Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

FY1 Learning > Glycaemic Control > Flashcards

Glycaemic Control Flashcards

1
Q

List the rapid acting analogues

A

Humalog
Apidra
Novorapid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

List the short acting analogues

A

Acts Hastily
Actrapid
Humulin S (short)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

List Intermediate analogues

A

Intermediate Hyperglycaemic Intervention
Insulatard
Humulin I
Insuman basal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Long acting analogues

A

Long Long Time
Lantus
Levemir
Tresiba

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Difference between pre-mixed regular and analogue?

A

Regular: Comb OR M3
analogue: Mix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How often do you review insulin for adjustment?

A

Every 48 hours
DONT OMIT IT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

For basal-bolus, how do you manage…
Recurrent hyperglycaemia
Unexplained hypoglycaemia

A

Increase/Reduce dose prior to episode by 2-4 units (eg morning reading, alter nightime) for hyper/hypo respectively

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do you alter the following regimens in recurrent hyperglycaemia/hypoglycaemia
Basal bolus
Twice daily mixed analogues
Long-acting analogues +/- oral hypoglycaemics

A

General:
Increase/reduce the dose prior to the reading* time by 2-4 units (breakfast reading –> alter nightime dose)*

Long acting:
Fasting hyperglycaemia: Increase 2-4 units
Non-fasting hyperglycaemia: Consider short acting at mealtimes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In T2DM, what is the typical first line?

A

Metformin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What should be checked prior to metformin prescription?

A

Baseline eGFR
<45: Reduce dose
<30: Contraindicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the common side effects of metformin and how are they managed?

A

GI upset: trial MR form
Lactic acidosis: stop and seek advice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the alternatives to metformin?

A

DPP-4Is (gliptins)
Sulfonylureas (gliciazide)
SGLT-2Is (flozins)
Pioglitazone (can be problematic tho)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is step up treatment following first line

A

2nd line: + another agent
3rd line: + 3rd agent OR commence insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a basal-bolus regimen

A

Long acting insulin + Rapid/Short acting insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When is VRIII considered?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

For basal-bolus, how do you manage…
Recurrent hyperglycaemia
Unexplained hypoglycaemia

A

Increase/Reduce dose prior to episode by 2-4 units (eg morning reading, alter nightime) for hyper/hypo respectively

16
Q

When is VRIII considered?

A

Hyperglycaemic emergencies
Surgical procedures/diabetic patients
Major vascular events (eg MI): use DIGAMI
Post-CVA
Refractory/fluctuating hyperglycaemia

17
Q

How do you know what dose of VRIII to give?

A

Measure glucose
Check against local protocol

18
Q

How often does a new VRIII need to be made?

A

Every 24 hours

19
Q

What electrolyte is particularly important in VRIII administration?

A

Potassium
Insulin drives potassium IN to cells

20
Q

How do you switch a T2DM patient from VRIII to oral?

A

Commence oral at next meal
Stop VRIII 30 mins after admin and patient finished eating

21
Q

How do you recommence SC GLP-1s after VRIII

A

Same as oral meds (Give at meal, stop VRIII after 30 mins + patient has eaten)

22
Q

What are the particular considerations for the following when switching from VRIII:
Metformin
Sulfonylureas
Thiazolinediones
DPPP4s
SGLT-2I

A

Metformin: eGFR >45 + no sepsis, liver/cardiac failure
Sulfonylureas: reduced dose if less oral intake
Thiazolinediones: As per SU + check HF
DPP4s + SGLT-2I: Senior advice

23
Q

When to restart SC insulin?

A

Eating and drinking without N+V
Give background before stopping VRIII
Seek diabetic input if poor optimisation

24
Q

Outline VRIII to basal bolus switch

A

Fast-acting: inject at meal time, discontinue VRIII 30-60 mins later
If long acting stopped in error: continue VRIII until background given
Converting basal to SC: half dose in morning, overlap fasting and VRIII at next mealtime, continue insulin regmien as normal

25
Q

VRIII to twice daily

A

Re-commence SC before breakfast or evening meal ONLY
Overlap the switch over 30-60 mins

26
Q

VRIII to SC infusion

A

Basal rate continued: Keep VRIII for 30 min mealtime overlap
Stopped: start basal rate once eating and drinking. Stop VRIII after mealtime bolus.

27
Q

Dont recommence CSII at what time?

A

BEDTIME

28
Q

How can you calculate the SC insulin dose for a naive patient

A

Weight based: kgs x 0.5 (0.3 if frail, 4-5CKD, HPB failure)

VRIII stable phase: Avg hrly dose over last 6 hours x 20

29
Q

What are the uses of the…
GIK regimen
DIGAMI

A

Reduce perioperative hypokalaemia as part of insulin regime
Giving insulin-glucose infusion + SC insulin to MI patients to improve survival

FY1 Learning (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions