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Insulin Protamine

Protamine - Wikipedia

Protamine - Wikipedia

Protamines are small, arginine -rich, nuclear proteins that replace histones late in the haploid phase of spermatogenesis and are believed essential for sperm head condensation and DNA stabilization. They may allow for denser packaging of DNA in the spermatozoon than histones, but they must be decompressed before the genetic data can be used for protein synthesis. However, in humans and maybe other primates, 10-15% of the sperm's genome is packaged by histones thought to bind genes that are essential for early embryonic development. [1] During the formation of sperm, protamine binds to the phosphate backbone of DNA using the arginine-rich domain as an anchor. DNA is then folded into a toroid , an O-shaped structure, although the mechanism is not known. A sperm cell can contain up to 50,000 toroid-shaped structures in its nucleus with each toroid containing about 50 kilobases. [2] Before the toroid is formed, histones are removed from the DNA by transition nuclear proteins, so that protamine can condense it. The effects of this change are 1) an increase in sperm hydrodynamics for better flow through liquids by reducing the head size 2) decrease in the occurrence of DNA damage 3) removal of the epigenetic markers that occur with histone modifications. [3] The structure of the sperm head is also related to protamine levels. The ratio of protamine 2 to protamine 1 and transition nuclear proteins has been found to change the sperm head shape in various species of mice, by altering the expression of protamine 2 via mutations in its promoter region. A decrease in the ratio has been found to increase the competitive ability of sperm in Mus species. However, further testing is required to determine how this ratio influences the shape of the head and whether monogamy influences Continue reading >>

Novolog Mix 70-30

Novolog Mix 70-30

NovoLog® Mix 70/30 (70% insulin aspart protamine suspension and 30% insulin aspart) Injection, [rDNA origin]) Suspension for Subcutaneous Injection DESCRIPTION NovoLog Mix 70/30 (insulin aspart protamine and insulin aspart rdna origin) (70% insulin aspart protamine suspension and 30% insulin aspart injection, [rDNA origin]) is a human insulin analog suspension containing 70% insulin aspart protamine crystals and 30% soluble insulin aspart. NovoLog Mix 70/30 is a blood glucoselowering agent with an earlier onset and an intermediate duration of action. Insulin aspart is homologous with regular human insulin with the exception of a single substitution of the amino acid proline by aspartic acid in position B28, and is produced by recombinant DNA technology utilizing Saccharomyces cerevisiae (baker's part (NovoLog) has the empirical formula C256H381N65O79S6 and a molecular weight of 5825.8 Da. Figure 1: Structural formula of insulin aspart NovoLog Mix 70/30 (insulin aspart protamine and insulin aspart rdna origin) is a uniform, white, sterile suspension that contains insulin aspart 100 Units/mL. Inactive ingredients for the 10 mL vial are mannitol 36.4 mg/mL, phenol 1.50 mg/mL, metacresol 1.72 mg/mL, zinc 19.6 μg/mL, disodium hydrogen phosphate dihydrate 1.25 mg/mL, sodium chloride 0.58 mg/mL, and protamine sulfate 0.32 mg/mL. Inactive ingredients for the NovoLog Mix 70/30 (insulin aspart protamine and insulin aspart rdna origin) FlexPen are glycerol 16.0 mg/mL, phenol 1.50 mg/mL, metacresol 1.72 mg/mL, zinc 19.6 μg/mL, disodium hydrogen phosphate dihydrate 1.25 mg/mL, sodium chloride 0.877 mg/mL, and protamine sulfate 0.32 mg/mL. NovoLog Mix 70/30 (insulin aspart protamine and insulin aspart rdna origin) has a pH of 7.20 - 7.44. Hydrochloric acid or sodium hydroxide may Continue reading >>

Insulin Aspart Protamine/insulin Aspart - Injection (novolog Mix) Side Effects, Medical Uses, And Drug Interactions.

Insulin Aspart Protamine/insulin Aspart - Injection (novolog Mix) Side Effects, Medical Uses, And Drug Interactions.

GENERIC NAME: INSULIN ASPART PROTAMINE/INSULIN ASPART - INJECTION (IN-sue-lin AS-part PRO-tah-meen/ IN-sue-lin AS-part) Medication Uses | How To Use | Side Effects | Precautions | Drug Interactions | Overdose | Notes | Missed Dose | Storage USES: Insulin aspart protamine/insulin aspart is used along with a proper diet and exercise program to control high blood sugar . It is used in people with type 1 (insulin-dependent) or type 2 diabetes . This product is a combination of two man-made insulins: intermediate-acting insulin aspart protamine and rapid-acting insulin aspart. This combination starts working faster and lasts for a longer time than regular insulin.Insulin is a natural substance that allows the body to properly use sugar from the diet . It replaces the insulin that your body no longer produces, thereby lowering your blood sugar . Controlling high blood sugar helps prevent kidney damage, blindness , nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke . HOW TO USE: Read the patient information leaflet provided by your pharmacist before you start using this medication and each time you get a refill. If you have any questions, consult your doctor or pharmacist.Follow all package directions for proper use/injection/storage of the particular type of device/insulin you are using. Your health care professional will teach you how to properly inject this medication. If any of the information is unclear, consult your doctor or pharmacist.Do not inject cold insulin because this can be painful. The insulin container you are currently using can be kept at room temperature (see also Storage section). Wash your hands before measuring and injecting insulin. Check the product visually for Continue reading >>

Protamine Adverse Reactions In Nph Insulin Treated Diabetics Undergoing Coronary Artery Bypass Grafting

Protamine Adverse Reactions In Nph Insulin Treated Diabetics Undergoing Coronary Artery Bypass Grafting

Background The routine use of protamine in cardiac surgery to neutralize heparin is usually associated with systemic reactions that result in substantial morbidity and mortality. Aim This study aimed to investigate the relationship between neutral protamine Hagedorn (NPH) insulin use and severe adverse reactions to intravenous protamine given after cardiopulmonary bypass. Methods After obtaining hospital ethics committee approval and after obtaining informed consent, 100 patients between 45 and 70 years of age of American Society of Anesthesiologist physical status II–III undergoing elective primary isolated coronary artery bypass grafting were included in this prospective study, which was conducted between May 2013 and June 2014. Patients were divided into two groups: the NPH group (50 patients), which included patients who were on NPH insulin preparation for more than 5 years before the study, and the non-NPH group (50 patients), which included patients on oral hypoglycemics. The incidence of protamine reactions was recorded for 30 min after protamine infusion. The incidence of severe hypotension, increased airway pressure, and cardiac arrest were compared using the χ2-test. A P value less than 0.05 was considered significant. Results All patients (50 in each group) completed the study. There was no significant difference in patients’ demographic data, preoperative comorbidities, and surgical factors between the two study groups. The number of patients who had hypotension was significantly higher in the NPH insulin group compared with the non-NPH group. For both groups, there was no significant difference with respect to bronchospasm, cardiac arrest, and increased pulmonary artery pressure. Conclusion This prospective study showed increased risk for hypotension a Continue reading >>

