Insulin Products and Pharmacodynamics

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which type of insulin is the only one that can be administered intravenously?

Insulin Glargine (Lantus)

NPH (Novolin N)

Human Regular Insulin (Novolin R) (correct)

Insulin Lispro (Humalog)

What is the duration of action for Insulin Glargine (Lantus)?

18-24 hours

24 hours (correct)

8 hours or longer

5-7 hours

Which of the following insulin types has no peak?

Insulin aspart (Novolog)

Insulin Glargine (Lantus) (correct)

Ultralente

NPH

When should the combination insulin NPH 70%/Human regular 30% typically be administered?

15-30 minutes before breakfast and supper Signup and view all the answers

Which oral hypoglycemic agent is known to have common side effects including hypoglycemia and heartburn?

Glipizide (Glucotrol) Signup and view all the answers

What is the onset time for U500 insulin?

30 minutes Signup and view all the answers

Which of the following insulin types is characterized as cloudy in appearance?

NPH (Novolin N) Signup and view all the answers

What is a common side effect of oral hypoglycemic agents?

Anorexia Signup and view all the answers

What should be done if a patient experiences severe gastrointestinal upset while taking medication?

Divide the dose between breakfast and the evening meal Signup and view all the answers

Which of the following medications is NOT recommended for the elderly?

Diabinese Signup and view all the answers

What increases the risk of hypoglycemia when taking diabetes medications?

Taking certain herbs like ginseng and juniper berries Signup and view all the answers

What must be monitored in patients taking corticosteroids over a long period?

Fluid retention and weight gain Signup and view all the answers

What should patients be educated about concerning corticosteroid therapy?

To taper the dose before stopping abruptly Signup and view all the answers

What is a common adverse reaction associated with the long-term use of corticosteroids?

Cushingoid appearance Signup and view all the answers

Which statement is true regarding the administration of Prednisone?

It may decrease infection response Signup and view all the answers

Which of the following is NOT an indication for corticosteroid therapy?

Chronic migraines Signup and view all the answers

Study Notes

Insulin Products Used at HFH

Rapid acting insulin:
- Insulin Lispro (Humalog)
- Administer when the food tray arrives, not before.
Short acting insulin:
- Human regular insulin (Novolin R)
- Only insulin that can be given intravenously (IV).
- Hypoglycemia is likely before lunch.
- Can be mixed with NPH or Lente insulin; draw regular insulin (clear) first.
Intermediate acting insulin:
- NPH (Novolin N)
- Hypoglycemia most likely occurs between 3pm and dinner.
Long acting insulin:
- Insulin Glargine (Lantus)
- Long-acting insulin with no peak.
- Clear and cannot be mixed with other insulins.
- Ultralente (Humulin U)
- Detemir (Levemir)
Combination insulin:
- NPH 70%/Human regular 30% mixture (Novolin 70/30)
- Usually given 15-30 minutes before breakfast and supper.
- Ultralente (Humulin U)
Concentrated Insulin:
- U500 insulin

Insulin Pharmacodynamics

Insulin aspart (Novolog) has an onset of 5-10 minutes, peaks in 1-3 hours, and lasts for 3-5 hours. It’s clear and given subcutaneously (SQ).
Human Regular insulin has an onset of 1/2 to 1 hour, peaks in 2-4 hours, and lasts for 5-7 hours. It’s clear and given IV or SQ.
NPH has an onset of 1-2 hours, peaks in 6-14 hours, and lasts for 24+ hours. It’s cloudy and given SQ.
Ultralente has an onset of 6 hours, peaks in 18-24 hours, and lasts for 36+ hours. It’s cloudy and given SQ.
Insulin glargine (Lantus, Levemir) has an onset of 1 hour, has no peak, and lasts for 24 hours. It’s clear and given SQ.
U500 has an onset of 30 minutes, peaks in 2-4 hours, and lasts for 8 or longer hours. It’s clear and given SQ.

Oral Hypoglycemic Agents

Chlorpropamide (Diabinese), Glipizide (Glucotrol), Glyburide (Diabeta, Glynase, PresTab, Micronase), Tolbutamide (Orinase), Metformin (Glucophage), Tolazamide (Tolinase), Sitagliptin (Januvia), Canagliflozin (Invokana), Empagliflozin (Jardiance)

General Information About Oral Hypoglycemic Agents

Stimulates insulin release from pancreatic beta cells, reduces glucose output by the liver, and enhances excretion of glucose by the kidneys.
Onset is 1 hour, peak is 3-4 hours, and duration is 60 hours.
Common side effects: anorexia, nausea, vomiting, epigastric discomfort, heartburn, and hypoglycemia.
Administer before breakfast. If severe GI upset, divide the dose - one before breakfast and one before the evening meal.
IV glucose for severe hypoglycemia.
Not to be used for type I diabetes, in pregnancy, or lactation.
Avoid alcohol and take at the same time each day.
Diabinese is NOT recommended for the elderly.
Glipizide (Glucotrol) has very few drug-to-drug interactions and IS recommended for the elderly.
Increased risk of hypoglycemia if taken with juniper berries, ginseng, garlic, fenugreek, coriander, dandelion root, or celery.

Corticosteroids

Prednisone, prednisolone, hydrocortisone (Cortisol)

Indications for Corticosteroids

Treatment of various diseases, including:
- Adrenocortical insufficiency
- Hypercalcemia
- Rheumatic and collagen disorders
- Dermatologic, respiratory, gastrointestinal, and neoplastic disease
- Organ transplantation
- Hematologic, allergic, inflammatory, and autoimmune diseases.

Adverse Reactions of Corticosteroids

Chronic, long-term use may result in Cushingoid appearance, osteoporosis, muscle weakness, and suppression of the adrenal-hypothalamic-pituitary axis.
Insomnia
Nervousness
Increased appetite
Indigestion
Headache
Diabetes mellitus
Cataracts
Glaucoma
Hirsutism

Nursing Considerations for Corticosteroids

Monitor patient for weight gain and fluid retention.
Withdraw therapy with gradual tapering of the dose.
Administer oral dose with food or after meals to reduce GI irritation.
Prednisone may decrease response and increase potential infections.
Prednisone may increase blood glucose levels.

Patient Education for Corticosteroids

Take exactly as directed. Do not take more than prescribed.
Do not discontinue abruptly.
Take with meals or after meals.
If diabetic, monitor serum glucose closely and notify physician of changes.
Notify physician if experiencing higher than normal levels of stress, as medication may need to be adjusted.
Periodic ophthalmic examinations will be necessary with long-term use.
Monitor for signs and symptoms of infections and avoid crowds or infectious people with contagious diseases.
Report weakness, change in menstrual pattern, vision changes, signs of hyperglycemia, signs of infection, or worsening of the condition.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz covers various types of insulin products used at HFH, including their administration methods, acting times, and specific details of each type. Additionally, it delves into the pharmacodynamics of insulin, providing essential information for understanding its functions. Perfect for healthcare professionals and students in pharmacology.