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Chapter 45

Drugs for Diabetes Mellitus

QuestionAnswer
What are the causes of Diabetes Mellitus type 1? Caused by absolute lack of insulin secretion. Due to autoimmune destruction of pancreatic islet cells (islets of Langerhans)
What are the causes of Diabetes Mellitus type 2? Insulin resistance. Target cells become unresponsive to insulin (defective insulin receptor function); blood glucose levels rise
What is the treatment for Diabetes Mellitus type 2? Oral hypoglycemic drugs
What are the treatment goals for DM type 2? Preprandial blood sugar below 110 mg/dL. HbA1C of 6.5% of less
insulin aspart (NovoLog) action/onset/peak/duration/administration & timing/compatibility? Rapid/ 15min/1-3hr/3-5hr/Subcutaneous; 5–10 min before a meal/Can give with NPH; draw aspart up first and give immediately
insulin lispro (Humalog)action/onset/peak/duration/administration & timing/compatibility? Rapid/5–15 min/0.5–1 h/3–4 h/Subcutaneous; 5–10 min before a meal/Can give with NPH; draw lispro up first and give immediately
insulin glulisine (Apidra)action/onset/peak/duration/administration & timing/compatibility? Rapid/15–30 min/1 h/3–4 h/Subcutaneous; 15 min before a meal or within 20 min after starting meal/Can give with NPH; draw glulisine up first and give immediately
insulin regular (Humulin R, Novolin R) action/onset/peak/duration/administration & timing/compatibility? Short/30–60 min/2–4 h/5–7 h/Subcutaneous; 30–60 min before a meal; IV/ Can mix with NPH, sterile water, or normal saline; do not mix with glargine
insulin isophane (NPH, Humulin N, Novolin N, ReliOn N)action/onset/peak/duration/administration & timing/compatibility? Intermediate/1–2 h/ 4–12 h/18–24 h/ Subcutaneous; 30 min before first meal of the day, and 30 min before supper, if necessary/Can mix with aspart, lispro, or regular; do not mix with glargine
insulin detemir (Levemir)action/onset/peak/duration/administration & timing/compatibility? Long/Gradual: over 24 h/ 6–8 h/To 24 h/Subcutaneous; with evening meal or at bedtime/ Do not mix with any other insulin
insulin glargine (Lantus)action/onset/peak/duration/administration & timing/compatibility? Long/Gradual: begins at 1.1 h/No peak/To 24 h/ Subcutaneous; once daily, given at the same time each day/ Do not mix with any other insulin
Prototype drug: human regular insulin (Humulin R, Novolin R) mechanism of action: To promote entry of glucose into cells
Adverse effects of Prototype drug: human regular insulin (Humulin R, Novolin R): hypoglycemia
Only regular insulin can be given? Intravenously
Stimulate release of insulin from pancreatic islet cells
What drug is in the Biguanides class? Metformin (Glucophage)
Block enzymes in small intestine responsible for breaking down complex carbohydrates into monosaccharides Alpha-Glucosidase Inhibitors
Reduce blood glucose by decreasing insulin resistance and inhibiting hepatic gluconeogenesis Thiazolidinediones (Glitazones)
Act by stimulating release of insulin from pancreatic islet cells Meglitinides
Mimic effects of incretins—hormones released into blood by intestine in response to food to signal insulin secretion and stop glucagon production Incretin Enhancers
Created by: alyxinwndrland