Ch. 52 Antidiabetics Flashcards
What are Antidiabetics used for?
To control diabetes mellitus, a chronic disease that affects carbohydrate metabolism
What are the 2 groups of antidiabetic drugs?
Insulin and oral hypoglycemics
Where does insulin come from?
A protein secreted from the beta cells of the pancreas
What is the purpose of insulin?
It is necessary for carbohydrate metabolism and plays an important role in protein and fat metabolism
What does the alpha cells of pancreas secrete?
Glucagon
What is glucagon?
A hyperglycemia agent
What is the function of oral hypoglycemic drugs?
They are synthetic preparations that stimulate insulin release or otherwise alter the metabolic response to hyperglycemia
What is diabetes mellitus?
A chronic disease resulting from deficient glucose metabolism
What causes diabetes mellitus?
Caused by insufficient insulin secretion from the beta cells or impaired insulin utilization
What are the 3 P’s that DM is characterized by?
Polyuria (increased urine output), polydipsia (increased thirst), and polyphagia (increased hunger)
List the 4 types of diabetes.
Type 1, Type 2, Secondary diabetes (medications, hormonal changes), and Gestational diabetes (GDM)
What is the onset of Type 1 DM?
Generally early age of onset
What is another symptom seen in Type 1 DM besides the 3 P’s?
Weight loss
What is the onset of Humalog or lispro?
15 min
What is the peak of Humalog or lispro?
30-90 min
What is the duration of Humalog or lispro?
3-5 hours
What is the onset of Novolog or aspart?
10-20 min
What is the peak of Novolog or aspart?
40-50 min
What is the duration of Novolog or aspart?
3-5 hours
What is the onset of Apidra or glulisine?
20-30 min
What is the peak of Apidra or glulisine?
30-90 min
What is the duration of Apidra or glulisine?
1-21/2 hours
What does rapid-acting insulin cover?
It covers insulin needs for meals eaten at the same time as the injection.
What type of insulin is used with the rapid-acting insulins?
Longer-acting insulins
Which other insulins can rapid-acting insulins be mixed with?
Can only be mixed with NPH insulin.
What is the appearance of rapid-acting insulins?
Appearance is CLEAR
What is the onset of Regular (R) humulin or novolin?
30 min - 1 hour
What is the peak of regular (R) or novolin?
2-3 hours
What is the duration of regular (R) or novolin?
5-8 hours
What is the onset of Velosulin (for use in the insulin pump)?
30 min - 1 hour
What is the peak of Velosulin (for use in the insulin pump)?
2-3 hours
What is the duration of Velosulin (for use in the insulin pump)?
2-3 hours
List the rapid-acting insulins.
Humalog or lispro, Novolog or aspart, and Apidra or glulisine
List the short-acting insulins.
Regular (R) humulin or novolin and Velosulin (for use in the insulin pump)
List the long-acting insulins.
Ultralente (U), Lantus, and Levemir or detemir
List the pre-mixed insulins.
Humulin 70/30, Novolin 70/30, Novolog 70/30, Humulin 50/50, and Humalog mix 75/25
What does short-acting insulins cover?
They cover insulin needs for meals eaten within 30-60 minutes
What is the appearance of short-acting insulins?
Appearance is CLEAR
List the intermediate-acting insulins.
NPH (N) and Lente (L)
What is the onset of NPH (N)?
1-2 hours
What is the peak of NPH (N)?
4-12 hours
What is the duration of NPH (N)?
18-24 hours
What is the onset of Lente (L)?
1-21/2 hours
What is the peak of Lente (L)?
3-10 hours
What is the duration of Lente (L)?
18-24 hours
What does intermediate-acting insulins cover?
They cover insulin needs for about half the day or overnight.
What other insulins are the intermediate-acting insulins often combined with?
They are often combined with rapid- or short-acting insulins
What is the appearance of intermediate-acting insulins?
Appearance is CLOUDY
What is the onset of Ultralente (U)?
30 min - 3 hours
What is the peak of Ultralente (U)?
10-20 hours
What is the duration of Ultralente (U)?
20-36 hours
What is the onset of Lantus?
1-11/2 hours
What is the peak of Lantus?
No peak time; insulin is delivered at a steady level
What is the duration of Lantus?
20-24 hours
What is the onset of Levemir or detemir?
1-2 hours
What is the peak of Levemir or detemir?
6-8 hours
What is the duration of Levemir or detemir?
Up to 24 hours
What does long-acting insulin cover?
They cover insulin needs for about one full day
What other insulins are often given, when needed, wiith long-acting?
Rapid- or short-acting insulins
Can you mix long-acting insulins?
These should NEVER be mixed with other insulins
What is the appearance of long-acting insulins?
Appearance is CLEAR
What is the onset of Humulin 70/30?
30 min
What is the peak of Humulin 70/30?
2-4 hours
What is the duration of Humulin 70/30?
14-24 hours
What is the onset of Novolin 70/30?
30 min
What is the peak of Novolin 70/30?
2-12 hours
What is the duration of Novolin 70/30?
Up to 24 hours
What is the onset of Novolog 70/30?
10-20 min
What is the peak of Novolog 70/30?
1-4 hours
What is the duration of Novolog 70/30?
Up to 24 hours
What is the onset of Humulin 50/50?
30 min
What is the peak of Humulin 50/50?
2-5 hours
What is the duration of Humulin 50/50?
18-24 hours
What is the onset of Humalog mix 75/25?
15 min
What is the peak of Humalog mix 75/25?
30 min-21/2 hours
What is the duration of Humalog mix 75/25?
16-20 hours
When are pre-mixed insulins generally taken?
These products are generally taken twice a day before mealtime
What is the appearance of pre-mixed insulins?
Appearance is CLOUDY
What are pre-mixed insulins a combination of?
Premixed insulins are a combination of specific proportions of intermediate-acting and short-acting insulin in one bottle or insulin pen (the numbers following the brand name indicate the percentage of each type of insulin)
