D.M

Question 1

Glyburide

Answer 1

Treat insulin resistant (type 2 diabetes mellitus)

Question 2

Pramlintide

Answer 2

Amylin analogue (S.C injectable) used as adjunct for D.M
Decrease gastric emptying , decreases postprandial glucagon secretion, and improves satiety

Question 3

Lispro
Aspart
Glulisne

Answer 3

Fast acting insulin analog
1 lysine - proline exchange in their sites
2 displace proline with aspartate
3 displace lysine with glutamine

Question 4

Glargine

Answer 4

Long-acting insulin analog

Add 2 aspartate to periphery

Question 5

NPH

Answer 5

Intermediate-acting insulin analog combined with protamine

It is cloudy

Question 6

Insulin detemir

Answer 6

Long acting insulin analog ,

Have slow dissociation rate from albumin so it is long-acting

Question 7

Sulfonylureas :
Glymepiride
Glipizide
Glyburide

Answer 7

Increase insulin secretion + sensitivity
Glucagon - - ==> decrease gluconeogenesis
Excreted by kidney or liver

Question 8

Glinides :
Repaglinide
Nateglinide

Answer 8

Like sulfonylureas but it is so so fast in action ,
Low weight gain.
Biliary excretion .
Metabolism : CYP450

Question 9

Biguanide:

Metformin

Answer 9

Decrease intestinal glucose absorption .
Increase G uptake by tissue + anaerobic glycolysis ===> decrease insulin resistance .
Lactic acidosis.
Excreted by urine

Question 10

Thiazolidinedione (glitazone) :
Pioglitazone
Rosiglitazone

Answer 10

PPAR-GAMMA ==> insulin sensitivity
Rosi ; increase LDL. Excreted by kidney
Pio. ; decrease LDL. Excreted by liver
BOTH INC. HDL
Hepatotoxicity is common .
Heart failure
CYP450

Question 11

Glucosidase inhibitors :
Miglitol
Acarbose

Answer 11

Inhibit glucosidase in brush border , acarbose also inhibit pancreatic amylase

Acarbose metabolism is in normal flora of intestines
Miglitol excreted by urine