Antidiabetic agents

Question 0

diazoxide functions (3)

Answer 0

directly inhibit insulin secretion
decreased peripheral glucose utilization
increased hepatic glucose production

Question 1

diazoxide drug type (3 things)

Answer 1

non-diuretic thiazide
vasodilator
hyperglycemic

Question 2

sulfonylureas MOA (2)

Answer 2

stimulate insulin release from pancreatic B-cells

indirectly potentiate action of insulin on target tissues

Question 3

Tolbutamine, Chlorpropamide, Tolzamide drug class

Answer 3

Sulfonylureas 1st gen

Question 4

sulfonylureas adverse effects (3)

Answer 4

renal disease
hepatic dysfunction
weight gain

Question 5

sulfonylureas contraindications

Answer 5

renal disease
hepatic dysfunction
sulfa

Question 6

tolbutamide (2 special characteristics)

Answer 6

rapid

safest in the elderly

Question 7

chlorpropamide (2 special things)

Answer 7

disulfram-like effect

worst hypoglycemia

Question 8

1st gen sulfonylureas (3)

Answer 8

Tolbutamide
Chlorpropamide
Tolzamide

Question 9

Glyburide, Gliphizide, Glimepiride

drug class

Answer 9

2nd gen sulfonylureas

Question 10

2nd gen sulfonylureas (3)

Answer 10

Glyburide
Glipizide
Glimepiride

Question 11

Glyburide

Answer 11

worst hypoglycemia

Question 12

Glipizide (special characteristic)

Answer 12

least hypoglycemia of 2nd gens

Question 13

Glimepiride (2)

Answer 13

daily dosing

smaller hypoglycemic effect

Question 14

meglitinides (2)

Answer 14

Repaglinide (Prandin)

Nateglinide (Starlix)

Question 15

Repaglinide & Nateglinide drug class

Answer 15

Meglitinides

Question 16

meglitinides MOA

Answer 16

binds to receptors on K+ channels on B-cells —> increased insulin release

Question 17

meglitinides effects (3)

Answer 17

decreased postprandial glucose
rapid/short action
decreased HbA1c

Question 18

meglitinides administration (3)

Answer 18

oral
preprandial administration
peak effect at 1 hour

Question 19

meglitinides cautions/contraindications (3)

Answer 19

not used w/ sulfonylureas
caution w/ liver impairment
hypoglycemia

Question 20

Metformin (Glucophage) actions (4)

Answer 20

increased glucose uptake (increased insulin action)
decreased glucose absorption from the GI
decreased glucagon
decreased gluconeogenesis

Question 21

Metformin bonus effects (3)

Answer 21

dereased plasma TGs
no weight gain
decreased macrovascular events

Question 22

Metformin adverse effects (3)

Answer 22

lactic acidosis
crazy diarrhea
n/v

Question 23

metformin contraindications

Answer 23

Lactic Acidosis conditions: renal/hepatic disease, alcoholism
tissue hypoxia (CHF, COPD)

Question 24

thiazolidinediones/TZDs (2)

Answer 24

Pioglitazone (Actos) | Rosiglitazone (Avandia)

Question 25

Pioglitazone (Actos) & Rosiglitazone (Avandia) | drug class

Answer 25

TZDs

Question 26

TZD MOA (3)

Answer 26

insulin sensitizers insulin-mimetic action via ligands of the nuclear PPAR receptor increase glucose transporter synthesis in adipose

Question 27

TZD effects (3)

Answer 27

decreased insulin resistance long term TG decrease slight increase in HDL

Question 28

TZD special use

Answer 28

prophylactic for type 2 diabetes

Question 29

TZD that is contraindicated in hx MI or angina

Answer 29

Rosiglitazone (Avandia)

Question 30

TZD adverse effects (5)

Answer 30

``` edema weight gain back pain fatigue headache ```

Question 31

a-glucosidase inhibitors (2)

Answer 31

Acarbose (Precose) | Miglitol (Glyset)

Question 32

Acarbose (Precose) & Miglitol (Glyset) | drug class

Answer 32

a-glucosidase inhibitors

Question 33

a-glucosidase inhibitor MOA & effect

Answer 33

inhibit a-glucosidases in small intestine ---> delayed carbohydrate digestion & absorption ---> reduced glucose absorption

Question 34

a-glucosidase results (4)

Answer 34

decreased postprandial glucose minimal effects of fasting glucose decreased HA1c no weight effects

Question 35

adverse effects of a-glucosidase inhibitors (3)

Answer 35

GI- farting!! increased hepatic enzymes jaundice

Question 36

a-glucosidase inhibitor contraindications (3)

Answer 36

GI disease hepatic disease renal impairment

Question 37

incretin mimetic MOA and effects (3)

Answer 37

resistant to degradation by DPP-IV increased insulin decreased glucagon release decreased hepatic gluconeogenesis

Question 38

incretin mimetics (3)

Answer 38

Exenatide (Byetta) Liraglutide (Victoza) Dulaglutide (Trulicity)

Question 39

Exenatide (Byetta), Liraglutide (Victoza), Dulaglutide (Trulicity) drug class & MOA

Answer 39

incretin mimetics | resistant to degradation by DPP-IV

Question 40

incretin mimetics effects on diabetes (3)

Answer 40

decreased postprandial & fasting glucose increased B-cell number & function slows gastric emptying ---> weight loss

Question 41

Exenatide administration?

Answer 41

injected about 60 min before meals

Question 42

incretin mimetic adverse effects (4)

Answer 42

GI hypoglycemia in combo therapy hypersens. to injection pancreatitis

Question 43

DPP-IV inhibitor MOA & effects (2)

Answer 43

potentiates effects of incretin hormones decrease postprandial & fasting glucose modest decr. HA1c

Question 44

-gliptin drugs are which class

Answer 44

DPP-IV inhibitors

Question 45

DPP-IV inhibitors have what suffix

Answer 45

-gliptin

Question 46

DPP-IV inhibitor contraindications

Answer 46

slow GI disease | renal impairment

Question 47

Pramlintide (Symlin) drug type

Answer 47

amylin-like peptide

Question 48

Pramlintide use

Answer 48

adjunct to insulin in Type 1 and 2

Question 49

Pramlintide MOA & effects (4)

Answer 49

works with insulin to decrease gastric emptying decreased postprandial glucose decreased appetite/weight loss decreased HbA1c

Question 50

Pramlintide administration

Answer 50

injection 3x dailey w/ bolus of insulin