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Block 7 Exam 2 > Endo 27/28 - Endo Pharm I > Flashcards

Endo 27/28 - Endo Pharm I Flashcards

1
Q

Which class of drug is indicated for gestational diabetes mellitus

A

Any class of insulin

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2
Q

Most reproducible effect of the intermediate and long-acting insulins

Associated with less hypoglycemia

Dose-dependent onset of action

A

Detemir (Long-acting)

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3
Q

Synthetic analog of human amylin, which slows gastric emptying thus reducing the rate of rise of plasma glucose

A

Pramlintide

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4
Q

1st gen sulfonylrea safe for use in elderly and pts with renal impairment

A

Tolbutamide

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5
Q

Insulin prep with unpredictable action

Usually combined with regular or rapid-acting insulin

A

Intermediate-acting insulin

  • NPH (isophane)
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6
Q

Only insulin prep that cab be administered IV

Dilution causes hexameric insulin to immediately dissociate into monomers.

A

Short-acting, regular insulin

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7
Q

Besides the insulins, which 2 drug classes require subcutaneous administration

A

GLP-1 receptor agonists

DPP-4 inhibitors

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8
Q

Which DDP-4 inhibitor needs to be reduced when given with other CYP450 3A4/5 inhibitor?

A

Saxagliptin

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9
Q

Which obesity drug interferes with absorption of fat-soluble vitamins and beta-carotene

A

Orlistat

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10
Q

This serotonin agonist is used for chronic weight management.

Selectively activates 5-HT2C receptors in CNS –> Increased POMC –> Melanocortin receptor activation –> Decreased appetite

A

Lorcaserin

Rare adverse effects: Mood changes, Serotonin Syndrome

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11
Q

Insulin prep whose time to peak is relatively constant, regardless of dose

Lowest variability of adsorption

A

Rapid-acting insulin

  • Lispro
  • Aspart
  • Glulisine
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12
Q

IV management of DKA

A

Short-acting, regular insulin

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13
Q

Provides reproducible, convenient, background insulin replacement

Contain long-chain fatty acid added at C terminus of B chain

A

Long-acting insulin

  • 2 Arg added at C terminus of B chain
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14
Q

Drug combination that can be used for long-term tx of obesity

Contraindicated in pregnancy

A

Phentermine/Topiramate

  • Topiramate (anticonvulsant) causes weight loss
  • Phentermine (stimulant) counteracts sedation, adds more weight loss
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15
Q

Drug used for weight loss or weight management by decreasing gastric and pancreatic lipases

A

Lipase inhibitor - Orlistat

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16
Q

Which drug class inhibits hepatic gluconeogenesis and has a risk of lactic acidosis in pts with renal insufficiency?

A

Biguanides

  • Metformin
17
Q

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.

A

Diethylpropion

Phentermine

Problem: tolerance within weeks and weight loss plateus (discontinue once plateu is reached)

Toxicity: avoid concominant use with MAOIs

18
Q

Dopamine agonist (and) Bile acid sequestrant that both produce modest reductions in HbA1c

A

Bromocriptine

Colesevelam

19
Q

Drug class that enhances glucose-dependent insulin secretion and inhibits glucagon secretion

Slows gastric emptying and increases satiety

A

GLP-1 (Glucagon-like peptide-1)

  • Exenatide
  • Liraglutide
20
Q

The “-gliptin’s” fall into what drug class

A

Dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors)

  • Alogliptin
  • Linagliptin
  • Saxagliptin
  • Sitagliptin
  • other gliptin
21
Q

Which drug is indicated for patients with severe insulin resistance

A

Pioglitazone

22
Q

What 5 drug classes increase insulin release

A

Sulfonylureas (Tolbutamide, Glyburide)

Meglitinide analogs (Repaglinide)

D-phenylalanine derivative (Nateglinide)

DPP-4 inhibitors (Saxagliptin)

GLP-1 agonist (Exenatide)

23
Q

Drug class that increases insulin release by closing ATP-sensitive K channels

–> deoplarization, Ca entry, insulin release

A

Sulfonylureas

24
Q

Drug class that increases insulin sensitivity in adipose, liver, and skeletal muscle through increased activation of the peroxisome proliferatory-activated receptor-gamma (PPAR-gamma)

A

Thiazolidinediones

  • Pioglitazone
  • Rosiglitazone
25
Q

Drug class that reduces renal tubular reabsorption of glucose in the proximal tubule

A

Sodium glucose co-transporter 2 (SGLT2) inhibitors

  • Canagliflozin
  • Dapagliflozin
  • Empagliflozin
26
Q

Which 2 drug classes increase insulin sensitivity

A

Biguanides (Metformin)

Thiazolidinediones (Pioglitazone)

27
Q

Name the first generation sulfonylureas

Name the second generation sulfonylureas

A

1st gen:

  • Tolbutamide
  • Chlorpropamide
  • Tolazamide

2nd gen:

  • Glipizide
  • Glyburide
  • Glimepiride
28
Q

What is the MC adverse effect of the gliflozin’s?

A

UTI

SGLT2 inhibitors are also avoided in pts with renal dysfunction

29
Q

Drug class that inhibits dietary glucose absorption from GI by inhibiting specific intestinal brush border enzymes

A

Alpha-glucosidase inhibitors

  • Acarbose
  • Miglitol
30
Q

Differences in dose schedule between these GLP-1 agonists:

  • Exenatide
  • Liraglutide
  • Albiglutide
A
  • Exenatide: before breakfast and dinner
  • Liraglutide: once daily
  • Albiglutide: once weekly
31
Q

Meglitinide analog that closes ATP-sensitive K channels

How does this compare to sulfonylureas?

A

Repaglinide

  • more rapid onset and shorter duration of action

(useful for postprandial glycemic control)

32
Q

D-phenylalanine derivative that closes ATP-sensitive K channels

A

Nateglinide

  • amplifies insulin release in response to gluclose load, but has markedly diminished effect in the presence of normoglycemia
33
Q

2nd gen sulfonylureas are generally contraindicated in what patient populations?

A

Hepatic impairment

Renal insufficiency

34
Q

Insulin preps (2) with long-chain fatty acid added at C terminus of B chain

A

Long-acting insulins

  • Detemir
  • Degludec

Block 7 Exam 2 (3 decks)

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