Regular Insulin

dr.joandr.joan عضو ماسي
تم تعديل 2009/08/25 في أدوية الطوارئ Emergency drugs
Trade names: Humulin R, Insulin-Toronto, Novolin R, Iletin II Regular, Velosulin BR
Class: Short-acting insulin
Pregnancy: (Category B)

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  • Invert the vial several times to mix before the material is withdrawn “avoid vigorous shaking”.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

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