Ihe mmanu insulin na-eme ka mmadu nwee mmerite oge (nke mere site na nnwekorita mmadu nke disemir insulin na mpaghara ochichi na mmekorita nke umu anwuru ya na albumin site na ime ka onye ozo megharia ya. .
Tụnyere insulin-isofan, insulin detemir ji nwayọ gbasasịa na anụ ahụ a chọrọ, nke na-eme ka mmụba na-arụpụta yana mmetụta dị mkpa nke onye ọrụ ahụ. Ezi mmekọrịta na onye nnabata nke mkpụrụ ndụ sel cytoplasmic nke dị na-arịba ama.
Ọgwụ ahụ mepụtakwara ọgwụ insulin-receptor nke na - eme ka usoro ndị a na - eme n'ime mkpụrụ ndụ pụta, gụnyere ọ na - akpali njikọ nke ụfọdụ enzymes isi (dịka ọmụmaatụ, glycogen synthetase).
Ọ bụ shuga dị n'ọbara bụ:
- mmụba nke njem ya n'ime sel;
- activation nke glycogenogenesis, lipogenesis;
- ịmụba ụba nke anụ ahụ;
- mbelata na ọnụego glucose na-emepụta site na imeju.
In gwachaa ọgwụ ahụ (0.2-0.4 nkeji / n'arọ 50%), a na-arụ ọrụ kachasị elu mgbe awa 3-4 gachara ruo awa iri na anọ. Ogologo oge nke mmetụta ahụ dị ụbọchị 1.
TCmax - site na 6 ruo 8 awa. Css, ma ọ bụrụhaala na a na-elekọta ya ugboro abụọ kwa ụbọchị, enwere ike nweta ya mgbe ịgba ya nke abụọ gasịrị. Nkesa bu 0.1 l / n'arọ.
Metabolism yiri metabolism nke insulin mmadụ, ihe niile metabolites guzobere bụ ihe na-agafe agafe. T1 / 2 site na awa asaa ruo asaa.
Mmekọrịta na ụzọ ndị ọzọ
Ngme ka usoro hypoglycemic sie ike na-eso:
- Ọgwụ ndị nwere ethanol;
- ọgwụ hypoglycemic (ọnụ);
- Li +;
- Ndị na - egbochi MAO;
- fenfluramine,
- Ndị na - egbochi ACE;
- cyclophosphamide;
- carbonic anhydrase inhibitors;
- theophylline;
- ndị na - achọghị beta-mgbochi;
- pyridoxine;
- bromocriptine;
- mebendazole;
- sulfonamides;
- ketonazole;
- ndị na-anabolic;
- clofibrate;
- tetracyclines.
Ọgwụ Hypoglycemic
Nicotine, ọgwụ mgbochi (na ọnụ), corticosteroids, phenytoin, homonụ thyroid, morphine, thiazide diuretics, diazoxide, heparin, ndị na-egbochi calcium (adịghị ewe), tricyclic antidepressants, clonidine, danazole na sympathomimets belata mmetụta hypoglycemic.
Salicylates na reserpine na-enwe ike ịkwalite ma ọ bụ belata mmetụta detemir nwere na insulin. Lanreotide na octreotide na-abawanye ma ọ bụ belata insulin chọrọ.
Attentionaa ntị! N'ihi njirimara ha pụrụ iche, ndị na-egbochi beta na-ekpuchikarị ihe ngosi nke hypoglycemia ma na-egbu oge iweghachi ọkwa glucose nkịtị.
Ọgwụ Ethanol nwere ọgwụ na-akwalite ma na-abawanye ike hypoglycemic nke insulin. Ọgwụ a ekwekọghị na ọgwụ ndị dabere na sulfite ma ọ bụ thiol (ebibi insulin detemir). Ọzọkwa, ọgwụ ahụ enweghị ike ịgwakọta ya na ngwakọta infusion.
Ntụziaka pụrụ iche
Can nweghị ike ịbanye na detemir intravenly, maka ụdị hypoglycemia siri ike nwere ike ịmalite. Ọgwụ ịgwọ ọrịa na ọgwụ adịghị enye aka na nchịkọta nke pound.
E jiri ya tụnyere insulins ndị ọzọ, insulin detemir na-ebelata ihe ize ndụ nke hypoglycemia n'abalị ma na-enye aka n'ịhọrọ oke onunu ogwu nke a chọrọ iji wee nweta nnabata shuga dị n'ọbara.
Dị Mkpa! Therapykwụsị ọgwụ ma ọ bụ ị incorrectụ ọgwụ ọ incorrectụ incorrectụ na-ezighi ezi, akpan akpan ụdị ọrịa shuga m, na-eme ka ngosipụta nke hyperglycemia ma ọ bụ ketoacidosis.
Ihe nrịbama nke hyperglycemia bụ nke kachasị n’usoro nkebi. Ha na-egosi n'ime awa ole na ole ma ọ bụ ụbọchị ole na ole. Ihe mgbaàmà hyperglycemia gụnyere:
- isi acetone mgbe ume gwusiri;
- akpịrị ịkpọ nkụ
- enweghị agụụ;
- polyuria;
- mmetụta nke nkụ kpọrọ nkụ na oghere ọnya;
- ọgbụgbọ
- akpukpo aru
- gagging;
- hyperemia;
- ụra na-atụ mgbe niile.
Imega ahụ na mberede, yana iri nri oge na -adị ụtụ na-eso akpata hypoglycemia.
Agbanyeghị, mgbe ịmalitere metabolism metabolism, njirimara njirimara nke na-egosi hypoglycemia nwere ike gbanwee, yabụ onye dibịa bekee kwesịrị ịgwa onye ọrịa ahụ. Mgbaàmà ndị a na-ahụkarị nwere ike ikpuchi ọnya na-arịa ọrịa shuga ogologo oge. Ọrịa na-efe efe na-esokwa na-amụba mkpa nke insulin.
