High dose insulin therapy - Revision history

Neil.m.young: Text replacement - "beta blocker" to "β-blocker"

2017-07-30T00:45:14Z

Text replacement - "beta blocker" to "β-blocker"

← Older revision		Revision as of 00:45, 30 July 2017
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	==Background==		==Background==
	*Used in [[~~beta~~ blocker toxicity\| ~~beta~~ blocker]] and [[calcium channel blocker toxicity]]		*Used in [[β-blocker toxicity\| β-blocker]] and [[calcium channel blocker toxicity]]
	*Response is delayed for 30 to 60 minutes		*Response is delayed for 30 to 60 minutes
	*Recommend simultaneous implementation of other therapies to support the patient's pulse and blood pressure		*Recommend simultaneous implementation of other therapies to support the patient's pulse and blood pressure

Mholtz: Text replacement - "* " to "*"

2017-07-24T01:13:36Z

Text replacement - "* " to "*"

← Older revision		Revision as of 01:13, 24 July 2017
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	==Background==		==Background==
	* Used in [[beta blocker toxicity\| beta blocker]] and [[calcium channel blocker toxicity]]		*Used in [[beta blocker toxicity\| beta blocker]] and [[calcium channel blocker toxicity]]
	* Response is delayed for 30 to 60 minutes		*Response is delayed for 30 to 60 minutes
	*Recommend simultaneous implementation of other therapies to support the patient's pulse and blood pressure		*Recommend simultaneous implementation of other therapies to support the patient's pulse and blood pressure

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	**Peds: 0.25g/kg, usually given as 2.5mL/kg of D10		**Peds: 0.25g/kg, usually given as 2.5mL/kg of D10
	**If potassium 3mEq/L, give 20meq of potassium IV		**If potassium 3mEq/L, give 20meq of potassium IV
	* High-dose insulin therapy		*High-dose insulin therapy
	**Bolus of 1 unit/kg of regular, short-acting insulin IV		**Bolus of 1 unit/kg of regular, short-acting insulin IV
	** then 0.5 units/kg per hour IV, uptitrate until hypotension is corrected (max 10 units/kg per hour)		**then 0.5 units/kg per hour IV, uptitrate until hypotension is corrected (max 10 units/kg per hour)
	*Maintain euglycemia by infusion of D5 or D10		*Maintain euglycemia by infusion of D5 or D10
	**Initial rate 0.5 to 1g of dextrose/kg/hr		**Initial rate 0.5 to 1g of dextrose/kg/hr

Lisayee25: /* Mechanism of Action */

2017-05-06T18:54:36Z

Mechanism of Action

← Older revision		Revision as of 18:54, 6 May 2017
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	==Mechanism of Action==		==Mechanism of Action==
	*Mechanism not fully understood		*Mechanism not fully understood
	**~~thought~~ to optimize use of carbohydrates for fuel by cardiac myocytes and modulate intracellular calcium		**Thought to optimize use of carbohydrates for fuel by cardiac myocytes and modulate intracellular calcium
	**Improves cardiac output by increasing stroke volume		**Improves cardiac output by increasing stroke volume

Lisayee25: Created page with "==Background== * Used in beta blocker and calcium channel blocker toxicity * Response is delayed for 30 to 60 minutes *Recommend simultaneous im..."

2017-05-06T18:54:14Z

Created page with "==Background== * Used in beta blocker and calcium channel blocker toxicity * Response is delayed for 30 to 60 minutes *Recommend simultaneous im..."

New page

==Background==
* Used in [[beta blocker toxicity| beta blocker]] and [[calcium channel blocker toxicity]]
* Response is delayed for 30 to 60 minutes
*Recommend simultaneous implementation of other therapies to support the patient's pulse and blood pressure

==Dosing==
*Hypoglycemia and hypokalemia must be corrected prior to initiating HDI
**If glucose <150mg/dl, give 50mL of D50W
**Peds: 0.25g/kg, usually given as 2.5mL/kg of D10
**If potassium 3mEq/L, give 20meq of potassium IV
* High-dose insulin therapy
**Bolus of 1 unit/kg of regular, short-acting insulin IV
** then 0.5 units/kg per hour IV, uptitrate until hypotension is corrected (max 10 units/kg per hour)
*Maintain euglycemia by infusion of D5 or D10
**Initial rate 0.5 to 1g of dextrose/kg/hr
**Check POC glucose q15-30 minutes until stable glucose concentration, then check q1hour
*Check serum potassium q 30 minutes until stable, then q 1-2 hours, replete as necessary
*Repletion of magnesium may also be needed

==Mechanism of Action==
*Mechanism not fully understood
**thought to optimize use of carbohydrates for fuel by cardiac myocytes and modulate intracellular calcium
**Improves cardiac output by increasing stroke volume

==See Also==
*[[Beta blocker toxicity]]
*[[Calcium channel blocker toxicity]]
*[[Lipid emulsion]]

==References==
<references/>

[[Category:Pharmacology]]
[[Category:Toxicology]]