Nph Insulin

Nph Insulin

NPH insulin, also known as isophane insulin, is an intermediate–acting insulin given to help control blood sugar levels in people with diabetes.[3] It is used by injection under the skin once to twice a day.[1] Onset of effects is typically in 90 minutes and they last for 24 hours.[3] Versions are available that come premixed with a short–acting insulin, such as regular insulin.[2] The common side effect is low blood sugar.[3] Other side effects may include pain or skin changes at the sites of injection, low blood potassium, and allergic reactions.[3] Use during pregnancy is relatively safe for the baby.[3] NPH insulin is made by mixing regular insulin and protamine in exact proportions with zinc and phenol such that a neutral-pH is maintained and crystals form.[1] There are human and pig insulin based versions.[1] Protamine insulin was first created in 1936 and NPH insulin in 1946.[1] It is on the World Health Organization's List of Essential Medicines, the most important medications needed in a basic health system.[4] The wholesale cost in the developing world is about 2.23 to 10.35 USD per 1,000 iu of NPH insulin.[5] In the United Kingdom 1,000 iu of NPH insulin costs the NHS 7.48 pounds while in the United States this amount costs about 134.00 USD.[2][6] Chemistry[edit] NPH insulin is cloudy and has an onset of 1–4 hours. Its peak is 6–10 hours and its duration is about 10–16 hours. History[edit] Hans Christian Hagedorn (1888–1971) and August Krogh (1874–1949) obtained the rights for insulin from Banting and Best in Toronto, Canada. In 1923 they formed Nordisk Insulin laboratorium, and in 1926 with August Kongsted he obtained a Danish Royal Charter as a non-profit foundation. In 1936, Hagedorn and B. Norman Jensen discovered that the effects of injecte Continue reading >>

Protamine Zinc Insulin For Veterinary Use

Protamine Zinc Insulin For Veterinary Use

Protamine Zinc Insulin for Veterinary Use Protamine zinc insulin (PZI) is a long-acting insulin combination. Protamine zinc is added to insulin as a means of slowing insulin absorption. PZI once was made with beef and pork insulin but the PZI described in this monograph is made with human recombinant insulin. Diabetes mellitus is a relatively common metabolic disease seen in middle-aged cats and dogs. Most dogs suffer from Type 1 diabetes, while cats usually have Type 2 diabetes. Type 3 diabetes may occur in either cats or dogs. In addition to insulin, the veterinary management of diabetes requires owner education, dietary management, and regular glucose testing. With appropriate management, most animals can live a normal-duration life. Human recombinant insulin found in PZI is acceptable for use in dogs and most cats. When administered subcutaneously, the onset of action is between one and four hours; the peak is between four and eight hours; the duration of action is from six to 24 hours in the cat and six to 28 hours in the dog. PZI generally is given once a day. There are oral hypoglycemic drugs that may be used in addition to or in place of insulin in some cats. Hypoglycemia: The initial signs of hypoglycemia include nervousness, vocalization, anxiety, muscle tremors, ataxia, and pupillary dilation. The alert owner may be able to offer the patient some food or oral dextrose to counteract the hypoglycemia. Positive response should occur within one or two minutes. More severe signs of hypoglycemia include seizures, shock, and coma. These animals require prompt veterinary intervention. Urinary tract infections are a common secondary problem in cats with diabetes. Intact female cats should be neutered because the increased progesterone with diestrus makes managing of Continue reading >>

What Is Insulin Lispro And Insulin Lispro Protamine?

What Is Insulin Lispro And Insulin Lispro Protamine?

What is the most important information I should know about insulin lispro and insulin lispro protamine? Use this medication within 15 minutes before eating a meal. Low blood sugar (hypoglycemia) can occur if you skip a meal, exercise too long, drink alcohol, or are under stress. Symptoms include headache, hunger, weakness, sweating, tremors, irritability, or trouble concentrating. Carry hard candy or glucose tablets with you in case you have low blood sugar. Other sugar sources include orange juice and milk. Be sure your family and close friends know how to help you in an emergency. Signs of blood sugar that is too high (hyperglycemia) may include increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, and weight loss. Your blood sugar will need to be checked often, and you may need to adjust your insulin dose. Never share an injection pen or cartridge with another person. Sharing injection pens or cartridges can allow disease such as hepatitis or HIV to pass from one person to another. Insulin is a hormone that is produced in the body. It works by lowering levels of glucose (sugar) in the blood. Insulin lispro is a fast-acting form of insulin. Insulin lispro protamine is an intermediate-acting form of insulin. Insulin lispro and insulin lispro protamine is used to treat type 1 diabetes in adults. It is usually given together with another long-acting insulin. Insulin lispro and insulin lispro protamine may also be used for purposes not listed in this medication guide. What should I discuss with my healthcare provider before using insulin lispro and insulin lispro protamine? Do not use this medication if you are allergic to insulin, or if you are having an episode of hypoglycemia (low blood sugar). To make sure Continue reading >>

Protamine - An Overview | Sciencedirect Topics

Protamine - An Overview | Sciencedirect Topics

Nathaen Weitzel MD, in Anesthesia Secrets (Fourth Edition) , 2011 How is the heparin effect reversed? What are potential complications? Protamine, a positively charged protein molecule, binds the negatively charged heparin, and this complex is removed from the circulation by the reticuloendothelial system. Although there are different regimens to determine how much protamine should be administered, the simplest and most common method is to dose protamine based on the heparin administered (roughly 1mg protamine per 100 units heparin). The efficacy of heparin reversal should be assessed by ACT but can also be determined using thromboelastography. Protamine has been associated with systemic hypotension because of histamine release or true anaphylaxis, along with catastrophic pulmonary hypertension due to anaphylactoid thromboxane release. Risk factors include preexisting pulmonary hypertension, patients with diabetes treated with NPH insulin preparations, bolus protamine administration, and central administration of protamine. Janine E. Polifka, Juliane Habermann, in Drugs During Pregnancy and Lactation (Third Edition) , 2015 Protamines are simple (alkaline) proteins found in the sperm of several species. Protamine-HCl and protamine sulfate are agents that are used intravenously to reverse the effects of heparin prior to surgical procedures or for the treatment of heparin overdose. They are basic polypeptides that neutralize the strongly negatively charged heparin by complexing with it to form a stable salt. Protamine-heparin complexes have no inhibitory effect on coagulation. The ability of protamines to neutralize heparin varies with heparin chain length. Short chain fragments cannot be neutralized with protamine, resulting in incomplete neutralization of anti-factor Xa Continue reading >>

Comparison Of Insulin Lispro Protamine Suspension With Nph Insulin In Pregnant Women With Type 2 And Gestational Diabetes Mellitus: Maternal And Perinatal Outcomes

Comparison Of Insulin Lispro Protamine Suspension With Nph Insulin In Pregnant Women With Type 2 And Gestational Diabetes Mellitus: Maternal And Perinatal Outcomes

International Journal of Endocrinology Volume 2013 (2013), Article ID 151975, 8 pages 1Department of Clinical and Molecular Medicine, S. Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University, Via di Grottarossa 1035–1039, 00189 Rome, Italy 2Unit of Dietology, Diabetology and Metabolic Diseases, Sandro Pertini Hospital, Via dei Monti Tiburtini 385, 00157 Rome, Italy Academic Editor: Ilias Migdalis Copyright © 2013 Antonietta Colatrella et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Insulin therapy is still the gold standard in diabetic pregnancy. Insulin lispro protamine suspension is an available basal insulin analogue. Aim. To study pregnancy outcomes of women with type 2 and gestational diabetes mellitus when insulin lispro protamine suspension or human NPH insulin was added to medical nutrition therapy and/or short-acting insulin. Methods. In this retrospective study, for maternal outcome we recorded time and mode of delivery, hypertension, glycaemic control (fasting blood glucose and HbA1c), hypoglycemias, weight increase, and insulin need. For neonatal outcome birth weight and weight class, congenital malformations was recorded and main neonatal complications. Two-tail Student's t-test and chi-square test were performed when applicable; significant . Results. Eighty-nine pregnant women (25 with type 2 diabetes and 64 with gestational diabetes mellitus; 53 under insulin lispro protamine suspension and 36 under human NPH insulin) were recruited. Maternal and neonatal outcomes were quite similar between the two therapeutic approaches; however, insulin need was hi Continue reading >>

