natgillin/translations-raw huggingface dataset:
If this occurs, you should contact your doctor immediately.
Če se to zgodi, se morate nemudoma posvetovati z zdravnikom.
Acute toxicity of insulin human was studied following subcutaneous administration in rats.
Akutno toksičnost humanega insulina so preučili po podkožni uporabi pri podganah.
The vials of insulin should be withdrawn from the refrigerator and stored at room temperature in the outer carton in order to protect from light for a minimum of 4 hours and no longer than 24 hours before use.
Viale z insulinom je treba vzeti iz hladilnika in jih shraniti na sobni temperaturi (v zunanji ovojnini za zagotovitev zaščite pred svetlobo) vsaj 4 ure pred uporabo, a ne več kot 24 ur pred uporabo.
If you are using clear insulin (Insuman Rapid), do not use this pen if the insulin is cloudy, coloured or has particles.
Če uporabljate bister insulin (Insuman Rapid), ne uporabite SoloStarja, če je insulin moten, obaravan ali so v njem delci.
Medication errors involving mix-up between subcutaneous Insuman formulations or other subcutaneous insulins have been reported.
Opisane so bile napake pri uporabi zdravila, povezane z zamenjavo med podkožnimi oblikami insulina Insuman ali drugimi podkožno uporabljanimi insulini.
In addition, under the influence of sympatholytic medicinal products such as beta-blockers, clonidine, guanethidine and reserpine, the signs of adrenergic counter-regulation may be reduced or absent.
Poleg tega se lahko pod vplivom simpatikolitičnih zdravil, npr. blokatorjev adrenergičnih receptorjev beta, klonidina, gvanetidina in rezerpina, znaki adrenergične protiregulacije zmanjšajo ali izginejo.
To avoid microbial contamination and infection, aseptic skin preparation should be performed according to the healthcare institution's standard sterile operating procedures.
Da bi preprečili kontaminacijo z mikrobi in okužbo, je treba kožo aseptično pripraviti upoštevaje standardni operativni postopek za sterilno pripravo, ki velja v zdravstveni ustanovi.
As soon as patients notice a rapid increase in blood glucose, which does not respond to a bolus dose of insulin, the possibility of pump obstruction should be investigated by a physician trained to perform pump investigations.
Čim bolnik opazi hitro zvišanje glukoze v krvi, ki se ne odzove na bolusni odmerek insulina, mora zdravnik, usposobljen za izvajanje preiskav črpalke, preučiti možnost zamašitve črpalke.
If you are allergic to this medicine or to animal insulins, talk to your doctor.
Če ste alergični na to zdravilo ali na živalske insuline, se posvetujte s svojim zdravnikom.
Insulin administration via the pump can cause a fat infiltration of the liver at single, well-defined locations (called focal hepatic steatosis).
Dajanje insulina s črpalko lahko povzroči maščobno infiltracijo jeter na posameznih, dobro omejenih mestih (to imenujemo žariščna (fokalna) steatoza jeter).
Due to the large size of the implantable pump, use of Insuman Implantable in paediatric patients who have not reached adult size is contraindicated (see section 4.2 and 4.3).
Zaradi velikosti implantabilne črpalke je uporaba zdravila Insuman Implantable kontraindicirana pri pediatričnih bolnikih, ki še niso dosegli odrasle velikosti (glejte poglavji 4.2 in 4.3).
Insuman Infusat may be infused by the subcutaneous route.
Insuman Infusat se lahko infundira subkutano.
• Device components
• Sestavni deli pripomočka.
• have a tendency to hypoglycaemia,
• so nagnjeni k hipoglikemijam,
Detailed instructions on programming these limitations are contained in the Physician's Manual.
Podrobna navodila o programiranju teh omejitev so navedena v priročniku za zdravnika.
After stopping insulin infusion or removal or repositioning of the peritoneal catheter, focal hepatic steatosis seems to be reversible and without clinical consequence (see section 4.8).
Kaže, da je fokalna steatoza jeter po prenehanju infundiranja insulina oziroma odstranitvi ali spremembi položaja peritonealnega katetra reverzibilna in brez kliničnih posledic (glejte poglavje 4.8).
The solution must only be used if it is clear, colourless or almost colourless and practically free from visible particles.
