Treatment of Diabetes - Insulins Flashcards
Name the 3 Rapid-acting insulins:
lispro (Humalog)
aspart (Novolog)
glulisine (Apidra
What are the pharmacokinetics of rapid acting insulins:
lispro (Humalog)
aspart (Novolog)
glulisine (Apidra
Onset of action 5-15 min
Peak 1-1.5 hr
Duration 3-5 hr
When should patients take rapid releasing insulins and what is the route of admission
Given just prior to a meal by SQ injection or insulin pump
name the Rapid-acting insulin that is Inhaled
Afrezza
name the 2 Short-acting: Regular Insulins
(Humulin R; Novolin R)
what are the pharmacokinetics of Humulin R; Novolin R
Onset of action 30-60 min
Peak 2 hr
Duration 6-8 hr
what are the routes of admission for Humulin R; Novolin R
SQ injection, IV infusion
name the 2 Intermediate-acting: NPH Insulins
Humulin N; Novolin N
what are the pharmacokinetics of Humulin N; Novolin N
Onset of action 1-3 hr
Peak 6-8 hr
Duration 12-16 hr
what is the route of admission of Humulin N; Novolin N
SQ injection only,
twice daily for basal coverage
name the 4 long acting insulins
glargine (Lantus).
detemir (Levemir).
degludec (Tresiba).
glargine U-300 (Toujeo)
what are the pharmacokinetics of the long acting insulins: glargine (Lantus). detemir (Levemir). degludec (Tresiba). glargine U-300 (Toujeo)
Onset of action 1-1.5 hr No pronounced peak Duration: 24 hr (glargine) 12-20 hr (detemir) 42 hr (degludec)
which insulins Cannot be mixed in the same syringe with any other insulins
ong acting insulins: glargine (Lantus). detemir (Levemir). degludec (Tresiba). glargine U-300 (Toujeo)
when are biphasic insulins used?
Used twice a day just before AM and PM meals
what are biphasic insulins
Mixture of intermediate- and short- or rapid- acting insulins - for basal AND meal insulin needs
Basal insulin: definition
Insulin taken to suppress hepatic glucose production and to maintain normal fasting blood glucose levels
______ insulin is used to metabolize nutrients in a meal or snack, and cover the postprandial rise in glucose. The ____________and inhaled insulin can be used for this purpose
Prandial,
rapid-acting insulins lispro, aspart, glulisine, fiasp,
basal insulin is used even when a patient is fasting. insulin are used for this purpose
Glargine, detemir, NPH, and degludec
The three purposes for insulin therapy include coverage of basal, prandial, and correctional needs. Together, the prandial and correctional insulin doses make up “bolus” insulin. Patients on this type of regimen are on ______ therapy.
basal bolus
When is insulin therapy instituted in individuals with type 2 diabetes
When lifestyle modifications and combinations of non-insulin glucose-lowering therapies are inadequate to achieve target blood glucose levels,
In some instances, individuals with type 2 diabetes come to medical attention experiencing marked weight loss with fasting blood glucoses _____, random glucoses of ____, and/or hemoglobin A1c of _____. In this instance, insulin therapy is instituted immediately because of these signs of severe insulin deficiency
> 250 mg/dL,
300 mg/dL,
10%
Another situation necessitating the use of insulin therapy in type 2 diabetes is hospital admission for ________
hyperglycemic hyperosmolar state or diabetic ketoacidosis
what is the treatment target for fasting blood glucose levels in diabetics
80 - 130 mg/dl
what is the target therapeutic level of a1c levels in diabetics
< 7% for most adults
(<6.5%* if low risk for hypoglecemia
or <8%** higher risk hypoglycemia)
<7.5% for children
what is the “closed-loop” system or “artificial pancreas
This a combination insulin pump and continuous glucose monitor that delivers insulin in a manner that requires less intervention and decision-making by the patient
