Diabetes part II
Help!
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| What medications other than stimulants are used in the treatment of ADHD? | TCAs, bupropion, alpha 2 agonists (clonidine)
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| What are the 3 reasons for involuntary psych hospitalization? | 1. Danger to self
2. Danger to others
3. Gravely disabled (cannot care for self)
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| 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!
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| What skin finding can be a sign of having insulin resistance? | Acanthosis nigricans
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| Which diabetic medications should be avoided in pts with heart failure? | TZDs/glitazones
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| 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
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| 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
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| 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)
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| 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
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| What kind of insulin is suitable for use in pumps and DKA tx drips? | Regular or short acting (lispro, aspart, glulisine). HY!
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| NAME THAT DRUG!: decreases heaptic gluconeogenesis, increases insulin activity | Metformin
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| NAME THAT DRUG!: in the biguanide class | Metformin
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| NAME THAT DRUG!: lactic acidosis is a rare but serious SE | Metformin
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| NAME THAT DRUG!: stimulates insulin release which requires a functioning pancreas | Sulfonylureas
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| Name 3 classic sulfonylurea drugs. | Tolbutamide, glyburide, and glipizide
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| NAME THAT DRUG!: Decreases heaptic gluconeogenesis and increases tissue sensitivity to insulin | TZDs/glitazones
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| Name two classic TZD/glitazone drugs. | 1. Rosiglitazone
2. Pioglitazone
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| NAME THAT DRUG!: oral hypoglycemic that increases risk of MI | Rosiglitazone
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| NAME THAT DRUG!: should be avoided in pts with renal or liver failure | Metformin and sulfonylureas
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| 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*
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| NAME THAT DRUG!: cause fluid retention so should be avoided in heart failure pts | TZDs/glitazones (rosi and pio)
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| NAME THAT DRUG!: decreases GI absorption of starch and disaccharides; diarrhea and farting are common SE. Ewww! | alpha-glucosidase inhibitors (acarbose)
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| How do meglitinides (repaglinide, nateglinide) work? | Stimulate insulin release from beta cells (diff mech from sulfonylureas tho)
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| What are the most common SE of metformin? | GI disturbance: nausea, vomiting, diarrhea. Metformin should NOT cause hypoglycemia.
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| NAME THAT DRUG!: Oldest and cheapest of oral hypoglycemic agents? | Sulfonylureas
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| NAME THAT DRUG!: often used in combo with the other oral agents | Metformin
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| NAME THAT DRUG!: also helps lower triglycerides and LDL levels | metformin
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| NAME THAT DRUG!: should not be used in pts with IBD | acarbose/alpha-glucosidase inhibitor
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| NAME THAT DRUG!: hepatic serum transaminases should be carefully monitored while using these agents | metformin, TZDs
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| NAME THAT DRUG!: not assoc'd with weight gain; often used in overweight diabetics | metformin
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| NAME THAT DRUG!: metabolized by liver; excellent choice for pts with renal dz | TZDs
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| NAME THAT DRUG!: primarily affects postprandial hyperglycemia; taken with meals | acarbose/alpha-glucosidase inhibitor
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| 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*
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| 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.
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| NAME THAT DRUG!: stimulates insulin release | sulfonylurea and meglitinides
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| NAME THAT DRUG!: increases tissue glucose uptake and improves insulin sensitivity | TZDs
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| NAME THAT DRUG!: mimcs action of GLD-1 (dec glucagon, inc insulin, delays gastric emptying) | Exanatide and liraglutide
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| NAME THAT DRUG!: inhibits DPP-IV leading to dec glucagon, incr insulin, delayed gastric emptying | Sitagliptin and saxagliptin
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| NAME THAT DRUG!: An amylin analog which decreases glucagon and delays gastric emptying | Pramlintide
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