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My own Naplex > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Which lab tells you if you have T1DM

A

C-peptide low or absent

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2
Q

examples of microvascular complications from hyperglycemia

A

retinopathy, nephropathy, neuropathy

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3
Q

examples of macrovascular complications from hyperglycemia

A

atheroschlerosis –> ASCVD

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4
Q

at what age should people be screened regardless of risk factors

A

45 years old

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5
Q

A1c to bg equivilence

A

6% = 126 mg/dL and each 1% increases by 28 mg/dL

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6
Q

diabetes vaccines

A

hep b, prevnar 13 and pneumococcal

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7
Q

Which diabetes drugs have best evidence for weight loss

A

SGLT2, GLP1 (semaglutide, liraglutide, dulaglutide)

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8
Q

which diabetes drugs do not cause hypoglycemia

A

DPP4, GLP-1, SGLT2, Thiazolidenediones

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9
Q

which class drugs do you use if ASCVD is major issue

A

GLP 1 (semaglutide, liraglutide, dulaglutide) or SGLT2 (empaglifozin, canaglifozen) if GFR < 30

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10
Q

which class to use 1st if CKD or HF is major issue

A

SGLT2

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11
Q

what is the a1c and BG cutoff for severe hyperglycemia

A

> 300 or aic >10

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12
Q

what dose to start bedtime insulin

A

0.1-0.2 units/kg/day (TBW)

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13
Q

Actoplus Met

A

Metformin/pioglitazone (tzd)

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14
Q

Janumet

A

Metformin/Stigaliptin (DPP4)

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15
Q

Invokamet

A

Metformin/canaglifozin (SGLT2)

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16
Q

fortamet, glucophage, glumteza

A

metformin names

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17
Q

metformin moa

A

decrease hepatic glucose output

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18
Q

metformin warnings

A

may cause B12 deficiency, do not start with GFR less than 30, stop prior to iodated contrast media

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19
Q

actos

A

pioglitazone

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20
Q

avandia

A

rosiglitazone

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21
Q

moa of thiaglitazones

A

increase muscle sensitivity to insulin to increase BG entry

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22
Q

pioglitazone and rosalitazone are what drug class

A

thiazolidinediones

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23
Q

glycemia/weight effects of thiazolidinediones

A

not known for hypoglycemia by itself but may enhance effect of insulin. May cause weight gain

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24
Q

thiazolidinedione side effects, warnings, and boxed warning

A

S/E: edema, bone fractures
Warnings: Hepatic failure, can simulate ovulation, bladder cancer
Boxed warning: Do not use in HF

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25
Q

Canaglifozen, empaglifozen

A

SGLT2 inhibitors

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26
Q

Invokana

A

Canaglifozen

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27
Q

Jardiance

A

Empaglifozen

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28
Q

Sitagliptin, Linagliptin

A

DPP-4 inhibitors

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29
Q

MOA of SGLT2

A

increase BG renal excretion (pee out glucose)

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30
Q

MOA of DPP4

A

increase incretin

31
Q

Januvia

A

Sitagliptin

32
Q

Tradjenta

A

Linagliptin

33
Q

Glucotrol

A

Glipizide

34
Q

Amaryl

A

Glimepiride

35
Q

Glynase

A

Glyburide

36
Q

MOA of Sulfonylureas

A

increase insulin secretion

37
Q

Hypoglycemia/weight loss of SGLT2

A

Hypoglycemia in combo with insulin and may cause weight loss

38
Q

warnings, and side effects of SGLT2

A

Warning: UTI, genital fungal infection

Warning: Increase LDL, hyperkalemia, fluid loss, hypotension, ketoacidosis

39
Q

boxed warning canaglifozn

A

amputations

40
Q

hypoglycemia and weight loss of DPP4

A

No hypoglycemia by itself but maybe with insulin, no weight change

41
Q

which two classes should not be used together (x2)

