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Chapter 14: Endocrine Drugs 1. Which type of insulin is also known as regular insulin? a. insulin derived from animals b. intermediate-acting insulin c. long-acting insulin d. rapid-acting insulin Answer: d. rapid-acting insulin Correct Feedback: Rapid-acting insulin is also known as regular insulin, and is sometimes reflected in the drug’s trade name as the abbreviation R. a. insulin derived from animals Incorrect Feedback: How the insulin is derived does not indicate whether it called regular or not. b. intermediate-acting insulin Incorrect Feedback: Intermediate-acting insulin is not known as regular insulin. c. long-acting insulin Incorrect Feedback: Long-acting insulin is not known as regular insulin. 2. Antithyroid drugs treat hyperthyroidism by ________. a. inhibiting the production of T3 and T4 in the parathyroid gland b. inhibiting the production of T3 and T4 in the thyroid gland c. stimulating the production of T3 and T4 in the parathyroid gland d. stimulating the production of T3 and T4 in the thyroid gland. Answer: b. inhibiting the production of T3 and T4 in the thyroid gland Correct Feedback: Antithyroid drugs treat hyperthyroidism (thyrotoxicosis) by inhibiting the production of T3 and T4 in the thyroid gland. a. inhibiting the production of T3 and T4 in the parathyroid gland Incorrect Feedback: T3 and T4 do not come from the parathyroid gland. c. stimulating the production of T3 and T4 in the parathyroid gland Incorrect Feedback: Antithyroid drugs do not stimulating the production of T3 and T4. d. stimulating the production of T3 and T4 in the thyroid gland. Incorrect Feedback: Antithyroid drugs do not stimulate the production of T3 and T4. 3. Insulin lowers blood glucose levels by ________. a. binding with glucose, rendering it ineffective b. competing with glucose receptors on cell membranes c. enabling cells to utilize glucose d. inhibiting the production of glucose Answer: c. enabling cells to utilize glucose Correct Feedback: Insulin lowers blood glucose levels by enabling cells to utilize glucose. a. binding with glucose, rendering it ineffective Incorrect Feedback: Insulin does not bind to glucose. b. competing with glucose receptors on cell membranes Incorrect Feedback: Insulin does not compete with glucose and there are no glucose receptors on cell membranes. d. inhibiting the production of glucose Incorrect Feedback: Insulin does not inhibit the production of glucose. 4. Which type of diabetes was previously known as insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes? a. diabetes insipidus b. syndrome of inappropriate ADH c. type 1 diabetes mellitus d. type 2 diabetes mellitus Answer: c. type 1 diabetes mellitus Correct Feedback: Type 1 diabetes mellitus was previously known as insulindependent diabetes mellitus (IDDM) or juvenile-onset diabetes mellitus. a. diabetes insipidus Incorrect Feedback: Diabetes insipidus is not a type of diabetes mellitus. b. syndrome of inappropriate ADH Incorrect Feedback: Syndrome of inappropriate ADH is not related to diabetes mellitus. d. type 2 diabetes mellitus Incorrect Feedback: Type 2 diabetes mellitus was previously known as non– insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes mellitus. 5. The size of the crystals of insulin determines _______. a. if the insulin can be used to treat type 1 or type 2 diabetes mellitus b. how many hours the therapeutic action continues c. how quickly the insulin can act in the body to lower the blood glucose level d. which cells will be able to utilize glucose Answer: c. how quickly the insulin can act in the body to lower the blood glucose level Correct Feedback: Regardless of the original source of the insulin (whether from an animal or created by recombinant DNA or other technology), all insulin drugs are grouped according to how quickly they act in the body to lower the blood glucose level (this depends on the size of the insulin crystal). a. if the insulin can be used to treat type 1 or type 2 diabetes mellitus Incorrect Feedback: The size of the crystals does not determine which type of diabetes mellitus it can be used to treat. b. how many hours the therapeutic action continues Incorrect Feedback: The size of the crystals is not related to the length of the therapeutic action. d. which cells will be able to utilize glucose Incorrect Feedback: The size of the crystals does not determine which cells will utilize glucose. 6. A syringe calibrated in units can be used to administer ________. a. any antidiabetic drug in a liquid form b. any type of drug in a liquid form. c. only insulin d. only rapid-acting insulin drugs Answer: c. only insulin Correct Feedback: Insulin drugs come in a standardized concentration of 100 units/mL and are administered in a special insulin syringe that is calibrated in units. Any type of insulin (rapid-acting, intermediate-acting, or long-acting insulin drugs) can be administered using an insulin syringe. a. any antidiabetic drug in a liquid form Incorrect Feedback: A syringe calibrated in units cannot be used to administer any antidiabetic drug in a liquid form. b. any type of drug in a liquid form. Incorrect Feedback: A syringe calibrated in units cannot be used to administer any type of drug in a liquid form. d. only rapid-acting insulin drugs Incorrect Feedback: A syringe calibrated in units can be used to administer more than just rapid-acting insulin drugs. 7. Oral antidiabetic drugs are used to treat patients with _______. a. diabetes insipidus b. both type 1 and type 2 diabetes mellitus c. type 1 diabetes mellitus only d. type 2 diabetes mellitus only Answer: d. type 2 diabetes mellitus only Correct Feedback: Contrary to popular belief, oral antidiabetic drugs are not insulin and are not effective in treating patients with type 1 diabetes mellitus. a. diabetes insipidus Incorrect Feedback: Oral antidiabetic drugs are not used to treat diabetes insipidus. b. both type 1 and type 2 diabetes mellitus Incorrect Feedback: Oral antidiabetic drugs are not effective in treating type 1 diabetes mellitus. c. type 1 diabetes mellitus only Incorrect Feedback: Oral antidiabetic drugs are not effective in treating type 1 diabetes mellitus. 