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NR565 Week 5 Midterm Study Guide

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NR565 Week 5 Study Guide


Advanced Pharmacology Fundamentals (Chamberlain University)




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Week 5 Study Guide
Saturday, May 31, 2025 12:27 AM



Chapter 48- Drugs for Diabetes
Glycemic Goals in Type 2 Diabetes
• Goal:
○ Maintain blood glucose levels to prevent long-term complications like
nephropathy, retinopathy, neuropathy, and cardiovascular disease
• Target A1c:
○ Generally aim for an A1C of <7% for most adults, individualizing based on
patient characteristics. Less than 8% in patients with severe hypoglycemia
§ Some may have a less stringent target, especially elderly patients or
those with severe hypoglycemia risks.
§ The goal of therapy should be individualized based on patient-specific
factors, including the duration of diabetes, age, comorbid conditions,
and other risk factors.
• Fasting Plasma glucose:
○ Typically aim for 80-130 mg/dL
○ Diabetes may be diagnosed with a fasting plasma glucose of >126 and a
random plasma glucose of >200
• Postprandial glucose:
§ Aim for <180 mg/dL at 1-2 hours after meals
○ Patients with A1C greater than 10% and fasting blood glucose of 300 or more
may be started on combination injectable therapy immediately

Diabetic Nephropathy Prevention


1st generation vs 2nd generation Sulfonylurea
• 1st generation:
○ Examples: Tolbutamide, Chlorpropamide
○ Were the initial class of antidiabetic agents
○ These drugs work by promoting the release of insulin from pancreatic beta
cells, a mechanism that effectively lowers blood glucose levels
○ Require higher doses to achieve therapeutic effects
○ Less potent and have a higher risk of adverse effects
○ More likely to cause frequent and severe drug interactions
§ Especially drugs that are metabolized by the liver or excreted by the
kidneys--> leading to unpredictable effects on blood glucose levels.
• 2nd generation:
○ Examples: Glipizide, Glyburide, Glimepiride
○ More potent, require lower doses, and have few side effects
○ While both generations can cause hypoglycemia, second-generation
sulfonylureas are less likely to lead to severe hypoglycemic episodes when
used appropriately.
○ Generally have a longer duration of action, which provides more stable blood
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glucose control throughout the day.

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