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ILE I > ILE I U2 D2 > Flashcards

ILE I U2 D2 Flashcards

1
Q

Regular insulin onset

A

Rapid, 30 min

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2
Q

Reg insulin duration

A

1.5 hour

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3
Q

Reg insulin duration IV

A

30-60 min, HEXAMERS -> DIMERS

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4
Q

Reg insulin use

A

Ketoacidosis, surgery, diabetic coma

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5
Q

Reg insulin class

A

Rapid acting, short duration

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6
Q

Rapid acting insulin contains

A

Clear, small amount of zinc to improve stability and shelf life

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7
Q

Intermediate acting insulin contains

A

Protamine

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8
Q

Long acting insulins

A

Detemir, glargine

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9
Q

NPH

A

Neutral protamine hagedorn (from fish testes)

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10
Q

Protamine Insulin works by creating a ___

A

PZI - protamine:zinc complex

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11
Q

PZIs are more/less readily absorbed?

A

Less

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12
Q

Protamine insulin (PZI) onset

A

4-8 hours

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13
Q

Protamine insuline (PZI) duration

A

> 36 hours (peak at 14-28)

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14
Q

Use protein insulin in emergencies?

A

No

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15
Q

NPH insulin is ___ injection only

A

Intermittent (not continuous)

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16
Q

NPH has ___ duration

A

Intermediate

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17
Q

NPH onset

A

1-3 hours

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18
Q

NPH has ___ duration

A

short

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19
Q

NPH duration

A

12-16 hours

20
Q

70/30, 50/50 mixes are usually associated with which type of insulin

A

NPH

21
Q

NPH insulin use

A

Day-to-day

22
Q

NPH insulin in emergencies?

A

No

23
Q

Reg insulin type

A

rapid acting, short duration

24
Q

aspart insulin type

A

rapid acting, short duration

25
Q

lispro insulin type

A

rapid acting, short duration

26
Q

Glulisine insulin type

A

rapid acting, short duration

27
Q

NPH insulin types

A

intermediate acting

28
Q

Detemir/levemir type

A

long acting, slow onset

29
Q

glargine/lantus insulin type

A

long acting, slow onset

30
Q

ultralente insulin type

A

long acting, slow onset

31
Q

Insulin aspart

A

proline at position B28 has been replaced with an aspartate. This substitution, like with lispro, results in reduced hexamer formation and more rapid dissolution

32
Q

Novolog70/30 contains

A

70% insulin aspart protamine suspension and 30% insulin aspart.

33
Q

Insulin glulisine

A

B3 is replaced by lysine and the lysine in position B29 is replaced by glutamic acid, less hexameter formation, rapid dissolution
aster onset of action, higher initial plasma concentrations, and shorter duration of action than regular human insulin..

34
Q

Glulisine brand

A

Apidra

35
Q

Aspart brand

A

Novolog

36
Q

Which rapid acting insulin is intended for subcutaneous administration and to be used by an external infusion pump?

A

Glulisine

37
Q

Lantus (glargine)

A

A21 is replaced by glycine and two arginines are added to the C-terminus of the B-chain. Glargine has 86% the activity of human insulin.

38
Q

Injected lantus is what pH? Why is this important?

A

4, allowing for complete solubility for basic insulin derivative

39
Q

Insulin glargine administration

A

once, subq, at bedtime

40
Q

Levemir (detemir)

A

amino acid threonine in position B30 has been omitted, and a C14 fatty acid chain (myristic acid) has been attached to the amino acid B29 (Thr), imparting its long-acting properties.

41
Q

which insulin tightly binds to albumin?

A

levemir

42
Q

Triseba duration

A

up to 42 hours

43
Q

Triseba

A

Engineered human insulin with the deletion of Thr B30 and the addition of hexadecanoic acid to Lys B29 via a γ -L-glutamic acid linker

44
Q

Triseba pathway

A

DiHEXamers -phenol-> MultiHEXamers -Zn-> monomers

45
Q

Sliding Scale definition

A

progressive increase in the pre-meal or nighttime insulin dose, based on pre-defined blood glucose ranges. Sliding scale insulin regimens approximate daily insulin requirements

46
Q

What factors determine a sliding scale?

A
  1. Amount of carbs
  2. Basal (background) insulin doesn’t change
  3. Bolus insulin based on BG before meal or at bedtime
  4. Pre-mixed insulin based on BG before meals
47
Q

3 problems with sliding scales

A
  1. doesn’t accommodate changes in needs related to snacks, stress and activity.
  2. Counting carbs
  3. less effective in covering a pre-meal high blood sugar, because the high blood glucose correction and food bolus cannot be split.

ILE I (18 decks)

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