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Pharm > Diabetes mellitus > Flashcards

Diabetes mellitus Flashcards

1
Q

exocrine cells involves synthesis and release of what?

A

digestive enzymes and sodium bicarbonate

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2
Q

what does the exocrine cells play an essential role in what?

A

digestion and absorption of food in small intestine

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3
Q

endocrine cells involves synthesis and release of what?

A

hormones

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4
Q

which cells are produced from acini cells?

A

exocrine

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5
Q

which cells are produced from islets of langerhans

A

endocrine

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6
Q

what does the endocrine cells play an essential role in what?

A

blood glucose levels

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7
Q

Insulin comes from which cells

A

beta

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8
Q

glucagon comes from which cells

A

alpha

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9
Q

somatostatin comes from which cells

A

delta

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10
Q

glycogenesis

A

glucose is stored in liver as glycogen

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11
Q

lipogenesis

A

glycogen coverts to glucose which converts to fatty acids which is stored as triglycerides in fat cells

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12
Q

what happens between meals?

A

liver releases glucose to maintain blood glucose within normal limits

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13
Q

glycogenolysis

A

glycogen broken down to release glucose

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14
Q

gluconeogenesis

A

synthesis of glucose from amino acids, glycerol and lactic acid

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15
Q

which type of diabetic goes into DKA?

A

type I

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16
Q

which type of diabetic has islet cell Ab

A

type I

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17
Q

AlC should be greater than or equal to what to diagnose Diabetes? fasting BG?

A

6.5/ >126mg/dl

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18
Q

A normal A1C should be? fasting BG should be?

A

below 5.7/ <100mg/dl

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19
Q

prediabetic A1C? fasting BG?

A

5.7-6.4/100-125mg/dl

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20
Q

when are all pregnant women screened for diabetes regaurdless of risk with an OGTT?

A

24-28 weeks

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21
Q

primary goal of diabetes treatment?

A

prevent long term complications

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22
Q

preferred treatment for severe hypoglycemia

A

IV glucose or Glucagon

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23
Q

macrovascular damage

A

heart disease HTN, stroke

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24
Q

microvascular damage

A

retinopathy, neuropathy, erectile dysfunction

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25
Q

what drug is important to prescribe for a diabetic who has HTN?

A

ACE inhibitor (lisinopril) or ARB (losartan)

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26
Q

treatment principles for diabetic management step 1

A

initiate lifestyle changes, start metformin

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27
Q

treatment principles for diabetic management step 2

A

add 2nd drug to metformin, continue lifestyle changes

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28
Q

treatment principles for diabetic management step 3

A

add 3rd drug to metformin and the other drug

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29
Q

treatment principles for diabetic management step 4

A

add insulin to to 3 other drugs,

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30
Q

A1C treatment goal

A

<7%

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31
Q

preprandial

A

before a meal

32
Q

Preprandial plasma glucose treatment goal?

A

80-130 mg/dl

33
Q

peak postprandial plasma glucose treatment goal?

A

<180

34
Q

BP treatment goal for risk CVD and non risk CVD

A

Risk = 130/80

non risk= <140/90

35
Q

LDL, triglycerides and HDL treatment goals

A

LDL <100
triglycerides <150
HDL >50

36
Q

when is tight glycemic control inappropriate?

A 
long standing type 2
advanced microvascular or macrovascular damage
comorid conditions
hx severe hypoglycemia
limited life expectancy
37
Q

which drugs help with nephropathy

A

ACE1 or ARB

38
Q

which drugs help with neuropathy?

A

tricylic antidepressants, gabapentin

39
Q

which drugs help with patients at high risk for hypoglycemia

A

metformin or pioglitazone

40
Q

which drugs help with postprandial hyperglycemia

A

alpha-glucosidase inhibitor, Byetta

41
Q

How does insulin effect K?

A

it increases K uptake into cells

42
Q

how does insulin effect adipose tissue?

