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Flashcards in Diabetic medications Deck (51):
1

Sulfonyl ureas _____ insulin secretion

stimulate

2

_____ is the only insulin preparation that can be injected IV.

Regular insulin (short-actin)

3

What is NPH insulin?

Intermediated acting insulin

4

What is lente insulin?

Mixture of 30% semilente (short acting) and 70% ultralente (long acting) zinc insulin crystals--> intermediate acting insulin

5

How many times is insulin measured a day? How often will insulin be injected?

4- before each meal
2- one before breakfast one before dinner

6

What is humulin?

recombinant human insulin made in bacteria/yeast

7

What is novolin?

made by switching the aa that is different in pork insulin

8

T or F. Insulin in circulation forms hexamers with Zn, but hexamers dont bind the insulin receptor until dissoc.

T

9

Structure of insulin lispro

proline B28 and lysine B29 of humulin are switched--- doesnt form hexamers

10

MOA of insulin lispro

doesn't form hexamers, faster onset of action and shorter half-life than regular insulin

11

Describe insulin glulisine

rapid acting-insulin analogue that differs from human insulin in that the amino acid Asp at B3 is replaced by lysine and the lysine in B29 is replaced by glutamic acid. Does not form hexamers

12

Describe nsulin aspart

rapid acting insulin analog that exists only as a monomer

13

___, ____, and ____ all have the same pharmacokinetic properties - faster onset of action and shorter duration than regular insulin- because they exist in monomer form.

Insulin lispro, insulin aspart, insulin glulisine

14

What insulin therapies have an altered isoelectric point?

Insulin glargine, insulin detemir

15

What is insulin glargine?

recombinant human insulin analogue used for injection. Differs in a few amino acids, Long duration of action. Can be injected once a day.

16

What is insulin detemir?

Long acting human insulin recombinant analogue

17

Explain why insulin glargin and determir are long-acting.

When injected, the acidic solution is neutralized causing crystals to precipitate=slow absorption=long acting. The low peak insulin concentration decreases chances of nocturnal hypoglycemia.

18

____ is the treatment for DKA.

Insulin

19

____ is the treatment for hypoglycemic coma.

glucagon

20

Normal HbA1C is ___. Over __ is not good. ___ is dangerous

6,8,10

21

What are the sulfonylureas

glyburide, glipizide, gliclazide, glimepiride

22

MOA of sulfonylureas

Oral hypoglycemics. Act on insulin. Initially may increase insulin release. Long term treatment may decrease insulin metabolism and increase insulin sensitivity.

23

ADME of sulfonyureas

Rapidly absorbed from GI. extensively protein bound, metabolized in liver, excreted by kidney

24

What are the meglitinides

repaglinide and nateglinide

25

MOA of meglitinides

Oral hypoglycemics. Benzoic acid derivatives that increase insulin secretion.

26

ADME of meglitinides

Oral, GI rapid absoprtion, short half-life, take before each meal to control post-prandial glucose, metabolized by liver

27

AD of meglitinides

hypoglycema

28

What are the biguanides

metformin, metformin+glyburide

29

MOA and ADME of biguanides

oral hypoglycemics, does not affect insulin secretion, no hypoglycemia. Decreases hepatic glucose production
Absorbed from GI; little metabolism

30

What are the thiazolidinediones?

rosi-, pio-, rosi- + metformin ...-glitazone

31

MOA and ADME of thiazolidinediones?

Bind PPARy, increase insulin sensitivity, increase glucose transport, absorb GI tract, little metabolism

32

What are the a-glucosidase inhibitors?

acarbose, miglitol

33

MOA, ADME of a-glucosidase inhibitors

reduce intestinal absorption of starch at brush border, reduce uptake of carbs to reduce post-prandial glucose rise, used in combination with other hypoglycemic drugs/insulin

34

Which oral hypoglycemic drugs act on hepatic glucose secretion?

Biguanides: metformin +/- glyburide

35

Which oral hypoglycemic drugs act on the brush border?

a-glucosidase inhibitors, acarbose and miglitol

36

Which oral hypoglycemic drugs act on insulin secretion?

meglitinides: regalinide, nateglinide

37

Which oral hypoglycemic drugs act on insulin sensitivity and increase glucose transport?

Thiazolidinediones- rosi, pio glitazone

38

Which oral hypoglycemic drugs decrease insulin metabolism, increase insulin sensitivity, and increase insulin uptake?

Sulfonylureas: glyburide, glipizide, gliclazide, glimepiride

39

_____ enhance the hypoglycemic actions of sulfonyureas.

NSAIDs

40

Therapeutic uses of somatostatins

insulinomas, glucagonomas, acromegaly

41

_____ is an antihypertensive antidiuretic that has potent hyperglycemic actions

Diazoxide

42

MOA of diazoxide

inhibits insulin secretion but NOT synthesis. So there is a build up in B cells.

43

Therapeutic uses of diazoxide

various forms of hypoglycemia including inoperable insulinomas

44

GLP-1 ____ glucose-dependent insulin secretion.

Increases

45

MOA for GLP1

increase glucose dependent insulin secretion, inhibits glucagon stimulated glycogenolysis, slow gastric emptying, decrease appetite, decrease glucagon, decrease postprandial glucose

46

What are incretins?

hormones that increase insulin secretion

47

What are the GLP1 receptor agonists?

Exenatide, liraglutide

48

What are the DPP4 inhibitors?

sitagliptin, saxagliptin, linagliptin

49

What are the amylin analogues

Pramlintide symlin

50

MOA of amylin analogues

aids glucose absorption, promote satiety, inhibits inappropriate secretion of glucagon, weight loss

51

MOA of colesevelam hydrochloride

bile acid sequesterant, lowers blood cholesterol, lowers HbA1C by .5%, LDL by 15%, interrupts enterohepatic cycling