Anticoagulation, endocrine and GI
Insulin (regular) (Humulin R) drip
Humulin R, Novolin R
Dosing
| Start | DKA: 0.1 units/kg/h once K is above 3.5 (2024 consensus; older sources 3.3, or 0.14 with no bolus); bolus 0.1 units/kg only if IV access is delayed. ICU hyperglycemia: per protocol, target 140–180 |
|---|---|
| Titrate | Per protocol with hourly glucose |
| Maximum | Per protocol |
| Common bags | 100 units in 100 mL (1 units/mL) |
| Dose units | units/h, units/kg/h |
Line and administration
- Prime and flush the tubing: insulin binds to plastic
Watch for
- Hypoglycemia; add dextrose at glucose under 250 in DKA
- Low potassium
Insulin (regular): full drug monographIndications, mechanism, pharmacokinetics, cautions and every dose the app lists.
In the one-pagers
- Electrolyte ImbalancesHyperkalemia: stabilize, shift, remove: Shift: regular insulin 10 units IV with dextrose 25–50 g. K falls within 15 min, lowest at 30–60 min.
- Medical Emergencies: Neuro, Endocrine, Blood and InfectionDiabetes: meters, pumps, look-alikes: Pump failure: Pump (no long-acting insulin) kinked for hours: No waiting for a set change: NS bolus, go: ED
- Toxidromes and AntidotesCardiotoxic drugs: Beta-blockers, CCBs: High-dose insulin 1 unit/kg, then 1–10 units/kg/h: Give dextrose; check glucose, K
- BurnsBurn shock and the systemic response: From about day 3 the flow phase takes over: catecholamines rise up to 50-fold, with cortisol and glucagon (Williams 2009), driving tachycardia, fever, high cardiac output, low SVR, insulin resistance and muscle wasting, so fever and tachycardia no longer prove infection. In children with burns over 30% TBSA the response was still measurable 3 years later (Jesc
- EMT By-Complaint Quick PagesSeizure, confusion, diabetes, stroke: Low glucose: 60 mg/dL or less with symptoms (ADA: under 70): Oral glucose per protocol (NASEMSO 25 g; ADA 15 g; child 0.5-1 g/kg) only if awake and swallowing; cannot swallow: airway, ALS; stop the insulin pump if ALS is not available
- ACLS Algorithms in BriefReversible causes: bedside clues and ultrasound: Potassium: Dialysis, missed session, peaked T or wide QRS: High: calcium, bicarbonate, insulin; low: K⁺
Practice Electrolyte Imbalances questions free26 exam-style questions with rationales on the topic where insulin (regular) comes up most. No account or download needed.
Other anticoagulation, endocrine and gi
- Heparin
- Amiodarone
- Diltiazem
- Octreotide
- Pantoprazole
- Furosemide
- Argatroban
- Bivalirudin
- Procainamide
- Lidocaine
- Magnesium sulfate
- Naloxone
- Eptifibatide
- Bumetanide
Practice free in your browser2,450+ exam-style questions with rationales. No account, no ads. Also free on the App Store and Google Play.
For education and exam preparation only. Follow your institution’s protocols. Study aid: check every dose against your local protocols and medical direction, the bag label and your pump.