Lec 3.5 - Diabetes drugs Flashcards
humilin is made from human insulin _____ in a plasmid expressed in ____
cDNA;
E. coli
Insulin:
name the 3 rapid acting/short action drugs:
lispro, aspart, glulisine;
ie act within 15 min, lasta for 4-8 hours
insulin:
____ has a rapid onset and is short acting.
____ has intermediate action and onset;
which has a cloudy appearance?
regular insulin (ie act within an hour, last 12 hours); NPH (neutral protamine hagedorn) (acts within an hour, lasts 24 hours)
NPH
insulin:
name the 3 slow onset, long acting insulins
glargine, detemir; decludec
last 24 hoiurs, usually taken at bed time or after breakfast
_____ binds insulin and releases insulin after cleavage by tissue proteases, accounting for its slow absorption
NPH
why are the rapid onset insulins so rapid?
what are they used for?
they don’t polymerize into insulin hexamers (due to altered amino acids);
for post-prandial spike (ie administer immediately before meal
insulin detemir and degludec bind _____ extensively = long duration of action
albumin
mixtures of _____ and _____ insulin can give a transient preprandial bolus and a prolonged basal level in a single injection
fast-onset, long acting
routes of administration:
subcutaneous = _____;
insulin infusion pump = ____ _____ and the rapid acting ones
all forms;
buffered regular
____ insulin may be administed via IV for ____ or ____
regular; hyperglycemia, ketoacidosis
_____ is a regular human insulin inhaled as a dry powder. it has a _____ duration of action than regular sub-cu insulin. contradicted in patients with ___ or ____ due to decreased FEV
afrezza; shorter;
asthma, COPD
insulin side effects:
_____ due to too much insulin or not enough food. treat with ____ or _____;
important agent that can increase risk of this side effect?
hypoglycemia;
Glucagon, glucose;
alcohol
other insulin side effects:
____ or _____ at an injection site
lipodystrophy, lipoatrophy
replacement insulin is necessary in treatment of type _____ DM;
oral agents and non-insulin injectables require functional ____ cells and are used in type ___ DM
1 (used in severe type 2);
beta, 2
mechanism of action of sulfonylureas
bind and close K+ channel–>depolarization–>calcium influx and insulin release
what transporter does glucose use to enter a beta cell?
GLUT2
the 1st gen sulfonylureas end in ___. name 2 of them
“-amide”;
chlorpropamide (more potent, longer lasting ie 1-3 days), tolbutamide (12 hr duration)
2nd gen sulfonylureas (3):
glimepiride, glipizide, glyburide;
all have 24 hour duration
name the 2 meglitinides: (end in ____)
mechanism of action?
glinide = nateglinide, repaglinide;
bind K+ channels (similar to sulfonylureas)
sulfonylurea vs meglitinides:
which are used for post prandial insulin release (ie short acting)?
which can cause a sulfa allergy?
which require functional beta cells?
meglitinides;
sulfonylureas;
both