title: Insulin (Actrapid – for hyperglycaemia)
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  Insulin (Actrapid – for hyperglycaemia)
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  bet | 316/654 | Sana | 03.01.2022 | Hajmi | 1,5 Mb. | | #14803 |
  Insulin (Actrapid – for hyperglycaemia)
  Revision Date : 2-3-2020
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  Approved: TC, KOH
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  Alert
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  High risk of hypoglycaemia.
  Insulin binds to the plastic of giving sets. Flush the plastic tubing with 20 mL of prepared insulin solution into a receptacle prior to connecting to the infant. This is to saturate the binding.
  Insulin concentrations ≤ 0.05 Unit/mL are not reliably delivered even after preconditioning and flushing.
  Do not filter infusion. Insulin also binds to the filter.
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  Indication
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  Treatment of persistent hyperglycaemia.
  [For treatment of hyperkalaemia, see Insulin – hyperkalaemia].
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  Action
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  Insulin is a polypeptide hormone that acts on cells throughout the body to stimulate uptake, utilisation and storage of glucose resulting in a lowering of blood glucose. Insulin stimulates the liver to store glucose in the form of glycogen and facilitates the entry of glucose into muscle and adipose tissue. It inhibits lipolysis, proteolysis and gluconeogenesis, enhances protein synthesis and conversion of excess glucose into fat.
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  Drug Type
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  Polypeptide hormone – lowers blood glucose.
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  Trade Name
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  Actrapid [Novo Nordisk]
  Humulin R [Eli Lilly]
  Hypurin Neutral Injection [Aspen]
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  Presentation
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  Vial: 100 units/mL in a 10 mL vial and 3 mL Pen-fill.
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  Dosage/Interval
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  Treatment of hyperglycaemia:
  Intravenous:
  Starting dose: 0.05 unit/kg/hour.
  Dose range: 0.01 to 0.1 unit/kg/hour.
  Titrate in small increments to blood glucose: Target blood glucose 6 to 10 mmol/L [1, 2].
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  Route
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  IV
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  Preparation/Dilution
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  SINGLE STRENGTH INFUSION (suitable if weight > 1 kg)
  Infusion strength
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  Prescribed amount
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  1 mL/hour = 0.1 unit/kg/hour
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  5 unit/kg insulin and make up to 50 mL
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  Draw up 0.6 mL (60 units of insulin) and add 29.4 mL glucose 5%, glucose 10% or sodium chloride 0.9% to make a final volume of 30 mL with a concentration of 2 unit/mL.
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