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pharmacology > Antidiabetic Drugs > Flashcards

Antidiabetic Drugs Flashcards

1
Q

In which type of diabetes does the patient not secrete insulin?

A

Type 1

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2
Q

Which type of diabetes is an autoimmune disease?

A

Type 1

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3
Q

In which form of diabetes are the insulin receptors desensitized?

A

Type 2

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4
Q

Which form of diabetes is genetic?

A

Type 2

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5
Q

Which form of diabetes is associated with obesity?

A

Type 2

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6
Q

In which form of diabetes is the patient prone to ketogenesis?

A

Type 1

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7
Q

Hyperglycemia causes vascular, neural, and ocular damage. The neural and ocular damages are caused by an accumulation of what?

A

Sorbitol

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8
Q

Concerning canine (porcine) insulin, A = ___ aa.

A

A = 21 aa

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9
Q

Concerning canine (porcine) insulin, B = ____ aa.

A

B = 30 aa

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10
Q

How are the A and B chains connected in canine (porcine) insulin?

A

Via 2 disulfide bonds

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11
Q

What is proinsulin?

A

Insulin + C-peptide

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12
Q

What are the 3 stimulators of insulin secretion?

A
  1. Glucose
  2. Calcium, cyclic AMP
  3. GI hormones (gastrin, secretin, cholescystokinin, glucagon)
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13
Q

What are the inhibitors of insulin secretion?

A

Somatostatin and alpha-adrenergic agonists

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14
Q

How do beta2 adrenergic agonists affect insulin secretion?

A

Stimulate secretion

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15
Q

How do alpha2 adrenergic agonists affect insulin secretion?

A

Inhibit secretion

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16
Q

How do cholinergic agonists affect insulin secretion?

A

Stimulate secretion

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17
Q

How does glucose stimulate insulin release?

A

Glucose –> ATP –> blocks K+ channels –> decreased K+ efflux –> increased intracellular K+ –> depolarization –> open Ca2+ channels –> influx of Ca2+ –> increase in insulin exocytosis

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18
Q

In addition to glucose, what else blocks K+ channels?

A

Sulfonylurea

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19
Q

What are the 2 actions of insulin?

A
  1. To conserve energy

2. To increase glucose transport into cells

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20
Q

What are the 4 effects of insulin on carbohydrate metabolism?

A
  1. Decreased gluconeogenesis
  2. Decreased glycogenolysis
  3. Increased glucagon synthesis
  4. Increased glucose transport into striated muscle and adipose tissue
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21
Q

What is the effect of insulin on lipid metabolism?

A

Increased lipid synthesis, decreased lipolysis

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22
Q

What is the effect of insulin on protein metabolism?

A

Increased uptake of amino acids into cells, increased protein synthesis

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23
Q

What is the effect of insulin of K+ metabolism?

A

Increases Na+/K+ - ATPase activity, leading to increased K+ intracellularly

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24
Q

What is the half life of insulin in the plasma?

A

9 minutes

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25
Q

Where is insulin destroyed?

A
  1. Liver

2. Kidney

26
Q

What is closest to feline insulin?

A

Bovine insulin

27
Q

True or False: Canine and porcine insulin are identical.

A

TRUE

28
Q

What is the term used to describe the following: not crystallized?

A

Amorphous

29
Q

What is the term used to describe the following: large crystals slowing down absorption, and thus increasing the duration of action?

A

Crystalline

30
Q

What is the term used to describe the following: an aid in crystallization?

A

Zinc

31
Q

What is the term used to describe the following: a basic protein to form an insulin complex?

A

Protamine

32
Q

What is a diluted protamine solution?

A

Isophane

33
Q

What is the time of onset for rapid-acting insulin preparations?

A

5-15 minutes

34
Q

What is the duration of action of rapid-acting?

A

2-4 hours

35
Q

What is the onset of action of short-acting?

A

> 1 hour

36
Q

What is the duration of action of short-acting?

A

5-8 hours

37
Q

What is the onset of action of intermediate-acting?

A

2 hours

38
Q

What is the duration of action of intermediate-acting?

A

18-24 hours

39
Q

What is the onset of action of long-acting?

A

2-7 hours

40
Q

What is the duration of action of long-acting?

A

36 hours

41
Q

Into which class would you place “Insulin Injection (Regular)” such as HumulinR?

A

Short-acting

42
Q

Into which class would you place “Insulin Lispro”?

A

Rapid-acting

43
Q

Insulin Lispro:

B___ = ___

A

B28 = Lys

44
Q

Insulin Lispro:

B___ = ___

A

B29 = Pro

45
Q

Into which class would you place “Insulin Aspart”?

A

Rapid-acting

46
Q

Insulin Aspart:

B___ = ___

A

B28 = Asp

47
Q

Into which class would you place “Isophane insulin suspension” such as HumulinN?

A

Intermediate-acting

48
Q

Into which class would you place “Insulin zinc suspension” such as Vetsulin?

A

Intermediate-acting

49
Q

What are the 4 classes of long-acting insulin preparations?

A
  1. Protamine zinc insulin
  2. Insulin extended zinc suspension (HumulinU)
  3. Insulin glargine
  4. Insulin detemir
50
Q

With Insulin Glargine, where are Gly and Arg located?

A

Gly = A21

Arg = B31, B32

51
Q

With Insulin Detemir, where is Lysine located?

A

B29

52
Q

How are Insulin Glargine and Insulin Detemir administered?

A

SQ

53
Q

Which is bound to albumin upon SQ injection, Insulin Glargine or Insulin Detemir?

A

Insulin Detemir

54
Q

What are the 5 causes of false insulin resistance?

A
  1. Owner can’t give injection
  2. Injected into the same spot
  3. Over eating
  4. Inactive insulin
  5. Insulin overdose
55
Q

How do Sulfonylureas stimulate insulin secretion?

A

Block K+ channels –> increased intracellular K+ –> depolarization –> open Ca2+ channels –> increased intracellular Ca2+ –> insulin exocytosis

56
Q

What is Biguanide?

A

An anti-hyperglycemic agent

57
Q

What is the mechanism of action of Biguanide?

A
  1. Decreased gut glucose absorption
  2. Decreased hepatic glucose output
  3. Increased glucose utilization by increasing sensitivity to insulin
58
Q

What is the mechanism of action of pioglitazone?

A
  1. Increased insulin receptor sensitivity by activating nuclear receptors (PPARs)
  2. Increase proteins and enzymes involved in insulin actions (GLUT4)
59
Q

What is the mechanism of action of SGLT2 inhibitors?

A

Block reabsorption of glucose from proximal tubules by Na-glucose transporter 2

60
Q

What is an example of one SGLT2 inhibitor?

A

Gliflozins

61
Q

What are the 2 advantages of Glifozins?

A
  1. Oral administration

2. No hypoglycemia

62
Q

What are the 3 disadvantages of Glifozins?

A
  1. Increased PU/PD
  2. Sodium loss
  3. UTIs

pharmacology (21 decks)

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