NURS 676 week 6 quiz
Benefits of transdermal estrogen - answer• total dose of estrogen is greatly reduced
(because the liver is bypassed).
• Less N/V
• Blood levels of estrogen fluctuate less
• lower risk for DVT, pulmonary embolism, and stroke
Type 1 diabetes diagnosis - answer-fasting plasma glucose >/= 126 mg/dL
-random plasma glucose >/= 200mg/dL PLUS symptoms
- Oral glucose tolerance test (OGTT): 2-h plasma glucose >/= 200mg/dL
-hemoglobin A1C 6.5 or higher
which cells produce insulin - answerBeta cells of the islets of Langerhans in pancreas
Type 1 diabetes management - answer1. diet
2. self-monitoring of blood glucose (SMBG)
3. Physical activity
4. Insulin replacement
what is given to manage hypertension in diabetics - answerACEIs or ARBs
-reduces risk for diabetic nephropathy
what is given to manage dyslipidemia in diabetics - answerStatins
Type 1 diabetes complications - answerDiabetic Ketoacidosis (DKA)
heart disease, renal failure, blindness, neuropathy, amputations, impotence, stroke
Diabetic Ketoacidosis (DKA) pathophysiology - answerwhen insulin is not present to
move glucose into cells for energy, the body begins to metabolize fat; fatty acid
metabolism results in the formation of ketone bodies; ketone bodies are acidic and
produce metabolic acidosis, diuresis, and electrolyte loss
Type 2 diabetes management - answer1. lifestyle changes PLUS metformin
2. add a second drug (thiazolidinedione, DPP-4 inhibitor, SGLT-2 inhibitor, or GLP-1
receptor agonist
3. 3 drug combo
4. Insulin & GLP-1 receptor agonist
Metformin - answerBiguanide
MOA:
,1. inhibits glucose production in liver
2. reduces glucose absorption in the gut
3. sensitizes insulin receptors in target tissues--increases glucose uptake
NOT METABOLIZED
SE: GI, lactic acidosis
-Type II, prevention, PCOS, Gestational
Meglitinides (Glinides) - answer-stimulate pancreatic insulin release
-shorter acting than sulfonylureas and are taken w/ each meal
repaglinide and nateglinide
Thiazolidinediones (TZDs) - answerGlitazones
MOA:
-decrease insulin resistance, increasing glucose uptake by muscle and fat
-decrease glucose production by liver
SE: hypoglycemia when there is excessive insulin, HF, bladder cancer, fractures in
women, ovulation
Dipeptidyl Peptidase-4 (DPP-4) Inhibitors - answerGliptins
- enhance actions of incretin hormones to stimulate glucose-dependent insulin and
suppress glucagon release by inhibiting DPP-4
-DPP-4 is an enzyme that inactivates incretin hormones
AE: hypoglycemia and pancreatitis
Incretin Hormones (GIP and GLP-1) - answer(1) stimulate glucose-dependent release
of insulin (2) suppress postprandial release of glucagon
Glucagon - answerincreases glucose production in the liver
sodium-glucose cotransporter 2 (SGLT-2) inhibitor - answer"-gliflozin"
SGLT-2 accounts for 90% of glucose reabsorption in the kidney
blocks reabsorption of filtered glucose, increasing urinary excretion of glucose
AE: hypoglycemia, UTI, vulvovaginal infection, dehydration
glucagon-like peptide-1 (GLP-1) receptor agonist - answerincretin mimetics
, -slow gastric emptying
-stimulate glucose-dependent release o insulin
-inhibit postprandial release of glucagon
-suppress appetite
AE: hypoglycemia, renal impairment, fetal harm, pancreatitis
Sulfonylureas - answerglipizide, glyburide, glimepiride -stimulate release of insulin from
pancreatic islet
>> bind with/block ATP-sensitive potassium channels in cell membrane, which causes
influx of calcium, leading to insulin release
AE: hypoglycemia
C-peptide - answerProduct of proinsulin cleavage
indicates pancreas is still making some insulin
Type 2 diabetes complications - answer
Type 1 diabetes and pregnancy - answer1. placenta produces hormones that
antagonize insulin's actions
2. cortisol (promotes hyperglycemia) increases x3
3. glucose can pass to fetus, so hyperglycemia in mother leads to excessive insulin
secretion in fetus
Hypoglycemia symptoms - answertachycardia, palpitations, sweating, nervousness
hypoglycemic agents - answersulfonylureas, glinides, alcohol
hyperglycemic agents - answerthiazide diuretics, glucocorticoids, sympathomimetics
insulin actions - answer1. cellular uptake of glucose, amino acids, nucleotides, and
potassium
2. synthesis of complex organic molecules
Gluconeogenesis - answerformation of glucose from amino acids and fatty acids
Glargine management - answerOnset: 70 min
Peak: NONE
Duration: 18-24 hours
SubQ inj 1-2x/daily at same time
U-100 or U-300
Benefits of transdermal estrogen - answer• total dose of estrogen is greatly reduced
(because the liver is bypassed).
