What are the 2 most rapid acting insulins?
lispro and aspart
What is the trade name for lispro insulin?
Humalog
What is the trade name for aspart insulin?
Novolog
What are the routes of administration for lispro and aspart insulins?
SQ injection or infusion
What is the only cloudy insulin?
NPH
What is the onset, peak, and duration time for lispro and aspart insulins?
0.25hr onset, 1 hr peak, 3-4hr duration
Are regular (Humulin-R, Novolin-R) insulins short acting or long acting?
Short acting
What is the route of administration for regular (Humulin-R, Novolin-R) insulins?
SQ injection, infusion, and IV infusion
What is the onset, peak, and duration of regular (Humulin-R, Novolin-R) insulin?
0.5-1hr, 2-3 hr, and 3-6 hr
What are the 2 trade names of NPH insulin?
Humulin-N and Novolin-N
Is NPH insulin short acting, intermediate acting, or long acting?
Intermediate acting
What is the route of administration of NPH insulins?
SQ injection
What is the onset, peak, and duration of NPH insulins?
2-4hr, 4-10hr, 10-16hr
What is the trade name of glargine insulin?
Lantus
What is the trade name of detemir insulins?
Levemir
Are glargine and detemir insulins short, intermediate, or long acting?
Long acting
What is the route of administration for glargine and detemir insulins?
SQ injection
What is the onset, peak, and duration of glargine and detemir?
1-2hrs, none, 24+hrs
What is a nursing consideration of glargine and detemir?
CANNOT be mixed with other insulins
What drug class is metformin?
Biguanide
What is the trade name for metformin?
Glucophage
What is MOA of metformin?
Reduces hepatic glucose production and enhances insulin sensitivity
What route of administration is metformin given?
PO
What are nursing considerations for metformin?
1. does not promote weight gain
2. Withhold preoperatively or if IV contrast has been used and for 48 hrs after
3. DO not use it in pt. with renal failure
4. Good for cholesterol levels
What are the SE of metformin?
weight loss, GI upset, lactic acidosis (life threatening), B12 deficiency
What drug class is glipizide?
Sulfonylureas
What is the MOA of glipizide?
Increase insulin production in pancreas
What is the route of administration of glipizide?
PO
What are nursing considerations of the first generation of glipizide?
hypoglycemia
What are nursing considerations of the second generation of glipizide?
1. Give 30mins before a meal
2. Less risk of hypoglycemia than first gen
What is the trade name of glipizide?
Glucotrol, Glucotrol XL
What are SE of glipizide?
-Hypoglycemia
-flushing
-palpations
-Nausea when combined with alcohol
-Beta blockers diminish effect of drug
What class is pioglitazone?
Thiazolidinediones (TZDs)
What is the trade name of pioglitazone?
Actos
What is the MOA of pioglitazone?
Decreases insulin resistance and may decrease hepatic glucose production
pioglitazone is mainly taken with _________?
Metformin
Why is pioglitazone not widely used?
Due to risk of MI and sudden death
What are SE of pioglitazone?
-Headaches
-sinusitis
-myalagia (muscle pain)
-URI (upper respiratory infection)
What are AE of pioglitazone?
Heart failure d/t renal fluid retention
What class is sitaglipitin?
DPP-4 Inhibitors
What is the trade name of sitaglipitin?
Januvia
What is the MOA of sitagliptin?
Enhances incretin hormone system:
1. Inhibits DP-4
2. Stimulates release of insulin from the pancreas
3. Suppresses post prandial release of glucagon
What is the route of administration for sitagliptin?
PO
What is a nursing consideration for sitagliptin?
No weight gain
What are SE of sitagliptin?
Rare SE of pancreatitis
What is the the class of exenatide and semaglutide?
Incretin mimetic (GLP-1 RA)
What are the trade names of exenatide?
Byetta and Bydureon
What is the trade name of semaglutide?
Ozempic
What is the MOA of exenatide and semaglutide?
Stimulates incretin hormone
-decreases glucagon production
-increases satiety and slows GI emptying
What is the route of administration for exenatide and semaglutide?
SQ injection daily for exantide and weekly for semaglutide
What are nursing considerations for exenatide and semaglutide?
-Should not be used with insulin therapy
-Can be used with oral agents
-Should be started at low doses
What are SE of exenatide and semaglutide?
-GI upset
-Hypoglycemia
-pancreatitis
-Renal impairment
What is the class for canaglifozin?
Sodium-glucose CO-transporter 2 (SGLT-2) inhibitors
What is the trade name of canaglifozin?
Invokana
What is the MOA of canagliflozin?
-Reduces glucose re-absorption in renal tubes
-Glucosuria
-Promotes osmotic diuresis, polyuria may occur
What is the route of administration for canagliflozin?
PO
What are the SE of canagliflozin?
-Weight loss
-orthostatic hypotension
-GU yeast uinfections