Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Diabetes/Endocrine (Insulin) > Flashcards

Diabetes/Endocrine (Insulin) Flashcards

1
Q

Regular Insulin (action profile)

A
  • Type: Short Acting
  • Onset of Action: 30-60 min
  • Peak: 1-5 hours
  • Duration: 6-10 hours
  • Bolus insulin (give it before a meal)
  • Regular is cheap!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Lispro/Humalog (action profile)

A
  • Type: Rapid acting
  • Onset of action: 15-30 minutes
  • Peak: 0.5-2.5 hours
  • Duration: 3-6 hours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Aspart/Novolog (action profile)

A
  • Type: Rapid acting
  • Onset of action: 10-20 minutes
  • Peak: 1-3 hours
  • Duration: 3-5 hours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

NPH (action profile)

A
  • Type: Intermediate Acting
  • Onset: 1-2 hour
  • Peak: 6-14 hours
  • Duration: 16-24 hours
  • Before breakfast and before supper
  • 2nd cheapest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

70% NPH/30% Reg (novolog) (action profile)

A
  • Type: Pre-mixed combo
  • Onset: 10-20 minutes
  • Peak (2 peaks): 1.5-16 hours & 1-4 hours
  • Duration: 10-16 hours
  • % vary
  • 2 peaks
  • Morning and afternoon peaks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Levimir (Determir) (action profile)

A
  • Type: Long-acting
  • Onset: 2 hours (Clear)
  • Peak: Peakless
  • Duration: 24
  • keep blood sugar in a nice and steady state
  • Basal insulins (long acting)
  • Usually have to only take 1 injection in the evening
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Lantus (Glargine) (action profile)

A
  • Type: Long Acting
  • Onset: 2-4 hours (clear)
  • Peak: Peakless
  • Duration: 20-24 hours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Humalog (Lispro)

A
  • Give subQ only 5-15 minutes before a meal
  • Very quick acting but action lasts for only 5 hours
  • Good for those who eat IRREGULARLY
  • Does not provide basal insulin needs (use NPH, Lantus, or other long-acting insulin
  • Can be mixed with NPH
  • DO NOT MIX WITH LANTUS
  • Monitor BG levels, hypoglycemia, allergic reaction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Apidra (glulisine)

*not too important: go over briefly

A

Rapid Acting Insulin Analog

Can be used in insulin pump, syringes, pens

Mix only with NPH, drawing Apidra up 1st

Must be used with a basal insulin

Give premeal or within about 20 minutes postmeal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Human Insulin Glargine (Lantus)

A
  • Produced by recombinant DNA using E coli
  • Differs from human insulin in that the amino acid asparagine at position A21 is replaced by glycine and two arginines are added to the C-terminus of the B-Chain
  • Give SC only, NEVER IV.
  • Peakless insulin, lasting 24 hours
  • DO NOT MIX WITH OTHER INSULINS OR DILUTE WITH OTHER SOLUTIONS
  • Keep Refrigerated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Lantus Cont.

A
  • Given at bedtime once per day; can be given twice per day**
  • Monitor for hypoglycemia, allergic reactions, injection site reactions, lipodystrophy
  • When switching from bid NPH, reduce dose by 20%
  • Lantus is a CLEAR solution unlike other long-acting insulins
  • Pregnancy studies in humans not done
  • Not known if excreted in breast milk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Detemir (Levemir)

A
  • Approved by FDA June 17, 2005; Similar to Lantus;
  • Has less hypoglycemia and weight gain than Lantus
  • Long Acting insulin given -once or twice a day, Peakless
  • Clear Insulin; do not mix with other insulins; do not put in insulin pumps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Humalog mix 75/25

A
  • 75% lispro protamine
  • 25% lispro (rapid)
  • Peak effect at two hours
  • Duration: 12 hours
  • Manufactured by altering E-coli
  • Give SC only
  • Give 15 minutes before meal
  • Do not mix with any other insulin
  • Side effects: hypoglycemia, hypokalemia, lipodystrophy and sensitivity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Intermediate Acting FIXED Mixed Insulin

A
  • nonanalogs
  • 70/30: 70% NPH, 30% Regular

*Analogs
75/25
50/50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Client education:

A
  • Make sure you are using the correct U100 syringe that matches the type of insulin
  • Disposal of needles: State law requires that syringes and lancets be disposed of as a single unit in a hard container without recapping or breaking the needle
  • Store syringes at room temperature
  • Reuse of syringes and needles should be discouraged
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Insulin Infusion Pumps

A
  • Delivers continuous 24 hour regular insulin SQ
  • The basal dose is meant to cover blood glucose levels between meals and overnight
  • Bolus doses are programmable
  • Bolus doses are based on 4-12x/day measurement of glucose
17
Q

Addition of sliding scale _ per day allows for maximum control of BG

A

4x

18
Q

Many type 2’s are on both _____ and ____ hypoglycemic agents

A

Insulin and oral

19
Q

HYPOGLYCEMIA

LESS THAN 52 mg/dl

A

s/s vary: hunger, nervousness, anxiety, sweating, confusion, drowsiness, coma

  • more common in Type 1
  • Always carry a quick-acting glucose source such as hard candy or glucose tablets
  • Unconscious at home: Teach a family member to give glucagon SQ or IM; call 911
20
Q

__g glucose source should be given to those experiencing hypoglycemia

A

15 g glucose source

21
Q

Hypoglycemia Cont.

A
  • Usual causes: Eating too little for the amount of insulin received; too much exercise and too little food; medications, sulfonylureas
  • Quick onset; if food doesn’t relieve symptoms then unconsciousness will follow
  • BS<18 and brain damage is likely
  • Hospitalized pt., get capillary BS and then give 10-15 grams of glucose e.g. orange juice
22
Q

Hypoglycemia Cont…

A
  • If person unconscious, treat as if hypoglycemic and not hyperglycemic, if unknown
  • Unconscious: Give 50 cc. 50% IV Dextrose (Glucose) per push, give slowly *
  • Symptoms are usually the same each time
  • Behavioral changes will occur in children
  • Hypoglycemia unawareness (loss of autonomic nerve activity)- caused by diabetes complications or beta blockers
23
Q

Insulin Sensitivity: How much of a blood glucose drop is achieved with one unit of insulin?

A
  • usually 10-50 points
  • TDD (total daily dose):
  • Type 1 (new onset): 0.6-0.7 Units/kg/day
  • TDD Type 2 new onset (FBS 140-220): 0.3-0.4 units/kg/day
  • (FBS>220): 0.5-1.2 units/kg/day
24
Q

Changing Insulin Dosage

A
  • Correct lows first
  • Second, get FBG normal (about 90-100); adjusting basal dosing q4 days in 1-4 unit increments
  • Third, use bolus dosing (humalog, novolog, or regular) premeal to obtain normal post prandials (<140)
  • Make adjustments in rapid acting in 1-2 unit increments, every 2-4 day
25
Q

Therapeutic goals

A

Look at chart on slide 71**

ADA GOALS

26
Q

Rotation sites include:

A

Abdomen, upper arm, anterior and medial thighs, upper hips

Absorbed fastest in abdomen*

In hospitals, it is best to use arms due to lack of use at home*

27
Q

Use about _ sites in each area then move to next area to prevent __________

A

8 sites

prevent lipohypertrophy

*cool insulin may cause lipohypertrophy; recommend room temperature

Pharmacology (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions