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Pharm > 11a: Diabetes > Flashcards

11a: Diabetes Flashcards

1
Q

how does the pancreas function as an exocrine gland?

A

it excretes digestive enzymes into the duodenum of the pancreatic duct

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2
Q

how does the pancreas function as an endocrine gland?

A

it secretes 2 hormones into the bloodstream, insulin and glucagon

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3
Q

what is the function of insulin?

A

regulates blood glucose levels, and helps with metabolism of carbohydrates, proteins, and lipids

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4
Q

what is the function of glucagon?

A

it increases blood glucose in order to maintain normal blood glucose levels and to prevent hypoglycemia

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5
Q

is glucagon an agonist or antagonist of insulin?

A

hormonal antagonist of insulin

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6
Q

how does glucagon increase blood glucose?

A

it causes a rapid increase in glycogen breakdown in the liver, which releases glucose into the bloodstream from hepatic glycogen stores

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7
Q

what is normal fasting blood glucose (between meals)?

A

70-110mg of glucose

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8
Q

when does blood glucose rise?

A

after a meal

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9
Q

how does a rise in blood glucose after a meal affect insulin secretion?

A

insulin is secreted from the pancreas to promote the movement of glucose from the bloodstream to the tissues (to return blood glucose levels back to normal)

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10
Q

what does glucagon do when blood glucose levels fall?

A

glucagon is released, when then releases glucose from the liver

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11
Q

what is the issue with insulin in type 1 diabetes?

A

unable to synthesize insulin due to a destruction of pancreatic beta cells

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12
Q

what is the issue with insulin in type 2 diabetes?

A

combination of beta cell dysfunction and decreased sensitivity of peripheral tissues to circulating insulin (insulin resistance)

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13
Q

what are risk factors for type 2 diabetes?

A

genetic predisposition, poor diet, obesity, lack of exercise

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14
Q

what is the most common symptom of type 1 and type 2, and what does it mean?

A

hyperglycemia – lack of insulin causes glucose to be taken up by the peripheral tissues

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15
Q

how is type 1 diabetes treated?

A

exogenous insulin is given to replace normal pancreatic insulin

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16
Q

how is exogenous insulin used to treat type 2 diabetes?

A

may be given along with other drugs to supplement endogenous insulin release

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17
Q

what are the three concentrations of insulin?

A

short-acting, intermediate-acting, long-acting (these can be combined)

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18
Q

how does insulin have to be administered, and why?

A

subcutaneous injection, because it cannot be absorbed through the GI wall

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19
Q

what factors affect insulin dosage?

A

blood sugar levels, exercise, and dietary modifications

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20
Q

what is the purpose of insulin pumps?

A

continuous infusion that is delivered subcutaneously through a catheter

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21
Q

what is intensive insulin therapy?

A

method of insulin administration that is used when exogenous insulin is required for diabetics; patient monitors blood glucose throughout the day and administers insulin as needed (may be given long-acting once daily and short-acting as needed)

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22
Q

what is hypoglycemia?

A

when blood sugars drop too low which can cause decreased BP

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23
Q

when can hypoglycemia occur?

A
  • when insulin dose is higher than needed
  • if the patient misses or delays a meal
  • strenous physical activity
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24
Q

what are symptoms of hypoglycemia?

A

headache, fatigue, hunger, tachycardia, sweating, anxiety, confusion

25
Q

what is the goal of medications for type 2 diabetes?

A

stimulate insulin secretion and supply by working on the pancreatic beat cells, which then travel to the liver and inhibit hepatic glucose production

26
Q

what is an example of an insulin sensitizer (for type 2)?

A

metformin (glucophage)

27
Q

what is the function of metformin?

A

acts on the liver to inhibit glucose production, and increases the sensitivity of peripheral tissues to insulin

28
Q

how is metformin administered (why is it unique)?

A

administered orally (diabetes medications are usually administered subcutaneously)

29
Q

what is the main adverse effect of metformin?

A

lactic acidosis

30
Q

what are symptoms of lactic acidosis?

A

confusion, lethargy, stupor, shallow rapid breathing, tachycardia (especially during exercise)

31
Q

what are three generic types/purposes used for treating type 2 diabetes?