Raztopino se sme uporabiti le, če je bistra, brezbarvna ali skoraj brezbarvna in praktično brez vidnih delcev.
There is no clinical information with the use of Insuman Implantable in an implantable pump in pregnant women.
Kliničnih podatkov o uporabi zdravila Insuman Implantable v implantabilni črpalki pri nosečnicah ni.
In case of insufficient glucose control or a tendency to hyper- or hypoglycaemic episodes, the patient's adherence to the prescribed treatment regimen and all other relevant factors must be reviewed before dose adjustment is considered.
V primeru nezadostne urejenosti glukoze ali nagnjenosti k hiper- ali hipoglikemijam je treba pred spreminjanjem odmerka preveriti, ali bolnik upošteva predpisano shemo zdravljenja in vse druge pomembne dejavnike.
The physician must program specific limitations for insulin basal insulin rates, bolus delivery amounts.
Zdravnik mora programirati specifične omejitve za bazalno hitrost insulina in bolusne odmerke.
Part of the daily insulin dose is infused continuously by the Medtronic MiniMed Implantable Pump and the remaining part of the daily dose is administered by you, using the same pump, as a bolus before meals.
Del dnevnega odmerka insulina vam stalno infundira črpalka Medtronic MiniMed Implantable Pump, preostanek dnevnega odmerka pa si daste sami z uporabo iste črpalke, kot bolus pred obroki.
If you stop using Insuman Rapid
Če ste prenehali uporabljati Insuman Rapid
If you experience severe low blood sugar levels, this may indicate a problem with your pump.
Pojav zelo nizkega krvnega sladkorja je lahko znak težav s črpalko.
Immediate type allergic reactions to insulin or to the excipients may be life-threatening.
Alergijske reakcije takojšnega tipa na insulin ali pomožne snovi so lahko smrtno nevarne.
Because you have type 1 diabetes, an insulin dependent diabetes mellitus, do not stop your insulin.
Ker imate sladkorno bolezen tipa 1 (od insulina odvisno sladkorno bolezen), ne prenehajte uporabljati insulina.
If you are allergic to insulin or any of the other ingredients of this medicine (listed in section 6).
če ste alergični na insulin ali katero koli sestavino tega zdravila (navedeno v poglavju 6).
She/he is trained to perform pump procedures which are needed tomake sure your pump works properly.
Vaša zdravnica/vaš zdravnik je usposobljen za izvedbo tistih postopkov s črpalko, ki so potrebni za zagotovitev njenega pravilnega delovanja.
You should contact your doctor for advice on driving if: you have frequent episodes of hypoglycaemia, the first warning symptoms which help you to recognise hypoglycaemia are reduced or absent.
O upravljanju vozil se posvetujte z zdravnikom: če imate pogoste hipoglikemije, če so se vam prvi opozorilni simptomi, ki vam pomagajo prepoznati hipoglikemijo, zmanjšali ali so odsotni.
Insuman Infusat in a vial may also be used in other insulin pumps for which it has been shown that they are suitable for this insulin (see pump manual).
Insuman Infusat v vložku se lahko uporablja tudi v drugih insulinskih črpalkah, za katere je dokazano, da so primerne za ta insulin (glejte priročnik črpalke).
Implantation of the pump in patients who reside permanently at elevations above 2439 meters (8000 feet) (see section 4.4).
Vsaditev črpalke bolnikom, ki stalno živijo na nadmorski višini nad 2439 metrov (glejte poglavje 4.4).
Insuman Implantable has been designed only for intraperitoneal use with the Medtronic MiniMed Implantable Pump supplied by Medtronic MiniMed which delivers insulin directly into the peritoneal cavity.
Zdravilo Insuman Implantable je izdelano le za intraperitonealno uporabo s črpalko Medtronic MiniMed Implantable Pump, ki jo dobavlja družba Medtronic MiniMed in ki dovaja insulin neposredno v peritonealno votlino.
The warning symptoms of hypoglycaemia may be changed, be less pronounced or be absent in certain risk groups.
Opozorilni simptomi hipoglikemije se lahko v nekaterih ogroženih skupinah bolnikov spremenijo, tako da so manj izraziti ali jih sploh ni.
Solution for infusion 4,000 IU/10 ml 1 vial
Raztopina za infundiranje 4,000 i.e./10 ml 1 viala
Elevated levels of antibodies to insulin are not commonly associated with a need to change your insulin dose or occurrence of serious side effects.
