Question 1

Which of the following demonstrates the primary differences between meglitinides and sulfonylureas?

Accepted Answer

A) Meglitinides have the propensity to cause weight loss;sulfonylureas cause weight gain. 
B) Meglitinides are longer acting than sulfonylureas. 
C) Meglitinides are shorter acting than sulfonylureas. 
D) Meglitinides decrease glucose production;sulfonylureas stimulate insulin secretion. 
A) Meglitinides have the propensity to cause weight loss;sulfonylureas cause weight gain. 
B) Meglitinides are longer acting than sulfonylureas. 
C) Meglitinides are shorter acting than sulfonylureas. 
D) Meglitinides decrease glucose production;sulfonylureas stimulate insulin secretion. C

Question 2

Which patient newly diagnosed with T2DM would respond best to sulfonylureas?

Accepted Answer

A) A patient with mild to moderate fasting hyperglycemia 
B) A patient with moderate to severe fasting hyperglycemia 
C) A patient with an HbgA1C of 12% 
D) All newly diagnosed T2DM patients 
A) A patient with mild to moderate fasting hyperglycemia 
B) A patient with moderate to severe fasting hyperglycemia 
C) A patient with an HbgA1C of 12% 
D) All newly diagnosed T2DM patients A

Question 3

A patient who was just recently started on repaglinide (Prandin)has called in to ask for your advice.She will not be able to take time to eat lunch today and because she is on the medication three times daily,she needs to know what to do about her usual lunch time dose.How should you advise her?

Accepted Answer

A) Continue to take the medication as prescribed. 
B) Skip the lunch dose and double the dose for dinner. 
C) Skip the lunch dose and continue with the normal dose for dinner. 
D) Skip both the lunch and dinner doses. 
E) Take the lunch and dinner doses at 10 minutes before the meal. 
A) Continue to take the medication as prescribed. 
B) Skip the lunch dose and double the dose for dinner. 
C) Skip the lunch dose and continue with the normal dose for dinner. 
D) Skip both the lunch and dinner doses. 
E) Take the lunch and dinner doses at 10 minutes before the meal. C

Question 4

A 35-year-old male patient with diabetes presents to the emergency department with complaints of weakness and dizziness.He states that he thinks the symptoms are related to a recently played soccer game.He is on insulin and took his normal recommended dose before he ate lunch.As you are talking to him,he becomes diaphoretic,complains of being very hungry,and his heart rate increases to 100 beats/minute.What is the most likely problem at this time?

Accepted Answer

A) Patient took too little insulin 
B) Patient took too much insulin 
A) Patient took too little insulin 
B) Patient took too much insulin

Question 5

The most common adverse effects of the drug class thiazolidinediones (TZDs)are weight gain and:

Accepted Answer

A) Headaches. 
B) GI upset. 
C) Constipation. 
D) Fluid retention. 
E) Hypoglycemia. 
A) Headaches. 
B) GI upset. 
C) Constipation. 
D) Fluid retention. 
E) Hypoglycemia.

Question 6

One reason diabetic patients have difficulty losing weight is due to the effects of insulin.Which of the following effects most specifically relates to this inability to lose weight?

Accepted Answer

A) Insulin acts on glucose cell membrane transporters. 
B) Insulin acts on glucose/glycogen storage in the liver. 
C) Insulin acts on adipose tissue,circulating free fatty acids. 
D) Insulin acts on muscle cell growth,promoting protein synthesis. 
A) Insulin acts on glucose cell membrane transporters. 
B) Insulin acts on glucose/glycogen storage in the liver. 
C) Insulin acts on adipose tissue,circulating free fatty acids. 
D) Insulin acts on muscle cell growth,promoting protein synthesis.

Question 7

Which of the following is a common side effect seen in patients taking DPP-IV inhibitors?

Accepted Answer

A) Significant weight gain 
B) Significant weight loss 
C) Significant GI distress 
D) Significant hypoglycemia 
E) Significant chance of pancreatitis 
A) Significant weight gain 
B) Significant weight loss 
C) Significant GI distress 
D) Significant hypoglycemia 
E) Significant chance of pancreatitis

Question 8

GLP-1 agonists are indicated to treat which type of patient?

Accepted Answer

A) Newly diagnosed patient with T2DM who has had no prior drug therapy 
B) Newly diagnosed patient with T1DM who has not started insulin therapy 
C) Newly diagnosed patient with T1DM whose postprandial glucose remains elevated 
D) Established T2DM patient whose postprandial glucose remain elevated with metformin 
E) Established T1DM patient whose postprandial glucose remains elevated 
A) Newly diagnosed patient with T2DM who has had no prior drug therapy 
B) Newly diagnosed patient with T1DM who has not started insulin therapy 
C) Newly diagnosed patient with T1DM whose postprandial glucose remains elevated 
D) Established T2DM patient whose postprandial glucose remain elevated with metformin 
E) Established T1DM patient whose postprandial glucose remains elevated

Question 9

Which of the following groups has not experienced a decrease in problems with vision secondary to diabetes?

