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Diabetes Flashcards

(73 cards)

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1
Q

Which lab tells you if you have T1DM

A

C-peptide low or absent

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2
Q

examples of microvascular complications from hyperglycemia

A

retinopathy, nephropathy, neuropathy

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3
Q

examples of macrovascular complications from hyperglycemia

A

atheroschlerosis –> ASCVD

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4
Q

at what age should people be screened regardless of risk factors

A

45 years old

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5
Q

A1c to bg equivilence

A

6% = 126 mg/dL and each 1% increases by 28 mg/dL

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6
Q

diabetes vaccines

A

hep b, prevnar 13 and pneumococcal

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7
Q

Which diabetes drugs have best evidence for weight loss

A

SGLT2, GLP1 (semaglutide, liraglutide, dulaglutide)

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8
Q

which diabetes drugs do not cause hypoglycemia

A

DPP4, GLP-1, SGLT2, Thiazolidenediones

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9
Q

which class drugs do you use if ASCVD is major issue

A

GLP 1 (semaglutide, liraglutide, dulaglutide) or SGLT2 (empaglifozin, canaglifozen) if GFR < 30

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10
Q

which class to use 1st if CKD or HF is major issue

A

SGLT2

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11
Q

what is the a1c and BG cutoff for severe hyperglycemia

A

> 300 or aic >10

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12
Q

what dose to start bedtime insulin

A

0.1-0.2 units/kg/day (TBW)

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13
Q

Actoplus Met

A

Metformin/pioglitazone (tzd)

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14
Q

Janumet

A

Metformin/Stigaliptin (DPP4)

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15
Q

Invokamet

A

Metformin/canaglifozin (SGLT2)

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16
Q

fortamet, glucophage, glumteza

A

metformin names

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17
Q

metformin moa

A

decrease hepatic glucose output

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18
Q

metformin warnings

A

may cause B12 deficiency, do not start with GFR less than 30, stop prior to iodated contrast media

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19
Q

actos

A

pioglitazone

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20
Q

avandia

A

rosiglitazone

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21
Q

moa of thiaglitazones

A

increase muscle sensitivity to insulin to increase BG entry

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22
Q

pioglitazone and rosalitazone are what drug class

A

thiazolidinediones

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23
Q

glycemia/weight effects of thiazolidinediones

A

not known for hypoglycemia by itself but may enhance effect of insulin. May cause weight gain

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24
Q

thiazolidinedione side effects, warnings, and boxed warning

A

S/E: edema, bone fractures
Warnings: Hepatic failure, can simulate ovulation, bladder cancer
Boxed warning: Do not use in HF

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25
Canaglifozen, empaglifozen
SGLT2 inhibitors
26
Invokana
Canaglifozen
27
Jardiance
Empaglifozen
28
Sitagliptin, Linagliptin
DPP-4 inhibitors
29
MOA of SGLT2
increase BG renal excretion (pee out glucose)
30
MOA of DPP4
increase incretin
31
Januvia
Sitagliptin
32
Tradjenta
Linagliptin
33
Glucotrol
Glipizide
34
Amaryl
Glimepiride
35
Glynase
Glyburide
36
MOA of Sulfonylureas
increase insulin secretion
37
Hypoglycemia/weight loss of SGLT2
Hypoglycemia in combo with insulin and may cause weight loss
38
warnings, and side effects of SGLT2
Warning: UTI, genital fungal infection Warning: Increase LDL, hyperkalemia, fluid loss, hypotension, ketoacidosis
39
boxed warning canaglifozn
amputations
40
hypoglycemia and weight loss of DPP4
No hypoglycemia by itself but maybe with insulin, no weight change
41
which two classes should not be used together (x2)
DPP4 and GLP 1 because both insulin increetin Meglinitides and sulfonylureas because both insulin secretaloges
42
dpp4 warnings
pancreatitis, arthralgia, renal failure, saxagliptin/alogliptin do not use with HF, alogliptin hepatotoxicity
43
sulfonylurea hypoglycemia and weight effects
may cause hypoglycemia, may cause weight gain
44
contraindacations sulfonylureas
sulfa allergy, BEERS elderly
45
meglinitide hypoglycemia and weight effects
may cause hypoglycemia and weight gain
46
GLP 1 receptor agonist moa
increase incretin
47
warning GLP-1
pancreatitis
48
hypoglycemia and weight effects of GLP1
no hypoglycemia, weight loss
49
what is the effect of pramilitide and what is it
a synthetic analog of amylin and can cause gastroparesis, n/w/anorexia, headache and severe hypoglycemia
50
colveselam effects and moa
welchol, a bile acid binding resin, may decrease the absorption of fat soluble vitamins, may cause constipation and increase TG and should not be used in pancreatitis
51
Which diabtetes drug classes can cause weight loss
GLP-1, SGLT-2
52
which diabetes drug classes can cause weight gain
thiazolidinediones, sulfonulureas, meglinitides
53
which diabetes drugs are weight neutral
DPP-4, metformin
54
which diabetes drugs can cause hypoglycemia by themselves
sulfonylureas, meglinitides, pramlinitide
55
A1c, FPG and PPG goal in diabetes
Aic less than 6.5, ppg less than 126, ppg less than 200
56
rapid acting insulins
aspart (novolog), lispro (humalog)
57
short acting insulin
regular (humulin R, novolin R)
58
intermediate acting
NPH (humulin N, Novalin N) *cloudy
59
long acting basal insulin
``` insulin detemir (levemir) insulin glargine (lantus, toujeo) ```
60
insulin mix ratios
70/30 (humulin and novolon), 75/25, 50/50
61
dka cutoff
BG > 250
62
how to calculate TDD for insulin
0.5 units/kg/day and then seperate into 50% basal and 50% bolus
63
Exceptions to insulin 1:1 conversion
1) NPH (2x) to glargine (1x) - Use 80% of TDD NPH 2) Toujeo (glargine, 1x) to lantus (detemir) or basaglar (glargine, 1x) - Use 80% of TDD * basically from glargine to glargine......
64
ratio Rule for rapid acting insulin, correction factor for rapid acting
ICR 500 | Correction: 1800
65
ratio rule for regular insulin
ICR: 450 Correction: 1500
66
Correction dose equation
(blood glucose now - target)/correction dose
67
Calculating ICR is for what type of insulin
Mealtime so Regular and rapid acting
68
hum = eli lili insulin = how long stability
usually 1 month except for the concentrated insulin (humulin U500 - 40) and the pens
69
nov = novo norodisk insulin = how long stability
rapid acting (novolog) - 28 days short acting/others (i.e. detemir, novolin R/N) - usually 42 days ultra long acting (tresiba) - 56 days
70
sanofi rapid actng (aspidra, lispro) or basal (lantus, toijeo)
usually 28 or double that 56 (for toujeo)
71
drugs that can raise BG
BB, diuretics, tacrolimus, cyclospirine, PI, Quinolones, antipsycphotics, statins, steroids, cough syrups, niacin
72
drugs that can lower BG
linezolid, lorcaserin, pentamidine, beta blockers, quioolones, tramadol
73
tx for dka and hhs
fluids (NS) for dehydration, regular insulin IV, prevent hypokalemia so give K+, treat acedosis if pH <6.9

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