L18/19: diabetes mellitus drug therapy

Question 1

what are the symptoms of DM?

Answer 1

KETONEMIA
negative nitrogen balance

Question 2

what are the microvascular complications of diabetes ?

Answer 2

artheosclerosis
dyslipidemia

Question 3

what are the microvascular complications of DM?

Answer 3

neuropathy
nephropathy
retinopathy

Question 4

type III diabetes is ___

Answer 4

drug induced

Question 5

what’s the effect of insulin on glucose ?

Answer 5

conversation to glucose-6-phosphate

Question 6

what are the adverse effects of subcutaneous insulin ?

Answer 6

lipodystrophy at site of injection

Question 7

insulin resistance is characterized by no effect at what dose ?

Answer 7

100IU/ day

Question 8

sulfonylurease all start with G

Answer 8

G drugs fr

Question 9

what is the mechanism of sulfonylurease ?

Answer 9

competitively blocks SUR receptors on ATP-sensitive K channels located on pancreatic B cell membrane , resulting in insulin secretion

Question 10

what are the adverse effects of sulfonylurease ?

Answer 10

hyperinsulinemia , hypoglycemia particularly in ealderly patients

weight gain due to fluid retention and edema

crosses placenta barrier , may cause fetal hypoglycemia

Question 11

metformin is an example of which class of DM drug therapies?

Answer 11

biguanide

Question 12

what are the mechanisms of metformin ?

Answer 12

-increased uptake and utilization of glucose (decrease insulin resistance )

-inhibition of hepatic and renal gluconeogenesis

-slowing glucose absorption from GIT

-promotion of insulin binding to its receptors

Question 13

what are the advantages of metformin?

Answer 13

it does not result in any weight gain

lowers LDL and VLDL while increasing HDL

rarely causes hypoglycemia (anti-hyperglycemic effect )

Question 14

what’s the drug of choice for type II DM patients ?

Answer 14

metformin

Question 15

what are the adverse effects of metformin?

Answer 15

nausea , metallic taste , anorexia , diarrhea ,

long term use may decrease VIT B12 absorption

Question 16

extended use of which drug could result in decreased Vitamin B12 deficiency ?

Answer 16

metformin

Question 17

which drug is an example of an insulin sensitizers ?

Answer 17

pioglitazone

Question 18

what is the mechanism of pioglitazone (insulin sensitizers)?

Answer 18

increases insulin sensitivity and reverses insulin resistance

Question 19

what are the adverse effects of insulin sensitizers ?

Answer 19

weight gain due to fluid retention and rarely hepatotoxicity

Question 20

what is an example of insulin secretagogues ?

Answer 20

repaglinide

Question 21

what is the mechanism of DPP-4 inhibitors ?

Answer 21

inhibit DPP-4 which metabolizes GLP-1

Question 22

what’s the action go GLP-1 in the body?

Answer 22

released from the gut in response to oral glucose . it enhances postprandial insulin release , surpasses glucagon, and delays gastric emptying and surpasses appetite

Question 23

which anti diabetic drug therapy is used in combination with metformin/ SUR

Answer 23

DPP-4 inhibitors

Question 24

what is an example of DPP-4 inhibitors ?

Answer 24

vildagliptin

Question 25

what drug should not be used alongside SUR ?

Answer 25

insulin secretagogues

Question 26

what is the mechanism of insulin secretagogues?

Answer 26

Like the SUR, it stimulate insulin secretion. Rapid onset and a short duration of action

Question 27

what are the adverse effects of insulin secretagogues?

Answer 27

hypoglycemia and weight gain (incidence is lower than with SUR)

Question 28

Which drug has a longer T1/2?

Answer 28

vildagliptin

Question 29

what are the adverse effects of DDP-4 inhibitors?

Answer 29

nasopharyngitis , GI distress , diahrrea