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Year 2 Pharmacology > Insulin > Flashcards

Insulin Flashcards

1
Q

Which of the following is an insulin-secretagogue used in the treatment of diabetes?

  • Glibenclamide
  • Metformin
  • Diazoxide
  • Acarbose
A

GLIBENCLAMIDE (is a Sulphonylureas Meglitinides)

It’s a Potassium ATP Channel Inhibitor - long acting

Boosts insulin release by enhancing all the normal physiology of glucose stimulated insulin release.

ORAL before meals 1/2x Daily

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2
Q

Insulin resistance will cause:

  1. reduction of glucose transport into muscle and adipose tissue
  2. inhibition of hepatic glucose production
  3. dyslipidemia due to inhibition of fatty acid transport into mitochondria
  4. hypertrophy of the pancreatic beta cells
A

reduction of glucose transport into muscle and adipose tissue

Can result in Keto-acidosis as the body is burning fat and protein for weight loss

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3
Q

How does Exanatide work?
-Activating the glucagon-like peptide 1 (GLP-1) receptor

  • Acting on adipocytes to increase insulin sensitivity
  • Slowing the absorption of polysaccharides
  • Sensitising the liver and muscle cells to insulin
A

-Activating the glucagon-like peptide 1 (GLP-1) receptor

It’s a Insulin Secretagogue and boosts insulin release by enhancing normal physiology incretin mediated insulin release. (Incretin Memetic)

SC injection given with other therapies. SE n/v and diarrhea, GORD, headache dizziness.

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4
Q

Name some INSULIN SECRETAGOGUES

A
  • K ATP Channel Inhibitors (Sulphonylureas, Meglitinides)
  • DPP-4 Inhibitors (Gliptins)
  • GLP-1 Receptor Agonists (Exantide, Liraglutide)
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5
Q

Which of the following is NOT a principal target for the actions of insulin?

  • The brain
  • The liver
  • The muscles
  • Adipose tissue
A

THE BRAIN

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6
Q

Describe the Process of Gluocse Stimulated Insulin Release

And therefor target for diabetes drugs

A 
Food Intake
--------------
Digestion
-------------
Glucose  Uptake by B cells
--------------
Inhibition of K ATP channels
-------
Depolorisation of the cell
------------
Calcium Unfux
-------
Insulin Release
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7
Q

What drugs raise the half life of serum GLP-1 which therefore boosts insulin release…

A

GLIPTINS (GLP for GLIptins)

For example
SITAGLIPTIN
VIOAGLIPTIN

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8
Q

`When are Hyperglycemia therapies such as DIAZOXIDE used?

A

They’re used for congenital hyperinsulin sensitivity in infants, insulinomas and sever cases of transient hypoglycemia.
GIVEN ORALLY with Chlorothiazide

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9
Q

What do SGLT2 Inhibitors stand for and how do they work…

A

Sodium Coupled Glucose Transporter Inhibitors (Dapaliifozin, Canaglifozin)
The SCGT reabsorbs glucose so if you inhibit this it causes excess glucose to be excreted in the urine.
(zin bit like wizz ;P )

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10
Q

Name some SGLT2 Inhibitors

A

Dapaglifozin
Canglifozin
Empaglifozin
(end in ZIN like Wizz ;) because they cause glucose in urine)

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11
Q

What do these T2DM terms stand for:
GDM
NDM
MODY

A

Gestational Diabetes Mellitus
Neonatal Diabetes Mellitus
Maturity Onset Diabetes Mellitus

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12
Q

Name the 3 basic Insulin Preparations for T1DM

A
  1. Short Duration; Rapid onset of Action (insulin aspart, glulisine and lispro)
  2. Intermediate Action (Isophane Insulin-human bovine or atrificail)
  3. Longer Lasting: Slower in Onset and Lasts for long periods (zinc insulins, insulin determir & glargine
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13
Q

Insulin ASPART, Insulin GLULISINE and Insulin LISPRO are all what type of insulin for T1DM

A

SHORT ACTING:

  • Rapid onsed 30-60 mins
  • Peak acion: 2-4 Hours
  • Duration 8 hours
  • Inject before food
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14
Q

Name some Intermediate Insulins for T1DM

A

Insulin DETERMIR,
Insulin GLARGINE,
Insulin ZINC SUSPENSION, ISOPHANE insulin,
PROTAMINE ZINC Insulin

Onset 1-2 hours. Peak action 4-12 hours, Duration 16-53 Hours

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15
Q

What is a healthy fasting glucose level? aka Normoglycemia

A

3-5mmol/L healthy fasting value (normoglycaemia)

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16
Q

Which pancreas cells release Glucagon and which release Insulin?

