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NR 565/NR565 FINAL EXAM/NR 565 PHARM FINAL EXAM 2 LATEST
VERSIONS 2023-2024 EACH VERSION CONTAINS 75 QUESTIONS
AND DETAILED ANSWERS|ALREADY GRADED A+
VERSION A
- How do Glucagon-like peptide-1 receptor agonist (Byetta, Victoza, trulicity) work to decrease blood
sugar levels?
o they slow gastric emptying, stimulate glucose-dependent release of insulin, inhibit
postprandial release of glucagon, and suppress appetite. - What is the most common side effect of Byetta?
o Nausea and + weight loss - For a new diagnosis of diabetes, insulin should be started if the A1c is greater than what?
o >10 - What is the typical starting insulin dose?
o patients should be started on 10 IU a day - How do you calculate a starting insulin dose?
o OR 0.1-0.2 IU/kg a day - Which cardiac medication can mask the symptoms of hypoglycemia?
o β-Blockers can delay awareness of and response to hypoglycemia by masking signs
that are associated with stimulation of the sympathetic nervous system (e.g.,
tachycardia, palpitations) that hypoglycemia normally causes. - What are the most common adverse effects of Metformin?
o Gastrointestinal (GI) symptoms: decreased appetite, nausea, diarrhea, Lactic acidosis
(rarely) - Is Metformin or sulfonylureas more likely to significantly drop a patients blood sugar?
o sulfonylureas
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- Which oral hypoglycemic is associated with heart failure?
o Pioglitazone is associated with heart failure (HF) secondary to renal retention of fluid.
If HF is diagnosed, pioglitazone should be discontinued or used in reduced dosage and
Thiazolidinediones - Which medication should we use caution when prescribing to a patient with history of pancreatitis?
o Dipeptidyl Peptidase-4 Inhibitors (Gliptins) - How does metformin work?
o 1.decreases glucogenesis and insulin resistance and increases glucose uptake. - What is first-line treatment for a new diagnosis of diabetes type 2?
o Lifestyle + metformin - What is the A1c goal for people with diabetes?
o <7 - What is the premeal glucose goal for someone with diabetes?
o 70-130 - What is the typical onset of short acting insulin?
o 30-60
• - Is a fasting blood glucose of 126 consistent with pre-diabetes or diabetes?
o Diabetes - What is a hemoglobin A1C of 5.7?
o Prediabetes - What is a hemoglobin A!C of 6.5?
o Diabetes - What are the “classic” signs of diabetes?
o polyuria, polydipsia, and unexplained weight loss. - A random plasma glucose of is suggestive of diabetes.
o 200 - When mixing short-acting insulin and NPH which one should be drawn up first in the syringe?
o the short-acting insulin should be drawn into the syringe first to avoid contaminating
the stock vial of the short-acting insulin with NPH insulin - A BG less than what is considered hypoglycemia?
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o <70 and it can be caused by what? excessive consumption of alcohol (which promotes
hypoglycemia), unusually intense exercise (which promotes cellular glucose uptake and
metabolism), and childbirth (which reduces insulin requirements).
- When glucose levels fall rapidly what symptoms may a patient exhibit?
o tachycardia, palpitations, sweating, and nervousness. - When glucose levels fall gradually how might symptoms be different?
o Mild CNS symptoms include headache, confusion, drowsiness, and fatigue. If
hypoglycemia is severe, convulsions, coma, and death may follow. - How often should HgbA1c be drawn?
o Q3 Months - What is black-box warning for Metformin and what are the signs?
o 1.lactic acidosis, early signs of lactic acidosis—hyperventilation, myalgia, malaise, and
unusual somnolence - What would thyroid hormone levels look like in hyperthyroidism?
o decreased TSH, increases T3 or T4 - What are some s/s of hyperthyroidism?
o nervousness, insomnia, rapid thought flow, and rapid speech. Skeletal muscles may
weaken and atrophy. Metabolic rate is raised, resulting in increased heat production,
increased body temperature, intolerance to heat, and skin that is warm and moist.
Appetite is increased, weight loss - What are s/s of thyroid storm?
o 1.hyperthermia (105°F or even higher), severe tachycardia, restlessness, agitation, and
tremor. Unconsciousness, coma, hypotension, and heart failure may ensue. - What is the first-line drug for hyperthyroidism?
o Methimazole (for Graves disease, adjunct to radiation therapy, to suppress thyroid
hormone synthesis in preparation for thyroid gland surgery, it can be given to patients
experiencing thyrotoxic crisis. - What is the most dangerous adverse effect of the above drug?
o Agranulocytosis is the most dangerous toxicity.