Insulins & Antidiabetics Flashcards
Very Rapid-Acting Insulin
Lispro
Insulin aspart
Glulisine
Very Rapid-Acting ONSET
5-15min
Very Rapid-Acting PEAK
45-75min
Very Rapid-Acting DURATION
2-4hr
Rapid-Acting Insulin
Regular
Rapid-Acting ONSET
30min
Rapid-Acting PEAK
2-4hr
Rapid-Acting DURATION
6-8hr
Intermediate-Acting Insulin
NPH
Intermediate-Acting ONSET
2hr
Intermediate-Acting PEAK
4-12hr
Intermediate-Acting DURATION
18-28hr
Long-Acting Insulin
Detemir
Glargine
Long-Acting ONSET
Detemir 2hr
Glargine 1.5hr
Long-Acting PEAK
Detemir 3-9hr
Glargine NONE
Long-Acting DURATION
Detemir 6-24hr
Glargine 20-24+hr
Ultra Long-Acting Insulin
Degludec
Ultra Long-Acting ONSET
2hr
Ultra Long-Acting PEAK
NONE
Ultra Long-Acting DURATION
> 40hr
Metformin MOA
Biguanide
Inhibits glucose production by the liver
↓GI glucose absorption
↑insulin sensitivity
Metformin Anesthesia Implications
Discontinue 48hr prior to surgery
Monitor for lactic acidosis
Sulfonylureas MOA
Stimulate insulin secretion & ↓insulin resistance ↑sensitivity
Sulfonylurea receptors on pancreatic & cardiac cells
Requires some β cell function
Glyburide, Glipizide, Glimepiride
Sulfonylureas SE
Hypoglycemia more prolonged & dangerous than d/t insulin