Exam 1 - Insulin Analogs

Question 1

Which are the Ultra­Rapid Onset Short DOA drugs?

Answer 1

1. Insulin lispro ( Humalog )
2. Insulin aspart ( Novolog )
3. Insulin glulisine ( Apidra )

Question 2

What are the characteristics of Ultra­Rapid Onset Short DOA?

Answer 2

● Onset: 15 min (quickest)
● DOA: 2-­5 hr
● Can dose on sliding scale 
●Soluble(Clear)–can be used I.V.
● Use immed at start of meals

Question 3

Which are the Rapid Onset Short DOA drugs?

Answer 3

Regular (crystalline zinc) Insulin

Humulin R, Velosulin BR, Regular Iletin II

Question 4

What are the characteristics of Rapid Onset Short DOA drugs?

Answer 4

● Onset: 30 min
● DOA: 5­-7 hr
● Can dose on sliding scale 
●Soluble(Clear)–can be used I.V.
● Used IV in emergencies (ketoacidois)
● Inject S.C.  30­-60 min before meal

Question 5

Which are the Intermediate Onset Intermediate DOA drugs?

Answer 5

Neutral Protamine Hagedorn
( Humulin N, NPH Insulin, NPH IletinII)
(“Isophane Insulin Susp.”)
(Phosphate buffer)

Question 6

What are the characteristics of Intermediate Onset Intermediate DOA drugs?

Answer 6

● Onset: 2­-4 hr
● DOA: 10­-16 hr
● Suspension(crystalline insulin/zinc/protamine)
● Not used IV (S.C. only)
● Phosphate buffer
● Used to maintain fasting blood glucose levels

Question 7

Which are the Intermediate Onset Extended DOA drugs?

Answer 7

1. Insulin glargine (Lantus)
2. Insulin detemir (Levemir)
3. Insulin degludec (Tresiba)

Question 8

What are the characteristics of Insulin glargine (Lantus)?

Answer 8

● Onset: 1.1hr
● DOA: 24hr (peakless) 
● Clear soln. in vial at pH 4
(micro­ precipitates upon injection.) 
● Dose 1x daily at bedtime

Question 9

What are the characteristics of Insulin detemir (Levemir)?

Answer 9

● Onset: 2hr
● DOA: 22hr (peakless)
● Soluble( in vial and upon injection)
● Insulin derivative bound to a fatty acid which allows binding to subcutaneous albumin to extend duration of action

Question 10

What are the characteristics of Insulin degludec (Tresiba)?

Answer 10

● Attachment of a fatty acid via a glutamyl spacer to this insulin derivative favors multi­hexamer formation and additionally allows binding to circulating albumin
● Ultra­ long acting insulin analog (>42 hours)