Insulin
A to Z Drug Facts
Insulin |
(IN-suh-lin) |
Humulin-R, Iletin I Regular, Iletin II Regular, Novolin R, Novolin R PenFill, Novolin R Prefilled, Regular Purified Pork Insulin, Velosulin Human BR, Humulin 10/90, Humulin 20/80, Humulin 40/60, Humulin 50/50, Iletin II Pork Regular, Iletin Regular, Novolin ge 10/90, Novolin ge 20/80, Novolin ge 40/60, Novolin ge 50/50, Novolin ge Toronto |
Class: Antidiabetic |
Action Regulates proper glucose use in normal metabolic processes.
Indications Management of type 1 diabetes mellitus (insulin-dependent) and type 2 diabetes mellitus (non insulin-dependent) not properly controlled by diet, exercise, and weight reduction. In hyperkalemia, infusions of glucose and insulin lower serum potassium levels. IV or IM regular insulin may be given for rapid effect in severe ketoacidosis or diabetic coma. Highly purified (single component) and human insulins are used for treatment of local insulin allergy, immunologic insulin resistance, lipodystrophy at injection site, temporary insulin administration, and in newly diagnosed diabetic patients.
Contraindications Hypersensitivity to pork or mixed beef/pork insulin unless successful desensitization has been accomplished.
Insulin preparations are classified into 3 groups based on promptness, duration, and intensity of action following SC administration. These classifications are rapid-(Regular or Semilente), intermediate-(Lente or NPH) or long-(Ultralente) acting. Maintenance doses are given SC and must be individualized by monitoring patients closely. Consider following dosage guidelines. CHILDREN AND ADULTS: 0.5 to 1 U/kg/day. ADOLESCENTS (DURING GROWTH SPURT): 0.8 to 1.2 U/kg/day. Adjust doses to achieve premeal and bedtime blood glucose levels of 80 to 140 mg/dl (children < 5 yr 100 to 200 mg/dl). Regular insulin is given IV or IM for severe ketoacidosis or diabetic coma.
Contraceptives (oral), corticosteroids, dextrothyroxine, diltiazem, dobutamine, epinephrine, smoking, thiazide diuretics, thyroid hormone: May decrease hypoglycemic effects of insulin. Alcohol, anabolic steroids, beta blockers, clofibrate, fenfluramine, guanthidine, MAO inhibitors, phenylbutazone, salicylates, sulfinpyrazone, tetracyclines: May increase hypoglycemic effects of insulin.
Lab Test Interferences None well documented.
META: Hypoglycemia. DERM: Lipodystrophy (from repeated insulin injection into same site). OTHER: Hypersensitivity reaction (eg, rash, shortness of breath, fast pulse, sweating, hypotension, anaphylaxis, angioedema); local reactions (eg, redness, swelling, itching at injection site).
Pregnancy: Insulin is drug of choice for control of diabetes in pregnancy; supervise carefully. Lactation: Not excreted in breast milk. Breastfeeding may decrease insulin requirements despite increase in necessary caloric intake. Changing insulin: Changes in purity, strength, brand, type, or species source of insulin may necessitate dosage adjustment. Make changes cautiously under medical supervision. Diabetic ketoacidosis: May result from stress, illness, or insulin omission and may develop slowly after long period of poor insulin control. Condition is potentially life-threatening and requires prompt diagnosis and treatment. Hypoglycemia: May result from excessive insulin dose, increased work or exercise without eating, or from illness with vomiting, fever, or diarrhea. May also occur when insulin requirements decline. Insulin resistance: Requirements of > 200 units/day of insulin for > 2 days in absence of ketoacidosis or acute infection may occur, especially in obese patients, patients with acanthosis nigricans, patients with insulin receptor defects, or during infection.
PATIENT CARE CONSIDERATIONS |
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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts