INSULIN, ISOPHANE (NPH)
(in'su-lin)
Humulin N, Insulatard NPH, Mixtard, Novolin 70/30, Novolin N
Classifications: hormone and synthetic substitute; antidiabetic agent; intermediate acting insulin
Prototype: Insulin
Pregnancy Category: B

Availability

100 units/mL

Actions

Intermediate-acting, cloudy suspension of zinc insulin crystals modified by protamine in a neutral buffer. NPH Iletin II (pork), and Insulatard NPH are "purified" or "single component" insulins that have been purified and are less likely to cause allergic reactions than nonpurified preparations.

Therapeutic Effects

Lowers blood glucose levels by increasing peripheral glucose uptake, especially by skeletal muscle and fat tissue, and by inhibiting the liver from changing glycogen to glucose. Therapeutic effect controls postprandial hyperglycemia, usually without supplemental doses of insulin injection.

Uses

Used to control hyperglycemia in the diabetic patient. Mixtard and Novolin 70/30 are fixed combinations of purified regular insulin 30% and NPH 70%.

Contraindications

During episodes of hypoglycemia or in patients sensitive to any ingredient in the formulation.

Cautious Use

In insulin resistant patients, hyperthyroidism or hypothyroidism; lactation, older adults, pregnancy (category B), renal or hepatic impairment. Safety and efficacy in children <3 y are not established.

Route & Dosage

Diabetes Mellitus
Adult: SC Individualized doses (see INSULIN, REGULAR)

Administration

Subcutaneous

Adverse Effects (1%)

(see INSULIN, REGULAR).

Interactions

(see insulin, regular).

Pharmacokinetics

Onset: 1–2 h. Peak: 4–12 h NPH. Duration: 18–24 h NPH. Metabolism: Metabolized in liver and kidney. Elimination: <2% excreted unchanged in urine. Half-Life: up to 13 h.

Nursing Implications

(see INSULIN, REGULAR)

Assessment & Drug Effects

Patient & Family Education


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