Endocrine System Drugs ATI

Endocrine System Drugs
<question question="What is the brand/trade name of the alphaglucosidase inhibitor drug whose generic name is acarbose?"
answer="Precose"/>
<question question="What is the brand/trade name of the amylin mimetic
drug whose generic name is pramlintide?" answer="Symlin"/>
<question question="What are the brand/trade names of the antidiuretic
hormone drug whose generic name is desmopressin? " answer="DDAVP, Stimate,
Minirin"/>
<question question="What is the brand/trade name of the antithyroid drug
whose generic name is propylthiouracil (PTU)?" answer="Propyl-Thyracil"/>
<question question="What is the brand/trade name of the antithyroid
drug/radioactive iodine drug whose generic name is iodine-131 ?"
answer="Iodotope"/>
<question question="What is the brand/trade name of the biguanide drug
whose generic name is metformin? " answer="Glucophage"/>
<question question="What is the brand/trade name of the gliptin drug
whose generic name is sitagliptin? " answer="Januvia"/>
<question question="What are the brand/trade names of the glucocorticoid
drug whose generic name is hydrocortisone?" answer="Hydrocortone, SoluCortef"/>
<question question="What are the brand/trade names of the growth hormone
drug whose generic name is somatropin?" answer="Genotropin, Nutropin,
Humatrope, Serostim"/>
<question question="What is the brand/trade name of the hyperglycemic
agent drug whose generic name is glucagon?" answer="GlucaGen"/>
<question question="What is the brand/trade name of the incretin mimetic
drug whose generic name is exenatide? " answer="Byetta"/>
<question question="What is the brand/trade name of the meglitinide drug
whose generic name is repaglinide? " answer="Prandin"/>
<question question="What is the brand/trade name of the
mineralocorticoid drug whose generic name is fludrocortisone? "
answer="Florinef Acetate"/>
<question question="What is the brand/trade name of the sulfonylurea
drug whose generic name is glipizide?" answer=" Glucotrol"/>
<question question="What is the brand/trade name of the
thiazolidinedione drug whose generic name is rosiglitazone?"
answer="Avandia"/>
<question question="What is the brand/trade name of the thyroid
replacement drug whose generic name is levothyroxine?" answer="Synthroid"/>
<question question="What is the brand/trade name of the rapid-acting
insulin drug whose generic name is Lispro?" answer="Humalog"/>
<question question="What is the brand/trade name of the short-acting
insulin drug whose generic name is Regular?" answer="Humulin R"/>
<question question="What is the brand/trade name of the intermediateacting insulin drug whose generic name is NPH?" answer="Humulin N"/>
<question question="What is the brand/trade name of the long-acting
insulin drug whose generic name is insulin glargine?" answer="Lantus"/>
</chapter>
<chapter ChapterName="Generic Drugs">
<question question="What is the generic name of the
alpha-glucosidase inhibitor drug whose brand/trade name is Precose?" answer="
acarbose"/>
amylin mimetic drug whose brand/trade name is Symlin?" answer="pramlintide "/>
antidiuretic hormone drug whose brand/trade names are DDAVP, Stimate,
Minirin?" answer="desmopressin "/>
antithyroid drug whose brand/trade name is Propyl-Thyracil?"
answer="propylthiouracil (PTU)"/>
antithyroid drug/radioactive iodine drug whose brand/trade name is Iodotope?"
answer="iodine-131 "/>
biguanide drug whose brand/trade name is Glucophage?" answer="metformin "/>
gliptin drug whose brand/trade name is Januvia?" answer="sitagliptin"/>
glucocorticoid drug whose brand/trade names are Hydrocortone and Solu-Cortef?"
answer="hydrocortisone "/>
growth hormone drug whose brand/trade names are Genotropin, Nutropin,
Humatrope, and Serostim?" answer="somatropin"/>
hyperglycemic agent whose brand/trade name is GlucaGen?" answer="glucagon"/>
incretin mimetic drug whose brand/trade name is Byetta?" answer="exenatide "/>
meglitinide drug whose brand/trade name is Prandin?" answer="repaglinide"/>
mineralocorticoid drug whose brand/trade name is Florinef Acetate?"
answer="fludrocortisone "/>
sulfonylurea drug whose brand/trade name is Glucotrol?" answer="glipizide "/>
thiazolidinedione drug whose brand/trade name is Avandia?"
answer="rosiglitazone"/>

thyroid replacement drug whose brand/trade name is Synthroid?"
answer="levothyroxine "/>
rapid-acting insulin drug whose brand/trade name is Humalog? "
answer="Lispro"/>
short-acting insulin drug whose brand/trade name is Humulin R? "
answer="Regular"/>
intermediate-acting insulin drug whose brand/trade name is Humulin N?"
answer="NPH insulin"/>
long-acting insulin drug whose brand/trade name is Lantus? " answer="insulin
glargine"/>
</chapter>
<chapter ChapterName="Therapeutic Uses">
<question question="What is the therapeutic use for the
alpha-glucosidase inhibitor drug acarbose (Precose)?" answer="Type 2 diabetes
mellitus, with or without drug therapy with insulin, a sulfonylurea, or
metformin (Glucophage)"/>
amylin mimetic drug pramlintide (Symlin)?" answer="Types 1 and 2 diabetes
mellitus (as an insulin or hypoglycemic drug supplement)"/>
antidiuretic hormone desmopressin (DDAVP, Stimate, Minirin)?" answer="Diabetes
insipidus
</li></ul>"/>
<question question="What are some of the therapeutic
uses for the antithyroid drug propylthiouracil [PTU] (Propyl-Thyracil)?"
answer="<ul><li> Hyperthyroidism (Graves' disease)
</li><li>Thyrotoxic crisis
</li><li>Suppression of thyroid hormone production in preparation for
thyroidectomy
</li></ul>"/>
uses for the antithyroid drug/radioactive iodine drug iodine-131 (Iodotope)?"
answer="<ul><li> Hyperthyroidism (Graves' disease)
</li><li>Thyroid cancer
</li></ul>"/>
biguanide drug metformin (Glucophage)?" answer="Type 2 diabetes mellitus"/>

