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Pharm > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Insulin Classes

A 
Rapid Acting
Short Acting
Intermediate Acting
Long Acting
Inhalant
Mixture
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2
Q

Rapid Acting Insulin

A

Lispro (Humalog)
Aspart (Novolog)
Glulisine (Apidra)

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3
Q

Short Acting Insulin

A

Regular (Humilin R)

Regular (Novolin R)

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4
Q

Intermediate Acting Insulin

A

NPH (Humilin N)

NPH ( Novolin N)

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5
Q

Long Acting Insulin

A

Glargine (Lantus)

Detemir (Levemir)

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6
Q

Inhalant Insulin

A

Afrezza

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7
Q

Insulin Mixtures

A

70/30, Insulin Aspart Protamine/Insulin Aspart

75/25, Insulin Lispro Protamine/Insulin Lispro

50/50 Insulin Lispro Protamine/Insulin Lispro

70/30, NPH/Regular Humalin

70/30, NPH/Regular Novolin

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8
Q

Insulin -

Class MOA

A

Replaces (T1DM)
Supplements (T2DM)

Facilitates glucose uptake into peripheral tissues, inhibits hepatic glucose output and glucagon secretion.

Ultimately reduces glucose in circulation

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9
Q

Insulin:

Rapid/Short Acting - Clin Use

A

Bolus Insulins:

Control of post-prandial hyperglycemia

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10
Q

Insulin:

Intermediate/Long Acting - Clin Use

A

Basal Insulins

Controls fasting hyperglycemia

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11
Q

Insulin:

Inhalant - Clin Use

A

In T1DM must be used with a long-acting insulin

Not used in Diabetic Ketoacidosis or patients with respiratory complications

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12
Q

Insulin:

Adverse Effects

A

Hypoglycemia
Wet Gain
Lipodystrophies

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13
Q

Insulin

Drug Interactions

A

Any drug that increases/decreases blood glucose

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14
Q

Rapid Acting Insulin:

Lispro - Dose

A

Peak 30-190 mins

Give SQ 15 before or immediately after meals

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15
Q

Rapid Acting Insulin:

Aspart - Dose

A

Peak 40-50 mins

Give SQ 5-10 mins before meals”

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16
Q

Rapid Acting Insulin:

Glulisine - Dose

A

Peak 45-48 mins

Give SQ 15 mins before or within 20m after a meal

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17
Q

Rapid Acting Insulin:

Lispro - Notes

A

Can mix with NPH (clear before cloudy) Approved for CSII

18
Q

Rapid Acting Insulin:

Aspart, Glulisine - Notes

A

Can mix with NPH:
Rapid before NPH (clear before cloudy) and inject immediately after mixing.
Approved for IV and CSII use

19
Q

Short Acting Insulin:

Regular - Dose

A

Admin 30 mins prior to meals using a tuberculin syringe

20
Q

Short Acting Insulin:

Regular - Notes

A

DOC for IV infusions U-500 dose is indicated for highly insulin resistant

21
Q

Intermediate Acting Insulin:

NPH - Dose

A

Admin NOT in relation to meals;

Looks cloudy

22
Q

Intermediate Acting Insulin:

NPH - Notes

A

Can mix with Aspart, glulisine, lispro and regular insulins

Greater risk of nocturnal hypoglycemia

23
Q

Long Acting Insulin:

Glargine, Detmir - Dose

A

No significant peak

Do not mix with other insulins or dilute

Less risk of nocturnal hypoglycemia than NPH

24
Q

Long Acting Insulin:

Detmir - Notes

A

Bound to Albumin

25
Q

Insulin Inhalant:

Afrezza - Dose

A

Admin prior to meals

26
Q

Insulin Inhalant:

Afrezza - Note

A

Considered Rapid Acting/Bolus

27
Q

Insulin Mixtures:

70/30 IAP/IA - Dose

A

Peak 1-4hrs

Admin within 15min before a meal Cloudy color

28
Q

Insulin Mixtures:

75/25 ILP/IL - Dose

A

Peak 1-6.5hrs

Admin 15mins before a meal Cloudy

29
Q

Insulin Mixtures:

50/50 ILP/IL - Dose

A

Peak 0.8-4.8hrs

Admin within 15mins before a meal Cloudy

30
Q

Insulin Mixtures:

70/30 NPH/Reg. Humalin - Dose

A

Peak 1.5-6.5hrs

Admin 30-45mins prior to meal Cloudy

31
Q

Insulin Mixtures:

70/30 NPH/Reg. Novolin - Dose

A

Peak 2-12hrs

Admin 30-45 mins prior to meal Cloudy

32
Q

Insulin Mixtures:

All - Notes

A

Do not mix with other Insulins

33
Q

Biguanides:

“Insulin Sensitizers”

A

Metformin

34
Q

Biguanides:

Metformin - MOA

A

Decreases hepatic glucose production, glycogenolysis, and enhances insulin sensitivity in fat and peripheral tissues:
Allows for an increased uptake of glucose into insulin sensitive tissues

35
Q

Biguanides:

Metformin - Clin Use

A

1st Line for T2DM

Poly Cystic Ovary Syndrome

36
Q

Biguanides:

Metformin - Adverse Effects

A

GI (upset stomach, diarrhea)
Metallic taste
Low risk of hypoglycemia
Lactic acidosis (rare)

37
Q

Biguanides:

Metformin - Contraindications

A

Scr >1.4 (F) >1.5 (M)

Risk of lactic acidosis: CHF 
Elderly with decreased CrCl
Active Liver dz
Chronic Alcohol Abuse
Sepsis
38
Q

Biguanides:

Metformin - Drug Interactions

A

Hold metformin if iodinated contrast is given

Cimetidine competes for renal secretion with metformin and can increase serum levels

39
Q

Biguanides:

Metformin - Dose

A

Immediate release and extended release dosing available

40
Q

Biguanides:

Metformin - Notes

A

Monitor for lactic acid increases, liver disease and chronic alcohol abuse

Pharm (5 decks)

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