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Pharmacology HOSA > Antidiabetic Drugs > Flashcards

Antidiabetic Drugs Flashcards

1
Q

Nasal/bolus insulin dose

A

Diabetes mellitus the routine of taking a long acting insulin to keep blood glucose levels stable during fasting periods and shorter acting insulin to prevent rises in blood glucose after meals

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2
Q

Diabetes mellitus

A

Disease in which insulin doesn’t help glucose enter the cell

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3
Q

Diabetic ketoacidosis (DKA)

A

Life threatening deficiency of insulin, resulting in severe hyperglycemia and excessively high levels of ketones in the blood

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4
Q

Glucagon

A

Hormone secreted by the alpha cells of the pancreas that increase the concentration of glucose in the blood

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5
Q

Glucometer

A

Device to monitor blood glucose level

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6
Q

Glycoslated hemoglobin

A

Blood test that monitors average blood glucose level over a 3-4 month period

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7
Q

Incretin hormones

A

Hormones that stimulate an increase of insulin from the beta cells of the pancreas, they slow gastric emptying and inhibit glucagon release

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8
Q

Lipodystrophy

A

Atrophy of subcutaneous fat

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9
Q

Polydipsia

A

Excessive thirst

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10
Q

Polyphagia

A

Eating large amounts of food

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11
Q

Polyuria

A

Increased urination

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12
Q

Prediabetes

A

A conviction of blood glucose higher than normal, yet not to a diabetic level as evidence by an impaired glucose tolerance/fasting glucose, or metabolic syndrome

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13
Q

How does insulin affect blood glucose levels

A

Insulin insufficiency results in elevated blood glucose levels

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14
Q

Major symptoms of type 1 and type 2 diabetes

A

Hyperglycemia, polydipsia, polyphagia, polyuria, and weight loss

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15
Q

Insulin onset

A

When insulin first begins to act in the body

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16
Q

Insulin peak

A

When the insulin is exerting maximum action

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17
Q

Insulin duration

A

The length of time the insulin remains in effect

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18
Q

Insulin MOA

A

Helps glucose molecules enter the cells of striated muscle and adipose tissue , stimulates the synthesis of glycogen by the liver and promotes protein synthesis and helps the body store fat by preventing its breakdown for energy

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19
Q

Insulin analogs ex

A

Lispro, aspart, and glulisine

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20
Q

Insulin analogs use

A

Fast onset, slow release, long duration: used for premeal coverage, Constance administration in an insulin pump, or basal insulin administration

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21
Q

Glargine MOA

A

Very slow and even release into bloodstream, so it doesn’t have a peak action

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22
Q

Insulin products use

A

Replace insulin hormone in type 1 diabetes, supplement insulin production of type 2 diabetes when uncontrolled by TLCs or other antidiabetics, treat severe diabetic ketoacidosis, diabetic coma, hypokalemia in combination with glucose

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23
Q

Insulin products side effects

A

Hypoglycemia, and hyperglycemia

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24
Q

When does hypoglycemia occur

A

Too much insulin in relation to glucose, can occur when they eat too little food or go too loony between meals, drastically increased demands (activity or illness), too much insulin is given

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25
Q

When does hyperglycemia occur

A

Too little insulin in comparison to glucose, can occur when they eat too much food, too little insulin is given, emotional stress, infection, surgery, pregnancy, or an acute illness

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26
Q

How can someone become insulin resistant

A

When antibodies develop against insulin, these patients have impaired receptor function and require much higher doses

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27
Q

Hypoglycemia signs

A

Sudden onset, blood glucose less than 60 mg/dL, fatigue, weakness, nervousness, agitation, confusion, diplopia, convulsions, dizziness, unconsciousness, rapid and shallow breathing, hunger, nausea, pale, moist and cool skin, numbness, tingling of lips or tongue

