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Flashcards in Diabetes Deck (29)
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1

What are the three rapid acting insulins?

Glulisine
Aspart
Lispro

2

Rapid acting insulin: indication?

For meals or acute hyperglycemia- inject immediately before meals

3

Regular insulin: indication?

For meals or acute hyperglycemia: needs to be injected 30-45 minutes before meals

4

NPH: indication

Provides basal insulin and overnight coverage

5

Name two long acting insulins

Glargine
Detmir

6

Glargine/detmir; indications?

Provides basal insulin and overnight coverage

7

Metformin: MOA?

Inhibition of mito complex I --> increased AMP --> decreased adenylate cyclase and increased AMPK

This OPPOSES glucagon and decreases hepatic gluconeogenesis (increases glucose utilization and insulin sensitivity)

8

What is the main advantage of metformin?

Lowers fasting glucose levels

9

Main side effect of metformin?

Lactic acidosis

10

Metformin: contraindications?

Renal insufficiency, MI, CHF

11

MOA of sulfonylureas?

Inhibition of beta cell K+ channels --> increased insulin secretion

12

What is the advantage of sulfonylureas?

Slow onset/long duration --> lowers fasting glucose

13

What is the main adverse effect associated with sulfonylureas?

Increased risk of hypoglycemia

14

Sulfonylureas: contraindications?

Renal/liver disease

15

Meglitinides: MOA?

Inhibition of K+ channels --> glucose-dependent insulin secretion

16

Meglitinides: advantages?

Fast acting, short duration to decrease postprandial glucose

17

Thiazolidinediones: MOA?

Agonist of PPARgamma TF

Increased insulin sensitivity
Increase glucose utilization
Decrease insulin resistance

18

Thiazolidinediones: advantages?

Lowers fasting glucose

Lowers triglycerides

19

Thiazolidinediones: Adverse effects?

Weight gain (subQ)
Fluid retention/edema
Increased HF Risk
Increased bone fractures in women

20

Pioglitazone and Rosiglitazone are what type of drugs?

thiazolidinediones

21

Name two alpha-glucosidase inhibitors

Acarbose, Miglitol

22

What is the MOA of the alpha-glucosidase inhibitors?

Inhibits the conversion of carbohydrates into monosaccharides/inhibits absorption

23

Name two incretin mimetics

Exenatide
Liraglutide

24

What is the MOA of exenatide/liraglutide?

Potentiates glucose-induced insulin release as a GLP-1 analog

Decreases pancreatic glucagon and decreases hepatic gluconeogenesis

25

Sitagliptin and Saxagliptin are what type of drug?

DPP4 inhibitors

26

How do the DPP-4 inhibitors work?

Potentiates GLP-1 through inhibition of DPP-4, the peptidase that breaks down GLP-1

27

What is the MOA of pramlitide?

Amylin mimetic- decreases postprandial glucagon and decreases hepatic gluconeogenesis

28

Canagliflozin and dapagliflozin are what class of drug?

SGLT2 inhibitors

29

How do the SGLT2 inhibitors work?

Inhibit the sodium/glucose transporters of the proximal renal tubule --> osmotic diuresis of glucose