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Insulin review.docx

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NURS 2050
Cynthia Barkhouse Mckeen

Insulin Type Trade Names Onset Peak Duration MOA Rapid onset Humalog 10 – 15 min 60 – 90 min 4 – 5 hrs analogue (clear) (insulin lispro) NovoRapid (insulin aspart) Fast acting Humulin R 0.5- 1 hr 2-4 hrs 5-8 hrs (clear) Novolin ge Toronto Intermediate Humulin L 1-3 hrs 5-8 hrs Up to 18 hrs Lente Contains zinc acting (cloudy) Humulin N NPH = regular insulin + Novolin ge NPH protamine, which is a large PN that decreases solubility and slows absorption Long-acting Humulin U 3-4 hrs 8-15 hrs 22-26 hrs Ultralente is combined with zinc (cloudy) Insulin glargine (lantus) is newer and NOT CLOUDY. It microprecipitates due to low solubility at physiologic pH. It is not given IV and cannot be mixed with other insulins. Extended LA Lantus (insulin 90 minutes 24 hrs analogue (clear) glargine) Hypoglycemia Neruogenic: Controlled by nervous tissue Neuroglycopenic: shortage of glucose (glycopenia) in the brain, usually due to hypoglycemia Trembling/ Tingling Diff. concentrating Palpations Confusion Sweating Weakness Anxiety Drowsiness Hunger Vision change Nausea Recommended targets for glycemic control A1C* (%) Preprandial PG 2 hour postprandial Type 1 & <7.0 (longterm, visual measurement ) 4.0-7.0 5.0-10.0 Type 2 Average glucose over the past few months (before eating a (5.0-8.0 if A1C targets not being met) meal) (2hrs after eating a meal) Hypoglycemics
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