Insulin

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Author:
jdonaldson
ID:
102506
Filename:
Insulin
Updated:
2011-09-18 13:44:34
Tags:
james James donaldson Donaldson usp USP insulin Insulin diabetes Diabetes
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  1. List the 3 rapid acting insulin preparations.
    Onset ____
    Peak ____
    Duration ____
    • 1. Lispro (Humalog)
    • 2. Aspart (NovoLog)
    • 3. Glulisine (Apidra)
    • Onset: 15 - 30 mins
    • Peak: 2 - 3 hours
    • Duration: 4 - 6 hours
  2. List the 3 Short-acting insulin preparations.
    Onset ____
    Peak ____
    Duration ____
    • 1. Humulin R
    • 2. Novolin R
    • 3. Humulin R (U-500)
    • Onset: 30 mins - 1 hour
    • Peak: 2 - 3 hours
    • Duration: 6 - 8 hours
  3. List the 2 intermediate-acting insulin preparations.
    Onset ____
    Peak ____
    Duration ____
    • 1. NPH - Humulin N
    • 2. Novolin N
    • Onset: 2 - 4 hours
    • Peak: 6 - 9 hours
    • Duration: 14 - 18 hours
  4. List the 2 long-acting insulin preparations.
    Onset ____
    Peak ____
    Duration ____
    • 1. Glargine (Lantus) Onset 4 - 5 hours, no peak, 22 - 24 hour duration
    • 2. Detemir (Levemir) Onset 2 hours, peak 6 - 9 hours, 14 - 24 hour duration
  5. What are the adverse effects associated with insulin products?
    • - hypoglycemia (more common in DMI)
    • - weight gain
    • - lipohypertophy (not good, changes kinetics of absorption)
  6. What is the weight based dosing for insulin products in DMI and DMII?
    • 0.5 - 0.6 units/kg for DMI
    • 0.1 - 0.15 units/kg for DMII?
    • DMII may need as much as 2 U/kg (titrate to this amount) ? OR a set dose of 10 units?
  7. What medications are immediately indicated following diagnosis with DMI?
    • 1. Intermediate OR long-acting insulin (basal insulin)
    • AND
    • 2. rapid OR short-acting insulin with meals
    • *Pramlintide may be used in combo with insulin (only non-insulin product allowed for DMI)
  8. What medications are immediately indicated for a pt following diagnosis with DMII?
    FPG: 195 mg/dL
    A1C: 7.8 %
    Lifestyle modifications + metformin

    *If FPG > 250 mg/dL, random BG > 300 mg/dL consistenly, A1C > 10 %, ketonuria, sig. weight loss with polyuria polydipsia and polyphagai --> bring BG back to near normal levels with insulin first and then d/c insulin and initiate oral therapy.
  9. What medications are immediately indicated for a pt following diagnosis with DMII?
    FPG: 273 mg/dL
    Random BG: average 310 mg/dL
    A1C: 9.5 %
    [long-acting?] insulin
  10. What medications are indicated for a pt with a Hx of DMII whose A1C is > 9 % following years of oral anti-diabetic therapy?
    • Intermediate or long-acting insulin ac dinner OR at bedtime
    • - 0.1 - 0.15 units/kg?
    • OR
    • - a set dose of 10 units?

    • *A rapid or shot-acting insulin may be used with largest meal
    • ** Eventually a pt with DMII will transition to typical insulin therapy
    • *** STOP SU Tx when combination of basal-bolus insulin is initiated

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