DM Pharm

Question 1

Lispro

Answer 1

Humalog
Rapid-acting insulin
Genetically modified to reverse AAs 28-29 of the B chain to minimize postprandial hyperglycemia (avoids formation of hexameters that happens w/ regular insulin and slows absorption)

Question 2

Regular insulin

Answer 2

Humulin R

Short-acting insulin

Question 3

Insulin Glargine

Answer 3

Lantus
Long-acting insulin
“Peakless” b/c appears in pt system so slowly - precipitates at a neutral pH and takes time to get into solution and be absorbed

Question 4

NPH

Answer 4

Humulin N
Intermediate-acting insulin
Precipitated w/ protamine - insulin can’t be metabolized until protamine is metabolized

Question 5

Pramlintide

Answer 5

Symlin
Analog of amylin
Mech: slows gastric emptying, increases responsiveness to insulin, central inhibitor of appetite
SC injection

Question 6

Glyburide

Answer 6

sulfonylurea
acts on pancreas to enhance pancreatic secretion of insulin
mech: binds receptor on panc beta cell –> blocks K channel –> K builds up and Ca channels open –> insulin released
SE: weight gain, hypoglycemia

Question 7

metformin

Answer 7

glucophage
acts on liver to reduce excessive liver output of glucose
less weight gain than insulin
SE: lactic acidosis (increased risk w/ hepatic or renal impairment)

Question 8

Thiazolidinediones

Answer 8

Actos/ pioglitazone
acts on insulin target tissues (muscle, fat) to increase target tissue sensitivity to insulin
mech: binds PPAR transcriptional regulator to change gene expression
SE: weight gain, fluid retention

Question 9

Exenatide

Answer 9

Byetta
Analog of incretin (GI hormone)
mimicks GLP-1 and enhances insulin secretion
SC injection, expensive/new

Question 10

floxacins - dapgliflozin, canagliflozacin

Answer 10

inhibits sodium-glucose transporter 2 in proximal tubule of kidney –> reduced glucose reuptake –> glucose lost in urine –> decreased glucose toxicity