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Diabetes
| Question | Answer |
|---|---|
| What drug is used for Type 1 diabetes? | Insulin |
| How is Type 2 diabetes controlled? | Diet, exercise, oral drugs, insulin |
| How is gestational diabetes controlled? | insulin, metformin |
| Humalog | rapid-acting |
| Novolog | rapid-acting |
| Apidra | rapid-acting |
| Warm & dry | sugar is high |
| Cold & clammy | need some candy |
| Controls food bolus | rapid-acting insulin |
| Rapid-acting onset | 10-15 min |
| Rapid-acting peak | 30-50 min |
| Rapid-acting duration | 5 hrs or less |
| Regular insulin | short-acting |
| Humulin R | short-acting |
| Novolin R | short-acting |
| Short-acting onset | 30-60 min |
| Short-acting peak | 2-4 hrs |
| Short-acting duration | 5-7 hrs |
| When should short-acting insulin (regular) be administered? | 30 min before meals |
| NPH | Intermediate-acting insulin |
| Humulin N | Intermediate |
| Novolin N | Intermediate |
| Intermediate onset | 1-4 hrs |
| Intermediate peak | 8-12 hrs |
| Intermediate duration | 18-24 hrs |
| Detemir | Intermediae; 1-2 x day dosing CANNOT be mixed |
| Detemir onset | 6-8 hrs |
| Detemir peak | 12-24 hrs |
| When is long-acting insulin given? | Bedtime |
| Lantus | Long-acting CANNOT be mixed or used IV |
| Long-acting onset | 1-1 1/2 hrs |
| Long-acting peak | none |
| Long-acting duration | 24 hrs |
| Combination insulin | NPH-regular 70/30 |
| When is a sliding scale used? | When pt is hospitalized |
| Biguanides MOA | decrease hepatic formation of glucose & reduce insulin resistance |
| Biguanides prototype | Metformin |
| Metformin SE | GI, wt loss, lactic acidosis |
| Do not give this with contrast dye | Metformin |
| Sulfonylureas MOA | Stimulate release of insulin & increase sensitivity of insulin receptors |
| Sulfonylureas prototype | Glucotrol (glipizide) |
| Sulfonylureas SE | HYPOGLYCEMIA, wt gain, disulfiram effect |
| Glinides MOA | stimulate release of insulin |
| Glinides SE | HYPOGLYCEMIA, wt gain |
| Glinides prototype | repaglinide (Prandin) |
| When should glinides be administered? | W/meal or 30 min before |
| Thiazolidinediones ("-glitazones") MOA | Decrease insulin resistance |
| -glitazones SE | fluid retention, HA, wt gain, increased plasma lipids MONITOR LIVER FUNCTION |
| -glitazones prototype | rosiglitazone (Avandia) |
| Which oral DM drug should not be given to heart pts? | -glitazones |
| Alpha-glucoside inhibitors MOA | Blocks enzyme in small intestine for breaking down starches |
| Alpha-glucoside SE | GI; long-term, liver dysfunction |
| Alphe-glucoside prototype | acarbose (Precose) |
| When should acarbose be administered? | With 1st bite of food |
| Amylin mimetics MOA | synthetic amylin; delays gastric emptying; suppresses glucagon secretion; decreases postprandial glucose elevations |
| Whem should Symlin be administered? | Before meals, SQ |
| Amylin mimetics prototype | pramlintide (Symlin) |
| Symlin SE | hypoglycemia when used w/insulin; NV |
| Incretin mimetics MOA | Signals pancreas to increase insulin secretion; liver to stop producing glucagon |
| Incretin mimetics prototype | exenatide (Byetta) |
| When should Byetta be administered | SQ 30-60 min before, NOT WITH, meal |
| Byetta SE | NV,diarrheat, risk for pancreatitis, hypoglycemia if combined with sulfonylureas |
| Incretin Glucose Control prototype | sitagloptin (Januvia) |
| Incretin Glucose Control MOA | decrease breakdown of incretins; increase incretin levels |
| Januvia SE | Cold symptoms |
| How is Januvia administered? | one pill once a day. May be combined with sulfonylureas. |
Created by:
bunnybee63