ACTRAPID

1) Action Hypoglycaemic

2) Mechanism Insulin binds to receptor protein on cell surface

—> second messenger

—> initiate transport effects & anabolic effects

3) Indications • Treatment of insulin requiring diabetes

• Hyperkalaemia

4) Effects on organs—side effects

• Generally promotes fat and glucose storage

• Liver: increase storage of glucose as glycogen

Inhibits conversion of fatty acids & aa to ketoacids

• Muscle: increase protein synthesis & glycogen storage

• Adipose: reduce circulating free fatty acids by increasing adipose uptake

5) Toxic effects/ precautions with administration

• Hypoglycaemic reactions most common reaction due to too large a dose or too small a meal

• Immune allergy: may result in anaphylaxis

• Immune insulin resistance: circulating AB neutralise insulin necessitating larger dosages

• Concomitant use of b-adrenergic drugs [esp non cardioselective] may mask symptoms of hypoglycaemia

6) Contraindications Hypoglycaemia

7) Reversal, antagonism or antidote Glucose

8) Loading dose, maintenance dose, frequency & method of administration

• Short acting insulins [eg actrapid] are the only types that can be administered via an infusion pump

• Hyperkalaemia: 50 g glucose with 15 -25 units actrapid IV

• Hyperglycaemia: IV infusion [eg 5-10 units/hr] while regularly monitoring BSL

9) Drug’s metabolism—Drug’s excretion—Half life (pharmacokinetics)

• Rapid onset of action (several minutes)

• Lasts several hours (<6hrs)