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561 Pharm > Anti-Diabetic > Flashcards

Anti-Diabetic Flashcards

1
Q

DM I pathophys

A

beta cell failure, genetic autoimmune destruction
insulin dependent due to insulin deficiency

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2
Q

DM II pathophys

A

gradual beta cell deterioration leading to resistance to insulin

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3
Q

symptoms of DM

A

increased thirst, slow healing, fatigue, blurred vision, frequent urination, unexplained weight loss

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4
Q

insulin MOA

A

bind insulin receptors to activate tyrosine kinase to adipose, liver, skeletal muscle and promote storage

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5
Q

lispro insulin features

A

3-5 hours duration
IV/prick
onset 15 min

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6
Q

regular crystalline insulin features

A

7-10 hour duration
IV/prick
most common

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7
Q

neutral protamine hagedorn features

duration

A

16-20 hour duration
can be used with regular

insulin!

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8
Q

oral antidiabetic drugs include

A

sulfonylureas
metformin
thiazolidinediones
acarbose/miglitol

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9
Q

effect of sulfonylureas on blood sugar

A

reduce by stimulating pancreatic insulin release

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10
Q

effect of metformin/biguanides on blood sugar

A

reduce biosynthesis of glucose in the liver

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11
Q

effect of thiazolidinediones on blood sugar

A

reduce by increasing sensitivity of target cells to insulin
combat insulin resistance

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12
Q

effect of acarbose/miglitol on blood sugar

A

reduce by retarding the absorption of sugars from the GI tract

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13
Q

sulfonylureas MOA

A

inhibit K+ channels to increase intracellular Ca+, increase insulin release from pancreatic beta cells

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14
Q

are sulfonylureas commonly used now?

A

No, there are 3 generations of these drugs but they are not commonly prescribed now due to better alternatives

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15
Q

sulfonylureas side effects

A

hypoglycemia
cholestatic jaundice
weight gain
cross placenta/fetal hypoglycemia

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16
Q

meglitinides pros and cons

A

pros: rapidly acting insulin enhancers with shorter duration than sulfonylureas
less weight gain
minimal renal excretion so safe for patients with impaired renal function
cons: adverse effect of hypoglycemia, cannot be taken without food/meal

17
Q

metformin MOA

A

decrease hepatic glucose production by inhibiting GnG
increases muscle and liver sensitivity to insulin

18
Q

pros of metformin

A

modest weight loss
no hypoglycemia
decreases triglycerides and LDL
increases HDL

19
Q

side effects of metformin

A

GI effects
lactic acidosis, esp if kidney disease present

20
Q

first line medication for diabetes

A

metformin
additional medications added if needed

21
Q

thiazolidinediones MOA

A

enhance GLC/lipid metabolism with PPAR action to increase sensitvity to insulin
increases GLUT 4 GLC transporters

22
Q

pros of thiazolidinediones

A

decrease triglycerides and increase HDL

23
Q

side effects of thiazolidinediones

A

edema

24
Q

alpha glucosidase inhibitors MOA

A

inhibit alpha glucosidase that converts starch and complex carbs into simple sugars, decreasing absorption of GLC after meals

25
Q

side effects of alpha glucosidase inhibitors

A

flatulence
diarrhea

26
Q

incretins effect on GLC homeostasis

A

include glucose dependent insulinotrophic peptide and glucagon like peptide 1 (GLP1)
GIP/GLP1 affect glucagon and insulin secretion to regulate glycogen breakdown

27
Q

effects of GLP1 agonists

A

incretin that increases insulin release from small instestine
decrease liver GLC output, gastric emptying, appetite

28
Q

effect of DPP4 inhibitors

A

inhibit enzyme that breaks down GLP1
increase endogenous GLP1, inuslin release
decrease glucagon and liver GLC output

29
Q

GLP 1 analogs include:

A

semaglutide/ozempic
exenatide/byetta
liraglutide/victoza

30
Q

side effects of GLP 1 inhibitors

A

GI issues
injection site reaction (subcutaneous)
pancreatitis

31
Q

DPP 4 inhibitors include

A

sitagliptin
saxagliptin
-gliptin

32
Q

side effects of DPP4 inhibitors

A

nasooharyngitis
headache
pancreatitis

33
Q

SGLT2 inhibitors MOA

A

inhibit SGLT2 in kidney to decrease GLC reabsorption, increase renal elimination of GLC

34
Q

side effects of SGLT2 inhibitors

A

genital yeast infection
UTI
bone Fx risk
ketoacidosis

35
Q

PT considerations for anti diabetic drugs

A

blood sugar monitoring
signs of hypoglycemia/hyperglycemia
foot care
CV precautions
kidney complications
skin conditions/breakdown
pt education on monitoring s/s
warm up/cool down each session
dehydration due to high blood sugar

561 Pharm (21 decks)

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