Diabetic Pharmacology

Question 1

effect of insulin on liver

Answer 1

reveral of catabolic reactions

anabolic action

Question 2

effect of insulin on muscle

Answer 2

increased protein synthesis

increased glycogen synthesis

Question 3

effect of insulin on adipose tissue

Answer 3

increased triglyceride storage

Question 4

diabetes mellitus

-characteristics

Answer 4

elevation of blood glucose
metabolic perturbation
caused by a relative or absolute insulin deficiency

Question 5

diabetes Dx and glycemia

Answer 5

A1c >/= 6.5%
fasting plasma glucose >/= 126 mg/dL
glucose tolerance test (2h postprandial glucose) >/= 200 mg/dL
patient with hyperglycemia symptoms and blood sugar >/= 200 mg/dL

Question 6

insulin MOA

Answer 6

stimulates peripheral glucose uptake

inhibits hepatic glucose production

Question 7

insulin administration method

Answer 7

subcutaneous injection

• rotate site
• check blood sugars regularly

Question 8

insulin storage

Answer 8

refrigerate until use

once vial is punctures, it is good for 28 days and can be left at room temp

Question 9

insulin: special population considerations

- renal dysfunction

Answer 9

decrease dose

Question 10

dosing of insulin for type 1 patients

Answer 10

adjust according to fasting blood glucose
1 unit can account for 30 grams of carbs
1 unit can lower 50 mg/dL blood glucose

Question 11

Thiazolidinediones (TZD)

-indiciations

Answer 11

adjunct to diet and exercise for type II diabetes

Question 12

thiazolidinediones

-MOA

Answer 12

increase insulin sensitivity by affecting PPAR-y (a receptor) at adipose tissue, skeletal muscle and in the liver

Question 13

TZD

-cautions

Answer 13

heart failure
hepatic failure
anemia
bone loss

Question 14

dipeptidyl peptidase IV inhibitor MOA

Answer 14

stimulates insulin secretion at mealtime

Question 15

2nd generation sulfonylureas

• MOA
• side effect

Answer 15

stimulates insulin secretion

weight gain can occur

Question 16

biguanides

• MOA
• how popular

Answer 16

decreases endogenous hepatic production of glucose

preferred agent for type 2 diabetes

Question 17

thiazolidinediones

-side effects

Answer 17

can cause weight gain and edema

Question 18

sodium glucose co-transporter 2 inhibitor

• MOA
• side effects

Answer 18

increases urinary excretion of glucose
side effects
-weight loss can occur
-can cause UTIs and yeast infections

Question 19

meglitinides

-MOA

Answer 19

stimulates insulin secretion

Question 20

glucagon-like peptide-1 agonist

• MOA
• side effect
• only available via

Answer 20

enhances glucose-dependent insulin secretion at mealtime
weight loss can occur
only available by injection

Question 21

hypoglycemia Sx

Answer 21

anxiety
blurred vision
palpitations
shakiness
slurred speech
sweathing

Question 22

hypoglycemia Tx

Answer 22

glucose/simple sugars: 3-4 glucose tablets, 1/2 can of soda

glucagon injection

Question 23

diabetes adjunctive therapy

Answer 23

energy balance, diet, exercise

-low-card, low-fat, calorie-restricted diet is recommended

Question 24

diabetes and dyslipidemia

Answer 24

patients with type II diabetes should receive a moderate to high-intensity statin
can also use fiber and omega-3 fatty acids as adjunct therapy

Question 25

diabetes and antiplatelet agents

Answer 25

consider starting daily low dose aspirin to prevent ischemic events

Question 26

diabetes: considerations for the PT

Answer 26

exercise has an insulin-type effect, reducing blood glucose