Chapter 57 drugs

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Short/ rapid insulins

Insulin pro ( homolog) , insulin aspartame (novo log) , insulin glulisine (apidra)

Peak of insulin pro ( homolog)

5 - 2.5 hrs

Onset of insulin pro ( humolog)

15 - 30 min

Duration of insulin pro ( humolog)

3 - 6 hrs

On set of insulin as part( novo log)

10-20 mins

Peak of insulin aspart (novo log)

1-3 hrs

Duration of insulin aspart (novo log)

3-5 hrs

Onset of insulin glulisine (apidra)

10- 15 mins

Peak of insulin glulisine (apidra)

1-1.5 hrs

Duration of insulin glulisine (apidra)

3-5 hrs

Short/ slow insulins

Regular insulin (humulin R & Novolin N)

Onset for regular insulin

30- 60 mins

Peak for normal insulin

1-5 hrs

Duration for normal insulin

6-10 hrs

Intermediate insulin

NPH (humulin N, & Novolin N )

Onset for NPH

60-120 mins

Peak for NPH

6-14 hrs

Duration for NPH

16-24 hrs

long duration insulin

Insulin glargine (lantus)

onset of insulin glargin (lantus)

70 mins

peak of insulin glargine (lantus)

has no peak

This insulin has no peak

Glargine (lantus)

duration of insulin Glargine ( lantus)

24 hrs

Adverse effets of Acarbose

flatulence,cramps, diarrhea, bowel sounds

alpha - glucosisose inhibitor

Acarbose

actions of arcabose

decrease the rise of glucose after a meal

exenatide

injected drug for type 2 diabetics

adverse effects of exenatide

hypoglycemia, GI effects

Exenatide is for patients...

already taking metformin & sulfolyurea

meteformin adverse efffects

lactic acidosis, decreased apetite, naseau/ diarrhea

meteformin should be given with cuation for patients with

renal failure, heart failure, liver disease, lactic acidosis, severe infections

1st oral diabetic drug given to newly diagnosed diabetics unless they have a contra indication

meteformin

decreases glucose production by the LIVER, increases glucose uptake by the muscles

Meteformin

prototype for biquanides

Meteformin

meteformin should not be given with patients who...

drink large amounts of alchohol

sulfonylureas should not be given to

women breast feeding, pregnant, or with alcohol

1st oral antidiabetic drug

sulfonylureas

sulfonlylureas should be used with cuation for patients with

liver and kidney disease

Adverse effects of sulfonylureas

hypoglycemia, cardiovascular toxicity

actions of sulfonylureas

promotes insulin release from PANCREAS

sulfonylureas

increase sensitivity to insulin

oral antidiabetic drug are only for

type 2 diabetes

ploglitazon (actos)

promotes water retention

if sulfonylureas is taken with alcohol what occurs

lactic acidodsis

ploglitizone (actos)

insulin must be present

thiazolidiodiones prototype

ploglitazone (actos)

adverse effects of ploglitazone

hypoglycemia, heart failure, liver damage

high risk patients for ploglitazone

bladder cancer and heart failure

gliptins (pp4 inhinitors)

3rd line drug for diabetes

Beta blocker

delay awarness of hyppoglycemia & inhibit breakdown of glacogen

insulin are all clear except

NPH

lipohypertrophy

accumulation of subcutaneus fat from continuous injections

gliptins actions

promote glycemic control & increase incretin hormone actions

dispose insulin if

clumps

insulin is given ....

sub q

measure glucose

before meals and at bedtime

insulin w/ hypoglycemic agents (sulfonylureas, beta blockers, glinides) cause

severe hypoglycemia

Pramilitide

delay gastric emptying, suppress glucogen release

give meglitinides

30 min befor eating

adverse effects of meglitinides

hypoglycemia

deutact is the combination of

proglitazone & glimepinide (sulfonlylurea)

duetact risk (2)

hypoglycemia & heart failure

Glucovane is a combination of

meteformin & glyburide (sulfonlylurea)

glucovane adverse effects

hypoglycemia, GI disturbance, decreased appetite, lactic acidosis

combinations are used for

to type 2 diabetics , when both drugs dont work well alone

metaglip is a combination of

meteformin and glipizide

actolus met is a combination of

meteformin and proglitazone

adverse effects of metaglip

gi disturbances, decreased appetite, lactic acidosis

adverse effects of actoplus met

renal insufeciency, decreased appetite, lactic acidosis, gi disturbance

insulin with hyperglycemic agents (thiazide diuretics,glucocorticoids) cause

insulin effects to decrease

this generation of sulfonlylureas are used the most

2nd generation

1st generation sulfonylureas end in

"mide"

silagliptin (junuvia)

gliptin, 3rd line drug for diabetes

insuline glulisine should be given with

intermediate or long acting insulin

insulin actions

promote conservation of energy and promote cell growth/ devision

all insulins concentration

100 units/ ml (u-100)

humulin r concentration

(u-500) 500 units/ ml

treat insulin overdose with

iv glucose

iv glucogen can not be used if

hypoglycemia is caused by not eating

treatment for type 2 diabetes

oral drugs (antidiabetics)

treatment for type 1 diabetics

insulin replacements

insulins basic effects

stimulate cellular uptake & promote synthesis

adverse effects of insulin

hypoglycemia, hypokalemia, allergic reactions