tion of drug•Treatment for a few days after area has cleared•Storage at room temperatureEvaluate:•Therapeutic response: absence of severe itching, patches on skin, flakingTeach patient/family:•To avoid sunlight on affected area; burns may occurINSULIN,Beef NPH Iletin II, Humulin N, Iletin NPH, Insulatard NPH, NPH Iletin I, Pork NPH Iletin II, Novolin N, NPH Insulin, NPH Purified PorkFunc. class.: AntidiabeticChem. class.: Exogenous unmodified insulinAction: Decreases blood sugar; indirectly increases blood pyruvate, lactate; decreases phosphate, potassiumUses: Ketoacidosis, type I (IDDM), type II (NIDDM) diabetes mellitus, hyperkalemiaDosage and routes:•Adult: SC dosage individualized by blood, urine glucose, usual dose 7-26 U; may increase by 2-10 U/day if neededAvailable forms: SC 100 U/mlSide effects/adverse reactions:CNS:Headache, lethargy, tremors, weakness, fatigue, delirium, sweatingCV:Tachycardia, palpitationsEENT:Blurred vision, dry mouthGI:Hunger, nauseaMETA:HypoglycemiaINTEG:Flushing, rash, urticaria, warmth, lipodystrophy, lipohypertrophySYST:AnaphylaxisContraindications: Hypersensitivity to protaminePrecautions: Pregnancy (B)Interactions/incompatibilities:•Increased hypoglycemia: salicylate, alcohol, b-blockers, anabolic steroids, fenfluramine, phenylbutazone, sulfinpyrazone, guanethidine, oral hypoglycemics, MAOIs, tetracycline•Decreased hypoglycemia: thiazides, thyroid hormones, oral contraceptives, corticosteroids, estrogens, dobutamine, epinephrinePharmacokinetics:SC:Onset 1-2 hr, peak 4-12 hr, duration 18-24 hrMetabolized by liver, muscle, kidneys; excreted in urineLab test interferences:Increase: VMADecrease: K, CaInterference: Liver function studies, thyroid function studiesNURSING CONSIDERATIONSAssess:•Fasting blood glucose, 2 hr PP (80-150 mg/dl normal fasting level) (70-130 mg/dl-normal 2 hr level) •Urine ketones during illness; insulin requirements may incre...
