Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Endocrine Pharm > Diabetes > Flashcards

Diabetes Flashcards

1
Q

What is the pathology of type 1 DM?

A

Autoimmune destruction of beta cells in the pancreas. Patients have little to no insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the pathology of type 2 DM?

A

Increased resistance to insulin. Patients have normal or elevated insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which DM (type 1 or 2) is associated with juvenile onset?

A

Type 1; remember, type 2 is a later onset (familial, assc with obesity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which DM (type 1 or 2) absolutely requires exogenous insulin as a treatment?

A

Type 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What glucose receptor is on the pancreatic beta cells?

A

GLUT 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What glucose receptor is on muscle/adipose tissue?

A

GLUT 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe a glucose tolerance test

A

Check the patient’s blood levels of glucose and insulin. Then, give the patient oral glucose. Then check their blood glucose measure BG and insulin again. Obviously in a diabetic, the BG will be elevated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Insulin is secreted as proinsulin, a single chain made of 3 components (alpha chain, beta chain, and C peptide). Which 2 of these are joined by disulfide bonds?

A

The alpha and beta chains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Insulin is secreted as proinsulin, a single chain made of 3 components (alpha chain, beta chain, and C peptide). Which of these components is measured in the blood as a marker of endogenous insulin production?

A

C peptide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Physiology review: List the steps in insulin secretion starting with GLUT 2 uptake of circulating glucose

A
  1. Glucose is elevated so GLUT 2 takes in circulating glucose (into pancreatic beta cell)
  2. Glucose is generated to ATP
  3. ATP closes the K channel of beta cell
  4. Cell is depolarized
  5. Depolarization –> influx of Calcium
  6. Influx of Ca causes exocytosis of insulin granules into blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What do alpha cells of the islets of langerhans make?

A

Glucagon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What do beta cells of the islets of langerhans make?

A

Insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What do delta cells of the islets of langerhans make?

A

Somatostatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are 4 stimulants of insulin release?

A
  1. Increased blood glucose
  2. Increased blood amino acids
  3. Vagal stimulation
  4. Increased sulfonyl ureas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are 2 amplifiers of insulin release?

A
  1. Enteric hormones: gastrin, cholecystokinin (CCK), and secretin
  2. Beta adrenergic stimulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are 3 inhibitors of insulin release?

A
  1. Somatostatin
  2. Drugs (such as diazoxide)
  3. Catecholamines (Epi, Norepi)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe a ketoacidotic coma

A

Caused by low insulin –> increased liver ketone production (beta-hydroxybutyrate & acetoacetate) –> decreased pH, fruity breath odor, Kussmaul breathing, hyperglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do you treat a ketoacidotic coma (diabetic ketoacidosis)?

A

Give insulin (also IV fluids if they are dehydrated)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Diabetic ketoacidosis is usually seen in type 1 or 2 DM?

A

Type 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe a hypoglycemic coma

A

Caused by insulin overdose. It is so common that all comatose patients are given glucose while you wait for labs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Tx of hypoglycemic coma?

A

Glucose.. duh

22
Q

Hypoglycemic coma is usually in type 1 or 2 DM?

23
Q

This is a blood test for long term BG control

24
Q

The 3 principal types of insulin secretion are?

A
  1. Short acting/ short half life
  2. Intermediate acting/ longer half life
  3. Long acting/ longest half life (largest crystals)
25
Short acting insulin is called "Regular insulin". what is unique about it?
Is is the only form that can be injected IV. All others are IM or SC
26
NHP preps are short, intermediate, or long acting?
Intermediate
27
Lente insulins are short, intermediate, or long acting?
Intermediate, they are 30% short acting and 70% ultralenta (long acting)
28
These forms of insulin alter the isoelectric point of insulin to drastically increase half life and thus are very long acting
1. Insulin glargine | 2. Insulin demetir
29
How is insulin glargine formed?
Switch the B21 asparagine to glycine and add 2 asparagines to B-chain C terminus
30
These drugs are benzoic acid derivatives that increase insulin secretion. They have rapid GI absorption
The Meglitinides: Repaglinide, Nateglinide **Increased insulin secretion via blocking potassium channels in pancreatic beta cells --> depolarization --> Ca influx --> insulin secretion
31
How does insulin demetir work?
It is acidic, so when it is injected it neutralizes and forms a precipitate
32
How does Metformin & Phenformin work (the biguanides)? | **Phenformin was withdrawn due to lactic acidosis AE
Decrease hepatic gluconeogenesis. Also decreases GI glucose absorption & increases peripheral tissue insulin sensitivity (according to Medscape)
33
Name the sulfonylureas (4)
1. Glyburide 2. Glipizide 3. Gliclazide 4. Glimepiride
34
Does metformin affect insulin secretion?
No! This is a good thing bc it means that metformin has no hypoglycemia AE Medscape: Metformin has BBW of Lactic acidosis
35
What is the MOA, metabolism, & elimination of the sulfonylureas?
MOA: increase insulin sensitivity in peripheral tissues Metabolism: hepatic Elimination: renal
36
What drug class enhances the hypoglycemic action of sulfonylureas?
NSAIDs
37
What the alpha-glucosidase inhibitors and how do they work?
Acarbose: reduce intestinal absorption of starch, disaccharides by inhibiting brush border alpha-glucosidase. They reduce post-prandial BG elevation. **Are not used alone
38
What is the absorption, metabolism, and AE of the Meglitinides?
Absorption: GI (rapid) Metabolism: Hepatic AE: Hypoglycemia
39
What is the dipeptidyl peptidase-4 inhibitors & how do they work?
Sitagliptin- inhibits dipeptidyl peptidase-4 which acts to degrade incretin hormones
40
When are the meglitinides taken?
Before a meal (to control post-prandial BG)
41
What is the absorption and metabolism of metformin
Oral absorption, no metabolism
42
How does Rosiglitazone & Pioglitazone (the Thiazolidinediones) work?
Bind to PPAR-gamma. Major drug for increasing insulin sensitivity in peripheral tissues by increasing GLUT-4 activity
43
What is the absorption & metabolism of Rosiglitazone & Pioglitazone?
Oral absorption, little metabolism
44
What is the somatostatin analog & how does it work?
Ocreotide: works like somatostatin --> inhibits insulin/glucagon secretion from pancreas. **Useful for tx of insulinomas/glucagonomas **Also could treat GH adenoma bc somatostatin inhibits GH!
45
What is the bile acid sequestrate?
Colesevelam hydrochloride
46
How does Colesevelam hydrochloride work?
Lowers blood cholesterol and lowers HbA1C- so treats DM & high cholesterol (thats a start for metabolic syndrome**)
47
MOA of Colesevelam hydrochloride?
Interrupts enterohepatic cycling, lowers farsenoid X receptor activation
48
AE of Colesevelam?
GI
49
Cinagliflozin MOA
SGLT-2 inhibitor; SGLT-2 is a Na-glucose transporter in kidney responsible for 90% of reabsorption of glucose (inhibiting the transporter would cause increased urine glucose)
50
AE's of Cinagliflozin?
Hypotension, Hyperkalemia, decreased BG, increased LDL; contra w/ renal dz & dialysis

Endocrine Pharm (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions