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Pharm- Exam 2 > Insulin > Flashcards

Insulin Flashcards

1
Q

What Insulin therapy MUST you being in Type 1 DM?

A

Basal-Bolus Insulin

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2
Q

What does basal-bolus insulin therapy include?

A
  1. Basal Insulin: For fasting and post-absorptive control

2. Rapid Acting Bolus Insulin: For mealtime

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3
Q

What Insulin Therapy are you going to begin with in Type 2 DM?

A

Background/Basal Insulin + Metformin (usually)

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4
Q

List the Rapid-Acting Insulins

A
  1. Aspart
  2. Lispro
  3. Glulisine
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5
Q

Onset of Rapid Acting Insulins

A

15-30 minutes

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6
Q

Peaks onset of Rapid Acting Insulin

A

1-2 hrs

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7
Q

Duration Rapid Acting Insulin

A

3-6 hrs

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8
Q

List the Short-Acting Insulin

A

Regular

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9
Q

When do you administer Regular? What meals does it cover?

A

Before AM

Covers: 1st, noon, and PM meals

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10
Q

Onset of Regular (short acting)

A

30 min-1 hr

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11
Q

Peak onset of Regular (short acting)

A

2-3 hrs

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12
Q

Duration of Regular (short acting)

A

4-8 hrs

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13
Q

List the Intermediate Acting Insulin

A

NPH

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14
Q

Onset of NPH (Intermediate)

A

2-4 hrs

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15
Q

Peak onset of NPH (Intermediate)

A

4-8 hrs

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16
Q

Duration of NPH (Intermediate)

A

8-18 hrs

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17
Q

What meals does NPH (intermediate) cover?

A

AM and PM meals

18
Q

List the Long-Acting Insulin

A
  1. Detemir
  2. Glargine
  3. Degludec
19
Q

Duration of Long-Acting Insulin

A

24 hrs

Administer once daily

20
Q

List the NON-ANALOG insulins

A
  1. NPH Regular Combinations:Humili 70/30, Novolin 70/30

2. Inhaled Insulin: Afrezza

21
Q

what should NOT be refrigerated once in use?

A
  1. Durable Pens

2. Dosing Devices

22
Q

What should UNOPENED vials be refrigerated at?

A

36-46 deg. F

23
Q

What temperature do you keep OPEN vials at?

A

Room temp

24
Q

In DM Type 2, how many grams of CHO does 1 unit of bolus insulin cover?

A

15 g

25
Q

In DM Type 2, how much does 1 unit of bolus insulin decrease blood sugar by?

A

30 mg/dL

26
Q

In DM Type 1, how much does 1 unit of bolus insulin decrease blood sugar by?

A

50 mg/dL

27
Q

What injection site/location has the most consistent absorption?

A

Abdomen

28
Q

What can Hyperglycemia be d/t?

A
  1. Too little insulin

2. “Rebound” from low glucose and overcorrection with CHO

29
Q

How much should you increase the basal (long acting) insulin to reach glycemic control?

A

2 Units every 2-3 days

30
Q

What is the IDEAL FBS?

A

100

31
Q

What target blood sugar is often used?

A

110-120

32
Q

What is the rise in BS post meal?

A

20-40

33
Q

What is a relative CI to continued intensive insulin therapy?

A

Loss of hypoglycemia warning signs

34
Q

What can Hypoglycemia unawareness results from?

A
  1. Autonomic neuropathy

2. Frequent episodes of hypoglycemia

35
Q

How can you restore Hypoglycemia awareness

A

Reduce/adjust insulin dose

36
Q

Asx erratic gastric emptying tx

A

Pramlinitide

37
Q

How long can exercise continue to decrease blood sugars?

A

up to 6-8 hrs

38
Q

Exercise recommendations

A
  1. Exercise @ consistent time

2. Avoid late evening exercise until insulin dose is stable

39
Q

Minor surgery recommendations in both Type 1 and 2 DM

A
  1. No Insulin day of operation (Type 2), D/c Pump night before + 24 hr basal insulin (type 1)
  2. 5% Dextrose infusion
  3. Monitor blood glucose
  4. SubQ short acting insulin q. 4-6 hrs
40
Q

Mjr surgery recommendations in both Type 1

A
  1. Insulin infusion morning of procedure

2. Transition back to regimen when eating

41
Q

What is the recommended CHO intake on sick days?

A

120-150 g CHO

42
Q

How many years following pancreas transplants do 80% of patients need to reinitiate insulin therapy?

A

2 years

Pharm- Exam 2 (5 decks)

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