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Advanced Pharm > Endocrine II > Flashcards

Endocrine II Flashcards

Exam 3

1
Q

What do the Islets of Langerhans produce?

A

insulin, glucagon

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2
Q

Action of insulins (2)

A

inhibits catabolic actions, anabolic actions

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3
Q

The effects of this are predominantly opposite to insulin

A

glucagon

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4
Q

tx goals of diabetes

A

avoid ketoacidosis, reduce long term complications, reduce hypoglycemic events, prevent diabetes

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5
Q

Types of absorption delayed insulin

A

neutral protamine hagedorn, ultralente, insulin glargine

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6
Q

types of insulin

A

speed of onset, duration of onset

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7
Q

Speedy insulins

A

lispro, aspart

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8
Q

Insulin pumps provide these features (2)

A

steady injection rate, can program for boluses

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9
Q

Hypoglycemia involves what adverse effects?

A

reduced cognition, impaired sympathetic response, coma, seizure, brain damage, death

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10
Q

This analog is used to increase satiety and reduce post meal glucagon secretion

A

amylin analog

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11
Q

What vaccine is in trial to prevent type 1 diabetes?

A

glutamic acid decarboxylase 65 vaccine

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12
Q

Immunomodulation in type 1 diabetes is achieved via this vaccine

A

BCG

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13
Q

Hallmarks of type 2 diabetics

A

insulin resistance, gradual loss of islet beta cells

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14
Q

T/F: ketoacidosis is common in type 2 diabetes

A

false, but can happen in later stages

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15
Q

These drug classes increase insulin secretion

A

1st and 2nd generations sulfonylurias, meglitinides

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16
Q

What type of pt do you avoid sulfonylurias in?

A

hepatic and renal failure pt

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17
Q

1st generation sulfonylurias adverse effects?

A

drug interactions- sulfa and warafin; hematologic tox; prolonged hypoglycemia; tachyphylaxis

18
Q

What pt do you avoid 2nd generation sulfonylurias?

A

CVD and elderly

19
Q

3 preps of 2nd generation sulfonylureas

A

glipizide, glyburide, glimepiride

20
Q

These drugs have a fast onset, short duration and hepatic excretion

A

meglitinides

21
Q

Ending of the meglitinides?

A

-glinide

22
Q

What drugs are used to reduce insulin resistance?

A

biguanides, thiazolidinediones

23
Q

Drug of choice for most type 2 diabetes?

A

metformin

24
Q

What are the adverse effects of biguanides?

A

GI side effects

25
Q

Biguanide caution about lactic acidosis in these pt

A

COPD, chronic renal or hepatic disease

26
Q

How do thiazolidinediones work?

A

enhance tissue sensitivity to insulin

27
Q

Which glitazone increases the risk of an MI?

A

rosiglitazone

28
Q

How do GLP-1s work?

A

decrease glucagon secretion, responsible for incretin, increase pancreatic beta cell mass

29
Q

DPP4 inhibitors do what?

A

prevents GLP-1 and incretin from being broke down and will stimulate insulin release inhibiting glucagon release

30
Q

2 GLP-1 Names

A

Liraglutide (Victoza), Linagliptin (Trajenta)

31
Q

T/F GLP-1 facilitates weight loss

A

T

32
Q

2 names of DPP4 inhibitors

A

Sitagliptin (Januvia), Saxagliptin (onglyza)

33
Q

GLP-1 legal issues

A

pancreatitis and pancreas cancer

34
Q

T/F DPP-4 are oral pills?

A

True

35
Q

FDA warnings of DPP-4?

A

severe and disabling joint pain

36
Q

Do DPP-4s have a low risk of hypoglycemia?

A

yes

37
Q

T/F alpha-glucosidase inhibitors change microbiome of GI Tract and more CO2 is made.

A

true

38
Q

MOA of SLGT- inhibitors

A

enhance glucose excretion in the urine by blocking na/glucose co-transporter

39
Q

Empagliflozin (Jardiance), Dapaglifloxin (Farxiaga), Canaglifloxin (invokana) are what type of drugs?

A

SGLT-2

40
Q

Adverse effects of gliflozines

A

increased risk of ketoacidosis, limb amputations, UTI, crotch gangrene

41
Q

benefits of adding SGLT-2 drugs?

A

MI and CHF protection

42
Q

common protocol for type 2 diabetes meds?

A

lifestyle mods + metformin

Advanced Pharm (23 decks)

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