Zvišano raven protiteles proti insulinu včasih spremlja potreba po spremembi odmerka insulina ali pojav resnih neželenih učinkov.
The insulin in your pump must be replaced every 40 to 45 days with new insulin or earlier based on your insulin needs.
Insulin v črpalki je treba na 40 do 45 dni nadomestiti z novim insulinom (lahko pa že prej, odvisno od vaših potreb po insulinu).
For insulin human, no clinical data on exposed pregnancies are available.
Za humani insulin ni na voljo kliničnih podatkov od nosečnic, ki so bile izpostavljene zdravilu.
In the following situations, the management of your diabetes may require extra care (e.g. urine and blood tests): - If you are ill or have a major injury then your blood sugar level may increase (hyperglycaemia).
V naslednjih okoliščinah lahko vodenje vaše sladkorne bolezni zahteva dodatno skrb (npr. teste urina in krvi): - če ste bolni ali imate večjo poškodbo, se vam lahko krvni sladkor zviša (hiperglikemija).
In patients who require high insulin doses because of the presence of insulin antibodies, transfer under medical supervision in a hospital or similar setting must be considered.
Pri bolnikih, ki zaradi protiteles proti insulinu potrebujejo velike odmerke insulina, je treba razmisliti o zdravljenju pod zdravniškim nadzorstvom v bolnišnici ali podobnem okolju.
Medical imaging technique
Medicinska slikanja
• Refractory hyperglycaemia occurs.
• se pojavi neodzivna hiperglikemija.
Infection of the pump pocket (where your pump is placed), erosion of the skin where your pump is implanted and poor healing of the incision site in your skin can occur.
Pojavijo se lahko okužba žepa črpalke (tj. mesta, kjer je vsajena črpalka), erozija kože na mestu, kjer je vsajena črpalka, ali slabo celjenje reza na koži.
For use in an infusion pump, Insuman Infusat is filled into the sterile cartridge of the pump.
Za uporabo v infuzijski črpalki se Insuman Infusat napolni v sterilni vložek črpalke.
Insuman Implantable must not be used with any other type of injection devices (e.g. syringes).
Zdravila Insuman Implantable ne smete uporabljati z nobenim drugim pripomočkom za injiciranje (npr. z brizgami).
Continuous infusion via the intraperitoneal and intravenous routes (combined data) resulted in higher plasma free insulin Cmax values than multiple daily subcutaneous injections and continuous subcutaneous insulin infusion via an external pump (combined data) in patients with type 1 diabetes mellitus.
Stalno intraperitonealno in intravensko infundiranje (kombinirani podatki) je pri bolnikih s sladkorno boleznijo tipa 1 povzročilo večjo Cmax prostega insulina v plazmi kot večkratne dnevne podkožne injekcije ali stalno podkožno infundiranje insulina z zunanjo črpalko (kombinirani podatki).
No effects on the breastfed child are anticipated.
Učinki na dojenčke niso pričakovani.
Patients should practice good diabetes self care and check their blood glucose a minimum of 4 times daily to detect and prevent hyperglycemia and possible diabetic ketoacidosis due to pump under-delivery.
Bolniki morajo izvajati dobro samooskrbo sladkorne bolezni in morajo glukozo v krvi meriti vsaj 4-krat na dan, da bi odkrili in preprečili hiperglikemijo ter možno diabetično ketoacidozo zaradi nezadostnega dovajanja insulina.
Failure to properly degas all fluids may introduce air in the pump causing insulin aggregation and under-delivery.
Nepravilno razplinjenje vseh tekočin lahko v črpalko vnese zrak, povzroči agregacijo insulina in nezadostno dovajanje insulina.
Insuman Implantable administered in continuous intraperitoneal infusion was also similar to semi-synthetic human insulin as demonstrated by the refill accuracy criteria over the 4-refill cycles (per protocol population: mean difference: -3.15 ± 1.34; [95% CI: -5.81; -0.50]).
V stalni intraperitonealni infuziji uporabljeno zdravilo Insuman Implantable je bilo podobno polsinteznemu humanemu insulinu tudi sodeč po točnosti ponovnega polnjenja v 4 ciklusih ponovnega polnjenja (populacija po-protokolu: povprečna razlika: -3,15 ± 1,34, 95 % IZ:
There are no fixed rules for insulin dose regimen.
