Nurses Compass
Drug Guide
Insulin Lispro-aabc
Classification
Therapeutic: Antidiabetic agent
Pharmacological: Insulin analog, rapid-acting
FDA Approved Indications
- Treatment of adults and pediatric patients with diabetes mellitus to improve glycemic control
Mechanism of Action
Insulin Lispro-aabc mimics endogenous rapid-acting insulin by stimulating peripheral glucose uptake, inhibiting hepatic glucose production, and modulating carbohydrate, fat, and protein metabolism.
Dosage and Administration
Adult: Injected subcutaneously within 15 minutes before or just after starting a meal. Dose individualized based on patient needs.
Pediatric: Same as adult, with dose adjustments based on age, weight, and clinical response.
Geriatric: Adjust dose based on glycemic response and renal/hepatic function, with caution due to increased risk of hypoglycemia.
Renal Impairment: May require dose adjustment; monitor blood glucose closely.
Hepatic Impairment: Use with caution; monitor blood glucose levels regularly.
Pharmacokinetics
Absorption: Rapid absorption after subcutaneous injection, with onset of action within 15 minutes.
Distribution: Distributed throughout the body; the volume of distribution is approximately 0.2 L/kg.
Metabolism: Metabolized mainly in the liver and kidneys via proteolytic enzymes.
Excretion: Excreted primarily as degraded metabolites.
Half Life: Approximately 1 hour in plasma.
Contraindications
- Hypoglycemia at the time of administration
Precautions
- Risk of hypoglycemia, especially during peak activity; adjust doses accordingly.
- Use with caution in patients with renal or hepatic impairment.
- Inspect injection site regularly for signs of lipodystrophy or skin reactions.
Adverse Reactions - Common
- Hypoglycemia (Common)
- Injection site reactions (redness, swelling, itching) (Less common)
Adverse Reactions - Serious
- Severe hypoglycemia (Rare)
- Anaphylaxis (Very rare)
Drug-Drug Interactions
- Other hypoglycemic agents, corticosteroids, beta-blockers, diuretics, thyroid hormones, and certain antidepressants.
Drug-Food Interactions
- Alcohol may potentiate or mask hypoglycemia.
- High carbohydrate meals may affect insulin needs.
Drug-Herb Interactions
- vera, ginseng may affect blood glucose.
Nursing Implications
Assessment: Monitor blood glucose levels regularly. Assess for signs of hypoglycemia or hyperglycemia.
Diagnoses:
- Risk for unstable blood glucose levels.
- Risk for hypoglycemia.
Implementation: Administer at prescribed times relative to meals. Educate patients on symptoms of hypoglycemia and hyperglycemia.
Evaluation: Maintain blood glucose within target range. Observe for adverse reactions or injection site issues.
Patient/Family Teaching
- How to inject insulin properly.
- Signs and management of hypoglycemia and hyperglycemia.
- Importance of regular blood glucose monitoring.
- Diet and lifestyle considerations.
Special Considerations
Black Box Warnings:
- None specified for this formulation.
Genetic Factors: Insulin sensitivity may vary due to genetic factors.
Lab Test Interference: May affect certain blood tests related to glucose monitoring.
Overdose Management
Signs/Symptoms: Hypoglycemia presenting as sweating, trembling, hunger, confusion, seizures.
Treatment: Administer fast-acting carbohydrate; if severe, glucagon injection or IV dextrose is indicated.
Storage and Handling
Storage: Unopened vials refrigerated at 2°C to 8°C. Do not freeze. Once in use, can be kept at room temperature (up to 30°C) for up to 28 days.
Stability: Stable under recommended storage conditions for up to 28 days once opened.