Diabetus TBL

Question 1

insulin MOA

Answer 1

activates the TK insulin receptors on liver, skeltal muscle and adipose tissue

Question 2

effects of insulin on liver

Answer 2

increases glucose storage by inserting additional GLUT2 receptors and decreases protein metabolism

Question 3

effects of insulin on skeletal muscle

Answer 3

stimulates glycogen synthesis and protein syntheis by activating glut4 receptors

Question 4

effects of insulin on adipose tissue

Answer 4

facilities trigliceride storage by activating lipoprotein lipase inceraseing glucose uptake into cells via glut4

Question 5

rapid acting insulin

Answer 5

lispro aspar glulisine

Question 6

use of rapid acting insulin

Answer 6

before a meal, continupus subQ infusion, emergancy treatment for ketoacidosis

Question 7

intermediate-acting insulin

Answer 7

hagedom

Question 8

long acting insulin

Answer 8

glargine and detemir

Question 9

use of long actine insulin

Answer 9

control basal glucose levels

Question 10

SE of insulin

Answer 10

hypoglycemia

rare allergic reactions

Question 11

population with risk of insulin hypoglycemia

Answer 11

old and kidney pts

Question 12

metformin

Answer 12

inhibits gluconeogenesis, stimulating glucose uptake and glycolosis on peripheral tissuesm slowing glucose uptake in GI and reducing plasma glucgon levels

Question 13

effects of metformin

Answer 13

reduces postprandial and fasting glucose levels

Question 14

use of metformin

Answer 14

first line in Type II DM

Question 15

restores infertility with PCOD and insulin resistance

Answer 15

metformin

Question 16

used to reduce risk of DM in high risk pts

Answer 16

metformin

Question 17

SE of metformin

Answer 17

GI distress

n/v leading to acidocis

Question 18

tolbutamide

Answer 18

sulfonylureas

Question 19

cholorpropamide

Answer 19

sulfonylureas

Question 20

glyburide

Answer 20

sulfonylureas

Question 21

glipizide

Answer 21

sulfonylureas

Question 22

glimepiride

Answer 22

sulfonylureas

Question 23

MOA of sulfonylureas

Answer 23

closes K channels in beta cell membranes resulting in depolarizing cells

Question 24

effect of sulfonylureas

Answer 24

release of endogenous insulin by beta cells

Question 25

sulfonylureas will not work on

Answer 25

Juvinle diabetes

Question 26

SE of sulfonylureas

Answer 26

hypoglycemia allergic rxn weight gain

Question 27

rosiglitazone

Answer 27

thiazoledindiones

Question 28

pioglizatone

Answer 28

thiazoledindiones

Question 29

thiazoledindiones MOA

Answer 29

activates PPAR-y which regulates genes involved in carbohydrate and lipd metabolism

Question 30

thiazoledindiones effect

Answer 30

increase insulin sensitivity in muscle and adipose and inhibits hepatic gluconeogenesis

Question 31

thiazoledindiones use

Answer 31

reduce fasting and postprandial hyperglycemia

Question 32

SE of thiazoledindiones

Answer 32

fluid retension anemia Edema leading to increased risk of CHF bone fractures in women

Question 33

drug that has MI risk

Answer 33

rosiglitizone

Question 34

drug class with liver risk

Answer 34

thiazoledindiones

Question 35

inhbits DPP-4 degrading glucagon like peptide and other incretins

Answer 35

sitagliptin

Question 36

use of sitagliptin

Answer 36

DM2

Question 37

SE of sitagliptin

Answer 37

headachem nasopharyngitis URTI

Question 38

can mask sx of hypoglycemis

Answer 38

beta-blockers

Question 39

diuretics that can impair release of insulin and tissue utilization of glucose

Answer 39

thiazide

Question 40

pathogenisis of DM1

Answer 40

lack of insulin secretion due to loss of beta cells -auto-immune destruction of Beta cells by T-cells

Question 41

pathogenisis of DMII

Answer 41

peripheral resistance to insulin and inadequate compensatory response by beta cells

Question 42

mutations in DMI

Answer 42

CTLA4 and PTPN22

Question 43

diseases that can trigger diabetes

Answer 43

mumps, rubella, coxsackie

Question 44

inhibtors of insulin signalling

Answer 44

TGs

Question 45

replaces islets of langerhauns in long term DMII

Answer 45

amyloid

Question 46

DX criteria of DM

Answer 46

HbA1C > 6.4 OR fasting glucose >125 OR >200 mg/dl in glucose tolerance test OR SX of hyperglycemia/hyperglycemic crisis and random glucose over 200

Question 47

goals of insulin therapy

Answer 47

get A1C at or below 7% possibly higher if pt is sick possibly lower if pt is young and healthy

Question 48

complications of DM

Answer 48

``` pancreatic changes CVD stroke renal failure gangrene hyalline arteriosclerosis Diabetic neuropathy visual impairments CNS damage infection ```

Question 49

BP goals for diabetiics

Answer 49

better than 140/80

Question 50

pharm therapy for HTN in diabetes

Answer 50

ACEi or ARB

Question 51

preggers BP goals in diabetics

Answer 51

110-129/65-79

Question 52

contraindicated in preggers

Answer 52

ARBs and ACE inhibitors, statins

Question 53

fats goals

Answer 53

TG 40