Pharmacology for Nurses
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| Insulin- Functions | Regulated carbohydrate metabolism, helps metabolize fates and proteins, lower blood glucose by stimulating peripheral glucose uptake
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| Insulin- In the liver | Suppresses gluconeogenesis and glycogenolysis (glucose to glucose)
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| Insulin Therapy | Sliding Scale Insulin- Regular insulin, AC and HS, Q 4-6 hours with TPN
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| Classification of Insulin | Rapid acting, short acting, intermediate acting, long acting, mixture
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| Insulin | Insulin is a protein and cannot be given orally -there is no such thing as oral insulin
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| Rapid-Acting Insulin | Insulin lispro (Humalog)
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| Rapid-Acting Insulin | Insulin aspart (Novolog)
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| Rapid-Acting Insulin | Insuling glulisine (Apidra)
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| 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.
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| Short-acting Insulin | Humulin Regular -Humulin R
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| Short-acting Insulin | Novolin -R
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| Short-acting Insulin | Exubera
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| 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
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| Intermediate-Acting Insulin | NPH Insulin - Humulin N, Novolin N
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| Intermediate-Acting Insulin | Insuling detemir- Levemir
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| 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
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| Intermediate-acting Insulin | not for postprandial hyperglycemia (that is rapid acting and short acting insulin’s job).
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| Long-Acting Insulin | Insulin glargine (Lantus)
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| 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
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| Long-Acting Insulin | It is a clear solution, but cannot be mixed with other insulins and can NEVER be given IV.
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