Hypoglycemic angents

Question 1

crystallin zinc (regular)

Answer 1

onset 30 min; peak 1-3 hrs; duration 6-8 hrs

Question 2

Insulin aspart

Answer 2

onset 15 min; peak 1-5 hrs; duration 3-5 hrs

Question 3

Lispro insulin (humalog)

Answer 3

Onset 15 min; peak 1 hr; duration 3-6 hrs

Question 4

Insulin glulisine

Answer 4

Onset <15 min; peak 0.5-2hrs; duration 3-5 hrs

Question 5

NPH Insulin

Answer 5

onset 1-2 hrs; peak 8-10 hrs; duration 12-16 hrs

Question 6

Insulin Detemir

Answer 6

Onset 1-2 hrs; duration 12-24hrs

Question 7

Insulin Glargine

Answer 7

Onset 1hr; duration about 24 hrs; goes into muscle and leaks out

Question 8

Mixtures

Answer 8

NPH/Lispro and NPH/Aspart

Question 9

Factors altering dose

Answer 9

Hyperthyroidism, stress, cessations of physical exercise, increased food intake, drug therapy (HCTZ lower K levels leads to reduction in insulin)

Question 10

Beta Blocker contraindicated

Answer 10

Masks symptoms of hypoglycemia (tremor and HR) and prevents the liver from producing glucose

Question 11

Sulfinyl ureas

Answer 11

Glyburide, Glipizide, Glimepiride; MOA: Blocks K channel and increases insulin secretion; AE: GI upset, hypoglycemia

Question 12

Metformin

Answer 12

Decreases glucose production in liver and increases glucose uptake; AE Metallic taste, GI upset, anorexia, lactic acidosis (impaired renal function)

Question 13

Acarbose

Answer 13

Taken with meals, inhibits alpha-glucosidase (inhibits breakdown of complex carbohydrates (delays glucose absorption)

Question 14

Pioglitazone

Answer 14

Binds to PPAR-gamma receptor; increases transcription of insulin responsive genes, reduced gluconeogenesis and increases glucose uptoake; AE: increased fluid retention resulting in heart failure

Question 15

Repaglinide

Answer 15

Stimulates insulin secretion like sulfonylureas but shorter acting, taken with meals

Question 16

Sitagliptan

Answer 16

inhibit metabolism of GIP and GLP-1 (higher levels in blood), stimulates insulin and inhibits glucagon, inhibits dipeptidyl-peptidase 4

Question 17

Canagliflozin

Answer 17

Inhibits SGLT2 in kidney, prevents reabsorption in nephron, AE dehydration, Urinary tract and genital mycotic infections

Question 18

Exenatide

Answer 18

GLP-1 receptor agonist, stimulates insulin secretion and supresses glucagon, Makes pt. feel fuller eating less

Question 19

Pramlintidine

Answer 19

Modulates postprandial glucose levels (amylin analog); combined with other drugs in type 1 and type 2