Pharmacy teaching_ insulin

Question 1

What are the different effects of insulin?

Answer 1

• increase glucose uptake into fat muscle
• stimulates glycogen synthesis
• stimulates triglycerides storage in adipose tissue
• increases protein synthesis
• decreases hepatic gluconeogenesis
• prevents ketogenesis

Question 2

Pathophysiology of DKA

Answer 2

Question 3

Examples of long-acting insulin

Answer 3

Question 4

Example of ultralong insulin

Answer 4

Question 5

Examples of intermediate insulin

Answer 5

Question 6

Examples of short-acting insulin

Answer 6

Question 7

Examples of rapid-acting insulins

Answer 7

Question 8

Which (2) insulins would we use to treat high K+?

Answer 8

• Actrapid
• Humulin S

As these are soluble insulins

Question 9

What’s pre-mixed insulin?

Answer 9

Question 10

Answer 10

e) multiple daily injections → basal - bolus

Reasons

• mimics body’s natural insulin release

Question 11

Describe basal-bolus regimen

Answer 11

Question 12

What (other than basal-bolus) insulin regimes are there?

Answer 12

Question 13

Answer 13

Remember to:

• prescribe by brand
• indicate device and its strength

Question 14

Answer 14

dinner and bedtime ones are too high

*e.g. lunchtime BM reading relies on breakfast dose

To adjust the dose we look at:

• trends over a couple of days (aim for <15)
• only adjust one dose at a time by 10-20% (1-2 units)

Question 15

Causes of increased insulin requirements

Answer 15

Question 16

Causes of decreased insulin requirements

Answer 16

Question 17

Answer 17

This is mixed insulin with the biphasic release → if we want to make any changes we need to adjust morning one

Question 19

Answer 19

Pt suffers from hypoglycaemia and is conscious + able to swallow

so e.g. prescribe glucoGel

Question 20

Management of hypoglycaemic episode

Answer 20