Antidiabetic Drugs

Front 1

Insulin used for?

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Back 1

Treatment of Type 1 diabetes, gestational diabetes and for patients on TPN (total parenteral nutrition)

Front 2

Reason for TPN to get insulin

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Back 2

Sugar goes into blood and not liver to be metablolizm, not stimulated

Front 3

Insulin goal

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Back 3

A steady state of the blood glucose is the goal of therapy in order to minimize long term complications of hyperglycemia and to prevent hypoglycemic events.

3

Front 4

What glucose levels should be

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Back 4

HgbA1c<7% Indication of glucose control every 4 months.
Glucose levels 80-140 mg/dl
Bedtime Glucose levels >/or= to, 140mg/dl

Front 5

Rapid acting insulins

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Back 5

lispro works 30 min or less given with meals.
o=minutes
p=30-60min
d=3-4hrs.

Front 6

Other rapid acting

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Back 6

Aspart
Glulisrine
onset 15min good till 5 hrs.

Front 7

Short Acting regular insulin subcue

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Back 7

o=30-60min
p=2-4hrs
d=5-7hrs
Humilin R- only one available
Numbulin R- becauase of reaction.
Given for sliding scale. If bs level to high.

Front 8

Regular insulin IV

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Back 8

IV insulin always regular
o=10-30min
p=15-30min
d=30-60min

Front 9

Intermediate acting Insulins
isophane suspension, NPH insulin sc:

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Back 9

o=1-4hrs
p=6-12hrs
d=18-28hrs

Front 10

Intermediate acting insulin
zinc suspension, lente insulin

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Back 10

0=1-3hrs
p=8-12hrs
d=18-28hrs

Front 11

Long acting insulins
extend zinc suspension, ultralente insulin

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Back 11

o=4-6hrs
p=18-24hrs
d=36hrs

Front 12

Insulin mixtures

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Back 12

NPH insulin plus regular insulin
70/30 & 50/50
o=30min
p=4-8hrs
d=up to 24hrs

Front 13

Nursing Implications related to insulin administration
Patient Education

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Back 13

regarding
disease medical alert band
signs and symptoms and treatment of hypoglycemia
exercise
insulin administration
blood glucose monitoring
sick day management
patients activities

Front 14

Signs and symptoms of treatment of hypoglycemia

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Back 14

a patient shuold carry a quick acting form sugar at all times
Family members should be instructed in the administration of glucagon

Front 15

Excercise related to Insulin

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Back 15

Helps glucose get into the cells and can decrease daily requirements of insulin, lowers blood glucose levels
avoid exercising when at peak times of insulin absorption
do not exercise if glucose level is over 300 mg/dl, will increase rather then decrease

Front 16

Insulin administration

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Back 16

abdomen>arms>thighs>buttocks
Clear before cloudy, within 20 minutes after drawing up.

Front 17

Storage and Stability for insulin

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Back 17

Room temperature for 18-24 months, will lose potency if stored at temperatures over 100 degrees F; used vitals at room temperature, refrigerate unused vials, do not freeze, do not store in direct sunlight.

Front 18

Sick day management for insulin

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Back 18

More frequent monitoring of blood glucose levels, test urine for ketones, 200 and or your ketone levels are elevated on 2 or more consecutive testings.

Front 19

Sliding scale insulin

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Back 19

with regular insuline coverage, doctor order how many units

Front 20

10% rule

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Back 20

with regular insulin coverage, baseline 200-300.

Front 21

Activity level with insuline

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Back 21

consider the patients activities for the day before dosing with insulin, status patient is nauseated or has been vomiting.
Human type is the most widely used today.
Use only syringes calibrated for U-100 insulin,
Lispro rapid acting

Front 22

Adverse Effects of insulin

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Back 22

Hypoglycemia, (lipodystrophy, lipoatrophy)-sute if ubhectuib wgerem cab gave fat deposits, weight gain.

Front 23

Drug interactions related to insulin administration

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Back 23

Beta blockers may mask the signs and symptoms of hypoglycemia
Thiazide diuretics, glucocorticoids, calcium channel blockers, thyroid drugs, estrogen and nicotine may increase insulin requirements (ie. increase blood glucose levels)
Testosterone, ETOH, coumadin, oral hypoglycemic agents may decrease insulin requirements (ie. decrease blood glucose) levels)

Front 24

Sulfonylureas

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Back 24

May have allergies.
Stimulates the release of insulin from the pancreas.
Increases insulin receptor binding (helps imrove insulin resistance)

Front 25

First generation sulfonylureas

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Back 25

3 times a day more of a chance of reaction.

Front 26

Diabinese

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Back 26

o=60min
p=3-6hrs
d=24-72hrs

Front 27

Tolinase

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Back 27

o=60min
p=1-6hrs
d=12-24hrs

Front 28

Orinase

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Back 28

o=60min
p=4-6hrs
d=6-12hrs

Front 29

Second Generation Sulfonylureas

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Back 29

Give once a day

Front 30

Amaryl

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Back 30

o=??
p=2-3hrs
d=24hrs

Front 31

Glucotrol

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Back 31

o=15-30min
p=1-2hrs
d=24hrs

Front 32

Miconase, DiaBeta

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Back 32

o=45-60min
p=1.5-3hrs
d=24hrs
Glynase- 100% bioavilability

Front 33

Nursing Implications related to Sulfonylureas

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Back 33

Patients may need insulin
If sick the patient should not take thier Sulfonylurea
Patient should carry a quick acting sugar with them at all times for potential hypglycemic reactions
Patients should be taught to avoid ETOH
Patients should not be taught to use sunscreen and protective clothing when outside
Should not take oral hypoglycemic

Front 34

Adverse Effects related to Sulfonylureas

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Back 34

Hypoglycemia
Photosensitivity
GI upset
Headache
Rash
Weight Gain

Front 35

Drug Interactions related to Sulfonylureas

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Back 35

Similar to insulin, when sulfonylureas are combined with ETOH they can cause a disulfiram like reaction (anabuse-like reaction)

Front 36

Biguanides

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Back 36

Lactic acidosis- rare but fatal
decrease insulin resistance
Helps decrease insuline resistance
Decrease glucose absorption in the intestine
Decrease hepatic glucose production
Metaformin

Front 37

Alpha-glucosidase Inhibitors

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Back 37

Acarbose (precose)
Miglitol (glyset)

Front 38

Thiazolidinediones

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Back 38

Troglitazone (Rezulin)-took off market, liver toxicity.
Rosiglitazone (Avandia)

Front 39

Repaglinide (prandin)

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Back 39

Can give to Allergic to sulfa