인슐린

동물 종별 용량

투여 경로

금기

• Episodes of hypoglycemia (absolute contraindication)
• Systemic allergy to pork or pork products (specifically for Vetsulin/porcine lente)

이상반응

• 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)

약물 상호작용

• 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).

모니터링

• Blood glucose (serial curves or continuous monitoring)
• Patient weight
• Appetite and water intake
• Urine output
• Blood or urine ketones (if DKA suspected)
• Fructosamine (goal <450 micromol/L) or glycosylated hemoglobin

과용량

Overdosage of insulin leads to **hypoglycemia**, which can be rapidly fatal or cause permanent brain damage if untreated. **Clinical Signs:** * Weakness, lethargy, ataxia * Shaking, muscle fasciculations * Head tilting, bizarre behavior, blindness * Restlessness, extreme hunger * Seizures and coma **Treatment:** * **Mild:** Offer the animal its usual food. * **Severe (e.g., seizures):** Rub oral dextrose solutions (e.g., **Karo® syrup**) on the oral mucosa (do not pour down the throat to avoid aspiration). * **Veterinary Intervention:** Intravenous injections of 50% dextrose solutions (small amounts, slowly administered—usually 2-15 mL). * **Monitoring:** Once alleviated (usually within 1-2 minutes), monitor closely with serial blood glucose levels to prevent recurrence (especially with long-acting insulins) and adjust future doses.