PC707 MOD8 EXAM STUDY GUIDE 2024

type 1 DM autoimmune, beta cell destruction, 30yrs old onset, weight loss, polyuria/dyspia/phagia, ketoacidosis. needs insulin type 2 DM life-style related, stress, exercise, reduced insulin sensitivity Rapid acting Humalog, Novolog 5-15min onset 0.75-3 hours peak 3-5 hours duration short acting Humulin R, Novolin R onset 15-30min peak 2-4 hours duration 5-8 hours intermediate-acting insulin, NPH Humulin N, Novolin N onset 1-2 hours peak 4-12 ours duration 18-24 hours long acting insulin 1-2/day Glargine Lantus, Detemir Levemir onset 1-2 hours peak 4-8 hours duration 24 hours Intermediate acting/combos novolog 70/30 humalog 75/25 humulin 70/30 novolin 70/30 What method of administering insulin is most accurate? pump, drug used is lispro. may cause DKA if malfunction Insulin inhaler BBW acute bronchospasm has been observed in pts with asthma and COPD using inhaled insulin. Gliptins/Dipeptidyl peptidase DPP4 inhibits insulin release, reduce glucagon release, decrease hepatic glucose production Metformin MOA inhibits glucose production in liver, reduce absorption in gut, sensitized insulin receptors on targe tissues to increase glucose uptake. Does metformin drive down blood sugars? no, little risk of hypoglycemia metformin BBW lactic acidosis with severe renal impairment how to take metformin? take with meals, dc before surgery or IV contrast 48 hours, avoid etho, GI issues resovle in 3 months, contra if GFR 30 metformin d2d metformin and cimetidine (tagamet) Sulfonylureas 1st and 2nd gen 1st, not used as often 2nd, greater potency, less d2d requirements of sulfonylureas requires working beta cells, as DM progresses, it is less effective Sulfonylureas SE hypoglycemia, caution w/elderly, stop before starting insulin, nausea, skin rash, abnormal liver fx, weight gain. sulfonylureas d2d etho- enhance etho toxcicity abx-potentiate hypoglycemia bbl-mask hypoglycemia ophthalmic Dipeptidyl peptidase 4 DPP4 gliptins ex.