Drugs For Diabetes

Question 1

What are short duration/rapid acting insulins?

Answer 1

Insulin lispro, aspart, and glulisne

Question 2

What is the onset, peak, and duration of insulin lispro?

Answer 2

Onset: 15-30 min
Peak: 0.5-2.5 hours
Duration: 3-6 hours

Question 3

What is the onset, peak, and duration of insulin aspart (NovoLog)?

Answer 3

Onset: 15-20 min
Peak: 1-3 hours
Duration: 3-5 hours

Question 4

What is the onset, peak, and duration of insulin glulisine?

Answer 4

Onset: 10-15 min
Peak: 1-1.5 hours
Duration: 3-5 hours

Question 5

What are the short duration/slower acting insulins? Onset, peak, and duration?

Answer 5

Regular insulin
Onset: 30-60 min
Peak: 1-5 hours
Duration: 6-10 hours

Question 6

What insulin is classified as intermediate duration? What is its onset, peak, and duration?

Answer 6

NPH insulin
Onset: 60-120 minutes
Peak: 6-14 hours
Duration: 16-24 hours

Question 7

What are long duration insulins? What are their onset, peak, and duration times?

Answer 7

Insulin glargine (Lantus)
Onset: 70 minutes
Peak: none
Duration: 18-24 hours

Insulin detemir (Levemir)
Onset: 60-120 minutes
Peak: 12-24 hours
Duration: Varies

Question 8

What insulin is considered ultralong duration, and what is its onset, peak, and duration?

Answer 8

Insulin degludec
Onset: 60 min
Peak: none
Duration: 42 hours

Question 9

When do you administer insulin lispro, aspart, and glulisine?

Answer 9

Lispro is given within 15 minutes before or just after meals.

Aspart is given 5-10 minutes before meals.

Glulisine is given within 15 min before meals or within 20 min after.

Question 10

When should NPH be administered?

Answer 10

Twice daily at the same times each day; gently agitate before use

Question 11

When should regular insulin be administered?

Answer 11

30 min before meals

Question 12

Insulins glargine and insulin detemir are administered _____ or _____ daily at the same time each day.

Answer 12

Once or twice

Question 13

When should insulin degludec be given?

Answer 13

Once daily at the same time each day

Question 14

Which insulins can be mixed together? How should this mixture be prepared?

Answer 14

Only NPH insulin is appropriate for mixing with short-acting insulins (lispro, regular, aspart, and glulisine).

The short-acting insulin should be drawn into the syringe first to avoid contaminating the stock vial of the short-acting insulin with NPH.

Question 15

What non-insulin injectable drugs are used for type II diabetes?

Answer 15

Incretin mimetics (exenatide, liraglutide, albiglutide)

Amylin mimetics (pramlintide)

Question 16

What is the black box warning for Liraglutide?

Answer 16

It has been associated with development of thyroid C-cell cancer. The drug is contraindicated in patients with a family history of MTC and in those with multiple endocrine neoplasia syndrome type 2.

Question 17

What is the black box warning for pramlintide?

Answer 17

It poses a risk for severe hypoglycemia when combined with insulin, especially in patients with type I diabetes.