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Pharm 2 > Diabetes > Flashcards

Diabetes Flashcards

1
Q

What are the rapid-acting insulins?

A 
Insulin lispro (Humalog)
Insulin aspart (NovoLog)
Insulin glulisine (Apidra)
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2
Q

What is the short-acting insulin?

A

Regular insulin

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3
Q

What is the intermediate acting insulin?

A

NPH/Isophane Insulin

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4
Q

What are the long acting insulins?

A

Insulin glargine

Insulin detemire

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5
Q

Which groups of insulin can be given IV?

A

Rapid-acting and short-acting

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6
Q

What are normal responses to insulin?

A

Blood glucose level decreases
Blood pyruvate and lactate increase
Inorganic phosphate decreases
Plasma potassium decreases

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7
Q

Who should you never give insulin to?

A

hypokalemia

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8
Q

What are some causes of hypoglycemia? How do you treat in an emergency situation?

A

Vigorous exercise
Failure to eat
Over indulgence in alcohol; Give 50-100 ml of 50% glucose solution IV and 0.5-1 mg glucagon injection

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9
Q

What drugs are sulfonylureas? What is their MOA?

A 
Glyburide (Micronase)
Glipizide (Glucotrol)
Glimepriride (Amaryl)
Tolbutamine (Orinase)
Tolazamide (Tolinase)
Chlorpropamide (Diabinese)
They stimulate insulin release from pancreatic beta cells by blocking the K+ channel and causing depolarization, potentiate action at target cells
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10
Q

What are the first gen sulfonylureas? Second gen?

A

TCT, GGG

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11
Q

What is the safest sulfonylurea for use in elderly patients?

A

Tolbutamine (Orinase)

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12
Q

What are the primary adverse side effects of sulfonylureas?

A 
•All sulfonylureas can cause hypoglycemia
-More in long-lasting agents
–2nd gen. agents typically better
–Can be caused by drug interactions
•Some GI side effects (2nd gen better)
•Weight gain
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13
Q

What are in the class of meglitinides that are secretagogues but can be used with a sulfa allergy and with better likelihood of euglycemia?

A

RegaGLINIDE (Prandin) and NateGLINIDE (Starlix)

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14
Q

What are the two Thiazolidinediones? What is their MOA?

A

Pioglitazone
Rosiglitazone
Ligands of the nuclear PPARg receptor which can cause post-receptor insulin-mimetic action, upregulates GLUT4 receptors and insulin uptake enzymes

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15
Q

What is the one biguanide?

A

Metformin

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16
Q

What are the indications for TCDs?

A

Decreases HbA1c, MAY BE USEFUL FOR PROPHYLAXIS OF TYPE 2 DM (Pio only)

17
Q

What are CI to TCD?

A

LIVER DZ
CHF
ROSIGLITAZONE BLACK BOX MI/ANGINA!

18
Q

What is the MOA for Acarbose and Miglitol?

A

Inhibit alpha-glucosidases in small intestine  delayed carbohydrate digestion and absorption

19
Q

What are two indications for using alpha glucosidase inhibs?

A

decreases post prandial serum glucose

WEIGHT NEUTRAL

20
Q

Which two drugs are synthetic GLP1 that are resistant to degradation by DPPIV? What are two potential benefits to using these drugs?

A

Exenetide and liraglutide; may increase B cell number and function, slows gastric emptying so it leads to weight loss

21
Q

What is one absolute contraindication for liraglutide use?

A

THYROID CANCER-Black box

22
Q

What is one rare but serious side effect of incretin mimetics?

A

Pancreatitis

23
Q

What is the MOA for DPP-IV inhibs? What are they?

A 
Potentiates effects of incretins by acting as a direct inhibitor of DPP-IV; 
SitaGLIPTIN
SaxaGLIPTIN
LinaGLIPTIN
AloGLIPTIN
24
Q

What are some compelling indications for DPPIV use?

A

to decrease HbA1c and weight neutral

25
Q

What is the MOA for amylin-like peptide Pramlintide?

A

Works with insulin to regulate postprandial glucose by ↓ Gastric emptying without altering the overall absorption of nutrients,
suppression of postprandial glucagon secretion
centrally-mediated modulation of appetite
↓ caloric intake

26
Q

What are two compelling uses for pramlintide?

A

As adjunct to insulin therapy in TYPE 1 and 2

WEIGHT LOSS

27
Q

How is pramlintide administered?

A

SQ injection TID, similar to insulin. post prandial only!

28
Q

What is the MOA of Bromocriptine? What are two benefits to its use?

A

Dopamine agonist; prevents somogyi reaction (MORNING SURGE and ↓ postmeal plasma glucose levels due to enhanced suppression of hepatic glucose production
THIS MEANS IT POTENTIALLY REDUCES THE CARDIOVASCULAR END POINT PROBLEMS IN DIABETICS

29
Q

What are contraindications to bromocriptine use?

A

Pgn and lactation

30
Q

What is the only drug FDA approved for Type 1 DM? What is one FDA drug used off label for Type 1?

A

Pramlintide; acarbose or miglitol

Pharm 2 (11 decks)

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