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pharmacology > Insulin > Flashcards

Insulin Flashcards

(64 cards)

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1
Q

how man amino acids in insulin

A

51

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2
Q

what does insulin do

A

drives sugar into cell so the can be used as energy

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3
Q

what is diabetes?

A

Elevated blood sugar from inadequate insulin secretion of from insulin resistance

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4
Q

what are the cut off levels for dabetes

A

Ex: FPG 126 mg/dL or greater; OGTT 200 mg/dL or greater; A1C 6.5% or greater

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5
Q

type 1

A

autoimune response, 5-10% DM

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6
Q

Type 2

A

resistance 90-95% DM, 7.8% prevalance in US

slow onset

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7
Q

how is gestational DM affection

A

the mom

1-14% pregnancies

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8
Q

when is gestational DM common

A

3rd trimester

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9
Q

3 other types of diabetes

A

genetic defect
pancreatic disease
Rx induced

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10
Q

what is an absolute insulin deficinecy

A

when the cells in the pancreas do not work

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11
Q

what d\happens when there is no insulin

A

fats broken down, sugar stays in blood, fatty acids in blood, diabetes ket acidosis- death

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12
Q

treatment for DKA

A

exogenous insulin

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13
Q

typical type 2 pt.`

A

overwiehgtm high insulin levels, they are just resistentm high HDL and TG, do not need exogenous insulin

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14
Q

at any given time how much insulin is in the pancrease?

A

8mg

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15
Q

how many units of insulin are released per day

A

70-120

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16
Q

which organs remove insulin

A

kidney and liver

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17
Q

where did insulin used to come from

A

ground up animal pancrease , rabbits

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18
Q

how is dosing of insulin measured

A

units

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19
Q

how is insulin made nowadays

A

recombinant DNA

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20
Q

most insulin on the markets is U100. what does that mean?

A

U100- 100 units/ 1 mL of a solution

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21
Q

new basal insulin comes in what conc.?

A

U300

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22
Q

Humalog (insulin lispro) dose

A

U200

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23
Q

U500

A

special request

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24
Q

how many fake insulins are out there?

A

more than 17

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25
what is the diff. between all these insulins?
they are bound to different compounds so they last different amounts of time
26
what are the four categories of insulin
short acting, rapid acting, intermediate acting, long acting
27
short acting Rx
regular human insulin (Humulin and Novolin R)
28
rapid acting Rc
asparat (novolog) lispro (humalog) glulisine (apidra)
29
intermediate acting RX
Neutral protamine Hagedorn (NPH)
30
long acting Rx insulin
insulin glargine (Lantus 100Uml & Toujeo300UmL)); detemir (Levemir)
31
what are common combination insulin products
NPH/either regular or rapid-acting insulin-70/30, 75/25
32
short acting insulin
identical to human insulin, clear and neutral pH, onset 30 min, peak 2-3 hr, duration 3-6 hr
33
absorption of short acting insulin
aggregates under the skin when given SQ. It has to de-aggregate to be absorbed has slow absorption at first, and then faster absorption as it de-aggregates causing variable uneven absorption rate take immediatley before a meal IV there is no aggregation and physiologically it is similar to pancreatic secretion
34
Regular insulin use
SQ bolus- for pre-prandial or correction of high sugar 30-45 minutes before a meal to minimize this effect only type given IV-Need for DKA & when want tight control
35
rapid insulin absorption
1-2 amino acids different SQ These act more like insulin secreted from pancreas than if give regular insulin SQ Don’t give IV more rapid onset and shorter duration of action than human regular insulin
36
rapid insulin properties
clea, neutral pH, zinc, 5-15 min onset, peak in 20 min, lasts 4 hours
37
Use of Rapid insulin
before meal Don’t have to wait to eat as with SQ regular insulin best if used with a pump these are the most physiologic form of insulin (pumps are SQ
38
INtermediate insulin absorption
NPH (Humulin N or Novolin N) bound to protamine Protamine was developed to extend the insulins duration of action and onset
39
ONset etc. of intermediate insulin
onset: 2-5 hr duration: 10-20 hr Usualy mixed with rapid acting insulin, SQ x2/day
40
Long acting insulin
crystalizes once under the skin DO NOT MIX replicates basal secretion of insulin
41
What type of insulin greatly reduces hypoglycemia
long acting- does not have an exagerated peak
42
two types of mixing for insulin
comercially premixed an mix yourself right before inejction
43
what can Lispro be mixed with
neutral protamine lispro NPL
44
what can Aspart be mixed with?
neutral prtamine aspart NPA
45
mehtods of administering insulin
syringe, needle, pump, inhalation
46
how many mLs is 10 units?
.1 mL
47
what are the general syringe sizes for insulin?
.3, .5, .1
48
Nano needle
4 and 6 mm
49
short needle
8mm
50
long needle
12.7 mm
51
Gauge of needles
usualy 27 or smaller, | neddle gets larger and neddle numbers get smaller
52
ultrafine needle
31 gauge `
53
where to inject insulin
any part of body with loose skin, rotate injection site at the apendage in a clock wise manner , move to a new appendage when done,
54
insulin pen
easier to do multiple doses, leave needle in sekin for 10 seconds
55
insulin pump
The pump can deliver individualized basal rate of insulin infusion Pumps are an effective means of improving or stabilizing glycemic control require a high level of technical expertise and the motivation to perform frequent self-monitoring
56
inhaled insulin
Afezza (regular insulin) CA: lung disease ADR: hypoglucemia, cough
57
how do you get tight insulin control?
2 injections: One in am (2/3rds dose) and one in pm (remaining 1/3) injection a mix of short or rapid acting insulin for meal coverage with intermediate (NPH) for basal coverage Better control 3 or more doses with 2/3rds dose in morning and the remaining 1/3 dose split between dinner and basal component before bed One shot of a long acting for basal coverage Three separate injections of rapid acting insulin taken before meals.
58
Best insulin coverage and glucose control
pump
59
Estimate on units of insulin needed a day based on weight TDI- total basal insulin
0.3-0.6 unit/kg/day Basal requirements are 50% of estimated TDI Bolus requirements are 50% of estimated TDI split 3 ways before meals
60
Lipodystrophy
occurs at injection site, change injection site, hypertrophy of fat
61
What is the most common complication of insulin use?
hypoglycemia
62
symptoms of hypoglycimia
Sympathetic nervous system activation (tachycardia, palpitations, sweating, tremulousness) & PNS activation (nausea and hunger) to start then confusion, weakness, bizarre behavior, coma & seizures
63
Treatment for hypoglycemia
15-20 grmas of glucose, repeat 15 minutes untol sugar >70, then eat a meal
64
treatment for severe hypoglycemia
flucagon, 1 mG IM

pharmacology (5 decks)

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