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Pharmacology
Drugs for the Treatment of Diabetes Ch 18
| Question | Answer |
|---|---|
| Which pancreatic hormone promotes fuel mobilization? | Glucagon |
| Which pancreatic hormone promotes fuel storage? | Insulin |
| Why does insulin resistance develop? | because of prolonged hyperglycemia and resulting hyperinsulinemia |
| What is the cause of a “pooped out” or tired pancreas? | it results from a delay in insulin secretion and insulin resistance. |
| The criterion for a diagnosis of diabetes mellitus includes a hemoglobin A1C value of _________ or higher? | 6.5% or higher |
| What is the cause of Type I diabetes? | it results from autoimmune destruction of pancreatic beta cells |
| Why are more cases of type II diabetes being reported in persons younger than 20 years? | This is being attributed to a much more sedentary lifestyle, lack of exercise, and obesity. |
| What is considered first-line therapy for a patient with type 2 diabetes? | Diet and exercise first before drugs |
| More people are diagnosed with which type of diabetes in the United States? | Type II |
| Uncontrolled diabetes produces a pronounced susceptibility to what dental issue? | dental caries. |
| Why are uncontrolled diabetic patients more susceptible to dental caries? | This is caused mainly by decreased salivary flow related to fluid loss |
| Why are patients with uncontrolled or undiagnosed diabetes more prone to periodontal disease? | because of enhanced collagenase activity, changes in glucose tolerance factor, microangiopathy of the tissues, and altered polymorphonuclear leukocyte (PMN) function |
| Are patients with well-controlled diabetes more at risk for periodontal disease according to the Pharmacology textbook? | Although controversial, patients with well-controlled diabetes are still more prone to periodontal disease than the general public |
| When should oral surgical procedures should be performed in the diabetic patient? | 1.5 to 2 hours after the patient has eaten a normal breakfast and taken regular anti-diabetes medication |
| What is a systemic complication of diabetes that leads to reduced and sometimes absent feelings, especially in the lower extremities? | neuropathy |
| What can occur in the diabetic patient due to depressed immunity, less effective white blood cells, microvascular changes, and neuropathy? | gangrene in the peripheral extremities |
| What are some contributing factors to gangrene in the extremities of diabetic patients? | poor eyesight, poor circulation, and reduced sensation in the extremities |
| What is the major cause of blindness in adults? | Diabetes |
| What test more accurately measures the patient’s overall serum glucose control than the serum glucose test? | The glycosylated hemoglobin test |
| The primary goal of treating diabetes is to maintain hemoglobin A1c levels as close to normal as possible, which is what? | less than 7% |
| For every percentage point drop in hemoglobin A1C, the risk of microvascular complications decreases by what percentage? | 40% |
| How is insulin usually administered? | subcutaneous injection |
| What is the mechanism of action of the sulfonylureas? | stimulation of the release of insulin from the β cells of the pancreas, reduction of glucose from the liver, reduction in serum glucagon levels, and increase in the sensitivity of the target tissues to insulin |
| What type of medications can react with sulfonylureas to produce a decrease in serum glucose levels? | aspirin |
| Metformin (Glucophage) is a member of what group of drugs? | biguanide group |
| What is the mechanism of action of metformin? | It increases hepatic and peripheral insulin sensitivity, it lowers blood glucose but, used alone, does not produce hypoglycemia. |
| The biguanides, such as metformin, can cause what as it's most serious side effect? | lactic acidosis |
| Adverse reactions of metformin primarily occur where? | in the GI tract |
| What drug is an α-glucosidase inhibitor that slows the breakdown of ingested carbohydrates so that postprandial hyperglycemia is reduced? | Acarbose (Precose) |
| Which form of insulin has a faster onset of action as a consequence of exchanging two amino acids in the structure of human insulin? | Lispro insulin |
| The most common adverse reaction associated with any insulin product is what? | hypoglycemia |
| Which symptoms of hypoglycemia can be explained by glucose deprivation of the brain rather than the adrenal glands? | blurred vision and incoherent speech |
| What is the mechanism of action of nonsulfonylurea secretagogues such as repaglinide (Prandin) and nateglinide (Starlix)? | they bind to adenosine triphosphate (ATP)-sensitive potassium channels on beta cells and increase insulin resistance |
| What drug lowers blood glucose by slowing glucose absorption? | Acarbose |
| What drug can take up to 6 to 14 weeks to achieve maximal effect? | rosiglitazone (Avandia) |
| The U.S. FDA recommends checking what levels before starting therapy with thiazolidinediones and periodically thereafter? | serum alanine aminotransferase (ALT) levels |
| What drug is the first in a new class of drugs called incretin mimetics? | Exenatide (Byetta) |
| Exenatide (Byetta) will lower hemoglobin A1C levels by what percentage? | by 1 to 1.5% |
| What drug is approved for type I diabetes as an adjunct treatment and its use leads to decreased caloric intake and potential weight loss? | Pramlintide (Symlin) |
| What drug is a bile acid sequestrant that is used to decrease low-density lipoprotein (LDL) cholesterol? | Colesevelam (WelChol) |
| What is the treatment of hypoglycemia if the patient is unconscious and lacks a swallowing reflex? | intravenous dextrose (50%). |
Created by:
BrendaAlberts