Antidiabetic Drugs 1

Question 1

hyperglycemia without ketoacidosis is seen in type ___ DM

Answer 1

type 2 DM because the insulin secretion is enough to restrain ketogenesis

Question 2

insulin binding to the receptor causes ↑ expression of GLUT__ transporters

Answer 2

GLUT 4

Question 3

which long acting insulin has the longest half life?

Answer 3

degludec

Question 4

ATP blocks the _____ channels in the mechanism of insulin secretion

Answer 4

K channels

Question 5

what is effect of insulin on potassium?

Answer 5

↑ K+ uptake into the cell

Question 6

when do you see symptoms of Type 1 DM?

Answer 6

after 80-90% of β cells have been destroyed

Question 7

which insulins are human insulins preparations

Answer 7

NPH (intermediate) and short acting

Question 8

which has a higher risk of hypoglycemia: long acting insulin analogs or NPH insulin

Answer 8

long acting insulin analog

Question 9

insulin lispro is a _______ acting insulin; describe how it does so

Answer 9

rapid acting;
↓ the propensity to form a hexamer by flipping the AA’s on portion 28 and 29: pro and lysine is switched to lysine and proline on the B chain

Question 10

if the patient is exercising, how would they adjust their insulin dose?

Answer 10

• ↓ dose because exercise ↑ insulin sensitivity

Question 11

what are the three long acting insulins

Answer 11

• insulin glargine
• insulin detemir
• insulin degludec

Question 12

glucose given orally/IV results in higher insulin levels

Answer 12

orally; due to the incretins released by the GI which will cause ↑ secretion of insulin

Question 13

what type of insulin is given to provide basal coverage in insulin regimens

Answer 13

one shot of a long acting insulin: -insulin glargine, detemir, degludec

Question 14

rapid acting insulins are given to mimic the _____ release of insulin and are given _______

Answer 14

prandial; given 15 mins before meal

Question 15

what are incretins? what do they do?

Answer 15

incretins are GI hormones that are released after the ingestion of food and ↑ insulin secretion
incretins: glucagon like peptide 1 and GIP (glucose deponent insulinotopic polypeptide)

Question 16

soluble crystalline zinc insulin is a ____ acting insulin

Answer 16

short

Question 17

keeping insulin in a ________ form, it allows for it to be absorbed very quickly

Answer 17

monomeric form;

formation of hexameters SLOWS the absorption of insulin

Question 18

which has a higher risk of hypoglycemia:

rapid acting insulin analogs or regular insulin

Answer 18

regular insulin

Question 19

the _____ subunit is the recognition site for insulin

Answer 19

α

Question 20

describe the mechanism of insulin secretion:

Answer 20

• when there is ↑ insulin the blood there is ↑ glycolysis and CAC → ↑ ATP
• ATP will close the potassium channels which prevents K from leaving the cells → cell depolarizes
• depolarization of cell causes calcium channels to open → calcium enters cell → exocytosis of insulin

Question 21

which insulins are analogs of

Answer 21

rapid and long acting

Question 22

↑ propensity to form the hexamer form of insulin will ↑/ ↓ the time of activity of insulin

Answer 22

slows the time of action of insulin

Question 23

how can diuretics cause hyperglycemia?

Answer 23

peeing out the K will then prevent the membrane depolarization → less insulin secretion

Question 24

what are the tree rapid acting insulin drugs

Answer 24

• insulin lispro
• insulin aspart
• insulin glulisine

Question 25

insulin receptor consists of two covalently linked _______

Answer 25

heterodimers; | α subunits on the outside and β subunits expands the entire membrane

Question 26

________ (drugs) cause hyperglycemia by acting directly on peripheral tissues that antagonize the effect of insulin

Answer 26

epinephrine, glucocorticoids, atypical antipsychotics and HIV protease inhibitors

Question 27

which drugs cause hyperglycemia by directly inhibiting insulin secretion

Answer 27

- phenytoin - clonidine - Calcium channel blockers

Question 28

type 1 DM is characterized by marked elevations of blood glucose and _____

Answer 28

ketone bodies

Question 29

NPH (neutral protamine hagedorn) is a ______ acting insulin

Answer 29

intermediate

Question 30

what type of insulin is used in IV therapy?

Answer 30

human insulin

Question 31

what type of insulin is used in the insulin pump

Answer 31

rapid acting glulisine, lispro or aspart

Question 32

how would a patient adjust their insulin dose if they are suffering from an acute illness?

Answer 32

↑ dose because with illnesses there is ↑ insulin resistance

Question 33

_________ acting insulins are given for basal control of insulin release

Answer 33

intermediate aka isophane insulin; | cyrstalline zinc insulin + protamine

Question 34

what are drugs that can cause HYPOglycemia

Answer 34

- ethanol: inhibit gluconeogenesis - β blockers: inhibit the effects of catecholamines on the mobilization of glucose - salicylates: potentiate insulin secretion

Question 35

regiments based on ____ and _____ acting insulin improve HBA1c levels dn reduce hypoglycemia most effectively

Answer 35

rapid and long acting (better than NPH insulin and regular insulin)

Question 36

the β subunit is the recognition site for ______

Answer 36

tyrosine kinase

Question 37

omeprazole is what type of drug?

Answer 37

PPI