Insulin Pen: From 1 Different Sources
a user-friendly penlike device designed to inject a measured dose of insulin, typically containing 3 ml insulin (300 units in total) in a cartridge chamber. For each injection a new disposable needle is applied to the device. The insulin dose is then ‘dialled up’ and safely injected subcutaneously. The pen can be capped off and easily stored in a pocket or small bag; some types are disposable when the cartridge is empty, while others can be refilled with a new cartridge.
A metabolite of PENICILLIN which is one of the CHELATING AGENTS. It is sometimes used in RHEUMATOID ARTHRITIS that has not responded to the ?rst-line remedies and it is particularly useful when the disease is complicated by VASCULITIS. Penicillamine is also used as an antidote to poisoning by heavy metals, particularly copper and lead, as it is able to bind these metals and so remove their toxic effects. Because of its ability to bind copper it is also used in WILSON’S DISEASE where there is a de?ciency in the copper-binding protein so that copper is able to become deposited in the brain and liver, damaging these tissues.... penicillamine
A POLYPEPTIDE hormone (see HORMONES) produced in the PANCREAS by the beta cells of the ISLETS OF LANGERHANS. It plays a key role in the body’s regulation of CARBOHYDRATE, FAT, and PROTEIN, and its de?ciency leads to DIABETES MELLITUS. Diabetic patients are described as type 1 (insulin dependent), or type 2 (non-insulin dependent), although many of the latter may need insulin later on, in order to maintain good control.
Insulin is extracted mainly from pork pancreas and puri?ed by crystallisation; it may be made biosynthetically by recombinant DNA technology using Escherichia coli, or semisynthetically by enzymatic modi?cation of porcine insulin to produce human insulin. The latter is the form now generally used, although some patients ?nd it unsuitable and have to return to porcine insulin.
The hormone acts by enabling the muscles and other tissues requiring sugar for their activity to take up this substance from the blood. All insulin preparations are to a greater or lesser extent immunogenic in humans, but immunological resistance to insulin action is uncommon.
Previously available in three strengths, of 20, 40, and 80 units per millilitre (U/ml), these have now largely been replaced by a standard strength of 100 U/ml (U100). Numerous different insulin preparations are listed; these differ in their speed of onset and duration of action, and hence vary in their suitability for individual patients.
Insulin is inactivated by gastrointestinal enzymes and is therefore generally given by subcutaneous injection, usually into the upper arms, thighs, buttocks, or abdomen. Some insulins are also available in cartridge form, which may be administered by injection devices (‘pens’). The absorption may vary from di?erent sites and with strenuous activity. About 25 per cent of diabetics require insulin treatment: most children from the onset, and all patients presenting with ketoacidosis. Insulin is also often needed by those with a rapid onset of symptoms such as weight loss, weakness, and sometimes vomiting, often associated with ketonuria.
The aim of treatment is to maintain good control of blood glucose concentration, while avoiding severe HYPOGLYCAEMIA; this is usually achieved by a regimen of preprandial injections of short-acting insulin (often with a bedtime injection of long-acting insulin). Insulin may also be given by continuous subcutaneous infusion with an infusion pump. This technique has many disadvantages: patients must be well motivated and able to monitor their own blood glucose, with access to expert advice both day and night; it is therefore rarely used.
Hypoglycaemia is a potential hazard for many patients converting from porcine to human insulin, because human insulin may result in them being unaware of classical hypoglycaemic warning symptoms. Drivers must be particularly careful, and individuals may be forbidden to drive if they have frequent or severe hypoglycaemic attacks. For this reason, insurance companies should be warned, and diabetics should – after taking appropriate medical advice – either return to porcine insulin or consider stopping driving.... insulin
A drug that is used in the prevention and treatment of African trypanosomiasis (see SLEEPING SICKNESS), and in the treatment of LEISHMANIASIS.... pentamidine
A disorder in which the body produces excess INSULIN, which then reduces the amount of glucose in the blood (HYPOGLYCAEMIA). Treatment is with glucose or GLUCAGON. Untreated, the patient goes into a COMA and dies.... insulin shock
A bacterial ENZYME capable of neutralising the antibacterial properties of PENICILLIN and other beta-lactam antibiotics such as the CEPHALOSPORINS. Most staphylococci are now resistant to benzylpenicillin because they produce this enzyme; cloxacillin, ?ucloxacillin and temocillin are not inactivated.... penicillinase
The name given by Sir Alexander Fleming, in 1929, to an antibacterial substance produced by the mould Penicillium notatum. The story of penicillin is one of the most dramatic in the history of medicine, and its introduction into medicine initiated a new era in therapeutics comparable only to the introduction of ANAESTHESIA by Morton and Simpson and of ANTISEPTICS by Pasteur and Lister. The two great advantages of penicillin are that it is active against a large range of bacteria and that, even in large doses, it is non-toxic. Penicillin di?uses well into body tissues and ?uids and is excreted in the urine, but it penetrates poorly into the cerebrospinal ?uid.
Penicillin is a beta-lactam antibiotic, one of a group of drugs that also includes CEPHALOSPORINS. Drugs of this group have a four-part beta-lactam ring in their molecular structure and they act by interfering with the cell-wall growth of mutliplying bacteria.
Among the organisms to which it has been, and often still is, active are: streptococcus, pneumococcus, meningococcus, gonococcus, and the organisms responsible for syphilis and for gas gangrene (for more information on these organisms and the diseases they cause, refer to the separate dictionary entries). Most bacteria of the genus staphylococcus are now resistant because they produce an enzyme called PENICILLINASE that destroys the antibiotic. A particular problem has been the evolution of strains resistant to methicillin – a derivative originally designed to conquer the resistance problem. These bacteria, known as METHICILLINRESISTANT STAPHYLOCOCCUS AUREUS (MRSA), are an increasing problem, especially after major surgery. Some are also resistant to other antibiotics such as vancomycin.
An important side-e?ect of penicillins is hypersensitivity which causes rashes and sometimes ANAPHYLAXIS, which can be fatal.
Forms of penicillin These include the following broad groups: benzylpenicillin and phenoxymethyl-penicillin; penicillinase-resistant penicillins; broad-spectrum penicillins; antipseudomonal penicillins; and mecillinams. BENZYLPENICILLIN is given intramuscularly, and is the form that is used when a rapid action is required. PHENOXYMETHYLPENICILLIN (also called penicillin V) is given by mouth and used in treating such disorders as TONSILLITIS. AMPICILLIN, a broad-spectrum antibiotic, is another of the penicillins derived by semi-synthesis from the penicillin nucleus. It, too, is active when taken by mouth, but its special feature is that it is active against gram-negative (see GRAM’S STAIN) micro-organisms such as E. coli and the salmonellae. It has been superceded by amoxicillin to the extent that prescriptions for ampicillin written by GPs in the UK to be dispensed to children have fallen by 95 per cent in the last ten years. CARBENICILLIN, a semi-synthetic penicillin, this must be given by injection, which may be painful. Its main use is in dealing with infections due to Pseudomonas pyocanea. It is the only penicillin active against this micro-organism which can be better dealt with by certain non-penicillin antibiotics. PIPERACILLIN AND TICARCILLIN are carboxypenicillins used to treat infections caused by Pseudomonas aeruginosa and Proteus spp. FLUCLOXACILLIN, also a semi-synthetic penicillin, is active against penicillin-resistant staphylococci and has the practical advantage of being active when taken by mouth. TEMOCILLIN is another penicillinase-resistant penicillin, e?ective against most gram-negative bacteria. AMOXICILLIN is an oral semi-synthetic penicillin with the same range of action as ampicillin but less likely to cause side-effects. MECILLINAM is of value in the treatment of infections with salmonellae (see FOOD POISONING), including typhoid fever, and with E. coli (see ESCHERICHIA). It is given by injection. There is a derivative, pivmecillinam, which can be taken by mouth. TICARCILLIN is a carboxypenicillin used mainly for serious infections caused by Pseudomonas aeruginosa, though it is also active against some gram-negative bacilli. Ticarcillin is available only in combination with clarulanic acid.... penicillin
(Celtic) In mythology, the wife of Llyr... penardd un
Means “leaf of (plant name)”; usually refers to the rigid, cactus-like leaves of agave or aloe; look up the plant name which follows this description of the plant part used.... penca de
(African) One who loves and is loved Pendah, Penha, Penhah... penda
(French) A decorated woman Pendent, Pendante, Pendente... pendant
(Greek) Resembling a duck; in mythology, the faithful wife of Odysseus Peneloppe, Penelopy, Penelopey, Penelopi, Penelopie, Penelopee, Penella, Penelia, Pen, Penn, Penne, Penny, Pennie, Penni, Penney, Peni, Pennea, Penelopea... penelope
Also called Juvenile-onset Diabetes, IDDM (Insulin-Dependent Diabetes) and Type I, it is a deficiency condition wherein the pancreas does not manufacture enough insulin or what it makes is formed improperly. It is usually inherited, although it may not surface until pregnancy, recovering from a life-threatening illness, boot camp or some other profound metabolic stress. It can have a not-hereditary source, since it seems to enigmatically follow after a viral disorder, and can occur spontaneously as an auto-immune condition. The percentage of folks with non-hereditary Type I diabetes is constantly increasing (or the other group is stable, but total numbers are increasing). Radical environmentalists and tree-hugging Gaiaist Pagans (I’m using the dialectic current to the pro-business backlash of the 1990s, when Green is out, and White-With-Green i$ in) claim this is another aspect of massive though subtle pollution from organochemical soup, which even some Real Doctors admit can cause increased auto-immune disease. (SOMETHING is causing it, at any rate, not simply cola drinks.)... insulin-dependent diabetes
(English) The land of Penn; from the state of Pennsylvania... pennsylvania
(French) A thoughtful woman Pense, Pensi, Pensie, Pensy, Pensey, Pensea... pensee
Also called NIDDM (Non-Insulin-Dependent Diabetes) and Type II (Type II), it generally means you make your own insulin, you eat too many calories, your storage cells are filled and are taking no more fuel, your liver is stuck in a rut and keeps making more glucose out of everything you eat, your brain has no control over its consumption of glucose, but you have run out of places to put it so you pee it out, sweat it out, etc. etc. Also called Adult-onset Diabetes. An Internist may cry out in dismay at this simplification, and there are many subtle distinctions between the various types, as well as a number of distinct hereditary considerations. This, however, is the glossary of an herbalist, and this is the common picture of the Type II person that herbs will help.... insulin-resistant diabetes
