Endocrine Final Pharm Flashcards
Tissues where insulin doesn’t regulate glucose uptake
Brain/CNS, retina, peripheral neurons, renal medullary cells, endothelium in blood vessels, liver cells
Insulin lispro
Insulin that doesn’t aggregate and has very fast onset of action. Peak in 1-2 hours.
Disadvantage of regular insulin injection
Aggregates, therefore takes 30 min - 1 hour for onset. Makes meal timing difficult.
Insulin glargine
Aggregates more than regular insulin, therefore has sustained release in bloodstream. “Poor man’s pump.”
Glyburide
Sulfonylurea. Oral hypoglycemic, binds to K+ channels and opens them, stimulating insulin release.
Glipizide.
Sulfonylurea. Oral hypoglycemic, binds to K+ channels and opens them, stimulating insulin release. Better than glyburide.
Repaglinide
Not a sulfonylurea but has identical method of action, binds to K+ channels and opens them to stimulate insulin release.
Metformin
Biguanide, euglycemic. Inhibits gluconeogenesis, reduces hepatic glucose. Never causes hypoglycemia. Can cause lactic acidosis when given to pts with CHF or renal failure.
Acarbose
Euglycemic α-glucosidase inhibitor. Inhibits carbohydrate breakdown in the intestines, reducing intestinal glucose uptake and postprandial glucose spike.
Troglitazone
Glitazone (thiazolidinedione) no longer used because of hepatotoxicity
Pioglitazone
Selective PPAR-γ agonist. Increases insulin sensitivity by upregulating GLUT-4 in muscle & adipose tissue. Decreases gluconeogenesis in the liver.
Exenatide
Synthetic peptide that mimics glucagon-like-peptide 1 (GLP-1). Stimulates insulin release in pancreatic β cells, inhibits glucagon release. Reduces postprandial hyperglycemia.
Sitagliptin
Dipeptidyl peptidase 4 (DPP 4) inhibitor. Inhibits breakdown of GLP-1, leading to increased insulin stimulation and glucagon inhibition. No hypoglycemia.
Canagiflozin
Causes more glucose to be lost in the urine by upregulating SGLT-2 transporters in the proximal renal tubule, thereby inhibiting glucose reabsorption.
