WEEK 3+4 PHARMA Flashcards
Insulin is always required for type 2 diabetes. True or false?
False, Always required for type 1 diabetes
What is done for people with type 1 diabetes when body does not produce endogenous insulin?
replacement therapy
goal of insulin therapy
prevent long term complications of diabetes by keeping BG levels within targeet ranges
Are insulin requirements the same throughout for everybody?
No, it varies in response to fluctations of BG that occur with daily activities - excersise, sleeping, eating
Insulin: indication, moa, desired effects and adverse effects
Indication: required for those with type 1 diabetes and for those whose BG is uncontrolled in type 2 diabetes
Mechanism of action: replacement for endogenous insulin - literally works like endogenous insulin
Desired effects - restores ability to metabolize carbohydrates, fats and proteins, glucose uptake by cells
Adverse effects: Hypoglycemia (taking too much insulin, not timing insulin right with food intake, skipping a meal)
TCSD - Totally Care Seeing you Die
Signs of hypoglycemia
T- Tachycardia
C - confusion
S - sweating
D - drowsiness
If severe - convulsions, coma, death
How is hypoglycemia treated
glucagon, D50W or glucose source
Are insulin dosages/routes the same for everyone? if so, what does it depend on?
No, doses and route are higly individualized for each client
depends on - how many doses daily, type of insulin (long vs short)
Common route for insulin
subcutaneous
why is insulin given subcu and not orally or any other way?
if intramuscular - uptake is super fast and can be inconsistent
if oral - goes through digestive enzymes and may not produce action
what is an insulin pump?
- to deliver small doses of insulin at predetermined intervals, with large boluses programmed manually at mealtimes
- pump delivers insulin through small pliable catheter that is anchored in SC tissue of abdomen
Types of insulin
Rapid - Lispro
Short acting (regular) - Humulin-R
Intermdiate acting - Humulin - N
Long acting - glargine
Diabetes checklist
- USE - basal-bolus injection therapy or continuous subcutaneous insulin injection
- TAILOR - insulin regimen to treat individual treatment goals lifestyle, diet, age, general health, motivation, hypoglycemia motivation, self management
- COUNSEL- about the risk, prevention and treatment of insulin-induced hypoglycemia
Difference between basal - bolus injection therapy and continuous subcutaneous insulin infusion
- Basal-bolus injection therapy - bolus insulin at mealtime+basal insulin once or twice a day
- continuous subcu insulin infusion - insulin pump therapy with a continuous subcutaneous infusion of insulin via a catheter
Rapid:Lispro
- bolus injection
- prandial - 15 minutes before or after a meal
- onset of action - 10-15 minutes
- peak - 30-60 minutes
- duration of action - 5 hours or less
- used in combination with intermediate or long acting insulin - basal