Exam 2- 2024 Flashcards
Kid is taking several drugs. Routine drug monitoring reveals a drop in platelet levels from 320k to 160k. What med is most likely to contribute to dose related thrombocytopenia?
Valproic acid (Depakote)
Which of the following anti-epileptic medications is considered a controlled substance?
Phenobarbital (Luminal)
Antiepileptic medication known to cause significant amount of congnitive impairment and risk of nephrolithiasis if patient is not adequately hydrated?
topiramate (topamax)
Pt treated for focal seizures with dyscognitive features & 2nd generalization with carbamezapine. Pt is stable after 2 weeks with no seizures but seizures increase in frequency after 4 weeks of carbamezapine use. Drug level is at 5.6mg/L. What is explanation?
Autoinduction by carrbamezapine
Which of the following is a RAPID acting insulin?
Insulin Lispro
Rapid acting insulins?
- Lispro
- Aspart
- Glulisine
(LAG)
42 yo female has T2DM and takes the following meds
- canagliflozin
- metformin
- insuline glargine
- dulaglutide
- atorvastatin
- lisinopril
- hydrochlorothiazide
- metoprolol xl
She has history of heart failure. Which of these drugs is preferred in patients with HF?
Canagliflozin
10 year old female with type 1DM. What diabetes treatments would you expect her to use?
Basal-Bolus Insulin
Basal insulin injection total per day?
4
Which of the following oral anti-diabetic agents is most likely to cause hypoglycemia?
Glyburide
Laboratory diagnostic tests for DM:
- HgbA1c
- Oral glucose tolerance test
- Fasting plasma glucose
What is the primary mechanisms of action of canaglafozin?
Blocks the sodium glucose cotransporter-2 in the proximal tubule to inhibit glucose reabsoprtion
Which of the following insulin types are listed from the shortest acting to the longest acting?
- Humulin R
- NPH
- Insulin degludec
Short acting insulin:
Humulin R & Novolin R
Intermediate acting insulin also known as:
NPH
List two intermediate acting insulins:
Humulin N & Novoloin N
Long acting insulins:
Glargine,
Detemir
Toujeou
Which of the following is a macrovascular complication of DM?
Atherosclerotic coronary artery disease
Macrovascular DM:
- Brain
- Heart
- Extremities (PVD)
Microvascular DM:
- Eyes
- Kidneys
- Nerves
- Gums
Which of the following statements is true related to the increased prevalence of xerostomia in patients with DM?
- Decreased production of saliva is caused by complications of DM
- Medications used to treat DM cause dry mouth as side effect
What is the main difference between T1 and T2 DM?
Type 1 DM is caused by autoimmune destruction of pancreatic beta cells resulting in insulin deficiency
Type 2 DM is caused by insulin resistance
Hypoglycemia should be treated when glucose is:
Less than 70mg per deciliter
Patient undergoing surgery. Has well controlled DM, and is instructed to not eat past midnight. Which DM medication should he not take the morning of his surgery.
Insulin Lispro (Rapid-acting)
Calcium and vitamin D supplement is recommended for patients taking which antiepilcecptic meds?
Valproic acid (Depakote)
The following statements for basal-bolus insulin regimens are true except:
Basal-bolis regimens involve use of only one type of insulin
What is the primary mechanisms of action for exenatide?
stimulates GLP-1 receptors to increase insulin secretion, decrease glucagon secretion, and slow gastric emptying
65yomale with history of type 2DM who presents to dental office for cleaning. Has hypoglycemic symptoms. What should you have him do with a blood glucose of 64?
drink 4 oz of juice
Dulaglutide is recommended for patients with DM who also have additional goals for:
- reducing risk of CKD
- reducing risk of atherosclerotic cardiovascular diseases and associated risk factors
- weight loss
Which adverse affect is commonly associated with metformin?
Nausea & loose stools
Which medication stimulates beta cells in the pancreas causing increased insulin secretion?
Glipizide
What medications masks the usual signs and symptoms of hypoglycemia?
Metoprolol XL
Patient taking Oxcarbazepine are at risk for inducing subsequent seizures due to a condition called:
SIADH
Which of the following sets of lab orders would be most appropriate when conducting therapeutic drug monitoring for valproic acid?
Liver function test & platelet test
What is Levetiracetam (Keppra) used for?
Mood changes
Patient taking Amitriptyline with Percocet (Oxycodone) can exhibit which of the following?
Oversedation
Patient with SULFA allergy, which anti-epileptic drug should be avoided:
Zonisamide (Zonegran)
What type of seizure occur when a patient zones out for 10 seconds and regains consciousness immediately after?
Absence
Patient presents to ER with the following symptoms: diaphoresis, hyperflexia, low grade fever and tremors. Patient reports he took a Tranylcypromine (Parnate) + tramadol (Ultram). What is likely adverse drug reaction?
Serotonin syndrome
Tripeptide mechanism of action:
GLP-1 agonist and GIP
MOA of exenetide:
Stimulates GLP-1 receptors in the pancreas to increases insulin secretion, decrease glucagon secretion and slow gastric emptying
Additional benefit with diabetes drugs?
weightloss
Can cause hypoglycemia as a mono treatment for DM type 2:
Glipizide
Vasoconstriction for local anesthesia. What concern does it have for people with diabetes?
HYPERglycemia stimulates hepatic glucose production in the liver
What lab test should be done for a patient on Keppra?
Renal function test
(Keppra = KIDNEYS)
What is the risk associated with consumption of foods containing high levels of tyarimine with phenelzine (Nardil)
Hypertensive crisis
