Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology- Katzung (Spring 2019) > Diabetes mellitus 2 > Flashcards

Diabetes mellitus 2 Flashcards

1
Q

Biguanide antidiabetic drugs

A

Metformin

Phenformin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Metformin - MoA

A

Decreases hepatic glucose output and glucose absorption from the gut. Reduces expression of genes for gluconeogenesis enzymes. Increases insulin sensitivity. Increases glucose uptake and usage in skeletal muscle & adipose tissue. Does NOT stimulate insulin secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Metformin - Clinical use

A

DM2 (1st line) esp obese pt with insulin resistance, or with hyperlipideamia
Prediabetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Metformin - Special consideration and contraindications

A

May enable loss of weight
Duration of action: 18h
Used alone or in comb with a sulfonylurea, meglitinide, alpha gucosidase inh or incretin mimetic.
Contraind: renal/hepatic disease, alcoholism, predisposition for lactic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Metformin - Adverse effects

A

GI disturbances: diarrhea (30%)
Lactic acidosis (rare)
Weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Metformin - Interactions

A

Cimetidine can inhibit metabolism of metformin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Phenformin - MoA

A

Binds to mitochondria and interfere with glucose oxidation –>lactic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Phenformin - Special consideration and adverse effects

A

NOT used: fatal lactic acidosis as risk!

Adverse: lactic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Thiazolidinediones

A

Pioglitazone

Rosiglitazone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Thiazolidinediones - MoA

A

Agonists of peroxisome proliferator-activated receptor-γ (PPAR- γ). Increases transcription of insulin responsive genes that control glucose metabolism (GLUT-4 transporters). Results in increased insulin sensitivity and decreased insulin resistance. Suppress hepatic glucose output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Thiazolidinediones - Clinical use

A

Adjunct to diet & exercise for DM2. Pt unwilling to use injectable agents.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Thiazolidinediones - Special considerations and Contraindications

A

Oral adm.
Greater effect on skeletal muscle and adipose tissue, lesser on liver.

Contraind: heart failure risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Thiazolidinediones - Adverse effects

A

Edema, increased risk of heart failure
Increased body weight
Decrease bone mineral density, increases risk of osteoporosis and fractures in older women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pioglitazone - MoA

A

Partial PPAR-receptor agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pioglitazone - Clinical use

A

DM2 who cannot control disease with other oral drugs/unwilling to use insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Pioglitazone - Special considerations

A

Increased HDL and decreased triglycerides in serum more than rosiglitazone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Pioglitazone - Adverse effects

A

18 % risk of MI, stroke or death

Study: increased risk of bladder cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Rosiglitazone - MoA

A

Full PPAR-receptor agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Rosiglitazone - Special considerations

A

Increased LDL in serum more than pioglitazone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Rosiglitazone - Adverse effects

A

Increased risk for MI 43%.

Increased Cardiovascular death risk 64%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

α-Glucosidase inhibitors

A

Acarbose

Miglitol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

α-Glucosidase inhibitors - MoA

A

Competitive inhibition of α-Glucosidase, delaying starch and disaccharide digestion. Also decreases glucose absorption. Decreases postprandial hyperglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

α-Glucosidase inhibitors - Clinical use

A

DM2 (usually in combo with other oral antidiabetic)

24
Q

α-Glucosidase inhibitors - Special consideration

A

Adm at first bite of meal.

25
Q

α-Glucosidase inhibitors - Adverse effects

A

Increased Flatulence, abd bloating

26
Q

Acarbose - Interactions

A

Increases bioavailability of metformin

27
Q

Miglitol - Interactions

A

Decreased Iron absorption

Decreased Absorption of ranitidine and propranolol

28
Q

GLP-1 mimetics

A 
Exenatide
Liraglutide
Albiglutide
Dulaglutide
Lixisenatide
29
Q

Incretin mimetics - MoA

A

Enhances effect of glucagon-like peptide-1 (GLP-1)

Stimulation of glucose-dependent insulin secretion, increased uptake of glucose by muscle and fat tissue, decreased glucagon secretion, slowed gastric emptying, increased satiety, and decreased food intake.

