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ENR Biweekly 3 > Al-Mehdi- Rx of diabetes and hypoglycemia > Flashcards

Al-Mehdi- Rx of diabetes and hypoglycemia Flashcards

1
Q

treatment of type 1 diabetes

A

insulin

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2
Q

_____combination regimen is the most common insulin regimen

A

basal + bolus

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3
Q

Long- and ultra-long-acting insulin

A

basal insulin

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4
Q

Rapid- and intermediate-acting insulin

A

bolus insulin

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5
Q

what kind of insulin for DKA and HHS

A

regular insulin

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6
Q

LISPRO
ASPART
GLULISINE
(w/ 5-10 min onset)

A

bolus insulin

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7
Q

NPH (neutral protamine Hagedorn) w/ 2 hr onset

A

bolus insulin

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8
Q

regular insulin
(onset 30-60min)

A

short acting insulin

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9
Q

DETEMIR (2 hr onset)
GLARGINE U100 (2 hr onset)
GLARGINE U300 (6 hr onset)

A

basal insulin

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10
Q

DEGLUDEC
(1-4 hr onset)

A

basal insulin

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11
Q

most common and serious side effect of insulin drugs

A

hypoglycemia

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12
Q

Injection or infusion site rotation is necessary to avoid ______, subcutaneous fat accumulation

A

lipohypertrophy

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13
Q

All hormones, except sex hormones, are enemies of _____

A

insulin

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14
Q

new drug w/ moa of anti CD3 on T-cells; and used to treat T1DM

A

TEPLIZUMAB

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15
Q

β-cell peptide amylin analog used to treat type 1 DM

A

PRAMLINTIDE

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16
Q

LIRAGLUTIDE (for type 1 DM)

A

GLP-1R agonist

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17
Q

SOTAGLIFOZIN (for typ1 2 diabetes_

A

SGLT inhibitor (SE: DKA)

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18
Q

another noninsulin way to treat type 1 diabetes

A

pancreas and islet transplantation

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19
Q

an elevated C-peptide can have what effects (hopefully a drug will be made with this ability to treat T1DM

A

decreases A1C, retinopathy, nephropathy, hypoglycemia

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20
Q

how does T2DM start most of the time

A

as metabolic syndrome (overweight)

