Diabetes pharmacology - Lowwang Flashcards
Rapid-acting insulins
Humalog (Lispro)
Novalog (Aspart)
Glulisine (Apidra)
onset of action within 5-15 minutes, peaking at 1-1.5 hours, and lasting 3-5 hours.
Short-acting insulins (Regular)
Humulin R, Novolin R
Regular insulin is a recombinant human insulin.
The onset of action is 30-60 minutes, peaking at 2 hours, and lasting 6-8 hours
Long-acting insulins
Glargine (Lantus)
The onset of action is 1.5 hours, and it lasts for approximately 24 hours without a pronounced peak. Therefore it can be given once a day to provide basal coverage.
Detemir (Levemir)
(covered by medicare)
onset of action is 1 hour, and it lasts between 12 hours at lower doses to 20 hours with higher doses, so it is often injected twice per day to achieve basal coverage.
**THESE ARE THE ONLY INSULINS THAT CANNOT BE MIXED IN THE SAME SYRINGE WITH OTHER INSULINS
What is the dawn effect?
Rise in cortisol and growth hormone (conterregulatory hormones). So you get a more marked rise in blood sugar in the morning.
Intermediate-acting
NPH (neutral protamine Hagedorn) insulin (Humulin N, Novolin N)
NPH, or isophane, insulin is the only insulin dispensed as a cloudy solution. Its onset of action occurs at 1-3 hours, peaks at 6-8 hours, and lasts for 12-16 hours. NPH can be drawn up with regular insulin or rapid-acting insulin analogs in the same syringe for simultaneous injection.
What insulins might be taken prandially?
Humalog, novalog, glulisine, regular
Basal insulins?
Glargine, Detemir, NPH
What is the target BG 2 hrs post-prandially?
Less than 180
What is the target a1c?
Less than 7%, or 7.5 in adolescents/children.
Rapid insulin onset/duration?
15 mins
3-5 hrs
Regular insulin onset/duration
30-60 mins
6-8 hrs
NPH onset/duration?
1-3 hrs
12-16 hrs
Detemir onset/duration?
1 hr
12-20 hrs
Glargine onset/duration?
1.5 hrs
24 hrs
Target fasting BG for a diabetic patient?
70-130
