insulins

Question 1

Regular insulin compatible with

Answer 1

All insulins except glargine and glulisine

Question 2

Insuline detemir compatible with

Answer 2

Must be given alone

Question 3

insulin isophane suspension (NPH) when do you administer

Answer 3

30-45 min after meal.

Question 4

Adverse effects of insulin

Answer 4

shock, death, weight gain, lipodystrophy at injection site

Question 5

Drug that antagonize hypoglycemic effect insulin

Answer 5

Corticosteroids, niacin, thiazide, loop diuretics, thyroid hormone, sympathomometics

Question 6

which insulin should not be used in breast-feeding women

Answer 6

Insuline glargine(lantus)

Question 7

drugs that increase insulins hypoglycemic effect

Answer 7

Alcohol, anabolic steroids, slufa drugs, MAOI,salicylates

Question 8

how do non-slective beta blockers interact w/insulin

Answer 8

mask the tachycardia from hypoglycemia

Question 9

when do you give reg. insulin

Answer 9

30-60 min before a meal or on a sliding scale

Question 10

when do you give long acting insulin glargine

Answer 10

only once or twice daily dosing

Question 11

Reg insulin: duration

Answer 11

short acting

Question 12

Insulin Gargine (lantus) duration

Answer 12

Long-acting

Question 13

Insulin detemir (Levemir) duration

Answer 13

Intermediate

Question 14

Insulin idophane suspension (NPH) duration

Answer 14

current only available intermediate-acting insulin

Question 15

Reg insulin onset, peak

Answer 15

30-60 min, 2.5hr

Question 16

Insulin isophane suspension (NPH) onset, peak

Answer 16

1-2hr, 4-8 hr

Question 17

insulin glargine onset, peak

Answer 17

1-2hr, none

Question 18

most common oral drug for type 2 diabetes

Answer 18

metformin (glucophage)

Question 19

How does Metformin work

Answer 19

decrease glucose production by liver and decrease intestinal absorption of glucose and improve insulin receptor sensitivity

Question 20

Contraindications for metformin

Answer 20

renal disease (metformin excreted by kidney=accumulation and lactic acidosis) Also Alcoholics, liver disease, heart failure, cardiopulmonary disease

Question 21

AE: metformin

Answer 21

GI problems: bloating, nausea, crampin, feeling of fullness, diarrhea effects usually self-limiting less SE when start w/ low dose Decreased absorbtion of Vit B12 and folic acid

Question 22

less common SE metformin

Answer 22

metal taste in mouth and reduced vit B12 levels

Question 23

Interactions w/metformin

Answer 23

radiology dyes=renal failure and lactic acidosis, also interacts w/cimetidine, digoxin, propranolol

Question 24

pioglitazone (Actos) is what class of drug

Answer 24

Thiazolidinediones

Question 25

How does piogliazone work?

Answer 25

reduce insulin resistance by enhancing the sensitivity of insulin receptors also directly stimulate peripheral glucose uptake and storage, as well as inhibit glucose and triglyceride production in liver.

Question 26

Pioglitazone indications

Answer 26

Type 2 diabetes: high cost, lost of AE, and slow onset=reserved for pt who can't tolerate glucose control w/ metformin

Question 27

only thiazolidinediones approved for use w/ insulin

Answer 27

pioglitazone

Question 28

AE: pioglitazone

Answer 28

increase risk for Heart fail, peripheral edema, weight gain, reduced bone mineral density, increased risk of fracture, increased MI

Question 29

interactions w/pioglitazone

Answer 29

serum concentrations inc. w/ CYP3A4 inhibitor such as erythromycin and ketoconazole

Question 30

How does arcbose (Precose) work

Answer 30

delays glucose absorption

Question 31

How do you administer arcbose (Precose)

Answer 31

must be administered w/ food

Question 32

Contraindications for arcbose (Precose)

Answer 32

many adverse GI effects. inflammatory bowel disease, intestinal obstruction, malabsorption syndrome

Question 33

AE: arcbose (Precose)

Answer 33

flatulance, diarrhea, abdominal pain NO Hypoglycemia or weight gain.

Question 34

glipizide (Glucotrol)duration

Answer 34

rapid onset, short duration

Question 35

glipizide (Glucotrol) contraindicated

Answer 35

drug allergy, type 1 brittle diabetes, NOT contraindicated for renal failure

Question 36

glipizide (Glucotrol) when to dose

Answer 36

30 min before meal

Question 37

Sitagliptin (Junuvia) indications

Answer 37

mgmt of type 2 diabetes as monotherapy or a combination but NOT with insulin

Question 38

drug interactions w/Sitagliptin (Junuvia)

Answer 38

Sulfonylurea cause hypoglycemia

Question 39

AE Sitagliptin (Junuvia)

Answer 39

none

Question 40

treat hypoglycemia with

Answer 40

Iv glucose or sub-Q glucagon

Question 41

Nurse action prior to admin glucagon

Answer 41

roll pt. to side because they will most likely vomit.

Question 42

which insulin should be withdrawn first? Reg. or NPH.

Answer 42

clear (reg or rapid acting) followed by NPH (intermediate)

Question 43

oral anti-diabetic meds administered when

Answer 43

30 min before meal

Question 44

pt. on metformin undergoing test w/contrast dye

Answer 44

must dicontinue metformin prior to test and restart after test and evaluation of renal status