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28
Q

Hyperglycemia signs

A

Gradual onset, blood glucose higher than 200 mg/dL, drowsiness, dim vision, deep and rapid breaths, thirst, nausea, vomiting, abdominal pain, loss of appetite, dry, flushed and warm skin, rapid and weak pulse, and acetone breath and excessive urination

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29
Q

Insulin products contraindications

A

Hypoglycemic

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30
Q

Insulin precautions

A

Renal or hepatic impairment, pregnancy (cat B) and lactation

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31
Q

Glargine pregnancy cat

A

C

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32
Q

Aspart pregnancy cat

A

C

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33
Q

Insulin pregnancy considerations

A

Dose decrease in 1st trimester, increases in 2nd and 3rd trimester, and decrease fast after delivery, and pregnant women should have good metabolic control

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34
Q

Drugs that decrease the effect of insulin

A

Acetazolamide, albuterol, antipsychotics (atypical), asparaginase, calcitonin, oral contraceptives, corticosteroids, cyclophosphamide, danazol, dilatásemos, diuretics, dobutamine, epinephrine, estrogens, glucagon, HIV antivirals, isoniazid, lithium, morphine, niacin, nicotine, phenothiazines, phenytoin, progestogens, protease inhibitors, somatropin, terbutaline, thyroid hormones

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35
Q

Drugs that increase the effect of insulin

A

ACE inhibitors, alcohol, anabolic steroids, oral antidiabetics, beta blockers, calcium, clonidine, disopyramide, fluoxetine, fibrates, lithium, mebendazole, pentamidine, pentoxifylline, pyridoxine, salicylates, somastatin analog, tetracycline

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36
Q

Oral antidiabetic drugs use

A

Used with insulin with type 2 diabetes, and won’t help type 1 diabetes

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37
Q

Biguanides MOA

A

Sensitized the liver to circulating insulin levels, reduces intestinal glucose absorption, and reduces hepatic glucose production

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38
Q

Biguanides use

A

1st choice for initial type 2 diabetes, and usually started alone, they don’t increase insulin levels or cause weight gain

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39
Q

Biguanides ex

A

Metformin

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40
Q

Metformin side effects

A

When taken with insulin, it can cause hypoglycemia, and other side effects include nausea, vomiting, diarrhea, and increased flatulence, (usually taken with food to minimize GI reactions)

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41
Q

Metformin contraindications

A

Poor kidney function, people older than 80, and pregnancy (cat B) and lactation, and temporarily discontinued for surgical procedures

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42
Q

Metformin interactions

A

Contrast medium (in radiologic studies) can cause acute kidney failure, vitamin B12 malabsorption, increased whisk for lactic acidosis with glucocorticoids

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43
Q

Lactic acidosis symptoms

A

Malaise, abdominal pain, rapid respirations, shortness of breath, and muscular pain. Cardiovascular collapse can happen if not treated

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44
Q

Glucagon-like peptide 1 Agonists MOA

A

Injectable, mimic the incretin hormone, GLP-1, which stimulates insulin release when a person eats

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45
Q

Glucagon like peptide 1 Agonists ex

A

Albiglutide, dulaglutide, and exenatide, liraglutide

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46
Q

Glucagon like peptide 1 Agonists

A

Type 2 diabetes

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47
Q

Liraglutide use

A

Chronic weight management of those with a BMI greater than 27, who also have hypertension or dyslipidemia

48
Q

Glucagon like peptide 1 Agonists side effects

A

Diarrhea, nausea, vomiting, heartburn, local irritation at injection sites

49
Q

Exenatide side effects

A

Headaches

50
Q

Liraglutide side effects

A

Headaches

51
Q

GLP-1 contraindications

A

Personal or family history of thyroid or other endocrine disorders, type 1 diabetes, DKA,

52
Q

GLP-1s interactions

A

Androgens, insulin’s, pegvisomant can cause blood glucose levels to lower, and elevated blood glucose levels can occur with corticosteroids, danazol, luteinizing hormones, and thiazide diuretics, effectiveness of oral contraceptives is reduced, and bleeding is prolonged with vitamin K

