NR 293 EXAM 3 | COMPREHENSIVE PHARMACOLOGY STUDY GUIDE, PRACTICE
QUESTIONS & ANSWERS 2026/2027
Rapid acting insulin - ANS ✔✔- Onset: 15 minutes
- Peak: 1.5 hours
- Duration: 3 hours
- Ex: Lispro (Humalog), Aspart (Novolog), Guillotine (Apidra)
Short acting insulin - ANS ✔✔- Onset: 30 minutes
- Peak: 3 hours
- Duration: 6 hours
- Ex: Regular (Humulin R), Regular (Novolin R)
Intermediate acting insulin - ANS ✔✔- Onset: 60 minutes
- Peak: 6 hours
- Duration: 12 hours
- Ex: NPH (Humulin N), NRP (Novolin N)
Long acting insulin - ANS ✔✔- Onset: 120 minutes
- Duration: 24 hours
- Ex: Detemir (Levamir), Glargine (Lantus)
Therapeutic response anti-diabetic therapy - ANS ✔✔- fasting blood glucose 70-100 mg/dl
- hemoglobin A1c < 6.5%
Signs of low blood glucose - ANS ✔✔- < 70 mg/dl
- confusion
- irritability
- sweating
- give oral glucose (ie. apple juice, candy, etc)
Hemoglobin A1c - ANS ✔✔- % of blood glucose bound to hemoglobin
- when blood sugar is not controlled it builds up in the blood and binds to hemoglobin
- provides info on the average level of blood sugar control over the past 2-3 months
Hemoglobin - ANS ✔✔- oxygen carrying capacity of the blood cells
Hypoglycemia - ANS ✔✔- If patient becomes unconscious, give IV D50W (Dextrose 50% and water)
Glucagon IM - ANS ✔✔- used in emergency at HOME to treat hypoglycemia from insulin over dose
IV corticosterioids - ANS ✔✔- can increase glucose levels
Glucocorticoids - ANS ✔✔- secreted by adrenal glands
- Side effects: Edema, gastric irritation, hyperglycemia, osteoporosis
, Type 1 DM - ANS ✔✔- Pancreas not releasing insulin
- requires insulin therapy
Insulin therapy - ANS ✔✔- rotate inj sites to avoid scar tissue which can inhibit absorption
- when mixing insulin, draw up the 'clear' (ie. regular) into the syringe first
- long acting insulin ie. Detemier (Levemir) and Glargine (Lantus) CANNOT be mixed as the pH will change
and affect absorption rate.
- if a patient has both long acting and regular insulin ordered, do not mix. use two different syringes.
Basal dosing - ANS ✔✔- delivers constant dose of insulin
- done with intermediate or long acting insulin
- mimics body's 24-hour release of insulin
- regular insulin can be used for IV insulin drip
Bolus dosing - ANS ✔✔- based on carb counting
- administer 1-2 units of insulin for every 15g of carbs to be consumed in a meal to prevent blood
glucose spikes
Type 2 DM - ANS ✔✔- pancreas is releasing insulin but the body is not utilizing it properly
- oral medications and diet control
Oral anti-diabetic drugs: Biguanides - ANS ✔✔- Metformin (Glucophage)
- given to decrease production of glucose in the liver
Oral anti-diabetic drugs: Sulfonylurease - ANS ✔✔- "Glee Club"
- Glipizide (glucontrol)
- Glimepride (Amaryl) contraindicated with Repaglinide (Prandin) due to similar mechanism of action.
- Glyburide (Diabeta)
- take in the morning 30 min before breakfast
- Adverse effects: Hypoglycemia
Oral anti-diabetic drugs: Meglitinides - ANS ✔✔- Repaglinide (Prandin) contraindicated with Glimepride
(Amaryl) due to similar mechanism of action.
