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RxPrep
Type 1 Diabetes
| Question | Answer |
|---|---|
| Rapid-acting insulins? | Lispro, aspart, glulisine |
| Short-acting insulin? | Regular insulin |
| Intermediate insulin? | NPH |
| Long acting insulin? | Glargine, detemir |
| Ultra-long acting insulin? | Degludec |
| Which insulin is U-500? | Regular insulin (Humulin R U-500) |
| Which insulin is U-200? | Lispro U-200, degludec U-200 |
| Which insulin is U-300? | Which insulin is U-300? |
| When is it appropriate to use U-500 insulin? | Only if patient needs > 200 units per day |
| Glargine brands? | Lantus, toujeo (U300), basaglar |
| Tresiba generic? | Degludec |
| Humalog generic? | Lispro |
| Novolog generic? | Aspart |
| Apidra generic? | Glulisine |
| Afrezza generic? | Inhaled insulin |
| CI for Afrezza? | Any chronic lung condition (eg Asthma/COPD) or smokers |
| ADRs of Afrezza? | Bronchospams |
| Monitoring for Afrezza? | Pulmonary function tests (FEV1) |
| ADRs of insulin? | Hypoglycemia, weight gain, lipodystrophy (injection site reaction) |
| Can you store insulin at room temp? | If unopened: NO If opened: room temp is ok |
| Which insulin formulations are only good for 10-14 days at room temp? | Humolog/humilin mix 50/50 and 75/25 PENS (10 days) Humilin N pen and Novolog Mix 70/30 PENS (14 days) **Humilin.Novolog pens last 10-14 days** |
| Most insulins are good out of the fridge for what period of time? | 28-31 days (4 weeks) |
| Which insulin products are good for ~6 weeks at room temp? | Humilin-R U 500 vial (40 days) Novolin R, N, and 70/30 vials |
| Which insulin products are good for ~8 weeks at room temp? | Tresiba and toujeo pens (56 days) |
| Most insulin pens contain what volume? | 3mL mostly (toujeo has 1.5mL formulations) |
| What is the usual ratio of basal:bolus in most T1D patients? | 50:50 |
| Rapid-acting insulin carb ratio calculation? | 500 / total daily dose (including basal+bolus) |
| Regular insulin carb ratio calculation? | 450 / total daily dose (including basal and bolus) |
| Correction factor formula for rapid acting? | 1800 / TDD |
| Correction factor formula for regular acting? | 1500 / TDD |
| Correction dose formula? | (BG - goal) / correction factor |
| When is correction dosing needed? | If BG is high right before the next meal |
| Steps for calculating a dose correction? | Find TDD, Divide 1800/1500 by TDD, to get CF Then find: (BG - target)/CF |
| So when do we use the rule of 450 or 500? | When calculating a dose prior to a meal, to find the estimated ICR |
| So when do we use the rule of 1500 or 1800? | When theres hyperglycemia before the next meal (When dose needs correcting) |
| What are the steps for calculating a meal dose ahead of time? | Find TDD Divide 450/500 by TDD for ICR Then solve for: Meal carbs/ ICR |
| Timing for premixed insulins (like 70/30)? | Before meals |
| Counseling for insulin injection? | Abdomen, at 90 or 45 degree angle, and rotate sites |
| Treatment for hypoglycemia? | Rule of 15 (15 grams of carbs every 15 minutes) If severe/unconscious, give glucagon |
| Is sliding preferred for insulin dosing? | No |
| Preferred inpatient regimen for insulin? | Basal + bolus |
Created by:
cdaughtry