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Pharmacology > Type I Diabetes Mellitus > Flashcards

Type I Diabetes Mellitus Flashcards

1
Q

What does diabetes cause?

A

Diabetes is a major cause of blindness,
kidney failure, heart attacks, stroke and
lower limb amputation

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2
Q

Diabetes types?

A

Type 1 (β-cell destruction, usually leading to
absolute insulin deficiency), 5-10%

Type 2 (Insulin resistance with relative insulin
deficiency), 90-95%

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3
Q

Insulin function?

A

-Regulates glucose metabolism

-Inhibits the release of glucagon

-↑ lipogenesis

  • ↓ Lipolysis
  • ↑ amino acid transport into
    cells

-↓ blood levels of glucose,
free fatty acids and ketones

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4
Q

Types of insulin?

A
  1. Ultra fast-acting
  2. Fast-acting
  3. Intermediate to long acting
  4. Biphasic
  5. Ultra long-acting
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5
Q

Ultra fast-acting :

  1. Drugs
  2. Type of solution
  3. Hexamers
  4. OOA
  5. DOA
  6. Peak action
A
  1. Drugs:
    Lispro, Aspart, Glulisine
  2. Type of solution;
    Clear solution
  3. Hexamers:
    Weak hexamers
  4. OOA: 10-15mins
  5. DOA: 3-5hrs
  6. Peak action: 45-90mins
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6
Q

Short-acting insulin

  1. Complex
  2. Type of insulin
  3. Admin in emergency
  4. OOA
  5. DOA
A
  1. Complex:
    Soluble Zn-insulin complex
  2. Type of insulin:
    Regular / soluble / human insulin
  3. Admin in emergency: IV in emergency
  4. OOA: 30mins
  5. DOA: 6-8hrs
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7
Q

Intermediate-acting insulin:

  1. Type of solution
  2. Formulation
  3. OOA
  4. DOA
A
  1. Type of solution:
    -Cloudy solution – crystal formation

-Protamine in phosphate buffer – isophane
(NPH) – 6 insulin : 1 protamine

  1. Formulation:
    -Formuled with Zn or protamine
  2. OOA: 1-3HRS
  3. DOA: 18-20hrs
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8
Q

Premixed insulin:

  1. Combination
  2. OOA
  3. DOA
A
  1. Combination:
    Combination of short and intermediate-acting insulin
  2. OOA: 30mins
  3. DOA: 24hrs
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9
Q

Long-acting insulin drugs?

A

DDG

  1. Glargine
  2. Detemir
  3. Degludec
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10
Q

Glargine OOA and DOA?

A

OOA: 1hr
DOA: 24hr

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11
Q

Detemir OOA & DOA?

A

OOA: 1-2hrs
DOA: 20hrs

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12
Q

Degludec OOA & DOA?

A

OOA: 30-90mins

DOA: >24HRS

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13
Q

DI for hypoglycaemic and hyperglycaemic effects?

A

Hyperglycaemic effects: GED

  1. Glucocorticoster-oids
    2.Glucagon
  2. Estrogens
  3. Diuretics

Hypoglycaemic effects: SABA

  1. Alcohol
  2. Salicylates (aspirin)
  3. βeta blockers
  4. ACE inhibitors (eg captopril)
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14
Q

Drugs that mask hypoglycaemia?

A

Beta-blockers
eg: Propanolo, carvedilol

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15
Q

Therapeutic treatment regimes?

A
  1. Basal Bolus injection
  2. Daily regime
  3. Once daily regime
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16
Q

Basal bolus regimen

A

-30-45 min preprandial – short-acting 60% total daily dose in 3 divided doses

-Bedtime – intermediate acting
40% total daily dose

-Alternative: ultra-long acting at bedtime

17
Q

Twice daily regimen?

A

-Mixed short and intermediate-acting

-Breakfast – 67%; Supper – 33%

-If hyperinsulinemia occurs late evening\
hypoglycemia
→ hyperglycaemia
Somogyi phenomenon

18
Q

Once daily regimen?

A

Elderly, Type 2 diabetics – before bedtime, use
intermediate acting with oral hypoglycaemic
agent

19
Q

Pharmacology of Insulin S/E?

A

.1 Lipohypertrophy/Lipodystrophy

  1. Hypoglycaemia (tachycardia, tremors, polyphagia,
    confusion, vertigo)
  2. Allergic skin reactions
20
Q

Insulin treatment:

  1. Pregnancy
  2. Lactation
  3. Illness
A
  1. Pregnancy –
    - Agent of choice for treatment of diabetes (Both DB I &
    DB II)
    - Doses may require adjustment
  2. Lactation –
    - Not excreted in breast milk
  3. Illness – insulin requirements increase
21
Q

Insulin CI?

A

Hypoglycaemia

22
Q

Insulin of injection?

A

Sites of injection must be rotated regularly

23
Q

Insulin & massaging site of injection?

A

Massaging site of injection ↑ absorption by 10-20%

24
Q

Insulin and meals?

A

Time of injection prior to meal is NB

25
Q

Insulin and changing regime?

A

Changing patient’s insulin type & regimen should be
avoided

26
Q

Insulin pump QOL?

A

insulin pump (ultra fast acting insulin) ↑ QOL

Pharmacology (44 decks)

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