NR565 Pharmacology Final exam
testbank of 270 questions and
correct answers
Criteria for the Diagnosis of Diabetes Mellitus
-Fasting plasma glucose ≥126 mg/dL
-Random plasma glucose ≥ 200 mg/dL plus symptoms of diabetes
-Oral glucose tolerance test (OGTT): 2-h plasma glucose ≥200 mg/dLcor
-Hemoglobin A1c 6.5% or higher
T1DM Etiology and MOA
Autoimmune process; Loss of pancreatic β cells;
T2DM Etiology and MOA
Unknown—but there is a strong familial association, suggesting that heredity
is a risk factor; Insulin resistance and inappropriate insulin secretion
the total daily dose (TDD) of insulin calculation
total weight of the patient in kilograms (kg), multiplied by 0.6 units
,Basal insulin replacement
50% of the total daily insulin dose which replaces insulin from fasting
(overnight) and between meals.
Bolus insulin replacement
50% of the total daily insulin dose and provides carbohydrate coverage and
high blood sugar correction.
Biguanides Drug Class
Metformin
Metformin
Decreases glucose production by the liver (glucogenesis), increases tissue
response to insulin;
Decrease glucose absorption; Increase glucose uptake
drug of choice for initial therapy in most patients with type 2 diabetes
Metformin contraindications
renal disease, acidosis from hepatic disease, alcoholics, or in patients with
hypoxia.
,Metformin Major AE
Gastrointestinal (GI) symptoms: decreased appetite, nausea, diarrhea
Lactic acidosis (rarely)
Sulfonylureas Prototype/MOA
Glyburide (Prototype Drug)
-Promote insulin secretion by the pancreas; may also increase tissue
response to insulin;
-stimulate beta cells of the pancreas to secrete more insulin
Sulfonylureas AE
high risk of severe hypoglycemia;
photosensitivity; therefore, patient education is needed regarding sunscreen.
blood dyscrasias
weight gain.
Sulfonylureas Contraindication
should be avoided in patients with impaired hepatic or renal function.
Meglitinides (Glinides) Prototype/MOA
-Repaglinide (Prototype Drug)
, -stimulation of pancreatic insulin release though shorter acting then
sulfonylureas and are taken with each meal
-Facilitates calcium influx in pancreatic β cells, which leads to increased
insulin release
Meglitinides Main AE
Hypoglycemia
Meglitinides Contraindications
Use with caution in patients with liver impairment and those taking
gemfibrozil.
Thiazolidinediones (Glitazones) Prototype/MOA
-Pioglitazone (Prototype Drug)
-enhance insulin sensitivity/decrease insulin resistance in muscle tissue and
reduce glucagon production in the liver
-Mainly an add on to Metformin
Thiazolidinediones (TZDs) Main AE
Hypoglycemia but only in the presence of excessive insulin
Heart failure
Bladder cancer
testbank of 270 questions and
correct answers
Criteria for the Diagnosis of Diabetes Mellitus
-Fasting plasma glucose ≥126 mg/dL
-Random plasma glucose ≥ 200 mg/dL plus symptoms of diabetes
-Oral glucose tolerance test (OGTT): 2-h plasma glucose ≥200 mg/dLcor
-Hemoglobin A1c 6.5% or higher
T1DM Etiology and MOA
Autoimmune process; Loss of pancreatic β cells;
T2DM Etiology and MOA
Unknown—but there is a strong familial association, suggesting that heredity
is a risk factor; Insulin resistance and inappropriate insulin secretion
the total daily dose (TDD) of insulin calculation
total weight of the patient in kilograms (kg), multiplied by 0.6 units
,Basal insulin replacement
50% of the total daily insulin dose which replaces insulin from fasting
(overnight) and between meals.
Bolus insulin replacement
50% of the total daily insulin dose and provides carbohydrate coverage and
high blood sugar correction.
Biguanides Drug Class
Metformin
Metformin
Decreases glucose production by the liver (glucogenesis), increases tissue
response to insulin;
Decrease glucose absorption; Increase glucose uptake
drug of choice for initial therapy in most patients with type 2 diabetes
Metformin contraindications
renal disease, acidosis from hepatic disease, alcoholics, or in patients with
hypoxia.
,Metformin Major AE
Gastrointestinal (GI) symptoms: decreased appetite, nausea, diarrhea
Lactic acidosis (rarely)
Sulfonylureas Prototype/MOA
Glyburide (Prototype Drug)
-Promote insulin secretion by the pancreas; may also increase tissue
response to insulin;
-stimulate beta cells of the pancreas to secrete more insulin
Sulfonylureas AE
high risk of severe hypoglycemia;
photosensitivity; therefore, patient education is needed regarding sunscreen.
blood dyscrasias
weight gain.
Sulfonylureas Contraindication
should be avoided in patients with impaired hepatic or renal function.
Meglitinides (Glinides) Prototype/MOA
-Repaglinide (Prototype Drug)
, -stimulation of pancreatic insulin release though shorter acting then
sulfonylureas and are taken with each meal
-Facilitates calcium influx in pancreatic β cells, which leads to increased
insulin release
Meglitinides Main AE
Hypoglycemia
Meglitinides Contraindications
Use with caution in patients with liver impairment and those taking
gemfibrozil.
Thiazolidinediones (Glitazones) Prototype/MOA
-Pioglitazone (Prototype Drug)
-enhance insulin sensitivity/decrease insulin resistance in muscle tissue and
reduce glucagon production in the liver
-Mainly an add on to Metformin
Thiazolidinediones (TZDs) Main AE
Hypoglycemia but only in the presence of excessive insulin
Heart failure
Bladder cancer
