Medication Proficiency Exam Questions And Answers
short duration/rapid acting insulin - Answer lispro, aspart, glulisine "log" morelike
natural insulin
give immediately before eating
avaliable in insulin pen, insulin pump, IV, SQ
can be used in combo with NPH or long acting
SE: hypoglycemia, weight gain
short duration/slower acting - Answer Regular insulin (Humulin R, Novolin R)
IV, SQ
Good BS control
intermediate duration insluin - Answer NPH
Can be mixed with short duration
NEVER GIVE IV (difficult to reverse)
long duration insulin - Answer glargine and detemir
generally taken once a day (at night)
generally requires additional meal time insulin
CAN NOT BE MIXED
NEVER GIVEN IV
lispro - Answer Onset: 15-30 min
Peak: .5-2.5 hrs
,Duration: 3-6 hrs
aspart - Answer Onset: 10-20 min
Peak: 1-3 hrs
Duration: 3-5 hrs
Glulisine - Answer Onset: 10-15 min
Peak: 1-1.5 hrs
Duration: 3-5 hrs
regular insulin - Answer onset 30-60min
peak 1-5 hr
duration 6-10
NPH - Answer Onset: 60-120 min
Peak: 6-14 hr
Duration: 24 hrs
Glargine (Lantus) - Answer Onset: 1 hr
Peak: none
Duration: 18-24 hrs
*Can't be mixed w/ nothing
*Clear
detemir - Answer Onset: 60-120
Peak: 12-24
Duration: x
when administering insulin alternative injection sites to reduce risk of - Answer
lipidysthrophy
,How to mix insulin - Answer cloudy, clear, clear, cloudy
conventional mixing of insulin - Answer regular + NPH
2/3 dse @ breakfast and 1/3 dose @ dinner
Intensive conventional therapy (tight glycemic control) - Answer Glargine once/day
Regular insulin at breakfast, lunch, dinner adjusted by size of meal
Continuous subcutaneous insulin infusion Answer pump + subcutaneous catheter +
lispro/aspart/regular (short duration,rapid acting) basal insulin preset + bolus based on
size of meal
Flexible, tight glycemic control
Insulin when hot and dry Answer sugar high
Insulin when cold and clammy Answer need some candy
Glucophage-metformin biguanides Answer Improves glucose tolerance for DMII
Decreases glucose production by the liver & increases tissue response to insulin
Side effects:
Diarrhea, decreased appetite, nausea, lactic acidosis
Alcohol inhibits lactic acid breakdown & increases risk for lactic acidosis **NO
ALCOHOL
Doesn't produce hypoglycemia*****
Rosiglitazone (Avandia) - Thiazolidinediones (TZD) - AnswerDecreases insulin
resistance which increases glucose uptake by muscle & adipose tissue and decreases
glucose production by the liver
Side effects:
, Hypoglycemia, heart failure, bladder cancer, fractures, ovulation
Rarely used due to increased risk of MI & sudden cardiac death****
Glipizde - Answer 12-24 hour duration; Glimepiride - 24 hour duration - Sulfonylureas
-Stimulates insulin secretion by pancreas
-Adverse: hypoglycemia anxious, irritable, cool, clammy skin, blurred vision, hunger
Repaglinide - Glinides - Answer -Stimulates pancreatic production of insulin
-Short half-life
-**Eat within 30 minutes of taking or will experience hypoglycemia b/c it stimulates
insulin production
Acarbose; Miglitol - Alpha-Glucosidase Inhibitors - Answer -Act on intestines to delay
digestion and absorption of carbohydrates
-Adverse: flatulence, cramps, abdominal distention
-Monitor liver function; used alone or with other hypoglycemics
-**Take with first bite of food
anticoagulants action - Answer Action: decreases fibrin formation by promoting
inactivation of clotting factors (thrombin and factor Xa)
Activate anti-thrombin: Heparin (unfractionated) and Enoxaparin (Lovenox, low
molecular weight)
heparin administration Answer Heparin - SubQ, IV; protamine sulfate - **ONLY given in
hospital - high alert med
IV infusion - loading dose of 5000-10000 units based on weight; dose (U/hr) based on
PTT values
