NR 565 FINAL EXAM STUDY GUIDE FROM
WEEK 5-8
ADVANCED PHARMACOLOGY
FUDAMENTALS.
A COMPREHENSIVE STUDY GUIDE WITH
100% VERIFIED ANSWERS.
UPDATED VERSION 2026/2027
u
,NR 565 FINAL EXAM STUDY GUIDE FROM WEEK 5-8
ADVANCED PHARMACOLOGY FUDAMENTALS.
A COMPREHENSIVE STUDY GUIDE WITH 100% VERIFIED
ANSWERS.
UPDATED VERSION 2026/2027
Diabetes Mellitus
▪ Leading cause of kidney failure, nontraumatic limb amputation, new cases of adult
blindness, heart disease and stroke.
▪ Acute symptoms of diabetes plus casual plasma glucose concentration greater than or
equal to 200 mg/dL.
▪ Casual is defined as any time of day without regard to time since last meal. The classic
symptoms of diabetes are polyuria, polydipsia, and unexplained weight loss.
▪ 2 hour post-load plasma glucose in an oral glucose tolerance test greater than or equal to
200 mg/dL. The test uses a glucose load containing the equivalent of 75 g anhydrous
glucose dissolved in water.
▪ HgbA1C greater than or equal to 6.5%
▪ Fasting plasma glucose greater than or equal to 126 mg/dL.
▪ Fasting is defined as no caloric intake for at least 8 hours
Pre Diabetes
▪ Fasting plasma glucose 100 to 125 mg/dL (IFG) or
▪ HgbA1c 5.7% to 6.4%
▪ Plasma glucose 140 to 199 mg/dL (IGT) 2 hours post-ingestion of standard glucose load
(75 g)
Criteria for diagnosis
▪ FPG > or = to 126
▪ Oral glucose tolerance test (OGTT) 2hr plasma glucose > or = t0 200
▪ Random Plasma glucose > or = to 200mg/dL plus DM symptoms
▪ HgbA1C 6.5% or higher
Treatment
▪ Step 1Lifestyle change and metformin
▪ Step 2 Continue step 1 and add second drug
▪ Step 3 continue step one and progress to 3 drug combination
▪ If step 3 includes basal insulin falls, combine injectable regimen with possibly a GLP-1
receptor agonist
Insulin
▪ MOA: Anabolic, energy conservation, promotes cellular growth and division
▪ Baseline data: random plasma glucose, urinate glucose and ketones, A1c, serum
electrolyte
▪ Monitor glucose lever and A1c every 2-4 times per year (every 3 month max)
▪ CI: medication that impact blood glucose (sulfanuria and steroids)
▪ SE: educate s/s of hypo and hyperglycemia
Insulin lisipro Regular insulin Humulin N and Lantus Insulin
Rapid: Humalog Humulin R, Novolin N x(insulin xdegludec
Novolin R: short (NPH): xglargine) x(Tresiba)
acting intermediate xUltralong
xacting
Do w n lo a de d b y xcharles xnguyo (c ng uy o @ gm ail.com)
onset 15-30min 3 0- 60 min 6 0- 1 2 0 m in 70min 30-
, NR 565 FINAL EXAM STUDY GUIDE FROM WEEK 5-8
ADVANCED PHARMACOLOGY FUDAMENTALS.
A COMPREHENSIVE STUDY GUIDE WITH 100% VERIFIED
ANSWERS.
UPDATED VERSION 2026/2027
90min
duration 3-6hrs 6-10hrs 12-24hrs 18-24hrs >24hrs
Biguanides: Metformin (max 2000mg/day)
▪ MOA: inhibits glucose production in liver, reduces glucose absorption in the gut,
synthesizes insulin receptor to increase glucose uptake
▪ Therapeutic use
Glycemic control, DM2 prevention, gestational DM, PCOS
▪ Side effect: decrease appetite, nausea, diarrhea, absorption of vitamin B12 and folate
(can cause spinal bafida and neural tubal defect if taken while pregnant)
▪ Black box: lactic acidosis (hemodialysis might be needed)
▪ Monitor renal function
Sulfonylureas
▪ MOA: stimulate insulin release from pancreatic islets
▪ Basic data: random plasma glucose, fasting plasma glucose, A1c, serum electrolyte, urine
ketone and glucose
▪ Monitoring: glucose level and A1c 2-4times/year
▪ CI: pregnancy, Brest feeding, renal dysfunction and hepatic dysfunction
▪ SE: educate s/s of hypoglycemia
Meglitinides (Glinides)
▪ MOA: same as sulfonylureas, stimulate pancreatic insulin release
▪ Baseline data: random plasma glucose, fasting plasma glucose, A1c, serum electrolye,
urine glucose and ketones
▪ monitoring : glucose level, A1C 2-4 times per year
▪ CI: liver impairment, gemfibrozil
▪ SE: education on ss of hypoglycemia
▪ If Sulfonylureas don't work this drug group also does not work
Thiazolidinediones (glitazones or TZDs)
▪ MOA: decrease insulin resistance
▪ Baseline: random plasma glucose, fasting plasma glucose, A1c, serum electrolytes,
urinary ketones and glucose
▪ Monitoring: glucose and A1c 2-4 times a year
▪ SE: Heart failure and educate ss of hypoglycemia
Sodium-glucose cotransporter 2 inhibitors
▪ MOA: limits reabsorption of glucose in the renal tubules
▪ Baseline data: random plasma glucose, fasting plasma glucose, A1c, serum electrolyte,
urine glucose and ketones
▪ Monitoring : glucose level, A1C 2-4 times per year
▪ CI: caution with vulvovaginal infection and UTI
▪ SE: dehydration and education on ss of hypoglycemia
Incretin hormone are gut peptide not present in type two DM
Dipeptidyl Peptidase – 4 inhibitors (Gliptins)
▪ MOA: enhance action of incretin hormones
Downloaded by charles nguyo ()
WEEK 5-8
ADVANCED PHARMACOLOGY
FUDAMENTALS.
A COMPREHENSIVE STUDY GUIDE WITH
100% VERIFIED ANSWERS.
UPDATED VERSION 2026/2027
u
,NR 565 FINAL EXAM STUDY GUIDE FROM WEEK 5-8
ADVANCED PHARMACOLOGY FUDAMENTALS.
A COMPREHENSIVE STUDY GUIDE WITH 100% VERIFIED
ANSWERS.
UPDATED VERSION 2026/2027
Diabetes Mellitus
▪ Leading cause of kidney failure, nontraumatic limb amputation, new cases of adult
blindness, heart disease and stroke.
▪ Acute symptoms of diabetes plus casual plasma glucose concentration greater than or
equal to 200 mg/dL.
▪ Casual is defined as any time of day without regard to time since last meal. The classic
symptoms of diabetes are polyuria, polydipsia, and unexplained weight loss.
▪ 2 hour post-load plasma glucose in an oral glucose tolerance test greater than or equal to
200 mg/dL. The test uses a glucose load containing the equivalent of 75 g anhydrous
glucose dissolved in water.
▪ HgbA1C greater than or equal to 6.5%
▪ Fasting plasma glucose greater than or equal to 126 mg/dL.
