DRUG STUDY

Name of Patient:_________________________________________________________________________________________________________ Ward No.: _______ Bed No.: _______

Medical
Diagnosis:_______________________________________________________________________________________________________________________________________
Drug Name: INSULIN (Regular)
Indication for Patient:
USUAL DOSAGE/
AVAILABILITY
Injection (human): 100
units/mL (Humulin R,
Novolin R, Novolin R
PenFill, Novolin R
Prefilled)

PHARMACOLOGIC
ACTION OF DRUG
Increases glucose
transport across
muscle and fat cell
membranes to reduce
glucose level. Helps
convert glucose to
glycogen; triggers
amino acid uptake
and conversion to
protein in muscle
cells; stimulates
triglyceride formation
and inhibits release of
free fatty acids from
adipose tissue; and
stimulates lipoprotein
lipase activity, which
converts circulating
lipoproteins to fatty
acids.

CONTRAINDICATIONS

INTERACTION

Contraindicated in
patients with history of
systemic allergic
reactions to pork when
porcine-derived products
are used or
hypersensitivity to any
component of
preparation.
Contraindicated during
episodes of
hypoglycemia.
Overdose S&Sx:
Hypoglycemia

Drug-drug. ACE inhibitors, anabolic steroids, antidiabetics, calcium,

chloroquine, clonidine, disopyramide, fibrates, fluoxetine, guanethidine,
lithium, MAO inhibitors, mebendazole, octreotide, pentamidine,
propoxyphene, pyridoxine, salicylates, sulfinpyrazone, sulfonamides,
tetracyclines: May enhance hypoglycemic effects of insulin. Monitor
glucose level.
Acetazolamide, adrenocorticosteroids, albuterol, antiretrovirals,
asparaginase, calcitonin, cyclophosphamide, danazol, diazoxide,
diltiazem, diuretics, dobutamine, epinephrine, estrogens, ethacrynic acid,
hormonal contraceptives containing estrogen, isoniazid, lithium,
morphine, niacin, nicotine, pheothiazines, phenytoin, progestogens,
somatropin, terbutaline, thyroid hormones: May diminish insulin
response. Monitor glucose level.
Bronchodilators and other inhaled drugs: May alter the absorption of
inhaled insulin. Consistently time doses of other inhaled drugs with
inhaled insulin, and monitor glucose level closely.
Carteolol, Nadolol, Pindolol, Propanolol, Timolol: May mask symptoms of
hypoglycemia as a result of beta blockade (such as tachycardia). May
delay recovery from hypoglycemic episodes. Use together cautiously in
patients with diabetes.
Rosiglitazone: May cause fluid retention that may lead to or worsen heart
failure. Monitor patient closely.
Drug-herb. Basil, bay, bee pollen, burdock, ginseng, glucomannan,

ADVERSE
EFFECTS
EENT: blurred
vision
GI: dry mouth
Metabolic:
hypoglycemia,
hyperglycemia,
hypomagnesemia,
hypokalemia.
Skin: rash,
urticarial, pruritus,
swelling, redness,
stinging, warmth at
injection site.
Respiratory:
increased cough,
respiratory tract
infection, dyspnea,
reduced pulmonary
function
Other: lipoatrophy,
lipohypertrophy,
anaphylaxis,
hypersensitivity

DANICA PAULINE G. RAMOS|2012-63528

horehound, marshmallow, myrrh, sage: May affect glycemic control.

Discourage use together, and monitor glucose level carefully.
Drug-food. Unregulated diet: May cause hyperglycemia or hypoglycemia.
Urge caution and monitor patients diet.
Drug-lifestyle. Alcohol use: May cause hypoglycemic effect. Discourage
use together.
Marijuana use: May increase glucose level. Inform patient of this
interaction.
Smoking: May increase glucose level and decrease response to drug.
Monitor glucose level.

reactions.

NURSING RESPONSIBILITIES
Regular insulin is for patients with circulatory collapse, diabetic ketoacidosis, or hypokalemia. Dont use Humulin R (concentrated) U-500 I.V. Dont use intermediate- or
long-acting insulins for coma or other emergencies requiring rapid drug action. Also, ketosis-prone type 1, severely-ill, and newly diagnosed diabetic patients with very high
glucose levels may need hospitalization and I.V. treatment with regular fast-acting insulin
Some patients may develop insulin resistance and need large insulin doses to control symptoms of diabetes. U-500 insulin is available as Humulin R (concentrated) U-500
for such patients. Give pharmacy sufficient notice when requesting refill prescription. Never store U-500 insulin in same area with other insulin preparations because of the
risk of severe overdose if accidentally given to the wrong patient.
Monitor patient for hyperglycemia (rebound, or Somogyi, effect).

DANICA PAULINE G. RAMOS|2012-63528