Statins and Diabetes drugs

Question 1

HMG-CoA reductase inhibitors - statins

Answer 1

Mech: inhibit conversion to mevalonate
Side effects: hepatotoxicity, rhabdomyolysis

very decreased LDL
increased good chole
decreased triglycerides

Question 2

Niacin

Answer 2

Mech: inhibits lipolysis in adipose tissue, reduces VLDL
side effects: red, flushed face, hyperglycemia, hyperuricemia

decreased LDL
increased HDL
decreased triglycerides

Question 3

bile acid resins - cholestyramine, colestipol, colesevelam

Answer 3

mech: prevent reabsorption of bile acids
side effects: GI discomfort, cholesterol gallstones

decreased LDL
slightly increased HDL
slightly increased triglycerides

Question 4

cholesterol absorption blockers - ezetimibe

Answer 4

mech: prevent chole reabsorption at small intestine brush border
side effects: diarrhea

decreased LDL

Question 5

fibrates - gemfibrozil, clofibrate, bezafibrate, fenofibrate

Answer 5

mech: upregulate LPL, increase TG clearance
Side effects: myositis, hepatotoxicity, cholesterol gallstones

decreased LDL
increased HDL
very decreased triglycerides

Question 6

insulin - lispro, aspart, glulisine are rapid; regular is short; glargine, detemir are long acting

Answer 6

Use: diabetes type I and II, gestational diabetes, hyperkalemia

mech: bind insulin receptor, tyrosine kinase activity
toxicities: hypoglycemia

Question 7

metformin

Answer 7

use: first line for type 2 DM
toxicities: GI upset, lactic acidosis

Question 8

sulfonylureas - second gen: glyburide, glimepiride, glipizide

Answer 8

use: type 2 DM
mech: closes K+ channel in beta cell membrane –> triggers calcium influx
toxicities: hypoglycemia

Question 9

glitazones - pioglitazone, rosiglitazone

Answer 9

use: type 2 DM
mech: bnids to PPAR gamma nuclear transcription factor, increased insulin sensitivity in peripheral tissue
toxicities: weight gain, edema, hepatotoxicity, heart failure

Question 10

alpha glucosidase inhibitors - acarbose, miglitol

Answer 10

use: type 2 DM
mech: inhibit intestinal brush-border alpha glucosidases
side effects: GI disturbances

Question 11

amylin analogs - pramlintide

Answer 11

use: type I and type II DM
mech: decreased glucagon
side effects: hypoglycemia, nausea, diarrhea

Question 12

GLP-1 analogs - exenatide, liraglutide

Answer 12

use: type 2
mech: increased insulin, decrease glucagon
side effects: n/v pancreatitis

Question 13

DPP4 inhibitors - linagliptin, saxagliptin, sitagliptin

Answer 13

use: type 2 DM
mech: increased insulin, decreased glucagon
side effects: mild urinary or respiratory infections