Insulin lispro

When ATH: A10AB04

Pharmacological action

DNA-recombinant human insulin analog, It differs from it in the reverse sequence of proline and lysine residues at positions 28 and 29 Insulin B-chain. Regulates the metabolism of glucose, It has an anabolic effect. In muscle, etc.. tissues (except brain) accelerate the transition into cells of glucose and amino acids, It favors the formation of glycogen in the liver of glucose, It inhibits gluconeogenesis and stimulates the conversion of excess glucose into fat. Insulin lispro equimolar human insulin. As compared with the conventional preparation of human insulin has a more rapid onset of action, earlier onset of action and peak shorter period hypoglycemic activity (to 5 no). The rapid onset of action (through 15 minutes after administration) It associated with a high rate of absorption and allows it to enter directly before meals (for 15 m) – normal human insulin was administered 30 m. The rate of absorption of insulin lispro and the beginning of its operation can be affected by the choice of the site of injection, etc.. factors. The maximum effect observed between 0.5 and 2.5 no; duration – 3-4 no.

Testimony

Diabetes mellitus type 1, especially in case of intolerance, etc.. insulin, postprandial hyperglycemia, not amenable to correction, etc.. insulinami: Acute subcutaneous insulin (accelerated degradation of local insulin). Diabetes mellitus type 2 – in cases of resistance to oral hypoglycemic drugs; in violation of absorption, etc.. insulin; in operations, intercurrent diseases.

Contraindications

Hypersensitivity, gipoglikemiâ, insulinoma.

Side effects

Allergic reactions (hives, angioedema – fever, breathlessness, decrease in blood pressure); lipodystrophy, transient refractive error (usually in patients with, previously treated with insulin); gipoglikemiâ, hypoglycemic koma.Peredozirovka. Symptoms: slackness, evaporated, profuznыy sweat, heartbeat, tachycardia, tremor, hunger, anxiety, paresthesia in the mouth, pale skin, headache, tremor, vomiting, drowsiness, insomnia, fear, depressed mood, irritability, unusual behavior, lack of movement, speech and vision, confusion, gipoglikemicheskaya coma, convulsions. Treatment: If the patient is conscious, appoint dextrose inside; n / a, / m or / glucagon administered or / hypertonic dextrose. With the development of hypoglycemic coma in / jet injected 20-40 ml (to 100 ml) 40% dextrose until, until the patient is out of coma.

Dosing and Administration

The dose is determined individually, depending on the level of glucose. P /, for 15 minutes before eating. Single dose – 40 ED, the excess shall be permitted only in exceptional cases. If necessary, can be administered in / in, as well as in combination with long-acting insulin preparations or with sulfonylureas for oral. When administered alone 4-6 once a day, in combination with long-acting insulin preparations – 3 once a day. Injections should be made p / shoulders, hips, buttock or abdomen. Injection sites must be alternated so, to the same place no more used 1 once a month. When s / to a need for caution, not to fall into a blood vessel. Patients with renal and / or hepatic impairment increased level of circulating insulin, and the need for it can be reduced, that requires careful monitoring of blood glucose levels and insulin dose adjustments.

Cautions

Should strictly abide by way of introduction, designed for the dosage form. When transferring patients from insulinov animal origin fastest on insulin lizpro may require dose adjustment. Transfer of patients, receiving a daily dose of insulin, exceeding 100 ED, from one type of insulin on etc. recommended in the hospital. The need for insulin may increase during infection, When the emotional tension, as you increase the number of carbohydrates in food, while supplementation with hyperglycemic drug activity (thyroid hormones, GCS, oral contraceptives, thiazide diuretics). Insulin requirements may be reduced in patients with renal and / or hepatic insufficiency, while reducing the amount of carbohydrates in the food, when enhanced physical activity, while supplementation with drugs hypoglycemic activity (MAO inhibitors, non-selective beta-blockers, sulfonamides). The tendency to develop hypoglycemia can impair the ability of patients to actively participate in road traffic, as well as the maintenance of machinery. Diabetics can pain perceived themselves light hypoglycemia through the admission of sugar or food with a high carbohydrate diet (it is always recommended to have with you at least 20 g sugar). On the rescheduled hypoglycemia should inform the attending doctor to decide on the appropriate correction treatment. The need for insulin usually decreases in the first trimester of pregnancy and increases in II-III trimestrah. At the time of birth and immediately after their need for insulin may drop.

Drug Interactions

Pharmaceutical incompatible with solutions etc.. PM. Hypoglycemic effect increases sulfonamides (incl. oral hypoglycemic drugs, sulfonamides), MAO inhibitors (incl. furazolidon, procarbazine, selegiline), carbonic anhydrase inhibitors, ACE inhibitors, NSAIDs (incl. salicilaty), anabolic steroid (incl. stanozolol, oksandrolon, metandrostenolon), androgens, bromocriptine, tetracikliny, clofibrate, ketoconazole, meʙendazol, theophylline, cyclophosphamide, fenfluramin, drugs Li , pyridoxine, quinidine, quinones, khlorokhinin, ethanol. Gipoglikemicheskoe action oslablyayut glucagon, somatropin, GCS, oral contraceptives, Estrogens, thiazide and loop diuretics, BMKK, thyroid hormones, Heparin, sulfinpirazon, sympathomimetic, danazol, tricyclic antidepressants, klonidin, calcium antagonists, diazoksid, morphine, marijuana, nicotine, phenytoin, epinephrine, blockers of H1-histamine receptors. Beta-blockers, reserpine, Octreotide, pentamidine can both strengthen, and weaken the hypoglycemic action of insulin.