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Pharmacology II > Diabetes (exam 1) > Flashcards

Diabetes (exam 1) Flashcards

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1
Q

parts of the pancreas

A

endocrine
exocrine digestive enzymes

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2
Q

islets of langerhans

A

alpha cells
beta cells
gamma cells
epsilon cells

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3
Q

alpha cells

A

glucagon

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4
Q

beta cells

A

insulin
amylin

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5
Q

gamma cells

A

somatostatin (inhibits release of insulin and glucagon)

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6
Q

epsilon cells

A

gherlin (hunger hormone)

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7
Q

insulin

A

anabolic hormone
promotes glucose uptake, glycogenesis, lipogenesis and protein synthesis of skeletal muscle and fat tissue through tyrosine kinase receptor pathway

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8
Q

insulin counteracts

A

glucagon
epinephrine, glucocorticoid, and growth hormone

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9
Q

types of diabetes

A

type I DM
type 2 DM
gestational diabetes
diabetes insipidus
monogenic diabetes

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10
Q

gestational diabetes

A

develops in some women when they are pregnant
can turn into type II DM

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11
Q

diabetes insipidus

A

causes the body to produce large amounts of urine (up to 20 quarts)

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12
Q

monogenic diabetes

A

result from mutations or changes in a single gene

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13
Q

examples of monogenic diabetes

A

neonatal DM
maturity onset diabetes of the young (MODY)

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14
Q

effects of insulin on the liver

A

increased glycogen synthesis
inhibits gluconeogenesis
inhibits breakdown of fatty acids and AA
inhibits AA conversion to glucose

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15
Q

effects of insulin on skeletal muscle

A

increased protein synthesis
increased AA transport
increased glycogen synthesis
increased glucose transport

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16
Q

effects of insulin on adipose tissue

A

increased TG storage
increased glucose transport

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17
Q

how is hyperglycemia regulated by insulin and glucagon?

A

removal of glucose from the blood
increase storage of glucose

which
decreases blood glucose

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18
Q

how is hypoglycemia regulated by insulin and glucagon?

A

increases gluconeogenesis
decreases glycogen synthesis
increases glycogenolysis

which
increases blood glucose

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19
Q

drugs to treat diabetes mellitus type I

A

rapid acting insulin
short acting insulin
intermediate acting insulin
long acting insulin

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20
Q

Biguanides (metformin) is an example of drugs that

A

primarily lower glucose levels by their action on the liver, muscle and adipose tissue

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21
Q

1st gen sulfonylureas

A

tolbutamide
chlorpropamide
tolazamide

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22
Q

2nd gen sulfonylureas

A

glyburide
glipizide
glimepiride
gliclazide (NA in US)

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23
Q

Meglitinide analogs

A

repaglinide
mitiglinide (NA in US)

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24
Q

meglitinide analog that is a D-Phenylalanine derivative

A

nateglinide (NA in US)

