Human Insulin Injectiopn）
精蛋白重组人胰岛素注射液（精蛋白重组人胰岛素注射液）
本品主要成份为：鱼精蛋白和重组人胰岛素。
【性状】
本品为白或类白的混悬液，振落后应能均匀分散。在显微镜下观察，晶体呈棒状，且绝大多数晶体不得小于1mm，不得大于60mm，无聚合体存在。
【药理毒理】
本品为利用重组DNA技术生产的人胰岛素，与天然胰岛素有相同的结构和功能。本品是一种长效动物胰岛素制剂。皮下注射后，在注射部位逐渐释放出游离胰岛素而被吸收。本品药理作用与胰岛素相同，主要药效作用为降血糖。胰岛素对糖、蛋白质、脂肪的代谢和贮存起多方面的作用：①促进肌肉、脂肪组织等对葡萄糖的主动转运，促进葡萄糖分解代谢、生成能量，或是以糖原或甘油二酯的形式贮存起来；
②促进肝摄取葡萄糖并转变为糖原；③抑制肝糖原分解及糖原异生，抑制肝葡萄糖的输出；④促进许多组织对糖、蛋白质、脂肪的摄取，同时促进蛋白质的合成以及抑制脂肪细胞中游离脂肪酸的释放，抑制酮体生成，而调节物质代谢。对于胰岛素分泌有缺陷或不足的糖尿病患者，注射外源性胰岛素可在一定程度上纠正各种代谢紊乱，主要是降低血糖，并可延缓或防止糖尿病慢性并发症的发生。
【药代动力学】
黄致列 bangbangbang本品皮下注射吸收缓慢而均匀，注射后3～4小时开始生效，12～24
何雯娜陈一冰小时达高峰，药效持续时间可达24～36小时。吸收进入血浆的胰岛素主要分布于细胞外液，主要在肝、肾和骨骼肌中降解。其中，肝脏代谢50%左右。胰岛素极其降解产物主要经肾小球滤过而排泄。肾小管对胰岛素的重吸收功能及肾功能严重受损明显影响胰岛素的消除。
【适应症】
用于中、轻度糖尿病患者，重症须与正规胰岛素合用，有利于减少每日胰岛素注射次数，控制夜间高血糖。
【用法用量】
本品于早餐前30～60分钟皮下注射，起始每天一次，每次4～8单位，按血糖、尿糖变化调整维持剂量。有时需于晚餐前再注射一次，剂量根据病情而定，一般每日总量10～20单位。
使用前须滚动药瓶，使胰岛素混匀，但不要用力摇动以免产生气泡。stronger歌词
与正规胰岛素合用：开始时正规胰岛素与本品混合用的剂量比例为2～3∶1，剂量根据病情而调整。本品与正规胰岛素混合将有部分正规胰岛素转为长效胰岛素，使用时应先抽取正规胰岛素，后抽取本品。杨洋资料
剂量调整：胰岛素用量应随患者的运动量或饮食状态的改变而调整。
【不良反应】
1。低血糖反应：为胰岛素使用不当所致，胰岛素过量、注射胰岛素后未及时进餐或进行较剧烈的体力活动（肌肉摄取葡萄糖增加）时，易发生低血糖反应。低血糖反应的早期症状为无力、饥饿、眼花、出冷汗、皮肤苍白、心悸、兴奋、手抖、神经过敏、头痛、颤抖等类似交感神经兴奋的症状；进一步发展为抑郁、注意力不集中、嗜睡、缺小包总杨烁
乏判断和自制力、健忘，也可有偏瘫、共济失调、心动过速、复视、感觉异常，严重者可惊厥和昏迷。
2。过敏反应：过敏反应可为全身性及局部性的过敏，局部性过敏表现为注射部位出现红斑、丘疹、硬结，一般发生在注射胰岛素后几小时或数天。
Systemic allergic reaction occurred immediately after injection, the body appears with or without urticaria, angioedema, respiratory symptoms (such as asthma, dyspnea) and rare hypotension, shock and even death. Therefore, when injecting the product for the first time, we should pay close attention to the patient's sensitivity to this product and prevent allergic reactions.
3., injection site fat atrophy: more common in young women, mostly for insulin preparation caused by impure fat dissolution reaction.
4. fat hyperplasia at the site of injection: a fat producing reaction caused by insulin, which can be reduced by taking an injection at different sites.
[taboo]
Hypoglycemia, islet cell tumor.
[matters needing attention]
1., this product is slow, can not be used to rescue diabetic ketoacidosis, high glucose hyperosmolar coma patients;
2. can not be used for intravenous injection;
3. moderate to large amounts of alcohol can enhance insulin induced hypoglycemia, can cause severe and persistent hypoglycemia occurs in fasting or liver glycogen storage under the condition of less. During the period of delivery, patients should avoid alcohol.
4. smoking: smoking can release the catecholamine and antagonize the hypoglycemic effect of insulin. Therefore, the diabetic who is using insulin should suddenly reduce the amount of insulin when they give up smoking suddenly.
Should regularly check urine, urine routine, blood glucose, glycosylated hemoglobin, renal function, visual acuity, retinal blood vessels, blood pressure and ECG were 5. during the treatment, in order to understand the severity of disease and diabetic complications.
6., after hypoglycemia symptoms, should promptly fill the sugar, especially to prevent nocturnal hypoglycemia.
[pregnant women and lactating women]
Pregnant women, especially in the middle and late pregnancy, have an increased insulin requirement. Insulin requirements are rapidly reduced after delivery. If it is gestational diabetes, postpartum blood sugar can be normal, insulin should be discontinued.
[children medication]
Prepubertal children on insulin sensitivity than adolescents, so prone to hypoglycemia, should be appropriate to reduce the amount of insulin, adolescents shall be appropriately increased the amount of insulin (20% to 50%), and then decreased gradually after puberty.
[medication for elderly patients]
Elderly people are prone to hypoglycemia, we must pay special attention to, should pay attention to diet, proper physical activity and the amount of insulin coordination.
[drug interaction]
1. glucocorticoid, ACTH, glucagon, estrogen, oral contraceptives, thyroxine, epinephrine, thiazide diu
retics, two diazoxide, b2- receptor agonist, H2- receptor blockers, calcium channel blockers, clonidine, phenytoin can increase blood sugar concentration, the combination of these drugs or insulin should be adjusted dose.
2. oral hypoglycemic agents and insulin have synergistic hypoglycemic effect.山路十八弯伴奏
3. anti clotting drugs, salicylate, sulfa drugs and antitumor drugs such as methotrexate combined with insulin competition and plasma protein, so that the blood free insulin levels. Non steroidal anti-inflammatory analgesic drugs can enhance the hypoglycemic effect of insulin.
发布评论