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insulin preparations :fire: (Short-acting insulin (mimic the prandial…
insulin preparations :fire:
Short-acting insulin
mimic the prandial (mealtime) release of insulin and to
control postprandial glucose.
Before the development of rapid-acting insulins, it was the primary form of insulin used for controlling postprandial glucose concentrations.
Regular insulin
is used
-
IV in emergencies (Diabetic ketoacidosis
)
injected subcutaneously
30 minutes before a meal
Peak levels at
50 to 120
minutes for regular insulin
Humulin R , Actrapid
Rapid-acting insulin
Modification of the amino acid sequence of regular insulin
-->
rapid-acting insulins
(speed their entry into the circulation without affecting their interaction with the insulin receptor ).
more rapid absorption, a quicker onset, and a shorter duration of action after subcutaneous injection.
LISPRO
(Humalog) ,
ASPART
(Novorapid) ,
GLULISINE
( Apidra)
mimic the prandial (mealtime) release of insulin and to
control postprandial glucose
Peak levels of insulin lispro are seen at 30 to 90 min
administered in the
15 minutes proceeding a meal or within 15 to 20 minutes after starting a meal.
Preferred insulin for
continuous subcutaneous infusion devices
be given intravenously for
emergency treatmen
t of uncomplicated
diabetic ketoacidosis
Intermdiate-acting insulin
for basal (fasting) control in type 1 or 2 diabetes
FBG
usually given
along with rapid- or short-acting insulin for mealtime control.
Lente insulin
is a
insulin zinc suspension
which minimizes the solubility of insulin
:forbidden: :warning: given only SC (
never IV
)
:forbidden: :warning: should not be used when rapid glucose lowering is needed (for example, diabetic ketoacidosis).
Neutral protamine Hagedorn (NPH)
= Humulin N
formed by the
addition of zinc and protamine
to regular insulin [insulin isophane]
Given
2 or 3 times
per day
Long-acting insulin
Insulin detemir ( Levemir )
fatty acid a c-terminus of β chain that enhances association to albumin
Slow dissociation from albumin results in long-acting properties.
Twice
daily injections are needed
shorter action time compared to glargine
Insulin Glargine ( Lantus )
soluble at pH 4 but has slow solubility when injected into neutral pH environment.
After glargine is injected, micro-precipitates form and the insulin has to be desolubilized.
slow insulin absorption and provides a relatively constant level of insulin with practically no peaks over 24-hour time period.
Neither long-acting insulin should be mixed in the same syringe with other insulins, because doing so may alter the pharmacodynamic profile.
Insulin combinations
Premixed combinations of human insulins, such as
70% NPH insulin plus 30% regular insulin
50% of each of these are also available
:<3: decreases the number of daily injections
:unamused: makes it more difficult to adjust individual components of the insulin regimen
ex : mixtard , novomix
IMP DIAGRAM
