Unit 2: Ch 60-61

Question 1

What is type 1 diabetes mellitus?

Answer 1

caused by the destruction of pancreatic beta cells
insulin-dependent
no insulin is produced

Question 2

What is type 2 diabetes mellitus?

Answer 2

impaired insulin secretion
causes insulin resistance
non-insulin-dependent

Question 3

What are the long-term complications of macrovascular damage?

Answer 3

damages large blood vessels
Cardiovascular disease
HTN
Stroke

Question 4

What are the long-term complications of microvascular damage?

Answer 4

damage to small blood vessels and capillaries
Nephropathy
Amputations

Question 5

What are the 3 tests to diagnose diabetes?

Answer 5

Fasting plasma glucose
Casual plasma glucose
Oral glucose tolerance

Question 6

What does Hemoglobin A1C test and at what level is diabetes diagnosed?

Answer 6

Reflects average plasma glucose for the previous 2-3 months
6.5 or higher is diagnostic of diabetes

Question 7

What is the goal of treatment for type 1 diabetes?

Answer 7

maintaining glucose levels within acceptable range
A1C<7

Question 8

What is the goal of treatment for type 2 diabetes?

Answer 8

maintaining glucose within acceptable range
A1C<7

Question 9

How is insulin activated to promote secretion?

Answer 9

activation of beta2 adrenergic receptors

Question 10

How is insulin activated to inhibit secretion?

Answer 10

activation of alpha-adrenergic receptors

Question 11

What is catabolic mode?

Answer 11

Happens when body is without insulin

Question 12

What are the short-duration, short-acting insulin?

Answer 12

Regular insulin

Question 13

What are the routes of administration for short-duration, short-acting insulin?

Answer 13

SQ injection
SQ infusion
IM injection
IV therapy

Question 14

What are the intermediate-duration insulins?

Answer 14

NPH insulin

Question 15

Can you mix NPH insulin with short-acting insulins?

Answer 15

Yes

Question 16

What needs to be done with NPH insulins before administration?

Answer 16

agitate the bottle (roll gently between palms)

Question 17

How is NPH insulin administered?

Answer 17

SQ injection

Question 18

What are the Long-Duration insulins?

Answer 18

Insulin glargine

Question 19

When should long-duration insulin be given?

Answer 19

Once daily
Usually at bedtime

Question 20

Can long-duration insulin be mixed with other insulins?

Answer 20

No

Question 21

When mixing insulins, which form of insulin should be drawn up first?

Answer 21

short acting insulin

Question 22

What are some complications of insulin use?

Answer 22

Hypoglycemia
Lipodystrophies
Allergic reaction

Question 23

What are oral anti-diabetic agents?

Answer 23

Used in addition to lifestyle changes

Question 24

What are the mechanisms of action for Metformin?

Answer 24

inhibits production of glucose by liver
slows absorption of glucose from intestines
sensitizes insulin receptors in fat and muscle which increases glucose uptake

Question 25

What are the therapeutic uses of Metformin?

Answer 25

glycemic control in type 2 diabetes

Question 26

What are the adverse effects of Metformin?

Answer 26

decreased appetite nausea diarrhea lactic acidosis

Question 27

What are the interactions of Metformin?

Answer 27

alcohol (can increase risk of lactic acidosis)

Question 28

What are the mechanisms of action of Sulfonylureas?

Answer 28

stimulates release of insulin from pancreatic islets- Beta Cells Long term use: may increase insulin receptor sensitivity

Question 29

What are the therapeutic uses of Sulfonylureas?

Answer 29

glycemic control of type 2 diabetes

Question 30

What are the adverse effects of Sulfonylureas?

Answer 30

hypoglycemia weight gain increased risk of hypoglycemia in pts with liver/renal impairement

Question 31

What are the interactions of Sulfonylureas?

Answer 31

Disulfiram- like reaction with alcohol (hangover symptoms)

Question 32

What are the characteristics of Diabetic Ketoacidosis (DKA) work?

Answer 32

Hyperglycemia Ketoacids Coma

Question 33

What is the treatment for DKA?

Answer 33

decrease blood glucose (give short acting insulin) correct dehydration normalize high potassium level

Question 34

What is Levothyroxine given for?

Answer 34

Hypothyroidism

Question 35

How does Levothyroxine work?

Answer 35

Converts to T3 hormone

Question 36

What are the therapeutic uses of Levothyroxine?

Answer 36

Treats all forms of hypothyroidism no matter the cause

Question 37

What are the adverse effects of Levothyroxine?

Answer 37

Tachycardia Angina Tremors

Question 38

When should Levothyroxine be taken?

Answer 38

Taken in the morning on an empty stomach 30-60mins before breakfast

Question 39

What are some interactions of Levothyroxine?

Answer 39

reduce absorption or accelerate metabolism enhances warfarin affects increase response of heart to catecholamines

Question 40

What is Propylthiouracil (PTU) given for?

Answer 40

Hyperthyroidism

Question 41

How does Propylthiouracil (PTU) work?

Answer 41

inhibits thyroid hormone synthesis

Question 42

What are the therapeutic uses of Propylthiouracil (PTU)?

Answer 42

Grave's disease adjunct to radiation therapy thyroid surgery thyrotoxic crisis

Question 43

What are the adverse effects of Propythiouracil (PTU)?

Answer 43

agranulocytosis (rare) liver injury hypothyroidism neonatal hypothyroidism