Insulin Flashcards
1
Q
T/ F
the beta cells in the islets of Langerhans secrete insulin
A
T
2
Q
pancreatic acini
A. Exocrine
B. Endocrine
A
A
3
Q
digestive enzymes
A. Exocrine
B. Endocrine
A
A
4
Q
islets of Langerhans
A. Exocrine
B. Endocrine
A
B
5
Q
glucagon, insulin
A. Exocrine
B. Endocrine
A
B
6
Q
somatostatin, gastrin
A. Exocrine
B. Endocrine
A
B
7
Q
pancreatic polypeptide
A. Exocrine
B. Endocrine
A
B
8
Q
T/F
insulin inhibits glucose production
A
T
9
Q
T/ f
glucagon is produced by the alpha cells in the islets of
Langerhans and opposes the action of insulin
A
T
10
Q
T/ F
insulin promotes protein and lipid metabolism
A
T
11
Q
T/ F
insulin receptors are G-protein coupled receptors and need second messengers (tyrosine kinase)
A
T
12
Q
insulin-dependent
A. Type I
B. Type II
C. Type III
D. Type IV
A
A
13
Q
juvenile onset
A. Type I
B. Type II
C. Type III
D. Type IV
A
A
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
15
Q
cannot be given oral hypoglycemics
A. Type I
B. Type II
C. Type III
D. Type IV
A
A
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
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
18
Q
maturity onset
A. Type I
B. Type II
C. Type III
D. Type IV
A
B
19
Q
not insulin-dependent
A. Type I
B. Type II
C. Type III
D. Type IV
A
B
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
21
Q
other causes:
o pancreatitis
A. Type I
B. Type II
C. Type III
D. Type IV
A
C
22
Q
gestational diabetes
A. Type I
B. Type II
C. Type III
D. Type IV
A
D
23
Q
occurs during the third trimester of
pregnancy
A. Type I
B. Type II
C. Type III
D. Type IV
A
D
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
25
secretion is most commonly triggered by increase in blood glucose
INSULIN
26
T/ F
insulin binds to receptors found in the target tissues such as liver, muscle, adipose tissue
T
27
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
28
→ 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
29
→ 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
B
30
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
C
31
→ 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
C
32
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
C
33
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
D
34
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
D
35
LONG-ACTING INSULIN :
usually given daily
→ should not be used with other types of insulin
A. INSULIN GLARGINE
B. INSULIN DETEMIR
A
36
LONG-ACTING INSULIN:
“peakless”
A. INSULIN GLARGINE
B. INSULIN DETEMIR
A
37
→ slow dissociation with albumin
→ associated with less hypoglycemia
→ given twice (2x) daily
A. INSULIN GLARGINE
B. INSULIN DETEMIR
B
38
T/F
INSULIN DELIVERY SYSTEMS:
In IV injection, the onset of action is fast, but it has a short duration of action.
T
39
retinopathy, nephropathy, neuropathy
A. Microvascular
B. Macrovascular
A
40
MI
stroke
renal failure
A. Microvascular
B. Macrovascular
B
41
blindness,
lower extremity amputation
A. Microvascular
B. Macrovascular
B
42
INSULIN SECRETAGOGUES are? (2)
SULFONYLUREAS
MEGLITINIDE ANALOGS
43
INSULIN SENSITIZERS are? (5)
BIGUANIDES
THIAZOLIDINEDIONES OR GLITAZONES
ALPHA-GLUCOSIDASE INHIBITORS
DIPEPTIDYL PEPTIDASE-IV INHIBITORS
INCRETIN MIMETICS
44
Tolbutamide
A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS
A
45
Glipizide
A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS
A
46
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
A
47
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
A
48
Repaglinide
A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS
B
49
Nateglinide
A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS
B
50
ADVERSE EFFECTS
→ _____ caused by Repalinide with Gemfibrozil
hypoglycemia
51
Metformin
A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS
C
52
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
C
(Metformin)
53
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
C
54
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
C
55
Pioglitazone
A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS
D
56
Rosiglitazone
A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS
D
57
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
D
58
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
D
59
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
D
60
Acarbose
A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS
E
61
Miglitol
A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS
E
62
Sitagliptin
A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS
F
63
EXENATIDE
A. SULFONYLUREAS
B. MEGLITINIDE ANALOGS
C. BIGUANIDES
D. THIAZOLIDINEDIONES OR GLITAZONES
E. ALPHA-GLUCOSIDASE INHIBITORS
F. DIPEPTIDYL PEPTIDASE-IV INHIBITORS
G. INCRETIN MIMETICS
G
64
used as adjunct treatment in Type II diabetics that failed to
achieve adequate glycemic control with sulfonylurea, metformin, glitazine, or a combination thereof
EXENATIDE
65
useful in the treatment of Type II diabetes which cannot be managed with diet alone
INSULIN SECRETAGOGUES
66
can be combined with Metformin or Glitazones
MEGLITINIDE ANALOGS
67
risk of hypoglycemia is far less & may occur only if caloric
intake is not adequate or exercise is not compensated
calorically
Metformin
68
is poorly absorbed and metabolized primarily by
intestinal bacteria
Acarbose
69
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
DIPEPTIDYL PEPTIDASE-IV INHIBITORS
70
MODE OF ACTION
→ act by delaying the digestion of CHO, resulting in low postprandial glucose levels
ALPHA-GLUCOSIDASE INHIBITORS
71
PHARMACOKINETICS
→ well-absorbed
→ NOT METABOLIZE
→ excreted through urine
BIGUANIDES
72
MODE OF ACTION
→ reduction of hepatic glucose output by inhibiting hepatic gluconeogenesis
→ slows intestinal absorption of sugars & improves peripheral glucose uptake & utilization
Biguanides
73
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
ALPHA-GLUCOSIDASE INHIBITORS
74
→____ also inhibits pancreatic alpha-amylase, thus interfering with breakdown of starch to oligosaccharides
Acarbose
