NPH Neutral Protamine

Most adult drugs must be diluted to achieve appropriate pediatric dosages. Some drugs must be diluted several times. This introduces the potential for significant error in dilution. Some drugs such as NPH (Neutral Protamine Hagedorn) insulin may lose their effectiveness if diluted. 

Extent and duration of action of various types of insulin (in a fasting diabetic). NPH= neutral protamine Hagedom. 

NPH Neutral protamine Hagedom (isophane insulin) s.c. Subcutaneous(ly)... 

Glargine has a similar insulin receptor affinity as NPH (Neutral Protamine Hagedom, an intermediate-acting insulin that initially achieves slower action through the addition of protamine to short-acting insulin) so that once absorbed in the circulation, glargine is... 

Regular insulin (human) is clear solution of zinc insulin. Its time of onset is 30-60 min with peak activity at 2-3 hand duration of 3-6 h. The widely used insulin NPH (neutral protamine Hagedom) is a suspension of zinc insulin co-crystallized with protamine and has a slower onset (2-4 h) with longer time to peak (4-lOh) and duration of action (10-16h). Insulin lente is a suspension of mixed amorphous and crystalline zinc insulin, with onset time of 3-4 h and a duration of 12-18 h. Insulin ultralente, which is a suspension of crystalline insulin with a high zinc content, is the slowest onset (6-10 h) and longest duration (18-20h) of these preparations. Peak plasma concentrations occur after about 10 h with insulin ultralente (36). 

Neutral Protamine Hagedorn, better known as NPH insulin, is prepared by a process in which protamine is conjugated with... 

Neutral protamine Hagedorn (NPH) differs from extended insulin Zn suspension in which of the following actions ... 

Neutral protamine hagedorn (NPH) is intermediate-acting. Variability in absorption, inconsistent preparation by the patient, and inherent pharmacokinetic differences may contribute to a labile glucose response, nocturnal hypoglycemia, and fasting hyperglycemia. 

Isophane or Neutral Protamine Hagedorn (NPH) insulin (HUMINSULIN-N) 40 lU/ml SC... 

NPH Insulin Neutral Protamine Hagedorn Insulin equivalent to isophane insulin... 

Semilente insulin is a suspension of amorphous insulin zinc. The onset is 1-3 hours after subcutaneous administration, reaches maximum effect in 5-10 hours and the effect lasts 10-16 hours. Isophane insulin (NPH Neutral solution. Protamine, Hagedorn s laboratoiy insulin) is an intermediate-acting preparation prepared with protamine. The maximum effect is reached in 4-12 hours and lasts 8-26 hours. Patients using these preparations who present for cardiac surgery are at increased risk for anaphylactic reactions to protamine. Ultralente insulin is a long-acting preparation formed with zinc rather than protamine. Zinc retards the release of insulin and these preparations have a duration of up to 36 hours. Protamine zinc insulin, which contains both protamine and zinc, has a duration of 28-36 hours. 

Jehle PM, Micheler C, Jehle DR, Breitig D, Boehm BO. Inadequate suspension of neutral protamine Hagendorn (NPH) insulin in pens. Lancet 1999 354(9190) 1604-7. 

Isophane insulin suspension This insulin, sometimes called neutral protamine Hagedom, NPH, is a suspension of crystalline zinc insulin combined at neutral pH with the positively charged polypeptide, protamine. Its duration of action is intermediate. 

Humalog Mix 50/50 (50% neutral protamine lispro, 50% lispro) NPH-regular combinations Yes 3-mL pen... 

Intermediate-acting insulins are either the neutral protamine Hagedorn insulin (NPH isophane insulin suspension) or the Lente insulin (insulin zinc suspension) the former is a suspension of the insulin-protamine-zinc complex in a phosphate buffer and the latter is a mixture of crystallized and amorphous insulin in acetate buffer. These preparations have an onset of action within about 2h, peak activity after about 4-12 h, and a duration of up to 24 h (Table 4). Commercially available mixtures of soluble insulins and isophane insulins have activities that would normally place them within the intermediate-acting category. Mixed insulin-zinc suspensions are sometimes classified as either intermediate- or long-acting as the duration of action may be up to 30 h. 

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