Ch32 Diabetes Drugs

Question 1

Rapid acting insulin

Answer 1

15min onset
1-2hr peak
3-5hr duration
(Insulin lispro-humalog) 3-5 hr duration
Afrezza-inhaled insulin given 20 minutes before meal and 12-15 peak/taken with long acting insulin or oral diabetic drug risk for bronchospasm

Question 2

Type1 and Type 2 require what?

Answer 2

Type1-insulin therapy
Type2-lifestyle changes

Question 3

Short acting

Answer 3

Regular insulin. Clear
-IV iv infusion or im
Onset 30-60 mins
Peak 2.5 hrs
Duration 6-10hrs

Question 4

Intermediate acting insulin

Answer 4

Insulin Isophane suspension cloudy
NPH
-combined with regular insulin
Onset 1-2hrs
Peak 4-8 hrs
Duration 10-18hrs

Question 5

Thiazolidinediones

Answer 5

Oral anti diabetic drug
-regulates genes involved in glucose and lipid metabolism
-contraindicated patients with liver or kidney disease,heart failure
Black box warning
Can exacerbate heart failure

Question 6

Alpha glycosides inhibitor

Answer 6

Enzyme is found in small intestine responsible for hydrolysis of oligosacs and disaccharides
- reason patients take this is type 2dm
Adverse effects-flatulence,diarrhea abdominal pain
Does not cause-hypoglycemia,hyperinsulinemia,weight gain

Question 7

Glinides

Answer 7

Oral antidiabetic drug 3x day
-Increase insulin secretion from pancreas much shorter duration
Can be combined with metformin and thiazolidnediones but not sulfonyureas
Adverse effect
Weight gain
Hypoglycemia

Question 8

What is the preferred method of treatment for hospitalized diabetic patients?

Answer 8

Basal-Bolus insulin dosing

Question 9

Sulfonylureas

Answer 9

Oldest group of oral diabetics stimulates the release of insulin
-Don’t take with alcohol-disulfirmilike reaction
Glimpiride
Glyburide
Glipizide

Question 10

The most common precipitator of DKA and HNKS are

Answer 10

Physical or emotional stress

Question 11

HbA1c

Answer 11

-couple months study
<5.7-normal
5-7-6.4 pre diabetes
>6.5 type 2 diabetes

Question 12

Exenatide

Answer 12

Long acting analogue of G1p-1
Only available as a subcutaneous injection-patients with type 2 who haven’t achieve blood glucose control with metformin sulfonyurea
-can’t be used with insulin best given 60 mins before meal

Question 13

Metformin

Answer 13

First line drug
(BMI over 25)
Contraindication in patients with renal disease or renal disease or renal dysfunction
Decrease glucose production by liver
Decrease intestinal absorption of glucose
Adverse effects
Can cause lactic acidosis
Abdominal cramping nausea feeling full diarrhea