Insulin Flashcards
Stimulatory drugs of insulin
Sulfonylureas
Meglitinide
Nateglinide
Acetylcholine
Inhibitor drugs of insulin
Diazoxide
Phenytoin
Vinblastine
Colchicine and
Effect of insulin on liver
Inhibit glycogenolysis
Inhibit conversion of fatty acids into amino acids
Inhibit conversion of amino acids to glucose
Anabolic action of insulin
Promote glucose storage as glycogen
Inc triglycerides synthesis and VLDL
Effect of insulin on muscle
Increase protein synthesis
Inc glucose transport
Induce glycogen synthase
Rapid acting preparations of insulin
Lispro
Aspart
Glusinine
Rapid acting mixed with
Long acting insulin
Given 15 min after meal or immediately after meals
Rapid acting insulin
Shirt acting insulin
Regular insulin
Give it 30 min before meal
Short acting
(Regular insulin)( soluble)
Natural unmodifiable insulin identical to human insulin made by recombinant DNA technique
Regular insulin
Regular insulin is mixed with
NPH
Intermediate acting insulin
NPH (isophane)
Neutral protamine hagedorn insulin
Has Delayed absorption from its conjugation with protamine forming less soluble complex
Intermediate acting insulin
Used for basal control
Intermediate acting insulin
Given with rapid or short acting insulin for mealtime
Intermediate acting insulin
(NPH)
Mixed with lispro or regular insulin in overnight
Given twice daily in insulin dependent diabetes mellitus
NPH
Soluble peak less
Long acting insulin
From long acting insulin are
Insulin glargine (lantus)
Insulin detemir ( levimir)
Insulin degludec
Given only subcutaneous
Long acting insulin
Have flat prolonged hypoglycemic effect with no peak
Long acting insulin
Lantus
Levemir
That are not mixed with other insulin
Long acting insulin
Lantus
Levemir
Indications of insulin
Insulin dependent diabetes mellitus
Non insulin dependent diabetes mellitus
(
temporary use
infection, operations and pregnancy)
Permanently use
NIDD with renal impairment
Emergency diabetic ketoacidosis and hyperosmolar diabetic coma
Other uses of insulin
Hyperkalemia
Anorexia Nervosa
Test after gastrectomy
Side effects of insulin
Local reaction
Local atrophy or hypertrophy of sc fat
Secondary infection
Hypersensitivity reaction
systemic reaction
👉🏻Hypersensitivity due to change protamine containing insulin
👉🏻Insulin resistance due to high activity of insulinase or overproduction of insulin antibodies
👉🏻 Hypoglycemic coma
👉🏻 Somogyi effect
👉🏻 Weight gain
Treatment of hypoglycemic coma
Patient conscious 👉🏻 oral glucose
Patient in coma
👉🏻IV glucose
👉🏻Flush the vein with saline to avoid thrombosis
👉🏻 Glucagon if sterile glucose isn’t available
👉🏻 Adrenaline if no alternative and no cvs contraindications
Define somogyi effect
Rebound hyperglycemia due to excess release of counter regulatory hormones that follows insulin induced hypoglycemia during night
