Diabetes

Question 1

Drug interaction btw insulin and which 3 drugs cause hypoglycemia

E-B-S

Answer 1

• Ethanol inhibits gluconeogenesis.
• β-blockers can cause hypoglycemia in diabetic patients by blocking the effects of catecholamines on gluconeogenesis and glycogenolysis. β-blockers also mask the sympathetically-mediated symptoms of hypoglycemia (eg tremor and palpitations).
• Salicylates cause hypoglycemia by enhancing pancreatic β-cell sensitivity to glucose and potentiating insulin secretion. They also have a weak insulin like action in the periphery.

Question 2

List the 4 major classes of Oral Hypoglycemis and the individual drug names

B-a-I-T

Answer 2

***Insulin Secretagogues:

Sulfonylureas (1st and 2nd gen)

• FIRST-GENERATION SULFONYLUREAS*= Chlorpropamide
• SECOND GENERATION SULFONYLUREAS*=

Glyburide (Glibenclamide)

Glipizide

Glimepride

&

Meglitinides: Repaglinide & Nateglinide

***Biguanides= (Metformin)

***Thiazolidinediones (TZDs)=Pioglitazone & Rosiglitazone

***α-Glucosidase Inhibitors= Acarbose

Question 3

SECOND GENERATION SULFONYLUREAS=

Answer 3

Glyburide (Glibenclamide)

Glipizide

Glimepride

Question 4

FIRST-GENERATION SULFONYLUREAS=

Answer 4

Chlorpropamide

Question 5

List the 2 Meglitinides (oral hypoglycemis)

Answer 5

Repaglinide & Nateglinide

Question 6

the only drug in the Biguanide class (oral hypoglycemic)

Answer 6

(Metformin)

Question 7

Thiazolidinediones (TZDs)=

-glitazone

Answer 7

Pioglitazone & Rosiglitazone

Question 8

the only α-Glucosidase Inhibitor (Oral hypoglycemic) discussed in class is called

Answer 8

Acarbose

Question 9

agents have direct effects on peripheral tissues that counter the actions of insulin and cause HYPERglycemia (drug interaction with insulin)

Answer 9

epinephrine

glucocorticoids

atypical antipsychotic drugs (clozapine and olanzapine)

HIV protease inhibitors.

Question 10

these agents cause hyperglycemia by inhibiting insulin secretion directly

(3)

Answer 10

phenytoin

clonidine

Ca2+-channel blockers)

Question 11

these agents cause hyperglycemia indirectly via depletion of K+

Answer 11

(diuretics).

Loop diuretics [Furosemide, bumetanide, torsemide]

Thiazide diuretics [Hydrochlorothiazide, chlorthalidone, metolazone]

Question 12

which oral hypoglycemic drugs are safe to use in soemone wiht renal impairment ? which one is contraindicated if pt has renal impairment?

Answer 12

ok: Glitazones/ thiazolidinediones Pioglitazone & rosiglitazone

not ok: Metformin

Question 13

weight gain is an AE of which 2 oral hypoglycemic drugs?

Answer 13

Sulfonylureas

First generation: chlorpropamide, tolbutamide

Second generation: glimepiride, glipizide, glyburide

Glitazones/ thiazolidinediones (TZDs) Pioglitazone & rosiglitazone

Meglitinides

Nateglinide & repaglinide