Patient’s Name: Age/Sex:
Medical Diagnosis: Date of Assignment:
W
HUMAN REGULAR INSULIN
INDICATION: CLASSIFICATION: ANTI-DIABETIC, PANCREATIC HORMONE
INDICATIONS FOR USE: PREPARATION
□ Type 1 diabetes mellitus Available forms:
□ type 2 diabetes mellitus •NPH inj 100 units/ml; regular inj 100
units/ml, cartridges 100 units/ ml;
□ gestational diabetes, •insulin analog inj 100 units/ml;
□ insulin lispro may be used in combination with sulfonylureas •isophane insulin insj 100 units/ml,
cartridges 100 units/ ml
in children .3 yr
•insulin lispro 100 units/ml, 1.5-ml
Cartridges
•insulin lispro Humalog Pen sol for inj
ACTION: Decreases blood glucose; by transport of glucose into cells 100 units/ml
and the conversion of glucose to glycogen, indirectly increases blood
pyruvate and lactate, decreases phosphate and potassium; insulin may be •insulin glulisine inj 100 units/ml;
human (processed by recombinant DNA technologies) •insulin glargine inj 100 units/ml;
•insulin detemir inj 100 units/ml in 10
vials, 3-ml cartridges
CONTRAINDICATIONS:
• insulin aspart inj 100 mg/ml
□ Hypersensitivity to protamine; creosol (aspart)
□ Precautions: Pregnancy B (lispro, detemir, aspart, regular), C (all
others) Take note:
• Store at room temperature for ,1 mo
(some insulins); keep away from heat
and sunlight; refrigerate all other
supply; NPH, premixed insulins are
cloudy; regular, rapid-acting analogs,
long-acting analogs are clear; do not
freeze—IV route, regular only
Ward/Bed No:
ADMINISTRATION
SUBCUT route
• Give after warming to room temperature by rotating in palms
to prevent injecting cold insulin; use only insulin syringes with
markings or syringe matching units/ml; rotate inj sites within
one area: abdomen, upper back, thighs, upper arm, buttocks;
keep record of sites
• Give increased dosages if tolerance occurs
• Premixed insulins and NPH are cloudy suspensions
• Regular human insulin, rapid-acting analogs, and long-acting
analogs are clear; do not use if cloudy, thick, or discolored
CONT SUBCUT route (insulin infusion CSII)
• Do not mix with other insulins when using a pump
• Insulin lispro 3 ml cartridges are to be used in Disetronic
H-TRON plus V100 pump using Disetronic rapid inf sets; the
inf set and the cartridge adapter should be changed q3day;
replace 3 ml cartridge q6days
IV route (insulin glulisine only)
• Dilute to 1 international unit/ml in infusion systems with 0.9%
NaCl using PVC viaflex inf bags and PVC tubing; use
dedicated line; do not admix
IV route (regular only)
• When regular insulin is administered IV, monitor glucose,
potassium often to prevent fatal hypoglycemia, hypokalemia
• IV direct, undiluted via vein, Y-site, 3-way stopcock; give at
50 units/min or less
• Give by cont inf after diluting with IV sol and run at
prescribed rate; use IV inf pump for correct dosing; give
reduced dose at serum glucose level of 250 mg/100 ml
MONITORING
• Monitor for adverse side effects such as:
 EENT: Blurred vision, dry mouth
 INTEG: Flushing, rash, urticaria,
warmth, lipodystrophy, lipohypertrophy,
swelling, redness
 META: Hypoglycemia, rebound
Hyperglycemia, (Somogyi effect 12-72
hr or longer)
 MISC: Peripheral edema
 SYST: Anaphylaxis
• Fasting blood glucose, also Hgb A1c may be
tested to identify treatment effectiveness q3mo
• Urine ketones during illness; insulin requirements
may increase during stress, illness, surgery
• For hypoglycemic reaction that can occur during
peak time (sweating, weakness, dizziness, chills,
confusion, headache, nausea, rapid weak pulse,
fatigue, tachycardia, memory lapses, slurred
speech, staggering gait, anxiety, tremors, hunger)
• For hyperglycemia: acetone breath, polyuria,
fatigue, polydipsia, flushed, dry skin, lethargy
Watch out: drug-drug interactions
• Alcohol: increased hypoglycemia
• DOBUTamine: increased insulin need