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ADT Module 5-8 > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Alpha-Glucosidase Inhibitors include:

A

Acarbose (precose), Miglitol (glyset)

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2
Q

Alpha-Glucosidase Inhibitors are used for ___ ___ diabetes, alone or in combination w/a ___.

A

Type 2, sulfonylurea

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3
Q

The biggest s/e of alpha-glucosidase inhibitors is ___.

A

flatulence

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4
Q

Thiazolidinediones (aka ____) include:

A

TZD’s, rosiglitazone (avandia - REMS), pioglitazone (actos)

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5
Q

TZD’s are used as monotherapy or combination w/___, ___, or ___ for ___ ___ diabetes.

A

metformin, sulfonylurea, insulin, type 2

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6
Q

Biggest s/e of TZD’s is ___ and ___.

A

weight gain, edema

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7
Q

alpha-glucosidase inhibitors work in the ___ to delay ___ absorption.

A

gut, glucose

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8
Q

TZD’s work inside ___ to increase ___.

A

cell, GLUT4

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9
Q

TZD’s have ___ onset and take ___-___ weeks to reach full effect.

A

slow, 6-8

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10
Q

DPP-IV inhibitors (aka ____) include:

A

gliptins, saxagliptin (onglyza), sitagliptin (januvia), linagliptin (tradjenta)

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11
Q

Glucagon-like peptide: GLP-1 are ___ and include:

A

injections, exenatide (byetta), liraglutide (victoza)

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12
Q

MOA for GLP-1 is to: replace ___ phase insulin release, enhance BG-dependent ___ secretion, suppress elevated ___, and slow gastric ___.

A

first, insulin, glucagon, emptying

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13
Q

A s/e of combination therapy of GLP-1 and sulfonylurea is ___. Not seen in combination w/___.

A

hypoglycemia, metformin

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14
Q

GLP-1 help pt to feel ___ sooner so they eat ___ and have weight ___.

A

full, less, loss

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15
Q

Black-box warning for GLP-1 is ___ tumors.

A

thyroid

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16
Q

Exenatide is associated w/significant weight ___ in Type 2 DM.

A

loss

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17
Q

GLP-1 receptor analogs added to ___ are associated w/ better ___ control and ___ weight gain.

A

insulin, glycemic, less

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18
Q

___, ___, and ___ tumors have been observed in pts taking GLP-1’s.

A

pancreatitis, nausea, thyroid

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19
Q

GLP-1’s have been shows to decrease ___ risk factors, like b/p, cholesterol, triglycerides, and free fatty acids.

A

CVD

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20
Q

colesevelam HCL (welchol) is the only ___ ___ ___ indicated for the management of Type 2 diabetes (along w/management of lowering ___ levels).

A

bile acid sequestrant, LDL

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21
Q

As far as dietary therapy for Type 2 diabetes, ___% should be carbs, ___% should be protein, and less than ___% should be fats.

A

50, 20, 30

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22
Q

Carb budgeting is important. For females, it is ___-___ carb servings per meal. For males, it is ___-___-___ carb servings per meal.

A

2-3, 3-4-5

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23
Q

Important to do ___ minutes of exercise/day, or at least ___ minutes/week for diabetic pt’s. Wt loss requires ___ minutes of exercise/day.

A

30, 150, 60

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24
Q

___ is the leading cause of adult blindness, kidney disease, and non-traumatic amputations.

A

Diabetes

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25
Q

Ethnic groups have a 2-3 time ___ risk than caucasians for developing ___.

A

higher, diabetes

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26
Q

DM criteria for being dx: 1) a fasting plasma glucose of > ___, 2) a random plasma glucose > ___, 3) an oral glucose tolerance test w/BG > ___, and 4) HbA1c > ___%.

A

126, 200, 200, 6.5

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27
Q

What are the 3 “poly’s that accompany Type 2 diabetes?

A

polyphagia, polyuria, polydipsia

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28
Q

Common s/s of Type 2 diabetes include ___, ___ vision, ___ infections.

A

fatigue, blurry, yeast

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29
Q

Pre-diabetes is impaired glucose tolerance level ___-___ or impaired fasting glucose ___-___.

A

140-200, 100-126

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30
Q

Secondary diabetes is d/t ___ disease, meds like ___, ___, or ___.

A

pancreatic, prednisone, hormones, genetics

31
Q

Gestational DM presents in the ___ or ___ trimester. Dx using criteria of: FBS > ___, at 1hr > ___, at 2hrs > ___.

A

second, third, 92, 180, 153

32
Q

Drug therapy for gestational DM includes: ___, ___, ___.

A

insulin (safest), metformin, glyburide

33
Q

Targets for glycemic control: A1c = ___%, fasting/premeal = ___-___, postprandial = < ___, bedtime = ___-___.

A

6.5, 70-110, 140, 100-140

34
Q

C-Peptide test used to dx both Type 1 and Type 2 and confirms whether a pt is producing ___.

A

insulin

35
Q

Fructosamine is a diabetes test that gives ___ ___ over last 7-10 years.

A

average BS

36
Q

Urine glucose test is not as ___.

A

precise

37
Q

Biguanide Metformin (glucophage) is indicated for ___ ___ diabetes, alone or in combination w/___, ___, or ___.

A

Type 2, DPP4’s, GLP-1 agonists, sulfonylureas

38
Q

MOA for Metformin is: ___ hepatic glucose production, ___, and ___. It also ___ intestinal absorption of glucose, ___ insulin sensitivity, and ___ peripheral glucose uptake and utilization.

