Gensulin

Gensulin is a hypoglycemic drug containing insulin.

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Indications Gensulin

It is used for therapy in people with diabetes, which requires the use of insulin.

Release form

The drug is released as an injection suspension, in flasks of glass, having a volume of 10 ml (1 bottle inside the box). Also produced in cartridges with a capacity of 3 ml (5 pieces inside the pack).

Pharmacodynamics

Gensulin is a medicine for recombinant human isophane-insulin, which is produced using genetic engineering techniques, during which genetically modified, non-pathogenic strains of Escherichia coli are used.

Insulin is a hormone that is produced by the cells of the pancreas. He is a participant in the processes of carbohydrate, fat and protein metabolism - for example, reduces blood sugar levels. Deficiency of insulin inside the body leads to the appearance of diabetes mellitus.

The insulin injected through the injection has an effect similar to that of the hormone produced by the body.

Pharmacokinetics

The effect of the drug begins half an hour after the injection. Peak parameters of the therapeutic effect are noted in the period of 2-8 hours from the moment of administration, and its total duration is 24 hours and is determined by the size of the used portion.

In a healthy person, about 5% of insulin is synthesized with a blood protein. The presence of insulin in the cerebrospinal fluid was recorded at values equal to approximately 25% of the level found inside the blood serum.

The processes of insulin exchange occur inside the kidneys with the liver. A small part of the substance is metabolized inside the adipose tissue and musculature. Metabolism in diabetics proceeds analogously to metabolic processes in a healthy person.

Excretion of the substance is carried out by the kidneys. Trace volumes of drugs are excreted together with bile. The half-life of the component is about 4 minutes.

Hepatic or renal pathologies can delay the excretion of insulin. In older people, the processes of insulin elimination proceed at a lower rate, which is why the period of hypoglycemic influence of drugs increases.

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Dosing and administration

There is a large number of different therapeutic regimens using human insulin. Selection of the optimal treatment method suitable for each patient is performed by the doctor, taking into account the need of the patient for obtaining insulin. Based on the selected blood sugar concentration, the doctor selects a suitable portion and type of insulin medication for a particular patient.

Gensulin is administered by the subcutaneous method. Only in exceptional cases, its intramuscular administration is allowed. The medicine should be used 15-30 minutes before eating. In this case, you need to remove the drug from the refrigerator 10-20 minutes before the injection - so that the medicine has heated to room temperature.

Before using the substance, you should carefully inspect the cartridge or bottle with insulin. The injection suspension should have an opaque uniform appearance (milky or uniformly cloudy). It is forbidden to use a suspension that has remained clear after mixing, or a white precipitate appeared on the bottom of the container. In addition, the medication is not used in situations where after mixing inside the cartridge / vial flakes of substance float or on its walls there are small particles (this gives the drug a frozen form). It is also very important to ensure that the needle does not enter the lumen of the vessel when injected.

Injection medication through syringes.

For insulin injections, special syringes with dosage marks can be used. If there are no disposable needles and syringes, it is allowed to use reusable (they are sterilized before each new procedure). Use one type of syringe from one manufacturer. In addition, it is always necessary to check whether the syringe used is proportioned according to the portion of the insulin used.

It is required to agitate the bottle with the suspension until it acquires a milky or cloudy uniform appearance.

Insulin should be administered for at least 5 seconds, after pushing the piston of the used syringe to the stop. After removing the needle, it is required to apply a tampon for a few seconds to the injection site, which was previously impregnated with alcohol. Skin in the area of the injection can not be wiped.

To avoid damage to the skin and subcutaneous tissues, each new injection should be performed in a new place - each of them should be 1-2 cm from the previous one.

Use Gensulin in cartridges for special syringe handles.

Drug cartridges are used together with reusable handles of "Re" type syringes. When the pen is filled, the needle is attached to it, and the injection of the drug is carried out, follow the instructions of the manufacturer's instructions exactly. If required, it is allowed to take the substance from the cartridge into a standard insulin syringe.

Use Gensulin during pregnancy

Insulin is unable to penetrate the placenta.

Those patients who have diabetes even before or during pregnancy (gestational diabetes) need to carefully monitor the processes of carbohydrate metabolism throughout this period. The body's need for insulin can decrease on the 1st trimester and increase on the 2nd and 3rd. After the birth of the child, there is a sharp decrease in the patient's need for insulin, which increases the likelihood of developing hypoglycemia. In this regard, it is very important to closely monitor glucose.

There are no restrictions on the use of Gensulin in lactation. But breastfeeding women may need to change the dosage of LS and diet regimen.

Contraindications

The main contraindications:

• hypoglycemia;
• the presence of strong sensitivity with respect to the drug and its constituent elements (except for cases of using desensitizing treatment);
• intravenous administration of the drug.

Side effects Gensulin

A side symptom of the use of the drug is hypoglycemia - during insulin therapy it is noted most often. This disease develops in cases when the portion of insulin used exceeds many times the existing need for its receipt. In severe attacks of this disease (especially if they repeatedly develop), the function of the NS may be affected. Hypoglycemia, which is of a prolonged or severe nature, can be dangerous to the life of the patient.

Symptoms of moderate-onset hypoglycemia: dizziness, hunger, hyperhidrosis, anxiety, trembling, and tingling in the area of the feet and palms, tongue or lips. There may also be a feeling of confusion or drowsiness, a disturbance of mindfulness or sleep, visual fuzziness, depression, mydriasis, a feeling of irritability and speech disorder. Among the manifestations of severe form of pathology: loss of consciousness, orientation disorder and convulsions.

