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Farmakologia > Cukrovka 2.0. - Podla Prezentace > Flashcards

Cukrovka 2.0. - Podla Prezentace Flashcards

1
Q

Indikace inzulinu

A 
DM I
Gestační DM
Ketoza,ketonurie,ketoacidoza
Diabetici pod 30
Diabetici s infekci a gangrenou
DM II pri zlyhani PAD/užívanie glukokortik/jaterní,renální insuf.
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2
Q

NÚ inzulinu

A

Hypoglykemie
Alergie
Lipodystrofie
Rezistence

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3
Q

Kriteria výberu vhodného PAD

A

Vek,váha,hladina Inzulinu
Hyperglykemie nalačno a po jídle
Metabolický syndrom
Chronická pridružená onemocneni

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4
Q

Schéma terapie DM II

A

1) zivotosprava
2) ak nestačí: monoterapie PAD
3) kombinovaná PAD
4) PAD + inzulin

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5
Q

Co zahrnuje metabolický syndrom?

A 
Inzulinová rezistence
Hypertenze
Hypertriglyceridémie
Porucha glukozove tolerance (diabetes)
Abdominální obezita
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6
Q

Aká by mala byť hodnota glykemie nalacno?

A

5,8 - 7,2

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7
Q

Aka by mala byt hodnota glykemie po jedle?

A

5,5/8,8 - 10,0

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8
Q

Glykovaný hemoglobin - hodnoty

A

4,5 - 7

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9
Q

Čo zahrnuje zmena životosprávy diabetikov?

A

Diabetická dieta
Aerobna fyz.záťaž vytrvalostná
Boj s obezitou,dyslipidemii,hypertenzii a infekcemi

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10
Q

Čo znižuje sekreci inzulinu B-buňkami?

A

Somatostatin
Inzulin
Sympatikus-adrenalin

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11
Q

Co je inzulin?

A

Nizkomolekularny protein,2reťazce

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12
Q

Viaže sa inzulin na plazmatické B?

A

Nie

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13
Q

Kde je tvorený inzulin?

A

V B-bunkách Langerhaasových ostrovčekov pankreatu

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14
Q

Čo produkujú A-bunky?

A

glukagon

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15
Q

Čo produkujú D bunky?

A

Somatostatin

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16
Q

Čo produkujú PP bunky?

A

Pankreatický polypeptid

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17
Q

Čoho ukazatelom je C protein?

A

Endogenni sekrece inzulinu

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18
Q

Aké dva typy inzulinových receptorov poznáme?

A

IGF-I

IGF-II

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19
Q

Z čoho dostávame zvireci inzuliny?

A

Z veprovych/hovezich pankreatu, vysoce cistene, monokompetentne

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20
Q

Závisi tvorba protilatek na cistote preparátu?

A

Ano

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21
Q

Krárkodobo pôsobiace inzulinove analoga

A

Lispro,Aspart,Glulisin

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22
Q

Stredne dlho pôsobiace inzulinove analoga?

A

Protamin inzulin
Amorfni smesi
Lispro susp.

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23
Q

V akom pomere sa podávajú amorfne a krystalicke smesi?

A

30:70

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24
Q

Dlouze pusobici inzuliny

A 
Krystalicke suspenze
Glargin
Detemir
Degludec
PEG lispro
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25
Q

Doba nastupu a koniec ucinku kratko posobiacich inzulinovych analog

A

15min -> 2-5h

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26
Q

Doba nastupu a koniec ucinku dlouze pusobicich inzulinu

A

2-3h -> 24-36h

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27
Q

Doba nastupu a koniec ucinku stredne dlouho pusobicich inzulinu

A

1-2,5h -> 12-24h

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28
Q

Po kolika jednotkach su kalibrovane inzulinove pera?

A

1-2

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29
Q

Vymenuj 8 skupin PAD

A 
Biguandiny
Derivaty sulfonylmočoviny
Thiazolidindiony
Inhibitory strevnich glukosidaz
Meglitinity
Analogy GLP1- inkretinove mimetika
Gliptiny
Ingibitory SGLT2
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30
Q

Vymenuj tri biguandiny

A

Metformin
Buformin
Fenformin

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31
Q

Kam patri metformin?

A

Biguandiny

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32
Q

MU biguandinov

A

Zvyšenie senzitivity perifernych tkani k inzulinu-jatra,PPS
=>
Zvysenie vazby inzulinu na periferni receptor

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33
Q

Závisí účinok biguandinov na pankrease?

A

Nie, ale potrebujú k účinku inzulin

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34
Q

Extra výhoda biguandinov

A

Nevznikajú hypoglykemie lebo znízia hyperglykemiu bez ovlivnenia normoglykemie

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35
Q

Kontraindikace biguandinov?

A

ren/hepat/kardioresp insuficience
Gravidita
Alkohol
Tkáňové hypoxie (laktátová acidóza)

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36
Q

Ovlivňujú biguandiny aj metabolismus tukov?

A

Ano, hlavne nám zvyšujú HDL chol

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37
Q

Ovplyvňujú biguandiny hladinu glukagonu?

A

Áno,znížia ju

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38
Q

Aký majú biguandiny vplyv na krv?

A

Zlepšujú jej reologické vlastnosti (zlepšujú jej prúdenie)

39
Q

NU biguandinov

A 
Laktát.acid
Nauzea,GIT
Znízená absorpcia B12
Ztrata hmotnosti
Disulfiramova reakce
40
Q

U ktorých PAD pozorujeme disulfiramovú reakciu?

A

Biguandiny

41
Q

Ako biguandiny ovplyvnia hmotnosť?

A

Straty hmotnosti

-je indikovaná u obéznych pacientov

42
Q

Indikácie a zaradenie metforminu

A

Biguandin

liecba obeznych DM II

43
Q

Kedy sa použiva kombinácia biguandinov a derivárov sulfonylmočoviny

A

U neobeznych DM II

44
Q

Ako sa inak nazývajú Thiazolidindiony?

45
Q

Zástupci Thiazolidindionov (Glitazonov)

A

Rosiglitazon
Pioglitazon
Troglitazon

46
Q

MÚ thiazolidindionov (Glitazonov)

A

Aktivace jaderných PPAR-alfa receptorov

Senzitizace periferie k inzulinu

47
Q

Čo spôsobujú thiazolidindiony (Glitazony) u eu(normo)glykemickych pacientov?

A

Našťastie nic - nepotrebujeme hypoglykemiu

48
Q

Čo spôsobí aktivácia PPAR glitazony?

A

Zvýsi sa synteza glykogenu,glykolyza a lipogeneza a znizi sa glukoneogeneza v jatrech

49
Q

S čím sa kombinuje metformin?

A

S derivatmi sulfonylmočoviny

50
Q

NU thiazolidindionov (glitazonov)

A

Hepatotox

Retence tekutin

51
Q

Kontraindikace glitazonov (thiazolidindionov)

A

Alergie
Poškod.jater
Tehotenstvi
Laktace

52
Q

Ake dva druhy mechanizmu účinku maju derivaty sulfonylmočoviny?

A

Pankreaticke

Extrapankreaticke

53
Q

Aky je pankreaticky MU derivatov SU (sulfonylurey-močoviny)

A

Blok K + kanálu -> stimul B-b pankreatu a sekrece inzulinu

54
Q

Majú deriváty SU riziko hypoglykemie?

55
Q

Maju Thiazolidindiony (Glitazony) riziko hypoglykemie?

56
Q

Maju Biguandiny tiziko hypoglykemie?

57
Q

Extrapankreaticke ucinky Derivatov SU

A 
Zvysena afinita inzulinu k receptorom
Znizenie hepatalni degradace inzulinu
Znizena sekrece glukagonu
Znizenie glukoneogeneze
Zvysenie receptrov na erytro/adipo/monocytech
58
Q

Kolko generacii Derivatov SU pozname?

59
Q

Lieky PAD prvej volby u neobeznych DM I

A

Derivaty sulfonylmocoviny

60
Q

Kam patri glipizid?

A

Derivaty SU 2.generace

61
Q

NU derivatov SU

A

Zvysenie chuti k jedlu (pribrat)
Retence tekutin
Alergie
Fotosenzitivita

62
Q

U ktorej skupiny PAD je vyrazne riziko pribyvani na vaze? -bacha tak znela otazka v testu!!

