Drugs And Blood Glucose

Question 1

Two predictable effects of increasing insulin

Answer 1

Risk of hypoglycemia

Risk of weight gain

Question 2

Secretagogues

Answer 2

Block KATP channel
Sulfonylureas: Glyburide
Beta cell burn out, as disease progresses insulin requirements go up due to insulin resistance
Glinides: Repaglinide
Miss meal skip dose to dec risk hypoglycemia

Question 3

Insulin v Secretagogues

Answer 3

C peptide levels go up with each molecule of insulin secreted due to secretagogues

Question 4

Metformin

Answer 4

Activates AMPK
Increase peripheral sensitivity to insulin
AE: abdominal discomfort, lactic acidosis
No wt gain

Question 5

Dawn phenomenon

Answer 5

Cortisol in morning leads to hyperglycemia

Inc insulin night before

Question 6

Somogyi effect

Answer 6

Hypoglycemia in middle of night, over response causes hyperglycemia
Dec insulin at night

Question 7

PPARgamma Agonists

Answer 7

Thiazolididinediones
Inc insulin sensitivity of muscle and fat (inc expression of glut4)
Edema and worsened heart failure for PPARgamma and insulin

Question 8

Metformin v Thiazolididinediones

Answer 8

Metformin: CI in heart failure due to inc risk of lactic acidosis

Thiazolididinediones: CI in heart failure due to ability to cause Na retention making heart failure worse

Question 9

Hypoglycemia

Answer 9

Life threatening condition
Glucocorticoids decrease sensitivity of insulin receptors to insulin
Management: if on alpha glucosidase inhibitor intake dextrose

Question 10

SGLT2 inhibitors

Answer 10

Canagliflozin

AE: hypovolemia/hypotension

Question 11

Insulin

Answer 11

Insulin stimulated glucose and potassium transport in skeletal muscle (shifts intracellularly)
Promotes energy utilization and storage
Weight gain and hypoglycemia
Endogenous: insulin and C PEPTIDE
Aspart, regular, glargine, NPH