More DM questions

Question 1

What two groups of meds can both increase and decrease blood glucose?

Answer 1

Beta blockers
Fluoroquinolones

Question 2

List 2 meds that can treat neuropathy and depression in DM

Answer 2

Venlafaxine (effexor) and duloxetine (cymbalta)

Question 3

What is the MOA of metformin?

Answer 3

Decreases hepatic gluconeogenesis production
Decreases intestinal absorption of glucose
Improves insulin sensitivity by increasing peripheral glucose uptake and utilization

Question 4

What group of drugs end in -ide?

Answer 4

Sulfonylureas

Question 5

What stimulates pancreatic insulin secretion?

Answer 5

Sulfonylureas (and insulin)

Question 6

What increases insulin sensitivity in muscle and fat?

Answer 6

Pioglitazone (TZD)

Question 7

What has an FDA BBB for CHF?

Answer 7

Pioglitazone

Question 8

What should you NOT use with GLP-1 RAs due to overlapping MOAs?

Answer 8

DPP-4s

Question 9

List the MOAs of GLP-1 RAs

Answer 9

Increases insulin secretion in response to elevated blood glucose, decreases glucagon secretion, leading to reduced hepatic glucose production and slowed gastric emptying

Question 10

Which GLP-1 should you d/c if GFR <30? What else is unique about this one?

Answer 10

Exenatide (byetta); only one without cardiovasc. benefit

Question 11

What 2 GLP-1 RAs have gallbladder disease as an adverse effect?

Answer 11

1) Exenatide (byetta)
2) Liraglutide (victoza)

Question 12

Which drug class ends in “-gliptin”

Answer 12

DPP-4s

(“glip dip”)

Question 13

Which DPP-4 does NOT have CYP3A4 drug interactions?

Answer 13

Sitagliptin (januvia)

Question 14

Which drug class has the adverse effects of joint pain and rare risk of pancreatitis?

Answer 14

DPP-4s

Question 15

What is the only DPP-4 not renally dosed?

Answer 15

Linagliptin (tradjenta)

Question 15

Which DPP-4 is associated with new or worsening heart failure?

Answer 15

Saxagliptin

Question 16

What is the only ultra long acting insulin?

Answer 16

Insulin degludec (tresiba)

(deg is ultra long)

Question 17

What are the 2 long acting insulins?

Answer 17

Glargine (Lantus), detemir (Levemir)

(I’ll be glargling on my det for a long time)

Question 18

List the 2 dose options for initiating insulin for T2DM

Answer 18

Option 1: 0.2 units / kg
Option 2: 10 units SUBQ QHS

Question 19

When should you consider basal + bolus dosing for T2DM?

Answer 19

When total daily dose is greater 0.5 units / kg

Question 19

List the 2 options for initiating basal + bolus dosing for T2DM

Answer 19

Option 1: One prandial injection before largest meal
-10% of basal dose or 5 units
Option 2: Three prandial injections
50% basal & 50% bolus divided in three doses

Question 20

What dose do you initiate insulin at for T1DM?

Answer 20

0.5 units/kg/day
(50% prandial insulin; 50% basal insulin)