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Pharmacology > Treatment of Diabetes > Flashcards

Treatment of Diabetes Flashcards

1
Q

What diabetic drug mimics the mealtime release of insulin and used before a meal?

A

Short-acting insulin

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2
Q

How is short-acting insulin administered?

A

Not orally, subQ injection

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3
Q

Why does short-acting insulin have lower risk of hypoglycemia?

A

Has rapid onset and short duration of action which allows a flexible treatment regimen

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4
Q

Excessive doses of insulin can result in what symptoms? (8)

A
  • Headache
    • Tachycardia
    • Vertigo
    • Anxiety
    • Confusion
    • Diaphoresis
    • Lipodystrophy
    • Hypersensitivity
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5
Q

What is given as insulin replacement?

A

basal insulin AND pre-meal insulin

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6
Q

What kind of insulin works over the course of the day to maintain appropriate insulin levels?

A

Long acting insulin

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7
Q

What is long-acting insulin used for?

A

Used for basal control and is taken first in the morning

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8
Q

How is long acting insulin administered?

A

SubQ

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9
Q

What type of diabetic drug delays gastric emptying, decreases glucagon secretion, and decreases the amount of insulin needed?

A

Amylinomimetic
Pramlintide

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10
Q

How much does a dose of short acting insulin decrease by when also taking preamlintide?

A

50%

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11
Q

When do you take pramlintide (amylinomimetic)

A

Take it during right before mealtime

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12
Q

How do you administer pramlintide?

A

SubQ with different syringe than insulin

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13
Q

Effects of taking a GLP-1 Agonist

A

1) Activate incretin (responsible for 60-70% of post-meal insulin secretion)
2) Potentiation of glucose-mediated insulin secretion
3) Suppression of post-meal glucagon release
4) Slows gastric emptying and loss of appetite
5) May allow for weight loss!

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14
Q

When is Liraglutide contraindicated?

A

In patients with a family history of cancer because it has produced thyroid tumors in rodents.

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15
Q

Adverse effects of GLP-1 agonists

A

Pancreatitis
Headache
Nausea
Diarrhea

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16
Q

What are GLP-1 agonists often associated with? What may this medication reduce?

A

Associated with weight loss
May reduce risk of heart attack and stroke

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17
Q

What drug precipitates at the injection site and has a prolonged effect with no peak?

A

Insulin Glargine

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18
Q

What diabetic drug has an enhanced association with albumin?

A

Insulin Detemir

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19
Q

What diabetic drug is contraindicated with patients with a family history of cancer?

A

Liraglutide

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20
Q

What drug increases LDL cholesterol and triglycerides and Increases HDL cholesterol? It is cautioned in patients with high cholesterol

A

Rosiglitazone

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21
Q

What diabetic drug decreases triglycerides
Increases HDL cholesterol?

A

Pioglitazone

22
Q

What diabetic drug increases the risk of lower limb amputation?

A

Canagliflozin

23
Q

What drug lowers glucose production in the liver and improves the body’s sensitivity to insulin?

A

Metformin

24
Q

What effects does metformin have?

A

1) lowers glucose production in the liver and improves body’s sensitivity to insulin

2) Increases hepatic sensitivity to insulin

3) Reduces energy supply for production

4) Increases glucose uptake in skeletal muscle

25
Q

What is considered the drug of choice for newly diagnosed patients with T2DM?

A

metformin

26
Q

When would you avoid taking metformin?

A

Poor kidney or liver function, respiratory insufficiency, cardiac insufficiency, and hypotension

27
Q

What is the main side effect of metformin?

A

GI distress

28
Q

What is the main effect of sulfonylureas?

A

Helps the body secrete more insulin

29
Q

What kind of patients would you prefer to prescribe sulfonylureas?

A

Patients who are not overweight

30
Q

What other medications would you not use sulfonylureas with?

A

other medications that increase insulin release (meglitinides)

31
Q

What are some side effects of taking sulfonylureas?

A

Hypogylcemia
Weight gain
Skin reactions
possible cardiac effects (increase BP, arrythmia)

32
Q

If metformin is contraindicated, what is the first-line therapy drug that you would prescribe next?

A

Sulfonylureas

33
Q

The main effect of meglitinides

A

stimulate insulin secretion from pancreas

34
Q

What drug was developed to decrease post-meal hyperglycemia and is taken 15-30 minutes before a meal?

A

Meglitinides

35
Q

What are some side effects of meglitinides?

A

Hypoglycemia
Weight gain

36
Q

What diabetic drug category is best taken with people who dont have regular eating habits?

A

Meglitinides

37
Q

What is the main effect of thiazolidinediones?

A

-Decreases insulin resistance and improves whole-body insulin sensitivitity
-Promotes/enhances the effects of insulin so body can use the insulin it already has better
-Does NOT release more insulin!

38
Q

What is typically given with thiazolidinediones?

A

Spironolactone or other diuretic to prevent fluid retention

39
Q

Adverse effects of thiazolidinediones

A

Little weight gain
Increase risk of heart disease
Fluid retention

40
Q

Who would you caution the use of thiazolidinediones in?

A

Patients with heart failure

41
Q

Main effects of alpha glucose inhibitors

A

Reduces post-meal glucose absorption

42
Q

When do you take an alpha glucose inhibitor?

A

At the start of a meal

43
Q

When would you avoid use of alpha-glucose inhibitors?

A

In patients with GI disease, especially IBD.
Avoid in patients with liver or kidney disease

44
Q

What do alpha-glucose inhibitors target?

A

Target the alpha-glucosidase enzymes and prevent the breakdown of carbohydrates

45
Q

What is the DPP-4 inhibitor’s main effect?

A

Prolongs the action of incretin-hormones (GLP-1)
Results in an increase in insulin secretion in response to meals.
Also results in a decrease in glucagon levels

46
Q

When is DPP-4 inhibitors an adjunct therapy?

A

When patient is dieting and excercising

47
Q

Adverse effects of DPP-4 inhibitors

A

Nasopharyngitis
Headache

48
Q

What drug does not increase fullness and keeps your weight neutral?

A

DPP-4 inhibitors

49
Q

Main effect for sodium glucose transporter 2 inhibitors*

A

Prevents the kidney from reabsorbing sugar/glucose into the blood and also reduces BP

50
Q

What are the major side effects in Sodium-glucose transporter 2 inhibitors?

A

The majority of side effects are in the urinary tract!
-UTIs
-Yeast infections
-Increased urination frequency

Hypotension

Pharmacology (34 decks)

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