pharm 4 diabetes dx

test that gives avg. blood glucose levels for 2-3 months

in the Islets of Langerhans

• does not provide tight control
• not based on caloric intake

pre-prandial dosage adjusted according to caloric intake

adaptable to caloric intake --> tight control

achieve tight control through use of infusion pump

provide basalar level based on caloric intake

• given in association with meals. Controls postpradnial blood glucose
• given subQ and via continuous SC pump
• can be given IV-rare

clear solutions (except NPH)

• analog of regular insulin
• onset 15-30 minutes
• duration 3-6 hours

short dur, rapid act

• onset 10-15 minutes
• taken at the start of eating
• duration 3-5 hours
• given subQ and continusously via subQ pumps

short dur, rapid act

• given in association with meals. control postprandial blood glucose
• -SubQ, IM, IV, via pump
• BEST IV form of insulin

• short dur, slower act
• unmodified HUMAN insululin
• SubQ injection and infusion, IM, Oral inhalation

• onset 30-60 mintues
• peaks 1-5 hours
• duration up to 10 hours

twice daily to control b/w meals and at night

• regular insulin plus Protamine
• only Cloudy solution
• given subQ twice daily, at the same time

intermediate duration

• slow onset, dose dependent duration
• for Basal glycemic control
• admin twice daily @ same time

• intermediate duration
• **never mixed and never IV

• precipitates in human pH and slowly dissolves
• -lasts 24 hours

• mostly given at night, but time may vary
• DO NOT mix or give IV
• SubQ only

clear solution

• Tx of type I and II diabetes
• once daily subQ 2 same time

Long duration

• used for peeps with stable condition
• eliminates need for additional injections
• used subQ only

• only NPH can be mixed with short acting
• -short act: regular, lispro, aspart, glulisine

• hypoglycemia
• hypokalemia
• lipohypertrophy
• allergic rxns

beta blockers can mask the S & Sx of hypoglycemia

oral insulin is only for type II diabetes and only after diet and exercise don't work

DOC for intial therapy

• act: lower bld glucose and improve glucose tolerance.
• -inhib glucose production in liver
• -reduce glucose absorp in gut
• -sensitiize insulin recepts in target tissues

work= NOT metabolized, excreted unchanged by kidneys

uses= glycemic control, prevent diabetes, gestational diabetes,

• se= dec. appetite, nausea, diarrhea
•   -dec absorp of vit b12 and folic acid

toxic= lactic acid

interact= alcohol  inhibits lactic acid breakdown

drug that is classified as a biguanine

introduced as oral antidiabetis meds, but hypoglycemia was major side effect

• act= stimulate the release of insulin from pancreas
• **doesn't work in type I b/c no insulin is produced

use= Tx type II diabetes

se= hypoglycemia, cardiovascular toxicity, pregnancy and lactation

• also called TZD's
• Decrease insulin resistence
• added on to metformin
• used in Type II

ONLY TZD left on the market

• reduce insulin resistence and increase production
• usually combined with Metformin, Sulfonylurea, and/or supplament to insulin

• upper resp tract infections
• headache
• sinusitus
• myalgia
• HF
• hypoglycemia

inducers= higher dose of actos needed

inhibitors= lower dose of actos needed

• stimulate pancreatic insulin release
• used in mono and combined therapy

a meglitinide

rapid absorption and excretion

can cause hypoglycemia

alpha-glucose inhibitor

• acts in the intestine to delay absorption of carbs
• effects do not depend on insulin

se= gas, cramps, abd distention, anemia, liver problems

• classified: Gliptins
• 3rd line drug

• enhances actions of incretin hormones
• mono or combined therapy
• rapid and complete absorption
• excreted in urine

only used as last ditch effort

• upper resp trat infect
• headache
• inflamm of nasal and throat
• pancreatitis
• hypersense rxn

new injectable drug for type I and II

new injectable drugs for type II only

• Ex= 1st incretin mimetic
• =improve glucose control
• =nausea is common
• =risk of pancreatitis and kidney trouble