Exam 1

Question 1

Biguanides

Answer 1

*Metformin
*NO hypoglycemia
*Inhibit gluconeogenesis and glycogenolysis
*DC 48 hours prior to surgery

Question 2

Sulfonylureas

Answer 2

*-ides
*HYPOGLYCEMIA
*Stimulate insulin secretion
*DC 24-48 hours before surgery

Question 3

Meglitinides

Answer 3

*-nides
*HYPOGLYCEMIA
*Stimulate insulin secretion

Question 4

Thiazolidinediones

Answer 4

*-azones
*Decrease insulin resistance
*NO hypoglycemia

Question 5

Alpha-glucosidase inhibitors

Answer 5

*Acarbose, Miglitol
*NO hypoglycemia
*Slows digestion and absorption of carbs

Question 6

Glucagon-like Peptide-1 Receptor Agonist

Answer 6

*-tides
*HYPOGLYCEMIA
*Increase insulin release, decreae glucagon release, slow gastric emptying

Question 7

Dipeptidyl-Peptidase-4 Inhibitors

Answer 7

*-liptin (Januvia)
*HYPOGLYCEMIA
*Increase insulin release, decrease glucagon release

Question 8

Amylin Agonists

Answer 8

*Pramlintide
*HYPOGLYCEMIA w/insulin
*Inhibits glucagon release, decreased gastric emptying

Question 9

Morning of surgery insulin adjustments
-short acting
-intermediate acting
-long acting
-insulin pump

Answer 9

Before 10 am
SA: hold
IA: 1/2 dose
LA: normal dose

After 10 am
SA: hold
IA: 1/2 dose
LA: 3/4 dose

Question 10

Diabetic Anesthesia Considerations

Answer 10

*Atlanto-occipital joint
*Difficult airway
*Retinopathies
*Neuropathies
*Autonomic neuropathy
*Gastroparesis
*CKD