuas yog tam sim ntawd tom qab txhaj tshuaj muaj lub sijhawm luv luv nce ntxiv ntawm qab los noj mov.

Cov tshuaj insulin luv thiab ntev - siv sib xyaw

Hauv kev kho niaj hnub mob ntshav qab zib mellitus, ob qho tshuaj insulin ntev ntev thiab luv luv insulin siv. Nws yuav yooj yim dua rau ntau tus neeg mob uas siv cov kev kho mob nyuaj los sib xyaw cov tshuaj insulin luv thiab txuas ntev hauv ib qho koob txhaj, ua rau tsuas yog ib qho nqaij tawv nqaij hloov ob sab xwb.

Sib Koom

Kev ua yeeb yaj kiab luv luv ua yeeb yam luv luv thiab insulin tsis tsim nyog los sib xyaw ua ke. T.N. tshuaj lom neeg (galenic) kev sib xyaw ntawm cov tshuaj insulin kom ntau dua tuaj yeem tso cai rau koj los sib xyaw ua yeeb yam luv luv thiab insulin.

• Thaum muab sib xyaw, nws yog ib qho tsim nyog yuav tsum xav txog tias cov insulin luv luv dua thiab yog tias tsis sib xyaw, nws cov nyhuv yuav ploj. Nws tau dhau los ua pov thawj tias luv insulin tuaj yeem sib xyaw nyob rau hauv tib lub koob tshuaj nrog kev daws cov tshuaj tiv thaiv-insulin. Cov nyhuv ntawm cov tshuaj insulin luv luv tsis qeeb, yog li cov tshuaj insulin tsis khi rau cov tshuaj tiv thaiv.
• Nws tsis muaj teeb meem txhua lub tuam txhab uas tsim cov tshuaj no. Yog li, nws yooj yim heev los sib tov nrog actrapid nrog humulin H lossis actrapid nrog protafan. Cov tshuaj insulin no feem ntau khaws cia.
• Txawm li cas los xij, crystalline insulin-zinc raug tshem tawm yuav tsum tsis txhob tov nrog luv insulin, li ua ke nrog cov zinc ions ntau dhau, luv luv insulin yog hloov kho ib feem rau qhov insulin ntev ntev.

Nws tsis yog qhov txawv rau cov neeg mob tau xub txhaj cov tshuaj insulin luv luv, thiab tom qab ntawd, tsis tas muab rab koob tawm hauv qab daim tawv, lawv txhaj zinc insulin. Nws tsis yog cov pov thawj tau hais tias, txawm li cas los xij, nws tuaj yeem xav tias nrog xws li cov lus qhia, kev sib xyaw ntawm luv luv insulin nrog zinc insulin cov ntaub ntawv hauv qab daim tawv nqaij, thiab qhov no tsis tuaj yeem ua rau lub cev tsis haum ntawm thawj feem.

Txhawm rau kom tsis txhob muaj qhov tsis zoo, qhov kev tswj hwm cais luv ntawm insulin thiab zinc insulin yog qhov kev pom zoo (nyob rau hauv daim ntawv ntawm kev txhaj tshuaj sib cais nyob rau ntau thaj chaw ntawm daim tawv nqaij, qhov kev ncua deb ntawm cov ntsiab lus txhaj tshuaj tsawg kawg yog 1 cm).

Cov kev qhia rau kev siv ncua kev ncua ntawm cov tshuaj tiv thaiv-zinc-insulin

Ib qho kev ncua ntawm crystalline zinc insulin yog siv rau cov ntshav qab zib mellitus ntawm cov qauv hauv sim thiab hnyav.

Cov kab mob ntshav qab zib insulin kuj tsim tawm cov tshuaj insulin. Cov tshuaj no yog kev sib xyaw ntawm cov tshuaj insulin luv luv thiab cov tshuaj tiv thaiv insulin hauv qhov sib piv ruaj khov (sib tov, actrafan, insuman comb, thiab lwm yam).

Kev pom qhov ua tau zoo tshaj plaws yog qhov sib xyaw ua ke uas muaj 30% cov tshuaj insulin luv luv thiab 70% cov tshuaj tiv thaiv insulin lossis 25% luv luv insulin thiab 75% cov tshuaj insulin. Qhov piv ntawm cov feem tau qhia nyob rau hauv cov lus qhia rau kev siv.

Cov tshuaj no tsim nyog rau cov neeg mob uas ua raws li kev noj haus tas mus li, ua rau lub neej muaj sia, thiab lwm yam. (feem ntau cov neeg laus muaj kev hlub nrog hom ntshav qab zib hom II).

