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Endocrinology > Diabetic medications > Flashcards

Diabetic medications Flashcards

1
Q

Sulfonyl ureas _____ insulin secretion

A

stimulate

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2
Q

_____ is the only insulin preparation that can be injected IV.

A

Regular insulin (short-actin)

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3
Q

What is NPH insulin?

A

Intermediated acting insulin

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4
Q

What is lente insulin?

A

Mixture of 30% semilente (short acting) and 70% ultralente (long acting) zinc insulin crystals–> intermediate acting insulin

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5
Q

How many times is insulin measured a day? How often will insulin be injected?

A

4- before each meal

2- one before breakfast one before dinner

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6
Q

What is humulin?

A

recombinant human insulin made in bacteria/yeast

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7
Q

What is novolin?

A

made by switching the aa that is different in pork insulin

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8
Q

T or F. Insulin in circulation forms hexamers with Zn, but hexamers dont bind the insulin receptor until dissoc.

A

T

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9
Q

Structure of insulin lispro

A

proline B28 and lysine B29 of humulin are switched— doesnt form hexamers

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10
Q

MOA of insulin lispro

A

doesn’t form hexamers, faster onset of action and shorter half-life than regular insulin

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11
Q

Describe insulin glulisine

A

rapid acting-insulin analogue that differs from human insulin in that the amino acid Asp at B3 is replaced by lysine and the lysine in B29 is replaced by glutamic acid. Does not form hexamers

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12
Q

Describe nsulin aspart

A

rapid acting insulin analog that exists only as a monomer

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13
Q

___, ____, and ____ all have the same pharmacokinetic properties - faster onset of action and shorter duration than regular insulin- because they exist in monomer form.

A

Insulin lispro, insulin aspart, insulin glulisine

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14
Q

What insulin therapies have an altered isoelectric point?

A

Insulin glargine, insulin detemir

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15
Q

What is insulin glargine?

A

recombinant human insulin analogue used for injection. Differs in a few amino acids, Long duration of action. Can be injected once a day.

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16
Q

What is insulin detemir?

A

Long acting human insulin recombinant analogue

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17
Q

Explain why insulin glargin and determir are long-acting.

A

When injected, the acidic solution is neutralized causing crystals to precipitate=slow absorption=long acting. The low peak insulin concentration decreases chances of nocturnal hypoglycemia.

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18
Q

____ is the treatment for DKA.

A

Insulin

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19
Q

____ is the treatment for hypoglycemic coma.

A

glucagon

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20
Q

Normal HbA1C is ___. Over __ is not good. ___ is dangerous

A

6,8,10

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21
Q

What are the sulfonylureas

A

glyburide, glipizide, gliclazide, glimepiride

22
Q

MOA of sulfonylureas

A

Oral hypoglycemics. Act on insulin. Initially may increase insulin release. Long term treatment may decrease insulin metabolism and increase insulin sensitivity.

23
Q

ADME of sulfonyureas

A

Rapidly absorbed from GI. extensively protein bound, metabolized in liver, excreted by kidney

24
Q

What are the meglitinides

A

repaglinide and nateglinide

25
Q

MOA of meglitinides

A

Oral hypoglycemics. Benzoic acid derivatives that increase insulin secretion.

26
Q

ADME of meglitinides

A

Oral, GI rapid absoprtion, short half-life, take before each meal to control post-prandial glucose, metabolized by liver

27
Q

AD of meglitinides

A

hypoglycema

28
Q

What are the biguanides

A

metformin, metformin+glyburide

29
Q

MOA and ADME of biguanides

A

oral hypoglycemics, does not affect insulin secretion, no hypoglycemia. Decreases hepatic glucose production
Absorbed from GI; little metabolism

30
Q

What are the thiazolidinediones?

A

rosi-, pio-, rosi- + metformin …-glitazone

31
Q

MOA and ADME of thiazolidinediones?

A

Bind PPARy, increase insulin sensitivity, increase glucose transport, absorb GI tract, little metabolism

32
Q

What are the a-glucosidase inhibitors?

A

acarbose, miglitol

33
Q

MOA, ADME of a-glucosidase inhibitors

A

reduce intestinal absorption of starch at brush border, reduce uptake of carbs to reduce post-prandial glucose rise, used in combination with other hypoglycemic drugs/insulin

34
Q

Which oral hypoglycemic drugs act on hepatic glucose secretion?

A

Biguanides: metformin +/- glyburide

35
Q

Which oral hypoglycemic drugs act on the brush border?

A

a-glucosidase inhibitors, acarbose and miglitol

36
Q

Which oral hypoglycemic drugs act on insulin secretion?

A

meglitinides: regalinide, nateglinide

37
Q

Which oral hypoglycemic drugs act on insulin sensitivity and increase glucose transport?

A

Thiazolidinediones- rosi, pio glitazone

38
Q

Which oral hypoglycemic drugs decrease insulin metabolism, increase insulin sensitivity, and increase insulin uptake?

A

Sulfonylureas: glyburide, glipizide, gliclazide, glimepiride

39
Q

_____ enhance the hypoglycemic actions of sulfonyureas.

A

NSAIDs

40
Q

Therapeutic uses of somatostatins

A

insulinomas, glucagonomas, acromegaly

41
Q

_____ is an antihypertensive antidiuretic that has potent hyperglycemic actions

A

Diazoxide

42
Q

MOA of diazoxide

A

inhibits insulin secretion but NOT synthesis. So there is a build up in B cells.

43
Q

Therapeutic uses of diazoxide

A

various forms of hypoglycemia including inoperable insulinomas

44
Q

GLP-1 ____ glucose-dependent insulin secretion.

A

Increases

45
Q

MOA for GLP1

A

increase glucose dependent insulin secretion, inhibits glucagon stimulated glycogenolysis, slow gastric emptying, decrease appetite, decrease glucagon, decrease postprandial glucose

46
Q

What are incretins?

A

hormones that increase insulin secretion

47
Q

What are the GLP1 receptor agonists?

A

Exenatide, liraglutide

48
Q

What are the DPP4 inhibitors?

A

sitagliptin, saxagliptin, linagliptin

49
Q

What are the amylin analogues

A

Pramlintide symlin

50
Q

MOA of amylin analogues

A

aids glucose absorption, promote satiety, inhibits inappropriate secretion of glucagon, weight loss

51
Q

MOA of colesevelam hydrochloride

A

bile acid sequesterant, lowers blood cholesterol, lowers HbA1C by .5%, LDL by 15%, interrupts enterohepatic cycling

Endocrinology (31 decks)

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