Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endocrine II midterm > Konorev: Drugs for Diabetes > Flashcards

Konorev: Drugs for Diabetes Flashcards

1
Q

What is Diabetes mellitus?

A

a group of common metabolic disorders resulting in hyperglycemia

  • deficiency of insulin
  • inability of body to respond to insulin
  • increased level of counter-regulatory hormones that oppose insulin action
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Diagnostic criteria for DM?

A

-increased plasma glucose levels

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

Type 1 DM

A

-insulin dependent

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

Type 2 DM

A

-no insulin dependent

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

What does insulin normally do?

A

lowers blood glucose

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

What are things that raise blood glucose levels?

A
  • T3/4
  • Glucagon
  • Epinephrine
  • Glucocorticoids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is insulin’s effect on plasma K+ levels?

A

decreases them
-when ATP is generated in the cell due to glucose metabolism after insulin lets it in, that ATP blocks the K+ efflux channel

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

What does PKA do?

A
  • generated after GPCR=Gs ligands are activated (B2-AR agonists or GLP-1 receptor agonists)
  • it opens up the Ca2+ channel so that can rush in and promote the exocytosis of insulin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What opposes the creation of PKA?

A
  • GPCR-Gi ligands:
  • Somatostatin
  • alpha2-AR agonists
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the VDCC

A

-L-type Ca2+ channel

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

What drugs are used in diabetes?

A
  • insulins
  • amylin analog
  • insulin secretagogues
  • Biguanides
  • Thiazolidinediones
  • Sodium-glucose co-transporter 2 (SGLT2) inhibitors
  • Inhibitors of a-glycosidases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the insulin secretagogues?

A
  • Sulfonylureas
  • Meglitinides
  • GLP-1 agonists
  • Dipeptidyl Peptidase-4 (DPP-4) inhibitors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is most important when treating Diabetes?

A

tight glycemic control

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

Rapid acting insulins (3)

A
  • Aspart
  • Lispro
  • Gluisine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Short acting insulin

A

-regular insulin

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

Intermediate acting insulin

A

NPH: neutral Protamine Hagerdorn

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

Long acting insulin

A
  • Detemir

- Glargine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Standard delivery of insulins

A

Subcutaneous injection using disposable nedles and syringes

19
Q

What is that really cool new technology thing he talked about?

A
  • a bi hormonal bionic pancreas
  • secretes insulin and glucagon
  • registers HR
20
Q

What is Amylin?

A

a pancreatic hormone synthesized by B-cells

21
Q

MOA of amylin

A
  • inhibits glucagon secretion
  • enhances insulin sensitivity
  • decreased gastric emptying (slows the rate of intestinal glucose absorption)
  • causes satiety
22
Q

What does satiety mean?

A

feeling full

23
Q

What is the amylin analog drug?

A

Pramlintide

-these amylins are usd with insulin to control postprandial hyperglycemia

24
Q

What are the Incretins?

A

a group of FI hormones that stimulate a decrease in blood glucose levels
-Glucagon-like peptide-1 (GLP-1)

25
Q

What is GLP-1?

A
  • synthesized by intestinal L-cells
  • promotes: B cell proliferation, insulin gene expression, glucose-dependent insulin secretion
  • inhibits glucagon secretion
  • also causes satiety, inhibits gastric emptying
26
Q

What is the one thing that’s wrong with GLP-1?

A

it has a very short half-life

  • 1-2 minutes
  • not an effective drug
27
Q

What are the incretin mimetics?

A
  • long-acting GLP-1 receptor agonists
  • Dipeptidyl peptidase-4 (DPP-4) inhibitors
  • remember, it stimulates insulin release and inhibits glucagon release
  • does a great job of lowering blood glucose
28
Q

Long-acting GLP-1 receptor agonists

A
  • Exenatide

- Liraglutide

29
Q

What does the GLP-1 receptor agonists do? MOA?

A
  • Gs protein receptor
  • makes PKA…. upregulates insulin gene transcription and potentiates the Ca2+ influx so we can secrete it
  • Glucose enters cell and makes ATP… blocks K+ efflux channels
30
Q

DPP-4 inhibitors

A
  • Sitagliptin
  • Linagliptin
  • Saxagliptin
  • Alogliptin
31
Q

MOA of DPP-4 inhibitors

A
  • they stop DPP-4 which is a serine protease that degrades GLP-1 and other incretins
  • keeps that good GLP-1 intact
32
Q

What are the K(ATP) channel blockers?

A

Sulfonylureas: first and second gen

Non-sulfonylureas(meglitinides)

33
Q

Sulfonylureas

A
  • First Gen: Chlorpropamide, Tolbutamide, Tolazamide

- Second gen: Glipizide, Glyburide, Glimepiride

34
Q

non- sulfonylureas (meglitinides)

A
  • Nateglinide

- Repaglinide

35
Q

MOA of Katp channel blockers

A
  • Bind to SUR- sulfonylurea receptor

- blocking K+ current through Kir6.2, inwardly rectifying potassium channel

36
Q

Biguanides

A

Metformin

37
Q

MOA of metformin

A
  • Activation of AMP-dependent Protein Kinase
  • but then it shows metformin blocking a mitochondria
  • decreases glucoeogenesis
  • decreases glucose and insulin if elevated
38
Q

Thiazolidinediones

A
  • Pioglitazone

- Tosiglitazone

39
Q

Thiazolidinediones MOA

A
  • ligands of peroxisome proliferator-activated receptor-gamma (PPARg)
  • PPARg is a nuclear receptor expressed primarily in fat, muscle, liver tissue, and endothelium
  • inhibits NFKB, AP-1, and STAT
40
Q

What are the Sodium-glucose co transporter 2 inhibitors (Gliflozins)?

A
  • Canagliflozin
  • Dapagliglozin
  • Empagliglozin
41
Q

What does SGLT2 do?

A
  • normally, it lets glucose get completely reabsorbed in the kidney
  • now, we can excrete some of it in the urine which is nice if you’re diabetic
42
Q

Alpha glycosidase inhibitors

A
  • Acarbose

- Miglitol

43
Q

MOA of alpha glycosidase inhibitors

A
  • only monosaccharides are absorbed from GI into the blood
  • competitive inhibition of a-glycosidases, a family of enzymes on the intestinal epithelium defer digestion and thus absorption of ingested starch and disaccharides
  • lower postprandial hyperglycemia to create an insulin-sparing effect

Endocrine II midterm (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions