Exam 4 Blood Glucose Flashcards
amylin
peptide cosecreted from B cells to help reduce blood glucose
PPAR gamma
acts like insulin and lowers blood glucose
effect of DM competition for myoinositol
altered nerve function
lispro (humalog), aspart (novolog), glulisine (apidra)
ultra short acting
humulin, novolin, relion
rapid acting short duration
afrezza
inhaled insulin
humulin, novolin, relion (aspart or lispro protamine)
intermediate/several hours
glargine (lantus), determir (levemir)
slow acting, long duration. no peak
pramlintide (symlin)
anti-DM, supp amylin which is absent in type 1 and low in type 2, slows gastric emptying, reduces pp glucagon, decrease appetite. used for type 1 or 2 DM
1st gen sulfonureas: tolbutamide, tolazamide, chlorpropamide
shorter DOA
2nd gen glipizide, glimepiride, glyburide
100x more potent, longer DOA
sulfonureas general MOA
inhibition of ATP-sensitive K channel, appear to increase tissue response to insulin. used for type2
repaglinide, nateglinide
meglitinides. like sulfonureas, but only if high glucose, nateglinide more selective for ATP-gated K channels. used for type 2 DM.
pioglitazone, rosiglitazone
thiazolinediones. activate peroxisome proliferator activated receptor gamma (PPARgamma) which acts like insulin. for type 2 DM.
exenatide (byetta), liraglutide (victoza), dulaglutide (trulicity), abiglutide (tranzeum)
incretin memetics. activate GLP receptors to increase insulin secretion, decrease glucagon secretion, slow gastric empty, decrease food intake and increase beta cell prolif. used for type 2 DM.
sitagliptin, saxagliptin, linagliptin, alogliptin
incretin degradation inhibitors. inhibit DPP4 enzymes. used for type 2 DM. combo or monotherapy based on GFR (except for linagliptin).
canagliflozin (invokana), dapagliflozin (farxiga), empagliflozin (jardiance)
glucose reabs blockers. inhibits sodium-glucose co-transporter 2 (SGLT2) blocking reabs of glucose (and sodium) by the kidney. good for type 2 DM.
bromocriptine
dopamine receptor agonist. for type 2 DM. reduce HbA1c and blood glucose, hyperprolactinemia and acromegaly
colevalam (welchol)
bild acid sequestrant. binds bile acid in gut, increasing conversion of cholesterol to bile acid, mechanism in low blood glucose. used for hypercholesterolemia and/or type2 DM, reduces LDL, hbA1C and blood glucose.
acarbose, miglitol
alpha glucosidase inhibitor. inhibition of alpha glucosidase in intestinal brush border, delaying absorption of carbs and limiting pp glucose. used for pp hyperglycemia
diazoxide (hyperstat)
anti-hypoglycemic. activates ATP sensitive K channels, inhibits insulin secretion, also relaxes arterial smooth muscles. used for hypoglycemia from hyperinsulinemia or for treating HTN IV.
