NR565 / NR 565 Advanced Pharmacology Fundamentals
Final Exam: Week 5, 6, 7 & 8
100% Guarantee Pass
1. Glucose Production & Release
Answer
All cells in the body need energy to function
• primarily comes from glucose; a type of sugar found in carbohydrates.
-between meals, glucose stores in the liver are released into the bloodstream
• ensures a constant source of energy for the body
-After a meal, carbohydrates are digested & release glucose into the bloodstream
2. Insulin Release in Type I Diabetes
Answer
As glucose levels in the blood rise, beta cells in the pancreas are stimulated to
release insulin
-Insulin halts the livers glucose release & initiates small amounts of glucose to be
stored in the liver for future use
-type 1 diabetes, pancreatic beta cells are damaged or destroyed
• damaged beta cells produce little to no insulin
Jo
sh
ua
,3. Systemic Insulin and Glucose in Type I Diabetes
Answer
Insulin & glucose travel through the bloodstream to reach cells throughout the
body
-Due to diminished insulin production, patients with type 1 diabetes have a low
insulin concentration & high glucose (sugar) concentration in their blood
4. Glucose Absorption in Type I Diabetes
Answer
Insulin is required for glucose to enter cells & be used as energy
-Once arriving at the intended cell, insulin binds to specialized receptors on the cell
surface
• initiates glucose transporters to open & glucose to flow into the cell
-type 1 diabetes, low levels of insulin prevent adequate amounts of glucose from
entering the cell
• Because glucose remains in the bloodstream & is not used by the cell as energy,
patients with type 1 diabetes may experience fatigue, exhaustion, & dizziness
5. Insulin Release in Type II Diabetes
Answer
As glucose levels in the blood rise, beta cells in the pancreas are stimulated to
release insulin
-insulin halts the livers glucose release & initiates small amounts of glucose to be
Jo
stored in the liver for future use
sh
ua
,-In type 2 diabetes, pancreatic beta cells become damaged or destroyed over time
• damaged beta cells produce little to no insulin.
6. Systemic Insulin and Glucose in Type II Diabetes
Answer
Insulin & glucose travel through the bloodstream to reach cells throughout the
body
-Insulin is required for glucose to enter cells & be used as energy
-In type 2 diabetes, insulin is not used properly & glucose remains in the bloodstream
• leads to high levels of glucose in the blood (hyperglycemia).
7. Glucose Absorption in Type II Diabetes
Answer
Once arriving at the intended cell, insulin binds to specialized receptors on the
cell surface
• initiates glucose transporters to open & glucose to flow into the cell
-type 2 diabetes, the body is resistant to the effects of insulin & does not properly
bind to insulin receptors
-Due to insulin resistance & resulting hyperglycemia, patients with type 2 diabetes
may experience increased thirst or hunger, fatigue, blurry vision, and slow-healing
wounds
8. Hypothyroidism
Answer
Jo
an underproduction of the hormone thyroxine (T4)
sh
ua
,-When the thyroid produces too little thyroxine
• body's metabolism slows down
• wide array of effects on the body
-Hypothyroidism can cause:
• fatigue
• depressed mood
• slow heart rate
• constipation
• weight gain
• irregular menstrual periods
-more common in women >60 & people who have a family hx of the condition
9. Hyperthyroidism
Answer
an overproduction of thyroid hormones: triiodothyronine (T3),
& thyroxine (T4)
-When the thyroid produces too much T3 & T4
• metabolism increases
• can cause a wide variety of symptoms:
£hand tremors
£rapid heart rate
£anxiety or irritability
£frequent bowel movements
£increased appetite
Jo
£weight loss
sh
ua
,£infrequent menstrual periods
£trouble sleeping
-more common in women & people who have a family hx of the condition
10. hpa:
Answer
hypothalamic-pituitary-adrenal axis
11. Diabetes Mellitus
Answer
complex chronic disease
-one of the top ten causes of death in the United States
-considered the leading cause of kidney failure, nontraumatic limb amputation, new
cases of adult blindness, heart disease, & stroke
12. 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.
Diabetes mellitus
Pre-diabetes
Jo
Answer
sh
ua
,: Diabetes mellitus
13. Fasting plasma glucose greater than or equal to 126 mg/dL.
*Fasting is defined as no caloric intake for at least 8 hours.
Diabetes mellitus
Pre-diabetes:
Answer
Diabetes mellitus
14. 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.
Diabetes mellitus
Pre-diabetes
Answer
: Diabetes mellitus
15. HgbA1c greater than or equal to 6.5%
Diabetes mellitus
Pre-diabetes
: Answer
Jo
sh
ua
,Diabetes mellitus
16. Fasting plasma glucose 100 to 125 mg/dL (IFG) or
Diabetes mellitus
Pre-diabetes:
Answer
Pre-diabetes
17. Plasma glucose 140 to 199 mg/dL (IGT) 2 hours post-ingestion of standard
glucose load (75 g) or
Diabetes mellitus
Pre-diabetes
Answer
: Pre-diabetes
19. HgbA1c 5.7% to 6.4%
Diabetes mellitus
Pre-diabetes:
Jo
Answer
sh
ua
,Pre-diabetes
20. Diabetes: Basic overview of Tx
Answer
Step 1
• lifestyle change
• Metformin
-Step 2
• continue step 1
• add a 2nd drug
-Step 3
• continue step 1
• progress to a 3-drug combination
-Step 4
• if step 3 includes basal insulin fails, combine injectable regimen with possibly a
GLP-1 receptor agonist
21. Diabetes: Drug classes used to Tx
Answer
Jo
sh
insulin preparations
ua
,-biguanides
-sulfonylureas
-meglitinides (glinides)
-thiazolidinediones (glitazones)
-a-glucosidase
-gliptins (dipeptidyl peptidase-4 inhibitors)
-sodium-glucose cotransporter 2 inhibitors
-glucagon-like peptide-1 receptor antagonists
22. Insulin
Answer
MOA
• anabolic
• energy conservation
• promotes cellular growth & division
-Baseline data
• random plasma glucose
• fasting plasma glucose
• A1C
• serum electrolytes
• urinary glucose & ketones
-Monitoring
• glucose levels
Jo
sh
• AIC (2-4x/year)
ua
, -Contraindications
• other meds that impact blood glucose
-AEs
• education on S/S of hyper & hypoglycemia
23. Biguanides (Metformin)
Answer
Metformin with lifestyle changes (diet & exercise) is
the first-line tx for diabetes
• decreases glucogenesis & insulin resistance
• Rarely causes hypoglycemia
• preferred for obese pts due to ability to promote weight loss
-contraindicated:
• pts with renal disease
• acidosis from hepatic disease
• alcoholics
• pts with hypoxia
-Laboratory monitoring:
• renal & hepatic function studies
-increased risk of lactic acidosis
• rare but life threatening
-IV contrast for imaging
• metformin should be held on the day of the procedure & for 48 hours afterward
Jo
sh
• Serum creatinine should be normal before resuming metformin
ua
10 /
76
Final Exam: Week 5, 6, 7 & 8
100% Guarantee Pass
1. Glucose Production & Release
Answer
All cells in the body need energy to function
• primarily comes from glucose; a type of sugar found in carbohydrates.
-between meals, glucose stores in the liver are released into the bloodstream
• ensures a constant source of energy for the body
-After a meal, carbohydrates are digested & release glucose into the bloodstream
2. Insulin Release in Type I Diabetes
Answer
As glucose levels in the blood rise, beta cells in the pancreas are stimulated to
release insulin
-Insulin halts the livers glucose release & initiates small amounts of glucose to be
stored in the liver for future use
-type 1 diabetes, pancreatic beta cells are damaged or destroyed
• damaged beta cells produce little to no insulin
Jo
sh
ua
,3. Systemic Insulin and Glucose in Type I Diabetes
Answer
Insulin & glucose travel through the bloodstream to reach cells throughout the
body
-Due to diminished insulin production, patients with type 1 diabetes have a low
insulin concentration & high glucose (sugar) concentration in their blood
4. Glucose Absorption in Type I Diabetes
Answer
Insulin is required for glucose to enter cells & be used as energy
-Once arriving at the intended cell, insulin binds to specialized receptors on the cell
surface
• initiates glucose transporters to open & glucose to flow into the cell
-type 1 diabetes, low levels of insulin prevent adequate amounts of glucose from
entering the cell
• Because glucose remains in the bloodstream & is not used by the cell as energy,
patients with type 1 diabetes may experience fatigue, exhaustion, & dizziness
5. Insulin Release in Type II Diabetes
Answer
As glucose levels in the blood rise, beta cells in the pancreas are stimulated to
release insulin
-insulin halts the livers glucose release & initiates small amounts of glucose to be
Jo
stored in the liver for future use
sh
ua
,-In type 2 diabetes, pancreatic beta cells become damaged or destroyed over time
• damaged beta cells produce little to no insulin.
6. Systemic Insulin and Glucose in Type II Diabetes
Answer
Insulin & glucose travel through the bloodstream to reach cells throughout the
body
-Insulin is required for glucose to enter cells & be used as energy
-In type 2 diabetes, insulin is not used properly & glucose remains in the bloodstream
• leads to high levels of glucose in the blood (hyperglycemia).
