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Pharm Test 6 > Insulin > Flashcards

Insulin Flashcards

1
Q

Insulin

A

Categorized according to their strength, onset of action, duration, and species source

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2
Q

Insulin strength

A

Most patients use U-100 (U-40 and U-500 are available). The numeral following the “U” indicates the number of units of insulin per milliliter

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3
Q

Source of Insulin

A

All insulins currently on market are “semi-synthetic” or “human” insulin (using recombinant DNA technology ) Some products are referred to as human insulin identical to insulin produced in pancreas (Humulin R, Humulin N, Humulin 70/30); Other products, referred to as human insulin analogs, are modified forms of human insulin (Humalog, insulin lispro):

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4
Q

Rapid Acting***

A

Trade Name: Humalog (insulin lispro) Onset: 15-30 min. Peak: 0.5-2.5 hrs. Duration: 3-6.5 hrs.

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5
Q

Short Acting

A

Trade Name: Humulin R Regular Onset: 30-60 min. Peak: 1-5 hrs. Duration: 6-10 hrs.

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6
Q

Intermediate Acting

A

Trade Name: Humulin N Levemir Onset: 60-120 mins Peak: 6-14 hrs. Duration: 16-24 hrs.

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7
Q

Levemir

A

Onset: 6-8 hrs. Peak: 12-24 hours

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8
Q

Long Acting

A

Trade Name: Lantus Onset: 70 min. Peak: NONE Duration: 24 hrs.

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9
Q

what insulin is given now

A

humlin or humalog

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10
Q

effects of rapid acting

A

immediate effects so blood glucose will drop fast so pt need to eat. don’t want pt blood glucose to bottom out

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11
Q

how many units of insulin depends on

A

blood glucose level

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12
Q

patients can be on both

A

rapid acting and intermediate acting

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13
Q

Humalog (insulin lispro)

A

rapid acting; Can be injected immediately before eating instead of 30 minutes before meals

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14
Q

Humalog (insulin lispro) eliminated

A

more quickly than regular

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15
Q

Humalog (insulin lispro) effects

A

begin 15-30 minutes

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16
Q

Humalog (insulin lispro) has a closer

A

approximation to physiologic insulin release

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17
Q

which insulin has less nocturnal episodes of hypoglycemia than regular insulin

A

Humalog (insulin lispro)

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18
Q

Which insulin can you administer close to meal times

A

Humalog (insulin lispro); Closer administration to meal times within 5-10 minutes; even shortly after the meal if necessary

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19
Q

Humulin R/Regular

A

short acting

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20
Q

Humulin R/Regular administered

A

subQ and can be given IV for hyperglycemia emergencies

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21
Q

Humulin R/Regular is for

A

routine treatment, given subQ before meals to control postprandial hyperglycemia

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22
Q

Humulin R/Regular effects

A

begin in 30-60 minutes, peaks 1-5 hours and persists up to 10 hours

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23
Q

Humulin N (Neutral Protamine Hagedorn) prepared

A

by conjugating regular insulin with protamine; the protamine decreases the solubility of NPH insulin and prolongs absorption (intermediate acting)

24
Q

Humulin N (Neutral Protamine Hagedorn) onset of action

A

is delayed and duration of action extended

25
Q

Humulin N (Neutral Protamine Hagedorn) given

A

twice daily to provide glycemic control between meals and during night

26
Q

Humulin N (Neutral Protamine Hagedorn) can be mixed with

A

with regular insulin (draw up regular first in syringe)

27
Q

Humulin N (Neutral Protamine Hagedorn) onset

A

60-120 min. Peaks: 6-14 hrs. Lasts 16-24 hrs

28
Q

Humulin N (Neutral Protamine Hagedorn) supplied

A

as a cloudy suspension

29
Q

if mixing humulin N with regular then draw up

A

regular (clear) insulin first then humlin N (cloudy)

30
Q

Lantus (insulin glargine)

A

long acting

31
Q

Lantus (insulin glargine) ia a

A

modified human insulin with a prolonged duration of action (at least 24 hours)

32
Q

Lantus (insulin glargine) given

A

once-daily subQ, recommended at night

33
Q

Lantus (insulin glargine) allows for

A

Allows for once-daily dosing; most like patient’s basal insulin release Lantus

34
Q

after injection of Lantus (insulin glargine) the

A

the acidic solution is neutralized, leading to formation of microprecipitates from which small amounts of insulin are slowly released; • Result is a relatively constant concentration over 24 hours with no pronounced peak

35
Q

Can you mix other types of insulin with Lantus?

A

no

36
Q

Does Lantus “look” funny?

A

YES, compared to NPH, it’s clear

37
Q

pt on lantus would also most likely been on what for meal time

A

rapid acting insulin

38
Q

when administering insulin you should know

A

your onset, peak, & duration times

39
Q

pts must _______ when receiving insulin

A

EAT

40
Q

Consider holding or lowering insulin dose if patient

A

is NPO…Consult physician

41
Q

when administering insulin look for

A

signs & symptoms of hypoglycemia

42
Q

signs & symptoms of hypoglycemia **

A

headache, light headedness; nervousness, apprehension, tremors; excess perspiration, cold, clammy skin; tachycardia, slurred speech, confusion

43
Q

signs of hypoglycemia appear when blood sugar level

A

is < 60 mg/dl (the more it drops the more pronounced the symptoms are

44
Q

pts must _______ when receiving insulin

A

EAT

45
Q

Consider holding or lowering insulin dose if patient

A

is NPO…Consult physician

46
Q

when administering insulin look for

A

signs & symptoms of hypoglycemia

47
Q

signs & symptoms of hypoglycemia **

A

headache, light headedness; nervousness, apprehension, tremors; excess perspiration, cold, clammy skin; tachycardia, slurred speech, confusion

48
Q

signs of hypoglycemia appear when blood sugar level

A

is < 60 mg/dl (the more it drops the more pronounced the symptoms are

49
Q

insulin keep at

A

room temperature but only for 1 month after opening (date). Keep Unopened bottles in refrigerator

50
Q

for injections absorption is

A

fastest in abdomen, then deltoid, thigh, and buttocks

51
Q

for injections rotating sites prevent

A

lipohypertrophy (increased swelling of fat tissue in skin) and lipoatrophy (loss of fatty tissue); • Rotation WITHIN on anatomic site is preferred

52
Q

The equivalency of 10-15 grams of glucose (approximate servings) are:

A

Four lifesavers ; 4 teaspoons of sugar ; 1/2 can of regular soda or juice (can be used for Treatment of Hypoglycemia)

53
Q

Once the acute episode of hypoglycemia has been treated,

A

a healthy, long-acting carbohydrate to maintain blood sugars in the appropriate range should be consumed. Half a sandwich is a reasonable option

54
Q

What if pt is hypoglycemic and is comatose & cannot take anything by mouth?

A

then use glucagon

55
Q

glucagon

A

causes a rapid release of glucose stores from the liver. It is an injection given intramuscularly to a patient who cannot take glucose by mouth. A response is usually seen in minutes and lasts for about 90 minutes.

56
Q

If glucagon is not available and the patient is not able to take anything by mouth,

A

emergency services (for example 911) should be called immediately. An intravenous route of glucose (Dextrose 50%) should be administered immediately.

Pharm Test 6 (10 decks)

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