Pharmacology Quiz: Diabetes and GERD Treatments

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What effect do Thiazolidinediones have on insulin sensitivity?

They increase insulin production in pancreas only.

They have no effect on insulin sensitivity.

They increase insulin sensitivity in fat, muscle, and liver. (correct)

They decrease insulin sensitivity in fat, muscle, and liver.

What is a serious adverse drug event associated with Sulfonylureas?

Weight gain.

Fatigue.

Hypoglycemia. (correct)

Nausea and vomiting.

Which agent works the fastest for treating GERD?

Sucralfate.

Proton Pump Inhibitors (PPIs).

H2 Antagonists.

Antacids. (correct)

What is a potential adverse effect associated with long-term PPI use in the elderly?

Osteoporosis. Signup and view all the answers

When should antacids ideally be administered to enhance their effectiveness?

1 hour after meals and at bedtime. Signup and view all the answers

What side effect is commonly associated with aluminum-based antacids?

Constipation. Signup and view all the answers

What mechanism does sucralfate utilize in treating ulcers?

Forms a protective paste over the ulcer. Signup and view all the answers

In what situation are topical corticosteroids contraindicated?

For skin infections. Signup and view all the answers

Which laboratory values would indicate hypothyroidism?

High TSH, low T4 Signup and view all the answers

What are common symptoms associated with hyperthyroidism?

Weight loss and increased appetite Signup and view all the answers

What is the primary function of Levothyroxine?

To restore thyroid hormone levels Signup and view all the answers

What is the mechanism of action (MOA) of metformin?

It decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity. Signup and view all the answers

Which medication should be monitored for renal and liver enzyme levels?

Systemic antifungal medication Signup and view all the answers

Which of the following is a severe adverse effect (ADE) associated with metformin?

Lactic acidosis Signup and view all the answers

Which lifestyle factor is NOT associated with Type II diabetes?

High daily sugar consumption Signup and view all the answers

What is the main characteristic of subclinical hypothyroidism?

Elevated TSH with normal T4 Signup and view all the answers

Which of the following is a potential adverse effect of oral antibiotics like tetracycline?

GI upset Signup and view all the answers

What effect does decreased glucagon production have on glucose production in the liver?

Decreases hepatic glucose production. Signup and view all the answers

Which medications are classified as GLP-1 receptor agonists?

Exenatide and semaglutide Signup and view all the answers

What is the primary consequence of elevated TSH levels?

Decreased thyroid function Signup and view all the answers

What is a contraindication for the use of metformin?

Severe renal impairment Signup and view all the answers

Which statement accurately describes the action of IV antivirals in immunosuppressed patients?

They are administered with inpatient observation. Signup and view all the answers

What is one of the benefits of rotating insulin injection sites?

Decreases the risk of insulin resistance and absorption issues. Signup and view all the answers

Which cancer has been associated with GLP-1 receptor agonists?

Medullary thyroid cancer Signup and view all the answers

What is the active form of thyroid hormone found in Liothyronine?

Triiodothyronine Signup and view all the answers

What is the normal range for TSH levels in mU/L?

0.4 - 4.5 Signup and view all the answers

Which medication is often used to manage the symptoms of hyperthyroidism?

Methimazole Signup and view all the answers

Which symptom is typically associated with hypothyroidism?

Fatigue Signup and view all the answers

What is the potential consequence of abrupt discontinuation of anti-thyroid medications?

Thyroid storm Signup and view all the answers

Which of the following is NOT a symptom of hyperthyroidism?

Cold intolerance Signup and view all the answers

What is the clinical presentation of a thyroid storm characterized by?

Intensified symptoms of hyperthyroidism Signup and view all the answers

What is the primary purpose of beta-blockers in the treatment of hyperthyroidism?

To alleviate cardiac symptoms Signup and view all the answers

What condition is typically associated with myxedema?

Hypothyroidism Signup and view all the answers

What characterizes euthyroidism?

Normal TSH and thyroid hormone levels Signup and view all the answers

Which statement about subclinical hypothyroidism is true?

TSH levels are elevated while thyroid hormone levels are normal. Signup and view all the answers

What is the recommended monitoring frequency for hypothyroidism treatment?

Every 6-8 weeks Signup and view all the answers

What management approach should be taken for treating hypothyroidism in pregnant women?

Increase the dose by 20-50%. Signup and view all the answers

What is the most commonly prescribed medication for hypothyroidism?

Levothyroxine (Synthetic T4) Signup and view all the answers

Which of the following is a potential risk of untreated hypothyroidism during pregnancy?

Preeclampsia Signup and view all the answers

What autoimmune condition is commonly associated with hypothyroidism?

Hashimoto's disease Signup and view all the answers

What medications are used for long-term hyperthyroidism treatment?

Antithyroid drugs and RAI therapy Signup and view all the answers

What is a common adverse effect associated with long-term use of topical corticosteroids?

Rosacea Signup and view all the answers

Which topical steroid class is considered safe for use on the face?

Low potency Signup and view all the answers

What is the mechanism of action of topical corticosteroids?

Suppress cytokines and immune cells Signup and view all the answers

What lab tests should be monitored when using systemic antifungals for onychomycosis?

Liver function and CBC Signup and view all the answers

Which medication is indicated for treating severe, treatment-resistant acne?

Isotretinoin Signup and view all the answers

What lab results typically indicate hypothyroidism?

High TSH and low T4 Signup and view all the answers

What is the primary purpose of monitoring patients prescribed isotretinoin?

To check liver function and pregnancy status Signup and view all the answers

Study Notes

Insulin Regimens for Lowering HgA1c

Basal bolus and intensive insulin regimens can improve long-term outcomes by reducing A1C
Basal bolus involves multiple daily insulin injections or continuous subcutaneous administration via an insulin pump
Intensive insulin replacement therapy can lower A1C and improve long-term outcomes.

Adverse Effects of Lack of Insulin

Lack of insulin can result in hyperglycemia
Ketoacidosis: Acidic buildup, fruity breath, high blood sugar, weight loss, and elevated lipids and triglycerides. Nausea, vomiting, and abdominal pain are also symptoms
Tissue catabolism: Breakdown of body tissues
Hypertriglyceridemia: Elevated triglycerides in the blood

Basal Insulin Function

Basal insulin suppresses hepatic glucose production, maintaining near-normal blood sugar levels in the fasting state.

Bolus Insulin Purpose

Bolus insulin (prandial/premeal) controls postprandial glucose excursions, compensating for the increased glucose requirements after food absorption.

Basal Insulin Types

NPH: One type of basal, long-acting insulin with longer duration of action, and flatter, more constant plasma levels
Long-acting insulin analogs (e.g., glargine, detemir, degludec): Flatter, more predictable glucose control.
Continuous delivery of rapid-acting insulin pumps another option.

Bolus Insulin Types

Regular insulin: One type of short-acting insulin.
Rapid-acting insulin analogs (e.g., lispro, aspart, glulisine): Quick onset, short duration of action, less weight gain, and fewer episodes of low blood sugar.

Lispro Insulin Onset

Lispro insulin onset = 15-30 minutes

Insulin Glargine Duration of Action

Insulin glargine duration of action = 20 hours or more.

General Insulin Needed for Type 1 Diabetes

Newly diagnosed type 1 diabetics may initially need a 50/50 balance between basal and bolus insulin.

Factors to Consider with Insulin Dosing

Carbohydrate intake
Pregnancy, puberty, and medical illness may require adjustments to insulin doses
Illness usually requires increasing insulin

Bolus Insulin Factors

Regular, rapid-acting, inhaled insulin
Pre-meal glucose levels
Carbohydrate consumption (consider fat and protein levels)
Anticipated activity levels: Muscle activity uses glucose and can affect insulin needs

Insulin Injection Sites

Subcutaneous injection sites like abdomen, thigh, buttock, and upper arms are recommended
Rotate injection sites to prevent lipohypertrophy, an abnormal fat accumulation.

