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Pharmacology ATI > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Rapid-acting insulin:
prototype
onset
peak
duration

A

Lispro insulin
Onset: 15-30 min
Peak: 1/2 hr to 3 hr
Duration: 3-5 hr

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2
Q

Short-acting insulin
Prototype
Onset
Peak
Duration

A

Regular insulin
Onset: 0.5 to 1 hr
Peak: 1 to 5 hr
Duration: 6 to 10 hr

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3
Q

Intermediate-acting insulin
Prototype
Onset
Peak
Duration

A

NPH insulin
Onset: 1 to 2 hr
Peak: 4 to 14 hr
Duration: 14 to 24 hr

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4
Q

Long-acting insulin
Prototype
Onset
Peak
Duration

A

Insulin glargine U-100
Onset: 1 to 4 hr
Peak: none
Duration: 24 hr

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5
Q

List of rapid-acting insulin

A

Lispro
Aspart
Glulisine
Inhaled insulin

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6
Q

List of short-acting insulin

A

Regular insulin (U-500)

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7
Q

List of long acting insulin

A

Insulin Glargine U-100
Insulin detemir with higher doses

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8
Q

Ultra long insulin

A

U-300 insulin glargine or insulin degludec

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9
Q

How are insulins usually mixed?

A

Primarily intermediate acting (NPH) with some short (regular) or rapid (insulin lispro) acting

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10
Q

Pharmacological action of insulin

A
  • Enhance cellular uptake of glucose to decrease blood levels
  • Convert glucose into glycogen for storage
  • Moves potassium into cells with glucose
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11
Q

When would someone with type II diabetes need insulin?

A
  • bgl is not controlled with oral meds, exercise, and diet
  • severe renal or liver disease
  • painful neuropathy
  • undergoing surgery
  • in a state of severe stress
  • DKA and hyperosmolar hyperglycemic
  • hyperkalemia
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12
Q

define hypoglycemia

A

blood glucose < 70 mg/dL

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13
Q

Clinical presentation of hypoglycemia

A

Abrupt onset:
* Tachycardia
* Palpitations
* Diaphoresis
* Shakiness

Gradual onset:
* headache
* tremors
* weakness
* lethargy
* disorientation

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14
Q

Hypoglycemia intervention

A
  • Administer glucose:
  • 15 g carb snack (4 oz juice, 8 oz milk, glucose tabs)
  • If unconcious: administer glucose parenterally or subq
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15
Q

Sulfonylureas

A

First gen: chlorpropamide
second gen: glipizide

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16
Q

Meglitinides

A

Repaglinide

17
Q

Biguanides

A

Metformin

18
Q

Thiazolidinediones (glitazones)

A

Pioglitazone

19
Q

Alpha-glucosidase inhibitors

A

Acarbose

20
Q

DPP-4 inhibitors

A

Sitagliptin

21
Q

SGLT-2 inhibitors

A

Canagliflozin

22
Q

Pharmacologic action of sulfonylureas

A

Insulin release from pancreas
Increases tissue sensitivity to insulin

23
Q

Pharmacologic action of meglitinides

A

Insulin release from pancreas

24
Q

Pharmacologic action of biguanides

A
  • reduces glucose production in liver (suppresses gluconeogenesis)
  • increases glucose uptake
  • Decreases glucose absorption in GI tract
25
Q

Pharmacologic action of glitazones

A
  • increases cell response to insulin
  • increases glucose uptake
  • decreases glucose production
26
Q

Pharmacologic action of alpha-glucosidase inhibitors

A
  • Slows carb absorption and digestion
27
Q

Pharmacologic action of DPP-4 inhibitors

A
  • enhances incretin hormones, which promote release of insulin and decrease glucagon
28
Q

Pharmacologic action of SGLT-2 inhibitors

A
  • Excretes glucose through urine by preventing reabsorption
  • Used with insulin in type I diabetes
29
Q

Side effects and adverse effects of metformin

A
  • GI effects (nausea, diarrhea, anorexia)
  • Vitamin B12 and folic acid deficiency
  • Lactic acidosis
30
Q

Can oral diabetes drugs be used in pregnancy?

A

Yes, but with risk (categories B and C)

31
Q

When are oral diabetic medications totally contraindicated?

A

Treatment of DKA

32
Q

When is metformin contraindicated?

A
  • severe infection
  • shock
  • Kidney impairment
  • Hypoxia
  • Alcohol use disorder
  • Caution in pregnancy
33
Q

Interactions with metformin

A
  • Alcohol increases risk of lactic acidosis
  • Cimetidine (histamine) increases risk of lactic acidosis
  • Iodine-containing contrast media can cause acute kidney failure
34
Q

Amylin mimetics prototype and route

A

Pramlintide
Subq

35
Q

Incretin mimetics prototype and route

A

Exenatide
Subq

36
Q

Pharmacologic action of amylin mimetics

A
  • Mimics naturally occurring peptide hormone amylin to decrease gastric emptying time and inhibit secretion of glucagon
37
Q

Pharmacologic action of incretin mimetics

A

Mimics naturally occuring glucagon-like peptide-1 type of incretin hormone by releasing insulin, decreasing glucagon, and slowing gastric emptying

38
Q

Therapeutic use of amylin mimetics

A

Supplemental glucose control for type 1 or 2 diabetes

39
Q

Therapeutic use of incretin mimetics

A

Supplemental glucose ocntrol for type 2 diabetes
Used with oral diabetes meds

Pharmacology ATI (19 decks)

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