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Endocrine 2 Diabetes

Diabetes part II

QuestionAnswer
What medications other than stimulants are used in the treatment of ADHD? TCAs, bupropion, alpha 2 agonists (clonidine)
What are the 3 reasons for involuntary psych hospitalization? 1. Danger to self 2. Danger to others 3. Gravely disabled (cannot care for self)
What is the psych condition in which a person travels a long distance, takes a new name, and has no memory of his prior life? Dissociative fugue (kinda like a FUGUtive!). HY!
What skin finding can be a sign of having insulin resistance? Acanthosis nigricans
Which diabetic medications should be avoided in pts with heart failure? TZDs/glitazones
A type 2 diabetic well-controlled on a regimen of metformin, piolglitazone, and glyburide is now developing some episodes of sweating, tachycardia, and confusion. These episodes resolve quickly if he eats something. Which med is causing his hypoglycemia? Glyburide
What is the initial 2-part therapy recommended for most type 2 diabetics? 1. Lifestyle changes (excercise, stop putting so much food in your mouth) 2. Metformin
At what point should a type 2 diabetic be considered for addition of a second drug to metformin? Name 2 drug classes commonly added. If Hgb A1c remains >7 after 2-3mos. Add a sulfonylurea and/or TZD (rosi, pio)
At what point should insulin be added to a type 2 diabetics regimen? If Hgb A1c remains >8.5 or if pt shows signs of decreased insulin production
What kind of insulin is suitable for use in pumps and DKA tx drips? Regular or short acting (lispro, aspart, glulisine). HY!
NAME THAT DRUG!: decreases heaptic gluconeogenesis, increases insulin activity Metformin
NAME THAT DRUG!: in the biguanide class Metformin
NAME THAT DRUG!: lactic acidosis is a rare but serious SE Metformin
NAME THAT DRUG!: stimulates insulin release which requires a functioning pancreas Sulfonylureas
Name 3 classic sulfonylurea drugs. Tolbutamide, glyburide, and glipizide
NAME THAT DRUG!: Decreases heaptic gluconeogenesis and increases tissue sensitivity to insulin TZDs/glitazones
Name two classic TZD/glitazone drugs. 1. Rosiglitazone 2. Pioglitazone
NAME THAT DRUG!: oral hypoglycemic that increases risk of MI Rosiglitazone
NAME THAT DRUG!: should be avoided in pts with renal or liver failure Metformin and sulfonylureas
Name 2 oral hypoglycemic drug classes that can cause hypoglycemia. 1. Sulfonylureas (tolbutamide, glyburide, and glipizide) 2. Meglitinides (repaglinide, nateglinide) *#2 is low yield, so just remember the glidy slidy drugs make your blood sugar slide down*
NAME THAT DRUG!: cause fluid retention so should be avoided in heart failure pts TZDs/glitazones (rosi and pio)
NAME THAT DRUG!: decreases GI absorption of starch and disaccharides; diarrhea and farting are common SE. Ewww! alpha-glucosidase inhibitors (acarbose)
How do meglitinides (repaglinide, nateglinide) work? Stimulate insulin release from beta cells (diff mech from sulfonylureas tho)
What are the most common SE of metformin? GI disturbance: nausea, vomiting, diarrhea. Metformin should NOT cause hypoglycemia.
NAME THAT DRUG!: Oldest and cheapest of oral hypoglycemic agents? Sulfonylureas
NAME THAT DRUG!: often used in combo with the other oral agents Metformin
NAME THAT DRUG!: also helps lower triglycerides and LDL levels metformin
NAME THAT DRUG!: should not be used in pts with IBD acarbose/alpha-glucosidase inhibitor
NAME THAT DRUG!: hepatic serum transaminases should be carefully monitored while using these agents metformin, TZDs
NAME THAT DRUG!: not assoc'd with weight gain; often used in overweight diabetics metformin
NAME THAT DRUG!: metabolized by liver; excellent choice for pts with renal dz TZDs
NAME THAT DRUG!: primarily affects postprandial hyperglycemia; taken with meals acarbose/alpha-glucosidase inhibitor
Name 5 criteria for the diagnosis of metabolic syndrome. 1. Abdominal obesity 2. Elev triglycerides 3. Low HDL 4. Elevated BP 5. Elevated fasting serum glucose *Must have 3 of 5 for dx*
You have a well-controlled DM II pt who needs a CT scan with IV contrast. What med is this pt likely on that must be temporarily held? Metformin. Hold 24h prior and 48h after.
NAME THAT DRUG!: stimulates insulin release sulfonylurea and meglitinides
NAME THAT DRUG!: increases tissue glucose uptake and improves insulin sensitivity TZDs
NAME THAT DRUG!: mimcs action of GLD-1 (dec glucagon, inc insulin, delays gastric emptying) Exanatide and liraglutide
NAME THAT DRUG!: inhibits DPP-IV leading to dec glucagon, incr insulin, delayed gastric emptying Sitagliptin and saxagliptin
NAME THAT DRUG!: An amylin analog which decreases glucagon and delays gastric emptying Pramlintide
Created by: sarah3148