Five Factors Associated with Type II Diabetes

Insulin resistance
Impaired insulin secretion
Elevated glucose production by the liver
Decreased liver's ability to reduce glucose productions
Lean patients with type II

Self-Management for Type II Diabetic

Lifestyle factors like diabetes self-management, education, support, and avoidance of clinical inertia
Social determinants of health
Established/high-risk atherosclerotic cardiovascular disease (CVD), heart failure (HF), and chronic kidney disease (CKD).
Use agents that reduce cardiovascular and kidney risk factors
Weight management
Appropriate medication use

Metformin MOA

Metformin's MOA is to decrease hepatic glucose production, decrease intestinal glucose absorption, and improve insulin sensitivity

SGLT2 Inhibitors & Adverse Effects

SGLT2 inhibitors work to inhibit sodium-glucose co-transporter 2, increasing urine glucose excretion.
Potential adverse effects include hypotension, urogenital infections, and acute kidney injury, especially in certain patient populations with chronic kidney disease.

GLP-1 Receptor Agonists MOA

GLP-1 receptor agonists enhance glucose-dependent insulin secretion, slow gastric emptying, and reduce postprandial glucagon secretion.

Medications/Cancer associated with GLP-1

Liraglutide, Lixisenatide, Semaglutide, Dulaglutide, and Exenatide are some GLP-1 medications
Medulary thyroid cancer, thyroid C-cell tumors

Thiazolidinediones (TZDs) Impact on Insulin

Improve insulin sensitivity in fat, liver, and muscle tissue
Don't directly increase insulin production

Sulfonylureas and Adverse Effects

Serious adverse effect is hypoglycemia
Other possible side effects associated with use.

GERD Treatment

Antacids work more quickly
PPIs work longer
H2 antagonists are an alternative option but slower than PPIs

PPI Use in Elderly

Possible adverse effect of osteoporosis when taken for more than a year

Magnesium-based Antacids Side Effects

Diarrhea is a potential side effect

Aluminum-based Antacids Side Effects

Constipation

Sucralfate Mechanism of Action

Forms a complex with exudate or injured tissue in the stomach, helping prevent further damage by peptic acid, pepsin, and bile salts.

Topical Corticosteroids Usage

Topical corticosteroids with high potency may be used for significant skin issues such as severe dermatitis, psoriasis or eczema.
It is important to avoid using them on infected or damaged skin.

Potency of Topical Corticosteroids

Ranked from weakest to strongest, potency levels are given for each medication listed

Isotretinoin Monitoring Parameters

Two negative pregnancy tests before treatment. Monthly pregnancy tests throughout the treatment period.
Monitoring Cholesterol, triglycerides, CBC, and Liver Function tests at treatment initiation and 4 weeks into the treatment. Regular monitoring as needed.

Hypothyroidism Lab Tests

High TSH and low T4 levels are indicative

Levothyroxine Mechanism of Action

Replaces missing thyroid hormone, to normalize the thyroid levels in the body.

Monitoring Hypothyroidism Treatment

Monitor TSH every 6-8 weeks. T4 levels may not be necessary.

Hashimoto's Disease

Enlarged thyroid, fatigue, weight gain, cold intolerance, dry skin, hair loss, constipation, depression, and muscle aches.

Desiccated Thyroid Origin

Derived from dried animal thyroid glands (cow/pig)

Hypothyroidism Target TSH Level

0.4 to 4.0 mU/L

Hyperthyroidism Signs & Symptoms

Heat intolerance, increased sweating, nervous and anxiety related symptoms. Elevated T4, Low TSH levels.

Hyperthyroidism Complication

untreated hyperthyroidism can cause potential complications such as atrial fibrillation, congestive heart failure, thrombotic events, and/or osteoporosis (bone damage).

Hyperthyroidism Treatment

Antithyroid drugs - Methimazole (MMI) and propylthiouracil (PTU)
Radioactive iodine (RAI) therapy

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on key pharmacological agents and their effects, including Thiazolidinediones, Sulfonylureas, and medications for GERD. This quiz covers mechanisms of action, adverse effects, and clinical considerations in elderly patients. Enhance your understanding of diabetes treatments and gastrointestinal medications with these challenging questions.