Exam 3 - Diabetes Day 3 Jeopardy Questions Flashcards Preview

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Flashcards in Exam 3 - Diabetes Day 3 Jeopardy Questions Deck (28):
1

Sitagliptin works via this MOA

DPP-4 inhibitor

2

In addition to effective pharm therapy, it is important to counsel pt's on the importance of these types of modifications

Lifestyle!! (diet and exercise)

3

This medication class can take several weeks to see maximum effect (3-4 months)

TZD's
--> rosiglitizone
--> pioglitizone

4

Sulfonylurea and glinides need to be dosed this way

w/ food

If they skip a meal, they don't take that dose

5

If this agent is used, the dose of preprandial insulin should be decreased by 50%

Pramlintide

6

These 2 drug classes are associated w/ either weight loss or weight neutral effects

1. Pramlintide (amylin)
2. Biguanides
3. DPP-4 inhibitors
4. GLP1's

7

This is what we recommend w/ patients with a sulfa allergy and they are about to start a sulgonylurea

Normally this should be fine

Be cautious w/ patien'ts who have had anaphylactic rxn w/ sulfa drug in the past

8

This medication was removed from the market d/t hepatotoxicity

Troglitazone

9

Female pts that have taken TZDs or metformin need to be aware of this possible side effect

Induced ovulation for pt's w/ POS

10

Acarbose works by this MOA

Competitively inhibits enzymes in small intestine which delays breakdown of sucrose and complex carbs

11

The following DDP-4's require dose adjustment in renal dz

1. Sitagliptin
2. Saxagliptin
3. Alogliptin

12

TZD's are associated w/ these common side effects

Edema
Weight gain

13

We wouldn't want to use Symlin in these patients

- Pediatrics
- A1C > 9
- Pt's w/ poor compliance with insulin regimen and monitoring their blood glucose
- Recurrent/severe hypoglycemia in past 6 months
- Confirmed gastroparesis dx
- Use of drugs that stimulate gastric motility
- Hypoglycemic unawareness

14

The glucose lowering effects tend to plateau at about 1/2 max dose of this class of meds

Sulfonylureas

15

This class of meds enhances insulin sensitivity (muscle, liver, fat) and they do it by binding to the PPAR receptor

TZDs

16

Flatulence, bloating, abdominal discomfort, and diarrhea occur in > 70% of patients taking this medication

Alpha Glucosidase inhibitors

17

If a patient is on Acarbose and begins to have symptoms of hypoglycemia, you recommed they take this tx

Glucose tablets bc drug prevents complex sugars from being absorbed

18

This is the MOA of glipizide

Increase secretion of insulin from the beta cells in the pancreas

(Glipizide is a sulfonylurea)

19

AST/ALT need to be monitored at baseline and fluid status is another monitoring parameter for this drug class

TZD's
(rosiglitizone and pioglitizone)

20

This is an important point to mention when discussing the timing of doses of Nategline and regaglinide

Take 15-30 min before meals and be sure to skip the dose if you are skipping a meal

21

This med decreases glucose production in the liver

Metformin

22

This sulfonylurea is the best agent choice for patients w/ renal impairment

Glipizide

23

Hypoglycemia is mainly associated w/ these 2 classes of meds

Sulfas and glinides

24

This is one contraindication associated w/ TZDs

Class 3 or 4 heart failure

25

The hgA1C will fall by this % when metformin is utilized at max dose

1.5-2%

26

This is the goal dose of metformin

1000mg BID

27

It is important to explain to the patient that GI effects of the medication will subside and we will titrate the dose of this med as tolerated:

Metformin

28

This is a contraindication associated w/ metformin

Cr > 1.4 in women
Cr > 1.5 in men