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PHARMACOLOGY > 10-Diabetes Lec > Flashcards

10-Diabetes Lec Flashcards

1
Q

Type 1 diabetes characteristics

A
  • insulin dependant
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2
Q

Are type one diabetes onset of symptoms sudden or acute?

A

Sudden

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3
Q

Type one diabetes typically effects how many people and what age?

A

around 10% and childhood and teen years

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4
Q

Is type one diabetes normally associated with family history?

A

uncommon

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5
Q

Symptoms of type one diabetes

A
  • polyuria
  • polydypsia
  • polyphagia
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6
Q

T2DM characteristics

A

-not insulin dependant

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7
Q

Are symptoms of DM2 more acute or sudden?

A

little more benign and not as obvious

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8
Q

What is a characteristic normally noticed with T2DM?

A

sudden decline in eye sight

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9
Q

What age group is normally affected by T2DM?

A

over 40 years

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10
Q

Is T2DM associated with family history?

A

yes

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11
Q

Are symptoms normally evident in T2DM?

A

may or may not have symptoms

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12
Q

Insulin inside of the body is known as?

A

Endogenous

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13
Q

Insulin outside of body?

A

exogenous

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14
Q

Bolus insulin

A
  • multiple daily injections mimics what your body would normally do
  • When we eat = burst of endogenous insulin
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15
Q

Basal Insulin

A
  • covers you throughout the day

- even when we are not eating

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16
Q

Best practices include:

A

● Multiple daily injections (MDI);

● Continuous Subcutaneous Insulin Infusions (CSII)

17
Q

Smart loop system

A
  • pump that gives you insulin and captures interstitial fluid and glucose levels in accurate time
  • More people are moving towards pumps b/c it reduces the risk of hypoglycemia (BIGGEST medical emergency for people with diabetes)
18
Q

What type of insulin is great for kids?

A

● FAST insulins is great for kids
○ Watch what they ate
○ Depending on what they ate - injects afterwards and it works fast

19
Q

Why are insulin regiments different?

A
  • diff for each person

- depends on lifestyle , age etc

20
Q

T1DM

A

autoimmune disease assault on pancreas

21
Q

T2DM

A
  • not as simple as eating too much and not being active

- lots of other organs involved

22
Q

Are most drugs for T2 oral or injectable?

A

oral

- we can use other drugs besides insulin injectables that help manage blood sugars

23
Q

Best Practice?

A

combination therapy

24
Q

Function, side effects of biguanide?

A

Function- targets liver and enhances insulin sensitivity in liver and peripheral tissues by activation of AMP activated protein kinase

  • SE:: GI concerns, B12 deficiency, not RX if renal insufficiencies or hepatic failure.
  • Hypo: Negligible risk as monotherapy
25
Q

Function, side effects of Glucagon like Peptide-1 (GLP-1)

A
  • Action: activates incretin pathway by utilizing DPP-4 resistant analogue to GLP-1.
  • Hypo: Negligible risk as monotherapy
  • SE: Nausea & Vomitting, pancreatitis, parafollicular cell hyperplasia, not Rx for family hx of medullary thyroid cancer/multiple endocrine neoplasia syndrome.
  • This is injectable, and you can do it once a day
26
Q

Suffix for Glucagon like Peptide-1 (GLP-1)

A

IDE

27
Q

Function, side effects of Sodium Glucose Co-Transporter-2 Inhibitor (SGLT-2)

A

● Action: Inhibits renal glucose reabsorption.
● Blood come into kidneys for filtration and excrete glucose into urine
● Hypo: Negligible risk as monotherapy
● SE: polyuria, increased genital and UTI
● Older aging frail women are at most risks

28
Q

Suffix for Sodium Glucose Co-Transporter-2 Inhibitor (SGLT-2)

A

● End of these names are “-flozin”

29
Q

Effects and action of Dipeptidyl Peptidase-4 Inhibitor (DPP-4)

A

● Action: Amplifies incretin pathway activation by inhibition of enzymatic breakdown of GLP-1 and GIP.
which inhibit glucagon release, which in turn increases insulin secretion, decreases gastric emptying, and decreases blood glucose levels.
● Normally once a day dosing
● Hypo: Negligible risk as monotherapy
● SE: pancreatitis?

30
Q

Suffix for Dipeptidyl Peptidase-4 Inhibitor (DPP-4)

A

● These names end in “-gliptin”

31
Q

Side Effects and action of insulin

A
  • Best for lowering glucose levels - most potent
  • Biggest risk is hypoglycemia
  • Action: activates insulin receptors to regulate metabolism of carbohydrate, fat and protein.
  • Hypo: Significant, highest with short and intermediate acting insulin.
  • SE: potential weight gain
32
Q

Effects and Action

Thiazolidinediones (TZD)

A

-Drugs that came out as the “wonder drug” seemed to do it all
- A lot of people were dying on this class of drug
● Action: enhances insulin sensitivity in peripheral tissues and liver by activation of peroxisome proliferator-activated receptor-gamma receptors
● Weight gain, edema, congestive heart failure
○ Biggest problem = prescribed to the wrong people
○ Anyone with a heart problem should NOT be prescribed this medication
● Hypo: Negligible risk as monotherapy
● SE: weight gain, edema, CHF (heart failure), macular edema, fractures, MI, CA increase (possible).

33
Q

anyone with heart problems should not be prescribed what drug class of medications?

A

Thiazolidinediones (TZD)

34
Q

Side effects and action of Alpha Glucosidase Inhibitor (AGI)

A

● Action: Inhibits pancreatic alpha-amylase and intestinal alpha-glucosidase.
● Let’s carbs pass through the intestines
● Hypo: Negligible as monotherapy.
● SE: GI side effects.

35
Q

Suffix for Thiazolidinediones (TZD)

A

ends in Zone

36
Q

Side effects of Insulin Secretagogues - Sulfonylureas & Meglitinides

A

● Pushes the pancreas to make more insulin or helps it along
● A lot of elder people are on this medication
○ Really cheap and easy dosing
○ Removed off of these drugs b/c there are far better options out there
● Action: activates sulfonylurea receptor on beta-cell to stimulate endogenous insulin secretion.
● Hypo: Moderate to significant.
● SE: weight gain, caution with renal/hepatic issues and elderly; elderly older adults (cheap medication so more people and government use it)

37
Q

Side effects and action of anti obesity agent

A
  • Action: inhibits lipase
  • Hypo: None
  • Se: GI side effects; more diarrhea with high carb meal
  • People taking need to be on multivitamin as they are not absorbing some nutrients
38
Q

Agent characteristics

A 
●	BG lowering efficacy and durability
●	Risk of inducing hypoglycemia
●	Effect on weight
●	Contraindications and/or side effects
●	Cost/coverage
●	Other…cardioprotection?
39
Q

Patient characteristics

A 
●	Degree of hyperglycemia
●	Risk of hypoglycemia
●	Overweight or obese
●	Comorbidities (renal, hepatic issues)
●	Preferences (medication adherence)
●	Access to treatment

PHARMACOLOGY (27 decks)

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