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Insulin Flashcards

1
Q

T/ F

the beta cells in the islets of Langerhans secrete insulin

A

T

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2
Q

pancreatic acini

A. Exocrine
B. Endocrine

A

A

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3
Q

digestive enzymes

A. Exocrine
B. Endocrine

A

A

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4
Q

islets of Langerhans

A. Exocrine
B. Endocrine

A

B

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5
Q

glucagon, insulin

A. Exocrine
B. Endocrine

A

B

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6
Q

somatostatin, gastrin

A. Exocrine
B. Endocrine

A

B

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7
Q

pancreatic polypeptide

A. Exocrine
B. Endocrine

A

B

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8
Q

T/F

insulin inhibits glucose production

A

T

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9
Q

T/ f

glucagon is produced by the alpha cells in the islets of
Langerhans and opposes the action of insulin

A

T

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10
Q

T/ F

insulin promotes protein and lipid metabolism

A

T

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11
Q

T/ F

insulin receptors are G-protein coupled receptors and need second messengers (tyrosine kinase)

A

T

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12
Q

insulin-dependent

A. Type I
B. Type II
C. Type III
D. Type IV

A

A

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13
Q

juvenile onset

A. Type I
B. Type II
C. Type III
D. Type IV

A

A

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14
Q

selective beta cell destruction & severe or
absolute insulin deficiency (hallmark)

A. Type I
B. Type II
C. Type III
D. Type IV

A

A

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15
Q

cannot be given oral hypoglycemics

A. Type I
B. Type II
C. Type III
D. Type IV

A

A

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16
Q

can be triggered by invasion of viruses or by
chemical toxins

A. Type I
B. Type II
C. Type III
D. Type IV

A

A

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17
Q

shows classic symptoms:

o polydipsia
o polyphagia
o polyuria
o weight loss

A. Type I
B. Type II
C. Type III
D. Type IV

A

A

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18
Q

maturity onset

A. Type I
B. Type II
C. Type III
D. Type IV

A

B

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19
Q

not insulin-dependent

A. Type I
B. Type II
C. Type III
D. Type IV

A

B

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20
Q

tissue resistance to the action of insulin combined with relative deficiency of insulin

A. Type I
B. Type II
C. Type III
D. Type IV

A

B

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21
Q

other causes:

o pancreatitis

A. Type I
B. Type II
C. Type III
D. Type IV

A

C

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22
Q

gestational diabetes

A. Type I
B. Type II
C. Type III
D. Type IV

A

D

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23
Q

occurs during the third trimester of
pregnancy

A. Type I
B. Type II
C. Type III
D. Type IV

A

D

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24
Q

T/ F

it is important to treat first the other diseases, such as hypertension, because most often they coincide together like in the Big Three: hypertension, high cholesterol levels, and diabetes

A

T

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25
Q

secretion is most commonly triggered by increase in blood glucose

A

INSULIN

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26
Q

T/ F

insulin binds to receptors found in the target tissues such as liver, muscle, adipose tissue

A

T

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27
Q

permit more physiologic prandial insulin replacement because their rapid onset & early peak action more closely mimic normal endogenous prandial insulin secretion

A. RAPID-ACTING INSULIN (INSULIN LISPRO)

B. SHORT-ACTING INSULIN (REGULAR INSULIN)

C. INTERMEDIATE-ACTING INSULIN (NEUTRAL PROTAMINE HAGEDORN INSULIN)

D. LONG-ACTING INSULIN

A

A

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28
Q

→ preferred insulin for use in continuous subcutaneous insulin infusion devices

→ administered prior to a meal

A. RAPID-ACTING INSULIN (INSULIN LISPRO)

B. SHORT-ACTING INSULIN (REGULAR INSULIN)

C. INTERMEDIATE-ACTING INSULIN (NEUTRAL PROTAMINE HAGEDORN INSULIN)

D. LONG-ACTING INSULIN

A

A

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29
Q

→ given 30-45 minutes before a meal
→ only type that should be administered IV

A. RAPID-ACTING INSULIN (INSULIN LISPRO)

B. SHORT-ACTING INSULIN (REGULAR INSULIN)

C. INTERMEDIATE-ACTING INSULIN (NEUTRAL PROTAMINE HAGEDORN INSULIN)

D. LONG-ACTING INSULIN

A

B

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30
Q

delayed absorption because of its conjugation with protamine

A. RAPID-ACTING INSULIN (INSULIN LISPRO)

B. SHORT-ACTING INSULIN (REGULAR INSULIN)

C. INTERMEDIATE-ACTING INSULIN (NEUTRAL PROTAMINE HAGEDORN INSULIN)

D. LONG-ACTING INSULIN

31
Q

→ only given SQ

→ useful in treating all types of diabetes except diabetic
ketoacidosis or emergency hyperglycemia

