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Pharmacology Test #5 > Test #5 > Flashcards

Test #5 Flashcards

1
Q

For diagnosis in diabetes, what must the fasting plasma glucose be? random plasma glucose? oral glucose tolerance test?

A

greater than 126; greater than 200 with symptoms of diabetes; greater than 200 after 2h of glucose intake

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2
Q

How often should you monitor the A1 C

A

Every 3 to 6 months depending on previous value

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3
Q

In addition to high blood sugar what secondary disease should be corrected when treating diabetes

A

Hyperlipidemia

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4
Q

When are medications started in diabetic treatment

A

Upon diagnosis

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5
Q

What is included in step two of type II diabetes treatment

A

Add a second drug and consider a sulfonylurea for basal insulin if patient does not achieve goal with these drugs

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6
Q

What is included in step three of type II diabetes treatment

A

Progress to a three drug combination

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7
Q

What is included in step 4 of diabetes management

A

If a three drug combination therapy including insulin does not achieve treatment goals after 3 to 6 months, proceed to a combination injectable regimen including insulin and possibly a GLP 1 receptor agonist

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8
Q

What stuff do you start out if a patient has an A1 C of 9% or higher at the time of diagnosis

A

Step two, 2-drug therapy

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9
Q

What step do you start at if the patient has an A1 C of 10% or greater, has a fasting blood glucose of 300 or more, or is markedly symptomatic?

A

Start at step 4 - combination injectable therapy

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10
Q

What are the target values for a blood glucose before meals and at bedtime

A

before meals - 70-130

at bedtime - 100-140

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11
Q

The A1 C a should be measured every ___ months until the value drops below 7 percent in at least every ___ month thereafter

A

3,6

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12
Q

The presence of what in the blood indicates the pancreas is still producing some insulin of its own

A

The presence of C-peptide

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13
Q

Activation of beta2 adrenergic preceptors in the pancreas ___ secretion of insulin and activation of alpha-adrenergic preceptors in the pancreas ____ insulin release

A

promotes; inhibits

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14
Q

Insulin is responsible for what metabolic actions

A

Increased glucose uptake and storage, increased amino acid uptake and synthesis, and conversion of fatty acids into triglycerides

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15
Q

Stewart acting insulins must be used in conjunction with what in patients with type I diabetes

A

Intermediate or long acting insulin

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16
Q

What kind of insulin is insulin lispro and how long does it take for effects to begin and how long do they last

A

Rapid acting analog; 15 to 30 minutes; 3 to 6 hours

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17
Q

Which insulin is administered 30 to 60 minutes before a meal

A

Regular insulin

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18
Q

What is the onset time and the duration of insulin aspart

A

10 to 20 minutes and lasts 3 to 5 hours

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19
Q

How long does regular insulin last

A

Up to 10 hours

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20
Q

Which insulin is the only one suitable for mixing with short acting insulin

A

NPH

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21
Q

What is the onset and duration of lantus

A

70 minutes, 18 to 24 hours

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22
Q

In pregnancy, when are insulin needs increased and decreased

A

Increased after the first trimester and decreased during the first trimester

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23
Q

What is defined as hypoglycemia

A

Blood sugar less than 70

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24
Q

What does alcohol do to blood sugar

A

Lowers it

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25
Q

What is a fatal complication of metformin

A

Lactic acidosis

26
Q

does metformin stimulate the release of insulin from the pancreas?

A

no

27
Q

who shoudl you be cautious in prescribing metformin to? why?

A

renally impaired patients because it is excreted unchanged

28
Q

What is the mechanism of action metformin

A

inhibits glucose production in the liver, reduces glucose absorption in the gut, and sensitizes insulin receptors in target tissues resulting in increased glucose uptake

29
Q

Metformin decreases absorption of which two vitamins

A

Vitamin B 12 and folic acid

30
Q

What are the early signs of lactic acidosis

A

Hyper ventilation, myalgia, malaise, and unusual somnolence

31
Q

What are the two major side effects of sulfonylureas

A

Hypoglycemia and weight gain

32
Q

With regard to sulfonylureas, hypoglycemic reactions are more common in which patients?

A

Liver and renally impaired

33
Q

sulfonylureas are contraindicated in which patients

A

Pregnant and breast-feeding

34
Q

What is the difference between sulfonylureas and meglitinides

A

The glinides are shorter acting and are taken with each meal

35
Q

A patient who does not respond to a sulfonylurea will likely not respond to which other class

A

Glinides

36
Q

It is imperative that patients eat no later than 30 minutes after taking which drug

A

glinides

37
Q

How do TZDs work

A

Reduce glucose levels by decreasing insulin resistance

38
Q

how does pioglitazone work

A

Enhances responses to insulin

39
Q

What is the black box warning for Pioglitazone

A

Heart failure secondary to renal retention of fluid so discontinue or use in reduced dosage

40
Q

Which antidiabetic medication has been associated with heart attack

A

rosiglitazone

41
Q

Which antidiabetic medication can cause ovulation

A

pioglitazone

42
Q

Which antidiabetic medication may causing an increased risk for bladder cancer

A

pioglitazone

43
Q

Which antidiabetic medication can cause increased risk for fractures in women

A

pioglitazone

44
Q

Monitor which labs with pioglitazone admin?

A

liver function tests

45
Q

Which antidiabetic medication delays the absorption of carbohydrates

A

a-glucosidase inhibitors

46
Q

Which antidiabetic medication G.I. upset and a risk for anemia

A

Acarbose

47
Q

When the patient is taking acarbose and develops hypoglycemia, the patient must receive what and not what?

A

Glucose and not sucrose

48
Q

What labs should be monitored when acarbose is administered

A

lfts

49
Q

Which antidiabetic medication enhances the actions of incretin hormones by preventing incretin breakdown

A

gliptins

50
Q

which antidiabetic medication enhances the actions of incretin hormones by mimicking incretin actions

A

GLP-1 receptor agonists

51
Q

Inform the patients taking which medication for diabetes about fatal pancreatitis and hypersensitivity reactions

A

sitagliptin

52
Q

Which medication for diabetes is used only as adjunct therapy

A

sitagliptin

53
Q

Which medication for diabetes reduces resorption of filtered glucose and causes all glucose to be excreted in the urine

A

canagliflozin

54
Q

What are the most common side effects of canagliflozin?

A

Female genital fungal infections, urinary tract infections, and increased urination

55
Q

What can happen if you combine rifampin, phenytoin, or phenobarbital with canagliflozin?

A

Decreased efficacy of canagliflozin

56
Q

What will happen if you combine canagliflozin and a diuretic?

A

Risk for dehydration and hypotension

57
Q

Which antidiabetic medication slows gastric emptying, stimulates glucose-dependent release of insulin, inhibit postprandial release of glucagon, and suppresses appetite– all to mimic the incretin actions?

A

Exenatide

58
Q

hypoglycemia is common when exenatide is combined with what and not common when combined with what?

A

sulfonylurea; metformin

59
Q

In addition to sitagliptin, which other antidiabetic medication carries a risk for pancreatitis and hypersensitivity reactions/

A

exenatide

60
Q

exenatide can cause what? especially when what?

A

renal impairemnt; dehydration is present

61
Q

exenatide and pregnancy?

A

dont do it

Pharmacology Test #5 (1 decks)

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