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Diabetes > Diabetes things to remember > Flashcards

Diabetes things to remember Flashcards

(59 cards)

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1
Q

What are the Fasting, 1 hour post-meal, 2 hour post meal goals for diabetes in Pregnancy?

A

Fasting < or = 95 mg/dl
1 hour post meal < or = 140
2 hour post meal < or = 120

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2
Q

Diagnostic Criteria for Prediabetes
Fasting Plasma glucose (FPG)?
2 hr plasma glucose?
A1c?

A

FPG 100-125
2 hr plasma glucose of 140-199
A1c 5.7-6.4%

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3
Q 
Diagnostic criteria for diabetes 
Random glucose level?
Fasting plasma glucsoe?
2 hr plasma glucose?
A1c?
A

Random glucose level > or = 200
FPG > or = 126
2 hr plasma glucose > 200 mg/dl
A1C > 6.5%

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4
Q

What should the waist circumference be for females and males?

A

Waist circumference should be <35 inches for females and < 40 inches for males.

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5
Q

Microvascular complications of Diabetes? (4)

A

Retinopathy (most common)
Diabetic kidney disease
Peripheral neuropathy
Autonomic neuropathy ( Erectile dysfunction)

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6
Q

Macrovascular complications of diabetes? (3)

A

Coronary artery disease (MI, Stable angina)
Cerebrovascular disease (TIA/Stroke)
Peripheral artery disease

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7
Q

What is recommended for patients with diabetes and hypertension but NO albuminuria?

A

Thiazide, CCB, ACE inhibitor or ARB

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8
Q

What is recommended for patients with diabetes and albuminuria but NO hypertension

A

ACE inhibitor or ARB

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9
Q

what is recommended for patients with diabetes, hypertension and albuminuria

A

ACE inhibitor or ARB (add thiazide or CCB as needed for BP control)

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10
Q

What vaccinations should patients with diabetes receive?

A

Annual influenza (> 6 months)
PPSV23 (between age 2-64 years)
and, at age >65 years PCV13 and PPSV23 12 months later.
Hepatitis B vaccine

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11
Q

What are the Treatment goals for diabetes patients
A1C?
Preprandial plasma glucose?
Peak postprandial plasma glucose?

A

A1C: <7%
Preprandial plasma glucose 80-130
Peak postprandial plasma glucose <180

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12
Q

which 3 classes increase/replace insulin?

A

Insulin, Sulfonylureas, Meglitinides

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13
Q

Which class decreases Hepatic Glucose output?

A

Metformin

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14
Q

Which 3 classes decrease Glucagon, which decreases glucose production?

A

GLP-1 receptor agonist, DPP-4 inhibitors, Amylin analog (Pramlintide)

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15
Q

Which 2 classes slow gastric emptying (increase Satiety) aka make you feel full?

A

GLP-1 agonists, Amylin analog (Pramlintide)

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16
Q

Which class increases glucose excretion?

A

SGLT2 inhibitors

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17
Q

Which 2 classes increase insulin sensitivity?

A

Thiazolidinediones, Metformin

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18
Q

What are the main CI for Metformin?

A

eGFR < 30 or Metabolic acidosis

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19
Q

What is Metformin’s BBW?

A

Lactic acidosis (Risk increases with hypoxic (oxygen deprived) states acute HF, sepsis

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20
Q

When do you take Meglitinides?

A

Repaglinide (Prandin) - take 15-30 minutes before meals

Nateglinide (Starlix) - Take 1-30 minutes before meals

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21
Q

What are 3 CI for Sulfonyureas?

A

Type 1 diabetes,
DKA,
Sulfa allergy

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22
Q

When should Sulfonlureas be taken?

A

Sulfonylureas should be taken with breakfast (except glipizide IR is taken 30 minutes before meals)

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23
Q

What are the BBW for Thiazolidinediones?

A

May cause or exacerbate Heart Failure,

Rosiglitazone: increased risk of MI

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24
Q

What is the CI for Thiazolidinediones?

Study These Flashcards
A

NYHA class III/IV Heart failure

25
Which 2 medication has increased risk of urinary bladder tumors?
``` Pioglitazone (Actos) a Thiazolidinedione (TZD) and Dapagliflozin (Farxiga) a SGLT-2 inhibitor has a risk of bladder cancer ```
26
What is the BBW for Canagliflozin (Invokana)?
Increased risk of leg and foot amputations
27
what is the CI for SGLT-2 inhibitors?
eGFR < 30, ESRD, or on Dialysis.
28
Which class of medications can increase the risk of Yeast infections in the penis or vagina?
SGLT-2 inhibitors
29
Which 2 class of diabetes medications can increase the risk of Pancreatitis?
DPP-4 inhibitors, and GLP-1 receptor agonist
30
Which 2 DPP-4's increase the risk of heart failure?
Saxagliptin (Onglyza), and Alogliptin (Nesina)
31
Which 2 medications are shown to have cardiovascular benefit?
Empagliflozin (Jardiance) SGLT-2 inhibitor, and | Liraglutide (victoza)
32
What is the most common SE of Colesevelam (Welchol)?
Constipation. is a Bile Acid Binding Resin
33
What is Colesevelam (Welchol) also indicated for?
Dyslipidemia
34
When is Bromocriptine (Cycloset) CI?
CI in pts with syncopal migraines and those patients that are breastfeeding ( inhibits lactation). It is a Dopamine agonist, and should NOT be used with other dopamine agonists
35
Which 2 GLP-1 receptor agonist need to be given within 60 minutes of meals?
Byetta and Adlyxin need to be given within 60 minutes of meals; all others can be given without regard to meals.
36
With the exception of Byetta and Adlyxin, what is a BBW for the rest of the GLP-1's?
Risk of Thyroid C-cell carcinomas seen in rats, CI in pts with family history of medullary thyroid carcinoma (MTC)
37
Which GLP-1 must be injected immediately once it has been mixed?
Bydureon --> Exenatide LAR
38
How do you treat acidosis (only if pH <7)
Give sodium bicarbonate
39
Which 5 medication classes have the biggest decrease in A1C (>1%)?
Insulin (most), Meformin, Sulfonylureas, TZDs, GLP-1 agonist.
40
Which 4 classes of medications used for diabetes have the greatest risk of hypoglycemia?
Insulin (most), Sulfonylureas, Meglitinides, pramlintide (with insulin)
41
Which 4 classes are mostlikely to cause weight GAIN?
Insulin, Sulfonylureas, meglitinides, TZDs
42
Which 3 classes are most likely to cause weight LOSS
SGLT-2 inhibitors, GLP-1 agonists, pramlintide.
43
Which 2 medications have cardiac benefits?
Empagliflozin, and liraglutide
44
which 3 classes are the cheapest?
Metformin, sulfonylureas, TZDs
45
Which 3 classes are injectable?
Insulin, GLP-1 agonists, pramlintide
46
Which 4 medicatiosn do you NOT use if eGFR < 30?
Metformin, SGLT2 inhibitors, exenatide (Byetta), glyburide (Diabeta, Micronase)
47
Which 3 medications/classes do you not use if the patients has Heart failure?
TZDs, aloglipitin (Nesina), Saxaglipitn (Onglyza).
48
Which 2 medications/classes should you NOT use if the patient has a GI disorder?
GLP-1 agonists, pramlintide.
49
Which do you not use if the patient has a sulfa allergy?
Sulfonylureas
50
Which do you not use if the patient has a G6PD deficiency?
Sulfonylureas
51
Which medication has a Major risk of Lactic Acidosis?
Metformin
52
Which (2) medications have a major risk of Hepatotoxicity
TZDs, alogliptin (Nesina)
53
Which class of medications has a major risk of Hypotension/dehydration
SGLT2 inhibitors
54
Which classes of medication has a major risk of UTI/genital infections?
SGLT2 inhibitors
55
Which 2 class of medication has a major risk of Potassium abnormalities
Canagliflozin (hyperkalemia), insulin (hypokalemia)
56
Which 2 classes of medication has a major risk of Pancreatitis?
DPP-4 inhibitors, GLP-1 agonists
57
Which 2 classes of medication has a major risk hypersensitivity reactions
Sulfonylureas, DPP-4 inhibitors
58
Which class of medication has a major risk Ketoacidosis?
SGLT2 inhibitors (can occur when BG < 250 mg/dl)
59
Which 3 classes of medication has a major risk for Cancer
Pioglitazone, dapagliflozin (Bladder Cancer) | GLP-1 agonists (thyroid cancer)

Diabetes (3 decks)

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