11 Thera VI Midterm Study Questions Flashcards
What drugs should you avoid/use caution when you don’t want weight gain?
SFUs, Meglitinides, TZDs
What drugs should you avoid/use caution when you don’t want GI symptoms?
Metformin, a-glucosidase inhibitor
What drugs should you avoid/use caution when you don’t want Hypoglycemia?
SFUs, Meglitinides
What drugs should you avoid/use caution when you have impaired renal function?
Metformin (look at SCr levels). SFUs (depends what the CrCl is). DPP-4 inhibitor (Linagliptin ok)
What drugs should you avoid/use caution when you have impaired hepatic function?
Metformin, TZDs, a-glucosidase inhibitor
What drugs should you avoid/use caution when you have impaired CV/pulmonary function?
Metformin, TZDs
What is the normal C-peptide level?
2
What is the most identifiable risk factor for microvascular complications?
Hyperglycemia
What is more important to control in T2DM as A1c improves?
PPG
When giving long-acting and rapid-acting insulin to a patient, which one usually makes up the majority of the insulin taken in that day?
Long-acting (50-60%). Rapid-acting (40-50%)
What is the Empiric Dosing of insulin in T1DM?
0.5-0.8 units/kg/day
At what dose should insulin be started for T2DM?
0.1-0.2 units/kg/day
What is more common in T1DM: DKA or HSS?
DKA (presents with ketoacidosis, hyperglycemia, and hyperosmolarity)
What is more common in T2DM: DKA or HSS?
HSS (presents with hyperglycemia and hyperosmolarity)
What are the steps in muscle/FA storage breakdown?
Breakdown goes through 1) plasma glucose, 2) plasma FFA, 3) muscle TG, and finally 4) muscle glycogen
For women with Diabetes while pregnant (NOT GDM), what are their pre-meal/bedtime/overnight glucose goals?
60-99
For women with Diabetes while pregnant (NOT GDM), what are their peak PPG goals?
100-129
For women with Diabetes while pregnant (NOT GDM), what is their A1c goal?
< 6.1%
For women with GDM, what is their pre-prandial goal?
< 95
For woman with GDM, what is their 1h- and 2-hour post-meal goal?
1h: < 140. 2h: < 120
Which disorder do you usually find Thyroid Receptor Antibodies (TRAb)?
Graves ONLY (not in Hashimoto’s)
Which SFU requires hepatic metabolism to active metabolite?
Glyburide
Which diabetic medication is contraindicated with the use of Gemfibrozil?
Repaglinide (Meglitinide)
A patient has HF (NYHA Functional Class III/IV), which diabetes medications are contraindicated?
Thiazolidinediones (Pioglitazone, Rosiglitazone)
Which diabetes medications have a rare side-effect of causing hepatic failure?
Thiazolidinediones. a-Glucosidase Inhibitors (acarbose, miglitol)
Which DPP-4 Inhibitor does not require any renal or hepatic adjustment?
Linagliptin (Tradjenta)
Which Incretin Mimetic does not require any renal adjustment?
Liraglutide (Victoza)
What is the DOC for thyroid storm?
Propylthiouracil
What is the BBW associated with Propylthiouracil?
Hepatotoxicity
Which thioamide is ok to use in breastfeeding?
Propylthiouracil is safe in pregnancy and lactation. Methimazole is secreted in breast milk
When using BBs for hyperthyroidism, which agents should be avoided?
Intrinsic Sympathomimetic Activity (Acebutolol, Pinolol)
What are the BBs used as adjunctive therapy for Hyperthyroidism?
Propranolol, Esmolol, Nadolol. PEN
Which BB has the longest experience and the preferred BB for nursing mothers?
Propranolol
How do BBs work in hyperthyroidism?
Blocks T4 –> T3 conversion
When do you use SSKI (Iodine) for Thyroid Storm?
Do not start until 1 hour after antithyroid drugs
What agents are indicated for controlling PPG?
SFUs. Meglitinides. a-Glucosidase Inhibitors. DPP-4 Inhibitors (by MOA of promoting early satiety, increasing insulin secretion, and slowing gastric emptying). Short and Rapid-Acting Insulin
What agents are indicated for controlling FPG?
Biguanides. TZDs. DPP-4 Inhibitors (by MOA of suppressing secretion of glucagon)
What is the criteria for diagnosing DM?
1) A1c > 6.5%. 2) FPG > 126. 3) A 2h plasma glucose > 200 during 75g OGTT. 4) Symptoms of DM + random blood glucose > 200
What are the goal levels for the 75g OGTT?
Fasting: 92. 1h: 180. 2h: 153. 3h: 140
Whats an easy way to determine A1c with someones average blood glucose level?
140 = 6.5%. Every 1% increase or decrease is about 30 extra glucose
Which diabetes medication is preferred in advanced liver disease?
Insulin
Which diabetes medications are not eliminated by kidneys, no restriction on use?
Pioglitazone. Linagliptin
What are the GDM glucose goals?
Fasting < 95. 1h < 140. 2h < 120
What is the typical starting dose (after 28 weeks) of insulin for GDM?
NPH insulin 20 units every morning and 10 units of regular insulin
