Humulin

NPH Isophane Human Insulin Suspension. NPH isophane insulin, also called Humulin N, Insulatard NPH Human, or Novolin N is an intermediate-acting form of human insulin produced by recombinant DNA techniques. Mixtures Humulin 70/30 and Novolin 70/30 contain 70% NPH isophane and 30% regular, whereas Humulin 50/50 contains 50% NPH isophane and 50% regular. It is adrninistered subcutaneously and should not be given intravenously. Absorption is delayed because the insulin is conjugated with protamine in a complex of reduced isoelectric solubiUty. Therapeutically, this preparation is probably comparable to purified porcine NPH insulin. However, human NPH insulin may have a slightly shorter duration of action than comparable purified porcine products. 

The number and amount of daily insulin doses, times of administration, and diet and exercise requirements require continual assessment. Dosage adjustments may be necessary when changing types of insulin, particularly when changing from the single-peak to the more pure Humulin insulins. 

Administer regular humulin insulin subcutaneously 30 minutes before meals and at bedtime according to the following blood glucose levels. 

Insulin is ordered by die generic name (insulin zinc suspension, extended) or the trade (brand) name (Humulin U) (see the Summary Drug Table Insulin Preparations). The nurse must never substitute one brand of insulin for anodier unless the substitution is approved by the health care provider because some patients may be sensitive to changes in brands of insulin. In addition, it is important never to substitute one type of insulin for anodier. For example, do not use insulin zinc suspension instead of die prescribed protamine zinc insulin. 

Care must be taken when giving insulin to use the correct insulin. Names and packaging are similar and can easily be confused. The nurse carefully reads all drug labels before preparing any insulin preparation. For example, Humalog (insulin lispro) and Humulin R (regular human insulin) are easily confused because of die similar names. 

A patient is prescribed insulin Humulin L 32 U. Choose the correct label for the insulin. 

Neutral protamine Humulin N Eli Lilly U-100 2-4 hours 4-6 8-12 1 0 mL vial, 3 mL cartridge... 

The expression of recombinant proteins in cells in which they do not naturally occur is termed heterologous protein production (Chapter 3). The first biopharmaceutical produced by genetic engineering to gain marketing approval (in 1982) was recombinant human insulin (tradename Humulin ), produced in E. coli. An example of a more recently approved biopharmaceutical that is produced in E. coli is that of Kepivance, a recombinant keratinocyte growth factor used to treat oral mucositis (Chapter 10). Many additional examples are provided in subsequent chapters. 

Humulin Recombinant human insulin produced in E. coli Identical to native human insulin EliLilly 1982 (USA)... 

Short-acting insulins Humulin R (regular) No 100 units, 10-mL vial 500 units, 20-mL vial... 

Intermediate-acting insulins (NPH) Humulin N No InnoLet Vial, prefilled pen... 

Humalog41 Humulin 70/30 75 Humulin-N 42 Humulin-R 42 Hycodan 75 Hycomine 75 Hydalazine 40... 

The first drug to be produced using recombinant DNA methods was insulin. In 1979, researchers at Eli Lilly and Company devised a procedure for synthesizing insulin using the common bacterium E. coli. The procedure was approved by the U.S. Food and Drug Administration in 1982, and genetically modified human insulin became commercially available in that year under the trade name of Humulin . 

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