30
Q

Incretin mimetics - Clinical use

A

DIA2, comb with sulfonylurea or metformin –> improve A1C values and decreases body weight.

31
Q

Exenatide - Special consideration

A

Adm subcutn twice daily.
Once weekly injection.
Monitor for abd pain

32
Q

Exenatide - Adverse effects

A

Mild-moderate nausea, pancreatitis (pt with hypertriglycidemia/ gallstones). Abdominal pain

33
Q

Liraglutide and Albiglutide - Administration

A

Adm subc once daily

34
Q

Liraglutide - Adverse effects

A

Dose-dependent & treatment-duration-dependent thyroid C-cell tumor (study).
Increased Risk for pancreatitis

35
Q

Once weekly injected drugs

A

Exenatide, Albiglutide, Dulaglutide

36
Q

DPP-4 inhibitors

A

Sitagliptin
Linagliptin
Saxagliptin

37
Q

DPP-4 inhibitors - MoA

A

Increases GLP-1 levels: Stimulation of glucose-dependent insulin secretion, increased uptake of glucose by muscle and fat tissue, decreased glucagon secretion, slowed gastric emptying, increased satiety, and decreased food intake.

38
Q

DPP-4 inhibitors- Clincal use

A

DM2: improve glycemic control

39
Q

DPP-4 inhibitors- Special consideration

A

Well suited for old, frail people

Once daily oral adm

40
Q

DPP-4 inhibitors - Adverse effects

A

Joint and skeletal muscle pain
Nasopharyngitis
Rhinitis

41
Q

Sodium-glucose cotransporter 1 inhibitors

A

Canagliflozin
Dapagliflozin
Empagliflozin

42
Q

SGLT inhibitors - MoA

A

Inhibit SGL2: Decreased renal glucose reabsorption, Increased urinary glucose excretion, and lower blood glucose.

43
Q

SGLT inhibitors - Special consideration and Cotraindication

A

Efficacy dependent of glomerular filtration. Contraindication: pt with GFR <50mL/min

44
Q

SGLT inhibitors - Adverse effects

A

Weight loss, lower BP.
Increased incidence of UTI and genital yeast infections (because increased urinary glucose and facilitate growth of bacteria).
Volume depletion
Diabetic ketoacidosis
increased risk of osteoporosis and bone fractures (increased urinary calcium excretion)

45
Q

Canagliflozin and Dapagliflozin - Contraindication

A

Dehydration, heart failure, low BP, taking diuretics and ACE inhibitor.

46
Q

Canagliflozin and Dapagliflozin - Adverse effects

A

Acute renal injury (azotemia)

47
Q

Empagliflozin - Special consideration

A

Reduces progression to renal disease in DIA2 with high risk of cardiovascular event.

48
Q

Amylin analogue

A

Pramlintide acetate

49
Q

Amylin analogue - MoA

A

Antihyperglycemic effect
Decreases Rate of rise of blood glucose by slowing gastric emptying (Slows the rate at which food is delivered from the stomach to the intestines ), suppressing glucagon secretion and glucose output by the liver, Decreases appetite –> weight loss

50
Q

Amylin analogue - Clinical use

A

Weight loss and glycemic control in DM.

DM1 and DM2 on insulin treatment.

51
Q

Pramlintide acetate - Adverse effect

A

Hypoglycemia (esp in coadministration with insulin)

Nausea, anorexia, headache

52
Q

Dopamine agonist

A

Bromocriptine

53
Q

Bromocriptine - MoA

A

Resets disturbed circadian rhythm and reduces hepatic glucose output and serum triglycerides and free fatty acids.

54
Q

Bromocriptine- Clincal use

A

Hyperprolactinemia, Parkinson disease.

Study: Decreases insulin resistance and A1C

55
Q

Bromocriptine - Special consideration

A

Decreased Dopamine cause disturbances in circadian rhythm and can lead to insulin resistance, obesity and diabetes.
Should be taken with food

56
Q

Dopamine - Adverse effects

Pharmacology- Katzung (Spring 2019) (52 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions