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N172 Meds > INSULINS > Flashcards

INSULINS Flashcards

1
Q

RAPID acting insulin types (3)

A
  1. insulin aspart/NovoLOG
  2. insulin glulisine/Apidra/inhaled Afrezza
  3. insulin lispro/HumaLOG/Lyumjev
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2
Q

SHORT acting insulin types (2)

A
  1. regular insulin OTC/HumuLIN R, NovoLIN R, ReliOn R
  2. regular concentrated insulin Rx/Humulin R, Novolin R, HumuLIN R U-500.
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3
Q

INTERMEDIATE acting insulin names

A

isophane suspension insulin/ HumuLIN N, NovoLIN N, Novolin N Prefilled, ReliOn N.

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4
Q

LONG acting insulin types (3)

A
  1. insulin detemir/Levemir
  2. insulin degludec/Tresiba
  3. insulin glargine/Basaglar, Lantus, Semglee, Toujeo SoloStar
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5
Q

insulin MIXTURE types ((5)

A
  1. insulin degludec-insulin aspart / Ryzodeg 70/50
  2. insulin isophane suspension-regular insulin/ HumuLIN70/30, NovoLIN70/30
  3. NPH regular insulin mixture/ Humalin 7/30, Novolin7/30
  4. insulin lispro mixture/ HumaLOG Mix75/25, HumLOG mix 50/50
  5. insulin aspart mixture/ NovoLOG70/30, NovoLOG Mix Flexpen Prefilled 70/30.
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6
Q

insulin HOW IT WORKS

A

decreases blood glucose and allows cells to use glucose for energy

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7
Q

insulin MECHANISMS OF ACTION

A
  • activates transport of glucose into cells
  • facilitates conversion of glucose to glycogen
  • indirectly increases blood pyruvate and lactate
  • decreases phosphate and potassium
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8
Q

insulin INDICATIONS (3)

A

Type I DM (chronic/ pancreas produces no insulin)

Type 2 DM

Gestational diabetes

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9
Q

how to STORE insulins

A
  • Keep away from heat/sunlight.
  • Some can be stored at room temp for less than one month
  • Regrigerate
  • NPH and Premixed insulins should appear CLOUDY
  • Regular, Rapid, and Long acting insulins should appear CLEAR
  • do not freeze
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10
Q

For administration of insulins, which type of syringes should be used?

A

ONLY insulin syringes with markings matching units/mL.

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11
Q

Which types of insulins should appear as CLOUDY suspensions?

A
  1. Premixed and 2. NPH (neutral protamine Hagedorn) insulins

(trout semen)

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12
Q

which types of insulins should appear as CLEAR, colorless liquids? (3)

A
  1. regular human insulin
  2. rapid acting
  3. long acting
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13
Q

Is it OK to mix insulins when using a CSII pump?

A

NO

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14
Q

To prevent FATAL hypoglycemia & hypokalemia, which labs should be monitored often when regular insulin is being given IV?

A

BLOOD GLUCOSE

SERUM POTASSIUM

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15
Q

Common side effect of insulin use

A

hypoglycemia

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16
Q

What are the SOMOGYI and DAWN EFFECTS

A

post hypoglycemic HYPERglycemia or hyperglycemia upon waking… clinical research is mixed

17
Q

insulin glulisine/Apidra/Afrezza ONSET, PEAK, DURATION

A

15-30 min onset

30min-90min peak

3-4hr duration

RAPID ACTING

18
Q

insulin aspart/Novolog ONSET, PEAK, DURATION

A

onset 10-20min

peak 1-3hr

duration 3-5hr

RAPID ACTING

19
Q

insulin lispro/Humalog ONSET, PEAK, DURATION

A

onset 15-20 min

peak 30 min- 90 min

duration 3-5hr

RAPID ACTING

20
Q

insulin regular ONSET, PEAK, DURATION

A

onset 30 min

peak 2.5-5hr

duration up to 7hr

SHORT ACTING

21
Q

insulin isophanse suspension NPH

ONSET, PEAK, DURATION

A

onset 1.5-4hr

peak 4-12hr

duration < 24hr

INTERMEDIATE acting

22
Q

insulin degludec/Tresiba

ONSET, PEAK, DURATION

A

peak 9-12 h

duration 24hr after 8 doses?

this is a ONCE-DAILY insulin - but is considered INTERMEDIATE acting???

takes 3-4 days to achieve steady state

23
Q

insulin detemir/ Levemir ONSET, PEAK, DURATION

A

onset 0.8-2hr

peak UNKNOWN??

duration _<_24h dependent upon concentration

LONG ACTING

24
Q

insulin glargine/Basaglar, Lantus, SemGlee, Toujeo Solostar PEAK, ONSET, DURATION

A

onset 90 min

peak not identified

duration greater than >24h

LONG ACTING

25
Q

which blood tests will be used to identify effectiveness of insulin therapy?

A

Fasting Blood Glucose

HbA1c q3m

26
Q

Signs of HYPOglycemic reaction

A
  • sweating
  • weakness, dizziness
  • chills
  • confusion
  • headache
  • rapid pulse
  • anxiety, tremors, slurred speech, hunger

“Cold and clammy, need some candy”

27
Q

How are insulin requirements affected by STRESS, including illness or surgery?

A

Insulin requirements may INCREASE during times of stress

28
Q

Signs of HYPERglycemia

A
  • acetone breath
  • polyuria
  • flushing
  • dry skin
  • lethargy

“Hot and dry, sugar high.”

29
Q

What should the nurse assess in patients receiving insulin therapy?

A

FBG/CBG

HbA1c

urine ketones during illness

look for decrease in polyuria, polydipsia, & polyphagia to indicate therapeutic response

30
Q

What are three important points of patient teaching about insulin?

A
  1. Keep insulin equipment available at all times, with candy or oral glucose and glucagon kit
  2. Recognize HYPOglycemic reaction: headache, tremors, fatigue, tachycardia; and HYPERglycemic reaction: polyuria, thirst, flushing, dry skin, lethargy. (Cold and clammy, need some candy; hot and dry, sugar high)
  3. How to use blood glucose testing equipment
31
Q

Insulin times of onset from fastest to slowest

A

TIMES OF ONSET

  1. insulin ASPART 15min
  2. insulin GLULISINE 15min
  3. insulin LISPRO 15min
  4. regular insulin 30-60 min
  5. insulin DEGLUDEC 1h (ultra long acting)
  6. insulin DETEMIR 1-2hr (long acting)
  7. insulin GLARGINE 1-2h (long acting)
  8. insulin ISOPHANE suspension/NPH onset 2-4h (intermediate acting)
32
Q

Who are the three fast gals?

A

glulisine

aspart

lispro

33
Q

which insulin is ULTRA LONG ACTING (up to 42 hours)?

A

insulin degludec

34
Q

which long acting insulin has a typical duration of 24 hours

A

insulin glargine/Lantus

35
Q

which long acting insulin has a duration ranging from 6-24h?

A

insulin detemir/Levemir

36
Q
A

N172 Meds (5 decks)

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