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Pharmacology > Antidiabetic Drugs > Flashcards

Antidiabetic Drugs Flashcards

1
Q

Insulin glargine and Insulin determir belong to which drug class?
A. Rapid Acting
B. Intermediate Acting
C. Long Acting

A

C. Long Acting

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2
Q

True or False: Regular Insulin is a rapid acting insulin

A

True

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3
Q

___ is the only intermediate acting insulin

A

NPH Insulin

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4
Q

What drug class does metformin belong to?

A

Biguanides

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5
Q

Pioglitazone belongs to what drug class?

A

Thiazolidinediones

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6
Q

What are the three sulfonyureas?
(hint: all start with G)

A

1) Glipizide
2) Glyburide
3) Glimepiride

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7
Q

Which drug class does repaglinide belong to?

A

Meglitinides

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8
Q

Exenatide, Liraglutide, and Dulaglutide (all end in tide) belong to which drug class?

A

Glucagon like peptide 1 agonists

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9
Q

All the drugs that end in -liptin (sitagliptin, saxagliptin, linagiptin) belong to what drug class?

A

Dipeptidyl Peptidase 4 Inhibitors

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10
Q

First line T2DM treatment?
What if greater reduction is needed?
Even more reduction?

A

Metformin
Metformin + Sulfonylureas
Metformin + Sulfonylureas + Insulin

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11
Q

Glucagon like peptide-1 agonists can treat T2DM with what two conditions?

A

CVD and atherosclerosis

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12
Q

A patient has T2DM with renal impairment and CKD. What drug is best to treat this and why?

A

SGLT2 because it reduces progression of CKD

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13
Q

True or False: SGLT2 inhibitors have less glycemic effect, so more meds may be needed

A

True

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14
Q

How does insulin therapy affect gluconeogenesis and conversion of AA to glucose/ketoacids?

A

Decreases both processed

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15
Q

How does insulin therapy affect glucose storage?

A

Increases it

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16
Q

True or False: Protein synthesis, transportation of amino acids, and glucose are the result of insulin therapy

A

True

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17
Q

With insulin therapy, increased storage of TG leads to increased uptake of blood ___

A

glucose

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18
Q

Three main side effects of insulin therapy?

A

Hypoglycemia
Weight gain
Immune insulin resistance

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19
Q

True or False: Regular insulin given subcutaneously works faster than native insulin secreted by pancreas

A

False - regular insulin given SC works SLOWER than native insulin secreted by pancreas

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20
Q

Which type of insulin can form non-covalent hexamers in solution, which take time to break down?

A

Regular Insuln

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21
Q

Regular insulin analogs (aspart, glulisine, and lispro) more readily form monomers in solution

A

True

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22
Q

What is the only insulin suitable for IV use and forms hexamers?

A

Regular insulin

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23
Q

Why does NPH Insulin (intermediate acting) have a delayed, longer time course compared to regular insulin?

A

Need to break down aggregates

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24
Q

Which long term insulin preparation is soluble at pH for but not at 7?

A

Insulin glargine

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25
Q

True or False: Both insulin detemir and degludec (long acting insulin preparation) bind to albumin in blood stream

A

True

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26
Q

True or False: Insulin, lispro, aspart, and glulisine act most quickly and are similar to meal ingestion

A

True

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27
Q

___ and ___ acting insulins are given to mimic 24 hr basal insulin secretion

__ acting insulins are given preprandial to mimic nutrient stimulated insulin secretion

A

Intermediate and long acting

Short acting

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28
Q

Unlike insulin, metformin does not cause ___ or ____

A

weight gain; hypoglycemia

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29
Q

True or False: Metformin is 100% excreted by kidneys

A

True

30
Q

____ inhibits liver gluconeogenesis

A

Metformin

31
Q

What is the black box warning for metformin? who is at higher risk?

A

metabolic acidosis - impaired hepatic metabolism of lactic acid

32
Q

True or False: For patients with renal impairement, metformin is not eliminated as expected, leading to increased risk of met acidosis

A

True

33
Q

Which class is considered insulin secretagogoues?
A. Sulfonylureas
B. GLP-1 agonistswo

A

A. Sulfonylureas

34
Q

How do glyburide, glimepiride, and glipizide drugs act?

A

B cell depolarization and insulin secretion ; blocks K+ channel

35
Q

True or False: Glipizides can cause hypoglycemia and weight gain

A

True

36
Q

Repaglinide (sulfonylureas) requires ____ and is considered a insulin ____

A

functioning pancreatic b cells (ok for T2DM) ; secretagogue

37
Q

Which sulfonylureas inhibits K gated channels in pancreatic beta cells, leading to depolarization?

