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  Insulin

Pharmacokinetics | Indications | Routes of Administration and Dosage | Contra Indications | Precautions | Interactions | Brand Names


Systems General (Systemic)
Category Hypoglycaemic agent


Pharmacokinetics

Insulin is a peptide hormone produced by the pancreas. It gets distributed extracellularly. Since the drug is a peptide it gets degraded in the gut when given orally. Subcutaneous Insulin is cleared more by the kidney than by the liver when compared to the endogenous insulin. The liver clears only 30-40% of the insulin.



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Indications

Insulin is a peptide hormone with a molecular weight of about 5808 (human). It has two chains A and B linked by disulphide bond. Insulin is effective in all types of diabetes and is most effective in IDDM. It is a must in diabetes ketoacidosis which occurs in IDDM. It is also used in hyperosmolar (Non ketotic hyperglycemic) coma.



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Routes of Administration and Dosage

Sub-cutaneous dose : all patients with Type 1 diabetes: initially 0.2- 0.3 units/kg/day. Increase gradually to 0.5 - 1 U/kg/day. Obese patients may require 2 U/kg/day. 40-60 % of the daily dose is given as basal insulin with 1 or 2 injections of intermed



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Contra Indications

Insulin is contraindicated in hypoglycaemia, severe allergy to porcine or bovine insulins.Patients who are hypersensitive to a single species insulin can be changed to Human insulin.



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Precautions

Conditions like puberty, pregnancy, menstruation, severe pyrexia, Infection, Psychological stress may increase blood sugar and may increase the amount of insulin needed. In Hypopituitarism, addison's disease, and diabetes secondary to pancreatic disease the dose of insulin should be halved. Diarrhea, Gastroparesis, Intestinal obstruction, Vomiting may slow the metabolism time and absorption of food, hence may change the amount of insulin needed. Effects of insulin may be increased or decreased in surgery, renal and hepatic disease.



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Interactions

Higher doses of insulin may be needed during Corticosteroid treatment and for a period of time after Corticosteroid treatment ends. If the pancreas can still produce some insulin, then administration of Pentamidine can cause pancreas to release its insulin. Alcohol can increase the effect of insulin, to lower blood sugar. Beta-blockers can mask the symptoms of hypoglycaemia.



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Brand Names

Actrapid HM Pen fill(Knoll), Actrapid HM Penfil(Nova Nordisk), Actrapid MC(Knoll Pharma), Human Actrapid( Knoll Pharma), Human Insulatard(Knoll Pharma), Human mixtard(Knoll Pharma), Human Monatard(Knoll Pharma), Human Rapimix(Sarabhai), Huminsulin, Huminsulin-N, Huminsulin-R (Eli Lilly), Iletin-N, Iletin - R (Eli Lilly Ranbaxy) Insulatard(Knoll Pharma), Insulatard Hm Penfill (Novo Nordisk), Insulin (Knoll Pharma), Insulin Isophane(N.P.H), insulin Protamine zinc(Knoll Pharma), Insulin Zinc(Lente)(knoll Pharma), Insulan Rapid(Hoechst Marion Roussel), Mixtard, Mixtard-30 Hm Penfill(Novo Nordisk), Rapidica(Sarabhai), Rapimix(Sarabhai), Zinulin(Sarabhai).



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Pharmacokinetics | Indications | Routes of Administration and Dosage | Contra Indications | Precautions | Interactions | Brand Names

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