Insulin human

Characteristics

Insulin, which is analogous to hormone beta-kletok islets pancreas rights sinteziruemy special laboratory pathogenic strains of Escherichia coli, in which the gene is incorporated gene human insulin. 1 ml of sterile water transparent solution or suspension for injection human insulin containing 40 or 100 U insulin. Solution pH is 7,0-7,8.

Of drugs

The drugs-гипогликемическое. Regulates the level of glucose in the blood, exchange and deposit carbohydrates, proteins, lipids in organah-misheniah : liver, skeletal muscular, adipose tissue, the properties anabolica. Contact with the membrane receptor-tetramerom consisting of four DNA, two of which (alpha) located elamembranno and are responsible for the binding of hormones and the other two (Beta) loaded in zitoplazmaticescuu spring and are carriers тирозинпротеинкиназн ой Activity is the инсулин-рецепторный complex discriminated �утофосфорилированию. The intact cells of the complex fosfauriliruet serinove and treoninove ends proteinkinaz (C and Amf-zawisimoy), which results in the formation of secondary mediator - fosfatidil inositolglicana and starts Tiofat, fermentativuyu catalytic activity kletkah-misheniah. In muscle and other tissues (with the exception of the brain) to vnutricleternmu transport of glucose and amino acids, stimulates synthetic processes and inhibits protein catabolised. Is the accumulation of glucose in the liver as glycogen and suppresses glukoneogenez (гликогенолиз).Абсолю��ная bioavailability after s / to the introduction (healthy individuals and patients with инсулинзависимым diabetes) in the dose of 0.1-0.2 U / kg is 55-77% C_max achieved through 30-90 minutes. The distribution 0,26-0,36 l / kg T_1/2 when s / to a half-hour, as in / in the introduction depends on the dose : dose of 0.1 U / kg, 26 min, and the dose of 0.2 U / kg, 52 min. Degradation occurs in the liver by the action глютатионинсулинтран сгидрогеназы (insulinaza), which hydrolyzation disulfidnye between chains A and B, making them accessible to proteolytic enzymes; 35-40% of exogenous insulin excreted in faeces, about 60%, from urine.

Indications

Ketoacidosis, diabetic, and молочнокислая гиперосмолярная coma, инсулинзависимый diabetes mellitus (type I), including : интеркуррентных with conditions (infection, trauma, operative intervention, the worsening of chronic diseases), diabetes нефропатии and / or violations of the liver, pregnancy and childbirth, инсулиннезависимый diabetes (type II), with resistance to oral противодиабетическим means dystrophic skin (trophic ulcers, carbuncles, фурункулез) expressed астенизация patient with severe leaking pathology (infection burn disease, injuries, stomach), long infectious process (tuberculosis, medicine).

Contraindications

Hypersensitivity, hypoglycaemia, liver disease and / or kidney (possible accumulation), breast-feeding (there is a high risk of insulin excretion in breast milk).

Side-Effects

Hypoglycaemia, postglikemical giperglikemia (Somoji phenomenon), swelling, visual impairment, инсулинрезистентност ь (daily demand exceeds 200 U), allergic reactions : skin to skin going, sometimes accompanied by despnoe and hypotonia, anaphylactic shock; Local reaction : red, swelling and soreness of the skin and subcutaneous tissue (to be within the next few days, weeks), postingyektinaya lipodistrofia (jiroobrazovania increase in the injection-gipertrofica form atrophy or fat-atrofica form), plus violation of suction devices, the emergence of pain when changing atmospheric pressure.

Specific guidance

Reducing the number of daily injections is VPD insulinov varying duration.

Patient interaction

The effect of increasing doses of antidiabetics, alcohol, андрогены, 25.06.1997, дизопирамид, гуанетидин, MAO inhibitors, салицилаты (in high doses), etc. НПВС, бета-адреноблокаторы (mask symptoms гипогликемии-tachycardia, the AD, etc.), lower-АКТГ, глюкокортикоиды, amphetamines, баклофен, эстрогены, oral contraceptives, hormones thyroid, тиазидные etc. диуретики, триамтерен, симпатомиметики, глюкагон, phenytoin. Concentration in the blood increase (up induction) nikotinsoderjaschie drugs and smoking.

Overdosing

Symptoms : hypoglycaemia varying degrees until гипогликемической комы.Лечение : in light гипогликемии glucose ingestion is in dire in / in струйно (up to 50 ml of 40% solution), while the introduction of глюкагона or miss.

Precautions

Development gipoglikemii to overdose, diet, exercise, fat infiltration liver, organic kidney failure. To prevent postingyektini lipodistrofii to change places injections, the treatment is the introduction of insulin (10 U), mixed with 0.5-1.5 ml 0.25% solution novokaina, in the transition zone lipodistrofii closer to the healthy tissue to a depth of the thickness of 1/2-3/4 fat layer. In developing resistance should be transferred to the patient and монопиковые монокомпонентные purified инсулины temporarily appoint глюкокортикоиды and antipruritic drugs. Allergization requires hospitalization, the patient, identification of drugs, the allergen, the appointment of adequate treatment and replacement of insulin.

Dosing and Administration

P / KD Patient whose giperglikemia and glukozuria not repaired diet for a period of two to three days at the rate of 0.5-1 U / kg, and then adjust the dose according to the university and glukozuriceski profile; For pregnant women in the first 20 weeks insulin dose of 0.6 U / kg Bond introduction may be different (usually in the selection of doses used 3-5-kratnoe), the total dose is divided into several parts (depending on the number of meals) for the energy values : Breakfast-25 parts, the second breakfast-15 parts, lunch-30 parts, snack-10 parts, dinner-20 parts. Injections are for 15 minutes before eating. In the future, perhaps twice introduction (most convenient for patients).

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