Test 2 - Insulin (Josh) Flashcards
Short Duration: Rapid Acting insulins:
LOGs don’t LAG when rolling down a hill
- Lispro (HumaLOG)
- Aspart (NovoLOG)
- Glulisine (Apidra)
Which insulin can be administered IM?
Regular (Humulin R, Novolin R)
rarely done
Can Short Duration: Rapid Acting insulins be administered IV?
yes, but rarely done
A subQ injection of —— should be given within 15 mins before meals
A subQ injection of —– should be given 5-10 mins before meals
A subQ injection of —– should be given within 15 mins before or within 20 mins after meals.
Lispro (HumaLOG)
Which insulins are Short Duration: Slower Acting?
Regular (Humulin R, Novolin R)
Short Duration Insulins:
Rapid Acting: lispro, aspart, glulisine
Shorter Acting: regular
—— should be injected subQ ~30 mins before meals.
Regular Insulin (Humulin R, Novolin R)
Which insulin is given IV for emergencies?
Regular Insulin (Humulin R, Novolin R)
never give U-500 in IV
Which insulin can come in U-500 and U-100 strength?
Regular Insulin (Humulin R, Novolin R)
all others are U-100
Which insulin is administered subQ twice a day at the same time?
NPH (Humulin N, Novolin N)
Which insulins are OTC?
NPH (Humulin N, Novolin N)
Regular (Humulin R, Novolin R)
NPH is in which class of insulins?
iNtermediate Acting
give it twice a day at the same time every day
Which class of insulin can be given once (or twice) a day (at the same time)?
Long Duration
- Glargine (Lantus)
- Detemir (Levemir)
What are the seven types of insulin we need to know?
1) Lispro (HumaLOG)
2) Aspart (NovoLOG)
3) Glulisine (Apidra)
4) Regular (Humulin R, Novolin R)
5) NPH (Humulin N, Novolin N)
6) Glargine (Lantus)
7) Detemir (Levemir)
Onset: 15-30 mins
Peak: 0.5-2.5 hrs
Duration: 3-6 hr
Lispro (HumaLOG)
Onset: 10-20 mins
Peak: 1-3 hrs
Duration: 3-5 hr
Aspart (NovoLOG)
Onset: 10-15 mins
Peak: 1-1.5 hrs
Duration: 3-5 hr
Glulisine (Apidra)
Onset: 30-60 mins
Peak: 1-5 hrs
Duration: 6-10 hr
Regular (Humulin R, Novolin R)
Onset: 60-120 mins
Peak: 6-14 hrs
Duration: 16-24 hr
NPH (Humulin N, Novolin N)
Onset: 70 mins
Peak: none (levels are steady; no peak)
Duration: 18-24 hr
Glargine (Lantus)
Onset: 60-120 mins
Peak: 12-24 hrs
Duration: varies (dose dependent)
Detemir (Levemir)
Which insulin has no peak (i.e.: levels stay steady during the whole duration of the drug)?
Glargine (Lantus)
Long-duration insulin
Only —– is appropriate for mixing w/ short-acting insulins.
NPH
ex: 70% NPH/30% Regular (Humulin 70/30) or Novolin 70/30)
NPH means — —- —-
Neutral Protamine Hagedorn
What is the most common and serious side effect of insulin?
Hypoglycemia
b/c the insulin is stimulating uptake of the blood sugar into the muscle cells, lowering serum blood sugar
remember the first adverse effect of all drugs is if they WORK TOO WELL
Hypoglycemia is a blood sugar below —-
70 mg/dL
Why does hypoglycemia look like sympathetic stuff?
when glucose falls rapidly, activation of sympathetic nervous system leads to tachycardia, palpitations, sweating & nervousness
CNS issues, like fatigue, headache, confusion and drowsiness happen when….
blood sugar falls GRADUALLY
SNS issues, like tachycardia, sweating and palpitations, happen when….
blood sugar falls RAPIDLY
Insulin in —– should be stored in —— until needed.
Insulin in —– can be kept at room temp for up to ——
unopened vials
refrigerator
vial currently used
1 month
Mixtures of insulin in —— are stable for —– at room temp and —– if refrigerated
vials
1 month
3 months
Mixture of insulin in —– should be stored in the fridge for —–
pre-filled syringes
1 (possibly 2) weeks
If patient doesn’t rotate injection sites, what can happen?
lypodistrophy (destruction of adipose tissue)
