Test 5 Insulin and Diabetes Shi

Question 1

Regular Insulin (Humalin ) details

Answer 1

Onset: 30-60 min
Peak: 2-4 hours
Duration: 6-12 hours

Question 2

NPH insulin details (Novolin/ Humalin) (AKA intermiddiate insuli)

Answer 2

Onset: 1-2 hours
Peak: 6-14hours
Duration: 16-24 hours
Acts as basal insulin

Question 3

Lispro (humalog) details

Answer 3

Onset: 15 minutes
Peak: 30-90 minutes
Duration: 2-5 hours

Question 4

Glargine/ Lantus

Answer 4

Onset: 60-70 minutes
Peak: None
Duration: 24 hours

Question 5

Sulfonylureas MOA

Answer 5

Stimulate functioning beta cells in pancreas to release insulin
Only for type 2

Question 6

Examples of sulfonylureas

Answer 6

Glyburide: PO
Glipizide: PO immediate release tablet or extended
Glimeperide

Question 7

Contraindications of Sulfonylureas

Answer 7

Diabetic complications
Type 1 diabetes
Pregnancy

Question 8

Adverse effects of sulfonylureas

Answer 8

GI distress
Hypoglycemia
Allergic skin reactions

Question 9

Drug interactions of sulfonylureas

Answer 9

Beta Blockers
Alcohol
Many herbal things

Question 10

Glyburide facts

Answer 10

Onset: 1 hour
Peaks around 4 hours
Duration: 24 hours

Sulfa like effects: Photosensitivity
DO NOT drink alcohol with this, disulfiram like reactions
Sulfonylurea

Question 11

What kinds of Alpha Glucosidase Inhibators are there?

Answer 11

Acarbose
Miglitol

Question 12

How do Alpha Glucosidase Inhibitors work?

Answer 12

Inhibit alpha glucosidase which breaks down glucose for absorption
Delay absorption of glucose

Question 13

Contraindications of Alpha Glucosidase Inhibitors

Answer 13

DKA
GI disorders
Acarbose: Cirrhosis
Caution: Renal impairment

Question 14

Adverse effects of Alpha Glucosidase Inhibitors

Answer 14

GI
Anemia: Due to decreased iron absorption
Hepatotoxicity

Question 15

What drug is a biguanide?

Answer 15

Metformin

Question 16

How do biguanides work?

Answer 16

Used for type 2
Decrease production and increases uptake of glucose ; reduces glucose that the liver makes
Absorbed orally and not metabolized

Question 17

Contraindications of Biguanides

Answer 17

Metabolic Acidosis
Severe renal impairment
Excessive alcohol intake
Patients not eating/ drinking during surgery
Patients undergoing radiology with contrast
Age 65 or older
Hypoxic State

Question 18

Adverse effects of biguanides

Answer 18

LACTIC ACIDOSIS
GI side effects
Dizziness
Headache
Upper respiratory infections
Taste disturbances

Question 19

Drug Interactions of biguanides

Answer 19

Alcohol
Carbonic Anhydrase
Iodine Containing Contrast Media

Question 20

What are some signs of lactic acidosis?

Answer 20

Fatigue
Muscle Cramps
Vomiting
Bradycardia

Question 21

What are some DPP4 Inhibitors

Answer 21

Alogliptin
Linagliptin
Saxagliptin
Sitagliptin: PO , low hypoglycemia risk

-gliptin

Question 22

How do DPP4 Inhibitors work?

Answer 22

Slow inactivation of incretin hormones
Increase Insulin release
Lower glucagon secretion
For type 2

Question 23

Contraindications of DPP4 inhibitors

Answer 23

DKA or type 1 diabetes
Renal impairment

Question 24

Adverse effects of DPP4 inhibitors

Answer 24

Pancreatitis
Heart Failure
Severe Arthralgia
Exfoliative skin conditions

Question 25

Meglitinide examples

Answer 25

Repaglinide Nateglinide

Question 26

Contraindications of meglitinides

Answer 26

Type 1 diabetes or DKA Lactation

Question 27

Adverse effects of meglitinides

Answer 27

Upper respiratory infections Headache Arthralgia ND Hypoglyco

Question 28

What are the SGLT-2 Inhibitors?

Answer 28

Canagliflozin Dapagliflozin Empagliflozin -gliflozin

Question 29

How do SGLT 2 inhibitors work?

Answer 29

Cause excess glucose to be excreted through the urine For type 2

Question 30

Contraindications of SGLT 2 Inhibitors

Answer 30

DKA Severe renal impairment 2nd or 3rd trimester of pregnancy

Question 31

Adverse effects of SGLT 2 inhibitors

Answer 31

Dehydration or hypotension UTI's or fungal infections DKA Canagflozin: Loss of bone density and fractures Lower limb amputation

Question 32

What drugs are thiazolidinediones?

Answer 32

Pioglitazone Rosiglitazone - glitazone

Question 33

How do thiazolidinediones work?

Answer 33

Increase insulin sensitivity in body Decrease insulin resistance For type 2

Question 34

Contraindications of thiazolidinediones

Answer 34

Moderate or severe heart failure Caution: Monitor liver

Question 35

Adverse effects of thiazolidinediones

Answer 35

Upper resp infections Headaches, muscle pains Increased cholesterol Rare: Hepatic injury Rapid weight gain and edema due to fluid retention

Question 36

Examples of Human Amylin

Answer 36

Pramlintide

Question 37

How does human amylin things work?

Answer 37

Slows gastric emptying Suppress glucagon secretion from liver Regulates food intake by modulating appetite For type 1 and 2

Question 38

Contraindications of human amylin things

Answer 38

Gastroparesis Cautions: Insulin dosing should be decreased when starting

Question 39

Adverse effects of human amylin things

Answer 39

NV Anorexia Headache Injection site reactions Severe hypoglycemia

Question 40

Drug interactions of human amylin things

Answer 40

Pramlintide and insulin or other antidiabetic meds Absorption of oral meds may be inhibited Gastric slowing meds (Opioids)

Question 41

What drugs are GLP1 Agonists?

Answer 41

Dulaglutide Exenatide Liraglutide Lixisenatide Semaglutide -glutide except Lixisenatide

Question 42

How do GLP1 agonists work?

Answer 42

Increase insulin release Decrease glucagon release Slow GI emptying Used for type 2 Can be used for CV events in ppl with type 2

Question 43

Contraindications effects of GLP 1 agonists

Answer 43

Liraglutide and semaglutide: Boxed warning for risk of thyroid C cell tumors in animals Type 1 diabetes or DKA Pregnancy or lactating

Question 44

What are examples of glucose elevating agents?

Answer 44

Dasiglucagon Diazoxide Glucagon

Question 45

How do glucose elevating agents work?

Answer 45

Increase blood glucose by decreasing insulin release and accelerating breakdown of glycogen in liver to release glucose Can be used for treatment of hypoglycemia

Question 46

Contraindications of glucose elevating agents

Answer 46

Diazoxide: Known allergy to sulfonamides or thiazides ; pregnancy Caution: Hepatic dysfunction or CV disease

Question 47

Adverse effects of glucose elevating agents

Answer 47

Glucagon and dasiglucagon: GI upset, NV Diazoxide: Vascular effects

Question 48

Drug interactions of glucose elevating agents

Answer 48

Diazoxide: Thiazide Diuretics Glucagon and dasiglucagon: Oral anticoagulants

Question 49

Adverse effects of GLP1 agonists

Answer 49

Pancreatitis GI effects