Mob ntshav qab zib mellitus yog ib yam kab mob uas yuav tsum tau kho mus tas lub neej. Yog li, hauv thawj hom mob thiab hauv kev kis mob siab nrog rau hom mob thib ob, cov neeg mob xav tau cov tshuaj insulin tas li, uas pab ua kom cov piam thaj hauv lub cev sai sai, hloov nws mus rau lub zog.
Feem ntau muaj ntshav qab zib, insulin Aspart yog siv. Nov yog tshuaj ultrashort.
Cov cuab yeej yog qhov sib piv ntawm tib neeg cov tshuaj insulin, uas tau los ntawm cov khoom siv DNA thev naus laus zis siv kev lim ntawm Saccharomyces cerevisiae, qhov twg cov kab muag ntawm txoj hauj lwm B28 (amino acid) hloov nrog aspartic acid. Tus phaus lwg me me yog 5825.8.
Kev Sau, tso tawm daim ntawv thiab cov nyhuv pharmacological
Biphasic insulin ua ke nrog kev sib xyaw ua ke ntawm Aspart thiab crystalline insulin protamine hauv ib qho ntawm 30 txog 70%.
Qhov no yog rho tawm rau sc administration, muaj xim dawb. 1 milliliter muaj 100 units, thiab ib qho ED sib xws rau 35 μg ntawm anhydrous insulin Aspart.
Tib neeg cov tshuaj insulin tsim cov txheej txheem insulin receptor nrog rau sab nraud cytoplasmic cell membrane receptor. Cov tom kawg ua rau lub zog ntawm glycogen synthetase, pyruvate kinase thiab cov enzymes hexokinase.
Qhov kev txo qis hauv qab zib tshwm sim nrog kev nce hauv kev thauj khoom ntawm lub cev thiab kev txhim kho cov nqaij ntawm cov piam thaj. Kev txo ntshav qabzib kuj tseem ua tiav los ntawm kev txo qis sijhawm rau kev tso cov piam thaj los ntawm lub siab, glycogenogenesis thiab ua kom lipogenesis.
Biphasic insulin aspart yog tau los ntawm kev siv biotechnological thaum cov kua ntawm cov tshuaj tiv thaiv hormone hloov los ntawm aspartic acid. Xws li cov insipins biphasic muaj qhov cuam tshuam zoo rau glycosylated hemoglobin, zoo li tib neeg cov insulin.
Ob qho tshuaj yeeb yog qhov sib luag ntawm cov hniav sib npaug. Txawm li cas los xij, Aspart insulin ua haujlwm nrawm dua li soluble tib neeg txoj kev loj hlob. Thiab crystalline Aspart protamine muaj cov nyhuv ntawm nruab nrab lub sijhawm.
Qhov kev txiav txim tom qab sc tswj hwm ntawm cov tshuaj tau tiav tom qab 15 feeb. Qhov siab tshaj plaws ntawm cov tshuaj tshwm sim 1-4 teev tom qab txhaj tshuaj. Lub sijhawm tiv thaiv ntawm cov nyhuv yog li 24 teev.
Hauv ntshav dej, Cmax ntawm insulin yog 50% ntau dua thaum siv biphasic tib neeg cov insulin. Ntxiv mus, lub sijhawm nruab nrab kom ncav Cmax tsawg dua ib nrab.
T1 / 2 - txog 9 teev, nws qhia txog kev nqus ntawm qhov feem-tiv thaiv kev sib txawv. Lub hauv paus qib tshuaj insulin pom muaj li 15-18 teev tom qab kev tswj hwm.
Tab sis nrog hom ntshav qab zib hom 2, qhov ua tiav ntawm Cmax yog li 95 feeb. Nws ua kom txog qib qis dua 14 thiab siab dua 0 tom qab kev tswj hwm sc. Seb thaj tsam ntawm kev tswj hwm cuam tshuam rau lub xaib ntawm qhov nqus tsis tau kawm.
Tsuas tshuaj thiab tswj hwm
Feem ntau cov tshuaj insulin Degludek, Aspart-insulin yog tshuaj subcutaneously. Kev txhaj tshuaj yog tsim nyob hauv qee qhov ntawm lub cev:
- pob tw;
- Plab
- ncej puab
- xwb pwg.
Koj yuav tsum ua ib qho kev txhaj tshuaj insulin ua ntej noj mov (txoj kev nthuav dav) lossis tom qab noj mov (hom tom qab noj).
Lub algorithm thiab kev noj ntau npaum li cas ntawm kev tswj hwm yog txiav txim los ntawm tus kws kho mob koom nrog. Tab sis feem ntau cov tshuaj txhua hnub hauv ib hnub yog 0.5-1 UNITS ib 1 kg ntawm qhov hnyav.
Hauv cov xwm txheej loj, insulin Aspart biphasic raug tswj hwm iv. Cov txheej txheem yog nqa tawm siv infusion systems hauv qhov chaw kho mob sab nrauv lossis pw hauv tsev.
Cov nyom tsis haum, cov tshuaj tiv thaiv contraindications thiab noj ntau dhau
Kev siv cov tshuaj insulin Asparta tuaj yeem cuam tshuam rau kev ua haujlwm ntawm National Assembly, txij li qhov teeb meem sai sai ntawm qab zib qee zaum ua rau mob hlwb tsis meej. Txawm li cas los xij, tus mob no hla dhau sijhawm.
Tsis tas li, insulin biphasic ua rau cov tsos ntawm lipodystrophy hauv cheeb tsam txhaj tshuaj. Ntawm ib feem ntawm cov kab mob hauv nruab nrog, cov tsis pom kev thiab ua haujlwm tsis zoo hauv qhov refraction yog sau tseg.
Cov tshuaj tiv thaiv yog qhov tsis haum rau ib leeg ntawm cov tshuaj thiab cov ntshav qab zib tsawg.
Tsis tas li ntawd, kev siv cov Insulin Aspart tsis yog kev pom zoo kom txog thaum muaj hnub nyoog 18 xyoo. Txij li thaum tsis muaj cov ntaub ntawv soj ntsuam lees paub qhov ua tau zoo thiab kev nyab xeeb ntawm cov tshuaj rau cov kab mob tshwm sim.
Yog tias dhau ntawm kev siv ntau dhau, ua mob hauv qab no tshwm sim:
- cramps
- tus ntse txo cov piam thaj hauv;
- hypoglycemic coma mob ntshav qab zib.
Nrog rau qhov siab me dhau ntawm qhov koob tshuaj, txhawm rau ua kom cov piam thaj hauv siab, nws txaus los noj cov roj sai lossis haus cov dej qab zib. Koj tuaj yeem nkag mus rau hauv glucagon subcutaneously lossis intramuscularly lossis kev daws teeb meem ntawm dextrose (iv).
Yog tias qhov mob ntshav qab zib tsis tsaug zog, los ntawm 20 txog 100 ml ntawm dextrose (40%) tau txhaj rau hauv qhov kev siv dav hlau mus txog thaum tus neeg mob lub cev yuav tsum zoo li qub. Txhawm rau tiv thaiv kev txhim kho ntawm cov xwm txheej zoo li no, kev noj haus ntawm qhov ncauj mus rau hauv qhov ncauj yog qhov kev pom zoo.
Kev cuam tshuam nrog lwm cov tshuaj thiab cov lus qhia tshwj xeeb
Kev ua rau lub ntsej muag puas tuaj yeem txhim kho yog tias kev tswj hwm ntawm biphasic insulin yog ua ke nrog kev tswj hwm qhov ncauj ntawm cov tshuaj hauv qab no:
- haus cawv thiab muaj tshuaj hypoglycemic;
- MAO / carbonic anhydrase / ACE inhibitors;
- Fenfluramine;
- Bromocriptine;
- Cyclophosphamide;
- somatostatin analogues;
- Theophylline;
- Sulfonamides;
- Pyridoxine;
- Cov tshuaj steroid anabolic.
Kev siv tetracyclines, Mebendazole, Dizopyramide, Ketonazole, Fluoxetine thiab Fibrates kuj ua rau txo qis qab zib. Thiab tricyclic antidepressants, tshuaj tiv thaiv qhov ncauj, nicotine, sympathomimetics, glucocorticosteroids, thiazide diuretics, cov thyroid hormones thiab lwm yam tshuaj ua rau lub zog ntawm cov nyhuv hypoglycemic.
Qee cov tshuaj muaj peev xwm ua rau ob leeg nce thiab txo cov ntshav qab zib. Cov no suav nrog lithium npaj, beta-blockers, salicylates, clonidine thiab reserpine.
Nws tsim nyog sau cia tias siv Flekspen yuav tsum muab cia rau ntawm chav tsev kub, thiab muab cov kua tshuaj tshiab tso rau hauv lub tub yees. Ua ntej tswj hwm, cov ntsiab lus ntawm lub vial yog ib qho tseem ceeb kom sib xyaw kom huv.
Nrog kev ua kom lub cev muaj zog, mob ua paug lossis mob kis, kev nce ntxiv ntawm cov tshuaj insulin yog qhov tsim nyog. Thiab thaum pib kho, nws tsis pom zoo kom tswj cov twj thiab cov tsheb nyuaj. Daim vis dis aus hauv tsab xov xwm no yuav hais ntxiv txog cov tshuaj hormones.
