Diabetic Pharmacology Flashcards
effect of insulin on liver
reveral of catabolic reactions
anabolic action
effect of insulin on muscle
increased protein synthesis
increased glycogen synthesis
effect of insulin on adipose tissue
increased triglyceride storage
diabetes mellitus
-characteristics
elevation of blood glucose
metabolic perturbation
caused by a relative or absolute insulin deficiency
diabetes Dx and glycemia
A1c >/= 6.5%
fasting plasma glucose >/= 126 mg/dL
glucose tolerance test (2h postprandial glucose) >/= 200 mg/dL
patient with hyperglycemia symptoms and blood sugar >/= 200 mg/dL
insulin MOA
stimulates peripheral glucose uptake
inhibits hepatic glucose production
insulin administration method
subcutaneous injection
- rotate site
- check blood sugars regularly
insulin storage
refrigerate until use
once vial is punctures, it is good for 28 days and can be left at room temp
insulin: special population considerations
- renal dysfunction
decrease dose
dosing of insulin for type 1 patients
adjust according to fasting blood glucose
1 unit can account for 30 grams of carbs
1 unit can lower 50 mg/dL blood glucose
Thiazolidinediones (TZD)
-indiciations
adjunct to diet and exercise for type II diabetes
thiazolidinediones
-MOA
increase insulin sensitivity by affecting PPAR-y (a receptor) at adipose tissue, skeletal muscle and in the liver
TZD
-cautions
heart failure
hepatic failure
anemia
bone loss
dipeptidyl peptidase IV inhibitor MOA
stimulates insulin secretion at mealtime
2nd generation sulfonylureas
- MOA
- side effect
stimulates insulin secretion
weight gain can occur
biguanides
- MOA
- how popular
decreases endogenous hepatic production of glucose
preferred agent for type 2 diabetes
thiazolidinediones
-side effects
can cause weight gain and edema
sodium glucose co-transporter 2 inhibitor
- MOA
- side effects
increases urinary excretion of glucose
side effects
-weight loss can occur
-can cause UTIs and yeast infections
meglitinides
-MOA
stimulates insulin secretion
glucagon-like peptide-1 agonist
- MOA
- side effect
- only available via
enhances glucose-dependent insulin secretion at mealtime
weight loss can occur
only available by injection
hypoglycemia Sx
anxiety blurred vision palpitations shakiness slurred speech sweathing
hypoglycemia Tx
glucose/simple sugars: 3-4 glucose tablets, 1/2 can of soda
glucagon injection
diabetes adjunctive therapy
energy balance, diet, exercise
-low-card, low-fat, calorie-restricted diet is recommended
diabetes and dyslipidemia
patients with type II diabetes should receive a moderate to high-intensity statin
can also use fiber and omega-3 fatty acids as adjunct therapy
diabetes and antiplatelet agents
consider starting daily low dose aspirin to prevent ischemic events
diabetes: considerations for the PT
exercise has an insulin-type effect, reducing blood glucose
