General information about Insulin in the UK
Ketoacidosis, diabetic hyperosmolar coma and lactic acid, insulin dependent diabetes mellitus (I type), including during intercurrent conditions (infection, trauma, surgery, exacerbation of chronic disease), diabetic nephropathy and / or hepatic dysfunction, pregnancy and childbirth, non-insulin dependent diabetes mellitus (II type) with resistance to oral antidiabetic agents, dystrophic skin lesions (sores, carbuncles, furunculosis), expressed asthenia patient with heavily flowing pathology (infection, burn disease, trauma, frostbite), long infectious process (tuberculosis, pyelonephritis).
Hypersensitivity, hypoglycemia, liver and / or kidney problems (possible accumulation), breastfeeding (there is a high risk of insulin excretion in breast milk).
Hypoglycemia, hyperglycemia postglikemicheskaya (Somogyi phenomenon), edema, visual disturbances, insulin resistance (the daily requirement exceeds 200 units), allergic reactions: skin rash with itching, sometimes accompanied by dyspnea and hypotension, anaphylactic shock; local reactions: redness, swelling and tenderness of the skin and subcutaneous tissue (pass on their own within a few days - weeks) Postinjection lipodystrophy (increase zhiroobrazovaniya at the injection site - hypertrophic form, or atrophy of fat - atrophic form), accompanied by malabsorption of insulin, the occurrence of pain senses air pressure change.
The interaction with other drugs in the United Kingdom
The effect of increasing oral antidiabetic agents, alcohol, androgens, anabolic steroids, disopyramide, guanethidine, MAO inhibitors, salicylates (in high doses) and other NSAIDs, beta-blockers (mask symptoms of hypoglycaemia - tachycardia, increased blood pressure and. ., etc.), lower - ACTH, glucocorticoids, amphetamines, baclofen, estrogens, oral contraceptives, thyroid hormones, and other thiazide diuretics, triamterene, sympathomimetics, glucagon, phenytoin.. The concentration in the blood increases (accelerates the absorption) nicotine and tobacco products.
hypoglycemia of varying severity, up to hypoglycemic coma. Treatment: mild hypoglycemia glucose is given orally if severe - in / jet (50 ml of 40% solution) with simultaneous introduction of glucagon or epinephrine.
Dosage and administration:
n / a. Patients whose hyperglycemia and glycosuria are not eliminated in the diet for 2-3 days, at the rate of 0.5-1 U / kg, and the dosage is adjusted according to the glycemic profile and glyukozuricheskim; for pregnant women during the first 20 weeks of insulin dose of 0.6 units / kg. Multiplicity of administration may be different (usually used when selecting a dose 3-5 times), the total dose divided into several parts (depending on the number of meals) is proportional to the energy value: B - 25 parts, lunch - 15 parts, lunch - 30 pieces, afternoon snack - 10 pieces, dinner - 20 pieces. Injections produce for 15 minutes before eating. In the future, perhaps twice the introduction (the most convenient for patients).
hypoglycemia contributes to overdose, violation of diet, exercise, fatty liver, renal damage organic. For the prevention of post-injection lipodystrophy recommended to change the site of injection, the treatment comprises administering insulin (6-10 units), mixed with 0.5-1.5 ml of 0.25-0.5% solution of novocaine, the transition zone lipodystrophy, closer to a healthy tissues to a depth of 1 / 2-3 / 4 of the fat layer thickness. With the development of resistance should be transferred to the patient monopikovye monocomponent and highly purified temporarily appoint corticosteroids and antihistamines. Allergization requires hospitalization of the patient, identify the drug component, which is an allergen, the appointment of adequate treatment and replacement of insulin.
Reduce the number of daily injections of insulin is achieved by combining different duration.