Diabete's Pharmagology

Question 1

Cells in the pancreas that synthesize and secrete glucagon

Answer 1

alpha cells

Question 2

Cells in the pancreas that synthesize and secrete insulin

Answer 2

Beta cells

Question 3

Location in the pancreas where endocrine function occurs

Answer 3

Islets of Langerhons

Question 4

4 stimuli that trigger insulin release

Answer 4

1. Cholinergic transmission
2. Peptide hormones
3. AAs
4. glucose

Question 5

The biggest stimuli of insulin release

Answer 5

Glucose

Question 6

Transporter that uptakes glucose into beta cells of the pancreas

Answer 6

GLUT-2

Question 7

GTPases that hep to target insulin-containing vesicles to a specific area of the membrane

Answer 7

Rab proteins

Question 8

Proteins located on vesicles that bind calcium and promote docking to the membrane

Answer 8

SNAREs

Question 9

GPCR on beta cell membrane that are activated by acetylcholine released by parasympathetic nerve endings

Answer 9

M3R

Question 10

2 amino acids that can be taken up by beta cells and metabolized via TCA/Kerb’s cycle, increasing ATP

Answer 10

Alanine and glutamine

Question 11

The 3 primary transcription factors for the insulin gene

Answer 11

1. PDX-1
2. MafA
3. Beta2/NeuroD

Question 12

Pathway induced by oxidative stress due to glucotoxicity and causes phosphorylation of key kinases, such as PI3K, deactivating them

Answer 12

JNK

Question 13

Location of GLUT4 (Insulin-dependent)

Answer 13

Skeletal muscle and adipose tissue

Question 14

Receptor that allows the brain to constantly take up glucose without needing insulin

Answer 14

GLUT1

Question 15

The most important antigen in Type I DM

Answer 15

Insulin (B chain)

Question 16

Acute metabolic complication in type I diabetes due to cells metabolizing triglycerides and AAs for energy

Answer 16

Ketoacidosis

Question 17

The primary function of insulin in the vasculature

Answer 17

vasodilation

Question 18

Glucose transporter located in the vascular endothelium

Answer 18

GLUT1

Question 19

Cell adhesion molecules present in the endothelium that are important for the recruitment of macrophages and are decreased by PI3K/AKT pathways that are activated by insulin

Answer 19

ICAM-1 and VCAM-1

Question 20

Important inflammatory cytokines present in insulin resistance that inhibit IRS1,2, eNOS and NO production

Answer 20

TNF-alpha and IL-6

Question 21

MOA of sulfonylureas

Answer 21

Block ATP-sensitive K channels, stimulating insulin release from beta cells

Question 22

3 1st generation sulfonylureas

Answer 22

tolbutamide
tolazamide
chlorpropamide

Question 23

3 2nd generation sulfonylureas

Answer 23

glyburide
glipizide
glimpiride

Question 24

Subunit of K channel that sulfonylureas bind to

Answer 24

SUR1 (sulfonylurea receptor 1), a regulatory subunit

Question 25

2 meglitinides

Answer 25

repaglinide | nataglinide

Question 26

Major elimination route of meglitinides

Answer 26

liver

Question 27

MOA of metformin

Answer 27

inhibits mitochondrial respiratory complex-1, increasing AMP

Question 28

MOA of thiazolidinedione

Answer 28

Activate PPARs, inducing transcription of genes involved in glucose metabolism

Question 29

2 TZDs

Answer 29

rosiglitazone | pioglitazone

Question 30

TZD withdrawn from market due to increased incidence of hepatitis

Answer 30

troglitazone

Question 31

MOA of alpha-glucosidase inhibitors

Answer 31

Competitively inhibit digestion/absorption of carbs

Question 32

2 alpha-glucosidase inhibitors

Answer 32

acarbose | miglitol

Question 33

Peptide hormone that is co-secreted with insulin from pancreatic beta cells that slows gastric emptying, inhibits glucagon release and promotes satiety

Answer 33

Amylin

Question 34

Amylin analogue used in conjunction with insulin in type I and type II DM

Answer 34

Pramlintide

Question 35

Gut hormones that enhance insulin secretion in an insulin-dependent manner

Answer 35

Incretins

Question 36

2 types of incretins

Answer 36

GIP | GLP-1

Question 37

Protein that inactivates GLP-1 and GIP by cleaving N-terminal region

Answer 37

DPP4

Question 38

2 DPP4-resistant GLP-1 analogues

Answer 38

exenatide | liraglutide

Question 39

4 oral DPP4 inhibitors

Answer 39

sitagliptan saxagliptan linagliptan alogliptan

Question 40

Primary carbon source of fuel for all organisms

Answer 40

Glucose

Question 41

2 main kinases that are involved in signal transduction regulated by glucose in pancreatic beta cells

Answer 41

ERK and PI3K/AKT

Question 42

portion of proinsulin that is cleaved off to make insulin

Answer 42

chain C

Question 43

Location of insulin receptor

Answer 43

ubiquitus

Question 44

Type of receptor that insulin receptor is

Answer 44

tyrosine kinase

Question 45

substrates that are recruited to the insulin receptor and activate PI3K

Answer 45

IRS1/2

Question 46

Enzyme that inhibits glycogen synthase and is inactivated by insulin, allowing glycogen synthesis

Answer 46

GSK3

Question 47

Pathways that is activated by insulin that activates protein synthesis

Answer 47

AKT/mTOR

Question 48

Pathway that is involved in increased cell survival via inhibition of apoptosis by insulin action

Answer 48

PI3K/AKT

Question 49

Pathway involved in the insulin-induced mitogenic responses (proliferation)

Answer 49

MAPK/ERK1,2

Question 50

Primary function of insulin in the brain

Answer 50

satiety and appetite regulation

Question 51

Primary function of insulin in the bone

Answer 51

stimulates bone formation and decreases osteoclast function

Question 52

Cell surface molecules that bind peptide fragments from pathogens and are presented to thymocytes in the process of positive selection

Answer 52

MHC (major histocompatability complex)

Question 53

Pathway that is responsible for increased proliferation and hypertrophy during hyperglycemia due decreased signaling through PI3K pathway

Answer 53

Ras/MAPK

Question 54

Product of PI3K signaling that causes relaxation of the vasculature and is antithrombotic

Answer 54

NO

Question 55

Potent vasoconstrictor and prothrombotic agent that is produced by RAS/MAPK signaling during hyperinsulinema

Answer 55

endothelin

Question 56

Transporter that transports metformin into cells and is highly concentrated in hepatocytes

Answer 56

OCT1 (organic cation transporter-1)

Question 57

3 affects of metformin in hepatocytes due to decreased AMP

Answer 57

1. inhibits adenylate cyclase (alters gene expression) 2. Inhibits FBPase (enzyme in gluconeogenesis) 3. activates AMPK (inhibits lipid and cholesterol synthesis)

Question 58

3 key genes involved in glucose metabolism that PPAR/RXR induces

Answer 58

IRS1,2, PI3K, GLUT4

Question 59

2 mechanisms by which GLP-1 increases insulin secretion in beta-cells

Answer 59

1. upregulates insulin gene transcription | 2. increased Ca influx