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Diabetes Flashcards

1
Q

Stability of Humalog Mix 50/50 pens

A

10 days

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2
Q

Stability of Humulin 70/30 pens

A

10 days

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3
Q

Stability of Humulin N pen

A

14 days

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4
Q

Stability of Novolog Mix 70/30 pens

A

14 days

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5
Q

Stability of Apidra pens/vials

A

28 days

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6
Q

Stability of Humalog pens/vials

A

28 days

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7
Q

Stability of Novolog pens/vials

A

28 days

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8
Q

Stability of Admelog pens/vials

A

28 days

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9
Q

Stability of Lyumjev pens/vials

A

28 days

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10
Q

Stability of Fiasp pens/vials

A

28 days

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11
Q

Stability of Humalog Mix 75/25 vial

A

28 days

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12
Q

Stability of Novolog Mix 70/30 vial

A

28 days

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13
Q

Stability of Novolin R U-100, N, and 70/30 pens

A

28 days

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14
Q

Stability of Humulin R U-500 pens

A

28 days

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15
Q

Stability of Lantus, Basaglar, Semglee vials and pens

A

28 days

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16
Q

Stability of Humulin R U-100, N, and 70/30 vials

A

28 days

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17
Q

Stability of Humulin R U-500 vial

A

40 days

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18
Q

Stability of Novolog R U-100, N, and 70/30 vials

A

42 days

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19
Q

Stability of Levemir vial and pen

A

42 days

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20
Q

Stability of Toujeo pen

A

56 days

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21
Q

Stability of Tresiba pen

A

56 days

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22
Q

When mixing NPH and regular insulin together in the same syringe, how do you do it?

A

The regular/rapid-acting insulin is added first, then the NPH insulin

Clear before cloudy!

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23
Q

Selecting diabetes treatment: what to avoid in a cancer patient

A

GLP-1 agonists, Mounjaro

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24
Q

Selecting diabetes treatment: avoid in gastroparesis, GI disorders

A

GLP-1 agonists, pramlintide, Mounjaro

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25
Q

Selecting diabetes treatment: avoid in genital infections, UTIs

A

SGLT2is

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26
Q

Selecting diabetes treatment: avoid in heart failure

A

TZDs, alogliptin, saxagliptin

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27
Q

Selecting diabetes treatment: avoid in hypoglycemia

A

insulin, SUs, meglitinides, pramlintide

28
Q

Selecting diabetes treatment: avoid in hypotension/dehydration

29
Q

Selecting diabetes treatment: avoid in hypokalemia

30
Q

Selecting diabetes treatment: avoid in ketoacidosis

31
Q

Selecting diabetes treatment: avoid in lactic acidosis

32
Q

Selecting diabetes treatment: avoid in osteopenia/osteoporosis

A

canagliflozin, TZDs

33
Q

Selecting diabetes treatment: avoid in pancreatitis

A

DPP4is, GLP-1 agonists, Mounjaro

34
Q

Selecting diabetes treatment: avoid in peripheral neuropathy, PAD, foot ulcers

35
Q

Selecting diabetes treatment: avoid in sulfa allergy

36
Q

Selecting diabetes treatment: avoid in renal insufficiency

A

metformin, exenatide, glyburide; insulin may need to be started at a lower dose

37
Q

Selecting diabetes treatment: avoid in weight gain/obesity

A

SUs, meglitinides, TZDs, insulin

38
Q

Only GLP-1 that’s renally cleared

A

Exenatide (Byetta, Bydureon)

39
Q

BBW for GLP-1s

A

risk of thyroid C-cell carcinoma

40
Q

GLP1s that are recommended in patients with ASCVD risk

A

liraglutide (Victoza), dulaglutide (Trulicity), SQ semaglutide (Ozempic)

41
Q

Effects of GLP1s

A

increase glucose-dependent insulin secretion, decrease glucagon secretion, slows gastric emptying, improves satiety, weight loss

42
Q

SGLT2is are CI’ed in what?

43
Q

SGLT2is effects

A

reduce reabsorption of glucose, increase urinary glucose excretion

44
Q

SGLT2s that are beneficial in HF, CKD, ASCVD

A

Jardiance, Farxiga, Invokana

45
Q

eGFR minimum for SGLT2i use

46
Q

Metformin MoA

A

decrease hepatic glucose production, increase insulin sensitivity, decreased intestinal absorption of glucose

47
Q

BBW for metformin

A

lactic acidosis

48
Q

MoA of SUs and meglitinides

A

Stimulate insulin secretion from the pancreatic beta-cells to decrease postprandial BG

49
Q

DPP4is MoA

A

prevent DPP4 from breaking down incretin hormones, GLP-1, and GIP

50
Q

DPP4i effects

A

increase insulin release from pancreatic beta cells and decreased glucagon secretion

51
Q

DPP4i warnings

A

pancreatitis, severe arthralgia, acute renal failure, risk of heart failure

52
Q

TZD MoA

A

increase peripheral insulin sensitivity

53
Q

BBW for TZDs

A

can cause or exacerbate HF

54
Q

Warnings for TZDs

A

edema, risk of fractures, can stimulate ovulation

55
Q

Acarbose, miglitol MoA

A

inhibit the metabolism of intestinal sucrose, which delays glucose absorption

56
Q

Colesevelam side effect

A

Constipation

57
Q

Bromocriptine CI

A

syncopal migraines, breastfeeding

58
Q

Pramlintide side effect

A

Significant hypoglycemia risk; reduce mealtime insulin dose by 50% when starting

59
Q

Drugs that can increase BG

A

Beta-blockers
Thiazide and loops
Transplant drugs (tacrolimus, cyclosporine)
Protease inhibitors
Quinolones
APS (olanzapine and quetiapine)
Statins
systemic steroids
cough syrups
niacin

60
Q

Drugs that can decrease BG

A

beta-blockers, tramadol, quinolones

61
Q

DKA and HHS treatment: first step

A

FLUIDS! Start with NS, then change to D5W1/2NS when BG <200

62
Q

DKA and HHS treatment: second step

A

Regular insulin infusion

63
Q

DKA and HHS: what else to monitor

A

Potassium level

64
Q

When to treat acidosis in DKA/HHS

A

If pH <6.9, give sodium bicarb

NAPLEX (18 decks)

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