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142 Cards in this Set

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Which type of diabetes is juvenile (i.e. absolute insulin deficiency)

Type 1

What is another name for type 2 diabetes?

Relative diabetes

Answer choices: Hyper or Hypo glycemia


AE: dizziness, confusion, sweating, irritability, anxiety, nervous, lack of focus, weakness

Hypo

Which of the following is NOT a symptom of Hyper-glycemia?


nocturia, HA, thirst, confusion, blurred vision

confusion

If you have a pt who is fasting, what is their blood glucose parameter?

70-130 mg/dL

What is an ideal A1c for a fasting pt?

<7%

Insulin secretagogues means what?

to help pancrease make more insulin

Sulfonylurea agents are drugs that help the pancrease make more insulin


all the time or as glucose concentrations increase

All the time

What type of agents help the pancrease make more insulin as glucose concentrations increase?

Meglitinide agents

What type of agent is metformin?

Biguanide

What type of agents work on insulin resistance w/ musculoskeletal cells?

thiazolidinedione agents

What type of agents work to slow down glucose absorption after a meal?

Alpha-glucosidase inhibitors

Glitazones, avandia, and actos can all lead to what?

Edema (so be careful w/ CHF)

If you have a pt on a sulfonylurea or meglitinide agent, which type of diabetes is contraindicated? (type 1 or 2)

Type 1

What class of drugs may mask hypoglycemic warnings?

BB

What is a major class AE of sulfonylurea and meglitinide agents?

HypOglycemia

Matching time!


Regular glipizide


Regular glyburide


Meglitinides


Amaryl


Glucotrol XL
(match with: pre-meal, w/ meals, before or w/ a meal)



Regular glipizide - pre meal


Meglitinides- pre meal


Amaryl - w/ meals


Glucotrol XL- w/ meals


Regular glyburide- before or w/ a meal

Amaryl is?

Glimepiride

Glucotrol XL is?

glipizide XL

What is glyburide's name brand?

Micronase

Which of these should you take with your first main meal??


Glucotrol, Amaryl, or Micronase

Amaryl (glimepiride)

Which of these should you take (30 min) before a meal?


Glucotrol, Amaryl, or Micronase

Glucotrol

If a pt has renal/hepatic dysfunction, which of these drugs should you take precaution w/?


Glucotrol XL, Amaryl, Micronase

Micronase

Which of these should a pt take 30 minutes before food or with food?


Glucotrol XL, Amaryl, Micronase

Micronase

Who's dosage is this: 1-4 mg d


Glucotrol XL, Amaryl, Micronase

Amaryl

Who's dosage is this: 2.5-20 mg d


Glucotrol XL, Amaryl, Micronase

Glucotrol XL

Who's dosage is this: 2.5- 40 mg d on an empty stomach


Glipizide, Glimepiride, Glyburide

Glipizide

What is the dosing of Glyburide?

1.25- 20 mg d

Which of these works via the sulfonylurea receptor?


Glucotrol, Glipizide XL, Amaryl, Glyburide

Amaryl (Glimepiride)

If I say "If you don't eat, don't take the medication" which type of agent am I talking about?

Meglitinide agents

Meglitinide agents are indicated for what type of diabetes?

2

Name the two meglitinide agents (generic)

repaglinide and nateglitinide

What is repaglinide's name brand?

Prandin

What is nateglitinide's name brand?

Starlix

What is the dosing of Starlix?

60-120 mg tid ac

What is the dosing of Prandin?

0.5-4 mg tid ac

If I am counseling and say "You should take this 15 minutes before the meal, but you can take this immediately pre-meal" am I talking about repaglinide or nateglitinide?

Prandin (repaglinide)

T or F. If a pt doesn't eat lunch, they should skip their dose of Starlix.

True

T or F, if a pt doesn't eat dinner, they should skip their dose of Prandin.

true

What is sitagliptin's name brand?

Januvia

What exenatide's name brand?

Byetta

What is Glucophage's generic?

Metformin

What is Glucovance's generic?

glyburide/metformin

What is acarbose's name brand?

Precose

Which of these drugs works by mimicking incretin action (GLP-1 agonist), and increases glucose dependent insulin release?


Sitagliptin, Glucovance, Byetta, or Precose

Byetta

Which of these drugs works by DPP-IV inhibition (i.e. lowers glucose secretion) ?


