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David's lecture > Metabolism 4 > Flashcards

Metabolism 4 Flashcards

1
Q

In type 2 diabetes you treat the consequences rather than curing the disease. TRUE OR FALSE?

A

TRUE

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2
Q

Name the different types of classes of type 2 diabetes oral drugs?

A
  • SFU
  • Metformin
  • Glinides
  • DDP-inhibitors
  • A-glucosides
  • TZDs
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3
Q

Name the different type of classes of type 2 diabetes parental drugs?

A
  • Insulin

- GLP-4 receptors

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4
Q

Metformin is the standard drug for first in line therapy for most type 2 diabetic patienst. TRUE OR FALSE?

A
  • TRUE
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5
Q

what is the mechanism of action for metformin?

A
  • It reduces heaptic glucose output

- Increases sensitivity to insulin

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6
Q

Metformin causes hypoglycemia. TRUE OR FALSE?

A

FALSE

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7
Q

what are some ADRs for metformin?

A
  • It causes lactic acidosis
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8
Q

What is AMPK?

A
  • It is a protein kinase
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9
Q

When is AMPK actiavted?

A
  • When there is an increased in intracellular cAMP
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10
Q

AMPK is the cells fuel sensor. TRUE OR FALSE?

A

TRUE

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11
Q

What does AMPK actiavtes?

A
  • Glucose uptake
  • Glycolysis
  • Fatty acid oxidation
  • Mitochondrial biogenesis
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12
Q

What are the three classes of drugs that stimulate an increase in insulin secretion?

A
  • Sulfonylureas - glucose independent insulin release
  • GLP-1 receptor - glucose dependent increase insulin secretion
  • DDP-4 inhibitors - which stimulate activity of GLP-1 receptors
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13
Q

How does glucose-stimulated insulin secretion occur ?

A
  • An increase in intracellular glucose leads to increase in ATP levels
  • Causes ATP-sensitive K+ channels to close and memebrane depolarises
  • Volatge gated Ca+ channels open, ca+ floods into the cell
  • Leads to insulin secretion and synthesis
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14
Q

How do sulfonylureas work in causing insulin release?

A
  • SU binds to SUR-1 which is a component of the ATP-sensitive K+channel
  • ATP-sensitive K+ channle to close and membrane depolarises
  • Volateg agted Ca+ channles to open - ca+ flood in
  • Insulin secretion
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15
Q

Give an exmple of a sulfonylurea drug and what are they indicated for?

A
  • Gliclazide - indicated fo type 2 diabetes ont not effective in type 1
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16
Q

Meglinitides are also glucose independent insulin secrettagogues. TRUE OR FALSE?

A

TRUE

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17
Q

Sulfonylureas and meglinitides are preffered because of the the reduced chances of hypoglycemia? TRUE OR FALSE?

A

TRue

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18
Q

Sulfonylureas and meglinitides are highyl plasma bound. TRUE OR FLASE?

A

TRUE

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19
Q

Sulfonylureas and meglinitides do cause hypoglycemia at titrated doses and they cause weight gain. TRUE OR FALSE?

A

TRUE

20
Q

Repaglinide is clincally effective and cost effective and is a prefered choice if metformin is not working? TRUE OR FALSE?

A

TRUE

21
Q

Should not combine sulfonylureas and meglitinides as they both thave the same mechanism of action. TRUE OR FALSE?

A

TRUE

22
Q

what are incretins?

A
  • They are hormones that are secreted from the gut after a meal e.h GLP-1 OR GIP
23
Q

Incretins include GLP-1 agonist and DPP-4 antagonists and they cause glucose stimulated insulin release. TRUE OR FALSE?

A

TRUE

24
Q

Provide an example of a GLP-1 agonist and a DPP4 anatgonist?

A
  • GLP-1 agonist - Exenatide

- DPP4-antagonist - Sitagliptin

25
Q

How do GLP-1 agonists work?

A
  • They are glucose stimulated insulin release
  • They increase secretory machinery
  • Increase insulin biosynthesis
  • Increase activity of ca+channels
26
Q

GLP-1 do not cause insulin release in the absence of glucose so risk of hypoglycemia is reduced. TRUE OR FLASE?

A

TRUE

27
Q

GLP-1 have a short half life. TRUE OR FLASE?

A

TRUE

28
Q

How do DPP-4 inhibitors work?

A
  • They increase the plasma concentration of GLP-1 which increases insulin secretion
29
Q

DPP-4 inhibitors have good oral bioavailbility. TRUEOR FALSE?

A

TRUE

30
Q

GLP-1 agonists, are cleared by proteolytic degradation . TRUE OR FASE?

A

TRUE

31
Q

GLP-1 have a short half lives and no oral bioavailbilty so are given as injections. TRUE OR FALSE?

A

TRUE

32
Q

GLP-1 agonist cause signifcant weigth loss in some patients. true or flase?

A

true

33
Q

DPP-4 inhibitors are considered safe and have reduced risks of hypoglycemia. TRUE OR FALSE?

A

TRUE

34
Q

Why is the use of GLP-1 agonists so resticted?

A
  • Costs -they are more expensive
  • Conveniece - they are injecetdable whilst DPP-4 are oral
  • Side effects - cause vomiting and nausea whic cahave adherence issues
35
Q

What are TZDs and hwo do they work?

A
  • They are insulin sensitisers - they improve insulin sensitivity by decreasing ectopic fat storage
  • They act as ligands to the PPARg transcritpion factor
36
Q

Give an example of a TZD drug?

A
  • Pioglitazone
37
Q

TZDs can take several months to work? true or false?

A

true

38
Q

How do SGLT2 inhibitors work?

A
  • They increase excretion of glucose through the urine leading to decreased plasma glucose
39
Q

What are the ADRs of some SGLT2 inhibitors?

A
  • Can cause hypotension and hypovolemia due to increased urination
40
Q

what is ketone body production driven by?

A
  • Driven by uncrontolled lipolysis
41
Q

Ketone body is not used as a fuel when glucose level sare high which leads to accumulation of ketone bodies leading to acidifaction of blood. TRUE OR FALSE?

A

TRUE

42
Q

Diabetic ketoacidosis usually occurs in type 1 diabetes. true or fkase?

A

true

43
Q

Some patients being treated with SGLT2 inhibitors have been seen to have DKA. TRUE OR FALSE?

A

TRUE

44
Q

There are different types of insulin with diffrent duration of actions . true or false?

A

true

45
Q

hwo do inhibition of glucose uptake work?

A
  • Inhibits a-glucosidase
46
Q

Inhibition of glucose uptkae are indicated for uncontrolled type 2 diabetes. TRUE OR FLASE?

A

TRUE

David's lecture (13 decks)

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