1
NR565 Final Exam
Which diabetic medication(s) come with a concern of hypoglycemia? - ANSWER
Sulfonylureas
Examples: Glyburide, Glipizide, Glimepiride
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Mechanism: These drugs stimulate the pancreas to release insulin, regardless of blood
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glucose levels, which can lead to hypoglycemia, especially if meals are skipped, or if there
ail
is unexpected physical activity.
gm
Risk Factors: Elderly patients, those with renal impairment, or those taking higher doses
are at increased risk.
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o Meglitinides (Glinides):
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Examples: Repaglinide (Prandin), Nateglinide (Starlix)
hig
Mechanism: Similar to sulfonylureas, meglitinides stimulate rapid, short-acting insulin
release from the pancreas. They are taken before meals to cover postprandial glucose but
ing
can cause hypoglycemia if meals are delayed or missed.
fly
Risk Factors: Increased risk if not eating within the appropriate time frame after taking
the medication.
o Insulin:
, 2
Examples: Rapid-acting (Lispro, Aspart), Short-acting (Regular), Intermediate-acting
(NPH), Long-acting (Glargine, Detemir)
Mechanism: Insulin directly lowers blood glucose by promoting glucose uptake into cells.
Any form of insulin can cause hypoglycemia if the dose is too high, if there is a mismatch
between insulin administration and carbohydrate intake, or if physical activity increases
m
unexpectedly.
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Risk Factors: Poor coordination of insulin dosing with meals, changes in physical
ail
activity, or errors in insulin administration.
gm
Application to Basal Insulin: - ANSWER Basal Insulin: The basal insulin dose is
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calculated separately from the C
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Ratio and typically does not change based on carbohydrate intake.
hig
Basal insulin maintains consistent insulin levels throughout the day and night to manage
glucose production by the liver, not to cover the carbohydrates from meals.
ing
Calculating Basal Insulin:
fly
Basal insulin is often determined based on body weight, typically starting at 0.2 to 0.3
units per kilogram of body weight per day, or by adjusting based on fasting blood glucose
levels.
, 3
Appropriate hypothyroidism treatment regimen for adults? - ANSWER Lifelong
hormone replacement is needed.
Appropriate hypothyroidism treatment regimen for pregnancy? - ANSWER Should be
screened and treated as soon as possible and may require increased dosages for a period of
m
4-12 weeks.
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ail
Appropriate hypothyroidism treatment regimen infants? - ANSWER Hormone
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replacement therapy should last 3 years and then stop for 4 weeks to allow for follow-up
testing.
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he
At what time interval should the A1C be re-checked? - ANSWER · Routine
hig
Monitoring: For patients with stable glycemic control, A1C should be rechecked every 6
months.
ing
· Adjustment of Therapy: If therapy is being adjusted or if glycemic control is not at
fly
target, A1C should be rechecked every 3 months.
· New Diagnosis or Significant Changes: After the initiation of new therapies or
significant changes in treatment, checking A1C at 3-month intervals is appropriate to
assess the effectiveness of the intervention.
NR565 Final Exam
Which diabetic medication(s) come with a concern of hypoglycemia? - ANSWER
Sulfonylureas
Examples: Glyburide, Glipizide, Glimepiride
m
Mechanism: These drugs stimulate the pancreas to release insulin, regardless of blood
.co
glucose levels, which can lead to hypoglycemia, especially if meals are skipped, or if there
ail
is unexpected physical activity.
gm
Risk Factors: Elderly patients, those with renal impairment, or those taking higher doses
are at increased risk.
r@
o Meglitinides (Glinides):
he
Examples: Repaglinide (Prandin), Nateglinide (Starlix)
hig
Mechanism: Similar to sulfonylureas, meglitinides stimulate rapid, short-acting insulin
release from the pancreas. They are taken before meals to cover postprandial glucose but
ing
can cause hypoglycemia if meals are delayed or missed.
fly
Risk Factors: Increased risk if not eating within the appropriate time frame after taking
the medication.
o Insulin:
, 2
Examples: Rapid-acting (Lispro, Aspart), Short-acting (Regular), Intermediate-acting
(NPH), Long-acting (Glargine, Detemir)
Mechanism: Insulin directly lowers blood glucose by promoting glucose uptake into cells.
Any form of insulin can cause hypoglycemia if the dose is too high, if there is a mismatch
between insulin administration and carbohydrate intake, or if physical activity increases
m
unexpectedly.
.co
Risk Factors: Poor coordination of insulin dosing with meals, changes in physical
ail
activity, or errors in insulin administration.
gm
Application to Basal Insulin: - ANSWER Basal Insulin: The basal insulin dose is
r@
calculated separately from the C
he
Ratio and typically does not change based on carbohydrate intake.
hig
Basal insulin maintains consistent insulin levels throughout the day and night to manage
glucose production by the liver, not to cover the carbohydrates from meals.
ing
Calculating Basal Insulin:
fly
Basal insulin is often determined based on body weight, typically starting at 0.2 to 0.3
units per kilogram of body weight per day, or by adjusting based on fasting blood glucose
levels.
, 3
Appropriate hypothyroidism treatment regimen for adults? - ANSWER Lifelong
hormone replacement is needed.
Appropriate hypothyroidism treatment regimen for pregnancy? - ANSWER Should be
screened and treated as soon as possible and may require increased dosages for a period of
m
4-12 weeks.
.co
ail
Appropriate hypothyroidism treatment regimen infants? - ANSWER Hormone
gm
replacement therapy should last 3 years and then stop for 4 weeks to allow for follow-up
testing.
r@
he
At what time interval should the A1C be re-checked? - ANSWER · Routine
hig
Monitoring: For patients with stable glycemic control, A1C should be rechecked every 6
months.
ing
· Adjustment of Therapy: If therapy is being adjusted or if glycemic control is not at
fly
target, A1C should be rechecked every 3 months.
· New Diagnosis or Significant Changes: After the initiation of new therapies or
significant changes in treatment, checking A1C at 3-month intervals is appropriate to
assess the effectiveness of the intervention.
