Nurses Compass
Drug Guide
Insulin Aspart-szjj
Classification
Therapeutic: Antidiabetic, Hormone
Pharmacological: Insulin analog
FDA Approved Indications
- Treatment of type 1 diabetes mellitus in adults and children; management of type 2 diabetes mellitus in adults
Mechanism of Action
Insulin Aspart is a rapid-acting insulin analog that mimics the body's endogenous insulin response to meals by decreasing blood glucose levels through facilitation of cellular glucose uptake, inhibition of hepatic glucose production, and modulation of carbohydrate, fat, and protein metabolism.
Dosage and Administration
Adult: Dosing individualized based on patient needs; typically injected subcutaneously 5-10 minutes before meals.
Pediatric: Dosing individualized based on patient needs; administer subcutaneously before meals, typically 5-10 minutes prior.
Geriatric: Adjust dose based on renal function, age, and individual response.
Renal Impairment: Use with caution; adjust dose based on renal function.
Hepatic Impairment: Use with caution; monitor closely; adjust dosing as needed.
Pharmacokinetics
Absorption: Rapid after subcutaneous injection, with peak activity approximately 40-50 minutes.
Distribution: Distributed rapidly into body tissues.
Metabolism: Metabolized in the liver and kidneys into inactive metabolites.
Excretion: Excreted primarily in urine as metabolites.
Half Life: Approximately 1 hour.
Contraindications
- Known hypersensitivity to insulin aspart or any component of the formulation.
Precautions
- Monitor for hypoglycemia; caution in patients with renal or hepatic impairment; renal or hepatic function can affect insulin requirements.
Adverse Reactions - Common
- Hypoglycemia (Frequent)
- Injection site reactions (pain, erythema, swelling) (Less common)
Adverse Reactions - Serious
- Severe hypoglycemia (Less common)
- Allergic reactions, including anaphylaxis (Rare)
Drug-Drug Interactions
- Other antidiabetic agents (risk of hypoglycemia), corticosteroids (may increase blood glucose), beta-blockers (mask hypoglycemia signs)
Drug-Food Interactions
- Alcohol (can enhance hypoglycemia or hyperglycemia)
Drug-Herb Interactions
N/ANursing Implications
Assessment: Monitor blood glucose levels regularly; assess for signs of hypoglycemia or hyperglycemia.
Diagnoses:
- Risk for unstable blood glucose levels
- Risk for hypoglycemia
Implementation: Administer subcutaneously; ensure patient understands timing relative to meals; monitor for adverse reactions.
Evaluation: Assess effectiveness by blood glucose monitoring; evaluate for adverse reactions; adjust dose as needed.
Patient/Family Teaching
- Inject insulin as prescribed; do not skip meals after injection.
- Recognize and treat hypoglycemia (sweating, dizziness, confusion).
- Maintain regular blood glucose monitoring.
- Store insulin properly (see storage and handling).
Special Considerations
Black Box Warnings:
- Severe hypoglycemia can be life-threatening.
- Do not mix with other insulins except as recommended.
Genetic Factors: No specific genetic considerations.
Lab Test Interference: Insulin levels may affect some lab tests, but generally do not interfere with routine labs.
Overdose Management
Signs/Symptoms: Severe hypoglycemia: sweating, trembling, confusion, seizure, coma.
Treatment: Administer glucose orally or via IV; glucagon may be used if the patient is unable to take oral glucose; monitor blood glucose closely.
Storage and Handling
Storage: Unopened vials or pens should be refrigerated; opened containers may be stored at room temperature for up to 28 days.
Stability: Stable until expiration date when stored properly.