Ch # 14: Endocrine Drugs Flashcards
A type of diabetes mellitus
Former names: Insulin dependent and Juvenile-onset diabetes mellitus
Onset: childhood and young adulthood
Contributing factors: viral trigger and heredity
Treatment: diabetic diet, weight control, exercise and insulin
Type I Diabetes Mellitus
A type of diabetes mellitus
Former names: non-insulin dependent diabetes mellitus and adult
onset diabetes mellitus
Onset: middle age
Contributing factors: obesity and heredity
Treatment: diabetic diet, weight control, exercise, antidiabetic
drugs, sometimes insulin
Type II Diabetes Mellitus
This hormone carries glucose 2 a body cell, binds w/a receptor on the cell membrane and transports glucose inside the cell where glucose is metabolized 2 provide energy 4 the body
Lowers the blood glucose level by enabling cells 2 utilize glucose
Was 1st created by ground-up pancreas of cows and pigs
In 1936, protamine(semen from fish) was added 2 neutralize the pH so it could b injected in2 body tissues w/out a reaction
Cannot give orally because the digestive enzymes break it down so always given as an injection in2 sub Q: upper arms, thighs or abdomen
Insulin
A type of endocrine disorder
Occurs when:
- the pancreas doesn’t produce and insulin
or
- pancreas produces 2 little insulin
or
- the number of or sensitivity of insulin receptors on body cells is
decreased
Constantly elevated blood glucose level can lead 2 complcations:
-diabetic retinopathy, diabetic neuropathy, arteriosclerosis, ketoacidosis and death
Diabetes Mellitus
All insulin drugs 2day r created this way
Inserts the drug 4 human insulin into bacteria which then multiply rapidly and produces large amounts of the drug
Reincombient DNA technology
A type of insulin drugs
Taken in the morning or b4 eating
Therapeutic effect is almost immediate (less than 15 minutes) and lasts 2-12 hours
The 1st drug of this type was called regular insulin and now insulin regular
Always a clear liquid in the vial and is measured in units w/a special insulin syringe
Drug examples: “R” in trade name indicates regular
- insulin regular (Humulin R, Novolin R)
- insulin aspart (NovoLog)
- insulin glulisine (Apidra)
- insulin lispro (Humalog)
Rapid-Acting Insulin Drugs
2 names 4 a type of insulin drugs
Onset of therapeutic effect is slower 2 begin but lasts longer
1-2 hours 2 start and lasts for 15 hours
Contains protamine and zinc 2 prolong the therapeutic effect of the insulin
Drug example: insulin isophane (Humulin N, Novolin N)
Intermediate-Acting Drugs
NPH(neutral protamine Hagedorn) Insulin Drugs
A type of insulin drugs
Contain large insulin crystals and zinc that slows down the onset of insulin’s therapeutic effect
Onset can take over an hour 2 occur (anywhere from 1-8 hours) and the therapeutic effect can last 24 hours
These r never used in combination 2gether w/other insulin drugs
Drug examples:
- insulin detemir (Levemir)
- insulin glargine (Lantus)
Long-Lasting Insulin Drugs
A type of insulin drugs
These contain a mixture of rapid-acting insulin or an analog drug and an intermediate-acting insulin(NPH) or insulin analog drug
75/25 : the top # always refers 2 intermediate-acting drug; 75%
Bottom drug refers 2 rapid-acting insulin; 25%
These drugs r never used in any combination insulin drugs
Drug examples: Humalog Mix 75/25 Humalog Mix 50/50 Humulin 50/50 Humulin 70/30 Novolin 70/30 NovoLog Mix 70/30
Combination Insulin Drugs
Standardized measurement for insulin doses
Unit
A type of insulin drugs
Stimulates the beta cells of the pancreas 2 secrete more insulin and it also increases the amount of insulin receptors so that the body cells rn’t resistance 2 the effect of any insulin that is present
Only used 2 treat Type II Diabetes Mellitus because, in type I type 1, the pancreas cannot b stimulated in2 producing more insulin
7 categories of drugs:
- sulfonylurea drugs
- meglitinide drugs
- thiazolidinedione drugs
- alpha-glucosidase inhibitor drugs
- sodium-glucose cotransporter 2 ibhibitor drugs
- biguanide drugs
- DPP-4 inhibitor drugs
Oral Antidiabetic Drugs
A type of oral antidiabetic drugs
The 1st category of oral antidiabetic drugs 2 b created during the 50’s
Act 2 stimulate beta cells of the pancreas
Drug examples: ends in -amide, -ride and -zide
- chlorpropamide
- glimepiride (Amaryl)
- glipizide (Glucotrol, Glucotrol XL)
- glyburide (DiaBeta, Glynase)
- tolazmide
- tolbutamide
Sulfonylurea Drugs
A type of oral antidiabetic drugs
Stimulates the beta cells of the pancreas 2 secrete more insulin by closing potassium channels in the cell membrane of the beta cell
Lack of potassium changes the electrical charge of the beta cell causing calcium channels in the cell membrane 2 open and the calcium flowing in2 the beta cell stimulates it 2 secrete insulin
Drug examples: ends in -glinide
- nateglinide (Starlix)
- repaglinide (Prandin)
Meglitinide Oral Antidiabetic Drugs
A type of oral antidiabetic drugs
