Diabetic Medications Flashcards
(44 cards)
What pancreatic islet cell are damaged in diabetes?
B cells that secrete insulin
a pancreatic cells secrete?
Glucagon
What are the actions of insulin?
- Lowers BG level
- Regulates fat metabolism
- Regulates protein metabolism
- Increases K+ uptake into the cells
When is Type I DM usually diagnosed?
Usually diagnosed in early childhood to early adulthood
What is the cause of Type I DM?
Caused by autoimmune destruction of the B cells of the pancreas, absolute deficiency of insulin (B islet cells)
What HgbA1c is diagnostic for diabetes?
> 6.5
What are some complications associated with DM?
Retinopathy
Nephropathy
Neuropathy
CV complications
Gastroparesis, Autonomic insufficiency
What are the therapeutic goals of giving insulin?
- To replicate normal physiologic insulin secretion
- To replace basal insulin (overnight, fasting and between meals)
- To provide bolus at meal time
What are the rapid acting insulins?
- Insulin aspart (Novolog)
- Insulin lispro (Humalog)
- Insulin glulisine (Adidra)
What is the MOA of rapid acting insulins?
- Acts as natural insulin: facilitates glucose transport into cells, inhibit glycogenolysis and gluconeogensis, regulate fat and protein metabolism, increase K+ uptake in cells
What is the PK of rapid acting insulins?
- SubQ w/in 15 minute of a meal, or IV administration
- Onset 10-30 minutes, peak effects seen 30-90 minutes, effective up to 1-5 hours
What are the uses of rapid acting insulins?
- Rapid-acting insulins
- Admin to mimic mealtime release of insulin and to control postprandial glucose
- Fast correction of elv glucose
- Usually used in combo with longer acting insulin
What are the side effects of insulin?
Weight gain, Somogyi effect, Dawn phenomenon, hypogycemia
HA, tachycardia, vertigo, anxiety, confusion, diaphoresis, lipodystrophy, hypersensitivity
What are the regular short acting insulins?
Humulin R and Novolin R
What is the use of regular short acting insulin?
- Short acting insulin
- Admin to mimic mealtime release of insulin and to control postprandial glucose
- Fast correction of elevated glucose
- Usually used in combo with longer acting insulin
What is the Somogyi effect?
If the blood sugar level drops too low in the early morning hours, hormones (such as growth hormone, cortisol, and catecholamines) are released. These help reverse the low blood sugar level but may lead to blood sugar levels that are higher than normal in the morning.
What is the MOA of regular short acting insulin?
Acts as a natural insulin: facilitates glucose transport into cells, inhibits glycogenolysis and gluconeogensis, regulate fat and protein metabolism, increase K+ uptake in cells
What is the PK of regular short acting insulin?
- SubQ, 30 minutes before meal, or IV admin (emergency)
- Onset, 30 minutes- 5 hours, peak 2-3 hours, effective up to 8-12 hours
What type of insulin is NPH Insulin Isophane (Humulin N)?
An intermediate acting insulin
What are the uses for NPH Insulin Isophane (Humulin N)?
- Intermediate acting insulin
- Basal (fasting) control in type 1 or 2 diabetes
- Usually given along with rapid or short acting insulin for mealtime control
- DO NOT use when rapid glucose lowering is needed
What is the MOA of NPH Insulin Isophane (Humulin N)?
Acts as a natural insulin: facilitates glucose transport into cells, inhibits glycogenolysis and gluconeogenesis, regulate fat and protein metabolism, increase K+ uptake in cells
What is the PK of NPH Insulin Isophane (Humulin N)?
- SubQ admin only
- Onset 4-12 hours, peak 5.5 hours, effective up to 18-24 hours
What are the long-acting insulins?
Insulin detemir (Levemir) and Insulin Glargine (Lantus)
What are the uses of Insulin Determir and Insulin Glargine (long-acting insulins)?
- Long acting insulin
- Basal (fasting) control in type 1 and 2 diabetes
