Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm Test 3 > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Formulations attempt to cover insulin peaks at mealtimes
Peak: around 2.5 hrs (range 1-6 hrs)
Duration: 15-18 hrs
Efficacy: decrease both FPG and PPG

A

Pre-Mixed Insulins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Admin of Regular Insulin

A

30 min before meals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

MOA of Pioglitazone (Actos) and Rosiglitazone

A

TZDs- MOA: improve insulin sensitivity, reduce hepatic glucose production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Rapid Acting Insulins

A

Lispro
Aspart
Glulisine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Admin of regular intermediate insulin

A

30 min before meals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Admin of rapid acting insulins

A

15 min before or immediately after meals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the major AE for sulfonylureas? What risk factors contribute to this?

A

Hypoglycemia

exercise, missed meals, long acting formulations, ETOH, renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Exenaglutide (Byetta ), liraglutide (Victoza)

A

GLP 1 Agonists [SQ]

Incretin Mimetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Drug Classes that cause Hypoglycemia?

A

Sulfonylureas
Insulin
Meglitinides
SGLT2 Inhibitors

“SIMS”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

which insulin does not have a peak?

A

Glargine (lantus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Onset, Peak, and Duration of long acting glargine (lantus)

A

Onset= 2-4 hr
NO PEAK
Duration= 20-24 hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When would a patient most likely experience hypoglycemia after administering Humulin R?

A

2-4 hrs later

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Advantages/ Disadvantages of Premixed Insulin?

A

Advantage: 2 shots daily, relatively simple to use
Disadvantages: not much flexibility in dosing and meals must be eaten at regular schedule; cannot adjust insulins separately

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Onset, Peak, and Duration of intermediate Isophane Insulin

A 
onset= 2-4 hr 
peak= 4-10 hr 
duration= 10-16 hr
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What patient population should you avoid TZD -Pioglitazone (Actos ) and Rosiglitazone agents in?

Is there a low or high risk of hypoglycemia with these agents

A

Avoid in pts with symptomatic heart failure

Low risk of hypoglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MOA of Sodium Glucose CoTransporter 2 (SGLT2) Inhibitors:

Dapagliflozin (Farxiga ), Canagliflozin (Invokana)

A

Inhibiting SGLT-2 enhances the renal excretion of glucose by blocking reabsorption of glucose in the kidneys- more glucose excreted in urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Humilin R

Novolin R

A

regular insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what med class can have weight gain from heart failure but mostly causes weight loss/ weight neutral?

A

TZDs

Pioglitazone (Actos) and Rosiglitazone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the unique benefits of Metformin (a Biguanide) ?

A

moderate weight loss. Decreases LDL, TG

Increases HDL. Cardiovascular mortality benefit.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how does Glargine (Lantus) have a prolonged duration of action

A

low solubility at physiological pH which leads to precipitation at the injection site and therefore an extended duration of action

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

when should sulfonylureas be administered and why?

Meglitinides?

A

sulfonylureas 30 min before to increase absorption

Meglitinides 15-30 min before meal. Skip a meal… skip dose. Add meal… add dose

22
Q

Long acting insulins

A

Glargine (lantus)

Detemir (Levemir)

23
Q

Glipizide (Glucotrol), Glyburide

Micronase, Diabeta ), Glimepiride (Amaryl

A

2nd Gen Sulfonylureas

Insulin Secretagogues

24
Q

Intermediate acting insulins

A

Isophane (NPH)- Humulin N / Novolin N

Regular (U-500)- Humulin R

25
Q

Drug Class that causes heart failure

A

TZDs - Pioglitazone (Actos) and Rosiglitazone

26
Q

Do we use 1st Gen Sulfonylureas?

A

No more SE

27
Q

Onset, Peak, and Duration of long acting Detemir (levemir)

A 
Onset= 3-4 hr 
Peak= 6-and 8 hr 
Duration = 6-23 hr
28
Q

Which 2nd gen sulfonylurea is “safer” to use in patients with renal impairment?

A

Glipizide

29
Q

What is one of the concerns of using Sodium Glucose CoTransporter 2 (SGLT2) Inhibitors agents as
pertaining to risk of infection?

A

UTI, Genital fungal yeast infection

30
Q

When can you not use SGLT2 Inhibitors?

A

Crcl < 45: canagliflozin, dapagliflozin, empagliflozin

Crcl < 60: ertugliflozin

31
Q

Onset, Peak, and Duration of intermediate Regular Insulin

A 
Onset= 30 min 
Peak= 3.5-4.5 hr 
Duration= 6.5-10hr
32
Q

Med class that lowers lipids

A

Biguanides

33
Q

Advantages/ Disadvantages of Premixed Insulin?

A

Advantage: 2 shots daily, relatively simple to use
Disadvantages: not much flexibility in dosing and meals must be eaten at regular schedule; cannot adjust insulins separately

34
Q

Admin of Glargine (Lantus)

A

Every 24 hr

35
Q

what is significance of fact that incretin mimetics ( GLP-1 Agonists and DPP-IV inhibitors) are glucose dependent? MOA?

A

low risk of hypoglycemia
increases insulin secretion by the beta cells
suppresses glucagon secretion by the alpha cells

36
Q

What kind of drugs are Sitagliptan (Januvia), Saxagliptan Onglyza)

A

DPP IV Inhibitors [PO]

Incretin Mimetics

37
Q

Onset, Peak, and Duration of regular insulin

A 
Onset= 30-60 min 
peak= 2-3 hr 
Duration= 5-8 hr
38
Q

What kind of drugs are Exenatide (Byetta ), Liraglutide (Victoza)

A

GLP 1 Agonists [SQ]

Incretin Mimetics

39
Q

Sitagliptan
saxagliptan
Algogliptan
Linagliptan

A

DPP IV Inhibitors [PO]
(Incretin Mimetics)

stimulate glucose dependent release of insulin

40
Q

Med class that causes weight loss/ weight neutral

A

Biguanides
TZDs
GLP-1 agonists

41
Q

Meds that give cardiovascular benefit

A 
Metformin
Pioglitazone
Liraglutide
Canagliflozin 
Empagliflozin
42
Q

Stimulates insulin release from pancreatic beta cells

A

Insulin Secretagogues

Sulfonylureas
Glyburide, Glipizide, Glimepiride

Meglitinides
Nateglinide, Repaglinide

43
Q

Admin of Detemir (levemir)

A

every 12-24 hr

44
Q

Drug Classes that cause GI Effects

A

Mainly Biguanides and alpha glucosidase

also: Sulfonylureas, Meglitinides, GLP-1 agonists

45
Q

Drug Classes that cause weight gain?

A

Sulfonylureas, Meglitinides, TZDs, Insulin

46
Q

Admin of intermediate Isophane Insulin

A

30-60 min before meals or at bedtime

47
Q

Onset, Peak, and Duration of Rapid Acting Insulins

A 
onset= 15-30 min 
peak= 0.5-2.5hr 
Duration= 3-5 hr
48
Q

Repaglinide ( Prandin ),

Nateglinide (Starlix)

A

Meglitinides:(Insulin Secretagogues )

stimulate pancreatic insulin secretion

49
Q

What is a major AE of exenatide (Byetta)? *

A

Pancreatitis

50
Q

who is metformin contraindicated for? allowed?

A

pts with renal dysfunction: CrCl less than 30 mL/min

Safe in pts with moderate renal impairment (CrCl > 45 mL/min)

51
Q

What can occur with metformin if pt cannot adequately eliminate the drug?

A

Lactic Acidosis

Pharm Test 3 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions