Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacology II > Final topics- Diabetes > Flashcards

Final topics- Diabetes Flashcards

(105 cards)

Start Studying
1
Q

Balance between hepatic glucose production & peripheral gluocse uptake & utilization:

A

glucose homeostasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pancreatic islet hormones maintain:

A

gluocse balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pancreatic beta cells secrete:

A

insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pancreatic alpha cells secrete:

A

glucagon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Released by cells in the small intestines after food ingestion, stimulate insulin secretion when the blood glucose is above the fasting level:

A

incretin hormones

-glucagon-like peptide 1 (GLP1)
-glucose-dependent insulinotropic polypeptide (GIP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Two whammies that individuals who are obese often struggle with:

A
  1. uncontrolled hyperglycemia
  2. insulin resistance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hyperglycemia may be due to: (3)

A
  1. uncontrolled hepatic glucose output
  2. reduced uptake of glucose by skeletal muscle
  3. reduced glycogen synthesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Absolute insulin deficiency resulting from autoimmune destruction of pancreatic beta cells:

A

Type I DM (insulin deficiency)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What type of diabetics are prone to diabetic ketoacidosis (DKA)?

A

Type I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Type of drug that can cause transient hyperglycemia:

A

Glucocorticoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

T/F: Majority of type II diabetics are asymptomatic and diagnosed by laboratory testing

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Type ____ diabetes is often associated with weight loss and ketoacidosis

A

Type I (due to spilling of glucose into urine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Symptoms that are more common in type I diabetes, although they can occur in type II:

A

-lethargy
-stupor
-weight loss
-kussmaul breathing (hyperventilation)
-smell of acetone (fruity breath)
-nausea
-vomiting
-abdominal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

A1C basically meaures:

A

sugar-coated hemaglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Measures the average amount of glucose in a patients blood over the last 3-4 months:

A

A1C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

List the A1C lab ranges for the following:

Normal:
Pre-diabetic:
Diabetic:

A

Normal: Below 5.7%
Pre-diabetic: 5.7 - 6.4%
Diabetic: 6.5% +

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

List the fasting glucose lab ranges for the following:

Normal:
Pre-diabetic:
Diabetic:

A

Normal: 99mg/dL or below
Pre-diabetic: 100-125mg/dL
Diabetic: 126mg/dL +

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

List the glucose tolerance ranges for the following:

Normal:
Pre-diabetic:
Diabetic:

A

Normal: 140mg/dL or below
Pre-diabetic: 140-199mg/dL
Diabetic: 200mg/dL +

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Macrovascular complications of diabetes include:

A
  1. brain
  2. heart
  3. extremities (peripheral vascular disease)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What categories of conditions are the main type of death for patients with type II Dm?

A

Cardiovascular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Microvascular complications of diabetes include:

A
  1. eyes
  2. kidneys
  3. nerves (peripheral & autonomic)
  4. periodontal disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

A1C goal for both Type-I & Type-II DM?

A

Under 7.0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Risk reduction strategies aim to reduce the risk of ____ & ____ (and other) complications through glycemic control and controlling co-morbid conditions to which DM contributes

A

macrovascular; microvascular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

MOA for all insulins:

A

mimics endogenous insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Requirement for type I diabetes (no other treatment- they have to have it)
Insulin therapy
26
Human insulin is made by:
recombinant DNA-rDNA technology
27
Modified amino acid sequences (______) provide rapid/short acting & long acting/basal insulins
insulin analogs
28
Categorize the following diabetic medications: INSULIN LISPRO -humalog -amelog -lyumjev INSULIN ASPART -Novalog -Fiasp INSULIN GLULISINE -Apidra
Ultra-rapid/Rapid-acting insulin
29
Insulin that has an onset of 1--30 minutes:
Ultra-rapid/Rapid-acting insulin
30
Patients on short-acting (regular) insulins need to take there insulin:
30 min before meals (this allows it to get into the bloodstream in time)
31
Categorize the following diabetic medications: HUMULIN R NOVOLIN R
Short-acting (Regular) insulins
32
What is the onset of short-acting (regular) insulins?
around 30 minutes
33
Inhaled insulin (Afrezza) is considered a ______ insulin
Rapid-acting
34
Rapid-acting inhaled insulin:
Afrezza
35
Inhaled insulin is contraindicated in:
Chronic lung disease (asthma/COPD)
36
Intermediate-acting insulin is also known as:
NPH (neutral protamine hagedorn)
37
What is the onset of intermediate-acting insulin (NPH)?
1-2 hours
38
Categorize the following diabetic medications: HUMULIN N NOVOLIN N
Intermediate-acting (NPH) insulin
39
____ insulins CANNOT be taken with other types of insulins
Long-acting
40
Categorize the following diabetic medications: INSULIN GLARGINE -Lantus -Basaglar -Rezvoglar -Semglee INSULIN GLARGINE -Toujeo
Long-acting insulins
41
What is the onet of long-acting insulins?
about 1 hour
42
What is the duration of long-acting insulins?
about 24 hours (basal insulin)
43
Categorize the following diabetic medications: INSULIN DEGLUDEC -Tresiba
Ultra long-acting insulin
44
What is the duration of ultra long-acting insulin?
42 hours
45
What is the onset of ultra long-acting insulin?
30-90 minutes
46
Why do we want patients to give themselves multiple insulin injections per day?
to match what the pancreas does
47
Multiple daily injections:
Basal bolus regimens (4 injections per day)
48
How many injections are typically given with a basal bolus regimen?
4/day
49
Mimics physiologic insulin release:
Basal bolus regime
50
For basal injections of insulin, we use: For bolus injections of insulin, we use:
Long acting analog Ultra-rapid acting or rapid-acting analog
51
For patients that don't like injections but you can convince them to do two injections per day, they would likely be on:
Rpaid-acting (NPH) insulin
52
Continuous insulin infusion pump devices only use ____ as basal insulin continuous delivery with bolus administration as needed
short- or rapid-acting
53
Often requires lower doses of insulin because less issue with insulin resistance:
Type 1
54
Multiple daily injections od prandial insulin and basal insulin or continuous subcutaneous insulin infusion is recommended for:
Type 1
55
Often requires higher doses of insulin due to insulin resistance:
Type 2
56
Often start with basal/long-acting insulin and continue certain oral anti-diabetic medications:
Type 2
57
About ___% of patients with type 2 diabetes benefit from insulin
33 (1/3)
58
Adverse effects of insulin:
1. weight gain 2. hypoglycemia
59
Highest risk of any diabetic medication:
Hypoglycemia
60
Does basal or bolus insulin have a higher risk for causing hypoglycemia?
Bolus (higher risk)
61
Glucose alert value for hypoglycemia: Serious clinically significant glucose value for hypoglycemia:
Less than 70mg/dL Less than 54mg/dL
62
63
When is treatment for hypoglycemia indicated?
Glucose of less than 70 mg/dL
64
Describe the rule of 15 for treating hypoglycemia:
1. Eat or drink 15g of carbs 2. Wait 15 minutes & check blood sugar 3. If still low, eat another 15g of carbs 4. Check blood sugar again after 15 minutes
65
If a patient has to skip a meal prior to a dental procedure, what should their insulin regimen look like?
skip short/rapid acting insulin dose, but still take their basal insulin dose
66
If a patient becomes unconscious, unresponsive or unable speak due to hypoglycemia what should you do?
1. Call 9-1-1 (or have someone call 9-1-1 after administering the 1st dose of glucagon) 2. Stimulate gluconeogenesis
67
What is the dosing for stimulating gluconeogenesis in an unresponsive hypoglycemic patient?
1mg glucagon IV or IM in buttock/thigh/arm and repeat after 15 min if no response provoked (patient will need glucose after injection OR give 50mL of 50% dextrose IV)
68
What class of drug is Metformin in?
Biguanide
69
Another name for Metformin:
Glucophage
70
-MOA: -decreases hepatic glucose production (primary mechanism) -decreases insulin resistance (increases insulin sensitivity) \ -increases glucose utilization in muscle & adipose tissue -inhibits intestinal absorption of glucose
Metformin (Glucophage) (Drug class: Biguanides)
71
What is the formulation of Metformin (Glucophage):
Oral
72
Medication often used for the first line/initial aget for Type 2 DM:
Metformin (Glucophage)
73
T/F: Metformin (Glucopahge) can be used in pre-diabetes to decrease the risk of progression to DM
True
74
Describe the risk of hypoglycemia with use of only Metformin (Glucophage) in a pre-diabetic patient:
Low risk (with monotherapy)
75
What is a notable ADE associated with Metformin (Glcuophage):
Notable GI ADEs -diarrhea/loose stools -flatulence -dyspepsia -abdominal distention/pain -nausea/vomiting
76
All GLP1s end in:
"tide"
77
Biggest reason people cannot tolerate GLP1s:
abdominal side effects
78
-Albiglutide -Dulaglutide -Exenatide -Liraglutide -Lixisenatide -Semaglutide These drugs are all:
GLP1s
79
What is the MOA for GLP-1 receptor agonist?
1. stimulates GLP1 receptors in the pancreas to INCREASE INSULIN SECRETION in response to elevated glucose 2. Simulation of GLP1 receptors in the GI tract & CNS DECREASE GLUCAGON SECRETION and SLOW GASTRIC EMPTYING
80
Benefits of GLP1 receptor agonist:
1. weightloss 2. CV benefits (ASCVD) 3. kidney benefits (CKD)
81
ADEs of GLP1 receptor agonist:
GI issues (nausea & diarrhea)
82
What is the risk of hypoglycemia for GLP1 receptor agonist?
Low risk with monotherapy
83
Glucose-dependent insulinotropic polypeptide agonist + glucagon-like peptide-1 agonist:
GIP/GLP-1 receptor co-agonist
84
Tirzepatide (Mounjaro) is classified as:
GIP/GLP-1 receptor co-agonist
85
Diabetes drug that provides the best weightloss effects:
GIP/GLP-1 receptor Co-agonist
86
-Activates both the GLP-1 receptor and the GIP receptor -Increases insulin secretion in response to elevated glucose, decreases glucagon secretion, slows gastric emptying This is the MOA of:
GIP/GLP-1 receptor Co-agonist (Tirzepatide/Mounjaro)
87
ADEs for GIP/GLP1 receptor co-agonist ("twincretin")
GI (diarrhea, nausea, vomiting)
88
Diabetic medication that functions by targeting the kidneys (proximal renal tubal):
Sodium glucose cotransporter-2 (SGLT2) inhibitors
89
SGLT2 inhibitors end in:
"Flozin"
90
_____ is repsonsible for 90% of glucose reabsorption
SGLT2
91
-Bexagliflozin -Canagliflozin -Dapagliflozin -Empagliflozin -Ertugliflozin These are all type of:
SGLT2 Inhibitors
92
MOA: Blocks glucose reabsorption in the proximal convoluted tubules of the kidney which increases excretion of glucose in the urine (also blocks sodium reabsorption)
SGLT2 inhibitors (Flozins)
93
ADEs of SGLT2 inhibitors (Flozins):
-Fungal/yeast infections -UTIs
94
What is the risk of hypoglycemia when taking SGLT2 inhibitors (Flozins):
Low risk as monotherapy (may significantly reduce insulin needs)
95
What are the added benefits for SGLT2 inhibitors (Flozins):
1. CV benefits (ASCVD & HF) 2. Renal benefits (CKD) 3. Weightloss (less than GLP1 agonist)
96
What diabetic drug shows the most significant weightloss effects?
Twincretins (GLP-1 + GIP) (but these do not have the added benefits such as the CV and renal benefits)
97
MOA: DIRECTLY stimulate pancreatic beta cells to release more insulin:
Sulfonylureas (SU) Secretagogues
98
-Glimpiride -Glyburide -Glipizide (2nd generation) These drugs are all considered:
Sulfonylureas (SU) (Secretagogues)
99
-Nateglinide -Repaglinide These drugs are both:
Meglitinides
100
MOA: DIRECTLY increase insulin release from the pancreas in response to food, keeping blood glucose from rising too high after means (SHORTER ACTING)
Meglitinides
101
ADEs of both Meglinitides & Sulfonylureas:
-HYPOGLYCEMIA -Weight gain
102
MOA: - Increases peripheral insulin sensitivity -Binds to nuclear receptor -Reduces glucose output
Thia-zolidine-diones (Glitazones, TZDs)
103
What is the one drug that belongs to Thia-Zolidine-diones (Glitazones, TZDS)?
Pioglitizone
104
What type of insulin do we see patients on with non-alcoholic fatty liver disease?
TZDs (Glitazones)
105

Pharmacology II (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions