Pharmacology 5334 Module 6 Test Questions
with Verified Answers
Complications of diabetes - Answers✓✓Hyperglycemia; ketoacidosis (only occurs with type I);
hypoglycemia (can occur from treatments)
Long-term complications of DM - Answers✓✓Macrovascular damage (heart disease, HTN,
stroke, hyperglycemia, altered lipid metabolism); microvascular damage (retinopathy;
nephropathy; sensory and motor neuropathy; gastroparesis; amputation secondary to infection;
ED in males)
Type 2 Diabetes treatment steps - Answers✓✓Step 1: lifestyle changes + metformin
Step 2: continue step 1 and add 2nd drug
Step 3 : step up to 3 drug combination (including metformin)
Step4: more complex insulin regimen
Target values for blood glucose - Answers✓✓70-130 mg/dL before meals; 100-140 mg/dL at
bedtime
Insulin Lispro (Humalog) - Answers✓✓Short-duration (3-5 hours), rapid acting (10-20 minutes);
analog of human insulin. Administered immediately before or after eating
Insulin Aspart (Novolog) - Answers✓✓Short-duration (3-6 hours), rapid acting (15-30 minutes
after subQ injection). Rapid-acting analog of regular insulin. Acts faster than regular insulin but
has a shorter duration of action. Should be injected 5-10 minutes before meals.
Insulin Glulisine (Apidra) - Answers✓✓Short-duration (3-5 hours), rapid acting (10-15 minutes).
Synthetic analog of natural human insulin. Should be administered close to the time of eating
Regular insulin (Humulin R, Novolin R) - Answers✓✓Short-duration, slower-acting insulin.
Unmodified human insulin. Routes: subQ, subQ infusion, IM, and oral. Effects begin in 30-60
minutes; peaks in 1-5 hours; duration up to 10 hours. CLEAR solution.
NPH Insulin (Humulin N, Novolin N) - Answers✓✓Intermediate-duration insulin. Injected 2-3
times daily to provide glycemic control between meals and during the night. Only one suitable
for mixing with short-acting. CLOUDY suspensions. Administered subQ.
Insulin Glargine (Lantus) - Answers✓✓Long-duration insulin. Modified human insulin.
Prolonged duration of action (up to 24 hours). Once-daily subQ. CLEAR solution - do not mix
with other insulins.
Insulin detemir (Levemir) - Answers✓✓Long-duration insulin. Human insulin analog. Slow
onset and dose-dependent duration of action. Used to provide basal glycemic control (NOT
given before meals to control post-prandial hyperglycemia). CLEAR, colorless solution. Dosing:
1-2 times daily by subQ. Do not mix with other insulins.
Afrezza - Answers✓✓Inhalation insulin. Used for mealtime insulin. Provides good glycemic
control with relatively low incidents of hypoglycemia. Little to no effect on the pulmonary
function, but can cause bronchospasm, so us with caution in patients with chronic lung disease.
Metformin - Answers✓✓Drug of choice for initial therapy in most patients with T2DM. Most
common side effects: GI disturbances; lactic acidosis (be cautious in patients with CKD).
Inhibits glucose production in the liver; reduces glucose absorption in the gut; sensitizes insulin
receptors in target tissues scubas fat and skeletal muscle and increases the glucose uptake and
response to whatever insulin is available. Drug interactions: alcohol, cimetidine, iodinated radio
contrast (d/c drug 2-3 days before dye)
Sulfonylureas - Answers✓✓First generation: Chlorpropamide, Tolbutamide
Second: Glimepiride, Glipizide, Glyburide.
Promote insulin release; only to be used for T2DM. Major side effects: hypoglycemia, weight
gain. Drug interactions: alcohol, NSAIDs, cimetidine, beta blockers
Meglitindies - Answers✓✓Repaglinide and Nateglinide. Same MOA as Sulfonylureas; stimulate
the pancreatic insulin release. Adverse effect: hypoglycemia. Drug interactions: gemfibrozil
Thiazolidinediones (Glitazones) - Answers✓✓Reduce glucose levels primarily by decreasing
insulin resistance; only indicated for T2DM (add-on to metformin). Rosiglitazone; pioglitazone.
Do not give to patients with HF.
Pioglitazone - Answers✓✓Reduces insulin resistance and may also decrease glucose production.
Adverse effects: URI, headache, sinusitis, and myalgia. Drug interactions: insulin; drugs that
induce or inhibit the CYP2C8 system
Alpha-glucosidase inhibitors - Answers✓✓Act in the intestine to delay the absorption of
carbohydrates. T2DM. Acarbose ADE: frequently causes flatulence, cramps, abdominal
distention, borborygmus, diarrhea, and liver dysfunction. Miglitol: especially effective in Latinos
and African Americans; ADE: flatulence, abdominal discomfort, and other GI effects.
DPP-4 inhibitors (gliptins) - Answers✓✓Promote glycemic control by enhancing the actions of
incretin hormones; stimulate glucose-dependent release of insulin; suppress postprandial release
of glucagon. Sitagliptin. Saxagliptin. Linagliptin. Alogliptin.
Sodium-glucose co-transporter 2 (SGLT-2) inhibitors - Answers✓✓Block reabsorption of
filtered glucose in the kidney, leading to glucosuria. Canaglifozin: ADE - genital fungal
infections in female patients, UTI, increased urination. Dapagliflozin: use in caution with loop
diuretics because of risk of dehydration and hypotension. Empalifozin. Ertugliflozin.
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