Endocrine Pharmacology: Blood Glucose and Insulin
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Questions and Answers

What is the primary mechanism of action by which insulin decreases potassium levels in the body?

  • Insulin decreases the absorption of potassium from the gut
  • Insulin stimulates the uptake of potassium by muscles and liver cells (correct)
  • Insulin inhibits the release of aldosterone, leading to decreased potassium levels
  • Insulin increases the excretion of potassium by the kidneys

Why is it necessary to co-administer glucose when using IV insulin to treat hyperkalemia?

  • To increase the absorption of insulin
  • To potentiate the effect of insulin on potassium levels
  • To enhance the excretion of potassium by the kidneys
  • To prevent hypoglycemia (correct)

Which type of insulin has a cloudy appearance due to the presence of protamine?

  • Lispro insulin
  • Regular insulin
  • NPH insulin (correct)
  • Glargine insulin

What is the primary reason why insulin cannot be administered orally?

<p>Insulin is degraded by digestive enzymes in the gut (A)</p> Signup and view all the answers

What is the concentration of U-100 insulin?

<p>100 units of insulin per mL (B)</p> Signup and view all the answers

What is the primary reason why Glargine (Lantus) insulin should not be frozen?

<p>Freezing causes degradation of the insulin protein (B)</p> Signup and view all the answers

Which type of insulin is typically used in insulin pumps?

<p>Lispro insulin (D)</p> Signup and view all the answers

What is the primary guideline for healthcare professionals when prescribing medications to the elderly?

<p>Start with a low dose and titrate up as needed (C)</p> Signup and view all the answers

What is the purpose of sliding scale insulin?

<p>To reactively correct blood glucose levels (B)</p> Signup and view all the answers

Which of the following insulin types is contraindicated in patients with renal impairment?

<p>Thiazolidenediones (D)</p> Signup and view all the answers

What is the mechanism of action of sulfonylureas?

<p>Increase insulin secretion (A)</p> Signup and view all the answers

What is the suffix for Meglitinides?

<p>-glide (B)</p> Signup and view all the answers

What is the main difference between Humulin R and Humulin N?

<p>Duration of action (C)</p> Signup and view all the answers

What is the primary effect of SGLT2 inhibitors?

<p>Decrease glucose reabsorption in the kidneys (A)</p> Signup and view all the answers

What is the primary mechanism of action of GLP-1 agonists?

<p>Slow gastric emptying (B)</p> Signup and view all the answers

What is the primary side effect of DPP-4 inhibitors?

<p>Nasopharyngitis (B)</p> Signup and view all the answers

What is the main difference between GLP-1 agonists and DPP-4 inhibitors?

<p>Mechanism of action (A)</p> Signup and view all the answers

Which of the following medications is often used when diabetes treatment has been ineffective?

<p>Insulin (D)</p> Signup and view all the answers

What is the mechanism of action of Metiglinides?

<p>Binding to an allosteric site on the potassium channel, resulting in a conformational change (B)</p> Signup and view all the answers

What is the normal function of the SGLT2 receptor in the proximal convoluted tubules?

<p>To reabsorb sodium and glucose together (B)</p> Signup and view all the answers

What is the effect of GLP-1 on gastric emptying?

<p>It decreases gastric emptying (D)</p> Signup and view all the answers

What is the effect of DPP-4 inhibitors on glucagon release?

<p>They inhibit glucagon release (A)</p> Signup and view all the answers

What is the threshold for glucose excretion in the urine?

<p>200mg/dL (B)</p> Signup and view all the answers

What is a common side effect of SGLT2 inhibitors?

<p>Vaginal yeast infection (A)</p> Signup and view all the answers

What is the mechanism of action of GLP-1 receptor agonists?

<p>Mimicking the action of GLP-1, promoting insulin release and inhibiting glucagon release (B)</p> Signup and view all the answers

What is a rare but serious side effect of SGLT2 inhibitors?

