Test 2 - Insulin (Josh)

Question 1

Short Duration: Rapid Acting insulins:

Answer 1

LOGs don’t LAG when rolling down a hill

• Lispro (HumaLOG)
• Aspart (NovoLOG)
• Glulisine (Apidra)

Question 2

Which insulin can be administered IM?

Answer 2

Regular (Humulin R, Novolin R)

rarely done

Question 3

Can Short Duration: Rapid Acting insulins be administered IV?

Answer 3

yes, but rarely done

Question 4

A subQ injection of —— should be given within 15 mins before meals

A subQ injection of —– should be given 5-10 mins before meals

A subQ injection of —– should be given within 15 mins before or within 20 mins after meals.

Answer 4

Lispro (HumaLOG)

Question 5

Which insulins are Short Duration: Slower Acting?

Answer 5

Regular (Humulin R, Novolin R)

Question 6

Short Duration Insulins:

Answer 6

Rapid Acting: lispro, aspart, glulisine

Shorter Acting: regular

Question 7

—— should be injected subQ ~30 mins before meals.

Answer 7

Regular Insulin (Humulin R, Novolin R)

Question 8

Which insulin is given IV for emergencies?

Answer 8

Regular Insulin (Humulin R, Novolin R)

never give U-500 in IV

Question 9

Which insulin can come in U-500 and U-100 strength?

Answer 9

Regular Insulin (Humulin R, Novolin R)

all others are U-100

Question 10

Which insulin is administered subQ twice a day at the same time?

Answer 10

NPH (Humulin N, Novolin N)

Question 11

Which insulins are OTC?

Answer 11

NPH (Humulin N, Novolin N)

Regular (Humulin R, Novolin R)

Question 12

NPH is in which class of insulins?

Answer 12

iNtermediate Acting

give it twice a day at the same time every day

Question 13

Which class of insulin can be given once (or twice) a day (at the same time)?

Answer 13

Long Duration

• Glargine (Lantus)
• Detemir (Levemir)

Question 14

What are the seven types of insulin we need to know?

Answer 14

1) Lispro (HumaLOG)
2) Aspart (NovoLOG)
3) Glulisine (Apidra)
4) Regular (Humulin R, Novolin R)
5) NPH (Humulin N, Novolin N)
6) Glargine (Lantus)
7) Detemir (Levemir)

Question 15

Onset: 15-30 mins
Peak: 0.5-2.5 hrs
Duration: 3-6 hr

Answer 15

Lispro (HumaLOG)

Question 16

Onset: 10-20 mins
Peak: 1-3 hrs
Duration: 3-5 hr

Answer 16

Aspart (NovoLOG)

Question 17

Onset: 10-15 mins
Peak: 1-1.5 hrs
Duration: 3-5 hr

Answer 17

Glulisine (Apidra)

Question 18

Onset: 30-60 mins
Peak: 1-5 hrs
Duration: 6-10 hr

Answer 18

Regular (Humulin R, Novolin R)

Question 19

Onset: 60-120 mins
Peak: 6-14 hrs
Duration: 16-24 hr

Answer 19

NPH (Humulin N, Novolin N)

Question 20

Onset: 70 mins
Peak: none (levels are steady; no peak)
Duration: 18-24 hr

Answer 20

Glargine (Lantus)

Question 21

Onset: 60-120 mins
Peak: 12-24 hrs
Duration: varies (dose dependent)

Answer 21

Detemir (Levemir)

Question 22

Which insulin has no peak (i.e.: levels stay steady during the whole duration of the drug)?

Answer 22

Glargine (Lantus)

Long-duration insulin

Question 23

Only —– is appropriate for mixing w/ short-acting insulins.

Answer 23

NPH

ex: 70% NPH/30% Regular (Humulin 70/30) or Novolin 70/30)

Question 24

NPH means — —- —-

Answer 24

Neutral Protamine Hagedorn

Question 25

What is the most common and serious side effect of insulin?

Answer 25

Hypoglycemia

b/c the insulin is stimulating uptake of the blood sugar into the muscle cells, lowering serum blood sugar

remember the first adverse effect of all drugs is if they WORK TOO WELL

Question 26

Hypoglycemia is a blood sugar below —-

Answer 26

70 mg/dL

Question 27

Why does hypoglycemia look like sympathetic stuff?

Answer 27

when glucose falls rapidly, activation of sympathetic nervous system leads to tachycardia, palpitations, sweating & nervousness

Question 28

CNS issues, like fatigue, headache, confusion and drowsiness happen when….

Answer 28

blood sugar falls GRADUALLY

Question 29

SNS issues, like tachycardia, sweating and palpitations, happen when….

Answer 29

blood sugar falls RAPIDLY

Question 30

Insulin in —– should be stored in —— until needed.

Insulin in —– can be kept at room temp for up to ——

Answer 30

unopened vials

refrigerator

vial currently used

1 month

Question 31

Mixtures of insulin in —— are stable for —– at room temp and —– if refrigerated

Answer 31

vials

1 month

3 months

Question 32

Mixture of insulin in —– should be stored in the fridge for —–

Answer 32

pre-filled syringes

1 (possibly 2) weeks

Question 33

If patient doesn’t rotate injection sites, what can happen?

Answer 33

lypodistrophy (destruction of adipose tissue)