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RxPrep NAPLEX > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Fasting =

A

No caloric intake for at least 8 hours

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2
Q

DM tx in pregnancy

A

Insulin
Metformin
Glyburide

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3
Q

Dx of Pre DM

A

FBG 100-125
2 hr post 75g OGTT 140-199
A1C 5.7-6.4%

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4
Q

Dx of DM

A

Symptomatic AND random BG of 200 or greater
FBG 126 or greater
2 hr post 75g OGTT of 200 or greater
A1C of 6.5% or greater

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5
Q

15g of CHO

A

1 small piece of fruit
1 slide of bread
1/3 cup of rice/pasta
1/2 cup oatmeal

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6
Q

DM Goals for A1C

A

Less than 7%

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7
Q

DM goal preprandial

A

80-130

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8
Q

DM goal postprandial

A

(2hrs after a meal)

Less than 180

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9
Q

Calculation of A1C reading to BG average

A

(A1C -2) x 30

A1C of 7 = 150

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10
Q

Drugs than can increase BG

A 
BBs
Diuretics
Immunosuppressants 
Niacin
2nd gen antipsychotics
Statins
Steroids
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11
Q

What A1C reading would you go right to insulin

A

Over 10%

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12
Q

What A1C reading would you start dual therapy

A

Greater than or equal to 8.5%

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13
Q

DM meds that increase/replace insulin secretion

A

Insulin
SUs
Meglitinides

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14
Q

DM meds that decrease hepatic glucose output

A

Metformin

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15
Q

DM meds that decrease glucagon which decreases glucose production

A

GLP1 agonists
DPP4 inhibitors
Pramlintide

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16
Q

DM meds that slow gastric emptying (increasing satiety)

A

GLP1 agonists

Pramlinitide

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17
Q

DM drugs that increase glucose excretion

A

SGLT2 inhibitors

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18
Q

DM meds that increase insulin sensitivity

A

TZDs

Metformin

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19
Q

Max metformin dose

A

2000-2550 mg/day

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20
Q

eGFR and Metformin

A

<30: CI

30-45: do not start. And if already on, decrease by 50%

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21
Q

Meglitinides

A

Repaglinide (Prandin)

Nateglinide (Starlix)

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22
Q

Meglitinides counselling point

A

Skip a meal, skip a dose

-dosed with meals, 15-30 mins before each one

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23
Q

Thiazolidinediones (TZDs)

A

Pioglitazone (Actos)

Rosiglitazone (Avandia)

24
Q

Boxed warnings with TZDs

A

Can cause/exacerbate HF

25
Q

SGLT2 inhibitors

A

Canagliflozin (Invokana)
Empagliflozin (Jardiance)
Dapagliflozine (Farxiga)
Ertugliflozin (Steglatro)

26
Q

Dosing of SGLT2 inhibitors

A

All dosed based off eGFR

  • all CI if <30
  • not recommended if 30-45
27
Q

SE of SGLT2 inhibitors

A

Increased urination, weight loss, increased thirst, yeast infections and UTIs

28
Q

DPP4 inhibitors

A

Sitagliptan (Januvia)
Linagliptan (Tradjenta)
Saxagliptin (Onglyza)

29
Q

Only DPP4 inhibitor that does NOT need renal dose adjustment

A

Linagliptan (Tradgenta)

30
Q

SE of DPP4 inhibitors

A

Risk of HF and acute pancreatitis with all

-URTIs, UTIs, nasopharyngitis, edema, rash

31
Q

GLP1 agonists

A 
Exenatide (Byetta) BID
Exenatide (Bydureaon) WKLY
--both not recommended if CrCl <30
Semaglutide (Ozempic) WKLY
Dulaglutide (Trulicity) WKLY
Liraglutide (Victoza) (Saxenda) DAILY
Lixisenatide (Adlyxin) DAILY
32
Q

SE with GLP1 agonists

A

Nausea

-VD, weight loss, injection site rxns

33
Q

Only GLP1 agonist approved to decrease risk of CV event

34
Q

Missed doses with weekly GLP1 agonists

A

Take dose as soon as you remember as long as it is more than 72 hours before your next dose.
If it’s less than 72 hours, skip dose

35
Q

Rapid-acting insulins

A

Aspart (Novolog)
Lispro (Humalog)
-give up to 15 mins before meals, or immediately after

36
Q

Duration of action of aspart and lispro

A

Aspart 3-5hrs

Lispro 2-3hrs

37
Q

Short-acting regular insulins

A 
Regular insulin (Humalin R, Novolin R)
-give 30 mins before a meal
38
Q

Duration of action for short-acting insulin

39
Q

Prandial insulins

A

Rapid-acting: aspart, lispro

Short-acting: regular insulin

40
Q

Basal insulins

A

Intermediate-acting: NPH insulins

Long-acting: detemir, glargine, degludec

41
Q

Intermediate-acting insulins

A

NPH insulins (Humulin N, Novolin N)

  • cloudy insulins
  • given once or twice daily
42
Q

Mixing insulins

A

Can mix intermediate (NPH) insulins with prandial insulins, but draw up prandial insulins first
-clear before cloudy

43
Q

Duration of action of intermediate-acting insulin

A

NPH 14-24hr

44
Q

Long-acting insulins

A

Detemir (Levemir)
Glargine (Lantus, Basaglar, Toujeo)
Degludec (Tresiba)

45
Q

Duration of action of long-acting insulins

A

Detemir 6-23hr (dose-dependant)
Glargine over 24hrs
Degludec over 24hrs

46
Q

Premixed insulins naming

A

Named as a % of each component with Basal (NPH) first

47
Q

The one insulin you never mix

A

Long-acting

48
Q

Timing of administration of pre-mixed insulins?

A

Based before meals is based on whatever prandial insulin is used

49
Q

Usually dose the new insulin at the same dose of the old insulin (1:1 conversion) EXCEPT

A

Use 80% of NPH or Toujeo dose when switching to Lantus or Basaglar

50
Q

Room stability of injectables of 56 days

A

Tresiba

Ozempic

51
Q

Room stability of injectables of 42 days

A

Toujeo

Levemir

52
Q

Room stability of injectables of 30 days

A

Victoza

Byetta

53
Q

Room stability of injectables of 28 days

A

Lantus
Basaglar
Humalog
Novolog

54
Q

Room stability of injectables of 14 days

55
Q

Hypoglycemia reading

A

Less than 70

56
Q

BBs mask sx of hypoglycemia EXCEPT

A

Hunger and sweating

57
Q

Examples of 15-20g of glucose or simple carbs

A

4oz juice/soda
1tbsp honey or sugar
8oz milk

RxPrep NAPLEX (33 decks)

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