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214202 > Block 6 > Flashcards

Block 6 Flashcards

1
Q

Describe the actions, properties and usage of insulin preparations including any adverse effects.

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2
Q

Describe the pharmacological management of type 1 diabetes mellitus.

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3
Q

Know which medications are suitable to use in the management of gestational diabetes.

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4
Q

Why are there different types of insulins for treating DM?

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5
Q

Why must insulin be administered via injection?

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6
Q

What factors can affect the client’s response to glucose?

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7
Q

Why isn’t insulin administered orally?

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8
Q

Why are there different formulations of insulin?

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9
Q

What is the mode of action of glucagon?

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10
Q

Identify the main types of oral hypoglycaemic agents used and outline their main modes of action, benefits and adverse drug effects

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11
Q

Describe the pharmacological management of type 2 diabetes starting with metformin as preferred first-line treatment through to the initiation of insulin.

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12
Q

Are oral hypoglycaemics used for treatment of Type 1 diabetes?

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13
Q

Is hypoglycaemia an adverse effect of metformin?

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14
Q

When should the oral hypoglycaemics gliclazide be taken? Explain why.

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15
Q

SGLT 2 inhibitors block reabsorption of glucose in the renal tubule. Why would this help in improving glycaemic control?

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16
Q

Describe how steroidal agonists and antagonists work and explain why the natural steroids are not effective orally.

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17
Q

Oestrogens (+progestogens) can be used to treat a variety of conditions such as endometriosis and amenorrhoea but will NOT counter the infertility and promote production of ova. Why? (Clue – how does the combined oral contraceptive work?)

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18
Q

Tina in her early 20s has very scanty infrequent periods. She has expressed some concern because she really would like to have children at some future date though at this stage she’s on a career path. After having been prescribed an oestrogen and progestogen containing medication she now has regular menstrual periods and feels reassured about her potential fertility. What are your thoughts about this situation?

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19
Q

How does the mode of action of progestogens relate to its use as a contraceptive in the ‘minipill’ ?

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20
Q

Would the ‘minipill’ be a good choice of contraception for the woman who has endometriosis?

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21
Q

Why can’t trophic hormones be given orally?

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22
Q

What are some of the adverse effects of danazol?

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23
Q

Can you explain why some of these adverse effects may

arise in view of its mode of action?

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24
Q
  1. Which hormone is tamoxifen an antagonist of?
    (a) oestrogen
    (b) progesterone
    (c) testosterone
    (d) luteinizing hormone
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25
Q
  1. Which of the following cases is oestrogen NOT used for?
    (a) osteoporosis
    (b) primary hypogonadism
    (c) excessive uterine bleeding
    (d) enhance postpartum milk let-down
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26
Q

Why are chemically modified forms of oestrogen and progesterone needed to be used for oral administration?

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27
Q

List the different types of hormonal contraceptives.

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28
Q

Explain how the COC pill and POP work and the difference between them.

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29
Q

Describe the adverse effects specifically associated with the COC pill and relevant implications.

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30
Q

Know what types of long-acting reversible contraceptives (LARC) are available and how they work.

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31
Q

Describe possible causes of pill failure and appropriate interventions.

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32
Q

How does the COC work in preventing conception?

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33
Q

To identify the woman who might be at increased risk what are some of the other risk factors VTE? (see section further on)

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34
Q

Which COCs are associated with a higher risk of VTE? (See table in NZF).

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35
Q

How does the POP work in preventing conception?

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36
Q

How does this compare to the COC pill?

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37
Q

Why is it the recommended form of contraceptive pill for a breast-feeding mother?

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38
Q

What is menorrhagia?

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39
Q

Define contraception.

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40
Q

Explain how synthetic oestrogen and progestogen in COC pills work to stop conception occurring.

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41
Q

Side effects of the oral contraceptive pills are related to what components in these pills? Name some of the adverse effects.

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42
Q

What is the greatest risk of oral contraceptives?

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43
Q

What are some other serious adverse effects that are associated with COC pills?

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44
Q

What advice is given to the woman who has ‘forgotten to take her pill’

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45
Q

What are the non-contraception benefits associated with the COC pill?

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46
Q

What type of oral contraceptive is Mercilon 28?

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47
Q

How many active tablets does each calendar pack contain?

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48
Q

Kim is breastfeeding, would there be any problem going back on Mercilon 28?

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49
Q

What is a third generation COC and what are added risks in using these COC’s compared to other COC’s

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50
Q

Why has the Doctor recommended this change?

