Home Drug Guide Insulin Isophane Recombinant Human

Drug Guide

Generic Name

Insulin Isophane Recombinant Human

Brand Names Humulin N, Novolin N

Classification

Therapeutic: Antidiabetic agent

Pharmacological: Insulin, intermediate-acting

FDA Approved Indications

  • Treatment of diabetes mellitus in adults and children to control hyperglycemia

Mechanism of Action

Provides exogenous insulin similar to endogenous insulin, facilitating cellular uptake of glucose, inhibiting hepatic glucose production, and promoting lipid and protein synthesis.

Dosage and Administration

Adult: Individualized based on patient needs; typically administered subcutaneously once or twice daily. Dose adjustments are based on blood glucose monitoring.

Pediatric: Dosed based on weight and individual response; typically administered subcutaneously, frequency and amount determined by physician.

Geriatric: Generally similar to adults but with careful monitoring due to increased risk of hypoglycemia.

Renal Impairment: Dose adjustments may be necessary, and monitoring of blood glucose levels is essential.

Hepatic Impairment: Use with caution; monitor for hypoglycemia.

Pharmacokinetics

Absorption: Subcutaneously absorbed with a relatively slow onset and prolonged duration.

Distribution: Distributed throughout the body fluids.

Metabolism: Metabolized primarily in the liver and kidneys.

Excretion: Excreted as insulin metabolites; renal and hepatic clearance.

Half Life: Approximately 4-6 hours for insulin in general; insulin is continually utilized and replaced.

Contraindications

  • Hypoglycemia
  • Allergy to insulin or excipients

Precautions

  • Use with caution in hypoglycemia unawareness, liver or kidney disease, and during illness or stress.

Adverse Reactions - Common

  • Hypoglycemia (Common)
  • Injection site reactions (lipodystrophy, redness) (Less common)

Adverse Reactions - Serious

  • Severe hypoglycemia (Serious but less common)
  • Anaphylaxis (Rare)

Drug-Drug Interactions

  • Other antidiabetic agents, corticosteroids, beta-blockers, diuretics, tetracyclines

Drug-Food Interactions

  • Alcohol can increase hypoglycemia risk

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose and HbA1c levels, assess for signs of hypoglycemia and hyperglycemia.

Diagnoses:

  • Risk for unstable blood glucose levels
  • Risk for hypoglycemia

Implementation: Administer subcutaneously as ordered; educate patient on proper injection technique and recognizing signs of hypoglycemia.

Evaluation: Regular monitoring of blood glucose levels; adjust dose based on blood glucose and HbA1c.

Patient/Family Teaching

  • Importance of adhering to prescribed regimen
  • How to inject insulin properly
  • Recognition and management of hypoglycemia
  • Need for regular blood glucose monitoring

Special Considerations

Black Box Warnings:

  • Severe life-threatening hypoglycemia may occur if insulin is misused or overdosed.

Genetic Factors: Type 1 diabetes management may involve specific considerations.

Lab Test Interference: May affect certain血糖-related lab tests, ensure proper documentation.

Overdose Management

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

Treatment: Administer oral glucose if alert; if unconscious, give IV glucose or glucagon as directed, and seek emergency medical care.

Storage and Handling

Storage: Store unopened vials or pens in the refrigerator at 2°C–8°C. Do not freeze.

Stability: Once opened, insulin can generally be kept at room temperature up to 28 days, but check the specific product labeling for exact stability period.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.