Diabetes COPY Flashcards
What are the 3 rapid acting insulins
Sketchy: Girls And Lads
Glulisine, Aspart, Lispro
What type of activity does the insulin receptor have?
Tyrosine kinase
What glucose transporter does insulin activity upregulate
Leads to translocation of GLUT4 into cell membranes
What are the effects of insulin in the liver
Increased glucose stored as glycogen
What are the effects of insulin in muscle
Increased glyocogen storage and protein synthesis
Also increased Na+/K+ ATPase, which is what leads to hypokalemia
What are the effects of insulin in fat
Increased triglyceride storage in adipocytes
What insulin is best to treat post-prandial spikes
Short acting insulin (Glulisin, Aspart, Lispro)
What insulin is best at treating DKA
Regular insulin
Is the only one that can be administered IV
What insulin is best at treating hyperkalemia
Regular insulin
What type of drug is NPH
Intermediate acting insulin
Sketchy: Rest Now
regular insulin and NPH
What type of drug is Detemir
Long acting insulin
Sketchy: Don’t Go
What type of drug is Glargine
Long acting insulin
Sketchy: Don’t Go
Sulfonylureas
Sketchy: Swans
MOA:
Closes ATP-dependent K+ channel –> cell depolarizes –> endogenous insulin release
USES:
T2DM (will not work in T1DM)
Adverse effects:
Hypoglycemia
Disulfiram reaction in first generations
Weight gain
What type of drug is Chlorpropamide and Tolbutamide
First generation sulfonylureas
Sketchy: Mother swan in maid outfit “-amide”
What type of drug is Glimepiride, Glyburide, and Glipizide
Second generation sulfonylureas
Sketchy: Goslings “riding” on mother swan
Glipizide = zig-zagging gosling with shortest duration of action
Meglitinides (e.g. Repaglinide, Nateglinide)
Sketchy: Gliding father goose
MOA:
Bind and close K+ channels (similar to sulfonylureas but bind at a different site)
USES:
Type 2 DM
ADVERSE EFFECTS:
Hypoglycemia
Weight gain
Are NOT sulfa drugs
Exanatide and Liraglutide
Sketchy: “-tide” detergent
MOA:
GLP-1 agonist
EFFECTS:
Increase insulin release and decrease glucagon release
USES:
Type 2 DM
Adverse effects:
Increased risk for pancreatitis
Sitagliptin, Saxagliptin, Linagliptin
Sketchy: “-gliptins” clothespins
MOA:
DDP-4 inhibitors
EFFECTS:
Inhibits DDP-4 which usually inactivates GLP-1; leading to increased GLP-1; increased insulin release and decreased glucagon release
USES:
Type 2 DM
Metformin
Sketchy: metaphor
MOA:
Unknown
EFFECTS:
Decreased hepatic gluconeogenesis; Increased peripheral glucose uptake; increased insulin sensitivity
USES:
Type 2 DM
ADVERSE EFFECTS:
GI upset
Lactic acidosis
Weight loss
Thiazolidinediones aka Glitazones
Sketchy: Glitter
MOA:
Increases sensitivity to insulin
Binds to PPAR-y (regulates adiponectin, which enhances insulin sensitivity in fatty acid oxidation)
USES:
Type 2 DM
ADVERSE EFFECTS:
Weight gain
Exacerbation of heart failure (fluid retention)
Risk of fractures
Pramlintide (Amylin analog)
Sketchy: Amy and Lynn
MOA: Amylin is a peptide normally present in insulin secretory granules and secreted along with insulin
EFFECTS:
Decreases gastric emptying and glucagon
USES:
Post-prandial spikes in type I and type 2 DM
ADVERSE EFFECTS:
Hypoglycemia
Nausea
Alpha-glucosidase inhibitors (e.g. Acarbose and Miglitol)
Sketchy: A-carb wigglers
MOA:
Inhibition of a-glucosidase on the intestinal brush border decreases the conversion of disaccharides to absorbable monosaccharides –> delayed carbohydrate absorption
USES:
Type 2 DM
ADVERSE EFFECTS:
Diarrhea, flatulence (due to fermentation of undigested carbs)
SGLT-2 inhibitors (e.g. Canagliflozin, Dapagliflozin)
Sketchy: Flossing teacher and Salty Glucose Co. bag
MOA:
Inhibition of the sodium-glucose cotransporter in the proximal tubule
USES:
Type 2 DM
ADVERSE EFFECTS:
UTI
Vaginal candidiasis
Dehydration
