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Ch. 57 Diabetic Ther

Pharmacology for Nurses

Insulin- Functions Regulated carbohydrate metabolism, helps metabolize fates and proteins, lower blood glucose by stimulating peripheral glucose uptake
Insulin- In the liver Suppresses gluconeogenesis and glycogenolysis (glucose to glucose)
Insulin Therapy Sliding Scale Insulin- Regular insulin, AC and HS, Q 4-6 hours with TPN
Classification of Insulin Rapid acting, short acting, intermediate acting, long acting, mixture
Insulin Insulin is a protein and cannot be given orally -there is no such thing as oral insulin
Rapid-Acting Insulin Insulin lispro (Humalog)
Rapid-Acting Insulin Insulin aspart (Novolog)
Rapid-Acting Insulin Insuling glulisine (Apidra)
Rapid-Acting Insulin Onset 5-15 minutes; just before meals; can be given SQ or as a SQ infusion; cannot be given IV; clear solution; When used SQ, they are given in addition to an intermediate or longer acting insulin to achieve tight glucose control.
Short-acting Insulin Humulin Regular -Humulin R
Short-acting Insulin Novolin -R
Short-acting Insulin Exubera
Short-acting Insulin Injected or inhaled 30-60 minutes before meals; SQ, IM, IV, inhaled; control postprandial hyperglycemia; SQ to provide basal control; IV to treat DKA
Intermediate-Acting Insulin NPH Insulin - Humulin N, Novolin N
Intermediate-Acting Insulin Insuling detemir- Levemir
Intermediate-Acting Insulin Duration 6-14 hours; NPH insulin is the only insulin on the market that is still cloudy – it is cloudy because of the addition of protamine (a protein that slows absorption). It is used to provide glycemic control between meals and at night
Intermediate-acting Insulin not for postprandial hyperglycemia (that is rapid acting and short acting insulin’s job).
Long-Acting Insulin Insulin glargine (Lantus)
Long-Acting Insulin onset 1 hour; no peak=basal, so less risk of hypoglycemia; maintains s steady state for 24 hours; given once a day usually at bedtime
Long-Acting Insulin It is a clear solution, but cannot be mixed with other insulins and can NEVER be given IV.
Created by: emv2435