Metabolism Drugs

Question 1

Insulin

Answer 1

regular - (subq) & Short acting
aspart - (subq) & Fixed combination
lispro - (subq) & Rapid acting
determir - (subq) & Long acting
glargine - (subq) & Long acting

• Decreases blood glucose levels by stimulating insulin receptors and inhibiting glucose production by liver

Treats: Hyperglycemia

Contraindications: Beta blockers (mask hypoglycemia symptoms), thyroid hormone (decrease effects of insulin), alcohol (alter glucose control)

Adverse Effects: hypokalemia, hypoglycemia

Question 2

sulfonylureas

Answer 2

glyburide, glipizide

• glyburide: unknown; likely stimulates insulin release from pancreas and increases sensitivity to insulin
• glipizide: Stimulates insulin release from pancreas and increases sensitivity to insulin

Treats: hyperglycemia

Contraindications: Type 1 Diabetes, multiple drug interactions, alcohol (may alter glucose control)

Adverse Effects: Drowsiness, Dizziness, Headache, Abdominal bloating, Hypoglycemia

Question 3

biguanides

Answer 3

Met four men
metformin

• decreases blood glucose levels by decreasing GI absorption of glucose

Treats: hyperglycemia

Contraindications: Type 1 Diabetes, Beta Blockers (mask hypoglycemia symptoms), insulins (increase risk of hypoglycemia)

Question 4

incretin mimetics

Answer 4

liraglutide

• Decreases blood glucose levels by increasing secretion of insulin, reduces release of glucagon, delays stomach emptying

Treats: hyperglycemia

Contraindications: Type 1 Diabetes, alcohol (alter glucose control), multiple drug interactions

adverse effects: tachycardia, cholelithiasis (gallstones), flatulence

Question 5

DPP-4

Answer 5

sitagliptin

• Decreases blood glucose levels by prolonging the action of DPP-4 enzyme (Decrease glucagon release) resulting in decreasing glucose and increasing the secretion of insulin

Treats: hyperglycemia

Contraindications: Type 1 Diabetes, digoxin (increased levels), insulin (risk for hypoglycemia)

Question 6

glucose elevating agent

Answer 6

glucagon

• increase release of glucose

Treats: Severe Hypoglycemia

Question 7

thyroid hormone antagonist

Answer 7

methimazole

• inhibits synthesis of thyroid hormones

Treats: hyperthyroidism

Contraindications: Beta Blocker (increase effects), digoxin (increase effects), warfarin (increase effects)

Adverse Effects: loss of taste, hypothyroidism, coma, salivary gland enlargement, myalgia, lupus-like syndrome

Question 8

Bisphosphonates

Answer 8

alendronate

• inhibits breakdown of bone

Treats: osteoporosis

Contraindicated: Patients that cannot sit upright for 30 mins, antacids (interfere w/ absorption), foods (interfere w/ absorption)

Adverse Effects: taste alteration, acid reflux, esophageal ulcer, chest pain, difficulty swallowing

Question 9

Thyroid Hormone

Answer 9

Levothyroxine

• synthetic form of thyroxine

Treats: hypothyroidism

Contraindications: Antacids/grapefruit (affect absorption), amiodarone/lithium (reduce thyroid function), warfarin (has increased effects)

Adverse Effects: tremors, tachycardia, HTN, weight loss, decreased bone density, hair loss, heat intolerance