Diabetes And Insulin Preparations Flashcards
What is prepared for diabetic patients with physiologic level of zinc and no added protein, thus readily soluble and rapidly absorbed. Onset in 1/2-1 hour, peak in 2-4 hr, duration 5-8 hours? Given via injection or can be IV (a peptide)
Regular insulin
Diabetes: an insulin complex with the protein protamine at neutral pH. Exhibits slower absorption, longer action than regular insulin (onset in 1-2 hr, peak 6-12, duration 18-24. This is a cloudy suspension that should not be given IV. What is it?
Isophane insulin suspension (NPH)
What is used in diabetic patients for a more immediate effect but with a shorter duration of action and must be injected prior to meals?
Regular insulin
The insulin receptor is on the cell _________ and is a tyrosine __________.
Surface, kinase
Hypoglycemia can result from…
Excess insulin, inadequate food intake, or excess physical activity.
Synthetic insulin whose kinetics most closely resemble physiological, with peak at 30-60 min, duration 3-4 hr. Can be injected immediately before meals- less risk of hypoglycemia. Lys-Pro in place of Pro-Lys. What is it?
Insulin lispro (required). Also aspart and glulisine are rapid short analogs.
A synthetic insulin formulated with zinc at pH=4 to slow dissolution. Clear solution that precipitates in subQ tissue. Very slowly absorbed for very long, low, constant action. Administered once a day SQ. Early evidence of slight increased cancer risk. What is it?
Insulin glargine (required). Also detemir in long acting.
What drug form is administered IM or SC for severe hyperglycemia. It is a counter-regulatory hormone to insulin. A peptide hormone, released from pancreas in response to hypoglycemia. Increases glucose, by opposite metabolic effects of insulin.
Glucagon
Should insulin glaring be mixed with detemir in same syringe with regular insulin or rapid insulins?
No- this can slow absorption. But these drugs can be used in combo, just not mixed
What is an analog of Amylin, a peptide hormone released from beta cells along with insulin?
Pramlintide acetate
What does Pramlintide acetate do?
- Decreases post-prandial glucose, thus decreases short-acting insulin requirement.
- Slows gastric emptying, increases satiety, which avoids weight gain seen with insulin.
Pramlintide acetate is used in type 1 and 2 diabetics on insulin who lack adequate control with insulin alone. How is it given? What are side effects?
- injected SC before meals, along with insulin.
- SE: increase risk of hypoglycemia, avoid in pts with decreased GI motility or absorption, avoid in pts with renal disease because renal excretion.
