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Pharm 225B > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Insulin Physiology

A
  1. Metabolic actions: overall anabolic effect, anabolism- constructive part of metabolism
  2. insulin promotes cell growth and division
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2
Q

What is used for insulin overdose?

A

Glucagon

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3
Q

Types of insulin (4)

A

I. Rapid-acting (onset <30 min, short duration 3-5hr)
II. Regular or short (onset 15-60 min, duration 6-10 hrs)
III. Intermediate acting (onset 1-2hrs, duration 14-24hrs)
IV. Long-acting (onset 70 min, duration 14-24hrs)

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4
Q

Insulins (7)

A
  1. Insulin lispro [Humalog] - rapid
  2. Insulin aspart [Novolog] - rapid
  3. Insulin glulisine [Apidra] - rapid
  4. Regular insulin [Humulin R, Novolin R], natural insulin - regular or short
  5. Neutral protamine hagedorn (NPH) insulin [Novolin N, Humulin N] - intermediate
  6. Insulin detemir [Levemir] - long
  7. Insulin largine [Lantus] - long
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5
Q

Which insulin should not be mixed with other insulins?

A

Insulin detemir [Levemir] - long acting

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6
Q

Which insulin is the only one able to be administered IV?

A

Regular insulin

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7
Q

Insulin AE

A

hypoglycemia
lipodystrophies (depositions of subq fat at site of injection)
allergic rxns

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8
Q

Oral Hypoglycemics (7)

A
  1. Sulfonylureas (SU)
  2. Meglitinides (GLN)
  3. Biguanides
  4. Thiazolidinediones - TZD (Glitazones)
  5. Alpha-glucosidase Inhibitors (AGI)
  6. New agent: “DPP-4 inhibitors”
  7. New agent: SGLT2 inhibitors
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9
Q

Sulfonylureas (SU) (4)

A

Glipizide [Diabeta] *
Glyburide [Glucotrol] *
Glimepiride [Amaryl]
Chlorpropamide [Diabenes] - 1st gen

Insulin Secretagogues

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10
Q

Meglitinides (GLN) (2)

A

Repaglinide [Prandin]*
Nateglinide [Starlix]

Insulin Secretagogues

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11
Q

Sulfonylureas & Meglitinides AE

A

hypoglycemia
weight gain

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12
Q

Insulin Secretagogues

A

MOA: Stimulate insulin release from pancreatic islets -> lower bloo dglucose levels

risk of hypoglycemia!!!

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13
Q

Biguanides (1)

A

Metformin [Glucophage]

Insulin Sensitizers

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14
Q

Biguanides AE

A

GI effects: decrease appetite, nausea, diarrhea
May reduce vitamin B12 absorption

BBW: lactic acidosis if improperly prescribed

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15
Q

Thiazolidinediones - TZD (Glitazones)

A

Pioglitazone [Actos] *
Rosiglitazone [Avandia]

Insulin Sensitizers

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16
Q

Thiazolidinediones - TZD (Glitazones) AE

A

fluid retention -> peripheral edema, weight gain
increase HDL, LDL cholesterol and TG

BBW: increase risk of CHF and potential increase risk for heart attacks

17
Q

Insulin Sensitizers

A

MOA: decrease insulin resistance -> increase muscle and adipose tissues sensitivity to insulin -> increase glucose uptake by muscle and adipocytes -> decrease blood glucose

18
Q

Alpha-glucosidase Inhibitors (AGI) (2)

A

Acarbose [Precose] *
Miglitol [Glyset]

19
Q

Alpha-glucosidase Inhibitors

A

MOA: retard degredation of polysaccharides into monosaccharides

delay intestinal carbohydrates absoprtion -> decrease rise of nlood glucose levels after meal

20
Q

Alpha-glucosidase Inhibitors AE

A

GI effects: flatulence, diarrhea or abdominal discomfort

21
Q

Glp-1 and incretin enhancers

A

MOA: inhibitors of DDP-4 prevent the degredation of incretin hormones and Glp-1 -> increase the action of Glp-1 -> enhance the fxn of Glp-1

22
Q

Glp-1 and incretin enhancers

A

Dipeptidyl peptidase 4 (DDP-4) inhibitors
Gliptin Drugs
- Sitagliptin [Januvia] *
- Saxagliptin [Onglyza]
- Linagliptin [Tradjenta]

23
Q

Sodium glucose co-transporter inhibitor

A

SGLT2 inhibitors
Gliflozin Drug
- Canagliflozin [Invokana] *
- Empagliflozin [Jardiance]
- Dapagliflozin [Farxiga]

24
Q

Sodium glucose co-transporter inhibitor

A

MOA: SGLT2 inhibitor prevent the renal reabsorption o fglucose and increas eurinary excretion of glucose

25
Q

SGLT2 inhibitors AE

A

hypoglycemia
female genital mycotic infections, UTI’s, and increase urination
ketoacidosis
AKI

26
Q

Incretin mimetic- Glp-1 agonists (Glp1-RA) (2)

A

Exenatide [Byetta] [Byduron = extended release] *
Liraglutide [Victoza]

Route: subq

27
Q

Incretin mimetic- Glp-1 agonists (Glp1-RA)

A

MOA: synthetic analogues of Glp-1 (glucagon like peptide-1) a peptide hormone in the incretin family -> decrease postprandial levels of glucose

28
Q

Incretin mimetic- Glp-1 agonists (Glp1-RA) AE

A

GI- N/V, diarrhea
hypoglycemia
weight loss

BBW: thyroid cancer seen in rats

29
Q

Synthetic Analogue of amylin

A

MOA: act like amylin which is a neuroendocrine peptide produced by the pancreatic beta cells and released with insulin to assist postprandial glucose control -> slow down gastric emptying, decrease glucagon secretion and increase satiety -> decrease postprandial levels of glucose

30
Q

Synthetic Analogue of amylin (1)

A

Pramlintide [Symlin]

Route : subq

31
Q

Synthetic Analogue of amylin AE

A

hypoglycemia

BBW: co-administration with insulin may induce severe hypoglycemia (usually within 3 hrs following administration)

32
Q

Glp1-RA- Semaglutide MOA

A

MOA: synthetic analogues of GLP-1 (glucagon like peptide-1), a peptide hormone in the incretin family -> decrease postpandial levels of glucose -> suppress appetite, decrease calorie intake -> weight loss

33
Q

Glp1-RA- Semaglutide Indications

A

Type 2 DM
Obesity
disorder of CV system
prophylaxis DM and obesity

Route: Subq [Ozempic], oral [Rybelsus] *

34
Q

Glp1-RA- Semaglutide AE

A

GI- N/V, diarrhea
hypoglycemia
weight loss

BBW: thyroid cancer seen in rats

Pharm 225B (9 decks)

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