gliptin drug sitagliptin (Januvia)?" answer="Treats type 2 diabetes alone or
in combination with other drugs for diabetes"/>
glucocorticoid drug hydrocortisone (Hydrocortone, Solu-Cortef)?"
answer="Replacement therapy for acute and chronic adrenocortical insufficiency
(Addison's disease)
</li></ul>"/>
uses for the growth hormone somatropin (Genotropin, Nutropin, Humatrope,
Serostim)?" answer="<ul><li> Growth hormone deficiencies, such as Turner's
syndrome
</li><li>Growth hormone deficiency in adults to increase lean muscle mass
</li><li>AIDS wasting syndrome
</li></ul>"/>
hyperglycemic agent glucagon (GlucaGen)?" answer="Hypoglycemia from an insulin
overdose"/>
incretin mimetic drug exenatide (Byetta)?" answer="Type 2 diabetes mellitus,
as a supplement to sulfonylureas or metformin (Glucophage)"/>
insulin drugs Lispro (Humalog), Regular (Humulin R), NPH insulin (Humulin N),
insulin glargine (Lantus)?" answer="Diabetes mellitus (type 1, type 2,
gestational)"/>
meglitinide drug repaglinide (Prandin)?" answer="Type 2 diabetes mellitus"/>
mineralocorticoid drug fludrocortisone (Florinef Acetate)?"
answer="Replacement therapy for acute and chronic adrenocortical insufficiency
(Addison's disease, primary hypoaldosteronism, congenital adrenal hyperplasia)
usually along with hydrocortisone"/>
sulfonylurea drug glipizide (Glucotrol)?" answer="Type 2 diabetes mellitus"/>
thiazolidinedione drug rosiglitazone (Avandia)?" answer="Type 2 diabetes
mellitus, with or without drug therapy with insulin or metformin
(Glucophage)"/>
thyroid replacement drug levothyroxine (Synthroid)?" answer="Hypothyroidism"/>
</chapter>
<chapter ChapterName="Administration Considerations">
<question question="How should the alpha-glucosidase

inhibitor acarbose (Precose) be given?" answer="<ul><li> Give with the first
bite of food, three times a day.
</li><li>Tell patients who skip a meal to also skip the dose they usually take
with that meal and to take only one dose at the next meal.
</li></ul>"/>
<question question="How should the amylin mimetic drug
pramlintide (Symlin) be given?" answer="<ul><li> Do not mix with insulin in
the same syringe.
</li><li>Give subcutaneously in the thigh or abdomen prior to meals that
contain at least 30 g of carbohydrates.
</li><li>Rotate injection sites.
</li><li>Expect the peak action 20 min after dosing.
</li><li>Refrigerate unopened vials until their expiration date.
</li><li>Keep vials in use at room temperature for 28 days.
</li></ul>"/>
<question question="How should the antidiuretic hormone
drug desmopressin (DDAVP, Stimate, Minirin) be given?" answer="<ul><li>
Administer orally, intranasally, subcutaneously, or IV.
</li><li>Spray the nasal form high into the nasal cavity but not into the
throat.
</li><li>Monitor blood pressure, intake and output, urine and plasma
osmolality, and creatinine clearance.
</li><li>Expect lifelong therapy.
</li></ul>"/>
<question question="How should the antithyroid drug
propylthiouracil [PTU] (Propyl-Thyracil) be given?" answer="<ul><li> Give
orally at regular intervals, such as every 8 hr.
</li><li>Measure baseline vital signs and weight, and monitor periodically
thereafter.
</li><li>Monitor triiodothyronine and thyroxine levels.
</li></ul>"/>
<question question="How should the antithyroid
drug/radioactive iodine drug iodine-131 (Iodotope) be given?" answer="<ul><li>
Give orally once, although some patients require subsequent dosing.
</li><li>Obtain a negative pregnancy test before administration.
</li><li>Measure baseline vital signs and weight, and monitor periodically
thereafter.
</li><li>Initiate radiation precautions for large doses (limited contact,
increased fluids, body waste disposal per facility protocol).
</li></ul>"/>
<question question="How should the biguanide drug
metformin (Glucophage) be given?" answer="<ul><li> Give orally twice a day
with the morning and evening meals (immediate-release) or once a day with the
evening meal (extended-release).
</li><li>Make sure patients swallow the extended-release form whole and do not
crush or chew it.
</li></ul>"/>
<question question="How should the gliptin drug
sitagliptin (Januvia) be given?" answer="<ul><li> Administer orally alone or
as metformin/sitagliptin (Janumet).
</li><li>Give with or without food.
</li><li>Give a reduced dosage to patients who have severe renal impairment
and low creatinine clearance.
</li></ul>"/>
<question question="How should the glucocorticoid drug
hydrocortisone (Hydrocortone, Solu-Cortef) be given?" answer="<ul><li> Give
orally for chronic adrenal insufficiency, as a total daily dose at bedtime or
in divided doses (two thirds in the morning and one third in the early
afternoon).
</li><li>Give IV for acute and emergency situations.
</li><li>Obtain CBC, electrolyte, glucose, and glucocorticoid levels at
baseline and periodically thereafter.
</li><li>Make sure patients wear a medical alert band and carry an emergency
supply of glucocorticoids.
</li><li>Taper the dose slowly to establish the lowest possible oral dose.
</li><li>Give supplemental doses as needed in times of stress.
</li></ul>"/>
<question question="How should the growth hormone
somatropin (Genotropin, Nutropin, Humatrope, Serostim) be given?"
answer="<ul><li> Give IM or subcutaneously (preferable).
</li><li>Dosage is based on weight.
</li><li>Give daily or several times a week.
</li><li>Obtain baseline height, weight, thyroid function, and growth hormone
levels and monitor monthly; obtain yearly x-rays of long bones.
</li><li>When reconstituting the drug, rotate the vial gently; do not shake
it.
</li><li>Inject subcutaneously into the abdomen and thighs, and rotate sites.
</li><li>Discontinue treatment prior to epiphyseal closure in children.
</li></ul>"/>
<question question="How should the hyperglycemic agent
glucagon (GlucaGen) be given?" answer="<ul><li> Give IV, IM, or
subcutaneously.
</li><li>Expect unconscious patients to regain consciousness about 20 min
after IV administration.
</li><li>Provide food after patients regain consciousness and can swallow.
</li><li>Be aware that, for severe hypoglycemia, IV glucose is the treatment
of choice because it acts faster than glucagon does.
</li></ul>"/>
<question question="How should the incretin mimetic

