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Pharm Exam 4 > Type I DM & Insulin > Flashcards

Type I DM & Insulin Flashcards

1
Q

Traditional Insulin Preps

A

Regular and NPH

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2
Q

Regular Insulin PK

A

Rapidly absorbed & short acting
Onset: 30-60mins
Peak: 2-4 hours
Duration: 5-8 hours

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3
Q

Regular Insulin Use

A

~30 mins before meal

critical to March dose w/ glucose load

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4
Q

Regular Insulin Admin

A

IV (clear solution)

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5
Q

NPH Insulin PK

A

Slower absorption and longer DOA (than regular insulin), neutral pH
Onset: 1-2 hours
Peak: 6-12 hours
Duration: 18-24 hours

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6
Q

NPH Insulin Admin

A

Cloudy suspension, NOT IV

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7
Q

NPH Insulin use

A

Between meals

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8
Q

Synthetic Modified Insulin Analogs

A

Lispro
Aspart
Glulisine

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9
Q

Insulin Lispro PK

A

Faster onset and shorter DOA (than regular insulin)
Peak: 30-60mins
Duration: 3-4hours

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10
Q

Insulin Lispro Use

A

Immediately before meals

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11
Q

Insulin Aspart PK

A

Longer DOA than Lispro

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12
Q

Insulin Aspart Use

A

Injected @ mealtime

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13
Q

Insulin Glulisine use

A

Injected before OR after meals

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14
Q

Synthetic Modified Insulin Analog dose/admin

A

Must have Rx and given IV

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15
Q

Isophane form of rapid insulin analogs

A

NPA

NPL

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16
Q

NPA/NPL purpose

A

Combined with protamine to slow action b/w meals

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17
Q

What is the dosing for synthetic ultra-long + rapid analog?

A

Basal + bolus

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18
Q

Insulin Glargine MOA

A

Enhanced hexamer formation (to slow absorption and low, constant DOA)

19
Q

Insulin Glargine vial vs. tissue pH

A

Vial - 4

Tissue - 7.4

20
Q

Insulin Glargine PK

A

Slow absorption, slow and constant DOA

21
Q

Insulin Glargine Dose

A

1x/day; usually @ bedtime

22
Q

Insulin Determir MOA

A

Myristic acid attached to hind to albumin (prolongs DOA)

23
Q

Insulin Detemir pH

A

Neutral

24
Q

Insulin Detemir Dose

A

2x/day; somewhat shorter DOA than Glargine

25
Q

Insulin Detemir

A

Shorter DOA than Glargine, but still longer than regular

26
Q

Insulin Degludec MOA

A

FA chain to promote aggregation & slow release

27
Q

Insulin Degludec PK

A

Longer lasting than Glargine & Detemir

DOA: 42 hours

28
Q

Insulin Degludec Dose

A

1x/day; anytime of day

29
Q

PK from rapid/short to slow/long for insulin

A

Lispro/Aspart/Glulisine —> regular —> NPH (& NP analogs) —> Detemir/Glargine/Degludec

30
Q

Best method to reduce long term complications of DM? Inherent risk of this approach?

A

Tight control of Glucose

Hypoglycemia

31
Q

Type of insulin used by pumps for continuous SC insulin infusion?

A

Synthetic analogs

32
Q

Side effects of insulin

A

Hypoglycemia
Lipodystrophy
Weight gain

33
Q

Treatment of mild hypoglycemia

A

Juice, candy, honey, syrup

34
Q

Treatment of severe hypoglycemia

A

Glucose prep (tablets, gels, IV)

35
Q

Counter regulatory hormone of insulin

A

Glucagon (IM or SC)

36
Q

Drug that is analog of amylin

A

Pramlintide

37
Q

What is amylin?

A

Peptide hormone released from beta cells with insulin

38
Q

Pramlintide MOA

A

Decrease glucagon —> decrease liver glucose —> limit glucose fluctuation

39
Q

Pramlintide Use

A

Decrease post-prandial glucose and decrease need for short acting insulin

40
Q

Pramlintide PK

A

Slows gastric emptying to improve satiety

41
Q

Pramlintide dose

A

3x/day; SC before meals w/ insulin

42
Q

Why is Pramlintide not frequently used?

A

Not very powerful and requires lots of injections

43
Q

Pramlintide contraindications

A 
Decreased GI motility/absorption 
Renal disease (drug is excreted here)

Pharm Exam 4 (8 decks)

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