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UNRS 113 > Antidiabetic Drugs > Flashcards

Antidiabetic Drugs Flashcards

(74 cards)

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1
Q

What is diabetes mellitus?

A

A disorder of carbohydrate metabolism that involves either a deficiency of insulin, a resistance of tissue to insulin, or both

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2
Q

What are the signs and symptoms of diabetes mellitus?

A 
Elevated fasting blood glucose (> 126 mg/dL)
Hemoglobin A1C ≥ 6.5%
Polyuria
Polydipsia
Polyphagia
Glycosuria
Unexplained weight loss
Fatigue
Blurred vision
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3
Q

What is polyuria?

A

Excessive production of urine

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4
Q

What is polydipsia?

A

Excessive thirst

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5
Q

What is polyphagia?

A

Excessive hunger

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6
Q

What is glycosuria?

A

Excessive sugar in urine

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7
Q

What is the normal range of blood sugar?

A

70 - 100

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8
Q

What is type 1 diabetes mellitus characterized by?

A

Lack of insulin production

Production of defective insulin

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9
Q

What kind of treatment do patients with type 1 diabetes need?

A

Exogenous insulin

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10
Q

How many cases of diabetes mellitus are type 1?

A

10%

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11
Q

What are the complications of type 1 diabetes?

A 
Diabetic ketoacidosis (DKA)
Hyperosmolar nonketotic syndrome (HHNS)
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12
Q

What is the function of insulin?

A

Lowers blood sugar levels by storying sugar in fat tissue, muscle, and liver to be used for energy later

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13
Q

What is the function of glucagon?

A

Increases blood sugar level by releasing glucose from fat tissue when needed for energy

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14
Q

How many cases of diabetes mellitus are type 2?

A

90%

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15
Q

What causes type 2 diabetes?

A

Insulin deficiency

Insulin resistance

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16
Q

What causes insulin resistance?

A

Reduced number of insulin receptors

Insulin receptors are less responsive or defective

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17
Q

What are comorbid conditions of type 2 diabetes?

A 
Obesity
Coronary heart disease
Dyslipidemia
Hypertension
Microalbuminemia
Increased risk for thrombotic events
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18
Q

What are the comorbidities of type 2 diabetes collectively called?

A

Metabolic syndrome

Syndrome X

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19
Q

What is gestational diabetes?

A

Hyperglycemia that develops during pregnancy

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20
Q

What can happen to 30% of patients who have had gestational diabetes?

A

May develop type 2 diabetes within 10 - 15 years

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21
Q

What are the major long-term complications of type 1 and 2 diabetes?

A

Macrovascular (atherosclerotic plaque)

Microvascular (capillary damage)

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22
Q

Which structures are involved in the macrovascular complication of diabetes?

A

Coronary arteries
Cerebral arteries
Peripheral vessels

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23
Q

Microvascular complication of diabetes include which conditions?

A

Retinopathy
Neuropathy
Nephropathy

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24
Q

What are the acute diabetic complications?

A

DKA (diabetic ketoacidosis)

HHNS (hyperosmolar hyperglycemic syndrome)

