Diabetes Insulin PKPD

Question 1

What is the onset of action of ultra rapid-acting insulin?

Answer 1

15-20 mins

Question 2

Which insulin products are ultra rapid-acting?

Answer 2

-Fiasp (aspart)
-Lyumjev (lispro)

Question 3

What is the onset of action of rapid acting insulins?

Answer 3

<30 mins

Question 4

Which insulin products are rapid acting?

Answer 4

-Novolog (aspart)
-Humalog (lispro)
-Admelog (lispro)
-Apidra (glulisine)

Question 5

What is the onset of action of short acting insulins?

Answer 5

30 mins-2 hours

Question 6

Which insulin products are short acting?

Answer 6

-NovolinR (regular human insulin)
-HumulinR (regular human insulin)

Question 7

What is the onset of action of intermediate acting insulins?

Answer 7

1.5-6 hours

Question 8

Which insulin products are intermediate acting?

Answer 8

-NovolinN (NPH insulin)
-HumulinN (NPH insulin)

Question 9

What is the onset of action of long acting insulins?

Answer 9

2-10 hours

Question 10

Which insulin products are long acting?

Answer 10

-Lantus (glargine)
-Semglee (glargine)
-Basaglar (glargine)
-Toujeo (glargine)
-Tresiba (degludec)

Question 11

Which insulin products CAN be given IV?

Answer 11

-short acting (insulin regular)

Question 12

What is Afrezza?

Answer 12

inhaled regular insulin (mealtime)

Question 13

What is the BBW for Afrezza?

Answer 13

acute bronchospasm

Question 14

What is needed at baseline to start Afrezza therapy?

Answer 14

FEV1

Question 15

How should Afrezza be stored?

Answer 15

-not in use: fridge (unopened: until expiration date; opened: 1 month)
-in use: room temp (unopened strips: 10 days; opened strips: 3 days)

Question 16

What are some ADE of insulin?

Answer 16

-HYPOGLYCEMIA
-injection site rxns
-lipohypertrophy
-Afrezza: cough

Question 17

What is the starting basal insulin dose according to AACE guidelines if A1C < 8%?

Answer 17

0.1-0.2 units/kg

Question 18

According to AACE guidelines, if A1C>8% what is the starting basal insulin dose?

Answer 18

0.2-0.3 U/kg

Question 19

According to AACE guidelines, what is the starting BOLUS insulin dose if added stepwise?

Answer 19

10% of basal or 5 units

Question 20

According to AACE guidelines, what is the starting BOLUS insulin dose if added simultaneously?

Answer 20

TDD= 50% basal and 50% bolus:
-each bolus dose (with each meal)=basal/3
IF starting basal and bolus at same time:
-TDD= 0.3-0.5 U/kg/d

Question 21

According to ADA guidelines, what is the starting BOLUS insulin dose upon stepwise addition initiation?

Answer 21

4 units or 10% basal

Question 22

What DDIs does insulin have?

Answer 22

-TZDs
-ACEi
-MAOi
-thiazide diuretics
-hormones
-beta blockers
-AGIs

Question 23

What should be monitored while patient is on insulin?

Answer 23

-FBG/PPG
-weight gain
-ADE

Question 24

What changes to insulin regimen should be made for patients on TPNs?

Answer 24

-add regular insulin to TPN
-may use correctional insulin

Question 25

What is Soliqua?

Answer 25

insulin glargine + lixisenatide

Question 26

How should Soliqua be administered?

Answer 26

-administer 1 hour before breakfast

Question 27

What is Xultophy?

Answer 27

insulin degludec + liraglutide

Question 28

How should Xultophy be taken?

Answer 28

-anytime once daily with or without food -SQ