NSG6005 FINAL EXAM 2 REVISION
HANDBOOK 2026 CLINICAL DECISION
MAKING AND CARE MANAGEMENT
◉ Dipeptidyl Peptidase-4 Inhibitors MOA.
Answer: DDP-4 is an enzyme that inactivate incretin hormones. So,
by inhibiting this enzyme, sitagliptin enhances the activity of
incretins, stimulate release of insulin from pancreatic B cells,
decrease hepatic glucose production
◉ Dipeptidyl Peptidase-4 Inhibitors Adverse effects.
Answer: -Upper respiratory infection
-Headache and inflammation of nasal passages and throat
-Pancreatitis
-hypersensitivity reactions
◉ Sodium Glucose Co-Transporter-2 (SGLT2) Inhibitors.
Answer: Canagliflozin
Dapagliflozin
Empagliflozin
◉ Sodium Glucose Co-Transporter-2 (SGLT2) Inhibitors.
,Answer: - SGLT2 is expressed in the proximal renal tubules which is
responsible for the majority of the reabsorption of filtered glucose
from the tubular lumen. By inhibiting SGLT2, these agents reduce
reabsorption of filtered glucose, which increase urinary glucose
excretion.
◉ Sodium Glucose Co-Transporter-2 (SGLT2) Inhibitors adverse
effects.
Answer: UTI, genitalia fungal infections, increased urination, weight
loss. Hypotension and dizziness when used concurrently with
diuretics.
◉ Which diabetic medication(s) is beneficial for patients with heart
failure?.
Answer: SGLT-2 inhibitors 2/2 diuretic effect.
◉ Glucagon-like peptide 1 (GLP-1).
Answer: semaglutide, dulaglutide
◉ Glucagon-like peptide 1 (GLP-1) MOA.
Answer: Mimic and augment the effects of the incretin hormones
GLP-1. Slow gastric emptying, stimulate glucose dependent release
of insulin, suppress appetite, inhibit post meal release of glucagon
from liver, induce weight loss.
, ◉ Glucagon-like peptide 1 (GLP-1) adverse effects and
contraindications.
Answer: Pancreatitis, renal impairment, thyroid tumors, fetal harm.
Contraindicated for pregnant patients, those with renal impairment
or history of pancreatitis or endocrine tumors.
◉ How do we treat hypothyroidism in infants?.
Answer: Treat with levothyroxine for 3years. Cessation of
replacement therapy for 4 weeks- if TSH rises, thyroid hormone
production is low so we continue replacement therapy; if TSH
decreases, we know the hypothyroidism is transient and we can stop
replacement therapy.
◉ Lvothyroxine MOA.
Answer: Synthetic levothyroxine is identical to naturally occurring
thyroid hormone.
◉ Levothyroxine administration.
Answer: Take on empty stomach, 30-60 minutes before breakfast.
Don't take with mineral supplements, PPI, or antacids.
◉ Levothyroxine monitoring.
Answer: TSH and T4 every 6 weeks until euthyroid then yearly.
HANDBOOK 2026 CLINICAL DECISION
MAKING AND CARE MANAGEMENT
◉ Dipeptidyl Peptidase-4 Inhibitors MOA.
Answer: DDP-4 is an enzyme that inactivate incretin hormones. So,
by inhibiting this enzyme, sitagliptin enhances the activity of
incretins, stimulate release of insulin from pancreatic B cells,
decrease hepatic glucose production
◉ Dipeptidyl Peptidase-4 Inhibitors Adverse effects.
Answer: -Upper respiratory infection
-Headache and inflammation of nasal passages and throat
-Pancreatitis
-hypersensitivity reactions
◉ Sodium Glucose Co-Transporter-2 (SGLT2) Inhibitors.
Answer: Canagliflozin
Dapagliflozin
Empagliflozin
◉ Sodium Glucose Co-Transporter-2 (SGLT2) Inhibitors.
,Answer: - SGLT2 is expressed in the proximal renal tubules which is
responsible for the majority of the reabsorption of filtered glucose
from the tubular lumen. By inhibiting SGLT2, these agents reduce
reabsorption of filtered glucose, which increase urinary glucose
excretion.
◉ Sodium Glucose Co-Transporter-2 (SGLT2) Inhibitors adverse
effects.
Answer: UTI, genitalia fungal infections, increased urination, weight
loss. Hypotension and dizziness when used concurrently with
diuretics.
◉ Which diabetic medication(s) is beneficial for patients with heart
failure?.
Answer: SGLT-2 inhibitors 2/2 diuretic effect.
◉ Glucagon-like peptide 1 (GLP-1).
Answer: semaglutide, dulaglutide
◉ Glucagon-like peptide 1 (GLP-1) MOA.
Answer: Mimic and augment the effects of the incretin hormones
GLP-1. Slow gastric emptying, stimulate glucose dependent release
of insulin, suppress appetite, inhibit post meal release of glucagon
from liver, induce weight loss.
, ◉ Glucagon-like peptide 1 (GLP-1) adverse effects and
contraindications.
Answer: Pancreatitis, renal impairment, thyroid tumors, fetal harm.
Contraindicated for pregnant patients, those with renal impairment
or history of pancreatitis or endocrine tumors.
◉ How do we treat hypothyroidism in infants?.
Answer: Treat with levothyroxine for 3years. Cessation of
replacement therapy for 4 weeks- if TSH rises, thyroid hormone
production is low so we continue replacement therapy; if TSH
decreases, we know the hypothyroidism is transient and we can stop
replacement therapy.
◉ Lvothyroxine MOA.
Answer: Synthetic levothyroxine is identical to naturally occurring
thyroid hormone.
◉ Levothyroxine administration.
Answer: Take on empty stomach, 30-60 minutes before breakfast.
Don't take with mineral supplements, PPI, or antacids.
◉ Levothyroxine monitoring.
Answer: TSH and T4 every 6 weeks until euthyroid then yearly.
