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Flashcards in diabetes drugs (From farm exam) Deck (36):
1

Insulin:name the 3 rapid acting/short action drugs:

lispro, aspart, glulisine;
ie act within 15 min, last for 4-8 hours

2

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)

3

insulin:name the 2 slow onset, long acting insulins

glargine, detemir

4

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

5

mixtures of _____ and _____ insulin can give a transient preprandial bolus and a prolonged basal level in a single injection

fast-onset, long acting

6

routes of administration:subcutaneous = _____;insulin infusion pump = ____ _____ and the rapid acting ones

all forms; buffered regular

7

____ insulin may be administed via IV for ____ or ____

regular; hyperglycemia, ketoacidosis

8

_____ 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

9

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

10

other insulin side effects:____ or _____ at an injection site

lipodystrophy, lipoatrophy

11

mechanism of action of sulfonylureas

bind and close K+ channel-->depolarization-->calcium influx and insulin release

12

what transporter does glucose use to enter a beta cell?

GLUT2

13

the 1st gen sulfonylureas end in ___. name 2 of them

"-amide";chlorpropamide (more potent, longer lasting ie 1-3 days), tolbutamide (12 hr duration)

14

2nd gen sulfonylureas (3):

glimepiride, glipizide, glyburide;all have 24 hour duration

15

name the 2 meglitinides: (end in ____) mechanism of action?

glinide = nateglinide, repaglinide; bind K+ channels (similar to sulfonylureas)

16

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

17

sulfonylurea side effects risk of _____;weight ____

hypoglycemia (can be severe);weight gain
also disulfiram-like effects

18

name 2 GLP1 analogs: end in "___"these are used for type __ DM

tide = exenatide, liraglutide, 2

19

side effects of GLP1 analogs: nausea, vomiting, ____;

pancreatitis

20

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

21

gliptin side effects: increased ____ or ____ infections due to reduced WBC.

UTI, respiratory;

22

pramlintide is a _____ ____ that blunts the ____ ____ in blood glucose. used in what diabetes?

amylin analog; postprandial rise;ptype 1 and 2

23

pamlinitde slows ____ ____ and inhibits ___ release;

gastric emptying, glucagon

24

mechanism of action of acarbose and miglitol:

inhibit alpha glucosidases on brush border (Sucrase, maltase, glucoamylase) = decreased carb absorption

25

side effects of the alpha glucosidase inhibitors:____ ferment carbs, leading to ____ disturbances

bacteria;GI

26

the "-gliflozins" (name the 3 of them) are _____ inhibitors

cana-, dapa-, empagliflozin; SGLT2 ie block reabsorption in PCT = decrease threshold for glucose excretion

27

SGLT2 inhibitor side effects:weight _____; increased risk of ____ and ____ infections;contraindicated in patients with _____ impairment

loss; UTI, vaginal;renal

28

SGLT2 inhibitor side effects: volume _____; ____ hypotension;

depletion; orthostatic;

29

metformin is a _____. it rarely causes ____ or ____, as opposed to sulfonylureas

biguanide, weight gain, hypoglycemia

30

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

31

metformin side effets:_____ ____, GI upset

lactic acidosis

32

____ and ____ are thiazolidinediones. they are activators of ____, which is a _____ factor

pioglitazone, rosiglitazone ;PPAR gamma (peroxisome proliferator-activated receptor);transcription

33

glitazones: increase insulin _____ in peripheral tissue. the main target is _____.

sensitivity; adipocytes

34

glitazone side effects:weight ____; contraindicated in patients with ____. some _____ toxicity

gain;CHF;liver;

35

_____ are factors regulated by activation PPAR gamma. they are released by _____ adipose tissue

adipokines;white

36

more glitazone side effects:increased risk of fractures due to _____;peripheral _____ due to ____ retention

decreased differentiation of stem cells into osteoblasts;edema, Na