Endocrine Flashcards
strategy for DMI
insulin and low carb diet
strategy for DMII
lifestyle modification, oral agents, non insulin injecatblse, insulin
stragey for GDM
dietary modifications, exercise, insulin replacement
what are the side effects of insulin tx
hypoglycemia
rare hypersensitivities
what MOA of insulin pelase
binds insulin receptor (y kinase)
liver - increase glucose sotred as glycogen
muscle - increase glycogen and protein sytne and K uptake
fat - increase TAG storage
what are the rapid acting insulins
aspart
glulisine
lispro
what are aspart, glulisine and lispor used for
DMI
DMII
GDM
POST PRANDIAL GLUCOSE CONTROL
what are the short acting insulins
regular insuline
what is regular insulin used for
DM I DM II GDM DKA iv hyperkalemia and glucose stress hyperglycemia
what are the intermediate acting insulins
NPH
what is NPH used for
DM I
DM II
GDM
what are the long acting insulins
detemir
glargine
what are detemir and glargine used for
DM I
DM II
GDM
BASAL GLUCOSE CONTROL
whats a biguanide
metformin
MOA of metformin
unknown
decrease gluconeogenesis
icnreass glycolysis
increase peripheral glucose uptake
*increase insulin sensitivity
use of metformin
DOC at DMII
bc weight loss
a/se metformin
bad for renal failure
lactic acidosis
gi upset
what drug can be used when there is no residual islet cell function
metformin
what drugs cause increased release of insulin
the sulfonylurea: chlorpropamide, tobutamide, glimepiride, glipizide, glyburide
what are the first gen sulfonylureas
chlorpropamide, tolbutamide
what are the second gen sulfonylureas
glimepiride, glipizide, glyburide
a/se of first gen sulfonyulreas
disulfiarm reaction
a/se of secnd gen sulfonylueras
hypoglycemia
renal insfuff espeically
list the glitazones/glitter zones/thiazolidinedoines
pioglitazone
rosiglitazone
pio and rosi glitterzone
MOA of glitazones
increased sensitivity
bind to PPAR gamma nuclear transcription regulator
what are two drugs famils that increase insulin sensitivity
metform
glitazones
what is function fo PPARY
genets activated by it regulated fatty acid sorage and glucose metabolism; activation results in increase insulin esnsitivyt and increase levels of adiponectin
how are glitazones used
as MONO THERAY or in combo for type Ii
a/se of glitazones
weight gain oedema hepatoxicity heart failure increased risk of fractures
what two drugs can be used as monotherapy
glitazones and alpha glucosidase inhibitors
what are the GLP 1 analogs
exenatide
liraglutide
what is the moa of GLP1 analogs
increase insulin
decrease glucagon
what two drug families increase insulin and decreas glucagon
GLP1 and DDP4 inhibis