Humulin N Vial 1 pc

✔️ Uses of Humulin N

Diabetes mellitus (Type 1 and Type 2).

✔️ Side Effects of Humulin N

• Common: Hypoglycemia (dose-dependent).
• Other reactions: Lipodystrophy at the injection site, generalized hypersensitivity reactions (rash, itching, gastrointestinal upset), and edema during initial therapy.

✔️ Mode of Action:

Insulin lowers blood glucose by:

• Regulating carbohydrate, protein, and fat metabolism.
• Inhibiting hepatic glucose production.
• Enhancing peripheral glucose disposal.

Various insulin formulations differ by their duration of action:

• Short-acting insulin (e.g., regular insulin) acts quickly.
• Intermediate-acting insulin (e.g., NPH insulin) has a prolonged release due to complexing insulin with a protein (e.g., protamine).

✔️ Humulin N Injection is indicated for:

1. Treatment of type 1 diabetes.
2. Treatment of type 2 diabetes is not adequately controlled by diet and/or oral hypoglycemic agents.
3. Initial stabilization of diabetes in patients with diabetic ketoacidosis, hyperosmolar non-ketotic syndrome, and during periods of stress such as severe infections and major surgery in diabetic patients.
4. Treatment of gestational diabetes.

✔️ Pharmacology of Humulin N

Humulin N is a sterile, clear solution of human insulin with a medium duration of action. The blood glucose-lowering effect is achieved by promoting glucose uptake in muscle and fat cells and inhibiting glucose production in the liver.

• The onset of action: 30 minutes after injection.
• Peak action: 1-3 hours post-injection.
• Duration of action: 4-6 hours.

✔️ Dosage of Humulin N

Adult Dose:

• Type 1 Diabetes Mellitus:
  • Usual daily maintenance range: 0.5-1 unit/kg/day, divided into doses.
  • Non-obese patients may require 0.4-0.6 units/kg/day.
  • Obese patients may require 0.8-1.2 units/kg/day.
• Type 2 Diabetes Mellitus:
  • Usual insulin requirement: 0.3-0.6 IU/kg/day, in 1-2 divided doses.
  • Starting dose: 0.2 units/kg/day.
  • Dosage adjustments: 2-unit changes for Type 1, 2-4 unit changes for Type 2 diabetes.
  • In combination with regular insulin:
    • Morning: Two-thirds of the daily insulin dose (Regular insulin to NPH ratio of 1:2).
    • Evening: One-third of the daily insulin dose (Regular insulin to NPH ratio of 1:1).

Child Dose:

• Type 1 Diabetes Mellitus (≥12 years): 0.5-1 unit/kg/day subcutaneously, with a maximum of 1.2 units/kg/day during growth spurts.
• <12 years: Safety and efficacy not established.

Dosage should be individualized based on blood glucose and urine glucose tests.

• Hepatic impairment: Dosage reduction may be needed.
• Renal impairment: Dosage adjustments may be required.

✔️ Overdose Effects:

• Mild hypoglycemia: Treat with oral glucose or sugary products.
• Severe hypoglycemia: Treat with glucagon injection or intravenous glucose.

✔️ Administration of Humulin N

• Administer subcutaneously in the upper arm, thigh, or abdominal wall.
• Administer within 15 minutes before or immediately after a meal.
• Subcutaneous injection into the abdominal wall results in faster absorption compared to other sites.

✔️ Dosage Adjustment:

• Infections, fever, or stress may increase insulin requirements.
• Renal or hepatic impairment may reduce insulin requirements.
• Physical activity or changes in diet may also necessitate dosage adjustments.
• Transitioning between different types of insulin should be done under medical supervision.

✔️ Certain drugs may alter insulin requirements:

• Decrease insulin requirements: Oral hypoglycemic agents, MAOIs, beta-blockers, ACE inhibitors, salicylates, alcohol.
• Increase insulin requirements: Thiazides, glucocorticoids, thyroid hormones, beta-sympathomimetics, growth hormone.

✔️ Contraindications:

• Hypoglycemia.
• Hypersensitivity to human insulin or any excipients in the preparation.

✔️ Pregnancy & Lactation:

There are no restrictions on insulin therapy during pregnancy. Insulin does not cross the placenta, making it safe for use. Dosage adjustments are required during pregnancy and after delivery. It is also safe for use during breastfeeding.

✔️ Precautions & Warnings:

• Inadequate insulin dosing or discontinuation can lead to hyperglycemia and diabetic ketoacidosis, especially in type 1 diabetes.
• Hypoglycemia may occur if insulin dosage is too high.
• Medical supervision is required when switching insulin types or brands.
• Special precautions are necessary when traveling across time zones.

✔️ Storage Conditions:

• Store between 2°C and 8°C (in a refrigerator). Do not freeze.
• Protect from excessive heat and sunlight.
• Once in use, the vial can be stored at room temperature below 25°C for up to 6 weeks or below 30°C for 4 weeks.