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Ph T1DM

Pharm Endrocrine

QuestionAnswer
Rapid acting insulin: inject when: within 15 min of meal; as rescue: w/o regard to meals
Glulisine (Apidra): in insulin pumps Available for use in insulin pumps up to 48 hours
Glulisine (Apidra): Dosing: 15 min prior to meal OR within 20 min after starting a meal
Glulisine (Apidra): possibly better in what pts? Better in obese patients?
Short acting insulin: inject when: within 30 min of meal; as rescue: w/o regard to meals
NPH: typically inject how often: x2 / day (depending on meal schedule)
Detemir is bound to ? and is good out of the fridge for: bound to albumin; good for 42 days out of refrigerator
Glargine: characteristics peakless insulin; acidic pH; provides 24 hr coverage in most pts
Change in basal insulin: BID NPH to long-acting: Reduce TDD by 20%; administer total dose QD
Change in basal insulin: Levemir : Lantus : Levemir: unit-to-unit
NovoLog & Humalog = NovoLog 70/30 (30 Aspart & 70 Protamine); Humalog 75/25 (25 Lispro & 75 Protamine); Humalog 50/50 (good for pt eating 2 big CHO meals/ day)
Novolin / Humulin = Regular insulin (30) & NPH (70)
Insulin 50/50 rule Basal: 50% of TDD; Bolus: 50% of TDD (divided into mealtime doses)
50/50 rule with NPH as basal: Decrease amt used as bolus by 20%
Standard insulin split mix 2/3 of TDD in AM (1/3 short acting; 2/3 intermed); 1/3 of TDD in PM (1/2 short acting, 1/2 intermed)
Adjustment algorithm: Regular T1DM pt: 1 unit of bolus changes by: 50mg/dL
Adjustment algorithm: Insulin resistant pt: 1 unit of bolus changes by: 25-30 mg/dL
Adjustment algorithm: Insulin sensitive pt: 1 unit of bolus changes by: as much as 70- 100mg/dL
Adjustment algorithm: rule of 1800: based on: blood sugar level
Rule of 1800 formula 1800 / TDD = x (mg/dL changed by 1 unit insulin) = correction factor
Rule of 1800 at POC (FSBS) – (goal) / correction factor
Rule of 500: based on: CHO intake
Rule of 500: formula 500 / TDD = x gm CHO covered by 1 unit insulin
Rule of 500: if pt has frequent decreases in blood glucose: decrease by 0.5 units
Somogyi hypoglycemia triggers counter-reg hormones; causes hyperglycemia; manage insulin to prevent hypoglycemia
Dawn phenomenon d/t waning insulin levels; causes hyperglycemia; manage with insulin, or move peak to more physiologic time
Amylin = beta cell hormone co-secreted w/ insulin; suppresses glucagon secretion from panc; regulate gastric emptying; enhances satiety
Limitations of amylin Sticky; adheres to surfaces; forms aggregates & insoluble particles; Half-life is minutes, must be given IV
Pramlintide: mcg to units conversion 1 unit = 6 mcg
Pramlintide available in: 5 mL vial; 60 mcg T1DM pens (15-30-45-60); 120 mcg T2DM pens (60-120)
Pramlintide T1DM dosing 15mcg (2.5 units) before meals; decrease meal-time insulin by 50%; Increase pramlintide dose by 15mcg (2.5 units) q 3-7 days as tolerated to 60 mcg (10 units)
Pramlintide: AE Nausea & anorexia (T1 > T2); Black Box: severe insulin-induced hypoglycemia, usu within 3 hrs of dosing
Pramlintide education Take immed prior to meal of 30 gm or more of CHO; injection technique & admin site (abdomen or thigh); do not mix with insulin
Pramlintide storage Unopened vial/pen: refrigerated; Opened vial: refrig or rm temp; Opened pen: rm temp
Pramlintide: DI Oral agent needing rapid onset (analgesics); meds needing threshold conc for efficacy (Abx, contraceptives); Administer oral med at least 1 hr prior
Pramlintide CI Severe GI disease (diagnosed gastroparesis)
T1DM tx algorithm insulin (& diet & exercise); then adjunct oral tx (biguanide / TZD); then Inj Adjunct (amylin)
Created by: Abarnard
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