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ENDOCRINE > [PHARMA] INSULIN > Flashcards

[PHARMA] INSULIN Flashcards

1
Q

Insulin counter-regulatory hormones (5)

A

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

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2
Q

Drugs inducing diabetes (4)

A

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

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3
Q

thiazides induce DM via

A

↓ insulin release

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4
Q

BB induce DM via

A

glucose intolerance

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5
Q

ultra rapid ultra short (URUS) insulin

A

1-Lispro
2-Aspart
3-Glulisine

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6
Q

intermediate acting insulin

A

NPH (isophane)

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7
Q

Long acting insulin

A

Glargine
Detemir
Degludec

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8
Q

prandial preparations

A

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

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9
Q

basal preparation

A

NPH

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10
Q

lispro/aspart/glulisine
route?
time of administration?

A

SC
15 minutes before meal

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11
Q

Regular acting insulin
route?
time of administration

A

SC
30-45min before meal

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12
Q

NPH
route?
dosage?

A

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

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13
Q

Glargine/Detemir/Degludec
route?
dosage?

A

SC
once or twice/day

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14
Q

preparation w/ variable absorption>50%

A

NPH

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15
Q

preparation w/ broad conc plateau

A

Glargine/Detemir/Degludec

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16
Q

lispro/aspart/glulisine advantages

A

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

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17
Q

lispro/aspart/glulisine advantages

A

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

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18
Q

Regular insulin advantages

A

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

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19
Q

NPH advantages

A

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

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20
Q

Glargine advantages

A

effect= 24h
so better compliance

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21
Q

Glargine disadvantage

A

cant be mixed

22
Q

long acting preparation that CAN be mixed

A

Degludec

23
Q

NPH can be mixed w/

A

-regular insulin
-lispro
-aspart

24
Q

Degludec has very long duration due to

A

formation of multihexamers

25
Q

URUS duration

A

3-5h

26
Q

Regular insulin duration

A

5-8h

27
Q

NPH duration

A

4-12 hours
(great variability)

28
Q

Glargine duration

A

≥ 24h

29
Q

Degludec duration

A

24-42h

30
Q

Detemir duration

A

> 12 h (~20h)

31
Q

inhaled insulin

A

afrezza

32
Q

afrezza cc

A

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

33
Q

T1 diabetics on afrezza must use

A

SC long acting insulin

34
Q

afrezza CI

A

chronic lung disease

35
Q

afrezza disadvantages

A

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

36
Q

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

A

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

37
Q

insulin is indicated to T2 diabetics if

A

metformin, exercise,diet regulations fail to treat hyperglycemia

38
Q

insulin indications (6)

A

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

39
Q

insulin is indicated in pregnancy & lactation to

A

avoid sulfonyl-urea induced hypoglycemia in baby

40
Q

temporary indications of insulin (4)

A

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

41
Q

insulin adv effects (6)

A

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

42
Q

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

A

anti-insulin Ab
insulin requirements >120 units/d

43
Q

most frequent & serious adv effect

A

HYPOGLYCEMIA

44
Q

Lipohypertrophy occurs due to?
avoided by?

A

repeated injection at same site
changing site

45
Q

lipoatrophy used to occur w/

A

animal insulin=forms IC @ site of injection

46
Q

causes of insulin-induced hypoglycemia (3)

A

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

47
Q

warning signs of insulin-induced hypoglycemia

A

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

2-neurological= dizziness, convulsions, coma

48
Q

adrenergic warning signs are masked by

A

BB

49
Q

TTT of insulin-induced hypoglycemia

A

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

50
Q

to avoid hypoglycemia patient should be

A

aware of warning signs
carry candy/sugar

ENDOCRINE (9 decks)

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