Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Diabetes > Flashcards

Diabetes Flashcards

1
Q

What method is used to give insulin and where is insulin derived from?

A 
Given parenterally (not absorbed PO)
Derived from human insulin–more rapidly absorbed and less immunogenic than animal sources
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the standard preparation of insulin

A

100 units per milliliter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

List examples of immediate, short, intermediate, and long insulin drugs

A

Immediate –lispro, aspart, glulisine
Short – regular insulin
Intermediate – NPH
Long – Detemir, Glargine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which type of insulin lasts for 12 hours but peaks at four hours?

A

Intermediate (NPH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which type of insulin most closely mimics human insulin?

A

Immediate (lispro)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which type of insulin requires the most frequent administrations?

A

Immediate (lispro)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a conventional insulin prescription?

A

Two biphasic (70/30) injections daily with short acting agents PRN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

List six drugs that cause hyperglycemia

A

Glucagon, steroids, epinephrine, thyroid hormones, oral contraceptives, diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe how an all day insulin dose works

A

Long acting insulin agent (Glargine or detemir) covered by lispro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is added to insulin to make it long-acting?

A

Zinc and protamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What type of insulin is in an insulin pump?

A

Lispro (immediate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Who is more likely to be insulin dependent, patient under 30 with diabetes or a patient over 30 with diabetes?

A

Under 30 with diabetes always require insulin

Over 30 with diabetes can manage with diet, insulin, and PO agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which types of insulin maybe mixed?

A

Shorter acting agents maybe mixed in one syringe and immediately used
long-acting insulin should never be mixed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What happens to long acting insulin agents administered by IV?

A

They separate and precipitate (as all suspensions do) when administered IV
Only non-suspension insolent products should be administered via IV drip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why should insulin never be shaken?

A

Shaking denatures the protein (indicated by foam)

Instead, roll between hands to warm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When should insulin be refrigerated?

A

If prepared more than 30 days in advance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What size syringe should be used for insulin administration?

A

1 mL (or smaller, never larger)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the four signs of hypoglycemia?

A

Tremor, headache, malaise, tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How are pregnant patients with DM usually treated?

A

Switch to insulin – does not cross placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Why should patients on beta blockers be careful when taking insulin?

A

Beta blockers can mask signs of hypoglycemia (decrease headache, treat tremor, prevent tachycardia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe a proper insulin injection

A

Subcutaneously in hip/flank at 45° angle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Summarize the mechanism of sulfonylureas in treatment of DM

A

Increase insulin release and sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which type of oral diabetic agents require a 30% pancreatic function?

A

Sulfonylureas

24
Q

Which kind of sulfonylurea should be avoided in the elderly?

A

Long acting agents (chlorpropamide, tolbutamide)-can bottom out their blood sugar

25
Q

How are sulfonylureas excreted?

A

Renally, highly plasma protein bound

26
Q

What is the most common adverse effect of sulfonylureas?

A

Rash

27
Q

Which type of sulfonylurea may be coadministered with insulin?

A

Second or third generation (glimepiride, glyburide)

28
Q

Describe how biguanides work

A

They reduce hepatic glucose production (ineffective in absence of insulin)

29
Q

Why was phenformin removed from the market in 1970s?

A

It caused fatal lactic acidosis

30
Q

What is the only kind of biguanide agent still used?

A

Metformin (Glucophage)

31
Q

What is one added bonus of Exenatide (Byetta)?

A

Weight-loss

32
Q

Which patients should be extra cautious of taking biguanides (Metformin)?

A

Those with renal dysfunction – metformin can cause lactic acidosis, increased serum creatinine
Also, patients with hepatic dysfunction, cardiogenic shock, and pregnancy

33
Q

How is metformin dosing altered with the use of contrast dye?

A

Hold for 24 to 48 hours before use of dye

34
Q

What is another name for thiazolidinediones?

A

Glitazones

35
Q

How do Glitazones work?

A

They reduce peripheral insulin resistance (stimulate PPAR gamma resulting in adipose tissue differentiation)

36
Q

Which of these three tend to be least effective in diabetes treatment – sulfonylureas, biguanide’s, Glitazones ?

A

Glitazones are less effective

37
Q

List two common side effects of Glitazones

A

Weight gain and peripheral edema

38
Q

Which patients should avoid taking Glitazones?

A

Those with heart or hepatic failure

39
Q

How do Meglitinides work to treat diabetes?

A

Short acting secretagogues that release stored insulin (similar to sulfonylureas)

40
Q

List examples of two Meglitinides and when you should take them

A

Repaglinide (take QID 30 minutes before meal) and Nateglinide (TID)

41
Q

How does Exenatide work?

A

Functional analog of GLP-1 that enhances insulin secretion and delays gastric emptying, used as adjunct therapy with insulin or other oral

42
Q

What is an added bonus side effect of using Exenatide?

A

Weight loss

43
Q

List three major side effects of Exenatide

A

Nausea, vomiting, pancreatitis

44
Q

Why do long acting GLP-1 agonists come with a black box warning?

A

They can cause thyroid C cell tumors

45
Q

Explain the dosing of Exenatide

A

Take 5 to 10 µg b.i.d. one hour before morning and evening meals

46
Q

Explain how dipeptidylpeptidase-4 (DDP-4) inhibitors improve glucose control

A

They prevent metabolism of GLP-1 thereby enhancing insulin secretion and delaying gastric emptying

47
Q

List an example of a DPP-4 inhibitor

A

Januvia

48
Q

Explain how Acarbose and Miglitol work to control diabetes

A

Alpha–glucosidase inhibitor that reduces digestion of complex carbohydrates in the gut causing increased sugar excretion in stool (used as adjuncts with other diabetes meds)

49
Q

What are potential side effects of Acarbose and Miglitol?

A

Diarrhea, flatulence – bacteria in gut feed on undigested sugar

50
Q

Which 3 diabetes medications are given subcutaneously?

A

Insulin, Byetta, Symlin

51
Q

Describe how Pramlinitide (Symlin) works to control diabetes

A

Amylin analogue with longer half-life that reduces postprandial glucagon secretion, slows gastric emptying, reduces caloric intake and enhances effects of insulin

52
Q

What are 2 side effects of pramlintide (Symlin)?

A

Weight loss, nausea

53
Q

How is Symlin dosed?

A

15 µg subcutaneously just prior to large meals, titrate to 120 µg as tolerated

54
Q

How does Canaglifozin (Invokana) work to control diabetes?

A

Inhibits sodium–glucose cotransporter 2 (SGPT-2) in kidney to waste urinary glucose

55
Q

What are common side effects of Invokana?

A

Yeast infections, UTI, balanitis due to increased sugar in urine
Also osteoporosis and osteopenia due to potential calcium excretion (?)

56
Q

How is Invokana usually dosed?

A

100 mg QD before first daily meal for type two diabetes only

57
Q

What two tests must be monitored for patients on Invokana?

A

CrCl and serum K levels

Pharmacology (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions