Pancreatic hormones & Antidiabetic drugs Flashcards
hormone-producing cells inside the islets:
Alpha cell
Beta cell
Delta cell
Epsilon cell
hormone products of the cells inside the islets of Langerhans:
A: Glucagon - hyperglycemic factor
B: Insulin - storage & anabolic hormone
amylin - modulates appetite, gastric emptying, glucagon & insulin secretion
pancreatic peptide - facilitates digestive processes
D: Somatostatin - universal inhibitor of secretory cells
E: ghrelin - peptide that increases pituitary GH release.
Small protein w/ MW 5808.
51 Amino acids w/ 2 chains (A & B chain) linked by disulfide bridges.
INSULIN
long single-chain protein molecule processed within the Golgi apparatus of 𝞫 cells and packaged into granules, where it is hydrolyzed into insulin and a residual connecting segment called C-peptide:
Proinsulin
2 main organs that remove insulin from the circulation:
Liver & kidney
INSULIN STIMULANTS:
- Glucose
- Amino acids
- Hormones
- GIP
- Glucagon
- Cholecystokinin
- FA
All are examples of Stimulatory drugs except:
A. Sulfonylureas
B. Lorcaserin
C. Meglitinide
D. Nateglinide
E. Isoproterenol
F. Acetylcholine
B. Lorcaserin
Inhibitory signals except:
A. Hormones, insulin itself
B. Islet amyloid polypeptide
C. Glucagon
D. Somatostatin & leptin
E. 𝞪-adrenergic sympathetic activity
F. Low conc. FA
A,B,C
C AND D
A,D,E,F
C only
AOTA
C only
All are Inhibitory drugs except:
1. Diazoxide
2. Phenytoin
3. Vinblastine
4. Colchicine
1,2,3,4
1,2
2,4
1,2,3
4 only
NOTA
NOTA
- Heterodimers are covalently link
- 𝞪 subunit - spans the membrane, constitutes the recognition site. 𝞫 subunit - entirely extracellular, contains a tyrosine kinase.
- 1st proteins to be phosphorylated by the activated receptor tyrosine kinases are the docking proteins (IRS)
- The release of insulin from the pancreas is stimulated by increased blood glucose, incretins, vagal nerve stimulation, other factors.
1,2,3 is correct
1,4 are correct
only 4 is correct
1,3,4 is correct
1,3,4 is correct
Insulin’s anabolic action is to induce ____the rate limiting enzyme for hepatic glucose uptake and glycogen synthesis. And inhibits phosphorylase.
glucokinase (GK)
Synthesized in the alpha cells of the pancreatic islets of Langerhans.
a single chain of 29 amino acids
MW of 3485
GLUCAGON
precursor intermediate of glucagon consist of 69 AA.
Degraded in the liver and kidney as well as in plasma & its tissue receptor sites.
t½ in plasma: 3-6mins
Glicentin
Pharmacodynamics of glucagon except:
1. Raise blood glucose (glucagon infusion)
2. Potent inotropic & chronotropic effect on the heart.
3. Relaxation of the intestine
4. Increase glycogen synthesis
1
1,2
1,2,3
4 only
1,2,4
4 only
Clinical uses of glucagon except:
1. Severe hypoglycaemia
2. Endocrine diagnosis
3. Beta-adrenoceptor blocker overdose
4. Radiology of the bowel
1,4
1,2,3
4 only
1,2,4
NOTA
NOTA
Adverse reactions of Glucagon include the following except:
1. Transient nausea
2. Weight gain
3. Occasional vomiting
4. Edema and Fluid Retention
2,4
1,3,4
3 only
1,2,3,4
2,4
An elevated blood glucose associated w/ absent or inadequate pancreatic insulin secretion w/ or w/o concurrent impairment of insulin action.
DIABETES MELLITUS
Which among the statements are correct:
1. Type 1 diabetes is a selective 𝞫 cell destruction and severe or absolute insulin deficiency that is found in all ethnic groups and treated with insulin.
2. Latent immune diabetes of adulthood (LADA) - milder form of type 1 diabetes
3. Type 2 diabetes is a heterogenous group of conditions characterized by tissue resistance to the action of insulin combined w/ a relative deficiency in insulin secretion.
Can be controlled with diet, exercise and oral glucose lowering agents
4. Gestational diabetes mellitus - Any abnormality in glucose levels noted for the first-time during pregnancy.
5. Type 1a is idiopathic causes and Type 1b is immune mediated.
1,2,5
1,3,4
1,3 only
1,2,3,4
AOTA
1,2,3,4
The following are a rapid-acting human insulin analog except:
1. insulin lispro
2. insulin glargine
3. insulin detemir
4. insulin aspart
5. insulin glulisine
1,3
2,3
2,3,4
3,4,5
AOTA
2,3
The following are a long-acting human insulin analog except:
1. insulin glargine
2. insulin detemir
3. insulin degludec
4. insulin lispro
5. insulin glulisine
1,2,3
2,3,4
3 and 4
4 and 5
4 and 5
Sulfonylureas, Meglitinides, D-phenylalanine derivatives mechanism of action is best described as:
1. Agents that lower glucose level by their actions on liver, muscle & adipose tissue.
2. Agents that bind to the sulfonylurea receptor & stimulate insulin secretion.
3. Agents that principally slow the intestinal absorption of glucose.
4. Agents that mimic incretin effect or prolong incretin action.
5. Agents that inhibit the reabsorption of glucose in the kidney.
6. Agents that act by other or ill-defined mechanisms.
2
Biguanides and Thiazolidinediones mechanism of action is best described as:
1. Agents that lower glucose level by their actions on liver, muscle & adipose tissue.
2. Agents that bind to the sulfonylurea receptor & stimulate insulin secretion.
3. Agents that principally slow the intestinal absorption of glucose.
4. Agents that mimic incretin effect or prolong incretin action.
5. Agents that inhibit the reabsorption of glucose in the kidney.
6. Agents that act by other or ill-defined mechanisms.
1
The following are agents that act by other or ill-defined mechanisms except:
1. Biguanides
2. Pramlintide
3. Meglitinides
4. Bromocriptine
5. Colesevelam
1,2
1,3
4 only
3,5
NOTA
1,3
Agents that inhibit the reabsorption of glucose in the kidney
1. Sodium glucose co-transporter inhibitors (SGLTs)
2. GLP-1 receptor agonists
3. Dipeptidyl peptidase 4 (DPP-4) inhibitors
4. Alpha glucosidase inhibitors
- Sodium glucose co-transporter inhibitors (SGLTs)
