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Pharm > Pharm > Flashcards

Pharm Flashcards

1
Q

lispro, aspart, glulisine

A

Insulin, rapid acting

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2
Q

regular (insulin)

A

insulin, short actin

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3
Q

NPH

A

insulin, intermediate acting

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4
Q

detemir

glargine

A

insulin, long acting

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5
Q

which insulin prep treates DKA (IV)

A

Regular

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6
Q

risks/ concerns for insulin preparation

A

hypoglycemia, lipodystrophy, rare hypersenstiivty reactions

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7
Q

onset of action for insulin rapid acting

A

15 mins. peak 45-75 mins

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8
Q

Amino acid substitution at C terminal of insulin beta chain prevents what in lispro

A

prevents polymeraizaiton; allows for rapid absorption from injection site

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9
Q

which insulin prep is not preferred for mealtime bolus infusion

A

regular insulin

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10
Q

polymerizes into hexamers + dimers delaying time to dissociate after injection

A

regular insulin

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11
Q

crystalline suspesion of insulin with protamine and zinc

A

NPH

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12
Q

which insulin prep is a fatty acid bound to one of lysine amino acid

A

Detemir

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13
Q

Glargine is ____ soluble at phsyiologic ph, causing it to precipiate at injection site and be slowly release into circulation

A

less

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14
Q

first line therapy in dm 2

A

metformin (biguanides)

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15
Q

this drug inhibits hepatic gluconeogensis and action of glucagon, increases glycolysis, increases peripheral glucose uptake. increases insulin sensitivity

A

metformin

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16
Q

Most serious side effect of metformin

A

lactic acidosis (thus CI in renal insufficeincy). also gi upset

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17
Q

why can metformin be used in dm1 as well

A

bc can be used in pt’s without iselt function

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18
Q

chlorpropamide, tolbutamide

A

first gen sulfonylureas

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19
Q

glimepiride, glipizide, glyburide

A

second gen sulfonylureas

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20
Q

No use in type I dm

A

sulfonylureas

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21
Q

mechanism of action of sulfonylureas

A

close K+ channel in pancreatic beta cell membrane: causes cell depolariziation: leads to insulin release via increase Calcium influx

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22
Q

which second gen sulfonylurea are long acting

A

glimepiride, glyburide

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23
Q

short acting second sulfonylurea

A

glipizide: lower incidence of hypoglycemia compared to glimepiride, glyburide

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24
Q

SE sulfonylurea

A

risk of hypoglycemia increase in renal fialure, weight gain

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25
Q

first generation sulfonylurea side effect

A

disulfiram like effects

flushing w alcohol consumption

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26
Q

glitazones/thiazolidinediones drugs

A

pioglitazone

rosiglitazone

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27
Q

increases insulin sensitivity in peripheral tissues. also binds to PPAR-gamma nuclear transcription regulator

A

pioglitazone/rosiglitzaone.

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28
Q

stimulates AMPK: oral insulin drug

A

metformin

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29
Q

glitazones upregulate what genes

A 
GLUT 4 (increase glucose uptake)
adiponectin (cytokine secreted by fat tissue that increases # of snsulin responsive adipocytes and regulates FA oxidation
30
Q

increases adiponectin,

A

glitazones

31
Q

glitazone does what TNF a and leptin

A

decrease

32
Q

SE of oral drug that causes weight gain

A

glitazones

33
Q

se of glitzones

A 
weight gain(bc increase fat storage in apdocytes and increase # of adipocytes)
edema, HF, increase risk of fractures
34
Q

meglitinides

A

nateglinide, repaglinide

35
Q

stimulates post prandial insulin release by binding to K+ channels on B cell membranes (site differs from sulfonylureas)

A

meglitinides

36
Q

which oral diabetic drug has a low risk of hypoglycemia

A

glitazones. because mechanism is increasing insulin sensitivty in peripheral tissues

37
Q

SE of meglitiindes

A

weight gain, hypoglcyemia

38
Q

GLP 1 analogs drug

A

inulin, exenatide, liraglutide(sc injection)

39
Q

SE of GLP 1 analogs:

A

nausea, vomiting, pancreatitis, modest weight loss

40
Q

mechanism of action for GLP 1 analgos

A

increase glucose dependent insulin release, decrease glucagon release, decraes gastic emptying, increase satiety

41
Q

GLP 1 does what to satiety

A

induces it

42
Q

DPP-4 inhibitors drugs

A

linagliptin, saxagliptin, sitagliptin

43
Q

DPP-4 inhibitors inhibit what

A

DPP4 enzyme that deactivates GLP-1, thereby increases glucose dependent insulin release, decrase glucoagon release.

44
Q

SE of dpp4 inhibitors

A

mild urinary or respiratory infections; weigth neutral; does not cause hypoglycemia bc glucose dependent

45
Q

amylin analogs

A

pramlintide

46
Q

mechanism of action for amylin analgos

A

decrease gastric emptying, decrease glucagon

47
Q

se of amylin

A

hypoglycemai, nausea

48
Q

Sodium glucose co transporter 2 inhibitors (SGLT2)

A

canagliflozin, dapagliflozin, empagliflozin

49
Q

mechanism of action for SGLT2 inhibitors

A

block reabsorption of glucose in PCT: increase renal glucose excretion

50
Q

SE of SGLT2:

A

glucosuria, UTI’s vaginal yeast infections, hyperkalemia, dehydration (orthostatic hypotension), wt loss

51
Q

alpha glucosidase inhibitors

A

acarbose

miglitol

52
Q

amylin is used for type I and II Dm

A

true

53
Q

mechanism of action for a glucosidase inhibitors

A

inhibit intestinal brush border a glucosidases. (disacharides). delayed carbhydrolysis and glucose absorption : decrease postprandial hyperglycemia

54
Q

SE of acarbose, miglitol

A

GI distrubances

55
Q

ADH antagnoists drugs

A

conivaptin, tolvaptin

56
Q

desmorpressin acetate

A

central DI, von willebrand disase, sleep enuresis

57
Q

Somatostatin use

A

acromegaly, carcinoid syndrome, gastrinoma, glucagonoma, esophageal varices

58
Q

mechanism of action of cinacalcet

A

sensitizes ca2+ sensing receptor (casr) in parathyroid gland to cirucalting Ca 2+: decrase PTH

59
Q

use of cinacalcet

A

primary or secondary hyperparathyodrism

60
Q

fludrocortisone

A

synthethic analog of aldosterone with little glucocortioid effects

61
Q

use of fludrocortisone

A

mineralocorticoid repalcement in primary adrenal insufficiency

62
Q

thioamides drugs

A

propylthiouracil, methimazole

63
Q

mechanism of action for methimazole, propylthiouracil

A

blocks thyroid peroxidase,inhibiting oxidation of iodide and organification and coupling of iodine: inhibits thyroid hormone synthesis.

64
Q

Propylthiouracil also blcoks what

A

5’-deiodinase : decreases periphreal conversion of T4 to T3

65
Q

Ptu blocks

A

Peripheral conversion

66
Q

PTU is used in first trimester of pregnancy: not methimazole becaes

A

methimazole : teratogenicity

67
Q

methimazole used in 2nd/3rd trimester of pregnancy bc

A

PTU induced hepatoxciity

68
Q

SE of propylthiouracil, methimazole

A

skin rash, agranulocytosis, aplastic anemia, hepatotoxicyt.

69
Q

what is given prophylacitcally to protect thyroid from excessive accumulation of radioactive 131 i

A

potassium iodide

70
Q

analog used to treat HIV associated lipodystrophy

A

tesamorelin (GHRH analog)

Pharm (13 decks)

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