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Pharmacology 2 > Insulin And Hypoglycaemics > Flashcards

Insulin And Hypoglycaemics Flashcards

0
Q

What do SGLT2 Inhibitors promote?

A

Glucose loss

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1
Q

Name two insulin sensitisers?

A

Thiazolidinediones

Biguanides

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2
Q

What do alpha glucosidase inhibitors delay?

A

Glucose absorption

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3
Q

What are three insulin secretagogues?

A

DPP4 inhibitors, GLP-1 receptor agonists, sulphonylureas/megtinides.

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4
Q

What are the 7 stages of cellular insulin release?

A 
Glucose uptake
Glucose metabolism
Potassium channel opening
Depolarisation 
Calcium channel opening
Calcium influx
Insulin release
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5
Q

What are six functional effects of insulin?

A

Increase conversion of glucose to glycogen
Increases the break down of amino acids to protein
Increases the breakdown of glucose to fat
Decreases gluconeogenesis
Decreases glycogen break down
Increases glucose and amino acid transport into cells

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6
Q

Where is glucagon released from?

A

Pancreatic alpha cells

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7
Q

Which hormones in the small intestine stimulate insulin release?

A

GLP 1

GIP

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8
Q

Which nerves in the small intestine stimulate insulin release?

A

Enteric

NS

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9
Q

Which is more effective oral or IV glucose?

A

Oral

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10
Q

What is impaired glucose regulation?

A

Pre diabetes (type 2)

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11
Q

Name 6 less common types of diabetes

A

Gestational diabetes
Transient neonatal diabetes
Permanent neonatal diabetes
Maturity onset diabetes of the young
Maternally inherited diabetes and deafness
Associated with syndromes - wolfram, alstrom…

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12
Q

What type of disease is DM Type 1?

A

An auto immune disease

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13
Q

What causes DM type 1?

A

Destruction and damage of beta cells

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14
Q

What are four risk factors of DM Type 2?

A

Obesity, family history, ageing, ethnicity

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15
Q

What are the two main complications of type 1 DM

?

A

Decreased insulin signalling

Elevated glucose

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16
Q

What are the three main complications of type 2 DM?

A

Elevated glucose
Elevated lipids
Insulin resistance

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17
Q

What are the broad treatment plans for type 1 DM?

A

Lifelong insulin, healthy diet, regular exercise.

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18
Q

What are the broad treatment palms for type 2 DM?

A

Lifestyle changes - weight, diet, activity.

Hypoglycaemic therapy and/or insulin.

19
Q

Give three examples of short acting insulin

A

Insulin aspart
Insulin glulisine
Insulin lispro

20
Q

When should you inject short acting insulin and how long does it take to work?

A

Before, with or just after food.

30-60 mins. Lasts 8 hours (peak 2-4)

21
Q

Give five examples of intermediate/longer duration insulin

A 
Insulin detemir
Insulin glargine
Insulin zinc suspension
Isophane insulin
Protamine zinc insulin
22
Q

Where is zinc found?

A

Pamcreatic B cells

23
Q

How often should insulin be injected?

A

Subcutaneous 3-4 times daily

24
Q

Which insulin is a mixture of intermediate and fast acting drug and has a rapid onset with long - lasting actions?

A

Biphasic insulin preparations eg biphasic insulin aspart

25
Q

When would you give glucagon therapy?

A

First aid treatment for severe hypoglycaemia when oral glucose is not possible

26
Q

How do secretagogues work?

A

Close the potassium channel - boost insulin release by enhancing aspects of normal physiology of glucose stimulated insulin secretion.

27
Q

Name two short acting sulphonylureas

A

Gliclazide and tolbutamide

28
Q

Name two long acting sulphonylureas

A

Chlorpropamide

Gibenclamide

29
Q

What do long acting sulphonylureas increase the risk of especially in the elderly?

A

Hypoglycaemia

30
Q

What are the three types of secretagogues?

A

Sulphonylureas
Meglitinides
Diazoxides

31
Q

Name two short acting megnitilides

A

Repaglinide

Nateglinide

32
Q

What is diazoxide used to treat?

A

Congenital hyperinsulnism, insulinomas, transient hypoglycaemia.

33
Q

What are the side effects of diazoxide?

A

Anorexia, nausea, vomiting, hyperuricaemia, hypotension, oedema, tachycardia, arrhythmias, extrapyramidal effects.

34
Q

Name two GLP1 receptor agonists?

A

Exenatide

Liraglutide

35
Q

Which enzyme rapidly breaks down GLP 1?

A

DPP4

36
Q

What do DPP4 inhibitors do?

A

Preserve GLP 1 levels

37
Q

Gilptins are a type of what?

A

DDP4 inhibitor

38
Q

Name 3 gilptins

A

Sitagliptin
Vildagliptin
Saxagliptan

39
Q

How do insulin sensitisers work?

A

Improve the sensitivity of target organs to insulin

40
Q

How do biguanides work?

A

Activate enzymes - agonist of AMPK

41
Q

Name a biguanide

A

Metformin

42
Q

Metformin is also available in…

A

Combination

43
Q

Give an example of a thiazolidnedione?

A

Rosiglitizone

44
Q

Name an alpha glucosidase inhibitor

A

Acarbose

Pharmacology 2 (14 decks)

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