Diabetes Pharmacology (Exam 2) Flashcards
Goal of Diabetic Pharmacology
-Prevent Hyperglycemia and decrease chance of long-term complications
-Must maintain a tight glycemic control and blood lipid level. (We can observe the effectiveness with fasting blood glucose levels and HgbA1C, triglycerides, and cholestrol levels
What do you want to keep the blood sugar at in someone with diabetes
80-140
below 100 in someone without diabetes
History of treatment of diabetes (TYPE 1)
-Usually would die within days to weeks of being diagnosis
-Treated with starvation diets, where carbs and everything was eliminated
Frederick Banting
-Enter questionable dog experiments
-Injected with Insulin from a dog pancreas
Types of Insulin (all type 1 diabetics) (Some type 2 take insulin. Some take oral)
-Rapid Acting- Insulin lispro
-Short acting- human regular
-Intermediate-acting insulin- NPH
-Long-acting insulin- glargine
Insulin Administration
-Subcutaneous injection
-Via small needle or pen injector
-Sites: Back of arm, stomach, thighs
-Ordered in units
Rapid Acting Insulin
-Insulin lisrpo
-Onset: 15 min
-Peak: 1 hour (Lowest BS)
-Duration: 2-4 hrs
-Administer in association with meals to control postprandial meal glucose rises.
-Must be used in conjunction with either an intermediate or long-acting insulin
Short Acting Insulin
-Insulin regular
-Onset: 30-60 min
-Peak: 2-6 hours
-Duration: 3-8 hours
-Typically given before meals to control postprandial hyperglycemia, but can also be given for longer acting glycemic control. (In hospitals we often give this for patients receiving tube feeding) (Used in insulin infusions)
Intermediate acting insulin
Neutral Protamine Hagedorn (NPH)
-The protamine helps slow down absorption so that it last longer throughout the day
-Onset: 2-4 hours
-Peak: 4-10 hours
-Duration: 10-20 hours
-Clouding: Agitate before using (Shake the the bottle)
-Typically injected twice daily to help with glycemic control with meals and throughout the night
-Can be administered with rapid acting insulin and short acting insulin. Draw up rapid or short first. CLEAR BEFORE CLOUDY
Long acting Insulin
glargine
-Once-A-day
-Onset: around 70 minutes and lasts all day. Not really a peak.
-Helps control blood sugar all day
-NEVER MIX WITH OTHER INSULINS
-Often given at night: Patient checks blood sugar with meals and corrects if needed with rapid–acting insulins
Blood Sugar Monitoring
-Before you give any type of insulin you must know the blood sugar.
FSBG or CGM
When giving insulin
make sure their the blood sugar check wasnt to long ago
Insulin Pumps
-Patients usually dont keep in the hospital
-Typically type 1 but can be type 2
-Computerized devices with basal infusion of regular insulin
-Bolus doses calculated to match calorie/carb intake
Most Common Insulin Regimens
-Sliding scale
-Regular insulin doeses given throughout the day with meals according to blood glucose level
-Can also include a basal dose of long-acting insulin
-Very important to educate patient about this type of regimen. DIABETES EDUCATOR
Insulin complication: Hypoglycemia
-Insulin overdosed, decreased caloric intake, patient VND, excessive alcohol, unaccustomed exercise, childbirth
