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Antidiabetic Drugs Flashcards

(72 cards)

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1
Q

Insulin glargine and Insulin determir belong to which drug class?
A. Rapid Acting
B. Intermediate Acting
C. Long Acting

A

C. Long Acting

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2
Q

True or False: Regular Insulin is a rapid acting insulin

A

True

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3
Q

___ is the only intermediate acting insulin

A

NPH Insulin

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4
Q

What drug class does metformin belong to?

A

Biguanides

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5
Q

Pioglitazone belongs to what drug class?

A

Thiazolidinediones

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6
Q

What are the three sulfonyureas?
(hint: all start with G)

A

1) Glipizide
2) Glyburide
3) Glimepiride

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7
Q

Which drug class does repaglinide belong to?

A

Meglitinides

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8
Q

Exenatide, Liraglutide, and Dulaglutide (all end in tide) belong to which drug class?

A

Glucagon like peptide 1 agonists

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9
Q

All the drugs that end in -liptin (sitagliptin, saxagliptin, linagiptin) belong to what drug class?

A

Dipeptidyl Peptidase 4 Inhibitors

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10
Q

First line T2DM treatment?
What if greater reduction is needed?
Even more reduction?

A

Metformin
Metformin + Sulfonylureas
Metformin + Sulfonylureas + Insulin

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11
Q

Glucagon like peptide-1 agonists can treat T2DM with what two conditions?

A

CVD and atherosclerosis

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12
Q

A patient has T2DM with renal impairment and CKD. What drug is best to treat this and why?

A

SGLT2 because it reduces progression of CKD

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13
Q

True or False: SGLT2 inhibitors have less glycemic effect, so more meds may be needed

A

True

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14
Q

How does insulin therapy affect gluconeogenesis and conversion of AA to glucose/ketoacids?

A

Decreases both processed

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15
Q

How does insulin therapy affect glucose storage?

A

Increases it

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16
Q

True or False: Protein synthesis, transportation of amino acids, and glucose are the result of insulin therapy

A

True

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17
Q

With insulin therapy, increased storage of TG leads to increased uptake of blood ___

A

glucose

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18
Q

Three main side effects of insulin therapy?

A

Hypoglycemia
Weight gain
Immune insulin resistance

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19
Q

True or False: Regular insulin given subcutaneously works faster than native insulin secreted by pancreas

A

False - regular insulin given SC works SLOWER than native insulin secreted by pancreas

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20
Q

Which type of insulin can form non-covalent hexamers in solution, which take time to break down?

A

Regular Insuln

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21
Q

Regular insulin analogs (aspart, glulisine, and lispro) more readily form monomers in solution

A

True

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22
Q

What is the only insulin suitable for IV use and forms hexamers?

A

Regular insulin

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23
Q

Why does NPH Insulin (intermediate acting) have a delayed, longer time course compared to regular insulin?

A

Need to break down aggregates

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24
Q

Which long term insulin preparation is soluble at pH for but not at 7?

