Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Insulin in DM > Flashcards

Insulin in DM Flashcards

1
Q

T/F Insulin therapy has CHF risk

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is two major ADE of insulin therapy

A
  1. Hypoglycemia

2. Weight gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

MOA of NPH?

A

NPH – insulin bound with protamine and zinc –less soluble with longer duration of action

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

MOA of Detemir?

A

Detemir - fatty acid side change added - binds to albumin – slows absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

MOA of glargine?

A

Glargine – low solubility at neutral pH forming a precipitate in SQ tissue - slows absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

MOA of degludec?

A

Degludec – long chains of hexamer in SQ tissue depot - leads to slow release for absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

MOA of Lispro, Asport, and Glulisine?

A

rapid acting

Altered DNA sequence of amino acids decreases formation of hexamer and will increase absorption and onset of action

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the raid acting drugs?

A

Lispro, Aspart, Glulisine
All are analogs
28 day room temp expiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which short acting insulin has a 42 day expiration?

A

Novolin R

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are 2 premixed insulin/GLP-1R antagonist

A

degludec/liraglutide: prefilled pen

Glargine/Lixisenatide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

If inuslin therapy is needed what do you start?

A

consider GLP-1R antagonist sub Q
or
basal insulin or bedtime NPH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What can you add if A1C is still elevated and NPH and basal insulin is already started?

A

add prandial insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is starting point for insulin therapy in Type I DM?

A
  • Must begin basal-bolus insulin
  • Basal-bolus therapy includes a basal insulin for fasting and post absorptive control
  • -Rapid acting bolus insulin for mealtime
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is starting point for insulin therapy in Type II DM?

A

May begin with background/basal insulin with usually metformin +/- GLP-1
-If all things else are accounted for and yet A1c and blood sugars are increasing Consider dosing insulin for both basal first and add bolus (mealtime) as needed
-If economics is a factor
Use of the traditional insulins NPH and R can be prescribed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is starting point for insulin therapy in Type II DM?

A

May begin with background/basal insulin with usually metformin +/- GLP-1
-If all things else are accounted for and yet A1c and blood sugars are increasing Consider dosing insulin for both basal first and add bolus (mealtime) as needed
-If economics is a factor
Use of the traditional insulin NPH and R can be prescribed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

which injection site has best insulin absorption

A

abdomen

-give injection in same site of body and at the same time each day

17
Q

What is basal insulin replacement?

A
  • Approximately 40-50% of the total daily insulin dose is to replace insulin overnight, when you are fasting and between meals.
  • The basal or background insulin dose usually is constant from day to day
18
Q

What is bolus insulin?

A

The other 50-60% of the total daily insulin dose is for carbohydrate coverage (food) and high blood sugar correction.

19
Q

What are the use of traditional insulin?

A

improved adherence (less intense)
can achieve desired goal
financial concerns
requires patient eat consistent meals

20
Q

What can be some causes of not acheiving glucose control

A

too much insulin
injection technique
outdated product

21
Q

T/F The answer to all high glucose readings includes more insulin

A

False

22
Q

What is the site that is best for insulin injection

A

abdominal wall

should always give the insulin injection in the same region of the body and at the same time of the day each day

23
Q

How much carbs should men and women take per meal

A

women: 45-60
snack: 15
men: 60-75
snack: 15-30

24
Q

Which drugs cause weight gain? (6)

A 
steroids 
insulin, SU, TZD
Antiepileptic: gabapentin, VA
Antipsychotic: Clozapine 
Anti-depressants: TCA, mirtazapine
HIV HAART
25
Q

what is MOA or Orlistat?

A

reversibly inhibits gastric and pancreatic lipases and reduce absorption of fats,

26
Q

ADE of Orlistat?

A
  • don’t use in pregnancy
  • GI sx: flatulence, cramps, fecal incontinence, oily drops
  • can’t absorb vitamins ADEK
27
Q

MOA of Phentermine-topiramate?

A

hypothalamus releases epinephrine this causes suppressed appetite
-controlled substance

28
Q

ADE of Phentermine-Topiramate? (6)

A
  • abuse potential
  • taste disturbance
  • anxiety
  • depression
  • cognitive disturbance
  • insomnia
  • topiramate is teratogenic
29
Q

What are contraindications to Phentermine-topiramate? (4)

A

pregnancy
hyperthyroidism
glaucoma
MAO-I

30
Q

MOA of Bupropion-naltrexzone

A

regulates areas of the brain involved in food intake/hypothalamus and mesolimbic dopamine circuit

31
Q

ADE of Bupropion-Naltrexzone

A

transient increase in BP
insomnia
HA
dry mouth

32
Q

Contraindications to bupropion-naltrexzone?

A
  • uncontrolled HTN
  • seizure
  • pregnancy/breastfeeding
  • chronic opioid use
  • eating disorder
  • use of MOA-I within 14 days
33
Q

MOA Liraglutide in weight loss?

A
  • increases insulin secretion
  • decreases glucagon
  • slows gastric emptying
  • decreased food intake
34
Q

ADE of Liragltuide?

A
  • Gi sx-avoid dehydration
  • hypoglycemia
  • modest delay in gastric emptying

Pharmacology (47 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions