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Flashcards in DM drugs Deck (26)
1

Difference between DM1 and DM2?

DM1 born with it--->need insulin injection--->prone to DKA
DM2 late onset--->HHS

2

What increase and inhibits insulin?

Increase insulin--->glucose/sulfonylurea/M agonist/beta 2 agonist
Decrease insulin--->alpha 2 agonists

3

What are the short, intermediate, long acting insulin?

Short--->listpro/aspart/glulisine/regular
Intermediate--->NPH/NPL/NPA
Long acting--->glargine (basal)

4

What kind of insulin is used for meals?

Shorting acting after each meal

5

When is glargine's peak?

NONE--->less hypoglycemia

6

What are the symptoms of DKA?

polyuria/polydipsia/dehydration/Kussmaul breathing/fruity breath

7

How to treat DKA

Replenish K first if K is low/IV regular insulin and hydration /dextrose when glucose is 200-300

8

What is the only kind of insulin that can be given IV?

Regular

9

Which presents with higher glucose level, DKA or HHS?

HHS

10

Which glucose transporter is on beta cell of pancreas?

GLUT2

11

How does thiazide and loop cause hyperglycemia?

They cause hypokalemia--->keep K channel in beta cell of the pancreas open--->prevent insulin release--->hyperglycemia

12

What drug is used for insulinoma? how does it work?

Diazoxide--->keep K channel of the beta cell in pancreas open

13

What are sulfyonlurea and what are their MOA? side effect?

1st gen--->chlorpropamide
2nd gen--->Glyburide/glipizide---->inhibit K channel of the beta cell of pancreas--->increase insulin release
Weight gain and hypoglycemia

14

What are the 2 drugs that work just like sulfonylurea but short acting?

Repaglinide/Nateglinide
Use before meals

15

What are the symptoms of hypoglycemia? tx?

Lip/tongue tingling/lethargy/sweating/tachy
IV dextrose/glucagon

16

MOA of metformin? side effect?

Inhibit hepatic gluconeogensis
Lactic acidosis with renal dysfunction
B12 deficiency

17

When else can you use metformin?

For PCOS---->offset insuline resistance

18

What is the MOA of acarbose and miglitol?

Inhibit alpha-glucosidase in small intestine--->prevent glucose breakdown

19

What is the MOA of TZD (thiazolidinediones)? and what are they? side effects?

"glitazone"--->bind to PPARs--->increase insulin receptor--->increase insulin sensitivity
Weigh gain/edema

20

What other group of drugs bind to PPAR?

Fibrate--->increase LPL

21

What are the GLP-1 receptor agonists?

Exenatide and the "glutide"--->increase insulin release via incretin

22

What are the DDP-4 inhibitors? and what does DDP-4 do?

"gliptin"
DDP-4 degrade GLP-1

23

Which drug is an amylin analog and what is its MOA?

Pramlinitide--->make you feel full--->decrease appetite

24

What are SGLT-2 do and what drugs inhibit them?

SGLT-2 mediate glucose reabsorption in the proximal tubule of kidney
"glifloxin"

25

SUMMARY:
How to treat DM1 and DM2?

DM1--->basal insulin with meal time insulin
DM2--->check liver--->if liver is bad--->insulin
If liver is good check kidney--->if kidney is bad can't use metformin
If kidney is good--->use metformin first

26

What is the long term complications of DM? and what drugs are used for them?

Nephropathy--->ACEI/ARB
Neuropathy--->Gabapentin/TCAs
Gastroparesis--->metoclopramide/erthromycin