NPH Insulin Overview

Study Notes

NPH Insulin Overview

NPH insulin is a generic name for this intermediate-acting insulin used in diabetes management.
Marketed under brand names Humulin N and Novolin N.

Medication Classification

Considered a high alert medication due to potential for serious harm if misused.

Therapeutic Use

Indicated for controlling hyperglycemia in diabetes patients.

Mechanism of Action

Lowers blood sugar levels by enhancing glucose uptake in skeletal muscles and fat.
Inhibits hepatic (liver) glucose production.

Additional Effects

Insulin reduces lipolysis (fat breakdown) and proteolysis (protein breakdown).
Enhances protein synthesis, contributing to better metabolic function.

Pharmacokinetics

Absorption occurs quickly in subcutaneous (subcut) tissues.
Distribution patterns mirror those of endogenous insulin produced by the body.

Metabolism

Metabolized by liver, kidneys, spleen, and muscle tissues, although the specific half-life is unknown.

Administration

Administered via subcutaneous injection.
Onset of action is typically 2 to 4 hours after injection.
Peaks in effectiveness between 4 to 10 hours post-injection, lasting for 10 to 16 hours.

Contraindications and Precautions

Avoid use in patients with hypoglycemia or known allergies to insulin types.
Caution is advised for those under stress, with infections, or having renal or hepatic impairments.

Adverse Effects

Most common: hypoglycemia (low blood sugar) and hypokalemia (low potassium levels).
Local injection site reactions include lipodystrophy, pruritus (itching), erythema (redness), and swelling.
Potential for allergic reactions.

Drug Interactions

Glucosamine can worsen blood glucose control.
Coenzyme Q10 may lead to increased hypoglycemic effects.

Patient Monitoring

Regularly assess for signs of hypoglycemia (e.g., anxiety, cold sweats, confusion) and hyperglycemia (e.g., excessive thirst, dry skin).
Monitor blood sugar every 6 hours during therapy; potassium levels should also be checked.

Implementation and Safety

As a high alert medication, be vigilant against overmedication risks.
Distinguish clearly between long-acting and short-acting insulin.
Roll insulin bottles between palms to mix, avoiding shaking.

Patient Education

Teach proper injection techniques, including sites and angles of administration.
Educate on self-monitoring blood sugar and ketone levels.
Stress the importance of not sharing insulin pens/needles, adherence to dietary guidelines, and exercise.
Explain medication's purpose, side effects, and management strategies for adverse reactions.

Effectiveness

NPH insulin effectively manages blood glucose levels, minimizing occurrences of both hypoglycemia and hyperglycemia in patients with diabetes.

Description

This quiz covers the essential aspects of NPH insulin, including its classification, therapeutic use, mechanism of action, and pharmacokinetics. Understand how this intermediate-acting insulin helps manage diabetes and its role in lowering blood sugar levels.