Pharm 30 Endocrine Pancreas/Glucose Homeostasis Part II

Question 1

MOA: carbohydrate analogues that bind avidly to alpha glucosidase, slowing the breakdown and absorption of of dietary carbohydrates such as dextrin and dissaccharides.

Answer 1

alphaglucosidase inhibitors

Question 2

MOA: the classic anabolic hormone, insulin promotes carbohydrate metabolism and facilitates glucose, amino acid, and TG uptake and storage in liver, cardiac and skeletal muscle and adipose tissue

Answer 2

Exogenous Insulin

Question 3

MOA: inhibit the Beta cell K/ATP pump at the SUR1 subunit, thereby stimulating insulin release and increasing circulating levels to levels that are able to overcome insulin resistance

Answer 3

Sulfonylureas and Meglitinides

Question 4

MOA: Activates AMPK to block synthesis of FAs to inhibit hepatic gluconeogenesis and glycogenolysis; increases insulin receptor activity and metabolic responsiveness in liver and skeletal muscle

Answer 4

Biguanides

Question 5

MOA: co released with insulin , acts on receptors of the CNS to slow gastric emptying, reduce glucose and glucagon release and promote satiety

Answer 5

Pramlintide

Question 6

MOA: enhance glucose dependent insulin release delay gastric emptying, inhibit glucagon secretion, decrease appetite by inhibiting degradation by DPP-4 inhibitors or agonizing GLP-1 receptor

Answer 6

Incretins

Question 7

bind and stimulates PPARgamma, thereby increasing insulin sensitivity in adipose tissue liver and muscle

Answer 7

TZDs

Question 8

binds to SUR1 subunit of K+/ATP channel in pancreatic Beta cells and stabalizes ATP bound open state of the channel so b cell membrane remains HYPERpolarized, decreasing insuling secretion

Answer 8

Diazoxide

Question 9

modest increase in plasma TGs, aminotransferase levels should be monitered and is most useful for pts with postprandial hyperglycemia and for new-onset pts with mild hyperglycemia

Answer 9

alpha-glucosidases

Question 10

rapid acting analogues of inslulin

Answer 10

lispro, aspart, glulisine

Question 11

long - acting anlogues of insulin

Answer 11

glargine and detemir

Question 12

major dange of insulin therapy …

Answer 12

hypoglycemia in pts not taking in enough carbohydrates

Question 13

mainstay of Tx for Type II diabetes

Answer 13

Sulfonylureas

Question 14

can cause weight gain so better suited for nonobese pts, first generations have lower affinity than 2nd .

Answer 14

sulfonylureas

Question 15

can decrease weight, GI distrbances, lactic acidosis

Answer 15

Metformin

Question 16

less insulin is required when this drug is used

Answer 16

pramlintide

Question 17

can be used in combination with sulfonylureas and metformin to improve glucose control

Answer 17

GLP-1 analogues

Question 18

adjust dose in kidney, monitor digoxin levels

Answer 18

DPP-4 inhibitors (sitagliptin –> digoxin levels

Question 19

does not induce hypoglycemia, restricted to pts who did not respons to other antidiabetic medications

Answer 19

TZDs, (rosiglitazone for non-responsive)

Question 20

when oral/ VI glucose is not possible use this, it also depends on a hepatic store of glycogen to be useful

Answer 20

Glucagon