問題一覧
1
Drugs that may reduce the effects of Sulfa drugs
Atypical antipsychotics, Corticosterioids, Diuretics, Niacin, Phenothiazines, Sympathomimetics
2
Drugs that may increase the effects of Sulfa drugs
Azole Antifungals, Beta-Blockers, Clarithromycin, MAOIs, Probenecid, Salicylates, Sulfonamides
3
You are seeing a patient with diabetes, albuminuria and a blood pressure of 155/94. He is currently on no medications. According to the latest diabetes guidelines, which of the following will you prescribe first?
ACEIorARB
4
You are seeing a 35 y/o diabetic with a calculated ASCVD risk of >20%. You have decided to prescribe a high intensity statin—what is your desired outcome?
Lower LDL cholesterol by 50%
5
Current diabetes guidelines recommend drug selection based on the presence or absence of which conditions?
CVD, HF, renal disease
6
The sensitivity factor is calculated by dividing by ________ by the total daily dose of insulin
2000 [or 1800 if the patient is going for tight control]
7
You are prescribing NPH insulin to your diabetic patient. You tell the patient that the onset of this type of insulin is:
1-2 hours
8
Sarah is your patient with Type II diabetes, and she is on insulin detemir. You are going to add another insulin to control her after meal excursions. Which agent are you going to prescribe?
Insulin lispro
9
Basal metabolic needs can be achieved from exogenous source by all of the following except:
Regular insulin
10
You are educating Katie, who has just been started on meal- time insulin. Education related to injectable therapy includes all of the following except:
Fluid retention
11
-It is given SQ right before meals -When started—the dose of mealtime insulin should be decreased by 50% to avoid severe low BS
Pramlintide
12
ADEs—nausea, anorexia, vomiting, dizziness, pharyngitis -Avoid in those with gastroparesis or hypoglycemic unawareness
Pramlintide
13
GLP-1 should not be used in those with renal impairment
Exenatide
14
GLP-1 that reduces the risk of composite outcome of CV death, nonfatal MI and stroke by 13%
Liraglutide
15
Do not use this GLP-1 in those with GFR <15 cc/min, pregnancy (all GLP-1s), and also in gallbladder disease
Lixisenatide
16
What condition is a contraindication of Pramlintide therapy because of its effect of gastric slowing?
Gastroparesis
17
Which of the following has FDA indication to reduce the risk of major CV events in Type II diabetics with cardiovascular disease?
Liraglutide
18
Which of the following can be seen when initiating GLP-1 agonists?
Nausea and vomiting
19
Should NOT be used with Sulfonylureas or Gemfibrozil; use caution in liver disease
Repaglinide or Nateglinide
20
Will LOWER cholesterol, triglycerides and LDL and causes weight loss in most
Metformin
21
-It is excreted in the feces -Can be used as monotherapy or with Metformin, TZD or both
Repaglinide or Nateglinide
22
The drug does not cause low BS—unless the patient is taking insulin or another secretagogue
Metformin
23
-1⁄2 life of both formulations is 4-9 hours -Not metabolized by the liver; renal tubular secretion is route of elimination
Metformin
24
Onset of action is not known; peak effect is in 2 hours [this is delayed by food]; 1⁄2 life is 16-24 hours Excreted into the bile unchanged and eliminated in the feces
Pioglitazone and Rosiglitazone
25
Poorly absorbed—excreted in the urine
Acarbose
26
Is very well absorbed—but no systemic effects—excreted unchanged by the kidney
Miglitol
27
-Taken right before each meal -Onset of action is immediate; peaks in 1 hour; duration is near 6 hours; 1⁄2 life of the drug is 2 hours
Acarbose
28
-Take at the beginning of each meal -Rapid onset of action; peaks in 2 hours; duration of action is near 4 hours
Miglitol
29
All gliptins [DPP-4 Inhibitors] except _____ require dose adjustments for renal disease
Linagliptin
30
Metabolized by CYP450-3A4/5 to an active metabolite; metabolite is excreted renally
Saxagliptin
31
Which of the following diabetes drugs is most appropriately paired with the ADE associated with its use?
Canagliflozin—UTIs
32
Which of the following agents has been shown to reduce risks when the diabetic has renal dysfunction?
Canagliflozin
33
Although rare, there are some serious side effects linked to the use of SGLT2 inhibitors. One of the agents in the class [Canagliflozin] has a BB warning for:
Lower limb amputation
34
Your patient, Mr. George has Type II diabetes, HTN and HF—which is currently stable. Based on the most recent evidence, you know that you can reduce this risk of HF hospitalization by prescribing:
Dapagliflozin
35
Potential side effects of sulfonylureas include all of the following except:
Liver failure
36
All of the following are actions of Metformin therapy, except:
Increases beta cell production of insulin
37
All of the following are potential side effects of Acarbose and Miglitol except:
Dry mouth
38
The onset of action for regular insulin is:
15-30 minutes
39
Helen is a 50 y/o obese woman who has had Type II diabetes for 8 years. She is on Metformin ER, but her A1C is still above goal. She has a history of COPD and LE edema from venous insufficiency. You want to prescribe something that will not cause her to gain weight. Which of the following would you prescribe?
Linagliptin
40
Philip has Type II diabetes and chronic pancreatitis. Which of the following diabetes medications should not be prescribed to Phillip?
Do not prescribe Linagliptin or Exenatide
41
Which class of oral agents for diabetes is paired most closely with its primary mechanism of action?
SGLT2 inhibitors—increase the urinary excretion of glucose