Anti-Diabetic Drugs

Question 1

What are the 4 rapid and short acting insulting injections?

Answer 1

Insulin aspart(âme), Insulin glulisine, lispro insulin, and crystalline zinc

Question 2

What are the times of onset, peak, and duration of insulin aspart(me)?

Answer 2

15 min, 1-3 hrs, 3-5 hours.

Question 3

What are the times of onset, peak, and duration of insulin

glusiline?

Answer 3

Less than 15 min, 0.5-2hrs, 3-5 hrs.

Question 4

What are the times of onset, peak, and duration of lispro insulin?

Answer 4

15 min, 1 hr, 3-6 hrs

Question 5

What are the times of onset, peak, and duration of crystalline zinc insulin?

Answer 5

0.5 hrs, 1-3 hours, 6-8 hrs.

Question 6

What are the 3 intermediate/long acting insulin injections?

Answer 6

NPH insulin, insulin glargine, and insulin detemir

Question 7

What are the times of onset, peak, and duration of NPH insulin?

Answer 7

1-2 hrs, 8-10 hrs, 12- 16 hrs

Question 8

What are the times of onset, peak, and duration of insulin glargine?

Answer 8

1-1.5 hrs, no peak, 11-24 hrs or longer duration.

Question 9

What are the times of onset, peak, and duration of insulin detemir?

Answer 9

1-2 hrs, no peak, 12-24 hrs

Question 10

What factors may increase the needed dose of insulin in a diabetic?

Answer 10

Increased metabolic needs, stress, cessation of physical exercise, increased food intake, and drug therapy (estrogens, thiazide diuretics, etc)

Question 11

What is the mechanism of action of sulfonylureas?

Answer 11

They act by increasing the secretion of insulin.

Question 12

Explain the receptor mechanism of sulfonylureas.

Answer 12

Reduce K influx, which leads to depolarization, increase in Ca influx, and insulin secretion.

Question 13

Can sulfonylureas reduce serum glucagon?

Answer 13

Yes, when administered chronically.

Question 14

What are some adverse reactions of sulfonylureas?

Answer 14

Hypoglycemia, GI symptoms, muscle weakness, weight gain, and mental confusion.

Question 15

Name the 6 sulfonylureas.

Answer 15

Tolbutamide, Tolazamide, Chloropropamide, Glyburide, Glipizide, Glimepiride.

Question 16

What is the duration of Tolbutamide?

Answer 16

6-12 hours

Question 17

What is the duration of Tolazamide?

Answer 17

10-14 hours

Question 18

What is the duration of Chlorpropamide

Answer 18

Up to 60 hours

Question 19

What is the duration of Glyburide?

Answer 19

10-24 hours

Question 20

What is the duration of Glipizide?

Answer 20

10-24 hours

Question 21

What is the duration of Glimepiride?

Answer 21

12-24 hours

Question 22

What is the mechanism of action of Metformin?

Answer 22

Decreases glucose production in the liver and increases glucose uptake.

Question 23

True or false: Metformin has no effect on pancreatic insulin levels.

Answer 23

True. Metformin also requires the presence of insulin to be effective.

Question 24

True of false: Metformin causes clinical hypoglycemia.

Answer 24

False.

Question 25

What are some adverse reactions of Metformin?

Answer 25

Metallic taste, GI upset, and anorexia.

Question 26

True or false: Metformin usually produces lactic acidosis in patients with normal renal function.

Answer 26

False.

Question 27

What is the mechanism of action of Acarbose and Miglitol?

Answer 27

Inhibits alpha glucosidase and thus inhibits hydrolysis of dietary disaccharides and complex carbs.

Question 28

When should Acarbose or Miglitol be taken?

Answer 28

At the beginning of a meal.

Question 29

What are some adverse reactions of Acarbose/ Miglitol?

Answer 29

Farting, cramps, diarrhea.

Question 30

True or false: Acarbose and Miglitol may reduce the absorption of iron.

Answer 30

True.

Question 31

What is the mechanism of action of Pioglitazone?

Answer 31

Reduces insulin resistance by increasing transcription of insulin responsive genes, by binding to the PPAR-g receptor.

Question 32

What does Pioglitazone do in the presence of insulin?

Answer 32

Reduces gluconeogenesis and increases glucose uptake.

Question 33

What are the adverse effects of Pioglitazone?

Answer 33

Weight gain, edema, increased rate of heart failure and bone fracture.

Question 34

What is the mechanism of action of Repaglinide?

Answer 34

Closes K channels to stimulate insulin secretion.

Question 35

True or false: Repaglinide is shorter acting that sulfonylureas.

Answer 35

True.

Question 36

What is the mechanism of action of Sitagliptan and Saxagliptan?

Answer 36

Inhibit dipeptidyl peptidase 4. This leads to insulin synthesis/release and a reduction of glucagon production.

Question 37

What are the adverse effects of Sitagliptan/ Saxagliptan?

Answer 37

Mild GI upset; Hypoglycemia.

Question 38

What is the mechanism of action of Canagliflozin?

Answer 38

Sodium-glucose co-transporter inhibitor. Thus, reduces glucose reabsorption from the kidney.

Question 39

What are the adverse effects of canagliflozin?

Answer 39

Dehydration, UTI, and genital yeast infections.