In many patients, development of signs demonstrating a lack of glucose intake in the region of cerebral tissues (the appearance of neuroglycopenia) is preceded by symptoms of counter-regulation of the adrenergic type. Usually, the faster and in greater volumes the blood glucose is lowered, the more intense is counter-regulation, and the characteristic manifestations become more pronounced.

There may also be abnormalities on the part of the visual organs. A significant change in blood glucose values can lead to transient visual disturbance due to transient changes in turgor, as well as a refractive disorder in the lens.

The likelihood of progression of the diabetic form of retinopathy is weakened in the event of prolonged glycemic observation. But increasing the degree of insulin therapy, together with a sharp drop in the blood glucose level, can lead to a worsening of the course of the disease. In individuals with a proliferative form of retinopathy (especially those who have laser photocoagulation procedures) severe forms of hypoglycemia can be a cause of transient blindness.

As with any insulin, lipodystrophy can develop at the drug injection site, because of which the rate of absorption of the substance from this site decreases. Due to the constant change of injection sites within a limited injection area, it is possible to reduce the severity of this manifestation or prevent its development.

Signs in the zone of injection of drugs, as well as allergy symptoms - among such swelling, skin reddening, itching, pain, bruising, swelling, hives, or inflammation. Most of the light reactions to the action of insulin appearing on the injection site, often disappears in a few days or weeks.

Allergy to insulin, which has a generalized character (including severe forms of impairment here), manifests itself in the form of dyspnea, rashes throughout the body, weakening of blood pressure, wheezing, hyperhidrosis and increased heart rate.

Immediate manifestations of intolerance appear only once. Among them, such reactions as generalized skin symptoms, bronchial spasms, Quincke edema, a decrease in blood pressure and a shock condition, which can be dangerous for the life of the patient, stand out.

Among other features, the formation of antibodies to insulin is recognized as a reaction to its use. Occasionally, the presence of antibodies may provoke the need to change the portion of medicines to prevent the development of hyper- or hypoglycemia.

Insulin can cause sodium retention inside the body and the development of edemas, especially in situations where an increase in the intensity of insulin therapy can improve the previously inadequate glycemic observation.

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Overdose

Insulin intoxication causes signs of hypoglycemia, including dizziness, apathy, hunger, orientation disorder, anxiety or confusion, as well as muscle tremor, vomiting, palpitations, hyperhidrosis and headaches. A moderate degree of hypoglycemia can be eliminated by eating carbohydrate-rich foods or sweet liquids. Also need a little rest. Patients are required to always carry glucose, sugar pieces or sweets. It is forbidden to eat chocolate, because the fat contained in it prevents the absorption of glucose.

At a severe degree of hypoglycemia, convulsions appear, a loss of consciousness is observed and death may occur. In a comatose patient, glucose is injected into the / in the method.

When Gensulin is poisoned with hypoglycemia, signs of hypokalemia can be added, which then go on to myopathy. If there is severe hypokalemia, in which the patient is unable to consume food orally, intramuscular glucagon (1 mg) or a glucose solution intravenously is required. When the consciousness returns, the patient needs to eat. In addition, there may be a need to continue the consumption of carbohydrates with subsequent monitoring of blood sugar, because the development of hypoglycemia may occur after the patient recovers.

Interactions with other drugs

Gansulin is forbidden to combine with insulin, having an animal nature, and besides this with insulin of the biosynthetic type from other producers.

A large number of medications (including cardiac and antihypertensive drugs, drugs that lower serum lipid values, drugs used in pancreatic diseases, anticonvulsants, individual antidepressants, antibacterial drugs, salicylates and oral contraception) has an effect on insulin activity and the effectiveness of insulin treatment.

Medicines and substances that increase the effect of insulin: MAOI (antidepressants), chloroquine, β-adrenolytics, clonidine with methyldopa and salicylates, and besides this, ACE inhibitors, pentamidine, tetracycline with cyclophosphamide, anabolic, ethyl alcohol, sulfonamides and antibiotics from the category of quinolones .

Medicines that weaken the effectiveness of insulin: estrogens (among them also OK), heparin, dobutamine with phenytoin and diltiazem, and in addition GCS, phenothiazines, pancreatic hormones, niacin with calcitonin, antiviral drugs used for HIV therapy, and thiazide diuretics .

An increase in the need for insulin production can be noted with the use of drugs that have a hyperglycemic effect - among them hormones thyroid, GCS, thiazides, STH, danazol and β2-sympathomimetics (among them salbutamol with ritodrin and terbutaline).

Decreased drug demand is weakened by the use of medications that have hypoglycemic effects - among them salicylates (eg, aspirin), alcoholic beverages, indiscriminate beta-blockers, ingested anti-diabetic drugs, individual ACE inhibitors (enalapril with captopril), as well as individual antidepressants (MAOI).

Substances that are analogs of somatostatin (such as lanreotide or octreotide) are able to both weaken and increase the body's need for obtaining insulin.

With the combined use of Gensulin with pioglitazone substance, symptoms of heart failure may be noted, especially in people with risk factors for the latter. If such a combination is necessary, you need to constantly monitor the patient, monitoring the appearance of symptoms of heart failure and swelling, as well as weight gain. If the heart signs began to deteriorate, the use of pioglitazone should be stopped.

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Storage conditions

Gensulin should be kept out of the reach of children and sunlight. Do not freeze the drug. The temperature at the content is within the limits of marks 2-8 ° С.

Shelf life

Gensulin is allowed to be used within 24 months after the release of the therapeutic drug. Open packaging can be stored at temperature values of no more than 25 ° C for 42 days.

Application for children

There is insufficient data on the use of medication in pediatrics.

Analogues

The analogues of the medication are B-insulin, Monodar and Rinsulin with Vosulin and Monotard, and besides Insuman, Protafan and Khumulin npx with Farmasulin.

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