Insulin zinc suspension, compound

Characteristics

Монопиковый or монокомпонентный (высокоочищенный or purified) swine цинк-инсулин mixed. Refers to insulinam average length of action. Available in a neutral suspension for injection containing 30% amorphous and 70% crystalline insulin.

Of drugs

The drugs-gipoglikemicescoe. Regulates exchange carbohydrates, lipids and proteins. Interacts with the specific receptor zitoplazmaticescoy external cell membrane to form insulin-retseptornyi complex. After activation Zamf (in fat cells and liver cells) or directly penetrate the chest (muscles), a set of Wärmetauscher activates processes, including induces synthesis of the key enzymes гликолиза - гексокиназы, фосфофруктокиназы, пируваткиназы and several others, including гликогенсинтетазу in органах-мишенях (liver, skeletal muscles). Lower blood glucose by increasing lipogeneza, glikogenogeneza, protein synthesis and lower production of glucose liver; Increases the permeability of cell membranes to glucose, and the speed of recovery tissues, has indirect influence on the water and mineral exchanges. Activity begins in 1-3 h after s / to the introduction, reaching a peak in the interval between 7-15 hours, lasts about 24 hours (the parameters are усредненными).Всасыва ние and the beginning of the effect depends on the mode of (p / c or / m), the location (the abdomen, thigh, buttocks) and the injection of insulin product, etc. distributed to tissues uneven; not to cross the placental barrier, and in breast milk. T_1/2 is 5-6 min. Destroyed (insulinaza) mainly in the liver and kidneys. Write memory (30-80%).

Indications

Diabetes mellitus I (insulinzawisimy), including : in children and pregnant (with the poor diet), with the allergic reactions lipodistrofi or resistance to other drugs insulin, and II (insulinnezawisimy) types (with resistance to oral gipoglikemicakim means-derivative sulfonylureas), and complications of diabetes mellitus - ketoatsidoze, azidoze etc., and heavy infections, interkurrentnykh diseases extensive surgical interventions, aftercare period, injuries and other causes of stress in patients with diabetes mellitus.

Contraindications

Hypersensitivity, hypoglycaemia, insuloma.

Side-Effects

Hypoglycaemia (in high doses, or release late meal, heavy physical activity, in the face of infections or illnesses, especially vomiting and diarrhea) : pallor, sweating, rapid heartbeat, insomnia, tremor and other symptoms until prekomatosny and coma condition; Giperglikemia and diabetic acidosis (at low doses, leading injections, non-diet, against infection and fever), accompanied by sonlivostew, thirst, loss of appetite, reddening face and other symptoms, until prekomatosny and coma condition; allergic, including anaphylactoidnye reaction (rarely), skin rashes, swelling angioneuroticeski, laryngeal edema, anaphylactic shock; in the injection-hyperemia and itching (in the first week of treatment), lipodistrofia (with a long introduction in the same place).

Patient interaction

Gipoglikemiceski effect increase 25.06.1997, especially metandrostenolon, androgenne means pill gipoglikemicakie drugs (derivatives sulfonylureas), beta-adrenoblokatora, particularly selective, sulfanilamida, chloroquine, quinidine, quinine, carboangidraza inhibitors, especially acetazolamide, alcohol, drugs containing ethanol, klofibrat, fenfluramin, cyclophosphamide weakening - pill hormonal contraceptives, societies противовоспалительны е means tireoidnye hormones, heparin, lithium drugs, nicotine (smoking), and tiazidnye petleve dioretiki. Ethanol and disinfectants reduced activity (pharmaceutical interaction); Inconsistent (not be confused) with fosfatsoderjasimi insulinami, etc. cink-insulina suspension.

Overdosing

Symptoms : signs gipoglikemii-cold sweat, weakness, paleness of skin, rapid heartbeat, drugs, nervousness, nausea, pricking in the extremities, lips, tongue, headache; In the most severe cases - gipoglikemical Koma.lechenie : when slabovrajenna and temperate gipoglikemii-admission into glucose (glucose tablets, fruit juice, honey, sugar and other sugar-rich foods), with a development gipoglikemii, especially coma and loss of consciousness-50 ml 50% glucose solution in / on the follow-continuous infuziei 5-10% aqueous solution of glucose, or 1-2 mg glukagona (in / m, c / to, in / in), in some cases, in diazoxid / 300 mg for 30 minutes every four hours; monitoring vital functions, of glucose, urea nitrogen, creatinine in the blood; oteke with brain-mannit, dexamethasone.

Precautions

There is a need for dose adjustment in changing the nature and diet, increased physical activity, communicable diseases, fever, ponose, gastropareze and other conditions that delayed food intake, surgical interventions, the human thyroid gland, napochechnikov (Addison disease), pituitary (gipopituitrizm), renal insufficiency, progressirovanii liver disease, pregnancy, breastfeeding, children prepubescent age and the over-65s (elevated risk gipoglikemii). Older dose in the event of an abrupt stop smoking; Diabetes type I increase the interval between wvedeniami and reduce the dose at the time of gipoglikemia (add-in the appointment giperglikemisiruth drugs). Can dose adjustment in the first 1-2 weeks after the replacement of one type of insulin to another. There is a need for caution in the primary appointment insulin change, physical or mental stress of those involved in the driving of a car, the different mechanisms and other potentially hazardous activities that require increased attention and psychomotor speed reactions. During treatment every 3 months (or more instability in the state) determine the concentration of glucose in the blood and if it is above 11.1 mmol / l, it is necessary to identify the level of ketones (acetone, acid) in the urine. In gipoglikemii ketoatsidoze and record pH and the concentration of potassium ions in the serum; Symptoms io requires increasing dose, the emergence of allergic reactions, the replacement for another insulin and desencibiliziruta therapy. During pregnancy required the downward (I term), or raise (II and III trimenon) the need for insulin. During breastfeeding is recommended constant surveillance for several months (until stabilization needs insulin).

Dosing and Administration

P / to the deep (in the forearm, at the top of his thighs, buttocks and the abdomen), in / m; To the use of liquid ustraherve (gently or forcefully depending on the product) to obtain a homogeneous turbid or milk solids, immediately recruit and impose appropriate dose; The injections are not massaged. Dose establish a case-by-case basis (based on concentrations of glucose in the blood and body mass index). Assign one or two (with a daily dose of more than 0.6 U / kg) twice a day. During the migration from injection vsokoochischennogo pig or human insulin dose remains the same, with the replacement of floating a mixed insulin (a monitoring blood glucose) dose, as a rule, lower by about 10% (unless it is not more than 0.6 U / kg). Patients receiving a day 100 U or longer, with the replacement of insulin be hospitalized.

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