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Year 2 Applied Pharmacology > The pharmacology of insulin > Flashcards

The pharmacology of insulin Flashcards

1
Q

What are the normal ranges for blood glucose?

A

3-8mmol/L

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2
Q

What are the ranges for hypo and hyper glycaemia?

A

hypo = 10mmol/L

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3
Q

What are the stages of hyperglycaemia?

A

Food intake > rise in blood glucose > insulin release > insulin action: liver, muscle, CNS > lowers blood glucose

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4
Q

What are the stages in hypoglycaemia?

A

Fasting > fall in blood glucose > glucagon release> endogenous glucose production > raises blood glucose

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5
Q

Where is insulin and glucagon released from?

A

Pancreatic islets of langerhans - insulin = B cells, Glucagon = a cells.

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6
Q

How is insulin released?

A

Food intake > digestion > glucose uptake by B cells > inhibition of K channels > depolarisation of cell > calcium influx > insulin release.

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7
Q

What are the functional effects of insulin?

A

Convert glucose into glycogen and fats. Convert amino acids into proteins. Glucose and amino acid transport into cells.

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8
Q

What does insulin act on to lower blood sugar?

A

Glut4

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9
Q

What is T1DM?

A

Caused by destruction or damage to B cells. An autoimmune disease.

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10
Q

What is T2DM?

A

A disorder of epidemic proportions. Risk factors include: ageing, obesity, ethnicity, family history. Genetic and environmental predisposition.

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11
Q

What is the treatment plan for T1DM?

A

lifelong insulin, healthy diet, regular exercise.

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12
Q

What is the treatment plan for T2DM?

A

Lifestyle changes or hypoglycaemic therapy and/or insulin.

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13
Q

What are the short duration insulin therapies?

A

Insulin aspart, insulin glulisine, insulin lispro (s/c/I.v). Rapid onset - 30-60 mins. Duration of 8 hours.

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14
Q

What are the intermediate insulin therapies?

A

insulin detemir, insluin glargine, insulin zinc suspension. Onset o 1-2 hours, duration of 16-35 hours.

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15
Q

What are biphasic insulin preparations?

A

Mixture of intermediate and fast acting. rapid onset and long-lasting actions. Biphasic insulin aspart.

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16
Q

How is insulin administered?

A

SC Injection 3-4 times daily.

17
Q

What is glucagon therapy used for?

A

First-aid treatment for severe hypoglycaemia when oral glucose is not possible.

18
Q

What do secretagogues do?

A

Treat T2DM. Antagonists of the K channel. Boost insulin release.

19
Q

What are the 2 types of secretagogues?

A

Sulphonylureas. Meglitinides.

20
Q

What do secretagogues II do?

A

Peptide-agonists of the GLP-1 receptor and boost insulin release.

21
Q

What are the 2 types of secretagogues II?

A

Exenatide, Liraglutide.

22
Q

What are the side effects of secretagogues II?

A

GI disturbances, N&V, diarrhoea, dyspepsia, abdo pain, GORD, decreased appetite, dizziness, agitation, increased sweating

23
Q

What do secretagogues III do?

A

Inhibitors of DPP-4 and raise the half-life of serum GLP-1.

24
Q

What are the names of some secretagogues III?

A

Gliptins, Sitagliptin, Vildagliptin.

25
Q

What is Diazoxide?

A

Hyperglycaemia therapy. Agonist of the K channel - inhibition of insulin release.

26
Q

What are the side effects of diazoxide?

A

ANorexia, N&V, hypotension, oedema, tachycardia, arryhtmias.

27
Q

What are insulin sensitisers?

A

Improve the sensitivity of target organs to insulin. Two types - Biguanides which activate enzymes and Thiazolidinedoines which modify the transcription of genes.

28
Q

Which enzyme doe Biguanides activate?

A

AMP - protein kinase (AMPK)

29
Q

What are the two modes of action of Biguanides?

A

Prevents hepatic production of glucose. Overcomes insulin resistance by improving insulin sensitivity.

30
Q

What is the most common type of Biguanides?

A

Metformin.

31
Q

What does thiazolidinediones act on?

A

Activates PPAR for transcription of insulin-sensitive genes.

32
Q

What is an example of a thiazolidinedione?

A

Rosiglitizone

Year 2 Applied Pharmacology (12 decks)

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