NR 565 Advanced Pharmacology Final
Exam Study Guide 2026 Questions and
Answers Graded A+
Glycemic Goals in DM2 - Correct answer-Blood glucose of 80-130 before meals,
180 or less 1-2 hrs post meals, A1C under 7. Long term goals are to manage BG
and preveny long term complications.
Preventing Diabetic Nephropathy - Correct answer-ACE inhibitors, such as
lisinopril. Or ARBs such as losartan if patient cannot tolerate ACEs
ADAs Stepped Care Approach to DM Treatment - Correct answer-1. Lifestyle
changes plus metformin.
2. Lifestyle plus metformin plus a second drug (GLP-1)
3. Lifestyle plus metformin plus 2 more drugs based on patient characteristics. For
example, add SGLT2 inhibitor for patients with cardiovascular or renal disease.
Biguanides - Correct answer-Metformin
Initial therapy for DM2. Inhibits glucose production in liver. Reduces glucose
absorption in gut. Sensitized fat and skeletal muscle receptors to insulin (increased
,uptake of insulin). Safe in pregnancy. GI side effects so take with meals. Excreted
by kidneys so increased toxicity (lactic acidosis) if renal impairment. Low risk of
hypoglycemia.
1st vs. 2nd Generation Sulfonylurea - Correct answer-All 1st generation have been
discontinued. 2nd generation (Glipizide) have shorter duration of action and
increased potency.
Sulfonylureas - Correct answer-glipizide, glyburide, glimepiride. Promote insulin
release by beta cells. Block potassium channels of pancreatic islets to let calcium
in, which stimulates insulin release. Do not take with ETOH (disulfiram reaction
includes flushing, palpitations, nausea). Hypoglycemia and weight gain are also
common side effects. Do not take if pregnant or breastfeeding. Increased risk of
toxicity if liver or kidneys are impaired.
Meglitinides MOA - Correct answer-Stimulate a rapid/ short-lived release of
insulin from the pancreas.
Meglitinides (Glinides) - Correct answer-Repaglinide (Prandin)
Nateglinide (Starlix)
Meglitinides patient teaching - Correct answer-Tell patient to eat within 30
minutes.
, Meglitinides (Glinides) precautions - Correct answer-Hypoglycemia increased in
patients with liver dysfunction 2/2 slower metabolism of the drug.
Meglitinides vs. Sulfonylureas - Correct answer--meglitinides are rapid acting and
will have its effect on a single meal-decreasing post prandial hyperglycemia. Taken
with each meal.
-sulfonylureas continuously stimulate insulin release- having most of its effect on
fasting glucose levels.
Both stimulate pancreatic insulin release.
Thiazolidinediones (TZDs) - Correct answer-Pioglitazone (Actos)
Rosiglitazone (Avandia)
Thiazolidinediones (TZDs) MOA - Correct answer-Peroxisome proliferator-
activated receptor gamma agonists (PPAR𝜸 agonists) that increase peripheral
insulin sensitivity. Promotes increased glucose uptake by skeletal and adipose cells.
Thiazolidinediones (TZDs) adverse effects - Correct answer-Renal retention of
fluid- so not for patients with stage 3 or 4 heart failure. May also cause upper
respiratory infections, headache, and myalgia. Hepatotoxic. Monitor liver function.
Exam Study Guide 2026 Questions and
Answers Graded A+
Glycemic Goals in DM2 - Correct answer-Blood glucose of 80-130 before meals,
180 or less 1-2 hrs post meals, A1C under 7. Long term goals are to manage BG
and preveny long term complications.
Preventing Diabetic Nephropathy - Correct answer-ACE inhibitors, such as
lisinopril. Or ARBs such as losartan if patient cannot tolerate ACEs
ADAs Stepped Care Approach to DM Treatment - Correct answer-1. Lifestyle
changes plus metformin.
2. Lifestyle plus metformin plus a second drug (GLP-1)
3. Lifestyle plus metformin plus 2 more drugs based on patient characteristics. For
example, add SGLT2 inhibitor for patients with cardiovascular or renal disease.
Biguanides - Correct answer-Metformin
Initial therapy for DM2. Inhibits glucose production in liver. Reduces glucose
absorption in gut. Sensitized fat and skeletal muscle receptors to insulin (increased
,uptake of insulin). Safe in pregnancy. GI side effects so take with meals. Excreted
by kidneys so increased toxicity (lactic acidosis) if renal impairment. Low risk of
hypoglycemia.
1st vs. 2nd Generation Sulfonylurea - Correct answer-All 1st generation have been
discontinued. 2nd generation (Glipizide) have shorter duration of action and
increased potency.
Sulfonylureas - Correct answer-glipizide, glyburide, glimepiride. Promote insulin
release by beta cells. Block potassium channels of pancreatic islets to let calcium
in, which stimulates insulin release. Do not take with ETOH (disulfiram reaction
includes flushing, palpitations, nausea). Hypoglycemia and weight gain are also
common side effects. Do not take if pregnant or breastfeeding. Increased risk of
toxicity if liver or kidneys are impaired.
Meglitinides MOA - Correct answer-Stimulate a rapid/ short-lived release of
insulin from the pancreas.
Meglitinides (Glinides) - Correct answer-Repaglinide (Prandin)
Nateglinide (Starlix)
Meglitinides patient teaching - Correct answer-Tell patient to eat within 30
minutes.
, Meglitinides (Glinides) precautions - Correct answer-Hypoglycemia increased in
patients with liver dysfunction 2/2 slower metabolism of the drug.
Meglitinides vs. Sulfonylureas - Correct answer--meglitinides are rapid acting and
will have its effect on a single meal-decreasing post prandial hyperglycemia. Taken
with each meal.
-sulfonylureas continuously stimulate insulin release- having most of its effect on
fasting glucose levels.
Both stimulate pancreatic insulin release.
Thiazolidinediones (TZDs) - Correct answer-Pioglitazone (Actos)
Rosiglitazone (Avandia)
Thiazolidinediones (TZDs) MOA - Correct answer-Peroxisome proliferator-
activated receptor gamma agonists (PPAR𝜸 agonists) that increase peripheral
insulin sensitivity. Promotes increased glucose uptake by skeletal and adipose cells.
Thiazolidinediones (TZDs) adverse effects - Correct answer-Renal retention of
fluid- so not for patients with stage 3 or 4 heart failure. May also cause upper
respiratory infections, headache, and myalgia. Hepatotoxic. Monitor liver function.
