18 - DM pharm 1

Question 1

key 2 things that keeping under control will lower risk for micro vs macrovascular complications of DM

Answer 1

micro - glucose levels, BP

macro - BP, lipids

Question 2

insulin secretagogues - ex, what do they do best, AEs/main risk

Answer 2

sulfonylureas, repaglinide, nateglinide
inc basal and/or postprandial insulin sec (depends of duration of action). best for lowering postprandial glucose
wt gain, SIADH, hypoglycemia**

Question 3

insulin secretagogues act on what channel?

Answer 3

K channel (SUR1) on beta cell

Question 4

biguanides - example, what it does best, AEs/main risk

Answer 4

metformin!
dec hepatic glucose production > lowers fasting glucose best (but need insulin in body or else won’t work)
N/D, lactic acidosis**

Question 5

alpha glucosidase inhibs - ex, what they do, AEs

Answer 5

acarbose and miglitol
delay carb absorption in intestines - best for postprandial hyperglyemia
flatulence

Question 6

thiazolidinediones - suffix, why we don’t use them anymore

Answer 6

-glitazone

inc risk of MI and CHF

Question 7

GLP-1 agonists - ex

Answer 7

exenatide

Question 8

molecules responsible for diff response to oral vs iv glucose

Answer 8

incretins (GIP and GLP-1)

Question 9

how do DPP-4 inhibs work?

Answer 9

DPP4 inactivates incretins, so inhibiting DPP4 increases incretin activity

Question 10

glyburide class

Answer 10

sulfonylurea

Question 11

short, intermediate, and long acting insulins

Answer 11

short - regular
intermediate - NPH
long - lente and ultralente

Question 12

pramlintide - how does it work / what does it do

Answer 12

given with insulin (in granules) - analog of amylin which is normally cosecreted w/ insulin
dec post meal glucose, suppresses glucagon, slows gastric emptying (satiety, wt loss, nausea)

Question 13

HB A1c goal for diabetic adults

Answer 13

<7%