Insulin Isophane NPH Pharmacology
Insulin Isophane NPH
Insulin stimulates glucose transport across cell membrane by ATP dependent translocation of glucose transporters GLUT1 and GLUT4 to the plasma membrane and by increasing their activity. Insulin promotes the expression of genes directing synthesis of glucose transporters. It also regulates genes for a large number of enzymes and carriers primarily through muscle action potential (MAP) kinases
Insulin causes increased production of glucokinase improves intracellular utilization of glucose. It also stimulates glycogen synthetase and enhances glycogen synthesis and inhibits phosphorylase and thus decreases glycogenolysis in liver. Insulin reduces synthesis of phosphoenol pyruvate carboxykinase and inhibits gluconeogenesis. It inhibits lipolysis in adipose tissue and favours triglyceride synthesis. Insulin increases clearance of VLDL and chylomicrons by stimulating transcription of vascular endothelial lipoprotein lipase. Insulin improves synthesis of proteins from amino acids and prevents breakdown of proteins.
Distribution: It is widely distributed throughout the body.
Metabolism: It is metabolized in liver, muscles, and kidney.
2. Lipodystrophy at injection site
4. Insulin resistance
2. Along with other drugs
3. Along with alcohol
6. Hepatic impairment
7. Renal impairment
8. Rotate the injection site
2. Type II diabetes mellitus
3. Pregnant diabetics
4. Type II diabetes associated with chronic infections like tuberculosis
Drugs which increase hypoglycaemic effect of insulin : Alcohol, anabolic steroids, beta-blockers, clofibrate, guanethidine, MAO inhibitors, phenylbutazone, salicylates, tetracyclines.
Adults and children: 0.5 to 1U/kg/day. Adjust dosage based on blood glucose level.
Adolescents: 0.8 to 1.2 IU/kg/day
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