never aspirate or massage site
short duration/rapid acting insulin - Answer lispro, aspart, glulisine "log" morelike
natural insulin
give immediately before eating
avaliable in insulin pen, insulin pump, IV, SQ
can be used in combo with NPH or long acting
SE: hypoglycemia, weight gain
short duration/slower acting - Answer Regular insulin (Humulin R, Novolin R)
IV, SQ
Good BS control
intermediate duration insluin - Answer NPH
Can be mixed with short duration
NEVER GIVE IV (difficult to reverse)
long duration insulin - Answer glargine and detemir
generally taken once a day (at night)
generally requires additional meal time insulin
CAN NOT BE MIXED
NEVER GIVEN IV
lispro - Answer Onset: 15-30 min
Peak: .5-2.5 hrs
,Duration: 3-6 hrs
aspart - Answer Onset: 10-20 min
Peak: 1-3 hrs
Duration: 3-5 hrs
Glulisine - Answer Onset: 10-15 min
Peak: 1-1.5 hrs
Duration: 3-5 hrs
regular insulin - Answer onset 30-60min
peak 1-5 hr
duration 6-10
NPH - Answer Onset: 60-120 min
Peak: 6-14 hr
Duration: 24 hrs
Glargine (Lantus) - Answer Onset: 1 hr
Peak: none
Duration: 18-24 hrs
*Can't be mixed w/ nothing
*Clear
detemir - Answer Onset: 60-120
Peak: 12-24
Duration: x
when administering insulin alternative injection sites to reduce risk of - Answer
lipidysthrophy
,How to mix insulin - Answer cloudy, clear, clear, cloudy
conventional mixing of insulin - Answer regular + NPH
2/3 dse @ breakfast and 1/3 dose @ dinner
Intensive conventional therapy (tight glycemic control) - Answer Glargine once/day
Regular insulin at breakfast, lunch, dinner adjusted by size of meal
Continuous subcutaneous insulin infusion Answer pump + subcutaneous catheter +
lispro/aspart/regular (short duration,rapid acting) basal insulin preset + bolus based on
size of meal
Flexible, tight glycemic control
Insulin when hot and dry Answer sugar high
Insulin when cold and clammy Answer need some candy
Glucophage-metformin biguanides Answer Improves glucose tolerance for DMII
Decreases glucose production by the liver & increases tissue response to insulin
Side effects:
Diarrhea, decreased appetite, nausea, lactic acidosis
Alcohol inhibits lactic acid breakdown & increases risk for lactic acidosis **NO
ALCOHOL
Doesn't produce hypoglycemia*****
Rosiglitazone (Avandia) - Thiazolidinediones (TZD) - AnswerDecreases insulin
resistance which increases glucose uptake by muscle & adipose tissue and decreases
glucose production by the liver
Side effects:
, Hypoglycemia, heart failure, bladder cancer, fractures, ovulation
Rarely used due to increased risk of MI & sudden cardiac death****
Glipizde - Answer 12-24 hour duration; Glimepiride - 24 hour duration - Sulfonylureas
-Stimulates insulin secretion by pancreas
-Adverse: hypoglycemia anxious, irritable, cool, clammy skin, blurred vision, hunger
Repaglinide - Glinides - Answer -Stimulates pancreatic production of insulin
-Short half-life
-**Eat within 30 minutes of taking or will experience hypoglycemia b/c it stimulates
insulin production
Acarbose; Miglitol - Alpha-Glucosidase Inhibitors - Answer -Act on intestines to delay
digestion and absorption of carbohydrates
-Adverse: flatulence, cramps, abdominal distention
-Monitor liver function; used alone or with other hypoglycemics
-**Take with first bite of food
anticoagulants action - Answer Action: decreases fibrin formation by promoting
inactivation of clotting factors (thrombin and factor Xa)
Activate anti-thrombin: Heparin (unfractionated) and Enoxaparin (Lovenox, low
molecular weight)
heparin administration Answer Heparin - SubQ, IV; protamine sulfate - **ONLY given in
hospital - high alert med
IV infusion - loading dose of 5000-10000 units based on weight; dose (U/hr) based on
PTT values
never aspirate or massage site
