Common S/E: lipodystrophy (why we rotate injection sites) and hypoglycemia (can also result when giving insulin in an infrequently used site)
Hyperglycemia
Dry flushed skin
Kussmaul’s respirations (blowing off CO2)
Anorexia, N/V (trying to get sugar out)
Abdomina...
type of insulin generic name brand name works within works best or peak at lasts rapid acting insulin lispro human humalog 15 min 30 to 90 min 3 to 4 hrs insulin aspart novolog
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HESI PHARM
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HESI PHARMACOLOGY STUDY REVIEW
Works Works Best
Type of Insulin Generic Name Brand Name Lasts
Within or "Peak" at
insulin lispro
Rapid-Acting Humalog 15 min 30 to 90 min 3 to 4 hrs
(human)
insulin aspart NovoLog
insulin glusiline Apidra
Short-Acting insulin injection Humulin R 30 min 1 to 3 hrs 6 to 8 hrs
(regular) Novolin R
Velosulin Human BR
Regular Iletin II
Intermediate- isophane insulin
Humulin N 2 hrs 4 to 12 hrs 24 hrs
Acting suspension (NPH)
Lente Novolin N
NPH-N
Long-Acting insulin glargine Lantus 2 hrs no peak up to 24 hrs
insulin detemir
Levemir
ultralente
NPH/Regular insulin isophane
Humulin 70/30 30 min 2 to 12 hrs 18 to 24 hrs
Mixtures suspension
regular insulin Novolin 70/30
insulin lispro
Humalog 15 to 30 min 2 to 12 hrs 18 to 24 hrs
protamine
**ONLY REGULAR INSULIN MAY BE ADMINISTERED INTRAVENOUSLY!!
Gently rotate the vial between palms to disperse the medication particles before drawing up insulin
Always draw up clear (regular) before cloudy (intermediate and long acting); but never mix Lantus***
Sliding Scales
↑ insulin may be required during active infections, stress, 2nd and 3rd trimesters whereas
↓ insulin may be required in response to the patient’s exercise and the 1st trimester of pregnancy
Rapid acting (Novolog) and short acting (Regular) insulins are usually given per the Dr’s SS orders
Common S/E: lipodystrophy (why we rotate injection sites) and hypoglycemia (can also result when
giving insulin in an infrequently used site)
Hyperglycemia Hypoglycemia
Dry flushed skin Tachycardia and palpitations
Kussmaul’s respirations (blowing off CO2) Diaphoresis with pale, clammy skin
Anorexia, N/V (trying to get sugar out) Tremors, hunger (need to get sugar in)
Abdominal pain Headache and dizziness
CNS depression Anxiety and irritability (poor judgment)
Fruity breath odor Confusion
Eventual coma Seizures and coma
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,HESI PHARMACOLOGY STUDY REVIEW
Page 2 of 24
, HESI PHARMACOLOGY STUDY REVIEW
Endocrine Agents
Antithyroid drugs for HYPERthyroidism
PTU (propyltiouracil), Trapazole
Agranulocytosis is a major concern (early signs= sore throat, fever) need to report immediately!
Take medication at same time each day with meals to maintain therapeutic level and ↓GI
distress
Monitor for S/S of hypothyroidism (wt gain, bradycardia, depression, anorexia, cold intolerance)
Sodium Iodide (I 131)
Pts should avoid contact with children/pregnant women because they may be emitting radiation
May have temporary swelling and tenderness of the thyroid gland for a few days; this is normal
Monitor for S/S of hypothyroidism (wt gain, bradycardia, depression, anorexia, cold intolerance)
Thyroid Replacement for HYPOthyroidism
Synthroid, Cytomel, Triostat
Administer early in the day to prevent insomnia; withhold medication if apical pulse >100 bpm
Monitor for S/S of hyperthyroidism (anxiety, tachycardia, heat intolerance, abdominal cramping)
HYPERparathyroidism - the major concern here is hypercalcemia (released through bone decomposition)
Calcimar, Miracalcin (Calcitonin)
Phosphate supplements to remove calcium (inverse relationship with phosphate)
HYPOparathyroidism- treatment is aimed at replenishing calcium and vitamin D (to help with
absorption)
Calcium Chloride and Calcium Gluconate
HYPERpituitarism
Parlodel, Dostinex, Sandostatin- decrease hormone levels in acromegaly
Hypopituitarism
Somatropin, Protropin
Used to treat growth hormone deficiences; stimulates overall growth and protein production
Common S/E: hyperglycemia (will need increased insulin dosages; useful in diagnostics)
Diabetes Insipidus- a lack of ADH which manifests as gross polyuria
Vasopressin (ADH)
Monitor for S/S of fluid overload (lethargy, drowsiness, pounding HA) and hyperkalemia
Oral Hyperglycemic Agents- used mostly for type II diabetics; the pancreas has to be producing some
amount of insulin for them to work properly (HgA1C <7%)
Diabanese, Glucotrol, Diabeta
Longer duration of action and therefore can be given once/day
Common S/E: GI distress, hypoglycemia, hepatotoxicity and jaundice, rash (pruritus)
Prandin
Fast but short-lived release of insulin; take before each of 3 meals per day (poor compliance)
Metformin
Does not promote insulin release; therefore does not cause hypoglycemia
Black Box Warning: Lactic Acidosis (hyperventilation, myaligia, sluggishness)
Byetta, Symlin
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