Symptoms: hypoglycemia may develop.
Treatment: the patient can eliminate mild hypoglycemia by ingesting sugar or carbohydrate-rich foods. Therefore, patients with diabetes are recommended to always carry sugar, sweet fruit juice or other sweets.
In severe cases, when the patient loses consciousness, a 40% dextrose solution is administered, iv, p / c, iv — glucagon. After regaining consciousness, the patient is recommended to take a meal rich in carbohydrates to prevent the recurrence of hypoglycemia.
increased individual sensitivity to insulin or other components of the drug,
hypoglycemia.
There are a number of drugs that affect the need for insulin.
The hypoglycemic effect of insulin is enhanced by oral hypoglycemic drugs, MAO inhibitors, ACE inhibitors, carbonic anhydrase inhibitors, non-selective beta-blockers, bromocriptine, octreotide, sulfonamides, anabolic steroids, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, cyclophosphamide, fenfluramine, lithium preparations, drugs containing ethanol.
The hypoglycemic effect of insulin is weakened by oral contraceptives, corticosteroids, thyroid hormones, thiazide diuretics, heparin, tricyclic antidepressants, sympathomimetics, danazol, clonidine, BCC, diazoxide, morphine, phenytoin, nicotine.
Under the influence of reserpine and salicylates, both weakening and strengthening of the effect of the drug is possible.
Colorless or almost colorless, transparent liquid.
From the side of metabolism: hypoglycemic conditions (pallor of the skin, increased sweating, palpitations, tremors, hunger, agitation, paresthesia in the mouth, headache). Severe hypoglycemia can lead to the development of a hypoglycemic coma.
Local reactions: hyperemia, swelling and itching at the injection site, with prolonged use — lipodystrophy at the injection site.
Allergic reactions: rarely-skin rash, Quincke's edema, in isolated cases-anaphylactic shock.
Other: edema, transient refractive errors (usually at the beginning of therapy).
You can not use Biosulin® P, if the solution has become cloudy, colored, or solid particles are detected.
Against the background of insulin therapy, it is necessary to constantly monitor the level of glucose in the blood.
The causes of hypoglycemia, in addition to an overdose of insulin, can be: replacement of the drug, skipping meals, vomiting, diarrhea, increased physical activity, diseases that reduce the need for insulin (impaired liver and kidney function, hypofunction of the adrenal cortex, pituitary gland or thyroid gland), changing the injection site, as well as interaction with other drugs.
Incorrect dosage regimen or interruptions in the administration of insulin, especially in patients with type 1 diabetes, can lead to hyperglycemia. Usually, the first symptoms of hyperglycemia develop gradually, over several hours or days (the appearance of thirst, increased urination, nausea, vomiting, dizziness, redness and dryness of the skin, dry mouth, loss of appetite, the smell of acetone in the exhaled air). If left untreated, hyperglycemia in type 1 diabetes can lead to the development of life-threatening diabetic ketoacidosis.
The dose of the drug should be adjusted for significant physical activity, infectious diseases, fever, thyroid disorders, Addison's disease, hypopituitarism, liver and/or kidney disorders, diabetes mellitus in persons over 65 years of age, increased intensity of physical activity or changes in the usual diet.
Concomitant diseases (especially infectious diseases) and conditions accompanied by fever increase the need for insulin.
The transition from one type of insulin to another should be carried out under the control of blood glucose levels.
The drug reduces the tolerance to alcohol.
Due to the possibility of precipitation in some catheters, the use of the drug in insulin pumps is not recommended.
Influence on the ability to drive vehicles and manage mechanisms
In connection with the primary administration of insulin, a change in its type, or with significant physical or mental stressful effects on the body, it is possible to reduce the ability to drive a car or to control various mechanisms, as well as to engage in other potentially dangerous activities that require increased attention and speed of psychomotor reactions.
type 1 diabetes mellitus (insulin-dependent),
type 2 diabetes mellitus (non-insulin dependent): stage of resistance to oral hypoglycemic agents, partial resistance to these drugs (during combination therapy), intercurrent diseases,
emergency conditions in patients with diabetes mellitus, accompanied by decompensation of carbohydrate metabolism.
It is a human insulin obtained using recombinant DNA technology.
It interacts with a specific receptor of the external cytoplasmic membrane of cells and forms an insulin-receptor complex that stimulates intracellular processes, including the synthesis of a number of key enzymes (hexokinase, pyruvate kinase, glycogen synthetase). The decrease in blood glucose is due to an increase in its intracellular transport, increased absorption and assimilation by tissues, stimulation of lipogenesis, glycogenogenesis, and a decrease in the rate of glucose production by the liver.
The duration of action of insulin preparations is mainly due to the rate of absorption, which depends on several factors (for example, the dose, method and place of administration), and therefore the profile of the action of insulin is subject to significant fluctuations, both in different people and in the same person.
After p / c administration, the onset of action of the drug is noted in approximately 30 minutes, the maximum effect is in the interval between 2 and 4 hours, the duration of action is 6-8 hours.
