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INSULIN ASPART

Medical Diagnosis and Drugs, Medications
INSULIN ASPART
(in'su-lyn)
NovoLog
Classifications: hormone; antidiabetic agent; insulin, rapid-acting;
Therapeutic: antidiabetic; insulin rapid-acting
Prototype: Insulin injection
Pregnancy Category: C

Availability

100 U/mL injection

Action

A recombinant insulin analog that is more rapidly absorbed than human insulin, with a more rapid onset and shorter duration than regular human insulin.

Therapeutic Effect

Provides better blood glucose control than regular human insulin when given before a meal.

Uses

Treatment of diabetes mellitus.

Contraindications

Systemic allergic reactions; history of allergic reactions to insulin; hypoglycemia; pregnancy (category C).

Cautious Use

Fever, hyperthyroidism, surgery or trauma; decreased insulin requirements due to diarrhea, nausea, or vomiting, malabsorption; renal or hepatic impairment, hypokalemia.

Route & Dosage

Diabetes
Adult: SC 0.25–0.7 units/kg/d injected 5–10 min before each meal

Administration

Subcutaneous
  • Note: Must give 5–10 min before a meal.
  • Draw up insulin aspart first when mixing with NPH insulin. Give injection immediately after it is mixed. Do not give NPH mixture by IV.
  • Store refrigerated at 2°–8° C (36°–46° F); may be stored at room temperature, 15°–30° C (59°–86° F) for up to 28 d. Do not expose to excessive heat or sunlight, and do not freeze.

Adverse Effects (≥1%)

Body as a Whole: Allergic reactions. Endocrine: Hypoglycemia, hypokalemia. Skin: Injection site reaction, lipodystrophy, pruritus, rash.

Interactions

Drug: oral antidiabetic agents, ace inhibitors, disopyramide, fluoxetine, mao inhibitors, propoxyphene, salicylates, sulfonamide antibiotics, octreotide may enhance hypoglycemia; corticosteroids, niacin, danazol, diuretics, sympathomimetic agents, phenothiazines, thyroid hormones, estrogens, progestogens, isoniazid, somatropin my decrease hypoglycemic effects; beta-blockers, clonidine, lithium, alcohol may either potentiate or weaken effects of insulin; pentamidine may cause hypoglycemia followed by hyperglycemia. Herbal: Garlic, ginseng may potentiate hypoglycemic effects.

Pharmacokinetics

Absorption: Rapidly absorbed from SC injection site. Onset: 15 min. Peak: 1–3 h. Duration: 3–5 h. Distribution: Low protein binding. Metabolism: In liver with some metabolism in the kidneys. Half-Life: 81 min.

Nursing Implications

Assessment & Drug Effects

  • Monitor for S&S of hypoglycemia (see Appendix F). Initial hypoglycemic response begins within 15 min and peaks 45–90 min after injection.
  • Lab tests: Periodically monitor fasting blood glucose and HbA1C.
  • Withhold drug and notify physician if patient is hypokalemic.

Patient & Family Education

  • Do not inject into areas with redness, swelling, itching, or dimpling.
  • Ingest some form of sugar (e.g., orange juice, dissolved table sugar, honey) if symptoms of hypoglycemia develop, and seek medical assistance.
  • Check blood sugar as prescribed, especially postprandial values; notify physician of fasting blood glucose <80 and >120 mg/dL.
  • Notify the physician of any of the following: Fever, infection, trauma, diarrhea, nausea or vomiting. Dosage adjustment may be needed.
  • Do not take any other medication unless approved by the physician.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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