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30 Cards in this Set
- Front
- Back
How is insulin typically described?
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Duration, which usually reflections absorption
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What properties of insulin determine speed of insulin absorption?
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Aggregation - aggregation makes it slower
Volume - more volume, slower Binding to proteins - slower |
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What body properties determine speed of insulin absorption?
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Regional blood flow
Injection site Local muscle activity Local interstitial fluid flow (slower with edema) |
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Short acting insulin: name? how long does it last?
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Insulin regular, soluble insulin, Novolin R, Humulin R
4-8 hours |
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Rapid acting insulins: how is it obtained?
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All man-made with AA substitutions to prevent insulin dimerization. All not human.
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What are the names of rapid acting insulin?
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Insulin lispro = humalog
Insulin aspart = novalog |
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What are the intermediate insulins?
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Insulin isophane = NPH
Insulin premixes = protamine + insulin regular, insulin lispro, or insulin aspart Insulin detemir |
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What does isophane have horrible pharmacokinetics?
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Half life increases with dose size
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What is the long acting insulin?
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Insulin glargine = lantus
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Describe the absorption of glargine insulin?
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Has a neutral isoelectric point. With the change in pH in the body, it microprecipitates in the skin then is reabsorbed.
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How does insulin sensitivity change during pregnancy?
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Initial: insulin sensitive
Late: insulin resistance |
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What are the adverse effects of insulin?
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Hypoglycemia
Lipodystrophy, lipoatrophy Allergy Edema Variability of absorption |
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What concentration is insulin available in?
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U100 = 100 unit/mL
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What insulin do you use in pumps?
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Short or rapid insulin only
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What do non-insulin peptides do? Name.
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Affect net insulin affect
Amylin Pramlintide Exenatide Liraglutide Glucagon |
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Amylin: secretion? changes in diabetes?
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Co-secreted with insulin
Deficient in type 1, and late-stage type 2 diabetes |
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Pramlintide: what is it? what is its affects?
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Amylin analog
Reduce appetite, glucagon secretion, gastric emptying, meal insulin required |
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What are the side effects of pramlintide?
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Nausea, hypoglycemia
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Exenatide: what is it?
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Analog of intestinal GLP-1 (glucagon-like peptide 1)
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What are the affects of exenatide?
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Reduced appetite, gastric emptying, and glucagon secretion
Increases insulin secretion |
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What are the side effects of exenatide?
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N/V/D
Hypoglycemia Changes in drug absorption |
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What are contraindications of exenatide?
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Gastroparesis
Severe GI disease Renal impairment Pregnancy |
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What is liraglutide?
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Analog of GLP-1
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What are the affects of liraglutide?
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Reduced appetite
Reduced gastric emptying Reduced glucagon secretion Increased insulin secretion C-cell hyperplasia in mice |
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What are the side effects of liraglutide?
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N/V/D
Constipation Upper respiratory congestion Hypoglycemia Change in calcitonin in some Change in drug absorption |
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What are the contraindications of liraglutide?
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Gastroparesis
Severe GI disease Pregnancy Personal history of medullary carcinoma of the thyroid Family history of MEN |
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Glucagon: affects?
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Increased hepatic glucose output
Relaxes GI smooth muscle |
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How is glucagon administered?
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Inject subcutaneous, comes as a dry powder with something to dissolve it
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What are the side effects of glucagon? When is it contraindicated?
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Nausea
Diarrhea Headache |
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When is glucagon used? When should it not be used?
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Rapid treatment of hypoglycemia when the patient can't take oral glucose for some reason
Pheochromocytoma |