19 Insulin I
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This document summarizes different types of insulin, including their manufacturers and brand names. It discusses short-acting insulins like lispro, aspart, and glulisine which work rapidly, as well as intermediate and long-acting insulins like NPH, glargine, and detemir which work over longer periods of time. The document also notes that insulin is absorbed fastest from the abdominal wall and slowest from the leg and buttock.
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![lispro = Eli Lilly ---- Humalog
åíäåßîåéò
aspart = Novo Nordisk ---- NovoLog/NovoRapid
ìç êêñéóç éíóïõëßíçò
glulisine = Sanofi-Aventis ---- Apidra áíôßóôáóç óôçí éíóïõëßíç
üëïé ìå ÓÄ É
ÓÄ ÉÉ : as theirbeta cell function declines
NPH = Eli Lilly ---- Humulin N, Novolin N,Novolin NPH, NPH Lletin II, over time
and isophane insulin
óå êÜèå ô ï / çëéêßá :
glargine = Sanofi-Aventis ---- Lantus
o áíåî ãçôç á ÿëåéá âÜñïõò
detemir = Novo Nordisk ---- Levemir o a short history with severe symptoms
ÍPL = neutral protamine lispro o êåôïíïõñßá
NPH, NPL, DETEMIR, GLARGINE : 1 ÷2 / 24ùñï ãéá êÜëõøç óôéò åñéüäïõò Diabetic ketoacidosis = ÓÄ É
íçóôåßáò êáé ñïò á ïôñï ç áôéêç ò ãëõêïíåïã íåóçò
åîáßñåóç some patients with type 2
diabetes, especially in the Afro-Caribbean
populations (so-called "Flatbush
regular, lispro, aspart, glulisine : ñïãåõìáôéê ÷ïñ ãçóç diabetes]
conventional insulin therapy = intensive insulin therapy = Insulin is absorbed :
regular and NPH insulin, mixed ÷1, ÷2 ì óçò ìáêñÜò äñáóçò o fastest from the abdominal wall,
together in the o slowest from the leg and buttock, and
same syringe and given in fixed + ôá÷åßáò ñéí á ü ôá ãå ìáôá
amounts before breakfast and dinner o at an intermediate rate from the arm
at any of these sites, the rapidity of insulin
absorption
Premeal regular or rapid-acting insulin should be rapidly absorbed, and injection into
the abdominal wall may therefore be preferable. varies inversely with subcutaneous fat
thickness
On the other hand, slower absorption from the leg or buttock may be desirable with the
pre-evening meal dose of intermediate-acting insulin to ensure a duration of action that
lastsí through the night.](https://image.slidesharecdn.com/19insulini-091218120255-phpapp02/85/19-Insulin-I-1-320.jpg)
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3. Potential diagnoses are identified through disturbances of rhythm, conduction, hypertrophy, and ischemia. The relationship between P waves and QRS complexes helps determine block types.
38 Hypertension
Hypertension, or high blood pressure, is a major risk factor for coronary artery disease and cerebrovascular accidents. The risk of these conditions increases as blood pressure rises. For those over age 60, pulse pressure is the best predictor of outcomes from hypertension. Essential or primary hypertension, which has no identifiable cause, accounts for 80% of hypertension cases. It is defined as a diastolic blood pressure of 90-104 mmHg. Isolated systolic hypertension, affecting those over age 75, occurs when systolic pressure is over 160 mmHg and diastolic is under 90 mmHg.
37 Vitamins
This document discusses vitamin A, including its sources, forms, and functions. It notes that vitamin A is found primarily in animal foods as retinol, retinal, and retinoic acid. These forms are essential for growth, tissue integrity, and vision. Deficiencies can occur rarely due to absorption or storage issues, though stores usually last over 2 years. Toxicity risks exist from excessive supplementation, with symptoms taking long to resolve as stores are depleted slowly. The document recommends vitamin A supplementation only for deficiencies, pregnancy, or lactation, as normal diets provide sufficient amounts.
Gi Functional Dearangements
The document discusses a clinical case of a 30-year-old woman experiencing intermittent right upper quadrant pain. Her lab tests and ultrasound were normal. The key signs and symptoms suggest a diagnosis of biliary dyskinesia. There is no standardized test for this condition, but HIDA scanning is commonly used to assess gallbladder ejection fraction, with values under 35-40% indicating dysfunction. However, the test protocol can vary between providers and affect results. The most reliable approach may be one where CCK is administered at 30 and 60 minutes to better evaluate gallbladder motility.
33 Diverticuliti S
Diverticulitis is inflammation of diverticula in the colon. It can range from mild to severe, with complications including colonic perforation, abscesses, and peritonitis. Symptoms include abdominal pain, fever, and tenderness. Treatment involves antibiotics, clear liquid diets, and sometimes surgery for recurrent or complicated cases.
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4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
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19 Insulin I
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