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25
Glucagon-like Peptide-1 (GLP-1) receptor agonists are drugs that
mimic incretin effect or prolong incretin action
26
GLP-1 receptor agonists examples
exenatide liraglutide albiglutide dulaglutide
27
Dipeptidyl peptidase 4 (DPP-4) inhibitors
sitagliptin saxagliptin linagliptin alogliptin vildagliptin (NA in US)
28
Sodium-glucose CO-transporter 2 (SGLT2) inhibitors
canagliflozin dapagliflozin empagliflozin ertugliflozin
29
thiazolidinediones target
peroxisome proliferator activated receptor gamma PPAR-y
30
examples of thiazolidinediones
pioglitazone rosiglitazone
31
alpha glucoside inhibitors
acarbose miglitol voglibose
32
alpha glucoside inhibitors are drugs that
affect absorption of glucose
33
pramlintide
amylin analog
34
MSC drugs that treat diabetes type II
Colesevelam hydrochloride Bromocriptine
35
type I diabetes mellitus
destruction of pancreatic beta cells autoimmune, genetic, environmental or idiopathic decreased insulin productin
36
T1DM hallmark sign
hypoinsulinemia
37
Type II diabetes mellitus
progressive resistance to the effects of insulin loss of effective signaling in insulin pathway
38
T2DM hallmark sign
hyperinsulinemia can progress to hypoinsulinemia
39
diabetes mellitus can lead to
diabetic nephropathy diabetic retinopathy diabetic neuropathy cardiovascular disease peripheral vascular disease
40
which type of DM is prone to ketoacidosis?
T1DM
41
in regards to insulin deficiency, type 1 diabetes is _____________ while type 2 diabetes is _________________
absolute insulin deficiency relative insulin deficiency and/or insulin resistance
42
which type of diabetes is the pancreas damaged due to autoimmune attack?
Type 1 DM
43
which type of diabetes has HLA association?
Type 1 DM
44
treatment for type 1 diabetes? type 2?
1: insulin injections 2: diet, exercise, hypoglycemic tablets, insulin injections, nutrition
45
typical weight of people with type 1 diabetes? type 2?
1: normal/thin 2: obese
46
in which type of diabetes is insulin administration required for survival?
type 1 DM
47
key points about beta cell dysfunction in T2DM
insulin resistance beta cell exhaustion decreased beta cell mass impaired glucose sensing genetic factors
48
type 1 diabetes is considered a ______________ disorder
autoimmune
49
risk of developing T1DM is increased by certain variants of HLA: _______________. these genes provide instructions for __________________. These genes also belong to a family called the ___________
DQA1, DQB1 and DRB1 making proteins that play a critical role in the immune system human leukocyte antigen (HLA) complex
50
diabetic retinopathy
tiny blood vessels leak fluid into the retina
51
diabetic retinopathy signs/symptoms in the eye
abnormal blood vessels aneurysm hemorrhages cotton wool spots
52
diabetic nephropathy outcomes
glomerular hypertrophy mesangial expansion tubulo-interstitial fibrosis and inflammation glomerulosclerosis kidney fibrosis
53
diabetic neuropathy
weaker, degenerated blood vessels lead to inadequate nutrition and nerves become dysfunctional
54
GLUTs
glucose transporters sodium independent GLUT1-4
55
GLUT2
liver pancreatic beta cells insulin independent
56
GLUT4
skeletal muscle adipocytes insulin dependent
57
SGLTs
sodium glucose cotransporters sodium dependent SGLT1-2
58
SGLT1
major intestinal glucose transporter 10% renal glucose transport
59
SGLT2
major renal glucose transporter 90% renal glucose transport
60
5' AMP-activated protein kinase (AMPK)
pathway in response to glucose starvation activated by low energy status (ATP/ADP ratio) acts as an enzyme that works as a fuel gauge
61
which drug effects the AMPK pathway?
metformin and thiazolidinediones
62
activation of AMPK pathway leads to
sk muscle: glucose uptake, fatty acid oxidation heart: glucose uptake, fatty acid oxidation, glycolysis hypothalamus: food intake
63
inhibition of the AMPK pathway leads to
liver: fatty acid synthesis, gluconeogenesis adipose: fatty acid synthesis, lipolysis pancreas: insulin release
64
glucose is transported into beta cells through
facilitated diffusion of the GLUT2 glucose transporters
65
once glucose is metabolized into _________ in the beta cells, it elevates the ______________ which closes ________________ leading to ________________-
ATP ATP/ADP ratio KATP channels cell membrane depolorization
66
after KATP channels are closed in beta cells, what channels are opened and what is the effect?
voltage dependent Ca channels (VDCC) Ca influx into cell
67
what triggers exocytosis of insulin out of the beta cell?
rise in free systolic Ca
68
insulin mRNA is translated as a single chain precursor called
pre-proinsulin
69
how is proinsulin formed?
removal of signal peptide from pre-proinsulin during insertion into the ER
70
3 domains of proinsulin
amino-terminal B chain carboxy-terminal A chain connecting peptide C peptide
71
how is the mature form of insulin made?
proinsulin is exposed to endopeptidases inside ER which excise the C peptide
72
Insulin and free C peptide are packaged into ___________ into secretory granules which ________________
the Golgi accumulate in the cytoplasm
73
on stimulation, beta cells secrets ________________ via exocytosis
insulin and C peptide
74
C peptide has no
known biological activity
75
incretins functions
amplify glucose dependent insulin release inhibits glucagon release
76
incretins
gut derived protein factors that increase glucose stimulated insulin secretion
77
where is GLP-1 produced?
by L cells of distal small intestine and pancreatic alpha cells
78
where is GIP produced?
K cells in GI tract
79
GLP-1 ____________ gastric emptying which GIP has _____________ on gastric emptying
inhibits minimal effect
80
GLP-1 stimulates
beta cell growth
81
both GLP-1 and GIP stimulates __________ and their release is stimulated by ________________
glucose dependent insulin release glucose and nutrients in GI tract
82
because GLP-1 reduces food intake, there is a reduction in
body weight (SKINNYYYY)
83
GLP-1 also suppresses
hepatic glucose output
84
when a regular person is fasting, the insulin level is
less than 25 mIU/L

Pharmacology II (18 decks)

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