Za odmerjanje insulina ni trdnih pravil.
For further details on handling see section 6.6.
Za podrobnosti o ravnanju z zdravilom glejte poglavje 6.6.
Insuman Implantable with alcohol Your blood sugar levels may either rise or fall if you drink alcohol.
Zdravilo Insuman Implantable skupaj z alkoholom Če pijete alkoholne pijače, se vam krvni sladkor lahko zviša ali zniža.
• Alarms and messages displayed by the device and the appropriate actions to take • Recognition of signs and symptoms of under or no delivery of insulin and the appropriate actions to take
• Prepoznava znakov in simptomov nezadostnega dovajanja ali nedovajanja insulina in ustrezno ukrepanje.
Insuman Infusat must only be used in insulin pumps suitable for this insulin.
Insuman Infusat morate uporabljati samo v insulinskih črpalkah, primernih za ta insulin.
Solution for infusion (infusion).
FARMACEVTSKA OBLIKA Raztopina za infundiranje (infuzija).
Rinsing may be performed earlier, for example, when potential under-delivery is suspected based on a calculated refill accuracy of less than 85%.
Izpiranje se lahko opravi prej, na primer če zaradi izračunane točnosti ponovnega polnjenja, manjše od 85 %, obstaja sum na nezadostno dovajanje insulina.
The patient blood glucose levels must be monitored at least every 15 minutes following the flush.
Bolniku je treba po izpiranju vsaj na 15 minut kontrolirati koncentracijo glukoze v krvi.
Perform a safety test
3. korak Opravite varnostni preizkus.
In patients with severe hepatic impairment, insulin requirements may be diminished due to reduced capacity for gluconeogenesis and reduced insulin metabolism.
Pri bolnikih s hudo okvaro jeter se lahko potreba po insulinu zmanjša zaradi zmanjšane zmožnosti za glukoneogenezo in zmanjšane presnove insulina.
If your SoloStar is in cool storage, take it out 1 to 2 hours before you inject to allow it to warm up at room temperature.
Če imate SoloStar shranjen na hladnem, ga vzemite ven 1 do 2 uri pred injiciranjem, da se ogreje na sobno temperaturo.
Transfer to Insuman Infusat
Prehod na Insuman Infusat
In case of severe hypoglycaemia, the pump should be investigated by the treating physician for possible catheter occlusion leading to accumulation of insulin with subsequent release of this accumulated insulin (see sections 4.4 and 6.6).
V primeru hude hipoglikemije mora lečeči zdravnik črpalko preiskati glede možne zapore katetra, ki povzroči kopičenje insulina in posledično sprostitev tega nakopičenega insulina (glejte poglavji 4.4 in
You should practice good diabetes care and test your own blood sugar levels at least four times daily to check your blood sugar levels and determine insulin doses.
Izvajati morate dobro vodenje sladkorne bolezni in si koncentracijo krvnega sladkorja meriti vsaj štirikrat na dan, da boste preverjali raven krvnega sladkorja in določili odmerke insulina.
Shelf life in the pump Up to 45 days at 37°C.
Rok uporabnosti v črpalki Do 45 dni pri temperaturi 37 °C.
To prevent pump problems, your doctor will schedule appointments at least every 6-months to rinse your pump.
Za preprečitev težav s črpalko bo zdravnik predvidel kontrolne preglede na vsaj 6 mesecev za izpiranje črpalke.
This seems to be reversible when your catheter is repositioned or your insulin infusion stopped and without consequences on your health (see section 4).
Kot kaže, po premestitvi katetra ali prenehanju infundiranja insulina ta sprememba izgine, ne da bi imela kakšne posledice za vaše zdravje (glejte poglavje 4).
All of the findings suggest that continuous intraperitoneal insulin infusion in patients with type 1 diabetes mellitus, compared with continuous subcutaneous insulin infusion and multiple daily injections is more similar to the pharmacokinetics of endogenous insulin observed.
Vsi izsledki kažejo, da je stalno intraperitonealno infundiranje insulina pri bolnikih s sladkorno boleznijo tipa 1 bolj podobno opaženi farmakokinetiki endogenega insulina kot stalno podkožno infundiranje insulina ali večkratno dnevno injiciranje.
