Pancreatic Hormones and Anti-Diabetic Drugs

Question 1

soluble crystalline zinc insulin that is now made by recombinant DNA techniques to produce a molecular identical to that of human insulin

Answer 1

regular insulin

Question 1

Total daily insulin requirement in units is equal to the weight in pounds divided by 4; The type of therapy prescribed in patients with type 1 DM and as well as some type 2 DM

Answer 1

INTENSIVE Insulin Therapy

Question 1

safest sulfonylureas for elderly diabetics

Answer 1

Tolbutamide

Question 1

MOA of Thiazolidindiones

Answer 1

decrease insulin resistance; Ligands of peroxisomes proliferator activated receptor gamma (PPAR-y)

Question 2

Drug Interaction of Pioglitazone

Answer 2

Gemfibrozil

Question 3

in alpha glucosidase inhibitor treatment, only 2 sugars can be transported out of the human lumen. What are these?

Answer 3

Glucose Fructose

Question 4

If Chlorpropamide is given >500mg daily, it increases the risk of

Answer 4

jaundice

Question 5

Chlorpropamide is contraindicated in

Answer 5

Elderly

Question 5

Approved for use for pre-prandial use in person with type 1 & 2 DM

Answer 5

Pramlintide

Question 6

Rosiglitazone adverse effect

Answer 6

Fluid retention, Heart Failure, Bone fracture

Question 7

this appears to be reduced during long term metformin therapy

Answer 7

Absorption of Vit B12

Question 8

intermediate acting insulin analogs

Answer 8

Neutral protamine hagedorn/isophane insulin

Question 9

MOA of insulin secretagouges

Answer 9

 Increase insulin release from the pancreas  Reduction of serum glucagon levels  Closure of K channels in extrapancreatic tissue

Question 11

Soluble “peakless” insulin analog

Answer 11

Insulin Glargine

Question 12

1st Generation sulfonylureas that is well absorbed but rapidly metabolized in the liver

Answer 12

Tolbutamide

Question 12

1st Generation sulfonylureas that is slowly metabolized in the liver

Answer 12

Chlorpropamide

Question 12

promotes glucose uptake in adipose tissues and utilization and modulates synthesis of lipid hormones or cytokines

Answer 12

Thiazolidinediones

Question 13

Stimulates very rapid and transient release of insulin from beta cells thru closure of ATP-sensitive K channel

Answer 13

Nateglinide

Question 13

alpha glucosidase inhibitors

Answer 13

Acarbose Miglitol

Question 14

a condition where low titer of circulating Ig G anti insulin antibodies that neutralize the action of insulin to neglible extent develops in most insulin treated patient

Answer 14

Immune insulin resistance

Question 15

for controlling postprandial glucose excursion

Answer 15

Repaglinide

Question 15

delays the digestion and absorption of starch and disaccharides

Answer 15

alpha glucosidase inhibitors

Question 16

MOAof Sitagliptin

Answer 16

Inhibits Dipeptidyl Peptidase Increases circulating levels of GLIP1 and GIP

Question 17

delayed absorption when taken with food

Answer 17

Glipezide

Question 18

First incretin therapy to become available for treatment of diabetes

Answer 18

Exenatide

Question 19

diagnosed in person with type 2 DM , characterized by profound hyperglycemia and dehydration

Answer 19

Hyperosmolar Hyperglycemic Syndrome

Question 20

in combination therapy, what is the initial therapy?

Answer 20

Biguanides

Question 22

short acting insulin analog

Answer 22

Regular insulin

Question 23

Insulin sensitizer

Answer 23

Pioglitazone

Question 24

First line therapy for type 2 DM

Answer 24

Metformin

Question 26

an abnormal or degenerative condition of the body’s adipose tissue

Answer 26

Lipodystrophy

Question 27

Second Generation Sulfonylureas with shortest half life

Answer 27

Glipezide

Question 29

Most recently developed long acting insulin analogue Dose dependent onset of action

