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Pharmacology II > Pancreatic hormones & Antidiabetic drugs > Flashcards

Pancreatic hormones & Antidiabetic drugs Flashcards

1
Q

hormone-producing cells inside the islets:

A

Alpha cell
Beta cell
Delta cell
Epsilon cell

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2
Q

hormone products of the cells inside the islets of Langerhans:

A

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.

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3
Q

Small protein w/ MW 5808.
51 Amino acids w/ 2 chains (A & B chain) linked by disulfide bridges.

A

INSULIN

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4
Q

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:

A

Proinsulin

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5
Q

2 main organs that remove insulin from the circulation:

A

Liver & kidney

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6
Q

INSULIN STIMULANTS:

A
  • Glucose
  • Amino acids
  • Hormones
  • GIP
  • Glucagon
  • Cholecystokinin
  • FA
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7
Q

All are examples of Stimulatory drugs except:
A. Sulfonylureas
B. Lorcaserin
C. Meglitinide
D. Nateglinide
E. Isoproterenol
F. Acetylcholine

A

B. Lorcaserin

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8
Q

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

A

C only

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9
Q

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

A

NOTA

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10
Q
  1. Heterodimers are covalently link
  2. 𝞪 subunit - spans the membrane, constitutes the recognition site. 𝞫 subunit - entirely extracellular, contains a tyrosine kinase.
  3. 1st proteins to be phosphorylated by the activated receptor tyrosine kinases are the docking proteins (IRS)
  4. 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

A

1,3,4 is correct

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11
Q

Insulin’s anabolic action is to induce ____the rate limiting enzyme for hepatic glucose uptake and glycogen synthesis. And inhibits phosphorylase.

A

glucokinase (GK)

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12
Q

Synthesized in the alpha cells of the pancreatic islets of Langerhans.
a single chain of 29 amino acids
MW of 3485

A

GLUCAGON

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13
Q

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

A

Glicentin

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14
Q

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

A

4 only

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15
Q

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

A

NOTA

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16
Q

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

A

2,4

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17
Q

An elevated blood glucose associated w/ absent or inadequate pancreatic insulin secretion w/ or w/o concurrent impairment of insulin action.

A

DIABETES MELLITUS

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18
Q

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

A

1,2,3,4

19
Q

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

A

2,3

20
Q

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

A

4 and 5

21
Q

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.

A

2

22
Q

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.

A

1

23
Q

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

A

1,3

24
Q

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

A
  1. Sodium glucose co-transporter inhibitors (SGLTs)
25
Q

Agents that principally slow the intestinal absorption of glucose
1. Sodium glucose co-transporter inhibitors (SGLTs)
2. GLP-1 receptor agonists
3. Dipeptidyl peptidase 4 (DPP-4) inhibitors
4. Alpha glucosidase inhibitors

A
  1. Alpha glucosidase inhibitors
26
Q

Which among the statements are correct:
1. Sulfonylureas increase insulin release from the pancreas. Chlorpropamide, tolazamide, and acetohexamide are now rarely used in clinical practice
2. Tolbutamide, Chlorpropamide, Acetohexamide, Tolazamide belongs to 1st generation sulfonylureas.
3. Glyburide, Glipizide, Gliclazide, Glimepiride belongs to 2nd generation sulfonylureas
4. Tolazamide is comparable to chlorpropamide in potency but shorter DoA, slowly absorbed than the other sulfonylureas

2,3
1,2,3
4 only
NOTA
AOTA

A

AOTA

27
Q

Meglitinide analog that has a fast onset of action, the reason it is used in controlling postprandial glucose excursions. Can be used as a monotherapy or in combination with biguanides.

Pioglitazone
Repaglinide
Nateglinide
Rosiglitazone

A

Repaglinide

28
Q

Drugs that Primarily Stimulate Insulin Release by Binding to the Sulfonylurea Receptor except:

Metformin
Tolbutamide
Glimeperide
Nateglinide

1 only
1,2,3
3 only
AOTA

A

1 only

29
Q

First-line therapy for type 2 diabetes

Metformin
Tolbutamide
Rosiglitazone
Pioglitazone

A

Metformin

30
Q
  1. Thiazolidinediones act to decrease insulin resistance. They are ligands of peroxisome proliferator-activated receptor gamma.
  2. Metformin Toxicities include: Anorexia, Nausea, Vomiting, Abdomen discomfort, Diarrhea, Lactic acidosis.
  3. Liver function tests should be performed prior to initiation of treatment and periodically thereafter.
  4. Hyperglycemia is the main adverse effect of Nateglinide

