Pharm 30 Endocrine Pancreas/Glucose Homeostasis Treatment Questions

Question 1

What oral agent used to control type II diabetes has the following characteristic?
Lactic acidosis (rare but worrisome)

Answer 1

Biguanide: metformin

Question 2

What oral agent used to control type II diabetes has the following characteristic?
Most common side effect is hypoglycemia

Answer 2

Sulfonylureas
First generation: generally not used
Second generation Sulfonylurea: Glyburide, glimepiride and glipizide

Question 3

What oral agent used to control type II diabetes has the following characteristic?
Often used in combination with any of the other oral agents

Answer 3

Metformin

but many of these agents can be combined

Question 4

What oral agent used to control type II diabetes has the following characteristic?
Also help lower triglycerides and LDL cholesterol levels

Answer 4

Biguanides: Metformin

Question 5

What oral agent used to control type II diabetes has the following characteristic?
Not safe in settings of hepatic dysfunction or CHF

Answer 5

• Biguanides: metformin

- Glitazones/thiazolidinediones

Question 6

What oral agent used to control type II diabetes has the following characteristic?
Should not be used in patients with elevated serum creatinine

Answer 6

Biguanides: metformin (due to risk of lactic acidosis)

Question 7

What oral agent used to control type II diabetes has the following characteristic?
Should not be used in patients with liver cirrhosis, elevated serum creatinine or inflammatory bowel disease.

Answer 7

alpha- glucosidase inhibitors: acrabose and miglitol

Question 8

What oral agent used to control type II diabetes has the following characteristic?
Hepatic serum transaminase levels should be carefully monitored when using these agents.

Answer 8

• Biguanides: metformin

- Glitazones/thiazolidinediones

Question 9

What oral agent used to control type II diabetes has the following characteristic?
Not associated with weight gain, often used in overweight diabetics

Answer 9

Biguanide: metformin

Question 10

What oral agent used to control type II diabetes has the following characteristic?
Metabolized by liver; excellent choice in patients with renal disease

Answer 10

Gliazones/thiazolidinediones

Question 11

What oral agent used to control type II diabetes has the following characteristic?
Primarily effects postprandial hyperglycemia

Answer 11

alpha-glucosidase inhibitors: acarbose and miglitol

Question 12

What oral agent used to control type II diabetes has the following characteristic?
MOA: closes K channel on Beta cells causes depolarization and Ca influc and insulin release

Answer 12

Sulfonylureas: First gen and second gen (glyburide, glimepiride and glipizide)

Question 13

What oral agent used to control type II diabetes has the following characteristic?
MOA: inhibits alpha-glucosidase at intestinal brush border

Answer 13

alpha-glucosidase inhibitors: acarbose and miglitol

Question 14

What oral agent used to control type II diabetes has the following characteristic?
MOA: agonist at PPAR-gamma receptors and improves target cell response to insulin

Answer 14

Gliazone/thiazolidinediones: pioglitazone and rosglitazone

Question 15

A 40 yo male comes to the ER for Rx of DKA. His type I diabetes is normally well controlled and doesn’t know why he has DKA. What is the DDx for his development of his DKA?

Answer 15

• Infection
• Dehydration
• Med omission or reduction
• Severe medical illness (MI, trauma)
• glucocorticoids
• alcohol or drug abuse