Accepted Answer

A) Asian Americans 
B) African Americans 
C) All Caucasians 
D) Native Americans 
A) Asian Americans 
B) African Americans 
C) All Caucasians 
D) Native Americans

Question 10

From which location is the subcutaneous injection of insulin best absorbed?

Accepted Answer

A) Inner thigh 
B) Upper arm 
C) Buttock 
D) Abdomen 
E) Outer thigh 
A) Inner thigh 
B) Upper arm 
C) Buttock 
D) Abdomen 
E) Outer thigh

Question 11

Which medication class produces GI discomfort,including gas production,to the point that many patients discontinue them secondary to their side effects?

Accepted Answer

A) Alpha-glucosidase inhibitors 
B) TZDs 
C) Amylin analogs 
D) GLP-1 agonists 
A) Alpha-glucosidase inhibitors 
B) TZDs 
C) Amylin analogs 
D) GLP-1 agonists

Question 12

What is the mechanism of action for sulfonylureas?

Accepted Answer

A) Not fully known at this time 
B) Decreasing carbohydrate absorption in the GI tract 
C) Increasing insulin secretion from pancreatic beta cells 
D) Slowing gastric emptying and suppressing glucagon production 
A) Not fully known at this time 
B) Decreasing carbohydrate absorption in the GI tract 
C) Increasing insulin secretion from pancreatic beta cells 
D) Slowing gastric emptying and suppressing glucagon production

Question 13

You are caring for a patient with T2DM and are planning to add acarbose (Precose)to the medication regime.For what reason is it important to titrate the dosages of this medication?

Accepted Answer

A) To minimize hypoglycemic effect 
B) To minimize gastrointestinal (GI)side effects 
C) To minimize lactic acidosis 
D) To minimize weight gain 
E) To minimize weight loss 
A) To minimize hypoglycemic effect 
B) To minimize gastrointestinal (GI)side effects 
C) To minimize lactic acidosis 
D) To minimize weight gain 
E) To minimize weight loss

Question 14

When caring for a patient with diabetes,the most important therapeutic intervention is:

Accepted Answer

A) Insulin pump. 
B) Rapid-acting insulin. 
C) Lifestyle changes. 
D) Prefilled insulin syringes. 
A) Insulin pump. 
B) Rapid-acting insulin. 
C) Lifestyle changes. 
D) Prefilled insulin syringes.

Question 15

Which sulfonylurea causes the most side effects?

Accepted Answer

A) tolbutamide (Orinase) 
B) glyburide (DiaBeta) 
C) glimepiride (Amaryl) 
D) chlorpropamide (Diabinese) 
E) tolazamide (Orinase) 
A) tolbutamide (Orinase) 
B) glyburide (DiaBeta) 
C) glimepiride (Amaryl) 
D) chlorpropamide (Diabinese) 
E) tolazamide (Orinase)

Question 16

Which type of T1DM can have tyrosine phosphatase 1A-2 autoantibodies?

Accepted Answer

A) Immune mediated 
B) Nonimmune mediated 
C) Idiopathic mediated 
D) Cytomegalovirus mediated 
A) Immune mediated 
B) Nonimmune mediated 
C) Idiopathic mediated 
D) Cytomegalovirus mediated

Question 17

A plasma glucose concentration of 115 mg/dL is indicative of which category?

Accepted Answer

A) Within normal range 
B) Prediabetes 
C) Overt diabetes 
A) Within normal range 
B) Prediabetes 
C) Overt diabetes

Question 18

You have just examined a 45-year-old,slightly obese female who you diagnosed with T2DM 1 to 2 months ago.Her remaining medical history is unremarkable.Your first line of treatment consisted of the ADA's diet and exercise.You notice her self-reported blood glucose levels have shown an occasional hypoglycemic episode.When she returns today,she is still not in glycemic control.Which step would you recommended next in the treatment of this patient?

Accepted Answer

A) Begin insulin therapy immediately 
B) Begin a single pharmacological agent,metformin (Glucophage) 
C) Begin a single pharmacological agent,a sulfonylurea 
D) Begin treatment with two agents,metformin and a sulfonylurea 
A) Begin insulin therapy immediately 
B) Begin a single pharmacological agent,metformin (Glucophage) 
C) Begin a single pharmacological agent,a sulfonylurea 
D) Begin treatment with two agents,metformin and a sulfonylurea

Question 19

A patient with T2DM is 35 years old and has two children,but does not currently desire to enlarge her family and is therefore on oral contraceptives.She has been taking pioglitazone (Actos)without problems.Which recommendation is most important for you to discuss with the patient at this time?

