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42 Cards in this Set
- Front
- Back
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short acting insulin
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regular insulin
administered 30-60 min before eating |
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only insulin that can be administered IV for emergency situations
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regular insulin
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ultra-short acting insulins
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Lispro
Aspart Glulisine inhaled insulin given 0-15 minutes before a meal |
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can be given 15 minutes before a meal for up to 20 minutes after starting a meal
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glulisine
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contraindications of inhaled ultra-short acting insulin
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smokers
pts with uncontrolled restrictive lung diseases asthma COPD |
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SEs of inhaled ultra-short acting insulin
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cough upon inhalation
decline in lung function |
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intermediate-acting insulins
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Zinc-insulin (lente)
NPH or isophane insulin suspension |
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Zn (lente) insulin should not be mixed with
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regular insulin
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NPH can be mixed with
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regular insulin
insulin lispro |
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long-acting insulins
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ultra-lente
insulin glargine insulin detemir |
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Ultralente and lente can be mixed with
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lispro if premixed is "unstable"
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these insulins should not be mixed with other insulins
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glargine and detemir
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provides most effective control of glucose
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continous SC infusion pump
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insulins used with infusion pumps
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rapidly acting lispro, aspart, and glulisine
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administration of insulins
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SC injection in abdomen for most rapid absorption
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insulin SEs
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Lipodystrophies at injection sites: lipohypertorphy and atrophy
allergic rxn hypoglycemia weight gain |
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sulfonylureas and MOA
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tolbutamide, chlorpropamide, and glyburide
increase insulin release from beta cells by blocking K+ channels, hence only used for type 2 DM |
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meglitinides and MOA
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repa- and nateglinide
bind to sulfonylurea receptors leading to K+ channel blockade and insulin secretion |
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problem with using K+ channel blockers
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tachyphylaxis
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adverese effects of sulfonylureas and meglitinides
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weight gain and hypoglycemia
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administered in severe hypoglycemia
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glucagon
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glucagon not useful in
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starved or adrenal insufficient pts
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metformin MOA
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biguanide that inhibits hepatic gluconeogensis and enhances peripheral glucose uptake
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metformin elmination
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90% by kidneys
can accumulate in pts. with renal disease |
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metformin SEs
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transient GI problems
may cause weight loss impairs B12 and folate absorption may cause lactic acidosis |
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metformin drug interactions
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cationic drugs compete for secretion in tubules
IV iodinated contrast materials impair kidney function |
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metformin CIs
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congestive heart failure or MI
liver disease excessive alcohol consumption |
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thiazolidinedione(rosiglitazone) MOA
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promotes action of insulin in adipose tissue and muscle
agonist for PPAR-gamma receptor which regulates transcription of insulin-responsive genes |
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rosiglitazone SEs
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weight gain
edema |
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TZD toxicities
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severe liver toxicity
increased risk of fractures in women heart failure cardiac ischemia, angina, MI |
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acarbose and miglitol
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alpha-disaccacharidase inhibitors
slows down absorption of most carbs must be taken at start of meals |
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acarbose and miglitol SEs
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flatulence
diarrhea weight loss |
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acarbose and miglitol CIs
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inflammatory bowel disease due to gas/GI distension
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acarbose and miglitol elimination
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acarbose eliminated in feces
miglitol eliminated in kidney; contraindicated in renal impairment |
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pramlintide MOA
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amylin analog that inhibits post-prandial glucagon secretion
slows gastric emptying decreases appetite via CNS effects all cause glucose to enter bloodstream more slowly |
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pramlintide administration
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SC injection with short-acting insulin- but should not be mixed
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pramlintide SEs
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nausea
vomiting severe hypoglycemia can result |
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exenatide
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glucose-dependent promotion of insulin secretion and synthesis
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exenatide SEs
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nausea
vomiting diarrhea hypoglycemia if used with a sulfonylurea |
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acute pancreatitis associated with this drug
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exenatide
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sitagliptin MOA
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inhibitor of dipeptidyl peptidase-4 which inhibits insulin secreting effects of GLP-1 and GIP
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sitagliptin elimination
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kidney
dose drug according to kidney function |
