Antidiabetics

Question 1

A protein secreted from the beta cells of the pancreas and is necessary for carbohydrate metabolism and plays an important role in protein and fat metabolism

Answer 1

Insulin

Question 2

Synthetic preparations that stimulate insulin release or otherwise alter the metabolic response to hyperglycemia

Answer 2

Oral hypoglycemic drugs (oral antidiabetic drugs)

Question 3

A chronic disease that results from deficient glucose metabolism

Answer 3

Diabetes mellitus

Question 4

Increased urine output

Answer 4

Polyuria

Question 5

Increased thirst

Answer 5

Polydipsia

Question 6

Increased hunger

Answer 6

Polyphagia

Question 7

Diabetes that results from genetic factors and requires insulin administration

Answer 7

Type I Diabetes

Question 8

Diabetes that results from genetic factors and obesity and does not always require insulin administration

Answer 8

Type 2 Diabetes

Question 9

Tissue atrophy or hypertrophy

Answer 9

Lipodystrophy

Question 10

Results from administering too much insulin

Answer 10

Hypoglycemic reaction (insulin shock)

Question 11

Results when there is an inadequate amount of insulin in the body. Sugar cannot be metabolized, resulting in fat catabolism.

Answer 11

Ketoacidosis (DKA)

Question 12

What does Hemoglobin A1C tell us?

Answer 12

What a person’s blood sugar has been running over the last 3 months.

Question 13

Explain the ranges for HgA1C.

Answer 13

<5% = no diabetes
5.7 - 6.45 = prediabetes
>6.5% = diabetes
Desired level for diabetics = <7%

Question 14

Where does insulin have the greatest absorption?

Answer 14

Abdomen

Question 15

Why do insulin injection sites need to be rotated?

Answer 15

Repeated injections in the same spot can cause lipoatrophy and lypohypertrophy. Both can interfere with insulin absorption.

Question 16

When should rapid acting insulin be given?

Answer 16

Within 5-15 minutes of a meal.

Question 17

What is the only type of insulin that can be given IV?

Answer 17

Short-acting regular insulin, Humulin R, and Novolin R

Question 18

What type of insulin is isophane NPH, Novolin N, and Humulin N?

Answer 18

Intermediate-acting

Question 19

What type of insulin is glargine (Lantus)?

Answer 19

Long-acting

Question 20

What is the peak of glargine?

Answer 20

It doesn’t have one.

Question 21

True or False: All insulin pens must be refrigerated right after opening.

Answer 21

False
fridge for 3 month and room temp 1 months

Question 22

Why do we use combination insulins?

Answer 22

They have short and intermediate effects. Avoids the necessity for 2 separate shots.

Question 23

What drugs can cause an increase in blood glucose?

Answer 23

Thiazides, glucocorticoids, estrogen, and thyroid drugs.

Question 24

What drugs can cause a decrease in blood glucose?

Answer 24

TCAs, MAOIs, aspirin, oral anticoagulants

Question 25

What types of insulin do we use for sliding scales?

Answer 25

Rapid or short acting

Question 26

Why do we use insulin pumps?

Answer 26

They allow for tighter glucose control and less hypoglycemic reactions.

Question 27

What are symptoms of hypoglycemia?

Answer 27

Nervousness, tremors, lack of coordination, cold/clammy skin, headache, confusion

Question 28

Explain the Somogyi effect.

Answer 28

Occurs in the predawn hours (2-4am). The patient ahs a rapid decrease in blood glucose. This stimulates hormonal release to increase blood glucose. Management consists of monitoring the blood glucose between 2 and 4 and decreasing HS insulin.

Question 29

Explain the Dawn phenomenon.

Answer 29

The patient has hyperglycemia upon awaking. Symptoms include headache, night sweats, and nightmares. Treatment includes increasing the HS insulin dose.

Question 30

When combining insulins in one syringe, in which order should they be drawn up?

Answer 30

Clear to cloudy | Regular to intermediate

Question 31

True or False: Long-acting insulins can be combined with other insulins in the same syringe.

Answer 31

False

Question 32

True or False: It is important for diabetics to eat a snack before exercise.

Answer 32

True

Question 33

Tolbutamide, Tolazamide and Chlorpropamide are examples of which type of med?

Answer 33

1st generation sulfonylureas

Question 34

Glipizide, glyburide, and glimepiride are examples of which type of med?

Answer 34

2nd generation sulfonylureas

Question 35

Sulfonylureas work by:

Answer 35

Stimulating the pancreatic beta cells to secrete more insulin. 2nd generations also decrease glucose production by the liver.

Question 36

True or False: 2nd generation sulfonylureas have a longer duration and fewer side effects than 1st generation.

Answer 36

True

Question 37

Metformin is what type of antidiabetic drug?

Answer 37

Non-sulfonylurea/Biguanide

Question 38

How does metformin work?

Answer 38

It decreases the hepatic production of glucose from stored glycogen.

Question 39

What are the most common side effects of Metformin?

Answer 39

Nausea, diarrhea, bitter/metallic taste

Question 40

Acarbose and Miglitol are what type of med?

Answer 40

Alpha-glucosidase inhibitor

Question 41

How do alpha-glucosidase inhibitors work?

Answer 41

They inhibit alpha-glucosidase (a digestive enzyme) in the small intestine that is responsible for the release of glucose from complex carbs in the diet.

Question 42

Pioglitazone and rosiglitazone are what type of med?

Answer 42

Thiazolidinediones

Question 43

Repaglinide and netaglinide are what type of med?

Answer 43

meglitinides

Question 44

True or False: Meglitinides work in a manner similar to sulfonylureas.

Answer 44

True

Question 45

Sitagliptin and saxagliptin are what type of med?

Answer 45

Incretin modifiers

Question 46

According to the book, what are the criteria for use of antidiabetic drugs?

Answer 46

Onset of diabetes mellitus at age 40 or older. Diagnosis of diabetes for less than 5 year. Normal weight or overweight for age. Fasting blood glucose 200 mg/dL or less. Less than 40 units of insulin required per day. Normal renal and hepatic function.

Question 47

How does glucagon work?

Answer 47

It increases blood glucose by stimulating glycogenolysis.

Question 48

When do we use glucagon?

Answer 48

When a patient has hypoglycemia and they are unable to eat or drink.

Question 49

How does diazoxide work?

Answer 49

It increases blood sugar by inhibiting insulin release from the beta cells. They also stimulate release of epinephrine from adrenal medulla, which stimulates glycogenolysis.