Pancreatic Drugs Flashcards
Rapid acting insulin
3-4hrs
Lispro
Aspart
Glulisine
Short acting insulin
5-7hrs
Regular insulin
Intermediate acting insulin
18-24hrs
NPH
Lente
NPH is a combination of?
Regular insulin and protamine
Long acting insulin
18-28hrs
Ultralente
Ultra long acting insulin
>24hrs
LanDe mo Glar
Lantus
Detemir
Glargine
Glucose transporter in RBCs and brain
GLUT-1, 3
Glucose transporter in pancreas, liver, kidney, and gut
GLUT-2
Glucose transporter in muscle and adipose tissue
GLUT-4
MOA of 1st generation sulfonylureas
Increases insulin secretion by closing ATP-sensitive K channels
Causes disulfiram reaction
Chlorpropamide
Tolbutamide
Tolazamide
Used in diabetics with sulfa allergies
ReNaMi
Repaglinide
Nateglinide
Mitiglinide
Used in Type 2 DM (postprandial hyperglycemia)
Repaglinide
Nateglinide
Mitiglinide
Has the least incidence of hypoglycemia and may be used in CKD patients
Nateglinide
MOA of metformin
Activates AMP-stimulated protein kinase leading to inhibition of hepatic and renal gluconeogenesis; stimulates glycolysis in peripheral tissues; slows glucose absorption from the GIT; reduces plasma glucagon levels
1st line treatment of type 2 DM
Metformin
SE of metformin
Nausea
Diarrhea
Lactic acidosis
DOC for obese diabetics (DM type 2); restores fertility in anovulatory women with PCOS
Metformin
Thiazolidinediones
Mnemonic: thiaZONElidinediones
Pioglitazone
Rosiglitazone
Troglitazone
MOA of thiazolidinediones
Activates PPAR-gamma receptor; increases tissue sensitivity to insulin; can reduce both fasting and postprandial hyperglycemia
Used for DM prevention
Thiazolidinediones
Acarbose
Metformin
Thiazolidinedione which reduces mortality and macrovascular events (MI and stroke)
Pioglitazone
Thiazolidinedione which increases the risk of MI
Rosiglitazone
Causes CHF; CI in CHF; may increase the risk of bone fractures
Thiazolidinediones: can cause fluid retention, which presents as mild anemia and edema
Cytochrome P450 inducer
Pioglitazone
Troglitazone
Alpha-glucosidase inhibitors
Acarbose
Miglitol
Acarbose is contraindicated in?
Patients with renal impairment
GLP-1 agonist; incretin modulator; augments glucose-stimulated insulin release from pancreatic B cells; retards gastric emptying; inhibits glucagon secretion; produces a feeling of satiety
Exenatide (may cause acute pancreatitis)
Toxicities of alpha-glucosidase inhibitors
Flatulence, diarrhea, and abdominal pain
The enzyme that degrades GLP-1 and other incretins
Dipeptidyl peptidase-4 (DDP-4)
DDP-4 inhibitor; incretin modulator
Sitagliptin (may cause headache, nasopharyngitis, and URTI)
Side effect of Bangkok pills
Valvular heart disease
An injectable synthetic analog of amylin; supresses glucagon release; slows gastric emptying; supresses appetite
Pramlintide
Provides a peakless basal insulin level lasting more than 20h, which helps control basal levels without producing hypoglycemia
Long-acting insulin:
Glargine
Detemir
Most common complication of insulin use?
Hypoglycemia
Mechanism of insulin release
Increased extracellular glucose -> increased intracellular ATP -> Closure of K channels -> depolarization -> Opening of Ca channels -> Increased intracellular Ca -> Insulin release
The preferred insulin for continuous subcutaneous infusion devices; can be used for emergency treatment of uncomplicated DKA
Rapid-acting insulin: LAG
Lispro
Aspart
Glulisine