8. The alpha-glucosidase inhibitor class of oral antidiabetic drugs ________. a. inhibits the action of certain enzymes that digest carbohydrates b. inhibits the production of insulin in the islets of Langerhans of the pancreas c. prolongs the action of insulin on insulin receptors d. stimulates the beta cells of the pancreas Answer: a. inhibits the action of certain enzymes that digest carbohydrates Correct Feedback: The alpha-glucosidase inhibitor oral antidiabetic drugs inhibit the action of certain enzymes that digest carbohydrates. This means less glucose enters the blood and the pancreas does not need to produce as much insulin to keep glucose blood levels low. b. inhibits the production of insulin in the islets of Langerhans of the pancreas Incorrect Feedback: These drugs do not inhibit the production of insulin by the pancreas. c. prolongs the action of insulin on insulin receptors Incorrect Feedback: These drugs do not prolong the action of insulin on insulin receptors. d. stimulates the beta cells of the pancreas Incorrect Feedback: These drugs do not stimulate the beta cells of the pancreas. 9. Which of the following is NOT one of the ways in which biguanide oral antidiabetic drugs work? a. by decreasing the absorption of glucose from the intestine b. by improving the ability of cells to use the insulin that is produced c. by slowing the rate at which food leaves the stomach d. by suppressing the release of stored glucose from the liver Answer: c. by slowing the rate at which food leaves the stomach Correct Feedback: The biguanide class of oral antidiabetic drugs decreases the absorption of glucose from the intestine, suppresses the release of stored glucose from the liver, and improves the ability of cells to use the insulin that is produced by the pancreas. Biguanide oral antidiabetic drugs do not slow the rate at which food leaves the stomach. a. by decreasing the absorption of glucose from the intestine Incorrect Feedback: Biguanide oral antidiabetic drugs do decrease the absorption of glucose from the intestine. b. by improving the ability of cells to use the insulin that is produced Incorrect Feedback: Biguanide oral antidiabetic drugs do improve the ability of cells to use the insulin that is produced. d. by suppressing the release of stored glucose from the liver Incorrect Feedback: Biguanide oral antidiabetic drugs do suppress the release of stored glucose from the liver. 10. Which class of oral antidiabetic drugs used to treat type 2 diabetes mellitus was first approved to treat an elevated level of cholesterol in the blood? a. intermediate-acting insulin drugs b. bile acid sequestrant antidiabetic drugs c. sulfonylurea oral antidiabetic drugs d. incretin mimetic antidiabetic drugs Answer: b. bile acid sequestrant antidiabetic drugs Correct Feedback: Bile acid sequestrant drugs are commonly used to treat an elevated level of cholesterol in the blood. Now they have been approved to improve blood glucose control in patients with type 2 diabetes mellitus. a. intermediate-acting insulin drugs Incorrect Feedback: Intermediate-acting insulin drugs were not first approved to treat an elevated level of cholesterol c. sulfonylurea oral antidiabetic drugs Incorrect Feedback: Sulfonylurea oral antidiabetic drugs were not first approved to treat an elevated level of cholesterol. d. incretin mimetic antidiabetic drugs Incorrect Feedback: Incretin mimetic antidiabetic drugs were not used to treat an elevated level of cholesterol. 11. Which of the following is NOT one of the ways in which amylin analog antidiabetic drugs work? a. by decreasing the absorption of glucose from the intestine b. by slowing the rate at which food leaves the stomach c. by suppressing the release of stored glucose from the liver d. by working in the brain to decrease the appetite Answer: a. by decreasing the absorption of glucose from the intestine Correct Feedback: It is biguanide oral antidiabetic drugs that decrease the absorption of glucose from the intestine. The amylin analog class of antidiabetic drugs is based on the action of amylin, a substance in the body that is secreted from the beta cells of the pancreas at the same time as insulin. Amylin and the amylin analog class of antidiabetic drugs slow the rate at which food leaves the stomach, suppress the release of stored glucose from the liver, and work in the brain to decrease the appetite. b. by slowing the rate at which food leaves the stomach Incorrect Feedback: This is one of the ways in which amylin analog antidiabetic drugs work. c. by suppressing the release of stored glucose from the liver Incorrect Feedback: This is one of the ways in which amylin analog antidiabetic drugs work. d. by working in the brain to decrease the appetite Incorrect Feedback: This is one of the ways in which amylin analog antidiabetic drugs work. 12. Which of the following is NOT one of three types of rapid-acting insulin drugs? a. insulin analog drugs created by recombinant DNA technology. b. insulin drugs created by recombinant DNA technology. c. insulin drugs derived from pig pancreas d. insulin drugs synthesized from the saliva of the Gila monster Answer: d. insulin drugs synthesized from the saliva of the Gila monster Correct Feedback: The three types of rapid-acting insulin drugs are: 1. derived from pig pancreas (Regular Ilentin II); 2. created by recombinant DNA technology (Humulin R, Novolin R); and 3. insulin analog drugs created by recombinant DNA technology (insulin aspart, insulin glulisine, and insulin lispro). The antidiabetic drug Byetta is a synthetic version of a protein found in the saliva of a Gila monster; it is not a type of rapid-acting insulin drug. a. insulin analog drugs created by recombinant DNA technology. Incorrect Feedback: This is one of the three types of rapid-acting insulin drugs. b. insulin drugs created by recombinant DNA technology. Incorrect Feedback: This is one of the three types of rapid-acting insulin drugs. c. insulin drugs derived from pig pancreas Incorrect Feedback: This is one of the three types of rapid-acting insulin drugs. 