53
Q

Albiglutide pregnancy cat

A

C, and should be stopped 1 month prior to pregnancy

54
Q

Sodium glucose linked transporter 2 inhibitors MOA

A

decreases the amount of Glucose that is reabsorbed in the kidney

55
Q

SLGT-2 inhibitors use

A

Type 2 diabetes,

56
Q

SGLT-2 inhibitors side effects

A

Drop in the HbA1C weight, and systolic blood pressure, reduction in LDL, yeast infections, hypotension, and Hyperkalemia

57
Q

SGLT-2 inhibitors contraindications

A

End stage kidney disease, dialysis, pregnancy (cat C)

58
Q

SGLT-2 inhibitors interactions

A

Canagliflozin and dapagliflozin increase diuresis, and can cause dehydration, ACE inhibitors, ARBs, and potassium sparing diuretics increase risk of Hyperkalemia,

59
Q

Dipeptidyl peptidase-4 inhibitors MOA

A

Lower the blood glucose of those with type 2 diabetes by enhancing the secretion of incretin hormone, reducing glucagon

60
Q

Dipeptidyl peptidase 4 inhibitors use

A

Type 2 diabetes

61
Q

Dipeptidyl peptidase 4 inhibitors side effects

A

Headare, upper respiratory tract infections (nasopharyngitis)

62
Q

Dipeptidyl peptidase 4 inhibitors contraindications

A

DKA, type 1 diabetes,

63
Q

Dipeptidyl peptidase 4 inhibitors precautions

A

Chronic kidney disease or in elderly, pregnancy (cat B), and lactation

64
Q

Thiazolidinediones MOA

A

Inhibit gluconeogenesis (formation of glucose from glycogen), HbA1C lowers

65
Q

TZD use

A

Type 2 diabetes

66
Q

TZDs side effects

A

Upper respiratory infections, sinusitis, headache, pharyngitis, myalgia, diarrhea, and back pain. Weight gain and hypoglycemia occur with combination therapy

67
Q

TZDs contraindications

A

Symptomatic heart failure, type 1 diabetes,

68
Q

Rosiglitazone contraindications

A

Shouldnt be used in combination therapy with insulin,

69
Q

TZDs precautions

A

Edema, cardiovascular disease, liver or kidney disease, pregnancy (cat C)

70
Q

What to monitor with TZDs

A

Men and women for bone fractures, especially in the upper limbs

71
Q

TZD interactions

A

Decreased effectiveness of oral contraceptives

72
Q

Alpha glucosidase inhibitors ex

A

Acarbose, miglitol

73
Q

Alpha glucosidase inhibitors use

A

Prevent after meal surge in blood glucose levels

74
Q

Alpha glucosidase inhibitors MOA

A

Delaying the digestion absorption of carbs in the intestine

75
Q

Alpha glucosidase inhibtors side effects

A

Bloating, flatulence, diarrhea (increasing dose should be done slowly)

76
Q

Alpha glucosidase inhibitors side effects nature

A

Unpleasant and not well tolerated (use in the US is limited)

77
Q

Alpha glucosidase inhibitors contraindications

A

Pre existing GI problems, DKA, cirrhosis,

78
Q

Alpha glucosidase inhibitors precautions

A

Pregnancy (cat B), lactation

79
Q

Acarbose precautions

A

Renal impairment

80
Q

Miglitol precautions

A

Renal impairment

81
Q

Miglitol interactions

A

Digestive enzymes reduce miglitol effect

82
Q

Amylinomimetic MOA

A

Mimics the endogenous mauling effects by delaying gastric emptying, decreasing glucagon release, and decreasing appetite

83
Q

Amylinomimetc use

A

Reduce blood glucose levels and reduce weight (type 2 diabetes)

84
Q

Amylinomimetics side effects

A

Nausea, vomiting, decreased appetite, abdominal pain, headache, injection site irritation, and hypoglycemia

