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BNF/Pre-Reg 2017-2018 U > CV: General Diabetes > Flashcards

CV: General Diabetes Flashcards

1
Q

What are the short acting insulin analogues?

A

Aspart
GLULISINE
Lispro
Soluble human/bovine/porcine insulin.

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2
Q

What are the long acting insulin analogues?

A 
Determir
Glargine
Degludec
Protamine Zinc
Insulin Zinc
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3
Q

Aspart: short or long acting?

A

Short

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4
Q

Determir: short or long acting?

A

Long

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5
Q

Glargine: short or long acting?

A

Long

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6
Q

Lispro: short or long acting?

A

Short

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7
Q

Glulisine: short or long acting?

A

Short

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8
Q

Degludec: short or long acting?

A

Long

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9
Q

Glargine: once or twice daily?

A

Once

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10
Q

Degludec: once or twice daily?

A

Once

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11
Q

Determir: once or twice daily?

A

either

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12
Q

A long-acting recombinant human insulin analogue:

Actrapid
Humalog Mix 25
Hypurin porcine isophane
Insultard
Lantus
Victoza
Novomix 30
Novorapid
A

Actrapid: Fast-acting Human insulin produced by recombinant DNA technology in Saccharomyces cerevisiae. Most appropriate to use in diabetic emergency and at time of surgery.

Humalog Mix 25: Insulin lispro (recombinant DNA from E.coli) + 75% insulin lispro protamine.

Hypurin porcine: pig insulin

Insulatard: human insulin with a gradual onset and long duration of action: recombinant DNA therapy in Saccharoymces cervisiae.

Lantus: long acting recombinant insulin analogue: glargine.

Victoza: Liraglutide, GLP-1 agonist, weight loss.

Novomix 30: mixture or fast acting insulin aspart and protamine insulin aspart.

Novorapid: just insulin aspart, so rapid-acting/short duration of action.

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13
Q

The most appropriate to use in a diabetic emergency and at the time of surgery:

Actrapid
Humalog Mix 25
Hypurin porcine isophane
Insultard
Lantus
Victoza
Novomix 30
Novorapid
A

Actrapid: Fast-acting Human insulin produced by recombinant DNA technology in Saccharomyces cerevisiae. Most appropriate to use in diabetic emergency and at time of surgery.

Humalog Mix 25: Insulin lispro (recombinant DNA from E.coli) + 75% insulin lispro protamine.

Hypurin porcine: pig insulin

Insulatard: human insulin with a gradual onset and long duration of action: recombinant DNA therapy in Saccharoymces cervisiae.

Lantus: long acting recombinant insulin analogue: glargine.

Victoza: Liraglutide, GLP-1 agonist, weight loss.

Novomix 30: mixture or fast acting insulin aspart and protamine insulin aspart.

Novorapid: just insulin aspart, so rapid-acting/short duration of action.

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14
Q

Associated with the prevention of weight gain and the possible promotion of weight loss:

Actrapid
Humalog Mix 25
Hypurin porcine isophane
Insultard
Lantus
Victoza
Novomix 30
Novorapid
A

Actrapid: Fast-acting Human insulin produced by recombinant DNA technology in Saccharomyces cerevisiae. Most appropriate to use in diabetic emergency and at time of surgery.

Humalog Mix 25: Insulin lispro (recombinant DNA from E.coli) + 75% insulin lispro protamine.

Hypurin porcine: pig insulin

Insulatard: human insulin with a gradual onset and long duration of action: recombinant DNA therapy in Saccharoymces cervisiae.

Lantus: long acting recombinant insulin analogue: glargine.

Victoza: Liraglutide, GLP-1 agonist, weight loss.

Novomix 30: mixture or fast acting insulin aspart and protamine insulin aspart.

Novorapid: just insulin aspart, so rapid-acting/short duration of action.

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15
Q

Stimulates insulin secretion from pancreatic beta cells with a short duration of action:

Empaglifozin
Isophane insulin
Metformin
Nateglinide
Once daily long-acting insulin analogue 
Pioglitazone
Rapid-acting insulin analogue 
Twice daily premixed insulin
A

Empaglifozin: SGLT-2, blood pressure monitoring is recommended in patients also on anti-hypertensives

Isophane insulin: NICE recommended insulin of choice for insulin initiation in type 2 diabetics.

Metformin: decreased hepatic glucose production, decreased intestinal absorption of glucose, improved insulin sensitivity by increasing peripheral glucose uptake and utilisation.

Nateglinide: stimulates insulin secretion from pancreatic beta cells with a short duration of action.

Once-daily long-acting insulin analogue.

Pioglitazone: not suitable for people with or at high risk of HF: fluid retention.