A

Derivaty SU (napr.glipizid)

63
Q

Ktore dve skupiny PAD maju podobny ucinek,lisi se jen vazebnym mistem…

A

Derivaty SU
A
Meglitinidy (Glinidy)

64
Q

KI derivatov SU

A

Hypoglykemie
Ketoacidoza
Poškozeni jater/ledvin
Tehotenstvi

65
Q

Zastupci meglitinidov (glinidov)

A

Repaglinid
Nateglinid
Meglitinid

66
Q

Kombinujú sa meglitinidy s metforminom?

67
Q

NU meglitinidov (glinidov)

A

Hypoglykemie
Nausea
prujem

68
Q

Maju meglitinidy (glinidy) riziko hypoglykemie?

69
Q

KI inkretinovych mimetik (Analoga GLP1)

a zaroven meglitinidov (Glinidov)

A

DM I
Diab.ketoacidoza
Gravidita

70
Q

Ktore PAD su vyslovene kontraindikovane u DM I (2 skupiny)

A

Meglitinidy (Glinidy)

Analoga GLP-1

71
Q

Ako sa inak nazyvaju GLP1 analoga?

A

Inkretinova mimetika

72
Q

2 zástupci inkretinovych mimetik (analog GLP1)

A

Exenatid

Liraglutid

73
Q

MU inkretinovych mimetik (Analog GLP1)

A

Stimulace rec.pre GLP1 (glukagon-like peptid1)

74
Q

Čo sposobuje stimulacia GLP1 receptorov?

A

Stimulace sekrece inzulinu

Inhibice sekrece glukagonu

75
Q

NU analog GLP (inkretinovych mimetik)

A

Hypoglykemie
Nausea
Prujem

76
Q

KI inkretinovych mimetik (Analoga GLP1)

a zaroven meglitinidov (Glinidov)

A

DM I
Diabet ketoacidoza
Gravidita

77
Q

Zástupci gliptinov

A

Sitagliptin
Vildagliptin
Alogliptin
Linagliptin

78
Q

Mu Gliptinov

A

Inhibitory DPP-4 (ona je zlá-degraduje inkretiny a to su hormony stimulujuce B-bunky) proste nechceme aby fungovala DPP-4

79
Q

Indikace gliptinov

A

DM II kombinovane s PAD
Nizke riziko hypoglykemie
Lepsia kontrola Hb1Ac
Spomalenie progrese DM

80
Q

Kombinuju sa gliptiny?

A

Ano,s ostatnymi PAD

81
Q

Inhibitory SGLT2 (glifloziny)

A

Depagliflozin

Kanagliflozin

82
Q

Co sú SGLT2?

A

Koteansportery Na+/glukoza

83
Q

Kontraindikacie gliflozinov?

A

Pozor! Oni sú zakazane u pacientov s renalnymi patologiami

84
Q

MU inhibitorov SGLT2 (gliflozinov)

A

Inhibice reabsorpcie glukozy v ledvinach

85
Q

Mierny diureticky a natriureticky efekt - conje to za PAD?

A

Glifloziny (iSGLT2)

86
Q

Ktora skupina PAD ma NU infekce URGT traktu, hypoglykemiu, bolesti zas a polyuriu?

A

Inhibitory SGLT2 glifloziny

87
Q

Je u gliflozinov (iSGLT2) riziko hypoglykemie?

88
Q

Preco je u gliflozinov (iSGLT2) riziko infekcii urogenitalneho traktu?

A

Lebo je glukoza pritomna v moci - idealne prostredie pre cizorode patogeny

89
Q

Inhibitory strevnych alfaglukozidaz - zastupci?

A

Akarbóza,!!!
Voglibosa
Miglitol

90
Q

MU strevnych alfaglukosidaz

A

Kompetitivni inhibice - zpomaleni absorpce sacharidov z GIT ale neinterferuji so vstrebavanim monosacharidov

91
Q

NU iAlfaglukosidaz

A

GIT potize, ak sa kombinuju s inými PAD podaj aj monosacharid alebo glukagon

92
Q

Co robi alfaglukosidaza?

A

Stiepi Di/polysacharidy na monosacharidy. To nechceme pri diabete

93
Q

Co jsem komu udelala ?!??! :( :(

A

:( pryč s farmou

94
Q

Čo podporuje sekreci inzulinu z B-bunek?

A

Glukoza,glukagon,Lys,Arg, MastneKyseliny, PAD, gastrin, sekretin, AcChol a GLP-1

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