SC Antidiabetic Agents
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| Aspart (Novolog) | Rapid-acting, human; DM 1 & 2; Give 15 min q meals; All insulins: Never give to a hypoglycemic pt; allergy
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| Lispro (Humalog) - clear | Onset: 5-15 min; Use--DM 1 & 2;CI-- All insulins: Never give to a hypoglycemic pt; allergy
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| Human Regular (Humulin R, Velosulin BR) - clear | Short-acting, human; uses- DM 1 DM 1 & 2& 2Can be given IV for coma or DKA with Type 1;
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| Isophane Insulin Suspension (NPH, Humulin N, Novolin N) - cloudy | Intermediate-acting, human;DM 1 & 2
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| Insulin Zinc Suspension (Lente) (Humulin L, Novolin L) | Onset: 1-2 hours
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| Glargine (Lantus) insulin zinc suspension, extended (Ultralente, Humulin-U) - clear | Long-acting, human Onset: 1-2 hours; DM 1 & 2; Glargine can be given once-daily at bedtime and MUST be given alone
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| NPH 70% and regular insulin 30% (Humulin 70/30, Novolin 70/30): intermediate and short –acting combo | Combo Insulin Products
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| NPH 50% and Regular Insulin 50% (Humulin 50/50): intermediate and short –acting combo | Combo Insulin Products
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| Insulin Lispro Protamine Suspension 75% and Insulin Lispro 25% (Humalog mix 75/25): intermediate and rapid acting combo | Combo Insulin Products
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| Antidiabetic Side Effects CV | Tachycardia, palpitations
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| Antidiabetic Side Effectsn CNS | Headache, lethargy, tremors, weakness, fatigue, delirium, sweating
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| Antidiabetic Side Effects metobolic | Hypoglycemia – can result in shock and death
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| Antidiabetic Side Effects - other | Blurred vision, dry mouth, hunger, nausea, flushing, rash, urticaria, anaphylaxis
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| MOA for Antidiabetics | replaces the insulin that is either not made at all or is made defectively in the body of a diabetic person. Exogenously administered restores the diabetic patients ability to metabolize carbohydrates, fats, and proteins; to store glucose in the liver, a
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| Nursing Process and Teaching Tips for Insulins | Regular insulin, lispro (Humalog), and glargine (Lantus) are clear and colorless. The rest should be white opaque.
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| Interactions with antidiebetic dx | Corticosteroids antagonize hypoglycemic effect = elevates blood sugar; Alcohol can increase insulin’s hypoglycemic effect = lowers blood sugar
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| Nursing Process and Teaching Tips for Insulins | Teach signs of hypoglycemia: weakness, nervousness, cold and clammy skin, sweating, paleness of the skin, and shallow, rapid breathing. Notify MD if these occur.
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| Nursing Process and Teaching Tips for Insulins | Avoid alcohol – it will make glucose drop and they will be very ill.
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| Nursing Process and Teaching Tips for Insulins | Do not shake insulin, roll between hands instead.
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| Nursing Process and Teaching Tips for Insulins | Only use an insulin needle – they are calibrated in units.
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| Nursing Process and Teaching Tips for Insulins | MAOIs, alcohol, sulfa drugs, and ACE inhibitors may increase effects of insulin.
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| Nursing Process and Teaching Tips for Insulins | Beta-blockers, corticosteroids, isoniazid, niacin, thiazide diuretcs, and sympathomimetics can antagonize insulin causing hyperglycemia.
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| Nursing Process and Teaching Tips for Insulins | When mixing insulins, always withdraw the regular or rapid-acting first, then the intermediate so there is no contamination of the rapid-acting.
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