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ClinPhar II Lec > Criteria for Dx and Drugs- DM > Flashcards

Criteria for Dx and Drugs- DM Flashcards

1
Q

FPG ≥ ____________ (7.0) mg/dL (7.0 mmol/L)

A

126

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2
Q

2-h PG ≥ _________ (11.1) mg/dL; using a glucose load containing _______g anhydrous glucose dissolved in water

A

200; 75

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3
Q

A1C ≥ ________% (________ mmol/mol)

A

6.5%; 48

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4
Q

In a patient with classic symptoms of hyperglycemia or
hyperglycemic crisis, a random plasma glucose ≥ _________ mg/dL (11.1 mmol/L).

A

200 mg/dl

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5
Q

3 month average of the glucose level

A

A1C

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6
Q

n the absence of unequivocal hyperglycemia,
diagnosis requires ____________ abnormal test results from the
same sample or in _______ separate test samples

A

two; two

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7
Q

High-risk ethnicity

A

○ African Americans
○ Latino
○ Native Americans
○ Asian Americans
○ Pacific Islander

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8
Q

Women who delivered a baby weighing __________ can be considered asymptomatic

A

≥ 9 lbs.

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9
Q

Asymptomatic px:
Hypertension: __________ mmHg
HDL Level: __________mg/dL
TG level: ___________ mg/dL
Women with ________

A

≥140/90 mmgHg
<35 mg/dL
>250 mg/dL
PCOS

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10
Q

Lipid levels + Inflammatory molecules =

A

atherosclerosis

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11
Q

It could lead to Cataract and Glaucoma

A

RETINOPATHY

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12
Q

It could lead to Diabetic Foot

A

NEUROPATHY

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13
Q

Patients not meeting goals generally should be seen at
least every _________ months as long as progress is being
made

A

3

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14
Q

Drug of choice for T1

A

INSULIN

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15
Q

Insulin may be used in combination with

A

Amylin

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16
Q

Insulin stimulates ___________ synthesis, increase ________ synthesis and faciliates _________ synthesis and storage by adipocytes

A

hepatic glycogen, protein, triglycerides

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17
Q

Insulin inhibits _________

A

lipolysis

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18
Q

Stimulates peripheral uptake of glucose

A

Insulin

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19
Q

Humalog or Lispro
Novolog or Aspart
Apidra or Glulisine

A

Rapid-Acting

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20
Q

Inject 10-15 minutes before mealtime

A

Rapid-Acting insulin

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21
Q

Injected at
least 20-30
mins before
mealtime

A

Short-Acting

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22
Q

Regular humulin, Actrapid or Novolin, Velosulin

A

Short acting insulins

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23
Q

Commonly
used twice
daily. Often
combined with
rapid- or short
acting insulin.

A

INTERMEDIATE-ACTING INSULIN

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24
Q

NPH (N) /
Isophane
Lente (L)

A

INTERMEDIATE-ACTING INSULIN

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25
Q

Covers insulin
needs for 24
hrs. If needed,
often
combined with
rapid or short
acting insulin.

A

LONG-ACTING INSULIN

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26
Q

Ultralente
(U)
Lantus or
Glargine
Levemir or
Detemir

A

LONG-ACTING INSULIN

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27
Q

Long acting insulins that do not have any peaks.

A

Lantus or glargine

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28
Q

Combination
of intermediate
and short
acting insulin.
Commonly
used twice
daily before
mealtime.

A

PRE-MIXED INSULIN

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29
Q

Insulin levels is plateau in px with

A

Type 1 dm

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30
Q

Pramlintide

A

Amylin

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31
Q

Enhance post-prandial control in individual
with T1DM and T2DM

A

AMYLIN (Pramlintide)

32
Q

CI: Gastric motility disorder

A

AMYLIN (Pramlintide)

33
Q

AMYLIN (Pramlintide):
slows down ____________
decreases ______________
suppresses _________

A

slows down gastric emptying time
decreases post prandial glucagon secretion
suppresses appetite

34
Q

Exenatide, Liraglutide, -glutides

A

INCRETIN MIMETICS (GLP-1 AGONISTS)

35
Q

Management of T2DM

A

INCRETIN MIMETICS (GLP-1 AGONISTS)

36
Q

CI: Severe GI motility, pancreatitis, renal or hepatic
impairment

A

INCRETIN MIMETICS (GLP-1 AGONISTS)

37
Q

INCRETIN MIMETICS (GLP-1 AGONISTS):

○ Increase _______________ secretion,
○ Decrease ______________ output
○ Increase _______________ growth and replication
○ Slow gastric emptying time
○ Enhance satiety or feeling of fullness to suppress
appetite

A

○ Increase glucose-dependent insulin secretion,
○ Decrease hepatic glucose output
○ Increase beta cell growth and replication
○ Slow gastric emptying time
○ Enhance satiety or feeling of fullness to suppress
appetite