Answer 29

Insulin Detemir

Question 31

1st Generation sulfonylureas

Answer 31

Tolbutamide Chlorpropamide Tolazamide

Question 33

Complications of insulin therapy

Answer 33

Hypoglycemia Immunopathology of Insulin therapy Lipodystrophy

Question 33

More slowly absorbed than other sulfonylureas

Answer 33

Tolazamide

Question 34

Reduces Cardiovascular events in Diabetes

Answer 34

Acarbose

Question 35

Categories of Oral Anti-Diabetic Agents

Answer 35

1. Secretagougues: (Sulfonylureas, Meglitinide, D-phenylalanine derivatives) 2. Biguanides 3.Thiazolidinediones 4. a-glucosidase inhibitors 5. Incretin based 6. Amylin analog

Question 35

Minor MOA of Biguanides

Answer 35

 Impairment of renal gluconeogenesis, slowing of glucose absorption from GIT  Increase glucose to lactate conversion by enterocytes  Direct stimulation of glycolysis in tissues  Increased glucose removal from blood  Reduction of plasma glucagon levels

Question 36

ADR of Acarbose

Answer 36

Flatulence, diarrhea and abdominal pain

Question 37

MOA of Glucagon-like Polypeptide (GLP-1) receptor agonist

Answer 37

Potentiation of glucose mediated insulin secretion

Question 39

Rapid acting insulin analogs

Answer 39

Insulin Lispro Insulin Aspart Insulin Glulisine

Question 40

Second Generation Sulfonylureas that causes flushing with alcohol ingestion

Answer 40

Glyburide

Question 41

in combination therapy, what is the 2nd line of therapy?

Answer 41

Insulin Insulin Secretagogues TZD Incretin based therapy Amylin analog Glucosidase inhibitor

Question 42

Glucagon-like Polypeptide (GLP-1) receptor agonist

Answer 42

Exenatide

Question 44

Major MOA of Biguanides

Answer 44

Activation of AMP kinase to reduce hepatic glucose production

Question 45

most common complication of insulin therapy and usually results from inadequate carbohydrate consumption, unusual physical exertion or too large dose of insulin

Answer 45

Hypoglycemia

Question 46

Nateglinide is important in treatment of

Answer 46

isolated post prandial fasting glucose level

Question 47

Drug interaction of glucagon

Answer 47

Warfarin

Question 48

does not increase weight and provoke hypoglycemia (insulin sparing drug)

Answer 48

Metformin

Question 49

long acting insulin analogs

Answer 49

Insulin detemir Insulin Glargine

Question 51

Prescribed only for certain people with type 2 DM who are felt not to benefit from intensive glucose control

Answer 51

Conventional Insulin Therapy

Question 53

Single dose of 1mg has been shown to be effective

Answer 53

Glimepiride

Question 54

Not recommended for use in type 1 DM; Approved for use as monotherapy for type 2 DM

Answer 54

Rosiglitazone

Question 55

Referred as sliding scale regimen

Answer 55

Conventional Insulin Therapy

Question 56

adjunctive therapy in persons with type 2 DM treated with metformin or metformin plus sulfonylureas with suboptimal glycemic control

Answer 56

Exenatide

Question 57

Provide reproducible, convenient background insulin replacement

Answer 57

Insulin Glargine

Question 58

Treatment for DKA

Answer 58

Aggressive IV infusion and Insulin therapy

Question 59

Shown to lower HvA1c level by 0.7%

Answer 59

Sitagliptin

Question 60

Clinical consequences of regular insulin administration

Answer 60

early postprandial hyperglycemia late postprandial hypoglycemia

Question 61

Glucagon precursor intermediate made up of 69 amino acid peptide

Answer 61

Glucentin

Question 62

Synthetic analog of Amylin

Answer 62

Pramlintide

Question 63

Second Generation Sulfonylureas

Answer 63

Glyburide (Glibenclamide) Glipezide Glimepiride

Question 64

major site of action of TZD's

Answer 64

Adipose Tissue

Question 65

insulin delivery systems

Answer 65

Standard mode of insulin treatment (SQ) Portable Pen Injections Continuous Subcutaneous insulin infusion device (CSIID)