Sitagliptin, Glucovance, Byetta, or Precose?

Sitagliptin

Which of these drugs works by acting as an alpha-flucosidase inhibitor?


Sitagliptin, Glucovance, Byetta, or Precose

Precose

What is the dosing regimine of sitagliptin?

100 mg d

Byetta is given IM or SubQ?

SubQ

What is the strength of exenatide?

5-10 mcg BID

Who's dosing is: 500-1000 mg Bid


Glucophage, Glucophage XL, Glucovance, or Precose

Glucophage

Who's dosing is: 500-2000 mg q pm (w/ evening meal)


Glucophage, Metformin XL, Acarbose, Precose, or Exenatide

Metformin XL

What is the dosing of Precose?

50-100 mg TID w/ a meal.

Do you take Glucovance with our without meals?

WITH

Which of these drugs requires a dosage adjustment if a pt has a decreased renal function (CrCL<50ml/min)?


Byetta, Glucophage, Glucovance, Januvia

Januvia

Give me the AE effect most associated w/ sitagliptin.

HA

If you have a pt using exenatide, you want to counsel them to administer their medication when?

before a meal, but within 60 min of the meal.

Which of these drugs should you store in the fridge?


Sitagliptin, Acarbose, Exenatide, or metformin

Exenatide

An AE of ______ (that should last ____) will be seen with Byetta.

Nausea and lasts the first 3 weeks

Which of these drugs should you titrate slowly?


Sitagliptin, Exenatide, Glucophage, Precose

Glucophage

What is the major AE of metformin use?

GI issues (like diarrhea, Nv)

How is metformin eliminated?

90% unchanged in the urine (renally)

T or F. You should take metformin WITH meals and avoid alcohol.

True

What are the two major AE of Precose?

Flatulence and diarrhea

T or F


If a pt skips a meal they should not skip their dose of Precose.

False. (if you skip a meal skip this dose too)

If I say Ghost tab, you should think what drug?

Metformin

T or F


Thiazolidinedione Agents work on insulin resistance.

True

T or F


A class contraindication for Thiazolidinedione agents is type 2 diabetes.

False. Type1

Avandia and Actos should not be used in class ___ & _____ CHF.

3 and 4

If you have a pt taking a thiazolidinedione agent, what would be a class AE to watch out for?

Edema/weight gain.

T or F


A pt taking a thiazolidinedione agent as a monotherapy agent would experience hypoglycemia.

False (key being monotherapy)

Lab monitoring is important w/ pts taking a thiazolidinedione agent.

Thats just a fact jack.

What is pioglitazone's name brand?

Actos

What is rosiglitazone's name brand?

Avandia

What is the dosing of Avandia?

4-8 mg d.

What is the dosing of Actos?

15-45 mg d

T or F


Actos and Avandia can be taken w/out regards to meals.

True

How often should you titrate Avandia?

every 3 months

How often should you titrate Actos?

Every 3 months

Avandia and Actos have a long or short onset of action?

Long

When taking insulin, corticosteroids will have what effect on insulin's action?

oppose it! (hyperglycemia)

Insulin + alcohol will result in hyper or hypo glycemia?

hypo

Humalog and Novolog are considered short or long acting?

short

T or F


If you have split-mixed insulin, you should gently roll it to ensure the right dose is given and it's uniformly cloudy.

True

Heating and freezing can denature insulin and it is no longer viable after ____ days out of the fridge

28

Humalog mix (75/25, 50/50) generic is?

insulin lispro/ protamine suspension

Humalog is insulin lispro or protamine suspension?

insulin lispro

Humulin comes in what strength (formulations)?

70/30 and50/50

Humulin generic is?

regular insulin/ isophane suspension

Which is isophane insulin suspension and which is regular human insulin?


(answer choices Humulin N and Humulin R)

N = isophane insulin suspension


R= regular human insulin (R for regular)

What is insulin glargine name brand?

Lantus

Insulin aspart is what?

Novolog

What is Novolog Mix and what is the only strength it comes in?

insulin aspart/protamine sulfate and 70/30

Insulin detemir's name brand is?

Levemir

Which of these should you gently mix before administration?


