Diabetes Oral Meds

Question 1

All drugs except ___ are used for type II diabetes only

Answer 1

insulin

Question 2

Only __ and __ are usable during pregnancy

Answer 2

Glyburide; metformin

Question 3

__ is generally the first drug of choie

Answer 3

Metformin

Question 4

___ should not be used with meglitinides

Answer 4

sulfonylureas

Question 5

__ decreases gluconeogenesis at the liver

Answer 5

Metformin

Question 6

4 advantageous actions of diabetes drugs

Answer 6

injectable v. pill
frequency of delivery
no hypoglycemia
weight neutral/weight loss

Question 7

Major compliance reducing side effects of metformin (4)

Answer 7

Anorexia, GI Symptoms, Nausea, lactic acidosis

Question 8

Metformin phosphorylates __ in the liver and decreases __

Answer 8

AMPK; gluconeogenesis

Question 9

Metformin has an ___ onset and must be ___ up slowly

Answer 9

immediate; titrated

Question 10

Metformin does not cause ___ (positive)

Answer 10

hypoglycemia

Question 11

Contraindications of Metformin (5)

Answer 11

Metabolic acidosis, Hypoxic, cardiac, renal failure, type I diabetes

Question 12

Metformin requires ___ for its action

Answer 12

insulin

Question 13

Higher starting A1C with metformin results in ___ effect

Answer 13

greater

Question 14

Metformin phosphorylation of AMPK decreases __ activity

Answer 14

ACC

Question 15

Action of sulfonylureas

Answer 15

stimulates pancreatic insulin secretion

Question 16

sulfonylureas bind sulfonyl receptors in ___ cells causing depol due to ___ channels

Answer 16

beta cells; potassium

Question 17

Immediate effect during ___ ___ glucose level

Answer 17

pre meal

Question 18

sulfonylureas may cause ___ __ due to non-physiological increases in insulin levels

Answer 18

weight gain

Question 19

sulfonylureas Metabolized via ___ and excreted by ___ so check with __ failure

Answer 19

liver; kidney; renal

Question 20

sulfonylureas cause insulin secretion for __ hours and meglitinides cause secretion for __ hours

Answer 20

12-24; 3-4

Question 21

meglitinides has the same mechanism as

Answer 21

sulfonylureas

Question 22

Major disadvantage of meglitinides

Answer 22

patient compliance

Question 23

meglitinides are metabolized by the ___ and excreted by

Answer 23

liver; GI tract

Question 24

Thiazolidinediones bind __ receptor causing increased ___ transporter

Answer 24

PPAR; GLUT4

Question 25

Thiazolidinediones causes major major ___ __ due to glycemic control and increased __ reabsorption

Answer 25

weight gain; Na

Question 26

Increased risk of __ cancer with Thiazolidinediones because of location of receptor

Answer 26

bladder

Question 27

Thiazolidinediones increase __ failure due to increased volume

Answer 27

heart

Question 28

Thiazolidinediones is __ onset unlike every other drug

Answer 28

slow

Question 29

Thiazolidinediones raises every lipid but

Answer 29

triglycerides

Question 30

a-Glucosidase Inhibitors inhibits ability of enzymes to break down ____

Answer 30

oligosaccharides

Question 31

a-Glucosidase Inhibitors delays ___ absorption and increases

Answer 31

gut carb; GLP-1

Question 32

a-Glucosidase Inhibitors affects __ __ glucose only

Answer 32

post-prandial

Question 33

a-Glucosidase Inhibitors causes ___ symptoms and shouldn't be used with __ issues

Answer 33

GI

Question 34

a-Glucosidase Inhibitors excreted by

Answer 34

kidney

Question 35

GLP-1 is broken down by

Answer 35

DPP-4

Question 36

____ help release more insulin when glucose is taken PO

Answer 36

incretins

Question 37

Exenatide from ___ helps increases __ secretion

Answer 37

lizards; insulin

Question 38

GLP-1 effect takes glucose levels back to ___ and then the effect +++

Answer 38

normal; stops

Question 39

Contraindication for GLP-1 agonists

Answer 39

gastroparesis

Question 40

___ inhibitors help increase effects of GLP-1

Answer 40

DPP-4

Question 41

__ is exclusively expressed in the kidney and mediates glucose reabsorption

Answer 41

SGLT2

Question 42

SGLT2 inhibitors cause frequent ___ infections because of

Answer 42

vaginal; glucosuria

Question 43

Because of the SGLT2 induced diuresis, watch out for

Answer 43

hypotension/electrolyte loss