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25
What are the conditions that characterize DKA (diabetic ketoacidosis)?
``` Hyperglycemia Ketones in the serum Acidosis Dehydration Electrolyte imbalnce ```
26
How many newly diagnosed type 1 diabetic patients also present DKA?
25 - 30%
27
How long is the duration of symptoms of DKA and HHNS?
DKA: < 2 days HHNS: > 5 days
28
What is the average age of patients with DKA and the average age of patients with HHNS?
DKA: < 40 years old HHNS: > 40 years old
29
What is the serum glucose level in patients with DKA and the serum glucose level in patients with HHNS?
DKA: < 600 mg/dL HHNS: > 600 mg/dL
30
What is the screening recommendation concerning diabetes?
Patients 45 years and older are recommended to be screened every 3 years
31
What are prediabetic characteristics?
HbA1C of 5.7 - 6.4% | Fasting plasma glucose levels ≥ 100 mg/dL, but < 126 mg/dL
32
What are the nonpharmacologic treatment interventions for type 1 diabetes?
Needs insulin therapy
33
What are the nonpharmacologic treatment interventions for type 2 diabetes?
``` Weight loss Improved dietary habits Smoking cessation Reduced alcohol consumption Regular physical exercise ```
34
What are the glycemic goals of treatment of diabetes?
HbA1C < 7% Fasting blood glucose goal for diabetic patients 70 - 130 mg/dL Know estimated average glucose
35
What are the treatments for type 1 diabetes?
Insulin therapy
36
What are the treatments for type 2 diabetes?
Lifestyle changes Oral drug therapy Insulin when the above no longer provide glycemic control
37
What is the mechanism of action and drug effects of insulin?
Used as a substitute for endogenous insulin hormone Restores diabetic patient's ability to: -Metabolize carbohydrates, fats, and proteins -Store glucose in liver -Convert glycogen to fat stores
38
What are the indications of insulin?
Type 1 and 2 diabetes
39
What are the interactions with insulin?
Corticosteroids, diuretics, thyroid drugs, nonselective beta blockers: interferes with insulin and can mask tachycardia from hypoglycemia Hypoglycemic drugs: additive effects
40
What are the major classes of insulin?
Rapid-acting Short-acting Intermediate acting Long acting
41
Which drugs are in the class of rapid-acting insulin?
Humalog Novolog Apidra
42
What is the onset of action of rapid-acting insulin?
5 - 15 minutes
43
What is the peak of rapid-acting insulin?
1 -2 hours
44
What is the duration of rapid-acting insulin?
3 - 5 hours
45
When can you administer rapid-acting insulin?
Patient must eat a meal right after injection
46
What is the route of administration for rapid-acting insulin?
SQ (subcutaneous) | SQ infusion pump
47
What is the appearance of insulin?
Clear
48
Which drugs are in the class of short-acting insulin?
Humulin R | Regular insulin
49
What is the route of administration for short-acting insulin?
IV bolus IV infusion IM (intramuscular) SQ (subcutaneous)
50
What is the onset of action of short-acting insulin (SQ route)?
30 - 60 minutes
51
What is the peak of short-acting insulin (SQ route)?
2.5 hours
52
What is the duration of short-acting insulin (SQ route)?
6 - 10 hours
53
Which drugs are in the class of intermediate-acting insulin?
Insulin isophane suspension (NPH)
54
What is the appearance of intermediate-acting insulin?
Cloudy
55
What is the onset of action of intermediate-acting insulin?
1 - 2 hours
56
What is the peak of intermediate-acting insulin?
4 - 8 hours
57
What is the duration of intermediate-acting insulin?
10 - 18 hours
58
What is intermediate-acting insulin often combined with?
Regular insulin
59
Which drugs are in the class of long-acting insulins?
``` Insulin glargine (Lantus) Insulin detemir (Levemir) ```
60
What does Lantus do for the body?
Provides a constant level of insulin in the body
61
How often is Lantus (insulin glargine) administered to a patient?
Usually dosed once daily, but can be dosed every 12 hours
62
What is the onset of action of long-acting insulin?
1 - 2 hours
63
What is the peak of long-acting insulin?
None
64
What is the duration of Lantus (insulin glargine)?
24 hours
65
What is the duration of Levemir (insulin detemir)?
Duration of action is dose dependent
66
How often is Levemir (insulin detemir) administered to a patient?
Lower doses require twice-daily dosing | Higher doses may be given once daily
67
What are the indications of oral antidiabetic drugs?
Type 2 diabetes
68
What does effective treatment of type 2 diabetes require?
Lifestyle modifications Careful monitoring of blood glucose levels Therapy with one or more drugs Treatment of associated comorbid conditions (e.g. high cholesterol, high blood pressure)
69
What does the 2015 ADA guidelines recommend on how to treat new-onset type 2 diabetes?
Lifestyle interventions and the oral biguanide drug metformin If the above intervention does not reach HbA1C goals after 3 -6 months, additional treatment with a second oral agent should be added
70
Which drugs are biguanides?
Metformin (glucophage)
71
What is metformin used for?
First-line drug and most commonly used oral drug for treating type 2 diabetes
72
What is the mechanism of action of biguanides?
Decreases glucose production by the liver | May also decrease intestinal absorption of glucose and improve insulin receptor sensitivity
73
What are the indications of biguanides?
Newly diagnosed type 2 diabetes
74
What are the contraindications of biguanides?
Renal disease | Renal dysfunction

UNRS 113 (7 decks)

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