3/29/25, 8:38
AM
NR566 MIDTERM EXAM QUESTIONS AND ANSWERS WITH COMPLETE
SOLUTIONS VERIFIED GRADED A++
Terms in this set (251)
-increases levels of digoxin
Albuterol -safe if children
-first line therapy
Bisphosphonates
-90 day half life
-preg cat B
Etidronate (Didronel) reduces bone reabsorption
TX: low bone density, d/t cystic fibrosis, pagets disease (monitor xrays and labs),
heterotropic ossification, hip replacement, spinal cord injury
CI: entercolitis
Biphosphonates
-10 yr. half life
Alendeonate (fosamax) ( $cheapest)
TX: osteoporosis men, postmenopausal women, gluccorticoids induced, pagets
diseae
histamine 2 blocking, ranitadine agents double ALENDRONATE
bioavailability of biphosphonates TILUDRONATE decrease 50 % by aspirin and is increased by INDOMENTHACIN
*consider each nsaid individually
aromatase inhibitors
*hormone therapy to tx hormone receptor positive breast cancer.
AE: vertigo, insomnia, sleepiness, confusion, LIFE THREATENING BLOOD CLOTTING,
Anastozole, letroxole, exemestane
LOSS BONE MASS,
*take Ca+ vit D supplementation
*measure bone density
GH (somatotropin) *used in children with GH deficiency treats hypoglycemia
*empty stomach 8 oz water
Biophosphanates pt education avoid anitacids/ alcohol
ETIDRONATE increase in fx with pagets disease monitor labs and xrays
drugs associated with bone loss that aromatase inhibitors, thyroid hormones, gluccocorticoid, PPI, SSRI
should be monitored
Sulfonylureas -hypoglycemia
Glimpride
Antidiabetic mediations to avoid in elderly Glyburide- most likely to cause hypo
metformin *renal insuffiency HF
Alpha-glycosidase inhibitors- not well tolerated
>45 yrs old BMI >25 *test yearly
Screening of Type 2 DM >45 yrs old BMI WNL *q 3 yrs
<45 yrs old VMI >25* test more frequent.
rapid acting insulin
Lispro, Aspart, Glulisine
15 min peak 1 hr duration
short acting insulin * used as bolus to correct hyperglycemia
Regular insulin
Regular insulin onset 30-60- peak 2-3 dura. 3-7
Regular U -500
U-500 onset 30-45, peak 2-4, duration 8-24 hr
Neutral Protamine Hagedorn (NPH) NPH onset 30-60 peak 4-10 duration 10-16
1/
8
, 3/29/25, 8:38
AM
most rapid
Inhaled human insulin (afrezza) less weight gain
onset 12 min peak 1 hr duration 2-3 hrs
Alpha Glucosidase inbitors
-no weight gain
Acarbose, miglitol, voglibose -can give in combination with sulfonyureas
-CI digoxin
-reduce A1C
TX hyperthyroidism
Propythouracil PTU -safe in pregnancy
-risk for hepatic toxicity
-overactie thyroid gland r/t graves disease (mc) anterior pituitary disorder, plummers
Hyperthyroidism
disease, amiodarone therapy
cause
-s/s: tachycardia, cardiac arrythmias, chest pain, tremors, nervousness, insomnia,
s/s
irritability, diarrhea, vomiting, weight loss, menstural irregularites, heat intolerance
lab testing
-labs increase free T4 decrease TSH
fatigue, memory impairment, depression, swollen face, decrease sv, hr, increase
Hypothyroidism S/S periph resistance, macrocytic anemia (ass. B12 def.) decrease appetite, weight gain,
enlarged thyroid glad
Diabetic meds that need renal adjustment Metformin
Diabetic medications with increased risk for SGLT-2 selective sodium glucose co -transporter
genital mycotic infections
Diabetic meds to avoid when taking metformin * dig increases effects leading to lactic acidosis
digoxin
-used in children >10
Biguanides (Metformin) *INITAL DRUG OF CHOICE
*insulin production is necessary for metformin to be productive.
