S3_L1: Drugs for Diabetes Mellitus Flashcards
The following are nonpharmacological management for DM, EXCEPT:
A. Weight loss
B. Diet
C. Exercise
D. All of the above
E. None of the above
E. None of the above
What is the normal range for fasting blood sugar?
70-99 mg/dL
This must always be below 100 mg/dL
Identify: A glycated hemoglobin test for the average sugar within the past 3 months
HbA1c
TRUE OR FALSE: Insulin is released from alpha cells of the pancreas. Glucagon is released from beta cells of the islets of Langerhans of the pancreas.
A. Both statements are false
B. Both statements are true
C. Only the 1st statement is true
D. Only the 2nd statement is true
A. Both statements are false
The cells are interchanged.
Insulin - beta
Glucagon - alpha
TRUE OR FALSE: A low glucose in the blood leads to low blood sugar
True
TRUE OR FALSE: Sugar binds to hemoglobin. In doing so, it becomes a glycated hemoglobin
A. Both statements are false
B. Both statements are true
C. Only the 1st statement is true
D. Only the 2nd statement is true
B. Both statements are true
TRUE OR FALSE: Alcohol has an additive effect on blood sugar wherein it leads to hyperglycemia
False
additive effect leads to hypoglycemia
TRUE OR FALSE: DM leads to increase in risk for cataracts
True
TRUE OR FALSE: How many mg/deciliter is considered as diabetic in checking for FBS?
126mg/deciliter or higher
The following statements are true, EXCEPT:
A. DM leads to increase in risk for heart disease
B. DM leads to increase in risk for diabetic nephropathy
C. DM leads to increase in risk for retinopathy
D. DM leads to increase in risk for Htn
E. all of the above
F. none of the above
F. none of the above
TRUE OR FALSE: Too much sugar in the brain causes abnormalities. Too little sugar in the brain causes abnormalities
A. Both statements are false
B. Both statements are true
C. Only the 1st statement is true
D. Only the 2nd statement is true
B. Both statements are true
What is the action/s taken when a pt presents with insulin allergy?
options:
1. change to another brand/mode
3. treat allergy first
4. treat allergy and DM side by side
This happens due to chronic use of injecting insulin and the body does not respond anymore.
Insulin resistance
What is the action taken when a pt presents with insulin resistance?
change to another brand/mode
What is the effect of DM in the nerves?
it results in tingling and numbness (glove & stocking)
What is the effect of DM with gait?
Impaired balance d/t sensory problems (loss of proprioception), which may lead to falls and foot
problems
onset: 90-150 mins
A. rapid acting insulin
B. intermediate acting insulin
C. long acting insulin
B. intermediate acting insulin
115 mg/dL blood sugar level
A. normal
B. prediabetic
C. diabetic
B. prediabetic
range: 100-125 mg/dL
- Short hx, very acute onset
- First detected in pregnancy
- Has a rare occurence
A. Type 1 diabetes
B. Type 2 diabetes
C. Gestational diabetes
D. both a & b
E. both b & c
- A
- C
- A
- Genetic predisposition is often random
- Often overweight
- Seen through routine testing
A. Type 1 diabetes
B. Type 2 diabetes
C. Gestational diabetes
D. both a & b
E. both b & c
- A
- E
- C
TRUE OR FALSE: Gestational Dm has a family hx of T2DM
True
- Usually present in the young
- Insulin deficiency
- Insulin resistance
A. Type 1 diabetes
B. Type 2 diabetes
C. Gestational diabetes
D. both a & b
E. both b & c
- A
- A
- E
Note: gestational diabetes is secondary to placental hormones
- Insulin dependent
- Insulin requiring
- Usually seen in older generations
A. Type 1 diabetes
B. Type 2 diabetes
C. Gestational diabetes
D. both a & b
E. both b & c
- A
- B
- B
- Insidious/chronic/ lingering/long onset
- Mx includes oral hypoglycemic
- Mx includes diet and lifestyle change
A. Type 1 diabetes
B. Type 2 diabetes
C. Gestational diabetes
D. both a & b
E. both b & c
- B
- B
- E
TRUE OR FALSE: Pts with type 1 DM are usually overweight
False
This describes a rebound high blood glucose level in response to low blood glucose
Somogyi phenomenon
NOTE: This is also known as post-hypoglycemic hyperglycemia or chronic Somogyi rebound
TRUE OR FALSE: Nowadays, gestational DM is becoming more common
True
This is known as decreased blood sugar levels whose effects may be seen on the brain and on
the nervous system
hypoglycemia
This is known as damage to the lipid subcutaneous tissue at the injection site
Lipodystrophy
Note: legs & buttocks are usually affected since they are common sites for injections
What are the 3 possible mechanism of actions of oral hypoglycemic agents
- potentiate insulin release
- decrease insulin resistance
- decrease glucose absorption
Effect of thiazides
A. hypoglycemia
B. hyperglycemia
B. hyperglycemia
Effect of beta-blockers
A. hypoglycemia
B. hyperglycemia
B. hyperglycemia
Insulin also stores glucose in the form of (1)_____ in the (2)_____.
- glycogen
- liver
Enumerate the triad of symptoms for diabetes.
- polyuria
- polydipsia
- polyphagia
- excessive urination
- excessive hunger
- excessive thirst
A. polyuria
B. polydipsia
C. polyphagia
- A
- C
- B
- occurs due to the compensations of the kidney
- comes secondarily to excessive urination
A. polyuria
B. polydipsia
C. polyphagia
- A
- B & C
When testing for FBS or HbA1c, how many hours does an individual have to fast or have NPO?
6 hours
TRUE OR FALSE: Repeated samples of FBS is needed to confirm diabetes
True
The following are mode of administration for insulin, EXCEPT:
A. oral
B. subcutaneous
C. intramusular
D. intravenous
E. none
A. oral
NOTE: insulin is only avaible through injections. It is not available per oral since it is a protein. When you take it by mouth, it will only be digested.
The effects of hypoglycemia are seen in which parts or structures of the body?
brain and nervous system
Low blood sugar promotes release of what?
glucagon
Glucagon is converted into what to raise blood sugar levels?
Glucose
TRUE OR FALSE: Eating carbohydrates elevates the blood sugar level
True
Effect of salicylates
A. hypoglycemia
B. hyperglycemia
A. hypoglycemia
The following is true of the complications of diabetes, EXCEPT:
A. diabetes is a risk factor for stroke
B. diabetes is a risk factor MI
C. diabetes causes chest pain d/t coronary artery affectation
D. diabetes is a causes peripheral neuropathy
C. diabetes causes chest pain d/t coronary artery affectation
In DM pts, they do not manifest chest pain & straight to heart attack d/t peripheral neuropathy
Oral hypoglycemic agents is used for what type of DM?
Type 2
TRUE OR FALSE: Type I diabetes runs in the family
False
This is a characteristic of type II. DM
What’s the word for the sugar that can be found in your blood after eating something?
Glucose
Why does the body need glucose?
to have a source of energy
What’s the name of the hormone that works as a key to let glucose into muscle cells?
Insulin
What is the effect of exercise on blood glucose level?
decreases blood glucose level
What’s a clear symptom of low blood glucose?
Shakiness
The client with insulin-dependent diabetes mellitus (IDDM) has been brought to the emergency room. What should the nurse watch for if blood pH is 7.28?
A. Lactic acidosis
B. Ketoacidosis
C. Metabolic alkalosis
D. Respiratory Acidosis
B. Keto acidosis
Ketoacidosis is characterized by low blood pH. Type 1 diabetic clients are prone to ketoacidosis.
Which of the following laboratory test best indicate compliance of the diabetic client and insulin therapy?
