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D&T3 Exam 1 > Diabetes-valentovic > Flashcards

Diabetes-valentovic Flashcards

1
Q

Rapid acting

Types

A

Aspart

Glulisine

Lispro

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2
Q

Rapid acting

Onset, peak, duration

A

5-15min

30-90min

<5h

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3
Q

Short acting

Types

A

Regular insulin

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4
Q

Short acting

Onset, peak, duration

A

30-60 min

2-3hr

5-8hr

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5
Q

Intermediate acting

Types

A

NPH insulin (protamine (protein))

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6
Q

Intermediate acting

Onset, peak, duration

A

1-4hr

4-10hr

10-18hr

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7
Q

Long acting

Types

A

Detemir

Glargine

Degludec

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8
Q

Long acting

Onset, peak, duration

A

0.5-4hr

No peak

18-23 hr (degludec is 42hr)

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9
Q

Aspart

A

Absorbed 3x faster from subcutaneous site than regular insulin

Inject just prior to meal

Injected subq, pump and IV

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10
Q

Aspart

Compatibility

A

Only compatible with NPH insulin

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11
Q

Lispro

Modification

A

Inversion of amino acids proline-lysine at positions 28 and 29 of beta chain

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12
Q

Lispro

A

Monomer

Inject sc, pump, IV

15 min before meal or just after

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13
Q

Lispro

Compatibility

A

Compatible only with NPH insulin in the syringe

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14
Q

Glulisine

A

Inject sc, pumps, IV

Compatible only with NPH

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15
Q

Short acting insulin

Administration

A

Sc, pump, IV, IM

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16
Q

Isophane insulin suspension (NPH)

What is it?

A

Crystallized insulin complexed with pro taming and zinc

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17
Q

Detemir

Modification

A

B30 amino acid threonine omitted and a 14 carbon fatty acid is attached to the B29 amino acid

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18
Q

Detemir

Effects on insulin

A

Constant level of insulin similar to a basal insulin level, no peak

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19
Q

Glargine

A

Onset in 1 hr but constant response

Single injection provides flat level of insulin for 24 hr

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20
Q

When do you have an inc insulin requirement?

A

Fever

Hyperthyroidism

Surgery

Trauma

Infection

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21
Q

When do you have a decreased insulin requirement?

A

N/v

Hypothyroidism

Renal impairment

Liver impairment

22
Q

Insulin

ADR

A

Hypoglycemia MC

(Sx: sweating, dizziness, nervousness, tremor, hunger)

Hyperglycemia, insulin allergy, lipodystrophies

23
Q

Synthetic amylin analog

Pramlintide

Use

A

Approved for type 1 and 2 diabetics

Injected sc

24
Q

Synthetic amylin analog

Pramlintide

ADR

A

Hypoglycemia

Don’t mix with insulin in same syringe

DONT USE IN DIABETIC WITH GASTROPARESIS

25
Q

Stimulate insulin release

A

Sulphonylureas and meglitinides

Chlorpropamide, glyburide, repaglinide, nateglinide

26
Q

Dec hepatic glucos

A

Biguanides

Metformin

27
Q

Dec carbohydrate absorption

A

A-glucosidase inhibitors

Acarbose, miglitol

28
Q

Peripheral cell insulin sensitized

A

Thiazolinediones

Pioglitazone

29
Q

Amylin analogs

A

Amylin analogs

Pramlinitide

30
Q

Glucagon-like analog

A

Glucagon like peptide 1 agonist

Exanatide and liraglutide

31
Q

Dipeptidyl peptidase IV (DPP-4) inhibitor

A

DPP-4 enzyme inhibitor

Sitagliptin, saxagliptin

32
Q

Inc glucose excretion

A

Sodium-glucose co transporter 2 (SGLT2) inhibitor

Canagliflozin

33
Q

Sulphonylureas

MOA

A

Binds to cell surface receptor, stimulates insulin release

34
Q

Sulphonylureas

Types

A

1st gen: chlorpropamide and tolbutamide

2nd gen: glimepiride and glyburide

35
Q

Slphonylureas

First and 2nd gen oral hypoglycemics

Uses

A

Type II diabetes

Central diabetes insipidus (chlorpropamide in patients who cannot tolerate desmopressin)

36
Q

Slphonylureas

First and 2nd gen oral hypoglycemics

ADR

A

Hypoglycemia

Contraindication: ketoacidosis must use insulin

37
Q

Slphonylureas

First and 2nd gen oral hypoglycemics

Contraindications

A

DKA

38
Q

Meglitinides (repaglinide, nateglinide)

MOA

A

Stimulates pancreatic insulin release

39
Q

Meglitinides (repaglinide, nateglinide)

Use

A

Type II diabetics that are ketoacidosis resistant

40
Q

Meglitinides (repaglinide, nateglinide)

ADR and contraindications

A

Hypoglycemia

Can’t use in DKA, must treat with insulin

41
Q

Biguanides (metformin)

MOA

A

DOES NOT AFFECT INSULIN SECRETION

DOES NOT CAUSE HYPOGLYCEMIA

42
Q

Metformin

Can cause…

Unique

A

B12 deficiency

43
Q

Thiazolinediones (pioglitazone and rosiglitazone)

ADR

A

Hepatic dysfunction, elevated transminase levels

Monitor liver enzymes!

Edema

BLACK BOX: may worse heart failure

Contraindicated in moderate to severe heart failure

44
Q

Glucagon like peptide-1 (GLP-1) Agonists (exenatide, liraglutide and dulaglutide)

Use

A

Inject sc

Can be combined with meformin, sulphonylureas or metaglinides

45
Q

Glucagon like peptide-1 (GLP-1) Agonists (exenatide, liraglutide and dulaglutide)

BLACK BOX

A

Thyroid cancer

46
Q

Glucagon like peptide-1 (GLP-1) Agonists (exenatide, liraglutide and dulaglutide)

Contraindications

A

Liraglutide: family history of thyroid cancer

47
Q

Dipeptidyl peptidase 4 (DPP-4) inhibitors (alogliptin, saxagliptin and sitagliptin)

Precautions

A

Reduce dose when used with a cyp3a4 inhibitor

Ketoconazole, atazanvir, erythromycin

48
Q

Sodium-glucose co-transporter (SGLT2) inhibitors (canagliflozin and dapagliflozin)

MOA

A

Enhances urinary glucose excretion (PCT)

49
Q

Sodium-glucose co-transporter (SGLT2) inhibitors (canagliflozin and dapagliflozin)

Use

A

Type II diabetes

50
Q

Sodium-glucose co-transporter (SGLT2) inhibitors (canagliflozin and dapagliflozin)

Contraindications

A

Severe renal dysfunction

Warning for inc ketoacidosis

D&T3 Exam 1 (19 decks)

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