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PHAR 152 > Diabetes (Slide Deck 3) > Flashcards

Diabetes (Slide Deck 3) Flashcards

1
Q

Which cells secrete insulin?

A

B Cells

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2
Q

What is cleaved to produce insulin + C-peptide?

A

Proinsulin

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3
Q

What are the three ways one could take insulin?

A
  • Syringes
  • Pen needles
  • Continuous subcutaneous insulin infusion (CSII)
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4
Q

What are the two types of pancreatic functions that’s release insulin?

A

Basal (Long term)
Bolus (Fast term)

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5
Q

What is the Onset of Insulin Aspart (NovoRapid) or biosimilars: Trurapi®Kirsty®)

A

9-20 minutes

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6
Q

What is the onset of insulin glulisine (s)

A

9-20 minutes

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7
Q

What is the onset of Insulin lispro (Humalog® U-100 & U-200 and biosimilar: Admelog® U- 100)

A

10-15 minutes

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8
Q

What is the onset of Faster-acting insulin aspart (Fiasp®)

A

4 minutes

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9
Q

What is the onset of insulin regular (humulin-R Novolin ge Toronto)

A

30 minutes

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10
Q

What is the onset of Insulin regular U-500 (Entuzity® (U-500)

A

15 minutes

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11
Q

When should Insulin regular (Humulin®-R, Novolin® ge Toronto, Hypurin R) be administered?

A

30-45 minutes prior to meal time to cover glucose excursions

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12
Q

When are the RAIA administered?

A

0-15 minutes prior to meals.

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13
Q

What is an advantage of RAIA vs short acting insulins?

A

More closely mimic endogenous insulin release

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14
Q

What are the advantages of RAIA’s?

A
  • Fasteronset
  • Quickerpeak
  • Shorter duration of action

Convenience and decrease hypoglycemia risk

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15
Q

What is the importance of the Insulin Lispro as compared to other products?

A

Has a higher concentration of insulin, but the units that you are injecting on the dose knob will be the same as the 100 units/ml and 200 units/ml (The injections quantities will be different, but the concentration be the same)

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16
Q

Who should use and what is Insulin regular U-500 (Entuzity® (U-500)?

A

Contains 500u/mL of insulin and is for those who require >200U/D

17
Q

What is the onset and duration of Intermediate-acting (cloudy) *Insulin neutral protamine Hagedorn (Humulin® N, Novolin® ge NPH)

A

1-3 hours and 18 hours

18
Q

What is the onset of, Insulin detemir U-100 (Levemir®), Insulin glargine U-100 (Lantus®); biosimilars: (Basaglar® Semglee®), Insulin glargine U-300 (Toujeo®), Insulin degludec U-100, U-200 (Tresiba®)

A

90 minutes

19
Q

What is the duration of U-100 glargine insulin?

A

24 hours

20
Q

What is the duration of detemir?

A

16-24 hours

21
Q

What is the duration of U-300 glargine

A

> 30 hours

22
Q

What is the duration of degludec

A

42 hours

23
Q

Which insulins do we need to hand roll and invert prior to injection?

A

Humulin N, Novolin NPG, Hypurin NPH

24
Q

Which insulin is dose dependant based off of weight?

A

Insulin Detemir

25
Q

How often is insulin Glargine U100 given?

A

OD or BID

26
Q

How often is Insulin NPH given?.

A

BID

27
Q

Which method of insulin injection is the least expensive?

A

Syringes and vials.

28
Q

What are two of the main adverse effects of insulin?

A

Hypoglycemia, weight gain

29
Q

What is a side effect that can occur when first starting Insulin?

A

Blurry Vision

30
Q

What are the 7 factors affecting absorption of insulin?

A

Exercise of injected area
Massage
Temp
Lipohypertrophy (Fat)
Dose
Renal function
Depth of injection

31
Q

Which insulins can be mixed and stored together?

A

R + NPH

32
Q

Which insulins can be mixed but must be administered immediately?

A

RAIA + NPH

33
Q

Which insulin cannot be mixed together?

A

LAIA

34
Q

How much will 1U of insulin decrease BG by?

A

2-3mmol over the next 2-4 hours

35
Q

When adjusting insulin what is the general rule of thumb?

A

Fix the lows first and then go from there

36
Q

If glucose is <4mmol/l overnight and is high in the morning this suggests?

A

Somogyi effect

37
Q

If glucose >4mmol/l in the morning, this suggests the

A

dawn phenomenon

38
Q

Somogyi Effect define

A

*Unrecognized nocturnal hypoglycemia that patient sleeps through; as a result the body ↑’s prod’n of counter-regulatory hormones & see rebound hyperglycemia

Morning glucose less then 4mmol

PHAR 152 (8 decks)

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