A

helps to breakdown fat

43
Q

how does insulin effect muscle?

A

increases glycogen and protein synthesis

44
Q

how does insulin effect liver?

A

increases storage of glucose as glycogen

inhibits glycogenolysis, glucomeogensis, ketogenesis

45
Q

insulin analog example

A

Glargine (lantus)

46
Q

Rapid acting insulin

A

Lispro (Humalog), aspart (Novolog), glulisin (Apidra)

47
Q

how fast is rapid acting insulin and when does it peak, How long does it last

A

10-30 minutes, peaks 1 hour, lasts 3-6 hours

48
Q

Short acting insulin

A

Regular (Humulin) Novolin R

49
Q

When is short acting insulin given, peak? duration?

A

given 30-45 minutes, peaks at 1-5 hours and lasts about 6-10 hours

50
Q

Intermediate-acting insulin

A

NPH

51
Q

how fast is intermediate-acting insulin, peak? and duration?

A

1-2 hours, peaks 6-14 hours and lasts 16-24 hours

52
Q

Long acting insulin, peak? duration?

A

Glargine (Lantus) and Detemir (Levemir) no peak, lasts 12-24 hours

53
Q

ultra long acting insulin? peak? duration?

A

Degludec (Tresiba), no peak, lasts 42 hours

54
Q

NPH can only be mixed with which type of insulin?

A

short acting (Regular (Humulin) Novolin R)

55
Q

when mixing NPH which is drawn up first?

A

short acting (Regular (Humulin) Novolin R)

56
Q

which type of insulin can cause bronchospasm in patients since you can give it via oral inhalation

A

short acting (Regular (Humulin) Novolin R)

57
Q

short acting (Regular (Humulin) Novolin R) route

A

subq, IV infusion, IM, oral inhalation

58
Q

how much does 15gm CHO raise BG?

A

50gm/dl

59
Q

1 unit bolus of insulin lowers glucose by how much?

A

20-60mg/dl

60
Q

metformin is which type of oral hypoglycemic?

A

Biguanides

61
Q

Biguanides

A

metformin

62
Q

most common side effects of Biguanides (metformin)

A

GI upset, B12 deficiency

63
Q

when are Biguanides (metformin) given to a non diabetic?

A

Polycystic ovary syndrome (PCOS), to increase changes of pregnancy, prevention of type 2

64
Q

which antidiabetics increase insulin secretion?

A

sulfonyureas, incretins, meglitinides

65
Q

which antidiabetics increase glucose uptake and utilization?

A

Thiazolidinediones and Beguanides

66
Q

In order for Biguanides to work, what is needed?

A

they need to be making insulin for this to work

67
Q

Meglitinides (glinides)

A

Repaglinide (Prandin), Nateglinide (Starlix)

68
Q

which type of oral hypoglycemics are Repaglinide (Prandin), Nateglinide (Starlix)

A

Meglitinides (“glinides”)

69
Q

Thiazolidinediones (glitazones)

A

Rosi”glitazone” (Avandia)

70
Q

which type of oral hypoglycemics are Rosi”glitazone” (Avandia)

A

Thiazolidinediones (glitazones)

71
Q

Function of Biguanides (metformin)

A

prevents liver from making glucose
decreases intestinal absorption of glucose
increases insulin sensitivity to the tissues
lowers cholesterol
does NOT stimulate insulin secretion

72
Q

oral hypoglycemic for patients with secondary beta cellfailure

A

metformin

73
Q

Should you take Biguanides (metformin) with food?

A

no

74
Q

warnings precautions with Biguanides (metformin)

A

impaired hepatic function, decreased B12 absorption, elderly

75
Q

Sulfonylureas start with?

A

“Gli”

76
Q

which oral meds are bad for pregnancy?

A

sulfonylureas, thiazolidinediones (really nothing except for metform)

77
Q

bladder ca is a side effects of which med?

A

Thiazolidinediones

Pharm (33 decks)

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