NU 578 - Endocrine Drugs: Questions With Applicable
Solutions
Action of insulin on muscle Accurate Answer:- increase glucose
transport into cells, increase glycogenesis, increase protein and TG synthesis
Action of insulin on liver Accurate Answer:- increase glucose transport
into cells, increase glycogenesis, increase glucose utilization, increase protein
synthesis
Action of insulin on adipose Accurate Answer:- increase glucose
transport into cells, increase glycogenesis, increase TG synthesis
Goal of insulin therapy Accurate Answer:- adequate glucose control
with out a lot of injections in a 24hr period
Adequate glucose control Accurate Answer:- •Fasting plasma glucose <
126 mg/dL OR
-100-125 = prediabetes
-<100 is desirable
•Casual plasma glucose <200 mg/dL
•Oral glucose tolerance test (OGTT)—measured 2 h after glucose ingestion <
200 mg/dL
•HbA1c: tests BG over a period of months. Measure every 3-6 mos. Goal is to
keep this at <6.5% of total Hb (7% if the patient has other comorbidities)
-5.7-6.4% prediabetes
-4-5-6% desirable
New Diabetes Criteria Accurate Answer:- •FPG of <126 mg/dl
•OGTT of < 200 mg/dl
•HbA1c of < 6.5%
•Testing for all people should be done at 45 years of age
-Annual testing in those with prediabetes
•Testing should be done in children if they are obese
, Insulin Toxicity Accurate Answer:- hypoglycemia - weakness, sweating,
headache, ↑ HR, anxiety, tremor, mental/visual disturbances
due to hypoglycemic release of epinephrine, and hypokalemia
Mixing Insulins Accurate Answer:- Clear (short acting) to Cloudy (NPH)
Factors influencing Insulin requirements Accurate Answer:- •Food,
stress, and infection increase insulin need
•Exercise decreases insulin need
•Insulin given SC. Absorption is greatest from abdomen>arm>thigh>hip. Most
people need 2 injections/day of regular/NPH mixture.
Regular insulin (Humulin R, Novolin R) Accurate Answer:- Onset: 30-60
minutes
Peak: 1-5 hours
Duration: 6-10 hours
Lispro (Humalog) Accurate Answer:- Onset: 15-30 min
Peak: 30-90 min
Duration: 3-6 hr
Aspart (Novolog) Accurate Answer:- Onset: 10-20 min
Peak: 1-3 hr
Duration: 3-5 hr
NPH insulin Accurate Answer:- onset: 1-2 hours
peak: 4-12 hours
duration: 16-24 hours
Glargine (Lantus) Accurate Answer:- Onset: 1 hr
Peak: None
Duration: 24 hours
Detemir (Levemir) Accurate Answer:- Onset: 1-2 hr
Peak: 3-6 hr
Duration: 12- 24 hr
Solutions
Action of insulin on muscle Accurate Answer:- increase glucose
transport into cells, increase glycogenesis, increase protein and TG synthesis
Action of insulin on liver Accurate Answer:- increase glucose transport
into cells, increase glycogenesis, increase glucose utilization, increase protein
synthesis
Action of insulin on adipose Accurate Answer:- increase glucose
transport into cells, increase glycogenesis, increase TG synthesis
Goal of insulin therapy Accurate Answer:- adequate glucose control
with out a lot of injections in a 24hr period
Adequate glucose control Accurate Answer:- •Fasting plasma glucose <
126 mg/dL OR
-100-125 = prediabetes
-<100 is desirable
•Casual plasma glucose <200 mg/dL
•Oral glucose tolerance test (OGTT)—measured 2 h after glucose ingestion <
200 mg/dL
•HbA1c: tests BG over a period of months. Measure every 3-6 mos. Goal is to
keep this at <6.5% of total Hb (7% if the patient has other comorbidities)
-5.7-6.4% prediabetes
-4-5-6% desirable
New Diabetes Criteria Accurate Answer:- •FPG of <126 mg/dl
•OGTT of < 200 mg/dl
•HbA1c of < 6.5%
•Testing for all people should be done at 45 years of age
-Annual testing in those with prediabetes
•Testing should be done in children if they are obese
, Insulin Toxicity Accurate Answer:- hypoglycemia - weakness, sweating,
headache, ↑ HR, anxiety, tremor, mental/visual disturbances
due to hypoglycemic release of epinephrine, and hypokalemia
Mixing Insulins Accurate Answer:- Clear (short acting) to Cloudy (NPH)
Factors influencing Insulin requirements Accurate Answer:- •Food,
stress, and infection increase insulin need
•Exercise decreases insulin need
•Insulin given SC. Absorption is greatest from abdomen>arm>thigh>hip. Most
people need 2 injections/day of regular/NPH mixture.
Regular insulin (Humulin R, Novolin R) Accurate Answer:- Onset: 30-60
minutes
Peak: 1-5 hours
Duration: 6-10 hours
Lispro (Humalog) Accurate Answer:- Onset: 15-30 min
Peak: 30-90 min
Duration: 3-6 hr
Aspart (Novolog) Accurate Answer:- Onset: 10-20 min
Peak: 1-3 hr
Duration: 3-5 hr
NPH insulin Accurate Answer:- onset: 1-2 hours
peak: 4-12 hours
duration: 16-24 hours
Glargine (Lantus) Accurate Answer:- Onset: 1 hr
Peak: None
Duration: 24 hours
Detemir (Levemir) Accurate Answer:- Onset: 1-2 hr
Peak: 3-6 hr
Duration: 12- 24 hr
