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Pharmacology Exam 3 > Diabetes > Flashcards

Diabetes Flashcards

1
Q

what is a biguanide?

A

Metformin (Glucophage)

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2
Q

what are the three functions of Biguanides: Metformin (Glucophage)?

A
  1. Blocks gluconeogenesis in the liver
  2. Reduces absorption of glucose in the gut
  3. Increases skeletal muscle uptake of glucose
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3
Q

does metformin cause hypoglycemia?

A

no

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4
Q

what are the side effects of Biguanides: Metformin (Glucophage)?

A
  • Rare but possible lactic acidosis
  • GI upset: N/V, Bloating
  • Decreased appetite
  • Kidneys
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5
Q

what are some sulfonaureas?

A

glipizide, glimepiride, glyburide (-IDE)

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6
Q

How do sulfonaureas work?

A

Increase the function of the beta cells (increases the insulin)
-the cheerleaders

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7
Q

can sulfonaureas cause hypoglycemia?

A

yes

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8
Q

what should is important to watch for with sulfonaureas?

A

Sulfa allergies
Drug interactions: NSAIDS (alter the blood sugar)

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9
Q

what are some meglitinides?

A

repaglinide, nateglinide (-NIDES)

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10
Q

can meglitinides cause hypoglycemia?

A

yes

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11
Q

how do meglitinides work?

A
  • Increase the function of the beta cells
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12
Q

what is the advantage of meglinitides versus sulfonaureas?

A

no sulfa

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13
Q

what are some SGLT2’s?

A

canagliflozin, dapagliflozin, empagliflozin
-liflozin

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14
Q

how do SGLT2 work?

A

Blocks the receptor site
Blocks the reabsorption of glucose on the proximal tubules
o Glucose gets excreted in the urine

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15
Q

what are the side effects of SGLT2?

A

UTI, yeast infections, dehydration
Can cause hypovolemia, hypotension, dizziness
-Be careful when using other anti-HTN drugs

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16
Q

what are some Alpha-glucosidase inhibitors?

A

acarbose, miglitol

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17
Q

how do Alpha-glucosidase inhibitors work?

A
  • decreased absorption of glucose in the gut
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18
Q

what is the major side effect of Alpha-glucosidase inhibitors?

A

more gas produced (fart city)

19
Q

what is the prefered Alpha-glucosidase inhibitor and why?

A

miglitol preferred over acarbose due to the liver damage

20
Q

what are some Glucagon-like peptide agonist?

A

exenatide, exenatide, albiglutide, dulaglutide, liraglutide,
ALL END IN -TIDE

21
Q

what is a Glucagon-like peptide agonist and what does it inhibit?

A
  • Incretin mimetics
  • inhibit GLP-1
22
Q

what are some amylin mimetics?

A

pramlinatide,
ALL END IN -TIDE

23
Q

how does an amylin mimetic work?

A

body’s natural GLP-1 inhibitor (can also be synthesized)
co-secreted with insulin
inhibit GLP-1

24
Q

what do DPP4 inhibitors end in?

A

-gliptin

25
Q

GLP-1 is responsible for??

A

*feeling of fullness
*decrease the absorption of glucose in the gut
*decrease glycogen-gluconeogenesis
*increase insulin (glucose dependent)
o cannot overshoot it, no hypoglycemia

26
Q

what are some Thiazolidinedione’s (glitazones)?

A

TZD rosiglitazone, pioglitazone (-Zone)

27
Q

how do Thiazolidinedione’s (glitazones) work?

A
  • Increase fluid (not for CHF)
  • Increased skeletal uptake
  • Decrease hepatic glucose
28
Q

who should not take Thiazolidinedione’s (glitazones)?

A

those with CHF

29
Q

what are some rapid insulins?

A

lispro (humolog), aspart (novolog)

30
Q

what is the onset of rapid insulins?

A

10-15 mins

31
Q

what is the peak of rapid insulins?

A

1-2 hours

32
Q

what is the only insulin to be given IV?

A

short/regular

33
Q

what is the onset of short/regular insulin?

A

30 mins

34
Q

what is an intermediate insulin?

A

NPH

35
Q

how should we mix insulin?

A

rapid or short then add intermediate (clear to cloudy)

36
Q

what are the most common insulins to be taken at the same time together not mixed?

A

long and rapid acting insulin

37
Q

What info would we line to obtain from labs to diagnose diabetes??

A

-HBA1C
-urinalysis- proteins/albumin (how the kidneys are working), ketones, glucose
-cholesterol (triglycerides LDL’s
-blood glucose level

38
Q

what puts you at risk for diabetes?

A

-high BMI/ weight
-African American (race)
-gestational diabetes

39
Q

What education should she receive before starting medications?

A

-10-15 hours
-information on nutrition and exercise

40
Q

Diabetic treatment goals? (4 months later)

A

A1C less than 6.5%
Mean plasma glucose less than 130 mg/dL

41
Q

what can you die from with DKA?

A
  1. Dehydration, hypovolemia (fluids)
  2. Low pH
  3. High potassium
42
Q

-potassium must be what at least to start an insulin drip

A

3.3

43
Q

-do not want 100 dL drop per hour of a blood sugar or else it can cause what?

A

cerebral edema

44
Q

what are the Hyperkalemia treatments: (kidneys, 12 led EKG- peaked T-waves)?

A

-sodium polystyrene sulfonate (Kayexalate, definitive)
-calcium gluconate (calms the membrane)
-regular insulin (Temporize)
-sodium bicarbonate (causes alkalosis)
-D50 (temporize)
-Albuterol (beta-2 agonist, lets K in)
-Dialysis (definitive)

Pharmacology Exam 3 (3 decks)

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