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Pharmacology II > Diabetes (exam 1) > Flashcards

Diabetes (exam 1) Flashcards

1
Q

parts of the pancreas

A

endocrine
exocrine digestive enzymes

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2
Q

islets of langerhans

A

alpha cells
beta cells
gamma cells
epsilon cells

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3
Q

alpha cells

A

glucagon

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4
Q

beta cells

A

insulin
amylin

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5
Q

gamma cells

A

somatostatin (inhibits release of insulin and glucagon)

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6
Q

epsilon cells

A

gherlin (hunger hormone)

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7
Q

insulin

A

anabolic hormone
promotes glucose uptake, glycogenesis, lipogenesis and protein synthesis of skeletal muscle and fat tissue through tyrosine kinase receptor pathway

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8
Q

insulin counteracts

A

glucagon
epinephrine, glucocorticoid, and growth hormone

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9
Q

types of diabetes

A

type I DM
type 2 DM
gestational diabetes
diabetes insipidus
monogenic diabetes

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10
Q

gestational diabetes

A

develops in some women when they are pregnant
can turn into type II DM

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11
Q

diabetes insipidus

A

causes the body to produce large amounts of urine (up to 20 quarts)

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12
Q

monogenic diabetes

A

result from mutations or changes in a single gene

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13
Q

examples of monogenic diabetes

A

neonatal DM
maturity onset diabetes of the young (MODY)

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14
Q

effects of insulin on the liver

A

increased glycogen synthesis
inhibits gluconeogenesis
inhibits breakdown of fatty acids and AA
inhibits AA conversion to glucose

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15
Q

effects of insulin on skeletal muscle

A

increased protein synthesis
increased AA transport
increased glycogen synthesis
increased glucose transport

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16
Q

effects of insulin on adipose tissue

A

increased TG storage
increased glucose transport

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17
Q

how is hyperglycemia regulated by insulin and glucagon?

A

removal of glucose from the blood
increase storage of glucose

which
decreases blood glucose

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18
Q

how is hypoglycemia regulated by insulin and glucagon?

A

increases gluconeogenesis
decreases glycogen synthesis
increases glycogenolysis

which
increases blood glucose

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19
Q

drugs to treat diabetes mellitus type I

A

rapid acting insulin
short acting insulin
intermediate acting insulin
long acting insulin

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20
Q

Biguanides (metformin) is an example of drugs that

A

primarily lower glucose levels by their action on the liver, muscle and adipose tissue

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21
Q

1st gen sulfonylureas

A

tolbutamide
chlorpropamide
tolazamide

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22
Q

2nd gen sulfonylureas

A

glyburide
glipizide
glimepiride
gliclazide (NA in US)

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23
Q

Meglitinide analogs

A

repaglinide
mitiglinide (NA in US)

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24
Q

meglitinide analog that is a D-Phenylalanine derivative

A

nateglinide (NA in US)

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25
Q

Glucagon-like Peptide-1 (GLP-1) receptor agonists are drugs that

A

mimic incretin effect or prolong incretin action

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26
Q

GLP-1 receptor agonists examples

A

exenatide
liraglutide
albiglutide
dulaglutide

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27
Q

Dipeptidyl peptidase 4 (DPP-4) inhibitors

A

sitagliptin
saxagliptin
linagliptin
alogliptin
vildagliptin (NA in US)

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28
Q

Sodium-glucose CO-transporter 2 (SGLT2) inhibitors

A

canagliflozin
dapagliflozin
empagliflozin
ertugliflozin

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29
Q

thiazolidinediones target

A

peroxisome proliferator activated receptor gamma PPAR-y

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30
Q

examples of thiazolidinediones

A

pioglitazone
rosiglitazone

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31
Q

alpha glucoside inhibitors

A

acarbose
miglitol
voglibose

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32
Q

alpha glucoside inhibitors are drugs that

A

affect absorption of glucose

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33
Q

pramlintide

A

amylin analog

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34
Q

MSC drugs that treat diabetes type II

A

Colesevelam hydrochloride
Bromocriptine

35
Q

type I diabetes mellitus

A

destruction of pancreatic beta cells
autoimmune, genetic, environmental or idiopathic
decreased insulin productin

36
Q

T1DM hallmark sign

A

hypoinsulinemia

37
Q

Type II diabetes mellitus

A

progressive resistance to the effects of insulin
loss of effective signaling in insulin pathway

38
Q

T2DM hallmark sign

A

hyperinsulinemia

can progress to hypoinsulinemia

39
Q

diabetes mellitus can lead to

A

diabetic nephropathy
diabetic retinopathy
diabetic neuropathy
cardiovascular disease
peripheral vascular disease

40
Q

which type of DM is prone to ketoacidosis?

A

T1DM

41
Q

in regards to insulin deficiency, type 1 diabetes is _____________ while type 2 diabetes is _________________

A

absolute insulin deficiency

relative insulin deficiency and/or insulin resistance

42
Q

which type of diabetes is the pancreas damaged due to autoimmune attack?

