Final: Diabetes

Question 1

Insulin

Answer 1

Indications: Treatment of type 1 DM; treatment of type 2 DM in patients whose diabetes cannot be controlled by diet or other measures

Adverse effects: Hypoglycemia, hypokalemia

Drug-drug: Beta blockers (-lol) slow HR down puts at a higher risk for hypoglycemia

Question 2

Rapid-acting insulin (lispro)

Answer 2

Onset: 15 minutes

Question 3

Short-acting insulin (regular)

Answer 3

Onset: 30-60 minutes
Peak: 1 hour

Question 4

Intermediate-acting insulin (NPH)

Answer 4

Onset: 2-4 hours

Question 5

Long-acting insulin (glargine)

Answer 5

Onset: 1-2 hours

Question 6

Semiglutide (GLP-1 agonist)

Answer 6

Injection, Bind to and activate GLP-1 receptors works in pancreas, insulin secretion and synthesis are initiated. Stimulates satiety center to decrease appetite

Should expect mild weight loss

CAN give with Metformin (works on liver)
CANNOT give with insulin or sulfonylureas (works on pancreas)

Adverse effect: Hypoglycemia monitor two hours after dosing, nausea, acute pancreatitis (rare), thyroid c-cell tumors (rare)

Question 7

Sulfonylureas (Glipizide)

Answer 7

Adverse effects: Hypoglycemia, GI distress, allergic skin reactions

Drug-drug: Drugs that acidify urine, beta blockers, alcohol

Question 8

Empagliflozin (SGLT2 Inhibitor)

Answer 8

Increased secretion of glucose in urine, prevents reabsorption in kidney

Contraindications: GFR <45, end stage renal disease

Adverse effect: Increased risk for genital mycotic infections and UTI, increased risk for dehydration (excreting urine more quickly)

Question 9

Metformin

Answer 9

Works in the LIVER