NU 578 UNIT 4 EXAM QUESTIONS
WITH CORRECT ANSWERS
Insulin Complications/ Drug Interactions - Answer-hypoglycemia caused by overdose.
hypoglycemic agents (sulfonylureas, glinides, and alcohol), hyperglycemia agents, b
adrenergic blocking agents.
Sitagliptin - Answer-DP4 inhibitor.
stimulates glucose dependent release of insulin and suppresses postprandial release of
glycogen. both actions help keep BG from climbing to ohhight. used for type 2 dm
AE: URI, headache, inflammation of nasal passages, pancreatitis, hypersensitivity
reactions.
Canagliflozin - Answer-SGC2 inhibitor
reduces reabsorption of glucose and increases urinary glucose excretion
AE: UTI, yeast infection, increased urination
DDI: uridine 5 diphospho glucuronosyltransferase inducers can decrease effects. when
used with diuretic can cause dehydration
How does insulin deficiency promote hyperglycemia - Answer-increased glycogenolysis,
increase glucomeogemesis, and reduced glucose utilization. Glycogenolysis generates
free glucose by breaking down glycogen.
Metformin SE - Answer-GI upset and acidosis.
don't use in patients with renal disease or liver disease. d/c before using iodinated radio
contrast media. wait 48 hours after to restart.
both blocks iodine incorporate into thyroid hormones. PTU block conversion of T3 and
T4 in aperiphery.
Methimazole - Answer-first line drug for hyperthyroidism. benefits derive from inhibiting
thyroid hormone synthesis. safer and more convenient than PTU, except when pregnant
or breastfeeding.
MOA:prevents iodine oxidation and prevents iodinated tyrosine from coupling.
Methomazole uses/ AE - Answer-graves disease, adjunct to radiation therapy, suppress
thyroid hormone synthesis to prepare for thyroid gland surgery, thyrotoxic crisis. used
long term in absence of surgery.
AE: hypothyroidism, not safe in first trimester of pregnancy.
, Insulin therapy dosing schedules - Answer-Twice daily premixed: twice daily regimen
can be used to provide basal and prandial insulin coverage. if given with breakfast and
dinner, no mealtime coverage
Intensive basal/bolus strategy: type 1 uses this. use of long acting insulin in addition to
short acting. short acting with meals.
Insulin Glargine (Lantus) - Answer-long acting insulin. used for adults and children with
type 1 or 2 dm. injected Dubq once daily at bedtime or twice daily at the same time each
day. WATCH FOR HYPOGLYCEMIA! don't give IV or mix with other insulins
Insulin Aspart (Novolog) - Answer-rapid acting. absorbed faster than human insulin,
rapid onset (0.1-0.3 hours) and shorter duration (3-5 hours). should be used with int or
long acting insulin. REDUCES POSTPRANDIAL HYPERGLYCEMIA.
5 ways to manage postprandial hyperglycemia - Answer-alpha glucosiasase inhibitors,
short acting insulin, rapid acting insulin, thiazolinediones, amylin analogs.
Rapid acting insulin - Answer-insulin lisper, insulin aspart, insulin glulisine, inhaled
human insulin (mealtime insulin product).
ALL CAN BE GIVEN RIGHT BEFORE EATING OR RIGHT AFTER
Regular insulin - Answer-short duration and short acting. (humbling, novolin).
unmodified human insulin. can be given IM, subs injection, or subs infusion. can be
injected before meals to control postprandial hyperglycemia, infused via insulin pump to
provide basal glycemic contro. effects begin 30-60 minutes and peak in 1-5 hours and
last up to 10 hours.
NPH insulin - Answer-intermediate duration insulin. prepared by combining regular
insulin with protamine. protamine delays absorption. not administered at mealtime.
injected twice or theree times daily to control in between meals.
Insulin detemir - Answer-long acting insulin with slow onset and dose dependent
duration of action. low doses effects persist for 12 hours and long doses for 20-24
hours.
Meglitinides (Glinides) - Answer-antidiabetic agents that stimulate pancreatic insulin
release. glinides are shorter acting and taken with each meal.
only two available: repaglinide and nateglinide
AE: hypoglycemia.
Treatment of Ketoacidosis - Answer-IV fluids, electrolytes, IV insulin slowly to maintain
BG levels. Bicarb for acidosis, potassium for hypokalemia.
WITH CORRECT ANSWERS
Insulin Complications/ Drug Interactions - Answer-hypoglycemia caused by overdose.
hypoglycemic agents (sulfonylureas, glinides, and alcohol), hyperglycemia agents, b
adrenergic blocking agents.
Sitagliptin - Answer-DP4 inhibitor.
stimulates glucose dependent release of insulin and suppresses postprandial release of
glycogen. both actions help keep BG from climbing to ohhight. used for type 2 dm
AE: URI, headache, inflammation of nasal passages, pancreatitis, hypersensitivity
reactions.
Canagliflozin - Answer-SGC2 inhibitor
reduces reabsorption of glucose and increases urinary glucose excretion
AE: UTI, yeast infection, increased urination
DDI: uridine 5 diphospho glucuronosyltransferase inducers can decrease effects. when
used with diuretic can cause dehydration
How does insulin deficiency promote hyperglycemia - Answer-increased glycogenolysis,
increase glucomeogemesis, and reduced glucose utilization. Glycogenolysis generates
free glucose by breaking down glycogen.
Metformin SE - Answer-GI upset and acidosis.
don't use in patients with renal disease or liver disease. d/c before using iodinated radio
contrast media. wait 48 hours after to restart.
both blocks iodine incorporate into thyroid hormones. PTU block conversion of T3 and
T4 in aperiphery.
Methimazole - Answer-first line drug for hyperthyroidism. benefits derive from inhibiting
thyroid hormone synthesis. safer and more convenient than PTU, except when pregnant
or breastfeeding.
MOA:prevents iodine oxidation and prevents iodinated tyrosine from coupling.
Methomazole uses/ AE - Answer-graves disease, adjunct to radiation therapy, suppress
thyroid hormone synthesis to prepare for thyroid gland surgery, thyrotoxic crisis. used
long term in absence of surgery.
AE: hypothyroidism, not safe in first trimester of pregnancy.
, Insulin therapy dosing schedules - Answer-Twice daily premixed: twice daily regimen
can be used to provide basal and prandial insulin coverage. if given with breakfast and
dinner, no mealtime coverage
Intensive basal/bolus strategy: type 1 uses this. use of long acting insulin in addition to
short acting. short acting with meals.
Insulin Glargine (Lantus) - Answer-long acting insulin. used for adults and children with
type 1 or 2 dm. injected Dubq once daily at bedtime or twice daily at the same time each
day. WATCH FOR HYPOGLYCEMIA! don't give IV or mix with other insulins
Insulin Aspart (Novolog) - Answer-rapid acting. absorbed faster than human insulin,
rapid onset (0.1-0.3 hours) and shorter duration (3-5 hours). should be used with int or
long acting insulin. REDUCES POSTPRANDIAL HYPERGLYCEMIA.
5 ways to manage postprandial hyperglycemia - Answer-alpha glucosiasase inhibitors,
short acting insulin, rapid acting insulin, thiazolinediones, amylin analogs.
Rapid acting insulin - Answer-insulin lisper, insulin aspart, insulin glulisine, inhaled
human insulin (mealtime insulin product).
ALL CAN BE GIVEN RIGHT BEFORE EATING OR RIGHT AFTER
Regular insulin - Answer-short duration and short acting. (humbling, novolin).
unmodified human insulin. can be given IM, subs injection, or subs infusion. can be
injected before meals to control postprandial hyperglycemia, infused via insulin pump to
provide basal glycemic contro. effects begin 30-60 minutes and peak in 1-5 hours and
last up to 10 hours.
NPH insulin - Answer-intermediate duration insulin. prepared by combining regular
insulin with protamine. protamine delays absorption. not administered at mealtime.
injected twice or theree times daily to control in between meals.
Insulin detemir - Answer-long acting insulin with slow onset and dose dependent
duration of action. low doses effects persist for 12 hours and long doses for 20-24
hours.
Meglitinides (Glinides) - Answer-antidiabetic agents that stimulate pancreatic insulin
release. glinides are shorter acting and taken with each meal.
only two available: repaglinide and nateglinide
AE: hypoglycemia.
Treatment of Ketoacidosis - Answer-IV fluids, electrolytes, IV insulin slowly to maintain
BG levels. Bicarb for acidosis, potassium for hypokalemia.