- rapidly decreased blood sugar
- taking medication and skipping a meal can lead to severe hypoglycemia
- give 15-30 min before meal or right before eating
Oral anti-diabetic drugs: Alpha Glucosidase inhibitors - ANS ✔✔- Ascarbose (Precose)
- Side effects: abdominal pain and discomfort, bloating, diarrhea, flatulence
- contraindicated with irritable bowel disease
Oral anti-diabetic drugs: Thiazolidinediones - ANS ✔✔- "Glitazones"
- Piaglitazone (Actos)
- worsens heart failure, including edema and cause URI
Oral anti-diabetic drugs: DPP-IV inhibitors - ANS ✔✔- "Gliptans"
- Sitaglipin (Januvia)
QUESTIONS & ANSWERS 2026/2027
Rapid acting insulin - ANS ✔✔- Onset: 15 minutes
- Peak: 1.5 hours
- Duration: 3 hours
- Ex: Lispro (Humalog), Aspart (Novolog), Guillotine (Apidra)
Short acting insulin - ANS ✔✔- Onset: 30 minutes
- Peak: 3 hours
- Duration: 6 hours
- Ex: Regular (Humulin R), Regular (Novolin R)
Intermediate acting insulin - ANS ✔✔- Onset: 60 minutes
- Peak: 6 hours
- Duration: 12 hours
- Ex: NPH (Humulin N), NRP (Novolin N)
Long acting insulin - ANS ✔✔- Onset: 120 minutes
- Duration: 24 hours
- Ex: Detemir (Levamir), Glargine (Lantus)
Therapeutic response anti-diabetic therapy - ANS ✔✔- fasting blood glucose 70-100 mg/dl
- hemoglobin A1c < 6.5%
Signs of low blood glucose - ANS ✔✔- < 70 mg/dl
- confusion
- irritability
- sweating
- give oral glucose (ie. apple juice, candy, etc)
Hemoglobin A1c - ANS ✔✔- % of blood glucose bound to hemoglobin
- when blood sugar is not controlled it builds up in the blood and binds to hemoglobin
- provides info on the average level of blood sugar control over the past 2-3 months
Hemoglobin - ANS ✔✔- oxygen carrying capacity of the blood cells
Hypoglycemia - ANS ✔✔- If patient becomes unconscious, give IV D50W (Dextrose 50% and water)
Glucagon IM - ANS ✔✔- used in emergency at HOME to treat hypoglycemia from insulin over dose
IV corticosterioids - ANS ✔✔- can increase glucose levels
Glucocorticoids - ANS ✔✔- secreted by adrenal glands
- Side effects: Edema, gastric irritation, hyperglycemia, osteoporosis
, Type 1 DM - ANS ✔✔- Pancreas not releasing insulin
- requires insulin therapy
Insulin therapy - ANS ✔✔- rotate inj sites to avoid scar tissue which can inhibit absorption
- when mixing insulin, draw up the 'clear' (ie. regular) into the syringe first
- long acting insulin ie. Detemier (Levemir) and Glargine (Lantus) CANNOT be mixed as the pH will change
and affect absorption rate.
- if a patient has both long acting and regular insulin ordered, do not mix. use two different syringes.
Basal dosing - ANS ✔✔- delivers constant dose of insulin
- done with intermediate or long acting insulin
- mimics body's 24-hour release of insulin
- regular insulin can be used for IV insulin drip
Bolus dosing - ANS ✔✔- based on carb counting
- administer 1-2 units of insulin for every 15g of carbs to be consumed in a meal to prevent blood
glucose spikes
Type 2 DM - ANS ✔✔- pancreas is releasing insulin but the body is not utilizing it properly
- oral medications and diet control
Oral anti-diabetic drugs: Biguanides - ANS ✔✔- Metformin (Glucophage)
- given to decrease production of glucose in the liver
Oral anti-diabetic drugs: Sulfonylurease - ANS ✔✔- "Glee Club"
- Glipizide (glucontrol)
- Glimepride (Amaryl) contraindicated with Repaglinide (Prandin) due to similar mechanism of action.
- Glyburide (Diabeta)
- take in the morning 30 min before breakfast
- Adverse effects: Hypoglycemia
Oral anti-diabetic drugs: Meglitinides - ANS ✔✔- Repaglinide (Prandin) contraindicated with Glimepride
(Amaryl) due to similar mechanism of action.
- rapidly decreased blood sugar
- taking medication and skipping a meal can lead to severe hypoglycemia
- give 15-30 min before meal or right before eating
Oral anti-diabetic drugs: Alpha Glucosidase inhibitors - ANS ✔✔- Ascarbose (Precose)
- Side effects: abdominal pain and discomfort, bloating, diarrhea, flatulence
- contraindicated with irritable bowel disease
Oral anti-diabetic drugs: Thiazolidinediones - ANS ✔✔- "Glitazones"
- Piaglitazone (Actos)
- worsens heart failure, including edema and cause URI
Oral anti-diabetic drugs: DPP-IV inhibitors - ANS ✔✔- "Gliptans"
- Sitaglipin (Januvia)