Suction
The fullness of the suction and the beginning of the effect of insulin depends on the method of administration (p/C or V/m) and injection site (abdomen, thigh, buttocks), the dose (amount of insulin), insulin concentrations of the drug.
Distribution
It is distributed unevenly in the tissues. It does not penetrate the placental barrier and is not excreted in breast milk.
Metabolism
It is destroyed by insulinase mainly in the liver and kidneys.
Output
T1/2 "a few minutes." Excreted in the urine-30-80%.
In a dark place, at a temperature of 2-8 °C (do not freeze).
Keep out of reach of children.
Shelf life of the drug Biosulin® Rsolution for injection of 100 IU / ml — 2 years. After opening the bottles - 6 weeks, cartridges-4 weeks at a temperature of 15-25 °C.
Do not use after the expiration date indicated on the package.
| Solution for injection | 1 ml |
| soluble insulin (human genetically engineered) | 100 IU |
| excipients: glycerol, metacresol, water for injection |
in bottles of 10 ml, in a pack of cardboard 1 bottle or in cartridges of 3 ml, in a contour cell package of 5 pcs. , in a pack of cardboard 1 package.
Data on the use of the drug during pregnancy and during breastfeeding are not provided.
P/ c, v / m, v / v, 30 minutes before a meal or light snack containing carbohydrates.
The dose of the drug is determined by the doctor individually, in each specific case, based on the level of glucose in the blood.
On average, the daily dose is from 0.5 to 1 IU/kg of body weight (depending on the individual characteristics of the patient and the level of glucose in the blood).
The temperature of the injected insulin should correspond to room temperature.
With monotherapy, the frequency of administration is 3 times a day (if necessary, 5-6 times a day). With a daily dose exceeding 0.6 IU / kg, it is necessary to inject 2 or more injections into various areas of the body.
Biosulin® P is usually injected into the anterior abdominal wall. Injections can also be made in the thigh, buttock or the area of the deltoid muscle of the shoulder. It is necessary to change the injection sites within the anatomical area to prevent the development of lipodystrophy.
I / m and I / v Biosulin® P can only be administered under the supervision of a doctor.
Biosulin® P is a short-acting insulin and is usually used in combination with a medium-acting insulin (Biosulin® N).
The injection technique with the use of insulin in vials
If the patient uses only one type of insulin
1. The rubber membrane on the bottle should be disinfected.
2. Fill the syringe with air in the amount corresponding to the desired dose of insulin. Inject air into the insulin bottle.
3. Turn the bottle with the syringe upside down and dial the desired dose of insulin into the syringe. Remove the needle from the vial and remove the air from the syringe. Check the correct set of the insulin dose.
4. Immediately make an injection.
If the patient needs to mix two types of insulin
1. The rubber membranes on the vials should be disinfected.
2. Immediately before the set, roll the bottle of long-acting insulin ("cloudy") between your palms until the insulin becomes evenly white and cloudy.
3. Fill the syringe with air in the amount corresponding to the dose of "cloudy" insulin. Enter air into the bottle with "cloudy" insulin and remove the needle from the bottle ("cloudy" insulin at this stage should not be typed yet).
4. Fill the syringe with air in the amount corresponding to the dose of short-acting insulin ("transparent"). Inject air into a bottle of "clear" insulin. Turn the bottle with the syringe upside down and dial the desired dose of "transparent" insulin. Remove the needle and remove the air from the syringe. Check the correct dose.
5. Insert the needle into the bottle with "cloudy" insulin, turn the bottle with the syringe upside down and dial the desired dose of insulin. Remove the air from the syringe and check the correct dose. Immediately make an injection of the collected mixture of insulin.
6. You should always recruit insulins in the same sequence described above.
The injection technique with the use of insulin in cartridges
Cartridge with the drug Biosulin® P is intended for use only with the Biosulin Pen syringe pen. The patient should be warned about the need to carefully follow the instructions in the instructions for using the syringe pen for injecting insulin.
Before use, make sure that the cartridge with the drug Biosulin® P there is no damage (e.g. cracks). Do not use the cartridge if there is any visible damage. After the cartridge is inserted into the pen, a colored stripe should be visible through the window of the cartridge holder.
After the injection, the needle should remain under the skin for at least 6 seconds. Keep the button pressed until the needle is completely removed from under the skin, so that the correct dose is administered and the possibility of blood or lymph entering the needle or the insulin cartridge is limited.
Cartridge with the drug Biosulin® P is intended for individual use only and is not subject to re-filling.
Injection procedure
1. Use two fingers to collect the skin fold, then insert the needle into the base of the fold at an angle of about 45° and inject insulin under the skin.
2. After the injection, the needle should remain under the skin for at least 6 seconds, in order to make sure that the insulin is completely injected.
3. If blood appears at the injection site after removing the needle, press the injection site with your finger.
4. The injection sites should be changed.
A10AB01 Human Insulin
