NURS 615 Exam IV/ 81 Q&A/ Already Graded A+/ . Terms like:
How does metformin work? - Answer: Decreases hyperglycemia by decreasing hepatic glucose production called hepatic gluconeogenesis. The average person with type 2 diabetes has three times the rate of gluconeogenesis, metformin treatment...
NURS 615 Exam IV/ 81 Q&A/ Already Graded
A+/ 2024-2025.
How does metformin work? - Answer: Decreases hyperglycemia by decreasing
hepatic glucose production called hepatic gluconeogenesis. The average person
with type 2 diabetes has three times the rate of gluconeogenesis, metformin
treatment reduces this by over 1/3rd. The molecular mechanism of metformin
isn't completely understood. In addition to suppressing hepatic glucose
production, metformin increases insulin sensitivity, enhances peripheral glucose
uptake by inducing the phosphorilization of glu4 enhancer factor, decreases
insulin induced suppression of fatty acid oxidation, and decreases absorption of
glucose from the GI tract. Also of note** Metformin helps reduce LDL cholesterol
and triglyceride levels and is not associated with weight gain, in some people it
helps promote weight loss**
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,What diagnostic testing is required before and throughout therapy with
metformin? - Answer: Metformin is not metabolized, it is cleared from the body
by tubular secretion and is secreted unchanged in the urine. Metformin is
undetectable in blood plasma within 24 hrs of a single oral dose the average
elimination half-life in plasma is 6.2 hrs as it is secreted in the urine you should
check a serum crt to assess renal function.
What is the action of gliptin? - Answer: The mechanism of DDP-4 inhibitors is to
increase incretin levels incretin are GLP1 and GIP which inhibit glucagon release in
which in turn increases insulin secretion, decreases gastric emptying, and
decreases blood glucose levels
How do GLP agonists work? - Answer: They bind directly to a receptor in the
pancreatic beta cell. These agents work in the same pathway as the DPP-4
inhibitors as mentioned above but are generally considered more potent.
When should exenatide be administered? - Answer: 60 minutes prior to the
morning and evening meal
How will you assess for granulocytopenia? - Answer: Signs of a Cold or flu
including fever and sore throat
What are the adverse effects of propylthiouracil? - Answer: Agranulocytosis,
thrombocytopenia, and fulminant liver failure as stated above, pt's on PTU when
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, they develop fever or sore throat, it would be important to check a CBC preferably
with a smear and a diff.
What are the adverse effects of levothyroxine? - Answer: Tachycardia and angina
in the elderly
A patient develops a toxic goiter. What is the recommended treatment? - Answer:
Methimazole for one month then radioactive iodine (p. 641)
What are the adverse effects of PTU and methimazole? - Answer: PTU- Fatal
agranulocytopenia look for fever and sore throat and TEMPORARY ALOPECIA
What is the action of biphosphonates? - Answer: Bone undergoes constant
turnover and is kept in balance by osteoblasts creating bone and osteoclasts
destroying bone. Bisphosphonates inhibit the digestion of bone by encouraging
osteoclasts to undergo apoptosis or cell death there by slowing bone loss. Oral
bisphosphonates can cause upset stomach and inflammation as well as erosion.
Erosions of the esophagus which is the main problem of oral and containing
preparations. This can be prevented by sitting upright for 30-60 minutes after
taking the medication. If the patient does develop some type of gastric distress,
give them oral 30ml of Maalox 3 hrs after taking it. IV bisphosphonates can give
fever and flu like symptoms after the first infusion which is thought to occur
because of their potential to activate human T cells
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