CHAPTER 32 Pharm - Diabetes

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Questions and Answers

Which type of medications have a Black Box warning for the risk of developing C-Cell tumors or Thyroid cancer?

SGLT2 inhibitors

Pioglitazone and Rosiglitazone

GLP-1 agonists (correct)

DPP-IV inhibitors

What is a potential adverse effect of SGLT2 inhibitors (flozin medications) according to the text?

Hemorrhagic pancreatitis

Hypothyroidism

Fungal infections (correct)

Development of C-Cell tumors

In patients with DKA, what is the typical blood glucose level range mentioned in the text?

300-400 mg/dL (correct)

100-150 mg/dL

200-300 mg/dL

400-500 mg/dL

What condition will present with changes in mental status and confusion in addition to dehydration and a blood glucose level in the 300s?

Hyperglycemic Hyperosmolar State (HHS) Signup and view all the answers

What are some early signs of hypoglycemia mentioned in the text?

Tremors, sweating Signup and view all the answers

When administering glucose elevating drugs, what should be a concern according to the text?

Patient is stressed Signup and view all the answers

What is the key difference between Type 1 and Type 2 diabetes?

Type 1 always requires insulin therapy, whereas Type 2 can be managed with lifestyle changes. Signup and view all the answers

What lifestyle changes are recommended for managing Type 2 diabetes?

Dieting, exercise, and quitting smoking/drinking Signup and view all the answers

What fasting blood glucose range is considered the goal for diabetic patients?

80-130 mg/dL Signup and view all the answers

Which insulin types are suitable for diabetic patients with a busy lifestyle due to their long-acting nature?

Glargine, Detemir, and Degludec insulin Signup and view all the answers

What is the first-line drug typically prescribed for managing Type 2 diabetes?

Metformin Signup and view all the answers

What is the mechanism of action (MOA) for Metformin in managing diabetes?

Decreased production of and decreased intestinal absorption of glucose Signup and view all the answers

What is a potential late sign of hypoglycemia according to the text?

Hypothermia Signup and view all the answers

Which adverse effect are patients warned about when taking SGLT2 inhibitors?

Fourier's gangrene Signup and view all the answers

What is a key aspect to consider before administering glucose elevating drugs?

Unconsciousness Signup and view all the answers

Which characteristic helps distinguish fournier's gangrene from other conditions?

Necrotizing fasciitis of the perineum Signup and view all the answers

Which food item is NOT recommended for managing hypoglycemia based on the text?

Diet soft drink Signup and view all the answers

What are the common adverse effects of Pioglitazone and Rosiglitazone?

Edema and weight gain Signup and view all the answers

Which medication should not be given to patients with DKA or moderate to severe kidney impairment?

SGLT2 inhibitors Signup and view all the answers

What is a rare but lethal adverse effect associated with Metformin?

Lactic Acidosis Signup and view all the answers

What are adverse effects of DPP-IV inhibitors (gliptin medications)?

Respiratory infections and Pancreatitis Signup and view all the answers

What is a significant risk associated with Pioglitazone and Rosiglitazone use in patients?

Increased risk of fractures due to decreased bone density Signup and view all the answers

What is a notable adverse effect of GLP-1 (tide medications) mentioned in the text?

Pancreatitis Signup and view all the answers

What are some typical symptoms that may indicate plaque in the arteries and vessels of diabetic patients?

Edema, numbness, and tingling of extremities Signup and view all the answers

Which condition would necessitate insulin therapy according to the text?

Diabetic ketoacidosis (DKA) Signup and view all the answers

What is the recommended HbA1C level for individuals diagnosed with diabetes?

Less than 7% Signup and view all the answers

Which group of patients should not be given Metformin according to the information provided?

Patients with kidney issues Signup and view all the answers

What is a common presentation of DKA described in the text?

Fruity breath and fruity pee Signup and view all the answers

What is the main adverse effect of Metformin mentioned in the text?

Bloating, cramping, and feeling full Signup and view all the answers

Which medication should not be administered to patients with heart failure according to the text?

Rosiglitazone Signup and view all the answers

What is the primary symptom of retinopathy mentioned in the text?