A

Type 1 DM

43
Q

which type of diabetes has HLA association?

A

Type 1 DM

44
Q

treatment for type 1 diabetes?

type 2?

A

1: insulin injections

2: diet, exercise, hypoglycemic tablets, insulin injections, nutrition

45
Q

typical weight of people with type 1 diabetes?

type 2?

A

1: normal/thin

2: obese

46
Q

in which type of diabetes is insulin administration required for survival?

A

type 1 DM

47
Q

key points about beta cell dysfunction in T2DM

A

insulin resistance
beta cell exhaustion
decreased beta cell mass
impaired glucose sensing
genetic factors

48
Q

type 1 diabetes is considered a ______________ disorder

A

autoimmune

49
Q

risk of developing T1DM is increased by certain variants of HLA: _______________. these genes provide instructions for __________________. These genes also belong to a family called the ___________

A

DQA1, DQB1 and DRB1

making proteins that play a critical role in the immune system

human leukocyte antigen (HLA) complex

50
Q

diabetic retinopathy

A

tiny blood vessels leak fluid into the retina

51
Q

diabetic retinopathy signs/symptoms in the eye

A

abnormal blood vessels
aneurysm
hemorrhages
cotton wool spots

52
Q

diabetic nephropathy outcomes

A

glomerular hypertrophy
mesangial expansion
tubulo-interstitial fibrosis and inflammation
glomerulosclerosis
kidney fibrosis

53
Q

diabetic neuropathy

A

weaker, degenerated blood vessels lead to inadequate nutrition and nerves become dysfunctional

54
Q

GLUTs

A

glucose transporters
sodium independent
GLUT1-4

55
Q

GLUT2

A

liver
pancreatic beta cells
insulin independent

56
Q

GLUT4

A

skeletal muscle
adipocytes
insulin dependent

57
Q

SGLTs

A

sodium glucose cotransporters
sodium dependent
SGLT1-2

58
Q

SGLT1

A

major intestinal glucose transporter
10% renal glucose transport

59
Q

SGLT2

A

major renal glucose transporter
90% renal glucose transport

60
Q

5’ AMP-activated protein kinase (AMPK)

A

pathway in response to glucose starvation
activated by low energy status (ATP/ADP ratio)
acts as an enzyme that works as a fuel gauge

61
Q

which drug effects the AMPK pathway?

A

metformin and thiazolidinediones

62
Q

activation of AMPK pathway leads to

A

sk muscle: glucose uptake, fatty acid oxidation
heart: glucose uptake, fatty acid oxidation, glycolysis
hypothalamus: food intake

63
Q

inhibition of the AMPK pathway leads to

A

liver: fatty acid synthesis, gluconeogenesis
adipose: fatty acid synthesis, lipolysis
pancreas: insulin release

64
Q

glucose is transported into beta cells through

A

facilitated diffusion of the GLUT2 glucose transporters

65
Q

once glucose is metabolized into _________ in the beta cells, it elevates the ______________ which closes ________________ leading to ________________-

A

ATP

ATP/ADP ratio

KATP channels

cell membrane depolorization

66
Q

after KATP channels are closed in beta cells, what channels are opened and what is the effect?

A

voltage dependent Ca channels (VDCC)

Ca influx into cell

67
Q

what triggers exocytosis of insulin out of the beta cell?

A

rise in free systolic Ca

68
Q

insulin mRNA is translated as a single chain precursor called

A

pre-proinsulin

69
Q

how is proinsulin formed?

A

removal of signal peptide from pre-proinsulin during insertion into the ER

70
Q

3 domains of proinsulin

A

amino-terminal B chain
carboxy-terminal A chain
connecting peptide C peptide

71
Q

how is the mature form of insulin made?

A

proinsulin is exposed to endopeptidases inside ER which excise the C peptide

72
Q

Insulin and free C peptide are packaged into ___________ into secretory granules which ________________

A

the Golgi

accumulate in the cytoplasm

73
Q

on stimulation, beta cells secrets ________________ via exocytosis

A

insulin and C peptide

74
Q

C peptide has no

A

known biological activity

75
Q

incretins functions

A

amplify glucose dependent insulin release
inhibits glucagon release

76
Q

incretins

A

gut derived protein factors that increase glucose stimulated insulin secretion

77
Q

where is GLP-1 produced?

A

by L cells of distal small intestine and pancreatic alpha cells

78
Q

where is GIP produced?

A

K cells in GI tract

79
Q

GLP-1 ____________ gastric emptying which GIP has _____________ on gastric emptying

A

inhibits

minimal effect

80
Q

GLP-1 stimulates

A

beta cell growth

81
Q

both GLP-1 and GIP stimulates __________ and their release is stimulated by ________________

A

glucose dependent insulin release

glucose and nutrients in GI tract

82
Q

because GLP-1 reduces food intake, there is a reduction in

A

body weight (SKINNYYYY)

83
Q

GLP-1 also suppresses

A

hepatic glucose output

84
Q

when a regular person is fasting, the insulin level is

A

less than 25 mIU/L

Pharmacology II (5 decks)

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