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HD & T SG > Diabetes Pharmocology > Flashcards

Diabetes Pharmocology Flashcards

1
Q

Insulin replacement is required for what types of diabetes?

A

Required for all Type I DM, and for more serious Type II DM

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2
Q

How are insulin types classified?

A

Insulin types classified according to pharmacokinetics: i.e., onset of action, how quickly they absorbed, how long they last

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3
Q

How does insulin replacement replicate natural insulin patterns?

A

Basal background levels and burst release in response to glucose surges (e.g., eating)

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4
Q

What is the most common insulin strength?

A

U-100

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5
Q

What are the two main sources of insulin replacers?

A

Most formulations prepared in laboratory (i.e. genetics; from genetically modified benign e. coli-e.g., Humulin), but can still obtain animal insulin (e.g, bovine, porcine) for special cases

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6
Q

What are the 5 types of insulin?

A

Rapid-acting, short acting, NPH (neutral protein hagedorn), Insulin glargine, Insulin determir

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7
Q

Which two types of insulin are good long-acting, background insulins?

A

Insulin determir and insulin glargine

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8
Q

How long is the onset, peak, and persist of short-acting insulin?

A

30 min. onset, peaks 2-3 hours, persists 5-8 hours

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9
Q

What substance helps to delay onset and lengthen duration of short-acting insulin?

A

crystalline zinc

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10
Q

What are the pharmacokinetic features of NPH (neutral protein hagedorn)?

A

onset=2-15 hrs; duration=4-12 hours

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11
Q

Which type of insulin is often mixed with other shorter acting insulins for both immediate insulin and sustained insulin needs?

A

NPH (neutral protein hagedorn)

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12
Q

Which type of insulin has early peak action as lasts around 4 hours?

A

Rapid-action

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13
Q

(T/F) NPH (neutral protein hagedorn) is intermediate acting.

A

True

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14
Q

Which type of insulin is taken immediately before meal?

A

Rapid Acting

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15
Q

What peptide delays the release of insulin after injection NPH?

A

protamine

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16
Q

Lispro (Humalog)

A

Rapid Acting

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17
Q

Glargine

A

Long-acting sustained insulin: no peaks and valleys. Good as background insulin

18
Q

Determir

A

Long acting and good for background insulin

19
Q

Secretagogues

A

Increase release of insulin from beta cells. Sulfonylureas

20
Q

Side effects of secretagogues

A

Hypoglycemia, weight gain

bind to plasma proteins and can be dislodged by other drugs binding at same sites

21
Q

Biguanides mechanism

A
  1. Very popular

2. Decreases glucose production in the liver and likely increases efficiency of insulin binding.

22
Q

(T/F) Biguanides have no effect on insulin production of pancreas

23
Q

(T/F) Biguanides may invoke hypoglycemia

24
Q

Biguanides may have positive effects on the CVS related to type 2 DM

25
Q

Biguanides side effect

A

GI irritation

26
Q

DPP-4 inhibitor

A

Slows inactivation of incretin hormones by inhibiting DPP-4, which in turn, through glucose-dependent insulintropic polypeptide (GIP) and glucagon-like peptide-1, stimulates insulin synthesis and release (increases storage of glucose) and reduces glucagon activity leading to reduced hepatic glucose production and release

27
Q

Acabose (A-glucosimide inhibitor) Brush boarder of small intestine cells

A

Slows digestion and absorption of starch, disaccharides from small intestines—may help to prevent Type II diabetes

May cause GI irritation

28
Q

Thiazolidinediones. Think zones, golf heart commercials and GLUT-4

A

reduces insulin resistance (especially muscle and fat cells) in type II DM

29
Q

Rosiglitazone (Avandia)

A

Thiazolidinediones

30
Q

Glucagon

A

Produced in alpha cells of pancreas. It increases gluconeogenesis. Used to treat sever hypoglycemia caused by diabetes drugs.

31
Q

Tolbutamide (Orinase)

A

Sulfonylurea (Secretagogue)

32
Q

Glitinides (Prandin)

A

Sulfonylurea (Secretagogue) K+

33
Q

Metformin-Glucophage

34
Q

Sitagliptin (Januvia)

A

DPP-4 inhibitor that increseases incretins like GLP-1 and GIP

35
Q

Three types of appetite supressants

A
  1. Amphetamines
  2. Orlistat-lipase inhibitor
  3. Belviq (Lorcaserin)
36
Q

Phentermine

A

Amphetamine that inhibits norepinephrine and dopamine uptake

37
Q

Phentermine side effects

A

Weight loss, dry mouth, hypertension, palpitation

38
Q

Phentermine interacts with what class of drugs

A

Sympathomimetics (including vasoconstrictors in local anesthetics)

39
Q

Topiramate and Phentermine

A

Qsymia (anticonvulsant)

40
Q

Lorcaserin (Belviq)

A

5-HT2C agonist (suppresses appetite in hypothalamus)

41
Q

Orlistat

A

Diminishes fat absorption in intestines. Lipase inhibitor. Explosive diarrhea.

HD & T SG (12 decks)

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