38
Q

Sitagliptin, Saxagliptin, Linagliptin

A

DIPEPTIDYL PEPTIDASE IV (DPP IV) INHIBITORS

39
Q

Patients with T2DM with normal or impaired
hepatic and renal function

A

DIPEPTIDYL PEPTIDASE IV (DPP IV) INHIBITORS

40
Q

CI: Pancreatitis

A

DIPEPTIDYL PEPTIDASE IV (DPP IV) INHIBITORS

41
Q

DIPEPTIDYL PEPTIDASE IV (DPP IV) INHIBITORS:

○ Prevents the ____________ of incretin hormones by
the enzyme DPP IV during hyperglycemia
○ Inhibits the _______________ allowing _______
insulin secretion and _______ hepatic glucose
production

A

inactivation; breakdown of GLP-1; increased; decrease

42
Q

INSULIN SECRETAGOGUES

A

SULFONYLUREAS

43
Q

Targets fasting blood glucose level

A

SULFONYLUREAS

44
Q

Binds to and inhibits the ATP-sensitive potassium
channels to increase the beta cell sensitivity to glucose
and stimulate the secretion of insulin

A

SULFONYLUREAS

45
Q

T/F: SULFONYLUREAS are protein-bound and are prone to drug-drug interaction

A

True

46
Q

SULFONYLUREAS:

Associated with
thrombocytopenia,
agranulocytosis, hemolytic anemia, hyponatremia, SIADH

A

1ST GENERATION

47
Q

Tolbutamide, Tolazamide,
Chlorpropamide

A

1ST GENERATION

48
Q

Glyburide, Glipizide,
Glimepiride

A

2ND GENERATION

49
Q

Repaglinide

A

Meglitinide

50
Q

Nateglinide

A

Phenylalanine derivatives

51
Q

Binds to ATP-sensitive potassium channel to
stimulate secretion of insulin from pancreatic Beta cell,
reduces hepatic glucose output

A

MEGLITINIDE AND PHENYLALANINE DERIVATIVES

52
Q

T/F: Meglitinide and phenylalaninen derivatives are Used in caution in elderly due to increased risk of
fall

A

True

53
Q

MEGLITINIDE AND PHENYLALANINE DERIVATIVES are used for

A

T2DM, postprandial glucose control

54
Q

Metformin

A

BIGUANIDES

55
Q

Used for the glycemic control for management of T1DM
and T2DM

A

BIGUANIDES

56
Q

Inhibits hepatic glucose output, thus exerting
beneficial effects on fasting blood glucose level

A

BIGUANIDES

57
Q

Promotes glucose uptake by fat and muscles,
improving insulin sensitivity

A

BIGUANIDES

58
Q

Minor role in decreasing intestinal absorption of
glucose

A

BIGUANIDES

59
Q

Pioglitazone, Rosiglitazone

A

THIAZOLIDINEDIONES (TZDs)

60
Q

Glycemic control in T2DM and primarily
affects fasting blood glucose level

A

THIAZOLIDINEDIONES (TZDs)

61
Q

Promote glucose uptake by** fat and muscle **and
inhibit hepatic glucose output by stimulation of
peroxisome proliferator-activated receptor-gamma
(PPAR–gamma)

A

THIAZOLIDINEDIONES (TZDs)

62
Q

ALPHA-GLUCOSIDASE INHIBITORS

A

Acarbose, Miglitol

63
Q

Management of post-prandial blood glucose

A

ALPHA-GLUCOSIDASE INHIBITORS

64
Q

Competitive inhibition of alpha-glucosidase in the
intestinal brush border, which leads to slower
absorption of complex carbohydrates

A

ALPHA-GLUCOSIDASE INHIBITORS

65
Q

New class of oral hypoglycemic agent

A

SODIUM-GLUCOSE COTRANSPORTER INHIBITORS

66
Q

Selectively and reversibly inhibits the
sodium-glucose cotransporter which is selectively
expressed in the proximal renal tubule

A

SODIUM-GLUCOSE COTRANSPORTER INHIBITORS

67
Q

Canagliflozin, Dapagliflozin, and Empagliflozin

A

SODIUM-GLUCOSE COTRANSPORTER INHIBITORS

68
Q

T2 DM + ATHEROSCLEROTIC
CARDIOVASCULAR DISEASE (ASCVD)

A

Monotherapy of GLP-1RA or SGL2

69
Q

For: T2 DM + ATHEROSCLEROTIC
CARDIOVASCULAR DISEASE (ASCVD)
If: A1C above target

A

Thiazolidinediones

70
Q

For: T2 DM + HEART FAILURE

A

SGL2

71
Q

For: T2 DM + CHRONIC KIDNEY DISEASE (CKD)

A

SGL2 or GLP-1

72
Q

For: T2 DM + CHRONIC KIDNEY DISEASE (CKD)
If: A1C above target

A

SGL2I and GLP-1 RA

73
Q

Preferred in GLYCEMIC CONTROL

A

Metformin

73
Q

Blood glucose less than 13 mmol/L (or less than 230
mg/dL)

A

continue with current dosage

74
Q

Blood glucose 13-22 mmol/L (or 230 to 390 mg/dL

A

patient should increase his insulin by 2 units per
injection, even if unable to eat

75
Q

Blood glucose greater than 22 mmol/L (or 390 mg/dL)

A

patient should increase his insulin by 4 units per
injection, even if unable to eat

ClinPhar II Lec (6 decks)

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