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Pharmacology > Diabetes > Flashcards

Diabetes Flashcards

1
Q

DM 1
Clinical manifestations

A

Sustained hyperglycemia
Polyuria
Polydipsia
Ketonuria
Weight loss

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2
Q

What are the rapid acting short duration types of insulin?

A

No LAG

Insulin lispro
Insulin aspart
Insulin glulisine

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3
Q

What are the forms of short duration and slower acting insulin?

A

Regular insulin (Humulin R, Novolin R)

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4
Q

What type of insulin is intermediate duration? (Onset 1.5 hours)

A

Neutral protamine Hagedorn (NPH) insulin

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5
Q

What types of insulin are long duration (onset 1-3 hours) day long coverage?

A

Insulin detemir (Levemir)
Insulin glargine (given once or twice daily)

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6
Q

What kind of insulin are used in hospital “sliding scales” as corrective doses?

A

Lispro
Aspart
Glulisine
Regular

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7
Q

Microvascular damage

A

Retinopathy
Nephropathy
Neuropathy
Gastroparesis - delayed gastric emptying
Amputations secondary to infections
Erectile dysfunction

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8
Q

Macrovascular damage

A

Heart disease
Hypertension
Stroke

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9
Q

What defines a fasting blood glucose? What level indicates diabetes?

A

Level of glucose in the blood after 8 hours fasting
126 mg/dl is diagnostic

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10
Q

What is hemoglobin A1C (glycosylated hemoglobin)? How is it useful? Can it be used to make the diagnosis of diabetes?

A

-Hemoglobin A1c - 6.5% or greater is diagnostic
-Does not require fasting
-A laboratory test used to measure the average blood sugar levels over the past 2-3 months

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11
Q

What is the normal pH of arterial blood?

A

7.35 - 7.45

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12
Q

What are the signs and symptoms of DKA?

A

-Urine smells like rotten apples, breath smells sweet
-CNS depression (fatigue or even coma)
-Increased respirations
-Dehydration -> high hematocrit

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13
Q

What is the treatment of DKA? What electrolyte should be monitored carefully as insulin is infused with normal saline?

A

-IV insulin
-IV NS
-Potassium replacement
Recall insulin drives potassium into cells

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14
Q

What is HHNS?

A

hyperglycemic hyperosmolar nonketotic syndrome

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15
Q

Which insulin provides all-day coverage and is given once a day?

A

Insulin glargine

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16
Q

Which insulin should be drawn up first (this is to prevent contamination of one of the two vials)?

A

-Always draw short-acting insulin first - make sure they are clear in appearance
-CLEAR to CLOUDY

17
Q

What is insulin’s effect on K?

A

Hypokalemia (insulin causes K+ to move into cells)

18
Q

Metformin:
Mechanism

A

-Inhibits glucose production in the liver
-Reduces glucose absorption in the gut

19
Q

Metformin:
What are its common side effects?

A

GI effects (anorexia, N/V)

20
Q

What patients are at special risk for lactic acidosis?

A

Do NOT give to people with kidney or liver disease or alcoholics

20
Q

Metformin:
Rare but serious adverse effect

A

lactic acidosis - build up of lactic acid - may be deadly

21
Q

Metformin:
Rare but serious adverse effect

A

lactic acidosis - build up of lactic acid - may be deadly

22
Q

What advantage does metformin have over many other antidiabetic drugs?

A

Does not cause hypoglycemia

23
Q

What class are glyburide / glypizide?

A

a sulfonylurea

24
Q

glyburide / glypizide (sulfonylureas)
Major side effect

A

Hypoglycemia

25
Q

List important drug interactions with sulfonylureas (4)

A

Sulfonylureas act like antabuse when combined with alcohol
NSAIDS, sulfonamides, cimetidine - hypoglycemia
Mnemonic: NSC = “no sugar coma”

26
Q

How do the gliflozins (like canagliflozin) work?

A

Sodium-glucose cotransporter inhibitors (prevent reabsorption of glucose in the kidney)

27
Q

gliflozins (like canagliflozin):
side effects

A

-Must be stopped a few days before surgery, as they increase the risk for DKA in patients with poor PO intake
-Side effects: yeast infections, UTIS, increased urination
(REMEMBER gliflozin sounds like fluconazole)

28
Q

Glyburide / glypizide (sulfonylureas):
Mechanism

A

Promote insulin release

28
Q

What class are the drugs exenatide (Byetta) and semglutide (Ozempic) ? How are these medications most commonly administered?

A

-GLP-1 agonist (glucagon like peptide agonists) - mimic incretin
-Incretins are hormones that regulate blood sugar
Administered subQ

28
Q

Meglitinides have the same mechanism and major side effect as ______

A

sulfonylureas

Pharmacology (21 decks)

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