Insulin, isophane

Characteristics

Highly (chromatographic), monokomponennetary swine isophane insulin protamine average duration of action.

Of drugs

The drugs-gipoglikemicescoe. Regulates exchange and deposit of carbohydrates, proteins and lipids in organah-misheniah (liver, skeletal muscle, fat tissue). Interacts with the specific receptor zitoplazmaticescoy cell membrane to form insulinretseptornyi complex. By activation synthesis Zamf (fat cells and liver) or directly penetrate the chest (muscles), a set of insulinretseptornyi stimulates Wärmetauscher processes, including induces synthesis of a number of key enzymes (gexokinaza, piruwatkinaza, glikiencintetaza etc.). Gipoglikemiceski effect is a consequence of intracellular transport of glucose uptake and assimilation of its tissues, stimulating lipogeneza, glikogenogeneza, fusion protein reduction of liver glucose (at the expense of glycogen), etc. When a patient diabetes corrects metabolic changes normalizes permeability membrane glucose, restores balance between glikolizom and glikoneogeneuze. When s / to the introduction of gipoglikemicescoe begins in 1-3 h, reaches the maximum 18 hour lasts about 24 hours (parameters depend mainly on the pharmaceutical form of insulin isophane and dose).

Indications

Diabetes mellitus I (insulinzawisimy) and II (insulinnezawisimy) type (for instance, the partial resistance to oral protivodiabeticski means pregnancy upcoming operational intervention interkurrentnykh diseases).

Contraindications

Hypersensitivity, hypoglycaemia, insuloma.

Side-Effects

Hypoglycaemia (in high doses, or release late meal, heavy physical activity, in the face of infections or diseases, especially diarrhoea violent or vomiting) : increased sweating, rapid heartbeat, tremor, sleep disorders, and prekomatosnoe comatose state, etc.; Giperglikemia and diabetic acidosis (at low doses, leading injections, non-diet, in the face of fever and infections) : drowsiness, and appetite, loss of appetite, reddening of prekomatosnoe and comatose condition; allergic reactions, skin rashes, swelling angioneuroticeski, laryngeal edema, anaphylactic shock; in the injection-hyperemia, itching, swelling, lipodistrofia, with the long-term use.

Patient interaction

Gipoglikemiceski effect reinforce MAO inhibitors, beta-adrenoblokatora, sulfanilamida reduce-glukokortikoida, oral contraceptives and hormone drugs thyroid, tiazidnye dioretiki, Tricyclic antidepressants.

Overdosing

Symptoms : gipoglikemii signs of weakness, cold sweat, paleness of skin, rapid heartbeat, drugs, nervousness, nausea, a feeling of hunger, parestesia hands, legs, lips, tongue, headache, insomnia; In the most severe cases - gipoglikemical Koma.lechenie : when slabovrajenna gipoglikemii-immediate admission glucose (glucose tablets, fruit juice, honey, sugar or sweet food); with the strong gipoglikemii-a solution in glukagona / m and then (if necessary), a 40% solution of glucose in / 386/1989

Precautions

There is a need for dose adjustment in changing diet, increased physical activity, surgery, infectious diseases, fever, the human thyroid gland, napochechnikov, including Addison disease, hypopituitarism (incl. gipopituitrizm), renal insufficiency, progressirovanii liver disease, as well as during pregnancy and breastfeeding, those over the age of 65. The caution used in the tense mental and physical activities, including driving or in the management of the various mechanisms, as with a significant mental or physical stress might decrease ability to focus, speed of mental and motor reactions.

Dosing and Administration

Only p / c; To the use of skin care ustraherve (for the full mixed with the solvent) to be evenly mutnogo or dairy color content, immediately gaining the dose and type. Doses set individually. In monotherapies diabetes-1-2 times a day. Switch from injection vsokoochischennogo pig or human insulin does not require correction doses; Replacing bovine or mixed insulin dose reduced by 10%, unless the daily intake does not exceed 0.6 U / kg body weight. Patients receiving a day 100 U or longer, with the replacement of insulin be hospitalized.

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