Home Drug Guide Insulin Lispro Recombinant

Drug Guide

Generic Name

Insulin Lispro Recombinant

Brand Names Humalog, Humalog Pen, Humalog Kwikpen, Humalog Tempo Pen

Classification

Therapeutic: Antidiabetic agent

Pharmacological: Rapid-acting insulin

FDA Approved Indications

  • Type 1 diabetes mellitus in adults and children
  • Type 2 diabetes mellitus in adults and children for blood sugar control

Mechanism of Action

Insulin Lispro is a recombinant human insulin analog that mimics endogenous insulin by facilitating cellular glucose uptake, inhibiting hepatic glucose production, and promoting lipid and protein synthesis. Its rapid onset of action helps control postprandial blood sugar levels.

Dosage and Administration

Adult: Dose individualized based on patient needs, typically administered 15 minutes before or immediately after meals.

Pediatric: Dosing similar to adults, tailored based on clinical response.

Geriatric: Use with caution; start at lower doses due to increased risk of hypoglycemia.

Renal Impairment: Adjust dose based on glycemic responses; monitor closely.

Hepatic Impairment: No specific adjustments, but cautious titration is advised.

Pharmacokinetics

Absorption: Rapid absorption after subcutaneous injection, with onset within 15 minutes.

Distribution: Distributes throughout the extracellular fluid; no significant plasma protein binding.

Metabolism: Metabolized in the liver and other tissues to inactive metabolites.

Excretion: Excreted primarily in urine as metabolites.

Half Life: Approximately 1 hour.

Contraindications

  • Hypoglycemia
  • Allergy to insulin or any component of the formulation

Precautions

  • Hypoglycemia risk, especially with improper dosing
  • Adjustments needed during illness, stress, or surgery. Monitor for lipodystrophy at injection sites.
  • Pregnancy category B: Use if benefits outweigh risks. Insulin is generally safe during pregnancy and lactation.

Adverse Reactions - Common

  • Hypoglycemia (Common)
  • Injection site reactions (redness, swelling, or itching) (Common)

Adverse Reactions - Serious

  • Severe hypoglycemia leading to coma or seizures (Uncommon)
  • Allergic reactions, including anaphylaxis (Rare)

Drug-Drug Interactions

  • Beta-blockers (may mask hypoglycemia symptoms)
  • Corticosteroids (may increase blood glucose)
  • Diuretics, thyroid hormones, and other antidiabetics

Drug-Food Interactions

  • Alcohol (can increase or decrease blood sugar)

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose levels regularly; assess for hypoglycemia and injection site reactions.

Diagnoses:

  • Risk for unstable blood glucose
  • Risk for hypoglycemia or hyperglycemia

Implementation: Administer subcutaneously; rotate injection sites; educate patient on blood glucose monitoring.

Evaluation: Evaluate effectiveness by blood glucose trends and reduction in hyperglycemia symptoms.

Patient/Family Teaching

  • Instruct on proper injection technique and site rotation.
  • Educate on recognizing and managing hypoglycemia (shaking, sweating, confusion).
  • Emphasize the importance of blood glucose monitoring.
  • Inform about possible side effects and when to seek medical attention.

Special Considerations

Black Box Warnings:

  • Severe hypoglycemia risk with improper dosing or missed meals.

Genetic Factors: No specific genetic considerations.

Lab Test Interference: May interfere with certain laboratory blood glucose measurements.

Overdose Management

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

Treatment: Administer oral glucose if conscious; glucagon injection or IV glucose if unconscious; contact emergency services.

Storage and Handling

Storage: Store unopened vials or pens in refrigerator at 2-8°C; avoid freezing.

Stability: Unopened pens/vials are stable until the expiration date; opened pens can usually be kept at room temperature up to 28 days, depending on manufacturer instructions.

🛡️ 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.