Pharmacological action Novolog Pen Mix 70/30:
Novolog Pen Mix 70/30 Hypoglycemic agent, an analogue of human insulin intermediate-acting. Interacts with a specific receptor of the outer membrane of cells to form insulin-receptor complex, stimulating intracellular processes, including synthesis of several key enzymes (hexokinase, pyruvate kinase, glikogensintetaza). Reducing the concentration of blood glucose due to an increase of intracellular transport, increased assimilation tissue, stimulation of lipogenesis, glikogenogeneza, reduced hepatic glucose production speed. Has the same activity with human insulin in a molar equivalent. Substitution of the amino acid proline at position B28 on the aspartic acid reduces the tendency of molecules to form hexamers in the soluble fraction of the drug, which occurs in a soluble human insulin. In this regard, insulin aspart is absorbed from the subcutaneous fat more quickly than soluble insulin, contained in a two-phase human insulin. Insulin aspart protamine soaked longer. After the s / c injection effect develops after 10-20 minutes, the maximum effect – after 1-4 hours duration of action of up to 24 hours (depending on the dose, injection site, blood flow, body temperature and physical activity).
Uses Novolog Pen Mix 70/30:
Diabetes mellitus type 1. Diabetes mellitus type 2 (in the case of resistance to oral hypoglycemic agents, partial resistance to these drugs during combination therapy, intercurrent disease).
Contraindications Novolog Pen Mix 70/30:
Hypersensitivity, hypoglycemia, age 18 years.
Side effects Novolog Pen Mix 70/30:
At the beginning of treatment – swelling, violation of refraction (usually of a temporary nature). Local allergic reactions: redness, swelling, itching at the injection site. Generalised allergic reactions: skin rash, itching, increased sweating, gastrointestinal dysfunction, angioedema, shortness of breath, tachycardia, decreased blood pressure. Lipodystrophy in place vvedeniya.Peredozirovka. Hypoglycemia: the “cold” sweat, pale skin, nervousness, tremor, anxiety, unusual tiredness, weakness, disorientation, impaired concentration, dizziness, expressed the feeling of hunger, temporary blurred vision, headache, nausea, tachycardia, loss of consciousness, temporary or irreversible disruption of brain death. Treatment: the patient is a minor hypoglycemia can fix itself, taking into glucose, sugar or carbohydrate-rich foods. In severe cases – a / c 40% dextrose; / m, n / a – glucagon. After regaining consciousness the patient is recommended to take food rich in carbohydrates to prevent recurrence of hypoglycemia.
Dosage and administration Novolog Pen Mix 70/30:
N / a in the region of the thigh or abdominal wall. If necessary – in the shoulder area, or buttocks. Necessary to change the injection site within the anatomical region to prevent the development of lipodystrophy. The drug is administered immediately before a meal, if necessary – immediately after a meal. Low insulin must correspond to room temperature. Dose is determined by the physician individually in each case based on the concentration of glucose in the blood. The average daily dose of 0.5-1 U / kg body weight. In patients with insulin resistance (including in relation to obesity), daily insulin requirement may be increased, and patients with residual endogenous insulin secretion – is reduced.
Cautions Novolog Pen Mix 70/30:
Do not enter into / in. Inadequate dosage or discontinuation of treatment, especially for patients with diabetes type 1 may lead to the development of hyperglycemia or diabetic ketoacidosis. Typically, the symptoms of hyperglycemia occur gradually over several hours or days. Symptoms of hyperglycemia include nausea, vomiting, drowsiness, flushed dry skin, dry mouth, increased number of urine, thirst and loss of appetite, as well as the odor of acetone in exhaled air. If left untreated, hyperglycemia can lead to death. After compensation of carbohydrate metabolism, such as intensive insulin therapy, patients may change their typical symptoms of hypoglycemia, the harbingers of what patients should be informed. In patients with diabetes with optimal metabolic control of diabetes, late complications develop later and progresses more slowly. In this regard, it is recommended to carry out activities aimed at optimizing metabolic control, including control of blood glucose concentration. The drug should be administered in immediate relation to food intake. It should be a high rate of onset of effect of the drug in the treatment of patients with comorbidities or those taking drugs that slow down the absorption of food. In the presence of concomitant diseases, particularly infectious nature, the need for insulin, as a rule, increases. Renal failure or liver disease may lead to a reduction in insulin requirements. Skipping a meal or unplanned physical activity can lead to hypoglycemia. Compared with biphasic human insulin, a drug has a stronger hypoglycemic effect in the first 6 h after injection. In this regard, in some cases, may require dosage adjustment of insulin and / or the nature of power. The transfer of patients to a new type of insulin or insulin medication, etc. manufacturer must carry out under strict medical supervision, may require dosage adjustment. Patients switching to treatment with insulin aspart may need to change the dose, compared with doses previously used insulin. If necessary, dose adjustment, it can be done at the first administration of the drug or during the first weeks or months of treatment. In addition, changing the dose may be required when changing diets and increased physical activity. Exercise performed immediately after a meal may increase the risk of hypoglycemia. You can not use the drug in insulin pumps. Clinical experience with insulin aspart in pregnancy is limited. Animal studies have found no differences between embryotoxic and teratogenic insulin aspart and human insulin. In the period of possible pregnancy and throughout its term is necessary to conduct careful monitoring of patients with diabetes and control blood glucose. Insulin requirements usually decrease in the I trimester and gradually rises in the II and III trimester of pregnancy. During childbirth and immediately after their need for insulin can dramatically decrease, but quickly returned to a level that was before pregnancy. During the period of lactation may be necessary to correct dose. Patients’ ability to concentrate and the reaction rate can be violated in the development of hypoglycemia and hyperglycemia, which can be dangerous when driving or operating machinery. Patients should be advised to take measures to prevent hypoglycemia and hyperglycemia while driving and using machinery. This is especially important for patients with no or reduced symptoms, precursors of developing hypoglycemia or frequent episodes of hypoglycemia sufferers. In these cases, should consider the implementation of such works.
Interaction Novolog Pen Mix 70/30:
Hypoglycemic effect of insulin increase the oral hypoglycemic drugs, MAO inhibitors, ACE inhibitors, carbonic anhydrase inhibitors, nonselective beta-blockers, bromocriptine, octreotide, sulfonamides, anabolic steroids, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, preparations Li +, ethanol and etanolsoderzhaschie drugs. Hypoglycemic effect of insulin impair oral contraceptives, corticosteroids, thyroid hormones, thiazide diuretics, heparin, antidepressants, sympathomimetics, danazol, clonidine, BCCI, diazoxide, morphine, phenytoin, nicotine. Under the influence of reserpine and salicylates may as weakening or strengthening of the drug.