drug exenatide (Byetta) be given?" answer="<ul><li> Give subcutaneously into
the thigh, abdomen, or upper arm up to 60 min prior to the morning and evening
meals, not after meals.
</li><li>Rotate injection sites.
</li><li>Expect the peak action 2 hr after dosing.
</li><li>The injection pen is available in 5 mcg and 10 mcg doses.
</li><li>Follow manufacturer's instructions for "New Pen Setup".
</li><li>Use needle size prescribed by provider.
</li><li>Use new needle each time injection pen is used.
</li><li>Keep pens in use at room temperature up to 30 days.
</li><li>Do not store pens with needle attached.
</li><li>Refrigerate unused injector pens until their expiration date.
</li></ul>"/>
<question question="How should the insulin drugs,
Lispro (Humalog), Regular (Humulin R), NPH insulin (Humulin N), insulin
glargine (Lantus) be given?" answer="<ul><li> Give subcutaneously (using an
insulin syringe) or IV (NPH subcutaneously only).
</li><li>Select an appropriate needle length for injecting insulin into
subcutaneous tissue versus intradermal (too short) or intramuscular (too
long).
</li><li>For insulin suspensions, gently rotate the vial between your palms to
disperse the particles.
</li><li>When mixing short-acting insulin with longer-acting insulin, draw the
short-acting insulin into the syringe first, then the longer-acting insulin.
</li><li>Do not mix insulin glargine or insulin detemir with any other
insulin.
</li><li>Do not administer short-acting insulins if they appear cloudy or
discolored.
</li><li>Instruct patients to self-administer insulin subcutaneously in one
general area for consistent absorption rates.
</li><li>Keep vials in use at room temperature for 1 month.
</li><li>Refrigerate unopened vials of a single type of insulin until their
expiration date.
</li><li>Keep insulins premixed in syringes for 1 to 2 weeks under
refrigeration and vertical, with the needles pointing upward. Prior to
administration, resuspend the insulin via gentle motion.
</li><li>Expect dosage adjustments in response to caloric intake, infection,
exercise, stress, growth spurts, and pregnancy.
</li><li>Make sure adequate glucose is available at onset and peak insulin
times.
</li></ul>"/>
<question question="How should the meglitinide drug
repaglinide (Prandin) be given?" answer="<ul><li> Give orally 30 min or less
before meals, usually three times a day.
</li><li>Tell patients to skip a dose if they skip a meal and to add a dose if
they add a meal.
</li><li>Do not exceed four doses per day.
</li></ul>"/>
<question question="How should the mineralocorticoid
drug fludrocortisone (Florinef Acetate) be given?" answer="<ul><li> Give
orally daily or three times a week.
</li><li>Obtain CBC and electrolyte levels at baseline and periodically
thereafter.
</li><li>Make sure patients wear a medical alert band.
</li><li>Expect lifelong therapy.
</li></ul>"/>
<question question="How should the sulfonylurea drug
glipizide (Glucotrol) be given?" answer="<ul><li> Give orally and 30 min
before selected meals.
</li><li>Make sure patients swallow the sustained-release form whole and do
not crush or chew it.
</li><li>Make sure patients who are pregnant stop taking it at least 48 hr
before delivery.
</li></ul>"/>
<question question="How should the thiazolidinedione
drug rosiglitazone (Avandia) be given?" answer="<ul><li> Give orally once or
twice a day with or without food."/>
<question question="How should the thyroid replacement
drug levothyroxine (Synthroid) be given?" answer="<ul><li> Give orally to
treat hypothyroidism and IV to treat myxedema coma.
</li><li>Give daily on an empty stomach (at least 30 min before breakfast).
</li><li>Measure baseline vital signs, weight, and height, and monitor
periodically thereafter.
</li><li>Monitor for cardiac excitability (angina, chest pain, palpitations,
dysrhythmias).
</li><li>Monitor thyroxine and thyroid-stimulating hormone levels.
</li><li>Be aware that the various formulations of thyroxine are not
interchangeable; instruct patients to notify the provider if a pharmacy
dispenses a different levothyroxine product.
</li><li>Expect lifelong replacement therapy.
</li></ul>"/>
<question question="What is the onset of action time
for rapid-acting insulins? " answer="Less than 15 min"/>
for short-acting insulins? " answer="30 to 60 min"/>
for intermediate-acting insulins? " answer="1 to 2 hr"/>
for long-acting insulins? " answer="1 hr"/>
<question question="What is the peak action time for

rapid-acting insulins?" answer="30 to 60 min"/>
short-acting insulins?" answer="2 to 3 hr"/>
intermediate-acting insulins?" answer="4 to 12 hr"/>
<question question="What is the peak action time of the
drug classified as a long-acting inulin?" answer="There is no peak time; the
levels are steady."/>
<question question="What is the duration of action time
for rapid-acting insulins?" answer="3 to 4 hr"/>
for short-acting insulins?" answer="5 to 7 hr"/>
for intermediate-acting insulins?" answer="18 to 24 hr"/>
for long-acting insulins?" answer="24 hr"/>
</chapter>
<chapter ChapterName="Common Side Effects">
<question question="What are some of the side and/or
adverse effects of the alpha-glucosidase inhibitor drug acarbose (Precose)?"
answer="<ul><li> Distention, flatus, hyperactive bowel sounds, diarrhea
</li><li>Hypoglycemia (combination therapy with insulin or a sulfonylurea)
</li><li>Liver dysfunction
</li><li>Anemia
</li></ul>"/>
adverse effects of the amylin mimetic drug pramlintide (Symlin)?"
answer="<ul><li> Hypoglycemia (severe) when combined with insulin
</li><li>Nausea
</li><li>Injection site reactions
</li></ul>"/>
<question question="What is a side and/or adverse
effect of the antidiuretic hormone desmopressin (DDAVP, Stimate, Minirin)?"
answer="Fluid retention (leading to water intoxication), hyponatremia
</li></ul>"/>
adverse effects of the antithyroid drug propylthiouracil [PTU] (PropylThyracil)?" answer="<ul><li> Hypothyroidism
</li><li>Agranulocytosis
</li><li>Rash
</li><li>Arthralgia, myalgia, headache
</li></ul>"/>