1 only is correct
1,2,3 is correct
4 is correct
2 and 4 is correct

A

1,2,3 is correct

31
Q

competitively inhibit the intestinal α-glucosidase enzymes and reduce post-meal glucose excursions by delaying the digestion and absorption of starch and disaccharides

Biguanides
Glucagon-like polypeptide-1 (GLP-1) receptor agonists
α-glucosidase inhibitors
Thiazolidinediones

A

α-glucosidase inhibitors

32
Q

The following are drugs that Affect Absorption of Glucose (α-glucosidase inhibitors):

  1. Acarbose
  2. Miglitol
  3. Voglibose
  4. Liraglutide

1,2,3
3,4,5
2,3,5
AOTA

A

1,2,3

33
Q

It stimulates insulin release and lowers glucose levels.

A

Glucagon-like polypeptide-1 (GLP-1) receptor agonists

34
Q

The following are true about (GLP-1) receptor agonists except:
1. All of the GLP-1 receptor agonists may increase the risk of pancreatitis.
2. Should not be used in persons w/ past medical/family history of medullary thyroid cancer or multiple endocrine neoplasia (MEN) syndrome type 2.
3. Has a lower risk for hypoglycaemia than sulfonylureas

1,2
1,3
AOTA
NOTA

A

NOTA

35
Q

The following are Dipeptidyl Peptidase 4 (DPP-4) Inhibitors except:

Sitagliptin
Saxagliptin
Linagliptin
Alogliptin
Vildagliptin

1,3
1,2,5
3,4
NOTA

A

NOTA

36
Q

Which among the following statement is not TRUE:
1. Canagliflozin, Dapagliflozin, Empagliflozin belongs to SODIUM-GLUCOSE CO-TRANSPORTER 2 (SGLT2) INHIBITORS.
2. Canagliflozin, Dapagliflozin, Empagliflozin blocks renal glucose resorption and lower plasma glucose level
3. SODIUM-GLUCOSE CO-TRANSPORTER 2 (SGLT2) INHIBITORS increase glucosuria

1
1,3
2 only
NOTA
AOTA

A

NOTA

37
Q

Most common complication in patients having insulin therapy and patients taking oral agents. Occurs more frequently with use of long-acting sulfonylureas.

A

Hypoglycemia

38
Q

treatment for severe hypoglycaemia

Glucagon 1mg SQ or IM
Dulaglutide 0.75 mg SQ
Saxagliptin 2.5–5 mg orally
Glucose administration

A

Glucagon 1mg SQ or IM

39
Q

All Hypoglycemic symptoms can be relieved by:

Glucagon 1mg SQ or IM
Dulaglutide 0.75 mg SQ
Saxagliptin 2.5–5 mg orally
Glucose administration

A

Glucose administration

40
Q

a life-threatening medical emergency caused by inadequate or absent insulin replacement which occurs in people with type 1 diabetes and infrequently in type 2 diabetes
*Newly diagnosed type 1 patients
*Interrupted insulin replacement
*Patients on insulin pumps
*Poor compliance
*Inadequate education

A

Diabetic ketoacidosis (DKA)

41
Q

Diabetic ketoacidosis (DKA) Treatment:

  1. IV hydration
  2. insulin therapy
  3. maintenance of potassium
  4. electrolyte levels

1,2
1,2,3
1,2,4
1,2,3,4

A

1,2,3,4

42
Q

diagnosed in patients with type 2 diabetes
Characterized with profound hyperglycemia and dehydration
*Inadequate oral hydration
*Other illnesses
*Medication that elevates blood sugar or causes dehydration such as phenytoin, steroids, diuretics, calcium-channel blockers, and with peritoneal dialysis and hemodialysis

A

Hyperosmolar hyperglycemic syndrome (HHS)

43
Q

Hyperosmolar hyperglycemic syndrome (HHS) Treatment:

  1. Rehydration
  2. Restoration of glucose
  3. Electrolyte homeostasis

1,2
2,3
1,2,3
NOTA

A

1,2,3

Pharmacology II (8 decks)

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