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Diabetes Pharmacology > Insulin > Flashcards

Insulin Flashcards

1
Q

Which is the only insulin that can be administered intravenously?

A

Short Acting Insulin

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2
Q

What is the goal of rapid acting insulin?

A

Minimise post-prandial blood sugar rise

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3
Q

What is the goal of short acting insulin?

A

It works like natural insulin. Increases overall bodily ability to absorb glucose

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4
Q

When is short acting insulin administered?

A

Pre-prandially

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5
Q

What is the goal of intermediate acting insulin?

A

To control post prandial blood sugar after eating.

Helps regulate sugars throughout the day

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6
Q

What type of insulin has a high risk of causing hypoglycaemia?

A

Intermediate acting insulin

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7
Q

What is the onset time of Rapid acting insulin?

A

15 mins

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8
Q

What is the peak time of rapid acting insulin?

A

1-3 hours

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9
Q

What is the duration of Rapid Acting Insulin?

A

3-5 hours

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10
Q

What is the onset of short acting insulin?

A

30-60 mins

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11
Q

What is the peak time of short acting insulin?

A

2-3 hours

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12
Q

What is the duration of action of short acting insulin?

A

5-7 hours

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13
Q

What is the onset of action time for intermediate acting insulin?

A

60-90 mins

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14
Q

What is the peak time for intermediate acting insulin?

A

8-12 hours

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15
Q

What is the duration of action for intermediate acting insulin?

A

18-24 hours

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16
Q

What is the onset of action for Long Acting insulin?

A

4-8 hours

17
Q

What is the peak time of Long acting insulin?

A

10-30 hours

18
Q

What is the duration of action of Long acting insulin?

A

36+ hours

19
Q

What is the onset of action of insulin analogues?

A

1.1 hours

20
Q

What is the duration of action of Insulin analogues?

A

24 hours

21
Q

What is the peak serum time of insulin analogues?

A

None, they are designed to act uniformly

22
Q

What type of hormone is insulin?

A

Peptide Hormone

23
Q

As well as making cells permeable to Glucose, what other substances do cells become more permeable to in the presence of insulin?

A

Amino Acids
Fatty Acids
Electrolytes

24
Q

In the presence of insulin, cells in which tissues become “permeable” to glucose?

A 
Hepatic
Skeletal Muscle
Adipose
Myocardial
Uterine
25
Q

Insulin affects a number of metabolic pathways involving which substances?

A

Carbohydrates
Fats
Protein

26
Q

What is Glycogenolysis? Where does it occur?

A

Breakdown of Glycogen into sugars. Liver

27
Q

What is Glycogenesis?

A

Formation of glycogen from glucose

28
Q

Which processes relating to glycogen does insulin affect?

A

Increases glycogenesis

Inhibits glycogenolysis

29
Q

What is the mechanism by which insulin promotes fat storage?

A
  1. It promotes absorption of glucose by adipocytes
  2. Glucose gets broken down into products including A-glycerophosphate
  3. A-glycerophosphate together with free fatty acids ultimately leads to formation of triglycerides
30
Q

What is Lypolysis?

A

Triglycerides stored in fat cells break down into free fatty acids and glycerol and are released and transported to the liver to fuel certain metabolic pathways

31
Q

What waste products are produced by lypolysis?

A

Ketone Bodies

Acetate

32
Q

What advise should parents/carers/patients be given regarding insulin?

A

Trained to monitor blood glucose
Know signs of hypoglycaemia and how to rectify it
Driving precautions - may need to advise DVLA

33
Q

What blood sugar levels should be maintained for those using insulin?

A

Adults - Maintain between 4-9 mmol/l most of the time
Aim for 4-7 mmol/l Pre-prandial
Aim for <9 mmol/l Post prandial

34
Q

What is the goad of long acting insulin?

A

Consistent delivery of activity throughout the day; no peak in activity

35
Q

What is the first line recommendation for insulin?

A 
Patients with type 1 diabetes should be offered multiple daily injection basal-bolus insulin regimens as the first-line choice.
Insulin Detemir (long acting analogue) recommended - Alternative Insulin Glargine (long acting analogue)
Rapid acting insulin analogue for mealtime insulin
36
Q

What is the second line recommendation for insulin?

A

Twice daily mixed insulin regime.
Short acting insulin or rapid acting insulin analogue mixed with intermediate acting or long acting insulin analogue once or twice daily (before meals).

37
Q

Insulin Side Effects?

A

Fat hypertrophy at injection site;
local reactions at injection site;
transient oedema

Diabetes Pharmacology (2 decks)

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