GENERIC THERAPEUTIC INDICATIONS CONTRA- ADVERSE EFFECTS NURSING CONSIDERATION

NAME ACTIONS INDICATIONS

Insulin Insulin is a  Treatment of  Contraindicated Hypersensitivity: Ra Assessment

hormone secreted type 1 (insulin- with allergy to sh, anaphylaxis
Insulin  History: Allergy to pork products; pregnancy; lactation
by the beta cells dependent) pork products or angioedema
injection:  Physical: Skin color, lesions; eyeball turgor; orientation, reflexes,
of the pancreas diabetes (varies with  Local: Allergy—local
Humulin R, peripheral sensation; P, BP, adventitious sounds; R, adventitious
that, by receptor-  Treatment of preparations; reactions at injection
Humulin R sounds; urinalysis, blood glucose
mediated effects, type 2 (non– human insulin site—redness,
Regular U-500
promotes the insulin- not swelling, itching;
(concentrated) Interventions
storage of the dependent) contraindicated usually resolves in a
, Novolin ge
body's fuels, diabetes that with pork few days to a few  Ensure uniform dispersion of insulin suspensions by rolling the
Toronto
facilitating the cannot be allergy). weeks; a change in vial gently between hands; avoid vigorous shaking.
(CAN),
transport of controlled by  Use cautiously type or species  Give maintenance doses subcutaneously, rotating injection sites
Novolin R,
metabolites and diet or oral with pregnancy source of insulin regularly to decrease incidence of lipodystrophy; give regular
Novolin R
ions (potassium) agents (keep patients may be tried;
PenFill, insulin IV or IM in severe ketoacidosis or diabetic coma.
through cell  Regular insulin under close lipodystrophy;
Regular Iletin  Monitor patients receiving insulin IV carefully; plastic IV infusion
membranes and injection: supervision; pruritus
II, Velosulin sets have been reported to remove 20%–80% of the insulin;
stimulating the Treatment of rigid control is Metabolic: Hypoglyc
Human BR dosage delivered to the patient will vary.
synthesis of severe ketoacid desired; emia; ketoacidosis
glycogen from osis or diabetic following  Do not give insulin injection concentrated IV; severe
Regular insulin glucose, of fats anaphylactic reactions can occur.
coma delivery,
from lipids, and  Treatment requirements  Use caution when mixing two types of insulin; always draw the
– It has an proteins from of hyperkalemia may drop for regular insulin into the syringe first; if mixing with insulin lispro,
onset of amino acids. with infusion of 24–72 hr, rising draw the lispro first; use mixtures of regular and NPH or regular
action glucose to to normal levels and Lente insulins within 5–15 min of combining
(begins to produce a shift during next 6
them; Lantus insulin (insulin glargine) cannot be mixed in
of potassium wk); lactation
reduce solution with any other drug, including other insulins.
into the cells (monitor mother
blood sugar) carefully;  WARNING: Double-check, or have a colleague check, the
 Highly purified
within 30 insulin dosage drawn up for pediatric patients, for patients receiving
and
minutes of human insulins requirements concentrated insulin injection, or patients receiving very small
injection, promoted for may decrease doses; even small errors in dosage can cause serious problems.
reaches a short courses of during  Carefully monitor patients being switched from one type of insulin
peak effect therapy lactation). to another carefully; dosage adjustments are often needed.
at 1-3 hours, (surgery, intercu Human insulins often require smaller doses than beef or pork
and has rrent disease),
insulin; monitor cautiously if patients are switched; lispro insulin
newly
effects that is given 15 min before a meal.
diagnosed
last 6-8 patients,  Store insulin in a cool place away from direct sunlight.
hours. patients with Refrigeration is preferred. Do not freeze insulin.
poor metabolic Insulin prefilled in glass or plastic syringes is stable for 1 wk
Intermediate control, and refrigerated; this is a safe way of ensuring proper dosage for
Insulin patients with patients with limited vision or who have problems with drawing
gestational up insulin.
diabetes  Monitor urine or serum glucose levels frequently to determine
– It has an  Insulin injection
onset of effectiveness of drug and dosage. Patients can learn to adjust
concentrated:
insulin dosage on a sliding scale based on test results.
 Treatment of  Monitor insulin needs during times of trauma or severe stress;
action diabetic patients dosage adjustments may be needed.
starting with marked  WARNING: Keep life support equipment and glucose readily
insulin available to deal with ketoacidosis or hypoglycemic reactions.
about 2
resistance
hours (requirements of
following > 200 units/day) Teaching points
injection. It  Glargine  Use the same type and brand of syringe; use the same type and
has a peak (Lantus): brand of insulin to avoid dosage errors.
effect 4-12 Treatment of  Do not change the order of mixing insulins. Rotate injection sites
hours after adult patients regularly (keep a chart) to prevent breakdown at injection sites.
with type 2  Dosage may vary with activities, stress, diet. Monitor blood or
injection,
diabetes who urine glucose levels, and consult physician if problems arise.
and a require basal
duration of  Store drug in the refrigerator or in a cool place out of direct
insulin control
action of 18- of sunlight; do not freeze insulin.
26 hours. hyperglycemia  If refrigeration is not possible, drug is stable at controlled room
 Treatment of temperature and out of direct sunlight for up to 1 month.
adults and  Monitor your urine or blood for glucose and ketones as
children > 6 yr prescribed.
Drug classes: who require  Wear a medical alert tag stating that you have diabetes and are
Antidiabetic baseline insulin taking insulin so that emergency medical personnel will take
Hormone control proper care of you.
 Avoid alcohol; serious reactions can occur.
Pregnancy  Report fever, sore throat, vomiting, hypoglycemic or
Category B hyperglycemic reactions, rash.