Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

M4 Pharm B2 > 3 - Drugs Used in DM > Flashcards

3 - Drugs Used in DM Flashcards

(56 cards)

Start Studying
1
Q

Diabetes Mellitus (DM)/Idiopathic DDM Type I (5 features)

A

NO INSULIN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Diabetes Mellitus (DM)/NIDDM Type II Features (5 features)

A

90% Type II

Have insulin but resistance

> 40 years old

NO autoabs

Hypersomolar coma (HHNS)

Oral hypoglycemics +/- insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Criteria

A

Slide 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

HYPERglycemia symptoms (8)

A

Increased thirst

Increased urination

Blurry Vision

Feeling tired

Slow healing of cuts or wounds

More frequent infections

Weight loss

Nausea and vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Long Term Problems of HYPERglycemia (7)

A

Blindness

Kidney Disease

Nerve Damage

Amputations

Heart attack

Stroke

7th leading cause of death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pancreas: First Buzzword, Cells that Secrete Buzzword, and Trigger

A

Buzzword: Insulin

Beta cell of the islets of Langerhans

Triggered by: Increase blood glucose level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Pancreas: Second Buzzword, Cells that Secrete Buzzword, and Trigger

A

Glucagon

Alpha cells of the islets of Langerans

Triggered by decrease blood glucose level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Insulin MOA

A

Insulin binds to transmembrane receptors

The receptor consists of 2alpha and 2beta subunits

Binding to alpha subunits occurs through a complex series (tyrosine kinase) of phosphorylation promotes entry of glucose into the cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Insulin Preparations: Rapid Acting - Drugs, Onset, Peak Effect, Duration

A

Drugs: Lispro, Aspart, Glulisine (LAG)

Onset: 5-15 minutes

Peak effect: 1-2 hours

Duration 3-4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Insulin Preparations: Short Acting - Drugs, Onset, Peak Effect, Duration

A

Drugs: Regular (SC/IV)

Onset:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Insulin Preparations: Intermediate - Drugs, Onset, Peak Effect, Duration

A

Drugs: Neutral Protamine Hegedorn (NPH, IV), Lente

Onset: 2 hours

Peak effect: 4 hours

Duration: 16 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Insulin Preparations: Long Acting - Drugs, Onset, Peak Effect, Duration

A

Drugs: Glargine, Determir, Ultralente (GDU)

Onset: 60-90 minutes

Peak Effect: Peakless

Duration: >24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the standard mode of insulin therapy?

A

Subcutaneous (SC) injection

KNOW GRAPHS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Mixtures of Insulin (4 Types)

A

75%/25% NPL / Lispro Insulin

50%/50% NPL / Lispro Insulin

70%/30% NPH / Regular Insulin

70%/30% NPA / Aspart Insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Insuline glargine and detemir must be given as?

A

Separate injections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Continuous Subcutaneous Insulin Infusion Devices (CSII, Insulin Pumps) (2)

A

Programmed to deliver insulin at a low basal rate and premeal boluses to control post prandial glycemia

Insulin aspart, lispro, & glulisine all are specially approved pump use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Indications of Insulin (4)

A
  1. Diabetes mellitus (type 1, 2 and gestational diabetes)
  2. Post-pancreatectomy diabetes
  3. Diabetic ketoacidosis
  4. Hyperglycemia, nonketotic coma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Goals for Therapy

A

See Notes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Adverse Effects of Insulin Therapy: Hypoglycemia (

A
  1. Sweating
  2. Hunger
  3. Paresthesias
  4. Palpitations
  5. Tremor
  6. Anxiety
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Adverse Effects of Insulin Therapy: Hypoglycemia (

A

1.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Adverse Effects of Insulin Therapy: Immunepathology of Insulin - Insulin Allergy (3)

A

Anti-insulin IgE-mediated local cutaneous reactions

Angioedema

Urticaria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Adverse Effects of Insulin Therapy: Immunepathology of Insulin - Immune Insulin Resistance (1)

A

IgG antibodies neutralize the action of insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Adverse Effects of Insulin Therapy: Lipoatrophy and Lipohypertrophy (2)

Study These Flashcards
A

Atrophy of subcutaneous fat at the site of insulin rejection (lipoatrophy)

Liophypertrophy (enlargement of subcutaneous fat depots)

24
Q

Hypoglycemia: Why do you get the excitatory side effects of hypoglycemia?

