Diabetes - Biochemistry and Pharmacology

Question 1

what is the precursor molecule of

1. modified amino acid hormones?
2. steroid hormones?

Answer 1

1. tyramine

2. cholesterol

Question 2

describe the release of modified AA/ peptides / protein hormones

Answer 2

1. made through conversion from tyrosine / breakdown of larger protein
2. stored in vesicles
3. Ca dependent exocytosis
4. travel free in the plasma

Question 3

what is the key intermediate stage in steroid hormone production?

Answer 3

pregnenolone

Question 4

where is cortisol broken down? (3)

Answer 4

site of action
liver
kidneys

Question 5

what does albumin mostly carry? (2)

Answer 5

steroid hormones

sometimes thyroxine

Question 6

what does transthyretin mostly carry? (2)

Answer 6

thyroxine

sometimes steroids

Question 7

what it the trade name for ultra long acting insulin? why is it called this?

Answer 7

Insulin Glargine

the ARG and ARG are swapped / added?

Question 8

what is the trade name for short fast acting insulin? why is it called this?

Answer 8

Insulin Lispro

LYS and PRO are switched

Question 9

what stage of the insulin pathway do sulfonylureas act?

Answer 9

cause depolarisation to trigger Ca to open.

they aren’t appropriate in T1 because they work on working B cells.

Question 10

sally has just started on a new drug, and she now has feels nauseas, has diarrhoea and a metallic tasting mouth. why?

Answer 10

started on metformin - the main Biguanide.

Question 11

jim has heart failure and newly diagnosed diabetes. what 2 drugs should be avoided?

Answer 11

Metformin and pioglitazone. Avoid using thiazides/ corticosteroids with SUs.

Question 12

what drug class are chlorpropamide and tolbutamide??

Answer 12

sulfonylureas

Question 13

what is the somogyi effect?

Answer 13

hyperglycaemia with insulin due to an excessive response to a slight hypoglucaemia.

Question 14

good drug for diabetics with NAFLD?

Answer 14

pioglitazone (TZD)

Question 15

why can 1/3rd of the population not tolerate metformin?

Answer 15

it can cause lactic acidosis

Question 16

what is glipizide

Answer 16

a sulphonylurea drug

Question 17

what is gliclazide?

Answer 17

a sulphonylurea drug

Question 18

what is leptin?

Answer 18

hormone made by adipose cells that inhibits hunger

Question 19

what happens to leptin sensitivity in obesity?

Answer 19

decreased sensitivity - you cant detect being full

Question 20

what does orlistat do?

Answer 20

blocks fat absorption by inhibiting lipases (fat breakdown enzymes).

lots of undigested fat is excreted

Question 21

what is “adaptive thermogenesis” ???

Answer 21

slowing of the resting metabolic rate caused by weight loss - the body wants to retain its mass. makes weight loss hard.
RMR is high in fat people

Question 22

how do adipocytes attract macrophages?

Answer 22

by releasing “adipokines”

Question 23

what 2 drugs cause weight gain?

Answer 23

GLP1 analogues

Sulphonylureas

Question 24

as well as insulin, what 2 drugs cause hypoglycaemia?

Answer 24

GLP1 analogues and SUs

the same drugs that cause weight gain!!

Question 25

what drug causes UTIs and thrush, and how?

Answer 25

Gliflozins - SGLT2 inhibitors - through increased renal excretion of glucose in urine

Question 26

what are the gliflozins? 2 examples

Answer 26

SGLT2 inhibtiros = canagliflozin and dapagliflozin

Question 27

what are the gliptins? an example?

Answer 27

DPP4 inhibitors - Sitagliptin