Insulin Preparations - Exam 2 Hockerman Flashcards

Insulin Prep and their rate of onset, duration of action, and modifications of each

1
Q

Ultra-rapid Insulins (Rate of Onset = 5-15 min)

A

Lispro (Humalog), Aspart (Novolog), Glulisine (Apidra), Afrezza (inhaled)

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2
Q

Rapid Insulin (Rate of Onset = 30-60 min

A

Regular insulin (Humulin, Novolin)

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3
Q

Intermediate Insulin (Rate of Onset = 60-90 min)

A

NPH

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4
Q

Slow Insulins

A

Glargine (Lantus), Detemir (Levemir), Degludec (Tresiba)

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5
Q

Glargine (Lantus) Rate of Onset

A

60-90 min

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6
Q

Detemir (Levemir) Rate of Onset

A

1-2 h

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7
Q

Degludec (Tresiba) Rate of Onset

A

1 h

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8
Q

Lispro (Humalog) Duration of Action

A

6-8 h

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9
Q

Aspart (Novolog), Glulisine (Apidra), and Afrezza (inhaled) Duration of Action

A

3-5 h

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10
Q

Regular Insulin (Humulin, Novolin) Duration of Action

A

8-12 h

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11
Q

NPH Duration of Action

A

24 h

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12
Q

Glargine (Lantus), Detemir (Levemir), and Degludec (Tresiba) Duration of Action

A

> 24 h

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13
Q

Lispro (Humalog) Modifications

A

Reversing proline-28 and lysine-29 (K29) on insulin B chain to decrease self-association/destabilize dimerization

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14
Q

Aspart (Novolog) Modifications

A

Proline-28 on insulin B chain is switched to Aspartate-28 (D28) to decrease self-association/destabilize dimerization

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15
Q

Glulisine (Apidra) Modifications

A

Asparagine-3 (N3) and Lysine-29 (K29) on insulin B chain are switched to Lysine-3 (K3) and Glutamic Acid-29 (E29)

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16
Q

Afrezza (inhaled) Modifications

A

Uses a technosphere particle that has insulin bound to a peptide. It is small but it has a lot of surface area

17
Q

Regular Insulin Modifications

A

Nothing lol, forms a dimer/hexamer

18
Q

NPH Modifications

A

Neutral Protamine Hagedorn, forms an insoluble insulin complex where insulin is bound to protamine and must be freed by proteases before absorption

19
Q

Glargine (Lantus) Modifications

A

Asparagine-21 (N21) of the insulin A chain is changed to Gycine-21 (G21), which makes the insulin very soluble at a pH of 4 (but not at pH of 7 - blood), so it must precipitate and release slowly. Also, 2 Arginine residues are added to the end of the insulin B chain (R30 and R31)

20
Q

Detemir (Levemir) Modifications

A

Threonine (T30) of the insulin B chain is deleted, and Lysine-29 (K29) is myristylated (aka added a fatty acid). This makes it easier to bind to serum albumin extensively.

21
Q

Degludec (Tresiba) Modifications

A

Threonine-30 (T30) of insulin B chain is replaced by gamma-Glu/C16 fatty acid. This makes it easier to bind to serum albumin extensively.