13. Rapid-acting insulin drugs begin to lower the blood glucose level in _______. a. 15 minutes b. one hour c. two hours d. three hours Answer: a. 15 minutes Correct Feedback: Rapid-acting insulin drugs can begin to lower the blood glucose level in as little as 15 minutes. The therapeutic effect of these drugs lasts from 2 to 12 hours. b. one hour Incorrect Feedback: Rapid-acting insulin drugs begin to lower the blood glucose level in less time than one hour. c. two hours Incorrect Feedback: Rapid-acting insulin drugs begin to lower the blood glucose level in less time than two hours. d. three hours Incorrect Feedback: Rapid-acting insulin drugs begin to lower the blood glucose level in less time than three hours. 14. ________ drugs are prescribed for AIDS patients to counteract the loss of muscle mass and strength that occurs with AIDS wasting syndrome. a. Antidiabetic b. Corticosteroid c. Growth hormone replacement d. Anabolic steroid Answer: d. Anabolic steroid Correct Feedback: Anabolic steroid drugs are prescribed for AIDS patients to counteract the loss of muscle mass and strength that occurs with AIDS wasting syndrome. a. Antidiabetic Incorrect Feedback: Antidiabetic drugs are not prescribed for AIDS wasting syndrome. b. Corticosteroid Incorrect Feedback: Corticosteroid drugs are not prescribed for AIDS wasting syndrome. c. Growth hormone replacement Incorrect Feedback: Growth hormone replacement drugs are not prescribed for AIDS wasting syndrome. 15. Former President John F. Kennedy had _______, which gave his skin an unusually bronzed and tanned appearance. a. hyperthyroidism b. Addison’s disease c. diabetes mellitus, type 2 d. acromegaly Answer: b. Addison’s disease Correct Feedback: Former President John F. Kennedy had Addison’s disease, which gave his skin its unusually bronzed and tanned appearance. a. hyperthyroidism Incorrect Feedback: Former President John F. Kennedy did not have hyperthyroidism. c. diabetes mellitus, type 2 Incorrect Feedback: Former President John F. Kennedy did not have diabetes mellitus, type 2. d. acromegaly Incorrect Feedback: Former President John F. Kennedy did not have acromegaly. 16. Insulin drug groups include which of the following? a. rapid-acting insulin b. intermediate-acting insulin c. long-acting insulin d. all of the above Answer: d. all of the above Correct Feedback: Insulin drug groups include rapid-acting insulin, intermediate-acting insulin, and long-acting insulin. a. rapid-acting insulin Incorrect Feedback: This is true, but it is not the only correct answer. b. intermediate-acting insulin Incorrect Feedback: This is true, but it is not the only correct answer. c. long-acting insulin Incorrect Feedback: This is true, but it is not the only correct answer. 17. Which of the following is NOT part of the endocrine system? a. the salivary glands in the mouth b. the pituitary gland in the brain c. the pancreas in the abdominal cavity d. the adrenal glands Answer: a. the salivary glands in the mouth Correct Feedback: The glands of the endocrine system include the pineal gland, hypothalamus, and anterior and posterior pituitary gland in the brain; the thyroid gland and parathyroid glands in the neck; the thymus in the chest; the adrenal glands anterior to each kidney; the pancreas in the abdominal cavity; the female ovaries in the pelvic cavity; and the male testes in the scrotum. b. the pituitary gland in the brain Incorrect Feedback: The pituitary gland is a part of the endocrine system. c. the pancreas in the abdominal cavity Incorrect Feedback: The pancreas is part of the endocrine system. d. the adrenal glands Incorrect Feedback: The adrenal glands are part of the endocrine system. 18. Insulin plays a role in glucose (sugar) _______. a. production b. excretion c. metabolism d. all of the above Answer: c. metabolism Correct Feedback: Insulin plays an essential role in glucose (sugar) metabolism. a. production Incorrect Feedback: Insulin does not play a role in glucose production. b. excretion Incorrect Feedback: Insulin does not play a role in glucose excretion. d. all of the above Incorrect Feedback: Only one of the answers is correct. 19. What do these drugs—insulin aspart (NovoLog), insulin glulisine (Apidra), and insulin lispro (Humalog)—have in common? a. They were created using recombinant DNA technology. b. They are insulin analog drugs. c. They are rapid-acting insulin drugs. d. All of the above are true. Answer: d. All of the above are true. Correct Feedback: Insulin aspart, insulin glulisine, and insulin lispro are three different types of rapid-acting insulin analog drugs created by recombinant DNA technology. a. They were created using recombinant DNA technology. Incorrect Feedback: This is true, but it is not the only correct answer. b. They are insulin analog drugs. Incorrect Feedback: This is true, but it is not the only correct answer. c. They are rapid-acting insulin drugs. Incorrect Feedback: This is true, but it is not the only correct answer. 20. The drug radioactive sodium iodide 131 ________. a. emits low-level radiation b. destroys thyroid tissue to treat hyperthyroidism c. is used to treat thyroid cancer d. all of the above Answer: d. all of the above Correct Feedback: Radioactive sodium iodide 131 is used to treat both hyperthyroidism and thyroid cancer; the low-level radiation emitted by this drug destroys both hyperactive benign thyroid tissue and cancerous thyroid tissue. a. emits low-level radiation Incorrect Feedback: This is true, but it is not the only correct answer. b. destroys thyroid tissue to treat hyperthyroidism Incorrect Feedback: This is true, but it is not the only correct answer. c. is used to treat thyroid cancer Incorrect Feedback: This is true, but it is not the only correct answer. 21. All of the following drugs are used to treat diabetes mellitus EXCEPT _______ . a. Humulin N insulin b. Synthroid c. Regular Iletin II d. DiaBeta Answer: b. Synthroid Correct Feedback: Levothyroxine (Levothroid, Synthroid) is a thyroid hormone drug containing only T4 and is used to treat hypothyroidism, not diabetes mellitus. a. Humulin N insulin Incorrect Feedback: Humulin insulin is used to treat diabetes mellitus. c. Regular Iletin II Incorrect Feedback: Regular Iletin II is used to treat diabetes mellitus. d. DiaBeta Incorrect Feedback: DiaBeta is used to treat diabetes mellitus. 