Antidiabetic Drugs 1

Question 1

Rapid acting insulin analogs

Answer 1

Insulin Lispro- lysine and proline
Insulin Aspart- aspartate
Insulin Glulisine - lysine and glutamic acid

Question 2

Native insulin monomers are associated as hexamers in currently available insulin preparations.what do hexamers do

Answer 2

They slow absorption of insulin

Question 3

Drugs given to mimic the prandial release of insulin

Answer 3

Rapid acting insulins

• Usually given along with a longer acting insulin to assure proper glucose control.
• Given SC.
• Given 15 minutes before a meal.
• Also suitable for IV.

Question 4

Short-acting Insulins

Answer 4

Regular insulin
• Short-acting soluble crystalline zinc insulin.
• Should be given 30 minutes before a meal.
• Given SC
• Given IV in emergencies.

Question 5

Drug used for basal control

Answer 5

Neutral protamine Hagedorn (NPH)

• Also called Isophane Insulin.
• Suspension of crystalline zinc insulin combined with protamine.
• Should only be given SC.
• Used for basal control.
• Usuallygivenalongwithrapid-or short-acting insulin for mealtime control.

Question 6

Who are the three long acting insulin

Answer 6

• Insulin Glargine - glycine or arg + arg
• Insulin Detemir - C=O- R
• Insulin Degludec- C=O-R’

Question 7

Summary of drugs

Answer 7

Question 8

How can insulin be administered

Answer 8

Syringe- SC
Insulin pen
Insulin pump
inhaled insulin

Question 9

Adverse effects of inhaled insulin

Answer 9

cough,throat pain, hypoglycemia

Contraindicated in patients with asthma, COPD, and smokers.

Question 10

Two methods used to achieve insulin release

Answer 10

• Basal-Bolus Insulin Regimens

* Insulin Pump Therapy

Question 11

Basal-Bolus Insulin Regimens

Answer 11

Question 12

Which drugs are used in insulin pump therapy

Answer 12

Glulisine, lispro, or insulin aspart

It consists of a battery-operated pump and a computer that programs the pump to deliver predetermined amounts of insulin.

Question 13

Adverse Reactions of Insulin: Hypoglycemia

Answer 13

• Risk of hypoglycemia with rapid-acting insulin analogs is less than with regular insulin.
• Risk of hypoglycemia with long-acting insulin analogs is less than with NPH insulin.

Question 14

Management of hypoglycemia

Answer 14

• Mildhypoglycaemia,conscious:orangejuice,glucose or any sugar-containing beverage or food.
• Severe hypoglycemia, unconsciousness or stupor: IV glucose infusion.
• IVtherapynotavailable:glucagonSCorIM.

Question 15

Drugs that cause hypoglycemia

Answer 15

• Ethanol
• beta blockers
• Salicylates

Question 16

Drugs that cause hyperglycemia

Answer 16

• Epinephrine
• Glucocorticoids
• Atypicalantipsychotics
• HIVproteaseinhibitors
• Phenytoin
• Clonidine
• Ca2+-channelblockers
• Diuretics

Question 17

Management of Diabetes in Hospitalized Patients

Answer 17

Oral antidiabetic agents should be discontinued during acute illness and replaced with insulin.