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HomeFactsWhat Does Nph Insulin Stand For

What Does Nph Insulin Stand For

Is Levemir Better Than Nph

Dosage Calculation: Insulin Calculation

Both Levemir and Lantus are preferred over NPH insulin because they have a longer duration of action, a less pronounced peak, and are more consistent in their effects with less risk of hypoglycemia. Both Levemir and Lantus are clear solutions, unlike NPH which requires resuspension prior to injection.

How Is Nph Made

Insulin NPH is manufactured using recombinant DNA technology from a non-pathological strain of E. coli. It combines human insulin with protamine sulfate to create a crystalline suspension. The NPH in insulin NPH stands for neutral protamine HagedornNeutral refers to the fact that this insulin has a neutral pH of 7. Protamine is the protein molecule that is combined with this insulin to create the crystallized structure that prolongs its effectiveness in the body. Hagedorn is the last name of the scientist who developed this form of insulin.

How To Use Insulin Nph And Regular Human Suspension

Read the Patient Information Leaflet provided by your pharmacist before you start using combination isophane/regular insulin and each time you get a refill. If you have any questions, ask your doctor, diabetes educator, or pharmacist.

Learn all preparation and usage instructions from your health care professional and the product package.

Before using, gently roll the vial or cartridge, turning it upside down and back 10 times to mix the medication. Do not shake the container. Check this product visually for particles or discoloration. If either is present, do not use the insulin. Combination isophane/regular insulin should look evenly cloudy/milky after mixing. Do not use if you see clumps of white material, a “frosty” appearance, or particles stuck to the sides of the vial or cartridge.

Before injecting each dose, clean the injection site with rubbing alcohol. Change where you inject each time to lessen the risk of problems or damage under the skin . Inject this medication under the skin as directed by your doctor, usually once or twice a day. This insulin product may be injected in the stomach area, the thigh, the buttocks, or the back of the upper arm. Do not inject into a vein or muscle because very low blood sugar may occur. Do not rub the area after the injection. Do not inject into skin that is red, swollen, itchy, or damaged. Do not inject cold insulin because this can be painful. The insulin container you are currently using can be kept at room temperature.

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Getting To The Best Answer

Answer 1 is correct. 56.89% chose this answer, In most states, it can be purchased over the counter without a prescription. YES, GREAT JOB. Actually, there are three over-the-counter insulins that are available for purchase without a prescription. They include regular insulin, NPH , and 70/30 insulin, a premixed combination of NPH and regular.

People might be interested in purchasing these older insulins because of their lower cost. Walmart sells all three types under the ReliOn brand umbrella for roughly $25 a vial. Chain pharmacies can also sell regular, NPH, and 70-30 insulin. However, OTC insulin is more frequently sold at Walmart than other chain pharmacies, likely due to the considerably lower price point. For more info on the different types of insulins, download our FREE PocketCards. For Info on affordable insulin, please visit our Insulin Cost Savings Resource page.

Answer 2 is incorrect. 20.09% of you chose this answer, Instructions include to gently shake before injection to adequately mix the particles. Shaking NPH insulin can cause clumping and is not recommended. According to the package insert, the most accurate instruction is to gently roll NPH insulin or invert it repeatedly until the particles are evenly distributed. NPH looks milky and homogeneous when properly mixed.

We hope you appreciate this weeks rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this important learning activity!

What Are Side Effects Associated With Using Insulin Nph


Common side effects of Insulin NPH include:

  • thickening or hollowing of the skin at the injection site
  • redness or swelling at the injection site

Serious side effects of Insulin NPH include:

  • itchy skin rash over the entire body,
  • swelling of the tongue or throat,
  • weight gain,

Rare side effects of Insulin NPH include:

  • none

This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

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What Are Some Side Effects That I Need To Call My Doctor About Right Away

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash hives itching red, swollen, blistered, or peeling skin with or without fever wheezing tightness in the chest or throat trouble breathing, swallowing, or talking unusual hoarseness or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of low potassium levels like muscle pain or weakness, muscle cramps, or a heartbeat that does not feel normal.
  • Change in eyesight.

Type 1 Diabetes Mellitus

< 12 years: Safety and efficacy not established

> 12 years: Suggested dose is 0.5-1 unit/kg/day SC use adult dosing usual daily maintenance range in adolescents is 1.2 units/kg/day during growth spurts

Dosing considerations

  • Dosage of human insulin, which is always expressed in USP units, must be based on the results of blood and urine glucose tests and must be carefully individualized to optimal effect
  • insulin NPH, pramlintide. Mechanism: unspecified interaction mechanism. Contraindicated. Must be administered separately.

Serious – Use Alternative

  • ethanol

    ethanol, insulin NPH. Other . Avoid or Use Alternate Drug. Comment: Alcohol may either increase or decrease the blood glucose lowering effect of insulin alcohol may decrease endogenous glucose production or worsen glycemic control by adding calories.

  • macimorelin

    insulin NPH, macimorelin. unspecified interaction mechanism. Avoid or Use Alternate Drug. Drugs that may transiently elevate growth hormone concentrations may impact the accuracy of the macimorelin diagnostic test. Allow sufficient washout time of drugs affecting GH release before administering macimorelin.

Monitor Closely


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How Is Nph Administered

NPH is administered via subcutaneous injection . It should not be injected into a vein or a muscle.

NPH is available in a vial, to be injected with a syringe. It can also be administered using the pre-filled KwikPen device.

A vial can be stored unopened in the refrigerator until its expiration date, or at room temperature for 31 days. An opened vial can be stored either in the refrigerator or at room temperature and it should be used within 31 days.

NPH should be gently mixed before injection by rolling the vial gently between your fingers for as long as two minutes. This insulin should look cloudy after mixing. If it is clear or you can see particles floating in it, call your pharmacist to replace your medication.

What Is Regular Insulin

How to Use NPH Insulin from Walmart

Regular insulin is a type of insulin that lowers blood glucose levels rapidly. Human insulin, cow insulin, and pig insulin are the three types of insulin present in regular insulin. The human version of regular insulin is often made by modifying pig insulin or by using recombinant technology.

Figure 02: Human Insulin

Regular insulin rapidly lowers blood glucose levels. Hence, it is administered to patients with severe levels of diabetes . The reaction of regular insulin starts in 15-20 minutes once injected and peaks within an hour. Unlike NPH, the effect of regular insulin wears off after 4-5 hours. Hence, regular insulin is a drug with a rapid onset but shorter in duration. For type 1 diabetes patients, regular insulin is the only option to manage high levels of blood glucose. Hence, it is a therapeutic drug used for the long-term management of type 1 diabetes.

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Things To Watch For When Using Nph Insulin

As mentioned, NPH insulin aims at regulating blood sugar levels. So, its important for you to watch for symptoms that indicate a rise or fall in blood sugar levels.

Low blood sugar can happen to anyone with diabetes easily. Symptoms of low blood sugar include sweating, hunger, headache, nausea, feeling shaky, dizziness, and irritability.

As NPH insulin acts after two to four hours, you may need to take some fast-acting source of sugar with you such as fruit juice, hard candy, crackers, raisins, or non-diet soda. However, make sure your family or friends who are around you know how to inject NPH insulin, in case of emergencies.

You should also watch for signs of high blood sugar . Common symptoms of high blood sugar include headache, tiredness, blurred vision, increased thirst, or urination.

Its also important to remember that blood sugar can be affected by exercise, alcohol use, surgery, illness, and skipping meals. So, its important to watch for these things while taking NPH insulin. You should also ask your doctor regarding any NPH insulin dosage schedule that you plan on changing.

Regarding the effective use of this insulin, lets take a look at some precautions when using this insulin.

Neutral Protamine Hagedorn Insulin

Neutral protamine Hagedorn insulin is a crystalline suspension of insulin with protamine and zinc, providing an intermediate-acting insulin with onset of action in 1 to 3 hours, duration of action up to 24 hours, and peak action from 6 to 8 hours. NPH insulin usually cannot be administered once daily in the setting of T1DM, at least in combination with rapid-acting monomeric analogue insulin. In the preanalogue era, NPH insulin was used successfully in combination with regular insulin, although this human insulin-based regimen has now been largely supplanted by analogue insulin because of a perceived lower risk of hypoglycemia.310

Gail T. Galasko, in, 2017

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Enhancing Healthcare Team Outcomes

For a patient to achieve successful treatment with NPH insulin, an interprofessional team effort is necessary. Patient education is imperative to improve outcomes from NPH insulin treatment. Healthcare workers should teach patients how to resuspend NPH premixed insulin before injection. Health care professionals, particularly the diabetes nurse educator, should demonstrate the correct injection technique and educate patients about the importance of timing and accuracy of dosage. Regular monitoring is vital to avoid adverse effects. Patients need a detailed explanation of the side effects of insulin, and if available, a dedicated diabetic education session by a certified diabetic educator is necessary this can be a nurse or pharmacist, preferably with specialty training in diabetes management. This interprofessional approach will drive improved patient compliance and outcomes with fewer adverse effects.

Recent clinical trials have shown that modern basal insulin analogs such as insulin glargine and insulin detemir have a lower risk of hypoglycemia and lower variability of fasting blood glucose compared to NPH insulin. But in clinical practice, these new analogs may not have better outcomes regarding the quality of life, morbidity, or cost.

