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Pharmocology > Endocrine Part 1-Diabetes- INSULIN.ppt > Flashcards

Endocrine Part 1-Diabetes- INSULIN.ppt Flashcards

1
Q

Which is Rapid Acting

a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)

A

a. Insulin lispro (Humalog®)
c. Aspart (Novolog®),
f. Glulisine (Apidra®)

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2
Q

Which is Regular Acting

a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)

A

e. Regular insulin (Humulin R®/Novolin R®)

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3
Q

Which is Intermediate Acting

a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)

A

g. Neutral Protamine Hagedorn (NPH)

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4
Q

Which is Long Acting

a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)

A

b. Insulin detemir (Levemir®)

h. Insulin glargine (Lantus®)

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5
Q

Which hormones play an important part in the Pancreas?

a. Estrogen
b. Insulin
c. Progesterone
d. Prolactin
e. Glucagon

A

b. Insulin

e. Glucagon

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6
Q

Which is stored insulin

a. Estrogen
b. Insulin
c. Progesterone
d. Prolactin
e. Glucagon

A

e. Glucagon

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7
Q

Excess glucose stored in liver and skeletal muscle tissue?

a. Glycogenolysis
b. Glycogen

A

b. Glycogen

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8
Q

Conversion of glycogen into glucose when needed?

a. Glycogenolysis
b. Glycogen

A

a. Glycogenolysis

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9
Q

Which is release when you eat food?

a. Estrogen
b. Insulin
c. Progesterone
d. Prolactin
e. Glucagon

A

b. Insulin

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10
Q

Which is released when your starving?

a. Estrogen
b. Insulin
c. Progesterone
d. Prolactin
e. Glucagon

A

e. Glucagon

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11
Q

Insulin does which of the following

a. Direct effect on fat metabolism
b. Stimulates lipogenesis and inhibits lipolysis
c. Stimulates protein synthesis
d. None

A

All

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12
Q

Which promotes intracellular shift of potassium (Hyperkalemia) and magnesium into the cells

a. Estrogen
b. Insulin
c. Progesterone
d. Prolactin
e. Glucagon

A

b. Insulin

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13
Q

Which is an autoinmmune disorder with insulin (dependent)

a. Type 1
b. Type 2

A

a. Type 1

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14
Q

Which is resistance to insulin (Highrer dose)

a. Type 1
b. Type 2

A

b. Type 2

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15
Q

Which means production of abnormally large volumes of dilute urine?

a. Polydipsia
b. Polyuria
c. Glycosuria
d. Polyphagia (hyperphagia)

A

b. Polyuria

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16
Q

Which is abnormally great thirst as a symptom of disease (such as diabetes) or psychological disturbance?

a. Polydipsia
b. Polyuria
c. Glycosuria
d. Polyphagia (hyperphagia)

A

a. Polydipsia

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17
Q

Which is the medical term for excessive or extreme hunge?

a. Polydipsia
b. Polyuria
c. Glycosuria
d. Polyphagia (hyperphagia)

A

d. Polyphagia (hyperphagia)

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18
Q

Which is a rare condition in which the simple sugar glucose is eliminated (excreted) in the urine despite normal or low blood glucose levels.

a. Polydipsia
b. Polyuria
c. Glycosuria
d. Polyphagia (hyperphagia)

A

c. Glycosuria

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19
Q

Diabetes Mellitus

Elevated fasting blood glucose (higher than ? mg/dL) or a hemoglobin A1C (HbA1C) level greater than or equal to ? %

A

126

6.5

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20
Q

Which are symptoms of Diabetes Mellitus?

a. Polyuria,
b. Polydipsia,
c. Polyphagia
d. Glycosuria
e. Unexplained weight gain
f. Unexplained weight loss
g. Fatigue
h. Blurred vision

A

a. Polyuria,
b. Polydipsia,
c. Polyphagia
d. Glycosuria
f. Unexplained weight loss
g. Fatigue
h. Blurred vision

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21
Q

A patient with Diabetes Mellitus what is the HbA1C must be?

A

Less than 7

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22
Q

The Fasting blood glucose ? to ? mg/dL is the goal for diabetic patients.

