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Summary HESI PHARMACOLOGY STUDY REVIEW

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 Common S/E: lipodystrophy (why we rotate injection sites) and hypoglycemia (can also result when giving insulin in an infrequently used site)  Hyperglycemia  Dry flushed skin  Kussmaul’s respirations (blowing off CO2)  Anorexia, N/V (trying to get sugar out)  Abdomina...

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  • March 11, 2022
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  • 2022/2023
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HESI PHARMACOLOGY STUDY REVIEW


Works Works Best
Type of Insulin Generic Name Brand Name Lasts
Within or "Peak" at
insulin lispro
Rapid-Acting Humalog 15 min 30 to 90 min 3 to 4 hrs
(human)
insulin aspart NovoLog
insulin glusiline Apidra
Short-Acting insulin injection Humulin R 30 min 1 to 3 hrs 6 to 8 hrs
(regular) Novolin R
Velosulin Human BR
Regular Iletin II
Intermediate- isophane insulin
Humulin N 2 hrs 4 to 12 hrs 24 hrs
Acting suspension (NPH)
Lente Novolin N
NPH-N
Long-Acting insulin glargine Lantus 2 hrs no peak up to 24 hrs
insulin detemir
Levemir
ultralente
NPH/Regular insulin isophane
Humulin 70/30 30 min 2 to 12 hrs 18 to 24 hrs
Mixtures suspension
regular insulin Novolin 70/30
insulin lispro
Humalog 15 to 30 min 2 to 12 hrs 18 to 24 hrs
protamine
**ONLY REGULAR INSULIN MAY BE ADMINISTERED INTRAVENOUSLY!!

 Gently rotate the vial between palms to disperse the medication particles before drawing up insulin
 Always draw up clear (regular) before cloudy (intermediate and long acting); but never mix Lantus***
 Sliding Scales
 ↑ insulin may be required during active infections, stress, 2nd and 3rd trimesters whereas
↓ insulin may be required in response to the patient’s exercise and the 1st trimester of pregnancy
 Rapid acting (Novolog) and short acting (Regular) insulins are usually given per the Dr’s SS orders
 Common S/E: lipodystrophy (why we rotate injection sites) and hypoglycemia (can also result when
giving insulin in an infrequently used site)




 Hyperglycemia  Hypoglycemia
 Dry flushed skin  Tachycardia and palpitations
 Kussmaul’s respirations (blowing off CO2)  Diaphoresis with pale, clammy skin
 Anorexia, N/V (trying to get sugar out)  Tremors, hunger (need to get sugar in)
 Abdominal pain  Headache and dizziness
 CNS depression  Anxiety and irritability (poor judgment)
 Fruity breath odor  Confusion
 Eventual coma  Seizures and coma


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,HESI PHARMACOLOGY STUDY REVIEW




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, HESI PHARMACOLOGY STUDY REVIEW


Endocrine Agents
 Antithyroid drugs for HYPERthyroidism
 PTU (propyltiouracil), Trapazole
 Agranulocytosis is a major concern (early signs= sore throat, fever) need to report immediately!
 Take medication at same time each day with meals to maintain therapeutic level and ↓GI
distress
 Monitor for S/S of hypothyroidism (wt gain, bradycardia, depression, anorexia, cold intolerance)
 Sodium Iodide (I 131)
 Pts should avoid contact with children/pregnant women because they may be emitting radiation
 May have temporary swelling and tenderness of the thyroid gland for a few days; this is normal
 Monitor for S/S of hypothyroidism (wt gain, bradycardia, depression, anorexia, cold intolerance)
 Thyroid Replacement for HYPOthyroidism
 Synthroid, Cytomel, Triostat
 Administer early in the day to prevent insomnia; withhold medication if apical pulse >100 bpm
 Monitor for S/S of hyperthyroidism (anxiety, tachycardia, heat intolerance, abdominal cramping)
 HYPERparathyroidism - the major concern here is hypercalcemia (released through bone decomposition)
 Calcimar, Miracalcin (Calcitonin)
 Phosphate supplements to remove calcium (inverse relationship with phosphate)
 HYPOparathyroidism- treatment is aimed at replenishing calcium and vitamin D (to help with
absorption)
 Calcium Chloride and Calcium Gluconate
 HYPERpituitarism
 Parlodel, Dostinex, Sandostatin- decrease hormone levels in acromegaly
 Hypopituitarism
 Somatropin, Protropin
 Used to treat growth hormone deficiences; stimulates overall growth and protein production
 Common S/E: hyperglycemia (will need increased insulin dosages; useful in diagnostics)
 Diabetes Insipidus- a lack of ADH which manifests as gross polyuria
 Vasopressin (ADH)
 Monitor for S/S of fluid overload (lethargy, drowsiness, pounding HA) and hyperkalemia
 Oral Hyperglycemic Agents- used mostly for type II diabetics; the pancreas has to be producing some
amount of insulin for them to work properly (HgA1C <7%)
 Diabanese, Glucotrol, Diabeta
 Longer duration of action and therefore can be given once/day
 Common S/E: GI distress, hypoglycemia, hepatotoxicity and jaundice, rash (pruritus)
 Prandin
 Fast but short-lived release of insulin; take before each of 3 meals per day (poor compliance)
 Metformin
 Does not promote insulin release; therefore does not cause hypoglycemia
 Black Box Warning: Lactic Acidosis (hyperventilation, myaligia, sluggishness)
 Byetta, Symlin

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