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Pharmacology > Diabetes Medications > Flashcards

Diabetes Medications Flashcards

(53 cards)

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1
Q

What do alpha cells of the pancreas secrete?

A

Glucagon, problucagon

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2
Q

Beta cells from the pancreas secrete

A

Insulin
C-peptide
Proinsulin
Amylin

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3
Q

Delta cells from the pancreas secrete what?

A

Somatostatin

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4
Q

Epsilon cells from the pancreas secrete what?

A

Ghrelin

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5
Q

G cells from the pancrease secrete

What about F cells?

A

Gastrin

Pancreatic polypeptide

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6
Q

What are the 8 reasons for Hyperglycemia aka Ominous Ocete?

A
  1. Increase glucose reabsorption
  2. Increased lipolysis
  3. Decreased incretin effect
  4. Impaired insulin secretion
  5. Increased glucagon secretion
  6. Increased hepatic glucose production
  7. Neurotransmitter dysfunction
  8. Decreased glucose uptake
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7
Q

slide 12

A

slide12

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8
Q

Definition of Type 1 diabetes?

A

Autoimmune B-cell destruction, leading to insulin deficiency

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9
Q

Definition of Type 2 diabetes?

A
  1. Progressive loss of B-cell insulin secretion due to insulin resistance
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10
Q

Definition of Gestational diabetes?

A

Diabetes diagnosed int eh second or third trimester of pregnancy

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11
Q

Signs and Symptoms of Type 1 DM

A
  1. Polyuria, polydipsia, polyphagia
  2. Weight loss
  3. Lethargy accompanied by hyperglycemia
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12
Q

Signs and symptoms of Type 2 DM

A
  1. Lethargy
  2. Polyuria, nocturia, and polydipsia can be present
  3. Significant weight loss is less common
  4. Most patients are overweight of obese
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13
Q

In additional to medication what other modification must been done according to the ADA algorithm?

A

Lifestyle management may reveal that 1-2 foods might be the cause of hyperglycemia, need to correct this first

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14
Q

What drinks can a diabetic who is hypoglycemia take to help?

A

15 g of simple carbohydrate (eg, 8 oz [240 mL] orange juice or milk, 4 glucose tables, or 1 tube of glucose gel and then retest BG 15 minutes later.

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15
Q

Criteria to diagnose Diabetes Melitus

A
  1. FPG >126 (or equal)
  2. 2 hour BG >200 (or equal) during OGTT
  3. A1c >6.5 (or equal)
  4. Symptomatic RBG >200 (or over)
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16
Q

Prediabetic A1c levels?

A

5.7-6.4

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17
Q

Metabolic syndrome

A

Central obesisty plus any two of the following

(1) raised triglycerides (≥ 150 mg/dL)
(2) reduced HDL cholesterol (< 40 mg/dL) in males or < 50 mg/dL in females)
(3) increased blood pressure (systolic BP ≥ 130 mm Hg, diastolic BP ≥ 85 mm Hg, or treatment of previously-diagnosed hypertension)
(4) raised fasting plasma glucose (≥ 100 mg/dL) or previous diagnosis of type 2 DM

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18
Q

What are are considered modifiable care in managing hyperglycemia?

A

Behavioral health
Motivational interviewing
Nutrition for weight loss
Exercise for weight loss managment

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19
Q

Microvascular complications in DM

A
  1. Retinopathy
  2. Neuropathy
  3. Nephropathy
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20
Q

Macrovascular complications in DM

A
  1. Coronary Heart Disease
  2. Hypertension
  3. Peripheral vascular disease
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21
Q

What are the 5 interventions for complications and mortality

A
  1. Smoking cessation
  2. Blood pressure control
  3. Metformin
  4. Lipid reduction
  5. Glycemic control
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22
Q

When performing SBGM what does Fasting glucose help measure

Study These Flashcards
A

Measures the effectiveness of basal insulin or agents which decrease hepatic gluconeogenesis overnight (“leaky liver”)

23
Q

When performing SBGM what does Pre-meal blood sugar?

Study These Flashcards
A

To help calculate bolus dose of insulin or agents given to improve insulin secretion

24
Q

When performing SBSM what does Post meal blood sugar (2 hour post prandial) measure?

