[PHARMA] INSULIN

Question 1

Insulin counter-regulatory hormones (5)

Answer 1

1-Glucagon
2-GH
3-Cortisol
4-Catecholamines
5-Thyroxine

Question 2

Drugs inducing diabetes (4)

Answer 2

1-Cortisol
2-OC
3-Thiazide diuretics
4-BB

Question 3

thiazides induce DM via

Answer 3

↓ insulin release

Question 4

BB induce DM via

Answer 4

glucose intolerance

Question 5

ultra rapid ultra short (URUS) insulin

Answer 5

1-Lispro
2-Aspart
3-Glulisine

Question 6

intermediate acting insulin

Answer 6

NPH (isophane)

Question 7

Long acting insulin

Answer 7

Glargine
Detemir
Degludec

Question 8

prandial preparations

Answer 8

1-URUS
2-Regular insulin
3-long acting
4-afrezza

Question 9

basal preparation

Answer 9

NPH

Question 10

lispro/aspart/glulisine
route?
time of administration?

Answer 10

SC
15 minutes before meal

Question 11

Regular acting insulin
route?
time of administration

Answer 11

SC
30-45min before meal

Question 12

NPH
route?
dosage?

Answer 12

SC
T1DM= 2-4times/d
T2DM= once/day

Question 13

Glargine/Detemir/Degludec
route?
dosage?

Answer 13

SC
once or twice/day

Question 14

preparation w/ variable absorption>50%

Answer 14

NPH

Question 15

preparation w/ broad conc plateau

Answer 15

Glargine/Detemir/Degludec

Question 16

lispro/aspart/glulisine advantages

Answer 16

rapid onset,duration,action & absorption—>
1-better postprandial glycemic control
2-↓risk of hypoglycemia

Question 17

lispro/aspart/glulisine advantages

Answer 17

rapid onset & absorption—>
1-better postprandial glycemic control
2-↓risk of hypoglycemia

Question 18

Regular insulin advantages

Answer 18

rapid onset, short duration–>
useful in emergencies & ketoacidosis (IV/IM)

Question 19

NPH advantages

Answer 19

1-can be mixed w/ regular insulin
2-useful in ALL DM types (except DKA)

Question 20

Glargine advantages

Answer 20

effect= 24h
so better compliance

Question 21

Glargine disadvantage

Answer 21

cant be mixed

Question 22

long acting preparation that CAN be mixed

Answer 22

Degludec

Question 23

NPH can be mixed w/

Answer 23

-regular insulin
-lispro
-aspart

Question 24

Degludec has very long duration due to

Answer 24

formation of multihexamers

Question 25

URUS duration

Answer 25

3-5h

Question 26

Regular insulin duration

Answer 26

5-8h

Question 27

NPH duration

Answer 27

4-12 hours
(great variability)

Question 28

Glargine duration

Answer 28

≥ 24h

Question 29

Degludec duration

Answer 29

24-42h

Question 30

Detemir duration

Answer 30

> 12 h (~20h)

Question 31

inhaled insulin

Answer 31

afrezza

Question 32

afrezza cc

Answer 32

1-inhaled powder
2-rapid acting
3-covers prandial requirements

Question 33

T1 diabetics on afrezza must use

Answer 33

SC long acting insulin

Question 34

afrezza CI

Answer 34

chronic lung disease

Question 35

afrezza disadvantages

Answer 35

1-no fine dose adjustments
2-cant be used in smokers & pt w/ lung disease

Question 36

insulin is first-line therapy in T2 diabetics in case of (4)

Answer 36

A1c>10%
FPG>250mg/dL
random glucose>300 mg/dl
ketonuria

Question 37

insulin is indicated to T2 diabetics if

Answer 37

metformin, exercise,diet regulations fail to treat hyperglycemia

Question 38

insulin indications (6)

Answer 38

1- T1DM
2-T2DM
3-DM w/ pregnancy & lactation
4-DM w/ stress & emergencies
5-DM w/ renal/liver disease
6-Hyperkalemia

Question 39

insulin is indicated in pregnancy & lactation to

Answer 39

avoid sulfonyl-urea induced hypoglycemia in baby

Question 40

temporary indications of insulin (4)

Answer 40

1-pregnancy
2-lactation
3-stress & emergency
4-hyperkalemia

Question 41

insulin adv effects (6)

Answer 41

1-HYPOGLYCEMIA
2-↑ weight
3-insulin resistance
4-urticaria (rare)
5-Lipodystrophy
6-hypokalemia

Question 42

insulin resistance w/ insulin therapy occurs due to?
requirements?

Answer 42

anti-insulin Ab
insulin requirements >120 units/d

Question 43

most frequent & serious adv effect

Answer 43

HYPOGLYCEMIA

Question 44

Lipohypertrophy occurs due to?
avoided by?

Answer 44

repeated injection at same site
changing site

Question 45

lipoatrophy used to occur w/

Answer 45

animal insulin=forms IC @ site of injection

Question 46

causes of insulin-induced hypoglycemia (3)

Answer 46

1-insulin overdose
2-↓food intake
3-physical effort

Question 47

warning signs of insulin-induced hypoglycemia

Answer 47

1-adrenergic (+)= ↑HR, sweating, tremors

2-neurological= dizziness, convulsions, coma

Question 48

adrenergic warning signs are masked by

Answer 48

BB

Question 49

TTT of insulin-induced hypoglycemia

Answer 49

1-rapid oral glucose administration
2-1mg IV/IM glucose or glucagon

Question 50

to avoid hypoglycemia patient should be

Answer 50

aware of warning signs
carry candy/sugar