Question

DIABETES MEDICATIONS

23. Please fill in the following insulin chart. (The first one is done as example).

Classification	Insulin	Onset of action	Peak	Duration
Rapid/ fast acting	Lispro(Humalog)	15 minutes or less	0.5-1 hour	3-4 hours
Short Acting	Regular Insulin
Intermediate	NPH Insulin
Long acting	Glargine (Lantus)

24. Mr. Smith gets his breakfast tray at 8am. At what time should the Nurse administer Regular Insulin (Humulin R) and what is the rationale behind it?

25. Oral Diabetic Medications

Class/Medication	Action	Side effects	Nursing and client teaching
Sulfonylureas
Meglitinides
Biguanides (Metformin)
Thiazolidinediones
Alpha Glucosidase inhibitors
Glipitines

Answer 1

23.

Classification	Insulin	Onset of action	Peak	Duration
Rapid/Fast acting	Lispro	15minutes or less	0.5_1hr	3_4 hr
Short acting	Regular insulin	30 minutes to 1 hours	2_4 hr	6 _8 hours
Intermediate	NPH insulin	1-2 hours	4-6 hours	12 hours
Long acting	Glargine (Lantus)	2_4 hours	8_12 hours	18_24 hours

24.The nurse should administer the regular insulin half an hour before breakfast (7.30am) because the onset of action starts by 30 minutes

25.Oral diabetic medications

Class/Medication	Action	Side effects	Nursing and client teaching
Sulphonylurea	the pancreas are stimulated to release the insulin	Hypoglycemia Weight gain Dark urine Confusion Dizziness	Adhering to drug, diet and exercise Report any side effects Stop insulin if hypoglycemic and contact healthcare professional No alcohol Monitor weight
Meglitinides	the pancreas are stimulated to release insulin	Hypoglycemia Gastrointestinal problems like nausea, increased appetite vomiting,diarrhea Pain in joint and back Respiratory:flu like symptoms Sensory:blurred vision CNS:headache, dizziness Jaundice Urinary: yellow urine	Monitor side effects and report Good nutritious food to stay infection free Regular mild exercise to ease pain
Biguanides	The glucose production in the liver is stopped ,the intestinal absorption of glucose is reduced and improve the insulin function	Hypoglycemia Vitamin B12 deficiency Muscle pain Abdominal pain Flatulence Infection Diarrhea	Include green leafy and vegetables in diet Exercise regularly Immunization to prevent respiratory infections Monitor blood glucose
Thiazolidinediones	The Gene's responsible for glucose metabolism and lipid metabolism is altered to stop glucose release.	Fracture Weight gain cardiovascular diseases Macular edema	Monitor blood pressure Maintain balanced weight Avoid extreme activity or exercise Periodic vision examination
Alpha glucosidase inhibitors	The carbohydrate digestion are stopped this the release of glucose is not possible	Diarrhea Flatus Abdominal pain	Watch the diet to be low in carbohydrates Report any side effects
Glipitines	It stimulates the action of uncertain by stopping the function of gliptins there by insulin is secreted in increased quantity to reduce glucose	Abdominal pain Diarrhea Rash Sore throat Hypoglycemia	Monitor glucose levels Hot water gargle