Drugs for Diabetes

Question 1

insulin aspart
insulin lispro
insulin glulisine

(CHECK)

Answer 1

• Rapid acting
• taken before meals to prevent postprandial hyperglycemia
• risk of hypoglycemia, hypokalemia, hypertrophy of fat at injection site, resistance, allergy

Question 2

regular insulin

Answer 2

• Short acting
• can be used for basal insulin maintenance, overnight coverage, given 45 min before meal to prevent post prandial hyperglycemia, or injected IV for urgent situations
• risk of hypoglycemia, hypokalemia, hypertrophy of fat at injection site, resistance, allergy

Question 3

NPH

neutral protamine hagerdorn

Answer 3

• intermediate acting
• can be used for basal insulin maintenance, or overnight coverage
• risk of hypoglycemia, hypokalemia, hypertrophy of fat at injection site, resistance, allergy

Question 4

insulin detemir

Answer 4

• long acting
• rapidly absorbed in blood, but binds strongly to albumin
• risk of hypoglycemia, hypokalemia, hypertrophy of fat at injection site, resistance, allergy

Question 5

insulin glargine

Answer 5

• long acting
• used for basal insulin maintenance
• soluble at pH4 but precipitates at pH7 and forms a depot
• risk of hypoglycemia, hypokalemia, hypertrophy of fat at injection site, resistance, allergy

Question 6

pramlintide

Answer 6

• amylin analog
• used to manage postprandial hyperglycemia
• enhances action of insulin by inhibiting glucagon secretion, slows gastric emptying, and causes a feeling of satiety
• risk of hypoglycemia and drug interactions

Question 7

exenatide
liraglutide

Which is derived from gila monster saliva

Answer 7

• incretin mimetic, and insulin secretagogue
• GLP-1 receptor agonist (activates a Gs GPCR)
• only used for T2DM

Exenatide

Question 8

sitagliptin
linagliptin
saxagliptin
alogliptin

Answer 8

• incretin mimetic, and insulin secretagogue
• DDP-4 inhibitor, prevents GLP-1 breakdown
• only used for T2DM

Question 9

chlorpromide
tolbutamide
tolazamide

Answer 9

• first generation sulfonylurea
• blocks K+ ATP channels
• many drug interactions: risk or hypoglycemia and reduced glucose lowering effect
• only used for T2DM

Question 10

glipizide
glyburide
glimepiride

Answer 10

• second generation sulfonylurea
• blocks K+ ATP channels
• many drug interactions: risk or hypoglycemia and reduced glucose lowering effect
• only used for T2DM

Question 11

nateglinide

repaglinide

Answer 11

• meglitinide
• blocks K+ ATP channels and enhances insulin secretion
• used for prevention of postprandial hyperglycemia
• only used for T2DM

Question 12

metformin

Answer 12

• biguanide
• activates AMP-activated protein kinase
• does not bind to plasma proteins or get metabolized by body
• risk of lactic acidosis
• only used for T2DM

Question 13

pioglitazone

rosiglitazone

Answer 13

• thiazolidinedione
• PPARγ agonist, increases GLUT4 levels
• delay progression to T2DM, and reduce insulin resistance
• metabolized by CYP450s
• risk of edema, exacerbation of CHF, and osteoporotic fractures
• only used for T2DM

Question 14

canagliflozin
dapagliflozin
empagliflozin

Answer 14

• SGLT-2 inhibitor
• increases glucose excretion in kidney
• only used for COMBINATION THERAPY IN T2DM

Question 15

acarbose

miglitol

Answer 15

• α-glucosidase competitive inhibitor
• reduce the amount of starch/disaccharide digestion and therefore reduce the amount of monosaccharide absorption
• risk of flatulence and bloating
• only used for T2DM