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Pharm 3 module 1 > Diabetic drugs > Flashcards

Diabetic drugs Flashcards

1
Q

What type of cell make and secretes pancreatic juice

A

Acinar cells

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2
Q

What properties make up the pancreas’ endocrine system

A

islets of langerhans
-beta cells
-alpha cells
-delta cells

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3
Q

What do beta cells secrete

A

insulin

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4
Q

what do alpha cells secrete

A

glucagon

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5
Q

What do delta cells secrete

A

somatostatin

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6
Q

What stimulates a higher secretion of insulin

A

High blood glucose

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7
Q

What hormones will cause an increase in insulin secretion

A

GIP
GLP-1

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8
Q

What is Insulins role in the body

A

lower BG levels
regulate metabolism (Fat & Protein)
increase K+ uptake in the cell

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9
Q

How does insulin lower BG levels in the body

A

facilitate glucose into the cells
inhibit glycogenolysis
Inhibits gluconeogenesis

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10
Q

When is type 1 diabetes often diagnosed

A

early childhood to early adulthood

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11
Q

What causes type 1 diabetes

A

autoimmune destruction of the beta cells in the pancreas

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12
Q

What is the treatment for type 1 diabetes

A

insulin

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13
Q

What is the greatest concern with those who have type 1 diabetes

A

DKA
Infection
End-organ damage from untreated hyperglycemia

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14
Q

What is the cause of type 2 diabetes

A

inability of the beta cels to produce the appropriate quantities of insulin

insulin resistance

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15
Q

When is type 2 diabetes typically diagnosed

A

after 35

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16
Q

What type of diabetes is most common

A

type 2

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17
Q

What are some complications of DM

A

Retinopathy
Nephropathy
neuropathy
CV complications
Gastroparesis, autonomic insufficiency

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18
Q

What is the normal glucose tolerance on FBG compared to DM

A

<100 vs >126

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19
Q

What is a normal A1C compared to DM

A

5.7 vs >6.5

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20
Q

What are the different groups of insulin that can be used to manage DM

A

Long acting
Intermediate acting
Rapid acting
Short acting

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21
Q

How is insulin typically administered

A

SQ
*IV in emergencies like DKA

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22
Q

What are some long acting insulin products

A

Insulin Glargine (Lantus)
Insulin detemir (Levemir)

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23
Q

What is an intermediate acting insulin product

A

neutral protamine hagedorn (NPH)

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24
Q

What are the short acting insulin products

A

regular (Humalin, Novolin)
*SQ & IV options

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25
Q

What are the rapid acting inulin products

A

Insulin Lispro (Humalog)
Insulin aspart (Novolog)
Insulin glulisine (Apidra)

26
Q

Which type of DM may require higher doses of insulin and why

A

Type 2 because of resistance patterns

27
Q

What are adverse reactions to insulin

A

Weight gain
Somogyi effect
Dawn phenomenon
Hypoglycemia

28
Q

What is Somogyi effect

A

If blood sugar drops too low in the early morning, hormones are released to help reverse the low blood sugar and may have the opposite effect

29
Q

What is the Dawn phenomenon

A

normal rise in blood sugar as a persons body prepares to wake up

30
Q

What are some symptoms of hypoglycemia

A

headache
tachycardia
vertigo
anxiety
confusion
diaphoresis

31
Q

What are some GLP-1 receptor agonists

A

Exenatide
Liraglutide
Dulaglutide
**IV only

32
Q

What form of diabetes has a reduced secretion of incretin

A

Type 2

33
Q

What is the job of incretin

A

Responsible for most of the postprandial insulin secretion

34
Q

What is the action of GLP-1 agonists

A

Promote insulin secretion
enhances satiety
decrease post prandial glucagon secretion
promotes beta cell proliferation

35
Q

Which medications stimulate insulin secretion

A

Sulfonylureas
meglitinides

36
Q

Which medications increase insulin sensitivity

A

Biguanides (Metformin)
Thiazolindediones (Glitazones)

37
Q

What are some oral agents to manage DM

A

Dipeptidyl peptidase-4 inhibitors
Alpha glucosidase inhibitors
Sodium-glucose co-transport 2 inhibitors

38
Q

What are first generation sulfonylureas (Not currently used)

A

Tolbutamide
Chlorpropamide

39
Q

What are second generation of sulfonylureas

A

Glyburide
Glipizide
Glimepiride

40
Q

What is the MOA for sulfonylureas

A

Stimulates insulin release from pancreatic beta cells

decreases production of hepatic glucose

increased sensitivity of insulin in the periphery

41
Q

What are the adverse reactions and contraindications of sulfonylureas

A

Weight gain
hyperinsulinemia
hypoglycemia

Contra: Sulfa allergy / preggers

caution w/: Hepatic or renal insufficiency, geriatric patients

42
Q

What drugs are meglitinides

A

Repaglinide
Nateglinide

43
Q

What is the MOA of meglitinides

A

release insulin from pancreatic beta cells

*has rapid onset and short duration

44
Q

What are the ADRs for metglitinides

A

Hypeglycemia
caution w/ renal/hepatic insufficiency (repaglinide)

45
Q

What is the MOA of metformin (biguanides)

A

Decreases hepatic gluconeogenesis and increases insulin sensitivity

46
Q

What is the ADR for metformin

A

abdominal discomfort

47
Q

What are the contraindications of metformin

A

hepatic/renal impairment
DKA
AMI
CHF
IV contract
Alcoholism

48
Q

What drugs are thiazolidinediones (glitazones)

A

Rostiglazone
pioglitazone

49
Q

What is the MOA for the glitazones

A

Increases insulin sensitivity
enhances peripheral glucose uptake
reduce hepatic glucose production

50
Q

What are the contraindications of the glitazones

A

Heart failure

51
Q

What are the ADRs for the glitazones

A

Weight gain
osteopenia
HA
anemia

52
Q

Which drugs are alpha-glucosidase inhibitors

A

Acarbose
Miglitol

53
Q

What is the MOA for alpha-glucosidase

A

inhibitor of alpha-glucosidase in intestinal brush border

delay digestion of carbs which lowers postprandial glucose levels

54
Q

What are the ADRs of the alpha glucosidase inhibitor

A

GI intolerance

55
Q

What are the contraindications for alpha-glucosidase inhibitors

A

IBD
colon CA / other conditions that predispose them to obstruction or perforation

56
Q

What drugs are DPP-4 inhibitors

A

Sitagliptin
Saxagliptin

57
Q

What is the MOA of the DPP-4 inhibitors

A

Inhibits DPP-4 which increases the release of insulin and decrease glucagon release

58
Q

What is GLP-1

A

glucagon like peptide

59
Q

Which drugs are SGLT2 inhibitors

A

Canagliflozin
Dapagliflozin
Empagliflozen

60
Q

What is the MOA of SGLT2 inhibitors

A

They reabsorb filtered glucose in the tubular lumen of the kidney. Therefore, by inhibiting this cotransporter, there will be decreased absorption of glucose

61
Q

What is the ADR for the SGLT2 inhibitors

A

Vaginal candidiasis
UTI

Pharm 3 module 1 (3 decks)

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