Pancreas

Question 1

Lispro

Aspart

Answer 1

Mechanism

• short acting, fast onset
• for prandial hyperglycemia and emergencies
• will dissocite to monomers very quickly

Question 2

NPH

lente

Answer 2

• intermediate acting
• cover basal and prandial hyperglycemia

Question 3

Ultralente

glargine

Answer 3

• Long acting
• ultralent = cloudy and buffered
• glargine = no buffer and clear
  
  • slow acting and peakless

Question 4

Sulfonylureas

Answer 4

• insulin secretagogues
  
  • bind to B cell ATP K+ channel –> cell depolarization and insulin release
  • used when diet is insufficient
• longer acting agent
• less adverse effects

Question 5

Meglitinides

Answer 5

• Insulin Secretagogues
  
  • inhibit B cell ATP K channel –> depolarization and insulin release
  • where change in diet doesnt work
• rapidly absorbed, short 1/2 life
• used in comibation with longer acting agents
• less gypoglycemia seen than sulfonylureas

Question 6

Thiazolidinediones

Answer 6

• Insulin sensitizers
  
  • require insulin
  • DO NOT PROMOTE RELEASE
  • reduce hep. gluconeogenesis
• decrease peripheral insulin resistance
• ligands at peroxisome proliferator-activated receptor gamma (PPAR);
• regulate genes lipid / glu metab
• slow onset! –> involve gene transcription

Question 7

alpha glucosidase inhibitors

Answer 7

• Insulin sensitizers
  
  • require insulin
  • DO NOT PROMOTE RELEASE
  • reduce gluconeo and inc insulin utilization
• inhibit intestinal alpha glucosidase & post-prandial digestion
• can use alone or w/ sulfonylureas or insulin
• Adverse effects - abd pain, fart, diarrhea

Question 8

Incretins

Answer 8

• Insulin sensitizers
  
  • require insulin
  • DO NOT PROMOTE RELEASE
  • reduce hepatic gng –> inc insulin by peripheral target cells
• derivatiev of natural hormone –> enhance insulin response

Question 9

Glucagon

Answer 9

• used in emergency for hypoglycemia in type I DM

Question 10

GLP1 (exenatide)

Answer 10

• for type II DB
• augments glucose dependent insulin secretion