PC707 Module 8 – Exam with 100% Verified and Updated Solutions

PC707 Module 8 – Exam with 100% Verified and Updated Solutions result of autoimmune induced pancreatic beta cell destruction with resulting insulin deficiency - answerWhat is Type 1 diabetes? genetically predetermined and environmentally modified condition Reduced tissue sensitivity to insulin - answerWhat is Type 2 diabetes? less than 5.7 - answerWhat is normal A1C? 5.7-6.4 - answerWhat A1C is pre-diabetic? Rapid acting short acting intermediate acting long acting intermediate acting/combination - answerWhat are the 5 common types of insulin preparations? Long acting Lantus - answerWhat type of insulin does not have a peak? hypoglycemia (profound or prolonged can result in seizures, LOC, brain damage and death) weight gain at risk for hypokalemia - answerWhat are the S/E of insulin? moderate control instead of tight control tight control is A1C <7 - answerWhat type of insulin control do you want with the elderly? first line drug for Type 2 DM PCOS Pre-DM in adults GDM - answerUses of Biguanides (metformin) decreases hepatic glucose production, decreasing intestinal absorption of glucose and improves insulin sensitivity (increases peripheral glucose uptake and utilization) - answerMOA of biguanides (metformin) a rare problem is lactic acidosis- serious lactic acid accumulation - answerWhat is the black box warning for the biguanide metformin? most common are GI (metallic taste in mouth, mild anorexia, nausea, abdominal discomfort, diarrhea) malaise myalgia respiratory distress somnolence abdominal distress - answerS/E of the biguanide metformin severe renal disease (eGFR < 30 ml) acute or chronic metabolic acidosis including diabetic ketoacidosis with or without coma hypersensitivity to metformin - answerContraindications of biguanide metformin tagamet- causing an increase in metformin blood levels sulfonylurea or insulin- can increase the risk of hypoglycemia can increase the risk of lactic acidosis in those with impaired renal function - answerWhat D2D interactions can you see with metformin? renal function (eGFR) prior to therapy initiation and at least annually- more often in patients at risk of developing renal impairment - answerWhat specific monitoring parameters are there with metformin before any radiologic procedure involving the administration of iodinated contrast material in the blood. May need to hold metformin for 48 hours after administration of IV contrast. Reevaluate eGFR in 48 hours, if stable restart metformin - answerWhat would be a reason to discontinue metformin? Serious lactic acid accumulation usually occurs only in the presence of a predisposing condition including Renal insufficiency Current liver disease or alcohol abuse heart failure past history of lactic acidosis severe infection with decreased tissue perfusion hypoxic states serious acute illness hemodynamic instability age 80 or older Increased risk associated with renal or hepatic impairment, aged 65 or older, having a radiological study with contrast, surgery, or other procedures, excessive alcohol intake - answerWhich patients are at increased risk of lactic acidosis? discontinue for 48 hours - answerWhat should you do if your patient is on metformin and has a procedure that uses contrast in the blood? yes, the sulfonamide component in the typical sulfa antibiotics is of a different molecular structure than that found in sulfonylureas - answerIf the patient is allergic to sulfa abs can they sulfonylureas? type 2 diabetes - answerUses for sulfonylureas binds to potassium channels in beta cells, stimulating the release one insulin from the pancreas and increase tissue sen