Insulin

Question 1

Used to Treat

Answer 1

Diabetes mellitus (type I and type II)

Question 2

Mechanism of Action

Answer 2

Acts as insulin produced naturally in the body
Must be administered parenterally
Because insulin is a protein, if administered orally it would be digested by gastric acids
Insulin helps transport glucose molecules from bloodstream to store for later use

Question 3

Notes

Answer 3

Injected subcutaneously (SC, SQ)
Store in fridge, can be stored at room temperature for 28-30 days
Most often available in concentration of 100U/mL
Available in vials (10mL), penfill cartridges or Pens (15mL)

Question 4

Common Adverse Reactions

Answer 4

Too little insulin can lead to hyperglycemia
-Increased thirst, urination, hunger
-Weakness, blurred vision, dry mouth
-Fruity smelling breath
-Decreased consciousness
Too much insulin can lead to hypoglycemia
-Confusion, difficulty concentrating, hunger, nausea, headache, fatigue, uncontrolled yawning
-Anxiety, nervousness, irritability, sweating
-Tremors, muscle weakness, tingling in fingers
-Rapid heartbeat, palpitations
-Loss of consciousness

Question 5

Humalog

Answer 5

Rapid acting insulin
Generic name: lispro
Onset of action: 15 minutes
Patients often use on a sliding scale (adjust their dose based on blood glucose readings)
Often dosed multiple times per day
Lispro duration of action: 6-8 hours

Question 6

Novo-Rapid

Answer 6

Generic name: aspart
Onset of action: 15 minutes
Patients often use these on a sliding scale (adjust their dose based on blood glucose readings)
Often dosed multiple times per day
Should be injected 5-15 minutes prior to eating
Duration of action: 3-5 hours

Question 7

Toronto, Humulin R

Answer 7

Short acting insulin
Generic name: regular
Only insulin that can be administered IV (intravenously)
Clear solution; if appears cloudy, should be suspended
Onset of action: 30 minutes
Duration of action: 8-12 hours

Question 8

Novo NPH, Humulin N

Answer 8

Immediate Acting Insulin
Generic name: isophane (NPH)
Cloudy suspension, needed to be re-suspended prior to use
Onset of action: 1-4 hours
Duration of action: 10-24 hours

Question 9

Levemir

Answer 9

Long acting insulin
Generic name: detemir
Often dosed once daily, at bedtime
Duration of action: 24 hours
Onset of action: 4-12 hours