A

70

130

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23
Q

Fill in the blank
? = Normal
? = Prediabetes
? = Type 2 diabetes

A

<5.7
5.7 to 6.4
>6.5

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24
Q

Fasting blood glucose 70 mg/dL is ( hyperglycemia or hypoglycemia) and should you give insulin ? Y/N

A

hypoglycemia

No

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25
Q 
Which type of Diabetes Mellitus:
Lifestyle changes
ORAL drug therapy
Insulin when the above no longer provide glycemic control
a. Type 1
b. Tyoe 2
A

b. Tyoe 2

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26
Q

Which type of Diabetes Mellitus:
Insulin therapy
a. Type 1
b. Tyoe 2

A

a. Type 1

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27
Q

Insulin treats?

a. hyperglycemia
b. hypoglycemia
c. Type I
d. Type II
e. Hypokalemia
f. Hyperkalemia

A

a. hyperglycemia
c. Type I
d. Type II
f. Hyperkalemia

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28
Q

Insulin move what into our cells?

a. Estrogen
b. Insulin
c. Progesterone
d. Prolactin
e. Glucagon
f. Pottasium

A

e. Glucagon

f. Pottasium

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29
Q

Which shows the onset, peak, and duration of insulin?

a. Background Insulin replacement
b. Bolus Insulin Replacement
c. Natural Insulin Secretion

A

b. Bolus Insulin Replacement

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30
Q

Which insulin would you give a patient after they eat?

a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)

A

a. Insulin lispro (Humalog®)
c. Aspart (Novolog®),
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)

FAST & REGULAR

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31
Q

Rapid‑acting: Lispro insulin
◦ONSET: ? to ? min
◦PEAK: ? to ? hr
◦DURATION: ? to ? hr

A

◦ONSET: 15 to 30 min
◦PEAK: 0.5 to 2.5 hr
◦DURATION: 3 to 6 hr

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32
Q

Short‑acting: Regular insulin
◦ONSET: ? to ? hr
◦PEAK: ? to ? hr
◦DURATION: ? to ? hr

A

◦ONSET: 0.5 to 1 hr
◦PEAK: 1 to 5 hr
◦DURATION: 6 to 10 hr

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33
Q

Intermediate‑acting: NPH insulin
•ONSET: ? to ? hr
•PEAK: ? to ? hr
•DURATION: ? to ? hr

A
  • ONSET: 1 to 2 hr
  • PEAK: 6 to 14 hr
  • DURATION: 16 to 24 hr
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34
Q

Long‑acting: Insulin glargine
•ONSET: ? min
•PEAK:
•DURATION: ? to ? hr

A
  • ONSET: 70 min
  • PEAK: None
  • DURATION: 18 to 24 hr
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35
Q

Which insulin does not have a peak?

a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)

A

b. Insulin detemir (Levemir®)

h. Insulin glargine (Lantus®)

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36
Q

Which is true about administering insulin

a. Hyperglycemia is defined as <70 mg/dL
b. Consider holding if <130
c. Consider holding dose if patient not eating
d. Give dose if patient not eating

A

b. Consider holding if <130

c. Consider holding dose if patient not eating

37
Q

Which lab level should you check when patients are on insulin IV Drip?

a. Estrogen
b. Insulin
c. Progesterone
d. Prolactin
e. Glucagon
f. Pottasium

A

f. Pottasium

38
Q

Which Hemoglobin A1C 3monthaverage of glucose levels.
Would you use the average to administer insulin?
Y/N

A

No - do a need glucose screening!

39
Q

Which is insulin given 95 percent of the time?

a. Inhaled
b. Oral
c. IV
d. SQ
e. Rapid Insulin
f. Regular Insulin

A

d. SQ

40
Q

Which is insulin not given?

a. Inhaled
b. Oral
c. IV
d. SQ
e. Rapid Insulin
f. Regular Insulin

A

b. Oral

41
Q

Which come in a form of injections or pumps?

a. Inhaled
b. Oral
c. IV
d. SQ
e. Rapid Insulin
f. Regular Insulin

A

d. SQ

42
Q

Which is is a complication of type 2 diabetes. It involves extremely high blood sugar (glucose) level without the presence of ketones?

a. Diabetic ketoacidosis (DKA)
b. Hyperglycemic hyperosmolar syndrome (HHS)

A

b. Hyperglycemic hyperosmolar syndrome (HHS)

43
Q

Which is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. The condition develops when your body can’t produce enough insulin?

a. Diabetic ketoacidosis (DKA)
b. Hyperglycemic hyperosmolar syndrome (HHS)

A

a. Diabetic ketoacidosis (DKA)

44
Q

Which is given as a continuous infusion for HHS/DKA patients?

a. Inhaled
b. Oral
c. IV
d. SQ
e. Rapid Insulin
f. Regular Insulin

A

c. IV
e. Rapid Insulin
f. Regular Insulin

45
Q

Which is given to push to treat hyperkalemia or critically high glucose?

a. Inhaled
b. Oral
c. IV
d. SQ
e. Rapid Insulin
f. Regular Insulin

A

c. IV

e. Rapid Insulin

46
Q

Which is given for for emergency purposes

a. Inhaled
b. Oral
c. IV
d. SQ
e. Rapid Insulin
f. Regular Insulin

A

c. IV

47
Q

Which is a lump under the skin caused by accumulation of extra fat at the site of many subcutaneous injections of insulin?

a. Hypoglycemia
b. Lipo-hypertrophy
c. Hypokalemia
d. Weight gain

A

b. Lipo-hypertrophy

48
Q 
Which Insulins hav this adverse side effect?
Hypoglycemia
Lipo-hypertrophy
Hypokalemia
Weight gain
a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH) 
h. Insulin glargine (Lantus®)
A

All

49
Q

Which all insulin not Rotate injection sites weekly could cause?

a. Hypoglycemia
b. Lipo-hypertrophy
c. Hypokalemia
d. Weight gain

A

b. Lipo-hypertrophy

50
Q

With all insulins should educate your patients about

a. hypoglycemia
b. hyperglycemia

A

a. hypoglycemia

51
Q

Which all insulins the hypoglycemia is a risk during?

a. Onset
b. Peak
c. Duration

A

b. Peak

52
Q

Which treats diabetes?

a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)

A

All

53
Q

Which treats DKA/HHS & Hyperkalemia Emergencies

a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)

A

e. Regular insulin (Humulin R®/Novolin R®)

54
Q

Is it true that all insulins can be given by SQ? Y/N
If yes, which ones are only given with IV+SQ?
a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)

A

Yes

a. Insulin lispro (Humalog®)
c. Aspart (Novolog®),
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)

55
Q

All insulins are clear except? and why?

a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)

A

g. Neutral Protamine Hagedorn (NPH)/ Intermediate

because it is cloudy!

56
Q

Which insulin is cloudy?

a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)

A

g. Neutral Protamine Hagedorn (NPH)/ Intermediate

because it is cloudy!

57
Q

Which is Administer 15 minutes before a meal or with the meal

a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)

A

a. Insulin lispro (Humalog®)
c. Aspart (Novolog®),
f. Glulisine (Apidra®)

58
Q

Which Administer 30 minutes before a meal

a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)

A

e. Regular insulin (Humulin R®/Novolin R®)

g. Neutral Protamine Hagedorn (NPH)

59
Q

Which does not matter with or without food

a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)

A

b. Insulin detemir (Levemir®)

h. Insulin glargine (Lantus®)

60
Q

Which is given once a day

a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)

A

b. Insulin detemir (Levemir®)

h. Insulin glargine (Lantus®)

61
Q

What is true about SQ?

a. Small needle
b. Large needle
c. 23 to 25 gauge
d. 28 to 31 gauge
e. Shorter length
f. Larger length
g. Site: Arms, Thighs, Abdomen
g. Site: Deltoid, Thighs, Abdomen

A

a. Small needle
d. 28 to 31 gauge
e. Shorter length
g. Site: Arms, Thighs, Abdomen

62
Q

Cold insulin can cause ?

a. Hypoglycemia
b. Lipo-hypertrophy
c. Hypokalemia
d. Weight gain

A

b. Lipo-hypertrophy

63
Q

To avoid Lipo-hypertrophy

a. rotate sites ?
b. Each day, rotate around ? from previous site,
c. then go to new site after ? week

A

Weekly
½-1 inch
1

64
Q

Should you hold insulin if patient is having nausea or vomiting. Y/N

A

Yes

65
Q

If a patient is NPO before a procedure shoudl you check with provider before admistering insulin? Y/N

A

Yes

66
Q

Which is early signs of Hypoglycemia

a. Irritability
b. Sweating
c. SNS activation
d. Hypothermia,
e. tremor,
f. seizures
g. Coma and death will occur if not treated
h. Confusion

A

a. Irritability
b. Sweating
c. SNS activation
e. tremor,
h. Confusion

67
Q

Which are late signs of Hypoglycemia

a. Irritability
b. Sweating
c. SNS activation
d. Hypothermia,
e. tremor,
f. seizures
g. Coma and death will occur if not treated
h. Confusion

A

d. Hypothermia,
f. seizures
g. Coma and death will occur if not treated

68
Q

Should you always check Glucose levels first with Hypoglycemia. Y/N

A

Yes

69
Q

Hypoglycemia

a. Give ? grams of carbohydrates
b. Hospitals will always have ?
c. If at home, can do ? ounces of orange juice, ? oz of grape juice

A

15
glucose tablets
4
2

70
Q

What do you give If patient has altered mental status?

a. IV Normal Saline
b. IV glucose (DEXTROSE)
c. SQ Insulin
d. IM Glucagon

A

b. IV glucose (DEXTROSE)

d. IM Glucagon

71
Q

If a patient is Hypoglycemia should they?

