Diabetic drugs Flashcards
name 3 things released from Beta cells of pancreas
insulin
C-peptide
Amylin
Insulin is stored as secretory granule in what form
hexamer
what is the biologically active form of insulin
monomer
Insulin release requires what from the beta cells
increased intracellular calcium
a rise in plasma glucose increases what ratio
ATP/ADP
increase ATP in beta cell causes what
- close K channel
- depolarization
- influx voltage-dependent Ca channel
what is the principal stimulus for insulin? best route of administration
glucose
better response with oral
What beta agonist can stimulate inuslin
isoproterenol
name 4 substances what will inhibit insulin release
Diazoxide
somatostatin
alpha2-agonist
beta2-antagonist
what are the different parts of insulin receptor
alpha and beta
Name the rapid insulin analgouges
aspart
glulisine
lispro
what rapid insulin analogue is absorbed the fastest? when is it injected? How is it injected
aspart
- 5 min before meal
- sub-cutaneous, IV
which short acting insulin is compatible only with NPH insulin in syringe? compatible only with NPH insulin?
Lispro and gluilisine
aspart
Name long acting insuline
Determir
Glargine
Determir biochemical arrangement
B30 amino acid threonine omitted and a 14 carbon fatty acid is attached to the
B29 amino acid.
What is onset of Gargine
-Onset in 1 hr but constant response
fever, hyperthyroidism, surgery, trauma, infection does what to insulin
increase insulin requirements
nausea/ vomiting; hypothyroidism, renal impairment, liver impairment does what to insulin
Decreased insulin requirements
most common adverse effects of insuline
hypoglycemia
PRAMLINTIDE MOA
Synthetic amylin analog. Amylin released with insulin by βeta cells.
Pramlintide use and how do you take the drug
Approved for Type 1 and 2 diabetics
Injected sc
Pramlintide
- Hypoglycemia – severe
- Never mix with insulin in same syringe
- DO not use in diabetic with gastroparesis
SULPHONYLUREAS
1. MECHANISM OF ACTION OF SULPHONYLUREAS
Stimulate insulin release
-Binds to cell surface receptor
Chlorpropamide, Tolbutamide
1st generation of sulphonylureas
Glimepiride, Glyburide
2st generation of sulphonylureas
Sulphonylureas uses
a. Type II Diabetes who are ketosis resistant
c. Central Diabetes Insipidus
Chlorpropamide in patients who cannot tolerate desmopressin
Sulphonylureas contrandications
a. Hypoglycemia
b. Contraindication ketoacidosis must use insulin
c. Chlorpropamide