A

DPP4 and GLP 1 because both insulin increetin

Meglinitides and sulfonylureas because both insulin secretaloges

42
Q

dpp4 warnings

A

pancreatitis, arthralgia, renal failure, saxagliptin/alogliptin do not use with HF, alogliptin hepatotoxicity

43
Q

sulfonylurea hypoglycemia and weight effects

A

may cause hypoglycemia, may cause weight gain

44
Q

contraindacations sulfonylureas

A

sulfa allergy, BEERS elderly

45
Q

meglinitide hypoglycemia and weight effects

A

may cause hypoglycemia and weight gain

46
Q

GLP 1 receptor agonist moa

A

increase incretin

47
Q

warning GLP-1

A

pancreatitis

48
Q

hypoglycemia and weight effects of GLP1

A

no hypoglycemia, weight loss

49
Q

what is the effect of pramilitide and what is it

A

a synthetic analog of amylin and can cause gastroparesis, n/w/anorexia, headache and severe hypoglycemia

50
Q

colveselam effects and moa

A

welchol, a bile acid binding resin, may decrease the absorption of fat soluble vitamins, may cause constipation and increase TG and should not be used in pancreatitis

51
Q

Which diabtetes drug classes can cause weight loss

A

GLP-1, SGLT-2

52
Q

which diabetes drug classes can cause weight gain

A

thiazolidinediones, sulfonulureas, meglinitides

53
Q

which diabetes drugs are weight neutral

A

DPP-4, metformin

54
Q

which diabetes drugs can cause hypoglycemia by themselves

A

sulfonylureas, meglinitides, pramlinitide

55
Q

A1c, FPG and PPG goal in diabetes

A

Aic less than 6.5, ppg less than 126, ppg less than 200

56
Q

rapid acting insulins

A

aspart (novolog), lispro (humalog)

57
Q

short acting insulin

A

regular (humulin R, novolin R)

58
Q

intermediate acting

A

NPH (humulin N, Novalin N) *cloudy

59
Q

long acting basal insulin

A 
insulin detemir (levemir)
insulin glargine (lantus, toujeo)
60
Q

insulin mix ratios

A

70/30 (humulin and novolon), 75/25, 50/50

61
Q

dka cutoff

A

BG > 250

62
Q

how to calculate TDD for insulin

A

0.5 units/kg/day and then seperate into 50% basal and 50% bolus

63
Q

Exceptions to insulin 1:1 conversion

A

1) NPH (2x) to glargine (1x) - Use 80% of TDD NPH
2) Toujeo (glargine, 1x) to lantus (detemir) or basaglar (glargine, 1x) - Use 80% of TDD
* basically from glargine to glargine……

64
Q

ratio Rule for rapid acting insulin, correction factor for rapid acting

A

ICR 500

Correction: 1800

65
Q

ratio rule for regular insulin

A

ICR: 450
Correction: 1500

66
Q

Correction dose equation

A

(blood glucose now - target)/correction dose

67
Q

Calculating ICR is for what type of insulin

A

Mealtime so Regular and rapid acting

68
Q

hum = eli lili insulin = how long stability

A

usually 1 month except for the concentrated insulin (humulin U500 - 40) and the pens

69
Q

nov = novo norodisk insulin = how long stability

A

rapid acting (novolog) - 28 days

short acting/others (i.e. detemir, novolin R/N) - usually 42 days

ultra long acting (tresiba) - 56 days

70
Q

sanofi rapid actng (aspidra, lispro) or basal (lantus, toijeo)

A

usually 28 or double that 56 (for toujeo)

71
Q

drugs that can raise BG

A

BB, diuretics, tacrolimus, cyclospirine, PI, Quinolones, antipsycphotics, statins, steroids, cough syrups, niacin

72
Q

drugs that can lower BG

A

linezolid, lorcaserin, pentamidine, beta blockers, quioolones, tramadol

73
Q

tx for dka and hhs

A

fluids (NS) for dehydration, regular insulin IV, prevent hypokalemia so give K+, treat acedosis if pH <6.9

My own Naplex (39 decks)

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