Whittiker Insulin Products Flashcards
Rapid Acting Insulin
Drugs
Peak
Duration
Aspart (Novolog, Fiasp)
Lispro (Humalog, Admelog)
Glulisine (Apidra)
Oral inhalation (Afrezza)
Onset: 10-30 minutes
Peak: 30 minutes to 1.5 hours
Duration: 3-5 hours
Short Acting Insulin
Drugs
Peak
Duration
Insulin regular (Humulin R, Novolin R)
Onset: 30 minutes to 1 hour
Peak: 2-3 hours
Duration: 5-8 hours
**pt needs to take 30 minutes before food, problem is if pt doesnt eat you will bottom out
**need to watch out for insulin stacking, meaning if it doesnt get cleared in the 8 hours and they inject again it will add on to the dose they already had
Intermediate Acting Insulin
Drugs
Peak
Duration
Insulin NPH (Humulin N, Novolin N)
Onset: 2-4 hours
Peak: 4-10 hours
Duration: 10-16 hours
**this product has a very variable duration in pts
Long Acting Insulin
Drugs
Peak
Duration
Glargine (Lantus, Toujeo, Basaglar)
Detemir (Levemir)
Degludec (Tresiba)
Onset:
Lantus: 3-4 hours
Levemir: 2 hours
Tresiba: 1 hour
Peak:
Lantus: Peakless
Levemir: 3-9 hours
Tresiba: 9 hours
Duration:
Lantus: 24 hours
Levemir: 16-24 (depends on dose, low doses is closer to 16 and high doses closer to 24)
Tresiba: 25 hours
Simplified Activity of Insulins
Rapid
Onset: .2-.5 hours
Peak Activity: 0.5-1.5 hours
Duration: 3-5 hours
Short:
Onset: 0.5-1 hour
Peak: 2-3 hours
Duration: 5-8
Intermediate:
Onset: 2-4 hours
Peak: 4-10 hours
Duration: 10-16
Long acting (Glargine)
Onset: 3-4 hours
Peak: peakless
Duration: 24 hours
Long acting (Detemir)
Onset: 2
Peak: 3-9
Duration: 16-24
Long acting (Degludec)
Onset: 1
Peak: 9
Duration: 25
ADE and Pearls for insulin
ADE:
Hypoglycemia
Weight gain
Injection site issues
HypoK
Pearls:
Reduces A1C infinity
Reduces FPG and PPG
Take bolus insulin before or with meals
Type 1- MUST have basal and bolus regimen
Can cause sever Hypoglycemia
Adjust doses based on renal function
Therapy is very individualized
Weight gain
What are treatment options for patients with hypoglycemia
When their glucose is below 70
Give 15g of carbs:
3-4 glucose tabs
1 serving glucose gel
4 oz regular soda or fruit juice (cant be diet soda)
8 oz of milk
5-6 hard candies
1 tbs sugar, honey
3 graham crackers
Glucagon (IF PT IS UNABLE TO TAKE PO)
***also if unable you can do AMP of D50, or if pt is on basal and long term glucose needed you can give in IV bag
What are the weight loss medications and when would you use them?
Used when a pt has a BMI > 27 as adjunct to diet, physical activity and counseling
**IF pt loses < 5% of body weight after 3 months you D/C
Locaserin
Naltrexone/bupropion
Orlistat
Phentermine/Topiramate
Liraglutide (3mg dosing), you give a higher dose when using for weight los over diabetes dosing