A

β-cells; release insulin

α-cell; release glucagon

17
Q

True or false:

IV glucose load produces a faster insulin response than oral glucose load.

A

FALSE:

Oral glucose load produces a faster insulin response than intravenous glucose

18
Q

What are the types of Diabetes?

A

T1DM
T2DM: GDM, MODY, NDM

Then there are people on the spectrum who aren’t diabetic but are at risk (pre-diabetes)

19
Q

What time of life are people more susceptible to T1DM?

A

Childhood

20
Q

True or false?

In people with Type 1 DM, insulin-producing cells have no b-cells and insulin must be provided

A

TRUE

21
Q

How is Glucagon therapy used and name some characteristics of Glucagon therapy.

A

It’s a HYPERglycemic inducing drug:
Glycogenolysis (glycogen to glucose)
Gluconeogenesis
Lipolysis (fat to FAs)

Used in severe HYPO-glycemia when oral glucose is not possible. It’s given SC,IM,IV and must be reconstituted prior to use.

22
Q

Name some K ATP Insulin secretagogues that are used for the treatment of T2DM

A 
GlicaZIDE
TolbutamIDE
ChlopropaMIDE
GlipizIDE
GlimepRIDE

k ATP inhibitors all end in IDE (ATP/IDE)

23
Q

Name a common SE of the drug DIAZOXIDE used for the congenital treatment of hyper-insulin sensitivity in infants.

A

HYPERTRICHOSIS

Excess hair growth!!! But it is reversible if treatment stops

24
Q

What drug makes you wee out glucose in their urine?

Hint: ZIN (wizz)

A

SGLT2 Inhibirots - sodium coupled glucose transporter inhibitors

Dapaglifozin
Canaglifozin
Empaglifozin

25
Q

What drugs target the K ATP channels?

A

Sulfphonylureas and Meglitinides

26
Q

What drug raises the half life of serum GLP-1?

A

GLIPTINS; Sitagliptin, Vioagliptin (ORAL)

27
Q

What drug is often used for T2DM falls under the ‘Biguanides’ category of insulin sensitizers?

A

Metformin
It’s preferred as it doesn’t cause weight gain, can be used in children and teens. Can be used in heart failure patients.
It’s often in combined therapies with other drugs like gliptins (glipizide) and K ATP channel inhibitors (repaglinide)

28
Q

What are the two classes of insulin sensitisers?

A
  • Biguanides (metformin) (metformin is the BIGdog of insulins haha)
  • Thiazolidinediones (Roseglitizone, Pioglitazone)
29
Q

Name some thiazolidiedione Insulin Sensitizers…

hint: DIONE/ ZONE

A

Rosiglitizone
Pioglitazone

Oral 2x daily. Regular glucose and fat metabolism drugs.

Also : Arandia- had to be banned as it caused Heart SE

30
Q

What is the basic role of insulin sensitizers?

A

They increase the sensitivity of target organs to insulin

Can act in different ways (Biguanides, Thiazolidinediones)

31
Q

What is the difference between insulin sensitizers

Biguanides and Thiazolidinediones?

A

Biguanides - activate enzymes which prevent heptatic priduction of glucose and overcome insulin resistance by improving insulin sensitivity
Thiazolindinediones - Modify gene transcription

32
Q

What drugs modify Glucose Breakdown?

Hint: Glucos is in the name

A

a_Glucosidase Inhibitors

Such as
Acarbose
Glucobay

33
Q

What is the mechanism of a-Glucosidase Inhibitors?

Such as Acarbose and Glucobay

A

a-Glucosidase converts oligosaccharides into glucose and by inhibiting this you modify glucose breakdown
Also slows the absorbsion of starchy foods so slows the rise in blood sugars (Acarbose)

34
Q

What does the name of this drug stand for?

SGLT2

A

Soduim-Coupled Glucose Transporter2

It role is in glucose reabsorbsion and work by causing excessive glucose to be excreted in the urine which reduces the hyperglycemia levels.

Year 2 Pharmacology (11 decks)

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