<p>Fournier's gangrene (C)</p> Signup and view all the answers

What is the result of rapid drops in potassium levels?

<p>Hypokalemia (D)</p> Signup and view all the answers

What is the effect of insulin on the sodium potassium pump?

<p>Increases the activity of the pump, moving sodium out of the cells and potassium into the cells (B)</p> Signup and view all the answers

What is the purpose of mixing clear and cloudy insulin?

<p>To create a combination of short and intermediate acting insulin (A)</p> Signup and view all the answers

What is the concentration of insulin denoted by '100 units/mL'?

<p>There are 100 units of insulin per mL of solution (A)</p> Signup and view all the answers

What is the normal range of blood glucose levels?

<p>80 mg/dL (C)</p> Signup and view all the answers

What is the purpose of sliding scale insulin?

<p>To address hyperglycemia after it occurs (B)</p> Signup and view all the answers

What is the action of metformin?

<p>Reduces liver ability to undergo gluconeogenesis, increases cell insulin receptor sensitivity to insulin, and reduces glucose absorption in the GI tract (A)</p> Signup and view all the answers

What is the action of pioglitazone?

<p>Lowers glucose production in the liver, alters gene transcription involved in glucose metabolism, and helps muscle and adipose tissues use glucose (A)</p> Signup and view all the answers

What is the common side effect of sulfonylureas?

<p>Hypoglycemia and weight gain (C)</p> Signup and view all the answers

What is the mechanism of action of glitazones?

<p>Turn on genes that increase the sensitivity of cells to insulin, improving glucose uptake and utilization (D)</p> Signup and view all the answers

What is the typical range of hemoglobin A1C for a diabetic patient?

<p>7-8% (A)</p> Signup and view all the answers

Which type of insulin is often used in critical care settings due to its rapid onset and short duration of action?

<p>Regular insulin (D)</p> Signup and view all the answers

What is the primary reason why insulin cannot be administered orally?

<p>It is broken down by digestive enzymes (C)</p> Signup and view all the answers

What is the typical action taken when a patient's glucose level is greater than 400?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary reason why potassium levels should be monitored when administering IV insulin?

<p>IV insulin can cause hypokalemia (C)</p> Signup and view all the answers

What is the typical concentration of U-100 insulin?

<p>100 units/mL (A)</p> Signup and view all the answers

What is the primary reason why NPH insulin cannot be mixed with other insulin types?

<p>It has a different pH level (D)</p> Signup and view all the answers

What is the primary guideline for healthcare professionals when prescribing medications to the elderly?

<p>Start with low doses and titrate up (B)</p> Signup and view all the answers

What is the primary mechanism of action of thiazolidenediones?

<p>Activate the PPAR-gamma receptor (C)</p> Signup and view all the answers

Which of the following insulin types is associated with the highest risk of hypoglycemia?

<p>Lispro (C)</p> Signup and view all the answers

What is the primary mechanism of action of sodium-glucose cotransporter 2 (SGLT2) inhibitors?

<p>Inhibit the reabsorption of glucose in the kidneys (A)</p> Signup and view all the answers

Which of the following medications is contraindicated in patients with renal impairment?

<p>Metformin (A)</p> Signup and view all the answers

What is the primary mechanism of action of glucagon-like peptide-1 (GLP-1) agonists?

<p>Stimulate the release of insulin (A)</p> Signup and view all the answers

What is the primary side effect of dipeptidyl peptidase-4 (DPP-4) inhibitors?

<p>Nasopharyngitis (B)</p> Signup and view all the answers

What is the primary mechanism of action of sulfonylureas?

<p>Increase the release of insulin (B)</p> Signup and view all the answers

Which of the following medications is associated with a higher risk of cardiovascular events?

<p>Thiazolidenediones (D)</p> Signup and view all the answers

What is the primary mechanism of action of meglitinides?

<p>Increase the release of insulin (C)</p> Signup and view all the answers

Which of the following medications is often used when diabetes treatment has been ineffective?

