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Kol- Pharm 323 Spring > Diabetes Insulin > Flashcards

Diabetes Insulin Flashcards

1
Q

what is the ONLY hormone known to have a direct effect in lowering blood glucose levels?

A

Insulin

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2
Q

Is insulin anabolic or catabolic? why do i care?

A

• Anabolic hormone –> conservative, constructive, builds up energy stores like gylcogen, promotes cell growth/division

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3
Q

what are the 3 actions of insulin?

A
  1. Glucose uptake by cells and glucose storage as glycogen in liver
  2. Prevent fat and glycogen breakdown and inhibits gluconeogenesis
  3. Increase protein synthesis
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4
Q

Route for insulin admin?

A

SubQ, IV, IV infusion, inhaled

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5
Q

Types of insulin are classified but what characteristics?

A

Onset, peak, and DURATION** –>

• Short duration
	◦ Rapid or slower onset
• Intermediate duration
• Long duration
	◦ Long and ultra-long
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6
Q

prototype for short duration RAPID acting insulin?

A

Aspart (novolog)

I want to get through the ass part very quickly

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7
Q

Onset, peak and duration for Aspart (Novolog)

A

Onset : 10-20 minutes
Peak: 1-3 hours
Duration: 3-5 hours

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8
Q

Which of our insulins acts most like for the pancreas acts in repsonse to a rise in blood glucose?

A

Aspart (Novolog)

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9
Q

Which insulin is out highest risk of hypoglycemia?

A

Aspart (novolog)

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10
Q

onset for inhaled insulin?

A

12 minutes!

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11
Q

inhaled insulin is contraindicated in…..

A

respiratory disorder like COPD

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12
Q

what is the route for aspart?

A

SQ or infusion pump/drip

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13
Q

When do we want to give Aspart in relation to food?

A

◦ Don’t give until food tray arrives! (5-10 min AC)

◦ “Give the shot while the tray is hot”

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14
Q

prototype for SLOWER acting insulin?

A

RegulAR (Humulin R, Novolin R)

slowAR regulAR R R R R

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15
Q

onset peak and duration for regular insulin

A

slowAR acting
Onset: 30-60 minutes
Peak: 1-5 hours
Duration: up to 10 hours
(longer peak and duration than rapid acting)
-does not mimic what the body naturally does as well

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16
Q

drug of choice for insulin drips?

A

regular (Humulin R, Novolin R)

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17
Q

When do we give regular insulin in relation to food?

A

◦ 30 to 60 min AC

◦ give before meal even arrives!

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18
Q

What is U500 insulin ? how do we admin it?

A

5x more concentrated than normal

• Special syringe that says U500 on it OR have conversion sheet to use regular insulin or tuberculin syringe

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19
Q

who is taking U500 insulin?

A

• Reserved for patients takes more than 200 units on insulin/day

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20
Q

All insulin is _____ ____ but U 500 is ____ ____ ___ (think safety)

A

high alert, very high alert

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21
Q

prototype for intermediate acting insulin?

A

Intermediate acting NPH (Humulin N, Novolin N)

iNtermediate Nph humulin N N N N N

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22
Q

How do they make NPH last longer?

A

regular insulin mixed with a special protein that slows down absorption

23
Q

onset peak and duration for NPH

A

Onset: 1-2 hours
Peak: 6-14
Duration: 16-24

24
Q

when do we want to give NPH in relation to food?

A

30 minutes before meal

25
Q

NPH- once per day? BID? TID?

A

BID or TID

26
Q

NPH + Regular insulin- how ya gonna give it?

A

clear (reg) then cloudy (NPH)

27
Q

prototype for long acting insulin?

A

glargine (Lantus) (U-100)

Long Acting - LAntus, gLArgine

28
Q

onset peak and duration of glargine (Lantus) (U-100)

A

Onset: 70 min
Peak: none
Duration: 18-24

29
Q

indication for using glargine (Lantus) (U-100)

A

used for basal control?

30
Q

is there a risk of hypoglycemia with glargine (Lantus) (U-100)?

A

No peak, so low risk for hypogly

31
Q

frequency and admin of glargine (Lantus) (U-100)?

A

1-2x day
Give it at same time
Cant be mixed or given IV

32
Q

prototype for Ultra-long duration Insulin

A

Insulin glargine (U-300) (Toujeo)

33
Q

Duration, peak and onset for Insulin glargine (U-300) (Toujeo)?

A

Onset: ? same as u100? my notes dont say and the book is too heavy
Peak: None
Duration: >24 hours

34
Q

frequency f admin for Insulin glargine (U-300) (Toujeo)?

A

Q 24 hours

35
Q

prototype for combination insulin

A

NPH/regular 70/30 (Humulin 70/30)

36
Q

onset peak duration for NPH/regular 70/30 (Humulin 70/30)

A

Onset: 30-60 min
Peak: 1.5-16 hours
Duration: 10-16

37
Q

what kind of patients use NPH/regular 70/30 (Humulin 70/30)

A

*unpredictable b/c of wide range

• Good for patients with routine lives (diet, exercise) and set doses will work for them

38
Q

indication for using sliding scale dose insulin?

A

when patients are hospitalized

39
Q

what is a sliding dose scale insulin?

A

• will give certain amount of insulin based on patients current blood sugar
◦ backward thinking! give units based on elevation that has already occurred

40
Q

what are correction dose insulins?

A

• Based on patient’s weight and current blood sugar
• Calculator in computer
◦ backward thinking! based on what has already occurred in body and what current reading is

41
Q

what is meal dose insulin?

A

• Adjust insulin based on % amount eaten
◦ forward thinking!

-Can have sliding scale + meal dose or correction dose + meal dose

42
Q

what is standing dose insulin?

A

• Doesn’t matter what CBG is, how much they ate –> give set amount every meal

43
Q

4 doses scales for insulin?

A

sliding scale
correction
meal %
standing

44
Q

insulin drips have ______ mortality

A

improved

45
Q

considerations for patient on insulin drip (what is the nurse having to do?)

A
  • More frequent blood sugar monitoring : the more stable the patient gets the wider we can make those time frames
  • Titrate frequently
46
Q

what kind of insulin goes in a drip?

A

Usually use regular or rapid acting insulins insulin

◦ All rapid acting insulins could be used

47
Q

how do we discontinue an insulin drip?

A

give patient a longer acting insulin before stop drip, frequent CBG, rapid acting + long acting to normal routine
–> cant stop the drip cold turkey

48
Q

Insulin pumps provide ____ dose with rapid acting analogs

A

basal

—• Set for bolus dose based on Carbohydrate count

49
Q

consideration for insulin pumps: D/C them before…..

A

mri/procedures/ when admitted

50
Q

when is hypoglycemia likely to occur for a diabetic?

A

◦ Especially at peak times
◦ During increased exercise
◦ Too much insulin
◦ Skipped meal

51
Q

2 main side effects from insulin

A

hypoglycemia
lipodystrophy -hard formation of tissue @ injection site over time
◦ Rotate injection sites

52
Q

where is insulin absorbed the quickest?

A

abdomen

53
Q

storage of insulin: room temp vs fridge - how long is it good for

A
  • RoomTemp: 30 days

- Fridge: 3 month –> give @ room temp**

54
Q

how long is insulin good for in a syringe pre mixed? how do we want to store it?

A

1-2 weeks in syringe already mixed. Store upright to avoid clogging of needle

Kol- Pharm 323 Spring (41 decks)

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