Pharmacology Nursing Medication Guide and Combination

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ALL ABOUT INSULIN SHORT-ACTING

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

INTERMEDIATE-ACTING

LONG-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

KEY: NO PEAK  CAN’T BE MIXED WITH OTHER INSULIN!

 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)

1. Detrimir THINK: “Lasts all year” lasts a long time

 Given 2x/day

2. Lantus THINK: “Lantern” lanterns burn for a long time

Onset: 30-60 minutes Peak: 2-4 hours Duration: 5-8 hours Onset: 60-120 minutes Peak: 4-12 hours Duration: 14 hours (hence, given 2x/day)

WHEN DO YOU EAT? 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

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

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

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