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Pharmacology > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Lispro (class, mechanism [3], use, risks [3])?

A

Class: Rapid acting insulin prep
Mechanism: Binds insulin receptor (tyrosine kinase) rapidly.
- Liver = ↑ glucose stored as glycogen
- Muscle = ↑ glycogen and protein synthesis & ↑ K+ uptake
- Fat = ↑ TG storage
Use: Postprandial glucose control in Type 1 DM, Type 2 DM, GDM
Risks: Hypoglycemia, lipodystrophy, rare hypersensitivity reactions

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2
Q

Regular Insulin (class, use [3], risks)?

A 
Class: Short acting insulin prep
Use: 
- Type 1 DM, Type 2 DM, GDM
- Diabetic Ketoacidosis (give IV)
*In DKA, no insulin to take up the high serum glucose levels
- Hyperkalemia (+ glucose)
- Stress hyperglycemia
Risks: Hypoglycemia, lipodystrophy, rare hypersensitivity reactions
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3
Q

NPH (class, use, risks)?

A

Class: Intermediate acting insulin prep
Use: Type 1 DM, Type 2 DM, GDM
Risks: Hypoglycemia, lipodystrophy, rare hypersensitivity reactions

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4
Q

Detemir (class, use, risks)?

A

Class: Long acting insulin prep
Use: Basal glucose control in Type 1 DM, Type 2 DM, GDM
Risks: Hypoglycemia, lipodystrophy, rare hypersensitivity reactions

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5
Q

Metformin (class, mechanism [3], mode, use, side effect, risks [2])?

A

Class: Biguanide
Mechanism: ↓ gluconeogenesis, ↑ glycolysis, ↑ peripheral glucose uptake (due to ↑ insulin sensitivity)
Mode: Oral
Use: First-line therapy in type 2 DM
***Can be used in patients without islet function.
Side effect: Causes modest weight loss
Risks:
- GI upset
- Most serious is lactic acidosis (thus contraindicated in renal insufficiency).

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6
Q

Chlorpropamide (class, mechanism, use, risks [3])?

A

Class: 1st gen Sulfonylurea
Mechanism: Close K+ channel in β-cell
membrane →Ž cell depolarizes → insulin release via Ca+2 influx.
Use: Stimulate release of endogenous insulin in type 2 DM (useless in type 1 DM)
Risks:
- Risk of hypoglycemia ↑ in renal failure
- Weight gain.
- Disulfiram-like effects.

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7
Q

Glimepiride (class, mechanism, use, risks [3])?

A

Class: 2nd gen Sulfonylurea
Mechanism: Close K+ channel in β-cell
membrane →Ž cell depolarizes → insulin release via Ca+2 influx.
Use: Stimulate release of endogenous insulin in type 2 DM (useless in type 1 DM)
Risks:
- Risk of hypoglycemia ↑ in renal failure
- Weight gain.
- Hypoglycemia

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8
Q

Nateglinide (class, mechanism, use [2], risks [2])?

A

Class: Meglitinides
Mechanism: Stimulate postprandial insulin
release by binding to K+ channels on β-cell membranes (site differs from sulfonylureas).
Use:
- Monotherapy in DM2 or combined with Metformin
- Are NOT sulfa drugs (as are sulfonylureas)
Risks:
- Hypoglycemia (↑ risk in renal failure)
- Weight gain

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9
Q

Exenatide (class, mechanism [4], use, risks [4], note)?

A 
Class: GLP-1 analog
Mechanism: 
- ↑ Glucose-dependent insulin release
- ↓ Glucagon release
- ↓ Gastric emptying
- ↑ Satiety.
Use: Type 2 DM
Risks:
- Nausea
- Vomiting
- Pancreatitis
- Modest weight loss
Note: Does NOT cause hypoglycemia
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10
Q

Linagliptin (class, mechanism [5], use, risks, notes [2])?

A 
Class: DPP-4 inhibitors
Mechanism: 
- Inhibits DPP-4 enzyme that deactivates GLP-1
- ↑ Glucose-dependent insulin release
- ↓ Glucagon release
- ↓ Gastric emptying
- ↑ Satiety.
Use: Type 2 DM
Risks:
- Urinary or Respiratory infections
Notes:
- Weight neutral
- Does NOT cause hypoglycemia
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11
Q

Aspart (class, mechanism [3], use, risks [3])?

A

Class: Rapid acting insulin prep
Mechanism: Binds insulin receptor (tyrosine kinase) rapidly.
- Liver = ↑ glucose stored as glycogen
- Muscle = ↑ glycogen and protein synthesis & ↑ K+ uptake
- Fat = ↑ TG storage
Use: Postprandial glucose control in Type 1 DM, Type 2 DM, GDM
Risks: Hypoglycemia, lipodystrophy, rare hypersensitivity reactions

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12
Q

Glargine (class, use, risks)?

A

Class: Long acting insulin prep
Use: Basal glucose control in Type 1 DM, Type 2 DM, GDM
Risks: Hypoglycemia, lipodystrophy, rare hypersensitivity reactions

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13
Q

Tolbutamide (class, mechanism, use, risks [3])?

A

Class: 1st gen Sulfonylurea
Mechanism: Close K+ channel in β-cell
membrane →Ž cell depolarizes → insulin release via Ca+2 influx.
Use: Stimulate release of endogenous insulin in type 2 DM (useless in type 1 DM)
Risks:
- Risk of hypoglycemia ↑ in renal failure
- Weight gain.
- Disulfiram-like effects.

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14
Q

Glipizide (class, mechanism, use, risks [3])?

A

Class: 2nd gen Sulfonylurea
Mechanism: Close K+ channel in β-cell
membrane →Ž cell depolarizes → insulin release via Ca+2 influx.
Use: Stimulate release of endogenous insulin in type 2 DM (useless in type 1 DM)
Risks:
- Risk of hypoglycemia ↑ in renal failure
- Weight gain.
- Hypoglycemia

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15
Q

Repaglinide (class, mechanism, use [2], risks [2])?

A

Class: Meglitinides
Mechanism: Stimulate postprandial insulin
release by binding to K+ channels on β-cell membranes (site differs from sulfonylureas).
Use:
- Monotherapy in DM2 or combined with Metformin
- Are NOT sulfa drugs (as are sulfonylureas)
Risks:
- Hypoglycemia (↑ risk in renal failure)
- Weight gain

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16
Q

Liraglutide (class, mechanism [4], use, risks [4], note)?

A 
Class: GLP-1 analog
Mechanism: 
- ↑ Glucose-dependent insulin release
- ↓ Glucagon release
- ↓ Gastric emptying
- ↑ Satiety.
Use: Type 2 DM
Risks:
- Nausea
- Vomiting
- Pancreatitis
- Modest weight loss
Note: Does NOT cause hypoglycemia
17
Q

Saxagliptin (class, mechanism [5], use, risks, notes [2])?

A 
Class: DPP-4 inhibitors
Mechanism: 
- Inhibits DPP-4 enzyme that deactivates GLP-1
- ↑ Glucose-dependent insulin release
- ↓ Glucagon release
- ↓ Gastric emptying
- ↑ Satiety.
Use: Type 2 DM
Risks:
- Urinary or Respiratory infections
Notes:
- Weight neutral
- Does NOT cause hypoglycemia
18
Q

Glulisine (class, mechanism [3], use, risks [3])?

A

Class: Rapid acting insulin prep
Mechanism: Binds insulin receptor (tyrosine kinase) rapidly.
- Liver = ↑ glucose stored as glycogen
- Muscle = ↑ glycogen and protein synthesis & ↑ K+ uptake
- Fat = ↑ TG storage
Use: Postprandial glucose control in Type 1 DM, Type 2 DM, GDM
Risks: Hypoglycemia, lipodystrophy, rare hypersensitivity reactions

19
Q

Glyburide (class, mechanism, use, risks [3])?

A

Class: 2nd gen Sulfonylurea
Mechanism: Close K+ channel in β-cell
membrane →Ž cell depolarizes → insulin release via Ca+2 influx.
Use: Stimulate release of endogenous insulin in type 2 DM (useless in type 1 DM)
Risks:
- Risk of hypoglycemia ↑ in renal failure
- Weight gain.
- Hypoglycemia

20
Q

Sitagliptin (class, mechanism [5], use, risks, notes [2])?

A 
Class: DPP-4 inhibitors
Mechanism: 
- Inhibits DPP-4 enzyme that deactivates GLP-1
- ↑ Glucose-dependent insulin release
- ↓ Glucagon release
- ↓ Gastric emptying
- ↑ Satiety.
Use: Type 2 DM
Risks:
- Urinary or Respiratory infections
Notes:
- Weight neutral
- Does NOT cause hypoglycemia

Pharmacology (5 decks)

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