7. Glucose Absorption in Type II Diabetes
Answer
Once arriving at the intended cell, insulin binds to specialized receptors on the
cell surface
• initiates glucose transporters to open & glucose to flow into the cell
-type 2 diabetes, the body is resistant to the effects of insulin & does not properly
bind to insulin receptors
-Due to insulin resistance & resulting hyperglycemia, patients with type 2 diabetes
may experience increased thirst or hunger, fatigue, blurry vision, and slow-healing
wounds
8. Hypothyroidism
Answer
Jo
an underproduction of the hormone thyroxine (T4)
sh
ua
,-When the thyroid produces too little thyroxine
• body's metabolism slows down
• wide array of effects on the body
-Hypothyroidism can cause:
• fatigue
• depressed mood
• slow heart rate
• constipation
• weight gain
• irregular menstrual periods
-more common in women >60 & people who have a family hx of the condition
9. Hyperthyroidism
Answer
an overproduction of thyroid hormones: triiodothyronine (T3),
& thyroxine (T4)
-When the thyroid produces too much T3 & T4
• metabolism increases
• can cause a wide variety of symptoms:
£hand tremors
£rapid heart rate
£anxiety or irritability
£frequent bowel movements
£increased appetite
Jo
£weight loss
sh
ua
,£infrequent menstrual periods
£trouble sleeping
-more common in women & people who have a family hx of the condition
10. hpa:
Answer
hypothalamic-pituitary-adrenal axis
11. Diabetes Mellitus
Answer
complex chronic disease
-one of the top ten causes of death in the United States
-considered the leading cause of kidney failure, nontraumatic limb amputation, new
cases of adult blindness, heart disease, & stroke
12. 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.
Diabetes mellitus
Pre-diabetes
Jo
Answer
sh
ua
,: Diabetes mellitus
13. Fasting plasma glucose greater than or equal to 126 mg/dL.
*Fasting is defined as no caloric intake for at least 8 hours.
Diabetes mellitus
Pre-diabetes:
Answer
Diabetes mellitus
14. 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.
Diabetes mellitus
Pre-diabetes
Answer
: Diabetes mellitus
15. HgbA1c greater than or equal to 6.5%
Diabetes mellitus
Pre-diabetes
: Answer
Jo
sh
ua
,Diabetes mellitus
16. Fasting plasma glucose 100 to 125 mg/dL (IFG) or
Diabetes mellitus
Pre-diabetes:
Answer
Pre-diabetes
17. Plasma glucose 140 to 199 mg/dL (IGT) 2 hours post-ingestion of standard
glucose load (75 g) or
Diabetes mellitus
Pre-diabetes
Answer
: Pre-diabetes
19. HgbA1c 5.7% to 6.4%
Diabetes mellitus
Pre-diabetes:
Jo
Answer
sh
ua
,Pre-diabetes
20. Diabetes: Basic overview of Tx
Answer
Step 1
• lifestyle change
• Metformin
-Step 2
• continue step 1
• add a 2nd drug
-Step 3
• continue step 1
• progress to a 3-drug combination
-Step 4
• if step 3 includes basal insulin fails, combine injectable regimen with possibly a
GLP-1 receptor agonist
21. Diabetes: Drug classes used to Tx
Answer
Jo
sh
insulin preparations
ua
,-biguanides
-sulfonylureas
-meglitinides (glinides)
-thiazolidinediones (glitazones)
-a-glucosidase
-gliptins (dipeptidyl peptidase-4 inhibitors)
-sodium-glucose cotransporter 2 inhibitors
-glucagon-like peptide-1 receptor antagonists
22. Insulin
Answer
MOA
• anabolic
• energy conservation
• promotes cellular growth & division
-Baseline data
• random plasma glucose
• fasting plasma glucose
• A1C
• serum electrolytes
• urinary glucose & ketones
-Monitoring
• glucose levels
Jo
sh
• AIC (2-4x/year)
ua
, -Contraindications
• other meds that impact blood glucose
-AEs
• education on S/S of hyper & hypoglycemia
23. Biguanides (Metformin)
Answer
Metformin with lifestyle changes (diet & exercise) is
the first-line tx for diabetes
• decreases glucogenesis & insulin resistance
• Rarely causes hypoglycemia
• preferred for obese pts due to ability to promote weight loss
-contraindicated:
• pts with renal disease
• acidosis from hepatic disease
• alcoholics
• pts with hypoxia
-Laboratory monitoring:
• renal & hepatic function studies
-increased risk of lactic acidosis
• rare but life threatening
-IV contrast for imaging
• metformin should be held on the day of the procedure & for 48 hours afterward
Jo
sh
• Serum creatinine should be normal before resuming metformin
ua
10 /
76
