ILE I U2 D2

Question 1

Regular insulin onset

Answer 1

Rapid, 30 min

Question 2

Reg insulin duration

Answer 2

1.5 hour

Question 3

Reg insulin duration IV

Answer 3

30-60 min, HEXAMERS -> DIMERS

Question 4

Reg insulin use

Answer 4

Ketoacidosis, surgery, diabetic coma

Question 5

Reg insulin class

Answer 5

Rapid acting, short duration

Question 6

Rapid acting insulin contains

Answer 6

Clear, small amount of zinc to improve stability and shelf life

Question 7

Intermediate acting insulin contains

Answer 7

Protamine

Question 8

Long acting insulins

Answer 8

Detemir, glargine

Question 9

NPH

Answer 9

Neutral protamine hagedorn (from fish testes)

Question 10

Protamine Insulin works by creating a ___

Answer 10

PZI - protamine:zinc complex

Question 11

PZIs are more/less readily absorbed?

Answer 11

Less

Question 12

Protamine insulin (PZI) onset

Answer 12

4-8 hours

Question 13

Protamine insuline (PZI) duration

Answer 13

> 36 hours (peak at 14-28)

Question 14

Use protein insulin in emergencies?

Answer 14

No

Question 15

NPH insulin is ___ injection only

Answer 15

Intermittent (not continuous)

Question 16

NPH has ___ duration

Answer 16

Intermediate

Question 17

NPH onset

Answer 17

1-3 hours

Question 18

NPH has ___ duration

Answer 18

short

Question 19

NPH duration

Answer 19

12-16 hours

Question 20

70/30, 50/50 mixes are usually associated with which type of insulin

Answer 20

NPH

Question 21

NPH insulin use

Answer 21

Day-to-day

Question 22

NPH insulin in emergencies?

Answer 22

No

Question 23

Reg insulin type

Answer 23

rapid acting, short duration

Question 24

aspart insulin type

Answer 24

rapid acting, short duration

Question 25

lispro insulin type

Answer 25

rapid acting, short duration

Question 26

Glulisine insulin type

Answer 26

rapid acting, short duration

Question 27

NPH insulin types

Answer 27

intermediate acting

Question 28

Detemir/levemir type

Answer 28

long acting, slow onset

Question 29

glargine/lantus insulin type

Answer 29

long acting, slow onset

Question 30

ultralente insulin type

Answer 30

long acting, slow onset

Question 31

Insulin aspart

Answer 31

proline at position B28 has been replaced with an aspartate. This substitution, like with lispro, results in reduced hexamer formation and more rapid dissolution

Question 32

Novolog70/30 contains

Answer 32

70% insulin aspart protamine suspension and 30% insulin aspart.

Question 33

Insulin glulisine

Answer 33

B3 is replaced by lysine and the lysine in position B29 is replaced by glutamic acid, less hexameter formation, rapid dissolution aster onset of action, higher initial plasma concentrations, and shorter duration of action than regular human insulin..

Question 34

Glulisine brand

Answer 34

Apidra

Question 35

Aspart brand

Answer 35

Novolog

Question 36

Which rapid acting insulin is intended for subcutaneous administration and to be used by an external infusion pump?

Answer 36

Glulisine

Question 37

Lantus (glargine)

Answer 37

A21 is replaced by glycine and two arginines are added to the C-terminus of the B-chain. Glargine has 86% the activity of human insulin.

Question 38

Injected lantus is what pH? Why is this important?

Answer 38

4, allowing for complete solubility for basic insulin derivative

Question 39

Insulin glargine administration

Answer 39

once, subq, at bedtime

Question 40

Levemir (detemir)

Answer 40

amino acid threonine in position B30 has been omitted, and a C14 fatty acid chain (myristic acid) has been attached to the amino acid B29 (Thr), imparting its long-acting properties.

Question 41

which insulin tightly binds to albumin?

Answer 41

levemir

Question 42

Triseba duration

Answer 42

up to 42 hours

Question 43

Triseba

Answer 43

Engineered human insulin with the deletion of Thr B30 and the addition of hexadecanoic acid to Lys B29 via a γ -L-glutamic acid linker

Question 44

Triseba pathway

Answer 44

DiHEXamers -phenol-> MultiHEXamers -Zn-> monomers

Question 45

Sliding Scale definition

Answer 45

progressive increase in the pre-meal or nighttime insulin dose, based on pre-defined blood glucose ranges. Sliding scale insulin regimens approximate daily insulin requirements

Question 46

What factors determine a sliding scale?

Answer 46

1. Amount of carbs 2. Basal (background) insulin doesn't change 3. Bolus insulin based on BG before meal or at bedtime 4. Pre-mixed insulin based on BG before meals

Question 47

3 problems with sliding scales

Answer 47

1. doesn't accommodate changes in needs related to snacks, stress and activity. 2. Counting carbs 3. less effective in covering a pre-meal high blood sugar, because the high blood glucose correction and food bolus cannot be split.