Insulin Lispro Protamine, Human

Insulin Lispro Protamine, Human

Description Humalog Mix75/25™ [75% insulin lispro protamine suspension and 25% insulin lispro injection, (rDNA origin)] is a mixture of insulin lispro solution, a rapid-acting blood glucose-lowering agent and insulin lispro protamine suspension, an intermediate-acting blood glucose-lowering agent. Chemically, insulin lispro is Lys(B28), Pro(B29) human insulin analog, created when the amino acids at positions 28 and 29 on the insulin B-chain are reversed. Insulin lispro is synthesized in a special non-pathogenic laboratory strain of Escherichia coli bacteria that has been genetically altered by the addition of the gene for insulin lispro. Insulin lispro protamine suspension (NPL component) is a suspension of crystals produced from combining insulin lispro and protamine sulfate under appropriate conditions for crystal formation. Insulin lispro has the following primary structure: Insulin lispro has the empirical formula C 257 H 383 N 65 O 77 S 6 and a molecular weight of 5808, both identical to that of human insulin. Humalog Mix75/25 disposable insulin delivery devices contain a sterile suspension of insulin lispro protamine suspension mixed with soluble insulin lispro for use as an injection. Each milliliter of Humalog Mix75/25 injection contains insulin lispro 100 Units, 0.28 mg protamine sulfate, 16 mg glycerin, 3.78 mg dibasic sodium phosphate, 1.76 mg m -cresol, zinc oxide content adjusted to provide 0.025 mg zinc ion, 0.715 mg phenol, and water for injection. Humalog Mix75/25 has a pH of 7.0-7.8. Hydrochloric acid 10% and/or sodium hydroxide 10% may have been added to adjust pH. Clinical Pharmacology Antidiabetic Activity --The primary activity of insulin, including Humalog Mix75/25, is the regulation of glucose metabolism. In addition, all insulins have several a Continue reading >>

Time Action Of Globin Insulin Compared With That Of Protamine Insulin Modifications

Time Action Of Globin Insulin Compared With That Of Protamine Insulin Modifications

TIME ACTION OF GLOBIN INSULIN COMPARED WITH THAT OF PROTAMINE INSULIN MODIFICATIONS IN THE routine daily treatment of diabetes mellitus with insulin the depot insulins have become almost universally accepted as standard because of their ability to maintain smoother control of diabetes with fewer hypodermic injections. They have almost completely replaced the ordinary solutions of the hormone, "regular" or "plain" insulin and "crystalline" insulin, in the day by day maintenance therapy of diabetes. The ordinary soluble preparations of the hormone have such an intense and brief action that they are unsuitable for maintenance therapy by themselves. Their use is confined chiefly to the treatment of emergencies in diabetes in which prompt action is required, to augmentation of the slow action of depot insulins when this is desirable, to treatment of occasional patients who are allergic or unresponsive to the depot insulins and to induction of shock in psychotherapy. How do the various depot insulins compare with one another and what are the Continue reading >>

The Use Of Mixtures Of Protamine Zinc And Regular Insulin(the Use Of Mixtures Of Protamine Zinc And Regular Insulin*)

The Use Of Mixtures Of Protamine Zinc And Regular Insulin(the Use Of Mixtures Of Protamine Zinc And Regular Insulin*)

During the past 10 years a considerable experience in the use of adjustable mixtures of protamine zinc and regular insulin in the Section on Metabolism Therapy of the Mayo Clinic has led to the formation of certain opinions about the usefulness and limitations of this method of insulin therapy of diabetes. Among other things, it has become apparent that appropriate mixtures, because of the intermediate character of their action with respect to onset, intensity and duration, have great usefulness in cases of moderately severe to severe diabetes. It is in these cases that protamine zinc insulin, used alone, lacks sufficient OBSERVATIONS ON THE COMPARABLE EFFECTS OF PROTAMINE ZINC AND REGULAR INSULIN IN DIABETIC PATIENTS FOLLOWED OVER A PERIOD OF YEARS( OBSERVATIONS ON THE COMPARABLE EFFECTS OF PROTAMINE ZINC AND REGULAR INSULIN IN DIABETIC PATIENTS FOLLOWED OVER A PERIOD OF YEARS* ) Annals of Internal Medicine; 16 (4): 750-761 CLINICAL EXPERIMENTS WITH MIXTURES OF STANDARD AND PROTAMINE ZINC INSULINS( CLINICAL EXPERIMENTS WITH MIXTURES OF STANDARD AND PROTAMINE ZINC INSULINS* ) Annals of Internal Medicine; 14 (7): 1166-1179 Addition of Neutral Protamine Lispro Insulin or Insulin Glargine to Oral Type 2 Diabetes Regimens for Patients with Suboptimal Glycemic Control: A Randomized Trial Annals of Internal Medicine; 149 (8): 531-539 Continue reading >>

Protamine Antibody Production In Diabetic Subjects Treated With Nph Insulin.

