Insulin Pharmacology Flashcards
What is insulin?
protein hormone made by beta islet cells
What is the function of insulin
increase glucose/protein/fat synthesis and uptake
via GLUT4 receptos
What is the mechanism of insulin action
bind tyrosine kinase receptors
induce GLUT4 translocation to a cell membrane
suppress gluconeogenesis in liver
increase K and Mg intracellularly
How does insulin inform the treatment of a blocked cat?
should treat with insulin and dextrose
- insulin will induce potassium uptake into cells
- must also give dextrose because by giving insulin you may induce hypoglycemia
What are the effects of insulin deficiency
hyperglycemia
ketoacidosis
endothelial cell damage
neuropathy/nephropathy/cardiomyopathy
hyperkalemia
What is insulin supplementation primarily used for
diabetes
- cat = type 2
- dog = type 1
+/- septic foal or equine hepatic lipidoses
What are the adverse effects of insulin
hypoglycemia and +/- death
What are the general prinicples of treating diabetes
avoid hypoglycemia
species variation
- can give dogs pig insulin
pharmacokinetics can vary individually = must titrate to the individual
What are 4 types of insulin? What species are they for?
crystalline = for emergency use
caninsulin (lente) = pig derived , for dogs
prozinc = cats
lantus = human product for cats
How is insulin stored/handled appropriately?
refridgerate
read label
mixing can vary (invert several times)
Explain how insulin is dosed and drawn up
units: 1 unit of insulin is the amount needed to cause hypovolemic convulsion in a 2kg rabbit
= 34.7 ug of crystalline insulin
There are either 40 or 100U/ml syringes
- the correct syringe will be indicated on the product label
- if you use a 40 instead of a 100 = overdose
- if you use a 100 instead of a 40 = underdose