DM & Endocrine

Question 1

Short duration rapid acting insulin qualities

Answer 1

• clear
• can be mixed with other insulins
• given with food
• can be given IV, not normally

Question 2

short duration rapid acting insulin names

Answer 2

lispro, aspart, glulisine (GAL)

Question 3

Lispro onset

Answer 3

15-30min

Question 4

Lispro peak

Answer 4

0.5-2.5 hrs

Question 5

Lispro duration

Answer 5

3-6 hrs

Question 6

Aspart onset

Answer 6

10-20 mins

Question 7

Aspart peak

Answer 7

1-3 hrs

Question 8

Aspart duration

Answer 8

3-5 hrs

Question 9

Glulisine onset

Answer 9

10-15 min

Question 10

glulisine peak

Answer 10

1-1.5 hrs

Question 11

Glulisine duration

Answer 11

3-5 hrs

Question 12

Short duration slower acting insulin qualities

Answer 12

• clear
• can be mixed with other insulins
• used with sliding scale and meals (30 mins prior to meal)
• can be given IV

Question 13

Short duration slower acting insulin names

Answer 13

regular insulin

Question 14

Regular insulin onset

Answer 14

30-60 mins

Question 15

Regular insulin peak

Answer 15

1-5 hours

Question 16

Regular insulin duration

Answer 16

6-10 hrs

Question 17

Intermediate acting insulin qualities

Answer 17

• cloudy
• can be given with short acting

Question 18

Intermediate acting insulin name

Answer 18

NPH insulin

Question 19

NPH insulin onset

Answer 19

60-120 mins

Question 20

NPH insulin peak

Answer 20

6-14 hrs

Question 21

Intermediate acting insulin duration

Answer 21

16-24 hrs

Question 22

Long duration insulin qualities

Answer 22

• clear
• should not be mixed with other insulins

Question 23

Long duration insulin names

Answer 23

insulin glargine, insulin detemir

Question 24

Insulin glargine onset

Answer 24

70 mins

Question 25

Insulin glargine peak

Answer 25

none

Question 26

insulin glargine duration

Answer 26

18-24 hrs

Question 27

Insulin detemir onset

Answer 27

60-120 minsI

Question 28

Insulin detemir peak

Answer 28

none

Question 29

Insulin detemir duration

Answer 29

12-24 hrs

Question 30

Ultra-long duration insulin

Answer 30

insulin glargine

Question 31

Insulin glargine (ultra long) onset

Answer 31

360 mins

Question 32

Insulin glargine (ultra long) peak

Answer 32

none

Question 33

Insulin glargine (ultra long) duration

Answer 33

>24 hrs

Question 34

Glipizide - sulfonylureas use

Answer 34

T2DM

Question 35

Glipizide moa

Answer 35

stimulates release of insulin by beta cells, may also increase response to insulin

Question 36

Glipizide adverse effects

Answer 36

hypoglycemia, weight gain

Question 37

Glipizide interactions

Answer 37

alcohol - disulfiram like reaction drugs that intensify hypoglycemia (BBs)

Question 38

Glipizide implications

Answer 38

- do not give with sulfa allergy - give 30 minutes before breakfast (missing food increases risk of hypoglycemia) - no alcohol - monitor for hypoglycemia (tachycardia, palpitations, sweating, tremors, n/v)

Question 39

Metformin - biguanides use

Answer 39

T2DM, PCOS, gestational diabetes, prediabetes, metabolic syndrome

Question 40

Metformin MOA

Answer 40

- decrease glucose production in liver - decrease glucose absorption from gut - increase tissue response to insulin (uptake of glucose by cells)

Question 41

Metformin adverse effects

Answer 41

- GI: decrease appetite, n/d, gas - Rare: lactic acidosis - hyperventilation, myalgia, malaise, somnolence - do not use with renal disease or CHF

Question 42

Metformin interactions

Answer 42

- ETOH increases lactic acidosis - IV contrast - increases risk of lactic acidosis and renal failure

Question 43

Metformin additive effects

Answer 43

- least likely to cause hypoglycemia - decrease LDL, increase HDL - weight loss

Question 44

Metformin implications

Answer 44

- avoid alcohol - monitor for lactic acidosis - stop medication 1-2 days before IV contrast administration

Question 45

Sitagliptin - Gliptins - DPP-4 Inhibitors use

Answer 45

T2DM

Question 46

Sitagliptin moa

Answer 46

- increase insulin release in pancreas - reduce glucagon release in liver - decrease hepatic glucose production

Question 47

Sitagliptin adverse effects

Answer 47

pancreatitis, hypersensitivity reactions

Question 48

Sitagliptin implications

Answer 48

- educate on pancreatitis (abdominal pain, maybe vomiting) - monitor for hypersensitivity (angioedema, anaphylaxis, SJ syndrome)