Diabetes

Question 1

Lispro (humalog)

Answer 1

Rapid acting, short duration insulin

Question 2

Aspart (novalog)

Answer 2

Rapid acting, short duration insulin

Question 3

Glulisine (apidra)

Answer 3

Rapid acting, short duration insulin

Question 4

Humulin r

Answer 4

Fast acting, short duration insulin

Question 5

Novolin R

Answer 5

Fast acting, short duration insulin

Question 6

NPH (humulin N)

Answer 6

Slow acting, intermediate duration insulin

Question 7

Nph (novolin N)

Answer 7

Slow acting, intermediate duration insulin

Question 8

Detemir (levemir)

Answer 8

Slow acting, intermediate duration insulin

Question 9

Glargine (lantin)

Answer 9

Slowest acting, long duration insulin

Question 10

Indicated in all T1 cases, 40% of T2, ketoacidosis, acute hyperglycaemia, and hyperkalemia

Answer 10

Insulin

Question 11

Indicated for glycemic control, prevention of T2, GDM, and can be used for polycystic ovary syndrome

Answer 11

Biguanides

Question 12

Indicated in T2 only in combo with diet and exercise modifications, contraindicated in pregnancy

Answer 12

Sulfonylureas

Question 13

Indicated in T2, lowers Hgb A1c levels, not typically used in pts who were not responsive to sulfonylureas, approved for monotherapy or combination therapy with metformin or glitazone

Answer 13

Meglitinides

Question 14

Indicated in T2 in conjunction with diet and exercise, may be used as monotherapy or in combination with insulin, metformin, or sulfonylureas, lowers hgb A1c

Answer 14

Alpha-glucosidase inhibitors

Question 15

Indicated in T2 (insulin must be present), increase insulin at receptor sites as well as possibly decreasing glucose production, Used as monotherapy or in combination with sulfonylureas, metformin, or insulin

Answer 15

Glitazones

Question 16

Insulin MOA

Answer 16

External form of naturally produced insulin. Same MOA as intrinsic insulin

Question 17

Biguanides MOA

Answer 17

Inhibits glucose production in liver, reduces intestinal absorption of glucose, sensitizes insulin receptors in target tissues, not metabolized

Question 18

Sulfonylureas MOA

Answer 18

Stimulates the release of insulin from the pancreatic beta cells

Question 19

Meglitinides MOA

Answer 19

Structurally different from sulfonylureas but work similarly, stimulate insulin release in pancreas

Question 20

Alpha-glucosidase inhibitor MOA

Answer 20

Blocks Alpha-glucosidase which is responsible for converting carbs into sugars, only anti-diabetic agent that does not depend on the presence of insulin

Question 21

Glitazones MOA

Answer 21

Insulin sensitizing medications, decrease insulin resistance by enhancing the sensitivity to insulin receptors, directly stimulates peripheral glucose uptake and storage, no known effect on insulin secretion, reduce risk of T2 in those at risk

Question 22

Insulin Adverse effects

Answer 22

Fluid retention, hypoglycemia, Hypokalemia, lipohypertrophy

Question 23

Hypoglycemia treatment

Answer 23

Check BGM, if conscious give juice or glucose gel, if unconscious give IV dextrose

Question 24

Biguanides Adverse effects

Answer 24

Don’t last long and usually resolve on their own, weight loss, GI side effects, Metallic taste, Reduction in Vitamin B12, lactic acidosis

Question 25

Sulfonylureas Adverse effects

Answer 25

Hypoglycemia, CV toxicity, GI effects

Question 26

Meglitinides adverse effects

Answer 26

Hypoglycemia (especially in those with poor liver function), affects insulin (eat no later that 30 minutes after taking), Headache, dizziness, joint pain, URTI, weight gain, Flu like symptoms

Question 27

Alpha-glucosidase inhibitors adverse effects

Answer 27

GI effects, Flatulence, cramps, abdominal distension, borborygmus, diarrhea, decreased absorption of iron, hepatotoxicity

Question 28

Glitazones Adverse Effects

Answer 28

Common: URTI, Headache, sinusitis, myalgia. Also, renal retention of fluid, hypoglycemia, Pioglitazone can cause ovulation in anovulatory premenopausal women, risk of bladder cancer, with long-term/high dose therapy, hepatotoxicity

Question 29

Insulin Interactions

Answer 29

Hypoglycemic agents (Intesifies hypoglycemia from insulin), Hyperglycemic agents (counteracts insulin), beta blockers (mask signs of hypoglycemia)

Question 30

Biguanides interactions

Answer 30

Concentrations increase when given with digoxin, furosemide, and cimetidine

Question 31

Sulfonylureas Interactions

Answer 31

Alcohol, NSAIDs, sulfa antibiotics, cimetidine, Beta Blockers (can diminish effects by suppressing insulin release, and can mask hypoglycemia)

Question 32

Meglitinides interactions

Answer 32

Hypoglycemic effects with fluconazole, gemfibrozil, NSAIDs, Pioglitazone, and sulfonylureas, reduced Hypoglycemic effects when given with phenobarbital, phenytoin, carbamazepine, nafcillin, and thiazide diuretics

Question 33

Glitazones interactions

Answer 33

Fluid retention when given with insulin, increase drug response when given with atorvostatin and ketoconazole, decrease drug response when given with rifampin and cimetidine

Question 34

Metformin (Glucophage)

Answer 34

Biguanide

Question 35

Chloropamide

Answer 35

1st gen sulfonylureas

Question 36

Tolbuamide

Answer 36

1st gen sulfonylureas

Question 37

Glicazide

Answer 37

2nd gen sulfonylureas

Question 38

Glimepiride

Answer 38

2nd gen sulfonylureas

Question 39

Glyburide

Answer 39

2nd gen sulfonylureas

Question 40

Repaglinide (glucoNorm)

Answer 40

Meglitinides

Question 41

Nateglinide (Starlix)

Answer 41

Meglitinides

Question 42

Acarbose

Answer 42

Alpha-glucosidase Inhibitors

Question 43

Pioglitazone

Answer 43

Glitazones

Question 44

Rosiglitazone

Answer 44

Glitazones