Antidiabetics Flashcards

1
Q

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

A

Insulin

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2
Q

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

A

Oral hypoglycemic drugs (oral antidiabetic drugs)

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3
Q

A chronic disease that results from deficient glucose metabolism

A

Diabetes mellitus

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4
Q

Increased urine output

A

Polyuria

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5
Q

Increased thirst

A

Polydipsia

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6
Q

Increased hunger

A

Polyphagia

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7
Q

Diabetes that results from genetic factors and requires insulin administration

A

Type I Diabetes

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8
Q

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

A

Type 2 Diabetes

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9
Q

Tissue atrophy or hypertrophy

A

Lipodystrophy

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10
Q

Results from administering too much insulin

A

Hypoglycemic reaction (insulin shock)

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11
Q

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

A

Ketoacidosis (DKA)

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12
Q

What does Hemoglobin A1C tell us?

A

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

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13
Q

Explain the ranges for HgA1C.

A

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

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14
Q

Where does insulin have the greatest absorption?

A

Abdomen

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15
Q

Why do insulin injection sites need to be rotated?

A

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

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16
Q

When should rapid acting insulin be given?

A

Within 5-15 minutes of a meal.

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17
Q

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

A

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

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18
Q

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

A

Intermediate-acting

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19
Q

What type of insulin is glargine (Lantus)?

A

Long-acting

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20
Q

What is the peak of glargine?

A

It doesn’t have one.

21
Q

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

A

False
fridge for 3 month and room temp 1 months

22
Q

Why do we use combination insulins?

A

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

23
Q

What drugs can cause an increase in blood glucose?

A

Thiazides, glucocorticoids, estrogen, and thyroid drugs.

24
Q

What drugs can cause a decrease in blood glucose?

A

TCAs, MAOIs, aspirin, oral anticoagulants

25
Q

What types of insulin do we use for sliding scales?

A

Rapid or short acting

26
Q

Why do we use insulin pumps?

A

They allow for tighter glucose control and less hypoglycemic reactions.

27
Q

What are symptoms of hypoglycemia?

A

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

28
Q

Explain the Somogyi effect.

A

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.

29
Q

Explain the Dawn phenomenon.

A

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

30
Q

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

A

Clear to cloudy

Regular to intermediate

31
Q

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

A

False

32
Q

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

A

True

33
Q

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

A

1st generation sulfonylureas

34
Q

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

A

2nd generation sulfonylureas

35
Q

Sulfonylureas work by:

A

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

36
Q

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

A

True

37
Q

Metformin is what type of antidiabetic drug?

A

Non-sulfonylurea/Biguanide

38
Q

How does metformin work?

A

It decreases the hepatic production of glucose from stored glycogen.

39
Q

What are the most common side effects of Metformin?

A

Nausea, diarrhea, bitter/metallic taste

40
Q

Acarbose and Miglitol are what type of med?

A

Alpha-glucosidase inhibitor

41
Q

How do alpha-glucosidase inhibitors work?

A

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.

42
Q

Pioglitazone and rosiglitazone are what type of med?

A

Thiazolidinediones

43
Q

Repaglinide and netaglinide are what type of med?

A

meglitinides

44
Q

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

A

True

45
Q

Sitagliptin and saxagliptin are what type of med?

A

Incretin modifiers

46
Q

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

A

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.

47
Q

How does glucagon work?

A

It increases blood glucose by stimulating glycogenolysis.

48
Q

When do we use glucagon?

A

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

49
Q

How does diazoxide work?

A

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