85
Q

Amylinomimetics contraindications

A 
Problems with stomach emptying, shouldn’t be taken with drugs that slow 
GI motility (alpha glucosidase inhibitors)
86
Q

Amylinomimetics precautions

A

Pregnancy (cat C), and lactation

87
Q

Pramlintide interactions

A

Will delay onset of action when taken with an oral antidiabetic, and can cause severe hypoglycemic reactions in people with type 1 diabetes when taken with insulin

88
Q

Sulfonylureas use

A

Lower blood glucose

89
Q

Sulfonylureas MOA

A

Stimulate the beta cells of the pancreas to release insulin

90
Q

Sulfonylureas side effects

A

Hypoglycemia, anorexia, nausea, vomiting, epigastric discomfort, weight gain, heartburn, weakness, numbness of the extremity

91
Q

Sulfonylureas: what is most commonly used

A

2nd and 3rd generation

92
Q

1st generation sulfonylureas contraindications

A

Coronary artery disease, liver or renal dysfunction

93
Q

First generation sulfonylureas ex

A

Chlorpropamide, tolazamide, tolbutamide

94
Q

Sulfonylureas precautions

A

Impaired liver function, renal impairment and severe cardiovascular disease, risk for cross sensitivity with sulfonamides

95
Q

Sulfonylureas interactions

A

Increased hypoglycemic effect with anticoagulants, clofibrate, fluconazole, histamine H2 antagonists, MAOIs, NSAIDs, salicylates, sulfonamides, and TCAs. Hypoglycemic effect will decrease with beta blockers, CCBs, cholestyramine, corticosteroids, estrogens, hydantoins, isoniazid, oral contraceptives, phenothiazines, rifampin, thiazide diuretics, and thyroid agents

96
Q

Meglitinides Use

A

Lower blood glucose levels

97
Q

Meglitinides MOA

A

Stimulate the release of insulin form the pancreas, have very rapid action and short duration, so must be taken 3 times a day

98
Q

Meglitinides side effects

A

Upper respiratory tract infection, headache, rhinitis, bronchitis, headache, back pain, hypoglycemia

99
Q

Meglitinides interactions

A

Corticosteroids, carbamazepine, and rifampin decrease hypoglycemic effect, and debilitated, malnourished and elderly are more sensitive to hypoglycemic effects

100
Q

Meglitinides precautions

A

Pregnancy (cat C) And lactation

101
Q

Colesevelam use

A

Adjunctive therapy to improve glycemic control in adults with type 2 diabetes

102
Q

Bromocriptine

use

A

Normalize blood glucose patients with insulin resistance

103
Q

Bromocriptine MOA

A

Acts on circadian neuronal activities and may help regulate the hypothalamus

104
Q

Rapid acting insulin ex

A

Regular insulin, aspart, glulisine, lispro

105
Q

Intermediate acting insulin ex

A

Isophane insulin suspension

106
Q

Long acting insulin’s ex

A

Insulin degludec, insulin detemir, insulin glargine

107
Q

Biguanides ex

A

Metformin

108
Q

GLP-1 Agonists ex

A

Albiglutide, dulaglutide, exenatide, liraglutide, lixisenatide

109
Q

SLGT-2 inhibitors ex

A

Canagliflozin, dapagliflozin, empagliflozin,

110
Q

Dipeptidyl peptidase 4 inhibitors ex

A

Alogliptin, sitagliptin, linagliptin, saxagliptin,

111
Q

TZD ex

A

Pioglitazone, rosiglitazone

112
Q

Alpha glucosidase inhibitors ex

A

Acarbose, miglitol

113
Q

Amylinomimetics ex

A

Pramlintide

114
Q

3rd generation sulfonylureas ex

A

Glimepiride

115
Q

2nd generation sulfonylureas ex

A

Glipizide. Glyburide

116
Q

Meglitinides ex

A

Nateglinide, repaglinide

117
Q

Glucose elevating agents ex

A

Diazoxide. Glucagon

Pharmacology HOSA (37 decks)

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