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Pharmacology > Insulin > Flashcards

Insulin Flashcards

1
Q

What are the aims of insulin therapy

How is this achieved

A

Mimic normal insulin release:
Continuous basal secretion
Surges at mealtimes

Use of different formulations that have different rate of absorption
By modifying insulin structure: add aspartate, long FA chains

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2
Q

How is insulin administered and why

A

Parenterally - Subcutaneous injection

It will be digested in GIT

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3
Q

What are the categories of insulin

A 
Rapid acting
Short acting
Intermediate acting
Long acting 
Very long acting
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4
Q

What are the types of rapid acting insulin

A

Humalog - insulin lispro

Novorapid - insulin aspart

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5
Q

What are the time of onset, peak, duration of rapid acting insulin

A

10 mins
1 hour
4-6 hours

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6
Q

When do you use rapid acting insulin

A

Mealtimes - bolus dose before each meal

Acute hyperglycaemia - IV admin

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7
Q

What are the types of short acting insulin

A

Actrapid

Humulin S

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8
Q

What are the times of onset, peak, duration of short acting insulin

A

30 mins
3 hours
8-10 hours

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9
Q

When do you use short acting insulin

A

Mealtimes - bolus dose 30mins before each meal

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10
Q

What are the types of intermediate insulin

A

Isophane
Isulatard
Humulin

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11
Q

What are the times of onset, peak, duration of intermediate insulin

A

2 hours
4-8 hours
12-20 hours

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12
Q

When do you use intermediate insulin

A

Between meals
Overnight
In premixed preparations with rapid acting insulin
(Basal insulin)

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13
Q

What precaution do you need to take with use of intermediate acting insulin for overnight control

A

Must eat before bed

To avoid nocturnal hypoglycaemic episode bc Peaks in the night

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14
Q

What are the types of long acting insulin

A

Glargine
Detemir
Degludec

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15
Q

What are the times of onset, peak, duration of long acting insulin

A

2 hours
24 hours
Peakless

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16
Q

What is the benefit of long acting insulin being peakless

A 
Less risk of hypoglycaemia 
More physiological (basal insulin release)
17
Q

What is insulin pump therapy

A

Continuous SC insulin infusions that deliver continuous basal infusion and patient-activated bolus dose

18
Q

What are the indications of insulin pump therapy

A

When fail to achieve HbA1c despite careful management

Multiple injections caused disabling hypoglycaemia

19
Q

What are the benefits of insulin pump therapy

A

Constant delivery of insulin

Release more adapted to daily activity

20
Q

What are the main side effects of insulin therapy

Why do they occur

A

Hypoglycaemia - overdose, inadequate calorie intake

Lipodystrophy - insulin promotes fatty tissue growth

21
Q

What are the types of premixed preparations

What are the components

A

Novomix 30: 30% insulin aspart, 70% insulin aspart protamine
Humalog mix25: 25% insulin lispro, 75% lispro protamine
Humulin M3: biphasic isophane insulin - 30% short acting, 70% intermediate acting

22
Q

What is the mechanism of action of premixed preparations

A

Rapid acting insulin provides bolus release

Isophane insulin provides basal release

23
Q

What are the main types insulin regimen

A

BD biphasic regimen
QDS regimen
Once-daily before-bed long acting regimen

24
Q

What is used in the BD biphasic regimen and when is it indicated

A

Twice daily premixed insulin (Novomix 30)

T1 and T2 with regular lifestyle

25
Q

What is used in QDS regimen and when is it indicated

A

Rapid acting insulin QDS before meals and long acting insulin before bed

T1 to achieve flexible lifestyle
Insulin regimen of choice for all adults

26
Q

What is used in Once daily long acting insulin regimen and when is it indicated

A

Glargine, Detemir

Initial regimen for T2 when switching from oral hypoglycaemic agents
Basal insulin therapy for T1 when BD insulin Detemir contraindicated

Pharmacology (19 decks)

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