Questions and Answers
What is the generic name for NPH insulin?
Which of the following are brand names for NPH insulin?
NPH insulin is considered a high alert medication.
True
What is the indication for NPH insulin?
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How does NPH insulin lower blood sugar?
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What is the absorption characteristic of NPH insulin?
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What is the typical onset time for NPH insulin?
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What is the peak action time for NPH insulin?
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What is the duration of action for NPH insulin?
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What are the contraindications for NPH insulin?
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What are some adverse effects associated with NPH insulin?
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What should be monitored during therapy with NPH insulin?
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What is important about the implementation of NPH insulin?
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What teaching should be provided regarding NPH insulin?
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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.
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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.
