Pharmacological action Novolin R (insulin regular):
Novolin R Insulin is a specific saharoponizhayushim tool has the ability to regulate carbohydrate metabolism, strengthens the tissue uptake of glucose and facilitates its conversion into glycogen, also facilitates entry of glucose into tissue cells.
In addition to the hypoglycemic action (lowering blood sugar levels), insulin has other effects: it increases the glycogen in the muscles, stimulates the synthesis of peptides, reduces the consumption of protein and other
Effect of insulin is accompanied by a stimulation or inhibition (repression) of certain enzymes stimulated glikogensintetaza, pyruvate dehydrogenase, hexokinase, inhibited lipase activating fatty acids of adipose tissue lipoprotein lipase, which reduces the “haze” of blood serum after ingestion of food rich in fat.
The degree of biosynthesis and secretion (release) of insulin is dependent on the concentration of glucose in the blood. With an increase in its content increases the secretion of insulin from the pancreas, on the contrary, decrease in blood glucose concentration slows down the secretion of insulin.
In realization of the effects of insulin leading role played by its interaction with specific receptors localized on the plasma membrane of cells and the formation of insulinretseptorny complex. Insulin receptor in complex with insulin enters the cell, where the influence on the processes of cellular proteins fosfolirovaniya; further intracellular reactions is unclear.
Insulin is the primary means of specific treatment of diabetes, because it reduces hyperglycemia (increased blood glucose) and glycosuria (presence of sugar in the urine), replenishes glycogen stores in the liver and muscles, reduces glucose mitigates diabetic lipemia (the presence of fat in the blood) , improves the general condition of the patient.
Insulin for medical use prepared from the pancreases of cattle and pigs. There is a method of chemical synthesis of insulin, but it is inaccessible. Recently developed biotechnological methods for producing human insulin. The resulting genetically engineered insulin is fully consistent with a number of amino acid human insulin.
In cases where insulin is produced from the pancreases of animals in the drug due to insufficient cleaning may contain various impurities (insulin, glucagon, samotostatin, proteins, polypeptides, etc.). Poorly purified preparations of insulin can cause various side effects.
Modern methods allow to obtain purified (monopikovye – purified by chromatography with the release of “peak” of insulin), highly purified (monocomponent) and crystallized insulin preparations. Currently, increasing use is crystalline human insulin. Of insulin of animal insulin is preferred that obtained from the pancreas of pigs.
Activity of insulin is determined by biological (in their ability to lower blood glucose in healthy rabbits) and one of the physical and chemical methods (by paper electrophoresis or chromatography paper). For one unit of (ED), or an international unit (IU), to actively 0.04082 mg of crystalline insulin.
Indications Novolin R (insulin regular):
The main indication for the use of insulin is to diabetes mellitus type I (insulin-dependent), but under certain conditions it is prescribed and diabetes type II (insulin dependent).
How to use Novolin R (insulin regular):
In the treatment of diabetes are insulin preparations of different duration of action (see below).
Short-acting insulin is also used in some other pathological processes: to cause hypoglycemic state (decrease in blood sugar levels) in certain forms of schizophrenia, as an anabolic (protein synthesis, reinforcing) the means for the general exhaustion, lack of supply, furunculosis (multiple purulent inflammation of the skin) , thyrotoxicosis (thyroid disease), diseases of the stomach (atony / loss of tone / ventroptosis / bathygastry /), chronic hepatitis (inflammation of the liver), the initial forms of cirrhosis of the liver, as well as a component of “polarizing” solutions used for the treatment of Acute coronary insufficiency (mismatch between the need of the heart for oxygen and its delivery).
The choice of insulin for diabetes treatment depends on the severity and characteristics of the disease, patient’s general condition as well as the speed of onset and duration of hypoglycemic action of the drug. The primary purpose of establishing the dose of insulin and it is desirable to in-patient (hospital).
Short-acting insulin preparations – are solutions intended for subcutaneous or intramuscular injection. If necessary, they are also introducing a vein. They have a rapid and relatively short saharoponizhayushim action. They are usually injected subcutaneously or intramuscularly for 15-20 minutes before eating from one to several times during the day. Effect after subcutaneous injection occurs within 15-20 minutes, reaching a maximum after 2 h, the total duration of no more than 6 hours They are used primarily in hospitals to determine the necessary dose of insulin to the patient, as well as in cases where required to achieve rapid changes in insulin activity in the body – in diabetic coma and precoma (complete or partial loss of consciousness due to the sudden sharp rise in blood sugar levels).
