7370257
Description
Flashcards by Andrew Street, updated more than 1 year ago
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Created by Andrew Street
almost 8 years ago
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| Question | Answer |
| Give eg's of & indications for insulin. | eg's: insulin aspart, insulin glargine, biphasic insulin, soluble insulin Indications: • DM I - insulin replacement • DM II - control of BD glucose where oral hypoglycaemic Rx is inadequate or poorly tolerated • Diabetic emergencies (IV) - diabetic ketoacidosis, hyperglycaemic hyperosmolar syndrome • Perioperative glycaemic control - in selected diabetic pt's • With glucose to Rx hyperkalaemia whilst underlying cause is sought |
| MOA of insulin. | In DM, exogenous insulin functions similarly to endogenous insulin. It stimulates glucose uptake from the circulation into tissues, including skeletal muscle & fat, & ^use of glucose as an energy source. Insulin stimulates glycogen, lipid & protein synthesis & inhibits gluconeogenesis & ketogenesis. For the Rx of hyperkalaemia, insulin drives K+ into cells, reducing serum K+ concentrations. However, once insulin Rx is stopped, K+ leaks back out of the cells into the circulation, so this is a short-term measure while other Rx is commenced. The wide choice of insulin preparations for Rx of DM can be classified as: rapid acting (immediate onset, short duration): insulin aspart, eg Novorapid®; short acting (early onset, short duration): soluble insulin, eg Actrapid®; intermediate acting (intermediate onset and duration): isophane (NPH) insulin, eg Humulin I®; & long acting (flat profile with regular administration): insulin glargine (Lantus®), insulin detemir (Levemir®). Biphasic insulin preparations contain a mixture of rapid & intermediate acting insulins, eg Novomix® 30. |
| SE's of insulin. | SE's: • Hypoglycaemia • Lipohypertrophy - at regular injection sites |
| CI's, cautions, & important interactions of insulin. | CI's: • None Cautions: • ^ Risk of hypoglycaemia in pt's with renal impairment due to reduced clearance Important interactions: Although often necessary, combining insulin with other hypoglycaemic agents ^risk of hypoglycaemia. Concurrent Rx with systemic corticosteroids ^insulin requirements. |
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