<p>Insulin (C)</p> Signup and view all the answers

What is the primary reason for rapid drops in potassium levels when using insulin?

<p>Increased activity of the sodium potassium pump (C)</p> Signup and view all the answers

What is the purpose of administering glucose with IV insulin to treat hyperkalemia?

<p>To prevent hypoglycemia (A)</p> Signup and view all the answers

What is the primary difference between Humulin R and Humulin N?

<p>Humulin R is short-acting, while Humulin N is long-acting (D)</p> Signup and view all the answers

What is the primary mechanism of action of Amylin mimetics?

<p>Inhibit the release of glucagon from the pancreas (C)</p> Signup and view all the answers

What is the primary side effect of sulfonylureas?

<p>All of the above (D)</p> Signup and view all the answers

What is the purpose of Beers criteria?

<p>To guide medication prescribing in the elderly (A)</p> Signup and view all the answers

What is the primary mechanism of action of glitazones?

<p>Increase the sensitivity of cells to insulin (D)</p> Signup and view all the answers

What is the primary effect of SGLT2 inhibitors?

<p>Increase the excretion of glucose in the urine (A)</p> Signup and view all the answers

What is the primary mechanism of action of metformin?

<p>Reduce the production of glucose in the liver (C)</p> Signup and view all the answers

What is the primary reason for storing insulin in the refrigerator?

<p>To prevent the degradation of the insulin (D)</p> Signup and view all the answers

What is the effect of blocking potassium channels on insulin release?

<p>Increased potassium levels, leading to depolarization and increased insulin release (B)</p> Signup and view all the answers

What is the primary mechanism of action of SGLT2 inhibitors?

<p>Inhibiting the reabsorption of sodium and glucose in the proximal convoluted tubules (B)</p> Signup and view all the answers

What is the effect of GLP-1 on gastric emptying?

<p>Decreases gastric emptying, leading to slower glucose absorption (C)</p> Signup and view all the answers

What is the primary side effect of SGLT2 inhibitors?

<p>UTI (A)</p> Signup and view all the answers

What is the mechanism of action of DPP-4 inhibitors?

<p>Inhibiting the breakdown of incretin, leading to increased insulin release (A)</p> Signup and view all the answers

What is the primary difference between GLP-1 agonists and DPP-4 inhibitors?

<p>MOA, GLP-1 agonists stimulate insulin release directly, while DPP-4 inhibitors inhibit the breakdown of incretin (C)</p> Signup and view all the answers

What is the threshold for glucose excretion in the urine?

<p>200mg/dL (C)</p> Signup and view all the answers

What is a rare but serious side effect of SGLT2 inhibitors?

<p>Fournier’s gangrene (B)</p> Signup and view all the answers

Study Notes

Endocrine Pharmacology

Blood Glucose Levels

  • Normal hemoglobin A1C: < 5.6%
  • Prediabetic hemoglobin A1C: 5.7-6.4%
  • Diabetic A1C: 6.5% and above
  • Normal fasting blood glucose: 80-100 mg/dL
  • Prediabetic fasting blood glucose: 100-125 mg/dL
  • Diabetic fasting blood glucose: 126 mg/dL and above

Insulin

  • A1C aim for diabetics: < 7.0%
  • Short-duration/fast-acting insulin: Lispro, Aspart, Glulisine
  • Insulin and glucagon are released from beta cells and alpha cells of the pancreas, respectively
  • Glucagon is used in emergency situations to treat severe hypoglycemia
  • Insulin cannot be taken orally due to enzymatic degradation
  • Long-duration insulin: Glargine, Detemir
  • NPH insulin: intermediate-acting, cloudy appearance
  • Regular insulin: can be given both subQ and IV
  • IV insulin is used to treat diabetic ketoacidosis and perioperative care

Potassium Levels and Insulin

  • When insulin is administered, potassium levels may drop due to increased cellular uptake
  • Normal potassium levels: 3.5-5.2 mEq/L
  • Insulin increases the activity of the sodium-potassium pump, leading to decreased potassium levels

Insulin Administration

  • Rapid-acting insulin: Lispro, Aspart, Glulisine (used in insulin pumps)
  • Sliding scale insulin: used as a dosing guide for insulin, addressing hyperglycemia after it occurs
  • Common sites for insulin administration: abdomen, back, thighs, love handles, etc.

