Insulin isophane
Insulin isophane or NPH insulin is a man-made form of a hormone that is produced in the body. It works by lowering levels of glucose (sugar) in the blood. Insulin isophane is a long-acting form of insulin that is slightly different from other forms of insulin that are not man-made.Insulin isophane is used to treat diabetes.
Mechanism of effect
The primary activity of insulin is the regulation of glucose metabolism Insulin isophane binds to the insulin receptor (IR).
Pharmacodynamic
When 0.3 Units/kg of NPH insulin was subcutaneously administered, the onset of action was approximately 0.8 hours. The duration of action was 13.2 hours. The peak activity of NPH insulin occurs 4-6 hours post-dose. Compared to insulin glargine, NPH insulin has a quicker onset of action and shorter duration of action
Pharmacokinetics
NPH insulin is generally well and rapidly absorbed from the site of injection.Vd is 0.15 L/kg. Protein binding: 5% protein bound. Insulin is predominantly cleared by metabolic degradation via a receptor-mediated process
Dosage
Isophane insulin (NPH) is an intermediate acting insulin which is administered 1 to 3 times daily. It may provide 30 to 50% of the daily basal insulin requirements. Insulin dosage should be individualized to achieve/maintain a target blood glucose level and is determined by various factors including body weight, body fat, physical activity, insulin sensitivity, blood glucose levels, and target blood glucose
Alerts
1-Do not use this medicine if you are allergic to insulin, or if you are having an episode of hypoglycemia 2-To make sure you can safely use insulin isophane, tell your doctor if you have liver or kidney disease 3-Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, pale skin, irritability, dizziness, feeling shaky, or trouble concentrating 4-Do not give IV or IM.
Points of recommendation
1-Do not change the brand of insulin or syringe you are using without first talking to your doctor or pharmacist. Some brands of insulin isophane and syringes are interchangeable, while others are not. Your doctor and/or pharmacist know which brands can be substituted for one another 2-Avoid drinking alcohol. Your blood sugar may become dangerously low if you drink alcohol while using insulin isophane 3-Check your blood sugar carefully during times of stress, travel, illness, surgery or medical emergency, vigorous exercise, or if you drink alcohol or skip meals 4-At least twice weekly blood glucose monitoring is recommended for type I and II diabetes on conventional insulin therapy 5-Urine ketone testing is recommended for patients with type I diabetes if they develop symptoms of colds, influenza, nausea, vomiting, or other illnesses, polyuria, or if blood glucose levels are unexpectedly high or inconsisten 6-Glycosylated hemoglobin measurements are recommended every 3 months 7-At least yearly serum creatinine, BUN, ECG determinations, and ophthalmologic examinations are recommended.
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