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Pharm - T1DM
Pharm t5
48
Pharmacology
Graduate
04/02/2010

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Term
insulins produced w recombinant DNa technology with identical AA sequence to human insulin.
Definition
regular insulins: humalin & novolin
Term
5 insulin analogs:
Definition
1. humalog
2. novolog
3. Apidra
4. lantus
5. levemir
Term
3 rapid acting insulins:
Definition
1. humalog
2. novolog
3. apidra
Term
short to intermediate acting insulins:
Definition
1. regular
2. NPH

both are novalin & humalin
Term
2 long acting insulins:
Definition
1. lantus
2. levemir
Term
insulins: time of onset = 15-30minutes
Definition
1. humalog
2. novalog
3. apidra
Term
insulin: time of onset 30-60min
Definition
regular insulin (novolin/humalin)
Term
insulin: time of onset 2-4hrs
Definition
NPH
Term
insulin: time of onset 4-5hrs
Definition
lantus
Term
insulin: time of onset and effective duration is unknown
Definition
levemir
Term
insulins: peak @ 1-2hrs
Definition
1. humalog
2. novolog
3. apidra
Term
insulin: peak @ 2-3hrs
Definition
regular
Term
insulin: peak @ 4-10hrs
Definition
NPH
Term
insulin: peak @ 6-8hrs
Definition
levemir
Term
insulin: peak @ 4-5hrs
Definition
lantus
Term
insulin: effective duration 2-3hrs
Definition
1. humalog
2. novolog
3. apidra
Term
insulin: effective duration 3-6hrs
Definition
regular
Term
insulin: effective duration 8-12hrs
Definition
NPH
Term
insulin: effective duration unkown:
Definition
levemir
Term
insulin: effective duration 22-24hrs
Definition
lantus
Term
insulin dosing for adult w T1DM in units/kg/day
Definition
0.5-1mg/kg/day
Term
children with T1DM: insulin dosing in units/kg/d
Definition
0.4-0.8units/kg/day
Term
insulin dosing for adolescents in units/kg/day
Definition
1.0 to 1.5 units/kg/d during puberty until they reach adulthood
Term
basal insulin should comprise what % of the total daily insulin dose>
Definition
50-70%
Term
bolus insulin should comprise what % of total daily insulin dose?
Definition
30-50%
Term
if weight based dosing needs adjustment, what increments of units should insulin be changed?
Definition
1-2untis no more than 10%of total daily dose
Term
in an insulin sensative preson (T1DM) 1 unit of insulin will decrease BG by:
Definition
50mg/dl
Term
insulin adjustments can be made every __to __ days IF pt routine is stable:
Definition
every 3-4days
Term
define intensive insulin therapy:
Definition
3-4inj per day; basal insulin + bolus insulin - recommended for T1DM
Term
one unit of insulin will cover __g of carbs:
Definition
15g of carbs
Term
70kg adult insulin dose in units/day
Definition
35-70units/day.... begin w 36units
Term
recommended carb intake for breakfast, lunch, supper and snack:
Definition
breakfast: 60g
lunch: 75g
supper: 75g
snack: 15-30g
Term
converting NPH to lantus
Definition
daily NPH x0.8 = lantus dose (give lantus at bedtime)
Term
dawn phenom:
Definition
normal physiologic rise in BG during awakening
Term
smogyi effect:
Definition
hyperactive hyperglycemia in response to nocturnal hypoglycemia. BG near normal at bedtime and elevated upon awakening. have them take a 3am BG to distinguish btwn dawn phenom
Term
describe mild hypoglycemia:
Definition
BG<60, adrenergic effects(anxiety sweating, tremor, tachy, hunger)
Term
mild hypoglycemia tx:
Definition
oral ingestion on 10-15g carb resolve in 10-15min
Term
describe moderate hypoglycemia:
Definition
adrenergic sx + neuroglycopenic sx (HA, irritable, confused, slurred speech)
Term
moderate hypoglycemia tx:
Definition
2 doses of 10-15g of carbs
Term
describe severe hypoglycemia:
Definition
unresponsive, unconsious, convulsions.
Term
severe hypoglycemia tx:
Definition
emergency IV dextrose or IM glucagon
Term
what is a GlucaGen Hypokit?
Definition
glucagon for emergency injection
Term
what is extendbar/nitebite:
Definition
tiem released glucose bar to prevent nocturnal hypoglycemia
Term
what is pramlintide:
Definition
synthetic anylin: amylin is screted with insulin, slows gastric emptying and inhibits glucagon secretions
Term
indications for pramlintide:
Definition
adjunct tx for T1&T2DM who have not achieved control with insulin; A1c<9% higher indicates increased insulin needed
Term
dosing pramlintide:
Definition
initially 60mcg injected before meals increase to 120mcg when there is no nausea assoc w dose.
Term
adjustment of insulin upon pramlintide initiation:
Definition
1. decrease insulin 25% when A1c>8%
2. decr insulin 25-50% when A1c<8%
3. reduce total dose of premix insulin by 25%
Term
2 adverse affects of pramlintide:
Definition
1. Hypoglycemia
2. GI (N/V,anorexia,early satiety)
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