antidiabetics

Question 1

what are the positive regulators of insulin release

Answer 1

glu, aa, incretins, epi/b2 adrenergic stimulation, vagal stimulation

Question 2

what are the negative regulators of insulin release

Answer 2

1. NE/alpha-2 adrenergc stimulation

2. amylin

Question 3

which GLUT transporter is regulated by insulin?

Answer 3

GLUT4

found in muscle, adipose tissue

Question 4

fasting plasma glu >126?

Answer 4

diabetes

Question 5

fasting plasma glu >96

Answer 5

gestational diabetes

Question 6

fasting plasma glu > 110-125

Answer 6

pre-diabetic

Question 7

casual plasma glu >200 + sx

Answer 7

diabetes

Question 8

oral glu tolerance test >200

Answer 8

diabetes

Question 9

oral glu tolerance test 141-199 at 2 hr interval

Answer 9

pre-diabetes

Question 10

NORMAL fasting plasma glu

Answer 10

less than 110

Question 11

list the rapid acting insulin

Answer 11

1. Insulin Lispro
2. Insulin aspart
3. Insulin glulisine
4. inhaled insulin

Question 12

short acting insulin?

Answer 12

regular insulin

Question 13

intermediate acting insulin?

Answer 13

NPH (Protamine-insulin complex)

Question 14

long acting insulin

Answer 14

1. glargine

2. determir

Question 15

mechanical pump delivery uses what type of insulin?

Answer 15

short acting

Question 16

what is the most common adverse effect of insulin administration?

Answer 16

hypoglycemia

Question 17

autonomic manifestations of hypoglycemia

Answer 17

tachycardia, sweating, tremor, nausea, hunger

Question 18

neuroglycopenic manifestations of hypoglycemia

Answer 18

irritability, confusion, HA

Question 19

how to tx hypoglycemia

Answer 19

glucose, glucagon

Question 20

MOA: decr hepatic glu output, incr peripheral glu utilization, activation of hepatic enzyme AMP-activated protein kinase (AMPK)

Answer 20

metformin

Question 21

MOA: Inhib ATP-sensitive K+ channel of B cell–> insulin release

Answer 21

Sulfonylureas

Meglitinides

Question 22

MOA: Inhib brush border glucosidase enzyme and subsequent absorption of glucose

Answer 22

1. acarbose

2. miglitol

Question 23

MOA: incr expression of GLUT4 channel

Answer 23

1. Pioglitazone

2. Rosiglitazone

Question 24

AE: cardiovascular, weight gain, peripheral edema, hepatotoxicity, bone fractures

Answer 24

Thiazolidinediones

Question 25

which type of oral antidiabetic agent should not be given to someone with preexisting GI issues?

Answer 25

glucosidase inhibs (acarbose + Miglitol)

Question 26

which antidiabetic agents must be injected?

Answer 26

1. Amylinomimetic

2. incretins

Question 27

which drug can cause acute pancreatitis?

Answer 27

incretins

DPP inhibitors

Question 28

AE: Nasopharyngitis, URT infections, HA, acute pancreatitis, Hemorrhagic/necrotizing pancreatitis

Answer 28

1. Sitagliptin
2. Saxagliptin
3. Linagliptin
   (DPP inhibs)