Injectable Drugs for Diabetes Part 3.docx

**Slide 21: Long-Acting Insulin** 1. **Which of the following insulins is classified as long-acting?** - A. Lantus (insulin glargine) - B. Humalog - C. NPH - D. Regular insulin\ **Answer:** A. Lantus (insulin glargine) 2. **What is the duration of action for L...

**Slide 21: Long-Acting Insulin** 1. **Which of the following insulins is classified as long-acting?** - A. Lantus (insulin glargine) - B. Humalog - C. NPH - D. Regular insulin\ **Answer:** A. Lantus (insulin glargine) 2. **What is the duration of action for Lantus (insulin glargine)?** - A. 12-16 hours - B. 20-24 hours - C. 8-10 hours - D. 42 hours\ **Answer:** B. 20-24 hours 3. **Why should long-acting insulins not be mixed with other insulin types in the same syringe?** - A. It increases the risk of hypoglycemia - B. It inactivates the long-acting insulin - C. It reduces insulin absorption - D. It prolongs the onset of action\ **Answer:** B. It inactivates the long-acting insulin **Slide 22: Long-Acting Insulin Duration** 1. **Toujeo (insulin glargine U-300) has a duration of action that can last for:** - A. 18-20 hours - B. 20-24 hours - C. 24-36 hours - D. 42 hours\ **Answer:** C. 24-36 hours 2. **Which of the following long-acting insulins has the longest duration of action, up to 42 hours?** - A. Lantus - B. Tresiba (insulin degludec) - C. Levemir - D. Humulin R\ **Answer:** B. Tresiba (insulin degludec) 3. **Which of the following best describes the clinical importance of the onset time for long-acting insulin?** - A. Critical to control postprandial glucose - B. Not clinically important for basal insulin therapy - C. Important for nocturnal hypoglycemia prevention - D. Essential for bolus insulin administration\ **Answer:** B. Not clinically important for basal insulin therapy **Slide 23: Basal Insulin Titration** 1. **When initiating basal insulin therapy with Lantus, the starting dose is generally:** - A. 0.5-1 units/kg at bedtime - B. 10 units or 0.1-0.2 units/kg at bedtime - C. 20 units before each meal - D. 5 units per kilogram of body weight\ **Answer:** B. 10 units or 0.1-0.2 units/kg at bedtime 2. **For basal insulin titration, what dose adjustment should be made if the fasting blood glucose is 140-180 mg/dL?** - A. Increase by 2 units - B. Increase by 4 units - C. Increase by 6 units - D. Increase by 8 units\ **Answer:** C. Increase by 6 units 3. **In basal insulin titration, if hypoglycemia occurs and no clear cause is found, how should the insulin dose be adjusted?** - A. Reduce by 2 units - B. Reduce by 4 units or 10-20% - C. Reduce by 10 units - D. No dose adjustment needed\ **Answer:** B. Reduce by 4 units or 10-20% **Slide 24: Combination Products** 1. **What is the typical composition of combination insulin products like Humalog Mix 75/25?** - A. 75% regular insulin / 25% NPH - B. 75% insulin lispro protamine / 25% insulin lispro - C. 75% insulin aspart / 25% insulin glulisine - D. 75% insulin glargine / 25% insulin detemir\ **Answer:** B. 75% insulin lispro protamine / 25% insulin lispro 2. **Combination insulin products are typically used to control which blood glucose levels?** - A. Fasting glucose levels only - B. Postprandial glucose levels only - C. Both fasting and postprandial glucose levels - D. Glucose levels during exercise\ **Answer:** C. Both fasting and postprandial glucose levels 3. **Glargine/Lixisenatide combination insulin therapy involves which of the following mechanisms?** - A. Long-acting insulin with a GLP-1 receptor agonist - B. Rapid-acting insulin with a DPP-4 inhibitor - C. Intermediate-acting insulin with amylin analog - D. Short-acting insulin with a sulfonylurea\ **Answer:** A. Long-acting insulin with a GLP-1 receptor agonist **Slide 25: Inhaled Insulin (Afrezza)** 1. **Inhaled insulin (Afrezza) is used primarily to control:** - A. Fasting glucose levels - B. Postprandial hyperglycemia - C. Hypoglycemia - D. Nocturnal hypoglycemia\ **Answer:** B. Postprandial hyperglycemia 2. **What is a major contraindication for the use of inhaled insulin?** - A. Type 1 diabetes - B. COPD or asthma - C. Pregnancy - D. Obesity\ **Answer:** B. COPD or asthma 3. **Inhaled insulin carries a boxed warning for which of the following conditions?