INSULIN AND
ITS DOSAGE FORMS
1-Rate of insulin infusion:
i-If blood glucose level is less than 4mmol/lit. than give 0.5 units of insulin per hour.
ii-If blood glucose level is less than 4-15mmol/lit. than give 2 units per hour.
iii- If blood glucose level is less than 15-20mmol/lit. than give 4 units per hour
i-If blood glucose level is less than 4mmol/lit. than give 0.5 units of insulin per hour.
ii-If blood glucose level is less than 4-15mmol/lit. than give 2 units per hour.
iii- If blood glucose level is less than 15-20mmol/lit. than give 4 units per hour
2-TYPES OF INSULINS
All insulin is not the same. Insulin actually
comes in several forms. Each of these forms are designed to work at different
rate. The following are seven of the common forms of insulin that are commonly
administered to a diabetic:
1. Lispro
Lispro is a very rapid acting form of insulin. Within five
minutes of administering Lispro blood glucose levels begin to drop. It remains
active in lowering blood glucose levels for about 2.5 hours, though it is most
effective when it has been in the blood about 1 hour. Because it does not
remain active very long, Lispro has less chance of inducing a hypoglycemic
reaction several hours later.
2. Normal insulin
Normal insulin starts working in about thirty minutes. It works
most effectively after it has been in the body for about three hours, but it
can continue working in the bloodstream for nearly seven hours.
3. NPH
This form of insulin has been designed to mimic the insulin
produced inside the human body. It lowers blood glucose levels at a more
consistent rate. It reaches its peak when it has been in the bloodstream about
2 hours, but remains at peak for up to 12 hours. It continues working for about
24 hours total, though not as vigorously in the last 10 hours
4. Lente
Lente is another insulin that is designed to work like the
insulin that naturally occurs inside the human body. It works over long periods
of time, but takes about two hours to reach its peak effectiveness in lowering
blood sugar. It will continue at its peak for about half of the day and then
function more moderately the second half of the day.
5. Ultralente
Ultralente was designed with the idea of providing a once per
day insulin option. It takes nearly six hours after taking Ultralente before it
starts lowering blood glucose levels. However, it continues functioning
effectively all day long.
6. Glargine
Glargine is a popular insulin that is used mainly with type 1
diabetes. This is a long acting form of insulin that is injected just once per
twenty four hours. Great care must be taken not to contaminate this insulin
with the other forms of insulin by using the same syringe or storage equipment.
7. Pre-Mixed Insulin
Pre-mixed insulins are popular because they help take patient
dosage and administration errors out of the diabetic treatment equation. e.g
HUMULIN 70/30
Dosage
forms of insulin
1-Standard mode of therapy:
Standard mode of insulin therapy is subcutaneous injection using
conventional disposable needle and syringes.
2-Portable pen injection:
To facilitate subcutaneous injection of insulin, particularly
during intensive insulin therapy. portable pen sized injections have been
developed.It inject measureable quantity of insulin.
3-Disposable insulin pens:
disposable insulin pens are also available for selected
formulations e.g regular insulin ,insulin lispro, insulin aspart, insulin
glulisine, glargine etc
4-Continuous insulin infusion devices(insulin pumps):
These are external open loop pumps for insulin delivery. it has
user programmable pump that delivers individualized basal and bolas insulin
replacement doses based on blood glucose self monitoring results. these are
implanted subcutaneously always.
5-Buccal dosage forms :
As insulin is degraded in acidic pH. buccal
film of insulin may be very useful for the treatment of diabetes more
efficiently. the release mechanism is diffusion controlled and rate of
diffusion was by first order kinetics. a significant reduction of blood sugar
was observed at 2 hr
6-Inhalation:
A new ultra rapid acting mealtime insulin that is orally inhaled
for absorption via the lung ,that closely mimics the normal early insulin
response seen in healthy individuals. a thumb size device is used and patient
inhales a small amount of the powder, this drug is rapidly absorbed ultra rapid
so it become effective much more quickly than an injection of same drug(matches
the body’s natural responses in processes like secretion).
Fig: Insulin inhalation device
Fig: Insulin inhalation device
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