AntiDiabetic Drugs

Question 1

Decreases insulin release; increases glucose output from liver and muscles; increases breakdown of fat to Free Fatty Acids

Answer 1

Catecholamines

Question 1

From beta cells of the pancreas; Decreases blood glucose; glycogen storage;
adipose tissue deposit; synthesis of proteins to form amino acids

Answer 1

Insulin

Question 1

From alpha cells of the pancreas;
Increases blood glucose

Answer 1

Glucagon

Question 1

Increases insulin release; decreases glucagon release; stimulates satiety center; slows GI emptying

Answer 1

Incretins

Question 2

Increases glucose output; decreases insulin sensitivity

Answer 2

Corticosteroids

Question 3

Type __ diabetes is common in
younger people and is connected
with cases of destruction of beta
cells of the pancreas.

Answer 3

1

Question 4

*Type _ is adult-onset and is
associated with not enough insulin
to maintain glucose control.

Answer 4

2

Question 5

results when there is an increase in
glucose in the blood.

*Clinical signs and symptoms include
fatigue, lethargy, irritation, glycosuria,
polyuria, polyphagia, polydipsia, and
itchy skin (from the accumulation of
wastes that liver cannot clear).

Answer 5

Hyperglycemia (high blood sugar)

Question 6

• If unchecked, it can lead to ____ showing fruity breath from ketons excreted
  through the lungs, slow, deep respirations
  (Kussmaul respiration) & loss of orientation and
  coma.

Answer 6

Diabetic ketoacidosis (DKA)

Question 7

___ is a blood glucose
concentration lower than 40 mg/dL
and can occur in many clinical situations like starvation and overtreatment of hyperglycemia.
Manifestations include headache, paresthesias (numbness), hunger, and diaphoresis (sweating).

Answer 7

Hypoglycemia

Question 8

a drug that is used to control
glucose in patients with diabetes mellitus.

• It is the only parenteral antidiabetic
  agent available for exogenous
  replacement of low levels of insulin

Answer 8

insulin

Question 9

Indications
* Treatment of type 1 diabetes
* Treatment of type 2 diabetes
when other agents have failed
* Short-term treatment of type
2 diabetes during periods of stress
* Management of diabetic
ketoacidosis, hyperkalemia,

Answer 9

insulin

Question 10

Insulin does enter breast milk but it
is destroyed in the GI tract and does
not affect the nursing infant

Answer 10

Insulin does enter breast milk but it
is destroyed in the GI tract and does
not affect the nursing infant

Question 11

Adverse Effects

*hypoglycemia and ketoacidosis
* local reactions at the injection site
lipodystrophy (due to injecting cold insulin)

Answer 11

Insulin

Question 12

nursing consideration in injecting insulin

Answer 12

• avoid vigorous shaking to ensure uniform
  suspension of insulin
• Distance of rotations should be at least 1 inch or 2.54cm
• Do not inject in the 2-inch radius around the umbilicus

Question 13

only intravenous (IV) insulin is ___

Answer 13

Regular insulin

Question 14

stimulate insulin release
from the beta cells in pancreas. They
improve insulin binding to insulin
receptors and may actually increase
the number of insulin receptors.

• These drugs are only effective in
  patients who have functioning beta
  cells.

Answer 14

Sulfonylureas

Question 15

Indications
* used as adjunct to diet and exercise for
the treatment of type 2 diabetes older
than 10 years of age; extended release
form for patients older than 17 years of
age;

Answer 15

Sulfonylureas

Question 15

___ generation sulfonylureas
* safer for patients with renal dysfunction as
they are excreted in urine and bile,
* absence of interaction to many protein-
bound drugs, and longer duration of action.

Answer 15

2nd

Question 16

___ generation sulfonylureas

declining as more effective drugs
* thought to possibly cause an increase in
cardiovascular death.

Answer 16

1st

Question 17

Antidiabetic drugs are a group of
drug structurally unrelated to
sulfonylureas and are effective when
used in combination with insulin or
sulfonylureas.

Answer 17

Other Oral Hypoglycemic Agents (OHA)

Question 18

Other Oral Hypoglycemic Agents (OHA)/ Antidiabetic Agents

*Alpha-glucosidase inhibitors
* Biguanide
*Meglitinides
* Synthetic human amylin
* Incretin mimetics
*DPP-4 inhibitors

Answer 18

Other Oral Hypoglycemic Agents (OHA)/ Antidiabetic Agents

*Alpha-glucosidase inhibitors
* Biguanide
*Meglitinides
* Synthetic human amylin
* Incretin mimetics
*DPP-4 inhibitors

Question 19

• E.g. Acarbose and Miglitol
• inhibit alpha-glucosidase, an enzyme that
  breaks down glucose for absorption.
  Therefore, they delay the absorption of
  glucose.
• They have only a mild effect on glucose
  levels and do not enhance insulin
  secretion.
• They are associated with severe hepatic
  toxicity and GI distress.

Answer 19

Alpha-glucosidase inhibitors

Question 20

• E.g. Metformin
• decrease the production and increases
  the uptake of glucose.
• effective in lowering blood glucose and
  [does not cause hypoglycemia as the
  sulfonylureas do.]
• It has been associated with
  development of lactic acidosis and GI
  distress.

Answer 20

Biguanide

Question 21

• E.g. Pramlintide
• works to modulate gastric emptying after a
  meal to cause a feeling of fullness or satiety.
• prevents the postmeal rise (SUGAR RUSH) in glucagon that
  usually elevates glucose levels.
• Human amylin is a hormone produced by
  beta cells in the pancreas that is important
  in regulating postmeal glucose levels.
• It should not be used when patient is unable
  to eat.

Answer 21

Synthetic human amylin

Question 21

E.g. Nateglinide and Repaglinide
* are newer agents that act like
sulfonylureas to increase insulin
release.

Answer 21

Meglitinides

Question 21

• E.g. Exenatide and Liraglutide
• mimic the effects of GLP-1(enzyme that breakdown protein): enhancement of glucose-dependent insulin secretion by the beta cells in
  the pancreas
• depression of elevated glucagon
  secretion, and slowed gastric emptying
  to help moderate and lower blood
  glucose levels.

Answer 21

Incretin mimetics

Question 21

• lina-, saxa-, and sitagliptin
• slow the breakdown of GLP-1 to
  prolong the effects of increased
  insulin secretion, decreased
  glucagon secretion, and slowed GI
  emptying.

Answer 21

DPP-4 inhibitors