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Ch. 57 Diabetic Ther
Pharmacology for Nurses
Question | Answer |
---|---|
Insulin- Functions | Regulated carbohydrate metabolism, helps metabolize fates and proteins, lower blood glucose by stimulating peripheral glucose uptake |
Insulin- In the liver | Suppresses gluconeogenesis and glycogenolysis (glucose to glucose) |
Insulin Therapy | Sliding Scale Insulin- Regular insulin, AC and HS, Q 4-6 hours with TPN |
Classification of Insulin | Rapid acting, short acting, intermediate acting, long acting, mixture |
Insulin | Insulin is a protein and cannot be given orally -there is no such thing as oral insulin |
Rapid-Acting Insulin | Insulin lispro (Humalog) |
Rapid-Acting Insulin | Insulin aspart (Novolog) |
Rapid-Acting Insulin | Insuling glulisine (Apidra) |
Rapid-Acting Insulin | Onset 5-15 minutes; just before meals; can be given SQ or as a SQ infusion; cannot be given IV; clear solution; When used SQ, they are given in addition to an intermediate or longer acting insulin to achieve tight glucose control. |
Short-acting Insulin | Humulin Regular -Humulin R |
Short-acting Insulin | Novolin -R |
Short-acting Insulin | Exubera |
Short-acting Insulin | Injected or inhaled 30-60 minutes before meals; SQ, IM, IV, inhaled; control postprandial hyperglycemia; SQ to provide basal control; IV to treat DKA |
Intermediate-Acting Insulin | NPH Insulin - Humulin N, Novolin N |
Intermediate-Acting Insulin | Insuling detemir- Levemir |
Intermediate-Acting Insulin | Duration 6-14 hours; NPH insulin is the only insulin on the market that is still cloudy – it is cloudy because of the addition of protamine (a protein that slows absorption). It is used to provide glycemic control between meals and at night |
Intermediate-acting Insulin | not for postprandial hyperglycemia (that is rapid acting and short acting insulin’s job). |
Long-Acting Insulin | Insulin glargine (Lantus) |
Long-Acting Insulin | onset 1 hour; no peak=basal, so less risk of hypoglycemia; maintains s steady state for 24 hours; given once a day usually at bedtime |
Long-Acting Insulin | It is a clear solution, but cannot be mixed with other insulins and can NEVER be given IV. |