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Final Exam - Individual Flashcards

1
Q

rapid and short-acting, mimics spikes of physiologic secretion insulin after eating

A

bolus insulin

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2
Q

intermediate/long-acting, mimics normal pancreatic insulin secretion with constant levels, suppresses glucose production in the fasting and post-absorptive period

A

basal insulin

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3
Q

mixture of short-acting and intermediate/long-acting insulin derivatives

A

combination therapy

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4
Q

insulin - target

A

insulin receptor agonist

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5
Q

insulin - biochemical, physiological, stage/type

A

activates the insulin receptor tyrosine kinase - activates PI3K/Akt enzyme cascade
movement of GLUT4 transporters to surface of cell - uptake of glucose from systemic circulation into cells
stage 3 type 2 DM

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6
Q

insulin - adverse effects

A

hypoglycemia, lipodystrophy

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7
Q

insulin - interactions

A

none serious

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8
Q

glipizide, glimepiride, glyburide - class

A

2nd generation sulfonylureas

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9
Q

glipizide, glimepiride, glyburide - target

A

inhibition of the K+ channel in beta cells

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10
Q

glipizide, glimepiride, glyburide - biochemical, physiological, stage/type

A

mimics rise in intracellular ATP - causes beta cell depolarization
depolarization results in migration of insulin granules to cell surface and release of insulin into systemic circulation
stage 2 type 2

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11
Q

glipizide, glimepiride, glyburide - adverse effects

A

hypoglycemia, cardiovascular (myocardial damage/infarction)

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12
Q

glipizide, glimepiride, glyburide - interactions

A

none serious

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13
Q

metformin - target

A

activation of AMPK

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14
Q

metformin - biochemical, physiological, stage/type

A

initiation of insulin-independent migration of glucose transporters to cell surface
movement of GLUT4 transporters to surface of cell - uptake of glucose from systemic circulation into cells
stage 1/2 type 2 (doesn’t rely on insulin receptors or beta cells to work)

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15
Q

metformin - adverse effects

A

hypoglycemia, lactic/ketoacidosis, cardiovascular (tachycardia)

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16
Q

metformin - interactions

A

contrast agents induce ketoacidosis, substrate and inhibitor for the P-gp membrane efflux protein

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17
Q

pioglitazone, rosiglitazone - class

A

thiazolidinediones

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18
Q

pioglitazone, rosiglitazone - target

A

peroxisome proliferation activating receptor gamma (PPAR gamma) agonists

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19
Q

pioglitazone, rosiglitazone - biochemical, physiological, stage/type

A

increased expression of genes under the control of the PPAR gamma receptor
an increase in glucose uptake and fatty acid oxidation/metabolism
stage 2 type 2

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20
Q

pioglitazone, rosiglitazone - adverse effects

A

cardiovascular (congestive heart failure, myocardial ischemia), increased percent of bone fractures in women, hepatotoxicity, hematological (anemia)

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21
Q

pioglitazone, rosiglitazone - interactions

A

none serious

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22
Q

semaglutide, exenatide, liraglutide - class

A

GLP-1 agonists

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23
Q

semaglutide, exenatide, liraglutide - target

A

agonist for the glucagon-like peptide receptor

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24
Q

semaglutide, exenatide, liraglutide - biochemical, physiological, stage/type

A

stimulation of the GLP receptor and subsequent activation of the cellular enzyme cascade
stimulates insulin secretion, inhibits glucagon release, delays gastric emptying, decreases appetite
stage 2 type 2

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25
Q

semaglutide, exenatide, liraglutide - adverse effects

A

hypoglycemia, pancreatitis

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26
Q

semaglutide, exenatide, liraglutide - interactions

A

delayed gastric emptying - can affect the pharmacokinetic profile of other therapeutics (oral contraceptives and some antibiotics)

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27
Q

saxagliptin, sitagliptin - class

A

DPP-4 inhibitors

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28
Q

saxagliptin, sitagliptin - target

A

inhibition of dipeptidyl peptidase (DPP-4)

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29
Q

saxagliptin, sitagliptin - biochemical, physiological, stage/type

A

decreased metabolism/deactivation of GLP-1
increased GLP-1 - stimulates insulin secretion, inhibits glucagon release, delays gastric emptying, decreases appetite
stage 2 type 2

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30
Q

saxagliptin, sitagliptin - adverse effects

A

these compounds inhibit CD26 on lymphocytes - concern regarding immune function but nothing has been reported as of yet

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31
Q

saxagliptin, sitagliptin - interactions

A

delayed gastric emptying - can affect pharmacokinetic profile of other therapeutics (oral contraceptives and some antibiotics)

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32
Q

dapagliflozin, empagliflozin, canagliflozin - class

A

SGLT-2 inhibitors

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33
Q

dapagliflozin, empagliflozin, canagliflozin - target

A

inhibition of the sodium-glucose cotransporter 2 (SGLT-2)

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34
Q

dapagliflozin, empagliflozin, canagliflozin - biochemical, physiological

A

prevents reabsorption of glucose from kidneys into systemic circulation
decrease in sugar reabsorption from lumen of kidney into systemic circulation - lowering blood glucose levels

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35
Q

dapagliflozin, empagliflozin, canagliflozin - adverse effects

A

cardiovascular (hypotension), lactic/ketoacidosis, hyperkalemia, hypoglycemia, increased risk of bone fractures, increased risk of UTIs

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36
Q

dapagliflozin, empagliflozin, canagliflozin - interactions

A

diuretic drugs - increased risk of severe dehydration

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37
Q

glucagon - target

A

glucagon receptor agonist

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38
Q

glucagon - biochemical, physiological

A

stimulation of glucagon receptor
stimulates the production of glucose - glycogen breakdown and gluconeogenesis

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39
Q

glucagon - adverse effects

A

cardiovascular (hypotension, tachycardia, hypertension)

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40
Q

glucagon - interactions

A

none severe

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41
Q

cimetidine, famotidine, ranitidine - class

A

H2 receptor antagonists

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42
Q

cimetidine, famotidine, ranitidine - target

A

inhibits the activation of the H2 receptor

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43
Q

cimetidine, famotidine, ranitidine - biochemical, physiological

A

inability of parietal cells to release H+ into the lumen due to H+/K+ ATPase loss
decrease in stomach acid production

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44
Q

cimetidine, famotidine, ranitidine - treatment

A

peptic ulcers, GERD - increase in pH (decrease in acid concentration) allows the stomach/esophagus to heal

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45
Q

cimetidine, famotidine, ranitidine - adverse effects

A

generally well tolerated

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46
Q

cimetidine, famotidine, ranitidine - interactions

A

may alter the absorption of other drugs through the GI tract (those that rely on acidic environment for absorption)
CYP1A2/2D6 inhibitor

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47
Q

esomeprazole, omeprazole, lansoprazole - class

A

proton pump inhibitors

48
Q

esomeprazole, omeprazole, lansoprazole - target

A

irreversible inhibition of the H+/K+ ATPase

49
Q

esomeprazole, omeprazole, lansoprazole - biochemical, physiological

A

inability of parietal cells to release H+ ions into the lumen due to H+/K+ ATPase activity loss
decrease in stomach acid production

50
Q

esomeprazole, omeprazole, lansoprazole - treatment

A

peptic ulcers, GERD - increase in pH (decrease in acid concentration) allows the stomach/esophagus to heal

51
Q

esomeprazole, omeprazole, lansoprazole - adverse effects

A

none predictable

52
Q

esomeprazole, omeprazole, lansoprazole - interactions

A

may alter the absorption of other drugs through the GI tract (those that rely on acidic environment for absorption)
CYP2C19 inhibitor