Nyefee onye ọrịa na ụdị ọ bụla ma ọ bụ insulin, nke onye nrụpụta ọzọ mepụtara, na-arụ ya mgbe niile ka a na-elekọta ya. N'ọnọdụ mgbanwe nke onye nrụpụta, usoro onunu ogwu, udiri, ụdị ma ọ bụ usoro eji emepụta insulin, ọ na-adịkarị mkpa idozi usoro onwonye
Ọrịa ebugharị na ọgwụgwọ nke a na-eji insulin anya insulin na-achọkarị mgbanwe mmegharị ọzọ ma e jiri ya tụnyere olu insulin na-achịkwa na mbụ. Mkpa ịgbanwe ogwu ahụ pụtara mgbe iwere ntụtụ nke izizi ma ọ bụ n'izu ma ọ bụ ọnwa. Usoro nnabata ọgwụ ahụ n'ihe banyere nchịkwa intramuscular dị ngwa ngwa ma e jiri ya tụnyere sc nchịkwa.
Detemir ga - agbanwe ụdị ọrụ ya ma ọ bụrụ na agwakọta ya na ụdị insulin ndị ọzọ. Nchikota ya na insulin aspart ga-eduga na profaịlụ nke ime ihe di ala, nke ekwesighi idi nma ma oburu na ochichi ozo. Ekwesighi iji insulin nke Detemir na nfuli insulin.
Ruo ugbu a, enweghi data banyere ọgwụ a na-adakarị n'oge ọgwụ ime, lact na ụmụaka na-erubeghị afọ isii.
Onye ọrịa ahụ kwesịrị ịdọ aka na ntị banyere ike ọrịa hyperglycemia na hypoglycemia na usoro ịkwọ ụgbọala na usoro ịchịkwa. Nke kachasị, ọ dị mkpa maka ndị nwere ọrịa mgbaàmà dị nro ma ọ bụ ndị na-anọghị ya tupu ha abịa hypoglycemia.
Ihe ngosiputa maka ojiji na onunu ogwu
Ọrịa shuga mellitus bụ ọrịa bụ isi nke egosipụtara ọgwụ a.
A na-eme ntinye ahụ n'ubu, eriri afọ ma ọ bụ apata ụkwụ. Aga-aghọrọrịrịrị ebe ndị a na-agbanye insulin n'ime. Usoro onunu ogwu na oge nke inpa na edobere n’otu n’otu.
Mgbe etinyere ya okpukpu abụọ iji mee ka nchịkwa glucose dị elu, ọ dị mma ịnye ọgwụ nke abụọ mgbe elekere iri na abụọ gachara, mgbe nri mgbede ma ọ bụ tupu ị lakpuo ụra.
Imeghari usoro onodu ogwu ya na oge ochichi o gha achoo ka oburu nyefee onye oria ya na insulin ogologo oge ya na onodu ogwu ndi ozo rue insulin.
Nsonaazụ
Nsonaazụ ndị a na-ahụkarị (1 n’ime 100, mgbe ụfọdụ 1 n’ime 10) gụnyere hypoglycemia na mgbaàmà niile na-eso ya: ọgbụgbọ, pallor nke anụ ahụ, agụụ iri nri, enweghị nchekasị, ọnọdụ ụjọ na ọbụna ụbụrụ nke nwere ike ibute ọnwụ. Mmeghachi omume mpaghara (itching, swelling, hyperemia at injection) nwekwara ike, mana ha na-adị nwa oge, na-apụ n'anya n’oge ọgwụgwọ.
Mmetụta ndị na-adịghị ahụkebe (1/1000, mgbe ụfọdụ 1/100) gụnyere:
- lipodystrophy injection;
- nwa oge ịgbasa na mmalite nke ọgwụgwọ insulin;
- Ihe ngosi ihe nfụkasị (mbelata ọbara mgbali, urticaria, palpitations na ike iku ume, itching, malfunction nke digestive tract, hyperhidrosis, wdg);
- na ọkwa mbụ nke usoro ọgwụgwọ insulin, imeghari uche nwa oge na-apụta;
- ọrịa mamịrị retinopathy.
Banyere retinopathy, njikwa glycemic ruo ogologo oge na-ebelata ohere nke ịmụpụta ọrịa, mana ọgwụgwọ insulin na-enwe nnukwu mmụba na njikwa metabolism metabolism na mberede nwere ike ibute nsogbu nwa oge na steetipathy mamịrị.
Ọ dị ụkọ (1/10000, mgbe ụfọdụ 1/1000) nsonaazụ n’akụkụ neuropathy ma ọ bụ nnukwu mgbu neuropathy, bụ nke na-agbanwegharikarị.
Dodoụbiga ya ókè
Isi ihe nrịba ama nke ịdoụ ọgwụ gabigara ókè bụ hypoglycemia. Onye ọrịa ahụ nwere ike iwepụ ụdị hypoglycemia dị nwayọ site na iri nri glucose ma ọ bụ nri carbohydrate.
N'ihe banyere s / c siri ike, a na-emezi 0 / mg nke glucagon 0.5-1 mg nke glucagon ma ọ bụ usoro dextrose na / n'ime. Ọ bụrụ na mgbe nkeji iri na ise gachara glucagon, onye ọrịa ahụ enwetaghị onwe ya, mgbe ahụ, ekwesịrị inye ọgwụgwọ nke dextrose. Mgbe mmadụ nwetatụrụ mmụọ maka ebumnuche mgbochi, o kwesịrị iri nri ndị carbohydrates jupụtara.
