Injectables for DM

Question 1

Glucagon (endogenous)

Answer 1

Pancreas hormone
Secreted by alpha cells
Catabolic activity (breaking down)
Stimulates glycogenolysis (conversion of glycogen stored in liver back into glucose in blood)

Question 2

Insulin (endogenous)

Answer 2

Pancreas hormone
Secreted by beta cells
Anabolic activity (building up)
High glucose levels in blood –> insulin secreted –> insulin coverts glucose into glycogen –> glycogen stored in liver

Question 3

AEs of insulin (drug)

Answer 3

High-risk med - serious potential for fatal harm
Weight gain
Hypokalemia shift (drug stimulates uptake of K)
Hypoglycemia (CNS s/sx like confusion, irritability, tremors, diaphoresis)
Lipohypertrophy (from not rotating injection sites)

Question 4

Mixing insulin

Answer 4

Clear (rapid/reg) to cloudy (NPH)!

Question 5

Insulin mixtures

Answer 5

(Info from textbook) 
Bigger # longer-acting insulin, smaller # shorter-acting insulin 
Humulin: NPH + reg as 70/30 or 50/50
Humulog: NPH + lispro as 75/25
Novolog: NPH + aspart as 75/25

Question 6

Rapid-acting insulin

Answer 6

Incl Lispro, Aspart, Glulisine
Onset: 15-20 min
Peak: 40-90 min
Duration: 3-5 hr

Question 7

Reg-acting insulin

Answer 7

AKA short-acting insulin
Onset: 30-60 min
Peak: 80-120 min
Duration: 4-6 hr

Question 8

Intermediate-acting insulin

Answer 8

Incl NPH
*Cloudy* (all other insulins clear)
Onset: 2-4 hr
Peak: 6-12 hr
Duration: 14-16 hr

Question 9

Insulin Glargine

Answer 9

Long-acting (“basal”) insulin
Onset: 2-3 hr
Peak: PEAKLESS
Duration: 18-24 hr

Question 10

Insulin Determir

Answer 10

Long-acting ("basal") insulin
Some consider intermediate-acting insulin
Onset: 1-2 hr
Peak: 8-10 hr
Duration: 14-24 hr

Question 11

GLP-1 receptor agonists

Answer 11

Incl Exenatide, Liraglutide
Synthetic GLP agonists –> delay gastric emptying –> increase satiety, eat less
Weight LOSS
Boxed warning: thyroid tumors in rats/mice

Question 12

Glucagon

Answer 12

“Antidote” for hypoglycemia
Promotes hepatic glycogenolysis and gluconeogenesis –> raises blood glucose level
If someone w/DM passed out and not sure if hypo- or hyperglycemic, tx as hypoglycemic (or can kill them)

Question 13

GLP (endogenous)

Answer 13

Intestinal hormone (incretin hormone)
Glucagon-like peptide
Delays gastric emptying –> increases satiety, eat less

Question 14

GIP (endogenous)

Answer 14

Intestinal hormone (incretin hormone)
Gastric inhibitory peptide
Stimulates insulin secretion