adverse effects of the antithyroid drug/radioactive iodine drug iodine-131
(Iodotope)?" answer="<ul><li> Hypothyroidism (expected for most patients, but
still requires drug therapy)
</li><li>Bone marrow depression (rare)
</li><li>Radiation sickness (rare)
</li></ul>"/>
adverse effects of the biguanide drug metformin (Glucophage)?"
answer="<ul><li> Lactic acidosis (rare, but potentially fatal)
</li><li>Nausea, diarrhea, anorexia
</li><li>Vitamin deficiencies (vitamin B12, folic acid)
</li></ul>"/>
adverse effects of the gliptin drug sitagliptin (Januvia)?" answer="<ul><li>
Upper respiratory tract infection and inflamed nasal passages
</li><li>Headache
</li><li>Pancreatitis
</li></ul>"/>
adverse effects of the glucocorticoid drug hydrocortisone (Hydrocortone, SoluCortef)?" answer="<ul><li> Few at low, therapeutic levels
</li><li>Multiple at high levels needed to suppress inflammation and the
immune system
</li></ul>"/>
adverse effects of the growth hormone somatropin (Genotropin, Nutropin,
Humatrope, Serostim)?" answer="<ul><li> Hyperglycemia
</li><li>Myalgia
</li><li>Hypercalciuria
</li></ul>"/>
adverse effects of the hyperglycemic agent glucagon (GlucaGen)?"
answer="Nausea, vomiting"/>
adverse effects of the incretin mimetic drug exenatide (Byetta)?"
answer="<ul><li> Hypoglycemia
</li><li>Nausea, vomiting, diarrhea
</li><li>Pancreatitis
</li></ul>"/>
adverse effects of the insulin drugs, lispro (Humalog), regular (Humulin R),
NPH (Humulin N), insulin glargine (Lantus)?" answer="<ul><li> Hypoglycemia
</li><li>Lipohypertrophy
</li><li>Hypokalemia
</li></ul>"/>
adverse effects of the meglitinide drug repaglinide (Prandin)?"
</li><li>Nausea, diarrhea
</li></ul>"/>
adverse effects of the mineralocorticoid drug fludrocortisone (Florinef
Acetate)?" answer="<ul><li> Few at low, therapeutic levels
</li><li>At levels above therapeutic, fluid and electrolyte imbalances that
can lead to hypertension, edema, heart failure, hypokalemia
</li></ul>"/>
adverse effects of the sulfonylurea drug glipizide (Glucotrol)?"
</li><li>Nausea, diarrhea
</li></ul>"/>
adverse effects of the thiazolidinedione drug rosiglitazone (Avandia)?"
answer="<ul><li> Fluid retention
</li><li>Hepatotoxicity
</li><li>Serum lipid levels
</li></ul>"/>
adverse effects of the thyroid replacement drug levothyroxine (Synthroid)?"
answer="<ul><li> Hyperthyroidism (from excessive doses) - anxiety,
tachycardia, palpitations, tremors, altered appetite, abdominal cramping,
diarrhea, heat intolerance, fever, diaphoresis, weight loss, menstrual
irregularities"/>
</chapter>
<chapter ChapterName="Nursing Interventions">
<question question="What interventions should the
health care professional use when caring for a patient who is taking the
alpha-glucosidase inhibitor drug acarbose (Precose)?" answer="<ul><li> Monitor
hyperactive bowel sounds, distention, and diarrhea.
</li><li>Report persistent gastric distress.
</li><li>Monitor for signs of hypoglycemia (diaphoresis, tachycardia, fatigue,
excessive hunger, tremors).
</li><li>Treat hypoglycemia with 4 g of dextrose, not glucose.
</li><li>Measure liver enzymes at baseline, every 3 months for the first year,
and periodically thereafter.
</li><li>Stop drug therapy for indications of liver injury.
</li><li>Monitor CBC.
</li><li>Watch for indications of anemia (pallor, fatigue, shortness of
breath).
</li><li>Recommend iron-rich foods and supplements accordingly.

</li></ul>"/>
amylin mimetic drug pramlintide (Symlin)?" answer="<ul><li> Recommend a
reduced insulin dosage when initiating therapy.
</li><li>Monitor for signs of hypoglycemia, which tends to occur within 3 hr
after dosing.
</li><li>Recommend gradual titration of doses.
</li><li>Monitor for persistent nausea and vomiting (more common with type 1
than with type 2 diabetes mellitus).
</li><li>Use appropriate injection technique to prevent injection-site
reactions.
</li></ul>"/>
antidiuretic hormone drug desmopressin (DDAVP, Stimate, Minirin)? "
answer="<ul><li> Monitor for headache, confusion, or other signs of water
intoxication.
</li><li>Monitor fluid intake and output.
</li><li>Monitor serum sodium levels.
</li><li>Restrict fluid intake when appropriate.
</li><li>Recommend diuretic therapy for moderate and severe fluid retention.
</li><li>Monitor for signs of myocardial infarction, angina pectoris, or
cardiac insufficiency.
</li></ul>"/>
antithyroid drug propylthiouracil (PTU) (Propyl-Thyracil)?" answer="<ul><li>
Monitor thyroid function.
</li><li>Monitor for indications of hypothyroidism (drowsiness, depression,
weight gain, edema, bradycardia, anorexia, cold intolerance, dry skin,
menorrhagia).
</li><li>Recommend a reduced dosage for patients who develop hypothyroidism.
</li><li>Monitor CBC at baseline and periodically thereafter (leukocytes,
neutrophils).
</li><li>Monitor for indications of agranulocytosis; for these symptoms, stop
therapy.
</li><li>Monitor integumentary status because the drug can cause a rash.
</li><li>Monitor for joint and muscle pain and headache.
</li></ul>"/>
antithyroid drug/radioactive iodine drug iodine-131 (Iodotope)?"
answer="<ul><li> Monitor thyroid function.
</li><li>Monitor for indications of hypothyroidism (drowsiness, depression,

weight gain, edema, bradycardia, anorexia, cold intolerance, dry skin,
menorrhagia).
</li><li>Monitor CBC and platelet count at baseline and periodically
thereafter.
</li><li>Monitor for indications of anemia, leukopenia, and thrombocytopenia.
</li><li>Monitor for manifestations of radiation sickness (hematemesis,
epistaxis, intense nausea, vomiting).
</li></ul>"/>
biguanide drug metformin (Glucophage)?" answer="<ul><li> Monitor for
indications of lactic acidosis.
</li><li>For signs of lactic acidosis, stop drug therapy immediately.
</li><li>Expect that severe lactic acidosis will require hemodialysis.
</li><li>Monitor for persistent nausea, vomiting, or diarrhea.
</li><li>Monitor for indications of vitamin B12 or folic acid deficiency.
</li><li>Recommend appropriate supplements.
</li></ul>"/>
gliptin drug sitagliptin (Januvia)?" answer="<ul><li> Monitor for respiratory
symptoms.
</li><li>Monitor temperature if respiratory effects occur.
</li><li>Monitor for headaches.
</li><li>Administer over-the-counter analgesic for persistent headache, if
provider approves.
</li><li>Monitor for gastrointestinal effects that could be signs of
pancreatitis.
</li><li>Be prepared to monitor blood amylase level to help confirm
pancreatitis.
</li></ul>"/>
<question question="What intervention should the health
care professional use when caring for a patient who is taking the
glucocorticoid drug hydrocortisone (Hydrocortone, Solu-Cortef)?"
answer="Monitor for side effects related to inappropriate dosing, such as
hypercortisolism (hyperglycemia, fat redistribution, osteoporosis) or
hypocortisolism (fatigue, weakness, weight loss, hypoglycemia).
</li></ul>"/>
growth hormone somatropin (Genotropin, Nutropin, Humatrope, Serostim)?"
answer="<ul><li> Monitor blood glucose levels.
</li><li>Monitor for muscle pain and administer a mild analgesic as needed.
</li><li>Monitor urine calcium because the drug can cause increased levels.
</li><li>Monitor for renal stones.
</li></ul>"/>
hyperglycemic agent glucagon (GlucaGen)?" answer="<ul><li> For an unconscious
patient, turn on side to prevent aspiration from vomiting.
</li><li>Monitor for persistent nausea and vomiting.
</li><li>Monitor fluid and carbohydrate intake.
</li></ul>"/>
incretin mimetic drug exenatide (Byetta)?" answer="<ul><li> Recommend a
reduced oral hypoglycemic drug dosage when initiating therapy.
</li><li>Monitor for signs of hypoglycemia.
</li><li>Monitor fluid and carbohydrate intake.
</li><li>Monitor for indications of pancreatitis; stop drug therapy if they
occur.
</li></ul>"/>
insulin drugs, Lispro (Humalog), Regular (Humulin R), NPH insulin (Humulin N),
insulin glargine (Lantus)?" answer="<ul><li> Monitor for signs of hypoglycemia
(abrupt onset: tachycardia, palpitations, diaphoresis, shakiness; gradual
onset: headache, tremors, weakness).
</li><li>Check blood glucose level to confirm hypoglycemia, then give 15 g of
carbohydrate (4 oz fruit juice, 1 tbsp honey, glucose tablets per
manufacturer's suggestion to equal 15 g).
</li><li>For an unconscious patient, administer glucose or glucagon
parenterally.
</li><li>Monitor skin for subcutaneous fat accumulation.
</li><li>Monitor potassium levels.
</li><li>Monitor ECG.
</li><li>Monitor for indications of hypokalemia.
</li></ul>"/>
meglitinide drug repaglinide (Prandin)?" answer="<ul><li> Monitor for signs of
hypoglycemia (diaphoresis, tachycardia, fatigue, excessive hunger, tremors).
</li><li>Give 15 to 20 g carbohydrate to treat hypoglycemia.
</li><li>If the patient is conscious, give glucose orally either in pill form,
4 oz of fruit juice, 6 saltines, or 1 tbsp of honey.
</li><li>If the patient is unconscious, give IV glucose; give glucagon 1 mg
either subcutaneously or intramuscularly.
</li><li>Check the patient's blood glucose every 15 to 20 min.

