PHARM - Diabetes Drugs

Question 1

What are the 4 types of Insulin drugs (based on PK)?

Answer 1

Rapid

Short

Intermediate

Long

Question 2

What are the 3 rapid releasing insulin drugs?

Answer 2

Aspart

Lispro

Glulisine

Question 3

What is the 1 short release insulin drug?

Answer 3

Regular insulin (analog)

Question 4

What is the one intermediate insulin drug?

Answer 4

NPH

Question 5

What are the two long releasing insulin drugs?

Answer 5

Detemir and Glargine

Question 6

What is the MOA of Insulin-like drugs?

(what two pathways are activated)

(Why would we give Insulin - what is too high?)

Answer 6

Binds Insulin receptors via the PI3k pathway and MAP kinase pathway

Results in upregulation of GLUT4 to the cell membrane thus increased glucose into the cell

Insulin ultimately lowers Blood glucose

Question 7

How are insulin drugs administered?

Answer 7

primarily via SubQ injection, portable pens, or insulin pumps

Question 8

What Amylin analog is used to treat Diabetes?

MOA? — 4 actions

Answer 8

Pramlintide

MOA:

1. Inhibits glucagon secretion
2. Enhances insulin sensitivity
3. lowers gastric emptying
4. Increases satiety

Question 9

Insulin Secreatgogues is a massive category with what 4 subgroups?

Answer 9

Incretins,

Long-acting GLP-1 agonists

DPP-4 Inhibitors,

and K-ATP ch blockers

Question 10

Incretins (1) and MOA (3 effects)

Answer 10

GLP-1 Glucagon-like peptide

MOA : promotes B-cell proliferation, Increases insulin gene expression, and increases insulin secretion

Question 11

Long-acting GLP-1 agonists (2) and MOA

Answer 11

Exenatide

Liraglutide

MOA: Binds Gs-GPCR, leads to upregulation of PKA and increased insulin release

Question 12

DPP-4 Inhibitors (4)

(what is the root?) and MOA

Answer 12

(gliptins) Sita gliptin

Lina gliptin

Saxa gliptin

Alo gliptin

MOA: blocks DPP-4 therefore GLP-1 is not broken down = increase Gs signaling and etc.

Question 13

K-ATP ch blockers (2 sub-subgroups) and MOA

Frequent Tx for?

Answer 13

Sulfonylureas and Non-sulfonylureas

MOA: binds to sulfonylurea receptor and thus block inward rectifying K+ channel

T2DM

Question 14

Sulfonylureas

1st gen and 2nd gen (6 total)

Answer 14

1st gen - chlorpropamide, tolbutamide, tolazamide (CTT)

2nd gen - glipizide, glyburide, glimepiride (GGG)

Question 15

Non-sulfonylureas (2)

root = ?

Answer 15

Nate - glinide

Repa - glinide

Question 16

Biguanides ******* and MOA

Answer 16

Metformin

- 1st line Tx for T2DM

MOA: activates AMP-dependent protein kinases within mitochondria of liver cells

ultimately reduces hepatic glucose production (decresed gluconeogenesis)

Question 17

Thiazolidinediones (2) (root) and MOA

Answer 17

Pio glitazone

Rosa glitazone

MOA = binds PPAR-gamma receptor which upregulates GLUT receptor in fat, muscle, liver, and endothelium

Question 18

Sodium- Glucose Co-transporter blockers (3 with root) MOA

Answer 18

Cana gliflozin

Dapa glifozin

Empa gliflozin

MOA: blocks cotransporter in kindey (SLGT-2), less glucose reabsorbed, glucose is excreted in urine

Question 19

alpha-glycosidose blockers (2) and MOA

Answer 19

Acarbose and Miglitol

MOA = blocks alpha-glycosidases which thus inhibits the breakdown of starch and disaccarides === thus not absorbed (only monosaccarides are absorbed)