pharm anti-diabetic drugs pt 2

Question 1

oral antihyperglycemics are usually for type __ diabetes

Answer 1

2

Question 2

target of oral hyperglycemics

Answer 2

lower hemoglobin A1c to less than 7%

Question 3

if A1C exceeds 9%

Answer 3

combination therapy, two drugs from 2 different classes.

Question 3

other treatments for type 2

Answer 3

• lifestyle changes
• monitoring of blood glucose
• drug therapy
• treatments of associated conditions: hypertension and high cholesterol

Question 3

new onset type 2 treatment drug name

Answer 3

biguanide metformin

Question 4

if modifications dont work with metformin after 3-6 months..

Answer 4

additional treatment with DPP-4 inhibitors and GLP-1 receptor agonists, or insulin

Question 5

biguanide metformin mechanism of action (pancreas)

Answer 5

doesnt increase insulin secreion form pancreas, doesn’t casue hypoglycemia

Question 6

metformin decreases____

Answer 6

hepatic glucose production and intestinal absorption of glucose

Question 7

metformin improves uptake of glucose in the ____

Answer 7

skeletal muscle, adipose and liver for energy

Question 8

metformin can be used with ____ & ____ if mono therapy is unsuccessful

Answer 8

sulfonylureas and thiazolidinediones

Question 9

adverse effects of metformin

Answer 9

-abdominal bloating, nausea, etc
-metallic taste, hypoglycemia, reduced vit B12

Question 10

extremely rare complication of metformin use

Answer 10

lactic acidosis

Question 11

if undergoing a radiological test with iodine test….

Answer 11

discontinue metformin the day of the test and 48 hours after. can lead to acute kidney injury and lactic acidosis

Question 12

metformin is contraindicated in pts with

Answer 12

kidney disease or kidney dysfunction

Question 13

sulfonylureas MOA

Answer 13

stimulate insulin secretion from B cells and enhances action of insulin in muscle, liver and adipose tissue

Question 14

sulfonylureas enhace action of insulin in

Answer 14

liver, adipose and pancreas

Question 15

usually use the first generation of sulfonylureas T or F

Answer 15

false, second generation

Question 16

gliclazide adverse effects

Answer 16

hypoglycemia, weight gain, skin rash , nausea, epigastric fullness

Question 17

gliclazide MOA

Answer 17

sulfonylurea
rapid onset of action, acts as pasncreas would after a meal to increase insulin rapidly

Question 18

contraindications of gliclazide

Answer 18

• liver and kidney disease
• active hypoglycemia
  -not used in pregnancy
  -cross allergic reaction if used with sulfa drugs

Question 19

gliclazide interactions increased effects

Answer 19

increased hypoglycemia ( w/ use of alc, anabolic steroids, MAOIs, ginger, ginseng)

Question 20

gliclazide interactions: decreased effects

Answer 20

adrenergics, coticosteroids, thiazides, thyroid drugs

Question 21

other antidiabetics

Answer 21

thiazolidinediones, glinides, dipeptyl petidase 4 inhibitors (DPP-4)

Question 22

thiazolidinediones (glitazones) MOA

Answer 22

insulin sensitizing drugs, enhance receptor sensitivity, slow onset: up to months.

Question 23

thiazolidineiones example

Answer 23

pioglitazone. Actos (TN)

Question 24

glinides MOA

Answer 24

similar to sulfolyureas, increase pancreas secretion of insulin, shorter duration of action

Question 25

glinides example

Answer 25

repaglinide. GLucoNorm (TN)

Question 26

dipeptyl petidase 4 inhibitor MOA

Answer 26

slow incretin hormone breakdown, increase insulin secretion, lower glucagon secretion.

Question 27

dipeptyl petidase 4 inhibitor example

Answer 27

sitagliptin. Januvia (TN)

Question 28

sodium glucose cotransporter inhibitor MOA

Answer 28

decrease blood glucose and increased renal excretion

Question 29

hypoglycemia level

Answer 29

below 4mmol/l

Question 30

mild cases of hypoglycemia can be treated with..

Answer 30

more protein, less carbs to prevent postprandial hypoglycemia

Question 31

hypoglycemia adrenergic symptoms

Answer 31

anxiety, tremors, hunger, palpation, sweating

Question 32

hypoglycemia CNS symptoms

Answer 32

difficulty concentrating, confusion, weak, drowsy, vision changes, headache

Question 33

hypoglycemia later signs

Answer 33

hypothermia, seizures, coma and death

Question 34

concentrated glucose

Answer 34

used for hypoglycemia, buccal, rapid dissolving

Question 35

D50W

Answer 35

50% dextrose in water. IV for hypoglycemia

Question 36

glucagon: diazoxide

Answer 36

for long term illnesses like pancreatic cancer.

Question 37

what does HA1C measure

Answer 37

avg blood glucose over 2-3 months

Question 38

what does CBG measure

Answer 38

current blood glucose

Question 39

foot care is important in diabetics becuase..

Answer 39

pvd and damaged nerves can cause unresolved and unnoticed injuries

Question 40

order of drawing up insulin

Answer 40

clear (glargine) before cloudy

Question 41

oral anti diabetics are given ___ mins before a meal

Answer 41

30 mins