Deck 18: Drugs Affecting the Endocrine System: Antidiabetic Drugs

Question 1

Metformin is a primary choice of drug to treat hyperglycemia in type 2 diabetes because it:

A)Substitutes for insulin usually secreted by the pancreas
B)Decreases glycogenolysis by the liver
C)Increases the release of insulin from beta cells
D)Decreases peripheral glucose utilization

Answer 1

Decreases glycogenolysis by the liver

Question 2

When is metformin typically initiated for glucose metabolism issues?

A)Only after the HgA1C is greater than 8.0
B)When the patient is diagnosed with prediabetes
C)When metabolic syndrome ensues
D)When true diabetes mellitus (DM_ is diagnosed

Answer 2

When the patient is diagnosed with prediabetes

Question 3

Long-term injection site skin changes are called:

A)Lipodystrophy
B)Tuberous sclerosis
C)Telangiectasia
D)Medication caveronosa

Answer 3

Lipodystrophy

Question 4

Prior to prescribing metformin, the provider should:

A)Draw a serum creatinine to assess renal function
B)Try the patient on insulin
C)Tell the patient to increase iodine intake
D)Have the patient stop taking any sulfonylurea to avoid dangerous drug interactions

Question 5

When blood glucose levels are difficult to control in type 2 diabetes, some form of insulin may be added to the treatment regimen to control blood glucose and limit complication risks. Which of the following statements is accurate based on research?

A)Premixed insulin analogues are better at lowering HbA1C and have less risk for hypoglycemia.
B)Premixed insulin analogues and the newer premixed insulins are associated with more weight gain than the oral antidiabetic agents.
C)Newer premixed insulins are better at lowering HbA1C and postprandial glucose levels than long-acting insulins.
D)Patients who are not controlled on oral agents and have postprandial hyperglycemia can have NPH insulin added at bedtime.

Question 6

When given subcutaneously, how long until neutral protamine Hagedorn (NPH) insulin begins to take effect (onset of action) after administration?

A)Fifteen to thirty minutes
B)Sixty to ninety minutes
C)Three to four hours
D)Six to eight hours

Question 7

Nonselective beta blockers and alcohol create serious drug interactions with insulin because they:

A)Increase blood glucose levels
B)Produce unexplained diaphoresis
C)Interfere with the ability of the body to metabolize glucose
D)Mask the signs and symptoms of altered glucose levels

Question 8

Administration of exenatide is by subcutaneous injection:

A)Thirty minutes prior to the morning meal
B)Sixty minutes prior to the morning and evening meal
C)Fifteen minutes after the evening meal
D)Sixty minutes before each meal daily

Question 9

GLP-1 agonists:

A)Directly bind to a receptor in the pancreatic beta cell
B)Have been approved for monotherapy
C)Speed gastric emptying to decrease appetite
D)Can be given orally once daily

Question 10

Hypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs and symptoms of hypoglycemia include:

A)"Fruity" breath odor and rapid respiration
B)Diarrhea, abdominal pain, weight loss, and hypertension
C)Dizziness, confusion, diaphoresis, and tachycardia
D)Easy bruising, palpitations, cardiac dysrhythmias, and coma

Question 11

Which characteristic of metformin makes it a popular selection for diabetes care?

A)No gastrointestinal (GI) side effects
B)Only rarely causes hypoglycemia
C)Pain-free injections due to the micro needle
D)Once-weekly dosing

Question 12

The decision may be made to switch from twice daily NPH insulin to insulin glargine to improve glycemia control throughout the day. If this is done:

A)The initial dose of glargine is reduced by 20% to avoid hypoglycemia.
B)The initial dose of glargine is 2 to 10 units per day.
C)Patients who have been on high doses of NPH will need tests for insulin antibodies.
D)Obese patients may require more than 100 units per day.

Question 13

The action of gliptins is different from other antidiabetic agents because they:

A)Have a low risk for hypoglycemia
B)Are not associated with weight gain
C)Close ATP-dependent potassium channels in the beta cell
D)Act on the incretin system to indirectly increase insulin production

Question 14

All of the following are options for insulin injections when each dose is close to 100 units except:

A)Split dosing
B)Move to insulin pen use
C)Change to U500 insulin
D)Stop injectable insulin and change to oral methods only

Question 15

Sitagliptin has been approved for:

A)Monotherapy in once-daily doses
B)Combination therapy with metformin
C)Both 1 and 2
D)Neither 1 nor 2

Question 16

Angiotensin-converting enzyme (ACE) inhibitors are considered renal-protective in DM; however, they must be reduced and/or discontinued when:

A)The patient reaches stage 3 chronic kidney disease (CKD)
B)Creatinine levels reach 1.1
C)Potassium levels are consistently found to be below four
D)The patient first starts spilling protein in their urine

Question 17

Avoid concurrent administration of exenatide with which of the following drugs?

A)Digoxin
B)Warfarin
C)Lovastatin
D)All of the above

Question 18

Lispro is an insulin analogue produced by recombinant DNA technology. Which of the following statements about this form of insulin is NOT true?

A)Optimal time of preprandial injection is 15 minutes.
B)Duration of action is increased when the dose is increased.
C)It is compatible with NPH insulin.
D)It has no pronounced peak.