pharm antidiabetic part 1

Question 1

HA1C levels of diabetic

Answer 1

6.5 %

Question 1

blood fasting glucose of a diabetic

Answer 1

> 7 mmol/l

Question 2

other signs of diabetes

Answer 2

polyuria, phagia and dipsia, weight loss, fatigue, blurred vision

Question 3

type 1 diabetes

Answer 3

lack of insulin or production of defective insulin

Question 4

what percent of cases are type 1 diabetes

Answer 4

fewer than 10%

Question 5

complications of diabetes

Answer 5

diabetic ketoacidosis and hyperosmolar hyperglycemic state

Question 6

type 2 diabetes is caused by

Answer 6

insulin deficiency and insulin resistance

Question 7

what happens in type 2 insulin resistance

Answer 7

reduced number of receptors or receptors become less responsive

Question 8

type 2 diabetes comorbid conditions

Answer 8

obesity, coronary heart disease, dyslipidemia (high cholest), hypertension, microalbuminemia (protein in urine), risk for stroke

Question 9

do ppl develop type 2 diabetes after giving birth

Answer 9

usually goes away after birth but 30% of ppl get it within next 10-15 years

Question 10

long term complications of diabetes (macrovascular)

Answer 10

coronary arteries (mycardial infraction), cerebral arteries (stroke), peripheral vessels (PVD)

Question 11

long term complications of diabetes (microvascular)

Answer 11

retinopathy, neuropathy, nephropathy

Question 12

prediabetic HA1C levels

Answer 12

6-6.4%

Question 13

prediabetic fasting plasma glucose levels

Answer 13

6.1>6.9

Question 14

how often should diabetic screening happen for 40yo

Answer 14

every 3 years

Question 15

does type 1 always require insulin therapy

Answer 15

yes

Question 16

lifestyle changes for type 2

Answer 16

weight loss, diet, stop smoking and drinking , exercise

Question 17

glycemic goal of treatment (ha1c, fasting and postprandial)

Answer 17

ha1c- less that 7%
fasting- 4-7 mmol/l
2 hour postprandial-5-10 mmol/l

Question 18

treatment for type 1diabetes

Answer 18

insulin therapy

Question 19

treatment for type 2 diabetes

Answer 19

lifestyle changes, oral drug therapy, insulin when there’s no more glycemic control

Question 20

insulin restores the diabetic pts ability to

Answer 20

-metabloize carbs, fats and proteins
- store glucose in liver
- convert glycogen to fat stores

Question 21

rapid acting insulin

Answer 21

insulin lispro

Question 22

short acting insulin

Answer 22

regular insulin

Question 23

intermediate acting insulin

Answer 23

insulin NPH

Question 24

long acting insulin

Answer 24

insulin detemir and glargine

Question 25

rapid onset of action of insulin

Answer 25

10-15 minutes

Question 26

insulin peak

Answer 26

1-2 hours

Question 27

insulin duration rapid

Answer 27

3-5 hours

Question 28

does the pt need to eat after an insulin injection

Answer 28

yes

Question 29

examples of rapid-acting insulin

Answer 29

insulin lispro and insulin aspart
both have rapid onset, short lasting, similar to endogenous insulin

Question 30

how is rapid-acting insulin given

Answer 30

subcutaneously or continuous subcutaneous infusion pump

Question 31

short acting insulin examples

Answer 31

humulin R and novolin ge Toronto

Question 32

short acting insulin routes of administration

Answer 32

IV bolus, IV infusion, intramuscular

Question 33

onset of short acting insulin

Answer 33

30 min

Question 34

peak of short acting insulin

Answer 34

2-3 hours

Question 35

duration of short acting insulin

Answer 35

6.5 hours

Question 36

Insulin NPH other name

Answer 36

insulin isophane suspension
milky
onset- 1-3 hrs
peak- 5-8 hrs
duration- up to 18

Question 37

insulin glargine stuff (OPD and referred to as)

Answer 37

clear
referred to as basal insulin
usually dosed once daily
onset- 90 mins
peak- none
duration- 24 hrs

Question 38

insulin detemir

Answer 38

duration- dose dependant

Question 39

fixed combinations of insulin

Answer 39

humulin 30/70
novolin 30/70, 40/60, 50/50

Question 40

what do the fixed combination insulins contain

Answer 40

• one intermediate acting
• either one rapid or one short

Question 41

insulin contraindications

Answer 41

drug allergy and pts with pork restriction

Question 42

insulin adverse effects

Answer 42

hypoglycemia, tachycardia, headache, treamors, blurred vision, dry mouth

Question 43

insulin interactions (reduced effects)

Answer 43

result in elevated bg
B blockers, corticosteroids, epinepherine, thyroid hormones

Question 44

insulin interactions (increased effects)

Answer 44

results in lowered bg
alc, anabolic steroids, ace inhibitors, sulfa drugs, MAOIs, salicylates

Question 45

sliding scale insulin dosing

Answer 45

rapid acting or short acting insulin given according to blood glucose results.

Question 46

sliding scale is mainly used for

Answer 46

hospitalized patients, pt on tube/enteral feeding

Question 47

sliding scale disadvantages

Answer 47

insulin only administered when hyperglycemia occurs resulting in large swings of glucose control

Question 48

basal bolus insulin dosing

Answer 48

preferred for hospitalized diabetics, mimics pancreas by delivering basal insulin constantly and then as needed as a bolus

Question 49

basal insulin is _____ acting

Answer 49

long acting
insulin glargine

Question 50

bolus insulin ex

Answer 50

insulin lispro or insulin aspart

Question 51

injectable antidiabetic drug adverse effects

Answer 51

amylin agonist- nausea, anorexia
incretin mimetics- hemorrhagic pancreatitis, weight loss