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Can regular insulin and nph be mixed together?

Updated: 1/8/2024
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Wiki User

∙ 12y ago
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Yes, regular insulin and NPH (Neutral Protamine Hagedorn) insulin can be mixed in the same syringe. This combination is commonly referred to as "mixed insulin" and is used for certain insulin therapy regimens. Regular insulin is a short-acting insulin, while NPH insulin is an intermediate-acting insulin.

It's important to follow proper mixing techniques to ensure the effectiveness of the insulin and to avoid contamination. Here are general steps for mixing regular insulin and NPH insulin in the same syringe:

Wash your hands: Clean your hands thoroughly with soap and water.

Gather supplies: Collect the vials of regular insulin and NPH insulin, a syringe, and alcohol swabs.

Roll the NPH insulin vial: Gently roll the NPH insulin vial between your palms to ensure uniform suspension.

Clean the rubber stoppers: Wipe the rubber stoppers of both insulin vials with alcohol swabs.

Draw up air into the syringe: Draw air into the syringe equal to the dose of NPH insulin needed.

Inject air into the NPH insulin vial: Insert the needle into the NPH insulin vial and inject the air.

Draw up NPH insulin: Invert the vial and withdraw the correct dose of NPH insulin.

Inject air into the regular insulin vial: Insert the needle into the regular insulin vial and inject the air.

Draw up regular insulin: Invert the vial and withdraw the correct dose of regular insulin.

Check for air bubbles: Hold the syringe upright and tap it to dislodge any air bubbles. Push the plunger slightly to remove any air.

Verify the dose: Double-check that you have the correct total dose in the syringe.

Administer the injection: Administer the injection as prescribed by your healthcare provider.

Always follow the specific instructions provided by your healthcare provider or the insulin manufacturer. If you are unsure about the proper technique for mixing insulin or have any concerns, consult with your healthcare team for guidance.

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raghu.punarjan

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∙ 3mo ago
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∙ 12y ago

yes...because regular insulin and Isophane Insulin(NPH) is a human-made form of insulin. Insulin is a hormone produced naturally by pancreas

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Cerebral spinal fluid (CSF) collection?

DefinitionCerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. Cerebrospinal fluid acts as a cushion, protecting the brain and spine from injury. The fluid is normally clear. The test is also used to measure pressure in the spinal fluid.See also: CSF cultureAlternative NamesSpinal tap; Ventricular puncture; Lumbar puncture; Cisternal puncture; Cerebral spinal fluid cultureHow the test is performedThere are different ways to get a sample of CSF. Lumbar puncture, commonly called a spinal tap, is the most common method. The test is usually done like this:The patient lies on his or her side, with knees pulled up toward the chest, and chin tucked downward. Sometimes the test is done with the person sitting up, but bent forward.After the back is cleaned, the health care provider will inject a local numbing medicine (anesthetic) into the lower spine.A spinal needle is inserted, usually into the lower back area.Once the needle is properly positioned, CSF pressure is measured and a sample is collected.The needle is removed, the area is cleaned, and a bandage is placed over the needle site. The person is often asked to lie down for a short time after the test.Occasionally, special x-rays are used to help guide the needle into the proper position. This is called fluoroscopy.Lumbar puncture with fluid collection may also be part of other procedures, particularly a myelogram (x-ray or CT scan after dye has been inserted into the CSF).Alternative methods of CSF collection are rarely used, but may be necessary if the person has a back deformity or an infection.Cisternal puncture uses a needle placed below the occipital bone (back of the skull). It can be dangerous because it is so close to the brain stem. It is always done with fluoroscopy.Ventricular puncture is even more rare, but may be recommended in people with possible brain herniation. This test is usually done in the operating room. A hole is drilled in the skull, and a needle is inserted directly into one of brain's ventricles.CSF may also be collected from a tube that's already placed in the fluid, such as a shunt or a venitricular drain. These sorts of tubes are usually placed in the intensive care unit.How to prepare for the testThe patient (or guardian) must give the health care team permission to do the test.Afterward, you should plan to rest for several hours, even if you feel fine. You won't be required to lie flat on your back the entire time, but rest is advised to prevent additional leakage of CSF around the site of the puncture.How the test will feelThe test is usually done with you curled up on your side with knees pulled up and chin to chest. Sometimes, CSF is collected with the person seated and bent forward over a table or chair. Holding the position may be uncomfortable, but it is extremely important to stay in this bent position to avoid moving the needle and possibly injuring the spinal cord. The person doing the test may ask you to straighten out slightly after the needle is in place, in order to accurately measure the CSF pressure, called the "opening pressure."The anesthetic will sting or burn when first injected. There will be a hard pressure sensation when the needle is inserted, and there is usually some brief pain when the needle goes through the tissue surrounding the spinal cord. This pain should stop in a few seconds.Overall, discomfort is minimal to moderate. The entire procedure usually takes about 30 minutes, but it may take longer. The actual pressure measurements and CSF collection only take a few minutes.Why the test is performedThis test is done to measure pressures within the cerebrospinal fluid and to collect a sample of the fluid for further testing. CSF analysis can be used to diagnose certain neurologic disorders, particularly infections (such as meningitis) and brain or spinal cord damage.See also:CSF coccidioides complement fixationCSF oligoclonal bandingCSF smearCSF VDRL testNormal ValuesNormal values typically range as follows:Pressure: 70 - 180 mm H20Appearance: clear, colorlessCSF total protein: 15 - 60 mg/100 mLGamma globulin: 3 - 12% of the total proteinCSF glucose: 50 - 80 mg/100 mL (or greater than 2/3 of blood sugar level)CSF cell count: 0 - 5 white blood cells (all mononuclear), and no red blood cellsChloride: 110 - 125 mEq/LNote: mg/mL = milligrams per milliliter; mEq/L = milliequivalents per literNote: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.What abnormal results meanIf the CSF looks cloudy, it could mean there is an infection or a build up of white blood cells or protein.If the CSF looks bloody or red, it may be a sign of bleeding or spinal cord obstruction. If it is brown, orange, or yellow, it may be a sign of increased CSF protein or previous bleeding (more than 3 days ago). Occasionally, there may be blood in the sample that came from the spinal tap intself. This makes it harder to interpret the test results.Increased CSF pressure may be due to increased intracranial pressure (pressure within the skull). Decreased CSF pressure may be due to spinal cord tumor, shock, fainting, or diabetic coma.Increased CSF protein may be due to blood in the CSF, diabetes, polyneuritis, tumor, injury, or any inflammatory or infectious condition. Decreased protein is a sign of rapid CSF production.Increased CSF gamma globulin levels may be due to diseases such as multiple sclerosis, neurosyphilis, or Guillain-Barre syndrome.Increased CSF glucose is a sign of high blood sugar. Decreased CSF glucose may be due to hypoglycemia (low blood sugar), bacterial or fungal infection (such as meningitis), tuberculosis, or certain other types of meningitis.Increased white blood cells in the CSF may be a sign of meningitis, acuteinfection, beginning of a chronic illness, tumor, abscess,stroke, or demyelinating disease (such as multiple sclerosis).Red blood cells in the CSF sample may be a sign of bleeding into the spinal fluid or the result of a traumatic lumbar puncture.Additional conditions under which the test may be performed:Chronic inflammatory polyneuropathyDementia due to metabolic causesEncephalitisEpilepsyFebrile seizure (children)Generalized tonic-clonic seizureHydrocephalusInhalation anthraxNormal pressure hydrocephalus (NPH)Pituitary tumorReye syndromeWhat the risks areRisks of lumbar puncture include:Bleeding into the spinal canalDiscomfort during the testHeadache after the testHypersensitivity (allergic) reaction to the anestheticInfection introduced by the needle going through the skinThere is an increased risk of bleeding in people who take blood thinners.Brain herniation may occur if this test is done on a person with a mass in the brain (such as a tumor or abscess). This can result in brain damage or death. This test is not done if an exam or test reveals signs of a brain mass.Damage to the nerves in the spinal cord may occur, particularly if the person moves during the test.Cisternal puncture or ventricular puncture carry additional risks of brain or spinal cord damage and bleeding within the brain.Special considerationsThis test is particularly dangerous for people with:A tumor in the back of the brain that is pressing down on the brain stemBlood clotting problemsThrombocytopeniaReferencesGriggs RC, Jozefowicz RF, Aminoff MJ. Approach to the patient with neurologic disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier. 2007: chap 418.

Related questions

Can NPH and Regular insulin be mixed?

yes...because regular insulin and Isophane Insulin(NPH) is a human-made form of insulin. Insulin is a hormone produced naturally by pancreas

Is Regular Insulin and NPH insulin the same thing?

NPH is a long acting insulin that peaks 8 hours after administration. Regular insulin is fast acting that peaks 30 minutes after administration. Regular insulin should be taken before meals.

When mixing regular and nph insulin which do you draw up first?

Draw up the regular insulin first. You always want to go from clear to cloudy. Also, you do not want the NPH insulin mixing into the regular insulin, therefore the regular insulin should be drawn up before the NPH (long-acting) insulin.

What is the peak time when administering regular insulin and NPH insulin?

the peak time for Regular insulin is 4 hours and the peak time for NPH is 8 hours. I take both of them.

What are the types of insulin?

regular, nph, glargazine, novilog

What are the names of regular insulin?

There are several different names for regular insulin, depending on the maker. The one constant is that all of them contain the letter "R" for "regular," in their name. For instance, one maker of insulin called all their insulins Novolin. The "regular" insulin is "Novolin R," their NPH is called "Novolin N," etc.

When drawing up NPH insulin do you shake the bottle or gently rotate the bottle?

Gently rotate the bottle with the NPH insulin content. DO NOT shake the bottle.

With NPH insulin when are snacks encouraged?

whenever you want.

How long does NPH insulin last?

N Insulin last around 8-12 hours, and peaks from 4-6 hours. NPH Insulin is really a medium length acting insulin. It was used more frequently a few years ago when a regime of R and NPH or "N" was used twice a day. Today, more doctors are suggesting an insulin pump.

Is humalog insulin cloudy?

yes. always draw up clear before cloudy. (regular before NPH)

What is the Peak action of insulin?

It depends on which insuline... There's many formulation available now (NPH, rapid, regular, etc..) But "regular" insuline as a peak action of 2-4 hours, with an effect after 30-60 minutes.

Can novolog insulin be given by iv?

NPH is a suspension. Only solutions should be given intravenously.

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