Insulin/T1D Flashcards

(32 cards)

1
Q

What kind of molecule is insulin?

A

Peptide

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2
Q

Insulin main action

A

Decrease blood glucose

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3
Q

Insulin binds to an extracellular insulin receptor, activating an intracellular ____

A

Tyrosine kinase

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4
Q

What effect does activation of tyrosine kinase by insulin have?

A

Glucose transporters (GLUT4) are translocated into the cell membrane to increase glucose uptake

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5
Q

Efficacy of all insulins is equal; the differences among them is in their ______

A

Pharmacokinetics

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6
Q

Regular insulin is ___-acting and ___ -acting

A

Rapid acting
Short acting

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7
Q

Gold standard insulin

A

Regular insulin

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8
Q

Most current insulins have a ____ pH

A

Neutral

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9
Q

Isophane insulin suspension is also called

A

NPH

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10
Q

Difference between regular insulin and NPH

A

NPH has slower onset and longer action than regular

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11
Q

Unique physical characteristic of NPH

A

Cloudy (cannot give via IV)

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12
Q

When is regular insulin usually used?

A

Before meals (1/2-1 hour before)

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13
Q

NPH insulin is used for glucose control ___ and ___

A

Between meals
Overnight

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14
Q

Rapid and short acting insulins

A

Lispro
Aspart
Glulisine

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15
Q

Slow and long acting insulins

A

Glargine
Detemir
Degludec

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16
Q

Insulin lispro peaks within __ minutes

17
Q

Timing of meal is __ critical with insulin lispro

A

Less critical (less risk of hypoglycemia from missed meal)

18
Q

When can insulin glulisine be injected?

A

Before meal
Immediately after meal

19
Q

Rapid acting synthetic insulins can be formulated with isophane/NP for ___

A

Between meal glucose control

20
Q

First ultra-long synthetic insulin

A

Insulin glargine

21
Q

When does insulin glargine peak?

A

Does not have a peak
Long, constant activity for 24+ hours

22
Q

When is insulin glargine administered?

23
Q

Differences between insulin glargine and detemir

A

Detemir has neutral pH, glargine is acidic
Detemir has 18 hour action, glargine is 24+

24
Q

Insulin with longest duration of action

A

Degludec (42+ hours)

25
Why is insulin usually administered at bedtime?
Protects against nighttime glucose production by liver glycogen breakdown
26
Insulin side effects
Hypoglycemia Sympathoadrenal symptoms CNS symptoms Weight gain
27
Treatment for severe hypoglycemia (unconscious)
Glucagon
28
Insulin drug interactions
Tons of common drugs, especially propranolol and other B-blockers
29
Non-insulin drug for T1D
Pramlintide
30
Pramlintide is an analog of ____
Amylin (peptide hormone released with insulin from pancreatic beta cells)
31
Effects of Pramlintide
Decreases post-prandial glucose Decreases glucagon Increases satiety/slows gastric emptying
32
Downside to pramlintide
Increases number of injections