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Disease and Therapeutics > Diabetes, Weight, Thyroid Pharm > Flashcards

Diabetes, Weight, Thyroid Pharm Flashcards

1
Q

Which pancreatic cells account for 20% of islet mass and secrete glucagon?

A

Alpha Cells

*Hyperglycemic factor that mobilizes glycogen stores

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2
Q

Which pancreatic cells account for 75% of islet mass and secrete insulin?

A

Beta Cell

*storage and anabolic hormone

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3
Q

What are the 4 types of diabetes?

A

1-Type 1-insulin dependent
2-Type 2- non-insulin dependent
3- Type 3 (Others)
4- Type 4 Gestational

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4
Q

Insulin promotes glucose transport into muscle and fat cells via what transporter?

A

Glut-4

*Glut-2 in B-cells

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5
Q

What are the 5 steps of insulin release in B-cells?

A 
1-Increase glucose through Glut-2
2-Increased ATP
3-Close K+ channel
4-Increase Ca influx through Ca channels
5-Release insulin

*sulfonylureas act here

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6
Q

What are the 3 main targets of insulin?

A

1-Liver
2-Muscle
3-Adipose tissue

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7
Q

What 4 effects does insulin have on the liver?

A

1-Inhibit glycogenolysis
2-Inhibit conversion of fatty and amino acid to keto acids
3-Inhibit conversion of AA to glucos
4-Anabolic action

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8
Q

What 3 effects does insulin have on muscle?

A

1-increase protein synthesis
2-Increase glycogen synthesis
3-Increase glucose transport

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9
Q

What effect does insulin have on adipose tissue?

A

Increased triglyceride storage

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10
Q

The length of time before insulin reaches the bloodstream and begins lowering blood glucose is?

A

Onset

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11
Q

The time during which insulin is at maximum strength in terms of lowering blood glucose is?

A

Peak time

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12
Q

how long insulin continues to lower blood glucose is?

A

Duration

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13
Q

Long-acting insulin mimics ____ and rapid acting is for_____

A

Basal

Meals

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14
Q

Which type of insulin group more closely mimic normal endogenous insulin when taken right before a meal?

A

Rapid-Acting insulin

*lasts approximately 4 hours

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15
Q

Which type of insulin group takes 30 minutes to take effect, peaks at 2-3 hours and persist 5-8 hours?

A

Short-acting insulin

*soluble crystalline zinc insulin. Take 30 min before meal

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16
Q

Which kind of insulin used to be the longest acting, is delayed when combined with protamine and is usually mixed with other insulins given throughout the day?

A

NPH (Neutral Protein Hagedorn)

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17
Q

Which long acting insulin has “peaks” with arginine and glycine attached to make it soluble in acid but precipitate at body pH and is a background insulin replacement?

A

Insulin Glargine

18
Q

Which long acting insulin is a background replacement that has threonine dropped and myristic acid added to prolong availability through self-aggregation and albumin binding?

A

Insulin Determir

19
Q

What are 3 possible insulin delivery systems?

A

1-S.C. injection
2-Portable pen injectors
3-Continuous S.C. infusion devices

20
Q

Too much insulin causes what?

A

Hypoglycemia

21
Q

Which type of diabetes may benefit from both insulin and other drug treatment?

A

Type II

*usually no ketoacidosis

22
Q

What are the three principles mechanisms of action of oral anti-diabetic agents?

A

1-Binding to sulfonylurea and stimulate insulin secretion
2-Agents that lower glucose actions on liver, muscles, and adipose tissue
3-Slow intestinal absorption of glucose

23
Q

Which drugs increase insulin release from B cells but bind to carrier proteins in the blood which can be dislodged by other drugs leading to rapid hypoglycemia?

A

Sulfonylureas

*hypoglycemia and weight gain side effects

24
Q

Which three drugs are 1st generation sulfonylureas?

A

1-Tolbutamide (Orinase)
2-Tolazamide (Tolinase)
3-Chlorpropramine (Diabenase)

25
Q

Which three drugs are 2nd gen sulfonylureas and do not bind carrier proteins and thus are less likely to cause hypoglycemia?

A

1-Glipizide (Glucotrol)
2-Glyburide (Glynase)
3-Glimepiride (Amaryl)

26
Q

Which drugs are sometimes called metglitinides (repaglinide/prandin), also function at K+ channels and may cause hypoglycemia and weight gain?

A

Glitinides

27
Q

Which diabetes drug in insulin-sparing and does not provoke hypoglycemia, decreases glucose production in the liver but has an illusive mechanism?

A

Biguanides (Metformin)

*GI upset, B12 deficiency, don’t use in alcoholics

28
Q

Which diabetes drug reduces insulins resistance (especially in muscle and fat) by targeting PPAR-y, increases GLUT-4 expression but causes bone loss and weight gain?

A

Thiazolidinediones

*controversy regarding cardiac issue.

29
Q

What two drugs are Thiazolidinediones?

A

1-Rosiglitazone (Avandia)

2-Pioglitazone (Actosel)

30
Q

Which drug is a DPP-4 inhibitor and slows the inactivation of incretin hormones?

A

Sitagliptin (Januvia)

*Increases insulin, decreases hepatic glucose

31
Q

Which type of drugs slow the digest/absorption of starch in the small intestines and must be taken with the first bite of meal?

A

a-Glucosidase inhibitors

*side effect of flatulence

32
Q

Acarbose (prandase) is what kind of drug?

A

a-Glucosidase inhibitor

*reduces starch absorption

33
Q

What two types of drugs are used as appetite suppressants?

A

1-Amphetamines (Ephedrine/PPA)

2-SSRI (Prozac)

34
Q

Which weight loss drug works by inhibiting NE and DA uptake but may cause dry mouth and hypertension?

A

Phentermine

*May interact with MAOIs, SSRIs, CNS stimulants and antihypertensives

35
Q

Which combination weight loss drug is contraindicated in pregnancy and may increase the risk of low blood sugar in patients with type II diabetes?

A

Phentermine + Topiramate (Qsymia)

36
Q

Which weight loss drug is a 5-HT2c receptor agonist and activates receptors in the hypothalamus to suppress appetite?

A

Belviq (Lorcaserin)

*pro-opiomelanocortin is produced in the hypothalamus to suppress appetite

37
Q

Which weight loss drug is a lipase inhibitor and thus diminishes fat absorption in the intestines but can cause diarrhea?

A

Orlistat (Alli)

38
Q

Graves disease is a _______ condition

A

Hyperthyroidism

39
Q

What are 4 drugs used to treat hyperthyroidism?

A

1-Thioamides (inhibit thyroid peroxidase rxns)
2-Iodides
3-beta blockers (inhibit T4-T3 conversion)
4-Radioactive iodine

40
Q

Methimazole and propylthiouracil are two agents used to treat hyperthyroidism and are what kind of drugs?

A

Thioamides

41
Q

What two drugs are used to treat hypothyroidism?

A

1-Levothyroxine (T4)

2-Liothyronine (T3)

42
Q

What drug is a DPP-4 inhibitor to slow inactivation of uncertain hormones?

A

Sitagliptin (Januvia)

*results in insulin release and reduces glucagon activity

Disease and Therapeutics (39 decks)

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