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21
Q

very highly effective drug class for goal of weight loss in T2DM

A

GLP-1RA

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22
Q

SEMAGLUTIDE
TIRZEPATIDE

A

GLP-1RA used to treat weight loss in T2DM

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23
Q

first line drug for prediabetes and diabetes

A

Metformin

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24
Q

very highly effective drug class for goal of glycemic control in T2DM

A

GLP-1RA

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25
SEMAGLUTIDE TIRZEPATIDE DULAGLUTIDE
GLP-1RA used to treat type 2 DM
26
for T2DM patients who have existing atherosclerotic cardiovascular disease /MI/stroke or be at high risk-----what to treat with
GLP-1RA or SGLT2i
27
for T2DM patients who have existing atherosclerotic cardiovascular disease /MI/stroke or be at high risk, and if A1C is still above goal measurement after trying single drug, what to use
GLP-1RA and SGLT2i
28
what to treat T2DM patients with existing heart failure
SGLT2i
29
what to treat T2DM patient with chronic kidney disease
ARBs; SGLT2i
30
how to treat T2DM patient with cirrhosis
insulin
31
(new drug) one SQ injection weekly; insulin for T2DM
Insulin Epsitora
32
what to do next
start basal insulin then progress to basal-bolus
33
function of enteroendocrine cell w/ its taste receptors
release GLP-1
34
incretin (GLP-1) increases ____
insulin
35
in intestinal cells (Na+ and glucose in)
SGLT1
36
Na+/glucose symporter in kidneys
SGLT2
37
through _____, hepatocytes have to take in glucose to make glycogen and be used for other purposes (has high capacity transporter)
GLUT2
38
pancreatic beta cell glucose transporter
GLUT2
39
take in glucose so fat cells can convert it to fat
GLUT4
40
receptor tyrosine kinase signaling
insulin
41
GPCR (Gs)
glucagon
42
need to use it and make glycogen for themselves and have GLUT4
skeletal muscle
43
in cardiomyocytes, no insulin receptor; when muscle cell contracts, creates signaling pathways that will exocytose _____ to plasma membrane and bring in glucose
GLUT4
44
Sulfonylureas Meglitinides GLP-1R agonists DPP-4 inhibitors amylinomimetic insulin (all have SE of what)
hypoglycemia
45
first line for T2DM; inhibits hepatic gluconeogenesis by inhibiting G3PD
Metformin
46
GLIPIZIDE GLIMEPIRIDE
sulfonylureas
47
K+ channel blockers that allows for insulin release
sulfonylureas
48
block K channels but chemically different than sulfonylureas
Meglitinides
49
REPAGLINIDE NATEGLINIDE
Meglitinides
50
PIOGLITAZONE
PPAR-gamma activator
51
-GLUTIDES
GLP-1R agonists
52
TIRZEPATIDE
dual GIP and GLP-1R agonist
53
-GLIPTINs
DDP-4 inhibitors
54
-GLIFOZINs
SGLT2 inhibitors
55
ACARBOSE MIGLITOL
alpha-glucosidase inhibitors
56
PRAMLINTIDE
Amylinomimetic
57
COLESEVELAM
bile acid sequestrant
58
BROMOCRIPTINE
D2-agonist
59
SE of metformin
weight loss lactic acidosis
60
contraindicated in heart failure (activates PPAR-gamma)
PIOGLITAZONE
61
-GLIPTINs
DDP-4 inhibitors (which causes GLP-1 to increase)
62
since -GLIFOZINs cause peeing out glucose, what can happen
urinary tract infection (glucose down there is food for bugs)
63
enzyme that breaks down complex carbs into glucose
alpha-glucosidase
64
slows down passage of food and is adjunct therapy
alpha-glucosidase inhibitors
65
ACARBOSE MIGLITOL
alpha-glucosidase inhibitors
66
Slows the pace of food moving out of the stomach
Amylin
67
Amylin-mimetic that is used as adjunct drug
PRAMLINTIDE
68
glucose challenge test 1st, then if glucose at 1 hour is >140 mg/dL, proceed to what
glucose tolerance test
69
gold standard treatment of diabetes during pregnancy
insulin subcutaneously
70
blood glucose level of <70 mg/dL
hypoglycemia
71
About 4 h after a carbohydrate-rich meal → exaggerated insulin release → hypoglycemia (carbs get digested within 2 h, but insulin secretion continues up to 3-4 hours
postprandial (reactive) hypoglycemia
72
including dumping syndrome after gastric bypass surgery (non-diabetic)
postprandial hypoglycemia
73
hypoglycemia after GI surgeries
Pancreatogenous hypoglycemia
74
another type of non-diabetic hypoglycemia dealing with hypo/hyperthyroidism and Addison's
hormonal
75
what can alcohol cause
hypoglycemia
76
tumor that can cause hypoglycemia
insulinoma
77
top middle bottom
top: exogenous insulin middle: insulinoma bottom: sulfonylurea
78
have sympathetic symptoms when BG is between what
50-55 mg/dL
79
have neuroglycopenic symptoms when BG is <____
50 mg/dL
80
Whipple triad
81
______ of hypothalamus senses low glucose sends signal to PVN (paraventricular nucleus)---most important of hypothalamus); direct connection to IML neuron (increase sympathetics) Other pathway: CRH release and ACTH then increase cortisol levels
VMN
82
Neuronal glucose transporter is _____ (sense low glucose and increase sympathetic activation)
GLUT3
83
_____ may Mask Sympathetic Effects of Hypoglycemia
β-blockers
84
If patient alert and can swallow, how to treat hypoglycemia
Dextrose P.O.
85
If patient is not alert, how to treat hypoglycemia
Dextrose I.V. (50% dextrose)

ENR Biweekly 3 (14 decks)

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