Diabetes, Pt. 2 Flashcards
Types of insulin:
When should animals be started at the lower end of the dose range of insulin?
- hypoglycemia concerns
- mild hyperglycemia (<300 mg/dL)
How is insulin measured? What syringes are used?
units (U) = 1/100th of a mL
- U40 (ProZinc, Vetsulin) = 40 U/mL
- U100 = 100 U/mL
- U300 = 300 U/mL
What preparation of insulin is not recommended?
dilution, which can cause uncertainty with stability and pharmacokinetics - use pens or other insulin type
- do not dilute glargine ever
How does U100 syringes compare to U40? If a patient requires 10 U, how would filling up both syringes with 10 U compare?
U100 is 2.5x more concentrated
- U100 syringe+ U40 insulin = 4 units
- U40 syringe + U100 insulin = 25 units
What is the only insulin given IV? When is it most commonly used?
Regular
- emergency treatment of ketoacidosis
- hospitalized patients that need BGs lowered quickly while being monitored
What type of action is Lente (Vetsulin)? In what animals is it used? How is it used?
intermediate-acting (porcine)
FDA approved in dogs* and cats
- U40 syringes - not many pharmacists familiar
- can also use a VetPen
- must shake the bottle!
When should nadirs in dogs and cats be reached with Lente (Vetsulin)?
DOGS - 1-10 hrs with a duration of 10-24 hrs
CATS - 2-8 hrs with a duration of 8-14 hrs
What kind of action does NPH insulin have? What syringes does it use? In what animal is it most commonly used?
intermediate action
U100
dogs - economical in larger breeds
What kind of action does Prozinc have? What syringe does it use? In what animals is it most commonly used?
long-acting - can be used SID in dogs
U40
dogs and cats
What action does Lantus (Glargine) have? Why must it be carefully dosed? What syringes does it use?
ultra-long action —> peakless
U100
In what animals is Lantus (Glargine) most commonly used? What is it associated with?
cats - 1-3 U per cat BID
high rate of remission after a minimum of 2 weeks of therapy
How does insulin use compare in animals compared to humans?
much smaller dose = not used up as fast, can keep refrigerated longer than date on bottle —> has bacteriostat in it, monitor for discoloration or cloudiness
What is considered the most potent insulin? What action does it have? What syringes does it used?
Detemir/Levemir
long acting, similar to Glargine but requires lower dosing
U100
In what animal is Detemir/Levemir most potent?
dogs —> peakless, must be used cautiously
What insulin blend can be used? Why would it be used?
70/30 MPH/Regular (U100)
- intermediate/regular
allows for fine tuning
How is insulin stored? What must be done before its use? Which insulin has an exception?
refrigerated, no direct light
re-suspension - rolled
Vetsulin must be shaken