Ch 47, Antidiabetics

Question 1

Diabetes mellitus is characterized by the three Ps:

Answer 1

polyuria, polydipsia, and polyphagia.

Question 2

The normal range for fasting blood glucose ___-___

Answer 2

is 70–99 mg/dL.

Question 3

When the blood glucose level is greater than _____, glycosuria can occur.

Answer 3

180 mg/dL

Question 4

Increased blood glucose acts as an ______ ______, causing ____. (r/t renal)

Answer 4

osmotic diuretic
polyuria

Question 5

When blood glucose remains elevated (>____ mg/dL), diabetes mellitus occurs.

Answer 5

> 200 mg/dL

Question 6

The HbA1c level reflects the average glucose level for up to ______.

Answer 6

3 months

Question 7

In monitoring treatment, the goal is to keep the diabetic’s HbA1c below _____%.

Answer 7

7%

Question 8

For diagnostic purposes, an HbA1c level of __ or less indicates that the patient does not have diabetes, ____ to ___ indicates prediabetes, and ___ or greater indicates a diagnosis of diabetes mellitus.

Answer 8

5%
5.7% to 6.4%
6.5%

Question 9

_______ injections of insulin are absorbed faster than other body sites and found to be more consistent.

Answer 9

Abdominal

Question 10

Insulin injection sites should be rotated to prevent _____, which can interfere with insulin absorption.

Answer 10

lipodystrophy

Question 11

_____ and _____ increase the need for insulin. Insulin doses should not be withheld during ________, including ____ and _____

Answer 11

Illness and stress
illness, including infections and stress.

Question 12

_____-acting and ____-acting insulins are in a clear solution.

Answer 12

Rapid
short

Question 13

_______-acting insulins are cloudy and may contain ________

Answer 13

Intermediate
protamine

Question 14

_____ is a protein that prolongs the action of insulin, or ____, which also slows the onset of action and prolongs the duration of activity.

Answer 14

Protamine
zinc

Question 15

Rapid-acting insulins include ____, _____, ______, and _______.

Answer 15

insulin lispro, human insulin aspart, insulin glulisine, and human oral inhalation insulin.

Question 16

_____ insulins must be administered within 10–15 min before mealtime.

Answer 16

Rapid-acting

Question 17

Short-acting insulin has an onset of action of ___ min. The peak action occurs in__ - ___ , and the duration of action is ____- ____ .

Answer 17

30 min
2.5–5 h
4–12 h

Question 18

Regular insulin is _____-acting insulin that can be administered ________ or _______. Regular insulin is generally given ____ - _____min before meals.

Answer 18

short acting
intravenously or subcutaneously
30-60 min

Question 19

neutral protamine Hagedorn (NPH) is _____ acting insulin

Answer 19

Intermediate-acting insulin

Question 20

The onset of intermediate-acting insulin is __-__, peak action occurs in __-__ , and the duration of action is __–__ .

Answer 20

1–2 h
4–12 h
14–24 h

Question 21

Insulin glargine is ____-acting insulin

Answer 21

long-acting

Question 22

Insulin glargine insulin has an onset of __–___ . It is evenly distributed over a ___ duration of action; thus, it is administered __ a day, usually at _____

Answer 22

1–1.5 h
24
once a day
bedtime.

Question 23

____ has a low incidence of nocturnal hypoglycemia is not as common as with other insulins.

Answer 23

Insulin glargine

Question 24

Insulin detemir is ______ insulin that peaks in __-__ and lasts for __-___.

Answer 24

long-acting
6–8 h
12–24 h

Question 25

Insulin degludec, is _____ insulin, has an onset of __, peaks at ___, and lasts for ____.

Answer 25

long-acting 1 h 12 h 42 h

Question 26

Unopened insulin vials are ________ until needed. Once an insulin vial has been opened, it may be kept at room temperature for ___ month or in the refrigerator for __ months.

Answer 26

refrigerated 1 month 3 months

Question 27

Drugs such as ______, _______, _______, and ______ increase the blood sugar.

Answer 27

thiazide diuretics, glucocorticoids, thyroid agents, and estrogen

Question 28

Drugs that decrease insulin needs are _____, ________, _______ products and ______________.

Answer 28

tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), aspirin products, and oral anticoagulants.

Question 29

hypoglycemic symptoms

Answer 29

The person may exhibit nervousness, trembling, and lack of coordination; have cold and clammy skin; and complain of a headache. Some patients become combative and incoherent.

Question 30

Oral antidiabetic drugs should be used by those with type __ diabetes

Answer 30

2

Question 31

____used to treat insulin-induced hypoglycemia when other methods of providing glucose are not available.

Answer 31

Glucagon

Question 32

Metformin action (3)

Answer 32

1. biguanide compound that acts by decreasing hepatic production of glucose from stored glycogen 2. decreases the absorption of glucose from the small intestine, 3. evidence that it increases insulin receptor sensitivity as well as peripheral glucose uptake at the cellular level.

Question 33

_______ does not produce hypoglycemia or hyperglycemia.

Answer 33

Metformin

Question 34

Metformin contraindication/ side effect

Answer 34

renal impairment se: GI disturbances.

Question 35

Metformin therapy should be withheld for __ before and after administration of IV contrast because _____ or _______ may develop.

Answer 35

48 h lactic acidosis acute renal failure