Eye pain Signup and view all the answers

Which medication class slows gastric emptying according to the text?

GLP-1 medications Signup and view all the answers

What is a concerning effect of using Metformin in patients with renal or hepatic disease?

Worsening kidney function Signup and view all the answers

What is neuropathy?

Nerve pain Signup and view all the answers

What is nephropathy?

Kidney issues Signup and view all the answers

In the context of hypoglycemia, what blood glucose level is considered abnormally low?

Less than 70 mg/dL Signup and view all the answers

When should glucose elevating drugs be used according to the text?

Only if patients are conscious and have been thoroughly assessed Signup and view all the answers

What is a key instruction for patients taking SUBQ insulin according to the text?

Rotate admission site and administer at least 2 inches from the belly button Signup and view all the answers

Glucose elevating drugs are used in acute hypoglycemic situations to raise blood sugar.

True Signup and view all the answers

Study Notes

Diabetes Overview

Type 1 diabetes is genetic and characterized by a complete lack of insulin production.
Type 2 diabetes is marked by insufficient insulin production and can be controlled through lifestyle changes.

Complications of Diabetes

Retinopathy is a complication of diabetes that causes eye pain.
Neuropathy is a complication of diabetes that causes nerve pain.
Nephropathy is a complication of diabetes that affects the kidneys.
Long-term diabetes can lead to edema, numbness, tingling in the extremities, and decreased circulation, indicating plaque buildup in arteries and vessels.

Treatment of Diabetes

Type 1 diabetics always require insulin therapy.
Type 2 diabetics may require lifestyle changes, including weight loss, dieting, exercise, and quitting smoking and drinking.
The goal for HbA1C levels is less than 7%.
The goal for fasting blood glucose levels is 80-130 mg/dL.

Medications for Diabetes

Metformin is the first-line drug for type 2 diabetes and should be taken with a meal.
The mechanism of action (MOA) for Metformin is to decrease glucose production and intestinal absorption.
Adverse effects of Metformin include bloating, cramping, and feeling full.
Lactic acidosis is a rare but lethal side effect of Metformin.
Metformin is contraindicated in patients with renal or hepatic disease.

Other Medications for Diabetes

Pioglitazone and Rosiglitazone have adverse effects, including edema, weight gain, and potential heart failure exacerbation.
Patients taking Pioglitazone and Rosiglitazone are at risk for fractures due to decreased bone marrow.
Pioglitazone and Rosiglitazone are contraindicated in patients with heart failure.
DPP-IV inhibitors (gliptin medications) may cause upper respiratory infections and pancreatitis.
The MOA for GLP-1 (tide medications) is to slow gastric emptying.
Adverse effects of GLP-1 (tide medications) include hemorrhagic or necrotizing pancreatitis (rare).
GLP-1 (tide medications) have a Black Box warning for thyroid cancer risk.

SGLT2 Inhibitors (Flozin Medications)

Contraindications for SGLT2 inhibitors include DKA and moderate to severe kidney impairment.
Adverse effects of SGLT2 inhibitors include yeast infections, UTIs, acute kidney injury, hypotension, and hypovolemia.
The FDA warns of the possible adverse effect of Fournier's gangrene (necrotizing fasciitis of the perineum) with SGLT2 inhibitors.

Hypoglycemia

Hypoglycemia is defined as a blood glucose level of less than 70 mg/dL.
Early signs of hypoglycemia include confusion, irritability, tremors, and sweating.
Late signs of hypoglycemia include hypothermia, seizures, and possible coma or death.
Glucose-elevating drugs are used in acute hypoglycemic situations to raise blood sugar.
Glucose-elevating drugs should only be used in conscious patients who have had a thorough assessment, including vital signs and blood sugar levels.
Educate patients taking SUBQ insulin to rotate their injection site, administer at least 2 inches from the belly button, and have clean and dry skin.
Foods that can help with hypoglycemia include corn syrup, honey, fruit juice, non-diet soft drinks, crackers, or half a sandwich.

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Description

Test your knowledge on diabetes types, complications, and symptoms such as edema, numbness, and decreased circulation. Learn about retinopathy, neuropathy, nephropathy, and the differences between Type 1 and Type 2 diabetes.