Home Drug Guide Insulin Recombinant Human

Drug Guide

Generic Name

Insulin Recombinant Human

Brand Names Humulin R, Humulin R Pen, Novolin R, Afrezza

Classification

Therapeutic: Antidiabetic agent

Pharmacological: Insulin, rapid-acting or regular insulin

FDA Approved Indications

Management of diabetes mellitus to improve glycemic control

Mechanism of Action

Recombinant human insulin replaces endogenous insulin, facilitating cellular uptake of glucose and promoting glycogen synthesis, thus lowering blood glucose levels.

Dosage and Administration

Adult: Dosage individualized based on patient's blood glucose levels, body weight, and response. Administer subcutaneously 30 min before meals for regular insulins.

Pediatric: Dosing based on weight and blood glucose monitoring, similar to adult dosing strategies but carefully adjusted for age and development.

Geriatric: Start with lower doses due to increased risk of hypoglycemia; monitor blood glucose closely.

Renal Impairment: May require dose adjustments; monitor blood glucose more frequently.

Hepatic Impairment: Adjust dosing cautiously due to potential alterations in insulin sensitivity.

Pharmacokinetics

Absorption: Rapid onset after subcutaneous administration, especially with inhaled Afrezza.

Distribution: Distributed throughout the body; cross-reacts with insulin antibodies.

Metabolism: Metabolized mainly in the liver and kidneys.

Excretion: Excreted via renal pathways mainly as insulin metabolites.

Half Life: Approximately 4-6 hours for regular insulin.

Contraindications

Hypersensitivity to human insulin or components.
Hypoglycemia.

Precautions

Use with caution in patients with renal or hepatic impairment, elderly patients, or during pregnancy and lactation. Monitor blood glucose levels regularly.

Adverse Reactions - Common

Hypoglycemia (Common)
Weight gain (Common)

Adverse Reactions - Serious

Severe hypoglycemia leading to unconsciousness or seizures (Serious)
Anaphylaxis (Rare)

Drug-Drug Interactions

Other antidiabetic agents increasing risk of hypoglycemia (e.g., sulfonylureas, meglitinides)

Drug-Food Interactions

Alcohol can potentiate hypoglycemia

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose levels, signs of hypoglycemia, and injection sites.

Diagnoses:

Risk for hypoglycemia
Impaired skin integrity at injection site

Implementation: Administer insulin as prescribed, rotate injection sites, educate patient on self-monitoring.

Evaluation: Assess for effectiveness in maintaining glycemic control and absence of adverse effects.

Patient/Family Teaching

Recognize signs of hypoglycemia and hyperglycemia.
How to administer insulin and rotate injection sites.
Importance of regular blood glucose monitoring.
Maintain proper storage of insulin.

Special Considerations

Black Box Warnings:

Severe hypoglycemia can be life-threatening.

Genetic Factors: Genetic variations may affect insulin requirements.

Lab Test Interference: None typically.

Overdose Management

Signs/Symptoms: Severe hypoglycemia, seizures, unconsciousness.

Treatment: Administer oral glucose if conscious; if unconscious, administer dextrose intravenously and seek emergency care.

Storage and Handling

Storage: Refrigerate unopened vials or pens; opened vials can usually be kept at room temperature for a limited period (check manufacturer instructions).

Stability: Stable until expiry date when stored properly.