Diabetes Meds

  1. How does insulin affect fat metabolism?
    it stimulates triglyceride synthesis and inhibits fat breakdown
  2. How does insulin affect protein metabolism?
    it increases protein synthesis and inhibits protein breakdown
  3. How do you prepare/give NPH and Regular insulin together?
    • air into NPH (cloudy) equal to dosage
    • air into Regular (clear) equal to dosage and withdraw dose
    • withdraw NPH dose to equal total amount of units

    Clear to Cloudy...short acting first and affect will happen rapidly to make sure they are ok
  4. Absorption sites......which are fastest?
    fastest-abdomen, then arm then thigh
  5. Which insulin has no pronounced peak and has a low chance of causing hypoglycemia?
    Lantus (Long Acting)
  6. Which insulin has a high chance for hypoglycemia in the afternoon between lunch and dinner?

    How do I prevent it?

    give them snacks
  7. 2 rapid acting insulins
    • lispro-Humalog 
    • aspart-Novolog
  8. 2 Short Acting Regular Insulins
    • humulin R
    • Novolin R
  9. Intermediate acting Insulin
  10. Long Acting Insulin
  11. lispro-Humalog and aspart-Novolog

    • Onset 15 min
    • Peak 1-1.5 hrs
    • Duration 3-4 hrs
  12. Humulin R and Novolin R

    • Onset 30-60 min
    • Peak 2-3 hrs
    • Duration 3-6 hrs
  13. NPH

    • Onset 2-4 hrs
    • Peak 4-10 hrs
    • Duration 10-16 hrs
  14. Lantus

    • Onset 1-2 hrs
    • Peak NONE
    • Duration 24+ hrs
  15. Advantages of oral agents
    • convenience
    • cheaper
    • less chance of hypoglycemia
    • more flexibility with diet
  16. Disadvantages of oral meds
    • GI distress
    • drug-drug interactions
    • Potential sulfa allergies
    • Multiple side effects
  17. How do orinase, diabines, Glucotrol, micronase Prandin and Starlix work?
    all cause the pancreas to release insulin
  18. Adverse effects of orinase, diabines, Glucotrol,  micronase, Prandin and Starlix
  19. How do you prevent hypoglycemia?
    carry snacks and know the s/s
  20. How does Metformin work?
    suppresses glucogenesis by reducing the production of glucose within the liver
  21. Adverse effects of Metformin
    • N/V
    • Anorexia
    • B12 and folic acid deficiency
    • Lactic acidosis from hyperventilation
    • somnolence
  22. Patient for  teaching for Metformin
    • discontinue the medication if you
    • hyperventilate
    • myalgia (muscle pain)
    • sluggish
    • somnolence
  23. What is somnolence a sign of?
    Lactic Acidosis
  24. How does Pioglitazone and Rosiglitazone work?
    decreases insulin resistance/increase cellular response to insulin
  25. Adverse effects of Pioglitazone and Rosiglitazone
    • Fluid Retention
    • Elevation of LDL's
    • Hepatoxicity
  26. Patient teaching for Pioglitazone and Rosiglitazone
    monitor cholesterol and report symptoms of hepatotoxicity
  27. How does Precose and Glyset work?
    slows carb absorption and digestion
  28. Adverse effects of Precose and Glyset
    • Abdominal distention and cramping
    • hyperactive bowel sounds
    • diarrhea/excessive gas
    • anemia
    • hepatotoxicity
  29. Patient teaching for Precose and Glyset
    Have hemoglobin and iron levels monitored
  30. How does Januvia work?
    Increases hormones which release insulin and decrease secretion of glucagon
  31. Adverse effects for Januvia
    None....well tolerated
Card Set
Diabetes Meds
Diabetes meds