Pharmacology Essentials: Key Drug Information
I. Insulin Medications: Onset, Peak, and Duration
Understanding the pharmacokinetics of different insulin types is crucial for
effective diabetes management.
Rapid-Acting Insulin:
o Lispro (Humalog):
Onset: 5 - 15 minutes
Peak: 30 - 90 minutes
Duration: 3 - 4 hours
Short-Acting Insulin:
o Regular (Humulin R):
Onset: 30 - 60 minutes
Peak: 2 - 3 hours
Duration: 5 - 7 hours
Intermediate-Acting Insulin:
o NPH (Humulin N):
Onset: 1 - 2 hours
Peak: 4 - 12 hours
Duration: 18 - 24 hours
Long-Acting Insulin:
o Glargine (Lantus):
Onset: 60 - 90 minutes
Peak: No significant peak
Duration: 20 - 24 hours
II. Medication Administration Precautions & Timing
Proper administration is vital for drug efficacy and patient safety.
A. General Precautions:
Avoid giving with milk or antacids: This applies generally to many
medications as these substances can interfere with absorption.
, Do not combine with anti-hyperlipidemic medications: Unless
specifically prescribed and monitored due to potential interactions.
B. Timing of Administration:
Stand up for 30 minutes after administration:
o Bone Reabsorption Inhibitors - Bisphosphonates: To prevent
esophageal irritation.
Administer Before Breakfast:
o Anti-diabetic (Non-Insulin) Medications: For optimal glycemic
control throughout the day.
o Bone Reabsorption Inhibitors - Bisphosphonates: For better
absorption on an empty stomach.
Administer in the Morning:
o SSRI (Selective Serotonin Reuptake Inhibitors): To minimize sleep
disturbances.
o Diuretics: To avoid nocturia.
o Bisphosphonates: (as mentioned above).
o Thyroid Hormone (Levothyroxine): For optimal absorption on an
empty stomach.
o Flomax (Tamsulosin): Often taken in the morning.
o Antitussives: Depending on the cough pattern.
o Immunosuppressants: As prescribed.
Administer at Night:
o Anti-hyperlipidemic Medications (e.g., Lipitor): Cholesterol
synthesis is often higher at night.
o Alpha 1 Adrenergic Blockers: To minimize initial orthostatic
hypotension during sleep.
C. Medications to be Taken Without Food:
Iron: Food can decrease absorption.
Sucralfate: Forms a protective barrier on an empty stomach.
Bisphosphonates: (as mentioned above).
Tetracyclines: Absorption is impaired by food, especially dairy.
Sulfonamides: Best absorbed on an empty stomach.
Anti-lipidemic Medications: (some types).
Antihistamines: Absorption can be affected by food.
Quinolones: Food can interfere with absorption.
, D. Medications to be Taken Without Milk:
Tetracyclines: Calcium in milk binds to the drug, reducing absorption.
E. Medications Interacting with Antacids, PPIs, or Calcium Citrate:
Antacids: Can affect the absorption of many drugs due to altered gastric pH.
PPI (Proton Pump Inhibitors): Reduce stomach acid, potentially affecting
absorption.
Calcium Citrate: May interact with other medications.
F. Medications to be Taken With Meals:
Glucocorticosteroids: To minimize gastric irritation.
Vitamin C: Can be taken with meals to aid absorption and reduce stomach
upset.
Calcium Carbonate: Better absorbed with food due to stomach acid.
Antithyroid Medications: As prescribed.
Potassium Supplements: To reduce gastrointestinal upset.
Analgesics (for UTI - Phenazopyridine): To minimize stomach upset.
Anticonvulsants (Carbamazepine/Tegretol): To improve absorption and
reduce GI side effects.
Antihypertensives (Beta Blockers, Hydralazine): May improve
tolerability.
Anti-TB (Rifampin): Absorption can be enhanced with food.
Immunosuppressants: As prescribed.
NSAIDs (Aspirin, Ibuprofen): To reduce gastric irritation.
Nitrofurantoin: To enhance absorption and reduce GI upset.
Diuretics: Some diuretics are better tolerated with food.
Bipolar Medications: As prescribed.
Antifungal Medications: Some are better absorbed with food.
Antihistamines: (some types).
Antibiotics (Sulfonamides, Cephalosporins): To reduce GI upset or
enhance absorption.
H2 Receptor Blockers (Tagamet, Zantac): Can be taken with or without
food, but consistency is key.
G. Interactions with Grapefruit Juice:
Avoid Grapefruit Juice: Can significantly alter the metabolism and
effectiveness of Anti-Impotence medications and other drugs.