22. All of the following are trade names for sulfonylurea oral antidiabetic drugs EXCEPT _______ . a. glipizide (Glucotrol, Glucotrol XL) b. chlorpropamide (Diabinese) c. glyburide (DiaBeta, Micronase) d. exenatide (Byetta) Answer: d. exenatide (Byetta) Correct Feedback: Exenatide (Byetta) is an incretin mimetic antidiabetic drug, not a sulfonylurea oral antidiabetic drug. a. glipizide (Glucotrol, Glucotrol XL) Incorrect Feedback: Glipizide (Glucotrol, Glucotrol XL) is a sulfonylurea oral antidiabetic drug. b. chlorpropamide (Diabinese) Incorrect Feedback: Chlorpropamide (Diabinese) is a sulfonylurea oral antidiabetic drug. c. glyburide (DiaBeta, Micronase) Incorrect Feedback: Glyburide (DiaBeta, Micronase) is a sulfonylurea oral antidiabetic drug. 23. The first drug to be produced using recombinant DNA technology was ________. a. NPH insulin b. Humulin insulin c. insulin glargine (Lantus) d. triamcinolone (Aristocort, Kenalog) Answer: b. Humulin insulin Correct Feedback: Humulin insulin was the first recombinant DNA drug of any type to be marketed. a. NPH insulin Incorrect Feedback: NPH insulin was not the first recombinant DNA technology drug. c. insulin glargine (Lantus) Incorrect Feedback: Insulin glargine (Lantus) was not the first recombinant DNA technology drug. d. triamcinolone (Aristocort, Kenalog) Incorrect Feedback: Triamcinolone (Aristocort, Kenalog) was not the first recombinant DNA technology drug. 24. Which statement about long-acting insulin drugs is FALSE? a. Their therapeutic effect lasts 24 hours. b. They are also known as ultralente insulin. c. There are currently no long-acting insulin drugs on the market. d. They have large insulin crystals and contain zinc. Answer: c. There are currently no long-acting insulin drugs on the market. Correct Feedback: There currently are no ultralente long-acting insulin drugs on the market, but there are two long-acting insulin analog drugs: Levemir and Lantus. Long-acting insulin drugs have large insulin crystals and contain added zinc. The therapeutic effect of long-acting insulin drugs lasts a full 24 hours after just one dose. Long-acting insulin drugs are also known as ultralente insulin. a. Their therapeutic effect lasts 24 hours. Incorrect Feedback: This is a true statement. b. They are also known as ultralente insulin. Incorrect Feedback: This is a true statement. d. They have large insulin crystals and contain zinc. Incorrect Feedback: This is a true statement. 25. Which of the following statements is FALSE? a. Insulin doses are measured in units. b. Regular insulin is also known as rapid-acting insulin. c. NPH insulin contains protamine and zinc. d. Type 2 diabetes mellitus is also known as juvenile diabetes. Answer: d. Type 2 diabetes mellitus is also known as juvenile diabetes. Correct Feedback: Type 1 diabetes mellitus was previously known as insulindependent diabetes mellitus (IDDM) or juvenile-onset diabetes mellitus. a. Insulin doses are measured in units. Incorrect Feedback: This is a true statement. b. Regular insulin is also known as rapid-acting insulin. Incorrect Feedback: This is a true statement. c. NPH insulin contains protamine and zinc. Incorrect Feedback: This is a true statement. 26. Insulin does all of the following EXCEPT ________. a. stimulates the pancreas to produce hormones b. transports glucose to the cell c. binds with an insulin receptor on the cell membrane d. transports glucose into the cell Answer: a. stimulates the pancreas to produce hormones Correct Feedback: Insulin transports glucose to the cell, binds with an insulin receptor on the cell membrane, and transports glucose inside the cell where the glucose is metabolized to provide energy. b. transports glucose to the cell Incorrect Feedback: Insulin does transport glucose to the cell. c. binds with an insulin receptor on the cell membrane Incorrect Feedback: Insulin does bind with an insulin receptor on the cell membrane. d. transports glucose into the cell Incorrect Feedback: Insulin does transport glucose into the cell. 27. All of the following are thyroid supplement drugs used to treat hypothyroidism EXCEPT ______. a. oxandrolone (Oxandrin) b. liothyronine (Cytomel, Triostat) c. levothyroxine (Levothroid, Synthroid) d. liotrix (Thyrolar) Answer: a. oxandrolone (Oxandrin) Correct Feedback: Oxandrolone (Oxandrin) is an anabolic steroid drug. b. liothyronine (Cytomel, Triostat) Incorrect Feedback: Liothyronine (Cytomel, Triostat) is a thyroid supplement drug used to treat hypothyroidism. c. levothyroxine (Levothroid, Synthroid) Incorrect Feedback: Levothyroxine (Levothroid, Synthroid) is a thyroid supplement drug used to treat hypothyroidism. d. liotrix (Thyrolar) Incorrect Feedback: Liotrix (Thyrolar) is a thyroid supplement drug used to treat hypothyroidism. 28. Patients with type 1 diabetes mellitus inject insulin once or several times a day at various sites in which of these places on the body? a. the upper arms b. thighs c. abdomen d. all of the above. Answer: d. all of the above. Correct Feedback: Patients with type 1 diabetes mellitus inject insulin subcutaneously once or several times a day at various sites on the upper arms, thighs, or abdomen where there is some subcutaneous fat. a. the upper arms Incorrect Feedback: This is true, but it is not the only correct answer. b. thighs Incorrect Feedback: This is true, but it is not the only correct answer. c. abdomen Incorrect Feedback: This is true, but it is not the only correct answer. 29. When a patient with type 1 diabetes mellitus injects insulin, the needle must be at a ______ degree angle in order to place the insulin in the correct tissue layer. a. 10 b. 45 c. 90 d. 130 Answer: b. 45 Correct Feedback: Insulin must be injected subcutaneously into the fat layer beneath the skin. The needle is inserted at a 45-degree angle so that it does not go into the muscle layer. a. 10 Incorrect Feedback: Insulin is not injected at a 10-degree angle. c. 90 Incorrect Feedback: Insulin is not injected at a 90-degree angle. d. 130 Incorrect Feedback: Insulin is not injected at a 130-degree angle. 30. The thyroid supplement drug for hypothyroidism that contains both T3 and T4 is _______. a. liotrix (Thyrolar) b. methimazole (Tapazole) c. Cytomel d. all of the above Answer: a. liotrix (Thyrolar) Correct Feedback: These thyroid hormone drugs contain both T3 and T4: desiccated thyroid (Armour Thyroid), liotrix (Thyrolar) b. methimazole (Tapazole) Incorrect Feedback: Methimazole (Tapazole) is used to treat hyperthyroidism, not hypothyroidism. c. Cytomel Incorrect Feedback: Liothyronine (Cytomel, Triostat) is a thyroid supplement drug, but it contains only T3. d. all of the above Incorrect Feedback: Only one of the answers is correct. 