Insulin

Question 1

Rapid Acting Drugs

Answer 1

Lispro

Aspart

Question 2

Short Acting

Answer 2

Regular

Question 3

Intermediate Acting

Answer 3

Isophane NPH

Question 4

Long Acting

Answer 4

Glargine

Detemir

Question 5

Rapid Acting Onset

Answer 5

15 minutes or less

Question 6

Rapid Acting Peak

Answer 6

lispro 30min to 2.5 hours

aspart 1 to 3 hours

Question 7

Rapid Acting Duration

Answer 7

lispro 3 to 6 hours

aspart 3 hours

Question 8

Time of Rapid Acting Adverse Reaction & symptoms

Answer 8

Midmorning; trembling, weakness

Client should eat within 5 to 15 minutes after injection; also used in insulin pumps

Question 9

Short Acting Onset

Answer 9

30 to 60 min

Question 10

Short Acting Peak

Answer 10

1 to 5 hours

Question 11

Short Acting Duration

Answer 11

6 to 10 hours

Question 12

Time of Short Acting Adverse Reaction & symptoms

Answer 12

Midmorning, Afternoon; weakness, fatigue

Clear solution; given 20 to 30 min before meal; can be alone or with other insulins

Question 13

Intermediate-Acting Onset

Answer 13

1 to 2 hours

Question 14

Intermediate Acting Peak

Answer 14

6 to 14 hours

Question 15

Intermediate Acting Duration

Answer 15

16 hours

Question 16

Time of Intermediate Acting Adverse Reaction & symptoms

Answer 16

Early evening; weakness, fatigue

White and cloudy solution; can be given with meals

Question 17

Long acting Onset

Answer 17

3 to 4 hours

Question 18

Long acting Peak

Answer 18

Continuous; no peak

Question 19

Long acting Duration

Answer 19

24 hours

Question 20

Characteristics of Long acting Insulin

Answer 20

Maintains blood sugar levels regardless of meals; cannot be mixed with other insulins; given at bedtime

Question 21

Herbal interactions

Answer 21

Bee pollen, ginkgo biloba, glucosamine: may increase glucose

basil, bay leaf, chrmium, echinacea, garlic, ginseng: may decrease glucose

Question 22

Oral Hypoglycemic agent: sulfonylureas

Answer 22

Glimepiride
Glipizide
Glyburide

Question 23

Sulfonylurea side effects

Answer 23

Only used if very little beta-cell function
GI symptoms and dermatologic reactions
Take with food

Question 24

Oral Hypoglycemic agent: Biguanides

Answer 24

Metformin

Question 25

Biguanide side effects

Answer 25

``` Nausea, Diarrhea, Abdominal discomfort avoid if renal impairment can cause lactic acidosis avoid alcohol Do no give with alpha-glucodiase inhibitors ```

Question 26

Oral Hypoglycemic agent: Alpha glucosidase inhibitors

Answer 26

acarbose | miglitol

Question 27

Alpha glucosidase inhibitor side effects

Answer 27

abdominal discomfort diarrhea & gas delays digestion of carbohydrates must take immediately before a meal

Question 28

Oral Hypoglycemic agent: Thiazolidinediones

Answer 28

Rosiglitazone | Pioglitazone

Question 29

Thiazolidinedione side effects

Answer 29

infection headache pain rare cases of liver failure must have regularly scheduled liver-function studies can cause resumption of ovulation in perimenopause

Question 30

oral hypoglycemic agent: meglitinides

Answer 30

repaglinide

Question 31

meglitinide side effects

Answer 31

``` hypoglycemia GI disturbances URIs Back pain Headache med should not be taken if meal is skipped ```

Question 32

oral hypoglycemic agent: gliptins

Answer 32

sitagliptin

Question 33

gliptin side effects

Answer 33

Upper respiratory infections | hypoglycemia

Question 34

oral hypoglycemic agent: incretin mimetic

Answer 34

Exanatide

Question 35

Incretin mimetic side effects

Answer 35

GI upset hypoglycemia pancreatitis administer 1 hour before meals