Inquire through: | Professional | Confidential Support
Pharm Exam 3 Verified and Updated
Questions and Answers (100% Correct
Answers)
Early Quinolones/Fluoroquinolones were better for _______, while later are better for
_____
Answer: Early agents (Cipro) were better for Gram -, later (Levaquin) better for Gram
+
Elevated glucose eats away at
Answer: vasculature
Microvasculature damage from DM:
Answer: Retinopathy (micro)
Neuropathy (micro)
Nephropathy (micro)
Macrovasculature damage from DM:
Answer: MI (macro)
CVA (macro)
CV death (macro)
Easier to show interventions in _____ events -->
Answer: the macrovascualr events are likely years down the road, "harder to show
reduction in macrovasculature"
DM: Acute issue we're trying to avoid
Answer: diabetic ketoacidosis which can be life threatening
If you have diabetes you are at risk for
Answer: heart disease, it almost equates to having a past cardiac event in terms of
risk factors
Monitor glucose with hemoglobin A1C
Answer: o Normal: <5.7% --> non diabetic
,Inquire through: | Professional | Confidential Support
o Prediabetes: 5.7%>x<low-mid 6’s%
o Diabetic: x> low-mid 6’s%
o Goal A1C for the average person is x<7% (this is just an example, it varies by
person)
T1DM
Answer: autoimmune --> body attacks cells in pancreas and those cells lose the
ability to make insulin
o Tx: give back the insulin
o Usually diagnosed in kids, seldom in teenagers
T2DM
Answer: insulin resistance, inability of receptos to recognize insulin, takes more
insulin than average to produced usual effect
o Usually Dx in adults
o Family Hx very strong predictor: 1st degree relative with T2DM --> reasonable
chance you'll grow into it
o More kids are being diagnosed with this now d/t sedentary lifestyle and diet
IDDM=
Answer: insulin dependent diabetes mellitus (but this can be misleading b/c T2DM
can also be insulin dependent)
Saying "insulin dependent diabetes" is the same as T1DM isn't totally accurate
because
Answer: patients with T2DM can "grow into" being dependent over time if the
disease gets bad enough
DM therapy depends on
Answer: the patient's goals, their other issues, their life expectancy
Role of Insulin Therapy
Answer: replace what body can't make enough of
,Inquire through: | Professional | Confidential Support
Source of Insulin Therapy
Answer: o we now use bacteria and human genes to reproduce it via bioengineering
(since 1980's), but we used to use porcine (pig) and bovine (cow) sources, pretty
much identical in animals and humans, not perfect but pretty good, however 2 issues
with using animal insulin...
- Rarely body would produce allergic reaction
- Body may trigger inactivating enzymes so that any dose would lose predictability so
we couldn't dose it
- This is solved by using human insulin, this is what we use now
Storage of Insulin Therapy
Answer: o insulin is a protein that will denature if not stored properly, leave in
fridge until opened then room temp once opened, good for 30 days out of the fridge
--> not guaranteed
efficacy after 30 days
- Usually use up the pens well before 30 days so this is rarely an issue
Administration of Insulin Therapy
Answer: o : SC, can be given continuous IV infusion if very ill, easy to administer SC
- Encourage abdomen b/c ease of access, readily absorbed and most consistent from
dose to dose because it isn't very vascular therefore there isn't a change in how much
blood is flowing to that area (and therefore how quickly the insulin is absorbed). Not
related to site of injection being close to gut/pancreas
- Can also use back of arm or leg
- Not well absorbed orally, there is research being
- It is a protein that is denatured in the gut
"Endocrine Effects":
Answer: Lowering blood glucose, weight gain
Acute elevation in blood sugar symptoms:
Answer: feel fatigued, increased thirst --> polyuria, increase in appetite, irritation at
injection site
, Inquire through: | Professional | Confidential Support
Extra glucose from the blood spills over into the
Answer: kidneys and acts as an osmotic diuretic
As a result of fatigue from excess glucose, we have an increase in
Answer: appetite because your cells don't have what they need --> giving insulin
corrects this and because you can't store sugars chronically you store them with
insulin replacement and therefore gain weight
Newly diagnosed T1DM patient is generally
Answer: relatively thin and otherwise healthy
The liver produces hepatic glucose in between meals to
Answer: keep our blood sugar levels, dependent on how much the pancreas tells it
to produce
Insulin pens can cost
Answer: 2x the vials d/t improved convenience and ease of use
In addition to the Rx for insulin you'll need an Rx for
Answer: glucagon and needles
The amount of insulin needed (dose) directly related to
Answer: the amount of carbohydrates
basal insulin (longer acting) works to address
Answer: hepatic glucose therefore their action is independent of meals
T1DM pts usually use a basal insulin ______day and a mealtime insulin _______
Answer: T1DM pts usually use a basal insulin 1-2x/day and a mealtime insulin as
needed (usually use a pump for the mealtime insulin)
T2DM patients usually start with a _______insulin
Answer: (like NPH or Lantus), if/when the disease advances we add on mealtime
insulin as needed
Example Question: A person is receiving mealtime and basal insulin, which two drugs
could they be taking?
