Protamine zinc. Medicinal reference book geotar. Injection technique when using insulin in vials

Currently, a combination of insulin and protamine-zinc-insulin is also used. When both insulin and protamine-zinc-insulin are injected at the same time (the injection is done with one needle, but with two syringes), only the direction of the needle under the skin is changed.

With this combination, when insulin is administered, blood sugar decreases in the first 5 - 6 hours, and the gradually increasing effect of protamine-zinc insulin ensures a further decrease in blood sugar throughout the day.

The Moscow Plant of Endocrine Preparations produces insulin-zinc suspensions with extended action.

According to instructions: insulin suspension various shapes in acetate buffer with pH 7.1 - 7.3. As a preservative, 0.3% phenol solution. Preparations are prepared from crystalline and amorphous insulin.

There are three insulin options long acting

1. Insulin-zinc-suspension of amorphous insulin (IZS-A). Duration of action is 10 - 12 hours. Maximum effect during the first 7 hours.
2. Insulin-zinc-crystalline insulin suspension (ICS-C). Duration of action is from 24 to 30 - 36 hours. Maximum effect after 12 - 18 hours.
3. Insulin-zinc suspension (IZS) is a mixture of amorphous and crystalline insulin-zinc suspensions in a ratio of 3:7. Duration of action is up to 20 - 24 hours. Maximum effect after 8 - 10 hours.

The administration of these drugs is only subcutaneous. They cannot be administered intravenously. 1 ml contains 40 units of insulin.

The duration of action of crystalline zinc insulin suspension exceeds the duration of amorphous one. A mixture of these drugs ICS-K and ICS-A ensured uniformity of action and duration of action and, as observations have shown, for many patients it turned out to be the most convenient.

In some cases, it is possible to use amorphous and crystalline suspensions of zinc insulin in other ratios. Combinations of insulin-zinc suspension with fast-acting insulin are also acceptable.

"Hyperglycemic syndrome"
L.N.Anosova

See also:

Extended-acting insulin preparation in the form of a suspension. It is obtained by adding a solution of protamine, zinc chloride and sodium phosphate to a solution of crystalline insulin. Sterile aqueous suspension white; When shaken, it should not contain large particles.

When standing, the suspension separates with the formation of sediment and colorless liquid. Preserved with tricresol or phenol (0.25-0.3% solution), suspension pH = 6.9-7.3. Activity is determined biologically. 1 ml contains 40 units of insulin.

Compared to regular insulin, protamine-zinc insulin has a delayed and prolonged effect. A decrease in blood sugar is observed within 12-24 hours after administration of the drug. Injections are given only subcutaneously. Injection into a vein is not permitted. Used only in the treatment of diabetes mellitus (simultaneously with a rational diet).

Doses are set individually, ranging from 20 to 60 units, depending on the severity of the disease. With average and severe forms diabetes mellitus, when the injection of regular insulin must be done 3-4 times a day, replace 2/3 of the total amount with one injection of protamine-zinc insulin; 1/3 is supplemented with regular insulin, which is administered until the effect of protamine-zinc-insulin develops.

For precomatose and comatose states and if there is a tendency to acidosis, the drug is not used.

Release form: bottles of 5 and 10 ml. Before drawing the drug into the syringe, the bottle must be shaken until a uniform suspension is formed. Store in a cool place, protected from light.

"Medicines", M.D. Mashkovsky

Protamine-zinc-nisulin suspension for injection - a drug insulin groups.

long-acting insulin preparation with protamine.

Synonym: Insulinum ultralente.

Release form. Hermetically sealed bottles of 5 ml with an activity of 40 units in 1 ml.

Pharmacokinetics. Has a prolonged effect. The hypoglycemic effect occurs 6-8 hours after administration, reaches a maximum after 12-17 hours, lasts up to 24-30 hours. The prolonged effect is due to slow absorption drug from the depot.

Application. At diabetes mellitus with the flow moderate severity and severe, especially in cases of high nighttime glycemia and glucosuria. The dose is selected strictly individually according to the glycemic and glucosuric profile, administered only subcutaneously ( intravenous administration contraindicated), usually in the morning before breakfast. Due to its slowly developing effect, it is prescribed in combination with an aqueous solution of crystalline insulin or with one of the insulins average duration action (insulin B, amorphous zinc insulin suspension). IN in rare cases there is a need to combine three types of insulin: regular (6-hour action), medium duration (10-12 hour action) and longer action. Doses of these drugs are selected strictly individually. It is advisable to prescribe long-acting insulin preparations after diabetes has been compensated with the help of aqueous solution crystalline insulin. To mix various drugs Insulin is not allowed in one syringe.

Before use, the bottle of protamine-zinc-insulin suspension must be shaken until a uniform mixture is formed.

Contraindications for use. Comatose and precomatose states, infectious diseases, period of delivery and surgical treatment patients with diabetes mellitus. In the future, after the condition improves, patients can again be prescribed treatment with long-acting insulin.

Side effect. Allergic reactions and hypoglycemic conditions, lipodystrophy at the injection sites.

Interaction with other drugs. Cm. .

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