Untitled Flashcards Set

NPH Insulin ● Intermediate-acting ● Onset: 1-1.5 hrs ● Peak: 4-12 hrs ● Duration: up to 24 hrs ● Food should be taken around time of onset & peak

Metformin Drug class ● Biguanides MOA- ● Inhibit production of glucose by the liver ● Increase body tissue sensitivity to insulin ● Decrease hepatic synthesis of cholesterol Adverse effects- ● Lactic acidosis ● Hypoglycemia ● GI disturbances Contraindications- ● Impaired kidney or liver function ● respiratory insufficiency ● severe infection ● alcohol abuse Nursing interventions- ● Monitor kidney function ● Patients taking metformin are at increased risk for AKI and lactic acidosis with the use of iodinated contrast material for diagnostic studies ● HOLD for 48 h prior to and for 48 h after the use of contrast agent

Lispro Insulin ● Rapid-acting ● Onset: 15-30 min ● Peak: 30-90 min ● Duration: less than or equal to 5 hours ● Used for rapid reduction of glucose level, to treat postprandial hyperglycemia, or to prevent nocturnal hypoglycemia

Insulin Glargine (Lantus and detemir) ● Long-acting ● Onset: 3-6 hrs, unknown ● Peak: continuous, no peak ● Duration: 24 hours ● Used for basal dose ● Basal insulin is necessary to maintain blood glucose levels irrespective of meals. A constant level of insulin is required at all times

Insulin Pumps ● Uses ONLY rapid-acting insulin ● infused continuously at a low rate called basal rate (commonly 0.5–1.5 units/h) and premeal bolus doses

Glipizide Drug class ● Sulfonylureas MOA- ● Stimulate beta cells of the pancreas to secrete insulin; may improve binding between insulin and insulin receptors or increase the number of insulin receptors ● May be used in combination w/ insulin or metformin Adverse effects- ● Hypoglycemia ● Mild GI symptoms ● Weight gain Interactions- ● NSAIDs, warfarin, sulfonamides Key notes- ● Patients at high risk for hypoglycemia: advanced age, renal insufficiency. ● When taken with beta-adrenergic blocking agents, may mask usual warning s/s of hypoglycemia. ● Contraindicated with sulfa allergy. ● Avoid alcohol Glyburide ● Same as glipizide