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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
Q

SEMAGLUTIDE
TIRZEPATIDE
DULAGLUTIDE

A

GLP-1RA used to treat type 2 DM

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26
Q

for T2DM patients who have existing atherosclerotic cardiovascular disease /MI/stroke or be at high risk—–what to treat with

A

GLP-1RA or SGLT2i

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27
Q

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

A

GLP-1RA and SGLT2i

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28
Q

what to treat T2DM patients with existing heart failure

A

SGLT2i

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29
Q

what to treat T2DM patient with chronic kidney disease

A

ARBs; SGLT2i

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30
Q

how to treat T2DM patient with cirrhosis

A

insulin

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31
Q

(new drug) one SQ injection weekly; insulin for T2DM

A

Insulin Epsitora

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32
Q

what to do next

A

start basal insulin then progress to basal-bolus

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33
Q

function of enteroendocrine cell w/ its taste receptors

A

release GLP-1

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34
Q

incretin (GLP-1) increases ____

A

insulin

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35
Q

in intestinal cells (Na+ and glucose in)

36
Q

Na+/glucose symporter in kidneys

37
Q

through _____, hepatocytes have to take in glucose to make glycogen and be used for other purposes (has high capacity transporter)

38
Q

pancreatic beta cell glucose transporter

39
Q

take in glucose so fat cells can convert it to fat

40
Q

receptor tyrosine kinase signaling

41
Q

GPCR (Gs)

42
Q

need to use it and make glycogen for themselves and have GLUT4

A

skeletal muscle

43
Q

in cardiomyocytes, no insulin receptor; when muscle cell contracts, creates signaling pathways that will exocytose _____ to plasma membrane and bring in glucose

44
Q

Sulfonylureas
Meglitinides
GLP-1R agonists
DPP-4 inhibitors
amylinomimetic
insulin
(all have SE of what)

A

hypoglycemia

45
Q

first line for T2DM; inhibits hepatic gluconeogenesis by inhibiting G3PD

46
Q

GLIPIZIDE
GLIMEPIRIDE

A

sulfonylureas

47
Q

K+ channel blockers that allows for insulin release

A

sulfonylureas

48
Q

block K channels but chemically different than sulfonylureas

A

Meglitinides

49
Q

REPAGLINIDE
NATEGLINIDE

A

Meglitinides

50
Q

PIOGLITAZONE

A

PPAR-gamma activator

51
Q

-GLUTIDES

A

GLP-1R agonists

52
Q

TIRZEPATIDE

A

dual GIP and GLP-1R agonist

53
Q

-GLIPTINs

A

DDP-4 inhibitors

54
Q

-GLIFOZINs

A

SGLT2 inhibitors

55
Q

ACARBOSE
MIGLITOL

A

alpha-glucosidase inhibitors

56
Q

PRAMLINTIDE

A

Amylinomimetic

57
Q

COLESEVELAM

A

bile acid sequestrant

58
Q

BROMOCRIPTINE

A

D2-agonist

59
Q

SE of metformin

A

weight loss
lactic acidosis

60
Q

contraindicated in heart failure (activates PPAR-gamma)

A

PIOGLITAZONE

61
Q

-GLIPTINs

A

DDP-4 inhibitors (which causes GLP-1 to increase)

62
Q

since -GLIFOZINs cause peeing out glucose, what can happen

A

urinary tract infection (glucose down there is food for bugs)

63
Q

enzyme that breaks down complex carbs into glucose

A

alpha-glucosidase

64
Q

slows down passage of food and is adjunct therapy

A

alpha-glucosidase inhibitors

65
Q

ACARBOSE
MIGLITOL

A

alpha-glucosidase inhibitors

66
Q

Slows the pace of food moving out of the stomach

67
Q

Amylin-mimetic that is used as adjunct drug

A

PRAMLINTIDE

68
Q

glucose challenge test 1st, then if glucose at 1 hour is >140 mg/dL, proceed to what

A

glucose tolerance test

69
Q

gold standard treatment of diabetes during pregnancy

A

insulin subcutaneously

70
Q

blood glucose level of <70 mg/dL

A

hypoglycemia

71
Q

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

A

postprandial (reactive) hypoglycemia

72
Q

including dumping syndrome after gastric bypass surgery (non-diabetic)

A

postprandial hypoglycemia

73
Q

hypoglycemia after GI surgeries

A

Pancreatogenous hypoglycemia

74
Q

another type of non-diabetic hypoglycemia dealing with hypo/hyperthyroidism and Addison’s

75
Q

what can alcohol cause

A

hypoglycemia

76
Q

tumor that can cause hypoglycemia

A

insulinoma

77
Q

top
middle
bottom

A

top: exogenous insulin
middle: insulinoma
bottom: sulfonylurea

78
Q

have sympathetic symptoms when BG is between what

A

50-55 mg/dL

79
Q

have neuroglycopenic symptoms when BG is <____

80
Q
A

Whipple triad

81
Q

______ 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

82
Q

Neuronal glucose transporter is _____ (sense low glucose and increase sympathetic activation)

83
Q

_____ may Mask Sympathetic Effects of Hypoglycemia

A

β-blockers

84
Q

If patient alert and can swallow, how to treat hypoglycemia

A

Dextrose P.O.

85
Q

If patient is not alert, how to treat hypoglycemia

A

Dextrose I.V. (50% dextrose)

ENR Biweekly 3 (14 decks)

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