Insulin and Oral hypoglycemics

  1. What is basal continuous insulin
    last for 24 hours Glargine
  2. What are the rapid acting insulins and their characteristics
    • Glulisine, humalog, Lispro, aspart (exubera)Rapid acting
    • onset <15 mins
    • peak 1-2 hours
    • duration 3-4 hours
    • Covers meal intake
    • used for elevated BG
    • may be used with longer acting insulin (mix)
  3. What are the short acting insulins and their characteristics
    • (Humulin R, Novolin R)
    • Clear
    • short acting
    • onset 30-60 mins
    • peak 2-3 hours
    • duration 4-6 hours
    • Covers meals eaten within 30-60 mins
    • Must eat within the hour
  4. What are the intermediate/long acting insulins and their characteristics
    • NPH, Lantus and levemir
    • Cloudy
    • onset 2 hours
    • peak (peakless)
    • Duration: Lantus (24 hours(
    • Levemir (17-24 hours)
    • used for basal insulin needs (coverage overnight)
    • not intended to cover meals
  5. Special details of Levemir
    • DO NOT MIX
    • do not use with a pump
    • peak: 6-8 hours
  6. NPH and Regular as a mixture (details)
    • 70/30 or 50/50
    • onset 30 mins
    • peak 50/50 (3 hours)
    • humulin 70/30 (4-8 hours)
    • novulin 70/30 (4-8 hours)
    • Duration 22-24 hours
    • Usually BID before meals
  7. Details about how to take insulin
    • Cannot be taken orally
    • SQ injection for self administration
    • IV administration only with Regular insulin
  8. How long will insulin last at room temp, how should it be stored for long term
    about a month (can be stored in fridge, never in freezer) injecting cold insulin can be painful
  9. what is lipodystrophy
    lump/dent in skin (sub Q tissue) body begins to reject med, won't absorb it, considers it a trauma site
  10. What is somogyi effect
    hypoglycemia undetected low usually about 70 and rebounds to hyperglycemia above 200. Usually happens at night. Body BGM too low and body responds by rapidly going to other extreme
  11. Oral hypoglycemic that treat mild nonketotic type 2 DM without obesity. Stimulates pancreatic cells to secrete more insulin
    • Glimepiride (amaryl)
    • Glipizide (Glucotrol, (XL))
    • Glyburide (Diabeta, Micronase)
    • Tolazamide (Tolinase)
    • Tolbitamide (Orinase)
  12. lowers BG by stimulating release of insulin from pancreatic islet cells
    stimulates rapid and short secretion of insulin from beta cells to increase glucose following meals and reduce over all BG levels
    side effects: low blood sugar, weight gain, nausea, vomiting, diarhhea, joint pain, and flu like symptoms
    use after meals
    • Repaglinide (Prandin)
    • Nateglinide (starlix)
  13. Metformin (glucophage)
    • type 2 DM
    • reduces fasting and post prandial hyperglycemia
    • decreases over production of glucose by liver
    • makes insulin more effective in tissues
    • major side effect renal failure
    • discontinue before and 48 hours after contrast media is used
    • doctor will discontinue use in renal failure
    • used for obese patients
  14. acarboe (precose)
    miglitol (glyset)
    • slows carbs digestion in the small intestine to delay glucose absorption
    • postprandial and glycosylated hgb are more controlled
    • side effects: flatulence, diarhhea and abdominal discomfort
  15. Sitagliptin (januvia)
    Saxagliptin (Onglyza)
    • Degrades incretin hormones to promote insulin secretion
    • stable glucose levels by decreasing liver release of glucose and increasing insulin secretion
    • side effects: headache, nasopharyngitis and UTI
    • (possible rash and hives)
  16. Pramlintide (Symlin)
    • Synthetic
    • Limits glucose levels by delaying gastric emptying and supressing glucagon secretions after meals
    • Used with insulin for type 1&2
    • increased risk of severe hypoglycemia
  17. Nursing responsibilities for Oral Hypoglycemics
    • Assess for therapeutic response and side effects
    • Give with fod
    • Monitor for hypoglycemia
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Insulin and Oral hypoglycemics