A. RAPID-ACTING INSULIN (INSULIN LISPRO)

B. SHORT-ACTING INSULIN (REGULAR INSULIN)

C. INTERMEDIATE-ACTING INSULIN (NEUTRAL PROTAMINE HAGEDORN INSULIN)

D. LONG-ACTING INSULIN

32
Q

usually given along with rapid or short-acting insulin for
mealtime control

A. RAPID-ACTING INSULIN (INSULIN LISPRO)

B. SHORT-ACTING INSULIN (REGULAR INSULIN)

C. INTERMEDIATE-ACTING INSULIN (NEUTRAL PROTAMINE HAGEDORN INSULIN)

D. LONG-ACTING INSULIN

33
Q

INSULIN GLARGINE

A. RAPID-ACTING INSULIN (INSULIN LISPRO)

B. SHORT-ACTING INSULIN (REGULAR INSULIN)

C. INTERMEDIATE-ACTING INSULIN (NEUTRAL PROTAMINE HAGEDORN INSULIN)

D. LONG-ACTING INSULIN

34
Q

INSULIN DETEMIR

A. RAPID-ACTING INSULIN (INSULIN LISPRO)

B. SHORT-ACTING INSULIN (REGULAR INSULIN)

C. INTERMEDIATE-ACTING INSULIN (NEUTRAL PROTAMINE HAGEDORN INSULIN)

D. LONG-ACTING INSULIN

35
Q

LONG-ACTING INSULIN :

usually given daily

→ should not be used with other types of insulin

A. INSULIN GLARGINE
B. INSULIN DETEMIR

36
Q

LONG-ACTING INSULIN:

“peakless”

A. INSULIN GLARGINE
B. INSULIN DETEMIR

37
Q

→ slow dissociation with albumin
→ associated with less hypoglycemia

→ given twice (2x) daily

A. INSULIN GLARGINE
B. INSULIN DETEMIR

38
Q

T/F

INSULIN DELIVERY SYSTEMS:

In IV injection, the onset of action is fast, but it has a short duration of action.

39
Q

retinopathy, nephropathy, neuropathy

A. Microvascular
B. Macrovascular

40
Q

MI
stroke
renal failure

A. Microvascular
B. Macrovascular

41
Q

blindness,
lower extremity amputation

A. Microvascular
B. Macrovascular

42
Q

INSULIN SECRETAGOGUES are? (2)

A

SULFONYLUREAS

MEGLITINIDE ANALOGS

43
Q

INSULIN SENSITIZERS are? (5)

A

BIGUANIDES

THIAZOLIDINEDIONES OR GLITAZONES

ALPHA-GLUCOSIDASE INHIBITORS

DIPEPTIDYL PEPTIDASE-IV INHIBITORS

INCRETIN MIMETICS

44
Q

Tolbutamide

A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS

45
Q

Glipizide

A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS

46
Q

promote the release of insulin from the pancreas

A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS

47
Q

used with caution in patients with hepatic or renal insufficiency
→ delayed excretion

A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS

48
Q

Repaglinide

A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS

49
Q

Nateglinide

A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS

50
Q

ADVERSE EFFECTS
→ _____ caused by Repalinide with Gemfibrozil

A

hypoglycemia

51
Q

Metformin

A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS

52
Q

drug of choice for newly diagnosed patients of Type II DM

A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS

A

C

(Metformin)

53
Q

ADVERSE EFFECTS

flatulence

A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS

54
Q

CONTRAINDICATIONS & COMPLICATIONS :

→ used with caution in:
o patients more than 80 years old
o patients with history of CHF (congestive heart failure) o alcoholic abuse
→ long term use may interfere with B12 absorption

A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS

55
Q

Pioglitazone

A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS

56
Q

Rosiglitazone

A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS

57
Q

synergistic with sulfonylureas & metformin

A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS

58
Q

MODE OF ACTION
→ target peroxisome proliferator-activated receptor gamma

A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS

59
Q

not used in nursing mothers

ADVERSE EFFECTS :
increased risk of fracture (osteopenia)

A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS

60
Q

Acarbose

A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS

61
Q

Miglitol

A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS

62
Q

Sitagliptin

A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS

63
Q

EXENATIDE

A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS

64
Q

used as adjunct treatment in Type II diabetics that failed to
achieve adequate glycemic control with sulfonylurea, metformin, glitazine, or a combination thereof

65
Q

useful in the treatment of Type II diabetes which cannot be managed with diet alone

A

INSULIN SECRETAGOGUES

66
Q

can be combined with Metformin or Glitazones

A

MEGLITINIDE ANALOGS

67
Q

risk of hypoglycemia is far less & may occur only if caloric
intake is not adequate or exercise is not compensated
calorically

68
Q

is poorly absorbed and metabolized primarily by
intestinal bacteria

69
Q

MODE OF ACTION
→ inhibition of enzyme peptidyl peptidase-IV which is responsible for inactivation of incretin hormones such as glucagon-like peptide-I → prolong the activity of incretin hormones → increase in insulin release & decrease in secretion of glucagon

A

DIPEPTIDYL PEPTIDASE-IV INHIBITORS

70
Q

MODE OF ACTION
→ act by delaying the digestion of CHO, resulting in low postprandial glucose levels

A

ALPHA-GLUCOSIDASE INHIBITORS

71
Q

PHARMACOKINETICS
→ well-absorbed
→ NOT METABOLIZE
→ excreted through urine

A

BIGUANIDES

72
Q

MODE OF ACTION
→ reduction of hepatic glucose output by inhibiting hepatic gluconeogenesis
→ slows intestinal absorption of sugars & improves peripheral glucose uptake & utilization

A

Biguanides

73
Q

MODE OF ACTION
→ act by delaying the digestion of CHO, resulting in low postprandial glucose levels
→ exert their effects by reversely inhibiting membrane-bound alpha-glucosidase in intestinal brush border

A

ALPHA-GLUCOSIDASE INHIBITORS

74
Q

→____ also inhibits pancreatic alpha-amylase, thus interfering with breakdown of starch to oligosaccharides

PHARMA (15 decks)

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