2010/06/07

Insulin biphasic [human semisynthetic]

International name:
Insulin biphasic [human semisynthetic] (Insulin biphasic [human semisynthetic])

Group Affiliation:
Hypoglycemic tool - a combination of insulin and the short average duration of

Description of the active substance (INN):
Insulin biphasic [human semisynthetic]

Dosage form:
Suspension for subcutaneous injection

Mode of action:
Insulin average duration of action. Interacting with specific receptor outer cell membrane, forming insulinretseptorny complex. By increasing the synthesis of cAMP (in the fat cells and liver cells) or directly penetrate the cell (muscle), insulinretseptorny complex stimulates intracellular processes, including synthesis of several key enzymes (hexokinase, pyruvate kinase, glikogensintetaza, etc.). Reduction of blood glucose due to an increase of intracellular transport, increased absorption and assimilation tissue, stimulation of lipogenesis, glikogenogeneza, protein synthesis, reduced speed hepatic glucose production (reduction of the collapse of glycogen), etc. After sc injection effect occurs after 30-45 minutes . The maximum effect - in between 1-8.5 h duration - from 10 to 20 hours (depending on the composition of insulin), dose-dependent and reflects the considerable inter-and vnutripersonalnye deviation.

Indications:
Diabetes mellitus type 1. Diabetes mellitus type 2, stage of resistance to oral hypoglycemic, in part resistance to oral hypoglycemic drugs (combination therapy), intercurrent diseases, surgical interventions (mono or combination therapy), diabetes against a background of pregnancy (in ineffectiveness diet ).

Contraindications:
Hypersensitivity, Hypoglycemia, insulinoma.

Side effects:
Allergic reactions (urticaria, angioedema - fever, shortness of breath, blood pressure reduction), including Local (hyperemia, swelling, itching of the skin at the injection site); lipodystrophy at injection of the drug; hypoglycemia (pale skin, sweating, perspiration, palpitations, tremor, hunger, excitement, anxiety, paresthesia in the mouth, headache, drowsiness , insomnia, fear, depressed mood, irritability, unusual behavior, lack of movement, speech and vision), hypoglycemic coma. At the beginning of treatment - swelling and a violation of refraction (of a temporary nature and are continuing with treatment.) overdose. Symptoms: perspiration, palpitations, tremor, hunger, anxiety, paresthesia in the mouth, pallor, headache, drowsiness, insomnia, fear, depressed mood, irritability, unusual behavior, lack of movement, speech and vision, hypoglycemic coma, convulsions. Treatment: if the patient is conscious, appoint dextrose inside; n / a, i / m or i / v injected glucagon or in / in hypertonic dextrose. With the development of hypoglycemic coma in / jet injected 20-40 ml (100 ml) 40% dextrose until until the patient is out of a coma.

Dosage and administration:
P / K, 1-2 times a day for 30-45 minutes before breakfast (the place of injections should be changed every time). In special cases, the doctor may prescribe a / m injection. In / in insulin average duration of the forbidden! Doses are selected individually and depend on the concentration of glucose in the blood and urine, the characteristics of the disease. Typically, doses are 8-24 IU 1 time per day. In adults and children with a high sensitivity to insulin may be sufficient dose of less than 8 IU / day, patients with low sensitivity - exceeding 24 IU / day. With a daily dose exceeding 0.6 IU / kg - in the form of two injections in different places. Patients receiving 100 IU per day or more, the replacement of insulin appropriate to be hospitalized. Translation from one drug to others should be under the control of blood glucose concentration.

Cautions:
Possible immunological cross-reaction with human insulin. If hypersensitivity to animal insulin should test the tolerance of insulin with skin tests (in / for the introduction). If / to test confirms expressed hypersensitivity to insulin (an allergic reaction of immediate type - Arthus phenomenon) further treatment should be conducted only under clinical control. Ability to transfer a patient in the event of increased insulin sensitivity of animals to human insulin is often hampered by cross-immunological reaction between human and animal insulin. Before taking insulin from a vial to check the transparency of the solution. When a foreign body, turbidity or precipitation of the substance on the glass bottle solution of the drug can not be used. Temperature of insulin must correspond to room temperature. Insulin dose must be adjusted in cases of infectious diseases, thyroid, Addison's disease, hypopituitarism, chronic renal failure and diabetes diabetes in individuals over 65 years. The causes of hypoglycemia can be: an overdose of insulin replacement medication, skipping meals, vomiting and diarrhea, physical stress, disease, reducing the need for insulin (very advanced kidney and liver, and hypofunction of adrenal, pituitary or thyroid gland), change the injection site (such as the skin on the abdomen, shoulder, hip), as well as interaction with other drugs. May decrease the concentration of glucose in the blood during transfer of a patient with insulin animals to human insulin. Transfer the patient to human insulin should always be medically justified and undertaken only under medical supervision. The tendency to develop hypoglycemia can impair the ability of patients to actively participate in traffic, as well as maintenance of machinery. Diabetics can cut short by themselves felt by a slight hypoglycemia by taking sugar or foods with high carbohydrate content (recommended to always carry with them no less than 20 grams of sugar). The transfer of hypoglycemia should inform the attending physician to decide on the need for correction of treatment. During pregnancy should take into account the reduction of (I trimester) or increase (II-III trimesters) in insulin requirements. During childbirth and immediately after their need for insulin can dramatically decrease. During the period of lactation should be monitored daily for several months (up to stabilize insulin requirements).

Interaction:
Pharmaceutical incompatible with solutions of other drugs. Hypoglycemic action of sulfonamides increase (including oral hypoglycemic drugs, sulfonamides), MAO inhibitors (including furazolidone, procarbazine, selegiline), carbonic anhydrase inhibitors, ACE inhibitors, NSAIDs (in m . salicylates hours), anabolic steroids (including stanozolol, oxandrolone, methandrostenolone), androgens, bromocriptine, tetracyclines, clofibrate, ketoconazole, mebendazole, theophylline, cyclophosphamide, fenfluramin, preparations Li +, pyridoxine, quinidine, quinine, hlorohinin, ethanol. hypoglycemic effect of weakening glucagon, somatropin, GCS, oral contraceptives, estrogens, thiazide and loop diuretics, BCCI, thyroid hormones, heparin, sulfinpirazon, sympathomimetic, danazol, tricyclic antidepressants, clonidine, calcium antagonists, diazoxide, morphine, marijuana, nicotine, phenytoin, epinephrine, blockers of H1-histamine receptors. Beta-blockers, reserpine, octreotide, pentamidine can both strengthen and weaken the hypoglycemic effect of insulin.