31. Each of the following is a category of oral antidiabetic drugs EXCEPT ________. a. sulfonylurea drugs b. biguanide drugs c. corticosteroid drugs d. alpha-glucosidase inhibitor drugs Answer: c. corticosteroid drugs Correct Feedback: There are six categories of oral antidiabetic drugs: sulfonylurea drugs, meglitinide drugs, thiazolidinedione drugs, alpha-glucosidase inhibitor drugs, biguanide drugs, and DPP-4 inhibitor drugs. a. sulfonylurea drugs Incorrect Feedback: Sulfonylurea drugs are a category of oral antidiabetic drugs. b. biguanide drugs Incorrect Feedback: Biguanide drugs are a category of oral antidiabetic drugs. d. alpha-glucosidase inhibitor drugs Incorrect Feedback: Alpha-glucosidase inhibitor drugs are a category of oral antidiabetic drugs. 32. ______ secreted by the alpha cells of the pancreas stimulates the liver to break down glycogen and release glucose into the blood. a. Thyroxine b. Glucocorticoid hormones c. Glucagon d. Insulin Answer: c. Glucagon Correct Feedback: When the blood glucose level is low, the alpha cells of the pancreas secrete glucagon, which stimulates the liver to break down glycogen (stored glucose) and release it into the blood. a. Thyroxine Incorrect Feedback: Thyroxine is secreted by the thyroid gland, not the pancreas. b. Glucocorticoid hormones Incorrect Feedback: Glucocorticoid hormones are secreted by the adrenal cortex, not the pancreas. d. Insulin Incorrect Feedback: Insulin is secreted by the beta, not alpha, cells of the pancreas. 33. Insulin can be administered via a(n) _______. a. insulin syringe b. portable insulin pump c. implantable computerized insulin pump d. all of the above Answer: d. all of the above Correct Feedback: An insulin syringe is used to administer insulin drugs. Insulin can also be administered directly into the blood via tubing connected to a portable insulin pump that is attached to a belt or carried in a pocket. A totally implantable computerized insulin pump is also available. a. insulin syringe Incorrect Feedback: This is true, but it is not the only correct answer. b. portable insulin pump Incorrect Feedback: This is true, but it is not the only correct answer. c. implantable computerized insulin pump Incorrect Feedback: This is true, but it is not the only correct answer. 34. Besides an antidiabetic drug, what lifestyle activities are important for managing diabetes mellitus? a. exercise b. controlled amounts of calories from carbohydrates and fats in the diet c. weight control d. all of the above Answer: d. all of the above Correct Feedback: A diet with controlled amounts of calories from carbohydrates and fats, weight control, and exercise are also very important components of managing both types of diabetes mellitus. a. exercise Incorrect Feedback: This is true, but it is not the only correct answer. b. controlled amounts of calories from carbohydrates and fats in the diet Incorrect Feedback: This is true, but it is not the only correct answer. c. weight control Incorrect Feedback: This is true, but it is not the only correct answer. 35. An insulin pump sounds an audible alarm if the _______. a. patient’s blood sugar is too low b. insulin reservoir is empty c. tubing is blocked d. b and c Answer: d. b and c Correct Feedback: An insulin pump can deliver as little as 0.1 unit of insulin and has alarms to alert the patient if the tubing becomes blocked or if the insulin reservoir is empty. a. patient’s blood sugar is too low Incorrect Feedback: An insulin pump delivers insulin, but does not monitor the patient’s blood sugar. b. insulin reservoir is empty Incorrect Feedback: This is true, but it is not the only correct answer. c. tubing is blocked Incorrect Feedback: This is true, but it is not the only correct answer. 36. All of the following are corticosteroid drugs EXCEPT ______. a. dexamethasone (Decadron) b. prednisolone (Pediapred, Prelone) c. betamethasone (Celestone) d. somatrem (Protropin) Answer: d. somatrem (Protropin) Correct Feedback: Somatrem (Protropin) is a growth hormone replacement drug. a. dexamethasone (Decadron) Incorrect Feedback: Dexamethasone (Decadron) is a corticosteroid drug. b. prednisolone (Pediapred, Prelone) Incorrect Feedback: Prednisolone (Pediapred, Prelone) is a corticosteroid drug. c. betamethasone (Celestone) Incorrect Feedback: Betamethasone (Celestone) is a corticosteroid drug. 37. Which of the following statements is FALSE? a. Increased growth hormone after puberty causes acromegaly. b. Hyperthyroidism can be treated with Synthroid. c. “Stacking” is using two or more anabolic steroids drugs at the same time. d. The thyroid hormone drug Thyrolar is measured in both grains and milligrams. Answer: b. Hyperthyroidism can be treated with Synthroid. Correct Feedback: Synthroid contains the thyroid hormone T4 and is used to treat hypothyroidism, not hyperthyroidism. a. Increased growth hormone after puberty causes acromegaly. Incorrect Feedback: This is a true statement. c. “Stacking” is using two or more anabolic steroids drugs at the same time. Incorrect Feedback: This is a true statement. d. The thyroid hormone drug Thyrolar is measured in both grains and milligrams. Incorrect Feedback: This is a true statement. 38. In the name of an insulin drug, the letter R stands for ______. a. recombinant DNA technology drug b. rapid-onset diabetes mellitus c. regular d. none of the above Answer: c. regular Correct Feedback: Regular Iletin II is a regular insulin drug with a rapid onset of action. The label shows a large capital R that stands for regular insulin. a. recombinant DNA technology drug Incorrect Feedback: The letter R does not stand for recombinant DNA technology drug. b. rapid-onset diabetes mellitus Incorrect Feedback: There is no such disease. d. none of the above Incorrect Feedback: One of the answers is correct. 