Exam 4 Blood Glucose

Question 1

amylin

Answer 1

peptide cosecreted from B cells to help reduce blood glucose

Question 2

PPAR gamma

Answer 2

acts like insulin and lowers blood glucose

Question 3

effect of DM competition for myoinositol

Answer 3

altered nerve function

Question 4

lispro (humalog), aspart (novolog), glulisine (apidra)

Answer 4

ultra short acting

Question 5

humulin, novolin, relion

Answer 5

rapid acting short duration

Question 6

afrezza

Answer 6

inhaled insulin

Question 7

humulin, novolin, relion (aspart or lispro protamine)

Answer 7

intermediate/several hours

Question 8

glargine (lantus), determir (levemir)

Answer 8

slow acting, long duration. no peak

Question 9

pramlintide (symlin)

Answer 9

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

Question 10

1st gen sulfonureas: tolbutamide, tolazamide, chlorpropamide

Answer 10

shorter DOA

Question 11

2nd gen glipizide, glimepiride, glyburide

Answer 11

100x more potent, longer DOA

Question 12

sulfonureas general MOA

Answer 12

inhibition of ATP-sensitive K channel, appear to increase tissue response to insulin. used for type2

Question 13

repaglinide, nateglinide

Answer 13

meglitinides. like sulfonureas, but only if high glucose, nateglinide more selective for ATP-gated K channels. used for type 2 DM.

Question 14

pioglitazone, rosiglitazone

Answer 14

thiazolinediones. activate peroxisome proliferator activated receptor gamma (PPARgamma) which acts like insulin. for type 2 DM.

Question 15

exenatide (byetta), liraglutide (victoza), dulaglutide (trulicity), abiglutide (tranzeum)

Answer 15

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.

Question 16

sitagliptin, saxagliptin, linagliptin, alogliptin

Answer 16

incretin degradation inhibitors. inhibit DPP4 enzymes. used for type 2 DM. combo or monotherapy based on GFR (except for linagliptin).

Question 17

canagliflozin (invokana), dapagliflozin (farxiga), empagliflozin (jardiance)

Answer 17

glucose reabs blockers. inhibits sodium-glucose co-transporter 2 (SGLT2) blocking reabs of glucose (and sodium) by the kidney. good for type 2 DM.

Question 18

bromocriptine

Answer 18

dopamine receptor agonist. for type 2 DM. reduce HbA1c and blood glucose, hyperprolactinemia and acromegaly

Question 19

colevalam (welchol)

Answer 19

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.

Question 20

acarbose, miglitol

Answer 20

alpha glucosidase inhibitor. inhibition of alpha glucosidase in intestinal brush border, delaying absorption of carbs and limiting pp glucose. used for pp hyperglycemia

Question 21

diazoxide (hyperstat)

Answer 21

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.