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Pharm Test 3 > Diabetes Drugs > Flashcards

Diabetes Drugs Flashcards

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1
Q

What are the micro vascular complication associated with diabetes?

A

Retinopathy neuropathy, neuropathy

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2
Q

What are the macro vascular complications of diabetes?

A

Coronary heart disease stroke, myocardial infarction

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3
Q

When is insulin indicated?

A

Type 1, LADA, GDM, and type 2 as step therapy.

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4
Q

When is insulin recommended in type 2?

A

10% HGBA1C 10% or BG or > 300 and unexpected weight loss

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5
Q

What are the three rapid acting insulin’s?

A

Aspart, glulisine, lispro

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6
Q

Short acting insulin type?

A

Human regular?

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7
Q

What is the intermediate acting insulin?

A

NPH

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8
Q

What is the long acting (basal) insulin?

A

Glargine, detemir, degludec

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9
Q

Which insulin lasts for 42 hours?

A

Degludec

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10
Q

Which insulin is ULTRA rapid acting

A

Inhaled afrezza

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11
Q

What is basal insulin used for?

A

Maintain insulin of NPO patients

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12
Q

What is the goal of basal insulin?

A

To supress hepatic glucose production, and improve fasting hyperglycemia

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13
Q

Which insulin cannot be mixed with other insulin?

A

Glargine the basal insulin

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14
Q

What is the drug of choice for patient with gestational diabetes?

A

Glargine

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15
Q

Which insulin can you use in both type one and two

A

Degludec

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16
Q

Which insulin has no true peak and is marketed as a premix insulin with Aspart

A

Degludec

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17
Q

When should glulusine insulin be administered?

A

30 minutes prior to meals

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18
Q

Which insulin’s are available over-the-counter

A

NPH regular and 7030 premix

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19
Q

Which insulins are available premixed

A

NovoLog, Humalog, humulin, and novolin

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20
Q

What is the goal of basil bowl is coverage

A

To avoid hypoglycemic and hypoglycemic values by suppressing hepatic glucose production and improved fasting hyperglycemia

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21
Q

When a ministering replacement therapy and people with type two diabetes, how is insulin given?

A

50% of the total daily insulin dose is given as basal and 50% as a bonus divided up before breakfast lunch and dinner

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22
Q

How do you dose correction doses

A

One unit for acting insulin for every 25 mg that the glucose is above target

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23
Q

What is split mixed dose?

A

Pre breakfast and pre dinner dose of an intermediate insulin like lispro or regular.

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24
Q

How is basal bolus dosed by three injections?

A

Three injections daily as preprandial, regular or Lispro and then basal and bolus was pre-meals right insulin.

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25
How is basal bolus dosed by four inductions daily?
Preprandial regular or Lispro and then intermediate acting NPH at a.m. and HS
26
Which two insulins are bolus insulin
Preprandial regular or Lispro
27
What are the basal insulin?
Glargine, detemir, and degludec
28
What is the rate of CSII?
.4-2 units an hour
29
Which diabetic medication do you use for PCOS?
Metformin
30
What are the major drug interactions of insulin?
Beta blockers, levothyroxine, alcohol, corticosteroids, and thiazide diuretics
31
Why must insulin be given by induction and not orally?
Insulin is the protein digested in the stomach for this reason it may not administered orally
32
Which type of insulin is preferred for these in continuous subcutaneous insulin?
Rapid acting
33
What is the first line pharmacologic treatment recommended for gestational diabetes?
Insulin
34
Which insulin could be administered IV
Regular
35
What should you take into account when choosing what to start a patient on?
Amount and rapidity of the glucose lowering required, adverse effects, the possible min glycemic effects like lipid lowering, compliance issues, and cost.
36
When are oral meds considered?
They are add on meds after hgba1c gangs be reached after 3 months of injections.
37
How should you dose metformin?
Start at a low dose and titrate up to 1000mg twice daily. Max dose is 2550. Dose with meals.
38
39
How is glocophage XR different from metformin
It is extended related and increased aborsption with food
40
At what GFR should you discontinue metformin?
30
41
When is metformin contraindicated?
When GFR is less than 30 alcohol use disorder, cardio, respiratory insufficiency, hypersensitivity, and greater than 80 years old unless they have a normal creatinine clearance
42
What labs did you check with metformin once a year?
LFTs and creatinine
43
What medication causes decreased serum B12 levels
Metformin
44
Which alpha glucosidase inhibitor has less drug interactions?
Miglitol
45
When do you see benefits of TZDs
6-12 weeks
46
T or F TZDs cause hypoglycemia
False
47
Which diabetic medication would you take if you also want to lower triglycerides?
TZDs
48
How is TZDs metabolized?
CYP3A4 and CYP2C8
49
Which medication causes increased bone fracture rates in women and risk for bladder cancer
TZDs
50
What are the common adverse reactions to TZD’s?
Sinusitis, myalgia, fluid retention, edema, delusional, anemia, and weight gain
51
When are SGLT2 inhibitors recommended
Type two diabetes and people that are high risk for atherosclerotic cardiovascular disease
52
What are advantages of SGLT 2 inhibitors?
Moderate lowering glucose levels, weight loss, reducing blood pressure, low risk of hypoglycemia effective as monotherapy or combo
53
What are the adverse reactions of SGLT – two inhibitors
Increase potassium increased genital yeast infections increased risk for renal insufficiency, hypovolemia or the side of hypotension UTI and non-HDL cholesterol
54
At what GFR level should you avoid starting? SGLT – two inhibitors
60
55
At the four classes of oral agents which one binds to enzyme and slows absorption of carbohydrates
Alpha glucosidase inhibitors
56
Which class of oral agents reduces absorption of filtered glucose from the renal tubular lumen increasing urinary excretion of glucose
SGLT – two inhibitors
57
Which drug class is a selective agonist for PPARY
TZD
58
What is the oral GLP1
Semaglutide rybelsus
59
What are the most common incretin hormones?
GIP and GLP1
60
How does GIP differ from GLP in the gut?
GIP does not slow gastric motility
61
What are GLP one receptor agonist contraindicated?
Type 1 DM, DKA, gastroparesis, reglan use, pancreatitis, and for bydureon a history of thyroid cancer
62
Which DPP4 inhibitors has the best compliance?
Linagliptin
63
Which DPP4 has the longest half life?
Alogliptin
64
Where do TZDs act in the body?
The liver, skeletal muscle, and adipose tissue.
65
Where do incretins works?
The guy, brain, and pancreas.
66
Where do SGLT-2 inhibitors work in the body?
Renal tubules to decrease glucose reabsorption
67
What are the two non insulin injectable classes?
GLP-1 incretin or amylimomimetics
68
How do sulfonyureas work?
The stimulate the pancreas to release more insulin
69
Which generation of sulfonureas is more frequently prescribed?
Second gen
70
When is glyburide contraindicated?
In hepatic and renal disease
71
Which sulfonureas has the shortest half life and is more commonly prescribed?
Glipizide
72
How is glimepiride given?
Once daily as mono therapy or with insulin
73
How should sulfonylureas be given in regard to meals?
With meals except for glipizide which is 30 min prior to meals.
74
Why should patients with angina avoid sulfonylureas?
They can cause myocardial ischemia
75
What are the two meglitinides?
Repaglinide and nateglinide
76
When should dose with meglitinides in regard to food?
With 15 minutes of meals
77
Which oral agent is more likely to cause hypoglycemia
Sulfonylureas and meglitinides
78
What is the side effect of metformin that becomes less bothersome overtime?
G.I. upset
79

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