Card Set Information
What are the common rapid-acting insulin?
What are the common short-acting insulin?
regular (Novolin R)
What are the common intermediate-acting insulin?
NPH (Humulin N)
What are the common long-acting insulin?
What is the Onset, Peak, & Duration of rapid-acting insulin?
: 15-20 min
: 1-2 hr
: 3-4 hr
What is the Onset, Peak, & Duration of short-acting insulin?
: 30 min
Peak 2-4 hr
Duration 5-8 hr
What is the Onset, Peak, & Duration of intermediate-acting insulin?
: 1-1.5 hr
: 4-12 hr
Duration 16-24 hr
What is the Onset, Peak, & Duration of long-acting insulin?
: 2-4 hr
Duration 24 hr
Which insulin are cloudy and clear?
Short-acting & Long-acting are
Intervention for rapid-acting insulin?
Give within 15 min of meal
May be mixed with longer acting insulin
Intervention for short-acting insulin?
Only insulin given IV
May be mixed with intermediate-acting insulin
Used to treat DKA & newly dx T1DM
Intervention for intermediate-acting insulin?
Given often in combination with regular insulin
Interventino for long-acting insulin?
Used as basal coverage once or twice daily
Usually given at bedtime
DO NOT MIX WITH ANY OTHER INSULIN
S/S of hypoglycemia
cool pale skin
AE of insulin
lipodystrophy (fat wasting or accumulation)
redness at site
What drugs are in the class of Biguanide?
metformin oral solution (Riomet)
metformin extended release (Glucophage XR)
Action of Biguanide class of drugs
Reduces liver glucose production.
Increases sensitivity to insulin.
Improves glucose transport into cells.
Assessments when taking Biguanide class of drugs
Observe for S/S of hypoglycemia.
Assess renal/liver function at start & annually.
Long term use - monitor folic acid & Vit B12.
Interventions for the drug metformin
HOLD DOSE FOR ANY SURGERY/PROCEDURE WITH RESTRICTED INTAKE AND WHEN IV CONSTRAST MEDIA USED AND 48 HRS
Give with meal to minimize GI effect
AE of Biguanide class
R/F lactic acidosis (especially if kidney problems)
What drugs are in the class of Sulfonylureas?
Action of Sulfonylureas class of drugs
Lowers BG by
stimulating release of insulin from pancreas.
Increasing insulin sensitivity.
Assessments when taking Sulfonylureas class of drugs
Observe for S/S of
Assess for allergies to sulfonamides
Monitor BUN & creatinine
Interventions for the drug class of Sulfonylureas
Administer with 1st meal of day.
Many drug to drug interactions.
AE of Sulfonylureas class
Kidney or liver dysfunction more susceptible to hypoglycemia
What drugs are in the class of Meglitinides?
Action of Meglitinide class of drugs
Action similar to sulfonylureas but works at different receptor site.
Faster onset and shorter duration.
Assessments of Meglitinide class of drugs
Observe for S/S of hypoglycemia
Interventions for Meglitinides class of drugs
Give up to 30 min before meals
SKIP DOSE IF SKIPPING MEAL
AE of Meglitinides class of drugs
Do not take with Lopid
What drugs are in the class of Alpha-Glucosidase Inhibitors (starch blockers)?
Action of startch blockers
Works in intestines to slow digestion of carbs.
Delays and reduces glucose absorption.
Assessments of starch blockers class of drugs
Observe for S/S of hypoglycemia after meals
Interventions of starch blockers class of drugs
GIVE WITH FIRST BITE OF EACH MEAL
If hypoglycemia, treat with glucose (tabs or gel) or milk
AE of starch blockers class of drugs
Risk of hypoglycemia if taken with other diabetic medications
What drugs are in the class of Thiazolidinediones (TZD)?
Action of TZD
Improves insulin sensitivity
in muscle cells
Decreases insulin resistance
Enhances insulin action
Assessments of TZD class of drugs
Observe for S/S of hypoglycemia if taking insulin
Assess for edema
S/S of HF and elevated liver enzymes
Interventions of TZD class of drugs
Administer with or without food
BLACK BOX WARNING FOR AVANDIA
: INCREASE RISK FOR MI, CVA,
DO NOT USE WITH HF
AE of TZD class of drugs
May cause increase total cholesterol and LDL
HF, edema, wt. gain
Metabolized entirely by liver, so should not be used with liver dysfunction
What drugs are in the class of Incretin mimetic
Action of Incretin mimetic class of drugs
Mimics action of incretins (gut hormones) by
stimulating insulin secretion
and inhibiting glucagon after ingestion of carbohydrates
Promotes feeling of satiety
Assessments of Incretin mimetic class of drugs
Observe for S/S of hypoglycemia especially when taking TZDs
Intervention of Incretin mimetic class of drugs
Only used in T2 DM
SQ injection from pre-filled pen
into thigh or abdomen before breakfast/dinner
Used with biguanide and/or sulfonylurea
Profoundly slows gastric emptying & can affect absorption of oral meds
SE of Incretin mimetic class of drugs
(usally with first doses)
Minimal R/F hypoglycemia
& kidney problems have been associated with Byetta use
What drugs are in the class of Dipeptidyl Peptidase IV Inhibitor (DPP-4)
Action of DPP-4
DPP-4 (an enzyme that breaks down incretin hormones), is inhibited
increasing & prolonging action of incretin hormones
by slowing inactivation
Assessments of DPP-4 class of drugs
Monitor S/S of hypoglycemia especially if taken with sulfonylureas
Assess renal function tests before starting & regularly during therapy
Interventions of DPP-4 class of drugs
24 hr duration of action
Decrease dose if renal dysfunction
SE of DPP-4 class of drugs
Stuffy or runny nose
does not cause wt. gain
What drugs are in the class of Amylin Mimetic?
Action of Amylin Mimetic class of drugs
Mimics action of amylin (pancreatic hormone) that
controls after meal glucose
by slowing gastric emptying
Suppressing glucagon secretion
Triggering satiety (decrease caloric intake & wt. loss)
Assessments of Amylin Mimetic class of drugs
Assess for S/S of hypoglycemia within 3 hrs of injection when used with insulin
Intervention of Amylin Mimetic class of drugs
Dose depends on T1 or T2 DM
Used in conjunction with insulin therapy
STAT before meals (2 separate syringes must be used)
DO NOT MIX WITH INSULIN
AE of Amylin Mimetic class of drugs
when used with insulin
May need to reduce insuln dose
Nausea, vomitting, anorexia