53
Q

antacids - target

A

NaHCO3, CaCO3, Al(OH)3/Mg(OH)2

54
Q

antacids - biochemical, physiological

A

neutralizes stomach acid
decrease in stomach acid/increase in stomach pH

55
Q

antacids - treatment

A

acute GERD

56
Q

antacids - adverse effects

A

rebound hyperacidity upon discontinuation of therapy

57
Q

antacids - interactions

A

aluminum antacids - avoid with aluminum containing agents (nephrotoxic)
may alter the absorption of other drugs through the GI tract (those that rely on acidic environment for absorption)

58
Q

ondansetron, granisetron, palonosetron, dolasetron - class

A

5-HT3 receptor antagonists

59
Q

ondansetron, granisetron, palonosetron, dolasetron - target

A

inhibition of the 5-HT3 receptor

60
Q

ondansetron, granisetron, palonosetron, dolasetron - biochemical/physiological

A

inhibition of electrochemical/neurochemical signal from the CTZ and the vagus nerve (from the GI tract) to the Vomiting Center
emesis inhibition, relief of nausea

61
Q

ondansetron, granisetron, palonosetron, dolasetron - treatment

A

very effective in treating chemo-induced, pregnancy related, and post-op nausea and emesis

62
Q

ondansetron, granisetron, palonosetron, dolasetron - adverse effects

A

CNS (headache, lightheadedness), cardiovascular (EKG abnormalities)

63
Q

ondansetron, granisetron, palonosetron, dolasetron - interactions

A

causes prolongation of QT interval

64
Q

promethazine, cyclizine, meclizine, dimenhydrinate - class

A

anti-histamines

65
Q

promethazine, cyclizine, meclizine, dimenhydrinate - target

A

inverse agonist of the H1 receptor

66
Q

promethazine, cyclizine, meclizine, dimenhydrinate - biochemical/physiological

A

inhibition of electrochemical/neurochemical signal from inner ear to vestibular nuclei
emesis inhibition, relief of nausea

67
Q

promethazine, cyclizine, meclizine, dimenhydrinate - treatment

A

motion sickness

68
Q

promethazine, cyclizine, meclizine, dimenhydrinate - adverse effects

A

CNS (sedation), antimuscarinic (urinary retention, constipation, dry eyes)

69
Q

promethazine, cyclizine, meclizine, dimenhydrinate - interactions

A

CNS depressants, CYP2D6 inhibitor, bupropion, contrast agents, tramadol (increased incidence of seizures)

70
Q

scopolamine - target

A

antagonist for the H1 and muscarinic receptors of the inner ear

71
Q

scopolamine - biochemical, physiological

A

inhibition of electrochemical/neurochemical signal from the inner ear to the vestibular nuclei
emesis inhibition, relief of nausea

72
Q

scopolamine - treatment

A

motion sickness

73
Q

scopolamine - adverse effects

A

generally well-tolerated

74
Q

scopolamine - interactions

A

bupropion, contrast agents, tramadol (increased incidence of seizures)

75
Q

aprepitant - target

A

NK1 receptor (in the STN and CTZ) antagonista

76
Q

aprepitant - biochemical, physiological

A

inhibition of electrochemical/neurochemical signal from the STN and CTZ
reduces drug-induced inflammation and emesis/nausea

77
Q

aprepitant - treatment

A

delayed phase drug-induced emesis (platinum associated complexes, chemotherapy), postoperative nausea and emesis

78
Q

aprepitant - adverse effects

A

CNS (fatigue, dizziness, headache), dehydration

79
Q

aprepitant - interactions

A

CYP3A4 inhibitor

80
Q

nabilone, dronabinol - class

A

cannabinoids

81
Q

nabilone, dronabinol - target

A

CB1 receptor agonist

82
Q

nabilone, dronabinol - biochemical/physiological

A

stimulation of the CB1 cannabinoid receptors in and around vomiting center
emesis inhibition, relief of nausea

