lOMoAR cPSD| 36357603
INSULIN CHART AND DIABETIC MEDS NURSING EXAMPLARS(NUTR 170)
l
Note: Side effects of all insulins include hypoglycemia, weight gain, allergic reactions, injection-site reactions, lipodystrophy,
pruritus, rash, edema.
If mixing insulins in one syringe, the clear (regular) insulin is always drawn up in to the syringe first. Patients always need to
rotate injection sites.
Insulin Trade name/ Onset of Peak Nursing considerations
Brand name action/Duration action
Rapid Lispro 15-30 min/3-5 hours 30-90 Stable at room temp. 28 days. Refrigerate unopened vials. Don’t
acting Aspart 10-20 min/3-5 hours min freeze.
Glulisine 20-30 min/1.5 hours 40-50 “ “ “ “, Can mix with NPH
Oral Inhalation 12-15 min/2.5 hours min “ “ “ “, Can mix with NPH
55 min
53 min
Short acting Regular insulin SubQ 30 min SubQ Stable at room temp. 28 days, Refrigerate unopened vials. Don’t
Humulin R, IV 15 min 1.5-3.5 freeze.
Novolin R hours Can mix with NPH
IV 15-30
min
Intermediat Isophane NPH 1.5 hours/14-24 hours 4-12 Stable at room temp. 31 days (Pen 14 days), Refrigerate unopened
e acting Humulin N hours vials. Don’t freeze. Can mix with Aspart, Lispro, Glulisine,
Novolin N (Rapids)
Long acting Glargine 1-1.5 hours/24 hours NONE Stable at room temp. 28 days.
Detemir 1-2 hours/24 hours 6-8 hours Stable at room temp. 42 days.
Degludec 1 hour/42 hours 12 hours Stable at room temp. 56 days.
DO NOT MIX WITH ANY OTHER INSULINS
, lOMoAR cPSD| 36357603
Name Understanding Risk Factors Side effects Education
Biguanides- hepatic glucose BLACK BOX: Lactic GI effects (metallic Avoid: Garlic- may
production, 𝖳 secretion acidosis mortality 50%. taste, N/V/D, abdominal cause hypoglycemia.
*Metformin PO 1,500- of glucagon-like pain) After receiving IV
2,550 mg/day- 2-3 peptide-1. Hold: PTs contrast dye-wait 48 hrs.
divided doses w/hypoxemia, vitamin B12 deficiency
Insulin Resistance dehydration, Alter Lab values-
hypoperfusion, sepsis lactic acidosis cholesterol, LDL,
Manage: Type 2 DM. (unexplained triglycerides, HDL.
Contraindicated: hyperventilation,
Renal disease, muscle aches, extreme DM requires life-long
Acute/chronic metabolic fatigue, unusual control.
acidosis drowsiness)
Report: signs of Lactic
Acidosis
Sulfonylureas- “-ide” blood sugar by Monitor: glucose & Hypoglycemia Watch: signs of
stimulating release of HbA1c levels, hypoglycemia
Tolbutamide (1st short) insulin from pancreas & postprandial glucose weight gain
Tolazamide (1st 𝖳 the sensitivity to levels, CBC w/diff., Monitor: glucose levels
intermediate) dizziness before/after meals &
insulin at receptor sites. LFT/RFT
Chlorpropamide (1st headache bedtime
long) Treat: type 2 DM Assess: PT for
sulfonamide allergy- nausea Do not use Alcohol
nd
*Glipizide (2 ) PO 2.5- cross sensitivity can (disulfiram-like effect)
40 mg/day occur. Aplastic Anemia
Photosensitivity
nd
*Glyburide (2 ) PO
1.25-20 mg/day Wear medic-alert
INSULIN CHART AND DIABETIC MEDS NURSING EXAMPLARS(NUTR 170)
l
Note: Side effects of all insulins include hypoglycemia, weight gain, allergic reactions, injection-site reactions, lipodystrophy,
pruritus, rash, edema.
If mixing insulins in one syringe, the clear (regular) insulin is always drawn up in to the syringe first. Patients always need to
rotate injection sites.
Insulin Trade name/ Onset of Peak Nursing considerations
Brand name action/Duration action
Rapid Lispro 15-30 min/3-5 hours 30-90 Stable at room temp. 28 days. Refrigerate unopened vials. Don’t
acting Aspart 10-20 min/3-5 hours min freeze.
Glulisine 20-30 min/1.5 hours 40-50 “ “ “ “, Can mix with NPH
Oral Inhalation 12-15 min/2.5 hours min “ “ “ “, Can mix with NPH
55 min
53 min
Short acting Regular insulin SubQ 30 min SubQ Stable at room temp. 28 days, Refrigerate unopened vials. Don’t
Humulin R, IV 15 min 1.5-3.5 freeze.
Novolin R hours Can mix with NPH
IV 15-30
min
Intermediat Isophane NPH 1.5 hours/14-24 hours 4-12 Stable at room temp. 31 days (Pen 14 days), Refrigerate unopened
e acting Humulin N hours vials. Don’t freeze. Can mix with Aspart, Lispro, Glulisine,
Novolin N (Rapids)
Long acting Glargine 1-1.5 hours/24 hours NONE Stable at room temp. 28 days.
Detemir 1-2 hours/24 hours 6-8 hours Stable at room temp. 42 days.
Degludec 1 hour/42 hours 12 hours Stable at room temp. 56 days.
DO NOT MIX WITH ANY OTHER INSULINS
, lOMoAR cPSD| 36357603
Name Understanding Risk Factors Side effects Education
Biguanides- hepatic glucose BLACK BOX: Lactic GI effects (metallic Avoid: Garlic- may
production, 𝖳 secretion acidosis mortality 50%. taste, N/V/D, abdominal cause hypoglycemia.
*Metformin PO 1,500- of glucagon-like pain) After receiving IV
2,550 mg/day- 2-3 peptide-1. Hold: PTs contrast dye-wait 48 hrs.
divided doses w/hypoxemia, vitamin B12 deficiency
Insulin Resistance dehydration, Alter Lab values-
hypoperfusion, sepsis lactic acidosis cholesterol, LDL,
Manage: Type 2 DM. (unexplained triglycerides, HDL.
Contraindicated: hyperventilation,
Renal disease, muscle aches, extreme DM requires life-long
Acute/chronic metabolic fatigue, unusual control.
acidosis drowsiness)
Report: signs of Lactic
Acidosis
Sulfonylureas- “-ide” blood sugar by Monitor: glucose & Hypoglycemia Watch: signs of
stimulating release of HbA1c levels, hypoglycemia
Tolbutamide (1st short) insulin from pancreas & postprandial glucose weight gain
Tolazamide (1st 𝖳 the sensitivity to levels, CBC w/diff., Monitor: glucose levels
intermediate) dizziness before/after meals &
insulin at receptor sites. LFT/RFT
Chlorpropamide (1st headache bedtime
long) Treat: type 2 DM Assess: PT for
sulfonamide allergy- nausea Do not use Alcohol
nd
*Glipizide (2 ) PO 2.5- cross sensitivity can (disulfiram-like effect)
40 mg/day occur. Aplastic Anemia
Photosensitivity
nd
*Glyburide (2 ) PO
1.25-20 mg/day Wear medic-alert