Study These Flashcards
A
  1. Measures the effectiveness of bolus insulin or agents given to increase levels of insulin (pancreas “poop out”)
  2. Helps determine needed food intake changes

***Most useful for Type 2 DM

25
What is the purpose of measuring Bedtime blood sugar
To avoid early A.M. lows from insulins or oral agents
26
What are ADA glycemic recommendations for: A1c Preprandial capillary plasma glucose Peak postprandial capillary plasma glucose
1. A1c: <7.0% 2. Preprandial capillary plasma glucose: 80-130 mg/dL 3. Peak postprandial capillary plasma glucose: <180 mg/dL
27
What are AACE/ACE glycemic recommendations for A1c Preprandial capillary plasma glucose Peak postprandial capillary plasma glucose
A1c: <6.5 Pre: <110 mg/dL Post: <140 mg/dL **More stringent
28
Symptoms of HYPOglycemia?
``` Weakness/Fatigue Irritability Shaking Fast heartbeat Sweating Hunger Impaired vision ```
29
What are are Symptoms of HYPERglycemia
1. Extreme thirst 2. Frequent urination 3. Dry skin 4. Hunger 5. Blurred vision 6. Drowsiness 7. Nausea
30
Which diabetic medication has the highest rate of efficacy?
Insulin an anabolic hormone, causes weight gain
31
Which medications cause weight gain?
a. Thizolidinediones b. Sulfonylureas c. Insulin
32
Meformin: Class? MOA? Dosing key?
a. Biguanides b. Enhances insulin sensitivity of hepatic and peripheral (muscle tissues) allowing for increased glucose uptake c. Key start slow and go slow (take smallest dose with largest meal)
33
What drug class does Thizolidinediones (TZD) fall under? MOA?
a. Glitazones MOA: Enhances insulin sensitivity in muscle, liver, and fat tissues indirectly
34
What is fist line medications for DM
Metformin/Biguanides
35
What are examples of Sulfonylureas?
Glipizide | Glimerpiride
36
What are examples of Metaglinides?
"Glinides" Regaglinide Nateglinide
37
What are side effects of Sulfonylureas and Metaglinides?
Weight gain | Hypoglycemia
38
Examples of GLP-1 agonists
``` Exenatide (Byetta) Liraglutide (Victoza) Albiglutide (Tanzeum) Dulaglutide (Trulicity) Semaglutide (Ozempic) Lixisenatide (Adlyxin) ```
39
MOA for GLP-1 agonists
``` Enhances insulin secretion Suppresses inappropriately high postprandial glucagon secretion Decreases hepatic glucose production Increases satiety Slows gastric emptying Weight loss*** ```
40
DPP-4 inhibitors drugs?
"Gliptins" Sitagliptin Saxagliptin Linigliptin
41
MOA of DPP-4 inhibitors
Prolongs the half-life of endogenous produced GLP-1
42
SGLT-2 inhibitors drugs?
"Gliflozins" Canagliflozins Dapafliflozins
43
MOA of SGLT-2 lowers
Lowers the renal tubular threshold for glucose reabsorption glucosuria occurs at lower plasma glucose concentrations
44
alpha-Glucosidase inhibitors?
Acarbose | Miglitol
45
MOA of alpha-Glucosidase inhibitors?
Breakdown of sucrose and complex carbohydrates in the small intestine, prolonging carbohydrate absorption
46
What are side effects of alpha-Glucosidase inhibitors?
Flatulaence, bloating, abdominal discomfort, diarhea
47
What is key when treating hyperglycemia with Sulfonylureas?
Only take with 60 g or less with carbs
48
What causes the Somogyi effect?
Most likley to occur following episode of untreated nighttime hypoglycemia, resulting in high blood sugar levels in the morning
49
How can the Somogyi Effect be prevented?
Check their blood glucose levels in the middle of the night (for example, around 3 AM) Increase food intake or lower insulin dose in the evening.
50
When treating hypoglycemia what type of sugars should you treat with?
with glucose (dextrose) products or glucagon, not sucrose
51
Side effects of TZD?
Weight gain CHF risk Moderate fracture risk
52
What is the Dawn Phenomenon?
Surge of hormones that the body produces daily in the early morning hours before waking
53
How does the Dawn Phenomenon differ in diabetes?
People with diabetes don't have normal insulin responses to adjust for this, and may see their fasting glucose go up The rise in glucose is mostly because the body is making less insulin and more glucagon (a hormone that increases blood glucose) than it needs The less insulin made by the pancreas, the more glucagon the pancreas makes as a result.

Pharmacology (12 decks)

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