Which insulin can be administered through continuous intravenous infusion?
A. insulin glargine (Lantus)
B. insulin aspart (Novolog)
C. insulin detemir (Levemir)
D. insulin Afrezza
E. regular insulin (Novolin R)
Correct Answer: E. regular insulin (Novolin R)
Regular insulin is a short-acting insulin that can be given intravenously in a continuous manner. For intravenous infusions, to minimize insulin adsorption to plastic IV tubing, flush the intravenous tube with a priming infusion of 20 mL from a 100 mL-polyvinyl chloride bag insulin every time a new intravenous tubing is added to the insulin infusion container.
Option A: Insulin glargine comes either in 100 ml vials or in dosing pens that contain 3 ml cartridges of medication and is administered via subcutaneous injection only. The drug is available at a concentration of 100 units per ml. Its administration includes a diluent with a pH of 4.0 to maintain the solubility of the drug before use.
Option B: Insulin aspart should be administered subcutaneously (SC) within 5 to 10 minutes before a meal, with 1 to 4 meals per day. Rotate injection sites between the top of thighs, back of upper arms, buttocks, or abdomen to avoid lipodystrophy. Avoid injecting within 2 inches of the naval.
Option C: Long-acting insulins, such as glargine and detemir, start action in 1 to 2 hours. They provide a plateau effect over 12 to 24 hours. Dosing is usually during the night time after meals. Their long duration of action helps in reducing the frequency of dosing throughout the day.
Option D: Insulin degludec is a long-acting, man-made version of human insulin. Insulin degludec works by replacing the insulin that is normally produced by the body and by helping move sugar from the blood into other body tissues where it is used for energy. It also stops the liver from producing more sugar. Insulin degludec comes as a solution (liquid) to inject subcutaneously (under the skin). It is injected once a day.
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