DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsFibrates: may improve glucose tolerance; additive effect with insulin

ADMINISTRATION

Reconstition

–

Route

IV via CRIP

Rate of Administration

Over 30 minutes or as required

Comments

Add 15–25 IU insulin to 50 mL 50% glucoseFor maintenance infusion or sliding scale infusion, add 50 IU insulin to 500 mL 10% glucose and adjust rate according to blood glucose levelsContinue infusing insulin/glucose solution at rate of 10 mL/hour according to serum potassium

OTHER INFORMATION

Monitor blood glucose Prior to insulin/glucose infusion for hyperkalaemia, give IV 20 mL 10% calcium gluconate to protect myocardium and 50–100 mL 8.4% sodium bicarbonate to correct acidosisCommence calcium resonium 15 g 4 times per day orallyInsulin is metabolised renally; therefore, requirements may be reduced in ERF