Anesthesia Pharmacology Chapter 29 Diabetes Mangement Practice Questions

Sulfonylureas (first-generation e.g. tolbutamide, tolazamide, and chloropropamide as well as 2nd generation agents (glyburide, glipizide, glimepiride):
1. ATPase inhibitors
2. K_ATP channel modulators
3. Both
4. Neither
Mechanism/mechanisms of sulfonylurea action:
1. Stimulation of insulin release through association with ß-cell K_ATP with resultant reduction in channel activity.
2. K_ATP channel inhibition promotes membrane depolarization and induces subsequent events that reduce insulin secretion
3. Both
4. Neither
Sulfonylurea administration: action/actions in patients with type II diabetes
1. Acute administration associated with increasing pancreatic insulin release.
2. Chronic administration: decreases insulin levels below baseline but maintains reduce plasma glucose levels.
3. Both
4. Neither
Efficacy exhibited by sulfonylureas during chronic administration: likely due to reduction of cell surface receptors for sulfonylureas at the targeted pancreatic ß cell.
1. True
2. False
Sulfonylureas: absorption, distribution, metabolism, excretion-
1. Well absorbed from the G.I. tract.
2. Absorption reduced by the presence of food and in hyperglycemia.
3. Short half-lives (3-5 hours)
4. Hypoglycemic actions present for 12-24 hours
5. A & B
6. B & C
7. A & C
8. A, B, C & D
In appropriately selected diabetic populations, about 50%-80% of individuals respond to sulfonylureas.
1. True
2. False
Initial responders to sulfonylureas:
1. Usually maintain the response essentially indefinitely.
2. Many patients develop secondary hyperglycemia probably due to poor patient compliance.
3. Both
4. Neither
Some/A contraindication/contraindications to the use of sulfonylureas clinically includes/includes:
1. Diagnosis of type I diabetes
2. Significant renal or liver insufficiency in elderly patients. (earlier drugs)
3. Both
4. Neither
Adverse effects/effects associated with sulfonylurea administration:
1. Hypoglycemia (may cause coma)
2. Weight gain
3. Both
4. Neither
Hypoglycemic activity of sulfonylureas may be increased by:
1. Increased hepatic metabolism are renal excretion
2. Displacement of sulfonylurea from binding proteins.
3. Both
4. Neither