DB Drugs

Question 1

Clues a patient has T1DM

Answer 1

Young ,slender, sudden onset, DKA (ketoacidosis), undx levels of C-peptide

Question 2

Tx a person in T1DM with ketoacidosis

Answer 2

Premeal rapid-acting insulin (aspart) with glargine at bed time

Question 3

Tx a T1DM pt and in an emergent situation

Answer 3

give regular insulin bc only one that can be given via IV

Question 4

________ can precipitate if there is a change in body temperature /pkA

Answer 4

insulin glargine

Question 5

MOA of insulin

Answer 5

1. binds to receptor
2. • P13K-AKT pathway (phosphoinositude -3 - kinase)
     1. makes lipids, fats and glycogen
     2. puts GLUT4 on cell surface
3. • MAPK pathway
     1. gene transcription and cell proliferation

Question 6

Insulin is an anabolic hormone and does what

Answer 6

1. moves GLUT 4 on membrane
2. • glycolysis and glycogen synthesis
3. Inhibits gluconeogenesis and glycogenolysis

Question 7

most imp electrolyte to watch in T1DM on insulin therapy

Answer 7

1. K+: bc insulin moves Na/K+ATPase on membrane and moves K+ into cells

Question 8

when is hyperkalemia most common

Answer 8

T1DM pt with DKA

Question 9

what do we see in patient with DKA

Answer 9

1. insulin def
2. Acidosis
3. Hyperosmolarity

Question 10

Pt has T2DM and takes a drug that causes hypoglycemia. what is the most common

Answer 10

1. Sulfonylrurea drugs and meglitinide drugs (insulin secreting drugs)

Question 11

Highest risk of hypoglycemia

Answer 11

insulin (T1DM)

Question 12

Moderate risk of hypoglycemia

Answer 12

1. Sulfonylurea/ non-sulfonurea drugs = insulin secreting

Question 13

Low risk of hypoglycemia

Answer 13

Glucose-dependent insulinotropism drugs = do not induce the release of insulin themselves; they enhance the release of insulin when hyperglycemic d/t ATP

1. DDP-4 inhibitors
2. GLP-1 AGO

Question 14

Euglycemic drugs (ONLY decrease levels of glucose in HYPERGLYCEMIC pt; not in a person with NL glucose levels)

Answer 14

• 1. Biguanides
• 2. SGLT2-I
• 3. Alpha-glycosidase inhibitors
• 4. Thiazoladindiones

Does cause hypoglycemia when taking w other drugs

Question 15

Glucose-dependent insulinotropism drugs

Answer 15

those that enhance ther release of insulin when pt is HYPERGLYCEMIC d/t ATP; does not release it themselves

1. DDP4-I
2. GLP-receptor AGO

Question 16

Which drugs with T2DM will prevent WG?

Answer 16

1. SGLT-2 inhibitors (-gliflozins)
   
   1. canagliflozin
   2. depagliflozin
   3. rampagliflozin

Question 17

T2DM pts who are obsese/ gaining weight should avoid what drugs?

Answer 17

1. Insulin

2. TZDs

3. Sulfonurea/meglitinides

Question 18

What drugs cause WL

Answer 18

1. Metaformin
2. SGLT2-I
3. DDP-4 I
4. GLP-1 AGO

Question 19

effects of SLGT2-I (gliflozins)

Answer 19

1. osmotic diuresis
2. WL
3. Decrease BP

4. Loss of uric acids

Question 20

T1DM who is hypoglycemic is often due to

Answer 20

Insulin OD

Skipped meal/late meal

Question 21

MCC of T2DB w hypoglycemia

Answer 21

Sulfonurea/meglinitiines

Question 22

Tx of T1DM pt with hypoglycemia

Answer 22

1. Glucose
2. Glucagon (SQ): + Gs => + AC => + pKA => glycogenolysis and gluconeogenesis

3.

Question 23

Tx of T2DM hypoglycemia due to sulfonureas

Answer 23

• 1. Glucose
• 2. Octreotide (somatostatin- r ANT => inhibits release of insulin)
• 3. Diazoxide: + Katp channels on B-cell => inhibits the release of insulin
• 4. Glucagon