39. All of the following are trade name combination oral antidiabetic drugs EXCEPT ______. a. Januvia b. Glucovance c. Avandamet d. Metaglip Answer: a. Januvia Correct Feedback: Sitagliptin (Januvia) is a DPP-4 inhibitor oral antidiabetic drug, not a combination drug. Combination oral antidiabetic drugs include ActoPlus Met, Avandamet, Avandaryl, Duetact, Glucovance, Janumet, Metaglip, and PrandiMet. b. Glucovance Incorrect Feedback: Glucovance is a combination oral antidiabetic drug. c. Avandamet Incorrect Feedback: Avandamet is a combination oral antidiabetic drug. d. Metaglip Incorrect Feedback: Metaglip is a combination oral antidiabetic drug. 40. Growth hormone replacement drugs consist of all of the following EXCEPT ______. a. sermorelin (Geref) b. methimazole (Tapazole) c. somatrem (Protropin) d. somatropin (Humatrope, Nutropin) Answer: b. methimazole (Tapazole) Correct Feedback: Methimazole (Tapazole) is an antithyroid drug used to treat hyperthyroidism. Growth hormone replacement drugs include sermorelin (Geref), somatrem (Protropin), and somatropin (Humatrope, Nutropin). a. sermorelin (Geref) Incorrect Feedback: Sermorelin (Geref) is a growth hormone replacement drug. c. somatrem (Protropin) Incorrect Feedback: Somatrem (Protropin) is a growth hormone replacement drug. d. somatropin (Humatrope, Nutropin) Incorrect Feedback: Somatropin (Humatrope, Nutropin) is a growth hormone replacement drug. 41. Drugs used to treat diabetes insipidus act as replacement therapy for ______. a. thyroid hormone b. corticosteroids c. growth hormone d. antidiuretic hormone Answer: d. antidiuretic hormone Correct Feedback: These drugs treat diabetes insipidus by acting as replacement therapy for antidiuretic hormone (ADH). a. thyroid hormone Incorrect Feedback: Diabetes insipidus is not treated with thyroid hormone. b. corticosteroids Incorrect Feedback: Diabetes insipidus is not treated with corticosteroids. c. growth hormone Incorrect Feedback: Diabetes insipidus is not treated with growth hormone. 42. Which of the following statements about Addison’s disease is FALSE? a. Its symptoms include fatigue, weight loss, and decreased ability to tolerate stress, disease, or surgery. b. It is an autoimmune disease. c. The adrenal cortex secretes too much corticosteroid drugs. d. It causes a bronzed color to the skin. Answer: c. The adrenal cortex secretes too much corticosteroid drugs. Correct Feedback: The adrenal cortex does not secrete corticosteroid drugs. Corticosteroid drugs are used to treat Addison’s disease. Addison’s disease is an autoimmune disease in which the body’s own antibodies destroy the adrenal cortex and too little cortisol is secreted. Addison’s disease causes fatigue, weight loss, and decreased ability to tolerate stress, disease, or surgery. In addition, patients have an unusual bronzed color to the skin. a. Its symptoms include fatigue, weight loss, and decreased ability to tolerate stress, disease, or surgery. Incorrect Feedback: This is a true statement. b. It is an autoimmune disease. Incorrect Feedback: This is a true statement. d. It causes a bronzed color to the skin. Incorrect Feedback: This is a true statement. 43. Roberta Clark must take high doses of a prescribed corticosteroid drug. Over time, she might develop ______. a. a moon face b. reddened cheeks c. buffalo hump d. all of the above Answer: d. all of the above Correct Feedback: Patients who must take prolonged or high doses of a corticosteroid drug develop a unique appearance. These patients have increased deposition of fat in the face (moon face) and back of the neck (buffalo hump); they also have a thinning of facial connective tissue which allows the blood vessels to show through, giving their cheeks a reddened appearance. a. a moon face Incorrect Feedback: This is true, but it is not the only correct answer. b. reddened cheeks Incorrect Feedback: This is true, but it is not the only correct answer. c. buffalo hump Incorrect Feedback: This is true, but it is not the only correct answer. 44. Anabolic steroids can be used legally in all of the following ways EXCEPT ______. a. to promote weight gain after surgery or trauma b. to increase the red blood cell (RBC) count to treat anemia c. to increase the muscle mass in professional athletes d. to increase the muscle mass in patients with muscular dystrophy Answer: c. to increase the muscle mass in professional athletes Correct Feedback: Although the use of anabolic steroid drugs to increase muscle mass, strength, and endurance is illegal in amateur and professional sports competitions, anabolic steroids are prescribed to promote weight gain following extensive surgery or trauma, to increase the RBC count and treat anemia, or to increase muscle mass in patients with muscular dystrophy. a. to promote weight gain after surgery or trauma Incorrect Feedback: This is a true statement. b. to increase the red blood cell (RBC) count to treat anemia Incorrect Feedback: This is a true statement. d. to increase the muscle mass in patients with muscular dystrophy Incorrect Feedback: This is a true statement. 45. Type 2 diabetes mellitus is first treated with insulin, but an antidiabetic drug may also be needed. Answer: False Feedback: Type 2 diabetes mellitus is first treated with antidiabetic drugs, but insulin may also be needed. 46. There are two types of intermediate-acting insulin drugs: those with added protamine and zinc to prolong the therapeutic action of the insulin and those with different sizes of insulin crystals to slow down the onset of action of the insulin. Answer: True Feedback: There are two types of intermediate-acting insulin drugs: those with added protamine and zinc (NPH insulin drugs) to prolong the therapeutic action of the insulin and those with different sizes of insulin crystals (lente insulin drugs) to slow down the onset of action of the insulin. 47. The meglitinide class of oral antidiabetic drugs increases the sensitivity of the cell to insulin produced by the pancreas and suppresses the release of stored glucose from the liver. Answer: False Feedback: It is the thiazolidinedione class of oral antidiabetic drugs, not the meglitinide class, that increases the sensitivity of the cell to any insulin produced by the pancreas and suppresses the release of stored glucose from the liver. 48. Drugs used to treat hypothyroidism act by supplementing existing levels of T3 and/or T4. Answer: True Feedback: Drugs used to treat hypothyroidism act by supplementing existing levels of T3 and/or T4. 49. Drugs used to treat acromegaly decrease the production of growth hormone or block growth hormone from activating receptors on the cell membrane. Answer: True Feedback: Drugs used to treat acromegaly decrease the production of growth hormone by the anterior pituitary gland or block growth hormone from activating receptors on the cell membrane. 