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pharmacology > Anti-diabetic drugs > Flashcards

Anti-diabetic drugs Flashcards

1
Q

Which are the rapid onset insulins?

A

Lispro, aspart, glulisine

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2
Q

NPH belongs to slow onset or intermediate onset insulin?

A

Intermediate onset

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3
Q

What is the relative time to peak for regular insulin?

A

2-4 hr

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4
Q

What is the relative time to peak for NPH?

A

4-8 hr

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5
Q

Does glargine have peak in its action?

A

No peak

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6
Q

What is the best strategy to prevent microvascular complications of diabetes?

A

Tight glycemic control

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7
Q

Diabetic microvascular complications includes…?

A

Retinopathy, nephropathy, neuropathy

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8
Q

Does intensive glycemic control prevent coronary heart disease?

A

Yes

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9
Q

What is the mechanism of insulin secretion?

A

GLUT1 allows entry of glucose inside beta cell, it is broken down and increases ATP which inhibits K efflux, depolarization occurs and insulin is released by Ca dependent exocytosis. Insulin binds cell membrane tyrosine kinase and does not enter nucleus.

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10
Q

What is the mechanism of action of sulfonylurea?

A

Insulin secretagogues (K channel modulators). Bind SUR1 inhibit K efflux leading to depolarization and insulin release.

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11
Q

What is the most important side effect of sulfonylurea?

A

Hypoglycemia, weight gain, not given in pregnancy.

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12
Q

Which sulfonylurea causes SIADH and disulfiram-like action?

A

Chlorpropamide

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13
Q

What is the mechanism of action of metformin?

A

Biguanide- insulin sensitizer. Reduces hepatic gluconeogenesis and activates GLUT4 receptors in skeletal muscles.

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14
Q

What are the contraindications for metformin use?

A

Renal or liver disease, cardiac failure, chronic hypoxic lung disease and radiologic procedure using IV iodinated contrast medium.

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15
Q

What is most important side effect of metformin?

A

Lactic acidosis and decreased absorption of Vit B12.

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16
Q

What is the mechanism of action of repaglinide?

A

Meglitinides (K channel modulators) also nateglinide. Closes K channel similar to sulfonylurea.

17
Q

What is the MoA of pioglitazone? How about rosiglitazone?

A

Thiazolidinediones. Pioglitazone- binds and activates PPAR-y (primarily on adipocytes- increases tissue sensitivity to insulin) and PPAR-a (decreases triglycerides).
Rosiglitazone- binds PPAR-y

18
Q

What are the side effects of thiazolidinediones?

A

Pioglitazone- bladder cancer, weight gain and edema
Rosiglitazone- increased risk of heart failure
CI- HF, pregnancy and liver dysfunction

19
Q

What is the MoA of pramlintide?

A

Amylin analog, binds to its receptor in hindbrain causes decrease in glucagon release, delays gastric emptying- feeling of satiety.

20
Q

Which are the incretins? What is its function?

A

Glucagon-like polypeptide-1 (GLP-1) and glucose dependent insulinotropic polypeptide (GIP). They increase glucose- induced insulin secretion cause less hypoglycemia.

21
Q

What is the MoA of exenatide?

A

GLP-1 agonist same as liraglutide

22
Q

What is function of DPP-4?

A

Inactivates GLP-1

23
Q

What is the MoA of Sitagliptin?

A

DPP-4 inhibitor, increases levels of GLP-1, increase insulin secretion decreases glucagon secretion less hypoglycemia.

24
Q

In the setting of diabetes + hypertension, which drug is the first choice to treat hypertension?

A

ACEI

25
Q

What disorders does glucagon treat?

A

Severe hypoglycemia and severe beta blocker poisoning

26
Q

Which drugs have hyperglycemic side effects?

A 
β-adrenergic blockers
Thiazide diuretics
Diazoxide
Clozapine, olanzapine
Corticosteroid
Cyclosporine, tacrolimus, sirolimus
Protease inhibitors
27
Q

Sulfonylureas are cross-allergy to what drugs?

A

Sulfonamide antibiotics, thiazide diuretics, loop diuretics (except ethacrynic acid) and carbonic anhydrase inhibitors, celecoxib, diazoxide and sumatriptan.

pharmacology (8 decks)

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