• Less N/V
• Blood levels of estrogen fluctuate less
• lower risk for DVT, pulmonary embolism, and stroke
Type 1 diabetes diagnosis - answer-fasting plasma glucose >/= 126 mg/dL
-random plasma glucose >/= 200mg/dL PLUS symptoms
- Oral glucose tolerance test (OGTT): 2-h plasma glucose >/= 200mg/dL
-hemoglobin A1C 6.5 or higher
which cells produce insulin - answerBeta cells of the islets of Langerhans in pancreas
Type 1 diabetes management - answer1. diet
2. self-monitoring of blood glucose (SMBG)
3. Physical activity
4. Insulin replacement
what is given to manage hypertension in diabetics - answerACEIs or ARBs
-reduces risk for diabetic nephropathy
what is given to manage dyslipidemia in diabetics - answerStatins
Type 1 diabetes complications - answerDiabetic Ketoacidosis (DKA)
heart disease, renal failure, blindness, neuropathy, amputations, impotence, stroke
Diabetic Ketoacidosis (DKA) pathophysiology - answerwhen insulin is not present to
move glucose into cells for energy, the body begins to metabolize fat; fatty acid
metabolism results in the formation of ketone bodies; ketone bodies are acidic and
produce metabolic acidosis, diuresis, and electrolyte loss
Type 2 diabetes management - answer1. lifestyle changes PLUS metformin
2. add a second drug (thiazolidinedione, DPP-4 inhibitor, SGLT-2 inhibitor, or GLP-1
receptor agonist
3. 3 drug combo
4. Insulin & GLP-1 receptor agonist
Metformin - answerBiguanide
MOA:
,1. inhibits glucose production in liver
2. reduces glucose absorption in the gut
3. sensitizes insulin receptors in target tissues--increases glucose uptake
NOT METABOLIZED
SE: GI, lactic acidosis
-Type II, prevention, PCOS, Gestational
Meglitinides (Glinides) - answer-stimulate pancreatic insulin release
-shorter acting than sulfonylureas and are taken w/ each meal
repaglinide and nateglinide
Thiazolidinediones (TZDs) - answerGlitazones
MOA:
-decrease insulin resistance, increasing glucose uptake by muscle and fat
-decrease glucose production by liver
SE: hypoglycemia when there is excessive insulin, HF, bladder cancer, fractures in
women, ovulation
Dipeptidyl Peptidase-4 (DPP-4) Inhibitors - answerGliptins
- enhance actions of incretin hormones to stimulate glucose-dependent insulin and
suppress glucagon release by inhibiting DPP-4
-DPP-4 is an enzyme that inactivates incretin hormones
AE: hypoglycemia and pancreatitis
Incretin Hormones (GIP and GLP-1) - answer(1) stimulate glucose-dependent release
of insulin (2) suppress postprandial release of glucagon
Glucagon - answerincreases glucose production in the liver
sodium-glucose cotransporter 2 (SGLT-2) inhibitor - answer"-gliflozin"
SGLT-2 accounts for 90% of glucose reabsorption in the kidney
blocks reabsorption of filtered glucose, increasing urinary excretion of glucose
AE: hypoglycemia, UTI, vulvovaginal infection, dehydration
glucagon-like peptide-1 (GLP-1) receptor agonist - answerincretin mimetics
, -slow gastric emptying
-stimulate glucose-dependent release o insulin
-inhibit postprandial release of glucagon
-suppress appetite
AE: hypoglycemia, renal impairment, fetal harm, pancreatitis
Sulfonylureas - answerglipizide, glyburide, glimepiride -stimulate release of insulin from
pancreatic islet
>> bind with/block ATP-sensitive potassium channels in cell membrane, which causes
influx of calcium, leading to insulin release
AE: hypoglycemia
C-peptide - answerProduct of proinsulin cleavage
indicates pancreas is still making some insulin
Type 2 diabetes complications - answer
Type 1 diabetes and pregnancy - answer1. placenta produces hormones that
antagonize insulin's actions
2. cortisol (promotes hyperglycemia) increases x3
3. glucose can pass to fetus, so hyperglycemia in mother leads to excessive insulin
secretion in fetus
Hypoglycemia symptoms - answertachycardia, palpitations, sweating, nervousness
hypoglycemic agents - answersulfonylureas, glinides, alcohol
hyperglycemic agents - answerthiazide diuretics, glucocorticoids, sympathomimetics
insulin actions - answer1. cellular uptake of glucose, amino acids, nucleotides, and
potassium
2. synthesis of complex organic molecules
Gluconeogenesis - answerformation of glucose from amino acids and fatty acids
Glargine management - answerOnset: 70 min
Peak: NONE
Duration: 18-24 hours
SubQ inj 1-2x/daily at same time
U-100 or U-300