50. The drugs used to treat Cushing’s syndrome inhibit pregnenolone (the precursor to all the hormones secreted by the adrenal cortex). Answer: True Feedback: Drugs used to treat Cushing’s syndrome inhibit pregnenolone (the precursor to all the hormones secreted by the adrenal cortex). Decreasing the amount of pregnenolone lowers elevated levels of cortisol and treats Cushing’s syndrome. 51. Intermediate-acting insulin drugs have a faster onset but a longer effect than rapidacting insulin drugs. Answer: False Feedback: Intermediate-acting insulin drugs have a slower onset but a longer effect than rapid-acting insulin drugs. 52. Incretin mimetic antidiabetic drugs are given orally and are used to treat type 1 diabetes mellitus. Answer: False Feedback: Incretin mimetic antidiabetic drugs are used to treat type 2 diabetes mellitus. These drugs are given subcutaneously. 53. Antithyroid drugs used for hyperthyroidism can also be given prior to a thyroidectomy. Answer: True Feedback: Antithyroid drugs treat hyperthyroidism (thyrotoxicosis) by inhibiting the production of T3 and T4 in the thyroid gland. These drugs can also be given prior to a thyroidectomy. 54. The pancreas of a patient with type 2 diabetes mellitus is still producing insulin, but in smaller amounts than normal. Answer: True Feedback: The pancreas of a patient with type 2 diabetes mellitus is still producing insulin, but in a smaller amount than normal. 55. Sulfonylurea oral antidiabetic drugs stimulate the beta cells of the pancreas to produce more insulin. Answer: True Feedback: All sulfonylurea oral antidiabetic drugs stimulate the beta cells of the pancreas to produce more insulin. 56. Drugs used to treat hypothyroidism are obtained from natural sources, such as desiccated (dried) animal pancreas, or they are synthetically manufactured. Answer: False Feedback: Drugs used to treat hypothyroidism are obtained from natural sources, such as desiccated (dried) animal thyroid glands, or they are synthetically manufactured. 57. The drug insulin was first introduced in the 1960s. Answer: False Feedback: The drug insulin was first isolated in the 1920s. 58. Oral antidiabetic drugs can increase the number of insulin receptors on cells. Answer: True Feedback: Oral antidiabetic drugs stimulate the beta cells of the pancreas to produce more insulin; these drugs also increase the number of insulin receptors so that the cells are not resistant to the effects of any insulin that is present. 59. GLP-1 and GIP are hormones that are released by the intestine when food is present in the stomach. They stimulate the pancreas to make more insulin. Answer: True Feedback: GLP-1 and GIP are two hormones that are normally released by the intestine when food is present in the stomach. Both GLP-1 and GIP stimulate the beta cells of the pancreas to make more insulin. 60. On an insulin drug label, U-100 means 100 units/mL. True Answer: True Feedback: Doses are measured in 100 units/mL. U-100 or the equivalent 100 units/mL is a universal standard of measurement for insulin. 61. To make NPH, protamine and zinc are added. Protamine was originally taken from the semen of a river trout. Answer: True Feedback: The abbreviation NPH stands for neutral protamine Hagedorn. Hans Christian Hagedorn (1888-1971), a Scandinavian physician, took animal insulin and added protamine, a substance from the semen of river trout, to prolong the therapeutic action of insulin. 62. One drug used to treat diabetes insipidus—desmopressin (DDAVP, Stimate)—is given in the form of an intranasal spray. Answer: True Feedback: Desmopressin is a synthetic analog of ADH; its route of administration is unusual in that it is given as an intranasal spray. 63. Beef, beef/pork, and pork insulin drugs are available in the United States. Answer: False Feedback: Beef and beef/pork insulin drugs are no longer on the market in the United States. Only pork insulin is available in the United States. 64. In the trade name Humalog Mix 75/20 or Novolin 70/30, the first number given is the percentage of rapid-acting insulin in that combination insulin drug. Answer: False Feedback: Combination insulin drugs contain a mixture of an intermediate-acting insulin (NPH insulin drug or insulin analog drug) and a rapidacting insulin (regular insulin drug or insulin analog drug). The percentage of the intermediate-acting insulin drug is always listed first. 65. Untreated or uncontrolled diabetes mellitus eventually leads to the diabetic complications of diabetic retinopathy, diabetic neuropathy, arteriosclerosis, ketoacidosis, and even death. Answer: True Feedback: Untreated or uncontrolled diabetes mellitus results in blood glucose levels that are constantly elevated. This eventually leads to the diabetic complications of diabetic retinopathy, diabetic neuropathy, arteriosclerosis, ketoacidosis, and even death. 66. The thyroid gland secretes the hormones T3 and T4. Decreased levels of these hormones cause hyperthyroidism. Answer: False Feedback: The thyroid gland secretes the hormones triiodothyronine (T3) and thyroxine (T4). Decreased levels of these hormones cause hypothyroidism. Increased levels of T3 and T4 cause hyperthyroidism. 67. Oral antidiabetic drugs are a unique drug form of insulin. Answer: False Feedback: Contrary to popular belief, oral antidiabetic drugs are not insulin and are not effective in treating patients with type 1 diabetes mellitus. 68. Because the insulin molecule is broken down by digestive enzymes, insulin can never be given orally. Answer: True Feedback: Because the insulin molecule is broken down by digestive enzymes, insulin can never be given orally. 69. Long-acting insulin drugs are also known as _________ insulin. Answer: ultralente Feedback: Long-acting insulin drugs are also known as ultralente insulin. 70. An insulin syringe’s calibration is unique, because it is calibrated in _______, a standardized measurement for insulin doses. Answer: units Feedback: An insulin syringe’s calibration is unique, because it is in units, a standardized measurement for insulin doses. 71. The __________ class of oral antidiabetic drugs are structurally derived from sulfonamide anti-infective drugs, but they do not have any anti-infective action. Answer: sulfonylurea Feedback: The sulfonylurea class of oral antidiabetic drugs are structurally derived from sulfonamide anti-infective drugs, but they do not have any anti-infective action. 