ANTI-DIABETIC DRUGS Flashcards
Diabetes mellitus (DM) is defined as a ______geneous metabolic disorder characterized by (acute or chronic?) ______glycemia with relative disturbance of ————,________,________
heterogeneous
chronic
hyperglycemia
carbohydrate, fat and protein metabolism
There are two major types of DM and a number of minor types
Major types
Type 1/ _______ Dependent DM
Type 2/ __________ Dependent DM
Minor types
•____________ DM
•_______ Onset Diabetes of the _______
•_____________ DM
Insulin
Non Insulin
Gestational DM
Maturity ; Young
Secondary DM
PATHOPHYSIOLOGY
In a normal patient, Glucose metabolism is regulated by the hormone _________
And this is a polypeptide hormone made up of _____ amino acids
It is produced in the _________ Cells of the _________
It is secreted into circulation usually in response to _____ease in Glucose in the _________, usually (before or after?) a meal
INSULIN
51 amino acids
Beta Islet ; Pancreas
increase ; blood ; after
Function of Insulin after release includes
Enables _________ by tissues in the body
___________ Glycogen synthesis
___________ Gluconeogenesis and Glycogenolysis
___________ Lipogenesis
___________ Lipolysis
___________ Protein ______bolism
Glucose uptake
Stimulates
Inhibits
Stimulates
Inhibits
Stimulates
Anabolism
Hence absence or inactivity of Insulin would lead to
(Reduced or Increased ?) Uptake of Glucose by Tissues
(Reduced or Increased ?) Hepatic Glycogenosis and Gluconeogenesis
(Reduced or Increased ?) Lipolysis
(Reduced or Increased ?) Protein Catabolism
(Reduced or Increased ?) uptake of Glucose by tissues leads to accumulation of Glucose in the blood
Thus (ACUTE or CHRONIC?) HYPERGLYCEMIA
Reduced
Increased
Increased
Increased
Reduced
CHRONIC HYPERGLYCEMIA
ETIOLOGY
Type I Insulin-dependent diabetes mellitus (IDDM)
There is ____________ in pancreatic _______;
____________ (type _____) antibodies that ___________ are detectable in blood.
_________ INSULIN DEFICIENCY from ______
β cell destruction ; islets
Autoimmune (type 1A)
destroy β cells
Absolute; start
Type II Noninsulin-dependent diabetes mellitus (NIDDM)
Reduced ________ of ________ to ______ or ________
________ INSULIN DEFICIENCY at ______ stage
sensitivity ; peripheral tissues
insulin ; Insulin resistance
Relative ; later stage
Classification of hypoglycemic agents
A and B
B can be divided into C and D
A can be divided into E, F , G
A parenteral
B oral
C sulfonylureas
D Biguanides
E short acting
F intermediate acting
G long acting
INSULINS
Rapid
Insulin _______
Insulin _______
Insulin _______
Short acting
_______ Insulin
Intermediate acting
Neutral protamine Hagedorn/Insulin _______
Long acting
Insulin _______
Insulin _______
Rapid
Insulin Lipro
Insulin Aspart Insulin Glulisine
Short acting
Regular Insulin
Intermediate acting
Neutral protamine Hagedorn/Insulin isophane
Long acting
Insulin glargine
Insulin detemir
INSULIN
SOURCE
Naturally
Extracted from ______
– Artificially
Produced by ___________ technology using special strains of ___________ or _________ that have been genetically altered to ______________________________
PIGS
recombinant DNA technology
Escherichia coli ; yeast
contain the gene for human insulin
INSULIN
Binds to Insulin Receptor in the __________, __________ and __________
Insulin receptors are a type of __________ RECEPTOR
Activation of this receptor leads to the expression of unique glucose transporters on the membrane of the cells called __________
_______ expression causes an uptake of GLUCOSE from the blood
LIVER, SKELETAL MUSCLE and ADIPOSE TISSUE
TYROSINE KINASE RECEPTOR
GLUT; GLUT
INSULIN: PHARMACOKINETICS
Administered _____________
Insulin preparations vary primarily based on
________ and _____________
Metabolized in the _____ and _______ by _____________ ENZYME/ _____________
SUBCUTANEOUSLY
Onset; Duration of action
Liver and Kidney
INSULIN-DEGRADING ENZYME/ INSULIN PROTEASE
INSULIN: ADVERSE EFFECT
_____________
Weight _____
____________ at injection site
______kalemia
______/ _________ reaction
Edema
______ and _________ at Injection site
Hypoglycemia; gain
Lipodystrophy ; Hypokalemia
Allergic/ Hypersensitivity
Pain and Erythema
NON-Insulins
Insulin Secretagogues
____________
____________
Insulin Sensitizer
____________
____________/____________
Glucosidase Inhibitors
____________
____________
Meglitinide
Sulfonylurea
Biguanides
Thiazolidinediones/Glitazone
Acarbose
Miglitol
NON-Insulins
Insulin ________
Insulin _________
_________ Inhibitors
___________ Inhibitor
________ analogue
__________ ________
Secretagogues
Sensitizer
Glucosidase
Dipeptidyl Peptidase IV
Amylin
Incretin mimetic
NON-INSULINS
Dipeptidyl Peptidase IV Inhibitor
___________
Amylin analogue
__________
Incretin mimetic
___________
Sitagliptin
Pramlintide
Exenatide