What Does Nph Stand For When Talking About Insulin


What does NPH stand for when talking about insulin? Neutral Protamine Hagedorn insulin, also known as isophane insulin, is an intermediate-acting insulin given to help control blood sugar levels in people with diabetes. It is used by injection under the skin once to twice a day.

Can NPH be mixed with regular insulin? Regular insulin can be mixed with NPH insulin in the same syringe. Be sure to draw up the regular insulin first. For this diabetes drug to work properly, it must be taken as directed.

What happens when you give to much insulin? Symptoms of insulin overdose. Excess insulin in the bloodstream causes cells in your body to absorb too much glucose from your blood. It also causes the liver to release less glucose. These two effects together create dangerously low glucose levels in your blood. This condition is called hypoglycemia.

When does NPH insulin peaks? NPH Human Insulin which has an onset of insulin effect of 1 to 2 hours, a peak effect of 4 to 6 hours , and duration of action of more than 12 hours. Very small doses will have an earlier peak effect and shorter duration of action, while higher doses will have a longer time to peak effect and prolonged duration.

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Rationale Of The Week

We quizzed test takers on NPH insulin. 57% of respondents, chose the best answer. We want to share this important info so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!

Before we start though, if you dont want any spoilers and havent tried the question yet, you can answer below: Answer Question

Question: NPH insulin, introduced in 1946 was one of the first basal insulins. It is considered intermediate-acting basal insulin since the duration of action is about a half-day. Given its effectiveness and affordability, it is on the World Health Organizations List of Essential Medicines.

Which of the following is a true statement regarding NPH insulin?

Answer Choices:

  • In most states, it can be purchased over the counter without a prescription
  • Instructions include to gently shake before injection to adequately mix the particles
  • NPH stands for Natural Proinsulin Hagedorn
  • Due to its high rates of hypoglycemia, NPH is no longer recommended.

As shown above, the most common choice was option 1, the second most common answer was option 2, then option 3, and then finally option 4.

Generic Name: Insulin Nph And Regular Human

Combination isophane/regular insulin is used with a proper diet and exercise program to control high blood sugar in people with diabetes. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke.

This man-made insulin product is the same as human insulin. It replaces the insulin that your body would normally make. It is a mixture of 70% intermediate-acting insulin and 30% short-acting insulin . It starts to work as quickly as regular insulin but lasts longer. This insulin product works by helping blood sugar get into cells so your body can use it for energy. This product may be used alone or with other oral diabetes drugs .

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What Other Drugs Interact With Insulin Nph

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first

  • Insulin NPH has severe interactions with the following drug:
  • pramlintide
  • Insulin NPH has moderate interactions with at least 124 other drugs.
  • Insulin NPH has minor interactions with at least 77 other drugs.
  • This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this drug, tell your doctor or pharmacist of all the drugs you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

    Nph Insulin What Is It How To Use It Side Effects Help And Advice

    Using the Antihyperglycemic (AHG) Deprescribing Algorithm – When to Reduce or Stop AHGs and How?

    Heres where you can find out all the information you need to know regarding NPH Insulin. How to use it, benefits, side effects, knowing the symptoms if you feel you might have overdosed, and much more.

    But, for those that have not come across it before, lets start with a quick takeaway answer, then we can get into more detail.

    What Is NPH Insulin? Neutral Protamine Hagedorn also known as Isophane insulin is used to improve blood sugar control in adults and children with diabetes. Its an intermediate-acting insulin that starts to work within 2-4 hours after injection. The insulin peaks in 4-12 hours and works for 12-18 hours.

    For those unaware of the background on insulin, it is normally produced naturally by the pancreas. Insulin products are produced by pharmaceutical manufacturers and are categorized based on the time of onset, the peak, and how long they last in the bodys system. They work to lower blood sugar levels in patients that have diabetes.

    With that background set up, lets get into more details about this insulin.

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    What Is The Difference Between Nph And Regular Insulin

    NHP is a type of insulin that lowers blood glucose levels slowly, while regular insulin is a type of insulin that lowers blood glucose levels rapidly. Thus, this is the key difference between NPH and regular insulin. Moreover, NPH has a slower onset phase but lasts for a longer period of time. Regular insulin has a rapid onset but wears off in shorter time periods. Besides, during synthesis, NPH uses a mixture of different types of insulin, but in regular insulin production, only one type of insulin is used.

    The below infographic presents the differences between NPH and regular insulin in tabular form for side by side comparison.

    What To Do When You Accidentally Overdose On Nph Insulin

    If you accidentally overdose on NPH insulin, seek immediate medical attention right away or call the poison helpline at 1-800-222-1222.

    If youre not sure, then youll need to understand the symptoms of overdose so you can recognize it. Heres a list of the main symptoms. If you are suffering from any of these then look to consult a doctor as soon as possible. Even if you havent overdosed, its still better to be safe.

    • Blurred Vision

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