Insulin and Oral Drugs used in the Tx of DM 1 & II
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| Onset: 10-15 min Peak: 30-60 min Dur: 5 hrs or less | Rapid Acting Insulin
(Humalog)(Aspart)(Apidra)
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| Onset: 30-60 min Peak: 2-4 hrs Dur: 5-7 hrs | Short Acting Insulin
regular (Humulin R, Novolin R)
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| Onset: 1-4 hrs Peak: 8-12 hrs Dur: 18-24 | NPH (Humulin N, Novolin N)
Intermediate Acting
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| Onset: 6-8 hrs Peak: 12-24 hrs Dur: ??? | Detemir (Levemir)
Intermediate Acting
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| Onset: 1-1.5 hrs Peak: NONE Dur: 24 hrs | Lantus
Long Acting
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| "Give the Shot while the tray is hot." | Rapid Acting
(Humalog, Novolog, Apidra)
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| Used in Insulin Drips | Regular
(Humulin R, Novolin R)
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| Associated with U-500 | Regular
(Humulin R, Novolin R)
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| Give 30 min before meal once or twice a day | NPH
(Humulin N, Novolin N)
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| This is usually mixed with regular insulin | NPH
(Humulin N, Novolin N)
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| "Cloudy" | NPH
(Humulin N, Novolin N)
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| This cannot be mixed | Detemir
(Levemir)
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| This drug does not have a peak | Lantus
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| This drug is usually given at bedtime | Lantus
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| Least risk of Hypoglycemia (Insulin) | Lantus
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| No mixing No IVs | Lantus
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| Hypoglycemia is of greatest risk at these times... | Peak drug times
During exercise
Too much Insulin
Skipped meals
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| Build up off fat cause by lack of rotating injection sites | Lipodystrophy
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| This drug decreases hepatoglycogenesis AND decreases Insulin resistance | metformin (Glucophage)
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| An added benefit on this drug is weight loss | metformin (Glucophage)
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| Only oral antidiabetic that can be used in pregnancy | metformin (Glucophage)
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| Drug of choice for type II diabetics | metformin (Glucophage)
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| IV contrast dye in contraindicated with this drug | metformin (Glucophage)
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| This should be D/C during hospital stay or 48 hrs before and after dx procedures | metformin (Glucophage)
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| IV Contrast Dye + Metformin = | Lactic Acidosis
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| An adverse effect of IV contrast dye related to renal impairment | Lactic Acidosis
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| This drug produces an antabuse effect when mixed with alcohol | glipizide (Glucotrol)
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| Due to the effects on the pancreas, hypoglycemia is a concern for which drugs? | Glucotrol (Sulfa) and Prandin (glinide)
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| Weight gain is an adverse effect in these three oral antidiabetics | Glucotrol (Sulfa), Prandin (glinide), and Avandia (glitazone)
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| This drug is similar to insulin in that it's action is short and fast (meal coverage) | Prandin
Glinide
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| This oral antidiabetic should be administered with meals OR Prandially | Prandin
Glinide
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| These drugs stimulate release of insulin by acting on the pancreas | Glucotrol and Prandin
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| This drug decreases insulin resistance | Avandia
"glitazone"
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| Fluid retention and Edema are adverse rxns to which drug? | Avandia
"glitazone"
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| Increase plasma lipid levels are cause by which drug? | Avandia
"glitazone"
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| Liver problems are associated with which two oral antidiabetic drugs? | Avandia (glitazone) and Precose (Alpha)
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| This drug is contraindicated in pts with cardiovascular disease | Avandia (glitazone)
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| This drug works in the GI tract by blocking absorption of carbs. Thereby preventing serum glucose spikes | Precose (Alpha)
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| GI effects such as Ab cramping, diarrhea, flatulence, and borborygmus are caused by which drug? | Precose (Alpha)
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| This drug should be taken with the first bite of a meal | Precose (Alpha)
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| Liver toxicity is HUGE with this oral antidiabetic | Precose (Alpha)
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| Amylin synthetic | Symlin
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| This drug delays gastric emptying which suppresses glucagon secretion | Symlin
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| This drug is given SubQ to Type I & II diabetics | Symlin
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| This SubQ antidiabetic should be given with meals | Symlin
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| This drug should be monitored extra carefully for hypoglycemic rxns when taken with insulin | Symlin
**Especially important with Type I**
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| Other meds should be taken an hour before these two drugs | Symlin and Byetta
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| Injection site rxns and Nausea are common side effects with these two SubQ antidiabetics | Symlin and Byetta
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| Hormones secreted by intestine after a meal. | Incretins
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| Signal pancreas to increase insulin secretion | Incretins
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| Mimic Incretin hormones | Byetta
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| This drug has a high risk of pancreatitis | Byetta
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| This drug can cause hypoglycemia when mixed with Sulfonylureas (glucotrol) | Byetta
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| This drug is often confused with insulin | Byetta
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| This subQ antidiabetic drug should be administered 30-60 minutes preprandial. | Byetta
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| This drug reduces the breakdown of incretins thereby increasing incretin levels | Januvia
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| Adverse rxns of this drug resemble theh common cold | Januvia
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| This incretin mimetic may be combined with Sulfonylureas (Glucotrol) | Januvia
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| This incretin drug requires only once a day dosing | Januvia
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