Managing Hypoglycemia & Hyperglycemia Critical Care

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Critical care patient

Saúde e medicina

Managing Hypoglycemia & Hyperglycemia

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Effective glucose control in the intensive care unit (ICU) has been shown to decrease morbidity across a large range of conditions and also to decrease mortality (IHI,2009).

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Medication Insulin Lispro Due July 2, 2017 Document APA Format Note any additional references used (See Attached information from the FDA-Food & Drug Administration) Include information in the paper that is in Bold (see information noted from my initial research) Pharmacokinetics of Lispro (Information to use) Used in management of Diabetes mellitus, types 1 and 2: Treatment of type 1 diabetes mellitus (insulin dependent, IDDM) and type 2 diabetes mellitus (noninsulin dependent, NIDDM) to improve glycemic control Onset of action Peak Rapid acting: insulin lispro (Humalog) 0 to 15 minutes (Peak) 30 to 90 minutes (Onset of Action) Half-life Duration of action Pharmacodynamics of Lispro insulin Pharmacotherapeutics of Lispro Include Drug-to-drug interactions, Drug-to-food interactions , Drug-to-herb interactions Routes and dosage ranges For Children For Adults (Information to consider in writing paper) Type 1 Diabetic : Note: Multiple daily doses or continuous subcutaneous infusions guided by blood glucose monitoring are the standard of diabetes care. Combinations of insulin formulations are commonly used. The daily doses presented below are expressed as the total units/kg/day of all insulin formulations combined. Initial total insulin dose: 0.2 to 0.6 units/kg/day in divided doses. Conservative initial doses of 0.2 to 0.4 units/kg/day are often recommended to avoid the potential for hypoglycemia. A rapid-acting insulin may be the only insulin formulation used initially. Usual maintenance range: 0.5 to 1 units/kg/day in divided doses. An estimate of anticipated needs may be based on body weight and/or activity factors as follows: Nonobese: 0.4 to 0.6 units/kg/day Obese: 0.8 to 1.2 units/kg/day Adverse effects of Lispro · Cardiovascular: Peripheral edema · Central nervous system: Headache (type 1 diabetes: 30%; type 2 diabetes: 12%), pain (11% to 20%) · Endocrine & metabolic: Hypoglycemia, hypokalemia, weight gain · Gastrointestinal: Diarrhea (type 1 diabetes: 9%), nausea (type 1 diabetes: 6%) · · Genitourinary: Urinary tract infection (type 1 diabetes: 6%) · · Hypersensitivity: Hypersensitivity reaction · · Immunologic: Antibody development · · Infection: Infection (10% to 14%) · · Local: Hypertrophy at injection site, injection site reaction, lipoatrophy at injection site · · Neuromuscular & skeletal: Myalgia (type 1 diabetes: 7%; most likely secondary to excipient metacresol) · · Respiratory: Flu-like symptoms (type 1 diabetes: 35%; type 2 diabetes: 6%), pharyngitis (type 1 diabetes: 33%; type 2 diabetes: 7%), rhinitis (type 1 diabetes: 25%; type 2 diabetes: 8%) • Glycemic control: The most common adverse effect of insulin is hypoglycemia. The timing of hypoglycemia differs among various insulin formulations. Hypoglycemia may result from changes in meal pattern (eg, macronutrient content or timing of meals), changes in the level of physical activity, increased work or exercise without eating o ...

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