Answer: (all below are correct)
o Humalog/Lantus
o Regular/Lantus
Pharm Exam 3 Verified and Updated
Questions and Answers (100% Correct
Answers)
Early Quinolones/Fluoroquinolones were better for _______, while later are better for
_____
Answer: Early agents (Cipro) were better for Gram -, later (Levaquin) better for Gram
+
Elevated glucose eats away at
Answer: vasculature
Microvasculature damage from DM:
Answer: Retinopathy (micro)
Neuropathy (micro)
Nephropathy (micro)
Macrovasculature damage from DM:
Answer: MI (macro)
CVA (macro)
CV death (macro)
Easier to show interventions in _____ events -->
Answer: the macrovascualr events are likely years down the road, "harder to show
reduction in macrovasculature"
DM: Acute issue we're trying to avoid
Answer: diabetic ketoacidosis which can be life threatening
If you have diabetes you are at risk for
Answer: heart disease, it almost equates to having a past cardiac event in terms of
risk factors
Monitor glucose with hemoglobin A1C
Answer: o Normal: <5.7% --> non diabetic
,Inquire through: | Professional | Confidential Support
o Prediabetes: 5.7%>x<low-mid 6’s%
o Diabetic: x> low-mid 6’s%
o Goal A1C for the average person is x<7% (this is just an example, it varies by
person)
T1DM
Answer: autoimmune --> body attacks cells in pancreas and those cells lose the
ability to make insulin
o Tx: give back the insulin
o Usually diagnosed in kids, seldom in teenagers
T2DM
Answer: insulin resistance, inability of receptos to recognize insulin, takes more
insulin than average to produced usual effect
o Usually Dx in adults
o Family Hx very strong predictor: 1st degree relative with T2DM --> reasonable
chance you'll grow into it
o More kids are being diagnosed with this now d/t sedentary lifestyle and diet
IDDM=
Answer: insulin dependent diabetes mellitus (but this can be misleading b/c T2DM
can also be insulin dependent)
Saying "insulin dependent diabetes" is the same as T1DM isn't totally accurate
because
Answer: patients with T2DM can "grow into" being dependent over time if the
disease gets bad enough
DM therapy depends on
Answer: the patient's goals, their other issues, their life expectancy
Role of Insulin Therapy
Answer: replace what body can't make enough of
,Inquire through: | Professional | Confidential Support
Source of Insulin Therapy
Answer: o we now use bacteria and human genes to reproduce it via bioengineering
(since 1980's), but we used to use porcine (pig) and bovine (cow) sources, pretty
much identical in animals and humans, not perfect but pretty good, however 2 issues
with using animal insulin...
- Rarely body would produce allergic reaction
- Body may trigger inactivating enzymes so that any dose would lose predictability so
we couldn't dose it
- This is solved by using human insulin, this is what we use now
Storage of Insulin Therapy
Answer: o insulin is a protein that will denature if not stored properly, leave in
fridge until opened then room temp once opened, good for 30 days out of the fridge
--> not guaranteed
efficacy after 30 days
- Usually use up the pens well before 30 days so this is rarely an issue
Administration of Insulin Therapy
Answer: o : SC, can be given continuous IV infusion if very ill, easy to administer SC
- Encourage abdomen b/c ease of access, readily absorbed and most consistent from
dose to dose because it isn't very vascular therefore there isn't a change in how much
blood is flowing to that area (and therefore how quickly the insulin is absorbed). Not
related to site of injection being close to gut/pancreas
- Can also use back of arm or leg
- Not well absorbed orally, there is research being
- It is a protein that is denatured in the gut
"Endocrine Effects":
Answer: Lowering blood glucose, weight gain
Acute elevation in blood sugar symptoms:
Answer: feel fatigued, increased thirst --> polyuria, increase in appetite, irritation at
injection site
, Inquire through: | Professional | Confidential Support
Extra glucose from the blood spills over into the
Answer: kidneys and acts as an osmotic diuretic
As a result of fatigue from excess glucose, we have an increase in
Answer: appetite because your cells don't have what they need --> giving insulin
corrects this and because you can't store sugars chronically you store them with
insulin replacement and therefore gain weight
Newly diagnosed T1DM patient is generally
Answer: relatively thin and otherwise healthy
The liver produces hepatic glucose in between meals to
Answer: keep our blood sugar levels, dependent on how much the pancreas tells it
to produce
Insulin pens can cost
Answer: 2x the vials d/t improved convenience and ease of use
In addition to the Rx for insulin you'll need an Rx for
Answer: glucagon and needles
The amount of insulin needed (dose) directly related to
Answer: the amount of carbohydrates
basal insulin (longer acting) works to address
Answer: hepatic glucose therefore their action is independent of meals
T1DM pts usually use a basal insulin ______day and a mealtime insulin _______
Answer: T1DM pts usually use a basal insulin 1-2x/day and a mealtime insulin as
needed (usually use a pump for the mealtime insulin)
T2DM patients usually start with a _______insulin
Answer: (like NPH or Lantus), if/when the disease advances we add on mealtime
insulin as needed
Example Question: A person is receiving mealtime and basal insulin, which two drugs
could they be taking?
Answer: (all below are correct)
o Humalog/Lantus
o Regular/Lantus
