NUR 5334 EXAM 3 2024/ ACTUAL EXAM WITH 100%
CORRECT ANSWERS/ NUR 5334 ADVANCED
PHARMACOLOGY EXAM 3 2024 -2025/ALREADY
GRADED A+: UNIVERSITY OF TEXAS
What medications are used to treat gestational diabetes?
ANSWER :->>>Metformin and Insulin
- What A1C value indicates diabetes mellitus? Pre-DM?
ANSWER :->>>6.5% or greater is considered
diabetes5.7-6.4% pre- diabetes
- What fasting and random values indicate DM?
ANSWER :->>>Fasting plasma glucose—126 or greater is diabetes
Random (casual) plasma glucose—anything greater than 200 is diabetes
- What are complications of insulin therapy?
ANSWER :->>>Hypoglycemia
Can develop lipohypertrophy
Accumulation of subcutaneous fat that occurs when it is injected too frequently atthe same site
ANSWER :->>>Allergic reactions
Characterized by red and intensely itchy welts, breathing becomes difficult If
severe allergy develops:
-Desensitization procedure (small doses to larger doses)Hypokalemia
Promotes the uptake of potassium cells and insulin activates a membrane-bound enzyme with sodium potassium and ATPase that pumps potassium into the cells and sodium out 1 / 4
- Drug interactions?
ANSWER :->>>Hypoglycemic agents
Can intensify the hypoglycemia included by insulin
Examples: sulfonylureas, glinides, alcohol
Use with caution with hyperglycemic agents
Examples: thiazide and glucocorticoids and sympathomimetics
- What effect do beta blockers have on insulin?
▪ ANSWER :->>>delay awareness of and response to hypoglycemia by masking the signs that areassociated with stimulation of sympathetic nervous system ▪ Impair glycogenolysis ▪ Prevent the bodies counter-regulatory response
- What are other therapeutic uses besides DM?
□ ANSWER :->>>Hyperkalemia
□ Aids in diagnosis of GH deficiency □ Diabetic ketoacidosis
- Insulin dosage must be coordinated with what?
ANSWER :->>>Carbohydrate intake
- What is B/P goal in diabetic?
ANSWER :->>>To be controlled, within normal 120/80
- What medication can be given to decrease risk of diabetic nephropathy?
ANSWER :->>>ACE inhibitor or ARB 2 / 4
- What role does exercise play in treatment of both type 1 and type 2 DM?
ANSWER :->>>Exercise increases cellular responsiveness to insulin and increases glucosetolerance 150 minute per week of moderate intensity exercise is recommended
- What are the 4 steps in the 4-step approach?
ANSWER :->>>Step 1—diagnosis
□ Lifestyle changes plus metforminStep 2
□ Lifestyle changes plus metformin and a second drug (sulfonylurea, TZD or a DPP4 inhibitor, a sodium glucose cotransporter or SGLT-2 inhibitor, a glucagon-like peptide 1, or a GLP-1 receptor agonist or basal insulin □ Second drug choice made considering efficacy, the hypoglycemia risk of the patient, the patient tolerability, and weight-related considerations (some helpweight loss, some cause weight gain), cost Step 3
□ Three drug combination □ Metformin □ Plus 2 other medications from step 2
Decided based on a drug and patient specific considerationsStep 4
□ If 3 drug combination that includes basal insulin fails after 3-6 months, morecomplex insulin regimen □ Usually in combination with one or more non-insulin medications
- When a patient is on insulin therapy what are the blood glucose goals beforemeals? At bedtime?
□ ANSWER :->>>Before meals—70-130
□ Bedtime—100-140 3 / 4
- What is the A1C goal? When is goal below 7 not appropriate?
□ ANSWER :->>>7% or below
□ Those with severe hypoglycemia risk, limited life expectancy, advanced microvascular or macro vascular complications—not below 7
- What are the short acting insulins? Intermediate? Long acting?
ANSWER :->>>Short duration: Rapid acting
□ Insulin lispro [Humalog] □ Insulin aspart [NovoLog] □ Insulin glulisine
[Apidra]Short duration: Slower
acting □ Regular insulin [Humulin R, Novolin R]Intermediate duration □ Neutral protamine Hagedorn (NPH) insulin □ Insulin detemir [Levemir]Long duration □ Insulin glargine
- When are short duration insulins used?
□ ANSWER :->>>Administered in association with meals to control the post-prandial rise in bloodglucose between meals and at night
- When are intermediate insulins needed?
□ Administer 2-3 times daily to provide glycemic control between meals and duringthe night
- How long is duration of glargine? Levemir? Degludec?
ANSWER :->>>Glargine—up to 24 hours
- / 4