Insulin, injectable

Insulin is a peptide hormone, secreted by the pancreas, that regulates glucose metabolism in the body. Insufficient production of insulin or failure of insulin to stimulate target sites in liver, muscle, and adipose tissue leads to the serious metabolic disorder known as diabetes mellitus. Diabetes afflicts millions of people worldwide. Diabetic individuals typically exhibit high levels of glucose in the blood, but insulin injection therapy allows diabetic individuals to maintain normal levels of blood glucose. 

BENZENESULFONIC ACID DERIVATIVES As has been discussed previously, substituted -alkylbenzene-sulfonylureas often possess the property of releasing bound insulin, thus sparing the requirement for insulin injections in adult-onset diabetes. A pyrimidine moiety, interestingly, can serve as a surrogate for the urea function. 

Therapeutic Function Hypoglycemic Chemical Name Isophane insulin Common Name Isophane insulin injection... 

Those with type 1 diabetes mellitus produce insulin in insufficient amounts and tiierefore must have insulin supplementation to survive Type 1 diabetes usually has a rapid onset, occurs before die age of 20 years, produces more severe symptoms tiian type 2 diabetes, and is more difficult to control. Major symptoms of type 1 diabetes include hyperglycemia, polydipsia (increased thirst), polyphagia (increased appetite), polyuria (increased urination), and weight loss. Treatment of type 1 diabetes is particularly difficult to control because of the lack of insulin production by die pancreas. Treatment requires a strict regimen tiiat typically includes a carefully calculated diet, planned physical activity, home glucose testing several times a day, and multiple daily insulin injections. 

Administration of insulin—sites to be used rotation of injection sites (see Home Care Checklist Rotating Insulin Injection Sites) angle of injection administration at die time of day prescribed by the health care provider disposal of die needle and syringe... 

TABLE 40-10. Non-insulin Injectible Agents for the Treatment of Diabetes Mellitus... 

Administer intermediate or long-acting insulin as soon as patient is eating. Allow for overlap in insulin infusion and subcutaneous insulin injection. 

Linear descendants of the antimicrobial sulfonamides, the orally active sulfonylureas continue to be of interest as alternatives to insulin injections in patients with adult-onset diabetes. Tolpyrramide (153) is synthesized from unsymmetrical O-methylurea... 

Insulin, at typical normal plasma concentrations (approximately 1 x 10-9 mol l-1) exists in true solution as a monomer. Any insulin injected directly into the bloodstream exhibits a half-life of only a few minutes. 

In both types of diabetes, however, this normal process malfunctions. A gland called the pancreas, found just behind the stomach, makes insulin. In people with insulin-dependent diabetes, the pancreas does not produce insulin at all. This condition usually begins in childhood and is known as Type I (formerly called juvenile-onset) diabetes. These patients must have daily insulin injections to survive. People with non-insulin-dependent diabetes usually produce some insulin in their pancreas, but their bodies tissues do not respond well to the insulin signal and, therefore, do not metabolize the glucose properly, a condition known as insulin resistance. 

A physician orders 1 unit of insulin injection subcutaneously for every 10 mg% of blood sugar over 175 mg% with blood sugar levels and injections performed twice daily in the morning and evening. The patient s blood sugar was 210 mg% in the morning and 320 mg% in the evening. How many total units of insulin injection should be administered ... 

How many mL of Regular U-100 insulin injection should be used to obtain 60 units ... 

When there is insufficient insulin to bind to receptors, the cells are starved because sugar cannot reach the interior to provide energy for vital biological processes. Patients with IDDM become unwell when this happens. They depend on insulin injection for survival. 

Exubera is an inhaled insulin. It represents a major step forward since the first insulin injection was approved in the 1920s. The insulin particles are formulated to a certain micron size for deep lung delivery. An inhaler is used to achieve the delivery. The large surface area of the thin alveolar walls in the lungs allows for fast absorption of the insulin into the bloodstream. 

Each pramlintide dose should be administered subcutaneously into the abdomen or thigh (administration into the arm is not recommended because of variable absorption). Injection sites should be rotated so that the same site is not used repeatedly. The injection site selected should also be distinct from the site chosen for any concomitant insulin injection. Patients should always use a new syringe and needle to give pramlintide and insulin injections. 

ISOPHANE INSULIN SUSPENSION (NPH) AND INSULIN INJECTION (REGULAR) ... 

Severe ketoacidosis/diabetic coma Insulin injection (regular insulin) may be given IV or IM for rapid effect in severe ketoacidosis or diabetic coma. 

Concentrated insulin injection frequently has a duration similar to repository insulin a single dose demonstrates activity for 24 hours. 

Lipoatrophy- Lipoatrophy is the breakdown of adipose tissue at the insulin injection site causing a depression in the skin. 

Lipohypertrophy- Lipohypertrophy is the result of repeated insulin injection into the same site. This condition may be avoided by rotating the injection site. 

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