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systemic pharm > diabetes > Flashcards

diabetes Flashcards

1
Q

what percent of diabetes are type 1 and majority are diagnosed before 20 yo?

A

5%

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2
Q

insulin dependent diabetes

A

type 1

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3
Q

diabetics who are overweight, non white and diagnosed after 40

A

type 2 diabetes

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4
Q

what percent of people with type 2 diabetes are undiagnosed

A

25%

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5
Q

Therapy is aimed at keeping A1-C below ____?

A

7

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6
Q

blood pressure below ______; and LDL cholesterol below _____

A

140/180 AND 100

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7
Q

does arcus ever go away?

A

no there for life

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8
Q

whats the lowest a1c level?

A

6

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9
Q

whats the highest a1c level?

A

10

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10
Q

2 diabetic drug classes

A

oral hypoglycemics

insulin

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11
Q

4 oral therapy drug classes

A
  • Biguanides
    • Sulfonylureas
    • Thiazolinediones / Glitazones
    • DPP-4 Inhibitors
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12
Q

fuel for brain

A

only glucose

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13
Q

why is hypoglycemia dangerous?

A

life threatening –> due to loss of sugar for brain

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14
Q

when metformin is combined with dpp4 inhibitor what do we see?

A

neutral weight loss

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15
Q

MODY

A

maturity onset diabetes of the young; MONOGENIC (unlike the others); autosomal dominant disorder (only requires one gene to be affected)

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16
Q

polygenic and influenced by environment

A

type 1 and type 2 diabetes

17
Q

INDICATION
DM-II, Polycystic Ovary Syndrome (PCOS)
DOSING [500-1000mg]
1 tab bid

A

metformin indication

18
Q

reason why metformin is used for polycystic ovary syndrome

A

similar manifestations to diabetes

19
Q

what organ fails towards end of diabetes

A

renal

20
Q

CLINICAL PHARMACOLOGY
Oral Hypoglycemic, Infertility
Mechanism of Action
Biguanide-based; activates AMP-activated protein kinase (AMPK) which in turn suppresses hepatic gluconeogenesis & intestinal glucose absorption; increases insulin sensitivity

A

metformin moa

21
Q

biguanides are found in diabetic drugs and what else?

A

preservative for cls

22
Q

lactic acidosis from metformin –> mechanism

A

lactic acidosis from metformin –> if m. is in fight and flight –> under hypoxia it produces lactic acid –> liver must spew out more glucose for m. –> but liver refuses to uptake lactate –> therefore no stimulus to produce glucose

23
Q

why do beta blockers mask hypoglycemia?

A

heart slows down –> they dont feel hyperglycemic

blood sugar levels rapidly decrease, if decreased too far brain needs sugar and they could shut down –> diabetic coma

24
Q

metfomin plus what drug makes a pt suffer from hypoglycemic crisis?

A

cyclosporine

25
Q

sympathetic ns role for beta 2 receptor on hepatic

A

glycogenolysis; gluconeogenesis

26
Q

developed as an extension with work done on sulfomide antibiotics

A

sulfonylureas

27
Q 
2nd Generation (succeed 1st gen)
•  Glipizide [Glucotrol®]
•  Glibenclamide / Glyburide
[Micronase®, Diabeta®]
1st Generation
•  Tolbutamide [Orinase®]
•  Chlorpropamide [Diabinese®] (discontinued in usa)
A

types of sulfonylureas

28
Q

INDICATION
DM-II
DOSING [5, 10 mg]
2.5 – 20 mg PO qd - bid

A

glipzide

29
Q

CLINICAL PHARMACOLOGY
Oral Hypoglycemic
Mechanism of Action
Stimulates pancreatic islet beta cell insulin release
Actions involve binding to an ATP-dependent K+ channel: blocked efflux leads to depolarization, Ca++ release and insulin vesicle effusion

A

glipzide moa

30
Q

INDICATION
DM-2
DOSING [15/30/45mg]
1 tab qd

A

pioglitazone

31
Q

2 types of glitazones

A
  • Pioglitazone [Actos®]

* Rosiglitazone [Avandia®]

32
Q

CLINICAL PHARMACOLOGY
Hypoglycemic/Anti-Diabetic
Mechanism of Action
A thiazolidinedione (aka glitazone) insulin sensitizer selectively stimulates nuclear receptor PPAR which increases insulin sensitivity in liver, skeletal muscle and adipose tissue

A

pioglitazone moa

33
Q

regluates amount of glucose released

A

liver

systemic pharm (16 decks)

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