A

Repaglinide

38
Q

True or False: Repaglinide can be used in patient with sulfur allergy

A

True

39
Q

How is pioglitazone similar to metformin?

A

Effects peripheral tissues

40
Q

Which sulfonylurea drug increases expression of GLUT1/4 in muscle, adipose, and liver tissues and acts on PPAR?

A

Pioglitazone

41
Q

True or False: GLP-1 produces feeling of hunger

A

False - satiety

42
Q

How are all GLP-1 agonists given?

How are DPP-4’s administered?

A

GLP1: SC injection
DPP-4: Oral

43
Q

Endogenous ___ is released from intestinal L cells in response to nutrient ingestion, acts to “wake up” body in preparation of eventual elevation in glucose

A

GLP-1

44
Q

True or False: GLP-1 agonists belong to the sulfonylureas

A

True

45
Q

____ receptor activation in pancreatic b-cells enhance or augment glucose stimulated insulin secretion

A

GLP-1

46
Q

Exenatide belongs to what class of drugs?

A

GLP1 Receptor Agonists (dosed 60 min before meal)

47
Q

What is the only DPP-4 inhibitor that requires NO dose adjustment for RENAL DYSFUNCTIOn or CKD?

A

Linagliptin

48
Q

_____ inhibits DEGRADATION of GLP-1, therefore extending actions of GLP-1 on pancreatic B cells

A

DPP-4 Inhibitors

49
Q

SGLT2 Inhibitors are not as effective as __

A

GLP-1 agonists

50
Q

SGLT2 inhibitors has less effective in what patients?

A

Pts with CDK

51
Q

Drugs that end in -fozin?

A

SGLT2

52
Q

GLP1 agonists and SGLT2 inhibitors share what beneficial side effect?

A

Reduced weight

53
Q

True or False: Canaglifozin (SGLT-2 inhibitor) increases risk of bone fractures

A

True

54
Q

True or False: All SGLT-2 drugs increase UTI risk

A

True

55
Q

What H2 agent has anti-androgen effect?

A

Cimetidine

56
Q

PPI are administered as ____and activated by ___/___cells

A

inactive prodrugs; protonation/parietal cells

57
Q

PPI irreversibly inactivates ____

A

H/K ATPase

58
Q

What class of drugs can lead to microbial overgrowth of upper GI tract with chronic use?

A

Omeprazole (PPI)

59
Q

What drug can prevent stress and NSAID-induced ulcers?

A

Omeprazole/PPI’s

60
Q

Three primary uses of PPI’s?

A

1) GERD
2) Peptic ulcer disease
3) Zollinger Ellison Syndrome

61
Q

First line drug for treating excess acid production?

A

PPI’s!

62
Q

___ and ___ are strongest inhibitors of CYP2C19 while ___ has least effect on CYP2C19

A

Omeprazole/esomeprazole

Pantoprazole

63
Q

___ polymerizes to make a viscious material that binds to proteins on ulcer crater and forms protective barrier

A

Sucralfate
- facilitates ulcer healing

64
Q

____ is a PGE1 analog that prevents NSAID induced ulcers

A

Misoprostol
- should not be given to pregnant women

65
Q

True or False: Colloid Bismuth exerts a coating action to protect stomach; may inhibit pepsin; and has antibacterial activity against H. pylorii

A

True

66
Q

______ contains salicylates and has been associated with Reye’s Syndrome in kids

A

Colloid Bismuth

67
Q

Triple therapy treats H. pylori and includes ___ ; either ___or____; and ___/___

A

1) Bismuth salt
2) Metronidazole/Amoxicillin
3) Tetracycline/Clarithomycin

68
Q

___ are agents that mimic effects of well balanced diet

A

Bulk Forming Laxatives

69
Q

Dietary fiber, methylcellulose, psyllium, and polycarbophil belong to _____

A

bulk forming laxatives

70
Q

Which laxatives act on intestinal mucosa to either enhance secretion, inhibit absorption of water/induce peristalsis?

A

Contact/Stimulus Cathartic

71
Q

Senna/Bisacodyl are ____ laxatives

A

contact/stimulant

72
Q

Active agent of castor oil is ____, which acts on mucosa of ____ to inhibit absorption of fluid and stimulate peristaltic movements

A

ricinoleic acid; small intestine

Pharmacology (53 decks)

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