A

Insulin glargine

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25
True or False: Both insulin detemir and degludec (long acting insulin preparation) bind to albumin in blood stream
True
26
True or False: Insulin, lispro, aspart, and glulisine act most quickly and are similar to meal ingestion
True
27
___ and ___ acting insulins are given to mimic 24 hr basal insulin secretion __ acting insulins are given preprandial to mimic nutrient stimulated insulin secretion
Intermediate and long acting Short acting
28
Unlike insulin, metformin does not cause ___ or ____
weight gain; hypoglycemia
29
True or False: Metformin is 100% excreted by kidneys
True
30
____ inhibits liver gluconeogenesis
Metformin
31
What is the black box warning for metformin? who is at higher risk?
metabolic acidosis - impaired hepatic metabolism of lactic acid
32
True or False: For patients with renal impairement, metformin is not eliminated as expected, leading to increased risk of met acidosis
True
33
Which class is considered insulin secretagogoues? A. Sulfonylureas B. GLP-1 agonistswo
A. Sulfonylureas
34
How do glyburide, glimepiride, and glipizide drugs act?
B cell depolarization and insulin secretion ; blocks K+ channel
35
True or False: Glipizides can cause hypoglycemia and weight gain
True
36
Repaglinide (sulfonylureas) requires ____ and is considered a insulin ____
functioning pancreatic b cells (ok for T2DM) ; secretagogue
37
Which sulfonylureas inhibits K gated channels in pancreatic beta cells, leading to depolarization?
Repaglinide
38
True or False: Repaglinide can be used in patient with sulfur allergy
True
39
How is pioglitazone similar to metformin?
Effects peripheral tissues
40
Which sulfonylurea drug increases expression of GLUT1/4 in muscle, adipose, and liver tissues and acts on PPAR?
Pioglitazone
41
True or False: GLP-1 produces feeling of hunger
False - satiety
42
How are all GLP-1 agonists given? How are DPP-4's administered?
GLP1: SC injection DPP-4: Oral
43
Endogenous ___ is released from intestinal L cells in response to nutrient ingestion, acts to "wake up" body in preparation of eventual elevation in glucose
GLP-1
44
True or False: GLP-1 agonists belong to the sulfonylureas
True
45
____ receptor activation in pancreatic b-cells enhance or augment glucose stimulated insulin secretion
GLP-1
46
Exenatide belongs to what class of drugs?
GLP1 Receptor Agonists (dosed 60 min before meal)
47
What is the only DPP-4 inhibitor that requires NO dose adjustment for RENAL DYSFUNCTIOn or CKD?
Linagliptin
48
_____ inhibits DEGRADATION of GLP-1, therefore extending actions of GLP-1 on pancreatic B cells
DPP-4 Inhibitors
49
SGLT2 Inhibitors are not as effective as __
GLP-1 agonists
50
SGLT2 inhibitors has less effective in what patients?
Pts with CDK
51
Drugs that end in -fozin?
SGLT2
52
GLP1 agonists and SGLT2 inhibitors share what beneficial side effect?
Reduced weight
53
True or False: Canaglifozin (SGLT-2 inhibitor) increases risk of bone fractures
True
54
True or False: All SGLT-2 drugs increase UTI risk
True
55
What H2 agent has anti-androgen effect?
Cimetidine
56
PPI are administered as ____and activated by ___/___cells
inactive prodrugs; protonation/parietal cells
57
PPI irreversibly inactivates ____
H/K ATPase
58
What class of drugs can lead to microbial overgrowth of upper GI tract with chronic use?
Omeprazole (PPI)
59
What drug can prevent stress and NSAID-induced ulcers?
Omeprazole/PPI's
60
Three primary uses of PPI's?
1) GERD 2) Peptic ulcer disease 3) Zollinger Ellison Syndrome
61
First line drug for treating excess acid production?
PPI's!
62
___ and ___ are strongest inhibitors of CYP2C19 while ___ has least effect on CYP2C19
Omeprazole/esomeprazole Pantoprazole
63
___ polymerizes to make a viscious material that binds to proteins on ulcer crater and forms protective barrier
Sucralfate - facilitates ulcer healing
64
____ is a PGE1 analog that prevents NSAID induced ulcers
Misoprostol - should not be given to pregnant women
65
True or False: Colloid Bismuth exerts a coating action to protect stomach; may inhibit pepsin; and has antibacterial activity against H. pylorii
True
66
______ contains salicylates and has been associated with Reye's Syndrome in kids
Colloid Bismuth
67
Triple therapy treats H. pylori and includes ___ ; either ___or____; and ___/___
1) Bismuth salt 2) Metronidazole/Amoxicillin 3) Tetracycline/Clarithomycin
68
___ are agents that mimic effects of well balanced diet
Bulk Forming Laxatives
69
Dietary fiber, methylcellulose, psyllium, and polycarbophil belong to _____
bulk forming laxatives
70
Which laxatives act on intestinal mucosa to either enhance secretion, inhibit absorption of water/induce peristalsis?
Contact/Stimulus Cathartic
71
Senna/Bisacodyl are ____ laxatives
contact/stimulant
72
Active agent of castor oil is ____, which acts on mucosa of ____ to inhibit absorption of fluid and stimulate peristaltic movements
ricinoleic acid; small intestine

Pharmacology (53 decks)

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