Insulin Formulations Flashcards

1
Q

What does it mean if it is more soluble?

A

Faster acting = shorter-acting

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2
Q

What is insulin self-association?

A

Monomers form dimers form hexamers

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3
Q

What is the most soluble?

A

Monomers = most
Dimers
Hexamers = least

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4
Q

How are subunits linked together?

A

By disulphide bridges

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5
Q

What are the interactions between?

A

Subunit B

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6
Q

What is insulin self-association linked with?

A

Equilibrium

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7
Q

What factors affect insulin self-association?

A

Relative concentration of each form
Excipients

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8
Q

What happens if there are more hexamers?

A

Equilibrium shifts so less hexamers = more monomers

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9
Q

What can modifying insulin structure cause?

A

High absorption rate = faster-acting
Lower absorption rate = lower-absorption rate

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10
Q

What is animal insulin?

A

Extracted + purified from bovine + porcine pancreas

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11
Q

What are the cons of animal insulin?

A

Some cultures NOT accepted

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12
Q

What is recombinant human insulin?

A

Structurally identical to human insulin
BUT produced in bioreactor using recombinant DNA technology

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13
Q

What is an example of recombinant human insulin?

A

Insuman

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14
Q

What is an example of animal insulin?

A

Hypurin

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15
Q

What do solutions tend to be?

A

Rapid onset, shorter-acting

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16
Q

What do suspensions tend to be?

A

Slower onset, longer-acting

17
Q

How do excipients influence duration?

A

Zinc + phenolic compounds promote self-association of insulin into hexamers

18
Q

What is NPH?

A

Neutral Protamine Hagedorn
= Isophane insulin (intermediate)

19
Q

How does NPH (isophane) insulin work?

A

Protamine complexes with insulin to form aggregates through ionic interactions = suspension
= prolongs insulin release

20
Q

What are the more soluble forms of insulin?

A

Lispro
Aspart
Glulisine

21
Q

What are the less soluble forms of insulin?

A

Degludec
Detemir
Glargine

22
Q

How does the change in Insulin Lispro make it faster-acting?

A

Destabilises dimers + hexamers
= monomers favoured
ALSO binds to zinc less avidly = doesn’t form dimers + hexamers

23
Q

How is Insulin Lispro formed?

A

Proline is swapped for lysine
Lysine is swapped for proline

24
Q

How is Insulin Aspart formed?

A

Proline swapped for aspartic acid

25
How does the change in Insulin Aspart make it faster-acting?
Destabilisers dimers + hexamers = monomers favoured
26
How is Insulin Glulisine formed?
Asparagine swapped for lysine Lysine swapped for glutamic acid
27
How does the change in Insulin Glulisine make it faster-acting?
Decreased hexamer formation Monomer stabilisation Enhanced solubility
28
How is Insulin Degludec formed?
Threonine removed Attach hexadecandioyl through glutamic acid spacer at lysine
29
What is an example of Insulin Degludec?
Tresiba
30
How does the change in Insulin Degludec make it longer-acting?
Injected As phenol from vehicle diffuses = insulin degludec hexamers link up via single side-chain contacts = less soluble than hexamers = long chain dissociates = releases insulin
31
How is Insulin Detemir formed?
Remove threonine Attach myristic acid at lysine
32
How does the change in Insulin Detemir make it longer-acting?
Binds albumin = makes it stay longer in blood = prolonging t1/2
33
How is Insulin Glargine formed?
Swap asparagine for glycine Then add 2 arginine's
34
How does the change in Insulin Glargine make it longer-acting?
Changes isoelectric point to 6.7 = reduced solubility at physiological pH
35
What is an example of Insulin Glargine?
Toujeo
36
What is an example of Insulin Detemir?
Levemir
37
What devices are there?
Insulin pen Insulin pumps Closed-loop systems Inhaled insulin - Exubera (discontinued) + Afrezza