SARAH MICHELLE LIVE REVIEW EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED
A+||NEWEST VERSION, EXAMS OF NURSING
What are some examples of long acting insulin? - ANSWER-Lantus, Levemir
What is the onset, peak and duration of long acting insulin? - ANSWER-Onset: 2 hours
Peak: NONE
Duration: 24 hours
What is truly our GO TO oral diabetes medication? - ANSWER-Metformin (Biguanides)
What is the maximum daily dosage of Metformin? - ANSWER-2,550 mg in a day
What labs do we need to monitor when a patient is on Metformin? - ANSWER-Monitor renal
function, if GFR drop to less than 30- have to discontinue Metformin
Why does Metformin need to be stopped prior to having any procedure with contrast? -
ANSWER-Contrast dye is harsh on the kidneys, need to be sure that there is pause with that
Metformin so that their kidneys are not seriously injured.
Long term usage of Metformin can lead to what deficiency? - ANSWER-B12 deficiency anemia
How does Metformin impact weight? - ANSWER-Metformin is weight NEUTRAL, some patient
even will have weight loss with this drug
,2|Page
Does Metformin cause hypoglycemia? - ANSWER-NO, Metformin works in the body by inhibiting
glucose production in the liver. Due to that there are no issues with hypoglycemia
What are some examples of SGLT-2 inhibitors? - ANSWER-All the -flozin's
Empagiflozin
What is the MOA for SGLT-2 inhibitors? - ANSWER-Reduce absorption of glucose in the renal
tubules, the patient will urinate out the extra glucose
What lab should be assessed prior to prescribing SGLT-2 inhibitors? - ANSWER-Renal function
Does SGLT-2 inhibitors cause hypoglycemia? - ANSWER-SGLT-2 inhibitors have a LOW risk for
hypoglycemia
What education is required for patients who are on SGLT-2 inhibitors? - ANSWER-Staying
hydrated and reporting any new urinary issues
What patients are NOT good candidates for SGLT-2 inhibitors? - ANSWER-Patients who cannot
make it to the bathroom in time
Patients with frequent UTIs or yeast infections already
What is a major perk to SGLT-2 inhibitors? - ANSWER-They are cardio-protective- they have
shown to reduce overall risk of mortality associated with coexisting cardiac conditions, and they
may even prevent future cardiac issues.
What diabetes medication classes are cardioprotective? - ANSWER-SGLT-2 inhibitors and GLP-1
agonists
,3|Page
What are examples of DPP-4 inhibitors? - ANSWER-Alt he -gliptins
Sitagliptin
What is the MOA of DPP-4 inhibitors? - ANSWER-Increase insulin production/decrease glucagon
secretion
Impacts fasting and postprandial glucose levels
DPP-4 inhibitors are contraindicated in patients with a history of what condition? - ANSWER-
Pancreatitis
What are examples of sulfonylureas? - ANSWER-All the ide's
glipizide, glyburide, glimepiride
What is the MOA of sulfonyureas? - ANSWER-Cause the pancreases to secrete insulin, but do
NOT reduce insulin resistance
What is a major consideration with sulfonyureas, especially within the elderly population? -
ANSWER-These cause hypoglycemia and put the elderly at increased risk for falls
What are examples of Thiazolidinediones (TZDs)? - ANSWER-All the zone's
Pioglitazone (Actos)
How does TZDs work? - ANSWER-Lower your insulin resistance, they are insulin sensitizers
What are the side effects of TZDs? - ANSWER-Toxicity to the liver- need to monitor LFTs
Toxic in patients with heart failure
Causes weight gain and peripheral edema
, 4|Page
What patients are TZD's contraindicated in? - ANSWER-Heart failure patients
What are some examples of Alpha-glucosidase inhibitors? - ANSWER-Acarbose (Precose)
Miglitol (Glyset)
How do alpha-glucose dose inhibitors work? - ANSWER-Inhibit glucosidase in the small
intestines
What are common side effects of alpha-glucosidase inhibitors, and what patients should NOT
take this drug? - ANSWER-Tend to see lots of GI side effects
C/I in patients with chronic bowel disease of any kind
What are the 2 most important things about alpha-glucosidase inhibitors class? - ANSWER-1.
Educate patient to take the medication with the beginning of their meal bc these drugs lowers
the blood glucose by preventing the breakdown of carbs immediately after ingestion
2. If the patient experiences issues with hypoglycemia while taking this drug class, they need to
take ACTUAL glucose tablets
What are examples of GLP-1 agonists? - ANSWER-All the -tides
Dulaglutide
What are the 4 main purposes of GLP-1 agonists? - ANSWER-1. Increase feelings of fullness
2. Delays gastric emptying
3. Increases sensitivity to insulin
4. Cardioprotective