Pharmacology Quiz: Medications and Interactions

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Questions and Answers

What is the effect of insulin on peripheral glucose uptake?

No effect

Decreases

Increases (correct)

Variable

What is the effect of insulin on potassium levels?

Variable

Increases

No effect

Decreases (correct)

How long does intermediate-acting insulin take to start working?

10-18 hours

2-4 hours

24 hours

4-12 hours (correct)

What is the duration of action of long-acting insulin?

Up to 24 hours Signup and view all the answers

When changing from NPH to Glargine, what should you do to the initial dose?

Decrease by 20% Signup and view all the answers

How long is insulin stable at room temperature once opened?

28 days Signup and view all the answers

What is the effect of insulin on skeletal muscle?

Increases glucose uptake Signup and view all the answers

What type of insulin has no peak action?

Long-acting insulin Signup and view all the answers

What is the primary mechanism of action of Thiazolidinediones (TZDs)?

Decreasing insulin resistance and improving insulin sensitivity Signup and view all the answers

What is a common side effect of Thiazolidinediones (TZDs)?

Water retention and edema Signup and view all the answers

Which medication should not be used in patients with Class III heart failure?

Rosiglitazone Signup and view all the answers

Premenopausal anovulatory women taking which medication should consider a birth control method?

Thiazolidinediones (TZD) Signup and view all the answers

What is the mechanism of action of Meglitinides?

Closing ATP-dependent potassium channels in beta cell membrane Signup and view all the answers

What is a common side effect of Meglitinides?

Hypoglycemia Signup and view all the answers

Which medication is most appropriate for a truck driver with a history of maturity-onset diabetes of the young (MODY) and obesity?

Meglitinide Signup and view all the answers

What is a black box warning for Thiazolidinediones (TZDs)?

Ischemic cardiovascular risk and heart failure Signup and view all the answers

What is the best combination of medication for patients with DM2 and high cholesterol?

Meglitinide and metformin Signup and view all the answers

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

Blocking DPPD-4 to increase incretin levels Signup and view all the answers

What is a common side effect of DPPD-4 inhibitors?

Minimal side effects Signup and view all the answers

Why should the APN avoid using saxagliptin (Onglyza) in a patient with a history of pancreatitis?

Due to the patient's history of pancreatitis Signup and view all the answers

What medication is most appropriate to improve pre- and postprandial blood glucose levels in a patient with type 2 diabetes mellitus?

Sitagliptin Signup and view all the answers

What is a caution when using DPPD-4 inhibitors with ACE inhibitors?

Increased risk of angioedema Signup and view all the answers

What is a consideration when using DPPD-4 inhibitors in patients with renal disease?

Monitor renal function and use with caution Signup and view all the answers

What is the effect of DPPD-4 inhibitors on gastric emptying?

Decrease gastric emptying Signup and view all the answers

What is the major cause of CVD?

Atherosclerosis Signup and view all the answers

What is the effect of 3 K+ channel blockers on ERP, QT interval, and action potential?

Prolong Signup and view all the answers

What is the effect of Ca+ channel blockers on conduction between atria and ventricles?

Slow Signup and view all the answers

What is the name of the type of lipoprotein that is considered 'bad' cholesterol?

LDL Signup and view all the answers

What is a common side effect of Ca+ channel blockers?

All of the above Signup and view all the answers

What should patients taking anti-lipid drugs be encouraged to do?

Follow a cardiac diet and exercise Signup and view all the answers

What is the effect of 3 K+ channel blockers on Na+/Ca+ channels?

Blockade Signup and view all the answers

What is a contraindication for the use of non-selective beta blockers?

Asthma Signup and view all the answers

What should patients taking anti-lipid drugs avoid doing with their medication?

Skipping doses or doubling up on missed doses Signup and view all the answers

What is a potential problem with abruptly stopping beta blockers?

Myocardial infarction Signup and view all the answers

Which of the following diuretics is considered safe in pregnancy?

Any of the above Signup and view all the answers

What is the primary mechanism of action of potassium-sparing diuretics?

Blockade of aldosterone receptors Signup and view all the answers

Which of the following is a common side effect of loop diuretics?

Electrolyte abnormalities Signup and view all the answers

What is a potential interaction between potassium-sparing diuretics and other medications?

Increased risk of hyperkalemia with ACE inhibitors Signup and view all the answers

Which of the following is a precaution or contraindication for the use of diuretics?

Hepatic dysfunction Signup and view all the answers

Which patient is at risk for cardiac glycoside toxicity due to loop diuretic use?

A 45-year-old with heart failure Signup and view all the answers

Which laboratory abnormality can occur with the treatment of loop diuretics?

Low potassium levels Signup and view all the answers

What is the primary indication for potassium-sparing diuretics?

Hypertension Signup and view all the answers

Study Notes

Insulin

Intermediate-acting insulin: takes 2-4 hours to start working, peaks in 4-12 hours, and lasts for 10-18 hours
Long-acting insulin: takes 3-4 hours to start working, has no peak, and lasts up to 24 hours
When changing from NPH to Glargine, initial dose should be decreased by 20% to avoid hypoglycemia

Thiazolidinediones (TZDs) "Glitazones"

Use: DM2 (off label PCOS)
MOA: decreases insulin resistance and improves insulin sensitivity
Side Effects: water retention, edema, heart failure, weight gain, hypoglycemia, increased risk for bone fractures
Black Box Warning: ischemic cardiovascular risk and heart failure, bladder cancer, and bone fractures
Monitoring & Teaching: monitor weight and cardiac function, use backup birth control

Meglitinides "Glinides"

Use: DM2
MOA: stimulates pancreas to produce more insulin
Side Effects: hypoglycemia (less likely due to shorter half-life), weight gain
Monitoring & Teaching: take at the start of the meal; do not take if meal is not eaten; do not take at bedtime

Dipeptidyl Peptidase-4 Inhibitors (DPPD-4)---"Gliptins"

Use: DM2 (combined with metformin is best for patients with high cholesterol)
MOA: blocks DPPD-4, increasing incretin levels; inhibits glucagon release, increases insulin secretion, and decreases gastric emptying and blood glucose
Side Effects: very minimal; low risk for hypoglycemia; no weight gain
Caution & Monitoring: concurrent ACE inhibitors increase risk for angioedema; increases concentration of digoxin with gliptin; monitor renal function and caution use with renal disease

Anti-Lipid Drugs

Four major classes of lipoproteins: LDL, HDL, VLDL, and Triglycerides
Patient Teaching: take as prescribed and do not skip doses or double up on missed doses; encourage healthy lifestyle, cardiac diet, exercise, and smoking cessation

Diuretics

MOA: increases urine production, reduces blood volume, and lowers blood pressure
Side Effects: ↑ urination, headache, dizziness, thirst, muscle cramps, stomach cramps, N/V/D, electrolyte abnormalities which can lead to arrhythmia, ototoxicity when given alongside aminoglycosides and cisplatin, hyperglycemia, and lithium or digoxin toxicity
Most safe in pregnancy: Furosemide, Toresemide, Metolazone
Potassium-Sparing diuretic: blocks mineralocorticoid receptors, inhibiting effects of aldosterone on collecting ducts and distal tubule, resulting in excretion of sodium, water, bicarbonate, and calcium

Cardiac Glycosides (CG)

Which patient is at risk for CG toxicity: A 45-year-old who is on loop diuretics
Common laboratory abnormality with treatment of loop diuretics: Low potassium levels

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Description

Test your knowledge of medications, their interactions, and effects on the human body. This quiz covers various pharmacological concepts and applications.