Protamine Antibody Production In Diabetic Subjects Treated With Nph Insulin.

Protamine antibody production in diabetic subjects treated with NPH insulin. Department of Medicine, Baylor College of Medicine, Houston, Texas 77030. Treatment with neutral protamine Hagedorn (NPH) insulin predisposes individuals with diabetes to anaphylactoid reactions when given bolus protamine for heparin reversal during cardiovascular procedures. To prospectively examine production of protamine antibodies, 30 patients with non-insulin dependent diabetes were followed for 12 months from initiation of therapy with porcine NPH or Lente insulin. Twenty-one subjects were randomly assigned to NPH (protamine containing) and nine controls to Lente (protamine free) insulin. Protamine specific IgG antibody was produced by 6/21 (29%) of NPH-treated subjects and 0/9 controls. Among NPH treated subjects, there was no difference between protamine antibody producers and non-producers with regard to age, race, weight, or pre-treatment glycosylated hemoglobin. Both producer and non-producer groups received similar amounts of insulin and protamine and achieved similar glycemic control. Insulin antibodies were made by 4/6 (67%) of protamine antibody producers and by 6/15 (40%) of non-producers (NS). The authors conclude that one of three new diabetics who are treated with porcine NPH insulin will make IgG protamine antibodies. These antibodies do not affect insulin requirements, glycemic control, or insulin antibody production. Because of the frequency of protamine antibody production and the risk of anaphylaxis to bolus protamine administration in NPH treated diabetics, the authors suggest that NPH insulin-treated individuals should avoid heparin reversal by protamine. Continue reading >>

Protamine Insulin Versus Ordinary Insulin

Protamine Insulin Versus Ordinary Insulin

PROTAMINE INSULIN VERSUS ORDINARY INSULIN Hagedorn and his co-workers1 have prepared from the sperm of a trout (Salmo iridius) the substance protamine, which, properly buffered, combines with insulin to form the compound protamine insulinate or, for want of a less confusing name, "protamine insulin." When this compound, which is sparingly soluble in the tissue fluid, is given hypodermically, it slowly breaks down so that the active insulin is gradually released and absorbed, thereby causing a continuous and prolonged action on the blood sugar. It has been reported that occasionally the final effectiveness of protamine is delayed beyond the day of its administration as late as four or five days.2 The duration of this prolonged absorption appears to approach nature's method of continuous insulin secretion. The Hagedorn investigators, basing their conclusions on a carefully treated group of diabetic patients, have shown these encouraging results with protamine insulin: a more prolonged insulin action without increasing Continue reading >>

Insulin Lispro Protamine And Insulin Lispro (subcutaneous Route)

Insulin Lispro Protamine And Insulin Lispro (subcutaneous Route)

Description and Brand Names Drug information provided by: Micromedex US Brand Name Humalog Mix 5050 Humalog Mix 7525 Descriptions Insulin lispro protamine and insulin lispro is a combination of a fast-acting insulin and an intermediate-acting type of human insulin. Insulin is used by people with diabetes to help keep blood sugar levels under control. When you have diabetes mellitus, your body cannot make enough or does not use insulin properly. So, you must take additional insulin to regulate your blood sugar and keep your body healthy. This is very important as too much sugar in your blood can be harmful to your health. This medicine is available only with your doctor's prescription. This product is available in the following dosage forms: Suspension Copyright © 2018 Truven Health Analytics Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. Continue reading >>

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