(Greek) The fifth-born child Penthia, Pentheah, Penthiah, Penthiya, Penthiyah... penthea
(Greek) In mythology, a queen of the Amazons... penthesilea
See: GOTU KOLA. ... indian pennywort
See warts, genital.... penile warts
An opioid analgesic drug used to relieve moderate or severe pain caused by injury, surgery, cancer, or childbirth. It is rarely used because of its adverse affects, which include dizziness, drowsiness, nausea, vomiting, and, rarely, hallucinations. Drug dependence may develop if high doses are taken for prolonged periods.... pentazocine
the administration of insulin by continuous infusion into the subcutaneous tissue via a small pump worn under the clothing and connected to the skin by a tube and a fine needle. The insulin is delivered at a precalculated background rate, but patient-activated *boluses can be administered at meal times. This method is particularly appropriate (as an alternative to regular injections) for patients with repeated or unpredictable episodes of hypoglycaemia.... continuous subcutaneous insulin infusion
see thought echo.... echo de la pensée
diminution in the response of the body’s tissues to insulin, so that higher concentrations of serum insulin are required to maintain normal circulating glucose levels. Eventually the islet cells can no longer produce adequate amounts of insulin for effective glucose lowering, resulting in hyperglycaemia. Insulin resistance is one of the risk factors for cardiovascular disease. See also diabetes mellitus; metabolic syndrome.... insulin resistance
a group of synthetic human insulins with specific alterations in their amino-acid sequences designed to modify their rate of absorption from the subcutaneous injection site. Some are absorbed more rapidly and have a shorter duration of action than conventional short-acting human insulin; others are absorbed more slowly at a more consistent rate than conventional medium-acting *isophane insulin to give a more sustained control of fasting and premeal blood glucose levels and therefore a reduced risk of *hypoglycaemia. These analogues include the short-acting insulin aspart, insulin glulisine, and insulin lispro; the long-acting insulin detemir and insulin glargine; and the ultra-long-acting insulin degludec.... insulin analogues
an important but potentially dangerous test of anterior pituitary function involving the deliberate induction of a hypoglycaemic episode with injected insulin and the subsequent measurement of plasma cortisol and growth hormone at regular intervals over the next three hours. The stress of the hypoglycaemia should induce a rise in the levels of these hormones unless the anterior pituitary or the adrenal glands are diseased. The test can induce epileptic seizures or angina in those with a predisposition and should not be performed in susceptible individuals. It is often combined with the thyrotrophin-releasing hormone (TRH) test and the gonadotrophin-releasing hormone (GnRH) test in what is known as the triple test (or dynamic pituitary function test).... insulin stress test
a recommended surgical treatment of congenital anal malformation.... pena operation
goitre associated with congenital deafness due to deficiency of *peroxidase, an enzyme that is essential for the utilization of iodine. [V. Pendred (1869–1946), British physician]... pendred’s syndrome
n. surgical removal of the penis, most commonly performed for penile cancer. It may be partial or total, depending on the degree of local tumour invasion.... penectomy
n. the frequency with which the characteristic controlled by a gene is seen in the individuals possessing it. Complete penetrance occurs when the characteristic is seen in all individuals known to possess the gene. If a percentage of individuals with the gene do not show its effects, penetrance is incomplete. In this way a characteristic in a family may appear to ‘skip’ a generation.... penetrance
n. a genus of mouldlike fungi that commonly grow on decaying fruit, bread, or cheese. The species P. rubrum is the major natural source of the antibiotic *penicillin. Some species of Penicillium are pathogenic to humans, causing diseases of the skin and respiratory tract.... penicillium
the traumatic rupture of the *tunica albuginea of the erect penis (the fibrous covering of the spongy tissue of the penis).... penile fracture
(PIN) cellular changes affecting the glans, prepuce, or penile shaft that precede the invasive stages of cancer of the penis. There are three stages (PIN I, II, or III) based on the degree of *dysplasia. The pathological features of PIN III indicate *carcinoma in situ, known as *erythroplasia of Queyrat and Bowen’s disease.... penile intraepithelial neoplasia
pale or skin-coloured papules that cluster around the corona of the glans penis in young uncircumcised men. They are asymptomatic but may be mistaken for viral warts.... penile pearly papules
see prosthesis.... penile prosthesis
(penta-) combining form denoting five.... pent
n. a simple sugar with five carbon atoms: for example, ribose and xylose.... pentose
n. a *cytotoxic drug that is used in treating *hairy cell leukaemia; it works by interfering with the action of the enzyme adenosine deaminase. Side-effects, which may be severe, include *myelosuppression.... pentostatin
n. an inborn defect of sugar metabolism causing abnormal excretion of pentose in the urine. There are no serious ill-effects.... pentosuria
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