Diabetes - Biochemistry and Pharmacology Flashcards
what is the precursor molecule of
- modified amino acid hormones?
- steroid hormones?
- tyramine
2. cholesterol
describe the release of modified AA/ peptides / protein hormones
- made through conversion from tyrosine / breakdown of larger protein
- stored in vesicles
- Ca dependent exocytosis
- travel free in the plasma
what is the key intermediate stage in steroid hormone production?
pregnenolone
where is cortisol broken down? (3)
site of action
liver
kidneys
what does albumin mostly carry? (2)
steroid hormones
sometimes thyroxine
what does transthyretin mostly carry? (2)
thyroxine
sometimes steroids
what it the trade name for ultra long acting insulin? why is it called this?
Insulin Glargine
the ARG and ARG are swapped / added?
what is the trade name for short fast acting insulin? why is it called this?
Insulin Lispro
LYS and PRO are switched
what stage of the insulin pathway do sulfonylureas act?
cause depolarisation to trigger Ca to open.
they aren’t appropriate in T1 because they work on working B cells.
sally has just started on a new drug, and she now has feels nauseas, has diarrhoea and a metallic tasting mouth. why?
started on metformin - the main Biguanide.
jim has heart failure and newly diagnosed diabetes. what 2 drugs should be avoided?
Metformin and pioglitazone. Avoid using thiazides/ corticosteroids with SUs.
what drug class are chlorpropamide and tolbutamide??
sulfonylureas
what is the somogyi effect?
hyperglycaemia with insulin due to an excessive response to a slight hypoglucaemia.
good drug for diabetics with NAFLD?
pioglitazone (TZD)
why can 1/3rd of the population not tolerate metformin?
it can cause lactic acidosis
what is glipizide
a sulphonylurea drug
what is gliclazide?
a sulphonylurea drug
what is leptin?
hormone made by adipose cells that inhibits hunger
what happens to leptin sensitivity in obesity?
decreased sensitivity - you cant detect being full
what does orlistat do?
blocks fat absorption by inhibiting lipases (fat breakdown enzymes).
lots of undigested fat is excreted
what is “adaptive thermogenesis” ???
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
how do adipocytes attract macrophages?
by releasing “adipokines”
what 2 drugs cause weight gain?
GLP1 analogues
Sulphonylureas
as well as insulin, what 2 drugs cause hypoglycaemia?
GLP1 analogues and SUs
the same drugs that cause weight gain!!
what drug causes UTIs and thrush, and how?
Gliflozins - SGLT2 inhibitors - through increased renal excretion of glucose in urine
what are the gliflozins? 2 examples
SGLT2 inhibtiros = canagliflozin and dapagliflozin
what are the gliptins? an example?
DPP4 inhibitors - Sitagliptin
