pharmacology of diabetes mellitus Flashcards
type one diabetes characteristics - common, population, onset, symptoms, insulin?
uncommon, 10% childhood, sudden onset, insulin needed
characteristics of T2DM
adult onset, 90%, 40 years over, common, onset is gradual, may or may not have symptoms , insulin required by some people
best practice pharmacotherapy for T1DM
multiple daily injections, continous subcutaneous insulin infusions
example of subcutaneous insulin infections
insulin pumos
what is basal insulin
this is insulin that runs in the background
what is bolus insulin
this is insulin that is secreted in response to energy intake ans glucose
is an insulin is short acting, when should you administer it
inject before eating
if an insulin is fast acting, when should you inject
after you have eaten
what is the pathophysiology of T2DM
when there is decreased insulin by the pancreas and increased glucagon secretion in islet cells
pharmacotherapy for T2DM
oral or injectable
examples of oral pharmacotherapy management
medication by mouth
what injectable and oral medications would we want ideally for pharmacotherpay for T2DM
drugs that can help decreased blood sugar and chances of heart issues
what risk factors should be considered with T2DM
risk of heart issues
what is biguanide, what does it do
enhances insulin sensitivity in live and peripheral tissues
what does biguanide activate
AMP - activated protien kinase
glucagon like peptide
injectable once a week, works to activate the incretin pathway
sodium glucose co-transporter 2 inhibitor
works on the kidneys to get rid of extra glucose
dipeptidyl peptidase-4 inhibitor
works to amplify the incretin pathway activation by inhibition of enzymatic breakdown of GLP-1 and GIP
works to amplify the incretin pathway activation by inhibition of enzymatic breakdown of GLP-1 and GIP
dipeptidyl peptidase-4 inhibitor
what is the incretin pathway
after eating, gut hormones are secreted into blood and enteroendocrine cells
what is the role of the incretin pathway
to manage/regulate the amount of insulin secreted
how does insulin work
activates insulin receptors to regulate metabolism of carbohydrates, fats and protien
what do thiazolidinediones do?
they work to make the body more sensitive to insulin
alpha glucosidase inhibitor
inhibits the pancreatic alpha-amylase and intesinal alpha glucosidase or delay the absorption of carbohydrates from the small intestine, lowering the effect on glucose levels
what are the most lethal treatment for t2dm
insulin secretagogues
how do insulin secretagogues work?
they activate sulfonylurea receptor on beta cell to stimute endogenous insulin secretion
how do anti-obesity agents work?
inhibit lipase
what are some considerations for agent characteristics concerning the pharmacotherapy of T2DM
blood glucose lowering the efficacy and durability, risk of inducing hypoglycemia, effect on weight, side effects, cost, cardioprotection
blood glucose lowering the efficacy and durability, risk of inducing hypoglycemia, effect on weight, side effects, cost, cardioprotection are what?
agent characteristics
what are some patient characteristics that should be considered when considering pharmacotherapy??
degree of hyperglycemia, risk of hypoglycemia, weight, comorbidities, preferences, access to treatment
what are some comorbidities
renal and hepatic issues, insulin secretagogues can increase this risk
