Diabetes Insulin Flashcards by Kol Giessel

what is the ONLY hormone known to have a direct effect in lowering blood glucose levels?

Insulin

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Is insulin anabolic or catabolic? why do i care?

• Anabolic hormone –> conservative, constructive, builds up energy stores like gylcogen, promotes cell growth/division

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what are the 3 actions of insulin?

Glucose uptake by cells and glucose storage as glycogen in liver
Prevent fat and glycogen breakdown and inhibits gluconeogenesis
Increase protein synthesis

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Route for insulin admin?

SubQ, IV, IV infusion, inhaled

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Types of insulin are classified but what characteristics?

Onset, peak, and DURATION** –>

• Short duration
	◦ Rapid or slower onset
• Intermediate duration
• Long duration
	◦ Long and ultra-long

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prototype for short duration RAPID acting insulin?

Aspart (novolog)

I want to get through the ass part very quickly

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Onset, peak and duration for Aspart (Novolog)

Onset : 10-20 minutes
Peak: 1-3 hours
Duration: 3-5 hours

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Which of our insulins acts most like for the pancreas acts in repsonse to a rise in blood glucose?

Aspart (Novolog)

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Which insulin is out highest risk of hypoglycemia?

Aspart (novolog)

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onset for inhaled insulin?

12 minutes!

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inhaled insulin is contraindicated in…..

respiratory disorder like COPD

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what is the route for aspart?

SQ or infusion pump/drip

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When do we want to give Aspart in relation to food?

◦ Don’t give until food tray arrives! (5-10 min AC)

◦ “Give the shot while the tray is hot”

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prototype for SLOWER acting insulin?

RegulAR (Humulin R, Novolin R)

slowAR regulAR R R R R

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onset peak and duration for regular insulin

slowAR acting
Onset: 30-60 minutes
Peak: 1-5 hours
Duration: up to 10 hours
(longer peak and duration than rapid acting)
-does not mimic what the body naturally does as well

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drug of choice for insulin drips?

regular (Humulin R, Novolin R)

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When do we give regular insulin in relation to food?

◦ 30 to 60 min AC

◦ give before meal even arrives!

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What is U500 insulin ? how do we admin it?

5x more concentrated than normal

• Special syringe that says U500 on it OR have conversion sheet to use regular insulin or tuberculin syringe

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who is taking U500 insulin?

• Reserved for patients takes more than 200 units on insulin/day

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All insulin is _____ ____ but U 500 is ____ ____ ___ (think safety)

high alert, very high alert

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prototype for intermediate acting insulin?

Intermediate acting NPH (Humulin N, Novolin N)

iNtermediate Nph humulin N N N N N

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How do they make NPH last longer?

Study These Flashcards

regular insulin mixed with a special protein that slows down absorption

onset peak and duration for NPH

Study These Flashcards

Onset: 1-2 hours
Peak: 6-14
Duration: 16-24

when do we want to give NPH in relation to food?

Study These Flashcards

30 minutes before meal

NPH- once per day? BID? TID?

BID or TID

NPH + Regular insulin- how ya gonna give it?

clear (reg) then cloudy (NPH)

prototype for long acting insulin?

glargine (Lantus) (U-100) | Long Acting - LAntus, gLArgine

onset peak and duration of glargine (Lantus) (U-100)

Onset: 70 min Peak: none Duration: 18-24

indication for using glargine (Lantus) (U-100)

used for basal control?

is there a risk of hypoglycemia with glargine (Lantus) (U-100)?

No peak, so low risk for hypogly

frequency and admin of glargine (Lantus) (U-100)?

1-2x day Give it at same time Cant be mixed or given IV

prototype for Ultra-long duration Insulin

Insulin glargine (U-300) (Toujeo)

Duration, peak and onset for Insulin glargine (U-300) (Toujeo)?

Onset: ? same as u100? my notes dont say and the book is too heavy Peak: None Duration: >24 hours

frequency f admin for Insulin glargine (U-300) (Toujeo)?

Q 24 hours

prototype for combination insulin

NPH/regular 70/30 (Humulin 70/30)

onset peak duration for NPH/regular 70/30 (Humulin 70/30)

Onset: 30-60 min Peak: 1.5-16 hours Duration: 10-16

what kind of patients use NPH/regular 70/30 (Humulin 70/30)

*unpredictable b/c of wide range | • Good for patients with routine lives (diet, exercise) and set doses will work for them

indication for using sliding scale dose insulin?

when patients are hospitalized

what is a sliding dose scale insulin?

• will give certain amount of insulin based on patients current blood sugar ◦ backward thinking! give units based on elevation that has already occurred

what are correction dose insulins?

• Based on patient’s weight and current blood sugar • Calculator in computer ◦ backward thinking! based on what has already occurred in body and what current reading is

what is meal dose insulin?

• Adjust insulin based on % amount eaten ◦ forward thinking! -Can have sliding scale + meal dose or correction dose + meal dose

what is standing dose insulin?

• Doesn't matter what CBG is, how much they ate --> give set amount every meal

4 doses scales for insulin?

sliding scale correction meal % standing

insulin drips have ______ mortality

improved

considerations for patient on insulin drip (what is the nurse having to do?)

* More frequent blood sugar monitoring : the more stable the patient gets the wider we can make those time frames * Titrate frequently

what kind of insulin goes in a drip?

Usually use regular or rapid acting insulins insulin | ◦ All rapid acting insulins could be used

how do we discontinue an insulin drip?

give patient a longer acting insulin before stop drip, frequent CBG, rapid acting + long acting to normal routine --> cant stop the drip cold turkey

Insulin pumps provide ____ dose with rapid acting analogs

basal ---• Set for bolus dose based on Carbohydrate count

consideration for insulin pumps: D/C them before.....

mri/procedures/ when admitted

when is hypoglycemia likely to occur for a diabetic?

◦ Especially at peak times ◦ During increased exercise ◦ Too much insulin ◦ Skipped meal

2 main side effects from insulin

hypoglycemia lipodystrophy -hard formation of tissue @ injection site over time ◦ Rotate injection sites

where is insulin absorbed the quickest?

abdomen

storage of insulin: room temp vs fridge - how long is it good for

- RoomTemp: 30 days | - Fridge: 3 month --> give @ room temp**

how long is insulin good for in a syringe pre mixed? how do we want to store it?

1-2 weeks in syringe already mixed. Store upright to avoid clogging of needle

Diabetes Insulin Flashcards

(54 cards)