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Applied Pharmacology > Hypoglycaemic > Flashcards

Hypoglycaemic Flashcards

1
Q

Use of blood glucose…

A

energy

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2
Q

What is Glucosuria?

A

Elevated glucose levels saturate glucose reuptake mechanisms in kidney. Leads to osmotic diuresis, high thirst and urine production and dehydration.

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3
Q

Hyperglycaemia homeostasis…

A

Food intake/ glucose production > rise blood glucose > insulin release beta cells > insulin action, liver muscle adipocytes > lower blood glucose.

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4
Q

Hypoglycaemia homeostasis…

A

Fasting > fall in blood glucose > glucagon release alpha cells > raise blood glucose.

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5
Q

Pancreatic islets of langerhans…

A 
1-2% human pancreas mass. 
Alpha cells - release glucagon
Beta cells - release insulin
O cells - release somatostatin
E cells - release gherkin
PP cells - release pancreatic polypeptide.
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6
Q

Glucose stimulated insulin release…

A

Molecules closing K channel mimic actions of glucose trading hyperglycaemia.

Molecules opening K channel inhibit action of glucose treating hypoglycaemia.

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7
Q

Role of insulin…

A

Uptake, storage and utilisation of glucose.
Protein/Triglyceride synthesis.
Gene expression/growth.
Decreases proteolysis, lipolysis and lipid oxidation.

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8
Q

T1DM…

A

Autoimmune destruction of Bcell producing insulin. Detected by anti-islet antibodies presence.
Starts in childhood.

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9
Q

T2DM…

A

tissues insensitive to insulin, decrease of absence of glucose, high concentration of insulin.
Risk factors; age, obesity, ethnicity, genes and polygenic disorder.

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10
Q

Aims of diabetic treatment…

A

Achieve normoglycemia, return BP/cholesterol to normal and adopt a healthy lifestyle.

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11
Q

Insulin Therapy (T1)…

A

Insulin apart / glusine/ lisper = Given 30-60 minute of onset to last 8 hours, injected with food.
Isoprene insulin = lasting 16-35 hours.
Protamine Zinc / Biphasic insulin = long lasting.

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12
Q

Glucagon Therapy (T1)…

A

For severe hypoglycaemia.
Reconstituted prior to use.
Acutely raises plasma glucose to promote glycogenolysis, gluconeogenesis and lipolysis.

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13
Q

Hypoglycaemic Therapy (T2)….

A

Oral/injectable peptide agents that stimulate Bcell release to improve insulin sensitivity and slow rate of glucose absorption.

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14
Q

Secretagogues I (T2)…

A

Boost insulin release and enhance normal physiology of glucose stimulated insulin secretion.

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15
Q

Examples of Secretagogues I…

A

Sulphonylureas -Small molecule antagonists of K channel.
Gliclazide / Diamicron / Tolbutamide / Orinase / meglintides - short acting.
Chlorpropamide / Diabinese / Glibenclamide/ Glipizide / Glucotrol / Glimepride / Amaryl - long lasting.

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16
Q

Secretagogues II (T2) Incretin Mimetics…

A

Eventide / Liraglutide / Byetta / Victoze. Injectable.

GLP-1 breakdown by DPP4

17
Q

Side Effects of Secretagogues II…

A

GI disturbance, N&V, diarrhoea, dyspepsia, abode pain, distention, gastro-eoso reflux, loss appetite, headache, dizziness, agitation, asthenia, sweating, antibody formation.

18
Q

Secretagogues III…

A

Glistens, Sitagliptin and Bildagliptin.

19
Q

Side effects of Secretagogues III…

A

Vomit, dyspepsia, gastritis, peripheral oedema, headache, dizziness, fatigue, uti, upper resp infection, gastroenteritis, sinusitis, nasopharyngitis, hypoglycaemia, myalgia, cyslipiaemia, hypertpolyeridaemia, erectile dysfunction, arthralgia, rashes.

20
Q

Mechanism of Diazoxide…

A

Treats congenital hyperinsulinism in infancy, insulinomas and severe transient hypoglycaemia.
Small molecule agonist of K channel.

21
Q

Side effects of Diazoxide…

A

Anorexia, N&V, hyperuricaemia, hypotension, oedema, tachycardia, arrhythmia, extrapyramidal effects, hypertrichosis.

22
Q

Mechanism of Insulin sensitisers…

A

Improve sensitivity of target organs to insulin.

23
Q

Examples of Insulin sensitisers…

A

Biguanides (Proglitazone, Glipzide, Glibenclamide, Sitagliptin) = prevent hepatic production of glucose and overcome insulin resistance by increasing sensitivity.
Thiazolidinediones/Glitazones - activate PPARy protein in insulin sensitive gene transcription to regulate glucose/fat metabolism.

24
Q

Mechanism of A-Glucodase inhibitors…

A

Concert oligosaccharides to glucose.

Acarbose inhibits this slowing absorption of starch and blood glucose rise.

25
Q

Examples of A-Glucodase inhibitors…

A

Acarbose and Glucobay

26
Q

Side effects of A-Glucodase inhibitors…

A

flatulence, diarrhoea, abode pain, N&V, indigestion, liver function problems, oedema, blood disorders, allergic skin reactions, intestinal problems.

27
Q

SGLT2 inhibitor action…

A

Glucose reabsorption, eliminating excess glucose from urine = weight loss an osmotic diuresis to reduce hypertension.

28
Q

Examples of SGLT2 inhibitors…

A

Dapaglifozin, Canaglifozin and Empaglifozin.

Applied Pharmacology (13 decks)

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