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