Antidiuretic Hormone and its Medications

Study Notes

Premixed Insulins

70% NPH and 30% regular: mixture of intermediate- and short-acting insulin
75% insulin lispro protamine and 25% insulin lispro: mixture of intermediate- and rapid-acting insulin

Pharmacological Action

Promotes cellular uptake of glucose (decreases glucose levels)
Converts glucose into glycogen and promotes energy storage
Moves potassium into cells (along with glucose)

Therapeutic Uses

Used for glycemic control of diabetes mellitus (type 1, type 2, gestational) to prevent complications
Clients with type 2 diabetes mellitus may require insulin when:
- Oral antidiabetic medications, diet, and exercise are unable to control blood glucose levels
- Severe renal or liver disease is present
- Painful neuropathy is present
- Undergoing surgery or diagnostic tests
- Experiencing severe stress (infection and trauma)
- Undergoing emergency treatment of diabetes ketoacidosis (DKA) and hyperosmolar hyperglycemic nonketotic syndrome
- Requiring treatment of hyperkalemia

Complications

Hypoglycemia: occurs when blood glucose is less than 70 mg/dL
Causes of hypoglycemia:
- Toxic dose of insulin
- Too little food
- Vomiting and diarrhea
- Alcohol intake
- Strenuous exercise
- Childbirth

Diabetes Mellitus

Chronic illness resulting from an absolute or relative deficiency of insulin, often combined with a cellular resistance to insulin’s actions

Insulin Types

Rapid-acting:
- Lispro insulin
- Onset: 15 to 30 min
- Peak: 0.5 to 3 hr
- Duration: 3 to 5 hr
Short-acting:
- Regular insulin
- Onset: 0.5 to 1 hr
- Peak: 1 to 5 hr
- Duration: 6 to 10 hr
Intermediate-acting:
- NPH insulin
- Onset: 1 to 2 hr
- Peak: 4 to 14 hr
- Duration: 14 to 24 hr
Long-acting:
- Insulin glargine U-100
- Onset: 1 to 4 hr
- Peak: None
- Duration: 24 hr

Antidiuretic Hormone

Promotion of reabsorption of water within the kidney through vasoconstriction
Therapeutic uses:
- Diabetes insipidus (DI)
- Nocturnal enuresis (decreases the production of urine)
- Hemophilia (promote release of certain clotting factors)
Route of administration:
- Desmopressin: oral, intranasal, subcutaneous, IV
- Vasopressin: subcutaneous, IM, IV
Complications:
- Water intoxication (retention of too much water)
- Myocardial ischemia from excessive vasoconstriction (vasopressin) of coronary arteries

Description

This quiz covers the role of antidiuretic hormone (ADH) in the body, its effects on the kidney, and the therapeutic uses of medications like vasopressin and desmopressin in treating diabetes insipidus. Test your knowledge of ADH and its medications!