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PHARMACOLOGY 4.0 > Pancreatic Hormones and Anti-Diabetic Drugs > Flashcards

Pancreatic Hormones and Anti-Diabetic Drugs Flashcards

1
Q

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

A

regular insulin

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1
Q

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

A

INTENSIVE Insulin Therapy

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1
Q

safest sulfonylureas for elderly diabetics

A

Tolbutamide

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1
Q

MOA of Thiazolidindiones

A

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

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2
Q

Drug Interaction of Pioglitazone

A

Gemfibrozil

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3
Q

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

A

Glucose Fructose

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4
Q

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

A

jaundice

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5
Q

Chlorpropamide is contraindicated in

A

Elderly

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5
Q

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

A

Pramlintide

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6
Q

Rosiglitazone adverse effect

A

Fluid retention, Heart Failure, Bone fracture

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7
Q

this appears to be reduced during long term metformin therapy

A

Absorption of Vit B12

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8
Q

intermediate acting insulin analogs

A

Neutral protamine hagedorn/isophane insulin

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9
Q

MOA of insulin secretagouges

A

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

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11
Q

Soluble “peakless” insulin analog

A

Insulin Glargine

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12
Q

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

A

Tolbutamide

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12
Q

1st Generation sulfonylureas that is slowly metabolized in the liver

A

Chlorpropamide

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12
Q

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

A

Thiazolidinediones

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13
Q

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

A

Nateglinide

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13
Q

alpha glucosidase inhibitors

A

Acarbose Miglitol

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14
Q

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

A

Immune insulin resistance

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15
Q

for controlling postprandial glucose excursion

A

Repaglinide

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15
Q

delays the digestion and absorption of starch and disaccharides

A

alpha glucosidase inhibitors

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16
Q

MOAof Sitagliptin

A

Inhibits Dipeptidyl Peptidase Increases circulating levels of GLIP1 and GIP

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17
Q

delayed absorption when taken with food

A

Glipezide

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18
Q

First incretin therapy to become available for treatment of diabetes

A

Exenatide

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19
Q

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

A

Hyperosmolar Hyperglycemic Syndrome

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20
Q

in combination therapy, what is the initial therapy?

A

Biguanides

22
Q

short acting insulin analog

A

Regular insulin

23
Q

Insulin sensitizer

A

Pioglitazone

24
Q

First line therapy for type 2 DM

A

Metformin

26
Q

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

A

Lipodystrophy

27
Q

Second Generation Sulfonylureas with shortest half life

A

Glipezide

29
Q

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

A

Insulin Detemir

31
Q

1st Generation sulfonylureas

A

Tolbutamide Chlorpropamide Tolazamide

33
Q

Complications of insulin therapy

A

Hypoglycemia Immunopathology of Insulin therapy Lipodystrophy

33
Q

More slowly absorbed than other sulfonylureas

A

Tolazamide

34
Q

Reduces Cardiovascular events in Diabetes

A

Acarbose

35
Q

Categories of Oral Anti-Diabetic Agents

A
  1. Secretagougues: (Sulfonylureas, Meglitinide, D-phenylalanine derivatives) 2. Biguanides 3.Thiazolidinediones 4. a-glucosidase inhibitors 5. Incretin based 6. Amylin analog
35
Q

Minor MOA of Biguanides

A

 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

36
Q

ADR of Acarbose

A

Flatulence, diarrhea and abdominal pain

37
Q

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

A

Potentiation of glucose mediated insulin secretion

39
Q

Rapid acting insulin analogs

A

Insulin Lispro Insulin Aspart Insulin Glulisine

40
Q

Second Generation Sulfonylureas that causes flushing with alcohol ingestion

A

Glyburide

41
Q

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

A

Insulin Insulin Secretagogues TZD Incretin based therapy Amylin analog Glucosidase inhibitor

42
Q

Glucagon-like Polypeptide (GLP-1) receptor agonist

A

Exenatide

44
Q

Major MOA of Biguanides

A

Activation of AMP kinase to reduce hepatic glucose production

45
Q

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

A

Hypoglycemia

46
Q

Nateglinide is important in treatment of

A

isolated post prandial fasting glucose level

47
Q

Drug interaction of glucagon

A

Warfarin

48
Q

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

A

Metformin

49
Q

long acting insulin analogs

A

Insulin detemir Insulin Glargine

51
Q

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

A

Conventional Insulin Therapy

53
Q

Single dose of 1mg has been shown to be effective

A

Glimepiride

54
Q

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

A

Rosiglitazone

55
Q

Referred as sliding scale regimen

A

Conventional Insulin Therapy

56
Q

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

A

Exenatide

57
Q

Provide reproducible, convenient background insulin replacement

A

Insulin Glargine

58
Q

Treatment for DKA

A

Aggressive IV infusion and Insulin therapy

59
Q

Shown to lower HvA1c level by 0.7%

A

Sitagliptin

60
Q

Clinical consequences of regular insulin administration

A

early postprandial hyperglycemia late postprandial hypoglycemia

61
Q

Glucagon precursor intermediate made up of 69 amino acid peptide

A

Glucentin

62
Q

Synthetic analog of Amylin

A

Pramlintide

63
Q

Second Generation Sulfonylureas

A

Glyburide (Glibenclamide) Glipezide Glimepiride

64
Q

major site of action of TZD’s

A

Adipose Tissue

65
Q

insulin delivery systems

A

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

PHARMACOLOGY 4.0 (3 decks)

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