▪ Fasting is defined as no caloric intake for at least 8 hours
Pre Diabetes
▪ Fasting plasma glucose 100 to 125 mg/dL (IFG) or
▪ HgbA1c 5.7% to 6.4%
▪ Plasma glucose 140 to 199 mg/dL (IGT) 2 hours post-ingestion of standard glucose load
(75 g)
Criteria for diagnosis
▪ FPG > or = to 126
▪ Oral glucose tolerance test (OGTT) 2hr plasma glucose > or = t0 200
▪ Random Plasma glucose > or = to 200mg/dL plus DM symptoms
▪ HgbA1C 6.5% or higher
Treatment
▪ Step 1Lifestyle change and metformin
▪ Step 2 Continue step 1 and add second drug
▪ Step 3 continue step one and progress to 3 drug combination
▪ If step 3 includes basal insulin falls, combine injectable regimen with possibly a GLP-1
receptor agonist
Insulin
▪ MOA: Anabolic, energy conservation, promotes cellular growth and division
▪ Baseline data: random plasma glucose, urinate glucose and ketones, A1c, serum
electrolyte
▪ Monitor glucose lever and A1c every 2-4 times per year (every 3 month max)
▪ CI: medication that impact blood glucose (sulfanuria and steroids)
▪ SE: educate s/s of hypo and hyperglycemia
Insulin lisipro Regular insulin Humulin N and Lantus Insulin
Rapid: Humalog Humulin R, Novolin N x(insulin xdegludec
Novolin R: short (NPH): xglargine) x(Tresiba)
acting intermediate xUltralong
xacting
Do w n lo a de d b y xcharles xnguyo (c ng uy o @ gm ail.com)
onset 15-30min 3 0- 60 min 6 0- 1 2 0 m in 70min 30-
, NR 565 FINAL EXAM STUDY GUIDE FROM WEEK 5-8
ADVANCED PHARMACOLOGY FUDAMENTALS.
A COMPREHENSIVE STUDY GUIDE WITH 100% VERIFIED
ANSWERS.
UPDATED VERSION 2026/2027
90min
duration 3-6hrs 6-10hrs 12-24hrs 18-24hrs >24hrs
Biguanides: Metformin (max 2000mg/day)
▪ MOA: inhibits glucose production in liver, reduces glucose absorption in the gut,
synthesizes insulin receptor to increase glucose uptake
▪ Therapeutic use
Glycemic control, DM2 prevention, gestational DM, PCOS
▪ Side effect: decrease appetite, nausea, diarrhea, absorption of vitamin B12 and folate
(can cause spinal bafida and neural tubal defect if taken while pregnant)
▪ Black box: lactic acidosis (hemodialysis might be needed)
▪ Monitor renal function
Sulfonylureas
▪ MOA: stimulate insulin release from pancreatic islets
▪ Basic data: random plasma glucose, fasting plasma glucose, A1c, serum electrolyte, urine
ketone and glucose
▪ Monitoring: glucose level and A1c 2-4times/year
▪ CI: pregnancy, Brest feeding, renal dysfunction and hepatic dysfunction
▪ SE: educate s/s of hypoglycemia
Meglitinides (Glinides)
▪ MOA: same as sulfonylureas, stimulate pancreatic insulin release
▪ Baseline data: random plasma glucose, fasting plasma glucose, A1c, serum electrolye,
urine glucose and ketones
▪ monitoring : glucose level, A1C 2-4 times per year
▪ CI: liver impairment, gemfibrozil
▪ SE: education on ss of hypoglycemia
▪ If Sulfonylureas don't work this drug group also does not work
Thiazolidinediones (glitazones or TZDs)
▪ MOA: decrease insulin resistance
▪ Baseline: random plasma glucose, fasting plasma glucose, A1c, serum electrolytes,
urinary ketones and glucose
▪ Monitoring: glucose and A1c 2-4 times a year
▪ SE: Heart failure and educate ss of hypoglycemia
Sodium-glucose cotransporter 2 inhibitors
▪ MOA: limits reabsorption of glucose in the renal tubules
▪ Baseline data: random plasma glucose, fasting plasma glucose, A1c, serum electrolyte,
urine glucose and ketones
▪ Monitoring : glucose level, A1C 2-4 times per year
▪ CI: caution with vulvovaginal infection and UTI
▪ SE: dehydration and education on ss of hypoglycemia
Incretin hormone are gut peptide not present in type two DM
Dipeptidyl Peptidase – 4 inhibitors (Gliptins)
▪ MOA: enhance action of incretin hormones
Downloaded by charles nguyo ()
