wilkes nsg 552 university exam 2

ARBs are considered a reasonable alternative for those intolerant of ACEI —

correct answer–

Cardioprotective dose ASA (IE baby aspirin or clopidrogel as alternative)For

SECONDARY PREVENTION of CV Events- Use in ALL diabetics with CV

diseaseFor PRIMARY PREVENTION of CV EventsUSE in: high CV risk

patients (10-yr CV risk > 10%) – Typically: male > 50 yo or female >60 yo

with 1 additional major risk factor (FH of CVD, HTN, smoker, dyslipidemia

or albuminuria)MAY consider: intermediate CV risk patrients 10-yr CV risk

of 5-10%) – younger patients with 1 or more risk factors, older patients with

no risk factorsNOT recommended: low CV risk patients – men <50 yo or

women <60 yo without major CV risk factors or 10-yr CV risk < 5%Note –

Many authorities consider DM to be an ASCVD risk equivalentThis is

basically everyone with DM –correct answer–

What are the goals set by ACE /ACCE and are they written in stone for all

patients? –correct answer–Primary target for glycemic control is HbA1C

Individualize HbA1C goal – based on…Duration of DMAge/life

expectancyComorbid conditions

Known CVD or advanced comorbid conditionsHypoglycemic unawareness

Individual patient considerations

Please note when transitioning from oral therapy for type II DM to insulin,

metformin is retained! Secretagogues are discontinued possibly when basal

insulin is initiated, but definitely when prandial (fast/rapid) insulin is to be

added –correct answer–Options to add to basal insulin for prandial

coverage…

Fast-acting insulin

DPP-4 inhibitors

Incretin mimetics

Glinides

Alpha-glucosidase inhibitors

Published by Henry