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Pharma > Insulin > Flashcards

Insulin Flashcards

1
Q

Aspart

A

Insulin

Rapid

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2
Q

detemir

A

Insulin
Long acting

Modded C-terminal thr B chain deleted and myristic acid added to increase self aggregation and binding to albumin

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3
Q

glargine

A

Insulin
Long acting

Modded A21 from Asn to Gly and two Arg residues at B31 and B32

Makes insulin soluble at acidic pH but precipitates in neutral pH slowing the absorption

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4
Q

glulisine

A

Insulin

Rapid

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5
Q

lispro

A

Insulin

Rapid

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6
Q

NPH

A

Insulin

Intermediate acting

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7
Q

regular crystalline insulin

A

Insulin

Short Acting, wild type insulin

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8
Q

exenatide

A

incretin-like drugs

Incretin agonist

SQ

SE:

  • Nausea
  • Anorexia
  • Headaches
  • Diarrhea
  • Pancreatitis
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9
Q

sitagliptin

A

incretin-like drugs

Inhibit incretin degradation

Oral (sit and eat)

Incretin stimulates insulin release from B cells and reduces glucagon from A cells

SE:

  • Headache
  • Increased rate of infections
  • Pancreatitis

Lowers postprandial glucose

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10
Q

pramlintide

A

amylin analogs

Amylin hormone made by B cells that inhibit glucagon secretion by A cells

CNS anorectic Effect

SQ

W/insulin useful in type I diabetics

SE:

  • hypoglycemia
  • nausea
  • vomiting
  • anorexia
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11
Q

chlorpropamide

A

sulfonylureas:
First Gen
60 h

They

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12
Q

glipizide

A

sulfonylureas
Second Gen
More potent and available
10-24 h

They

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13
Q

glyburide

A

sulfonylureas
2nd Gen
10-24h

They

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14
Q

glimepiride

A

sulfonylureas
2nd gen
10-24h

They

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15
Q

tolbutamide

A

sulfonylureas
1st Gen
6-12h

They

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16
Q

repaglinide

A

meglitinides:

Similiar to sulfonylureas prevent K efflux from B cells increasing insulin production

Chemically unrelated

Binding affinity to K channels higher than sulfonylureas

More potent than sulfonylureas but shorter acting 4-5h

Side effects:
Hypoglycemia

Cautiously use in patients with renal or hepatic insufficiency

17
Q

nateglinide

A

phenylalanine analogs

Stimulates insulin production by preventing the efflux of K in B cells

Faster response but less sustained

Side Effects:
Hypoglycemia but less pronounced

Safer in reduced renal function patients

18
Q

metformin

A

biguanides

Oldest insulin drug

Inactivate mito gylcerophosphate dehydrogenase

Antagonize the action of glucagon and/or activate AMP-activated protein kinase

Occur in Liver

Reduce gluconeogenesis and hepatic glucose output

First line therapy in type 2 diabetes

SE:

  • GI discomfort
  • Lactic acidosis
  • Does not induce weight gain or hypoglycemia
19
Q

rosiglitazone

A

thiazolidinediones

Agonist of PPARy
Increase insulin sensitivity in target tissues

SE:

  • weight gain
  • fluid retention
  • liver toxicity
20
Q

pioglitazone

A

thiazolidinediones

Agonist of PPARy
Increase insulin sensitivity in target tissues

SE:

  • weight gain
  • fluid retention
  • liver toxicity
21
Q

acarbose

A

a-glucosidase inhibitors

Reduce intestinal absorption of carbs by inhibiting alpha glucosidases

SE:

  • Flatulence
  • Diarrhea
  • Abd pain
22
Q

miglitol

A

a-glucosidase inhibitors

Reduce intestinal absorption of carbs by inhibiting alpha glucosidases

SE:

  • Flatulence
  • Diarrhea
  • Abd pain
23
Q

bromocriptine

A

dopaminergic agents

Stimulates insulin secretion through adrenergic stimulation

24
Q

canagliflozin

A

inhibitors of glucose reabsorption

Inhibits SGLT2 in Kidney

Inhibit reabsorption promoting glucose excretion of kidney

ORAL

SE:

  • UTIs
  • Increased Urination
25
Q

Adverse Reaction to Insulin

A

Hypoglycemia

  • Cause overdose or failure to eat
  • Treatment: oral glucose, IV glucose, SQ or IM glucagon

Lipodystrophy at site of injection

Insulin allergy and resistance

26
Q

Adverse Reactions to Sulfonylrueas

A

Hypoglycemia

Resistance

Tachyphylaxis

Pharma (39 decks)

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