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Pharmacology > Diabets 2 > Flashcards

Diabets 2 Flashcards

1
Q

What function does insulin serve

A

inhibit hepatic glucose productionstimulates glucose storagefacilitates glucose transport into cells

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2
Q

what are the 3 rapid acting insulins

A

Lispro (humalog)aspart (novalog)glulisine (apadria)

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3
Q

what are the short acting insulins

A

novolinhumulin

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4
Q

what is an intermediate acting insulin

A

NPH

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5
Q

what are the long acting insulins

A

glargine (lantus)dentimir (levamir)

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6
Q

what is so special about glargine compared to other insulin

A

last for 24 hours

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7
Q

what is the function of insulin analogs

A

targets post prandial glucoses

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8
Q

what is the purpose of basal insulin

A

provide peakless and prolonged insulin coverage

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9
Q

what are the PRO’s of rapid acting insulin

A

better post prandial glucose controllower freq of hypoglycemia in type 1convient can inject before or after meal

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10
Q

what are the CON’s of rapid insulin

A

Expensivecan not be give PRIOR TO HIGH FAT MEAN BECAUSE OF RISK OF HYPOGLYCEMIA

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11
Q

what are the PRO’s of short acting insulin

A

no prescription neededFairly inexpensiveonly insulin that can be used IVprovides some basal coverage

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12
Q

what are the CONs of short acting insulin

A

absorbed TOO SLOWLY to match rate of glucose after mealPost prandial hyperglycemiaNeeds to be used 30-45 min prior to meanrelatively long duration late post meal hypoglycemia

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13
Q

What are important things to know about NPH

A

dosed twice dailypeak thus can cause hypoglycemiacan be mixed

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14
Q

what is important to know about glargine

A

dosed oncemay not always provide 24 hour glucose coverageno peaks less hypoglycemiaCAN NOT BE MIXED

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15
Q

what is important to know about detemir?

A

duration is a little longer than NPHMay require 2x day dosingsmaller peak than NPHless variability compared to NPH

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16
Q

What are the considerations to using insulin with diabetics

A

patients with A1C>8%Type II may require higher doses of insulin that Type 1

17
Q

Who do you have to be more careful with increasing 1 unit of insulin with

A

Type 1 because it may have more drastic result and cause hypoglycemia

18
Q

how is dosing determined for insulin

A

50% of daily dose is provided as basal (glargine)50% daily as bolus insulin which gets divided into 3 for Bfast,lunch,dinnercan be given before or after mealsNO MEAL NO BOLUS

19
Q

when would you consider dosing adjustments

A

correct dosingdiet changesexercise and activitywight loss/gainhypoglycemia or hyperglycemiamed changes

20
Q

how much does 1 unit of insulin drop the blood glucose by

A

30-60mg/dl

21
Q

what is the carbohydrate rule

A

500 rule500/total daily dose=xgrams of carbs covered by 1unit of insulin

22
Q

what is the rule for post meal adjustment

A

15001500/total daily dose=Xgrams of glucose that will be lowered by 1 unit of insulin

23
Q

how do we choose insulin regimen

A

patient willingnesspatient adaptabilitylifestyleglycemic patterns

24
Q

what is the somogyi effect

A

early moring glucose followed by rebound hyperglycemiatreat by reducing insulin

25
Q

what is the dawn phenomenon

A

relative resistance to insulin in the early morning because of regulatory hormones

26
Q

what should you have a diabetic do on their sick days?

A

continue normal diabetic meds/insulin and may require more insulincheck glucose levels more frequentlystay hydrated

27
Q

what are the side effects of insulin

A

Hypoglycemiasweating, tachycardia, palitations, tremors, headache, confusionnightmares, night sweatsWeight gainfat deposit under injection site

28
Q

how do you treat the side effects of insulin

A

rule of 15take glucose tablets15grams of glucose will raise blood sugar by 15 points in 15minglucose gelorange juiceglucagon pen is unconscious

29
Q

how should insulin be stored

A

refrigeratorcan store at room temp for 28 daysNPH refrig up 21days

30
Q

how do you draw up clear and cloudy insulin

A

clear before cloudyclear are usually rapid acting and cloudy are longer lasting

Pharmacology (14 decks)

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