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Pharm > Diabetes Meds > Flashcards

Diabetes Meds Flashcards

1
Q

Where is insulin secreted from and in what amount?

A
  • synthesized and stored bound to zinc in granules in the B-islet cells of the pancreas
  • 60 units/day (25% total content)
  • continuously released + additional increases following carbohydrate ingestion
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2
Q

Describe how high blood glucose stimulates insulin release:

A
  • glucose enters B-cell via GLUT-2 transporter
  • converted to ATP via oxidation
  • closes ATP-sensitive K+ channel causing depolarization
  • Ca2+ enters cell
  • insulin is secreted
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3
Q

GLP-1 stands for…

A

glucagon-like peptide-1

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4
Q

GIP stands for…

A

glucose-dependent insulinotropic peptide

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5
Q

DPP-4 stands for…

A

dipeptidyl peptidase

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6
Q

Describe the incretin effect:

A

GLP-1 and GIP are released from specialized neuroendocrine cells of the small bowel –> stimulate insulin release

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7
Q

What is the function of DPP-4?

A

rapidly inactivates GLP-1 and GIP

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8
Q

How is the incretin response affected by type 2 DM?

A

type 2 DM blunts the incretin response and GIP becomes ineffective in stimulating insulin release

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9
Q

List the 4 hormones that increase serum glucose:

A

1) cortisol
2) catecholamines
3) glucagon
4) growth hormone

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10
Q

List the 4 peptides that stimulate insulin release:

A

1) glucagon-like peptide-1 (GLP-1)
2) glucose-dependent insulinotropic peptide (GIP)
3) pituitary adenylate cyclase-activating polypeptide (PACAP)
4) vasoactive intestinal peptide (VIP)

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11
Q

Action of insulin on muscle:

A
  • anabolic hormone enhancing protein synthesis and decreasing protein breakdown
  • glucose transport into muscle using GLUT-4 transporter
  • glycogen synthesis and storage
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12
Q

Action of insulin on fat:

A
  • increases fatty acid and triglyceride uptake into adipose tissues (lowers plasma FA levels)
  • increased glucose transport into fat cells using GLUT-4 transporter
  • inhibits fat breakdown
  • increased clearance of ketone bodies
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13
Q

Which 3 types of tissues do not require insulin for transportation of glucose?

A
  • brain
  • liver
  • kidney
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14
Q

Action of insulin on liver:

A
  • increased synthesis of glycogen in liver
  • inhibited gluconeogenesis, glycogenolysis, and ketogenesis
  • excess glucose converted to FFA
  • synthesis of FFA and glycerol into triglycerides for fat storage
  • increased protein synthesis from amino acids
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15
Q

Action of insulin on electrolytes:

A
  • increases K+ uptake into cells
  • increase renal Na+ retention
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16
Q

Action of insulin on brain:

A
  • stimulates memory
  • controls appetite
17
Q

Action of insulin on cardiovascular system:

A

vasodilatory properties

18
Q

Summary of insulin effects on the body:

A
  • increase glucose update
  • increase glycolysis
  • increase protein synthesis
  • increase lipogenesis
  • decrease gluconeogenesis
  • decrease lipolysis
  • decrease proteolysis
19
Q

Diabetes diagnosis A1C, fasting BG test, and GTT:

A

A1C = 6.5%+
FBG = 126 mg/dL+
GTT = 200 mg/dL+

20
Q

Prediabetes diagnosis A1C, FBGT, and GTT:

A
  • A1C = 5.7-6.4%
  • FBG = 100-125 mg/dL
  • GTT = 140-199 mg/dL
21
Q

Normal A1C, FBGT, and GTT:

A
  • A1C = <5.7%
  • FBG = <99 mg/dL
  • GTT = <140 mg/dL
22
Q

Lifestyle r/f type 2 DM:

A
  • high carbohydrate intake
  • metabolic syndrome
  • inactivity
  • obesity
  • HTN
  • high cholesterol
23
Q

What is a HgA1C?

A
  • glycosylated hemoglobin
  • amount of glucose combined with Hgb is directly proportion to the total amount of sugar in the body
  • useful tool in measuring long-term glucose control d/t life span of rbc = 8-12 weeks
  • goal is <6.5%
24
Q

Diabetic complications:

A
  • Alzheimer’s dz
  • nerve damage
  • eye damage
  • hearing impairment
  • dental problems
  • cardio/cerebro/vascular dz
  • kidney damage
  • extremity damage
  • skin conditions r/t poor wound healing
25
Q

Hierarchy of DMII treatment:

A
  • diet & lifestyle mgmt
  • monotherapy with PO agent
  • combination therapy with PO agents
  • insulin/injection therapy alone or combo
26
Q

What was the first type of oral diabetic agent?

A

sulfonylureas (1955)

27
Q

5 types of glucose lowering medications:

A

1) secretagogues (increase endogenous insulin release)
2) insulin sensitizers (reduce insulin resistance)
3) dopamine agonist (increase early morning dopamine levels)
4) agents that reduce glucose absorption
5) agents that inhibit glucagon secretion

28
Q

Sulfonylurea candidates…

A
  • must have 30% normal B-cell function
  • cannot be overweight
  • may have an intolerance to Metformin
29
Q

Most commonly prescribed diabetes medications:

A

1 biguanides (Metformin)

#2 insulin analogs
#3 sulfolnylureas

Pharm (19 decks)

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