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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?

25
GLP-1 is responsible for??
*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
what are some Thiazolidinedione’s (glitazones)?
TZD rosiglitazone, pioglitazone (-Zone)
27
how do Thiazolidinedione’s (glitazones) work?
* Increase fluid (not for CHF) * Increased skeletal uptake * Decrease hepatic glucose
28
who should not take Thiazolidinedione’s (glitazones)?
those with CHF
29
what are some rapid insulins?
lispro (humolog), aspart (novolog)
30
what is the onset of rapid insulins?
10-15 mins
31
what is the peak of rapid insulins?
1-2 hours
32
what is the only insulin to be given IV?
short/regular
33
what is the onset of short/regular insulin?
30 mins
34
what is an intermediate insulin?
NPH
35
how should we mix insulin?
rapid or short then add intermediate (clear to cloudy)
36
what are the most common insulins to be taken at the same time together not mixed?
long and rapid acting insulin
37
What info would we line to obtain from labs to diagnose diabetes??
-HBA1C -urinalysis- proteins/albumin (how the kidneys are working), ketones, glucose -cholesterol (triglycerides LDL’s -blood glucose level
38
what puts you at risk for diabetes?
-high BMI/ weight -African American (race) -gestational diabetes
39
What education should she receive before starting medications?
-10-15 hours -information on nutrition and exercise
40
Diabetic treatment goals? (4 months later)
A1C less than 6.5% Mean plasma glucose less than 130 mg/dL
41
what can you die from with DKA?
1. Dehydration, hypovolemia (fluids) 2. Low pH 3. High potassium
42
-potassium must be what at least to start an insulin drip
3.3
43
-do not want 100 dL drop per hour of a blood sugar or else it can cause what?
cerebral edema
44
what are the Hyperkalemia treatments: (kidneys, 12 led EKG- peaked T-waves)?
-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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