Endocrine - Diabetes Flashcards
(29 cards)
Rapid-acting insulin
lispro (Humalog)
aspart (NovoLog)
glulisine (Apidra)
Onset about 5 minutes, peaks in 1 hour, duration about 4 to 5 hours
Short-acting insulin
“regular”(Humulin) insulin is sometimes used around mealtime.
Taken about 30 to 45 minutes before eating, peaks in 3 to 4 hours, duration 4 to 10 hours
Intermediate-acting insulin
Regular insulin is mixed with protamine, delaying absorption.
Insulin looks cloudy and has to be mixed before injected.
Onset one-half to 1 hour, peak 4 to 10 hours, duration 12 to 24 hours
Long-acting insulin
glargine (Lantus)
detemir (Levemir) insulins
Onset 1-2 hours, duration 24 hours with little or no peak
Alcohol use ______ hypoglycemia
INCREASES
Beta blockers ____ hypoglycemic symptoms
MASK
Pregnant women and insulin
Pregnant women can use rapid- or short-acting human insulin; does not cross placenta.
Insulin aspart, insulin glargine, and insulin glulisine are pregnancy category C.
Altered thyroid function and insulin
Hypothyroidism: delays insulin breakdown, therefore may require less insulin units
Hyperthyroidism: increases renal clearance, requiring more insulin than baseline
Metformin (Glucophage)
Biguanides Pregnancy Cat B Decrease glucose production by liver Decrease GI glucose absorption Improves insulin sensitivity
1st-line drug for menopausal women; tx osteoporosis
S/E:
METABOLIC ACIDOSIS
GI upset
Glipizide (Glucotrol)
Sulfonylureas
Pregnancy Category C
Increase endogenous insulin release from pancreas
Treat DM II, neurogenic DI
S/E:
HYPOGYCEMIA
WEIGHT GAIN
GI upset
Glyburide (Diabeta)
Sulfonylureas
Pregnancy Category B
Increase endogenous insulin release from pancreas
Treat DM II, neurogenic DI
S/E:
HYPOGYCEMIA
WEIGHT GAIN
GI upset
Glimepiride (Amaryl)
Sulfonylureas
Pregnancy Category C
Increase endogenous insulin release from pancreas
Treat DM II, neurogenic DI
S/E:
HYPOGYCEMIA
WEIGHT GAIN
GI upset
Acarbose (Precose)
Alpha-Glucosidase Inhibitors
Pregnancy Cat B
Adjunct, not monotherapy
S/E:
HYPOGLYCEMIA
Flatulance
Contra:
Bowel/GI issues
Pediatrics
Miglitol (Glyset)
Alpha-Glucosidase Inhibitors
Pregnancy Cat B
Adjunct, not monotherapy
S/E:
HYPOGLYCEMIA
Flatulance
Contra:
Bowel/GI issues
Pediatrics
Pioglitazone (Actos)
Thiazolidinediones
Pregnancy Cat C
Improves sensitivity to insulin in muscle/adipose
Adjunct OR monotherapy
S/E: EDEMA Upper respiratory infections Liver disease R/f bladder CA
Rosiglitazone (Avandia)
Thiazolidinediones
Pregnancy Cat C
Improves sensitivity to insulin in muscle/adipose
Adjunct OR monotherapy
S/E:
EDEMA
Upper respiratory infections
R/f bladder CA
Contra:
Liver disease, edema, pediatrics
Nateglinide (Starlix)
Meglitinides
Pregnancy Cat C
Increase release of insulin from pancreatic Beta cells
S/E:
Hypoglycemia
Contra:
Liver disease, pediatrics
Sitagliptin (Januvia)
DPP4-Inhibitors
Pregnancy Cat B
Inhibits DPP4 breakdown -> increase insulin and decrease glucagon release
S/E:
Mild weight loss
Pancreatitis
Contra:
Renal, pediatric, pancreatitis, thyroid nodules
Saxagliptin (Onglyza)
DPP4-Inhibitors
Pregnancy Cat B
Inhibits DPP4 breakdown -> increase insulin and decrease glucagon release
S/E:
Mild weight loss
Pancreatitis
Contra:
Renal, pediatric, pancreatitis, thyroid nodules
Dulaglutide (Trulicity)
GLP-1 Receptor Agonist
Pregnancy Cat C
Promote release of insulin from pancreas
Slows glucose absorption
S/E:
Hypoglycemia
Pancreatitis
GI upset
Contra:
GI disease
Renal
Exenatide (Bydureon)
GLP-1 Receptor Agonist
Pregnancy Cat C
Promote release of insulin from pancreas
Slows glucose absorption
S/E:
Hypoglycemia
Pancreatitis
GI upset
Contra:
GI disease
Renal
Liraglutide (Saxenda)
GLP-1 Receptor Agonist
Pregnancy Cat C
Promote release of insulin from pancreas
Slows glucose absorption
S/E:
Hypoglycemia
Pancreatitis
GI upset
Contra:
GI disease
Renal
Albiglutide (Tanzeum)
GLP-1 Receptor Agonist
Pregnancy Cat C
Promote release of insulin from pancreas
Slows glucose absorption
S/E:
Hypoglycemia
Pancreatitis
GI upset
Contra:
GI disease
Renal
Lixisentatide (Lyxumia)
GLP-1 Receptor Agonist
Pregnancy Cat C
Promote release of insulin from pancreas
Slows glucose absorption
S/E:
Hypoglycemia
Pancreatitis
GI upset
Contra:
GI disease
Renal
