endo pharm

Question 1

Thyroid drug for Increase T3?
Thyroid drug to Increase T4?
C/U?
S/E?

Answer 1

1) Liothyronine
2) Levothyroxine
3) Hypothyroidism; myxedema
4) S/e: Tacky, Heat intolerance, Arrhythmias (basically hyperthyroidism)

Question 2

DM content

Answer 2

+Lean pt <30yo
+no insulin–> so GIVE Insulin
+AutoAB
+Ketoacidosis

Question 3

Type 2 DM criteria

Answer 3

+insulin resistant
+>40yo obese person
+NO autoAB
+Hyperosmolar coma

Question 4

Type 3 Diabetes Mellitus

Answer 4

multiple other specific causes of elevated blood glucose.
Rx: Insulin

Question 5

Type 4 Diabetes Mellitus

Answer 5

Gestational DM during 3rd trimester since placenta creates insulin resistance hormones

Question 6

Symptoms of HYPERglycemia

Answer 6

INCREASED Thirst-peeing
Blurry vision
Fatigue
Slow-healing cuts/ulcers
More frequent infections
WT loss

Question 7

MOA for Insulin

Answer 7

Binds to a transmembrane receptor 2a subunit (has 2a and 2b) and goes through complex series (tyrosine kinase) of phosphorylation to get glucose entering the cell

Question 8

4 types of insulin preps–> onsets–> DOA

Answer 8

5-15min—> RAPID–> 1-2hrs –> 4hrs
<30 min–> regular (SC/IV) –> 2-4hrs—> 8hrs
2hrs intermediate—> NPH—> 4hrs –> 16hrs
60-90min—> none –> 24hrs

[HELPFUL TIP:]
Peak x2 (rapid and short) or x4 (intermediate)

Question 9

name the Rapid-acting insulin prep

Answer 9

LAG

Lispro
Aspart
Glulisine

Question 10

Name the short-acting

Answer 10

Regular (SC/IV)

Question 11

Name the intermediate Insulin prep

Answer 11

NPH

Question 12

Name the Long-acting insulin prep

Answer 12

Degludec
Detemir
Glargine

Question 13

insulin mixes

Answer 13

 70%/30% NPH (Neutral Protamine Hegedorn) / regular insulin
 50%/50% NPL (Neutral Protamine Lispro) / Lispro insulin
 75%/25% NPL (Neutral Protamine Lispro)/ Lispro insulin
 70%/30% NPA (retinal nonperfusion area) / Aspart insulin

Question 14

How do continuous subcutaneous Insulin infusion devices work

Answer 14

Rapid-acting Insulin Aspart, lispro, or glulisine are delivered at low basal rate and premeal boluses to control post-prandial glycemia

Question 15

What is the goal of diabetic therapy

Answer 15

Postprandial Blood Sugar Test (PBBS): <180
and
HB1AC <7

Question 16

why is HB1AC measured

Answer 16

Glucose in hemoglobin reflects the degree of hyperglycemia within the past 3 months

Question 17

DOSAGE of Insulin and how is it divided t/o the day?

Answer 17

Dose: 0.3-0.5 U/kg
2/3 Morning (2/3 NPH; 1/3 R); 1/3 night (1/2 NPH and 1/2 R)

Question 18

WHat conditions do you use Insulin

Answer 18

 Diabetes mellitus (type 1,2 & 4-gestational diabetes)
 Postpancreatectomy diabetes
 Diabetic ketoacidosis
 Hyperglycemic-nonketotic coma