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Pharm - Ch. 56

Drugs for Diabetes Mellitus

QuestionAnswer
What are the main differences between types of insulin? 1) time to be bioavailable, 2) duration of bioavailability, 3) intensity of action (how high insulin level peaks)
In Type 2 DM, first-line treatment involves ____ Therapeutic lifestyle changes
Ketoacidosis is seen in which type of DM? IDDM/Type 1
List some long-term complications of diabetes macrovascular disease (hypertension, stroke, heart disease), microvascular disease, nephropathy, neuropathy, amputations, impotence, gastroparesis, retinopathy
Type 2 can be treated using a stepwise approach. What is the order of treatment used for this method? Lifestyle changes -> one oral hypoglycemic drug -> two different PO drugs, -> oral drug + insulin -> insulin alone -> insulin + thiazolidinedione
True or false: short-duration insulin is separated into two categories True. Rapid acting and slower acting
Lispro is a short-duration, slower acting insulin False. Regular/natural insulin is short duration, slower acting. Lispro is RAPID acting
True or false: regular insulin is the only form given via IV True
What is an example of an intermediate duration insulin? NPH insulin
What is the name of the long duration insulin? Insulin glargine
Explain how Lispro acts faster than regular insulin In layman terms, regular insulin is somewhat sticky and can bind to itself. Lispro is a "less sticky" insulin, so instead of sticking to itself, it is more readily able to interact with insulin receptors
What sort of syringe is commonly used for insulin injections? U100
What is a major complication of insulin therapy? Hypoglycemia
How would you treat hypoglycemia? Provide oral carbohydrate, administer glucagon which will cause glycogen metabolism
List some HYPOglycemic agents that may interact with insulin therapy Sulonylureas, meglitinides, beta-blockers, alcohol. (Remember: beta blockers may conceal hypoglycemia)
HYPERglycemic agents include... thiazide diuretics, glucocorticoids, sympathomimetics
List a prototype of sulfonylureas Tolbutamide
List different types of oral hypoglycemics (unique to the diabetes chapter) Sulfoynylureas, thiazolidinediones, biguanides
What is the name of a thiazolidinedione? Rosiglitazone
What is the difference between tolbutamide and rosiglitazone? Tobutamide stimulates the release of insulin. Rosiglitazone increases insulin sensitivity and decreases insulin resistance
Tolbutamide has potential DDI with what kind of substance? Alcohol
Which oral hypoglycemic works better in lean patients? Tolbutamide
List the adverse effects of rosiglitzone Increase of edema and CV events
True or false: metformin often causes hypoglycemia False. Tends to not cause hypoglycemia
Metformin ____ glucose production Decreases
What are the SE of metformin? Lactic acidosis, GI distress
Which oral hypoglycemic is often given to obese patients? Biguanides/metformin
True or false: metformin can be used prophylactically for NIDDM True.
Diabetic ketoacidosis is a result of _____ __________ Insulin deficiency
List the treatments used for diabetic ketoacidosis Insulin replacement, bicarbonate for acidosis, water and sodium replacement, potassium replacement, stabilization of glucose levels
Why is DM difficult to control during pregnancy? Placenta-producing hormones antagonize insulin's actions. Cortisol production increases x3. Maternal hyperglycemia can stimulate fetal insulin secretion
What is gestational diabetes? DM that appears durin pregnancy then subsides rapidly after baby delivered
Created by: choel
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