Class

Endogenous hormone

Mechanism of action
  • Acts on ligand-regulated tyrosine kinase receptor
  • Promotes uptake of glucose from blood into tissues, especially fat, liver, skeletal muscle
  • Promotes glycogen synthesis
Formulations
  • IV or SC administration
  • Rapid and short acting:
    • Clear solution, neutral pH
    • Rapid onset, short duration
    • e.g. insulin lispro
    • Short-acting regular soluble insulin is used for IV infusion, as it immediately dissociates on dilution and thus is able to be more precisely delivered
  • Intermediate acting:
    • Turbid solution, neutral pH
    • Protamine in phosphate buffer (NPH) to prolong action
    • e.g. insulin aspart protamine
  • Long-acting:
    • Clear solution
    • Slow onset, prolonged action
    • Daily administration mimics basal insulin secretion
    • e.g. insulin glargine
Clinical uses
  • Regulation of blood glucose:
    • Combinations of insulins with different durations of actions (see below) aim to replace basal insulin requirement (50%) and meal requirement (50%) to achieve optimal glycaemic control
  • Hyperkalaemia
  • Calcium channel blocker overdose
Adverse effects
  • Hypoglycaemia
  • Hypoglycaemia unawareness
  • Allergy (usually due to non-insulin contaminants)
  • Immune insulin resistance
  • Lipodystrophy at injection sites
References
Pharm 101 700

Pharmacology 101

Top 200 drugs

MBBS CCPU (RCE, Biliary, DVT, E-FAST, AAA) Rob is an Emergency Medicine Advanced Trainee based in Melbourne, Australia. He has special interests in medical education, ECG interpretation, and the use of diagnostic and procedural ultrasound in the undifferentiated and unwell patient.

Follow him on twitter: @rob_buttner | ECG Library |

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.