Study These Flashcards
A

Because decreased blood glucose triggers epinephrine

25
Hypoglycemia: Classifications (2)
a. Post-prandial after lunch blood glucose is low | b. Fasting hypoglycemia: low blood glucose + symptoms --> they get better if they eat sugar
26
Insulinoma: Defined (2)
Benign tumor producing insulin Inappropriate high insulin DESPITE low blood glucose
27
Insulinoma: Values
Serum insuling 8 ug/ml and blood close below 40 mg/dl
28
Insulinoma: Rx
Surgery
29
Factitious Hyperinsulinism: Defined
Self-ingestion insulin
30
Factitious Hyperinsulinism: Triad of? (3)
1. Hypoglycemia 2. Antibodies 3. Suppressed plasma C peptide
31
In both insulinoma and factitious hyperinsulinism, what is elevated? (2)
1. Plasma insulin | 2. Insuling/glucose ratio
32
How can you tell if it's insulinoma or factitious hyperinsulinism? (2)
Only in insulinoma, you will see proinsulin AND C peptide --> because it's endogenously made Only in factitious, you will look for antibodies against insulin if it's exogenous
33
How do you test to see if someone is taking Glipizide (Making more of what, what is increased, and absence of what?)
They are making more insulin C peptide is INCREASED Antibodies are absent
34
How do you test if someone is ingesting sulphonylurea (e.g. Glipizide)?
Do urine sulphonyl-urea
35
Hypoglycemia: Drugs Used to Treat Hypoglycemia (3)
Glucagon Dextrose Diazoxide
36
Hypoglycemia: Indication (1)
Insulinoma causing hyperinsulinism
37
Hypoglycemia: Diazoxide Overdose Symptoms (2)
Hyperglycemia Ketoacidosis
38
Hypoglycemia: Clinical Uses of Glucagon (4)
1. Severe hypoglycemia (1 mg injection) 2. Endocrine diagnossi 3. Beta adrenergic receptor blocker overdose (ability to increase cAMP production in the heart) 4. Radiology of bowel (relaxes intestine and used in radio as an aid to X-ray visualization)
39
Complication of Type I Diabetes: Diabetic Ketoacidosis/DKA (Values)
Increased plasma glucose, H+, ketones, K+ Decreased HCO3 and intracellular K+
40
DKA (Type I): Precipitated by (4)
Insufficient insulin therapy Infection Emotional stress Excessive alcohol intake
41
DKA Mechanism
See Slide 30
42
DKA: Classic Symptom and Treatment
Fruity breath odor of acetone Give insulin drip until acetone goes away
43
DKA: Blood glucose is (value)?
400 mg/DL + ketone bodies
44
DKA: Treatment (3)
IV insulin (regular) IV fluids, dextrose Correct electrolytes, K+
45
Complication of Type II Diabetes: Hyperosmolar Coma (HHNS)
HHNS - Hyperosmolar Hyperglycemia Non-Ketotic Syndrome Severe hyperglycemia up to 100 mg/dL without significant ketosis
46
Hyperosmolar Coma (HHNS): Precipitating Factors (5)
Infections Strokes MI Common in elderly diabetics
47
Hyperosmolar Coma (HHNS): Diagnosis (4)
Blood glucose > 1000 mg/dL High serum osmolality High BUN No ketosis
48
Chronic Complications of Diabetes (4, 3a and 3b)
1. Retinopathy: leading cause of blindness 2. Nephropathy 3. Neuropathy a. Peripheral: numbness, paresthesia, and pain b. Autonimic: gastroparesis and impotence 4. Amputations (serious complication)
49
What hormone kicks in if glucose is high?
Insulin
50
What hormones kick in if glucose is low (counterregulatory hormones)? (4)
Glucagon Growth Hormone Cortisol Epinephrine
51
What type of diabetics experience honeymoon period?
IDDM (Type I Diabetocs)
52
Honeymoon Period: Have what type of insulin need and why?
Decrease insulin need Restoration of some insulin production, only for a short period of time
53
What is the somogyi effect and why does it occur?
Rebound hyperglycemia in the morning due to too much insulin before bed time
54
Somogyi Effect: MOA and Correcting to
Too much insulin at night time -- > hypoglycemic episode in middle of night --> stimulates glucagon and growth hormone release --> hyperglycemia in hormone Correct by lowering insulin before bed time
55
What is the Dawn Phenomenin why does it occur, and how to correct?
Early morning HYPERglycemia Counter-regulatory hormones kicks in at night (reduced sensitivity to insulin between 5 am and 8 am) Increase insulin at PM
56
How can you tell Somogyi from Dawn?
Slide 39

M4 Pharm B2 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions