Module 6 Pharm Flashcards
(98 cards)
Which drugs can be used in gestational diabetes? (select all that apply)
a) glucotrol
b) metformin
c) pioglitazone
d) insulin
e) sitagliptin
Answer: b) metformin and d)insulin
These are the preferred agents.
What drugs can cause hypoglycemia?
a) sulfonylureas
b) metformin
c) glinides
d) alcohol
e) GLP-1 receptor agonists
Answer: sulfonyureas, glinides, alcohol
Insulin also increases risk for hypoglycemia. Amylin mimetics (pramlintide) can also cause hypoglycemia. Beta blockers can block glycogenolysis.
Which is diagnostic for diabetes?
a) fasting glucose 120
b) random glucose 126
c) A1C 6.5+
d) symptoms of diabetes
Answer: c) A1C of 6.5+ is considered diagnostic for DM
Which is diagnostic for diabetes (check all that apply)
a) fasting glucose 126
b) random glucose 180+ symptoms of DM
c) A1C 6.4
d) random glucose 200+ without symptoms of DM
Answer: a & d
Diagnostic values are A1C 6.5+; random glucose of 200+ with or without symptoms of DM and fasting glucose of 126
Which drug can cause hyperglycemia?
a) sulfonyureas
b) beta blockers
c) thiazide diuretics
d) glucocorticoids
e) statins
Answer: c & d
Others include sympathomimetics (mimic the sympathetic nervous system)
A patient concurrently taking a beta-blocker. What does the patient need to be aware of?
a) beta blockers increase glycogenolysis and help the body react to low glucose
b) beta blockers impair glycogenolysis (glycogenolysis is a process by which the body can respond to and counteract a fall in glucose)
c) beta blockers can make the patient more aware of hypoglycemia
d) beta blockers have no effect on glycogenolysis
Answer: b) beta blockers impair glycogenolysis (glycogen–> glucose) whereby the patient may experience hypoglycemia and it may go undetected
What is the blood pressure goal for diabetics?
140/90 or below
Insulin dosing must be coordinated with what?
Carbohydrate intake
What are good drug options to decrease risk of diabetic nephropathy?
a) ACEI
b) statins
c) sulfonureas
d) HCTZ
Answer: a) ACEI and ARBS are both good choices
Step 1 of the 4 step approach for DM management involves:
Lifestyle change plus metformin
Step 2 of the 4 step approach for DM management involves:
a) TZD
b) DPP-4 inhibitor
c) SGLT-2 inhibitor
d) basal insulin
e) combination insulin
Answer: Step 2: Step 1+(TZD,DPP-4 inhibitor, SGLT-2 inhibitor,GLP-1 receptor agonist);
Note: may consider sulfonyurea or basal insulin if goals are not achieved with previously listed drugs for step 2
Step 3 of the 4 step approach for DM management involves:
A 3-drug regimen (including metformin)
Step 4 out of the 4 step approach to DM management includes:
If step 3 (3 drug) insufficient: use a more complex insulin regimen in conjunction with 1+ noninsulin medicines
Which is a short duration, short acting insulin?
a) lispro (Humalog)
b) glargine (Lantus)
c) Humulin R
d) glulisine (Apidra)
Answer: c) Humulin R
These insulins are considered “regular” or natural insulins and include Humulin R and Novolin R
Which is an intermediate acting insulin?
a) lispro (Humalog)
b) glargine (Lantus)
c) Humulin R
d) Humulin N
Answer: d) Humulin N
These insulins are NPH insulin (Humulin N & Novolin N)
Long acting insulins include (select all that apply)
a) glulisine (Apidra)
b) glargine (Lantus)
c) Humulin N
d) detemir (Levemir)
Answer: b (Lantus) & d (Levemir)
Which is not a side effect of metformin ( select all that apply)?
a) GI upset
b) hypoglycemia
c) medullary thyroid cancer
d) lactic acidosis
Answer: b & c
Medullary thyroid cancer is associated with Exenatide (a GLP-1 receptor agonist)
Which patient comorbidities place the patient at high risk for lactic acidosis while taking metformin?
a) CHF
b) CKD
c) cirrhosis
d) hypothyroid
Answer: a &b
Lactic acidosis is especially concerning in patients with CKG/CHF
True or false, patients should take metformin on an empty stomach.
False, they should take with food to minimize GI upset.
The ER version also has less GI effects.
Which of the following is NOT a MOA for metformin?
a) blocks the ATP/K channel which causes membrane depolarization
b) inhibits glucose production in liver
c) confers resistance to DPP-4 inactivation of GLP-1 in the gut
d) reduces glucose absorption in gut
e) sensitizes insulin receptors in target tissue
Answer: a & c
Metformin works by inhibiting glucose production by the liver; reduces glucose absorption from gut; sensitizes insulin receptors in target tissue; increases glucose uptake in response to available insulin
Which drug does not cause weight gain?
a) meglitinides
b) metformin
c) sulfonyureas
d) thiazolidinediones
Answer: b) metformin
(My Skinny Thighs) - (My Best Form?)
Metformin causes weight loss.
Which drug class can reduce A1C by 1.5%-2.0%?
a) metformin
b) sulfonylureas
c) DPP-4 inhibitors (gliptins)
d) Thiazolidinediones
Answer: b) sulfonylureas
Think Sulfonylureas= Super reduction of A1C (they reduce A1C more than any other drug)
Metformin can reduce 1%-2%
What is the drug name prefix for Sulfonylureas?
“Gly____” and “Gli_____”
Glypizide, Glyburide, Glimepiride
Meglitinide names have what name component?
“_____glinide”
Nateglinide & Repaglinide