Insuman Rapid with alcohol
Zdravilo Insuman Rapid z alkoholom
However, use only those injection syringes which are designed for an insulin concentration of 100 IU (International Units) per ml.
Vendar uporabite le injekcijske brizge, namenjene za insulin s koncentracijo 100 i.e. (mednarodnih enot) na ml.
She/he is trained to perform pump investigations.
Vaša zdravnica/vaš zdravnik je usposobljen za izvajanje preiskav črpalke.
Examples include: you have not administered your insulin or not administered enough, e.g. due to pump not working properly or catheter blockage.
Med možnimi vzroki so: niste si dali insulina, ali ga niste dali dovolj, npr. zaradi nepravilnega delovanja črpalke ali zamašitve katetra.
To avoid under-delivery which may occur when insulin deposits collect in the pumping mechanism inside the pump, it is recommended to follow a rinse procedure every 6 months.
Izpiranje črpalke za preprečitev nezadostnega dovajanja insulina Da bi preprečili nezadostno dovajanje insulina, ki se lahko pojavi v primeru nabiranja odložkov insulina v črpalnem mehanizmu, je priporočljivo vsakih 6 mesecev opraviti izpiranje.
During this procedure, a very small amount of Insuman Implantable may be deposited under your skin, which may result in low blood sugar levels.
Med tem postopkom lahko zelo majhna količina zdravila Insuman Implantable pride pod kožo; to lahko povzroči nizek krvni sladkor.
Transfer to Insuman Rapid
Prehod na Insuman Rapid
In another study, rats also received the same semi-synthetic insulin via an intraperitoneally implanted osmotic mini-pump infusion for up to 6 weeks.
ČAS - ure študiji so podgane do 6 tednov prejemale enak polsintezni insulin z intraperitonealno infuzijo po vsajeni osmotski mini-črpalki.
It is possible that the insulin can cause blockage of the implantable pump.
Insulin lahko povzroči, da se implantabilna črpalka zamaši.
PEN LABEL SOLOSTAR
NALEPKA INJEKCIJSKEGA PERESNIKA SOLOSTAR
From experience gained in a 6-month comparative phase III study (HUBIN_L_05335) with Insuman Implantable administered via the Medtronic MiniMed Implantable Pump in 84 patients aged 26 to 80 years (see section 5.1) and from clinical experience with insulin human 100 IU/ml and 40 IU/ml, the following adverse reactions were observed.
Naslednje neželene učinke so opažali v 6-mesečni primerjalni študiji III. faze (HUBIN_L_05335) z zdravilom Insuman Implantable, uporabljenim s črpalko Medtronic MiniMed Implantable Pump pri 84 bolnikih, starih od 26 do 80 let (glejte poglavje 5.1), in med klinično uporabo humanega insulina 100 i.e./ml in 40 i.e./ml.
Insuman Rapid may also be used for treating hyperglycaemic coma (coma caused by too much blood sugar) and ketoacidosis (build-up of acid in the blood because the body is breaking down fat instead of sugar) as well as for controlling blood sugar before, during and after surgery.
Insuman Rapid se lahko uporablja tudi za zdravljenje hiperglikemične kome (koma, ki jo povzroči preveč sladkorja v krvi) in ketoacidoze (kopičenje kisline v krvi, ker telo razgrajuje maščobe namesto sladkorja) ter za uravnavanje krvnega sladkorja pred operacijo, med operacijo in po njej.
If you stop using Insuman Infusat
Če ste prenehali uporabljati Insuman Infusat
In each case, it may be necessary to adjust your insulin dose to avoid blood sugar levels that are either too low or too high.
V vsakem primeru utegne biti potrebna prilagoditev odmerka insulina, da bi se izognili prenizkemu ali previsokemu krvnemu sladkorju.
Do not use Insuman Rapid
Ne uporabljajte zdravila Insuman Rapid
Skin erosion at pump implantation site (see section 4.4)
Bolezni kože in podkožja erozija kože na mestu vsaditve črpalke (glejte poglavje 4.4)
► Side effects reported with the insulin
► Neželeni učinki, opisani z insulinom
Insuman Rapid must not be used in external or implanted insulin pumps or in peristaltic pumps with silicone tubing.
Insulina Insuman Rapid se ne sme uporabljati v zunanjih ali vsajenih insulinskih črpalkah ali v peristaltičnih črpalkah s silikonskimi cevkami.
Transfer to Insuman Basal
Prehod na Insuman Basal
If you stop using Insuman Basal
Če ste prenehali uporabljati Insuman Basal
• Outward bulge in the navel area (Umbilical hernia)
• Izbočenje v predelu popka (umbilikalna hernija)
Insulin treatment may cause temporary build-up of water in the body with swelling in the calves and ankles.
Edemi Zdravljenje z insulinom lahko povzroči prehodno kopičenje vode v telesu z otekanjem meč in gležnjev.
Close metabolic monitoring is recommended during the transition and in the initial weeks thereafter.
Med prehodom in v prvih tednih po njem je potreben natančen presnovni nadzor.
Pharmacotherapeutic group: Drugs used in diabetes, insulins and analogues for injection, fast-acting.
Farmakoterapevtska skupina: zdravila za zdravljenje diabetesa, insulini s hitrim delovanjem in analogi.
If you forget to use Insuman Implantable
Če ste pozabili uporabiti zdravilo Insuman Implantable
One IU (International Unit) corresponds to 0.035 mg of anhydrous human insulin*.
Ena i.e. (mednarodna enota) ustreza 0,035 mg brezvodnega humanega insulina*.
- Do not mix Insuman Rapid with any other medicines.
Zdravila Insuman Rapid ne mešajte z drugimi zdravili.
TEXT TO APPEAR ON THE ALUMINIUM FOIL WHICH IS USED FOR SEALING TRANSPARENT PLASTIC TRAY CONTAINING THE CARTRIDGE
BESEDILO ZA NA ALUMINIJSKO FOLIJO, S KATERO JE NEPRODUŠNO ZAPRTO PROZORNO PLASTIČNO LEŽIŠČE, V KATEREM JE VLOŽEK
SoloStar is a pre-filled disposable pen containing insulin human.
SoloStar je napolnjen injekcijski peresnik, ki vsebuje humani insulin.
Do not use SoloStar if it is damaged or not working properly, it has to be discarded and a new SoloStar has to be used.
Če je SoloStar poškodovan ali ne deluje pravilno, ga zavrzite in uporabite novega.
you are doing less exercise than usual, you are under stress (emotional distress, excitement), or you have an injury, are having an operation, have an infection or fever, you are taking or have taken certain other medicines (see section 2, "Other medicines and Insuman Implantable").
telesno ste manj dejavni kot po navadi, ste pod stresom (čustvena stiska, razburjenje), ste imeli poškodbo, imate operacijo, okužbo ali zvišano telesno temperaturo, jemljete ali ste jemali določena druga zdravila (glejte poglavje 2, "Druga zdravila in zdravilo Insuman Implantable").
HYPERGLYCAEMIA (high blood sugar levels)
HIPERGLIKEMIJA (visok krvni sladkor)
Use of other insulin medicinal products with the Medtronic MiniMed Implantable Pump.
Uporaba drugih insulinskih zdravil s črpalko Medtronic MiniMed Implantable Pump.
If you think you may have a problem with SoloStar, consult your doctor, pharmacist or nurse.
Če menite, da imate težave s SoloStarjem, se posvetujte s svojim zdravnikom, s farmacevtom ali z medicinsko sestro.
Abdominal pain Umbilical hernia
Bolezni prebavil bolečine v trebuhu umbilikalna hernija
Insuman Infusat must not be used in peristaltic pumps with silicone tubing.
Zdravila Insuman Infusat se ne sme uporabljati v peristaltičnih črpalkah s silikonskimi cevkami.
Insulin may also cause sodium retention, particularly if previously poor metabolic control is improved by intensified insulin therapy
Insulin lahko povzroči tudi zadrževanje natrija, še zlasti če se prej slaba presnovna urejenost z intenziviranim insulinskim zdravljenjem izboljša.
• with a long history of diabetes,
• imajo sladkorno bolezen že dolgo časa,
Colourless glass vial (type I) closed with flanged cap made of aluminium with tear-off lid and inserted sealing disk made of chlorobutyl rubber.
Brezbarvna steklena viala (tipa I), zaprta s prirobljeno zaporko iz aluminija z varnostnim pokrovčkom, ki se odtrga in vstavljeno tesnilno ploščico iz klorobutilne gume.