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ENRP Exam 2 > Drugs for Diabetes > Flashcards

Drugs for Diabetes Flashcards

1
Q

Rapid-acting Insulins

A

Aspart
Lispro
Glulisine

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2
Q

Short-acting Insulin

A

Regular Insulin

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3
Q

Intermediate-acting Insulin

A

Neutral Protamine Hagerdorn (NPH)

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4
Q

Long-acting Insulin

A

Detemir

Glargine

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5
Q

Amylin Analog name

A

Pramlintide

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6
Q

GLP-1 agonists

A

Exantide

Liraglutide

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7
Q

DPP-4 Inhibitors

A 
-liptins 
Sitagliptin
Linagliptin
Saxagliptin
Alogliptin
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8
Q

First gen K-channel blockers (Sulfonylureas)

A

-amides
Chlorpropamide
Tolbutamide
Tolazamide

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9
Q

Second-gen K channel blockers

A

Glipizide
Glyburide
Glimepiride

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10
Q

Meglitinides (Non-sulfonylurea K channel blocker)

A

-inide
Nateglinide
Repaglinide

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11
Q

Thiazolidinediones

A

-azones
Pioglitazone
Rosiglitazone

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12
Q

SGLT2 inhibitors

A

-flozin
Canagliflozin
Dapagliflozin
Empagliflozin

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13
Q

a-glycosidase inhibitors

A

Acarbose

Miglitol

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14
Q

What is the diagnostic criteria for Diabetes Mellitus?

A

Fasting plasma glucose over 125 mg/dl

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15
Q

Is insulin anabolic or catabolic?

A

only anabolic hormone that lowers blood glucose

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16
Q

2 pathways that insulin activates to increase glucose transport into cell and promote growth

A

PI3K-Akt- GLUT4 insertion into membrane

MAP kinase- proliferation

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17
Q

How does Insulin act as a antihyperglycemic?

A

Activation of glycolysis and glycogen synthesis

Inhibition of gluconeogenesis and glycogenolysis

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18
Q

How do the short acting insulins increase pharmacokinetics?

A

mutated to block formation of dimers and hexamers which allows faster absorption

19
Q

When are short acting insulins used?

A

Postprandial hyperglycemia

20
Q

When is regular insulin used?

A

Basal insulin maintenance
Overnight maintenance
Can be given IV in emergencies

21
Q

A patient wants to stabilize their blood sugar throughout the day with 1-2 injections. What can be prescribed?

A

Long acting insulins Detemir or Glargine

22
Q

Can insulins be used for TIDM and TIIDM?

A

Yes, compared to regulators of insulin secretion which works only on TIIDM

23
Q

What BMP abnormality can be corrected with insulin?

A

Hyperkalemia- Insulin drives K+ into cells via activation of Na/K ATPase

24
Q

Adverse effects of Insulin

A 
Hypoglycemia if over-dosed (most common)
Lipodistrophy at injection site
Insulin resistance
Type I hypersensitivity reaction
Hypokalemia
25
Q

What hormone released by B-cells of the pancreas enhances insulin action?

A

Amylin

26
Q

When is Pramlintide indicated?

A

Adjunct to Post prandial insulin

27
Q

What endogenous factors increase insulin release?

A 
B2 agonists (Terbutaline, Albuterol) 
Incretins (GLP-1 agonists)
28
Q

What endogenous factors decrease insulin release?

A

Somatostatin

a2-agonists (Clonidine)

29
Q

4 targets to regulate insulin secretion

A
  1. Gs (stimulate insulin)
  2. Gi (decrease)
  3. K+ channel (block to decrease)
  4. Ca2+ channel
30
Q

What are incretins?

A

GI hormones that decrease blood glucose

31
Q

Glucagon-Like Peptide-1 (GLP-1) MOA

A

Promotes B-cell proliferation
Insulin gene expression
Increases glucose-dependent insulin secretion
Promotes satiety

32
Q

What is the action of Dipeptidyl Peptidase-4?

A

Breaks down GLP-1

33
Q

How do the Sulfonylureas work to increase insulin release?

A

Blocks K+ channel by binding to SUR1 which depolarizes the cell

34
Q

Adverse affects of Sulfonylureas

A

Hypoglycemia
Weight gain
CYP inhibitor

35
Q

What other drugs increase the efficacy of sulfonylureas leading to hypoglycemia risk?

A

NSAIDS!!

36
Q

When are the meglitinides recommended to take?

A

Orally before a meal

37
Q

What are advantages of Metformin?

A

Doesn’t cause hypoglycemia
No weight gain
Not metabolized (excreted unchanged)

38
Q

Side effects of Metformin

A

GI issues

Lactic Acidosis under hypoxic conditions

39
Q

Thiazolidinediones MOA

A

PPARy ligand that increases Glut4

40
Q

Use of Thiazolidinediones

A

T2DM and is a euglycemic drug (will not cause hypoglycemia)

41
Q

Adverse effects of Thiazolidinediones

A

Increased vascular permeability
Increased ENaC expression leading to edema
Osteoporosis risk

42
Q

How do the SGLT2 inhibitors work?

A

Block reabsorption of Glucose in the PCT

43
Q

If you’re patient is hypotensive/hypovolemic, should you use SGLT2 inhibitors

A

Only after correcting volume due to the osmotic diuresis effect the -flozins

44
Q

a-glycosidade inhibitor MOA

A

Blocks breakdown of polysaccharides into mono’s, which inhibits their absorption.

ENRP Exam 2 (11 decks)

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