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WorksheetsDrugs for diabetes
Total questions: 25
Worksheet time: 14mins
Which of the following statements is correct regarding insulin glargine?
It is primarily used to control postprandial hyperglycemia.
It is a “peakless” insulin.
The prolonged duration of activity is due to slow
dissociation from albumin.
It should not be used in a regimen with insulin lispro
or glulisine.
It may be administered intravenously in emergency
cases.
DW is a patient with type 2 diabetes who has a blood glucose of 400 mg/dL today at his office visit. The physician would like to give some insulin to bring the glucose down before he leaves the office. Which of the following would lower the glucose in the quickest manner in DW?
Insulin aspart
Insulin glargine
NPH insulin
Regular insulin
Which of the following classes of oral diabetes drugs is paired most appropriately with its primary mechanism of action?
DPP-4 inhibitor—inhibits breakdown of complex carbohydrates.
Glinide—increases insulin sensitivity.
Sulfonylurea—increases insulin secretion.
Thiazolidinedione—decreases hepatic gluconeogenesis.
Which of the following statements is characteristic of metformin?
Metformin is inappropriate for initial management of type 2 diabetes.
Metformin decreases hepatic glucose production.
Metformin undergoes significant metabolism via the cytochrome P450 system.
Metformin should not be combined with sulfonylureas or insulin.
Weight gain is a common adverse effect.
Which of the following is the most appropriate initial oral agent for management of type 2 diabetes in patients with no other comorbid conditions?
Glipizide
Insulin
Metformin
Pioglitazone
A 64-year-old woman with a history of type 2 diabetes is diagnosed with heart failure. Which of the following medications would be a poor choice for controlling her diabetes?
Exenatide
Glyburide
Nateglinide
Pioglitazone
Sitagliptin
KD is a 69-year-old male with type 2 diabetes and advanced chronic kidney disease. Which of the following diabetes medications is contraindicated in this patient?
Glipizide
Insulin lispro
Metformin
Saxagliptin
Which of the following drugs for diabetes would be LEAST likely to cause weight gain?
Glimepiride
Liraglutide
Pioglitazone
Repaglinide
Insulin glulisine
A patient with type 2 diabetes is taking metformin. The fasting glucose levels are in range, but the postprandial glucose is uncontrolled. All of the following drugs would be appropriate to add to metformin to target postprandial glucose except:
Acarbose
Exenatide
Insulin aspart
Pramlintide
Which of the following diabetes medications is most appropriately paired with an adverse effect associated with its use?
Canagliflozin—lactic acidosis.
Metformin—urinary tract infections
Nateglinide—heart failure.
Liraglutide—pancreatitis.
A 13-year-old boy with type 1 diabetes is brought to the hospital complaining of dizziness. Laboratory findings include severe hyperglycemia, ketoacidosis, and a blood pH of 7.15. Which of the following agents should be administered to achieve rapid control of the severe ketoacidosis in this diabetic boy?
Crystalline zinc insulin
Glyburide
Insulinglargine
NPH insulin
Tolbutamide
A 13-year-old boy with type 1 diabetes is brought to the hospital complaining of dizziness. Laboratory findings include severe hyperglycemia, ketoacidosis, and a blood pH of 7.15. Which of the following is the most likely complication of insulin therapy in this patient?
Dilutional hyponatremia
Hypoglycemia
Increased bleeding tendency
Pancreatitis
Severe hypertension
A 24-year-old woman with type 1 diabetes wishes to try tight control of her diabetes to improve her long-term prognosis. Which of the following regimens is most appropriate?
Morning injections of mixed insulin lispro and insulin aspart
Evening injections of mixed regular insulin and insulin glargine
Morning and evening injections of regular insulin, supplemented by small amounts of NPH insulin at mealtimes
Morning injections of insulin glargine, supplemented by small amounts of insulin lispro at mealtimes
Morning injection of NPH insulin and evening injection of regular insulin
Which one of the following drugs promotes the release of endogenous insulin?
Acarbose
Canagliflozin
Glipizide
Metformin
Miglitol
Which of the following is an important effect of insulin?
Increased conversion of amino acids into glucose
Increased glucose transport into cells
Increased glucose transport into cells
Inhibition of lipoprotein lipase
Stimulation of glycogenolysis
A 54-year-old obese patient with type 2 diabetes has a history of alcoholism. In this patient, metformin should either be avoided or used with extreme caution because the combination of metformin and ethanol increases the risk of which of the following?
A disulfiram-like reaction
Excessive weight gain
Hypoglycemia
Lactic acidosis
Serious hepatotoxicity
Which of the following drugs is taken during the first part of a meal for the purpose of delaying the absorption of dietary carbohydrates?
Acarbose
Exenatide
Glipizide
Pioglitazone
Repaglinide
The PPAR-γ receptor that is activated by thiazolidinediones increases tissue sensitivity to insulin by which of the following mechanisms?
Activating adenylyl cyclase and increasing the intracellular concentration of cAMP
Inactivating a cellular inhibitor of the GLUT2 glucose transporter
Inhibiting acid glucosidase, a key enzyme in glycogen breakdown pathways
Regulating transcription of genes involved in glucose utilization
Stimulating the activity of a tyrosine kinase that phosphorylates the insulin receptor
Which of the following drugs is most likely to cause hypoglycemia when used as monotherapy in the treatment of type 2 diabetes?
Acarbose
Canagliflozin
Glyburide
Metformin
Miglitol
Which of the following patients is most likely to be treated with intravenous glucagon?
An 18-year-old woman who took an overdose of cocaine and now has a blood pressure of 190/110 mm Hg
A 27-year-old woman with severe diarrhea caused by a
flare in her inflammatory bowel disease
A 57-year-old woman with type 2 diabetes who has not
taken her glyburide for the last 3 d
A 62-year-old man with severe bradycardia and hypotension resulting from ingestion of an overdose of atenolol
A 74-year-old man with lactic acidosis as a complication
of severe infection and shock
A woman takes an orally administered drug 30 minutes before each meal and must eat at that time to prevent hypoglycemia. Which mechanism is responsible for the therapeutic effect of this drug?
closing of potassium channels
slowed gastric emptying
inhibition of α-glucosidase
inhibition of DPP-4
insertion of glucose transporters in cell membranes
At mealtimes, a patient with type 1 diabetes injects both insulin and a drug that slows gastric emptying. Which
adverse effect may result from this drug?
nausea and anorexia
flatulence and bloating
weight gain
increased risk of heart failure
increased appetite
A woman takes an agent that activates PPAR-γ. Which
effect is produced by this drug?
increased insulin secretion
lowered HDL cholesterol levels
increased serum triglyceride levels
insertion of glucose transporters in adipose tissue
weight loss
An individual with diabetes injects an insulin preparation that forms microprecipitates in subcutaneous tissue. Which structural modification is found in this insulin analogue?
addition of a 14-carbon fatty acid chain
transposition of proline and lysine
substitution of aspartate for another amino acid
substitution of glutamate and lysine for other amino
acids
addition of two arginine residues
A woman is placed on a drug that increases insulin sensitivity and typically results in a loss of body weight. Which adverse effect commonly results from taking this medication?
increased risk of heart failure
increased triglyceride and LDL cholesterol levels
diarrhea
lactic acidosis
hypoglycemia
