DM & Endocrine Flashcards
Short duration rapid acting insulin qualities
- clear
- can be mixed with other insulins
- given with food
- can be given IV, not normally
short duration rapid acting insulin names
lispro, aspart, glulisine (GAL)
Lispro onset
15-30min
Lispro peak
0.5-2.5 hrs
Lispro duration
3-6 hrs
Aspart onset
10-20 mins
Aspart peak
1-3 hrs
Aspart duration
3-5 hrs
Glulisine onset
10-15 min
glulisine peak
1-1.5 hrs
Glulisine duration
3-5 hrs
Short duration slower acting insulin qualities
- clear
- can be mixed with other insulins
- used with sliding scale and meals (30 mins prior to meal)
- can be given IV
Short duration slower acting insulin names
regular insulin
Regular insulin onset
30-60 mins
Regular insulin peak
1-5 hours
Regular insulin duration
6-10 hrs
Intermediate acting insulin qualities
- cloudy
- can be given with short acting
Intermediate acting insulin name
NPH insulin
NPH insulin onset
60-120 mins
NPH insulin peak
6-14 hrs
Intermediate acting insulin duration
16-24 hrs
Long duration insulin qualities
- clear
- should not be mixed with other insulins
Long duration insulin names
insulin glargine, insulin detemir
Insulin glargine onset
70 mins
Insulin glargine peak
none
insulin glargine duration
18-24 hrs
Insulin detemir onset
60-120 minsI
Insulin detemir peak
none
Insulin detemir duration
12-24 hrs
Ultra-long duration insulin
insulin glargine
Insulin glargine (ultra long) onset
360 mins
Insulin glargine (ultra long) peak
none
Insulin glargine (ultra long) duration
> 24 hrs
Glipizide - sulfonylureas use
T2DM
Glipizide moa
stimulates release of insulin by beta cells, may also increase response to insulin
Glipizide adverse effects
hypoglycemia, weight gain
Glipizide interactions
alcohol - disulfiram like reaction
drugs that intensify hypoglycemia (BBs)
Glipizide implications
- do not give with sulfa allergy
- give 30 minutes before breakfast (missing food increases risk of hypoglycemia)
- no alcohol
- monitor for hypoglycemia (tachycardia, palpitations, sweating, tremors, n/v)
Metformin - biguanides use
T2DM, PCOS, gestational diabetes, prediabetes, metabolic syndrome
Metformin MOA
- decrease glucose production in liver
- decrease glucose absorption from gut
- increase tissue response to insulin (uptake of glucose by cells)
Metformin adverse effects
- GI: decrease appetite, n/d, gas
- Rare: lactic acidosis - hyperventilation, myalgia, malaise, somnolence
- do not use with renal disease or CHF
Metformin interactions
- ETOH increases lactic acidosis
- IV contrast - increases risk of lactic acidosis and renal failure
Metformin additive effects
- least likely to cause hypoglycemia
- decrease LDL, increase HDL
- weight loss
Metformin implications
- avoid alcohol
- monitor for lactic acidosis
- stop medication 1-2 days before IV contrast administration
Sitagliptin - Gliptins - DPP-4 Inhibitors use
T2DM
Sitagliptin moa
- increase insulin release in pancreas
- reduce glucagon release in liver
- decrease hepatic glucose production
Sitagliptin adverse effects
pancreatitis, hypersensitivity reactions
Sitagliptin implications
- educate on pancreatitis (abdominal pain, maybe vomiting)
- monitor for hypersensitivity (angioedema, anaphylaxis, SJ syndrome)