calculate appropriate daily dose of insulin 0.3-0.5 units kg day
2 hr post load >200mg/dl
DM diagnosis fasting plasma glucose >126
HBA1C >6.5
2/
8
AM
NR566 MIDTERM EXAM QUESTIONS AND ANSWERS WITH COMPLETE
SOLUTIONS VERIFIED GRADED A++
Terms in this set (251)
-increases levels of digoxin
Albuterol -safe if children
-first line therapy
Bisphosphonates
-90 day half life
-preg cat B
Etidronate (Didronel) reduces bone reabsorption
TX: low bone density, d/t cystic fibrosis, pagets disease (monitor xrays and labs),
heterotropic ossification, hip replacement, spinal cord injury
CI: entercolitis
Biphosphonates
-10 yr. half life
Alendeonate (fosamax) ( $cheapest)
TX: osteoporosis men, postmenopausal women, gluccorticoids induced, pagets
diseae
histamine 2 blocking, ranitadine agents double ALENDRONATE
bioavailability of biphosphonates TILUDRONATE decrease 50 % by aspirin and is increased by INDOMENTHACIN
*consider each nsaid individually
aromatase inhibitors
*hormone therapy to tx hormone receptor positive breast cancer.
AE: vertigo, insomnia, sleepiness, confusion, LIFE THREATENING BLOOD CLOTTING,
Anastozole, letroxole, exemestane
LOSS BONE MASS,
*take Ca+ vit D supplementation
*measure bone density
GH (somatotropin) *used in children with GH deficiency treats hypoglycemia
*empty stomach 8 oz water
Biophosphanates pt education avoid anitacids/ alcohol
ETIDRONATE increase in fx with pagets disease monitor labs and xrays
drugs associated with bone loss that aromatase inhibitors, thyroid hormones, gluccocorticoid, PPI, SSRI
should be monitored
Sulfonylureas -hypoglycemia
Glimpride
Antidiabetic mediations to avoid in elderly Glyburide- most likely to cause hypo
metformin *renal insuffiency HF
Alpha-glycosidase inhibitors- not well tolerated
>45 yrs old BMI >25 *test yearly
Screening of Type 2 DM >45 yrs old BMI WNL *q 3 yrs
<45 yrs old VMI >25* test more frequent.
rapid acting insulin
Lispro, Aspart, Glulisine
15 min peak 1 hr duration
short acting insulin * used as bolus to correct hyperglycemia
Regular insulin
Regular insulin onset 30-60- peak 2-3 dura. 3-7
Regular U -500
U-500 onset 30-45, peak 2-4, duration 8-24 hr
Neutral Protamine Hagedorn (NPH) NPH onset 30-60 peak 4-10 duration 10-16
1/
8
, 3/29/25, 8:38
AM
most rapid
Inhaled human insulin (afrezza) less weight gain
onset 12 min peak 1 hr duration 2-3 hrs
Alpha Glucosidase inbitors
-no weight gain
Acarbose, miglitol, voglibose -can give in combination with sulfonyureas
-CI digoxin
-reduce A1C
TX hyperthyroidism
Propythouracil PTU -safe in pregnancy
-risk for hepatic toxicity
-overactie thyroid gland r/t graves disease (mc) anterior pituitary disorder, plummers
Hyperthyroidism
disease, amiodarone therapy
cause
-s/s: tachycardia, cardiac arrythmias, chest pain, tremors, nervousness, insomnia,
s/s
irritability, diarrhea, vomiting, weight loss, menstural irregularites, heat intolerance
lab testing
-labs increase free T4 decrease TSH
fatigue, memory impairment, depression, swollen face, decrease sv, hr, increase
Hypothyroidism S/S periph resistance, macrocytic anemia (ass. B12 def.) decrease appetite, weight gain,
enlarged thyroid glad
Diabetic meds that need renal adjustment Metformin
Diabetic medications with increased risk for SGLT-2 selective sodium glucose co -transporter
genital mycotic infections
Diabetic meds to avoid when taking metformin * dig increases effects leading to lactic acidosis
digoxin
-used in children >10
Biguanides (Metformin) *INITAL DRUG OF CHOICE
*insulin production is necessary for metformin to be productive.
calculate appropriate daily dose of insulin 0.3-0.5 units kg day
2 hr post load >200mg/dl
DM diagnosis fasting plasma glucose >126
HBA1C >6.5
2/
8
