MEDICATION

Name:

Medication Name: Regular Insulin

Drug Classification: Therapeutic: antidiabetic drug, pancreatic hormone

Pharmacologic: short-acting hypoglycemic drug

Indication for Patient: It is used to control hyperglycemia in patients with diabetes mellitus. An
unlabeled use for regular insulin is to treat hyperkalemia.

Action/Therapeutic Use: It lowers blood glucose by stimulating glucose uptake in skeletal

muscle and fat, inhibiting hepatic glucose production. It also inhibits lipolysis and proteolysis,
enhanced protein synthesis.

Contraindications/Precautions: Contraindicated in: hypoglycemia, allergy or hypersensitivity the

particular type of insulin, preservatives, or other additives. Use cautiously in: stress and infection
(may temporarily increase insulin requirements), renal/hepatic impairments (may decrease
insulin requirements), concomitant use with pioglitazone or rosiglitazone (increased risk of fluid
retention and worsening HF), pregnancy (may temporarily increase insulin requirements).

Adverse Reactions/Side Effects: hypoglycemia, hypokalemia, erythema, lipohypertrophy

(accumulation of fat at injection site), pruritis, swelling, anaphylaxis

Interactions: Drug-drug: Beta-blockers, clonidine, and reserpine (may mask the signs and
symptoms of hypoglycemia). Corticosteroids, thyroid supplements, estrogens, isoniazid, niacin,
phenothiazines, and rifampin (may increase insulin requirements). Alcohol, ACE inhibitors,
MAOIs, octreotide, oral hypoglycemic agents, and salicylates (may decrease insulin
requirements). Concurrent use with pioglitazone or rosiglitazone may increase risk of fluid
retention and worsen HF. Drug-natural products: Glucosamine (may worsen blood glucose
control). Fenugreek, chromium, and coenzyme Q-10 (may produce additive hypoglycemic
effects). Drug-Food: garlic, chromium, bitter melon, ginseng (hypoglycemic effect).

Nursing Implications (Assessments/Labs Considerations): Assess for symptoms of

hyperglycemia and hypoglycemia periodically during therapy. Monitor weight periodically to
ensure the insulin dose does not need to be changed. Monitor blood glucose levels every 6 hours
during therapy, more frequently during keta acidosis and times of stress. Hemoglobin A1C may
also be monitored 3-6 months to determine effectiveness. Monitor serum potassium in patients at
risk for hypokalemia periodically during therapy. Assess for signs and symptoms of overdose.
Overdose is manifested by symptoms of hypoglycemia. Mild hypoglycemia may be treated by
ingestion of oral glucose, but severe hypoglycemia is a life-threatening emergency treated by IV
glucose, glucagon, or epinephrine.

Client Education: Teach the patient proper administration techniques. Include: type of insulin,
equipment, storage, and how to discard syringes. Ensure that they know they cannot share
needles/pens with anyone else. Teach them how to check their serum glucose and ketones.
Emphasize the importance of compliance with nutritional guidelines and regular exercise as
directed by HCP. Instruct patient on signs and symptoms of hypoglycemia and hyperglycemia
and what to do if they occur. Advise patient to notify HCP if nausea, vomiting, pregnancy, or
fever develops, if unable to eat regular diet, or if blood glucose levels are not controlled. Advise
the patient to keep a source of sugar on them, identification describing their disease, and
treatment regimen at all times. Emphasize the importance of regular follow-ups, especially
during the first few weeks of therapy.

Textbook Reference:(Pharmacology: Connections to Nursing Practice, 3rd edition pg. 1118-1119)

-Adams, M., & 1951-. (2010). Pharmacology: connections to nursing practice. Upper Saddle
River, NJ: Pearson Prentice Hall.

(Davis’s Drug Guide for Nurses; Sixteenth Edition; pages 693-695)

- Vallerand, A. H., Sanoski, C. A., & Quiring, C. (2019). Davis’s Drug Guide for Nurses.
Philadelphia, PA: F.A. Davis Company.

Please include the title of the text, edition, and page number(s) you referenced.
Your ATI Book will NOT be accepted as a reference.