Week 1 - Diabetes Pharm

Question 1

What are Biguanide (Metformin) and TZDs (Rosiglitazone)?

Answer 1

insulin sensitizers

Question 2

What do insulin sensitizers do?

Answer 2

help cells take in insulin at the receptor level in muscle, fat cells and liver

Question 3

Do insulin sensitizers lower or raise BS?

Answer 3

lower - bring it into the cell, decrease glycogenolysis, decrease glucose release from the liver

Question 4

what is an adverse effect of metformin?

Answer 4

lactic acidosis b/c it acts on the liverw

Question 5

what are 4 adverse effects of TZD?

Answer 5

1. upper resp. tract infections
2. headache
3. sinitus
4. HF b/c of fluid retention so BP goes up and increases afterload and thus workload of the heart

Question 6

What three drug classes do not cause hypoglycemia?

Answer 6

1. insulin sensitizers
2. Incretin agents
3. Glucose wasters

Question 7

what two medications do cause hypoglycemia?

Answer 7

Insulin secretagogues
Sulfonylureas (glyburide)
meglitinides (repaglinide)

Question 8

what are the 2 adverse effects of DPP4 inhibitors (Sitagliptin)

Answer 8

1. pancreatitis
2. hypoglycemia when with sulfonylureas (glyburide)

Question 9

What are the 4 adverse effects of GLP 1 receptor agonists

Answer 9

1. GI issues
2. anaphalayxis
3. pancreatitis
4. thyroid cancers (maybe)

Question 10

what drugs are glucose dependant?

Answer 10

Incretin agents

Question 11

What are the adverse effects of insulin secretagogues?

Answer 11

hypoglycemia b/c kicks pancreas into high gear regardless of food

Question 12

Is glyburide basal or bolus?

Answer 12

basal - think glidinggggg (slow)

Question 13

is repaglinide basal or bolus?

Answer 13

bolus - think rapidddd fast

Question 14

when should someone take repaglinide?

Answer 14

within 30 min of a meal

Question 15

what meds must be given with food?

Answer 15

insulin secretagogues
glyburide & repaglinide

Question 16

What does SGLT 2 inhibitor (canagliflozin) do?

Answer 16

less glucose reabsorption in the kidneys so more come out in urine

Question 17

what does alpha-glucosidase inhibitors (acarbose) ?

Answer 17

delays glucose absorption in GI and no glucose is absorbed in the stomach so more gets pooped out

Question 18

who should not have alpha-glucosidase inhibitors (acarbose)

Answer 18

type 1 diabetic b/c no glucose is absorbed in the stomach

Question 19

What are 5 adverse effects of alpha-glucosidase inhibitors (acarbose)

Answer 19

1. Gi issues
2. distention
3. hyperactive bowel sounds
4. anemia (malabsorption)
5. liver dysfunction

Question 20

what are adverse effects of SGLT2 inhibitors?

Answer 20

1. UTI
2. Yeast infection
3. postural hypotension (b/c of fluid loss due to glucose in urine)
4. hyponatremia

Question 21

Short & rapid acting insulin

Answer 21

1. lispro (humalog)
2. aspart (novalog)

Question 22

Which insulins are used for sliding scale the most?

Answer 22

lispro
aspart

Question 23

short acting insulin

Answer 23

Regular insulin (humalin R, Novolin R, toronto)

Question 24

long acting insulins

Answer 24

1. glargine (lantus)
2. detemir (levemir)

Question 25

ultra long acting insulin

Answer 25

degludec (tresiba)

Question 26

intermediate insulin

Answer 26

NPH (humulin N and Novolin N)

Question 27

what can intermediate insulin be mixed with?

Answer 27

short or rapid insulins

Question 28

which insulin is cloudy?

Answer 28

intermediate NPH

Question 29

when do we administer lispro (humalog)?

Answer 29

15 min before/after meals

Question 30

when do we administer aspart (novalog ) ?

Answer 30

5-10 min before meals

Question 31

when do we administer regular insulin?

Answer 31

30 min before a meal