FNP II NURS 5433 Final Exam University Of Texas - Arlington -
NURS 5433 MOST TESTED Questions With Complete Solutions
2026 | INSTANT PDF ACCESS
Management for Metabolic Syndrome
- Antihypertensives
- Statins
- ASA oer guidelines (not primary prevention)
- Possibly ACEIs and ARBs
What meds to avoid with Metabolic Syndrome
- Beta blockers - worsen IR and decrease glucose uptake by 25-37%
- The same effect for diuretics, so not drug of choice
Preferred initial treatment for T2DM
Metformin
*Long term use may be associated with vitamin b-12 deficiency (periodic
measurements should be considered)
Biguanides -- (Metformin)
- Generic/Brand names:
Glucophage, Glucophage XR, Fortamet, Glumetza
- Target organ: Liver, secondary effects on muscle and fat
- Primary physiological agents:
Decrease hepatic glucose production
Increase number of insulin receptors on muscle and fat cells
- A1C reduction 1.5-2%
- Time to reach max effect: 2-4 hrs
- Taken with meals
- Dosing:
500 mg BID with meals
,Increase by 500 mg every 1-3 wks
Most effective dose 2000 mg daily, max dose 2550 mg daily
Long acting: XR 500 mg daily, max dose 2000 mg daily
- Advantages:
Extensive experience, rare hypoglycemia, decreased CV events, relatively high A1c
efficacy
-SE: bloating, fullness, nausea, cramping, diarrhea, vitamin B12 deficiency,
headache, metallic taste, agitation, lactic acidosis
*Contraindications: DKA, alcoholism, binge drinking, kidney or liver disease (GFR <
30 mL.min), congestive HF, pregnancy, use of contrast media, surgery, heart
attack, age >80
T2DM: DPP-4 inhibitors
Sitagliptin (januvia) - 25 mg $420, 50 mg $413, 100 mg $410
Saxagliptin (Onglyza)
Linagliptin (Tradjenta) - 5mg $410
Alogliptin (Nesina) - 6.25 mg $356, 12.5 mg $411, 25 mg $356
T2DM: sodium glucose transporter 2 drugs (SGLT2)
- Generic/Brand names:
Canagliflozin (Invokana) 100-300 mg daily
Dapagliflozin (Farxiga) 5-10 mg q am
Empagliflozin (Jardiance) 10-25 mg q am
- Target organ: kidney
- Primary physiological agents:
Inhibits SGLT2
Reducing glucose reabsorption
,Increasing urinary glucose excretion
-SE: hyperkalemia, genital mycotic infection, increase cholesterol, increase
magnesium, hypoglycemia, UTI, increased urination, increased hemoglobin,
vulvovaginal pruritus, thirst, hypotension, constipation, fatigue, nausea, increased
creatinine, lower limb amputation risk, ketoacidosis, bone fractures
* contraindications: T1DM, DKA, dehydration, hypotension, elderly, hyperkalemia,
increased creatinine clearance
T2DM: Thiazolidinediones (TZDs)
- Generic/Brand names:
Pioglitazone (Actos) 15-45mg daily
Rosiglitazone (Avandia) 2-8 mg daily
- Target organ: muscle, fat, and liver
- Primary physiological agents: improve receptivity of insulin receptors, reduce
glucose production by liver
- A1C reduction - 0.5-1.5%
- Time to reach max effect: 6-8 wks
- Taken with or w/o food
- SE: swelling of legs, fluid retention, weight gain (URI, headaches, muscle aches,
tooth aches, sore throat in less than 1%)
* Contraindications - kidney or liver disease, enlarged heart, CHF, edema,
pregnancy
T2DM: Alpha-Glucosidase Inhibitors
- Generic/Brand names:
Precose (Acarbose)
Glyset (miglitol)
* Not used very often
, - Primary physiological agents: inhibits intestinal alpha-glucosidase
Slows intestinal carbohydrate digestion/reabsorption
- Target organ: intestine
- A1C reduction 0.7-1%
- Time to reach max effect: 1 hr
- Taken before meals with first bite of food
- SE: rare hypoglycemia, bloating, nausea, diarrhea, excess gas abd pain
* Contraindications - liver disease, bowel or intestinal disease, intestinal
obstruction
T2DM: Sulfonylureas
- Generic/Brand names:
1st gen - Tolbutamide (omase), Tolazamide (tolinase), Chlorpropamide
(Diabenese) * rarely used in the US anymore
2nd gen - Glyburide (micronase, diabeta, glynase), Glipizide (glucotrol, glucotrol
XL), Glimepiride (amaryl)
- Target organ: pancreas
- Primary physiological agents: Increase insulin release in pancreas
- A1C reduction 1-2%
- Taken with or w/o food
- Dosing: take 1-2 times a day or once with XL - may cause lows 30 min before
meal
- SE: HYPOGLYCEMIA, bloating, nausea, heartburn, anemia, weight gain, sun
sensitivity, metallic or change in taste 1-3%
*Contraindications - T1DM, advanced liver or kidney disease, sulfa allergy
NURS 5433 MOST TESTED Questions With Complete Solutions
2026 | INSTANT PDF ACCESS
Management for Metabolic Syndrome
- Antihypertensives
- Statins
- ASA oer guidelines (not primary prevention)
- Possibly ACEIs and ARBs
What meds to avoid with Metabolic Syndrome
- Beta blockers - worsen IR and decrease glucose uptake by 25-37%
- The same effect for diuretics, so not drug of choice
Preferred initial treatment for T2DM
Metformin
*Long term use may be associated with vitamin b-12 deficiency (periodic
measurements should be considered)
Biguanides -- (Metformin)
- Generic/Brand names:
Glucophage, Glucophage XR, Fortamet, Glumetza
- Target organ: Liver, secondary effects on muscle and fat
- Primary physiological agents:
Decrease hepatic glucose production
Increase number of insulin receptors on muscle and fat cells
- A1C reduction 1.5-2%
- Time to reach max effect: 2-4 hrs
- Taken with meals
- Dosing:
500 mg BID with meals
,Increase by 500 mg every 1-3 wks
Most effective dose 2000 mg daily, max dose 2550 mg daily
Long acting: XR 500 mg daily, max dose 2000 mg daily
- Advantages:
Extensive experience, rare hypoglycemia, decreased CV events, relatively high A1c
efficacy
-SE: bloating, fullness, nausea, cramping, diarrhea, vitamin B12 deficiency,
headache, metallic taste, agitation, lactic acidosis
*Contraindications: DKA, alcoholism, binge drinking, kidney or liver disease (GFR <
30 mL.min), congestive HF, pregnancy, use of contrast media, surgery, heart
attack, age >80
T2DM: DPP-4 inhibitors
Sitagliptin (januvia) - 25 mg $420, 50 mg $413, 100 mg $410
Saxagliptin (Onglyza)
Linagliptin (Tradjenta) - 5mg $410
Alogliptin (Nesina) - 6.25 mg $356, 12.5 mg $411, 25 mg $356
T2DM: sodium glucose transporter 2 drugs (SGLT2)
- Generic/Brand names:
Canagliflozin (Invokana) 100-300 mg daily
Dapagliflozin (Farxiga) 5-10 mg q am
Empagliflozin (Jardiance) 10-25 mg q am
- Target organ: kidney
- Primary physiological agents:
Inhibits SGLT2
Reducing glucose reabsorption
,Increasing urinary glucose excretion
-SE: hyperkalemia, genital mycotic infection, increase cholesterol, increase
magnesium, hypoglycemia, UTI, increased urination, increased hemoglobin,
vulvovaginal pruritus, thirst, hypotension, constipation, fatigue, nausea, increased
creatinine, lower limb amputation risk, ketoacidosis, bone fractures
* contraindications: T1DM, DKA, dehydration, hypotension, elderly, hyperkalemia,
increased creatinine clearance
T2DM: Thiazolidinediones (TZDs)
- Generic/Brand names:
Pioglitazone (Actos) 15-45mg daily
Rosiglitazone (Avandia) 2-8 mg daily
- Target organ: muscle, fat, and liver
- Primary physiological agents: improve receptivity of insulin receptors, reduce
glucose production by liver
- A1C reduction - 0.5-1.5%
- Time to reach max effect: 6-8 wks
- Taken with or w/o food
- SE: swelling of legs, fluid retention, weight gain (URI, headaches, muscle aches,
tooth aches, sore throat in less than 1%)
* Contraindications - kidney or liver disease, enlarged heart, CHF, edema,
pregnancy
T2DM: Alpha-Glucosidase Inhibitors
- Generic/Brand names:
Precose (Acarbose)
Glyset (miglitol)
* Not used very often
, - Primary physiological agents: inhibits intestinal alpha-glucosidase
Slows intestinal carbohydrate digestion/reabsorption
- Target organ: intestine
- A1C reduction 0.7-1%
- Time to reach max effect: 1 hr
- Taken before meals with first bite of food
- SE: rare hypoglycemia, bloating, nausea, diarrhea, excess gas abd pain
* Contraindications - liver disease, bowel or intestinal disease, intestinal
obstruction
T2DM: Sulfonylureas
- Generic/Brand names:
1st gen - Tolbutamide (omase), Tolazamide (tolinase), Chlorpropamide
(Diabenese) * rarely used in the US anymore
2nd gen - Glyburide (micronase, diabeta, glynase), Glipizide (glucotrol, glucotrol
XL), Glimepiride (amaryl)
- Target organ: pancreas
- Primary physiological agents: Increase insulin release in pancreas
- A1C reduction 1-2%
- Taken with or w/o food
- Dosing: take 1-2 times a day or once with XL - may cause lows 30 min before
meal
- SE: HYPOGLYCEMIA, bloating, nausea, heartburn, anemia, weight gain, sun
sensitivity, metallic or change in taste 1-3%
*Contraindications - T1DM, advanced liver or kidney disease, sulfa allergy
