Insulin isophane
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Clinical Pharmacology
Hypoglycemic. Protaphane HM interacts with a specific plasma membrane receptor and enters the cell, where it activates the phosphorylation of cellular proteins, stimulates glycogen synthetase, pyruvate dehydrogenase, hexokinase, inhibits adipose tissue lipase and lipoprotein lipase. In combination with a specific receptor, it facilitates the penetration of glucose into cells, enhances its absorption by tissues and contributes to its conversion to glycogen. Increases the supply of glycogen in the muscles, stimulates the synthesis of peptides.
Indications
Diabetes mellitus type I, diabetes mellitus type II (with resistance to sulfonylurea derivatives, intercurrent diseases, operations and in the postoperative period, during pregnancy).
Composition
Active ingredient: insulin-isophane (human genetically engineered);
Auxiliary substances: zinc chloride; glycerol (glycerol); metacresol; phenol; sodium hydrogen phosphate dihydrate; protamine sulfate; sodium hydroxide and / or hydrochloric acid (to adjust pH); water for injections
Insulin isophane is marketed under different brands and generic names, and comes in different dosage forms:
Brand name | Manufacturer | Country | Dosage form |
---|---|---|---|
cartridge | |||
Protaphane HM | vials | ||
Biosulin N | Pharmstandard Ufavita | Russia | suspension |
Rinsulin NPH | Geropharm | Russia | cartridge |
Insuman Bazal GT | Sanofi-aventis | France | pen |
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Dosage and Administration
Subcutaneously. The drug is intended for subcutaneous administration. Insulin suspensions should not be administered IV.
The dose of the drug is selected individually, taking into account the needs of the patient. Usually the need for insulin ranges from 0.3 to 1 IU / kg / day. Daily insulin requirements may be higher in patients with insulin resistance (for example, during puberty, as well as in patients with obesity), and lower in patients with residual endogenous insulin production.
Protafan® NM can be used both in monotherapy and in combination with insulin of fast or short action.
Protafan® NM is usually injected subcutaneously in the thigh. If this is convenient, injections can also be made in the anterior abdominal wall, in the gluteal region, or in the deltoid muscle of the shoulder. With the introduction of the drug in the thigh area, a slower absorption is observed than with the introduction in other areas. If the injection is made into a skin fold, the risk of accidental intramuscular injection of the drug is minimized.
The needle should remain under the skin for at least 6 s, which guarantees a complete dose. It is necessary to constantly change the injection sites within the anatomical region to prevent the development of lipodystrophies.
Protafan® NM Penfill® developed for use with Novo Nordisk injection systems for injection and NovoFine needles® or NovoTvist®. Follow the detailed recommendations on the use and administration of the drug.
Dose adjustment
Concomitant diseases, especially infectious and accompanied by fever, usually increase the body's need for insulin. Dose adjustment of the drug may also be required if the patient has concomitant diseases of the kidneys, liver, dysfunction of the adrenal glands, pituitary gland or thyroid gland. The need for dose adjustment may also occur when changing physical activity or the usual diet of the patient. Dose adjustment may be required when transferring a patient from one type of insulin to another.
Adverse reactions
Hypoglycemic conditions, allergic reactions, lipodystrophy (with prolonged use).
Contraindications
Hypoglycemia, insulinoma.
Drug interactions
The hypoglycemic effect is enhanced by acetylsalicylic acid, alcohol, alpha- and beta-adrenergic blockers, and those who are trained in people working with people who are working in school. thiazides), glucocorticoids, heparin, hormonal contraceptives, isoniazid, lithium carbonate, nicotinic acid, phenothiazines, sympathomimetics, tricyclic antidepressants.
Overdosage
Symptoms: development of hypoglycemia (cold sweat, palpitations, tremor, hunger, agitation, irritability, pallor, headache, drowsiness, lack of confidence of movements, impaired speech and vision, depression). Severe hypoglycemia can lead to temporary or permanent dysfunction of the brain, coma and death.
Treatment: sugar or glucose solution inside (if the patient is conscious), p / c, v / m or v / v - glucagon or v / v - glucose.
- Active ingredient: Insulin isophane
Studies and clinical trials of Insulin isophane (Click to expand)
- Insulin pen for administration of isophane insulin
- Isophane insulin not Ultratard™
- Comparison of two twice-daily insulin regimens: Ultralente/soluble and soluble/isophane
- Absorption kinetics of regular and isophane (NPH) insulin in the normal dog
- MI incidence is lower with insulin glargine versus insulin suspension isophane
- Benefits of detemir over isophane insulin add up over time in T1DM
- Insulin detemir vs isophane insulin suspension for paediatric type I diabetes
- Insulin glargine as effective as insulin suspension isophane in type 2 diabetes
- Insulin suspension isophane: nocturnal glucose control
- Insulin glargine: potential benefits over insulin suspension isophane
- Insulin suspension isophane often inadequately resuspended
- Cochrane Database of Systematic Reviews (Protocols) || Long acting insulin analogues versus NPH insulin (human isophane insulin) for type 2 diabetes mellitus
- Cochrane Database of Systematic Reviews (Reviews) || Long-acting insulin analogues versus NPH insulin (human isophane insulin) for type 2 diabetes mellitus
- Insulin suspension isophane/insulin aspart
- Insulin glargine/insulin suspension isophane
- Insulin suspension isophane
- Insulin/insulin suspension isophane overdose
- Absorption kinetics of regular, isophane, and protamine zinc insulin in normal cats
- Glibenclamide/insulin/insulin suspension isophane/repaglinide
- Insulin/insulin suspension isophane
- Insulin suspension isophane/insulin
- Insulin/insulin suspension isophane
- Insulin suspension isophane
- Insulin suspension isophane/insulin