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Pharm exam 3 > AntiDiabetic Drugs > Flashcards

AntiDiabetic Drugs Flashcards

1
Q

what is a leading complication of diabetes

A

dental disease

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2
Q

what is glycogenesis

A

the process of glycogen synthesis in which glucose molecules are added to glycogen for storage

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3
Q

what is glycogenolysis

A

the breakdown of glycogen glucose-6-phosphate and glycogen , helps avoid hypoglycemia

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4
Q

what is gluconeogenesis

A

results in generation of glucose from non carbs C substrates such as pyruvate. Helps maintain blood glucose levels avoiding low Blood glucose levels (hypoglycemia)

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5
Q

what are the mediators of blood sugar levels

A

glucagon and insulin

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6
Q

where is glucagon synthesized?

insulin?

A

Glucagon: Alpha cells
Insulin: beta cells

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7
Q

what provides a window into the average blood sugar of an individual over a period of months?

A

the A1C test measures glycation of hemoglobin

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8
Q

what does insulin do

A

causes dec in blood sugar levels by stimulating cell glucose uptake

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9
Q

Type 1 diabetes

A

NO insulin, causing INC blood sugar levels and inability for muscles to use glucose > leading to ketoacidosis

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10
Q

Type 2 diabetes

A

Insulin resistance, INC blood glucose levels > inability for muscles to use glucose bc insulin resistance > Obesity, inheritance factors leading to insulin resistance

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11
Q

7 drugs to treat diabetes

A 
Insulin
Sulfonylureas, Meglitinides, Incretins (Secretagogues)
Biguanides
thiazolidinediones
Alpha glucosidase inhibitors
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12
Q

how to treat Type 1 diabetes

A

INSULIN!

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13
Q

What do secretagogues do

A

K channel regulates insulin release from pancreatic B cells by sensing ATP

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14
Q

When is insulin not secreted

A

ATP/ ADP low from fasting, channel open, cell hyper polarized, L type Ca channels closed thus insulin NOT secreted

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15
Q

When is insulin secreted

A

ATP/ ADP high after meal, channel closed, cell depolarized, L type type Ca channel open thus insulin released

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16
Q

What is the standard of care for type 2? and what is their general duration of action

A

Sulfonylureas which generally last 12-24 hours used to beat down glucose levels

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17
Q

What sulfonylureas has the longest duration of action used once per day

A

Glimepride

18
Q

What sulfonylureas has the shortest duration of action?

A

Glipizide

19
Q

MoA of sulfonylureas

A

Sulfonylureas binds to B cell ATP activated K channel complex > DEC efflux of K so channel closes > membrane depolarizes and Ca influx > INC Ca influx leads to alteration of cytoskeleton > INC release of insulin

20
Q

Describe Meglitinides and their concern

A

more rapid onset but shorter duration than sulfonylureas . USED BEFORE MEALS > hypoglycemia big CONCERN and PT doesn’t eat!!!
use as ADD ON

21
Q

how do both meglitinides and sulfonylureases work

A

both work to promote insulin release by inhibiting K efflux from ATP/ ADP regulated K channels

22
Q

what are the 2 meglitinides

A

nateglinide and glipizide

23
Q

whats the difference between nateglinidide and glipizide

A

glipizide= more pronounced and sustained postmeal insulin secretory response compared to nateglinidide
glipizide facilitates the return to near fasting glucose levels at 4 hour postal but with the possible risk of INC frequency of postmeal hypoglycemia in drug naive PTs

24
Q

what do drugs working on GLP 1 receptors do?

what are these drugs AKA

A

AKA as incretins

incretins: GLP1 and GIP act at the GLP 1 receptor on B cells to stimulate insulin release

25
Q

What does exenatide do?

What does sitagliptin do?

A

Exenatide: GLP1 agonist
Sitagliptin: inhibits GP 1 and GIP degradation

26
Q

when do you use incretins?

A

To ADD ON to standard of care

27
Q

describe Biguanide (metformin)

A

Metformin is the 1st line of defense medication for Type 2 diabetes. prescribed at initial diagnosis with exercise and weight loss.
Immediate and extended release forms.

28
Q

when is Metformin (a biguanide) prescribed

A

To PTS experiencing GI side effects

29
Q

what does Metformin NOT do?

A

Metformin DOES NOT stimulate insulin secretion! Its INSLUIN SPARING

30
Q

What does Metformin do?

A

Metformin INC glucose uptake and utilisation in skeletal m, reducing insulin resistance and reducing hepatic glucose production

31
Q

What is the 1st line of defense in obese PTs?

A

obese= metformin, helps lower HbA1 by 1.5%

32
Q

Metformin is associated with what risk?

A

LOW risk of hypoglycemia

33
Q

describe MoA of metformin

A

metformin dec hepatic glucose production through a mild inhibition of the mitochondrial respiratory chain complex
DEC intestinal absorption of glucose
Anti oxidative properties of metformin on endothelial cells

34
Q

some of metformins action can be explained through what

A

through activation of AMP dependent protein kinase (AMPK)

35
Q

What do thiazolidinediones do

2 examples?

A

Thiazolidinediones DEC insulin resistance

pioglitazone and rosiglitazone

36
Q

what are thiazolidinediones

A

Thiazolidinediones are agonists of the peroxisome proliferator activated receptor Gamma

37
Q

What is insulin resistance

A

insulin resistance is a pathological condition in which cells fail to respond to normal actions of insulin, body makes insulin but the body’s cells are unable to use it as effectively leading to HYPERGLYCEMIA

38
Q

What does PPAR gamma do

A

PPAR gamma regulates fatty acid storage and glucose metabolism - stimulates lipid uptake and adipogenesis by fat cells

39
Q

what do Alpha Glucosidase inhibitors do?

2 examples of alpha glucosidase inhibitors

A

A- glucosidase inhibitors act by inhibiting the digestion of glucose and delay absorption of carbs into the GI tract
examples: acarbose and miglitol

40
Q

what does A glucosidase do

A

A glucosidase break down starch and disaccharides to glucose

Pharm exam 3 (3 decks)

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