Diabetes Rx

Question 1

DPP-4 Inhibitors (mechanism)

The “Gliptins”

Answer 1

Question 2

DPP-4 Inhibitors (clinical use)

Answer 2

Question 3

Homeostatic feedback control in DPP-4 Inhibitors compared to other Diabetes Rx:

Answer 3

Question 4

GLP-1 analogs (mechanism)

The “Glutides”

Answer 4

Question 5

GLP-1 analogs (clinical use)

Answer 5

Question 6

GLP-1 also maintains body’s natural feedback control like DPP-4 Inhibitors (release insulin only when glucose is present)

Answer 6

Question 7

Insulin (mechanism)

Answer 7

Question 8

Insulin (clinical)

Answer 8

Question 9

GLP-1 vs. Sulfonylureas & Insulin injections

Answer 9

Question 10

GLP-1 analogs & DPP-4 Inhibitors don’t cause what in diabetic patients?

Answer 10

Hypoglycemia.

Question 11

Insulin lowers what electrolyte in the blood?

Answer 11

K+&raquo_space; can be used to treat hyperkalemia. Can also cause hypokalemia.

Question 12

Rapid-acting & short-acting Insulins

Answer 12

Question 13

Intermediate-acting & Long-acting Insulins

Answer 13

Question 14

What kind of Injection is Insulin?

Answer 14

Subcutaneous Injection (as opposed to IV/IM). Except for Regular Insulin&raquo_space; which can be given intravenously

Question 15

Metformin (mechanism)

Biguanides

Answer 15

Question 16

Metformin (clinical use)

Answer 16

Question 17

What is a special thing that Metformin and TZDs (the glitazones) does compared to other Diabetes Rx?

Answer 17

They improve insulin sensitivity

Question 18

Interesting Metformin contraindication:

Answer 18

Renal insufficiency&raquo_space; b/c it can cause lactic acidosis (increased glycolysis)

Also Metformin is excreted by the kidneys.

Question 19

TZDs (mechanism)

The Glitazones.

Answer 19

Question 20

TZDs (clinical use)

The Glitazones.

Answer 20

Question 21

Diabetes Drugs that cause weight loss:

Answer 21

1. GLP-1 analogs
2. Metformin
3. SGLT-2 Inhibitors
4. Amylin analogs (Pramlintide)

Question 22

Diabetes Drugs that don’t cause hypoglycemia:

Answer 22

1. DPP-4 Inhibitors
2. GLP-1 analogs
3. Metformin
4. TZDs
5. SGLT-2 Inhibitors
6. Alpha-Glucosidase Inhibitors

Question 23

What is Rosiglitazone’s weird side effect?

Answer 23

Increased risk of myocardial infarction & CV death.

Heart attacks.

Question 24

Sulfonylureas (mechanism)

Answer 24

Question 25

Sulfonylureas (clinical use)

Answer 25

Question 26

What is the main thing biochemical effect of Sulfonylureas?

Answer 26

Stimulation of endogenous insulin release.

Question 27

Use these drugs with caution in patients with renal insufficiency:

Answer 27

1. Metformin
2. Sulfonylureas
3. Meglitinides
4. SGLT-2 Inhibitors
5. Alpha-Glucosidase Inhibitors (Miglitol)

Question 28

Meglitinides (mechanism)

“Glee night” – Glinides.

Answer 28

Question 29

Meglitinides (clinical use)

“Glee night” – Glinides.

Answer 29

Question 30

Meglitinides have a similar MOA to which drug?

Answer 30

Sulfonylureas. But they have a different site of action (for closing K+ channels) for starting the whole cascade.

Both ultimately result in:
* Endogenous insulin release

Question 31

SGLT-2 Inhibitors (mechanism)

The Glee-Frozen movies – “gliflozins.”

Answer 31

Question 32

SGLT-2 Inhibitors (clinical use)

The Glee-Frozen movies – “gliflozins.”

Answer 32

Question 33

Alpha-Glucosidase Inhibitors (mechanism)

Answer 33

Question 34

Alpha-Glucosidase Inhibitors (clinical use)

Answer 34

Question 35

Alpha-Glucosidase Inhibitors&raquo_space; visual

Answer 35

Question 36

A-G Inhibitors&raquo_space; decreased time in post-prandial hyperglycemia

Answer 36

Question 37

Diabetes drugs that are weight-neutral:

Answer 37

1. DPP-4 Inhibitors
2. Alpha-Glucosidase Inhibitors

Question 38

Amylin analogs (mechanism & clinical use)

Pramlintide

Answer 38

Question 39

Synergistic effects of Insulin & Amylin analogs&raquo_space; hypoglycemia

Answer 39