Pancreatic Hormones & Drugs for DM Flashcards
[Insulin or Glucagon]
▪️Pancreatic B-cells
▪️FED state
▪️Response: HYPOglycemia
▪️Metabolism: Anabolic
- (+) Glycogenesis
- (-) Glycogenolysis
- (+) Lipogenesis
- (-) Lipolysis
Insulin
[Insulin or Glucagon]
▪️Pancreatic a-cells
▪️FASTED state
▪️Response: HYPERglycemia
▪️Metabolism: Catabolic
- (-) Glycogenesis
- (+) Glycogenolysis
- (-) Lipogenesis
- (+) Lipolysis
Glucagon
What type of DM is stated below:
▪️Old term: Insulin dependent DM
▪️ Absolute lack of insulin due to destruction of beta cells to the pancreas
▪️Tx: Insulin, Pramlintide
Type 1 DM
What type of DM is stated below:
▪️Old term: Non-Insulin dependent DM
▪️ Relative lack of insulin
▪️Insulin is normal, receptors are resistant
▪️Tx: Oral Antidiabetics
Type 2 DM
What is the hormone secreted by the pancreatic beta cells
Insulin
Regular Insulin is given through which route?
IV
What are the Rapid-Acting Insulin Drug?
Onset: 5 min.
Lispro - SQ
Aspart - SQ
Glulisine (Apidra) -SQ
What are the Short-Acting Insulin Drug
Onset: 30 min.
Regular Insulin (only insulin that can be administered through IV)
What are the Intermediate-Acting Insulin Drug
Onset: 1-3 hrs.
Isophane Insulin (aka: Neutral Protamine Hagedorn) -SQ
- Proramine containing
What are the Long-Acting Insulin Drug
Onset: 1-2 hrs.
Glargine (Lantus) peak less
Detemir (Levemir)
Degludec (Tresiba)
Is it Demand or Basal Insulin
▪️ to control post-prandial (after meals) hyperglycemia
▪️given multiple x a day
Demand Insulin
Is it Demand or Basal Insulin
▪️ to control normal blood glucose within 24 hours
▪️given 1x-2x a day
Basal Insulin
What type of insulin DOA is given to
Demand Insulin?
Rapid & Short Acting
What type of insulin DOA is given to
Basal Insulin?
Intermediate & Long Acting
What are the Oral Antidiabetic Agents
- Insulin Secretagogues
- Biguanides
- Thiazolidinediones/Insulin Sensitizers
- Alpha-Glucosidase Inh.
- Incretin-Base Drugs
- SGLT2 Inh.
- Pramlintide (SQ)
What class/type of Oral Antidiabetic is stated below:
▪️↑ insulin secretion from B-cells
▪️K+ channel blockers (B-cells)
▪️exocytosis (release)
▪️hypoglycemia
Insulin Secretagogues
What are the First Generation Drugs in Sulfonyureas
- less potent; ↑ dose = ↑ S/E
- Chlorpropamide
- Tolbutamide
- Tolazamide
- Acetohexamide
-amide
In First Generation Sulfonyureas which has the ff:
▪️longest t1/2
▪️use with caution in patients with hepatic or renal insufficiency
Chlorpropramide
In First Generation Sulfonyureas which has the ff:
▪️shortest t1/2
▪️preferred for used in elderly/geriatics
▪️Cardiotoxic
Tolbutamide
What are the Second Generation Drugs in Sulfonyureas
- more potent; ↓ dose = ↓ S/E
- Glibenclamide/Glyburide
- Gliclazide
- Glipizide
- Glimepiride
What are the drugs under Meglitinides?
- Repaglinide
- Nateglinide
- For T1DM
What class/type of Oral Antidiabetic is stated below:
▪️Activates AMP-activated protein kinase
▪️1st line agent in T2DM
▪️Mgt. Pre-Diabetes
Biguanides
Drugs under Biguanides
Metformin
What agent is use for blood glucose to normal
Euglycemic Agent
1st line agent for T2DM
Biguanides-Metformin
What drugs under by Biguanides is withdrawn due to lactic acidosis
Phenformin
What class/type of Oral Antidiabetic is stated below:
▪️MOA: PPAR-gamma (y) agonist
▪️↑ glucose utilization
▪️↑ FA utilization
▪️Alt. T2DM
▪️-glitazone
Thiazolidinediones/Insulin Sensitizers
What are the drugs under Thiazolidinediones
Pioglitazone (Prialta)
Rosiglitazone (withdrawn)
What drugs under thiazolidinediones is withdrawn due to cardiotoxicity
Rosiglitazone
What class/type of Oral Antidiabetic is stated below:
▪️MOA:
Complex CHO -(a-glucosidase) -> Simple Sugar
▪️Drugs: Acarbose, Voglibose, Miglitol
▪️Alt. T2DM
Alpha-Glucosidase Inh.
What are the two classes of Incretin-Base drugs
- Incretin-mimetics: GLP-1 Agonist
- Dipeptidylpeptidase-IV Inh.
What class/type of Oral Antidiabetic is stated below:
▪️Use for T2DM
▪️Monotherapy
▪️In combination with Biguanides (Janumet) & SGLT-2 Inh. (Glyxambi)
Incretin-Base Drugs (Dipeptidylpeptidase-IV Inh.)
What Classes of Incretin-Base Drug are the ff drugs: (-gliptin)
▪️Sitagliptin (Januvia)
▪️Saxagliptin (Onglyza)
▪️Teneligliptin (Glipten)
▪️Linagliptin (Trajenta)
▪️Vildagliptin (Galvus) or (Proglin)
Dipeptidylpeptidase-IV Inh.
-gliptin
BN: Janumet
GN: ?
Sitagliptin & Metformin
BN: Glyxambi
GN: ?
Empagliflozin & Linagliptin
What class/type of Oral Antidiabetic is stated below:
▪️-gliflozin
▪️Sodium-glucose linked transporter 2
▪️Use: T2DM
SGLT2-Inh.
(Biguanides & SGLT2-Inh.)
BN: Jardiance Duo
GN: ?
Empagliflozin + Metformin
What class/type of Oral Antidiabetic is stated below:
▪️Dapagliflozin
▪️Empagliflozin
▪️Luseogliflozin
▪️Canagliflozin
SGLT2-Inh.
What class/type of Oral Antidiabetic is stated below:
▪️Amylin analogue
▪️Use: T1DM
Pramlintide (SQ)
What Drugs->Androgens is stated below:
▪️(-) 5-a-reductase Inh.
▪️Androgen Agents
▪️Mgt. of BPH (benign prostate hyperplasia)
Finasteride
Dutasteride
What Drugs->Androgens is stated below:
▪️Androgen Antagonist
▪️Tx. of Prostate CA & BPH
Bicalutamide
Flutamide
What Drug under Androgen Antagonist is use for Tx. of excessive sexual drive in men
Cyproterone Acetate
What Estrogen & Progestin Agents is stated below:
▪️ progesterone antagonist
▪️ contraceptive; abortifacient
Mifepristone
What Estrogen & Progestin Agents is stated below:
▪️lower estrogen
Anastrozole
Letrozole
(under SERM: Selective Estrogen Receptor Modulators)
▪️Tx. for Estrogen (+) breast CA
Tamoxifen
(under SERM: Selective Estrogen Receptor Modulators)
▪️Tx. of Osteoporosis
Raloxifene
