Diabetes Flashcards
Four factors that increase insulin release
Glucose, sulfonylureas, M-agonists, B2-agonist
IV forms of insulin
Lispro and regular
Long-acting insulin with no peak
Glargine
Mechanism of action: Insulin
binds transmembrane receptors–>tyrosine kinase–> phosphorylate tissue-specific substrates
Does a-2 agonist cause hyper- or hypoglycemia
↓ insulin resistance–>hyperglycemia
Symptoms of DKA
polyuria, polydipsia, nausea, fatigue, dehydration, Kussmaul breathing, fruity breath
Symptoms of hypoglycemia
lip/tongue tingling, lethargy, confusion, sweats, tremors, tachycardia, coma, seizures
Mechanism of action: Glucose
Enters Beta cell via GLUT2–> glycolysis produces ATP–> ATP closes K channels–> cell depolarizes–> Ca channels open–> insulin release
Mechanism of action: Sulfonylureas
Blocks K channels–> depolarization–> insulin release, ↓glucagon release and ↑insulin receptor sensitivity
First generation oral sulfonylureas (OSU)
Acetohexamide, Tolbutamide, Chlorpropamide
Acetohexamide: Class and unique properties
FG OSU; active metabolite (long duration), need to ↓ dose in renal dysfxn
Tolbutamide: Class and unique properties
FG OSU; appropriate in renal dysfxn
Chlorpropamide: Class and unique properties
long-acting, SIADH/disulfiram reactions
Second generation OSU
Glipizide and Glyburide
Glipizide: Class and unique properties
need to ↓ dose in hepatic dysfuntion
Glyburide: Class and unique properties
active metabolite, need to ↓ dose in renal dysfunction
SE’s of OSU’s
hypoglycemia, weight gain, drug interactions w/cimetidine, insulin, salicylates and sulfonamides