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GIR Test 3 > B5-003 Diabetes Mellitus Drugs > Flashcards

B5-003 Diabetes Mellitus Drugs Flashcards

(69 cards)

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1
Q

bind receptors to:
* increase glucose storage as glycogen in liver
* increase glycogen and protein synthesis in muscle
* increase TG storage in fat
* increase K+ uptake at the cell membrane

what drug class

A

insulin preparations

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2
Q

rapid acting insulin preparations

A

Lispro
Aspart
Glulisine

no LAG

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3
Q

intermediate acting insulin preparation

A

NPH

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4
Q

long acting insulin preparations

A

determir
glargine

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5
Q

very long acting insulin preparation

A

degludec

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6
Q

adverse effects of insulin preparations

4

A
  • hypoglycemia
  • lipodystrophy
  • hypersensitivity rxn
  • weight gain
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7
Q

inhibits mGPD causing the inhibition of hepatic gluconeogenesis and the action of glucagon

A

metformin

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8
Q

increases glycolysis, peripheral glucose uptake, and insulin sensitivity

A

metformin

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9
Q

adverse effects of metformin

A
  • GI upset
  • lactic acidosis (caution with renal insufficiency)
  • B12 deficiency
  • weight loss
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10
Q
  • activates PPAR-y to increase insulin sensitivity and levels of adiponectin
  • leads to regulation of glucose metabolism and FA storage
A

pioglitazone

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11
Q

adverse effects of pioglitazone

A
  • weight gain
  • edema
  • HF
  • increased risk of fractures
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12
Q

pioglitazone has a delayed onset of action of […]

duration

A

several weeks

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13
Q

what 2 drugs work to increase insulin sensitivity

A

pioglitazone
metformin

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14
Q

what drugs work to increase insulin secretion?

2 groups

A

sulfonylureas
meglitinides

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15
Q

close K+ channels in pancreatic B cell membrane causing the cell to depolarize and increasing insulin release via the Ca+ influx

A

sulfonylureas
meglitinides

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16
Q

1 gen sulfonylureas

2

A

chlorpropamide
tobutamide

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17
Q

2nd gen sulfonylureas

2

A

glipizide
glyburide

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18
Q

meglitinides

2

A

nateglinide
repaglinide

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19
Q

adverse effect of 1st gen sulfonylureas

A

disulfram-like reaction

rarely used

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20
Q

adverse effects of 2nd gen sulfonylureas and meglitinides

A
  • hypoglycemia (greater in renal insufficiency)
  • weight gain
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21
Q

what drug classes work to increase glucose-induced insulin secretion?

A

GLP-1 analogs
DPP-4 inhibitors

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22
Q
  • decrease glucagon release
  • delay gastric emptying
  • increase glucose-dependent insulin release
  • decrease appetite
A

GLP-1 analogs

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23
Q

adverse effects of GLP-1 analogs

A
  • nausea/vomiting
  • pancreatitis
  • weight loss
  • increased satiety
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24
Q

GLP-1 analogs

3

A

exenatide
liraglutide
semaglutide

-glutide

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25
DPP-4 inhibitors | 3
linagliptin saxagliptin sitagliptin
26
inhibit enzyme that deactivates GLP-1, giving similar effects as GLP-1 analogs
DPP-4 inhibitors
27
adverse effects of DDP-4 inhibitors
* RTIs and UTIs * pancreatitis * weight neutral * increased satiety
28
what drug classes work to decrease glucose absorption? | 2
SGLT2 inhibitors a-glucosidase inhibitors
29
-flozins
SGLT2 inhibitors
30
-gliptin
DDP-4 inhibitors
31
-glinide
meglitinides
32
block reabsorption of glucose in proximal convoluted tubule
SGLT2 inhibitors
33
adverse effects of SGLT2 inhibitors
* glucosuria (UTI, GU infection) * dehydration --> hypotension * weight loss * caution with renal insufficiency
34
a-glucosidase inhibitors | 2
acarbose miglitol
35
* inhibit intestinal brush-border enzymes causing delayed carbohydrate hydrolysis and glucose absorption * decreases postprandial hyperglycemia
a-glucosidase inhibitors
36
adverse effects of a-glucosidase inhibitors
GI upset- flatulence, bloating, etc
37
pramlintide is a
amylin analog | Pr**amlin**tide
38
decreases glucagon release and delays gastric empyting promotes satiety
pramlintide
39
adverse effects of pramlintide
* hypoglycemia * nausea * increased satiety
40
which medications are not recommended in renal insufficiency? | 4
* a-glucosidase inhibitors * SGLT2 inhibitors * meglitinides, sulfonylureas * metformin
41
goal fasting glucose: 2 hr post prandial: HbA1C:
fasting glucose: 90-120 2 hr post prandial: below 150 HbA1C: 7
42
* takes a couple hours to reach peak * effective for about 6 hrs | which type of insulin
short (regular)
43
* onset within 30-45 min * shorter duration of action | which type of insulin
rapid acting | no LAG
44
* slower onset * duration of about 12 hrs | which type of insulin
intermediate NPH
45
very long half lives to stabilize insulin long term | which type of insulin
long acting
46
treatment of DKA
IV insulin (0.1) + glucose to prevent hypoglycemia fluids and electrolytes
47
bind to SUR1 to close the K/ATP channel
sulfonylureas meglitinides
48
bind to SUR1 with higher affinity so less dose required
sulfonylureas Gen 2
49
contraindications of sulfonylureas
* DM1 * pregnancy/breastfeeding * significant hepatic/renal insufficiency
50
really cheap DM2 option
sulfonylureas
51
-glinide
meglitide
52
first line therapy for DM2
metformin
53
-glitazone
thiazolidinediones
54
PPARy agonists with PPARa agonist activity
thiazolidinediones
55
removed from market due to hepatotoxicity
troglitazone
56
* promote transport of serum lipids to adipose * promote insulin sensitivity
thiazolidinediones
57
adverse effects of thiazolidinediones
* weight gain * hepatotoxicity * CHF
58
incretins (GLP and GIP) are released from L cells in the
ileum
59
-glutide
GLP-1 analog
60
GIP analog that activates both GLP-1 and GIP receptors
tirezepatide | mounjaro
61
principles of combination therapy
* different MOA * target different proteins | advantages: lower doses, fewer adverse effects
62
options for DM 2 monotherapy | 4
* metformin * GLP-1 * SGLT2 * DDP-4 | add others as needed to get target A1C, add insulin last if needed
63
second choice agents in DM2 therapy | 2
sulfonylureas TZDs
64
metformin requires [...] daily dosing
twice
65
sulfonylureas and DDP4i offer [...] daily dosing
once
66
what drug classes are contraindicated in patients with a hx of pancreatitis?
GLP-1 and DPP-4i
67
inhibits GI glycosidases leading to an increas in the accumulation of complex sugars in the GI tract
a-glucosidase i
68
cause flatulence and diarrhea
a-glucosidase inhibi.
69
has a sulfonamide structure and is contraindicated in patients with sulfa allergies
glyburide

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