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Med Chem 7 > Anti diabetics (4) > Flashcards

Anti diabetics (4) Flashcards

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1
Q

Where does amylin function? What does it contribute to?

A

pancreas

Glycemic control

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2
Q

What is a synergistic partner to insulin?

A

amylin

**co-secreted

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3
Q

T/F the amount of insulin and amylin released is 1:1

A

false!

1:100 amylin: insulin

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4
Q

What does amylin work to do?

A

provide postprandial glucose control

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5
Q

Native amylin is single chain peptide of ____ AA

A

37

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6
Q

t/f human amylin can be given

A

false!!

highly amyloidogenic and potentially toxic

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7
Q

How can you give amylin to a patient?

A

rat amylin is used for analogs

**not amyloidogenic

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8
Q

amylin AKA

A

IAPP (islet amyloid polypeptide)

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9
Q

What is a new adjunct treatment for T1D and T2D?

A

amylin

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10
Q

What do IAPP result in?

A
  • weight loss
  • use less insulin
  • lower average BG levels
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11
Q

ADE of IAPP

A

severe hypoglycemia (esp T1D)

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12
Q

How do SGLT2 inhibitors work?

A

improve glycemic control by increasing urinary excretion of glucose

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13
Q

Who can use SGLT2 inhibitors?

A

T2D

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14
Q

Which SGLT is in S3 segment of proximal tubule and contributes to 10% of glucose reabsorption?

A

SGLT1

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15
Q

Which SGLT is in S1 and S2 segments of proximal tubule and contributes to 90% of glucose reabsorption?

A

SGLT2

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16
Q

how much glucose is excreted?

A

<1%

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17
Q

how much glucose is reabsorbed?

A

99%

18
Q

What type of drugs are SGLT2 inhibitors?

A

gliflozins

19
Q

What are SGLT2 inhibitors associated with?

A

increased UTIs

20
Q

What could SGLT2 inhibitors lead to?

A

ketoacidosis

21
Q

ketoacidosis

A

metabolic state with high concentrations of ketone bodies

22
Q

structural modification of phlorizin has lead to a number of SGLT2 selective inhibitors by _____

A

lead optimization

23
Q

(SAR) OH group on B ring of SGLT2 inhibitors

A

not essential for inhibition

**responsible for toxicity

24
Q

What can dual therapy help with?

A

reduce blood glucose quicker and remain there longer

25
Q

complications of DM

A

neuropathy
nephropathy
microangiopathy
macroangiopathy

26
Q

T/f all diabetics will develop the late complications associated with the disease

A

true

27
Q

DCCT study

A

T1D

  • **keep BG levels under tight control
  • slows progression of damage
28
Q

UKPDS study

A

T2D

  • **keep BG levels under tight control
  • decreased complications
29
Q

People newly diagnosed with T2D but otherwise good health, ADA suggests aiming for _____

A

tight control (normal) + lifestyle changes

30
Q

Ideal HbA1C under tight control

A

6-6.5%

31
Q

People who have had diabetes for awhile, HbA1C goal is

A

slightly higher 7.5-8%

32
Q

Why would people who already have diabetes have looser blood sugar control?

A
  • older age
  • frequent bouts of hypoglycemia
  • presence of other medical conditions requiring multiple meds and needing more than 2 drugs to lower BG
  • limited finances
33
Q

Who is tight control most worthwhile for?

A

healthy people who can live at least 10 more years

34
Q

Who is not recommended to go on tight control?

A
  • children **need glucose for brain development

- elderly

35
Q

Ways to measure hyperglycemia

A
  • glucose levels
  • Frductosamine
  • glycated hemoglobin (HbA1C
  • 1,5-AG
36
Q

How do you measure fructosamine?

A

colorimetric procedure

37
Q

How do you measure HgA1C?

A

affinity chromatography

38
Q

How do you measure glucose levels?

A

blood

urine

39
Q

1,5-AG

A

naturally occurring monosaccharide

100% non metabolized

40
Q

1,5 AG during hyperglycemia

A

decrease

41
Q

1,5 AG post hyperglycemia

A

return to normal

Med Chem 7 (9 decks)

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