インスリン

使用用途

• Diabetic ketoacidosis (Regular insulin)
• Diabetic ketoacidosis (Glargine)
• Severe hyperkalemia
• Uncomplicated diabetes mellitus (Glargine, Detemir, or PZI)
• Uncomplicated diabetes mellitus (ProZinc)
• Uncomplicated diabetes mellitus (Vetsulin)
• Uncomplicated diabetes mellitus (Lente)
• Diabetes mellitus
• Adjunctive treatment of ketosis
• Diabetes mellitus
• Hyperlipemia in ponies
• Diabetes mellitus
• Diabetic ketoacidosis (Intermittent IM technique)

投与方法

考えられる副作用

• Hypoglycemia (most common and potentially life-threatening)
• Insulin-induced hyperglycemia ('Somogyi effect' due to counter-regulatory hormone release following hypoglycemia)
• Insulin antagonism or resistance
• Rapid insulin metabolism
• Local hypersensitivity reactions to 'foreign' proteins
• Lipodystrophy at the injection site (if sites are not rotated)

注意事項と禁忌

• Episodes of hypoglycemia (absolute contraindication)
• Systemic allergy to pork or pork products (specifically for Vetsulin/porcine lente)
• Because there are no alternatives for insulin in diabetic indications, there are no absolute contraindications except during hypoglycemia. * **Antibody Formation:** Beef/pork insulin produces antibody formation in ~45% of dogs, leading to erratic control. Pork insulin is identical to canine insulin and is preferred. Cats have a low incidence of antibody production regardless of source. * **Injection Site:** Do not inject at the exact same site day after day to prevent lipodystrophic reactions. * **Prescription Safety:** Do NOT abbreviate Units as 'U', as it significantly increases the rate of transcription and fatal dosage errors (often misread as a zero).

薬物相互作用

• Beta-adrenergic blockers (e.g., propranolol): Can have variable effects on glycemic control and can mask the clinical signs associated with hypoglycemia.
• Clonidine, Reserpine: Can mask the signs associated with hypoglycemia.
• Digoxin: Insulin alters serum potassium levels; concurrent use requires close monitoring for cardiac arrhythmias, especially with concurrent diuretics.
• Alcohol, Anabolic steroids, ACE inhibitors, Aspirin, Disopyramide, Fluoxetine, MAOIs, Somatostatin derivatives, Sulfonamides: May potentiate the hypoglycemic activity of insulin.
• Calcium channel blockers, Corticosteroids, Danazol, Diuretics, Isoniazid, Niacin, Phenothiazines, Thyroid hormones: May decrease the hypoglycemic activity of insulin (cause insulin resistance).

よくある質問