a. Not eat food
b. Eat food

A

b. Eat food

72
Q

Which causes higher risk for HYPO event with Insulin?

a. Beta blockers
b. Diuretics
c. HCTZ (hydrochlorothiazide)
d. Steroids
e. Other diabetes med

A

e. Other diabetes med

73
Q

What can mask S/S of hypoglycemia + suppress the liver with insulin?

a. Beta blockers
b. Diuretics
c. HCTZ (hydrochlorothiazide)
d. Steroids
e. Other diabetes med

A

a. Beta blockers

74
Q

Which is known to cause HYPERglycemia with insulin?

a. Beta blockers
b. Diuretics
c. HCTZ (hydrochlorothiazide)
d. Steroids
e. Other diabetes med

A

b. Diuretics
c. HCTZ (hydrochlorothiazide)
d. Steroids

75
Q

Which is true about cloudy insulins?

a. You can use all insulins that appear cloudy
b. Neutral Protamine Hagedorn (NPH) (Intermediate) is the only insulin that cloudy.
c. Acceptable insulins mixed with Neutral Protamine Hagedorn can be cloudy.
d. Insulins besides NPH that appear cloudy are infused with bacteria.

A

b. Neutral Protamine Hagedorn (NPH) (Intermediate) is the only insulin that cloudy.
c. Acceptable insulins mixed with Neutral Protamine Hagedorn can be cloudy.
d. Insulins besides NPH that appear cloudy are infused with bacteria.

76
Q

What are the acceptable insulins that can be mixed with NPH SEPERATELY?

a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)

A

a. Insulin lispro (Humalog®)
c. Aspart (Novolog®),
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)

Rapid and Short

77
Q

Which can not be mixed with NPH

a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)

A

b. Insulin detemir (Levemir®)
h. Insulin glargine (Lantus®)
Long acting

78
Q

Which is true when you mix other insulins with NPH

a. Cloudy to Clear
b. Clear to Cloudy

A

b. Clear to Cloudy

79
Q

Put in order!

a. Put 10 units of air in Rapid Insulin
b. Put 10 units of air in NPH
c. Pull 10 units od NPH
d. Pull 10 units of Rapid Insulin

A

b. Put 10 units of air in NPH
a. Put 10 units of air in Rapid Insulin
d. Pull 10 units of Rapid Insulin
c. Pull 10 units od NPH

80
Q

In order to mix the suspension?

a. Shake the vials
b. Roll the vials

A

b. Roll the vials

81
Q

Which drugs can you shake?

a. Parental
b. Oral

A

b. Oral

82
Q 
What do the ratios Mean?
What does the bigger number mean?
Humulin 70/30
Novolin 70/30
Humalog 75/25
NovoLog 70/30
A

The number insulin inside.

The longer it takes for the insulin work through the body.

83
Q

Insulin
UNOPENED
a. Keep at room temp to avoid cold injection in your abdomen.
b. Can keep at room temperature
c. In general, keep insulin in refrigerator
d. Must discard after 28 days
e. Use normal expiration date on vial
f. Keep at Room Temp to avoid Lipo-hypertrophy
g. Keeping it refrigerated makes it last longer and prevents any bacterial growth

A

c. In general, keep insulin in refrigerator
e. Use normal expiration date on vial
g. Keeping it refrigerated makes it last longer and prevents any bacterial growth

84
Q

Insulin
OPENED
a. Keep at room temp to avoid cold injection in your abdomen.
b. Can keep at room temperature
c. In general, keep insulin in refrigerator
d. Must discard after 28 days
e. Use normal expiration date on vial
f. Keep at Room Temp to avoid Lipo-hypertrophy
g. Keeping it refrigerated makes it last longer and prevents any bacterial growth

A

a. Keep at room temp to avoid cold injection in your abdomen.
b. Can keep at room temperature
d. Must discard after 28 days
f. Keep at Room Temp to avoid Lipo-hypertrophy

85
Q

Which isa Preferred method of treatment for hospitalized patients with DM

a. Basal insulin
b. Bolus insulin
c. None

A

a. Basal insulin

b. Bolus insulin

86
Q

? insulin is a long-acting insulin (insulin glargine)

a. Basal insulin
b. Bolus insulin
c. None

A

a. Basal insulin

87
Q

? insulin (insulin lispro or insulin aspart)

a. Basal insulin
b. Bolus insulin
c. None

A

b. Bolus insulin

88
Q

What type of insulin would you use for in an Insulin Pump?

a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)

A

a. Insulin lispro (Humalog®)
c. Aspart (Novolog®),
f. Glulisine (Apidra®)

Pharmocology (36 decks)

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