Pancreatic Hormones & Drugs for DM Flashcards

1
Q

[Insulin or Glucagon]

▪️Pancreatic B-cells
▪️FED state
▪️Response: HYPOglycemia
▪️Metabolism: Anabolic
- (+) Glycogenesis
- (-) Glycogenolysis
- (+) Lipogenesis
- (-) Lipolysis

A

Insulin

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2
Q

[Insulin or Glucagon]

▪️Pancreatic a-cells
▪️FASTED state
▪️Response: HYPERglycemia
▪️Metabolism: Catabolic
- (-) Glycogenesis
- (+) Glycogenolysis
- (-) Lipogenesis
- (+) Lipolysis

A

Glucagon

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3
Q

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

A

Type 1 DM

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4
Q

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

A

Type 2 DM

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5
Q

What is the hormone secreted by the pancreatic beta cells

A

Insulin

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6
Q

Regular Insulin is given through which route?

A

IV

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7
Q

What are the Rapid-Acting Insulin Drug?

Onset: 5 min.

A

Lispro - SQ
Aspart - SQ
Glulisine (Apidra) -SQ

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8
Q

What are the Short-Acting Insulin Drug

Onset: 30 min.

A

Regular Insulin (only insulin that can be administered through IV)

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9
Q

What are the Intermediate-Acting Insulin Drug

Onset: 1-3 hrs.

A

Isophane Insulin (aka: Neutral Protamine Hagedorn) -SQ

  • Proramine containing
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10
Q

What are the Long-Acting Insulin Drug

Onset: 1-2 hrs.

A

Glargine (Lantus) peak less
Detemir (Levemir)
Degludec (Tresiba)

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11
Q

Is it Demand or Basal Insulin

▪️ to control post-prandial (after meals) hyperglycemia
▪️given multiple x a day

A

Demand Insulin

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12
Q

Is it Demand or Basal Insulin

▪️ to control normal blood glucose within 24 hours
▪️given 1x-2x a day

A

Basal Insulin

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13
Q

What type of insulin DOA is given to
Demand Insulin?

A

Rapid & Short Acting

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14
Q

What type of insulin DOA is given to
Basal Insulin?

A

Intermediate & Long Acting

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15
Q

What are the Oral Antidiabetic Agents

A
  1. Insulin Secretagogues
  2. Biguanides
  3. Thiazolidinediones/Insulin Sensitizers
  4. Alpha-Glucosidase Inh.
  5. Incretin-Base Drugs
  6. SGLT2 Inh.
  7. Pramlintide (SQ)
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16
Q

What class/type of Oral Antidiabetic is stated below:

▪️↑ insulin secretion from B-cells
▪️K+ channel blockers (B-cells)
▪️exocytosis (release)
▪️hypoglycemia

A

Insulin Secretagogues

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17
Q

What are the First Generation Drugs in Sulfonyureas

  • less potent; ↑ dose = ↑ S/E
A
  1. Chlorpropamide
  2. Tolbutamide
  3. Tolazamide
  4. Acetohexamide

-amide

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18
Q

In First Generation Sulfonyureas which has the ff:

▪️longest t1/2
▪️use with caution in patients with hepatic or renal insufficiency

A

Chlorpropramide

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19
Q

In First Generation Sulfonyureas which has the ff:

▪️shortest t1/2
▪️preferred for used in elderly/geriatics
▪️Cardiotoxic

A

Tolbutamide

20
Q

What are the Second Generation Drugs in Sulfonyureas

  • more potent; ↓ dose = ↓ S/E
A
  1. Glibenclamide/Glyburide
  2. Gliclazide
  3. Glipizide
  4. Glimepiride
21
Q

What are the drugs under Meglitinides?

A
  1. Repaglinide
  2. Nateglinide
  • For T1DM
22
Q

What class/type of Oral Antidiabetic is stated below:

▪️Activates AMP-activated protein kinase
▪️1st line agent in T2DM
▪️Mgt. Pre-Diabetes

A

Biguanides

23
Q

Drugs under Biguanides

24
Q

What agent is use for blood glucose to normal

A

Euglycemic Agent

25
1st line agent for T2DM
Biguanides-Metformin
26
What drugs under by Biguanides is withdrawn due to lactic acidosis
Phenformin
27
What class/type of Oral Antidiabetic is stated below: ▪️MOA: PPAR-gamma (y) agonist ▪️↑ glucose utilization ▪️↑ FA utilization ▪️Alt. T2DM ▪️-glitazone
Thiazolidinediones/Insulin Sensitizers
28
What are the drugs under Thiazolidinediones
Pioglitazone (Prialta) Rosiglitazone (withdrawn)
29
What drugs under thiazolidinediones is withdrawn due to cardiotoxicity
Rosiglitazone
30
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.
31
What are the two classes of Incretin-Base drugs
1. Incretin-mimetics: GLP-1 Agonist 2. Dipeptidylpeptidase-IV Inh.
32
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.)
33
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
34
BN: Janumet GN: ?
Sitagliptin & Metformin
35
BN: Glyxambi GN: ?
Empagliflozin & Linagliptin
36
What class/type of Oral Antidiabetic is stated below: ▪️-gliflozin ▪️Sodium-glucose linked transporter 2 ▪️Use: T2DM
SGLT2-Inh.
37
(Biguanides & SGLT2-Inh.) BN: Jardiance Duo GN: ?
Empagliflozin + Metformin
38
What class/type of Oral Antidiabetic is stated below: ▪️Dapagliflozin ▪️Empagliflozin ▪️Luseogliflozin ▪️Canagliflozin
SGLT2-Inh.
39
What class/type of Oral Antidiabetic is stated below: ▪️Amylin analogue ▪️Use: T1DM
Pramlintide (SQ)
40
What Drugs->Androgens is stated below: ▪️(-) 5-a-reductase Inh. ▪️Androgen Agents ▪️Mgt. of BPH (benign prostate hyperplasia)
Finasteride Dutasteride
41
What Drugs->Androgens is stated below: ▪️Androgen Antagonist ▪️Tx. of Prostate CA & BPH
Bicalutamide Flutamide
42
What Drug under Androgen Antagonist is use for Tx. of excessive sexual drive in men
Cyproterone Acetate
43
What Estrogen & Progestin Agents is stated below: ▪️ progesterone antagonist ▪️ contraceptive; abortifacient
Mifepristone
44
What Estrogen & Progestin Agents is stated below: ▪️lower estrogen
Anastrozole Letrozole
45
(under SERM: Selective Estrogen Receptor Modulators) ▪️Tx. for Estrogen (+) breast CA
Tamoxifen
46
(under SERM: Selective Estrogen Receptor Modulators) ▪️Tx. of Osteoporosis
Raloxifene