A

decreases, glycogenolysis, gluconeogenesis, decreased, improves, increases

39
Q

Clinical therapy for metformin is to initially start dose at ___mg at ___-time, then eventually increase to ___ for a total of ___mg/day. Clinical therapeutic dose is ___mg/day.

A

500, supper, bid, 1000, 2000

40
Q

Avoid using ___ in pt’s w/heart failure or decreased kidney function.

A

metformin

41
Q

You should stop Metformin ___ hrs before using ___ ___ and do not restart until ___ hrs after procedure.

A

24, iodinated contrast, 48

42
Q

Sulfonylureas (2nd generation) and is used as ___-line treatment only for pt’s w/low income and include:

A

second, glipizide (glucotrol), glyburide (diabeta), micronized-glyburide (glynase), glimepiride (amaryl)

43
Q

Use ___ alone. MOA is to increase ___ cell insulin secretion.

A

sulfonylureas, beta

44
Q

S/E of sulfonylureas is weight ___.

A

gain

45
Q

Meglitinides: D-Phenylalanine include: ___, ___. Cause a ___ of insulin to be released so given immediately ___ meals.

A

repaglinide (prandin), nateglinide (starlix), bolus, before

46
Q

Barriers to initiating insulin therapy for patients include: ___ resort, ___ of injection, fear of ___ and weight ___.

A

last, fear, hypoglycemia, gain

47
Q

For every 1% drop in A1c = ___ lb weight gain for pts typically.

A

10

48
Q

___ cells fail over time.

A

Beta

49
Q

Should take Lispro and Glulisine ___-___ mins prior to mealtime.

A

15-30

50
Q

Rule for basal insulin = body ___ in lbs x ___%. Example: 210 lbs x 10% = 21 units insulin.

A

weight, 10

51
Q

Pt’s tend to have more insulin resistance in the ___, so may need a ___ dose of insulin before ___.

A

morning, higher, breakfast

52
Q

___ injections is the GOLD standard insulin regimen. They receive it ___ times/day at mealtime, which would be ___-acting. Then do ___-acting at bedtime.

A

Multiple, 3, rapid, long

53
Q

Rapid-acting insulins include: ___, ___, and ___. Long-acting insulins include: ___ and ___.

A

humalog, novalog, apidra, lantus, levemir

54
Q

Amylin analog includes: ___. It is given at ___ and is indicated as an adjunct therapy in pt’s who use mealtime insulin therapy already and have ___ to achieve desired glucose control.

A

pramlintide (symlin), mealtime, failed

55
Q

pramlintide (symlin) is an ___ given to pt’s w/ Type 1 or Type 2 DM not controlled by ___. Also helps pt’s to feel ___, so weight ___.

A

injection, insulin, full, loss

56
Q

pramlintide (symlin) is not appropriate for pt’s w/: poor ___ w/current insulin regimen, A1C > ___%, recurrent ___, dx of ___, ___.

A

compliance, 9.0, hypoglycemia, gastroparesis, pediatrics

57
Q

Role of SGLT-2 inhibitors ___ glucose reabsorption in proximal ___ ___.

A

inhibit, renal tubules

58
Q

Targets for lipids, b/p, and microalbumin: LDL < ___, HDL ___-___, total cholesterol < ___, triglycerides < ___, b/p < ___/___, microalbumin < ___.

A

100, 45-55, 200, 150, 130/80, 30

59
Q

Things to be performed at every visit: ___ and ___ exam.
Every 3-6 months: check ___ level.
Annually: ___ exam, ___ levels, check ___.

A

b/p, foot
A1C
eye, lipid, microalbumin

60
Q

___ hormones GLP-1 and GIP are released by the ___ throughout the day that nudge the pancreas to increase insulin secretion in response to a ___.

A

Incretins, intestine, meal

61
Q

Glimeperide/Glucatrol XL may provide better ___ hr coverage.

A

24

62
Q

Glipizide/Gluburide may be more effective for ___-___ blood glucose.

A

post-prandial

63
Q

Glipizide/Glimeperide better to use in pt’s w/impaired ___ function.

A

renal

64
Q

___ increase ovlulation, so increases pregnancy. Good for ___ pt’s. Also have higher risk of ___ CA. Do not use in pt’s w/___.

A

TZD’s, PCOS, bladder, CHF

65
Q

You know TZD’s are working when they ___ weight.

A

gain

66
Q

Black-box warning for GLP-1’s is ___ tumors.

A

tumors

67
Q

GI s/e of delayed gastric emptying and n/v is more likely in ___ than in ___.

A

GLP-1’s, DPP-IV’s

68
Q

Eat slowly after injections of ___ to prevent the s/e of nausea. It make’s you feel ___ sooner.

A

GLP-1’s, full

69
Q

Regular exercise lowers ___, improves plasma ___ levels and ___ activity.

A

b/p, lipid, fibrinolytic

70
Q

___ cells decline/fail over time.

A

Beta

71
Q

Type 2 diabetes loses ___-___ insulin.

A

first-phase

72
Q

___ injections is the Gold standard for insulin. You want to use rapid-acting of ___, ___, or ___ at mealtimes (3 x/day), and long-acting of ___ or ___ at bedtime.

A

Multiple, humalog, novolog, apidra, lantus, levemir

73
Q

Pramlintide (Symlin) is started at ___ units for Type 2 and increased to ___. For Type 1, start at ___ units and increase by ___ units every 3 days to max of ___ units.

A

60, 120, 15, 15, 60

ADT Module 5-8 (18 decks)

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