Trade names: Humulin R, Insulin-Toronto, Novolin R, Iletin II Regular, Velosulin BR
Class: Short-acting insulin
Pregnancy: (Category
Action:
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Lower blood glucose by increasing transport into cells and promoting the conversion of glucose to glycogen
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Promote the conversion of amino acids to proteins in muscle and stimulate triglyceride formation
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Inhibit the release of free fatty acids
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Sources include pork, beef/pork combinations, semisynthetic, biosynthetic, and recombinant DNA.
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Therapeutic Effects:
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Treatment of insulin-dependent diabetes mellitus (IDDM, type 1)
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Management of non–insulin-dependent diabetes mellitus (NIDDM, type 2) unresponsive to treatment with diet and/or oral hypoglycemic agents
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Concentrated insulin U-500: Only for use in patients with insulin requirements >200 units/day.
Dose:
by subcutaneous, intramuscular, or intravenous injection or intravenous infusion, according to requirements " usually bolus 0.1 unit/kg followed by infusion 0.05-0.1 unit/kg/hour
Contraindications:
Side effects:
Derm: urticaria.
Endo: Hypoglycemia, rebound hyperglycemia (Somogyi effect).
Local: lipodystrophy, itching, lipohypertrophy, redness, swelling.
Misc: allergic reactions including Anaphylaxis.
Nursing considerations:
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Read the product information & any important notes inserted into the package.
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Refrigerate stock supply of insulin but avoid freezing.
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Follow the guidelines with respect to mixing the various types of insulin.
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Invert the vial several times to mix before the material is withdrawn “avoid vigorous shaking”.
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Assist patient for self-administration of insulin.
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Rotate the sites of S.C. injections to prevent the problem of hypertrophy or atrophy at injection site.
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Allow insulin to remain at room temperature 1 hour before administration.
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Apply pressure for 1 minute, don’t massage since it may interfere with rate of absorption.
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If breakfast must be delayed, delay the administration of morning dose of insulin.
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Obtain a thorough nursing history from the client / family.
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If the client has symptoms of hyperglycemia reaction:
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Have regular insulin available for administration.
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Monitor client closely after administration.
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Check blood glucose, urine glucose, and acetone.
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Check for early symptoms of hypoglycemia.
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Assess diabetic more closely for infection or emotional disturbances that
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may increase insulin requirements.
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Explain the necessity for close regular medical supervision.
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Explain to patient how to test the urine for sugar & acetone.
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Explain the use & care of equipment & the storage of medication.
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Explain the importance of exercise & adhering to the prescribed diet.
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Explain the importance of carrying candy or sugar at all times to counteract
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hypoglycemia should it occur.
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Provide the client & family with a printed chart explaining symptoms of hypoglycemia , hyperglycemia & instructions concerning what to do for each.
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Instruct client that blurring of vision will subside within 6-8 weeks.
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Advise client to check vials of insulin carefully before each dose. Regular
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insulin should be clear, where as other forms may be cloudy.
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