Txawm li cas los xij, kev sib xyaw ua ke npaj insulin yog qhov tsis yooj yim rau kev hloov pauv tshuaj insulin. Nrog rau txoj kev kho no, nws yog ib qho tsim nyog thiab feem ntau yuav hloov pauv qhov ntau npaum li cas ntawm cov tshuaj insulin luv luv, nyob ntawm cov ntsiab lus ntawm carbohydrates hauv zaub mov, kev siv dag zog, thiab lwm yam). Qhov kev noj tshuaj ntawm lub sijhawm ntev (hauv paus) cov kua dej insulin kuj sib txawv me me.

Tsuas tshuaj thiab tswj hwm

S / c sib sib zog nqus (hauv sab caj npab, sab hauv qab ncej puab, pob tw, hauv plab), ua ntej siv, co lub raj mis kom txog thaum muaj kev txwv tsis pub homogeneous, txais tam sim ntawd thiab nkag mus rau qhov tsim nyog, tsis txhob zaws qhov chaw txhaj tshuaj.

Cov koob tshuaj tau muab teeb tsa ib qho zuj zus (raws li qhov kev mloog zoo ntawm cov piam thaj hauv cov ntshav thiab lub cev qhov hnyav). Hauv kev txhaj tshuaj txhua hnub ntau dua 0.6 U / kg, nws yog qhov yuav tsum tau muab rau kev txhaj tshuaj 2 lossis ntau dua kev txhaj tshuaj nyob rau ntau qhov chaw ntawm lub cev.

Thaum hloov los ntawm kev txhaj tshuaj ntawm cov ntshav ua kom huv siab los yog tib neeg insulin, qhov koob tshuaj tsis hloov, thaum hloov bovine lossis lwm yam tshuaj insulin (ntshav qabzib soj ntsuam yog tsim nyog), qhov tshuaj feem ntau raug txo txog li 10% (tshwj tsis yog thaum nws tsis dhau 0.6 U / kg). Cov neeg mob tau txais 100 IU lossis ntau dua toj ib hnub, thaum hloov cov tshuaj insulin, nws raug nquahu kom mus pw hauv tsev kho mob.

Kev tiv thaiv kev nyab xeeb

Kev hloov koob tshuaj yog qhov tsim nyog thaum hloov qhov xwm thiab kev noj haus, kev ua si lub cev, kis kab mob, kub cev, raws plab, mob plab thiab lwm yam mob uas ncua kev noj zaub mov, kev phais mob, kev ua haujlwm ntawm lub qog caj pas, lub qog adrenal (Cov kab mob ntxiv), lub caj pas pituitary (hypopituitism), lub raum tsis ua hauj lwm, kev mob siab rau lub siab, cev xeeb tub, pub niam mis, hauv cov menyuam yaus prepubertal thiab cov neeg mob hnub nyoog tshaj 65 xyoo (muaj kev pheej hmoo ntawm cov ntshav qog ntshav qab zib).

Txo cov koob tshuaj nyob rau thaum muaj qhov tsis kam haus luam yeeb, nrog hom 1 mob ntshav qab zib mellitus, nce lub sijhawm nruab nrab ntawm kev tswj hwm thiab txo cov koob tshuaj nyob rau tom qab ntawm cov neeg sawv cev uas ua rau hypoglycemia (nce - nrog lub sijhawm teem tshuaj hyperglycemic).

Qhov kev hloov kho koob tshuaj yog ua tau nyob rau hauv thawj 1-2 lub lis piam tom qab hloov ib hom tshuaj insulin nrog lwm qhov. Kev ceeb toom yog qhov yuav tsum tau ua hauv thawj zaug teem caij, hloov insulin, lub cev lossis lub hlwb kev ntxhov siab hauv cov neeg koom nrog hauv kev tsav tsheb, tswj ntau cov txheej txheem thiab lwm yam kev muaj peev xwm txaus ntshai uas xav tau kev nce siab thiab ceev ntawm psychomotor cov kev hloov.

Thaum kho, txhua txhua 3 lub hlis (lossis ntau zaus muaj qhov tsis txaus siab), cov ntsiab lus ntawm cov piam thaj hauv cov ntshav tau txiav txim siab thiab, yog tias nws siab tshaj 11,1 mmol / l, qib ntawm ketones (acetone, keto acids) hauv cov zis yog kwv yees. Nrog hypoglycemia thiab ketoacidosis, cov pH thiab cov concentration ntawm cov potassium ions hauv cov ntshav cov cim tau sau cia,