Term
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Definition
Rapid Acting: Short duration
Onset:6-15 min
Peak:30-60 min
Duration:3-4 hrs
Comments:Cannot be used IV |
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Term
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Definition
Rapid Acting: Short duration
Onset:SubQ:10-15 min
Peak:30-60 min
Duration:3-5 hrs
Comments:Give within 15 minutes ac, or just after meals within 20 minutes. Can be given IV.Cannot be used IV |
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Term
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Definition
Rapid Acting: Longer Duration
SQ
Onset:30-60 min
Peak:2-4 hrs
Duration: 5-8 hrs
Comments:Give 30 minutes before meals
IV
Onset:10-30 min
Peak:15-30 min
Duration:30-60 min
Comments: The only one which may be used IV as well as SQ; |
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Term
| NPH, Lente(Humulin N, Novolin N) |
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Definition
Intermediate Acting:
Onset:60-90 min
Peak:6-12 hrs
Duration:18-24 hrs |
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Term
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Definition
Long Acting:
Onset:4-8 hrs
Peak:14-20 hrs
Duration:22-36 hrs |
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Term
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Definition
Long Acting:
Onset:1-2 hrs
Peak:None
Duration:24+ hrs |
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Term
| Humulin 50/50(NPH/ regular 50/50) |
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Definition
Combinations:
Onset:30 min
Peak:3 hrs
Duration:22-24 hrs |
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Term
| Humulin 70/30 (NPH/ regular) 70/30 |
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Definition
Combinations:
Onset:30 min
Peak:4-8 hrs
Duration:24 hr |
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Term
Humulin 75/25
NPH/ lispro 75/25 |
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Definition
Combinations:
Onset:6-15 min
Peak:4-8 hrs
Duration:24 hr |
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Term
| Symlin (amylin) (pramlintide) |
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Definition
Insulin helpers
1. SQ—give with mealtime insulin but NOT in same syringe
2. For Type I and II diabetes; 20 minutes onset; peak 50 minutes.
3. a & b)Watch for hypoglycemia 3 hours after injection:
4. Watch for nausea and hypoglycemia |
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Term
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Definition
Insulin helpers
1. Give SQ BID within 1 hour before morning & evening meal
2. For TYPE II diabetes
3. a & b)Watch for hypoglycemia 3 hours after injection:
4. Watch for nausea and hypoglycemia |
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Term
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Definition
Thiazolidinediones (take with or without food)
Increases glucose uptake in muscle, decrease endogenous glucose production
Note: AVANDIA—associated with cardiac risks (MI) |
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Term
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Definition
α-Glucosidase Inhibitors (take with 1st bite of meal) (starch blockers)
Decrease CHO absorption |
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Term
| Other drugs affecting blood glucose levels: |
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Definition
-Adrenergic blockers (also mask sx/s of hypoglycemia)
Thiazides & Loop diuretics
Corticosteroids (prednisone, hydrocortisone, dexamethasone) |
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Term
| Incretin mimetic (Subcu injection) |
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Definition
Synthetic peptide that stimulates release of insulin from cells. Not to be used with insulin.
Suppresses glucagon secretion
Slows gastric emptying, patient feels full, thus reduces food intake.
Example
Byetta (exenatide); Comes in pen injectors as 5-10 mcg dose. Give before the 1st meal of the day and again before evening meal.
Teach: May have nausea at 1st, this lessens
May reduce appetite, food intake, and body weight—but DO NOT CHANGE meds without MD consult
Not a substitute for insulin |
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Term
| Amylin analog (Subcu in thigh or abdomen) |
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Definition
Hormone secreted by cells of pancreas; Co-secreted with insulin: Indicated for type 1 and type 2 diabetics to control postprandial blood glucose levels. Insulin is usually given also BUT the 2 meds cannot be mixed. Requires 2 injections.
M of A: Slows gastric emptying, reduces postprandial glucagon secretion, increases satiety
Example
Pramlintide (Symlin) |
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Term
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Definition
Report if nursing or pregnant; Do not take with other drugs that can also slow gastric emptying—e.g. opioids, antacids containing aluminum, & lithium.
Must eat! Give pre-meal. If miss a dose, wait till next meal. Watch for & treat hypoglycemia—peaks at 3 hours! Keep fast acting CHO ready!—e.g. glucose tablets, hard candy, glucagon
Nausea at 1st
Do not drink alcohol (increases hypoglycemia risk);
Other side effects: dizziness, anorexia, vomiting, stomach pain, fatigue, & indigestion
Advise patient to discuss troublesome reactions with her diabetes care provider |
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Term
| Dipeptidyl Peptidase-4 (DPP-4) inhibitors: |
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Definition
A new approach to type 2 diabetes
Control ppg (post prandial glucose)
Januvia (sitagliptin) is FDA approved
M of A: suppresses glucagon secretion in response to meals. Glucagon tells liver to release glucose. Glucose levels remain less elevated with Januvia.
Gut hormones GLP-1, incretins, stimulate insulin in response to food (this is good). DPP-4 is an enzyme that halts insulin action. The new med group, i.e. DPP-4 inhibitors allow insulin to work well so glucose levels remain unelevated.
Diabetics have a GLP-1 deficiency, thus ppg levels remain elevated. The new DPP-4 inhibitors counter this deficiency by blocking DPP-4 enzymes that inactivate GLP-1.
Recommended dosing: 100 mg p.o. once daily with or without food. Not to be given to pregnant or breastfeeding women. Not tested in pediatric groups.
Common adverse effects: stuffy or runny nose, sore throat, URI, and headache.
Does not cause weight gain like other antidiabetics. Sometimes combined with metformin which causes some weight loss. This is often very good for the Type 2 diabetic. |
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Term
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Definition
(take with meals)
e.g.-Glipizide (Glucotrol), glyburide (Diabeta)
(stimulate release of insulin, decrease gluconeogenesis; increase receptor sensitivity) |
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Term
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Definition
(take 15 minutes before meals)
e.g. (regaglinide (Prandin); nateglinide (Starlix)
stimulates a rapid, short release of insulin |
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Term
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Definition
(take with meals, withhold before contrast)
e.g. Metformin (Glucophage)
decrease hepatic glucose production, increases uptake of glucose by tissues, increases insulin sensitivity of cells |
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