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(Duluth) HRM Final Review > Hellekant Pancreas > Flashcards

Hellekant Pancreas Flashcards

1
Q

Insulin inhibits breakdown of fat/adipose by inhibiting what enzyme?

A

Intracellular lipases that hydrolyze TGs

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2
Q

What are the effects of sympathetics on beta islet cells?

A

Inhibit insulin and amylin secretion

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3
Q

Parasympathetic nerves via the vagus n. Are involved in what phase of insulin secretion?

A

Cephalic phase

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4
Q

What cells secrete glucagon?

A

Alpha islet cells

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5
Q

What cells of the pancreas secrete somatostatin?

A

Delta cells

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6
Q

What is amylin?

A

Amino acid that is Co-packaged and co-secreted with insulin in beta cells

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7
Q

What is the function of amylin?

A

Inhibits glucagon secretion (at alpha cell); induces satiety, delays gastric emptying, inhibits secretion of digestive enzymes

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8
Q

Glucagon increases in response to what?

A

Hypoglycemia, amino acids, and sympathetics

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9
Q

What triggers the release of somatostatin in regards to pancreatic hormones?

A

Insulin

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10
Q

What inhibits release of somatostatin in regards to pancreatic hormones?

A

Ghrelin

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11
Q

What cells release ghrelin?

A

Epsilon

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12
Q

What is the function of somatostatin in regards to pancreatic functions?

A

Inhibits release of insulin, glucagon, and ghrelin.

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13
Q

What are examples of incretins? What is their broad function?

A

GIP, and GLP-1; promote beta cell insulin release after eating

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14
Q

What cells produce GLP-1?

A

L cells

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15
Q

What is the function of GLP-1?

A

Stimulates insulin in high glucose situation and inhibits glucagon secretion euglycemia or hypoglycemia

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16
Q

What degrades glp-1?

A

Dipeptidyl peptidase -4

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17
Q

What cells produce GIP?

A

K cells

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18
Q

What is the function of GIP?

A

Stimulates insulin in high glucose situation and promotes glucagon secretion following a meal

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19
Q

How is GLP-1 formed?

A

Alternative splicing from glucagon gene

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20
Q

What is the function of dipeptidyl-peptidase 4?

A

Degradation of GLP-1

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21
Q

What is a big difference in the effects of GLP-1 vs. GIP?

A

GLP-1 decreases PP glucagon, while GIP increases PP glucagon

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22
Q

During what phase are the incretins released? What causes the release?

A

GI phase; released due to hyperosmolarity due to glucose in gut

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23
Q

Why is there a larger insulin response from oral vs. IV glucose?

A

Due to oral (carbs stimulate sweet receptors) and intestinal (incretins released) phases of insulin secretion

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24
Q

Where are SGLT1 transporters found?

A

Mostly small intestine; if in kidney fond in late proximal straight tubule

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25
Q

Where are SGLT2 transporters found?

A

Kidney - early PCT

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26
Q

What cells are GLUT1 found on?

A

Most cells

27
Q

What cells are GLUT2 found on?

A

Liver, beta cells, kidney, hypothalamus, basolateral membrane of small intestine

28
Q

Where are GLUT3 transporters found?

A

Brain, placenta, testes

29
Q

Where are GLUT4 transporters found?

A

Skeletal and cardiac muscle; fat

30
Q

Where are GLUT5 transporters found?

A

Mucosal surface in small intestine; sperm

31
Q

What glucose transporter is activated by insulin?

A

GLUT4

32
Q

What GLUT is the sensor for beta pancreatic cells?

A

GLUT2

33
Q

What is the function of GLUT7?

A

Transports glucose in endoplasmic reticulum

34
Q

What drug for DM impairs gluconeogenesis?

A

Metformin

35
Q

What is a common side effect of biguanides (metformin)?

A

Diarrhea - reduce by gradually increasing the dose

36
Q

What is the most serious SE of metformin?

A

Lactic acidosis

37
Q

What is the MOA of sulfonylureas?

A

Promote insulin secretion by binding SUR1 subunit of ATP-sensitive K channel, closing the K channel, activating Ca++ channels, and thus fusing/release of insulin containing vesicles

38
Q

What are the primary SEs of sulfonylureas?

A

Hypoglycemia (esp in renal failure) and weight gain

39
Q

What class of drug does glimepiride belong to?

A

Sulfonylureas

40
Q

What are the first gen sulfonylureas? What is a SE of them?

A

Chlorpropamide and tolbutamide; disulfiram-like

41
Q

What is the MOA of meglitinides?

A

Bind the K+ channel at site different than sulfonylureas; same MOA - stimulate insulin release

42
Q

What drugs are in the meglitinide class?

A

Nateglinide, repaglinide

43
Q

What are the second generation sulfonylureas?

A

Glimepiride, glyburide, glipizide

44
Q

What is exanitide?

A

GLP-1 analog

45
Q

What is the MOA of GLP-1 analogs?

A

Stimulate insulin and inhibit glucagon release; early satiety, delay gastric emptying

46
Q

What drugs are in the GLP-1 analog class?

A

Exenatide and liraglutide

47
Q

What drugs are in the dipeptidyl peptidase IV inhibitor class?

A

Linagliptin, saxagliptin, sitagliptin

48
Q

What is the MOA of sitagliptin?

A

Inhibits dipeptidyl peptidase IV, therefore enhancing the activity of incretins (GLP-1 and GIP)

49
Q

What is the MOA of repaglinide?

A

Binds K+ channel at site different than sulfonylureas; promotes release of insulin from beta cells

50
Q

What are examples of drugs in the alpha-glucosidase inhibitor class?

A

Acarbose and miglitol

51
Q

What are the primary side effects of nataglinide?

A

Nataglinide = meglitinides; SEs hypoglycemia and weight gain; other: tremor, GI and dizziness

52
Q

What is the MOA of acarbose?

A

Inhibits glucosidases (enzymes that hydrolyze carbs to monosaccharides), therefore decreasing the ability to absorb sugars

53
Q

What are the side effects of alpha-glucosidase inhibitors?

A

Predominantly GI

54
Q

What is the MOA of amylin analogs?

A

Bind amylin receptor and inhibit glucagon synthesis, glucose synthesis in liver, and delays gastric emptying and increases satiety

55
Q

What class does pramlintide belong to?

A

Amylin analog

56
Q

What drug class increases uptake and storage of glucose in skeletal muscle and adipose tissue?

A

Thiazolidinediones

57
Q

What is the MOA of thiazolidinediones?

A

Binds and activates PPAR gamma receptor; results in increasing synthesis and transport of GLUT transporters in muscle, adipose and liver; therefore increases insulin sensitivity in peripheral tissue

58
Q

What drugs are in the thiazolidinedione class?

A

Rosiglitazone and pioglitazone

59
Q

What are the SEs of thiazolidinediones?

A

Weight gain; edema, heart failure/cv events, URI, HA, hepatotoxic

60
Q

What diabetes drug increases risk for bladder cancer?

A

Pioglitazone

61
Q

What are the rapid acting insulin preparations?

A

Lispro, aspart, glulisine

62
Q

What insulin is short acting?

A

Regular insulin

63
Q

What insulin preparation is considered intermediate acting?

A

NPH insulin

64
Q

What insulin preparations are considered long acting?

A

Glargine an detemir

(Duluth) HRM Final Review (22 decks)

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