** - A. Acute bronchospasm in patients with asthma or COPD - B. Hypoglycemia in patients with type 2 diabetes - C. Ketoacidosis in patients with type 1 diabetes - D. Weight gain in insulin-dependent patients\ **Answer:** A. Acute bronchospasm in patients with asthma or COPD \-\-- \#\#\# \*\*Slide 26: Insulin Adverse Effects\*\* 1\. \*\*What is the most common adverse effect of insulin therapy?\*\* \- A. Weight loss \- B. Hypoglycemia \- C. Hyperglycemia \- D. Hypotension \*\*Answer:\*\* B. Hypoglycemia 2\. \*\*Which insulin-related complication is associated with excessive weight gain?\*\* \- A. Ketoacidosis \- B. Lipohypertrophy \- C. Hypoglycemia \- D. Hyperkalemia \*\*Answer:\*\* B. Lipohypertrophy 3\. \*\*How can insulin-induced hypoglycemia be prevented?\*\* \- A. Reducing basal insulin doses only \- B. Providing appropriate meal timing for bolus and NPH insulin \- C. Administering insulin at irregular times \- D. Increasing the frequency of insulin doses \*\*Answer:\*\* B. Providing appropriate meal timing for bolus and NPH insulin \-\-- \#\#\# \*\*Slide 27: Insulin Absorption\*\* 1\. \*\*Which factor can affect the rate of insulin absorption at the injection site?\*\* \- A. Insulin concentration \- B. Needle length \- C. Injection site rotation \- D. All of the above \*\*Answer:\*\* D. All of the above 2\. \*\*Which insulin injection site is associated with the most consistent and rapid absorption?\*\* \- A. Thigh \- B. Arm \- C. Abdomen \- D. Buttock \*\*Answer:\*\* C. Abdomen 3\. \*\*Why should insulin injection sites be rotated?\*\* \- A. To avoid developing insulin resistance \- B. To prevent tissue reactions such as lipodystrophy \- C. To increase insulin potency \- D. To improve insulin production \*\*Answer:\*\* B. To prevent tissue reactions such as lipodystrophy \-\-- \#\#\# \*\*Slide 28: Insulin Therapy\*\* 1\. \*\*What is the primary goal of basal insulin therapy?\*\* \- A. To manage postprandial glucose spikes \- B. To maintain glucose control between meals and overnight \- C. To increase insulin secretion during exercise \- D. To manage acute hypoglycemia \*\*Answer:\*\* B. To maintain glucose control between meals and overnight 2\. \*\*Which type of insulin is used as part of bolus insulin therapy to manage postprandial glucose levels?\*\* \- A. Long-acting insulin \- B. Intermediate-acting insulin \- C. Rapid-acting insulin \- D. Regular insulin \*\*Answer:\*\* C. Rapid-acting insulin 3\. \*\*Basal insulin aims to provide a:\*\* \- A. Continuous release of insulin to control fasting glucose levels \- B. Spike in insulin levels after meals \- C. Rapid response to carbohydrate intake \- D. Short-term correction of blood glucose levels \*\*Answer:\*\* A. Continuous release of insulin to control fasting glucose levels \-\-- \#\#\# \*\*Slide 29: Monitoring Blood Glucose\*\* 1\. \*\*In which of the following situations is frequent blood glucose monitoring especially important?\*\* \- A. During pregnancy \- B. When starting or changing diabetes medications \- C. During illness \- D. All of the above \*\*Answer:\*\* D. All of the above 2\. \*\*What is a potential downside of frequent blood glucose monitoring?\*\* \- A. Increased accuracy of glucose control \- B. High cost and potential for patient depression \- C. Reduced ability to track hypoglycemia \- D. Decreased motivation for patients \*\*Answer:\*\* B. High cost and potential for patient depression 3\. \*\*How often should patients on multiple daily injections of insulin check their blood glucose?\*\* \- A. Once daily \- B. Before and after every meal \- C. At least four times a day (qACHS) \- D. Only at bedtime \*\*Answer:\*\* C. At least four times a day (qACHS) \-\-- \#\#\# \*\*Slide 30: Insulin Therapy -- Bolus vs Basal\*\* 1\. \*\*What is the main function of bolus insulin in diabetes therapy?\*\* \- A. To manage blood glucose levels between meals \- B. To control glucose spikes after meals and snacks \- C. To replace basal insulin \- D. To prevent nocturnal hypoglycemia \*\*Answer:\*\* B. To control glucose spikes after meals and snacks 2\. \*\*Basal insulin is essential for controlling glucose during which periods?\*\* \- A. After meals \- B. Between meals and overnight \- C. During exercise \- D. Immediately before breakfast \*\*Answer:\*\* B. Between meals and overnight 3\. \*\*When should bolus insulin typically be administered in relation to meals?\*\* \- A. 1 hour after a meal \- B. 30-60 minutes before a meal \- C. 15-30 minutes before a meal \- D. Right after waking up \*\*Answer:\*\* C. 15-30 minutes before a meal \-\--