Diabetes Medications

Question 1

Rapid acting insulins

Answer 1

• insulin aspart (Novolog)
• insulin lispro (Humalog)
• insuline glulisine (Apidra)

Question 2

Short acting insulins

Answer 2

• insulin regular (Humulin R)

Question 3

Intermediate acting insulins

Answer 3

• insulin isophane (NPH, Humulin N, Novolin IV, Relion N)

Question 4

Long acting insulins

Answer 4

• insulin degludec (Tresiba)
• insulin detemir (Levemir)
• insulins glargine (Lantus, Toujeo)

Question 5

Insulin aspart

Answer 5

• Novolog
• rapid acting
• onset 10-15 mins
• peak 1-2 hr
• duration 3-5 hr
• administer sub-q 5-10 mins before meal
• can give with NPH, draw insulin aspart first

Question 6

Insulin lispro

Answer 6

• Humalog
• rapid acting
• onset 10-15 mins
• peak 1-2 hr
• duration 3-5 hr
• administer sub-q 5-10 mins before meal
• can give with NPH, draw insulin lispro first

Question 7

Insulin glulisine

Answer 7

• Apidra
• rapid acting
• onset 10-15 mins
• peak 1-2 hr
• duration 3-5 hr
• administer sub-q 15 mins before meal or within 20 mins after starting meal
• can give with NPH, draw insulin glulisine first

Question 8

Insulin regular

Answer 8

• Humulin R
• short acting
• onset 30 mins
• peak 2-3 hr
• duration 6-7 hr
• administer sub-q 30-60 mins before meal
• can administer IV
• can give with NPH, sterile water, or normal saline
• do not mix with insulin glargine

Question 9

Insulin isophane

Answer 9

• NPH, Humulin N, Novolin IV, Relion N
• intermediate acting
• onset 1-3 hr
• peak 5-8 hr
• duration 18 hr
• administer sub-q 30 mins before breakfast and 30 mins before supper
• can mix with aspart, lispro, or regular
• do not mix with glargine

Question 10

Insulin deluded

Answer 10

• Tresiba
• long acting
• onset 1.6 hr
• no peak
• duration up to 42 hr
• administer sub-q once daily at any time
• do not mix with other insulins

Question 11

Insulin detemir

Answer 11

• Levemir
• long acting
• onset 1.6 hr
• no peak
• duration up to 24 hr
• administer sub-q with evening meal or at bedtime
• do not mix with other insulins

Question 12

Insulin glargine

Answer 12

• Lantus, Toujeo
• long acting
• onset 1.5 hr for Lantus and 6 hr for Toujeo
• no peak for Lantus 12hr for Toujeo
• duration up to 24 hr
• administer sub-q once daily at same time each day
• do not mix with other insulins

Question 13

Sulfonylureas

Answer 13

• stimulate release of insulin from pancreatic islet cells
• increase sensitivity of insulin receptors on target cells
• most common adverse effect is hypoglycaemia

Question 14

Biganuides

Answer 14

• decreases gluconeogenesis and insulin resistance
• decreases triglyceride and LDL levels promoting weight loss
• obtain fasting BG every 3 months
• adverse effects: GI related. hypoglycaemia, weight gain, and lactic acidosis are rare but may occur

Question 15

Alpha-Glucosidase Inhibitor

Answer 15

• blocks enzyme in small intestine responsible for breaking down complex carbs into monosaccharides
• delays digestion of glucose
• minimal side effects mostly GI related
• treat hypoglycaemia with glucose not sucrose

Question 16

Thiazolidinediones (Giltazones)

Answer 16

• decreased BG and insulins resistance and inhibits gluconeogenesis
• takes 3-4 months for optimal results
• adverse effects: fluid retention, headache, weight gain
• hypoglycaemia does not occur

Question 17

Meglitinides

Answer 17

• stimulates release of insulin from islet cells
• short duration of action (2-4hr)
• as effective as sulfonylureas
• well tolerated with hypoglycaemia as most common side effect

Question 18

Incretin enhancers

Answer 18

• mimics effects of incretins which secrete to signal insulin secretion and stoppage of glucose production
• decreases food intake by decreasing gastric emptying and increasing feeling of fullness

Question 19

Type 2 diabetes medications

Answer 19

• sulfonylureas
• biguanides
• alpha-glucose inhibitor
• thiazolidinediones
• meglitinides
• incretin enhancers
• miscellaneous agents