In addition tog9, short-acting insulin preparations are used as anabolic drugs and prescribed, usually in small doses (4-8 IU 1-2 times a day).
Insulin preparations with prolonged (long-term) actions are available in different dosage forms, with varying duration of effect saharoponizhayushego (semylong, long, ultralong). Different drugs effect lasts from 10 to 36 h. Because these drugs can reduce the number of daily injections. They are usually issued in the form of a suspension (suspension of solid particles in a liquid preparation), introduced only subcutaneously or intramuscularly, intravenous administration is not allowed. In diabetic coma and prolonged prekomatoznogo states do not use drugs.
Choosing a drug insulin, you must ensure that the period of maximum effect saharoponizhayushego coincided in time with the reception of write. If necessary, a syringe can introduce two long-acting drug. Some patients need not only long, but the rapid normalization of blood glucose levels. They need to prescribe insulin with prolonged and short action.
Typically, drugs are long-acting injected before breakfast, however, the injection can be done at other times.
All insulin preparations used, provided that we comply with dietary treatment. Determination of the energy value of write (from 1700 to 3000 khalu) must be due to the patient’s body weight during treatment, type of activity. Thus, at low power and heavy physical labor, the number of calories needed per day to the patient, is at least 3000, when there is excessive eating and sedentary lifestyle should not exceed 2000.
The introduction of too high doses, and the lack of carbohydrates from food can cause a hypoglycemic state (decrease in blood sugar levels), accompanied by a feeling of hunger, weakness, sweating, shaking body, headache, dizziness, palpitations, euphoria (gratuitous good-mood) or aggressive . In the following may develop hypoglycemic coma (loss of consciousness, characterized by the complete absence of reactions to external stimuli, due to a sharp reduction in blood sugar levels), with loss of consciousness, seizures, and a sharp decline in cardiac activity. To prevent hypoglycemic state patients must drink sweet tea or eat a few pieces of sugar.
If hypoglycemic (associated with a decrease in blood sugar levels) coma in the vein type 40% glucose solution in an amount of 10-40 ml, sometimes up to 100 ml, but no more.
Correction of hypoglycemia (decrease in blood sugar levels) in the acute form can be carried out by intramuscular or subcutaneous administration of glucagon.
Side effects Novolin R (insulin regular):
Subcutaneous administration of insulin may develop lipodystrophy (body fat reduction in the subcutaneous tissue) at the injection site.
Modern vysokoochishennye insulin preparations is relatively rare cause of allergy conditions, but such cases are not excluded. The development of a severe allergic reaction requires immediate desensitizing (warning or braking allergic reactions) replacement therapy and medication.
Contraindications Novolin R (insulin regular):
Contraindications to the use of insulin are diseases that occur with hypoglycemia, acute hepatitis, liver cirrhosis, hemolytic jaundice (yellowing of the skin and mucous membranes of the eyes caused by the collapse of red blood cells), pancreatitis (inflammation of the pancreas), nephritis (inflammation of the kidneys), renal amyloidosis ( kidney disease, metabolic disorders associated with protein / amyloid /), urolithiasis, peptic ulcer, decompensated heart defects (failure of heart disease because of its valves).
Most ostorozhnoeschrebuetsya in the treatment of diabetic patients suffering from coronary nedostatochnortyu (mismatch between the demand of the heart for oxygen and its delivery) and breach of the Ministry of Health | Doping circulation. Caution is needed when applying insuling! in patients with thyroid disease, Addison’s disease (adrenal insufficiency), renal insufficiency.
Insulynoterapiya pregnant} should be carefully monitored. During Itrimestra pregnancy, insulin requirements are usually a few drops and rises in IIItrimestrah IIi.
Alpha-blockers and beta-adrenostimulyatory, tetracyclines, salicylates increase the secretion of endogenous (produced in the allocation of the body) insulin. Thiazide diupetiki (diuretics), beta-blockers, alcohol can cause hypoglycemia.