These drugs increase the sensitivity of body cells so that they can respond even 2 small amounts of insulin and decreases the release of stored glucose from the liver so there is less glucose in the blood
These drugs DO NOT stimulate the pancreas in2 producing more insulin
Drug examples: ends in -glitazone
- pioglitazone (Actos)
- rosiglitazone (Avandia)
Thiazolidinedione Drugs
A type of oral antidiabetic drugs
It inhibits the actions of 2 enzymes that digest carbohydrates causing smaller amounts of glucose r produced from food resulting a lower glucose level in the blood
- amylase (from pancreas)
- alpha-glucoside hydrolase (from small intestine)
These drugs DO NOT stimulate the pancreas 2 secrete insulin
Drug examples:
- acarbose (Precose)
- miglitol (Glyset)
Alpha-Glucosidase Inhibitor Oral Antidiabetic Drugs
A type of oral antidiabetic drugs
These drugs inhibit a substance that transports both sodium and glucose from the renal tubules back in2 the blood as urine is being formed causing glucose 2 b kept in the renal tubules. It does NOT go back in2 the blood thus reducing glucose levels in the blood
Drug examples: ends in -glifozin
- canagliflozin (Invokana)
- dapaglifozin (Farxiga)
Sodium-Glucose Cotransporter 2 Inhibitor Oral Antidiabetic Drugs
A type of oral antidiabetic drugs
This drug has 3 separate effects all of which lower the level of glucose in the blood by:
-decreasing the absorption of glucose from the intestine in2 the
blood
-decreases the release of stored glucose from the liver in2 the
blood
-improves the ability of body cells 2 use any insulin that is secreted
by the pancreas
This drug does NOT increase the pancreas 2 secrete more insulin so it is often included in combination w/other oral antidiabetic drugs that DO stimulate the pancreas
Drug example: metformin (Glucophage, Glucophage XR)
Biguanide Oral Antidiabetic Drugs
A type of oral antidiabetic drugs
These drugs prolong the actions of 2 hormones (GLP-1, GIP) and r released in2 the blood by the small intestine after food is eaten which stimulates the pancreas 2 produce more insulin, lowering blood glucose levels
Drug examples: ends in -gliptin
- alogliptin (Nesina)
- linagliptin (Trajenta)
- saxagliptin (Onglyza)
- sitagliptin (Januvia)
DPP-4 Inhibitor Oral Antidiabetic Drugs
A type of oral antidiabetic drugs
These various oral antidiabetic drugs r mixed w/metformin
Drug examples: ActoPlus Met (metformin, pioglitazone) Avandamet (metformin, rosiglitazone) Glucovance (metformin, glyburide) Janumet (metformin, sitagliptin) Jentadueto (metformin, linagliptin) Kazano (metformin, aloglipizide) Kombiglyze XR (metformin, saxagliptin) Metaglip (metformin, glipizide) PrandiMet (metformin, repaglinide)
Combination Oral Antidiabetic Drugs
A category of drugs that has therapeutic effects that r different from those of insulin or oral antidiabetic drugs
Categories include:
- incretin mimetic antidiabetic drugs
- amylin analog antidiabetic drugs
- bile acid sequestrant antidiabetic drugs
Used 2 treat type II diabetes mellitus and sometimes type I as well
Other Antidiabetic Drugs
2 names 4 a type of other antidiabetic drugs
These drugs mimic the action of incretins by stimulating GLP receptors in the beta cells of the pancreas 2 secrete insulin when the blood glucose level is high
Never an oral drug-always by Sub Q injection
Drug examples:
- exenatide (Byetta, Bydureon) from the saliva of gila monsters
- liraglutide (Victoza)
Incretin Mimic Antidiabetic Drugs
Glucagon-Like Peptide 1 Receptor Agonist Drugs
A type of other antidiabetic drugs
These drugs r similar 2 amylin, a substance secreted from beta cells of the pancreas at the same time that insulin is secreted which:
- slows the rate that food leaves the stomach,
- stops the release of stored glucose from the liver
- works in the brain 2 decrease appatite
Used 2 treat type II and sometimes type I but it is in addition 2 insulin
Always given as a Sub Q injection
Drug example: pramlintide (Symlin)
Amylin Analog Antidiabetic Drugs
A type of other antidiabetic drugs
These drugs r normally used 2 treat an elevated level of cholesterol in the blood
It stimulates receptors in the liver that then produce a protein that increases glucose metabolism in the cells
Used 2 treat type II diabetic mellitus and is always given orally
Bile Acid Sequestrant Antidiabetic Drugs
These drugs r used 2 treat diseases of the thyroid gland
This disease occurs when the thyroid gland secretes decreased levels of the hormones triiodothyronine (T3) and thyroxine (T4) so this drug increases these hormone levels
These drugs r made from natural sources like dried animal thyroid glands or synthetically made
Drug examples:
- liothyronine (Cytomel, Triostat) only contains T3 hormone
- levothyroxine (Synthroid) only contains T4 hormone
These drugs contain both T3 and T4 hormones that r made from ground up dried pig thyroid glands:
- liotrix (Thyrolar)
- thyroid desiccated (Armour Thyroid)
Drugs 4 Hypothyroidism
