Generic Name

Insulin Aspart

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Classification

FDA Approved Indications

• Management of blood glucose in patients with diabetes mellitus

Mechanism of Action

Insulin Aspart is a recombinant human insulin analog that replaces endogenous insulin, facilitating the uptake of glucose into fat and skeletal muscle cells and inhibiting hepatic glucose production, thus lowering blood glucose levels. It acts rapidly to control postprandial blood glucose.

Dosage and Administration

Adult: Dosing is individualized; typically administered subcutaneously 5-10 minutes before meal. Dose adjustments are made based on blood glucose monitoring.

Pediatric: Dosing similar to adults, individualized based on age, weight, and response.

Geriatric: Careful dose adjustments due to potential hypoglycemia risk.

Renal Impairment: Adjustments may be necessary; monitor closely.

Hepatic Impairment: Use with caution; monitor blood glucose levels.

Pharmacokinetics

Absorption: Rapid absorption following subcutaneous injection.

Distribution: Widely distributed in the body; approximately 60% bound to plasma proteins.

Metabolism: Metabolized in the liver and kidneys similar to human insulin.

Excretion: Excreted primarily in urine as metabolites.

Half Life: Approximately 1 hour; effects last for about 3-5 hours.

Contraindications

• Hypoglycemia
• Allergy to insulin or excipients.

Precautions

• Use with caution in patients with hepatic or renal impairment, or in patients prone to hypoglycemia.

Adverse Reactions - Common

• Hypoglycemia (Common)
• Injection site reactions (Less common)
• Weight gain (Common)

Adverse Reactions - Serious

• Severe hypoglycemia (Serious, if not managed promptly)
• Anaphylaxis (Rare)

Drug-Drug Interactions

• Other antidiabetic agents (risk of hypoglycemia or hyperglycemia)
• Beta-blockers (mask hypoglycemia symptoms)

Drug-Food Interactions

• Alcohol (can cause hypoglycemia or hyperglycemia)

Drug-Herb Interactions

• Herbs that affect blood glucose levels, e.g., ginseng

Nursing Implications

Patient/Family Teaching

• Inject insulin as prescribed, timing around meals.
• Recognize and treat hypoglycemia symptoms promptly.
• Maintain proper rotation of injection sites.
• Follow dietary recommendations and regular blood glucose monitoring.

Special Considerations

Black Box Warnings:

• Severe hypoglycemia can occur if insulin doses are too high or if meals are delayed or omitted.

Genetic Factors: Genetic variations may influence insulin requirement.

Lab Test Interference: Blood glucose measurements may be affected by certain testing methods; follow device instructions.

Overdose Management

Signs/Symptoms: Severe hypoglycemia: sweating, tremors, confusion, seizures, loss of consciousness.

Treatment: Administer orally absorbed glucose or glucagon; in severe cases, intravenous dextrose may be necessary.

Storage and Handling

Storage: Store unopened vials or pens in the refrigerator, protected from light. Once opened, Fiasp can be kept at room temperature for up to 4 weeks.

Stability: Stable under recommended storage conditions.