You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is Long acting insulin: and explain in detail?
Ans. C. GlargineRef: Essentials of Medical Pharmacology by KD Tripathi 7thled, p263ExplanationLente insulin is a combination of 30% semilente (amorphous) and 70% ultralente (crystalline) insulin zinc suspension.# One of the problems with regular insulin is it peaks 2 to 3 hours after administration and sustains over 6 to 8 hours, which does not mimic the physiological insulin response. This leads to postprandial hyperglycemia and intermittent hypoglycemia. To overcome this, long-acting 'modified' or 'retard' preparations of insulin were developed.# Retard preparations, are obtained by making insulin insoluble either by:# Complexing it with protamine (isophane) or# By precipitating it with excess zinc and increasing the particle size (ultralente, semilente, lente).Insulin-zinc suspensionIsophane (Neutral Protamine Hagedorn or NPH) insulinTwo types of insulin-zinc suspensions have been produced* Protamine is added in a quantity just sufficient to complex all insulin molecules* Neither of the two is present in free form* On S.C. injection, the complex dissociates slowly to yield an intermediate duration of action* Mostly used in combination with regular insulin (70:30 or 50:50)1. Ultralente # Large particles # Crystalline # Long-acting # Insoluble in water2. Semilente# Smaller particles# Amorphous# Short acting* Lente = ultralente + semilente in the ratio of 7:3 (It can be remembered like this: 70% bigger particle and 30% smaller particle)# Therefore lente insulin which is 70% ultralente + 30% semilente can be written in different ways as follows:# 70 % large particle + 30% small particle# 70 % crystalline + 30% amorphous (Answer)# 70 % long acting + 30% short acting# Apart from the above mentioned retard preparations, recently other insulin analogs like rapidly acting (lispro, aspart, glulisine) peakless and long-acting (glargine and detemir) have become available.TypeExampleRapid actingLisproAspartGlulisineShort actingRegular (soluble) insulinIntermediate actingLenteNPH or isophaneLong actingInsulin glargineInsulin detemir