Other Diabetes Medications

  • Metformin: biguanide, reduces liver glucose production, increases insulin receptor sensitivity
  • Thiazolidinediones: suffix -glitazone, lowers glucose production in the liver, alters gene transcription
  • Sulfonylureas: suffix -ide, promote insulin release from the beta cells of the pancreas
  • Meglitinides: suffix -glinide, binds to an allosteric site on the potassium channel, increasing insulin release
  • SGLT2 inhibitors: suffix -Flozin, blocks glucose reabsorption in the proximal convoluted tubules, leading to increased glucose excretion in the urine
  • GLP-1 agonists: suffix -tide, natural substance released after carb ingestion, promotes insulin release and inhibits glucagon release
  • DPP-4 inhibitors: suffix -gliptin, inhibits the breakdown of incretin, leading to increased insulin release and decreased blood sugar levels

Endocrine Pharmacology

Blood Glucose Levels

  • Normal hemoglobin A1C: < 5.6%
  • Prediabetic hemoglobin A1C: 5.7-6.4%
  • Diabetic A1C: 6.5% and above
  • Normal fasting blood glucose: 80-100 mg/dL
  • Prediabetic fasting blood glucose: 100-125 mg/dL
  • Diabetic fasting blood glucose: 126 mg/dL and above

Insulin

  • A1C aim for diabetics: < 7.0%
  • Short-duration/fast-acting insulin: Lispro, Aspart, Glulisine
  • Insulin and glucagon are released from beta cells and alpha cells of the pancreas, respectively
  • Glucagon is used in emergency situations to treat severe hypoglycemia
  • Insulin cannot be taken orally due to enzymatic degradation
  • Long-duration insulin: Glargine, Detemir
  • NPH insulin: intermediate-acting, cloudy appearance
  • Regular insulin: can be given both subQ and IV
  • IV insulin is used to treat diabetic ketoacidosis and perioperative care

Potassium Levels and Insulin

  • When insulin is administered, potassium levels may drop due to increased cellular uptake
  • Normal potassium levels: 3.5-5.2 mEq/L
  • Insulin increases the activity of the sodium-potassium pump, leading to decreased potassium levels

Insulin Administration

  • Rapid-acting insulin: Lispro, Aspart, Glulisine (used in insulin pumps)
  • Sliding scale insulin: used as a dosing guide for insulin, addressing hyperglycemia after it occurs
  • Common sites for insulin administration: abdomen, back, thighs, love handles, etc.

Other Diabetes Medications

  • Metformin: biguanide, reduces liver glucose production, increases insulin receptor sensitivity
  • Thiazolidinediones: suffix -glitazone, lowers glucose production in the liver, alters gene transcription
  • Sulfonylureas: suffix -ide, promote insulin release from the beta cells of the pancreas
  • Meglitinides: suffix -glinide, binds to an allosteric site on the potassium channel, increasing insulin release
  • SGLT2 inhibitors: suffix -Flozin, blocks glucose reabsorption in the proximal convoluted tubules, leading to increased glucose excretion in the urine
  • GLP-1 agonists: suffix -tide, natural substance released after carb ingestion, promotes insulin release and inhibits glucagon release
  • DPP-4 inhibitors: suffix -gliptin, inhibits the breakdown of incretin, leading to increased insulin release and decreased blood sugar levels

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Description

This quiz covers the normal and abnormal levels of blood glucose, hemoglobin A1C, and the types of insulin used to manage diabetic conditions.

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