Rapid-acting insulin analogue:

Twice daily premixed insulin: NICE recommended second-choice insulin if a basal-bolus regimen is not acceptable for a person with type 1 diabetes.

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16
Q

Blood pressure monitoring is recommended in patients who are also taking anti-hypertensive medication:

Empaglifozin
Isophane insulin
Metformin
Nateglinide
Once daily long-acting insulin analogue 
Pioglitazone
Rapid-acting insulin analogue 
Twice daily premixed insulin
A

Empaglifozin: SGLT-2, blood pressure monitoring is recommended in patients also on anti-hypertensives

Isophane insulin: NICE recommended insulin of choice for insulin initiation in type 2 diabetics.

Metformin: decreased hepatic glucose production, decreased intestinal absorption of glucose, improved insulin sensitivity by increasing peripheral glucose uptake and utilisation.

Nateglinide: stimulates insulin secretion from pancreatic beta cells with a short duration of action.

Once-daily long-acting insulin analogue.

Pioglitazone: not suitable for people with or at high risk of HF: fluid retention.

Rapid-acting insulin analogue:

Twice daily premixed insulin: NICE recommended second-choice insulin if a basal-bolus regimen is not acceptable for a person with type 1 diabetes.

17
Q

NICE recommended insulin of choice for insulin initiation in people with type 2 diabetes:

Empaglifozin
Isophane insulin
Metformin
Nateglinide
Once daily long-acting insulin analogue 
Pioglitazone
Rapid-acting insulin analogue 
Twice daily premixed insulin
A

Empaglifozin: SGLT-2, blood pressure monitoring is recommended in patients also on anti-hypertensives

Isophane insulin: NICE recommended insulin of choice for insulin initiation in type 2 diabetics.

Metformin: decreased hepatic glucose production, decreased intestinal absorption of glucose, improved insulin sensitivity by increasing peripheral glucose uptake and utilisation.

Nateglinide: stimulates insulin secretion from pancreatic beta cells with a short duration of action.

Once-daily long-acting insulin analogue.

Pioglitazone: not suitable for people with or at high risk of HF: fluid retention.

Rapid-acting insulin analogue:

Twice daily premixed insulin: NICE recommended second-choice insulin if a basal-bolus regimen is not acceptable for a person with type 1 diabetes.

18
Q

NICE recommended second-choice insulin if a basal-bolus insulin regimen is not acceptable for a person with type 1 diabetes:

Empaglifozin
Isophane insulin
Metformin
Nateglinide
Once daily long-acting insulin analogue 
Pioglitazone
Rapid-acting insulin analogue 
Twice daily premixed insulin
A

Empaglifozin: SGLT-2, blood pressure monitoring is recommended in patients also on anti-hypertensives

Isophane insulin: NICE recommended insulin of choice for insulin initiation in type 2 diabetics.

Metformin: decreased hepatic glucose production, decreased intestinal absorption of glucose, improved insulin sensitivity by increasing peripheral glucose uptake and utilisation.

Nateglinide: stimulates insulin secretion from pancreatic beta cells with a short duration of action.

Once-daily long-acting insulin analogue.

Pioglitazone: not suitable for people with or at high risk of HF: fluid retention.

Rapid-acting insulin analogue:??

Twice daily premixed insulin: NICE recommended second-choice insulin if a basal-bolus regimen is not acceptable for a person with type 1 diabetes.

19
Q

Abasaglar means what?

A

a basal glargine: long acting analogue.

20
Q

What does the brand name Apidra mean?

A

rearranges to raapid: insulin glulisine

21
Q

Which of the following is the most appropriate insulin combination for a patient with Type 2 diabetes to be started on insulin - her hospital consultant has requested mealtime plus basal insulin regime:

Insulin detemir plus Humulin S
Insulin glargine plus Humulin I
Insulin determir plus Humulin I
Insulin glargine plus Humulin M3
Humulin I plus Humulin M3
A

Insuline detemir is a long acting insulin analogue.

Humulin S is a rapidly acting insulin preparation

Humulin I is isophane insulin which is intermediate-acting.

Insulin Glargine is a long acting insulin analogue.

Insulin M3 is an intermediate acting and fast acting insulin combination.

Therefore the only combination that works is insulin detemir (basal) and Humulin S (rapid for meals)

22
Q

What is Humulin S?

A

Rapidly acting insulin

23
Q

What is Humulin M3?

A

Insulin M3 is an intermediate acting and fast acting insulin combination.

24
Q

What is Humulin I?

A

Isophane insulin analogue which is intermediate acting

BNF/Pre-Reg 2017-2018 U (144 decks)

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