Brainscape's Knowledge GenomeTM

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


See full index

Therapeutics 2 Exam 3 -Diabetes pt 2 > Insulin Treatment > Flashcards

Insulin Treatment Flashcards

1
Q

What is the origin for insulin biosynthesis?

A

Recombinant DNA

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

Which is the only insulin used as an IV formulation?

A

Regular

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

Why can NPH not be given as an IV?

A

It is a suspension

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

Why can glargine not be given as an IV?

A

Clear solution but it precipitates at physiological pH and stings when injected

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

Why can detemir not be given as an IV?

A

Clear solution but it binds albumin

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

Why can degludec not be given as an IV?

A

Clear solution but it causes severe hypoglycemia when given IV

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

Is insulin given in Type 1 or Type 2 diabetes?

A

BOTH
-especially Type 1

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

What fasting glucose levels indicate that insulin should be started?

A

High levels >280-300 mg/dL

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

What affect does insulin have on hyperkalemia?

A

Insulin pushes potassium back into cells
-this is used to treat hyperkalemia

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

What is a disadvantage to using pre-mixed insulins?

A

Cannot adjust the dosing of just one of the ingredients
(decreased individuality of dosing)

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

Arrange the routes of administration of insulin from fastest acting to slowest acting
(Include: IM, SQ, IV, Intranasal)

A

Intranasal > IV > IM > SQ

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

What are the three sites for insulin injection and how fast is the insulin absorbed at the sites?

A

Fastest: Stomach
Slowest: Buttocks, Thigh

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

How does temperature affect insulin absorption?

A

Heat increases insulin absorption and action

*do not want patient rubbing their injection site because it changes heat and blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does exercise/ massage affect insulin absorption and action?

A

Increases absorption and action

*do not want patients exercising right after injecting insulin

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

When making a mixture of insulin, which insulins should be drawn up first and second?

A

Short-acting should always be drawn up first

NPH should be drawn up second

(can make the insulin cloudy, contaminate it and lose the short-acting insulin effects if drawn up first)

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

How does U-500 insulin compare to U-100 insulin?

A

U-500 insulin has:

-Delayed onset and peak
-Longer duration of action
-Smaller volume
-Increased absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What affect does renal failure have on insulin action?

A

Renal failure decreases insulin clearance
**this INCREASES insulin action

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What percent of insulin metabolism occurs in the kidneys?

A

15-20%

19
Q

How does stress affect insulin clearance?

A

Increases clearance

20
Q

How long are insulin vials stable at room temperature?

A

28 days

21
Q

What is the one insulin that stays stable at room temperature longer than the others and how long does is stay stable?

A

Levemir

42 days

22
Q

When should OPENED insulin vials/pens be discarded?

A

After 28 days

23
Q

How long do prefilled insulin syringes that are being REFRIGERATED remain stable for?

A

28 days

24
Q

How long do prefilled insulin syringes that are at ROOM TEMPERATURE remain stable for?

A

10-28 days
**highly variable

25
Q

How long does the mixture of Regular/NPH insulin remain stable for?

A

7 days with refrigeration

26
Q

How long does the mixture of Aspart, Glulisine, or Lispro (ultra short-acting) with NPH remain stable for?

A

Hardly any time
GIVE IMMEDIATELY

27
Q

Can you create a mixture with Degludec, Detemir, or Glargine (long-acting) with any other insulin?

A

NO

28
Q

Can excessive alcohol cause hypo or hyper glycemia?

A

Hypoglycemia

29
Q

What glucose level is considered Level 1 hypoglycemia?

A

<70 mg/dL

30
Q

What glucose level is considered Level 2 hypoglycemia?

A

<54 mg/dL

31
Q

What glucose level is considered Level 3 hypoglycemia?

A

Severe event with altered mental and/or physical functioning that requires another person for recovery

32
Q

What affect do beta blockers have on hypoglycemia?

A

Decrease responsiveness to hypoglycemia through blocking sympathetic warning symptoms

33
Q

What is the Rule of 15’s used for?

A

Hypoglycemia treatment

34
Q

What is the rule of 15’s?

A

When a person is hypoglycemic:

  1. Start with 15 gm of fast-acting carbohydrates
    **Unless BS < 50mg/dL (then use 30gm)
  2. Wait 15 minutes then check BS again

3.If BS is not >79 mg/dL repeat with another 15gm

  1. Follow up with a complex carbohydrate
    (eat meal if it is within the hour OR eat a 30gm snack if meal is > 1 hour away)

For level 2 or 3 patients:
Use glucagon (Intranasal, SQ, IM, or IV)

35
Q

What are examples of 15 gm of fast-acting carbs that can be eaten during hypoglycemia?

A

4 oz OJ
6 oz Cola (not sugar free, not the whole can)
5-6 lifesavers
2 tsp sugar (real sugar)
1 tbs honey
Glucose tablets (4-5 gm of carbs per tablet)
Glucose gel (great if patient cannot chew)

36
Q

What blood sugar are we aiming to be above that signals the end of a hypoglycemic episode?

A

> 79 mg/dL

37
Q

What affect does insulin have on weight?

A

Causes weight GAIN
5-10 pound gain is typical

38
Q

What causes lipohypertrophy?

A

Repeated injections of insulin to the same site

39
Q

What is/causes lipoatrophy?

A

Concavities caused by destruction of fat from antibodies or an allergic reaction to insulin
-rare

40
Q

What are the advantages of Glulisine, Lispro, and Aspart insulin analogs?

A

-Decreases post-prandial hypoglycemia
-Superior postprandial lowering of blood sugars
*Less overall hypoglycemia
-Flexibility

41
Q

What are the advantages of Glargine, Detemir, and Degludec insulins?

A

24+ hour coverage with constant absorption patterns and no pronounced
peaks

May benefit patients suffering from nocturnal hypoglycemic episodes

42
Q

The DEVOTE trial showed that which insulin (degludec or glargine) is MORE likely to cause hypoglycemia?

A

Glargine

43
Q

Which of the long-acting insulins is the shortest acting and may require BID dosing?

A

Detemir

44
Q

What are the side effects of Afrezza?

A

-Cough
-Acute bronchospasm
-Upper Respiratory Infection
-Decreased pulmonary function
-Lung Cancer
-Throat pain/irritation
-Hypersensitivity reactions

Therapeutics 2 Exam 3 -Diabetes pt 2 (8 decks)

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