Antidiabetic Drugs part 1 Flashcards
What are signs and symptoms of diabetes
polyuria, polydipsia, polyphagia, glycosuria, Weight loss, fatigue, Blurred vision
What is type 1 diabetes
Lack of insulin production or production of defective insulin
What is type 2 diabetes?
Insulin deficiency or resistance
What are the comorbid conditions or type 2 diabetes?
Obesity, Coronary heart disease, Dyslipidemia, Microalbuminemia(protein in urine), Hypertension and increased risk of blood clotting
What are the macrovascular (atherosclerotic plaque) conditions of diabetes?
Coronary arteries, cerebral arteries and peripheral vessels
What are the microvascular (capillary damage) conditions of diabetes?
Retinopathy, Neuropathy and Nephropathy
How often is screening recommended for patients over 40 years.
Every 3 years
What are the nonpharmacological interventions for type 1 and type 2?
Type 1: Insulin therapy. Type 2: Weight loss, Improved dietary habits, smoking cessation, reduced alcohol consumption, regular physical exercise.
What are the 4 major classes of insulin
Rapid-acting, short-acting, intermediate-acting, long-acting
What are the 4 types of antidiabetic drugs
Insulin, oral hypoglycemic, Combo of hypoglycemic drugs and insulin, injectable hypoglycemic drugs
Describe the onset, peak, and duration of rapid-acting insulin. What are the examples of it?
Onset: 10-15 minutes, Peak: 1-2 hours, Duration, 3-5 hours. insulin lispro (humalog), insulin aspart (novorapid)
How is rapid-acting insulin administered and when is the ideal time
SQ, or via continuous SQ infusion pump (no IV). Ideally before a meal
What is the onset, peak and duration of short-acting insulin? What are the examples of it?
Onset 30 mins, Peak: 2 to 3 hours, Duration 6.5 hours. Regular insulin (Humulin R, Novolin ge Toronto)
How is short-acting insulin administered
IV bolus, IV infusion, IM, SQ
What is the onset, peak and duration of intermediate-acting insulins? What is an example of it?
Onset: 1-3 hours, Peak: 5 to 8 hours, Duration: Up to 18 hours. Insulin isophane suspension AKA NPH
Insulin NPH is _____ in appearance
Cloudy
What is the onset, peak and duration of long-acting insulin glargine?
Onset: 90 minutes, No peak, Duration: 24 hours
Insulin glargine is AKA
Basal insulin
How is insulin detemir different from glargine?
Duration of action for determir is dose-dependent
Lower doses require twice daily dosing unlike once a day for glargine
What is a fixed combination insulin?
Contains two different insulins: one intermediate and one rapid or short-acting.
What are examples of fixed combination insulin?
Humulin 30/70, Novolin 30/70, 40/60, 50/50
What are adverse effects of insulin therapy?
Hypoglycemia, Tachycardia, palpitations, Headaches, lethargy, tremors, blurred vision, dry mouth, hunger
What drug interactions reduce the effects of insulin?
Beta-blockers, corticosteroids, epinephrine, furosemide, thyroid hormones
What drug interactions enhance the effect of insulin?
Alcohol, anabolic steroids, sulfa drugs, ACE inhibitors, MAOIs, Propanolol and salicylates.
What is Basal-Bolus insulin dosing
Delivers basal insulin constantly as a basal then as needed as a bolus
Basal is long acting (glargine)
Bolus is short-acting (lispro or aspart)
It is the preferred method
What is the function of Amylin agonsists and when is it used?
Mimics the natural hormone amylin which suppresses glucagon secretion. It is used when other drugs have not achieved adequate glucose control.
What is incretin mimetic ?
Mimics incretin hormones and enhances glucose-driven insulin secretion from beta cells
What are adverse effects of amylin agonist
Nausea, vomiting, anorexia, headache
What are the adverse effects of incretin mimetics?
Nausea, vomiting, diarrhea, weight loss, hemorrhagic or necrotizing pancreatitis