Humalog, Humulin R, Novolog, Humalog Mix, Levemir

Humalog Mix

Which of these is usually given bid before am and pm meals?


Novolog Mix or Humalog Mix

Both!

Which of these has a bi-phasic peak?


Humalog mix or humalog

Humalog mix

You should administer Humalog ___ minutes prior to eating.

15 min

You should administer Humalog Mix_____ minutes prior to am and pm meal.

15 min

Humalog usually peaks how quickly in the body?

w/in 90 minutes.

Humalog is usually cleared how quickly in the body?

w/in 4 hours

Which has the longest duration of action out of: Humulin 70/30, Humulin N, Humulin R

Humulin R

Which of these is generally bid (before am and pm meals), daily or bid, and generally pre-meals.


(Humulin 70/30, Humulin N, Humulin R)

70/30 = generally bid (am and pm meals)


R= generally pre-meals


N- daily or bid

In Humulin 70/30, which is the long acting % and what does the other part do?

70% = long acting and the 30% provides meal coverage

Which insulin is not given in relation to food?

Lantus (glargine)

When is Lantus usually administered?

Generally at bedtime

Lantus is usually given once daily, but they can give it BID when?

Only when burning upon administration due to high volume.

T or F


Lantus can be diluted or mixed with other insulins

FALSE FALSE GALSE

T or F.


You should counsel a pt who's using Lantus to give it at the SAME time every day.

True

Which is considered a "long-acting/basal insulin"?

Lantus and Levemir

T or F


Novolog is more rapid acting than regular insulin.

True

When counseling a pt using Novolog you want to tell them to administer the drug _____ minutes prior to meal.

10-15

Lantus is given IM or SQ?

SQ

Levemir is given IM or SQ?

SQ

You can dose Levemir how often?

Q12 hours

If you have a pt who's taking Levemir once daily,you should advise them to use it when?

PM or QHS

T or F


You can dilute or mix Levemir with another insulin.

FALSE GALSE FALSE GALSE

Which of these is not like the other due to onset time?


Aspart, Glulisine (Apidra), Humulin N, Lispro

Humulin N (2-4 hours)


The rest are 5-15 minutes

The onset time of Regular insulin (Humulin R and Novolin R) is?

30-60 minutes

T or F


Novolog, Apidra, and Humalog all have the same onset, peak, usual effective duration, max duration, and usual dosing frequency.

False. (only difference is max duration. Humalogs is 4-6 hours. The other two are 5-6 hours)

When do you dose Novolog, Apidra, and Humalog?

15 minutes before meals

Which of these drugs has a peak of 1-2 hours?


Humulin R, Levemir, Novolog, or Lantus

Novolog

Which of these has the fastest onset?


Humulin R, Levemir, Novolog, or Lantus

Novolog

Which of these has the slowest onset?


Humulin R, Levemir, Novolog, or Lantus

Lantus

Which of these is actually Peak-less?


Humulin R, Levemir, Apidra, Lantus, or Humalog

Lantus

What is the max duration of Humulin R (and Novolin R)?

6-8 hours

Which of these has a max duration of 14-18 hours?


Apidra, Novolin R, Humulin N, or Levemir

Humulin N

The onset time of Levemir is?

2 hours

Which drug has a peak of 2-3 hours?

Humulin R

Which drug has a peak of 6-10 hours?

Levemir

You would administer which of these 30 minutes before a meal?


Humulin R, Humulin N, Levemir, Lantus, or Novolog

Humulin R

The max duration of Levemir is?

24 hours

1 cc = ___ units

100

Most insulin vials are how many mLs?

10 mLs

There are how many pens per box (and how many mL per pen)

5 pens per box each containing 3 mL (so 15 mL per box)

T or F.


The larger the gauge the finer the needle.

True

If you have a pt who is hypotensive and crashing what gauge needle do you use?

22

A 3/10 cc syringe will hold how much insulin?

30 units

A 1/2 cc syringe will hold how much insulin?

50 units

IBW equation?

Males:


50 +2.3(Height in inches - 60)




Females


45.5 + 2.3 (height in inches - 60)

Cockcroft-Gault equation?

[(140-Age)*Wt (kg)]/ (Scr * 72)




For women multiply all that by 0.85

When do you use ABW vs IBW?

I still don't actually know. So ask somebody cuz I am.