Diabetes Flashcards
1
Q
Lispro
- onset
- peak effect
- duration
A
- 0.3-0.5hrs
- 1-2hrs
- 3-4hrs
2
Q
Aspart
- onset
- peak effect
- duration
A
- 0.3-0.5hrs
- 1-2hrs
- 3-4hrs
3
Q
Glulisin
- onset
- peak effect
- duration
A
- 0.3-0.5hrs
- 1-2hrs
- 3-4hrs
4
Q
Insulin
- onset
- peak effect
- duration
A
- 0.5-1hrs
- 2-4hrs
- 5-7hrs
5
Q
NPH, NPL, NPA
- onset
- peak effect
- duration
A
- 1-4hrs
- 4-10hrs
- 14-24hrs
6
Q
Glargine
- onset
- peak effect
- duration
A
- 2-3hrs
- no peak
- > 24hrs
7
Q
Detemir
- onset
- peak effect
- duration
A
- 3-4hrs
- 4-8hrs
- 6-24hrs
8
Q
Which insulin analog has no danger of hypoglycemia
A
glargine
9
Q
Canagliflozin
- mechanism
- side effect
A
SGLT2 inhibitor
- reduce glucose reabsorption in kidney, increase urinary glucose excretion
- UTI’s genital mycotic infection, volume depletion, hyperkalemia, hypersensitivity
10
Q
Dapaglifloxin
- mechanism
- side effect
A
SGLT2 inhibitor
- reduce glucose reabsorption in kidney, increase urinary glucose excretion
- UTI’s genital mycotic infection, volume depletion, hyperkalemia, hypersensitivity
11
Q
Empaglifloxin
- mechanism
- side effect
A
SGLT2 inhibitor
- reduce glucose reabsorption in kidney, increase urinary glucose excretion
- UTI’s genital mycotic infection, volume depletion, hyperkalemia, hypersensitivity
12
Q
Glipizide
- mechanism
- side effects
- *
A
sulfonylureas
- block K+ channels in beta cells > depolarize cell > open Ca channel > Ca enters cell > insulin release
- hypoglycemia (early morning), weight gain, drug interaction due to protein binding, allergies
- *decreased hepatic dysfunction
13
Q
Glypuride
- mechanism
- side effects
- *
A
sulfonylureas
- block K+ channels in beta cells > depolarize cell > open Ca channel > Ca enters cell > insulin release
- hypoglycemia (early morning), weight gain, drug interaction due to protein binding, allergies
- *active metabolite, decreased dose in renal dysfunction
14
Q
Glimepiride
- mechanism
- side effect
A
sulfonylureas
- block K+ channels in beta cells > depolarize cell > open Ca channel > Ca enters cell > insulin release
- hypoglycemia (early morning), weight gain, drug interaction due to protein binding, allergies
15
Q
Name 3 sulfonylureas
A
glimepiride, glypuride, glipizide
16
Q
Metformin
- mechanism
- side effects
A
- decrease postprandial glucose levels w/o causing hypoglycemia or weight gain, may involve increased tissue sensitivity to insulin (bypasses insulin receptor to enter cell and activate TFs) and/or decreased hepatic gluconeogenesis
- lactic acidosis, GI distress (most common)
17
Q
What condition are oral sulfonylureas most effective for
A
Type II only! Type I doesn’t have beta cells for OSU’s to work on
18
Q
Acarbose/Miglitol
- mechanism
- side effect
A
- inhibits alpha-glucosidase in brush borders of sm intestine > decreased formation of absorbable carbohydrate > decreased postprandial glucose > decreased demand for insulin
- GI discomfort, flatulence, diarrhea, potential hepatotoxicity
19
Q
Pioglitazone
- mechanism
- side effect
A
thiazolidinediones
- binds to PPARs involved in transcription of insulin-responsive genes > increased sensitization of tissues to insulin
- less hypoglycemia than OSU’s, weight gain, edema
20
Q
Rosiglitazone
- mechanism
- side effect
A
thiazolidinediones
- binds to PPARs involved in transcription of insulin-responsive genes > increased sensitization of tissues to insulin
- less hypoglycemia than OSU’s, weight gain, edema
21
Q
What DM drugs decrease liver gluconeogenesis (2)
A
Metformin, glitazone
22
Q
What DM drugs increase tissue sensitivity to insulin (3)
A
Glitazone, metformin, bromocriptine
23
Q
What DM drugs increase pancreas production of insulin (2)
A
Repaglinide, OSU’s
24
Q
What DM drugs act in the GI tract to limit uptake of carbs (4)
A
acarbose, miglitol, colesevelam, pramlintide
25
Repaglinide
- mechanism
- side effect
Meglitinide
- closure of ATP-sensitive K channels on beta cells > depolarize cell > open Ca channels > Ca influx > insulin release
- weight gain, hypoglycemia
26
Nateglinide
- mechanism
- side effect
Meglitinide
- closure of ATP-sensitive K channels on beta cells > depolarize cell > open Ca channels > Ca influx > insulin release
- weight gain, hypoglycemia
27
Colesevelam
- mechanism
- side effect
- bile acid sequestrate
| - no hypoglycemia, dizziness/syncope
28
Pramlintide
- mechanism
- side effect
amylin analog
- mimics amylin, slows gastric emptying, suppresses post prandial glucose secretion, reduce appetite
- hypoglycemia
29
Exenatide
- mechanism
- side effect
- long-acting GLP-1 receptor agonst, used in type II DM > augments glucose-dependent insulin secretion
- nausea and hypoglycemia (esp combined w/ OSU's)
30
Liraglutide
- mechanism
- side effect
- long-acting GLP-1 receptor agonst, used in type II DM > augments glucose-dependent insulin secretion
- nausea and hypoglycemia (esp combined w/ OSU's)
31
Albiglutide
- mechanism
- side effect
- long-acting GLP-1 receptor agonst, used in type II DM > augments glucose-dependent insulin secretion
- nausea and hypoglycemia (esp combined w/ OSU's)
32
Dulaglutide
- mechanism
- side effect
- long-acting GLP-1 receptor agonst, used in type II DM > augments glucose-dependent insulin secretion
- nausea and hypoglycemia (esp combined w/ OSU's)
33
Sitagliptin
| -mechanism
-inhibit dipeptidyl peptidase (DPP-4) > inhibit inactivation of GLP-1
34
Alogliptin
| -mechanism
-inhibit dipeptidyl peptidase (DPP-4) > inhibit inactivation of GLP-1
35
Saxagliptin
| -mechanism
-inhibit dipeptidyl peptidase (DPP-4) > inhibit inactivation of GLP-1
36
Linagliptin
| -mechanism
-inhibit dipeptidyl peptidase (DPP-4) > inhibit inactivation of GLP-1