72. One class of antidiabetic drugs is based on the action of ____________, a group of substances in the body that stimulate the beta cells of the pancreas to produce insulin only when blood glucose levels are high. Answer: incretins Feedback: The incretin mimetic class of antidiabetic drugs is based on the action of incretins, a group of substances in the body that stimulate the beta cells of the pancreas to produce insulin only when blood glucose level is high. 73. In diabetes insipidus, there are insufficient levels of ADH. The abbreviation ADH stands for ________. Answer: antidiuretic hormone Feedback: Insufficient levels of antidiuretic hormone (ADH) cause diabetes insipidus. 74. Glucocorticoid hormones are powerful anti-inflammatory hormones from the adrenal cortex. These are also available as drugs that are known as __________ drugs because they act in the same way as the natural hormones from the adrenal cortex and their chemical structure is that of a steroid. Answer: corticosteroid Feedback: The adrenal cortex secretes the glucocorticoid hormones hydrocortisone and cortisol, both of which are powerful anti-inflammatory hormones. Glucocorticoid hormones available as drugs are known as corticosteroid drugs because they act in the same way as the natural hormones secreted by the adrenal cortex. 75. Insulin is secreted by _______ cells in the islets of Langerhans in the pancreas. Answer: beta Feedback: Insulin is secreted by beta cells in the islets of Langerhans in the pancreas. 76. Type 2 diabetes was previously known as NIDDM. This abbreviation stands for _________. Answer: non–insulin-dependent diabetes mellitus Feedback: Type 2 diabetes mellitus was previously known as non– insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes mellitus. 77. The abbreviation rDNA indicates that a drug is manufactured using _______. Answer: recombinant DNA technology Feedback: The designation rDNA origin indicates that this drug is manufactured using recombinant DNA technology. 78. Insulin is always injected via the _______ route. Answer: subcutaneous Feedback: Insulin must be injected via the subcutaneous route into the fat layer beneath the skin. 79. The process of using a different site for each insulin injection is known as site ______. Answer: rotation Feedback: A new site must be selected for each insulin injection to avoid tissue damage. This process is known as site rotation. 80. When a tumor in the adrenal cortex causes it to secrete too much of the hormone cortisol, this causes ______ syndrome. Answer: Cushing’s Feedback: The adrenal cortex secretes the hormone cortisol. If a tumor causes the adrenal cortex to secrete increased amounts of cortisol, this causes Cushing’s syndrome. 81. The antidiabetic drug exenatide (trade name ______) is a synthetic version of a protein found in the saliva of the poisonous Gila monster, a lizard that lives in the Sonoran Desert of the southwestern United States and in Mexico. Answer: Byetta Feedback: The antidiabetic drug Byetta is a synthetic version of a protein found in the saliva of the poisonous Gila monster, a lizard that lives in the Sonoran Desert of the southwestern United States and in Mexico. 82. In adults, an overproduction of growth hormone by the anterior pituitary gland causes ______, a widening and enlargement of the facial features, hands, and feet. Answer: acromegaly Feedback: In adults, an overproduction of growth hormone by the anterior pituitary gland causes acromegaly, a widening and enlargement of the facial features, hands, and feet. 83. All anabolic steroid drugs are classified as Schedule ______ controlled substances because of their high potential for addiction and abuse. Answer: III Feedback: All anabolic steroid drugs are classified as Schedule III controlled substances because of their high potential for addiction and abuse. 84. 1. conivaptan (Vaprisol) A. biguanide oral antidiabetic drug 2. exenatide (Byetta) B. drug for diabetes insipidus 3. glipizide (Glucotrol, Glucotrol XL) C. DPP-4 inhibitor oral antidiabetic drug 4. Humulin N D. drug for hyperthyroidism 5. Humulin R E. drug for hypothyroidism 6. iodine (ThyroShield) F. incretin mimetic antidiabetic drug 7. levothyroxine (Levothroid, Synthroid) G. intermediate-acting insulin 8. metformin (Glucophage, Glucophage XR) H. rapid-acting insulin 9. sitagliptin (Januvia) I. drug for SIADH 10. vasopressin (Pitressin) J. sulfonylurea oral antidiabetic drug Answer: I Answer: F Answer: J Answer: G Answer: H Answer: D Answer: E Answer: A Answer: C Answer: B 85. Diabetes mellitus is a disease of the pancreas and body cells. Describe the one reason why type 1 diabetes mellitus occurs and the two reasons why type 2 diabetes mellitus occurs. Answer: Diabetes mellitus is a disease of the pancreas and body cells. It occurs when: 1. the pancreas does not produce any insulin (type 1 diabetes mellitus), 2. the pancreas produces too little insulin (type 2 diabetes mellitus), 3. the number of or sensitivity of insulin receptors on body cells is decreased (type 2 diabetes mellitus). 86. New insulin drugs have been created using recombinant DNA technology. Briefly explain the process involved for creating insulin drugs using recombinant DNA technology. Answer: New insulin drugs have been created using recombinant DNA technology. This technology inserts the gene for human insulin into bacteria or yeasts which then multiply rapidly and produce large amounts of the insulin drug. Other insulin drugs created by recombinant DNA technology include the insulin analog drugs. An analog is structurally similar to the original molecule (human insulin) but is not entirely the same. 87. Briefly discuss why beef and beef/pork insulins are no longer on the market in the United States. Answer: Beef and beef/pork insulin drugs are no longer on the market in the United States because of the risk that they might transmit bovine spongiform encephalopathy (a fatal disease in cows) that has been linked to outbreaks of a fatal neurologic condition in humans known as Creutzfeldt-Jakob disease. Test Bank for Understanding Pharmacology for Health Professionals Susan M. Turley 9780135145708, 9780133911268
