Diabetes injectables Flashcards
What is the fastest acting insulin, fast acting
Insulin Aspart (Fiasp)/ Insulin Lispro, Insulin Aspart, Insulin Glulisine
What are the fast acting insulin pens
Humalog and Admelog (Lispro), Novolog (Aspart), Apirda (Glusine)
What are the short-acting/regular insulins
Humulin R and Novolin R
What are the intermediate-acting insulins/NPH
Humulin N and Novolin N
What are the long-acting insulins and their pens
Insulin Glargine (Lantus and Basaglar) and Insulin Determir (Levemir)
What are the ULTRA long lasting insulin and their pens
Insulin Glargine (Toujeo) and Insulin Degludec (Tresiba)
When are the fast acting analogs (Fiasp) dosed
Beginning of a meal or within 20 minutes after starting a meal
When are the rapid acting analogs administered
Administration immediately prior to meals (Novolog: 5-10 minutes before meals/ Humalog and Ademolg: 15 minutes before eating or right after eating)
What is the duration of action for regular (short-acting) insulin, when should it be given
Up to 8 hours (slow to correct hyperglycemia/could cause post prandial hypoglycemia)/ Give 20 to 40 minutes before a meal
T/F: Intermediate (NPH) acting insulin has variable absorption but is always less than 24 hours, usually around 12 to 16
True
How often should intermediate (NPH) acting insulin should be dosed
Twice a day
What are the benefits of long-lasting or ultra long lasting insulins
They lower the risk of hypoglycemia
How long dose ultra long acting insulin last
Troujeo/Glargine: 36 hours
Tresiba/Degludec: Greater than 42 hours
How should insulin be stored
Store unopened products in the refrigerator, insulin in use can be kept at room temperature,
What insulins cannot be mixed in the same syringe
glargine, determir, degludec
T/F: NPH insulin can be mixed with regular insulin or any of the rapid-acting insulin analogs in the same syringe
True
What are the adverse effects of insulin
Hypoglycemia, weight gain, lipohypertrophy, noctornal hypoglycemia followed by rebound hyperglycemia
What are symptoms of hypoglycemia
Shaking, sweating, anxious, dizziness, hunger, tachycardia, impaired vision, fatigue. headache
To prevent injection site complications what are tips that patients should take
Rotate injection sites, use larger injection sites, do not reuse needles
How is the bolus/basal regimen initiated
1) Give a typical daily dose based on weight: 0.4-0.5 units/kg/ day
2) Give 20% of the total daily dose for each meal as a bolus insulin (aspart/lispro/glulisine)
3) Give 40% of the total daily dose at bedtime (glargine/determir/degludec/NPH)
How is the mixed insulin regimen initiated
1) Estimate a total daily dose
2) Split two-thirds of the total daily dose before breakfast and one-third of the total daily dose before breakfast