A. 2-hour postprandial blood glucose
B. Fasting blood glucose
C. Glycosylated hemoglobin (HbA1c)
D. Oral glucose tolerance test
C - Glycosylated hemoglobin (HbA1c) is the best indicator of diabetic control. If reflects blood glucose level for the past 3 months
The client has been diagnosed to have IDDM. The following is indicated for the patient, EXCEPT:
A. Propranolol
B. Insulin injection
C. Acetaminophen
D. Diltiazem
A - Propranolol, a beta-adrenergic blocker causes hyperglycemia. It is contraindicated among diabetes clients.
duration: 24 hours
A. rapid acting insulin
B. intermediate acting insulin
C. long acting insulin
B. intermediate acting insulin
duration: 36 hours
A. rapid acting insulin
B. intermediate acting insulin
C. long acting insulin
C. long acting insulin
onset: 30-90 mins
A. rapid acting insulin
B. intermediate acting insulin
C. long acting insulin
A. rapid acting insulin
duration: 6-16 hours
A. rapid acting insulin
B. intermediate acting insulin
C. long acting insulin
A. rapid acting insulin
The following are adverse effects possibly seen in intake of oral hypoglycemic agents, EXCEPT:
A. nausea
B. vomiting
C. pruritis
D. hemolytic anemia
E. bone marrow aplasia
F. all of the above
G. none of the above
G. none of the above
The following are symptoms seen in diabetic peripheral neuropathy, EXCEPT:
A. Painful cramps
B. Shooting pain
C. Burning pain
D. Tingling pain
E. None
E. None
Choose the following that are symptoms seen in diabetic peripheral neuropathy.
A. Numbness
B. Weakness
C. Sensory Loss
D. Foot Deformities
E. Impaired Balance
A, C, D, E
Choose the following that are symptoms seen in diabetic peripheral neuropathy.
A. Fatigue
B. Hot sensitivity
C. Cold sensitivity
D. Dizziness
E. Confusion
B & C
The following are adverse effects possibly seen in intake of oral hypoglycemic agents
A. rashes
B. low blood sugar
C. high blood sugar
D. fatigue
E. drowsiness
A & B only
metformin mechanism of action
A. potentiate insulin release
B. decrease insulin resistance
C. decrease glucose absorption
B. decrease insulin resistance
- 5.5% HbA1c result
- 6.3 HbA1c result
A. normal
B. prediabetic
C. diabetic
- A
- B
○ Normal: Less than 5.7%
○ Pre-diabetes: 5.7% to 6.4%
- 6.5% HbA1c result
- 7.2% HbA1c result
A. normal
B. prediabetic
C. diabetic
both C. diabetic
○ Diabetes: 6.5% or higher
TRUE OR FALSE: prediabetic patients needs to be monitored of their blood sugar level
True
- Pancreas are not producing insulin
- Insulin resistance
- Occur due to hormones reaching the placenta
A. Type 1 diabetes
B. Type 2 diabetes
C. Gestational diabetes
- A
- B
- C
- Body is not using the insulin
- Affects size and length growth
- Leads to hormonal imbalance
A. Type 1 diabetes
B. Type 2 diabetes
C. Gestational diabetes
- B
- C
- C
Happens d/t autoimmune disease or by genetics
A. Type 1 diabetes
B. Type 2 diabetes
C. Gestational diabetes
D. None
A. Type 1 diabetes
This is a microvascular effect of DM that leads to AKA or BKA
diabetic foot > poor wound healing
TRUE OR FALSE: Prothesis and strengthening exercises may be used for pts c diabetic foot
True
- tremors
- convulsions
- abnormal behavior
- confusion
A. immediate/ acute effect of moderately low hypoglycemia
B. effect of severely low hypoglycemia
- A
2-4. B
- sweating
- nervousness
- palpitations
- loss of consciousness
A. immediate/ acute effect of moderately low hypoglycemia
B. effect of severely low hypoglycemia
All A except #4
TRUE OR FALSE: Insulin may be taken orally and as an injectable
False
Insulin is ONLY available through injections
TRUE OR FALSE: The brain is highly dependent on sugar
True
TRUE OR FALSE: The brain is capable of producing sugar
False
TRUE OR FALSE: The brain has a high rate of metabolism for glucose
True