Accepted Answer

A) She should use a higher dose oral contraceptive. 
B) She does not need to alter her oral contraceptive dose. 
C) She may increase her chance of conceiving a child with Down's syndrome. 
D) She will not have problems if she adds metformin to her medication regimen. 
E) She will not have problems if she adds glimepiride to her medication regimen. 
A) She should use a higher dose oral contraceptive. 
B) She does not need to alter her oral contraceptive dose. 
C) She may increase her chance of conceiving a child with Down's syndrome. 
D) She will not have problems if she adds metformin to her medication regimen. 
E) She will not have problems if she adds glimepiride to her medication regimen.

Question 20

While working in the emergency department,you see a 24-year-old male with T1DM who appears lethargic,confused,and disoriented.A stat blood sugar reveals the patient is severely hypoglycemic.Which action is most appropriate for immediate treatment for this patient?

Accepted Answer

A) Instruct the nurse to give the patient a glass of orange juice. 
B) Instruct the nurse to give the patient another dose of his regular insulin. 
C) Instruct the nurse to administer 1 mg IV glucagon. 
D) Instruct the nurse to administer 3 mg IM glucagon. 
E) Instruct the nurse to administer 5mg SQ glucagon. 
A) Instruct the nurse to give the patient a glass of orange juice. 
B) Instruct the nurse to give the patient another dose of his regular insulin. 
C) Instruct the nurse to administer 1 mg IV glucagon. 
D) Instruct the nurse to administer 3 mg IM glucagon. 
E) Instruct the nurse to administer 5mg SQ glucagon.

Exam 13: Drugs Used in the Treatment of Diabetes Mellitus

Which of the following demonstrates the primary differences between meglitinides and sulfonylureas?

Which patient newly diagnosed with T2DM would respond best to sulfonylureas?

A patient who was just recently started on repaglinide (Prandin)has called in to ask for your advice.She will not be able to take time to eat lunch today and because she is on the medication three times daily,she needs to know what to do about her usual lunch time dose.How should you advise her?

The most common adverse effects of the drug class thiazolidinediones (TZDs)are weight gain and:

One reason diabetic patients have difficulty losing weight is due to the effects of insulin.Which of the following effects most specifically relates to this inability to lose weight?

Which of the following is a common side effect seen in patients taking DPP-IV inhibitors?

GLP-1 agonists are indicated to treat which type of patient?

Which of the following groups has not experienced a decrease in problems with vision secondary to diabetes?

From which location is the subcutaneous injection of insulin best absorbed?

Which medication class produces GI discomfort,including gas production,to the point that many patients discontinue them secondary to their side effects?

What is the mechanism of action for sulfonylureas?

You are caring for a patient with T2DM and are planning to add acarbose (Precose)to the medication regime.For what reason is it important to titrate the dosages of this medication?

When caring for a patient with diabetes,the most important therapeutic intervention is:

Which sulfonylurea causes the most side effects?

Which type of T1DM can have tyrosine phosphatase 1A-2 autoantibodies?

A plasma glucose concentration of 115 mg/dL is indicative of which category?

A patient with T2DM is 35 years old and has two children,but does not currently desire to enlarge her family and is therefore on oral contraceptives.She has been taking pioglitazone (Actos)without problems.Which recommendation is most important for you to discuss with the patient at this time?

While working in the emergency department,you see a 24-year-old male with T1DM who appears lethargic,confused,and disoriented.A stat blood sugar reveals the patient is severely hypoglycemic.Which action is most appropriate for immediate treatment for this patient?

Conscientious and Rational Prescribing in the 21st Century

An Introduction to Pharmacodynamics and Pharmacokinetics

Communicating With Patients About Medications: a Patient-Centered Approach

Drugs Used in the Treatment of Bone and Joint Disorders

Drugs Used in the Treatment of Eye and Ear Disorders

Drugs Used in the Treatment of Cardiovascular Disorders

Drugs Used to Regulate Blood Pressure

Drugs Used in the Treatment of Hyperlipidemias

Drugs Used in the Treatment of Blood Disorders

Drugs Used in the Treatment of Pulmonary Diseases and Disorders

Drugs Used in the Treatment of Common Disorders of the Gastrointestinal System

Drugs Used to Treat Endocrine Gland Disorders

Drugs Used to Treat Common Neurological Conditions

Practical Pharmacotherapy of Drugs Used to Treat Psychiatric Disorders

Drugs Used in the Treatment of Skin Disorders

Modern Approaches to Managing Bacterial Infections

Drugs Used in the Treatment of Nonbacterial Infections

Drugs Used in the Treatment of Neoplasms

Drugs Used to Affect Womens Health

Drugs Used to Affect Mens Health

Prescribing for the Geriatric Patient

Prescribing for the Pediatric Patient

Drugs Used to Manage Pain

The Integrative Medicine Pharmacopoeia: Herbals, vitamins, and Dietary Supplements

Agents Used to Manipulate the Immune Response

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