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1.5 CE Test Hours

Type 2 Diabetes

A Pharmacologic Update

Contrada, Emily

AJN The American Journal of Nursing: March 2019 - Volume 119 - Issue 3 - p 42
doi: 10.1097/01.NAJ.0000554009.84637.8a
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Type 2 Diabetes: A Pharmacologic Update


To provide information about established as well as more recently introduced type 2 diabetes treatments and the nursing implications for patient teaching and monitoring for adverse effects.

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After completing this continuing education activity, you should be able to

  • outline indications and contraindications for the drugs discussed in this article.
  • identify adverse effects related to these drugs.
  • summarize key points for patient teaching about these drugs.
  1. For treating type 2 diabetes mellitus, metformin is
    1. one of the more expensive antidiabetic drugs available.
    2. the first-line drug when nonpharmacologic therapy is not effective.
    3. known to cause significant weight gain in most patients who use it.
  2. The most serious adverse effect associated with metformin is
    1. osteoporosis.
    2. renal toxicity.
    3. lactic acidosis.
  3. Metformin is associated with deficiency of which of the following vitamins?
    1. B12
    2. D
    3. K
  4. Compared with metformin, sulfonylureas have a
    1. lower risk of weight gain.
    2. higher risk of hypoglycemia.
    3. lower risk of cardiovascular mortality.
  5. The second-generation sulfonylurea that patients should take on an empty stomach 30 minutes before a meal is
    1. glimepiride.
    2. glyburide.
    3. glipizide.
  6. Meglitinides act by
    1. inhibiting gluconeogenesis and glycogenolysis to reduce hepatic glucose output.
    2. altering the ATP-sensitive potassium channel of the pancreatic beta cells.
    3. impeding the conversion of oligosaccharides to monosaccharides.
  7. Of the following, the most commonly reported adverse effect of meglitinide use is
    1. hypoglycemia.
    2. nasopharyngitis.
    3. abdominal bloating.
  8. Thiazolidinediones act by
    1. filtering glucose reabsorption in the proximal tubules of the kidney.
    2. impeding the conversion of oligosaccharides to monosaccharides.
    3. directly increasing insulin sensitivity in muscle, fat, and liver tissues.
  9. A contraindication for thiazolidinedione use is
    1. osteopenia.
    2. renal disease.
    3. bowel disorders.
  10. Taking thiazolidinediones may increase the risk of
    1. bleeding.
    2. pregnancy.
    3. thyroid tumors.
  11. A contraindication for taking α-glucosidase inhibitors is
    1. osteopenia.
    2. renal disease.
    3. bowel disorders.
  12. There have been reports that use of dipeptidyl peptidase 4 (DPP-4) inhibitors may be associated with
    1. amputation.
    2. acute pancreatitis.
    3. myocardial infarction.
  13. Patients should take DPP-4 inhibitors
    1. 3 times a day with a meal.
    2. on arising and again at bedtime.
    3. once daily, with or without meals.
  14. Which glucagon-like peptide 1 (GLP-1) receptor agonist is approved by the U.S. Food and Drug Administration for treating obesity?
    1. exenatide
    2. liraglutide
    3. albiglutide
  15. Which GLP-1 receptor agonist is a long-acting agent administered once weekly?
    1. exenatide
    2. liraglutide
    3. albiglutide
  16. Clinical trials with liraglutide have reported
    1. thyroid neoplasms.
    2. mycotic infections.
    3. decreased calcitonin levels.
  17. Adverse reactions to sodium–glucose cotransporter 2 inhibitors include
    1. hypotension.
    2. thrombocytopenia.
    3. urinary tract infections.
  18. Canagliflozin may increase the risk of
    1. fracture.
    2. hypokalemia.
    3. tendon rupture.
  19. Adverse reactions to pramlintide include
    1. increased appetite.
    2. vomiting.
    3. myalgia.
  20. Pramlintide should be injected into the thigh or
    1. abdomen.
    2. buttocks.
    3. upper arm.
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