Endocrine drugs

Question 1

A 17-year-old type 1 diabetic patient is currently on diabetic medications. All of the following antidiabetic drugs are not used in type I diabetes EXCEPT:
A-Chlorpropamide
B-Glyburide
C-Repaglinide
D-Nateglinide
E-Pioglitazone

Answer 1

E??

But Thiazolidinediones DEPEND on INSULIN PRESENCE for MOA

Question 2

Pioglitazone and Rosiglitazone effects on TG, HDL and LDL

Answer 2

P: ↓ TG (have more lipid effect, more DIs)
R: ↑LDL and HDL, ↓ TG

Question 3

Drug class antidiabetic drug is gender selective?

Answer 3

Thiazolidinediones: Pio and Rosi

Question 4

Diabetic patient with hypercholesterolemia has high cholesterol, high LDL, normal TG. What would be the drug of choice?

Answer 4

Statins— Lovastatin

Question 5

-Antidiabetic drug may be taken regardless of meals?

Answer 5

Thiazolidinediones— Rosiglitazone (OD, w or wo food)

Question 6

The risk of lactic acidosis, associated with metformin, is enhanced by what factors?

Answer 6

Alcohol, renal and hepatic disease

Question 7

Which antidiabetic drug should be skipped if you skip meals?

Which does not cause hypoglycemia?

Answer 7

Both Acarbose:

• taken upon first bite of meal
• by itself does not cause hypoglycemia

Question 8

Metformin most common SE and rare?

Answer 8

Diarrhea (most common)

-Lactic acidosis

Question 9

A obese patient has CHF, renal disease and drinks alcohol. Recently diagnosed with type II DM, what is drug of choice amongst the antidiabetic drugs?

Answer 9

Acarbose
** Metformin is CI in renal, hepatic, diseases. Chlorpropamide dose adjustment required in renal impairment rosiglitazone contraindicated in congestive heart failure CHF.

Question 10

Diabetic patient have increased risk following infections:

Answer 10

skin and foot infections, Cellulitis, Gangrene, UTI

Question 11

What are symptoms of hypoglycemia?

Answer 11

sweating, hunger, dizziness, fainting, fatigue

Question 12

What are symptoms of hyperglycemia?

Answer 12

Polyurea, polydipsea, polyphagea, neuropathic pains, and blurred vision

Question 13

If a patient is not treated for asymptomatic sexually transmitted infections, this can lead to?

Answer 13

Can cause pelvic inflammatory disease and infertility

-NOT endometrial and cervical cancer

Question 14

DOC for pregnancy in hyperthyroidism

Answer 14

Propylthiouracil

Question 15

Patient receiving levothyroxine (L-T4) (Synthroid) should monitor levels of:

Answer 15

TSH

Question 16

Instructions for Synthroid (levothyroxin) tablet, give CIs.
I. Should not be taken with Iron supplements
II. Should not be taken within 4 hours of Ibuprofen
III. Should not be cut

Answer 16

Synthroid should not be taken with aluminum hydroxide, cholestyramine resins, colestipol, ferrous sulfate, sod. Polystyrene sulfonate, soybean flour (infant formula) due to decreased absorption of levothyroxin from GI tract

Question 17

What is the most common side effects of propylthiouracil?

Answer 17

Agranulocytosis- reduction in WBC

Question 18

What is the elevated TSH value and what does it indicate? Also for the opposite.

Answer 18

> 5mU/L hypothyroidism

< 0.5mU/L hyperthyroidism

Question 19

Excessive dose of Prednisone can lead to what disease/syndrome? State the opposite.

Answer 19

Cushing’s

Addison’s

Question 20

Which of the following is the least likely decrease absorption of levothyroxine
A) Al antacids
B) Mg antacids
C) Diary products
D) Iron supplements
E) Low fiber diet

Answer 20

E. Food and formula containing large amount of soybean, fiber, or iron should not be used for administration of levothyroxine. However low fiber food does not interact with thyroxin.

Question 21

Antidiabetic drugs taken with or after food?

Answer 21

Biguanides, Sulfonylureas, Thiazolidinediones

Question 22

Antidiabetic drugs not used for DM type 1?

Answer 22

Sulfonylureas and Meglitinides

Question 23

Metformin monitoring

Answer 23

BSL, HbA1C, CrCl, CBC