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15 Cards in this Set
- Front
- Back
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Rapid-Acting Insulin (Bolus) |
Lispro, asparte, glulisine Injected 0-15 min before meal Onset: 15 min Peak: 1-1.5 hours Duration: 3-4 hours |
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Short-Acting Insulin (Bolus) |
Regular insulin Only insulin that can be given IV (all others are SubQ injections) Injected 30-45 min before meal Onset: 30-60 min Peak: 2-3 hours Duration: 3-6 hours |
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Intermediate-Acting Insulin |
NPH Insulin Drug is injected twice daily to provide glycemic control between meals and during the night Suitable for mixing with short-acting insulin (regular) Cloudy suspensions that must be agitated first Onset: 2-4 hours Peak: 4-10 hours Duration: 10-16 hours |
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Long-Acting Insulin (Basal) |
Glargine/Lantus, Detemir Injected once daily at bedtime or morning No peak action Cannot be mixed with other insulin Onset: 2-4 hours Duration: 24 hours |
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Oral Diabetic Agents |
Biguanides Sulfonylureas Thiazolidinediones (glitazones) Meglitinides (glinides) Alpha-glucosidase Inhibitors DPP-4 Inhibitors (gliptins) SGLT2 Inhibitors (gliflozins) Incretin Mimetics Amylin Analogs |
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Biguanides |
Metformin (Glucophage) First-line choice Reduce gluconeogenesis, enhance insulin sensitivity, slightly reduce glucose absorption in gut Precautions: renal failure (drug can cause lactic acidosis); don’t take with alcohol CIs: hold before radiology procedure where dye is injected (dye is toxic to kidneys) Side effects: GI issues |
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Sulfonylureas |
Glipizide (Glucotrol), Glyburide, Glimepiride (Amaryl) Promote insulin production from pancreas Major SEs: Hypoglycemia, weight gain Precautions: take with meals, many drug interactions |
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Meglitinides |
Suffix—“glinide” Promote insulin secretion by the pancreas Used as a bolus with meals Adverse effect: hypoglycemia Precautions: take with meals
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Thiazolidinediones |
Suffix—“glitazone” Improve insulin sensitivity, transport, and utilization at tissues; reduce gluconeogenesis Precautions: increased risk for HF and macular edema SEs: weight gain, peripheral edema |
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Alpha-Glucosidase Inhibitors |
Acarbose (Precarbose) and Miglitol Delay absorption of carbohydrates in intestine Adverse effects: flatulence, cramps, abdominal distention, borborygmus, diarrhea, liver dysfunction Patient teaching: take with meals |
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DPP4 Inhibitors |
Suffix—“gliptin” Enhance actions of incretin hormones (stimulate release of insulin and suppress release of glucagon) Adverse effects: hypoglycemia, allergic reactions, risk for HF, risk for pancreatitis |
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SGLT2 Inhibitors |
Suffix—“gliflozin” Block reabsorption of glucose in kidney leading to glucosuria Adverse effects: hypoglycemia, dehydration, Hyponatremia, GU fungal infections in females, UTIs, polyuria, risk for Fournier gangrene with perineal fasciitis |
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Incretin Mimetics |
Suffix—“glutide” “natide” Reduce glucagon secretion and gluconeogenesis; delay gastric emptying Patient teaching: only available SQ, ER forms injected weekly Adverse effects: hypoglycemia, risk for pancreatitis |
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Amylin Analogs |
Pramlintide Acts like Amylin and works with insulin to decrease glucagon, delay gastric emptying, and trigger satiety Patient teaching: only SQ, not compatible with insulin Adverse effects: hypoglycemia SEs: N/V |
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Watch for S/S of Hypoglycemia |
Sulfonylureas Incretin Mimetics DPP4 Inhibitors SGLT2 Inhibitors Amylin Analogs |
