Insulin Flashcards
Rapid Acting Drugs
Lispro
Aspart
Short Acting
Regular
Intermediate Acting
Isophane NPH
Long Acting
Glargine
Detemir
Rapid Acting Onset
15 minutes or less
Rapid Acting Peak
lispro 30min to 2.5 hours
aspart 1 to 3 hours
Rapid Acting Duration
lispro 3 to 6 hours
aspart 3 hours
Time of Rapid Acting Adverse Reaction & symptoms
Midmorning; trembling, weakness
Client should eat within 5 to 15 minutes after injection; also used in insulin pumps
Short Acting Onset
30 to 60 min
Short Acting Peak
1 to 5 hours
Short Acting Duration
6 to 10 hours
Time of Short Acting Adverse Reaction & symptoms
Midmorning, Afternoon; weakness, fatigue
Clear solution; given 20 to 30 min before meal; can be alone or with other insulins
Intermediate-Acting Onset
1 to 2 hours
Intermediate Acting Peak
6 to 14 hours
Intermediate Acting Duration
16 hours
Time of Intermediate Acting Adverse Reaction & symptoms
Early evening; weakness, fatigue
White and cloudy solution; can be given with meals
Long acting Onset
3 to 4 hours
Long acting Peak
Continuous; no peak
Long acting Duration
24 hours
Characteristics of Long acting Insulin
Maintains blood sugar levels regardless of meals; cannot be mixed with other insulins; given at bedtime
Herbal interactions
Bee pollen, ginkgo biloba, glucosamine: may increase glucose
basil, bay leaf, chrmium, echinacea, garlic, ginseng: may decrease glucose
Oral Hypoglycemic agent: sulfonylureas
Glimepiride
Glipizide
Glyburide
Sulfonylurea side effects
Only used if very little beta-cell function
GI symptoms and dermatologic reactions
Take with food
Oral Hypoglycemic agent: Biguanides
Metformin
Biguanide side effects
Nausea, Diarrhea, Abdominal discomfort avoid if renal impairment can cause lactic acidosis avoid alcohol Do no give with alpha-glucodiase inhibitors
Oral Hypoglycemic agent: Alpha glucosidase inhibitors
acarbose
miglitol
Alpha glucosidase inhibitor side effects
abdominal discomfort
diarrhea & gas
delays digestion of carbohydrates
must take immediately before a meal
Oral Hypoglycemic agent: Thiazolidinediones
Rosiglitazone
Pioglitazone
Thiazolidinedione side effects
infection
headache
pain
rare cases of liver failure
must have regularly scheduled liver-function studies
can cause resumption of ovulation in perimenopause
oral hypoglycemic agent: meglitinides
repaglinide
meglitinide side effects
hypoglycemia GI disturbances URIs Back pain Headache med should not be taken if meal is skipped
oral hypoglycemic agent: gliptins
sitagliptin
gliptin side effects
Upper respiratory infections
hypoglycemia
oral hypoglycemic agent: incretin mimetic
Exanatide
Incretin mimetic side effects
GI upset
hypoglycemia
pancreatitis
administer 1 hour before meals
