Insulin Regular

Insulin Regular

Note: "Regular" insulin is the generic name. Be certain that you have regular insulin since there are several other forms of insulin

Indication

• Used in the treatment of hyperglycemia and hyperkalemia

Pharmacology

• Insulin is a hormone that is derived from the beta cells of the pancreas; it is the principal hormone needed for glucose utilization
• Facilitates transport of glucose into skeletal and cardiac muscle and adipose tissue
• promotes intracellular shift of potassium and magnesium

Side Effects

• hypoglycemia, hyperglycemic rebound

Monitoring

• carefully monitor serum glucose, potassium and sodium

Dose

• Hyperglycemia
  • Loading Dose: 0.1 unit/kg IV push or slow IV infusion as ordered
  • Maintenance Dose: 0.02 to 0.1 unit/kg/h by continuous IV infusion (titrate with hourly determinations of serum glucose and 4 hourly determinations of serum potassium until these levels are stable) See standard concentrations below for infusions
• Hyperkalemia
  • 0.05 to 0.1 unit/kg/h by continuous IV infusion (titrate with hourly determinations of serum glucose and 4 hourly determinations of serum potassium until these levels are stable)
• Standard Concentrations for continuous infusions implemented October 2014: 
  • Weight 2kg or less: 0.1units/mL or 5 units/50mL of IV fluid
  • Weight over 2kg: 0.5 units/mL or 25 units/50mL of IV fluid
  • Dose = 0.05 unit/kg/h Weight = 0.7 kg
  • = 0.035 unit/h
  • = 0.035 unit/mL (solution to be run at 1mL/h)
  • = 1.75 units/50mL
• Always prepare an initial insulin dilution of 1 unit/mL for smaller doses
• Emergency Preparation:
  • Add 0.1 mL of Regular Insulin (100 units/mL) to a 10 mL vial of 0.9% NaCl. Mix.
  • Concentration = 1 unit/mL of Regular Insulin
• Non-Emergency Preparation:
  • Add 0.1 mL of Regular Insulin (100 units/mL) to 9.9 mL of IV solution. Mix.
  • Concentration = 1 unit/mL of Regular Insulin
• To make 50 mL of Insulin [0.1 unit/mL]
  • [5 units/50 mL]:
    1. Add 0.1 mL (10 units) of regular insulin (100 unit/mL) to 9.9 mL of IV solution and mix. This results in a diluted 1 unit/mL Stock Solution
    2. Add 5 mL (5 units ) of the diluted stock insulin [1 unit/mL] to 45 mL of IV solution, resulting in a 0.1unit/mL solution. Discard the diluted 1mg/mL stock solution after use, do not store.
• To make 50 mL of Insulin [0.5 units/mL]
  • [25 units/ 50 mL]:

1. Add 0.25mL (25 units) of regular insulin [100 units/mL] to 49.75 mL of IV Solution

Supplied As

• 100 unit/mL vial of "Regular" Human Insulin ( Novolin Toronto (R)) (10 mL size)
• Patient specific standard concentration syringes for infusions of 5units/50mL and 25units/50mL of IV fluid
• Date and initials should be written on yellow sticker (which is on the vial) when the vial is punctured for the first time. Insulin may be kept for 2 months after the vial is punctured for the first time