Diabetes Mellitus: Insulin
Sort Nursing Implications Monitor BG as ordered and prn Monitor injection sites for lipohypertrophy -rotation of sites to decrease scarring -injections in the abdomen are most rapidly absorbed/consistent, arm is 2nd choice -staying w/in the same anatomical area decreased fluctuations Technique for mixing insulins Encourage pt to wear a Medic-Alert bracelet Carry emergency glucose at all times Pen Injectors: Selecting the Dose & Injecting the Dose Verify that the dose window displays the correct dosage Hold the pen in the palm on one hand Place pen needle on the skin for subcutaneous injection technique Press the injection button in all the way Hold the button in that position, continue to press on the skin, and slowly count to 10 Remove the needle from the pt (notice the safety lock on the needle is RED) Put the outer cap back on the needle and use it to unscrew the used needle and place in the sharps container Put the cap on the pen and place in the pt's drug storage area for reuse Intermediate Acting Insulin: Combinations Humulin 70/30, Novolin 70/30 NPH + regular insulin premixed insulins: 70/30 NPH/regular (70% NPH, 30% regular), 50/50 NPH/regular (50% NPH, 50% regular) NPH can be given by itself regular = fast acting, right-away uses, while NPH = longer acting, covers you for a longer amount of time (essentially covering breakfast & lunch) don't want to mix b/c chemicals in long-acting (NPH) can cause regular insulin to become long-acting -> defeats the whole purpose Long Acting Insulin insulin glargine (Lantus) -clear insulin -small amounts released over extended time period qd SC administration @ bedtime (preferred) (options), very stable -more practical for Type 2's b/c it covers glucose production by liver throughout the day vs regular is used more for meals wh Continue reading >>
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Insulin Regular
Pronunciation (IN soo lin REG yoo ler) Index Terms Regular Insulin Dosage Forms Excipient information presented when available (limited, particularly for generics); consult specific product labeling. Solution, Injection: HumuLIN R: 100 units/mL (3 mL, 10 mL) [contains metacresol, phenol] NovoLIN R: 100 units/mL (10 mL) [contains metacresol] NovoLIN R ReliOn: 100 units/mL (10 mL) [contains metacresol] Solution, Subcutaneous: HumuLIN R U-500 (CONCENTRATED): 500 units/mL (20 mL) [contains metacresol] Solution Pen-injector, Subcutaneous: HumuLIN R U-500 KwikPen: 500 units/mL (3 mL) [contains metacresol] Brand Names: U.S. HumuLIN R U-500 (CONCENTRATED) HumuLIN R U-500 KwikPen HumuLIN R [OTC] NovoLIN R ReliOn [OTC] NovoLIN R [OTC] Pharmacologic Category Insulin, Short-Acting Pharmacology Insulin acts via specific membrane-bound receptors on target tissues to regulate metabolism of carbohydrate, protein, and fats. Target organs for insulin include the liver, skeletal muscle, and adipose tissue. Within the liver, insulin stimulates hepatic glycogen synthesis. Insulin promotes hepatic synthesis of fatty acids, which are released into the circulation as lipoproteins. Skeletal muscle effects of insulin include increased protein synthesis and increased glycogen synthesis. Within adipose tissue, insulin stimulates the processing of circulating lipoproteins to provide free fatty acids, facilitating triglyceride synthesis and storage by adipocytes; also directly inhibits the hydrolysis of triglycerides. In addition, insulin stimulates the cellular uptake of amino acids and increases cellular permeability to several ions, including potassium, magnesium, and phosphate. By activating sodium-potassium ATPases, insulin promotes the intracellular movement of potassium. Normally secreted by Continue reading >>
