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Pharma > ANTI-DM > Flashcards

ANTI-DM Flashcards

1
Q 
insulin stimulatory or inhibitory?
glucose
glucagon
GIP
GLP-1
gastrin
secretin
cholecystokinin
somatostatin
VIP
GRP
enteroglucagon
A

glucagon & somatostatin are the only inhibitory

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2
Q

transporter of glucose in beta cell

A

GLUT-2

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3
Q

pathway of insulin secretion in beta cell

A

glucose enter via GLUT-2, K channel closes, cell depolarizes, Ca channel open, insulin release

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4
Q

activator of K+ ATP channel, dec. insulin secretion

A

Diazoxide

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5
Q

DM criteria for diagnosis

A

FBS- 7 (126)
RBS- 11 (200)
HgbA1c > 6.5%

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6
Q

how many % of beta cell mass remaining to produce DM1?

A

<10%

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7
Q

what regimen? regular + intermediate acting. 2x/d injections

A

regimen a

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8
Q

what regimen? regular + intermediate acting (more delayed). 3x/d injections

A

regimen b

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9
Q

what regimen? rapid-acting preprandial + long acting 1x/d injections

A

regmen c

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10
Q

what regimen? rapid + intermediate acting

A

regimen d

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11
Q

what regimen? continuous subq insulin pump

A

regimen e

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12
Q

hypoglycemic drugs

A

beta antagonist, naproxen, saliylates, ethanol, ACE-ihb, lithium, theophylline, calcium, bromocriptine, mebendazole, sulfo, tetracycline, pyridoxine pentamidine

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13
Q

hyperglycemic drugs

A

epi, diuretics, glucocorticoids, anti-psychotics, diazoxide, beta agonist, clonidine, phenytoin, heparin, morphine, H2-R blockers, marijuana, nicotine

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14
Q

3 insulin secretagouge for DM2

A

sulfonylurea
meglitinides
Phe derivatives

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15
Q

sulfonylurea 1st gen

A

(-mide)

tolbutamide, acetohexamide, talazamide, chlorpropamide

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16
Q

sulfonylurea 2nd gen

A

(-r/zide)

glyburide, glipizide, gliclazide, glimepiride

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17
Q

sulfonylurea MOA

A

inc. insulin release; reduce hepatic clearance of insulin

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18
Q

sulfonylurea AE

A

hypoglycemia, nausea, vomiting, jaundice rare, anemia

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19
Q

sulfonylurea contraind.

A

DM1, pregnancy, hep/renal insufficiency

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20
Q

meglitinide (repaglinide) MOA

A

closes ATP-dependent K+ channel in b-cell; h-1hr

21
Q

Phe derivative (nateglinide) MOA

A

closes ATP-dependent K+ channel in b-cell; hepatic metab.

22
Q

2 insulin sensitizers

A

biguanides

thiazolidinediones

23
Q

biguanide drugs

A

(-formin)

metformin, buformin, phentoformin

24
Q

biguanides MOA

A

activates AMPK; reduce hepatic glucose production

25
Q

first line mgmt for DM2

A

biguanides

26
Q

metformin pharmakokinetics

A 
SI absp.;
h-2hrs; 
2.5g max; 
red. HbA1c by 2%, plasma TGL 15-20%
red. macrovascular events
27
Q

metformin contraind.

A

renal imp, hepatic disease, hx of LA, cardiac failure, chronic hypoxic lung disease

28
Q

metformin AE

A

GI disturbances, metallic taste, dec. absp of vit. B12 and folate, LA

29
Q

thiazolidinedione drugs

A

(-glitazone)

pioglitazone, rosiglitazone, troglitazone

30
Q

thiazolidinediones MOA

A

selective antag. of PPAR-gamma

31
Q

biguanide drug withdrawn d/t LA

A

phenformin

32
Q

thiazolidinedione drug withdrawn d/t severe hepatic toxicity

A

troglitazone

33
Q

insulin sensitizer for muscles and fat

A

biguanide

34
Q

insulin sensitizers for peripheral tissue

A

thiazolidinedione

35
Q

thiazolidinedione AE

A

edema, anemia, wt gain, hepatoxicity

36
Q

a-glucosidase inhb. drugs

A

acarbose, miglitol

37
Q

a-glucosidase inhb. MOA

A

slows absp of carbs, dec. postprandial hyperglycemia

38
Q

a-glucosidase inhb. AE

A

GI disturbances

39
Q

augment glucose-dependent insulin secretion

A

incretin

40
Q

GLP-R agonist drugs

A 
(LEAD) -glutide
liraglutide
exenatide
albiglutide
dulaglutide
41
Q

GLP-R agonist drugs MOA

A

dec. hepa glucose, inc. insulin

42
Q

drugs that prolong incretin action

A

DPP-IV inh

43
Q

53% homology for GLP-1 , derived from salivary gland of Gila monster

A

exendin-4

44
Q

DPP-IV inh. drugs

A 
(-gliptin)
sitagliptin
saxagliptin
linagliptin
vildagliptin
alogliptin
45
Q

Amylin (pramlintide) MOA

A

glycemic control and osteogenesis

46
Q

pramlintide effects

A

dec. appetite & glucagon, inc. insulin

47
Q

reversal of BB overdose

A

glucagon

48
Q

hypoglycemia cutoff

A

<60mg/dL

Pharma (6 decks)

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