</li><li>Continue treatment until blood glucose has returned to the expected
reference range and the patient is no longer symptomatic.
</li></ul>"/>
<question question="What intervention should the health
care professional use when caring for a patient who is taking the
mineralocorticoid drug fludrocortisone (Florinef Acetate)?" answer="Monitor
for side effects related to excess dosing (increase in weight, fluid
retention, increase in blood pressure, hypokalemia) or inadequate dosing
(weight loss, poor appetite, fatigue, muscle weakness, hypotension).
</li></ul>"/>
sulfonylurea drug glipizide (Glucotrol)?" answer="<ul><li> Monitor for signs
of hypoglycemia (diaphoresis, tachycardia, fatigue, excessive hunger,
tremors).
</li><li>Give 15 to 20 g carbohydrate for hypoglycemia.
</li><li>If the patient is conscious, give glucose orally in either pill form,
4 oz of fruit juice, 6 saltines, or 1 tbsp of honey.
</li><li>If the patient is not conscious, give IV glucose or glucagon 1 mg
either subcutaneously or intramuscularly.
</li><li>Check the patient's blood glucose every 15 to 20 min.
</li><li>Continue treatment until the blood glucose has returned to the
expected reference range and the patient is no longer symptomatic.
</li><li>Monitor caloric intake.
</li></ul>"/>
thiazolidinedione drug rosiglitazone (Avandia)?" answer="<ul><li> Monitor for
edema, weight gain, or indications of heart failure.
</li><li>For hepatotoxicity, obtain serum alanine aminotransferase (ALT)
levels at baseline and every 3 to 6 months thereafter.
</li><li>Stop drug therapy for indications of liver injury.
</li><li>Monitor serum lipid levels, watching for increases in triglycerides
and in both high-density (favorable) and low-density (unfavorable)
lipoproteins.
</li></ul>"/>
thyroid replacement drug levothyroxine (Synthroid)?" answer="<ul><li> Monitor
thyroid function.
</li><li>Monitor for indications of hyperthyroidism (anxiety, tachycardia,

palpitations, tremors, altered appetite, abdominal cramping, diarrhea, heat
intolerance, fever, diaphoresis, weight loss, menstrual irregularities)
</li></ul>"/>
</chapter>
<chapter ChapterName="Patient Instructions">
<question question="What important instructions should
the health care professional give the patient who is taking the alphaglucosidase inhibitor drug acarbose (Precose)?" answer="<ul><li> Be aware of
the gastric side effects of alpha-glucosidase inhibitors.
</li><li>Follow the diet regimen recommended by the provider.
</li><li>Wear a medical alert bracelet.
</li><li>Watch for and report symptoms of hypoglycemia; test blood glucose to
confirm; consume 4 g of dextrose (GlucoTabs), retest in 15 min and repeat if
still low.
</li><li>Carry dextrose tablets at all times.
</li><li>Report dark urine, abdominal pain, vomiting, or fatigue.
</li><li>Report pallor, fatigue, or shortness of breath.
</li></ul>"/>
the health care professional give the patient who is taking the amylin mimetic
drug pramlintide (Symlin)?" answer="<ul><li> Wear a medical alert bracelet.
</li><li>Watch for and report symptoms of hypoglycemia, especially 3 hr after
dosing. Test blood glucose to confirm, then consume a snack of 15 to 20 g
carbohydrates, and retest in 15 to 20 min, and repeat if still low.
</li><li>Carry a carbohydrate snack at all times.
</li><li>Lie down when feeling nauseated.
</li><li>Follow proper injection technique.
</li></ul>"/>
the health care professional give the patient who is taking the antidiuretic
hormone desmopressin (DDAVP, Stimate, Minirin)?" answer="<ul><li> Expect
lifelong therapy.
</li><li>Report pounding headache, sleepiness, fluid retention, weight gain,
and edema.
</li><li>Limit fluid intake during therapy.
</li><li>Record fluid intake and output daily.
</li><li>Report chest pain or pressure.
</li></ul>"/>
the health care professional give the patient who is taking the antithyroid
drug propylthiouracil (PTU) (Propyl-Thyracil)?" answer="<ul><li> Be aware of
the goal of drug therapy.
</li><li>Expect 3 to 12 weeks of therapy to return to acceptable thyroid
levels and 6 to 12 months to stabilize thyroid hormone production.
</li><li>Do not discontinue abruptly.

</li><li>Watch for and report anxiety, drowsiness, depression, weight gain,
swelling, slow heart rate, appetite loss, cold intolerance, dry skin, or heavy
menstrual bleeding.
</li><li>Report fever or sore throat.
</li><li>Report rash.
</li><li>Report joint or muscle pain, or headache.
</li><li>Try over-the-counter analgesics to relieve pain.
</li></ul>"/>
the health care professional give the patient who is taking the antithyroid
drug/radioactive iodine drug iodine-131 (Iodotope)?"
answer="<ul><li>Understand the goal of drug therapy.
</li><li>Expect some effects in a few days or weeks and full effects in 2 to 3
months.
</li><li>Watch for and report anxiety, drowsiness, depression, weight gain,
swelling, slow heart rate, appetite loss, cold intolerance, dry skin, or heavy
menstrual bleeding.
</li><li>Report fever, sore throat, weakness, or fatigue.
</li><li>Report bloody vomit, nosebleeds, or severe nausea and vomiting.
</li></ul>"/>
the health care professional give the patient who is taking the biguanide drug
metformin (Glucophage)?" answer="<ul><li> Avoid drinking alcohol.
</li><li>Report weakness, fatigue, lethargy, or hyperventilation. If these
symptoms develop, stop taking the drug and seek medical care immediately.
</li><li>Expect nausea, diarrhea, anorexia to diminish as drug therapy
continues.
</li><li>Maintain adequate carbohydrate and fluid intake.
</li><li>Report weakness, fatigue, pallor, or reddened tongue.
</li></ul>"/>
the health care professional give the patient who is taking the gliptin drug
sitagliptin (Januvia)?" answer="<ul><li> Report persistent upper respiratory
symptoms or fever.
</li><li>Report persistent or unrelieved headaches.
</li><li>Report severe upper abdominal pain or abdominal pain that radiates to
the back and is associated with nausea or vomiting.
</li></ul>"/>
the health care professional give the patient who is taking the glucocorticoid
drug hydrocortisone (Hydrocortone, Solu-Cortef)?" answer="<ul><li> Expect
lifelong therapy.
</li><li>Report increased stress because higher dosages are essential at such