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51
Q

How does the POP work, compared to the COC?

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52
Q

How should Kim take her Noriday?

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53
Q

Kim telephones you 2 months later to say that she forgot to take her pill yesterday and to ask what she should do. What do you tell her?

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54
Q

Kim and her partner and of course little Ngaire have a holiday up the East Coast with Kim’s family. Unfortunately, Kim who really loves all seafood, has a major bout of food poisoning. Could this cause a problem with her contraception?

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55
Q

What does the implant contain and how does it work?

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56
Q

Make a list of the advantages and disadvantages associated with this form of contraceptive

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57
Q

Make a list of the advantages and disadvantages associated with this form of contraceptive

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58
Q

Case study 1 - Jenny is 25 and a marathon runner. She is at the GP today because her
menstrual periods have stopped (4 months ago) and she is worried, she took a test and
wasn’t pregnant. She asks whether she can still get pregnant as she has been having casual
unprotected sex with a man she trains with.

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59
Q

Case study 2 - Izzy is 19 and at uni, she is seeking contraceptive advice, she says she is scatty
and not very good at remembering to take the pill. She recently took the morning after pill
and has also had a pharmacological abortion.

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60
Q

Case study 3 - Donna is 25 and suffers from migraines and knows that she can’t take
oestrogen containing pills. A good friend suggested that she get the ‘implant’, which she
thought sounded great as she currently works irregular shifts, but she doesn’t like the
thought of something being inserted under her skin.

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61
Q

Case study 4 - Veronica is 41, happily married and has two children, but she doesn’t want
anymore. She is concerned that at her age being on a combined contraceptive pill may no
longer be the best option.

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62
Q

Describe how insulin works, adverse effects associated with this drug, care considerations and therapeutic
indications.

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63
Q

Discuss why metformin is the first-line treatment option for most T2D patients.

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64
Q

Describe how metformin works, what common adverse effects it has, and understand why it is important to
determine renal function before initiating treatment.

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65
Q

Describe modes of action of the sulphonylurea gliclazide and the DPP-4 inhibitor vidagliptin, their place in the treatment of T2D and their common adverse effects.

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66
Q

Explain the role of glucagon in controlling blood glucose levels and care considerations

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67
Q

Pathophysiology and treatment strategies of T1DM

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68
Q

Pathophysiology and treatment strategies of T2DM

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69
Q

Sean asks why he has to take insulin when other people with he knows with diabetes don’t have to.
What should your response be?

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70
Q

Why is insulin administered subcutaneously and not orally?

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71
Q

Sean has been given a pen to inject his insulin with. Have a read of the patient advice given in the NZF
under biphasic isophane insulins and identify the key things that Sean needs to do before he administers the insulin.

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72
Q

If Sean is prescribed to inject 12 units in the morning and 14 units at night (plus 2 units wastage/dose).
How many 3 mL vials of Penmix (100units/mL) would he need to cover 90 days supply?

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73
Q

How should Sean store his insulin?

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74
Q

What are some other things that it be useful to educate Sean and his family about in relation to his
condition and using insulin.

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75
Q

Why do we have short acting/intermediate acting/long acting insulins for treatment of diabetes mellitus?

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76
Q

Describe how does metformin works?

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77
Q

Why is metformin preferred as the first drug of choice for most patients with type 2 diabetes?

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78
Q

Why should renal function tests be carried out before metformin is prescribed and taken by the
person? (Hint: Section 5.2 Pharmacokinetic properties in Medsafe datasheet)

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79
Q

Gastro-intestinal adverse effects are common, particularly when starting metformin. How can these
be managed? After 6 months on metformin Jackson is still not reaching his HbA1c target and so his Doctor decides to add a second oral-glucose lower medication.

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80
Q

Jackson is prescribed gliclazide. Explain how this drug works.

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81
Q

Hypoglycaemia is a potential adverse effect of taking sulfonylureas. Why?

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82
Q

Explain how vildagliptin works?

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83
Q

What are the main advantages that vildagliptin has over gliclazide?

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84
Q

The recommendation when starting someone with T2D on insulin is to select a basal insulin. What does this mean and give an example of a basal insulin?

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85
Q

Glucagon is a drug that is administered for severe hypoglycaemia. An effect should be seen within
10 minutes after administration. Why is glucagon being administered?

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86
Q

Describe mode of action of glucagon.

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87
Q

Why must oral carbohydrate be administered after you can see the person has responded to
treatment?

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214202 (6 decks)

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