Diabetic pharmacology Flashcards Preview

Pharmacology > Diabetic pharmacology > Flashcards

Flashcards in Diabetic pharmacology Deck (49):
1

Name the insulin analogues

Lispro
Aspart
Glulisine

2

What is the onset of Lispro, Aspart and Glulisine

15 min

3

What is the Peak of Lispro, Aspart and Glulisine

0.5- 1.5 hrs

4

What is the Duration of Lispro, Aspart and Glulisine

3-5 hrs.

5

What is the onset of human insulin

0.5-1 hr

6

What is the Peak of human insulin

2-3 hrs

7

What is the duration of human insulin

5-8 hrs

8

What is the onset human NPH/Lente

1-3 hrs

9

What is the peak of human NPH/Lente

4-8 hrs

10

What is the duration of human NPH/Lente

8-20 hrs

11

What is the onset of human ultralente

4-8 hrs

12

What is the Peak of ultralente

8-12 hrs

13

What is the duration of ultralente

18-36 hrs

14

What is the onset of glargine, determir

1-2 hrs

15

What is the peak of glargine, determir

Flat

16

What is the duration of glargine, determir

24 hrs

17

Name the 2nd generation sulfonylureas

Glyburide
Glipizide
Glimepiride

18

What is the MOA of the sulfonylureas

stimulates insulin secretion from pancreatic islet beta cells

*Inhibits SUR1 ATP-sensitive potassium channels on beta cells

*Does NOT decrease insulin resistance

19

Thiazide diuretics have what effect on sulfonylureas

excretes it from blood

*Must increase the dose of sulfonylurea

20

Renal disease has what effect on sulfonylureas

decreases elimination

21

Meglitinides are the newer oral diabetic agents and include which drugs

"NIDEs"
Repaglinide
Netaglinide
Miglitinide

22

What is the MOA of Meglitinides

Stimulates insulin secretion from beta cell
*Same MOA as sulfonylurea but peaks in 1 hour and shorter DOA of 4 hours

23

Meglitinides are active ONLY

in the presence of glucose

*less risk of hypoglycemic episodes

24

What is the major Biguanides

Metformin

25

What is the MOA of metformin

Decrease hepatic glucose production
Decreases absorption from gut
Increases insulin sensitivity in skeletal muscles and adipose tissue

*Does NOT stimulate insulin secretion

26

What are the adverse effects associated with metformin

Hypoglycemia (rare)
Diarrhea (20%)
Lactic acidosis

27

Why does metformin cause lactic acidosis

Blocks mitochondrial membranes preventing mitochondria from converting pyruvate to acetyl-CoA and oxidation

28

What are alpha glucosidase

enzymes that breakdown starch and dissacharides into glucose

29

What are the a-Glucosidase inhibitors

Acarbose
Miglitol
Voglibose

30

Where do a-Glucosidase inhibitors exert their effects in the body

On the enzymes in intestinal brush border

31

What are a-glucosidase inhibitors used for

to prevent post-prandial hyperglycemia

32

What are the PPAR gama-agonists

"litazones"

33

Why were the PPAR gama-agonists pulled off the market

Cause CHF, MI

34

What is amylin

a polypeptide cosecreted with insulin from the pancreatic beta cells responsible for slowing gastric emptying, suppressing glucagon, and promoting satiety

35

What drug mimics amylin

Pramlintide

36

Amylin is ------ in diabetics

deficient

37

What are incretins

a group of GI hormones that stimulate insulin release and inhibits glucagon release with net effect of lowering blood glucose

*Glucagon-like polypeptide-1 (GLP-1)

38

What inactivates incretins

DPP-4

39

What are the drugs designed to MIMIC incretins

Liraglutide
Exenatide
Taspoglutide

40

GLP-1 activity is similar to amylin activity in what three ways

Suppresses glucagon secretion from pancreatic alpha cells

slows gastric emptying

Promotes satiety

41

What are the two additional MOA of GLP-1 that distinguishes it from the amylins

Improves insulin sensitivity

Stimulates insulin secretion from pancreatic beta cells

42

Exenatide does what to the hemoglobin A1c levels

decreases it by 1%

43

Exenatide does what for weight

decreases by 2.5 kg or 5 lbs

44

exenatide is associated with what disease

acute pancreatitis

*don't give to patients with severe abdominal pain radiating to back and vomiting

45

What is DPP-4

The enzyme that inactivates incretins

46

What are the DPP-4 inhibitors

"...gliptins"

47

What are the concerns with Vildagliptin

Skin lesions
Bowel CA
Lung CA

48

What is Sodium Glucose Transporter 2 (SGLT-2)

Receptors found on proximal kidney tubules that reabsorb glucose from ultrafiltrate regardless of hyperglycemia

49

What are the SGLT-2 inhibitors

"...liflozin"