Anti-diabetic drugs Flashcards
Type 1 diabetes is known as:
insulin dependent (10% of cases)
Type 2 diabetes is known as:
Non-insulin dependent (90% of cases)
What are some signs of diabetes mellitus?
PU/PD
Glucosuria, ketouria, weight loss, fatigue
What are some chronic effects of hyperglycemia?
Vascular damages in kidneys/limbs
Neural and ocular damage due to sorbital accumulation
What is proinsulin?
Insulin + C-peptide
What factors regulate insulin secretion?
Glucose, AA, fatty acids are all stimulatiors
Inhibitors: alpha-2 agonists and somatostatin
What is the mechanism by which glucose stimulates insulin secretion?
glucose enters beta cells > metabolized to generate ATP > ATP blocks K channels > decreases K efflux > increased K concentration > depolarization > opens Ca channels > increases Ca > increases insulin exocytosis
Can insulin be administered orally?
NO; peptide so it’s destroyed by the GI tract
What effect does an alpha-2 agonist have on insulin secretion?
Decreases secretion
What effects does Beta-2 agonist have on insulin secretion?
Increased secretion
What is the general action of insulin?>
Conserve energy amd increase glucose transport into cells
What is the action of insulin on carbohydrate metabolism?
Increased glucose transport into striated muscles and adipocytes and increase glycogen synthesis
What is the action of insulin on lipid metabolism?
Increased lipid synthesis
Decreased lipolysis
What is the action of insulin on protein metabolism?
Increased uptake of amino acids into cells for protein synthesis
What is the action of insulin on potassium metabolism? What will you commonly see in diabetic animals?
Increased Na/K ATPase activity
Hyperkalemia because you don’t have insulin so you do not have ATP to pump K into the cells
What are the signs associated with insulin overdose?
Rapdi fall: peripheral weakness, sweating, hunger
Slow fall: CNS effects and disturbances (coma or seizures)
Describe fast acting insulin preparations:
Describe intermediate acting insulin preparations:
Onset is 2 hours
Can mix with regular insulin to make action quicker but duration shorter
Describe long acting insulin preparations:
Onset is 7 hours, lasts 36
Is human insulin the best choice to control feline diabetes?
NO; bovine would be, but it is off the market
What is the only way to treat insulin resistance right now?
Increase the dose of insulin
What is somogyi rebound?
Insulin overdose; induces hypoglycemia and then a short hyperglycemia
How does Glipizide work as an oral hypoglycemic agent?
It is used to stimulate insulin secretion by blocking K channels
What type of diabetes can Glipizide be used against?
Type 1
What is the MOA for the anti-hyperglycemic agent Metformin?
Decreases absorption of glucose from gut
Decreases hepatic output of glucose
Increases glucose utilization by increasing sensitivity to insulin
What is the MOA for the anti-hyperglycemic agent Thiazolidinediones?
Increases the tissue sensitivity to insulin; used in type 2 patients
Why is Metformin referred to as an anti-hyperglycemic agent but is not a hypoglycemic agent?
It does not increase insulin release, so it only alleviates hyperglycemia. Does not cause hypoglycemia
What is the structure of canine insulin?
A:21 aa, B:30 aa
These are connected by 2 disulfide bonds 3
