Pharmacology Bundle PDF

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ALL ABOUT INSULIN RAPID-ACTING 1. Aspart THINK: “Move your Ass” Ass-part 2. Lispro THINK: “Let’s go!!” Lispro 3. Glulisine THINK: Glue dries fast Onset: 15 MIN! Peak: 30-90 minutes Duration: 3-5 hours

SHORT-ACTING

INTERMEDIATE-ACTING

AKA: Regular Insulin

AKA: NPH

KEY: This is the ONLY insulin type given IV route

KEY: If given with regular insulin, draw up: clear-to-cloudy

• Can be given with NPH at the same time in the same syringe • Can be given with long-acting at the same time in a different syringe

THINK: R-N Regular before NPH (clear before cloudy)

KEY: NO PEAK • CAN’T BE MIXED WITH OTHER INSULIN! 1. Detrimir THINK: “Lasts all year” lasts a long time 2. Lantus THINK: “Lantern” lanterns burn for a long time

• Given 2x/day

3. Glargine THINK: “Large” lasts for a large amount of time

Onset: 30-60 minutes Peak: 2-4 hours Duration: 5-8 hours

WHEN DO YOU EAT?

LONG-ACTING

Onset: 60-120 minutes Peak: 4-12 hours Duration: 14 hours (hence, given 2x/day)

1. Rapid-acting: Covers insulin needs for meals eaten at the same time of injection 2. Short-acting (Regular): Covers insulin needs for meals eaten within 30-60 minutes of injection 3. Intermediate-acting (NPH): Covers insulin needs for half the day or overnight; typically given morning and night 4. Long-acting: Covers insulin needs for the full day; can be combined with other insulin but never mixed

RULES OF INSULIN • Watch for signs and symptoms of hypoglycemia shaky, clammy, pale, sweaty o THINK: “Cool and clammy, give me candy” o IF AWAKE: Ask the patient to eat (candy, juice, low fat milk) o IF UNCONSCIOUS: Stab with IV D50 • Regular insulin: ONLY insulin given IV • NPH: If mixed, clear-to-cloudy (NPH is cloudy) • Long-acting: Do not mix; NO PEAK • Rotate injection sites do not aspirate/massage • Always increase insulin with: (glucose with any type of stress) o Stress o Sepsis o Sickness o Steroids

Onset: 60-120 minutes Peak: NO PEAK Duration: 24 hours

REMEMBER TYPE 1: YOU HAVE NONE • NO insulin being produced • Patients will need insulin! TYPE 2: THE PROBLEM IS YOU • Encourage healthy diet and exercise • Potential oral medication use • Insulin (last resort)

INSULIN PUMP • Give a steady dose of insulin for Type 1 DM • Check BG 4x/day • Push bolus at meals...