Flashcards in diabetes drugs (From farm exam) Deck (36):
Insulin:name the 3 rapid acting/short action drugs:
lispro, aspart, glulisine;
ie act within 15 min, last for 4-8 hours
insulin:____ has a rapid onset and is short acting.____ has intermediate action and onset;
regular insulin (ie act within an hour, last 12 hours); NPH (neutral protamine hagedorn) (acts within an hour, lasts 24 hours)
insulin:name the 2 slow onset, long acting insulins
why are the rapid onset insulins so rapid? what are they used for?
they don't polymerize into insulin hexamers (due to altered amino acids); for post-prandial spike (ie administer immediately before meal
mixtures of _____ and _____ insulin can give a transient preprandial bolus and a prolonged basal level in a single injection
fast-onset, long acting
routes of administration:subcutaneous = _____;insulin infusion pump = ____ _____ and the rapid acting ones
all forms; buffered regular
____ insulin may be administed via IV for ____ or ____
regular; hyperglycemia, ketoacidosis
_____ is a regular human insulin inhaled as a dry powder. it has a _____ duration of action than regular sub-cu insulin. contradicted in patients with ___ or ____ due to decreased FEV
afrezza; shorter;asthma, COPD
insulin side effects:_____ due to too much insulin or not enough food. treat with ____ or _____;important agent that can increase risk of this side effect?
hypoglycemia; Glucagon, glucose;alcohol
other insulin side effects:____ or _____ at an injection site
mechanism of action of sulfonylureas
bind and close K+ channel-->depolarization-->calcium influx and insulin release
what transporter does glucose use to enter a beta cell?
the 1st gen sulfonylureas end in ___. name 2 of them
"-amide";chlorpropamide (more potent, longer lasting ie 1-3 days), tolbutamide (12 hr duration)
2nd gen sulfonylureas (3):
glimepiride, glipizide, glyburide;all have 24 hour duration
name the 2 meglitinides: (end in ____) mechanism of action?
glinide = nateglinide, repaglinide; bind K+ channels (similar to sulfonylureas)
sulfonylurea vs meglitinides:which are used for post prandial insulin release (ie short acting)?which can cause a sulfa allergy?which require functional beta cells?
meglitinides; sulfonylureas ;both
sulfonylurea side effects risk of _____;weight ____
hypoglycemia (can be severe);weight gain
also disulfiram-like effects
name 2 GLP1 analogs: end in "___"these are used for type __ DM
tide = exenatide, liraglutide, 2
side effects of GLP1 analogs: nausea, vomiting, ____;
name the 3 gliptins :what do these molecules do?
lina, saxa, sitagliptan; inhibit dipeptidyl-peptidase 4 (DDP4), which deactivates GLP1; thus, increase endogenous insulin release
gliptin side effects: increased ____ or ____ infections due to reduced WBC.
pramlintide is a _____ ____ that blunts the ____ ____ in blood glucose. used in what diabetes?
amylin analog; postprandial rise;ptype 1 and 2
pamlinitde slows ____ ____ and inhibits ___ release;
gastric emptying, glucagon
mechanism of action of acarbose and miglitol:
inhibit alpha glucosidases on brush border (Sucrase, maltase, glucoamylase) = decreased carb absorption
side effects of the alpha glucosidase inhibitors:____ ferment carbs, leading to ____ disturbances
the "-gliflozins" (name the 3 of them) are _____ inhibitors
cana-, dapa-, empagliflozin; SGLT2 ie block reabsorption in PCT = decrease threshold for glucose excretion
SGLT2 inhibitor side effects:weight _____; increased risk of ____ and ____ infections;contraindicated in patients with _____ impairment
loss; UTI, vaginal;renal
SGLT2 inhibitor side effects: volume _____; ____ hypotension;
metformin is a _____. it rarely causes ____ or ____, as opposed to sulfonylureas
biguanide, weight gain, hypoglycemia
metformin activates ______. this causes decreased ____ in the liver and increased ____ and _____ in muscle and fat cells. it ____ insulin sensitivity
AMP-activated protein kinase; gluconeogensis; glycolysis, glucose uptake; increases
metformin side effets:_____ ____, GI upset
____ and ____ are thiazolidinediones. they are activators of ____, which is a _____ factor
pioglitazone, rosiglitazone ;PPAR gamma (peroxisome proliferator-activated receptor);transcription
glitazones: increase insulin _____ in peripheral tissue. the main target is _____.
glitazone side effects:weight ____; contraindicated in patients with ____. some _____ toxicity
_____ are factors regulated by activation PPAR gamma. they are released by _____ adipose tissue