A

drugs that:
- stimulate insulin secretion
- act on liver to inhibit glucose production
- suppress glucagon secretion

32
Q

what are the most important factors in controlling both type 1 and 2?

A

weight control, diet, exercise

33
Q

rehab implications for diabetes

A
  • peripheral neuropathies
  • decreased peripheral blood flow leading to tissue ischemia, ulcers, poor wound healing, amputations
  • hypoglycemia – have snacks available
  • emphasize regular diet and avoid missing meals (esp before PT)
  • emphasize appropriate diet and physical activity
  • educate in proper skin care and footwear
34
Q

what is the goal of drugs used to treat infectious diseases?

A

selective toxicity – kill the problem without causing excessive damage to other cells

35
Q

what is the purpose of antimicrobial/antibiotics?

A

treat small, unicellular organisms (bacteria)

36
Q

broad spectrum agents

A

drugs that are effective against a variety of bacteria

37
Q

factors that determine which antibiotic is chosen (5)

A
  • spectrum of the drug
  • patient tolerance
  • bacterial resistance
  • type and location of infection
  • physician preference
38
Q

bactericidal drugs

A

drugs that kill or destroy bacteria

39
Q

bacteriostatic drugs

A

drugs that limit bacteria growth

40
Q

three mechanisms of antibacterial drugs

A
  • inhibit bacterial cell wall synthesis and function
  • inhibit bacterial protein synthesis
  • inhibit bacterial DNA/RNA function
41
Q

examples of antibacterial drugs

A

penicillin
erythromycin
clindamycin

42
Q

adverse effects of antibiotics

A

hypersensitivity reactions – skin rashes, itching, respiratory difficulties (wheezing)
GI problems – nausea, vomiting, diarrhea

43
Q

what is one of the most serious problems with antibacterial drugs?

A

the development of strains of bacteria that are resistant to one or more antibacterial agents

44
Q

what are the most common drug resistance?

A

VRSA
MRSA
VRE
PRSP

45
Q

rehab implications of antibacterials

A
  • infections (bone, wounds, UTIs, pneumonia) – recognize and prevent
  • potential for hypersensitivity reactions & GI problems
46
Q

why are viruses unique?

A

they rely on the host (human) cell to function, so it is hard to treat without harming some human cells

47
Q

what are examples of conditions that antiviral drugs can treat?

A

hep B, influenza, herpes simplex, CMV, warts, RSV

48
Q

viral resistance

A

growing concern due to viruses being able to mutate and change structure so that drugs are no longer effective

49
Q

interferons

A

group of proteins that are made in response to viral infection and help healthy cells resist infection; they are effective in controlling some forms of cancer

50
Q

adverse effects of interferons (body’s response to infection)

A

fever, sweating, chills, muscle aches, general malaise, depression

51
Q

two goals of pharmacological management of HIV

A
  • control proliferation of HIV
  • treat and prevent opportunistic infections that overwhelm the immune system
52
Q

are there any drugs that kill HIV in humans?

A

no, but several antiviral drugs can reduce mortality and morbidity

53
Q

protease inhibitors

A

drugs that inhibit HIV protease enzyme, which prevents the progression of HIV

54
Q

verse effects of protease inhibitors

A

abdominal fat deposition, increased cholesterol, insulin resistance, increased risk of CV disease, diarrhea, headache, fatigue

55
Q

mechanism of reverse transcriptase inhibitors

A

inhibit a key step in HIV replication, keep it from spreading

56
Q

adverse effects of reverse transcriptase inhibitors

A

anemia, fever, chills, diarrhea, dizziness, headache, fatigue, myopathy, atrophy

57
Q

highly active antiretroviral therapy (HAART)

A

when several anti-HIV drugs (usually 3 or more) are administered simultaneously to provide optimal inhibition of HIV replication and proliferation

58
Q

opportunistic infections

A

major cause of illness and death in HIV patients due to decreased immune functions

59
Q

examples of opportunistic infections

A

pneumonia, hepatitis, necrotizing lesions, vesicular eruption of the skin, tuberculosis, CNS infections

Pharm (18 decks)

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