times (generally three times the usual dose for three days).
</li></ul>"/>
the health care professional give the patient who is taking the growth hormone
somatropin (Genotropin, Nutropin, Humatrope, Serostim)?" answer="
</li><li>Report polyphagia, polydipsia, and polyuria.
</li><li>Report muscle pain not relieved by mild analgesics.
</li><li>Report flank pain, urinary frequency, or blood in the urine.
</li></ul>"/>
the health care professional give the patient who is taking the hyperglycemic
agent glucagon (GlucaGen)?" answer="<ul><li> Be prepared to take glucagon in
an emergency situation.
</li><li>Obtain a commercial glucagon kit and carry it at all times.
</li><li>Understand that vomiting is common after administration of glucagon.
</li><li>Inform family members of importance of turning unconscious patient on
side.
</li><li>Take orally when tolerated to prevent another episode of
hypoglycemia.
</li></ul>"/>
the health care professional give the patient who is taking the incretin
mimetic drug exenatide (Byetta)?" answer="<ul><li> Watch for and report
symptoms of hypoglycemia. Test blood glucose to confirm, then consume a snack
of 15 to 20 g carbohydrates, and retest in 15 to 20 min and repeat treatment
if still low.
</li><li>Consume an adequate number of calories.
</li><li>Report severe, persistent abdominal pain and stop taking exenatide.
</li></ul>"/>
the health care professional give the patient who is taking the insulin drugs,
lispro (Humalog), regular (Humulin R), NPH (Humulin N), insulin glargine
(Lantus)?" answer="
</li><li>Draw up prescribed amount of insulin using insulin syringe and
administer subcutaneously.
</li><li>Rotate injection sites systematically and space them 1 inch apart.
</li><li>Do not inject cold insulin. Keep insulin at room temperature.
</li><li>Watch for symptoms of hypoglycemia. Test blood glucose to confirm,

then consume a snack of 15 to 20 g carbohydrates, and retest in 15 to 20 min
and repeat treatment if still low.
</li><li>Report recurring episodes of hypoglycemia to provider.
</li><li>Report weakness, nausea, palpitations, or paresthesias.
</li></ul>"/>
the health care professional give the patient who is taking the meglitinide
drug repaglinide (Prandin)?" answer="<ul><li> Wear a medical alert bracelet.
</li><li>Watch for and report symptoms of hypoglycemia.
</li><li>Test blood glucose to confirm hypoglycemia. Consume a snack of 15 to
20 g carbohydrates. Retest in 15 to 20 min and repeat treatment if still low.
</li><li>Consume adequate carbohydrates.
</li></ul>"/>
the health care professional give the patient who is taking the
mineralocorticoid drug fludrocortisone (Florinef Acetate)?" answer="<ul><li>
Expect lifelong therapy.
</li><li>Report weight gain or swelling (high sodium levels).
</li><li>Report weakness or palpitations (low potassium levels).
</li><li>Have blood pressure checked regularly.
</li></ul>"/>
the health care professional give the patient who is taking the sulfonylurea
drug glipizide (Glucotrol)?" answer="<ul><li> Wear a medical alert bracelet.
</li><li>Watch for and report symptoms of hypoglycemia.
</li><li>Test blood glucose to confirm hypoglycemia. Consume a snack of 15 to
20 g carbohydrates. Retest in 15 to 20 min and repeat if still low.
</li></ul>"/>
the health care professional give the patient who is taking the
thiazolidinedione drug rosiglitazone (Avandia)? " answer="<ul><li> Follow
instructions provided in access program.
</li><li>Report swelling, weight gain, or shortness of breath immediately.
</li><li>Report jaundice, dark urine, abdominal pain, vomiting, or fatigue.
</li><li>Expect periodic cholesterol testing.
</li><li>Report chest pain or discomfort, diaphoresis, or fatigue.
</li></ul>"/>
<question question="What important instruction should
the health care professional give the patient who is taking the thyroid
replacement drug levothyroxine (Synthroid)? " answer="Watch for and report

anxiety, rapid heart rate, palpitations, tremors, altered appetite, abdominal
cramping, diarrhea, heat intolerance, fever, sweating, weight loss, and
menstrual irregularities."/>
</chapter>
<chapter ChapterName="Contraindications">
<question question="What are some contraindications
that would make taking the alpha-glucosidase inhibitor drug acarbose (Precose)
risky for the patient?" answer="Gastrointestinal disorders (such as
inflammatory bowel disease), obstruction, ulceration"/>
that would make taking the amylin mimetic drug pramlintide (Symlin) risky for
the patient?" answer="<ul><li> Renal failure
</li><li>Hemodialysis
</li><li>Poor insulin regimen adherence
</li><li>HbA1c above 9%
</li><li>Gastroparesis
</li></ul>"/>
that would make taking the antidiuretic hormone desmopressin (DDAVP, Stimate,
Minirin) risky for the patient? " answer="
</li><li>Electrolyte imbalances (oral form)
</li><li>Renal failure
</li><li>Nephrogenic diabetes insipidus
</li></ul>"/>
<question question="What is a contraindication that
would make taking the antithyroid drug propylthiouracil (PTU) (PropylThyracil) risky for the patient?" answer="<ul><li> Pregnancy (risk category D
- can cause neonatal hypothyroidism and goiter)"/>
that would make taking the antithyroid drug/radioactive iodine drug iodine-131
(Iodotope) risky for the patient?" answer="<ul><li> Pregnancy (risk category
X)
</li><li>Lactation
</li></ul>"/>
that would make taking the biguanide drug metformin (Glucophage) risky for the
patient?" answer="<ul><li> Diabetic ketoacidosis
</li><li>Cardiopulmonary, hepatic, or renal insufficiency
</li><li>Alcoholism
</li><li>Heart failure
</li><li>Severe infection
</li><li>Shock
</li><li>Acute myocardial infarction
</li><li>Hypoxemia
</li><li>Lactic acidosis
</li></ul>"/>
that would make taking the gliptin drug sitagliptin (Januvia) risky for the
patient?" answer="<ul><li> Type 1 diabetes mellitus
</li><li>Lactic acidosis"/>
would make taking the glucocorticoid drug hydrocortisone (Hydrocortone, SoluCortef) risky for the patient?" answer="When given in small doses - none"/>
that would make taking the growth hormone somatropin (Genotropin, Nutropin,
Humatrope, Serostim) risky for the patient?" answer="<ul><li> Severe obesity
</li><li>Severe respiratory impairment
</li><li>Closed epiphyses in a child
</li><li>Critical illness
</li></ul>"/>
that would make taking the hyperglycemic agent glucagon (GlucaGen) risky for
the patient?" answer="<ul><li> Hypoglycemia from starvation (due to the lack
of stored glycogen)
</li><li>Pheochromocytoma
</li></ul>"/>
that would make taking the incretin mimetic drug exenatide (Byetta) risky for
the patient?" answer="<ul><li> Renal failure
</li><li>Type 1 diabetes mellitus
</li><li>Diabetic ketoacidosis
</li><li>Ulcerative colitis
</li><li>Crohn's disease
</li></ul>"/>
would make taking the insulin drugs, Lispro (Humalog), Regular (Humulin R),
NPH insulin (Humulin N), insulin glargine (Lantus) risky for the patient?"
answer="Hypersensitivity to insulin"/>
would make taking the meglitinide drug repaglinide (Prandin) risky for the
patient? " answer="Diabetic ketoacidosis"/>
that would make taking the mineralocorticoid fludrocortisone (Florinef
Acetate) risky for the patient?" answer="<ul><li> Potassium-depleting
diuretics
</li><li>Acute glomerulonephritis
</li><li>Hypercortisolism
</li><li>Viral or bacterial skin diseases uncontrolled by antibiotics
</li></ul>"/>
that would make taking the sulfonylurea drug glipizide (Glucotrol) risky for
the patient?" answer="<ul><li> Pregnancy, lactation
</li><li>Diabetic ketoacidosis
</li></ul>"/>
that would make taking the thiazolidinedione drug rosiglitazone (Avandia)
risky for the patient?" answer="<ul><li> Cardiovascular disease, including
hypertension
</li><li>Severe heart failure
</li><li>Active hepatic disease
</li></ul>"/>
that would make taking the thyroid replacement drug levothyroxine (Synthroid)
risky for the patient?" answer="<ul><li> Thyrotoxicosis
</li><li>Recent myocardial infarction
</li></ul>"/>
</chapter>
<chapter ChapterName="Precautions">
<question question="What factors increase the risk of
side and adverse effects and thus warrant precautions for a patient who takes
the alpha-glucosidase inhibitor acarbose (Precose)?" answer="<ul><li> Hepatic
impairment
</li><li>Gastrointestinal distress"/>
the amylin mimetic drug pramlintide (Symlin)?" answer="<ul><li> Thyroid
disease
</li><li>Osteoporosis
</li><li>Alcoholism"/>
the antidiuretic hormone desmopressin (DDAVP, Stimate, Minirin)?"
answer="<ul><li> Older adult
</li><li>Cardiovascular disease
</li><li>Hypertension
</li><li>History of hyponatremia
</li><li>Severe heart failure
</li><li>History of thromboembolic events
</li></ul>"/>
the antithyroid drug propylthiouracil (PTU) (Propyl-Thyracil)?" answer="
</li><li>Immunosuppression
</li><li>Bone marrow depression

</li><li>Infection
</li><li>Liver dysfunction
</li></ul>"/>
<question question="What factor increases the risk of
the antithyroid drug/radioactive iodine drug iodine-131 (Iodotope)?"
answer="Child prior to puberty"/>
the biguanide drug metformin (Glucophage)" answer="<ul><li> Diarrhea
</li><li>Dehydration
</li><li>Anemia
</li><li>Pituitary insufficiency
</li><li>Gastrointestinal obstruction
</li><li>Hypothyroidism
</li><li>Polycystic ovary syndrome
</li><li>Older adult"/>
the gliptin drug sitagliptin (Januvia)?" answer="<ul><li> Hemodialysis
</li><li>Moderate to severe renal dysfunction
</li><li>History of pancreatitis
</li></ul>"/>
the growth hormone somatropin (Genotropin, Nutropin, Humatrope, Serostim)?"
answer="<ul><li> Diabetes mellitus
</li><li>Prader-Willi syndrome
</li><li>Hypothyroidism
</li><li>Chronic renal failure
</li></ul>"/>
the hyperglycemic agent glucagon (GlucaGen)?" answer="<ul><li> Cardiovascular
disorders
</li><li>Adrenal insufficiency
</li></ul>"/>
the incretin mimetic drug exenatide (Byetta)?" answer="<ul><li> Thyroid
disease
</li><li>Renal dysfunction

the insulin drugs, Lispro (Humalog), Regular (Humulin R), NPH insulin (Humulin
N), insulin glargine (Lantus)?" answer="<ul><li> Older adult
</li><li>Renal or hepatic dysfunction
</li><li>Fever
</li><li>Thyroid disease
</li></ul>"/>
the meglitinide drug repaglinide (Prandin)?" answer="<ul><li> Renal or hepatic
dysfunction
</li><li>Systemic infection
the mineralocorticoid drug fludrocortisone (Florinef Acetate)?"
answer="<ul><li> Heart failure
</li><li>Systemic fungal infection
</li><li>Thromboembolic disorders
</li><li>Diabetes mellitus
</li><li>Hypertension
</li><li>Renal dysfunction
</li></ul>"/>
the sulfonylurea drug glipizide (Glucotrol)?" answer="<ul><li> Thyroid disease
</li><li>Renal or hepatic dysfunction
</li><li>Adrenal or pituitary insufficiency
</li></ul>"/>
the thiazolidinedione drug rosiglitazone (Avandia)?" answer="<ul><li> Mild
heart failure, risk for heart failure
</li><li>Hepatic impairment
</li></ul>"/>
the thyroid replacement drug levothyroxine (Synthroid)?" answer="<ul><li>
Cardiovascular disorders (hypertension, angina pectoris, ischemic heart
disease)
</li><li>Renal impairment
</li><li>Diabetes mellitus
</li><li>Older adult
</li></ul>"/>
</chapter>
<chapter ChapterName="Food & Drug Interactions">
<question question="What drugs or food have the
potential to interact with the alpha-glucosidase inhibitor acarbose
(Precose)?" answer="<ul><li> Insulin and sulfonylureas increase the risk of
hypoglycemia.
</li><li>Metformin (Glucophage) worsens gastrointestinal effects.
</li><li>Estrogens, thiazides, corticosteroids, phenothiazines, isoniazid
(INH), and phenytoin (Dilantin) counteract hypoglycemic effects.
</li><li>The herbal ginseng increases hypoglycemic effects.
</li></ul>"/>
potential to interact with the amylin mimetic, pramlintide (Symlin)?"
answer="<ul><li> Insulin increases the risk for hypoglycemia.
</li><li>Absorption of oral drugs slows, so patients should take them 1 hr
before or 2 hr after pramlintide.
</li><li>Drugs that slow gastric emptying, such as opioids, and drugs that
delay food absorption, such as acarbose (Precose) and miglitol (Glyset),
further slow gastric emptying.
</li></ul>"/>
potential to interact with the antidiuretic hormone desmopressin (DDAVP,
Stimate, Minirin)?" answer="<ul><li> Carbamazepine (Tegretol) and
chlorpropamide (Diabinese) increase antidiuretic action.
</li><li>Other vasopressors and lithium (Eskalith) decrease antidiuretic
action.
</li></ul>"/>
potential to interact with the antithyroid drug propylthiouracil (PTU)
(Propyl-Thyracil)?" answer="<ul><li> Effects of anticoagulants increase.
</li><li>Food alters absorption rates.
</li><li>Potassium iodide (SSKI), sodium iodide (Iodopen), and amiodarone
(Cordarone) counteract therapeutic effects.
</li></ul>"/>
potential to interact with the antithyroid drug/radioactive iodine drug
iodine-131 (Iodotope)?" answer="Other antithyroid drugs reduce uptake."/>
potential to interact with the biguanide drug metformin (Glucophage)"
answer="<ul><li> Alcohol and cimetidine (Tagamet) increase the risk of lactic
acidosis.
</li><li>Any contrast medium containing iodine increases the risk of acute
renal failure, thus worsening lactic acidosis.
</li><li>Herbals ginseng and garlic increase hypoglycemic effects.
</li><li>Captopril (Capoten), nifedipine (Procardia), furosemide (Lasix),

