Drugs for DM

Question 1

what is the MOA of insulin

Answer 1

binds to insulin receptors on plasma membrane and activates tyrosine kinase which allows for glucose up take into the cells

Question 2

what are the types of cells that insulin impacts

Answer 2

1) Muscle
2) liver
3) adipose tissue

Question 3

how does insulin impact the liver

Answer 3

stimulates: it promotes storage of glucose as glycogen
inhibits: gluconeogenesis thus decreasing glucose output from the liver and decreasing protein catabolism

Question 4

how does insulin impact the muscle

Answer 4

stimulates: glycogen synthesis using GLUT 4
inhibits: protein catabolism

Question 5

how does insulin impact the adipose tissue

Answer 5

Stimulates: storage of triglyceride by activating the plasm lipoprotein liase and increasing the glucose uptake through GULT 4
inhibits: intracellular lipolysis

Question 6

what are the common adverse effects of insulin

Answer 6

• hypoglycemia
• allergic reaction/injection
• lipodystrophy
• seizures and coma

Question 7

what are fast acting insulin time line

Answer 7

3-5 hours

Question 8

lispro

Answer 8

fast acting insulin

Question 9

aspart

Answer 9

fast acting insulin

Question 10

glulisine

Answer 10

fast acting insulin

Question 11

what is the time line for short acting insulin

Answer 11

7-10 hrs

Question 12

regular crystalline

Answer 12

short acting insulin

Question 13

what is the timeline for intermediate acting insulin

Answer 13

16-20 hrs

Question 14

NPH (isophane)

Answer 14

intermediate acting insulin

Question 15

Lente (insulin zinc)

Answer 15

intermediate acting insulin

Question 16

what is the time line for long acting insulin

Answer 16

over 20 hours

Question 17

detemir

Answer 17

long acting insulin

Question 18

glargine

Answer 18

long acting insulin

Question 19

what are the 8 types of oral anti-diabetic classes of drugs

Answer 19

1) Sulfonylureas
2) Meglitindes
3) Metform (biguanides)
4) Thiazolidediones
5) Alpha-Glucosidase Inhibitor
6) DPP-4 inhibitor
7) GLP-1 analogs
8)Sodium-Glucose Transporter Inhibitors (SGLT-2)

Question 20

what is the suffix for generation 1 sulfonylureas

Answer 20

(-amide)

Question 21

what is the suffix for generation 2 and 2 sulfonylureas

Answer 21

(Gl-ide)

Question 22

what is the MOA of sulfonylureas

Answer 22

increases insulin secretion from pancreatic B cells by blocking SURI and K+ channels

Question 23

what are the side effects of sulfonylureas

Answer 23

1) hypoglycemia
2) cholestatic jaudice
3) wt gain
4) fetal hypoglycemia

Question 24

what is the suffix for meglitnides

Answer 24

(glinide)

Question 25

what is the MOA of meglitnides

Answer 25

stimulates rapid short lived insulin release

Question 26

what are the side effects with meglitnides

Answer 26

- hypoglycemia - wt gain - must be taken with a meal

Question 27

what is the drug under the Biguanides class

Answer 27

metformin

Question 28

what is the MOA of Biguanides/Metformin

Answer 28

reduces liver glucose production and increases insulin sensitivity in the muscle

Question 29

what are the side effects of Biguanides/Metformin

Answer 29

- wt loss - decrease LDL and increase HDL - GI side effects - lactic acidosis

Question 30

what are the drugs under the thiazolidediones

Answer 30

(-litazone)

Question 31

what is the MOA of thiazolidediones (TDZs)

Answer 31

increases insulin sensitivity in the peripheral tissues though enhancing glucose metabolism through action of PPAR 4 and increase in GLUT 4

Question 32

what are the side effects of thiazolidediones (TDZs)

Answer 32

- wt gain - fluid retention - risk of fx - edema

Question 33

what are the drugs in the alpha glucosidase inhibitor class

Answer 33

acarbose and miglitol

Question 34

what is the MOA of alpha glucosidase inhibitors

Answer 34

delaying the absorption of glucose from the intestine

Question 35

what are the side effects of alpha glucosidase inhibitors

Answer 35

- flatulence - diarrhea - abdominal pain

Question 36

what is the suffix for the drugs in the DDP 4 inhibitor class

Answer 36

(-gliptin)

Question 37

what is the MOA for DDP 4 inhibitors

Answer 37

increases and prolongs the action of the incretin hormones, enhancing insulin secretion and decreasing glucagon secretion

Question 38

what are the side effects of DDP 4 inhibitors

Answer 38

- Nasopharyngitis (upper respiratory tract inflection) - Headache - Pancreatitis

Question 39

GLP-1 analogs drug suffix

Answer 39

(-tide)

Question 40

what is the MOA of GLP-1 analogs

Answer 40

increase glucose dependent insulin secretion and reduces glucose excretion

Question 41

what are the side effects for GLP-1 analogs

Answer 41

- GI issues - injection site reactions - pancreatitis

Question 42

what is the suffix for sodium-glucose transporter inhibitor (SGLT-2)

Answer 42

-gliflozin

Question 43

what is the MOA of sodium-glucose transporter inhibitor

Answer 43

inhibit SGLT-2 in kidney which decreases glucose reabsorption leading to increase glucose excretion

Question 44

what are the side effect of sodium-glucose transporter inhibitor (SGLT-2)

Answer 44

- genital yeast inflection - UTI - bone fx - ketoacidosis