Endo 27/28 - Endo Pharm I Flashcards
Which class of drug is indicated for gestational diabetes mellitus
Any class of insulin
Most reproducible effect of the intermediate and long-acting insulins
Associated with less hypoglycemia
Dose-dependent onset of action
Detemir (Long-acting)
Synthetic analog of human amylin, which slows gastric emptying thus reducing the rate of rise of plasma glucose
Pramlintide
1st gen sulfonylrea safe for use in elderly and pts with renal impairment
Tolbutamide
Insulin prep with unpredictable action
Usually combined with regular or rapid-acting insulin
Intermediate-acting insulin
- NPH (isophane)
Only insulin prep that cab be administered IV
Dilution causes hexameric insulin to immediately dissociate into monomers.
Short-acting, regular insulin
Besides the insulins, which 2 drug classes require subcutaneous administration
GLP-1 receptor agonists
DPP-4 inhibitors
Which DDP-4 inhibitor needs to be reduced when given with other CYP450 3A4/5 inhibitor?
Saxagliptin
Which obesity drug interferes with absorption of fat-soluble vitamins and beta-carotene
Orlistat
This serotonin agonist is used for chronic weight management.
Selectively activates 5-HT2C receptors in CNS –> Increased POMC –> Melanocortin receptor activation –> Decreased appetite
Lorcaserin
Rare adverse effects: Mood changes, Serotonin Syndrome
Insulin prep whose time to peak is relatively constant, regardless of dose
Lowest variability of adsorption
Rapid-acting insulin
- Lispro
- Aspart
- Glulisine
IV management of DKA
Short-acting, regular insulin
Provides reproducible, convenient, background insulin replacement
Contain long-chain fatty acid added at C terminus of B chain
Long-acting insulin
- 2 Arg added at C terminus of B chain
Drug combination that can be used for long-term tx of obesity
Contraindicated in pregnancy
Phentermine/Topiramate
- Topiramate (anticonvulsant) causes weight loss
- Phentermine (stimulant) counteracts sedation, adds more weight loss
Drug used for weight loss or weight management by decreasing gastric and pancreatic lipases
Lipase inhibitor - Orlistat
Which drug class inhibits hepatic gluconeogenesis and has a risk of lactic acidosis in pts with renal insufficiency?
Biguanides
- Metformin
These 2 anorexiants/appetite suppressants increase release of NE and Dopamine and inhibit their reuptake. Signals “fight-or-flight” response, which decreases appetite.
Both are controlled substances.
Diethylpropion
Phentermine
Problem: tolerance within weeks and weight loss plateus (discontinue once plateu is reached)
Toxicity: avoid concominant use with MAOIs
Dopamine agonist (and) Bile acid sequestrant that both produce modest reductions in HbA1c
Bromocriptine
Colesevelam
Drug class that enhances glucose-dependent insulin secretion and inhibits glucagon secretion
Slows gastric emptying and increases satiety
GLP-1 (Glucagon-like peptide-1)
- Exenatide
- Liraglutide
The “-gliptin’s” fall into what drug class
Dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors)
- Alogliptin
- Linagliptin
- Saxagliptin
- Sitagliptin
- other gliptin
Which drug is indicated for patients with severe insulin resistance
Pioglitazone
What 5 drug classes increase insulin release
Sulfonylureas (Tolbutamide, Glyburide)
Meglitinide analogs (Repaglinide)
D-phenylalanine derivative (Nateglinide)
DPP-4 inhibitors (Saxagliptin)
GLP-1 agonist (Exenatide)
Drug class that increases insulin release by closing ATP-sensitive K channels
–> deoplarization, Ca entry, insulin release
Sulfonylureas
Drug class that increases insulin sensitivity in adipose, liver, and skeletal muscle through increased activation of the peroxisome proliferatory-activated receptor-gamma (PPAR-gamma)
Thiazolidinediones
- Pioglitazone
- Rosiglitazone