83
Q

nabilone, dronabinol - treatment

A

prophylaxis for cancer chemotherapy-induced emesis when other treatments are ineffective, appetite stimulation/emesis suppression in AIDS and anorexic patients

84
Q

nabilone, dronabinol - adverse effects

A

cardiovascular, abstinence syndrome (withdrawal)

85
Q

nabilone, dronabinol - interactions

A

CNS/respiratory depressants

86
Q

droperidol, prochlorperazine - class

A

dopamine receptor antagonists

87
Q

droperidol, prochlorperazine - target

A

D2 receptor antagonist

88
Q

droperidol, prochlorperazine - biochemical, physiological

A

inhibition of electrochemical/neurochemical signal from the CTZ to the vomiting center
emesis inhibition, relief of nausea

89
Q

droperidol, prochlorperazine - treatment

A

effective in treating nausea as a result of an infection or unknown cause, postoperative nausea

90
Q

droperidol, prochlorperazine - adverse effects

A

CNS (restlessness, anxiety), cardiovascular (hypotension, tachycardia)

91
Q

droperidol, prochlorperazine - interactions

A

causes prolongation of QT interval

92
Q

erythromycin - target

A

motilin analog - agonist for the motilin receptor

93
Q

erythromycin - biochemical, physiological

A

motilin receptor agonist - stimulation of motilin receptor
increase in GI motility

94
Q

erythromycin - treatment

A

emesis, constipation, GI irregularity

95
Q

sincalide - target

A

cholecystokinin analog - agonist for the cholecystokinin receptor

96
Q

sincalide - biochemical, physiological

A

stimulation of the cholecystokinin receptor
increase in GI motility, increase in digestion secretions

97
Q

sincalide - treatment

A

emesis, constipation, GI irregularity, malnutrition

98
Q

sincalide - adverse effects

A

cardiovascular (hypo or hypertension), CNS (headache, dizziness)

99
Q

sincalide - interactions

A

none reported

100
Q

loperamide - target

A

mu opioid receptor agonist

101
Q

loperamide - biochemical, physiological

A

inhibition of contraction/relaxation of smooth muscle
inhibition of intestinal motility (increases small intestine transit time), allows for reabsorption of water and electrolytes

102
Q

loperamide - treatment

A

available OTC for treatment of mild diarrhea

103
Q

loperamide - adverse effects

A

CNS (sedation/drowsiness, headache, depression, euphoria)

104
Q

loperamide - interactions

A

none reported, may interfere with absorption of some drugs

105
Q

octreotide - class

A

somatostatin analogs

106
Q

octreotide - target

A

inhibition of hormone-secreting tumors of the pancreas and GI tract

107
Q

octreotide - biochemical, physiological

A

decreased secretion of 5-HT, gastrin, secretin, pancreatic polypeptide, and GLP-2
fluid retention, inhibition of motility

108
Q

octreotide - treatment

A

severe secretory diarrhea

109
Q

octreotide - adverse effects

A

gallbladder abnormalities, cardiovascular, hypo/hyperglycemia, hypothyroidism

110
Q

octreotide - interactions

A

none reported, may interfere with absorption of some drugs

111
Q

colestipol, cholestyramine - class

A

bile acid sequestrants

112
Q

colestipol, cholestyramine - target

A

increases the amount of bile that reaches the colon

113
Q

colestipol, cholestyramine - biochemical, physiological

A

increased fat absorption from intestine, decreased water/electrolyte secretion into the lumen of the GI tract
inhibition of GI motility

114
Q

colestipol, cholestyramine - treatment

A

exudation (fluid loss), secretory diarrhea

115
Q

colestipol, cholestyramine - adverse effects

A

anorexia, intestinal obstruction

116
Q

colestipol, cholestyramine - interactions

A

none reported, may interfere with absorption of some drugs

PDA I (3 decks)

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