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Clinical Pharmacology > 5.2 The Pharmacology Of Insulim > Flashcards

5.2 The Pharmacology Of Insulim Flashcards

1
Q

what is the role of insulin?

A
  • stimulates uptake of glucose into liver, muscle and adipose tissue
  • decreases hepatic glucose output via inhibition of gluconeogenesis
  • inhibits glycogenolysis
  • promotes uptake of fats
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2
Q

what are the 6 main categories of insulin?

A 
ultrafast acting
rapid acting
short acting
intermediate acting
long acting very long acting
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3
Q

what are rapid acting insulins? name an example.

A
  • rapid onset of action - 5 to 15 minutes
  • inject just before eating
  • peaks 60 mins after
  • duration of 4-6 hrs

e.g. humalog

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4
Q

what are short acting insulins? give an example

A
  • start to work 30-60 mins after
  • need to inject 15-30 mins before eating several times a day to cover meals
  • peaks at 2-3 hrs
  • duration 8-10 hrs

e.g actrapid

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5
Q

what are some intermediate acting insulins? give an example.

A
  • slower onset 2-4 hrs
  • peaks 4-8 hrs
  • duration up to 12-20hrs

e.g insulatard

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6
Q

what are long and very long acting insulins? give an example.

A
  • slow onset 2-6 hrs
  • duration up to 24 hrs
  • very long, up to 50+ hrs
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7
Q

what is insulin pump therapy?

A

sensor augmented pump therapy with threshold suspend

rapid acting insulin is constantly given

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8
Q

what are the adverse effects of insulin?

A
  • hypoglycaemia
  • hyperglycaemia
  • lipodystrophy
  • painful injections
  • insulin allergies
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9
Q

how do we treat type 2 diabeties?

A

lifestyle changes and non insulin therapies (may eventually need to take insulin)

  • insulin
  • bariatric surgery
  • low calorie diet
  • exercise
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10
Q

what are the nice targets in type 2 diabeties?

A

HbA1c 6.5-7.5% in general

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11
Q

what is metformin and what does it do?

A

metformin

  • decreases insulin resistance, leading to increased glucose taken in by tissues
  • decreased hepatic glucose production
  • limits weight gain
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12
Q

what are the ADRs of metformin?

A
  • GI symptoms
  • lactic acidosis
  • vit b12 deficiency
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13
Q

what are sulphonylureas and what do they do?

A

stimulate beta cell to release insulin

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14
Q

what are the ADR of sulphonylureas?

A

weight gain
hypoglycaemia
cost low

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15
Q

what is acarbose and what does it do?

A

Acarbose = a glucosidase inhibitor

inhibits breakdown of carbohydrates to glucose by blocking action of the enzyme alpha glucosidase

this means less cholesterol is produced as less carbs are broken down

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16
Q

what are the side effects of acarbose?

A

flatulence
loose stools
diarrhoea

due to less cholesterol being absorbed = poo it straight out

rarely if every used

17
Q

what are glucagon like peptide 1 therapies?

A

increase insulin secretion from the beta cells
decrease production of glucagon from the alpha cells

this is useful in type 2 diabetics as high glucose is present due to low insulin and high glucagon

it also

  • decreases glucose production from the liver
  • decreases gastric emptying
  • increases glucose uptake in muscles
18
Q

What is HbA1c?

A

HbA1c is your average blood glucose levels for the last two to three months.

A high HbA1c means you have too much sugar in your blood. This means you’re more likely to develop diabetes complications, like serious problems with your eyes and feet.

19
Q

what are gliptins or DPP 4 inhibitors used for and how do they work?

A

e.g sitagliptin

inhibit DPP-4 activity, increasing active glycogen like peptide activity post meal

20
Q

what are the side effects of gliptins and DPP-4 inhibitors?

A 
GI symptoms
pancreatitis
low risk of hypoglycaemia 
weight neutral 
modest HbA1C reduction 
high cost
21
Q

what are the adverse side effects of Glucagon-like peptide 1 (GLP-1) ?

A
  • gastrointestinal symptoms, nausea, loose stools, diarrhoea
  • gastro oesophageal reflux
  • painful to Inject someties
  • maybe pancreatitis??? nobody knows
22
Q

what is dapaglifozin?

A

a type of glifozin

removes excess glucose via excretion in urine by inhibiting SGLT2 transporters that would reuptake it

23
Q

what are the side effects of glifozins?

A

increased risk of lower urinary tract symptoms and UTI’s

polyuria

hypoglycaemia risk low

Clinical Pharmacology (27 decks)

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