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30 Cards in this Set

  • Front
  • Back
How is insulin typically described?
Duration, which usually reflections absorption
What properties of insulin determine speed of insulin absorption?
Aggregation - aggregation makes it slower
Volume - more volume, slower
Binding to proteins - slower
What body properties determine speed of insulin absorption?
Regional blood flow
Injection site
Local muscle activity
Local interstitial fluid flow (slower with edema)
Short acting insulin: name? how long does it last?
Insulin regular, soluble insulin, Novolin R, Humulin R

4-8 hours
Rapid acting insulins: how is it obtained?
All man-made with AA substitutions to prevent insulin dimerization. All not human.
What are the names of rapid acting insulin?
Insulin lispro = humalog
Insulin aspart = novalog
What are the intermediate insulins?
Insulin isophane = NPH
Insulin premixes = protamine + insulin regular, insulin lispro, or insulin aspart
Insulin detemir
What does isophane have horrible pharmacokinetics?
Half life increases with dose size
What is the long acting insulin?
Insulin glargine = lantus
Describe the absorption of glargine insulin?
Has a neutral isoelectric point. With the change in pH in the body, it microprecipitates in the skin then is reabsorbed.
How does insulin sensitivity change during pregnancy?
Initial: insulin sensitive
Late: insulin resistance
What are the adverse effects of insulin?
Hypoglycemia
Lipodystrophy, lipoatrophy
Allergy
Edema
Variability of absorption
What concentration is insulin available in?
U100 = 100 unit/mL
What insulin do you use in pumps?
Short or rapid insulin only
What do non-insulin peptides do? Name.
Affect net insulin affect

Amylin
Pramlintide
Exenatide
Liraglutide
Glucagon
Amylin: secretion? changes in diabetes?
Co-secreted with insulin

Deficient in type 1, and late-stage type 2 diabetes
Pramlintide: what is it? what is its affects?
Amylin analog

Reduce appetite, glucagon secretion, gastric emptying, meal insulin required
What are the side effects of pramlintide?
Nausea, hypoglycemia
Exenatide: what is it?
Analog of intestinal GLP-1 (glucagon-like peptide 1)
What are the affects of exenatide?
Reduced appetite, gastric emptying, and glucagon secretion
Increases insulin secretion
What are the side effects of exenatide?
N/V/D
Hypoglycemia
Changes in drug absorption
What are contraindications of exenatide?
Gastroparesis
Severe GI disease
Renal impairment
Pregnancy
What is liraglutide?
Analog of GLP-1
What are the affects of liraglutide?
Reduced appetite
Reduced gastric emptying
Reduced glucagon secretion
Increased insulin secretion
C-cell hyperplasia in mice
What are the side effects of liraglutide?
N/V/D
Constipation
Upper respiratory congestion
Hypoglycemia
Change in calcitonin in some
Change in drug absorption
What are the contraindications of liraglutide?
Gastroparesis
Severe GI disease
Pregnancy
Personal history of medullary carcinoma of the thyroid
Family history of MEN
Glucagon: affects?
Increased hepatic glucose output
Relaxes GI smooth muscle
How is glucagon administered?
Inject subcutaneous, comes as a dry powder with something to dissolve it
What are the side effects of glucagon? When is it contraindicated?
Nausea
Diarrhea
Headache
When is glucagon used? When should it not be used?
Rapid treatment of hypoglycemia when the patient can't take oral glucose for some reason

Pheochromocytoma