morphine, ranitidine (Zantac), antifungals, and many other drugs increase
hypoglycemic effects.
</li></ul>"/>
potential to interact with the gliptin drug sitagliptin (Januvia)?"
answer="Sitagliptin may increase digoxin levels."/>
potential to interact with the growth hormone somatropin (Genotropin,
Nutropin, Humatrope, Serostim)?" answer="<ul><li> Glucocorticoids and
adrenocorticotropic hormone counteract growth-stimulating effects.
</li><li>Thyroid hormones, estrogens, and androgens promote epiphyseal
closure.
</li></ul>"/>
potential to interact with the hyperglycemic agent glucagon (GlucaGen)?"
answer="Effects of oral anticoagulants increase."/>
potential to interact with the incretin mimetic drug exenatide (Byetta)?"
answer="<ul><li> Sulfonylureas increase the risk for hypoglycemia.
</li><li>Absorption of oral drugs slows, especially oral contraceptives and
antibiotics, so patients should take them 1 hr before taking exenatide.
</li></ul>"/>
potential to interact with the insulin drugs, Lispro (Humalog), Regular
(Humulin R), NPH insulin (Humulin N), insulin glargine (Lantus)?"
answer="<ul><li> Sulfonylureas, meglitinides, beta blockers, salicylates, and
alcohol increase hypoglycemic effects.
</li><li>Thiazide and loop diuretics, sympathomimetics, thyroid hormones, and
glucocorticoids increase blood glucose levels, thus counteracting hypoglycemic
effects.
</li><li>Beta blockers mask manifestations of hypoglycemia (tachycardia,
tremors).
</li></ul>"/>
potential to interact with the meglitinide drug repaglinide (Prandin)?"
answer="<ul><li> Gemfibrozil (Lopid), erythromycin (E-Mycin), and ketoconazole
(Nizoral) increase hypoglycemic effects.
</li><li>Grapefruit juice (more than 1 L/day) and herbals ginseng and garlic
increase hypoglycemic effects.
</li><li>Barbiturates, carbamazepine (Tegretol), rifampin (Rifadin), and
others counteract hypoglycemic effects.
</li></ul>"/>

potential to interact with the mineralocorticoid drug fludrocortisone
(Florinef Acetate)?" answer="<ul><li> Rifampin (Rifadin) decreases levels.
</li><li>Antidiabetes effects of insulin and sulfonylureas decrease.
</li><li>Potassium-depleting diuretics, such as furosemide (Lasix), increase
the risk of hypokalemia.
</li></ul>"/>
potential to interact with the sulfonylurea drug glipizide (Glucotrol)?"
answer="<ul><li> Alcohol poses a risk for a disulfiram (Antabuse)-like
reaction (nausea, palpitations, flushing) and increases hypoglycemic effects.
</li><li>Sulfonamide antibiotics, NSAIDs, oral anticoagulants, salicylates,
monoamine oxidase inhibitors, and cimetidine (Tagamet) increase hypoglycemic
effects.
</li><li>Thiazides counteract hypoglycemic effects.
</li><li>Beta blockers mask manifestations of hypoglycemia.
</li></ul>"/>
potential to interact with the thiazolidinedione drug rosiglitazone
(Avandia)?" answer="<ul><li> Insulin increases the risk of heart failure and
edema.
</li><li>Gemfibrozil (Lopid) and ketoconazole (Nizoral) increase hypoglycemic
effects.
</li><li>Green tea and herbals ginseng and garlic increase hypoglycemic
effects.
</li></ul>"/>
potential to interact with the thyroid replacement drug levothyroxine
(Synthroid)?" answer="<ul><li> Cholestyramine (Questran), antacids, iron and
calcium supplements, and sucralfate (Carafate) reduce absorption, so patients
should not take levothyroxine within 4 hr of these drugs.
</li><li>Food reduces absorption.
</li><li>Many antiseizure and antidepressant drugs, including carbamazepine
(Tegretol), phenytoin (Dilantin), phenobarbital, and sertraline (Zoloft),
decrease levels.
</li><li>Anticoagulant effects of warfarin (Coumadin) increase.
</li><li>Cardiac response to catecholamines (such as epinephrine) increases.
</li></ul>"/>
</chapter>
</course>
</courses>

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Endocrine System Drugs

<question question="What is the generic name of the

<question question="What is the therapeutic use for the

<question question="How should the alpha-glucosidase

<question question="How should the incretin mimetic

<question question="What is the peak action time for

<question question="What are some of the side and/or

</li><li>Recommend iron-rich foods and supplements accordingly.

</li><li>Monitor for indications of hypothyroidism (drowsiness, depression,

</li><li>Check the patient's blood glucose every 15 to 20 min.

</li><li>Monitor for indications of hyperthyroidism (anxiety, tachycardia,

</li><li>Do not discontinue abruptly.

</li><li>Report increased stress because higher dosages are essential at such

</li><li>Watch for symptoms of hypoglycemia. Test blood glucose to confirm,

replacement drug levothyroxine (Synthroid)? " answer="Watch for and report

</li><li>Bone marrow depression

<question question="What factors increase the risk of

</li><li>Captopril (Capoten), nifedipine (Procardia), furosemide (Lasix),

<question question="What drugs or food have the

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