Insulin - Pharmacology - Endocrine System | @LevelUpRN

Summary

This video provides a comprehensive overview of insulin types and administration techniques, focusing on rapid-acting, short-acting, intermediate-acting, and long-acting insulins. The presenter explains the onset, peak, and duration of each insulin type, offering mnemonic devices to help remember them. Key considerations for insulin administration, such as rotating injection sites to prevent lipohypertrophy and recognizing symptoms of hypoglycemia, are highlighted. The video also includes practical tips for mixing insulins and managing hypoglycemia with food or glucagon. The importance of adjusting insulin doses during illness or stress is emphasized, making it a valuable resource for diabetic patients and healthcare professionals.

Takeaways

• 😀 Insulin is used for both type 1 and type 2 diabetes, but oral antidiabetic medications are only for type 2 diabetes.
• 😀 There are four main types of insulin: rapid-acting, short-acting, intermediate-acting, and long-acting.
• 😀 Rapid-acting insulins (e.g., Humalog, Novolog) have a quick onset (15 minutes), peak at 1 hour, and last for 2-4 hours.
• 😀 Short-acting insulins (e.g., Humulin R, Novolin R) have an onset of 30 minutes, peak in 2-3 hours, and last for 3-6 hours.
• 😀 Intermediate-acting insulin (e.g., NPH) takes 2-4 hours to start working, peaks at 4-12 hours, and lasts 12-18 hours.
• 😀 Long-acting insulins (e.g., Lantus, Levemir) start working in 3-4 hours, have no peak, and last for 24 hours.
• 😀 When administering insulin, rotate injection sites to avoid lipohypertrophy (scar tissue).
• 😀 The main adverse effect of insulin is hypoglycemia. Signs include tachycardia, sweating, shakiness, headache, and weakness.
• 😀 If a patient is conscious and hypoglycemic, give them 15 grams of glucose (e.g., 4 oz of juice or 8 oz of milk).
• 😀 If a patient is unconscious and hypoglycemic, administer glucagon, which will be covered in a future video.
• 😀 When mixing insulin types, always draw up the clear insulin before the cloudy insulin (e.g., regular insulin before NPH).

Q & A

What are the four types of insulin mentioned in the video?

The four types of insulin mentioned are rapid-acting, short-acting, intermediate-acting, and long-acting insulins.

What is the onset, peak, and duration of rapid-acting insulins?

Rapid-acting insulins, such as insulin lispro (Humalog) and insulin aspart (Novolog), have an onset of 15 minutes, a peak at around 1 hour, and a duration of 2 to 4 hours.

How can you remember that insulins ending in '-log' are rapid-acting?

To remember that '-log' insulins are rapid-acting, think of a log rolling rapidly down a hill.

What is the onset, peak, and duration of short-acting insulins?

Short-acting insulins, like Humulin R or Novolin R, have an onset of about 30 minutes, a peak between 2 to 3 hours, and a duration of 3 to 6 hours.

What is the key consideration when administering regular (short-acting) insulin?

When administering regular insulin, it is important to ensure that the meal tray is either on the floor or near the patient to avoid hypoglycemia.

What is the mnemonic used to remember intermediate-acting insulin (NPH)?

The mnemonic for intermediate-acting insulin (NPH) is Neil Patrick Harris, whose initials are NPH. He is described as a hard-working actor who works for 2 to 4 hours and stays for up to 18 hours.

What is the onset, peak, and duration of intermediate-acting insulin (NPH)?

NPH insulin has an onset of 2 to 4 hours, a peak between 4 to 12 hours, and a duration of 12 to 18 hours.

How can you remember that insulin glargine (Lantus) is long-acting?

To remember that insulin glargine is long-acting, think of a comfy pair of jeans that you want to wear for 24 hours.

What is the onset, peak, and duration of long-acting insulins?

Long-acting insulins, such as insulin glargine (Lantus) and insulin detemir (Levemir), have an onset of 3 to 4 hours, no peak, and a duration of around 24 hours.

What are some key adverse effects of insulin administration?

The key adverse effect of insulin administration is hypoglycemia, which can manifest as tachycardia, diaphoresis, shakiness, headache, and weakness.

What should you do if a patient experiences hypoglycemia and is fully conscious?

If a patient is fully conscious and experiences hypoglycemia, you can give them a source of glucose, such as 4 ounces of orange juice or 8 ounces of milk, which contain about 15 grams of glucose.

What should you do if a patient is unconscious during a hypoglycemic episode?

If the patient is unconscious during hypoglycemia, you should administer glucagon instead of giving them juice or milk.

What is the proper technique when mixing insulins?

When mixing insulins, always draw up the clear (short-acting) insulin before the cloudy (intermediate-acting) insulin. A helpful mnemonic is 'Registered Nurse' (RN), meaning 'Regular before NPH'.

What should you do with insulin suspensions before administering them?

You should gently rotate insulin suspensions before administration to ensure they are mixed properly.

What should you do if a short-acting insulin looks cloudy or discolored?

If a short-acting insulin appears cloudy or discolored, it should be discarded, as this indicates it is no longer safe to use.