INSULIN

Antidiabetic
DZ = cr metabolic disease. – Major disorder is hyperglycemia which is based on scarcity absolute / relative insulin
Type I insulin-dependent diabetes
ØDebut => 40 years
Type II diabetes Noninsulinodependent
ØDebut 40 years =>
Pharmacodynamic actions:
The biological effects of

insulin
a carbohydrate metabolism:
↓ glucose: – ↓ glycogenolysis
– ↓ GLICONEOGENEZA
– ↑ glycogenesis
– TRANSPORT transmembrane G ↑
B. Lipid metabolism: – ↓ lipolysis
– ↑ SUMMARY AGL
– SUMMARY TG ↑
– ↑ CONSUMPTION DC (muscles)
c protein metabolism:
– ↑ LIVER PROTEIN anabolism and muscle
– ↓ protein catabolism (↓ urea)
SIDE EFFECTS:

a.HIPOGLICEMIA (commonly encountered): sweating, pallor, hunger, anxiety, tremor
b.ALERGIA insulin – rare;
c.LIPODISTROFIA after insulin administration in the same place long

Types of insulin
I. ORIGIN
A. I. animals: pigs and cattle
I. b component (MC): I animals chromatographic purification
v. I. human (HM) genetically engineered with superior tolerance, without impurities
II. After installing and hypoglycemic TIME

I. A fast-acting, short
! SC.; debut 30 ‘, duration 6-8 hours;
ACTRAPID, Humulin R, Apidra NOVORAPID
intermediate-acting b I.
! s.c., beginning 1-2 hours Duration 12 – 4:00 p.m.
INSULIN NOVO SEMILENTA;
Humulin N, Insulatard, Insuman BASAL
nInsuline with long-acting – Long-acting analogues Lantus Levemir
start – 2:00, action-24 hours
nInsuline premixed
– Blends 20/80, 30/70, 40/60, the short-acting insulin and NPH – Humulin M3 Mixtard 30HM, Insuman Comb 25, Insuman Comb 50 – debut 30 minute action-4:00 p.m.
– Mixtures of rapid-acting analogues and NPH Humalog Mix 25, Humalog Mix 50, NOVOMIX 30; debut – 25 minutes act.-10:00
RULES
ADMINISTRATION:
nintroducerea air in the bottle
(How many units to be taken)
nfixarea insulin dose by
Its aspiration is not slow to
froth
I do not antiseptizeaza injection
nscoaterea needle without compressing
region then
nSeringa insulin-100U/ml,
Needle 12, 8, 6 mm which can be
reused to produce discomfort
puncture or for 7 days
Management Rules
nCunoaşterea injection site – subcutaneous injection (arm, thigh, abdomen, buttock);
nAlternarea injection site to prevent lipodystrophy;
nAlternarea region of administration in order to prevent changes in the absorption and overall risk of late;
n Avoiding insulin administration regions to be requested immediately by intense exercise (increased absorption of insulin, I risk of hypoglycaemia);
Management Rules
nCondiţii Storage
– Avoid extreme temperatures and direct exposure to sunlight
– Keep at room temperature – 14 to 30 days
– Open bottle stored at 2-8 ° C within 1-2 months
– Dark bottle stored at 2-8 ° C until expiry
Knowing ways to manage their
a) s.c. deep in region: – deltoid
– Thighs
– Abdominal wall
– Portable with pen
– Subcutaneous catheter (modern pumps
insulin)
b) i.v. ketoacidosis coma
nCunoaşterea insulin doses
nCunoaşterea side effects of insulin therapy:
– Hypoglycaemia – insulin injection sites to be requested immediately by exercise;
-Deviations from the diet
– Lipodystrophy
-Practical allergy to insulin. eliminated by using human insulin
– Edema, blurred vision, weight gain
– Pain by injection of needle used, scrap alcohol on the skin, intradermal injection,
– Use of insulin in the refrigerator cold
nOnce injection:
1.Prevenirea any hypoglycemia (sugar candy);
February. In case of doubt regarding hypo-or hyperglycemia is preferable to treat the case as hypoglycemia;
Three. If hypoglycemic patients who can not swallow should be administered sc glucagon, insulin syringe;
Always wear 4.Pacientul carry a medical documents identifying him as a diabetic and mention the type and dosage of insulin needed.
Timing of insulin
Human nInsulinele: is administered 30-45 min before meal
nAnalogii insulin: is given immediately before the meal
nFor human insulin required 3 meals / day and 3 snacks
nFor insulin analogues are not usually necessary snacks.
B. METHOD OF ADMINISTRATION
I. Classical treatment

a) 3 doses / 24 H
– Morning (D1) – the largest
– Lunch (D2) – less than D1
– Evening – comparable to D1
b) 2 doze/24 h
– Am – 2/3 D/24
– Evening third of D/24
II. Intensified treatment
(PHYSIOLOGICAL)
• Assessment of needs I by blood glucose and / or glycosuria
• Very effective!
• Disadvantages: – ↑ frequency of hypoglycaemia
– Weight tend ↑
– Cost ↑

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