Drug Index

Insulin

 
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Synonyms :

Aspart, Glargine, Human Insulin, Lispro, NPH

Mechanism :

Insulin is synthesized in a special non-disease-producing special laboratory strain of Escherichia coli bacteria that has been genetically altered by the addition of the gene for human insulin production.


Indication :

• Diabetes mellitus type 1

• Uncontrolled diabetes mellitus type 2


Contraindications :

Hypersensitivity to drug/class/component.

Dosage may need to be reduced in severe renal impairment.


Dosing :

For Type I Diabetes Mellitus.

Aspart:

Above 2 years: May require 0.8-1.2 units/kg/day given subcutaneously parallel to growth spurts.

Above 12 years: 0.5units/kg/day OR <1.2 units/kg/day.

Glargine:

Under 6 years: Safety and efficacy is not established.

Above 6 years: Initiate therapy with 33% of total daily dose and the remaining 67% of the drug can be given as premeal short acting insulin.

Above 12 years: Use 1.2 units/kg/day as a maintenance dose parallel with growth spurts.

Lispro:

Under 3 years: Safety and efficacy not established.

Above 3 years: 0.4-1 units/kg/day given subcutaneously with either increased doses during puberty OR 0.5-1 units/kg/day, which is an adult dose.

NPH:

Under 12 years: Safety and efficacy not established.

Above 12 years: 0.5-1 units/kg/day (adult dose). Maintain patient on less than 1.2 units/kg/day parallel to growth spurts.

Human Insulin:

Initiate treatment with 0.2-0.4 units/kg/day given subcutaneously thrice a day or increased as per requirement. Maintain the patient on: 0.5-1 units/kg/day given subcutaneously thrice a day or increased as per requirement. Higher doses to given to obese and insulin resistant patients.

Adolescents undergoing puberty may require upto 1.5 units/kg/day while prepubertal children require 0.7-1 units/kg/day or lesser.


Adverse Effect :

Hypoglycaemia is the most common adverse effect. Local reactions and fat hypertrophy at injection site may occur. Symptoms of hypoglycemia are sweating, dizziness, palpitation, tremor, hunger, restlessness, tingling in the hands, feet, lips, or tongue, light-headedness, inability to concentrate, headache, drowsiness, sleep disturbances, anxiety, blurred vision, slurred speech, depressive mood, irritability, abnormal behaviour, unsteady movement and personality changes.


Interaction :

Beta-Blockers, Loop and Thiazide Diuretics, Nifedipine and Corticosteroids: Enhanced hypoglycemic effect.


07/14/2019 19:43:42 Insulin
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