II. Background
- Exubera (listed for historical reasons)
- Off U.S. Market as of October 2007 (based on business decisions, not on recall)
III. Indications
- Diabetes Mellitus when intollerant to SQ Injection
IV. Contraindications
- COPD
- Asthma
- Lung Cancer
- Tobacco use
V. Mechanism
VI. Preparations: Afrezza
- Released in 2014, as a Bolus Insulin substitute
- Does not replace basal Insulin
- Dose
- Delivered in 4 or 8 units cartridge
- Convert Insulin unit for unit, and round dose up to nearest 4 unit cartridge
- Cost
- Twice the cost of Bolus Insulin
- Activity
- Onset of activity is similar to SC injected Bolus Insulin
- Duration is shorter than SC injected Bolus Insulin
VII. Preparations: Exubera (off market as of 2007)
VIII. Efficacy
- Similar to SC Bolus Insulin
IX. Adverse Effects: Exubera
- Hypoglycemia (esp. when used with Oral Hypoglycemics)
- Cough (<5%)
- Chest Pain (<5%)
- Dyspnea (<5%)
- Dry Mouth (<5%)
X. Monitoring: Pulmonary Function Tests
- Schedule: Baseline, 6 months and annually
- Stop Inhaled Insulin if FEV1 with >20% decline from baseline