Diabetic Drugs

Question 1

Lispro/Aspart

Answer 1

Onset: 5-15 min
Peak:30-90 min
Duration:3-5 hour
No more than
5 minutes
before food.When mixing
regular and NPH
must give within
15 minutes after
combining. Hypoglycemia

Question 2

Humulin R
Novolin R

Answer 2

Onset: 30-60 min
Peak:2-4 hours
Duration:5-12 hours
30 minutes
before meals
Can be given
IV; used in
emergency

Question 3

NPH

Answer 3

Onset:1-4 hours
Peak: 4-12 hours
Duration:18-24
hours
Commonly
given with a
regular-acting
insulin

Question 4

Glargine/Detemir

Answer 4

G:Onset:2 – 4 hours
Peak: None
Duration: 24 hours
D:Onset: 3-4 hours
Peak: 3-6 hours
(relatively peakless)
Duration: 24 hours. Evenly
distributed
over 24 hours
Give at the
same time
each day.Glargine and
detemir cannot
be mixed in
solution with
any other drug,
including other
insulins

Question 5

Glimepiride/
Glipizide/
Glyburide

Answer 5

Type 2
Diabetes
Use with
exercise and
diet changes
May also use
with insulin
or Metformin
Endocrine:
hypoglycemia
Do NOT use in
pregnancy
Caution with
Beta Blockers
and herbs
(mask
hypoglycemia)
Have longer
duration of
action and
fewer side
effects than 1st
generation
drugs
safer for those
with renal
dysfunction

Question 6

Metformin

Answer 6

Type 2
Diabetes
Use with
exercise and
diet changes
Does NOT cause
hypoglycemia
Adverse: upset
lactic acidosis or renal
failure if given
within 48 hours
before pt
undergoes
contrast dye
Approved for
children > 10
years
Monitor BUN &
Creatinine esp.
when
administering
IVP dye for CT
scan

Question 7

Pramlintide

Answer 7

Type 1 and
Type 2 DM
Use with
exercise and
diet changes
Severe
hypoglycemia
when used with
insulin
GI: nausea,
vomiting
SQ before or
after a meal
(Rapid onset)
Monitor BG
Cannot be
mixed with
insulin in the
same syringe

Question 8

Exenatide

Answer 8

Type 2 DM
Use with
exercise and
diet changes
GI: severe
abdominal pain
Hypoglycemia is
uncommon
Give SQ BID
within 60
minutes of a
meal

Question 9

Liraglutide

Answer 9

Type 2 DM
Use with
exercise and
diet changes
Adverse: severe
abdominal pain,
acute
pancreatitis
thyroid C-
cell tumors
Hypoglycemia is
uncommon
Give SQ once
daily
Monitor for
pancreatitis

Question 10

Sitagliptin

Answer 10

Type 2 DM
Use with
exercise and
diet changes
Adverse:
hypoglycemia
headache
vomiting,
acute
pancreatitis
Oral agent
Given once a
day usually
with other
agents

Question 11

Glucagon

Answer 11

Severe insulin
induced
hypoglycemia
when other
methods of
giving glucose
are not
available.
Adverse: nausea,
vomiting
hyperglycemia
Available: IV,
IM, SQ
Blood glucose
rises in 10
minutes
Place pt on side
if ↓LOC when
administering
due to risk for vomiting